bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Medical Pedagogy of Mutual Suffering
Authors: Frank Arthur W. 
Published: October 2018

AbstractWho's afflicted? Early in Nicole Piemonte's book Afflicted: How Vulnerability Can Heal Medical Education and Practice, she quotes an email from a physician whose voice sets the problem and tone. He describes himself as someone “who has intended well” but then “nearly burned out because of the insidious process of physician formation that left me a mess at the threshold of the suffering of other human beings.” His confessional manifesto regrets “the sad things I have seen and done.” His narrative then turns to redemption: “I was—pardon the sentiment—loved back into a good medical practice as a form of growing wisdom and care” (pp. x–xi). Afflicted is written for those who hear this voice speaking for many others.
Becoming Good Citizens of Aging Societies
Authors: Berlinger Nancy , Solomon Mildred Z. 
Published: October 2018

AbstractThe ethical dimensions of an aging society are larger than the experience of chronic illness, the moral concerns of health care professionals, or the allocation of health care resources. What, then, is the role of bioethics in an aging society, beyond calling attention to these problems? Once we’ve agreed that aging is morally important and that population‐level aging across wealthy nations raises ethical concerns that cannot be fixed through transhumanism or other appeals to transcend aging and mortality through technology, what is our field’s contribution? We argue that it is time for bioethics to turn toward social justice and problems of injustice and that part of doing so is articulating a concept of good citizenship in an aging society that goes beyond health care relationships.
What Can Thinking Like a Gerontologist Bring to Bioethics?
Authors: de Medeiros Kate 
Published: October 2018

AbstractI am a social gerontologist, broadly defined as a social scientist who studies how later life is experienced, structured, and controlled in a society and in social settings. Although gerontology is often confused with geriatrics (a medical specialty), gerontologists are typically not clinicians but may study issues related to old age and health care such as the societal conditions that shape how medical care is provided and financed and how early exposure to education relates to later life health.In this essay, I argue that thinking like a gerontologist is important when considering what makes a good life in late life. To think like a gerontologist is to consider the cultural and societal values—past and present—that shape the experience of aging, to recognize people as complex beings whose individual lives do not follow predictable patterns or easily identified trajectories, and to recognize our own habits of regarding older persons as “other” and the consequences of “othering” for older persons and social systems. After a brief history of gerontology, highlighting a few core concepts that gerontologists share, I propose three important questions to consider regarding a good life in late life.
Solidarity and Care Coming of Age: New Reasons in the Politics of Social Welfare Policy
Authors: Jennings Bruce 
Published: October 2018

AbstractAging brings about the ordeal of coping. Younger people also cope, but for those in old age, the ordeal is so often elegiac, forced upon the self by changing functions within the body and by the outside social world, with its many impediments to the continuity of former roles, pursuits, and self‐identities. Coping with change can be affirming, but when what is being forgone seems more valuable than what lies ahead, it is travail. For most, the coping is managed more moderately by a sense of resignation. This is especially true for those who survive into profound old age, when one is viewed as if being old is one’s essential identity and nature. We must recognize and affirm difference and change without stigmatizing or losing sight of the specific capabilities and circumstances of the individual. This is what I think the often‐used, but less often clearly defined, notion of a “person‐centered” orientation should signify.Individuals age, but so do societies, not simply because they have a large population over age sixty‐five, but in the sense that societies as a whole are also buffeted by significant disruption in orders of meaning. Aging has a public as well as a private manifestation, a social as well as a personal embodiment, and how it is paid attention to in culture, politics, and policy makes a great difference to how aging is concretely experienced in human lives. In this essay, I explore how the moral imagination nurtured by the practices of solidarity and care—and nurturing them in turn—can come of age—and how these practices can take their rightful place in an ethically mature political culture.
Realizing and Maintaining Capabilities: Late Life as a Social Project
Authors: Dunn Michael 
Published: October 2018

