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Objective: For people with advanced cancer, the months preceding death can be very stressful. Moreover, cancer-related stressors can arise within multiple dimensions. However, little research has examined how people cope differentially with different types of stressors. The goal of this study was to examine patterns of coping across different dimensions of stress.Method: Fifty-two patients who were receiving palliative care for cancer were asked to indicate their most significant stressors within social, physical, and existential dimensions. A structured interview was then conducted to describe how the participants coped with these stressors.Results: Overall, stressor severity ratings were correlated significantly across the three dimensions, although physical symptoms received the highest mean rating. Participants generally used a range of coping strategies to deal with their stressors, but there were clear differences across dimensions in the relative use of problem-focused versus emotion-focused strategies. Problem-focused coping was less frequent for existential issues, whereas emotion-focused strategies were used less frequently for physical stressors. Coping efforts were not clearly related to psychological distress.Significance Of Results: Although coping is an important research theme within psycho-oncology, it may be overly broad to ask, "How do people cope with cancer"? In fact, different cancer-related stressors are coped with in very different ways. There is not necessarily any particular pattern of coping that is best for relieving psychological distress. [ABSTRACT FROM AUTHOR]

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Terminal sedation is a phrase that has appeared in the palliative care literature in the last few years. There has not been a clear definition proposed for this term, nor has there been any agreement on the frequency with which the technique is used. A postal survey of 61 selected palliative care experts (59 physicians, two nurses) was carried out to examine their response to a proposed definition for 'terminal sedation', to estimate the frequency of this practice and the reasons for its use, to identify the drugs and dosages used, to determine the outcome, and to explore the decision-making process. Opinions on physician-assisted suicide and voluntary euthanasia were also sought. Eighty-seven per cent of the experts responded from eight countries, although predominantly from Canada and the United Kingdom. Forty per cent agreed unequivocally with the proposed definition, while 4% disagreed completely. Eighty-nine per cent agreed that 'terminal sedation' is sometimes necessary and 77% reported using it in the last 12 months--over half of these for up to four patients. Reasons for using this method included various physical and psychological symptoms. The most common drugs used were midazolam and methotrimeprazine. Decision making usually involved the patient or family, and varied with respect to the ease with which the decision was made. The use of sedation was perceived to be successful in 90 out of 100 patients recalled. Ninety per cent of respondents did not support legalization of euthanasia. In conclusion, sedating agents are used by palliative care experts as tools for the management of symptoms. The term 'terminal sedation' should be abandoned and replaced with the phrase 'sedation for intractable distress in the dying'. Further research into the management of intractable symptoms and suffering is warranted. [ABSTRACT FROM AUTHOR]

Profiles the unique needs and problems of moms on campus. Programs which are 20 years behind current needs; Recruitment and retention of the student-mother; Problems of welfare mothers; Combatting educational and cultural obstacles; Gender stereotypes regarding math and science achievement. INSET: TWU makes student-moms feel at home, by K. Alger..

Movements of four adult giant trevally Caranx ignobilis were tracked using passive acoustic telemetry after being released from uShaka Sea World Aquarium in Durban, South Africa, where they had been kept on display for a period of 8 years. All four individuals were detected on a large network of deployed acoustic receivers for a minimum of 3 months to a maximum of over 6 years. Their movements were compared to 43 wild-caught and tagged C. ignobilis over a similar period and two individuals adopted movement behavior similar to that of their conspecifics, including repeated annual seasonal migrations to a known spawning aggregation site. This study shows that with good animal husbandry, indigenous fish kept in captivity can be released back into the wild and not only survive but adopt natural movement behavior and contribute to future generations of their species., (© 2023 Wiley Periodicals LLC.)

