Management of polycythaemia vera: a critical review of current data

Polycythaemia vera (PV) is a chronic blood cancer; its clinical features are dominated by myeloproliferation (erythrocytosis, often leucocytosis and/or thrombocytosis) and a tendency for thrombosis and transformation to myelofibrosis or acute myeloid leukaemia. In the past 10 years the pathophysiology of this condition has been defined as JAK/STAT pathway activation, almost always due to mutations in JAK2 exons 12 or 14 (JAK2 V617F). In the same time period our understanding of the optimal management of PV has expanded, most recently culminating in the approval of JAK inhibitors for the treatment of PV patients who are resistant or intolerant to therapy with hydroxycarbamide. It has also been demonstrated that life expectancy for many patients with PV is not normal, nor is their quality of life. We critically explore these findings and discuss their impact. In addition, we highlight persisting gaps in our current management strategy; for example, what is the optimal first line cytoreductive therapy and, indeed, which patients need cytoreductive drugs.

Territories of scarcity and creativity: a critical view of informal settlements and emerging tactics under conditions of scarcity in Nairobi, Kenya and Quito, Ecuador

This thesis explores the processes through which scarcity is constructed in informal settlements and how conditions emerging within its limits gives way to particular socio-spatial phenomena and influence the emergence of self-organisation and creative strategies from a non-expert perspective. At the same time, this thesis deconstructs these emerging tactics (reactive and transformative) in a diagrammatic way to generate a critical study of their potential for socio-spatial change that goes beyond the everyday survival. Most people associate scarcity with “not having enough” of something, most usually of a material nature. In contrast, this paper is based on the premise that scarcity is a constructed condition, therefore exploring it beyond its immediate manifestation and illustrating its discursive, distributive and socio-material components. In this line, the research uses Assemblage Theory as both an approach and a tool for analysis. This approach allows the research to depart from everyday narratives of the residents, and gradually evolve into a multi-scalar, non-linear reading of scarcity, by following leads into different realms and unpacking a series of routine events to uncover their connections to wider processes and particular elements affecting the settlement and the city as a whole. For this purpose, the research is based on a qualitative, flexible and multi-sited methodology, using different case studies as testing grounds. Collected data stems from a 11-months ethnographic fieldwork in informal settlements in Ecuador and Kenya, analysing the socio-spatial practices and strategies deployed by the different actors producing the built environment and arising from everyday and latent experiences of scarcity. The thesis examines the multi-scalar nature of these strategies, including self-building and management tactics, the mobilisation of grassroots organisations, the innovative ways of collaborating deployed by different coalitions and the reformulation of urban development policies. As outcomes of the research, the thesis will show illustrative diagrams that allow a better understanding of, firstly, the construction of scarcity in the built environment beyond its immediate manifestation and secondly, the way that emerging tactics a) improve existing conditions of scarcity, b) reinforce the status quo or c) contribute to the worsening of the original condition. Therefore, this thesis aims to offer lessons with both practical and theoretical considerations, by firstly, giving an insight into the complexity and transcalar nature of the construction of scarcity in informal settlements; secondly, by illustrating how acute conditions related to scarcity gives birth to a plethora of particular phenomena shaping the territory, social relationships and processes; and thirdly, by identifying specific characteristics within the informal that might allow for new readings of the city and possibilities for socio-spatial change under conditions of scarcity.

Heading east this time: critical readings on gender in southeast Asia

This essay intends to discuss some critical readings of fictional and theoretical texts on gender condition in Southeast Asian countries. Nowadays, many texts about women in Southeast Asia apply concepts of power in unusual areas. Traditional forms of gender hegemony have been replaced by other powerful, if somewhat more covert, forms. We will discuss some universal values concerning conventional female roles as well as the strategies used to recognize women in political fields traditionally characterized by male dominance. Female empowerment will mean different things at different times in history, as a result of culture, local geography and individual circumstances. Empowerment needs to be perceived as an individual attitude, but it also has to be facilitated at the macrolevel by society and the State. Gender is very much at the heart of all these dynamics, strongly related to specificities of historical, cultural, ethnic and class situatedness, requiring an interdisciplinary transnational approach.

