bluuebunny/crossref_metadata_2025 huggingface dataset:
Iron Deficiency in two Adolescents with Conduct, Dysthymic and Movement Disorders
Authors: Tu Jun-Bi , Shafey Hany , Vandewetering Cathy
Published: April 2017

Enquiry into a marginally subnormal hemogram in two adolescents with complex conduct, dysthymic and movement disorders uncovered a striking iron deficiency and prompted a trial of replacing psychotropic medication with iron therapy. The rationale of iron therapy for behavioural disturbance was examined from the clinical, neurochemical and psychopharmacological points of view. Although further study is required to confirm the therapeutic efficacy and to define the precise nature of iron deficiency in conduct disorder, the weight of the evidence suggests that correcting the nutrient deficit may be an essential step toward a refinement of therapeutic strategies. The presence of a borderline hemogram, hypermenorrhea and malnutrition should alert clinicians to the possibility of iron deficiency, and laboratory screening for hypoferremia should be considered when assessing conduct disorder.
The Effect of Testosterone on Psychopathology and Sexual Function in a Paranoid Schizophrenic Self-Castrate
Authors: Cooper A. J. , Swamy G.N.
Published: April 2017

It has been suggested that the administration of androgens to paranoid schizophrenics who castrate themselves because of religious delusions and sexual guilt might exacerbate the psychosis and increase the risk of further self-mutilation. We administered testosterone enanthate to such a case intermittently during his 12 week hospital stay and studied simultaneously, psychopathology (Brief Psychiatric Rating Scale and clinical assessment), hormone levels and sexual behaviours. Sexual behaviours increased in line with increased serum testosterone levels; psychopathology declined. Following his discharge, he was managed on a regime of phenothiazines and monthly testosterone injections. After one year, he was enjoying normal heterosexual activities (without guilt) although his extreme religiosity had not declined.
A Neural Network Model of Cortical Information Processing in Schizophrenia. I: Interaction between Biological and Social Factors in Symptom Formation
Authors: Chen Eric Y.H.
Published: April 2017

Exploiting the biological and psychological plausibility of parallel distributed processing, a neural network model of cortical processing is proposed in order to provide a framework for understanding pathological processes in schizophrenia. Major psychosocial and neurobiological factors are assigned to appropriate parameters in the model. Behaviour of the network is explored through simulation, in particular interaction between the temperature and memory loading parameters is studied. The emergent network behaviour provides a model for complex interaction between dopaminergic activity, cortical and hippocampal pathology, and psychosocial factors in the production of psychotic symptoms. This integrative model provides an account of a wide range of observations in schizophrenia. It also produces testable predictions concerning cognitive performance and the course of schizophrenia.
The Treatment of Avoidant Personality Disorder by Social Skills Training in the Clinic or in Real-Life Settings
Authors: Stravynski Ariel , Belisle Marc , Marcouiller Marielle , Lavallée Yvon-Jacques , Eue Robert
Published: April 2017

Twenty-eight outpatients who met DSM-III diagnostic criteria for avoidant personality disorder completed 14 one and a half hour sessions of social skills training in the clinic only or a combination of four sessions in the clinic, four sessions in real-life and six follow-up sessions in the clinic. Subjects were assessed before treatment began, after four sessions, at the end of treatment and at three month follow-up points. Training in real-life did not enhance social skills training; no significant difference between the groups at any assessment points was found. In both groups improvement in time was significant and clinically worthwhile. The treatment effects were maintained up to the three month follow-up, where available. Social skills training appears to be a useful and promising intervention for avoidant personality disorder but its long term impact remains to be investigated.
A Five Year Review of Youth Suicide in Manitoba
Authors: Sigurdson Eric , Staley Douglas , Matas Manuel , Hildahl Keith , Souair Kathy
Published: April 2017

Suicide is the second leading cause of death in adolescents. The suicide rate in the 15 to 24 year old age group has increased at a faster rate than in any other age group. This study is a descriptive and retrospective investigation of 204 files from the Chief Medical Examiner's office of all youths aged 24 years and less in the province of Manitoba who committed suicide between 1984 and 1988. The study found a high male to female ratio, a large number of younger adolescents and a suicide rate in the Native population which was ten times that of non-Natives. The method of suicide varied by gender and race. Males more often used hanging and guns; females were more likely to overdose. Natives tended to hang themselves more than non-Natives, while non-Natives more often used guns. The highest percentage of Native suicides occurred in urban areas. Depression and substance abuse were identified as risk factors. A number of recommendations regarding information gathering post-suicide, as well as prevention and intervention programs are proposed.
Mandatory Training in Geriatric Psychiatry: Can Programs Deliver the Goods?
Authors: Herrmann Nathan
Published: April 2017

