bluuebunny/crossref_metadata_2025 huggingface dataset:
Groundhog day for inclusive education
Authors: Thomas Gary , Loxley Andrew
Published: July 2022

Those who work in education strive to create more inclusive environments in school but are often stymied in their efforts by challenges coming from many and varied directions. Politicians, for example, exhort us to be more inclusive but create conditions that encourage separation and exclusion, and inclusive education's history in special education means that the default response of the system around special education is to diagnose, treat and manage separately. That legacy continues to have its effects. Looking both at the history of the management of ‘special needs’ and at the continuing rise in numbers of marginalised, separated and excluded youngsters, we suggest that some fundamental shifts are necessary in the way that we think about and research into difficulty at school if we are to move beyond Groundhog Day.
North–South asymmetry, unilateral environmental policy and carbon tariffs
Authors: Hong Liming , Huang Wei , Anwar Sajid , Lv Xiaofeng
Published: July 2022

This paper focuses on the potential impact of a carbon tariff on carbon emissions, North–South trade and welfare. We use a North–South trade model, where North implements a unilateral environmental policy on domestic carbon‐intensive industries followed by a carbon tariff on imports from South. Unlike the existing studies, we allow asymmetry in clean production technologies and marginal environmental damage. We show that a carbon tariff can reduce the global carbon emission via the use of a more advanced clean production technology in North, which increases the firm profit and welfare. However, improvement in welfare of North is associated with a decrease in global trade flows and welfare of South. We find that, in the presence of asymmetry in clean production technologies between North and South, a carbon tariff introduced by the North can eliminate carbon leakage, but the exports of South decrease below the pre‐unilateral environmental policy level and hence North can potentially use a carbon tariff for trade protectionism in the name of reducing carbon leakage in South.
Detecting cow milk in sheep yoghurt by TaqMan real‐time PCR
Authors: Biçer Yusuf , Sönmez Gonca
Published: July 2022

The detection of adulteration in the production of milk and other dairy products is crucial for economic reasons and consumer protection. In this study, yoghurts were produced from mixed milk (cow and sheep) in different ratios, and the percentage of sheep and cow milk was determined using TaqMan real‐time polymerase chain reaction (PCR). 1% of cow milk was determined in the yoghurts and 0.01 ng of cow and sheep DNA was determined in sensitivity analyses. Therefore, TaqMan real‐time PCR can be considered as a sensitive and reliable method for detecting cow DNA in yoghurt produced from mixed milk.
A method for the development of cranial fracture histology slides
Authors: Isaac Carolyn V. , Cornelison Jered B. , Devota Clara J. , Bailey Kristi , Langworthy Jonathan
Published: July 2022

Cranial vault fractures are of medicolegal interest as they have long‐term impacts to someone's health and may contribute to an individual's death. The ability to distinguish antemortem from perimortem fractures and to assess the age of the injury is increasingly dependent on histology. Despite the increasing role of histology in assessing the microanatomy of osseous fractures, there are no methods currently available which account for the nuances and difficulties in creating high‐quality histologic slides of cranial vault fractures that allow visualization of cellular features associated with healing bone. The authors present a modified method specific to slide development of human cranial vault fractures derived from the trial‐and‐error process of creating 730 such slides over a 3‐year period which are suitable for the evaluation of the tissues, cells, and nuclei involved in fracture healing. This method adapts and troubleshoots typical histological procedures including sample excision, fixation, decalcification, dehydrating, clearing, embedding, microtomy, and staining, and introduces new procedures including preprocessing photography and cassette placement. By implementing these modifications, the number of poor‐quality slides that required a new section to be sent to the histology laboratory was greatly reduced. Proactively implementing this new method into cranial fracture histologic slide development significantly reduces the number of slide rejections due to common issues like folding, chatter, or insufficient staining, saving both time and financial resources for forensic practitioners, researchers, and histotechnologists.
A quantitative RT‐qLAMP for the detection of SARS‐CoV‐2 and human gene in clinical application
Authors: Yu Yejiong , Zhou Johnny X. Y. , Li Binbin , Ji Mengmeng , Wang Yun , Carnaby Emma , Andersson Monique I. , Huang Wei E. , Cui Zhanfeng
Published: July 2022

Reverse transcription (RT) – loop‐mediated isothermal amplification (LAMP) assay is a rapid and one‐step method to detect SARS‐CoV‐2 in the pandemic. Quantitative estimation of the viral load of SARS‐CoV‐2 in patient samples could help physicians make decisions on clinical treatment and patient management. Here, we propose to use a quantitative LAMP (qLAMP) method to evaluate the viral load of SARS‐CoV‐2 in samples. We used threshold time (TT) values of qLAMP, the isothermal incubation time required for the fluorescent or colorimetric signal to reach the threshold, to indicate the viral load of clinical samples. Similar to the cycle threshold (Ct) values in conventional qPCR, TT values of qLAMP show a linear relationship to the copy numbers of SARS‐CoV‐2. The higher the viral loadings, the lower qLAMP TT values are. The RT‐qLAMP assay was demonstrated to quantify the viral loads of synthesized full‐length RNA, inactivated viral particles (BBIBP‐CorV), and clinical samples within 15 min by fluorescent reading and 25 min by colorimetric reading. The RT‐qLAMP has been applied to detect Alpha, Beta, Kappa, Delta, and Omicron variants of SARS‐CoV‐2, as well as the human beta‐actin gene, and their TT values showed the linear patterns. The RT‐qLAMP assays were evaluated by 64 clinical samples (25 positives and 39 negatives) for the assessment of viral loads, and it was also used to quantify the human beta‐actin gene, which was used as a control and an indicator of sampling quality in clinical swab samples. The result of RT‐qLAMP was in good agreement with the result of RT‐qPCR. The RT‐qLAMP assay detected all clinical samples, including those with Ct = 35, within 10 min using fluorescent reading.
On opinion, freedom of speech and its responsibilities
Authors: Brüssow Harald
Published: July 2022

