Summer Camp as a Force for 21st Century Learning: Exploring Divergent Thinking and Activity Selection in a Residential Camp Setting

This study investigated change in divergent thinking (DT), an indicator of creative potential, at two gender-specific residential summer camps. Additionally, this study examined whether the change in DT varied by gender and by the type of activities campers self-select. Quantitative methods, using a quasi-experimental design was used in order to understand differences in camper scores. A total of 189 youth, 100 girls, 89 boys, between the ages of 9 and 14 years participated in the current study. Participants were administered a modified version of Guilford\u27s (1967) alternate uses task, a measure of DT, in which respondents were asked questions such as name all of the uses for a brick or name all of the uses for a plate before the camp session started, and then again at the end of the two-week session. Results indicate overall mean significant increases in DT across all scoring methods of fluency, flexibility, and originality. Participants who self-selected one or more artistic activities (e.g., drama, arts and crafts, dance) had significant increases on the tasks as opposed to participants who did not select any artistic activities (e.g., basketball, baseball, archery). Finally, girls significantly increased across all scoring methods, whereas boys slightly increased in fluency and flexibility but not in originality. These results indicate residential summer camp may provide a creativity benefit for youth in attendance, especially those who participate in certain activities. Practitioners should use this study to understand their own programming in terms of creativity, activity offerings, and camp cultur

Commercialization of a 2nd generation intensified perfusion process during life cycle management

Continuous biomanufacturing provides many advantages for the production of therapeutic proteins through process integration, automation and intensification. Sanofi is currently developing robust cell culture processes using ATF perfusion technology to achieve improved volumetric productivity with consistent product quality. This presentation is a case study on how we applied intensified process technology on product commercialization. Using QbD approach, we successfully implemented an intensified perfusion process coupled with continuous capturing on a commercial product life cycle management. For the 2nd generation process, entire production and capturing stage is fully integrated and automated. The new perfusion process comprises of high cell density and achieves significant increase in volumetric productivity, which allows a substantial footprint reduction and increases flexibility in a new facility. More importantly, product quality was remarkably comparable with the 1st generation process. Dramatic improvement in process robustness and consistency were demonstrated as well. Facilitated by computational fluid dynamics (CFD) simulation, we successfully scaled up to commercial scale. In support of technology transfer and manufacturing, process control strategy was drafted based on the results of bioreactor characterization using univariate and multivariate studies

Evaluation of the ‘Live Life Better Service’, a community-based weight management service, for morbidly obese patients

Background There is a limited evidence on the effectiveness of lifestyle interventions in achieving and maintaining a significant level of weight loss in morbidly obese patients. This study evaluated the impact on weight loss and psychological well-being of a community-based weight management service for morbidly obese patients [body mass index (BMI) ≥35 with related co-morbidities or BMI >40] in Derbyshire county. Methods Five hundred and fifty-one participants entered the service since 2010, and 238 participants were still active within the service or had completed the 2-year intervention in April 2013. A one-group pre–post design was used to determine average weight loss (kg) and impact on mental health and well-being [using the validated clinical outcomes of routine evaluation-outcome measure (CORE-OM) questionnaire] among participants. Measurements were recorded at baseline, 12 weeks, 24 weeks, 1 year, 18 months and 2 years, and significance (P [less than] 0.05) was determined using the paired sample t-test. Results Statistically significant weight loss was recorded at each measurement point for those participants who remained engaged with the service (4.9 kg weight loss at 12 weeks to 18.2 kg at 2 years). There was a significant positive impact on psychological well-being demonstrated by CORE-OM score. Conclusions Findings show clinically and statistically significant weight loss among participants with improvements in physical and mental health

Process scale up and characterization of an intensified perfusion process

Continuous biomanufacturing provides many advantages for the production of therapeutic proteins through process integration, automation and intensification. Sanofi currently has developed a robust and integrated continuous biomanufacturing platform to achieve improved volumetric productivity and consistent product quality. Process intensification reduces the physical footprint as well as capital and operating expenses of manufacturing facilities. This presentation is a case study on the implementation of the intensified process for commercialization of a biotherapeutic product. Using a QbD approach, we successfully implemented an intensified perfusion process coupled with continuous product capture for a commercial product. High cell densities have resulted in a significant increase in volumetric productivity, which allows a substantial footprint reduction and increases flexibility in the commercial facility. To understand the impact of process parameters on critical quality attributes (CQAs), univariate and multivariate studies were conducted in small scale bioreactors. Mix model repeated measurement was applied in the data analysis to incorporate time-dependent information into the predictive model. This was followed by Monte Carlo simulation to determine proven acceptable ranges (PARs) for critical process parameters in support of process control strategy (PCS). Facilitated by computational fluid dynamics (CFD) simulation, we successfully scaled up the process to commercial scale. In this presentation, challenges associated with application of QbD approach for a perfusion process and the advantages of an intensified perfusion process will be discussed

