bluuebunny/crossref_metadata_2025_split huggingface dataset:
Weaponizing Principles: Clinical Ethics Consultations & the Plight of the Morally Vulnerable
Authors: Fiester Autumn M. 
Published: September 2014

AbstractInternationally, there is an on‐going dialogue about how to professionalize ethics consultation services (ECSs). Despite these efforts, one aspect of ECS‐competence that has received scant attention is the liability of failing to adequately capture all of the relevant moral considerations in an ethics conflict. This failure carries a high price for the least powerful stakeholders in the dispute. When an ECS does not possess a sophisticated dexterity at translating what stakeholders say in a conflict into ethical concepts or principles, it runs the risk of naming one side's claims as morally legitimate and decrying the other's as merely self‐serving. The result of this failure is that one side in a dispute is granted significantly more moral weight and authority than the other. The remedy to this problem is that ECSs learn how to expand the diagnostic moral lens they employ in clinical ethics conflicts.
Will General Practitioners be adequately prepared to meet the complexities of enhanced dementia screening for people with learning disabilities and Down syndrome: key considerations
Authors: Rowe Michelle 
Published: September 2014

Accessible summary

General Practitioners (GPs) will offer dementia screening for people with learning disabilities and Down syndrome.

Dementia screening will require GPs to invest time and get to know the person with learning disabilities.

The benefits and harms of dementia screening in the health setting are not fully known.

SummaryThis article provides a timely response in regard to the Department of Health's current initiative to financially reward GPs to prioritise and undertake dementia screening for people with learning disabilities over the age of 50 years and for people with Down syndrome over the age of 40 years. Whilst GPs are becoming increasingly aware of their responsibility to care for the complex needs of people with learning disabilities, the implementation of dementia screening poses a multitude of challenges. Research has continued to suggest how difficult it is to detect the early and often ambiguous signs of dementia for someone who has pre‐existing cognitive impairments and may present with atypical symptomology. And it continues to be a difficult process even for those who specialise within this area. However, GPs who choose to opt into this financially incentivised scheme will now be offering dementia screening. This article outlines the main GP aims within the dementia screening process and the difficulties that may be encountered, with specific focus upon

Offering a dementia screen

Obtaining consent

Undertaking screening within the most appropriate setting

Choosing a dementia screening tool and developing a baseline

Detecting early dementia signs
REGULATION OF POLLUTION IN THE LABORATORY: RANDOM INSPECTIONS, AMBIENT INSPECTIONS, AND COMMITMENT PROBLEMS
Authors: Cochard François , Le Gallo Julie , Franckx Laurent 
Published: September 2014

ABSTRACTWe compare experimentally a traditional random inspection policy and a variant where the agency may carry out a preliminary inspection of the level of ambient pollution before implementing any individual inspection. Since the agency may have an incentive to announce high inspection probabilities and then secretly renege on its announcement to avoid implementing costly inspections, we are also interested in the agency's commitment power. We find that overall, ambient inspections increase efficiency but the effect is weaker than expected when the agency has no commitment power; and polluters' reactions to the lack of commitment power of the agency vary depending on whether the agency uses ambient inspections or not.
Biofilm Eradication Kinetics of the Ultrashort Lipopeptide C12‐OOWW‐NH2 Utilizing a Modified MBEC Assay™
Authors: Laverty Garry , Gorman Sean P. , Gilmore Brendan F. 
Published: September 2014

In this study, we report the antimicrobial planktonic and biofilm kill kinetics of ultrashort cationic lipopeptides previously demonstrated by our group to have a minimum biofilm eradication concentration (MBEC) in the microgram per mL (μg/mL) range against clinically relevant biofilm‐forming micro‐organisms. We compare the rate of kill for the most potent of these lipopeptides, dodecanoic (lauric) acid‐conjugated C12‐Orn‐Orn‐Trp‐Trp‐NH2 against the tetrapeptide amide H‐Orn‐Orn‐Trp‐Trp‐NH2 motif and the amphibian peptide Maximin‐4 via a modification of the MBEC Assay™ for Physiology & Genetics (P&G). Improved antimicrobial activity is achieved upon N‐terminal lipidation of the tetrapeptide amide. Increased antimicrobial potency was demonstrated against both planktonic and biofilm forms of Gram‐positive micro‐organisms. We hypothesize rapid kill to be achieved by targeting of microbial membranes. Complete kill against established 24‐h Gram‐positive biofilms occurred within 4 h of exposure to C12‐OOWW‐NH2 at MBEC values [methicillin‐resistant Staphylococcus epidermidis (ATCC 35984): 15.63 μg/mL] close to the values for the planktonic minimum inhibitory concentration (MIC) [methicillin‐resistant Staphylococcus epidermidis (ATCC 35984): 1.95 μg/mL]. Such rapid kill, especially against sessile biofilm forms, is indicative of a reduction in the likelihood of resistant strains developing with the potential for quicker resolution of pathogenic infection. Ultrashort antimicrobial lipopeptides have high potential as antimicrobial therapy.
Microvenular hemangioma: a clinicopathologic review of 13 cases
Authors: Napekoski Karl M. , Fernandez Anthony P. , Billings Steven D. 
Published: September 2014

