bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethical challenges in care for older patients who resist help
Authors: Brodtkorb Kari , Skisland Anne Valen-Sendstad , Slettebø Åshild , Skaar Ragnhild 
Published: August 2014

Background: Situations where patients resist necessary help can be professionally and ethically challenging for health professionals, and the risk of paternalism, abuse and coercion are present. Research question: The purpose of this study was to examine ethical challenges in situations where the patient resists healthcare. Research design: The method used was clinical application research. Academic staff and clinical co-researchers collaborated in a hermeneutical process to shed light on situations and create a basis for new action. Participants and research context: Four research groups were established. Each group consisted of six to eight clinical co-researchers, all employees with different health profession backgrounds and from different parts of the municipal healthcare services, and two scientific researchers. Ethical considerations: The study was conducted in compliance with ethical guidelines and principles. Participants were informed that participation was voluntary and that confidentiality would be maintained. They signed a consent form. Findings: The findings showed that the situations where patients opposed help related to personal hygiene, detention in an institution and medication associated with dental treatment. The situations were perceived as demanding and emotionally stressful for the clinicians. Discussion: The situations can be described as everyday ethics and are more characterised by moral uncertainty and moral distress than by being classic ethical dilemmas. Conclusion: Norwegian legislation governing the use of force seems to provide decision guidance with the potential to reduce uncertainty and moral stress if the clinicians’ legal competence had been greater.
A new clinical guideline to improve sedation safety in patients transferred under the Mental Health Act from remote parts of Western Australia
Authors: Balaratnasingam Sivasankaran 
Published: August 2014

Objective: Clinicians dealing with referrals under the Mental Health Act in rural and remote parts of Australia face the difficult task of providing safe sedation whilst transferring the patient to an appropriate authorized facility. This paper reviews the efforts to overcome these challenges in the remote north-west of Australia. Methods: Senior medical staff undertook a review of sedation practice in the region. A search was made of the medical literature to determine whether evidence based treatment may exist elsewhere and this information was used in conjunction with consensus opinion to devise a new guideline. Results: Scant literature exists in the field of sedation and aeronautical evacuation of patients with acute mental health presentations in remote areas. Issues and challenges were identified and a new clinical guideline based on local expert consensus of good practice was developed. Conclusions: Standardizing the approach to managing agitated patients who are transferred under the Mental Health Act is essential in order to mitigate medical morbidity that may arise from sedation related complications. The sedation guideline developed by our service has been well received by staff, seems practical and feasible to implement and has the potential to reduce sedation related morbidity.
Paliperidone: another treatment option for delusional parasitosis
Authors: Altınöz Ali Ercan , Tosun Altınöz Şengül , Küçükkarapınar Melike , Coşar Behçet 
Published: August 2014

Objective: Patients with delusional parasitosis (DP) have a fixed belief of being infested by small pathogens. Typical and atypical antipsychotics are widely used for treating DP. There are limited controlled trials about the treatment of DP and the most useful antipsychotic agent is still unknown. Paliperidone treatment for DP will be demonstrated through two cases. One of these cases had previously used pimozide but had not responded to treatment. Both cases had remission from symptoms with paliperidone. There are only two case reports published about paliperidone treatment for DP. Conclusion: Paliperidone appears to have promise in the treatment of DP; however, more case reports and controlled trials are required.
Analysis of the torque characteristic of a magnetorheological clutch using neural networks
Authors: Bucchi F , Forte P , Frendo F 
Published: August 2014

In this paper the dependence of the torque characteristic of a magnetorheological clutch on several working parameters is analyzed by means of a feedforward neural network. The clutch was envisaged to have the possibility to disengage the vacuum pump in diesel engine vehicles, in order to increase the overall vehicle efficiency. A large set of test was carried out following different protocols in order to obtain a detailed characterization of the clutch. Results showed that, due to the characteristics of MR fluids and to the complex mechanism of torque transmission, the torque characteristics (both the yield torque and the torque-slip behavior) are a function of the relative speed between the input and output shafts, of the energy dissipated during the clutch slip and of the rest time between consecutive slippages. The data acquired during all tests were used to train a neural network with five input elements and one output element. The developed neural network proved to satisfactorily reproduce the actual clutch properties and could be used in the future in an engine-vehicle simulator in order to model the torque characteristic of the clutch subjected to different operating cycles.
Effects of temperature and salinity on metabolic rate of the Asiatic clam Corbicula fluminea (Müller, 1774)
Authors: Xiao Bai-cai , Li Er-chao , Du Zhen-yu , Jiang Run-lan , Chen Li-qiao , Yu Na 
Published: August 2014