Association between benzodiazepine use and exacerbations and mortality in patients with asthma: a matched case-control and survival analysis using the United Kingdom Clinical Practice Research Datalink

Purpose: To investigate the association between the GABAergic drugs, benzodiazepines or zopiclone, and the occurrence of asthma exacerbations and subsequent mortality in a cohort of asthma patients. Methods: 105,747 patients without asthma exacerbation and 25,895 patients with exacerbated asthma were included. A nested case-control study probed the association between benzodiazepines or zopiclone and occurrence of asthma exacerbation (primary outcome) using conditional logistic regression. Cox regression was used to determine the association between the drugs and all-cause mortality in patients with recorded asthma exacerbation. Adjusted matched odds ratios (adj mOR), and adjusted hazard ratios (adj HR) with 95% confidence intervals (CI) are presented. Results: Current benzodiazepine use was associated with increased occurrence of asthma exacerbation (adj mOR 1.49; 1.15-1.93; P=0.001) as was current zopiclone use (adj mOR 1.59; 95% CI 1.37-1.85; P<0.001). In patients with an asthma exacerbation, current benzodiazepine use was associated with increased all-cause mortality during a median follow-up of 2 years (adj HR 2.78; 95% CI 1.26-6.12; P=0.011), and the association between zopiclone use and all-cause mortality showed borderline statistical significance (adj HR 1.58; 95% CI 0.98-2.54; P=0.058). Conclusion: Benzodiazepines and zopiclone may increase the likelihood of asthma exacerbation and benzodiazepines may also increase the likelihood of mortality following exacerbation. These data suggest that caution should be exercised when prescribing benzodiazepines to patients with asthma

Neuraminidase inhibitors: who, when, where?

Although the neuraminidase inhibitors (NIs), oseltamivir and zanamivir were first licensed in 1999, their clinical effectiveness is still hotly debated. Two rigorous systematic reviews and meta-analyses of the data from clinical trials conducted in community settings against relatively benign influenza, both suggest that reductions in symptom duration are extremely modest, under one day. Whilst one of these reviews could find no evidence of reductions in complications, the most recent review reported clinically meaningful and statistically significant reductions in the likelihood of requiring antibiotics (44%) and hospitalizations (63%) in adult patients with confirmed influenza, treated with oseltamivir. A further meta-analysis of observational data from the 2009 influenza A(H1N1) pandemic suggested that, in hospitalised patients, NIs significantly reduced mortality in adults by 25% overall, and by 62% if started within 48 hours of symptom onset, compared with no treatment. But, the effectiveness of NIs in children is far less clear. Taken together, these data suggest that NIs should be reserved for patients with influenza who are at high-risk of complications, or when clinically assessed found to be markedly unwell, or rapidly deteriorating. In such patients, treatment should be initiated empirically, as soon as possible, preferably with follow-on virological confirmation

Umbilical hernia rupture with evisceration of omentum from massive ascites: a case report

<p>Abstract</p> <p>Introduction</p> <p>The incidence of hernias is increased in patients with alcoholic liver disease with ascites. To the best of our knowledge, this is the first report of an acute rise in intra-abdominal pressure from straining for stool as the cause of a ruptured umbilical hernia.</p> <p>Case presentation</p> <p>An 81-year-old Caucasian man with a history of alcoholic liver disease presented to our emergency department with an erythematous umbilical hernia and clear, yellow discharge from the umbilicus. On straining for stool, after initial clinical assessment, our patient noted a gush of fluid and evisceration of omentum from the umbilical hernia. An urgent laparotomy was performed with excision of the umbilicus and devitalized omentum.</p> <p>Conclusion</p> <p>We report the case of a patient with a history of alcoholic liver disease with ascites. Ascites causes a chronic increase in intra-abdominal pressure. A sudden increase in intra-abdominal pressure, such as coughing, vomiting, gastroscopy or, as in this case, straining for stool can cause rupture of an umbilical hernia. The presence of discoloration, ulceration or a rapid increase in size of the umbilical hernia signals impending rupture and should prompt the physician to reduce the intra-abdominal pressure.</p

Limits of agricultural greenhouse gas calculators to predict soil N2O and CH4 fluxes in tropical agriculture

Acknowledgements This work was undertaken as part of the CGIAR Research Program on Climate Change, Agriculture and Food Security (CCAFS), which is a strategic partnership of CGIAR and Future Earth. This research was carried out with funding by the European Union (EU) and with technical support from the International Fund for Agricultural Development (IFAD). The UN FAO Mitigation of Climate Change in Agriculture (MICCA) Programme funded data collection in Kenya and Tanzania. The views expressed in the document cannot be taken to reflect the official opinions of CGIAR, Future Earth, or donors. We thank Louis Bockel of the UN FAO Agricultural Development Economics Division (ESA) for his comments on an earlier draft of the manuscript.Peer reviewedPublisher PD