bluuebunny/crossref_metadata_2025 huggingface dataset:
“IT'S NOT JUST ABOUT THE PATIENT, IT'S THE FAMILIES TOO”: END-OF-LIFE CARE IN THE HOME ENVIRONMENT
Authors: Brooks JM , Bravington A , Hardy B , Melvin J , King N
Published: February 2015

Introduction

Most people when asked say they would prefer to die at home. However, ‘Death in Usual Place of Residence’ (DiUPR) does not give any real insight into the quality and experiences of care received. Additionally, DiUPR involves other family members resident in the home environment and their needs, preferences and experiences also need consideration.

Aim(s) and method(s)

The aim of this work was to explore the experiences of patients and informal caregivers receiving at-home care from a specialist palliative care service. We undertook individual interviews with 11 patients and 10 significant others. We used the Pictor technique, a novel interview tool used to sensitively explore networks of support and experiences of palliative care. Interviews were analysed thematically.

Results

Caring for a loved one at home was acknowledged as draining, but participants were effusive about the excellent at-home professional support they received from the specialist service. The care provided evidently recognised the needs of both patients and their families. Effective co-ordination of care, including liaison with other services was especially appreciated.

Conclusion(s)

With increasing trends towards DiUPR, it is vital that there are sufficient well-resourced palliative care services available in the community to support both patients and their families at the end of life. Pictor is a useful means to obtain detailed insight into individual experiences of end of life care. Care co-ordination emerged as key concern for patients receiving End of Life Care and their families.
ORGANISATIONAL FACTORS INFLUENCING UPTAKE OF A CARER SUPPORT NEEDS ASSESSMENT TOOL IN PALLIATIVE HOME CARE
Authors: Austin L , Ewing G , Grande G
Published: February 2015

Introduction

The Carer Support Needs Assessment Tool (CSNAT) is a comprehensive, evidence-based tool for carer assessment and support. Successful implementation requires a change from existing practitioner led approaches to carer assessment to one which is facilitated by the practitioner, but led by the carer.

Aim(s) and method(s)

To identify organisational factors which facilitate or hinder implementation of the CSNAT. The CSNAT was implemented in 6 palliative home care services. Qualitative data were collected via interviews (15), focus groups (2) and workshops (3), with practitioner ‘champions’ and service managers. All were audio-recorded, transcribed and analysed thematically.

Results

Uptake of the CSNAT varied between services and was influenced by the receptivity of the context into which it was introduced. ‘Organisational preparedness’, with regard to existing administration systems, working patterns and competing demands, was a key factor. Additionally, facilitation to support implementation of the CSNAT was paramount; this included ‘internal facilitation’ from within the service (e.g. clear organisation steer) and ‘external facilitation’ from the research team (e.g. provision of training and on-going support).

Conclusion(s)

The study identified two main factors which influence effective implementation of the CSNAT: a) receptivity of the organisational context and b) level of facilitation). These findings are in keeping with theory and practice models relating to sustainable implementation of practice developments. Further work is underway to explore how organisations can best be supported when implementing the CSNAT.

Funder NIHR Research for Patient Benefit.
MARIE CURIE PALLIATIVE CARE DEMENTIA SERVICE—AN EVALUATION OF PROCESSES, OUTCOMES AND IMPACT AFTER THE FIRST YEAR OF OPERATION
Authors: Borkowska Monika
Published: February 2015

Introduction

Access to the end of life care received for patients with dementia and their carers is of paramount importance–by 2021 the number of people with dementia in Wales is projected to increase by 31%. Currently, inappropriate hospital admissions are common and patients are less likely to be referred to palliative care services. Primarily this is because patients and carers are infrequently informed of the terminal nature of dementia and advance planning discussions are rare.

The Marie Curie Palliative Care Dementia Service has been developed to; support dementia patients in achieving their preferred place of care and death, other health and social care professionals in understanding and meeting the needs of dementia patients at the end of their lives.

Having reached its first year of operations, an evaluation has been conducted to establish the impact of the service thus far.

Aim(s) and method(s)

The evaluation has been conducted through the analysis of service performance data, case notes, and interviews with carers, patients, primary and secondary care professionals, using content analysis.

Results

This paper will focus on the primary aims of the MCPC Dementia services; processes, outcomes and impact. Service performances and outcomes will be presented against relevant frameworks for end of life care for dementia, and the impact of the service on patients, their carers, and NHS services will also be.

Conclusion(s)

This paper will conclude with its vision for the future direction and development of the MCPC Dementia service, outlining its recommendations for palliative care for dementia patients.
THE EXPERIENCES OF CAREGIVERS OF PATIENTS WITH DELIRIUM AND THEIR ROLE IN ITS MANAGEMENT IN A PALLIATIVE CARE SETTING
Authors: Lugton J , Finucane A M , Kennedy C , Spiller J
Published: February 2015

Introduction

Delirium remains the most common and distressing neuropsychiatric complication in patients with advanced cancer. This study examines the experiences of caregivers of patients with delirium and their role in its management. It explores evidence for interventions that improve support for these caregivers and which help them support the patient.

Aim(s) and method(s)

An integrative literature review was undertaken. Four databases were searched using the terms ‘delirium’, ‘terminal restlessness’ or ‘terminal agitation’ combined with ‘carer’ or ‘caregiver’, ‘family’ or ‘families’. Twenty five papers were included in the final review.

