bluuebunny/crossref_metadata_2025 huggingface dataset:
Positioning Women in Conflict Studies
Authors: Karim Sabrina , Hill, Jr. Daniel W
Published: August 2024

This book explores how different types of women’s status, including women’s inclusion (in politics), women’s rights, harm to women, and beliefs about women’s gender roles affect political violence, including interstate war, civil war, repression, and terrorism. However, it argues that before scholars, policymakers, and practitioners can explore these connections, it is important to overcome existing problems in the scholarship—conceptual stretching of gender equality and resulting measurement invalidity. Much of the current scholarship and policymaking conflate gender equality and women’s status. That is, they use gender equality as a catchall term that includes anything related to women. This conflation masks the individual ways in which women’s status affects different forms of political violence. Scholars and policymakers also use a multitude of indicators to measure gender equality when in reality they are measuring other concepts. This book corrects these problems and develops novel concepts and scales to determine how women’s inclusion, women’s rights, harm to women, and beliefs about women’s roles affect interstate war, civil war, repression, and terrorism within a given society. It finds that women’s inclusion is associated with fewer terror attacks; women’s rights in combination with strong women’s advocacy groups are related to less state repression; harm to women is associated with a higher probability of civil and interstate wars; and beliefs about women’s traditional gender roles within a society are correlated with more terrorism. The findings shed light on the various pathways to reduce political violence globally.
Solving the Measurement Invalidity Problem
Authors: Karim Sabrina , Hill, Jr. Daniel W
Published: August 2024

Chapter 2 explores the problem of measurement invalidity in depth. The chapter starts out by discussing the usefulness of using quantitative measures. It then moves on to address common measurement problems. It demonstrates how there are numerous measures of gender equality and how this creates problems for interpreting and comparing results from different studies. It highlights other problems such as a lack of agreement among indicators that are supposed to measure the same concept, and problems with aggregate scales and the way they are commonly created. The chapter ends with an explanation of how measurement models can address these problems, their benefits, and how they are used to create the measures of women’s status presented in subsequent chapters.
Haemostasis and thromboembolic disorders
Authors: Boarder Michael , Dixon Jane , Newby David , Navti Phyllis , Zetterström Tyra
Published: August 2024

This chapter explores the extent of haemostasis and looks at thromboembolic disorders. It explains that haemostasis refers to the underlying mechanism behind the arrest of blood loss from a damaged blood vessel. Common and potentially serious conditions associated with blood vessel occlusion by thrombi and emboli, such as stroke, angina, and myocardial infarction, are known collectively as thromboembolic disorders. Numerous drugs are available to modify the processes of haemostasis which underlie thromboembolic disorders. The chapter also provides an overview of the drugs used in the treatment of thromboembolic disorders, such as anticoagulant drugs, antiplatelet drugs, fibrinolytics (thrombolytics), antifibrinolytic drugs, and haemostatics.
Atherosclerosis and ischaemic heart disease
Authors: Boarder Michael , Dixon Jane , Newby David , Navti Phyllis , Zetterström Tyra
Published: August 2024

This chapter focuses on atherosclerosis and ischaemic heart disease. The chapter shows that the blockage of blood vessels reduces the supply of oxygenated blood to areas of the heart muscle, which then causes myocardial ischaemia or ischaemic heart disease. The chapter then examines the underlying disease of the coronary arteries caused by atherosclerosis. Lifestyle changes, including regular exercise, reduction in alcohol intake, and the cessation of smoking offer great benefits in the prevention of ischaemic heart disease. The chapter explains how lipid-lowering drugs prevent atherosclerosis before detailing the types of angina and myocardial infarction caused by a thrombotic event in a diseased coronary artery leading to a sudden decrease in blood flow.
Arrhythmias and chronic heart failure
Authors: Boarder Michael , Dixon Jane , Newby David , Navti Phyllis , Zetterström Tyra
Published: August 2024

This chapter examines the interplay of arrhythmias and chronic heart failure. It defines arrhythmia as an abnormality in the normal pattern of rhythmic excitation of the heart. Atrial fibrillation (AF) is the most common arrhythmia and the drug treatment to manage AF works through rate control or rhythm control at the same time as preventing thromboembolism. Meanwhile, chronic heart failure refers to the state where the heart is unable to maintain adequate circulation for the needs of the body despite an adequate venous filling pressure.
Thyroid disorders and pharmacological methods of contraception
Authors: Boarder Michael , Dixon Jane , Newby David , Navti Phyllis , Zetterström Tyra
Published: August 2024

This chapter looks at thyroid disorders and pharmacological methods of contraception. It notes that the thyroid gland is responsible for controlling the body's basal metabolic rate. It also has an essential roles in growth and development. The regulation of the thyroid gland involves the pituitary and hypothalamus, both of which play a significant role in the treatment of common thyroid diseases. The chapter provides an overview of hyperthyroidism, hypothyroidism, and their subsequent treatments. It also looks into how the female reproductive system can be manipulated to prevent conception using drugs, like the oral contraceptive pill, mimicking the effects of endogenous female sex hormones.
Drug addiction and recreational drugs
Authors: Boarder Michael , Dixon Jane , Newby David , Navti Phyllis , Zetterström Tyra
Published: August 2024

