bluuebunny/crossref_metadata_2025 huggingface dataset:
Electronic Fetal Monitoring: Physician Liability and Informed Consent
Authors: Gilfix Myra Gerson
Published: February 2021

Electronic fetal monitoring (EFM) has been criticized as ineffective, unsafe and costly. Despite existing controversy regarding the risks involved in using EFM, this monitoring procedure continues to be widely employed. In many jurisdictions, in fact, the use of EFM during labor may be considered the customary practice. This Article analyzes the medical and legal issues arising from a physician's use of or failure to use EFM. The Author argues that EFM subjects the mother and the fetus to risks which may be avoided if auscultation, a less intrusive monitoring technique, is employed. The ‘customary practice’ standard of care, the ordinary negligence standard of care, and the ‘best judgment’ and ‘duty to keep abreast’ standards of care are compared and applied to the physician's decision to use EFM. The Author contends that physicians who employ auscultation may not be liable for failing to use EFM; however, physicians who use EFM despite the evidence of its risks may be liable for failing to ‘keep abreast’ or to use their ‘best judgment’ or for negligence. Finally, the Author contends that both physicians and their patients are best protected when the physician elicits the mother's informed consent to employ a particular monitoring technique during labor.
The Future of Public Health Law
Authors: Gostin Lawrence O.
Published: February 2021

Developments in medicine and constitutional law dictate modification of public health legislation in the United States. Traditionally overlooked by legislators, present public health laws provide inadequate decisionmaking criteria and inappropriate procedures for dealing with issues. Revised legislation should provide health care officials and agencies with the tools to balance individual rights against public health necessities. This Article makes four recommendations for legislative reform: (1) remove artificial legislative distinction between venereal and other communicable diseases; (2) provide criteria denning “public health necessity” to limit discretionary exercise of police power by health officials; (3) provide strong confidentiality protections in the collection and storage of public health information; (4) empower public health officials to select from a graded series of less restrictive alternatives in dealing with public health problems.
Groping for the Reins: ERISA, HMO Malpractice, and Enterprise Liability
Authors: Kilcullen Jack K.
Published: February 2021

As Canada approaches the end of its first decade of government-run health care with universal coverage and controlled costs, the majority in the United States Congress has proposed repealing the federal guarantee of health coverage to poor and disabled persons embodied in Medicaid. This somber turn in the history of American health care comes only a few years after an optimistic President Clinton resurrected the efforts of Presidents Truman and Nixon to establish universal coverage. Clinton’s own party quashed his Health Security Act prior to any formal debate. Characterizing the plan as Byzantine government that would limit choice, health insurance companies, the very industry President Clinton tried to accommodate by rejecting the Canadian model, opposed the plan. Ironically, the possibility of such legislation accelerated the movement by health care insurers and other large-scale payers to assume control of health care delivery through the establishment of “managed care” systems. While this movement has initially reduced costs, it has also restricted consumers’ choice and imposed new administrative procedures.
Conferring a Federal Property Right in Genetic Material: Stepping into the Future with the Genetic Privacy Act
Authors: Lin Michael M.J.
Published: February 2021

“A wise man can hear profit in the wind.”

—Pel, quoting the Ferengi Rules of Acquisition

The expansive biotechnology field includes many facets of medical research, from drug discovery and design, to gene therapy and the diagnosis of genetic diseases, to the use of deoxyribonucleic acid (DNA) evidence to identify individuals and genetic characteristics. The biotechnology industry requires a readily available supply of biological raw materials; much of current research is founded on cells, tissues, organs, fetal tissues and placentas, and other samples derived from human donors. However, this growing need for raw materials presents many economic, social, and ethical issues to society, researchers, and the existing legal regime. Furthermore, because courts and legislatures fail to provide a clear national rule regarding biological materials, the resulting legal uncertainties chill research and investment. Although very few cases address property rights in a person’s organs, tissues, and genetic material, the issues of autonomy and privacy involved evoke analogies to deep-seated issues such as slavery, the freezing of embryos, and abortion.
An Analysis of Genetic Discrimination Legislation Proposed by the 105th Congress
Authors: Colby Jeremy A.
Published: February 2021

It was the best of times, it was the worst of times, it was the age of wisdom, it was the age of foolishness … it was the spring of hope, it was the winter of despair … we were all going direct to Heaven, we were all going direct the other way.

—Charles Dickens

The Human Genome Project (HGP) provides information about the human genome that will forever alter society and the way we view ourselves. The genetic age offers great potential, including a future where gene and germ-cell therapy may virtually eliminate genetic disease. However, genetic information may also result in a world characterized by genetic discrimination and genetic determinism. Although genetic information will be used to develop revolutionary treatments, such as gene therapy and other molecular medicine, it will also bring genetic discrimination and heretofore unrealized invasions into the privacy of our genetic codes.
No Longer Disabled: The Legal Impact of the New Social Construction of HIV
Authors: Parmet Wendy E. , Jackson Daniel J.
Published: February 2021

The second social construction of HIV disease has begun. In the first fifteen years of the HIV epidemic, many viewed the disease “as the modern plague.” Now, as the epidemic matures and new “miracle treatments" are heralded, the disease is beginning to conjure a very different set of images. Where once AIDS was dreaded as the inexplicable cataclysm of the end of the millennium, now, as the virus appears amenable to treatment, we are beginning to see the disease as something both preventable and controllable, no longer beyond human direction. And, where the disease was once synonymous with death, disability, and decline, we now witness stories of miracle recoveries and long-term survival. In the minds of many, the terminal disease has become the chronic disease; the dreaded plague has become but another social problem.

