bluuebunny/crossref_metadata_2025_split huggingface dataset:
Treatment Patterns, Toxicity, and Outcomes of Older Adults With Advanced Pancreatic Cancer Receiving First-line Palliative Chemotherapy
Authors: McAndrew Erin N. , Zhang Hanbo , Lambert Pascal , Rittberg Rebekah , Dawe David E. , Kim Christina A. 
Published: December 2021

Objectives:
Advanced pancreatic cancer (APC) disproportionately impacts older adults. Randomized trials demonstrate improved overall survival (OS) with combination chemotherapy including 5-fluorouracil, irinotecan, leucovorin, and oxaliplatin (FOLFIRINOX) or nab-paclitaxel and gemcitabine compared with gemcitabine alone, but with increased toxicity. Older adults are at increased risk of side effects from chemotherapy. The aim of this study was to assess the efficacy and toxicity of chemotherapy in older adults with APC.

Methods:
Patients diagnosed with APC from 2011 to 2016 were identified using the Manitoba Cancer Registry. Patient and treatment characteristics, toxicity, and outcomes of patients 65 years of age and above treated with palliative chemotherapy were compared by treatment regimen. OS was assessed using the Kaplan-Meier method. A Cox regression was used to identify independent predictors of OS.

Results:
A total of 87 patients aged 65 years and above received palliative chemotherapy: 52 (59.7%) FOLFIRINOX, 21 (24.1%) nab-paclitaxel and gemcitabine, and 14 (16.1%) gemcitabine, with a median age of 69 (65 to 84), 75 (65 to 88), and 73 (67 to 82), Eastern Cooperative Oncology Group (ECOG) performance status difference in hematologic toxicity between regimens (P=0.807). An increase in nonhematologic toxicity was seen with FOLFIRINOX (P<0.001), specifically neuropathy (P=0.008), fatigue (P<0.001), and nausea/vomiting (P=0.008). FOLFIRINOX was associated with improved radiologic response (P=0.05) and OS (P=0.035). PS, baseline carbohydrate antigen 19-9 level, and chemotherapy regimen were independent predictors of survival.

Conclusions:
FOLFIRINOX is associated with improved response and OS in older adults with APC. FOLFIRINOX has a manageable safety profile in this population and should be considered in fit older adults with APC.
A Hand Call Curriculum for Plastic Surgery Residents
Authors: Bjorklund Kim A. , Bourgeois Tran , O’Brien Meghan 
Published: December 2021

Background:
The ability to diagnose and manage patients with acute hand injuries is an essential component of plastic surgery residency. This study proposes an innovative and feasible curriculum to improve hand surgery education for plastic surgery residents and ensure optimal care for patients with hand injuries.

Methods:
A hand call curriculum for plastic surgery residents (n = 29) from two institutions was implemented from 2018 to 2020. In 2018 and 2019, a hand call boot camp was conducted, while additional curricular sessions for anatomy and didactic learning were added in 2019–2020. Pre and post test assessments, as well as confidence assessments were conducted in 2018 and 2019.

Results:
In 2019, after having completed the boot camp, residents indicated significantly more confidence in identifying hand emergencies and formulating a basic treatment plan, including when to enlist help (P = 0.0313). Overall, residents in earlier years (PGY 1–3) demonstrated steeper changes in confidence and readiness to take hand call than those in more senior years (PGY 4-8). Knowledge test scores improved amongst residents in both PGY groups following boot camp in both 2018 and 2019.

Conclusion:
Findings from our study will be used to optimize the hand call curriculum following limitations with COVID-19 and consider wider implementation across other plastic surgery programs nationally.
Marked intrafamilial aggregation and heritability of aortic flow in a community with prevalent volume-dependent hypertension in Africa
Authors: Yusuf Suraj M. , Norton Gavin R. , Peterson Vernice , Libhaber Carlos D. , Mmopi Keneilwe N. , Bello Hamza , Masiu Mohlabani , Da Silva Fernandes Daniel , Tade Grace , Mthembu Nonhlanhla , Peters Ferande , Dessein Patrick , Sareli Pinhas , Woodiwiss Angela J. 
Published: December 2021

Aims:
Although peak aortic flow (Q) is now recognized as a major determinant of hypertension in Africa, current therapy has no proven ability to target this change. The mechanisms of this effect, therefore, require elucidation. We compared the intrafamilial aggregation and heritability of Q to that of the vascular determinants of pulse pressure (PP) and SBP in Africa.

