bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ex nihilo nihil fit? Medicine rests on solid foundations
Authors: Little Miles 
Published: May 2013

AbstractRationaleThere seem to be some misunderstandings abroad in the literature about medical epistemology and person‐centered medicine concerning the nature of ‘modest’ or aetiological foundationalism, and some vagueness about ‘emergence’.Aims and objectivesThis paper urges a greater tolerance for a modest, Humean variety of foundationalism, not least because it seems to offer significant support for person‐centred medicine. It also suggests a closer examination of emergence as an explanation or justification for medicine, since emergence is a complex concept that does nothing to rule out foundationalism.MethodsReading of relevant literatures relating to foundationalism, emergence and person‐centered medicine, and reflection on the arguments they contain.ResultsFoundationalism has been condemned tout court without recognizing that it comes in various styles and degrees. Emergence has been used as a property of medicine to dismiss any need to seek its foundations. But emergence too comes in different forms, not all of them at odds with modest foundationalism. Modest or aetiological foundationalism is far more flexible than Cartesian foundationalism, and is compatible with modern understandings of emergence.ConclusionsModest foundationalism and a particular understanding of emergence support the ontological and epistemological underpinning of person‐centered medicine.
The tribunal of modern life: the case of UZ Brussels in the light of Odo Marquard's discussion on autonomy and theodicy
Authors: Devisch Ignaas 
Published: May 2013

AbstractRecently, a court in Belgium awarded a sum of 400 000 euros to the parents of a child with disability who at that point had already died of Sanfilippo syndrome. Their charge was not that the baby was born with disability, but that the child was born. The charge was brought in the child's name, and so effectively, the child had sued against its own birth.This so‐called ‘unique case’ is analyzed with the work of the German philosopher Odo Marquard. Marquard's work on theodicy, and the question of suffering and evil, is very useful to explain why this case is the current apotheosis of a logic present in modernity: existence as a tribunal. This paper explains why Marquard's work sheds an interesting light on this case for today's medicine.
Metaphysics and medical education: taking holism seriously
Authors: Wilson Bruce 
Published: May 2013

AbstractMedical education is now suffused with concepts that have their source outside the traditional scientific and medical disciplines: concepts such as holism, connectedness and reflective practice. Teaching of these, and other problematic concepts such as medical uncertainty and error, has been defined more by the challenge they pose to the standard model rather than being informed by a strong positive understanding. This challenge typically involves a critical engagement with the idea of objectivity, which is rarely acknowledged as an inherently metaphysical critique. Consequently, these ideas prove to be difficult to teach well. I suggest that the lack of an integrating, positive narrative is the reason for teaching difficulty, and propose that what is needed is an explicit commitment to teach the metaphysics of medicine, with the concept of holism being the fulcrum on which the remaining concepts turn. An acknowledged metaphysical narrative will encompass the scientific realism that medical students typically bring to their tertiary education, and at the same time enable a bigger picture to be drawn that puts the newer and more problematic concepts into context.
The frustrations of virtue: the myth of moral neutrality in psychotherapy
Authors: Hamilton Richard 
Published: May 2013

AbstractThis article questions a number of widely held views of the role of values in psychotherapy. It begins with a discussion of the now largely discredited view that psychotherapy can be value free. It also broadens this challenge to question the popular idea that values form an inescapable part of the therapeutic encounter. While this view is correct in outline, it is necessary to reject the underlying conception of values as largely arbitrary preferences that the client and the therapist bring to the encounter, as this fails to do justice to the inherently ethical nature of psychotherapy. It argues that we should recover the Greek notion of therapy as essentially concerned with the character of a person. In other words, the goal of therapy is virtue.
‘Understanding it makes it normal’: is it a reasoning fallacy or not?
Authors: Gurova Lilia 
Published: May 2013

