Transcending differences to study the transcendent: an exploratory study of researchers' and chaplains' reflections on interdisciplinary spiritual care research collaboration.

Background: Despite recognition of the centrality of professional board-certified chaplains (BCC) in palliative care, the discipline has little research to guide its practices. To help address this limitation, HealthCare Chaplaincy Network funded six proposals in which BCCs worked collaboratively with established researchers. Recognizing the importance of interdisciplinary collaboration in the development of a new field, this paper reports on an exploratory study of project members' reflections over time on the benefits and challenges of conducting inter-disciplinary spiritual care research.

Biomimicking Robust Hydrogel for the Mesenchymal Stem Cell Carrier.

Purpose: This study was aimed to develop a hydrogel-nanofiber as an advanced carrier for adipose derived human mesenchymal stem cells (AD-MSCs) and evaluate its potential for immunomodulatory therapies applicable to surface coating of drug eluting stent (DES) against coronary artery diseases (CAD).

Methods: A mixture of dispersing-nanofibers (dNFs) and poly (ethylene glycol)-diacrylate (PEGDA) were blended with sodium alginate to achieve robust mechanical strength. The effects of stem cell niche on cell viability and proliferation rates were evaluated using LDH assay and alamar blue assay, respectively.

Fluorescence quenching studies of structure and dynamics in calmodulin-eNOS complexes.

Activation of endothelial nitric oxide synthase (eNOS) by calmodulin (CaM) facilitates formation of a sequence of conformational states that is not well understood. Fluorescence decays of fluorescently labeled CaM bound to eNOS reveal four distinct conformational states and single-molecule fluorescence trajectories show multiple fluorescence states with transitions between states occurring on time scales of milliseconds to seconds. A model is proposed relating fluorescence quenching states to enzyme conformations.

Janus kinase 2/signal transducer and activator of transcription 3 inhibitors attenuate the effect of cardiotrophin-like cytokine factor 1 and human focal segmental glomerulosclerosis serum on glomerular filtration barrier.

Recurrence of idiopathic focal segmental glomerulosclerosis (FSGS) after renal transplantation is believed to be caused by a circulating factor(s). We detected cardiotrophin-like cytokine factor 1 (CLCF1), a member of the interleukin 6 family, in the plasma from patients with recurrent FSGS. We hypothesized that CLCF1 contributes to the effect of FSGS serum on the glomerular filtration barrier in vitro.

Discrepancies in the normative neonatal blood pressure reference ranges.

Numerous normative blood pressure (BP) reference ranges with considerable variation in the data have been published for neonates. This poses unique challenges for the definition and management of BP abnormalities in neonates. The aim of this study was to investigate the factors that have led to varying normative BP reference ranges in the studies conducted to date and to discuss potential study designs that would help better define the normative data.

Dermatophytes activate skin keratinocytes via mitogen-activated protein kinase signaling and induce immune responses.

Dermatophytes cause superficial and cutaneous fungal infections in immunocompetent hosts and invasive disease in immunocompromised hosts. However, the host mechanisms that regulate innate immune responses against these fungi are largely unknown. Here, we utilized commercially available epidermal tissues and primary keratinocytes to assess (i) damage induction by anthropophilic, geophilic, and zoophilic dermatophyte strains and (ii) the keratinocyte signaling pathways, transcription factors, and proinflammatory responses induced by a representative dermatophyte, Trichophyton equinum.

The evolution of drug resistance in clinical isolates of Candida albicans.

Candida albicans is both a member of the healthy human microbiome and a major pathogen in immunocompromised individuals. Infections are typically treated with azole inhibitors of ergosterol biosynthesis often leading to drug resistance. Studies in clinical isolates have implicated multiple mechanisms in resistance, but have focused on large-scale aberrations or candidate genes, and do not comprehensively chart the genetic basis of adaptation.

Surgical management of metastatic disease of the proximal part of the femur.