In most respects, the new social construction of HIV, emerging from the advent of potentially effective medical interventions, is a positive development.
Genetic Predispositions, Prophylactic Treatments and Private Health Insurance: Nothing is Better Than a Good Pair of Genes
Authors: Glazier Alexandra K.
Published: February 2021

Discovering the genetic basis of a particular disease is not only of great interest to the medical community; private health insurers are also anxiously awaiting the results of genetic linkage studies. Apart from the scientific value of DNA studies, the results of genetic linkage research are relevant to health care delivery in two principal ways. First, identifying the genetic origin of a disease may allow doctors to detect the disease earlier. If doctors know that an individual is genetically predisposed to a particular disease, then health care providers can increase screening efforts and watch for early symptoms. Second, if an individual has a genetic predisposition to a particular disease, health care providers may employ preventive or “prophylactic" measures to reduce or eliminate the risk of developing the disease or condition to which the individual is genetically predisposed. Genetic linkage studies will soon allow more individuals to learn of their own genetic predispositions to certain diseases. Currently genetic predisposition tests (both pedigrees of family history and DNA analysis) can indicate that an individual is at high risk for developing a disease.
Narrowing Provider Choice: Any Willing Provider Laws After New York Blue Cross v. Travelers
Authors: McCarthy Dianne
Published: February 2021

Two competing public policies, an individual’s right to choice of medical provider and the need to reduce health care costs, have collided as the federal government and the states implement health care reform. During his first year in office, President William J. Clinton focused on health care reform; however, Clinton was unsuccessful in implementing his “Health Security Act" and national debate dissolved into partisan bickering. With the failure to establish a coherent national policy on health care, the states and private and public health care entities are reshaping the market. Simultaneously, the courts and administrative agencies entertain public policy arguments favoring choice or cost reductions.

Fee-for-service (FFS) medical care allows individuals to receive medical care from their provider of choice. Under the FFS model, individuals chose their health care provider, receive care, and the provider bills an indemnity insurance plan on the basis of service provided. The emergence of managed care organizations (MCOs) narrowed and, in some cases, eliminated this right to choose one’s health care provider.
Developing Issues Under the Massachusetts ‘Physician Profile’ Act
Authors: Donohue Jeffrey P.
Published: February 2021

Massachusetts recently became the first state in the United States to publish physician malpractice histories and hospital disciplinary records. On August 9, 1996, Governor William F. Weld signed the Physician Profile Act (Profile Act or Act) into law, making “profiles” of the Commonwealth’s approximately twentyseven thousand doctors available to the public. Under the Act, the Massachusetts Board of Registration in Medicine (Board) provides information on physicians’ insurance plans, specialties, training, honors, and malpractice histories over a toll-free telephone number, through the Internet and on CD-ROM.

The Act developed partially as a legislative response to a series of Boston Globe articles appearing in late 1994 which savaged the Board. Spotlighting a number of high-profile iatrogenic incidents, this highly charged series of articles, accompanied by a blistering editorial, alleged that some patients suffered substandard medical care at the hands of physicians who had been sued repeatedly for malpractice but never disciplined by the Board.
Iceland's Health Sector Database: A Significant Head Start in the Search for the Biological Grail or an Irreversible Error?
Authors: Jónatansson Hróbjartur
Published: February 2021

In December 1998, Iceland's Parliament, the Althing, passed the Act on a Health Sector Database (the Database Act or Act), a highly controversial law authorizing the development of a Health Sector Database (the Database) to collect genetic and medical information already contained in various locations around Iceland as part of Iceland's national health system. As a result of the Database Act, Iceland is the only country in the world with laws authorizing collection and storage of the genetic heritage of an entire population by a private biotechnology corporation with rights to exploit the data as a commercial commodity. Many databases now exist in Iceland as individual and segregated entities that contain detailed medical information about every Icelandic person, both living and dead, dating back to 1915 when the recording commenced.
Medicine in the New Millennium: A Self-Help Guide for the Perplexed
Authors: Hyman David A.
Published: February 2021

When Austin Powers, ace British secret agent, is thawed out after thirty years of suspended animation, he is greeted by his old boss, accompanied by a Russian general. Powers is alarmed by the presence of the Russian general, and complains about the breach of security. Powers' boss tells him “a lot's happened since you were frozen. The Cold War is over.” Powers thinks for a moment, and then responds, “finally those capitalist pigs will pay for their crimes eh, eh comrades, eh?“ His boss gently interrupts, and informs Powers that “we won.” Powers clumsily responds, “Oh groovy, smashing, yeah capitalism,” his tactlessness prefiguring his behavior through the rest of the movie. Despite Powers' noteworthy skills as a secret agent, he has foolishly disregarded the first rule of forecasting the future: don't be around when your predictions are assessed for accuracy and completeness.
Applying Fiduciary Responsibilities in the Managed Care Context
Authors: Jacobson Peter D. , Cahill Michael T.
Published: February 2021