Results

Distress is experienced by many caregivers of patients with delirium. Fear, anger, disappointment and sadness are common. However, caregivers potentially play an important role in caring for patients with delirium in (i) prevention and detection of delirium ii) acting as advocates for patients, and iii) assisting in monitoring patient symptoms. Caregivers desire more information about delirium and advice on how to behave towards patients during a delirium episode however there is little evidence for specific interventions in this regard.

Conclusion(s)

Caregiver focused interventions need to be developed and evaluated to determine the type of approaches that help the caregiver support the patient, and increase support for caregivers themselves.
THE USE OF MEDICATIONS IN THE LAST 24 HOURS OF LIFE IN THE ACUTE HOSPITAL SETTING—A DESCRIPTIVE COMPARISON OF CANCER AND NON CANCER PATIENTS USING DATA FROM THE NATIONAL CARE OF THE DYING AUDIT HOSPITALS—ENGLAND (NCDAH) 2013/14
Authors: Tewani K , Mulholland H , Gambles M , Lowe D , Husk J , Stewart K , Ellershaw J
Published: February 2015

Introduction

International consensus exists for the use of 4 key drugs pertinent to care of the dying and the use of CSCI is advocated, where appropriate, to support patient comfort. In the NCDAH 2008/09, 54% of 3,893 patients had CSCI prescribed; of these 1026 were cancer patients (67% of all cancer patients) and 1080 were non-cancer patients (46% of all non-cancer patients).

Aim(s) and method(s)

Aim: to explore medications and dosages prescribed via CSCI in the last 24 hours of life for cancer and non-cancer patients.

Using clinical data from 6,580 cases (from 149 sites) reported within the NCDAH 2013/14, combinations and doses of drugs given via CSCI in the last 24 hours of life were analysed descriptively.

Results

CSCI prescribed for 1,850 (28%) patients. 722 were cancer patients; 1128 were non-cancer patients (representing 46% and 22% of all cancer and non-cancer patients, respectively). Non-cancer patients were older (83 vs 74) and had recognition of ‘dying’ earlier (75 hours vs 62 hours prior to death). The 4 key drugs were regularly prescribed. Most (both groups) received 2 or 3 drugs; most common 2 drug combination – sedative (usually Midazolam) and opiate (usually Morphine). Median doses – Midazolam (both groups) – 10 mg over 24 hours; Opiates: Morphine – cancer 15 mg, non-cancer 10 mg; Diamorphine – cancer 12.5 mg, non-cancer 10 mg; Oxycodone – cancer 20 mg, non-cancer 10 mg.

Conclusion(s)

The use of CSCI is around half of that in 2008/9. Type of drugs administered was similar in both groups. Dose of opiates for non-cancer patients was lower on average.
Postcards from the Front
Authors: Boyd C. Trenton , Jones Bruce Vivash
Published: February 2015

Postcards provide an original insight into many aspects of human activity, including veterinary medicine. C. Trenton Boyd has collected a unique archive of some 8000 postcards from all over the world, dealing with almost every veterinary situation. Of these, over 1000 deal with the First World War, with about 600 directly related to the British Army and animal charities. Bruce Vivash Jones provides an outline of the war illustrated by a selection of images from the C. Trenton Boyd Postcard Collection
Piecing together the puzzle of perilipin proteins and skeletal muscle lipolysis
Authors: MacPherson Rebecca E.K. , Peters Sandra J.
Published: February 2015

The regulation of skeletal muscle lipolysis and fat oxidation is a complex process involving multiple proteins and enzymes. Emerging work indicates that skeletal muscle PLIN proteins likely play a role in the hydrolysis of triglycerides stored in lipid droplets and the passage of fatty acids to the mitochondria for oxidation. In adipocytes, PLIN1 regulates lipolysis by interacting with comparative gene identification-58 (CGI-58), an activator of adipose triglyceride lipase (ATGL). Upon lipolytic stimulation, PLIN1 is phosphorylated, releasing CGI-58 to activate ATGL and initiate triglyceride breakdown. The absence of PLIN1 in skeletal muscle leads us to believe that other PLIN family members undertake this role. The focus of this review is on the PLIN family proteins expressed in skeletal muscle: PLIN2, PLIN3, and PLIN5. To date, most studies involving these PLIN proteins have used nonmuscle tissues and cell cultures to determine their potential roles. Results from work in these models support a role for PLIN proteins in sequestering lipases during basal conditions and in potentially working together for lipase translocation and activity during lipolysis. In skeletal muscle, PLIN2 tends to mirror the lipid content and may play a role in lipid droplet growth and stability through lipase interactions on the lipid droplet surface, whereas the skeletal muscle roles of both PLIN3 and PLIN5 seem to be more complex because they are found not only on the lipid droplet, but also at the mitochondria. Clearly, further work is needed to fully understand the intricate mechanisms by which PLIN proteins contribute to skeletal muscle lipid metabolism.
Determination of phenazopyridine in biological fluids using electromembrane extraction followed by high-performance liquid chromatography
Authors: Fotouhi Lida , Yamini Yadollah , Hosseini Razieh , Rezazadeh Maryam
Published: February 2015

