bluuebunny/crossref_metadata_2025_split huggingface dataset:
On Being Fired: When Patients or Their Parents Fire Their Physician
Authors: Cummings Christy L. 
Published: September 2016

AbstractWait, what? I've been fired?” I repeated, in the middle of morning rounds in the neonatal intensive care unit. Finally, the nurse who was taking care of our patient, Angela, responded, “Her parents fired you last night. They've already called Patient Relations. They want a new doctor.” My heart sank. Only days into my block of service time as the attending physician in the NICU and I was fired, axed, canned, rejected by a family. How could this have happened? On my first day of service, I had introduced myself to Angela's parents, and I had then met with them daily to review results and the plan and to answer their questions. I thought we had connected well. I thought I had done everything right. I thought they trusted me to care for their daughter.
Ethics Hype?
Authors: Caulfield Timothy 
Published: September 2016

AbstractThere has been growing concern about the phenomenon of science hype, the tendency to exaggerate the value or near‐future application of research results. Although this is a problem that touches every area of biomedicine, the topic of genetics seems to be particularly prone to enthusiastic predictions. The world has been told for over two decades‐by the media, researchers, politicians, and the biotech industry‐that a genome‐driven health care revolution is just around the corner. And while the revolution never seems to arrive, the hopeful rhetoric continues. It has been suggested that this unrelenting “genohype” is having a range of adverse social consequences, including misleading the public and hurting the long‐term legitimacy of the field. While we need more good data on the nature and magnitude of these possible harms, few would argue with the proposition that sustained science hype is a bad thing. We all benefit from robust science and accurate public representations of biomedical research. But, to date, there has been very little consideration of the degree to which the scholarship on the related ethical, legal, and social issues has been hyped. Are the conclusions from ELSI scholarship also exaggerated?
From “Personalized” to “Precision” Medicine: The Ethical and Social Implications of Rhetorical Reform in Genomic Medicine
Authors: Juengst Eric , McGowan Michelle L. , Fishman Jennifer R. , Settersten Richard A. 
Published: September 2016

AbstractSince the late 1980s, the human genetics and genomics research community has been promising to usher in a “new paradigm for health care”—one that uses molecular profiling to identify human genetic variants implicated in multifactorial health risks. After the completion of the Human Genome Project in 2003, a wide range of stakeholders became committed to this “paradigm shift,” creating a confluence of investment, advocacy, and enthusiasm that bears all the marks of a “scientific/intellectual social movement” within biomedicine. Proponents of this movement usually offer four ways in which their approach to medical diagnosis and health care improves upon current practices, arguing that it is more “personalized,” “predictive,” “preventive,” and “participatory” than the medical status quo. Initially, it was personalization that seemed to best sum up the movement's appeal. By 2012, however, powerful opinion leaders were abandoning “personalized medicine” in favor of a new label: “precision medicine.” The new label received a decisive seal of approval when, in January 2015, President Obama unveiled plans for a national “precision medicine initiative” to promote the development and use of genomic tools in health care.
A Conceptual Model for the Translation of Bioethics Research and Scholarship
Authors: Mathews Debra J.H. , Hester D. Micah , Kahn Jeffrey , McGuire Amy , McKinney Ross , Meador Keith , Philpott‐Jones Sean , Youngner Stuart , Wilfond Benjamin S. 
Published: September 2016

