bluuebunny/crossref_metadata_2025 huggingface dataset:
Testing for Algal Toxins In Vitro
Authors: Aune T.
Published: August 2020

Toxic blooms of several strains of blue-green algae are found in both natural and man-made freshwater lakes. Furthermore, mussels may accumulate toxic marine dinoflagellates, rendering them toxic to humans.

Traditionally, the presence of algal toxins is tested by intraperitoneal injections of extracts in mice. However, toxic waterblooms and mussels can both be detected by means of freshly prepared rat hepatocytes in suspension.
A Model for Cellular Neurotoxicology
Authors: Rönnback L. , Hansson Elisabeth
Published: August 2020

A model system for cellular neurotoxicology involving the use of primary cultures from various brain regions, is presented. Morphine affected protein synthesis in astroglial enriched cultures dose-dependently showing increases and decreases with time. A differential sensitivity to morphine was considered probably to be due to the cellular heterogeneity and specialisation found even in small brain regions.
A Model System for Studies of Effects on Oligodendroglia Development
Authors: Grundt I.K.
Published: August 2020

The effects of methylmercury (MeHg) and triethyllead (Et3Pb) were tested on the development of oligodendroglia cells (OG) in primary glia-rich cultures of rat brain cells. The marker enzyme 2'3’-cyclic nucelotide 3’-phosphodiesterase (CNP) was used as an index of OG development. The increase in CNP was followed during 1–4 weeks of exposure. MeHg at 2.5x107 and 10 8M, and Et3Pb at 2.5x10 7M, markedly inhibited the age-dependent increase in CNP shown in control cultures. CNP was highly stimulated by 2.5x10-8M Et3Pb. These observations are discussed in relation to results from experiments in vivo on CNP activities after toxic exposure.
A Comparison of In Vitro Cytotoxicity Assays and Their Application to Water Samples
Authors: Hunt Stephen M. , Chrzanowska Christina , Barnett Christopher R. , Brand Helen N. , Fawell John K.
Published: August 2020

A group of 13 compounds were tested for in vitro cytotoxicity in four test systems; MIT-24 test, inhibition of cell growth (protein method), inhibition of cell growth (vital dye method) and cloning efficiency. In general, all four assays tended to rank compounds in a similar order for toxicity. The length of the exposure period appeared to be important for some compounds.

The cytotoxicity of a variety of water samples was examined in two tests; inhibition of cell growth (vital dye method) and cloning efficiency. Under the conditions in which the assays were carried out, the latter proved to be the more sensitive test. River water samples gave little or no indication of cytotoxicity, samples of domestic sewage effluent gave some evidence of cytotoxicity, while an industrial effluent was markedly cytotoxic.
Use of Epidemiological and Toxicological Observations in Domestic and Wild Animal Populations for Evaluating Human Health Risks
Authors: Dorn C. Richard , Miller Gay Y.
Published: August 2020

Domesticated and wild animal populations are important resources in evaluating human health risks. Animals not only share man's environment, but some of them are also part of the human food chain. Three examples of monitoring the health of animal populations and using these data in evaluating human health risk were reviewed.

A study of horses, cattle and wildlife in a Missouri lead mining and smelting area revealed that horses were sensitive indicators of environmental lead contamination; they developed clinical signs of lead poisoning and died, while other animal species in the same area did not exhibit signs of illness. Although they did not appear ill, cattle in the same area had liver and kidney lead concentrations that were higher than tolerance levels established in England, Wales and Canada. Wildlife such as bullfrogs, muskrats, and greenbacked herons collected downstream from an old lead mining area had significantly higher lead and cadmium levels than either upstream samples or comparable downstream samples collected at a new lead mining area. Some of these data were used in a court trial which resulted in the lead company buying the farmland so that humans and domestic animals would not be exposed.

Another study of municipal sludge application on Ohio farms did not reveal excess illness rates for either livestock or humans living on farms receiving the sludge, as compared with those on control farms. However, cattle were more sensitive than humans as early indicators of low level exposure to toxic heavy metals such as cadmium and lead. Also, calves on sludge-receiving farms accumulated cadmium and lead in their kidneys.

The National Animal Health Monitoring System (NAHMS), currently in a pilot stage in eight states, is another example of the use of animal populations to evaluate human health risk. Information from NAHMS about zoonotic infections, use of drugs in food producing animals and diseases common to both animals and man, provide a better understanding of human disease. Population-based animal studies are desirable adjuncts to laboratory animal studies in assessing human health risk due to environmental exposure.
Power Calculations in Toxicology
Authors: Healey Graham F.
Published: August 2020

The ability of a study to detect a dose-related effect when one exists, is called its power. Power is defined statistically as the probability of obtaining a significant result of a particular size, given the experimental conditions. It depends not only on study size and variability, but also on the size of effect it is desired to detect, the particular significance test chosen and the validity of the assumptions.

