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https://www.readbyqxmd.com/read/27913987/a-moral-normative-framework-for-the-judgment-of-actions-and-decisions-in-the-construction-industry-and-engineering-part-ii
#1
Omar J Alkhatib
The construction industry is typically characterized as a fragmented, multi-organizational setting in which members from different technical backgrounds and moral values join together to develop a particular business or project. The most challenging obstacle in the construction process is to achieve a successful practice and to identify and apply an ethical framework to manage the behavior of involved specialists and contractors and to ensure the quality of all completed construction activities. The framework should reflect a common moral ground for myriad people involved in this process to survive and compete ethically in today's turbulent construction market...
December 2, 2016: Science and Engineering Ethics
https://www.readbyqxmd.com/read/27913914/tragedy-in-moral-case-deliberation
#2
Benita Spronk, Margreet Stolper, Guy Widdershoven
In healthcare practice, care providers are confronted with tragic situations, in which they are expected to make choices and decisions that can have far-reaching consequences. This article investigates the role of moral case deliberation (MCD) in dealing with tragic situations. It focuses on experiences of care givers involved in the treatment of a pregnant woman with a brain tumour, and their evaluation of a series of MCD meetings in which the dilemmas around care were discussed. The study was qualitative, focusing on the views and experiences of the participants...
December 2, 2016: Medicine, Health Care, and Philosophy
https://www.readbyqxmd.com/read/27909727/anti%C3%A2-proliferative-activity-of-epigallocatechin%C3%A2-3%C3%A2-gallate-and-silibinin-on-soft-tissue-sarcoma-cells
#3
Kamran Harati, Björn Behr, Christoph Wallner, Adrien Daigeler, Tobias Hirsch, Frank Jacobsen, Marcus Renner, Ali Harati, Marcus Lehnhardt, Mustafa Becerikli
Disseminated soft tissue sarcomas (STS) present a therapeutic dilemma. The first-line cytostatic doxorubicin demonstrates a response rate of 30% and is not suitable for elderly patients with underlying cardiac disease, due to its cardiotoxicity. Well‑tolerated alternative treatment options, particularly in palliative situations, are rare. Therefore, the present study assessed the anti‑proliferative effects of the natural compounds epigallocatechin-3-gallate (EGCG), silibinin and noscapine on STS cells. A total of eight different human STS cell lines were used in the study: Fibrosarcoma (HT1080), liposarcoma (SW872, T778 and MLS‑402), synovial sarcoma (SW982, SYO1 and 1273) and pleomorphic sarcoma (U2197)...
November 28, 2016: Molecular Medicine Reports
https://www.readbyqxmd.com/read/27909484/lyme-arrhythmia-in-an-avid-golfer-a-diagnostic-challenge-and-a-therapeutic-dilemma
#4
Ujjwal Rastogi, Dr Nidhi Kumars
Lyme disease is a multisystem disorder affecting dermatologic, cardiac, nervous and musculoskeletal systems. Cardiac manifestations occur in about 5% of Lyme infections and stem from the involvement of the cardiac conduction system, resulting in varying degrees of sino-atrioventricular block. Occasionally, Lyme infection may also present with myopericarditis. Unlike isolated conduction node disease, myocardial involvement presents a great diagnostic and therapeutic dilemma for the physician. We report the case of a 68 year-old male cardiologist who presented with new onset exertional dyspnea and palpitations...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27908388/the-unknown-association-of-ppis-with-chest-pain-in-patients-with-known-treated-coronary-artery-disease-a-diagnostic-dilemma
#5
Fahad Javed, Stephen Ramee
Patients with coronary artery disease (CAD) are destined to lifelong antiplatelet therapy in form of aspirin (acetylsalicylic acid) alone, or in combination with other P2Y2 inhibitors. Proton pump inhibitors (PPIs) are the preferred agents for the treatment and prophylaxis of gastrointestinal injury associated with nonsteroidal anti-inflammatory drug or acetylsalicylic acid or both,(1) but recent data has raised questions about their association with negative cardiovascular events. We report 2 cases of patients with known CAD presented with chest pain mimicking angina pectoris that successfully resolved on discontinuation of the PPIs...
July 2016: Current Problems in Cardiology
https://www.readbyqxmd.com/read/27908334/antimicrobial-stewardship-in-the-management-of-sepsis
#6
REVIEW
Michael S Pulia, Robert Redwood, Brian Sharp
Sepsis represents a unique clinical dilemma with regard to antimicrobial stewardship. The standard approach to suspected sepsis in the emergency department centers on fluid resuscitation and timely broad-spectrum antimicrobials. The lack of gold standard diagnostics and evolving definitions for sepsis introduce a significant degree of diagnostic uncertainty that may raise the potential for inappropriate antimicrobial prescribing. Intervention bundles that combine traditional quality improvement strategies with emerging electronic health record-based clinical decision support tools and rapid molecular diagnostics represent the most promising approach to enhancing antimicrobial stewardship in the management of suspected sepsis in the emergency department...
