bluuebunny/crossref_metadata_2025 huggingface dataset:
Rapid Induction of the Unfolded Protein Response and Apoptosis by Estrogen Mimic TTC-352 for the Treatment of Endocrine-Resistant Breast Cancer
Authors: Abderrahman Balkees , Maximov Philipp Y. , Curpan Ramona F. , Fanning Sean W. , Hanspal Jay S. , Fan Ping , Foulds Charles E. , Chen Yue , Malovannaya Anna , Jain Antrix , Xiong Rui , Greene Geoffrey L. , Tonetti Debra A. , Thatcher Gregory R.J. , Jordan V. Craig
Published: November 2020

Patients with long-term estrogen-deprived breast cancer, after resistance to tamoxifen or aromatase inhibitors develops, can experience tumor regression when treated with estrogens. Estrogen's antitumor effect is attributed to apoptosis via the estrogen receptor (ER). Estrogen treatment can have unpleasant gynecologic and nongynecologic adverse events; thus, the development of safer estrogenic agents remains a clinical priority. Here, we study synthetic selective estrogen mimics (SEM) BMI-135 and TTC-352, and the naturally occurring estrogen estetrol (E4), which are proposed as safer estrogenic agents compared with 17β-estradiol (E2), for the treatment of endocrine-resistant breast cancer. TTC-352 and E4 are being evaluated in breast cancer clinical trials. Cell viability assays, real-time PCR, immunoblotting, ERE DNA pulldowns, mass spectrometry, X-ray crystallography, docking and molecular dynamic simulations, live cell imaging, and Annexin V staining were conducted in 11 biologically different breast cancer models. Results were compared with the potent full agonist E2, less potent full agonist E4, the benchmark partial agonist triphenylethylene bisphenol (BPTPE), and antagonists 4-hydroxytamoxifen and endoxifen. We report ERα's regulation and coregulators’ binding profiles with SEMs and E4. We describe TTC-352′s pharmacology as a weak full agonist and antitumor molecular mechanisms. This study highlights TTC-352′s benzothiophene scaffold that yields an H-bond with Glu353, which allows Asp351-to-helix 12 (H12) interaction, sealing ERα's ligand-binding domain, recruiting E2-enriched coactivators, and triggering rapid ERα-induced unfolded protein response (UPR) and apoptosis, as the basis of its anticancer properties. BPTPE's phenolic OH yields an H-Bond with Thr347, which disrupts Asp351-to-H12 interaction, delaying UPR and apoptosis and increasing clonal evolution risk.
Implementation of Risk-reducing Strategies for Breast Cancer is Long Overdue
Authors: Vogel Victor G.
Published: November 2020

Despite strong evidence that it is efficacious, chemoprevention has been underused in eligible women. Reasons offered not to adopt and initiate strategies to reduce the risk of breast cancer include the fear of adverse effects, medication costs, lack of reasonably accurate and feasible methods for assessing an individual's personal risk, and lack of established risk thresholds that maximize benefit and minimize harms. The article by Macdonald and colleagues remind us that the problem of lack of uptake of risk-reducing medications for breast cancer remains a worldwide clinical challenge despite endorsements from national and international organizations that recommend the use of risk-reducing medications for breast cancer with level I evidence. Several strategies are suggested to improve uptake and utilization of safe and effective chemoprevention medications with high therapeutic indices.

See related article by Macdonald et al., p. 131
Oral Microbiota and Cancer Development
Authors: Tuominen Heidi , Rautava Jaana
Published: November 2020

Oral microbiota are among the most diverse in the human body. More than 700 species have been identified in the mouth, and new sequencing methods are allowing us to discover even more species. The anatomy of the oral cavity is different from that of other body sites. The oral cavity has mucosal surfaces (the tongue, the buccal mucosa, the gingiva, and the palate), hard tissues (the teeth), and exocrine gland tissue (major and minor salivary glands), all of which present unique features for microbiota composition. The connection between oral microbiota and diseases of the human body has been under intensive research in the past years. Furthermore, oral microbiota have been associated with cancer development. Patients suffering from periodontitis, a common advanced gingival disease caused by bacterial dysbiosis, have a 2–5 times higher risk of acquiring any cancer compared to healthy individuals. Some oral taxa, especially Porphyromonas gingivalis and Fusobacterium nucleatum, have been shown to have carcinogenic potential by several different mechanisms. They can inhibit apoptosis, activate cell proliferation, promote cellular invasion, induce chronic inflammation, and directly produce carcinogens. These microbiota changes can already be seen with potentially malignant lesions of the oral cavity. The causal relationship between microbiota and cancer is complex. It is difficult to accurately study the impact of specific bacteria on carcinoma development in humans. This review focuses on the elucidating the interactions between oral cavity bacterial microbiota and cancer. We gather literature on the current knowledge of the bacterial contribution to cancer development and the mechanisms behind it.
Recent Advances in Medical Image Processing
Authors: Huang Zhen , Li Qiang , Lu Ju , Feng Junlin , Hu Jiajia , Chen Ping
Published: November 2020