This chapter examines the impact of drug addiction and recreational drugs. It cites that recreational drugs can be viewed from four perspectives: level of medicinal value, legal status, potential for harm, and addictive potential. Despite their addictive properties, psychostimulants are used to treat symptoms of conduct disorder and attention deficit hyperactivity disorder (ADHD) in young children. The chapter looks into the factors that influence addiction and the treatment of addiction. This treatment aims to relieve abstinence syndrome and prevent relapse. The chapter then details the key understanding of psychostimulants, psychotomimetics, CNS depressants, and mixed-classified drugs as four main classes of drugs taken for pleasure.
SARS-CoV-2 antibody prevalence by industry, workplace characteristics, and workplace infection prevention and control measures, North Carolina, USA, 2021 to 2022
Authors: Gigot Carolyn , Pisanic Nora , Spicer Kristoffer , Davis Meghan F , Kruczynski Kate , Gregory Rivera Magdielis , Koehler Kirsten , Hall D J , Hall Devon J , Heaney Christopher D
Published: August 2024

The COVID-19 pandemic has disproportionately affected workers in certain industries and occupations, and the workplace can be a high-risk setting for SARS-CoV-2 transmission. In this study, we measured SARS-CoV-2 antibody prevalence and identified work-related risk factors in a population primarily working at industrial livestock operations. We used a multiplex salivary SARS-CoV-2 IgG assay to determine infection-induced antibody prevalence among 236 adult (≥18 yr) North Carolina residents between February 2021 and August 2022. We used the National Institute for Occupational Safety and Health Industry and Occupation Computerized Coding System (NIOCCS) to classify employed participants’ industry. Most participants (55%, 95% confidence interval [CI] 49% to 62%) were infection-induced IgG positive, including 71% (95% CI 60% to 83%) of animal slaughtering and processing industry workers, 1.5 to 4.3 times North Carolina general population infection-induced seroprevalence estimates during overlapping time periods. Considering self-reported diagnostic test positivity and vaccination history in addition to antibodies, the proportion of participants with evidence of prior infection increased slightly to 61% (95% CI 55% to 67%), including 75% (95% CI 64% to 87%) of animal slaughtering and processing workers. Participants with more than 1000 compared to 10 or fewer coworkers at their jobsite had higher odds of prior infection (adjusted odds ratio 4.5, 95% CI 1.0 to 21.0). This study contributes evidence of the severe and disproportionate impacts of COVID-19 on animal slaughtering and processing workers and workers in large congregate settings.
Deuterium MR spectroscopy: potential applications in oncology research
Authors: Bitencourt Almir Galvão Vieira , Bhowmik Arka , Marcal Filho Eduardo Flavio De Lacerda , Lo Gullo Roberto , Mazaheri Yousef , Kapetas Panagiotis , Eskreis-Winkler Sarah , Young Robert , Pinker Katja , Thakur Sunitha B
Published: August 2024

Metabolic imaging in clinical practice has long relied on PET with fluorodeoxyglucose (FDG), a radioactive tracer. However, this conventional method presents inherent limitations such as exposure to ionizing radiation and potential diagnostic uncertainties, particularly in organs with heightened glucose uptake like the brain. This review underscores the transformative potential of traditional deuterium MR spectroscopy (MRS) when integrated with gradient techniques, culminating in an advanced metabolic imaging modality known as deuterium MRI (DMRI). While recent advancements in hyperpolarized MRS hold promise for metabolic analysis, their widespread clinical usage is hindered by cost constraints and the availability of hyperpolarizer devices or facilities. DMRI, also denoted as deuterium metabolic imaging (DMI), represents a pioneering, single-shot, and noninvasive paradigm that fuses conventional MRS with nonradioactive deuterium-labelled substrates. Extensively tested in animal models and patient cohorts, particularly in cases of brain tumours, DMI's standout feature lies in its seamless integration into standard clinical MRI scanners, necessitating only minor adjustments such as radiofrequency coil tuning to the deuterium frequency. DMRI emerges as a versatile tool for quantifying crucial metabolites in clinical oncology, including glucose, lactate, glutamate, glutamine, and characterizing IDH mutations. Its potential applications in this domain are broad, spanning diagnostic profiling, treatment response monitoring, and the identification of novel therapeutic targets across diverse cancer subtypes.
Inconvenient Truth: Challenges to Diversity, Equity and Inclusion in Social Work Education and Practice
Authors: Kwok Kim , Kwan Chi Kin , Lo Kai Chung
Published: August 2024

