bluuebunny/crossref_metadata_2025_split huggingface dataset:
Eliminating LGBTIQQ Health Disparities: The Associated Roles of Electronic Health Records and Institutional Culture
Authors: Callahan Edward J. , Hazarian Shea , Yarborough Mark , Sánchez John Paul 
Published: October 2014

AbstractFor all humans, sexual orientation and gender identity are essential elements of identity, informing how we plan and live our lives. The historic invisibility of sexual minorities in medicine has meant that these important aspects of their identities as patients have been ignored, with the result that these patients have been denied respect, culturally competent services, and proper treatment. Likely due to historic rejection and mistreatment, there is evidence of reluctance on the part of LGBT patients to disclose their sexual orientation (SO) or gender identity (GI) to their health care providers. There is some perception of risk in sharing SO and GI for many patients who have had bad prior experiences. Despite these risks, we argue that we can improve the quality of care provided this population only by encouraging them to self‐identify and then using that information to improve quality of care.One strategy both to prompt patient self‐identification and to store and use SO and GI data to improve care centers on the use of electronic health records. However, gathering SO and GI data in the EHR requires a workforce that knows both how to obtain and how to use that information. To develop these competencies, educational programs for health professionals must prepare students and educators to elicit and to use sexual orientation and gender identity information to improve care while simultaneously ensuring the safety of patients, trainees, and staff and faculty members as SO and GI become openly discussed and integral parts of ongoing medical discussion and care. As determination of SO and GI demographics becomes more common in health research, we will more fully understand the health risks for all the LGBTIQQ populations.
Repaving the Road of Good Intentions: LGBT Health Care and the Queer Bioethical Lens
Authors: Wahlert Lance , Fiester Autumn 
Published: October 2014

AbstractAs the saying goes, “The road to hell is paved with good intentions.” And in the recent burst of clinical attention being paid to the needs of lesbian, gay, bisexual, and transgender patients, good intentions abound. But while this long‐overdue interest in LGBT health care aims to highlight important gaps and bring into relief serious issues in health care delivery for LGBT persons, such work can inadvertently reinforce both the marginalization of sexual minorities and the cultural norms related to sexuality, gender identity, and the conventional family. To ensure that positive outcomes for LGBT patients are inextricably paired with those noble intentions, we advocate for a new, queer bioethics—a methodology of scholastic, bioethical, and critical scrutiny that not only addresses the needs of LGBT persons in health care settings but also considers the perspectives, histories, and feelings of such parties.
Reflections from a Troubled Stream: Giubilini and Minerva on “After‐Birth Abortion”
Authors: Hauskeller Michael 
Published: October 2014

AbstractWhen Jonathan Swift published “A Modest Proposal for Preventing the Children of Poor People of Being a Burden on their Country or Parents, and for Making Them Beneficial to the Publick” in 1729, many early readers were shocked and repulsed. Yet if a similar proposal were published today in a reputable academic journal, we could not be sure of its satirical character: it might well be entirely sincere. In late February this year, the Journal of Medical Ethics prepublished online a paper that can be seen as a modernized bioethical version of Swift's “Modest Proposal.” All the authors had done is present a “well reasoned argument based on widely accepted premises” that allowed them to “proceed logically” from those premises to the conclusions.
What Law Really Requires
Authors: JOHNSON SANDRA H. 
Published: October 2014

AbstractMost health reform efforts focus on devising legal norms and procedures that will push the practice of health care professionals in the desired direction. In fact, although the law is a powerful influence on health care delivery and treatment decision‐making, many health reform efforts that rely on changes in the law fail to produce the expected good effect. Experience teaches that there are many reasons a legal requirement can fail to work as expected. In health care, one occasion for slippage between good intentions and good outcomes for law reform is the transformation of legal standards through the formal and informal standards and procedures established within health care organizations.
How Many Justices Does It Take to Change the U.S. Health System?
Authors: Sage William M. 
Published: October 2014

