bluuebunny/crossref_metadata_2025 huggingface dataset:
Disaggregating inequalities in the career outcomes of international medical graduates in the United States
Authors: Schut Rebecca Anna
Published: January 2022

Although research finds that international medical graduates (IMGs) fill gaps in US health care left by US medical graduates (USMGs), the extent to which IMGs' career outcomes are stratified along the lines of their country of medical education remains understudied. Using data from the 2019 American Medical Association Physician Masterfile (n = 19,985), I find IMGs from developed countries chart less marginalised paths in their US careers relative to IMGs from developing countries; they are more likely to practise in more competitive and popular medical specialities; to attend prestigious residency programmes; and to practise in less disadvantaged counties that employ more USMGs relative to IMGs. These findings suggest IMGs experience divergent outcomes in the United States based on their place of medical education, with IMGs from developing countries experiencing more constraints in their careers relative to IMGs from developed countries. This understudied axis of stratification in medicine has important implications for our understanding of how nativism and racism may intersect to generate inequalities in the medical profession and in US health care more broadly.
Regional disparities, firm heterogeneity, and the activity of Japanese manufacturing multinationals in India
Authors: Nishiyama Hiroyuki , Fujimori Azusa , Sato Takahiro
Published: January 2022

This paper empirically explores the determinants of Japanese multinational enterprise (MNE) activity in India using firm‐level data, with particular focus on the country or regional characteristics predicted from a North–South firm‐heterogeneity model featuring foreign direct investment (FDI), the exchange rate, and endogenous wages. We identify the economic variables and country or regional characteristics that significantly affect the activity of Japanese MNEs. We show the importance of accumulating human capital and improving infrastructure to raise the sales level of Japanese MNEs in India.
Application of a Large‐Scale Terrain‐Analysis‐Based Flood Mapping System to Hurricane Harvey
Authors: Zheng Xing , D'Angelo Claudia , Maidment David R. , Passalacqua Paola
Published: January 2022

Flood modeling provides inundation estimates and improves disaster preparedness and response. Recent development in hydrologic modeling and inundation mapping enables the creation of such estimates in near real time. To quantify their performance, these estimates need to be compared to measurements collected during historical events. We present an application of a flood mapping system based on the National Water Model and the Height Above Nearest Drainage method to Hurricane Harvey. The outputs are validated with high‐water marks collected to record the highest water levels during the flood. We use these points to compute elevation‐related variables and flood extents and measure the quality of the estimates. To improve the performance of the method, we calibrate the roughness coefficient based on stream order. We also use lidar data with a workflow named GeoFlood and we compare the modeled inundation to that recorded by the high‐water marks and to the maximum inundation extent provided by the Dartmouth Flood Observatory based on remotely sensed data from multiple sources. The results show that our mapping system estimates local water depth with a mean error of about 0.5 m and that the inundation extent covers over 90% of that derived from high‐water marks. Using a calibrated roughness coefficient and lidar data reduces the mean error in flood depth but does not affect as much the inundation extent estimation.
Wilson Drilling Inc.*
Authors: Jin Yan , Niu Flora
Published: January 2022

Wilson Drilling Inc. is a leading Canadian provider of contract drilling rigs and well services to the oil and gas industry. This case exposes students to important financial reporting issues relevant to fixed assets, such as asset impairment and decommissioning and changing the accounting method for depreciation, as well as reporting of deferred income taxes in a real‐world situation. This case is suitable for use in undergraduate Intermediate Accounting or Advanced Financial Accounting classes.
A smartphone program to support adherence to oral chemotherapy in people with cancer: Proof‐of‐concept trial
Authors: Skrabal Ross Xiomara , Gunn Kate M. , Suppiah Vijayaprakash , Patterson Pandora , Boyle Terry , Carrington Christine , Tan Shir Ley , Ryan Marissa , Joshi Rohit , Olver Ian
Published: January 2022

Aim

Nonadherence to oral chemotherapy (OC) can lead to health complications, including premature death. Mobile phones are increasingly used to deliver medication adherence interventions. However, there is limited evidence about mobile phone–based interventions to increase adherence to OC, specifically. This study explores the proof‐of‐concept of a smartphone program to support adherence to OC in people with cancer.

Methods

This was a 10‐week, nonrandomized, multisite trial. The outcomes assessed were acceptability, satisfaction with the intervention, adherence to OC, knowledge about OC, and side‐effects presence and severity. The program consisted of short message service (SMS) reminders to take OC, as well as information about OC, including the management of side‐effects.

Results

Twenty‐two participants (17–74 y/o, median age 60 y/o) were recruited at six hospitals. The sample included 10 different cancer diagnoses (predominance of breast cancer) and 11 OC medications. Acceptability of the intervention was high, with 95% of the enrolled participants completing postintervention measures, and 81% reporting high satisfaction with the program. The intervention was found to have no effect on supporting adherence to OC (assessed by self‐report and medication event monitoring system) in this sample. An increase in knowledge about OC was observed at postintervention (p = 0.010).

