bluuebunny/crossref_metadata_2025_split huggingface dataset:
An innovative approach to teaching bioethics in management of healthcare
Authors: Aleksandrova-Yankulovska Silviya 
Published: December 2014

Background: Bioethical courses were introduced in the curricula in medical universities in Bulgaria in 1990s. In the beginning, the courses were mainly theoretical, and systematic case analyses and discussions of movies were introduced later on. The benefits of using films to teach ethics have been previously analyzed in the literature; however, to our knowledge such studies in Bulgaria are yet lacking. Objective: The aim of this study was to survey the opinions of students and analyze the results from the application of movies in bioethics teaching in a medical university in the north of Bulgaria. Methodology: A survey was carried out among 92 students in the management of healthcare. Two movies were used, and separate protocols for film discussion were developed. Ethical considerations: The study was conducted anonymously and with students’ free informed consent. Results and discussion: The students distinguished in total 21 different dilemmas and concepts in the first movie. The ethical dilemmas were classified into five groups: general ethical issues, deontological issues, special ethical issues, principles of bioethics, and theories of ethics. The second movie focused students’ attention on the issues of death and dying. In total, 18 elements of palliative care were described by the students. The range of different categories was a positive indicator of an increased ethical sensitivity. The students evaluated the movies’ discussions as a generally positive educational approach. They perceived the experience as contributing to their better understanding of bioethical issues. Conclusion: The innovative approach was well accepted by the students. The introduction of movies in the courses of bioethics had the potential to provide vivid illustrations of bioethical issues and to contribute to the exploration of specific theses and arguments. The presentation and discussion should be preceded by accumulation of theoretical knowledge. The future of effective bioethics education lays in the interactive involvement of students.
Indwelling pleural catheters for pleural effusions associated with end-stage renal disease: a case series
Authors: Potechin Rajini , Amjadi Kayvan , Srour Nadim 
Published: December 2014

Background: Pleural effusions are a common complication of end-stage renal disease. These effusions are occasionally refractory to medical management, but few options are then available. Indwelling pleural catheter insertion (IPC) has been well described for the management of malignant pleural effusions and, more recently, of nonmalignant effusions of other origin. We aimed to analyze our experience and to evaluate the safety and feasibility of using IPCs for pleural effusion associated with end-stage renal disease. Methods: We constructed a cohort of patients who underwent IPC insertion for pleural effusions associated with end-stage renal disease. The IPCs were inserted as a palliative measure in patients who had thoracentesis twice within the preceding 2 weeks, no evidence of infection and either failure to respond, complications or intolerance to maximal medical therapy, or if IPC insertion would enable discharge when the patient was hospitalized mainly for dyspnea due to pleural effusion. Results: There were nine IPCs inserted in eight patients. Patients had significant dyspnea at baseline with a median baseline dyspnea index of 1.5 [interquartile range (IQR) 0–3]. Dyspnea improved significantly 2 weeks after catheter insertion with a median transitional dyspnea index of 6 (IQR 4.5–7.0). There was no occurrence of empyema or other major complications. Serum albumin did not decrease after catheter insertion. IPCs were removed in four patients (50%) and successful spontaneous pleurodesis occurred in three patients (37.5%) after a median of 77 days (IQR 9–208). Conclusion: IPC insertion for pleural effusions associated with end-stage renal disease appears safe and effective. Larger studies are needed, particularly regarding the impact of this intervention on quality of life.
Development of a Highly Stable, Nonaqueous Glucagon Formulation for Delivery via Infusion Pump Systems
Authors: Newswanger Brett , Ammons Steve , Phadnis Neelima , Ward W. Kenneth , Castle Jessica , Campbell Robert W. , Prestrelski Steven J. 
Published: December 2014

Background: Despite a vigorous research effort, to date, the development of systems that achieve glucagon stability in aqueous formulations (without reconstitution) has failed to produce any clinical candidates. We have developed a novel, nonaqueous glucagon formulation based on a biocompatible pharmaceutical solvent, dimethyl sulfoxide, which demonstrates excellent physical and chemical stability at relatively high concentrations and at high temperatures. Methods: This article reports the development of a novel, biocompatible, nonaqueous native human glucagon formulation for potential use in subcutaneous infusion pump systems. Results: Data are presented that demonstrate physical and chemical stability under presumed storage conditions (>2 years at room temperature) as well as “in use” stability and compatibility in an Insulet’s OmniPod® infusion pump. Also presented are results of a skin irritation study in a rabbit model and pharmacokinetics/pharmacodynamics data following pump administration of glucagon in a diabetic swine model. Conclusions: This nonaqueous glucagon formulation is suitable for further clinical development in pump systems.
Pediatric Cardiac Surgery Parent Education Discharge Instruction (PEDI) Program
Authors: Staveski Sandra L. , Zhelva Bistra , Paul Reena , Conway Rosalind , Carlson Anna , Soma Gouthami , Kools Susan , Franck Linda S. 
Published: December 2014