AbstractOne central and unfortunately unavoidable characteristic of the aging process is its association with chronic physiological deterioration. Frailty, cognitive impairment, and physical conditions such as cardiovascular disease and vision and hearing loss are more frequent in this phase of life, and these conditions translate into an increasing need for care and support of multiple kinds. In traditional bioethical scholarship, these distinctive features of aging have been examined predominantly through a health‐focused lens. My main contention in this essay, however, is that viewing aging within bioethics as primarily a health problem, to be addressed through frameworks for decision‐making or for resource allocation, is inadequate. My aim is to consider how the health conditions associated with aging affect older people’s lives in a much more expansive way than has typically been acknowledged. Just as importantly, I intend to show how shifting our bioethical imagination in this way raises different and challenging questions about what a good life in late life consists in and about what is owed to older people, in their personal and social lives, as a matter of justice.
Housing, the Built Environment, and the Good Life
Authors: Molinsky Jennifer , Forsyth Ann 
Published: October 2018

AbstractAt any age, the pursuit of a good life is easier in a physical environment that promotes health, supports activities important to self‐fulfillment, and facilitates connections to the larger community. In old age, the home and neighborhood environments are particularly important: they are the locations where older people spend most their time, and they can have a great impact on independence, social connection, feelings of self‐worth, and physical and emotional well‐being.Within the urban planning field, home and neighborhood characteristics are important dimensions of debates about the measurement of human progress and quality of life, particularly as an alternative to purely economic measures. They are also key issues in public health, particularly as they relate to physical, social, and mental well‐being. Here, we focus on how to improve the fit of environments for people as they age.
Advance Directives for Refusing Life‐Sustaining Treatment in Dementia
Authors: Steinbock Bonnie , Menzel Paul T. 
Published: October 2018

AbstractAid‐in‐dying laws in the United States have two important restrictions. First, only patients who are terminally ill, defined as having a prognosis of six months or less to live, qualify. Second, at the time the patients take the lethal medication, they must be competent to make medical decisions. This means that an advance directive requesting aid in dying for a later time when the patient lacks decision‐making capacity would be invalid. However, many people are more concerned about avoiding living into severe dementia for years—a time when they will lack decision‐making capacity—than they are about preventing suffering or the loss of dignity or autonomy for a few months at the end of life.Gillian Bennett is an example of someone determined not to live into severe dementia. She opted for preemptive suicide in 2014, explaining why in a letter she posted online: “Every day I lose bits of myself, and it’s obvious that I am heading toward the state that all dementia patients eventually get to: not knowing who I am and requiring full‐time care.”A major problem with Bennett’s solution, however, is that the individual is likely thereby to be giving up some “good time.” A legal alternative to preemptive suicide is to create an advance directive stating the circumstances under which one wants not to receive any lifesaving or life‐sustaining treatment, even the most basic and noninvasive. This option is our focus in this paper: how to create effective advance directives to avoid living into severe dementia. To be relevant to progressive dementia, the directive would need to state what kinds of care should be withheld and when. At the same time, advance directives for severe dementia face serious challenges. Before addressing these, we review the normative force of directives themselves.
Aging: Drawing a Map for the Future
Authors: Callahan Daniel 
Published: October 2018

AbstractI live on a short street in a small town, Hastings‐on‐Hudson, some fifteen miles up the Hudson River from New York City. Over the past decade a number of families have moved in, with about sixteen children among them. More than a bit housebound now because of old age and watching them romping about, I try to imagine what their world will be like when they have reached my present age, some eighty years from now. But I have a problem. I just can’t imagine it. The demographic changes now appearing on the horizon will force unforeseeable changes. What would it have been like in 1930, when I was born, if someone then had to project the future of aging? They could not have guessed.Some momentous changes are now emerging, and they are bound to change the aging picture. What’s being done to respond to those growing pressures?
Evidence and Human Genome Editing
Authors: Maschke Karen J. 
Published: October 2018

