bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do bioethics teachers in Japan cope with ethical disagreement among healthcare university students in the classroom? A survey on educators in charge
Authors: Itai K , Asai A , Tsuchiya Y , Onishi M , Kosugi S 
Published: April 2006

Objective:The purpose of this study was to demonstrate how educators involved in the teaching of bioethics to healthcare university students in Japan would cope with ethical disagreement in the classroom, and to identify factors influencing them.Methods:A cross sectional survey was conducted using self administered questionnaires mailed to a sample of university faculty in charge of bioethics curriculum for university healthcare students.Results:A total of 107 usable questionnaires were returned: a response rate of 61.5%. When facing ethical disagreement in the classroom, coping behaviour differed depending on the topic of discussion, was influenced by educators’ individual clear ethical attitudes regarding the topic of discussion, and was independent of many respondents’ individual and social backgrounds. Among educators, it was commonly recognised that the purpose of bioethics education was to raise the level of awareness of ethical problems, to provide information about and knowledge of those issues, to raise students’ sensitivity to ethical problems, and to teach students methods of reasoning and logical argument. Yet, despite this, several respondents considered the purpose of bioethics education to be to influence students about normative ethical judgments. There was no clear relationship, however, between ways of coping with ethical disagreement and educators’ sense of the purpose of bioethics education.Conclusions:This descriptive study suggests that educators involved in bioethics education for healthcare university students in Japan coped in various ways with ethical disagreement. Further research concerning ethical disagreement in educational settings is needed to provide better bioethics education for healthcare students.
Occupational exposure to organic solvent mixtures during pregnancy and the risk of non-syndromic oral clefts
Authors: Chevrier C , Dananché B , Bahuau M , Nelva A , Herman C , Francannet C , Robert-Gnansia E , Cordier S 
Published: April 2006

Objectives:To examine the association between maternal occupational exposure to mixtures of organic solvents during pregnancy and the risk of non-syndromic oral clefts.Methods:A case-control study (164 cleft lip with/without cleft palate (CL/P), 76 cleft palate (CP), 236 controls) was conducted in France to investigate the role of maternal occupational exposure to organic solvents at the beginning of pregnancy in the risk of non-syndromic oral clefts. An expert chemist, guided by a detailed description of the women’s occupational tasks, assessed exposure for each. Analysis of the findings used logistic regression.Results:In the control group, 39% of the women who reported working during pregnancy were exposed to at least one type of organic solvent. The risk of oral clefts was associated with oxygenated (for CL/P: OR = 1.8, 95% CI 1.1 to 2.9; and for CP, OR = 1.4, 95% CI 0.7 to 2.7), chlorinated (OR = 9.4, 95% CI 2.5 to 35.3; OR = 3.8, 95% CI 0.7 to 20.7), and petroleum (OR = 3.6, 95% CI 1.5 to 8.8; OR = 1.2, 95% CI 0.3 to 4.9) solvents. The risk of oral clefts increased linearly with level of exposure within the three subgroups of oxygenated solvents we considered (aliphatic alcohols, glycol ethers, and other oxygenated solvents, including esters, ketones, and aliphatic aldehydes).Conclusions:Results suggest that maternal occupational exposure to organic solvents during pregnancy may play a role in the aetiology of oral clefts. The limited number of subjects and the problem of multiple exposures require that these results be interpreted cautiously.
Metabolomic database annotations via query of elemental compositions: Mass accuracy is insufficient even at less than 1 ppm
Authors: Kind Tobias , Fiehn Oliver 
Published: April 2006

Abstract

Background
Metabolomic studies are targeted at identifying and quantifying all metabolites in a given biological context. Among the tools used for metabolomic research, mass spectrometry is one of the most powerful tools. However, metabolomics by mass spectrometry always reveals a high number of unknown compounds which complicate in depth mechanistic or biochemical understanding. In principle, mass spectrometry can be utilized within strategies of de novo structure elucidation of small molecules, starting with the computation of the elemental composition of an unknown metabolite using accurate masses with errors <5 ppm (parts per million). However even with very high mass accuracy (<1 ppm) many chemically possible formulae are obtained in higher mass regions. In automatic routines an additional orthogonal filter therefore needs to be applied in order to reduce the number of potential elemental compositions. This report demonstrates the necessity of isotope abundance information by mathematical confirmation of the concept.

