bluuebunny/crossref_metadata_2025_split huggingface dataset:
Training physicians to care for the dying
Authors: Bulkin Wilma , Lukashok Herbert 
Published: May 2006

Problem: The education of medical students and house staffre garding management of death and timely discussions of death with patients and families has been deficient, leaving physicians ill equipped to provide appropriate care to dying patients. Method: We propose a five-pronged curriculum in terminal care to be ongoing frommedicalschool through postgraduate training. Thisprogram includes: • Clinical skill' — including pain and symptom management, prognostication and care in various settings; • Communication skills — including listening and how to discuss bad news withpatient andfamily; • Psychosocial issues; • Administrative/management and team interaction, and • Bioethical issues, including DNR and living wills. Conclusion: It is hoped that such training will teach physicians to accept death as inevitable, to recognize and acknowledge the state ofdying and,flnally, to understand that appropriate care includes appropriate death, which isone arrived at with minimal suffering, with minimal social and emotional impoverishment, with preservation or restoration of important relationships and with resolution of residual conflicts.
Training our future physicians: A hospice rotation for medical students
Authors: Knight Carol F. , Knight Peter F. , Gellula Mark H. , Holman Gerald H. 
Published: May 2006

A required 16 hour hospice clinical rotation was developed as part of a medical student family practice clerkship. The effect of the hospice rotation on student beliefs and attitudes towards the care of dying patients was measured by pre and post-test questionnaires using a Likert scale. Sixty-five completed pre and post-tests were analyzed using a paired t-test. It was determined that there were statistically significant changes in responses to 15 of 23 items. The rotation positively q1 fected student attitudes about hospice care, student attitudes about a hospice rotation, and beliefs concerning palliative care. The authors believe that qualified hospice programs can, and should, serve an active role in teaching medical students about the physical and psychosocial aspects of caring for the dying.
The effect of the Medicare regulations on hospice practice: Enhancing staff performance
Authors: Tierney Jeanette , Wilson Damien 
Published: May 2006

The purpose of this paper is to examine the federal hospice regulations (42 CFR 418.50 - .100) and identify from these standards key characteristics that help define important aspects of palliative hospice care. The other purpose will be to examine these requirements to determine what these standards say or imply about the functioning of the hospice staff within the certified program. We assert that in order for a certified program to function in the capacity outlined in the federal hospice requirements, both the administration and staff need to understand, and then practice, the complex role delineated within the Congressional Law and ensuing regulations. The Medicare hospice regulations are a recognized program standard throughout the nation. These requirements, finalized in 1983, were developed by the Health Care Financing Administration (HCFA) as a result of the Congressional Tax Equity and Fiscal Responsibility Act (TEFRA, 1982).1 Since the promulgation of these regulations, hospices wishing to gain certification have had to adapt and mold their program focus and clinical procedures to meet this legislative mandate. Although some hospice administrators may perceive the Medicare requirements simply as hoops to be jumped through in order to gain funding, in truth, these regulations stand as a benchmark in the history of American hospice care. In their totality, the rules set forth a system of health care that is singular in program design.
Splenic irradiation in the palliation of patients with lymphoproliferative and myeloproliferative disorders
Authors: Paulino Arnold C. , Reddy Sarada P. 
Published: May 2006

Introduction: Splenic irradiation is an accepted mode of treatment for palliation of hypersplenism and splenic pain for patients with lymphoproliferative or myeloproliferative disorders. However, results are conflicting regarding the duration of palliation and the toxicity associated with this treatment. Methods: Twenty-five patients with lymphoproliferative or myeloproliferative disorders were treated with splenic irradiation for palliation of splenomegaly and pain. The spleen was measured and pain and toxicity were assessed during radiation therapy. Results: Splenomegaly and splenic pain decreased in 60 percent and 91 percent of patients, respectively. Radiation doses higher than 500 cGy appeared to be more effective than lower doses in reducing the spleen size in patients with chronic lymphocytic leukemia. Regression of splenomegaly and pain relief were maintained for less than one year and more than six months, respectively. Acute radiation toxicity resulted in the cessation of radiotherapy in two patients. Conclusion: Splenic irradiation is effective in the short-term palliation of splenomegaly and pain and may be most useful in the subset of patients with a life expectancy of less than one year. Terminally ill patients with splenomegaly secondary to lymphoproliferative or myeloproliferative disorders may benefit from splenic irradiation to minimize pain and pressure symptoms in addition to possible reduction of narcotic use.
Part two: Breast cancer, colorectal cancer, and esophageal cancer
Authors: Kemp Charles 
Published: May 2006