AbstractWhile the bioethics literature demonstrates that the field has spent substantial time and thought over the last four decades on the goals, methods, and desired outcomes for service and training in bioethics, there has been less progress defining the nature and goals of bioethics research and scholarship. This gap makes it difficult both to describe the breadth and depth of these areas of bioethics and, importantly, to gauge their success. However, the gap also presents us with an opportunity to define this scope of work for ourselves and to help shape the broader conversation about the impact of academic research.Because of growing constraints on academic funding, researchers and scholars in many fields are being asked to demonstrate and also forecast the value and impact of their work. To do that, and also to satisfy ourselves that our work has meaningful effect, we must understand how our work can motivate change and how that change can be meaningfully measured. In a field as diverse as bioethics, the pathways to and metrics of change will likewise be diverse. It is therefore critical that any assessment of the impact of bioethics research and scholarship be informed by an understanding of the nature of the work, its goals, and how those goals can and ought to be furthered. In this paper, we propose a conceptual model that connects individual bioethics projects to the broader goals of scholarship, describing the translation of research and scholarly output into changes in thinking, practice, and policy. One of the key implications of the model is that impact in bioethics is generally the result of a collection of projects rather than of any single piece of research or scholarship. Our goal is to lay the groundwork for a thoroughgoing conversation about bioethics research and scholarship that will advance and shape the important conversation about their impact.
Nurses at the Table
Authors: Ulrich Connie M. 
Published: September 2016

AbstractFew bioethicists are educated with a view into nursing. Thus, much of the conceptual and empirical research on ethical issues in nursing practice has been conducted by nurse ethicists themselves and, to a lesser degree, by individuals with a strong interest in nursing ethics. Although this work has internally shaped nursing practice, education, and policy, the broader field of bioethics has seldom examined and acknowledged the everyday ethical concerns of practicing nurses and their important contributions to bioethics discourse. In this special report of the Hastings Center Report —the first to focus on nursing—Christine Grady, Ann Hamric, and I, along with consulting editor Nancy Berlinger, strive to give voice to the contributions of nurses in addressing some of our obstinate everyday ethics and health policy challenges.
Educating Nurses for Ethical Practice in Contemporary Health Care Environments
Authors: Grace Pam , Milliken Aimee 
Published: September 2016

AbstractBecause health care professions exist to provide a good for society, ethical questions are inherently part of them. Such professions and their members can be assessed based on how effective they are in developing knowledge and enacting practices that further the health and well‐being of individuals and society. The complexity of contemporary health care environments makes it important to prepare clinicians who can anticipate, recognize, and address problems that arise in practice or that prevent a profession from fulfilling its service goals and obligations. Different health care professions have evolved distinct perspectives about appropriate goals for, and the purposes of, their clinicians, even when the goal of improving health and well‐being for society is shared across professions. While medicine and nursing goals are shared in principle, they differ in the particulars. Given the centrality to nursing of ethical questions, the profession has a collective responsibility to help clinicians at all levels of practice become ethically savvy and to reinforce their moral agency as needed. Both knowledge of nursing ethics and knowledge of the interdisciplinary field of bioethics are critical to nursing work.
Creating a Culture of Ethical Practice in Health Care Delivery Systems
Authors: Rushton Cynda Hylton 
Published: September 2016

AbstractUndisputedly, the United States’ health care system is in the midst of unprecedented complexity and transformation. In 2014 alone there were well over thirty‐five million admissions to hospitals in the nation, indicating that there was an extraordinary number of very sick and frail people requiring highly skilled clinicians to manage and coordinate their complex care across multiple care settings. Medical advances give us the ability to send patients home more efficiently than ever before and simultaneously create ethical questions about the balance of benefits and burdens associated with these advances. Every day on every shift, nurses at the bedside feel an intense array of ethical issues. At the same time, administrators, policy‐makers, and regulators struggle to balance commitments to patients, families, staff members, and governing boards. Ethical responsibilities and the fiduciary, regulatory, and community service goals of health care institutions are not mutually exclusive; they must go hand in hand. If they do not, our health care system will continue to lose valued professionals to moral distress, risk breaking the public's trust, and potentially undermine patient care. At this critical juncture in health care, we must look to new models, tools, and skills to confront contemporary ethical issues that impact clinical practice. The antidote to the current reality is to create a new health care paradigm grounded in compassion and sustained by a culture of ethical practice.
Genomic alterations in human epidermal growth factor receptor 2 (HER2/ERBB2) in head and neck squamous cell carcinoma
Authors: Chung Christine H. , Germain Alexis , Subramaniam Rathan M. , Heilmann Andreas M. , Fedorchak Kyle , Ali Siraj M. , Miller Vincent A. , Palermo Robert A. , Fakhry Carole 
Published: September 2016

