27 research outputs found
Interdisciplinarity in practice: reflections from early-career researchers developing a risk-informed decision support environment for Tomorrow's cities
The concept of disaster risk is cross-disciplinary by nature and reducing disaster risk has become of interest for various disciplines. Yet, moving from a collection of multiple disciplinary perspectives to integrated interdisciplinary disaster risk approaches remains a fundamental challenge. This paper reflects on the experience of a group of early-career researchers spanning physical scientists, engineers and social scientists from different organisations across the global North and global South who came together to lead the refinement, operationalisation and testing of a risk-informed decision support environment for Tomorrow's Cities (TCDSE). Drawing on the notions of subjects and boundary objects, members of the group reflect on their individual and collective journey of transgressing disciplinary boundaries across three case studies between JuneâDecember 2021: operationalisation process of the TCDSE; development of a virtual urban testbed as a demonstration case for the implementation of the TCDSE; and consolidation of frequently asked questions about the TCDSE for communication purposes. The paper argues that (1) the production of boundary objects in interdisciplinary research nurtures relations of reciprocal recognition and the emergence of interdisciplinary subjects; (2) the intrinsic characteristics of boundary objects define the norms of engagement between disciplinary subjects and constrain the expression of interdisciplinary contradictions; and (3) affects and operations of power explain the contingent settlement of interdisciplinary disagreements and the emergence of new knowledge. Activating the interdisciplinary capacities of early-career researchers across disciplines and geographies is a fundamental step towards transforming siloed research practices to reduce disaster risk
Salivary glucose concentration exhibits threshold kinetics in normal-weight, overweight, and obese children
Mor-Li Hartman,1 J Max Goodson,1 Roula Barake,2 Osama Alsmadi,3 Sabiha Al-Mutawa,4 Jitendra Ariga,4 Pramod Soparkar,1 Jawad Behbehani,5 Kazem Behbehani,6 Francine Welty7 1Department of Applied Oral Sciences, The Forsyth Institute, Cambridge, MA, USA; 2Department of Nutrition, The Dasman Diabetes Institute, Dasman, Kuwait; 3Genome Center, The Dasman Diabetes Institute, Dasman, Kuwait; 4Ministry of Health, Kuwait City, Kuwait; 5Faculty of Dentistry, Kuwait University, Kuwait City, Kuwait; 6The Dasman Diabetes Institute, Dasman, Kuwait; 7Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA Background: Metabolic syndrome in childhood predicts the development of cardiovascular disease and type 2 diabetes (T2D) in adulthood. Testing for features of metabolic syndrome, such as fasting plasma glucose concentration, requires blood sampling which can be difficult in children. Here we evaluated salivary glucose concentration as a surrogate measurement for plasma glucose concentration in 11-year-old US children. Methods: Children from Portland, Maine, and Cambridge, Massachusetts, with a mean age of 10.6±0.2 years provided 6-hour fasting samples of both blood and whole saliva. Salivary glucose levels were measured with a high-sensitivity assay (sensitivity =0.002 mg/dL). Plasma glucose levels were determined by a commercial clinical laboratory. Blood pressure, salivary flow rate, height, and weight were also measured. Results: Of the 65 children enrolled, there were two underweight children (3.1%), 30 normal-weight children (46.2%), 12 overweight children (18.4%), and 21 obese children (32.3%). The mean overall glucose concentrations were 0.11±0.02 mg/dL in saliva and 86.3±0.8 mg/dL in plasma, and these did not differ significantly by body–weight groups. By regression analysis, the plasma concentration equaled 13.5 times the saliva concentration, with a threshold level of 84.8 mg/dL. Salivary glucose values less than threshold plasma concentration were essentially zero. Diagnostic analysis indicated a positive predictive value of 50%, a negative predictive value of 90%, and a sensitivity and specificity both of approximately 75%. The salivary glucose concentration did not vary with saliva flow rate. Conclusion: Taking into account the threshold response characteristics of the salivary glucose concentration response, these results suggest that testing salivary glucose levels may be useful as a screening assay for high fasting plasma glucose levels. The low false positive value is important to assure a low fraction of missed diagnoses. Keywords: saliva, salivary glucose, plasma glucose, childre
JOIN empowering a bibliographic infrastructure to support scientists
