bluuebunny/crossref_metadata_2025 huggingface dataset:
Employment profiles of autistic people: An 8-year longitudinal study
Authors: Bury Simon M , Hedley Darren , Uljarević Mirko , Li Xia , Stokes Mark A , Begeer Sander
Published: January 2024

Autistic adults experience high rates of unemployment, yet research investigating what predicts employment success produces inconsistent results. By utilising longitudinal person-oriented analyses, this study aimed to identify employment trajectories of autistic adults to better understand what may predict stable autistic employment. Participants were 2449 autistic adults (1077 men, 1352 women, 20 non-binary, M  = 42.25 years, SD = 14.24), recruited via the Netherlands Autism Register. Latent class analysis utilising employment status across eight annual waves was used to identify longitudinal employment profiles. Fit indices and the interpretability of results indicated a four-class model best fit the data, with profiles reflecting stable unemployment ( n = 1189), stable employment ( n = 801), early unemployment increasing in probability of employment ( n = 183) and high probability of employment reducing across time to low employment ( n = 134). Multinominal analyses suggested that compared to the ‘stable unemployment’ group, membership in the ‘stable employment’ profile was predicted by fewer autistic traits, lower age, male gender, higher education and diagnosis age, and fewer co-occurring conditions. Higher education predicted both other profiles, with lower age and fewer co-occurring conditions predicting membership in the increasing employment class. Taken together, findings highlight the utility of person-oriented approaches in understanding the longitudinal challenges autistic adults experience maintaining employment and identifies key areas of support.

Lay abstract

Autistic adults experience difficulties finding and keeping employment. However, research investigating reasons that might explain this difficulty produce mixed results. We gave a survey to 2449 autistic adults and used a statistic method to group them based on their employment status over 8 years. We identified four employment groups that best captured the experiences of autistic adults; this included a group that experienced stable unemployment, a group that experienced stable employment, a group that had high employment that reduced over time, and a group whose employment increased over the 8 years. Further analysis showed that those with fewer autistic traits, younger age, male gender, higher education, later diagnosis age and no co-occurring conditions were more likely to have stable employment. People whose employment changed over time were more likely to have a higher level of education than the stable unemployment group, and those in the increasing employment group were younger age and had no co-occurring conditions. These findings help us better understand that not all autistic adults’ experiences of employment are the same, which helps focus where employment programmes and support may be most needed, for example, people who identify as women or have a co-occurring condition.
Public inquiries into conflict and security: Scandals, archives, and the politics of epistemology
Authors: Thomas Owen D , Tudor Margot , Pennell Catriona
Published: January 2024

Public inquiries into matters of conflict and security are vitally important yet undertheorised. This article explores the potential of inquiries for the democratic scrutiny of foreign policy, military doctrine, and grand strategy. In recent decades, there have been numerous inquiries into contentious foreign and security policy incidents in Britain, a trend reflected elsewhere in global politics. Inquiries can unveil facts, identify lessons, and rebuild trust. But critics claim that inquiries overlook systemic flaws. Our analysis transcends the usual arguments for or against public inquiries by explaining how inquiries produce knowledge and how this could be improved. We argue that inquiries necessarily involve the following three distinct processes: scandalisation, archivisation, and epistemology. We suggest how future inquiries could overcome extant limitations through a broader scope, diversification of evidence, and methodological pluralism. Such inquiries can play an improved role in promoting reflection and dialogue about a just international order and Britain’s role within it.
A novel graph structure data-driven crack damage identification for compressor blade based on vibro-acoustic signal
Authors: Ding Peng , Song Di , Shen Junxian , Zhao Xiaoli , Jia Minping
Published: January 2024

The evolution of advanced sensing techniques and intelligent algorithms has significantly underpinned the growth of structural health monitoring and damage identification. Modern industry equipment like compressors, which are indispensable to the petrochemical and other process industries, usually operate under complex conditions including variable speed. The more vulnerable compressor components, such as the blades, are prone to diverse levels of damage over time. Existing research usually discusses the damage identification problem of blades under the Euclidean space, facing challenges in linking multi-source heterogeneous signals. This study introduces a novel approach, employing a graph-structured data-based method for identifying compressor blade cracks. It specifically focuses on variable rotating speed conditions, subsequently proposing an intelligent identification framework based on vibro-acoustic graph-structured data. Firstly, the affinity graphs made of vibro-acoustic damage signal are constructed to express the latent damage information beyond Euclidean space after Fourier transform and residual learning-based feature extraction for one-dimensional data. Then the developed multi-order graph convolutional network and domain discriminator layers are used to extract the domain-invariant damage features, which will be fed into the linear layer for class prediction. Finally, the method's efficacy is cross-verified through experiments with actual measurements on a compressor platform, specifically focusing on variable rotating speed cases.
Research note: Red light to mitigate light pollution: Is it possible to balance functionality and ecological impact?
Authors: Durmus D , Jägerbrand AK , Tengelin MN
Published: January 2024