Recently, electro-assisted extraction of ionic drugs from biological fluids through a supported liquid membrane and into an aqueous acceptor solution was introduced as a new sample preparation technique and has been termed electromembrane extraction (EME). In the present work, this microextraction technique combined with high-performance liquid chromatography and ultraviolet detection has been developed for detection of phenazopyridine (PP) as a local analgesic drug in human plasma and urine samples. From a 6.5 mL neutral aqueous sample, PP was extracted for 20 min through a thin supported liquid membrane of 2-nitrophenyl octyl ether sustained in the pores of the wall of a porous hollow fiber and into an aqueous acidic acceptor solution (25 μL, containing negative electrode) by application of a DC electrical potential. The effects of several factors, including the nature of organic solvent, HCl concentration in donor and acceptor solutions, stirring speed, extraction time, and applied voltage on the extraction efficiency of the drug, were investigated and optimized. Satisfactory linearity ranges with correlation coefficients higher than 0.996 in different extraction media, admissible limits of detection (0.5 and 1.0 ng mL−1 in urine and plasma samples, respectively) and good repeatability and reproducibility (intra- and inter-assay precisions ranged between 3.7%–6.8% and 8.8%–12.5%, respectively) were obtained. The optimized EME procedure was applied to determine the concentration of PP in various matrices, such as plasma and urine samples, and satisfactory results were obtained.
Protonated heterocyclic derivatives of cyclopropane and cyclopropanone: classical species, alternate sites, and ring fragmentation
Authors: Miranda Margarida S. , Duarte Darío J.R. , Esteves da Silva Joaquim C.G. , Liebman Joel F.
Published: February 2015

A computational study has been performed for protonated oxygen- or nitrogen-containing heterocyclic derivatives of cyclopropane and cyclopropanone. We have searched for the most stable conformations of the protonated species using density functional theory with the B3LYP functional and the 6-31G(2df,p) basis set. More accurate enthalpy values were obtained from G4 calculations. Proton affinities and gas-phase basicities were accordingly derived.
Discharge and flow field of the circular channel along the side weir
Authors: Azimi Hamed , Hadad Hazhar , Shokati Zakarya , Salimi Mohammad Sajad
Published: February 2015

The side weir is one of the most important hydraulic structures that is used by hydraulic engineers for adjusting and controlling flow in urban waste collection systems, irrigation and drainage networks. In this study, an equation is proposed for computing side weir discharge located on circular channels. The equation computes the side weir discharge with sufficient accuracy. Then, the RNG k–ε turbulence model is used for simulating the turbulence of the flow field and the free surface flow variations are modeled using volume of fluid scheme. Comparing experimental results with numerical simulations indicates acceptable accuracy of the numerical model. Also, the side weir discharge coefficients, flow free surface variation, behavior of dividing stream surface and variations of stagnation point height for different discharges within a circular channel along a side weir were examined.
Short-term effects of mastication on fuel moisture and thermal regime of boreal fuel beds
Authors: Schiks Tom , Thompson Dan K. , Wotton B. Mike
Published: February 2015

Mechanical mastication is becoming a common fuel management treatment to reduce vertical fuel connectivity, as well as crown fire initiation and potential fire-line intensity, but the moisture dynamics of these novel fuel types have been largely unstudied. We recorded concurrent in situ meteorological observations with moisture and temperature profiles (at depths of 5 and 13 cm) for masticated fuel beds in three treatments in a lodgepole pine (Pinus contorta Dougl. var. latifolia Engelm.) – black spruce (Picea mariana (Mill.) B.S.P.) boreal stand located in the Upper Foothills of west-central Alberta. Mulch at the 5 cm depth remained at or near 100% moisture content for a majority of the observation period within the treatment that lacked any residual canopy cover. Only during a 10-day rain-free period was substantial drying observed at a depth of 5 cm. At the interface with the underlying duff layer, mulch remained at upwards of 150% moisture content. Drying was typically <10% of potential evaporation rates, except on days after rain, when drying equal to 25%–100% of potential evaporation was observed. Thermal properties of the mulch showed approximately five times the thermal diffusivity of soils, but less than a fuel crib, suggesting that masticated fuel beds have a thermal and moisture regime more similar to soils than fuel cribs, with a diffusion-dominated regime enhanced by minor advection. Low moisture movement observed from depth to the surface promoted highly variable surface moisture that created surface mulch with temperatures far in excess of air temperatures during periods of full sun. Such excess temperatures are shown to be an efficient indicator of surface dryness and high ignition probability.
Pleiotropic preconditioning-like cardioprotective effects of hypolipidemic drugs in acute ischemia–reperfusion in normal and hypertensive rats
Authors: Ravingerová Táňa , Ledvényiová-Farkašová Veronika , Ferko Miroslav , Barteková Monika , Bernátová Iveta , Pecháňová Ol’ga , Adameová Adriana , Kolář František , Lazou Antigone
Published: February 2015