Power calculations are illustrated for the t-test, normal test for proportions, and the analysis-of-variance F-test. Some suggestions for increasing the power are given.
Cultured Human Bronchial Cells as a Model System in Lung Toxicology and Carcinogenesis: Implications from Studies with Acrolein
Authors: Grafström Roland C. , Edman Charlotte C. , Sundqvist Kristina , Liu Yun , Hybbinette Sverker S. , Atzori Luigi , Nicotera Pierluigi , Dypbukt Jeannette M.
Published: August 2020

Tissues and cells from both humans and laboratory animals can now be successfully cultured and used to examine in vitro the interspecial extrapolation of toxicity data. In particular, epithelial cells or fibroblasts from the human bronchus are systematically being used to study pathobiological effects of inhalation toxicants, e.g. acrolein, present in tobacco smoke and automobile emissions. Micromolar concentrations of acrolein are highly toxic to both bronchial epithelial cells and fibroblasts, and decrease their colony-forming efficiency, ability to exclude trypan blue dye, and content of low-molecular-weight thiols in a dose-dependent manner. Cytosolic free-calcium levels are increased at concentrations of acrolein lower than those required to decrease plasma membrane integrity (measured by exclusion of ethidium bromide dye). Acrolein also decreases growth rate and increases formation of cross-linked envelopes in bronchial epithelial cells, which are indicative of squamous differentiation. Moreover, acrolein causes several types of DNA damage, including single strand breaks, DNA-protein cross-links, interstrand cross-links and alkali-labile sites. The dose-response relationships in this study indicate that disturbance of the cellular thiol and calcium homeostasis and/or formation of DNA damage may be involved in acrolein-related toxicity and accelerated epithelial differentiation. These results also demonstrate that acrolein causes pathobiological effects associated with various phases of multi-stage carcinogenesis in human airway epithelium.
Effects of Organic and Inorganic Selenium on Mercury Accumulation in Cultures of Normal Human Epithelial Cells
Authors: Arenholt-Bindslev Dorthe , Danscher Gorm
Published: August 2020

Cultures of normal human epithelial cells were exposed to methylmercury alone or in combination with organic or inorganic selenium. The resulting subcellular distribution of mercury accumulation was demonstrated cytochemically by the silver enhancement method. With this method, accumulation of mercury-selenide complexes is visualised at both the light microscope and electron microscope levels. Substantially more mercury complexes were found in cultures exposed to mercury and selenite than in cultures exposed to mercury and selenomethionine. All visualised mercury-complexes were localised in lysosome-like structures.
Effects of Carbon Tetrachloride on Neuronal Differentiation in Rat Embryo Mid-Brain Micromass Cultures
Authors: Clemedson Cecilia , Walum Erik , Flint Oliver
Published: August 2020

The effects of carbon tetrachloride on neuronal development and differentiation have been studied. Rat embryo mid-brain micromass cultures were exposed for five days to 50, 100, 250, 500 or 1000ppm CCl4 in closed chambers. Differentiation was indicated by the formation of neuronal foci in the cultures. Effects on cell survival were estimated using a neutral red staining method. Carbon tetrachloride at 100ppm caused a drastic increase in neuronal differentiation, accompanied by a slight increase in total cell number. At 250ppm the number of differentiated foci was still elevated, but the outgrowth of neurites was markedly reduced. Neuronal differentiation and cell survival were reduced by 50% at a concentration of 430ppm. Using criteria previously defined for the identification of potentially teratogenic substances in the micromass system, CCl4 was classified as a non-teratogen. Nevertheless, the results show that a substance can cause inhibition of differentiation (reduction in neunte formation) without altering focus formation.
Estimation of LC50 Values by Assay of Lactate Dehydrogenase and DNA Redistribution in Human Lymphocyte Cultures
Authors: Skaanild Metter Tingleff , Clausen Jørgen
Published: August 2020

The acute toxicities of selected drugs were assayed biochemically in vitro by estimation of LC50 dose in human lymphocyte cultures. Two methods were compared for estimation of LC50 values, the redistribution of DNA and lactate dehydrogenase after treatment with various concentrations of the compound. Ten of the chemicals used had previously been tested in HeLa cells using morphological changes as the endpoint. The LC50 values found in this study were a little lower than the IC50 values for HeLa cells. The enzyme assay gave lower LC50 values than the DNA assay, but the differences were not significant. LC50 values were also found for two drugs tested in several cell lines with redistribution of DNA and proteins. Again, no significant differences were apparent.
The Opacifying Effects of Carteolol HCl and Benzalkonium Chloride on Porcine Isolated Corneas
Authors: Igarashi Haruyoshi , Katsuta Yasunaga , Nakazato Yoshiharu , Kawasaki Tohru
Published: August 2020

Porcine isolated corneas (intact, with the epithelium or endothelium plus Descemet's membrane or both epithelium and endothelium plus Descemet's membrane removed) have been incubated with solutions of carteolol HCl (5 x 10-4 M-5 x 10 2M), or solutions of benzalkonium chloride (0.005%–0.05%), or solutions of carteolol (5 x 10 4M-5 x 10 2M) plus benzalkonium chloride (0.005%). Concentration-dependent opacities developed in corneas with both compounds, but whereas the effect of carteolol seems to involve mainly the endothelium, the effect of benzalkonium seems to involve mainly the epithelium. Possible modes of action of the two compounds are discussed.
Eccentricity Effect of Deformation Detection for Radial Frequency Patterns With Their Centers at Fixation Point
Authors: Feng Yang , Wu Qiong , Yang Jiajia , Takahashi Satoshi , Ejima Yoshimichi , Wu Jinglong , Zhang Ming
Published: August 2020

