bluuebunny/crossref_metadata_2025 huggingface dataset:
11. Child Protection: State Support for Children
Authors: Morgan Polly
Published: August 2024

This chapter considers how the Children Act 1989 provides a legal framework within which the state can support children to remain with their families through difficult situations and intervene to protect them when they face unacceptable risks. The chapter starts by giving a brief history of child protection law. It then looks at the inherent tension between protecting children while aspiring to support their lives with their families, before considering local authorities’ powers, duties, and resources. It considers why there are ever-increasing numbers of children who are involved with social services, whether as children in need, looked after children, or as subjects of child protection investigations or applications.
12. Child Protection: Care, Supervision, and Adoption
Authors: Morgan Polly
Published: August 2024

This chapter looks at what happens when compulsory intervention to protect children, in the form of care or supervision applications, is needed. It considers the legal tests, the processes, and the practicalities involved in proceedings. It analyses the legal test for making the child subject to a care or supervision order—that the child in question is suffering or likely to suffer significant harm attributable to their care or to them being beyond parental control—before turning to what happens when this test is met. As far as the court is concerned, the best interests of the child are paramount. The court has to consider all realistic options for the child’s future, including a return to the birth family, foster care, special guardianship, supervision, and adoption. It looks in depth at the law surrounding adoption and the human rights implications of changing a child’s family.
Current situation of tobacco industry carbon emissions based on sensor equipment monitoring and cloud computing and optimization of ‘light storage, straight and flexible’ carbon neutralization path
Authors: Huang Tao , Lian Yongsheng , Guo Lanxia , Zhang Huijuan , Meng Jinghua
Published: August 2024

In recent years, China has faced enormous pressure to reduce carbon emissions. As one of the pillar industries of China’s economy, the tobacco industry has been a high-energy and inefficient industry for a long time. However, the carbon emissions generated by the tobacco industry are also increasing the greenhouse effect. Therefore, this research uses information physics system technology to conduct real-time sensor monitoring and cloud computing on carbon emissions of the tobacco industry and uses an ant colony algorithm to perform multiobjective optimization based on ‘carbon emissions of construction period cost’. The experimental results show that, from the perspective of total carbon cost design, the carbon cost and carbon emission reductions obtained through process decomposition accounting provide a data basis for measuring the emission reduction effect of different low-carbon technology paths using ‘optical storage, direct and flexible’ path optimization. Emission reduction can be seen from three emission reduction technology paths. The supercritical unit technology path of the tobacco industry can reduce 225 000 tons of carbon dioxide emissions annually, while carbon capture technology can reduce 120 000 tons of carbon dioxide emissions annually. The emission reduction of carbon dioxide through online monitoring technology is limited, less than one-tenth of the first two technical approaches. The total carbon cost of carbon dioxide online monitoring technology is 1 953 383 900 yuan, with substantial economic value.
Mechanisms and effects of activation of innate immunity by mitochondrial nucleic acids
Authors: Rai Prashant , Fessler Michael B
Published: August 2024

In recent years, a growing number of roles have been identified for mitochondria in innate immunity. One principal mechanism is that the translocation of mitochondrial nucleic acid species from the mitochondrial matrix to the cytosol and endolysosomal lumen in response to an array of microbial and non-microbial environmental stressors has been found to serve as a second messenger event in the cell signaling of the innate immune response. Thus, mitochondrial DNA and RNA have been shown to access the cytosol through several regulated mechanisms involving remodeling of the mitochondrial inner and outer membranes and to access lysosomes via vesicular transport, thereby activating cytosolic [e.g. cyclic GMP-AMP synthase (cGAS), retinoic acid-inducible gene I (RIG-I)-like receptors], and endolysosomal (Toll-like receptor 7, 9) nucleic acid receptors that induce type I interferons and pro-inflammatory cytokines. In this mini-review, we discuss these molecular mechanisms of mitochondrial nucleic acid mislocalization and their roles in host defense, autoimmunity, and auto-inflammatory disorders. The emergent paradigm is one in which host-derived DNA interestingly serves as a signal amplifier in the innate immune response and also as an alarm signal for disturbances in organellar homeostasis. The apparent vast excess of mitochondria and mitochondrial DNA nucleoids per cell may thus serve to sensitize the cell response to stressors while ensuring an underlying reserve of intact mitochondria to sustain cellular metabolism. An improved understanding of these molecular mechanisms will hopefully afford future opportunities for therapeutic intervention in human disease.
Which Stranger’s Disease? Immigration, Immunization, and the Whitening of Cuba in the Age of Atlantic Revolutions
Authors: Yero Farren
Published: August 2024

