bluuebunny/crossref_metadata_2025_split huggingface dataset:
Justification for Conscience Exemptions in Health Care
Authors: Kantymir Lori , McLeod Carolyn 
Published: October 2013

AbstractSome bioethicists argue that conscientious objectors in health care should have to justify themselves, just as objectors in the military do. They should have to provide reasons that explain why they should be exempt from offering the services that they find offensive. There are two versions of this view in the literature, each giving different standards of justification. We show these views are each either too permissive (i.e. would result in problematic exemptions based on conscience) or too restrictive (i.e. would produce problematic denials of exemption). We then develop a middle ground position that we believe better combines respect for the conscience of healthcare professionals with concern for the duties that they owe to patients. Our claim, in short, is that insofar as objectors should have to justify themselves, they should have to do it according to the standard that we defend rather than according to the standards that others have developed.
Biomedical Enhancements as Justice
Authors: Nam Jeesoo 
Published: October 2013

AbstractBiomedical enhancements, the applications of medical technology to make better those who are neither ill nor deficient, have made great strides in the past few decades. Using Amartya Sen's capability approach as my framework, I argue in this article that far from being simply permissible, we have a prima facie moral obligation to use these new developments for the end goal of promoting social justice. In terms of both range and magnitude, the use of biomedical enhancements will mark a radical advance in how we compensate the most disadvantaged members of society.
The roles of emotion regulation and ruminative thoughts in non‐suicidal self‐injury
Authors: Voon David , Hasking Penelope , Martin Graham 
Published: October 2013

ObjectivesThis study explored how cognitive reappraisal, expressive suppression, and facets of ruminative thinking could be brought together in a model to explain non‐suicidal self‐injury (NSSI) in the context of experiencing stressful life events and psychological distress.MethodsData from 2,507 participants aged 12–18 years (68% female, mean age 13.93 years) recruited from 40 Australian secondary schools were analysed, including 254 participants with a history of NSSI (72% female, mean age 14.21 years). Participants completed a self‐report questionnaire assessing the constructs of interest.ResultsAlthough meeting minimum fit indices, our hypothesized model showed poorer fit compared to an empirically derived model. There was little evidence for the mediating role of psychological distress in NSSI, and we found adverse life events, psychological distress, emotion regulation, and two facets of ruminative thinking (counterfactual thinking and anticipatory thoughts) had direct, though weak, relationships with NSSI. Among the subsample of adolescents with a history of NSSI, anticipatory rumination moderated the relationship between psychological distress and NSSI, while cognitive reappraisal demonstrated a direct, although weak relationship with NSSI.ConclusionsOur observations suggest that, among adolescents, contextual, social, and behavioural factors may have a strong influence on NSSI and this may suggest that prevention and treatment efforts for NSSI among adolescents need to focus on contextual, social, and behavioural factors.Practitioner points

Emotion regulation and repetitively dwelling on current problems and concerns are implicated in non‐suicidal self‐injury (NSSI) only to the extent they increase or reduce the experience of psychological distress.

Prevention and treatment efforts for NSSI among adolescents would be better focused on contextual, social, and behavioural factors than cognitive factors.

The cross‐sectional nature of the research suggests interpretations regarding the influence of these psychological factors on NSSI can only be speculative and further research is warranted to establish causality.

Replication with a larger, more representative sample is warranted.
Twitter for teaching: Can social media be used to enhance the process of learning?
Authors: Evans Chris 
Published: October 2013

AbstractCan social media be used to enhance the process of learning by students in higher education? Social media have become widely adopted by students in their personal lives. However, the application of social media to teaching and learning remains to be fully explored. In this study, the use of the social media tool Twitter for teaching was considered. Undergraduate students in Business and Management (n = 252) were encouraged to use Twitter for communicating with their tutor and each other during a 12‐week course. Their involvement was evaluated using a survey considering amount of Twitter usage and students' attitudes and experiences. The data were analysed using factor analyses, which revealed a single usage construct and three attitudinal factors. Three findings emerged. Firstly, a positive correlation was found between amount of Twitter usage and student engagement in university‐associated activities including organising their social lives and sharing information. Secondly, course‐related tweeting was not related to interpersonal relationships between students and their tutor. Thirdly, Twitter usage did not impact class attendance. The results are salient for educational practitioners wishing to introduce social media into their teaching.
Clinical applicability and prognostic significance of molecular response assessed by fluorescent‐PCRof immunoglobulin genes in multiple myeloma. Results from aGEM/PETHEMAstudy
Authors: Martinez‐Lopez Joaquin , Fernández‐Redondo Elena , García‐Sánz Ramón , Montalbán María Angeles , Martínez‐Sánchez Pilar , Pavia Bruno , Mateos María Victoria , Rosiñol Laura , Martín Marisa , Ayala Rosa , Martínez Rafael , Blanchard María Jesus , Alegre Adrian , Besalduch Joan , Bargay Joan , Hernandez Miguel T. , Sarasquete María Eugenia , Sanchez‐Godoy Pedro , Fernández Manuela , Blade Joan , San Miguel Jesús F. , Lahuerta Juan Jose ,   the GEM (Grupo Español Multidisciplinar de Melanoma)/PETHEMA (Programa para el Estudio de la Terapéutica en Hemopatías Malignas) cooperative study group
Published: October 2013

