Research on mathematical competencies in engineering education: where are we now?

In tertiary mathematics education for engineers (hereafter called service mathematics education, SME), there is a long-lasting controversy on what and how to teach. The goal of SME is to provide a base for engineering-specific courses and to develop mathematical competencies needed for academic success and professional practice. A leading question in engineering education is how to take mathematical competencies into account when designing content. Mathematical competencies are employed to understand, judge, do, and use mathematics in a variety of mathematical contexts and situations in which mathematics could play a role [1]. Although mathematical competencies have been introduced for about two decades, Alpers [2] noted that research in engineering higher education had focused chiefly on the modelling competency and less on other competencies. By means of a scoping review, the current study aims to examine how mathematical competencies are investigated in higher education research. The main research question is “To what extent and in what ways have mathematical competencies been examined in higher engineering education research?” Papers were retrieved and qualitatively reviewed using the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) guidelines. A systematic search yielded 166 records, of which, 65 unique records were relevant to engineering education and screened for eligibility. A synthesis of 23 studies reviewed showed that problem-solving and modelling were the most investigated mathematical competencies and were often investigated together or with other mathematical competencies. The inconsistencies in the terminologies used suggest a need for clearer conceptualizations to advance research and inform practice on mathematical competencies

Cumulative effects assessment: proof of concept marine mammals

This development of the framework and approach for a Cumulative Effects Assessment (CEA) is based on a literature review. The literature identified some key challenges that need to be addressed for CEA to evolve into a consistent, appropriate tool to assist decision-making. These challenges included • A clear distinction of the receptor-led CEA from the dominating stressor-led Environmental Impact Assessment (EIA) approaches and • Enabling CEA to provide ecosystem-relevant information at an appropriate regional scale. Therefore this CEA is explicitly developed to be a receptor-led and fully integrated framework, i.e. involving multiple occurrences of multiple pressures (from single and/or different sources) on multiple receptors, as opposed to other existing approaches dealing with only a subset of those pressures or receptors, hence our use of the phrase iCEA for integrated CEA. As a proof of concept for this iCEA we selected one receptor, the ecosystem component marine mammals. The main conclusions of this exercise (see Chapter 6) are that the iCEA framework and approach presented in this study appear suitable to fulfil its main purpose and ultimately inform the policy process as described in the conception phase. However it should be acknowledged this is only the very first step in a process where through many iterations new information can be introduced and assessed (relative to existing information) based on the criteria provided resulting in an improved iCEA with increasing confidence levels. As more information becomes available the relative importance of impact chains and its corresponding information modules may change giving direction to new areas for research. For further development of this iCEA towards its intended applications we can distinguish between the first purpose, i.e. identification of the main impact chains contributing to the risk that a specific ecosystem component is impacted, which can be achieved with the approach presented here focussing on one specific ecosystem component and the second purpose, i.e. an evaluation of the performance of possible management strategies, which would require all ecosystem components to be included as would be required for ecosystem-based management. Thus to further the development and application of this iCEA towards its (two) purpose(s) the recommendation is to: • Include the available information presented in this report into the iCEA and develop the Bayesian Belief Network such that it can process this information and its associated confidence into an assessment that identifies the main impact chains for the marine mammals. • Extend the framework and approach to (all) the other ecosystem components so that a truly integrated CEA is possible. Note that this is likely to affect the identification of what should be considered the main pressures to guide management. • Improve the information modules that emerged from the evaluation as the most promising to increase the confidence in the outcome of the iCEA. Note that the previous two steps may result in a different prioritisation of the information modules as the importance of pressures and hence impact chains changes

Distinct Biomarker Profiles and Clinical Characteristics in T1-T2 Glottic and Supraglottic Carcinomas