Background: In developing countries, more children with complex cardiac defects now receive treatment for their condition. For successful long-term outcomes, children also need skilled care at home after discharge. The Parent Education Discharge Instruction (PEDI) program was developed to educate nurses on the importance of discharge teaching and to provide them with a structured process for conducting parent teaching for home care of children after cardiac surgery. The aim of this pilot study was to generate preliminary data on the feasibility and acceptability of the nurse-led structured discharge program on an Indian pediatric cardiac surgery unit. Methods: A pre-/post-design was used. Questionnaires were used to evaluate role acceptability, nurse and parent knowledge of discharge content, and utility of training materials with 40 nurses and 20 parents. Retrospective audits of 50 patient medical records (25 pre and 25 post) were performed to evaluate discharge teaching documentation. Results: Nurses’ discharge knowledge increased from a mean of 81% to 96% ( P = .001) after participation in the training. Nurses and parents reported high levels of satisfaction with the education materials (3.75-4 on a 4.00-point scale). Evidence of discharge teaching documentation in patient medical records improved from 48% (12 of 25 medical records) to 96% (24 of 25 medical records) six months after the implementation of the PEDI program. Conclusion: The structured nurse-led parent discharge teaching program demonstrated feasibility, acceptability, utility, and sustainability in the cardiac unit. Future studies are needed to examine nurse, parent, child, and organizational outcomes related to this expanded nursing role in resource-constrained environments.
Disease-Specific Outcome Analysis of Palliation With the Modified Blalock-Taussig Shunt
Authors: Bove Thierry , Vandekerckhove Kristof , Panzer Joseph , De Groote Katya , De Wolf Daniel , François Katrien 
Published: December 2014

Background: Albeit being a simple surgical procedure, adverse outcomes with the modified Blalock-Taussig shunt (MBTS) are commonly reported in generalizing terms, independent of the underlying heart disorder. Methods: From August 1995 to December 2013, a total of 150 children underwent an MBTS for tetralogy of Fallot (TOF; n = 44, 29%), pulmonary atresia with ventricular septal defect (PA/VSD; n = 28, 19%), pulmonary atresia with intact ventricular septum (PA/IVS; n = 17, 11%), transposition of the great arteries with ventricular septal defect (TGA/VSD) with pulmonary stenosis (PS; n = 12, 8%), Ebstein malformation (n = 2, 1%), and complex univentricular anomalies (n = 47, 31%). Outcome analysis focused on operative mortality and survival until shunt takedown, adjusted to the underlying disease. Results: In-hospital mortality was 8.7% (n = 13), and interstage mortality was 5.1% (n = 7), resulting in 86.1% survival to the next surgery. Hospital mortality was 14% in PA/VSD, 13% in univentricular heart, and 18% in PA/IVS, while no mortality was observed in TOF, TGA/VSD/PS, and Ebstein disease. A shunt-related complication was observed in 18% (n = 27) of the children, including acute thrombosis (n = 7, 5%), shunt stenosis (n = 3, 2%), overshunting (n = 7, 5%), and pulmonary artery stenosis (n = 10, 7%). Multivariate analysis of shunt-dependent time survival identified a shunt complication occurring in a univentricular circulation (hazard ratio [HR] 4.10, 95% confidence interval [CI] = 1.05-17.43, P = .01) and increased shunt size-to-weight ratio (HR 2.72, 95% CI = 0.80-9.18, P = .04) as risk factors. Shunt thrombosis was also a negative outcome predictor in PA/VSD, when requiring associated unifocalization ( P = .05). Conclusion: This study shows that the outcome of palliation with the MBTS is importantly affected by the occurrence of a shunt-related complication, whose circulatory effect is even more dismal in single ventricle hearts. Since an increased shunt size-to-weight ratio additionally compromises the shunt-dependent survival, it emphasizes that the choice of the shunt with regard to size as well as surgical approach remains critical.
C-reactive protein enhances IgG-mediated phagocyte responses and thrombocytopenia
Authors: Kapur Rick , Heitink-Pollé Katja M. J. , Porcelijn Leendert , Bentlage Arthur E. H. , Bruin Marrie C. A. , Visser Remco , Roos Dirk , Schasfoort Richard B. M. , de Haas Masja , van der Schoot C. Ellen , Vidarsson Gestur 
Published: December 2014