Social work is recognised as a profession committed to promoting diversity, equity and inclusion (DEI). However, it is concerning that social work still faces significant challenges in achieving these critical goals. This qualitative study examines the systemic barriers encountered by ethnically diverse social workers in Hong Kong as they navigate social work education and frontline practice. Nineteen social workers from diverse ethnic backgrounds participated in focus group interviews. The findings revealed interconnected, systemic challenges to equity and inclusion in social work, ranging from individual biases to organisational barriers. This is the inconvenient truth that highlights the social work profession’s inadequate efforts to develop and implement comprehensive DEI strategies needed to confront inequalities and exclusion present in social work education and the workforce. By adopting a combined approach of the DEI and critical race theory (CRT) frameworks, this article expands the traditional diversity discourses in social work, moving beyond embracing superficial diversity and considering deep-seated systemic issues, such as racism, in order to address cultural differences. It also centres the voices of marginalised social workers in Hong Kong, challenging dominant narratives and enriching regional knowledge. The article concludes with recommendations to enhance inclusive social work education and the workforce.
Efficacy of renal denervation as an adjunct to pulmonary vein isolation for atrial fibrillation treatment: a systematic review and meta-analysis
Authors: Thavabalan Karish , Sheikh Majed , Phuah YuZhi , Rajput Sanjay K , Fatima Noor , Sutaria Aman , Bray Jonathan J H , Ahmad Mahmood , Glatzel Hannah , Ahmad Reubeen , Snell Lily , Kumar Niraj S , García-Pérez Carmen-Lucía , Candilio Luciano , Providencia Rui
Published: August 2024

Aims

Catheter ablation, consisting of pulmonary vein isolation (PVI), is the most effective treatment modality for the management of symptomatic patients with atrial fibrillation (AF). Unfortunately, this procedure has a considerable relapse rate, ranging from 15 to 50% depending on AF type and other patient factors. Hypertension (HTN) is associated with a higher risk of developing AF and can also be managed with a catheter-based procedure—renal denervation (RDN). This meta-analysis aimed to compare the effect of PVI with and without RDN in hypertensive patients with AF.

Methods and results

OVID MEDLINE and Embase were searched on 1 February 2023 and trials that reported the effects of RDN on AF recurrence in hypertensive patients were included. A total of 637 patients across 8 randomised controlled trials were included. The results from the pooled analysis showed that when compared with PVI alone, RDN added to PVI: (1) Lowered AF recurrence [RR 0.67 (0.53, 0.85), P = 0.001, I2 = 23%, NNT = 5.9 patients]; (2) Reduced both systolic blood pressure and diastolic blood pressure, with medium effect size, as reflected by standardised mean differences of 0.5 (P = 0.02, I2 = 80%) and 0.43 (P = 0.006, I2 = 60%), respectively; and (3) was not associated with a decrease in estimated glomerular filtration rate (+7.19 mL/min/1.73 m2, P = 0.15, I2 = 89%).

Conclusion

Adding RDN to PVI in patients with AF and resistant HTN was associated with a reduction of blood pressure levels and AF recurrence. Consideration to RDN should be given as an adjunctive treatment for patients with AF and resistant HTN.
European survey of diagnosis and management of the polycystic ovary syndrome: full report on the ESE PCOS Special Interest Group's 2023 Questionnaire
Authors: Livadas Sarantis , Yildiz Bulent O , Mastorakos George , Gambineri Alessandra , Pignatelli Duarte , Giorgino Francesco , Andersen Marianne Skovsager , Obermayer-Pietsch Barbara , Macut Djuro ,   ESE PCOS Special Interest Group, Macut Djuro , Gambineri Alessandra , Yildiz Bulent O , Pignatelli Duarte , Mastorakos George , Andersen Marianne Skovsager , Obermayer-Pietsch Barbara , Giorgino Francesco , Livadas Sarantis
Published: August 2024

Background

Although polycystic ovary syndrome (PCOS) is a very common endocrinopathy, there are several issues related to this disorder which perplex clinicians in their everyday practice.

Objective

To determine the current state of knowledge among European endocrinologists concerning the full spectrum of PCOS.

Methods

An online survey comprising 41 items covering various aspects of PCOS diagnosis and management was distributed to members of the European Society of Endocrinology.

Results

A total of 505 European endocrinologists (64% females), with a mean age of 47 ± 11.6 years, participated in the survey. The Rotterdam criteria were the primary diagnostic tool for 85% of respondents. Most referrals (87.1%) occurred between ages 20 and 40 years. Twenty-five percent of physicians have access to mass spectrometry for the evaluation of androgen levels. While an extended metabolic profile was commonly employed as part of the workup, there was uncertainty regarding chronic anovulation diagnosis. Diabetes, including gestational or type 2, was recognized as a significant risk factor with universal screening irrespective of BMI status. Lifestyle modification and metformin were considered as standard interventions by all participants alongside oral contraceptives, though there was significant discrepancy in treatment duration.

Conclusions

The Rotterdam diagnostic criteria are widely adopted for PCOS diagnosis among European endocrinologists. The current updated survey shows an emphasis on steroid profiling as an important part of diagnostic workup and a strong position held for recognition of PCOS as a metabolic condition with potentially serious implications. Current therapy thus shifted to the demand for prioritizing lifestyle interventions and metabolic therapies, either as monotherapy or in combination with standard hormone compounds.
In-silico trial emulation to predict the cardiovascular protection of new lipid-lowering drugs: an illustration through the design of the SIRIUS programme
Authors: Angoulvant Denis , Granjeon-Noriot Solène , Amarenco Pierre , Bastien Alexandre , Bechet Emmanuelle , Boccara Franck , Boissel Jean-Pierre , Cariou Bertrand , Courcelles Eulalie , Diatchenko Alizée , Filipovics Anne , Kahoul Riad , Mahé Guillaume , Peyronnet Emmanuel , Portal Lolita , Porte Solène , Wang Yishu , Steg Philippe Gabriel
Published: August 2024

