bluuebunny/crossref_metadata_2025_split huggingface dataset:
MEDICAL STUDENTS' ATTITIDES TO END OF LIFE CARE THROUGHOUT THEIR COURSE
Authors: Barclay Stephen , Thiemann Pia , Parker Richard , Whyte Rebecca , Benson John , Wood Diana , Quince Thelma 
Published: February 2014

BackgroundMedical student End of Life Care (EOLC) education is increasingly recognised as important. Knowledge concerning drugs and services can be readily taught and skills of communicating with patients and families are increasingly addressed. Attitudes towards EOLC are important as they influence behaviour in clinical practice.AimsTo examine medical students' attitudes to EOLC in each year of their courseTo investigate change in these attitudes over time during their courseTo identify gender differences in attitudes and attitudinal change.MethodsQuestionnaire administered to four cohorts of core science and clinical medical students at the University of Cambridge Medical School in 2007 to 2010, with longitudinal follow-up in subsequent years; 1027 participants in total. Students indicated their agreement towards 8 EOLC statements on five-point Likert scales, based on Sullivan's US study.ResultsStudents started their course with broadly positive attitudes (towards the doctor's responsibility, psychological aspects for patients and personal impact) which largely persisted into the final years. During core science some attitudes became more negative, whereas during clinical studies some attitudes became more positive. Analysis of a subsample of 55 students for whom 6 year longitudinal data were available revealed significant positive change regarding the doctor's responsibility from year 1 to year 6. Although statistically significant, all of these changes were small. No significant effect of gender on attitudes or attitudinal change was found.ConclusionMedical students' attitudes towards their future role in EOLC were broadly positive. Core science was associated with increasingly negative attitudes and clinical studies with increasingly positive attitudes. For teaching faculty, the challenge remains to address negative and foster positive attitudes towards EOLC during medical school.
PALLIATIVE CARE (PC) EDUCATION FOR MEDICAL STUDENTS: HAS IT IMPROVED OVER THE LAST DECADE? A SURVEY OF PC EDUCATION
Authors: Walker Steven , Gibbins Jane , Barclay Stephen , Barnett Mandy , Adams Astrid , Pees Paul , Chandratilake Madawa , Lodge Philip , Wee Bee 
Published: February 2014

BackgroundA survey of UK medical schools conducted in 1983, 1994 and 2000/2001 showed an increase in PC teaching time and course diversity. Gaps included limited assessment.1AimsTo investigate changes in PC training for medical students at UK medical schools over the last decade.MethodsA web-based questionnaire developed from previous surveys was sent to PC leads in UK medical schools. Responses were compared with those obtained in 2000/2001. The study received ethical approval.ResultsResults were obtained from all 30 medical schools and for 24 programmes in 23 medical schools providing teaching in 2000/2001. All continue to deliver teaching on last days of life, death and bereavement. This is now mandatory. Generally, this remains a module within a larger course or is fully integrated. Teaching methods remain similar (2013 v 2001): lectures [28 (93%) v 21 (88%)], seminars/small group discussion [28 (93%) v 23 (96%)], video [18 (60%) v 19 (79%)], case discussion [17 (57%) v 23 (96%)], patient addressing students [18 (60%) v 9 (38%)] and role play [16 (53%) v 22 (92%)]. New features are MDT meetings [12/30 (40%)] and e-learning [14/30 (47%)]. Teaching is most commonly delivered by medical PC specialists [30 v 24 (100%)], GPs [17 (57%) v 20 (83%)] and specialist nurses [24 (80%) v 15 (63%)]. All major topics are covered to varying degrees. Teaching about PC for young patients remains limited [7 (29 responses 24%) v 8 (33%)]. Opportunities for patient contact has increased with 27 (28 respondents 96%) offering inpatient PC unit/hospice visits compared to 18 in 2001 (75%). More medical schools are assessing PC learning [25 (83%) v 6 (25%)]ConclusionPC training for medical students continues to evolve. Recent changes are increased patient contact and assessment of PC learning.
Impact of the 2011 Great East Japan Earthquake and Tsunami on functional disability among older people: a longitudinal comparison of disability prevalence among Japanese municipalities
Authors: Tomata Yasutake , Kakizaki Masako , Suzuki Yoshinori , Hashimoto Shuji , Kawado Miyuki , Tsuji Ichiro 
Published: February 2014

