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2. Risk profiles and one-year outcomes of patients with newly diagnosed atrial fibrillation in India: Insights from the GARFIELD-AF Registry
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Jitendra PS. Sawhney, Veerappa A. Kothiwale, Vikas Bisne, Rajashekhar Durgaprasad, Praveen Jadhav, Manoj Chopda, Velam Vanajakshamma, Ramdhan Meena, Govindan Vijayaraghavan, Kamaldeep Chawla, Jagan Allu, Karen S. Pieper, A. John Camm, Ajay K. Kakkar, Jean-Pierre Bassand, David A. Fitzmaurice, Samuel Z. Goldhaber, Shinya Goto, Sylvia Haas, Werner Hacke, Lorenzo G. Mantovani, Frank Misselwitz, Alexander G.G. Turpie, Martin van Eickels, Freek W.A. Verheugt, Gloria Kayani, Keith A.A. Fox, Bernard J. Gersh, Hector Lucas Luciardi, Harry Gibbs, Marianne Brodmann, Frank Cools, Antonio Carlos Pereira Barretto, Stuart J. Connolly, Alex Spyropoulos, John Eikelboom, Ramon Corbalan, Dayi Hu, Petr Jansky, Jørn Dalsgaard Nielsen, Hany Ragy, Pekka Raatikainen, Jean-Yves Le Heuzey, Harald Darius, Matyas Keltai, Sanjay Kakkar, Jitendra Pal Singh Sawhney, Giancarlo Agnelli, Giuseppe Ambrosio, Yukihiro Koretsune, Carlos Jerjes Sánchez Díaz, Hugo Ten Cate, Dan Atar, Janina Stepinska, Elizaveta Panchenko, Toon Wei Lim, Barry Jacobson, Seil Oh, Xavier Viñolas, Marten Rosenqvist, Jan Steffel, Pantep Angchaisuksiri, Ali Oto, Alex Parkhomenko, Wael Al Mahmeed, David Fitzmaurice, D.Y. Hu, K.N. Chen, Y.S. Zhao, H.Q. Zhang, J.Z. Chen, S.P. Cao, D.W. Wang, Y.J. Yang, W.H. Li, Y.H. Yin, G.Z. Tao, P. Yang, Y.M. Chen, S.H. He, Ying Wang, Yong Wang, G.S. Fu, X. Li, T.G. Wu, X.S. Cheng, X.W. Yan, R.P. Zhao, M.S. Chen, L.G. Xiong, P. Chen, Y. Jiao, Y. Guo, L. Xue, F.Z. Wang, H. Li, Z.M. Yang, C.L. Bai, J. Chen, J.Y. Chen, X. Chen, S. Feng, Q.H. Fu, X.J. Gao, W.N. Guo, R.H. He, X.A. He, X.S. Hu, X.F. Huang, B. Li, J. Li, L. Li, Y.H. Li, T.T. Liu, W.L. Liu, Y.Y. Liu, Z.C. Lu, X.L. Luo, T.Y. Ma, J.Q. Peng, X. Sheng, X.J. Shi, Y.H. Sun, G. Tian, K. Wang, L. Wang, R.N. Wu, Q. Xie, R.Y. Xu, J.S. Yang, L.L. Yang, Q. Yang, Y. Ye, H.Y. Yu, J.H. Yu, T. Yu, H. Zhai, Q. Zhan, G.S. Zhang, Q. Zhang, R. Zhang, Y. Zhang, W.Y. Zheng, B. Zhou, Z.H. Zhou, X.Y. Zhu, S. Kakkar, J.P.S. Sawhney, P. Jadhav, R. Durgaprasad, A.G. Ravi Shankar, R.K. Rajput, K. Bhargava, R. Sarma, A. Srinivas, D. Roy, U.M. Nagamalesh, M. Chopda, R. Kishore, G. Kulkarni, P. Chandwani, R.A. Pothiwala, M. Padinhare Purayil, S. Shah, K. Chawla, V.A. Kothiwale, B. Raghuraman, G. Vijayaraghavan, V.M. Vijan, G. Bantwal, V. Bisne, A. Khan, J.B. Gupta, S. Kumar, D. Jain, S. Abraham, D. Adak, A. Barai, H. Begum, P. Bhattacharjee, M. Dargude, D. Davies, B. Deshpande, P. Dhakrao, V. Dhyani, S. Duhan, M. Earath, A. Ganatra, S. Giradkar, V. Jain, R. Karthikeyan, L. Kasala, S. Kaur, S. Krishnappa, A. Lawande, B. Lokesh, N. Madarkar, R. Meena, P. More, D. Naik, K. Prashanth, M. Rao, N.M. Rao, N. Sadhu, D. Shah, M. Sharma, P. Shiva, S. Singhal, S. Suresh, V. Vanajakshamma, S.G. Panse, Y. Koretsune, S. Kanamori, K. Yamamoto, K. Kumagai, Y. Katsuda, K. Sadamatsu, F. Toyota, Y. Mizuno, I. Misumi, H. Noguchi, S. Ando, T. Suetsugu, M. Minamoto, Hiroshi Oda, K. Shiraishi, S. Adachi, K. Chiba, H. Norita, M. Tsuruta, T. Koyanagi, H. Ando, T. Higashi, K. Okada, S. Azakami, S. Komaki, K. Kumeda, T. Murayama, J. Matsumura, Y. Oba, R. Sonoda, K. Goto, K. Minoda, Y. Haraguchi, H. Suefuji, H. Miyagi, H. Kato, Tadashi Nakamura, Tsugihiro Nakamura, H. Nandate, R. Zaitsu, Yoshihisa Fujiura, A. Yoshimura, H. Numata, J. Ogawa, H. Tatematsu, Y. Kamogawa, K. Murakami, Y. Wakasa, M. Yamasawa, H. Maekawa, S. Abe, H. Kihara, S. Tsunoda, Katsumi Saito, Kazuyuki Saito, T. Fudo, K. Obunai, H. Tachibana, I. Oba, T. Kuwahata, S. Higa, M. Gushiken, T. Eto, H. Yoshida, D. Ikeda, Yoshitake Fujiura, M. Ishizawa, M. Nakatsuka, K. Murata, C. Ogurusu, M. Shimoyama, M. Akutsu, I. Takamura, F. Hoshino, N. Yokota, T. Iwao, K. Tsuchida, M. Takeuchi, Y. Hatori, Y. Kitami, Yoichi Nakamura, R. Oyama, M. Ageta, Hiroyuki Oda, Y. Go, K. Mishima, T. Unoki, S. Morii, Yuhei Shiga, H. Sumi, T. Nagatomo, K. Sanno, K. Fujisawa, Y. Atsuchi, T. Nagoshi, T. Seto, T. Tabuchi, M. Kameko, K. Nii, K. Oshiro, H. Takezawa, S. Nagano, N. Miyamoto, M. Iwaki, Yuichiro Nakamura, M. Fujii, M. Okawa, Masahiko Abe, Masatake Abe, Mitsunori Abe, T. Saito, T. Mito, K. Nagao, J. Minami, T. Mita, I. Sakuma, T. Taguchi, S. Marusaki, H. Doi, M. Tanaka, T. Fujito, M. Matsuta, T. Kusumoto, S. Kakinoki, K. Ashida, N. Yoshizawa, J. Agata, O. Arasaki, M. Manita, M. Ikemura, S. Fukuoka, H. Murakami, S. Matsukawa, Y. Hata, T. Taniguchi, T. Ko, H. Kubo, M. Imamaki, M. Akiyama, M. Inagaki, H. Odakura, T. Ueda, Y. Katsube, A. Nakata, H. Watanabe, M. Techigawara, M. Igarashi, K. Taga, T. Kimura, S. Tomimoto, M. Shibuya, M. Nakano, K. Ito, T. Seo, S. Hiramitsu, H. Hosokawa, M. Hoshiai, M. Hibino, K. Miyagawa, Hajime Horie, N. Sugishita, Yukio Shiga, A. Soma, K. Neya, Tetsuro Yoshida, Tomoki Yoshida, M. Mizuguchi, M. Ishiguro, T. Minagawa, M. Wada, H. Mukawa, F. Okuda, S. Nagasaka, Y. Abe, Sen Adachi, Susumu Adachi, T. Adachi, K. Akahane, T. Amano, K. Aoki, T. Aoyama, H. Arai, S. Arima, T. Arino, H. Asano, T. Asano, J. Azuma, T. Baba, T. Betsuyaku, H. Chibana, H. Date, J. Doiuchi, Y. Emura, M. Endo, Y. Fujii, R. Fujiki, A. Fujisawa, Y. Fujisawa, T. Fukuda, T. Fukui, N. Furukawa, T. Furukawa, W. Furumoto, T. Goto, M. Hamaoka, N. Hanazono, K. Hasegawa, T. Hatsuno, Y. Hayashi, K. Higuchi, K. Hirasawa, H. Hirayama, M. Hirose, S. Hirota, M. Honda, Hideki Horie, T. Ido, O. Iiji, H. Ikeda, K. Ikeda, K. Ikeoka, M. Imaizumi, H. Inaba, T. Inoue, F. Iseki, A. Ishihara, N. Ishioka, N. Ito, T. Iwase, H. Kakuda, J. Kamata, H. Kanai, H. Kanda, M. Kaneko, H. Kano, T. Kasai, T. Kato, Y. Kato, Y. Kawada, K. Kawai, K. Kawakami, S. Kawakami, T. Kawamoto, S. Kawano, J. Kim, T. Kira, H. Kitazawa, H. Kitazumi, T. Kito, T. Kobayashi, T. Koeda, J. Kojima, H. Komatsu, I. Komatsu, Y. Koshibu, T. Kotani, T. Kozuka, Y. Kumai, T. Kumazaki, I. Maeda, K. Maeda, Y. Maruyama, S. Matsui, K. Matsushita, Y. Matsuura, K. Mineoi, H. Mitsuhashi, N. Miura, S. Miyaguchi, S. Miyajima, H. Miyamoto, A. Miyashita, S. Miyata, I. Mizuguchi, A. Mizuno, T. Mori, O. Moriai, K. Morishita, O. Murai, Sho Nagai, Shunichi Nagai, E. Nagata, H. Nagata, A. Nakagomi, S. Nakahara, M. Nakamura, R. Nakamura, N. Nakanishi, T. Nakayama, R. Nakazato, T. Nanke, J. Nariyama, Y. Niijima, H. Niinuma, Y. Nishida, Y. Nishihata, K. Nishino, H. Nishioka, K. Nishizawa, I. Niwa, K. Nomura, S. Nomura, M. Nozoe, T. Ogawa, N. Ohara, M. Okada, K. Okamoto, H. Okita, M. Okuyama, H. Ono, T. Ono, Y. Onuki Pearce, S. Oriso, A. Ota, E. Otaki, Y. Saito, H. Sakai, N. Sakamoto, Y. Sakamoto, Y. Samejima, Y. Sasagawa, H. Sasaguri, A. Sasaki, T. Sasaki, Kazuki Sato, Kiyoharu Sato, M. Sawano, S. Seki, Y. Sekine, Y. Seta, K. Sezaki, N. Shibata, Y. Shiina, H. Shimono, Y. Shimoyama, T. Shindo, H. Shinohara, R. Shinohe, T. Shinozuka, T. Shirai, T. Shiraiwa, Y. Shozawa, T. Suga, C. Sugimoto, Kazuo Suzuki, Keita Suzuki, Shu Suzuki, Shunji Suzuki, Susumu Suzuki, Y. Suzuki, M. Tada, A. Taguchi, T. Takagi, Y. Takagi, K. Takahashi, S. Takahashi, H. Takai, C. Takanaka, S. Take, H. Takeda, K. Takei, K. Takenaka, T. Tana, G. Tanabe, K. Taya, H. Teragawa, S. Tohyo, S. Toru, Y. Tsuchiya, T. Tsuji, K. Tsuzaki, H. Uchiyama, O. Ueda, Y. Ueyama, N. Wakaki, T. Wakiyama, T. Washizuka, M. Watanabe, T. Yamada, T. Yamagishi, H. Yamaguchi, Kenichi Yamamoto, Kentaro Yamamoto, Kunihiko Yamamoto, T. Yamamoto, M. Yamaura, M. Yamazoe, K. Yasui, Y. Yokoyama, K. Yoshida, T.W. Lim, C.K. Ching, C.G. Foo, J.H. Chow, D.D. Chen, F.R. Jaufeerally, Y.M. Lee, G. Lim, W.T. Lim, S. Thng, S.Y. Yap, C. Yeo, S. Oh, H.N. Pak, J.