AbstractThere were two ways for the solicitor general of the United States to litigate the constitutional challenge to the Patient Protection and Affordable Care Act of 2010 brought by twenty‐six states and the National Federation of Independent Business. One path, which the solicitor general pursued, was to cautiously navigate judicial precedents, claim the barest increment of new congressional authority, and give the Supreme Court as many hooks as possible on which to hang a favorable decision.The road not traveled was to offer a full‐throated defense of federal authority to comprehensively regulate the U.S. health care system, a multitrillion dollar commercial and social enterprise that represents the largest component of federal expenditure after national defense. The ACA has three cornerstones. First, make health insurance coverage as widespread as possible. Second, improve the quality and efficiency of health care delivery. Third, make individuals and communities healthier. The second and third pillars are sometimes overlooked because so much attention is paid to expanding coverage, but the hallmark of the ACA is that it combines major changes to health insurance, health care delivery, and health in a single piece of federal legislation.The Obama administration's timidity echoes what is strikingly absent from the new law. Although the ACA represents the successful culmination of a decades‐long struggle to universalize coverage, its structure and text never convey the intent that all Americans have a common stake in the health care system. This lack of shared national identity is the missing fourth pillar of the ACA.
Abortion Bans Premised on Fetal Pain Capacity
Authors: Wilson Katie 
Published: October 2014

AbstractAbortion bans premised on fetal pain capacity are this decade's “partial‐birth abortion”: a medically suspect anti‐choice initiative that can be politically difficult to oppose. No one is “pro–fetal pain.” But rhetorically, the concept of “fetal pain” works to conflate the capacity for pain with the experience of pain. If pain justified banning medical procedures, all surgery would be illegal. Pain is a routine side effect of medical practice. What's unethical is unnecessary pain, and that's why the standard medical response to pain is palliation.
Seven Things to Know about Female Genital Surgeries in Africa
Authors:   By The Public Policy Advisory Network on Female Genital Surgeries in Africa
Published: October 2014

AbstractStarting in the early 1980s, media coverage of customary African genital surgeries for females has been problematic and overly reliant on sources from within a global activist and advocacy movement opposed to the practice, variously described as female genital mutilation, female genital cutting, or female circumcision. Here, we use the more neutral expression female genital surgery. In their passion to end the practice, anti‐mutilation advocacy organizations often make claims about female genital surgeries in Africa that are inaccurate or overgeneralized or that don't apply to most cases.The aim of this article—which we offer as a public policy advisory statement from a group of concerned research scholars, physicians, and policy experts—is not to take a collective stance on the practice of genital surgeries for either females or males. Our main aim is to express our concern about the media coverage of female genital surgeries in Africa, to call for greater accuracy in cultural representations of little‐known others, and to strive for evenhandedness and high standards of reason and evidence in any future public policy debates. In effect, the statement is an invitation to actually have that debate, with all sides of the story fairly represented.
Physician, Patient, Parent: Where Exactly Is the Line?
Authors: Opel Douglas J. 
Published: October 2014

AbstractI have Crohn's disease. This essay is about how my experiences with this disease have shaped my perceptions of boundaries in medicine, particularly around the issue of self‐disclosure. I became a pediatrician first, then a parent, and now a patient, and with each new role, I have become increasingly confused on where boundaries regarding self‐disclosures in medicine lie. I'd like to make the case for more of a reframing and a blurring of personal and professional boundaries regarding physicians’ disclosures about their own health. Although historically thought of as a way to strengthen the physician‐patient relationship and therefore encouraged, physician disclosure has recently become more controversial, and boundary discussions that include it seem to increasingly begin from the edict, “Don't do it.” But why not capitalize on the shared experience of physicians and patients? It offers an opportunity to deepen our therapeutic relationship with our patients, to build trust, to help understanding, and maybe even to improve patient outcomes.
Progress in the Animal Research War
Authors: Gilbert Susan 
Published: October 2014

