bluuebunny/crossref_metadata_2025 huggingface dataset:
Histopathological and Anti-hemorrhoid Effect of the Leaf Extract of Ocimum gratissimum in Croton Oil-induced Hemorrhoid
Authors: E. C. Moneme, , A. C. Nwaka, , A.A. Oladejo, , R. O. Anyanwu, , M. E Onuegbu, , F. O. Ajakpofo,
Published: November 2024

The use of medicinal plants in the treatment of various diseases dates back into centuries. Hemorrhoids are swollen veins in the lower rectum or anus, ranging from being acute to a complicated state; and affecting several millions of people worldwide. This study evaluates the histopathological and anti-hemorrhoid effect of the leaf extract of Ocimum gratissimum in croton oil-induced hemorrhoid in wistar rats. Hemorrhoids was induced to the experimental animals using croton oil, following standard methods. Thirty five (35) wistar rats were randomly grouped into five classes (A, B, C, D and E) of seven rats each. Groups A, B and C served as normal control (un-induced, untreated), negative control (induced, untreated) and standard control (induced, treated with standard drug; Daflon) respectively while groups D and E served as treatment groups and were administered 100 and 400 mg/kg dose of ethanol leaf extract of Ocimum gratissimum respectively.  All the rats (except the group A) animals were induced with croton oil  and were thereafter treated for  fourteen days (two weeks). The body weight of the animals were monitored throughout the experimental period and percentage rectal water content, anorectal coefficient as well as histopathological assay were carried out at the end of the fourteen days, using standard methods. Results showed a significant decrease (p>0.05) in body weight of the untreated group while there was  a marked increase in the body weight of the animals in the extract treated groups from day 1 to the 14th day. The result of the percentage rectal water content as well as anorectal coefficient of the untreated group showed a significant increase (p<0.05) (76%) when compared to the extract treated groups (67%), while the histopathological studies showed a reversal of the inflammatory and necrotic conditions of the induced anorectal portion for the extract treated animals. From the result of this study, it could be concluded that  the leaf extract of Ocimum gratissimum could help to mitigate anorectal disorders and contribute significantly to improved health.
Use of Jute in Road Subgrade
Authors: Rahman MD Rafiur , Rofi MD Rofiul Islam
Published: November 2024

In recent years jute geotextile used different areas of construction. It is relatively cheap and durable. It increases the bearing capability of soil that used in construction. It can be used in different purposes such as prevention of soil erosion,strengthening road subgrade etc. By using different length of jute fibre in pavement the strength of the subgrade can be increased. CBR value for different position of road has been studied by using different length of moulde of jute. In this review paper we studied about uses of jute to improve the strength of subgrade on road construction with the help of different kind of soil.Black Cotton soil,Murum soil and Mix soil are used to compare CBR value
Copper/carbon composites from waste printed circuit boards as catalysts for Fenton‐like degradation of Acid Orange 7 enhanced by ultrasound
Authors: Wang Chong‐Qing , Jiang Xiao‐Yan , Huang Rong , Cao Yi‐Jun , Xu Jing , Han Yi‐Fan
Published: December 2018

A novel strategy of “waste treating waste” has been implemented in this work. Copper/carbon (Cu/C) composites prepared by the carbonization of waste printed circuit boards (PCBs) were used for the degradation of Acid Orange 7 (AO7). Catalytic degradation of AO7 was conducted by varying carbonization temperatures, catalyst dosage, H2O2 dosage, AO7 concentration, pH values, and anions. Ultrasound significantly improved AO7 degradation, obtaining 93.27% degradation within 90 min. We report that Cu/C composites show good catalytic activity in a broad pH range. Cu/C catalysts were characterized by multitechniques. Cu0 was the main active component for the generation of •OH that was the reactive oxidant for AO7 degradation. The plausible pathway and catalytic mechanism for AO7 degradation were proposed. The unique structure of Cu/C composites gave a combined mechanism of adsorption and catalysis. Cu/C composites showed superior durability for AO7 degradation. Using Cu/C composites as catalysts provides a green approach for wastewater treatment and waste management. © 2019 American Institute of Chemical Engineers AIChE J, 65: 1234–1244, 2019
Inbreeding in the last ruling dynasty of Portugal: The house of Braganza
Authors: Álvarez Gonzalo , Vilas Román , Ceballos Francisco C. , Carvalhal Hélder , Peters Timothy J.
Published: December 2018

Objectives

To determine whether: (1) there are high levels of inbreeding in a European royal dynasty that continues until the 20th century, and (2) whether inbreeding is negatively associated with pre‐reproductive survival and longevity.

Methods

Genealogical information of all Braganza monarchs (1640‐1910) was used to compute the individual's inbreeding coefficient (F) and the coefficient of kinship (θ) of the marriage which were examined in relation to two life‐history traits.

