bluuebunny/crossref_metadata_2025 huggingface dataset:
High-Q silica zipper cavity for optical radiation pressure driven MOMS switch
Authors: Tetsumoto Tomohiro , Tanabe Takasumi
Published: August 2014

We design a silica zipper cavity that has high optical and mechanical Q (quality factor) values and demonstrate numerically the feasibility of a radiation pressure driven micro opto-mechanical system (MOMS) directional switch. The silica zipper cavity has an optical Q of 4.0 × 104 and an effective mode volume Vmode of 0.67λ3 when the gap between two cavities is 34 nm. The mechanical Q (Qm) is determined by thermo-elastic damping and is 2.0 × 106 in a vacuum at room temperature. The opto-mechanical coupling rate gOM is as high as 100 GHz/nm, which allows us to move the directional cavity-waveguide system and switch 1550-nm light with 770-nm light by controlling the radiation pressure.
Concentration-dependent diffusion of ion-implanted silicon in In0.53Ga0.47As
Authors: Aldridge H. L. , Lind A. G. , Law M. E. , Hatem C. , Jones K. S.
Published: August 2014

In contrast to prior reports, evidence of concentration-dependent diffusion is reported for Si implanted In0.53Ga0.47As. The Fickian and concentration-dependent components of diffusivities were extracted using the Florida object oriented process and device simulator. The migration energy for silicon diffusion in In0.53Ga0.47As was calculated to be 2.4 and 1.5 eV for the Fickian and concentration dependent components of diffusion, respectively. A lack of change in diffusivities at given anneal temperatures suggest that transient-enhanced diffusion has not occurred. Due to these findings, silicon diffusion at high doping concentrations (>1 × 1020 cm−3) should be better characterized and understood for future complimentary metal-oxide semiconductor applications.
Tip radius preservation for high resolution imaging in amplitude modulation atomic force microscopy
Authors: Ramos Jorge R.
Published: August 2014

The acquisition of high resolution images in atomic force microscopy (AFM) is correlated to the cantilever's tip shape, size, and imaging conditions. In this work, relative tip wear is quantified based on the evolution of a direct experimental observable in amplitude modulation atomic force microscopy, i.e., the critical amplitude. We further show that the scanning parameters required to guarantee a maximum compressive stress that is lower than the yield/fracture stress of the tip can be estimated via experimental observables. In both counts, the optimized parameters to acquire AFM images while preserving the tip are discussed. The results are validated experimentally by employing IgG antibodies as a model system.
The Emerging Role of Metabolomics in the Development of Biomarkers for Pulmonary Hypertension and other Cardiovascular Diseases (2013 Grover Conference Series)
Authors: Lewis Gregory D.
Published: August 2014

The functional and prognostic significance of pulmonary hypertension (PH) is well established, yet our understanding of circulating peptides and metabolites that might mark or contribute to various forms of PH remains limited. Metabolites are the end result of all the regulatory complexity present in a cell, tissue, or organism and therefore serve as the most proximal reporters of the body's response to a disease process or drug therapy. This review presents the rationale, methodology, and preliminary findings from studies that apply comprehensive metabolite profiling to gain knowledge of new circulating markers of PH.
Clinical neurophysiology
Authors: Samandouras George
Published: August 2014

Chapter 1.2 covers nerve conduction studies (NCSs), EEG, and evoked potentials.
Magnetic resonance imaging
Authors: Samandouras George
Published: August 2014

Chapter 2.4 covers the basic concepts of magnetic resonance imaging (MRI), MR angiography (MRA), MR spectroscopy (MRS), MR perfusion (PWI), and MRI safety.
Fluid and electrolyte problems in neurosurgery
Authors: Samandouras George
Published: August 2014

Chapter 3.2 discusses fluid and electrolyte problems in neurosurgery, including fluid homeostasis disorders, sodium homeostasis disorders, potassium homeostasis disorders, calcium homeostasis disorders, magnesium homeostasis disorders, and acid-base disorders.
Spinal biomechanics for neurosurgeons
Authors: Samandouras George
Published: August 2014

Chapter 6.3 covers spinal biomechanics for neurosurgeons, including definitions, stability, instability, spinal stability after decompression, and spinal stability after fusion.
Cervical spine injuries
Authors: Samandouras George
Published: August 2014

Chapter 6.6 covers cervical spine injuries, including atlanto-occipital dislocation (AOD), occipital condyle fracture (OCF), fracture of the atlas: C1 (FOTA), fracture of the axis: C2 (FOAX), combination fractures: C1–C2, atlanto-axial instability (AAI), and subaxial cervical spine fractures.
Introduction to neuro-oncology
Authors: Samandouras George
Published: August 2014

Chapter 8.1 introduces neuro-oncology, including molecular biology for neurosurgeons, neuropathology for neurosurgeons, and the WHO classification (2007).
Radiotherapy and chemotherapy
Authors: Samandouras George
Published: August 2014

Chapter 8.2 covers basic concepts in radiotherapy, delivering radiotherapy, basic concepts in chemotherapy, and examples of chemotherapy agents.
Astrocytic tumours
Authors: Samandouras George
Published: August 2014