Multinational drug corporations, intellectual property rights and the Canadian state : a historical and critical analysis

This study critically analyzes the historical role and influence of multinational drug cotpOrations and multinational corporations in general; the u.s. government and the Canadian state in negotiating the global recognition ofIntellectual Property Rights (IPR) under GATT/NAFTA. This process began in 1969 when the Liberal government, in response to high prices for brand-name drugs amended the Patent Act to introduce compulsory licensing by reducing monopoly protection from 20 to seven years. Although the financial position ofthe multinational drug industry was not affected, it campaigned vigorously to change the 1969 legislation. In 1987, the Patent Act was amended to extend protection to 10 years as a condition for free trade talks with the u.s. Nonetheless, the drug industry was not satisfied and accused Canada of providing a bad example to other nations. Therefore, it continued to campaign for global recognition ofIPR laws under GATT. Following the conclusion of the GATTI Trade-Related aspects of Intellectual Property Rights agreement (TRIPS) in 1991, the multinational drug industry and the American government, to the surprise of many, were still not satisfied and sought to implement harsher conditions under NAFTA. The Progressive Conservative government readily agreed without any objections or consideration for the social consequences. As a result, Bill C-91 was introduced. It abandoned compulsory licenses and was made retroactive from December 21, 1991. It is the contention of this thesis that the economic survival of multinational corporations on a global scale depends on the role and functions of the modem state. Similarly, the existence of the state depends on the ideological-political and socioeconomic assistance it gives to multinational corporations on a national and international scale. This dialectical relation of the state and multinational corporations is explored in our theoretical and historical analysis of their role in public policy.

Lier les présents aux absents : regards sur la condition d’exilé dans les littératures libano-québécoise et arabe contemporaine

Les paramètres de l’exil, comme déplacement, se transforment aujourd’hui dans un contexte de mondialisation, interrogeant le rôle des nations alors que les sociétés impliquent de plus en plus de mobilité et de diversité culturelle. Cette condition d’exilé aux repères mouvants, inscrite dans une temporalité discontinue et dont l’expérience est toujours douloureuse, a donné lieu à une littérature prolifique dans le domaine des études littéraires au cours du 20e siècle. En quoi le 21e propose-t-il un regard différent sur cette condition ? Dans ce mémoire nous analyserons quatre œuvres contemporaines qui nous proposent différentes variations des transformations identitaires profondes qui caractérisent la condition d’exilé. Deux des grands axes autour desquels s’est articulée la condition d’exilé ont été développés par Edward Said, qui propose une posture critique et politique, et Julia Kristeva, qui présente l’exil comme une condition plutôt psychique. Suivant cette perspective analytique, l’autobiographie de Mourid Barghouti fait écho à la compréhension de l’exil telle que l’entend Said, en pleine autonomie instauratrice. Puis, le roman de Rawi Hage dans une expérience plus psychique de l’exil, plus traumatique et plus violente du vécu avant l’exil, suggère que le rapport avec le milieu environnant a un impact sur l’expérience de l’exil, alors que dans ce cas il reste dysfonctionnel, et qu’un rapport pathologique à l’existence peut ensuite se manifester. Ensuite, le roman d’Abla Farhoud expose la possibilité d’un dépassement de cette expérience pathologique de l’exil par la distance, celle de l’âge et de la prise de parole. Finalement, dans la pièce Incendies de Mouawad, l’expérience psychique de l’exil est dépassée à la fois par une traduction de l’indicible de la violence, par un retour sur les traumas précédant l’exil, et par un travail collectif – comme autres formes de distances. Cette dernière œuvre est donc porteuse d’une compréhension de l’exil impliquant une dimension psychique, tout en devenant critique et politique, telle que le révèlent les écrits de Jacques Rancière. À la lumière de ces analyses, la condition d’exilé réclame d’urgence un retour sur les traumas précédents, le trauma qu’est l’exil, afin qu’une autonomie, une créativité et un engagement s’en dégagent, dans une société, dans un monde plus grand que soi. Pour les trois derniers auteurs, c’est la société québécoise qui révèle à la fois une compréhension des problématiques majeures de la condition d’exilé et une ouverture face à celles-ci, en ce début de 21e siècle.

Intervention familiale visant à faciliter le processus entourant la décision de non-réanimation de leur enfant atteint d'une condition médicale complexe

Travail dirigé présenté à la Faculté des sciences infirmières en vue de l’obtention du grade de Maîtrise ès sciences (M. Sc.) en sciences infirmières, option expertise-conseil

'he perceives himself as a caterpillar […]' constructions of the disabled subject in the critical response to Alfred Hitchcock's 'Rear Window'

This chapter focuses on critical responses to Alfred Hitchcock’s Rear Window, especially their construction of disability. The suggestion is that such criticism takes the disabled body to be both necessary and superfluous to the meaning of the film, a difficulty that, I argue, can be read more widely within film theory. Ever since Christian Metz’s ‘the Imaginary Signifier’, the condition of being ‘bound to a wheelchair’ is understood to have a resonance for theories of film spectatorship, but only ever in a sense that does away with the wheelchair as a mark of difference.