Methods:
The intrafamilial aggregation and heritability of Q and aortic characteristic impedance (Z
c) or total arterial compliance (TAC) was determined in 669 participants of 194 families (69 father–mother, 385 parent–child, 157 sibling–sibling pairs) in a community in Africa with prevalent flow-dependent primary hypertension. Haemodynamics were determined from velocity and diameter measurements in the outflow tract (echocardiography) and central arterial pressures.

Results:
No mother–father correlations were noted for either Q or Z
c. However, with adjustments for confounders, parent–child (P < 0.0001) and sibling–sibling (P < 0.0001) correlations were noted for Q. Parent–child and/or sibling–sibling correlations were also noted for Z
c or TAC but were weaker for Z
c and mother–father correlations were noted for TAC. Moreover, Q showed markedly stronger multivariate adjusted heritability estimates (h
2 = 0.82 ± 0.07, P < 0.0001) than Z
c (h
2 = 0.44 ± 0.10, P < 0.0001)(P < 0.005 for comparisons) and TAC (h
2 = 0.47 ± 0.08, P < 0.0001)(P < 0.005 for comparisons). Importantly, the heritability of Q was also greater than that for PP (h
2 = 0.12 ± 0.09, P = 0.11) (P < 0.0001 for comparisons), or SBP (h
2 = 0.13 ± 0.10, P = 0.08) (P < 0.0001 for comparisons).

Conclusion:
Of the haemodynamic determinants of SBP, peak aortic flow is the most strongly inherited in Africa. Peak aortic flow, therefore, represents an important target for identifying novel therapeutic approaches to controlling SBP in Africa.
Implantation of a Coronary Stent Into the Canaliculus of a Human Cadaver: A Pilot Study
Authors: Daigle Patrick , Morand Meggie , Nijhawan Navdeep 
Published: December 2021

Purpose:
To evaluate the possibility of implanting a drug-eluting coronary stent into the canaliculus of a human cadaver.

Methods:
The punctum and canaliculus of an embalmed human cadaver were identified and dilated using a punctum dilator and Bowman probes. At this stage, the integrity of the lacrimal drainage system was assessed by dacryoendoscopy. A drug-eluting coronary stent, which was collapsed around a balloon at the tip of a catheter, was inserted into the canaliculus. The balloon was inflated to expand and lock the spring-like stent into position. The balloon catheter was then deflated and removed from the canaliculus. Dacryoendoscopy was used once again to assess the position of each stent after implantation.

Results:
The four canaliculi of one human cadaver were successfully identified, dilated, and intubated using drug-eluting coronary stents. Dacryoendoscopy confirmed that each stent achieved a satisfactory position within the canaliculi. The seamless integration of the stent with the surrounding tissues resulted in a significant dilation of the canaliculi. The procedure was deemed short and simple, with the time required to implant a stent into the canaliculus and asses its position being less than a minute.

Conclusions:
Canalicular obstructions can often be a source of therapeutic challenges. Our pilot study shows that a drug-eluting coronary stent can be implanted with precision into the canaliculus of a human cadaver. We propose that at least some canalicular obstructions could be treated using a novel rigid mesh tube similar to drug-eluting coronary stents.
Current state and future potential of AI in occupational respiratory medicine
Authors: Tran Dylan , Kwo Elizabeth , Nguyen Ethan 
Published: December 2021

Purpose of review
The COVID-19 pandemic has accelerated the pace of technological development relating to pulmonary diseases. The advent of newer technologies, such as Artificial Intelligence (AI), continues to be adapted for diagnostic purposes. AI offers comparable precision to trained physicians under certain circumstances, as well as the unique ability to process the information characteristic of Big Data. With respect to individual susceptibilities/pre-existing diseases, AI seems poised to integrate such individualized information and contribute to a greater implementation of precision medicine.

Recent findings
AI can match trained clinicians in specific applications, but AI has limitations that require clearly defined questions and a high quality of data. Data collected for this purpose is predicted to increase both in quality and volume, as technology concerned with personal health (FitBit, Apple Watch) proliferates. However, the role of AI with respect to physicians in a clinical setting is still being debated. AI generally aims to increase objectivity through its correlational methodology.