Most scientific organizations have established bibliographic databases to collect and present the scholarly output generated by their researchers and research projects. In many cases, an institutional repository is included to enable and promote open access. Besides publications lists on the Web, the data is even more valuable to support internal procedures such as reuse in citation management software for new publications or grant applications and in particular to alleviate the burden of administrative reporting according to complex sorting or filtering criteria.In 2010 the libraries and documentation departments of DESY (Hamburg), GSI (Darmstadt), Forschungszentrum JĂŒlich (JĂŒlich), Heinz Maier-Leibnitz Zentrum (MLZ) (Garching) and RWTH Aachen University (Aachen) founded joinÂČ to establish such an infrastructure based on Invenio. Main focuses were a solution, which is easy to use and accepted by scientists, to incorporate specific and precise data sources of an organization on for example, people and projects, as well as (inter-)nationally accepted authority records -e.g. on journals- and sources for data import. By merging bibliographic database and repository the addition of full texts is encouraged, furthering OpenAccess. Local protected working areas for publication exchange serve as an additional value to the scientists. The project addresses that each organizations has its specifics and thus the infrastructure must be suitable configured and tailored while still profiting from the shared development resources.As a result six independent repositories are currently in operation. As an open project, we recently also welcomed Deutsches Krebsforschungszentrum (Heidelberg) as a new partner.joinÂČ repositories today serve more than 20.000 staff members and more than 5.000 local visitors annually on campus. They provide more than 300.000 records as well as nearly 90.000 high quality authority records freely accessible on the Internet. This makes joinÂČ one of the larger Invenio users world wide.We present the flexible structure of our project based on shared content, its various use cases and give an overview of its internal work flows
The Kuwait-Scotland eHealth Innovation Network (KSeHIN):a sustainable approach to quality improvement in healthcare
Background: The rising prevalence of obesity and diabetes in Kuwait represents a significant challenge for the country's healthcare system. Diabetes care in Scotland has improved by adopting a system of managed clinical networks supported by a national informatics platform. In 2010, a KuwaitâDundee collaboration was established with a view to transforming diabetes care in Kuwait. This paper describes the significant progress that has been made to date.Methods: The KuwaitâScotland eHealth Innovation Network (KSeHIN) is a partnership among health, education, industry and government. KSeHIN aims to deliver a package of clinical service development, education (including a formal postgraduate programme and continuing professional development) and research underpinned by a comprehensive informatics system.Results: The informatics system includes a disease registry for children and adults with diabetes. At the patient level, the system provides an overview of clinical and operational data. At the population level, users view key performance indicators based on national standards of diabetes care established by KSeHIN. The national childhood registry (CODeR) accumulates approximately 300 children a year. The adult registry (KHN), implemented in four primary healthcare centres in 2013, has approximately 4000 registered patients, most of whom are not yet meeting national clinical targets.A credit-bearing postgraduate educational programme provides module-based teaching and workplace-based projects. In addition, a new clinical skills centre provides simulator-based training. Over 150 masters students from throughout Kuwait are enrolled and over 400 work-based projects have been completed to date.Conclusion: KSeHIN represents a successful collaboration between multiple stakeholders working across traditional boundaries. It is targeting patient outcomes, system performance and professional development to provide a sustainable transformation in the quality of diabetes healthcare for the growing population of Kuwaitis with diabetes in Kuwait
Subclinical Atrial Fibrillation in Older Patients
Long-term continuous electrocardiographic monitoring shows a substantial prevalence of asymptomatic, subclinical atrial fibrillation (SCAF) in patients with pacemakers and patients with cryptogenic stroke. Whether SCAF is also common in other patients without these conditions is unknown. We implanted subcutaneous electrocardiographic monitors (St. Jude CONFIRM-AF) in patients â„65 years of age attending cardiovascular or neurology outpatient clinics if they had no history of atrial fibrillation but had any of the following: CHA2DS2-VASc score of â„2, sleep apnea, or body mass index >30 kg/m2. Eligibility also required either left atrial enlargement (â„4.4 cm or volume â„58 mL) or increased (â„290 pg/mL) serum NT-proBNP (N-terminal pro-B-type natriuretic peptide). Patients were monitored for SCAF lasting â„5 minutes. Two hundred fifty-six patients were followed up for 16.3±3.8 months. Baseline age was 74±6 years; mean CHA2DS2-VASc score was 4.1±1.4; left atrial diameter averaged 4.7±0.8 cm; and 48% had a prior stroke, transient ischemic attack, or systemic embolism. SCAF â„5 minutes was detected in 90 patients (detection rate, 34.4%/y; 95% confidence interval [CI], 27.7-42.3). Baseline predictors of SCAF were increased age (hazard ratio [HR] per decade, 1.55; 95% CI, 1.11-2.15), left atrial dimension (HR per centimeter diameter, 1.43; 95% CI, 1.09-1.86), and blood pressure (HR per 10 mmâHg, 0.87; 95% CI, 0.78-0.98), but not prior stroke. The rate of occurrence of SCAF in those with a history of stroke, systemic embolism, or transient ischemic attack was 39.4%/y versus 30.3%/y without (P=0.32). The cumulative SCAF detection rate was higher (51.9%/y) in those with left atrial volume above the median value of 73.5 mL. SCAF is frequently detected by continuous electrocardiographic monitoring in older patients without a history of atrial fibrillation who are attending outpatient cardiology and neurology clinics. Its clinical significance is unclear. URL: http://www.clinicaltrials.gov. Unique identifier: NCT0169439