There have been a number of recent attempts to establish guidelines and curricula for training of general psychiatry residents in geriatric psychiatry. However, concerns have arisen as to whether or not many training programs have the resources necessary to train residents using these guidelines. In an attempt to deterrmine how closely training guidelines are adhered to, the Division of Geriatric Psychiatry at the University of Toronto anonymously surveyed all general psychiatry residents completing their mandatory training in geriatric psychiatry between June 1992 and July 1993 (N = 30). The supervisors of these residents were surveyed anonymously as well (N = 15). The response rate was 83% for the residents and 80% for staff. In general, the training guidelines were closely adhered to except possibly for the required number of patient contact hours per week. The author concludes that when training guidelines are developed which include consideration of appropriate program resources and the number of residents required to train, residents and supervisors adhere closely to these guidelines.
Frequency of Electroconvulsive Therapy Use at a Provincial Mental Hospital: A Retrospective Study
Authors: Karagianis James
Published: April 2017

In this retrospective study the frequency of electroconvulsive therapy use in the Waterford Hospital, a provincial mental hospital over a period of 14 years is examined. The results indicate that the use of electroconvulsive therapy has declined significantly. The three local general hospitals, St. Claire's Mercy Hospital, The Grace Hospital and the General Hospital have also experienced a decline in the use of electroconvulsive therapy. The potential reasons for this decline are explored and the findings are discussed particularly in the context of a 1986 study that found high rates of electroconvulsive therapy use at the Waterford Hospital.
Relation Entre Dépression, Tempérament Et Trouble De Personnalité: Quelques Implications Thérapeutiques
Authors: Leblanc Jean , Streit Ursula , Tanguay Yolande
Published: April 2017

Certain personality traits or disorders in combination with clinical signs complicate the diagnosis and treatment of depression. The approaches to the relationships between personality and mood disorders vary. Some see important links between normal personality types (or temperaments) and depression, while others see certain temperaments as sub-syndromic variants of mood disorders. Finally, a third approach proposes an analysis, drawing on Robins and Guze's criteria, of the validity of psychiatric diagnoses for determining whether this frequent comorbidity of depression and personality disorders (DSM-III) is consistent with a nosologic relationship, or is merely some definitional or other artefact. A category-based diagnostic approach provides little clarification; in some studies, a dimensional model attempts to better define the links between depression, temperament and personality and clarify the content of the apparently heterogeneous notion of depression, with therapeutic implications. Research in this area should lead to the development of increasingly specific therapeutic approaches to depression.
Factors Complicating the Diagnosis of Depression in Cerebrovascular Disease, Part Ii — Neurological Deficits and Various Assessment Methods*
Authors: Ramasubbu Rajamannar , Kennedy Sidney H.
Published: April 2017

Neurological deficits associated with cerebrovascular disease such as aphasia, dementia, anosognosia and aprosodia may impair the ability to express or experience depressive symptoms. Identification of depression in the absence of verbal report on subjective mood state is a difficult task. The value of various diagnostic methods including depressive rating scales, standard psychiatric interviews and biological variables in the diagnosis of depression in cerebrovascular disease is considered. This review concludes by focusing on the deficiencies of existing approaches in the diagnostic assessment of depression in patients with severe communication and comprehension deficits and emphasizes the importance of devising a standard diagnostic method with less reliance on verbal responses.
Psychosocial Impact of Laryngectomy Mediated by Perceived Stigma and Illness Intrusiveness*
Authors: Devins Gerald M. , Stam Henderikus J. , Koopmans Janice P.
Published: April 2017

In addition to prolonging life, successful treatment by laryngectomy also results in functional disability (loss of speech) and physical disfigurement (stoma). It was hypothesized that these after-effects contribute to perceived stigma which, in turn, compromises quality of life. The hypothesis that the psychosocial impact of perceived stigma operates through illness intrusiveness — ilthess-induced disruptions that interfere with continued involvements in valued activities and interests — was tested. Data were collected from 51 laryngectomy recipients via standardized interviews. As hypothesized, results indicated that: 1. both perceived stigma and illness intrusiveness are related to psychosocial well-being and emotional distress; 2. illness intrusiveness mediates the relation between perceived stigma and psychosocial outcomes; 3. the psychosocial impact of illness intrusiveness is most devastating in the context of highly stigmatized self-perception; and 4. unique profiles of illness intrusiveness across individual life domains may be associated with specific psychosocial outcomes. Findings are discussed in relation to the hypothesis that illness intrusiveness is a common underlying determinant of the psychosocial impact of chronic illness.
Social Dysfunction and Mental Illness in a Community Sample
Authors: Thompson A.H. , Bland Roger C.
Published: April 2017

The purpose of this study was to determine the extent of the association between psychiatric disorders and various social problems. The Diagnostic Interview Schedule was administered to a community sample of 3258 individuals and the association between eight “core” psychiatric disorders and eight social problem behaviours was determined. The results confirmed findings from many clinical studies that had previously found a strong relationship between social problem behaviours and mental illness. However, certain disorders tended to be associated with specific problems. In addition, a positive association was found between the number of social problems exhibited and the prevalence of psychiatric disorder. These data suggest the presence of a common underlying factor (or factors) and call into question the common practice of creating separate services for each definable social problem that arises.
Homicide D'Enfant Commis Par la Mère
Authors: Jacques D. Marleau , Roy Renée , Laporte Line , Webanck Thierry , Poulin Bernard
Published: April 2017

