bluuebunny/crossref_metadata_2025_split huggingface dataset:
Brain Death: A Conclusion in Search of a Justification
Authors: Shewmon D. Alan 
Published: December 2018

AbstractAt its inception, “brain death” was proposed not as a coherent concept but as a useful one. The 1968 Ad Hoc Committee of the Harvard Medical School to Examine the Definition of Brain Death gave no reason that “irreversible coma” should be death itself, but simply asserted that the time had come for it to be declared so. Subsequent writings by chairman Henry Beecher made clear that, to him at least, death was essentially a social construct, and society could define it however it pleased. The first widely endorsed attempt at a philosophical justification appeared thirteen years later, with a report from the President's Commission for the Study of Ethical Problems in Medicine and Biomedical and Behavioral Research and a seminal paper by James Bernat, Charles Culver, and Bernard Gert, which introduced the insightful tripartite scheme of concept, criterion, and tests for death. Their paper proposed that the correct concept of death is the “permanent cessation of functioning of the organism as a whole,” which tenuously remains the mainstream concept to this day. In this essay, I focus on this mainstream concept, arguing that equating brain death with death involves several levels of incoherence: between concept and criterion, between criterion and tests, between tests and concept, and between all of these and actual brain death praxis.
Conceptual Issues in DCDD Donor Death Determination
Authors: Bernat James L. 
Published: December 2018

AbstractDespite the popularity, success, and growth of programs of organ donation after the circulatory determination of death (DCDD), a long‐standing controversy persists over whether the organ donor is truly dead at the moment physicians declare death, usually following five minutes of circulatory and respiratory arrest. Advocates of the prevailing death determination standard claim that the donor is dead when declared because of permanent cessation of respiration and circulation. Critics of this standard argue that while the cessation of respiration and circulation may be permanent, it may not be irreversible at the moment death is declared because, if cardiopulmonary resuscitation were performed, it might succeed. And because irreversibility of cessation of respiration and circulation is required by both the statute and the biological concept of death, the donor must be alive. Who is correct?Making two related distinctions clarifies the cause of the disagreement over whether the DCDD donor is dead and points to a possible resolution. First, in a determination of death, there is an important distinction between the permanent and the irreversible cessation of circulation and respiration—two associated phenomena that are often confounded. Second, there is an important distinction between the medical practice standard for death determination, in which physicians certify the permanent cessation of vital functions as sufficient for death declaration, and the underlying biological concept of death that requires the irreversible cessation of vital functions because death, by definition, is an irreversible event.
Rethinking Brain Death as a Legal Fiction: Is the Terminology the Problem?
Authors: Shah Seema K. 
Published: December 2018

AbstractBrain death, or the determination of death by neurological criteria, has been described as a legal fiction. Legal fictions are devices by which the law treats two analogous things (in this case, biological death and brain death) in the same way so that the law developed for one can also cover the other. Some scholars argue that brain death should be understood as a fiction for two reasons: the way brain death is determined does not actually satisfy legal criteria requiring the permanent cessation of all brain function, and brain death is not consistent with the biological conception of death as involving the irreversible cessation of the functioning of an organism as a whole. Critics counter that the idea that brain death is a legal fiction is deceptive and undemocratic. I will argue that diagnosing brain death as a hidden legal fiction is a helpful way to understand its historical development and current status. For the legal‐fictions approach to be ethically justifiable, however, the fact that brain death is a legal fiction not aligned with the standard biological conception of death must be acknowledged and made transparent.
Respecting Choice in Definitions of Death
Authors: Ross Lainie Friedman 
Published: December 2018

AbstractThe definition of death was clearer one hundred years ago than it is today. People were declared dead if diagnosed with permanent cessation of both cardio‐circulatory function and respiratory function. But the definition has been muddled by the development of new technologies and interventions—first by cardiopulmonary resuscitation and ventilators, which were introduced in the mid‐twentieth century, and now by extracorporeal membrane oxygenation, which creates the ability to keep oxygenated blood circulating, with or without a beating heart or functioning lungs. In Defining Death: The Case for Choice, Robert Veatch and I argue that the definition of death should focus on “what change in a human being is so fundamental that we can say the individual is no longer with us as a member of the human community bearing rights such as the right not to be killed.” We assert that this decision is a normative issue about which different stakeholders may believe that different changes are fundamental, and we therefore propose that the optimal policy solution may be to allow stakeholders to choose their own definition within a reasonable range of options. There are three caveats that need to be highlighted regarding this approach.
Imposing Death: Religious Witness on Brain Death
Authors: Campbell Courtney S. 
Published: December 2018

