Reasons For Rejection Research Articles

The Need for an Alternative Health Claim Process for Foods Based on Both Nutrient and Contaminant Profiles

Most authorized health claims on foods have been established on the basis of single dietary components, mainly micronutrients, such as vitamins, minerals, and possibly bioactives. Failure to sufficiently define and characterize the nutritional profile of a food product is one of the main reasons for rejection or incomplete status for thousands of health claim applications, whereas the food’s contaminant profile is simply not accounted for. The objective of this work was to highlight the accumulating scientific evidence supporting a reform of the health claim evaluation process for foods toward more holistic approaches. This would entail the characterization of multiple nutrient-contaminant pairs and contaminant mixture profiles at contaminant levels currently considered “safe,” including their interactions that would impact human health outcome(s) in a net positive or negative direction. The notion of a stable nutritional profile in food commodities has been challenged by studies reporting a variable food contaminant content and a declining content of proteins/micronutrients in crops due to anthropogenic greenhouse gas emissions. A holistic approach in the health claim process for foods would entail the incorporation of cumulative risk assessment and/or risk-benefit protocols that effectively combine health risks and benefits associated with multiple nutritional and contaminant attributes of the food/diet under evaluation.

A referrals audit and qualitative analysis of staff experience of referrals in a specialist community learning disability service

PHOTO CREDIT: Aaron BurdenSpecialist community teams are set up to support people living with Learning Disability (LD) who are unable to access mainstream mental health (MH) teams with reasonable adjustments. National guidance is available to guide best practice in making reasonable adjustments, to support increased access to mainstream services. This audit of referrals into a specialist Community LD team, aimed to establish referral acceptance rates and reasons for referral rejection. Total referrals and referrals made specifically from mainstream MH teams were investigated. A focus group explored LD clinicians’ experiences of the referral process and criteria in the context of working alongside mainstream MH teams. A lower acceptance rate of referrals from mainstream MH teams than overall acceptance rate was found, and differences in the reasons for rejection were highlighted. No LD diagnosis in the referral was the most common rejection reason for mainstream MH team referrals. Thematic analysis highlighted four themes of clinician’s experiences which focused on: referral point struggles; service limitations; lack of diagnostic clarity; and attempts to bridge a gap between services. Recommendations include review of the referral process, joint working protocols, clarification of remit and dissemination of shared learning.

Why do patients refuse hospital meals? Reflections on the nutritionDay Audit at the University Hospital in Krakow.

I n t r o d u c t i o n: Despite increased awareness of malnutrition and improved nutrition-related policies, there are still cases of deterioration of nutritional status during hospitalisation. NutritionDay is an audit organised by the European Society for Clinical Nutrition and Metabolism (ESPEN), the Medical University of Vienna and the Friedrich-Alexander University Erlangen-Nürnberg (FAU) to prevent the onset of malnutrition and to improve hospital policies to deal with this problem. The aim of the study was to analyse the results of the audit with regard to factors that may contribute to the deterioration of a patients' nutritional status in hospital setting. Materials and Methods: This cross-sectional study was performed in a tertiary teaching hospital and was part of an international audit. The questionnaires used were provided by the nutritionDay office, and included information on weight loss, patients' appetite, dietary restrictions, food intake and reasons for food rejection during hospital stay. R e s u l t s: Of the examined patients, 61% reported weight loss prior to the current hospital stay. We identified 25 patients who did not consume a whole portion of their main meal on the day the audit took place. Approximately 17% of the patients' complaints could be resolved within a hospital ward. C o n c l u s i o n s: Hospital patients often eat less than a standard meal portion. Identifying the reasons for meal rejection may be helpful for development of standards for nutritional care in the hospitals.