Summary
AI continues to be a proliferative field of study. It has defined strengths and weaknesses which, if accounted for, has the potential to increase healthcare access as well as the quality of care delivered.
Physical Literacy in Elementary Physical Education: A Survey of Fundamental Movement Skill Practice Patterns
Authors: Butler Lauren S. , Gupta Apeksha , DeVerna Amie , Moore James G. , Latz Kevin , Foley Davelaar Cassidy M , Salyakina Daria , Sugimoto Dai 
Published: December 2021

Purpose:
To describe fundamental movement skill (FMS) practice patterns in the elementary physical education (PE) curriculum.

Methods:
A cross-sectional survey was sent to PE teachers of grades 1 through 6. Sixty-eight responses were included for analysis.

Results:
Only 38.2% of teachers taught all 12 FMS components. Compared with PE teachers for grades 4 to 6, a significantly higher proportion of PE teachers for grades 1 to 3 taught all 12 FMS and used direct instruction methods. For children falling behind, only 8.8% reported referring to an exercise program and no PE teacher sought a health care referral. A video abstract can be found in Supplemental Digital Content 1 (available at: http://links.lww.com/PPT/A342).
Functional Symmetry Observation Scale, Version 2: Development and Content Validation Using a Modified Delphi Method
Authors: Rahlin Mary , Barnett Joyce , Sarmiento Bernadette 
Published: December 2021

Purpose:
To describe the development of the Functional Symmetry Observation Scale (FSOS) Version 2 and its content validation.

Methods:
The FSOS Version 2 is an observational assessment that quantifies symmetry in spontaneous movement and posture in infants with congenital muscular torticollis, age birth to 18 months. Twenty expert pediatric physical therapists were identified through purposive sampling and invited to participate in a modified Delphi study. Survey data were collected on Qualtrics. Consensus was evaluated using median ratings and percent agreement on Likert Scale items. Thematic analysis was performed for open-ended question responses.

Results:
Thirteen experts completed Round 1 and 2 surveys. In Round 1, consensus was achieved on all but 1 item. The scale was modified based on received feedback. In Round 2, consensus was achieved on all items (median rating of 4, agreement at 85%-100%).

Conclusions:
This study established the content validity of the FSOS Version 2.
Sincalide-Stimulated Cholescintigraphy
Authors: Vasireddi Anil , Nguyen Nghi C. 
Published: December 2021

Purpose
Current guidelines for sincalide-stimulated cholescintigraphy (SSC) call for a 60-minute sincalide infusion, and a gallbladder ejection fraction (GBEF) ≥38% is considered normal. In this retrospective study, we hypothesize that most patients reach a normal GBEF by 30 minutes.

Methods
Eligible patients had undergone a 60-minute SSC from January to December 2019. The clinical SSC data were previously processed on a Xeleris workstation (GE Healthcare). In subjects with GBEF ≥38% based on standard SSC, the GBEF at 20 minutes and 30 minutes were retrospectively calculated using manual pixel height measurements. Receiving operating characteristic was analyzed to determine the best GBEF cutoff at 30 minutes.

Results
Of 302 subjects, mean age of 46 ± 17 years, 33 (10.9%) showed an abnormal GBEF <38% suggestive of functional gallbladder disorder. In the remaining 269 patients (89.1%) with a normal GBEF, 60.6% and 86.6% reached a normal GBEF at 20 minutes and 30 minutes, respectively. Moreover, a GBEF threshold >29.1% at 30 minutes was associated with a negative predictive value of 99.6%, indicating that a 60-minute SSC was not necessary. The GBEF values were not associated with sex, age, patient symptoms, or type of referral. Manually calculated GBEFs on the time-activity curve showed excellent correlation with the primary values. We propose a modified workflow that splits the 60-minute SSC into two 30-minute image sets to allow for a screening GBEF at 30 minutes. If GBEF is >29.1% at 30 minutes, the second image set may be stopped, and the examination is complete.