ObjectiveTo examine the hypothesis that disability prevalence has increased to a greater degree in the areas severely affected by the earthquake and tsunami of 11 March 2011 than in other areas.MethodsLongitudinal analysis using public statistics data from the Ministry of Health, Labour and Welfare in Japan. The analysis included 1549 municipalities covered by the Long-term Care Insurance (LTCI) system. ‘Disaster areas’ were defined as three prefectures (Iwate, Miyagi, Fukushima). The outcome measure was the number of aged people (≥65 years) with LTCI disability certification. Rates of change in disability prevalence from February 2011 to February 2012 were used as the primary outcome variable, and were compared by analysis of covariance between ‘Coastal disaster areas’, ‘Inland disaster areas’ and ‘Non-disaster areas’.ResultsRegarding disability prevalence at all levels, the mean value of the increase rate in Coastal disaster areas (7.1%) was higher than in Inland disaster areas (3.7%) and Non-disaster areas (2.8%) (p<0.001).ConclusionsThe areas that were severely affected by the earthquake and tsunami had a significantly higher increase in disability prevalence during the 1 year after the earthquake disaster than other areas.
Fertility after fetotomy: a clinical study focusing on heavy draft mares
Authors: Raś A. , Rapacz‐Leonard A. , Raś‐Noryńska M. , Barański W. 
Published: February 2014

Although fetotomy is recommended for all mares when the fetus is dead and difficult to extract, little has been written about fetotomy and heavy draft mares. This lack includes indications for fetotomy in heavy draft mares, differences in treatment and prognosis of heavy mares kept by farmers of low socioeconomic status, and how this procedure affects the mare's further fertility. The literature on mares, in general, also differs on the survival rate of mares that undergo fetotomy, the prevalence of postpartum complications, and further fertility. To answer these questions, we reviewed the medical records of 102 mares that underwent fetotomy, mostly heavy draft mares (n=93). Head malposture (62.7 per cent) was the most common fetal maldisposition, which required fetotomy in all cases. The survival rate was 84.3 per cent (n=86). The most common postpartum complications were endometritis puerperalis (32.5 per cent) and retained placenta (27.9 per cent). 61 mares (70.9 per cent) both showed foal heat and cycled regularly in the first season after fetotomy. Out of 45 mares that were bred in the first season, 14 became pregnant (31.1 per cent). Survival rate and further fertility were reduced by delayed requests for veterinary assistance due to the difficult economic situation of the owners. Fetotomy is the method of choice for serious maldispositions, especially head malpostures, because in contrast with cesarean sections, it has a higher survival rate and allows the mare to return to breeding in the same season.
Detrital zircon age constraints on basement history on the margins of the northern Rockall Basin
Authors: Morton Andrew , Frei Dirk , Stoker Martyn , Ellis David 
Published: February 2014

Abstract

Detrital zircon dating has proven to be an effective way to constrain ages of submerged basement terranes on the margins of the northern Rockall Basin, a region where direct evidence of crustal affinities is scarce or absent. Zircons have been dated from sandstones of Paleocene–Oligocene age known to have been derived from the east (Hebridean Platform) and west (Rockall and George Bligh highs). The results show that the Hebridean Platform is a westward extension of the Lewisian Complex, with Archaean and Palaeoproterozoic ages that can be directly correlated with events identified in the Outer Hebrides and NW Scotland. The detrital zircons derived from the Hebridean Platform also provide evidence for a Mesoproterozoic thermal event and two phases of intrusions in the Palaeozoic. The Rockall High consists of a Palaeoproterozoic terrane dated as
c.
1760–1800 Ma, similar to ages previously determined from both basement samples and detrital sediment. The data also provide evidence for the subsequent intrusion of alkaline igneous rocks in the Paleocene–Eocene. The George Bligh High represents an Archaean terrane heavily affected by Palaeoproterozoic tectonothermal events, and was also the site of intrusion of alkaline igneous rocks during Paleocene time.
Success in exploring for reliable, robust Paleocene traps west of Shetland
Authors: Loizou N. 
Published: February 2014

