bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical relevance of cardiac structure and function abnormalities in patients with Cushing’s syndrome before and after cure
Authors: Toja Paola M. , Branzi Giovanna , Ciambellotti Francesca , Radaelli Piero , De Martin Martina , Lonati Laura Maria , Scacchi Massimo , Parati Gianfranco , Cavagnini Francesco , Pecori Giraldi Francesca 
Published: August 2011

SummaryObjectives  Sustained hypercortisolism impacts cardiac function, and, indeed, cardiac disease is one of the major determinants of mortality in patients with Cushing’s syndrome. The aim of this study was to assess the clinical relevance of cardiac structure and function alterations by echocardiography in patients with active Cushing’s syndrome and after disease remission.Study design  Seventy‐one patients (61 women, 10 men) with Cushing’s syndrome and 70 age‐, sex‐ and blood pressure‐matched controls were enrolled. Echocardiography was performed in 49 patients with active disease and at several time points after remission in 44 patients (median follow‐up 46·4 months), and prevalence of abnormal left ventricular mass measurements and systolic and diastolic functions indices was compared between patients with active disease, after remission and controls. Twenty‐two patients were evaluated both before and after remission.Results  Up to 70% of patients with active Cushing’s syndrome presented abnormal left ventricular mass parameters; 42% presented concentric hypertrophy and 23% concentric remodelling. Major indices of systolic and diastolic functions, i.e. ejection fraction and E/A ratio, respectively, were normal. Upon remission of hypercortisolism, left ventricular mass parameters ameliorated considerably, although abnormal values were still more frequent than in controls. Both cortisol excess and hypertension contribute to cardiac mass alterations and increase the prevalence of target organ damage.Conclusions  Cushing’s syndrome is associated with an increased risk for abnormalities of cardiac mass, which ameliorates, but does not fully disappear after remission. Systolic and diastolic functions are largely within the normal range in these patients.
A Steinian approach to an empathic understanding of hope among patients and clinicians in the culture of palliative care
Authors: Richardson Kate , MacLeod Rod , Kent Bridie 
Published: August 2011

richardson k., macleod r.. & kent b.
(2012) A Steinian approach to an empathic understanding of hope among patients and clinicians in the culture of palliative care. Journal of Advanced Nursing68(3), 686–694.AbstractAim.  This article presents a discussion of empathy in the context of human person, reason and hopes in the clinical setting.Background.  Empathy was introduced to nursing as part of an ethical and philosophical foundation for caring. It helped to solve the tension and meet the demands that empathy placed upon nursing practice.Data sources.  This article is based on two studies undertaken between 2008 and 2010 to understand the concept of hope and empathy among people with terminal cancer and doctors who care for them. Doctoral dissertations and theses of Edith Stein (1916–1917), Marianne Sawicki [Body, Text and Science. The Literary of Investigative Practices and the Phenomenology of Edith Stein (1997) Kluwer Academic Publisher, Dordrecht], and Sister M. Judith Parsons (2005) have been used to examine: ‘the essence of acts of empathy’, ‘the constitution of the psycho‐physical individual’ and ‘empathy as understanding of intellectual persons’. CINAHL, MEDLINE and PROQUEST have provided further supporting data.Discussion.  Steinian empathy requires that we use affective resonance, cognitive understanding and distance, as we grasp another person’s emotional and situational reality while in the caring role as nurses.Implications for current nursing.  Steinian empathy is about recognizing a lived experience and standing side‐by‐side with that person. Nurses can transmit this knowledge to enable and support courage and wisdom to reduce feelings of helplessness when caring for people with terminal illness.Conclusion.  Not only is empathy a safe and permissible emotion, it is the linchpin to a caring patient–nurse relationship and we must embrace this.
Pain descriptors for critically ill patients unable to self‐report
Authors: Haslam Lynn , Dale Craig , Knechtel Leasa , Rose Louise 
Published: August 2011