In 1804, Cuban physician Tomás Romay tried and failed to create the first yellow fever vaccine. The article analyzes his experimental efforts, foregrounding the enslaved and enlisted subjects at the center of this early vaccine trial. Though a scientific failure, this brief experiment, the desires and logics embedded within it, and the measures deployed in its wake — in the form of European whitening campaigns — allow us to consider the political uses of immunity during the Age of Atlantic Revolutions. Historicizing these events within the wider geopolitics of the Caribbean, the article explicates the central role that yellow fever immunization played in Cuban authorities’ attempts to shore up their political and economic sovereignty in the midst of anti-colonial and anti-slavery resistance. As such, it shows how yellow fever and its threat to social and economic order fits within a broader history of vaccination as a mechanism of colonial governance. Finally, by situating Cuban efforts to prevent yellow fever alongside the health concerns of enslaved people — concerns that arguably informed their resistance to slavery — the article also demonstrates how ideas about immunity and political belonging increasingly intersected through whiteness as an elite ideal in the era that Cuba first became a slave society.
Attitudes toward mothers as sexual beings and the sexual functioning of parents
Authors: Leistner Christine E , Mark Kristen P
Published: August 2024

Background

Research has shown that negative sexual attitudes are associated with lower levels of sexual functioning among men and women, however, little is known about how attitudes about mothers as sexual beings are associated with sexual functioning for parents.

Aim

The aim of the current study was to examine how attitudes toward mothers as sexual beings (ATMSB) were associated with sexual functioning for women and partners of women among parents with young children.

Methods

Cross-sectional retrospective data were collected online via Qualtrics Panels from 475 women and men (partnered to women) who reported having their first child within the last 5 years.

Outcomes: The Revised Female Sexual Function Index and revised Expanded Prostate Cancer Index Composite–Short Form were used to measure sexual function in women and men, respectively.

Results

Results indicated that after controlling for age and relationship length, more positive ATMSB predicted higher levels of sexual functioning (and multiple domains of functioning) for men and women.

Clinical Implications: These findings indicate that sexual functioning, especially in parents, is linked to the attitudes held toward seeing mothers as inherently sexual (or not).

Strengths and Limitations

This is the first study to examine how attitudes toward mothers as sexual beings can impact sexual functioning, though the cis heterosexual mostly white sample is a notable limitation.

Conclusion

ATMSB may need to be examined and challenged in the context of treating sexual dysfunction during this transitional period for mothers and those partnered to mothers.
Antioxidant, antibacterial, and anti-biofilm activities of selected indigenous plant species against nosocomial bacterial pathogens
Authors: Mnisi Talita J , Matotoka Mashilo M , Masoko Peter
Published: August 2024

Biofilms are responsible for over 60% of nosocomial infections. The focus of this study was to investigate the antioxidant, antibacterial, antibiofilm, and anti-motility activities of Gardenia volkensii, Carissa bispinosa, Peltophorum africanum, and Senna petersiana. Antioxidant activity was evaluated using free radical (DPPH) scavenging and ferric reducing power assays. Antibacterial and antibiofilm activities were evaluated using the broth micro-dilution and the crystal violet assays, respectively. Anti-motility was evaluated using anti-swarming activities, and the brine shrimp lethality assay was used for cytotoxicity. Gardenia volkensii and C. bispinosa acetone extracts had low EC50 values of 9.59 and 9.99 μg ml−1on the free-radical scavenging activity, respectively. All the plant extracts demonstrated broad-spectrum antibacterial activity against Klebsiella pneumoniae, Pseudomonasa aeruginosa, Escherichia coli, Enterococcus faecalis, and Staphylococcus aureus [minimum inhibitory concentration (MIC) < 0.63 mg ml−1]. The initial cell adherence stage of P. aeruginosa and E. coli was the most susceptible stage where sub-MICs resulted in inhibitions >50%. Peltophorum africanum had the least cytotoxic effects. All extracts had anti-motility activity against P. aeruginosa and E. coli. This study showed that not only do the plants have strong antibacterial activity but had noteworthy inhibition (>50%) of initial cell adherence and may be suitable candidates for the treatment of nosocomial pathogens.
The Right to Scientific Progress and to Scientific Freedom
Authors: Romano Cesare PR , Boggio Andrea
Published: August 2024

This chapter describes the normative basis and content of the first cluster of rights within the right to science: to scientific progress and what makes it possible, namely, scientific freedom. It contains eleven distinct rights, divided into four groups, labeled “intellectual,” “social,” “labor,” and “cultural.” The “intellectual” group includes (1) the freedom of scientific thought; (2) the freedom of scientific opinion and investigation; and (3) the freedom of scientific expression. The “social” group includes (4) the freedom of scientific assembly; (5) the freedom of scientific association; (6) the freedom of movement of scientists; and (7) the right of scientists to take part in the conduct of public affairs (passive and active participation). The “labor” group includes (8) the right of scientists to work and follow scientific vocation freely; and (9) the right of scientists to just and favorable conditions of work and safe and healthy working conditions. The “cultural” group includes (10) the right to take part in cultural life; and (11) the right to benefit from the protection of the moral and material interests resulting from scientific production. The chapter starts by conceptualizing scientific freedom and identifying its normative basis in international legal instruments. Then, it discusses each of the eleven rights, analyzes what States must do to respect, protect, and fulfill those rights, and finishes by putting forward indicators (structural, process, and outcome) that are or could be used to measure progress (or regress) toward their implementation.
The Right to Participate in Scientific Progress
Authors: Romano Cesare PR , Boggio Andrea
Published: August 2024

