bluuebunny/crossref_metadata_2025 huggingface dataset:
From quality to outcomes: a national study of afterschool STEM programming
Authors: Allen Patricia J. , Chang Rong , Gorrall Britt K. , Waggenspack Luke , Fukuda Eriko , Little Todd D. , Noam Gil G.
Published: November 2019

Background

State afterschool networks across the US are engaged in system-building efforts to improve the quality of science, technology, engineering, and math (STEM)-focused afterschool programming. This study examined national trends in STEM program quality, youth outcomes, and the connections between these two data sources.

Methods

One thousand five hundred ninety-nine youths (grades 4–12) enrolled in 158 STEM-focused afterschool programs across 11 state networks completed a retrospective self-assessment measuring STEM attitudes and social-emotional learning (SEL)/twenty-first-century skills. Two hundred fifty standardized observations of STEM activities were performed to measure STEM program quality.

Results

(1) Most youth (65–85%) reported increases in STEM engagement, identity, career interest, career knowledge, relationships, critical thinking, and perseverance, with the largest gains reported by those engaging with STEM activities for 4 weeks or more; (2) there were significant, strong correlations between STEM and SEL/twenty-first-century outcomes reported by youth; and (3) youth participating in higher-quality STEM programming reported more growth than peers participating in lower-quality programs.

Conclusion

This effort demonstrates how investments in STEM program quality yield high returns for programs and youth and how collaborations between research and practice can track successes and challenges, determine investments in program management, and expand advocacy and policy efforts. Additionally, this study supports a growing body of literature that suggests a synergy between youth development and STEM learning approaches that can improve outcomes for youth.
The 32nd summer school of the Research Community for Mechanisms of Mutations
Authors: Kawanishi Masanobu
Published: November 2019

The 32nd summer school of the Research Community for Mechanisms of Mutations was held at Inter-University Seminar House in Hachioji city, Tokyo, from September 7 to 8, 2019. Thirty-eight people attended this annual event, and three eminent researchers were invited to discuss DNA damage induced by endogenous aldehydes, “action-at-a-distance mutagenesis” and a novel genome editing method, and DNA repair in fungi and plants. In addition to these plenary sessions, eleven participants presented their own research in oral sessions. More than half of the participants were young scientists such as graduate/undergraduate students, post-doctoral fellows and assistant professors. All members joined in enthusiastic discussions and acquired new scientific knowledge through these two days.
Expert consensus on relevant risk predictors for the occurrence of osteoporotic fractures in specific clinical subgroups – Delphi survey
Authors: Bodmer Nicolas S. , Häuselmann Hans Jörg , Frey Diana , Aeberli Daniel , Bachmann Lucas M.
Published: November 2019

Background

There is an ongoing discussion about incorporating additional risk factors to established WHO fracture risk assessment tool (FRAX) to improve the prediction accuracy in clinical subgroups. We aimed to reach an expert consensus on possible additional predictive parameters for specific clinical subgroups.

Methods

Two-round modified Delphi survey: We generated a shortlist of experts from the authors’ lists of the pertinent literature and complemented the list with experts known to the authors. Participants were asked to name possible relevant risk factors besides the FRAX-parameters for the occurrence of osteoporotic fractures. Experts specified these possible predictors for specific subgroups of patients. In the second round the expert panel was asked to weight each parameter of every subgroup assigning a number between one (not important) to ten (very important). We defined the threshold for an expert consensus if the interquartile range (IQR) of a predictor was ≤2. The cut-off value of the median attributed weights for a relevant predictor was set at ≥7.

Results

Eleven experts of seven countries completed both rounds of the Delphi. The participants agreed on nine additional parameters for seven categories. For the category “secondary osteoporosis”, “older adults” and “nursing home patients”, there was a consensus that history of previous falls was relevant, while for men and postmenopausal women, there was a consensus that the spine fracture status was important. For the group “primary and secondary osteoporosis” the experts agreed on the parameters “high risk of falls”, “lumbar spine bone mineral density (BMD)” and “sarcopenia”.

Conclusion

This Delphi survey reached a consensus on various parameters that could be used to refine the currently existing FRAX for specific clinical situations or patient groups. The results may be useful for studies aiming at improving the predictive properties of instruments for fracture prediction.
Can lung ultrasound assist in the decision of weaning mechanically ventilated neonates?
Authors: Eltomey Mohamed Adel , Shehata Ahmed Hany , Nassar Mohamed Abd Ellatiff , Elmashad Abd Elrahman Mohamed
Published: November 2019

Background

Mechanical ventilation is widely used in neonates presenting with respiratory distress; however, it is not without complications. Early weaning of neonates is vital however the process of extubation is difficult to determine precisely. The use of lung ultrasound in neonates is recently accepted as a reliable tool in the assessment of several lung conditions. The aim of this study was to assess the use of lung ultrasound score as a quantitative method to assist in the decision of weaning mechanically ventilated neonates.