Pedagogical art of K. D. Ushinsky through the prism of historical reality

Introduction. The founder of Russian pedagogical anthropology K. D. Ushinsky connected the art of teaching with the need for interdisciplinary anthropological research into the process of transferring knowledge and a system of values to the younger generation. The article attempts to analyze the reasons for the long-term rejection at the state level of the principles of «the art of creating something that does not exist» as Ushinsky defined pedagogy, and to identify the main promising directions for possible current application.Materials and Methods. During the research, within the framework of an interdisciplinary approach, historical-biographical, historical-legal, historical-pedagogical methods, general scientific principles and approaches to scientific analysis were used.Results. As the purpose of the educational and pedagogical influence K. D. Ushinsky saw the formation of a generation of free, intellectually developed citizens capable of creation – the patriots of Russia. Due to certain circumstances of an ideological and administrative-political nature, his teaching was not fully accepted and did not become widespread during his lifetime. Only in the middle of 1930s the state turned to the legacy of K.D. Ushinsky. Later Soviet society failed to perceive the creative potential of the great teacher. Modern Russia should not miss this chance.Discussion and Conclusions. The conclusions presented in the article can be attributed to fundamental provisions, the implementation and development of which can give not only a short-term effect of optimizing teaching activities, but also serve as a strategic guideline for the development of modern society.

Clinical Profile and Prognosis of Patients with Left-Sided Infective Endocarditis with Surgical Indication Who Are Not Operated.

Approximately a quarter of patients with infective endocarditis (IE) who have surgical indication only receive antibiotic treatment. Their short-term prognosis is dismal. We aimed to describe the characteristics of this group of patients to evaluate the mortality according to the cause of rejection and type of surgical indication and to analyze their prognostic factors of mortality. From 2005 to 2022, 1105 patients with definite left-sided IE were consecutively attended in three tertiary hospitals. Of them, 912 (82.5%) had formal surgical indication according to the most recent European Guidelines available in each period of the study and 303 (33%) only received medical treatment. These were older, had more comorbidities and higher in-hospital (46% vs. 24%; p < 0.001) and one year mortality (57.1% vs. 27.6%; p < 0.001) than operated patients. The main reason for surgical rejection was high surgical risk (57.1%) and the highest mortality when the cause were severe neurological conditions (76%). When the endocarditis team took the decision not to operate (25.5% of the patients), in-hospital (7%) and one-year mortality (17%) were low. In-hospital mortality associated with each surgical indication was 67% in heart failure, 53% in uncontrolled infection and 45% in prevention of embolisms (p < 0.001). Heart failure (OR: 2.26 CI95%: 1.29-3.96; p = 0.005), Staphylococcus aureus (OR: 3.17; CI95%: 1.72-5.86; p < 0.001) and persistent infection (OR: 5.07 CI95%: 2.85-9.03) are the independent risk factors of in-hospital mortality. One third of the patients with left-sided IE and formal surgical indication are rejected for surgery. In-hospital mortality is very high, especially when heart failure is the indication for surgery and when severe neurological conditions the reason for rejection. Short term prognosis of patients rejected by a specialized endocarditis team is favorable.

Sex and gender differences in upper extremity prosthesis rejection: A review of literature.

Prosthesis rejection is a significant barrier to rehabilitation of persons with upper limb difference. Many individual factors can affect device rejection, including a person's sex or gender. The objective of this narrative review was to explore the reported differences between the sexes and genders in upper limb prosthesis rejection. This review considered peer-reviewed, published research studies in which the study population were adults (aged 18 and older) who had unilateral or bilateral limb difference (any level) of any etiology with current, past, or no history of prosthetic device usage. Using identified keywords, index terms, and a peer-reviewed search filter, the literature was searched in MEDLINE, Embase, and PsycInfo. The reasons for rejection, disuse, or abandonment of prosthetic devices were extracted, with the focus on reported differences between sex and genders. After searching, 29 articles were selected for full-text review and 15 were included. Only 5 of 15 articles examined differences between the sexes. Women tend to reject upper extremity prostheses more than men both before and after being fit with a device; device characteristics, such as weight and cosmesis, do not appear to be appropriately designed for women; and there may not be adequate consideration of the goals for women with limb difference(s). There is inadequate reporting of sex and gender in the literature on prosthesis rejection; future studies should report and explore these factors to determine whether the needs of the full population with limb loss are being met.