Conclusions
The majority of patients (77.2%) undergoing the standard 60-minute SSC reach a normal GBEF already by 30 minutes. The proposed workflow shortens the SCC procedure by 30 minutes, while maintaining high diagnostic accuracy and contributing to improved procedure efficiency and reduced patient discomfort as well as symptoms.
Changes in natural transformation after salt adaptation
Authors: Kittredge HA , Evans SE 
Published: December 2021

AbstractThe exchange of genes between potentially unrelated bacteria is termed horizontal gene transfer (HGT) and is a driving force in bacterial evolution. Natural transformation is one mechanism of HGT where extracellular DNA (eDNA) from the environment is recombined into a host genome. The widespread conservation of transformation in bacterial lineages implies there is a fitness benefit. However, the nature of these benefits and the evolutionary origins of transformation are still unknown. Here, I examine how ∼330 generations or 100 days of serial passage in either constant or increasing salinities impacts the growth rate and transformation efficiency of Pseudomonas stutzeri. While the growth rate generally improved in response to serial transfer, the transformation efficiency of the evolved lineages varied extensively, with only 39-64% of populations undergoing transformation at the end of adaptive evolution. In comparison, 100% of the ancestral populations were able to undergo natural transformation. I also found that evolving P. stutzeri with different cell lysates (or populations of dead cells) minimally affected the growth rate and transformation efficiency, especially in comparison to the pervasiveness with which transformation capacity was lost across the evolved populations. Taken together, I show that the efficiency of eDNA uptake changes over relatively rapid timescales, suggesting that transformation is an adaptive and selectable trait that could be lost in environments where it is not beneficial.
A tool for the in vivo gating of gene expression in neurons using the co-occurrence of neural activity and light
Authors: Vogel Adam T. , Russek Shelley J. 
Published: December 2021

AbstractAdvancements in genetically based technologies have begun to allow us to better understand the relationships between underlying neural activity and the patterns of measurable behavior that can be reproducibly studied in the laboratory. As this field develops, there are key limitations to the currently available technologies hindering their full potential to deliver meaningful datasets. The limitations which are most critical to advancement of these technologies in behavioral neuroscience are: the temporal resolution at which physiological events can be windowed, the divergent molecular pathways in signal transduction that introduce ambiguity into the output of activity sensors, and the impractical size of the genetic material that requires 3-4 separate AAV vectors to deliver a fully functional system into a cell. To address these limitations and help bring the potential of these types of technologies into better realization, we have engineered a nucleus localized light-sensitive Ca2+-dependent gene expression system based on AsLOV2 and the downstream responsive element antagonist modulator (DREAM). The design and engineering of each component was performed in such a way to: 1) preserve behaviorally relevant temporal dynamics, 2) preserve signal fidelity appropriate for studying experience-driven neural activity patterns and their relationship to specific animal responses, and 3) have full delivery of the genetic material via a single AAV vector. The system was tested in vitro and subsequently in vivo with neural activity induced by Channelrhodopsin and could be used in the future with behaviorally-driven neural activity. To our knowledge this is the first optogenetic tool for the practical use of linking activity-dependent gene activation in response to direct nuclear calcium transduction.
Combinatorial T cell engineering eliminates on-target off-tumor toxicity of CD229 CAR T cells while maintaining anti-tumor activity
Authors: Vander Mause Erica R. , Baker Jillian M. , Dietze Kenneth A. , Radhakrishnan Sabarinath V. , Iraguha Thierry , Davis Patricia , Panse Jens , Marvin James E. , Olson Michael L. , Steinbach Mary , Ng David P. , Lim Carol S. , Atanackovic Djordje , Luetkens Tim 
Published: December 2021

ABSTRACTT cells expressing chimeric antigen receptors have shown remarkable therapeutic activity against different types of cancer. However, their wider use has been hampered by the potential for life-threatening toxicities due to the unintended targeting of healthy cells expressing low levels of the targeted antigen. We have now developed an affinity-tuning approach for the generation of minimally modified, low-affinity antibody variants derived from existing high-affinity antibodies. Using this approach, we engineered low affinity variants of the fully human CD229-specific antibody 2D3. Parental 2D3 originally efficiently targeted multiple myeloma cells but also healthy T cells expressing low levels of CD229. We demonstrate that CAR T cells based on a low affinity variant of 2D3, engineered to also express CJUN to increase CAR T cell expansion, maintain the parental antibody’s anti-tumor activity but lack its targeting of healthy T cells in vitro and in vivo. In addition, we found that low affinity CD229 CAR T cells show reduced trogocytosis potentially augmenting CAR T cell persistence. The fast off-rate CAR produced using our affinity tuning approach eliminates a key liability of CD229 CAR T cells and paves the way for the effective and safe treatment of patients with multiple myeloma and other lymphoid malignancies.One sentence summaryRational T cell engineering yields low affinity CD229 CAR T cells overexpressing CJUN, which maintain the parental cells’ anti-tumor activity but eliminate killing of healthy T cells, increasing CAR T cell expansion, and decreasing trogocytosis.
Toilets for all: corporate social entrepreneurship in Bangladesh and countries in Sub-Saharan Africa
Authors: Trusty Juanita , Fabian Frances , Montague-Mfuni Michelle Amy 
Published: December 2021