Introduction

Inclisiran, an siRNA targeting hepatic PCSK9 mRNA, administered twice-yearly (after initial and 3-month doses), substantially and sustainably reduced LDL-cholesterol (LDL-C) in Phase III trials. Whether lowering LDL-C with inclisiran translates into a reduced risk of major adverse cardiovascular events (MACE) is not yet established. In-silico trials applying a disease computational model to virtual patients receiving new treatments allow to emulate large scale long-term clinical trials. The SIRIUS in-silico trial programme aims to predict the efficacy of inclisiran on CV events in individuals with established atherosclerotic cardiovascular disease (ASCVD).

Methods and results

A knowledge-based mechanistic model of ASCVD was built, calibrated, and validated to conduct the SIRIUS programme (NCT05974345) aiming to predict the effect of inclisiran on CV outcomes. The SIRIUS Virtual Population included patients with established ASCVD (previous myocardial infarction (MI), previous ischemic stroke (IS), previous symptomatic lower limb peripheral arterial disease (PAD) defined as either intermittent claudication with ankle-brachial index <0.85, prior peripheral arterial revascularization procedure, or vascular amputation) and fasting LDL-C ≥ 70 mg/dL, despite stable (≥4 weeks) well-tolerated lipid-lowering therapies.

SIRIUS is an in-silico multi-arm trial programme. It follows an idealized crossover design where each virtual patient is its own control, comparing inclisiran to (i) placebo as adjunct to high-intensity statin therapy with or without ezetimibe, (ii) ezetimibe as adjunct to high-intensity statin therapy, (iii) evolocumab as adjunct to high-intensity statin therapy and ezetimibe.

The co-primary efficacy outcomes are based on the time to the first occurrence of any component of 3P-MACE (composite of CV death, nonfatal MI, or nonfatal IS) and time to occurrence of CV death over 5 years.

Perspectives/conclusion

The SIRIUS in-silico trial programme will provide early insights regarding potential effect of inclisiran on MACE in ASCVD patients, several years before the availability of the results from ongoing CV outcomes trials (ORION-4 and VICTORION-2-P).

Clinical trial registration

Clinicaltrials.gov identifier: NCT05974345
Genome-wide association studies from spoken phenotypic descriptions: a proof of concept from maize field studies
Authors: Yanarella Colleen F , Fattel Leila , Lawrence-Dill Carolyn J
Published: August 2024

We present a novel approach to genome-wide association studies (GWAS) by leveraging unstructured, spoken phenotypic descriptions to identify genomic regions associated with maize traits. Utilizing the Wisconsin Diversity panel, we collected spoken descriptions of Zea mays ssp. mays traits, converting these qualitative observations into quantitative data amenable to GWAS analysis. First, we determined that visually striking phenotypes could be detected from unstructured spoken phenotypic descriptions. Next, we developed two methods to process the same descriptions to derive the trait plant height, a well-characterized phenotypic feature in maize: (1) a semantic similarity metric that assigns a score based on the resemblance of each observation to the concept of ‘tallness’ and (2) a manual scoring system that categorizes and assigns values to phrases related to plant height. Our analysis successfully corroborated known genomic associations and uncovered novel candidate genes potentially linked to plant height. Some of these genes are associated with gene ontology terms that suggest a plausible involvement in determining plant stature. This proof-of-concept demonstrates the viability of spoken phenotypic descriptions in GWAS and introduces a scalable framework for incorporating unstructured language data into genetic association studies. This methodology has the potential not only to enrich the phenotypic data used in GWAS and to enhance the discovery of genetic elements linked to complex traits but also to expand the repertoire of phenotype data collection methods available for use in the field environment.
Chromosome-Scale Assembly and Annotation of Eight Arabidopsis thaliana Ecotypes
Authors: Kileeg Zachary , Wang Pauline , Mott G Adam
Published: August 2024

The plant Arabidopsis thaliana is a model system used by researchers through much of plant research. Recent efforts have focused on discovering the genomic variation found in naturally occurring ecotypes isolated from around the world. These ecotypes have come from diverse climates and therefore have faced and adapted to a variety of abiotic and biotic stressors. The sequencing and comparative analysis of these genomes can offer insight into the adaptive strategies of plants. While there are a large number of ecotype genome sequences available, the majority were created using short-read technology. Mapping of short-reads containing structural variation to a reference genome bereft of that variation leads to incorrect mapping of those reads, resulting in a loss of genetic information and introduction of false heterozygosity. For this reason, long-read de novo sequencing of genomes is required to resolve structural variation events. In this article, we sequenced the genomes of eight natural variants of A. thaliana using nanopore sequencing. This resulted in highly contiguous assemblies with >95% of the genome contained within five contigs. The sequencing results from this study include five ecotypes from relict and African populations, an area of untapped genetic diversity. With this study, we increase the knowledge of diversity we have across A. thaliana ecotypes and contribute to ongoing production of an A. thaliana pan-genome.
Effect of Soundscape Augmentation on Behavioral Symptoms in People With Dementia: A Pilot Randomized Controlled Trial
Authors: Talebzadeh Arezoo , Botteldooren Dick , Thomas Pieter , Stewart Steven , Van de Velde Dominique , De Vriendt Patricia , Devos Paul , Iaboni Andrea
Published: August 2024

Background and Objectives

Sound is an important environmental factor that influences the expression of behavioral and psychological symptoms of dementia. Recent research on the effect of soundscape has shown promising results in improving environmental impact on people with dementia. However, no controlled studies have aimed to quantify the effects of soundscape intervention on resident outcomes. The aim of this study was to assess the feasibility and impact of a soundscape intervention on people with dementia and behavioral symptoms.

