bluuebunny/crossref_metadata_2025 huggingface dataset:
CD26 upregulates proliferation and invasion in keloid fibroblasts through an IGF-1-induced PI3K/AKT/mTOR pathway
Authors: Xin Yu , Min Peiru , Xu Heng , Zhang Zheng , Zhang Yan , Zhang Yixin
Published: June 2020

Background

Keloid is a fibrotic dermal disease characterized by an abnormal increase in fibroblast proliferation and invasion. These pathological behaviours may be related to the heterogeneity of keloid fibroblasts (KFs); however, because of a lack of effective biomarkers for KFs it is difficult to study the underlying mechanism. Our previous studies revealed that the expansion of CD26+ KFs was responsible for increased keloid proliferation and invasion capabilities; the intrinsic relationship and mechanism between CD26 and keloid is therefore worthy of further investigation. The aim of this study was to explore molecular mechanisms in the process of CD26 upregulated KFs proliferation and invasion abilities, and provide more evidence for CD26 as an effective biomarker of keloid and a new clinical therapeutic target.

Methods

Flow cytometry was performed to isolate CD26+/CD26− fibroblasts from KFs and normal fibroblasts. To generate stably silenced KFs for CD26 and insulin-like growth factor-1 receptor (IGF-1R), lentiviral particles encoding shRNA targeting CD26 and IGF-1R were used for transfection. Cell proliferations were analysed by cell counting kit-8 assay and 5-ethynyl-2′-deoxyuridine (EdU) incorporation assay. Scratching assay and transwell assay were used to assess cell migration and invasion abilities. To further quantify the regulatory role of CD26 expression in the relevant signalling pathway, RT-qPCR, western blot, ELISA, PI3K activity assay and immunofluorescence were used.

Results

Aberrant expression of CD26 in KFs was proven to be associated with increased proliferation and invasion of KFs. Furthermore, the role of the IGF-1/IGF-1 receptor axis was also studied in CD26 and was found to upregulate KF proliferation and invasion. The PI3K/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) pathway was shown to affect CD26-regulated KF proliferation and invasion by increasing phosphorylation levels of S6 kinase and 4E-binding protein.

Conclusions

CD26 can be the effective biomarker for KFs, and its expression is closely related to proliferation and invasion in keloids through the IGF-1-induced PI3K/AKT/mTOR pathway. This work provides a novel perspective on the pathological mechanisms affecting KFs and therapeutic strategies against keloids.
Configuration models of random hypergraphs
Authors: Chodrow Philip S
Published: June 2020

Many empirical networks are intrinsically polyadic, with interactions occurring within groups of agents of arbitrary size. There are, however, few flexible null models that can support statistical inference in polyadic networks. We define a class of null random hypergraphs that hold constant both the node degree and edge dimension sequences, thereby generalizing the classical dyadic configuration model. We provide a Markov Chain Monte Carlo scheme for sampling from these models and discuss connections and distinctions between our proposed models and previous approaches. We then illustrate the application of these models through a triplet of data-analytic vignettes. We start with two classical topics in network science—triadic clustering and degree-assortativity. In each, we emphasize the importance of randomizing over hypergraph space rather than projected graph space, showing that this choice can dramatically alter both the quantitative and qualitative outcomes of statistical inference. We then define and study the edge intersection profile of a hypergraph as a measure of higher-order correlation between edges, and derive asymptotic approximations for this profile under the stub-labeled null. We close with suggestions for multiple avenues of future work. Taken as a whole, our experiments emphasize the ability of explicit, statistically grounded polyadic modelling to significantly enhance the toolbox of network data science.
Comparing Biological Age Estimates Using Domain-Specific Measures From the Canadian Longitudinal Study on Aging
Authors: Verschoor Chris P , Belsky Daniel W , Ma Jinhui , Cohen Alan A , Griffith Lauren E , Raina Parminder
Published: June 2020

Many studies have shown that estimates of biological age (BA) can predict health-related outcomes in older adults. Often, researchers employ multiple measures belonging to a variety of biological/physiological systems, and assess the validity of BA estimates by how well they approximate chronological age (CA). However, it is not clear whether this is the best approach for judging a BA estimate, or whether certain groups of measures are more informative to this end. Using data from the Canadian Longitudinal Study on Aging, we composed panels of biological measures based on the physiological systems/domains they belong to (blood, organ function, physical/cognitive performance), and also composed a panel of measures that optimized the association of BA with CA. We then compared BA estimates for each according to their association with CA and health-related outcomes, including frailty, multimorbidity, chronic condition domains, disability, and health care utilization. Although BA estimated using all 40 measures (r = 0.74) or our age-optimized panel (r = 0.77) most closely approximated CA, the strength of associations to health-related outcomes was comparable or weaker than that of our panel composed only of physical performance measures (CA r = 0.59). All BA estimates were significantly associated to the outcomes considered, with exception to the neurological and musculoskeletal disease domains, and only varied slightly by sex. In summary, while the approximation of CA is important to consider when estimating BA, the strength of associations to prospective outcomes may be of greater importance. Hence, the context in which BA is estimated should be influenced by an investigator’s specific research goals.
A systematic analysis of protein–carbohydrate interactions in the Protein Data Bank
Authors: Cao Yiwei , Park Sang-Jun , Im Wonpil
Published: June 2020

