bluuebunny/crossref_metadata_2025 huggingface dataset:
En busca de una Pacto Tributario para el desarrollo del país
Authors: Borges Humberto , Optiz Christian
Published: May 2023

El presente artículo se encuentra dividido en dos partes, la primera se centra en la participación del profesor (DGT) y abogado Christian Optiz en los Diálogos por un Pacto Tributario 2023 y luego se analiza por Humberto Borges, director del Diplomado en Gestión Tributaria los principales puntos que se deben abordar en una próxima reforma tributaria. Continuar leyendo...
Oncogenic Transformation Drives DNA Methylation Loss and Transcriptional Activation at Transposable Element Loci
Authors: Kanholm Tomas , Rentia Uzma , Hadley Melissa , Karlow Jennifer A. , Cox Olivia L. , Diab Noor , Bendall Matthew L. , Dawson Tyson , McDonald James I. , Xie Wenbing , Crandall Keith A. , Burns Kathleen H. , Baylin Stephen B. , Easwaran Hari , Chiappinelli Katherine B.
Published: May 2023

Transposable elements (TE) are typically silenced by DNA methylation and repressive histone modifications in differentiated healthy human tissues. However, TE expression increases in a wide range of cancers and is correlated with global hypomethylation of cancer genomes. We assessed expression and DNA methylation of TEs in fibroblast cells that were serially transduced with hTERT, SV40, and HRASR24C to immortalize and then transform them, modeling the different steps of the tumorigenesis process. RNA sequencing and whole-genome bisulfite sequencing were performed at each stage of transformation. TE expression significantly increased as cells progressed through transformation, with the largest increase in expression after the final stage of transformation, consistent with data from human tumors. The upregulated TEs were dominated by endogenous retroviruses [long terminal repeats (LTR)]. Most differentially methylated regions (DMR) in all stages were hypomethylated, with the greatest hypomethylation in the final stage of transformation. A majority of the DMRs overlapped TEs from the RepeatMasker database, indicating that TEs are preferentially demethylated. Many hypomethylated TEs displayed a concordant increase in expression. Demethylation began during immortalization and continued into transformation, while upregulation of TE transcription occurred in transformation. Numerous LTR elements upregulated in the model were also identified in The Cancer Genome Atlas datasets of breast, colon, and prostate cancer. Overall, these findings indicate that TEs, specifically endogenous retroviruses, are demethylated and transcribed during transformation.

Significance:

Analysis of epigenetic and transcriptional changes in a transformation model reveals that transposable element expression and methylation are dysregulated during oncogenic transformation.
An Old Dog Has a New Trick: Somatic Exonic Deletions inRUNX1Are Frequent in AML
Authors: Chakraborty Joyeeta , Stengel Kristy R.
Published: May 2023

Somatic loss-of-function RUNX1 mutations in acute myeloid leukemia (AML) include missense, nonsense, and frameshift mutations, whereas germline RUNX1 variants in RUNX1-FPDMM also include large exonic deletions. Alternative variant detection approaches revealed that large exonic deletions in RUNX1 are also common in sporadic AML, which has implications for patient stratification and therapeutic decision-making.

See related article by Eriksson et al., p. 2826
O discurso heterossexista no “romance homossexual” latino-americano
Authors: Gómez Sánchez Darío
Published: May 2023

Nas linhas seguintes propõe-se uma análise comparativa de um conjunto de romances latino-americanos protagonizados por personagens homossexuais e publicados ao longo do século XX. O artigo se ocupa em demonstrar que esses relatos reproduzem a dicotomia heterossexualidade-homossexualidade e, em consequência, o discurso que considera inferiores ou anormais as relações sexuais entre homens. Na análise, destacam-se algumas constantes narrativas que contribuem para essa reprodução, tais como a recorrência de estereótipos referentes à masculinidade e à feminidade, o egocentrismo das personagens homossexuais e a ausência de questionamento da discriminação institucional. Conclui-se que, nessas narrações, são representados os mecanismos de exclusão e discriminação da homossexualidade, e com eles o heterossexismo e a homofobia.
Enunciar desde los márgenes. Sentidos de la palabra voz en discursos desde la prostitución y el trabajo sexual en Argentina (2007-2021)
Authors: Caballero Felipa Mabel
Published: May 2023

Este trabajo analiza, desde la teoría materialista del discurso (Pêcheux, [1975] 2016), los sentidos de la palabra voz en discursos producidos por quienes transitan o han transitado la prostitución y el trabajo sexual. El objetivo consiste en analizar el problema de la voz y diversos tipos de reflexiones que se inscriben, a su vez, en la ubicuidad y transversalidad general que adquirieron los debates o disputas por el lenguaje en los feminismos, teorías de género(s) y sexualidad(es) en las últimas décadas (Glozman, 2020). La hipótesis está fundada en la idea de que la comprensión de la experiencia (Trebisacce, 2016) y de las propias voces (Caballero, 2022), marcan en estos discursos, una delimitación de la palabra propia y un lugar enunciativo legítimo en el decir. Plantea metodológicamente la estructuración de series discursivas para el análisis de las relaciones interdiscursivas que muestra la polisemia de sentidos y tensiones que presenta una misma palabra o una misma expresión.
A regulação da linguagem neutra: uma análise discursiva de leis e projetos do Brasil e da Argentina
Authors: Noronha Raquel
Published: May 2023

