Wild Card Research Articles

A multicenter study to evaluate the analytical precision by pathologists using the Aperio GT 450 DX

BackgroundDigital pathology systems (DPS) are emerging as capable technologies for clinical practice. Studies have analyzed pathologists' diagnostic concordance by comparing reviews of whole slide images (WSIs) to glass slides (e.g., accuracy). This observational study evaluated the reproducibility of pathologists' diagnostic reviews using the Aperio GT 450 DX under slightly different conditions (precision). MethodDiagnostic precision was tested in three conditions: intra-system (within systems), inter-system/site (between systems/sites), and intra- and inter-pathologist (within and between pathologists). A total of five study/reading pathologists (one pathologist each for intra-system, inter-system/site, and three for intra-pathologist/inter-pathologist analyses) were assigned to the respective sub-studies.A panel of 69 glass slides with 23 unique histological features was used to evaluate the WSI system's precision. Each glass slide was scanned to generate a unique WSI. From each WSI, the field of view (FOV) was generated (at least 2 FOVs/WSI), which included the selected features (1–3 features/FOV). Each pathologist reviewed the digital slides and identified which morphological features, if any, were present in each defined FOV. To minimize recall bias, an additional 12 wild card slides from different organ types were used for which FOVs were extracted. The pathologists also read these wild card slides FOVs; however, the corresponding feature identification was not included in the final data analysis. ResultsEach measured endpoint met the pre-defined acceptance criteria of the lower bound of the 95% confidence interval (CI) overall agreement (OA) rate being ≥85% for each sub-study. The lower bound of the 95% CI for the intra-system OA rate was 95.8%; for inter-system analysis, it was 94.9%; for intra-pathologist analysis, 92.4%, whereas for inter-pathologist analyses, the lower bound of the 95% CI of the OA was 90.6%. ConclusionThe study results indicate that pathologists using the Aperio GT 450 DX WSI system can precisely identify histological features that may be required for accurately diagnosing anatomic pathology cases.

Outcomes of firm resilience in wild card crises—Country, industry, and firm effects in the Covid-19 crisis

In this paper, we examine to what extent external factors (country and industry) and internal factors (capabilities of firms) explain firm resilience outcomes during the first and toughest months of a wild card crisis. Our study uses multivariable regressions on a sample of 1,180 firms. Using evidence from a survey of 58 countries and 17 industries, our results show that, contrary to the mainstream, external effects play a more significant role in explaining resilience outcomes than internal effects. They also highlight the important role of firms’ adaptive capabilities in the initial phase of crises. The study contributes to the existing literature by shedding light on the importance of resilience and on the relative influence of internal and external factors in predicting resilience outcomes in the face of a global shock. The paper highlights the need for further research into performance variance in the very short run when firms face a wild card situation. It also discusses implications for governments and firms in improving their resilience capabilities and emphasizes the importance of ensuring that aid reaches small firms and that managers prepare firms with excess liquidity for times of crisis.

Financial Well-Being of Micro-Entrepreneurs: A Proposed Conceptual Framework

The financial well-being of micro-entrepreneurs is a multifaceted concept that encompasses both financial stability and personal satisfaction with one's financial situation. The pandemic experienced by the country has affected people from all walks of life, including micro-entrepreneurs. These self-employed people not only scored the lowest when it comes to financial behaviors but they are also the most vulnerable in terms of financial well-being. This study intends to fill a gap in the literature by looking at the factors that influence micro-entrepreneurs' financial well-being in Malaysia. A systematic review of reviews was conducted through electronic databases between January 2018 and December 2022 using refined search methods, such as the Boolean operator, phrase searching, truncation, wild card, and field code functions, based on enriched keywords: ("FINANCIAL WELL-BEING*" OR “FINANCIAL WELLBEING) AND ("MICRO-ENTREPRENEUR* OR “MICRO-ENTERPRISE*"). Scopus and Web of Science were selected as the two primary databases to search for relevant articles and materials for the review. The results demonstrate the incorporation of several variables into the proposed framework of financial well-being of micro-entrepreneurs, namely social trust, social networks, financial self-efficacy, and financial innovation as a mediator. The proposed framework is derived from the Social Capital Theory and the Social Cognitive Theory, as well as reviews of past empirical studies.

