Search

Introduction: Alcohol screening among Indigenous Australians is important to identify individuals needing support to reduce their drinking. Understanding clinical contexts in which clients are screened, and which clients are more or less likely to be screened, could help identify areas of services and communities that might benefit from increased screening. Methods: We analysed routinely collected data from 22 Aboriginal Community Controlled Health Organisations Australia‐wide. Data collected between February 2016 and February 2021 were analysed using R, and aggregated to describe screening activity per client, within 2‐monthly extraction periods. Descriptive analyses were performed to identify contexts in which clients received an Alcohol Use Disorders Identification Test consumption (AUDIT‐C) screen. Multi‐level logistic regression determined demographic factors associated with receiving an AUDIT‐C screen. Three models are presented to examine if screening was predicted by: (i) age; (ii) age and gender; (iii) age, gender and service remoteness. Results: We observed 83,931 occasions where AUDIT‐C was performed at least once during a 2‐monthly extraction period. Most common contexts were adult health check (55.0%), followed by pre‐consult examination (18.4%) and standalone item (9.9%). For every 10 years' increase in client age, odds of being screened with AUDIT‐C slightly decreased (odds ratio 0.98; 95% confidence interval [CI] 0.98, 0.99). Women were less likely to be screened with AUDIT‐C (odds ratio 0.95; 95% CI 0.93, 0.96) than men. Discussion and Conclusions: This study identified areas where alcohol screening can be increased (e.g., among women). Increasing AUDIT‐C screening across entire communities could help reduce or prevent alcohol‐related harms. Future Indigenous‐led research could help identify strategies to increase screening rates. [ABSTRACT FROM AUTHOR]

Potato production in East Africa is seriously impacted by the potato cyst nematode (PCN), Globodera rostochiensis, where it has been recorded in at least three countries. In Kenya, it is widespread in all major potato-growing regions, often at very high densities. Consecutive cropping of potato on the same land and a sub-tropical climate have influenced PCN biology. For example, unusually large cysts have been regularly recovered. We have analysed the biological properties of these ‘giant cysts’. The giant cysts contained more eggs than those recovered from UK fields. Egg size did not differ from UK populations and there was no difference in overall lipid content or lipid profile in J2 from giant cysts, compared to control samples. The nematodes in giant cysts were also genetically indistinguishable from any other G. rostochiensis sampled. When grown under UK glasshouse conditions, the offspring of nematodes from giant cysts were no different in size from those grown from control cysts, indicating that gigantism is not a heritable trait and may simply reflect favourable conditions for PCN under Kenyan farming systems. To date, all the PCN tested from Kenya, including those from giant cysts, are avirulent on potato cultivars containing the H 1 resistance gene. [ABSTRACT FROM AUTHOR]

Restoration of root hemiparasite trees, such as Hawaiʻi's endemic Santalum species (ʻiliahi), may benefit from underplanting in stands of suitable hosts like the nitrogen‐fixing native tree, Acacia koa (koa). At a pasture site on Hawaiʻi Island previously reforested with koa, we underplanted seedlings of the island‐endemic sandalwood species, Santalum paniculatum, to examine the tradeoff between access to an established root network (distance to the nearest koa tree) under variable overstory shading (8.8–90.1% canopy openness range) during regeneration establishment. We hypothesized that there is an optimal parasite–host spacing and canopy openness that balance parasitic resource transfer with light availability. ʻIliahi seedling survival was 96% with no survival treatment differences. 'Iliahi seedling growth was positively related to canopy openness but negatively related to the distance to the nearest koa tree, and the slope of these relationships increased over time. Leaf photosynthetic light compensation points, light saturation points, and stomatal density mostly followed similar trends as growth. These results demonstrate that 'iliahi can be successfully underplanted in an established koa stand, which benefits 'iliahi plantings and contributes to diversifying initial restoration and reforestation plantings. There appears to be a significant tradeoff in planting distance between benefits from and competition with the host; however, the improvement in growth with increased canopy openness appeared to be much greater than the effect of planting distance. Underplanting into an established host stand with sufficient canopy openness can help restore functionally compatible and abundant 'iliahi regeneration into forests. [ABSTRACT FROM AUTHOR]

The decline of wild bee pollinators has prompted habitat reconstruction in many regions around the world in order to increase the floral resources available to pollinators. Relatively little research has monitored the genetic differentiation and the relatedness of founding bumblebee populations during the colony recruitment process after vegetation is planted in the landscape. We surveyed nine 3‐year post‐planting reconstructed prairie sites located in the corn belt of the U.S. Midwest, where the landscape is largely dominated by industrialized row crops. Using seven microsatellite loci from 103 Bombus griseocollis, we examined the population genetics of this generalist bee's colonies established on these newly constructed prairie sites. When analyzed, B. griseocollis populations from an older reconstructed site were more genetically distinct from newly established bumblebee populations on reconstructed sites, while the new reconstructed sites exhibited no genetic structure. The floral richness or abundance at the reconstructed sites did not contribute to the allelic richness of the recolonized bumblebee populations. We did, however, find significant negative correlations between the bumblebee populations' allelic richness and the percent coverage of row‐crop farmland in the surrounding landscape and positive correlations between the allelic richness and forest and woody wetland habitat covers. This finding strongly indicates the importance of the composition of the surrounding landscape in the recruitment period of the founding pollinator populations. [ABSTRACT FROM AUTHOR]

Plant–plant interactions, often studied in the context of plant traits, are considered crucial assembly mechanisms for plant communities and offer insights into how neighbours affect growth. Three key questions regarding these interactions have theoretical importance but limited empirical support: (1) does similarity in plant traits enhance competitive interactions among species, (2) is the "competitive environment" determined through plant traits of the resident species, and (3) do greater species diversity and niche use result in increased competition among co‐occurring species. Here we use a simple experimental design to directly test these foundational questions.In a mesocosm experiment using native grassland fragments, we investigated our questions simultaneously by manipulating trait relationships among resident and colonizing plants. To assess the net impact of neighbours on plant growth, we measured the degree of suppression experienced by focal plants compared to growth in the absence of neighbours. We further tested whether trait‐function relationships are context‐dependent by modifying available resources.Contrary to the limiting similarity hypothesis, we found that reduced overall dissimilarity mitigated neighbour‐induced growth suppression, with more negative effects occurring among dissimilar neighbours. The influence of trait dissimilarity depended on nutrient context and was stronger under increased resource availability. We found little support for the idea that specific plant traits are "functional" in creating competitive environments: no community traits (community weighted means) were associated with net neighbour effects. In contrast, resource supply significantly affected species interactions, with increased resources exacerbating negative neighbour effects on plant growth.We found that plant trait dissimilarity does function in competition but is contingent on resource context. However, trait values were not inherently competitive: traits may have physiological functions but did not function in focal plants' competitive response. We provide some of the limited data directly testing the core mechanisms of community assembly. We encourage such direct experimental tests as they are essential to building an understanding of ecological processes. Read the free Plain Language Summary for this article on the Journal blog. [ABSTRACT FROM AUTHOR]