The widespread use of electric lighting has revolutionised society but brought unintended consequences, notably light pollution, impacting ecosystems and human circadian rhythms. Concerns about anthropogenic light at night (ALAN) have prompted innovative solutions, such as spectral tuning of light sources. In Europe, a recent focus involves the enforcement of red light in outdoor settings to minimise ALAN’s impact, particularly on bats. This mini review synthesises literature to provide an overview of the advantages and disadvantages of the use of red light outdoors. There is a need for further examination of the potential ecological consequences of red light, considering challenges in lighting design functionality and broader impacts on diverse species.
Assessing the Performance of a Nutrition Knowledge Questionnaire With a Low Socioeconomic Status Population Using Rasch Analysis
Authors: Huye Holly F. , Paprzycki Peter , Connell Carol L.
Published: January 2024

Parents and preschool teachers play a key role in shaping children’s dietary behaviors. Knowledge of nutrition and healthy dietary choices is a key component to improve dietary habits and reduce the prevalence of obesity and associated co-morbidities. Using valid and reliable instruments is necessary for accurate assessment of knowledge to tailor interventions and measure effectiveness specific to the population of interest. The objectives of this paper are to (1) identify potential gaps in the baseline nutrition knowledge among parents and teachers using a previously validated questionnaire prior to a preschool obesity prevention intervention; and (2) assess the instrument’s reliability and construct validity for a low socioeconomic status population using a post hoc Rasch analysis. Participants included 177 parents and 75 teachers who participated in a Head Start intervention study. Knowledge scores, instrument reliability, and item fit and difficulty were assessed using a Rasch analysis; t-tests were used to determine differences in scores between parents and teachers. Parents answered 38% of questions correctly while teachers correctly answered 46% of the questions. Adequate item fit and reliability were indicated for Sections 1 and 2 of the Nutrition Knowledge Questionnaire (NKQ). Section 3 demonstrated less adequate reliability. The items were found to adequately and reliably define the unidimensional measures of the three components of knowledge represented in this instrument, providing evidence of construct validity. However, Rasch measures indicated the NKQ overall was difficult for participants. Recommendations for improving the instrument for nutrition education/intervention and research practice areas related to obesity and obesity-related conditions are addressed.
The Privilege of Control and the Constraint of Presence: Fieldwork and Ontologies of Time
Authors: Senda-Cook Samantha
Published: January 2024

The Asian Rural Institute (ARI)—a Christian, sustainable, nonprofit farm in Tochigi, Japan—keeps a strict schedule to ensure equality in job distribution and duration. Staff, participants, and volunteers must relinquish some control over their time and be present to do this work, two conditions that illuminate the privilege that many scholars have in their daily lives. As qualitative researcher, I was aware of some privileges that I brought with me but had not considered control over my work schedule one of them, until I was volunteering and researching at ARI. Implied in scholars’ work schedules are time ontologies, which are culturally and contextually specific. Time is both material and conceptual, meaning that although a day has a fixed length (a material condition), the way that we break up the day into hours and regions of the world into time zones, for example, is a product of thought and communication. With abstraction and standardization come issues of power and control. For researchers who work with communities in the field, it is worth considering time’s complexities to help navigate issues, such as power, ethics, relationships, research sites, and trust.
Stitching Narratives: Poetic Autoethnography of Black Women’s Mentorship in Academia
Authors: Watson Venus Trevae , Smith Felicia A. , Gooden Chalandra
Published: January 2024

This study utilizes collaborative poetic autoethnography to explore the mentorship experiences of three Black women doctoral students at predominantly White institutions (PWIs). Through a series of poems, the research illustrates the nuanced challenges and resilience in seeking guidance within spaces that often marginalize their voices. This writing centers intersectionality as a theoretical framework, illuminating the complex dynamics of identity as they intersect with academia. The poetic narratives serve as a way for expressing the lived realities of these students, highlighting the lack of Black women mentors and the consequent need to navigate a system not built with them in mind. The study calls for a reimagined mentorship that is acutely responsive to the multifaceted identities of Black women in academia, advocating for increased representation and intentional support.
Implementation of Virtual Integrative Oncology Shared Medical Appointment Series (VIOSMAS) Within Mixed Diagnosis Population
Authors: Loy Michelle H. , Prisco Lauren , Parikh Chiti
Published: January 2024

Background:

Integrative oncology [IO] is sought-after by patients, endorsed by clinical guidelines, and valued within National Cancer Institute Centers. Shared Medical Appointments [SMA] leverage health education and social connection to deliver enhanced patient experience, population health, cost-reduction, and clinician well-being. Integrative Oncology Shared Medical Appointments increase access to integrative medicine but delivering these services via telehealth have not been evaluated.

Objective:

We created, and pilot tested a Virtual Integrative Oncology Shared Medical Appointment Series (VIOSMAS) to assess its feasibility, acceptability, and efficacy at an urban academic teaching hospital.