We measured the eccentricity effect of deformation thresholds of circular contours for two types of the radial frequency (RF) patterns with their centers at the fixation point: constant circular contour frequency (CCF) RF patterns and constant RF magnified (retino-cortical scaling) RF patterns. We varied the eccentricity by changing the mean radius of the RF patterns while keeping the centers of the RF patterns at the fixation point. Our peripheral stimulus presentation was distinguished from previous studies which have simply translated RF patterns at different locations in the visual field. Sensitivity for such shape discrimination fell off as the moderate and high CCF patterns were presented on more eccentric sites but did not as the low CCF patterns. However, sensitivity held constant as the magnified RF patterns were presented on more eccentric sites, indicating that the eccentricity effects observed for the high and moderate CCF patterns were neutralized by retinocortical mapping. Notably, sensitivity for the magnified RF patterns with large radii (4°–16°) presented in the peripheral field revealed a similar RF dependence observed for RF patterns with small radii (0.25°–1.0°) presented at the fovea in previous studies.
Toddlers Categorically Perceive Emotional Facial Expressions Along a Happy–Sad Continuum
Authors: Lee Vivian , Da Silva Natasha , Rutherford M. D.
Published: August 2020

Adults perceive a continuum of emotional facial expressions categorically rather than continuously. Categorical perception is thought to be adaptive and functional, allowing for inferences that inform behavior. To date, studies have demonstrated categorical perception of some emotional facial expressions in infants. However, a recent study reported that 12-month-olds infants do not perceive facial emotional expressions categorically across a happy–sad continuum. In contrast, toddlers at 3.5 years of age appear to use categorical perception along the happy–sad continuum. Using a novel paradigm that employed the use of a looking-time discrimination task and an explicit identification task, this study measured 26-month-old’s identification of faces and ability to discriminate between faces along a happy–sad continuum. Results suggest that 26-month-olds perceive facial expressions categorically along the happy–sad continuum.
The book of Jonah and the theme of exile
Authors: Kelsey Marian
Published: August 2020

This article examines the exilic theme of many inner-biblical allusions in the book of Jonah. Although there are few allusions to the Babylonian exile itself, allusions to the primeval and exodus narratives focus upon and draw out the exilic motifs in those texts. The allusions characterize the prophet Jonah, accentuating his wrongdoing and dissatisfaction while also indicating a more hopeful outcome for him than the ending of the book would otherwise suggest. Furthermore, the allusions illustrate the literary approach of the author in using biblical narratives to enrich his own story while simultaneously influencing the reader’s interpretation of the texts that he evokes. This insight into the author’s techniques is informative for exploring other instances of inner-biblical allusion in the book.
Real-world effectiveness and tolerability of erenumab: A retrospective cohort study
Authors: Kanaan Saad , Hettie Gabrielle , Loder Elizabeth , Burch Rebecca
Published: August 2020

Background

We aimed to systematically assess the effectiveness and tolerability of erenumab in a clinical setting, specifically a tertiary headache center.

Methods

This was a retrospective cohort study at the John Graham Headache Center of Brigham and Women’s Hospital. All patients who received erenumab from a headache specialist at the Center from 17 May 2018 to 31 January 2019 were included. Patients were contacted and underwent a structured clinical interview including information about erenumab use, perceived benefit, adverse events (AEs), and a global assessment of benefit versus drawbacks. Chart review was performed for patients who could not be contacted.

Results

Four hundred and forty-four patients were initially identified and 418 were eligible. Two hundred and ninety-five participants completed the structured clinical interview portion of the study (response rate 70.6%). Seventy-four patient charts were additionally reviewed. Two hundred and forty-one participants had used erenumab. One hundred and sixty nine (70%) of participants experienced at least one adverse event, with constipation (43%), injection site reaction (24%), fatigue (15%), worsening headache (12%), and dizziness (11%) the five most commonly reported AEs. One hundred and sixty-eight participants (69.7%) felt that the benefits of erenumab outweighed any drawbacks. One hundred and fifty-one participants (62.7%) planned to continue using erenumab. Cost of treatment was cited by 12% of participants as a reason for either not starting or for stopping erenumab. Of patients who had an increase in dose due to lack of or partial efficacy, 46.5% felt that the dose increase was helpful. We identified one case of unintended pregnancy in our study population.

Conclusions

This large “real-world” study validates the findings of benefit of erenumab observed in clinical trials. Although adverse events were far more common in this population than in clinical trials, the planned continuation rate was relatively high. The substantial discrepancy between adverse events seen in clinical practice compared with clinical trials suggests systematic differences between clinical trial participants and patients who receive the treatment in clinical practice, or may indicate suboptimal ascertainment of adverse events in the trials. Clinicians should continue to be vigilant for adverse events in clinical practice.
Migraine and aura triggered by normobaric hypoxia
Authors: Frank Florian , Faulhaber Martin , Messlinger Karl , Accinelli Chiara , Peball Marina , Schiefecker Alois , Kaltseis Katharina , Burtscher Martin , Broessner Gregor
Published: August 2020

Background

For future experimental studies or the development of targeted pharmaceutical agents, a deeper insight into the pathophysiology of migraine is of utmost interest. Reliable methods to trigger migraine attacks including aura are desirable to study this complex disease in vivo.

