Issues in implementing cell‐free DNA cancer screening tests in blood donors. image
As automated tools become commonplace for coordinating meeting times and other forms of decentralized cooperative decision-making, it is important to understand the behavior of people using those tools. Even when a tool or online platform is simply a form of approval voting, the specifics of the voting scenario need to be considered. Approval voting often assumes that voters are sincere, never voting yes to an option that is less desirable than one for which they have voted no. A small study suggested that the assumption of sincerity among users in cooperative polls should not be taken for granted. This work expands the study to a larger sample of college students at multiple institutions, showing that people responding to polls may aim to be sincere, but are influenced by various factors, including the nature of the meeting.KeywordsApproval votingDoodle pollsSincerity
Background Previous studies indicate obesity is a risk factor of suicide behaviors among adolescents. Whether this association has remained consistent during the ongoing obesity epidemic remains unknown. Method The time trends of the obesity-suicide association were examined using the 1999–2019 biannual Youth Risk Behavior Survey data (n = 161,606). Prevalence odds ratio of suicide behaviors among obese adolescents (vs. non-obese) for each survey year and time trends using National Cancer Institute joinpoint regression analysis were calculated. Results For each year post-baseline, there was a significant increase of prevalence odds ratio of 1.4 (1.2–1.6)-1.6(1.3-2.0) for ideation, 1.3(1.1–1.7)-1.7(1.4-2.0) for plan, and 1.3(1.0-1.7)-1.9(1.5–2.4) for an attempt, except for the 2013 survey for the attempt (1.19 [0.9–1.6]). Significant positive trends were found during 1999–2019 for ideation and plan, with biannual %-changes of + 0.92% and + 1.22%, respectively. Conclusion Obese adolescents have consistently higher odds of engaging in suicide behaviors than their non-obese peers since the beginning of the national obesity epidemic, and that this association grew stronger as the obesity epidemic continued
Background Because plagiarism is such a common form of academic dishonesty, many instructors are seeking ways to effectively teach students to avoid plagiarism. Objective The current study tested the effectiveness of a 3-pronged intervention to teach students in an upper-level psychology course to better understand plagiarism. Method The intervention involved three different assignments across the first part of the semester: an online plagiarism tutorial, an in-class lecture over a plagiarism handout, and a follow-up homework exercise that helped students apply what they learned from the tutorial and handout. Results Study 1 showed that students in the intervention class scored higher on an end-of-semester plagiarism test compared to a control group of classes that did not use the intervention. Study 2 replicated these results and ruled out the possibility of preexisting differences in plagiarism knowledge by comparing plagiarism test scores on a beginning-of-semester pretest and an end-of-semester posttest in both the intervention and control classes. Conclusion The results of this naturalistic, quasi-experimental study suggest that multiple exposures to anti-plagiarism instruction in different formats can be effective. Teaching Implications Psychology instructors can improve students’ understanding of plagiarism and how to avoid it by using this 3-pronged approach in their courses.
Following emerging sociological critiques of hegemonic femininities and calls for embodied research that troubles long standing assumptions about academia as a "safe haven," this essay provides critical reflections on quotidian forms of gendered racism and vigilantism in the classroom. Specifically, I draw on undergraduate student engagement with "Cat Person," a short story about a "bad date" that was published in the New Yorker in 2017 and is now considered essential reading for the #MeToo era. By bringing pop culture artifacts and autoethnographic reflections into conversation with what philosopher Barbara Applebaum refers to as the "pedagogical practice of comforting discomfort," I examine forms of Karenism that emerge in higher education classrooms, particularly for women of color faculty. I argue that in an institutional context where class-privileged white women most readily access narratives about violability and fragility, they are better positioned to summon pedagogical forms of comforting and care.