This chapter presents the normative basis and content of the third cluster of rights within the right to science: the right to participate in scientific progress. This right contains four distinct rights: to scientific literacy; to access the scientific professions; to participate in research as citizen scientists or as research subjects (as citizen scientists and as research subjects); and to participate in science affairs. The chapter discusses the responsibility of States to implement public engagement and participation strategies to enable participation in scientific progress. The chapter closes by proposing indicators to monitor compliance with participatory standards associated with the human right to science.
Sphere of application
Authors: Schwenzer Ingeborg , Schroeter Ulrich G
Published: August 2024

This chapter concerns Article 1 of the CISG. This article contains the basic rules regarding the applicability of the CISG, which requires in general that parties in different States concluded a contract for the sale of goods and specifically requires that the either the parties have their relevant places of business in Contracting States or that the forum’s conflict of laws rules lead to the law of a Contracting State. The CISG does not distinguish between commercial and other parties and is indifferent to domestic registration requirements, if such exist. Where the internationality of the contractual relationship was not apparent from objective circumstances at contract formation, the CISG does not apply. The provision does not define any of the concepts it mentions (contract of sale, goods, place of business), nor do the other provisions of the CISG requiring interpretation in accordance with Article 7.
Effectiveness and withdrawability of offer
Authors: Schwenzer Ingeborg , Schroeter Ulrich G
Published: August 2024

This chapter discusses Article 15. Article 15(1) enshrines the principle that an offer only becomes effective it reaches the offeree (receipt principle, Zugangsprinzip). The moment when an offer ‘reaches’ the offeree is not governed by Article 15(1), but by Article 24. Article 15(2) allows for the withdrawal of an offer if the declaration of withdrawal reaches the offeree before or at the same time as the offer. A comparable provision for the withdrawal of acceptances can be found in Article 22. By contrast, the offeror’s right to distance themselves from an offer that has already reached the offeree (‘revocation’) is governed by Article 16.
Judgment for specific performance
Authors: Schwenzer Ingeborg , Schroeter Ulrich G
Published: August 2024

This chapter focuses on Article 28 of CISG. It explores the difference between continental European legal system and the English and American legal system on the grounds of the right to require performance. In common law, a breach of contract will result in the right to claim damages. Moreover, Article 28 covers the buyer’s rights to require performance such as delivery of goods. However, foreign exchange and currency laws are not applicable with Article 28. The chapter also discusses the legal consequence of rejecting the action for performance. It explains Article 28 is directed to the national courts and does not affect the rights and duties of the parties subject to private autonomy.
General obligations of the seller
Authors: Schwenzer Ingeborg , Schroeter Ulrich G
Published: August 2024

This chapter tackles the general obligations of the seller under the CISG. It outlines the main obligations of delivering goods, handing over documents, and transferring the property in goods. Moreover, the scope and substance of the sellers’ obligations are determined by the parties’ contracts. Delivery pertains to either the dispatch of goods to the buyer or the seller’s placing the goods at the buyer’s disposal. On the other hand, the detailed rules on documents that the seller provides will be in line with the Incoterms. The transfer of property is usually governed by the lex rei sitae. Good faith, confidentiality, the exclusivity of agreements, and trade usages are further obligations of the seller.
Buyer’s notice of third party claims
Authors: Schwenzer Ingeborg , Schroeter Ulrich G
Published: August 2024

This chapter notes the responsibility of giving notice of third party claims indicated in Article 43. The buyer loses the right to rely on general defects or intellectual property rights if it does not notify the seller specifying the nature of the third party right or claim. The chapter expounds on the concept of reasonable time to notify the sellers about the defect on third party claims. If the buyer fails to give the notice of the defect under Article 43(1), it loses the right to depend on Articles 41 and 42 as well. However, the buyer retains its rights if the seller knew of the right or claim of the third party and the nature of it.
Buyer’s notice fixing additional time for performance
Authors: Schwenzer Ingeborg , Schroeter Ulrich G
Published: August 2024

This chapter notes the fixing of additional period for performance in line with the rules indicated in Article 47. even without specific legal authorization, the buyer can set one or more additional periods of time for performance by the seller of any obligation regardless of whether it is a primary or secondary obligation. The chapter lists the considerations for fixing the length of the additional time such as the transmission period for the declaration fixing an additional period of time, the delivery circumstances, and the scope and nature of the seller’s obligation. The chapter also includes the burden of proof for buyers and sellers.
Price determination in case of open price contracts
Authors: Schwenzer Ingeborg , Schroeter Ulrich G
Published: August 2024

This chapter centers on Article 55 which contains a default rule for the determination of the price where a contract has been validly concluded but does not expressly or implicitly fix or make provision for determining the price. It states that when this happens, the parties are considered to have impliedly made reference to the price generally charged at the time of the conclusion of the contract for such goods sold under comparable circumstances in the trade concerned. The chapter touches on the controversial views on open price contracts. Then it looks at the scope of application of Article 55, noting that this only comes into play if the purchase price is neither determined nor determinable in accordance with Article 14.
Buyer’s obligation to preserve the goods
Authors: Schwenzer Ingeborg , Schroeter Ulrich G
Published: August 2024