February 2017: Emergency Medicine Clinics of North America
https://www.readbyqxmd.com/read/27908054/can-weekly-noise-levels-of-urban-road-traffic-as-predominant-noise-source-estimate-annual-ones
#7
Carlos Prieto Gajardo, Juan Miguel Barrigón Morillas, Guillermo Rey Gozalo, Rosendo Vílchez-Gómez
The effects of noise pollution on human quality of life and health were recognised by the World Health Organisation a long time ago. There is a crucial dilemma for the study of urban noise when one is looking for proven methodologies that can allow, on the one hand, an increase in the quality of predictions, and on the other hand, saving resources in the spatial and temporal sampling. The temporal structure of urban noise is studied in this work from a different point of view. This methodology, based on Fourier analysis, is applied to several measurements of urban noise, mainly from road traffic and one-week long, carried out in two cities located on different continents and with different sociological life styles (Cáceres, Spain and Talca, Chile)...
November 2016: Journal of the Acoustical Society of America
https://www.readbyqxmd.com/read/27907899/reducing-the-number-of-fetuses-in-a-pregnancy-providers-and-patients-views-of-challenges
#8
Robert L Klitzman
STUDY QUESTION: How do patients and providers perceive and make decisions about possible reductions of multi-fetal pregnancies? SUMMARY ANSWER: Physicians may be transferring additional embryos, assuming that patients will later undergo reduction if need be; but decisions to reduce pregnancies are difficult for patients, who may agree to undergo the procedure in advance and later renege. WHAT IS ALREADY KNOWN: Implanting more than one embryo increases the likelihood that at least one embryo will successfully lead to a child but also that the patient may end up with twins or higher-order multiple births...
November 2016: Human Reproduction
https://www.readbyqxmd.com/read/27907024/utility-evaluation-based-on-one-to-n-mapping-in-the-prisoner-s-dilemma-game-for-interdependent-networks
#9
Juan Wang, Wenwen Lu, Lina Liu, Li Li, Chengyi Xia
In the field of evolutionary game theory, network reciprocity has become an important means to promote the level of promotion within the population system. Recently, the interdependency provides a novel perspective to understand the widespread cooperation behavior in many real-world systems. In previous works, interdependency is often built from the direct or indirect connections between two networks through the one-to-one mapping mode. However, under many realistic scenarios, players may need much more information from many neighboring agents so as to make a more rational decision...
2016: PloS One
https://www.readbyqxmd.com/read/27903725/hippocampal-damage-increases-deontological-responses-during-moral-decision-making
#10
Cornelia McCormick, Clive R Rosenthal, Thomas D Miller, Eleanor A Maguire
: Complex moral decision making is associated with the ventromedial prefrontal cortex (vmPFC) in humans, and damage to this region significantly increases the frequency of utilitarian judgments. Since the vmPFC has strong anatomical and functional links with the hippocampus, here we asked how patients with selective bilateral hippocampal damage would derive moral decisions on a classic moral dilemmas paradigm. We found that the patients approved of the utilitarian options significantly less often than control participants, favoring instead deontological responses-rejecting actions that harm even one person...
November 30, 2016: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/27903579/medium-chain-acyl-coenzyme-a-dehydrogenase-deficiency-mcadd-a-cause-of-severe-hypoglycaemia-in-an-apparently-well-child
#11
Kene Ebuka Maduemem
Medium-chain acyl-Coenzyme A dehydrogenase deficiency (MCADD) is a disorder of fatty acid β oxidation inherited in an autosomal recessive manner. The enzyme is useful in hepatic ketogenesis, a major source of energy once hepatic glycogen stores become depleted during prolonged fasting. It is a cause of hypoketotic hypoglycaemia in a previously well child. MCADD is not part of newborn screening in Ireland; children are likely to be missed if routine hypoglycaemic screen is not instituted when blood glucose level is below 2...
November 30, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27903322/non-use-of-day-care-services-for-dementia-in-singapore-a-dilemma-for-caregivers
#12
Shan Huang, Konstadina Griva, Christina A Bryant, Philip Yap
BACKGROUND: Day care services for patients with dementia (PWD) are generally under-utilized worldwide despite evidence of positive outcomes, such as improved behavioral, psychological, and cognitive functioning for patients, and reduced caregiver burden. This study sought to gain an in-depth understanding of the reasons for non-utilization of day care services in Singapore using qualitative methodology. METHODS: A purposive sample of 16 caregivers of PWD who had never attended day care services participated in semi-structured interviews...
December 1, 2016: International Psychogeriatrics
https://www.readbyqxmd.com/read/27902883/metastatic-carotid-body-paraganglioma-of-lungs-and-lymph-nodes-unsuspected-diagnosis-on-ebus-tbna
#13
Kalpana Kumari, Deepali Jain, Rohit Kumar, Anant Mohan, Rakesh Kumar
Paragangliomas are tumors that originate from the extra-adrenal chromaffin and nonchromaffin cells of neural crest origin. Lymph node metastases are common, while distant metastases to lung, liver, and bone are rare events and usually occur in the presence of a long standing clinically evident primary tumor. Primary diagnosis of paraganglioma at a metastatic site without a known primary is a diagnostic challenge. We report a case of an adult woman with incidentally detected metastasis to bilateral lungs from an occult carotid body paraganglioma, which presented a cytopathological diagnostic dilemma on EBUS-TBNA from paratracheal lymph nodes...