AbstractSome years ago, Deborah Blum, a Pulitzer Prize–winning science journalist, nailed the divide between scientists who conduct research on animals in the hope of advancing medical knowledge and people who object to that work for being immoral and inhumane. They are “like two different nations, nations locked in a long, bitter, seemingly intractable political standoff,” she wrote in her 1994 book, The Monkey Wars. The two sides certainly have been like nations locked in a long, bitter standoff. That standoff has seemed intractable. But when Blum talked to people on both sides, she found glimmers of hope—a few individuals willing to listen to one another and find common ground. “When they can be freely heard,” she concluded, “then we will have progressed to another place, beyond this time of hostilities.”Today, while we are not yet beyond hostilities, we have progressed to another place.
DNA Microarray and Signal Transduction Analysis in Pulmonary Artery Smooth Muscle Cells From Heritable and Idiopathic Pulmonary Arterial Hypertension Subjects
Authors: Yu Jun , Wilson Jamie , Taylor Linda , Polgar Peter 
Published: October 2014

AbstractPulmonary arterial hypertension (PAH) is characterized by increased pulmonary vascular smooth muscle contraction and proliferation. Here, we analyze genome‐wide mRNA expression in human pulmonary arterial smooth muscle cells (HPASMC) isolated from three control, three hereditary (HPAH), and three idiopathic PAH (IPAH) subjects using the Affymetrix Human Gene ST 1.0 chip. The microarray analysis reveals the expression of 537 genes in HPAH and 1024 genes in IPAH changed compared with control HPASMC. Among those genes, 227 genes show similar directionality of expression in both HPAH and IPAH HPASMC. Ingenuity™ Pathway Analysis (IPA) suggests that many of those genes are involved in cellular growth/proliferation and cell cycle regulation and that signaling pathways such as the mitotic activators, polo‐like kinases, ATM signaling are activated under PAH conditions. Furthermore, the analysis demonstrates downregulated mRNA expression of certain vasoactive receptors such as bradykinin receptor B2 (BKB2R). Using real time PCR, we verified the downregulated BKB2R expression in the PAH cells. Bradykinin‐stimulated calcium influx is also decreased in PAH PASMC. IPA also identified transcriptional factors such p53 and Rb as downregulated, and FoxM1 and Myc as upregulated in both HPAH and IPAH HPASMC. The decreased level of phospho‐p53 in PAH cells was confirmed with a phospho‐protein array; and we experimentally show a dysregulated proliferation of both HPAH and IPAH PASMC. Together, the microarray experiments and bioinformatics analysis highlight an aberrant proliferation and cell cycle regulation in HPASMC from PAH subjects. These newly identified pathways may provide new targets for the treatment of both hereditary and idiopathic PAH. J. Cell. Biochem. 116: 386–397, 2015. © 2014 Wiley Periodicals, Inc.
Modelling sustainable salt water management under deficit irrigation conditions for melon in Spain and Brazil
Authors: Leite Kelly N , Cabello María J , Valnir Júnior Manuel , Tarjuelo José M , Domínguez Alfonso 
Published: October 2014

AbstractBACKGROUNDIn water scarcity areas the use of saline water for irrigation is a common practice. In this study, experimental data from two two‐year melon tests were collected for the calibration (2004 ‘Yellow Melon’ (YeMe) type) and validation (2002 YeMe, 2005 and 2006 ‘Piel de Sapo’ (PiSa) type) processes in melon crop simulation under deficit irrigation conditions using salt water. The simulations were carried out for Castilla‐La Mancha (Spain) and Ceará (Brazil) using the MOPECO model, which includes optimized regulated deficit irrigation (ORDI) methodology. The objective was to determine the most suitable irrigation strategy for both areas.RESULTSUnder fresh water conditions, ORDI may increase yield by up to 20% (PiSa) and 7% (YeMe) compared with constant deficit irrigation. Higher water deficit should be induced during the vegetative development and ripening stages. The rainfall between irrigation periods is able to leach the salts supplied by the irrigation water.CONCLUSIONThe combination of ORDI with different strategies for managing saline water may increase water use efficiency. In these areas it may be of interest not to apply the leaching fraction (saving up to 67% of irrigation water). However, leaching of the soluble salts accumulated before starting the most sensitive periods may be suitable. © 2014 Society of Chemical Industry
Effects of levodopa on regional cerebral metabolism and blood flow
Authors: Ko Ji Hyun , Lerner Renata P. , Eidelberg David 
Published: October 2014