Analyzing clinical laboratory specimen rejection rates at a specialized hospital in Ethiopia: A 2-year document review.

Accurate laboratory diagnosis is essential for effective patient care, but the rejection of specimens within laboratories can have serious consequences. A retrospective cross-sectional study was conducted from September to November 2021 at the University of Gondar Comprehensive Specialized Hospital laboratory. Two years of laboratory data were collected from laboratory log books and analyzed to determine trends in specimen rejection rates and identify potential reasons for those rejections. We analyzed 114,439 specimens, of which 786 (0.70%) were rejected. The hematology service exhibited the highest rejection rate, at 273 (0.2%). The main reasons for specimen rejection were specimens without requests or requests without specimens (40.2%), poor smear preparation (12.3%), clotted specimens (11.3%), and labeling problems (8.0%). This study emphasized a significant incidence of specimen rejection, particularly in the hematology laboratory, underscoring the need for immediate implementation of corrective actions and preventive measures. Furthermore, conducting comprehensive larger-scale studies is recommended to deepen our understanding of and investigate the specific factors contributing to specimen rejection in greater detail.

FROM THE ELIMINATION OF SEXUAL VIOLENCE DRAFT BILL TO THE SEXUAL VIOLENCE CRIME : CONFLICT OF IDEOLOGY FEMINIST AND RELIGIOUS IDEOLOGY RELATED TO SEXUAL CONSENT

The Sexual Violence Crime Law (UU TPKS) was passed in 2022. However, the TPKS Law cannot be separated from various incidents, this is also the background for the TPKS Law taking a long time to be ratified. One of the controversial ones is related to the sexual consent paradigm which is often the reason for rejection of the TPKS Bill. This research uses the library study method, namely the author collects data by searching for data and information through books, journals, documents, articles, news and other library sources. The author will collect library data, record and analyze discourse related to sexual consent in the TPKS Bill, both within the DPR and external parties, namely community organizations. The Prosperous Justice Party (PKS), Islamic Defenders Front (FPI) and several other organizations use religious ideology in rejecting the TPKS Bill, while KUPI, Komnas Perempuan, Gusdurian, and other women's activist groups try to remember the mindset of the initial purpose of the TPKS Bill which was formed in basically departs from feminist ideology.

Reasons for Acceptance or Rejection of Online Record Access Among Patients Affected by a Severe Mental Illness: Mixed Methods Study.

Over the past few years, online record access (ORA) has been established through secure patient portals in various countries, allowing patients to access their health data, including clinical notes ("open notes"). Previous research indicates that ORA in mental health, particularly among patients with severe mental illness (SMI), has been rarely offered. Little is known about the expectations and motivations of patients with SMI when reading what their clinicians share via ORA. The aim of this study is to explore the reasons why patients with SMI consider or reject ORA and whether sociodemographic characteristics may influence patient decisions. ORA was offered to randomly selected patients at 3 university outpatient clinics in Brandenburg, Germany, which exclusively treat patients with SMI. Within the framework of a mixed methods evaluation, qualitative interviews were conducted with patients who chose to participate in ORA and those who declined, aiming to explore the underlying reasons for their decisions. The interviews were transcribed and analyzed using thematic analysis. Sociodemographic characteristics of patients were examined using descriptive statistics to identify predictors of acceptance or rejection of ORA. Out of 103 included patients, 58% (n=60) wished to read their clinical notes. The reasons varied, ranging from a desire to engage more actively in their treatment to critically monitoring it and using the accessible data for third-party purposes. Conversely, 42% (n=43) chose not to use ORA, voicing concerns about possibly harming the trustful relationship with their clinicians as well as potential personal distress or uncertainty arising from reading the notes. Practical barriers such as a lack of digital literacy or suspected difficult-to-understand medical language were also named as contributing factors. Correlation analysis revealed that the majority of patients with depressive disorder desired to read the clinical notes (P<.001), while individuals with psychotic disorders showed a higher tendency to decline ORA (P<.05). No significant group differences were observed for other patient groups or characteristics. The adoption of ORA is influenced by a wide range of motivational factors, while patients also present a similar variety of reasons for declining its use. The results emphasize the urgent need for knowledge and patient education regarding factors that may hinder the decision to use ORA, including its practical usage, its application possibilities, and concerns related to data privacy. Further research is needed to explore approaches for adequately preparing individuals with SMI to transition from their inherent interest to active engagement with ORA. German Clinical Trial Register DRKS00030188; https://drks.de/search/en/trial/DRKS00030188.