haslam l., dale c., knechtel l. & rose l. (2011) Pain descriptors for critically ill patients unable to self‐report. Journal of Advanced Nursing 68(5), 1082–1089.AbstractAim.  To examine descriptors used by nurses in two Canadian intensive care units to document pain presence for critically ill patients unable to self‐report.Background.  Systematic documentation of pain assessment is essential for communication and continuity of pain management, thereby enabling better pain control, maximizing recovery and reducing physical and psychological sequelae.Method.  A retrospective, mixed method, having observational design in two Level‐III intensive care units of a quaternary academic centre in Toronto, Canada. During 2008–2009, data were abstracted via chart review guided by a reference compendium of potential behavioural descriptors compiled from existing behavioural pain assessment tools.Results.  A total of 679 narrative descriptions were extracted. Behavioural descriptors (232, 34%), physiological descriptors (93, 14%), and descriptors indicating the patient was pain free (117, 17%) were used to describe pain presence or absence. Narratives also described analgesia administered without descriptors of pain assessment (117, 17%) and assessment and analgesic administration prior to a known painful procedure (30, 4%). Emerging themes included life‐threatening treatment interference, decisional uncertainty and a wakefulness continuum.Conclusion.  Inconsistent or ambiguous documentation was problematic in this sample. This may reflect confounding behaviours and concomitant safety priorities. Developing a lexicon of pain assessment descriptors of critically ill patients unable to self‐report for use in combination with valid and reliable measures may improve documentation facilitating appropriate analgesic management. Protocols or unit guidelines that prioritize a trial of analgesia before administration of sedatives may decrease decisional uncertainty when patients exhibit ambiguous behaviours such as agitation or restlessness.
The consequences of unsafe abortion : a qualitative study
Authors: Shahbazi Shirin 
Published: August 2011

shahbazi s. (2012) The consequences of unsafe abortion : a qualitative study. Journal of Advanced Nursing68(6), 1247–1255.AbstractAim.  This paper is a report of a study of the consequences of illegal abortions experienced by Iranian women.Background.  Despite the increase in effective and safe methods of contraception and the distribution of information about these methods, unwanted pregnancy is still a problem in some societies. Induced abortion is a common procedure throughout the world and at least half of more than 45 million induced abortions which happen in a year are performed under unsafe circumstances. Unsafe abortions carry a high risk of maternal mortality and morbidity, accounting for more than 80,000 maternal deaths per year.Method.  In this qualitative study, 27 participants were interviewed in 2006. Some participants were women who had illegal abortions and others were people who had contact with those women. Content analysis was used to identify and categorize participants’ responses to the interview questions.Findings.  Four consequences of women’s experiences of illegal abortion were identified: physical, psychological, socio‐political and judicial.Conclusion.  In Iran, as in some other developing countries intentional abortion, except for some special cases, is illegal because of social and religious beliefs. In these countries, offering services and support to women with unwanted pregnancies seems to be the best solution for reducing or preventing illegal abortion.
Medical humanities' challenge to medicine
Authors: Macnaughton Jane 
Published: August 2011

AbstractMedicine is predicated on a view of human nature that is highly positivist and atomistic. This is apparent in the way in which its students are taught, clinical consultations are structured and medical evidence is generated. The field of medical humanities originally emerged as a challenge to this overly narrow view, but it has rarely progressed beyond tinkering around the edges of medical education. This is partly because its practitioners have largely been working from within a pervasive medical culture from which it is difficult to break free, and partly because the field has been insufficiently armed with scholarly thinking from the humanities. This is beginning to change and there is a sign that research in medical humanities has the potential to mount a persuasive challenge to medicine's ways of teaching, working and finding out. This article problematizes medicine's narrow viewpoint, grounding its critique in philosophical ideas from phenomenology and pragmatism. I will reflect upon the historical context within which medical humanities has emerged and briefly examine specific examples of how its interdisciplinary approach, involving humanities scholars with clinicians and medical scientists, may develop new research directions in medicine.
Y chromosome genetic diversity in the Lidia bovine breed: a highly fragmented population
Authors: Cortes O. , Tupac‐Yupanqui I. , Dunner S. , Fernández J. , Cañón J. 
Published: August 2011