➤ Pathologic fracture of the proximal part of the femur resulting from metastatic disease causes severe pain and an inability to walk. Surgical stabilization can be challenging because of bone loss resulting from the underlying metastatic lesions, the potential for major blood loss, and the poor health of the patient.➤ The goal of surgical treatment is the creation of a stable construct to allow early weight-bearing.

Should we tell parents when we've made an error?

One of the most difficult experiences for any doctor or nurse is when they realize that they have made a mistake that has harmed a patient. In the past, mistakes were seldom disclosed to patients. The prevailing ethos was one of professional silence, secrecy, and shame.

Ethanol at low concentrations protects glomerular podocytes through alcohol dehydrogenase and 20-HETE.

Clinical studies suggest cardiovascular and renal benefits of ingesting small amounts of ethanol. Effects of ethanol, role of alcohol dehydrogenase (ADH) or of 20-hydroxyeicosatetraenoic acid (20-HETE) in podocytes of the glomerular filtration barrier have not been reported. We found that mouse podocytes at baseline generate 20-HETE and express ADH but not CYP2e1.

Acute hemorrhagic leukoencephalitis associated with autoimmune myopathy.

Introduction: Acute hemorrhagic leukoencephalitis is a rare acute inflammatory myelinopathy of central nervous system with high mortality. We report a case of an unusual presentation of acute hemorrhagic leukoencephalitis with autoimmune myopathy and a complete recovery with steroids and plasmapheresis.

Methods: A 24-year-old female admitted with generalized seizure, lethargy, but no focal neurological signs.

Deception and the death of Ilyusha: truth and the best interest of a dying child in The Brothers Karamazov.

For centuries, many physicians and parents assumed that it was ethically justifiable to lie to a dying child. The reasoning was clear. Because the lie would likely eliminate or prevent a concrete harm (the child's fear), and the lie is about a harm that is unavoidable anyway, a lie appeared to be the morally desirable thing to do.

Mechanical ventilation for a child with quadriplegia.

Parents generally have the right to make medical decisions for their children. This right can be challenged when the parents' decision seems to go against the child's interests. The toughest such decisions are for a child who will survive with physical and neurocognitive impairments.

Assessment of musculoskeletal toxicity 5 years after therapy with levofloxacin.

Background: Safety concerns for fluoroquinolones exist from animal studies demonstrating cartilage injury in weight-bearing joints, dependent on dose and duration of therapy. For children treated with levofloxacin or comparator in randomized, prospective, comparative studies for acute otitis media and community-acquired pneumonia, this 5-year follow-up safety study was designed to assess the presence/absence of cartilage injury.

Methods: Children enrolled in treatment studies were also enrolled in a 1-year follow-up safety study, which; focused on musculoskeletal adverse events (MSAE).

The role of a preliminary PGY-3 in general surgery training.

Introduction: Even before the preliminary postgraduate year (PGY)-3 was eliminated from surgical residency, it had become increasingly difficult to fill general surgery PGY-4 vacancies. This ongoing need prompted the Association of Program Directors in Surgery (APDS) leadership to form a task force to study the possibility of requesting the restoration of the preliminary PGY-3 to Accreditation Council for Graduate Medical Education-approved general surgery residency programs.

Methods: The task force conducted a 10-year review of the APDS list serve to ascertain the number of advertised PGY-4 open positions.

Self-rated health predicts healthcare utilization in heart failure.

Background: Heart failure (HF) patients experience impaired functional status, diminished quality of life, high utilization of healthcare resources, and poor survival. Yet, the identification of patient-centered factors that influence prognosis is lacking.

Methods And Results: We determined the association of 2 measures of self-rated health with healthcare utilization and skilled nursing facility (SNF) admission in a community cohort of 417 HF patients prospectively enrolled between October 2007 and December 2010 from Olmsted County, MN.

Activation of c-Src: a hub for exogenous pro-oxidant-mediated activation of Toll-like receptor 4 signaling.