Impact of formulary-related pharmacy claim rejections of cariprazine on health care utilization and treatment patterns among patients with bipolar I disorder.

Formulary restrictions, intended to limit inappropriate medication use and decrease pharmacy costs, may prevent or delay patients with bipolar I disorder from initiating cariprazine, a dopamine D3-preferring D3/D2 and serotonin 5HT1A receptor partial agonist that is approved to treat manic/mixed or depressive episodes associated with bipolar I disorder. Little is known about the downstream consequences of formulary-related cariprazine prescription rejections. To evaluate the impact of formulary-related cariprazine claim rejections on health care resource utilization (HCRU) and treatment patterns among patients newly prescribed cariprazine for bipolar I disorder. Symphony Health Integrated Dataverse was used to identify commercially insured adults (aged ≥18 years) with bipolar I disorder and at least 1 pharmacy claim for cariprazine (rejected because of formulary restrictions or approved; date of the first claim is the index date) from March 2015 through October 2020. Formulary-related rejection reasons included noncoverage, prior authorization requirement, and step therapy requirement. Baseline characteristics were evaluated during the 12 months pre-index and balanced between rejected and approved cohorts using 1:2 propensity score matching. HCRU outcomes included all-cause and mental health (MH)-related hospitalizations, emergency department (ED) visits, and outpatient visits. Treatment patterns were analyzed descriptively and included treatment delay and atypical antipsychotic use. HCRU was reported per patient-year and compared between cohorts using rate ratios; 95% CIs and P values were calculated using nonparametric bootstrap procedures. The matched rejected and approved cohorts comprised 1,554 and 3,108 patients, respectively. The rejected cohort had 22% more all-cause and 24% more MH-related hospitalizations per patient-year vs the approved cohort (rate ratio [95% CI], all-cause: 1.22 [1.01-1.48], P = 0.024; MH-related: 1.24 [1.01-1.55], P = 0.044). ED and outpatient visits were numerically, but not significantly, greater in the rejected cohort. Of patients in the rejected cohort, 34.7% never received an atypical antipsychotic and 76.8% never received cariprazine. For those who later received cariprazine or another atypical antipsychotic, the average treatment delay was approximately 6 months (188 days) and approximately 4 months (123 days) after the initial rejection, respectively. Patients with bipolar I disorder and formulary-related cariprazine claim rejections experienced significantly more hospitalizations than patients whose initial claim was approved; ED and outpatient visits were similar between cohorts. Less than a quarter of patients whose initial claim was rejected later received cariprazine, and more than one-third never received any atypical antipsychotic. To our knowledge, this is the first study to evaluate the impact of formulary-related rejections of cariprazine on HCRU and treatment patterns in patients with bipolar I disorder.

Evaluation of Sensitive Analytes to Hemolysis Interference on an Automated Chemistry Analyzer.