This is the second of a six-part series on metastatic spread and natural history of 18 common tumors. Part one summarized symptom/problem anticipation, cancer metastasis, and the 18 tumors that each cause more than 6,000 deaths per year in the United States. Bladder and brain cancer were discussed, with information given on tumor types, metastatic spread and invasion, and common symptoms. Part two charts the natural histories of breast, colorectal, and esophageal cancers. Each of these cancers is presented separately, with information given on mortality rates, the most common tumor types, sites of metastases, common problems, and common oncologic emergencies. Sites of spread, resulting problems (including site-specific symptoms), and assessment parameters are presented as tables. Material is presented so that clinicians will be able to anticipate the spread of these cancers and thus identify problems early in their development so that the problems are more easily managed.
Perceptions and decision-making on rehydration of terminally ill cancer patients and family members
Authors: Morita Tatsuya , Tsunoda Junichi , Inoue Satoshi , Chihara Satoshi 
Published: May 2006

Although the appropriateness of forced rehydration for terminally ill cancer patients has been actively discussed, few studies have investigated its psychological aspects. To clarify patients’ and family members’ perceptions about rehydration and identify contributing factors for decision-making, a prospective structured survey was performed on 121 hospice inpatients with insufficient oral intake. Physicians did not recommend rehydration in 78 percent of patients, and 75 percent decided not to receive artificial fluid therapy. Various concerns affected decision-making: 76 percent of patients and 85 percent of family members believed patients could not get appropriate nutrition without artificial rehydration. Some 56 percent of patients and 84 percent of family members said that withholding rehydration would cause premature death, while more than half agreed that forced rehydration might worsen the patients’ suffering. Patients’ performance status, fluid retention signs, denial, physicians’ recommendations, patients’ and family members’ beliefs about the effect of hydration on patients’ distress, and family members’ anxiety about withholding rehydration were significantly associated with decision-making. Multiple regression analyses revealed patients’ denial, physicians’ recommendations determined by patients’ performance status and fluid retention symptoms, and family members’ belief that rehydration could worsen patients’ distress as independent determinants for rehydration. In conclusion, hospice care receivers had various concerns about rehydration, related to patients’ nutrition, survival, and distress. The main determinants for rehydration therapy were patients’ performance status, fluid retention symptoms, denial, and care receivers’ beliefs about the effect of hydration on the patients’ distress.
Co-morbidity associated with dementia
Authors: Sanderson Maureen , Wang Jing , Davis Dorothy R. , Lane Marcia J. , Cornman Carol B. , Fadden Mary K. 
Published: May 2006

Purpose: The purpose of this study was to identify common co-morbid conditions associated with dementia subtypes and to evaluate the association of hypertension, diabetes mellitus, atrial fibrillation, congestive heart failure, and anemia with dementia subtypes relative to controls. Methods: Hospital discharge data were used to identify 15,013 subjects from South Carolina with a diagnosis of dementia between 1998 and 1999. A control group of 15,013 persons without dementia was randomly sampled from hospital discharge records and matched to persons with dementia on the basis of age, race, and gender. Multiple hospitalizations for each patient were merged, and repeated diagnoses during separate hospitalizations were counted once. Results: After adjusting for age, race, and gender, persons with Alzheimer's disease and dementia associated with medical conditions were less likely to be diagnosed with hypertension, diabetes, congestive heart failure, and atrial fibrillation than were controls. Patients with multiinfarct dementia were also less likely to have congestive heart failure, but were more likely to have diabetes. Anemia was not associated with any dementia subtype. Conclusions: There are distinct differences in comorbid conditions among dementia subtypes. Our research does not support previous studies that suggest a circulatory component to the development of Alzheimer's disease.
Attitudes of relatives and nursing staff toward tuboenteral feeding in severely demented patients
Authors: Lubart Emilia , Leibovitz Arthur , Habot Beni 
Published: May 2006

Elder y patients with advanced dementia present a challenge with respect to efficient nutrition and hydration because of oropharyngeal dysphagia and lack of patient cooperation. For increasing numbers ofpatients, long-term tuboenteralfeeding (TEF) is an alternative for providing food and fluids, with the hope of reducing the risk of aspiration. The purpose of this study is to learn about the opinions and the attitudes of relatives and nursing staff regarding patients on TEFfor at least one year. The study included all the dementedpatients on TEF in four skilled nursing facilities andfour nursing wards. Researchers retrieved clinical data from patients' medical records and prepared a questionnaire to survey the opinions of relatives and staff members. The study included 1]] patients: 89 on nasogastric tube (NGT) feeding and 22 on percutaneous endoscopic gastrostomy (PEG) feeding. The clinical condition of both groups was satisfactory, as reflected by albumin, hemoglobin, and Body Mass Index (BMI). Relatives of the demented patients as well as the staff members were ambivalent toward TEE Although most of them called it an essential procedure for delivering food and fluids for life support, about the same number expressed concerns that TEF prolonged a life of suffering. Nevertheless, most relatives and staff members were resistant to the idea of withholding TEF. The data show that TEF does provide efficient nutrition and hydration to patients with advanced dementia, and it is used in accordance with the will of the relatives. Any change in the present approach regarding TEF in these patients should be preceded by discussions with their relatives.
Neurocognitive testing supports a broader concept of mild cognitive impairment
Authors: Gualtieri C. Thomas , Johnson Lynda G. 
Published: May 2006