The cost containment innovations offered by managed care have been needed corrections to the excesses of the fee-for-service health care system. Yet, implementing these innovations raises inevitable questions about conflicts of interest regarding the allocation of resources under managed care. The inherent conflict faced by physicians and health plan administrators between the health care needs of individual patients and the need to preserve scarce resources for patient populations is at issue in the managed care era. The sources of the conflict are the economic incentives that underlie the managed care revolution, such as capitated funding arrangements, limitations on referrals to specialists, bonuses and withholds. In making individual clinical decisions, physicians and administrators potentially infuse their own economic interests into the process.
Health Care Reform In The Year 2000: The View From The Front Of The Classroom
Authors: Wing Kenneth R.
Published: February 2021

My thoughts about the status of American health care as it enters the twenty-first century have less to do with any theory or model—or even my own politics—and more to do with my efforts as a teacher. For the past twenty-five years I have taught introductory health law courses in law and public health schools. While what I teach and how I do so have changed enormously during that time, my basic objective has changed very little: preparing my students for the political and legal issues that they will likely confront in their individual and professional lives. It is a task that I find endlessly challenging. I have to amass and continually update a tremendous amount of information concerning individual and institutional providers, various financing arrangements, state and federal programs, and all the other things that many Americans only partially understand or ignore altogether. But the real challenge is in delivering this information. It must be presented in some useful and retainable way. As in all other important things, the devils in American health care can only be found in the details; but the trick for a teacher ultimately, is figuring out which devilish details are important, which are not and why, and how to pass all that along to tomorrow's decision makers—whether tomorrow is just tomorrow or whether it is the beginning of a new century.
Rights Discourse and Assisted Suicide
Authors: Lewis Penney
Published: February 2021

The debate surrounding the legalization of assisted suicide has been galvanized in recent years by reports of specific cases of assisted suicide, primarily involving physicians such as Kevorkian and Quill, and by impassioned pleas for legalization and assistance in suicide from individuals suffering in the throes of terminal or agonizing diseases, such as Sue Rodriguez. Media attention on criminal trials of individuals accused of assisting in a suicide has heightened public awareness of the issue. The constitutionality of criminal prohibitions on assisted suicide has been tested in various jurisdictions, and has recently been considered by the Supreme Courts of both the United States and Canada. Following two narrowly unsuccessful attempts to enact dignified death provisions by referenda in Washington and California, Oregon voters passed the first of such proposed laws in November 1994, providing for physician-assisted suicide under certain specified conditions. Attempts to introduce legislation to legalize assisted suicide in other jurisdictions have been galvanized by the success in Oregon. A model statute has been drafted by a group of law professors, philosophers and medical professionals.
The Americans with (or without) Disabilities Act: Pre-employment Medical Inquiries and the Non-disabled
Authors: Behm Allyson R.
Published: February 2021

In 1990, approximately 43 million Americans suffered from mental or physical disabilities. There is no question that disabled Americans face discrimination in their daily lives. However, prior to 1990, disabled individuals were only able to obtain legal redress from discrimination they experienced in the federal arena. As such, many were left with no legal course of action whatsoever. To address this previously unpunished discrimination against disabled persons, President George H. Bush signed the Americans with Disabilities Act (“ADA” or “the Act”) into law on July 26, 1990. With the purpose of setting forth a “clear and comprehensive national mandate for the elimination of discrimination against individuals with disabilities,” the Act placed able-bodied status among other statutorily protected categories such as race, national origin, gender and age. As with legislation protecting other groups victimized by discrimination, Congress, in enacting the ADA, recognized the need for equal treatment of disabled persons in the realm of employment.
Financial Conflict of Interest: an Unresolved Ethical Frontier
Authors: Kassirer Jerome P.
Published: February 2021

Financial conflict of interest has become one of the most contentious issues in medicine today. Several decades ago studies disclosed that physicians who had investments in medical facilities were referring patients for more tests and procedures than physicians who had no such investments. More recently, physicians who forego expensive tests and treatments for patients have been accused of skimping on care for personal financial gain. Physicians who emphatically tout certain treatments have been criticized for possessing hidden financial ties to the manufacturer of the products. Some physicians engaged in clinical trials have been suspected of enrolling patients who do not strictly conform to the research protocols so that they can collect fees from contract research organizations. And in the aftermath of deaths and complications in gene therapy experiments, some scientists and their institutions have been criticized for possessing a financial stake in companies that are involved in the studies.
Any DNA to Declare? Regulating Offshore Access to Genetic Enhancement
Authors: Mehlman Maxwell J. , Rabe Kirsten M.
Published: February 2021