Hemolysis is a common reason for specimen rejection in the laboratory. Our experience suggested that hemolysis (H) flag limits are too strict for some analytes leading to unnecessary specimen rejections. This study summarizes H flags for commonly rejected analytes on the Beckman Coulter DxC 700 AU analyzer. We evaluated analytes with low-limit H flags and high rejection rates. These included: aspartate aminotransferase (AST), alanine aminotransferase (ALT), iron (IRN), potassium (K), direct bilirubin (DBIL), magnesium (Mg), amylase (AMY), sodium (Na), gamma-glutamyltransferase (GGT), phosphorus (PHOS), albumin (ALB), alkaline phosphatase (ALKP), and lactate dehydrogenase (LDH). Five patient plasma pools without hemolysis were made from 50 patient specimens. Neat pools were analyzed to establish baseline analyte concentrations. A hemolysate was created by diluting whole blood with distilled water. Each analyte was tested after spiking each pool with the hemolysate to specific hemoglobin concentrations corresponding to manufacturer's H flags. Percent differences were calculated between baseline pool means and each flag's pool mean. Acceptance limits were based upon the average of the 2019 CLIA and the method precision limits. Calculated percent differences greater than the acceptance limits were considered significant. Manufacturer-defined hemolysis flags can be updated to greater than 1+ for Na, K, and AST, greater than 3+ for ALKP, and greater than 4+ for AMY and Mg. No changes were noted for the remaining analytes. The hemolysis criteria set for ALKP, AMY, AST, Mg, K, and Na were updated in the Remisol Advance middleware, which led to a 56% reduction in rejected hemolyzed specimens.

Improved Patient Adherence to Family-Based Helicobacter pylori Infection Control and Management Strategy in Central China and Its Influencing Factors.

Patient adherence status to the newly introduced family-based Helicobacter pylori (H. pylori) infection control and management strategy remains unclear, so are its influencing factors. We aim to investigate family members' adherence and its influencing factors during the family-based H. pylori infection management practice for related disease prevention. Based on our previously family-based H. pylori survey in 2021, 282 families including 772 individuals were followed up 2 years after the initial survey to compare if the investigation and education might improve family member's adherence. The participant's adherence to H. pylori infection awareness, retest, treatment, publicity, gastroscopy, and hygiene habits were followed up, and their influencing factors were also analyzed. The overall participant's adherence to recommendations on H. pylori awareness, retest, treatment, publicity, gastroscopy, and hygiene habits were 77% (187/243), 67.3% (138/205), 60.1% (211/351), 46.5% (107/230), 45.6% (159/349), and 39.1% (213/545), respectively; and all showed improvements compared with their prior survey stages. The top reasons for rejection to treatment, retest, and gastroscopy were forgetting or unaware of H. pylori infection (30.3%), busy (32.8%), and asymptomatic (67.9%), respectively. Independent risk factor for low adherence to treatment was occupation (e.g., staff: OR 4.49, 95% CI 1.34-15.10). Independent favorable factors for treatment adherence were individuals at the ages of 18-44 years (OR 0.19, 95% CI 0.04-0.89) and had a large family size (e.g., four family members: OR 0.15, 95% CI 0.06-0.41); for retest adherence, it was individuals at the ages of 60-69 years (OR 0.23, 95% CI 0.06-0.97); for gastroscopy adherence, it was individuals at the age of 60-69 years (OR 0.46, 95% CI 0.28-0.75), and with gastrointestinal symptoms (OR 0.57, 95% CI 0.36-0.90). Family-based H. pylori management increases individual adherence to treatment, retest, and awareness, and there are also improved adherence to gastroscopy, publicity, and personal hygiene recommendations; further efforts are required to enhance the individual adherence rate for related disease prevention.

Acceptability, Preferred Medium, and Components of Nurse-Led Cardiac Telerehabilitation: A Cross-Sectional Study.