SummaryMinimal residual disease monitoring is becoming increasingly important in multiple myeloma (MM), but multiparameter flow cytometry (MFC) and allele‐specific oligonucleotide polymerase chain reaction (ASO‐PCR) techniques are not routinely available. This study investigated the prognostic influence of achieving molecular response assessed by fluorescent‐PCR(F‐PCR) in 130 newly diagnosedMMpatients fromGrupoEspañolMultidisciplinar deMelanoma (GEM)2000/GEM05 trials (NCT00560053,NCT00443235,NCT00464217) who achieved almost very good partial response after induction therapy. As a reference, we used the results observed with simultaneousMFC. F‐PCRat diagnosis was performed onDNAusing three different multiplexPCRs:IGHD‐J,IGKV‐J andKDErearrangements. The applicability of F‐PCRwas 91·5%. After induction therapy, 64 patients achieved molecular response and 66 non‐molecular response; median progression‐free survival (PFS) was 61versus36 months, respectively (P = 0·001). Median overall survival (OS) was not reached (NR) in molecular response patients (5‐year survival: 75%)versus66 months in the non‐molecular response group (P = 0·03). The correspondingPFSandOSvalues for patients with immunophenotypicversusnon‐immunophenotypic response were 67versus42 months (P = 0·005) andNR(5‐year survival: 95%)versus69 months (P = 0·004), respectively. F‐PCRanalysis is a rapid, affordable, and easily performable technique that, in some circumstances, may be a valid approach for minimal residual disease investigations inMM.
Pro‐apoptotic TP53 homolog TAp63 is repressed via epigenetic silencing and B‐cell receptor signalling in chronic lymphocytic leukaemia
Authors: Humphries Leigh A. , Godbersen J. Claire , Danilova Olga V. , Kaur Prabhjot , Christensen Brock C. , Danilov Alexey V. 
Published: October 2013

SummaryChronic lymphocytic leukaemia (CLL) is an accumulative disorder marked by deficient apoptosis. The TP53 homolog TAp63 promotes apoptosis and chemosensitivity in solid tumours and its deregulation may contribute to CLL cell survival. We found that TAp63α was the most prevalent TP63 isoform in CLL. Compared to healthy B cells, TAp63 mRNA was repressed in 55·7% of CLL samples. TP63 promoter methylation was high in CLL and inversely correlated with TP63 protein expression in B‐cell lymphoma cell lines. siRNA‐mediated knockdown of TP63 resulted in partial protection from spontaneous apoptosis accompanied by reductions in PMAIP1 (NOXA), BBC3 (PUMA), and BAX mRNA in CLL cells and increased proliferation of Raji lymphoma cells. TAp63 mRNA levels were higher in CLL with unmutated IGHV. B‐cell receptor (BCR) engagement led to repression of TP63 mRNA expression in malignant B cells, while pharmacological inhibition of BCR signalling prevented TP63 downregulation. MIR21, known to target TAp63, correlated inversely with TAp63 expression in CLL, and BCR‐mediated downregulation of TP63 was accompanied by MIR21 upregulation in most CLL samples. Our data illustrate the pro‐apoptotic function of TP63, provide insights into the mechanisms of BCR‐targeting agents, and establish a rationale for designing novel approaches to induce TP63 in CLL and B‐cell lymphoma.
Prospective phase II study of rituximab with alternating cycles of hyper‐CVAD and high‐dose methotrexate with cytarabine for young patients with high‐risk diffuse large B‐cell lymphoma
Authors: Oki Yasuhiro , Westin Jason R. , Vega Francisco , Chuang Hubert , Fowler Nathan , Neelapu Sattva , Hagemeister Fredrick B. , McLaughlin Peter , Kwak Larry W. , Romaguera Jorge E. , Fanale Michelle , Younes Anas , Rodriguez Maria Alma , Orlowski Robert Z. , Wang Michael , Ouzounian Souzanne T. , Samaniego Felipe , Fayad Luis 
Published: October 2013

