Safety net hospital risk model demonstrates stronger, population-specific applicability in characterizing lung cancer risk.

Background: Determining lung cancer (LC) risk using personalized risk stratification may improve screening effectiveness. While the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO) is a well-established stratification model for LC screening, it was derived from a predominantly Caucasian population and its effectiveness in a safety net hospital (SNH) population is unknown. We have developed a model more tailored to the SNH population and compared its performance to the PLCO model in a SNH setting. Methods: Retrospective dataset was compiled from patients screened for LC at SNH from 2015 to 2019. Descriptive statistics were calculated using the following variables: age, sex, race, education, body mass index (BMI), smoking history, personal cancer history, family LC history, chronic obstructive pulmonary disease (COPD), and emphysema. Variables distribution was compared using t- and chi-square tests. LC risk scores were calculated using SNH and PLCO models and categorized as low (scores <0.65%), moderate (0.65-1.49%), and high (>1.5%). Linear regression was applied to evaluate the relationship between models and covariates. Results: Of 896 individuals, 38 were diagnosed with LC. Data reflected the SNH patient demographics, which predominantly were African American (53.5%), current smokers (69.9%), and with emphysema (70.1%). Among the non-LC cohort, SNH model most frequently categorized patients as low risk, while PLCO model most frequently classified patients as moderate risk. Among the LC cohort, there was no significant difference between mean scores or risk stratification. SNH model showed 92.1% sensitivity and 96.8% specificity while PLCO model showed 89.4% sensitivity and 26.1% specificity. Emphysema demonstrated a strong association in SNH model (P<0.001) while race showed no relation. Conclusions: SNH model demonstrated greater specificity for characterizing LC risk in a SNH population. The results demonstrated the importance of study sample representation when identifying risk factors in a stratification model.

Rare Earth Nitrate Hybrid Double Perovskites [Me4N]2[MLn(NO3)6] (M = Na-Cs; Ln = La-Gd, ex. Pm).

An exploration of the synthetic and structural phase space of rare earth hybrid double perovskites A2B'BX6 (A = organocation, B' = M+, B = M3+, X = molecular bridging anion) that include X = NO3- and B' = alkali metal is reported, complementing earlier studies of the [Me4N]2[KB(NO3)6] (B = Am, Cm, La-Nd, Sm-Lu, Y) (Me4N = (CH3)4N+) compounds. In the present efforts, the synthetic phase space of these systems is explored by varying the identity of the alkali metal ion at the B'-site. Herein, we report three new series of the form [Me4N]2[B'B(NO3)6] (B = La-Nd, Sm-Gd; B' = Na, Rb, Cs). The early members of the Na-series crystallize in the trigonal space group R3̅ from La to Nd where a phase transition occurs in the phase between 273 and 300 K, going from R3̅ to the high-symmetry, cubic space group Fm3̅m. The preceding trigonal members of the Na-series also undergo phase transitions to cubic symmetry at temperatures above 300 K, establishing a decreasing trend in the phase-transition temperature. The remainder of the Na-series, as well as the Rb- and Cs-series, all crystallize in Fm3̅m at 300 K. The temperature-dependent phase behavior of the synthesized phases is studied via variable-temperature spectroscopic methods and high-resolution powder X-ray diffractometry. All phases were characterized via single-crystal and powder X-ray diffraction and Fourier transform infrared (FT-IR) and Raman spectroscopic methods. These results demonstrate the versatility of the perovskite structure type to include rare earth ions, nitrate ions, and a suite of alkali metal ions and serve as a foundation for the design of functional rare earth hybrid double perovskite materials such as those possessing useful multiferroic, optical, and magnetic properties.

Sex disparities in lung cancer survival rates based on screening status.

OBJECTIVE: Low dose computed tomography (LDCT) became the standard method for lung cancer (LC) screening in 2013. However, it is unclear whether there are differences in survival rates based on sex and whether the differences depend on screening status. We aimed to evaluate the LC survival rates between females and males based on screening. MATERIAL AND METHODS: This retrospective cohort study examined data from the Boston LC Study (BLCS) between 2013 and 2021. LC screening depends on patients' demographics (age and smoking history) to determine whether a person is a high-risk individual and, therefore, undergo LDCT. Descriptive statistics were calculated for race, age, histology, smoking history, stage, and treatment. These variables' distributions were compared between sex and screening status using t-test and chi-square, respectively. Cox proportional hazards model and Kaplan-Meier curves were used to compare survival between sex and screening. Propensity score matching was applied to account for selection bias in screening when evaluating the association between screening and stage. RESULTS: A total of 1,216 LC patients were identified with a screening incidence of 9.4 %, among whom 56 % were female. Unscreened males had 1.59 times higher risk of mortality than unscreened females (P=.0002) and had a worse 5-year survival (male 50 %; 95 %CI, 0.38,0.6 vs female 70 %; 95 %CI,0.62,0.76). In contrast, there were no significant differences in survival between sexes among screened. In a balanced cohort of screened and unscreened, the odds of being diagnosed at late stages for females and smokers were 1.33 and 2.51 times that of males and nonsmokers; however, there were no statistical significance. CONCLUSION: Unscreened females had a lower risk of mortality and better survival than unscreened males, while among the screened population, there was no difference in the overall survival. These observations demonstrate the influence of sex on survival prognosis in LC when screening is not performed.

