Exploring alternative purchasing strategies: just-in-time or just enough?

What are the prevalent purchasing strategies used by manufacturing firms to purchase components that are critical to the quality of their most important products? This research reports the findings from data on purchasing strategies collected from 248 companies. The data indicate that although firms seem to be moving away from a transaction-based purchasing strategy towards partnership relations necessary for successful just-in-time strategies, firms are likely to embrace one of four hybrid purchasing strategies that on a spectrum would fall somewhere between the two pure strategies. These identified strategies offer purchasing managers viable alternatives to moving directly into a just-in-time environment

Rural After-School Programs: Meeting the Needs of At-Risk Youth and Their Families

Extant research has focused on out-of-school time among urban and suburban youth, yet there remains scant information on rural low-income youth and their families. This study examines the salience of after-school programs for rural youth. Using an ecological framework, we assess changes in youth behavior and skill acquisition based on reports from 47 youth attending after-school programs in two rural communities, along with their primary caregivers and teachers. Results indicate enhanced life skills and social behaviors among youth attendees. Implications for future research, programming, and policymaking are discussed

Formation of large viroplasms and virulence of Cauliflower mosaic virus in turnip plants depend on the N-terminal EKI sequence of viral protein TAV

International audienc

Rationale and design of the Novel Uses of adaptive Designs to Guide provider Engagement in Electronic Health Records (NUDGE-EHR) pragmatic adaptive randomized trial: a trial protocol

Background: The prescribing of high-risk medications to older adults remains extremely common and results in potentially avoidable health consequences. Efforts to reduce prescribing have had limited success, in part because they have been sub-optimally timed, poorly designed, or not provided actionable information. Electronic health record (EHR)-based tools are commonly used but have had limited application in facilitating deprescribing in older adults. The objective is to determine whether designing EHR tools using behavioral science principles reduces inappropriate prescribing and clinical outcomes in older adults. Methods: The Novel Uses of Designs to Guide provider Engagement in Electronic Health Records (NUDGE-EHR) project uses a two-stage, 16-arm adaptive randomized pragmatic trial with a “pick-the-winner” design to identify the most effective of many potential EHR tools among primary care providers and their patients ≥ 65 years chronically using benzodiazepines, sedative hypnotic (“Z-drugs”), or anticholinergics in a large integrated delivery system. In stage 1, we randomized providers and their patients to usual care (n = 81 providers) or one of 15 EHR tools (n = 8 providers per arm) designed using behavioral principles including salience, choice architecture, or defaulting. After 6 months of follow-up, we will rank order the arms based upon their impact on the trial’s primary outcome (for both stages): reduction in inappropriate prescribing (via discontinuation or tapering). In stage 2, we will randomize (a) stage 1 usual care providers in a 1:1 ratio to one of the up to 5 most promising stage 1 interventions or continue usual care and (b) stage 1 providers in the unselected arms in a 1:1 ratio to one of the 5 most promising interventions or usual care. Secondary and tertiary outcomes include quantities of medication prescribed and utilized and clinically significant adverse outcomes. Discussion: Stage 1 launched in October 2020. We plan to complete stage 2 follow-up in December 2021. These results will advance understanding about how behavioral science can optimize EHR decision support to improve prescribing and health outcomes. Adaptive trials have rarely been used in implementation science, so these findings also provide insight into how trials in this field could be more efficiently conducted. Trial registration: Clinicaltrials.gov (NCT04284553, registered: February 26, 2020

Laser microdissection and mass spectrometry–based proteomics aids the diagnosis and typing of renal amyloidosis

Accurate diagnosis and typing of renal amyloidosis is critical for prognosis, genetic counseling, and treatment. Laser microdissection and mass spectrometry are emerging techniques for the analysis and diagnosis of many renal diseases. Here we present the results of laser microdissection and mass spectrometry performed on 127 cases of renal amyloidosis during 2008–2010. We found the following proteins in the amyloid deposits: immunoglobulin light and heavy chains, secondary reactive serum amyloid A protein, leukocyte cell–derived chemotaxin-2, fibrinogen-α chain, transthyretin, apolipoprotein A-I and A-IV, gelsolin, and β-2 microglobulin. Thus, laser microdissection of affected areas within the kidney followed by mass spectrometry provides a direct test of the composition of the deposit and forms a useful ancillary technique for the accurate diagnosis and typing of renal amyloidosis in a single procedure

The main and accessory olfactory systems interact in the control of mate recognition and sexual behavior

