Explore the vast range of titles available.

Creativity and morality are key attributes that stakeholders demand of organizations. Accordingly, higher education institutions and professional training programs also seek to cultivate these attributes in future leaders. However, research has hitherto shown that, under certain conditions, creativity may conflict with morality. This complicates the development of creative individuals who are also moral. We examined the complex relationship between creativity and moral reasoning with data collected from a group of undergraduate students. By considering the cognitive processes behind creativity and moral reasoning, we propose perspective taking as a moderating factor. Specifically, we found that while creative individuals might not necessarily adopt a lower level of moral reasoning, there was a more nuanced moderating relationship among creativity, perspective taking, and moral reasoning. That is, individuals who were weak in perspective taking tended to adopt a lower level of moral reasoning if they were also creative. Perspective taking was also directly and positively associated with moral reasoning. We explore the implications of our findings for future research and curriculum/program design.

The aim of this study was to evaluate two proteases (P1 and P2) on the apparent and standardized ileal digestibility (AID and SID, respectively), of crude protein (CP) and amino acids (AAs) and apparent total tract digestibility (ATTD) of nutrients and gross energy (GE) of corn and soybean meal, with 46% and 48% CP, in pigs by the index method. Ninety crossbred castrated male piglets (13.52 ± 1.96 kg body weight) were fed a nitrogen-free diet, or diets containing corn or soybean meal as the sole sources of CP and AAs, supplemented or not with 0.05% of P1 or 0.01% of P2, an acid protease. Treatment differences were considered statistically significant at p < 0.05. The inclusion of proteases in corn and of P1 in soybean meal diets did not improve the digestibility of nutrients and energy. Otherwise, the addition of P2, an acid protease, in soybean meal diets increased (p < 0.05) the AID and SID of Lys, Met, Phe, Ala, Cys, and Glu, and the respective digestible AA values, from 7.5% to 22%, compared to soybean meal without proteases. The use of the acid protease can be an important tool to enhance the digestibility of the AAs of soybean meal in piglets.

BackgroundData on patients’ self-reported hospital experience can help guide quality improvement. Traditional patient survey programmes are resource intensive, and results are not always publicly accessible. Unsolicited online hospital reviews are an alternative data source; however, the nature of online reviews for Canadian hospitals is unknown.MethodsWe conducted a nationwide cross-sectional study of Canadian acute care hospitals with more than 10 Google Reviews during the 2018–2019 fiscal year. We characterised the volume and distribution of Google Reviews of Canadian hospitals, and assessed their correlation with hospital characteristics (teaching status, size, occupancy rate, length of stay, resource utilisation) and Canadian Patient Experience Survey on Inpatient Care (CPES-IC) scores.Results167 out of 523 (31.9%) acute care hospitals in Canada met the inclusion criteria. Among included hospitals, there was a total of 10 395 Google Reviews and a median of 35 reviews per hospital. The mean Google Star Rating for included hospitals was 2.85 out of 5, with a range of 1.36–4.57. Teaching hospitals had significantly higher mean Google Star Ratings compared with non-teaching hospitals (3.16 vs 2.81, p <0.01). There was a weak, positive correlation between hospitals’ Google Star Ratings and CPES-IC ‘Overall Hospital Experience’ scores (p =0.04), but no significant correlation between Google Star Ratings and other hospital characteristics or subcategories of CPES-IC scores.InterpretationThere is significant interhospital variation in patients’ self-reported care experiences at Canadian acute care hospitals. Online reviews can serve as a readily accessible source of real-time data for hospitals to monitor and improve the patient experience.