SummaryTo assess the paternal gene pool in the Lidia bovine breed (or fighting bull), a total of 603 animals belonging to 81 herds classified in 33 lineages were genotyped for six Y chromosome microsatellites, one single nucleotide polymorphism and one indel. A total of 10 haplotypes were determined with a high level of frequency variation between them, ranging from 0.2 to 74%. All the haplotypes identified belong to two previously defined major haplogroups (Y1 and Y2). Two major paternal influences were identified, corresponding to the two most common haplotypes (H1Y1 and H3Y2) with frequencies of 74 and 18%, respectively. The detection of the INRA189‐104 allele evidenced an African influence in the Lidia bovine breed. Low levels of haplotype diversity have been achieved and only eight lineages showed more than one haplotype. Analysis of molecular variance showed a high level of interlineage variance (FST = 86%). Network results evidenced two main clusters made for those haplotypes belonging to Y1 and Y2 haplogroups, respectively. The findings support a high level of genetic structure together with a low level of genetic diversity in the Lidia bovine breed.
Patterns of spatial variation of nutrient content, epiphyte load and shoot size of Posidonia oceanica seagrass meadows (Mediterranean Sea)
Authors: Castejón‐Silvo Inés , Terrados Jorge 
Published: August 2011

AbstractKnowledge of patterns of spatial variability of vegetative development, epiphyte load and nutrient availability in seagrass meadows is essential for the adequate design of research and environmental monitoring programmes. Differences in shoot size, epiphyte load and nutrient content of leaves and epiphytes of the Mediterranean endemic seagrass Posidonia oceanica at spatial scales ranging from metres to hundreds of metres are evaluated using a hierarchical nested sampling design. The size and epiphyte load of P. oceanica shoots and the nitrogen and phosphorus content of leaves and epiphytes were different in most of the spatial scales considered. Sampling efforts concentrated at the metre scale incorporated most of the variability in size, epiphyte load and nutrient content of the leaves and epiphytes of P. oceanica shoots. Epiphyte load showed no correlation with nutrient content in the epiphytes or in the leaves. However, epiphyte load and shoot size were negatively correlated, which suggests that light penetration in the canopy may be a main determinant of epiphyte load.
Genome content of uncultivated marine Roseobacters in the surface ocean
Authors: Luo Haiwei , Löytynoja Ari , Moran Mary Ann 
Published: August 2011

SummaryUnderstanding of the ecological roles and evolutionary histories of marine bacterial taxa can be complicated by mismatches in genome content between wild populations and their better‐studied cultured relatives. We used computed patterns of non‐synonymous (amino acid‐altering) nucleotide diversity in marine metagenomic data to provide high‐confidence identification of DNA fragments from uncultivated members of the Roseobacter clade, an abundant taxon of heterotrophic marine bacterioplankton in the world's oceans. Differences in gene stoichiometry in the Global Ocean Survey metagenomic data set compared with 39 sequenced isolates indicated that natural Roseobacter populations differ systematically in several genomic attributes from their cultured representatives, including fewer genes for signal transduction and cell surface modifications but more genes for Sec‐like protein secretion systems, anaplerotic CO2 incorporation, and phosphorus and sulfate uptake. Several of these trends match well with characteristics previously identified as distinguishing r‐ versus K‐selected ecological strategies in bacteria, suggesting that the r‐strategist model assigned to cultured roseobacters may be less applicable to their free‐living oceanic counterparts. The metagenomic Roseobacter DNA fragments revealed several traits with evolutionary histories suggestive of horizontal gene transfer from other marine bacterioplankton taxa or viruses, including pyrophosphatases and glycosylation proteins.
EXCHANGE RATE TARGET ZONES: A SURVEY OF THE LITERATURE
Authors: Portugal Duarte António , Sousa Andrade João , Duarte Adelaide 
Published: August 2011