AbstractIn 1973, P. Meehl drew attention to the fact that some clinicians tend to interpret the otherwise clear symptomatic behaviour of their patients as ‘normal’ if they are given a plausible causal story of patients' behaviours. He claimed that this way of thinking is, in fact, fallacious and gave the alleged fallacy the ‘catchy’ name ‘understanding it makes it normal’.Thirty years later, the cognitive psychologists W.K. Ahn, L. Novick and N. Kim questioned the fallacy status of ‘understanding it makes it normal’ by arguing that this way of reasoning is not only quite common among clinicians but that it is in fact rational.The controversy over whether ‘understanding it makes it normal’ is a reasoning fallacy or not is still unresolved and this is evident from the recent discussion about the proposed removal of the ‘normal grief’ exclusion criterion for Major Depressive Disorder from DSM‐5.This paper proposes an analysis of what stands behind the two opposing claims about ‘understanding it makes it normal’. The analysis builds on the distinction between validity and utility of psychiatric diagnoses and reaches the following conclusions: (1) the fallacy claim is consistent with the assumption that the psychiatric diagnoses are valid descriptions of real mental disorders; (2) the non‐fallacy claim is consistent with the opposite assumption that current psychiatric diagnoses are not valid but only useful descriptions and their utility varies across different contexts; (3) if we agree that there is not enough evidence for the validity of the diagnostic categories embedded in DSM‐4 and ICD‐10, we should also agree that the behaviour of those mental health professionals who change their diagnoses under the influence of the causal context is rational; (4) nevertheless, the ‘understanding it makes it normal’ reasoning strategy should be considered a bias insofar as it takes into account only part of the causal context: the causes of the symptoms but not what they themselves might cause. The neglect of the latter might have dramatic negative consequences in clinical practice. In addition, some recent studies suggest that this bias probably has cultural roots.
Uncovering values‐based practice:VBP's implicit commitments to subjectivism and relativism
Authors: Cassidy Ben 
Published: May 2013

AbstractDespite assertions to the contrary,KWM Fulford's values‐based practice is implicitly committed to subjectivism when it comes to reasoning about values. This renders the approach unworkable. The act of merely uncovering underlying values is not enough to effect change and, therefore, resolve problems if we have no way, even in principle, of determining which values are right and which are wrong.Fulford's only departure from subjectivism about value is his commitment to ‘framework values’, which seems grounded in a version of ethical relativism.Iargue that we need to reject both subjectivism and relativism if progress within ethical discussions about practice is to be meaningful and a real possibility.
Lactose malabsorption diagnosed by 50‐g dose is inferior to assess clinical intolerance and to predict response to milk withdrawal than 25‐g dose in an endemic area
Authors: Ghoshal Uday C , Kumar Sunil , Misra Asha , Mittal Balraj 
Published: May 2013

AbstractBackgroundLactose malabsorption (LM), diagnosed currently using lactose hydrogen breath and tolerance tests (LHBT, LTT) with a high, nonphysiological dose (50‐g), may mimic irritable bowel syndrome (IBS). In LM‐endemic areas, clinically significant malabsorption (lactose intolerance) may be better diagnosed using a lesser dose, and positive results so obtained may predict response to milk withdrawal more effectively.MethodsFifty patients each with IBS (Rome III) were evaluated using LHBT and LTT with 50‐g, 25‐g, and 12‐g lactose. Sensitivity and specificity of LHBT and LTT with different dosages (gold standard: lactase gene C/T‐13910 polymorphism) and symptom development were evaluated. Effect of milk withdrawal was studied.ResultOf 150 patients, 37/50 (74%) and 28/50 (56%) had LM by LHBT and LTT using 50‐g lactose; 41/50 (82%) and 31/50 (62%) had LM using 25‐g lactose, and 14/50 (28%) and 29/50 (58%) using 12‐g lactose, respectively. Sensitivity and specificity of LHBT using 50‐g, 25‐g, and 12‐g lactose were 92.6%, 52.0%, and 94%, 60%, and 36.4%, 88.2%, and those of LTT, 92%, 80.0%, and 84.8%, 82.4%, and 66.7%, 58.8%, respectively. Breath hydrogen correlated with lactose dose. Though patients developing symptoms with 50‐g lactose exhaled more hydrogen than those remaining asymptomatic, hydrogen levels did not differ following 25‐g and 12‐g dosages in relation to symptom development. Patients' milk intake was 335 ± 92 mL/d (≈ 16.7 ± 9.6‐g lactose). Positive LHBT using 25‐g dose better predicted symptom resolution than by 50‐g and 12‐g lactose.ConclusionTwenty‐five gram is the ideal dose of lactose for LHBT and LTT in LM‐endemic areas.
Variants in CCK and CCKAR genes to susceptibility to biliary tract cancers and stones: A population‐based study in Shanghai, China
Authors: Xu Hong‐Li , Hsing Ann W. , Vogtmann Emily , Chu Lisa W. , Cheng Jia‐Rong , Gao Jing , Tan Yu‐Ting , Wang Bing‐Sheng , Shen Ming‐Chang , Gao Yu‐Tang 
Published: May 2013