Results

Mean F of the monarchs was 0.0530, close to that corresponding to the progeny of first cousins (F = 0.0625). A statistically significant effect of maternal inbreeding on offspring longevity (P = 0.037) and a significant effect of individual's F on survival from birth to 10 years (P = 0.023) were detected.

Conclusions

Another European royal dynasty besides the Habsburgs had high levels of inbreeding, especially high during a period after the early modern age. The lineage showed evidence of inbreeding depression. Results support the hypothesis that an increase in maternal homozygosity affects the lifespan of the progeny.
Clinical diversity of MYH7‐related cardiomyopathies: Insights into genotype–phenotype correlations
Authors: Hershkovitz Tova , Kurolap Alina , Ruhrman‐Shahar Noa , Monakier Daniel , DeChene Elizabeth T. , Peretz‐Amit Gabriela , Funke Birgit , Zucker Nili , Hirsch Rafael , Tan Wen‐Hann , Baris Feldman Hagit
Published: December 2018

MYH7‐related disease (MRD) is the most common hereditary primary cardiomyopathy (CM), with pathogenic MYH7 variants accounting for approximately 40% of familial hypertrophic CMs. MRDs may also present as skeletal myopathies, with or without CM. Since pathogenic MYH7 variants result in highly variable clinical phenotypes, from mild to fatal forms of cardiac and skeletal myopathies, genotype–phenotype correlations are not always apparent, and translation of the genetic findings to clinical practice can be complicated. Data on genotype–phenotype correlations can help facilitate more specific and personalized decisions on treatment strategies, surveillance, and genetic counseling. We present a series of six MRD pedigrees with rare genotypes, encompassing various clinical presentations and inheritance patterns. This study provides new insights into the spectrum of MRD that is directly translatable to clinical practice.
The efficacy of whole human genome capture on ancient dental calculus and dentin
Authors: Ziesemer Kirsten A. , Ramos‐Madrigal Jazmín , Mann Allison E. , Brandt Bernd W. , Sankaranarayanan Krithivasan , Ozga Andrew T. , Hoogland Menno , Hofman Courtney A. , Salazar‐García Domingo C. , Frohlich Bruno , Milner George R. , Stone Anne C. , Aldenderfer Mark , Lewis Cecil M. , Hofman Corinne L. , Warinner Christina , Schroeder Hannes
Published: December 2018

Objectives

Dental calculus is among the richest known sources of ancient DNA in the archaeological record. Although most DNA within calculus is microbial, it has been shown to contain sufficient human DNA for the targeted retrieval of whole mitochondrial genomes. Here, we explore whether calculus is also a viable substrate for whole human genome recovery using targeted enrichment techniques.

Materials and methods

Total DNA extracted from 24 paired archaeological human dentin and calculus samples was subjected to whole human genome enrichment using in‐solution hybridization capture and high‐throughput sequencing.

Results

Total DNA from calculus exceeded that of dentin in all cases, and although the proportion of human DNA was generally lower in calculus, the absolute human DNA content of calculus and dentin was not significantly different. Whole genome enrichment resulted in up to four‐fold enrichment of the human endogenous DNA content for both dentin and dental calculus libraries, albeit with some loss in complexity. Recovering more on‐target reads for the same sequencing effort generally improved the quality of downstream analyses, such as sex and ancestry estimation. For nonhuman DNA, comparison of phylum‐level microbial community structure revealed few differences between precapture and postcapture libraries, indicating that off‐target sequences in human genome‐enriched calculus libraries may still be useful for oral microbiome reconstruction.

Discussion

While ancient human dental calculus does contain endogenous human DNA sequences, their relative proportion is low when compared with other skeletal tissues. Whole genome enrichment can help increase the proportion of recovered human reads, but in this instance enrichment efficiency was relatively low when compared with other forms of capture. We conclude that further optimization is necessary before the method can be routinely applied to archaeological samples.
New distance‐based exponential regression method and equations for estimating the chronology of linear enamel hypoplasia (LEH) defects on the anterior dentition
Authors: Cares Henriquez Alejandra , Oxenham Marc F.
Published: December 2018

Objectives

We present a new distance‐based exponential regression approach based on published histological data to refine the objectivity, accuracy, and precision of age estimates of LEH defect formation on the anterior dentition.

Methods

Published histological data of anterior tooth crown growth for two samples (northern European and southern African) were fitted with exponential trendlines to construct exponential regression equations for each tooth type. A theoretical comparison of the age estimates produced by two commonly used methods (decile chart and linear regression), and those based on the exponential regression equations presented in this article were undertaken. Paired‐samplest‐tests were used to determine whether the estimates obtained by these methods differed significantly.

Results

Exponential regression equations were able to accurately replicate age estimates produced by the decile‐chart method. For defects that fell precisely on a decile, estimates differed by 1–23 days. Estimates based on the linear regression method were consistently younger by 4.5–16 months. For defects that fell within deciles, the exponential regression equation estimates, when different, were 12 days to 4 months older than those yielded by the decile method.