Chapter 8.3 covers astrocytic tumours, including pilocytic astrocytoma (PA), diffuse astrocytoma, anaplastic astrocytoma (AA), glioblastomamultiforme (GBM), and pleomorphic xanthoastrocytoma (PXA).
Metastatic tumours
Authors: Samandouras George
Published: August 2014

Chapter 8.15 covers metastatic tumours, focusing on epidemiology, pathology, imaging, clinical features, and treatment.
Cerebral blood flow
Authors: Samandouras George
Published: August 2014

Chapter 9.2 covers cerebral blood flow, including basic concepts, brain oedema, ischaemic brain disease, cerebral autoregulation, cerebral blood flow measurement, and cerebral blood flow imaging.
Principles of coiling and clipping
Authors: Samandouras George
Published: August 2014

Chapter 9.7 covers principles of coiling and clipping, including delayed complications and principles of clipping.
Cavernous malformations
Authors: Samandouras George
Published: August 2014

Chapter 9.12 covers cavernous malformations, focusing on epidemiology, clinical presentation, imaging, and treatment.
Cranial revascularization procedures
Authors: Samandouras George
Published: August 2014

Chapter 9.16 covers cranial revascularization procedures, including basic concepts, anterior circulation, and posterior circulation.
Cervical disc disease
Authors: Samandouras George
Published: August 2014

Chapter 16.5 covers cervical disc disease, including cervical spine fusion.
Low back pain
Authors: Samandouras George
Published: August 2014

Chapter 16.10 covers low back pain, including epidemiology, examination, imaging, treatment, surgical management of ALBP, operative technique for ALIF with cages, and operative technique for PLIF with pedicle screws.
Extradural spinal tumours
Authors: Samandouras George
Published: August 2014

Chapter 16.17 covers extradural spinal tumours, including benign spinal tumours, malignant spinal tumours, and metastatic spinal tumours.
Severe iron deficiency anaemia
Authors: Marks Daniel , Harbord Marcus
Published: August 2014

Implication of iron deficiency

Causes of iron deficiency

Overt or occult bleeding

Diagnosing iron deficiency

Presentation and investigations

Treatment

Anaemia of chronic disease

In the developed world, the commonest cause of iron deficiency anaemia (IDA) and its prelude iron deficiency is menstrual blood loss. Worldwide, hookworm infection is prevalent and causes IDA in those with heavy parasite load. About 4% of men/post-menopausal women have iron deficiency, and 1–2% have related IDA. Iron deficiency rises to ~20% in pre-menopausal women (remainder often have considerably reduced iron stores)....
Malnutrition and chronic gastrointestinal disease
Authors: Marks Daniel , Harbord Marcus
Published: August 2014

Anorexia and bulimia nervosa

Acute presentations of gastrointestinal malignancy

Short bowel syndrome

Protein-losing enteropathy

Other causes of severe malnutrition

Syndromes resulting from lack of essential nutrients

Eating disorders arise from a severe preoccupation with food and body image, leading to disturbed eating habits and impaired physical and psychosocial functioning. For diagnostic criteria, see ...
Assessment of liver function
Authors: Marks Daniel , Harbord Marcus
Published: August 2014

Interpretation of liver function tests

Imaging

Liver biopsy

The patient with persistently deranged liver function tests but normal investigations

Liver function tests (LFT) can be divided into markers of hepatocyte or biliary epithelial cell integrity (ALT, AST, ALP, γ‎GT), and those indicative of synthetic/metabolic function (albumin, INR/PTT, bilirubin, ammonia). In addition, hypoglycaemia, lactic acidosis, and elevated lactate dehydrogenase (LDH) can be non-specific markers of severe hepatic dysfunction....
Infections and the liver
Authors: Marks Daniel , Harbord Marcus
Published: August 2014

Infections and the liver

Liver abscesses

Bacterial infections

Parasitic infections

The liver in sepsis

The liver may be involved in direct infection or as part of a systemic illness. This chapter considers both processes. The viral hepatitides are covered in Chapter 14, and liver disease in HIV-infected patients in ...
Sleep and pain in children and adolescents
Authors: Dick Bruce D. , Corkum Penny , Witmans Manisha , Chambers Christine T.
Published: August 2014

Ongoing pain is a problem that affects a large number of children and adolescents. It has been well documented that recurrent and chronic pain are associated with many difficulties related to both physical and psychological function. A major difficulty that many young people with chronic or recurrent pain experience is disrupted sleep. Sleep problems have been reported to exist in as many as 50% or more of children with chronic illnesses (Owens, 2007). In many cases, pain is reported by the sufferers to cause sleep fragmentation as well as significant difficulties with delayed sleep onset. As well, there is increasing evidence that disrupted sleep is associated with increased pain. Both pain and sleep disruption further complicate the patient’s overall clinical picture by making it more difficult for children and teens to cope with health problems and associated difficulties. Further, there is evidence that childhood sleep problems can have important negative effects on adult sleep patterns and, thereby, influence health status later in life (Fricke-Oerkermann et al., 2007; Sivertsen et al., 2009). This chapter will address the prevalence, importance, and consequences of sleep problems in children and adolescents with pain. First, the prevalence and possible relationship between pain and sleep will be discussed. Next, we will highlight the assessment of sleep with a specific focus on assessment of sleep in paediatric pain populations. We will then review established and emerging medical and psychological treatment strategies used to effectively treat these important difficulties. Practical suggestions will also be provided as a general and basic guide for treatment of children and teens with pain and sleep problems.
Pain management in major paediatric trauma and burns
Authors: Palmer Greta M. , Babl Franz E.
Published: August 2014