AbstractThis work selectively reviews the literature on exchange rate target zones and their theoretical and empirical methodologies and examines whether they can be used to clarify to what extent this type of exchange rate regime could contribute to greater exchange rate stability. We discuss the main contributions of the first and second generations of exchange rate target zone models. In an attempt to reconcile the poor empirical performance of the Krugman model with the reality of exchange rate target zone regimes, this line of research integrates target zones with alternative underlying economic models, such as imperfect credibility, intra‐marginal interventions and sticky price models. It was thus possible to understand the correlations observed between the exchange rate, its fundamentals determinants and the interest rate differential, and to explain the fact that the statistical distribution of the exchange rate is hump shaped rather than U shaped. This implies that the initial emphasis of target zone models on nonlinearities, ‘honeymoon effect’, ‘smooth pasting’ and marginal interventions has vanished. Exchange rate target zones are better described as similar to managed floating regimes with intra‐marginal interventions, with some marginal interventions when the exchange rate reaches the edges of the floating band.
Clinical characteristics of well women seeking labial reduction surgery: a prospective study
Authors: Crouch NS , Deans R , Michala L , Liao L‐M , Creighton SM 
Published: August 2011

Please cite this paper as: Crouch N, Deans R, Michala L‐M, Liao L, Creighton S. Clinical characteristics of well women seeking labial reduction surgery: a prospective study. BJOG 2011;118:1507–1510.Objective  To assess clinical characteristics and expectations in well women requesting elective labial reduction surgery.Design  Prospective study of women attending an outpatient gynaecology clinic.Setting  General gynaecology clinic at a Central London teaching hospital.Sample  Women requesting labial reduction surgery and referred by their general practitioner.Methods  The labia minora width and length were measured for all participants for comparison with published normal values. The presenting complaint was recorded, along with demographic details, expectations of surgery and sources of information regarding appearance of the labia.Main outcome measures  Labial measurements, reported symptoms and expectations of surgery.Results  The labia of all participants were within normal published limits, with a mean (SD) of 26.9 (12.8) mm (right labia), and 24.8 (13.1) mm (left labia). The majority of complaints were regarding appearance or discomfort. Expectations were to alter the appearance with surgery.Conclusions  All women seeking surgery had normal‐sized labia minora. Clear guidance is needed for clinicians on how best to care for the worried well woman seeking surgery.
Renal endpoints in renal and cardiovascular randomized clinical trials: time for a consensus?
Authors: Halimi Jean‐Michel , Sautenet Bénédicte , Gatault Philippe , Roland Mélanie , Giraudeau Bruno 
Published: August 2011

AbstractSeveral recent major randomized clinical trials (RCTs) using renal outcomes resulted in conflicting results. We searched MEDLINE via PubMed with the search request ‘(dialysis OR end‐stage renal disease) and creatinine’ in six major general journals and two leading journals of nephrology; 123 articles were found; 17/123 were relevant RCTs. Some disagreement among surrogate endpoints in 11/15 articles (missing data in two RCTs) and between surrogate and hard renal endpoints in 10/13; the intervention effects were in the opposite direction in 4/15, mostly in patients with cardiovascular disease, but discrepancies and conflicting results were also found among renal trials. Among our selected RCTs, 14/17 used composite endpoints: vital and renal endpoints were mixed in 11/14 trials, the components of the composite endpoints were of similar importance in 0/14 trials and of similar frequency in 1/11 trials, the intervention was likely to have a similar effect on the components in 4/14 trials, and the relative risk reduction was similar for the different components in 2/10 trials. None of the trials fulfiled all conditions of validation. Based on this analysis, we believe that the current use of renal endpoints in RCTs must be reviewed and their conditions of validation defined.
Oncostatin M decreases interleukin‐1 β secretion by human synovial fibroblasts and attenuates an acute inflammatory reaction in vivo
Authors: Dumas Aline , Lagarde Stéphanie , Laflamme Cynthia , Pouliot Marc 
Published: August 2011