Results
High mass accuracy (<1 ppm) alone is not enough to exclude enough candidates with complex elemental compositions (C, H, N, S, O, P, and potentially F, Cl, Br and Si). Use of isotopic abundance patterns as a single further constraint removes >95% of false candidates. This orthogonal filter can condense several thousand candidates down to only a small number of molecular formulas. Example calculations for 10, 5, 3, 1 and 0.1 ppm mass accuracy are given. Corresponding software scripts can be downloaded from http://fiehnlab.ucdavis.edu. A comparison of eight chemical databases revealed that PubChem and the Dictionary of Natural Products can be recommended for automatic queries using molecular formulae.

Conclusion
More than 1.6 million molecular formulae in the range 0–500 Da were generated in an exhaustive manner under strict observation of mathematical and chemical rules. Assuming that ion species are fully resolved (either by chromatography or by high resolution mass spectrometry), we conclude that a mass spectrometer capable of 3 ppm mass accuracy and 2% error for isotopic abundance patterns outperforms mass spectrometers with less than 1 ppm mass accuracy or even hypothetical mass spectrometers with 0.1 ppm mass accuracy that do not include isotope information in the calculation of molecular formulae.
A genetic dissection of the LlaJI restriction cassette reveals insights on a novel bacteriophage resistance system
Authors: O'Driscoll Jonathan , Heiter Daniel F , Wilson Geoffrey G , Fitzgerald Gerald F , Roberts Richard , Sinderen Douwe van 
Published: April 2006

Abstract

Background
Restriction/modification systems provide the dual function of protecting host DNA against restriction by methylation of appropriate bases within their recognition sequences, and restriction of foreign invading un-methylated DNA, such as promiscuous plasmids or infecting bacteriphage. The plasmid-encoded LlaJI restriction/modification system from Lactococcus lactis recognizes an asymmetric, complementary DNA sequence, consisting of 5'GACGC'3 in one strand and 5'GCGTC'3 in the other and provides a prodigious barrier to bacteriophage infection. LlaJI is comprised of four similarly oriented genes, encoding two 5mC-MTases (M1.LlaJI and M2.LlaJI) and two subunits responsible for restriction activity (R1.LlaJI and R2.LlaJI). Here we employ a detailed genetic analysis of the LlaJI restriction determinants in an attempt to characterize mechanistic features of this unusual hetero-oligomeric endonuclease.

Results
Detailed bioinformatics analysis confirmed the presence of a conserved GTP binding and hydrolysis domain within the C-terminal half of the R1.LlaJI amino acid sequence whilst the N-terminal half appeared to be entirely unique. This domain architecture was homologous with that of the "B" subunit of the GTP-dependent, methyl-specific McrBC endonuclease from E.coli K-12. R1.LlaJI did not appear to contain a catalytic centre, whereas this conserved motif; PD....D/EXK, was clearly identified within the amino acid sequence for R2.LlaJI. Both R1.LlaJI and R2.LlaJI were found to be absolutely required for detectable LlaJI activity in vivo. The LlaJI restriction subunits were purified and examined in vitro, which allowed the assignment of R1.LlaJI as the sole specificity determining subunit, whilst R2.LlaJI is believed to mediate DNA cleavage.

