Tun: Reliable Modalities

Unified ubiquitous models have led to many essential advances, including redundancy and sen- sor networks. In fact, few developers would disagree with the understanding of cache coherence. In order to fulfill this goal, we prove that though the acclaimed homogeneous algorithm for the refinement of superpages by G. Wang et al. [14] is maximally efficient, replication and multicast systems can agree to surmount this issue

Higher Education Instructional Change in a U.S. Context: Investigating the Scholarship of Teaching and Learning (SoTL) Innovations at Niagara University

A metà Settembre 2013, due degli autori di questo articolo sono stati a Lecce (Italia) realizzando una presentazionein una conferenza sull’istruzione superiore. In quella sede, è stato possibile condividere con i partecipanti i dieci cambiamenti più potenti e significativi che hanno avuto luogo nel vasto panoramadell’accademia americana. L’elenco si componeva di sviluppi di tipo teorico; così come da diversi livelli di implementazione e pratica presso l’Università di Niagara, nell’angolo Nord Est degli Stati Uniti. Tra le iniziative messe in evidenza è stata prima e soprattutto menzionato il lavoro di Ernest Boyer sulla Scholarshipof Teaching and Learning (SoTL), ovvero la sua visione su strade alternative comunque accademiche, basate sulla didattica, per il successo della formazione universitaria. Il percorso tracciato dal movimento SoTL cambia la cultura universitaria, collocando l’insegnamento come priorità; e la “scholarship” (ricerca didattica) emergente dagli studi sull’innovazione didattica come una disciplina di ricerca che può alinearse ad altre nell’ambito accademico. Le esperienze all’Università Niagara forniscono sia un caso di studio dell’implementazione dei suddetti concetti in una moderna istituzione americana; sia un’opportunità per la comparazione con i vari casi delle istituzioni italiane. Inoltre, il lavoro portato avanti dall’università di Niagara risulta competitivo con riguardo ad alcune delle più riconosciute università americane, potendo essere considerato all’avanguardia dell’emergente movimentoSoTL. Questo articolo fornisce un breve resoconto e definizione del modello di Boyer su SoTL, suggerendo come le istituzioni potrebbero adottare tale paradigma sia come strategia per lo sviluppo professionale accademico, sia come adeguata base per la valutazione del lavoro del docente universitario

Management of diarrhea in patients with HER2-positive breast cancer treated with neratinib: A case series and summary of the literature

INTRODUCTION: Neratinib and neratinib-based combinations have demonstrated efficacy for treatment of human epidermal growth factor receptor 2-positive (HER2+) early-stage and metastatic breast cancers. However, diarrhea has been reported as a common adverse event leading to neratinib discontinuation. Results from the CONTROL trial suggest that proactive diarrhea management with antidiarrheal prophylaxis or dose escalation of neratinib from a lower starting dose to the full FDA-approved dose of 240 mg/day can reduce the incidence, duration, and severity of neratinib-associated diarrhea in patients with early-stage breast cancer. Dose escalation has been included in the FDA-approved label for both early-stage and metastatic HER2+ breast cancer since June 2021. CASE SERIES: This series of five cases details real-world clinical implementation of strategies for management of neratinib-induced diarrhea in patients with early-stage and metastatic HER2+ breast cancer, including a patient with a pre-existing gastrointestinal disorder. MANAGEMENT AND OUTCOME: In four of five cases, diarrhea was managed with neratinib dose escalation, and antidiarrheal prophylaxis with loperamide plus colestipol was used in the remaining case. Management of diarrhea allowed all patients to remain on therapy. DISCUSSION: This case series shows that neratinib-associated diarrhea can be managed effectively with neratinib dose escalation from a lower initial starting dose and/or prophylactic antidiarrheal medications in a real-world clinical setting. The findings highlight the importance of patient-provider communication in proactive management of adverse events. Widespread implementation of the strategies described here may improve adherence and thereby clinical outcomes for patients with HER2+ breast cancer treated with neratinib

Infection of ectocervical tissue and universal targeting of T-cells mediated by primary non-macrophage-tropic and highly macrophage-tropic HIV-1 R5 envelopes