Background: Application and development of the artificial intelligence technology have generated a profound impact in the field of medical imaging. It helps medical personnel to make an early and more accurate diagnosis. Recently, the deep convolution neural network is emerging as a principal machine learning method in computer vision and has received significant attention in medical imaging. Key Message: In this paper, we will review recent advances in artificial intelligence, machine learning, and deep convolution neural network, focusing on their applications in medical image processing. To illustrate with a concrete example, we discuss in detail the architecture of a convolution neural network through visualization to help understand its internal working mechanism. Summary: This review discusses several open questions, current trends, and critical challenges faced by medical image processing and artificial intelligence technology.
Evaluation of Brain Cytokines and the Level of Brain-Derived Neurotrophic Factor in an Inflammatory Model of Depression
Authors: Horita Janine Karina Hideko Alfenas , da Silva Maria Carolina Machado , Ferrari Carolina Zaniboni , Vieira Erica Leandro Marciano , Moreira Fabricio A. , de Oliveira Antônio Carlos Pinheiro , Reis Helton José 
Published: November 2020

Introduction: Major depressive disorder is considered a global public health problem. Inflammatory processes are likely involved in its pathophysiology, but the underlying mechanisms have remained uncertain.Here, we used the model of systemic lipopolysaccharide (LPS) injection to test the hypothesis that depressive-like behaviors occur along with changes in the levels of cytokines and brain-derived neurotrophic factor (BDNF) in the hippocampus (HC), prefrontal cortex (PFC), and hypothalamus (HT), and can be prevented by dexamethasone administration. Methods: Adult C57Bl/6 male mice were first isolated for 10 days, and thereafter received an injection of dexamethasone (6 mg/kg, intraperitoneal [i.p.]), saline followed by LPS (0.83 mg/kg, i.p.), or saline. After 6 h, animals were subjected to the forced-swim test (FST) and open-field tests. Immediately after the behavioral tests, they were euthanized and their brains were collected for the biochemical analyses. Results: LPS increased the immobility time and reduced the distance travelled in the FST and open-field test, respectively. Dexamethasone increased the immobility time in saline-treated mice but reduced this behavior in the LPS group. LPS increased the levels of tumor necrosis factor (TNF)-α, interleukin (IL)-6 and interferon (IFN)-γ in most of the regions evaluated. Dexamethasone prevented LPS-induced IL-6 in the HC, PFC, and HT. Interestingly, dexamethasone increased IL-4 and IL-10 levels in both the LPS- and saline-treated groups. Although dexamethasone reduced BDNF in saline-treated mice, it prevented LPS-induced reduction in this neurotrophic factor. Conclusion: In summary, dexamethasone decreased proinflammatory and increased anti-inflammatory levels of cytokines and prevented a reduction in BDNF levels induced by the inflammatory stimulus. Thus, the attenuation of depressive-like behavior induced by dexamethasone may be related to the effects on these parameters.
Effect of Empagliflozin on Cardiovascular and Renal Outcomes in Patients With Heart Failure by Baseline Diabetes Status
Authors: Anker Stefan D. , Butler Javed , Filippatos Gerasimos , Khan Muhammad Shahzeb , Marx Nikolaus , Lam Carolyn S.P. , Schnaidt Sven , Ofstad Anne Pernille , Brueckmann Martina , Jamal Waheed , Bocchi Edimar A. , Ponikowski Piotr , Perrone Sergio V. , Januzzi James L. , Verma Subodh , Böhm Michael , Ferreira João Pedro , Pocock Stuart J. , Zannad Faiez , Packer Milton ,   On behalf of the EMPEROR-Reduced Trial Committees and Investigators
Published: November 2020

Background:

Sodium-glucose cotransporter 2 inhibitors improve outcomes in patients with heart failure with reduced ejection fraction, but additional information is needed about whether glycemic status influences the magnitude of their benefits on heart failure and renal events.

Methods:

Patients with Class II–IV heart failure and a left ventricular ejection fraction ≤40% were randomized to receive empagliflozin (10 mg daily) or placebo in addition to recommended therapy. We prespecified a comparison of the effect of empagliflozin in patients with and without diabetes.

Results:

Of the 3730 patients enrolled, 1856 (50%) had diabetes, 1268 (34%) had prediabetes (hemoglobin A1c [HbA1c] 5.7–6.4%), and 606 (16%) had normoglycemia (HbA1c <5.7%). The risks of the primary outcome (cardiovascular death or hospitalization for heart failure), total hospitalizations for heart failure, and adverse renal outcomes were higher in patients with diabetes, but were similar between patients with prediabetes and normoglycemia. Empagliflozin reduced the risk of the primary outcome in patients with and without diabetes (hazard ratio, 0.72 [95% CI, 0.60–0.87] and 0.78 [95% CI, 0.64–0.97], respectively,
P
-interaction=0.57). Patients with and without diabetes also did not differ with respect to the effect of empagliflozin on total hospitalizations for heart failure, on the decline in estimated glomerular filtration rate over time, and on the risk of serious adverse renal outcomes. Among these end points, the effects of the drug did not differ in patients with prediabetes or normoglycemia. When analyzed as a continuous variable, baseline HbA1c did not significantly modify the benefits of empagliflozin on the primary outcome (
P
-interaction=0.40). Empagliflozin did not lower HbA1c in patients with prediabetes or normoglycemia and was not associated with increased risk of hypoglycemia.

Conclusions:

In EMPEROR-Reduced (Empagliflozin Outcome Trial in Patients With Chronic Heart Failure With Reduced Ejection Fraction), empagliflozin significantly improved cardiovascular and renal outcomes in patients with heart failure and a reduced ejection fraction, independent of baseline diabetes status and across the continuum of HbA1c.