Imagine a world in which parents can genetically enhance their child's height so that he becomes a professional basketball player. Or imagine a law school student preparing for the bar who takes out an extra loan to genetically enhance his intelligence. What if going to your physician for a routine physical included the option of genetically enhancing any trait you desired? And what if such a practice was expensive and, therefore, only available to the privileged members of society? Is this desirable or should the U.S. government ban genetic enhancement? What if the government bans it and citizens travel abroad to receive genetic enhancement treatments? Can the U.S. government do anything to prevent access to illegal genetic enhancement abroad?
Trav'lin’ Light: Early Retirees and the Availability of Post-Retirement Health Benefits
Authors: Russel Tamara E.
Published: February 2021

George Eastman may not have been a father, but to the residents of Rochester, New York, the principal founder of Eastman Kodak was a doting uncle. In addition to donating millions of dollars to Rochester-area schools and hospitals, Eastman reportedly paid to remove the tonsils of every child in town. Even after his death in 1932, his company looked after of its employees and retirees. For example, Kodak refused to use its size to negotiate for cheaper medical care for its Rochester employees. If it had, most small businesses in the area would have likely faced higher insurance rates and the prospect of eliminating health benefits for their employees entirely. Only about seven percent of Rochester residents do not have health insurance today, compared with fifteen percent nationally.

That may change, however. Faced with growing foreign competition and demands for higher returns, last summer Kodak threatened to desert its long-standing approach to buying insurance and encouraged its 44,000 retirees to join a health plan that excluded two high-priced hospitals.
Abortion Counseling and the First Amendment: Open Questions After Webster
Authors: Pine Rachael N.
Published: February 2021

The Missouri statute at issue in Webster v. Reproductive Health Services, contained three related prohibitions on speech about abortion. The statute: (1) prohibited public employees from encouraging or counseling a woman to have an abortion except where necessary to save her life; (2) banned such counseling in a public facility; and (3) prohibited the expenditure of public funds for such a purpose in any context. In essence, Missouri's statute attempted to censor the speech of physicians and counselors, even where an abortion would be medically indicated though not necessary to save the woman's life. The statutory scheme thus invades the doctor-patient relationship, jeopardizes free speech and access to medical information, and seeks to manipulate and mislead women who are considering the appropriate course of action for their unwanted pregnancies.
The Role of Stare Decisis in the Reconsideration of Roe v. Wade
Authors: Blaustein Albert P. , Grant Edward R. , Lohr Ann-Louise , Todd Kevin J.
Published: February 2021

Webster v. Reproductive Health Services represented the first occasion in which a state, defending a challenge to its abortion laws, called for the Supreme Court to reconsider Roe v. Wade. This opportunity presented a two-fold challenge to those engaged in seeking the reversal of Roe through the courts. First was to persuade the Court that Roe had been erroneously decided. Second was to overcome the defense of Roe premised upon stare decisis.

Two briefs, representing separate groups of Members of Congress and Senators as amici, were filed on behalf of the appellants, each addressed to one of these challenges.
Judicial Standard of Review and Webster
Authors: Bopp James , Coleson Richard E.
Published: February 2021

The necessary first step in the judicial review of any state statute is to determine the appropriate standard of review. Without resolution of this threshold issue, the court would be uncertain what constitutional analysis to employ, whether a low level of scrutiny, strict scrutiny or some intermediate standard.

Thus, in Webster v. Reproductive Health Services, the Court should not merely assume, without confronting, the continued viability of Roe v. Wade. Failure to reexamine Roe would depart from precedents of the Court and lead to untoward results.

In determining the standard of review to be applied to the Missouri statute at issue in Webster, the Court should be guided by the analysis of Bowers v. Hardwick, and find that there is no constitutional right to abortion. Thus, the standard of review to be employed in Webster is the rational basis test. Under this test, the Missouri statute should be upheld.
Roe v. Wade Is Constitutionally Unprincipled and Logically Incoherent: A Brief in Support of Judicial Restraint
Authors: Gerard Jules B.
Published: February 2021

The Center for Judicial Studies is the only educational and public policy organization in the United States that focuses exclusively on the problem of judicial activism. It seeks to confine the power of the federal judiciary to the bounds envisioned by the Framers of the Constitution. The Center's brief was signed by fifty-six members of Congress who were concerned that Roe v. Wade “has expanded federal judicial powers into areas that are within the rightful legislative domain of Congress and the states.”
Evaluating physicians’ perspectives on the efficiency and effectiveness of the electronic prescribing system
Authors: Raeesi Ahmad , Abbasi Reza , Khajouei Reza
Published: February 2021

Background

The implementation of the electronic prescribing system follows certain objectives, and users’ perspectives can contribute to understanding the efficiency and effectiveness of this system. This study aimed to evaluate physicians’ perspectives on the efficiency and effectiveness of the electronic prescribing system.

Methods

This study was conducted on all physicians using the electronic prescribing system in clinics and hospitals affiliated with the treatment deputy of the Social Security Organization (SSO) in Sistan and Baluchistan Province in Iran. Data were collected using a self-administered questionnaire containing three sections: (i) Six items related to demographic data and clinical experience, (ii) Specific questions based on a five-point Likert scale-related physicians’ perspectives about efficiency (19 questions) and effectiveness (13 questions), and (iii) Open-ended questions about the positive and negative aspects of using the electronic prescribing system.