Results

The study was conducted on 40 neonates admitted to the NICU with different causes of respiratory distress needing respiratory support by mechanical ventilation. Lung ultrasound was performed using a linear superficial probe at least three times, at admission, before switching mechanical ventilation mode and before weaning. The initial lung ultrasound score for all patients was between 9 and 36 (mean 25 ± 6.97, median 26) with the 11 patients initiated on Sync. Intermittent ventilation (SIMV) showing significantly lower scores than those initiated on assist/control ventilation (ACV). Patients successfully switched from ACV to SIMV showed significantly lower scores than those who failed. Patients successfully weaned from SIMV showed significantly lower scores than those who failed. ROC analysis showed a cut-off score of ≤ 14 had 85% sensitivity and 100% specificity for a successful switch between ACV to SIMV. It also showed that a score ≤ 6 had 87.5% sensitivity and 100% specificity for successful extubation.

Conclusion

The use of quantitative lung ultrasound scores in assessment of mechanically ventilated neonates shows a great potential in aiding the process of weaning.
Different aspects in manipulating overlapped spectra used for the analysis of trimebutine maleate and structure elucidation of its degradation products
Authors: Lotfy Hayam M. , Morgan Eman M. , Fayez Yasmin Mohammed , Abdelkawy M.
Published: November 2019

Background

Four rapid, accurate, and validated stability-indicating spectrophotometric methods have been described in the present work for the analysis of trimebutine maleate (TM) in existence of its degradation products in its authentic form and in pharmaceutical formulations excluding any separation steps.

Results

These methods were a dual-wavelength (DW) method which allows the determination of TM in existence of its degradation products at 243 nm and 269 nm, second derivative (D2) method measured at peak amplitude at 268 nm, ratio difference (RD) method at 242 nm and 278 nm, and constant center coupled with spectrum subtraction (CC-SS) method at 242 nm and 278 nm versus 278 nm. By applying the suggested methods, TM could be quantified in the range of 5.0–60.0 μg/mL with percentage recoveries 99.97 ± 0.40, 100.36 ± 0.58, 99.90 ± 0.42, and 100.15 ± 0.45 for DW,D2, RD, and CC-SS methods, respectively. International Conference on Harmonization guidelines were followed for validation of the described methods, and the application of laboratory-prepared mixtures along with different pharmaceutical drugs including the target drug showed favorable results without any contribution from additives.

Conclusions

Statistical comparison was used to compare the proposed and official methods, and satisfactory results for both accuracy and precision were obtained. The results confirm the applicability of the suggested methods for the determination of TM in quality control laboratories.
Long-Term Mental Health Outcomes in Mothers and Siblings of Children With Cancer: A Population-Based, Matched Cohort Study
Authors: van Warmerdam Jacqui , Sutradhar Rinku , Kurdyak Paul , Lau Cindy , Pole Jason D. , Nathan Paul C. , Gupta Sumit
Published: November 2019

PURPOSE

Although a diagnosis of childhood cancer can have a profound effect on the entire family unit, its impact on the long-term mental health of family members is not well characterized.

METHODS

A provincial childhood cancer registry in Ontario, Canada, was linked to birth records to identify separate population-based cohorts of mothers and siblings of children diagnosed with cancer between 1998 and 2014. The mother and sibling cohorts were matched to corresponding population controls and linked to health services data. The rate of mental health–related outpatient visits (family physician, psychiatrist) and the incidence of severe psychiatric events (psychiatric emergency department visit, psychiatric hospitalization, suicide) were compared between mothers and siblings and their controls. Possible predictors of mental health outcomes were examined, including demographics, characteristics of the cancer-affected child, and cancer treatment.

RESULTS

We identified 4,773 mothers and 7,897 siblings of children diagnosed with cancer during the study period. Compared with controls, both groups experienced elevated rates of outpatient visits (mothers: rate ratio [RR], 1.4; P < .0001; siblings: RR, 1.1; P < .0001). The risk of severe psychiatric events was not increased in either cohort. Mother and sibling demographic factors associated with increased risk of adverse mental health included younger maternal age at cancer diagnosis, low socioeconomic status, and rural residence among mothers and older sibling age among siblings. Treatment-related variables pertaining to the cancer-affected child were not associated with mental health outcomes. Mental health outcomes clustered within families.

CONCLUSION

Both mothers and siblings experience elevated and prolonged need for mental health–related health care as compared with the general population. Demographic risk factors predict subpopulations at highest risk. Increased psychosocial support for family members during and after cancer therapy is warranted.
Harmonization of Tumor Mutational Burden Quantification and Association With Response to Immune Checkpoint Blockade in Non–Small-Cell Lung Cancer
Authors: Vokes Natalie I. , Liu David , Ricciuti Biagio , Jimenez-Aguilar Elizabeth , Rizvi Hira , Dietlein Felix , He Meng Xiao , Margolis Claire A. , Elmarakeby Haitham A. , Girshman Jeffrey , Adeni Anika , Sanchez-Vega Francisco , Schultz Nikolaus , Dahlberg Suzanne , Zehir Ahmet , Jänne Pasi A. , Nishino Mizuki , Umeton Renato , Sholl Lynette M. , Van Allen Eliezer M. , Hellmann Matthew D. , Awad Mark M.
Published: November 2019

PURPOSE

Heterogeneity in tumor mutational burden (TMB) quantification across sequencing platforms limits the application and further study of this potential biomarker of response to immune checkpoint inhibitors (ICIs). We hypothesized that harmonization of TMB across platforms would enable integration of distinct clinical data sets to better characterize the association between TMB and ICI response.