A consensus process to identify research priorities in paediatric urology in the United Kingdom

Paediatric urologists manage a spectrum of conditions, much of the evidence for relevant treatment pathways is of low quality. For many conditions treatment varies according to location and surgeon; children with the same condition might have surgery in one unit but watchful waiting in another. Underlying this variation are differences in opinion, and insufficient high-level evidence with few prospective randomized studies. Such studies may be challenging to design, fund and recruit into, and are more likely to succeed if there is a collaborative approach. Research prioritization is a tool to identify the research of most value. Delphi methodology is an interpretive technique aiming to gain the consensus view of interested parties. The British Association of Paediatric Urologists (BAPU) set out to ascertain consensus on what paediatric urologists, working in the UK, consider to be areas of priority for research. This paper describes the process used, and the resulting list of research questions. A scoping survey of paediatric urologists in the UK was undertaken to identify an initial set of research questions. These were refined by the BAPU research committee (BAPU RC), then prioritized using a modified Delphi process. During Stage 1a multiple new research questions were submitted leading to Stage 1b, an interim process. All UK paediatric urologists were invited to take part in Stage 2 of the prioritization process. Sixty-five questions were submitted to the scoping survey by 24 paediatric urologists. The BAPU RC refined these to 60 questions, which were submitted to Stage 1a of the modified Delphi process. Sixty-seven people completed Stage 1a, at the same time submitting 224 additional research questions. The BAPU RC revised the entire question set, ensuring the key subject of the original question was not altered and novel questions were retained. The BAPU RC undertook interim scoring of the resultant 79 questions, the top scoring 25 questions plus 5 lower scoring 'wild card' questions (to ensure the breadth of the specialty was represented) were put forward to Stage 2. A total of 65 people completed Stage 2, including a lay representative. A list of 30 priority research questions was generated; the top 10 includes management of neuropathic bladder, posterior urethral valves, antibiotic prophylaxis, DSD & CAH, continence, male external genitalia, VUR and transition care (Table). This process has provided BAPU, paediatric urologists in the UK, and funders with areas of research considered a priority in the specialty.

The Blood of the Colony: Wine and the Rise and Fall of French Algeria by Owen White (review)

Reviewed by: The Blood of the Colony: Wine and the Rise and Fall of French Algeria by Owen White Kolleen M. Guy White, Owen–The Blood of the Colony: Wine and the Rise and Fall of French Algeria. Cambridge: Harvard University Press, 2021. 319 p. French Algeria was the fourth-largest wine producer in the world for much of the twentieth century. And, yet, there has been no comprehensive study of wine and the vine in Algeria since the publication of Hildebert Isnard’s La vigne en Algérie: étude géographique in the 1950s (volume 1 in 1951, and volume 2 in 1954). Writing at a moment when Algerian vineyards were on the frontline of a nationalist insurrection, Isnard’s two-volume work was based on an impressive albeit limited range of archival sources. It has remained the starting point for scholars interested in colonial agriculture and the culture of the vine in North Africa—until now. With the publication of Owen White’s magisterial study, we have a comprehensive overview of the vine and wine in Algeria that makes use of new archival collections and new methodological approaches. The result is an essential read for anyone interested in French wine, environment, race, and the aggressive capitalism of imperialism. [End Page 236] It was the aggressive capitalist pursuit of commodities that shaped the early French colonizer’s vision of the landscape of Algeria. Agricultural production in North Africa, including the cultivation of vines for wine, was diverse and thriving at the time of conquest. What the early colonists saw, however, was not success but “potential.” French inspection after 1830 projected the ecology of southern France on North Africa with rows of grain, olive trees, and grape vines enhanced under an agricultural mission civilisatrice. Much like in other colonial ventures, the European-born settlers and planners experimented with the best path to extract wealth. Land appropriation and diminished property rights for Indigenous Algerians led to widespread destruction of local forms of cultivation. Great hopes were placed by colonial advocates in crops like tobacco and cotton that would complement the metropolitan economy. By the late 1860s, with the colony running a commercial deficit and famine and other hardships facing those on the land, settlers turned away from these experiments and returned to crops that had long been cultivated by Indigenous Algerians, including the vine. It would be a mistake, however, to see the spectacular rise in vine cultivation after 1870 as inevitable. White makes a case that the expansion of the Algerian vineyard had a gold-rush quality where gamblers who were willing to place bold bets might reap big payoffs. Some of the high stakes gamblers built fortunes by betting on vineyard expansion just as the metropolitan wine production was crippled by a still unnamed vine blight. Smaller players with ties to Europe were also able to improve their fortunes through some well-timed gambles on land, vines, or allied services, such as barrel making or wine transport. Phylloxera was a wild card, however, creating opportunities and ruining fortunes when it eventually was discovered on Algerian vines. White argues that the combination of phylloxera and market fluctuations made for the consolidation of land in the hands of banks and wealthy investors. This reality did not deter the creation of the myth of the French “colonizing genius.” By 1892, Jules Ferry toured the Algerian vineyards highlighting what he saw as the heroic achievement of colonization and the role of vines in “consecrating” the land to assure it was “fully and authentically French” (p. 64). Vines became a symbol of the “spirit of enterprise” in the French colonial project. While South Africa had its “Randlords” with portfolios based on a similar rush for gold and diamond extraction, Algeria now had what White calls “vinelords” with fortunes and political power based on vast tracts of vine monoculture and vertical investments (p. 79). On the eve of the Great War, Algeria exported more wine than any other region of the world. With this new global position came a “refashioning of the land and the shaping of local identities” (p. 79). These local identities, in the first half of the twentieth century, were shaped...