-B. Kim, J.H. Kim, S.-W. Jang, D.H. Kim, D.R. Ryu, S.W. Park, D.-K. Kim, D.J. Choi, Y.S. Oh, M.-C. Cho, S.-H. Kim, H.-K. Jeon, D.-G. Shin, J.S. Park, H.K. Park, S.-J. Han, J.H. Sung, J.-G. Cho, G.-B. Nam, Y.K. On, H.E. Lim, J.J. Kwak, T.-J. Cha, T.J. Hong, S.H. Park, J.H. Yoon, N.-H. Kim, K.-S. Kim, B.C. Jung, G.-S. Hwang, C.-J. Kim, D.B. Kim, J.J. Ahn, H.J. An, H. Bae, A.L. Baek, W.J. Chi, E.A. Choi, E.H. Choi, H.K. Choi, H.S. Choi, S. Han, E.S. Heo, K.O. Her, S.W. Hwang, E.M. Jang, H.-S. Jang, S. Jang, H.-G. Jeon, S.R. Jeon, Y.R. Jeon, H.K. Jeong, I.-A. Jung, Hyeon Jeong Kim, Hyun Ju Kim, Ji Seon Kim, Jung Sook Kim, J.A. Kim, K.T. Kim, M.S. Kim, Sang Hee Kim, Sang Hyun Kim, Y.-I. Kim, C.S. Lee, E.H. Lee, G.H. Lee, H.Y. Lee, H.-Y. Lee, K.H. Lee, K.R. Lee, M.S. Lee, M.-Y. Lee, R.W. Lee, S.E. Lee, S.H. Lee, S. Lee, W.Y. Lee, I.K. Noh, A.R. Park, B.R. Park, H.N. Park, J.H. Park, M. Park, Y. Park, S.-Y. Seo, J. Shim, J.H. Sim, Y.M. Sohn, W.S. Son, Y.S. Son, H.J. Song, H.K. Wi, J.J. Woo, S. Ye, K.H. Yim, K.M. Yoo, E.J. Yoon, S.Y. Yun, P. Angchaisuksiri, S. Chawanadelert, P. Mongkolwongroj, K. Kanokphatcharakun, S. Cheewatanakornkul, T. Laksomya, S. Pattanaprichakul, T. Chantrarat, S. Rungaramsin, S. Silaruks, W. Wongcharoen, K. Siriwattana, K. Likittanasombat, P. Katekangplu, W. Boonyapisit, D. Cholsaringkarl, B. Chatlaong, P. Chattranukulchai, Y. Santanakorn, P. Hutayanon, P. Khunrong, T. Bunyapipat, S. Jai-Aue, P. Kaewsuwanna, P. Bamungpong, S. Gunaparn, S. Hongsuppinyo, R. Inphontan, R. Khattaroek, K. Khunkong, U. Kitmapawanont, C. Kongsin, B. Naratreekoon, S. Ninwaranon, J. Phangyota, A. Phrommintikul, P. Phunpinyosak, K. Pongmorakot, S. Poomiphol, N. Pornnimitthum, S. Pumprueg, S. Ratchasikaew, K. Sanit, K. Sawanyawisuth, B. Silaruks, R. Sirichai, A. Sriwichian, W. Suebjaksing, P. Sukklad, T. Suttana, A. Tangsirira, O. Thangpet, W. Tiyanon, Y. Vorasettakarnkij, T. Wisaratapong, W. Wongtheptien, A. Wutthimanop, S. Yawila, A. Oto, A. Altun, I. Ozdogru, K. Ozdemir, O. Yilmaz, A. Aydinlar, M.B. Yilmaz, E. Yeter, Z. Ongen, M. Cayli, H. Pekdemir, M. Ozdemir, M. Sucu, T. Sayin, M. Demir, H. Yorgun, M. Ersanli, E. Okuyan, D. Aras, H. Abdelrahman, O. Aktas, D. Alpay, F. Aras, M.F. Bireciklioglu, S. Budeyri, M. Buyukpapuc, S. Caliskan, M. Esen, M.A. Felekoglu, D. Genc, B. Ikitimur, E.B. Karaayvaz, S. Kılıç Karataş, S. Okutucu, E. Ozcelik, A. Quisi, H. Sag, L. Sahiner, B.Y. Sayin, T. Seker, D. Uzun Alkan, E. Yildirim, R. Yildirim, F. Yilmaz, V. Yuksekdag, H.L. Luciardi, N. Vensentini, A.C. Ingaramo, G.A. Sambadaro, V. Fernandez Caputi, S.G. Berman, P. Dragotto, A.J. Kleiban, N. Centurion, G. Giacomi, R.A. Ahuad Guerrero, D. Conde, G. Zapata, L.A. Di Paola, J.L. Ramos, R.D. Dran, J. Egido, A.A. Fernandez, M.J. Fosco, S. Sassone, V.A. Sinisi, L.R. Cartasegna, M.A. Berli, O.A. Gomez Vilamajo, F. Ferroni, E.D. Alaguibe, A. Alvarez D'Amelio, C. Arabetti, L. Arias, J.A. Belardi, L. Bergesio, F. Berli, M. Berli, S. Borchowiec, C. Buzzetti, R. Cabrini, V. Campisi, A.L. Cappi, R. Carrizo, F. Colombo Berra, J.P. Costabel, O.J.A. Costamagna, A.A. Damonte, I.N. De Urquiza, F. Diez, M.F. Edén, M. Fanuele, F. Fernandez Voena, M. Foa Torres, C. Funosas, M.P. Giacomi, C.H. Gimenez, E.P. Gurfinkel, M. de L.M. Had, V. Hansen, A.D. Hrabar, M. Ingratta, A. Lopez, G. Maehara, L. Maffei, A. Martinelli, C. Martinelli, J. Matkovich, B. Mautner, A. Meirino, R. Munguia, A. Navarro, V. Novas, G. Perez Prados, J. Pontoriero, R.N. Potito, C. Ricotti, M.A. Rodriguez, F. Rolandi, M.E. Said Palladino, M. Salinger, L.S. Sanziani, P.O. Schygiel, A. Sossich, J.F. Tinto, L. Tonelli, A.L. Tufare, M. Vallejo, M.E. Yunis, M. Zillo, F.J. Zurbrigk, A.C.P. Barretto, D.C. Sobral Filho, J. Jaber, D. Armaganijan, J. Faria Neto, A. Steffens, W. Kunz Sebba Barroso de Souza, J.D. de Souza Neto, J.M. Ribeiro, M. Silveira Teixeira, P.R. Ferreira Rossi, L. Pires, D. Moreira, J.C. Moura Jorge, A. Menezes Lorga Filho, L.C. Bodanese, M. Westerlund Montera, C.H. Del Carlo, T. Da Rocha Rodrigues, F.A. Alves da Costa, A. Lopes, R. Lopes, G.R. Araújo, E.R. Fernandes Manenti, J.F. Kerr Saraiva, J.C. Ferreira Braga, A. Negri, L. Souto, C. Moncada, D. Bertolim Precoma, F. Roquette, G. Reis, R.A. Ramos Filho, E. Lanna Figueiredo, R. Vieira Botelho, C. Munhoz da Fontoura Tavares, C.R. Costantini Frack, J. Abdalla Saad, H.C. Finimundi, C. Pisani, D. Chemello, M. Pereira Martins, C.C. Broilo França, F. Alban, G.B. Aranha Rosito, J.B. de Moura Xavier Moraes Junior, R.T. Tumelero, L. Nigro Maia, R. Simões de Almeida, N.C. do Carmo Borges, L.G. Gomes Ferreira, P. Agliardi, J. Alves de Oliveira Gomes, V. Araujo, M. Arruda Nakazone, T. Barbosa, S. Barroso, E. Belisario Falchetto, H. Bellotti Lopes, M.A. Benez Teixeira Lemos, G. Biazus, L. Borges Queiroz, F.E. Camazzola, M. Caporale, S. Cardoso Boscato, F. Chieza, M.O. Chokr, R. Clemente Mingireanov, N. Codonho Góes, C. Correa, M. Costa, C. Costantini Ortiz, L.S. da Silva, F. da Silva Paulitsch, J.A. da Silveira, E. Daros, G.R. de Araújo, M.I. Del Monaco, C. Dias, M.A. Dias, A.P. Drummond Wainstein, P. Ely Pizzato, D.C. Esteves, P. Fabri, T. Félix Lorenzato Fonseca, E. Fernandes, C. Fonseca, C.R. Frack Costantini, R. Franchin Ferraz, F. Freire, P. Gottardo, D. Guanaes, S. Guizzardi, E. Hettwer Magedanz, F. Igansi, F. Jannuzzi, G. Junior, D. Komar, E.G. Lino, D. Lopes, O. Lourenço da Silva Júnior, E. Lustosa, A.P. Macagnan, M.C. Marinho, M. Mazzoni, G. Melo, L. Mortari, O.M.C.C. Mouco, C. Nanzer Vital, C. Ormundo, S. Oss Emmer, E. Palmegiani, R. Pavani, L. Pereira, V.L. Pereira, R. Perreira, S. Poletti, S.C. Quaia Fortunato, C. Queirantes, N. Ramos Pereira, R.L. Rech, S. Ribeiro, A. Rodrigues, H. Roesch, T. Ruaro Reichert, D. Santos, I. Santos, M. Santos, M.V. Seroqui, S. Silva, L. Soares, L. Spolaor, C. Stoll, N. Toazza Duda, L. Trama, B. Unterkircher, M.V. Valois, T. Vargas, T. Viana, C. Vicente, L. Vidal Armaganijan, R. Vieira Homem, L.G. Vieira Torres, L. Vila Boas, F. Villaça Guimarães Filho, R. Corbalan, G. Eggers, C. Bugueño Gutiérrez, G. Arriagada, S. Potthoff Cardenas, B.A.J. Stockins Fernandez, C. Conejeros, C. Houzvic, P. Marin Cuevas, H. Montecinos, A. Forero, F. Lanas, M. Larico Gómez, G. Charme Vilches, C. Rey, C. Astudillo, J. Aguilar, Y. Campisto, C. Lara, E. Molina, J. Munoz Oyarzon, V. Olguin, M. Vergara, C. Villan, C.J. Sánchez Díaz, J. Illescas Diaz, R. Leal Cantú, M.G. Ramos Zavala, R. Cabrera Jardines, N. Espinola Zavaleta, S. Villarreal Umaña, E. López Rosas, G. Llamas Esperón, G. Pozas, E. Cardona Muñoz, N. Matadamas Hernández, A. Leyva Rendón, N. García Hernández, M. de los Ríos Ibarra, L. Virgen Carrillo, D. López Villezca, C. Hernández Herrera, J.J. López Prieto, R. Gaona Rodríguez, E. Villeda Espinosa, D. Flores Martínez, J. Velasco Barcena, R. Yong, I. Rodríguez Briones, J.L. Leiva Pons, H. Álvarez López, R. Olvera Ruiz, C. Díaz de la Vega, C. Cantú Brito, E. Chuquiure Valenzuela, R. Reyes-Sanchez, A. Bazzoni Ruiz, O. Nandayapa Flores, M. Benavides Gonzalez, R. Arriaga Nava, J.D. Morales Cerda, O. Fierro Fierro, P. Fajardo Campos, T.A.A. Alfaro, S. Altamirano Bellorin, R. 