Results

The mean and standard deviation of the efficiency and effectiveness of the electronic prescribing system were 3.68 ± 0.67 and 3.84 ± 0.65, respectively. Patient safety had the highest mean score among all dimensions (4.0 ± 0.64). Most participants (n = 55, 79%) considered the efficiency and effectiveness of this system high. More than 90 percent of the physicians (n = 63) believed that the electronic prescribing system enables a better medication prescription by providing alerts and access to patients’ medication history.

Conclusion

The findings showed that most physicians believed that the electronic prescribing system of Iran's SSO has high efficiency and effectiveness. In particular, physicians believed that using this system improves patient safety and reduces costs.
SARS-CoV-2 molecular testing in Greek hospital paediatric departments: a nationwide study
Authors: Michos Athanasios , Savvidou Parthena , Syridou Garyfallia , Eleftheriou Eirini , Iosifidis Elias , Grivea Ioanna , Spoulou Vana , Galanakis Emmanouil , Syrogiannopoulos George , Tsolia Maria , Roilides Emmanuel , Papaevangelou Vassiliki
Published: February 2021

As most children infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) present with mild symptoms or they are asymptomatic, the optimal strategy for molecular testing it is not well defined. The aim of the study was to determine the extent and aetiology of molecular testing for SARS-CoV-2 in Greek paediatric departments during the first phase of the pandemic and identify possible differences in incidence, depending on the age group and geographical area. We conducted a nationwide study of molecular testing for SARS-CoV-2 of children in paediatric departments between March and June 2020. A total of 65 paediatric departments participated in the study, representing 4901 children who were tested for SARS-CoV-2 and 90 (1.8%) were positive. Most paediatric cases were associated with topical outbreaks. Adolescents 11–16 years had the highest positivity rate (3.6%) followed by children 6–10 years (1.9%). However, since the testing rate significantly differed between age groups, the modified incidence of SARS-CoV-2 infection per age group was highest in infants <1 year (19.25/105 population). Most children tested presented with fever (70.9%), respiratory (50.1%) or gastrointestinal symptoms (28.1%). Significant differences were detected between public and private hospitals regarding the positivity rate (2.34% vs. 0.39%, P-value <0.001). Significant variation in SARS-CoV-2 molecular testing positivity rate and incidence between age groups indicate discrepancies in risk factors among different age groups that shall be considered when ordering molecular testing.
Health Care Organizations: Soft Target during COVID-19 Pandemic
Authors: De Cauwer Harald G. , Somville Francis
Published: February 2021

Health care organizations have been challenged by the coronavirus disease 2019 (COVID-19) pandemic for some time, while in January 2020, it was not immediately suspected that it would take such a global expansion. In the past, other studies have already pointed out that health care systems, and more specifically hospitals, can be a so-called “soft target” for terrorist attacks. This report has now examined whether this is also the case in the context of the COVID-19 pandemic.

During the lockdown, hospitals turned out to be the only remaining soft targets for attacks, given that the other classic targets were closed during the lockdown. On the other hand, other important factors have limited the risk of such attacks in hospitals. The main delaying and relative risk-reducing factors were the access control on temperature and wearing a mask, no visits allowed, limited consultations, and investigations.

But even then, health care systems and hospitals were prone to (cyber)terrorism, as shown by other COVID-19-related institutions, such as pharmaceuticals involved in developing vaccines and health care facilities involved in swab testing and contact tracing. Counter-terrorism medicine (CTM) and social behavioral science can reduce the likelihood and impact of terrorism, but cannot prevent (state-driven) cyberterrorism and actions of lone wolves and extremist factions.
Enlightenment and Erudition: Writing Cultural History at the Académie des inscriptions
Authors: Matytsin Anton M.
Published: February 2021

This article explores continuities between the antiquarian erudition of humanist historians and Enlightenment philosophical histories, showing that supposedly revolutionary developments in eighteenth-century historiography emerged from an older scholarly tradition. It focuses on the research of the Royal Academy of Inscriptions and Letters, a learned society in seventeenth- and eighteenth-century France that went from serving as a propaganda tool for promoting King Louis XIV's absolutist regime to becoming the first modern historical research institute and a cradle of the Enlightenment. The article examines the emergence of what might be called “cultural history” or “the history of culture” (histoire des moeurs, as eighteenth-century authors called it). It analyzes how the academicians studied pagan beliefs and speculated about the functions of ancient myths and cults, thus transforming the views about the origin of religion and its role in society. The article also discusses how the academicians made sense of customs and daily practices and how they understood the causes of the progress and decline of civilizations.
Pre-trial detention and legal defence in Latin America
Authors: Fondevila Gustavo , Quintana-Navarrete Miguel
Published: February 2021