Peer reviewe

Optimising intraperitoneal gentamicin dosing in peritoneal dialysis patients with peritonitis (GIPD) study

Background: Antibiotics are preferentially delivered via the peritoneal route to treat peritonitis, a major complication of peritoneal dialysis (PD), so that maximal concentrations are delivered at the site of infection. However, drugs administered intraperitoneally can be absorbed into the systemic circulation. Drugs excreted by the kidneys accumulate in PD patients, increasing the risk of toxicity. The aim of this study is to examine a model of gentamicin pharmacokinetics and to develop an intraperitoneal drug dosing regime that maximises bacterial killing and minimises toxicity

Air Quality Forecasts Using the NASA GEOS Model

We provide an introduction to a new high-resolution (0.25 degree) global composition forecast produced by NASA's Global Modeling and Assimilation office. The NASA Goddard Earth Observing System version 5 (GEOS-5) model has been expanded to provide global near-real-time forecasts of atmospheric composition at a horizontal resolution of 0.25 degrees (~25 km). Previously, this combination of detailed chemistry and resolution was only provided by regional models. This system combines the operational GEOS-5 weather forecasting model with the state-of-the-science GEOS-Chem chemistry module (version 11) to provide detailed chemical analysis of a wide range of air pollutants such as ozone, carbon monoxide, nitrogen oxides, and fine particulate matter (PM2.5)

Air Quality Forecasts Using the NASA GEOS Model

We provide an introduction to a new high-resolution (0.25 degree) global composition forecast produced by NASA's Global Modeling and Assimilation office. The NASA Goddard Earth Observing System version 5 (GEOS-5) model has been expanded to provide global near-real-time forecasts of atmospheric composition at a horizontal resolution of 0.25 degrees (~25 km). Previously, this combination of detailed chemistry and resolution was only provided by regional models. This system combines the operational GEOS-5 weather forecasting model with the state-of-the-science GEOS-Chem chemistry module (version 11) to provide detailed chemical analysis of a wide range of air pollutants such as ozone, carbon monoxide, nitrogen oxides, and fine particulate matter (PM2.5). The resolution of the forecasts is the highest resolution compared to current, publically-available global composition forecasts. Evaluation and validation of modeled trace gases and aerosols compared to surface and satellite observations will be presented for constituents relative to health air quality standards. Comparisons of modeled trace gases and aerosols against satellite observations show that the model produces realistic concentrations of atmospheric constituents in the free troposphere. Model comparisons against surface observations highlight the model's capability to capture the diurnal variability of air pollutants under a variety of meteorological conditions. The GEOS-5 composition forecasting system offers a new tool for scientists and the public health community, and is being developed jointly with several government and non-profit partners. Potential applications include air quality warnings, flight campaign planning and exposure studies using the archived analysis fields

PUF60 variants cause a syndrome of ID, short stature, microcephaly, coloboma, craniofacial, cardiac, renal and spinal features.

PUF60 encodes a nucleic acid-binding protein, a component of multimeric complexes regulating RNA splicing and transcription. In 2013, patients with microdeletions of chromosome 8q24.3 including PUF60 were found to have developmental delay, microcephaly, craniofacial, renal and cardiac defects. Very similar phenotypes have been described in six patients with variants in PUF60, suggesting that it underlies the syndrome. We report 12 additional patients with PUF60 variants who were ascertained using exome sequencing: six through the Deciphering Developmental Disorders Study and six through similar projects. Detailed phenotypic analysis of all patients was undertaken. All 12 patients had de novo heterozygous PUF60 variants on exome analysis, each confirmed by Sanger sequencing: four frameshift variants resulting in premature stop codons, three missense variants that clustered within the RNA recognition motif of PUF60 and five essential splice-site (ESS) variant. Analysis of cDNA from a fibroblast cell line derived from one of the patients with an ESS variants revealed aberrant splicing. The consistent feature was developmental delay and most patients had short stature. The phenotypic variability was striking; however, we observed similarities including spinal segmentation anomalies, congenital heart disease, ocular colobomata, hand anomalies and (in two patients) unilateral renal agenesis/horseshoe kidney. Characteristic facial features included micrognathia, a thin upper lip and long philtrum, narrow almond-shaped palpebral fissures, synophrys, flared eyebrows and facial hypertrichosis. Heterozygote loss-of-function variants in PUF60 cause a phenotype comprising growth/developmental delay and craniofacial, cardiac, renal, ocular and spinal anomalies, adding to disorders of human development resulting from aberrant RNA processing/spliceosomal function