Key PointsCRP enhances IgG-mediated respiratory burst and phagocytosis of platelets in vitro and their clearance in vivo. CRP levels are increased in ITP patients and correlate with platelet counts and bleeding severity and predict time to recovery.
Cytokine crowdsourcing: multicellular production of TH17-associated cytokines
Authors: Busman-Sahay Kathleen O , Walrath Travis , Huber Samuel , O’Connor William 
Published: December 2014

Abstract
In the 2 decades since its discovery, IL-17A has become appreciated for mounting robust, protective responses against bacterial and fungal pathogens. When improperly regulated, however, IL-17A can play a profoundly pathogenic role in perpetuating inflammation and has been linked to a wide variety of debilitating diseases. IL-17A is often present in a composite milieu that includes cytokines produced by TH17 cells (i.e., IL-17F, IL-21, IL-22, and IL-26) or associated with other T cell lineages (e.g., IFN-γ). These combinatorial effects add mechanistic complexity and more importantly, contribute differentially to disease outcome. Whereas TH17 cells are among the best-understood cell types that secrete IL-17A, they are frequently neither the earliest nor dominant producers. Indeed, non-TH17 cell sources of IL-17A can dramatically alter the course and severity of inflammatory episodes. The dissection of the temporal regulation of TH17-associated cytokines and the resulting net signaling outcomes will be critical toward understanding the increasingly intricate role of IL-17A and TH17-associated cytokines in disease, informing our therapeutic decisions. Herein, we discuss important non-TH17 cell sources of IL-17A and other TH17-associated cytokines relevant to inflammatory events in mucosal tissues.
Age-Dependent Changes in Health Status in the Childhood Cancer Survivor Cohort
Authors: Hudson Melissa M. , Oeffinger Kevin C. , Jones Kendra , Brinkman Tara M. , Krull Kevin R. , Mulrooney Daniel A. , Mertens Ann , Castellino Sharon M. , Casillas Jacqueline , Gurney James G. , Nathan Paul C. , Leisenring Wendy , Robison Leslie L. , Ness Kirsten K. 
Published: December 2014

Purpose To compare age-dependent changes in health status among childhood cancer survivors and a sibling cohort. Methods Adult survivors of childhood cancer and siblings, all participants of the Childhood Cancer Survivor Study, completed three surveys assessing health status. At each of three time points, participants were classified as having poor outcomes in general health, mental health, function, or daily activities if they indicated moderate to extreme impairment. Generalized linear mixed models were used to compare survivors with siblings for each outcome as a function of age and to identify host- and treatment-related factors associated with age-dependent worsening health status. Results Adverse health status outcomes were more frequent among survivors than siblings, with evidence of a steeper trajectory of age-dependent change among female survivors with impairment in at least one health status domain (P = .01). In adjusted models, survivors were more likely than siblings to report poor general health (prevalence ratio [PR], 2.37; 95% CI, 2.09 to 2.68), adverse mental health (PR, 1.66; 95% CI, 1.52 to 1.80), functional impairment (PR, 4.53; 95% CI, 3.91 to 5.24), activity limitations (PR, 2.38; 95% CI, 2.12 to 2.67), and an adverse health status outcome in any domain (PR, 2.10; 95% CI, 1.97 to 2.23). Cancer treatment and health behaviors influence the magnitude of differences by age groups. Chronic conditions were associated with adverse health status outcomes across organ systems. Conclusion The prevalence of poor health status is higher among survivors than siblings, increases rapidly with age, particularly among female participants, and is related to an increasing burden of chronic health conditions.
Central Sirt1 Regulates Body Weight and Energy Expenditure Along With the POMC-Derived Peptide α-MSH and the Processing Enzyme CPE Production in Diet-Induced Obese Male Rats
Authors: Cyr Nicole E. , Steger Jennifer S. , Toorie Anika M. , Yang Jonathan Z. , Stuart Ronald , Nillni Eduardo A. 
Published: December 2014