METHODS

Cohorts of patients with non–small-cell lung cancer sequenced by 1 of 3 targeted panels or by whole-exome sequencing (WES) were compared (N = 7,297). TMB was calculated uniformly and compared across cohorts. TMB distributions were harmonized by applying a normal transformation followed by standardization to z scores. In subcohorts of patients treated with ICIs (Dana-Farber Cancer Institute n = 272; Memorial Sloan Kettering Cancer Center n = 227), the association between TMB and outcome was assessed. Durable clinical benefit (DCB) was defined as responsive/stable disease lasting ≥ 6 months.

RESULTS

TMB values were higher in the panel cohorts than in the WES cohort. Average mutation rates per gene were highly concordant across cohorts (Pearson’s correlation coefficients, 0.842-0.866). Subsetting the WES cohort by gene panels only partially reproduced the observed differences in TMB. Standardization of TMB into z scores harmonized TMB distributions and enabled integration of the ICI-treated subcohorts. Simulations indicated that cohorts > 900 are necessary for this approach. TMB did not associate with response in never-smokers or patients who harbor targetable driver alterations, although these analyses were underpowered. An increase of TMB thresholds increased DCB rate, but DCB rates within deciles varied. Receiver operating characteristic curves yielded an area under the curve of 0.614, with no natural inflection point.

CONCLUSION

The z score conversion harmonizes TMB values and enables integration of data sets derived from different sequencing panels. Clinical and biologic features may provide context to the clinical application of TMB and warrant additional study.
In Situ Observation of Efflorescence and Deliquescence Phase Transitions of Single NaCl and NaNO3 Mixture Particles in Air Using a Laser Trapping Technique
Authors: Ishizaka Shoji , Guo Fangqin , Tian Xiaomeng , Seng Samantha , Tobon Yeny A , Sobanska Sophie
Published: November 2019

A novel experimental approach to study the hygroscopic properties of multi-component inorganic aerosols was demonstrated using a laser trapping technique. The efflorescence and deliquescence phase transitions of the equimolar mixture of NaCl and NaNO3 particles levitated in air were reversibly induced by controlling relative humidity. The two-stage phase transitions of the particles during the dehumidifying and humidifying processes were successfully observed in air. To our knowledge, this is the first experimental result to observe the reversible hygroscopic behavior of single optically-levitated multi-component inorganic aerosols in air. Furthermore, to elucidate the influence of solid substrates on the homogeneous and heterogeneous nucleation processes, the efflorescence relative humidity (ERH) and mutual efflorescence relative humidity (MERH) in air were compared with those observed on a hydrophobic glass substrate. The average ERH and MERH values of the NaCl–NaNO3 particles levitated in air were lower than those obtained for the particles deposited on the hydrophobic glass substrate.
Variable expression and silencing of CRISPR-Cas9 targeted transgenes identifies the AAVS1 locus as not an entirely safe harbour
Authors: Bhagwan Jamie R. , Collins Emma , Mosqueira Diogo , Bakar Mine , Johnson Benjamin B. , Thompson Alexander , Smith James G.W. , Denning Chris
Published: November 2019

Background: Diseases such as hypertrophic cardiomyopathy (HCM) can lead to severe outcomes including sudden death. The generation of human induced pluripotent stem cell (hiPSC) reporter lines can be useful for disease modelling and drug screening by providing physiologically relevant in vitro models of disease. The AAVS1 locus is cited as a safe harbour that is permissive for stable transgene expression, and hence is favoured for creating gene targeted reporter lines.

Methods: We generated hiPSC reporters using a plasmid-based CRISPR/Cas9 nickase strategy. The first intron of PPP1R12C, the AAVS1 locus, was targeted with constructs expressing a genetically encoded calcium indicator (R-GECO1.0) or HOXA9-T2A-mScarlet reporter under the control of a pCAG or inducible pTRE promoter, respectively. Transgene expression was compared between clones before, during and/or after directed differentiation to mesodermal lineages.

Results: Successful targeting to AAVS1 was confirmed by PCR and sequencing. Of 24 hiPSC clones targeted with pCAG-R-GECO1.0, only 20 expressed the transgene and in these, the percentage of positive cells ranged from 0% to 99.5%. Differentiation of a subset of clones produced cardiomyocytes, wherein the percentage of cells positive for R-GECO1.0 ranged from 2.1% to 93.1%. In the highest expressing R-GECO1.0 clones, transgene silencing occurred during cardiomyocyte differentiation causing a decrease in expression from 98.93% to 1.3%. In HOXA9-T2A-mScarlet hiPSC reporter lines directed towards mesoderm lineages, doxycycline induced a peak in transgene expression after two days but this reduced by up to ten-thousand-fold over the next 8-10 days. Nevertheless, for R-GECO1.0 lines differentiated into cardiomyocytes, transgene expression was rescued by continuous puromycin drug selection, which allowed the Ca2+ responses associated with HCM to be investigated in vitro using single cell analysis.