ABSTRACTBackgroundDespite recent advances, survival outcomes for those with metastatic or recurrent head and neck squamous cell carcinoma (HNSCC) have remained poor. Novel approaches should be investigated to improve outcomes.MethodsA retrospective chart review was performed of a patient who presented with a TNM classification III HNSCC of the oropharynx, positive for human papillomavirus (HPV) who had a complete response to a human epidermal growth factor receptor 2 (HER2)‐targeted therapy. Amplification rates of HER2 in the HNSCC Cancer Genome Atlas Network (TCGA) dataset and the FoundationOne genomic profiling dataset were evaluated.ResultsComprehensive genomic profiling of the tumor obtained from the dermal metastasis identified amplification of HER2. Data from TCGA and FoundationOne showed that the frequency of HER2 alteration was not observed to vary significantly with HPV tumor status.ConclusionThis case demonstrates the application of genomic profiling to guide treatments in a patient with HNSCC with advanced metastatic disease refractory to standard of care therapies. © 2016 Wiley Periodicals, Inc. Head Neck 39: E15–E19, 2017
Theta burst stimulation‐induced LTP: Differences and similarities between the dorsal and ventral CA1 hippocampal synapses
Authors: Kouvaros Stylianos , Papatheodoropoulos Costas 
Published: September 2016

ABSTRACTThe hippocampal synapses display a conspicuous ability for long‐term plasticity, which is thought to contribute to learning and memory. Previous research has shown that long‐term potentiation (LTP) greatly differs between the dorsal (DH) and ventral (VH) CA1 hippocampal synapses when induced by high‐frequency stimulation. In this study, using rat hippocampal slices and more physiologically relevant activity patterns based on the frequency of the theta rhythm (i.e., theta‐burst stimulation, TBS) we found that the DH compared with the VH displayed a higher ability for induction and stability of NMDA receptor‐dependent LTP of the field excitatory postsynaptic potential. Nevertheless, the maximal magnitude of LTP was similar in the two hippocampal segments. Blockade of GABAB receptors prevented the LTP induction by the minimal effective TBS and reduced the magnitude of LTP induced by longer TBS. TBS produced a three‐fold higher facilitation of the synaptic burst responses in the DH compared with the VH, accompanied by a strong enhancement in the postsynaptic excitation in the DH but mostly depression in the VH. The DH displayed NMDA receptor‐dependent and NMDA receptor‐independent facilitation, but the facilitation in the VH was only NMDA receptor‐dependent. Also, the TBS‐associated activity of GABAB receptors was higher in the DH than in the VH. The different response profiles during TBS could underlie the differences in LTP between the two hippocampal segments. L‐type voltage‐dependent calcium channels (L‐VDCC) and the metabotropic glutamate receptor‐5 (mGluR5) equally contributed in DH and VH to compound LTP induced by relatively long TBS. We propose that these dorsoventral differences in synaptic plasticity reflect specializations of the intrinsic circuitry of the hippocampus, that are involved in the distinct information processing performed by the two hippocampal segments and could effectively support the contribution of the dorsal and the ventral hippocampal segment to single event memory and to emotional memory respectively. © 2016 Wiley Periodicals, Inc.
The progress and challenges in metabolic research in China
Authors: Xu Li , Ren Hao , Gao Guangang , Zhou Linkang , Malik Muhammad Arshad , Li Peng 
Published: September 2016