AbstractIn July, the United Kingdom's Nuffield Council on Bioethics issued a report on human genome editing in which it said that editing a human embryo's genome to reduce the possibility that the future child will inherit a genetic disorder could be ethically acceptable when certain conditions are met: the intended use of genome‐editing interventions secures and is consistent with the “welfare of the future person” and does not “increase disadvantage, discrimination or division in society.” Yet the Council noted that if current legal restrictions on the use of heritable genome‐editing interventions were lifted, the interventions should be used only in the context of “well‐designed and supervised studies” to ensure that they are safe and effective. Some people might contend that it is premature to talk about what kind of evidence—and how much—will be needed to gauge the safety and effectiveness of genome‐editing interventions since the United Kingdom, the United States, and several other countries currently prohibit clinical trials that involve transferring into a woman an embryo whose genome was edited. Yet based on an analysis of evidentiary disputes involving several medical technologies (an analysis that I conducted with my Hastings colleague Michael Gusmano for a forthcoming book, Debating Modern Medical Technologies: The Politics of Safety, Effectiveness, and Patient Access), I suggest that now is the time to start the conversation about evidentiary standards for the use of genome editing in reproductive medicine.
Inhibition of kynurenine aminotransferase II attenuates hippocampus‐dependent memory deficit in adult rats treated prenatally with kynurenine
Authors: Pocivavsek Ana , Elmer Greg I. , Schwarcz Robert 
Published: October 2018

AbstractA combination of genetic and environmental factors contributes to schizophrenia (SZ), a catastrophic psychiatric disorder with a hypothesized neurodevelopmental origin. Increases in the brain levels of the tryptophan metabolite kynurenic acid (KYNA), an endogenous antagonist of α7 nicotinic acetylcholine and NMDA receptors, have been implicated specifically in the cognitive deficits seen in persons with SZ. Here we evaluated this role of KYNA by adding the KYNA precursor kynurenine (100 mg/day) to chow fed to pregnant rat dams from embryonic day (ED) 15 to ED 22 (control: ECon; kynurenine treated: EKyn). Upon termination of the treatment, all rats received normal rodent chow until the animals were evaluated in adulthood (postnatal days 56–85). EKyn treatment resulted in increased extracellular KYNA and reduced extracellular glutamate in the hippocampus, measured by in vivo microdialysis, and caused impairments in hippocampus‐dependent learning in adult rats. Acute administration of BFF816, a systemically active inhibitor of kynurenine aminotransferase II (KAT II), the major KYNA‐synthesizing enzyme in the brain, normalized neurochemistry and prevented contextual memory deficits in adult EKyn animals. Collectively, these results demonstrate that acute inhibition of KYNA neosynthesis can overcome cognitive impairments that arise as a consequence of elevated brain KYNA in early brain development.
Lithium, valproate, and carbamazepine prescribing patterns for long‐term treatment of bipolar I and II disorders: A prospective study
Authors: Musetti Laura , Tundo Antonio , Benedetti Alessandra , Massimetti Gabriele , Cambiali Erika , Pergentini Irene , Del Grande Claudia , Dell'Osso Liliana 
Published: October 2018

AbstractObjectiveThis study aims to describe the prescription patterns of the mood stabilizers most commonly used for the treatment of bipolar I and II disorders (lithium, valproate, and carbamazepine) and to analyze the treatment outcomes.MethodsTwo hundred and thirty‐four outpatients with bipolar disorders receiving prophylactic treatment with lithium, valproate, carbamazepine, or their combination were followed up for at least 18 months in two Italian psychiatric centers specialized in mood disorders.ResultsThe combination of lithium and valproate or carbamazepine was the most common prophylactic treatment (54.3%), followed by valproate or carbamazepine (24%) and lithium monotherapy (22%). Polytherapy was prescribed mainly to patients with bipolar I disorder, a high number of previous episodes and lifetime psychotic symptoms, whereas valproate or carbamazepine monotherapy was prescribed to patients with anxiety comorbidity. The annual frequency of recurrences decreased significantly after entering the study in the overall sample, and the reduction was significantly higher in patients on lithium plus valproate or carbamazepine compared with the valproate or carbamazepine group, but not with the lithium monotherapy group. The number of mixed recurrences during the follow‐up was significantly higher in patients on lithium plus valproate or carbamazepine.ConclusionsOur findings may help clinicians to personalize long‐term treatment to prevent relapses of bipolar disorder according to clinical presentation.
Multiperiod stochastic programming portfolio optimization for diversified funds
Authors: Fulton Lawrence V. , Bastian Nathaniel D. 
Published: October 2018