Conclusions

By combining currently published histological data on anterior tooth crown growth with a regression approach, it is possible to produce more accurate age estimates than yielded by methods that do not rely on histological data. Furthermore, this approach also greatly improves the objectivity, precision and replicability of results, especially for defects that fall between deciles, when compared to the decile chart method.
Applications of Insect‐Derived Protein Ingredients in Food and Feed Industry
Authors: Lamsal Buddhi , Wang Hui , Pinsirodom Praphan , Dossey Aaron T.
Published: December 2018

The need for novel and diverse sources of protein to feed the growing world population is urgent and stark. At the same time, peoples’ eating habits and values are also changing, with more consumers considering alternatives to traditional sources of protein. Novel protein sources not only need to provide essential amino acids and nutrition, but also cater to taste, convenience, cost economics, and personal needs. They also need to be ethically produced, with a smaller environmental footprint, and when feasible, closer to consumer. Insect protein has been researched intensively in recent years with promises to best fulfill these needs. As the insect protein field and industry are expanding and getting more mature at this stage, this review summarizes their properties and applications within the context of the food and feed industry. The important functional properties that make insect proteins useful are also discussed.
A machine learning approach to investigate potential risk factors for gastroschisis in California
Authors: Weber Kari A. , Yang Wei , Carmichael Suzan L. , Padula Amy M. , Shaw Gary M.
Published: December 2018

Background

To generate new leads about risk factors for gastroschisis, a birth defect that has been increasing in prevalence over time, we performed an untargeted data mining statistical approach.

Methods

Using data exclusively from the California Center of the National Birth Defects Prevention Study, we compared 286 cases of gastroschisis and 1,263 non‐malformed, live‐born controls. All infants had delivery dates between October 1997 and December 2011 and were stratified by maternal age at birth (<20 and ≥ 20 years). Cases and controls were compared by maternal responses to 183 questions (219 variables) using random forest, a data mining procedure. Variables deemed important by random forest were included in logistic regression models to estimate odds ratios and 95% confidence intervals.

Results

Among women younger than 20, of variables deemed important, there were higher odds observed for higher consumption of chocolate, low intake of iron, acetaminophen use, and urinary tract infections during the beginning of pregnancy. After adjustment, the higher odds remained for low iron intake and a urinary tract infection in the first month of pregnancy. Among women aged 20 or older, of variables deemed important, higher odds were observed for US‐born women of Hispanic ethnicity and for parental substance abuse. There were lower odds observed for obese women, women who ate any cereal the month before pregnancy, and those with higher parity.

Conclusions

We did not discover many previously unreported associations, despite our novel approach to generate new hypotheses. However, our results do add evidence to some previously proposed risk factors.
The link between fiction and teenagers’ reading skills: International evidence from the OECD PISA study
Authors: Jerrim John , Moss Gemma
Published: December 2018

It is well known that children who read more tend to achieve higher scores in academic reading tests. Much less is known, however, about the link between reading different types of text and young people's reading performance. We investigate this issue using the Programme for International Student Assessment (PISA) 2009 database, exploring the association between the frequency with which teenagers read five different types of text (magazines, non‐fiction, fiction, newspapers and comics) and their PISA reading scores. Analysing data from more than 250,000 teenagers from across 35 industrialised countries, we find evidence of a sizeable ‘fiction effect’; young people who read this type of text frequently have significantly stronger reading skills than their peers who do not. In contrast, the same does not hold true for the four other text types. We therefore conclude that encouraging young people to read fiction may be particularly beneficial for their reading skills. Interventions encouraging fiction reading may be especially important for boys from disadvantaged socio‐economic backgrounds, who are less likely to read this text type.
Can variation in standard metabolic rate explain context‐dependent performance of farmed Atlantic salmon offspring?
Authors: Robertsen Grethe , Reid Donald , Einum Sigurd , Aronsen Tonje , Fleming Ian A. , Sundt‐Hansen Line E. , Karlsson Sten , Kvingedal Eli , Ugedal Ola , Hindar Kjetil
Published: December 2018