This chapter examines the application of Article 87 if a party is obliged to preserve the goods by virtue of Articles 85 or 86. The party in question is entitled, but not obliged, to deposit the goods in a third person’s warehouse. It notes that in Article 87 there are no other conditions and the only limiting factor are the costs of warehousing. The chapter talks about the deposition in a warehouse, as with all other steps taken to preserve the goods, that is only admissible if the resulting costs are not unreasonable. If the amount expended on warehousing the goods exceeds that limit, that affects only the depositing party’s right to obtain reimbursement and the incurring of unreasonable expense does not lead to the risk of storage in a warehouse being transferred to the other party.
Extracorporeal Circulation in Neonatal Respiratory Failure
Authors: Baker Elizabeth , Davis Peter G.
Published: August 2024

Using a randomized play-the-winner strategy, only 12 infants were needed to prove this study’s hypothesis that extracorporeal membrane oxygenation (ECMO), as compared with standard therapy, can reduce mortality for infants with birth weight >2 kg and severe respiratory failure in the first week of life. According to an a priori stopping rule, the randomization was halted after 11 patients who had been randomized to ECMO all survived. Only one infant had been assigned to receive standard care and died. The study methodology was highly criticized and labelled a failure by some. However, similar conclusions have been drawn from subsequent randomized play-the-winner trials and more conventional trials.
Optimizing Feedback Culture and Experience in Clinical Medicine
Authors: Fromme H. Barrett , Paradise Black Nicole M.
Published: August 2024

Feedback in the clinical setting is essential to learner growth and development in medical education. Despite that, feedback is one of the most challenging activities that teachers do in clinical practice with their learners. Lack of feedback can have a detrimental effect on learners and, ultimately, patients. Fortunately, there are simple approaches that individual clinical teachers can take to enhance the feedback they give. This chapter describes evidence-based feedback strategies that enhance feedback culture. Feedback should be viewed beyond the content that is provided and instead seen as a continual coaching process of guided self-assessment with the learner, direct observation, feedback delivery, and a plan for follow-up. Learners should be engaged in and engage themselves throughout the process. Frameworks are offered to make content delivery more learner-centered and robust.
Coaching, Mentoring, and Advising
Authors: Deutsch Nina
Published: August 2024

While the terms “mentoring,” “advising,” and “coaching” are often used interchangeably, they describe very different processes. Often, these concepts are thought of on a continuum. Mentoring is at one end of the spectrum and involves the sharing of advice and expertise related to common interests between the mentor and mentee. Coaching is at the other end of the continuum and involves facilitated exploration of specific task-related issues. Advising involves the sharing of expertise at a granular level and episodically. Timeframes, styles, and formality vary along this continuum as well. Sponsorship, in which a person with significant influence on decision-making processes within an organization is publicly advocating for the career advancement of another, continues to be recognized as an important entity for women and underrepresented individuals. A network of all these individuals is key to future success.
Confidentiality of Patient Information
Authors: Tan Jonathan M.
Published: August 2024

The Health Insurance Portability and Accountability Act (HIPAA) was passed in 1996 with the intent of expanding the number of Americans with health insurance and making the delivery of healthcare more efficient. It contains three main provisions: portability, tax, and administrative simplification. Portability was designed to prevent individuals from losing healthcare coverage due to a preexisting condition when changing to a new health plan. The tax provision was designed to make health insurance more affordable through tax breaks and incentives. Administrative simplification was designed to simplify and standardize the process and use of electronic health information. The privacy component is known as the Privacy Rule and applies to individuals and organizations transmitting health information during normal healthcare practice. The Privacy Rule designates all personally identifiable health information as protected, otherwise known as protected health information (PHI). Eighteen identifiers constitute private health information, or PHI. The privacy rule extends to cover research activities as well. In general, public health needs are exempt from HIPAA regulations. Breaches in patient privacy and PHI are serious and costly events with legal and financial ramifications for individuals, health systems, and other entities covered by the rule.
Developmental Social Neuroscience
Authors: Harris James C. , Coyle Joseph T.
Published: August 2024

Developmental social neuroscience studies the development and neural underpinnings of social behavior. It seeks to specify the evolutionary, neural, hormonal, cellular, and genetic mechanisms underlying social behavior. This chapter reviews the findings of evolutionary biology and social behavior with emphasis on mutual aid as the driving force in evolution. Development takes place in the context of the family. Experience expectant systems include preference for human faces. Social skills including empathy, goal-based imitation, and face-specific processing are gradually refined. Emotion regulation evolves with the maturation of the automatic nervous system. Cortical self-regulation is accomplished with effortful control as the cortex matures. Social attachment is a developmental milestone and is facilitated by release of oxytocin and vasopressin during infancy.
Chemical models of interstellar glycine and adenine precursor aminoacetonitrile (NH2CH2CN)
Authors: Zhang Xia , Quan Donghui , Li Xiaohu , Esimbek Jarken , Li Fangfang , Zhou Yan , Li Dalei
Published: August 2024