Plato and Aristotle place opinion intermediate between knowledge and ignorance with all opinions under the suspicion of error. Kant summarized that opinion is a consciously insufficient judgement, subjectively and objectively. Belief is subjectively sufficient, but is recognized as being objectively insufficient. Only knowledge is subjectively and objectively sufficient. Despite this philosophically doubtful value of opinions, thinkers such as Milton, Locke, Montesquieu and Mill maintain that the freedom of opinion and speech are the basis of open societies but find limits when it represents a definite risk of damage, either to an individual or to the public. Also the UN Covenant on Civil and Political Rights proclaims the right to hold opinions without interference provided that it respects the rights or reputations of others and does not interfere with the protection of public health. Hate speech and propaganda for war are expressively prohibited. Postwar US politicians formulated the position that every man has a right to his own opinion, but no man has a right to be wrong in his facts. The impact of this discussion on opinions about control measures of the COVID‐19 pandemic is explored in this editorial.
A retrospective multi‐centre study of splenic volumes measured by CT following splenic artery angioembolisation for high‐grade blunt splenic injuries in adults
Authors: Bell Alastair , Patel Bhavik , Rapier Cheryl , Campbell Don , Grieve John
Published: July 2022

Introduction

Splenic artery embolisation is a recognised modality in the management of high grade blunt splenic injury. The impact of embolisation on the spleen in terms of volume and function remains unclear. This results in a lack of clarity regarding post embolisation vaccination policy.

Methods

This was a two‐centre, retrospective observational study over a 24‐month period involving all patients who underwent splenic artery embolisation for high grade blunt splenic trauma (AAST grades III–V). Splenic volumes were calculated from an initial CT and a repeat CT at 6 months post embolisation. Subgroup analysis was performed analysing the location of embolisation, AAST grading, and evidence of splenic dysfunction as defined by the presence of altered red cell morphology.

Results

Thirty patients achieved successful splenic salvage with angioembolisation. Mean volume loss was 44.14 cm3 (P = 0.038), with decreased volumes for distal embolisation and increased volumes for proximal embolisation. Three patients had altered red cell morphology; two demonstrated recovery at 6 months, with the third lost to follow up. There were significant associations between, initial splenic volume, AAST grade of injury, and altered red cell morphology. There was no significant association between location of embolisation, initial splenic volumes, or percentage volume change.

Conclusion

This study demonstrated a statistically significant change in splenic volume post angioembolisation in trauma, which was associated with AAST grading but not location of embolisation. The low rate of altered red cell morphology appears transient.
Free‐of‐charge dispensing of antipsychotics for schizophrenia in Denmark: Impact on the nationwide prescription registry and redemption of somatic medications
Authors: Rohde Christopher , Højlund Mikkel , Gasse Christiane , Hallas Jesper , Köhler‐Forsberg Ole
Published: July 2022

Objective

Free‐of‐charge dispensing of antipsychotics for schizophrenia was introduced in Denmark around 2008. However, free‐of‐charge dispensing is not recorded in the Danish National Prescription Register (DNPR), potentially introducing bias and misclassification.

Methods

We identified all 30 275 individuals with a first‐episode schizophrenia diagnosis in Denmark between 1 January 1999 and 1 March 2017 including all redeemed prescriptions registered in the DNPR during the 2 years after the schizophrenia diagnosis. For each calendar year, we calculated the proportion of individuals who had filled ≥1 prescription for psychotropic and/or somatic medications within the first 2 years after the schizophrenia diagnosis.

Results

From 2007 to 2017, the proportion of individuals with prescription‐records for any psychotropic medication during the 2 years after the schizophrenia diagnosis decreased from 88% to 74%, particularly antipsychotics (from 83% to 61%) and antidepressants (from 49% to 35%). This was particularly observed among those aged 18–30 years at the schizophrenia diagnosis. A similar decrease was not observed for prescription‐records of somatic medications.

Conclusion

The introduction of free‐of‐charge antipsychotics has affected the redemption of specific psychotropic drugs in the DNPR in first‐episode schizophrenia. This limitation needs to be considered in register‐based studies and emphasizes the need to identify solutions.
Adapting the protocol for narrative exposure therapy for adults with mild intellectual disabilities
Authors: Marlow Katie , Schröder Thomas , Tickle Anna , Renton Jess
Published: July 2022

Background

Narrative exposure therapy (NET) is a trauma‐focused cognitive behavioural therapy, recommended by the National Institute for Health and Care Excellence in 2018, to treat posttraumatic stress disorder in adults. There is a lack of research exploring the effectiveness of NET with adults with intellectual disabilities. The aim of this study is to develop an adapted version of the NET protocol (IDNET) for use with adults with mild intellectual disability.