Experiencing existing spaces and designed environments, as well as engaging with their possibilities and production, is fundamental to students' learning in construction and built environments disciplines. Site visits serve a range of learning objectives, and offer a place and a mode to practice professional expertise. The major dislocation of learning and teaching precipitated by COVID-19 required reimagining these authentic and valuable site experiences. This article explores the design of virtual site visits (VSVs) through the lens of teaching activities and learning aims, and describes a VSV typology developed through a phenomenographic approach. The typology draws on exemplars and related interviews with designers and educators from across a built environments faculty of a comprehensive Australian university. It distinguishes between those developed to inspire and contextualize; those that demonstrate or demarcate; and those that ground abstract experiences via specific locations. This work suggests complementary roles for virtual and physical site visits within hybrid and flexible learning environments, even while much teaching returns to campus. It is relevant to academic developers who seek to frame the use of VSVs through learning rather than technical lenses, and all educators who aim to incorporate site experiences for student learning ... wherever they are. [ABSTRACT FROM AUTHOR]

Purpose: The Open Payments Program (OPP), established in 2013 under the Sunshine Act, mandated medical device and pharmaceutical manufacturers to submit records of financial incentives given to physicians for public availability. The study aims to characterize the gap in real general and real research payments between man and woman urologists. Materials and Methods: The study sample included all urologists in the United States who received at least one general or research payment in the OPP database from 2015 to 2021. Recipients were identified using the National Provider Identifier and National Downloadable File datasets. Payments were analyzed by geography, year, payment type, and years since graduation. Multivariable analysis on odds of being in above the median in terms of money received was done with gender as a covariate. This analysis was also completed for all academic urologists. Results: There was a total of 15,980 urologists; 13.6% were woman, and 86.4% were man. Compared to man urologists, woman urologists were less likely to be in the top half of total payments received (odds ratio [OR] 0.62) when adjusted for other variables. When looking at academic urologists, 18.1% were woman and 81.9% were man. However, woman academic urologists were even less likely to be in the top 50% of payments received (OR 0.55). Conclusions: This study is the first to characterize the difference in industry payments between man and woman urologists. The results should be utilized to educate physicians and industry, in order to achieve equitable engagement and funding for woman urologists. [ABSTRACT FROM AUTHOR]

Global forests are increasingly lost to climate change, disturbance, and human management. Evaluating forests' capacities to regenerate and colonize new habitats has to start with the seed production of individual trees and how it depends on nutrient access. Studies on the linkage between reproduction and foliar nutrients are limited to a few locations and few species, due to the large investment needed for field measurements on both variables. We synthesized tree fecundity estimates from the Masting Inference and Forecasting (MASTIF) network with foliar nutrient concentrations from hyperspectral remote sensing at the National Ecological Observatory Network (NEON) across the contiguous United States. We evaluated the relationships between seed production and foliar nutrients for 56,544 tree‐years from 26 species at individual and community scales. We found a prevalent association between high foliar phosphorous (P) concentration and low individual seed production (ISP) across the continent. Within‐species coefficients to nitrogen (N), potassium (K), calcium (Ca), and magnesium (Mg) are related to species differences in nutrient demand, with distinct biogeographic patterns. Community seed production (CSP) decreased four orders of magnitude from the lowest to the highest foliar P. This first continental‐scale study sheds light on the relationship between seed production and foliar nutrients, highlighting the potential of using combined Light Detection And Ranging (LiDAR) and hyperspectral remote sensing to evaluate forest regeneration. The fact that both ISP and CSP decline in the presence of high foliar P levels has immediate application in improving forest demographic and regeneration models by providing more realistic nutrient effects at multiple scales. [ABSTRACT FROM AUTHOR]

In this paper, we compute the limit distribution of partial transposes (when both the number and the size of blocks tends to infinity) for a large class of ensembles of unitarily invariant random matrices. Furthermore, the asymptotic freeness relation between the ensembles of random matrices, their transposes and their left and right partial transposes is shown. [ABSTRACT FROM AUTHOR]

Background Aim Methods Results Conclusion Current guidelines highlight a paucity of evidence guiding optimal timing for non‐ST‐elevation myocardial infarction (NSTEMI) in high‐risk and non‐high‐risk cases.We assessed long‐term major adverse cardiovascular events (MACEs) in NSTEMI patients undergoing early (<24 h) versus delayed (>24 h) coronary angiography at 6 years. Secondary end‐points included all‐cause mortality and cumulative MACE outcomes.Baseline characteristics and clinical outcomes were assessed among 355 patients presenting to a tertiary regional hospital between 2017 and 2018. Cox proportional hazard models were generated for MACE and all‐cause mortality outcomes, adjusting for the Global Registry of Acute Coronary Events (GRACE) score, patient demographics, biomarkers and comorbidities.Two hundred and seventy patients were included; 147 (54.4%) and 123 (45.6%) underwent early and delayed coronary angiography respectively. Median time to coronary angiography was 13.3 and 45.4 h respectively. At 6 years, 103 patients (38.1%) experienced MACE; 41 in the early group and 62 in the delayed group (hazard ratio (HR) = 2.23; 95% confidence interval (CI) = 1.50–3.31). After multivariable adjustment, the delayed group had higher rates of MACE (HR = 1.79; 95% CI = 1.19–2.70), all‐cause mortality (HR = 2.76; 95% CI = 1.36–5.63) and cumulative MACE (incidence rate ratio = 1.54; 95% CI = 1.12–2.11). Subgroup analysis of MACE outcomes in rural and weekend NSTEMI presentations was not significant between early and delayed coronary angiography (HR = 1.49; 95% CI = 0.83–2.62).Higher MACE rates in the delayed intervention group suggest further investigation is needed. Randomised control trials would be well suited to assess the role of early invasive intervention across all NSTEMI risk groups. [ABSTRACT FROM AUTHOR]

Keloid disorder is a morbid and disfiguring benign fibroproliferative disease with a higher incidence in groups with darker skin pigmentation. Predicting keloidogenesis in patients is difficult with treatment primarily aimed at preventing further scar expansion and improving aesthetics without addressing their unknown underlying pathophysiology. We aimed to identify potential genetic predispositions to keloid scarring in the literature. A search was conducted on 21 August 2023, by the first and second authors independently from 1985 to August 2023 using PubMed, MEDLINE, Embase, Web of Science, Scopus and CINAHL. The following MeSH terms were used: ‘Keloid’, ‘Risk’ and ‘Genetic’. Two researchers independently searched for studies based on titles and abstracts and screened filtered articles by reviewing full text. If no agreement could be reached, a third senior author designated whether the article should be included. We used the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses 2020 statement as the basis of our organisation. Human studies with genetic analysis to determine an association of a protein or gene to keloidogenesis were selected for inclusion. Studies in languages other than English, reviews, conference articles, and book chapters were excluded. Fifty studies met inclusion criteria. The human leukocyte antigen (HLA) system was broadly implicated, and the DRB1*15 allele was associated with an increased risk of keloid in three separate ethnic groups. Some HLA Class I alleles were associated with keloid in one population but not in others. Additionally, polymorphisms in the E3 ubiquitin‐protein ligase (NEDD4) signal cascade and vitamin D receptor (VDR) have been implicated in diverse groups. No current genetic test can predict keloid risk. Our review identified candidate predisposing genes, including NEDD4, VDR and components of the HLA system. Further studies in heterogeneous populations are needed to identify reliable screening targets. [ABSTRACT FROM AUTHOR]

Authentic assessment is a widely discussed concept in higher education, but it has a problem: the concept has become so all-encompassing that its meaning is now unclear. The notion has been expanded and diluted. For example, adding social justice to the definition or positioning exams as authentic, adds to the contradictions inherent within in the term. We argue for a more critical stance regarding the existing claims related to authentic assessment to ensure that the field remains evidence informed. From a position where we wholeheartedly believe in the aims and approaches of the authentic assessment movement, we conclude that for the sake of coherence and clarity, we should stop using the term ‘authentic assessment’ and instead turn our attention to focus on the component characteristics. [ABSTRACT FROM AUTHOR]