Pre-trial detention is used extensively in Latin America as a systematic practice implemented by courts. Despite this fact, few empirical studies have analysed the role of defence attorneys in pre-trial incarceration. This paper attempts to describe the actions taken by lawyers in order to free their clients during the judicial process, using new empirical evidence collected from the incarcerated population in Argentina, Brazil, El Salvador, Chile, Mexico and Peru. Results suggest that public defenders request conditional release less frequently but do so more effectively than their private counterparts.
Weak Crust in Southeast Tibetan Plateau Revealed by Lg‐Wave Attenuation Tomography: Implications for Crustal Material Escape
Authors: He Xi , Zhao Lian‐Feng , Xie Xiao‐Bi , Tian Xiaobo , Yao Zhen‐Xing
Published: February 2021

The continuous convergence between the Indian and Eurasian plates caused massive lithospheric deformation in the Tibetan Plateau and led to excessive crustal material escaping through its southeastern margin. However, the mechanisms that accommodate the escaping materials and whether they intrude into the Indochina Peninsula are continually under debate. Seismic Lg waves mostly propagate within the crust waveguide with an amplitude decay that is sensitive to crustal material properties, such as temperature, partial melting, and fracture. Therefore, Lg attenuation can be a useful indicator of potential crustal material escape. In this study, we developed a high‐resolution broadband Lg attenuation model in this region between 0.05 and 10.0 Hz, with the resolution reaching 1° in regions with dense raypath coverage. Prominent low‐Q anomalies beneath the southeastern margin of the Tibetan Plateau, correlating with previously observed low velocity, high conductivity and high Poisson’s ratio, may indicate possible high temperature and/or partial melting within a relatively weak crust, and suggest a north‐south interconnected corridor for gravity‐driven material flow. Through our results and other geological and geophysical observations, a dynamic model is suggested here by combining shallow rigid block extrusion and deep viscous crustal flow to explain crustal material escape in the southeastern margin of the Tibetan Plateau. Additionally, neither shallow extrusion nor deep material flow enter the Indochina Peninsula based on the relatively high Q values, which indicate a stronger crust there.
Needle Propagation and Twinkling Characteristics
Authors: Hare B. M. , Scholten O. , Dwyer J. , Strepka C. , Buitink S. , Corstanje A. , Falcke H. , Hörandel J. R. , Huege T. , Krampah G. K. , Mitra P. , Mulrey K. , Nelles A. , Pandya H. , Rachen J. P. , Thoudam S. , Trinh T. N. G. , ter Veen S. , Winchen T.
Published: February 2021

Recently, a new lightning phenomena, termed needles, has been observed in both VHF and in optical along positive lightning leaders. They appear as small (<100 m) leader branches that undergo dielectric breakdown at regular intervals (called twinkles). Providing a coherent and consistent explanation for this phenomenon is challenging as each twinkle is a form of negative breakdown that propagates away from the positive leader. In this study, we provide detailed observations of needles in VHF, observed during two lightning flashes. We show distributions of different needle properties, including twinkle propagation speeds, time between twinkles, and needle lengths, among others. We show a return stroke and multiple recoil leaders that quench needle activity. We also show that nearby needle activity does not seem to correlate together, and that needle twinkling can slow down by 10%–30% per twinkle. We conclude by presenting possibilities for how the positive leader could induce negative propagation away from the positive channel, and we argue that twinkles can propagate like a stepped leader or like a recoil leader depending on the temperature of the needle, which implies that needle twinkles can probably propagate without emitting VHF.
Assessing Social Equity in Disasters
Authors: Tate Eric , Emrich Christopher
Published: February 2021

Natural hazard impacts and resources allocated for risk reduction and disaster recovery are often inequitably distributed. New research is developing and applying methods to measure these inequities.
Building Equity into Hazards Research
Authors: Goss Heather
Published: February 2021

In the March issue of Eos, we look at how scientists who study earthquakes, floods, and other hazards are factoring people into their models.
Alternative splicing and cancer: a systematic review
Authors: Zhang Yuanjiao , Qian Jinjun , Gu Chunyan , Yang Ye
Published: February 2021

The abnormal regulation of alternative splicing is usually accompanied by the occurrence and development of tumors, which would produce multiple different isoforms and diversify protein expression. The aim of the present study was to conduct a systematic review in order to describe the regulatory mechanisms of alternative splicing, as well as its functions in tumor cells, from proliferation and apoptosis to invasion and metastasis, and from angiogenesis to metabolism. The abnormal splicing events contributed to tumor progression as oncogenic drivers and/or bystander factors. The alterations in splicing factors detected in tumors and other mis-splicing events (i.e., long non-coding and circular RNAs) in tumorigenesis were also included. The findings of recent therapeutic approaches targeting splicing catalysis and splicing regulatory proteins to modulate pathogenically spliced events (including tumor-specific neo-antigens for cancer immunotherapy) were introduced. The emerging RNA-based strategies for the treatment of cancer with abnormally alternative splicing isoforms were also discussed. However, further studies are still required to address the association between alternative splicing and cancer in more detail.
Activation of BDNF by transcription factor Nrf2 contributes to antidepressant-like actions in rodents
Authors: Yao Wei , Lin Song , Su Jin , Cao Qianqian , Chen Yueyue , Chen Jiaxu , Zhang Zhentao , Hashimoto Kenji , Qi Qi , Zhang Ji-chun
Published: February 2021