BackgroundMicrovenular hemangioma is an uncommon benign vascular tumor that can potentially be mistaken for malignancy.MethodsWe reviewed the histopathologic and clinical features of 13 microvenular hemangiomas, which represents the largest series reported to date.ResultsThe patients [female (F) = 8 and male (M) = 5] had a mean age of 39 years (range: 16 months–69 years). All presented with a similar history of a new, asymptomatic, stable or slow‐growing, red to purple plaque or nodule. The lesions were located on the extremities, chest, back or abdomen. Two patients had multiple lesions. In six, a vascular tumor was not suspected clinically. Histologically, all were composed of a dermal proliferation of thin‐walled, often branching, vascular channels dissecting through collagen fibers. The vessels were surrounded by a conspicuous layer of pericytes. Immunohistochemistry showed that all were positive for a vascular marker. Stains for WT‐1 were positive in 9 of 10. None of the lesions tested (0/12) were positive for podoplanin or human herpesvirus‐8 (HHV‐8) (0/9). Follow‐up available on six patients showed no recurrences.ConclusionThe histomorphology of microvenular hemangioma frequently raises concern for a malignant vascular lesion, especially Kaposi sarcoma. Identification of characteristic features, particularly the pericyte layer in routinely stained sections or with an SMA immunostain, allows an accurate diagnosis.
Targeted vertebrate surveys enhance the faunal importance and improve explanatory models within the Eastern Arc Mountains of Kenya and Tanzania
Authors: Rovero Francesco , Menegon Michele , Fjeldså Jon , Collett Leah , Doggart Nike , Leonard Charles , Norton Guy , Owen Nisha , Perkin Andrew , Spitale Daniel , Ahrends Antje , Burgess Neil D. 
Published: September 2014

AbstractAimDetailed knowledge of species distributions, endemism patterns and threats is critical to site prioritization and conservation planning. However, data from biodiversity inventories are still limited, especially for tropical forests, and even well recognized hotspots remain understudied. We provide an example of how updated knowledge on species occurrence from strategically directed biodiversity surveys can change knowledge on perceived biodiversity importance, and facilitate understanding diversity patterns and the delivery of conservation recommendations.LocationEastern Arc Mountains (EAM), Kenya and Tanzania.MethodsWe surveyed amphibians, reptiles, birds and mammals during 2005–2009, targeting mountain blocks that had been poorly surveyed or unsurveyed by the early Noughties. We combined new and old data to produce a database of species presence by mountain block spanning four decades of research. Species richness is regressed against survey effort, funding, ecological and human disturbance factors to analyse the best predictors of vertebrate richness across mountain blocks. Similarity among species assemblages among blocks is analysed using dissimilarity analysis.ResultsNew surveys raised the number of endemic and regional endemic vertebrates by 24% (from 170 to 211 species), including 27 new species of which 23 are amphibians and reptiles. Vertebrate richness is best explained by forest area, but rainfall is also important, especially for amphibians and reptiles. Forest elevational range is important for mammals and for block‐endemic birds. Funding explains 19% of the variation in total species richness, while survey effort generally explains < 10% of variance. Cluster analysis shows that species assemblages are partitioned by geographical proximity among mountain blocks.Main conclusionsThe biological value of the EAM has been underestimated, and strategic surveys are important even in well‐recognized hotspots. The exceptional and global importance of these mountains for endemic vertebrates is highlighted, supporting the development of a network of Nature Reserves and the proposed inclusion within UNESCO's natural World Heritage Sites.
Epidemiology and prognostic factors of candidemia in elderly patients
Authors: Tang Hung‐Jen , Liu Wei‐Lun , Lin Hsin‐Lan , Lai Chih‐Cheng 
Published: September 2014