Pain management in major paediatric trauma and burns is challenging. It involves many phases including pre-hospital and emergency department care, ward management frequently including intensive care, and multiple operative and procedural interventions (as inpatients and later outpatients). Distress, anxiety, post-traumatic stress disorder (from the primary event and the ensuing in-hospital and post-discharge course), itch, neuropathic pain (in addition to pain of nociceptive origin), and sleep disorders frequently affect major trauma and burns victims and can persist long term. An evidence-based discussion follows of the pharmacological and non-pharmacological interventions employed during these various phases to address pain and the associated issues in these patients.
Inflammatory arthritis and arthropathy
Authors: Chira Peter , Schanberg Laura E.
Published: August 2014

Musculoskeletal pain is a common symptom in inflammatory arthritides such as juvenile idiopathic arthritis; however, identifying the underlying pathological process is often challenging for health care providers due to the extensive differential diagnoses. In children with inflammatory arthritides, physical examination abnormalities including swelling and/or pain on movement and joint limitation accompany the pain at initial presentation. Control of disease activity through anti-inflammatories and other disease-modifying agents can limit disease progression and joint damage; however, pain may persist in spite of these measures. Optimal treatment of pain in juvenile idiopathic arthritis and related conditions is based on a biopsychosocial model, which addresses biological, environmental, and cognitive-behavioural factors. Analgesics such as opioids and neuropathic pain medications, in conjunction with other modalities such as pain coping skills training, aerobic exercise, and improved sleep hygiene may be appropriate in certain circumstances. Further research is needed to prospectively identify patients and families early in the course of disease who would benefit from additional support to optimize pain management and limit distress. In addition, future clinical trials should assess the impact of study interventions on pain as a primary endpoint, assessed independently from other response variables.
Recurrent abdominal pain
Authors: Schurman Jennifer Verrill , Deacy Amanda Drews , Friesen Craig A.
Published: August 2014

Recurrent abdominal pain is a common complaint in children and adolescents; however, it has been historically understudied and not well understood. Recently, an improved diagnostic classification system has resulted in new research information being generated at an increasing rate. Although significant gaps in our knowledge remain, we are gradually coming to understand the complex aetiology of recurrent abdominal pain in children and are making strides in clinical treatment. However, specific clinical practice guidelines do not yet exist and evidence remains limited for most, if not all, of the common treatments employed. This chapter highlights current theory and evidence available to guide office-based assessment and intervention efforts, as well as promising directions for future research.
Persisting pain in childhood medical illness
Authors: Mherekumombe Martha , Collins John J.
Published: August 2014

Persisting pain in the context of medical illness has been recognized recently as a global problem by the World Health Organization (WHO, 2012). Whilst the epidemiology of medical illness varies throughout the world, the general principles of pain management are applicable to most medical illnesses in children and are effective. Successful pain management for most children is contingent on the availability of the WHO model list of essential medicines for children (WHO, 2011), although regrettably not all medicines are available in every country in the world.
Developmental pharmacology of opioids
Authors: Hathway Gareth J.
Published: August 2014

Recognition of the need for alternative analgesic regimens for managing neonatal and childhood pain has led to a rich literature concerning the ways in which early life pain differs from that at older ages. As in adults, opiates are often considered the gold standard analgesic class of drugs, of which morphine is the prototypical agent. There is a wealth of data detailing clinical observations, measurements, and interventions with regard to the use of opioids in treating pain in children. Studies in the early part of this century have highlighted that, in humans, age is an important factor that influences the morphine requirement of neonates following surgery; and dose requirements are influenced by both pharmacokinetic and pharmacodynamic factors. Laboratory studies have extended our understanding of changes within the peripheral and central nervous systems that underlie alterations in nociception in early life. This chapter will review what is currently known about the actions of opioids upon nociceptive and nociresponsive elements of the nervous system in early life, how they differ from adult responses, and ask whether manipulating endogenous opioid systems in early life may have consequences on neurodevelopment.
Drugs for neuropathic pain
Authors: Rastogi Sachin , Campbell Fiona
Published: August 2014

Neuropathic pain is defined as ‘pain arising as a direct consequence of a lesion or disease affecting the somatosensory system’. It is often contrasted with nociceptive pain which is associated with tissue injury or inflammation. Neuropathic pain exhibits certain clinical features that differentiate it from nociceptive pain. Neuropathic pain conditions in children are different from those in adults and include complex regional pain syndrome (CRPS), phantom limb pain, postoperative and post-traumatic neuropathic pain, and autoimmune and degenerative neuropathies, e.g. Guillain–Barré syndrome, Charcot–Marie–Tooth disease. However, a lack of randomized controlled trials in children means that evidence from adult studies guides pharmacological management of neuropathic pain in children, which is problematic as the aetiologies and mechanisms are different.
In this chapter we propose an algorithm for drug therapy for neuropathic pain in children based on best available evidence, our clinical experience, and the safety of these drugs in paediatric practice. We suggest a step-wise approach incorporating first-, second-, third-, and fourth-line therapies that should be tried methodically according to effectiveness and side effects. Neuropathic pain in children, if identified and treated in a timely manner as part of an interdisciplinary framework, using multimodal strategies can be managed effectively.
Child life interventions in paediatric pain
Authors: LeBlanc Chantal K. , Chambers Christine T.
Published: August 2014

