Stage Evaluation of Cystic Duct Cancer.

Purpose: Cystic duct cancers (CDCs) have been classified as extrahepatic bile duct cancers or gallbladder cancers (GBCs); however, it is unclear whether their clinical behavior is similar to that of distal extrahepatic bile duct cancers (DBDCs) or GBCs. Materials and Methods: T category of the CDCs was classified using current T category scheme of the GBCs and DBDCs, and clinicopathological factors were compared among 38 CDCs, 345 GBCs, and 349 DBDCs. We modified Nakata's classifications (type 1, confined within cystic duct (CD); combined types 2-4, extension beyond CD) and compared them. Results: No significant overall survival (OS) difference was observed between the patients with CDC, GBC, and DBDC. The T category of GBC staging was more accurate at distinguishing OS in patients with CDC than the DBDC staging. Patients with T3 CDC and GBC showed a significant OS difference when using the T category for GBC staging, while those with T1-T2 CDC and GBC showed no significant difference. In contrast, the T category of DBDC staging did not show any significant OS difference between patients with T1-T2 CDC and DBDC or T3 CDC and DBDC. Patients with type 1 CDC had significantly better OS than those with combined types. Conclusion: Unlike GBCs and DBDCs, CDCs exhibit distinct clinicopathological characteristics. The OS is better when the CDC confines within the CD, compared to when it extends beyond it. Therefore, we propose a new T category scheme (T1, confined to CD; T2, invaded beyond CD) for better classifying CDCs.

Do COVID-19 Vaccination Policies Backfire? The Effects of Mandates, Vaccination Passports, and Financial Incentives on COVID-19 Vaccination.

Faced with the challenges of motivating people to vaccinate, many countries have introduced policy-level interventions to encourage vaccination against COVID-19. For example, mandates were widely imposed requiring individuals to vaccinate to work and attend school, and vaccination passports required individuals to show proof of vaccination to travel and access public spaces and events. Furthermore, some countries also began offering financial incentives for getting vaccinated. One major criticism of these policies was the possibility that they would produce reactance and thus undermine voluntary vaccination. This article therefore reviews relevant empirical evidence to examine whether this is indeed the case. Specifically, we devote separate sections to reviewing and discussing the impacts of three major policies that were implemented during the COVID-19 pandemic: vaccination mandates, vaccination passports, and the provision of financial incentives. A careful analysis of the evidence provides little support that these policies backfire but instead can effectively promote vaccination at the population level. The policies are not without limitations, however, such as their inability to mobilize those that are strongly hesitant to vaccines. Finally, we discuss how policy-level interventions should be designed and implemented to address future epidemics and pandemics.

How Social Media Algorithms Shape Offline Civic Participation: A Framework of Social-Psychological Processes.

Even though social media platforms have created opportunities for more efficient and convenient civic participation, they are unlikely to bring about social change if the online actions do not propagate to offline civic participation. This article begins by reviewing the meta-analytic evidence on the relation between social media use and offline civic participation. Following this discussion, we present a theoretical framework that incorporates the attitudinal, motivational, and relational processes that may mediate the effect of social media use on offline civic participation. The framework highlights how social media algorithms may shape attitudes on important societal issues, promote generalized action goals among habitual users, and build social capital. We further discuss factors that may strengthen or undermine each of these processes, suggest ways to design and implement algorithms that may promote offline civic participation, and propose questions for future research.

State policies increase vaccination by shaping social norms.

In a survey and four preregistered experiments, we examined if implementing a vaccine-promoting policy is likely to encourage vaccination by shaping the norms of a society. By combining state-level policy data with a longitudinal survey, we found that vaccine-supportive policies and laws are associated with more positive social norms. To establish a causal effect, we conducted four preregistered experiments to gauge the impact of policies, including the government recommendation for children to receive the COVID-19 vaccine and changes in funding for immunization programs. We find that vaccine-supportive policies strengthen the intention to receive an additional recommended COVID-19 booster shot and the intention to vaccinate children against COVID-19. We also find that these effects are mediated by the promotion of social norms supportive of vaccination. In this context, communicating about laws and policies in favor of vaccination may create a culture of vaccination and increase vaccination coverage.

How people use information about changes in infections and disease prevalence.