AbstractMetabolism refers to a chain of chemical reactions converting food/fuel into energy to conduct cellular processes, including the synthesis of the building blocks of the body, such as proteins, lipids, nucleic acids, and carbohydrates, and the elimination of nitrogenous wastes. Metabolic chain reactions are catalyzed by various enzymes that are orchestrated in specific pathways. Metabolic pathways are important for organisms to grow and reproduce, maintain their structures, and respond to their environments. The coordinated regulation of metabolic pathways is important for maintaining metabolic homeostasis. The key steps and crucial enzymes in these pathways have been well investigated. However, the crucial regulatory factors and feedback (or feedforward) mechanisms of nutrients and intermediate metabolites of these biochemical processes remain to be fully elucidated. In addition, the roles of these enzymes and regulatory factors in controlling metabolism under physiological and pathological conditions are largely unknown. In particular, metabolic dysregulation is closely linked to the development of many diseases, including obesity, fatty liver, diabetes, cancer, cardiovascular, cerebrovascular, and neurodegenerative diseases. Therefore, metabolism, an old area of biochemistry, has attracted much attention in the last decade. With substantially increased government funding, the involvement of talented researchers, an improved infrastructure and scientific environment over the last ten years, the basic research in the field of metabolism in China has dramatically advanced. Here, we have summarized the major discoveries of scientists in China in the last decade in the area of metabolism. Due to the vast amount of information, we focused this review on specific aspects of metabolism, particularly metabolic regulation and lipid metabolism in vertebrates. © 2016 IUBMB Life, 68(11):847–853, 2016
In vivo study of alginate hydrogel conglutinating cells to polycaprolactone vascular scaffolds fabricated by electrospinning
Authors: Sun Kwang‐Hsiao , Liu Zhao , Liu Chang‐Jian , Yu Tong , Zhou Min , Liu Cheng , Ran Feng , Pan Li‐Jia , Zhang Huan 
Published: September 2016

AbstractObjectiveThe aim of this study was to explore an innovative cell‐seeding technology applied on artificial vascular scaffolds.MethodsScaffolds were fabricated by electrospinning polycaprolactone (PCL) and seeded with rat endothelial progenitor cells differentiated from adipose‐derived stem cells. Then, we modified the PCL scaffolds through the use of alginate hydrogel conglutinating cells (AHCC), a blank alginate hydrogel coating (BAHC), and natural sedimentation seeding cells (NSSC). The blank PCL (BP) scaffolds without any modifications were considered the blank control group. After modification, the scaffolds were implanted in a rat model. The implanted scaffolds were harvested and observed using histological and immunohistochemical methods and scanning electron microscopy (SEM) at 1, 2, and 4 weeks after implantation, respectively.ResultsThe best regeneration and configuration of the endothelium tissue and the most similar morphology to that of natural endangium was observed qualitatively in the AHCC scaffolds. The BP scaffolds had qualitatively the worst regeneration and configuration and the most dissimilar morphology at the same time point. In the AHCC group, cells could adhere directly on the inner surface of the vascular scaffolds, eliminating the time delay via the NSSC method prior to cell adhesion.ConclusionAHCC are an effective method for seeding cells on vascular scaffolds and can eliminate the time delay for cell adhesion. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 2443–2454, 2017.
Bone Density Loss Is Associated With Blood Cell Counts
Authors: Valderrábano Rodrigo J , Lui Li-Yung , Lee Jennifer , Cummings Steven R , Orwoll Eric S , Hoffman Andrew R , Wu Joy Y ,   for the Osteoporotic Fractures in Men (MrOS) Study Research Group
Published: September 2016