Background: In early stage laryngeal squamous cell carcinoma (LSCC) radiotherapy with curative intent is a major treatment modality. TNM classification is used to define patients eligible for radiotherapy. Studies in early stage glottic LSCC identified several predictive biomarkers associated with local control. However, we recently reported that this predictive value could not be confirmed in supraglottic LSCC. Objective: To examine whether clinical behavior and protein expression patterns of these biomarkers differ between glottic and supraglottic LSCC. Study Design: Retrospective cohort study. Methods: Tumor tissue sections of 196 glottic and 80 supraglottic T1-T2 LSCC treated primarily with RT were assessed immunohistochemically for expression of pAKT, Ki-67 and β-Catenin. Expression data of HIF-1α, CA-IX, OPN, FADD, pFADD, Cyclin D1, Cortactin and EGFR in the same cohort of glottic and supraglottic LSCC, were retrieved from previously reported data. The relationship between glottic and supraglottic sublocalization and clinicopathological, follow-up, and immunohistochemical staining characteristics were evaluated using logistic regression and Cox regression analyses. Results: Glottic LSCC were correlated with male gender (P =.001), hoarseness as a primary symptom (P <.001), T1 tumor stage (P <.001), negative lymph node status (P <.001), and an older age at presentation (P =.004). Supraglottic LSCC patients developed more post-treatment distant metastasis when adjusted for gender, age, and T-status. While supraglottic LSCC was associated with higher expression of HIF-1α (P =.001), Cortactin (P <.001), EGFR (P <.001), and Ki-67 (P =.027), glottic LSCC demonstrated higher expression of CA-IX (P =.005) and Cyclin D1 (P =.001). Conclusion: Differences in clinicopathological and immunohistochemical staining characteristics suggest that T1-T2 glottic and supraglottic LSCC should be considered as different entities. Level of Evidence: N/A. Laryngoscope, 2020

The periodontium of periodontitis patients contains citrullinated proteins which may play a role in ACPA (anti-citrullinated protein antibody) formation

Aim To determine the presence and location (stroma versus epithelium) of citrullinated proteins in periodontitis tissue as compared to non-periodontitis tissue and synovial tissue of RA patients. Materials & Methods Periodontitis, healthy periodontal and RA-affected synovial tissue samples were collected in addition to buccal swabs. These samples were stained for the presence of citrullinated proteins using polyclonal (Ab5612) and monoclonal (F95) antibodies. Furthermore, Western blotting with F95 was performed on lysates prepared from periodontal and synovial tissues. Results In periodontitis stroma, increased citrullinated protein presence (80%) was observed compared with control stroma (33%), the latter was associated with inflammation of non-periodontitis origin. Periodontal epithelium always stained positive for Ab5612. Noteworthy, only periodontitis-affected epithelium stained positive for F95. All buccal mucosal swabs and 3 of 4 synovial tissue samples stained positive for both Ab5612 and F95. Western blotting with F95 showed presence of similar citrullinated proteins in both periodontitis and RA-affected synovial tissue. Conclusion Within the periodontal stroma, citrullination is an inflammation-depended process. In periodontal epithelium, citrullination is a physiological process. Additional citrullinated proteins are formed in periodontitis, apparently similar to those formed in RA-affected synovial tissue. Periodontitis induced citrullination may play a role in the aetiology of rheumatoid arthritis

PTEN Is Associated With Worse Local Control in Early Stage Supraglottic Laryngeal Cancer Treated With Radiotherapy