Conclusion
The hetero-subunit structure of LlaJI, wherein one subunit mediates DNA binding whilst the other subunit is predicted to catalyze strand hydrolysis distinguishes LlaJI from previously characterized restriction-modification systems. Furthermore, this distinction is accentuated by the fact that whilst LlaJI behaves as a conventional Type IIA system in vivo, in that it restricts un-methylated DNA, it resembles the Type IV McrBC endonuclease, an enzyme specific for methylated DNA. A number of similar restriction determinants were identified in the database and it is likely LlaJI together with these homologous systems, comprise a new subtype of the Type II class incorporating features of Type II and Type IV systems.
Assessment of the potential impact of a reminder system on the reduction of diagnostic errors: a quasi-experimental study
Authors: Ramnarayan Padmanabhan , Roberts Graham C , Coren Michael , Nanduri Vasantha , Tomlinson Amanda , Taylor Paul M , Wyatt Jeremy C , Britto Joseph F 
Published: April 2006

Abstract

Background
Computerized decision support systems (DSS) have mainly focused on improving clinicians' diagnostic accuracy in unusual and challenging cases. However, since diagnostic omission errors may predominantly result from incomplete workup in routine clinical practice, the provision of appropriate patient- and context-specific reminders may result in greater impact on patient safety. In this experimental study, a mix of easy and difficult simulated cases were used to assess the impact of a novel diagnostic reminder system (ISABEL) on the quality of clinical decisions made by various grades of clinicians during acute assessment.

Methods
Subjects of different grades (consultants, registrars, senior house officers and medical students), assessed a balanced set of 24 simulated cases on a trial website. Subjects recorded their clinical decisions for the cases (differential diagnosis, test-ordering and treatment), before and after system consultation. A panel of two pediatric consultants independently provided gold standard responses for each case, against which subjects' quality of decisions was measured. The primary outcome measure was change in the count of diagnostic errors of omission (DEO). A more sensitive assessment of the system's impact was achieved using specific quality scores; additional consultation time resulting from DSS use was also calculated.

Results
76 subjects (18 consultants, 24 registrars, 19 senior house officers and 15 students) completed a total of 751 case episodes. The mean count of DEO fell from 5.5 to 5.0 across all subjects (repeated measures ANOVA, p < 0.001); no significant interaction was seen with subject grade. Mean diagnostic quality score increased after system consultation (0.044; 95% confidence interval 0.032, 0.054). ISABEL reminded subjects to consider at least one clinically important diagnosis in 1 in 8 case episodes, and prompted them to order an important test in 1 in 10 case episodes. Median extra time taken for DSS consultation was 1 min (IQR: 30 sec to 2 min).

Conclusion
The provision of patient- and context-specific reminders has the potential to reduce diagnostic omissions across all subject grades for a range of cases. This study suggests a promising role for the use of future reminder-based DSS in the reduction of diagnostic error.
Identification, cloning and functional characterization of novel sperm associated antigen 11 (SPAG11) isoforms in the rat
Authors: Yenugu Suresh , Hamil Katherine G , Grossman Gail , Petrusz Peter , French Frank S , Hall Susan H 
Published: April 2006

AbstractBackgroundSperm binding proteins and their C-terminal peptides of the Sperm Associated Antigen 11 (SPAG11) family were found to play an important role in epididymal innate immunity in addition to their role in sperm maturation. However, the expression of Spag11 transcripts in rodents is not well documented.MethodsComputational analysis was employed to identify novel Spag11 isoforms in the rat. RT-PCR analyses were carried out on RNAs isolated from the male reproductive tract tissues of rat using gene specific primers for Spag11c and Spag11t. The identities of PCR products were confirmed by sequencing. Tissue distribution, developmental expression and androgen regulation of Spag11t and Spag11c were studied using RT-PCR. The antimicrobial activities of recombinant Spag11t and Spag11c were tested against E coli in a colony forming unit assay.ResultsIn this study, we identified two novel Spag11 transcripts, namely, Spag11t and Spag11c derived from the long arm of chromosome 16 in the rat (Rattus norvegicus), using both in silico and molecular biology approaches. Spag11c is expressed in all three regions of the epididymis, in testis and in ovary but is absent from the seminal vesicle. Spag11t expression is confined to the caput and it is not expressed in the testis, seminal vesicle or ovary. Age dependent expression of Spag11t and Spag11c was observed in the epididymides of rats (10–60 day old). Their expression was found to be most abundant in the adult rat (60 day) suggesting roles in mature reproductive function. Further, both Spag11t and Spag11c expression was down regulated in castrated rat epididymides and the expression was maintained in the testosterone replaced castrated rats. SPAG11C is a potent antibacterial agent. SPAG11T also displayed bactericidal capacity although weaker than SPAG11C and SPAG11E.ConclusionThe abundant expression of Spag11t and Spag11c in the male reproductive tract suggests an important role in male reproductive tract immunity. Their expression is developmentally regulated and androgen dependent. Characterization of novel SPAG11 isoforms will contribute to our understanding of the role of epididymal proteins in sperm maturation and innate immunity.
Modification of Cul1 regulates its association with proteasomal subunits
Authors: Bloom Joanna , Peschiaroli Angelo , DeMartino George , Pagano Michele 
Published: April 2006