Methods

To investigate hypoxia as a trigger for migraine and aura, we exposed volunteers diagnosed with migraine, with (n = 16) and without aura (n = 14), to hypoxia utilizing a hypoxic chamber adjusted to a FiO2 of 12.6%. The occurrence of headache, migraine, aura, and accompanying symptoms were registered and vital signs were collected for 6 hours under hypoxia and 2 hours of follow-up. A binary logistic regression analysis examined the probability of triggering headaches, migraines, aura, photo- and phonophobia.

Findings

Of 30 participants, 24 (80.0%) developed headaches and 19 (63.3%) migraine, five (16.7%) reported aura. Two patients that developed aura never experienced aura symptoms before in their life. The increase of mean heart frequency was higher in patients developing headaches or migraine. Mean SpO2 during hypoxia was 83.39%.

Conclusion

Hypoxia was able to trigger migraine attacks and aura independently of any pharmacological agent.
[123I]-IMP single-photon emission computed tomography imaging in visual snow syndrome: A case series
Authors: Shibata Mamoru , Tsutsumi Kei , Iwabuchi Yu , Kameyama Masashi , Takizawa Tsubasa , Nakahara Tadaki , Fujiwara Hirokazu , Jinzaki Masahiro , Nakahara Jin , Dodick David W
Published: August 2020

Background

Visual snow syndrome (VSS) is a neurological condition characterized by persistent flickering dots in the visual fields, palinopsia, enhanced entoptic phenomenon, photophobia, and nyctalopia. Neuroimaging evidence supports the role of the visual association cortex in visual snow syndrome. Case series: We provided clinical care to three patients with visual snow syndrome, in whom [123I]-IMP single-photon emission computed tomography (SPECT) imaging was performed. Case 1 was a 21-year-old male with a past history of migraine with aura who exhibited visual snow and entoptic phenomenon. In this patient, [123I]-IMP SPECT imaging revealed right occipital and temporal hypoperfusion with a distribution matching the ventral visual stream. [123I]-IMP SPECT imaging detected only mild bilateral frontal hypoperfusion in Case 2 and no overt abnormalities in Case 3.

Conclusion

Although visual snow syndrome seems to be a heterogenous condition, our observations indicate that abnormal visual processing within the ventral visual stream may play a role in the pathogenesis of this condition.
Epidemiology, Treatment, and Performance-Based Outcomes in American Professional Baseball Players With Symptomatic Spondylolysis and Isthmic Spondylolisthesis
Authors: Gould Heath P. , Winkelman Robert D. , Tanenbaum Joseph E. , Hu Emily , Haines Colin M. , Hsu Wellington K. , Kalfas Iain H. , Savage Jason W. , Schickendantz Mark S. , Mroz Thomas E.
Published: August 2020

Background:

Repetitive lumbar hyperextension and rotation during athletic activity affect the structural integrity of the lumbar spine. While many sports have been associated with an increased risk of developing a pars defect, few previous studies have systematically investigated spondylolysis and spondylolisthesis in professional baseball players.

Purpose:

To characterize the epidemiology and treatment of symptomatic lumbar spondylolysis and isthmic spondylolisthesis in American professional baseball players. We also sought to report the return-to-play (RTP) and performance-based outcomes associated with the diagnosis of a pars defect in this elite athlete population.

Study Design:

Descriptive epidemiology study.

Methods:

A retrospective cohort study was conducted among all Major and Minor League Baseball (MLB and MiLB, respectively) players who had low back pain and underwent lumbar spine imaging between 2011 and 2016. Players with radiological evidence of a pars defect (with or without listhesis) were included. Analyses were conducted to assess the association between player-specific characteristics and RTP time. Baseball performance metrics were also compared before and after the injury episode to determine whether there was an association between the diagnosis of a pars defect and diminished player performance.

Results:

During the study period of 6 MLB seasons, 272 professional baseball players had low back pain and underwent lumbar spine imaging. Overall, 75 of these athletes (27.6%) received a diagnosis of pars defect. All affected athletes except one (98.7%) successfully returned to professional baseball, with a median RTP time of 51 days. Players with spondylolisthesis returned to play faster than those with spondylolysis, MLB athletes returned faster than MiLB athletes, and position players returned faster than pitchers. Athletes with a diagnosed pars defect did not show a significant decline in performance after returning to competition after their injury episode.

Conclusion:

Lumbar pars defects were a common cause of low back pain in American professional baseball players. The vast majority of affected athletes were able to return to competition without demonstrating a significant decline in baseball performance.
Association of cigarette smoking and adverse events in left ventricular assist device patients
Authors: Youmans Quentin R , Zhou Amy , Harap Rebecca , Eskender Mickyas H , Anderson Allen S , Ezema Ashley U , Ghafourian Kambiz , Ohiomoba Ramael , Pham Duc T , Rich Jonathan D , Vorovich Esther E , Wilcox Jane E , Yancy Clyde W , Okwuosa Ike S
Published: August 2020

Introduction:

Adverse events (AEs) associated with left ventricular assist devices (LVADs) cause significant morbidity and mortality. Little is known about patient-specific factors that contribute to rates of AEs. The purpose of this study was to assess the association of cigarette smoking history and AEs following LVAD implantation.