Protein–carbohydrate interactions underlie essential biological processes. Elucidating the mechanism of protein–carbohydrate recognition is a prerequisite for modeling and optimizing protein–carbohydrate interactions, which will help in discovery of carbohydrate-derived therapeutics. In this work, we present a survey of a curated database consisting of 6,402 protein–carbohydrate complexes in the Protein Data Bank (PDB). We performed an all-against-all comparison of a subset of nonredundant binding sites, and the result indicates that the interaction pattern similarity is not completely relevant to the binding site structural similarity. Investigation of both binding site and ligand promiscuities reveals that the geometry of chemical feature points is more important than local backbone structure in determining protein–carbohydrate interactions. A further analysis on the frequency and geometry of atomic interactions shows that carbohydrate functional groups are not equally involved in binding interactions. Finally, we discuss the usefulness of protein–carbohydrate complexes in the PDB with acknowledgement that the carbohydrates in many structures are incomplete.
‘Sheds for Life’: getting the balance right in delivering health promotion through Sheds in Ireland
Authors: Bergin Niamh , Richardson Noel
Published: June 2020

Men with the poorest health outcomes are, paradoxically, the least likely to access health services or to engage with health promotion interventions. This has focused attention on developing gender-sensitive and strengths-based approaches to engage so-called ‘hard-to-reach’ men. Men’s Sheds (‘Sheds’) are recognized as an alternative space in which to engage older and more marginalized groups of men in health. The aim of this study was to establish key principles that could align the ethos of Sheds with a national health promotion initiative (‘Sheds for Life’; SFL) in terms of methods of engagement, programme content and models of delivery. Qualitative methods incorporating semi-structured interviews, focus groups and observations were conducted with men in Sheds (‘Shedders’; n = 38), oversight/advisory groups (n = 11) and partner organizations (n = 8). The principles of grounded theory were used to inform data collection and analysis. Findings revealed a range of mediating factors in terms of how Shedders engage with or ‘do’ health that were grounded in a recognition of the health-enhancing ‘essence’ of Sheds and in ‘making men’s health men’s business’. Key learnings arising from the process of engaging with Shedders included the importance of investing in relationships, establishing credibility and tailoring SFL programme content and delivery to individual Sheds. In terms of conceptualizing SFL, attention was drawn to the need for a coherent and formalized SFL strategy and ‘rules of engagement’, as well as a robust and sustainable system for implementation. This is the first study that informs a more systematic and formal approach to health promotion in Sheds.
TCF12 haploinsufficiency causes autosomal dominant Kallmann syndrome and reveals network-level interactions between causal loci
Authors: Davis Erica E , Balasubramanian Ravikumar , Kupchinsky Zachary A , Keefe David L , Plummer Lacey , Khan Kamal , Meczekalski Blazej , Heath Karen E , Lopez-Gonzalez Vanesa , Ballesta-Martinez Mary J , Margabanthu Gomathi , Price Susan , Greening James , Brauner Raja , Valenzuela Irene , Cusco Ivon , Fernandez-Alvarez Paula , Wierman Margaret E , Li Taibo , Lage Kasper , Barroso Priscila Sales , Chan Yee-Ming , Crowley William F , Katsanis Nicholas
Published: June 2020

Dysfunction of the gonadotropin-releasing hormone (GnRH) axis causes a range of reproductive phenotypes resulting from defects in the specification, migration and/or function of GnRH neurons. To identify additional molecular components of this system, we initiated a systematic genetic interrogation of families with isolated GnRH deficiency (IGD). Here, we report 13 families (12 autosomal dominant and one autosomal recessive) with an anosmic form of IGD (Kallmann syndrome) with loss-of-function mutations in TCF12, a locus also known to cause syndromic and non-syndromic craniosynostosis. We show that loss of tcf12 in zebrafish larvae perturbs GnRH neuronal patterning with concomitant attenuation of the orthologous expression of tcf3a/b, encoding a binding partner of TCF12, and stub1, a gene that is both mutated in other syndromic forms of IGD and maps to a TCF12 affinity network. Finally, we report that restored STUB1 mRNA rescues loss of tcf12 in vivo. Our data extend the mutational landscape of IGD, highlight the genetic links between craniofacial patterning and GnRH dysfunction and begin to assemble the functional network that regulates the development of the GnRH axis.
Freeness over the diagonal and outliers detection in deformed random matrices with a variance profile
Authors: Bigot Jérémie , Male Camille
Published: June 2020