OBJECTIVE: To determine the influence of two representative metrics of epidemiological risk, changes in new infections, and disease prevalence, on people's risk judgments and disease-prevention behaviors. METHOD: Four experiments were conducted from August 2020 to May 2021. In Experiments 1 and 2, participants were exposed to information about different directions of change (upward and downward) and varying levels of prevalence of an infectious disease. In Experiments 3 and 4, participants were exposed to information about only one direction of change (upward or downward) and varying levels of prevalence. Participants reported risk judgments and intentions to engage in disease-prevention behaviors for each disease situation presented to them. RESULTS: When both the direction of change and levels of prevalence varied, risk judgments and intentions were more influenced by change (vs. prevalence) information. Participants' reliance on prevalence information to guide risk judgments increased when they were presented with only an upward or downward change, particularly for situations with worsening infections. In all cases, the effects of epidemiological information on behavioral intentions were mediated by its effects on risk judgments. CONCLUSIONS: Information about changes in infections consistently influences people's risk judgments and drive subsequent behavioral response. The impact of prevalence information, however, is limited to situations in which changes in infections are stable, such that it affects risk judgments and behavior decisions only when changes in infections demonstrate a constant upward or downward direction. The results point to the need for public health interventions to increase the impact of prevalence information. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Clinicopathologic Impact of Peptide Hormonal Expression in Rectal Neuroendocrine Tumors.

CONTEXT.­: Although several neuroendocrine cell types constitute gastroenteropancreatic neuroendocrine tumors (NETs), the clinical and prognostic implications of the expression of multiple peptide hormones have not been comprehensively evaluated in rectal NETs. OBJECTIVE.­: To identify the clinicopathologic characteristics and prognostic impact of peptide hormone expression. DESIGN.­: We evaluated the expression of peptide YY (PYY), glucagon, somatostatin, serotonin, insulin, and gastrin using immunolabeling in 446 endoscopically or surgically resected rectal NETs. RESULTS.­: PYY, glucagon, serotonin, somatostatin, insulin, and gastrin were expressed in 261 of 389 (67.1%), 205 of 446 (46.0%), 36 of 446 (8.1%), 33 of 446 (7.4%), 2 of 446 (0.4%), and 1 of 446 cases (0.2%), respectively. Immunoreactivity to any peptide hormone was present in 345 of 446 cases (77.4%). Tumors expressing serotonin or somatostatin were associated with lymphovascular invasion, chromogranin A expression, and shorter disease-free survival (DFS). Rectal NETs were classified as L-cell, enterochromaffin-cell, D-cell, null-expression, or mixed-expression type based on peptide hormonal expression status. Patients with D-cell NET had the shortest DFS (10-year DFS, 54.5%), followed by those with enterochromaffin-cell NET (89.5%), null expression (97.0%), L-cell NET (99.6%), and mixed-expression NET (100%; P < .001). Multivariable analyses revealed that somatostatin expression was an independent indicator of poor prognosis with respect to DFS in rectal NETs (P = .001). CONCLUSIONS.­: Somatostatin expression is a poor prognostic indicator in patients with rectal NETs. Therefore, additional peptide hormonal immunolabeling, including somatostatin, serotonin, and PYY, in rectal NETs can provide more information regarding DFS.

Double Ki-67 and synaptophysin labeling in pancreatic neuroendocrine tumor biopsies.