Although pleiotropy, which is defined as multiple effects derived from a single gene, was recognized many years ago, and considerable progress has since been achieved in this field, it is not very clear how much this feature of a drug is clinically relevant. During the last decade, beneficial pleiotropic effects from hypolipidemic drugs (as in, effects that are different from the primary ones) have been associated with reduction of cardiovascular risk. As with statins, the agonists of peroxisome proliferator-activated receptors (PPARs), niacin and fibrates, have been suggested to exhibit pleiotropic activity that could significantly modify the outcome of a cardiovascular ailment. This review examines findings demonstrating the impacts of treatment with hypolipidemic drugs on cardiac response to ischemia in a setting of acute ischemia–reperfusion, in relation to PPAR activation. Specifically, it addresses the issue of susceptibility to ischemia, with particular regard to the preconditioning-like cardioprotection conferred by hypolipidemic drugs, as well as the potential molecular mechanisms behind this cardioprotection. Finally, the involvement of PPAR activation in the mechanisms of non-metabolic cardioprotective effects from hypolipidemic drugs, and their effects on normal and pathologically altered myocardium (in the hearts of hypertensive rats) is also discussed.
Review of physics results from the Tevatron
Authors: Bandurin D. , Bernardi G. , Gerber C. , Junk T. , Juste A. , Kotwal A. , Lewis J. , Mesropian C. , Schellman H. , Sekaric J. , Toback D. , Van Kooten R. , Vellidis C. , Zivkovic L.
Published: February 2015

We present a comprehensive review of the physics results obtained by the CDF and D0 collaborations up to summer 2014, with emphasis on those achieved in the Run II of the Tevatron collider which delivered a total integrated luminosity of ~10 fb-1 at [Formula: see text]. The results are presented in six main physics topics: QCD, Heavy Flavor, Electroweak, Top quark, Higgs boson and searches for New Particles and Interactions. The characteristics of the accelerator, detectors, and the techniques used to achieve these results are also briefly summarized.
Stability analysis of a two-phase suspension between rotating porous cylinder with the radial flow
Authors: Wang Feng-Hui , Zhu Yu-Chuan , Wan Zhan-Hong , He Song
Published: February 2015

The hydrodynamic stability analysis of viscous flow between rotating porous cylinder has been researched for a long time by many researchers. But little works have been carried out about the linear stability analysis of the two-phase suspension. When the radial flow is present, the linear hydrodynamic stability analysis of suspension has been carried out between rotating porous cylinder. We know that the continuous and Stokes equations cannot only solve the stability problem of the continuous fluid phase, but also solving the stability problem of the discontinuous particle phase. The stability equations from an eigenvalue problem that was solved by a numerical technique based on Wan's method. The results reveal that the radial Reynolds number have a great effect on the critical Taylor number in the suspension. In this paper, we also researched on how the critical Taylor number changes as the radius ratio η, the axial wave number k, the particle concentration and the circumferential direction wave number happen to change with the radial Reynolds number increasing range from -5 to 5. Thus, our research discovered the radial inflow and outflow have a stabilizing effect on the two-phase suspension and the circumferential direction wave number also has a stabilizing effect.
Synthesis, structural and magnetic behavior of undoped andMn-doped anataseTiO2nanoparticles
Authors: Mahmood Asif , Ramay Shahid M. , Al-Zaghayer Yousef S. , Atiq Shahid , Saleem Murtaza , Al Masary Waheed A. , Haider Sajjad
Published: February 2015

Ti1-xMnxO2(x = 0, 0.05) nanoparticles have been synthesized using chemically derived self-propagating combustion reaction method. X-ray diffraction studies demonstrate the formation of anatase phase of TiO2belonging to 141/amd space group in both samples without the formation of any impurity phase. The incorporation of 5 at.% Mn content does not produce any changes in crystal structure which reveals the exact substitution of Mn atoms at Ti sites. Some change in lattice parameters and crystallite size is observed in Mn -doped composition, attributed to the difference in ionic radii. The size of grains obtained using scanning electron micrographs shows the consistent trend with the crystallite size evaluated from X-ray diffraction analysis. Energy dispersive X-ray analysis confirms the incorporation of Mn content in TiO2structure. Ferromagnetic behavior detected only in Mn -doped TiO2composition correspond to the strong Mn  d-shell contribution.
Mechanical properties prediction for carbon nanotubes/epoxy composites by using support vector regression
Authors: Cheng W. D. , Cai C. Z. , Luo Y. , Li Y. H. , Zhao C. J.
Published: February 2015

Studies have shown there are several process/geometry parameters affecting the mechanical properties of the carbon nanotubes/epoxy composites. The relationship between the response and process/geometry parameters is highly nonlinear and quite complicated. It is very valuable to have an accurate model to estimate the response under different process/geometry parameters. In this paper, the support vector regression (SVR) combined with particle swarm optimization (PSO) for its parameter optimization was employed to construct mathematical models for prediction of mechanical properties of the carbon nanotubes/epoxy composites according to an experimental data set. The leave-one-out cross-validation (LOOCV) test results by SVR models support that the generalization ability of SVR model is high enough. The statistical mean absolute percentage error for tensile strength, elongation and elastic modulus are 3.96%, 3.14% and 2.62%, the correlation coefficients (R2) achieve as high as 0.991, 0.990 and 0.997, respectively. This study suggests that the established SVR model can be used to accurately foresee the mechanical properties of carbon nanotubes/epoxy composites and can be used to optimize designing or controlling of the experimental process/geometry in practice.
GROWTH OF MALIGNANT CELLS AND THERMODYNAMICS
Authors: KARALIS T. K. , KARALIS KONSTANTINOS T. , PAPAVASILEIOY KONSTANTINA N.
Published: February 2015