A partir de uma concepção materialista da linguagem, apoiando-nos teórica e metodologicamente na Análise de Discurso, pretendemos analisar dois projetos de lei propostos no Brasil (5198/2020 e 5.248/2020), uma lei em vigor na Argentina (RESFC-2020-900-APN-DI#INAES) e um projeto de lei que visam regular o uso do que se tem chamado de linguagem neutra ou linguagem inclusiva. Para tanto, trabalharemos com o funcionamento jurídico de leis e projetos, considerando o efeito de segregação (Orlandi, 2003) produzido por eles. Objetivamos compreender os efeitos, sobretudo, dos processos de interdição de uma enunciação já em uso. Consideramos que apesar de algumas dessas regulações assumirem que o uso da linguagem neutra/inclusiva poderia trazer problemas de “comunicação”, ao legislarem ou desejarem legislar sobre seu uso, não apenas reconhecem sua existência como também se legitima, de certa forma, seu uso, como algo potencialmente transformador a ponto de ser necessário o uso da lei para detê-lo.
“Devenir-travesti” o la resistencia de las “locas”: la prototeoría queer de Néstor Perlongher ante el advenir de las identidades LGBT+
Authors: Reyes García Samy
Published: May 2023

Partiendo de la lectura de Néstor Perlongher de los exponentes de la filosofía nacida de Mayo del 68, trataremos de dar cuenta cómo su pensamiento teórico propone postulados posidentitarios de la sexualidad, siendo el travesti o “la loca” los sujetos específicos para expresar esta postura. Bajo este análisis seremos capaces de mostrar cómo los análisis de Perlongher pueden ser considerados “prototeoría queer” latinoamericana. De tal suerte, el pensamiento de Perlongher se inserta en los postulados de Gilles Deleuze y Félix Guattari quienes proponen el devenir como la alternativa necesaria ante cualquier totalitarismo identitario que las sexualidades y los regímenes de signos producen. Nuestro objetivo es recuperar el pensamiento de Perlongher como un pivote olvidado de las teorías queer latinoamericanas que nos permite comprender el modo en que las identidades sexuales son un riesgo totalitarista, así como alternativas para escapar a esta situación.
Mirar de cerca el horror. Los ejércitos de Evelio Rosero y Laberinto de Eduardo Antonio Parra
Authors: Oliver Felipe
Published: May 2023

Las novelas Los ejércitos (2007) del colombiano Evelio Rosero y Laberinto (2019) del mexicano Eduardo Antonio Parra narran la devastación de toda una comunidad a manos de grupos armados vinculados con el crimen organizado.  Desde la mirada de un profesor escolar, ambas obras revelan la indefensión de la población civil ante la violencia aparatosa e insensible que se cierne sobre ellos. Este trabajo analiza desde la mirada la representación de la violencia presente en ambas novelas. ¿Cómo o de qué manera la acción de mirar vulnera implica y expone a los testigos de la masacre? ¿Cuál es el valor o la funcionalidad del maestro escolar como testigo privilegiado de la destrucción de la comunidad?
Role of Family Risk and of Pre-Reading Auditory and Neurostructural Measures in Predicting Reading Outcome
Authors: Blockmans Lauren , Golestani Narly , Dalboni da Rocha Josué Luiz , Wouters Jan , Ghesquière Pol , Vandermosten Maaike
Published: May 2023

Some children who develop dyslexia show pre-reading auditory and speech processing difficulties. Furthermore, left auditory cortex structure might be related to family risk for dyslexia rather than to reading outcome. However, it remains unclear to what extent auditory and speech processing and auditory cortex structure mediate the relationship between family risk and reading. In the current longitudinal study, we investigated the role of family risk (measured using parental reading questionnaires) and of pre-reading auditory measures in predicting third grade word reading. We measured auditory and speech processing in 162 pre-readers varying in family risk. In 129 of them, we also acquired structural magnetic resonance imaging (MRI). We quantified surface area and duplication patterns of the bilateral transverse temporal gyri (TTG(s)), and surface area of the bilateral planum temporale (PT). We found effects of pre-reading auditory and speech processing, surface area of the left first TTG and of bilateral PT and of left TTG duplication pattern on later reading. Higher pre-reading values on these measures were predictive of better word reading. Although we also found some evidence for an effect of family risk on auditory and speech processing, these latter measures did not mediate the strong relationship between family risk and later reading. Our study shows the importance of pre-reading auditory and speech processing and of auditory cortex anatomy for later reading. A better understanding of such interrelations during reading development will facilitate early diagnosis and intervention, which can be especially important given the continuity of family risk in the general population.
Resourcing a Technological Portfolio: How Fairtown Hospital Preserved Results While Degrading Its Older Surgical Robot
Authors: Beane Matthew
Published: May 2023