AbstractThe bioethical, professional, and policy discourse over brain death criteria has been portrayed by some scholars as illustrative of the minimal influence of religious perspectives in bioethics. Three questions then lie at the core of my inquiry: What interests of secular pluralistic societies and the medical profession are advanced in examining religious understandings of criteria for determining death? Can bioethical and professional engagement with religious interpretations of death present substantive insights for policy discussions on neurological criteria for death? And finally, how extensive should the scope of policy accommodations be for deeply held religiously based dissent from neurological criteria for death? I begin with a short synopsis of a recent case litigated in Ontario, Canada, Ouanounou v. Humber River Hospital, to illuminate this contested moral terrain.
Lessons from the Case of Jahi McMath
Authors: Truog Robert D. 
Published: December 2018

AbstractJahi McMath's case has raised challenging uncertainties about one of the most profound existential questions that we can ask: how do we know whether someone is alive or dead? The case is striking in at least two ways. First, how can it be that a person diagnosed as dead by qualified physicians continued to live, at least in a biological sense, more than four years after a death certificate was issued? Second, the diagnosis of brain death has been considered irreversible; in fact, there has never been a case of a person correctly diagnosed as brain‐dead who improved to the point that the person no longer fulfilled the diagnostic criteria. If the neurologist Alan Shewmon is correct that, prior to her cardiac arrest in June 2018, McMath no longer met the criteria for brain death and was actually in a minimally conscious state, this case could have momentous implications for how we think about this diagnosis going forward. In this essay, I will offer a hypothesis that could, perhaps, explain both these aspects of the case. The hypothesis is based on differences in how we distinguish between biological and legal categories. The law tends to prefer to draw bright‐line distinctions between categories, whereas biological categories tend to fall along a spectrum, without sharp distinctions.
Recurrent unilateral peripheral facial palsy in a patient with an enlarged styloid process
Authors: Péus Dominik , Kollias Spyros S. , Huber Alexander M. , Huber Gerhard F. 
Published: December 2018

AbstractBackgroundRecurrent peripheral facial paresis is a rare symptom that may be caused by multiple pathologic conditions.MethodsWe report a case of recurrent peripheral facial palsies caused by an ipsilateral enlarged styloid process. A surgical excision of the process was performed.ResultsThe treatment was well tolerated. Postoperatively, no further recurrent paresis was observed.ConclusionTo the best of our knowledge, this is the first case study of an enlarged styloid process with facial paresis. A detailed workup, including imaging, should be performed in cases with recurrent facial paresis and/or cases with a history of trauma and facial paresis and, of course, to exclude a neoplastic etiology.
Primary Ewing sarcoma of the squamous temporal bone with intracranial and extracranial extension: A rare cause of sudden sensorineural hearing loss
Authors: Choi Sung‐Won , Ko Hoon 
Published: December 2018

AbstractBackgroundPrimary Ewing sarcoma of the cranial bone is rare, accounting for only 1% of all Ewing sarcomas. Primary Ewing sarcoma arising in the squamous temporal bone is particularly rare.MethodsA 16‐year‐old male was seen with signs of sudden sensorineural hearing loss (SSNHL). After 1 week of SSNHL and new‐onset headache, imaging studies showed a mass that originated in the left squamous temporal bone with intracranial and extracranial extension. Histopathological study revealed that the mass was a Ewing sarcoma.ResultsThe patient manifested the diagnostic EWSR1 mutation and was treated with adjuvant multidrug chemotherapy and focal radiotherapy after surgery according to the Children's Oncology Group interval compression arm of AEWS0031 with a regimen of vincristine, doxorubicin, and cyclophosphamide alternating with ifosfamide/etoposide.ConclusionsThis case showed an extremely uncommon location, as well as unusual symptoms of primary Ewing sarcoma.
Impact of social deprivation on the outcome of major head and neck cancer surgery in England: A national analysis
Authors: Mirza Adal H. , Aylin Paul , Middleton Steve , King Emma V. , Nouraei Reza A. R. , Repanos Costa 
Published: December 2018