The earlier studies on brain vasculature semantic segmentation used classical image analysis methods to extract the vascular tree from images. Nowadays, deep learning methods are widely exploited for various image analysis tasks. One of the strong restrictions when dealing with neural networks in the framework of semantic segmentation is the need to dispose of a ground truth segmentation dataset, on which the task will be learned. It may be cumbersome to manually segment the arteries in a 3D volumes (MRA-TOF typically). In this work, we aim to tackle the vascular tree segmentation from a new perspective. Our objective is to build an image dataset from mouse vasculatures acquired using CT-Scans, and enhance these vasculatures in such a way to precisely mimic the statistical properties of the human brain. The segmentation of mouse images is easily automatized thanks to their specific acquisition modality. Thus, such a framework allows to generate the data necessary for the training of a Convolutional Neural Network - i.e. the enhanced mouse images and there corresponding ground truth segmentation - without requiring any manual segmentation procedure. However, in order to generate an image dataset having consistent properties (strong resemblance with MRA images), we have to ensure that the statistical properties of the enhanced mouse images do match correctly the human MRA acquisitions. In this work, we evaluate at length the similarities between the human arteries as acquired on MRA-TOF and the "humanized" mouse arteries produced by our model. Finally, once the model duly validated, we experiment its applicability with a Convolutional Neural Network.

Background: To ensure patients and families receive appropriate end-of-life care pathways and guidelines aim to inform clinical decision making. Ensuring appropriate outcomes through the use of these decision aids is dependent on timely use. Diagnosing dying is a complex clinical decision, and most of the available practice checklists relate to cancer. There is a need to review evidence to establish diagnostic indicators that death is imminent on the basis of need rather than a cancer diagnosis., Aim: To examine the evidence as to how patients are judged by clinicians as being in the final hours or days of life., Design: Integrative literature review., Data Sources: Five electronic databases (2001-2011): Cochrane Central Register of Controlled Trials (CENTRAL) on The Cochrane Library, MEDLINE, EMBASE, PsycINFO and CINAHL. The search yielded a total of 576 hits, 331 titles and abstracts were screened, 42 papers were retrieved and reviewed and 23 articles were included., Results: Analysis reveals an overarching theme of uncertainty in diagnosing dying and two subthemes: (1) 'characteristics of dying' involve dying trajectories that incorporate physical, social, spiritual and psychological decline towards death; (2) 'treatment orientation' where decision making related to diagnosing dying may remain focused towards biomedical interventions rather than systematic planning for end-of-life care., Conclusions: The findings of this review support the explicit recognition of 'uncertainty in diagnosing dying' and the need to work with and within this concept. Clinical decision making needs to allow for recovery where that potential exists, but equally there is the need to avoid futile interventions., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.)

In the present study, we have investigated the influence of sub-acute treatment with cadmium (Cd) on some parameters indicative of oxidative stress and DNA damage in tissues of pregnant female rats. Pregnant female rats (n=6) were injected subcutaneously, daily with a dose of cadmium chloride of 3 mg/kg body weight (b.w.) from day 6 to day 19 of pregnancy, and they were allowed to deliver normally. MDA level and GPx, CAT and SOD activities were used as markers of oxidative stress in liver and kidney. The 8-oxo-dG level was measured by the HPLC-EC system. Cd treatment increased MDA (+116%, p<0.01) in kidney. Moreover, Cd treatment also decreased CuZn-SOD (-11%, p<0.05) and GSH level (-52%, p<0.05) in kidney. Treated rats displayed an increase of the liver metallothionein (MT) level. Induction of MT in liver was probably implicated in the detoxification of Cd. The high level of Cd (3 mg/kg) used in the present study is partially neutralized by MT in liver, whereas the free fraction could be implicated in the oxidative stress and DNA oxidation observed in kidney. Cd treatment failed to alter 8-oxodGuo, indicating the absence of DNA oxidation in liver; by contrast, the same treatment increased the 8-oxodGuo level (+51%, p<0.05) in the kidney of pregnant female rats, indicating an oxidative stress associated with DNA damage only in kidney.