Aminoacetonitrile (AAN), also known as glycinenitrile, has been suggested as a possible precursor of glycine and adenine in the interstellar medium. Here, we present the chemical modelling of AAN and its isomers in hot cores using the three-phase chemical model NAUTILUS with the addition of over 300 chemical reactions of the three AAN isomers and related species. Our models predicted a peak gas-phase abundance of AAN reaching the order of 10$^{-8}$, which is consistent with observation towards Sgr B2(N). Regarding the reaction pathways of AAN and its isomers, we found that AAN is primarily formed via free radical reactions on grain surfaces during the early evolutionary stages. Subsequently, it is thermally desorbed into the gas phase as the temperature rises and is then destroyed by positive ions and radicals in gas phase. The isomers of AAN are formed through the hydrogenation reaction of CH$_3$NCN on the grain surface and via electron recombination reactions of ion C$_2$H$_5$N$_2^+$ in gas phase. We speculate that there is a possibility for NCCN and AAN to react with each other, eventually leading to the formation of adenine in hot cores. However, further investigation is required to understand the efficiency of grain surfaces in adenine formation, through theoretical calculations or laboratory experiments in future research.
DANTE and DANTE_LTR: lineage-centric annotation pipelines for long terminal repeat retrotransposons in plant genomes
Authors: Novák Petr , Hoštáková Nina , Neumann Pavel , Macas Jiří
Published: August 2024

Long terminal repeat (LTR) retrotransposons constitute a predominant class of repetitive DNA elements in most plant genomes. With the increasing number of sequenced plant genomes, there is an ongoing demand for computational tools facilitating efficient annotation and classification of LTR retrotransposons in plant genome assemblies. Herein, we introduce DANTE, a computational pipeline for Domain-based ANnotation of Transposable Elements, designed for sensitive detection of these elements via their conserved protein domain sequences. The identified protein domains are subsequently inputted into the DANTE_LTR pipeline to annotate complete element sequences by detecting their structural features, such as LTRs, in adjacent genomic regions. Leveraging domain sequences allows for precise classification of elements into phylogenetic lineages, offering a more granular annotation compared with coarser conventional superfamily-based classification methods. The efficiency and accuracy of this approach were evidenced via annotation of LTR retrotransposons in 93 plant genomes. Results were benchmarked against several established pipelines, showing that DANTE_LTR is capable of identifying significantly more intact LTR retrotransposons. DANTE and DANTE_LTR are provided as user-friendly Galaxy tools accessible via a public server (https://repeatexplorer-elixir.cerit-sc.cz), installable on local Galaxy instances from the Galaxy tool shed or executable from the command line.
Progerin mRNA expression in non-HGPS patients is correlated with widespread shifts in transcript isoforms
Authors: Yu Reynold , Xue Huijing , Lin Wanru , Collins Francis S , Mount Stephen M , Cao Kan
Published: August 2024

Hutchinson–Gilford Progeria Syndrome (HGPS) is a premature aging disease caused primarily by a C1824T mutation in LMNA. This mutation activates a cryptic splice donor site, producing a lamin variant called progerin. Interestingly, progerin has also been detected in cells and tissues of non-HGPS patients. Here, we investigated progerin expression using publicly available RNA-seq data from non-HGPS patients in the GTEx project. We found that progerin expression is present across all tissue types in non-HGPS patients and correlated with telomere shortening in the skin. Transcriptome-wide correlation analyses suggest that the level of progerin expression is correlated with switches in gene isoform expression patterns. Differential expression analyses show that progerin expression is correlated with significant changes in genes involved in splicing regulation and mitochondrial function. Interestingly, 5′ splice sites whose use is correlated with progerin expression have significantly altered frequencies of consensus trinucleotides within the core 5′ splice site. Furthermore, introns whose alternative splicing correlates with progerin have reduced GC content. Our study suggests that progerin expression in non-HGPS patients is part of a global shift in splicing patterns.
Neuroanatomical profiles of cognitive phenotypes in patients with primary brain tumors
Authors: Kohli Jiwandeep S , Reyes Anny , Hopper Austin , Stasenko Alena , Menendez Natalia , Tringale Kathryn R , Salans Mia , Karunamuni Roshan , Hattangadi-Gluth Jona A , McDonald Carrie R
Published: August 2024

Background

Patients with brain tumors demonstrate heterogeneous patterns of cognitive impairment, likely related to multifactorial etiologies and variable tumor-specific factors. Cognitive phenotyping offers a patient-centered approach to parsing heterogeneity by classifying individuals based on patterns of impairment. The aim of this study was to investigate the neuroanatomical patterns associated with each phenotype to gain a better understanding of the mechanisms underlying impairments.

Methods

Patients with primary brain tumors were recruited for a prospective, observational study. Patients were cognitively phenotyped using latent profile analysis in a prior study, revealing 3 distinct groups: generalized, isolated verbal memory, and minimal impairment. Whole brain cortical thickness (CT), fractional anisotropy, and mean diffusivity (MD) were compared across phenotypes, and associations between imaging metrics and cognitive scores were explored.