Abstract
The effects of temperature and salinity on the metabolism of the Asiatic clam Corbicula fluminea (mollusca, Lamellibranchia) were studied experimentally. Firstly, three indexes of basal metabolism (oxygen consumption rate, OCR; ammonia excretion rate, AER; and CO2 emission rate, CER), patterns of diurnal rhythm and O: N ratios were measured for three size ranges (large: h = 25.54 ± 1.96 mm, medium: h = 22.07 ± 1.33 mm and small: h = 17.70 ± 1.43 mm) at two salinities (0.3‰ and 1.8‰). The results showed that: (1) three indexes decreased with increasing body size. (2) no significant difference was found between two salinities for the O: N ratios of the small and large size, but a significant difference was found for the medium-sized one; (3) however, there were similar and distinct diurnal rhythms of metabolic rate at two salinities over a 24 hour period in three size C. fluminea.
OCR, AER, CER, O: N ratios and Q10 (temperature coefficient) of small-sized C. fluminea were measured across five water temperatures (4, 11, 18, 25 and 32°C) and two salinities (0.3‰ and 1.8‰) in the following experiments. Our results of the small C. fluminea were as follows: there was no significant difference in the O: N ratios among the five temperatures and two salinity treatments; and no significant difference of three indexes between both salinity levels were observed at same temperature controlled; and three indexes increased significantly with increasing temperature from 4°C to 25°C, while no significant difference was observed in the 25-32°C range; and the highest Q10 coefficients (Q10 = 1.825 at salinity of 0.3‰ and Q10 = 1.683 at salinity of 1.8‰) were observed at the 18-25°C temperature increase, and the low values were found in the 4-11°C, 11-18°C and 25-32°C interval. It indicates that there is not a synergetic effect of our temperature and salinity on the metabolic rate of small C. fluminea, and a temperature of 18-25°C may represent an optimum adequate metabolic temperature range. For the purposes of ecological monitoring and restoration, small individuals of C. fluminea planted are more likely to survive than larger ones.
Organizing knowledge to enable personalization of medicine in cancer
Authors: Good Benjamin M , Ainscough Benjamin J , McMichael Josh F , Su Andrew I , Griffith Obi L 
Published: August 2014

AbstractInterpretation of the clinical significance of genomic alterations remains the most severe bottleneck preventing the realization of personalized medicine in cancer. We propose a knowledge commons to facilitate collaborative contributions and open discussion of clinical decision-making based on genomic events in cancer.
Overexpression of the Aspergillus niger GatA transporter leads to preferential use of D-galacturonic acid over D-xylose
Authors: Sloothaak Jasper , Schilders Mike , Schaap Peter J , de Graaff Leo H 
Published: August 2014

Abstract
Pectin is a structural heteropolysaccharide of the primary cell walls of plants and as such is a significant fraction of agricultural waste residues that is currently insufficiently used. Its main component, D-galacturonic acid, is an attractive substrate for bioconversion. The complete metabolic pathway is present in the genome of Aspergillus niger, that is used in this study. The objective was to identify the D-galacturonic acid transporter in A. niger and to use this transporter to study D-galacturonic acid metabolism.
We have functionally characterized the gene An14g04280 that encodes the D-galacturonic acid transporter in A. niger. In a mixed sugar fermentation it was found that the An14g04280 overexpression strain, in contrast to the parent control strain, has a preference for D-galacturonic acid over D-xylose as substrate. Overexpression of this transporter in A. niger resulted in a strong increase of D-galacturonic acid uptake and induction of the D-galacturonic acid reductase activity, suggesting a metabolite controlled regulation of the endogenous D-galacturonic acid catabolic pathway.
Perceived risk of exposure to indoor residential radon and its relationship to willingness to test among health care providers in Tehran
Authors: Hazar Narjes , Karbakhsh Mojgan , Yunesian Masud , Nedjat Saharnaz , Naddafi Kazem 
Published: August 2014