Introduction Elevated preoperative glycated hemoglobin (HbA1c) is believed to predict complications in diabetic patients undergoing ventral hernia repair (VHR). Our objective was to assess the association between HbA1c and outcomes of VHR in diabetic patients. Methods We conducted a retrospective cohort study using the Abdominal Core Health Quality Collaborative (ACHQC) database. We included adult diabetic patients who underwent elective VHR with an available HbA1c result. The patients were divided into two groups (HbA1c < 8% and HbA1c ≥ 8%). Patient demographics, comorbidities, hernia characteristics, operative details, and surgical outcomes were compared. Multivariable logistic regression analysis of complications was performed. Cox proportional hazard regression was used to assess probability of composite recurrence at different HbA1c levels. Results 2167 patients met the inclusion criteria (HbA1c < 8% = 1,776 and HbA1c ≥ 8% = 391). Median age was 61 years and median body mass index was 34 kg/m². 75% had an American Society of Anesthesiology class of 3. The median HbA1c was 6.5% in the HbA1c < 8% group versus 8.7% in the HbA1c ≥ 8% group. 73% were incisional hernias, 34% were recurrent, and median hernia width was 6 cm. Open approach was used in 63% and myofascial release was performed in 46%. Median follow-up was 27 days. There were no clinically significant differences in the rates of overall 30-day complications, wound complications, reoperation, readmission, mortality, length of stay and quality of life and pain scores between the two groups. Regression analyses did not identify an association between HbA1c and the rates of complications, surgical site infection or composite recurrence across the spectrum of HbA1c values. Conclusion Our study finds no evidence of an association between HbA1c and operative outcomes in diabetic patients undergoing elective VHR. Graphical abstract
Background: Neuroendocrine differentiation in the prostate gland ranges from clinically insignificant neuroendocrine differentiation detected with markers in an otherwise conventional prostatic adenocarcinoma to a lethal high-grade small/large cell neuroendocrine carcinoma. The concept of neuroendocrine differentiation in prostatic adenocarcinoma has gained considerable importance due to its prognostic and therapeutic ramifications and pathologists play a pivotal role in its recognition. However, its awareness, reporting, and resource utilization practice patterns among pathologists are largely unknown. Methods: Representative examples of different spectrums of neuroendocrine differentiation along with a detailed questionnaire were shared among 39 urologic pathologists using the survey monkey software. Participants were specifically questioned about the use and awareness of the 2016 WHO classification of neuroendocrine tumors of the prostate, understanding of the clinical significance of each entity, and use of different immunohistochemical (IHC) markers. De-identified respondent data were analyzed. Results: A vast majority (90%) of the participants utilize IHC markers to confirm the diagnosis of small cell neuroendocrine carcinoma. A majority (87%) of the respondents were in agreement regarding the utilization of type of IHC markers for small cell neuroendocrine carcinoma for which 85% of the pathologists agreed that determination of the site of origin of a high-grade neuroendocrine carcinoma is not critical, as these are treated similarly. In the setting of mixed carcinomas, 62% of respondents indicated that they provide quantification and grading of the acinar component. There were varied responses regarding the prognostic implication of focal neuroendocrine cells in an otherwise conventional acinar adenocarcinoma and for Paneth cell-like differentiation. The classification of large cell neuroendocrine carcinoma was highly varied, with only 38% agreement in the illustrated case. Finally, despite the recommendation not to perform neuroendocrine markers in the absence of morphologic evidence of neuroendocrine differentiation, 62% would routinely utilize IHC in the work-up of a Gleason score 5 + 5 = 10 acinar adenocarcinoma and its differentiation from high-grade neuroendocrine carcinoma. Conclusion: There is a disparity in the practice utilization patterns among the urologic pathologists with regard to diagnosing high-grade neuroendocrine carcinoma and in understanding the clinical significance of focal neuroendocrine cells in an otherwise conventional acinar adenocarcinoma and Paneth cell-like neuroendocrine differentiation. There seems to have a trend towards overutilization of IHC to determine neuroendocrine differentiation in the absence of neuroendocrine features on morphology. The survey results suggest a need for further refinement and development of standardized guidelines for the classification and reporting of neuroendocrine differentiation in the prostate gland.
The ability to respond rapidly to changes in oxygen tension is critical for many forms of life. Challenges to oxygen homeostasis, specifically in the contexts of evolutionary biology and biomedicine, provide important insights into mechanisms of hypoxia adaptation and tolerance. Here we synthesize findings across varying time domains of hypoxia in terms of oxygen delivery, ranging from early animal to modern human evolution and examine the potential impacts of environmental and clinical challenges through emerging multi-omics approaches. We discuss how diverse animal species have adapted to hypoxic environments, how humans vary in their responses to hypoxia (i.e., in the context of high-altitude exposure, cardiopulmonary disease, and sleep apnea), and how findings from each of these fields inform the other and lead to promising new directions in basic and clinical hypoxia research.