Illusions of Empire: The Civil War and Reconstruction in the US-Mexico Borderlands

Illusions of Empire: The Civil War and Reconstruction in the US-Mexico Borderlands

Sophie, Greta, Cuiyuan, and Feminist Desire

Sophie, Greta, Cuiyuan, and Feminist Desire

Last Chance Dance by Lakita Wilson

Reviewed by: Last Chance Dance by Lakita Wilson Aaren Tucker Wilson, Lakita Last Chance Dance. Viking, 2023 [336p] Trade ed. ISBN 9780593525616 $18.99 E-book ed. ISBN 9780593525630 $10.99 Reviewed from digital galleys Ad Gr. 8-12 Leila and her boyfriend have been the perfect couple all four years of high school, so Leila is blindsided when he breaks up with her only three weeks before graduation. Leila’s best friend convinces her to participate in the senior class tradition of Last Chance Dance, which may be just what Leila needs to pull herself out of her misery. Seniors choose their top three crushes and if their crush also picked them, it’s time to go on a date. Lucky Leila matched with all three of her crushes: Instagram model Kai, social justice crusader Mason, and bookworm Eva. Then, there’s the fourth wild card option, class clown Tre’, whom Leila swears she will never, ever go out with. This reality-dating-show-worthy premise is plenty of fun, but introducing the story with a break-up and its mopey aftermath is a tough sell for readers just getting invested. Those who stick around will find a great literary role model in confident Leila, and Wilson’s snappy, funny dialogue effectively builds chemistry between Leila and her chosen date. This book has a valuable message about embracing life’s ups and downs, letting go of your past, and learning to choose your own happiness in spite of what others may think. Although lacking some depth, it is a fun romance for fans of other TV-inspired works, like Maurene Goo’s I Believe in a Thing Called Love. Copyright © 2022 The Board of Trustees of the University of Illinois

Attenuated phase shift masks: an interview with Andreas Erdmann

JM3 Associate Editor Emily Gallagher, a principal researcher at imec, interviews Andreas Erdmann, head of the Fraunhofer IISB Computational Lithography and Optics Group. With Hazem Mesilhy and Peter Evanschitzky, Erdmann is the lead author of “Attenuated phase shift masks: a wild card resolution enhancement for extreme ultraviolet lithography?,” a review paper in the April-June 2022 issue of the Journal of Micro/Nanopatterning, Materials, and Metrology.