BACKGROUND: Pancreatic neuroendocrine tumors (PanNETs) are frequently detected on endoscopic ultrasound-guided fine-needle aspiration biopsy (EUS-FNAB) specimens. The conventional methods for evaluating the Ki-67 labeling index (Ki67LI) in EUS-FNAB specimens are laborious, and their results are difficult to interpret. More practical and easy methods for evaluating the Ki67LI in PanNETs from EUS-FNAB specimens is increasing in need. METHODS: We used double Ki-67 and synaptophysin (double Ki-Syn) antibody cocktail; Ki67LI, total Ki-67 positive cells, and total tumor cells were counted and compared with those detected on conventional single Ki-67 immunostaining (single Ki-67) of 96 PanNETs [Grade 1 (G1), 68 cases (71%); G2, 26 (27%); G3, 2 (2%)] from EUS-FNAB specimens. RESULTS: The tumor grading between double Ki-Syn and single Ki-67 immunolabeling was highly concordant (correlation, 0.95; Fisher's exact test, P < 0.001). Seven EUS-FNAB specimens (7%) had discrepant results, of which 2 were removed through surgical resection and showed the same tumor grade as that detected on double Ki-Syn immunolabeling. Fifty-four specimens (56%) had higher Ki-67 positive tumor cell counts on single Ki-67 immunolabeling. Sixty-two specimens (65%) had higher total tumor cell counts on double Ki-Syn immunolabeling. The number of specimens with less than 500 total counted tumor cells were significantly reduced when double Ki-Syn immunolabeling was applied [P = 0.046; single Ki-67, 17 specimens (18%); double Ki-Syn, 9 specimens (9%)]. CONCLUSION: Double Ki-Syn immunolabeling enables the accurate counting of the number of proliferating tumor cells without including inflammatory and contaminant epithelial cells compared with single Ki-67 immunolabeling in PanNETs from EUS-FNAB specimens.

Testing a digitally distributed method to recruit a network of community organizations to fight the consequences of the drug epidemic: A study in 13 American states.

To mitigate the opioid epidemic, a concerted effort to educate, prevent, diagnose, treat, and engage residents is required. In this study, a digitally distributed method to form a large network of organizations was tested with 99 counties in regions with high vulnerability to hepatitis C virus (HCV). The method involved a cascade of contacts going from email to phone calls, to videoconferencing and measuring the number of contacts required, amount of time taken, and the proportion of success at recruiting at least one community organization per county. A recruitment period of 5 months and 2118 contact attempts led to the recruitment of organizations from 73 out of our 99 target counties. Organizations belonging to health departments required more attempts and time to recruit but ultimately enrolled at higher rates than did other organizations such as coalitions and agencies. Organizations from counties more (vs. less) vulnerable to HCV outbreaks required more attempts to recruit and, using multiple recruitment methods (e.g., emails, phone calls, and Zoom meetings), improved enrollment success. Overall, this method proved to be successful at remotely engaging a large-scale network of communities with different levels of risk within a large geographic region.

Classical and Nonclassical Nucleation and Growth Mechanisms for Nanoparticle Formation.

All solid materials are created via nucleation. In this evolutionary process, nuclei form in solution or at interfaces, expand by monomeric growth and oriented attachment, and undergo phase transformation. Nucleation determines the location and size of nuclei, whereas growth controls the size, shape, and aggregation of newly formed nanoparticles. These physical properties of nanoparticles can affect their functionalities, reactivities, and porosities, as well as their fate and transport. Recent advances in nanoscale analytical technologies allow in situ real-time observations, enabling us to uncover the molecular nature of nuclei and the critical controlling factors for nucleation and growth. Although a single theory cannot yet fully explain such evolving processes, we have started to better understand how both classical andnonclassical theories can work together, and we have begun to recognize the importance of connecting these theories. This review discusses the recent convergence of knowledge about the nucleation and growth of nanoparticles.

Rather than inducing psychological reactance, requiring vaccination strengthens intentions to vaccinate in US populations.

In a survey and three experiments (one preregistered with a nationally representative sample), we examined if vaccination requirements are likely to backfire, as commonly feared. We investigated if relative to encouraging free choice in vaccination, requiring a vaccine weakens or strengthens vaccination intentions, both in general and among individuals with a predisposition to experience psychological reactance. In the four studies, compared to free choice, requirements strengthened vaccination intentions across racial and ethnic groups, across studies, and across levels of trait psychological reactance. The results consistently suggest that fears of a backlash against vaccine mandates may be unfounded and that requirements will promote COVID-19 vaccine uptake in the United States.

Transformation and Mobility of Cu, Zn, and Cr in Sewage Sludge during Anaerobic Digestion with Pre- or Interstage Hydrothermal Treatment.