AbstractBackgroundRadon exposure is the second cause of lung cancer after exposure to tobacco smoke and the first cause in nonsmokers. The purpose of this study was to assess perceived risk of exposure to indoor residential radon among health care providers in urban and rural health centers affiliated to Tehran University of Medical Sciences.MethodIn 2012–2013, a survey was carried out on 462 health care providers to assess their awareness and risk perception about exposure to indoor residential radon. Only subjects who had previously heard about radon were asked to answer knowledge-based and risk perception questions and report source of knowledge, willingness to test and willingness to pay for radon test kits.ResultsAbout 67% of responders had heard about radon before this study and of these, 83.5 % recognized it as being hazardous and 34.5 % identified lung cancer as the main health outcome of exposure to radon. Overall, 33% of 310 subjects had knowledgeable awareness. Seventy percent of responders who had previously heard about radon, had high perceived risk and they were more willing to test their houses and more willing to pay for radon test kits.ConclusionHaving knowledge about radon and perceiving it as a risk had a significant association with willing to take relevant health related behaviors. Furthermore, risk perception contributes to willing to spend more money when health is a concern. Education of health care providers seems to be a pre-requisite to public campaigns on radon awareness and testing.
The Louvre Crucifix by Giotto – Unveiling the original decoration by 2D-XRF, X-ray radiography, Emissiography and SEM-EDX analysis
Authors: Eveno Myriam , Ravaud Elisabeth , Calligaro Thomas , Pichon Laurent , Laval Eric 
Published: August 2014

Abstract

Introduction
Giotto (1266–1337) and his workshop realized c. 1315 the large Crucifix now in the Louvre Museum. The conservation of this masterpiece in 2010–2013 in the C2RMF studios gave the opportunity for a comprehensive investigation of the execution technique through a characterization of the paint layers. The first examinations revealed an original gilding and decoration surrounding the Christ which was repainted during the 19th C., raising the question of the original decoration appearance.

Results
The original decoration still present underneath was unveiled. The different imaging analytical techniques applied brought complementary results allowing us to reconstruct the original decoration. Elemental images of selected areas on the Crucifix were obtained using bi-dimensional X-ray fluorescence imaging technique (2D-XRF) with a prototype XRF spectrometer mounted on a motorized X-Y system. The head of the instrument was moved over a 150 x150 mm2 area with 1 mm steps, using a 1 mm beam spot and acquisition time of 2 seconds per pixel. The XRF spectra of each pixel provided semi-quantitative elemental maps of the layers: gilding and pigments even at low concentrations could be recognised. The XRF maps achieved were completed by X-ray radiographs and emissiographs of the Crucifix. Some micro-samples analyzed with the scanning electron microscope (SEM-EDX) allowed a better understanding of the stratigraphy. The comparison of the direct light and the X-ray pictures enabled us to distinguish the repaint from the original pattern. The visible metallic leaf is a thin gold leaf applied on a mordant gilding while the original one is a double leaf of gold and silver (Zwischgold) applied on a red bole. As for the painting, the visible decoration is composed of brown earth and organic greenish color whereas the original is made of red lake, copper green, azurite and vermillion. The 2D-XRF maps evidenced two levels of copper that could be ascribed to two different copper pigments, a blue and a green one.