The cultural adaptation of the go wish card game for use in Flanders, Belgium: a public health tool to identify and discuss end-of-life preferences

BackgroundPublic health tools like the Go Wish card game from the US, have been found useful to support people in reflecting on their end-of-life preferences, but a cultural adaptation is essential for their success. In the present study, we explore the necessary cultural adaptations to the Go Wish cards by applying an extensive, systematic, and community-engaging negotiating procedure to facilitate the use of the cards in the general population of Flanders, Belgium.MethodsWe used an iterative cultural adaptation process with repeated discussions with various community organizations and representatives of minority and religious groups. After that, the cards were evaluated by 12 healthcare professionals in relation to: linguistic equivalence to the original version, applicability, comprehensibility, and relevance per card. Additional testing with potential users preceded final adjustments.ResultsWe found that stakeholders were keen to engage throughout the process of cultural adaptation and we were able to make a range of cultural adaptations for the use of the cards in Flanders. All original statements were rephrased from passive to more active statements. Sixteen out of 36 cards were adjusted to make them more culturally appropriate for use in Flanders, e.g., “to meet with clergy or a chaplain” to “having a spiritual counselor as support.” Three new cards were added: two with statements appropriate to the Belgian patient rights and euthanasia legislation and one extra Wild Card. Potential users (n = 33) felt that the cards supported conversations about end-of-life preferences.ConclusionBy making community engagement a cornerstone of our adaption process, we developed a card set that potential end-users considered a supportive public health tool for reflecting and discussing end-of-life values and preferences. The described process is particularly valuable for culturally adapt interventions, especially given that community engagement in adapting interventions is essential to creating grounded interventions.

The economic value rationale of fuel hedging: An empirical perspective from the global airline industry

The airline industry continues to face external shocks such as oil spikes which continue to put downward pressure on an airline’s operating model and fuel prices remains the industry’s wild card. Due to the cyclicality nature of the industry, risk of commodity price (oil) exposure significantly impacts the airlines’ performance outcomes.In this study, the traditional literature that underpins airline fuel hedging within a global setting is re-visited. The results from the existing literature are considered when conceptualizing a model that describes the impact of fuel hedging on a carriers’s firm value using two measures, i.e. stock prices and Tobin’s Q. Aside from the primary effects of fuel price hedging the study considers tertiary effects emitted by the origin and type of carrier. Combining these three aspects into a comprehensive study, contrasting legacy and low-costs at the same time as European and US carriers, over a horizon of nine years provides to the existing literature.The results of the study strengthen previous studies that report a limited impact of fuel hedging endeavors on operators’ firm performance, ceteris paribus. These effects are slightly mitigated by the origin and the type of operator (legacy vs. low-cost) as well as tertiary control variables. As a consequence for practitioners, hedging may be seen as a tool of risk mitigation but not as a tool to strengthen an airlines firm value.