Using data gathered at the Institut Philippe Pinel in Montréal, we shall describe the sociodemographic and psychiatric profile of a sample of 17 women who have killed (n = 14) or attempted to kill (n = 3) one of their children. Our data indicate that women who have committed this type of offence generally come from a disadvantaged socioeconomic environment. Most have a psychiatric history (evaluation and/or hospitalization). Review of the offence demonstrates that most women do not use a weapon to kill their child; the preferred methods are strangulation or drowning. Most of these offences may be classified as extended suicide or altruistic acts. Several of the women present with a severe personality disorder and an additional depressive episode in the context of the offence. We hope our study will help clarify understanding of filicide and assist in the development of certain prevention axes. These results indicate that the population at large and various intervenors in our society (family physicians, psychiatrists, criminologists, social workers, pediatricians, psychologists, gynecologists) must become increasingly vigilant and avoid trivialization of signals such as verbalization of homicidal thoughts about the child or recourse to certain disorganized behaviours.
The Use of Placebos in Clinical Trials for Acute Schizophrenia
Authors: Addington Donald
Published: April 2017

This review examines the scientific and ethical justification for the use of randomized concurrent placebo-controlled trials in the treatment of acute relapse in chronic, schizophrenia. A literature search was conducted, and the national regulatory authority was consulted. Many placebo-controlled studies of acute or chronic schizophrenia are being published and it is the official position of both the Canadian and US regulatory authorities that such studies are required for both scientific and ethical reasons. The specific strengths and limitations of placebo-controlled studies are reviewed. Examples, drawn from Canadian studies, are presented to illustrate their benefits. It is concluded that the use of placebos in the particular situation of acute or chronic schizophrenia is ethically and scientifically justified. It forms an essential component of a comprehensive drug evaluation for new antipsychotic medications.
The Influence of Gonadal Hormones on Periodicity of Obsessive-Compulsive Disorder
Authors: Weiss Margaret , Baerg Elizabeth , Wisebord Susan , Temple Julia
Published: April 2017

Objective

This paper reviews the evidence linking gonadal hormones and obsessive-compulsive disorder (OCD) symptoms.

Method

Four case reports of the relationship between obsessive-compulsive disorder symptoms and exogenous sex hormone changes are presented. These cases are reviewed within the context of other case reports and the literature on the relationship between serotonin, gonadal hormones and OCD.

Results

The authors suggest that there is a relationship between onset or exacerbation of OCD and changes in gonadal hormones.

Conclusion

Clinicians should carefully evaluate patients for exogenous and endogenous changes in gonadal hormones when evaluating onset or exacerbation of OCD.
The Effects of Changes in the Law concerning Mentally Disordered Offenders: The Alberta Experience with Bill C-30
Authors: Arboleda-Flórez J. , Crisanti A. , Holley H.L.
Published: April 2017

Objective

Until recently, the Criminal Code of Canada, enacted in 1892, stood stalwart to social, political and technological changes, particularly with respect to the regulations pertaining to the management of the mentally ill offender. This became more definitely so with the enactment of the Canadian Charter of Rights and Freedoms (1984) as many regulations in the Code about mentally ill offenders contravened the mandates contained in the Charter. The Supreme Court of Canada's decision on Regina v. Swain spurred the Federal Government to bring the regulations on the mentally ill offender into line with the Charter. The result was the enactment of Bill C-30 which was intended to dramatically change the way in which forensic psychiatry was practised in Canada. This paper presents the Alberta findings from a multi-site evaluation commissioned by the Federal Department of Justice to judge the effects of Bill C-30 on forensic health care practices.

Methods

Health records data were used to compare utilization patterns from the year prior to the enactment of Bill C-30 with the year following. In addition, qualitative data were obtained from key clinical and legal informants outlining implementation difficulties that they had experienced.

Results

Results support the judgement that Bill C-30 has not achieved its desired effects with respect to the length of the remand, and has resulted in an increased burden on hospitals and health care providers. In addition, an unanticipated finding was the increased use of the Mental Health Act which was considered to place forensic patients in a position of double jeopardy.
The Role of Research in Systems Reform
Authors: Donald A. Wasylenki , Paula N. Goering
Published: April 2017

Knowledge concerning the care of people with severe and persistent mental illness has grown dramatically, but that knowledge is seldom translated into improvements in care. The authors describe their involvement in three service delivery projects in Ontario and discuss how, by assuming multiple roles, they were able to ensure that planning and policy development were informed by current knowledge. In addition to being an investigator, such roles may include being an administrator, planner, consultant and advocate. The redevelopment of Whitby Psychiatric Hospital resulted in an innovative plan for a comprehensive, integrated service delivery system based upon community support services research. Implementation of the Graham Report in Ontario provided an array of district mental health plans which incorporate current knowledge with regard to service delivery. Ontario's mental health reform strategy represents a close connection between public policy and scientific information. The authors recommend that researchers be prepared to assume multiple roles in the service delivery field so as to reduce the gap between science and practice.
Immigrant Child and Adolescent Psychiatric Referrals: A Five-Year Retrospective Study of Asian and Caucasian Families
Authors: Roberts Nasreen , Cawthorpe David
Published: April 2017

Objective

Referrals to the Bradford (England) Child and Family Psychiatric Clinic were studied over a five-year period with the purpose of comparing native Caucasian and immigrant groups. Punjabi Moslems of Pakistani descent formed a majority of immigrant referrals.

