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Boston University1, Montreal Children's Hospital2, Canadian Blood Services3, New York University4, Albany Medical College5, University of Chicago6, Dartmouth College7, University of Washington8, Hacettepe University9, University of Tennessee Health Science Center10, University of Pittsburgh11, Northwestern University12, University of Milano-Bicocca13, Universidad del Desarrollo14, University of Sydney15, Southmead Hospital16, University of Florida17, William Mitchell College of Law18, University of Melbourne19, University of Cape Town20, Dubai Hospital21, University of Valencia22, University of Toronto23, The Queen's Medical Center24, University of Texas Health Science Center at Houston25, Seoul National University Bundang Hospital26, Sir Charles Gairdner Hospital27, Texas A&M University28, Kagawa University29, Capital Medical University30, Tribhuvan University31, Indiana University – Purdue University Indianapolis32, Montreal Neurological Institute and Hospital33, Ruby Hall Clinic34, University of Southern California35
TL;DR: Recommendations are provided for the minimum clinical standards for determination of brain death/death by neurologic criteria in adults and children with clear guidance for various clinical circumstances and have widespread international society endorsement.
Abstract: Importance There are inconsistencies in concept, criteria, practice, and documentation of brain death/death by neurologic criteria (BD/DNC) both internationally and within countries. Objective To formulate a consensus statement of recommendations on determination of BD/DNC based on review of the literature and expert opinion of a large multidisciplinary, international panel. Process Relevant international professional societies were recruited to develop recommendations regarding determination of BD/DNC. Literature searches of the Cochrane, Embase, and MEDLINE databases included January 1, 1992, through April 2020 identified pertinent articles for review. Because of the lack of high-quality data from randomized clinical trials or large observational studies, recommendations were formulated based on consensus of contributors and medical societies that represented relevant disciplines, including critical care, neurology, and neurosurgery. Evidence Synthesis Based on review of the literature and consensus from a large multidisciplinary, international panel, minimum clinical criteria needed to determine BD/DNC in various circumstances were developed. Recommendations Prior to evaluating a patient for BD/DNC, the patient should have an established neurologic diagnosis that can lead to the complete and irreversible loss of all brain function, and conditions that may confound the clinical examination and diseases that may mimic BD/DNC should be excluded. Determination of BD/DNC can be done with a clinical examination that demonstrates coma, brainstem areflexia, and apnea. This is seen when (1) there is no evidence of arousal or awareness to maximal external stimulation, including noxious visual, auditory, and tactile stimulation; (2) pupils are fixed in a midsize or dilated position and are nonreactive to light; (3) corneal, oculocephalic, and oculovestibular reflexes are absent; (4) there is no facial movement to noxious stimulation; (5) the gag reflex is absent to bilateral posterior pharyngeal stimulation; (6) the cough reflex is absent to deep tracheal suctioning; (7) there is no brain-mediated motor response to noxious stimulation of the limbs; and (8) spontaneous respirations are not observed when apnea test targets reach pH Conclusions and Relevance This report provides recommendations for the minimum clinical standards for determination of brain death/death by neurologic criteria in adults and children with clear guidance for various clinical circumstances. The recommendations have widespread international society endorsement and can serve to guide professional societies and countries in the revision or development of protocols and procedures for determination of brain death/death by neurologic criteria, leading to greater consistency within and between countries.
295 citations
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TL;DR: Data suggest that a component of airway remodeling associated with asthma may be directly regulated by MMP9, which exerts its effects on the epithelium by cleaving one or more components of cell-cell junctions and triggering anoikis.
Abstract: The family of zinc- and calcium-dependent matrix metalloproteases (MMPs) play an important role in remodeling of the airways in disease. Transcriptional regulation by proinflammatory cytokines increases lymphocyte-derived MMP9 levels in the airway lumen of asthmatics. Moreover, the levels of the MMP9 inhibitor, tissue inhibitor of metalloprotease (TIMP1), are decreased leading to increased protease activity. The mechanism by which MMP9 activity leads to asthma pathogenesis and remodeling remains unclear. Using a model of well-differentiated human airway epithelia, we found that apical MMP9 significantly increases transepithelial conductance. Moreover, apical MMP9 treatment decreased immunostaining of tight junction proteins suggesting disruption of barrier function. Consistent with this, viruses gained access to the epithelial basolateral surface after MMP9 treatment, which increased infection efficiency. All of these effects were blocked by TIMP1. In addition, loss of epithelial integrity correlated with increased epithelial cell death. Thus we hypothesized that MMP9 exerts its effects on the epithelium by cleaving one or more components of cell-cell junctions and triggering anoikis. Taken together, these data suggest that a component of airway remodeling associated with asthma may be directly regulated by MMP9.