Methods

A qualitative research design was employed. Stage one involved systematically adapting the NET protocol for adults with mild intellectual disabilities in collaboration with a service user group comprising eight consultants. Stage two involved gaining professionals' views on the adapted protocol and on the use of NET in intellectual disability services. This comprised a focus group of eight clinical psychologists specialising in intellectual disabilities and an expert panel of three NET clinicians. The framework approach was conducted on the focus group data only following guidance from a previous study.

Findings

An adapted NET protocol and collection of ‘easy read’ therapy materials were developed (IDNET), which incorporated feedback from the three stakeholder groups. Key concepts of ‘Optimism and motivation to adapt NET for people with mild intellectual disabilities’ and ‘Factors related to NET in practice’ were developed to describe the views of clinical psychologists. A number of issues were raised by professionals regarding the delivery of IDNET.

Conclusions

Professionals were optimistic about IDNET; however, issues raised regarding the delivery of IDNET require exploration when IDNET is trialled in practice. Specific implications for clinical practice and future research are discussed.
Cost‐effectiveness and estimated net monetary benefits of a fluoride varnish application program during well‐child visits by 9‐ to 30‐month‐old children in three areas of Thailand
Authors: Nantanee Ratichanok , Sriratanaban Jiruth
Published: July 2022

Objectives

To evaluate the cost‐effectiveness and estimated net monetary benefits of a fluoride varnish application program during well‐child visits in young children in three Thai provinces. Costs and benefits from both the provider and patients are presented.

Methods

Cost‐effectiveness and estimated net monetary benefit analysis of one to five visits for fluoride varnish application using a retro‐prospective cohort study design. Cost and outcomes were estimated using dental personnel survey data, hospital procurement data and guardian survey. The primary outcomes were decayed (treatment needed), missing due to caries and filled teeth (dmft).

Results

From the provider's perspective, one to three visits for fluoride varnish application decreased dmft and saved costs compared to no visits, one visit and two visit strategies (ICER = −468.36, −424.40 and −65.72, respectively). These strategies also showed an estimated net monetary benefit of 430.89, 216.44 and 7.23 THB, respectively. From the patient's perspective, the estimated net monetary benefits were positive for up to three visits (383.24, 212.45 and 45.82 THB, respectively); however, the incremental cost‐effectiveness ratios were no different with these strategies (ICER = −416.56). The one and two visit strategies had a very high chance of showing cost saving in the probabilistic sensitivity analysis (97.1% and 95.5%, respectively).

Conclusions

The one to three visits fluoride varnish application program during well‐child visits appears to be cost‐effective with estimated net benefit interventions for dental caries prevention. These findings suggest that children between 9 and 30 months old should attend at least three visits of the fluoride varnish application program during well‐child visits.
Objectives and curriculum for a graduate business analytics capstone: Reflections from practice
Authors: Anand Tej , Mitchell Daniel
Published: July 2022

Many higher education institutions have responded to the significant shortage of professionals with strong analytical expertise by offering graduate programs in business analytics and data science. These programs are typically designed to be practitioner focused and many of them offer a Capstone course that gives students the opportunity to conduct a real‐world analytics project. In this article, we describe the innovative design of a Capstone course offered to cohorts of approximately 110 graduate students in the business school at the University of Texas, Austin. This course is designed to deliver self‐directed and experiential learning from interacting with business stakeholders and successfully completing team‐based, business analytics projects within a commercial firm using the firm's data. The course design includes student and sponsor engagement, the formation of diverse balanced project teams, matching of teams with projects, and scaffolding, which includes consistent structured mentoring, team reflections, interim deliverables and in‐class learning for practical skills not covered elsewhere in the curriculum. This course has now been offered successfully to two cohorts. In this article, we will also describe changes made for the second cohort related to team formation, project matching, mentoring and in‐class learning. These changes were based on feedback from the first cohort.
What do male and female zebrafish prefer? Directional and colour preference in maze tasks
Authors: Marcon Matheus , Benvenutti Radharani , Gallas‐Lopes Matheus , Herrmann Ana Paula , Piato Angelo
Published: July 2022

Studies regarding the animals' innate preferences help elucidate and avoid probable sources of bias and serve as a reference to improve and develop new behavioural tasks. In zebrafish research, data obtained in behavioural assessments are often not replicated between research groups or even inside the same laboratory raising huge concerns about replicability and reproducibility. Among the potential causes that are not well considered, sexual differences can be a probable source of bias. Thus, this study aimed to investigate the male and female zebrafish directional and colour preferences in the plus‐maze and T‐maze behavioural tasks. Experiment 1 evaluated directional preference, and experiment 2 evaluated colour preference in a plus‐maze task; experiment 3 evaluated preference between black or white in a T‐maze task. Individual preferences were expressed as the percentage of time spent in each zone. Our results showed that male and female zebrafish demonstrated no difference in directional preference in the plus‐maze task. Surprisingly, male and female zebrafish showed colour preference differences in the plus‐maze task; males did not show any colour preference, while female zebrafish demonstrated a red preference compared to white, blue and yellow colours. Moreover, both male and female zebrafish demonstrated a strong black colour preference compared to the white colour in the T‐maze task. Our findings characterized the spontaneous preference of male and female zebrafish for direction and colour, identifying possible biases and providing insights that contribute to the standardization of future protocols.
Remembering apoptosis pioneer Andrew Wyllie (1944–2022)
Authors: Watson Christine J. , Melino Gerry , Martin Seamus J.
Published: July 2022