AbstractBackground and AimAltered motility of the gallbladder is associated with an increased risk of gallstones and can result in biliary tract cancers. Cholecystokinin (CCK) is an important modulator of gallbladder motility which functions by activating CCK type‐A receptor (CCKAR). The aim of this study was to determine whether genetic variants in CCK and CCKAR are associated with the risk of biliary tract cancers and stones.MethodsWe investigated the associations between nine single nucleotide polymorphisms in CCK and CCKAR in a population‐based case–control study, including 439 biliary tract cancer cases (253 gallbladder, 133 extrahepatic bile duct, and 53 ampulla of Vater cancer cases), 429 biliary stone cases, and 447 population controls in Shanghai, China.ResultsWe found that women with the CCKAR rs1800855 AA genotype had an increased risk of gallbladder cancer (odds ratio = 2.37, 95% confidence interval (CI): 1.36–4.14) compared with subjects with the TT genotype, and remained significant after Bonferroni correction (P = 0.0056). Additionally, female carriers of the CCKAR haplotype C‐T‐C‐T (rs2071011‐rs915889‐rs3822222‐rs1800855) had a reduced risk of gallbladder cancer (odds ratio = 0.61, 95% confidence interval: 0.43–0.86) compared with those with the G‐C‐C‐A haplotype; the association also remained significant after Bonferroni correction.ConclusionsThese findings suggest that variants in the CCKAR gene may influence the risk of gallbladder cancer in women. Additional studies are needed to confirm our findings.
Discovery of diamond in the Tromsø Nappe, Scandinavian Caledonides (N. Norway)
Authors: Janák M. , Krogh Ravna E. J. , Kullerud K. , Yoshida K. , Milovský R. , Hirajima T. 
Published: May 2013

AbstractWe report the first finding of diamond in crustal rocks from the Tromsø Nappe of the North Norwegian Caledonides. Diamond occurs in situ as inclusions in garnet from gneiss at Tønsvika near Tromsø. The rock is composed essentially of garnet, biotite, white mica, quartz and plagioclase, minor constituents include kyanite, zoisite, rutile, tourmaline, amphibole, zircon, apatite and carbonates (magnesite, dolomite, calcite). The microdiamond, identified by micro‐Raman spectroscopy, is cuboidal to octahedral in shape and ranges from 5 to 50 μm in diameter. The diamond occurs as single grains and as composite diamond + carbonate inclusions. Diamond vibration bands show a downshift from 1 332 to 1 325 cm−1, the majority of Raman peaks are centred between 1 332 and 1 330 cm−1 and all peaks exhibit a full width at half maximum between 3 and 5 cm−1. Several spectra show Raman bands typical for disordered and ordered graphite (sp2‐bonded carbon) indicating partial transformation of diamond to graphite. The calculated peak P–T conditions for the diamond‐bearing sample are 3.5 ± 0.5 GPa and 770 ± 50 °C. Metamorphic diamond found in situ in crustal rocks of the Tromsø Nappe thus provides unequivocal evidence for ultrahigh pressure metamorphism in this allochthonous unit of the Scandinavian Caledonides. Deep continental subduction, most probably in the Late Ordovician and shortly before or during the initial collision between Baltica and Laurentia, was required to stabilize the diamond at UHP conditions.
Bite force measurements with hard and soft bite surfaces
Authors: Serra C. M. , Manns A. E. 
Published: May 2013