Purpose The purpose of this cross-sectional study was to investigate whether obesity is associated with suicide attempt in a nationally representative sample of U.S. adults. Methods From the 2004–2005 National Epidemiologic Survey of Alcohol and Related Conditions Wave 2 data (n = 34,653 adults), survey responses were extracted on suicide attempt (ever, recent [≤ 2 years]), demographic (age, sex, race/ethnicity), mental disorders (internalizing, personality, substance abuse), and psychosocial factors (e.g., abuse, trauma, sexual identity). Current body mass index (BMI) categorized participants as obese (≥ 30 kg/m ² ) or non-obese (< 30 kg/m ² ). Odds ratio [95% confidence interval] of suicide attempt by obesity status was calculated by logistic regression, while adjusting for mental health, demographic, and psychosocial confounders. Results Ever and recent suicide attempt prevalence was 3.4% and 3.1%, respectively, and the obesity prevalence 28%. Compared to non-obese adults, obese adults were 1.43 [1.20–1.69] times and 1.40 [0.90–2.18] times more likely to have ever, and recently, attempted suicide, respectively. Among the obese, middle-age (36–55 years) adults were 0.64 [0.31–0.92] times less likely to have ever-attempted suicide than older (> 55 years) adults. Only 15% of the obesity’s association with lifetime suicide attempt was mediated by mental illnesses. Conclusion Current-obesity is associated with lifetime suicide attempt among U.S. adults, even after adjustment for mental health, demographic, and psychosocial confounders. Further research on the temporality and causality of this association is needed.
Background A significant challenge that non-elite collegiate triathletes encounter during competition is the decline in running performance immediately after cycling. Therefore, the purpose of this study was to determine if performing a 40-km bout of cycling immediately before running would negatively influence running economy and mechanical efficiency of running during simulated race conditions in collegiate triathletes. Methods Eight competitive club-level collegiate triathletes randomly performed two trials: cycling for 40 km (Cycle-Run) or running for 5 km (Run–Run), immediately followed by a four-minute running economy and mechanical efficiency of running test at race pace on an instrumented treadmill. Blood lactate, respiratory exchange ratio, mechanical work, energy expenditure, and muscle glycogen were also measured during the four-minute running test. Results Mechanical efficiency of running, but not running economy, was significantly lower in Cycle-Run, compared to Run–Run (42.1 ± 2.5% vs. 48.1 ± 2.5%, respectively; p = 0.027). Anaerobic energy expenditure was significantly higher in the Cycle-Run trial, compared to the Run–Run trial (16.3 ± 2.4 vs. 7.6 ± 1.1 kJ; p = 0.004); while net (151.0 ± 12.3 vs. 136.6 ± 9.6 kJ; p = 0.204) and aerobic energy expenditure (134.7 ± 12.3 vs. 129.1 ± 10.5 kJ; p = 0.549) were not statistically different between trials. Analysis of blood lactate, respiratory exchange ratio, mechanical work, and changes in muscle glycogen revealed no statistically significant differences between trials. Conclusions These results suggest that mechanical efficiency of running, but not running economy, is decreased and anaerobic energy expenditure is increased when a 40-km bout of cycling is performed immediately before running in collegiate triathletes.
Background: Aloe vera is a medically valuable plant with anti-epileptic activity; however, its mechanism of action remains unknown. In this study, network pharmacological, in vitro, and in vivo experiments were carried out to explore the potential anti-epileptic components and targets of Aloe vera. Methods: The main active components of Aloe vera were identified by searching the Traditional Chinese Medicine System Pharmacology database. Targets of Aloe vera were predicted using SwissTargetPrediction, whereas information about the epilepsy disease targets was obtained from Gene Cards. The protein–protein interaction network and core targets were screened according to the topological structure and CytoNCA plugin. The glutamate-induced HT22 cell line and pentylenetetrazol-induced seizure rats were used to confirm the effect of aloesone by detecting reactive oxygen species (ROS) and apoptosis, and predicting the targets. Results: A total of 14 core active components were selected based on the screening criteria of oral bioavailability ≥30% and drug-likeness ≥ 0.10. Four compounds, namely linoleic acid, aloesone, isoeleutherol glucosiden qt, and anthranol, demonstrated the potential ability of crossing the blood-brain barrier. A total of 153 targets associated with epilepsy were predicted for the four compounds. Moreover, after network analysis with CytoNCA, 10 targets, namely, MAPK1, SRC, MARK3, EGFR, ESR1, PTGS2, PTPN11, JAK2, PPKCA, and FYN, were selected as the core genes, and SRC, which has been predicted to be the target of aloesone and anthranol, exhibited the highest subgraph centrality value. In vitro experiments confirmed that aloesone treatment significantly inhibited the glutamate-induced neuronal injury by reducing the intracellular ROS content and the early phase of apoptosis. Additionally, treatment with 50 mg/kg aloesone resulted in anti-seizure effects by reducing the seizure score and prolonging the latent period in acute and chronic rats. Furthermore, aloesone treatment increased the phosphorylation of c-SRC at Y418 and reduced the phosphorylation at Y529, simultaneously activating c-SRC. Conclusion: Integrating network pharmacology with in vitro and in vivo experiments demonstrated that aloesone, which inhibited seizure by activating c-SRC, is a potential anti-seizure compound present in Aloe vera.