We study the eigenvalue distribution of a Gaussian unitary ensemble (GUE) matrix with a variance profile that is perturbed by an additive random matrix that may possess spikes. Our approach is guided by Voiculescu’s notion of freeness with amalgamation over the diagonal and by the notion of deterministic equivalent. This allows to derive a fixed point equation to approximate the spectral distribution of certain deformed GUE matrices with a variance profile and to characterize the location of potential outliers in such models in a non-asymptotic setting. We also consider the singular values distribution of a rectangular Gaussian random matrix with a variance profile in a similar setting of additive perturbation. We discuss the application of this approach to the study of low-rank matrix denoising models in the presence of heteroscedastic noise, that is when the amount of variance in the observed data matrix may change from entry to entry. Numerical experiments are used to illustrate our results. Deformed random matrix, Variance profile, Outlier detection, Free probability, Freeness with amalgamation, Operator-valued Stieltjes transform, Gaussian spiked model, Low-rank model. 2000 Math Subject Classification: 62G05, 62H12.
All-Cause and Cardiovascular Disease Mortality Among Breast Cancer Survivors in CLUE II, a Long-Standing Community-Based Cohort
Authors: Ramin Cody , Schaeffer Marcy L , Zheng Zihe , Connor Avonne E , Hoffman-Bolton Judith , Lau Bryan , Visvanathan Kala
Published: June 2020

Background

There is growing evidence that breast cancer survivors have higher cardiovascular disease (CVD) mortality relative to the general population. Information on temporal patterns for all-cause and CVD mortality among breast cancer survivors relative to cancer-free women is limited.

Methods

All-cause and CVD-related mortality were compared in 628 women with breast cancer and 3140 age-matched cancer-free women within CLUE II, a prospective cohort. We calculated adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) using Cox proportional hazards regression for all-cause mortality, and Fine and Gray models for CVD-related mortality to account for competing risks.

Results

Over 25 years of follow-up, 916 deaths occurred (249 CVD related). Breast cancer survivors had an overall higher risk of dying compared with cancer-free women (HR = 1.79, 95% CI = 1.53 to 2.09) irrespective of time since diagnosis, tumor stage, estrogen receptor status, and older age at diagnosis (≥70 years). Risk of death was greatest among older survivors at more than 15 years after diagnosis (HR = 2.69, 95% CI = 1.59 to 4.55). CVD (69.1% ischemic heart disease) was the leading cause of death among cancer-free women and the second among survivors. Survivors had an increase in CVD-related deaths compared with cancer-free women beginning at 8 years after diagnosis (HR = 1.65, 95% CI = 1.00 to 2.73), with the highest risk among older survivors (HR = 2.24, 95% CI = 1.29 to 3.88) and after estrogen receptor-positive disease (HR = 1.85, 95% CI = 1.06 to 3.20).

Conclusions

Breast cancer survivors continue to have an elevated mortality compared with the general population for many years after diagnosis. Preventing cardiac deaths, particularly among older breast cancer patients, could lead to reductions in mortality.
Large-Scale Communication is More Complex and Unpredictable with Automated Bots
Authors: Hilbert Martin , Darmon David
Published: June 2020

Automated communication bots follow deterministic local rules that either respond to programmed instructions or learned patterns. On the microlevel, their automated and reactive behavior makes certain parts of the communication dynamic more predictable. Studying communicative turns in the editing history of Wikipedia, we find that on the macrolevel, the overall emergent communication process becomes both more complex and less predictable. The increased presence of bots is the main explanatory variable for these seemingly contradictory tendencies. In short, individuals introduce bots to make communication more simple and predictable but end up with a large-scale dynamic that is more complex and more uncertain. We explain our results with the information processing nature of complex systems. The article also serves as a showcase for the use of information-theoretic measures from dynamical systems theory to assess changes in communication dynamics provoked by algorithms.
Papillary meningioma: a rare cause of massive supratentorial intracerebral hemorrhage
Authors: Hamilton Preci , Lawrence Peyton , Eisenring Christian Valentin
Published: June 2020

Papillary meningioma (PM) represents a very rare histological subtype, which may present with massive intracerebral hemorrhage. Gross total tumor resection results in a lower recurrence rate and mortality. A 69-year-old man had been experiencing headache for 6 months. After exacerbating right frontal headache, he was brought to the emergency room. His Glasgow Coma Scale (GCS) was 11/15 and he had a left-sided hemiparesis. A computed tomography brain scan revealed a massive right frontal intracerebral hematoma with transtentorial herniation. During right frontal craniotomy and blood clot evacuation, a fleshy, pigmented tissue was encountered. Histopathological findings were consistent with PM World Health Organization Grade III. Complete tumor resection, Simpson II was achieved with a second operation. The hemiparesis and GCS normalized subsequently. The diagnosis of PM relies largely on histopathology and is not commonly encountered preoperatively in emergency cases. Staged surgery in this case resulted in a good outcome.
Unraveling the puzzle of phloem parenchyma transfer cell wall ingrowth
Authors: McCubbin Tyler J , Braun David M
Published: June 2020