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Robiro Robiro, M. Roca, C. Roca Saumell, C. Rodrigo, E. Rodriguez, M. Rodriguez Garcia, S. Saez Jimenez, P. Sanchez Calderon, L. Sanchez Mendez, S. Sanchez Parra, C. Santolaya, M.R. Senan Sanz, A. Seoane Blanco, E. Serralvo, N. Sierra, C. Simon Valero, J. Sorribes Lopez, M. Teixido Fontanillas, M. Terns Riera, G. Tobajas, C. Torres, J. Torres Marques, M. Ubeda Pastor, M. Rosenqvist, A. Wirdby, J. Linden, K. Henriksson, M. Elmersson, A. Egilsson, U. Börjesson, G. Svärd, B. Liu, A. Lindh, L.-B. Olsson, M. Gustavsson, Lars Andersson, Lisbeth Andersson, L. Benson, C. Bothin, A. Hajimirsadeghi, K. Kadir, M. Ericsson, A. Ohlsson, H. Lindvall, P. Svensson, K. Thorne, H. Handel, P. Platonov, B. Eriksson, I. Timberg, K. Romberg, M. Crisby, J.-E. Karlsson, S.A. Jensen, A. Andersson, L. Malmqvist, B. Martinsson, F. Bernsten, J. Engdahl, J. Thulin, A. Hot-Bjelac, P. Stalby, H. Aaröe, E. Ahbeck, H. Ahlmark, F. Al-Khalili, G. Bonkowski, S. Dzeletovic, A.-B. Ekstrand, G.-B. Eriksson, K. Floren, C. Grässjö, S. Hahn, P. Jaensson, B. Jansson, J.-H. Jansson, R.-M. Kangert, A. Koch, D. Kusiak, A. Lettenström, A. Lindberg, C.-J. Lindholm, A. Mannermyr, K. Mansson, M. Millborg, C. Nilsson, A.-M. Ohlin, A. Olofsson, A. Osberg, A. Pedersen, K. Risbecker, K. Rosenberg, J. Samuelsson, M. Shayesteh, K. Skoglund, M. Stjernberg, C. Thorsen, J. Steffel, J.H. Beer, J. Debrunner, D. Amstutz, J. Bruegger, G. Elise, A. Grau, A. Guinand, I. Henriette, E. Saga, S. Winnik, A. Parkhomenko, I. Rudyk, V. Tseluyko, O. Karpenko, S. Zhurba, I. Kraiz, I. Kupnovytska, N. Serediuk, Y. Mostovoy, O. Ushakov, O. Koval, I. Kovalskyi, Y. Svyshchenko, O. Sychov, M. Stanislavchuk, O. Kraydashenko, A. Yagensky, S. Tykhonova, I. Fushtey, R. Belegai, G. Berko, L. Burdeuna, O. Chabanna, I. Daniuk, A. Ivanov, E. Kamenska, P. Kaplan, O. Khyzhnyak, S. Kizim, O. Matova, O. Medentseva, V. Mochonyi, M. Mospan, V. Nemtsova, T. Ovdiienko, O. Palamarchuk, M. Pavelko, R. Petrovskyy, D. Plevak, O. Proshak, S. Pyvovar, L. Rasputina, O. Romanenko, O. Romanova, A. Sapatyi, O. Shumakov, R. Stets, L. Todoriuk, V. Varenov, D. Fitzmaurice, N. Chauhan, D. Goodwin, P. Saunders, R. Evans, J. Leese, P.S. Jhittay, A. Ross, M.S. Kainth, G. Pickavance, J. McDonnell, A. Williams, T. Gooding, H. Wagner, S. Suryani, A. Singal, S. Sircar, R. Bilas, P. Hutchinson, A. Wakeman, M. Stokes, N. Paul, M. Aziz, C. Ramesh, P. Wilson, S. Franklin, S. Fairhead, J. Thompson, V. St Joseph, G. Taylor, D. Tragen, D. Seamark, C. Paul, M. Richardson, A. Jefferies, H. Sharp, H. Jones, C. Giles, M. Page, O. Oginni, J. Aldegather, S. Wetherwell, W. Lumb, P. Evans, F. Scouller, N. Macey, Y. Stipp, R. West, S. Thurston, P. Wadeson, J. Matthews, P. Pandya, A. Gallagher, T. Railton, B. Sinha, D. Russell, J.A. Davies, P. Ainsworth, C.P. Jones, P. Weeks, J. Eden, D. Kernick, W. Murdoch, L. Lumley, R.P. Patel, S.W. Wong, M. Saigol, K. Ladha, K. Douglas, D.F. Cumberlidge, C. Bradshaw, G. Van Zon, K.P. Jones, M.J. Thomas, E. Watson, B. Sarai, N. Ahmad, W. Willcock, J. Cairns, S. Sathananthan, N. de Kare-Silver, A. Gilliland, E. Strieder, A. Howitt, B. Vishwanathan, N. Bird, D. Gray, M. Clark, J. Bisatt, J. Litchfield, E. Fisher, T. Fooks, A.R. Kelsall, E. Alborough, J. Wakeling, M. Parfitt, K. Milne, S. Rogers, R. Priyadharshan, J.L. Oliver, E. Davies, S. Abushal, M. Jacobs, C. Hutton, N.I. Walls, R. Thompson, C. Chigbo, S.M.A. Zaidi, M. Howard, K.C. Butter, S. Barrow, H. Little, I.U. Haq, L. Gibbons, S. Glencross, A.J. McLeod, K. Poland, C. Mulholland, A. Warke, P. Conn, G. Burns, R.N. Smith, S. Lowe, R. Kamath, H.S. Dau, J. Webster, I. Hodgins, S. Vercoe, P.C. Roome, H. Pinnock, J.R.A. Patel, A. Ali, N. Hart, R. Davies, E. Stuart, C.A. Neden, M. Danielsen, R. Heath, P. Sharma, S. Galloway, C. Hawkins, R. Oliver, M. Aylward, S. Mannion, M. Braddick, D. Edwards, A.C. Rothwell, A. Sabir, F. Choudhary, S. Khalaque, A. Wilson, S. Peters, W. Coulson, N. Roberts, A. Heer, S. Coates, B. Ward, D. Jackson, S. Walton, D. Shepherd, M. Sterry, T. Wong, M. Boon, R. Bunney, R. Haria-Shah, R.T. Baron, S. Davies, T. Schatzberger, N. Hargreaves, T. Stephenson, H. Choi, R. Batson, L. Lucraft, T. Myhill, S. Estifano, D. Geatch, J. Wilkinson, R. Veale, K. Forshaw, T. Davies, K. Zaman, P. Vinson, C. Liley, M. Bandrapalli, P. McGinty, R. Wastling, P. McEleny, A. Beattie, P. Cooke, M. Wong, J. Gunasegaram, M. Pugsley, S. Ahmad, C. A'Court, J. Ayers, J. Bennett, S. Cartwright, S. Dobson, C. Dooldeniya, A. Flynn, R. Fox, J. Goram, A. Halpin, A. Hay, P. Jacobs, L. Jeffers, L. Lomax, I. Munro, R. Muvva, M. Nadaph, K. Powell, S. Randfield, D. Redpath, R. Reed, M. Rickenbach, G. Rogers, P.B. Saunders, C. Seamark, J. Shewring, P. Simmons, H. Simper, H. Stoddart, A. Sword, N. Thomas, A. Thomson, H. Gibbs, A. Blenkhorn, B. Singh, W. Van Gaal, W. Abhayaratna, R. Lehman, P. Roberts-Thomson, J. Kilian, D. Coulshed, A. Catanchin, D. Colquhoun, H. Kiat, D. Eccleston, J. French, L. Zimmett, B. Ayres, T. Phan, P. Blombery, D. Crimmins, D. O'Donnell, A. Choi, P. Astridge, M. Arstall, N. Jepson, M. Binnekamp, A. Lee, J. Rogers, G. Starmer, P. Carroll, J. Faunt, A. Aggarwala, L. Barry, C. Batta, R. Beveridge, A. Black, M. Bonner, J. Boys, E. Buckley, M. Campo, L. Carlton, A. Connelly, B. Conway, D. Cresp, H. Dimitri, S. Dixon, M. Dolman, M. Duroux, M. Eskandari, R. Eslick, A. Ferreira-Jardim, T. Fetahovic, D. Fitzpatrick, R. Geraghty, J. Gibbs, T. Grabek, M.H. Modi, K. Hayes, M.P. Hegde, L. Hesketh, B. Hoffmann, B. Jacobson, K. Johnson, C. Juergens, I. Kassam, V. Lawlor, M. Lehman, S. Lehman, D. Leung, S. Mackay, M. MacKenzie, C. McCarthy, C. McIntosh, L. McKeon, H. Morrison, C. Mussap, J.-D. Myers, V. Nagalingam, G. Oldfield, V. O'May, J. Palmer, L. Parsons, K. Patching, T. Patching, V. Paul, M. Plotz, S. Preston, H. Rashad, M. Ratcliffe, S. Raynes, J. Rose, L. Sanders, M. Seremetkoska, H. Setio, S. Shone, P. Shrestha, C. Singh, C. Singleton, N. Stoyanov, S. Sutcliffe, K. Swaraj, J. Tarrant, S. Thompson, I.M. Tsay, M. Vorster, A. Waldman, L. Wallis, E. Wilford, K. Wong, S.J. Connolly, A. Spyropoulos, J. Eikelboom, R. Luton, M. Gupta, A.S. Pandey, S. Cheung, R. Leader, P. Beaudry, F. Ayala-Paredes, J. Berlingieri, J. Heath, G. Poirier, M. Du Preez, R. Nadeau, G. Dresser, R. Dhillon, T. Hruczkowski, B. Schweitzer, B. Coutu, P. Angaran, P. MacDonald, S. Vizel, S. Fikry, R. Parkash, A. Lavoie, J. Cha, B. Ramjattan, J. Bonet, K. Ahmad, L. Aro, T. Aves, K. Beaudry, C. Bergeron, J. Bigcanoe, N. Bignell, L. Breakwell, E. Burke, L. Carroll, B. Clarke, T. Cleveland, S. Daheb, P. Dehghani, I. Denis, Z. Djaidani, P. Dorian, S. Douglass, J. Dunnigan, A. Ewert, D. Farquhar, A. Fearon, L. Ferleyko, D. Fournier, B. Fox, M.