AbstractBackgroundSocioeconomic status plays an important role in the incidence and prognosis of many cancers. We examined the relationship between social deprivation and clinical outcomes in patients undergoing major surgery for head and neck cancer.MethodsA retrospective population‐based observational study was performed. Patients undergoing head and neck surgical procedures in England between 2002 and 2012 were identified. This totaled 5051 patients in the less socially deprived (LSD) and 7282 in the more socially deprived (MSD) group.ResultsMSD patients were younger (61 vs 63) and were more likely to present with hypopharyngeal‐laryngeal cancers (41% vs 30%). They had higher burdens of morbidity and more frequently required emergency surgery (odds ratio [OR] 1.74 [95% CI 1.52‐1.99]). Following surgery, MSD patients had higher lengths of inpatient stay (OR 1.72 [95% CI 1.57‐1.88]) and higher proportions of both inpatient (OR 1.47 [95% CI 1.19‐1.82]) and overall mortality (OR 1.34 [95% CI 1.24‐1.45]).ConclusionIncreasing socioeconomic deprivation is associated with poor health outcomes in patients with head and neck cancer.
Changes in incidence and prevalence of human papillomavirus in tonsillar and base of tongue cancer during 2000‐2016 in the Stockholm region and Sweden
Authors: Haeggblom Linnea , Attoff Tove , Yu Jingru , Holzhauser Stefan , Vlastos Andrea , Mirzae Leila , Ährlund‐Richter Andreas , Munck‐Wikland Eva , Marklund Linda , Hammarstedt‐Nordenvall Lalle , Ye Weimin , Ramqvist Torbjörn , Näsman Anders , Dalianis Tina 
Published: December 2018

AbstractBackgroundTonsillar and base of tongue squamous cell carcinoma (TSCC/BOTSCC) has increased. In Stockholm, the proportion of human papillomavirus (HPV)‐positive cases and the incidence of TSCC rose between 1970 and 2006 then stabilized. Here, HPV‐prevalence, and TSCC/BOTSCC incidence 2000‐2016, in Stockholm and Sweden were followed.MethodsIncidence data for 2000‐2016 were obtained from the Swedish Cancer Registry. TSCC/BOTSCC biopsies, 2013‐2016 from Stockholm, were examined for HPV DNA and p16INK4a, or data obtained from medical reports. For cases 2000‐2012, data were available from previous studies.ResultsThe incidence of TSCC/BOTSCC has continued to rise in Stockholm and Sweden 2000‐2016, especially after 2008. HPV DNA and p16INK4a analysis was determined for 795 Stockholm cases from 2000 to 2016, with 72% being HPV DNA and p16INK4a positive 2013‐2016, and 70% positive 2000‐2016.ConclusionDuring 2000‐2016, especially after 2008, the incidence of TSCC/BOTSCC has continued to increase in Stockholm and Sweden, with an HPV‐prevalence of approximately 70% in Stockholm.
Derivation of heat transfer equations for a closed solar desalination pond to predict the produced mass of potable water
Authors: Farahbod Farshad 
Published: December 2018

AbstractIn many developing countries, access to clean and drinkable water is a major necessity. The sweetening of saline water in these areas is used to provide water for different requirements. The solar distillation is based on solar technology. The aim of this study is to calculate the efficiency of a solar desalination pond to produce freshwater. To achieve the purpose of research and validation of the obtained mathematical results, the experimental measurements are used. The conservation law of energy is considered and mathematics is applied to predict the required heat for the evaporation process. Finally, a new mass transfer equation on the basis of experimental data is introduced to predict the efficiency of solar desalination pond performance. The obtained results show the maximum deviation between the experimental and theoretical condensation rates. In October, the deviation is 4.93%, approximately, whereas, this deviation for June is 1.75%, approximately. So, the mathematical equation can predict the efficiency of a solar desalination pond precisely.
Experimental analysis and exergy efficiency of a conventional solar still with Fresnel lens and energy storage material
Authors: Sathyamurthy Ravishankar , El‐Agouz Elsayed 
Published: December 2018