Method

This immigrant sample was compared with native Caucasians matched for age and sex.

Results

Differences between these groups were found in the rates and sources of referral, together with family composition, diagnosis and adherence to treatment.

Conclusion

These results are discussed in terms of the influence of cultural background and gender socialization. This report makes suggestions with respect to service provision and the assessment of individuals from linguistically unassimilated ethnic minorities.
A Comparison of Comorbid Patterns in Treatment-Resistant Unipolar and Bipolar Depression
Authors: Sharma Verinder , Mazmanian Dwight , Persad Emmanuel , Kueneman Karen
Published: April 2017

Objective

To examine the occurrence of concomitant psychiatric disorders in patients with treatment-resistant unipolar and bipolar depression.

Method

Forty-nine patients participated as subjects. Twenty-four (49%) had unipolar depression and 25 (51%) had bipolar depression using DSM-III-R criteria. Structured clinical interviews were conducted with all patients. Chart reviews and interviews with family members were also carried out. Information relating to both current and lifetime diagnoses was obtained.

Results

Of the entire sample, 75.5% were found to have at least one other Axis I diagnosis and 46.9% had at least two additional Axis I diagnoses. The unipolar group had significantly more current comorbid diagnoses. When type of diagnoses was examined, unipolar patients had significantly more anxiety diagnoses at the time of the index episode, and over their entire lifetime. Bipolar patients had significantly more lifetime substance abuse diagnoses.

Conclusions

Axis I comorbidity appears to be differentially associated with treatment resistance in unipolar and bipolar depression.
Firesetting during the Preschool Period: Assessment and Intervention Issues
Authors: Hanson Mark , Mackay Sherri , Atkinson Leslie , Staley Shauna , Pignatiello Antonio
Published: April 2017

Objective

To describe a methodology of assessing preschoolers involved in firesetting incidents, and outline the psychiatric implications of firesetting incidents in young children.

Method

To outline The Arson Prevention Program for Children and present case vignettes.

Results

The heightened risk of burn injury or fatality in fires caused by young children is highlighted and practical suggestions for facilitating the immediate safety of the child and family are presented.

Conclusion

Despite the popular notion that fire interest and play is relatively benign in young children, the cases show that, as with older children, firesetting in preschoolers can be associated with serious child and/or family psychopathology.
Socio-Cultural Determinants of Psychiatric Symptomatology in James Bay Cree Children and Adolescents
Authors: Phil Regina Minde , Minde Klaus
Published: April 2017

Objective

To examine the type of psychiatric disorders found in 100 Cree children living in a Native community in northern Quebec.

Method

Standardized semi-structured interviews were given to all children and their caregivers, collecting 24 items of information.

Results

51% of the children did not qualify for a DSM-III-R diagnosis but their frequently severe behavioural symptoms could be categorized by using 5 types of socio-cultural disturbances. There were also significant correlations between parental educational level, including length of time spent away from home, and the number of stress factors the children had been exposed to.

Conclusion

There is a need to develop a diagnostic classification for child psychiatric disorders for aboriginal children.
The Acute Management of Aggressive Behaviour in Hospitalized Children and Adolescents
Authors: Toby J Measham
Published: April 2017

Objective

To examine how health care professionals attempt to manage acutely aggressive behaviours exhibited by children and adolescents in various hospital settings.

Method

A review of the literature examining management techniques on child psychiatric and pediatric wards is presented. Techniques reviewed include pharmacotherapy, psychotherapy, seclusion, restraint and the use of pro re nata (prn) medications.

Results

Effects of various management techniques are presented, where available.

Conclusion

There is little evidence for the effectiveness of most presently used acute management techniques in containing aggressive child behaviours over the long term. Suggestions for improved evaluation of management techniques are made.
A Single Mothers' Group for Mothers of Children Attending an Outpatient Psychiatric Clinic: Preliminary Results
Authors: Jane E Mcnamee , Ellen L Lipman , Hicks Frances
Published: April 2017

Objectives

To provide a preliminary report of data from 2 support groups for single mothers, all of whom were mothers of children attending a child outpatient psychiatric clinic. The groups' 2 purposes were: 1. to assess the feasibility of adding structured evaluation to a common clinical intervention; 2. to improve single mothers' parenting skills through raised levels of self-esteem, increased capacity for family functioning and reduced levels of depression.

Method

Three structured evaluation instruments were used to measure the domains of self-esteem, family functioning and depression. These instruments were given to both groups of women on 3 occasions: 1. before the group; 2. after the group; 3. at a follow-up session 4 months after group termination. Open-ended questions were also asked at group termination.

Results

The questionnaire response rate was 100%; overall response rate for the 3 open-ended questions was 89%. Comparisons of pre-group and post-group scores showed that there was a significant increase in self-esteem (p < 0.01) and significant improvements in family functioning (p < 0.05) and depression (p < 0.01).