-C. Grenier, W. Gulliver, K. Haveman, C. Hines, K. Hines, A.M. Jackson, C. Jean, G. Jethoo, R. Kahlon, S. Kelly, R. Kim, V. Korley, J. Kornder, L. Kwan, J. Largy, C. Lewis, S. Lewis, I. Mangat, R. Moor, J. Navratil, I. Neas, J. Otis, R. Otis, M. Pandey, F. Petrie, A. Pinter, M. Raines, P. Roberts, M. Robinson, G. Sas, S. Schulman, L. Snell, S. Spearson, J. Stevenson, T. Trahey, S. Wong, D. Wright, H. Ragy, A. Abd El-Aziz, S.K. Abou Seif, M.G. El Din, S. El Etriby, A. Elbahry, A. El-Etreby, M. Elkhadem, A. Katta, T. Khairy, A. Mowafy, M. Nawar, A. Ohanissian, A. Reda, M. Reda, H. Salem, N. Sami, S. Samir, M. Setiha, M. Sobhy, A. Soliman, N. Taha, M. Tawfik, E. Zaatout, D. Kettles, J. Bayat, H. Siebert, A. Horak, Y. Kelfkens, R. Garda, T. Pillay, M. Guerra, L. van Zyl, H. Theron, A. Murray, R. Louw, D. Greyling, P. Mntla, V. Ueckermann, R. Loghdey, S. Ismail, F. Ahmed, J. Engelbrecht, A. Ramdass, S. Maharajh, W. Oosthuysen, G. Angel, C. Bester, M. Booysen, C. Boshoff, C. Cannon, S. Cassimjee, C. Chami, G. Conway, A. Davids, L. de Meyer, G. Du Plessis, T. Ellis, L. Henley, M. Karsten, E. Loyd, J. Marks, L. Mavhusa, M. Mostert, A. Page, L. Rikhotso, M. Salie, J. Sasto, F. Shaik, A. Skein, L. Smith, G. Tarr, T. Tau, F. van Zyl, W. Al Mahmeed, G. Yousef, A. Agrawal, M. Nathani, M. Ibrahim, E.M. Esheiba, R. Singh, A. Naguib, M. Abu-Mahfouz, M. Al Omairi, A. Al Naeemi, R. Maruthanayagam, N. Bazargani, A. Wassef, R. Gupta, M. Khan, B. Subbaraman, A. Abdul, A. Al Mulla, S. El Bardisy, P. Haridas, S. Jadhav, K. Magdaluyo, M. Makdad, I. Maqsood, R. Mohamed, N. Sharma, R. Sharma, M. Thanzeel, S.Z. Goldhaber, R. Canosa, P. Rama, E. Blumberg, J. Garcia, P. Mullen, V. Wilson, A. Quick, K. Ferrick, W.M. Kutayli, M. Cox, M. Franco, S. Falkowski, R. Mendelson, M. Williams, S. Miller, S. Beach, A. Alfieri, T. Gutowski, I. Haque, R. Reddy, W. Ahmed, P. Delafontaine, D. Diercks, D. Theodoro, K. Remmel, M. Alberts, R. Ison, H. Noveck, P. Duffy, S. Pitta, D. Nishijima, C. Treasure, N. Asafu-Adjaye, K. Ball, M. Bartlett, M. Bentley, S. Bowers, A. Brown, A. Browne, J. Cameron-Watts, M. Canova, D. Cassidy, K. Cervellione, S. Congal, J. DePauw, A. Dickerson, M. Eley, L. Evans, S. Felpel, K. Ferdinand, D. Fielder, P. Gentry, A. Haideri, F. Hakimi, T. Harbour, E. Hartranft, B. Hawkins, M. Headlee, L. Henson, C. Herrick, T. Hicks, S. Jasinski, A. Jones, L. Jones, P. Jones, S. Karl, M. Keeling, J. Kerr, P. Knowles, J. Langdon, M. Lay, J.A. Lee, T. Lincoln, E. Malone, A. Merliss, D. Merritt, J. Minardo, B. Mooso, C. Orosco, V. Palumbo, M. Parker, T. Parrott, S. Paserchia, G. Pearl, J. Peterson, N. Pickelsimer, T. Purcell, J. Raynor, S. Raziano, C. Richard, T. Richardson, C. Robertson, A. Sage, T. Sanghera, P. Shaw, J. Shoemaker, K. Smith, B. Stephanie, A. Thatcher, H. Theobald, N. Thompson, L. Treasure, T. Tripti, C. Verdi, and V. Worthy
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Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: The Global Anticoagulant Registry in the FIELD–Atrial Fibrillation (GARFIELD-AF) is an ongoing prospective noninterventional registry, which is providing important information on the baseline characteristics, treatment patterns, and 1-year outcomes in patients with newly diagnosed non-valvular atrial fibrillation (NVAF). This report describes data from Indian patients recruited in this registry. Methods and results: A total of 52,014 patients with newly diagnosed AF were enrolled globally; of these, 1388 patients were recruited from 26 sites within India (2012–2016). In India, the mean age was 65.8 years at diagnosis of NVAF. Hypertension was the most prevalent risk factor for AF, present in 68.5% of patients from India and in 76.3% of patients globally (P
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- 2018
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3. Influence of the selected structural parameter on a depth of intergranular corrosion of Al-Si7-Mg0,3 aluminum alloy
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L. Bernat
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Aluminum alloy Al - Si - Mg ,corrosion distribution ,microstructure ,Mining engineering. Metallurgy ,TN1-997 - Abstract
The paper presents an influence of the Dendrite Arm Spacing (DAS) microstructure parameter on the intergranular corrosion of AlSi7Mg aluminum alloy. The samples were subjected to the corrosion process for: 2,5; 12; 24; 48 and 96 hours in NaCl + HCl + H2O solution. It was noted that the DAS parameter significantly influenced on a distribution and depth of the intergranular corrosion of the hypoeutectic Al - Si - Mg silumin.
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- 2015
4. Shaping the edges using flowdrill technology
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W. Matysiak and L. Bernat
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shaping ,edges ,Flowdrill ,microhardness ,burring rims ,Mining engineering. Metallurgy ,TN1-997 - Abstract
In this paper, was presented the results of experimental studies of the edgetrimming process obtained using technology Flowdrill, shows distributions of thickness and height of recurving edging and its microhardness made of aluminum, mild steel and stainless steel.
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- 2015
5. Answering global challenges to the determination of death: consensus-building leadership from Canada
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Dale Gardiner, David M. Greer, James L. Bernat, Maureen O. Meade, Helen Opdam, and Stephan K. W. Schwarz
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Anesthesiology and Pain Medicine ,General Medicine - Published
- 2023
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6. Opposed evolution of the osseous and soft parts of progestin-associated osteomeningioma after progestin intake discontinuation
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Simona M. Florea, Thibault Passeri, Rosaria Abbritti, Anne L. Bernat, Sylvie Fontanel, Isabelle Yoldjian, Thomas Funck-Brentano, Alain Weill, Emmanuel Mandonnet, and Sébastien Froelich
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General Medicine - Abstract
OBJECTIVE Numerous studies have confirmed a strong association between progestins and meningiomas and the regression and/or stabilization of meningiomas after discontinuation of treatment. Osteomeningiomas represent a small subgroup of meningiomas that appear to be more common among progestin-related meningiomas. However, the specificity of the behavior of this subset of meningiomas after discontinuation of progestin has not yet been assessed. METHODS Thirty-six patients (mean age 49.5 years) who presented with at least one progestin-related osteomeningioma (48 tumors total) were identified from a prospectively collected database of patients and had been referred to our department for meningioma and had documented use of cyproterone acetate, nomegestrol acetate, and/or chlormadinone acetate. Hormonal treatment was stopped at the time of diagnosis for all the patients, and the clinical and radiological evolution of this subgroup of tumors was evaluated. RESULTS For half of the 36 patients, treatment was prescribed for signs of hyperandrogenism, such as hirsutism, alopecia, or acne. Most lesions were spheno-orbital (35.4%) or frontal (31.2%). Although the tissular part of the meningioma shrank in 77.1% of cases, the osseous part exhibited discordant behavior with 81.3% showing volume progression. The combination of estrogens, as well as the prolonged duration of progestin treatment, seems to increase the risk of progression of the osseous part after treatment discontinuation (p = 0.02 and p = 0.028, respectively). No patient required surgical treatment at diagnosis or during the study. CONCLUSIONS These results show that while the soft intracranial part of progestin-related osteomeningioma tumor is the most likely to regress after treatment discontinuation, the bony part is more likely to increase in volume. These findings suggest the need for careful follow-up of these patients, especially those with tumors near the optical apparatus.