Abstract
This paper incorporates the results of recent exploration wells to provide a re-evaluation and re-validation of earlier publications by the author.
Following the discovery of the Foinaven and Schiehallion fields in the early 1990s, exploration success for Paleocene targets outside the Quadrant 204 area of the Faroe–Shetland Basin was initially rather limited. However, renewed interest in the last 10 years has seen 12 Paleocene exploration wells drilled, of which 9 have encountered notable hydrocarbons.
Since 1972, 151 exploration wells have been drilled west of Shetland with 79 wells (52%) specifically positioned on Paleocene prospects which resulted in 23 discoveries. Analysis of the 56 failed Paleocene wells shows that around 80% were drilled on either a poor or invalid trap, with the remaining 20% failing mainly due to either lack of or poor reservoir or poor top or lateral seal. Intriguingly, only 4 exploration wells have been exclusively positioned on Paleocene 4-way dip (or structural closures) structures, with all of these encountering hydrocarbons.
Fifty-six Paleocene prospects contained a stratigraphic component with 15 notable successes, all of which are within the Upper Paleocene Vaila sequence. Ten key discoveries are located in the Judd Sub-basin or adjacent Westray High (Foinaven, SE Foinaven, SW Foinaven, Schiehallion, Loyal, Alligin, Cuillin, Arkle, Amos and Tornado). A further four are located in the Flett Sub-basin (Laggan, Tormore, Torridon, Laxford) and one is in the Foula Sub-basin (Glenlivet).
Forty-six of the wells were positioned on an amplitude or amplitude-variation-with-offset (AVO) anomaly, of which 16 encountered notable hydrocarbons. Following post-mortem studies, the majority of the remaining 30 failed wells could be shown to have drilled poorly defined amplitude anomalies (various lithologies including igneous), AVO artefacts or spurious direct hydrocarbon indicator (DHIs) (which include multiples). Wells 204/17-1 and 204/18-1 are good examples of poorly interpreted AVO responses, in which high amplitudes are mainly present on the nears (low offset data) and there is significantly decreased amplitude on the highs (far offset data). Moreover, post-drill AVO analyses categorically show that both wells were indeed drilled on Class I AVO anomalies.
Not surprisingly, in recent years all of the wells positioned on sound AVO anomalies have been successful in encountering hydrocarbons. Moreover, these wells show both a clear increase in amplitude with offset and a conformance with structure. Undoubtedly, the recent triumphs firmly demonstrate there is potential for maintaining a high success rate in future Paleocene exploration west of Shetland. Equally, the evaluation and use of proven examples of successful traps such as Foinaven, Schiehallion, Laggan, Tormore, Glenlivet and other analogues can add value to future exploration programmes.
Antibiofilm Activity of Manuka Honey in Combination with Antibiotics
Authors: Campeau Michelle E. M. , Patel Robin 
Published: February 2014

We assessed the in vitro activity of Manuka honey against biofilm bacteria in combination with antibiotics and visualized the effect of Manuka honey on bacterial biofilms using scanning electron microscopy. The fractional biofilm eradication concentration (∑FBEC ) index for vancomycin plus Manuka honey against S. aureus IDRL-4284 biofilms was 0.34, indicating a synergistic interaction. The ∑FBEC index for gentamicin plus Manuka honey against P. aeruginosa PAO1 biofilms was 0.78–0.82, indicating an additive interaction. Scanning electron microscopy of S. aureus IDRL-4284 and P. aeruginosa PAO1 biofilms exposed to Manuka honey and artificial honey containing the same sugar composition as Manuka honey showed that the former had more pronounced effects than the latter on both S. aureus and P. aeruginosa biofilms. Visualized effects included distorted cell morphologies for both bacteria and a decrease in P. aeruginosa extracellular matrix. In conclusion, Manuka honey has a synergistic interaction with vancomycin against S. aureus biofilms and an additive interaction with gentamicin against P. aeruginosa biofilms.
Prognostic Implications of Pulmonary Hypertension in Patients With Severe Aortic Stenosis Undergoing Transcatheter Aortic Valve Implantation
Authors: Luçon Adrien , Oger Emmanuel , Bedossa Marc , Boulmier Dominique , Verhoye Jean Philippe , Eltchaninoff Hélène , Iung Bernard , Leguerrier Alain , Laskar Marc , Leprince Pascal , Gilard Martine , Le Breton Hervé 
Published: February 2014

Background—
Pulmonary hypertension (PH) is associated with poor prognosis in patients with severe aortic stenosis. The aim of this multicenter study was to describe clinical outcome after transcatheter aortic valve implantation.

Methods and Results—

The FRANCE 2 Registry included all patients undergoing transcatheter aortic valve implantation in France in 2010 and 2011. Patients were divided into 3 groups depending on systolic pulmonary artery pressure (sPAP) estimated in transthoracic echocardiography: group I, sPAP <40 mm Hg (no PH); group II, sPAP 40 to 59 mm Hg (mild-to-moderate PH); and group III, sPAP ≥60 mm Hg (severe PH). Patients were followed up for 1 year. A total of 2435 patients whose pre–transcatheter aortic valve implantation sPAP was reported were included. A total of 845 were in group I (34.7%), 1112 in group II (45.7%), and 478 in group III (19.6%). Procedural success, early complications, and 30-day mortality were statistically similar across sPAP groups. One-year mortality was higher in groups II and III (group I, 22%; group II, 28%; and group III, 28%;
P
=0.032). Mild-to-moderate and severe PH were identified as an independent factor of all-cause mortality. The major adverse cardiovascular event rates did not differ according to sPAP. New York Health Association functional class improved significantly in all groups.