In our environment, we have numerous chances to be exposed to not only static magnetic fields (SMFs) but also many chemicals containing mutagens. Therefore, the aim of this study was to investigate the effects of co-exposure to SMF and cadmium (Cd) on the antioxidant enzymes activity and DNA damage in pregnant rat tissues. Pregnant rats were treated with cadmium (CdCl(2), 3.0 mg/Kg body weight) or exposed to SMF (128 mT/h/day) and treated with cadmium chlorides (3.0 mg/kg, body weight) for 13 consecutive days as from the 6th to 19th day of gestation. Cd treatment increased malondialdehyde (MDA) and 8-oxodGuo levels in kidney of pregnant rats. However, the activity of superoxide dismutase (SOD) and glutathione level were decreased in kidney. Interestingly, the combined effects of SMF and Cd have no effects on activities of antioxidant in both tissues compared to cadmium treated group. However, the association between SMF and Cd decreased plasma MDA concentration. The same treatment failed to alter 8-oxodGuo concentration. Sub-acute Cd treatment altered antioxidant enzymes and DNA in kidney of pregnant rats. The results suggest that a homeostatic defence mechanism was activated when SMF was associated to Cd in pregnant rats.

Purpose: The purpose here was to identify whether ionizing radiation and oxaliplatin triggered testicular germ cells apoptosis through different executionary pathways., Materials and Methods: Adult male mice are treated with oxaliplatin (0.5 mg/kg, Ox) 4 h before being locally irradiated (0.5 Gy, IR, considered as time 0 h)., Results: The number of apoptotic germ cells was significantly higher for IR (p < 0.008), Ox (p < 0.0001) and Ox + IR (p < 0.0001) groups compared to the untreated mice group. Similarly, the different treatments induced an increase of p53 expression. Downstream p53, IR and Ox used different pathways. Indeed, IR increased effector caspase-3 expression in terms of mRNA (p < 0.002), pro-enzyme p < 0.0001) and active (3.7-fold, p < 0.003) protein levels but not the inhibitors of apoptosis proteins (IAP) including cIAP1, cIAP2 and XIAP. In contrast, while oxaliplatin treatment had no apparent effect on caspase-3 expression, it significantly decreased the cIAP1 (p < 0.005), cIAP2 (p < 0.008) and XIAP (p < 0.02) proteins levels. Finally, the combination of both treatments decreased IAP expression but did not modify caspase-3 levels while it increased the AIF (apoptosis-inducing factor) protein levels (5.5-fold, p < 0.003). No modification of AIF levels was observed with OX or IR alone., Conclusions: Together, these results indicate that the platinum analogue oxaliplatin and the ionizing radiations trigger apoptosis in the testicular germ cells, probably through different pathways.

Although spermatogenesis is a complex process under hormonal control, which includes mainly follicle stimulating hormone (FSH) and androgens, little is known about the intra-testicular mediators of these hormones. In the present study, galectin-3 (Gal-3) expression has been identified in human, rat and porcine testes where it is under hormonal control. Gal-3 is present in Sertoli cells and appears to be absent in human and (probably) in rat germ cells. Gal-3 expression was evidenced in the testes, in terms of both mRNA and protein (31 kDa). Gal-3 expression in cultured porcine Sertoli cells was shown to be under the positive control of FSH as well as of two cytokines epidermal growth factor (EGF) and tumour necrosis factor-alpha (TNF-alpha). Gal-3 expression in Sertoli cells is also potentially under the control of mature germ cells as an increased expression was observed in adult rat testes depleted in spermatocytes or spermatids. Although the function of testicular Gal-3 remains to be investigated, a potential role of Gal-3 in germ cell survival/regeneration is suggested based on its increased expression 1 month after a transient germ cell death process triggered by 10 days of treatment with the antiandrogen flutamide. Finally, although in the normal human testes, Gal-3 is exclusively located in the Sertoli cell cytoplasm, a nuclear localization is observed in the infertile testes. Together, the present findings have shown that (i) Gal-3 is expressed in the porcine, rat and human Sertoli cells; (ii) Gal-3 is under the positive control of FSH as well as of EGF and TNF-alpha and possibly of adult germ cells. These observations are compatible with a potential pro-survival role of Gal-3 in the testes.

