The physician as a professional and the moral implications of medical professionalism

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Doctors as fiduciaries: A legal construct of the patient-physician relationship

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The contractual model of the patient-physician relationship and the demise of medical professionalism

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The living will - pitfalls, benefits and a way forward

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The centrality of patient-physician relationship to medical professionalism: An ethical evaluation of some contemporary models

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The best interests of mentally incapacitated patients without a living will

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"Faith Maturity Scale" for Chinese: A Revision and Construct Validation

Using a large sample of Chinese Christians (n = 2,196), we examined the internal structure, reliability, and validity of the Faith Maturity Scale (FMS). Despite its being developed in North America, and for a mainline Protestant population, the FMS was shown to have validity among non-Western, non-mainline Protestants. There is convergent validity with self-reported religious practices and a belief measure of religiosity. Our analyses also confirmed good construct validity with the Big Five personality dimensions, social axioms, attributional style, and quality of life. FMS remained associated with religious practices and high quality of life after personality was statistically controlled. Findings supported that the Chinese version of the FMS assesses the same theoretical construct as does the original scale and that the distinction between the vertical and horizontal dimensions of faith maturity is meaningful. © 2011 Copyright Taylor and Francis Group, LLC.postprin

Visceral hyperalgesia induced by forebrain-specific suppression of native Kv7/KCNQ/M-current in mice

<p>Abstract</p> <p>Background</p> <p>Dysfunction of brain-gut interaction is thought to underlie visceral hypersensitivity which causes unexplained abdominal pain syndromes. However, the mechanism by which alteration of brain function in the brain-gut axis influences the perception of visceral pain remains largely elusive. In this study we investigated whether altered brain activity can generate visceral hyperalgesia.</p> <p>Results</p> <p>Using a forebrain specific αCaMKII promoter, we established a line of transgenic (Tg) mice expressing a dominant-negative pore mutant of the Kv7.2/KCNQ2 channel which suppresses native KCNQ/M-current and enhances forebrain neuronal excitability. Brain slice recording of hippocampal pyramidal neurons from these Tg mice confirmed the presence of hyperexcitable properties with increased firing. Behavioral evaluation of Tg mice exhibited increased sensitivity to visceral pain induced by intraperitoneal (i.p.) injection of either acetic acid or magnesium sulfate, and intracolon capsaicin stimulation, but not cutaneous sensation for thermal or inflammatory pain. Immunohistological staining showed increased c-Fos expression in the somatosensory SII cortex and insular cortex of Tg mice that were injected intraperitoneally with acetic acid. To mimic the effect of cortical hyperexcitability on visceral hyperalgesia, we injected KCNQ/M channel blocker XE991 into the lateral ventricle of wild type (WT) mice. Intracerebroventricular injection of XE991 resulted in increased writhes of WT mice induced by acetic acid, and this effect was reversed by co-injection of the channel opener retigabine.</p> <p>Conclusions</p> <p>Our findings provide evidence that forebrain hyperexcitability confers visceral hyperalgesia, and suppression of central hyperexcitability by activation of KCNQ/M-channel function may provide a therapeutic potential for treatment of abdominal pain syndromes.</p

The momentum analyticity of two-point correlators from perturbation theory and AdS/CFT

The momentum plane analyticity of two point function of a relativistic thermal field theory at zero chemical potential is explored. A general principle regarding the location of the singularities is extracted. In the case of the N=4 supersymmetric Yang-Mills theory at large $N_c$, a qualitative change in the nature of the singularity (branch points versus simple poles) from the weak coupling regime to the strong coupling regime is observed with the aid of the AdS/CFT correspondence.Comment: 18 pages, 3 figures, typos fixed, 1 figure update

A loop of cancer-stroma-cancer interaction promotes peritoneal metastasis of ovarian cancer via TNFα-TGFα-EGFR.

Peritoneum is the most common site for ovarian cancer metastasis. Here we investigate how cancer epigenetics regulates reciprocal tumor-stromal interactions in peritoneal metastasis of ovarian cancer. Firstly, we find that omental stromal fibroblasts enhance colony formation of metastatic ovarian cancer cells, and de novo expression of transforming growth factor-alpha (TGF-α) is induced in stromal fibroblasts co-cultured with ovarian cancer cells. We also observed an over-expression of tumor necrosis factor-alpha (TNF-α) in ovarian cancer cells, which is regulated by promoter DNA hypomethylation as well as chromatin remodeling. Interestingly, this ovarian cancer-derived TNF-α induces TGF-α transcription in stromal fibroblasts through nuclear factor-κB (NF-κB). We further show that TGF-α secreted by stromal fibroblasts in turn promotes peritoneal metastasis of ovarian cancer through epidermal growth factor receptor (EGFR) signaling. Finally, we identify a TNFα-TGFα-EGFR interacting loop between tumor and stromal compartments of human omental metastases. Our results therefore demonstrate cancer epigenetics induces a loop of cancer-stroma-cancer interaction in omental microenvironment that promotes peritoneal metastasis of ovarian cancer cells via TNFα-TGFα-EGFR