Hierarchical models can express ecological dynamics using a combination of fixed and random effects, and measurement of their complexity (effective degrees of freedom, EDF) requires estimating how much random effects are shrunk toward a shared mean. Estimating EDF is helpful to (1) penalize complexity during model selection and (2) to improve understanding of model behavior. I applied the conditional Akaike Information Criterion (cAIC) to estimate EDF from the finite‐difference approximation to the gradient of model predictions with respect to each datum. I confirmed that this has similar behavior to widely used Bayesian criteria, and I illustrated ecological applications using three case studies. The first compared model parsimony with or without time‐varying parameters when predicting density‐dependent survival, where cAIC favors time‐varying demographic parameters more than conventional Akaike Information Criterion. The second estimates EDF in a phylogenetic structural equation model, and identifies a larger EDF when predicting longevity than mortality rates in fishes. The third compares EDF for a species distribution model fitted for 20 bird species and identifies those species requiring more model complexity. These highlight the ecological and statistical insight from comparing EDF among experimental units, models, and data partitions, using an approach that can be broadly adopted for nonlinear ecological models. [ABSTRACT FROM AUTHOR]

The ecologically and economically vital symbiosis between nitrogen-fixing rhizobia and leguminous plants is often thought of as a bi-partite interaction, yet studies increasingly show the prevalence of non-rhizobial endophytes (NREs) that occupy nodules alongside rhizobia. Yet, what impact these NREs have on plant or rhizobium fitness remains unclear. Here, we investigated four NRE strains found to naturally co-occupy nodules of the legume Medicago truncatula alongside Sinorhizobium meliloti in native soils. Our objectives were to (1) examine the direct and indirect effects of NREs on M. truncatula and S. meliloti fitness, and (2) determine whether NREs can re-colonize root and nodule tissues upon reinoculation. We identified one NRE strain (522) as a novel Paenibacillus species, another strain (717A) as a novel Bacillus species, and the other two (702A and 733B) as novel Pseudomonas species. Additionally, we found that two NREs (Bacillus 717A and Pseudomonas 733B) reduced the fitness benefits obtained from symbiosis for both partners, while the other two (522, 702A) had little effect. Lastly, we found that NREs were able to co-infect host tissues alongside S. meliloti. This study demonstrates that variation of NREs present in natural populations must be considered to better understand legume–rhizobium dynamics in soil communities. [ABSTRACT FROM AUTHOR]

Despite evidence inferring muscle and contractile mode‐specific effects of high‐fat diet (HFD), no study has yet considered the impact of HFD directly on eccentric muscle function. The present work uniquely examined the effect of 20‐week HFD on the isometric, concentric and eccentric muscle function of isolated mouse soleus (SOL) and extensor digitorum longus (EDL) muscles. CD‐1 female mice were randomly split into a control (n = 16) or HFD (n = 17) group and for 20 weeks consumed standard lab chow or HFD. Following this period, SOL and EDL muscles were isolated and assessments of maximal isometric force and concentric work loop (WL) power were performed. Each muscle was then subjected to either multiple concentric or eccentric WL activations. Post‐fatigue recovery, as an indicator of incurred damage, was measured via assessment of concentric WL power. In the EDL, absolute concentric power and concentric power normalised to muscle mass were reduced in the HFD group (P < 0.038). HFD resulted in faster concentric fatigue and reduced eccentric activity‐induced muscle damage (P < 0.05). For the SOL, maximal isometric force was increased, and maximal eccentric power normalised to muscle mass and concentric fatigue were reduced in the HFD group (P < 0.05). HFD effects on eccentric muscle function are muscle‐specific and have little relationship with changes in isometric or concentric function. HFD has the potential to negatively affect the intrinsic concentric and eccentric power‐producing capacity of skeletal muscle, but a lack of a within‐muscle uniform response indicates disparate mechanisms of action which require further investigation. What is the central question of this study?Is there a direct and muscle specific impact of dietary‐induced obesity on eccentric muscle function and to what extent is this comparable to effects on isometric and concentric activity?What is the main finding and its importance?Effects of dietary‐induced obesity on eccentric muscle function are muscle‐specific and have little relationship to changes in isometric or concentric function. Impaired eccentric function could present a significant risk to people living with obesity. Moreover, these data are valuable to inform the design of therapeutic strategies to prevent obesity‐impaired muscle health inferring distinct mechanisms account for contractile mode‐specific effects. [ABSTRACT FROM AUTHOR]

Psychological Critical Race Theory (PCRT) was introduced in 1998. PCRT illustrates the integral connection of psychological research and theory to the legal framework of Critical Race Theory (CRT). Five tenets of PCRT were described: (1) Spontaneous and persistent influence of race; (2) Fairness is derived from divergent racial experiences; (3) Asymmetrical consequences of racial policies; (4) Paradoxes of racial diversity; and (5) Racial identity requires a multidimensional approach. These tenets are reviewed and updated. A new set of seven PCRT principles are proposed that provide a broad framework within which to examine the PCRT concept and its role in reframing critical approaches to racial justice. Principle 1: Race and culture make each other up; Principle 2: Meaning Matters; Principle 3: Multilevel analysis is critical to unraveling Systemic Racism; Principle 4: Activism is a lever for social change; Principle 5: Power drives racial inequality; Principle 6: Storytelling disrupts status quo narratives; Principle 7: Diversity does not ameliorate systemic racism. PCRT is a 100‐year enterprise of psychological science, offering a complex and comprehensive framework for understanding and ameliorating persistent racial inequality. The comprehensive network of ideas, methods, goals, and strategies can engage and guide this work for years to come. [ABSTRACT FROM AUTHOR]

Frequently referred to as 'sexting' or 'amateur pornography', digital sexual images and videos form an increasingly common part of adult sexual relationships. However, the vocabulary available to speak about these practices is limited, with 'sexting' often associated with young people in negative terms. This study is based on 23 interviews with adults in Australia who are 25 years and older. It explores the language adults employ to discuss and comprehend the creation and sharing of sexualised images and videos. Findings show that negative or positive connotations associated with the terms used to discuss sexual images and videos influenced the ways participants drew on, or rejected, terms to align digital practices with their sexual subjectivity. Reticence to engage in active communication about digital sexual practices, and participant's distancing of their own practices from the terms commonly understood to refer to such practices, made it difficult to engage in conversations about consent or desire in the context of digitally mediated sex. Findings provide insight into the ways that -digital sexual subjectivities are discursively framed and extend these implications for sexual health promotion with respect to how to frame messages of digital sexual safety in a sex-positive and open way. [ABSTRACT FROM AUTHOR]

This study examines the impact of message length and audience's perceived information overload on the effectiveness of a fact-check in reducing belief in fake news within the COVID-19 vaccination context. Through an online experiment (N = 374) conducted in Singapore, we found an interaction effect between one's level of information overload and the type of fact-check that was being shown (short, medium, or long). The findings from this study help to extend the literature on the effectiveness of fact-checks in reducing general public's belief in fake news. [ABSTRACT FROM AUTHOR]