Objectives: The aim of this study was to establish the prognostic value of the epidermal growth factor receptor (EGFR) and phosphatase and tensin homolog deleted on chromosome 10 (PTEN) expression on local control in patients with early stage supraglottic laryngeal squamous cell carcinoma (LSCC) treated with radiotherapy only. Study design: Retrospective cohort study. Methods: Immunohistochemical staining for EGFR and PTEN was performed on pretreatment biopsies of a selected well-defined homogeneous group of 52 patients with T1-T2 supraglottic LSCC treated with radiotherapy between 1990 and 2008. Kaplan-Meier analysis and univariate and multivariate Cox Regression analyses were performed to correlate clinical data and expression levels of EGFR and PTEN with local control. Results: Kaplan-Meier survival analysis and Cox Regression analysis showed a significant association between PTEN expression and local control (hazard ratio [HR] = 3.26, 95% confidence interval [CI] = 1.14-9.33, P = .027) and between lymph node status and local control (HR = 3.60, 95% CI = 1.26-10.31, P = .017). Both were independent prognostic factors in a multivariate analysis (HR = 3.28, 95% CI = 1.14-9.39, P = .027 and HR = 3.62, 95% CI = 1.26-10.37, P = .017, respectively). There was no significant association between EGFR expression and local control (HR = 1.32, 95% CI = 1.17-10.14, P = .79). Conclusion: This study showed an association between both high PTEN expression and the presence of lymph node metastasis and deteriorated local control in early stage supraglottic LSCC treated with radiotherapy. Level of Evidence: NA

Is a preoperative multidisciplinary team meeting (cost)effective to improve outcome for high-risk adult patients undergoing noncardiac surgery:the PREPARATION study-a multicenter stepped-wedge cluster randomized trial

BACKGROUND: As a result of increased life expectancy and improved care for patients suffering from chronic disease, the number of patients with multimorbidity requiring surgical intervention is increasing. For complex surgical patients, it is essential to balance the potential benefits of surgical treatment against the risk of permanent loss of functional capacity and quality of life due to complications. European and US guidelines on perioperative care recommend preoperative multidisciplinary team (MDT) discussions for high-risk noncardiac surgical patients. However, the evidence underlying benefits from preoperative MDT meetings with all relevant perioperative specialties present is limited. The current study aims to investigate the effect of implementation of preoperative MDT discussions for high-risk patients undergoing noncardiac surgery on serious adverse events.METHODS/DESIGN: PREPARATION is a stepped-wedge cluster randomized trial in 14 Dutch hospitals without currently established preoperative MDT meeting. The intervention, preoperative MDT meetings, will be implemented sequentially with seven blocks of 2 hospitals switching from control (preoperative screening as usual) to the intervention every 3 months. Each hospital will be randomized to one of seven blocks. We aim to include 1200 patients. The primary outcome is the incidence of serious adverse events at 6 months. Secondary outcomes include (cost)effectiveness, functional outcome, and quality of life for up to 12 months.DISCUSSION: PREPARATION is the first study to assess the effectiveness of a preoperative MDT meeting for high-risk noncardiac surgical patients in the presence of an anesthesiologist. If the results suggest that preoperative MDT discussions for high-risk patients are (cost)-effective, the current study facilitates implementation of preoperative MDT meetings in clinical practice.TRIAL REGISTRATION: ClinicalTrials.gov NCT05703230. Registered on 11/09/2022.</p

Cortactin overexpression results in sustained epidermal growth factor receptor signaling by preventing ligand-induced receptor degradation in human carcinoma cells

The chromosome 11q13 region is frequently amplified in human carcinomas and results in an increased expression of various genes including cortactin, and is also associated with an increased invasive potential. Cortactin acts as an important regulator of the actin cytoskeleton. It is therefore very tempting to speculate that cortactin is the crucial gene within the 11q13 amplicon that mediates the invasive potential of these carcinomas. Cortactin also participates in receptor-mediated endocytosis, and recent findings have shown that, during receptor internalization, cortactin overexpression inhibits the ubiquitylation-mediated degradation of the epidermal growth factor receptor, resulting in a sustained ligand-induced epidermal growth factor receptor activity

The state of the Martian climate

60°N was +2.0°C, relative to the 1981–2010 average value (Fig. 5.1). This marks a new high for the record. The average annual surface air temperature (SAT) anomaly for 2016 for land stations north of starting in 1900, and is a significant increase over the previous highest value of +1.2°C, which was observed in 2007, 2011, and 2015. Average global annual temperatures also showed record values in 2015 and 2016. Currently, the Arctic is warming at more than twice the rate of lower latitudes