A comparison of cervical smear adequacy using either the cytobrush or the Ayre spatula: a practice audit

Background: To obtain an adequate cervical (Papanicolaou) smear, the transformation zone, including the squamo-columnar junction, should be sampled as carcinoma develops preferentially in this transformation zone. The Ayre spatula has been widely used but is not very effective. Other sampling devices have been developed to improve efficiency, including the cytobrush. The purpose of this study was to compare the adequacy of cervical smears taken with the Ayre spatula as opposed to the cytobrush. Methods: This was a retrospective analytical study. One sampler, an experienced general practitioner, took the smears in the period 1990 to 2004. Initially, the Ayre spatula was used to consecutively sample the cervix and thereafter, a cytobrush alone was used. Two groups were thus formed for comparison. The presence of endocervical cells was accepted as an indicator of an adequate smear. A Cusco speculum was used to visualize the cervix. The sample was smeared onto a slide and fixated with an alcohol aerosol spray. Results: A total of 4561 smears were taken and 247 had no endocervical cells. A further 34 smears were classified as unsatisfactory due to the presence of degeneration (19), insufficient squamous cells (7), inflammatory exudate (4), excess blood (3) and/or a thick slide (1).The cytobrush group was similar demographically to the Ayre spatula group: 1981 (99%) and 2490 (98%) respectively were non pregnant; 67 (3%) and 110 (4%) were nulliparous, 1008 (50%) and 1370 (54%) were para 1 – 5, and 931 (46%) and 1075 (42%) were para 6 or more; 0 (0%) and 2 (0.1%) were aged between 10 – 19 years, 1496 (75%) and 2012 (78%) between 20 – 49, and 510 (25%) and 541 (21%) were aged 50 years or more. Of 2006 smears taken with a cytobrush, 1955 (97.5%) contained endocervical cells compared with 2325 (91%) of 2555 smears taken with an Ayre spatula. The difference was significant with an Odds Ratio of 4.56 (95% Confidence Interval 3.42-6.42). Conclusion: The cytobrush is significantly more efficacious than the Ayre spatula in obtaining adequate cervical smears. Use of the cytobrush will ensure less repeat smears with a consequent reduction in workload for samplers and laboratories. Although very few smears lacked sufficient squamous cells (an indicator of adequate ectocervical sampling), current best practice is that the cytobrush be used together with a wooden spatula to ensure adequate sampling of both the endocervical and ectocervical components of the transformation zone. For full text, click here: South African Family Practice2006;48(9): 15-15

Coopetition of software firms in Open source software ecosystems

Software firms participate in an ecosystem as a part of their innovation strategy to extend value creation beyond the firms boundary. Participation in an open and independent environment also implies the competition among firms with similar business models and targeted markets. Hence, firms need to consider potential opportunities and challenges upfront. This study explores how software firms interact with others in OSS ecosystems from a coopetition perspective. We performed a quantitative and qualitative analysis of three OSS projects. Finding shows that software firms emphasize the co-creation of common value and partly react to the potential competitiveness on OSS ecosystems. Six themes about coopetition were identified, including spanning gatekeepers, securing communication, open-core sourcing and filtering shared code. Our work contributes to software engineering research with a rich description of coopetition in OSS ecosystems. Moreover, we also come up with several implications for software firms in pursing a harmony participation in OSS ecosystems.Comment: This is the author's version of the work. Copyright owner's version can be accessed at https://link.springer.com/chapter/10.1007/978-3-319-69191-6_10, Coopetition of software firms in Open source software ecosystems, 8th ICSOB 2017, Essen, Germany (2017

Self-Doping of Gold Chains on Silicon: A New Structural Model for Si(111)5x2-Au

A new structural model for the Si(111)5x2-Au reconstruction is proposed and analyzed using first-principles calculations. The basic model consists of a "double honeycomb chain" decorated by Si adatoms. The 5x1 periodicity of the honeycomb chains is doubled by the presence of a half-occupied row of Si atoms that partially rebonds the chains. Additional adatoms supply electrons that dope the parent band structure and stabilize the period doubling; the optimal doping corresponds to one adatom per four 5x2 cells, in agreement with experiment. All the main features observed in scanning tunneling microscopy and photoemission are well reproduced.Comment: 4 pages, 4 figures, to appear in Phys. Rev. Lett. (preprint with high quality figures available at http://cst-www.nrl.navy.mil/~erwin/papers/ausi111

Appropriateness of strategy comparisons in cost-effectiveness analyses of infant pneumococcal vaccination: a systematic review

Objectives: Cost-effectiveness analysis (CEA) is the standard framework for informing the efficient allocation of scarce healthcare resources. The importance of considering all relevant intervention strategies and appropriate incremental comparisons have both long been recognized in CEA. Failure to apply methods correctly can lead to suboptimal policies. Our objective is to assess if CEAs of infant pneumococcal vaccination apply appropriate methods with respect to the completeness of strategies assessed and incremental comparisons between them. Methods: We conducted a systematic search of the PubMed, Scopus, Embase, and Web of Science databases and performed a comparative analysis of the retrieved pneumococcal vaccination CEAs. We checked the appropriateness of the incremental analyses by attempting to replicate the published incremental cost-effectiveness (CE) ratios from the reported costs and health effects. Results: Our search returned twenty-nine eligible articles. Most studies failed to recognize one or more intervention strategies (n = 21). Incremental comparisons were questionable in four CEAs and insufficient reporting of cost and health effect estimates was identified in three studies. Overall, we only found four studies that made appropriate comparisons between all strategies. Lastly, study findings appear to be strongly associated with manufacturer sponsorship. Conclusions: We found considerable scope for improvement regarding strategy comparison in the infant pneumococcal vaccination literature. To prevent overestimation of the CE of new vaccines, we urge greater adherence to existing guidelines recommending that all available strategies are evaluated to capture relevant comparators for CE evaluation. Closer adherence to existing guidelines will generate better evidence, leading to more effective vaccination policies