Andrew Wyllie was a key figure in the discovery of the programmed cell death process termed apoptosis. He pioneered the study of apoptosis when this was a little‐known phenomenon and discovered the first biochemical marker of the process, internucleosomal DNA degradation. Andrew recently passed away, aged 78, but leaves a legacy of scientific achievement that opened up a new field of research.
Evolution of choosiness dictates whether search costs of mate choice enhance speciation by sexual selection
Authors: Yukilevich Roman , Aoki Fumio
Published: July 2022

The role of sexual selection in speciation is implicated in both empirical case studies and larger comparative works. However, sexual selection faces two major problems in driving speciation. First, because females with novel preferences search for their initially rare males, search costs are expected to curtail initial sexual divergence. Second, if these populations come back into sympatry, sexual divergence may be erased due to hybridization. A major goal is to understand which conditions increase the likelihood of overcoming these problems. Here we generated a diploid population genetic model of how female search costs and evolution of female ‘choosiness’ (i.e. preference strength) interact to drive speciation in allopatry and secondary contact. We studied the model using numerical simulations in the context of two different male traits, ecologically ‘arbitrary’ versus ‘magic’ traits. First, in allopatry, without female search costs only minor and fluctuating sexual isolation evolved. In contrast, with female search costs, sexual isolation was highly curtailed with arbitrary male traits but was greatly facilitated with magic traits. However, because search costs selected for reduced choosiness, sexual isolation with magic traits was eventually eroded, the rate determined by the genetic architecture of choosiness. These factors also played a key role in secondary contact; with evolvable choosiness and female search costs, pure sexual selection models collapsed upon secondary contact. However, when we added selection against hybrids (i.e. reinforcement) to this model, we found that speciation could be maintained under a wide range of conditions with arbitrary male traits, but not with magic male traits. This surprisingly suggests that arbitrary male traits are in some cases more likely to aid speciation than magic male traits. We discuss these findings and relate them to empirical literature on female choosiness within species and in hybrids.
Realistic variations in substrate composition affect spawning preference and egg retention in river lamprey (Lampetra fluviatilis)
Authors: Daupagne Léa , Dhamelincourt Marius , Michaud Anne , Rives Jacques , Sebihi Stellia , Tentelier Cédric
Published: July 2022

Egg drift from the nest is clearly an important cause of mortality in lithophilic species, but the effect of substrate composition on this process has been overlooked. Here, we investigated the role of substrate on the spawning preference and egg retention of river lamprey (Lampetra fluviatilis) during a whole breeding season in a two‐option experimental setting. Despite no initial preference, the lamprey eventually favoured the most efficient substrate for egg retention. The pebbly substrate hosted 12 times as many matings as the sandy one, while blurting 20% fewer eggs.
First observation of the mating, egg‐laying and hatching behaviour of a captive female Kong skate, Okamejei kenojei (Müller & Henle, 1841)
Authors: Gao Guang , Xiao Zhizhong , Ji Guanglei , Xiao Yongshuang , Ma Daoyuan , Li Jun
Published: July 2022

This study provides a novel record of the reproductive behaviour of the Kong skate (Okamejei kenojei) in captivity. These skates were found to mate and deposit eggs at a temperature of 16.5 ± 0.5°C. The results showed that 76.13% of the eggs possessed one yolk, 0.77% of the eggs possessed two yolks and 23.11% of the eggs had no yolk (N = 1043). The deposition of non‐yolk and double‐yolk eggs was random. A total of 100 eggs were collected. After nearly 92 ± 5 days of incubation, 28 eggs failed to hatch, and 72 skates were successfully hatched with a female‐to‐male ratio of 1:1 (P > 0.05). The results enrich our knowledge of the reproduction in cartilaginous fishes and can inform management and conservation strategies for this species.
“Now at least we have something to call it”: Patient and care partner experiences receiving an amyloid PET scan
Authors: Gadbois Emily A. , Bélanger Emmanuelle , Shield Renee R. , Plassman Brenda L. , Van Houtven Courtney H. , Wetle Terrie Fox
Published: July 2022

Background

The primary objective of this paper was to examine perspectives and experiences of individuals with cognitive impairment who received an amyloid PET scan and their care partners, with regard to the process, logistics, and decision‐making associated with receiving an amyloid PET scan and its results.

Methods

Structured telephone interviews were conducted with 200 randomly sampled scan recipient/care partner dyads from the CARE IDEAS study. The audio‐recorded, transcribed responses were analyzed using an inductive qualitative content analytic approach.

Results

Participating individuals and care partners described their experiences in seeking a diagnosis for memory issues, including decision‐making and logistics involved with receiving an amyloid PET scan. Participants discussed the factors contributing to their decision to seek a diagnosis for their memory issues and their hopes and expectations in completing the scan. Participants also described the trajectory of this process, and although some described relatively straightforward trajectories, others described problems associated with identifying appropriate providers and coordinating care across numerous providers to obtain a diagnosis for their memory issues. Participants described an additional challenge of physicians attributing cognitive decline to normal aging, rather than signs of a neurodegenerative disorder.