Conclusions
A complementary methodology combining classical X-ray imaging, sample analysis and 2D-XRF was applied to large areas of the Giotto’s crucifix. This approach allowed us to distinguish the underlying original composition from the 19th C. overpainted decoration.
KISS1R Signals Independently of Gαq/11 and Triggers LH Secretion via the β-Arrestin Pathway in the Male Mouse
Authors: Ahow Maryse , Min Le , Pampillo Macarena , Nash Connor , Wen Junping , Soltis Kathleen , Carroll Rona S. , Glidewell-Kenney Christine A. , Mellon Pamela L. , Bhattacharya Moshmi , Tobet Stuart A. , Kaiser Ursula B. , Babwah Andy V. 
Published: August 2014

Abstract
Hypothalamic GnRH is the master regulator of the neuroendocrine reproductive axis, and its secretion is regulated by many factors. Among these is kisspeptin (Kp), a potent trigger of GnRH secretion. Kp signals via the Kp receptor (KISS1R), a Gαq/11-coupled 7-transmembrane–spanning receptor. Until this study, it was understood that KISS1R mediates GnRH secretion via the Gαq/11-coupled pathway in an ERK1/2-dependent manner. We recently demonstrated that KISS1R also signals independently of Gαq/11 via β-arrestin and that this pathway also mediates ERK1/2 activation. Because GnRH secretion is ERK1/2-dependent, we hypothesized that KISS1R regulates GnRH secretion via both the Gαq/11- and β-arrestin–coupled pathways. To test this hypothesis, we measured LH secretion, a surrogate marker of GnRH secretion, in mice lacking either β-arrestin-1 or β-arrestin-2. Results revealed that Kp-dependent LH secretion was significantly diminished relative to wild-type mice (P &lt; .001), thus supporting that β-arrestin mediates Kp-induced GnRH secretion. Based on this, we hypothesized that Gαq/11-uncoupled KISS1R mutants, like L148S, will display Gαq/11-independent signaling. To test this hypothesis, L148S was expressed in HEK 293 cells. and results confirmed that, although strongly uncoupled from Gαq/11, L148S retained the ability to trigger significant Kp-dependent ERK1/2 phosphorylation (P &lt; .05). Furthermore, using mouse embryonic fibroblasts lacking β-arrestin-1 and -2, we demonstrated that L148S-mediated ERK1/2 phosphorylation is β-arrestin–dependent. Overall, we conclude that KISS1R signals via Gαq/11 and β-arrestin to regulate GnRH secretion. This novel and important finding could explain why patients bearing some types of Gαq/11-uncoupled KISS1R mutants display partial gonadotropic deficiency and even a reversal of the condition, idiopathic hypogonadotropic hypogonadism.
Low Calcium-Phosphate Intakes Modulate the Low-Protein Diet-Related Effect on Peak Bone Mass Acquisition: A Hormonal and Bone Strength Determinants Study in Female Growing Rats
Authors: Fournier C. , Rizzoli R. , Ammann P. 
Published: August 2014

Abstract
Peak bone mass acquisition is influenced by environmental factors including dietary intake. A low-protein diet delays body and skeletal growth in association with a reduction in serum IGF-1 whereas serum FGF21 is increased by selective amino acid deprivation. Calcium (Ca) and phosphorous (P) are also key nutrients for skeletal health, and inadequate intakes reduce bone mass accrual in association with calciotropic hormone modulation. Besides, the effect of calcium supplementation on bone mass in prepubertal children appears to be influenced by protein intake. To further explore the interaction of dietary protein and Ca-P intake on bone growth, 1-month-old female rats were fed with an isocaloric 10%, 7.5%, or 5% casein diet containing normal or low Ca-P for an 8-week period (6 groups). Changes in tibia geometry, mineral content, microarchitecture, strength, and intrinsic bone quality were analyzed. At the hormonal level, serum IGF-1, fibroblast growth factor 21 (FGF21), PTH, 1,25-dihydroxyvitamin D3 (calcitriol), and FGF23 were investigated as well as the Ghr hepatic gene expression. In normal dietary Ca-P conditions, bone mineral content, trabecular and cortical bone volume, and bone strength were lower in the 5% casein group in association with a decrease in serum IGF-1 and an increase in FGF21 levels. Unexpectedly, the low-Ca-P diet attenuated the 5% casein diet-related reduction of serum IGF-1 and Ghr hepatic gene expression, as well as the low-protein diet-induced decrease in bone mass and strength. However, this was associated with lower cortical bone material level properties. The low-Ca-P diet increased serum calcitriol but decreased FGF23 levels. Calcitriol levels positively correlated with Ghr hepatic mRNA levels. These results suggest that hormonal modulation in response to a low-Ca-P diet may modify the low-protein diet-induced effect on Ghr hepatic mRNA levels and consequently the impact of low protein intakes on IGF-1 circulating levels and skeletal growth.
Striking Pondichéry: Religious Disputes and French Authority in an Indian Colony of the Ancien Régime
Authors: Agmon Danna 
Published: August 2014

