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To assess the effect of a Bayesian penalised likelihood (BPL) reconstruction algorithm on the five-point scale (5-PS) score, response categorisation, and potential implications for therapy decisions after interim 2-[The present study included new patients with HL undergoing iPET-CT from 2014-2019 after two cycles of doxorubicin (Adriamycin), bleomycin, vincristine, and dacarbazine (ABVD). Two reporters categorised response using the 5-PS and measured maximum standardised uptake values (SUVEighty-one iPET-CT examinations were reviewed. Compared with OSEM, BPL increased the 5-PS score by a single score in 18/81 (22.2%) patients. The frequency of potential treatment intensification by changing a score of 3-4 was 13.6% (11/81) and represented 25% (11/44) of patients with a score of 3 on OSEM. All 11 patients remained in remission without a change in therapy (mean 63 months) except one who required second-line treatment for refractory disease. Median SUVBPL PET reconstruction increased the 5-PS score on iPET-CT in 22% of HL patients and can potentially result in unnecessary treatment escalation in over half of these patients.

The purpose of this study was to determine the extent that language skills contribute to kindergarten children's classroom-based friendship networks. We assessed language skills and collected friendship data via individual interviews of 419 children from 21 kindergarten classrooms. Using social network analysis, we found that language skills were significantly associated with friendship centrality and reciprocity after controlling for classroom and child-level factors. Children classified as at risk for specific language impairment (SLI) were significantly less central to friendship networks, and the odds of a reciprocal friendship tie were more than 50% lower compared to children who were not classified as at risk. Of children at risk, girls were significantly more central than boys. We couch our results within limitations of our study and provide recommendations for future research. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

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Objectives The aim of this study was to assess the test-retest repeatability and interobserver variation in healthy tissue (HT) metabolism using 2-deoxy-2-[F-18]fluoro-d-glucose (F-18-FDG) PET/computed tomography (PET/CT) of the thorax in lung cancer patients. Methods A retrospective analysis was conducted in 22 patients with non-small cell lung cancer who had two PET/CT scans of the thorax performed 3 days apart with no interval treatment. The maximum, mean and peak standardized uptake values (SUVs) in different HTs were measured by a single observer for the test-retest analysis and two observers for interobserver variation. Bland-Altman plots were used to assess the repeatability and interobserver variation. Intrasubject variability was evaluated using within-subject coefficients of variation (wCV). Results The wCV of test-retest SUVmean measurements in mediastinal blood pool, bone marrow, skeletal muscles and lungs was less than 20%. The left ventricle (LV) showed higher wCV (>60%) in all SUV parameters with wide limits of repeatability. High interobserver agreement was found with wCV of less than 10% in SUVmean of all HT, but up to 22% was noted in the LV. Conclusion HT metabolism is stable in a test-retest scenario and has high interobserver agreement. SUVmean was the most stable metric in organs with low FDG uptake and SUVpeak in HTs with moderate uptake. Test-retest measurements in LV were highly variable irrespective of the SUV parameters used for measurements.

Background Workplace legal protections are important for perinatal health outcomes. Black birthing people are disproportionally affected by pregnancy discrimination and bias in the employment context and lack of family-friendly workplace policies, which may hinder their participation in the labor force and lead to gender and racial inequities in income and health. We aimed to explore Black pregnant women’s experiences of pregnancy discrimination and bias when looking for work, working while pregnant, and returning to work postpartum. Additionally, we explored Black pregnant women’s perspectives on how these experiences may influence their health. Methods Using an intersectional framework, where oppression is based on intersecting social identities such as race, gender, pregnancy, and socioeconomic status, we conducted an analysis of qualitative data collected for a study exploring the lived experience of pregnancy among Black pregnant women in New Haven, Connecticut, United States. Twenty-four women participated in semi-structured interviews (January 2017-August 2018). Interview transcripts were analyzed using grounded theory techniques. Results Participants expressed their desire to provide a financially secure future for their family. However, many described how pregnancy discrimination and bias made it difficult to find or keep a job during pregnancy. The following three themes were identified: 1) “You’re a liability”; difficulty seeking employment during pregnancy; 2) “This is not working”; experiences on the job and navigating leave and accommodations while pregnant and parenting; and 3) “It’s really depressing. I wanna work”; the stressors of experiencing pregnancy discrimination and bias. Conclusion Black pregnant women in this study anticipated and experienced pregnancy discrimination and bias, which influenced financial burden and stress. We used an intersectional framework in this study which allowed us to more fully examine how racism and economic marginalization contribute to the lived experience of Black birthing people. Promoting health equity and gender parity means addressing pregnancy discrimination and bias and the lack of family-friendly workplace policies and the harm they cause to individuals, families, and communities, particularly those of color, throughout the United States.