Anaerobic digestion (AD) combined with hydrothermal treatment (HT) is an attractive technology for sewage sludge treatment and resource recovery. The fate and distribution of heavy metals in the sludge during combined HT/AD significantly affect the sludge final disposal/utilization options, yet such information is still lacking. This study systematically characterizes the transformation of important heavy metals Cu, Zn, and Cr in sewage sludge during AD with pre- or interstage HT (i.e., HT-AD or AD-HT-AD, respectively). Complementary sequential chemical extraction and X-ray absorption spectroscopy were used to characterize the speciation and mobility of metals. For the HT-AD system, both Cu and Zn predominantly occur as sulfides in HT hydrochars. Subsequent AD favors the formation of Cu2S and partial transformation of nano-ZnS to adsorbed and organo-complexed Zn species. HT favors the formation of Cr-bearing silicates in hydrochars, whereas Fe(III)-Cr(III)-hydroxide and Cr(III)-humic complex are the predominant Cr species in AD solids. Similar reaction pathways occur in the AD-HT-AD system with some minor differences in metal species and contents, as the first-stage AD changed the sludge matrix. These findings have important implications for understanding the fate and mobility of heavy metals in sludge-derived hydrochars and AD solids.

Concerns for others increases the likelihood of vaccination against influenza and COVID-19 more in sparsely rather than densely populated areas.

Vaccination yields the direct individual benefit of protecting recipients from infectious diseases and also the indirect social benefit of reducing the transmission of infections to others, often referred to as herd immunity This research examines how prosocial concern for vaccination, defined as people's preoccupation with infecting others if they do not vaccinate themselves, motivates vaccination in more and less populated regions of the United States. A nationally representative, longitudinal survey of 2,490 Americans showed that prosocial concern had a larger positive influence on vaccination against influenza in sparser regions, as judged by a region's nonmetropolitan status, lesser population density, and lower proportion of urban land area. Two experiments (total n = 800), one preregistered, provide causal evidence that drawing attention to prosocial (vs. individual) concerns interacted with social density to affect vaccination intentions. Specifically, prosocial concern led to stronger intentions to vaccinate against influenza and COVID-19 but only when social density was low (vs. high). Moderated mediation analyses show that, in low-density conditions, the benefits of inducing prosocial concern were due to greater perceived impact of one's vaccination on others. In this light, public health communications may reap more benefits from emphasizing the prosocial aspects of vaccination in sparser environments.

Coevolution of Iron, Phosphorus, and Sulfur Speciation during Anaerobic Digestion with Hydrothermal Pretreatment of Sewage Sludge.

Anaerobic digestion (AD) with hydrothermal (HT) pretreatment is an emerging technology for enhanced resource recovery from sewage sludge. This study investigates the speciation of Fe, P, and S during sequential HT-AD treatment of sewage sludge using sequential chemical extraction, X-ray diffraction, and X-ray absorption spectroscopy. Results suggest strong correlations between Fe and P species as well as Fe and S species, affecting the solubility and bioavailability of each other. For instance, much vivianite formed in the hydrochars after HT treatment at low temperature, while more strengite precipitated at higher HT temperature. During the subsequent AD process, microbial reduction of strengite and other Fe(III) species led to the formation of more vivianite, with concurrent P release into the solution and adsorption onto other minerals. HT pretreatment of sewage sludge had a weak effect on the sulfidation of Fe during the AD process. This work has important implications for understanding the nutrient speciation and availability in sludge-derived hydrochars and AD solids. It also provides fundamental knowledge for the selection and optimization of HT pretreatment conditions for enhanced resource recovery through sequential HT-AD process.

Prosocial modeling: A meta-analytic review and synthesis.

Exposure to prosocial models is commonly used to foster prosocial behavior in various domains of society. The aim of the current article is to apply meta-analytic techniques to synthesize several decades of research on prosocial modeling, and to examine the extent to which prosocial modeling elicits helping behavior. We also identify the theoretical and methodological variables that moderate the prosocial modeling effect. Eighty-eight studies with 25,354 participants found a moderate effect (g = 0.45) of prosocial modeling in eliciting subsequent helping behavior. The prosocial modeling effect generalized across different types of helping behaviors, different targets in need of help, and was robust to experimenter bias. Nevertheless, there was cross-societal variation in the magnitude of the modeling effect, and the magnitude of the prosocial modeling effect was larger when participants were presented with an opportunity to help the model (vs. a third-party) after witnessing the model's generosity. The prosocial modeling effect was also larger for studies with higher percentage of female in the sample, when other people (vs. participants) benefitted from the model's prosocial behavior, and when the model was rewarded for helping (vs. was not). We discuss the publication bias in the prosocial modeling literature, limitations of our analyses and identify avenues for future research. We end with a discussion of the theoretical and practical implications of our findings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Redox Cycling Driven Transformation of Layered Manganese Oxides to Tunnel Structures.

