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"Andrew, Ruth"
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The British short story
\"The short story remains a crucial if neglected - part of British literary heritage. This accessible and up-to-date critical overview maps out the main strands and figures that shaped the British short story and novella from the 1850s to the present. It offers new readings of both classic and forgotten texts in a clear, jargon-free way\"--Provided by publisher.
Book
Transfer and Metabolism of Cortisol by the Isolated Perfused Human Placenta
Abstract
Context
Fetal overexposure to glucocorticoids in utero is associated with fetal growth restriction and is postulated to be a key mechanism linking suboptimal fetal growth with cardiovascular disease in later life.
Objective
To develop a model to predict maternal-fetal glucocorticoid transfer. We hypothesized placental 11-β-hydroxysteroid dehydrogenase-type 2 (11β-HSD2) would be the major rate-limiting step in maternal cortisol transfer to the fetus.
Design
We used a deuterated cortisol tracer in the ex vivo placental perfusion model, in combination with computational modeling, to investigate the role of interconversion of cortisol and its inactive metabolite cortisone on transfer of cortisol from mother to fetus.
Participants
Term placentas were collected from five women with uncomplicated pregnancies, at elective caesarean delivery.
Intervention
Maternal artery of the isolated perfused placenta was perfused with D4-cortisol.
Main Outcome Measures
D4-cortisol, D3-cortisone, and D3-cortisol were measured in maternal and fetal venous outflows.
Results
D4-cortisol, D3-cortisone, and D3-cortisol were detected and increased in maternal and fetal veins as the concentration of D4-cortisol perfusion increased. D3-cortisone synthesis was inhibited when 11-β-hydroxysteroid dehydrogenase (11β-HSD) activity was inhibited. At the highest inlet concentration, only 3.0% of the maternal cortisol was transferred to the fetal circulation, whereas 26.5% was metabolized and 70.5% exited via the maternal vein. Inhibiting 11β-HSD activity increased the transfer to the fetus to 7.3% of the maternal input, whereas 92.7% exited via the maternal vein.
Conclusions
Our findings challenge the concept that maternal cortisol diffuses freely across the placenta and confirm that 11β-HSD2 acts as a major “barrier” to cortisol transfer to the fetus.
Placental cortisol metabolism and transfer was studied using tracers and computational modeling. This indicated that the placenta presents both metabolic and physical barriers to cortisol transfer.
Journal Article
Charting New Imaginaries for DEI: Lessons from a Capabilities Approach to Justice
In the face of ongoing debate surrounding diversity, equity, and inclusion (DEI) in higher education, this essay examines the limitations of current DEI frameworks by interrogating the theories of justice on which they are implicitly based. While DEI initiatives aim to address both the symptoms and structural roots of marginalization, they often fall short of realizing transformative change within entrenched institutional dynamics. This essay contends that the justice paradigms most commonly underpinning DEI—rooted in rights-based and utilitarian traditions prevalent in modern liberal institutions—fail to fully engage the conditions necessary for human freedom, flourishing, and self-determination. In response, it advances a capabilities approach to justice as a more expansive framework for understanding and guiding DEI efforts. Emphasizing individuals’ real freedoms to achieve well-being in context, the capabilities approach foregrounds the relational, material, and institutional dimensions of justice. Reframing DEI through this lens, the essay invites higher education professionals to engage in equity work that is not only compliant or symbolic but rooted in the transformation of the conditions that support human and ecological thriving. Rather than offering a definitive model, this intervention aims to animate new questions and practices that expand the horizon of what justice-oriented DEI work in higher education can become.
Journal Article
Reduced Cortisol Metabolism during Critical Illness
This study shows that during critical illness, reduced cortisol breakdown, related to suppressed activity of cortisol-metabolizing enzymes, contributes to hypercortisolemia and hence corticotropin suppression, which may have clinical implications.
Critical illness, an example of severe acute physical stress, is often accompanied by hypercortisolemia that is proportionate to the severity of illness.
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,
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This observation has traditionally been attributed to stress-induced activation of the hypothalamic–pituitary–adrenal (HPA) axis and increased corticotropin-driven cortisol production.
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However, this stress response may not be sufficient for a good prognosis in patients with relative adrenal insufficiency.
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–
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Moreover, Vermes et al.
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reported only transiently elevated levels of corticotropin during critical illness, whereas cortisol levels remained high, a paradoxical dissociation between cortisol and corticotropin levels that has also been observed in other stress conditions.
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In addition to . . .
Journal Article
Zombies in the academy : living death in higher education
The theme of zombies is topical and provocative, with the potential to appeal to a wide range of readers. This book is an engaging call for recognition of the conditions of contemporary humanities research, teaching, and cultural and labour practices. The zombie trope offers an unusual perspective into discussions about the current crises in higher education, and the proposed structure of the book allows for the 3 editors to open up interdisciplinary discussion (with their 3 sections covering corporatisation & zombification, digital media & moribund content distribution, and zombie literacies & pedagogies). \"Zombies in the Academy\" taps into the current popular fascination with zombies and brings together scholars from a range of fields, including cultural and communications studies, sociology, film studies, and education, to give a critical account of the political, cultural, and pedagogical state of the university through the metaphor of zombiedom.