Results

Neurocognitive, structural MRI, and diffusion MRI data were available for 82 participants at baseline. Compared to the minimal impairment group, the generalized impairment group showed a widespread, bi-hemispheric pattern of decreased CT (P-value range: .004–.049), while the verbal memory impairment group showed decreased CT (P-value range: .006–.049) and increased MD (P-value range: .015–.045) bilaterally in the temporal lobes. In the verbal memory impairment group only, increased parahippocampal MD was associated with lower verbal memory scores (P-values < .01).

Conclusions

Cognitive phenotypes in patients with brain tumors showed unique patterns of brain pathology, suggesting different underlying mechanisms of their impairment profiles. These distinct patterns highlight the biological relevance of our phenotyping approach and help to identify areas of structural and microstructural vulnerability that could inform treatment decisions.
Breadth versus depth: whole transcriptome sequencing has reduced sensitivity for detection of clinically relevant fusions compared to RNA comprehensive genomic profiling
Authors: Keller-Evans Rachel B , Munafo Daniela , Ross Tristen , Rudawsky Sarah , Savol Andrej , Huang Richard S P
Published: August 2024

While there is great potential for unbiased next-generation sequencing (NGS) approaches—eg, whole transcriptome sequencing (WTS)—for exploration, discovery, and clinical application in the realm of oncology, there are limitations that should be considered when relying on these methodologies for clinical decision making. When using WTS for the detection of clinically relevant gene fusions in tumor specimens, a key consideration is whether a limited coverage depth (approximately 30-50X) is sufficient for detecting these events, especially in samples with low tumor purity. We demonstrate the reduced sensitivity of both a commercial WTS assay for the detection of clinically relevant fusions in analytical validation control samples and of a research use only (RUO) WTS assay for the detection of clinically relevant fusions in real-world clinical samples compared to RNA comprehensive genomic profiling (CGP). Notably, the RUO WTS assay would not have reported 30% (6/20) of fusions detected using RNA CGP assays in fusion-positive tumor samples, highlighting a potential disadvantage of broader sequencing.
Confronting Minimal Supersymmetric Standard Model Flat Direction Inflation with Planck/BICEP Data
Authors: Haba Naoyuki , Shimizu Yasuhiro , Tanabe Yoshihiro , Yamada Toshifumi
Published: August 2024

We study the scenario of inflection point inflation where a flat direction of the minimal supersymmetric standard model (MSSM) is identified with the inflaton. Specifically, we consider in full generality the cases where an MSSM flat direction is lifted by a higher-dimensional superpotential whose dimension is $n=4,5,6,7,9$. We confront the inflection point inflation scenarios with various n with the Planck and BICEP data, and thereby constrain the soft supersymmetry breaking mass and the coefficient of the higher-dimensional operator that lifts the flat direction.
An unidentified yet notable modification on INa and IK(DR) caused by ramelteon
Authors: Wu Po‐Ming , Tu Yi‐Fang , Cho Hsin‐Yen , Yu Meng‐Cheng , Wu Yen‐Hsien , Wu Sheng‐Nan
Published: August 2024

Despite advancement in anti‐seizure medications, 30% of patients continue to experience recurrent seizures. Previous data indicated the antiepileptic properties of melatonin and its agonists in several animal models. However, the underlying mechanisms of melatonin and its agonists on cellular excitability remain poorly understood. In this study, we demonstrated the electrophysiological changes of two main kinds of ion channels that are responsible for hyperexcitability of neurons after introduction of melatonin agonists‐ ramelteon (RAM). In Neuro‐2a cells, the amplitude of voltage‐gated Na+ (INa) and delayed‐rectifier K+ currents (IK (DR)) could be suppressed under RAM. The IC50 values of 8.7 and 2.9 μM, respectively. RAM also diminished the magnitude of window Na+ current (INa (W)) elicited by short ascending ramp voltage, with unchanged the overall steady‐state current–voltage relationship. The decaying time course of INa during a train of depolarizing pulses arose upon the exposure to RAM. The conditioning train protocol which blocked INa fitted the recovery time course into two exponential processes and increased the fast and slow time constant of recovery the presence of RAM. In pituitary tumor (GH3) cells, INa amplitude was also effectively suppressed by the RAM. In addition, GH3‐cells exposure to RAM decreased the firing frequency of spontaneous action potentials observed under current‐clamp conditions. As a result, the RAM‐mediated effect on INa was closely associated with its ability to decrease spontaneous action potentials. Collectively, we found the direct attenuation of INa and IK (DR) caused by RAM besides the agonistic action on melatonin receptors, which could partially explain its anti‐seizure activity.
Burden of cancers in six female organs in China and worldwide
Authors: Tan Nuopei , Wu You , Li Bin , Chen Wanqing
Published: August 2024

Background:

Cancers in female organs remain a substantial burden in China and worldwide. GLOBOCAN 2022 has recently updated the estimates of cancer burden. This study aims to depict the profiles of disease burden and to compare the age-specific rates of cancers in female organs in China with those in other countries.