Child life specialists, as members of the health care team, are frequently involved in the assessment and management of pain in hospitalized children and children in emergency settings. Child life refers to a non-medical therapeutic service designed to address the developmental, educational, and psychosocial needs of paediatric patients. Child life specialists are professionals who ‘promote effective coping through play, preparation, education, and self-expression activities. They provide emotional support for families, and encourage optimum development of children facing a broad range of challenging experiences, particularly those related to healthcare and hospitalization’ (Child Life Council, 2012a), including painful procedures and coping with other types of pain (e.g. postoperative pain). This chapter provides an overview of the role of a child life specialist, including a historical perspective on the evolution of the field and current child life practices. The chapter then provides a summary of the specific contributions of child life specialists to pain assessment and management, including innovative uses of technology often facilitated by child life specialists.
Mother care for procedural pain in infants
Authors: Johnston Celeste , Campbell-Yeo Marsha
Published: August 2014

A major role of maternal care is to protect their infant from harm, including pain. The aim of this chapter is to review the evidence on the effectiveness of maternal strategies that are efficacious in managing procedural pain including breastfeeding, kangaroo mother care, and facsimiles of maternal presence such as voice recordings, odour, and other care providers. The mechanisms, as currently understood, underlying the efficacy of maternal care, will be presented. Finally, pragmatic issues, such as feasibility, will be discussed.
Education for paediatric pain
Authors: Twycross Alison , O’Conner-Von Susan
Published: August 2014

This chapter focuses on educating children, parents, and health care professionals about pain management. The first half of the chapter examines issues related to children and parents while the second half concentrates on health care professionals. The current state of knowledge will be explored and strategies for educating each group discussed. The Promoting Action on Research Implementation in Health Services (PARiHS) model (see also Yamada and Hutchinson, Chapter 61, this volume) is used to help explain why healthcare professionals do not always use their knowledge in practice. Implications for practice, education and future research are also outlined.
The ethics of pain control in infants and children
Authors: Walco Gary A. , Kelley Maureen C.
Published: August 2014

In this chapter we will offer a way of framing the ethical balance of competing considerations in pain treatment in infants and children, distinguishing between analyses of harms and benefits, from other more pragmatic, contextual, and cultural considerations. We begin with the ethical foundations behind good pain management for any patient, and especially children: the ethical duty to prevent harm by alleviating pain or suffering, and the importance of assuring equal access to pain treatment. Historically, the driving ethical concern in paediatric pain has been the pervasive undertreatment of pain in children. In the second and main section of the chapter, we offer a detailed analysis of the practical ethical challenges involved in weighing the harms and benefits of pain relief against untreated or undertreated pain. In the third section, we will discuss the more specific concerns of socioeconomic and cultural determinants to paediatric pain treatment. Finally, in the last section, we will address concerns in conducting research on pain interventions in infants and children, as clearly many of the modal methodologies traditionally used for clinical trials in adults (e.g. placebo control designs) pose unjustifiable risk to younger individuals. We will also discuss the importance of considering local context as it impacts standards of care to guide ethical paediatric pain research.
Whole-Systems Healing
Authors: Kreitzer Mary Jo , Felgen Jayne , Roach Patricia A.
Published: August 2014

Integrative nursing embodies a whole person/whole systems approach to advancing the health and well-being of people, organizations, communities and the environment. It is based on a whole systems world view, an approach that recognizes that a change in any part of the systems causes a change in the whole system. Whole systems thinking and leadership draws from concepts and principles of complexity science, social networks, social change and gentle action. Whole systems leadership embodies competencies of deep listening, awareness of systems, awareness of self, seeking diverse perspectives, suspending certainty and embracing uncertainty, and taking adaptive action.
Building an Integrative Health Program
Authors: Kreitzer Mary Jo , Somerville Beth
Published: August 2014

In response to the changing healthcare environment, clinical care transformation can support the strategic goals of organizations. The creation of relevant and successful model(s) begins with a thorough assessment including the voices of all stakeholders. Program design is an iterative process that includes proto-typing, ongoing education and program evaluation. To ensure sustainability, patient outcome measures and employee feedback are an integral part of the new clinical care model.
Transforming the Healthcare Environment Through a Hospital-Based Integrative Health Initiative
Authors: Horner Arlene , Schellinger Ellen L.
Published: August 2014

This chapter describes the development of a hospital-based, nurse-led, integrative therapy program. Person-centered, relationship-based care is optimally sustained with solid administrative support, a robust infrastructure, and an emphasis on evidence, quality, and safety. Initial integrative therapies included aromatherapy, acupressure and guided imagery. Building blocks discussed for a healthy program include documentation in the electronic health record, easy retrieval of clinical outcomes, online access to resources, and a readiness to involve all stakeholders. Additional considerations include a focus on patient fit, common symptoms, nurse self-care, and cost effectiveness. Evaluations provided details on nurse competence and confidence.
Integrative Nursing Caring Science, Human Caring, and Peace
Authors: Watson Jean
Published: August 2014