SummaryWe conducted a prospective randomized phase II study to evaluate two chemotherapy regimens: (i) rituximab plus hyperfractionated cyclophosphamide, vincristine, doxorubicin and dexamethasone (R‐HCVAD) alternating with rituximab, high‐dose methotrexate, and cytarabine (R‐MA) and (ii) rituximab, cyclophosphamide, doxorubicin, vincristine and prednisone (R‐CHOP) in diffuse large B‐cell lymphoma (DLBCL). This study randomized patients aged ≤60 years with DLBCL and an age‐adjusted international prognostic index ≥2 to R‐HCVAD/R‐MA or R‐CHOP based on a Bayesian adaptive algorithm. Interim analysis of the first 26 eligible patients showed that the complete response rate (CRR) was higher with R‐HCVAD/R‐MA than R‐CHOP (P = 0·03); thus, R‐CHOP arm was closed. In the final analysis, 49 and 10 eligible patients were treated in R‐HCVAD/R‐MA and R‐CHOP arms respectively; CRR were 82% and 60% respectively (P = 0·13); 3‐year progression‐free survival (PFS) rates were 75·7% and 77·8% respectively (P = 0·53). In the R‐HCVAD/R‐MA arm, 3‐year PFS rates in patients aged 46–60 years and ≤45 years were 70·3% and 87·1% respectively (P = 0·13), and the treatment‐associated early mortality rate in patients >45 years was 12%. In conclusion, R‐HCVAD/R‐MA is associated with excellent outcome in patients ≤45 years old. However, in patients >45 years old, R‐HCVAD/R‐MA is associated with unacceptable mortality rates.
Assessing vividness of mental imagery: The Plymouth Sensory Imagery Questionnaire
Authors: Andrade Jackie , May Jon , Deeprose Catherine , Baugh Sarah‐Jane , Ganis Giorgio 
Published: October 2013

Mental imagery may occur in any sensory modality, although visual imagery has been most studied. A sensitive measure of the vividness of imagery across a range of modalities is needed: the shorter version of Bett's Questionnaire upon Mental Imagery (Sheehan, , J. Clin. Psychology, 23, 386) uses outdated items and has an unreliable factor structure. We report the development and initial validation of the Plymouth Sensory Imagery Questionnaire (Psi‐Q) comprising items for each of the following modalities: Vision, Sound, Smell, Taste, Touch, Bodily Sensation, and Emotional Feeling. An exploratory factor analysis on a 35‐item form indicated that these modalities formed separate factors, rather than a single imagery factor, and this was replicated by confirmatory factor analysis. The Psi‐Q was validated against the Spontaneous Use of Imagery Scale (Reisberg et al., , Appl. Cogn. Psychology, 17, 147) and Marks' (, J. Mental Imagery, 19, 153) Vividness of Visual Imagery Questionnaire‐2 (VVIQ‐2). A short 21‐item form comprising the best three items from the seven factors correlated with the total score and subscales of the full form, and with the VVIQ‐2. Inspection of the data shows that while visual and sound imagery is most often rated as vivid, individuals who rate one modality as strong and the other as weak are not uncommon. Findings are interpreted within a working memory framework and point to the need for further research to identify the specific cognitive processes underlying the vividness of imagery across sensory modalities.
MRI‐safe robot for targeted transrectal prostate biopsy: animal experiments
Authors: Srimathveeravalli Govindarajan , Kim Chunwoo , Petrisor Doru , Ezell Paula , Coleman Jonathan , Hricak Hedvig , Solomon Stephen B. , Stoianovici Dan 
Published: October 2013

