Peterborough Regional College

The Liver Imaging Reporting and Data System (LI-RADS, LR) provides a framework for diagnosing hepatocellular carcinoma (HCC, LR-5). However, not all HCCs meet LR-5 criteria and are instead categorized as LR-M, probably or definitely malignant but not specific for HCC, necessitating biopsy for diagnosis. The purpose is to identify factors associated with HCC in LR-M observations. This is an IRB-approved, retrospective analysis of participants from 8 institutions that had a LR-M observation on CT or MRI with corresponding histopathologic diagnosis. Demographics and biochemical data were examined. Central review using the LI-RADS v2018 algorithm was performed. Kappa statistics defined inter-reader agreement. Random forest and logistic regression analyses generated a model for HCC diagnosis. 162 participants with 162 LR-M observations were included. 46% of observations (74/162) were HCC and 37% were cholangiocarcinoma (60/162). Two of 34 imaging features- observation size and intra-lesion iron- showed moderate to strong inter-reader agreement (Kappa ≥ 0.60) while the remainder showed weak or no agreement (Kappa < 0.60). Random forest analysis showed biochemical features to be more predictive of HCC than imaging features. Logistic regression analysis of a model based on INR and AFP provided a 72% sensitivity and 61% specificity for HCC by Youden's index and a 90% specificity threshold yielded 38% sensitivity, 75% positive predictive value, and 66% negative predictive value. Our results show INR and AFP are associated with HCC in LR-M observations. A high-specificity threshold may assist in the non-invasive diagnosis of HCC in the appropriate setting. In certain at-risk patients with a LR-M observation on diagnostic imaging, serum AFP and INR maybe useful tools for the non-invasive diagnosis of HCC.

Higher Education Institutions (HEIs) are increasingly engaging with businesses to provide opportunities for their students whilst also promoting their own relevance and impact in society. However, this engagement often involves navigating multiple internal processes and practices. This paper presents an employer-engagement practitioner's reflections on HEI employer-engagement, using the lens of two institutional logics – professional and corporate logics. This paper considers how these logics are shaping HEI employer-engagement, the challenges for employer engagement middle managers (EE-MM), and tensions with senior leadership teams (SLT). This paper is framed and located from the point of view of a middle manager working within employer engagement, reflecting the challenges being faced by myself and seven other EE-MM across five English HEIs as part of my doctoral research. It explores the tensions between EE-MM and HEI-wide SLT; highlighting the competing demands between day-to-day management and strategic overview.

Although acetylsalicylic acid is the most commonly used antithrombotic agent for the secondary prevention of cardiovascular events, residual atherothrombotic risk has prompted a guideline recommendation for the addition of dual antiplatelet therapy (DAPT) or dual pathway inhibition (DPI) in high vascular risk patients. Accordingly, the CONNECT CVD quality enhancement initiative provides a contemporary "snapshot" of the clinical features and antithrombotic management of atherosclerotic cardiovascular disease (ASCVD) patients in Canada. Canadian cardiologists (49 cardiologists from six provinces) undertook a retrospective chart audit of 10 ASCVD patients in their outpatient practice who met the Cardiovascular Outcomes for People Using Anticoagulation Strategy-like criteria from May 2018 to April 2019. Of the 492 (two cardiologists provided 11 patients) enroled, average age was 70years, 25% were female, 39% had diabetes and 20% had atrial fibrillation. Prior revascularisation was common (percutaneous coronary artery intervention 61%, coronary artery bypass graft 39%), with 31% having multivessel disease. A total of 47% of patients had a Reduction of Atherothrombosis for Continued Health bleeding score of ≥11 (~2.8% risk of serious bleeding at 2years). Single antiplatelet therapy (SAPT) alone was most commonly used (62%), while 22% were on DAPT alone. In total, 22% were on oral anticoagulation (OAC), with 16% being on non-vitamin K oral anticoagulant alone, 5% on DPI and 1% received triple therapy. In contemporary Canadian clinical practice of stable ASCVD patients, a large number of patients receive antithrombotic therapy other than SAPT. Further efforts are required to guide the appropriate selection of patients in whom more potent antithrombotic therapies may safely reduce residual risk.