In the present paper, certain thermodynamic relations are considered to study tumor growth and how the mechanisms, responsible for the cell killing by temperature change in abnormal cells, can be estimated from direct measurements, during evolution of a tumor. The problem is considered in its most general form and the discussion focuses on how significant results can be estimated from: (i) The stress system acting on the tumor, tumor pressure and tumor volume changes measured by ultra-sonic computerized tomography, (ii) entropy change and entropy production, measured from the heat capacity profiles, and (iii) the chemical potential changes measured by fluorescent labeling techniques; all of them supported by other techniques based on histo-chemical and microscopic methods.
Synthesis and anti-cancer activities of a water soluble gold(III) porphyrin
Authors: Lammer Aaron D. , Cook Melissa E. , Sessler Jonathan L.
Published: February 2015

Gold(III) compounds continue to be explored for their potential utility as anticancer agents. A recognized limitation is the reactivity of gold(III), which is typically reduced to the more labile gold(I) state under physiological conditions. The use of porphyrins can overcome this problem. However, to date the stabilization provided by the use a strongly chelating porphyrin is offset by the poor solubility of the resulting complex in aqueous media. In this work, we describe the synthesis and in vitro anti-cancer activity of a gold(III)porphyrin complex with relatively good aqueous solubility. As judged from standard antiproliferation assays, this complex displays an IC50 of 9 μM for the A2780 human ovarian cancer cell line. This is a higher level of potency than displayed by two related control systems.
Reactions of a heme-superoxo complex toward a cuprous chelate and •NO(g):CcOand NOD chemistry
Authors: Sharma Savita K. , Rogler Patrick J. , Karlin Kenneth D.
Published: February 2015

Following up on the characterization of a new (heme) FeIII-superoxide species formed from the cryogenic oxygenation of a ferrous-heme ( PPy) FeII(1) ( PPy= a tetraarylporphyrinate with a covalently tethered pyridine group as a potential axial base), giving ( PPy) FeIII- O2•-(2) (Li Y et al., Polyhedron 2013; 58: 60–64), we report here on (i) its use in forming a cytochrome c oxidase ( C c O ) model compound, or (ii) in a reaction with nitrogen monoxide (•NO; nitric oxide) to mimic nitric oxide dioxygenase (NOD) chemistry. Reaction of (2) with the cuprous chelate [ CuI( AN )][ B ( C6F5)4] (AN = bis[3-(dimethylamino)propyl]amine) gives a meta-stable product [Formula: see text] (3a), possessing a high-spin iron(III) and Cu ( II ) side-on bridged peroxo moiety with a μ-η2:η2-binding motif. This complex thermally decays to a corresponding μ-oxo complex [( PPy) FeIII-( O2-)- CuII( AN )][ B ( C6F5)4] (3). Both (3) and (3a) have been characterized by UV-vis,2H NMR and EPR spectroscopies. When (2) is exposed to •NO(g), a ferric heme nitrato compound forms; if 2,4-di-tert-butylphenol is added prior to •NO(g)exposure, phenol ortho-nitration occurs with the iron product being the ferric hydroxide complex ( PPy) FeIII( OH ) (5). The latter reactions mimic the action of NOD's.
Payments for Watershed Services as Adaptation to Climate Change: Upstream Conservation and Downstream Aquifer Management
Authors: Roumasset James , Wada Christopher A.
Published: February 2015

Economically optimal groundwater extraction allocates water over space and time to its highest and best social use. But optimal management of water resources also requires optimal investment in watershed capital, even as the climate is changing. We augment a standard coastal groundwater management model with stock-dependent extraction costs to include recharge-enhancing natural and produced capital whose depreciation can be offset by investment in each period. In some parts of the world, including Hawaii, results from climate models suggest that mean annual rainfall will decrease but that the frequency of storms may increase. In the case of coastal aquifers, the implication is that runoff to the ocean will increase and groundwater recharge will decrease. Accordingly, the groundwater-extraction/watershed-investment problem is further extended to allow natural recharge to decline in response to climate change. The tendency of falling recharge is partially offset by increasing investment in watershed capital. If precipitation decreases sufficiently, however, it may be that optimal conservation eventually declines as the cost of increasing groundwater recharge correspondingly increases. Thus adaptation to climate change may involve an initial stage of increased conservation investment followed by controlled depreciation of natural capital. That is, instruments of adaptation may become increasingly ineffective as climate change progresses.
SUBMITTING ILLUMINATIONS FOR REVIEW
Authors: Rodenbaugh David W. , Collins Heidi L. , Dicarlo Stephen E.
Published: February 2015

As educators, we are continually designing new methods and procedures to enhance learning. During this process, good ideas are frequently generated and tested, but the extent of such activities may not be adequate for a full manuscript. Nonetheless, the ideas may be quite beneficial in improving the teaching and learning of physiology. Illuminations is a column designed to facilitate the sharing of these ideas (illuminations). The format of submissions is quite simple: a succinct description of about one or two double-spaced pages (less title and authorship) of something you have used for the classroom, teaching, lab, conference room, etc. You may include one or two simple figures or references. Submit ideas for inclusion in Illuminations directly to the Associate Editor in charge, Stephen DiCarlo (sdicarlo@med.wayne.edu).
Collaborative testing enhances student learning
Authors: Rao Sumangala P. , Collins Heidi L. , DiCarlo Stephen E.
Published: February 2015

