Equity and Patterns of Library Governance

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LaRC Aerothermodynamic Ground Tests in Support of BOLT Flight Experiment

A review is provided of recent aerothermodynamic ground-test contributions by NASA Langley Research Center (LaRC) to the BOLT flight test program. Several test entries into the Langley Aerothermodynamic Laboratory 20-Inch Mach 6 Air Tunnel are discussed. These entries were intended to support the development and design of flight hardware and instrumentation. Some trends and observations from these entries are provided. Also, a comparison of two different global heat transfer test techniques is included and discussed

Faire de la recherche collaborative : quelle sociologie dans le cadre d’un living lab ? Retour sur l’expérience de « mise en démocratie » de l’hydrogène

International audienceLa hausse des besoins en énergie au niveau mondial ainsi que la lutte contre le changement climatique imposent la redéfinition du modèle énergétique autour de la question de la sobriété et de la production d'énergies renouvelables. Cet article propose d'interroger la mise en oeuvre d'actions de transition en France à l'échelle locale (Bourgogne et Normandie) en se penchant sur le cas de l'énergie provenant de l'hydrogène en tant que vecteur énergétique au fort potentiel de décentralisation et d'appropriation citoyenne. Nous nous appuyons sur des expériences de « mise en démocratie » par la technique du living-lab, qui implique la participation active de différents publics autour de l'hydrogène, et qui fait des chercheurs engagés dans la démarche des participants comme les autres. A mi-parcours, il apparaît que cette démarche originale rencontre des écueils pour concilier ses prémisses techniques et l'éthique collaborative du « faire » à laquelle elle est le plus souvent associée : l'hydrogène n'apparaît pas comme une énergie « conviviale ». Dès lors, la question de l'avènement d'une démocratie technique à la faveur des expériences de transition est (au moins momentanément) remisée au profit de la réalisation de projets dont la dimension ludique devrait à terme ouvrir sur des questionnements éthiques et politiques, qui interrogent aussi bien les chercheurs en sciences humaines : doivent-ils travailler sur la transition ou pour la transition ? * Plan Introduction I. Transition énergétique et mise en oeuvre originale de la participation du public 1. Changement climatique, transition énergétique et hydrogène 2. Le living lab au Dôme (Caen, Normandie) 3. Les chercheurs en sciences sociales au coeur de la démarche II. Dépolitisation et effacement de l'éthique du « faire » 1. Sans le « faire » et son éthique : une dépolitisation de la démarche 2. Capabilités et capacité énergétique territorial

A formação de professores de Física e o ensino da EJA: uma abordagem crítico-reflexiva

Falar em Educação de Jovens e Adultos (EJA) não é uma tarefa fácil, principalmente pela grande variedade do público, pois as salas de EJA são bastante heterogêneas. Um dos grandes impasses de se ensinar física na EJA é a carência de referencial bibliográfico nesse ponto, esse trabalho visa contribuir com a discussão sobre a EJA, além de, aferir fatores que afetam o aprendizado nessa modalidade, propor soluções tendo como mecanismo para tal fim a crítica e a reflexão. A pesquisa foi desenvolvida em duas etapas com a primeira de revisão sobre EJA e a segunda na pesquisa de campo com alunos 6º e 8º período do curso de física em que se abordar a formação do professor de física com enfoque sobre o estágio supervisionado. Os resultados mostraram que existe uma fragilidade no estágio supervisionado dedicado a educação de jovens e adultos nos cursos de licenciatura física

A formação de professores de Física e o ensino da EJA: uma abordagem crítico-reflexiva

Falar em Educação de Jovens e Adultos (EJA) não é uma tarefa fácil, principalmente pela grande variedade do público, pois as salas de EJA são bastante heterogêneas. Um dos grandes impasses de se ensinar física na EJA é a carência de referencial bibliográfico nesse ponto, esse trabalho visa contribuir com a discussão sobre a EJA, além de, aferir fatores que afetam o aprendizado nessa modalidade, propor soluções tendo como mecanismo para tal fim a crítica e a reflexão. A pesquisa foi desenvolvida em duas etapas com a primeira de revisão sobre EJA e a segunda na pesquisa de campo com alunos 6º e 8º período do curso de física em que se abordar a formação do professor de física com enfoque sobre o estágio supervisionado. Os resultados mostraram que existe uma fragilidade no estágio supervisionado dedicado a educação de jovens e adultos nos cursos de licenciatura física

