bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physician perspectives on end-of-life care: Factors of race, specialty, and geography
Authors: CARTER CINDY L. , ZAPKA JANE G. , O'NEILL SUZANNE , DesHARNAIS SUSAN , HENNESSY WINNIE , KURENT JEROME , CARTER RICKEY 
Published: September 2006

Objectives: To describe physicians' end-of-life practices, perceptions regarding end-of-life care and characterize differences based upon physician specialty and demographic characteristics. To illuminate physicians' perceptions about differences among their African-American and Caucasian patients' preferences for end-of-life care.Design and methods: Twenty-four African-American and 16 Caucasian physicians (N= 40) participated in an in-person interview including 23 primary care physicians, 7 cardiologists, and 10 oncologists. Twenty-four practices were in urban areas and 16 were in rural counties.Results: Physicians perceived racial differences in preferences for end-of-life care between their Caucasian and African-American patients. Whereas oncologists and primary care physicians overwhelmingly reported having working relationships with hospice, only 57% of cardiologists reported having those contacts. African-American physicians were more likely than Caucasian physicians to perceive racial differences in their patients preferences for pain medication.Significance of results: Demographic factors such as race of physician and patient may impact the provider's perspective on end-of-life care including processes of care and communication with patients.
Physicians' interpretation of the prognostic term “terminal”: A survey among Norwegian physicians
Authors: ROGG LOTTE , GRAUGAARD PETER KJÆR , LOGE JON HÅVARD 
Published: September 2006

Objective: Optimal clinical practice depends upon a precise language with common understanding of core terms. The aim of the present study was to examine how Norwegian physicians understand the commonly used but poorly defined term “terminal.”Methods: A questionnaire was mailed to 1605 Norwegian physicians, representative of the Norwegian medical community. Nine hundred and sixty-eight responded and defined “terminal” in expected weeks left to live. The effects of gender, age, specialty, and experience with prognostication toward end of life on the estimation of “terminal” were investigated.Results: Norwegian physicians on average expect a “terminal” patient to have 3.6 (± 3.5SD) weeks to live with expectation ranging from 0 to 26 weeks. The majority (83.5%) defined “terminal” as less than 5 weeks' survival; 15.0% as 5 to 12 weeks' survival and 1.5% as more than 12 weeks' survival. No difference between genders was observed, whereas the youngest physicians (27–39 years) held shorter definitions than the other age groups. Physicians in internal medicine, surgery, and anaesthesiology held significantly shorter estimations of “terminal” than did physicians in general practice, public health, and psychiatry.Significance of results: Our study shows that the majority of Norwegian physicians restrict “terminal” to the last 2–4 weeks of patients' lives. A life expectancy of a few days compared to several weeks should lead to different clinical actions. Efforts should therefore be made to come to a common definition of the term. In our opinion the use of “terminal” should be limited to when death is expected within a few days.
Conceptualization of psycho-existential suffering by the Japanese Task Force: The first step of a nationwide project
Authors: MURATA HISAYUKI , MORITA TATSUYA 
Published: September 2006

Background and purpose:Although the relief of psycho-existential or spiritual suffering is one of the most important roles of palliative care clinicians, lack of an accepted conceptual framework leads to considerable confusion in research in this field. The primary aim of this article is to illustrate the process of developing a conceptual framework by the Japanese Task Force as the initial step of a nationwide project.Methods:We used consensus-building methods with 26 panel members and 100 multidisciplinary peer reviewers. The panel consisted of six palliative care physicians, six psychiatrists, five nursing experts, four social workers or psychologists, two philosophers, a pastoral care worker, a sociologist, and an occupational therapist. Through 2 days of face-to-face discussion and follow-up discussion by e-mail, we reached a consensus.Results:The group agreed to adopt a conceptual framework as the starting point of this study, by combining the empirical model from multicenter observations, a theoretical hypothesis, and good death studies in Japan. We defined “psycho-existential suffering” as “pain caused by extinction of the being and the meaning of the self.” We assumed that psycho-existential suffering is caused by the loss of essential components that compose the being and the meaning of human beings: loss of relationships (with others), loss of autonomy (independence, control over future, continuity of self), and loss of temporality (the future). Sense of meaning and peace of mind can be interpreted as an outcome of the psycho-existential state and thus the general end points of our interventions. This model extracted seven categories to be intensively studied in the future: relationship, control, continuity of self, burden to others, generativity, death anxiety, and hope.Conclusions:A Japanese nationwide multidisciplinary group agreed on a conceptual framework to facilitate research in psycho-existential suffering in terminally ill cancer patients. This model will be revised according to continuing qualitative studies, surveys, and intervention trials.
A literature review of palliative care, end of life, and dementia
Authors: ROGER KERSTIN STIEBER 
Published: September 2006