Registration:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03057977.
Office and Ambulatory Arterial Hypertension in Highlanders
Authors: Bilo Grzegorz , Acone Lorenzo , Anza-Ramírez Cecilia , Macarlupú José Luis , Soranna Davide , Zambon Antonella , Vizcardo-Galindo Gustavo , Pengo Martino F. , Villafuerte Francisco C. , Parati Gianfranco ,   on behalf of HIGHCARE-ANDES Highlanders Study Investigators
Published: November 2020

Millions of people worldwide live at high altitude, being chronically exposed to hypobaric hypoxia. Hypertension is a major cardiovascular risk factor but data on its prevalence and determinants in highlanders are limited, and systematic studies with ambulatory blood pressure monitoring are not available. Aim of this study was to assess the prevalence of clinic and ambulatory hypertension and the associated factors in a sample of Andean highlanders. Hypertension prevalence and phenotypes were assessed with office and ambulatory blood pressure measurement in a sample of adults living in Cerro de Pasco, Peru (altitude 4340 m). Basic clinical data, blood oxygen saturation, hematocrit, and Qinghai Chronic Mountain Sickness score were obtained. Participants were classified according to the presence of excessive erythrocytosis and chronic mountain sickness diagnosis. Data of 289 participants (143 women, 146 men, mean age 38.3 years) were analyzed. Office hypertension was present in 20 (7%) participants, while ambulatory hypertension was found in 58 (20%) participants. Masked hypertension was common (15%), and white coat hypertension was rare (2%). Among participants with ambulatory hypertension, the most prevalent phenotypes included isolated nocturnal hypertension, isolated diastolic hypertension, and systodiastolic hypertension. Ambulatory hypertension was associated with male gender, age, overweight/obesity, 24-hour heart rate, and excessive erythrocytosis. Prevalence of hypertension among Andean highlanders may be significantly underestimated when based on conventional blood pressure measurements, due to the high prevalence of masked hypertension. In highlanders, ambulatory hypertension may be independently associated with excessive erythrocytosis.
Contrastive Pragmatics and Second Language (L2) Pragmatics: Approaches to Assessing L2 Speech Act Production
Authors: Taguchi Naoko , Li Shuai
Published: November 2020

This state-of-the-art paper discusses common approaches to the assessment of pragmatic competence. Two approaches have dominated the assessment practice in the field of second language (L2) pragmatics. One approach, rooted in the tradition of contrastive pragmatics, involves comparing and contrasting L2 learners’ pragmalinguistic forms with those of native speakers to determine whether L2 forms approximate native speaker forms. The other approach, rooted in the tradition of performance-based assessment, involves using a rating scale to evaluate L2 pragmatic performance based on multiple criteria (e.g., clarity of intention, formality level of expressions, and interaction abilities). Focusing on the area of speech act assessment, this paper presents an overview of these two approaches, highlighting their advantages and disadvantages. By doing so, the paper intends to illustrate the interface between contrastive pragmatics and L2 pragmatics. The paper concludes with critical insights in terms of what is missing in these approaches under the current trend of globalization and intercultural communication.
6. 1792: Naigeon’s Article on ‘Diderot’ in the Encyclopédie méthodique
Authors: Warman Caroline
Published: November 2020

This short chapter discusses Naigeon’s article on ‘Diderot’, published as part of his Encyclopédie méthodique, and offers an explanation as to why Naigeon chose to advertise his forthcoming Mémoires historiques et philosophiques within this piece of writing. While limiting discussion to Diderot’s published works within the main body of his article, Naigeon explicitly advises readers to consult the Mémoires in the introduction and conclusion of ‘Diderot’. After consciously drawing readers’ attention to his own unreleased manuscript, Naigeon comments on an unnamed work by Diderot more ‘profound’ than any other of the philosopher’s writings. Warman argues that Naigeon was alluding here to the Éléments de physiologie, and wanted to build anticipation around a text that he felt would shake the foundations of Diderotian scholarship as soon as it entered the public domain.
11. 1820: Garat’s Mémoires historiques sur la vie de M. Suard, sur ses écrits, et sur le XVIIIe siècle
Authors: Warman Caroline
Published: November 2020

This chapter looks at Garat’s Mémoires sur Suard and identifies various moments in which Garat may have been cautiously alluding to Diderot’s Éléments de physiologie. Warman first notes that Garat potentially wanted his biographical text to be associated with other forthcoming memoirs during this period, including Naigeon’s Mémoires on Diderot, as a way of reinstating his position within the academic community from which he had been shunned. She then quotes an extensive passage from the Mémoires sur Suard on Bernard Le Bovier de Fontenelle in which Garat describes Fontenelle’s interest in and work on theories of human understanding. Although Fontenelle did actively engage with this topic, Warman argues that, with its framing references to literary fragments and posthumous papers, Garat’s description applies better to Diderot’s Éléments than to Fontenelle. At points, Garat mentions Diderot explicitly by combatting Suard’s criticism of the philosopher, and by claiming that Diderot excelled in one particular – albeit unspecified – field of science. Garat was most likely referring here to Diderot’s work on materialism but consciously masked his meaning for fear of backlash from the state and authoritarian theologians. Ultimately, it is impossible to fully prove that Garat was using his Mémoires sur Suard to allude to Diderot’s Éléments because, according to Warman, Garat ‘masks and conceals’ as much as he ‘suggests and signals’.
The Effect of Gravity Modulation on Double Diffusive Convection in the Presence of Applied Magnetic Field and Internal Heat Source
Authors: Kiran Palle , Manjula S. H. , Roslan R.
Published: November 2020