Methods:

This study was a single-center, observational examination of 355 consecutive patients who underwent continuous-flow LVAD implantation from May 1, 2008 to July 1, 2018. Based on self-report, 348 patients with available data were categorized as never, former, or current smokers. Pre-LVAD implantation baseline characteristics were obtained, and summary characteristics were calculated. Hospitalizations for gastrointestinal bleeds, driveline infections, strokes, pump thromboses, and acute heart failure were evaluated. The Cox proportional hazard model was used to estimate the association of smoking and AE-related hospital admissions. The cumulative incidence competing risk method was used for survival analysis.

Results:

Current (8.22%, p 0.006) and former (4.75%, p 0.026) smokers had a greater proportion of admissions for pump thrombosis compared to never smokers (2.22%). Former smoking was associated with admission for driveline infection (HR 2.43, CI 1.08–5.46, p 0.03) on multivariate analysis. There were no significant associations between smoking and the other AEs of interest. There was no difference in survival among the three groups.

Conclusions:

Smokers had a higher proportion of admissions for pump thrombosis compared to never smokers, and former smoking was associated with admission for driveline infections in patients with LVADs.
Making the Decision to Move to a Nursing Home: Longitudinal Evidence From the Health and Retirement Study
Authors: Lu Peiyi , Kong Dexia , Shelley Mack
Published: August 2020

This study applied the theory of planned behavior to examine predictors of U.S. older adults’ (65+ years) intention and behavior of moving to a nursing home. Two waves of Health and Retirement Study data were used ( N = 9,969). Moving intention was measured by respondents’ self-reported probability to move in the next 5 years in Wave 1. Moving behavior was measured by whether they actually moved in Wave 2. Structural equation modeling was used to examine the relationships of demographic and health predictors with moving intention and behavior. For both genders, advanced age, poorer health, having fewer children, and long-term care insurance were associated with higher levels of moving intention and behavior. Men’s intention was a significant predictor of subsequent moving behavior. However, women’s intention was not associated with moving behavior, probably due to inadequate resources to support their preference. The findings provide meaningful personhood-centered insights into nursing home entry decisions.
Five Experts Respond to Five Questions about Five Trends in Compensation and Benefits over the Next 5 Years
Authors: Bryant Phillip C. , Brown Duncan , Cotton Charles , Hill Brad , Gibbs Michael , Sturman Michael C.
Published: August 2020

In January of 2020, five compensation and benefits experts were asked to weigh in on five questions. The questions were intended to unveil trends in the field of compensation and benefits management over the next 5 years. The expert responses are provided in the article. Additionally, the experts were each given an opportunity to address a topic not covered in the five questions that they believed will grow in importance to compensation and benefits management over the next 5 years. These responses are also provided in the article. The article ends with a brief summary of expected trends in compensation and benefits management over the next 5 years.
Small Business Post–COVID-19: Motivational Needs through Uncertain Times
Authors: Ertel Stefanie
Published: August 2020

Small businesses have been significantly impacted by the effects of COVID-19. Not only have many needed to close their physical doors, but now there are extra health standards and social distancing requirements. Research from other studies, a one-question survey, and research from readily available resources have all been taken into account in the following research to focus on the motivating needs of businesses post–COVID-19. It is important for the small business owner to be aware of the effects this will have on the physical environment and also on the needs of their employees and customers. It is important to remember that various level needs can be worked on at the same time. Most importantly, it is critical to remember that one’s business is not just about numbers and to-do lists, but rather the relationships, the people that make up one’s business, and the impact on others and the community.
Wild, Wild Theft: Identity Crimes in the Digital Frontier
Authors: Gies Stephen V. , Piquero Nicole Leeper , Piquero Alex R. , Green Brandn , Bobnis Amanda
Published: August 2020

Identity theft is a pervasive and expensive problem. Not only does the crime incur a significant financial and mental cost on the victim, but also exhibits a financial toll on the organizations that are swept up in the crime. Yet, while there is some research on the offender part of the identity theft problem, much less research has been devoted to identity theft victims and almost no research has examined victim attempts at remediation. This article examines how the use of a nonprofit victim service organization, the Identity Theft Resource Center (ITRC), affects the experiences of identity crime victims with respect to a variety of problems. Findings reveal that victims incur many problems related to identity theft, that many problems linger over time, and that some services are useful in helping them manage the crime’s after-effects.
Mucosal Immunity and Liver Metabolism in the Complex Condition of Lactation Insufficiency
Authors: Betts Courtney B. , Quackenbush Alexandra , Anderson Weston , Marshall Nicole E. , Schedin Pepper J.
Published: August 2020