AbstractLevodopa (l‐dopa) has been at the forefront of antiparkinsonian therapy for a half century. Recent advances in functional brain imaging have contributed substantially to the understanding of the effects of l‐dopa and other dopaminergic treatment on the activity of abnormal motor and cognitive brain circuits in Parkinson's disease patients. Progress has also been made in understanding the functional pathology of dyskinesias, a common side effect of l‐dopa treatment, at both regional and network levels. Here, we review these studies, focusing mainly on the new mechanistic insights provided by metabolic brain imaging and network analysis. © 2014 International Parkinson and Movement Disorder Society
Norepinephrine deficiency in Parkinson's disease: The case for noradrenergic enhancement
Authors: Espay Alberto J. , LeWitt Peter A. , Kaufmann Horacio 
Published: October 2014

ABSTRACTThe dramatic response of most motor and some nonmotor symptoms to dopaminergic therapies has contributed to maintaining the long‐established identity of Parkinson's disease (PD) as primarily a nigrostriatal dopamine (DA) deficiency syndrome. However, DA neurotransmission may be neither the first nor the major neurotransmitter casualty in the neurodegenerative sequence of PD. Growing evidence supports earlier norepinephrine (NE) deficiency resulting from selective degeneration of neurons of the locus coeruleus and sympathetic ganglia. Dopaminergic replacement therapy therefore would seem to neglect some of the motor, behavioral, cognitive, and autonomic impairments that are directly or indirectly associated with the marked deficiency of NE in the brain and elsewhere. Therapeutic strategies to enhance NE neurotransmission have undergone only limited pharmacological testing. Currently, these approaches include selective NE reuptake inhibition, presynaptic α2‐adrenergic receptor blockade, and an NE prodrug, the artificial amino acid L‐threo‐3,4‐dihydroxyphenylserine. In addition to reducing the consequences of deficient noradrenergic signaling, enhancement strate	gies have the potential for augmenting the effects of dopaminergic therapies in PD. Furthermore, early recognition of the various clinical manifestations associated with NE deficiency, which may precede development of motor symptoms, could provide a window of opportunity for neuroprotective interventions. © 2014 International Parkinson and Movement Disorder Society
Parkinson's Disease, the Subthalamic Nucleus, Inhibition, and Impulsivity
Authors: Jahanshahi Marjan , Obeso Ignacio , Baunez Christelle , Alegre Manuel , Krack Paul 
Published: October 2014

ABSTRACTAlthough Parkinson's disease (PD) is primarily considered a disorder of initiation of actions, patients also have deficits in inhibitory control, both in the motor and cognitive domains. Impulse control disorders, which can develop in association with dopaminergic medication in a small proportion of patients with PD, are the symptoms most commonly considered as representing inhibitory deficits. However, there is now also a body of evidence suggesting a role for the subthalamic nucleus (STN), which is ordinarily hyperactive in PD, in inhibitory control. Here, we review evidence from animal studies, imaging studies, and investigations recording STN activity intra‐ or perioperatively in patients with PD having surgery for DBS of the STN (STN‐DBS). We also highlight relevant hypotheses about the role of the STN and consider evidence from studies that have examined the effect of STN‐DBS in patients with PD on performance of experimental tasks requiring inhibition of prepotent or habitual responses or decision making under conflict, as well as the psychiatric side effects of STN‐DBS. Though the results are not always consistent, nevertheless, this body of evidence supports the role of the STN in inhibitory and executive control. © 2014 International Parkinson and Movement Disorder Society
CHINA'S PENSION CHALLENGE: ADAPTIVE STRATEGY FOR SUCCESS
Authors: Dong Keyong , Wang Gengyu 
Published: October 2014