Conclusions

Findings shed light on the barriers and delays that individuals and care partners experience in connecting with physicians and obtaining a comprehensive evaluation for cognitive problems. Results from this study have implications for physicians who provide care to older adults, and specifically highlight the need for greater care coordination and clearer communication with and systems of referral for patients.
The Golden Mean: The Risk‐Mitigating Effect of Combining Tournament Rewards with High‐Powered Incentives
Authors: JIN DUNHONG , NOE THOMAS
Published: July 2022

The rewards received by financial managers depend on both relative performance (e.g., fund inflows based on fund rankings, promotions based on peer comparisons) and absolute performance (e.g., bonus payments for meeting accounting targets, hedge‐fund incentive fees). Both relative and absolute performance rewards engender risk‐taking. In this paper, we show that these two sources of risk‐taking, relative and absolute performance rewards, mitigate the risk‐taking incentives produced by the other. This mutual incentive‐reduction effect generates a number of novel predictions about the relationship of managerial risk‐taking with the structure of relative and absolute performance rewards.
The interaction of rurality and rare cancers for travel time to cancer care
Authors: Onega Tracy , Alford‐Teaster Jennifer , Leggett Chris , Loehrer Andrew , Weiss Julie E. , Moen Erika L. , Pollack, Catherine C. , Wang Fahui
Published: July 2022

Purpose

Geographic access to cancer care is known to significantly impact utilization and outcomes. Longer travel times have negative impacts for patients requiring highly specialized care, such as for rare cancers, and for those in rural areas. Scant population‐based research informs geographic access to care for rare cancers and whether rurality impacts that access.

Methods

Using Medicare data (2014‐2015), we identified prevalent cancers and cancer‐directed surgeries, chemotherapy, and radiation. We classified cancers as rare (incidence <6/100,000/year) or common (incidence ≥6/100,000/year) using previously published thresholds and categorized rurality from ZIP code of beneficiary residence. We estimated travel time between beneficiaries and providers for each service based on ZIP code. Descriptive statistics summarized travel time by rare versus common cancers, service type, and rurality.

Findings

We included 1,169,761 Medicare beneficiaries (21.9% in nonmetropolitan areas), 87,399; 7.5% had rare cancers, with 9,133,003 cancer‐directed services. Travel times for cancer services ranged from approximately 29 minutes (25th percentile) to 68 minutes (75th percentile). Travel times were similar for rare and common cancers overall (median: 45 vs 43 minutes) but differed by service type; 13.4% of surgeries were >2 hours away for rare cancers, compared to 8.3% for common cancers. Increasing rurality disproportionately increased travel time to surgical care for rare compared to common cancers.

Conclusions

Travel times to cancer services are longest for surgery, especially among rural residents, yet not markedly longer overall between rare versus common cancers. Understanding geographic access to cancer care for patients with rare cancers is important to delivering specialized care.
Telemedicine to improve reproductive health care for rural Coloradans: Perceptions of interest and access
Authors: Clure Cara , Sheeder Jeanelle , Teal Stephanie , Cohen Rebecca
Published: July 2022

Purpose

To evaluate rural Colorado women's access to and preferences for receiving reproductive health care services.

Methods

We conducted an online survey of women ages 18‐45 years old. We mailed recruitment postcards to a random sample of female, registered voters in rural Colorado zip codes. Survey questions assessed experiences, beliefs, and preferences regarding reproductive health care. We performed bivariate statistics and logistic regression for predictors of interest in telemedicine.

Findings

Respondents (n = 478) had a median age of 34 years (range 18‐45). Most women identified as White (90.2%) and were insured (67.1% private; 20.5% public). Most (74.1%) noted barriers to obtaining reproductive care in their communities. Those who reported barriers cited a median of 3 barriers (range 1‐8), most commonly too few community‐based providers (81.4%) and long distance to care (69.5%). Among respondents, 51.0% had used telemedicine before and 52.5% were interested in using telemedicine for reproductive health services. Interest in telemedicine significantly differed by perceived difficulty accessing care, previous telemedicine use, traveling over 100 miles for medical care in the last year, and belief in the safety of abortion. Those interested in telemedicine were less likely to value having an established relationship with providers and face‐to‐face visits.

Conclusions

Most reproductive‐aged, rural Colorado women endorsed barriers to obtaining reproductive health care in their communities. Over half of rural women are interested in using telemedicine for reproductive health care; however, many are not. Both optimizing telemedicine and developing additional innovative solutions are needed to improve access to reproductive care in rural communities.
KRAS mutation in intrahepatic cholangiocarcinoma: Linkage with metastasis‐free survival and reduced E‐cadherin expression
Authors: Tanaka Mariko , Kunita Akiko , Yamagishi Makoto , Katoh Hiroto , Ishikawa Shumpei , Yamamoto Hiroyuki , Abe Jun , Arita Junichi , Hasegawa Kiyoshi , Shibata Tatsuhiro , Ushiku Tetsuo
Published: July 2022

Background and Aims

Although KRAS mutations are the major driver of intrahepatic cholangiocarcinoma (ICC), their role remains unexplored. This study aimed to elucidate the prognostic effects, association with clinicopathologic characteristics and potent functions of KRAS mutations in ICC.

Methods

A hundred and seven resected stage I–III ICCs were analysed for KRAS mutation status and its link with clinicopathological features. An independent validation cohort (n = 138) was included. In vitro analyses using KRAS‐mutant ICC cell lines were performed.

