The Diversity Challenge for Higher Education in Canada: The Prospects and Challenges of Increased Access and Student Success

With the shifting demographics of societies such as the United States and Canada, access to higher education presents a variety of challenges to ensure that universities are able to meet the challenges associated with increased student diversity on campus. The current paper reviews first the literature on the linkages between social inequality and education, before turning to an examination of Canadian data with respect to access issues and the possible barriers to increasing diversity among postsecondary institutions. The evidence reveals that first-generation students and those whose parents did not attend university, Aboriginal peoples, and students with disabilities (among others) continue to be underrepresented in postsecondary education. At the same time, the paper argues that while institutions of higher learning can facilitate improved access, they must commit to developing support services and a more welcoming and inclusive environment in order to ensure student retention and success among an increasingly diverse student population. The paper concludes with a discussion of “best practices” from the perspective of a predominantly undergraduate, liberal arts institution in southern Ontario

Hematologic Safety of Radium-223 Dichloride: Baseline Prognostic Factors Associated With Myelosuppression in the ALSYMPCA Trial.

BACKGROUND: Myelosuppression is common in patients with progressive castration-resistant prostate cancer and bone metastases. Radium-223 prolongs overall survival in these patients but may cause myelosuppression; understanding risk factors will improve clinical decision making. We describe hematologic safety of radium-223 in ALSYMPCA and post hoc analyses identifying patients at increased risk for hematologic toxicity. PATIENTS AND METHODS: Hematologic parameters and adverse events were analyzed. Multivariate analyses assessing baseline risk factors for hematologic toxicities were performed separately for radium-223 and placebo patients. RESULTS: Nine hundred one patients received radium-223 (n = 600) or placebo (n = 301); 65% of radium-223 and 48% of placebo patients had the full 6 cycles. Grade 3/4 thrombocytopenia was more common in radium-223 versus placebo patients (6% vs. 2%). Logistic regression analyses identified significant baseline predictors for grade 2-4 hematologic toxicities related to radium-223 treatment: extent of disease (6-20 vs. < 6 bone metastases; odds ratio [OR] = 2.76; P = .022) and elevated prostate-specific antigen (OR = 1.65; P = .006) for anemia; prior docetaxel (OR = 2.16; P = .035), decreased hemoglobin (OR = 1.35; P = .008), and decreased platelets (OR = 1.44; P = .030) for thrombocytopenia. Neutropenia events were too few in placebo patients for a comparative analysis. There were no significant associations between hematologic toxicities and number of radium-223 injections received (4-6 vs. 1-3). CONCLUSION: Radium-223 has a favorable safety profile with a low myelosuppression incidence. Understanding baseline factors associated with myelosuppression may assist clinicians in avoiding severe myelosuppression events with radium-223

Mars: new insights and unresolved questions

Mars exploration motivates the search for extraterrestrial life, the development of space technologies, and the design of human missions and habitations. Here, we seek new insights and pose unresolved questions relating to the natural history of Mars, habitability, robotic and human exploration, planetary protection, and the impacts on human society. Key observations and findings include: – high escape rates of early Mars’ atmosphere, including loss of water, impact present-day habitability; – putative fossils on Mars will likely be ambiguous biomarkers for life; – microbial contamination resulting from human habitation is unavoidable; and – based on Mars’ current planetary protection category, robotic payload(s) should characterize the local martian environment for any life-forms prior to human habitation.Some of the outstanding questions are:– which interpretation of the hemispheric dichotomy of the planet is correct; – to what degree did deep-penetrating faults transport subsurface liquids to Mars’ surface; – in what abundance are carbonates formed by atmospheric processes; – what properties of martian meteorites could be used to constrain their source locations; – the origin(s) of organic macromolecules; – was/is Mars inhabited; – how can missions designed to uncover microbial activity in the subsurface eliminate potential false positives caused by microbial contaminants from Earth; – how can we ensure that humans and microbes form a stable and benign biosphere; and – should humans relate to putative extraterrestrial life from a biocentric viewpoint (preservation of all biology), or anthropocentric viewpoint of expanding habitation of space?Studies of Mars’ evolution can shed light on the habitability of extrasolar planets. In addition, Mars exploration can drive future policy developments and confirm (or put into question) the feasibility and/or extent of human habitability of space