Bilateral Achilles Tendon Ruptures in the NFL

Category: Sports Introduction/Purpose: Achilles tendon ruptures (ATR) can have devastating results for athletes in the National Football League (NFL). Although NFL athletes who suffer an ATR are successfully treated with surgery and rehabilitation, this potentially career- ending injury has demonstrated a decrease in return to play, playing time, and performance for athletes. With a mean career length of 3.3 years for NFL athletes, the ATR injury and subsequent 9 to 11 month rehabilitation period could adversely limit the impact athletes make both individually and at the team level. Although previous research has examined the effects of a unilateral ATR in athletes, the purpose of this study was to determine the effects of bilateral ATRs on the health, productivity, and career longevity of NFL athletes. Methods: Publicly available online injury data for NFL athletes who sustained bilateral ATRs between the start of the 2007 season and the start of the 2021 season were queried using online news and sports analysis web sources. Inclusion criteria consisted of NFL athletes who sustained two independent, contralateral ATRs and exclusion criteria were NFL athletes who only sustained a single ATR or athletes who subsequently reinjured the same tendon. Specific dates for the first ATR (ATR1), return to play after ATR1, second ATR (ATR2), return to play after ATR2, as well as most recent game played were recorded. NFL preseason, regular season, and postseason (playoff, wild card, Pro Bowl, and Super Bowl) games were used to tabulate the total number of games missed or played. Descriptive and univariate statistics were performed. Results: When analyzing five NFL athletes with bilateral ATRs, mean BMI was 33.4+-4, an average of 5.8+-4 seasons were completed before ATR1, and three athletes currently play. There was a significant decrease in Pro Bowl nominations with each successive ATR (p=0.027). A significant difference was observed for mean age at tendon rupture when comparing ATR1 and ATR2 (27.8+-4 vs 30.4+-4 years, p<0.01). Rehabilitation periods after ATR1 and ATR2 (9.3+-2 vs.10.9+-2 months), as well as number of games missed during rehabilitation periods for ATR1 and ATR2 (9.8+-4 vs.12.8+-6) were not significantly different. The mean time period after returning from ATR2 was 22.0+-16 months, with a mean number of 39.3+-24 games played (Table 1). When analyzing performance metrics of four defensive NFL athletes, forced fumbles was the only defensive metric to demonstrate significant change across ATRs (p=0.02). Conclusion: This case series investigated NFL athletes who sustained bilateral ATRs, demonstrating a significant difference in age at the time of each rupture along with a decreasing trend in the number of Pro Bowl nominations following successive Achilles injuries. Upon analyzing defensive NFL athletes, forced fumbles was the only performance metric that significantly changed across successive Achilles injuries. This case series is the first study to review the effect of bilateral ATRs in NFL athlete performance and further research should be conducted to continue analyzing how these injuries affect the health, productivity, and career longevity of NFL athletes.

Developing disruptive mobility scenarios for rural areas. Participatory mobility scenario building in a Belgian village for the year 2050

BackgroundHistorically, quantitative forecasting methods have been used in transport planning. As forecasts can be unreliable to plan for the medium- and long-term, scenario building has recently been increasingly used. However, scenario building methods often fail to take disruptions and wild cards into account, i.e., low probability but high impact events. When unaccounted for, wild card events, like the COVID-19 pandemic, lower the efficacy of scenario building in policy making, as these events may completely disturb the developed scenarios of the future.MethodsIn this paper, we develop and apply a creative and participatory methodology to develop visions and disrupted scenarios for rural mobility. Our research was carried out in the Belgian village of Oetingen, where inhabitants developed more resilient views of the future by creating disrupted mobility scenarios and a preferred mobility vision for their village for the year 2050 in a participatory scenario building exercise. Wild cards related to mobility were collected from mobility experts and inhabitants in three workshops. Inhabitants were engaged to define their mobility vision on a postcard that was distributed to all houses in the village as well as on a project website. Respondents were invited for a follow-up interview in which their preferred mobility vision was subjected to the wild cards, and participants described how these wild cards would change their preferred vision. As children tend to have more creative ideas, they were engaged via workshops at school.ResultsThis process resulted in mobility scenarios for the village for the year 2050 based on the different wild cards, as well as an overall desired vision. We found that the use of wild cards did not significantly change the scenarios when compared to the vision, although it did make the interviewees step outside of their comfort zones. We also found that the citizens did not have more original and less path-dependent ideas in developing wild cards when compared to experts. Lastly, we found that children have many outside-of-the-box suggestions when it comes to the future. Although some of their ideas can be judged as impractical by today’s standards, many ideas had an indirect implication for mobility in the village and gave insights into children’s priorities, as potential future residents of the village.

Examination of George Jacobs, Sr. [May 10, 1692

Tituba, referred to in the Salem witch trials court records as "Indian Woman, Servant," is blamed for beginning the Salem witchcraft hysteria: accused of witchcraft early on, she saved her life by admitting to being a witch and blaming two others of witchcraft. Because Tituba was an enslaved person, the only records of her life are the court transcripts themselves. Tituba herself remains a mystery. Even her race is debated. She has been treated like a wild card, pliable enough to make any argument. In writing Tituba's examinations, I wanted to avoid speaking for her, and instead comment on this dynamic and point to how little we know. Phrases are encased in quotation marks to draw attention to the fraught nature of speaking and quoting.

