European Paediatric Formulation Initiative workshop report: Improving the administration of oral liquid medicines in paediatrics using dosing syringes and enteral accessories

Accurate dosing of the right medicine to the right patient is a key element of safe and efficacious pharmacotherapy, yet prone to technical challenges and human error when dosing involves the administration of small volumes of liquid medicines. For this reason, the topic has gained increased attention over the last decade from multiple stakeholder parties e.g. academia, hospital pharmacy, the medical device and pharmaceutical industry, and regulatory agencies. It is now well acknowledged that spoons and cups are not suitable for the measurement of small volumes of oral liquid medicines and that syringes are a better alternative, but syringes for parenteral use should not be used for oral dosing in order to avoid accidental parenteral delivery of oral products. However, dosing accuracy of very small volumes of liquid medicines to young children, and especially pre-term neonates, is still not sufficiently ensured. A workshop was organised in 2018 by the European Paediatric Formulation Initiative to reflect on current status and challenges (first part) and possible strategies to improve the present situation (second part). A voting system (n = 24) was used to consider the most favourable solutions. The harmonisation and/or standardisation of the technical design of oral syringes (including e.g. female/male connection) was considered a key priority

Magnet reliability in the Fermilab Main Injector and implications for the ILC

The International Linear Collider reference design requires over 13000 magnets, of approximately 135 styles, which must operate with very high reliability. The Fermilab Main Injector represents a modern machine with many conventional magnet styles, each of significant quantity, that has now accumulated many hundreds of magnet-years of operation. We review here the performance of the magnets built for this machine, assess their reliability and categorize the failure modes, and discuss implications for reliability of similar magnet styles expected to be used at the ILC

Birmingham’s Eastside story: making steps towards sustainability?

Sustainability has come to play a dominant discursive role in the UK planning system, particularly relating to urban regeneration. The purpose of this paper is to evaluate the role that sustainability plays in a major regeneration programme, known as Eastside, currently underway in Birmingham, the UK. That this £6 billion redevelopment is now widely talked about by such key players as Birmingham City Council and the Regional Development Agency, Advantage West Midlands, as having a central sustainability agenda points to the growing importance of the ideal of sustainability in planning and regeneration agendas. In this paper, we investigate in detail how and why sustainability has become part of the planning discourse for Eastside and critically evaluate what impact, if any, this is having on public policy decision-making

Germline mutations in MAP3K6 are associated with familial gastric cancer

Gastric cancer is among the leading causes of cancer-related deaths worldwide. While heritable forms of gastric cancer are relatively rare, identifying the genes responsible for such cases can inform diagnosis and treatment for both hereditary and sporadic cases of gastric cancer. Mutations in the E-cadherin gene, CDH1, account for 40% of the most common form of familial gastric cancer (FGC), hereditary diffuse gastric cancer (HDGC). The genes responsible for the remaining forms of FGC are currently unknown. Here we examined a large family from Maritime Canada with FGC without CDH1 mutations, and identified a germline coding variant (p.P946L) in mitogen-activated protein kinase kinase kinase 6 (MAP3K6). Based on conservation, predicted pathogenicity and a known role of the gene in cancer predisposition, MAP3K6 was considered a strong candidate and was investigated further. Screening of an additional 115 unrelated individuals with non-CDH1 FGC identified the p.P946L MAP3K6 variant, as well as four additional coding variants in MAP3K6 (p.F849Sfs*142, p.P958T, p.D200Y and p.V207G). A somatic second-hit variant (p.H506Y) was present in DNA obtained from one of the tumor specimens, and evidence of DNA hypermethylation within the MAP3K6 gene was observed in DNA from the tumor of another affected individual. These findings, together with previous evidence from mouse models that MAP3K6 acts as a tumor suppressor, and studies showing the presence of somatic mutations in MAP3K6 in non-hereditary gastric cancers and gastric cancer cell lines, point towards MAP3K6 variants as a predisposing factor for FGC.The following agencies provided funding for this project: Genome Canada, Genome Atlantic, Nova Scotia Health Research Foundation, Nova Scotia Research and Innovation Trust, Dalhousie Faculty of Medicine, Dalhousie Department of Ophthalmology, Health Canada, The Centre for Drug Research and Development, Capital District Health Authority, IWK Health Centre Foundation, Capital Health Research Fund, and The COMPETE/FEDER Portuguese Foundation for Science and Technology (FCT), Projects Ref. FCT PTDC/SAU-GMG/110785/2009 and Post-doc grant SFRH/BPD/79499/2011 to HP “financiados no âmbito do Programa Operacional Temático Factores de Competitividade (COMPETE) e comparticipado pelo fundo Comunitário Europeu FEDER.” MES is supported by the CHU Ste-Justine Centre de Recherche. The authors would like to acknowledge the contribution of: the Genome Quebec High Throughput Sequencing Platform; and Sónia Sousa and José Carlos Machado from the IPATIMUP Diagnostics Unit, Porto, Portugal. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