AbstractIn the periphery, the nutrient-sensing enzyme Sirtuin 1 (silent mating type information regulation 2 homolog 1 [Sirt1]) reduces body weight in diet-induced obese (DIO) rodents. However, the role of hypothalamic Sirt1 in body weight and energy balance regulation is debated. The first studies to reveal that central Sirt1 regulates body weight came from experiments in our laboratory using Sprague-Dawley rats. Central inhibition of Sirt1 decreased body weight and food intake as a result of a forkhead box protein O1 (FoxO1)-mediated increase in the anorexigenic proopiomelanocortin (POMC) and decrease in the orexigenic Agouti-related peptide in the hypothalamic arcuate nucleus. Here, we demonstrate that central inhibition of Sirt1 in DIO decreased body weight and increased energy expenditure at higher levels as compared with the lean counterpart. Brain Sirt1 inhibition in DIO increased acetylated FoxO1, which in turn increased phosphorylated FoxO1 via improved insulin/phosphorylated AKT signaling. Elevated acetylated FoxO1 and phosphorylated FoxO1 increased POMC along with the α-melanocyte-stimulating hormone (α-MSH) maturation enzyme carboxypeptidase E, which resulted in more of the bioactive POMC product α-MSH released into the paraventricular nucleus. Increased in α-MSH led to augmented TRH levels and circulating T3 levels (triiodothyronine, thyroid hormone). These results indicate that inhibiting hypothalamic Sirt1 in DIO enhances the activity of the hypothalamic-pituitary-thyroid axis, which stimulates energy expenditure. Because we show that blocking central Sirt1 causes physiological changes that promote a negative energy balance in an obese individual, our results support brain Sirt1 as a significant target for weight loss therapeutics.
Debate on Rationality and Legitimacy of “House-for-Pension” Pension Model Use in People’s Republic of China
Authors: Вэйдун C , Veydun Cyuy , Хунтин  , Hongting Yan 
Published: December 2014

“House-for-pension” scheme also known as reverse mortgage is used in many
countries nowadays. An interest to this model is increasing in Chinese society
too. But is “house-for-pension” scheme really suitable for China? In the present
paper possible options related to &#34;house for pension&#34; scheme adaptation to the
Chinese conditions have been analyzed, and a conclusion that the similar model
doesn&#180;t suit China has been drawn. Chinese pension system still needs for state
budget support as a main source of financing, and for using of traditional
pension provision. “House-for-pension” scheme will be able become
a supplement source of financing only in the future.
O biógrafo António Franco S.J, autor da Imagem da Virtude
Authors: Urbano Carlota 
Published: December 2014

Este estudo apresenta o biógrafo jesuíta António Franco (1662-1732), autor da obra Imagem da Virtude. Embora confesse os seus propósitos pedagógicos e apologéticos, o Padre António Franco revela exigências históricas e críticas no momento em que a hagiografia (género literário em que poderíamos incluir as suas vidas edificantes) começa a afirmar-se como ciência crítica, mas não prescinde da sua dimensão apologética. O estudo propõe ainda uma leitura desta obra no contexto da pedagogia espiritual da Companhia que valoriza não só uma concepção edificante da história e da historiografia, como o princípio espiritual da imitatio sanctorum.http://dx.doi.org/10.14195/2183-1718_66_15
Enhancing the surface properties of linen by
non-thermal atmospheric air-plasma treatment
Authors: Erzsébet Szabó Orsolya , Csiszár Emília , Tóth András 
Published: December 2014

Abstract
In this research, a diffuse coplanar surface barrier discharge (DCSBD) type plasma reactor was used for the surface modification of raw linen fabric. Changes in physical properties and chemical composition of the fiber surface as well as color of the fabric were measured as
a function of time of the atmospheric air plasma treatment. Furthermore, ageing of the effects created on the fiber surface by plasma treatment was also characterized in
a period of 0-14 days elapsed after the plasma treatment. Significant differences were found between the properties of the raw and plasma treated linen fabrics, including increase of wettability, wickability, surface energy and O/C ratio, and decrease of water contact angle and deterioration of the waxy outer layer of the fibers.
Most of the parameters depended on the time of plasma treatment (0–180 s). O/C ratio increased steadily with the increase of duration of the plasma treatment, which was explained by destruction of the waxy surface layer, creation of polar groups and exposure of cellulosic components. Most of the properties tested were found
to be stable during two weeks of storage after the plasma treatment, indicating that the surface ‘topography’ created by plasma remained almost unaltered and the recovery
of the etched waxy coverage of the fiber did not occur.
Mathematics Textbook as an Object of Research/Matematički udžbenik kao predmet istraživanja
Authors: Glasnović Gracin Dubravka 
Published: December 2014