BACKGROUND: HIV-1 variants carrying non-macrophage-tropic HIV-1 R5 envelopes (Envs) are predominantly transmitted and persist in immune tissue even in AIDS patients who have highly macrophage-tropic variants in the brain. Non-macrophage-tropic R5 Envs require high levels of CD4 for infection contrasting with macrophage-tropic Envs, which can efficiently mediate infection of cells via low CD4. Here, we investigated whether non-macrophage-tropic R5 Envs from the acute stage of infection (including transmitted/founder Env) mediated more efficient infection of ectocervical explant cultures compared to non-macrophage-tropic and highly macrophage-tropic R5 Envs from late disease. RESULTS: We used Env+ pseudovirions that carried a GFP reporter gene to measure infection of the first cells targeted in ectocervical explant cultures. In straight titrations of Env+ pseudovirus supernatants, mac-tropic R5 Envs from late disease mediated slightly higher infectivities for ectocervical explants although this was not significant. Surprisingly, explant infection by several T/F/acute Envs was lower than for Envs from late disease. However, when infectivity for explants was corrected to account for differences in the overall infectivity of each Env+ pseudovirus (measured on highly permissive HeLa TZM-bl cells), non-mac-tropic early and late disease Env+ pseudoviruses mediated significantly higher infection. This observation suggests that cervical tissue preferentially supports non-mac-tropic Env+ viruses compared to mac-tropic viruses. Finally, we show that T-cells were the main targets for infection regardless of whether explants were stimulated with T-cell or monocyte/macrophage cytokines. There was no evidence of macrophage infection even for pseudovirions carrying highly mac-tropic Envs from brain tissue or for the highly mac-tropic, laboratory strain, BaL, which targeted T-cells in the explant tissue. CONCLUSIONS: Our data support ectocervical tissue as a favorable environment for non-mac-tropic HIV-1 R5 variants and emphasize the role of T-cells as initial targets for infection even for highly mac-tropic variants

A Prospective, Controlled Trial of a Protocol-based Strategy to Discontinue Mechanical Ventilation

Weaning protocols can improve outcomes, but their efficacy may vary with patient and staff characteristics. In this prospective, controlled trial, we compared protocol-based weaning to usual, physiciandirected weaning in a closed medical intensive care unit (ICU) with high physician staffing levels and structured, system-based rounds. Adult patients requiring mechanical ventilation for more than 24 hours were assigned to usual care (UC) or protocol weaning based on their hospital identification number. Patients assigned to UC (n ϭ 145) were managed at their physicians' discretion. Patients assigned to protocol (n ϭ 154) underwent daily screening and a spontaneous breathing trial by respiratory and nursing staff without physician intervention. There were no significant baseline differences in patient characteristics between groups

Science Communication Demands a Critical Approach That Centers Inclusion, Equity, and Intersectionality

We live in an era of abundant scientific information, yet access to information and to opportunities for substantive public engagement with the processes and outcomes of science are still inequitably distributed. Even with increasing interest in science communication and public engagement with science, historically marginalized and minoritized individuals and communities are largely overlooked and undervalued in these efforts. To address this gap, this paper aims to define inclusive science communication and clarify and amplify the field. We present inclusive science communication as one path forward to redress the systemic problems of inequitable access to and engagement with STEMM (science, technology, engineering, mathematics, and medicine). We describe the first national Inclusive Science Communication (InclusiveSciComm) Symposium held in the U.S. Based on the experience of organizing the symposium, we discuss recommendations for other convenings to help build a community of practice for inclusive science communication. In both research and practice, we advocate for more experimentation to help make inclusive science communication the future of science communication writ large, in order to engage diverse publics in their multiple ways of knowing and expand a sense of belonging in STEMM

A National Action Plan for Promoting Preconception Health and Health Care in the United States (2012–2014)

Preconception health and health care (PCHHC) has gained increasing popularity as a key prevention strategy for improving outcomes for women and infants, both domestically and internationally. The Action Plan for the National Initiative on Preconception Health and Health Care: A Report of the PCHHC Steering Committee (2012–2014) provides a model that states, communities, public, and private organizations can use to help guide strategic planning for promoting preconception care projects. Since 2005, a national public–private PCHHC initiative has worked to create and implement recommendations on this topic. Leadership and funding from the Centers for Disease Control and Prevention combined with the commitment of maternal and child health leaders across the country brought together key partners from the public and private sector to provide expertise and technical assistance to develop an updated national action plan for the PCHHC Initiative. Key activities for this process included the identification of goals, objectives, strategies, actions, and anticipated timelines for the five work-groups that were established as part of the original PCHHC Initiative. These are further described in the action plan. To assist other groups doing similar work, this article discusses the approach members of the PCHHC Initiative took to convene local, state, and national leaders to enhance the implementation of preconception care nationally through accomplishments, lessons learned, and projections for future directions