Conclusions—
PH (sPAP ≥40 mm Hg) in patients with aortic stenosis undergoing transcatheter aortic valve implantation was associated with increased 1-year mortality especially when severe (sPAP ≥60 mm Hg) but not with increased 30-day mortality, and functional status was significantly improved regardless of PAP level.
Feasibility and Short-Term Outcomes of Percutaneous Transcatheter Pulmonary Valve Replacement in Small (<30 kg) Children With Dysfunctional Right Ventricular Outflow Tract Conduits
Authors: Berman Darren P. , McElhinney Doff B. , Vincent Julie A. , Hellenbrand William E. , Zahn Evan M. 
Published: February 2014

Background—
In 2010, the Melody transcatheter pulmonary valve (TPV) received Food and Drug Administration approval for treatment of dysfunctional right ventricular outflow tract conduits in patients ≥30 kg. Limited data are available regarding use of this device in smaller patients.

Methods and Results—

We evaluated technical and short-term clinical outcomes of 25 patients <30 kg (10 patients <20 kg) who underwent TPV replacement for treatment of conduit dysfunction at 3 centers. Median age and weight were 8.0 years (3.4–14.4) and 21.4 kg (13.8–29.0). The median conduit diameter at the time of surgical implant was 17 mm (12–23). Two patients did not undergo TPV implant (risk of coronary compression in 1; inability to advance the delivery sheath beyond the common femoral vein in 1). After successful TPV implant, the peak conduit gradient fell from 29±16 to 9±6 mm Hg (
P
<0.001), and all but 2 patients had no/trivial regurgitation (down from moderate or severe preimplant in 20). TPV implant was via the femoral vein in 17 patients, the right internal jugular vein in 4, and the left subclavian vein in 2 patients. At a median follow-up of 16 months, 1 patient underwent conduit replacement for recurrent conduit stenosis, 2 developed stent fracture requiring a second TPV, and 2 developed bacterial endocarditis treated with antibiotics, 1 of whom then underwent conduit replacement. The average Melody valve mean Doppler gradient and conduit regurgitation were unchanged from early postimplant.

Conclusions—
Percutaneous TPV replacement can be performed in small children with good procedural and early hemodynamic results in the majority of patients.
Increasing Use of Computed Tomographic Perfusion and Computed Tomographic Angiograms in Acute Ischemic Stroke From 2006 to 2010
Authors: Vagal Achala , Meganathan Karthikeyan , Kleindorfer Dawn O. , Adeoye Opeolu , Hornung Richard , Khatri Pooja 
Published: February 2014

Background and Purpose—
Our objective was to study nationwide utilization trends of computed tomographic (CT) angiogram (CTA) and CT perfusion (CTP) in acute ischemic stroke and particularly in the context of use of reperfusion therapies.

Methods—
We reviewed the Premier Perspective Database for ischemic stroke–related hospitalizations of adult patients during a 5-year period, 2006 to 2010. Use of multimodal CT-based imaging and reperfusion therapies was determined through the procedure and billing codes. Logistic regression was used to identify predictors of utilization of imaging studies and reperfusion treatments.

Results—

An increasing proportion of ischemic strokes received CTA each year: 3.8% in 2006, 5.6% in 2007, 6.5% in 2008, 7.5% in 2009, and 9.1% in 2010 (
P
<0.0001). The proportion of acute strokes that were imaged with CTP imaging also increased each year: 0.05% in 2006, 0.05% in 2007, 0.9% in 2008, 2.2% in 2009, and 2.9% in 2010 (
P
<0.0001). Reperfusion treatment was more common among those who were imaged with CTA (13.0%) and CTP (17.6%) compared with those with CT head alone (4.0%;
P
<0.0001). Specifically, higher rates of recombinant tissue-type plasminogen activator were observed in CTA (10.2%) and CTP (11.4%) compared with those with CT head alone (3.8%;
P
<0.0001). Similarly, higher rates of mechanical embolectomy were observed in CTA (2.8%) and CTP (6.3%) compared with those with CT head alone (0.2%;
P
<0.0001).