Introduction/Aims Methods Results Discussion Fatigue is a common and debilitating symptom encountered in the neuromuscular clinic. The 7‐item Fatigue Severity Scale (FSS‐7) is a Rasch‐modified assessment validated in inflammatory neuropathies but not across a typical neuromuscular patient population. The aim of this study was to validate this measure in neuromuscular disorders and to compare between patient sex, age and diagnoses.The modified FSS‐7 was mailed to patients recruited from a specialist neuromuscular clinic at the Walton Centre. Responses were subjected to Rasch analysis and descriptive statistics were performed on the Rasch converted data.The mFSS‐7 met the Rasch model expectations with an overall Chi‐square probability of 0.4918, a strict unidimensional scale free from differential item functioning (DIF) that satisfied the model with substantial test–retest reliability using Lin's concordance correlation coefficient 0.71 (95% CI 0.63–0.77). A 15.7% ceiling effect was observed in this patient cohort. Post hoc analysis did not show any significant difference in fatigue between sex, age or neuromuscular diagnoses.The self‐completed Rasch mFSS‐7 showed acceptable test–retest reliability across patients with varied disorders under follow‐up in a specialist neuromuscular clinic. The ceiling effect constrains its use for those with the most severe fatigue. Future considerations could include assessment of the benefits of clinical interventions, particularly multidisciplinary team input or dedicated fatigue clinics. [ABSTRACT FROM AUTHOR]

This paper advances debates at the intersection of geographies of children, youth and families, digital geographies, and geographies of home. We argue that social, seasonal and limited time are vitally important for understanding the new landscape between gaming and gambling and have wider analytical purchase for geographers. This paper reveals parenting practices connected to the multi-billion-dollar industry of paid-for currency in digital games used to access gambling style systems and chance-based mechanisms such as loot boxes. We use this timely example to develop new digital geographies of home from original interviews with families based in England on their everyday lived experiences of gambling-style systems in digital games as well as data from video ethnographies with children and young people and interviews with international game designers. This paper challenges current understandings by examining how parents make sense of gambling-related harms and demonstrates the spatial and temporal dynamics of purchasing decisions, rules, and associated conflicts in domestic space. We argue these systems in digital games shape and are shaped by family geographies. This paper concludes by outlining its relevance for the social and health sciences at a time of intense legislative interest in the increasingly blurred space between gaming and gambling. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusion Advanced skull base malignancies are a heterogenous subset of head and neck cancers, and management is often complex. In recent times, there has been a paradigm shift in surgical technique and the advent of novel systemic options. Our goal was to analyse the long‐term outcomes of a single quaternary head and neck and skull base service.A retrospective review of 127 patients with advanced anterior skull base malignancies that were treated at our institution between 1999 and 2015 was performed. Multiple variables were investigated to assess their significance on 5 and 10‐year outcomes.The mean age was 60.9 (± 12.6 SD). Sixty‐four percent were males and 36% were females. Ninety percent of patients had T4 disease. Median survival time was 133 months. The 5‐year overall survival (OS) was 66.2%, disease‐specific survival (DSS) was 74.7%, and recurrence‐free survival (RFS) was 65.0%. The 10‐year OS was 55.1%, DSS was 72.1%, and RFS was 53.4%. Histological type and margin status significantly affected OS & DSS.Surgical management of advanced skull base tumours has evolved over the last few decades at our institution with acceptable survival outcomes and complication rates. Histological diagnosis and margin status are the main predictors of survival. The addition of neoadjuvant systemic agents in current trials may improve outcomes. [ABSTRACT FROM AUTHOR]

This study aimed to conduct a review of existing methods used to incorporate life cycle drug pricing (LCDP) in cost-effectiveness analyses (CEAs), identify common methodological challenges, and suggest modeling approaches for prospectively implementing LCDP in CEA. Two complementary searches were conducted in PubMed, combined with hand searching and reference mining, to identify English language full-text articles that explored (1) how drug prices change over time and (2) methods used to apply dynamic pricing in cost-effectiveness models (CEMs). Relevant articles were reviewed, and authors discussed the common methodological practices used in the literature and their associated challenges on prospectively implementing LCDP in CEMs. For each key challenge identified, we provide modeling suggestions to address the issue. We screened 1200 studies based on title and abstract; 117 were reviewed for eligibility, and 47 individual studies were included across both searches. Variations in prices over a product's life cycle are complex and multifactorial, and models applying LCDP in CEA varied in their methodology. We identified 4 key challenges to modeling LCDP in CEA, including how to model price trends before and after loss of exclusivity, how to capture the effect of price changes on future patient cohorts, and how to report results. Accurately quantifying the impact of LCDP requires careful consideration of multiple aspects pertaining to both the evolution of drug prices and how to reflect these in CEA. Although uncertainties remain, our findings can aid implementation and evaluation of LCDP in economic evaluations. • Drug prices are intrinsically dynamic across their life cycle, yet most cost-effectiveness analyses (CEA) assume they remain constant across the modeled time horizon. In part, this is because of uncertainties around when loss of exclusivity (LoE) will occur and how prices will change, both before and after LoE. • Based on the literature reviewed, we summarize 4 key challenges to model life cycle drug pricing (LCDP) in CEA including how to model price trends before and after LoE, how to capture the effect of price changes on future patient cohorts, and how to report results. • Notable heterogeneity was observed in current approaches to incorporating LCDP within CEAs. The methodological suggestions we provide on prospectively implementing LCDP in CEA will help improve the transparency, robustness, consistency, and hence relevance of LCPD-based economic evaluations. [ABSTRACT FROM AUTHOR]

A prominent scholarship contends that presidential norms are particularly vital to a well‐functioning democracy. However, scant empirical research exists on the topic. I investigate public attitudes toward a novel battery of what many scholars and journalists consider presidential norms and examine the extent to which partisan and policy concerns affect attitudes toward them. Original survey data show that Americans strongly support presidential norms. I argue that there are two salient dimensions of presidential norms—what I call structural norms and presentation norms. Structural norms promote and support constitutional government. Presentation norms concern expectations about when and how presidents should present themselves before the public. Partisans evaluate the two types of presidential norms differentially, with Republicans notably expressing lower support for structural norms. I then present experimental evidence that the public's support for presidential norms is malleable to partisan framing. These results suggest that the public supports presidential norms in the abstract, but compelling rhetoric can facilitate presidential norm violations. [ABSTRACT FROM AUTHOR]

The first televised presidential campaign commercials ran in the 1952 electoral contest between Dwight Eisenhower and Adlai Stevenson, specifically as part of the effort to draft and then elect General Eisenhower. These first spot ads were developed not by political parties or the candidates but by an independent citizens group, Citizens for Eisenhower. The group developed two distinct styles of television advertising. The best known of these stemmed from the hard‐sell Madison Avenue tradition of public relations and its advertising innovator, Rosser Reeves, who produced the “Eisenhower Answers America” campaign. Less well known is an ad created by volunteer workers from the Disney Corporation, who produced an animated, musical rendition promising that “We'll Take Ike to Washington.” Unlike Reeves's more substantive ads that focused on issues, the Disney ads emphasized the image and character of the candidate. Using archival sources, this article shows that the televised marketing of the presidency stemmed not only from the public relations experts and Madison Avenue advertisers like Reeves but also from those connected to the entertainment industry who sought to manipulate the public through character appeals. [ABSTRACT FROM AUTHOR]