ObjectivesTo study the feasibility and safety of using a magnetic resonance imaging (MRI)‐safe robot for assistingMRI‐guided transrectal needle placement and biopsy in the prostate, using a canine model.To determine the accuracy and precision afforded by the use of the robot while targeting a desired location in the organ.Materials and MethodsIn a study approved by theInstitutionalAnimalCare andUseCommittee, six healthy adult male beagles with prostates of at least 15 × 15 mm in size at the largest transverse section were chosen for the procedure.The probe portion of the robot was placed into the rectum of the dog, images were acquired and image‐to‐robot registration was performed. Images acquired after placement of the robot were reviewed and a radiologist selected targets for needle placement in the gland.Depending on the size of the prostate, up to a maximum of six needle placements were performed on each dog. After needle placement, robot‐assisted core biopsies were performed on four dogs that had larger prostate volumes and extracted cores were analysed for potential diagnostic value.ResultsRobot‐assistedMRI‐guided needle placements were performed to target a total of 30 locations in six dogs, achieving a targeting accuracy of 2.58 mm (mean) and precision of 1.31 mm (sd).All needle placements were successfully completed on the first attempt. The mean time required to select a desired target location in the prostate, align the needle guide to that point, insert the needle and perform the biopsy was ∼ 3 min. For this targeting accuracy study, the inserted needle was also imaged after its placement in the prostate, which took an additional 6–8 min.Signal‐to‐noise ratio analysis indicated that the presence of the robot within the scanner bore had minimal impact on the quality of the images acquired.Analysis of intact biopsy core samples indicated that the samples contained prostatic tissues, appropriate for making a potential diagnosis.Dogs used in the study did not experience device‐ or procedure‐related complications.ConclusionsResults from this preclinical pilot animal study suggest thatMRI‐targeted transrectal biopsies are feasible to perform and this procedure may be safely assisted by anMRI‐safe robotic device.
Cryoablation for locally advanced clinical stage T3 prostate cancer: a report from the Cryo‐On‐Line Database (COLD) Registry
Authors: Ward John F. , DiBlasio Christopher J. , Williams Christopher , Given Robert , Jones J. Stephen 
Published: October 2013

Objective
To assess the oncological and functional outcomes of primary prostate cryoablation for men with clinical stage T3 (cT3) prostate cancer, as although radical prostatectomy (RP) or external beam radiotherapy (EBRT) are the standard treatments for locally advanced cT3 prostate cancer some patients opt for nonextirpative prostate cryoablation instead.
Patients and Methods
The Cryo‐On‐Line Database (COLD) Registry was queried to identify patients with cT3 prostate cancer treated with whole‐gland cryoablation (366 patients).
We assessed biochemical disease‐free survival (bDFS) using the Phoenix definition and determined reported rates of urinary incontinence and retention, sexual activity, and rectourethral fistulisation after treatment.
Patients were subsequently assessed according to whether they were administered neoadjuvant androgen‐deprivation therapy or not (ADT; 115 patients, 31.4%).
Results
For the entire cohort, the 36‐ and 60‐month bDFS rates were 65.3% and 51.9%, respectively.
Patients who received neoadjuvant ADT had statistically nonsignificantly higher 36‐ and 60‐month bDFS rates (68.0% and 55.4%, respectively) than patients who did not receive neoadjuvant ADT (55.3% and 36.9%, respectively).
The after treatment urinary incontinence rate was 2.6%; urinary retention rate, 6.0%; sexual activity rate, 30.4%; and rectourethral fistulisation rate, 1.1%.
Conclusions
Cryoablation for patients with cT3 prostate cancer leads to less favourable bDFS than that after RP or RT for the same group of men.
The after treatment rectourethral fistulisation rates for patients with cT3 disease are higher than in those with organ‐confined prostate cancer treated with cryoablation; however, urinary dysfunction and sexual activity rates are similar for men with cT3 to those reported from this same registry in men with cT2 disease.
The addition of neoadjuvant ADT (though not studied prospectively here) should be strongly considered if a patient with cT3 prostate cancer is to be treated with cryoablation.
Urothelial carcinoma involving the prostate: the association of revised tumour stage and coexistent bladder cancer with survival after radical cystectomy
Authors: Knoedler John J. , Boorjian Stephen A. , Tollefson Matthew K. , Cheville John C. , Thapa Prabin , Tarrell Robert F. , Frank Igor 
Published: October 2013