Mn oxides are among the most ubiquitous minerals on Earth and play critical roles in numerous elemental cycles in biotic/abiotic loops as the key redox center. Yet, it has long puzzled geochemists why the laboratory synthesis of todorokite, a tunnel-structured Mn oxide, is extremely difficult while it is the dominant form over other tunneled phases in low-temperature natural environments. This study employs a novel electrochemical method to mimic the cyclic redox reactions occurring over long geological time scales in an accelerated manner. The results revealed that the kinetics and electron flux of the cyclic redox reaction are key to the layer-to-tunnel structure transformation of Mn oxides, provided new insights for natural biotic and abiotic redox reactions, and explained the dominance of todorokite in nature.

Photochemically assisted fast abiotic oxidation of manganese and formation of δ-MnO2 nanosheets in nitrate solution.

This study introduces a new and previously unconsidered fast abiotic formation of Mn(iv) oxides. We report photochemically assisted fast abiotic oxidation of Mn2+ (aq) to Mn(iv) (s) by superoxide radicals generated from nitrate photolysis. This photochemical pathway generates randomly stacked layered birnessite (δ-MnO2) nanosheets.

Structural Match of Heterogeneously Nucleated Mn(OH)2(s) Nanoparticles on Quartz under Various pH Conditions.

The early nucleation stage of Mn (hydr)oxide on mineral surfaces is crucial to understand its occurrence and the cycling of nutrients in environmental systems. However, there are only limited studies on the heterogeneous nucleation of Mn(OH)2(s) as the initial stage of Mn (hydr)oxide precipitation. Here, we investigated the effect of pH on the initial nucleation of Mn(OH)2(s) on quartz. Under various pH conditions of 9.8, 9.9, and 10.1, we analyzed the structural matches between quartz and heterogeneously nucleated Mn(OH)2(s). The structural matches were calculated by measuring the lateral and vertical dimensions using grazing incidence small angle X-ray scattering and atomic force microscopy (AFM), respectively. We found that a poorer structural match occurred at a higher pH than at a lower pH. The faster nucleation under a higher pH condition accounted for the poorer structural match observed. By fitting the structural match using classical nucleation theory, we also calculated the interfacial energy between Mn(OH)2(s) and water: γnf = 71 ± 7 mJ/m2. The calculated m values and γnf provided the variance of interfacial energy between quartz and Mn(OH)2(s): γsn = 262-272 mJ/m2. This study provides new qualitative and quantitative information on heterogeneous nucleation on an environmentally abundant mineral surface, quartz, and it offers important underpinnings for understanding the fate and transport of trace ions in environmental systems.

Ionic Strength-Controlled Mn (Hydr)oxide Nanoparticle Nucleation on Quartz: Effect of Aqueous Mn(OH)2.

The early formation of manganese (hydr)oxide nanoparticles at mineral-water interfaces is crucial in understanding how Mn oxides control the fate and transport of heavy metals and the cycling of nutrients. Using atomic force microscopy, we investigated the heterogeneous nucleation and growth of Mn (hydr)oxide under varied ionic strengths (IS; 1-100 mM NaNO3). Experimental conditions (i.e., 0.1 mM Mn(2+) (aq) concentration and pH 10.1) were chosen to be relevant to Mn remediation sites. We found that IS controls Mn(OH)2 (aq) formation, and that the controlled Mn(OH)2 (aq) formation can affect the system's saturation and subsequent Mn(OH)2 (s) and further Mn3O4 (s) nanoparticle formation. In 100 mM IS system, nucleated Mn (hydr)oxide particles had more coverage on the quartz substrate than those in 1 mM and 10 mM IS systems. This high IS also resulted in low supersaturation ratio and thus favor heterogeneous nucleation, having better structural matching between nucleating Mn (hydr)oxides and quartz. The unique information obtained in this work improves our understanding of Mn (hydr)oxide formation in natural as well as engineered aqueous environments, such as groundwater contaminated by natural leachate and acid mine drainage remediation.