Conclusions

This study demonstrated proof‐of‐concept of the smartphone program and highlighted the need for intervention and trial design‐related refinements. Future work should evaluate the effect of the program on adherence to OC with nonadherent patients.
The prognostic significance of immune checkpoint receptor expression in patients with lymphoma: Association with disease status and clinical outcomes
Authors: Shokrgozar Negin , Dehghani Mehdi , Golmoghaddam Hossein , Moghadam Mohamad , Rezaei Narges , Moayed Vida , Arandi Nargess
Published: January 2022

Introduction

Little is known about the expression of immune checkpoint receptors in the peripheral blood of lymphoma patients. Herein, we assessed the expression of inhibitory checkpoint receptors, including CTLA‐4, PD‐1/PDL‐1, LAG‐3, and TIM‐3 in the peripheral blood of lymphoma patients and its correlation with the clinical outcomes of patients. Therefore, 47 classical Hodgkin lymphoma (cHL), 48 non‐Hodgkin lymphoma patients with diffuse large B‐cell lymphoma (DLBCL) subtype, and 30 healthy controls were recruited.

Methods

The expression of inhibitory receptors was evaluated using SYBR Green real‐time PCR method.

Results

CTLA‐4, LAG‐3, and TIM‐3 genes were significantly upregulated in both cHL and DLBCL patients compared to the healthy controls. In addition, the level of these molecules was differentially expressed in cHL and DLBCL patients at different disease phases compared to the healthy controls. The CTLA‐4 gene was highly expressed in newly diagnosed (ND) cHL patients compared to the relapsed ones. Relapsed DLBCL patients had significantly increased LAG‐3 expression compared to patients at remission, as well as ND patients. Regarding cHL patients, high CTLA‐4 expression was correlated with low lactate dehydrogenase level and better performance status, whereas the level of LAG‐3 was significantly elevated in patients with poor performance status. Lower initial PD‐1 expression was associated with improved disease‐free survival in cHL patients.

Conclusions

Inhibitory immune checkpoint receptors are aberrantly expressed in the peripheral blood of cHL and DLBCL patients in which high LAG‐3 in DLBCL patients and PD‐1/LAG‐3 in cHL patients are associated with relapse occurrence and worse prognosis, respectively.
Clinical and molecular profile of young adults with early‐onset colorectal cancer: Experience from four Australian tertiary centers
Authors: Siu Derrick Ho Wai , Ali Arwa , Tjokrowidjaja Angelina , De Silva Madhawa , Lee Joanna , Clingan Philip R. , Aghmesheh Morteza , Brungs Daniel , Mapagu Cristina , Goldstein David , O'Neill Siobhan , Liauw Winston S. , Sjoquist Katrin M. , Thomas David , Pavlakis Nick , Clarke Stephen J. , Diakos Connie , Chantrill Lorraine A.
Published: January 2022

Background

Patients with early‐onset colorectal cancer (EO‐CRC) have unique characteristics. Contemporary data on the pathological and molecular features, and survival of EO‐CRC are limited in the Australian context.

Aim

To determine the demographic, histopathological and molecular characteristics of adults with EO‐CRC, and their survival.

Methods

We conducted a retrospective study of adults aged 18–49 years with EO‐CRC who were referred to the Illawarra Shoalhaven Local Health District, South Eastern Sydney Local Health District and Royal North Shore Hospital in New South Wales, Australia, between 2014 and 2018.

Results

Of 257 patients included, 94 (37%) patients presented with de novo metastatic CRC, 80% patients had near‐average risk family history and 89% had a symptomatic presentation. In 159 patients with nonmetastatic disease at diagnosis, stage III disease (OR 3.88 [95% CI: 1.13–13.3]; p = .03) and the presence of perineural invasion (PNI) (OR 6.63 [95% CI: 2.21–19.84]; p = .001) were risk factors associated with the development of metastatic disease. Among 94 patients with de novo metastatic disease, 43 (43%) and 12 (14%) patients harbored a KRAS or BRAF V600E mutation, respectively. The median overall survival was 29.6 months (95% CI: 20.4–38.7). BRAF mutation was associated with inferior survival (HR 3.00 [95% CI: 1.30–6.94]; p = .01).

Conclusion

The prevalence of KRAS and BRAF mutations in our cohort is similar to the overseas experience. Stage III disease at diagnosis, presence of PNI and BRAF mutation are adverse prognostic indicators. A better understanding of the molecular landscape is needed for this patient cohort, so as to better tailor prevention strategies, screening and treatment pathways.
Differences in microbial profile of endometrial fluid and tissue samples in women with in vitro fertilization failure are driven by Lactobacillus abundance
Authors: Lüll Kreete , Saare Merli , Peters Maire , Kakhiani Ekaterina , Zhdanova Anastasia , Salumets Andres , Boyarsky Konstantin , Org Elin
Published: January 2022

Introduction

The endometrial microbiota has been linked to several gynecological disorders, including infertility. It has been shown that the microbial profile of endometrium could have a role in fertilization and pregnancy outcomes. In this study we aim to assess the microbial community of endometrial tissue (ET) and endometrial fluid (EF) samples in women receiving in vitro fertilization (IVF) treatment. We also search for possible associations between chronic endometritis (CE) and endometrial microbiota.

Material and methods

This was a cohort study involving 25 women aged between 28 and 42 years with both primary and secondary infertility and with at least one IVF failure. The ET and EF sample collection was carried out between September 2016 and November 2018. Each of the participants provided two types of samples—tissue and fluid samples (50 samples in total). A 16S rRNA sequencing was performed on both of the sample types for microbial profile evaluation. CE was diagnosed based on a CD138 immunohistochemistry where CE diagnosis was confirmed in the presence of one or more plasma cells. Microbial profiles of women with and without CE were compared in both sample types separately.