Methods:

The 7-session hour-long Living Well with and after Cancer series included didactics, multi-disciplinary experiential sessions, and group discussion. Topics included (1) Introduction, (2) Herbs/Botanicals/Fungi, (3) Mindful Movement, (4) Acupuncture, (5) Narratives and Nature, (6) Diet and Culinary Medicine, and (7) Vitamins/Supplements. Virtual visits via telehealth were offered to enhance patient participation during the pandemic. Outcome measures included recruitment, retention, pre/post-series patient survey and qualitative clinician feedback.

Results:

Between 9/2021 and 4/2023, 72 unique patients were recruited to 5 cohorts and had a total of 332 VIOSMAS visits. A total of 50 patients (69%) attended 4 or more of the 7-session series; 60 (83% were women); patients ranged in age from 28 to 93 years (median 66); 36 (50%) lived outside the city center; the most common cancer diagnoses were breast, lymphoma, and lung cancer. Patients were from diverse demographics. Pre-program, patients reported desiring assistance in addressing diverse symptoms including fatigue, insomnia, pain, gastrointestinal (GI) symptoms, anxiety, and depression. Post-series, patients reported that the VIOSMAS addressed their goals and symptoms; they also reported incorporating recommended lifestyle changes in diet, exercise, sleep, and stress management; they were satisfied with the number of sessions and telehealth format. The participating clinicians reported high levels of satisfaction with VIOSMAS. Revenue to the institution from VIOSMAS exceeded the revenue potential of equivalent time spent for individual visits while supporting extended physician-patient contact.

Conclusion:

VIOSMAS is feasible for patients and clinicians, addresses patients’ symptoms and questions about lifestyle and complementary therapies, and generates more revenue than individual visits. Larger implementation trials with appropriate comparison groups are recommended.
The Music Education Legacy of William Frederick Cardin, or Pejawah: ‘A Language All America Should Know’
Authors: Brumbach Glen A. , Brumbach Andrea C.
Published: January 2024

William Frederick (“Fred”) Cardin served as a director of instrumental music in the Reading, Pennsylvania, School District from 1930 until his retirement in June 1960. An accomplished performer and composer, Cardin studied at the Curtis School of Music and the Conservatoire Américaine in Paris, France. He is remembered as an outstanding educator and conductor both in the public schools and with community organizations. Cardin was also known as Pejawah, his Native American name. To gain further insight regarding Cardin’s musical legacy and how it reflects his heritage, interviews were conducted with former students and colleagues. Additional artifacts were collected pertaining to his education, influences, and accomplishments. Cardin pursued a focused mission through compositions and performances to promote Native American music and culture while also demonstrating aptitude in music composition, performance, and conducting. Cardin is one individual who pursued a successful career in music and music education while navigating the issues of racial discrimination.
Professional Development with Emailed Practice-Based Feedback to Support Teacher-Led Inclusive Small Group Literacy Instruction
Authors: Toews Samantha Gross , Kurth Jennifer A. , Zimmerman Kathleen N. , Mansouri Mary K. , Lockman Turner Elissa , Crump Nicole
Published: January 2024

This study investigates the impact of in-person professional development (PD) with ongoing emailed practice-based feedback (EPF) on teacher correct implementation of a multicomponent shared reading intervention for students with extensive support needs (ESN) embedded within general education (GE) instruction within three multiple baseline across skills designs. Skills within the shared reading intervention included (a) student engagement, reinforcement, and redirection, (b) planned questioning with wait time and error correction, and (c) in the moment data collection. A functional relation between PD with EPF package and teacher correct implementation of the multicomponent shared reading intervention was established for all three teachers. Teachers reported the experience was positive and felt comfortable delivering the small group shared reading intervention. No negative impact on student comprehension occurred. Findings show general and special educators can embed individualized shared reading using modified grade-level books and collect data on literacy skills for students with ESN in GE instruction with fidelity. This successfully implemented specialized instruction and data collection on the individualized educational goals of students with ESN provides more evidence that GE settings are an effective location for individualized service delivery and progress monitoring. Further implications for research and practice are shared.
Not Automation Failures, but Automation Interface Failures
Authors: Mumaw Randall J.
Published: January 2024

While there is value in thinking about forms of automation failure, the primary role of human factors is to specify how the interface conveys automation state and behavior: when the automation fails and when the automation “performs as designed” but still results in safety events. How do we make automation an effective crewmember? I describe what the flightcrew, ideally, should understand about autoflight state or behavior, using aviation examples to illustrate how that information was not successfully conveyed to the flightcrew, leaving the flightcrew with an incomplete and/or incorrect understanding. Specifically, the interface needs to address automation state, its current targets or objectives, its limitations in achieving those targets, whether it is approaching an operational boundary, data validity, broader checks on what is operationally reasonable, and how to intervene.
Partially Lacerated Digital Flexor Tendons: A Cadaveric Study Determining the Intact Cross-sectional Area and Biomechanical Analysis
Authors: Hui-Ying Kang Gavrielle , Wong Yoke-Rung , LiYu Toh Alyssa , Yong Fok-Chuan
Published: January 2024

Background:

The extent of injury in partially lacerated tendons has conventionally been expressed as a percentage of the total tendon, to justify surgical repair. We propose a more objective method to estimate the cross-sectional area of the remnant intact tendon and to determine if the remaining tendon fibers can withstand the tensile forces of early active mobilization against resistance.