Escaped farmed Atlantic salmon interbreed with wild Atlantic salmon, leaving offspring that often have lower success in nature than pure wild salmon. On top of this, presence of farmed salmon descendants can impair production of wild‐type recruits. We hypothesize that both these effects connect with farmed salmon having acquired higher standard metabolic rates (SMR, the energetic cost of self‐maintenance) during domestication. Fitness‐related advantages of phenotypic traits associated with both high SMR and farmed salmon (e.g., social dominance) depend on environmental conditions, such as food availability. We hypothesize that farmed offspring have an advantage at high food availability due to, for example, dominance behavior but suffer increased risks of starvation when food is scarce because this behavior is energy‐demanding. To test these hypotheses, we first compare embryo SMR of pure farmed, farmed‐wild hybrids and pure wild offspring. Next, we test early‐life performance (in terms of survival and growth) of hybrids relative to that of their wild half‐siblings, as well as their competitive abilities, in semi‐natural conditions of high and low food availability. Finally, we test how SMR affects early‐life performance at high and low food availability. We find inconclusive support for the hypothesis that domestication has induced increased SMR. Further, wild and hybrid juveniles had similar survival and growth in the semi‐natural streams. Yet, the presence of hybrids led to decreased survival of their wild half‐siblings. Contrary to our hypothesis about context‐dependency, these effects were not modified by food availability. However, wild juveniles with high SMR had decreased survival when food was scarce, but there was no such effect at high food availability. This study provides further proof that farmed salmon introgression may compromise the viability of wild salmon populations. We cannot, however, conclude that this is connected to alterations in the metabolic phenotype of farmed salmon.
Migratory patterns and connectivity of two North American grassland bird species
Authors: Hill Jason M. , Renfrew Rosalind B.
Published: December 2018

Effective management and conservation of migratory bird populations require knowledge and incorporation of their movement patterns and space use throughout the annual cycle. To investigate the little‐known migratory patterns of two grassland bird species, we deployed 180 light‐level geolocators on Grasshopper Sparrows (Ammodramus savannarum) and 29 Argos‐GPS tags on Eastern Meadowlarks (Sturnella magna) at Konza Prairie, Kansas, USA, and six US Department of Defense (DoD) installations distributed across the species' breeding ranges. We analyzed location data from 34 light‐level geolocators and five Argos‐GPS tags attached for 1 year to Grasshopper Sparrows and Eastern Meadowlarks, respectively. Grasshopper Sparrows were present on the breeding grounds from mid‐April through early October, substantially longer than previously estimated, and migrated on average ~2,500 km over ~30 days. Grasshopper Sparrows exhibited strong migratory connectivity only at a continental scale. The North American Great Lakes region likely serves as a migratory divide for Midwest and East Coast Grasshopper Sparrows; Midwest populations (Kansas, Wisconsin, and North Dakota; n = 13) largely wintered in Texas or Mexico, whereas East Coast populations (Maryland and Massachusetts, n = 20) wintered in the northern Caribbean or Florida. Our data from Eastern Meadowlarks provided evidence for a diversity of stationary and short‐ and long‐distance migration strategies. By providing the most extensive examination of the nonbreeding movement ecology for these two North American grassland bird species to date, we refine information gaps and provide key insight for their management and conservation.
Phenology as a process rather than an event: from individual reaction norms to community metrics
Authors: Inouye Brian D. , Ehrlén Johan , Underwood Nora
Published: December 2018

Measures of the seasonal timing of biological events are key to addressing questions about how phenology evolves, modifies species interactions, and mediates biological responses to climate change. Phenology is often characterized in terms of discrete events, such as a date of first flowering or arrival of first migrants. We discuss how phenological events that are typically measured at the population or species level arise from distributions of phenological events across seasons, and from norms of reaction of these phenological events across environments. We argue that individual variation in phenological distributions and reaction norms has important implications for how we should collect, analyze, and interpret phenological information. Regarding phenology as a reaction norm rather than one year's specific values implies that selection acts on the phenologies that an individual expresses over its lifetime. To understand how climate change is likely to influence phenology, we need to consider not only plastic responses along the reaction norm but changes in the reaction norm itself. We show that when individuals vary in their reaction norms, correlations between reaction norm elevation and slope make first events particularly poor estimators of population sensitivity to climate change, and variation in slopes can obscure the pattern of selection on phenology. We also show that knowing the shape of the distribution of phenological events across the season is important for predicting biologically important phenological mismatches with climate change. Last, because phenological events are parts of a continuous developmental process, we suggest that the approach of measuring phenology by recording developmental stages of individuals in a population at a single point in time should be used more widely. We conclude that failure to account for phenological distributions and reaction norms may lead to overinterpretation of metrics based on single events, such as commonly recorded first event dates, and may confound meta‐analyses that use a range of metrics. Rather than prescribing a single universal approach to studying phenology, we point out limitations of inferences based on single metrics and encourage work that considers the multivariate nature of phenology and more tightly links data collection and analyses with biological hypotheses.
A perspective on a locally managed decentralized circular economy for waste plastic in developing countries
Authors: Joshi Chandni , Seay Jeffrey , Banadda Noble
Published: December 2018