ChatGPT, a language-learning model chatbot, has garnered considerable attention for its ability to respond to users’ questions. Using data from 14 countries and 186 institutions, we compare ChatGPT and student performance for 28,085 questions from accounting assessments and textbook test banks. As of January 2023, ChatGPT provides correct answers for 56.5 percent of questions and partially correct answers for an additional 9.4 percent of questions. When considering point values for questions, students significantly outperform ChatGPT with a 76.7 percent average on assessments compared to 47.5 percent for ChatGPT if no partial credit is awarded and 56.5 percent if partial credit is awarded. Still, ChatGPT performs better than the student average for 15.8 percent of assessments when we include partial credit. We provide evidence of how ChatGPT performs on different question types, accounting topics, class levels, open/closed assessments, and test bank questions. We also discuss implications for accounting education and research.

The prevailing discourse on autonomous vehicles (AVs) has not yet developed a sophisticated conceptualization of autonomy and has given insufficient attention to the autonomy of people. In response...

Effective decision making from randomised controlled clinical trials relies on robust interpretation of the numerical results. However, the language we use to describe clinical trials can cause confusion both in trial design and in comparing results across trials. ACceptability Curve Estimation using Probability Above Threshold (ACCEPT) aids comparison between trials (even where of different designs) by harmonising reporting of results, acknowledging different interpretations of the results may be valid in different situations, and moving the focus from comparison to a pre-specified value to interpretation of the trial data. ACCEPT can be applied to historical trials or incorporated into statistical analysis plans for future analyses. An online tool enables ACCEPT on up to three trials simultaneously.

Students’ language skills are a foundational component to their overall success, indicating the importance of rich language environments in classrooms. It is critical for teachers to understand how to create an environment aimed at maximizing language as they’re likely to have students with language disorders in their classroom. Typically, teachers receive minimal training on students with language disorders and how to support them academically. This paper discusses the significance of interdisciplinary collaborative relationships between speech-language pathologists (SLPs) and general education teachers to achieve a language rich environment in the classroom. We (a) introduce the essential components to an effective SLP-teacher partnership, (b) address barriers and provide plausible solutions, (c) overview common types of language disorders, (d) provide tips on how to use language-supportive strategies, and (e) discuss different types of effective partnerships to support students.

This case examines auditing implications of Bitcoin and blockchain, and is intended for either undergraduate or graduate auditing and assurance courses. Students are asked to engage in aspects of planning and risk assessment for the audit of an online retailer. The case provides an interesting setting in which to achieve the learning objectives of: (1) identifying risks of material misstatement, (2) linking risks of material misstatement to relevant financial statement assertions, (3) explaining changes in audit procedures for responding to risks, (4) understanding a financial statement auditor's use of service auditor reports, and (5) understanding management specialists and the role they play in an audit. The modular case can be used for in-class discussion or as an out-of-class assignment and requires minimal advance preparation by the instructor. The case may be assigned in part or in its entirety. Student responses indicate the case is interesting and offers a positive learning experience.