Methods:

The study was done on 20 cadaveric specimens, which were randomly assigned to receive a laceration of 25%, 50%, or 75% of the measured transverse tendon diameter. The circumference of the remaining intact portion of the partially lacerated tendon was measured and converted using a formula to determine the derived cross-sectional area (D-CSA). These D-CSA values were then validated by comparing them to digitally measured cross-sectional areas using a computer software program (computer-measured cross-sectional area, C-CSA). In addition, the ultimate tensile strength (UTS) of these partially lacerated tendons was analyzed to determine if a threshold exists beyond which surgical repair of a partially lacerated tendon is indicated.

Results:

We found that the D-CSAs matched moderately with C-CSAs, with 0.622 of Pearson correlation coefficient. The UTSs of tendons with CSAs above 8 mm in circumference were consistently above 150 N.

Conclusion:

Measurement of the circumference of the partially lacerated tendon to obtain the D-CSA could be an accurate and practical method to benchmark residual tendon strength in the management of partially lacerated tendons.
Current Evidence on Common Dietary Supplements for Sleep Quality
Authors: Esquivel Monica Kazlausky , Ghosn Brittany
Published: January 2024

Poor sleep quality impacts nearly 70 million adults in the United States, resulting in nearly 1 in 5 adults regularly utilizing some sleep aid, either prescription or over-the-counter. Common dietary supplements utilized to improve sleep quality include nitrates, melatonin, magnesium, zinc, vitamin D, and L-theanine. While underlying physiologic mechanisms support the potential impact these compounds have on sleep quality, evidence from clinical trials varies widely. Melatonin and magnesium are two of the more widely researched supplements, which have numerous studies, with conflicting results. Other compounds such as nitrates, zinc, vitamin D, and L-theanine are less supported. Additional research is needed in order to more appropriately recommend these dietary supplements for sleep improvements.
Statistical and practical considerations in planning and conduct of dose-optimization trials
Authors: Yuan Ying , Zhou Heng , Liu Suyu
Published: January 2024

The U.S. Food and Drug Administration launched Project Optimus with the aim of shifting the paradigm of dose-finding and selection toward identifying the optimal biological dose that offers the best balance between benefit and risk, rather than the maximum tolerated dose. However, achieving dose optimization is a challenging task that involves a variety of factors and is considerably more complicated than identifying the maximum tolerated dose, both in terms of design and implementation. This article provides a comprehensive review of various design strategies for dose-optimization trials, including phase 1/2 and 2/3 designs, and highlights their respective advantages and disadvantages. In addition, practical considerations for selecting an appropriate design and planning and executing the trial are discussed. The article also presents freely available software tools that can be utilized for designing and implementing dose-optimization trials. The approaches and their implementation are illustrated through real-world examples.
Adaptive Bayesian information borrowing methods for finding and optimizing subgroup-specific doses
Authors: Zhang Jingyi , Lin Ruitao , Chen Xin , Yan Fangrong
Published: January 2024

In precision oncology, integrating multiple cancer patient subgroups into a single master protocol allows for the simultaneous assessment of treatment effects in these subgroups and promotes the sharing of information between them, ultimately reducing sample sizes and costs and enhancing scientific validity. However, the safety and efficacy of these therapies may vary across different subgroups, resulting in heterogeneous outcomes. Therefore, identifying subgroup-specific optimal doses in early-phase clinical trials is crucial for the development of future trials. In this article, we review various innovative Bayesian information-borrowing strategies that aim to determine and optimize subgroup-specific doses. Specifically, we discuss Bayesian hierarchical modeling, Bayesian clustering, Bayesian model averaging or selection, pairwise borrowing, and other relevant approaches. By employing these Bayesian information-borrowing methods, investigators can gain a better understanding of the intricate relationships between dose, toxicity, and efficacy in each subgroup. This increased understanding significantly improves the chances of identifying an optimal dose tailored to each specific subgroup. Furthermore, we present several practical recommendations to guide the design of future early-phase oncology trials involving multiple subgroups when using the Bayesian information-borrowing methods.
The symbolic two-step method applied to cancer care delivery research: Safeguarding against designing an underpowered cluster randomized trial with a continuous outcome by accounting for the imprecision in the within- and between-center variation
Authors: Zahrieh David , Kandler Blaize W , Le-Rademacher Jennifer
Published: January 2024

Background:

Knowing the predictive factors of the variation in a center-level continuous outcome of interest is valuable in the design and analysis of parallel-arm cluster randomized trials. The symbolic two-step method for sample size planning that we present incorporates this knowledge while simultaneously accounting for patient-level characteristics. Our approach is illustrated through application to cluster randomized trials in cancer care delivery research. The required number of centers (clusters) depends on the between- and within-center variance; the within-center variance is a function of estimates obtained by regressing the log within-center variance on predictive factors. Obtaining accurate estimates of the components needed to characterize the within-center variation is challenging.