Methods:

The latest estimates of incidence and mortality of cancers in female organs from various regions and countries were extracted from the GLOBOCAN 2022 database. We compared the proportion of total cases or deaths for cancers affecting six female organs and other tumor types in China and globally. Correlation analysis was conducted to evaluate the relationship between age-standardized incidence rate (ASIR) or age-standardized mortality rate (ASMR) and the Human Development Index (HDI). Additionally, age-specific rate curves were plotted for ten exemplary countries with different income levels.

Results:

Globally, there are varying burdens of female organ cancers, with higher incidence rates in Northern America and elevated rates of cervical cancer in Africa. Female organ cancers in China remain a significant burden due to their large proportion of the six tumors. A positive correlation between socioeconomic development and the incidence of breast, uterine corpus, ovarian, and vulvar cancers was noted, whereas a negative association between the HDI tiers and mortality rates was found for cervical and vaginal cancers. In 2022, Chinese women aged 50–54 years are experiencing high incidence rates of breast, cervix uteri, corpus uteri, and ovarian cancers.

Conclusions:

Cancers in female organs continue to be a significant health concern for women in China and worldwide. It is crucial to implement comprehensive prevention strategies tailored to address the increasing trend among younger individuals and reduce regional disparities.
A Very Rare Salivary Gland Tumor: Sialoblastoma
Authors: Zinaw Dagmawi G. , Berhea Ataklitie B. , Aydeferu Endale K. , Beyera Tigist D.
Published: August 2024

Children seldom develop salivary gland tumors, which account for less than 5% of all salivary gland tumors. In total, 10%–15% of these neoplasms arise from the submandibular, sublingual, and small salivary glands, with the parotid gland accounting for the majority of cases. We describe a case of sialoblastoma in a 2-year-old female Ethiopian child who had a history of right cheek swelling gradually from birth. The mass had a firm consistency and was fungating in the center. In the right parotid gland and masticator space, a large lobulated irregular heterogeneously enhancing mass was discovered by magnetic resonance imaging. Fine needle aspiration cytology from the mass was suspicious of malignant salivary gland neoplasm. Radical parotidectomy and level I–IV neck lymph node dissection, followed by deltopectoral flap reconstruction, were done. The histopathology depicted sialoblastoma. When a parotid gland lesion is known to be congenital or is thought to be so, sialoblastoma should always be considered.
LncRNA H19 promoted alcohol-associated liver disease through dysregulation of alternative splicing and methionine metabolism
Authors: Yang Zhihong , Jiang Yanchao , Ma Jing , Wang Li , Han Sen , Huda Nazmul , Kusumanchi Praveen , Gao Hui , Thoudam Themis , Sun Zhaoli , Liangpunsakul Suthat
Published: August 2024

Background and Aims:

Long noncoding RNAs constitute a significant portion of the human genome. Among these, lncRNA H19, initially identified for its high expression during fetal development followed by a decline in the liver postnatally, re-emerges in various liver diseases. However, its specific role in alcohol-associated liver disease (ALD) remains unclear.

Approach and Results:

Elevated H19 levels were detected in peripheral blood and livers of patients with alcohol-associated cirrhosis and hepatitis, as well as in livers of ethanol-fed mice. Hepatic overexpression of H19 exacerbated ethanol-induced liver steatosis and injury. Metabolomics analysis revealed decreased methionine levels in H19-overexpressed mouse livers, attributable to H19-mediated inhibition of betaine homocysteine methyltransferase (BHMT), a crucial enzyme in methionine synthesis. H19 regulated BHMT alternative splicing through polypyrimidine tract-binding protein 1 (PTBP1), resulting in a reduced Bhmt protein-coding variant. The maternally specific knockout of H19 (H19Mat+/−) or liver-specific knockout of the H19 differentially methylated domain (H19DMDHep−/−) in ethanol-fed mice upregulated BHMT expression and ameliorated hepatic steatosis. Furthermore, BHMT restoration counteracted H19-induced ethanol-mediated hepatic steatosis.

Conclusions:

This study identifies a novel mechanism whereby H19, via PTBP1–mediated BHMT regulation, influences methionine metabolism in ALD. Targeting the H19-PTBP1-BHMT pathway may offer new therapeutic avenues for ALD.
Length of hospital stay and its predictors among burn patients in a resource limited setting: a multicenter prospective longitudinal study
Authors: Baraka Samuel Mandro , Kiswezi Ahmed , Edyedu Isaac , Molen Selamo Fabrice , Muhumuza Joshua , Kyomukama Lauben , Zawadi Gift Vulwaghe , Okedi Xaviour Francis
Published: August 2024

Introduction:

There is a paucity of data relating to length of hospital stay (LOS) among burn patients managed in hospitals with no burn units, yet this constitute a big percentage of hospitals in low-income countries. This study was aimed at determining the predictors of length of stay at three hospitals in a resource limited setting.