Conclusion

It is possible to introduce a structured evaluation component into a common clinical intervention, and this support group seemed to assist single mothers' parenting skills. Methodologic concerns and future directions are discussed.
Folie Simultanée in Monozygotic Twins
Authors: White Thomas G
Published: April 2017

Objective

To present a case report of folie simultanée in monozygotic twins. The literature describing folie à deux in twins is also reviewed and the common clinical findings are presented.

Method

Case presentation and review of the literature.

Results

Clinical observations of monozygotic twins with folie simultanée suggest that the delusions tend to progress over time with each twin reinforcing the delusion in the second.

Conclusions

The concept of a delusion resonating between individuals may account for the rapid progression and escalation of these delusions.
Looking at Legislative and Judicial Views of Psychic Trauma - Fluctuating Recognition and Discrimination
Authors: Hoffman Brian F
Published: April 2017

Objective

To describe how Canadian courts and legislation have viewed psychic or emotional trauma in the past century and the principles that are used.

Methods

The author reviews major trends in legislation and judicial findings pertaining to emotional trauma and gives examples of the fluctuating and ambivalent recognition by the courts.

Results

The courts have progressed from refusing to acknowledge emotional trauma, to accepting emotional trauma when accompanied by physical trauma, and finally acknowledging emotional trauma even in the absence of physical injury and the “indirect” emotional trauma suffered by the relatives of victims. However, from time to time, the courts or legislation may appear to deny the distress, dysfunction or the rights of a person who suffers significant emotional symptoms after an injury. This occurred recently in Ontario where injured persons in motor vehicle accidents who suffered emotional trauma were not allowed to sue for compensation from June 1990 to January 1994. Combined efforts by a coalition of mental health professionals with victims of trauma at least partially reversed the discriminatory laws.

Conclusions

Psychiatrists must continue to play a vital role in the education of the courts, politicians and the public about the realities of emotional trauma and mental illness and their long-term impact so that fair compensation can be assessed by the courts and discriminatory legislation reversed.
Clinical Management of Tourette's Syndrome and Associated Disorders
Authors: Sandor P
Published: April 2017

Objective

To review the clinical management of Tourette's syndrome (TS) and the associated disorders, namely obsessive-compulsive disorder (OCD) and attention deficit hyperactivity disorder (ADHD) with an emphasis on the pharmacologic intervention strategies.

Method

English language literature on the pharmacologic management of TS and the associated disorders published between 1985 and 1994 was critically reviewed.

Results

Pharmacologic management was placed in the context of the overall clinical management. Pharmacologic strategies for treatment of TS, OCD and ADHD were organized according to the therapeutic agent class.

Conclusions

The treatment of TS and its associated disorders requires the application of the full range of psychiatric skills to achieve a favourable outcome.
Conceptual Models and Integrative Therapy: Anorexia Nervosa as a Prototype
Authors: Greben Daniel H , Kaplan Allan S
Published: April 2017

Objective

To demonstrate how an integrative approach to psychiatric treatment can confer specific advantages.

Method

The impact of conceptual models on clinical information processing and therapeutic intervention, and the potential benefits resulting from the incorporation of multiple treatment modalities are outlined. These principles are applied using anorexia nervosa (AN) as a prototypical disorder.

Results

A brief structured review of the broad range of models which have been applied to AN illustrates the impact of conceptualization on outcome. The opportunity for positive integrative effects in the treatment of AN are demonstrated. They are seen to be related to 6 factors: flexibility, patient-treatment matching, stage-treatment matching, facilitation, complementarity, and synergism.

Conclusion

Integrative methods can address some limitations in clinical information processing associated with the exclusive application of a single conceptual model. Positive integrative effects are demonstrated in the context of AN; however, the approach is recommended for more general application.
Experimental investigation on separation control by slot jet in highly loaded compressor cascade
Authors: Jiaguo Hu , Rugen Wang , Renkang Li , Chen He , Qiushi Li
Published: April 2017

Separation control in compressor cascade is very significant for modern high efficiency compressor. This paper introduces a separation control approach using self-supplied jet in a highly loaded cascade. A novel arc slot is created into the cascade at the full span range, which connects the flow fields between the pressure and suction side. Because of the pressure difference, the slot enables to induce the jet flow into the suction side separation. Experiments are conducted to evaluate the separation control effects and preliminarily study the mechanism. The results show that the slot cascade acquires more ordered outflow by reducing the suction side separation and suppressing the complex vortices. Due to the great reduction of the separation, the total loss significantly decreases by 21.9% and the flow turning angle increases by 2.1° in average. According to the improvements of the cascade performance, the stable operating margin of the highly loaded cascade is greatly improved at least 3° in terms of the incidence angle.
Informed consent and the aftermath of cardiopulmonary resuscitation: Ethical considerations
Authors: Bjorklund Pamela , Lund Denise M
Published: April 2017

Background:

Patients often are confronted with the choice to allow cardiopulmonary resuscitation (CPR) should cardiac arrest occur. Typically, informed consent for CPR does not also include detailed discussion about survival rates, possible consequences of survival, and/or potential impacts on functionality post-CPR.

