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Neonatal thrombocytopenia, defined as the presence of a circulating platelet count <150 × 109/L, is a common abnormality in babies admitted to neonatal intensive care units. ...Thrombocytopenia that is typically mild and self-limiting often accompanies neonatal stress in scenarios such as premature delivery or intrauterine growth restriction. However, the differential diagnosis of neonatal thrombocytopenia is wide and includes potentially life-threatening disorders, such as bacterial sepsis, viral infection, and necrotizing enterocolitis. Distinguishing these causes of thrombocytopenia from entities such as genetic thrombocytopenia and fetal and neonatal alloimmune thrombocytopenia is critical for the accurate quantitation of significant adverse events, such as intracranial bleeding, and for the selection of treatments, such as platelet transfusion. In this review, we focus on common differential diagnoses of neonatal thrombocytopenia and highlight how the landscape of diagnosis and management is changing with recent advances in genomic technology and the completion of pivotal clinical trials of platelet transfusion practice. Increasing evidence highlights the need for judicious and restrictive use of platelet transfusions in neonates.
Using illustrative cases, Stanworth and Mumford explore the current thinking about how best to diagnose and, when appropriate, treat thrombocytopenia in neonates. This is a common scenario in neonatal intensive care units and can be self-limiting and mild or life-threatening. The authors discuss the current classification and how it helps guide action, as well as outline judicious use of transfusions.
Purpura fulminans (PF) is a haematological emergency in which there is skin necrosis and disseminated intravascular coagulation. This may progress rapidly to multi-organ failure caused by thrombotic ...occlusion of small and medium-sized blood vessels. PF may complicate severe sepsis or may occur as an autoimmune response to otherwise benign childhood infections. PF may also be the presenting symptom of severe heritable deficiency of the natural anticoagulants protein C or protein S. Early recognition and treatment of PF is essential to reduce mortality and to prevent major long-term health sequelae. However, management strategies require accurate identification of the underlying cause. This review focuses on the clinical features, differential diagnosis and laboratory features of the range of PF disorders and includes expert consensus opinion about immediate and on-going management.
Harmful non-indigenous species (NIS) impose great economic and environmental impacts globally, but little is known about their impacts in Southeast Asia. Lack of knowledge of the magnitude of the ...problem hinders the allocation of appropriate resources for NIS prevention and management. We used benefit-cost analysis embedded in a Monte-Carlo simulation model and analysed economic and environmental impacts of NIS in the region to estimate the total burden of NIS in Southeast Asia. The total annual loss caused by NIS to agriculture, human health and the environment in Southeast Asia is estimated to be US$33.5 billion (5(th) and 95(th) percentile US$25.8-39.8 billion). Losses and costs to the agricultural sector are estimated to be nearly 90% of the total (US$23.4-33.9 billion), while the annual costs associated with human health and the environment are US$1.85 billion (US$1.4-2.5 billion) and US$2.1 billion (US$0.9-3.3 billion), respectively, although these estimates are based on conservative assumptions. We demonstrate that the economic and environmental impacts of NIS in low and middle-income regions can be considerable and that further measures, such as the adoption of regional risk assessment protocols to inform decisions on prevention and control of NIS in Southeast Asia, could be beneficial.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
The large, positive correlation between speaking time and leader emergence is well-established. As such, some authors have argued for a “babble hypothesis” of leadership, suggesting that only the ...quantity of speaking, not its quality, determines leader emergence. However, previous tests of this notion may have been problematic. Some studies have asserted a causal effect of speaking time on leader emergence based on experimental studies, but have limited participant communication, access to reliable information, or both. Other studies have used more ecologically valid designs, but have not always controlled for relevant participant traits or roles, suggesting potential endogeneity effects. Testing the babble hypothesis thus requires a study that is both ecologically valid and supports strong inference. The current study fills that gap and finds that speaking time retains its direct effect on leader emergence when accounting for intelligence, personality, gender, and the endogeneity of speaking time.
Issue Title: Special Issue: Computer Vision and Pattern Recognition-CVPR 2004 The study of 2D shapes and their similarities is a central problem in the field of vision. It arises in particular from ...the task of classifying and recognizing objects from their observed silhouette. Defining natural distances between 2D shapes creates a metric space of shapes, whose mathematical structure is inherently relevant to the classification task. One intriguing metric space comes from using conformal mappings of 2D shapes into each other, via the theory of Teichmüller spaces. In this space every simple closed curve in the plane (a "shape") is represented by a 'fingerprint' which is a diffeomorphism of the unit circle to itself (a differentiable and invertible, periodic function). More precisely, every shape defines to a unique equivalence class of such diffeomorphisms up to right multiplication by a Möbius map. The fingerprint does not change if the shape is varied by translations and scaling and any such equivalence class comes from some shape. This coset space, equipped with the infinitesimal Weil-Petersson (WP) Riemannian norm is a metric space. In this space, the shortest path between each two shapes is unique, and is given by a geodesic connecting them. Their distance from each other is given by integrating the WP-norm along that geodesic. In this paper we concentrate on solving the "welding" problem of "sewing" together conformally the interior and exterior of the unit circle, glued on the unit circle by a given diffeomorphism, to obtain the unique 2D shape associated with this diffeomorphism. This will allow us to go back and forth between 2D shapes and their representing diffeomorphisms in this "space of shapes". We then present an efficient method for computing the unique shortest path, the geodesic of shape morphing between each two end-point shapes. The group of diffeomorphisms of S^sup 1^ acts as a group of isometries on the space of shapes and we show how this can be used to define shape transformations, like for instance 'adding a protruding limb' to any shape.PUBLICATION ABSTRACT
Organizational leaders face environmental challenges and pressures that put them under ethical risk. Navigating this ethical risk is demanding given the dynamics of contemporary organizations. ...Traditional models of ethical decision-making (EDM) are an inadequate framework for understanding how leaders respond to ethical dilemmas under conditions of uncertainty and equivocality. Sensemaking models more accurately illustrate leader EDM and account for individual, social, and environmental constraints. Using the sensemaking approach as a foundation, previous EDM models are revised and extended to comprise a conceptual model of leader EDM. Moreover, the underlying factors in the model are highlighted—constraints and strategies. Four trainable, compensatory strategies (emotion regulation, self-reflection, forecasting, and information integration) are proposed and described that aid leaders in navigating ethical dilemmas in organizations. Empirical examinations demonstrate that tactical application of the strategies may aid leaders in making sense of complex and ambiguous ethical dilemmas and promote ethical behavior. Compensatory tactics such as these should be central to organizational ethics initiatives at the leader level.