Lactation insufficiency is variously defined and includes the inability to produce milk, not producing enough milk to exclusively meet infant growth requirements, and pathological interruption of lactation (e.g., mastitis). Of women with intent-to-breastfeed, lactation insufficiency has been estimated to affect 38%–44% of newly postpartum women, likely contributing to the nearly 60% of infants that are not breastfed according to the World Health Organization’s guidelines. To date, research and clinical practice aimed at improving feeding outcomes have focused on hospital lactation support and education, with laudable results. However, researchers’ reports of recent rodent studies concerning fundamental lactation biology have suggested that the underlying pathologies of lactation insufficiency may be more nuanced than is currently appreciated. In this article, we identify mucosal biology of the breast and lactation-specific liver biology as two under-researched aspects of lactation physiology. Specifically, we argue that further scientific inquiry into reproductive state-dependent regulation of immunity in the human breast will reveal insights into novel immune based requirements for healthy lactation. Additionally, our synthesis of the literature supports the hypothesis that the liver is an essential player in lactation—highlighting the potential that pathologies of the liver may also be associated with lactation insufficiency. More research into these biologic underpinnings of lactation is anticipated to provide new avenues to understand and treat lactation insufficiency.
Supplementary schools with connections to religious organisations in the United Kingdom: A heuristic device for school leaders and researchers
Authors: Thorpe Anthony
Published: August 2020

Many supplementary and complementary schools operating in the United Kingdom and other countries have connections and relationships with religious organisations. However, there is considerable variety and complexity in these links and connections. Amidst some public concerns about these schools and as so little is known about them compared with other school sectors, a new heuristic device is offered to support leadership practice in supplementary and mainstream schools, and to encourage research particularly in the areas of governance, leadership and management. The need for this heuristic is made all the more urgent because of the disengagement of the state, at various levels, from appreciation of and support for the work of these schools, compounded by the lack of knowledge and understanding of their governance, leadership and management in particular. The exclusion of supplementary schools with religious links from future research and school partnerships needs to be avoided.
Investigation on deformation behavior of magnesium alloy sheet AZ31B in pulsating hydroforming
Authors: Hu Guolin , Pan Chunrong
Published: August 2020

Magnesium alloys have been known as the next generation material for lightweight body structures. Pulsating hydroforming is an effective method to improve magnesium alloy sheet forming performance, and the formed parts are characterized by lightweight, high-specific strength and stiffness. The deformation performance of magnesium alloy sheet AZ31B with a thickness of 0.6 mm under pulsating hydroforming has been investigated by means of experimental study, numerical simulation and theoretical analysis. The results show that under the same maximum hydraulic pressure, compared with simple linear loading, the magnesium alloy forming parts with pulsating hydraulic loading not only have better wall thickness uniformity and larger bulging height but also can delay the occurrence of fracture, improve the forming performance and ultimate the forming ability of magnesium alloy sheet. A new evaluation index is proposed to simplify the comprehensive forming performance of magnesium alloy parts with different amplitudes and frequencies more accurately, which can also be applied to determine the optimal forming parameters of magnesium alloy sheet AZ31B in the pulsating loading condition.
Vibrational and thermoelastic behavior of punched-beam micro resonators containing odd-number of slots
Authors: Asadi Saeid , Moghimi Zand Mahdi , Fanaei Sheikholeslami Tahereh
Published: August 2020

Thermoelastic quality factor is an important mechanism for determining quality factor of a microelectromechanical system resonator, which works in near vacuum, and the resonant frequency is an important characteristic of a resonator. This paper studies variations of the thermoelastic quality factor and the resonant frequency of three- and five-slotted clamped-clamped beam microelectromechanical system resonators. The study has been done by using three-dimensional simulations based on finite element method by COMSOL Multiphysics. Resonant frequency is a function of stiffness and mass of the beam, therefore punching slots in the beam changes the resonant frequency. In addition, slots usually decrease the amount of coupling between mechanical resonant mode and thermal modes, thus improve the thermoelastic quality factor. The C–C beam lengths are considered to be 30.5 µm, 100 µm, and 400 µm. The results show the resonant frequency and corresponding thermoelastic quality factor of the three-slotted beams are greater than five-slotted beams, and a maximum resonant frequency of the three-slotted beams is achieved when the length of inner slot is about 32%–36% of the beam length.
Robust tracking control of robot manipulators with friction and variable loads without velocity measurement: A switched control strategy
Authors: Noghreian Elizabeth , Koofigar Hamid Reza
Published: August 2020

This article addresses the adaptive-based robust output feedback tracking control for robot manipulators with friction and alternating unknown loads. A switched nonlinear system is first established to model the friction and parameter variations, caused by the load change. Under arbitrary load changings, an adaptive [Formula: see text] tracking control strategy is proposed to ensure link position tracking, in the presence of uncertainties and external disturbances. Then, for bounded external disturbances, a novel robust adaptive output tracking control strategy is developed, which guarantees all the closed-loop signals are bounded and tracking error is driven to zero. Unlike some previous studies, the proposed algorithms do not require velocity measurements, and the unknown switched parameters and disturbances are neither required to be periodic nor to have known bounds. A simulation study is also given to demonstrate the analytically proved properties of the proposed schemes.
Vertical gaze palsy and intraoral numbness in a patient with neuro-psychiatric systemic lupus erythematosus: A case report and literature review
Authors: Fung Kin Fen Kevin , Chan Eugene Yu-hin , Ma Alison Lap-tak , Yeung Wai-lan , Lai Wai-ming , Kan Elaine Yee-ling
Published: August 2020