AimThe present retrospective study was carried out to investigate the epidemiological characteristics and the prognostic factors of candidemia among elderly patients.MethodsFrom 2009 to 2012, elderly patients with candidemia were identified at the Chi Mei medical center, a 900‐bed regional hospital in southern Taiwan, and their medical records retrospectively reviewed.ResultsDuring the 4‐year period, a total of 175 episodes of candidemia among elderly patients were identified. The patients ranged in age from 65 to 98 years (mean 76.4 years) and the mean (±standard deviation) Charlson Comorbidity Index score was 7.6 (±2.7). Cancer was the most common underlying disease (n = 127, 72.6%), followed by diabetes mellitus (n = 69, 39.4%). Candida albicans (n = 96, 54.9%) was the most common pathogen, followed by C. tropicalis (n = 39, 22.3%), C. parapsilosis (n = 24, 13.7%), C. glabrata (n = 22, 12.6%), C. guilliermondii (n = 2, 1.1%) and Candida species (n = 3, 1.7%). The ratio of C. albicans causing candidemia was significantly higher in young‐old than old‐old patients (64.1% vs 47.4%, P = 0.027). The overall in‐hospital mortality was 50.3%. Multivariate analysis showed that the in‐hospital mortality was only significantly associated with jaundice (P = 0.004), no use of antifungal agent (P = 0.021) and intensive care unit admission (P < 0.001).ConclusionsCandidemia can develop in elderly patients, especially patients with cancer or other risk factors. C. albicans is the most common Candida species causing candidemia among elderly patients, followed by C. tropicalis. The mortality of candidemia among elderly patients remains high. Geriatr Gerontol Int 2015; 15: 688–693.
Clinical characteristics and therapeutic outcomes of elderly patients with chronic myeloid leukemia: A retrospective multicenter study
Authors: Korkmaz Serdal , Dal Mehmet Sinan , Berber Ilhami , Sahin Deniz Goren , Dogu Mehmet Hilmi , Ayyildiz Orhan , Nizam Ilknur , Albayrak Murat , Esen Ramazan , Namdaroglu Sinem , Sencan Mehmet , Akay Olga Meltem , Hacioglu Sibel , Yildirim Rahsan , Eser Ali , Tombak Anil , Pala Cigdem , Ilhan Osman 
Published: September 2014

AimsWe aimed to investigate whether older age leads to limitations in the starting dose of imatinib in daily treatment of chronic myeloid leukemia, and to determine the compliance of elderly patients with tyrosine kinase inhibitors (TKI) therapy.MethodsData including the clinical characteristics, therapeutic outcomes and compliance with TKI therapy of elderly patients with chronic myeloid leukemia aged >65 years were collected from 13 institutions in Turkey, retrospectively.ResultsA total of 69 patients (27 [39%] men, 42 [61%] women) were evaluated retrospectively. The median age of the patients was 71 years (range 66–85 years). Of the patients, 66 (96%) were in the chronic phase and three (4.3%) were in the accelerated phase when diagnosed. A total of 63 (91.3%) patients were receiving imatinib as the first‐line therapy. The initial dose of imatinib was 400 mg/day in 59 patients (93.6%). Imatinib treatment induced 57 (90.5%) complete hematological responses at 3 months, 29 (46%) complete cytogenetic responses at 6 months and 49 (77.7%) major molecular responses at 12 months. As a result, nilotinib and dasatinib were used in 14 patients as second‐line therapy. Second‐line TKI induced nine complete hematological responses (64.3%) at 3 months, four complete cytogenetic responses (28.6%) at 12 months and seven major molecular responses (50%) at 18 months. A total of 56 of the patients (81.2%) are still alive. The median overall survival and progression‐free survival rates were 35 months (range 1–95 months) and 17 months (range 0.8–95 months), respectively.ConclusionElderly patients should receive TKI according to the same guidelines that apply to younger patients. Geriatr Gerontol Int 2015; 15: 729–735.
Prevalence of medication adherence and its associated factors among community‐dwelling Chinese older adults in Hong Kong
Authors: Leung Doris YP , Bai Xue , Leung Angela YM , Liu Ben CP , Chi Iris 
Published: September 2014