This chapter focuses on human caring and peace within the context of integrative nursing principles embedded in a framework of caring science and caritas (a Latin word conveying universal caring and love). Nurses’ practice of human caring is an emergent quality of whole systems, making new connections between the unitary energetic patterns of worldwide human caring practices and peace in our world. This relationship between human caring and peace represents a fundamental path of consciously attending to the pattern of unity and the human-environmental global-universal field of oneness
Advancing Wellbeing in People, Organizations, and Communities
Authors: Kreitzer Mary Jo , Delagran Louise , Uptmor Andrea
Published: August 2014

Well-being is a state of being in balance or alignment in body, mind and spirit. Well-being is impacted by many dimensions including health, purpose, relationships, community, safety and security and the environment. Advancing well-being and increasing capacity and potential within people, organizations, and communities is a core integrative nursing strategy.
Facilitating Lifestyle Choice and Change
Authors: Aufenthie Judith
Published: August 2014

Creating optimal well being is a multifaceted, complex process. It involves many biological, psychological, physical, behavioral, emotional as well as neurobiological factors which all interact and effect the choices we make and changes that we are able to implement. Research has begun to connect with the decision making process to better understand how our decisions and choices are made. This research coupled with research and evidence based models provides integrative nurses and patients with validated tools to optimize change and wellness.
Nutrition and Integrative Nursing
Authors: Sandquist Laura , Kubes Laurie
Published: August 2014

An integrative nursing approach to nutrition respects the beauty with which nature has designed whole foods to deliver nutrients to the body and the way with which the body is designed to accept and utilize those nutrients. Food today is highly processed, genetically modified and contains additives previously unknown to human physiology. A return to eating whole foods found in nature offers potential to decrease rising rates of human disease such as cancer and type 2 diabetes. The impact of assisting individuals to optimize well-being through healthy food choices must be realized. Nutrition from an integrative nursing perspective supports this realization.
Integrative Nursing Management of Depressed Mood
Authors: Kaas Merrie J. , Kristofersson Gisli , Towey Sue
Published: August 2014

Integrative mental health nursing is founded on the principles of whole person, relationship-based care provided within the personal, lived context, and the use of the best range of evidence-informed interventions to support the individual’s mental health and healing. Using a case study, this chapter describes the integrative mental health nursing approach for the holistic assessment of mood and the collaborative approaches developed by the psychiatric/mental health nurse practitioner and client to reduce her mood symptoms and promote mental health.
Integrative Nursing Management of Fatigue
Authors: Drake Diana
Published: August 2014

From the obvious to the extremely complex, fatigue is a varied and nonspecific symptom challenging to both the health care provider and the patient. The economic, mental health and relationship impact of fatigue is a significant burden to the patient and their families. If a physiologically based diagnosis is not found on an initial clinical assessment, further exploration and effective treatment often remains elusive. Integrative health care provides an alternative context through which to view and treat fatigue. Through the integrative perspective, fatigue is redefined as a state of imbalance that has roots in the physical, psychological, spiritual, energetic and/or environmental dimensions of the patient’s life. The complex discord of a fatigue disorder is effectively addressed utilizing integrative nursing principles to guide assessment and treatment. Through the implementation of fatigue specific, evidence-based therapies, the patient is able to identify and cultivate their uniquely innate healing process.
Integrative Nursing Management of Cognitive Impairment
Authors: Ross Rebecca L. , Bell Iris R.
Published: August 2014

Cognitively impaired individuals are often sensitive to the side effects of pharmacological agents, a mainstay of biomedical treatment in this condition. An integrative approach to cognitive impairment that employs therapeutic strategies that can minimize polypharmacy while supporting improved brain function is clinically essential. Integrative interventions for cognitive disorders are dependent on the etiology or type of cognitive disorder that is being treated. Integrative nurses also recognize that family caregivers have tremendous burden when with this condition. Therefore, integrative nurses work with both the individual and caregiver, with the goal of improving overall quality of life, reducing stress and improving function.
Pre-Licensure Nursing Education for Integrative Nursing
Authors: Potter Teddie , Halcón Linda L. , Rowan Mary M.
Published: August 2014

The essence of nursing is integrative yet various external and internal pressures often lead to the marginalization of integrative principles in undergraduate nursing curriculum. Even though both the American Association of Colleges of Nursing and the National League for Nursing emphasize knowledge compatible with integrative nursing, the bio-medical paradigm tends to dictate which knowledge is valued the most. This chapter briefly reviews the history of integrative curriculum and illustrates this history with a case study. It concludes with a call for a paradigm shift in nursing education, listing key steps nurse educators can take to promote integrative undergraduate nursing education.
Integrative Nursing in Ireland
Authors: Shannon Michael , McNamara Martin
Published: August 2014

As well as the economic collapse affecting health spending, two related developments are shaping Irish nursing. First, health-system restructuring with a policy goal to shift resources and services into primary care. Second, the development of specialist and advanced nursing roles. A recent report commended Ireland’s all-graduate entry to nursing model. The meta-theoretical perspectives and underlying tenets of integrative nursing are familiar to Irish nursing scholars, as exemplified in the “Careful Nursing” philosophy and practice model. Recent critical scholarship highlights a growing awareness of the long-term consequences for the profession of being unable to articulate a distinct nursing disciplinary perspective.
Global Activism, Advocacy, and Transformation
Authors: Beck Deva-Marie , Dossey Barbara M. , Rushton Cynda H.
Published: August 2014

