Use of baked milk challenges and milk ladders in clinical practice: a worldwide survey of healthcare professionals

In previous years, the cornerstone of the management of Cow's Milk Allergy (CMA) was solely based on the strict avoidance of all cow's milk (CM) and foods containing CM from the patient's diet [1]. More recently, the importance of baked milk (BM) introduction into the diet of children with CMA has become well-recognised as a part of CMA management. Current research suggests that 75% of children become tolerant to baked/heated forms of CM such as muffin and waffles before they become tolerant to pure/uncooked forms of CM [2]

Validation of the Youth Efficacy/Empowerment Scale – Mental Health Finnish version

Αdolescents face mental health problems and still their mental health needs are often neglected. Empowerment provides adolescents with the skills to impact their own lives and communities in general. The aim of the study is to examine the validity and reliability of the Finnish version of the Youth Efficacy/Empowerment Scale – Mental Health (YES-MH). Data was collected through an online questionnaire from pupils aged 12–17 years in Western Finland, comprised of the following instruments; the YES-MH, the Goodman’s the Strengths and Difficulties Questionnaire (SDQ), and the Warwick-Edinburgh Mental Wellbeing Scale. Exploratory factor analysis was carried out to evaluate construct validity and disclose underlying structures which yielded the following subscales: Self, Services, System. The internal consistency of subscales was analyzed with Cronbach’s α. Construct validity was further investigated by computing the Pearson’s correlations coefficients between the subscales. Furthermore, correlations with SDQ and mental well-being dimensions were explored as measures of convergent validity. In the final model all items the Youth Efficacy/ Empowerment Scale – Mental Health were entered into the factor analysis. All factor loadings were more than 0.40, ranging from 0.63 to 0.89. All the scales exceeded the minimum reliability standard of 0.70 and all corrected item-total correlations were high. All the YES-MH subscales were significantly and positively correlated each other with correlations coefficients ranging from medium to high. Correlations of Mental Well-being score with Self and Services subscales were significant. Moreover, Self subscale was significantly correlated with all SDQ dimensions. Services subscale was significantly correlated with Emotional symptoms and total SDQ score, while System subscale was significantly correlated with Conduct problems. The exploratory factor analysis showed a clear factor structure and the results suggest that the YES-MH is a reliable scale for assessing empowerment among young people. The YES-MH can be useful for health professionals not only as an assessment tool but also when they need to evaluate mental health interventions and examine empowerment as an outcome. However, further research can provide insights for the use of the scale in specific adolescent target groups and among different ethnic groups as well.</p

Dust impact on surface solar irradiance assessed with model simulations, satellite observations and ground-based measurements

This study assesses the impact of dust on surface solar radiation focussing on an extreme dust event. For this purpose, we exploited the synergy of AERONET measurements and passive and active satellite remote sensing (MODIS and CALIPSO) observations, in conjunction with radiative transfer model (RTM) and chemical transport model (CTM) simulations and the 1-day forecasts from the Copernicus Atmosphere Monitoring Service (CAMS). The area of interest is the eastern Mediterranean where anomalously high aerosol loads were recorded between 30 January and 3 February 2015. The intensity of the event was extremely high, with aerosol optical depth (AOD) reaching 3.5, and optical/microphysical properties suggesting aged dust. RTM and CTM simulations were able to quantify the extent of dust impact on surface irradiances and reveal substantial reduction in solar energy exploitation capacity of PV and CSP installations under this high aerosol load. We found that such an extreme dust event can result in Global Horizontal Irradiance (GHI) attenuation by as much as 40–50 % and a much stronger Direct Normal Irradiance (DNI) decrease (80–90 %), while spectrally this attenuation is distributed to 37 % in the UV region, 33 % in the visible and around 30 % in the infrared. CAMS forecasts provided a reliable available energy assessment (accuracy within 10 % of that obtained from MODIS). Spatially, the dust plume resulted in a zonally averaged reduction of GHI and DNI of the order of 150 W/m^2 in southern Greece, and a mean increase of 20 W/m^2 in the northern Greece as a result of lower AOD values combined with local atmospheric processes. This analysis of a real-world scenario contributes to the understanding and quantification of the impact range of high aerosol loads on solar energy and the potential for forecasting power generation failures at sunshine-privileged locations where solar power plants exist, are under construction or are being planned