SummaryBite force has been measured by different methods and over a wide variety of designs. In several instruments, the fact that bite surface has been manufactured with stiff materials might interfere in obtaining reliable data, by a more prompt activation of inhibitory reflex mechanisms. The purpose of this study was to compare the maximum voluntary bite force measured by a digital occlusal force gauge (GM10 Nagano Keiki, Japan) between different opponent teeth, employing semi‐hard or soft bite surfaces. A sample of 34 young adults with complete natural dentition was studied. The original semi‐hard bite surface was exchanged by a soft one, made of leather and rubber. Maximum voluntary bite force recordings were made for each tooth group and for both bite surfaces. Statistical analyses (Student's t‐test) revealed significant differences, with higher scores while using the soft surface across sexes and tooth groups (P < 0·05). Differential activation of periodontal mechanoreceptors of a specific tooth group is mainly conditioned by the hardness of the bite surface; a soft surface induces greater activation of elevator musculature, while a hard one induces inhibition more promptly. Thus, soft bite surfaces are recommended for higher reliability in maximum voluntary bite force recordings.
Salivary antioxidants in patients with systemic sclerosis
Authors: Zalewska Anna , Knaś Małgorzata , Gińdzieńska‐Sieśkiewicz Ewa , Waszkiewicz Napoleon , Klimiuk Anna , Litwin Katarzyna , Sierakowski Stanisław , Waszkiel Danuta 
Published: May 2013

BackgroundIn spite of relatively large amount of evidence that oxidative stress is implicated in the pathogenesis of systemic sclerosis, there is no study analyzing antioxidants profile of the saliva of these patients. The aim of this study was to compare salivary antioxidants in subjects with systemic sclerosis and the healthy controls.MethodsThe unstimulated and stimulated salivary flow and the specific activity of peroxidase, superoxide dismutase 1, the total amount of uric acid, and total antioxidant status were determined in two subgroups of systemic sclerosis women and healthy controls.ResultsA significant increase in the specific activity of peroxidase, a significant decrease in the total amount of uric acid and total antioxidants status in unstimulated saliva as well as a significant increase in all antioxidants examined in stimulated saliva of group with normal salivary flow rate as compared to the healthy controls were observed. Our results showed a significant decrease in the specific activity of peroxidase in unstimulated and a significant decrease in all antioxidants examined in stimulated saliva of the group with hyposalivation as compared to the group with normal salivary flow rate.ConclusionsOur results prove that impairment of the salivary glands in the course of systemic sclerosis may be attributed to free radicals, and it is correlated with disease duration.
Occurrence and Phylogenetic Analysis of Potyviruses, Carlaviruses and Allexiviruses in Garlic in Sudan
Authors: Salih Mohammed Heyam , Zicca Stefania , Manglli Ariana , Elaiderous Mohamed Moawia , El Siddig Marmar A. R. , El Hussein Adil Ali , Tomassoli Laura 
Published: May 2013

AbstractAllium sativum L. samples of three cultivars grown in Sudan were shown to contain several of the common garlic viruses of the genera Potyvirus, Carlavirus and Allexivirus. In particular, Onion yellow dwarf virus (OYDV), Leek yellow stripe virus (LYSV), Garlic common latent virus (GarCLV), Garlic virus A (GVA), Garlic virus B (GVB), Garlic virus C (GVC) and Garlic virus X (GVX) were detected by reverse transcription polymerase chain reaction (RT‐PCR) assay using degenerate genus‐specific and virus‐specific primer sets. Multiple viral infections with members of all three genera were found in all but one sample. Further, molecular and phylogenetic analysis of nucleotide and deduced amino acid sequences revealed that Sudanese isolates of LYSV, GarCLV and of Allexivirus genus were significantly divergent in partial coat protein genomic region from isolates of the same species retrieved from GenBank. This is the first report and study on viruses infecting garlic in Sudan.
Further mulinane diterpenoids from Azorella compacta
Authors: Areche Carlos , Rojas-Alvarez Francisca , Campos-Briones Carolina , Lima Carlos , Pérez Edwin G , Sepúlveda Beatriz 
Published: May 2013

Abstract

Objectives
The chemical study of a dichloromethane extract from Azorella compacta was directed to the isolation of characteristic mulinane and azorellane diterpenoids in order to determine their gastroprotective activity.

Methods
Usual chromatographic techniques on the extract led to the isolation of 12 compounds, which were identified by their spectroscopic properties. The HCl/ethanol-induced gastric lesions model in mice was used to determine the gastroprotective activity.