Research Design and Methods

Pilot single-blind repeated-measures randomized controlled trial of an augmented soundscape intervention. Participants were people with dementia in a hospital-based specialized dementia unit. Participants were randomized to an augmented soundscape intervention delivered in their room in the morning and evening or treatment as usual, with 2 baseline weeks and 4 weekly post-randomization assessments of the primary and secondary behavioral outcomes.

Results

The soundscape intervention was feasible in terms of recruitment, retention, and delivery of the intervention. There were improvements in the neuropsychiatric inventory total scores over time in both groups (−5.89, 95%CI −8.45 to −3.28, p < .001), but no differences between groups. There were no significant group, time, or group × time differences for the Pittsburgh Agitation Scale (PAS) total score. For the PAS-resisting care subscale, there was a significant group × time difference, with a greater reduction in the soundscape group over the study period (−0.81, 95% CI −1.59 to −0.03, p = .042).

Discussion and Implications

In this pilot study, soundscape augmentation was a feasible and effective nonpharmacological approach to reducing resistance to care in people with dementia, although it did not improve neuropsychiatric symptoms more globally. Further studies with larger samples and of longer duration are needed to investigate the long-term effects of augmented sonic environments on people with dementia.

Clinical Trials Registration Number

NCT04809545
MOBFinder: a tool for mobilization typing of plasmid metagenomic fragments based on a language model
Authors: Feng Tao , Wu Shufang , Zhou Hongwei , Fang Zhencheng
Published: August 2024

Background

Mobilization typing (MOB) is a classification scheme for plasmid genomes based on their relaxase gene. The host ranges of plasmids of different MOB categories are diverse, and MOB is crucial for investigating plasmid mobilization, especially the transmission of resistance genes and virulence factors. However, MOB typing of plasmid metagenomic data is challenging due to the highly fragmented characteristics of metagenomic contigs.

Results

We developed MOBFinder, an 11-class classifier, for categorizing plasmid fragments into 10 MOB types and a nonmobilizable category. We first performed MOB typing to classify complete plasmid genomes according to relaxase information and then constructed an artificial benchmark dataset of plasmid metagenomic fragments (PMFs) from those complete plasmid genomes whose MOB types are well annotated. Next, based on natural language models, we used word vectors to characterize the PMFs. Several random forest classification models were trained and integrated to predict fragments of different lengths. Evaluating the tool using the benchmark dataset, we found that MOBFinder outperforms previous tools such as MOBscan and MOB-suite, with an overall accuracy approximately 59% higher than that of MOB-suite. Moreover, the balanced accuracy, harmonic mean, and F1-score reached up to 99% for some MOB types. When applied to a cohort of patients with type 2 diabetes (T2D), MOBFinder offered insights suggesting that the MOBF type plasmid, which is widely present in Escherichia and Klebsiella, and the MOBQ type plasmid might accelerate antibiotic resistance transmission in patients with T2D.

Conclusions

To the best of our knowledge, MOBFinder is the first tool for MOB typing of PMFs. The tool is freely available at https://github.com/FengTaoSMU/MOBFinder.
CAT: a computational anatomy toolbox for the analysis of structural MRI data
Authors: Gaser Christian , Dahnke Robert , Thompson Paul M , Kurth Florian , Luders Eileen , the Alzheimer's Disease Neuroimaging Initiative
Published: August 2024

A large range of sophisticated brain image analysis tools have been developed by the neuroscience community, greatly advancing the field of human brain mapping. Here we introduce the Computational Anatomy Toolbox (CAT)—a powerful suite of tools for brain morphometric analyses with an intuitive graphical user interface but also usable as a shell script. CAT is suitable for beginners, casual users, experts, and developers alike, providing a comprehensive set of analysis options, workflows, and integrated pipelines. The available analysis streams—illustrated on an example dataset—allow for voxel-based, surface-based, and region-based morphometric analyses. Notably, CAT incorporates multiple quality control options and covers the entire analysis workflow, including the preprocessing of cross-sectional and longitudinal data, statistical analysis, and the visualization of results. The overarching aim of this article is to provide a complete description and evaluation of CAT while offering a citable standard for the neuroscience community.
Growing divergence between Medicare Advantage plan bids and payments to plans
Authors: McCormack Grace , Trish Erin
Published: August 2024