Efficient, high-throughput transfection of human embryonic stem cells

INTRODUCTION: Genetic manipulation of human embryonic stem cells (hESC) has been limited by their general resistance to common methods used to introduce exogenous DNA or RNA. Efficient and high throughput transfection of nucleic acids into hESC would be a valuable experimental tool to manipulate these cells for research and clinical applications. METHODS: We investigated the ability of two commercially available electroporation systems, the Nucleofection(® )96-well Shuttle(® )System from Lonza and the Neon™ Transfection System from Invitrogen to efficiently transfect hESC. Transfection efficiency was measured by flow cytometry for the expression of the green fluorescent protein and the viability of the transfected cells was determined by an ATP catalyzed luciferase reaction. The transfected cells were also analyzed by flow cytometry for common markers of pluripotency. RESULTS: Both systems are capable of transfecting hESC at high efficiencies with little loss of cell viability. However, the reproducibility and the ease of scaling for high throughput applications led us to perform more comprehensive tests on the Nucleofection(® )96-well Shuttle(® )System. We demonstrate that this method yields a large fraction of transiently transfected cells with minimal loss of cell viability and pluripotency, producing protein expression from plasmid vectors in several different hESC lines. The method scales to a 96-well plate with similar transfection efficiencies at the start and end of the plate. We also investigated the efficiency with which stable transfectants can be generated and recovered under antibiotic selection. Finally, we found that this method is effective in the delivery of short synthetic RNA oligonucleotides (siRNA) into hESC for knockdown of translation activity via RNA interference. CONCLUSIONS: Our results indicate that these electroporation methods provide a reliable, efficient, and high-throughput approach to the genetic manipulation of hESC

Barriers to SARS-CoV-2 Testing among U.S. Employers in the COVID-19 Pandemic: A Qualitative Analysis Conducted January through April 2021

During the first year of the COVID-19 pandemic, U.S. companies were seeking ways to support their employees to return to the workplace. Nonetheless, the development of strategies to support the access, use, and interpretation of SARS-CoV-2 testing was challenging. In the present study, we explore, from the perspective of owners and company leadership, the barriers to SARSCoV-2 testing among U.S. companies. Key informant interviews with company representatives were conducted during January--April 2021 about SARS-CoV-2 testing. A pre-interview survey assessed respondent socio-demographic and organizational characteristics. Interview sessions were transcribed, coded, and analyzed using MaxQDA. A total of twenty interviews were completed with at least two interviews conducted in each major U.S. industry sector. Ninety percent of participants represented companies in business \u3e10 years, comprising both small and large workforces. Using a grounded theory approach, six themes emerged: (1) access to and knowledge of SARS-CoV-2 tests; (2) strategies for symptomatic and asymptomatic testing of workers; (3) type/availability of personal protective equipment to mitigate coronavirus exposures; (4) return-to-work policies; (5) guidance and communication of SARS-CoV-2 Testing; and (6) use of contact tracing and SARS-CoV-2 vaccination. Various modifiable and non-modifiable challenges for SARS-CoV-2 testing among U.S. companies were identified and can inform work-related SARS-CoV-2 testing strategies

Global birth defects app: An innovative tool for describing and coding congenital anomalies at birth in low resource settings

BACKGROUND: Surveillance programs in low- and middle-income countries (LMICs) have difficulty in obtaining accurate information about congenital anomalies. METHODS: As part of the ZikaPLAN project, an International Committee developed an app for the description and coding of congenital anomalies that are externally visible at birth, for use in low resource settings. The “basic” version of the app was designed for a basic clinical setting and to overcome language and terminology barriers by providing diagrams and photos, sourced mainly from international Birth Defects Atlases. The “surveillance” version additionally allows recording of limited pseudonymized data relevant to diagnosis, which can be uploaded to a secure server, and downloaded by the surveillance program data center. RESULTS: The app contains 98 (88 major and 10 minor) externally visible anomalies and 12 syndromes (including congenital Zika syndrome), with definitions and International Classification of Disease v10 -based code. It also contains newborn examination videos and links to further resources. The user taps a region of the body, then selects among a range of images to choose the congenital anomaly that best resembles what they observe, with guidance regarding similar congenital anomalies. The “basic” version of the app has been reviewed by experts and made available on the Apple and Google Play stores. Since its launch in November 2019, it has been downloaded in 39 countries. The "surveillance” version is currently being field-tested. CONCLUSION: The global birth defects app is a mHealth tool that can help in developing congenital anomaly surveillance in low resource settings to support prevention and care