Methods:

Using our previously derived sample size formula, our objective in the current research is to directly account for the imprecision in these estimates, using a Bayesian approach, to safeguard against designing an underpowered study when using the symbolic two-step method. Using estimates of the required components, including the number of centers that contribute to those estimates, we make formal allowance for the imprecision in these estimates on which a sample size will be based.

Results:

The mean of the distribution for power is consistently smaller than the single point estimate that the sample size formula yields. The reduction in power is more pronounced in the presence of increased uncertainty about the estimates with the reduction becoming more attenuated with increased numbers of centers that contribute to the estimates.

Conclusions:

Accounting for imprecision in the estimates of the components required for sample size estimation using the symbolic two-step method in the design of a cluster randomized trial yields conservative estimates of power.
Joint optimization of maintenance and spares inventory policies for a series system with multiple voting subsystems supported by protective devices
Authors: Ning Ru , Wang Xiaoyue , Zhao Xian , Wang Siqi
Published: January 2024

The joint optimization of maintenance and spares inventory policies is a momentous topic in engineering domain due to its benefit for improving the system reliability. Equipping systems with protective devices is another effective way to enhance system reliability which has aroused the research interest of scholars in recent years. However, the joint optimization problem of maintenance and spare parts inventory for systems with protective devices has not been attached importance. Therefore, this paper develops a joint optimization model of maintenance and spares inventory strategies for a series system with multiple voting subsystems supported by protective devices. Internal degradation and external shocks are taken into consideration simultaneously to cause the deterioration of the system and devices. A limited number of repairmen is considered, and ( s, S) inventory policy is adopted for protective devices as well as each type of units. By applying the Markov process imbedding approach, system steady probability and relevant reliability probability indices including system availability, spares availability, and repairmen availability are obtained. The objective of developed joint optimization model is to derive the optimal repairmen allocation and spares inventory policies such that the system availability can be maximized while meeting the cost requirement. Finally, numerical examples based on the automobile engine system with cooling systems are presented to validate the superiority of the proposed joint policy of maintenance and spares inventory.
Memories in between: Daughters from the Chilean diaspora in Sweden speak about their mothers
Authors: de los Reyes Paulina , Mulinari Diana
Published: January 2024

While literature on memory and dictatorship in Latin America is extensive and narratives departing from the memories of children are evolving, the (gendered) intergenerational processes at the core of the experience of military terror, from the specific location of the diaspora, have so far been marginal in both research and in public debates. What is the language through which collective experiences of violence and political persecution are told to the next generation in diaspora contexts? What does it mean to articulate narratives from the dictatorship in Chile with memories emerging from the diaspora located in Sweden? This understanding is a vital point of departure in our study of young female adults whose parents came to Sweden after the Pinochet military takeover, a group that we here refer to as the daughters of the Chilean diaspora in Sweden.
Effect of altered gene expression in lipid metabolism on cognitive improvement in patients with Alzheimer’s dementia following fecal microbiota transplantation: a preliminary study
Authors: Kim Jun-Seob , Park Hyelim , Lee Jung-Hwan , Shin Jongbeom , Cha Boram , Kwon Kye Sook , Shin Yong Woon , Kim Yerim , Kim YeoJin , Bae Jong Seok , Lee Ju-Hun , Choi Seok-Jin , Kim Tae Jung , Ko Sang-Bae , Park Soo-Hyun
Published: January 2024

Background:

The brain–gut axis has emerged as a potential target in neurodegenerative diseases, including dementia, as individuals with dementia exhibit distinct gut microbiota compositions. Fecal microbiota transplantation (FMT), the transfer of fecal solution from a healthy donor to a patient, has shown promise in restoring homeostasis and cognitive enhancement.

Objective:

This study aimed to explore the effects of FMT on specific cognitive performance measures in Alzheimer’s dementia (AD) patients and investigate the relationship between cognition and the gut microbiota by evaluating changes in gene expression following FMT.

Methods:

Five AD patients underwent FMT, and their cognitive function [Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB)] was assessed before and after FMT. The patients’ fecal samples were analyzed with 16S rRNA to compare the composition of their gut microbiota. We also assessed modifications in the serum mRNA expression of patients’ genes related to lipid metabolism using serum RNA sequencing and quantitative real-time polymerase chain reaction.

Results:

Significant improvements in cognitive function, as measured by the MMSE (pre- and post-FMT was 13.00 and 18.00) and MoCA were seen. The MoCA scores at 3 months post-FMT (21.0) were the highest (12.0). The CDR-SOB scores at pre- and post-FMT were 10.00 and 5.50, respectively. Analysis of the gut microbiome composition revealed changes via 16S rRNA sequencing with an increase in Bacteroidaceae and a decrease in Enterococcaceae. Gene expression analysis identified alterations in lipid metabolism-related genes after FMT.