Conclusions—
There was a marked increase in the rate of CTA and CTP studies in setting of acute ischemic stroke from 2006 to 2010, and both modalities were associated with increased reperfusion therapy use.
Plasma Angiopoietin-1 Is Lower After Ischemic Stroke and Associated With Major Disability But Not Stroke Incidence
Authors: Golledge Jonathan , Clancy Paula , Maguire Jane , Lincz Lisa , Koblar Simon , McEvoy Mark , Attia John , Levi Chris , Sturm Jonathan , Almeida Osvaldo P. , Yeap Bu B. , Flicker Leon , Norman Paul E. , Hankey Graeme J. 
Published: February 2014

Background and Purpose—
Studies in rodent models suggest that upregulating angiopoietin-1 (Angpt1) improves stroke outcomes. The aims of this study were to assess the association of plasma Angpt1 with stroke occurrence and outcome.

Methods—
Plasma Angpt1 was measured in 336 patients who had experienced a recent stroke and 321 healthy controls with no stroke history. Patients with stroke (n=285) were reassessed at 3 months and plasma Angpt1 concentration on admission compared between those with severe and minor disability as assessed by the modified Rankin scale. In a separate cohort of 4032 community-acquired older men prospectively followed for a minimum of 6 years, the association of plasma Angpt1 with stroke incidence was examined.

Results—

Median plasma Angpt1 was 3-fold lower in patients who had experienced a recent stroke (6.42, interquartile range, 4.26–9.53 compared with 17.36; interquartile range, 14.01–22.46 ng/mL;
P
<0.001) and remained associated with stroke after adjustment for other risk factors. Plasma Angpt1 concentrations on admission were lower in patients who had severe disability or died at 3 months (median, 5.52; interquartile range, 3.81–8.75 ng/mL for modified Rankin scale 3–6; n=91) compared with those with minor disability (median, 7.04; interquartile range, 4.75–9.92 ng/mL for modified Rankin scale 0–2; n=194),
P
=0.012, and remained negatively associated with severe disability or death after adjusting for other risk factors. Plasma Angpt1 was not predictive of stroke incidence in community-dwelling older men.

Conclusions—
Plasma Angpt1 concentrations are low after ischemic stroke particularly in patients with poor stroke outcomes at 3 months. Interventions effective at upregulating Angpt1 could potentially improve stroke outcomes.
The Artistic Posterity of Joachim of Fiore in Latin America
Authors: Lara Jaime 
Published: February 2014

‭It has long been recognized that Joachim of Fiore (d. 1202), the Calabrian abbot, prophet, and artist, had a profound effect on the mendicant friars, particularly on the Franciscans and Dominicans who recognized their respective founders in his eschatological prophecies. Both orders made use of Joachim’s prognostications in their self-defense and in their world mission, especially when the New World was discovered. Franciscan art in the Andes and Mexico employed Joachimite references, and included the portrait of the Calabrian abbot in paintings depicting a flying Saint Francis of Assisi. There is evidence that native peoples saw and understood this unique New World iconography, with its utopian and apocalyptic messages, within their own cultural constructs and values. The end result suggests that Joachim of Fiore was better known in the Spanish colonial world than in the medieval European world of his own day, and that the visual arts had much to do with this.‬
Herds and Hierarchies: Class, Nature, and the Social Construction of Horses in Equestrian Culture
Authors: Coulter Kendra 
Published: February 2014

AbstractThis study centers on equestrian show culture in Ontario, Canada, and examines how horses are entangled symbolically and materially in socially constructed hierarchies of value. After examining horse-show social relations and practices, the paper traces the connections among equestrian culture, class, and the social constructions of horses. Equestrian relations expose multiple hierarchical intersections of nature and culture within which both human-horse relations and horses are affected by class structures and identities. In equestrian culture, class affects relations within and across species, and how horses are conceptualized and used, as symbols and as living animal bodies.
What Good Is a Bear to Society?
Authors: Harding Lauren 
Published: February 2014

AbstractArising out of fieldwork in the Canadian Rockies, this paper analyzes the role of bears in the conservation culture of Canadian national parks. Why is the presence of this large predator tolerated and even celebrated by some? And why do others fear and even despise this animal, whom they see as a danger and a menace, and resent its continued preservation? Bears may act as a token charismatic species in conservation mythology; they may be anthropomorphized into a cuddly roadside attraction evoking childhood nostalgia; or they may play the part of wrathful Nature guarding against human incursion into the wilderness. Tourists in Banff National Park take great pains to see bears, while local hikers and campers expend almost equal energy avoiding an ursine encounter. This paper explores what human reactions to bears reveal about social attitudes toward the natural world, particularly in areas like the Canadian Rockies where human and bear territory overlap.