Key findings
The new diterpenoids, 13β-hydroxymulinane (1), mulin-11,13-dien-20-ol (2), 13α-methoxyazorellanol (3) and mulin-11,13-dien-18-acetoxy-16,20-dioic acid (12) were isolated from A. compacta. The known diterpenoids mulin-11,13-dien-20-oic acid (4), 13α-hydroxyazorellane (5), 13β-hydroxyazorellane (6), mulinic acid (7), mulinolic acid (8) and azorellanol (9), and the aromatic compounds 5,7-dihydroxychromone (10) and isoflavonoid biochanin A (11), were also obtained from the extract. Compounds 6, 9 and 12 at 20 mg/kg reduced gastric lesions by 69%, 71% and 73%, respectively, being statistically similar to lansoprazole at the same dose.

Conclusions
The results corroborate the intraspecific chemical variations detected previously in specimens of A. compacta collected at different Chilean latitudes. A high concentration of azorellanol (9) could account in part for some of the therapeutic properties attributed to this species, in particular in ulcer treatment. Most of the mulinane and azorellane diterpenoids isolated in this study showed relevant gastroprotective activity at a low dose in the bioassay.
Dynamic Properties of Golden Delicious and Red Delicious Apple under Normal Contact Force Models
Authors: Barikloo Hossein , Ahmadi Ebrahim 
Published: May 2013

AbstractDynamic forces cause the most bruise damage during fruit transport and handling. In order to reduce this damage, it is necessary to model the impact forces. Limited information is available in the literature about the behavior dynamic and dynamic modeling for apple. The normal force‐displacement relationship between a viscoelastic sphere (fruit apple) and an impactor was analyzed using the Kuwabara and Kond and Tsuji models as normal force models. Fruits were subjected to dynamic loading by means of a pendulum at impact levels. In order to estimate the parameters (spring, “k” and damping, “c”) of the mentioned models for normal impacts, the nonlinear least squares technique (optimization method) was used.Practical ApplicationsA very promising approach for the simulation of fruit impact damage during transport and handling is the contact force discrete element method (DEM). In order to do so, models for the forces acting between particles (like fruits) in contact need to be specified. Forces acting between the two particles are decomposed into normal and tangential components. In this paper, the focus is set on normal contacts. The presented research determines the parameters of normal contact forces models suited for DEM simulation of viscoelastic materials (fruit).
Effect of Ovariohysterectomy at the Time of Tumor Removal in Dogs with Benign Mammary Tumors and Hyperplastic Lesions: A Randomized Controlled Clinical Trial
Authors: Kristiansen V.M. , Nødtvedt A. , Breen A.M. , Langeland M. , Teige J. , Goldschmidt M. , Jonasdottir T.J. , Grotmol T. , Sørenmo K. 
Published: May 2013

BackgroundNonmalignant mammary tumors (NMT) are common in intact female dogs. Little is known about the clinical significance of these tumors, and the effect of ovariohysterectomy (OHE) on their development.HypothesisOvarian hormone ablation through OHE decreases the risk of new tumors and thereby improves long‐term prognosis for dogs with NMT.AnimalsEighty‐four sexually intact bitches with NMT.MethodsDogs were allocated to undergo OHE (n = 42) or not (n = 42) at the time of NMT removal in a randomized clinical trial. Tumor diagnosis was confirmed histologically in all subjects. Information about new tumor development was collected via follow‐up phone calls and recheck examinations. Separate survival analyses were performed with the endpoints new tumor development and death. Cause of death was classified as related or unrelated to mammary tumor. In addition to OHE status, the influence of age, body weight, breed, tumor size, tumor number, tumor duration, type of surgery, and tumor histology was investigated.ResultsNew mammary tumor(s) developed in 27 of 42 (64%) intact dogs and 15 of 42 (36%) ovariohysterectomized dogs (hazard ratio 0.47, P = .022). Nine of the 42 dogs (21%) which developed new tumors were euthanized because of mammary tumor. Survival was not significantly different between the 2 treatment groups. In the intact group, nine dogs subsequently developed ovarian–uterine diseases.ConclusionOvariohysterectomy performed at the time of mammary tumor excision reduced the risk of new tumors by about 50% among dogs with NMT. Survival was not significantly affected. Adjuvant OHE should be considered in adult dogs with mammary tumors.