A novel symmetric pyrazine (pyz)-bridged uranyl dimer [UO2Cl3(H2O)(Pyz)0.5]22-: synthesis, structure and computational analysis.

Herein we report on the synthesis of (HPyz+)2[UO2Cl3(H2O)(Pyz)0.5]2·2H2O which features a novel pyrazine-bridged uranyl dimer, [UO2Cl3(H2O)(Pyz)0.5]22-. A rigorous computational and experimental analysis of this compound was performed to fully explore the influence of coordination on the electronic structure and potential charge-transfer characteristics of this dimer, revealing a delocalized π-system across the bridging pyrazine and the axial components of both uranyl centers. Electrostatic surface potentials, used to rationalize the observed assembly, indicate a decreased basicity of the uranyl oxo versus [UO2Cl4]2-, and signify a lessened capacity for the terminal -yl oxos of the [UO2Cl3(H2O)(Pyz)0.5]22- dimer to participate in supramolecular assembly. A combined density functional theory (DFT) and quantum theory of atoms in molecules (QTAIM) analysis further evidenced an increase in UO bond strengths within the dimer, which is supported by a blue shift in the characteristic Raman-active uranyl symmetric stretch (ν1) with respect to the more typically observed [UO2Cl4]2-.

Bimetallic uranyl/cobalt(II) isothiocyanates: structure, property and spectroscopic analysis of homo- and heterometallic phases.

We report the synthesis and characterization of a family of UO22+/Co2+ isothiocyanate materials containing [UO2(NCS)5]3- and/or [Co(NCS)4]2- building units charged balanced by tetramethylammonium cations and assembled via SS or SOyl non-covalent interactions (NCIs), namely (C4H12N)3[UO2(NCS)5], (C4H12N)2[Co(NCS)4], and (C4H12N)5[Co(NCS)4][UO2(NCS)5]. The homometallic uranyl phase preferentially assembles via SS interactions, whereas in the heterometallic phase SOyl interactions are predominant. The variation in assembly mode is explored using electrostatic surfaces potentials, revealing that the pendant -NCS ligands of the [Co(NCS)4]2- anion is capable of outcompeting those of the [UO2(NCS)5]3- anion. Notably, the heterometallic phase displays atypical blue shifting of the uranyl symmetric stretch in the Raman spectra, which is in contrast to many other compounds featuring non-covalent interactions at uranyl oxygen atoms. A combined experimental and computational (density functional theory and natural bond orbital analyses) approach revealed that coupling of the uranyl symmetric stretch with isothiocyanate modes of equatorial -NCS ligands was responsible for the atypical blue shift in the heterometallic phase.

Pharmacologic targeting of renal ischemia-reperfusion injury using a normothermic machine perfusion platform.

Normothermic machine perfusion (NMP) is an emerging modality for kidney preservation prior to transplantation. NMP may allow directed pharmacomodulation of renal ischemia-reperfusion injury (IRI) without the need for systemic donor/recipient therapies. Three proven anti-IRI agents not in widespread clinical use, CD47-blocking antibody (αCD47Ab), soluble complement receptor 1 (sCR1), and recombinant thrombomodulin (rTM), were compared in a murine model of kidney IRI. The most effective agent was then utilized in a custom NMP circuit for the treatment of isolated porcine kidneys, ascertaining the impact of the drug on perfusion and IRI-related parameters. αCD47Ab conferred the greatest protection against IRI in mice after 24 hours. αCD47Ab was therefore chosen as the candidate agent for addition to the NMP circuit. CD47 receptor binding was demonstrated by immunofluorescence. Renal perfusion/flow improved with CD47 blockade, with a corresponding reduction in oxidative stress and histologic damage compared to untreated NMP kidneys. Tubular and glomerular functional parameters were not significantly impacted by αCD47Ab treatment during NMP. In a murine renal IRI model, αCD47Ab was confirmed as a superior anti-IRI agent compared to therapies targeting other pathways. NMP enabled effective, direct delivery of this drug to porcine kidneys, although further efficacy needs to be proven in the transplantation setting.