We report, to the best of our knowledge, the first case of neuropsychiatric systemic lupus erythematosus with clinical presentation of bilateral upward gaze palsy and intraoral numbness. Magnetic resonance imaging of the brain was able to identify the pathogenic lesion at the left side of midbrain, involving the vertical gaze center and sensory pathways for innervating the buccal and hard palate mucosa. A course of aggressive immunosuppressive treatment resulted in prompt resolution of gaze palsy and the midbrain lesion.
Agricultural Mechanization in India: A Study on the Ownership and Investment in Farm Machinery by Cultivator Households across Agro-ecological Regions
Authors: Sarkar Anupam
Published: August 2020

Despite the signs of distress and fatigue in Indian agriculture, the use of machines in crop operations has increased manifold in recent times. Proponents of mechanization argue that mechanization saves time and cost, and improves agricultural productivity. The Government of India has also encouraged mechanization through subsiding farm machinery and establishing custom hiring centres. Earlier studies have found significant regional variation in the spread of agricultural mechanization. Cost of cultivation data collected by Commission for Agricultural Costs and Prices (CACP) reveal that although the share of machine labour in the cost of cultivation per hectare has increased, there exist significant differences across crops in the use of mechanical input. Empirical studies in different regions have found a significant presence of the rental market for services of agricultural machinery. However, in recent years there have been very few studies on the patterns of mechanization based on household-level data on ownership and investment in agricultural machinery and implements. Agro-ecological characteristics of a region are said to have a significant impact on the level of mechanization. Ownership of machinery is also significantly influenced by the factors such as size of landholding, access to irrigation and access to institutional credit. The pattern of investment and ownership of machinery has important implications on the profitability of farming. This article uses unit-level data from the All-India Debt and Investment Survey (NSS 70th round 2013) to study the pattern of agricultural mechanization in India based on the ownership of agricultural machinery and implements. Using ownership and expenditure data it studies the questions of recent patterns in agricultural mechanization across agro-ecological regions and land classes.
Reinvigoration of BIMSTEC and India’s Economic, Strategic and Security Concerns
Authors: Kumar Suneel
Published: August 2020

This article contends that India’s efforts for the reinvigoration of the Bay of Bengal Initiative for Multi-Sectoral Technical and Economic Cooperation (BIMSTEC) are the result of an amalgam of its Act East and Neighbourhood First policies’ objectives. Since 2014, India has been trying to rejuvenate the BIMSTEC to exploit the untapped trade opportunities, promote energy and food security and also boost the development of its North Eastern region by enhancing infrastructural connectivity with South East Asian countries and promoting greater economic integration in the Bay of Bengal region. Its strategic interests and security concerns, especially to build the pressure on Pakistan, counter China’s forays into its strategic backyard and ensure the security of the North Eastern region, have also resurged India’s interests in the revival of BIMSTEC. Like South Asian Association for Regional Cooperation (SAARC), there are some hurdles in the way of BIMSTEC, for instance its image of an India-dominated bloc, India’s bilateral differences with other BIMSTEC countries from South Asia, especially with Bangladesh and Nepal, and bilateral disputes between other member countries, particularly Bangladesh and Myanmar and Thailand and Myanmar.
Human Resources in Healthcare and Health Outcomes in India
Authors: Motkuri Venkatanarayana , Mishra Udaya S.
Published: August 2020

Human resources for health including health professionals and skilled health workers are crucial in shaping health outcomes. But the shortage of human resources in healthcare services is a reality and hence it has been a cause of concern in lower-middle income countries like India. The present exercise based on census data is a situation analysis of size, composition and distribution of human resources available in the Indian healthcare services. It also explores the relationship between educational development and health workers availability alongside the association between density of health workers and health outcomes across states of India.

It is observed that despite the remarkable improvement in health workers density particularly during 2001–2011, the country is falling short of the World Health Organization’s (WHO) need-based minimum requirement (4.45 health workers per 1,000 population) of health workers. The exploratory verification asserts that there is a significant and strong positive relationship/association between the density of health workers and health outcomes.
Culturally Congruent Health Care of COVID-19 in Minorities in the United States: A Clinical Practice Paper From the National Coalition of Ethnic Minority Nurse Associations
Authors: Cuellar Norma G. , Aquino Elizabeth , Dawson Martha A. , Garcia-Dia Mary Joy , Im Eun-Ok , Jurado Leo-Felix M. , Lee Young Shin , Littlejohn Sandy , Tom-Orme Lillian , Toney Debra A.
Published: August 2020