Results

We report no differences in the microbial composition and alpha diversity (pObserved = 0.07, pShannon = 0.65, pInverse Simpson = 0.59) between the EF and ET samples of IVF patients. We show that the abundance of the genus Lactobacillus influences the variation in microbial beta diversity between and fluid samples (r2 = 0.34; false discovery rate [FDR] <9.9 × 10−5). We report that 32% (8/25) of the participants had differences in Lactobacillus dominance in the paired samples and these samples also present a different microbial diversity (pShannon = 0.06, FDRweighted UniFrac = 0.01). These results suggest that the microbial differences between ET and fluid samples are driven by the abundance of genus Lactobacillus. The microbiome of CE and without CE (ie non‐CE) women in our sample set of IVF patients was similar.

Conclusions

Our findings show that genus Lactobacillus dominance is an important factor influencing the microbial composition of ET and fluid samples.
Bivalirudin vs. heparin in paediatric and adult patients on extracorporeal membrane oxygenation: A meta‐analysis
Authors: Li Mei‐juan , Shi Jin‐ying , Zhang Jin‐hua
Published: January 2022

Aims

Unfractionated heparin (UFH) has been the primary anticoagulant of choice on extracorporeal membrane oxygenation (ECMO). However, it is debatable whether bivalirudin (BIV), a direct thrombin inhibitor, may be considered a better alternative anticoagulant option.

Methods

We searched Embase, Pubmed, Cochrane library, Clinicaltrials.gov, CNKI and Wanfang databases up to 15 June 2021. Randomized controlled trials and observational studies were considered eligible for inclusion. Random‐effects meta‐analyses, including subgroup analyses, were conducted.

Results

A total of 9 studies containing 994 patients were enrolled. All articles were retrospective cohort studies. Compared with UFH, BIV was associated with lower risks of major bleeding (risk ratio [RR]: 0.32, 95% confidence interval [CI] 0.22–0.49), ECMO in‐circuit thrombosis (RR: 0.57, 95% CI 0.43–0.74), stroke (RR: 0.52, 95% CI 0.29–0.95) and in‐hospital mortality (RR: 0.82, 95% CI 0.69–0.99), and higher rates of survival to ECMO decannulation (RR: 1.18, 95% CI 1.03–1.34). Pooled risk estimates did not show a significant association with clinical thrombotic events (RR: 0.69, 95% CI 0.45–1.07). Moreover, BIV was associated with a lower risk of ECMO in‐circuit thrombosis and in‐hospital mortality in the adult subgroup but not in the paediatric subgroup. However, leave‐one‐out sensitivity analyses indicated that the results of stroke, survival to ECMO decannulation and in‐hospital mortality should be interpreted with caution.

Conclusion

BIV appears to be a potential alternative to UFH in paediatric and adult patients requiring ECMO.
Patients' preferences for distributing limited government‐funded IVF cycles
Authors: Jones Claire Ann , Gotz Tamas , Chauhan Nipa , Goldstein Sydney , Assal Angela
Published: January 2022

Objective

On December 21, 2015, Ontario began funding one cycle of IVF for each resident with a uterus under the age of 43, but with a program cap that is insufficient to meet the annual demand. Our objective was to determine how fertility patients believe that the limited number of funded IVF cycles should be distributed.

Methods

A survey was distributed to patients attending a university affiliated hospital‐based fertility clinic in downtown Toronto, including its associated peripheral satellite clinics.

Results

From August 2016 to March 2017, 271 patients responded to the survey, of whom 90.3% were in favour of public funding for IVF. The majority of participants favoured allocating IVF cycles to maximize patients’ access to IVF in Ontario rather than targeting funded IVF cycles so as to maximize live births (62.7% vs. 32.8%). Most participants wanted all clinics to adopt the same approach for distributing funded IVF cycles compared to the current system in which each clinic chooses its own criteria for allocation (84.5% vs. 8.5%). Participants favoured distributing IVF by way of a scoring system that took individual patient factors into account. However, the factors that each respondent considered important varied materially.

Conclusion

Patients overwhelmingly supported public funding for IVF, desired a consistent policy for distribution of limited funded IVF cycles at all clinics, and preferred a method that took individual patient factors into consideration when determining patient priority for funded IVF but there were heterogenous opinions on which factors should be included.
Holocene history of the eastern side of Novaya Zemlya from glaciomarine sediment records in the Tsivol’ki Fjord
Authors: Rusakov Valeriy Y. , Kuz’mina Tat’yana G. , Krupskaya Victoria V. , Gromyak Irina N. , Dogadkin Denis N. , Romashova Tat’yana V.
Published: January 2022

For the first time, the Holocene history of the Serp‐i‐Molot tidewater glacier at the eastern side of the Novaya Zemlya archipelago, Kara Sea, has been reconstructed based on AMS 14C dating and multiproxy analyses (lithology, mineralogy, geochemistry and microfossils) of glaciomarine sediments from the Tsivol’ki Fjord. Three main phases of the Holocene evolution of the fjord environment are identified. During the early phase, c. 10.6 to 4.6 cal. ka BP, the glacier front was located close to the fjord mouth. The middle phase, c. 4.6 to 0.9 cal. ka BP, was characterized by frontal glacier retreat and shallowing of the fjord owing to glacio‐isostatic uplift of the North Island of Novaya Zemlya. The late phase, from 0.9±0.1 cal. ka BP until present, reflects the stabilization of the glacier front in the inner fjord. The absence of major Neoglacial advances of the Serp‐i‐Molot glacier is explained by the local climate of the Kara Sea and Novaya Zemlya, which prevents the penetration of moist air flow from the North Atlantic.
Innis Lecture: Returns on student loans in Canada
Authors: Lochner Lance , Liu Qian , Gervais Martin
Published: January 2022