Novel Heterometallic Uranyl-Transition Metal Materials: Structure, Topology, and Solid State Photoluminescence Properties.

Six new uranyl hybrid materials have been synthesized solvothermally utilizing the ligands 2,2'-bipyridine-3,3'-dicarboxylic acid (H2L) and 2,2':6',2''-terpyridine (TPY). The six compounds are classified as either molecular complexes (I0O0 connectivity), [(UO2)(L)(TPY)]·H2O (1), [Ni(TPY)2][(UO2)(L)2]·3H2O (2), and [Cu(TPY)2][(UO2)(L)2]·3H2O (3), or 3D metal-organic frameworks (MOFs, I0O3 connectivity), [Cu2(UO2)2(OH)(C2H3O2)(L)3(TPY)2]·6H2O (4), [Zn2(UO2)2(OH)(NO3)(C2H3O2)(L)3(TPY)2]·4H2O (5), and Na[Ni(UO2)3(OH)(O)(L)3]·9H2O (6). A discussion of the influence of transition metal incorporation, chelating effects of the ligand, and synthesis conditions on the formation of uranyl materials is presented. The structure of compound 6 is of particular note due to large channel-like voids with a diameter of approximately 19.6 Å. A topological analysis of 6 reveals a new topology with a 9-nodal 3,3,3,3,3,3,3,4,5-connected network, designated geg1 hereafter. Further, solid state photoluminescence experiments show emission and lifetimes values consistent with related uranyl compounds.

The personality of past, present and future speech-language pathology students.

BACKGROUND: As allied health professions change over time to keep up with and reflect a rapidly changing society, it is quite possible that the people attracted to the profession may also change. If this is the case, then knowing this could be critical for future workforce marketing, training and planning. AIMS: The aim was to investigate whether the personality of students entering a speech-language pathology (SLP) program had changed over time and whether there were generational differences in personality. METHODS & PROCEDURES: The study used the Big Five personality inventory to consider whether there were differences in the personality in speech-language pathology (SLP) students enrolled in the same regional university in Australia in 2005 and 2016. OUTCOMES & RESULTS: The results showed there were significant differences between the two groups on the Agreeableness and Extroversion scales. The students who were more Conscientious were also more Confident in their ability to perform as an SLP. Generational differences across the two cohorts were also considered. CONCLUSIONS & IMPLICATIONS: SLP is a dynamic profession that is reflected through an evolving scope of practice, increasing utilization of technology and specialization. As careers evolve it is logical that the people attracted to those careers may also shift; as demonstrated here via changes in the personality of SLP students. Understanding the personality of current SLP students and future Generation Z students may assist universities to identify specific skills and experiences students need to be successful in the workforce.

Paradoxical perceptions towards the introduction of assistants in speech-language pathology and potential impact on consumers.

RATIONALE AND AIM: Working with assistants has the potential to be an economically and professionally sustainable solution to workforce shortages in speech-language pathology. However, there is some resistance to the workforce redesign, and factors that determine how assistants are utilised are not well understood. The aim of this study was to understand the perceptions that engender professional resistance and identify factors that may lessen such resistance. METHOD: Semi-structured interviews were conducted with 20 speech-language pathologists (SLPs) to learn about perceptions towards implementing assistants into the profession. FINDINGS AND DISCUSSION: While assistants were seen as augmenting existing capacity, findings demonstrated ambivalence towards their utilisation, with tension between perceived benefits and risks of SLPs utilising assistants. Sharing workload and reducing administrative duties in favour of increasing clinical output was an important positive perception. However, this perception was moderated by the concern that the introduction of assistants would result in a decrease in consumer focus, which was seen as being at odds with the strongly held values of the profession. Findings provide insight into professional acceptance of this vocationally trained group and highlight discrepancies between perceptions and actualities, both of which may influence how assistants are utilised. They suggest that implementation of a workforce redesign involving assistants may result in paradoxical perceptions among SLPs. Understanding the way SLPs think about working with assistants and how this workforce redesign may be realised will impact on how SLPs view their role and their relationships with co-workers. This understanding will also be useful in a wider sense for organisations seeking to introduce assistants, by allowing enhanced understanding of likely areas of resistance, as well as highlighting possible strategies that may be useful to address such issues.

Internet images of the speech pathology profession.