Beyond the Buzz: Scholarly Approaches to the Study of Work

The place of work in organization studies and management has waxed and waned. Yet, today, social and technological developments have raised again interest in the study of work and this curated discussion brings together experts in key approaches to this topic. Seven contributions have been selected to provide a panorama of what we know about work while pointing to some uncharted territories worthy of future exploration. The contributions outline the principles behind and value of systemic, contextualized, or holistic view of work and report insights on how changes in some work components reverberate in its broader ecology. We hope this curated discussion will make us more aware of the collective journey scholars have charted so far while posing new questions and opening or re-directing new avenues of inquiry

Earth observation applications for coastal sustainability: potential and challenges for implementation

Copyright remains with the author(s) or their institution(s). The coast is home to unique ecosystems, where complex ecological processes take place through the interaction of terrestrial, aquatic, atmospheric, and human landscapes. However, there are considerable knowledge and data gaps in achieving effective and future change-proof sustainable management of coastal zones around the world due to both technical and social barriers, as well as governance challenges. Currently, the role of Earth observation (EO) in addressing many of the recognised information gaps is small and under-utilised. While EO can provide much of the spatiotemporal information required for historical analysis and current status mapping, and offers the advantage of global coverage; its uptake can be limited by technical and methodological challenges associated mostly with lack of capacity and infrastructure, product accuracy and accessibility, costs, and institutional acceptance. While new initiatives and recent technological progress in the EO and information technology arena aim to tackle some of these issues so that EO products can be more easily used by non-EO experts, uptake is still limited.This paper discusses how EO can potentially inform transformative practices of planning in the coastal water zone, by using examples to demonstrate the EO potential in providing information relevant to decisionmaking framed by international agreements, such as the United Nations Agenda 2030, the Convention on Biological Diversity, and the Sendai Framework for Risk Reduction. By presenting evidence for how EO can contribute to innovative opportunities and data synergies at scale, the paper discusses opportunities and challenges for a more solution-led approach to sustainable coastal management.European Union’s Horizon 2020 research and innovation programme under grant agreement No. 687289 (Co-ReSyF project), the United Kingdom’s Natural Environment Research Council (NERC) under Grant NE/E009328 (GloboLakes project), and the Future Earth Coasts project.European Union’s Horizon 2020 research and innovation programme under grant agreement No. 687289 (Co-ReSyF project); United Kingdom’s Natural Environment Research Council (NERC) under Grant NE/E009328 (GloboLakes project); Future Earth Coasts project

Stabilization of protein-protein interactions in drug discovery

Introduction: PPIs are involved in every disease and specific modulation of these PPIs with small molecules would significantly improve our prospects of developing therapeutic agents. Both industry and academia have engaged in the identification and use of PPI inhibitors. However in comparison, the opposite strategy of employing small-molecule stabilizers of PPIs is underrepresented in drug discovery. Areas covered: PPI stabilization has not been exploited in a systematic manner. Rather, this concept validated by a number of therapeutically used natural products like rapamycin and paclitaxel has been shown retrospectively to be the basis of the activity of synthetic molecules originating from drug discovery projects among them lenalidomide and tafamidis. Here, the authors cover the growing number of synthetic small-molecule PPI stabilizers to advocate for a stronger consideration of this as a drug discovery approach. Expert opinion: Both the natural products and the growing number of synthetic molecules show that PPI stabilization is a viable strategy for drug discovery. There is certainly a significant challenge to adapt compound libraries, screening techniques and downstream methodologies to identify, characterize and optimize PPI stabilizers, but the examples of molecules reviewed here in our opinion justify these efforts.</p

Stabilization of protein-protein interactions in drug discovery

Introduction: PPIs are involved in every disease and specific modulation of these PPIs with small molecules would significantly improve our prospects of developing therapeutic agents. Both industry and academia have engaged in the identification and use of PPI inhibitors. However in comparison, the opposite strategy of employing small-molecule stabilizers of PPIs is underrepresented in drug discovery. Areas covered: PPI stabilization has not been exploited in a systematic manner. Rather, this concept validated by a number of therapeutically used natural products like rapamycin and paclitaxel has been shown retrospectively to be the basis of the activity of synthetic molecules originating from drug discovery projects among them lenalidomide and tafamidis. Here, the authors cover the growing number of synthetic small-molecule PPI stabilizers to advocate for a stronger consideration of this as a drug discovery approach. Expert opinion: Both the natural products and the growing number of synthetic molecules show that PPI stabilization is a viable strategy for drug discovery. There is certainly a significant challenge to adapt compound libraries, screening techniques and downstream methodologies to identify, characterize and optimize PPI stabilizers, but the examples of molecules reviewed here in our opinion justify these efforts.</p