Cardiac rehabilitation (CR) is a comprehensive and multidisciplinary secondary prevention care in coronary heart disease (CHD). There are barriers at the patient and health system levels that prevent CR from being utilized. Cardiac telerehabilitation led by nurses (Ne-CTR) can alleviate the obstacles to participation in CR. A patient perspective can improve CR access. This study was the first pre-program investigation to clarify the status of knowledge and participation in CTR. We sought to clarify the acceptability, the reasons for rejection, the desired form, components, and associated factors with the components needed for (Ne-CTR) in patients with CHD. The study aimed to help develop a protocol for Ne-CTR for Chinese patients with CHD. A cross-sectional study was conducted between 2020 and 2021. Hospitals in four provinces in China were included. The participants were 671 patients with CHD in hospitals located in three regions of China. A self-administered questionnaire collected information about demographics, knowledge, and participation in CTR, acceptability, preferred medium, and components of Ne-CTR. Student's t-test, analysis of variance, and multiple linear regression analyzed the factors associated with component needs. All the analyses were conducted using IBM SPSS version 25.0. Most participants (n = 434, 66.77%) had a poor understanding and participation in CTR. In addition, 65.38% (n = 439) of participants were willing to accept the Ne-CTR program, and 43.56% (n = 98) identified safety as reasons for not accepting such a program. In the group accepting Ne-CTR, 35% chose hospital-designed professional applications as a medium for Ne-CTR when offered. Education (4.44 ± 1.056) and drug information (4.44 ± 1.040) had the highest average need score. Education, monthly income, marital status, previous CTR participation, and health insurance were associated with the demand level scores of Ne-CTR. This study demonstrated high levels of need for Ne-CTR among patients with CHD and identified the desired medium, components, and associated factors of Ne-CTR. These findings provide reference information for the construction of a Ne-CTR program.

An Explainable AI framework for credit evaluation and analysis

Loan Facility is a profitable venture for the banking industry and can render great financial support to the beneficiary. The Global banking systems with secured private cloud are making the service reachable around the world around the clock. Loan acceptance and disbursal are governed by the protocol of the banks with the highest degree of privacy and integrity. As per the report of Experian, the loan acceptance rate of the banks has been reduced to 61%–70%, and it is further reduced to 50% post-pandemic since there is a huge financial setback and a higher rate of defaulters. The banks are not in a position to explain the reasoning behind the rejection since the rejection further diminishes the customers’ credit scores. With the parallel improvements in Industry 5.0, futuristic banking could evolve around Non Fungible Tokens (NFT) integrated Explainable AI (XAI) framework which can interact with the customer through the human-machine interface in the meta-verse. For such a kind of system, the proposed work could be a driving application which provides explanations for the loan rejection, with the Random Forest integrated XAI framework that provides the reasons for acceptance and rejection of the loan. The proposed Random Forest-based approach rendered the highest accuracy, sensitivity and specificity of 0.998, 0.998, and 0.997, respectively. The LIME and SHAPELY Explainers provide explanations with local and global surrogates of various parameters on the features.

UNNECESSARY PRETRANSFUSION BLOOD SAMPLING IN TRAUMA AND ORTHOPAEDICS IN WALES: A SUSTAINABILITY ISSUE AND FINANCIAL BURDEN

BACKGROUNDTheatre-listed trauma patients routinely require two ‘group and save’ blood-bank samples, in case they need perioperative transfusion. The Welsh Blood Service (WBS) need patients to have one recorded sample from any time in the last 10 years. A second sample, to permit cross-matching and blood issuing, must be within 7 days of transfusion (or within 48 hours if the patient is pregnant, or has been transfused within the last 3 months). The approximate cost of processing a sample is £15.00.AIMTo investigate whether routine pretransfusion blood sampling for trauma admissions exceeds requirements.METHODSElectronic records were used to collect pretransfusion sampling data for all adult non-elective trauma patients listed for theatre under a trauma and orthopaedics consultant between 1/1/2023-31/1/2023. Data were collected on unnecessary samples, rejected samples and total excess samples.RESULTS113 patients (mean age[±SD] 64.09[±19.96]) underwent 132 procedures. On average, unnecessary sampling occurred at a rate of 0.48 samples per operation, equating to a cost of £945.00/month. Samples were rejected by the laboratory at a rate of 0.25 samples per operation. Common reasons for rejection were ‘patient date of birth discrepancy’ (between sample and request form), ‘patient address discrepancy’ and ‘signature discrepancy’. Overall, total excessive sampling occurred at a rate of 0.60 samples per operation.CONCLUSIONNearly half of trauma patients undergo unnecessary blood testing in anticipation of potential perioperative transfusion. This has implications for sustainability, financial cost and patient welfare. This signals poor understanding of WBS requirements and is an area that requires improvement.