Unsound post‐consumer disposal is the primary pathway of plastic into the ecosystem. One way of addressing this problem is through the establishment of a circular economy for plastic. Much of the unsound disposal comes from economically disadvantaged regions where waste disposal and recycling infrastructure is limited. In economically disadvantaged regions however, the establishment of a circular economy for plastic must be locally managed and decentralized, meaning that the disposal, collection, remanufacture, and use must all occur within the same community. We suggest that waste plastic abatement strategies must be targeted to reduce, reuse, and recycle plastic waste onsite at the local level, initiating a circular economy appropriate for infrastructure limited regions. Technologies for recycling plastic must be low cost, economically viable, socially acceptable, and not adversely impact the environment, and also produce a product that has a ready local market. This is critical because unless proposed solutions are also economically viable and socially appropriate, they are unlikely to be successful, especially in underdeveloped regions. Using big data analysis, a metric for identifying countries that will have the most potential to benefit from a locally managed decentralized circular economy for plastic has been developed. The information obtained from this metric will help researchers and policy makers promote a locally managed decentralized circular economy of plastic for managing the accumulation of waste on land and its eventual migration into waterways. Additionally, we present a case study of a proposed locally managed decentralized waste plastic abatement strategy in the municipal solid waste infrastructure limited country of Uganda. © 2018 American Institute of Chemical Engineers Environ Prog, 38: 3–11, 2019
CD11a expression distinguishes infiltrating myeloid cells from plaque‐associated microglia in Alzheimer's disease
Authors: Shukla Ankita K. , McIntyre Laura L. , Marsh Samuel E. , Schneider Christine A. , Hoover Evelyn M. , Walsh Craig M. , Lodoen Melissa B. , Blurton‐Jones Mathew , Inlay Matthew A.
Published: December 2018

Alzheimer's disease (AD) is the leading cause of age‐related neurodegeneration and is characterized neuropathologically by the accumulation of insoluble beta‐amyloid (Aβ) peptides. In AD brains, plaque‐associated myeloid (PAM) cells cluster around Aβ plaques but fail to effectively clear Aβ by phagocytosis. PAM cells were originally thought to be brain‐resident microglia. However, several studies have also suggested that Aβ‐induced inflammation causes peripheral monocytes to enter the otherwise immune‐privileged brain. The relationship between AD progression and inflammation in the brain remains ambiguous because microglia and monocyte‐derived macrophages are extremely difficult to distinguish from one another in an inflamed brain. Whether PAM cells are microglia, peripheral macrophages, or a mixture of both remains unclear. CD11a is a component of the β2 integrin LFA1. We have determined that CD11a is highly expressed on peripheral immune cells, including macrophages, but is not expressed by mouse microglia. These expression patterns remain consistent in LPS‐treated inflamed mice, as well as in two mouse models of AD. Thus, CD11a can be used as a marker to distinguish murine microglia from infiltrating peripheral immune cells. Using CD11a, we show that PAM cells in AD transgenic brains are comprised entirely of microglia. We also demonstrate a novel fluorescence‐assisted quantification technique (FAQT), which reveals a significant increase in T lymphocytes, especially in the brains of female AD mice. Our findings support the notion that microglia are the lead myeloid players in AD and that rejuvenating their phagocytic potential may be an important therapeutic strategy.
Necl‐4/Cadm4 recruits Par‐3 to the Schwann cell adaxonal membrane
Authors: Meng Xiaosong , Maurel Patrice , Lam Isabel , Heffernan Corey , Stiffler Michael A. , McBeath Gavin , Salzer James L.
Published: December 2018

Interactions between axons and Schwann cells are essential for the acquisition of Schwann cell radial and longitudinal polarity and myelin sheath assembly. In the internode, the largest of these longitudinal domains, axon‐Schwann cell interactions are mediated by the Nectin‐like (Necl) cell adhesion proteins, also known as SynCAMs or Cadms. In particular, Necl‐1/Cadm3 expressed on the axon surface binds to Necl‐4/Cadm4 expressed along the adaxonal membrane of myelinating Schwann cells. Necl‐4 promotes myelination in vitro and is required for the timely onset of myelination and the fidelity of the organization of the myelin sheath and the internode in vivo. A key question is the identity of the downstream effectors of Necl‐4 that mediate its effects. The cytoplasmic terminal region (CTR) of Necl‐4 contains a PDZ‐domain binding motif. Accordingly, we used the CTR of Necl‐4 in an unbiased proteomic screen of PDZ‐domain proteins. We identify Par‐3, a multi‐PDZ domain containing protein of the Par‐aPKC polarity complex previously implicated in myelination, as an interacting protein. Necl‐4 and Par‐3 are colocalized along the inner Schwann cell membrane and coprecipitate from Schwann cell lysates. The CTR of Necl‐4 binds to the first PDZ domain of Par‐3 thereby recruiting Par‐3 to sites of Necl‐4/Necl‐1 interaction. Knockdown of Necl‐4 perturbs Par‐3 localization to the inner membrane of Schwann cells in myelinating co‐cultures. These findings implicate interactions of Necl‐1/Necl‐4 in the recruitment of Par‐3 to the Schwann cell adaxonal membrane and the establishment of Schwann cell radial polarity.
Research Information for Reasonable People
Authors: Dresser Rebecca
Published: December 2018