The Potential of Ecological Restoration Programs to Increase Erosion-Induced Carbon Sinks in Response to Future Climate Change

Erosion-induced carbon sinks are a wild card in the global carbon budget. Soil erosion results in aggregate carbon sequestration by reforming organic–inorganic complexes at depositional areas and plant reserves. The carbon sinks at the depositional sites are rarely considered in the prediction of erosion-induced carbon sink dynamics. The effects of large-scale ecological restoration programs (ERPs) in subtropical regions on soil carbon sinks are still unclear. This study analyzed the potential effects of ERPs on erosion-induced carbon sinks in a red soil hilly region (RSHR) from 2030 to 2060. Based on a land use dataset and two climate scenarios of moderate (RCP4.5) and high emission paths (RCP8.5), three land use change (LUC) patterns were designed: an Ecological Restoration (ER) pattern; a Business-As-Usual (BAU) pattern; and a No LUC pattern. The results of the ER pattern and BAU pattern were compared with those of the No LUC pattern to reflect the role of ERPs in reducing erosion and increasing erosion-induced carbon sinks. The results indicated that the erosion-induced carbon sinks of forestland increased (58 kg km−2) in the BAU pattern under the RCP8.5 scenario and erosion-induced carbon sinks of cropland increased (39 kg km−2) in the ER pattern under the RCP8.5 scenario. In RCP4.5 and RCP8.5, the erosion-induced carbon sinks of the RSHR increased by 210 Tg and 85 Tg from 2030 to 2060, respectively (1 Tg = 1012 g). The average annual erosion-induced carbon sink accounted for 3.84% and 1.41% of the annual average carbon sequestration of terrestrial ecosystems, respectively. Neither the BAU pattern nor the ER pattern achieved the purpose of increasing grassland carbon sinks induced by soil erosion. Therefore, the focus of future ERP optimization should be to increase grassland carbon sinks. Our study provides new evidence for research into erosion-induced carbon sinks to mitigate global climate change and a scientific basis for increasing erosion-induced carbon sinks in croplands, forestlands and grasslands in the RSHR of southern China.

Attenuated phase shift masks: a wild card resolution enhancement for extreme ultraviolet lithography?

Background: The successful introduction of extreme ultraviolet (EUV) lithography to high volume manufacturing has increased the interest to push this technology to its ultimate limits. This will require photoresist materials, which enable a better tradeoff between resolution, linewidth roughness and sensitivity, and the adaptation of optical resolution enhancements that were originally developed for deep ultraviolet (DUV) lithography. Aim: We review published research on attenuated phase shift masks (attPSM) for EUV with special emphasis on modeling and fundamental understanding of the imaging characteristics of alternative absorber materials. The overview on previous work is intended to summarize typical observations and learning on obtained results and to serve as a reference for further research on this important topic. Review approach: The review starts with a summary of related work on attPSM for DUV lithography. It is shown that the understanding and mitigation of mask topography (or mask 3D) effects is key for the analysis and optimization of attPSM for EUV lithography. Observations from several research groups and application of dedicated modeling approaches help to understand the physical mechanisms behind observed lateral image shifts and pitch-dependent shifts of the best focus position. Results: The imaging physics of attPSM for EUV lithography differs significantly from attPSM imaging in DUV lithography. The “double diffraction” of EUV light from the absorber, the reflection characteristics of the multilayer blank, and the guidance of light through the openings in a low-refractive-index (low-n) absorber introduce important effects that need to be considered in the design and use of attPSM in EUV lithography. It is important to use the optical properties (n and k) and the thickness of the absorber as predictive design parameters of attPSM for EUV lithography (instead of phase and reflectivity). The refractive index of the absorber material is important for binary masks as well. The discussion of low-n absorbers includes both “traditional” attPSM for EUV and low reflectivity absorbers, which exploit the guidance of light inside patterned layers. Conclusions: In-depth modeling investigations of attPSM and first experiments suggest that absorbers with a refractive index around 0.9 (low-n materials) can help to push high NA EUV lithography into the low k1 regime. Comprehensive optimization of source and mask is required to exploit the advantages of low-n absorbers. Further enhancements can help to push EUV imaging to its ultimate limit.