The French colony of Pondichéry, India, was roiled by religious struggles in the eighteenth century. In 1701-15 colonial French officials repeatedly attempted to restrict the practice of local religion in the town. Local laborers, artisans, and merchants responded with four different work stoppages and threats of abandoning the colony. Again and again local residents emerged from these conflicts with the upper hand, as the strikes resulted in near-complete French capitulation and a removal of the religious restrictions. This study explains these events by demonstrating that the administrators of the French trading company, the Compagnie des Indes, and French Jesuit missionaries could not agree on how to address the workers’ demands to practice their religion in the Catholic-ruled town. Fundamental conflicts between company officials and missionaries about the priorities of colonial rule, coupled with a mobile local labor system, allowed native actors a surprising measure of control over the development of this Indian Ocean colony and posed a significant challenge to French authority.
Au cours du dix-huitième siècle, la colonie française de Pondichéry en Inde fut secouée par des luttes religieuses. Entre 1701 et 1715, les autorités coloniales françaises essayèrent à plusieurs reprises de restreindre la pratique de la religion locale dans la ville. Les ouvriers, artisans et commerçants indiens réagirent alors en suspendant à quatre reprises toute activité et en menaçant d’abandonner la colonie. A chaque fois, les résidents locaux eurent gain de cause, les grèves entraînant une capitulation presque complète des autorités françaises et la levée des restrictions religieuses. La présente étude explique ces événements en montrant que les administrateurs de la Compagnie des Indes et les jésuites français installés à Pondichéry ne parvinrent pas à s’entendre sur la manière de répondre aux demandes des travailleurs de pratiquer leur religion dans cette ville catholique. Ce conflit de fond entre missionnaires et représentants officiels de la Compagnie sur les priorités du pouvoir colonial, ajouté à une organisation mobile de la main d’oeuvre autochtone, conféra aux acteurs locaux une marge étonnante de contrôle sur le développement de cette colonie de l’océan Indien, et constitua un défi de taille pour l’autorité française.
Titin force is enhanced in actively stretched skeletal muscle
Authors: Powers Krysta , Schappacher-Tilp Gudrun , Jinha Azim , Leonard Tim , Nishikawa Kiisa , Herzog Walter 
Published: August 2014

AbstractThe sliding filament theory of muscle contraction is widely accepted as the means by which muscles generate force during activation. Within the constraints of this theory, isometric, steady-state force produced during muscle activation is proportional to the amount of filament overlap. Previous studies from our laboratory demonstrated enhanced titin-based force in myofibrils that were actively stretched to lengths which exceeded filament overlap. This observation cannot be explained by the sliding filament theory. The aim of the present study was to further investigate the enhanced state of titin during active stretch. Specifically, we confirm that this enhanced state of force is observed in a mouse model and quantify the contribution of calcium to this force. Titin-based force was increased by up to four times that of passive force during active stretch of isolated myofibrils. Enhanced titin-based force has now been demonstrated in two distinct animal models, suggesting that modulation of titin-based force during active stretch is an inherent property of skeletal muscle. Our results also demonstrated that 15% of titin’s enhanced state can be attributed to direct calcium effects on the protein, presumably a stiffening of the protein upon calcium binding to the E-rich region of the PEVK segment and selected Ig domain segments. We suggest that the remaining unexplained 85% of this extra force results from titin binding to the thin filament. With this enhanced force confirmed in the mouse model, future studies will aim to elucidate the proposed titin-thin filament interaction in actively stretched sarcomeres.