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- 2023
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7. Understanding the Brain-based Determination of Death When Organ Recovery Is Performed With DCDD In Situ Normothermic Regional Perfusion
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James L. Bernat, Beatriz Domínguez-Gil, Alexandra K. Glazier, Dale Gardiner, Alexander R. Manara, Sam Shemie, Robert J. Porte, Dominique E. Martin, Helen Opdam, Andrew McGee, Marta López Fraga, Michel Rayar, Thomas Kerforne, Mirela Bušić, Renato Romagnoli, Marinella Zanierato, Stefan G. Tullius, Eduardo Miñambres, Mario Royo-Villanova, and Francis L. Delmonico
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Transplantation - Published
- 2023
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8. Clarifying the DDR and DCD
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James L. Bernat
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Issues, ethics and legal aspects ,Health Policy - Published
- 2023
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9. Emerging Subspecialties in Neurology: Neuroethics: An Emerging Career Path in Neurology
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Michael J. Young and James L. Bernat
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Resident & Fellow Section ,Neurology ,Neurosciences ,Brain ,Humans ,Neurology (clinical) - Abstract
Essential to responsible practice and progress in neurology and neuroscience research is robust engagement with associated ethical dimensions and challenges. By virtue of the privileged relationship between personhood and the brain, and the importance of properties of the nervous system to what for most makes life worth living, conditions that affect neurologic function introduce a growing host of novel ethical and philosophical issues. Rather than serving a reactionary role, it is important for neurologists to anticipate such issues and develop familiarity with ethical analysis to inform quality medical practice and to safeguard neuroscience research. The field of neuroethics is an emerging career path devoted to identifying and evaluating such issues with the aim of informing optimal clinical practice and responsible neuroscience research. This article describes the past, present, and future of neuroethics, informed by an interview with one of the field's key founders and luminaries, Dr. James Bernat, with specific focus on training and career opportunities for neurologists in training.
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- 2023
10. Normothermic Regional Perfusion Requires Careful Ethical Analysis Before Adoption Into Donation After Circulatory Determination of Death
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Harry Peled, Sajen Mathews, David Rhodes, and James L. Bernat
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Death ,Perfusion ,Tissue and Organ Procurement ,Humans ,Critical Care and Intensive Care Medicine ,Ethical Analysis ,Tissue Donors - Published
- 2022
11. Fred Plum (1924-2010)
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Nara Miriam, Michaelson, Nicholas D, Schiff, and James L, Bernat
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- 2022
12. Expanding controlled donation after the circulatory determination of death
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Alexandra K. Glazier, Alexander Morgan Capron, Dirk Van Raemdonck, Kumud Dhital, Didier Ledoux, James F. Markmann, Shaf Keshavjee, Constantino Fondevila, Stefan G. Tullius, Alexander R. Manara, Nancy L. Ascher, Jeffrey M. Singh, Dale Gardiner, Francis L. Delmonico, James M. DuBois, James L. Bernat, Robert J. Porte, Andrew McGee, Sam D. Shemie, Beatriz Domínguez-Gil, Sarah A. Hosgood, Galen V. Henderson, Eduardo Miñambres, Domínguez-Gil, Beatriz [0000-0002-5695-8993], Hosgood, Sarah [0000-0002-8039-143X], Apollo - University of Cambridge Repository, and Groningen Institute for Organ Transplantation (GIOT)
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Donation after the circulatory determination of death ,medicine.medical_specialty ,Statement (logic) ,Conference Reports and Expert Panel ,Perfusion scanning ,Normothermic regional perfusion ,Critical Care and Intensive Care Medicine ,Organ transplantation ,Tissue and organ procurement ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,Anesthesiology ,Humans ,Medicine ,Organ donation ,Intensive care medicine ,business.industry ,Correction ,030208 emergency & critical care medicine ,Determination of death ,Tissue Donors ,Organ repair ,Organ perfusion ,Death ,Transplantation ,Withdrawal of life-sustaining therapy ,030228 respiratory system ,Donation ,Quality of Life ,business - Abstract
A decision to withdraw life-sustaining treatment (WLST) is derived by a conclusion that further treatment will not enable a patient to survive or will not produce a functional outcome with acceptable quality of life that the patient and the treating team regard as beneficial. Although many hospitalized patients die under such circumstances, controlled donation after the circulatory determination of death (cDCDD) programs have been developed only in a reduced number of countries. This International Collaborative Statement aims at expanding cDCDD in the world to help countries progress towards self-sufficiency in transplantation and offer more patients the opportunity of organ donation. The Statement addresses three fundamental aspects of the cDCDD pathway. First, it describes the process of determining a prognosis that justifies the WLST, a decision that should be prior to and independent of any consideration of organ donation and in which transplant professionals must not participate. Second, the Statement establishes the permanent cessation of circulation to the brain as the standard to determine death by circulatory criteria. Death may be declared after an elapsed observation period of 5 min without circulation to the brain, which confirms that the absence of circulation to the brain is permanent. Finally, the Statement highlights the value of perfusion repair for increasing the success of cDCDD organ transplantation. cDCDD protocols may utilize either in situ or ex situ perfusion consistent with the practice of each country. Methods to accomplish the in situ normothermic reperfusion of organs must preclude the restoration of brain perfusion to not invalidate the determination of death. Supplementary Information The online version contains supplementary material available at 10.1007/s00134-020-06341-7.
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- 2021
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13. What Should We Do About the Mismatch Between Legal Criteria for Death and How Brain Death Is Diagnosed?
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James L. Bernat and Nathaniel M. Robbins
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Brain Death ,medicine.medical_specialty ,Health (social science) ,business.industry ,Extramural ,Health Policy ,MEDLINE ,Trust ,Statute ,Issues, ethics and legal aspects ,Family medicine ,Public trust ,Humans ,Medicine ,business - Abstract
Mismatch between whole-brain death criteria embedded in statutes and accepted tests physicians use to diagnose brain death have clinical and ethical implications that could undermine public trust in death pronouncements. We consider merits and drawbacks of 4 ways to address this problem.
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- 2020
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14. Why arch vessel ligation is unethical for thoracoabdominal normothermic regional perfusion
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Harry Peled and James L. Bernat
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Pulmonary and Respiratory Medicine ,Perfusion ,Aortic Aneurysm, Thoracic ,Humans ,Surgery ,Cardiology and Cardiovascular Medicine - Published
- 2022
15. Black Patients Matter in Neurology: Race, Racism, and Race-Based Neurodisparities
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Nathaniel M. Robbins, Larry Charleston, Altaf Saadi, Zaneta Thayer, Wilfred U. Codrington, Alden Landry, James L. Bernat, and Roy Hamilton
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Black or African American ,Racism ,Health Equity ,Neurology ,Black People ,Humans ,Neurology (clinical) ,United States ,Contemporary Issues in Practice, Education, & Research - Abstract
Black people living in the United States suffer disproportionate morbidity and mortality across a wide range of neurologic conditions. Despite common conceptions to the contrary, “race” is a socially defined construct with little genetic validity. Therefore, racial health inequities in neurology (“neurodisparities”) are not a consequence of biologic differences between races. Instead, racism and associated social determinants of health are the root of neurodisparities. To date, many neurologists have neglected racism as a root cause of neurologic disease, further perpetuating the problem. Structural racism, largely ignored in current neurologic practice and policy, drives neurodisparities through mediators such as excessive poverty, inferior health insurance, and poorer access to neurologic and preventative care. Interpersonal racism (implicit or explicit) and associated discriminatory practices in neurologic research, workforce advancement, and medical education also exacerbate neurodisparities. Neurologists cannot fulfill their professional and ethical responsibility to care for Black patients without understanding how racism, not biologic race, drives neurodisparities. In our review of race, racism, and race-based disparities in neurology, we highlight the current literature on neurodisparities across a wide range of neurologic conditions and focus on racism as the root cause. We discuss why all neurologists are ethically and professionally obligated to actively promote measures to counteract racism. We conclude with a call for actions that should be implemented by individual neurologists and professional neurologic organizations to mitigate racism and work towards health equity in neurology.
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- 2022
16. Arguments Supporting Neurologic Criteria to Determine Death
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James L. Bernat
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- 2022
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17. Taking the Pulse of Brain-Death: A Meta-Analysis of its Natural History with Somatic Support
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Ivancarmine Gambardella, Berhane Worku, Robert F. Tranbaugh, Aminat M. Ibrahim, and James L. Bernat
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History ,Polymers and Plastics ,Business and International Management ,Industrial and Manufacturing Engineering - Published
- 2022
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18. Historical Introduction
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James L. Bernat and Ariane Lewis
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- 2022
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19. Inconsistency between the circulatory and the brain criteria of death in the Uniform Determination of Death Act
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Alberto Molina Pérez, James L. Bernat, and Anne Dalle Ave
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The Uniform Determination of Death Act (UDDA) provides that “an individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions or (2) irreversible cessation of all functions of the entire brain, including the brain stem, is dead.” We show that the UDDA contains two conflicting interpretations of the phrase “cessation of functions”. By one interpretation, what matters for the determination of death is the cessation of spontaneous functions only, regardless of their generation by artificial means. By the other, what matters is the cessation of both spontaneous and artificially supported functions. Because each UDDA criterion uses a different interpretation, the law is conceptually inconsistent. A single consistent interpretation would lead to the conclusion that conscious individuals whose respiratory and circulatory functions are artificially supported are actually dead, or that individuals whose brain is entirely and irreversibly destroyed may be alive. We explore solutions to mitigate the inconsistency.
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- 2021
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20. 6. Defining Death in Donation after Circulatory Determination of Death
- Author
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James L. Bernat, David Shaw, and Anne L. Dalle Ave
- Subjects
medicine.medical_specialty ,business.industry ,Donation ,Circulatory system ,medicine ,Intensive care medicine ,business - Published
- 2021
- Full Text
- View/download PDF
21. Ethical Justifications for Pandemic Rationing Strategies
- Author
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James L. Bernat
- Subjects
2019-20 coronavirus outbreak ,Health Care Rationing ,Editorial ,Neurology ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Development economics ,Pandemic ,Rationing ,Humans ,Neurology (clinical) ,Business ,Pandemics - Published
- 2020
- Full Text
- View/download PDF
22. Refinements in the Organism as a Whole Rationale for Brain Death
- Author
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James L. Bernat
- Subjects
Cognitive science ,Health Policy ,Brain stem death ,Articles ,06 humanities and the arts ,0603 philosophy, ethics and religion ,medicine.disease ,03 medical and health sciences ,Philosophy ,0302 clinical medicine ,Conscious awareness ,medicine ,060301 applied ethics ,Psychology ,030217 neurology & neurosurgery ,Organism ,Mereology - Abstract
Death can be defined as the permanent cessation of the organism as a whole. Although the organism as a whole is a century-old concept, it remains better intuited than analyzed. Recent concepts in theoretical biology including hierarchies of organization, emergent functions, and mereology have informed the idea that the organism as a whole is the organism’s critical emergent functions. Because the brain conducts the critical emergent functions including conscious awareness and control of respiration and circulation, the cessation of brain functions is death of the organism. A newer concept, the brain as a whole, may offer a superior criterion of death to the whole-brain criterion, because it more closely matches accepted clinical brain death tests and confirms the cessation of the organism’s emergent functions. Although the concepts of organism as a whole and brain as a whole remain vague and in need of rigorous biophilosophical analysis, their future precision will be restricted by the categorical limitations intrinsic to theoretical biological models.