Background: The present investigation was designed to evaluate the effects of subacute exposure to static magnetic field (SMF) on some parameters indicative of oxidative stress and on oxidative DNA damage in pregnant rat., Methods: Females rats (n = 6) were exposed to a SMF (128 mT; 1 h/day) from day 6 to day 19 of pregnancy and were allowed to deliver normally. The control group (n = 6) was not exposed to SMF. Dams were sacrificed 3 days after delivery. The effects of subacute exposure to SMF on oxidative states were assessed on the measurements of malondialdehyde (MDA), superoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione (GSH) and catalase (CAT). The level of 8-oxo-dG was measured using high-performance liquid chromatography coupled to electrochemical detection., Results: Subacute exposure to SMF failed to alter plasma GPx, MDA, CAT and SOD respectively in liver and kidney. By contrast, SMF increased total GSH (+56%, p <0.05) and reduced GSH (+108%, p <0.05) in liver. Our results showed that the exposure to SMF did not induce oxidative DNA lesions in liver and kidney., Conclusions: The data do not provide evidence that subacute SMF exposure causes DNA damage in liver and kidney in pregnant rats. The present results suggest that hepatic GSH plays an important role in protection against SMF during pregnancy. These changes in antioxidant status (GSH) lead to some adaptive responses due to activation of systems controlling the body oxidative mechanism balance.

This study investigated the effects of a static magnetic field (SMF) on hematopoiesis and biochemical parameters in female rats. Pregnant rats were exposed to SMF (128 mT-1 hour/day from day 6 to day 19 of pregnancy). At 25 degrees C, the exposure of rats 1 hour/day for 13 consecutive days to SMF induced an increase in hematocrit (Ht) level (+6%, p < 0.05), hemoglobin (Hb) concentration (+12%, p < 0.05) and LDH levels (67%, p < 0.05 ), suggesting an hypoxia-like state. Moreover, exposure to SMF increased blood glucose and decreased insulin release, leading to a diabetic-like state in pregnant rats.

In the present study we investigated whether fetal exposure to flutamide affected messenger and protein levels of claudin-11, a key Sertoli cell factor in the establishment of the hemotesticular barrier, at the time of two key events of postnatal testis development: 1) before puberty (postnatal d 14) during the establishment of the hemotesticular barrier, and 2) at the adult age (postnatal d 90) at the time of full spermatogenesis. The data obtained show that claudin-11 expression was inhibited in prepubertal rat testes exposed in utero to 2 and 10 mg/kg x d flutamide. However, in adult testes, the inhibition was observed only with 2, and not with 10, mg/kg x d of the antiandrogen. It is shown here that these differences between prepubertal and adult testes could be related to dual and opposed regulation of claudin-11 expression resulting from positive control by androgens and an inhibitory effect of postmeiotic germ cells. Indeed, testosterone is shown to stimulate claudin-11 expression in cultured Sertoli cells in a dose- and time-dependent manner (maximum effect with 0.06 microm after 72 h of treatment). In contrast, postmeiotic germ cells potentially exert a negative effect on claudin-11 expression, because adult rat testes depleted in spermatids (after local irradiation) displayed increased claudin-11 expression, whereas in a model of cocultured Sertoli and germ cells, spermatids, but not spermatocytes, inhibited claudin-11 expression. The apparent absence of claudin-11 expression changes in adult rat testes exposed to 10 mg/kg x d flutamide therefore could result from the antagonistic effects of 1) the inhibitory action of the antiandrogen and 2) the stimulatory effect of the apoptotic germ cells on claudin-11 expression. Together, due to the key role of claudin-11 in the hemotesticular barrier, the present findings suggest that such regulatory mechanisms may potentially affect this barrier (re)modeling during spermatogenesis.