Case overview
This case uniquely challenges students by introducing the history of how LIXIL transformed its corporate social responsibility (CSR) program to create shared value within the global sanitation sector by launching the SATO business unit as a social enterprise. SATO is a “self-sustaining social business that establishes a local Make, Sell, Use cycle in the community – creating jobs and allowing local manufacturers and stakeholders to continue the business independently” (LIXIL, 2019). From 2012 to 2021, NGOs helped the company design and market the SATO toilet pan and other products that form the SATO business unit. The SATO business unit must balance its social mission of improved sanitation with the need to gain a profit and become a sustainable business – the ongoing challenge of social entrepreneurship.

Leaning objectives
After completing this case study, students will be able to meet the following objectives: understand the difference in corporate strategy between CSR and ventures that create shared value; understand the sometimes-competing goals of social enterprises and analyze how they can balance both economic and social objectives; understand that developing and emerging markets are different from each other; explain how corporations can decide which markets to pursue, and how they can meet the needs of the diverse BOP markets; understand how the pursuit of the Sustainable Development Goals can create economic opportunities for corporations; and (optional: suggested for post-graduates) identify activities and challenges of MNC market entry in developing country contexts. Analyze institutional voids in developing country contexts and explore how partnerships can help to address these voids.

Complexity academic level
This case is most appropriate for the study of international business, corporate social responsibility, and social entrepreneurship students at both the undergraduate and post-graduate levels. The case may be used for undergraduate students to illustrate corporate social entrepreneurship, creating shared value, NGO partnerships, and marketing to the base of the pyramid (BOP) consumers. An optional section on BOP market entry is presented for early- and late-stage post-graduate students, illustrating the concepts of the liability of foreignness and institutional voids.

Supplementary materials
Teaching notes are available for educators only.

Subject code
CCS 3: Entrepreneurship.
Understanding firm survival in a global crisis
Authors: Salunkhe Uday , Rajan Bharath , Kumar V. 
Published: December 2021

PurposeGlobal crises create an environment that is characterized by a fight for survival by countries, companies and citizens. While firms have adopted business initiatives to ensure survival in a global crisis, many measures are geared toward preventing customer churn, declining revenues and eroding market share. Such short-term focus raises an important question regarding long-term survival – how can firms survive a global crisis? The purpose of this study is to investigate how firms can survive a global crisis.Design/methodology/approachThis study considers pandemics as the study context and uses a triangulation methodology (past research, managerial insights and popular press articles) to advance the organizing framework. Using the process study approach, the proposed framework recognizes the onset characteristics of a global crisis with a focus on pandemics and the government actions that reflect the pandemic onset. The framework also identifies a logical order of three marketplace reactions to the pandemic – management response, consumer response and critical business transformations that ultimately lead to firm survival – and advances related research propositions of such reactions.FindingsBy deploying critical business transformations, firms can ensure firm survival in a pandemic by fostering engagement with customers, employees and resources. Additionally, the moderators that influence the relationships between (1) management response and critical business transformations, (2) consumer response and critical business transformations, and (3) critical business transformations and firm survival are identified. Finally, this study presents an agenda for future research.Research limitations/implicationsTo the authors' best knowledge, this is the first study to adopt an interdisciplinary approach to study firm survival in a global crisis such as a pandemic. This study answers the call for more research to the growing field of pandemic research in the areas of marketing research and marketing strategy.Practical implicationsThe learnings from this study can help firms on what to anticipate and how to respond in a crisis such as a pandemic.Social implicationsSocietal welfare is accounted for as firms plan to deal with a crisis.Originality/valueThis is the first study to propose a strategic framework to deal with a crisis that is largely unanticipated where the duration and the impact is not predictable.