AimThe aim of present study was to describe the prevalence of medication adherence, and to examine its risk factors among Chinese community‐dwelling older adults with chronic diseases.MethodsSecondary analysis was carried out on the data collected from 3167 Hong Kong adults aged ≥60 years who lived in their private home, had at least one type of chronic disease and had completed a screening instrument for long‐term care services for the first time in 2006. The outcome variable was the self‐ or caregiver‐reported medication adherence.ResultsAmong the respondents, 90.8% reported having good medication adherence in the past 7 days. More dependence on activities of daily living (P < 0.001), stroke (P = 0.003) or diabetes (P = 0.036), had medication review by physicians (P < 0.001) and received more informal care support (P = 0.005) were positively associated with medication adherence, whereas more cognitive impaired (P = 0.008), more negative mood (P = 0.071) and perceived poor health (P < 0.001) were negatively associated with medication adherence.ConclusionsThe prevalence of self‐reported medication adherence was high in Hong Kong Chinese community‐dwelling older adults. A number of modifiable factors associated with medication adherence were identified, which provides specific targets for interventions. Geriatr Gerontol Int 2015; 15: 789–796.
Use of the Barthel index, activities of daily living, in dermatologic surgery in patients aged 80 years and older
Authors: Pascual José C. , Belinchón Isabel , Ramos José M. 
Published: September 2014

AbstractBackgroundDermatologists often attend elderly patients with non‐melanoma skin cancer (NMSC). There is a lack of information regarding the optimum treatment for elderly patients with NMSC.MethodsThe objective of this study was to describe changes in the Barthel Index (BI) after dermatologic surgery for NMSC in patients aged 80 years and older. A prospective observational study was carried out in patients aged 80 years and older diagnosed with NMSC and treated with conventional dermatologic surgery. BI was performed by direct interview with the patients and/or their caregiver before the surgery, seven and 30 days after the surgery.ResultsA total of 180 dermatologic surgeries were performed in 144 patients. The average age of the patients was 84.2 years. There were 84 men (58.3%) and 60 women (41.7%). Mean BI score was 85.9 at baseline, 85.3 on day 7 after surgery, and 85.6 on day 30, showing minimal changes after dermatologic surgery. Changes in the BI occurred mainly in dressing, toilet use, transfers, mobility (on level surfaces) and walking stairs.ConclusionsActivities of daily living were not significantly affected in patients aged 80 years and older, after dermatologic surgery for NMSC.
Ethyl carbamate formation regulated by Saccharomyces cerevisiae ZJU in the processing of Chinese yellow rice wine
Authors: Fang Ruo‐Si , Dong Ya‐Chen , Li Hong‐Ji , Chen Qi‐He 
Published: September 2014

SummaryEthyl carbamate (EC) is a probable carcinogen existing in most fermented foods. Throughout traditional fermentation processes, the Chinese fermentation starter plays an important role, but it contains varieties of microorganisms which make inhibiting EC efficiently become a challenge. Therefore, the traditional fermentation starter is substituted with a single yeast strain (Saccharomyces cerevisiae ZJU) to regulate EC catabolism. In this work, S. cerevisiae ZJU can reduce EC formation and the data of EC concentration show that there is 85.6% reduction of EC at most using S. cerevisiae ZJU instead of the traditional fermentation starter. Extracellular urea and citrulline were the leading precursors of EC. The content of amino acids and volatile flavour compounds in the experimental group has no significant influence compared to the natural fermentation. The findings in this work suggest that EC can be regulated by means of the fermentation starters variation.
The affective dimension of early‐onset psychosis and its relationship with suicide
Authors: Sanchez‐Gistau Vanessa , Baeza Inmaculada , Arango Celso , González‐Pinto Ana , de la Serna Elena , Parellada Mara , Graell Montserrat , Paya Beatriz , Llorente Cloe , Castro‐Fornieles Josefina 
Published: September 2014