AbstractWe investigate a multiperiod, stochastic portfolio optimization model for diversified funds choices associated with traditional 401K or 403B plans. This optimization model minimizes the L1‐norm for negative return rate risk (the downside mean absolute deviation) while examining parameters that maintain model feasibility. Important components of the model are the incorporation of appropriate time‐series components and evaluation of scenarios based on investor outlook. A case study experimentation of the model on five potential investment funds using historical data from 2003 to 2013 was conducted, and parameter constraints for diversification and minimum acceptable return rates were manipulated to produce contour plots. The maximum geometric rate of return investment strategy provided by the optimization would have resulted in a 9.7% geometric return rate in 2014 as compared with a 5.0% for a uniform distribution of investment funds across choices.
Crude oil price shocks, monetary policy, and China's economy
Authors: Wen Fenghua , Min Feng , Zhang Yue‐Jun , Yang Can 
Published: October 2018

AbstractThis paper develops a time‐varying parameter vector autoregressive model to examine the dynamic effects of crude oil prices and monetary policy on China's economy during January 1996 to June 2017. The empirical results indicate that (a) in general, international crude oil price shocks have positive effect on China's economic growth and inflation in the short run, but the long‐run effect appears diverse; (b) China's monetary policy shocks have positive effect on the economic growth and inflation overall; specifically, an increase in monetary supply can partly offset crude oil prices' negative effect on China's economic growth; (c) China's monetary policy has positive effect on crude oil prices and plays an important role in the relationship between crude oil price shocks and economy; and (d) during the recent global financial crisis, crude oil price shocks produce greater negative effect on China's economic growth, whereas the long‐run effect of monetary policy on China's economic growth proves weaker, compared with other periods.
Investigating the relationship between high‐yield bonds and equities and its implications for strategic asset allocation during the Great Recession
Authors: Menounos Georgios , Alexiou Constantinos , Vogiazas Sofoklis 
Published: October 2018

AbstractIn this paper, we focus on investing in U.S. high‐yield bonds during the period 2007–2013, a period that covers the Great Recession in the aftermath of the global financial crisis of 2007–2008. First, we use the Fama and French three‐factor model to delve into the relationship between the risk‐adjusted returns of high‐yield bonds and equity market risk factors. Second, we gauge the extent to which the risk‐adjusted returns of high‐yield bonds are significantly higher than equity and investment‐grade bonds' risk‐adjusted returns. Third, by using a modified version of the Black–Litterman model, we explore the asset allocation to high‐yield bonds, accounting for investors' risk tolerance. Our findings suggest that equity market risk factors have significant explanatory power for high‐yield bonds' risk‐adjusted returns, whereas the hypothesis of superior returns on high‐yield bonds over investment‐grade corporate bonds and equities cannot be supported. Our key contribution relates to the strategic asset allocation to high‐yield bonds. Our results suggest that the share of high‐yield bonds does not exceed 4.1% of total assets in a global market portfolio over the period 2007–2013. Notably, the share of high‐yield bonds in a simulated portfolio remains relatively small and stable on a risk‐adjusted basis, irrespective of an investor's risk profile or the phase of the business cycle.
Impact of multimodal methods to teach advanced cardiovascular life support principles in the core doctor of pharmacy curriculum
Authors: Newsome Andrea S. , Smith Susan E. , Hawkins William A. , Fulford Michael , Phillips Beth B. 
Published: October 2018