ABSTRACT

Hematopoiesis depends on a supportive microenvironment. Preclinical studies in mice have demonstrated that osteoblasts influence the development of blood cells, particularly erythrocytes, B lymphocytes, and neutrophils. However, it is unknown whether osteoblast numbers or function impact blood cell counts in humans. We tested the hypothesis that men with low BMD or greater BMD loss have decreased circulating erythrocytes and lymphocytes and increased myeloid cells. We performed a cross-sectional analysis and prospective analysis in the Osteoporotic Fractures in Men (MrOS) study, a multisite longitudinal cohort study. A total of 2571 community-dwelling men (≥65 years) who were able to walk without assistance, did not have a hip replacement or fracture, and had complete blood counts (CBCs) at the third study visit were analyzed. Multivariable (MV)-adjusted logistic regression estimated odds of white blood cell (WBC) subtypes (highest and lowest quintile versus middle), and anemia (clinically defined) associated with BMD by DXA scan (at visit 3), annualized percent BMD change (baseline to visit 3), and high BMD loss (&gt;0.5%/year, from baseline to visit 3) at the femoral neck (FN) and total hip (TH). MV-adjusted models included age, BMI, cancer history, smoking status, alcohol intake, corticosteroid use, self-reported health, thiazide use, and physical activity. At visit 3 greater TH BMD loss (per 1 SD) was associated with increased odds of anemia, high neutrophils, and low lymphocytes. Annualized BMD loss of &gt;0.5% was associated with increased odds of anemia, high neutrophils, and low lymphocytes. Similar results were observed for FN BMD regarding anemia and lymphocytes. We conclude that community-dwelling older men with declining hip BMD over about 7 years had increased risks of anemia, lower lymphocyte count, and higher neutrophil count, consistent with preclinical studies. Bone health and hematopoiesis may have greater interdependency than previously recognized. © 2016 American Society for Bone and Mineral Research.
Influence of CMC Molecular Weight and Degree of Substitution on Clay Swelling Inhibition in Water‐Based Drilling Fluids
Authors: Santana Fagundes Keila R. , Fagundes Fabio P. , de Carvalho Laura G. G. , Amorim Luciana V. , Balaban Rosangela C. 
Published: September 2016

SummaryIn this paper, the clay hydration inhibitive properties of carboxymethylcellulose (CMC) in drilling fluids systems were studied. The clay swelling degree was evaluated as a function of time in presence of different aqueous solutions containing sodium chloride, potassium chloride, CMC A (9 × 104 g/mol − DS 0.7), CMC B (2.5 × 105 g/mol − DS 0.7), CMC C (2.5 × 105 g/mol − DS 1.2) and a commercial clay inhibitor based in quaternary amine, that was used as reference pattern. According to results obtained, the low molecular weight CMC showed slightly lower clay swelling degree compared to the high molecular weight along 180 minutes. In parallel, it was confirmed the higher efficiency of quaternary amine‐based commercial inhibitor (QABCI) to control the clay swelling mechanism. Basically, this inhibition effect was attributed to the ability of cationic quaternary ammonium groups to form electrostatic interactions with negatively charged surfaces of the clay, enhancing associative interaction between their particles. Besides, it was visualized by microscopy that the highest molecular weight of CMC provided a reduction in formation and pores size compared to CMC of lower molecular weight after 1,000 minutes in aqueous medium. This behavior could be attributed to the dynamic of interactions between clay and high molecular weight CMC along the time, which is a result of strong contribution of electrostatic interactions between carboxylate groups located along the polymer backbone and positively charged clay layers edges as well as hydrogen bonds.
Thermal Ageing and Accelerated Weathering of HMSPP: Structural and Morphological Studies
Authors: Oliani Washington L. , Komatsu Luiz G. H. , Lugao Ademar B. , Parra Duclerc F. 
Published: September 2016

SummaryThis work focuses of the influence of weathering factors − UV radiation, humidity, and temperature on the structure and morphology poly(propylene) (PP) with high melt strength (HMSPP), also called poly(propylene) modified by irradiation. The HMSPP was prepared from isotactic poly(propylene) (iPP) in presence of acetylene at 110 kPa pressure and irradiated with γ of60Co at doses of 5, 12.5 and 20 kGy. It has been observed that HMSPP deteriorates in the weathering and thermal resistance, and the long‐term stability of HMSPP, beyond substantial color changes. The aged samples were characterized by infrared spectroscopy (FTIR), optical microscopy (OM) and differential scanning calorimetry (DSC). The optical microscopy shows different mechanisms on thermal and artificial weathering ageing. The ageing result under elevated temperature in HMSPPs exposed surfaces follows the order: HMSPP 20 > 12.5 > 5 kGy > iPP. The intense crack formation in surface exposed justifies thermooxidative degradation.