Conclusions: Targeted knock-ins to AAVS1 can be used to create reporter lines but variability between clones and transgene silencing requires careful attention by researchers seeking robust reporter gene expression.
Planning and communicating prototype tests for the Nano Membrane Toilet: A critical review and proposed visual tool
Authors: Hennigs Jan , Parker Alison , Collins Matt , Jiang Ying , Kolios Athanasios , McAdam Ewan , Williams Leon , Tyrrel Sean
Published: November 2019

Urban sanitation in growing cities of the Global South presents particular challenges, like the speed of their growth, the high population density, and, often, the lack of existing wastewater infrastructure. This led to the Bill & Melinda Gates Foundation’s Reinvent The Toilet Challenge, a call to develop novel, non-sewered sanitation technologies, which sparked the development of various inventions, like the Nano Membrane Toilet. Complex technologies like this entail an extensive product development process, including various iterations of prototype tests. While there is an abundance of literature discussing how to build prototypes, and the optimal number of tests, there has been little focus on how to plan, communicate, and conduct tests, especially in a product development endeavour of this complexity. Multiple aspects of testing prototypes are reviewed. A visual test planning tool is proposed that encompasses the entire product development process and can be used to plan and communicate prototype tests for the Nano Membrane Toilet to ultimately achieve compliance with international standards.
Equitable data sharing: challenges and suggestions for ways forward
Authors: Barnes Karen I. , Canario Julio Arturo , Vernekar Sunil S. , Goudar Shivaprasad S. , Espinal Roberto , Merson Laura , Cheah Phaik Yeong
Published: November 2019

Data sharing is increasingly mandated by health research funders and publishers. In the context of data collected in low-resource settings, concerns have been raised regarding inequitable opportunities to engage in secondary use of data between researchers in well-resourced and resource-limited settings. In this context, we present three case studies and their issues related to equity: the multicountry Antenatal Corticosteroid Trial, health research in the Dominican Repulic and the WorldWide Antimalarial Resistance Network. These case studies were discussed at the 2018 Global Forum for Bioethics in Research in South Africa, focussing on the theme “The ethics of data sharing and biobanking in health research”. The case studies provide concrete examples of real challenges such as lack of prior consent for data sharing, potential for misinterpretation of data by secondary users and limited capacity of researchers in low-resource settings to conduct secondary analyses. We conclude by suggesting ways forward. We stress the importance of capacity building and investments in data management and data science skills, and in data sharing platforms supporting poverty-related disease research. In addition, we recommend that there should be incentives to promote data sharing and that research groups and institutions establish their own data sharing policies  tailored to their context, data and community while persuing harmonization with existing policies as much as possible. We also think that international guidelines on authorship criteria should be revisited. For new studies, researchers should obtain consent for sharing of participants’ data with secondary users. Lastly we recommend that community and stakeholder engagement be conducted to improve the consent process and identify what might be sensitive data to mitigate any potential harms to data subjects and their communities.
The SIPHER Consortium: Introducing the new UK hub for systems science in public health and health economic research
Authors: Meier Petra , Purshouse Robin , Bain Marion , Bambra Clare , Bentall Richard , Birkin Mark , Brazier John , Brennan Alan , Bryan Mark , Cox Julian , Fell Greg , Goyder Elizabeth , Heppenstall Alison , Holmes John , Hughes Ceri , Ishaq Asif , Kadirkamanathan Visakan , Lomax Nik , Lupton Ruth , Paisley Suzy , Smith Katherine , Stewart Ellen , Strong Mark , Such Elizabeth , Tsuchiya Aki , Watkins Craig
Published: November 2019

The conditions in which we are born, grow, live, work and age are key drivers of health and inequalities in life chances. To maximise health and wellbeing across the whole population, we need well-coordinated action across government sectors, in areas including economic, education, welfare, labour market and housing policy. Current research struggles to offer effective decision support on the cross-sector strategic alignment of policies, and to generate evidence that gives budget holders the confidence to change the way major investment decisions are made. This open letter introduces a new research initiative in this space. The SIPHER (Systems Science inPublicHealth and HealthEconomicsResearch) Consortium brings together a multi-disciplinary group of scientists from across six universities, three government partners at local, regional and national level, and ten practice partner organisations. The Consortium’s vision is a shift from health policy to healthy public policy, where the wellbeing impacts of policies are a core consideration across government sectors. Researchers and policy makers will jointly tackle fundamental questions about: a) the complex causal relationships between upstream policies and wellbeing, economic and equality outcomes; b) the multi-sectoral appraisal of costs and benefits of alternative investment options; c) public values and preferences for different outcomes, and how necessary trade-offs can be negotiated; and d) creating the conditions for intelligence-led adaptive policy design that maximises progress against economic, social and health goals. Whilst our methods will be adaptable across policy topics and jurisdictions, we will initially focus on four policy areas: Inclusive Economic Growth, Adverse Childhood Experiences, Mental Wellbeing and Housing.
Using simulated patients as a learning strategy to support undergraduate nurses to develop patient-teaching skills
Authors: Coleman Deborah , McLaughlin Dorry
Published: November 2019

Background:

An increase in the number of patients with long-term conditions has required a greater focus on nurse-led educational interventions to enable patients to develop self-management strategies. However, patient education is frequently taken for granted, and nurses sometimes consider that their undergraduate training does not prepare them to participate in effective patient teaching.

Aim:

The study aimed to formatively evaluate a simulated role-play scenario facilitated with third-year nursing students to support the development of patient-teaching skills.

Method:

The study combined two approaches to simulation, using high-fidelity and mid-fidelity simulation scenarios sequentially. This enabled students (n=20) to apply the communication strategies learnt to both a skills-based procedural situation and a patient-teaching simulation. A five-item pro forma with four open questions and one closed question was used for formative evaluation.