Objective:

A lack of communication about these issues between providers and patients/families complicates CPR decision-making and highlights the ethical imperative of practice changes that educate patients and families in those deeper and more detailed ways.

Design:

This review integrates disparate literature on the aftermath of CPR and the ethics implications of CPR decision-making as it relates to and is affected by informed consent and subsequent choices for code status by seriously ill patients and their surrogates/proxies within the hospital setting. Margaret Urban Walker’s moral philosophy provides a framework to view informed consent as a practice of responsibility.

Ethical considerations:

Given nurses’ communicative skills, ethos of care and advocacy, and expertise in therapeutic relationships, communication around DNAR decision-making might look quite different if institutional norms in education, healthcare, law, and public policy held nurses overtly responsible for informed consent in some greater measure.

Findings:

Analysis from this perspective shows where changes in informed consent practices are needed and where leverage might be exerted to create change in the direction of deeper and more detailed discussions about CPR survival rates and possible consequences of survival.
The overexpression of Rabl3 is associated with pathogenesis and clinicopathologic variables in hepatocellular carcinoma
Authors: Pan Yuhang , Liu Zhiyong , Feng Zhiying , Hui Dayang , Huang Xiangqi , Tong Dayue , Jin Yi
Published: April 2017

Overexpression of Rabl3 is associated with some malignancies. However, their relationship with hepatocellular carcinoma remains unclear. In this study, the expression of Rabl3 in hepatocellular carcinoma cell lines, and four pairs of matched hepatocellular carcinoma tissues and their adjacent normal hepatic tissues were detected by quantitative reverse transcription polymerase chain reaction and western blot. In addition, the protein expression of Rabl3 was examined in 162 cases of hepatocellular carcinoma by immunohistochemistry. Rabl3 in hepatocellular carcinoma cell lines was elevated at both messenger RNA and protein levels, and the Rabl3 protein was significantly upregulated by upto 3.3-fold in hepatocellular carcinoma compared with the paired normal hepatic tissues. Immunohistochemical analysis revealed that overexpressions of Rabl3 were 80.2% in hepatocellular carcinoma. Rabl3 is expressed at significantly higher rates in hepatocellular carcinoma compared with adjacent normal hepatic tissue (p < 0.01). Statistical analysis suggested the upregulation of Rabl3 was significantly associated with lymph node metastasis, tumor thrombus of the portal vein, and advanced clinical stage (p < 0.05). Furthermore, we found that overexpression of Rabl3 in hepatocellular carcinoma cells could significantly enhance cell proliferation and growth ability. Conversely, silencing Rabl3 by small hairpin RNA interference caused an inhibition of cell proliferation and growth. Our studies suggest that the Rabl3 is a valuable marker of hepatocellular carcinoma progression and that the overexpression of Rabl3 plays an important role in the development and pathogenesis of hepatocellular carcinoma.
Proteomic identification of potential biomarkers for cervical squamous cell carcinoma and human papillomavirus infection
Authors: Qing Song , Tulake Wuniqiemu , Ru Mingfang , Li Xiaohong , Yuemaier Reziwanguli , Lidifu Dilare , Rouzibilali Aierken , Hasimu Axiangu , Yang Yun , Rouziahong Reziya , Upur Halmurat , Abudula Abulizi
Published: April 2017

It is known that high-risk human papillomavirus infection is the main etiological factor in cervical carcinogenesis. However, human papillomavirus screening is not sufficient for early diagnosis. In this study, we aimed to identify potential biomarkers common to cervical carcinoma and human papillomavirus infection by proteomics for human papillomavirus–based early diagnosis and prognosis. To this end, we collected 76 cases of fresh cervical tissues and 116 cases of paraffin-embedded tissue slices, diagnosed as cervical squamous cell carcinoma, cervical intraepithelial neoplasia II–III, or normal cervix from ethnic Uighur and Han women. Human papillomavirus infection by eight oncogenic human papillomavirus types was detected in tissue DNA samples using a quantitative polymerase chain reaction. The protein profile of cervical specimens from human papillomavirus 16–positive squamous cell carcinoma and human papillomavirus–negative normal controls was analyzed by proteomics and bioinformatics. The expression of candidate proteins was further determined by quantitative reverse transcriptase-polymerase chain reaction and immunohistochemistry. We identified 67 proteins that were differentially expressed in human papillomavirus 16–positive squamous cell carcinoma compared to normal cervix. The quantitative reverse transcriptase-polymerase chain reaction analysis verified the upregulation of ASAH1, PCBP2, DDX5, MCM5, TAGLN2, hnRNPA1, ENO1, TYPH, CYC, and MCM4 in squamous cell carcinoma compared to normal cervix ( p < 0.05). In addition, the transcription of PCBP2, MCM5, hnRNPA1, TYPH, and CYC was also significantly increased in cervical intraepithelial neoplasia II–III compared to normal cervix. Immunohistochemistry staining further confirmed the overexpression of PCBP2, hnRNPA1, ASAH1, and DDX5 in squamous cell carcinoma and cervical intraepithelial neoplasia II–III compared to normal controls ( p < 0.05). Our data suggest that the expression of ASAH1, PCBP2, DDX5, and hnRNPA1, and possibly MCM4, MCM5, CYC, ENO1, and TYPH, is upregulated during cervical carcinogenesis and potentially associated with human papillomavirus infection. Further validation studies of the profile will contribute to establishing auxiliary diagnostic markers for human papillomavirus–based cancer prognosis.
MicroRNA-140-5p inhibits cell proliferation and invasion by regulating VEGFA/MMP2 signaling in glioma
Authors: Hu Yuan , Li Yanyan , Wu Chun , Zhou Liang , Han Xiaoxiao , Wang Qingyue , Xie Xueshun , Zhou Youxin , Du Ziwei
Published: April 2017