Objective:Little attention has been paid in research to the palliative care of those dying with dementia. This literature review summarizes current research in the social sciences, including medical sociology on palliative care in the example of dementia.Methods:A designated set of search words was applied to a comprehensive set of university-based search engines to ensure that relevant social science research since 200 was included.Results:Primary themes discussed in the article include person-centered care, grief, agitation, aggression, pain management, care provision, training and education, decision-making, primary settings of care, and spirituality and dignity. Other key gaps in the literature are discussed.Significance of the results:Given the projected increase within the next 20 years of people dying with dementia (Hanrahan et al., 2001), palliative care for those dying with dementia will become more relevant than ever.
Revision of the Agathidinae (Hymenoptera: Braconidae) with comparisons of static and dynamic alignments
Authors: Sharkey Michael J. , Laurenne Nina M. , Sharanowski Barbara , Quicke Donald L. J. , Murray Debra 
Published: September 2006

AbstractThe phylogeny of the Agathidinae (Insecta: Hymenoptera: Braconidae) is investigated based on morphological and sequence data from the D2–3 regions of 28S rDNA. Morphology and molecular data were run simultaneously and separately and the molecular and combined data sets were analyzed using both static, Clustal W, and dynamic, POY, alignments. Both alignments were conducted under a variety of gap costs and results are compared. Sixty‐two ingroup exemplars representing 22 genera and six outgroup taxa representing two subfamilies and five genera were included. Numerous taxa at the generic and tribal levels were tested for monophyly and the evolutionary history of several characters is discussed. The tribe Agathidini s.s. is found to be a derived member of the Microdini and the two are synonymized under the older name, Agathidini s.l. Support is substantial for the tribes Cremnoptini and Disophrini and Earinini but equivocal for the Agathidini s.l. At the generic level, Bassus is found to be polyphyletic. Numerous new synonymies and combinations are proposed.© The Willi Hennig Society 2006.
Re‐organization of the cytoskeleton and endoplasmic reticulum in the Arabidopsis pen1‐1 mutant inoculated with the non‐adapted powdery mildew pathogen, Blumeria graminis f. sp. hordei
Authors: TAKEMOTO DAIGO , JONES DAVID A. , HARDHAM ADRIENNE R. 
Published: September 2006