Findings:

The results indicated that using a simulated patient to practise patient-teaching skills was perceived by the students to be a valuable method of learning that they could transfer to clinical practice.

Conclusion:

The findings suggested that facilitating learning with a simulated patient is useful in replicating authentic verbal and practical interactions with a patient in practice.
The similarities and differences between advanced nurse practitioners and clinical nurse specialists
Authors: Cooper Mark A , McDowell Joan , Raeside Lavinia ,   the ANP–CNS Group
Published: November 2019

A lack of awareness exists within healthcare services on the differences between the roles of advanced nurse practitioner (ANP) and clinical nurse specialist (CNS). This may lead to ambiguity in relation to the development, scope of practice and impact of these roles. The aim of this review was to compare the similarities and differences between the ANP and CNS within the research literature. Databases (CINAHL, Medline and Embase) were searched using selected search terms. This resulted in 120 articles of potential interest being identified. Following a rigorous review process for content and relevance, this was reduced to 12. Both roles are valuable and effective, predominately being clinically based with education, leadership and research components. CNS roles are specialist, ANP are more likely to be generalist. Where there is regulation and governance the role of the ANP is clearly defined and structured; however, a lack of governance and regulation is evident in many countries.
Ensuring smooth transition of frail elderly patients from hospital to community
Authors: Glasper Alan
Published: November 2019

Emeritus Professor Alan Glasper, from the University of Southampton, discusses issues associated with the delayed discharge of elderly patients from hospital with reference to pertinent policies and procedures
Dressing use issues in primary abdominal wounds: a qualitative study of health staff and patient views
Authors: McMullan Christel , Blazeby Jane , Donovan Jenny L , Rooshenas Leila , Elliott Daisy , Mathers Jonathan ,   On behalf of the Bluebelle Study Group
Published: November 2019

Primary surgical abdominal wounds are usually covered with a dressing. However, little is known about the practical issues and costs around these dressings. This study aimed to provide an in-depth description of patients' and health professionals' perspectives on the clinical and practical issues associated with standard and novel dressing (glue-as-a-dressing) use on primary surgical wounds, and to establish whether and how their experience compares with these perspectives. During semi-structured interviews, patients and health professionals discussed their positive experience of glue-as-a-dressing and no dressing around six themes: wound contamination and infection, wound healing, wound care, physical protection afforded by simple dressings, the potential psychological impact of an exposed wound, and ability to carry out everyday tasks. Current views on the practice of dressings for primary abdominal wounds are influenced by ingrained clinical practice. These views can be challenged when exposed to novel dressing strategies or as new evidence of the clinical effect of dressing strategies emerges.
Outcomes of a new wrap compression system for patients with lower limb ulceration and oedema
Authors: Barker Alison , Todd Marie
Published: November 2019

JOBST® FarrowWrap® is indicated in patients presenting with venous leg ulceration in combination with mild-to-moderate oedema. These symptoms result in significant physical and psychological problems and management can be costly in terms of duration of input and resources. This article will present four case studies demonstrating the benefits and outcomes for patients with lower limb issues and will consider how the product helps improve shape, reduce oedema, heal ulceration, improve quality of life in relation to the lower limb and encourage self-care.
EGUS diagnosis – what happens next?
Authors: Mortenson Lars
Published: November 2019

Lars Mortenson DVM MRCVS, Veterinary Advisor, Norbrook Laboratories discusses the long term management and prevention options
Vets with Horsepower crosses Iberia
Authors: Wilmink Sanne
Published: November 2019

Sanne Wilmink outlines where the vets have been, the charities that are benefitting from their efforts and, what their plans are for next year
A sophisticated antibiotic-loading protocol in articulating cement spacers for the treatment of prosthetic joint infection
Authors: Yang Chuang , Wang Jin , Yin Zhifei , Wang Qiaojie , Zhang Xianlong , Jiang Yao , Shen Hao
Published: November 2019

Objectives

The optimal protocol for antibiotic loading in the articulating cement spacers for the treatment of prosthetic joint infection (PJI) remains controversial. The objective of the present study was to investigate the effectiveness of articulating cement spacers loaded with a new combination of antibiotics.

Methods

A retrospective cohort study involving 114 PJI cases treated with implantation of an articulating cement spacer between 2005 and 2016 was performed. The treatment outcomes of the conventional protocol (i.e. gentamicin and vancomycin (GV protocol)) were compared with those reported using the sophisticated antibiotic-loading protocol (i.e. vancomycin, meropenem, and amphotericin (VMA protocol)).

Results

There were 62 and 52 PJI cases treated with the GV and VMA protocols, respectively. Antimicrobial susceptibility testing revealed that 22/78 of all isolates (28.2%) in this series were resistant to gentamicin, whereas there were no vancomycin-, meropenem-, or amphotericin-resistant strains. The overall infection recurrence rates were 17.7% (11/62) and 1.9% (1/52), respectively (p = 0.006). In patients with a negative preoperative culture, there was no infection recurrence reported in the VMA cohort (0/45 (0%) vs 10/54 (18.5%) in the GV cohort; p = 0.002). Multivariate analysis indicated that the VMA protocol correlated with a decreased risk of infection recurrence compared with the GV protocol (p = 0.025).