Abstract

Background
Ubiquitylation targets proteins for degradation by the 26S proteasome. Some yeast and plant ubiquitin ligases, including the highly conserved SCF (S kp1/C ul1/F-box protein) complex, have been shown to associate with proteasomes. We sought to characterize interactions between SCF complexes and proteasomes in mammalian cells.

Results
We found that the binding of SCF complexes to proteasomes is conserved in higher eukaryotes. The Cul1 subunit associated with both sub-complexes of the proteasome, and high molecular weight forms of Cul1 bound to the 19S proteasome. Cul1 is ubiquitylated in vivo. Ubiquitylation of Cul1 promotes its binding to the S5a subunit of the 19S sub-complex without affecting Cul1 stability.

Conclusion
The association of ubiquitylating enzymes with proteasomes may be an additional means to target ubiquitylated substrates for degradation.
Increasing psychosocial assessment by introducing a self-harm pathway
Authors: Lepping Peter , Woodworth Barbara , Roberts Lucy , Turner Jim 
Published: April 2006

Aims and MethodTo audit whether the introduction of a self-harm pathway and protocol increases the number of psychosocial assessments. All episodes of self-harm in a defined period during 2002 (n=335) and 2004 (n=390) were reviewed before and after the introduction of a self-harm pathway and protocol. Adherence to the protocol was also investigated.ResultsAfter the introduction of the self-harm pathway and protocol, the proportion of psychosocial assessments requested had risen from 57% (2002) to 85% (2004). The proportion of psychosocial assessments completed had risen from 47% to 70%. Over the 2 years, the overall number of self-harm presentations was reduced by 27%.Clinical ImplicationsThe introduction of a self-harm pathway and protocol through a self-harm steering group is feasible, was well accepted and increased the number of psychosocial assessments after self-harm. It may also contribute to a reduction in the number of overall presentations with self-harm to the accident and emergency department.
Managing patients' information in a community mental health team
Authors: Uher Rudolf , Timehin Clive 
Published: April 2006

Aims and MethodTo explore current practice in offering patients copies of correspondence, we audited the documentation of 422 patients of a community mental health team.ResultsDiscussion about copying letters was documented in 194 case notes (46%); older patients and those with medically unexplained physical symptoms were less likely to be offered copies. There were 159 patients (82%) that wanted to receive copies of letters; male gender was associated with declining this option. In 167 (87%) instances the professional completing the form was a psychiatrist.Clinical ImplicationsOlder patients need to be offered the opportunity to receive correspondence. Clinicians should record and substantiate their decision not to offer copies of letters to some patients. Professionals other than psychiatrists should be encouraged to discuss copying letters with patients.
Support workers' attitudes to mental illness: implications for reducing stigma
Authors: Tipper Rfebecca , Mountain Deborah , Lorimer Stuart , McIntosh Andrew 
Published: April 2006

Aims and MethodWe conducted an anonymous survey of support workers to examine attitudes to people with different types of mental illness. Scores were based on a previously demonstrated stigmatisation score.ResultsA total of 133 questionnaires were returned, representing 27% of all possible recipients. Fewer than 20% of respondents considered people with schizophrenia to be dangerous, although nearly half thought that they would never fully recover. More stigmatising responses were demonstrated to alcohol and drug addiction than to other disorders.Clinical ImplicationsSupport workers who spend large amounts of time with people with mental illness, in particular schizophrenia, have a low perception of their dangerousness. This may have implications for planning further measures to reduce stigmatisation.
An audit of waiting times at a specialist psychotherapy service
Authors: Garry Ged , Paley Graham 
Published: April 2006