Multidimensional Signals and Analytic Flexibility: Estimating Degrees of Freedom in Human-Speech Analyses

Recent empirical studies have highlighted the large degree of analytic flexibility in data analysis that can lead to substantially different conclusions based on the same data set. Thus, researchers have expressed their concerns that these researcher degrees of freedom might facilitate bias and can lead to claims that do not stand the test of time. Even greater flexibility is to be expected in fields in which the primary data lend themselves to a variety of possible operationalizations. The multidimensional, temporally extended nature of speech constitutes an ideal testing ground for assessing the variability in analytic approaches, which derives not only from aspects of statistical modeling but also from decisions regarding the quantification of the measured behavior. In this study, we gave the same speech-production data set to 46 teams of researchers and asked them to answer the same research question, resulting in substantial variability in reported effect sizes and their interpretation. Using Bayesian meta-analytic tools, we further found little to no evidence that the observed variability can be explained by analysts’ prior beliefs, expertise, or the perceived quality of their analyses. In light of this idiosyncratic variability, we recommend that researchers more transparently share details of their analysis, strengthen the link between theoretical construct and quantitative system, and calibrate their (un)certainty in their conclusions

Topological insights in polynuclear Ni/Na coordination clusters derived from a schiff base ligand

This article presents the syntheses, crystal structures, topological features and magnetic properties of two NiII/NaI coordination clusters (CCs) formulated [NiII3Na(L1)3(HL1 (MeOH)2] (1) and [NiII6Na(L1)5(CO3)(MeO (MeOH)3(H2O)3]·4(MeOH) 2(H2O) [2 4(MeOH) 2(H2O)] where H2L1 is the semi rigid Schiff base ligand (E)-2-(2-hydroxy-3 methoxybenzylideneamino)-phenol). Compound 1 possesses a rare NiII3NaI cubane (3M4-1) topology and compound 2 is the first example in polynuclear Ni/Na chemistry that exhibits a 2,3,4M7-1 topology

Mapping the Relationship Among Political Ideology, CSR Mindset, and CSR Strategy: A Contingency Perspective Applied to Chinese Managers

The literature on antecedents of corporate social responsibility (CSR) strategies of firms has been predominately content driven. Informed by the managerial sense-making process perspective, we develop a contingency theoretical framework explaining how political ideology of managers affects the choice of CSR strategy for their firms through their CSR mindset. We also explain to what extent the outcome of this process is shaped by the firm’s internal institutional arrangements and external factors impacting on the firm. We develop and test several hypotheses using data collected from 129 Chinese managers. The results show that managers with a stronger socialist ideology are likely to develop a mindset favouring CSR, which induces the adoption of a proactive CSR strategy. The CSR mindset mediates the link between socialist ideology and CSR strategy. The strength of the relationship between the CSR mindset and the choice of CSR strategy is moderated by customer response to CSR, industry competition, the role of government, and CSR-related managerial incentives

Old wine in new bottles: Exploring pragmatism as a philosophical framework for the discipline of coaching