Mercury (Hg) released by mining activities can be dispersed in the environment, where it is subject to species transformations. Hg isotope ratios have been used to track sources in Hg contaminated areas, although it is unclear to what extent variations in δ-values are attributed to distinct Hg species. Hg was mined as Hg sulphide (cinnabar) in Idrija, Slovenia for centuries. Sediments are loaded with mining-residues (cinnabar and calcine), whereas contaminated soils mainly contain Hg bound to natural organic matter (NOM-Hg) related to atmospheric Hg deposition. Hg released from soils and sediments is transported as suspended matter (SM) in the Idrijca river to the Gulf of Trieste (GT), Italy. We determine Hg isotope ratios in river SM, sediments and soils from the Idrijca-catchment to decipher the Hg isotope ratio variability related to Hg species distribution in different grain-size fractions. δ202Hg values of SM collected from tributaries corresponded to those found in soils ranging from -2.58 to 0.19‰ and from -2.27 to -0.88‰, respectively. Speciation measurements reveal that fine fractions (0.45-20 μm) are dominated by NOM-Hg, while larger fractions contain more cinnabar. More negative δ202Hg values were related to higher proportions of NOM-Hg, which are predominant in soils and SM. Rain events increase SM-loads in the river, mainly due to resuspension of coarse grain-size fractions of bottom sediments bearing larger proportions of cinnabar, which leads to more positive δ202Hg values. The large magnitude of variation in δ202Hg and the smaller magnitude of variation in Δ199Hg (-0.37 to 0.09‰) are likely related to fractionation during ore roasting. Soil samples with high NOM-Hg content show more negative δ202Hg values and larger variation of Δ199Hg. More negative δ202Hg values in GT sediments were rather linked to distant sedimentation of soil derived NOM-Hg than to sedimentation of autochthonous marine material. Heterogeneity in the Idrija ore and ore processing likely produce large variations in the Hg isotopic composition of cinnabar and released metallic Hg, which complicate the differentiation of Hg sources. Combining Hg isotope measurements with solid phase Hg speciation reveals that Hg isotope ratios rather indicate different Hg species and are not necessarily symptomatic for Hg pollution sources.

The theory of regular model sets is highly developed, but does not cover examples such as the visible lattice points, the k-th power-free integers, or related systems. They belong to the class of weak model sets, where the window may have a boundary of positive measure, or even consists of boundary only. The latter phenomena are related to the topological entropy of the corresponding dynamical system and to various other unusual properties. Under a rather natural extremality assumption on the density of the weak model set we establish its pure point diffraction nature. We derive an explicit formula that can be seen as the generalisation of the case of regular model sets. Furthermore, the corresponding natural patch frequency measure is shown to be ergodic. Since weak model sets of extremal density are generic for this measure, one obtains that the dynamical spectrum of the hull is pure point as well.

&#x0D; &#x0D; &#x0D; While primate trapping is a widely used field methodology, there are substantial health, safety and social risks to handling wild primates, necessitating sharing of best-practice methods to minimize such risks. Yet, comprehensive capture-and-release protocols are rarely published, and updated even less frequently, despite advances that significantly elevate animal safety. Here, we propose a modified capture and release protocol for small primates and demonstrate its effectiveness on free-ranging populations of Saguinus weddelli (the saddleback tamarin) and Saguinus imperator (the emperor tamarin) in southeastern Peru. This study was conducted over seven years, from 2009 to 2015, and resulted in 346 capture instances with recaptures of the same individuals over years. We present a modified trap design that is lighter, locally produced, easy to set up and maintain, and is safer for animals. We provide data on how a ‘caller animal’ may dramatically increase the success of a new trapping program, but is not necessary on an ongoing basis. We also propose a conversion from previously used single-step anesthetization methods, which are more likely to result in loss of habituation or potential injury, to a novel dual-phase anesthetization process with no delays in processing times or increases in the amount of anesthetic administered. We discuss modifications to traditional trapping strategies that decrease distress to the animals before, during and after trapping. This method ensures high recapture rates and sustained animal habituation to trap sites and observers while also prioritizing animal safety.&#x0D; &#x0D; &#x0D;

Here we report evidence for enhanced hydride formation for Hg isotopes when using high sensitivity X skimmer cones and the Neptune MC-ICP-MS.