SUMMARYPlant cells attacked by microorganisms rapidly translocate cytoplasm to the site of pathogen penetration, a response that usually involves rearrangement of actin microfilaments. In this study, we monitored re‐organization of green fluorescent protein (GFP)‐labelled actin microfilaments, microtubules and endoplasmic reticulum (ER) during infection by the powdery mildew pathogen Blumeria graminis f. sp. hordei in non‐host Arabidopsis and in the Arabidopsis penetration 1‐1 (pen1‐1) mutant, which shows increased penetration susceptibility to non‐adapted pathogens. Comparison of pen1‐1 with wild‐type Arabidopsis showed that the actin, microtubule and ER networks all responded in the pen1‐1 mutant as they do in wild‐type plants. Actin microfilaments became focused on the penetration site and ER accumulated at the penetration site while the overall arrangement of microtubule arrays was largely unaffected. These results indicate that the block in vesicle secretion conferred by the pen1‐1 mutation does not interfere with cytoplasmic aggregation or recruitment of actin or ER to the infection site. In the pen1‐1 mutant, the higher rate of successful penetration by the non‐adapted pathogen results in an increased incidence of hypersensitive cell death. In dying cells, the structure of the ER was rapidly destroyed, in contrast to actin microfilaments and microtubules which remained for a longer time after the initiation of cell death. In Arabidopsis with GFP‐tagged tubulin, fluorescent vesicle‐like structures appeared near the cell surface during the initiation of cell death. In both wild‐type and pen1‐1 mutant plants, in cells surrounding the dying cell, bundles of actin microfilaments focused on the anticlinal walls adjacent to the dead cell and ER accumulated in the cortical cytoplasm near the dead cell. These observations suggest that the neighbouring, non‐infected cells use actin‐based transport to secrete material at the surface adjacent to the dead cell. They also indicate that disruption of secretion (in the pen1‐1 mutant) does not inhibit transmission of signals from the dying cells to their neighbours.
A novel link between tomato GRAS genes, plant disease resistance and mechanical stress response
Authors: MAYROSE MAYA , EKENGREN SOPHIA K. , MELECH‐BONFIL SHIRI , MARTIN GREGORY B. , SESSA GUIDO 
Published: September 2006

SUMMARYMembers of the GRAS family of transcriptional regulators have been implicated in the control of plant growth and development, and in the interaction of plants with symbiotic bacteria. Here we examine the complexity of the GRAS gene family in tomato (Solanum lycopersicum) and investigate its role in disease resistance and mechanical stress. A large number of tomato ESTs corresponding to GRAS transcripts were retrieved from the public database and assembled in 17 contigs of putative genes. Expression analysis of these genes by real‐time RT‐PCR revealed that six SlGRAS transcripts accumulate during the onset of disease resistance to Pseudomonas syringae pv. tomato. Further analysis of two selected family members showed that their transcripts preferentially accumulate in tomato plants in response to different avirulent bacteria or to the fungal elicitor EIX, and their expression kinetics correlate with the appearance of the hypersensitive response. In addition, transcript levels of eight SlGRAS genes, including all the Pseudomonas‐inducible family members, increased in response to mechanical stress much earlier than upon pathogen attack. Accumulation of SlGRAS transcripts following mechanical stress was in part dependent on the signalling molecule jasmonic acid. Remarkably, suppression of SlGRAS6 gene expression by virus‐induced gene silencing impaired tomato resistance to P. syringae pv. tomato. These results support a function for GRAS transcriptional regulators in the plant response to biotic and abiotic stress.
Quantitative measurement of hepatitis C virus core antigen is affected by the presence of cryoglobulins
Authors: Pham B-N , Martinot-Peignoux M , Ripault M-P , Boyer N , Levy V , Marcellin P 
Published: September 2006

SummaryMixed cryoglobulinaemia is associated strikingly with HCV infection. The aim of this study was to assess whether the adherence to proper methods of collecting samples for cryoglobulin detection was critical or not on virological parameters in hepatitis C virus (HCV) patients. We studied 56 consecutive patients. Blood samples were collected using a conventional method and a blood collection method at 37°C adapted to cryoglobulin detection. HCV core antigen and HCV RNA were measured in sera and cryoglobulins issued from both blood collection methods. In cryoglobulin-positive patients, serum concentrations of HCV core antigen, but not that of HCV RNA, were significantly higher when a conventional method was used, compared to a blood collection method at 37°C (P = 0·001). In the cryoprecipitates, concentration of HCV core antigen was optimum when the blood collection method at 37°C, rather than the conventional method, was applied for cryoglobulin detection (P &lt; 10−4). The recovery of HCV core antigen in the cryoprecipitate was improved when cryoglobulins were isolated using the blood collection method at 37°C rather than the conventional method (P &lt; 0·001). HCV parameter measurements and cryoglobulin study should not be performed on the same serum samples due to the potential impact of blood collection methods on results.
Remission of collagen-induced arthritis is associated with high levels of transforming growth factor-β expression in the joint
Authors: Marinova-Mutafchieva L , Gabay C , Funa K , Williams R O 
Published: September 2006