Population suppression gene drive has been proposed as a strategy for malaria vector control. A CRISPR-Cas9-based transgene homing at the doublesex locus (dsxF
) has recently been shown to increase ...rapidly in frequency in, and suppress, caged laboratory populations of the malaria mosquito vector Anopheles gambiae. Here, problem formulation, an initial step in environmental risk assessment (ERA), was performed for simulated field releases of the dsxF
transgene in West Africa.
Building on consultative workshops in Africa that previously identified relevant environmental and health protection goals for ERA of gene drive in malaria vector control, 8 potentially harmful effects from these simulated releases were identified. These were stratified into 46 plausible pathways describing the causal chain of events that would be required for potential harms to occur. Risk hypotheses to interrogate critical steps in each pathway, and an analysis plan involving experiments, modelling and literature review to test each of those risk hypotheses, were developed.
Most potential harms involved increased human (n = 13) or animal (n = 13) disease transmission, emphasizing the importance to subsequent stages of ERA of data on vectorial capacity comparing transgenics to non-transgenics. Although some of the pathways (n = 14) were based on known anatomical alterations in dsxF
homozygotes, many could also be applicable to field releases of a range of other transgenic strains of mosquito (n = 18). In addition to population suppression of target organisms being an accepted outcome for existing vector control programmes, these investigations also revealed that the efficacy of population suppression caused by the dsxF
transgene should itself directly affect most pathways (n = 35).
Modelling will play an essential role in subsequent stages of ERA by clarifying the dynamics of this relationship between population suppression and reduction in exposure to specific potential harms. This analysis represents a comprehensive identification of plausible pathways to potential harm using problem formulation for a specific gene drive transgene and organism, and a transparent communication tool that could inform future regulatory studies, guide subsequent stages of ERA, and stimulate further, broader engagement on the use of population suppression gene drive to control malaria vectors in West Africa.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Idea evaluation has been identified as a critical step in the creative problem-solving process. Yet, it is unclear how exactly individuals evaluate and compensate for weaknesses in their creative ...ideas. In the present study, both qualitative and quantitative methods were used to identify the compensatory strategies that undergraduate participants applied during the creative idea evaluation process. Additionally, the impact of the application of these strategies and the impact of leader feedback was examined on the production of high quality, original, and elegant solutions to a creative problem. Eleven compensatory strategies were identified and subsequently categorized as effective or ineffective based on their impact on the creative solutions developed. It was found that effective strategies were those that focused on improving product value with respect to the customer, and ineffective strategies were those that focused on profit and marketing strategy. It was also found that negative leader feedback reduced the application of ineffective compensatory strategies, and leader feedback that applied both innovative and operative standards led to the production of more original creative problem solutions. The implications of these findings for improving performance on creative tasks are discussed.
Celotno besedilo
Dostopno za:
BFBNIB, DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Excessive bleeding at surgery is a feared complication in patients with inherited platelet disorders. However, very few studies have evaluated the frequency of surgical bleeding in these hemorrhagic ...disorders. We performed a worldwide, multicentric, retrospective study to assess the bleeding complications of surgery, the preventive and therapeutic approaches adopted, and their efficacy in patients with inherited platelet disorders: the Surgery in Platelet disorders And Therapeutic Approach (SPATA) study. We rated the outcome of 829 surgical procedures carried out in 423 patients with well-defined forms of inherited platelet disorders: 238 inherited platelet function disorders and 185 inherited platelet number disorders. Frequency of surgical bleeding was high in patients with inherited platelet disorders (19.7%), with a significantly higher bleeding incidence in inherited platelet function disorders (24.8%) than in inherited platelet number disorders (13.4%). The frequency of bleeding varied according to the type of inherited platelet disorder, with biallelic Bernard Soulier syndrome having the highest occurrence (44.4%). Frequency of bleeding was predicted by a pre-operative World Health Organization bleeding score of 2 or higher. Some types of surgery were associated with a higher bleeding incidence, like cardiovascular and urological surgery. The use of pre-operative pro-hemostatic treatments was associated with a lower bleeding frequency in patients with inherited platelet function disorders but not in inherited platelet number disorders. Desmopressin, alone or with antifibrinolytic agents, was the preventive treatment associated with the lowest bleedings. Platelet transfusions were used more frequently in patients at higher bleeding risk. Surgical bleeding risk in inherited platelet disorders is substantial, especially in inherited platelet function disorders, and bleeding history, type of disorder, type of surgery and female sex are associated with higher bleeding frequency. Prophylactic pre-operative pro-hemostatic treatments appear to be required and are associated with a lower bleeding incidence.
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