Examinations and quizzes should be used as learning as well as assessment tools. To achieve this goal, an assessment procedure was developed to enhance as well as assess student learning. Students were tested on four different topics of cardiovascular physiology. Each topic was tested by a different type of quiz (fill in the blanks, single best response multiple choice, short essay, or true/false). The students first completed a quiz individually. Once the quiz was completed individually, the students completed the same quiz in groups. Eighty percent of the score on the quiz was based on the individual results, and 20% of the score on the quiz was based on the group results. The performance on the quizzes was significantly higher ( P < 0.001) when students completed the quizzes in groups than when they completed the quizzes individually. Results document that completing the quizzes in groups enhances the understanding of the material. In addition, students rated this format superior to the traditional method.
A simple and inexpensive apparatus for measuring fish metabolism
Authors: Bolduc Martin , Lamarre Simon , Rioux Pierre
Published: February 2015

A simple, noninvasive, and economical home-made respirometer has been used to determine the standard metabolism of goldfish. The apparatus has been tested on several fishes and has proved its accuracy in determining a mass effect on standard metabolism. The apparatus can be made easily by middle school, high school, and undergraduate students and can be used to introduce them to basic concepts in animal physiology and in biological statistics.
STUDENTS’ COLLEGES AND ACHIEVEMENT IN AN ADVANCED COURSE
Authors: Zolman James F. , Ott Cobern E.
Published: February 2015

The aim of the present study was to determine whether a significant relationship exists between a student’s college (Allied Health, Arts and Science, Education, and Graduate School) and achievement in an advanced-level course in human physiology (PGY 412G). The mean percentage of correct answers on four multiple-choice tests, collectively totaling 400 points, was used to assess each student’s performance. A four (college)-by-three (academic year) analysis of variance was used for statistical comparisons among 660 students enrolled in PGY 412G from the fall semester of 1995 through the spring semester of 1998. Subsequent pairwise comparisons tests found that the College of Education students had a significantly lower mean percentage of correct answers (61%) compared with students in each of the other colleges ( P < 0.001). No significant differences in percentage scores were found among students enrolled in Allied Health (78%), Arts and Science (78%), or the Graduate School (77%). Also, percentages of correct answers averaged across all students were significantly lower during the 1997–1998 academic year than those in either the 1996–1997 year ( P < 0.001) or the 1995–1996 year ( P < 0.05). Students’ scores during these two earlier years did not differ significantly. Upward letter grade adjustments based on class distributions were made each semester, and more As and Bs and fewer Cs and Ds were given as course grades than expected from an absolute assessment scale. This grade inflation benefited low-scoring students from all colleges, particularly those students enrolled in the College of Education. To improve the understanding of human function of these low-scoring students may require special educational programs.
ALDOSTERONE
Authors: Booth Rachell E. , Johnson John P. , Stockand James D.
Published: February 2015

Aldosterone plays a pivotal role in electrolyte and fluid homeostasis and thus control of blood pressure. The “classical” view of aldosterone action is that it targets epithelia of the distal colon and renal nephron to stimulate Na+(re)absorption and K+secretion. In these cells, aldosterone binds steroid receptors, promoting translocation to the nucleus, where they modulate gene expression with the induced proteins stimulating transport. This “genomic” action is dependent on transcription and translation and has a latency of 0.5–1.0 h. Recently, more rapid actions of aldosterone that are independent of transcription and translation have been described. These “nongenomic” actions are mediated by a distinct receptor that is insensitive to inhibitors of the classical mineralocorticoid receptor, such as spironolactone. The present review describes advances in our understanding of the classical model of aldosterone action as well as those that broaden this model to encompass nongenomic actions, nonepithelial targets, production of aldosterone outside of the adrenal gland, novel mechanisms of specificity, and novel mechanisms for mediating genomic actions.
Compensatory glomerular growth after unilateral nephrectomy is VEGF dependent
Authors: Flyvbjerg Allan , Schrijvers Bieke F. , De Vriese An S. , Tilton Ronald G. , Rasch Ruth
Published: February 2015

Various growth factors and cytokines have been implicated in different forms of kidney enlargement. Vascular endothelial growth factor (VEGF) is essential for normal renal development and plays a role in diabetic glomerular enlargement. To explore a possible role for VEGF in compensatory renal changes after uninephrectomy, we examined the effect of a neutralizing VEGF-antibody (VEGF-Ab) on glomerular volume and kidney weight in mice treated for 7 days. Serum and kidney insulin-like growth factor I (IGF-I) levels were measured, since IGF-I has been implicated in the pathogenesis of compensatory renal growth, and VEGF has been suggested to be a downstream mediator of IGF-I. Placebo-treated uninephrectomized mice displayed an early transient increase in kidney IGF-I concentration and an increase in glomerular volume and kidney weight. In VEGF-Ab-treated uninephrectomized animals, increased glomerular volume was abolished, whereas renal hypertrophy was partially blocked. Furthermore, the renal effects of VEGF-Ab administration were seen without affecting the renal IGF-I levels. In conclusion, these results demonstrate that compensatory glomerular growth after uninephrectomy is VEGF dependent.
Role of human liver, kidney, and skeletal muscle in postprandial glucose homeostasis
Authors: Meyer Christian , Dostou Jean M. , Welle Stephen L. , Gerich John E.
Published: February 2015