In 2017, federal officials issued a revised version of the Common Rule, the federal regulations that govern much of the human subject research conducted in the United States. Two provisions on information disclosure have reportedly provoked confusion among researchers and people responsible for research oversight. These provisions incorporate the familiar and foundational legal concept known as the reasonable person standard, applying this to research disclosure. Although other, long‐standing Common Rule provisions require reasonableness judgments, the new provisions differ in that they require reasonableness to be judged from the ordinary person's perspective instead of the perspective of scientists, clinicians, and other experts generally involved in designing and reviewing human studies.
Work Requirements That Don't Work
Authors: Latham Stephen R.
Published: December 2018

Early in 2018, the Trump administration's Centers for Medicare and Medicaid Services issued a guidance letter outlining a new and controversial kind of Medicaid waiver proposal. The administration invited states to propose waivers that would impose work (or other “community engagement”) requirements as a condition of eligibility for Medicaid. The Trump administration and state proponents of work requirements want to force able‐bodied Medicaid beneficiaries into the workplace. Critics allege that this is because they mistakenly believe that low‐income individuals are not working because they're lazy or because aid programs provide them with a disincentive to work. Proponents respond that the requirements can lower the public programs' costs while helping its recipients. Medicaid data seems to show that the work‐requirement proposals are a solution in search of a real‐life problem.
Who Deserves Access to Care in Children's Hospitals?
Authors: Caruso Brown Amy E. , Frega Katherine
Published: December 2018

An eighteen‐year‐old with sickle cell disease was admitted to the pediatric hematology service at his local children's hospital for management of an acute pain crisis, one of many such admissions. He had a good relationship with his primary hematologist and primary nurse, but with other health care providers, there was evident friction. Sometimes, he was simply rude, rolling over and pretending to sleep in response to questions about his symptoms. When frustrated or convinced that his pain was not being addressed appropriately, he was prone to yelling and cursing at his nurses. After members of the health care team complained, their supervisor decided to transfer the patient to an adult general medicine service. Reasons cited for the transition included the stressful work environment created by the patient's actions, his refusal to follow directives from staff (although he was generally adherent to treatment), and the hypothetical harm to other young patients who might witness his behavior. Was this a just outcome? Is it ever permissible to deny access to pediatric care to a patient whose best interests would be served by it? Can access be withheld for “bad” behavior, and can transfer of care be wielded as a punishment?
Wrestling with the Monster: Frankenstein and Organ Transplantation
Authors: Trump Eric
Published: December 2018

In December 1967, Louis Washkansky, a grocer living in South Africa, became the first person to awaken after a heart transplant. Some accounts say that his first words were, “I am the new Frankenstein.” Others claim that Christiaan Barnard, his transplant surgeon, uttered these. Much as people have long mixed up who Frankenstein is—creature or creator?—in Mary Shelley's novel, so patient and surgeon, repaired and repairer, are confused in retellings of this post‐op Frankensteinian moment. Whether Washkansky identified with Frankenstein's monster or not, he was probably feeling a bit monstrous after taking the donor heart of Denise Darvall into his chest. I know I was, over thirty years later, standing naked before a mirror and gazing at my shorn and bloated torso for the first time since a kidney transplant. My boundaries had been rearranged: a crescentic scar marked the frontier between me and not‐me.
Rereading Frankenstein: What If Victor Frankenstein Had Actually Been Evil?
Authors: Robert Jason Scott
Published: December 2018

As we reread Mary Shelley's Frankenstein at two hundred years, it is evident that Victor Frankenstein is both a mad scientist (fevered, obsessive) and a bad scientist (secretive, hubristic, irresponsible). He's also not a very nice person. He's a narcissist, a liar, and a bad “parent.” But he is not genuinely evil. And yet when we reimagine him as evil—as an evil scientist and as an evil person—we can learn some important lessons about science and technology, our contemporary society, and ourselves.
Locating the Source(s) of the Social Value Requirement(s)
Authors: Wendler David
Published: December 2018

In this issue of the Hastings Center Report, Danielle Wenner looks at a few prominent analyses of the social value requirement for clinical research, claiming that they are all based on what she calls a transactional model of research ethics. She argues that the transactional model fails to provide a secure foundation for the social value requirement, and then, appealing to John Rawls, she argues that a more secure foundation lies in the principles of social justice. Wenner's attempt to locate the source of the social value requirement raises important questions regarding its scope and strength. To determine what the social value requirement requires, we need to know why it's a requirement. Does the social value requirement apply to all trials or only to a subset? Is it a necessary condition on ethical research or an important consideration that can conflict with, and sometimes be defeated by, other considerations? Wenner's attempt to answer these questions is obscured by the fact that she mistakenly regards a minority view of research ethics as the mainstream view. Once we correct for that, her analysis of the foundation of the social value requirement provides a valuable opportunity to consider how the ethics of research as an institution might supplement or alter the ethics of individual clinical trials.
Poverty: Not a Justification for Banning Physician‐Assisted Death
Authors: Freeman Lindsey M. , Rose Susannah L. , Youngner Stuart J.
Published: December 2018