Glioma is the most common primary malignant tumor of the central nervous system, which results in both a poor prognosis and outcome because of the aggressive progression of disease, growth and resistance to surgery, chemotherapy, and radiotherapy. MiR-140-5p is a small, non-coding single-stranded RNA molecule, which was previously studied in the settings of human tongue cancer, hepatocellular carcinoma, and colorectal cancer. However, detailed data that formally demonstrate the contribution of miR-140-5p to glioma development are missing. Similarly, relatively little is known about the relationship of miR-140-5p, vascular endothelial growth factor A, and matrix metalloproteinase-2 in glioma progression. In this study, we found that miR-140-5p expression was significantly decreased in glioma tissues and in the glioma cell-lines U87 and U251 as compared with non-cancerous brain tissues by quantitative real-time polymerase chain reaction. In addition, miR-140-5p inhibited glioma cell proliferation and invasion and promoted glioma cell apoptosis both in vivo and in vitro. Interestingly, while the expression levels of miR-140-5p were higher in glioma cells, the messenger RNA or protein expression levels of vascular endothelial growth factor A and matrix metalloproteinase-2 were lower in glioma cells as determined by quantitative real-time polymerase chain reaction, western blot assay, and immunohistochemistry. By contrast, downregulation in the expression levels of miR-140-5p augmented the messenger RNA and protein expression levels of both vascular endothelial growth factor A and matrix metalloproteinase-2. These findings suggested that miR-140-5p inhibited glioma proliferation and invasion by regulating the vascular endothelial growth factor A/matrix metalloproteinase-2 signaling pathway both in vitro and in vivo.
Bauerenol, a triterpenoid from Indian Suregada angustifolia: Induces reactive oxygen species–mediated P38MAPK activation and apoptosis in human hepatocellular carcinoma (HepG2) cells
Authors: Sathish Kumar Perumal , Viswanathan Madepalli Byrappa Gowdu , Venkatesan Muthappan , Balakrishna Kedike
Published: April 2017

The triterpenoid, bauerenol, from Suregada angustifolia (Baill. ex Muell.-Arg.) Airy Shaw (Euphorbiaceae) was screened for anti-cancer property using hepatocellular carcinoma cell line, HepG2. Bauerenol exhibited growth inhibitory and apoptosis inducing potential against HepG2 cancer cells. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide cytotoxic assay revealed that bauerenol treatment significantly reduced the growth of HepG2 cells in a time- and dose-dependent manner with 50% growth inhibitory concentration doses of 45 and 25 µg/mL at 24 and 48 h treatments, respectively. Bauerenol-induced cell death reflected apoptotic morphological features, that is, cell membrane blebbing, vacuolization, chromatin condensation, and nuclear fragmentation. In addition, bauerenol treatment diminished the mitochondrial membrane potential, by inducing the efflux of cytochrome c, downregulating the levels of anti-apoptotic Bcl-2 as well as upregulating the levels of pro-apoptotic Bax, and inducing caspase activation and poly (ADP-ribose) polymerase cleavage. Moreover, bauerenol treatment activates p38MAPK and inactivates the anti-apoptotic kinases Akt and ERK1/2 through the induction of reactive oxygen species. Furthermore, bauerenol-mediated S-phase arrest was associated with downregulation of cell cycle-rate-limiting factor (cyclin D1) and upregulation of cyclin-dependent kinase inhibitor p21 and tumor suppressor p53. Interestingly, pre-treatment of cells with reactive oxygen species inhibitor and p38 inhibitor significantly decreases bauerenol-induced cytotoxicity, Bax upregulation, and p38 activation. This study clearly states that bauerenol induces cell cycle arrest and apoptosis through the reactive oxygen species–dependent p38MAPK activation in HepG2 cancer cells.
Decreased expression of hsa_circ_0001895 in human gastric cancer and its clinical significances
Authors: Shao Yongfu , Chen Linbo , Lu Rongdan , Zhang Xinjun , Xiao Bingxiu , Ye Guoliang , Guo Junming
Published: April 2017