Conclusion

The sophisticated VMA protocol for the loading of antibiotics in articulating cement spacers, as part of a two-stage exchange, was associated with a reduced rate of infection recurrence. This proposed protocol appears to be safe and effective, especially in patients with negative culture results prior to the first-stage operation. Cite this article: Bone Joint Res 2019;8:526–534.
The role of scientific knowledge in dealing with complex policy problems under conditions of uncertainty
Authors: Ylöstalo Hanna
Published: November 2019

This article concerns the recent shifts and tensions in the role of scientific knowledge in policymaking. Policy practitioners are striving to solve a compelling problem: how to deal with complex problems under conditions of uncertainty. This article focuses on two policy reforms in Finland that have been designed to address these issues: strategic governance reform and the take up of a culture of experimentation. It suggests that the knowledge-policy relations within these reforms are characterised by profound tensions between ‘good governance’ and ‘good knowledge’. Whereas good governance demands that knowledge is controlled, good knowledge entails uncertain and uncontrollable elements.
La afición por el cine ante la cultura digital: hacia una caracterización de la cinefilia 2.0
Authors: Abril Valdez José Alberto
Published: November 2019

Resumen: Durante décadas la cinefilia tuvo como paradigma la cultura cinematográfica francesa; se originó a mediados del siglo XX, se vinculaba a un discurso erudito sobre el cine y a unos espacios específicos para su cultivación. Pero la revolución digital instauró nuevas prácticas de consumo cinematográfico e Internet catapultó nuevas cinefilias. En este artículo se analiza el papel de la cultura digital en estas nuevas cinefilias y se describe cómo los jóvenes aficionados al cine encuentran hoy los nuevos espacios virtuales para forjarla y pronunciarla.PALABRAS CLAVE: Cinefilia; cine; estudios de audiencia; cultura fan; comunicación 2.0.
Pharmacokinetic Considerations to Maximize an ADC’s Therapeutic Index
Authors: Thurber Greg
Published: November 2019

The Antibody-drug Conjugate (ADC) field is poised for several significant advances in solid tumors as the industry has built upon knowledge gained over the past several years.

The biggest challenge facing clinical translation of these drugs is improving the therapeutic index (TI). With the use of proven targeting agents (monoclonal antibodies) and proven cancer cytotoxins (e.g. microtubule inhibitors and DNA alkylating agents), increasing delivery to cancer cells while avoiding healthy tissue is the key issue in improving the TI.
Evaluation of Job Satisfaction and Job Related Stress Among Community Pharmacists in North Khartoum and its Impact on Providing Pharmaceutical Care Services
Authors: Tahir Azza Mohamed , Hassan Tarig Mohamed , Ali Ali Awadallah , Babiker Mazin Yousif , Mousnad Mohamed Awad
Published: November 2019

Introduction
Pharmacists and pharmaceutical care services are among the most important tools in providing health services to the society. Pharmacists as the key players in presenting health services, critically impact on the health of the society and if they suffer low job satisfaction, their dissatisfaction may relatively threaten health in the society. This study was conducted to determine Sudanese community pharmacists’ job satisfaction and additionally, some causes of dissatisfaction among community pharmacists and their impact on providing pharmaceutical care services have been evaluated.

Method
The questionnaire was designed after reviewing relevant Literature in addition, The Job Satisfaction survey was used to measure the level of community pharmacists’ satisfaction with their current jobs, and the Toronto Alexithymia Scale (TAS-20) was used to evaluate emotional experience and awareness.

Results and Discussion
Generally low scores of job satisfaction were concluded among pharmacists while most of them were highly satisfied with being pharmacist.

Conclusion
Low levels of job satisfaction which were found among Sudanese community pharmacists could be considered as a deficiency of health system in Sudan. Fortunately, inherent interest in the pharmacy profession found among Sudanese pharmacists is an optimistic point at which policy-makers could develop their modifying policies. Health policy-makers must endeavor to take other steps to issue solutions for this current problem.
EFFECT OF DYNAMIC STRESSES ON THE DURABILITY OF QUARTZ OPTICAL FIBERS IN OPTOELECTRONIC MEASUREMENT DEVICES
Authors: Polyakov A. V.
Published: November 2019

The method of a theoretical estimation of optical fiber durability used in optical fiber sensors as a sensitive element, depending on the nonstationary longitudinal strain arising at dynamic temperature changes is offered. The developed analytical model takes into account design features of a fiber (diameters of a core and cladding, a metal or polymeric covering), doping types, relative humidity of an environment, as well as the temperature dependence of the activation energy and the Young's modulus of the optical fiber, the linear expansion coefficient of the metallic coating. Numerical modeling of optical fiber service life time at dynamic influences of measured temperature and comparison with experimental data is carried out.
Исследование социального доверия информационным технологиям при предоставлении электронных государственных услуг и использовании порталов электронного участия (кейс Санкт-Петербурга)
Authors: Видясова Людмила Александровна , Видясов Евгений Юрьевич , Тенсина Ярослава Дмитриевна
Published: November 2019

В статье представлены результаты опроса жителей Санкт-Петербурга о доверии к информационным технологиям. Исследование проводилось на основе идей акторно-сетевой теории и подхода социального конструирования технологий (SCOT). В опросе приняли участие 600 респондентов (ошибка выборки не превышает 4%, уровень достоверности 95%). В исследовании применяется подход к изучению киберсоциального доверия в сфере коммуникаций G2C: технологии электронного правительства, предоставления онлайн-услуг, электронного участия граждан в управлении городом. Анкета содержала параметры для оценки доверия новым технологиям, используемым для общения с представителями органов власти и получения государственных и общественных услуг, решения городских проблем и участия в управлении городом. Результаты опроса показали высокий уровень использования интернета, а также повышение уровня доверия к финансовым транзакциям через интернет.