- Published
- 2019
- Full Text
- View/download PDF
23. Scope and nature of financial conflicts of interest between neurologists and industry
- Author
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Nathaniel M. Robbins, James L. Bernat, and Mark J. Meyer
- Subjects
Finance ,Scope (project management) ,business.industry ,media_common.quotation_subject ,Yield (finance) ,Conflict of interest ,Payment ,Work (electrical) ,Value (economics) ,Public trust ,Neurology (clinical) ,Business ,Medicaid ,media_common - Abstract
ObjectiveTo detail the scope and nature of financial conflicts of interest (COIs) between neurologists and the pharmaceutical and medical device industries (Industry) using the Centers for Medicare and Medicaid Services Open Payments (OP) database, with a focus on trends from 2013 to 2016.MethodsPayments from Industry to US neurologists were categorized into research payments, general (nonresearch) payments, and value of ownership in Industry. We performed descriptive analyses to detail the scope and nature of these relationships and trends over time.ResultsAt least 9,505 neurologists received at least one payment from Industry each year. From 2013 to 2016, 1.6 million payments totaled $354 million, of which 99.5% of payments and 85.6% of payment value were for general/nonresearch-related payments. Most neurologists (between 65% and 80%) received less than $1,000 per year, but over 200 neurologists each received more than $100,000 during some years. Several received over $1 million. General payments are increasing, research payments are steady, and neurologists' ownership and investments are decreasing.ConclusionsNeurologists have extensive financial relationships with Industry, though this is driven by a well-paid minority. As a profession, we must work to establish firm rules to manage these potential COIs, ensuring that relationships with Industry yield synergistic advances while minimizing bias and maintaining public trust.
- Published
- 2019
- Full Text
- View/download PDF
24. TEACHERS AND HEADMASTERS INITIATIVES IN STRENGTHENING QUALITY EDUCATION THROUGH SCHOOL MANAGEMENT COMMITTEES
- Author
-
L Bernat
- Subjects
Medical education ,Political science ,Quality education - Published
- 2019
- Full Text
- View/download PDF
25. Ethical Issues in Stroke Management
- Author
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James L. Bernat and Timothy G. Lukovits
- Subjects
medicine.medical_specialty ,Ethical issues ,business.industry ,Infarction ,Case ,medicine.disease ,Pontine infarction ,Treatment Refusal ,Informed consent ,medicine ,Neurology (clinical) ,Intensive care medicine ,business ,Elderly patient ,Stroke ,Acute stroke - Abstract
A variety of ethical issues may arise in the management of patients with stroke.1 The adequacy of informed consent may be questioned in the incapacitated patient with acute stroke for whom IV alteplase administration is planned despite the absence of a lawful surrogate decision-maker. The decision-making capacity of a patient with a recent dominant hemispheric infarction causing nonfluent aphasia may become an issue when he appears to understand but cannot communicate his treatment preference. Neurologists may be unsure whether to provide medical hydration and nutrition to an elderly patient admitted with a massive intracranial hemorrhage and incipient herniation whose advance directive states that life-sustaining treatment is to be withheld in the event of a hopeless prognosis. A patient with chronic locked-in syndrome from pontine infarction may order that further life-sustaining treatment be withdrawn but her neurologist may be unsure of the ethical adequacy of her treatment refusal because of communication limitations.
- Published
- 2021
26. Analysis of Cooling a Printed 3D Mold Using a Casting and Solidification Simulation of a CuSn20 Bronze Bell Casting
- Author
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M. Nadolski, Ł. Bernat, D. Cekus, P. Kwiatoń, and A. Pietrzak
- Subjects
fran mold ,sand-base 3d printing ,bell bronze ,3d printing ,casting ,solidification ,Mining engineering. Metallurgy ,TN1-997 ,Materials of engineering and construction. Mechanics of materials ,TA401-492 - Abstract
The work done in this study is a preliminary investigation into the possibility of modelling the filling and solidification process of castings in molds made with the additive method. The work originated from an experiment to produce a bronze casting with a high tin content in an additive mold. The mold filling and solidification simulation was carried out in the MAGMASO FT program, and the lambda thermal conductivity coefficient used in the program’s material database was corrected based on the actual temperature values of the printed form. The results were compared with the modeling results for the physical properties of furan molds based on the program database. The microstructure of the castings obtained in the compared forms was assessed.
- Published
- 2024
- Full Text
- View/download PDF
27. The Limits of Advance Directives in Maintaining Autonomy in Patients with Advanced Dementia
- Author
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James L. Bernat, Donald O. Kollisch, and Robert B. Santulli
- Subjects
Population ageing ,media_common.quotation_subject ,030204 cardiovascular system & hematology ,Severity of Illness Index ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,mental disorders ,Terminal care ,Medicine ,Dementia ,Humans ,In patient ,030212 general & internal medicine ,media_common ,business.industry ,Cognition ,General Medicine ,medicine.disease ,Directive ,Advanced dementia ,Personal Autonomy ,business ,Advance Directives ,Autonomy - Abstract
As dementia becomes more prevalent in the aging population, clinicians increasingly face the challenge of caring for patients who had told family members that they preferred death to life with advanced dementia. Advance directives can guide management, but usually are inadequate in caring for patients with advanced dementia. The "now" patient has very different sensibilities than the "then" patient who had expressed preferences for terminal care before dementia severely impaired cognition and executive function. Clinicians lack clear means of following a patient's directive to die rather than to live with advanced dementia. Withholding life-sustaining oral feeding or fluids is ethically problematic. Controversies remain over precedent autonomy as the justification for advance dementia directives, and the consequent legal, ethical, and practical issues clinicians face, particularly involving feeding.
- Published
- 2021
28. Genetic variation regulates opioid-induced respiratory depression in mice
- Author
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Vivek M. Philip, Tyler A Roy, Rebecca L. Bernat, Elissa J. Chesler, Jason A. Bubier, Christian J Monroy Hernandez, Bruce F. O'Hara, Kevin D. Donohue, and Hao He
- Subjects
Male ,Quantitative Trait Loci ,Population ,lcsh:Medicine ,Quantitative trait ,Article ,Fentanyl ,Heroin ,Mice ,Inbred strain ,medicine ,Genetics ,Animals ,lcsh:Science ,education ,education.field_of_study ,Respiratory tract diseases ,Multidisciplinary ,Morphine ,business.industry ,lcsh:R ,Genetic Variation ,Opioid overdose ,medicine.disease ,Analgesics, Opioid ,Opioid ,Immunology ,N-Acetylgalactosaminyltransferases ,Female ,lcsh:Q ,Opiate ,Respiratory Insufficiency ,business ,Psychiatric disorders ,medicine.drug - Abstract
In the U.S., opioid prescription for treatment of pain nearly quadrupled from 1999 to 2014. The diversion and misuse of prescription opioids along with increased use of drugs like heroin and fentanyl, has led to an epidemic in addiction and overdose deaths. The most common cause of opioid overdose and death is opioid-induced respiratory depression (OIRD), a life-threatening depression in respiratory rate thought to be caused by stimulation of opioid receptors in the inspiratory-generating regions of the brain. Studies in mice have revealed that variation in opiate lethality is associated with strain differences, suggesting that sensitivity to OIRD is genetically determined. We first tested the hypothesis that genetic variation in inbred strains of mice influences the innate variability in opioid-induced responses in respiratory depression, recovery time and survival time. Using the founders of the advanced, high-diversity mouse population, the Diversity Outbred (DO), we found substantial sex and genetic effects on respiratory sensitivity and opiate lethality. We used DO mice treated with morphine to map quantitative trait loci for respiratory depression, recovery time and survival time. Trait mapping and integrative functional genomic analysis in GeneWeaver has allowed us to implicate Galnt11, an N-acetylgalactosaminyltransferase, as a gene that regulates OIRD.
- Published
- 2020
29. Language and Meaning: Then and now
- Author
-
James L. Bernat and Michael Shevell
- Subjects
History ,Developmental Neuroscience ,Neurology ,Sterilization (medicine) ,Books ,Pediatrics, Perinatology and Child Health ,Humans ,Sterilization ,Neurology (clinical) ,Meaning (existential) ,Linguistics ,United States ,Language - Published
- 2020
30. Financial Conflicts of Interest of United States-Based Authors in Neurology Journals: Cross-Sectional Study Using the Open Payments Database
- Author
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James L. Bernat, Jade E. Smith, Nathaniel M. Robbins, and Charlotte Wahle
- Subjects
medicine.medical_specialty ,Neurology ,Cross-sectional study ,media_common.quotation_subject ,MEDLINE ,Disclosure ,computer.software_genre ,Article ,medicine ,Humans ,media_common ,Finance ,Database ,business.industry ,Conflict of Interest ,Payment ,Authorship ,United States ,Clinical neurology ,Cross-Sectional Studies ,Work (electrical) ,Publishing ,Neurology (clinical) ,Business ,Periodicals as Topic ,computer ,Medicaid - Abstract
ObjectiveTo detail the scope, nature, and disclosure of financial conflicts of interest (COI) between the pharmaceutical and medical device industries (Industry) and authors in high-impact clinical neurology journals.MethodsUsing the Centers for Medicare and Medicaid Services Open Payments Database (OPD), we retrieved information on payments from Industry to 2,000 authors from randomly selected 2016 articles in 5 journals. We categorized payments by type (research, general, and associated research/institutional), sponsoring entity, and year (from 2013 to 2016). Each author's self-disclosures were compared to OPD-listed Industry relationships to measure discordance. Payments were manually reviewed to identify those from manufacturers of products that were directly tested or discussed in the article. We also quantified the prevalence and value of these nondisclosed, relevant COI.ResultsTwo hundred authors from 158 articles had at least 1 OPD payment. Median/mean annual payments per author were $4,229/$19,586 (general); $1,702/$5,966 (research); and $67,512/$362,102 (associated research). Most neurologists received 10% of authors) received more than $10,000 per year, and several received over $1 million. Of 3,013 payments deemed directly relevant to the article, 50.9% were not self-disclosed by the authors, totaling $5,782,197 ($1,665,603 general; $25,532 research; $4,091,062 associated research).ConclusionIndustry-related financial relationships are prevalent among United States–based physicians publishing in major neurology journals, and incomplete self-disclosure is common. As a profession, academic and other neurologists must work to establish firm rules to ensure and manage disclosure of financial COI.
- Published
- 2020
31. Permanent brain arrest as the sole criterion of death in systemic circulatory arrest
- Author
-
James L. Bernat, Andrew McGee, and Dale Gardiner
- Subjects
medicine.medical_specialty ,Brain Death ,business.industry ,medicine.medical_treatment ,media_common.quotation_subject ,Circulatory death ,Heart Arrest ,03 medical and health sciences ,0302 clinical medicine ,Anesthesiology and Pain Medicine ,030202 anesthesiology ,Circulatory system ,Extracorporeal membrane oxygenation ,Medicine ,Humans ,In patient ,030212 general & internal medicine ,Consciousness ,business ,Intensive care medicine ,Brain function ,media_common - Abstract
Historically, there has been a tendency to think that there are two types of death: circulatory and neurological. Holding onto this tendency is making it harder to navigate emerging resuscitative technologies, such as extracorporeal membrane oxygenation and the recent well-publicised experiment that demonstrated the possibility of restoring cellular function to some brain neurons 4 h after normothermic circulatory arrest (decapitation) in pigs. Attempts have been made to respond to these difficulties by proposing a unified brain-based criterion for human death, which we call ‘permanent brain arrest’. The clinical characteristics of permanent brain arrest are the permanent loss of capacity for consciousness and permanent loss of all brainstem functions, including the capacity to breathe. These losses could arise from a primary brain injury or as a result of systemic circulatory arrest. We argue that permanent brain arrest is the true and sole criterion for the death of human beings and show that this is already implicit in the circulatory-respiratory criterion itself. We argue that accepting the concept of permanent cessation of brain function in patients with systemic permanent circulatory arrest will help us better navigate the medical advances and new technologies of the future whilst continuing to provide sound medical criteria for the determination of death.