This paper uses new administrative data with detailed borrower information and lengthy repayment histories from the Canada Student Loans Program (CSLP) to measure rates of return on undergraduate student loans. We document substantial heterogeneity in returns based on information available at the time loans were disbursed, including province of residence, field of study and institution of attendance. Field of study is a particularly important determinant of rates of return, explaining 22% of the variation in predicted returns across borrowers. We explore the implications of this variation for CSLP cross‐subsidization across borrowers and potential risk‐based loan limits. Given the variation in ex ante predicted returns across borrowers, using all available information at the time of loan disbursement, we study the implications of potential cream‐skimming of high‐return borrowers by private lenders.
An exceptionally rare case of metastatic osteoclast‐like giant cell–rich variant of anaplastic thyroid carcinoma: A diagnostic challenge
Authors: Saini Tarunpreet , Dey Pranab
Published: January 2022

Osteoclast‐like giant cell–rich variant of anaplastic thyroid carcinoma is extremely uncommon. In this paper we describe one such case in a 50 year‐old male. The patient presented with enlarged cervical lymph node after initial total thyroidectomy. The fine needle aspiration cytology (FNAC) smear showed abundant multinucleated osteoclastic‐like giant cells and scattered large bizarre tumour cells. FNAC of such cases may often be mistaken as osteoclast‐like giant cell–rich lesions.
Reproductive phenology and female mating frequency of the praying mantidTenodera angustipennisin western Japan
Authors: Nagata Yuki , Nishino Hiroto , Kuroda Kazuki , Shinohara Tadashi , Satomi Daisuke , Terada Karen , Nishimura Taira , Kuroda Takahiro , Inoue Yoshitaka , Park Yonghwan , Takami Yasuoki
Published: January 2022

The timing and frequency of female mating are important determinants of male reproductive success. Elucidating reproductive phenology is crucial to understand the evolution of mating behaviour and mating systems.

Mate encounter rate is a key variable for understanding the evolutionary consequences of sexual cannibalism. However, remarkably little is known about female mating frequency in wild populations in mantids, charismatic insects that exhibit sexual cannibalism.

The authors examined the reproductive phenology of a wild population of the sexually cannibalistic praying mantidTenodera angustipennis, and paid special attention to female mating frequency.

Field surveys throughout two reproductive seasons were combined with survival model analysis to estimate the phenology of eclosion, adult sex ratio, female first mating, and oviposition, allowing quantification of time windows for reproductive maturation and female mating.

Genetic paternity analysis using newly developed microsatellite markers revealed that females mated with two to six males on average before oviposition in the wild.

The results provide a comprehensive record of the reproductive phenology and female mating frequency in a wild mantid population, and insight into the evolution of male mating behaviour under sperm competition and sexual cannibalism.
Stable‐ and radio‐isotopes and a bait‐choice experiment reveal changes in feeding habits of the ant community during primary succession
Authors: Hyodo Fujio , Tanaka Hiroshi O.
Published: January 2022

Ants play important roles in trophic dynamics through their functions, ranging from herbivores to predators. However, little is known about whether the ant community modifies diet preferences and feeding habits during primary succession.

We performed a bait‐choice experiment and analyses of stable carbon and nitrogen isotopes (δ13C and δ15N) and radiocarbon (Δ14C) of ants at four study sites that underwent primary succession on lava flows created by four volcanic eruptions approximately 70, 100, 230, and 540 years ago in Sakurajima, Japan.

The ant community increasingly preferred plant‐based diets over animal‐based diets as the primary succession proceeded, likely because the ants attempted to balance nutrition through compensatory feeding according to diet availability.

The δ13C values showed that the ants depended largely on carbon from C4 plants at the young sites with no canopy trees. The δ15N values of ants consistently differed among the species, suggesting that each species maintained the proportion of plant‐ and animal‐based diets during succession.

The baseline‐corrected δ15N values of the ants were significantly higher at the youngest site than at the older sites; this probably reflects intraguild predation or reliance on aerial prey from surrounding older sites, which exhibited a higher δ15N‐baseline partly due to the colonisation of nitrogen‐fixing plants.

The Δ14C values show that the two ant species examined had older diet ages, by approximately 2 years, at the old sites than those at the young sites, indicating their greater dependence on the detritus food web.
Impact on public attitudes of a mental health audio tour of the National Gallery in London
Authors: Riches Simon , Steer Natalie , Vasile Ruxandra , Lyles Sophie , O'Reilly Laoise , Guiotto Martina , Hughes Tom , McKay Meagan , Westhead Megan , Latham Rachel M. , Newbury Joanne B. , Murray Anna , Goneni Amber , Orehova Aleksandra , Temple Rachel , Thompson Rose , Houston Fiona , Fisher Helen L.
Published: January 2022

Aim

The arts have the potential to increase public awareness about mental health and reduce stigma. However, arts‐based projects to raise awareness have been small‐scale. In this study, a mental health‐awareness audio tour of The National Gallery in London was co‐produced and narrated by young adults with relevant lived experience. The study investigated the acceptability of the tour to the public and evaluated its impact on public attitudes about mental health.