The transcription factor erythroid 2-related factor 2 (Nrf2) and brain-derived neurotrophic factor (BDNF) play a key role in depression. However, the molecular mechanisms underlying the crosstalk between Nrf2 and BDNF in depression remain unclear. We examined whether Nrf2 regulates the transcription of Bdnf by binding to its exon I promoter. Furthermore, the role of Nrf2 and BDNF in the brain regions from mice with depression-like phenotypes was examined. Nrf2 regulated the transcription of Bdnf by binding to its exon I promoter. Activation of Nrf2 by sulforaphane (SFN) showed fast-acting antidepressant-like effects in mice by activating BDNF as well as by inhibiting the expression of its transcriptional repressors (HDAC2, mSin3A, and MeCP2) and revising abnormal synaptic transmission. In contrast, SFN did not affect the protein expression of BDNF and its transcriptional repressor proteins in the medial prefrontal cortex (mPFC) and hippocampus, nor did it reduce depression-like behaviors and abnormal synaptic transmission in Nrf2 knockout mice. In the mouse model of chronic social defeat stress (CSDS), protein levels of Nrf2 and BDNF in the mPFC and hippocampus were lower than those of control and CSDS-resilient mice. In contrast, the protein levels of BDNF transcriptional repressors in the CSDS-susceptible mice were higher than those of control and CSDS-resilient mice. These data suggest that Nrf2 activation increases the expression of Bdnf and decreases the expression of its transcriptional repressors, which result in fast-acting antidepressant-like actions. Furthermore, abnormalities in crosstalk between Nrf2 and BDNF may contribute to the resilience versus susceptibility of mice against CSDS.
The colour stability of crystallized acetyl resin material in comparison to other restorative materials. An in-vitro study
Authors: Aburaisi Sarah , Basha Abdulkarim , Al Najjar Khalid , Al Saqat Husam , Al Askar Faisal , Al Nazer Fareed
Published: February 2021

Aim

To investigate the colour stability of Crystalized Acetyl Resin, in comparison to three other aesthetic restorative materials, when immersed in different staining aqueous solutions.

Materials and methods

Fifteen disc-shaped specimens each, of the four materials tested, were immersed in either DW or 4 staining solutions. CIE L*a*b* values were recorded using a digital spectrophotometer on a weekly basis for 4 weeks. Data were compared using three- way/two-way ANOVA along with auto-regressive model.

Results

Two-way Anova indicates that there is a significant colour change in all materials over time when immersed in the different staining solutions. Auto-regressive model showed that the colour change in each successive week was statistically significant (P < 0.001).

Conclusion

The most staining solution affecting the materials during this study was black coffee. Within the limitation of this study, Acetyl Resin was the most colour stable material among the other materials.
Chemically induced local lattice distortions versus structural phase transformations in compositionally complex alloys
Authors: Ikeda Yuji , Gubaev Konstantin , Neugebauer Jörg , Grabowski Blazej , Körmann Fritz
Published: February 2021

Recent experiments show that the chemical composition of body-centered cubic (bcc) refractory high entropy alloys (HEAs) can be tuned to enable transformation-induced plasticity (TRIP), which significantly improves the ductility of these alloys. This calls for an accurate and efficient method to map the structural stability as a function of composition. A key challenge for atomistic simulations is to separate the structural transformation between the bcc and the ω phases from the intrinsic local lattice distortions in such chemically disordered alloys. To solve this issue, we develop a method that utilizes a symmetry analysis to detect differences in the crystal structures. Utilizing this method in combination with ab initio calculations, we demonstrate that local lattice distortions largely affect the phase stability of Ti–Zr–Hf–Ta and Ti–Zr–Nb–Hf–Ta HEAs. If relaxation effects are properly taken into account, the predicted compositions near the bcc–hcp energetic equilibrium are close to the experimental compositions, for which good strength and ductility due to the TRIP effect are observed.
Systematic evaluation of multiple qPCR platforms, NanoString and miRNA-Seq for microRNA biomarker discovery in human biofluids
Authors: Hong Lewis Z. , Zhou Lihan , Zou Ruiyang , Khoo Chin Meng , Chew Adeline Lai San , Chin Chih-Liang , Shih Shian-Jiun
Published: February 2021

Aberrant miRNA expression has been associated with many diseases, and extracellular miRNAs that circulate in the bloodstream are remarkably stable. Recently, there has been growing interest in identifying cell-free circulating miRNAs that can serve as non-invasive biomarkers for early detection of disease or selection of treatment options. However, quantifying miRNA levels in biofluids is technically challenging due to their low abundance. Using reference samples, we performed a cross-platform evaluation in which miRNA profiling was performed on four different qPCR platforms (MiRXES, Qiagen, Applied Biosystems, Exiqon), nCounter technology (NanoString), and miRNA-Seq. Overall, our results suggest that using miRNA-Seq for discovery and targeted qPCR for validation is a rational strategy for miRNA biomarker development in clinical samples that involve limited amounts of biofluids.
Optogenetic current in myofibroblasts acutely alters electrophysiology and conduction of co-cultured cardiomyocytes
Authors: Kostecki Geran M. , Shi Yu , Chen Christopher S. , Reich Daniel H. , Entcheva Emilia , Tung Leslie
Published: February 2021