- Published
- 2020
32. How Should Physicians Manage Organ Donation after the Circulatory Determination of Death in Patients with Extremely Poor Neurological Prognosis?
- Author
-
James L. Bernat and Nathaniel M. Robbins
- Subjects
Adult ,Brain Death ,medicine.medical_specialty ,Tissue and Organ Procurement ,Health (social science) ,Palliative care ,Diagnostic Techniques, Neurological ,Living donor ,Young Adult ,Informed consent ,Physicians ,medicine ,Humans ,In patient ,Organ donation ,Asystole ,Intensive care medicine ,Extremely Poor ,business.industry ,Health Policy ,Organ Transplantation ,medicine.disease ,United States ,Issues, ethics and legal aspects ,Practice Guidelines as Topic ,Female ,Death determination ,business - Abstract
Organ donation after the circulatory determination of death (DCDD) accounts for a growing percentage of deceased organ donations. Although hospital DCDD protocols stipulate donor death determination, some do not adhere to national guidelines that require mechanical, not electrical, asystole. Surrogate decisions to withdraw life-sustaining therapy should be separated from decisions to donate organs. Donor families should be given sufficient information about the DCDD protocol and its impact on the dying process to provide informed consent, and donors should be given proper palliative care during dying. An unresolved ethical question is whether and how donor consent should be seen as authorizing manipulation of a living donor during the dying process solely for to benefit of the organ recipient.
- Published
- 2018
- Full Text
- View/download PDF
33. Practice Current: When do you order ancillary tests to determine brain death?
- Author
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Nathaniel M. Robbins and James L. Bernat
- Subjects
medicine.medical_specialty ,MEDLINE ,Audience measurement ,03 medical and health sciences ,0302 clinical medicine ,Order (business) ,030225 pediatrics ,Mechanism of injury ,Legal definition ,Commentary ,medicine ,Neurology (clinical) ,Intensive care medicine ,Psychology ,030217 neurology & neurosurgery - Abstract
Brain death has been accepted as a legal definition of death in most countries, but practices for determining brain death vary widely. One source of variation is in the use of ancillary tests to assist in the diagnosis of brain death. Through case-based discussions with 3 experts from 3 continents, this article discusses selected aspects of brain death, with a focus on the use of ancillary tests. In particular, we explore the following questions: Are ancillary tests necessary, or is the clinical examination sufficient? What ancillary tests are preferred, and under which circumstances? Are ancillary tests required when the primary mechanism of injury is brainstem injury? Should the family's wishes play a role in the need for ancillary tests? The same case-based questions were posed to the rest of our readership in an online survey, the preliminary results of which are also presented.
- Published
- 2018
- Full Text
- View/download PDF
34. Medical Decision Making by Patients in the Locked-in Syndrome
- Author
-
James L. Bernat
- Subjects
medicine.medical_specialty ,Neurology ,Health Policy ,media_common.quotation_subject ,Neuropsychology ,Cognition ,06 humanities and the arts ,0603 philosophy, ethics and religion ,medicine.disease ,03 medical and health sciences ,Psychiatry and Mental health ,0302 clinical medicine ,Functional neuroimaging ,Covert ,medicine ,060301 applied ethics ,Neurosurgery ,Locked-in syndrome ,Consciousness ,Intensive care medicine ,Psychology ,030217 neurology & neurosurgery ,media_common - Abstract
The locked-in syndrome (LIS) is a state of profound paralysis with preserved awareness of self and environment who typically results from a brain stem stroke. Although patients in LIS have great difficulty communicating, their consciousness, cognition, and language usually remain intact. Medical decision-making by LIS patients is compromised, not by cognitive impairment, but by severe communication impairment. Former systems of communication that permitted LIS patients to make only “yes” or “no” responses to questions was sufficient to validate their consent for simple medical decisions but not for consequential medical decisions such as whether to refuse further life-sustaining therapy. Emerging technologies including computer-tracking assistance of retained partial motor function and brain-computer interfaces promise to improve the communication ability of LIS patients and, when better developed, will allow them to fully exercise their right to actively participate in consequential medical decisions about their own medical care. Although so-called “covert cognition” patients clinically diagnosed as vegetative state that are shown to be aware by functional neuroimaging maybe metaphorically considered locked-in, it is nosologically more coherent not to categorize them formally as LIS.
- Published
- 2018
- Full Text
- View/download PDF
35. Clinical Decision‐Making for Patients with Disorders of Consciousness
- Author
-
James L. Bernat
- Subjects
medicine.medical_specialty ,media_common.quotation_subject ,MEDLINE ,medicine.disease ,Neurology ,Clinical decision making ,Consciousness Disorders ,medicine ,Wakefulness ,Neurology (clinical) ,Consciousness ,Psychiatry ,Psychology ,Persistent vegetative state ,media_common - Published
- 2019
- Full Text
- View/download PDF
36. Restoring Activity of Pig Brain Cells After Death Does not Invalidate the Determination of Death by Neurologic Criteria or Undermine the Propriety of Organ Donation After Death
- Author
-
Francis L. Delmonico and James L. Bernat
- Subjects
Transplantation ,medicine.medical_specialty ,Tissue and Organ Procurement ,Pig brain ,Swine ,business.industry ,Brain ,Organ Transplantation ,Death ,medicine ,Animals ,Humans ,Organ donation ,Intensive care medicine ,business - Published
- 2019
- Full Text
- View/download PDF
37. Correction to: Expanding controlled donation after the circulatory determination of death: statement from an international collaborative
- Author
-
James L. Bernat, Sam D. Shemie, Jeffrey M. Singh, Dirk Van Raemdonck, Kumud Dhital, Robert J. Porte, Francis L. Delmonico, Eduardo Miñambres, Constantino Fondevila, Alexander R. Manara, Sarah A. Hosgood, Beatriz Domínguez-Gil, Galen V. Henderson, Didier Ledoux, Shaf Keshavjee, Dale Gardiner, Stefan G. Tullius, James M. DuBois, Nancy L. Ascher, Andrew McGee, James F. Markmann, Alexandra K. Glazier, and Alexander Morgan Capron
- Subjects
medicine.medical_specialty ,business.industry ,Statement (logic) ,Donation ,Anesthesiology ,Pain medicine ,Published Erratum ,MEDLINE ,Medicine ,Medical emergency ,Critical Care and Intensive Care Medicine ,business ,medicine.disease - Published
- 2021
- Full Text
- View/download PDF
38. Death Determination by Neurologic Criteria : Areas of Consensus and Controversy
- Author
-
Ariane Lewis, James L. Bernat, Ariane Lewis, and James L. Bernat
- Subjects
- Brain death, Neurosciences--Moral and ethical aspects
- Abstract
This book presents principal controversies over the determination of death by neurologic criteria (“brain death”). The editors and authors are exceedingly well-versed in this subject and are on the forefront of the current debates. The content is divided in the following disciplinary: philosophical (conceptual), medical, scientific, legal, religious, and ethical/social. Many of the topics feature pro-con debates, allowing readers to consider the merits of the arguments and decide their own position. The work is targeted to clinicians and nurses who treat critically ill and dying patients, organ donation personnel, ethicists and philosophers who write on end-of-life issues, and lawyers and legislative/public policy professionals who draft laws on death determination. It identifies and debates the essential controversies currently raging in academic and public policy circles over the medical adequacy, scientific validity, and conceptual coherence of death determination by neurologic criteria. Whether a professional or a student, the reader will be given a comprehensive course in the most pressing controversies and areas of consensus in the determination of death by neurologic criteria.
- Published
- 2022
39. Headache Professional Societies: Ethical Challenges and Suggested Solutions
- Author
-
James L. Bernat and David Borsook
- Subjects
Professional conduct ,medicine.medical_specialty ,Ethical issues ,business.industry ,education ,Specialty ,Conflict of interest ,Context (language use) ,03 medical and health sciences ,0302 clinical medicine ,Neurology ,Medicine ,Engineering ethics ,In patient ,Professional association ,030212 general & internal medicine ,Neurology (clinical) ,business ,Psychiatry ,health care economics and organizations ,030217 neurology & neurosurgery - Abstract
Codes of professional conduct continue to be an essential component of maintaining the integrity of individuals, academic institutions, and medical societies. We review ethical issues of professional conduct focusing on conflicts of interest (COI). We explain how to manage or mitigate COI in the context of professionals involved in headache medicine and its medical specialty societies. We identify the roles of institutional, medical society, and governmental regulation in the protection of patients and maintaining the integrity of physicians and others involved in patient care.