Objective: Assessment in palliative care requires a multidimensional review of physical symptoms and psychosocial concerns in a format appropriate for patients with advanced illness. In this study, we describe the initial development and validation of a structured interview for assessing common symptoms and concerns faced by terminally ill individuals., Method: We constructed a 13-item Structured Interview for Symptoms and Concerns (SISC) based on a review of end-of-life issues and administered it to 69 patients receiving palliative care for advanced cancer. Along with the interview, each participant completed visual analog scales (VAS) addressing the same constructs. Test-retest and interrater reliability were determined, as was the concordance between interview ratings and VAS scores., Results: Overall, the interview items had excellent interrater reliability (intraclass correlations were > 0.90) and at least moderate temporal stability (test-retest correlations ranged from 0.50 to 0.90). Concurrent validity was evident in the good concordance between interview items and VAS measures (correlations were > 0.70). The SISC was also sensitive to individual differences between subgroups of participants who did or did not meet diagnostic criteria for anxiety or depressive disorders., Conclusions: This study demonstrates that structured interviews provide a reliable and valid approach to assessment in palliative care and may be an appropriate alternative for some research applications.

Estrogens are key regulators of sexual differentiation and development in vertebrates. The P450 aromatase (P450arom) is the steroidogenic enzyme responsible for the synthesis of estrogens from androgens. In the adult rat testis, aromatase transcripts and activity have been observed in somatic cells and germ cells, including pachytene spermatocytes (PS) and round spermatids (RS), but little is known concerning regulation of the aromatase gene expression, especially in germ cells. The quality of germ cell preparations was assessed by the absence of androgen-binding protein and stem cell factor transcripts, two specific markers for Sertoli cells. By employing a competitive quantitative reverse transcriptase-polymerase chain reaction technique, we confirmed that germ cells contained P450arom transcripts and demonstrated that the aromatase gene was up-regulated by cAMP. Conversely, transforming growth factor (TGF) beta1 inhibited Cyp19 gene expression in a dose- and a time-dependent manner in both PS and RS. The addition of tumor necrosis factor (TNF) alpha to purified germ cells induced an increase of the amount of P450arom mRNA in PS, although an inhibitory effect was observed in RS. When PS were treated with dexamethasone (Dex), a similar enhancement of the aromatase transcript level was observed, whereas an inhibitory effect was recorded for RS. Furthermore, in either TGFbeta1- or TNFalpha-treated germ cells, the addition of Dex stimulated the aromatase gene transcription. Experiments using 5' rapid amplification of cDNA ends suggested that promoter PII is mainly concerned in the regulation of the aromatase gene expression in germ cells of adult male rats; however, the presence of other promoters could not be excluded.

Although it is established that in utero exposure to antiandrogenic compounds such as flutamide induces hypospermatogenesis in adult male rat offspring, the cellular and molecular mechanisms remain to be investigated. By using adult rats exposed in utero to flutamide (0.4, 2, 10 mg/kg.d) as a model, we show that the hypospermatogenesis could be related to a chronic apoptotic cell death process associated with a long-term increase in caspase-3 and -6 expression and activation in germ cells. The number of apoptotic (terminal deoxynucleotidyl transferase-mediated deoxyuridine positive) adult germ cells was dependent on the dose of flutamide. The apoptotic germ cell death process could be related to an increased expression and activation of effector caspases-3 and -6. Procaspases-3 and -6 were immunodetected in germ cells from both untreated or flutamide-treated rats, whereas cleaved active caspase-3 was detected exclusively in germ cells from adult rat exposed in utero to flutamide. Exposure to the antiandrogen increased in a dose-dependent manner as caspase-3 and -6 mRNA (in RT-PCR approaches) as well as procaspase-3 and -6 protein (in Western blotting analyses) levels in the adult rat testis. Flutamide also activates procaspases. Indeed, whereas cleaved active caspase-3 and -6 proteins were absent in control animals, they were detected in adult rat testes exposed in utero to flutamide. Our results show that whereas the apoptotic germ cell death process associated with the increased caspase expression and activation in adult rat germ cells was chronic and nonreversible when exposure to flutamide occurred in utero, it was transient when such an exposure occurred during adulthood. Indeed, although an increase in caspase-3 and -6 mRNA and procaspase-3 and -6 protein levels was observed in germ cells after 3 d of exposure to flutamide, 1-2 wk after the cessation of the antiandrogen exposure, the caspase mRNA and procaspase protein levels were back to control. Active cleaved caspase-3 and -6 protein appeared following the exposure to the antiandrogen, whereas they disappeared at cessation of exposure to flutamide. In summary, the present findings indicate that in utero exposure to the antiandrogen induced in the adult rat testes a chronic apoptotic germ cell death associated with a long-term increase in the expression and activation in germ cells of caspases-3 and -6, two key components in the death machinery.