Conclusion:

These findings suggest a link between alterations in the gut microbiome, gene expression related to lipid metabolism, and cognitive function. The study highlights the importance of gut microbiota in cognitive function and provides insights into potential biomarkers for cognitive decline progression. FMT could complement existing therapies and show potential as a therapeutic intervention to mitigate cognitive decline in AD.
Successful bladder-sparing partial cystectomy for muscle-invasive domal urothelial carcinoma with sarcomatoid differentiation: a case report
Authors: Sultan Mark , Abdelaziz Ahmad , Hammad Muhammed A. , Martinez Juan R. , Ibrahim Shady A. , Nourbakhsh Mahra , Youssef Ramy F.
Published: January 2024

High-grade (HG) urothelial carcinoma (UC) with variant histology has historically been managed conservatively. The presented case details a solitary lesion of muscle-invasive bladder cancer (MIBC) with sarcomatoid variant (SV) histology treated by partial cystectomy (PC) and adjuvant chemotherapy. A 71-year-old male with a 15-pack year smoking history presented after outside transurethral resection of bladder tumor (TURBT). Computerized tomography imaging was negative for pelvic lymphadenopathy, a 2 cm broad-based papillary tumor at the bladder dome was identified on office cystoscopy. Complete staging TURBT noted a final pathology of invasive HG UC with areas of spindle cell differentiation consistent with sarcomatous changes and no evidence of lymphovascular invasion. The patient was inclined toward bladder-preserving options. PC with a 2 cm margin and bilateral pelvic lymphadenectomy was performed. Final pathology revealed HG UC with sarcomatoid differentiation and invasion into the deep muscularis propria, consistent with pathologic T2bN0 disease, a negative margin, and no lymphovascular invasion. Subsequently, the patient pursued four doses of adjuvant doxorubicin though his treatment was complicated by hand-foot syndrome. At 21 months postoperatively, the patient developed a small (<1 cm) papillary lesion near but uninvolved with the left ureteral orifice. Blue light cystoscopy and TURBT revealed noninvasive low-grade Ta UC. To date, the patient has no evidence of HG UC recurrence; 8 years after PC. Patient maintains good bladder function and voiding every 3–4 h with a bladder capacity of around 350 ml. Surgical extirpation with PC followed by adjuvant chemotherapy may represent a durable solution for muscle invasive (pT2) UC with SV histology if tumor size and location are amenable. Due to the sparse nature of sarcomatous features within UC, large multicenter studies are required to further understand the clinical significance and optimal management options for this variant histology.
Differential prognostic value of tumor and plasma T790M mutations in EGFR TKI-treated advanced NSCLC
Authors: Tung Pi-Hung , Chiu Tzu-Hsuan , Huang Allen Chung-Cheng , Ju Jia-Shiuan , Huang Chi-Hsien , Wang Chin-Chou , Ko How-Wen , Chung Fu-Tsai , Hsu Ping-Chih , Fang Yueh-Fu , Guo Yi-Ke , Kuo Chih-Hsi Scott , Yang Cheng-Ta
Published: January 2024

Background:

Substitution of methionine for threonine at codon 790 (T790M) of epidermal growth factor receptor (EGFR) represents the major mechanism of resistance to EGFR tyrosine kinase inhibitors (TKIs) in EGFR-mutant non-small-cell lung cancer. We determined the prognostic impact and association of secondary T790M mutations with the outcomes of osimertinib and chemotherapy.

Methods:

Patients (n = 460) progressing from first-line EGFR-TKI treatment were assessed. Tissue and/or liquid biopsies were used to determine T790M status; post-progression overall survival (OS) was analyzed.

Results:

Overall, 143 (31.1%) patients were T790M positive, 95 (20.7%) were T790M negative, and 222 (48.2%) had unknown T790M status. T790M status [T790M positive versus T790M negative: hazard ratio (HR) 0.48 (95% confidence interval (CI), 0.32–0.70); p < 0.001, T790M unknown versus T790M negative: HR 1.97 (95% CI, 1.47–2.64); p < 0.001] was significantly associated with post-progression OS. T790M positivity rates were similar for tissue (90/168, 53.6%) and liquid (53/90, 58.9%) biopsies (Fisher’s exact test, p = 0.433). Tumor T790M-positive patients had significantly longer post-progression OS than tumor T790M-negative patients (34.1 versus 17.1 months; log-rank test, p = 8 × 10−5). Post-progression OS was similar between plasma T790M-positive and -negative patients (17.4 versus not reached; log-rank test, p = 0.600). In tumor T790M-positive patients, post-progression OS was similar after osimertinib and chemotherapy [34.1 versus 29.1 months; log-rank test, p = 0.900; HR 1.06 (95% CI, 0.44–2.57); p = 0.897].