This article comments on:

Wei X, Nguyen ST, Collings DA, McCurdy DW. 2020. Sucrose regulates wall ingrowth deposition in phloem parenchyma transfer cells in Arabidopsis via affecting phloem loading activity. Journal of Experimental Botany 71, 4690–4702.
Economic Growth and Economic Development
Authors: Cheng Thomas K
Published: June 2020

This chapter discusses economic growth and economic development. The relationship between growth and development seems to be highly interrelated and share significant overlap. On the one hand, it has been said that economic growth is a necessary condition for development. Growth is essential to poverty reduction. If development is understood as poverty reduction, or at least poverty reduction is taken to be a key component of development, then by extension, growth is a prerequisite for development. On the other hand, it has been argued that growth also depends on development. This is premised on the understanding of development as structural transformation. The argument is that for there to be continuous growth, the economy and society must undergo transformation to become more productive. The chapter then considers how the concepts of economic growth and economic development may relate to competition law enforcement.
Economic Characteristics of Developing Countries
Authors: Cheng Thomas K
Published: June 2020

This chapter highlights the economic characteristics of developing countries. The economy of a developing country may possess characteristics that distinguish it from an industrialized economy, and markets often function differently in developing countries. These characteristics include small, fragmented, and less competitive domestic markets; widespread poverty, which further exacerbates the small size of the domestic market; significant variations in firm productivity; barriers to entrepreneurship; missing institutions and prevalence of market failure; poorly developed financial markets; heavy state presence; prevalence of the informal sector; domination of large business groups; and widespread corruption and state capture. Approaches to competition law enforcement formulated in industrialized economies are based on the economic environment of these countries and do not reflect the circumstances of a developing country economy. The chapter then discusses each economic characteristic one by one, proposing necessary adjustments to competition law doctrines and enforcement approaches.
Cartels and Restrictive Agreements
Authors: Cheng Thomas K
Published: June 2020

This chapter explores how developing countries should approach restrictive agreements under the framework proposed in the previous chapter. Certain things are the same regardless of whether it is an industrialized economy or a developing country. Cartels are generally considered to be the cardinal sin in competition law and should be prohibited in any country. What may need to be adjusted in developing countries, however, is the proof required to establish an agreement from circumstantial evidence. One may even question whether the insistence on an agreement serves any useful purpose for developing countries. As for non-cartel horizontal agreements, it has been suggested that horizontal cooperation agreements may make valuable contributions to productivity growth. Given that productivity growth is one of the main engines of economic growth, developing country authorities may need to adopt a more permissive attitude toward horizontal cooperation agreements. At the same time, further linkages between competitors in already highly concentrated markets may render collusion or price coordination even more likely. Therefore, a compromise will need to be reached between these two conflicting considerations. The chapter also considers vertical agreements.
The 2015 Reform of Arbitration
Authors: Oda Hiroshi
Published: June 2020

This chapter discusses the 2015 Arbitral Reform. The arbitral reform, which started in 2011, culminated in two sets of laws adopted by Parliament and signed by the president on 25 December 2015. The package comprised the Law on Arbitration of the Russian Federation and the Law on the amendments to the Laws in relation to the adoption of the above law. The latter included amendments to the Law on Commercial Court Procedure and the Law on International Commercial Arbitration. On 27 December 2018, the Law on Arbitration was further amended. The power to grant license to perform functions of permanent arbitral institutions was shifted to the Ministry of Justice. One of the fundamental issues which were contested in the process of the reform was whether the existing regime of segregation of international and domestic arbitration should be abandoned altogether or should be maintained. With the strong opposition from experts of international commercial arbitration supported by the Codification Commission and the President’s Administration, the system of two separate laws, that is, the Law on Arbitration and the Law on International Commercial Arbitration, was maintained. However, organisational/institutional aspects of arbitration, including international arbitration, are now regulated by the Law on Arbitration.
Arbitrability of Disputes
Authors: Oda Hiroshi
Published: June 2020

This chapter examines the concept of arbitrability. Arbitrability is about whether a certain category of dispute is eligible for settlement by arbitration or should be reserved for state courts. The 1993 Law on International Commercial Arbitration provided that ‘disputes arising from contractual and other civil law relationships and other types of international economic relations, insofar as one of the parties is outside the country’, fall within the scope of this Law. Meanwhile, the 2002 Law on (domestic) Arbitration provided that any dispute arising from civil law relations could be handled by arbitration, unless otherwise provided by Federal law. Despite such provisions, Russian courts narrowly interpreted the scope of arbitrability. For example, disputes on real property were not arbitrable until the decision of the Constitutional Court in 2011. Since this decision, the focus was on the arbitrability of corporate disputes. The 2015 Reform acknowledged the arbitrability of corporate disputes with some exceptions and requirements. Some judges found a basis for non-arbitrability of certain disputes in the Code of Commercial Court Procedure (APK).
Detriment
Authors: McFarlane Ben
Published: June 2020