From molecules to neural morphology: understanding neuroinflammation in autism spectrum condition

Growing evidence points toward a critical role for early (prenatal) atypical neurodevelopmental processes in the aetiology of autism spectrum condition (ASC). One such process that could impact early neural development is inflammation. We review the evidence for atypical expression of molecular markers in the amniotic fluid, serum, cerebrospinal fluid (CSF), and the brain parenchyma that suggest a role for inflammation in the emergence of ASC. This is complemented with a number of neuroimaging and neuropathological studies describing microglial activation. Implications for treatment are discussed.

Positive solutions for the p-Laplacian involving critical and supercritical nonlinearities with zeros

In this paper we show the existence of multiple solutions to a class of quasilinear elliptic equations when the continuous non-linearity has a positive zero and it satisfies a p-linear condition only at zero. In particular, our approach allows us to consider superlinear, critical and supercritical nonlinearities. (C) 2009 Elsevier Masson SAS. All rights reserved.

Decay of geometry for Fibonacci critical covering maps of the circle

We study the growth of Df `` (f(c)) when f is a Fibonacci critical covering map of the circle with negative Schwarzian derivative, degree d >= 2 and critical point c of order l > 1. As an application we prove that f exhibits exponential decay of geometry if and only if l <= 2, and in this case it has an absolutely continuous invariant probability measure, although not satisfying the so-called Collet-Eckmann condition. (C) 2009 Elsevier Masson SAS. All rights reserved.

Genericity of Nondegenerate Critical Points and Morse Geodesic Functionals

We consider a family of variational problems on a Hilbert manifold parameterized by an open subset of a Banach manifold, and we discuss the genericity of the nondegeneracy condition for the critical points. Using classical techniques, we prove an abstract genericity result that employs the infinite dimensional Sard-Smale theorem, along the lines of an analogous result of B. White [29]. Applications are given by proving the genericity of metrics without degenerate geodesics between fixed endpoints in general (non compact) semi-Riemannian manifolds, in orthogonally split semi-Riemannian manifolds and in globally hyperbolic Lorentzian manifolds. We discuss the genericity property also in stationary Lorentzian manifolds.

ANALYSIS & STUDY OF AI TECHNIQUES FORAUTOMATIC CONDITION MONITORING OFRAILWAY TRACK INFRASTRUCTURE : Artificial Intelligence Techniques

Since the last decade the problem of surface inspection has been receiving great attention from the scientific community, the quality control and the maintenance of products are key points in several industrial applications.The railway associations spent much money to check the railway infrastructure. The railway infrastructure is a particular field in which the periodical surface inspection can help the operator to prevent critical situations. The maintenance and monitoring of this infrastructure is an important aspect for railway association.That is why the surface inspection of railway also makes importance to the railroad authority to investigate track components, identify problems and finding out the way that how to solve these problems. In railway industry, usually the problems find in railway sleepers, overhead, fastener, rail head, switching and crossing and in ballast section as well. In this thesis work, I have reviewed some research papers based on AI techniques together with NDT techniques which are able to collect data from the test object without making any damage. The research works which I have reviewed and demonstrated that by adopting the AI based system, it is almost possible to solve all the problems and this system is very much reliable and efficient for diagnose problems of this transportation domain. I have reviewed solutions provided by different companies based on AI techniques, their products and reviewed some white papers provided by some of those companies. AI based techniques likemachine vision, stereo vision, laser based techniques and neural network are used in most cases to solve the problems which are performed by the railway engineers.The problems in railway handled by the AI based techniques performed by NDT approach which is a very broad, interdisciplinary field that plays a critical role in assuring that structural components and systems perform their function in a reliable and cost effective fashion. The NDT approach ensures the uniformity, quality and serviceability of materials without causing any damage of that materials is being tested. This testing methods use some way to test product like, Visual and Optical testing, Radiography, Magnetic particle testing, Ultrasonic testing, Penetrate testing, electro mechanic testing and acoustic emission testing etc. The inspection procedure has done periodically because of better maintenance. This inspection procedure done by the railway engineers manually with the aid of AI based techniques.The main idea of thesis work is to demonstrate how the problems can be reduced of thistransportation area based on the works done by different researchers and companies. And I have also provided some ideas and comments according to those works and trying to provide some proposal to use better inspection method where it is needed.The scope of this thesis work is automatic interpretation of data from NDT, with the goal of detecting flaws accurately and efficiently. AI techniques such as neural networks, machine vision, knowledge-based systems and fuzzy logic were applied to a wide spectrum of problems in this area. Another scope is to provide an insight into possible research methods concerning railway sleeper, fastener, ballast and overhead inspection by automatic interpretation of data.In this thesis work, I have discussed about problems which are arise in railway sleepers,fastener, and overhead and ballasted track. For this reason I have reviewed some research papers related with these areas and demonstrated how their systems works and the results of those systems. After all the demonstrations were taking place of the advantages of using AI techniques in contrast with those manual systems exist previously.This work aims to summarize the findings of a large number of research papers deploying artificial intelligence (AI) techniques for the automatic interpretation of data from nondestructive testing (NDT). Problems in rail transport domain are mainly discussed in this work. The overall work of this paper goes to the inspection of railway sleepers, fastener, ballast and overhead.