Book
Incidence of type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors: population based cohort study
AbstractObjectiveTo investigate the incidence of new onset type 2 diabetes mellitus in men receiving steroid 5α-reductase inhibitors (dutasteride or finasteride) for long term treatment of benign prostatic hyperplasia.DesignPopulation based cohort study.SettingUK Clinical Practice Research Datalink (CPRD; 2003-14) and Taiwanese National Health Insurance Research Database (NHIRD; 2002-12).ParticipantsMen in the CPRD who received dutasteride (n=8231), finasteride (n=30 774), or tamsulosin (n=16 270) were evaluated. Propensity score matching (2:1; dutasteride to finasteride or tamsulosin) produced cohorts of 2090, 3445, and 4018, respectively. In the NHIRD, initial numbers were 1251 (dutasteride), 4194 (finasteride), and 86 263 (tamsulosin), reducing to 1251, 2445, and 2502, respectively, after propensity score matching.Main outcomes measureIncident type 2 diabetes using a Cox proportional hazard model.ResultsIn the CPRD, 2081 new onset type 2 diabetes events (368 dutasteride, 1207 finasteride, and 506 tamsulosin) were recorded during a mean follow-up time of 5.2 years (SD 3.1 years). The event rate per 10 000 person years was 76.2 (95% confidence interval 68.4 to 84.0) for dutasteride, 76.6 (72.3 to 80.9) for finasteride, and 60.3 (55.1 to 65.5) for tamsulosin. There was a modest increased risk of type 2 diabetes for dutasteride (adjusted hazard ratio 1.32, 95% confidence interval 1.08 to 1.61) and finasteride (1.26, 1.10 to 1.45) compared with tamsulosin. Results for the NHIRD were consistent with the findings for the CPRD (adjusted hazard ratio 1.34, 95% confidence interval 1.17 to 1.54 for dutasteride, and 1.49, 1.38 to 1.61 for finasteride compared with tamsulosin). Propensity score matched analyses showed similar results.ConclusionsThe risk of developing new onset type 2 diabetes appears to be higher in men with benign prostatic hyperplasia exposed to 5α-reductase inhibitors than in men receiving tamsulosin, but did not differ between men receiving dutasteride and those receiving finasteride. Additional monitoring might be required for men starting these drugs, particularly in those with other risk factors for type 2 diabetes.
Journal Article
Infinity wars
What does Infinity hold for the Marvel Universe? As the Infinity Stones come to Earth, so too comes the war for control over them. But none who wield the stones truly understand the power they contain...or comprehend what it would take to bring them to their end! The nature of the cosmos itself hangs in the balance as we learn the answer to the question on everyone's lips: Who is Requiem? The ramifications of this story will be felt throughout Infinity for years to come! As cosmic war begins to rage, Gerry Duggan and Mike Deodato Jr. gaze into the Infinite - and bring the truth to light!
Book
Higher Insulin Resistance and Adiposity in Postmenopausal Women With Breast Cancer Treated With Aromatase Inhibitors
Abstract
Context
Aromatase deficiency causes obesity and insulin resistance in aromatase knockout mice and humans with rare mutations of the aromatase gene (CYP19). Aromatase inhibitors are a commonly prescribed therapy for postmenopausal breast cancer.
Objective
We hypothesized that aromatase inhibitors induce obesity and insulin resistance when used in treatment of breast cancer.
Design
Case-control study.
Setting
University teaching hospital.
Participants
Patients with postmenopausal breast cancer (n = 20) treated with aromatase inhibitors and 20 age-matched control subjects.
Main outcome measures
The primary outcome measure was insulin sensitivity index – Matsuda, derived from a 75-g oral glucose tolerance test. Body composition was assessed by dual energy x-ray absorptiometry and biopsy specimens of subcutaneous adipose tissue obtained for assessment of mRNA transcript levels. Data are reported as mean ± SEM (patients receiving inhibitors vs control group, respectively).
Results
Aromatase inhibitor therapy was associated with significantly lower insulin sensitivity (5.15 ± 0.45 vs 6.80 ± 0.64; P = 0.041), higher peak insulin concentration after oral glucose tolerance test (693.4 ± 78.6 vs 527.6 ± 85.5 pmol/L; P = 0.035), greater percentage of body fat (38.4% ± 1.0% vs 34.6% ± 1.3%; P = 0.026), and higher plasma leptin concentration (23.5 ± 2.8 vs 15.5 ± 2.3 ng/mL; P = 0.035).
Conclusion
Women who received aromatase inhibitors for postmenopausal breast cancer had greater percentage body fat and insulin resistance compared with control subjects with no history of breast cancer.
We demonstrate increased insulin resistance, adiposity, and plasma leptin in patients with breast cancer treated with aromatase inhibitors, compared with control subjects matched for age and body mass index.
Journal Article