This chapter deals with B’s detriment; as this requirement is common to, and treated the same way in, each of the strands, a unified approach is taken. It shows that a proprietary estoppel claim, whether based on A’s acquiescence, representation, or promise, will fail if B cannot show that, were A free to act as A wishes, B would suffer a detriment. Some confusion has, however, been caused by the interaction between proprietary estoppel and other principles that, whilst related to proprietary estoppel, do not contain such a detriment requirement. It is therefore important to distinguish such principles from proprietary estoppel. In addition to this, the chapter also discusses the legal test for detriment.
Unconscionability
Authors: McFarlane Ben
Published: June 2020

This chapter considers whether B separately needs to show unconscionable conduct by A in order to establish a proprietary estoppel. It focuses in particular on A’s conscience. Here, the chapter notes that there is no such independent requirement, but that the concept of unconscionability, in each of two different senses, nonetheless has some role to play in the current law of proprietary estoppel. That role varies between each of the three strands and so they will again be considered separately. In addition, a clear analysis depends on making two important distinctions: first, between two different senses of unconscionability; and secondly, between each of the three different strands of proprietary estoppel set out in the first chapter.
The Extent of the Equity
Authors: McFarlane Ben
Published: June 2020

This chapter considers the impact of B’s claim on A: in relation to each of the acquiescence- and promise-based strands, the nature and extent of A’s liability to B is assessed; the effect of the representation-based strand is simply that A is precluded from denying the existence of a particular state of affairs. Therefore, in analysing the law in this area, it is helpful to keep in mind the distinction between the extent of B’s equity on the one hand and the means of giving effect to that equity on the other. Nonetheless, even when that remedial question is separated out, the law as to the extent of B’s equity is far from clear. Indeed, there are cases in which a court has justified its chosen response to a promise-based proprietary estoppel on the basis that it was the least unsatisfactory of the possible outcomes. The lack of clarity is most noticeable, and most problematic, in the most important of the three forms of proprietary estoppel: the promise-based strand.
The Wider Legal Context
Authors: McFarlane Ben
Published: June 2020

This chapter considers the wider legal context in which proprietary estoppel operates. It therefore considers some of the practical issues (for example, in relation to taxation or the conflict of laws) that may arise when making or defending a proprietary estoppel claim. It is split into three parts. Firstly, the chapter looks at issues that may arise where B brings a proprietary estoppel claim. It then examines alternative claims that may be relevant when a proprietary estoppel claim is brought or contemplated. Finally, the chapter considers possible future developments in the law of proprietary estoppel and presents a case for the expansion of the promise-based strand to promises that are unrelated to land or other property.
International Crimes: Law and Practice
Authors: Mettraux Guénaël
Published: June 2020

The law of international crimes has become increasingly dense over the years, which has rendered the law of international crimes more sophisticated and more complex. This is perhaps most apparent in relation to the law of crimes against humanity. From a single paragraph in Article 6 of the Nuremberg Charter, the law of crimes against humanity has grown into dozens of interacting definitional elements and an extensive body of practice. As part of this development, crimes against humanity have established their own normative identity with a distinctive chapeau or contextual element and a broad range of underlying offences, including discrimination-based crimes, penal translations of what are in effect serious human rights violations, a series of gender-based crimes and a residual offence of ‘other inhuman acts’. The combined effect of a sophisticated body of criminal law, international obligations directed at ensuring accountability and a multiplication of judicial venues competent to adjudicate upon such crimes, carries with it the hope that crimes against humanity could become an effective enforcer of international justice. However, resistance to full and universal accountability for such crimes is still a powerful political reality that undermines the possibility of justice and the institutions that are devoted to it. The present volume hopes to contribute to achieving that goal as the law of crimes against humanity is as important and relevant today as it was when first enforced. As it stands today, that law is a testimony to the efforts of many who have strived to ensure that atrocities should not remain unpunished.
Chapeau or Contextual Elements
Authors: Mettraux Guénaël
Published: June 2020

This chapter addresses the chapeau or contextual elements of crimes against humanity. To constitute a crime against humanity, a crime must be committed in the context of and as part of a widespread or systematic attack against a civilian population. This contextual element is the core distinguishing feature of crimes against humanity. It highlights their collective character and excludes isolated or random criminal acts. It also distinguishes crimes against humanity from ordinary crimes and other categories of international crimes. As a matter of customary international law, the chapeau element of crimes against humanity may be divided into five sub-elements: (i) there must be an ‘attack’; (ii) the attack must be ‘directed against any civilian population’; (iii) the attack must be ‘widespread or systematic’; (iv) there must be a sufficient link or ‘nexus’ between the acts of the accused and the attack; and (v) the accused must have known that there was a widespread or systematic attack directed against a civilian population, and he must have known that his acts formed part of that attack.
Cultural Oppression and Child Sex Trafficking
Authors: Bryant-Davis Thema , Tummala-Narra Pratyusha
Published: June 2020