Comparing nuclear power trajectories in Germany and the UK: from ‘regimes' to ‘democracies’ in sociotechnical transitions and Discontinuities

This paper focuses on arguably the single most striking contrast in contemporary major energy politics in Europe (and even the developed world as a whole): the starkly differing civil nuclear policies of Germany and the UK. Germany is seeking entirely to phase out nuclear power by 2022. Yet the UK advocates a ‘nuclear renaissance’, promoting the most ambitious new nuclear construction programme in Western Europe.Here,this paper poses a simple yet quite fundamental question: what are the particular divergent conditions most strongly implicated in the contrasting developments in these two countries. With nuclear playing such an iconic role in historical discussions over technological continuity and transformation, answering this may assist in wider understandings of sociotechnical incumbency and discontinuity in the burgeoning field of‘sustainability transitions’. To this end, an ‘abductive’ approach is taken: deploying nine potentially relevant criteria for understanding the different directions pursued in Germany and the UK. Together constituted by 30 parameters spanning literatures related to socio-technical regimes in general as well as nuclear technology in particular, the criteria are divided into those that are ‘internal’ and ‘external’ to the ‘focal regime configuration’ of nuclear power and associated ‘challenger technologies’ like renewables. It is ‘internal’ criteria that are emphasised in conventional sociotechnical regime theory, with ‘external’ criteria relatively less well explored. Asking under each criterion whether attempted discontinuation of nuclear power would be more likely in Germany or the UK, a clear picture emerges. ‘Internal’ criteria suggest attempted nuclear discontinuation should be more likely in the UK than in Germany– the reverse of what is occurring. ‘External’ criteria are more aligned with observed dynamics –especially those relating to military nuclear commitments and broader ‘qualities of democracy’. Despite many differences of framing concerning exactly what constitutes ‘democracy’, a rich political science literature on this point is unanimous in characterising Germany more positively than the UK. Although based only on a single case,a potentially important question is nonetheless raised as to whether sociotechnical regime theory might usefully give greater attention to the general importance of various aspects of democracy in constituting conditions for significant technological discontinuities and transformations. If so, the policy implications are significant. A number of important areas are identified for future research, including the roles of diverse understandings and specific aspects of democracy and the particular relevance of military nuclear commitments– whose under-discussion in civil nuclear policy literatures raises its own questions of democratic accountability

Anatomical study of the female reproductive system and bacteriome of Diaphorina citri Kuwayama, (Insecta: Hemiptera, Liviidae) using micro-computed tomography