Here I theorize about a common challenge that research on technology and organizing has not yet considered: how organizations preserve results given the challenges of managing increasingly heterogeneous technological portfolios. I do so via a study of how a top-tier hospital allocated scarce resources across two surgical robots. After acquiring its second robot, the hospital divided resources between the older and newer robots to build its surgical capacity: it allocated the best available infrastructure to the new robot, and it prioritized assigning inexperienced talent to the new technology to facilitate use and skill development. The hospital then adjusted its resources to build on initial successes, committing both the best available maintenance and more-complex surgical cases to the newer robot. These dynamics inadvertently degraded the older robot, making it increasingly difficult to use. In response, more-experienced surgeons and staff made do with the degrading system: they developed and mastered workarounds, and they developed a venting cycle with management. Their actions reduced concerns about the older technology and stabilized the situation for the hospital, such that for years this portfolio resourcing process facilitated satisfactory outcomes on organizational goals such as growth, new capability, and patient care. But by shunting scarce resources away from the older technology, this process also stressed the experienced talent (even as it built their resilience) and limited exploration of changes that could benefit the hospital.
Impact of HAT2CH2 Score on the Development of No-Reflow Phenomenon in Patients With ST-Segment Elevation Myocardial Infarction
Authors: Harbalıoğlu Hazar , Genç Ömer , Alıcı Gökhan , Quisi Alaa , Yıldırım Abdullah
Published: May 2023

The HAT2CH2 score [Hypertension (1 point), Age > 75 years (1 point), Stroke/Transient ischemic attack (2 points), Chronic obstructive pulmonary disease (1 point), and Heart failure (2 points)] was originally developed to predict the occurrence of new-onset atrial fibrillation. The aim of the present study was to examine whether this score could predict the development of no-reflow phenomenon (NR) in ST-segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (pPCI). Patients (n = 1552) with STEMI were consecutively enrolled in this single-center retrospective study. The SYNTAX score (SXscore) and HAT2CH2 score were calculated. The presence of thrombolysis in myocardial infarction (TIMI) score ≤2, without significant residual stenosis and mechanical obstruction, indicated the presence of NR. The HAT2CH2 score was significantly higher in the NR (+) group compared with the NR (−) group [2.29 ± 1.43 vs 1.46 ± 1.24, p < .001]. In multivariable logistic regression analysis, the HAT2CH2 score [OR = 1.585, p < .001] and SXscore [OR = 1.028, p = .017] were found to be independent predictors of NR. Receiver operating characteristic curve analysis showed that the HAT2CH2 score with a cutoff value of >2 determined NR, with 50.2% sensitivity and 79.4% specificity (AUC = .669, p < .001). In conclusion, the HAT2CH2 score may facilitate risk stratification in estimating NR in STEMI patients undergoing pPCI.
Stronger Challengers can Cause More (or Less) Conflict and Institutional Reform
Authors: Little Andrew T. , Paine Jack
Published: May 2023

Prominent theories propose that commitment problems drive phenomena such as war and democratization. However, existing work disagrees about a basic question: how does a challenger’s coercive strength affect prospects for conflict and/or institutional reform? We establish that the relationship depends on how challenger strength affects the average and maximum probability of winning a conflict in a given period (“threat”). We analyze a formal model with a general distribution of threats, and conceptualize challenger strength as affecting this distribution. If the maximum threat is fixed and stronger challengers pose a higher average threat, then weak challengers will rebel (absent reform) during the rare periods they pose a high threat. However, if stronger challengers pose a greater maximum threat, then they are harder to buy off. Applying these insights advances theoretical and empirical debates about democratization.
Moving beyond the sanctuary paradigm: Canada must face up to the reality of a contested and dangerous space environment
Authors: Perron Patrick
Published: May 2023

This article outlines historical shifts in US and Canadian space policies using the sanctuary-contested policy framework. It highlights how sanctuary policies were born out of necessity rather than the pursuit of a peaceful global commons; they were never intended to, and did not, prevent the militarization and weaponization of space. The paper then describes challenges to global space governance and argues that diplomacy will not prevent conflicts in space. After introducing elements of deterrence theory, this paper concludes that Canada should move beyond the sanctuary ideology, make space a national whole-of-government issue, and align its space policy and strategy with allies and partners, credibly communicating Canada's resolve to protect and defend space assets. It further recommends that Canada develop niche capabilities that contribute to more effective national and collective deterrence and defence in space. Those capabilities should build upon existing niche strengths, not create space debris, and leverage industrial innovation in space.
Mirror, Mirror Outside My Wall: Reflexive Impacts of Insider/Outsider Collaborative Inquiry on the Insider Researcher
Authors: McKenzie Jane , Bartunek Jean
Published: May 2023

Based to a considerable extent on Margaret Archer’s approach to reflexive agency, we discuss a multi-year insider/outsider research collaboration that has taken place in a University-based Centre designed to bring academics and management practitioners together to conduct applied research and learn from each other. We focus in particular on the experiences of the insider researcher, showing how, based on her reflexive practice, the collaboration has led to both scholarly contributions and changes in practice in the Centre and her University. In doing so, we flesh out the importance of reflexivity and its important impacts on academic-practitioner collaborations. In long-term insider/outsider collaborations that provide psychologically safe places, outsider researchers can metaphorically hold a mirror up to insider researchers that foster their reflexivity and its subsequent impacts.
Effects of nanosecond laser ablation parameters on surface modification of carbon fiber reinforced polymer composites
Authors: İplikçi Hande , Barisik Murat , Türkdoğan Ceren , Martin Seçkin , Yeke Melisa , Nuhoğlu Kaan , Esenoğlu Gözde , Tanoğlu Metin , Aktaş Engin , Dehneliler Serkan , İriş Mehmet Erdem
Published: May 2023