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase&nbsp;1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation&nbsp;disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age&nbsp; 6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score&nbsp; 652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc&nbsp;= 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N&nbsp;= 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in&nbsp;Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in&nbsp;Asia&nbsp;and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

The impact of surgical delay on resectability of colorectal cancer: An international prospective cohort study

AIM: The SARS-CoV-2 pandemic has provided a unique opportunity to explore the impact of surgical delays on cancer resectability. This study aimed to compare resectability for colorectal cancer patients undergoing delayed versus non-delayed surgery. METHODS: This was an international prospective cohort study of consecutive colorectal cancer patients with a decision for curative surgery (January-April 2020). Surgical delay was defined as an operation taking place more than 4 weeks after treatment decision, in a patient who did not receive neoadjuvant therapy. A subgroup analysis explored the effects of delay in elective patients only. The impact of longer delays was explored in a sensitivity analysis. The primary outcome was complete resection, defined as curative resection with an R0 margin. RESULTS: Overall, 5453 patients from 304 hospitals in 47 countries were included, of whom 6.6% (358/5453) did not receive their planned operation. Of the 4304 operated patients without neoadjuvant therapy, 40.5% (1744/4304) were delayed beyond 4 weeks. Delayed patients were more likely to be older, men, more comorbid, have higher body mass index and have rectal cancer and early stage disease. Delayed patients had higher unadjusted rates of complete resection (93.7% vs. 91.9%, P = 0.032) and lower rates of emergency surgery (4.5% vs. 22.5%, P < 0.001). After adjustment, delay was not associated with a lower rate of complete resection (OR 1.18, 95% CI 0.90-1.55, P = 0.224), which was consistent in elective patients only (OR 0.94, 95% CI 0.69-1.27, P = 0.672). Longer delays were not associated with poorer outcomes. CONCLUSION: One in 15 colorectal cancer patients did not receive their planned operation during the first wave of COVID-19. Surgical delay did not appear to compromise resectability, raising the hypothesis that any reduction in long-term survival attributable to delays is likely to be due to micro-metastatic disease

Octahedral chemistry of 2:1 clay minerals and hydroxyl band position in the near-infrared: Application to Mars

© 2016 by Walter de Gruyter Berlin/Boston.With the arrival of Curiosity on Mars, the MSL has started its ground validation of some of the phyllosilicate characterization carried out with remote sensing near-IR spectroscopy from orbital instruments. However, given the limited range of action of the rover, phyllosilicate identification and characterization will have to rely mainly on orbital near-IR data. Investigation of Earth analogs can greatly assist interpretation of martian spectra and enable more robust analyses. In this contribution, Mg/Fe-rich clays from submarine hydrothermal origin that had been thoroughly characterized previously were investigated with near-IR reflectance spectroscopy. The clays are mixed-layer glauconite-nontronite, talc-nontronite, talc-saponite, and nontronite samples. The hydroxyl bands in the range 2.1-2.35 μm were decomposed into their several individual components to investigate correlations between the octahedral chemistry of the samples and the normalized intensity of several bands. Good correlations were found for the samples of exclusive dioctahedral character (glauconite-nontronite and nontronite), whereas poor or no correlations emerged for the samples with one (talc-nontronite) or two (talc-saponite) trioctahedral layer components, indicating a more complex spectral response. Because these bands analyzed are a combination of the fundamental OH stretching and OH bending vibrations, the response of these fundamental bands to octahedral chemistry was considered. For 2:1 dioctahedral phyllosilicates, Fe and Mg substitution for Al displaces both fundamental bands to lower wavenumbers (longer wavelengths), so that their effect on the position of the combination band is coherent. In contrast, for trioctahedral clays, Al and Fe3+ substitution of octahedral Mg displaces the OH stretching band to lower wavenumber values, and the OH bending band to higher wavenumber values, resulting in partial or total mutual cancelation of their effects. As a result, clays with near-IR spectra indicating Mg-dominated octahedral compositions may in fact contain abundant Fe and some Al substitution. Thus, remote-sensing near-IR mineralogical and chemical identification of clays on Mars appears relatively straightforward for dioctahedral clay minerals but more problematic for trioctahedral clays, for which it may require a more detailed investigation of their near-IR spectra.Link_to_subscribed_fulltex