SARS-CoV-2 vaccination willingness and humoral vaccination response in radiation oncology patients

BackgroundSARS-CoV-2 infection has been and, in some parts, still is a threat to oncologic patients, making it crucial to understand perception of vaccination and immunologic responses in this vulnerable patient segment. SARS-CoV-2 vaccines in relation to malignant disease characteristics and therapies have so far not been studied consecutively in larger oncologic patient populations. This study captures SARS-CoV-2 vaccination willingness and humoral immune response in a large consecutive oncologic patient collective at the beginning of 2021. Methods1142 patients were consecutively recruited over 5.5 months at a tertiary department for radiation oncology and were assessed for vaccination willingness via a standardized interview. In already vaccinated patients total SARS-CoV-2 S antibody titres against the spike protein (Anti-SARS-CoV-2 S) and were evaluated 35 days or later after the first dose of SARS-CoV-2 vaccine. ResultsVaccination willingness was high with a rate of 90 %. The most frequent reasons for rejection were: undecided/potential vaccination after therapy, distrust in the vaccine and fear of interaction with comorbidities. Factors associated with lower vaccination willingness were: worse general condition, lower age and female sex. 80 % of the participants had been previously vaccinated, 8 % reported previous infection and 16 % received vaccination during antineoplastic therapy. In 97.5 % of the vaccinated patients Anti-SARS-CoV-2 S was detected. In a univariable analysis parameters associated with non-conversion were: lower performance status, spread to the local lymphatics (N + ), hematologic disease and diffuse metastases. All patients with oligometastatic disease achieved positive Anti-SARS-CoV-2 S titres. For patients with two vaccinations several risk factors were identified, that were associated with low antibody concentrations. ConclusionsSARS-CoV-2 vaccination willingness among oncologic patients was high in the first months after its availability, and most patients had already received one or two doses. Over 97 % of vaccinated patients had measurable anti-SARS-CoV-2 S titres. Our data supports early identification of low humoral responders after vaccination and could facilitate the design of future oncologic vaccine trials (clinicaltrials.gov Identifier: NCT04918888).

Political Self-consciousness of Captured White General Staff Officers Based on the Materials of Soviet Questionnaires of the Early 1920s

Based on Soviet questionnaires of captured White General Staff officers of the early 1920s kept in the funds of the Russian State Military Archive, this article considers the problem of political self-identification of the “former” officers in Red captivity. The survey of former Whites was carried out to account for them. Sections of questionnaires about the prisoners’ attitude to the events of the February and October Revolutions, as well as about their current beliefs were of particular importance for assessing their views. The analysis of questionnaires as a mass historical source makes it possible to get an idea of the sociopolitical position of the group of captured White General Staff officers. On most issues, the prisoners’ views converged. As a rule, they accepted the February Revolution and did not accept the October Revolution. Also, they were highly critical of the old regime. Explanations of the reasons for the rejection of the seizure of power by the Bolsheviks are of considerable interest. For many, an acceptable answer was an indication of a lack of understanding of the tasks of the new revolution. At the same time, some pointed out the real reasons for such rejection, i.e. the Red Terror, the collapse of the old army, and the hard Brest peace treaty. The strategies used by the questionnaire compilers in answering acute and potentially dangerous questions draw the researchers’ attention. Often, the answers indicated that the revolution was of a popular nature, and the author of the questionnaire sought to serve the people or welcomed the rule of the people and was in solidarity with the policy of the RCP(b). Some authors, not wanting to express their true views, declared the need to work honestly for the benefit of society. The “former” tried to give answers that would appeal to the new superiors and regulatory authorities, which would allow them to integrate into the command structure of the Red Army more quickly and remove from themselves the discriminatory status of former White officers who were on special registry.