Quality of life in restless legs syndrome: A systematic review of clinical trials and a critical review of instruments

Restless legs syndrome (RLS) is a neurological movement disorder characterized by sensory symptoms and motor disturbances. While the underlying cause remains unknown, it is suggested that 20–25% of people with RLS are affected seriously enough to require pharmacological treatment. Dopamine agonists (DAs) are the most common treatment and act by increasing the low levels of dopamine to which RLS is often attributed. A growing literature highlights the debilitating and distressing nature of this condition from the patient's perspective. While sleep problems are most commonly reported, the impact of RLS on quality of life (QOL) is wide ranging, affecting relationships with partners, sex life, family life, social life, leisure activities, friendships, everyday activities, concentration, travel, career/work, sleep, and health.

We conducted a systematic review of clinical trials in which DAs have been evaluated in terms of RLS-specific QOL, i.e. their impact on the QOL of people with RLS, and critically reviewed the development history and measurement properties of RLS-specific QOL instruments.

A systematic search using terms synonymous with RLS, DAs and QOL was conducted using Scopus software, which includes MEDLINE, PsycINFO, EMBASE, and CINAHL. Our search covered publications from 2000 (prior to which RLS-specific QOL measures did not exist) to August 2009. Trials were included in our review if they evaluated DAs for the treatment of adults with RLS and reported evaluation using an RLS-specific QOL measure. We also ran citation searches to identify papers reporting the development history and measurement properties of the identified RLS-specific QOL instruments.

Three measures of RLS-specific QOL have been developed in recent years and are reviewed here: the Restless Legs Syndrome Quality of Life (RLSQOL) questionnaire, the Restless Legs Syndrome Quality of Life Instrument (RLS-QLI), and the Quality of Life Restless Legs Syndrome (QOL-RLS) measure. Critical review indicates that each has limitations (particularly in terms of published developmental history and content validity). Eleven trials of DAs were identified that included assessment of RLS-specific QOL (nine using the RLSQOL and two using the QOL-RLS). In all studies, significant improvements in RLS-specific QOL were observed, although these were mostly short term (12 weeks) and large placebo effects were also noted.

In people with RLS, the use of DAs has been shown to improve RLS-specific QOL. Longer-term, large-scale studies may be needed to confirm these findings and demonstrate statistically significant improvements in RLS-specific QOL at lower doses. Further development of the RLS-specific QOL measures is needed to ensure that the full impact of RLS (and the full benefit of new treatments) on aspects of life identified as important to individuals is captured in future studies.

Critical design features for establishing a childhood obesity monitoring program in Australia

Efforts to combat childhood obesity in Australia are hampered by the lack of quality epidemiological data to routinely monitor the prevalence and distribution of the condition. This paper summarises the literature on issues relevant to childhood obesity monitoring and makes recommendations for implementing a school-based childhood obesity monitoring program in Australia. The primary purpose of such a program would be to collect population-level health data to inform both policy and the development and evaluation of community-based obesity prevention interventions. Recommendations are made for the types of data to be collected, data collection procedures and program management and evaluation. Data from an obesity monitoring program are crucial for directing and informing policies, practices and services, identifying subgroups at greatest risk of obesity and evaluating progress towards meeting obesity-related targets. Such data would also increase the community awareness necessary to foster change.

Oral bisphosphonate-related osteonecrosis of the jaws in rheumatoid arthritis patients: a critical discussion and two case reports

Background: Bisphosphonate-related osteonecrosis of the jaw (BRONJ) is a clinical condition characterized by the presence of exposed bone in the maxillofacial region. Its pathogenesis is still undetermined, but may be associated with risk factors such as rheumatoid arthritis (RA). The aim of this paper is to report two unpublished cases of BRONJ in patients with RA and to conduct a literature review of similar clinical cases with a view to describe the main issues concerning these patients, including demographic characteristics and therapeutic approaches applied.Methods: Two case reports of BRONJ involving RA patients were discussedResults: Both patients were aging female taking alendronate for more than 3 years. Lesions were detected in stage II in posterior mandible with no clear trigger agent. The treatment applied consisted of antibiotics, oral rinses with chlorhexidine, drug discontinuation and surgical procedures. Complete healing of the lesions was achieved.Conclusions: This paper brings to light the necessity for rheumatologists to be aware of the potential risk to their patients of developing BRONJ and to work together with dentists for the prevention and early detection of the lesions. Although some features seem to link RA with oral BRONJ and act as synergistic effects, more studies should be developed to support the scientific bases for this hypothesis.