Summary
Immunization of genetically susceptible strains of mice with heterologous type II collagen leads to the induction of a self-limiting polyarthritis that begins to subside around 10 days after onset of clinical disease. The aims of this study were to compare pro- and anti-inflammatory cytokine expression in the joints during the course of arthritis in order to identify cytokines involved in spontaneous remission of arthritis. DBA/1 mice were immunized with type II collagen and an immunohistochemical analysis of expression of proinflammatory cytokines [tumour necrosis factor (TNF)-α, interleukin (IL)-1β and IL-6] and anti-inflammatory cytokines [IL-10, IL-1ra, transforming growth factor (TGF)-β1, TGF-β2 and TGF-β3] in joints was carried out over the course of the disease. Both pro- and anti-inflammatory cytokines were found to be expressed in early arthritis. However, around 10 days after onset of arthritis, the level of expression of proinflammatory cytokines declined while the level of expression of anti-inflammatory cytokines, particularly TGF-β1 and TGF-β2, increased. Surprisingly, TNF-α continued to be expressed at low levels during the period of disease remission (30 days after onset). Blockade of TNF-α during the period of disease remission had no effect on TGF-β expression. This study confirms that the level of inflammation in arthritis correlates strongly with the balance of pro- and anti-inflammatory cytokine expression in the joints. Of the anti-inflammatory cytokines studied, TGF-β1 and TGF-β2 predominate during the time of disease remission, suggesting that these cytokines are involved in regulating disease activity.
Phenotypic features of circulating leucocytes as immunological markers for clinical status and bone marrow parasite density in dogs naturally infected by Leishmania chagasi
Authors: Reis A B , Teixeira-Carvalho A , Giunchetti R C , Guerra L L , Carvalho M G , Mayrink W , Genaro O , Corrêa-Oliveira R , Martins-Filho O A 
Published: September 2006

Summary
Canine visceral leishmaniasis (CVL) manifests itself as a broad clinical spectrum ranging from asymptomatic infection to patent severe disease. Despite relevant findings suggesting changes on lymphocytes subsets regarding the CVL clinical forms, it still remains to be elucidated whether a distinct phenotypic profile would be correlated with degree of tissue parasite density. Herein, we have assessed the correlation between the clinical status as well as the impact of bone marrow parasite density on the phenotypic profile of peripheral blood leucocytes in 40 Brazilian dogs naturally infected by Leishmania chagasi. Our major findings describe the lower frequency of B cells and monocytes as the most important markers of severe CVL. Our main statistically significant findings reveal that the CD8+ T cell subset reflects most accurately both the clinical status and the overall bone marrow parasite density, as increased levels of CD8+ lymphocytes appeared as the major phenotypic feature of asymptomatic disease and dogs bearing a low parasite load. Moreover, enhanced major histocompatibility complex (MHC)-II density as well as a higher CD45RB/CD45RA expression index seems to represent a key element to control disease morbidity. The association between clinical status, bone marrow parasitism and CD8+ T cells re-emphasizes the role of the T cell-mediated immune response in the resistance mechanisms during ongoing CVL. Higher levels of circulating T lymphocytes (both CD4+ and CD8+ T cells) and lower MHC-II expression by peripheral blood lymphocytes seem to be the key for the effective immunological response, a hallmark of asymptomatic CVL.
Alcohol-induced gastritis prevents oral tolerance induction in mice
Authors: Andrade M C , Menezes J S , Cassali G D , Martins-Filho O A , Cara D C , Faria A M C 
Published: September 2006