Each year, adverse events are reported in healthcare, of which many relate to healthcare workforce cognitive bias. The active involvement of workforce and consumers in the review and co-design of effective training for the healthcare workforce to recognise, monitor, and manage unconscious bias is required. We used participatory action research to co-design an innovative, interprofessional simulation based on 'real world' clinical incidents and lived experiences to improve the delivery of safe, high quality, consumer-focused healthcare. Following ethics approval, content analysis of serious adverse patient safety events involving cognitive bias was conducted. These data informed audio-recorded interviews with the healthcare workforce and consumers to explore their experiences of cognitive bias. Following thematic analysis, key themes of communication, stigma, diagnostic overshadowing, and fragmented systems were uncovered. Guided by consumers, these themes were interwoven into a simulation scenario that included real places, stories, and verbatim quotes delivered through mixed media artefacts. This heightened the immersive and experiential learning that aimed to uncover unconscious bias and help learners recognise its impact on clinical decisions and practice. To our knowledge, this is the first interprofessional, co-designed simulation to specifically address cognitive bias in current and future healthcare workforce. Plans to translate this research into a practical framework on how to work with key stakeholders (including consumers) to identify 'real-world' health service risks and co-design targeted simulations to address these gaps are described, including lessons learned. [ABSTRACT FROM AUTHOR]

Collaborations between basic science educators (BE) and clinical educators (CE) in medical education are common and necessary to create integrated learning materials. However, few studies describe experiences of or processes used by educators engaged in interdisciplinary teamwork. We use the lens of boundary crossing to explore processes described by BE and CE that support the co-creation of integrated learning materials, and the impact that this work has on them. We conducted qualitative content analysis on program evaluation data from 27 BE and CE who worked on 12 teams as part of a multi-institutional instructional design project. BE and CE productively engaged in collaboration using boundary crossing mechanisms. These included respecting diverse perspectives and expertise and finding efficient processes for completing shared work that allow BE and CE to build on each other's contributions. BE and CE developed confidence in connecting clinical concepts with causal explanations, and willingness to engage in and support such collaborations at their own institutions. BE and CE report the use of boundary crossing mechanisms that support collaboration in instructional design. Such practices could be harnessed in future collaborations between BE and CE. [ABSTRACT FROM AUTHOR]

The United States faces an impending crisis in primary care physician shortages, while Physician Associates (PAs) and Nurse Practitioners (NPs) are poised to help bridge the gap. This manuscript explores a groundbreaking solution: introducing a clinical doctorate program tailored to PAs and NPs, designed to equip them with the knowledge and skills to assume leadership roles in primary care. Unlike traditional medical education, this innovative approach allows these professionals to continue their clinical practice while advancing their education, addressing the workforce shortage and the need for advanced leadership within the primary care landscape. This comprehensive curriculum includes intensive didactic coursework, residency-like training, credentialing examinations, and research opportunities, positioning PAs and NPs as critical contributors to the future of primary care. By recognizing their untapped potential and investing in their advanced education, we can elevate the quality and accessibility of primary care, ensuring that healthcare delivery reaches new heights. [ABSTRACT FROM AUTHOR]

This article performs a 'logological' and 'spherological' reading of globalization to critique the topical generality of spatial rhetoric. Posited respectively by Barbara Cassin and Peter Sloterdijk, these seemingly distant theories both show how 'world' is created by discourse — that being is an effect of saying. An appropriately equivocal translation of the Greek logos, discourse is here read as the rhetorical forms of 'inning' that make space sensible. Cassin's 'counter-philosophical' reading of the ancient Greek Sophists challenges post-Parmenidean philosophy's 'ontopological' generalization of space into topics, instead attending to the worlds opened by the different ways space is described. This is read alongside Sloterdijk's spherology and its emphasis on transference and 'inning', arguing that space is a discursive product, a shared 'canopy' under which we make worlds to share meaning. Throughout 'human' history, these meanings have, as both Cassin and Sloterdijk argue, determined human life as the ontological being that can be represented under these discursive atmospheres. The article suggests that this can be thought less exclusively by taking up the Sophists' rhetorics of time and kairos, which reimagines the discursive production of space through contingency and particularity — the sense of reality as the autonomy of the political. [ABSTRACT FROM AUTHOR]

Increasing rates of depression, anxiety, substance use, and suicidal thoughts and behaviors among college students were exacerbated by the COVID-19 pandemic. This report describes how components of the Johns Hopkins Suicide Prevention Awareness, Response and Coordination (JH-SPARC) Project aligned with a multi-faceted strategy for suicide prevention. Key programs included suicide screening, gatekeeper trainings, and the use of third-party mental health services. Regarding suicide screening outcomes, staff sent 36,148 individual emails inviting students and trainees to participate in stress and depression screening. This approach garnered 2,634 responses and connected 130 students to care, 66 of whom (50.8%) indicated suicidal thoughts, plans, or behaviors. We estimate this screening cost $2.97 per student. Important lessons included the reliance on virtual platforms and the need to coordinate efforts across multiple campuses. Our manuscript provides an example of a transferable strategy for suicide prevention on college campuses in the pandemic era. [ABSTRACT FROM AUTHOR]

Fossil-Lagerstätten are amongst the most important windows onto the paleobiology of ancient ecosystems. Inconsistencies surrounding what constitutes a Lagerstätte limits our ability to compare sites and thus their scientific potential. Here, we provide a modern and utilitarian classification scheme for Konservat-Lagerstätten, allowing for more consistent and improved scientific discourse. [ABSTRACT FROM AUTHOR]

Accepted by: Aris Syntetos This paper examines the impact of temporary supply chain disruptions in a general equilibrium model with multiple stages of production for capital goods and a flexible time-to-build structure. Production disruptions at one or more stages result in declines in overall shipments and increases in the ratios of unfilled orders and work-in-process inventories to shipments. The model is calibrated to industries in durable goods manufacturing during the Covid-19 pandemic, and is shown to generate realistic dynamic responses to temporary production disruptions. Consistent with the data, an unanticipated 1-month disruption to upstream production results in a decline in shipments and an increase in the ratio of unfilled orders to shipments lasting more than 6 months. [ABSTRACT FROM AUTHOR]

The distribution of mass in galaxy-scale strong gravitational lenses is often modelled as an elliptical power-law plus 'external shear', which notionally accounts for neighbouring galaxies and cosmic shear along our line of sight. A small amount of external shear could come from these sources, but we show that the vast majority does not. Except in a handful of rare systems, the best-fitting values do not correlate with independent measurements of line-of-sight shear: from weak lensing in 45 Hubble Space Telescope images, or in 50 mock images of lenses with complex distributions of mass. Instead, the best-fit external shear is aligned with the major or minor axis of 88 per cent of lens galaxies; and the amplitude of the external shear increases if that galaxy is discy. We conclude that 'external shear' attached to a power-law model is not physically meaningful, but a fudge to compensate for lack of model complexity. Since it biases other model parameters that are interpreted as physically meaningful in several science analyses (e.g. measuring galaxy evolution, dark matter physics or cosmological parameters), we recommend that future studies of galaxy-scale strong lensing should employ more flexible mass models. [ABSTRACT FROM AUTHOR]