Recent studies indicate a role for the kidney in postabsorptive glucose homeostasis. The present studies were undertaken to evaluate the role of the kidney in postprandial glucose homeostasis and to compare its contribution to that of liver and skeletal muscle. Accordingly, we used the double isotope technique along with forearm and renal balance measurements to assess systemic, renal, and hepatic glucose release as well as glucose uptake by kidney, skeletal muscle, and splanchnic tissues in 10 normal volunteers after ingestion of 75 g of glucose. We found that, during the 4.5-h postprandial period, 22 ± 2 g (30 ± 3% of the ingested glucose) were initially extracted by splanchnic tissues. Of the remaining 53 ± 2 g that entered the systemic circulation, 19 ± 3 g were calculated to have been taken up by skeletal muscle and 7.5 ± 1.7 g by the kidney (26 ± 3 and 10 ± 2%, respectively, of the ingested glucose). Endogenous glucose release during the postprandial period (16 ± 2 g), calculated as the difference between overall systemic glucose appearance and the appearance of ingested glucose in the systemic circulation, was suppressed 61 ± 3%. Surprisingly, renal glucose release increased twofold (10.6 ± 2.5 g) and accounted for ∼60% of postprandial endogenous glucose release. Hepatic glucose release (6.7 ± 2.2 g), the difference between endogenous and renal glucose release, was suppressed 82 ± 6%. These results demonstrate a hitherto unappreciated contribution of the kidney to postprandial glucose homeostasis and indicate that postprandial suppression of hepatic glucose release is nearly twofold greater than had been calculated in previous studies (42 ± 4%), which had assumed that there was no renal glucose release. We postulate that increases in postprandial renal glucose release may play a role in facilitating efficient liver glycogen repletion by permitting substantial suppression of hepatic glucose release.
Function-specific calcium stores selectively regulate growth hormone secretion, storage, and mRNA level
Authors: Johnson James D. , Klausen Christian , Habibi Hamid R. , Chang John P.
Published: February 2015

Ca+stores may regulate multiple components of the secretory pathway. We examined the roles of biochemically independent intracellular Ca2+stores on acute and long-term growth hormone (GH) release, storage, and mRNA levels in goldfish somatotropes. Thapsigargin-evoked intracellular Ca2+concentration ([Ca2+]i) signal amplitude was similar to the Ca2+-mobilizing agonist gonadotropin-releasing hormone, but thapsigargin (2 μM) did not acutely increase GH release, suggesting uncoupling between [Ca2+]iand exocytosis. However, 2 μM thapsigargin affected long-term secretory function. Thapsigargin-treated cells displayed a steady secretion of GH (2, 12, and 24 h), which decreased GH content (12 and 24 h), but not GH mRNA/production (24 h). In contrast to the results with thapsigargin, activating the ryanodine (Ry) receptor (RyR) with 1 nM Ry transiently increased GH release (2 h). Prolonged activation of RyR (24 h) reduced GH release, contents and apparent production, without changing GH mRNA levels. Inhibiting RyR with 10 μM Ry increased GH mRNA levels, production, and storage (2 h). Increasing [Ca2+]iindependently of Ca2+stores with the use of 30 mM KCl decreased GH mRNA. Collectively, these results suggest that parts of the secretory pathway can be controlled independently by function-specific Ca2+stores.
Function and dysfunction of aPKC isoforms for glucose transport in insulin-sensitive and insulin-resistant states
Authors: Farese Robert V.
Published: February 2015

Considerable evidence suggests that atypical protein kinase C isoforms (aPKCs), serving downstream of insulin receptor substrates and phosphatidylinositol (PI) 3-kinase, are required for insulin-stimulated glucose transport in skeletal muscle and adipocytes. More recent findings further suggest that aPKCs are activated and required for glucose transport responses while serving downstream of 1) proline-rich tyrosine kinase-2, extracellular signal-regulated kinase, and phospholipase D, as during the actions of high concentrations of carbohydrates (glucose, sorbitol) and agents that activate 5′-AMP-activated protein kinase (exercise, 5-amino-imidazole-4-carboxamide-1-β-d-riboside, dinitrophenol), and 2) Cbl-dependent PI 3-kinase, as during the action of insulin-sensitizing thiazolidinediones. It therefore seems reasonable to postulate that, regardless of the initial mechanism, aPKCs may serve as terminal molecular switches for activating glucose transport responses. This postulation is of critical importance, as it now appears that insulin-stimulated aPKC activation is compromised in various states of insulin resistance.
KATP channels and insulin secretion disorders
Authors: Huopio H. , Shyng S.-L. , Otonkoski T. , Nichols C. G.
Published: February 2015

ATP-sensitive potassium (KATP) channels are inhibited by intracellular ATP and activated by ADP. Nutrient oxidation in β-cells leads to a rise in [ATP]-to-[ADP] ratios, which in turn leads to reduced KATP channel activity, depolarization, voltage-dependent Ca2+ channel activation, Ca2+ entry, and exocytosis. Persistent hyperinsulinemic hypoglycemia of infancy (HI) is a genetic disorder characterized by dysregulated insulin secretion and, although rare, causes severe mental retardation and epilepsy if left untreated. The last five or six years have seen rapid advance in understanding the molecular basis of KATP channel activity and the molecular genetics of HI. In the majority of cases for which a genotype has been uncovered, causal HI mutations are found in one or the other of the two genes, SUR1 and Kir6.2, that encode the KATP channel. This article will review studies that have defined the link between channel activity and defective insulin release and will consider implications for future understanding of the mechanisms of control of insulin secretion in normal and diseased states.
IGF-I does not affect the net increase in GH release in response to arginine
Authors: Nass Ralf , Pezzoli Suzan S. , Chapman Ian M. , Patrie James , Hintz Raymond L. , Hartman Mark L. , Thorner Michael O.
Published: February 2015