Благодарность. Исследование выполнено за счет гранта Российского фонда фундаментальных исследований (проект № 18-311-20001 «Исследование киберсоциального доверия в контексте использования и отказа от информационных технологий»).
«Война мемов»: новые повороты информационного противостояния
Authors: Шомова Светлана Андреевна
Published: November 2019

Среди цифровых феноменов политического дискурса XXI века особое место занимает интернет-мем, понимаемый не только как проявление сетевого творчества, но и как артефакт современной культуры участия, способ публичной дискуссии, инструмент электоральных и протестных коммуникаций. В статье анализируются процессы смыслового противостояния вирусных сообщений рунета, обозначенные как «война мемов», выделяются основные типы подобного противостояния, рассматриваются коммуникативные кейсы последних лет, позволяющие сделать выводы о специфике и технологиях подобной «войны».
Digitale Arbeits- und Organisationsräume
Authors: Sauerborn Elgen
Published: November 2019

Mit der Digitalisierung wandeln sich auch die Räume, in denen Arbeit stattfindet. Diese ist immer weniger an einen bestimmten Ort gebunden, jedoch nicht losgelöst von räumlicher Bedeutsamkeit. Aus diesem Grund wird im vorliegenden Beitrag anhand dreier Dimensionen eine Konzeptionalisierung des digitalen Arbeitsraums vorgeschlagen. Mit Rückbezug auf Grenzziehungen, affektive Relationen und den Informationsraum wird dargelegt, was digitale Arbeitsräume auszeichnet, und Annahmen zur Auflösung räumlicher Bedeutsamkeit werden kritisch hinterfragt. Anhand des Beispiels Crowdworking als eines Prototyps rein digitaler Arbeit wird anschließend erörtert, wie auch digitale Räume wie Plattformen oder Anwendungen als Organisationsräume verstanden werden können. Denn Plattformen übernehmen im Crowdworking die räumliche Funktion von traditionellen Organisationen, was die Notwendigkeit eines breiteren Verständnisses von digitalen Arbeits- und Organisationsräumen hervorruft.
Teilhabe trotz staatlicher Ausgrenzungspolitik
Authors: Huke Nikolai
Published: November 2019

Durch den Prozess einer Flucht wird gesellschaftliche Teilhabe erschwert: Netzwerke der sozialen Interaktion gehen verloren, sprachliche Schwierigkeiten und räumliche Isolation erschweren persönliche Kontakte, fehlendes Systemwissen und eingeschränkte Rechte reduzieren die eigenständige Handlungsfähigkeit. Teilhabe muss daher bei Geflüchteten stärker als bei anderen Gruppen der Bevölkerung aktiv hergestellt werden und bedarf - zumindest teilweise - der Unterstützung durch Andere. Inwiefern es Geflüchteten ermöglicht werden soll, an der Gesellschaft teilzuhaben, ist in Deutschland in den vergangenen Jahren politisch stark umkämpft. Der Artikel identifiziert Handlungslogiken in Bezug auf Teilhabe und veranschaulicht diese an drei verschiedenen Beispielen, wobei jeweils ein spezifischer Akteur als Träger in den Vordergrund gestellt wird: Die pragmatisch-präfigurative und im positiven Sinne naive Praxis der Bewegung der Flüchtlingssolidarität, die realistisch-integrationistische Perspektive der Arbeits- und Sozialverwaltungen sowie eine repressive, isolierend-exkludierende Praxis der Innenministerien. Alltäglicher Unterstützungsarbeit von Geflüchteten kommt vor diesem Hintergrund die demokratische Funktion zu, Teilhabe auch gegen staatliche Ausgrenzungspolitik zu ermöglichen.
Intersektionale Konflikte in sozialen Bewegungen
Authors: Lenz Ilse
Published: November 2019

Der Beitrag untersucht das Wechselverhältnis zwischen intersektionalen Ungleichheiten nach Klasse, ‚Rasse’, Geschlecht oder Begehren und sozialen Bewegungen. Zunächst stellt er verschiedene Varianten von Intersektionalität vor und bringt den Ansatz vonprozessualer Intersektionalitätein. Er schlägt vor, die Teilhabe in sozialen Bewegungen in intersektionaler Sicht alsProzesszu begreifen. Während die Teilhabechancen zu Beginn von ungleichen Positionen beeinflusst sind, bilden Bewegungen dann politische Räume, in denen die unterschiedlichen Akteure um ihre Partizipation darin und deren Symbole und Ziele verhandeln. Diese Prozesse können die Teilhabe verändern, was am Beispiel der Einwanderinnen in der neuen Frauenbewegung konkretisiert wird.
Associations between thyroid-stimulating hormone, blood pressure and adiponectin are attenuated in children and adolescents with overweight or obesity
Authors: Drivsholm Alberte , Lund Morten Asp Vonsild , Hedley Paula L. , Jespersen Thomas , Christiansen Michael , Hansen Torben , Holm Jens-Christian
Published: November 2019

Background

The association between thyroid-stimulating hormone (TSH) concentrations and blood pressure is well described in adults, but only studied to a limited extent in children and adolescents and almost entirely in population-based cohorts. The present study investigates the association between TSH and blood pressure, and the influence of leptin and adiponectin, in a cohort of children and adolescents enrolled in obesity treatment compared with a population-based cohort.