The vertebral column, a defining trait of all vertebrates, is organized as a concatenated chain of vertebrae, and therefore its support to the body depends on individual vertebral morphology. Consequently, studying the morphology of the vertebral centrum is of anatomical and clinical importance. Grass carp (GC) is a member of the infraclass Teleostei (teleost fish), which accounts for the majority of all vertebrate species; thus, its vertebral anatomical structure can help us understand vertebrate development and vertebral morphology. In this study, we have investigated the morphology and symmetry of the grass carp vertebral centrum using high‐resolution micro‐CT scans. To this end, three abdominal vertebrae (V9, V10, & V11) from eight grass carp were micro‐CT scanned and then segmented using Dragonfly (ORS Inc.). Grass carp vertebral centrum conformed to the basic teleost pattern and demonstrated an amphicoelous shape (biconcave hourglass). The centrum's cranial endplate was smaller, less circular, and shallower compared to the caudal endplate. While the vertebral centrum demonstrated bilateral symmetry along the sagittal plane (left/right), the centrum focus was shifted dorsally and cranially, breaking dorsoventral and craniocaudal symmetry. The sum of these findings implies that the caudal aspect of grass carp vertebral centrum is bigger and more robust. Currently, we have no information whether this is due to nature, for example, differences in gene expression, or nurture, for example, environmental effect. As the vertebral parapophyses and spinous processes are slanted caudally, the direction of muscle action during swimming may create a gradient of stresses from cranial to caudal, resulting in a more robust caudal aspect of the vertebral centrum. Expanding our study to include additional quadrupedal and bipedal (i.e., human) vertebrae, as well as testing if these morphological aspects of the vertebrae are indeed plastic and can be affected by environmental factors (i.e., temperature or other stressors) may help answer this question. [ABSTRACT FROM AUTHOR]

Young people with intellectual disabilities (ID) are at an increased risk for experiencing mental health issues compared to their peers without disabilities. Further, there are limited resources available to help accurately assess mental health disorders and that are accessible for adolescents with ID. This paper describes the iterative development and pilot testing of the Diagnostic Interview for Adolescents and Adults with Intellectual Disabilities (DIAAID). The authors utilized Evidence Center Design and Universal Design principals to develop the DIAAID; a multi-informant diagnostic interview. The DIAAID development resulted in the creation of 15 adolescents disorder interviews and 24 caregiver disorder interviews. Preliminary results suggest that the DIAAID is a feasible and accessible diagnostic interview for adolescents with ID and their caregivers. Lessons learned from DIAAID implementation and future areas research are discussed. [ABSTRACT FROM AUTHOR]

The national 'Competence for Quality' in-service programme in Norway aims to enhance the subject knowledge and instructional competences of primary and secondary school teachers across subjects. The programme is evaluated annually through a teacher survey which, however, does not capture in depth how the programme impacts on participants. This study tracked four primary school teachers of English over 26 months and found that the in-service course they completed had positive effects on their confidence to speak English in class and their oral fluency, though a reduction in the accuracy of their classroom English was also noted. Variable but positive changes in teachers' classroom practices during the course were noted too. Overall, the study highlights links between teacher knowledge, teacher confidence and teacher change, provides insight into how professional development impacts on these dimensions of teaching, and illustrates how case studies can complement quantitative evaluations of in-service programmes for teachers. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present systematic review is to synthesize existing evidence (qualitative and quantitative) regarding age- and sex-specific differences with glenohumeral osteoarthritis. Design: The electronic databases PubMed, MEDLINE, and Web of Science were searched up to March 15, 2023. Articles reporting on the association of risk factors (age and sex) with glenohumeral osteoarthritis were considered. We used Newcastle-Ottawa Scale to assess study quality. Meta-analysis was conducted to quantitatively summarize the association of age and sex with glenohumeral osteoarthritis. Results: A total of 24 articles were retrieved for full-text review. Of 24 articles, 8 reporting age-specific and 5 articles reporting sex-specific associations with glenohumeral osteoarthritis were included. The odds ratio for the age (odds ratio = 3.18; 95% confidence interval = 1.10–15.92) and female sex (odds ratio = 1.78; 95% confidence interval = 0.95–3.42) were increased and observed statistically significant. Conclusions: The present systematic review and meta-analysis suggests the role of increasing age as one of the significant contributors to glenohumeral osteoarthritis. However, association of female sex with glenohumeral osteoarthritis is least convincing. Future studies are required to understand the molecular mechanisms behind the contributory role of increasing age and female sex in the establishment of glenohumeral osteoarthritis. [ABSTRACT FROM AUTHOR]

Analgesic medication use occurs through a negative reinforcement model where pain and distress lead to medication use, which in turn leads to relief from pain and distress. People with chronic pain often attempt to manage pain and concurrent emotional distress with analgesic substances. Habitual use of such substances—even when not opioid-based—can pose side effect risks. A negative reinforcement model has been proposed whereby relief of pain and emotional distress following medication consumption increases the likelihood that the experience of elevated pain and distress will spur further medication use. People with chronic low back pain (N = 105) completed electronic diary assessments 5 times/day for 14 consecutive days. Lagged and cross-lagged analyses focused on links between time 1 pain and negative affect (NA) and time 2 analgesic medication use and vice versa. Sex differences were also explored. Primary results were as follows: (1) participants on average reported taking analgesic medication during 41.3% of the 3-hour reporting epochs (29 times over 14 days); (2) time 1 within-person increases in pain and NA predicted time 2 increases in the likelihood of ingesting analgesic medications; (3) time 1 within-person increases in medication use predicted time 2 decreases in pain and NA; and (4) lagged associations between time 1 pain/NA and time 2 medication use were strongest among women. Findings suggest that the use of analgesic medications for many people with chronic pain occurs frequently throughout the day. Results support the validity of a negative reinforcement model where pain and distress lead to pain medication use, which in turn leads to relief from pain and distress. [ABSTRACT FROM AUTHOR]

The willingness of voters on the losing side to accept electoral outcomes – losers' consent – is essential to democratic legitimacy. This article examines the role of emotions in shaping people's perceptions of electoral fairness, arguing that voters on the losing side who feel angry are less willing to accept democratic outcomes. This is examined in the context of the 2016 Brexit referendum, as well as the 2019 UK general election, using original survey data and an experiment in which specific emotional responses (anger and happiness) are induced to test the causal effect of emotions. The results show that losers who felt angry about an electoral outcome are less likely to accept the legitimacy of the democratic process and that anger has a causal effect in reducing losers' consent. These findings suggest that politicians may be able to influence voters' faith in democracy by mobilising emotional responses. [ABSTRACT FROM AUTHOR]

In this study, we compared the social media net sentiment of one policy with two names. Specifically, we analyzed Obamacare and the Affordable Care Act (ACA) to understand how social media users engaged with each term on social media from March 2010 to March 2017. The net sentiment was measured with a sample of over 50 million micro-blogs, and the analysis was done using a combination of digital instruments and human validation. We found a significant difference between the social media engagement and sentiment of both terms, with the ACA performing significantly better than Obamacare, despite Obamacare's higher conversation volume. With the ACA having an average of 26% less negative sentiment than Obamacare, the findings of this study emphasize the need to be careful when attaching nicknames to public policy. The findings also have implications for policymakers and politicians. [ABSTRACT FROM AUTHOR]