BackgroundThe affective dimension has scarcely been studied in early‐onset psychosis. Our aims were to investigate the prevalence and type of affective symptoms in the prodromal and acute phases of early‐onset psychosis and to examine their relationship with suicide. We also sought to establish whether the presence of premorbid antecedents or the presence of affective symptoms during the prodromal and acute phase might predict a later diagnosis of bipolar disorder (BP) or schizophrenia (SZ).MethodParticipants were 95 youths, aged 9–17 years, experiencing a first episode of a psychotic disorder (FEP) according to DSM‐IV criteria. Prodromal affective symptoms in the year prior to the onset of full‐blown psychosis were assessed by means of the K‐SADS. Affective symptoms during the acute episode were evaluated using the Hamilton Depression Rating Scale and the Young Mania Rating Scale. Suicidality was assessed during the acute episode and at 6 and 12 months.ResultsHalf of the patients experienced affective symptoms during the prodrome, with depressive symptoms being the most frequently reported. During the acute episode, 23.2% presented depressive, 41.4% mixed and 18.9% manic symptoms. After logistic regression analysis, only the presence of depressive symptoms was significantly associated with suicidality during the 12 months following the FEP. Neither early premorbid antecedents nor the prevalence or type of affective symptoms during the FEP predicted a diagnosis of BP or SZ at 12 months. However, both depressive and manic prodromal symptoms were associated with a later diagnosis of BP.ConclusionsThe FEP of both SZ and BP is preceded by an identifiable prodromal phase. Early detection programs should target young people at clinical risk for the extended psychosis phenotype. The high prevalence of affective symptoms during the early phases of psychosis may encourage clinicians to identify and treat them in order to prevent suicide behaviour.
Porokeratotic adnexal ostial naevus: review on the entity and therapeutic approach
Authors: Llamas‐Velasco M. , Hilty N. , Kempf W. 
Published: September 2014

AbstractBackgroundPorokeratotic adnexal ostial nevus (PAON) is a term that encompass porokeratotic eccrine ostial and dermal duct naevus and porokeratotic eccrine and hair follicle naevus. PAON is a rare adnexal hamartoma characterized by the presence of a cornoid lamella exclusively overlying eccrine acrosyringia or over both, eccrine acrosyringia and hair follicles.ObjectivesMost of the articles on PAON report its clinical or histopathological characteristics but literature review offer scarce data on the evolution or treatment. We have reviewed it.Case reportWe report an 8‐year‐old boy with presence of bilateral asymtomatic verrucous lesions mostly in left side of the body without other added abnormalities through the twelve‐year follow‐up. As our case presented cornoid lamella overlying eccrine acrosyringia and hair follicles we diagnosed PEHFN. He received treatment with CO2 ablation in 2004 and in 2012 with marked improvement.ResultsReview of the previous reported cases of PAON show that it is mostly unilateral and that some patients have coexisting problems like seizures, left hemiparesis, scoliosis, deafness, developmental delay, palmoplantar keratoderma, psoriasis, hyperthyroidism, polinerupathy, breast hipoplasia and KID.ConclusionPAON responded with tazaroten gel, dithranol short‐contact treatment and topical photodynamic therapy but laser treatments appear to be more efficient in most patients.
Comparison of steroidogenic pathways among normoandrogenic and hyperandrogenic polycystic ovary syndrome patients and normal cycling women
Authors: de Medeiros Sebastião Freitas , Barbosa Jacklyne Silva , Yamamoto Márcia Marly Winck 
Published: September 2014

AbstractAimTo compare the corticosteroidogenic enzyme activities between normal cycling non‐polycystic ovary syndrome (PCOS), and normoandrogenic PCOS (NA‐PCOS) and hyperandrogenic PCOS (HA‐PCOS) patients.MethodsThis cohort study was conducted at Julio Muller University Hospital and Tropical Institute of Reproductive Medicine and Menopause, and enrolled 114 non‐PCOS women and 355 PCOS patients. The steroidogenic enzyme activities were measured using the serum steroid product/precursor molar ratio.ResultsIn the Δ5 pathway the 17,20 lyase activity was equally low in the NA‐PCOS and HA‐PCOS women compared with the non‐PCOS women (P < 0.01 and P < 0.001, respectively). In the Δ4 pathway, the 17,20 lyase activity was higher only in the HA‐PCOS group (P < 0.001). The 17‐hydroxylase activity was the same in PCOS and non‐PCOS subjects (P > 0.05). The 3β‐hydroxysteroid dehydrogenase II (3β‐HSDII) activity was higher in the conversion of dehydroepiandrosterone into androstenedione in the HA‐PCOS than in the NA‐PCOS (P < 0.05) and the non‐PCOS patients (P < 0.01). The aromatase activity was lower in the HA‐PCOS than in the NA‐PCOS (P < 0.05) patients and non‐PCOS subjects (P < 0.01). In HA‐PCOS subjects, the 17,20 lyase activity was related to insulin, estradiol, total testosterone concentrations and free androgen index in the Δ5 pathway. 3β‐HSDII showed weak correlation with estradiol in the HA‐PCOS group. Anthropometric parameters had little impact, if any, on the steroidogenic enzyme activities.ConclusionThe NA‐PCOS and HA‐PCOS patients demonstrated different enzyme activities, and the results provided new directions for future studies including PCOS patients with different phenotypes.