AbstractThis study focuses on the experimental investigation and exergy analysis of a modified solar still (MSS) with convex lenses on glass cover to collect the solar radiation at the focus on surface water. A comparative analysis of the performance and yield of the MSS with convex lenses and the conventional single slope SS were carried out for the same climatic condition of Tanta (Egypt). Similarly, the effect of modification in the SS using convex lenses, with or without black stones, on the freshwater yield is experimentally investigated. The results indicated that the lenses focus the solar radiation to the water placed in the basin and increase the water‐glass temperature difference (T
w –
T
g). The yield of freshwater from the MSS with the convex lenses is comparatively higher than that of the conventional SS (26.64%). In addition to convex lenses in the inner cover surface, freshwater yield improved by 35.55% by adding blue stones as energy material inside the basin under constant water mass of 30 kg. The maximum exergy efficiency of the SS with lenses and blue stones was 11.7%, while the SS with lenses alone was 4%. The quality of freshwater produced after desalination was well within the World Health Organization standards. The total dissolved solids and pH after desalination were 22 mg/L and 8.08, respectively.
Downregulated microRNA‐27b attenuates lipopolysaccharide‐induced acute lung injury via activation of NF‐E2‐related factor 2 and inhibition of nuclear factor κB signaling pathway
Authors: Huang Yan , Huang Lixue , Zhu Guangfa , Pei Zhenye , Zhang Wenmei 
Published: December 2018

AbstractAcute lung injury (ALI) is a life‐threatening, diffuse heterogeneous lung injury characterized by acute onset, pulmonary edema, and respiratory failure. Lipopolysaccharide (LPS) is a leading cause for ALI and when administered to a mouse it induces a lung phenotype exhibiting some of the clinical characteristics of human ALI. This study focused on investigating whether microRNA‐27b (miR‐27b) affects ALI in a mouse model established by LPS‐induction and to further explore the underlying mechanism. After model establishment, the mice were treated with miR‐27b agomir, miR‐27b antagomir, or D‐ribofuranosylbenzimidazole (an inhibitor of nuclear factor‐E2‐related factor 2 [Nrf2]) to determine levels of miR‐27b, Nrf2, nuclear factor kappa‐light‐chain‐enhancer of activated B cells nuclear factor κB (NF‐κB), p‐NF‐κB, and heme oxygenase‐1 (HO‐1). The levels of interleukin (IL)‐1β, IL‐6, and tumor necrosis factor‐α (TNF‐α) in bronchoalveolar lavage fluid (BALF) were determined. The results of luciferase activity suggested that Nrf2 was a target gene of miR‐27b. It was indicated that the Nrf2 level decreased in lung tissues from ALI mice. The downregulation of miR‐27b decreased the levels of IL‐1β, IL‐6, and TNF‐α in BALF of ALI mice. Downregulated miR‐27b increased Nrf2 level, thus enhancing HO‐1 level along with reduction of NF‐κB level as well as the extent of NF‐κB phosphorylation in the lung tissues of the transfected mice. Pathological changes were ameliorated in LPS‐reduced mice elicited by miR‐27b inhibition. The results of this study demonstrate that downregulated miR‐27b couldenhance Nrf2 and HO‐1 expressions, inhibit NF‐κB signaling pathway, which exerts a protective effect on LPS‐induced ALI in mice.
Parathyroid hormone‐related peptide (1–34) promotes tooth eruption and inhibits osteogenesis of dental follicle cells during tooth development
Authors: Zhang Jiawei , Liao Lijun , Li Yuyu , Xu Yang , Guo Weihua , Tian Weidong , Zou Shujuan 
Published: December 2018