Background Flavorings in cigars increase their appeal, mask the harsh taste of tobacco, and may hinder successful cigar smoking cessation; however, limited evidence has examined whether flavors are associated with short- or long-term cigar smoking cessation. Aims and Methods Using restricted data from the Population Assessment of Tobacco and Health Study Waves 1–5, we examined whether flavored cigar use was associated with 30-day-plus and 1-year-plus cigar smoking cessation among US adults. Multivariable discrete-time survival models were fit to a nationally representative sample of US adult (18+) respondents who had a current, established cigar use, smoked five or more days in the past 30 days, and did not exclusively smoke traditional premium cigars at baseline. Models adjusted for age, sex, race and ethnicity, income, cigar and cigarette smoking intensity, and blunt use. Results At baseline, 44.6% of respondents (n = 674) were 18–34 years old, 75.0% were male, 56.7% were non-Hispanic White, 78.9% had household incomes of <$50,000, and 56.2% smoked flavored cigars. In fully adjusted models, flavored cigar use was associated with a lower risk of 30-day-plus (HR = 0.76, 95% CI = 0.60, 0.97) but not 1-year-plus cigar smoking cessation (HR = 0.81, 95% = 0.62, 1.05). Conclusions We found that flavored cigar use was associated with a lower risk of short-term but not long-term cigar smoking cessation. More work is needed to understand the dynamics of cigar smoking transitions, including initiation, cessation, and relapse, particularly in larger cohorts and among those who exclusively use cigars or dual-use cigars and cigarettes. Implications As local and some state jurisdictions continue to adopt partial or complete bans of flavored cigar products and the United States Food and Drug Administration considers a national ban of all characterizing flavors in cigars, there is a need for more longitudinal work examining the associations between flavorings in cigars and short and long-term cigar-smoking behaviors, including but not limited to initiation, cessation, intensity of use, and relapse, particularly in diverse cohorts. [ABSTRACT FROM AUTHOR]

In this Essay, I argue that the climate crisis has provided the global finance industry an opportunity to make exorbitant profits from majority Black and Brown countries in the Global South. I show how the global finance industry is leveraging its muscle over climate-vulnerable and heavily indebted countries in the Global South through complex financial transactions. These transactions commodify nature and the biodiversity resources of these Global South countries. In return, these Global South countries borrow capital to address the climate crisis and to pay off their debts. This borrowing that invariably comes at high interest rates, especially through bond instruments, gives the global finance industry power to price biodiversity resources such as forests as investible assets. These instruments include climate bonds; green, blue and sustainability linked bonds; and debt-for-nature swaps. Further, through transactions such as carbon credits, the global finance industry in conjunction with Global South governments have created a new terra nullius narrative under which the 'abundant' and 'valuable ecosystems' of the Global South are being paraded as open for foreign investors without any barriers. I claim that these profit-making and extractive initiatives are threatening to displace the historical ecological responsibility of the Global North countries most responsible for the climate crisis. As a result, the peoples of the countries least responsible for the climate crisis are bearing not only the brunt of the climate crisis but the increasing and unsustainable levels of sovereign debt as well. The ever-rising sovereign debt servicing costs now constitutes a very large percentages of the revenues of these governments. In addition, these loans offload the costs and risks of the business model of the global finance industry to indebted and climate vulnerable governments and particularly to their citizens who are almost always invariably Black or Brown. [ABSTRACT FROM AUTHOR]

Enhancing carbohydrate export from source to sink tissues is considered to be a realistic approach for improving photosynthetic efficiency and crop yield. The rice sucrose transporters OsSUT1, OsSWEET11a and OsSWEET14 contribute to sucrose phloem loading and seed filling. Crucially, Xanthomonas oryzae pv. oryzae (Xoo) infection in rice enhances the expression of OsSWEET11a and OsSWEET14 genes, and causes leaf blight. Here we show that co‐overexpression of OsSUT1, OsSWEET11a and OsSWEET14 in rice reduced sucrose synthesis and transport leading to lower growth and yield but reduced susceptibility to Xoo relative to controls. The immunity‐related hypersensitive response (HR) was enhanced in the transformed lines as indicated by the increased expression of defence genes, higher salicylic acid content and presence of HR lesions on the leaves. The results suggest that the increased expression of OsSWEET11a and OsSWEET14 in rice is perceived as a pathogen (Xoo) attack that triggers HR and results in constitutive activation of plant defences that are related to the signalling pathways of pathogen starvation. These findings provide a mechanistic basis for the trade‐off between plant growth and immunity because decreased susceptibility against Xoo compromised plant growth and yield. Summary statement: The study reported in this manuscript concerns the emerging topic of the roles played by SWEET sugar transporters in plant immunity. The data reported in this manuscript show that overexpression of Clade III SWEET sucrose transporters OsSWEET11a and OsSWEET14 that are exploited by bacterial blight pathogen Xanthomonas oryzae pv. oryzae to acquire sugars for its propagation elicits immune responses and activates plant defence responses leading to enhanced resistance against bacterial as well as fungal pathogens. The findings obtained by the overexpression of OsSWEET11a and OsSWEET14 in rice show that sucrose transport occurs via an apoplastic route, and overexpression of these sugar transporters inhibits sucrose synthesis and transport, which explains the inverse relationships between plant growth and yield, and resistance to pathogens. Moreover, our results show that sucrose transport and pathogen responses are coupled processes, and provide evidence for the concept that pathogen‐induced starvation is linked to plant defence. Also, to the best of our knowledge this is the first study where we show that disease susceptibility genes OsSWEET11a and OsSWEET14 can lead to hypersensitive reaction leading to enhanced plant immunity. [ABSTRACT FROM AUTHOR]

Studies of neighborhood crime are often limited in their ability to account for the dynamic nature of human mobility, a central tenet of prominent theoretical perspectives on the spatial distribution of crime. Yet, recent work indicates the utility of social media data for estimating the size and composition of such ambient population. In the present study, we assess whether four Twitter-derived measures are associated with crime counts across 2,348 block groups. Specifically, we focus on the density of Twitter users (and tweets), as well as the proportion of Twitter users (and tweets) that are "insiders." We inferred Twitter users' "insider" location from the block group in which they tweeted most frequently. [ABSTRACT FROM AUTHOR]

This paper provides an explanation for how the PKK, Kurdish Hezbollah, and ISIS, representing distinct ethno-nationalist, Islamist and ideologically motivated political movements, radicalize and recruit supporters in the regions of Eastern and Southeastern Turkey. In doing so, this paper contributes to ongoing theoretical debates about radicalization and recruitment. This study reveals how various regionally specific structural factors encourage radicalization and recruitment into violent politico-ideological movements. In particular, state oppression of ethnic minorities, economic inequalities, geography, and local demographics. While existing literature on radicalization focuses on push factors (structural) combined with pull factors (ideology), this research demonstrates that structural factors in Eastern and Southeastern Turkey are both push and pull factors in processes of radicalization. [ABSTRACT FROM AUTHOR]

NF2-related schwannomatosis (NF2) is a rare autosomal-dominant genetic disorder characterized by bilateral vestibular schwannomas and multiple meningiomas. This case report presents the extremely rare occurrence of an anaplastic meningioma in a 12-year-old male with previously undiagnosed NF2. The patient presented with a history of abdominal pain and episodic emesis, gait unsteadiness, right upper and lower extremity weakness, and facial weakness. He had sensorineural hearing loss and wore bilateral hearing aids. MR imaging revealed a sizable left frontoparietal, dural-based meningioma with heterogeneous enhancement with mass effect on the brain and midline shift. Multiple additional CNS lesions were noted including a homogenous lesion at the level of T5 indicative of compression of the spinal cord. The patient underwent a frontotemporoparietal craniotomy for the removal of his large dural-based meningioma, utilizing neuronavigation and transdural ultrasonography for precise en bloc resection of the mass. Histopathology revealed an anaplastic meningioma, WHO grade 3, characterized by brisk mitotic activity, small-cell changes, high Ki-67 proliferation rate, and significant loss of P16. We report an anaplastic meningioma associated with an underlying diagnosis of NF2 for which we describe clinical and histopathological features. [ABSTRACT FROM AUTHOR]