Conclusion:

T790M positivity predicts better post-progression OS than T790M negativity; tumor T790M positivity has a stronger prognostic impact than plasma T790M positivity. Osimertinib and chemotherapy provide similar OS benefits in patients with T790M-positive tumors.
Analysis of circulating tumor DNA identifies distinct therapeutic response to intraperitoneal and intravenous paclitaxel plus S-1 in gastric cancer patients with peritoneal metastasis
Authors: Yuan Hong , Xu Fei , Wang Shengzhou , Liu Di , Zhang Huan , Zhang Jun , Shi Min , Yan Chao , Zhu Zhenggang
Published: January 2024

Background:

Circulating tumor DNA (ctDNA) is a promising technique for predicting curative effects and monitoring tumor recurrence. The utility of ctDNA for gastric cancer with peritoneal dissemination remains elusive.

Objectives:

To assess the feasibility of ctDNA in predicting tumor response to chemotherapy in gastric cancer with peritoneal dissemination.

Design:

This was a prospective study.

Methods:

We enrolled 30 patients with gastric cancer peritoneal metastasis, treated with intraperitoneal and intravenous paclitaxel plus S-1. Peripheral blood samples of patients were prospectively collected at baseline, after treatment initiation accompanied by computed tomography scan and disease progression. Mutational profiles from ctDNA were analyzed to evaluate its association with chemotherapeutic response.

Results:

Tumor protein 53 ( TP53) was the most frequently altered gene at baseline blood samples. Although baseline TP53 mutation was not related to therapeutic response, patients with TP53 mutation had worse progression-free survival (PFS) and overall survival (OS). Additionally, baseline ctDNA content fraction (CCF) was found to be significantly lower in responders than non-responders. Meanwhile, patients with high CCF had a trend of worse PFS and OS. Combining TP53 alteration and CCF, the prognosis of TP53-wt patients could be further stratified. Patients with CCF-low_ TP53-wt had markedly longer survival than those with CCF-high_ TP53-wt.

Conclusion:

Our study highlighted the significance of ctDNA in predicting potential clinical outcomes in gastric cancer patients during chemotherapy.

Trial registration:

ChiCTR-IIR-16009802 (Chinese Clinical Trial Registry).
Supporting WFN Collective Social Entrepreneurship Through Social Movement Learning and Critical Participatory Action Research
Authors: Ray Sarah M. , Hinshaw Jessica , Trivedi Chitvan , Malhotra Gayatri
Published: January 2024

The purpose of this conceptual paper is to explore the complexities and connections between women, femme, and nonbinary (WFN) collective social entrepreneurs, social movement learning (SML), and critical participatory action research (CPAR) within the fields of adult education (AE) and human resource development (HRD). WFN collective social entrepreneurship serves as a reaction and solution to system failures, by creating supportive learning environments. We discuss the potential of social movement learning (SML) in these collectives, offering marginalized learners opportunities for skill development, knowledge sharing, and social impact efforts. This paper proposes using CPAR as a research approach to support social movements and amplify marginalized voices. CPAR can illuminate the development and learning networks of WFN social entrepreneur collectives and emphasize the importance of inclusive and intersectional approaches in entrepreneurial education and research within AE/HRD.
Cost-effective office 3D printing process in orthopaedics and its benefits: A case presentation and literature review
Authors: Cheo Feng Yi , Soeharno Henry , Woo Yew Lok
Published: January 2024

Background and objectives

The advent of 3-Dimensional (3D) printing technology is one of the most revolutionising breakthroughs of the generation. Its benefits in surgical practice are undeniable, however a steep learning curve and concerns regarding costs may pose a barrier to large scale implementation.

Methods

We set up an in-house 3D printing facility in our institution and described our workflow. Using the described workflow, we 3D printed models which were used in the surgical management of three patients with differing conditions.

Results

We present three case examples to display the uses that 3D printing technology is able to provide in our experience, and show how 3D printing technology can be beneficial in the field of orthopaedic oncology and surgically complex cases. 3D printing has proven to be useful and improved quality of care in these case examples. The processes for each case were described individually. The benefits of our in-house 3D printing facility were discussed in detail.