Methods

Participants were Gallery visitors over four consecutive days. The tour led visitors on 10 stops through the Gallery. Each stop focused on artworks and Gallery spaces, challenged common myths about mental health, and invited visitors to consider their personal views. Participants completed measures of mood and attitudes about mental health pre‐ and post‐tour and provided narrative feedback.

Results

Pre‐tour, participants (N = 213) reported high levels of happiness, compassion towards people with mental health conditions, comfort talking about mental health, and positive attitudes about mental health. Post‐tour, participants (N = 111) reported significant increases in happiness, comfort, and positive attitudes. In feedback, participants (N = 85) reported that strengths of the tour were the music, inclusion of lived experience, art and mental health links, and reported that the tour was informative, innovative, and improved mental health awareness.

Conclusions

The tour increased positive attitudes, despite positive baseline attitudes, indicating the feasibility of arts‐based interventions in major venues to reduce stigma. Sampling limitations and participant retention suggest that arts‐based projects to raise awareness should target more diverse audiences and consider data collection strategies in large venues.
Dental student perceptions of teamwork during a community‐engaged interprofessional learning experience
Authors: Raponi Jayne‐Marie , Black Erik W. , Rush Caronne C. , Childs Gail Schneider , Blue Amy V.
Published: January 2022

Introduction

Dental professionals have been strong advocates for interprofessional education (IPE). During PFF, students in diverse, interprofessional teams of four are assigned a local volunteer family during their first academic year. Teams conduct four home visits and implement a health improvement project focused on the family's health and well‐being. The purpose of our analysis was to examine dental student perspectives on the use of teamwork skills during this unique interprofessional educational experience.

Methods and Materials

Dental student responses from 2017 to 2018 and 2018 to2019 were qualitatively analysed. Open coding by hand was used to identify keywords and themes. The themes and open codes were compared and contrasted by the researchers until a consensus was reached on themes.

Results

Researchers discerned three meta‐themes: value, skills and time. Researchers also found eight sub‐themes prevalent in responses: teamwork, adaptability, mutual support, trust, interprofessional communication, time, feedback, coordination and accountability.

Discussion

Our findings indicate dental students understood the importance of interprofessional teamwork and experiential learning within the context of PFF. Students communicated an understanding of how teamwork skills can impact team‐oriented outcomes. Dental students seemed to value many teamwork skills that contributed to their interprofessional team's success and experiential learning experience.

Conclusion

Engagement in a longitudinal experience that is patient‐centred, requiring time outside of the classroom, is valued by dental students for its interprofessional collaborative competency development.
Progressive multifocal leukoencephalopathy in the context of newer therapies in hematology and review of new treatment strategies
Authors: Diamantopoulos Panagiotis T. , Kalopisis Konstantinos , Tsatsou Aikaterini , Efthymiou Athina , Giannakopoulou Nefeli , Hatzidavid Sevastianos , Viniou Nora‐Athina
Published: January 2022

Progressive multifocal leukoencephalopathy (PML) is a rare, often fatal demyelinating disease of the central nervous system (CNS) caused by the reactivation of JC polyomavirus in the CNS. We present a case of a 54‐year‐old man with follicular lymphoma diagnosed with PML after being treated with anti‐CD20 monoclonal antibody‐based regimens for several years. Due to the lack of effective treatment choices for PML, the patient was treated with nivolumab, based on recent reports, but succumbed to his disease a few months after diagnosis. In this paper, we focus on reviewing the literature of PML cases correlated with newer agents used in hematology, possible factors affecting disease prognosis, as well as the available data on upcoming therapeutic options for patients with PML. Though newer promising treatments such as anti‐PD1 monoclonal antibodies arise, a definitive treatment option is yet to be found. Vigilance, early detection, and prompt intervention play a crucial role in the prognosis of PML in patients with hematological malignancies.
Inflection Point: The Role of Testing in Admissions Decisions in a Postpandemic Environment
Authors: Camara Wayne J. , Mattern Krista
Published: January 2022

In 2020, the onset of COVID‐19 greatly restricted access to admissions testing in higher education and required innovative solutions and flexibility such as at home testing with remote proctoring, reducing testing time, pop‐up locations, and additional testing dates. Increased focus on social justice, diversity, and fairness continued to concern admissions professionals during this time. This article is intended to provide an update (Camara) on admissions testing as we enter 2022, documenting enhancements and changes across testing programs. In addition, we report recent data and findings on applications, enrollment, and test taking, as well as the prevalence of test optional and test blind policies and its impact on score sending in undergraduate, graduate, business, law, and medical schools. It is important to note that many questions remain unanswered. Our original intent was to include more information on the impact of test‐optional polices on diversity as we thought the pandemic would be in the rear‐view mirror by now. Given the lingering effects of the pandemic, it will be critical to evaluate the impact of these policies changes on the entering class of 2021 and beyond as those data become available.
Predictors of sustained response and effects of the discontinuation of anti‐calcitonin gene related peptide antibodies and reinitiation in resistant chronic migraine
Authors: Iannone Luigi Francesco , Fattori Davide , Benemei Silvia , Chiarugi Alberto , Geppetti Pierangelo , De Cesaris Francesco
Published: January 2022

Background and purpose

Guidelines for migraine prophylaxis suggest stopping medication after 6–12 months to reevaluate treatment appropriateness. The Italian Medicines Agency set a mandatory regulation to stop anti‐calcitonin gene related protein (CGRP) pathway monoclonal antibody (anti‐CGRP mAb) treatments for 3 months after 12 months of treatment. Herein, the effects of discontinuation and retreatment of anti‐CGRP mAbs in resistant chronic migraine patients are assessed, evaluating predictive factors of sustained response.