SummaryDespite several reports on the immunological relationship between inflammatory bowel diseases and immunoregulatory mechanisms in the gut, systematic studies addressing the impact of inflammatory processes in the gastric mucosa on events, such as oral tolerance, are still limited. Herein, we report the establishment of a novel murine model of gastritis induced by short-term administration of ethanol. The major immumological features of this clinical entity are characterized, as well as its impact on the induction of oral tolerance. Our data demonstrate that ethanol ingestion during 4 consecutive days triggered an acute inflammatory reaction in the stomach referred as ethanol-induced gastritis and characterized by hyperaemia, oedema and mixed mononuclear/polymorphonuclear cell infiltrate. Besides local immunological changes, such as high levels of gastric interleukin (IL)-4 and interferon (IFN)-γ, systemic alterations are also observed, including increased IL-4 synthesis, enhanced levels of serum IgE and absence of IL-10 production by spleen cells. Moreover, ethanol-induced gastritis prevents oral tolerance induction to ovalbumin (OVA) as demonstrated by unaltered anti-OVA humoral and cellular immune responses in treated animals. Tissue eosinophilia after footpad immunization with OVA suggests that oral treatment with ethanol induced an allergic-type reaction. Taken together, our findings indicate that short-term ethanol ingestion is associated with gastric inflammatory events able to break immunoregulatory mechanisms that maintain mucosal homeostasis and oral tolerance.
The myeloid differentiation factor 88 is dispensable for the development of a delayed host response to Pseudomonas aeruginosa lung infection in mice
Authors: Power M R , Marshall J S , Yamamoto M , Akira S , Lin T-J 
Published: September 2006

Summary
Because MyD88 transduces a core set of Toll-like receptor (TLR)-induced signals, microbial-induced host responses can be divided broadly into the MyD88-dependent and MyD88-independent pathways. A specific pathogen induces a distinct pattern of host response dependent upon the signalling pathways employed. Recently, we demonstrated that a MyD88-dependent pathway is essential for the development of early (4–8 h) host response to Pseudomonas aeruginosa lung infection. Here, we show that the development of a delayed (24–48 h) host response to P. aeruginosa is independent of MyD88. Using MyD88-deficient mice, the production of macrophage inflammatory protein 2, tumour necrosis factor and interleukin 1α in the airway was observed following P. aeruginosa lung infection for 24 or 48 h. Moreover, the MyD88-deficient mice recruited sufficient neutrophils in the lung and cleared the bacteria efficiently from the lung after 48 h. Thus, the full development of host responses to P. aeruginosa lung infection involves, in a sequential, stepwise fashion, a MyD88-dependent early response and a MyD88-independent delayed mechanism.
Expression and function of the purinergic receptor P2X7 in patients with pulmonary tuberculosis
Authors: Franco-Martínez S , Niño-Moreno P , Bernal-Silva S , Baranda L , Rocha-Meza M , Portales-Cervantes L , Layseca-Espinosa E , González-Amaro R , Portales-Pérez D 
Published: September 2006

SummaryP2X7 is a channel receptor gated by adenosine triphosphate (ATP) that is involved in the killing of intracellular mycobacteria. To explore further the role of P2X7 in immunity against Mycobacterium tuberculosis, we studied its expression and function in 19 patients with pulmonary tuberculosis (TB) and 19 healthy contacts. Flow cytometry analysis showed a similar and variable expression of P2X7 in TB patients and healthy subjects. In contrast, P2X7 mARN levels were significantly higher in TB patients. When the function of the P2X7 receptor in peripheral blood mononuclear cells (PBMC) was assessed by the effect of exogenous ATP on apoptosis, the uptake of the fluorescent marker Lucifer yellow or extracellular signal regulated kinase (ERK) phosphorylation, no significant differences were detected in patients and controls. However, mRNA macroarray analysis showed that upon stimulation with ATP, the PBMC from TB patients showed a significant induction of a higher number of cytokine genes (27 of 96), and a lower number of apoptosis genes (20 of 96) compared to healthy controls (17 and 76 genes, respectively). These results suggest that although the PBMC from TB patients do not show apparent abnormalities in the expression of P2X7, and the intracellular signals generated through it, the pattern of gene expression induced by ATP in these cells is different from that found in healthy contacts. This phenomenon suggests a defective function of P2X7 in the immune cells from TB patients, a condition that may contribute to the inability of these patients to eliminate the mycobacteria.