HIV Continuum of Care for Youth in the United States

BACKGROUND: Beneficial HIV treatment outcomes require success at multiple steps along the HIV Continuum of Care. Youth living with HIV are a key population, and sites in the Adolescent Medicine Trials Network for HIV/AIDS Interventions (ATN) are known for modeling optimum HIV adolescent care. METHODS: A longitudinal cohort study conducted at 14 network sites across the United States assessed how the later steps of the Continuum of Care were achieved among the youth: engagement, treatment, and viral load (VL) suppression. Youth aged 13-24 who were behaviorally infected with HIV and linked to care at an ATN-affiliated site were eligible to participate. RESULTS: A total of 467 youth were enrolled and had 1 year of available data. Most were aged 22-24 (57%), male (79%), and black/non-Hispanic (71%). Most used alcohol (81%) and marijuana (61%) in the 3 months before enrollment, and 40% had a history of incarceration. Among this cohort of youth, 86% met criteria for care engagement; among these, 98% were prescribed antiretroviral therapy and 89% achieved VL suppression. Sustained VL suppression at all measured time points was found among 59% with initial suppression. Site characteristics were notable for the prevalence of adherence counseling (100%), case management (100%), clinic-based mental health (93%), and substance use (64%) treatment. CONCLUSIONS: Youth living with HIV in the United States can be successfully treated at health care sites with experience, excellence, and important resources and services. Sustained VL suppression may be an important step to add to the Continuum of Care for youth

Diagnostic utility of small fiber analysis in skin biopsies from children with chronic pain

Introduction Small fiber neuropathies (SFN) are associated with a reduction in quality of life. In adults, epidermal nerve fiber density (END) analysis is recommended for the diagnosis of SFN. In children, END assessment is not often performed. We analyzed small nerve fiber innervation to elucidate the potential diagnostic role of skin biopsies in young patients with pain. Methods Epidermal nerve fiber density and sudomotor neurite density (SND) were assessed in skin biopsies from 26 patients aged 7 to 20 years (15 female patients) with unexplained chronic pain. The results were compared with clinical data. Results Epidermal nerve fiber density was abnormal in 50% and borderline in 35% of patients. An underlying medical condition was found in 42% of patients, including metabolic, autoimmune, and genetic disorders. Discussion Reduction of epidermal nerve fibers can be associated with treatable conditions. Therefore, the analysis of END in children with pain may help to uncover a possible cause and guide potential treatment options

Antimicrobial resistance among migrants in Europe: a systematic review and meta-analysis

BACKGROUND: Rates of antimicrobial resistance (AMR) are rising globally and there is concern that increased migration is contributing to the burden of antibiotic resistance in Europe. However, the effect of migration on the burden of AMR in Europe has not yet been comprehensively examined. Therefore, we did a systematic review and meta-analysis to identify and synthesise data for AMR carriage or infection in migrants to Europe to examine differences in patterns of AMR across migrant groups and in different settings. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, PubMed, and Scopus with no language restrictions from Jan 1, 2000, to Jan 18, 2017, for primary data from observational studies reporting antibacterial resistance in common bacterial pathogens among migrants to 21 European Union-15 and European Economic Area countries. To be eligible for inclusion, studies had to report data on carriage or infection with laboratory-confirmed antibiotic-resistant organisms in migrant populations. We extracted data from eligible studies and assessed quality using piloted, standardised forms. We did not examine drug resistance in tuberculosis and excluded articles solely reporting on this parameter. We also excluded articles in which migrant status was determined by ethnicity, country of birth of participants' parents, or was not defined, and articles in which data were not disaggregated by migrant status. Outcomes were carriage of or infection with antibiotic-resistant organisms. We used random-effects models to calculate the pooled prevalence of each outcome. The study protocol is registered with PROSPERO, number CRD42016043681. FINDINGS: We identified 2274 articles, of which 23 observational studies reporting on antibiotic resistance in 2319 migrants were included. The pooled prevalence of any AMR carriage or AMR infection in migrants was 25·4% (95% CI 19·1-31·8; I2 =98%), including meticillin-resistant Staphylococcus aureus (7·8%, 4·8-10·7; I2 =92%) and antibiotic-resistant Gram-negative bacteria (27·2%, 17·6-36·8; I2 =94%). The pooled prevalence of any AMR carriage or infection was higher in refugees and asylum seekers (33·0%, 18·3-47·6; I2 =98%) than in other migrant groups (6·6%, 1·8-11·3; I2 =92%). The pooled prevalence of antibiotic-resistant organisms was slightly higher in high-migrant community settings (33·1%, 11·1-55·1; I2 =96%) than in migrants in hospitals (24·3%, 16·1-32·6; I2 =98%). We did not find evidence of high rates of transmission of AMR from migrant to host populations. INTERPRETATION: Migrants are exposed to conditions favouring the emergence of drug resistance during transit and in host countries in Europe. Increased antibiotic resistance among refugees and asylum seekers and in high-migrant community settings (such as refugee camps and detention facilities) highlights the need for improved living conditions, access to health care, and initiatives to facilitate detection of and appropriate high-quality treatment for antibiotic-resistant infections during transit and in host countries. Protocols for the prevention and control of infection and for antibiotic surveillance need to be integrated in all aspects of health care, which should be accessible for all migrant groups, and should target determinants of AMR before, during, and after migration. FUNDING: UK National Institute for Health Research Imperial Biomedical Research Centre, Imperial College Healthcare Charity, the Wellcome Trust, and UK National Institute for Health Research Health Protection Research Unit in Healthcare-associated Infections and Antimictobial Resistance at Imperial College London