November 30, 2016: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/27901551/prolonged-second-stage-what-is-the-optimal-length
#14
Alexis C Gimovsky, Vincenzo Berghella
Importance: Prolonged second stage of labor is a clinical dilemma in which controversy exists on whether extending labor in nulliparous women with epidural anesthesia decreases the incidence of cesarean delivery without increasing maternal or neonatal risks. Objective: This narrative review was conducted to assess the current literature on management of and risks associated with a prolonged second stage in nulliparous women with epidurals. Evidence Acquisition: A review of the current literature was performed to evaluate the incidence of cesarean delivery and the maternal and neonatal outcomes...
November 2016: Obstetrical & Gynecological Survey
https://www.readbyqxmd.com/read/27899219/the-arduous-quest-for-translating-health-care-productivity-gains-into-cost-savings-lessons-from-their-evolution-at-economic-scoring-agencies-in-the-netherlands-and-the-us
#15
Ab Klink, H Christiaan Schakel, Sander Visser, Patrick Jeurissen
We analyze the assessments of recent health reforms by the Congressional Budget Office (CBO) in the United States and the Bureau for Economic Policy Analysis (CPB) in the Netherlands. Both reforms aim to capitalize on productivity gains, which is appealing for policymakers because of the potential for cost savings while maintaining - or enhancing - quality and access. These measures however generally translate into more health care, rather than care that is affordable and appropriate. Scoring agencies therefore have rightfully been reluctant to assign significant savings to these measures...
November 15, 2016: Health Policy
https://www.readbyqxmd.com/read/27898675/the-dengue-vaccine-dilemma-balancing-the-individual-and-population-risks-and-benefits
#16
Jacqueline Deen
In a Perspective, Jacqueline Deeen discusses challenges in balancing the individual and population risks and benefits for CYD-TDV (Dengvaxia), the first available dengue vaccine.
November 2016: PLoS Medicine
https://www.readbyqxmd.com/read/27898667/does-group-size-matter-for-behavior-in-online-trust-dilemmas
#17
Sabrina Artinger, Nir Vulkan
How does group size influence behavior in online trust dilemmas? We investigate cooperation in groups of 4 to 100 players. While overall levels of cooperation are stable across group sizes, we find significant gender differences: women increase cooperation with group size and cooperate significantly more than men in large groups. These results are robust when controlling for risk aversion, age, and other individual differences. They highlight the importance of studying behavior and gender differences in large groups...
2016: PloS One
https://www.readbyqxmd.com/read/27896169/rare-association-of-extended-total-colonic-aganglionosis-and-intestinal-malrotation
#18
Iulia Stratulat-Chiriac, Danielle Mc Laughlin, Brice Antao
Total colonic aganglionosis occurring together with malrotation is a rare occurrence and may pose diagnostic and management dilemmas for the paediatric surgeon. We report a case of a neonate that presented with extended total colonic aganglionosis and malrotation, along with a spectrum of central nervous system and renal abnormalities. The clinical and radiological features and potential diagnostic and management pitfalls are discussed along with a literature review of this exceptionally infrequent association...
October 2016: Journal of Neonatal Surgery
https://www.readbyqxmd.com/read/27895709/the-dilemma-for-lipid-productivity-in-green-microalgae-importance-of-substrate-provision-in-improving-oil-yield-without-sacrificing-growth
#19
REVIEW
Kenneth Wei Min Tan, Yuan Kun Lee
Rising oil prices and concerns over climate change have resulted in more emphasis on research into renewable biofuels from microalgae. Unlike plants, green microalgae have higher biomass productivity, will not compete with food and agriculture, and do not require fertile land for cultivation. However, microalgae biofuels currently suffer from high capital and operating costs due to low yields and costly extraction methods. Microalgae grown under optimal conditions produce large amounts of biomass but with low neutral lipid content, while microalgae grown in nutrient starvation accumulate high levels of neutral lipids but are slow growing...
2016: Biotechnology for Biofuels
https://www.readbyqxmd.com/read/27895413/hepatic-epithelioid-hemangioendothelioma-dilemma-and-challenges-in-the-preoperative-diagnosis
#20
Hai-Jie Hu, Yan-Wen Jin, Qiu-Yang Jing, Anuj Shrestha, Nan-Sheng Cheng, Fu-Yu Li
Hepatic epithelioid hemangioendothelioma (HEHE) is a rare category of vascular tumor with uncertain malignant potential. It commonly presents nonspecific and variable clinical manifestations, ranging from asymptomatic to hepatic failure. In addition, laboratory measurements and imaging features also lack specificity in the diagnosis of HEHE. The aim of the present study is to highlight the dilemma and challenges in the preoperative diagnosis of HEHE, and to enhance awareness of the range of hepatobiliary surgery available in patients with multiple hepatic nodular lesions on imaging...
November 7, 2016: World Journal of Gastroenterology: WJG
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