Background Several cases of autism spectrum disorder have been linked to mutations in the SHANK3 gene. Haploinsufficiency of the SHANK3 gene contributes to Phelan-McDermid syndrome, which often presents an autism spectrum disorder phenotype along with moderate to severe intellectual disability. A SHANK3 gene deletion in mice results in elevated excitation of cortical pyramidal neurons that alters signaling to other brain areas. Serotonin 1A receptors are highly expressed on layer 2 cortical neurons and are known to have inhibitory actions. Serotonin 1A receptor agonist treatment in autistic cases with SHANK3 mutations and possibly other cases may restore excitatory and inhibitory balance that attenuates core symptoms. Methods A series of experiments investigated the effects of acute tandospirone treatment on spatial learning and self-grooming, subchronic treatment of tandospirone on self-grooming behavior, and the effect of tandospirone infusion into the anterior cingulate on self-grooming behavior. Results Only male Shank3B+/− mice exhibited a spatial learning deficit and elevated self-grooming. Acute i.p. injection of tandospirone, 0.01 and 0.06 mg/kg in male Shank3B+/− mice, attenuated a spatial acquisition deficit by improving sensitivity to positive reinforcement and reduced elevated self-grooming behavior. Repeated tandospirone (0.06 mg/kg) treatment attenuated elevated self-grooming behavior in male Shank3B+/− mice. Tandospirone injected into the anterior cingulate/premotor area reduced self-grooming behavior in male Shank3B+/− mice. Conclusions These results suggest that stimulation of cortical serotonin 1A receptors may reduce repetitive behaviors and cognitive impairments as observed in autism spectrum disorder, possibly by attenuating an excitation/inhibition imbalance. Further, tandospirone may serve as a treatment in autism spectrum disorder and other disorders associated with SHANK3 mutations.

Pegargiminase (ADI-PEG 20I) degrades arginine in patients with argininosuccinate synthetase 1-deficient malignant pleural mesothelioma (MPM) and NSCLC. Imaging with proliferation biomarker 3'-deoxy-3'-[A total of 18 patients with thoracic malignancies (10 MPM; eight NSCLC) underwent imaging. FLT PET-CT was performed at baseline (PET1), 24 hours post-pegargiminase monotherapy (PET2), post one cycle of ADIPemCis (PET3), and at end of treatment (EOT, PET4). CT was performed at baseline (CT1) and EOT (CT4). CT4 (modified) Response Evaluation Criteria in Solid Tumors (RECIST) response was compared with treatment response on PET (changes in maximum standardized uptake value [SUVmax] on European Organisation for Research and Treatment of Cancer-based criteria). Categorical responses (progression, partial response, and stable disease) for PET2, PET3, and PET4 were compared against CT using Cohen's kappa.ADIPemCis treatment response resulted in 22% mean decrease in size between CT1 and CT4 and 37% mean decrease in SUVmax between PET1 and PET4. PET2 agreed with CT4 response in 62% (8 of 13) of patients (Early FLT imaging (PET2) agrees with EOT CT results in nearly two-thirds of patients. Both early and late FLT PET-CT provide evidence of response to ADIPemCis therapy in MPM and NSCLC. We provide first-in-human FLT PET-CT data in MPM, indicating it is comparable with modified RECIST.

To understand biological interactions of plastic litter in freshwater ecosystems, as well the potential effects of plastics on ecosystem processes, studies of the activity and composition of plastic-associated microbial communities are needed. The physical properties and chemical composition of plastic polymers are key components of plastic product design, and may also select for distinct microbial biofilms colonizing plastic litter. We monitored growth and succession of biofilm communities on plastic substrates of common morphotypes (i.e., hard, soft, foam, and film) and a natural surface (i.e., an unglazed ceramic tile) incubated in an urban stream. We measured biofilm biomass, metabolism, extracellular enzyme activity, and bacterial, fungal and algal community composition over four weeks during primary succession. Results demonstrated a general increase in biofilm biomass and enzymatic activity corresponding to carbon, nitrogen and phosphorus metabolism during biofilm development for all substrate types. We observed higher respiration rates and negative net ecosystem productivity on foam and tile surfaces in comparison to hard, soft and film plastic surfaces. Biofilm bacterial, fungal and algal assemblages showed few significant differences in composition among substrates. However, all microbial communities changed significantly in composition over time. While substrate type was not the major factor driving biofilm composition and activity, these data show plastic litter in streams is well colonized by an active and dynamic biofilm community. As plastic litter is increasing across all types of aquatic ecosystems, it should be considered a medium for biologically active organisms that contribute to key ecosystem processes.