Many critics of the legalization of physician‐assisted death oppose it in part because they fear it will further disadvantage those who are already economically disadvantaged. This argument points to a serious problem of how economic considerations can influence medical decisions, but in the context of PAD, the concern is not borne out. We will provide empirical evidence suggesting that concerns about money influence medical decisions throughout the full course of illness, but at the end of life, financial pressure is much more likely to influence a decision to pursue or reject aggressive life‐extending care than it is to influence a request for PAD. We will also address the question of whether financial pressure as a result of being poor—particularly in the context of an inadequate social safety net—robs people of their autonomy, rendering their informed request and consent invalid. We argue that it does not. We will emphasize the impracticality and injustice of rejecting the role of poverty as a legitimate factor in decision‐making, the irrational distinction between PAD and withdrawal of life‐sustaining care, and the more appropriate focus on the great flaws in the American health care system.
Baseline intraoperative intact parathyroid hormone levels in parathyroid surgery
Authors: Duke William S. , Omesiete Wilson I. , Walsh Nathaniel J. , Terris David J.
Published: December 2018

Background

We sought to evaluate the relationship between the preoperative core‐laboratory parathyroid hormone (CL‐PTH) level and the baseline intraoperative PTH (IOPTH) level and assess the impact of any differences on clinical decision making in consecutive surgical patients with primary hyperparathyroidism undergoing parathyroidectomy.

Methods

The CL‐PTH and baseline IOPTH levels were compared. The influence of relying on either the CL‐PTH or baseline PTH levels for intraoperative decision making was determined.

Results

Data were available for 316 patients. Baseline IOPTH measurements were usually higher than the CL‐PTH (247 patients; 78.2%) measurements, with a mean difference of 68.2 pg/mL (P < .001). Using the CL‐PTH as a surrogate for the baseline parathyroid hormone (PTH) would have prolonged the operation in 23 patients (7.3%).

Conclusion

Baseline point‐of‐care IOPTH levels were higher than the preoperative CL‐PTH levels in >75% of patients undergoing parathyroidectomy. Using the CL‐PTH in lieu of an IOPTH baseline value would prolong the operation in some patients.
Financial Compensation For Hepatologists in Different Practice Settings
Authors: Shiffman Mitchell L. , Sussman Norman L. , Ravendhran Natarajan , Ditmyer Macia , Kowdley Kris V. , Kugelmas Marcelo
Published: December 2018

Several governmental agencies and private organizations monitor data on relative value units (RVUs) and salary earned by various medical specialists. There are currently no data that define the RVU production and salary earned by hepatologists. A web‐based survey that queried the number of patients that a hepatologist cares for, RVU production, and salary support was sent to 2,587 members of the American Association for the Study of Liver Diseases. A total of 391 members completed the survey, 229 of whom reported spending more than 75% of their time in clinical practice/direct patient care and served as the basis for this analysis. The mean age of the cohort was 48 years, 77% were male, and all regions of country were represented. Their mean duration in clinical practice was 11.4 years. Hepatologists worked in four practice settings: university hospital with a liver transplant (LT) program (UHLT, n = 148), non‐university hospital with LT (nonUHLT, n = 35), university hospital with no LT (UHnoLT, n = 29), and community practice (CP, n = 17). The average number of patients seen monthly was lowest for hepatologists at a UHLT (154) and highest for those in CP (293). Hepatologists at LT programs saw the highest percentage of patients with liver disease (91% of encounters), performed the fewest endoscopic procedures (12%‐17%), but received the highest compensation/RVU ($68‐$85) compared with hepatologists at UHnoLT and CP ($44‐$63/RVU). The mean base salary for all hepatologists with fewer than 5 years of experience was $273,507, and this increased to $347,656 for those with more than 5 years of experience. We concluded that hepatologists at LT centers are compensated at much higher rates per encounter than in other practice settings. This may be due to salary subsidies provided by the UHLT and nonUHLT to their hepatologists.
Microfluidic enrichment, isolation and characterization of disseminated melanoma cells from lymph node samples
Authors: Weidele Kathrin , Stojanović Nataša , Feliciello Giancarlo , Markiewicz Aleksandra , Scheitler Sebastian , Alberter Barbara , Renner Philipp , Haferkamp Sebastian , Klein Christoph A. , Polzer Bernhard
Published: December 2018