Is it possible to build a stronger future for Social Security while, at the same time, protect the well being of the vulnerable elderly and maintain critical protection for families? Contrary to those who call for radical measures, the evidence is mounting: Social Security can be made stronger for the long-term with a package of modest, responsible reforms.

Breathlessness secondary to both cancer and non-malignant disease is a distressing, exhausting symptom which, to date, has been difficult to control. This paper reports a chart review undertaken on patients referred to the Ottawa Civic Hospital's Palliative Care Service over the 18-month period from 1 January 1992 to 30 June 1993. The intent of the review was to assess the recorded efficacy and safety of nebulized opioid use on patients with complaints of dyspnoea. Fifty-four patients were treated and subjective data have been compiled. The treatment was found to be effective, safe and convenient for the majority of the patients studied. In addition, nebulized opioids have been demonstrated as a treatment modality which is feasible for self-administration by the patient at home.

The visual function in 54 eyes of 27 patients with Best's disease was analyzed by retrospectively examining the Snellen visual acuities and the electrooculogram (EOG). Visual acuities, generally well maintained in most patients, were 20/40 (0.5) or better in 41 of 54 (75.9%) eyes, and showed no correlation with age. Those in the cicatricial stage had worse visual acuities than those in the previtelliform stage. The EOG was abnormal in 47 eyes (87.0%) with a subnormal light peak/dark trough (Lp/Dt) ratio less than 1.85. Seven eyes (13.0%) with an Lp/Dt ratio 1.85 or higher had significantly smaller Dt values compared with those with a low Lp/Dt ratio. The Lp/Dt ratio did not correlate with patient age or disease stage. No correlation existed between visual acuities and Lp/Dt ratios. The Lp/Dt ratio did not reflect the severity of the macular lesions. The results indicate that not only a low Lp/Dt ratio but also a low dark trough value in cases with a normal Lp/Dt ratio are helpful in diagnosing Best's disease.

The primary biochemical defect in Parkinsonism is dopamine depletion. Anticholinergics (except in the elderly) and amantadine are useful in treating early symptomatic disease. L-dopa remains the most effective drug, but experience has led to more modest use due to its late complications, particularly dyskinesias. Bromocriptine, a dopamine agonist, is relatively effective, but when it should be used is undecided. Beta-blockers may control tremor. Treatment should be tailored to each patient, and focus on functional motor ability. Dyskinesias and neuropsychiatric complications are the major limiting factors with most of these drugs. Several drugs are under investigation.

A conceptual framework provides boundaries within which facts, concepts, theories, and propositions from three theoretical sources interact with clarity, coherence, and consistency. From the framework objectives are derived. The framework gives direction to the curriculum design. Finally, the conceptual framework serves as a background against which objectives can be tested. A conceptual framework for curriculum encourages systematic curriculum evaluation that will eventually allow us to more accurately describe, explain, predict, and control the work of curriculum.