The narrow concept of mild cognitive impairment (MCI) as an early form of Alzheimer’s disease has been broadened by research that established the existence of alternative forms of the condition that may presage other forms of dementia. The research presented here was a naturalistic, cross-sectional study of patients in a community referral clinic—patients with MCI and mild dementia—compared to normal controls. A comprehensive, computerized neurocognitive screening battery developed by one of the authors (CNS Vital Signs) was administered to all of the subjects. Participants consisted of 36 patients with MCI and 53 patients with mild dementia, diagnosed by standard criteria, and 89 matched normal controls. Multivariate analysis indicated significant differences among the three groups for all 15 primary test variables and for all five of the domain scores. Tests of memory, processing speed, and cognitive flexibility were the most cogent discriminators between normal controls and MCI patients, and between MCI patients and patients with mild dementia. The same three tests also had the greatest sensitivity and specificity. The results of this study indicate that computerized testing can differentiate among normal controls, MCI patients, and patients with mild dementia. Also, in a diverse group of MCI and mild dementia patients, impairments in memory, processing speed, and cognitive flexibility were the most prominent observed deficits.
Inhibition of NF-κB activation by 5-lipoxygenase inhibitors protects brain against injury in a rat model of focal cerebral ischemia
Authors: Jatana Manu , Giri Shailendra , Ansari Mubeen A , Elango Chinnasamy , Singh Avtar K , Singh Inderjit , Khan Mushfiquddin 
Published: May 2006

AbstractBackgroundStroke is one of the leading causes of death worldwide and a major cause of morbidity and mortality in the United States of America. Brain ischemia-reperfusion (IR) triggers a complex series of biochemical events including inflammation. Leukotrienes derived from 5-lipoxygenase (5-LOX) cause inflammation and are thus involved in the pathobiology of stroke injury.MethodsTo test the neuroprotective efficacy of 5-LOX inhibition in a rat model of focal cerebral IR, ischemic animals were either pre- or post-treated with a potent selective 5-LOX inhibitor, (N- [3-[3-(-fluorophenoxy) phenyl]-1-methyl-2-propenyl]-N-hydroxyurea (BW-B 70C). They were evaluated at 24 h after reperfusion for brain infarction, neurological deficit score, and the expression of 5-LOX. Furthermore, the mechanism and the anti-inflammatory potential of BW-B 70C in the regulation of nuclear factor kappa B (NF-κB) and inflammatory inducible nitric oxide synthase (iNOS) were investigated bothin vivoandin vitro.Results and discussionBoth pre- and post-treatment with BW-B 70C reduced infarctions and improved neurological deficit scores. Immunohistochemical study of brain sections showed IR-mediated increased expression of 5-LOX in the neurons and microglia. BW-B 70C down-regulated 5-LOX and inhibited iNOS expression by preventing NF-κB activation. Two other structurally different 5-LOX inhibitors were also administered post IR: caffeic acid and 2, 3, 5-trimethyl-6- [12-hydroxy-5, 10-dodecadiynyl]-1, 4-benzoquinone (AA-861). As with BW-B 70C, they provided remarkable neuroprotection. Furthermore, in vitro, BW-B 70C inhibited lipopolysaccharide (LPS) mediated nitric oxide production, iNOS induction and NF-κB activation in the BV2 microglial cell line. Treating rat primary microglia with BW-B70C confirmed blockage of LPS-mediated translocation of the p65 subunit of NF-κB from cytosol to nucleus.ConclusionThe study demonstrates the neuroprotective potential of 5-LOX inhibition through down-regulation of NF-κB in a rat model of experimental stroke.
Arteriolar vasoconstrictive response: comparing the effects of arginine vasopressin and norepinephrine
Authors: Friesenecker Barbara E , Tsai Amy G , Martini Judith , Ulmer Hanno , Wenzel Volker , Hasibeder Walter R , Intaglietta Marcos , Dünser Martin W 
Published: May 2006

Abstract
Introduction
This study was designed to examine differences in the arteriolar vasoconstrictive response between arginine vasopressin (AVP) and norepinephrine (NE) on the microcirculatory level in the hamster window chamber model in unanesthetized, normotonic hamsters using intravital microscopy. It is known from patients with advanced vasodilatory shock that AVP exerts strong additional vasoconstriction when incremental dosage increases of NE have no further effect on mean arterial blood pressure (MAP).