- Published
- 2017
- Full Text
- View/download PDF
40. Intracranial hemorrhage related to brain vascular disease and COVID-19 containment: Where are the patients?
- Author
-
F Rault, T. Gaberel, C Peltier, A L Bernat, Clément Gakuba, B Baussart, V Civelli, F Clarençon, K Premat, Elsa Magro, Lorenzo Giammattei, Thomas Graillon, Sébastien Froelich, and A Nouet
- Subjects
medicine.medical_specialty ,2019-20 coronavirus outbreak ,Subarachnoid hemorrhage ,Critical Care ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Intracranial Hemorrhages ,Clinical Neurology ,03 medical and health sciences ,0302 clinical medicine ,Surveys and Questionnaires ,Pandemic ,medicine ,Humans ,Pandemics ,SARS-CoV-2 ,Vascular disease ,business.industry ,Brain ,COVID-19 ,Subarachnoid Hemorrhage ,medicine.disease ,Public Opinion ,030220 oncology & carcinogenesis ,Emergency medicine ,Surgery ,Neurology (clinical) ,business ,030217 neurology & neurosurgery - Abstract
Neurochirurgie - Sous presse. Epreuves corrigees par l'auteur. Disponible en ligne depuis le mardi 25 aout 2020
- Published
- 2020
- Full Text
- View/download PDF
41. Author’s Response
- Author
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Francis L. Delmonico, Beatriz Dominguez-Gil, Nancy L. Ascher, Alexandra K. Glazier, Galen V. Henderson, and James L. Bernat
- Subjects
Transplantation ,Tissue and Organ Procurement ,Swine ,Animals ,Brain ,Humans ,Organ Transplantation - Published
- 2020
- Full Text
- View/download PDF
42. On Shared Decision-making and Informed Consent
- Author
-
Michael P. McQuillen and James L. Bernat
- Subjects
Medical knowledge ,Medical education ,Editorial ,Informed consent ,business.industry ,Process (engineering) ,Health care ,Treatment options ,Neurology (clinical) ,business ,Psychology - Abstract
In the idealized concept of shared decision-making, the physician and patient comprise a collaborative clinical decision-making dyad.1 The physician contributes medical knowledge, training, experience, and judgment, whereas the patient contributes personal values and health care goals through which to evaluate how each treatment option could fulfill those goals. As partners, the patient and physician collaboratively achieve a mutually agreeable medical decision through an ongoing communication process that creates informed consent.2
- Published
- 2020
- Full Text
- View/download PDF
43. A Conceptual Justification for Brain Death
- Author
-
James L. Bernat
- Subjects
Cognitive science ,Brain Death ,Attitude to Death ,Health (social science) ,Biological phenomenon ,Health Policy ,Biomedical Technology ,Subject (philosophy) ,Holistic Health ,06 humanities and the arts ,0603 philosophy, ethics and religion ,030227 psychiatry ,Death ,03 medical and health sciences ,Philosophy ,Issues, ethics and legal aspects ,0302 clinical medicine ,Phenomenon ,Critical Pathways ,Humans ,060301 applied ethics ,Psychology ,Organism - Abstract
Among the old and new controversies over brain death, none is more fundamental than whether brain death is equivalent to the biological phenomenon of human death. Here, I defend this equivalency by offering a brief conceptual justification for this view of brain death, a subject that Andrew Huang and I recently analyzed elsewhere in greater detail. My defense of the concept of brain death has evolved since Bernard Gert, Charles Culver, and I first addressed it in 1981, a development that paralleled advances in intensive care unit treatment. The century-old concept of the organism as a whole provides the fundamental justification for the equivalency of brain death and human death. In our technological age, in which increasing numbers of components and systems of an organism can be kept alive, and for longer intervals, the permanent cessation of functioning of the organism as a whole is the phenomenon that best corresponds to its death.
- Published
- 2018
- Full Text
- View/download PDF
44. Conceptual Issues in DCDD Donor Death Determination
- Author
-
James L. Bernat
- Subjects
Brain Death ,medicine.medical_specialty ,Attitude to Death ,Tissue and Organ Procurement ,Health (social science) ,Attitude of Health Personnel ,medicine.medical_treatment ,Respiratory arrest ,0603 philosophy, ethics and religion ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,Bioethical Issues ,030212 general & internal medicine ,Organ donation ,Cardiopulmonary resuscitation ,Intensive care medicine ,business.industry ,Health Policy ,Medical practice ,Organ Transplantation ,06 humanities and the arts ,Death ,Philosophy ,Issues, ethics and legal aspects ,Social Perception ,Death determination ,060301 applied ethics ,medicine.symptom ,business - Abstract
Despite the popularity, success, and growth of programs of organ donation after the circulatory determination of death (DCDD), a long-standing controversy persists over whether the organ donor is truly dead at the moment physicians declare death, usually following five minutes of circulatory and respiratory arrest. Advocates of the prevailing death determination standard claim that the donor is dead when declared because of permanent cessation of respiration and circulation. Critics of this standard argue that while the cessation of respiration and circulation may be permanent, it may not be irreversible at the moment death is declared because, if cardiopulmonary resuscitation were performed, it might succeed. And because irreversibility of cessation of respiration and circulation is required by both the statute and the biological concept of death, the donor must be alive. Who is correct? Making two related distinctions clarifies the cause of the disagreement over whether the DCDD donor is dead and points to a possible resolution. First, in a determination of death, there is an important distinction between the permanent and the irreversible cessation of circulation and respiration-two associated phenomena that are often confounded. Second, there is an important distinction between the medical practice standard for death determination, in which physicians certify the permanent cessation of vital functions as sufficient for death declaration, and the underlying biological concept of death that requires the irreversible cessation of vital functions because death, by definition, is an irreversible event.
- Published
- 2018
- Full Text
- View/download PDF
45. The Organism as a Whole in an Analysis of Death
- Author
-
Andrew P Huang and James L. Bernat
- Subjects
Brain Death ,06 humanities and the arts ,General Medicine ,0603 philosophy, ethics and religion ,United States ,Developmental psychology ,Statute ,Death ,03 medical and health sciences ,Philosophy ,Issues, ethics and legal aspects ,0302 clinical medicine ,Conscious awareness ,Humans ,Wakefulness ,Death determination ,Ethics, Medical ,060301 applied ethics ,030212 general & internal medicine ,Philosophy, Medical ,Psychology ,Organism - Abstract
Although death statutes permitting physicians to declare brain death are relatively uniform throughout the United States, academic debate persists over the equivalency of human death and brain death. Alan Shewmon showed that the formerly accepted integration rationale was conceptually incomplete by showing that brain-dead patients demonstrated a degree of integration. We provide a more complete rationale for the equivalency of human death and brain death by defending a deeper understanding of the organism as a whole (OaaW) and by using a novel strategy with shared objectives to justify death determination criteria. Our OaaW account describes different types of OaaW, defining human death as the loss of status as a human OaaW. We defend human death as similar to nonhuman death in terms of wakefulness, but also distinct in terms of the sui generis properties, particularly conscious awareness. We thereby defend the equivalency of brain death and human death using a resulting neurocentric rationale.
- Published
- 2019
46. Commentary: Further Considerations in Using Functional Neuroimaging in Patients with Disorders of Consciousness
- Author
-
James L. Bernat
- Subjects
Health (social science) ,Consciousness ,Health Policy ,Functional Neuroimaging ,Disorders of consciousness ,Neuroimaging ,medicine.disease ,Issues, ethics and legal aspects ,Functional neuroimaging ,medicine ,Humans ,In patient ,Psychology ,Clinical psychology - Published
- 2019
47. Aligning the Criterion and Tests for Brain Death
- Author
-
Anne L. Dalle Ave and James L. Bernat
- Subjects
Brain dead ,medicine.medical_specialty ,Brain Death ,Health (social science) ,business.industry ,Health Policy ,Intact brain ,Diagnostic Techniques, Neurological ,03 medical and health sciences ,Issues, ethics and legal aspects ,0302 clinical medicine ,Cerebral blood flow ,Internal medicine ,Circulatory system ,medicine ,Cardiology ,Humans ,Death determination ,030212 general & internal medicine ,Diagnostic Errors ,business ,030217 neurology & neurosurgery - Abstract
Disturbing cases continue to be published of patients declared brain dead who later were found to have a few intact brain functions. We address the reasons for the mismatch between the whole-brain criterion and brain death tests, and suggest solutions. Many of the cases result from diagnostic errors in brain death determination. Others probably result from a tiny amount of residual blood flow to the brain despite intracranial circulatory arrest. Strategies to lessen the mismatch include improving brain death determination training for physicians, mandating a test showing complete intracranial circulatory arrest, or revising the whole-brain criterion.
- Published
- 2019
48. Author response: Ethical, palliative, and policy considerations in disorders of consciousness
- Author
-
James L. Bernat and Joseph J. Fins
- Subjects
medicine.medical_specialty ,Consciousness ,medicine.medical_treatment ,media_common.quotation_subject ,Context (language use) ,Disorders of consciousness ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Humans ,030212 general & internal medicine ,Psychiatry ,health care economics and organizations ,media_common ,Chronic care ,Rights issue ,Rehabilitation ,medicine.disease ,Policy ,Covert ,Resource allocation ,Consciousness Disorders ,Neurology (clinical) ,Psychology ,030217 neurology & neurosurgery - Abstract
In response to Dr. Sethi's query about the care of patients with disorders of consciousness (DoC) in the context of scarce resources,1 what is owed to conscious individuals with brain injury is as much a civil and disability rights issue as one of distributive justice.2,3 At a minimum, physicians should identify covert consciousness. Turning to the question of resource allocation, the provision of proper rehabilitation may be cost-effective. Because chronic care costs of DoC patients are fixed, improvements in functional status may decrease longitudinal costs.
- Published
- 2019
49. TEACHERS AND HEADMASTERS INITIATIVES IN STRENGTHENING QUALITY EDUCATION THROUGH SCHOOL MANAGEMENT COMMITTEES
- Author
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L. Bernat and M. Kanmani.
- Subjects
International Journal of Advanced Research (IJAR) - Abstract
Schools are miniatures of our society. Now a day?s schools are gradually isolated from the community. Our constitution and many domestic laws ensured the participation of people in governance. Right to education act has ensured School Management Committees (SMC)s in schools. SMCs are reducing the gap between communities and schools. Meantime headmasters and teachers play an important role in the SMCs. Teachers and headmasters are found stimulating and encouraging parents and community members towards strengthening the quality and universal elementary education for their children. This study tries to analyze the understanding, awareness and involvement of headmasters and teachers in the functioning of the SMCs in schools. This study tries to document good initiatives of headmasters and teachers in schools using purposive sampling method and questionnaire.
- Published
- 2019
- Full Text
- View/download PDF
50. Palliative care and inpatient neurology: Where to next?
- Author
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Benzi M. Kluger and James L. Bernat
- Subjects
medicine.medical_specialty ,Inpatients ,Neurology ,Palliative care ,Illness trajectory ,business.industry ,Palliative Care ,Article ,03 medical and health sciences ,0302 clinical medicine ,Family medicine ,Medicine ,Humans ,Disease ,030212 general & internal medicine ,Neurology (clinical) ,Medical diagnosis ,business ,Psychosocial ,Referral and Consultation ,030217 neurology & neurosurgery - Abstract
OBJECTIVES: To compare characteristics and needs of inpatients with neurologic disease to those with cancer referred for palliative care (PC) consultation. METHODS: This prospective cohort study used data collected by the Palliative Care Quality Network from January 2013 until December 2016. We compared demographics, reasons for consultation, discharge disposition, Palliative Performance Scale (PPS) score, and outcomes of care among patients with a primary diagnosis of neurologic disease vs cancer. RESULTS: The most common reason for PC consultation in all patients was assistance with goals of care and advanced care planning. PC consultation was less often requested for pain and symptom management in patients with neurologic disease compared to patients with cancer (13.7% vs 43%, odds ratio 0.3) and more often for assistance with transition to comfort measures only and withdrawal of life-sustaining treatment (19.1% vs 7.1%, odds ratio 1.3). Patients with cancer had higher PPS scores (42.1% vs 23.4%) and were more likely to be discharged home from the hospital, while patients with neurologic disease were more likely to die in hospital. CONCLUSIONS: Patients with neurologic disease as a reason for PC consultation are more in need of end-of-life care planning and more likely to die in the hospital than those with cancer, suggesting that targeted approaches may best address the needs of each patient population. Our results can direct further research and education in neuropalliative care.
- Published
- 2019
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