Removal of contaminants and top polymer layer from the surface of carbon-fiber-reinforced polymer (CFRP) composites is critical for high-quality adhesive-joining with direct bonding to the reinforcing fiber constituents. Surface treatment with a laser beam provides selective removal of the polymer matrix without damaging the fibers and increasing the wettability. However, inhomogeneous thermal properties of CFRP make control of laser ablation difficult as the laser energy absorbed by the carbon fibers is converted into heat and transmitted through the fiber structures during the laser operation. In this study, the effect of scanning speed and laser power on nanosecond laser surface treatment was characterized by scanning electron microscope images and wetting angle measurements. Low scanning speeds allowed laser energy to be conducted as thermal energy through the fibers, which resulted in less epoxy matrix removal and substantial thermal damage. Low laser power partially degraded the epoxy the surface while the high power damaged the carbon fibers. For the studied CFRP specimens consisting of unidirectional [45/0/−45/90]2s stacking of carbon/epoxy prepregs (HexPly®-M91), 100 mJ/mm2 generated by 10 m/s scanning speed and 30 W power appeared as optimum processing parameters for the complete removal of epoxy matrix from the top surface with mostly undamaged carbon fibers and super hydrophilic surface condition.
Performance analysis of recycled carbon fiber under recycling process parameters optimized using response surface methodology
Authors: Cheng Huanbo , Wang Huafeng , Zhou Jinhu , Guo Lijun , Wang Qingze , Tang Mingxi
Published: May 2023

The recycling of high-performance carbon fiber from carbon fiber-reinforced polymer (CFRP) wastes have great economic value and environmental significance. Based on the principle of thermally activated oxide semiconductors, the resin matrix decomposition of process model was established by response surface methodology (RSM). The morphology, elements, functional groups and mechanical properties of recycled carbon fiber were investigated. The results indicated that the degradation was positively correlated with time and temperature, and the degree of influence was significant, the effect of O2 flow rate and concentration were not significant. The influence of process parameters on resin decomposition was as follows shown: temperature > time > O2 concentration > O2 flow rate. The actual degradation was 96.12 wt.% under temperature of 520°C, time of 23 min, O2 concentration of 80% and flow rate of 180 mL/min. The recycled carbon fiber (rCF) was compared with the original carbon fiber the surface roughness of rCF was increased, and without carbon deposition on the surface. The content of C element and C–C bond on the surface of rCF were significantly increased, and functional group of COOH was produced. The tensile strength of rCF was maintained above 99%, the Young’s modulus was maintained at 92%, and the interfacial shear strength was maintained at 85%.
“Just the Facts Ma’am”: Moral and Ethical Considerations for Artificial Intelligence in Medicine and its Potential to Impact Patient Autonomy and Hope
Authors: Love Charles S.
Published: May 2023

Applying machine-based learning and synthetic cognition, commonly referred to as artificial intelligence (AI), to medicine intimates prescient knowledge. The ability of these algorithms to potentially unlock secrets held within vast data sets makes them invaluable to healthcare. Complex computer algorithms are routinely used to enhance diagnoses in fields like oncology, cardiology, and neurology. These algorithms have found utility in making healthcare decisions that are often complicated by seemingly endless relationships between exogenous and endogenous variables. They have also found utility in the allocation of limited healthcare resources and the management of end-of-life issues. With the increase in computing power and the ability to test a virtually unlimited number of relationships, scientists and engineers have the unprecedented ability to increase the prognostic confidence that comes from complex data analysis. While these systems present exciting opportunities for the democratization and precision of healthcare, their use raises important moral and ethical considerations around Christian concepts of autonomy and hope. The purpose of this essay is to explore some of the practical limitations associated with AI in medicine and discuss some of the potential theological implications that machine-generated diagnoses may present. Specifically, this article examines how these systems may disrupt the patient and healthcare provider relationship emblematic of Christ's healing mission. Finally, this article seeks to offer insights that might help in the development of a more robust ethical framework for the application of these systems in the future.
Immunity of shunt active power filter based on improved LADRC
Authors: Yin Yupeng
Published: May 2023

To improve the dynamic response speed and performance of active power filter controller, and improve the robustness, tracking ability, and disturbance rejection ability of linear active disturbance rejection controller (ADRC), an improved linear ADRC (LADRC) is proposed. First, a new error adjustment total disturbance is introduced into the linear expansion state observer to adjust the total disturbance of the linear expansion state observer. Then, on the premise of system stability, the controller is applied to the voltage outer loop of shunt active power filter (SAPF), and the mathematical model of active power filter is deduced, and it is controlled according to the first-order linear active disturbance rejection controller. Finally, through frequency domain analysis, the stability, noise immunity, and tracking performance of the improved LADRC are analyzed. Using MATLAB and Simulink simulation platform, the current stability and tracking performance of SAPF under improved LADRC control are simulated and verified, and compared with traditional methods. The simulation results show that the waveform fluctuation of A-phase voltage on the grid side of this method is relatively smooth, and the voltage on the grid side is always kept at ±50 V; the voltage curve of SAPF DC side is kept between the actual set values, about 820 V; the waveform fluctuation of A-phase current on the load side is small, which is ±220 A; the harmonic distortion rate is 4%. It is verified that this method has good tracking effect and anti-interference characteristics, which is of great significance to improve the control performance of active power filter.
Dynamic event-triggered predictive control for DoS attacks-based discrete-time networked linear systems
Authors: Yu Yang , Ding Sanbo
Published: May 2023