Huanglongbing (HLB) (citrus greening disease) is one of the most serious bacterial diseases of citrus. It is caused by (1) Candidatus Liberibacter africanus, transmitted by Trioza erytreae and (2) C.L. asiaticus and C.L. americanus, transmitted by Diaphorina citri. As part of a multidisciplinary project on D. citri (www.citrusgreening.org), we made a detailed study, using micro-computed tomography, of the female abdominal terminalia, reproductive system (ovaries, accessory glands, spermatheca, colleterial (= cement) gland, connecting ducts, and ovipositor) and bacteriome, which we present here. New terms and structures are introduced and described, particularly concerning the spermatheca, ovipositor and bacteriome. The quality of images and bacteriome reconstructions are comparable, or clearer, than those previously published using a synchrotron or fuorescence in situ hybridisation (FISH). This study: reviews knowledge of the female reproductive system and bacteriome organ in D. citri; represents the frst detailed morphological study of D. citri to use micro-CT; and extensively revises existing morphological information relevant to psylloids, hemipterans and insects in general. High quality images and supplementary videos represent a signifcant advance in knowledge of psylloid anatomy and are useful tools for future research and as educational aids.Kansas State University (KSU) S15192.01University of Granada, USDA-NIFA S15192.01 2014-70016-2302

Trends in the perceived body size of adolescent males and females in Scotland, 1990–2014: changing associations with mental well-being

Objectives: This paper explores trends in Scottish adolescents’ body size perceptions and associated mental well-being outcomes. Methods: Data were collected on Scottish 11, 13 and 15-year olds by the Health Behaviour in School-aged Children study between 1990 and 2014 (n=42,312). Logistic regression was used to examine changes in the prevalence of over- and underweight perceptions. Ordinal and linear regression was used to examine changes in the association between body perception and mental well-being. Results: Little change was observed in over- or under-weight perceptions between 1990 and 2014. However, relative to those perceiving their body as ‘about right’, those perceiving themselves as overweight reported decreasing confidence (all groups), decreasing happiness (11- and 13-year old girls) and increasing psychological symptoms (all girls and 15 year-old boys). Perceived underweight is associated with poor well-being, especially in males, but we present little evidence that this is a recent phenomenon. Conclusions: We present evidence suggesting that the influence of body image on adolescent mental health is increasing over time. This may play a role in the recently observed worsening of mental well-being in Scottish adolescents.Publisher PDFPeer reviewe

A Systemic approach to scoping of factors influencing more sustainable land use in Herefordshire

Defining and putting into practice sustainable land use is a complex, systemic problem. Systems models and techniques were used in a study of Herefordshire to clarify the situation and identify the potential for a more locally focused, learning-based approach to land use. Issues included: (i) uncertainty about the boundary of a 'system of sustainable Herefordshire land use'; (ii) the complexity of economic flows in the county and the absence of some critical data; (iii) the importance of the Herefordshire landscape to tourism and the role of agriculture as a determinant of the state of that landscape; (iv) weakness of the institutional linkage between tourism and agriculture; (v) the current lack of inclusion of many relevant stakeholders in concerted action. Factors favouring a learning approach included a strong local identity, local food-related developments, and educational initiatives. Barriers to such an approach included questions of power and landholding, government policies, and attitudes and skills within organizations. These findings are considered in relation to the wider debate over approaches to sustainability

Challenges and Lessons Learned from fabrication, testing and analysis of eight MQXFA Low Beta Quadrupole magnets for HL-LHC

By the end of October 2022, the US HL-LHC Accelerator Upgrade Project (AUP) had completed fabrication of ten MQXFA magnets and tested eight of them. The MQXFA magnets are the low beta quadrupole magnets to be used in the Q1 and Q3 Inner Triplet elements of the High Luminosity LHC. This AUP effort is shared by BNL, Fermilab, and LBNL, with strand verification tests at NHMFL. An important step of the AUP QA plan is the testing of MQXFA magnets in a vertical cryostat at BNL. The acceptance criteria that could be tested at BNL were all met by the first four production magnets (MQXFA03-MQXFA06). Subsequently, two magnets (MQXFA07 and MQXFA08) did not meet some criteria and were disassembled. Lessons learned during the disassembly of MQXFA07 caused a revision to the assembly specifications that were used for MQXFA10 and subsequent magnets. In this paper, we present a summary of: 1) the fabrication and test data of all the MQXFA magnets; 2) the analysis of MQXFA07/A08 test results with characterization of the limiting mechanism; 3) the outcome of the investigation, including the lessons learned during MQXFA07 disassembly; and 4) the finite element analysis correlating observations with test performance