BACKGROUND: Esophagectomy in locally advanced esophageal adenocarcinoma is challenging and carries risk. The value of esophagectomy in locally advanced esophageal adenocarcinoma is not well-defined. STUDY DESIGN: The National Cancer Database was used to identify patients with cT4 esophageal adenocarcinoma from 2004 to 2020. Multivariable regression was used to identify factors associated with use of esophagectomy. Cox modeling was used to identify factors associated with all-cause mortality. Patients undergoing esophagectomy were 1:1 propensity score--matched to patients treated nonsurgically. Kaplan--Meier analysis was used to compare 5-year overall survival (OS). RESULTS: A total of 3,703 patients met inclusion criteria. Of those, 541 (15%) underwent esophagectomy, and 3,162 (85%) did not. Age 65 years or less (adjusted odds ratio [aOR] 1.69, 95% CI 1.33 to 2.14), White race (aOR 2.98, 95% CI 2.24 to 3.96), treatment in academic centers (aOR 1.64, 95% CI 1.33 to 2.02), private insurance (aOR 1.88, 95% CI 1.50 to 2.36), and tumors less than 6 cm (aOR 1.86, 95% CI 1.44 to 2.40) were associated with use of esophagectomy. Government of lack of insurance (hazard ratio [HR] 1.23, 95% CI 1.12 to 1.35), income <$46,000 (HR 1.11, 95% CI 1.03 to 1.20), treatment in nonacademic centers (HR 1.16, 95% CI 1.07 to 1.25), Charlson-Deyo Comorbidity Index 1 or more (HR 1.22, 95% CI 1.12 to 1.32), and tumors 6 cm or more (HR 1.20, 95% CI 1.09 to 1.32) were associated with risk of all-cause mortality. Esophagectomy (HR 0.50, 95% CI 0.44 to 0.56) and systemic therapy (HR 0.40, 95% CI 0.37 to 0.43) were associated with decreased risk of all-cause mortality. Patients undergoing esophagectomy had higher rates of 5-year OS (27.4% vs 13.2%, p < 0.0001) and longer median OS (24.71 vs 10.09 months, p < 0.0001). Among cT4b patients, those who underwent esophagectomy had higher rates of 5-year OS (24.5% vs 12.3%, p < 0.0001) and longer median OS (25.53 vs 11.01 months, p < 0.0001). CONCLUSIONS: In cT4 esophageal adenocarcinoma, esophagectomy is associated with improved rates of 5-year OS compared with nonsurgical treatment. [ABSTRACT FROM AUTHOR]

BACKGROUND: For open minor hepatectomy, morbidity and recovery are dominated by the incision. The robotic approach may transform this "incision dominant procedure" into a safe outpatient procedure. STUDY DESIGN: We audited outpatient (less than 2 midnights) robotic hepatectomy at 6 hepatobiliary centers in 2 nations to test the hypothesis that the robotic approach can be a safe and effective shortstay procedure. Establishing early recovery after surgery programs were active at all sites, and home digital monitoring was available at 1 of the institutions. RESULTS: A total of 307 outpatient (26 same-day and 281 next-day discharge) robotic hepatectomies were identified (2013 to 2023). Most were minor hepatectomies (194 single segments, 90 bisegmentectomies, 14 three segments, and 8 four segments). Thirty-nine (13%) were for benign histology, whereas 268 were for cancer (33 hepatocellular carcinoma, 27 biliary, and 208 metastatic disease). Patient characteristics were a median age of 60 years (18 to 93 years), 55% male, and a median BMI of 26 kg/m2 (14 to 63 kg/m²). Thirty (10%) patients had cirrhosis. One hundred eighty-seven (61%) had previous abdominal operation. Median operative time was 163 minutes (30 to 433 minutes), with a median blood loss of 50 mL (10 to 900 mL). There were no deaths and 6 complications (2%): 2 wound infections, 1 failure to thrive, and 3 perihepatic abscesses. Readmission was required in 5 (1.6%) patients. Of the 268 malignancy cases, 25 (9%) were R1 resections. Of the 128 with superior segment resections (segments 7, 8, 4A, 2, and 1), there were 12 positive margins (9%) and 2 readmissions for abscess. CONCLUSIONS: Outpatient robotic hepatectomy in well-selected cases is safe (0 mortality, 2% complication, and 1.6% readmission), including resection in the superior or posterior portions of the liver that is challenging with nonarticulating laparoscopic instruments. [ABSTRACT FROM AUTHOR]

A digraph G $G$ is k $k$‐geodetic if for any (not necessarily distinct) vertices u,v $u,v$ there is at most one directed walk from u $u$ to v $v$ with length not exceeding k $k$. The order of a k $k$‐geodetic digraph with minimum out‐degree d $d$ is bounded below by the directed Moore bound M(d,k)=1+d+d2+⋯+dk $M(d,k)=1+d+{d}^{2}+\cdots +{d}^{k}$. The Moore bound can be met only in the trivial cases d=1 $d=1$ and k=1 $k=1$, so it is of interest to look for k $k$‐geodetic digraphs with out‐degree d $d$ and smallest possible order M(d,k)+ϵ $M(d,k)+{\epsilon }$, where ϵ ${\epsilon }$ is the excess of the digraph. Miller, Miret and Sillasen recently ruled out the existence of digraphs with excess one for k=3,4 $k=3,4$ and d≥2 $d\ge 2$ and for k=2 $k=2$ and d≥8 $d\ge 8$. We conjecture that there are no digraphs with excess one for d,k≥2 $d,k\ge 2$ and in this paper we investigate the structure of minimal counterexamples to this conjecture. We severely constrain the possible structures of the outlier function and prove the nonexistence of certain digraphs with degree three and excess one, as well closing the open cases k=2 $k=2$ and d=3,4,5,6,7 $d=3,4,5,6,7$ left by the analysis of Miller et al. We further show that there are no involutary digraphs with excess one, that is, the outlier function of any such digraph must contain a cycle of length ≥3 $\ge 3$. [ABSTRACT FROM AUTHOR]

Idealized ring species, with approximately continuous gene flow around a geographic barrier but singular reproductive isolation at a ring terminus, are rare in nature. A broken ring species model preserves the geographic setting and fundamental features of an idealized model but accommodates varying degrees of gene flow restriction over complex landscapes through evolutionary time. Here we examine broken ring species dynamics in Calisoga spiders, which, like the classic ring species Ensatina salamanders, are distributed around the Central Valley of California. Using nuclear and mitogenomic data, we test key predictions of common ancestry, ringlike biogeography, biogeographic timing, population connectivity, and terminal overlap. We show that a ring complex of populations shares a single common ancestor, and from an ancestral area in the Sierra Nevada mountains, two distributional and phylogenomic arms encircle the Central Valley. Isolation by distance occurs along these distributional arms, although gene flow restriction is also evident. Where divergent lineages meet in the South Coast Ranges, we find rare lineage sympatry, without evidence for nuclear gene flow and with clear evidence for morphological and ecological divergence. We discuss general insights provided by broken ring species and how such a model could be explored and extended in other systems and future studies. [ABSTRACT FROM AUTHOR]