This paper studies a novel method of the dynamic event-triggered mechanisms and the predictive control scheme for discrete-time networked linear systems subject to network delays and DoS attacks in both sensor-to-controller ([Formula: see text]) and controller-to-actuator ([Formula: see text]) channels. First, by assuming maximum allowable duration of DoS attacks, predictive control scheme is used to proactively offset the adverse impacts of communication constraints. Second, to further save communication resources, dynamic event-triggered mechanisms are configured on sensor and controller sides, respectively. Next, sufficient condition is derived for discrete-time networked linear systems under predictive control and dynamic event-triggered mechanisms, which guarantees the resulting closed-loop system’s asymptotical stability. Finally, a simulation example is used to confirm the availability and applicability of the proposed method.
“I am a Lonely Bird:” Psalm 102 and the Psychology of Loneliness
Authors: Hildebrandt Samuel
Published: May 2023

Already an urgent issue before the Covid-19 pandemic, the reality of loneliness became plain to see especially during the lockdowns and social protocols of those years. What we understand about this social phenomenon, however, is often as vague as the biblical assessment that lonely living is “not good” (Genesis 2:18). My study expands and explains what the Bible has to say on the topic (1) by identifying other relevant texts about loneliness, (2) by studying the imagery of the “lonely bird” in Psalm 102, and (3) by bringing these insights into conversation with contemporary psychological research. Their differences notwithstanding, I will show that the ancient psalm and modern psychology join their voices in portraying loneliness as a liminal and lethal force. Inasmuch as the struggle of articulation and acknowledgement hinders many from seeking support, the first-person poetry of the “lonely bird” in Psalm 102 can give language to human experience, break false assumptions, provide companionship, and pave the way towards a new-found freedom.
Prohibited Mixtures: Mixed Plowing and Sowing
Authors: Campbell Nicholas J.
Published: May 2023

This article explores the prohibitions against mixed plowing and sowing (Lev 19:19; Deut 22:10). The proposed interpretation is that these laws are intended to maintain agricultural purity. They prohibit mishandling seeds and using an unclean animal, the donkey, thereby avoiding defilement of the food. This goes against the allegorical interpretations of maintaining the created order or separation from pagan nations. The argument that mixtures belong to God is also critiqued since the texts do not address field confiscation or animal breeding. The agricultural purity interpretation is developed through examination of the grammar of each passage and other agricultural purity passages in the Old Testament.
The Little Known Language of Biblical Colors: The Example of melas in the Septuagint and the New Testament
Authors: Rambiert-Kwasniewska Anna
Published: May 2023

Color descriptions depend on both culture and era. An explicit example consists in the Greek term melas which was used at the earliest stage of developing the Greek literature to describe various dark colors, as well as difficult mental states and negative emotions, whereas in the Hellenistic papyrus texts it was used in noun form to describe the writing material and pigment in painting. Analyzing the Hebrew equivalent of šāḥōr has revealed a similarity in terms of perceiving and the nomenclature concerning dark colors also in Jewish environments. The conducted study constitutes an attempt to solve methodological difficulties as well as an attempt to capture the elusive semantics and symbolism of the Greek chromatic system in biblical terms.
Medicalized Motherhood and Normalized Autism: A Legacy of the Eugenic Ideology in Media Stories in Authoritarian Vietnam
Authors: Yến-Khanh Nguyễn
Published: May 2023

This article examines a mother's stories which might have prominently set the tone for the narratives about autism in Vietnam. The study analyses the media representation of her family life with a child on the autism spectrum with the terrified and anguished experience of coping with the severe autistic behavior of her son and triumphantly helping him to become a human (sic). The article critiques the medicalization, normalization, eugenicism, and responsibilization ideologies embedded in the media frames that autistic challenges belong to the individuals and must be fixed, through the family's efforts, without holding state institutions accountable for addressing this public health issue. The episodic frames to represent autism as a personal medical issue and family problem demotivated the urgency of advocating for a right-based social policy to accommodate individuals with autism, while the warrior-hero's narratives driven by fears might backfire when other parents cannot afford to do the same. The combination of framing analysis and critical discourse analysis with an emphasis on the cultural political economy fills the gap in global media and communication studies to contextualize how pervasively the structural factors in an authoritarian country might impact the media framing practice.
Integrative analysis of tertiary lymphoid structures and immune microenvironment in patients with esophageal carcinoma
Authors: Yao Yuanshan , Xuan Haojie , Wang Jing , Gong Libao , Gao Wen
Published: May 2023

Background:

Esophageal squamous cell carcinoma (ESCC) is one of the most common upper gastrointestinal malignancies worldwide. Tertiary lymphoid structures (TLS) are tumor-infiltrating immune cells aggregates coupled with stromal cells which are similar to secondary lymphoid organs. The objective of this study is to explore the predictive effects of two common genes associated with TLS models on prognosis and immunotherapy effects in ESCC patients.