As the Medicare Advantage (MA) program grows in enrollment and costs, there has been increasing concern that federal payments to MA plans exceed necessary levels. Estimates suggest that, in 2023, MA plans were paid up to 6% more per enrollee than would have been spent had that beneficiary instead enrolled in traditional Medicare (TM). We evaluated the factors driving this overpayment, characterizing trends in MA benchmarks, bids, and total payments from pre-Affordable Care Act (pre-ACA) levels through 2023. We found that, despite an overall decrease in risk-adjusted bids relative to average risk-adjusted TM enrollee costs, total payments to plans have modestly increased since 2015. Decomposing these trends into various factors in the MA payment formula, we found that divergent trends in benchmarks and bids are, in part, due to the increasing influence of payment adjustments, such as quartile spending adjustments, quality bonus payments, and risk adjustment. Our results suggest that current payment rules have contributed to overpayments and policy reform may be necessary.
The statement of profit or loss
Authors: Scott Peter
Published: August 2024

This chapter looks at the statement of profit and loss, the main source of information about an entity’s financial performance for the accounting year. Income and expenses are defined and the various categories of income and expenditure are presented. Various accounting conventions that are applied in the determination of income and expense for a period are also discussed and illustrated. The chapter demonstrates the preparation of the statement of profit or loss for an accounting period together with the statement of financial position.
The statement of cash flows
Authors: Scott Peter
Published: August 2024

This chapter considers the statement of cash flows, which presents users of financial information with details of cash inflows and outflows for an accounting period. It shows how the statement of cash flows links together the statement of profit or loss and the statement of financial position. It demonstrates the changes in an entity’s financial position over each accounting period arising from cash flows from operating, investing and financing activities. In addition, it covers the preparation of simple statements of cash flows using both the direct and indirect methods. Other topics covered include the accounting conventions applied and an illustration of how profit does not equal cash.
Human Resource Management
Authors: Berrington Catherine , Macdonald Emma
Published: August 2024

This chapter focuses on human resource management (HRM). It explains that key activity of management is managing individual human beings and the various groupings of people that make up organizations and its culture. Thus, HRM comprises all the activities associated with managing employment relationships in an organization. To fully understand an HRM system, competitors would need to understand the culture in the organization, the power dynamics in place, and how employees feel about their organization. The chapter considers the best practice approaches to HRM, and it examines the features and advantages of the situational contingency model and the high-commitment model.
Change, culture, and organizational structure
Authors: Gillespie Andrew
Published: August 2024

This chapter examines the interplay of change, culture, and organizational structure. The change will happen and it will create opportunities and threats, so businesses must explore the opportunity of change and mitigate the risks in order to be successful. The chapter then focuses on the key concept of organizational culture, which refers to the values, attitudes, and beliefs of the employees in a business and how they behave. Meanwhile, the structure of an organization can affect many aspects of business performance, such as its costs and speed of decision-making. The chapter also mentions that a level of hierarchy is a level of management responsibility.
An Overview of Biochemistry
Authors: Fahrenbach Albert C. , Cleaves Henderson J.
Published: August 2024

Extant life may be a useful guide to understand the origins of life. However, like any extant system that has an evolutionary history, how it came into existence may be convoluted, and some information about previous states may be lost.

A good example is language....
Respiration and Lipid Metabolism
Authors: Taiz Lincoln , Møller Ian Max , Murphy Angus , Peer Wendy A.
Published: August 2024

This chapter reviews plant respiration and lipid metabolism. Aerobic respiration is the biological process by which reduced organic compounds are oxidized in a controlled manner. The chapter looks at respiration in its metabolic context, emphasizing the interconnections among the processes involved and the special features that are peculiar to plants. It also relates respiration to recent developments in the understanding of the biochemistry and molecular biology of plant mitochondria and respiratory fluxes in intact plant tissues. The chapter then describes the pathways of lipid biosynthesis that lead to the accumulation of fats and oils, which many plant species use for energy and carbon storage. Finally, it discusses the catabolic pathways involved in the breakdown of lipids and the conversion of their degradation products into sugars that occurs during the germination of fat-storing seeds.
Animal Cognition
Authors: Nordell Shawn E. , Valone Thomas J.
Published: August 2024

This chapter explores contemporary animal cognition. The chapter opens with an examination of different methods used to characterize the cognitive abilities of animals. It goes on to discuss the positive associations between cognitive ability and fitness as well as the association between cognition and brain size. Large brains are energetically costly to maintain, and so to understand their evolution there is a need to examine the kinds of conditions that can favor their evolution and the enhanced cognitive ability associated with them. In the final two sections, the chapter examines how environmental and social challenges can influence the evolution of cognition.
Clinical cardiovascular disease
Authors: Blann Andrew
Published: August 2024

This chapter details the clinical aspects of the risk factors for cardiovascular disease (CVD). It explores the clinical consequences of disease processes in the heart, brain, and peripheral arteries of the abdomen, leg, and elsewhere. Similar to cancer, CVD is a large and complex group of conditions with a variety of aetiologies, many of which overlap. The chapter then discusses the presentation, diagnosis, and management of the major types of coronary artery disease before considering other forms of heart disease, such as valve disease, cardiomyopathy, arrhythmia, and heart failure. It also considers types of peripheral artery disease and the key clinical features of stroke and atrial fibrillation.
Blood and its diseases
Authors: Blann Andrew
Published: August 2024