Arginine stimulates growth hormone (GH) secretion, possibly by inhibiting hypothalamic somatostatin (SS) release. Insulin-like growth factor I (IGF-I) inhibits GH secretion via effects at the pituitary and/or hypothalamus. We hypothesized that if the dominant action of IGF-I is to suppress GH release at the level of the pituitary, then the arginine-induced net increase in GH concentration would be unaffected by an IGF-I infusion. Eight healthy young adults (3 women, 5 men) were studied on day 2 of a 47-h fast for 12 h (35th-47th h) on four occasions. Saline (Sal) or 10 μg · kg−1 · h−1recombinant human IGF-I was infused intravenously for 5 h from 37 to 42 h of the 47-h fast. Arginine (Arg) (30 g iv) or Sal was infused over 30 min during the IGF-I or Sal infusion from 40 to 40.5 h of the fast. Subjects received the following combinations of treatments in random order: 1) Sal + Sal; 2) Sal + Arg; 3) IGF-I + Sal; 4) IGF-I + Arg. Peak GH concentration on the IGF-I + Arg day was ∼45% of that on the Sal + Arg day. The effect of arginine on net GH release was calculated as [(Sal + Arg) − (Sal + Sal)] − [(IGF-I + Arg) − (IGF-I + Sal)]. There was no significant effect of IGF-I on net arginine-induced GH release over control conditions. These findings suggest that the negative feedback effect of IGF-I on GH secretion is primarily mediated at the pituitary level and/or at the hypothalamus through a mechanism different from the stimulatory effect of arginine.
Inducible nitric oxide synthase plays a role in LPS-induced hyperglycemia and insulin resistance
Authors: Sugita Hiroki , Kaneki Masao , Tokunaga Eriko , Sugita Michiko , Koike Chieko , Yasuhara Shingo , Tompkins Ronald G. , Martyn J. A. Jeevendra
Published: February 2015

The molecular mechanisms underlying endotoxin-induced insulin resistance remain unclear. Endotoxin or lipopolysaccharide (LPS) injection is a potent stimulator of inducible nitric oxide synthase (iNOS). This study in rats, using the specific iNOS inhibitor aminoguanidine, investigated the role of iNOS in endotoxin-induced hyperglycemia and insulin resistance. LPS injection led to hyperglycemia, insulin resistance, and increased iNOS protein expression and activity. Aminoguanidine prevented LPS-induced hyperglycemia without affecting insulin levels or iNOS expression. Aminoguanidine attenuated the LPS-induced insulin resistance, reflected by the requirement for a higher glucose infusion rate to maintain euglycemia during a hyperinsulinemic clamp study. Aminoguanidine completely blocked the LPS-elevated hepatic glucose output and also inhibited LPS-induced increases in hepatic glycogen phosphorylase activities and phospho enolpyruvate carboxykinase (PEPCK) mRNA expression, key enzymes for glycogenolysis and gluconeogenesis, respectively. Thus, these data demonstrate an important role for iNOS in LPS-induced insulin resistance, evidenced by the attenuation of LPS-induced hyperglycemia and reversal of increased hepatic glucose output by aminoguanidine. The protective effect of aminoguanidine on insulin resistance is probably by attenuation of hepatic glucose output via its inhibition of key enzymes for glycogenolysis and gluconeogenesis, including glycogen phosphorylase and PEPCK.
Activation of liver G-6-Pase in response to insulin-induced hypoglycemia or epinephrine infusion in the rat
Authors: Bady Isabelle , Zitoun Carine , Guignot Ludovic , Mithieux Gilles
Published: February 2015

This study was conducted to test the hypothesis of the activation of glucose-6-phosphatase (G-6-Pase) in situations where the liver is supposed to sustain high glucose supply, such as during the counterregulatory response to hypoglycemia. Hypoglycemia was induced by insulin infusion in anesthetized rats. Despite hyperinsulinemia, endogenous glucose production (EGP), assessed by [3-3H]glucose tracer dilution, was paradoxically not suppressed in hypoglycemic rats. G-6-Pase activity, assayed in a freeze-clamped liver lobe, was increased by 30% in hypoglycemia ( P < 0.01 vs. saline-infused controls). Infusion of epinephrine (1 μg · kg−1· min−1) in normal rats induced a dramatic 80% increase in EGP and a 60% increase in G-6-Pase activity. In contrast, infusion of dexamethasone had no effect on these parameters. Similar insulin-induced hypoglycemia experiments performed in adrenalectomized rats did not induce any stimulation of G-6-Pase. Infusion of epinephrine in adrenalectomized rats restored a stimulation of G-6-Pase similar to that triggered by hypoglycemia in normal rats. These results strongly suggest that specific activatory mechanisms of G-6-Pase take place and contribute to EGP in situations where the latter is supposed to be sustained.