In almost every nation, the severe and chronic global nursing shortage continues to threaten the health and well-being of people across the globe. Florence Nightingale’s legacy of activism is closely aligned with integrative nursing and the United Nations Millennium Goals. Together, they lay out a bold agenda that calls nurses to a way of being-doing-knowing that embraces activism, advocacy and transformation. As 21st century Nightingales, our own deep personal and professional integrative nursing mission can continually transform our own lives, thus allowing each of us to become effective catalysts for human health and to sustain our change agency for global transformation.
Liver
Authors: Johnson C. Daniel
Published: August 2014

Cases are presented related to diffuse diseases, masses, and miscellaneous conditions of the liver. Each case contains a relevant image or images, imaging findings, a differential diagnosis, the actual diagnosis, and a discussion. Supplementary materials provided with each chapter include differential diagnoses, anatomical illustrations, and a question and answer section.
Phenotypic Analyses of Arabidopsis T-DNA Insertion Lines and Expression Profiling Reveal That Multiple L-Type Lectin Receptor Kinases Are Involved in Plant Immunity
Authors: Wang Yan , Bouwmeester Klaas , Beseh Patrick , Shan Weixing , Govers Francine
Published: August 2014

L-type lectin receptor kinases (LecRK) are membrane-spanning receptor-like kinases with putative roles in biotic and abiotic stress responses and in plant development. In Arabidopsis, 45 LecRK were identified but their functions are largely unknown. Here, a systematic functional analysis was carried out by evaluating phenotypic changes of Arabidopsis LecRK T-DNA insertion lines in plant development and upon exposure to various external stimuli. None of the LecRK T-DNA insertion lines showed clear developmental changes, either under normal conditions or upon abiotic stress treatment. However, many of the T-DNA insertion lines showed altered resistance to Phytophthora brassicae, Phytophthora capsici, Pseudomonas syringae, or Alternaria brassicicola. One mutant defective in LecRK-V.5 expression was compromised in resistance to two Phytophthora spp. but showed enhanced resistance to Pseudomonas syringae. LecRK-V.5 overexpression confirmed its dual role in resistance and susceptibility depending on the pathogen. Combined analysis of these phenotypic data and LecRK expression profiles retrieved from public datasets revealed that LecRK which are hardly induced upon infection or even suppressed are also involved in pathogen resistance. Computed coexpression analysis revealed that LecRK with similar function displayed diverse expression patterns. Because LecRK are widespread in plants, the results presented here provide invaluable information for exploring the potential of LecRK as novel sources of resistance in crops.
A Meta-Analysis of Endoscopic versus Conventional Open Radial Artery Harvesting for Coronary Artery Bypass Graft Surgery
Authors: Cao Christopher , Tian David H. , Ang Su C. , Peeceeyen Sheen , Allan James , Fu Benjamin , Yan Tristan D.
Published: August 2014

Objective

The radial artery has been demonstrated to provide superior long-term patency outcomes compared with saphenous veins for selected patients who undergo coronary artery bypass graft surgery. Recently, endoscopic radial artery harvesting has been popularized to improve cosmetic and perioperative outcomes. However, concerns have been raised regarding the effects on long-term survival and graft patency of this relatively novel technique. The present meta-analysis aimed to assess the safety and the efficacy of endoscopic radial artery harvesting versus the conventional open approach.

Methods

A systematic review of the current literature was performed on five electronic databases. All comparative studies on endoscopic versus open radial artery harvesting were included for analysis. Primary endpoints included mortality and recurrent myocardial infarction. Secondary endpoints included graft patency, wound infection, hematoma formation, and paresthesia.

Results

Twelve studies involving 3314 patients were included for meta-analysis according to predefined selection criteria. There were no statistically significant differences in overall mortality, recurrent myocardial infarction, or graft patency between the two surgical techniques. However, patients who underwent endoscopic harvesting were found to have significantly lower incidences of wound infection, hematoma formation, and paresthesia.

Conclusions

Current literature on endoscopic harvesting of the radial artery for coronary artery bypass graft surgery is limited by relatively short follow-up periods as well as differences in patient selection and surgical techniques. In addition, there are currently no randomized controlled trials to provide robust clinical data. However, the available evidence suggests that the endoscopic approach is associated with superior perioperative outcomes without clear evidence demonstrating compromised patency or survival outcomes.
A unique DNA entry gate serves for regulated loading of the eukaryotic replicative helicase MCM2–7 onto DNA
Authors: Samel Stefan A. , Fernández-Cid Alejandra , Sun Jingchuan , Riera Alberto , Tognetti Silvia , Herrera M. Carmen , Li Huilin , Speck Christian
Published: August 2014