Objective
To evaluate survival among patients with urothelial carcinoma (UC) within the prostate in order to assess the impact of depth of tumour invasion as well as the importance of a concurrent bladder tumour.
Patients and Methods
We identified 201 patients who underwent radical cystectomy (RC) between 1980 and 2006 and were found to have UC involving the prostate.
All specimens were re‐reviewed by a genitourinary pathologist.
Survival was estimated using the Kaplan–Meier method and compared with the log‐rank test. Cox hazard regression models tested the association of clinicopathological variables with outcome.
Results
In all, 93 patients had pTis disease in the prostate, 43 had pT2 tumours, and 66 patients were pT4a. The median follow‐up was 10.5 years.
The 5‐year cancer‐specific survival for patients with pTis, pT2, and pT4a prostate UC was 73%, 57%, and 21% respectively (P < 0.001).
On multivariable analysis, higher prostate tumour stage (hazard ratio [HR] 2.09; P = 0.01), positive lymph node status (HR 2.09; P = 0.002), and concurrent ≥pT3 bladder cancer (HR 4.16; P < 0.001) were significantly associated with an increased risk of death from UC.
Conclusions
Among patients with prostatic UC involvement, depth of tumour invasion was significantly associated with cancer‐specific mortality, validating the staging reclassification.
Concurrent locally advanced bladder cancer also negatively impacted survival, suggesting the potential prognostic value of reporting a secondary tumour stage in such cases.
Jo's Story: the journey of one woman's experience of having cancer and a ‘learning disability’
Authors: Martean Melissa Hannah , Dallos Rudi , Stedmon Jacqui , Moss Duncan 
Published: October 2013

Accessible summaryTells story of a woman with learning disability and cancer.Highlights importance of research with people with learning disabilities.Promotes people with learning disabilities as reliable research participants.SummaryWith increasing longevity amongst people with learning disabilities, it is not surprising that prevalence and incidence rates of cancer are growing at a significant rate. Much of the research undertaken in the area of psycho‐oncology has focused on the ‘general population’, and over the last decade, there has been increasing interest in using a narrative approach to explore the lived experiences of people who have had cancer. Traditionally, research into cancer amongst people with learning disabilities has focused upon epidemiology or palliative care. However, the present article uses a narrative analysis to explore the lived and told experience of a person with a learning disability, who has been given a diagnosis of cancer. This article highlights the need and provides justification, for more qualitative research to be undertaken in this area.
‘My brother likes meeting new people, but don't ask him any direct questions’: involving adults with autism plus learning disability in a qualitative research project
Authors: Tozer Rosemary , Atkin Karl , Wenham Aniela 
Published: October 2013

Accessible Summary

People who have difficulties in communication and understanding are often excluded from research which is about them

In our research, we wanted to find out how people with autism plus learning disability get on with their brothers and sisters once they are grown up

We met with twelve people with autism along with their brother or sister without disability in a way that we hoped would make them feel relaxed

Meeting the brothers and sisters with autism was important, and it helped us understand their relationships much better. It also helped us make suggestions about how they and their siblings could be better supported.

SummaryAdult siblings of people with autism and a learning disability have hitherto been largely overlooked by research, policy and practice in the UK. As part of a qualitative study focussing on adult siblings, we met twelve people with autism plus severe learning disability with their brother or sister. Individually tailored resources were used to make the meeting accessible and positive. Sibling involvement was essential to the participation, and inclusion of adults with autism plus learning disability strengthened the research findings, making them more valid and more relevant to policy and practice. This article describes our experiences of facilitating this involvement, the methods used and understandings gained, with the aim of encouraging practitioners and researchers to do likewise.
Engendering biased signalling from the calcium‐sensing receptor for the pharmacotherapy of diverse disorders
Authors: Leach K , Sexton P M , Christopoulos A , Conigrave A D 
Published: October 2013

The human calcium‐sensing receptor (CaSR) is widely expressed in the body, where its activity is regulated by multiple orthosteric and endogenous allosteric ligands. Each ligand stabilizes a unique subset of conformational states, which enables the CaSR to couple to distinct intracellular signalling pathways depending on the extracellular milieu in which it is bathed. Differential signalling arising from distinct receptor conformations favoured by each ligand is referred to as biased signalling. The outcome of CaSR activation also depends on the cell type in which it is expressed. Thus, the same ligand may activate diverse pathways in distinct cell types. Given that the CaSR is implicated in numerous physiological and pathophysiological processes, it is an ideal target for biased ligands that could be rationally designed to selectively regulate desired signalling pathways in preferred cell types.Linked ArticlesThis article is part of a themed section on Molecular Pharmacology of GPCRs. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue‐5