Results

KRAS mutation was significantly associated with worse overall survival in stage I–III ICCs, which was validated in an independent cohort. Recurrence‐free survival did not significantly differ between cases with and without KRAS mutations, but if limited to recurrence with extrahepatic metastasis, KRAS‐mutant cases showed significantly worse distant metastasis‐free survival than KRAS‐wild cases showed. KRAS mutations were associated with frequent tumour budding with reduced E‐cadherin expression. In vitro, KRAS depletion caused marked inhibition of cell growth and migration together with E‐cadherin upregulation in KRAS‐mutant ICC cells. The RNA‐sequencing assay revealed that KRAS depletion caused MYC pathway downregulation and interferon pathway upregulation.

Conclusions

Our observations suggest that KRAS mutations are associated with aggressive behaviour of ICC, especially the development of extrahepatic metastasis. Mutant KRAS is likely to change the adhesive status of ICC cells, affect the responsiveness of tumour cells to interferon immune signals, and consequently promote extrahepatic metastasis. KRAS mutation status, which predicts the prognoses of patients with ICC after surgical resection, is expected to help stratify patients better for individual postoperative treatment strategies.
Healthier diet associated with reduced risk of excessive gestational weight gain: A Chinese prospective cohort study
Authors: Yang Mengtong , Feng Qiuyu , Chen Cong , Chen Sijia , Guo Yishan , Su Danping , Chen Hong , Sun Hong , Dong Hongli , Zeng Guo
Published: July 2022

Limited studies have examined the associations between diet quality and gestational weight gain (GWG) among Chinese pregnant women, adopting Chinese GWG guidelines. We prospectively investigate the associations of diet quality, using the Chinese Healthy Diet Index for Pregnancy (CHDI‐P), which assessed diet quality from ‘Diversity’, ‘Adequacy’ and ‘Limitation’ dimensions with overall 100 points, with GWG among participants enroled in Southwest China. Food consumption was collected by 24 h dietary recalls for three consecutive days and CHDI‐P scores were divided into tertiles. GWG was calculated according to the weight measured before delivery and classified into adequate weight gain (AWG), insufficient weight gain (IWG) and excessive weight gain(EWG) following Chinese GWG guidelines. Multinomial regression analyses and stratified analyses by pre‐pregnancy body mass index were performed to estimate the association between CHDI‐P and GWG. A total of 1416 participants were recruited in early pregnancy, and 971 and 997 participants were respectively followed up in middle and late pregnancy. The mean CHDI‐P score was 56.44 ± 6.74, 57.07 ± 7.44 and 57.38 ± 7.94 points in early, middle and late pregnancy, respectively. Women in the lowest CHDI‐P scores group had an increased risk of EWG in middle (OR = 1.53, 95% confidence interval [CI] = 1.08–2.17) and late pregnancy (OR = 1.71, 95% CI = 1.21–2.41) than women in the highest group, while overweight/obese women had a greater risk of EWG in late pregnancy (OR = 4.25, 95% CI = 1.30–13.90). No association was found between the CHDI‐P scores and IWG. Poor diet quality in middle and late pregnancy was associated with a higher risk of EWG.
A critical race analysis of structural and institutional racism: Rethinking overseas registered nurses' recruitment to and working conditions in the United Kingdom
Authors: Ugiagbe Iyore M. , Liu Liang Q. , Markowski Marianne , Allan Helen
Published: July 2022

Language tests for overseas registered nurses (ORN) working outside their home country are essential for patient safety, as communication competency needs to be established in any workforce. We argue that the current employment of existing language tests is structurally and institutionally racist and disadvantages ORNs from non‐European Union (EU) and non‐White countries seeking to work in the United Kingdom. Using Critical Race Theory (CRT), we argue that existing English language tests for ORNs seeking registration in the United Kingdom are discriminatory due to the UK's racist migration policies and a regulatory body for nursing and midwifery that fails to acknowledge and understand its own institutionally racist practices.
Fumarate hydratase gene germline variants and mosaicism associated with pheochromocytoma and paraganglioma
Authors: Ma Xiaosen , Cui Yunying , Gao Yinjie , Zhang Xuebin , Nie Min , Tong Anli
Published: July 2022

Fumarate hydratase (FH) catalyzes the conversion of fumaric acid to L‐malic acid. Heterozygous variants of the human fumarate hydratase gene (FH) predispose to hereditary leiomyomatosis and renal cell cancer and, rarely, pheochromocytoma/paraganglioma (PPGL). No mosaic variant in FH has been reported yet. Using next‐generation sequencing, five individuals with FH variants were found in 319 PPGL patients. Immunohistochemistry staining and loss of heterozygosity analysis in tumor tissues were performed to determine the pathogenicity of the variants. Deep targeted sequencing was performed on the peripheral blood DNA of a pheochromocytoma (PCC) patient with uterine leiomyomas. Finally, two of the five variants were found to be pathogenic. A germline variant (c.817G>A, p.Ala273Thr) was found in a patient with a PPGL family history. A mosaic variant (c.206G>A, p.Gly69Asp) with an allelic ratio of 5% in blood DNA was confirmed in the PCC patient with uterine leiomyomas. No metastatic PPGL was observed in the two PPGL patients with FH pathogenic variants. In summary, we report mosaicism in FH and the first PPGL pedigree with an FH pathogenic germline variant. Both germline variants and mosaicism should be taken into account during genetic testing.
Prognostic factors and treatment considerations of submandibular gland carcinomas: A population‐based study
Authors: Liu Shengwen , Xu Wanlin , Liu Limin , Zhu Yun , Wu Yifan , Lu Hao , Yang Wenjun , Zhang Chenping
Published: July 2022

Objectives

The therapeutic regimen of submandibular gland carcinoma (SGC) has not reached consensus, especially for the neck treatment of patients with cN0.