Continuous glucose monitoring in pregnant women with type 1 diabetes (CONCEPTT): a multicentre international randomised controlled trial.

BACKGROUND: Pregnant women with type 1 diabetes are a high-risk population who are recommended to strive for optimal glucose control, but neonatal outcomes attributed to maternal hyperglycaemia remain suboptimal. Our aim was to examine the effectiveness of continuous glucose monitoring (CGM) on maternal glucose control and obstetric and neonatal health outcomes. METHODS: In this multicentre, open-label, randomised controlled trial, we recruited women aged 18-40 years with type 1 diabetes for a minimum of 12 months who were receiving intensive insulin therapy. Participants were pregnant (≤13 weeks and 6 days' gestation) or planning pregnancy from 31 hospitals in Canada, England, Scotland, Spain, Italy, Ireland, and the USA. We ran two trials in parallel for pregnant participants and for participants planning pregnancy. In both trials, participants were randomly assigned to either CGM in addition to capillary glucose monitoring or capillary glucose monitoring alone. Randomisation was stratified by insulin delivery (pump or injections) and baseline glycated haemoglobin (HbA1c). The primary outcome was change in HbA1c from randomisation to 34 weeks' gestation in pregnant women and to 24 weeks or conception in women planning pregnancy, and was assessed in all randomised participants with baseline assessments. Secondary outcomes included obstetric and neonatal health outcomes, assessed with all available data without imputation. This trial is registered with ClinicalTrials.gov, number NCT01788527. FINDINGS: Between March 25, 2013, and March 22, 2016, we randomly assigned 325 women (215 pregnant, 110 planning pregnancy) to capillary glucose monitoring with CGM (108 pregnant and 53 planning pregnancy) or without (107 pregnant and 57 planning pregnancy). We found a small difference in HbA1c in pregnant women using CGM (mean difference -0·19%; 95% CI -0·34 to -0·03; p=0·0207). Pregnant CGM users spent more time in target (68% vs 61%; p=0·0034) and less time hyperglycaemic (27% vs 32%; p=0·0279) than did pregnant control participants, with comparable severe hypoglycaemia episodes (18 CGM and 21 control) and time spent hypoglycaemic (3% vs 4%; p=0·10). Neonatal health outcomes were significantly improved, with lower incidence of large for gestational age (odds ratio 0·51, 95% CI 0·28 to 0·90; p=0·0210), fewer neonatal intensive care admissions lasting more than 24 h (0·48; 0·26 to 0·86; p=0·0157), fewer incidences of neonatal hypoglycaemia (0·45; 0·22 to 0·89; p=0·0250), and 1-day shorter length of hospital stay (p=0·0091). We found no apparent benefit of CGM in women planning pregnancy. Adverse events occurred in 51 (48%) of CGM participants and 43 (40%) of control participants in the pregnancy trial, and in 12 (27%) of CGM participants and 21 (37%) of control participants in the planning pregnancy trial. Serious adverse events occurred in 13 (6%) participants in the pregnancy trial (eight [7%] CGM, five [5%] control) and in three (3%) participants in the planning pregnancy trial (two [4%] CGM and one [2%] control). The most common adverse events were skin reactions occurring in 49 (48%) of 103 CGM participants and eight (8%) of 104 control participants during pregnancy and in 23 (44%) of 52 CGM participants and five (9%) of 57 control participants in the planning pregnancy trial. The most common serious adverse events were gastrointestinal (nausea and vomiting in four participants during pregnancy and three participants planning pregnancy). INTERPRETATION: Use of CGM during pregnancy in patients with type 1 diabetes is associated with improved neonatal outcomes, which are likely to be attributed to reduced exposure to maternal hyperglycaemia. CGM should be offered to all pregnant women with type 1 diabetes using intensive insulin therapy. This study is the first to indicate potential for improvements in non-glycaemic health outcomes from CGM use. FUNDING: Juvenile Diabetes Research Foundation, Canadian Clinical Trials Network, and National Institute for Health Research