AbstractA mathematics textbook can be described as an officially authorized and pedagogically designed mathematics book written to provide mathematical knowledge to students. This description suggests the authority of the textbook - because it has been authorized by an administrative source and because it deals with authorized knowledge. This paper provides an overview of research on mathematics textbooks. The emphasis is on questions concerning the extent to which and how textbooks are used in mathematics education in Croatia and in the world. Research results show that mathematics textbooks are widely used in mathematics education worldwide. This finding points to the need for research on the content and structure of textbooks. Such studies are combined with the associated results on how textbooks are used in the classroom and which methods teachers apply in using textbooks in mathematics education. The results of the empirical studies show that teachers use textbooks for lesson preparation and pupils use mathematics textbooks for exercises to a great extent. These results imply that such an important role of textbooks in mathematics education deserves additional attention, with the goal of understanding and improving mathematics education. Key words: mathematics education; overview; research on textbook --- SažetakMatematički udžbenik može se opisati kao službeno autorizirana i pedagoški osmišljena matematička knjiga napisana s ciljem da učenicima ponudi matematičke sadržaje. Taj opis sugerira autoritet udžbenika jer ga je autorizirao administrativni izvor i jer sadrži autorizirano znanje. Ovaj članak daje pregled istraživanja matematičkih udžbenika, a naglasak je na pitanjima u kojoj mjeri i kako se udžbenici koriste u nastavi matematike u Hrvatskoj i u svijetu.Rezultati raznih istraživanja pokazuju da se udžbenici u velikoj mjeri koriste u nastavi matematike širom svijeta. Taj nalaz ukazuje na potrebu za istraživanjem sadržaja i strukture matematičkih udžbenika. Uz to, prikazani su rezultati istraživanja o tome na koji se način udžbenici koriste u razredu i koje metode nastavnici prakticiraju prilikom upotrebe udžbenika na nastavi. Rezultati empirijskih studija pokazuju da nastavnici udžbenike većinom koriste za pripremu nastavnog sata, a učenici udžbenike koriste u najvećoj mjeri za vježbanje. Ti rezultati ukazuju na to da tako važna uloga udžbenika u matematičkom obrazovanju zaslužuje dodatnu pažnju s ciljem razumijevanja i poboljšanja nastave matematike.Ključne riječi: istraživanje udžbenika; nastava matematike; pregled.
Salivary and Serum Leptin Concentrations in Patients With Chronic Periodontitis
Authors: Purwar Parth , Khan M.A. , Mahdi Abbas Ali , Pandey Shivani , Singh Babita , Dixit Jaya , Sareen Sagar 
Published: December 2014

Background: The discovery of leptin has led to the elucidation of a robust physiologic system that not only maintains fat stores but is also an integral part of the host defense mechanism. However, leptin concentrations in the saliva of patients with chronic periodontitis (CP) has not been explored despite the potential role of salivary biomarkers in determining the presence, risk, and progression of periodontal disease.Methods: Eighty‐four participants (44 with generalized severe CP and 40 without periodontitis) were enrolled. For each patient, the values of periodontal parameters were recorded, such as plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (AL), and percentage of sites with bleeding on probing (BOP) and clinical AL ≥5 mm. Saliva and serum samples were collected to estimate the leptin concentrations using enzyme‐linked immunosorbent assay kits. Statistical analysis was performed using software.Results: Participants with CP demonstrated significantly higher BOP, PI, GI, and percentage of sites with clinical AL >5 mm (P <0.05). Leptin was detectable in all the clinical samples. Salivary leptin concentrations in patients with CP were significantly lower than in healthy volunteers (6,200.61 ± 2,322.11 versus 8,799.60 ± 901.70 pg/mL), whereas serum leptin concentrations were significantly higher in patients with CP than in healthy volunteers (11,600.00 ± 1,705.01 versus 7,616.62 ± 1,169.83 pg/mL). In addition, the results reflected a significant negative correlation of salivary leptin and a positive correlation of serum leptin with PD (P <0.05).Conclusion: The results suggest that leptin concentrations in saliva and serum are significantly altered in CP and relate closely to current disease activity; however, further studies are needed to confirm the findings.