Materials and methods

Patients with SGC were identified from the medical database of Shanghai Ninth People's Hospital. Kaplan–Meier analysis, univariate and multivariate Cox regression were employed to evaluate the survival and independent prognostic factors.

Results

Two hundred and fifteen patients with SGC were retrospectively reviewed. The 5‐year disease‐free survival (DFS) and overall survival (OS) rates were 71.5% and 77.8%, respectively. Multivariate analysis revealed that histological grade, cT classification, cN classification, and perineural invasion (PNI) were independent prognostic factors for DFS, while histological grade, cT classification, cN classification, and age were those for OS. The neck dissection showed no significant survival benefit for patients with cN0. Lung was the most common site of distant metastasis (16.7%).

Conclusions

Histological grade, cT classification, cN classification, age, and PNI were independent prognostic factors of patient with SGC, which should be the main considerations for making therapeutic regimens. Our study also verifies the neck dissection of patient with cN0 is unnecessary, and postoperative radiotherapy (PORT) is vital for patients with pN+.
Comparison of modeled versus reported phosphate removal and modeled versus postdialysis serum phosphate levels in conventional hemodialysis
Authors: Daugirdas John T.
Published: July 2022

Background

We compared predictions of phosphate removal by a 2‐pool kinetic model with measured phosphate removal in spent dialysate as reported by others.

Methods

Twenty‐six studies were identified that reported phosphate removal in 35 groups of patients. In almost all studies, patients were dialyzed for close to 4 h (range 3 to 6 h). For each study, group mean values of predialysis serum phosphate, body size, dialyzer K0A urea, blood and dialysate flow rates, and session lengths were input into the kinetic model. Predictions of group mean phosphate removal and postdialysis serum phosphate were compared with reported measured values.

Results

Mean (by patient group) predicted phosphate removal was 931 ± 170 mg/treatment, somewhat higher (p < 0.001) than the reported measured value, 900 mg ± 287. The ratio of predicted/measured removal averaged 1.15 ± 0.427. In 5/35 patient groups (3/26 studies) the predicted/measured phosphate removal was greater than 1.50. If these groups were excluded, the mean measured phosphate removal was 990 mg versus 966 predicted, with a ratio of predicted/measured removal averaging 0.993. Measured group mean postdialysis serum phosphate values (reported in 25/35) were 2.64 ± 0.54, not significantly different from predicted (2.60 ± 0.24 mg/dl, p = NS).

Conclusions

For conventional 4‐h dialysis treatments, phosphate removal and postdialysis serum phosphate values predicted by a 2‐pool kinetic model are similar to reported measured values.
Metabolic dysfunction‐associated fatty liver disease (MAFLD) and advanced liver fibrosis among hemodialysis patients in a multiethnic urban population in Malaysia
Authors: Wong Wei‐Kei , Chan Wah‐Kheong , Ganapathy Shubash Shander , Lim Soo‐Kun
Published: July 2022

Background

Metabolic‐dysfunction‐associated fatty liver disease (MAFLD) and end stage kidney disease (ESKD) are complications of the metabolic syndrome. Our aim is to study the prevalence of MAFLD and advanced liver fibrosis and the associated factors among hemodialysis patients in a multiracial urban population in Malaysia.

Methods

A cross‐sectional study of hemodialysis patients from 10 hemodialysis centers was used. FibroTouch examination was performed on all patients. Fatty liver was diagnosed based on ultrasound attenuation parameter ≥248 dB/m while advanced liver fibrosis was diagnosed based on liver stiffness measurement ≥10 kPa.

Results

This study included 447 hemodialysis patients (median age 59 [50–67], male 55%, Chinese 61%, Malay 20%, Indian 18%). Dialysis vintage was 49 (22–93) months. The prevalence of MAFLD was 43.4%. Independent factors associated with MAFLD were elevated waist circumference (aOR = 10.1, 95% CI = 5.3–19.4, p < 0.001), normal platelet count (aOR = 3.1, 95% CI = 1.3–7.3, p < 0.05), low HDL cholesterol (aOR = 2.3, 95% CI = 1.3–4.2, p < 0.01), elevated fasting blood sugar (aOR = 2.3, 95% CI = 1.3–3.8, p < 0.01), elevated hsCRP (aOR = 2.2, 95% CI = 1.2–4.0, p < 0.01), and advanced liver fibrosis (aOR = 3.0, 95% CI = 1.6–5.6, p < 0.001). The prevalence of advanced liver fibrosis was 25.5%. Independent factors associated with advanced liver fibrosis were male gender (aOR = 1.8, 95% CI = 1.0–3.0, p < 0.05), elevated waist circumference (aOR = 2.0, 95% CI = 1.0–4.0, p < 0.05), low platelet count (aOR = 5.4, 95% CI = 2.7–11.0, p < 0.001), elevated GGT (aOR = 5.0, 95% CI = 2.9–8.8, p < 0.001), and MAFLD (aOR = 3.2, 95% CI = 1.7–5.9, p < 0.001).