AbstractDental follicle cells (DFCs) activate and recruit osteoclasts for tooth development and tooth eruption, whereas DFCs themselves differentiate into osteoblasts to form alveolar bone surrounding tooth roots through the interaction with Hertwig's epithelial root sheath (HERS). Also during tooth development, parathyroid hormone‐related peptide (PTHrP) is expressed surrounding the tooth germ. Thus, we aimed to investigate the effect of PTHrP (1–34) on bone resorption and osteogenesis of DFCs in vitro and in vivo. In vitro studies demonstrated that DFCs cocultured with HERS cells expressed higher levels of BSP and OPN than the DFCs control group, whereas cocultured DFCs treated with PTHrP (1–34) had lower expressions of ALP, RUNX2, BSP, and OPN than the cocultured DFCs control group. Moreover, we found PTHrP (1–34) inhibited osteogenesis of cocultured DFCs by inactivating the Wnt/β‐catenin pathway. PTHrP (1–34) also increased the expression of RANKL/OPG ratio in DFCs. Consistently, in vivo study found that PTHrP (1–34) accelerated tooth eruption and inhibited alveolar bone formation. Therefore, these results suggest that PTHrP (1–34) accelerates tooth eruption and inhibits osteogenesis of DFCs by inactivating Wnt/β‐catenin pathway.
Quantitative susceptibility mapping of articular cartilage in patients with osteoarthritis at 3T
Authors: Wei Hongjiang , Lin Huimin , Qin Le , Cao Steven , Zhang Yuyao , He Naying , Chen Weibo , Yan Fuhua , Liu Chunlei 
Published: December 2018

BackgroundQuantitative susceptibility mapping (QSM) has recently been applied in humans to quantify the magnetic susceptibility of collagen fibrils in the articular cartilage.PurposeTo determine the ability of QSM to detect cartilage matrix degeneration between normal and early knee osteoarthritis (OA) patients.Study TypeProspective.PopulationTwenty‐four patients with knee OA and 24 age‐ and sex‐matched healthy controls.Field Strength/Sequence3D gradient echo, T1 turbo spin echo, and proton density‐weighted (PDw) spectral attenuated inversion recovery (SPAIR) sequence at 3.0T.AssessmentScan–rescan reproducibility of the susceptibility values in the cartilage was assessed in control subjects. Cartilage thickness, volume, mean, and standard deviation (SD) of susceptibility values of the cartilage compartments were compared between normal and OA patients. The relationship between magnetic susceptibility values and cartilage lesion grading based on MR images was studied.Statistical TestsThe Wilcoxon Rank‐Sum test was used to compare cartilage thickness, volume, mean, and SD of susceptibility values between control subjects and OA patients. A Spearman rank correlation was performed to study the relationship between the mean and SD of susceptibility values and the cartilage thinning grades.ResultsThe SD of magnetic susceptibility values in the knee cartilage was significantly lower in OA patients compared with healthy controls, and it decreased with more severe MR grades of cartilage thinning degeneration. Significant correlations between the SD of susceptibility values and cartilage thinning grades were observed with R2 = 0.64 and P = 0.000, R2 = 0.47 and P = 0.002, R2 = 0.52 and P = 0.001, R2 = 0.42 and P = 0.0006, and R2 = 0.67 and P = 0.000 for medial femoral condyle (MFC), lateral femoral condyle (LFC), medial tibia (MT), lateral tibia (LT), and patella, respectively. No significant difference was found in cartilage volume (P = 0.17, P = 0.13, P = 0.20, P = 0.25, and P = 0.18 for MFC, LFC, MT, LT, and patella, respectively) and thickness (P = 0.31, P = 0.19, P = 0.16, P = 0.09, and P = 0.22 for MFC, LFC, MT, LT, and patella, respectively) between OA patients and healthy controls.Data ConclusionThe variations of susceptibility values in the knee cartilage decrease with the degree of cartilage degeneration. QSM may be a sensitive indicator for alteration of the collagen network and shows potential to detect cartilage degeneration at early stage.Level of Evidence: 2Technical Efficacy: Stage 3J. Magn. Reson. Imaging 2018.