BackgroundSome second-line medications used to treat type-2 diabetes have been shown in observational studies to reduce COPD exacerbations. The evidence for the first-line medication, metformin, is unclear but animal studies have shown that metformin decreases airway glucose and bacterial colonisation. Diabetes is common in COPD but often managed with diet for a prolonged period before starting medication. We hypothesised that metformin reduces COPD exacerbations and that its effects are enhanced when combined with other diabetic medications.MethodWe adopted a nested case-control design using primary care data (Clinical Practice Research Datalink) linked to secondary care data. The case-control was nested from a cohort of COPD patients with diabetes, naive to metformin at the start of follow-up. Cases were exacerbations (course of oral corticosteroids or hospital admission); controls were matched 4:1 by age, sex and GP practice. Conditional logistic regression was used to measure the association between metformin and exacerbations, after adjusting for COPD severity (MRC score, inhaler use and FEV1), BMI, HbA1c, smoking status, social deprivation, cardiovascular disease. The 1-year exposure window was divided into time since last prescription. Interaction analyses were conducted to assess if the association was modified by additional use of other anti-diabetic medications, BMI or HbA1c.Results14,292 cases and 54,529 controls were included. Metformin was associated with 24% reduced odds of an exacerbation, its effect remained up to 180 days after the prescription date (OR=0.76, 95%Cl 0.64–0.88) but there was no effect >180 days after metformin use (p>0.05). Using GLP-1 agonists with metformin had a multiplicative effect, associated with a 72% reduction in odds of an exacerbation (with GLP-1: OR=0.28, 95%Cl 0.11–0.75). BMI, HbA1c and other anti-diabetic medications (DDP-4 and SGLT-2 inhibitors, sulfonylureas and insulin) were not found to influence the effect of metformin on exacerbations.ConclusionMetformin reduces the risk of COPD exacerbations, but its mechanism may not be through improved systemic glycaemic control or weight loss. The concurrent use of GLP-1 receptor agonists augments the effect of metformin, other anti-diabetic medication does not. Diabetes is common in COPD and metformin is relatively cheap, early use may prevent exacerbations.Abstract P205 Table 1

Background: Spinal metastasis is a rare complication of supratentorial glioblastoma. We report the clinical features and prognosis of this phenomenon and review the relevant literature. Methods: This is a territory-wide, multicentre, retrospective review using data from the Hong Kong High-grade Glioma Registry from 2006 to 2023. Data of consecutive adult patients diagnosed with supratentorial glioblastoma and spinal metastasis were extracted and analyzed. Results: Among the 1342 patients with supratentorial glioblastoma, 15 were diagnosed to have spinal metastasis (1.1%). The median time to spinal metastasis from the initial diagnosis of glioblastoma was 38.7 weeks (IQR: 15.1–57.6). Multi-level spinal involvement was present in 60% (9/15) of patients. Neither the topographical location of the tumor in relation to the subventricular zone, extent of resection, occurrence of intraoperative ventricular entry, nor methylguanine methyltransferase (MGMT) promoter methylation status predicted the time to spinal metastasis. The median overall survival was 44.1 weeks (IQR: 29.9–80.2), and the median post-spinal metastasis survival was 12.6 weeks (IQR: 5.0–15.0). Two-thirds of patients received spinal radiotherapy, 26.7% had systemic therapy (chemotherapy, targeted therapy, and/or immunotherapy), and 13.3% underwent surgical spinal decompression. No significant survival improvement was observed among patients who received spinal radiotherapy (HR: 0.61; 95% CI: 0.17–2.23) or systemic therapy (HR: 0.94; 95% CI: 0.20–4.39). Conclusions: This case series illustrates the management practices and clinical course of glioblastoma patients with spinal metastasis. No treatment modality was proven to be superior. Treatment remains largely palliative and should be tailored on an individual basis.

Presently, pathologists need to stain biopsy samples with standard and antibody-based immunocytochemistry (ICC) reagents for final diagnosis. Antibody reagents take hours to days to perform staining, along with requiring specialized equipment and technical skills. We have developed an AI-based virtual ICC platform that measures individual cell morphological features in whole slide images and labels the cells as immuno-positive or negative. The platform runs on the cloud in minutes, saving pathologists significant time and cost. For this purpose, cytopathology slides were obtained from N  = 100 suspected cases of canine T-cell and B-cell lymph node lymphomas through Fine Needle Aspiration (FNA). Cytopathology slides were initially stained with the standard Wright-Giemsa (WG) and then re-stained with ICC reagents, anti-CD3 or anti-PAX5 antibodies, resulting in a pair of stained slides (WG-CD3 or WG-PAX5). Prior to AI training, cytopathology slides were digitally scanned, and the resulting images underwent a comprehensive pre-processing protocol to separate stains of interest for nuclei segmentation in WG and CD3 or PAX5. Following nuclei segmentation, the cell features from processed image pairs were translated into a structured tabular features format with immuno-positive and negative labeled classes. In total, the geometrical features of 8.48 million segmented cells (4.24 million pairs) were translated into a tabular format and paired based on the Euclidean cell matching algorithm. This approach facilitated the prediction of cell labels, achieving sensitivity and specificity of 0.98 and 0.97 (0.94 and 0.99), respectively for CD3 (PAX5). Additionally, the AI-based virtual ICC has demonstrated capabilities in cell counting, cell spatial distribution, cell segmentation, and classification. It offers a rapid, accurate, and precise evaluation of FNA samples and has the potential to help advance diagnostic cellular and molecular pathology capabilities.

