The quest for sustained multiple morbidity reduction in very low-birth-weight infants: the Antifragility project.

OBJECTIVE: Can a comprehensive, explicitly directive evidence-based guideline for all therapies that might affect the major morbidities of very low-birth-weight (VLBW) infants help a neonatal intensive care unit (NICU) further improve generally favorable morbidity rates? Can Antifragility principles of provider adaptive growth from stressors, enhanced infant risk assessment and adherence to effective therapies minimize unproven treatments and reduce all morbidities? STUDY DESIGN: Prospectively planned observational trial in VLBW infants: control group born October 2011 to September 2013 and study group October 2013 to September 2015. Multi-disciplinary evidence-based review assigned all NICU treatments into one of four distinct categories: (1) always employ this therapy for VLBW infants, (2) never use this therapy, (3) employ this questionable therapy thoughtfully, only in certain circumstances and (4) this therapy has insufficient evidence of efficacy and safety. Extensive staff education emphasized evidence-based potentially better practice (PBP) selection with compliance checks, appreciation of intertwined co-morbidities and prioritizing infant risk reduction strategies. RESULTS: Control included 221 infants, mean (s.d.) age 29 (2.6) weeks, birth weight 1129 (257) g and Study included 197 infants, 29 (2.7) weeks, 1093 (292) g. One hundred and four distinct therapies were placed into categories 1 to 4, with 32 specific compliance checks. Overall mean compliance with the process checks during the second era was 70%, high: 100% (exclusive breast milk use), low: 24% (correct pulse oximetry alarm settings). Morbidity and mortality rates did not significantly change during the second era. CONCLUSIONS: In our NICU with favorable morbidity rates, an expanded effort using a comprehensive therapy guideline for VLBW infants did not further improve outcomes. We need deeper understanding of continuous quality improvement (CQI) fundamentals, therapy compliance, co-morbidity relationships and enhanced sensitivity of risk assessment. Our innovative Antifragility PBP guideline could be useful to other NICUs seeking improvement in VLBW infant morbidities, as we offer a reasoned and concise template of a broad array of therapies categorized efficiently for transparency and review, designed to enhance responsible CQI decision-making

Enhanced direct oxidation of diclofenac (DCF) at a carbon paste electrode (CPE) modified with cellulose and its biodegradability by Scedosporium dehoogii

A novel carbon paste electrode modified with cellulose fibers and dedicated to diclofenac electroanalysis was prepared, optimized, and used for the determination of the kinetic parameters of DCF biodegradation by a filamentous fungus. The electrochemical response of the modified CPE was compared to that of the unmodified. This study conducted by cyclic voltammetry and linear sweep voltammetry allowed the optimization of the cellulose fibers modified CPE in terms of absence/presence of cellulose fibers, accumulation time (250 s), and initial potential (- 0.4 V/Ag/AgCl). Interestingly, in these conditions, the limit of detection observed through linear sweet voltammetry was found to be as low as 0.020 µmol L-1. This electrode was then used to follow the degradation of DCF. Our results demonstrated that among species belonging to the Scedosporium genus, S. dehoogii displayed the best assets in our process in terms of growth temperature and ability to metabolize DCF. More precisely, DCF biodegradation using S. dehoogii in the process revealed a kinetic of order of 1, a kinetic constant k of 0.012 day-1 and a half time of 57.8 days for an initial concentration of DCF of 1.65 ± 0.05 mg L-1 and at a temperature of 25°C. This study constitutes a solid proof of concept for future developments of fungal wastewater treatments for bioremediation of DCF which is refractory to standard bacterial-based bioprocesses

Submarine record of volcanic island construction and collapse in the Lesser Antilles arc: First scientific drilling of submarine volcanic island landslides by IODP Expedition 340

IODP Expedition 340 successfully drilled a series of sites offshore Montserrat, Martinique and Dominica in the Lesser Antilles from March to April 2012. These are among the few drill sites gathered around volcanic islands, and the first scientific drilling of large and likely tsunamigenic volcanic island-arc landslide deposits. These cores provide evidence and tests of previous hypotheses for the composition and origin of those deposits. Sites U1394, U1399, and U1400 that penetrated landslide deposits recovered exclusively seafloor-sediment, comprising mainly turbidites and hemipelagic deposits, and lacked debris avalanche deposits. This supports the concepts that i/ volcanic debris avalanches tend to stop at the slope break, and ii/ widespread and voluminous failures of pre-existing low-gradient seafloor sediment can be triggered by initial emplacement of material from the volcano. Offshore Martinique (U1399 and 1400), the landslide deposits comprised blocks of parallel strata that were tilted or micro-faulted, sometimes separated by intervals of homogenized sediment (intense shearing), while Site U1394 offshore Montserrat penetrated a flat-lying block of intact strata. The most likely mechanism for generating these large-scale seafloor-sediment failures appears to be propagation of a decollement from proximal areas loaded and incised by a volcanic debris avalanche. These results have implications for the magnitude of tsunami generation. Under some conditions, volcanic island landslide deposits comprised of mainly seafloor sediment will tend to form smaller magnitude tsunamis than equivalent volumes of subaerial block-rich mass flows rapidly entering water. Expedition 340 also successfully drilled sites to access the undisturbed record of eruption fallout layers intercalated with marine sediment which provide an outstanding high-resolution dataset to analyze eruption and landslides cycles, improve understanding of magmatic evolution as well as offshore sedimentation processes. This article is protected by copyright. All rights reserved