Objectives: To describe the findings of incidental asymptomatic COVID-19 infection on FDG PET-CT using a case–control design. Methods: Incidental pulmonary findings suspicious of asymptomatic COVID-19 infection on FDG PET-CT were classified as a confirmed (positive RT-PCR test) or suspected case (no/negative RT-PCR test). Control cases were identified using a 4:1 control:case ratio. Pulmonary findings were re-categorised by two reporters using the BSTI classification. SUV metrics in ground glass opacification (GGO)/consolidation (where present), background lung, intrathoracic nodes, liver, spleen and bone marrow were measured. Results: 7/9 confirmed and 11/15 suspected cases (COVID-19 group) were re-categorised as BSTI 1 (classic/probable COVID-19) or BSTI 2 (indeterminate COVID-19); 0/96 control cases were categorised as BSTI 1. Agreement between two reporters using the BSTI classification was almost perfect (weighted κ = 0.94). SUVmax GGO/consolidation (5.1 vs 2.2; p < 0.0001) and target-to-background ratio, normalised to liver SUVmean (2.4 vs 1.0; p < 0.0001) were higher in the BSTI 1 & 2 group vs BSTI 3 (non-COVID-19) cases. SUVmax GGO/consolidation discriminated between the BSTI 1 & 2 group vs BSTI 3 (non-COVID-19) cases with high accuracy (AUC = 0.93). SUV metrics were higher (p < 0.05) in the COVID-19 group vs control cases in the lungs, intrathoracic nodes and spleen. Conclusion: Asymptomatic COVID-19 infection on FDG PET-CT is characterised by bilateral areas of FDG avid (intensity > x2 liver SUVmean) GGO/consolidation and can be identified with high interobserver agreement using the BSTI classification. There is generalised background inflammation within the lungs, intrathoracic nodes and spleen. Advances in knowledge: Incidental asymptomatic COVID-19 infection on FDG PET-CT, characterised by bilateral areas of ground glass opacification and consolidation, can be identified with high reproducibility using the BSTI classification. The intensity of associated FDG uptake (>x2 liver SUVmean) provides high discriminative ability in differentiating such cases from pulmonary findings in a non-COVID-19 pattern. Asymptomatic COVID-19 infection causes a generalised background inflammation within the mid-lower zones of the lungs, hilar and central mediastinal nodal stations, and spleen on FDG PET-CT.

Background Specialty public health training consists of 48 months of practice across the domains of health protection, healthcare public health and health improvement. With the onset of the COVID-19 pandemic, activity pivoted towards pandemic management and the response became a significant element of registrar practice. This research aimed to understand the impact of this shift in focus on registrars’ role and training. Methods Participatory action research comprising (i) a reflective survey sent to all specialty registrars in the East Midlands training region and (ii) Delphi rounds with survey respondents to generate consensus and define themes. Results Sixteen (44%) registrars completed the survey with 12 (75%) participating in the Delphi rounds. The early pandemic response stages both challenged and re-affirmed registrars’ role and identity in public health and training while providing unique and diverse learning and development. Underpinning these themes is a variability in experience depending on prior experience, placement and training stage. Conclusions The pandemic impacted the practice, training and home-life of registrars who were required to negotiate significant challenge and uncertainty. This original work adds to a growing body of correspondence and opinion pieces articulating the experiences and challenges of medical and public health education during a pandemic.

Objectives The aim of this study was to investigate associations between baseline characteristics and CD4 cell count response on first-line antiretroviral therapy and risk of virological failure (VF) with or without drug resistance. Methods We conducted an analysis of UK Collaborative HIV Cohort data linked to the UK HIV Drug Resistance Database. Inclusion criteria were viral sequence showing no resistance prior to initiation of first-line efavirenz + tenofovir disoproxil fumarate + emtricitabine and virological suppression within 6 months. Outcomes of VF (≥200 copies/mL) with or without drug resistance were assessed using a competing risks approach fitted jointly with a model for CD4 cell count recovery. Hazard ratios for each VF outcome were estimated for baseline CD4 cell count and viral load and characteristics of CD4 cell count response using latent variables on a standard normal scale. Results A total of 3640 people were included with 338 VF events; corresponding viral sequences were available in 134 with ≥1 resistance mutation in 36. VF with resistance was associated with lower baseline CD4 (0.30, 0.09–0.62), lower CD4 recovery (0.04, 0.00–0.17) and higher CD4 variability (4.40, 1.22–12.68). A different pattern of associations was observed for VF without resistance, but the strength of these results was less consistent across sensitivity analyses. Cumulative incidence of VF with resistance was estimated to be >2% at 3 years for baseline CD4 ≥350 cells/μL. Conclusion Lower baseline CD4 cell count and suboptimal CD4 recovery are associated with VF with drug resistance. People with low CD4 cell count before ART or with suboptimal CD4 recovery on treatment should be a priority for regimens with high genetic barrier to resistance.