Methods:

Clinical information for ESCC patients in the TCGA(The Cancer Genome Altas) cohort and GSE 53625 were collected. All of the samples were classified as either high score group or low score group based on two TLS signatures, and the association between TLS signatures and survival, clinical indicators, genomic burden, stemness indices analysis, tumor microenvironment and immunotherapy response were performed. Furthermore, the mature TLS was also assessed in ESCC tissue microarray.

Results:

In our study, we quantified the score of TLS_9 and TLS_12, respectively, reflecting the different statuses of TLS (TLS_9 = B and T cells in TLSs; TLS_12 = neogenesis of TLSs). Subsequently, we explored the effect of TLS score on ESCC tumor microenvironment quantified by multiple algorithms. We found that a correlation analysis indicated that TLS_9 and TLS_12 were all positively correlated with CD8+ T cell, NK cells, CD4+ T cells, M1 macrophages and so on. Meanwhile, some cells present a different correlation pattern of TLS_9 and TLS_12, including activated CD4+ memory T cells and Tgd cells. Immune-related analysis revealed that the TLS_12 and TLS_9 scores were all positively correlated with immune dysfunction, yet negatively correlated with immune exclusion. Following this, the biological roles of TLS_9 and TLS_12 scores were investigated. Also, we noticed that the TLS score could significantly affect the CAFs infiltration and be associated with the genomic burden and tumor stemness. In addition, we explored the prognostic value of mature TLS through tissue microarray (TMA). Our result displayed ESCC patients with the presence of mature TLS had a better prognosis than ESCC patients without it.

Conclusions:

Our study indicated that ESCC patients with the presence of TLS had better outcomes and an inflamed immune microenvironment. In addition, both TLS-9 and TLS-12 gene signatures could be used as potential biomarkers for the immunotherapy of ESCC patients.
Vitamin C as a Potential Prophylactic Measure Against Frozen Shoulder in an In Vivo Shoulder Contracture Animal Model
Authors: Feusi Oscar , Fleischmann Thea , Waschkies Conny , Pape Hans-Christoph , Werner Clément M.L. , Tiziani Simon
Published: May 2023

Background:

Frozen shoulder is a common, painful, and movement-restricting condition. Although primary frozen shoulder is idiopathic, secondary frozen shoulder can occur after trauma or surgery. Prophylactic and therapeutic options are often unsatisfactory. Vitamin C (ascorbic acid) is a potent physiological antioxidant and likely inhibits the activation of nuclear factor κB, which plays a decisive role in inflammatory reactions.

Hypothesis:

Because of its anti-inflammatory effects, vitamin C may be valuable in the prevention of secondary frozen shoulder.

Study Design:

Controlled laboratory study.

Methods:

An in vivo shoulder contracture model was conducted by fixation of the right proximal limb of Sprague-Dawley rats. A treatment group (n = 8) receiving vitamin C orally was compared with a control group (n = 9) without vitamin C. The primary outcome was capsular thickness at the shoulder joint measured on magnetic resonance imaging (MRI) examination. Further histological examination was performed but was not statistically analyzed because of variability of the cutting plane through the glenoid.

Results:

Vitamin C treatment resulted in less thickening of the axillary fold of the operated shoulder at 2 of the 3 locations measured on MRI compared with untreated controls (insertion to the glenoid, P = .074; insertion to the humerus, P = .006; middle of the axillary recess, P = .008). The observed structural changes in histological examination corroborated the significant changes obtained from the MRI measurements.

Conclusion:

Prophylactic vitamin C seemed to reduce the thickening of the axillary recess in secondary frozen shoulder in this preclinical study.

Clinical Relevance:

Vitamin C may be helpful as a noninvasive therapeutic measure to prevent secondary frozen shoulder (eg, within the context of surgery in the shoulder region or immobilization) or to treat primary frozen shoulder at an early stage. Further studies are required to evaluate the effect of this treatment in humans and the necessary dosage in humans.
Extension of Tibial Spine Fractures Beyond the Tibial Spine: An MRI Analysis of 54 Patients
Authors: Cirrincione Peter M. , Salvato Damiano , Chipman Danielle E. , Mintz Douglas N. , Fabricant Peter D. , Green Daniel W.
Published: May 2023

Background:

To the authors’ knowledge, no previous study has thoroughly described the anteroposterior dimensions of tibial spine fractures (TSFs) on 3-dimensional imaging. The extension of TSFs into weightbearing regions of the tibial plateau, posterior extension within the epiphysis, and potential association between fracture size and patient age may have implications for treatment strategies and clinical outcomes.

Hypothesis:

TSF fragments would commonly involve weightbearing regions of the tibial plateau, would be larger in younger patients, and would extend more posteriorly than the anatomic footprint of the tibial spine.

Study Design:

Case series; Level of evidence, 4.

Methods:

Consecutive magnetic resonance imaging studies obtained between 2012 and 2020 in patients 5 to 18 years of age at the time of imaging for TSFs were included, measured, and classified via the Green and Tuca grading system. Anteroposterior fracture dimensions were measured and normalized to anteroposterior midepiphyseal length, as was fracture height to epiphyseal height. Extension into the weightbearing surface of the tibial plateau was recorded. Intraclass correlation coefficient and kappa values were calculated. Mean fracture bed size was compared using independent-samples t tests between older and younger patients based on median age and sex.