SUMMARYAfter 30 years of reformation, China has set up a multi‐tiered pension system. This paper aims to observe China's current complex pension scheme longitudinally by analyzing the overall impact and changes it brings to Chinese society. As a broad overview of the whole of China's pension scheme and a discussion of its future challenges, this paper will follow the following order. Firstly, China's pension scheme will be introduced along with the observation of the current standing of the pension scheme from the perspective of a multi‐tiered system and with a brief summary of its history. Secondly, different kinds of pension plans based on urban/rural areas and different occupational groups will be studied. Thirdly, problems of the current pension fund system and its future challenges focusing on financial stability, income support, and controversy over the system will be dealt with, and finally, the adaptive strategy of recent reforms will be discussed. Copyright © 2014 John Wiley & Sons, Ltd.
Apert syndrome: temporal lobe abnormalities on fetal brain imaging
Authors: Stark Zornitza , McGillivray George , Sampson Amanda , Palma‐Dias Ricardo , Edwards Andrew , Said Joanne M. , Whiteley Gillian , Fink A. Michelle 
Published: October 2014

AbstractObjectivesApert syndrome is characterized by craniosynostosis and complex hand and foot syndactyly, and an increased risk of brain, palate, heart, and visceral malformations, and intellectual disability. This study aims to describe the structural brain abnormalities detected by dedicated neuroimaging of fetuses with Apert syndrome.MethodsRetrospective review of ultrasound and magnetic resonance imaging brain imaging obtained in six fetuses with a diagnosis of Apert syndrome.ResultsFive fetuses had attenuation of the septal leaflets, and two had corpus callosum dysgenesis. All six had temporal lobe expansion and overconvolution and temporal lobe clefts. The temporal lobe abnormalities preceded the development of cranial deformity in two fetuses.ConclusionOverexpansion and overconvolution of the temporal lobe is evident antenatally and is particularly conspicuous in the fetus when the normal brain is still relatively smooth (approximately 24 to 28 weeks of gestation). © 2014 John Wiley & Sons, Ltd.
A single aromatic core mutation converts a designed “primitive” protein from halophile to mesophile folding
Authors: Longo Liam M. , Tenorio Connie A. , Kumru Ozan S. , Middaugh C. Russell , Blaber Michael 
Published: October 2014

AbstractThe halophile environment has a number of compelling aspects with regard to the origin of structured polypeptides (i.e., proteogenesis) and, instead of a curious niche that living systems adapted into, the halophile environment is emerging as a candidate “cradle” for proteogenesis. In this viewpoint, a subsequent halophile‐to‐mesophile transition was a key step in early evolution. Several lines of evidence indicate that aromatic amino acids were a late addition to the codon table and not part of the original “prebiotic” set comprising the earliest polypeptides. We test the hypothesis that the availability of aromatic amino acids could facilitate a halophile‐to‐mesophile transition by hydrophobic core‐packing enhancement. The effects of aromatic amino acid substitutions were evaluated in the core of a “primitive” designed protein enriched for the 10 prebiotic amino acids (A,D,E,G,I,L,P,S,T,V)—having an exclusively prebiotic core and requiring halophilic conditions for folding. The results indicate that a single aromatic amino acid substitution is capable of eliminating the requirement of halophile conditions for folding of a “primitive” polypeptide. Thus, the availability of aromatic amino acids could have facilitated a critical halophile‐to‐mesophile protein folding adaptation—identifying a selective advantage for the incorporation of aromatic amino acids into the codon table.
Kinetics study of vacancy–oxygen‐related defects in monocrystalline solar silicon
Authors: Quemener V. , Raeissi B. , Herklotz F. , Murin L. I. , Monakhov E. V. , Svensson B. G. 
Published: October 2014

In this work, diffusion and dissociation mechanisms related to the formation and evolution of vacancy–oxygen complexes have been studied. Czochralski‐grown silicon samples have been irradiated at room temperature using fast electrons resulting in the formation of several defects including vacancy–oxygen complexes (VO). The samples were isothermally annealed at different temperatures in the range of 370–470 C. Fourier‐transform infrared spectroscopy has been employed to measure the local vibrational modes associated with the individual defects. The evolution and generation kinetics of vacancy–oxygen complexes have been simulated within the framework of the theory for diffusion‐limited reactions and compared with the experimental data.