Methods

We studied 4154 children and adolescents aged 6–18 years from an obesity clinic cohort and a population-based cohort from The Danish Childhood Obesity Data- and Biobank. Anthropometrics, blood pressure and biochemical markers, including TSH, leptin and adiponectin concentrations, were collected. Adjusted correlation and interaction analyses were performed.

Results

Patients from the obesity clinic cohort exhibited higher concentrations of TSH and higher blood pressure than participants from the population-based cohort. TSH standard deviation scores (SDS) were significantly associated with all blood pressure-related variables in the population-based cohort, but only with systolic blood pressure SDS and hypertension in the obesity clinic cohort. The interaction between TSH SDS and adiponectin was found to be independently associated with systolic blood pressure and hypertension in the population-based cohort only.

Conclusions

The significant associations between TSH, adiponectin and blood pressure, observed in children and adolescents from a population-based cohort, are attenuated or absent in children and adolescents with overweight or obesity, suggesting that childhood obesity distorts the healthy interplay between the thyroid axis, thyroid-adipokine interaction and blood pressure.
Prolonged ventilation and postnatal growth of preterm infants
Authors: Williams Emma , Dassios Theodore , Arnold Kate , Hickey Ann , Greenough Anne
Published: November 2019

Background

Extremely premature infants often need invasive respiratory support from birth, but have low nutritional reserves and high metabolic demands. Our aim was to determine if there was a relationship between prolonged ventilation and reduced postnatal growth in such infants.

Methods

A retrospective, observational study was undertaken. Data from infants born at less than 28 weeks of gestational age and ventilated for 7 days or more were collected and analysed including gestational age, gender, birth and discharge weight, birth and discharge head circumference, days of invasive mechanical ventilation and use of postnatal corticosteroids. The duration of invasive mechanical ventilation and the differences in weight (ΔWz) and head circumference (ΔHz) z-score from birth to discharge were calculated.

Results

Fifty-five infants were studied with a median [interquartile range (IQR)] gestational age at birth of 25.3 (24.3–26.7) weeks and birth weight of 0.73 (0.65–0.87) kg. The median duration of mechanical ventilation was 45 (33–68) days. Both ΔWz and ΔHz were significantly negatively correlated to the number of invasive mechanical ventilation days (P = 0.01 and P = 0.03, respectively), but not to the use of postnatal corticosteroids.

Conclusion

Poor postnatal growth is significantly negatively associated with a longer duration of mechanical ventilation in extremely prematurely born infants.
Existence, Uniqueness and Stability of Nonlinear Implicit Fractional Dynamical Equation with Impulsive condition on Time Scales
Authors: Kumar Vipin , Malik Muslim
Published: November 2019

The main motive of this research article is to establish the existence, uniqueness and stability results for the non-linear fractional differential equation with impulsive condition on time scales. Banach, Leray-Schauder’s alternative type fixed point theorems are used to examine these results. Further, we give the existence and uniqueness of solution for the corresponding non-local problem. Moreover, to outline the utilization of these outcomes some examples are given.
Sonic environment of Singapore Botanic Gardens and benchmarking with various urban gardens of the world
Authors: Lee Heow Pueh , Lim Kian Meng , Garg Saurabh
Published: November 2019

The urban parks and gardens are usually surrounded by busy streets, commercial buildings and areas of high noise levels due to human activities and heavy traffic. These parks and gardens therefore have a unique function of providing relatively quiet areas to get away from the hustle and bustle of city lives. In this study, the sonic environment of the Singapore Botanic Gardens, which was the first UNESCO Heritage site in Singapore, was measured on various occasions and benchmarked with various urban gardens and parks around the world, namely the Luxembourg Gardens in Paris, Real Jardín Botánico in Madrid. St James’s Park in London, Old Botanical Gardens Hamburg, and Carlton Gardens in Melbourne. The Leq noise level was found to be compatible with the respective Leq noise level of the other urban parks and gardens. The sonic environment of the Singapore Botanic gardens was found to be dominated by cicada sound, human activities and water features. The sound level of various water features such as mini waterfalls and water fountains were also measured and analysed.
Mechanical properties of boron nitride sheet with randomly distributed vacancy defects
Authors: Liang Yingjing , Qin Hongfa , Huang Jianzhang , Huan Sha , Hui David
Published: November 2019

Defects and temperature effects on the mechanical properties of hexagonal boron nitride sheet (h-BN) containing randomly distributed defects are investigated by molecular dynamics simulations and the reasons of the results are discussed. Results show that defect deteriorate the mechanical performance of BNNS. The mechanical properties are reduced by increasing percentage of vacancy defects including fracture strength, fracture strain and Young’s modulus. Simulations also indicate that the mechanical properties decrease with the temperature increasing. Moreover, defects affect the stable configuration at high temperature. With the percentage of defect increases the nanostructures become more and more unstable. Positions of the defect influent the mechanical properties. The higher the temperature and the percentage of defect are, the stronger the position of the randomly distributed defect affects the mechanical properties. The study provides a theoretical basis for the preparation and performance optimization of BNNSs.