Circular RNAs are a special class of endogenous RNAs characterized by jointing 3′ and 5′ ends together via exon or intron circularization. Recent studies found that circular RNAs are involved in the development of some human diseases. However, little is known about their roles in human gastric cancer. In this study, we chose hsa_circ_0001895 as a targeted circRNA to investigate its clinical significances in gastric cancer patients. Hsa_circ_0001895 expression levels in five gastric cancer cell lines and 257 specimens of tissues were measured by real-time quantitative reverse transcription polymerase chain reaction. Then, the potential relationship between hsa_circ_0001895 expression levels and patients’ clinicopathological factors was investigated. A receiver operating characteristic curve was constructed for evaluating the diagnostic value of hsa_circ_0001895. Hsa_circ_0001895 expression levels in five detected gastric cancer cell lines (AGS, BGC-823, HGC-27, MGC-803, and SGC-7901) were all significantly downregulated than those in normal gastric epithelial GES-1 cells. Besides, compared with healthy control tissues, it was downregulated not only in 69.8% (67/96) gastric cancer tissues but also in gastric precancerous lesions. Moreover, hsa_circ_0001895 expression levels were significantly correlated with cell differentiation, Borrmann type, and tissue carcino-embryonic antigen expression. Our results suggested that hsa_circ_0001895 may play crucial roles during gastric cancerogenesis and is a potential biomarker for clinical prognosis prediction.
Beam damage uncertainty quantification using guided Lamb wave responses
Authors: Wang Gang
Published: April 2017

In this article, a Bayesian inference approach is applied to conduct uncertainty quantification on notch damage in a beam structure using guided Lamb wave responses. The proposed methodology not only determines the notch damage characteristics but also quantifies associated uncertainties of these inferred values. The correlation between crack location and extent is investigated as well, because such information is essential for decision-making in the structural health monitoring applications. First, a spectral finite element model is used to characterize Lamb wave propagation responses in a beam under lead-zirconate-titanate actuation and sensing. Very few elements are required to accurately capture the wave propagation. The lead-zirconate-titanate sensor can pick up the reflected wave responses from both boundaries and damages. Total 18 simulation cases were generated by varying notch damage extent, damage location, and noise level. Second, the Markov Chain Monte Carlo techniques are employed to estimate the notch damage location and extent from guided Lamb wave responses, in which the random walk metropolis algorithm is used. Finally, both crack size/location and associated uncertainties are characterized. In summary, the proposed probabilistic damage detection is successfully demonstrated in beam structures using guided wave responses, which can be extended to other structural health monitoring applications.
Testing a New Intervention With Incarcerated Women Serving Life Sentences
Authors: Fedock Gina , Kubiak Sheryl , Bybee Deborah
Published: April 2017

Purpose:

Incarcerated women serving life sentences are a growing subpopulation with multiple mental health needs. However, no existing interventions have been designed for or tested with this population.

Method:

This study tested a gender-responsive, trauma-informed intervention ( Beyond Violence) and examined changes in incarcerated women’s mental health and anger expression. Pre-, post-, and follow-up surveys were administered to two treatment groups with women with life sentences ( n = 26). Multilevel modeling was conducted to assess changes over time for women’s mental health and anger expression and to compare outcomes for women based on time served.

Results:

Significant positive outcomes were found for all women for some anger measures, and women who had been in prison for less than 10 years started with higher scores on multiple measures and showed significant changes over time.

Discussion:

This study offers insight into social work practice, policy advocacy, and research for this population of women.
On the Need for Methods Beyond Proceduralism: Speculative Middles, (In)Tensions, and Response-Ability in Research
Authors: Springgay Stephanie , Truman Sarah E.
Published: April 2017

This article responds to agitations occurring in qualitative research related to the incompatability between methodologies and methods, the preponderance of methodocentrism, the pre-supposition of methods, a reliance on data modeled on knowability and visibility, the ongoing emplacement of settler futurity, and the dilemma of representation. Enmeshments between ontological thought and qualitative research methodologies have rigorously interrogated the logic of anthropocentrism in conventional humanist research methods and have provoked some scholars to suggest that we can do away with method. Rather than a refusal of methods, we propose that particular (in)tensions need to be immanent to whatever method is used. If the intent of inquiry is to create a different world, to ask what kinds of futures are imaginable, then (in)tensions need attend to the immersion, friction, strain, and quivering unease of doing research differently.
The future of scientific workflows
Authors: Deelman Ewa , Peterka Tom , Altintas Ilkay , Carothers Christopher D , van Dam Kerstin Kleese , Moreland Kenneth , Parashar Manish , Ramakrishnan Lavanya , Taufer Michela , Vetter Jeffrey
Published: April 2017

Today’s computational, experimental, and observational sciences rely on computations that involve many related tasks. The success of a scientific mission often hinges on the computer automation of these workflows. In April 2015, the US Department of Energy (DOE) invited a diverse group of domain and computer scientists from national laboratories supported by the Office of Science, the National Nuclear Security Administration, from industry, and from academia to review the workflow requirements of DOE’s science and national security missions, to assess the current state of the art in science workflows, to understand the impact of emerging extreme-scale computing systems on those workflows, and to develop requirements for automated workflow management in future and existing environments. This article is a summary of the opinions of over 50 leading researchers attending this workshop. We highlight use cases, computing systems, workflow needs and conclude by summarizing the remaining challenges this community sees that inhibit large-scale scientific workflows from becoming a mainstream tool for extreme-scale science.