Rapid onset of mafic magmatism facilitated by volcanic edifice collapse

Volcanic edifice collapses generate some of Earth's largest landslides. How such unloading affects the magma storage systems is important for both hazard assessment and for determining long-term controls on volcano growth and decay. Here we present a detailed stratigraphic and petrological analyses of volcanic landslide and eruption deposits offshore Montserrat, in a subduction zone setting, sampled during Integrated Ocean Drilling Program Expedition 340. A large (6–10 km3) collapse of the Soufrière Hills Volcano at ~130 ka was followed by explosive basaltic volcanism and the formation of a new basaltic volcanic center, the South Soufrière Hills, estimated to have initiated <100 years after collapse. This basaltic volcanism was a sharp departure from the andesitic volcanism that characterized Soufrière Hills' activity before the collapse. Mineral-melt thermobarometry demonstrates that the basaltic magma's transit through the crust was rapid and from midcrustal depths. We suggest that this rapid ascent was promoted by unloading following collapse

Study of the plant COPII vesicle coat subunits by functional complementation of yeast Saccharomyces cerevisiae mutants

The formation and budding of endoplasmic reticulum ER-derived vesicles depends on the COPII coat protein complex that was first identified in yeast Saccharomyces cerevisiae. The ER-associated Sec12 and the Sar1 GTPase initiate the COPII coat formation by recruiting the Sec23-Sec24 heterodimer following the subsequent recruitment of the Sec13-Sec31 heterotetramer. In yeast, there is usually one gene encoding each COPII protein and these proteins are essential for yeast viability, whereas the plant genome encodes multiple isoforms of all COPII subunits. Here, we used a systematic yeast complementation assay to assess the functionality of Arabidopsis thaliana COPII proteins. In this study, the different plant COPII subunits were expressed in their corresponding temperature-sensitive yeast mutant strain to complement their thermosensitivity and secretion phenotypes. Secretion was assessed using two different yeast cargos: the soluble alpha-factor pheromone and the membranous v-SNARE (vesicle-soluble NSF (N-ethylmaleimide-sensitive factor) attachment protein receptor) Snc1 involved in the fusion of the secretory vesicles with the plasma membrane. This complementation study allowed the identification of functional A. thaliana COPII proteins for the Sec12, Sar1, Sec24 and Sec13 subunits that could represent an active COPII complex in plant cells. Moreover, we found that AtSec12 and AtSec23 were co-immunoprecipitated with AtSar1 in total cell extract of 15 day-old seedlings of A. thaliana. This demonstrates that AtSar1, AtSec12 and AtSec23 can form a protein complex that might represent an active COPII complex in plant cells

Btn3 regulates the endosomal sorting function of the yeast Ent3 epsin, an adaptor for SNARE proteins

Ent3 and Ent5 are yeast epsin N-terminal homology (ENTH) domain-containing proteins involved in protein trafficking between the Golgi and late endosomes. They interact with clathrin, clathrin adaptors at the Golgi (AP-1 and GGA) and different SNAREs (Vti1, Snc1, Pep12 and Syn8) required for vesicular transport at the Golgi and endosomes. To better understand the role of these epsins in membrane trafficking, we performed a protein-protein interaction screen. We identified Btn3 (also known as Tda3), a putative oxidoreductase, as a new partner of both Ent3 and Ent5. Btn3 is a negative regulator of the Batten-disease-linked protein Btn2 involved in the retrieval of specific SNAREs (Vti1, Snc1, Tlg1 and Tlg2) from the late endosome to the Golgi. We show that Btn3 endosomal localization depends on the epsins Ent3 and Ent5. We demonstrated that in btn3Delta mutant cells, endosomal sorting of ubiquitylated cargos and endosomal recycling of the Snc1 SNARE are delayed. We thus propose that Btn3 regulates the sorting function of two adaptors for SNARE proteins, the epsin Ent3 and the Batten-disease-linked protein Btn2

Chapter 7 : Use of Assessments to Inform Educational Policies in French-Speaking Belgium

In French-speaking Belgium, the national assessments developed only lately, and there are not yet national assessments developed by professionals that can be used to evaluate trends. Therefore, the only tools available to rigorously evaluate trends are international assessments. French-speaking Belgium has participated in international assessments since the early 1970s and their results are highly valued by policy-makers. Their level of awareness of the strengths and weaknesses of the education system can be considered as good. However, until recently, the impact of international assessments on education policies has been limited. Only scattered initiatives have been taken. From 2014, an extremely ambitious plan called Pacte pour un enseignement d’excellence has been launched. The Pact tackles most of the systemic weaknesses of the education system in FS Belgium and addresses at the same time structural change (lowering grade repetition, moving to a comprehensive lower secondary education), curricular changes and governance in a long-term perspective. A significant reform of the system of national assessments is currently under discussion