Child sex trafficking is a global crisis with devastating consequences physically, psychologically, and socially. Psychologically, child sex trafficking survivors often face post-traumatic stress disorder, depression, suicidal ideation, and substance dependence, among other consequences. Children and adolescents from marginalized communities face increased risk of sex trafficking due to intergenerational poverty and trauma, discrimination, objectification, low access to helping professionals, and disparities in responsiveness from judicial and health professionals. Cultural oppression is a historical and contemporary reality that shapes the vulnerability to sex trafficking and the lack of adequate, culturally responsive care services for rescue and restorative processes. This chapter, by psychologists with expertise in the cultural context of trauma recovery, provides an overview of sex trafficking, the ways in which cultural oppression intersects with this trauma, and recommendations for combating this pervasive human rights violation.
Juvenile Dependency Court
Authors: Cleveland Kyndra C. , Quas Jodi A.
Published: June 2020

The juvenile dependency court is designed to ensure children’s safety and best interests, primarily by providing services to families and reunifying children and parents, when possible. However, the dependency system’s informal and discretionary policies may perpetuate racial disproportionality and contribute to disparity. Historically, the system perpetuated bias by exerting control over poor and minority, particularly Black, families. Remnants of this past are still seen today in the disproportionate number of low-income and minority families involved in the system. Key to understanding this disparity and identifying interventions is greater knowledge about dependency professionals’ decision-making and better understanding of parents’ experiences, which are crucial to courts’ decisions. This chapter describes important differences in minority parents’ understanding of dependency cases, which may impact their perceptions of justice, engagement, and case outcomes. Implications of these differences and recommendations for improving juvenile dependency practice and policy for all parents, especially low-income and minority parents, are also discussed.
Empowering Yourself to Support Your Teen and Prevent Depression and Anxiety
Authors: Landau Carol
Published: June 2020

This chapter contends that parents have the power to support their children and to prevent depression and anxiety in college students. Depression in college is a mental health crisis as well as a major impediment to learning. Current prevalence of major depression in college is 13.6% and much higher in female students, over 30%. The rate of all of anxiety disorders is 31.9%. The chapter introduces the three types of prevention of depression and anxiety. Primary prevention involves changing social factors to reduce the occurrence. Secondary prevention involves early detection of the symptoms of depression to prevent a full-blown psychiatric disorder. Tertiary prevention involves adequate treatment in order to prevent relapse. The chapter introduces the book’s goals of creating a strong foundation for adolescents, changing vulnerabilities to depression, and describing the challenges of college life and how to cope with them.
Traveling Companions
Authors: Landau Carol
Published: June 2020

This chapter provides a review of adolescent depression and anxiety. The range and severity of depression are described, from symptoms to depressive episodes and mood disorders. The chapter presents a case of a student with major depressive episode, and one with persistent depressive disorder. Conditions that are comorbid with depression are identified, including attention deficit and especially the anxiety disorders. Adolescence can be seen as a developmental vulnerability to depression and anxiety owing to multiple changes and the ongoing growth process of the structures in the brain. The biological, psychological, and social vulnerabilities are examined. Psychological vulnerabilities include rumination and cognitive distortions; social vulnerabilities involve social isolation and harassment. Biological vulnerabilities include genetics, lower levels of neurotransmitters, and comorbidity of medical illnesses. The chapter also examines cultural differences in seeking mental health treatment. Surveys of students identify one major pressure that negatively affects their mental health––the extreme emphasis on application to elite colleges. Parents and educators can help reduce these stresses by adopting a more individualized and less pressured approach to the college application process.
“I Got This!”
Authors: Landau Carol
Published: June 2020

This chapter discusses the role of self-efficacy and confidence as foundations for student success and well-being. Based on the work of Albert Bandura and social learning theory, the goal is for individuals to feel that they are able to identify and solve problems on their own. Low self-efficacy can lead to depression because a lack of control causes disappointment and pessimism. Academic self-efficacy is identified as one of the factors that is necessary for a positive college experience. A case of a student with limited social self-efficacy is examined, with suggestions of how parents can help, including how to give accurate and optimistic feedback based on strengths and weaknesses. There is also a section on how bias and stereotyping undercut the feeling of self-efficacy and how parents can encourage their teens to push back and not internalize these prejudices.
Can We Change the Culture to Promote Psychological Health?
Authors: Landau Carol
Published: June 2020

All of the issues in this book take place in the context of a competitive, overly individualistic environment. Many educators and journalists have suggested that this is stressful to students. A study of stress in in the United States confirms that students view college application stress as detrimental to their mental health. This chapter suggests that it is incumbent upon parents and educators to lead the way in reducing the pressure, to focus more on collaboration and less on competition and individual achievement. At the same time, we need to reduce the stigma of psychological problems in order to be more humane and to encourage young people to get help when they need it.
Can Health Be Measured?
Authors: Hausman Daniel M.
Published: June 2020