IntroductionThe 2016 Accreditation Council for Pharmacy Education Accreditation Standards place clear expectations on the production of “practice ready” graduates. Advanced cardiovascular life support (ACLS) is an integrated, team‐based approach to optimizing patient outcomes in acute cardiovascular events. Foundational knowledge and skill with ACLS principles will support graduate pharmacists as essential members of the health care team.ObjectivesTo assess the impact of didactic and simulation based advanced cardiovascular life support training on student perception, knowledge, and skills.MethodsACLS training was incorporated into the third year pharmacy curriculum through the addition of a 2‐hour pharmacy‐oriented didactic lecture on ACLS fundamentals and reinforced with a 2‐hour simulation experience of various cardiovascular events. Perception and knowledge were evaluated in a pre‐ and post‐assessment format with 10 questions evaluating knowledge and 19 questions evaluating perceptions.ResultsAll students (n = 133) completed the pre‐ and post‐assessments. Knowledge of ACLS fundamentals improved by 35% from baseline (43.4% ± 16.7% to 79.2% ± 14.9%, P < 0.001). Perceptions also improved with self‐reported novice ranking decreasing from 46.4% ± 21.5% overall to 4.3% ± 2.1% (P < 0.001), and perceptions of proficient ranking increasing from 6.9% ± 5.5% to 32.5% ± 6.7% (P < 0.001). Skill‐based assessment demonstrated positive review of peers' simulation performance.ConclusionsACLS instruction using both didactic lecture and simulation experience enhanced student knowledge and confidence of ACLS fundamentals. Future implementation may include offering formal ACLS certification through an elective course.
Antibiotics release from cement spacers used for two‐stage treatment of implant‐associated infections after total joint arthroplasty
Authors: Klinder Annett , Zaatreh Sarah , Ellenrieder Martin , Redanz Sylvio , Podbielski Andreas , Reichel Tobias , Bösebeck Hans , Mittelmeier Wolfram , Bader Rainer 
Published: October 2018

AbstractTwo‐stage revision arthroplasty is the treatment of choice for periprosthetic infection, a serious complication after knee or hip arthroplasty. Our prospective clinical trial aimed to investigate the concentrations of gentamicin and vancomycin in wound exudate and tissue in two‐stage revision arthroplasty. Wound exudate and periprosthetic membrane samples were collected from 18 patients (10 hip and eight knee patients), who were due for two‐stage treatment after a periprosthetic joint infection. Samples were taken during insertion of antibiotic‐impregnated spacers and after their removal. The concentrations of gentamicin and vancomycin in wound exudates and adjacent tissue were analyzed using high‐performance liquid chromatography mass spectrometry. Average time period of spacer implantation was 13.6 weeks (9.3–22.6 weeks). The concentration of vancomycin in wound exudate decreased from a median of 43.28 μg/mL (0.28–261.22) after implantation to 0.46 μg/mL (0.13–37.47) after the removal of the spacer. In the adjacent tissue, vancomycin concentration was mainly undetectable prior to spacer implantation (0.003 μg/g [0.003–0.261]) and increased to 0.318 μg/g [0.024–484.16] at the time of spacer removal. This was also observed for gentamicin in the tissue of patients who previously had cement‐free implants (0.008 μg/g [0.008–0.087] vs. 0.164 μg/g [0.048–71.75]) while in the tissue of patients with previously cemented prosthesis, baseline concentration was already high (8.451 μg/g [0.152–42.926]). Despite the rapid decrease in antibiotics release from spacer cement observed in vitro, in vivo antibiotics are much longer detectable, especially in the adjacent soft tissue. © 2018 The Authors. Journal of Biomedical Materials Research Part B: Applied Biomaterials Published By Wiley Periodicals, Inc. J Biomed Mater Res B Part B, 2019. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 1587–1597, 2019.