Conclusion

A high prevalence of MAFLD and advanced liver fibrosis was observed among hemodialysis patients. Nephrologists should consider a more proactive approach in diagnosing MAFLD and/or advanced liver fibrosis in hemodialysis patients.
Staff perspectives on barriers and enablers to implementing alternative source plasma eligibility criteria for gay, bisexual, and other men who have sex with men
Authors: Castillo Gisell , Vesnaver Elisabeth , Gibson Emily , Butler‐Foster Terrie , Goldman Mindy , Hill Nolan E. , Rosser Andrew , Lapierre Don , Rubini Kyle A. , MacDonagh Richard , Miguel Glenndl , Palumbo Amelia , MacPherson Paul , Randall Taylor , Osbourne‐Sorrell William , O'Brien Sheila F. , Bridel William , Otis Joanne , Greaves Mark , Al‐Bakri Taim Bilal , Reid Marco , Labrecque Maximilian , Germain Marc , Orvis Shane , Clapperton Andrew T. , Devine Dana , Presseau Justin
Published: July 2022

Background

Canadian Blood Services introduced new eligibility criteria that allows some sexually active gay, bisexual, and other men who have sex with men (gbMSM) to donate source plasma, marking a significant change from time‐based deferral criteria. We aimed to identify potential barriers and enablers to implementing the new criteria from the perspective of donor center staff.

Study Design and Methods

We conducted Theoretical Domains Framework‐informed interviews with staff from two source plasma donation centers in Canada.

Results

We completed 28 interviews between June 2020 and April 2021. Three themes representing eight domains captured key tensions. Valuing inclusive eligibility criteria: staff support inclusive criteria; many were concerned the new criteria remained discriminatory. Investing in positive donor experiences: staff wished to foster positive donor experiences; however, they worried gbMSM donors would express anger and disappointment regarding the new criteria, staff would experience unease over using stigmatizing criteria and convey nonverbal cues of discomfort, and recurring plasma donors may behave inappropriately. Supporting education, training, and transparency of eligibility criteria: participants believed providing in‐person training (i.e., to explain criteria rationale, address discomfort, practice responding to donor questions) and ensuring donors and the public were well‐informed of the upcoming changes would improve implementation.

Discussion

Participant views emphasize the importance of supporting staff through training and transparent communication to optimize the delivery of world‐class equitable care for a new cohort of donors who have previously been excluded from plasma donation. Findings inform which staff supports to consider to improve implementation as policies continue to shift internationally.
Data-Driven Examination of the Impact Energy Efficiency has on Demand Response Capabilities in Institutional Buildings
Authors: Andrews Abigail , Roth Jonathan , Jain Rishee K. , Mathieu Johanna L.
Published: July 2022

Growing concerns over climate change and grid reliability have led to widespread adoption of energy efficiency (EE) and demand response (DR) programs at utilities. Despite such adoption, numerous questions exist regarding the interactions between EE and DR, including whether EE diminishes a building’s DR potential. In this brief, we empirically examine the impact a building’s EE level (quantified by traditional EE benchmarking metrics) has on its DR capabilities (quantified by a building’s normalized load shed) for 194 K-12 institutional school buildings in California, USA. We found inconclusive statistical evidence that a building’s EE level has an impact on its DR load shed capabilities. We provide initial evidence countering concerns that EE diminishes DR potential and thus pave the path for future work than can further support synergistic EE and DR strategies which can enhance demand-side management programs.
The Study of Artificial Intelligent in Risk-Based Inspection Assessment and Screening: A Study Case of Inline Inspection
Authors: Aditiyawarman Taufik , Soedarsono Johny Wahyuadi , Kaban Agus Paul Setiawan , Riastuti Rini , Rahmadani Haryo
Published: July 2022

The work reports the systematic approach to the study of artificial intelligence (AI) in addressing the complexity of inline inspection (ILI) data management to forecast the risk in natural gas pipelines. A recent conventional standard may not be sufficient to address the variation data of corrosion defects and inherent human subjectivity. Such methodology undermines the accuracy assessment confidence and is ineffective in reducing inspection costs. In this work, a combination of unsupervised and supervised machine learning and deep learning has profoundly accelerated the probability of failure (PoF) assessment and analysis. K-means clustering and Gaussian mixture models show direct relevance between the corrosion depth and corrosion rate, while the overlapping PoF value is scattered in three clusters. Logistic regression, support vector machine, k-nearest neighbors, and ensemble classifiers of AdaBoost, random forest, and gradient boosting are constructed using particular features, labels, and hyperparameters. The algorithm correctly predicted the score of PoF from 4790 instances and confirmed the 25% metal loss at a location of 13.399 m. The artificial neural network (ANN) is designed with various layers (input, hidden, and output) architecture. It is optimized using an activation function to predict that 74% of the pipeline's anomalies that classified at low-medium and medium-high risk. Furthermore, it provides a quick and precise prediction about the external defects at 13.1 m and requires the personnel to conduct wrapping composite. This work can be used as a standard guideline for risk assessment based on ILI and applies to industry and academia.