For the first time in melanoma, novel therapies have recently shown efficacy in the adjuvant therapy setting, which makes companion diagnostics to guide treatment decisions a desideratum. Early spread of disseminated cancer cells (DCC) to sentinel lymph nodes (SLN) is indicative of poor prognosis in melanoma and early DCCs could therefore provide important information about the malignant seed. Here, we present a strategy for enrichment of DCCs from SLN suspensions using a microfluidic device (Parsortix™, Angle plc). This approach enables the detection and isolation of viable DCCs, followed by molecular analysis and identification of genetic changes. By optimizing the workflow, the established protocol allows a high recovery of DCC from melanoma patient‐derived lymph node (LN) suspensions with harvest rates above 60%. We then assessed the integrity of the transcriptome and genome of individual, isolated DCCs. In LNs of melanoma patients, we detected the expression of melanoma‐associated transcripts including MLANA (encoding for MelanA protein), analyzed the BRAF and NRAS mutational status and confirmed the malignant origin of isolated melanoma DCCs by comparative genomic hybridization. We demonstrate the feasibility of epitope‐independent isolation of LN DCCs using Parsortix™ for subsequent molecular characterization of isolated single DCCs with ample application fields including the use for companion diagnostics or subsequent cellular studies in personalized medicine.
Maya children working in the streets: Value mismatches from the village to the street setting
Authors: Tovote Katrin E. , Maynard Ashley E.
Published: December 2018

In the highlands of Chiapas, Mexico, a large number of indigenous Maya people have relocated from their villages to an urban centre where many families, especially mothers and children, work as street vendors. We were interested in the typical cultural expectations for the development of Maya girls, the ways that these expected patterns were interrupted by street work, and the ways that girls and families dealt with this novel situation. In order to provide a more complete picture, we compared the daily experiences of girls who work on the street with those of their male counterparts and with the routines of girls who lived in traditional, rural settings. Our data include ethnographic observations and a census (N= 250–300), informal chats (N= 250–300), and semi‐structured interviews with children (N= 51) and adults (N= 25). Using Greenfield's theory of social change and development, we found a coexistence of value matches and mismatches. These addressed adherence to tradition versus embracing ethnic variety and innovation valued in money‐based market economies and collective responsibility versus individual choice and expression. This mix of values occurred in the domains of gender roles for work, motivation for street work, leisure time, and schooling.
Cross‐cultural value mismatch in German day care institutions: Perspectives of migrant parents and day care teachers
Authors: Bossong Laura , Keller Heidi
Published: December 2018

Immigrant parents encounter educational approaches in the host country that differ from what they know and expect from institutional childcare. With our study we would like to contribute to the understanding of these differences. We collected information concerning developmental goals and educational strategies from 151 mothers with children between 0 and 6 years, differing in level of education and ethnic background (German, Turkish, and Russian) and from 36 childcare teachers also of different ethnic origin (German, Turkish, and Russian). Interview and questionnaire data were analysed with qualitative content analysis and inferential statistics. Results indicate that in all childcare teachers prefer autonomy‐oriented developmental goals and a constructivist approach to education. More educated German mothers agree widely with the teachers. In contrast, migrant mothers and less‐educated German mothers differ significantly from the teacher's perspectives. These mothers prefer developmental goals oriented towards relatedness and a didactic approach to education. They are also more focused on the physical well‐being and the bodily integrity of their children. The discrepancies were most striking between childcare teachers and less‐educated Turkish and Russian migrant mothers. The results are discussed with respect to the claim of providing equal chances for all children.
A neurodevelopmental perspective on male violence
Authors: Raine Adrian
Published: December 2018

Research is increasingly documenting a neurobiological basis to violence. This review takes a neurodevelopmental perspective on the very small group of males who grow up to become persistent violent offenders. After outlining six criteria for what constitutes a neurodevelopmental disorder, the extent to which chronic violence meets these definitional criteria is examined, covering the fields of genetics, structural and functional brain imaging, and neuropsychology. Early health risk factors for violence are then outlined, including birth complications, minor physical anomalies, prenatal smoking and alcohol exposure, poor nutrition, lead exposure, and traumatic brain injury. Persistent adult violence is argued to originate in aberrant temperamental behavior in early childhood, to have a stable developmental trajectory, and to be associated with impaired education, social, and occupational functioning. Taken together, it is argued that chronic adult violence meets criterion for being conceptualized as having neurodevelopmental origins and that an important, but not sole, source of neural maldevelopment lies in prenatal and early postnatal risk factors. This review concludes with a recognition of the sociopolitical context within which a neurodevelopmental perspective on chronic violence sits, together with directions for future research, including whether a neurodevelopmental hypothesis is best applied to reactive as opposed to proactive aggression.
Early‐life risk for domestic violence perpetration: Implications for practice and policy
Authors: Corvo Kenneth
Published: December 2018

Research on risks and causes of domestic violence is hampered by a policy framework that not only does not fund but in some cases suppresses inquiry into those causes. This discussion, then, will be placed in the context of those policy frameworks that hamper and distort inquiry. This includes an overview of ideological, political, and historical issues that have shaped those frameworks. Related explanatory theories and theories of practice are summarized. The article will examine known early‐life risk factors for those disorders and behaviors associated with domestic violence perpetration. Particular emphasis will be placed on maltreatment and attachment/bonding processes. Framed in broad perspectives of psychosocial theory, risk factors from related literature sources (e.g. general violence and criminality) will be included where risk profiles are substantially similar.