This essay is concerned with conceptualizing the measurement of overall health. Its conclusion—that the measurement of health consists in assigning a value to health rather than in measuring some quantity or magnitude of health—challenges some of the claims made in the 2010 Global Burden of Disease Study (Salomon et al. 2012). The arguments here are drawn from the author’s book, Valuing Health: Well-Being, Freedom, and Suffering (Hausman 2015) and in several cases are developed further there. After saying a few words about why health needs to be measured or valued, what health is, and what measurement requires, the chapter argues that health is not measurable, because the relation “is at least as healthy as” is massively incomplete. The author also argues that even though the value of health is measurable, health itself cannot be measured indirectly by its value.
Healthy Nails versus Long Lives
Authors: Voorhoeve Alex
Published: June 2020

How should governments balance saving people from very large individual disease burdens (such as an early death) against saving them from middling burdens (such as erectile dysfunction) and minor burdens (such as nail fungus)? This chapter considers this question through an analysis of a priority-setting proposal in the Netherlands, on which avoiding a multitude of middling burdens takes priority over saving one person from early death, but no number of very small burdens can take priority over avoiding one death. It argues that there is some, albeit imperfect, evidence of substantial public support for such a policy. Furthermore, it provides a principled rationale for it in terms of respect for the person who faces the largest burden. However, it also argues that the threshold for what counts as a minor burden should be set substantially lower than in the Dutch proposal.
The Global Health Impact Index
Authors: Hassoun Nicole
Published: June 2020

There are many multi-attribute indicators of countries’ levels of wealth, poverty, inequality, and development. Some of these indicators, such as the Human Development Index, consider aspects of population health. This chapter presents the first multi-attribute indicator comparing the impact of key drugs on poor health across the world: the Global Health Impact (GHI) index. It evaluates the impact of key drugs on malaria, tuberculosis, HIV/AIDS, and several neglected tropical diseases in every country in the world. The chapter includes a discussion of possible future directions for research and ends with a discussion of the GHI index and numerous questions that remain regarding its methodology and implementation.
Eye Signs, Syndromes, and Reviews and Opinions
Authors: Caplan Louis R.
Published: June 2020

Abstract: This chapter discusses Fisher’s contributions in regard to abnormalities of visual perception, eye appearance, and eye movements (“eye signs”) and also new syndromes, especially the Miller Fisher variant of Guillain–Barré syndrome. Much of human brain activity relates to visual perception and exploration of the visual environment—looking and seeing. Many of Fisher’s observations during his lifetime were related to the appearance of eye structures, loss of vision, abnormal visual phenomena, and movements of the eyes, qualifying him as one of the first neuro-ophthalmologists. Fisher also described a number of new syndromes and condition. In addition, he urged neurologists to engage in self-observation.
Symptomatic Cystic Lesion Following Deep Brain Stimulation Surgery
Authors: Sharma Vibhash D. , Chitnis Shilpa
Published: June 2020

Deep brain stimulation therapy is an effective therapy for selected patients with movement disorders. The procedure is relatively safe, but complications related to the surgical procedure or implanted hardware can occur. The common complications include hemorrhage, infarct, infection, and confusion. Noninfectious cyst formation around the DBS lead is a rare but potential complication of this procedure, which can occur several weeks to months after DBS lead implantation. This chapter describes a case of noninfectious cyst formation at the tip of DBS lead in a patient with essential tremor. Clinical presentation, role of imaging, and the management options for this rare complication are discussed. This case also illustrates the importance of post-DBS imaging in suspected cases with new or unexplained symptoms.
Issues to Consider When Mild Cognitive Impairment Is Revealed in Preoperative Screening
Authors: Kola Sushma , Hassan Anhar
Published: June 2020

A 72-year-old man with Parkinson disease of 7 years duration, multifactorial gait disorder, and minor memory complaints underwent deep brain stimulation (DBS) evaluation to treat motor fluctuations and dyskinesia. Neuropsychometric evaluation revealed multidomain mild cognitive impairment, which was stable to improved on repeat testing 6 months later. He underwent bilateral subthalamic nucleus DBS with improvement in dyskinesia, and residual motor fluctuations were medically managed. He denied postoperative cognitive changes, although repeat neuropsychometric evaluation 9 months later showed decline in cognition. The patient moved to an assisted living facility shortly afterward because of progressive gait disability. One year later, he developed florid Parkinson disease psychosis, with partial improvement after cessation of entacapone. We discuss the rationale for the assessment of mild cognitive impairment before DBS, DBS target selection, risk factors associated with postoperative cognitive decline, and strategies to minimize this.
Deactivation of One Subthalamic Nucleus Deep Brain Stimulation Device to Address Brittle Ipsilateral Dyskinesia in a Patient With Tremor-Dominant Parkinson Disease
Authors: Kroth Julia , Schneider Susanne , Groppa Sergiu
Published: June 2020