Introduction: Race and ethnicity along with social determinants of health have been identified as risk factors for COVID-19. The purpose of this clinical paper is to provide an overview of the National Coalition of Ethnic Minority Nurse Associations (NCEMNA), present COVID-19 epidemiological data on five racial–ethnic groups, identify culturally congruent health care strategies for each group, and provide directions for practice and research. Method: NCEMNA collaborated to provide a clinical paper that addresses information about COVID-19 and culturally congruent health care in five racial–ethnic groups. Results: Every organization presented common themes across the different groups and unique perspectives that each group is faced with during this challenge. Discussion: This article provides an introduction to the issues that minority groups are facing. It is imperative that data are collected to determine the extent of the impact of COVID-19 in diverse communities in the country.
Implementing Serious Illness Communication Processes in Primary Care: A Qualitative Study
Authors: Paladino Joanna , Brannen Elise , Benotti Emily , Henrich Natalie , Ritchie Christine , Sanders Justin , Lakin Joshua R.
Published: August 2020

Purpose:

Primary care clinicians face barriers to engaging patients in conversations about prognosis, values, and goals (“serious illness conversations”). We introduced a structured, multi-component intervention, the Serious Illness Care Program (SICP), to facilitate conversations in the primary care setting. We present findings of a qualitative study to explore practical aspects of program implementation.

Methods:

We conducted semi-structured interviews of participating primary care physicians, nurse care coordinators, and social workers and coded transcripts to assess the activities used to integrate SICP into the workflow.

Results:

We conducted interviews with 14 of 46 clinicians from 6 primary care clinics, stopping with thematic saturation. Qualitative analysis revealed major themes around activities in the timing of the conversation (before, during, and after) and overarching insights about the program. Clinicians used a variety of strategies to adapt program components while preserving key program goals, including processes to generate accountability to ensure that conversations happen in busy clinical workflows. The interviews revealed changes to clinicians’ mindset and norms, such as the recognition of the need to start conversations earlier in the illness course and the use of more expansive models of prognostic communication that address function and quality of life. Data also revealed indicators of sustainable behavior change and the spread of communication practices to patients outside the intended program scope.

Conclusion:

SICP served as a framework for primary care clinicians to integrate serious illness communication into routine care. The shifts in processes employed by inter-professional clinicians revealed comprehensive models for prognostic communication and creative workflows to ensure that patients with complex illnesses had proactive, longitudinal, and patient-centered serious illness conversations and care planning.
Review of Newer Antidiabetic Agents for Diabetes Management in Kidney Transplant Recipients
Authors: Anderson Sonya , Cotiguala Laura , Tischer Sarah , Park Jeong Mi , McMurry Katie
Published: August 2020

Objective

This systematic review describes the efficacy, safety, and drug interactions of dipeptidyl peptidase-4 (DPP-4) inhibitors, glucagon-like peptide-1 receptor agonists (GLP-1 RAs), and sodium-glucose transport protein 2 (SGLT2) inhibitors in kidney transplant recipients (KTRs).

Data Sources

Articles were identified by English-language MEDLINE search, published prior to May 2020, using the terms kidney transplant, OR PTDM, OR NODAT, AND metformin, OR DPP4, OR GLP1, OR SGLT2.

Study Selection and Data Extraction

All selected studies were included if the study population was composed of adult KTRs who were diagnosed with either impaired glucose tolerance, diabetes mellitus (DM), new-onset diabetes after transplant (NODAT), or posttransplantation diabetes mellitus (PTDM).

Data Synthesis

In KTRs, there is evidence for safety with DPP-4 inhibitors, GLP-1 RAs, and SGLT2 inhibitors. However, urinary tract infections and a slight initial decrease in renal function may limit use of SGLT2 inhibitors. As compared with the nontransplant type 2 DM population, SGLT2 inhibitors are not as efficacious in KTRs.

Relevance to Patient Care and Clinical Practice

This review provides an overview of the current literature on newer antidiabetic agents, addressing efficacy, safety, and drug interactions to help guide clinical decision-making for their use in KTRs.

Conclusion

Newer antidiabetic agents have been recommended by the American Diabetes Association for potential cardiovascular, renal, and hypoglycemic benefits. Particular agents, such as DPP-4 inhibitors and GLP-1 RAs may play a role in correcting PTDM-related defects. Clinicians need to take into account both patient-specific and drug-specific characteristics when initiating these agents in KTRs.
Tier 2: Critical Issues in Systems, Practices, and Data
Authors: Bruhn Allison L. , McDaniel Sara C.
Published: August 2020

The purpose of Tier 2 positive behavior interventions and supports (PBIS) is to address identified social, emotional, and behavioral needs with efficient, targeted interventions. Although only 10% to 15% of each school’s population will require Tier 2 supports, without effective systems, practices, and data, students will continue to demonstrate unwanted behavior, which may lead to increased rates of exclusionary discipline (e.g., office discipline referrals and suspension). This article extends the logic of Tier 1 PBIS, which is founded in systems, practices, and data, by addressing research related to implementation issues of systems, practices, and data in Tier 2. First, we present current research and practice in systems with a specific focus on Tier 2 teaming, resources, and professional development (i.e., initial training and coaching). Second, we discuss Tier 2 practices and the need to consider intervention matching, as well as initial and in vivo intervention adaptations to improve acceptability and effectiveness. Third, we present Tier 2 data considerations for informing intervention design, progress monitoring, and treatment fidelity. Across Tier 2 systems, practices, and data, we offer recommendations for future research.