Objective The Internet provides the general public with information about speech pathology services, including client groups and service delivery models, as well as the professionals providing the services. Although this information assists the general public and other professionals to both access and understand speech pathology services, it also potentially provides information about speech pathology as a prospective career, including the types of people who are speech pathologists (i.e. demographics). The aim of the present study was to collect baseline data on how the speech pathology profession was presented via images on the Internet. Methods A pilot prospective observational study using content analysis methodology was conducted to analyse publicly available Internet images related to the speech pathology profession. The terms 'Speech Pathology' and 'speech pathologist' to represent both the profession and the professional were used, resulting in the identification of 200 images. These images were considered across a range of areas, including who was in the image (e.g. professional, client, significant other), the technology used and the types of intervention. Results The majority of images showed both a client and a professional (i.e. speech pathologist). While the professional was predominantly presented as female, the gender of the client was more evenly distributed. The clients were more likely to be preschool or school aged, however male speech pathologists were presented as providing therapy to selected age groups (i.e. school aged and younger adults). Images were predominantly of individual therapy and the few group images that were presented were all paediatric. Conclusion Current images of speech pathology continue to portray narrow professional demographics and client groups (e.g. paediatrics). Promoting images of wider scope to fully represent the depth and breadth of speech pathology professional practice may assist in attracting a more diverse group of people into the profession in the future. What is known about the topic? To date, research has not considered the promotional profile of allied health professionals on the Internet. There has been a lack of consideration of whether the way in which the professions are promoted may affect clients accessing allied health services or people entering careers. What does this paper add? This paper raises awareness of the lack of promotion of a diverse workforce in speech pathology and considers how this may affect changing the professional demographics in the future. It also provides a starting point for documentation in the form of a baseline for tracking future changes. It allows consideration of the fact that when designing health promotional and educational materials, it is crucial that diversity is displayed in the professional role, the client role and the setting in order to provide information and education to the general public about the health services provided. What are the implications for practitioners? The presentation of narrow demographics of both the professional and client may potentially affect people considering speech pathology as a future career. The appearance of narrow client demographics and diagnosis groups may also deter people from accessing services. For example, if the demonstrated images do not show older people accessing speech pathology services, then this may suggest that services are only for children. The results from the present case example are transferrable to other health professions with similar professional demographic profiles (e.g. occupational therapy). Consideration of the need to display a diverse client profile is relevant to all health and medical services, and demonstrates steps towards inclusiveness and increasing engagement of clients who may be currently less likely to access health services (including people who are Aboriginal or from a culturally and linguistically diverse background).

Exposure to occupational therapy as a factor influencing recruitment to the profession.

AIM: This article provides insight into the impact that exposure to an occupational therapist, in personal capacity or via a professional interaction, has on the decision to enter an occupational therapy undergraduate programme. METHODS: A quantitative survey was completed by 139 occupational therapy students. The survey tool focussed on the students' exposure to a range of allied health professions (e.g. occupational therapy, physiotherapy, psychology) and investigated how exposure to occupational therapy had influenced their decision to enter the programme. RESULTS: The results indicated that over 70% of respondents had personal professional exposure to occupational therapy prior to making a career decision. Exposure most frequently involved occupational therapy intervention of a friend or family member. The majority of students who had professional exposure to occupational therapy (e.g. family, self, friend received occupational therapy) identified that it was the most influential factor in their career choice. Forty per cent of the occupational therapy students did not enter the programme straight from school and the influence of 'working with an occupational therapist' was noteworthy for mature aged students. CONCLUSION: Occupational therapists need to consider that every interaction they have with the community provides valuable information regarding the profession and gives insight into occupational therapy as a potential career path for other people. Additionally, the current research identifies there were differences in the impact, type and number of exposures for different student groups, and this potentially offers some insight into ways in which occupational therapy could target specific groups within the community to increase future diversity in the profession.

Rural speech-language pathologists' perceptions of working with allied health assistants.

Workforce shortages are forecast for speech-language pathology in Australia, and will have a more significant impact on rural and remote areas than on metropolitan areas. Allied health (AH) disciplines such as physiotherapy and occupational therapy address the problem of workforce shortages and growing clinical demand by employing allied health assistants (AHAs) to provide clinical and administrative support to AH professionals. Currently, speech-language pathologists (SLPs) don't work with discipline-specific allied health assistants in all states of Australia (e.g., New South Wales). This paper aims to provide insight into the perceptions of SLPs in one Australian state (NSW) regarding working with AHAs. Semi-structured interviews were conducted with eight rural SLPs. Qualitative analysis indicated that participants perceived they had deficits in skills and knowledge required to work with AHAs and identified further training needs. Participants perceived the SLP role to be misunderstood and were concerned about poor consultation regarding the introduction of AHAs into the profession. Ambivalence was evident in overall perceptions of working with AHAs, and tasks performed. While previous research identified benefits of working with AHAs, results from this study suggest that significant professional, economic, and organizational issues need addressing before such a change should be implemented in speech-language pathology.