Objective To review existing structured MRI reports for primary staging of rectal cancer and create a new, freely available structured report based on multidisciplinary expert opinion and literature review. Methods Twenty abdominal imaging experts from the Society of Abdominal Radiology (SAR)’s Disease Focused Panel (DFP) on Rectal and Anal Cancer completed a questionnaire and participated in a subsequent consensus meeting based on the RAND-UCLA Appropriateness Method. Twenty-two items were classified via a group survey as “appropriate” or “inappropriate” (defined by ≥ 70% consensus), or “needs group discussion” (defined by < 70% consensus). Certain items were also discussed with multidisciplinary team members from colorectal surgery, oncology and pathology. Results After completion of the questionnaire, 16 (72%) items required further discussion (< 70% consensus). Following group discussion, consensus was achieved for 21 (95%) of the items. Based on the consensus meeting, a revised structured report was developed. The most significant modifications included (1) Exclusion of the T2/early T3 category; (2) Replacement of the term “circumferential resection margin (CRM)” with “mesorectal fascia (MRF)”; (3) A revised definition of “mucinous content”; (4) Creation of two distinct categories for suspicious lymph nodes (LNs) and tumor deposits; and (5) Classification of suspicious extra-mesorectal LNs by anatomic location. Conclusion The SAR DFP on Rectal and Anal Cancer recommends using this newly updated reporting template for primary MRI staging of rectal cancer. Graphical abstract
Objectives:Machine Learning (ML) and Artificial Intelligence (AI) remain crucial in education research and pedagogical development. The study provides an overview of ML and AI in education and research.Methods:In order to explore the field of ML and AI, a bibliometric approach was employed to extract and analyze data from the Scopus database. Bibliometrics analysis tools, VOS Viewer, Bibliometrics, and R packages were used to analyze the retrieved data.Results:A total of 1138 documents retrieved were written by 2800 authors, and published in 635 journals from 2000 to 2022, with average citations per document of 5.984 from 62 countries.Conclusion:The study identified an interesting gap that the previously published articles did not address: the implications of ML and AI in classroom learning activities and other pedagogical-related programmes.
Objectives To evaluate variability in antibiotic duration for necrotizing enterocolitis (NEC) and associated clinical outcomes. Study design Five-hundred ninety-one infants with NEC (315 medical; 276 surgical) were included from 22 centers participating in Children’s Hospitals Neonatal Consortium (CHNC). Multivariable analyses were used to determine predictors of variability in time to full feeds (TFF) and length of stay (LOS). Results Median (IQR) antibiotic duration was 12 (9, 17) days for medical and 17 (14, 21) days for surgical NEC. Wide variability in antibiotic use existed both within and among centers. Duration of antibiotic therapy was associated with longer TFF in both medical (OR 1.04, 95% CI [1.01, 1.05], p < 0.001) and surgical NEC (OR 1.02 [1, 1.03] p = 0.046); and with longer LOS in medical (OR 1.03 [1.02, 1.04], p < 0.001) and surgical NEC (OR 1.01 [1.01, 1.02], p = 0.002). Conclusion Antibiotic duration for both medical and surgical NEC remains variable within and among high level NICUs.
Rectal MR is the key diagnostic exam at initial presentation for rectal cancer patients. It is the primary determinant in establishing clinical stage for the patient and greatly impacts the clinical decision-making process. Consequently, structured reporting for MR is critically important to ensure that all required information is provided to the clinical care team. The SAR initial staging reporting template has been constructed to address these important items, including locoregional extent and factors impacting the surgical approach and management of the patient. Potential outputs to each item are defined, requiring the radiologist to commit to a result. This provides essential information to the surgeon or oncologist to make specific treatment deisions for the patient. The SAR Initial Staging MR reporting template has now been officially adopted by the NAPRC (National Accreditation Program for Rectal Cancer) under the American College of Surgery. With the recent revisions to the reporting template, this user guide has been revamped to improve its practicality and support to the radiologist to complete the structured report. Each line item of the report is supplemented with clinical perspectives, images, and illustrations to help the radiologist understand the potential implications for a given finding. Common errors and pitfalls to avoid are highlighted. Ideally, rectal MR interpretation should not occur in a vacuum but in the context of a multi-disciplinary tumor board to ensure that healthcare providers use common terminology and share a solid understanding of the strengths and weaknesses of MR.
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