We have investigated the study of double diffusive stationary convection in the presence of applied magnetic field and internal heating. A weakly nonlinear stability analysis has been performed using the finite amplitude Ginzburg-Landau model. This finite amplitude of convection is
obtained at third order of the system. It is assumed that the buoyancy term has two parts, steady and oscillatory parts. The second part is varying sinusoidally with time and vibrates the system with finite amplitude δ1 and frequency ω. The effects of δ1
and on heat/mass transports have been analysed and depicted graphically. The studies are established that the heat/mass transports can be controlled effectively by gravity modulation. Further, it is found that internal Rayleigh number Ri is to enhance heat transfer and reduces
the mass transfer in the system.
Flow Past a Circular Cylinder: A Comparison Between Commercial Finite Volume and Finite Element Codes
Authors: Vasconcellos Guilherme L. F. , de Oliveira Alex , Queiroz Matheus D. , Júnior Jánes Landre , Maia Cristiana B.
Published: November 2020

This study compares the numerical analyzes of two commercial computational fluid dynamics (CFD) software programs: Ansys® CFX 14.5, based on the finite volume method (FVM); and Altair® AcuSolve 13.0, based on the finite element method (FEM). For this purpose,
the flow around a circular cylinder inserted into the test section of a low speed wind tunnel was simulated. The same turbulence model, κ–ω SST (shear stress transport), was used in both software, and the numerical results were compared with experimental results.
Results of velocity, pressure, static pressure coefficient and skin friction coefficient are presented. A mesh test was carried out to evaluate the mesh convergence and the numerical uncertainties, which indicated greater uncertainties and sensitivity of FVM to the mesh quality. The average
computing time for the FEM method was ten times greater than for FVM. Numerical results of both codes showed a good agreement with experimental results and with the literature.
A Low Power Digital Binary Magnitude Comparator Design for Very Large Scale Integration Applications
Authors: Mukhopadhyay Abhijit Kumar
Published: November 2020

This paper reports two designs of low power digital binary magnitude comparator based on static complementary CMOS logic style. The designs make use of recently reported latest XNOR gate designs. The comparator designs proposed here are easily scalable for higher order bits and thus
highly suitable for VLSI applications. Mathematical equations establishing the relation between input bit width and transistor count of the magnitude comparators have also been derived in this paper. For a 64 bit magnitude comparator, the designs proposed in this paper outperform an existing
design by 12.17% and 10.42% in terms of transistor requirement and 14.81% and 11.78% in terms of average power consumption.
Expected values for gastrointestinal and pancreatic hormone concentrations in healthy volunteers in the fasting and postprandial state
Authors: Meek Claire L , Lewis Hannah B , Burling Keith , Reimann Frank , Gribble Fiona
Published: November 2020

Background

Gastrointestinal hormones regulate intestinal transit, control digestion, influence appetite and promote satiety. Altered production or action of gut hormones, including glucagon-like peptide-1 (GLP-1), glucose-dependent insulinotropic polypeptide (GIP) and peptide YY (PYY), may contribute to the biological basis of obesity and altered glucose homeostasis. However, challenges in analytical methodology and lack of clarity on expected values for healthy individuals have limited progress in this field. The aim of this study was to describe expected concentrations of gastrointestinal and pancreatic hormones in healthy volunteers following a standardized meal test (SMT) or 75 g oral glucose tolerance test (OGTT).

Methods

A total of 28 healthy volunteers (12 men, 16 women; mean age 31.3 years; mean body mass index 24.9 kg/m2) were recruited to attend a hospital clinic on two occasions. Volunteers had blood sampling in the fasting state and were given, in randomized order, an oral glucose tolerance test (OGTT) and standardized mixed liquid meal test with venepuncture at timed intervals for 4 h after ingestion. Analytical methods for gut and pancreatic hormones were assessed and optimized. Concentrations of gut and pancreatic hormones were measured and used to compile ranges of expected values.

Results

Ranges of expected values were created for glucose, insulin, glucagon, GLP-1, GIP, PYY and free fatty acids in response to a standardized mixed liquid meal or OGTT. Intact proinsulin and C-peptide levels were also measured following the OGTT.

Conclusions

These ranges of expected values can now be used to compare gut hormone concentrations between healthy individuals and patient groups.
From global risk to global threat: State capabilities and modernity in times of coronavirus
Authors: Domingues José Maurício
Published: November 2020

This article tries to understand the manifold impact the coronavirus crisis has had on social life. Beck’s ‘risk society’ is discussed, especially in the pandemic’s transition from a risk to a concrete threat. Moreover, the article shows that the World Health Organization was already framing its discourse in connection with risk, though the nation-state model that dominates global politics prevented it from taking more decisive action, not because nation-states are weak, but because they simply did not ascribe importance to looming pandemics. This is bound to change: politically-steered and policy-oriented state capabilities – taxation, managing, moulding, surveillance, coercion, materialization, along with a legal meta-capability, which never waned, return to the forefront. At least partly in the West and Latin America the security of populations has taken centre-stage. Keynesianism and some sort of state welfarism are making a comeback. Changes in ‘global health governance’ are happening, too. While the precise direction of change is unclear, the article presents some future possibilities.
Adverse Rainfall Shocks and Civil War: Myth or Reality?
Authors: Maertens Ricardo
Published: November 2020