Methods

This was a monocentric prospective cohort study, enrolling 44 severe (resistant to ≥3 preventive treatments) chronic migraine patients (all with medication‐overuse), treated with erenumab (54.5%) or galcanezumab (45.5%) for 12 months, who discontinued treatment for 3 months and then restarted for 1 month.

Results

Overall, patients reported an increasing deteriorating trend during the 3 months of discontinuation. Monthly migraine days, number of analgesics, days with at least one analgesic used, a ≥50% response rate (reduction in monthly migraine days), and Migraine Disability Assessment Score and Headache Impact Test 6 total score, remained lower than baseline values, but increased compared to month 12 of treatment. All outcome measures decreased again during the month of retreatment. Patients who did not meet criteria for restarting treatment had a lower Migraine Disability Assessment Score (p = 0.03) and Headache Impact Test 6 (p = 0.01) score at baseline and better outcome measures during discontinuation compared to patients who restarted treatment.

Conclusions

In most patients, the 3‐month discontinuation of anti‐CGRP mAbs resulted in progressive migraine deterioration that was rapidly reverted by retreatment. However, one‐quarter of patients who reported better quality of life indices before treatment showed a sustained benefit during discontinuation and did not need retreatment.
Antinociceptive, anxiolytic, and depression‐like effects of hydrogen sulfide, nitric oxide, and carbon monoxide in rats and the role of opioidergic and serotonergic systems in antinociceptive activity
Authors: Baskin Veysel , Eroglu Ezgi , Harmanci Nusin , Erol Kevser
Published: January 2022

l‐Arginine, a nitric oxide (NO) donor; sodium hydrosulfide (NaHS), a hydrogen sulfide (H2S) donor; and tricarbonyldichlororuthenium(II) dimer (CORM‐2), carbon monoxide (CO) donor, are characterized as bioactive gas mediators that have been researched for their roles in human physiology. This study aimed to compare the effects of these mediators on pain, anxiety, and depression. Ninety‐one adult male Sprague–Dawley rats were used for the experiments. Locomotor activity, elevated plus maze, forced swimming, tail clip, hot plate, and writhing tests were used for the assessments after the administration of l‐arginine (30–100 mg/kg), a NO donor; NaHS (5–10 mg/kg), a H2S donor; and CORM‐2 (5–10 mg/kg), CO donor. Intraperitoneal H2S, NO, malondialdehyde (MDA), glutathione (GSH), and tumor necrosis factor‐α (TNF‐α) levels were determined by enzyme‐linked immunosorbent assay (ELISA). No statistical significance was found in the locomotor activity. NO and CO significantly extended latency at high doses in tail clip test. No significant activity was observed at any dose of all three substances on a hot plate. Both doses of CO and high doses of NO and H2S showed an antinociceptive effect in the writhing test. While the opioidergic system plays a role in the spinal antinociceptive effect of l‐arginine, both serotonergic and opioidergic systems play a role in its peripheral antinociceptive effect. The serotonergic system plays a role in the peripheral antinociceptive effect of CORM‐2. The time spent in open arm increased significantly in all groups an elevated plus maze. High doses of all three substances significantly increased the duration of immobility in the forced swimming test. No statistical significance was observed in MDA, GSH, and TNF‐α levels. High doses of NO and CO showed a spinal antinociceptive effect. Both doses of CO and high doses of NO and H2S showed a peripheral antinociceptive effect. All three agents showed anxiolytic and depression‐like effects.
Emerging wild virus of native grass bioenergy feedstock is well‐established in the Midwestern USA and associated with premature stand senescence
Authors: Malmstrom Carolyn M. , Busch Anna K. , Cole Ellen A. , Trebicki Piotr , Bernardo Pauline , Brown Ally K. , Landis Douglas A. , Werling Ben P.
Published: January 2022

The North American native prairie grass Panicum virgatum (switchgrass) is a primary bioenergy feedstock candidate. Its widespread distribution and genetic diversity enable the possibility of developing this perennial grass for high production in a variety of conditions, including on marginal lands. A critical concern in feedstock development and deployment is the risk of novel pathogen emergence. Here, we investigate the landscape‐scale prevalence and epidemiology of a little‐studied North American virus that was first detected in switchgrass and other grasses in bioenergy trials in the US Midwest. Switchgrass mosaic virus (SwMV, Genus Marafivirus, Family Tymoviridae) is transmitted by leafhoppers and is phylogenetically a sister to Maize rayado fino virus, a significant pathogen of maize in parts of the Americas. Our goal was to determine whether SwMV is uniquely limited to specific bioenergy trials or well‐established and circulating more broadly. We used molecular diagnostics to quantify naturally occurring SwMV infection in leafhoppers and switchgrass in naturalistic stands throughout a large Midwestern landscape, and quantified leafhopper abundances and stand performance. Our analysis revealed that this apparently wild virus is well‐established and widespread. Infection was present at nearly all sites, across diverse landscape contexts, with its prevalence ranging as high as 33%–60%. Infection appeared to accumulate and persist in stands over time. It was associated with increases in premature stand senescence but not with reductions in stand height. Although wild viruses are believed to evolve benign relationships with their natural hosts, these data suggest that SwMV has the potential to impact yield components. Viruses are frequently overlooked in crop development efforts, but they represent the majority of emerging plant pathogens. For SwMV, it is imperative to quantify its impact on host performance, to identify the extent of any host resistance, and to assess any risks of virus spillover to agricultural plantings of other Poaceae species, including maize and sorghum.
Fundic gland polyps related to diverse aetiologies show subtle morphological differences: a multicentre retrospective study
Authors: Kővári Bence , El Naili Reima , Pereira Daniela Vinha , Kumarasinghe Priyanthi , De Boer Willem Bastiaan , Jiang Kun , Pimiento Jose M , Fukuda Masahide , Misdraji Joseph , Kushima Ryoji , Lauwers Gregory Y
Published: January 2022