The high costs in maintaining today’s complex and sophisticated equipment make it necessary to enhance modern maintenance management systems. Conventional condition-based maintenance (CBM) reduces the uncertainty of maintenance according to the needs indicated by the equipment condition. The intelligent predictive decision support system (IPDSS) for condition-based maintenance (CBM) supplements the conventional CBM approach by adding the capability of intelligent condition-based fault diagnosis and the power of predicting the trend of equipment deterioration. An IPDSS model, based on the recurrent neural network (RNN) approach, was developed and tested and run for the critical equipment of a power plant. The results showed that the IPDSS model provided reliable fault diagnosis and strong predictive power for the trend of equipment deterioration. These valuable results could be used as input to an integrated maintenance management system to pre-plan and pre-schedule maintenance work, to reduce inventory costs for spare parts, to cut down unplanned forced outage and to minimise the risk of catastrophic failure.

We study the linear stability of partitioned Runge—Kutta (PRK) methods applied to linear separable Hamiltonian ODEs and to the semidiscretization of certain Hamiltonian PDEs. We extend the work of Jay and Petzold [Highly Oscillatory Systems and Periodic Stability, Preprint 95-015, Army High Performance Computing Research Center, Stanford, CA, 1995] by presenting simplified expressions of the trace of the stability matrix, tr M s , for the Lobatto IIIA–IIIB family of symplectic PRK methods. By making the connection to Padé approximants and continued fractions, we study the asymptotic behavior of tr M s (ω) as a function of the frequency ω and stage number s.

When a figure discretely and instantaneously changes its shape, observers typically do not perceive the abrupt transition between shapes that in fact occurs. Rather, a continuous shape change is perceived. Although this illusory “transformational apparent motion” (TAM) is a faulty construction of the visual system, it is not arbitrary. From the many possible shape changes that could have been inferred, usually just one is perceived because only one is consistent with the shape-based rules that the visual system uses to (1) segment figures from one another within a scene and (2) match figures to themselves across successive scenes. TAM requires an interaction between neuronal circuits that process form relationships with circuits that compute motion trajectories. In particular, this form–motion interaction must happen before TAM is perceived because the direction of perceived motion is dictated by form relationships among figures in successive images. The present fMRI study ( n = 19) provides the first evidence that both form (LOC, posterior fusiform gyrus) and motion (hMT+) processing areas are more active when TAM is perceived than in a control stimulus where it is not. Retinotopic areas ( n = 10), hMT+ ( n = 7), and LOC ( n = 7) were mapped in a subset of subjects. Results: There is greater BOLD response to TAM than to the control condition in V1 and all subsequent retinotopic areas, as well as in hMT+ and the LOC, suggesting that areas that process form interact with hMT+ to construct the perception of moving figures.

Lymphoma is the most common tumor of the nasal cavity in cats. Commonly used treatment modalities are radiotherapy and chemotherapy, or both. Typical chemotherapy protocols used in cats with nasal lymphoma are COP (cyclophosphamide, vincristine prednisolone) and CHOP (cyclophosphamide, doxorubicin, vincristine and prednisolone). Thus far, the use of single-agent chlorambucil in nasal lymphoma has been evaluated in a single case report. We report a case series of three cats with B cell nasal lymphoma, two cats with intermediate cell, and one large cell, all with a low mitotic index (MI) of less than 5 mitotic figures per ×400 field, treated with chlorambucil and prednisolone. Two of the cases achieved a long disease-free interval, while the one with the highest MI did not. Protocols using chlorambucil and prednisolone may have potential as a first-line therapy for feline nasal lymphoma cases with a very low mitotic index.