News reports and policymakers frequently link African civil conflicts and wars to agricultural crises caused by droughts. However, empirical studies of the relationship between rainfall and civil conflict or war remain inconclusive. I reexamine this relationship focusing on rainfall over each country’s agricultural land during the growing seasons. I also incorporate that the relationship between rainfall and agricultural output is hump-shaped, as rainfall beyond a threshold decreases output. I find a U-shaped relationship between rainfall and the risk of civil conflict and war in (Sub-Saharan) African countries. This relationship mirrors the hump-shaped relationship between rainfall and agricultural output.
Monorails as international transborder links. The El Paso-Ciudad Juárez monorail proposal, 1964–1976
Authors: Taylor Lawrence Douglas
Published: November 2020

The paper uses primary and secondary sources to analyse the El Paso-Ciudad Juárez binational monorail project from 1964 to 1976 within the overall context of the growth of the cities as urban centres and the development of cross-border public transit links. The most significant of the earlier ties was the international streetcar line, which functioned for over 90 years and was a predecessor to the monorail project. The paper examines the complexities of negotiating and building an international transport project of this nature as well as the principal business and political directors of the El Paso International Monorail Corporation (IMC) and its Juárez counterpart, Monorriel Internacional (MI). It concludes with an assessment of the current outlook for cross-border mass transit projects in the light of the notable increment in USA border security and inspection controls of recent decades.
Should the Equality Act 2010 Be Extended to Prohibit Appearance Discrimination?
Authors: Mason Andrew , Minerva Francesca
Published: November 2020

The UK Equality Act 2010 prohibits direct and indirect discrimination with respect to nine characteristics: age, disability, gender reassignment, marriage and civil partnership, pregnancy and maternity, race, religion or belief, sex, and sexual orientation. We argue that the best way of understanding the Act is to see it as protecting those who are vulnerable to systematic disadvantage, partly in virtue of being at risk of experiencing discrimination that violates what we call the meritocratic principle. If this is a key principle underpinning the Act, then there is a compelling case for extending the legislation to include the protection of at least one further characteristic, namely, appearance. We consider but reject various difficulties that might be raised with extending the Act in this way, including the objection that those vulnerable to forms of appearance discrimination that violate the meritocratic principle could be adequately protected by treating them as disabled.
Stages of Change Scale to Measure Work Readiness of Transition-Age Youth With Disabilities: A Promising Approach
Authors: Schlegelmilch Amanda , Roskowski Matthew , Brinck Emily A. , Anderson Catherine A. , Hartman Ellie , Chan Fong , Tansey Timothy N. , Decker-Maurer Heidi
Published: November 2020

The experience of transitioning into adulthood is a critical phase in life. The navigation of government benefits adds further complexity that can affect employment outcomes for youth with disabilities. Some individuals hesitate to work out of fear to losing access to monetary, disability, and related health care benefits. However, using available work incentives while pursuing employment and career paths can provide opportunities to work and address poverty without forgoing needed services. The Wisconsin Promoting Readiness of Minors in Supplemental Security Income (PROMISE) research grant aimed to positively change youth readiness to work through the use of Motivational Interviewing, work incentive benefits counseling, financial capability building, shifting expectations, and help in navigating transition resources. To measure the impact on readiness to work, 126 transition-age youth receiving supplemental security income (SSI), 188 of their family members, and 411 Division of Vocational Rehabilitation (DVR) counselors working with the youth and families completed a modified Stages of Change Scale survey. Results indicated that youths’ work readiness and positive feelings about work significantly increased from baseline to follow-up, along with an increase in employment rates. The implications of these findings highlight the utility of incorporating the stages of change theory into the design and implementation of services and supports to increase work readiness for youth with disabilities in transition.
The Culture of Power Online: Cultural Responsiveness and Relevance in Vendor-Developed Online Courses
Authors: Darling-Aduana Jennifer , Good Annalee , Geraghty Elisabeth
Published: November 2020

With the expansion of online instruction in K-12 education, how and what is taught in a single course has the potential to affect the learning of thousands of students. Our mixed method study applies a critical lens to examine the extent to which four widely used online high school courses are culturally relevant and responsive. Online lessons reflected a culture of power, emphasizing normative cultural narratives, retreating to symbolic use versus application, and presenting neoliberal ideologies as fact. We end with a discussion of how systems can be leveraged to improve the educational experiences provided to students enrolled online.
Internal Consistency of Yesavage Geriatric Depression Scale (GDS 15-Item Version) in Ecuadorian Older Adults
Authors: Erazo María , Fors Martha , Mullo Sofía , González Paloma , Viada Carmen
Published: November 2020

The present study aimed to assess the validity of a Spanish version of the Geriatric Depression-15 Scale (GDS-15) in Ecuadorian adults. Cross-sectional study to validate GDS-15 in its short version (GDS-15). Internal consistency and factor structure were assessed through Kuder Richardson 20 and Confirmatory Factor Analysis. A total of 211 subjects 65 years of age and older participated in the validation process. Internal consistency was adequate, the Kuder Richardson 20 coefficient for the total scale was 0.73. Three factor structure was found for the scale. This study highlights the importance of having a validated scale for screening depression in the elderly. This study provides an evidence for the use of GDS-15 in Ecuadorian elderly population to screen for depression.
The Closer, the Better? Comparing Advisory Councils at Different Government Levels
Authors: Brugué Quim , Font Joan , Ruiz Jorge
Published: November 2020