The regulated loading of the replicative helicase minichromosome maintenance proteins 2–7 (MCM2–7) onto replication origins is a prerequisite for replication fork establishment and genomic stability. Origin recognition complex (ORC), Cdc6, and Cdt1 assemble two MCM2–7 hexamers into one double hexamer around dsDNA. Although the MCM2–7 hexamer can adopt a ring shape with a gap between Mcm2 and Mcm5, it is unknown which Mcm interface functions as the DNA entry gate during regulated helicase loading. Here, we establish that the Saccharomyces cerevisiae MCM2–7 hexamer assumes a closed ring structure, suggesting that helicase loading requires active ring opening. Using a chemical biology approach, we show that ORC–Cdc6–Cdt1-dependent helicase loading occurs through a unique DNA entry gate comprised of the Mcm2 and Mcm5 subunits. Controlled inhibition of DNA insertion triggers ATPase-driven complex disassembly in vitro, while in vivo analysis establishes that Mcm2/Mcm5 gate opening is essential for both helicase loading onto chromatin and cell cycle progression. Importantly, we demonstrate that the MCM2–7 helicase becomes loaded onto DNA as a single hexamer during ORC/Cdc6/Cdt1/MCM2–7 complex formation prior to MCM2–7 double hexamer formation. Our study establishes the existence of a unique DNA entry gate for regulated helicase loading, revealing key mechanisms in helicase loading, which has important implications for helicase activation.
BR-dependent phosphorylation modulates PIF4 transcriptional activity and shapes diurnal hypocotyl growth
Authors: Bernardo-García Stella , de Lucas Miguel , Martínez Cristina , Espinosa-Ruiz Ana , Davière Jean-Michel , Prat Salomé
Published: August 2014

Signaling by the hormones brassinosteroid (BR) and gibberellin (GA) is critical to normal plant growth and development and is required for hypocotyl elongation in response to dark and elevated temperatures. Active BR signaling is essential for GA promotion of hypocotyl growth and suppresses the dwarf phenotype of GA mutants. Cross-talk between these hormones occurs downstream from the DELLAs, as GA-induced destabilization of these GA signaling repressors is not affected by BRs. Here we show that the light-regulated PIF4 (phytochrome-interacting factor 4) factor is a phosphorylation target of the BR signaling kinase BRASSINOSTEROID-INSENSITIVE 2 (BIN2), which marks this transcriptional regulator for proteasome degradation. Expression of a mutated PIF41A protein lacking a conserved BIN2 phosphorylation consensus causes a severe elongated phenotype and strongly up-regulated expression of the gene targets. However, PIF41A is not able to suppress the dwarf phenotype of the bin2-1 mutant with constitutive activation of this kinase. PIFs were shown to be required for the constitutive BR response of bes1-D and bzr1-1D mutants, these factors acting in an interdependent manner to promote cell elongation. Here, we show that bes1-D seedlings are still repressed by the inhibitor BRZ in the light and that expression of the nonphosphorylatable PIF41A protein makes this mutant fully insensitive to brassinazole (BRZ). PIF41A is preferentially stabilized at dawn, coinciding with the diurnal time of maximal growth. These results uncover a main role of BRs in antagonizing light signaling by inhibiting BIN2-mediated destabilization of the PIF4 factor. This regulation plays a prevalent role in timing hypocotyl elongation to late night, before light activation of phytochrome B (PHYB) and accumulation of DELLAs restricts PIF4 transcriptional activity.
Transgenerationally inherited piRNAs trigger piRNA biogenesis by changing the chromatin of piRNA clusters and inducing precursor processing
Authors: Le Thomas Adrien , Stuwe Evelyn , Li Sisi , Du Jiamu , Marinov Georgi , Rozhkov Nikolay , Chen Yung-Chia Ariel , Luo Yicheng , Sachidanandam Ravi , Toth Katalin Fejes , Patel Dinshaw , Aravin Alexei A.
Published: August 2014

Small noncoding RNAs that associate with Piwi proteins, called piRNAs, serve as guides for repression of diverse transposable elements in germ cells of metazoa. In Drosophila, the genomic regions that give rise to piRNAs, the so-called piRNA clusters, are transcribed to generate long precursor molecules that are processed into mature piRNAs. How genomic regions that give rise to piRNA precursor transcripts are differentiated from the rest of the genome and how these transcripts are specifically channeled into the piRNA biogenesis pathway are not known. We found that transgenerationally inherited piRNAs provide the critical trigger for piRNA production from homologous genomic regions in the next generation by two different mechanisms. First, inherited piRNAs enhance processing of homologous transcripts into mature piRNAs by initiating the ping-pong cycle in the cytoplasm. Second, inherited piRNAs induce installment of the histone 3 Lys9 trimethylation (H3K9me3) mark on genomic piRNA cluster sequences. The heterochromatin protein 1 (HP1) homolog Rhino binds to the H3K9me3 mark through its chromodomain and is enriched over piRNA clusters. Rhino recruits the piRNA biogenesis factor Cutoff to piRNA clusters and is required for efficient transcription of piRNA precursors. We propose that transgenerationally inherited piRNAs act as an epigenetic memory for identification of substrates for piRNA biogenesis on two levels: by inducing a permissive chromatin environment for piRNA precursor synthesis and by enhancing processing of these precursors.
Myomaker is essential for muscle regeneration
Authors: Millay Douglas P. , Sutherland Lillian B. , Bassel-Duby Rhonda , Olson Eric N.
Published: August 2014