This chapter looks at blood and its diseases. Blood is an organ linked directly to all other tissues and organs via the vascular system and is composed of three different types of cells: red cells, white cells, and platelets. The chapter then details the role of the haematology laboratory, which offers a comprehensive panel of tests and procedures of great significance to the diagnosis and management of many diseases. It discusses the aetiology, presentation, and treatment of blood cancer, anaemia, and disorders of haemostasis. Finally, the chapter looks at the consequences of haemochromatosis, which is caused by hereditary haemochromatosis (HH) or blood transfusions. It also considers how blood transfusions damage organs such as the liver, heart, and pituitary.
Cells, genomes, and cancer
Authors: Divan Aysha , Royds Janice
Published: August 2024

This chapter provides an overview of key concepts which can be correlated with cancer. It discusses the scientific knowledge and understanding of cancer have changed over time. Moreover, cancer is not a single disease. The different forms of cancers are divided into carcinoma, sarcoma, leukaemia, and lymphoma. These are four main classes according to the cell type and origin. The chapter explains that cancer occurs when tightly regulated processes, like cell division, break down. It also explains that cancers arise as a result of mutations in two key classes of genes: the protooncogenes and the tumour suppressor genes.
Sustainable Solutions
Authors: Niesenbaum Richard
Published: August 2024

Sustainable Solutions: Problems for Solving Future Generations offers a problem-solving and solutions-based approach to teaching sustainability. The first part presents an introduction to sustainability and an outline of the problems we need to solve. The next part is about the earth as a resource and focuses particularly on air, water, food, natural resources, fossil fuels, and waste. The third part of the book is about integrating sustainable solutions at different levels of organization. It looks at what we can do as individuals, the part education can play, and how communities and regions can act. The last chapter looks at the future of sustainability.
Water: Using our Planet to Quench our Thirst
Authors: Niesenbaum Richard
Published: August 2024

This chapter looks into the sustainability of water as a resource. Water is considered a renewable resource, but rates of depletion often exceed rates of renewal. Tis is due to overexploitation and contamination. Access to water is becoming limited as a result of overdepletion, pollution, and other forces. Thus, human activity has threatened aquatic ecosystems and the services they perform. The chapter then examines how by 2050, national, international, and global policies, innovation and technology, and ecological approaches can serve as solutions to the global water crisis. It also looks at issues related to clean water, sanitation, and hygiene (WASH) following problems with public health in developing countries.
Organizations, Institutions, and Sustainability
Authors: Niesenbaum Richard
Published: August 2024

This chapter discusses the non-governmental institutions' potential to contribute to a broader sustainability transformation. The assessment of an organization or an institution's sustainability can be assessed in terms of both its survivorship and its ability to further sustainability objectives. To further sustainability objectives, organizations and institutions can design or change their infrastructure and operations which will minimize their negative impact on the environmental, economic, and social spheres of sustainability. The chapter next focuses on institutions of education and business to highlight their contribution to sustainability objectives. It also mentions that institutions such as government, religion, and healthcare have a major role to play in working toward a sustainable future through operations, policy, and activism.
Sustainable Development and Global Sustainability
Authors: Niesenbaum Richard
Published: August 2024

This chapter tackles the development of sustainability on a global level. It considers global climate change in relation to global sustainability by examining challenges and progress in dealing with it. The ultimate limitations to sustainable development are greed and the current growth paradigm. Central to sustainable development is the creation of equitable economic opportunity that offers all people the capacity to meet their own needs. The chapter identifies the major players in sustainable development including the UN and the International Institute for Sustainable Development, while some of the major programs in sustainable development include the UN's MDG and SDG programs.
Acids and bases
Authors: Madden Judith
Published: August 2024

This chapter describes the key concepts of acids and bases in correlation with appropriate dosage forms. An understanding of acidic and basic behaviour is significant for understanding how active pharmaceutical ingredients (APIs) will behave before, and following, administration to a patient. Moreover, the strength of acids and bases is determined by their structure and the solvent environment. Meanwhile, an ideal dosage form ensures that the API remains stable in storage for as long as reasonably practicable. The chapter also considers the significance of buffers in physiological systems and in chemical applications. These are used to maintain pH levels at the required value.
Hydrophobicity and partitioning
Authors: McAuley William
Published: August 2024

This chapter looks at the importance of hydrophobicity and partitioning. It notes that the hydrophobicity of a drug molecule is important for a wide range of situations in relation to pharmaceutical products. The hydrophobicity of active pharmaceutical ingredients (APIs) has an influence on various pharmaceutically relevant phenomena, including solubility and interactions with packaging. Partitioning is an example of a phase transition and it occurs when an API distributes itself between two immiscible liquids. The chapter also looks into the differences between the distribution coefficient and the partition coefficient, which has a wide application in pharmaceutical sciences, such as drug delivery, formulation, and packaging.
Drug discovery, development, and delivery
Authors: Russell Craig A. , Mohammed Afzal R.
Published: August 2024