Advisory councils exist at diverse government levels, making them especially appropriate to address the discussion about scaling up participatory institutions, by comparing their differences across different government levels. We analyze the characteristics of advisory councils in Spain, where they are quite similar at the national, regional, and local levels, allowing a controlled comparison of their functioning and results. Results show similarities across territorial levels and also signs of a better performance of the local and regional ones, especially regarding the satisfaction of participants. Relational goods and different understandings of what policy influence means are crucial explanations of these patterns.
Pintail Comb Injury as a Rare Cause of Penetrating Temporal Bone Trauma With Facial Paralysis
Authors: Cooper Dylan Jacob , Pelosi Stanley
Published: November 2020

We present a case of novel penetrating temporal bone trauma with a pintail comb causing facial paralysis. We describe a 42-year-old woman with acute facial paralysis, hearing loss, and dizziness following accidental tympanic membrane puncture. The patient underwent middle ear exploration with tympanoplasty and was found to have an intact but severely edematous facial nerve. The patient demonstrated less than 90% degeneration under electroneuronography and was treated medically without decompression, and by 6 months had exhibited complete resolution of facial nerve dysfunction with normal hearing. This case report highlights a unique cause of penetrating temporal bone trauma and supports the utility of electroneuronography in predicting the likelihood of recovery and need for decompression in patients where the facial nerve has obvious signs of trauma but remains grossly intact.
Posterior Pharyngeal Wall Tuberculosis—A Forgotten Entity Mimicking Malignancy
Authors: Kairo Arvind Kumar , Kajal Smile , Shamim Shamim Ahmed , Barwad Adarsh
Published: November 2020

Background:

Tuberculosis (TB) of posterior pharyngeal wall (PPW), either primary or secondary, is extremely rare and can mimic malignancy in elderly patients.

Case Report:

A 36-year-old female patient presented with complains of nonhealing ulcer at the back of her throat for 4 months. On examination, there was an ulceroproliferative growth covered with slough over PPW. Positron emission tomography scan showed uptake in PPW. There was no uptake in any other part of body. A biopsy from PPW lesion showed epithelioid cell granulomas with Langhans type giant cells. Auramine-rhodamine staining showed few beaded bacilli consistent with TB.

Conclusion:

Tuberculosis of PPW is an extremely uncommon entity and can mimic malignancy. It should be kept as one of the differential diagnosis as it can be cured solely by giving anti-tubercular therapy.
ECMO implantation training: Needle penetration in 3D printable materials and porcine aorta
Authors: Salewski Christoph , Spintzyk Sebastian , von Steuben Thore , Sandoval Boburg Rodrigo , Nemeth Attila , Schille Christine , Acharya Metesh , Geis-Gerstorfer Jürgen , Wendel Hans-Peter , Popov Aron-Frederik , Schlensak Christian
Published: November 2020

Aim

Patients with cardiogenic shock or ARDS, for example, in COVID-19/SARS-CoV-2, may require extracorporeal membrane oxygenation (ECMO). An ECLS/ECMO model simulating challenging vascular anatomy is desirable for cannula insertion training purposes. We assessed the ability of various 3D-printable materials to mimic the penetration properties of human tissue by using porcine aortae.

Methods:

A test bench for needle penetration and piercing in sampled porcine aorta and preselected 3D-printable polymers was assembled. The 3D-printable materials had Shore A hardness of 10, 20, and 50. 17G Vygon 1.0 × 1.4 mm × 70 mm needles were used for penetration tests.

Results:

For the porcine tissue and Shore A 10, Shore A 20, and Shore A 50 polymers, penetration forces of 0.9036 N, 0.9725 N, 1.0386 N, and 1.254 N were needed, respectively. For piercing through the porcine tissue and Shore A 10, Shore A 20, and Shore A 50 polymers, forces of 0.8399 N, 1.244 N, 1.475 N, and 1.482 N were needed, respectively. ANOVA showed different variances among the groups, and pairwise two-tailed t-tests showed significantly different needle penetration and piercing forces, except for penetration of Shore A 10 and 20 polymers (p = 0.234 and p = 0.0857). Significantly higher forces were required for all other materials.

Conclusion:

Shore A 10 and 20 polymers have similar needle penetration properties compared to the porcine tissue. Significantly more force is needed to pierce through the material fully. The most similar tested material to porcine aorta for needle penetration and piercing in ECMO-implantation is the silicon Shore A 10 polymer. This silicon could be a 3D-printable material in surgical training for ECMO-implantation.
Survivorship and Patient-Reported Outcomes After Comprehensive Arthroscopic Management of Glenohumeral Osteoarthritis: Minimum 10-Year Follow-up
Authors: Arner Justin W. , Elrick Bryant P. , Nolte Philip-C. , Haber Daniel B. , Horan Marilee P. , Millett Peter J.
Published: November 2020

Background:

Few long-term outcome studies exist evaluating glenohumeral osteoarthritis (GHOA) treatment with arthroscopic management.