Conclusion

An in-house office 3D printing facility is advantageous and cost-efficient. Its benefits can be maximised if implemented on a larger scale and has the potential to be standard of care in many institutions.
Analysis of student perceptions relating to satisfaction from online learning during COVID-19 in Sikkim, India: The mediating role of motivation and attitude, and the moderating role of constraints
Authors: Lama Sita
Published: January 2024

The objective of this study is to analyse the role that motivation and attitude play as mediators in the relationship between student satisfaction with online learning and comfort during COVID-19 pandemic in Sikkim, India. We define perceived comfort as the level of flexibility and convenience in using technologies for online learning. Motivation is defined as willingness and inspiration to learn. Attitude is defined as the student’s behaviour towards online learning platforms. And constraint is measured in terms of connectivity problem and data limitation in accessing online learning. A mediating and moderating model is developed and casual relationship is analysed between independent and dependent variable with the help of Macro process using IBM-SPSS software (Version 25). The study hypothesize that Motivation and Attitude of the students mediate the relationship between Comfort and Satisfaction from online learning and Constraints of online learning shall moderate the positive relationship between motivation and Satisfaction. For the study, an online data was collected from 403 students studying in various colleges and universities in Sikkim who were undergoing online classes during Covid-19 period. Models were formed to empirically examine and validate the positive relationship of comfort, motivation and attitude with level of satisfaction from online learning. The findings showed that in various higher educational institutions in Sikkim, the relationship between comfort and reported levels of satisfaction is partially mediated by both the degree of motivation and students' attitudes towards online learning. However, the moderating impact of Constraint is found to be negligible.
Designing equitable media literacy interventions for critical youth agency
Authors: Foster Bobbie , Mihailidis Paul , Johnson Patrick R. , Burth Shannon , Tully Melissa , Ramasubramanian Srividya , Riewestahl Emily
Published: January 2024

In recent years, young people engaged in political discourse and civic action online. U.S.-based social movements centered on equity issues, such as Black Lives Matter, Dreamers, and March for Our Lives, engaged young people in shaping and publicizing the goals of these movements through digital platforms. Increasingly in communities at the margins, young Americans need digital and media literacy skills to supplement contentious education restrictions within the United States, as with many state bills curtailing the teaching of LGBTQIA+ histories and critical race theory. With these considerations in mind, our team conducted a national study of impactful media literacy in the United States. The study included an extensive literature review, interviews with key stakeholders, and a national survey of educators within the United States. Aimed at understanding the practices in formal and informal learning spaces, the research process inspired the creation of a field guide focused on offering resources for equity-focused media literacy practices that can support educators where professional structures could not, a core finding from our study on impactful media literacy. This paper shares the process for creating the Field Guide for Equitable Media Literacy Practices, developed and published as a form of public-facing scholarship to encourage all media literacy practitioners to undergo a transformative learning process. The field guide offers a series of approaches to equitable media literacy practices centered on equity and inclusion. While the research is U.S.-based, we believe the practices suggested within the field guide apply globally, especially as we see an increase in youth movements that impact beyond geographic and cultural boundaries.
Update on therapeutic approaches for invasive fungal infections in adults
Authors: Boutin Catherine-Audrey , Luong Me-Linh
Published: January 2024

Invasive fungal infections are increasingly encountered with the expansion of iatrogenic immunosuppression, including not only solid organ and hematopoietic stem cell transplant recipients but also patients with malignancies or autoimmune diseases receiving immunomodulatory therapies, such as Bruton Tyrosine Kinase (BTK) inhibitor. Their attributable mortality remains elevated, part of which is a contribution from globally emerging resistance in both molds and yeasts. Because antifungal susceptibility test results are often unavailable or delayed, empiric and tailored antifungal approaches including choice of agent(s) and use of combination therapy are heterogeneous and often based on clinician experience with knowledge of host’s net state of immunosuppression, prior antifungal exposure, antifungal side effects and interaction profile, clinical severity of disease including site(s) of infection and local resistance data. In this review, we aim to summarize previous recommendations and most recent literature on treatment of invasive mold and yeast infections in adults to guide optimal evidence-based therapeutic approaches. We review the recent data that support use of available antifungal agents, including the different triazoles that have now been studied in comparison to previously preferred agents. We discuss management of complex infections with specific emerging fungi such as Scedosporium spp., Fusarium spp., Trichosporon asahii, and Candida auris. We briefly explore newer antifungal agents or formulations that are now being investigated to overcome therapeutic pitfalls, including but not limited to olorofim, rezafungin, fosmanogepix, and encochleated Amphotericin B. We discuss the role of surgical resection or debridement, duration of treatment, follow-up modalities, and need for secondary prophylaxis, all of which remain challenging, especially in patients chronically immunocompromised or awaiting more immunosuppressive therapies.
Draupadi and the paradigm of woman empowerment in Hinduism
Authors: Hazri Kalyani
Published: January 2024

This article aims to bring insights from the philosophy of Hinduism to contribute to contemporary issues related to justice/injustice, empowerment, and liberation. To make important observations, and raise significant questions in this direction, it analyzes and discusses in detail the character of Draupadi from the Indian epic The Mahabharata. The article invites critics to debate the potential for empowerment in feminine virtues through the example of Draupadi who defends her importance and value on the basis of stri-dharma (righteous feminine actions). The article also propounds that the typical masculine traits (aggression, individualistic and courageous actions, etc.) in the personality of Draupadi result from the socio-political normativity that puts Draupadi's virtue under examination because she had unconventionally married five men. Draupadi is under emotional and psychological pressure to publicly prove her virtuous self and this finds expression in emotionally-charged situations apparently as masculine traits.