Interactions between cardiac myofibroblasts and myocytes may slow conduction and generate spontaneous beating in fibrosis, increasing the chance of life-threatening arrhythmia. While co-culture studies have shown that myofibroblasts can affect cardiomyocyte electrophysiology in vitro, the extent of myofibroblast-myocyte electrical conductance in a syncytium is unknown. In this neonatal rat study, cardiac myofibroblasts were transduced with Channelrhodopsin-2, which allowed acute and selective increase of myofibroblast current, and plated on top of cardiomyocytes. Optical mapping revealed significantly decreased conduction velocity (− 27 ± 6%, p < 10–3), upstroke rate (− 13 ± 4%, p = 0.002), and action potential duration (− 14 ± 7%, p = 0.004) in co-cultures when 0.017 mW/mm2 light was applied, as well as focal spontaneous beating in 6/7 samples and a decreased cycle length (− 36 ± 18%, p = 0.002) at 0.057 mW/mm2 light. In silico modeling of the experiments reproduced the experimental findings and suggested the light levels used in experiments produced excess current similar in magnitude to endogenous myofibroblast current. Fitting the model to experimental data predicted a tissue-level electrical conductance across the 3-D interface between myofibroblasts and cardiomyocytes of ~ 5 nS/cardiomyocyte, and showed how increased myofibroblast-myocyte conductance, increased myofibroblast/myocyte capacitance ratio, and increased myofibroblast current, which occur in fibrosis, can work in tandem to produce pro-arrhythmic increases in conduction and spontaneous beating.
Effects of maize (Zea mays) genotypes and microbial sources in shaping fall armyworm (Spodoptera frugiperda) gut bacterial communities
Authors: Mason Charles J. , Hoover Kelli , Felton Gary W.
Published: February 2021

Plants can have fundamental roles in shaping bacterial communities associated with insect herbivores. For larval lepidopterans (caterpillars), diet has been shown to be a driving force shaping gut microbial communities, where the gut microbiome of insects feeding on different plant species and genotypes can vary in composition and diversity. In this study, we aimed to better understand the roles of plant genotypes, sources of microbiota, and the host gut environment in structuring bacterial communities. We used multiple maize genotypes and fall armyworm (Spodoptera frugiperda) larvae as models to parse these drivers. We performed a series of experiments using axenic larvae that received a mixed microbial community prepared from frass from larvae that consumed field-grown maize. The new larval recipients were then provided different maize genotypes that were gamma-irradiated to minimize bacteria coming from the plant during feeding. For field-collected maize, there were no differences in community structure, but we did observe differences in gut community membership. In the controlled experiment, the microbial inoculation source, plant genotype, and their interactions impacted the membership and structure of gut bacterial communities. Compared to axenic larvae, fall armyworm larvae that received frass inoculum experienced reduced growth. Our results document the role of microbial sources and plant genotypes in contributing to variation in gut bacterial communities in herbivorous larvae. While more research is needed to shed light on the mechanisms driving this variation, these results provide a method for incorporating greater gut bacterial community complexity into laboratory-reared larvae.
Outcomes of a 2-year treat-and-extend regimen with aflibercept for diabetic macular edema
Authors: Hirano Takao , Toriyama Yuichi , Takamura Yoshihiro , Sugimoto Masahiko , Nagaoka Taiji , Sugiura Yoshimi , Okamoto Fumiki , Saito Michiyuki , Noda Kousuke , Yoshida Shigeo , Ishibazawa Akihiro , Sawada Osamu , Murata Toshinori
Published: February 2021

This prospective, open-label, single-arm, non-randomized clinical trial, assessed the efficacy of a 2-year treat-and-extend (T&E) regimen involving intravitreal aflibercept injection (IAI), with the longest treatment interval set to 16 weeks, and adjunct focal/grid laser in diabetic macula edema (DME) patients. We examined 40 eyes (40 adults) with fovea-involving DME from 8 Japanese centers between April 2015 and February 2017. Participants received IAI with an induction period featuring monthly injections and a subsequent T&E period featuring 8–16-week injection interval, adjusted based on optical coherence tomography findings. The primary endpoints were mean changes in the best-corrected visual acuity (BCVA) and central subfield macular thickness (CST) from baseline. Thirty patients (75%) completed the 2-year follow-up. The mean BCVA and CST changed from 60.5 ± 15.6 letters and 499.2 ± 105.6 µm at baseline to 66.6 ± 17.1 letters (P = 0.217) and 315.2 ± 79.0 µm (P < 0.001), respectively, after 2 years. The treatment interval was extended to 12 and 16 weeks in 6.7% and 66.7% of patients, respectively, at the end of 2 years. The T&E aflibercept regimen with the longest treatment interval set to 16 weeks, with adjunct focal/grid laser may be a rational 2-year treatment strategy for DME.