Purpose:

To determine outcomes, risk factors for failure, and survivorship for the comprehensive arthroscopic management (CAM) procedure for the treatment of GHOA at minimum 10-year follow-up.

Study Design:

Case series; Level of evidence, 3.

Methods:

The CAM procedure was performed on a consecutive series of patients with advanced GHOA who opted for joint preservation surgery and otherwise met criteria for total shoulder arthroplasty. At minimum 10-year follow-up, postoperative outcome measures included change in the American Shoulder and Elbow Surgeons, Single Assessment Numeric Evaluation, 12-Item Short Form Health Survey (SF-12) Physical Component Summary, and visual analog scale for pain, along with the QuickDASH (shortened version of Disabilities of the Arm, Shoulder and Hand) and satisfaction score. Kaplan-Meier survivorship analysis was performed, with failure defined as progression to arthroplasty.

Results:

In total, 38 CAM procedures were performed with 10-year minimum follow-up (range, 10-14 years) with a mean patient age of 53 years (range, 27-68 years) at the time of surgery. Survivorship was 75.3% at 5 years and 63.2% at minimum 10 years. Those who progressed to arthroplasty did so at a mean 4.7 years (range, 0.8-9.6 years). For those who did not undergo arthroplasty, American Shoulder and Elbow Surgeons scores significantly improved postoperatively at 5 years (63.3 to 89.6; P < .001) and 10 years (63.3 to 80.6; P = .007). CAM failure was associated with severe preoperative humeral head incongruity in 93.8% of failures as compared with 50.0% of patients who did not go on to arthroplasty ( P = .008). Median satisfaction was 7.5 out of 10.

Conclusion:

Significant improvements in patient-reported outcomes were sustained at minimum 10-year follow-up in young patients with GHOA who underwent a CAM procedure. The survivorship rate at minimum 10-year follow-up was 63.2%. Humeral head flattening and severe joint incongruity were risk factors for CAM failure. The CAM procedure is an effective joint-preserving treatment for GHOA in appropriately selected patients, with sustained positive outcomes at 10 years.
Radiographic Reference Points Do Not Ensure Anatomic Femoral Fixation Sites in Medial Patellofemoral Ligament Reconstruction: A Quantified Anatomic Localization Method Based on the Saddle Sulcus
Authors: Chen Jiebo , Han Kang , Jiang Jia , Huangfu Xiaoqiao , Zhao Song , Zhao Jinzhong , Xie Guoming
Published: November 2020

Background:

Medial patellofemoral ligament (MPFL) reconstruction is one of the main treatments for lateral patellar translation. Based on intraoperative true lateral radiographs, the accepted methods for femoral MPFL tunnel location are potentially inaccurate. Direct assessment of anatomic characteristics during surgery through palpation of the anatomic landmarks involving the saddle sulcus might help eliminate tunnel malposition.

Hypothesis:

The saddle sulcus is a reliable osseous landmark where the MPFL attaches for tunnel placement.

Study Design:

Descriptive laboratory study.

Methods:

A total of 9 fresh-frozen unpaired human cadaveric knees were dissected; MPFL insertion point and relative osseous structures were marked. Three-dimensional images and transformed true lateral radiographs were obtained for analysis; 3 previously reported radiographic reference points for MPFL femoral tunnel placement were determined on all images and compared with the anatomic insertion.

Results:

A saddle sulcus consistently existed where the MPFL was attached, located at 11.7 ± 5.9 mm from the apex of the adductor tubercle (AT) to the medial epicondyle (ME), 62.8% of the average distance between the apexes of the AT and ME, and 5.6 ± 2.8 mm perpendicular-posterior to the border connecting the AT and ME. The reported radiographic reference points were located at average distances of 6.2 ± 3.2 mm (Schöttle method), 5.9 ± 2.3 mm (Redfern method), and 7.3 ± 6.6 mm (Fujino method) from the saddle sulcus center on the true lateral radiographs.

Conclusion:

The saddle sulcus was a reliable landmark where the MPFL was anatomically attached, located approximately 12 mm from the AT to the ME (approximately 60% along a line from the AT to the ME) and 6 mm perpendicular-posterior to the border connecting the apexes of the AT and ME. Additionally, the saddle sulcus position presented variability on the femoral aspect of different knees. All of the average direct distances from the sulcus to the reference radiographic points exceeded 5 mm, and tunnel localizations on a true lateral radiograph were inaccurate.

Clinical Relevance:

This study demonstrates the potential precise position of the saddle sulcus, according to the ME and AT, as a reliable anatomic landmark for MPFL femoral tunnel location. Radiographic reference points were not accurate during MPFL reconstruction. Direct palpation of the landmarks might be effective for femoral MPFL tunnel placement.
Harrodian Instability: An Unhelpful Analytical Concept
Authors: Trezzini Attilio
Published: November 2020

By reconsidering the concept of normal degree of utilization in view of the fact that growth occurs through irregular fluctuations, the paper points out elements of weakness in the formalizations of the principles that underlie the notion of Harrodian instability. Since the latter was at the origin of the adoption of fully adjusted positions to represent long-term trends of the economy, such arguments call into question this way of addressing demand-led growth.