Methods
In a prospective controlled experimental study, eleven awake, male golden Syrian hamsters were instrumented with a viewing window inserted into the dorsal skinfold. NE (2 μg/kg/minute) and AVP (0.0001 IU/kg/minute, equivalent to 4 IU/h in a 70 kg patient) were continuously infused to achieve a similar increase in MAP. According to their position within the arteriolar network, arterioles were grouped into five types: A0 (branch off small artery) to A4 (branch off A3 arteriole).

Results
Reduction of arteriolar diameter (NE, -31 ± 12% versus AVP, -49 ± 7%; p = 0.002), cross sectional area (NE, -49 ± 17% versus AVP, -73 ± 7%; p = 0.002), and arteriolar blood flow (NE, -62 ± 13% versus AVP, -80 ± 6%; p = 0.004) in A0 arterioles was significantly more pronounced in AVP animals. There was no difference in red blood cell velocities in A0 arterioles between groups. The reduction of diameter, cross sectional area, red blood cell velocity, and arteriolar blood flow in A1 to A4 arterioles was comparable in AVP and NE animals.

Conclusion
Within the microvascular network, AVP exerted significantly stronger vasoconstriction on large A0 arterioles than NE under physiological conditions. This observation may partly explain why AVP is such a potent vasopressor hormone and can increase systemic vascular resistance even in advanced vasodilatory shock unresponsive to increases in standard catecholamine therapy.
Transition Metal-Catalyzed C–C Bond Formation Reactions Using Alkyl Halides
Authors: Terao Jun , Kambe Nobuaki 
Published: May 2006

Abstract
This account reviews transition metal-catalyzed C–C bond formation reactions using alkyl halides, which have rarely been used as carbon sources in conventional transition metal-catalyzed systems. In the reactions, ate complexes formed by the reaction of transition metals with a Grignard reagent play important roles as the active catalytic species. The reactions mentioned here are mechanistically new and provide a promising methodology for the construction of carbon frameworks employing alkyl halides.
Rapid and Efficient Admicelle-Mediated Extraction of Chlorophenols in Water
Authors: Saitoh Tohru , Kondo Taizo , Hiraide Masataka 
Published: May 2006

Abstract
Cetyltrimethylammonium chloride was sorbed on silica gels and formed stable admicelles at pH 9. The extractabilities of chlorophenols were greater than those to sodium dodecyl sulfate–γ-alumina admicelles. Because the admicelles were floatable, the flotation was found to be useful for the rapid and efficient recovery of admicelles.
SmI2-Promoted Deacetoxylation of O-Acetylsugar Lactones. An Easy Access to Deoxysugar Lactones
Authors: Inanaga Junji , Katsuki Junko , Yamaguchi Masaru 
Published: May 2006

Abstract
Selective deacetoxylation of O-acetylsugar lactones and O-acetyl-3-deoxysugar lactones was accomplished at room temperature with the aid of SmI2 in the presence of pivalic acid or acetic acid to give the corresponding α,β-unsaturated lactones and saturated lactones (2,3-dideoxysugar derivatives), respectively.
Direct Amination of 2-Methylpropene with Ammonia into t-Butylamine on Proton-exchanged ZSM-5 Zeolite Catalyst
Authors: Tabata Masahiro , Mizuno Noritaka , Iwamoto Masakazu 
Published: May 2006

Abstract
Proton-exchanged ZSM-5 zeolite with silica/alumina = 51 showed a pronounced catalytic activity for the title reaction and it was suggested that this reaction would proceed on Brønsted acid site.
Spectroscopic Observation of Self-Assembly of a Macrocyclic Tetranuclear Complex Composed of Pt2+ and 4,4′-Bipyridine
Authors: Fujita Makoto , Yazaki Jun , Ogura Katsuyuki 
Published: May 2006

Abstract
Macrocyclic tetranuclear Pt(II) complex [(en)Pt(4,4′-bpy)]4(NO3)8 (en = ethylenediamine; bpy = bipyridine) assembled by treating (en)Pt(NO3)2 with 4,4′-bpy in water. The assembling was monitored by 1H NMR.
Template Synthesis of a Macrocyclic Tetracopper(II) Complex with Two Bridging Hydroxide Ions in Face-to-face Manner
Authors: Sakiyama Hiroshi , Motoda Ken-ichiro , Okawa Hisashi , Kida Sigeo 
Published: May 2006