This chapter provides an overview of drug discovery, development. It looks at delivery as an important area of the pharmaceutical industry. In rational drug design, candidate compounds are identified by studying the biological and physical properties of the therapeutic target. The chapter then discusses the optimization of lead compounds, which is the candidate compound considered to be the best prospect. Quantitative structure-activity relationships (QSAR) refer to mathematical models based on chemical compounds' biological activity and physicochemical descriptors. The chapter also looks into the correlation between routes of administration and associated dosage forms before the four phases involved in clinical trials of new medications.
Anarchy as Architect: Competitive Pressure, Technology, and the Internal Structure of States
Authors: MacInnes Morgan , Garfinkel Ben , Dafoe Allan
Published: August 2024

The internal institutional structures of states greatly impact their citizens’ welfare. However, states are not at complete liberty to adopt any internal form. Competitive pressure arising from anarchy limits the range of viable domestic institutions to those that do not impose a significant disadvantage. We argue that technological change can alter the relative competitiveness of different state forms and, by extension, improve or degrade human welfare. We empirically support this argument through a macrohistorical survey of competitively significant technologies. We conclude that the true costs of international anarchy are greater than commonly appreciated, as competitive pressure may force states to evolve into forms detrimental to the welfare of their inhabitants. Moreover, the adoption of state forms that improve human well-being is often driven by technological change as much as human agency. Finally, the invention of seemingly beneficial technologies may decrease human well-being by improving the competitiveness of inegalitarian state forms.
Promoting antifungal stewardship through an antifungal multidisciplinary team in a paediatric and adult tertiary centre in the UK
Authors: Soni Shuchita , Hettle David , Hutchings Stephanie , Wade Susan , Forrest-Jones Kate , Sequeiros Iara , Borman Andrew , Johnson Elizabeth M , Harding Irasha
Published: August 2024

Background

Invasive fungal infections (IFIs) present significant challenges, especially among immunocompromised patients, with associated high morbidity, mortality and significant economic impact. Diagnostic difficulties and the emergence of antifungal resistance necessitates enhanced antifungal stewardship (AFS) efforts.

Methods

We report outcomes from a review of our multidisciplinary approach to AFS, based in a 1300-bed teaching hospital in the South-West of England. Retrospectively reviewing all adult and paediatric cases over 12 months in 2022, we investigated demographics, diagnosis, antifungal therapy and adherence to AFS advice, including clinical, mycological, financial and teamwork metrics. Data were extracted from our AFS database, supported by pharmacy records.

Results

The AFS multidisciplinary team (MDT) reviewed 111 patients, with 30 day and 1 year mortality of 22.7% and 35.4%, respectively. IFIs classified as proven accounted for 26%, with fungal pathogens identified in 36.3% of cases. Antifungal consumption (by 25.1%) and expenditure (by 59.9%) decreased from 2018 to 2022. The AFS MDT issued 324 recommendations, with a 93% acceptance rate.

Conclusions

Our approach to AFS, centred around a weekly MDT, demonstrated improvements in IFI management, antifungal consumption and cost-efficiency. This single-centre study highlights the value of a comprehensive, collaborative approach to AFS involving experts in mycology, infection, radiology, antifungal therapies and clinical teams. The programme’s success in paediatric and adult populations and the near-universal acceptance of its recommendations show its potential as a model for replication. It represents a model for enhancing patient care and AFS practices, with future directions aimed at expanding service reach and the integration of further rapid diagnostic modalities.
Ceftriaxone-resistant viridans streptococci bacteraemia among patients treated at a large comprehensive cancer care centre: a retrospective eighteen-year study
Authors: Marsland Paula , Jain Rupali , Tverdek Frank , Hendrie Paul , Liu Catherine , Pergam Steven A , Bourassa Lori
Published: August 2024

Objectives

Viridans streptococci (VS) are opportunistic oral commensals and a common cause of bacteraemia in neutropenic patients. In this retrospective single centre cohort study, we investigated the prevalence of ceftriaxone resistance in VS (CRO-R VS) blood isolates between January 2005 and December 2022 from patients treated at a tertiary care hospital.

Methods

Blood culture isolates were identified using biochemicals and mass spectrometry. Susceptibility testing was performed by Kirby–Bauer and Epsilometer tests. Demographic data, clinical outcomes and antimicrobial use were assessed through electronic medical record review.

Results

Among 791 patients with VS bacteraemia, 31 (4%) had confirmed CRO-R VS bacteraemia over the 18-year period; 20/31 (65%) were patients also treated at the Fred Hutchinson Cancer Center and were the focus of this study. Of these 20 patients, 18 (90%) had a known haematologic malignancy; 14 (70%) had undergone haematopoietic cell transplant (HCT); 18 (90%) were neutropenic at the time of culture. Two (10%) patients died within 30 days of CRO-R VS bacteraemia. All the CRO-R isolates (20/20) were members of the Streptococcus mitis group, 12 were multi-drug resistant; all were susceptible to vancomycin. Most patients received vancomycin once blood cultures were positive for a Gram-positive organism.

Conclusions

During the study period, the frequency of VS isolate susceptibility testing increased; however, there was no concomitant increase in the percentage of CRO-R isolates at our facility. These data are important in an era where cefepime monotherapy is often used and reinforces the importance of routine resistance testing among VS bacteraemia.