Aims

Fundic gland polyps (FGPs) comprise 66% of all gastric polyps. Although they are usually non‐syndromic, they may be associated with various syndromes, including familial adenomatous polyposis (FAP) or gastric adenocarcinoma and proximal polyposis of the stomach (GAPPS). We aimed to evaluate how histological features relate to distinct FGP subtypes.

Methods and results

We performed a retrospective analysis of 118 FGPs from 109 patients for the architecture of fundic glands, microcyst lining, parietal cell hyperplasia and surface foveolar epithelial changes. Age, gender and history of FAP or GAPPS were collected. Based on combinations of histological features, three distinct patterns (A, B and C) of FGPs were delineated and correlated to the aetiologies. Non‐syndromic FGPs were well‐formed polyps composed of disordered fundic glands with intermediate‐sized microcysts typically lined by a mixture of oxyntic and mucin‐secreting cells (73%). Parietal cell hyperplasia (80%) and foveolar surface hyperplasia (78%) were common. FAP‐associated cases demonstrated small microcysts that were predominantly lined by fundic epithelium (77%), with limited parietal cell hyperplasia (27%); foveolar hyperplasia was uncommon. GAPPS‐related polyps were the largest, with prominent, mucin‐secreting epithelium‐lined microcysts (73%). Hyperproliferative aberrant pits were universally present, whereas parietal cell hyperplasia was uncommon. Pattern A was identified in most non‐syndromic FGPs (74%) and in a minority of FAP‐related FGPs (26%). The majority (82%) of FAP‐related FGPs showed pattern B, but only 18% of non‐syndromic FGPs did. Pattern C consisted exclusively of GAPPS‐associated polyps.

Conclusions

We conclude that, although FGPs share similar histomorphology, subtle differences exist between polyps of different aetiology. In the appropriate clinical setting, the recognition of these variations may help to consider syndromic aetiologies.
Visit‐to‐visit variability in albuminuria predicts renal function deterioration in patients with type 2 diabetes
Authors: Lin Chih‐Hung , Lai Ying‐Chuen , Chang Tien‐Jyun , Jiang Yi‐Der , Chang Yi‐Cheng , Chuang Lee‐Ming
Published: January 2022

Aims/Introduction

We aimed to study the predictive ability of visit‐to‐visit variability in albuminuria for changes in renal function in patients with type 2 diabetes mellitus.

Materials and Methods

The cohort study was carried out in a single medical center. In the model development cohort of 1008 subjects, we developed the albuminuria variability score (AVS) to evaluate the visit‐to‐visit variability in albuminuria, which was the percentage of the number of changes in the urine albumin : creatinine ratio ≥3.39 mg/mmol among all visit‐to‐visit urine albumin : creatinine ratio differences within an individual. Multivariate logistic regression was applied to predict the influence of AVS levels on the occurrence of study end‐points. In another independent validation cohort of 310 participants, survival analysis was carried out to evaluate the ability of AVS in predicting the study end‐point.

Results

In the model development cohort, a higher AVS was associated with higher adjusted odds of having a declined or rapidly declined estimated glomerular filtration rate (eGFR) trajectory (1.84, 95% confidence interval 1.23–2.76 and 5.70, 95% confidence interval 2.28–14.25, respectively), a resultant eGFR <60 mL/min/1.73 m2 (2.61, 95% confidence interval 1.63–4.16) and a >40% decline in eGFR from baseline (6.44, 95% confidence interval 2.15–19.26). In the validation cohort, a higher AVS independently predicted a 5‐year decrease of >40% in eGFR to <60 mL/min/1.73 m2 (adjusted hazard ratio 3.33, 95% confidence interval 1.10–10.05). Integrated discrimination index and concordance statistics showed that AVS significantly improved the predictive ability of the models.