If you are interested in plant evolution, try this quick exercise: take a phylogenetic tree of the plant kingdom, close your eyes, and point your finger randomly to a node of the phylogeny. Irrespective of the clade to which you are pointing, there is one thing you should know about it: the living representatives of that clade have evolved as a result of a long process in which failed attempts are the rule, and as a result, the diversity of extinct forms accumulated in the fossil record far exceeds that recorded in the extant flora. From this simple concept, Gar W. Rothwell made his career. Because of that, here is a second thing you should know about the plant clade to which you pointed at random: Gar has, more likely than not, contributed information about evolution in that clade at some point in his career. Gar was one of the principal contributors to the revival of paleobotany from a largely descriptive discipline to a vibrant field of investigation at the forefront of modern evolutionary sciences that contributes crucial insights into plant evolution, equal in importance to those provided by genetics and molecular biology. Because of this, the impact of Gar’s scientific contributions reaches far beyond the field of paleobotany, with important implications for wide areas of plant biology, including anatomy and morphology, development, systematics, phylogeny, and evolution. Gar earned a master’s degree in the laboratory of Thomas N. Taylor (University of Illinois at Chicago, 1966) studying Paleozoic seeds in the genus Conostoma (Rothwell and Eggert 1970; Rothwell 1971a). He subsequently earned his PhD degree in the laboratory of Wilson N. Stewart (University of Alberta, 1973), where he reconstructed the plants in the seed fern genus Callistophyton (Rothwell 1972b, 1975, 1980, 1981). His work was instrumental in ushering in studies of fossil plants as whole living organisms, looking at both structure and development. These early experiences launched Gar on a career in plant evolutionary biology that stretched over a half century, during which he occupied positions at the University of Alberta, University of London–Chelsea College, Ohio University, and Oregon State University. Throughout his career, Gar’s scholarly work and contributions have been recognized by numerous awards and honors: the Isabel Cookson Award, the Edgar T. Wherry Award, the Michael A. Cichan Award, the Merit Award of the Botanical Society of America, and honorary membership in the International Organization of Palaeobotany, where he served for 12 years as secretary-treasurer and president. Fil: Escapa, Ignacio Hernán. Museo Paleontológico Egidio Feruglio; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; Argentina Fil: Tomescu, Alexandru M. F.. Humboldt State University. Department of Biological Sciences; Estados Unidos Fil: Dunn, Michael T.. Cameron University. Department of Agriculture, Biology and Health Science; Estados Unidos Fil: Stockey, Ruth A.. State University of Oregon; Estados Unidos

Odontogenic sinusitis (ODS) can cause infectious orbital, intracranial, and osseous complications. Diagnosis and management of complicated ODS have not been discussed in recent sinusitis guidelines. The purpose of this systematic review was to describe epidemiological and clinical features, as well as management strategies of complicated ODS.PubMed, EMBASE, and Cochrane Library.A systematic review was performed to describe various features of complicated ODS. All complicated ODS studies were included in qualitative analysis, but studies were only included in quantitative analysis if they reported specific patient-level data.Of 1126 studies identified, 75 studies with 110 complicated ODS cases were included in qualitative analysis, and 47 studies with 62 orbital and intracranial complications were included in quantitative analyses. About 70% of complicated ODS cases were orbital complications. Only 23% of complicated ODS studies were published in otolaryngology journals. Regarding ODS-related orbital and intracranial complications, about 80% occurred in adults, and 75% were male. Complicated ODS occurred most commonly from apical periodontitis of maxillary molars. There were no relationships between sinusitis extent and orbital or intracranial complications. High rates of anaerobic and α-hemolytic streptococcal bacteria were identified in complicated ODS. Management generally included systemic antibiotics covering aerobic and anaerobic bacteria, and surgical interventions were generally performed to address both the complications (orbital and/or intracranial) and possible infectious sources (dentition and sinuses).ODS should be considered in all patients with infectious extrasinus complications. Multidisciplinary management between otolaryngologists, dental specialists, ophthalmologists, and neurosurgeons should be considered to optimize outcomes.