To study the role of c-Src kinase in pro-oxidant-induced stimulation of Toll-like receptor 4 (TLR4), we used lipopolysaccharide from Escherichia coli K12 (LPS-EK) and monophosphoryl lipid A, as TLR4-specific agonists and positive controls, and SIN-1 and potassium peroxychromate as pro-oxidant sources. We used the HEK-Blue mTLR4 cell line, which is stably transfected with mouse TLR4 and expresses optimized SEAP reporter under the control of a promoter inducible by NF-κB transcription factor. The level of SEAP released due to TLR4 stimulation was a measure of NF-κB activation.

Contemporary incidence, predictors, and outcomes of acute kidney injury in patients undergoing percutaneous coronary interventions: insights from the NCDR Cath-PCI registry.

Objectives: This study sought to examine the contemporary incidence, predictors and outcomes of acute kidney injury in patients undergoing percutaneous coronary interventions.

Background: Acute kidney injury (AKI) is a serious and potentially preventable complication of percutaneous coronary interventions (PCIs) that is associated with adverse outcomes. The contemporary incidence, predictors, and outcomes of AKI are not well defined, and clarifying these can help identify high-risk patients for proactive prevention.

Estrogen receptor α in osteocytes regulates trabecular bone formation in female mice.

Estrogens are well known steroid hormones necessary to maintain bone health. In addition, mechanical loading, in which estrogen signaling may intersect with the Wnt/β-catenin pathway, is essential for bone maintenance. As osteocytes are known as the major mechanosensory cells embedded in mineralized bone matrix, osteocyte ERα deletion mice (ERα(ΔOcy/ΔOcy)) were generated by mating ERα floxed mice with Dmp1-Cre mice to determine the role of ERα in osteocytes.

Validation of methods to assess potential biomarkers in pediatric patients with esophageal eosinophilia.

Aim: To validate methods for determining mast cell density, extracellular major basic protein content, and presence of fibrosis in esophageal eosinophilia.

Methods: Twenty specimens with > 20 eosinophils/high-power field (hpf) classified as high eosinophil density (HE) and 20 specimens with < 5 eosinophils/hpf classified as low esophageal density (LE) were identified. All 40 specimens underwent immunohistochemical staining and trichrome staining.

Fluid flow shear stress over podocytes is increased in the solitary kidney.

Background: Glomerular hyperfiltration is emerging as the key risk factor for progression of chronic kidney disease (CKD). Podocytes are exposed to fluid flow shear stress (FFSS) caused by the flow of ultrafiltrate within Bowman's space. The mechanism of hyperfiltration-induced podocyte injury is not clear.

Obstructive sleep apnea in adults.

Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder characterized by repeated episodes of obstructed (apnea) or reduced (hypopnea) airflow in the upper airway during sleep. Obstructive sleep apnea results in variable arterial oxygen desaturations and arousals leading to sleep fragmentation. Most patients with OSA first come to the attention of a clinician when they complain of daytime sleepiness or when their bed partner reports loud snoring and witnessed episodes.

Social disparities in dentition status among American adults.

Objectives: To assess the overall dentition status of American adults, to investigate disparities and changes in dentition using the National Health and Nutrition Examination Surveys 2005-2006 and 2007-2008 and to study the effects of family poverty status, education, citizenship and language on dentition after adjusting for other demographics.

Methods: Descriptive statistics were used to explore and summarise dentition status. The prevalence of dentition markers over two surveys were compared using tests of proportions and a series of regressions were used to estimate the strength of association of family poverty status, education, citizenship and language with the four markers of dentition status.

The relationship between lifestyle and self-reported oral health among American adults.

Objectives: Whereas an unhealthy lifestyle is a risk factor for chronic disease, its relationship to self-reported oral health is unclear. This paper studies this relationship among American adults using two dimensions of self-reported oral health, namely: (1) the extent to which a person's teeth are in poor condition, simply called 'bad teeth'; (2) the occurrences of negative consequences of poor oral health, simply called 'bad experience'. The main purpose of this study is to describe and assess their relationship to four markers of lifestyles and to use the results to make recommendations on improving oral health.