AbstractOncostatin M (OSM) is a pleiotropic cytokine of the IL‐6 family and displays both pro‐inflammatory and anti‐inflammatory activities. We studied the impact of OSM on the gene activation profile of human synovial cells, which play a central role in the progression of inflammatory responses in joints. In synovial cells stimulated with lipopolysaccharide and recombinant human granulocyte‐macrophage colony‐stimulating factor, recombinant human OSM and native OSM secreted by human granulocytes both reduced the gene expression and secretion of IL‐1β and CXCL8, but increased that of IL‐6 and CCL2. This impact on synovial cell activation was not obtained using IL‐6 or leukaemia inhibitory factor. Signal transducer and activator of transcription‐1 appeared to mediate the effects of OSM on stimulated human synovial fibroblasts. In the murine dorsal air pouch model of inflammation, OSM reduced the expression of the pro‐inflammatory cytokines IL‐1β and TNF‐α in lining tissues, and their presence in the cavity. These results as a whole suggest an anti‐inflammatory role for OSM, guiding inflammatory processes towards resolution.
Cyclic AMP increases COX‐2 expression via mitogen‐activated kinase in human myometrial cells
Authors: Chen Li , Sooranna Suren R. , Lei Kaiyu , Kandola Mandeep , Bennett Phillip R. , Liang Zhiqing , Grammatopoulos Dimitri , Johnson Mark R. 
Published: August 2011

AbstractCyclic AMP (cAMP) is the archetypal smooth muscle relaxant, mediating the effects of many hormones and drugs. However, recently PGI2, acting via cAMP/PKA, was found to increase contraction‐associated protein expression in myometrial cells and to promote oxytocin‐driven myometrial contractility. Cyclo‐oxygenase‐2 (COX‐2) is the rate‐limiting enzyme in prostaglandin synthesis, which is critical to the onset and progression of human labour. We have investigated the impact of cAMP on myometrial COX‐2 expression, synthesis and activity. Three cAMP agonists (8‐bromo‐cAMP, forskolin and rolipram) increased COX‐2 mRNA expression and further studies confirmed that this was associated with COX‐2 protein synthesis and activity (increased PGE2 and PGI2 in culture supernatant) in primary cultures of human myometrial cells. These effects were neither reproduced by specific agonists nor inhibited by specific inhibitors of known cAMP‐effectors (PKA, EPAC and AMPK). We then used shRNA to knockdown the same effectors and another recently described cAMP‐effector PDZ‐GEF1‐2, without changing the response to cAMP. We found that MAPK activation mediated the cAMP effects on COX‐2 expression and that PGE2 acts through EP‐2 to activate MAPK and increase COX‐2. These data provide further evidence in support of a dual role for cAMP in the regulation of myometrial function.
Tyrosine kinase gene fusions in cancer: translating mechanisms into targeted therapies
Authors: Medves Sandrine , Demoulin Jean‐Baptiste 
Published: August 2011

Abstract
Introduction
Tyrosine kinase inhibitors
Fusion gene structure and expression
Loss of wild‐type alleles
Oligomerization triggers TK activation
Inhibitory domain deletion
Signalling pathways
Recruitment of additional molecules by the fusion partner
Stabilization and degradation
Conclusion
Tyrosine kinase fusion genes represent an important class of oncogenes associated with leukaemia and solid tumours. They are produced by translocations and other chromosomal rearrangements of a subset of tyrosine kinase genes, including ABL, PDGFRA, PDGFRB, FGFR1, SYK, RET, JAK2 and ALK. Based on recent findings, this review discusses the common mechanisms of activation of these fusion genes. Enforced oligomerization and inactivation of inhibitory domains are the two key processes that switch on the kinase domain. Activated tyrosine kinase fusions then signal via an array of transduction cascades, which are largely shared. In addition, the fusion partner provides a scaffold for the recruitment of proteins that contribute to signalling, protein stability, cellular localization and oligomerization. The expression level of the fusion protein is another critical parameter. Its transcription is controlled by the partner gene promoter, while translation may be regulated by miRNA. Several mechanisms also prevent the degradation of the oncoprotein by proteasomes and lysosomes, leading to its accumulation in cells. The selective inhibition of the tyrosine kinase activity by adenosine‐5′‐triphosphate competitors, such as imatinib, is a major therapeutic success. Imatinib induces remission in leukaemia patients that are positive for BCR‐ABL or PDGFR fusions. Recently, crizotinib produced promising results in a subtype of lung cancers with ALK fusion. However, resistance was reported in both cases, partially due to mutations. To tackle this problem, additional levels of therapeutic interventions are suggested by the complex mechanisms of fusion tyrosine kinase activation. New approaches include allosteric inhibition and interfering with oligomerization or chaperones.