Methods:

This was a prospective longitudinal multicentre study that enrolled burn patients with moderate and severe burns according to the American Burn Association (ABA) admitted at three tertiary hospitals in western Uganda. Follow up was done till discharge. LOS and its predictors were determined using logistic regression in SPSS version 26. The cut off for prolonged hospital stay was a length of stay above the median which was 8 days.

Results:

This study included 101 patients with majority in the age bracket of 18–55 (56.4%). Majority were males (69.3%) from a rural setting (61.4%) and were accidentally burnt (95.0%) at home (75.2%). The median LOS was 8 days. The variables that independently predicted increased LOS were receiving medical attention after 12 h (P=0.002), burn severity according to the ABA (P=0.017), and type of procedure done (P<0.001).

Conclusion:

The factors independently associated with increased LOS were; time to medical attention, burn severity, and type of procedure done. Measures to ensure timely medical attention can reduce the length of stay among patients with burns even in the absence of a burn unit.
Antegrade and retrograde laser excision and ureterotomy laser for ureteral polyp causing total ureteral stenosis following left ureteral stones removal: a case report and literature review
Authors: Yusuf Krisna A. W. , Atmoko Widi , Rahman Fakhri , Birowo Ponco , Rasyid Nur
Published: August 2024

Background:

Ureteral polyps are rare, and the clinical manifestations are typically nonspecific. Obstruction from ureteral polyps can lead to ureteral stone formation. Excision using a less invasive approach is the most commonly performed procedure. Here, the authors report a patient with left proximal and distal ureteral polyps treated with laser excision after removal of the right kidney and left ureteral stone using a combined antegrade and retrograde route. This case is interesting because there was complete ureteral blockage, and polyps were found on the proximal and distal sides of the stenotic area.

Case Presentation:

A 55-year-old female patient came to our center with bilateral flank pain. Initially, the diagnosis was bilateral hydronephrosis, but after ureteroscopy (URS) was performed, proximal and distal ureteral polyps were identified. The polyp was excised using a Thulium laser, followed by DJ-stent placement.

Discussion:

Imaging with intravenous pyelography, CT, or retrograde urography can help diagnose ureteral polyps. Removal of the polyp’s base using ureteroscopy with laser coagulation allows for identification and histologic diagnosis. Endoscopic treatment has become the most commonly used treatment for ureteral polyps.

Conclusion:

Ureteral polyps are rare, and preoperative diagnosis may be difficult. Laser excision with stent placement after primary polyp removal has been reported in many studies to have good outcomes.
Eradicating the Loneliness Epidemic: One Phone Call at a Time
Authors: Feldmiller Ethan , Messner Lynnae , Gona Sridhar Rao , Joshi Maulik
Published: August 2024

Loneliness and social isolation are serious problems that can impose negative consequences on individual well-being. Research suggests that loneliness can lead to an increased risk of depression, anxiety, and other health issues. Meritus Health, recognizing that loneliness is an issue within its community, has set a goal to comprehensively eradicate loneliness. As part of this effort, Meritus implemented the Care Caller program in November of 2021 through which a volunteer is paired up with a patient from our institution who has indicated that they are lonely. Each duo then finds a weekly cadence to share in 15- to 30-minute phone calls to facilitate meaningful social interaction. As of July 2023, the program has 500 participants enrolled with 47 volunteers and 2 full-time employees, and over 350 people are called weekly. In the last fiscal year, over 75,000 minutes have been spent on the phone between care callers and participants with promising results. Of the 172 participants who have been in the program for 4+ months, 166 have indicated that they felt less lonely, yielding a success rate of 97%. Meritus Health continues to further this program by increasing the number of care callers and utilization of Plan-Do-Study-Act rapid improvement.
Challenges Meeting 21st Century Cures Act Patient Identity Interoperability and Information Blocking Rules
Authors: Gellert George A. , Erwich Mark E. , Krivicky Herdman Sara
Published: August 2024

Objective:

Gather insights into healthcare organization (HCO) preparedness for new 21st Century Cures Act information blocking disincentives and challenges in achieving greater accuracy /interoperability of patient identity/data.

Methods:

Survey of 197 U.S. healthcare executives (54.7% response rate), included 46 health systems (23.4%), 141 hospitals (71.6%), and 10 payer organizations (5.1%), evaluated organizational gaps in patient identity data management/interoperability and preparation for information deblocking.

Results:

Healthcare organizations are unprepared to meet information deblocking requirements and manage increased data influx/exchange. Although 61% have invested in meeting requirements, only 36% have capabilities in place. Majorities reported inability to comply with information blocking rules (59%), communicate electronic patient activity notifications to other organizations (56%), or share/receive patient-level information with patients and other HCOs (57%). Across 12 critical functionalities, 57% lacked key capabilities; 97% reported inadequate patient data/identity management/interoperability as data volume expands, adversely affecting care quality/safety and outcomes; and 57% envision patient data-matching errors precipitating a healthcare crisis in 5–10 years.

Conclusions:

Many HCOs are unprepared to meet new Cures Act information blocking requirements and resultant increase of internal/external patient data volumes. Next generation master data management, enterprise master patient index, and referential matching technologies can improve HCO patient identity and data management, and information interoperability.