Abstract
The reaction of 2,6-diformyl-4-methylphenol, triethylenetetramine, and copper(II) perchlorate hexahydrate in the 2:2:4 molar ratio formed a macrocyclic tetracopper(II) complex [Cu4(L)(OH)2](ClO4)4 where H2L denotes the macrocycle formed by two molecules of 2,6-diformyl-4-methylphenol and two molecules of triethylenetetramine. The two hydroxide groups, each bridging a pair of copper(II) ions, are facing each other in a close distance so as to be replaced by an azide ion, affording [Cu4(L)(N3)](ClO4)5.
Synthesis and Characterization of Poly(N-trialkylsilylmaleimide)s through Radical and Anionic Polymerizations
Authors: Matsumoto Akikazu , Oki Yoshitaka , Horie Atsushi , Otsu Takayuki 
Published: May 2006

Abstract
N-Trialkylsilylmaleimides bearing trimethylsilyl, t-butyldimethylsilyl and dimethylthexylsilyl groups as N-substituents were prepared and polymerized with a radical or anionic initiator. It was revealed that the resulting polymers had a high molecular weight, and showed excellent thermal stability. These polymers were readily converted to polymaleimide by acid hydrolysis.
Synthesis of Thermally Stable Vinyl Polymers from Adamantyl-Containing Acrylic Derivatives
Authors: Otsu Takayuki , Matsumoto Akikazu , Horie Atsushi , Tanaka Satoshi 
Published: May 2006

Abstract
1-Adamantyl and 3,5-dimethyl-1-adamantyl acrylates, methacrylates, and crotonates were polymerized through radical or anionic mechanism. Thermally stable and less-flexible vinyl polymers were obtained, depending on the structure of the repeating monomer units.
Correlation between Spin-Coupling Constants of Oxalate-bridged Binuclear Cu(II)–Cr(III) Complexes and of Ferromagnetic Phase-Transition Temperature Tc of {NBu4[CuCr(ox)3]}x
Authors: Ohba Masaaki , Tamaki Hiroko , Matsumoto Naohide , Okawa Hisashi , Kida Sigeo 
Published: May 2006

Abstract
Three oxalate-bridged binuclear Cu(II)–Cr(III) complexes [(salen)Cr(ox)Cu(Lm)] (1, HL1 = N-salicylidene-N-(2-pyridylethyl)amine; 2, HL2 = N-acetylacetonylidene-N-(2-pyridylethyl)amine; 3, HL3 = N-salicylidene-N′,N′-diethylethylenediamine) have been prepared and the cryomagnetic susceptibility measurements(4.2–300 K) revealed that the spin-coupling is ferromagnetic with the J values +2.8, +2.2, and +2.7 cm−1 for 1, 2, and 3, respectively, based on H = −2JSCuSCr. The J values are well compatible with J = +2.9 cm−1 of {NBu4[CuCr(ox)3]}x evaluated from the equation Tc=nJ/3k[SCr(SCr+1)SCu(SCu+1)]1/2 (Tc = 7 K, n = 3) based on Heisenberg’s theory of ferromagnetism.
Solid-Phase Synthesis of Oligoribonucleotides Using 5′-9-Fluorenylmethoxycarbonyl and 2′-1-(Isopropoxyl)ethyl Protection
Authors: Ogawa Takashi , Hosaka Hideo , Makita Tatsusi , Takaku Hiroshi 
Published: May 2006

Abstract
The 1-(isopropoxy)ethyl group (Ipe) has been employed for the protection of the 2′-hydroxy groups of ribonucleoside residues in the synthesis of oligoribonucleotides by the phosphoramidite approach on a solid support, using an base-labile 5′-9-fluorenylmethoxycarbonyl (Fmoc) group.
An Efficient Asymmetric Aldol Reaction Promoted by a Chiral Tin(II) Lewis Acid Consisting of Tin(II) Triflate, (R)-2-[(N-1-Naphthylamino)methyl]tetrahydrothiophene and a Tin(IV) Compound
Authors: Mukaiyama Teruaki , Asanuma Hajime , Hachiya Iwao , Harada Tsunehiro , Kobayashi Shu 
Published: May 2006

Abstract
The title chiral Lewis acid is successfully employed in the enantioselective aldol reactions of silyl enol ether of S-ethyl propanethioate with achiral aldehydes to afford the corresponding aldol-type adducts in a highly stereoselective manner.