Results:

Of 54 TSFs, 1 (2%), 28 (52%), and 25 (46%) were grades 1, 2, and 3, respectively. Fracture beds spanned 45% of the anteroposterior midepiphysis, and 54% of the TSF beds extended to the posterior third of the epiphysis. Younger and female patients, on average, had larger anteroposterior dimensions to TSF beds ( P = .018 and .006, respectively). The medial and lateral weightbearing surfaces of the tibial plateau were affected 57% and 25% of the time, respectively.

Conclusion:

This study demonstrated that TSF beds were larger in younger patients, extended to the posterior third of the epiphysis in 54% of cases, and should be examined carefully for extension into weightbearing regions of the tibial plateau. In pediatric patients, the TSF often involves more of the tibial plateau than the anatomic footprint of the tibial spine, and clinicians should be aware of the potential for extension posteriorly and into the weightbearing surfaces.
Complete Restoration of Native Glenoid Width Improves Glenohumeral Biomechanics After Simulated Latarjet
Authors: Rauck Ryan C. , Brusalis Christopher M. , Jahandar Amirhossein , Lamplot Joseph D. , Dines David M. , Warren Russell F. , Gulotta Lawrence V. , Kontaxis Andreas , Taylor Samuel A.
Published: May 2023

Background:

The amount of glenoid width that must be restored with a Latarjet procedure in order to reestablish glenohumeral stability has not been determined.

Purpose/Hypothesis:

The purpose of this article was to determine the percentage of glenoid width restoration necessary for glenohumeral stability after Latarjet by measuring anterior humeral head translation and force distribution on the coracoid graft. The hypothesis was that at least 100% of glenoid width restoration with Latarjet would be required to maintain glenohumeral stability.

Study Design:

Controlled laboratory study.

Methods:

Nine cadaveric shoulders were prepared and mounted on an established shoulder simulator. A lesser tuberosity osteotomy (LTO) was performed to allow accurate removal of glenoid bone. Coracoid osteotomy was performed, and the coracoid graft was sized to a depth of 10 mm. Glenoid bone was sequentially removed, and Latarjet was performed using 2 screws to reestablish 110%, 100%, 90%, and 80% of native glenoid width. The graft was passed through a subscapularis muscle split, and the LTO was repaired. A motion tracking system recorded glenohumeral translations, and force distribution was recorded using a TekScan pressure sensor secured to the glenoid face and coracoid graft. Testing conditions included native; LTO; Bankart tear; and 110%, 100%, 90%, and 80% of glenoid width restoration with Latarjet. Glenohumeral translations were recorded while applying an anteroinferior load of 44 N at 90° of humerothoracic abduction and 0° or 45° of glenohumeral external rotation. Force distribution was recorded without an anteroinferior load.

Results:

Anterior humeral head translation progressively increased as the proportion of glenoid width restored decreased. A marked increase in anterior humeral head translation was found with 90% versus 100% glenoid width restoration (10.8 ± 3.0 vs 4.1 ± 2.6 mm, respectively; P < .001). Greater glenoid bone loss also led to increased force on the coracoid graft relative to the native glenoid bone after Latarjet. A pronounced increase in force on the coracoid graft was seen with 90% versus 100% glenoid width restoration ( P < .001).

Conclusion:

Anterior humeral head translation and force distribution on the coracoid graft dramatically increased when <100% of the native glenoid width was restored with a Latarjet procedure.

Clinical Relevance:

If a Latarjet is unable to fully restore the native glenoid width, surgeons should consider alternative graft sources to minimize the risk of recurrent instability or coracoid overload.
Sufficient Metaphyseal Bone for Wedge Removal and Fixation Hardware During Supratuberosity Tibial Deflexion Osteotomy in Knees With Excessive Posterior Tibial Slope
Authors: Demey Guillaume , Giovannetti de Sanctis Edoardo , Mesnard Guillaume , Müller Jacobus H. , Saffarini Mo , Dejour David H.
Published: May 2023

Background:

Tibial deflexion osteotomy (TDO) is sometimes indicated for revision anterior cruciate ligament (ACL) reconstruction in knees with posterior tibial slope (PTS) ≥12° and aims to decrease PTS to around 5°. When planning TDO, measuring the anterior tibial metaphyseal height (aHt) could help ascertain whether the available metaphyseal bone would be sufficient to create the wedge and leave adequate residual bone.

Purpose:

To (1) determine whether, compared with knees with normal native PTS (<12°), aHt is greater in knees with excessive native PTS (≥12°), and (2) verify if, aiming to decrease PTS to 5°, supratuberosity TDO in knees with excessive native PTS could be performed without tibial tuberosity osteotomy, leaving a minimum of 15 mm of residual bone for fixation staples or plates.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

True lateral radiographs of 350 consecutive patients scheduled for ACL reconstruction were digitized to measure PTS, tibial medial plateau length, tibial anterior and posterior metaphyseal heights and inclinations, and patellar height. Measurements were compared between knees with PTS <12° and those with ≥12°. The wedge height required for supratuberosity TDO was estimated for knees with excessive PTS, aiming for a target PTS of 5°, to determine the proportion of knees that would have residual aHt <15 mm.