A 78-year-old right-handed woman with a 10-year history of tremor-dominant Parkinson disease (PD) was recommended for bilateral deep brain stimulation (DBS) in the subthalamic nucleus (STN). The patient was implanted with bilateral omnidirectional STN DBS electrodes after intraoperative microelectrode recordings and intraoperative test stimulation. Immediately after implantation, the motor symptoms improved considerably, but 3 to 4 weeks later, a debilitating left-sided resting tremor re-emerged. Personalized programming at the right STN ameliorated the tremor, while painful dyskinesia and hemiballism of the ipsilateral right side of the body developed subsequently over the next few days. Adapting the stimulation parameters and the dopaminergic medication improved these symptoms only marginally. After turning off the left STN electrode, the dyskinesia and hemiballism disappeared completely. In the following weeks, the amperage of the right STN electrode was increased gradually to control the left-sided resting tremor. This was possible without the development of ipsilateral hyperkinesia. During the off phases of stimulation, a considerable direct improvement of hyperkinesia was noted, and the decision to turn off the left STN electrode was ultimately made.
Management of Brittle Dyskinesia and Dopamine Dysregulation Syndrome in Subthalamic Deep Brain Stimulation
Authors: Siddiqui Junaid , Mehanna Raja , Bajwa Jawad A.
Published: June 2020

Deep brain stimulation (DBS) is the most commonly performed interventional therapy for advanced Parkinson disease (PD). Subthalamic nucleus (STN) is the most common target for DBS implantation. It is established that STN microlesion effect can result in dyskinesia, usually indicating a good lead placement. At times, this dyskinesia may be severe and prolonged, and it may be exaggerated with DBS adjustments and with slight increase in dopaminergic therapy, which may require antidyskinetic medications temporarily to manage it. This is called brittle dyskinesia. It is important to be aware of this phenomenon for optimal management of this condition because this may result in significant morbidity despite proper lead placement and DBS programming. Also during DBS programming, high pulse width can adversely affect speech and gait. This chapter presents a case with brittle dyskinesia and speech impairment while discussing technical troubleshooting and clinical management.
Globus Pallidus Interna Stimulation–Induced Gait Disturbance and Management by Reprogramming
Authors: Vijayakumar Dhanya , Jimenez-Shahed Joohi
Published: June 2020

In this case report, a patient with bilateral globus pallidus interna (GPi) deep brain stimulation (DBS) for treatment of Parkinson disease (PD) develops new onset of gait freezing following an implantable pulse generator exchange despite stable medication doses and unchanged stimulator settings. Lack of response to usual interventions prompted discontinuation of stimulation, yielding marked resolution of gait freezing followed by return of parkinsonism. The patient’s symptoms of new gait freezing resolved after a reprogramming strategy that reduced the total electrical energy delivered (TEED). This case demonstrates that similar to stimulation-induced gait difficulties that are well-recognized in DBS of the subthalamic nucleus in PD, GPi-induced gait disturbances can also occur and can be managed in a similar fashion.
Fibrous Scarring and Deep Brain Stimulation Lead Implantation
Authors: Vedam-Mai Vinata , Yachnis Anthony T. , Ullman Michael , Javedan Saman P. , Okun Michael S.
Published: June 2020

Deep brain stimulation (DBS) has emerged in recent years as a powerful surgical modality for the treatment of several movement disorders as well as neuropsychiatric syndromes. Despite its clinical efficacy, the mode of action of DBS and the cellular responses to this therapy remain unclear. This chapter presents an unusual case from the DBS Brain Tissue Network at the University of Florida of prominent tissue response to DBS. The patient was a 74-year-old man with idiopathic Parkinson disease, status post bilateral STN DBS leads. Neuropathologic examination of the tissue surrounding the distal lead tip of the right DBS using immunohistochemistry revealed a dense, collagen-filled fibrous sheath. There was no intraoperative bleeding during the procedure, and this finding was confirmed by postoperative imaging. Further, there was no perioperative decline in this patient’s condition. It is likely that the fibrous capsule resulted in less than optimal clinical benefit, which was previously reported in this patient. This severe type of exaggerated tissue response to DBS leads has not been observed in other cases in our Brain Bank network and has not been reported previously in the literature, to our knowledge.
Cerebral Venous Infarction After Deep Brain Stimulation Surgery
Authors: Sendjaja Andi Nugraha , Morishita Takashi , Inoue Tooru
Published: June 2020

Venous infarction is an important adverse event potentially encountered in the practice of deep brain stimulation (DBS). This adverse event is considered to result from damage to the cortical vein during surgery and is noted on postoperative day 1 or 2 owing to neurologic symptoms such as confusion and headache. The imaging findings are characterized by edema surrounding the trajectory of the DBS lead and flame-shaped hemorrhage in some cases. Venous infarction can be managed conservatively with careful observation, and the prognosis is usually benign. The neurologic condition of patients can in many cases return to baseline after days to weeks, as observed in this case. The prognostic information is valuable for reassuring afflicted patients and their families.