JEL Classification: O40, E12
Comparative Efficacy and Tolerability of Adjunctive Pharmacotherapies for Acute Bipolar Depression: A Systematic Review and Network Meta-analysis
Authors: Bahji Anees , Ermacora Dylan , Stephenson Callum , Hawken Emily R. , Vazquez Gustavo
Published: November 2020

Objective:

We investigated the comparative efficacy and tolerability of augmentation strategies for bipolar depression.

Data Sources:

We conducted a systematic review and network meta-analysis of 8 electronic databases for double-blind, randomized controlled trials of adjunctive pharmacotherapies for acute bipolar depression.

Data Extraction and Synthesis:

We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and applied the Cochrane risk of bias tool for study quality appraisal. Two reviewers independently abstracted data. We resolved all discrepancies by consensus.

Main Outcomes and Measures:

Primary outcomes were response and completion of treatment. We estimated summary rate ratios (RRs) and standardized mean differences (SMDs) relative to placebo controls using frequentist random-effects network meta-analysis.

Results:

We identified 69 trials meeting eligibility criteria (8,007 participants, 42.8 years, 58.0% female). Adjunctive racemic intravenous ketamine, coenzyme Q10, pramipexole, fluoxetine, and lamotrigine were more effective than placebo. Summary RRs for response ranged between 1.51 (95% confidence interval [CI], 1.11 to 2.06) for fluoxetine and 12.49 (95% CI, 3.06 to 50.93) for racemic intravenous ketamine. For completion of treatment, risperidone appeared less tolerable than placebo (RR = 0.59; 95% CI, 0.38 to 0.94), while fluoxetine seemed more tolerable than placebo (RR = 1.13; 95% CI, 1.02 to 1.24). None of the investigated agents were associated with increased treatment-emergent mood switches.

Conclusions and Relevance:

The evidence for augmentation strategies in bipolar depression is limited to a handful of agents. Fluoxetine appeared to have the most consistent evidence base for both efficacy and tolerability. There remains a need for additional research exploring novel treatment strategies for bipolar depression, particularly head-to-head studies.
Compressive properties of reversibly assembled lattice structures
Authors: Zhao Yueqing , Liu Mingyang , Zhang Tao , Xu Bo , Zhang Boming
Published: November 2020

Lattice structures are competitive to fabricate sandwich structures for their excellent mechanical properties and large internal space volume. A non-planar cross-shaped part as a regular building block has been designed and manufactured using glass fiber-reinforced thermoplastic composites. Identical cross-shaped parts can be assembled into 120-unit cell lattice structures by a mechanical interlocking method. The compressive properties of unit cell lattice structures assembled with different connections pins and sequences were investigated. Lattices with steel pins possess higher compressive modulus and strength than those with composites pins. The compressive moduli of unit cell structures are more sensitive to assembly sequence than that of multi-cell structures. When the structures change to multi-cell from unit-cell with the same assembly sequence, the compressive moduli significantly decrease. The connection between face sheets and core by the ultrasonic welding improves the compressive properties of the structures. The reversible disassembly and strong designability of lattice structures are helpful to satisfy multifunctional requirements, meanwhile realizing energy saving and emission reduction.
Relation Between Depression Symptoms and Suicide Risk in Adults and Older Adults: A Brief Report
Authors: Cui Ruifeng , Fiske Amy
Published: November 2020

Depression symptoms are key risk factors for suicide; however, older adults differ from younger adults in types of depression symptoms experienced and thus their risk factors for suicide. The present brief report investigated relations between different symptoms of depression and suicide risk and whether these relations are moderated by age. Participants were 944 community-dwelling adults ( N = 512, M = 39) and older adults ( N = 432, M = 66) from the United States recruited through Mechanical Turk. Participants completed self-report measures on depression symptoms and suicide risk. Age was found to moderate the relation between cognitive-affective and somatic symptoms and suicide risk. Younger age exacerbated the negative effects of these symptoms on suicide risk. The study is the first to investigate whether older adults differed from younger adults in the association between types of depression symptoms and suicide risk and found that the risk posed by cognitive-affective and somatic symptoms was greater for younger adults.
Meeting the COVID-19 Deadlines: Choosing Assessments to Determine Eligibility
Authors: Krach Shelley Kathleen , Paskiewicz Tracy L. , Ballard Staci C. , Howell James E. , Botana Suzanne M.
Published: November 2020

Timely identification of children with disabilities is required by federal special education law (Individuals with Disabilities Education Improvement Act, 20 U.S.C. § 1400, 2004). During COVID-19, school psychologists have been faced with the challenge of completing valid, comprehensive, and diagnostic assessments when traditional methods are not an option. Traditional methods of testing have become nearly impossible due to social distancing requirements; therefore, alternate methods need to be considered. These alternate methods may be unfamiliar to the practitioner and/or lack validation to use with confidence. This study offers a prospective guide to help practitioners make safe and valid test selection and interpretation decisions during a pandemic. Examples of assessments analyzed using this guide are provided for the reader. In addition, a case study is provided as an example.
Accommodating interests? Elite journalism, green interest groups and the U.K. reporting of climate change
Authors: Matthews Julian
Published: November 2020

We know that journalists accommodate green interest groups’ voices in the reporting of climate change. Argument continues, nevertheless, over the extent of groups’ contributions to coverage. The study on which this article is based traces groups’ presence during a rapid politicization of the issue (2000–2010). Its analysis of U.K. newspaper coverage shows that groups appear alongside a growing number of political messages “to tackle” climate change and act there as a critical foil to these performances and to explain climate consequences.