Results:

A total of 326 knees had adequate true lateral radiographs. The mean PTS was 9.8°± 3.1° (range, 1°-20°) and exceeded 12° in 83 (25%) knees. There were no significant differences between knees with normal versus excessive PTS when comparing aHt (30.7 ± 4.5 mm vs 31.6 ± 4.9 mm; P = .270) and medial tibial plateau length (43.1 ± 5.4 mm vs 43.3 ± 5.6 mm; P = .910). Setting the target mPTS at 5° for supratuberosity TDO, the mean residual aHt was 25.0 ± 4.4 mm, and 7 (8%) knees had a residual aHt <20 mm, of which only 1 (1%) had residual aHt <15 mm. Setting the target mPTS at 0°, the mean residual aHt was 21.3 ± 4.2 mm, and 36 (43%) knees had a residual aHt <20 mm, of which only 4 (5%) had residual aHt <15 mm.

Conclusion:

aHt was not significantly different between knees with normal versus excessive PTS. Estimation of the wedge height required for supratuberosity TDO to reduce excessive PTS to 5° revealed sufficient metaphyseal bone for wedge removal in all knees. Furthermore, 99% of knees would have sufficient residual bone (aHt, ≥15 mm) to accommodate fixation staples or plates, without the need for tibial tuberosity osteotomy.
Development of a consortium to examine organ donation legislative and system reforms: A report from the LEADDR consortium
Authors: Isenor Cynthia , Weiss Matthew J. , Beed Stephen , Urquhart Robin , Tennankore Karthik , Lucas Amanda , Tomblin-Murphy Gail , Krmpotic Kristina , Dhanani Sonny , Sullivan Victoria , West OC Lori J. , Gongal Patricia , Hartell David , Simpson Christy , James Lee , Landry Alain , Dirk Jade
Published: May 2023

In April 2019, the province of Nova Scotia became the first jurisdiction in North America to pass legislation that incorporated deemed consent for deceased organ donation. The reform included many other important updates, including the hierarchy for consent, enabled donor and recipient contact, and mandatory referral of potential deceased donors. Additionally, system reforms were implemented to improve the deceased donation system in Nova Scotia. A collection of national colleagues identified the magnitude of the opportunity to develop a comprehensive strategy to measure and evaluate the impact of the legislative and system reforms. This article describes the successful development of a consortium from both national and provincial jurisdictions that included experts from a variety of backgrounds and clinical and administrative disciplines. In describing the creation of this group, we hope to offer our case example as a model for the evaluation of other health system reforms from a multidisciplinary perspective.
Sexual Assaults, Bad Hookups, and Bad Dates: Comparisons of the Contextual Features Among College Women’s Hypothetical and Real-Life Sexual and Dating Experiences
Authors: Sheffield Alexis , Ross Ryan , Gillezeau Christina , Blackwell Meredith , Yeater Elizabeth A.
Published: May 2023

Two hundred forty-seven ( N = 247) undergraduate women at a medium-sized, Southwestern university provided written descriptions of a hypothetical sexual assault (SA). Women with a prior history of SA also described their actual SA experiences; women without a SA history provided a written description of a prior bad date or hookup. The contextual features of SA scripts were compared to those of actual SA experiences. Several characteristics of a stereotypical or “blitz rape” (e.g., physical force by a stranger) were more likely to be included in SA scripts relative to women’s actual SA experiences. Victimized women were also more likely to include verbal coercion, a hangout/hookup context, and previous consensual kissing in their SA experiences, in comparison to their SA scripts. The contextual features of SA experiences were also compared to the contextual features of bad dates or bad hookups. SA experiences, relative to bad dates, were more likely to include alcohol use, physical and verbal coercion by the perpetrator, and passive resistance. SA experiences, relative to bad hookups, were more likely to include physical and verbal coercion by the perpetrator, and knowing the man for less than 1 week. Victimized participants SA experiences were also found to be less likely to include previous consensual kissing and consensual intercourse in comparison to bad hookup experiences of nonvictimized women. Overall, there was considerable overlap between the contextual features present across all experiences. The lack of differentiation among these events may explain why women experience difficulty acknowledging whether they have experienced SA.
Advance Care Planning Among Sexual Minority Men: Sociodemographic, Health Care, and Health Status Predictors
Authors: Siconolfi Daniel , Thomas Emma G. , Chen Emily K. , Haberlen Sabina A. , Friedman M. Reuel , Ware Deanna , Meanley Steven , Brennan-Ing Mark , Brown Andre L. , Egan James E. , Bolan Robert , Stosor Valentina , Plankey Michael
Published: May 2023

Objectives: Advance care planning (ACP) specifies decision-making surrogates and preferences for serious illness or end-of-life medical care. ACP research has largely neglected sexual minority men (SMM), a population that experiences disparities in health care and health status. Methods: We examined formal and informal ACP among SMM ages 40+ in the Multicenter AIDS Cohort Study ( N = 1,071). Results: For informal ACP (50%), younger SMM and men with past cardiovascular events had greater odds of planning; single men had lower odds of planning. For formal ACP (39%), SMM with greater socioeconomic status had greater odds of planning; SMM who were younger, of racial/ethnic minority identities, who were single or in a relationship without legal protections, and who lacked a primary care home had lower odds of planning. Discussion: Findings warrant further exploration of both informal and formal planning. More equitable, culturally-humble engagement of SMM may facilitate access, uptake, and person-centered planning.