The practice and industry of organizational coaching are now well established, but how it is understood theoretically continues to lag behind. In this paper we analyze possible reasons for this state of affairs and argue that the development of coaching as an academic discipline will benefit from adopting philosophical pragmatism as an overarching theoretical framework. This move will enable coaching academics to utilize the contributions to knowledge that different paradigms generate. Positioning pragmatism as a theory of action we argue that organizational coaching is by default a pragmatic enterprise and provide three examples of the considerable benefits to be gained by conceptualizing it this way. (1) Drawing from the pragmatists’ ideas, particularly those of John Dewey, we demonstrate how the theoretical understanding of organizational coaching can be enhanced by considering its nature as a joint inquiry. (2) Pragmatism suggests development as an ultimate purpose for organizational coaching which also helps to resolve fundamental conceptual debates. (3) In light of the complexity and diversity involved in the way that organizational coaching is practiced, pragmatism offers coaches a useful framework for developing the flexibility required for navigating the multiplicity of influences on their practice

The evolution of lung cancer and impact of subclonal selection in TRACERx

Lung cancer is the leading cause of cancer-associated mortality worldwide1. Here we analysed 1,644 tumour regions sampled at surgery or during follow-up from the first 421 patients with non-small cell lung cancer prospectively enrolled into the TRACERx study. This project aims to decipher lung cancer evolution and address the primary study endpoint: determining the relationship between intratumour heterogeneity and clinical outcome. In lung adenocarcinoma, mutations in 22 out of 40 common cancer genes were under significant subclonal selection, including classical tumour initiators such as TP53 and KRAS. We defined evolutionary dependencies between drivers, mutational processes and whole genome doubling (WGD) events. Despite patients having a history of smoking, 8% of lung adenocarcinomas lacked evidence of tobacco-induced mutagenesis. These tumours also had similar detection rates for EGFR mutations and for RET, ROS1, ALK and MET oncogenic isoforms compared with tumours in never-smokers, which suggests that they have a similar aetiology and pathogenesis. Large subclonal expansions were associated with positive subclonal selection. Patients with tumours harbouring recent subclonal expansions, on the terminus of a phylogenetic branch, had significantly shorter disease-free survival. Subclonal WGD was detected in 19% of tumours, and 10% of tumours harboured multiple subclonal WGDs in parallel. Subclonal, but not truncal, WGD was associated with shorter disease-free survival. Copy number heterogeneity was associated with extrathoracic relapse within 1 year after surgery. These data demonstrate the importance of clonal expansion, WGD and copy number instability in determining the timing and patterns of relapse in non-small cell lung cancer and provide a comprehensive clinical cancer evolutionary data resource

Evolutionary characterization of lung adenocarcinoma morphology in TRACERx

Lung adenocarcinomas (LUADs) display a broad histological spectrum from low-grade lepidic tumors through to mid-grade acinar and papillary and high-grade solid, cribriform and micropapillary tumors. How morphology reflects tumor evolution and disease progression is poorly understood. Whole-exome sequencing data generated from 805 primary tumor regions and 121 paired metastatic samples across 248 LUADs from the TRACERx 421 cohort, together with RNA-sequencing data from 463 primary tumor regions, were integrated with detailed whole-tumor and regional histopathological analysis. Tumors with predominantly high-grade patterns showed increased chromosomal complexity, with higher burden of loss of heterozygosity and subclonal somatic copy number alterations. Individual regions in predominantly high-grade pattern tumors exhibited higher proliferation and lower clonal diversity, potentially reflecting large recent subclonal expansions. Co-occurrence of truncal loss of chromosomes 3p and 3q was enriched in predominantly low-/mid-grade tumors, while purely undifferentiated solid-pattern tumors had a higher frequency of truncal arm or focal 3q gains and SMARCA4 gene alterations compared with mixed-pattern tumors with a solid component, suggesting distinct evolutionary trajectories. Clonal evolution analysis revealed that tumors tend to evolve toward higher-grade patterns. The presence of micropapillary pattern and ‘tumor spread through air spaces’ were associated with intrathoracic recurrence, in contrast to the presence of solid/cribriform patterns, necrosis and preoperative circulating tumor DNA detection, which were associated with extra-thoracic recurrence. These data provide insights into the relationship between LUAD morphology, the underlying evolutionary genomic landscape, and clinical and anatomical relapse risk