Conclusions

Visit‐to‐visit variability in albuminuria can independently predict long‐term renal function deterioration in patients with type 2 diabetes mellitus. Further investigations are warranted to elucidate the potential clinical applications.
Diagnosis and treatment of nail melanoma: a review of the clinicopathologic, dermoscopic, and genetic characteristics
Authors: Darmawan C.C. , Ohn J. , Mun J.‐H. , Kim S. , Lim Y. , Jo S.J. , Kim Y.‐g. , Kim B. , Seong M.‐W. , Kim B.J. , Lee C. , Kwak Y. , Chung H.J. , Virós A. , Lee D.Y.
Published: January 2022

Nail melanoma (NM) is an important differential diagnosis in patients with longitudinal melanonychia. However, diagnosis is often challenging as it is difficult to differentiate from other pigmented nail disorders. The main challenge for diagnosis is obtaining adequate nail matrix biopsy specimens for histopathological assessment. Furthermore, the histopathological changes in the early stages of NM are subtle and contribute to a delay in diagnosis and care. Therefore, the integration of clinical and histopathological analyses is essential. Clinical and dermoscopic features, such as a broadened width of asymmetric bands in an irregular pattern, with multicolour pigmentation, periungual pigmentation, and continuous growth, are features that support the diagnosis of NM. The essential histological features that must be assessed are cellular morphology, architectural features, melanocyte density, and inflammatory changes. The reported mutations in NMs were BRAF (0–43%), NRAS (0–31%), KIT (0–50%), NF1 (0–50%), and GNAQ (0–25%). Surgery is the primary treatment for NM. The recommended treatment for in situ or minimally invasive NM is functional surgery, but cases with suspected bone invasion should be treated with amputation. Targeted therapy and immunotherapy are indicated for advanced stages of NM. This review summarizes the updated guidelines for the diagnosis and treatment of NM.
Epigenetic influences of mobile genetic elements on ciliate genome architecture and evolution
Authors: Timmons Caitlin M. , Shazib Shahed U. A. , Katz Laura A.
Published: January 2022

Mobile genetic elements (MGEs) are transient genetic material that can move either within a single organism's genome or between individuals or species. While historically considered “junk” DNA (i.e., deleterious or at best neutral), more recent studies reveal the potential adaptive advantages MGEs provide in lineages across the tree of life. Ciliates, a group of single‐celled microbial eukaryotes characterized by nuclear dimorphism, exemplify how epigenetic influences from MGEs shape genome architecture and patterns of molecular evolution. Ciliate nuclear dimorphism may have evolved as a response to transposon invasion and ciliates have since co‐opted transposons to carry out programmed DNA deletion. Another example of the effect of MGEs is in providing mechanisms for lateral gene transfer (LGT) from bacteria, which introduces genetic diversity and, in several cases, may drive ecological specialization in ciliates. As a third example, the integration of viral DNA, likely through transduction, provides new genetic materials and can change the way host cells defend themselves against other viral pathogens. We argue that the acquisition of MGEs through non‐Mendelian patterns of inheritance, coupled with their effects on ciliate genome architecture and persistence throughout evolutionary history, exemplify how the transmission of mobile elements should be considered a mechanism of transgenerational epigenetic inheritance.
Mitigating human impacts including climate change on proliferative kidney disease in salmonids of running waters
Authors: Ros Albert , Schmidt‐Posthaus Heike , Brinker Alexander
Published: January 2022

Over the last two decades, an increasing number of reports have identified a decline in salmonid populations, possibly linked to infection with the parasite Tetracapsuloides bryosalmonae and the corresponding disease, that is, proliferative kidney disease (PKD). The life cycle of this myxozoan parasite includes sessile bryozoan species as invertebrate host, which facilitates the distribution of the parasite in running waters. As the disease outcome is temperature dependent, the impact of the disease on salmonid populations is increasing with global warming due to climate change. The goal of this review is to provide a detailed overview of measures to mitigate the effects of PKD on salmonid populations. It first summarizes the parasite life cycle, temperature‐driven disease dynamics and new immunological and molecular research into disease resistance and, based on this, discusses management possibilities. Sophisticated management actions focusing on local adaptation of salmonid populations, restoration of the riverine ecosystem and keeping water temperatures cool are necessary to reduce the negative effects of PKD. Such actions include temporary stocking with PKD‐resistant salmonids, as this may assist in conserving current populations that fail to reproduce.
Clinical 7T MRI for epilepsy care: Value, patient selection, technical issues, and outlook
Authors: Young Geoffrey S. , Kimbrell Vera , Seethamraju Ravi , Bubrick Ellen J.
Published: January 2022

Ultra‐high‐field 7.0 Tesla (T) MRI offers substantial gains in signal‐to‐noise ratio (SNR) over 3T and 1.5T, but for over two decades has remained a research tool, while 3T scanners have achieved widespread clinical use. This much slower translation of 7T relates to daunting technical challenges encountered in ultra‐high‐field human MR imaging. The recent introduction of United States Food and Drug Administration (FDA)‐approved clinical 7T scanners promises to be a watershed for many 7T neuroimaging applications, including epilepsy imaging. The high SNR of 7T allows clinical imaging of fine neuroanatomic detail at unprecedented spatial resolution, helping with detection and differentiation of subtle, potentially treatable lesions undetectable or suboptimally assessed at 3T. The accompanying research paper reports our group's analysis of 7T MRI efficacy in epilepsy treatment planning. Here, we introduce the technical background and clinical approach we currently use, in order to assist clinical epileptologists and neuroimagers contemplating, creating, or referring patients to a clinical 7T epilepsy imaging service. We describe a tiered epilepsy imaging strategy and protocols designed to optimize 7T value and work around signal intensity variation and signal loss artifacts, which remain significant challenges to full exploitation of 7T clinical value. We describe FDA‐approved techniques for mitigating these artifacts and briefly outline techniques currently under development, but not yet FDA approved. Finally, we discuss the major issues in 7T patient safety and toleration, outlining their physical causes and effects on workflow, and provide references to more comprehensive technical reviews for readers seeking greater technical detail.