Rejection of Fecal Immunochemical Tests Within the Lower Gastrointestinal Diagnostic Pathway: A Cohort Study.

The fecal immunochemical test (FIT) helps triage primary care patients at risk of colorectal cancer (CRC). Improving FIT returns has received recent attention, however uncertainty exists regarding the accurate completion of samples provided for laboratory analysis. This study aims to identify the rejection rate of returned FIT samples and determine rejection causes. FIT samples from symptomatic patients within South Yorkshire, Bassetlaw, and North Derbyshire are processed at a central laboratory. Tests requests are made from 225 GP practices, which serve an estimated 2 million population. This study describes a retrospective review of FIT samples received in the central laboratory between 01/09/19 and 31/12/22. Locally held data was interrogated in March 2023 to determine the number of FIT samples received and rejected during the study period. Documented reasons for rejection were explored to identify common themes. Total FIT specimens received during the study period was 126 422. Of these, 5190 (4.1%) were rejected. Monthly rejection rates fell from 17.4% in September 2019 to 1.3% in December 2022 (P < .001). Sampling errors were the most frequent cause for FIT rejection (2151/5190), with other causes including: expired specimen; no sample collection date/ time, no request form, incomplete patient information and illegible handwriting. This is the first study exploring FIT rejection rates in symptomatic primary care patients, which shows improvements in rejection rates over time. Targeted interventions could improve rejection rates further, thereby reducing NHS resource use and costs and diagnostic delays.

주취살인에 대한 법원의 양형 동향 분석

The purpose of this study is to derive implications after analyzing trends related to the courts’ decision on mental disorder defense and the consideration of intoxication in sentencing in homicide under intoxication cases. In order to achieve this goal, the first trial judgments sentenced over the past two years in Korea were collected as subjects of analysis. The results of this study can be summarized as follows. First, in the case of homicide under intoxication, the attack on acquaintances, the manslaughter, and the use of weapons were found to be far more common than the attack on strangers, the murder, and the non-use of weapons. In addition, there were many cases of unmotivated murder while intoxicated. Second, except for one case, the rest of the mental disorder defenses were rejected, and one case in which a minor mental disorder was accepted was not commuted. The main reasons for rejection were prediction and preparation of crime in advance, a clear mental state at the time of the crime, an attempt to conceal evidences, and the memory of the circumstances of the crime. Third, in most cases that reflected the defendants’ intoxication as the sentencing factors, intoxication was considered in favor of sentencing. Furthermore, courts suspended prison sentence in more than half of these cases. This trial practice does not meet the purpose of the sentencing committee’s sentencing criteria, which recommends that alcoholic intoxication should not be reflected as a sentencing factor.

Vaccination Refusal During Pandemic Period

Identifying the causes of vaccination refusal is important in determining strategies to combat them. In a study examining the refusal of COVID-19 vaccines based on the 3C model of vaccine rejection, formed by the World Health Organization's vaccine rejection working group (SAGE) in Malaysia, the most common reason for vaccine rejection was found to be doubt on the efficacy and safety of the vaccine. In the model defined by SAGE as the 3C, three cs are defined as confidence (confidence in the vaccine), complacency (necessity of the vaccine), convenience (suitability for the vaccine, access to the vaccine). In the same study, misinformation was shown as an important reason for vaccination refusal