HIV testing in pregnancy: using women's voices to inform policy.

BACKGROUND: In Canadian provinces with opt-out policies for maternal HIV screening, pregnant women are told HIV screening is routine and are provided with the opportunity to refuse. In Newfoundland and Labrador an opt-out screening policy has been in place since 1997. PURPOSE: This research study aimed to (1) obtain an increased understanding of the information women receive about HIV/AIDS during the opt-out screening process and (2) to advance the policy related dialogue around best practices in HIV screening within the province of Newfoundland and Labrador. METHODS: Twelve women who were between 14 and 35 weeks gestation participated. Interviews were transcribed verbatim and a thematic analysis was carried out. FINDINGS: The major themes are that women have difficulty obtaining clear information about maternal HIV screening, are often not told they have the right to refuse maternal screening, and experience paternalism from physicians. CONCLUSION: We recommend that physicians and other health care providers in be reminded that that current opt-out testing requires women's consent and that women must be given the option to refuse the test.

Why do students from related professions choose not to enter speech-language pathology?

This paper provides insight into the reasons why students from similar undergraduate professional preparation programs (education and allied health) choose not to enter the speech-language pathology (SLP) program. A survey was conducted with students of education (n = 162), occupational therapy (n = 139), physiotherapy (n = 49) and social work (n = 64). Qualitative and quantitative analyses suggested that many of the students did not know about the speech-language pathology profession at the time when they selected their career or they had a limited knowledge of the scope of professional practice (e.g., identified SLP as too specific) and this may have influenced their decision making. These findings, along with recent research in regard to the factors that influence career choice in SLP, inform the SLP profession of the need for increased public education about the profession. Further, this increased need for public education becomes more vital as the profession prepares to ensure adequate number of SLPs for future service delivery in the face of increased service demands and SLP shortages.

Bennettcare to Medicare: the morphing of Medicare care insurance in British Columbia.

Introduced as a federal-provincial cost-sharing program in the 1960s, Canadian Medicare arose in the context of competing provincial models implemented by Saskatchewan, Alberta, and British Columbia. This article examines Bennettcare in British Columbia which, unlike the Saskatchewan and Alberta models, has never been analysed historically. Named after Premier W. A. C. Bennett, Bennettcare initially attempted to balance public support for a government-sponsored health insurance program with the free enterprise ideology espoused by the followers of Social Credit, the insurance industry, and the British Columbia Medical Association. However, in order to receive cost-sharing dollars from the federal government, Bennett was eventually compelled to change the design features in order to comply with the federal government's requirements of universality and public administration, morphing Bennettcare into Saskatchewan-style Medicare.

Differences in types and levels of altruism based on gender and program.

An individual's decision to enter into a career is based on several factors, such as his or her interests, personality, family, abilities, and values. This article considers altruism as a possible factor relating to the choice of a career in "helping" professions. The differences between altruism levels of students in relation to program choice and sex are examined, using both an altruism scale, which measures intention to help others in certain situations, and an interview format. Finally, qualitative results are presented to further describe possible altruistic differences between men and women. Overall, the results suggest there were no differences in self-reported altruism either between five helping programs (speech pathology, education, occupational therapy, physiotherapy and social work) or between sexes as measured by the altruism scale. However, from the interviews, men reported different altruistic reasons for entering helping professions that focused more on "society," whereas women focused more on the "individual" person. These sex differences will be discussed in light of future student recruitment. This research provides more descriptive information on altruistic motives for career choice in the helping professions than previously available.

Current and prospective speech-language pathology students' reports of exposure to speech-language pathology.

This paper presents findings of an investigation into the amount of exposure to the speech-language pathology profession that is reported by current and prospective speech-language pathology students. This study investigated both therapeutic and social exposures to speech-language pathology (SLP) as both were considered to play a role in providing information about the profession (e.g., work settings, professional demographics and caseloads). The results showed that the greater majority of both the current and prospective speech-language pathology students had some type of exposure to speech-language pathology either prior to entering or prior to considering entering the speech-language pathology program. Furthermore, both the current and prospective speech-language pathology students reported being influenced by their prior exposure the speech-language pathology profession. Finally, the results showed that parents played a large role in career choice for the current and prospective students, and this may have also included influence through parents' own exposure to speech-language pathology through work settings.