Regeneration of injured adult skeletal muscle involves fusion of activated satellite cells to form new myofibers. Myomaker is a muscle-specific membrane protein required for fusion of embryonic myoblasts, but its potential involvement in adult muscle regeneration has not been explored. We show that myogenic basic helix–loop–helix (bHLH) transcription factors induce myomaker expression in satellite cells during acute and chronic muscle regeneration. Moreover, genetic deletion of myomaker in adult satellite cells completely abolishes muscle regeneration, resulting in severe muscle destruction after injury. Myomaker is the only muscle-specific protein known to be absolutely essential for fusion of embryonic and adult myoblasts.
Challenges and opportunities in the investigation of unexplained intellectual disability using family‐based whole‐exome sequencing
Authors: Helsmoortel C. , Vandeweyer G. , Ordoukhanian P. , Van Nieuwerburgh F. , Van der Aa N. , Kooy R.F.
Published: August 2014

Intellectual disability (ID), characterized by an intellectual performance of at least 2 SD (standard deviations) below average is a frequent, lifelong disorder with a prevalence of 2–3%. Today, only for at most half of patients a diagnosis is made. Knowing the cause of the ID is important for patients and their relatives, as it allows for appropriate medical care, prognosis on further development of the disorder, familial counselling or access to support groups. Whole‐exome sequencing (WES) now offers the possibility to identify the genetic cause for patients for which all previously available genetic tests, including karyotyping, specific gene analysis, or microarray analysis did not reveal causative abnormalities. However, data analysis of WES experiments is challenging. Here we present an analysis workflow implementable in any laboratory, requiring no bioinformatics knowledge. We demonstrated its feasibility on a cohort of 10 patients, in which we found a conclusive diagnosis in 3 and a likely diagnosis in 2 more patients. Of the three conclusive diagnoses, one was a clinically suspected mutation missed by Sanger sequencing, and one was an atypical presentation of a known monogenic disorder, highlighting two essential strengths of WES‐based diagnostics.
Hematopoietic clonal dominance, stem cell mutations, and evolutionary pattern of JAK2V617F allele burden in polycythemia vera
Authors: Angona Anna , Alvarez‐Larrán Alberto , Bellosillo Beatriz , Martínez‐Avilés Luz , Camacho Laura , Fernández‐Rodríguez Concepción , Pairet Silvia , Longarón Raquel , Ancochea Águeda , Senín Alicia , Florensa Lourdes , Besses Carles
Published: August 2014

Objectives

Clonal dominance is characteristic of patients with post‐polycythemia vera myelofibrosis (post‐PV MF), whereas patients in chronic phase usually display polyclonal hematopoiesis. The aim of this work was to study the mutational burden of JAK2V617F at the progenitor level in patients with PV and correlate it with the evolutive phase of the disease and the presence of mutations in genes different to JAK2V617F.

Methods

JAK2V617F was measured in stem cells, progenitor cells, and granulocytes of 45 patients with PV (early chronic phase n = 26, late chronic phase n = 10, post‐PV MF n = 9). In addition, screening of TET2, DNMT3A, ASXL1, SF3B1, SRSF2, U2AF1, and TP53 was performed with quantification of the mutation in CD34+ cells in positive cases. Moreover, we assessed whether JAK2V617F allele burden in granulocytes (at a single time point or monitoring) could be used as a surrogate of clonal dominance.

Results

Ten patients presented clonal dominance at progenitor level (PV at diagnosis n = 2, late chronic phase n = 1, post‐PV MF n = 7). Additional mutations were identified in four patients at diagnosis, three in TET2, and one in DNMT3A gene, with clonal dominance present in three of them. At PV diagnosis, clonal dominance was demonstrated only in patients with additional mutations. JAK2V617F monitoring showed better diagnostic accuracy than single time point measurement as a marker of clonal dominance.

Conclusions

Clonal dominance may be present at diagnosis, especially in those cases carrying other mutations. JAK2V617F monitoring during follow‐up could help in the identification of patients with clonal dominance.
Reporting methodological search filter performance comparisons: a literature review
Authors: Harbour Jennifer , Fraser Cynthia , Lefebvre Carol , Glanville Julie , Beale Sophie , Boachie Charles , Duffy Steven , McCool Rachael , Smith Lynne
Published: August 2014

Background

Methodological search filters are tools for retrieving database records reporting studies which use a specific research method. Choosing a filter is likely to be based on filter performance data. This review examines which measures are reported, and the way that filter performance is presented, in filter comparisons.

Methods

Studies were identified from the current content and pending update (2010) of a filter website. Eligible studies compared two or more methodological search filters designed to identify randomised controlled trials, diagnostic test accuracy studies, systematic reviews or economic evaluations.

Results

Eighteen studies met the inclusion criteria. The number of filters compared in a single study ranged from 2 to 38. The most commonly reported measures were sensitivity/recall and precision. All studies displayed results in tables and gave results as percentages or proportions. Two studies supplemented results tables with graphical displays of data: a bar graph of the proportion of retrieved and missed gold standard references per filter; a forest plot of the overall sensitivity and specificity of each filter.

Conclusions

Sensitivity/recall and precision are the most frequently reported performance measures. This review highlights the potential for presenting results in novel and innovative ways to aid filter selection.