How Wild Can It Be?

How Wild Can It Be?

Values and preferences for future end-of-life care among the indigenous Sámi.

Research with Indigenous peoples internationally indicates the importance of socio-cultural contexts for end-of-life (EoL) preferences. However, knowledge about values and preferences for future EoL care among the Indigenous Sámi is limited. We investigated if and how a Swedish adaptation of the English-language GoWish cards, DöBra cards, supports reflection and discussion of values and preferences for future EoL care among the Sámi. This qualitative study is based on interviews with 31self-defined Sámi adults who used DöBra cards at four events targeting the Sámi population, between August 2019 and February 2020. Using directed content analysis, we examined aspects of interviews addressing Sámi-specific and Sámi-relevant motivations for choices. Data about individuals' card rankings were collated and compiled on group level to examine variation in card choices. All 37 pre-formulated card statements were ranked as a top 10 priority by at least one person. The cards most frequently ranked in the top 10 were a wild card used to formulate an individual preference and thus not representing the same statement, and the pre-formulated card 'to have those I am close to around me'. Reactions to interviews varied, with some participants commenting on the taboo-laden nature of discussing EoL issues, although many commented positively about EoL conversations in general, and the benefit of using the DöBra cards in particular. We categorised reasoning about Sámi-specific and Sámi-relevant values and preferences under the themes: Attributes of contemporary Sámi culture, Spirituality, Setting for death, Maintaining identity, Preferences related to death, Dying and EoL care and After death. The DöBra cards were found to be easy-to-use, understandable and a flexible tool for initiating and supporting conversations about EoL values and preferences. The open formulations of cards, with wild cards, enable discussions about individual values and preferences, with potential to reflect life as a Sámi in Sweden.

The wild card: colonial paper money in French North America, 1685 to 1719

Abstract We use the first French experiment with playing card money in its colony of Quebec between 1685 and 1719 to illustrate the link between legal tender restrictions and the price level. Initially, the quantity of playing card money and the government’s poor fiscal condition appears to have had little effect on prices. After 1705, however, the playing card money became inflationary. We argue that this was caused by the government’s increased enforcement of the legal tender laws and the adoption of a redemption plan intended to remove the notes from circulation.

Impact of recreational cannabis legalization on patient self-reporting of cannabis use at a pharmacist-led primary care clinic

BackgroundThe Cannabis Act, introduced in Canada in 2018, legalized the use of recreational cannabis. The impact of the announcement and implementation of this act on patient self-reporting of cannabis use has not been explored. ObjectiveThe study objective was to determine if patient self-reported cannabis use increased after the announcement and implementation of legislative changes to legalize recreational cannabis. MethodsA repeated cross-sectional design was used for a retrospective chart review of patients seen at a pharmacist-led primary care clinic. A convenience sample of patient records was divided into 3 panels, corresponding with the preannouncement (November 1, 2013-October 4, 2015), postannouncement (October 5, 2015-October 16, 2018), and postimplementation (October 17, 2018-October 17, 2019) stages of the legalization of recreational cannabis. Search terms used included cannabis, marijuana, marihuana, recreational drugs, natur∗, medicinal, pot, joint, oil, butter, brownies, edibles, cannabin∗, THC, tetrahydro∗, sativa, and indica (∗ = string wild card). The frequency of reporting use and the number of queries related to cannabis were assessed. The analysis of variance test and Pearson correlation (chi-square) were used to compare the 3 panels. ResultsA total of 298 patient charts were included in the analysis. One hundred, 99, and 99 patient charts corresponded with panels 1, 2, and 3, respectively. At each time point, 6%, 8%, and 14% of the patients reported cannabis use (P = 0.03). A statistically significant increase in topical oil use and a decrease in prescription tablet or capsule use between panels 1 and 3 (P = 0.036) were identified. ConclusionThis study found an increase in self-reporting of cannabis use across the 3 consecutive panels. The change in the product formulations used may reflect the various products available. Frontline pharmacists are encouraged to initiate conversations regarding cannabis use as part of routine practice.