120 citations
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TL;DR: In this paper, the authors propose a definition of "probability" of future harm and assesses the legal probability thresholds commitment courts actually use using published information about recidivism and actuarial prediction.
Abstract: Advocates and courts legitimize sex offender commitment laws by claiming the laws confine only those who are “highly likely” to engage in sexual violence This article proposes a definition of “probability” of future harm and assesses the legal probability thresholds commitment courts actually use Using published information about recidivism and actuarial prediction, the authors concludes that moderate, but not extravagant, claims about legal probability thresholds are supportable but only on a rather optimistic set of assumptions The authors recommend that sex offender commitment courts use the proposed methods to quantify judicial standards and findings about prediction This will allow the claims for legitimacy to be more readily assessed
109 citations
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TL;DR: The report emphasizes the need for continued multidisciplinary collaboration in order to better serve families affected by domestic violence and it includes an appendix of consensus points as well as suggestions for formation of ongoing work groups.
Abstract: In February 2007 the National Council of Juvenile and Family Court Judges and the Association of Family and Conciliation Courts brought together a working group of thirty-seven experienced practitioners and researchers to identify and explore conceptual and practical tensions that have hampered effective work with families in which domestic violence has been identified or alleged. Five central sets of issues were raised at the conference and are discussed in this report. These include the following: differentiation among families experiencing domestic violence, screening and triage, participation by families in various processes and services, appropriate outcomes for children, and family court roles and resources. The report emphasizes the need for continued multidisciplinary collaboration in order to better serve families affected by domestic violence and it includes an appendix of consensus points as well as suggestions for formation of ongoing work groups.
78 citations
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TL;DR: In this article, the authors discuss the determination of mental abnormality and its reliance on medical nosological systems and discuss relevant, though sometimes non-statutory, considerations, namely, the standards and the expectation for the treatment provided in high-security civil commitment programs.
Abstract: Adjudication of sexually violent predator commitment laws places demands on science. In the current article, the authors discuss the determination of mental abnormality and its reliance on medical nosological systems. Second, the authors examine the determination of current risk by reviewing three common concerns: (a) mechanistic estimations of risk, (b) mitigation of risk as a function of age, and (c) estimation of contemporaneous (dynamic) risk. The authors focus specifically on determinations of risk posed by the nexus of mental abnormality with prior history of sexually violent acts. Third, the article examines relevant, though sometimes nonstatutory, considerations, namely, the standards and the expectation for the treatment provided in high-security civil commitment programs. Potentially important dynamic or time-varying factors that may mitigate risk, such as offender age and treatment, are considered. Recommendations to promote good science and to avoid bad science are included with respect to determinations of mental abnormality, risk of reoffending, and treatment.
76 citations
Authors
Showing all 292 results
Name | H-index | Papers | Citations |
---|---|---|---|
Herbert M. Kritzer | 31 | 200 | 3258 |
Thaddeus Mason Pope | 22 | 179 | 2061 |
Jonathan Kahn | 19 | 70 | 1640 |
Israel Doron | 17 | 139 | 1229 |
Eric S. Janus | 15 | 47 | 879 |
Jayanth K. Krishnan | 14 | 52 | 580 |
Timothy D. Lytton | 13 | 63 | 503 |
Andrea Miller | 12 | 32 | 1448 |
Wayne A. Logan | 11 | 94 | 577 |
Sarah Deer | 11 | 19 | 371 |
Jillian K. Peterson | 11 | 28 | 1227 |
Lars Noah | 9 | 75 | 340 |
Alexandra B. Klass | 9 | 70 | 416 |
Nancy Ver Steegh | 8 | 24 | 291 |
Robert J. Delahunty | 8 | 52 | 212 |