Aims and MethodReferrals to a specialist psychotherapy service were audited to measure the average waiting time for a first appointment and the proportion of patients waiting longer than 13 weeks. Recommendations for improving service delivery were made, an action plan implemented and the audit repeated.ResultsIn 2003, an initial audit of 355 referrals was completed using data from 2002. This found a mean waiting time to first appointment of 11.5 weeks with 30% of patients waiting longer than 13 weeks. In 2004, following implementation of the action plan, a re-audit of 200 patients found that the mean waiting time from receipt of referral to first appointment had reduced to 6.7 weeks with only 2.3% waiting more than 13 weeks.Clinical ImplicationsAudit can improve the efficiency of service delivery in a specialist psychotherapy service. However, this may require that psychotherapists review traditional ways of working. Also, it is important that they feel personally involved in the audit process.
Childhood Injuries Caused by Falling Televisions
Authors: Ota Floyd S. , Maxson R. Todd , Okada Pamela J. 
Published: April 2006

Abstract
Objectives:
To obtain a detailed description of the injury scene in an attempt to identify methods for prevention and to describe the morbidity and mortality of children who present to an urban pediatric emergency department (ED) with an injury caused by a falling television.
Methods:
A retrospective descriptive study from a prospectively created database was conducted over one year. All adults accompanying a child younger than 13 years of age who was injured by a falling television were directly interviewed, and the patient medical charts were reviewed.
Results:
Twenty‐eight children were eligible, and 26 children were analyzed. The median age was 40 months (25th and 75th quartiles: 31, 51 months). None of the televisions, or the furniture that they were placed on, were secured. Most parents (85%) reported that they were unaware that injuries could occur by this mechanism. Fourteen children suffered head injuries, and nine children injured an extremity. Nine children were hospitalized, including two patients admitted to the intensive care unit (ICU).
Conclusions:
Children may present to the ED with injuries caused by falling televisions. These injuries are usually not severe; however, the potential for severe injury exists, and some children may require ICU monitoring. Our data indicate a lack of parental awareness and an absence of primary prevention as a root cause for this problem. Thus, more aggressive education to warn parents about the risk of injury must be implemented so that more families will take the time to place their televisions safely.
Response of Asymptomatic Brain Metastases From Small-Cell Lung Cancer to Systemic First-Line Chemotherapy
Authors: Seute Tatjana , Leffers Pieter , Wilmink Jan T. , ten Velde Guul P.M. , Twijnstra Albert 
Published: April 2006

Purpose The purpose of this study was to investigate the radiologic response of asymptomatic brain metastases (BM) from small-cell lung cancer (SCLC) to first-line systemic chemotherapy. Patients and Methods From 1990 to 2003, 181 consecutive patients with SCLC were enrolled onto this study. Patients were examined by a neurologist on a regular basis. Magnetic resonance imaging (MRI) of the brain was performed routinely before (at diagnosis of SCLC) and after first-line systemic chemotherapy. Patients were treated with combination chemotherapy consisting of cyclophosphamide, doxorubicin, and etoposide. Clinically manifest BM were treated with whole-brain radiotherapy (WBRT). The response rate (RR) of BM was assessed by changes in the size or the number of enhanced lesions on MRI using standard criteria. Results Synchronous asymptomatic BM were found in 24 SCLC patients (13%). In six (27%) of the 22 assessable patients, the asymptomatic BM responded to systemic chemotherapy. A systemic response was found in 16 patients (73%). All patients became symptomatic during follow-up. The symptom-free survival did not differ between cranial responders and cranial nonresponders. Conclusion The RR of asymptomatic BM from SCLC to systemic chemotherapy is 27% and evidently lower than the systemic RR. Future studies should focus on the possible beneficial effect of WBRT for patients with asymptomatic synchronous BM.