Nutrition-friendly Schools Initiative (NFSI): Another brain-storming strategy

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Difference in surgical outcomes of rectal cancer by study design: meta-analyses of randomized clinical trials, case-matched studies, and cohort studies

Background RCTs are considered the standard in surgical research, whereas case-matched studies and propensity score matching studies are conducted as an alternative option. Both study designs have been used to investigate the potential superiority of robotic surgery over laparoscopic surgery for rectal cancer. However, no conclusion has been reached regarding whether there are differences in findings according to study design. This study aimed to examine similarities and differences in findings relating to robotic surgery for rectal cancer by study design. Methods A comprehensive literature search was conducted using PubMed, Scopus, and Cochrane CENTRAL to identify RCTs, case-matched studies, and cohort studies that compared robotic versus laparoscopic surgery for rectal cancer. Primary outcomes were incidence of postoperative overall complications, incidence of anastomotic leakage, and postoperative mortality. Meta-analyses were performed for each study design using a random-effects model. Results Fifty-nine articles were identified and reviewed. No differences were observed in incidence of anastomotic leakage, mortality, rate of positive circumferential resection margins, conversion rate, and duration of operation by study design. With respect to the incidence of postoperative overall complications and duration of hospital stay, the superiority of robotic surgery was most evident in cohort studies (risk ratio (RR) 0.83, 95 per cent c.i. 0.74 to 0.92, P < 0.001; mean difference (MD) –1.11 (95 per cent c.i. –1.86 to –0.36) days, P = 0.004; respectively), and least evident in RCTs (RR 1.12, 0.91 to 1.38, P = 0.27; MD –0.28 (–1.44 to 0.88) days, P = 0.64; respectively). Conclusion Results of case-matched studies were often similar to those of RCTs in terms of outcomes of robotic surgery for rectal cancer. However, case-matched studies occasionally overestimated the effects of interventions compared with RCTs

Time to First-Line ART Failure and Time to Second-Line ART Switch in the IeDEA Pediatric Cohort

BACKGROUND: Globally, 49% of the estimated 1.8 million children living with HIV are accessing antiretroviral therapy (ART). There are limited data concerning long-term durability of first-line ART regimens and time to transition to second-line. METHODS: Children initiating their first ART regimen between 2 and 14 years of age and enrolled in one of 208 sites in 30 Asia-Pacific and African countries participating in the Pediatric International Epidemiology Databases to Evaluate AIDS consortium were included in this analysis. Outcomes of interest were: first-line ART failure (clinical, immunologic, or virologic), change to second-line, and attrition (death or loss to program ). Cumulative incidence was computed for first-line failure and second-line initiation, with attrition as a competing event. RESULTS: In 27,031 children, median age at ART initiation was 6.7 years. Median baseline CD4% for children ≤5 years of age was 13.2% and CD4 count for those >5 years was 258 cells per microliter. Almost all (94.4%) initiated a nonnucleoside reverse transcriptase inhibitor; 5.3% a protease inhibitor, and 0.3% a triple nucleoside reverse transcriptase inhibitor-based regimen. At 1 year, 7.7% had failed and 14.4% had experienced attrition; by 5 years, the cumulative incidence was 25.9% and 29.4%, respectively. At 1 year after ART failure, 13.7% had transitioned to second-line and 11.2% had experienced attrition; by 5 years, the cumulative incidence was 31.6% and 25.9%, respectively. CONCLUSIONS: High rates of first-line failure and attrition were identified in children within 5 years after ART initiation. Of children meeting failure criteria, only one-third were transitioned to second-line ART within 5 years

In situ observation of rolling contact fatigue cracks by laminography using ultrabright synchrotron radiation

In rolling contact fatigue (RCF), cracks usually initiate from inclusions beneath the surface andpropagate to the contact surface. In the present study, synchrotron radiation computed laminography (SRCL)imaging was performed to observe flaking defects during the RCF of a high-strength steel. Specially fabricatedinclusion-rich steel plate specimens were employed in the experiments. For the in situ observation of crackpropagation, a compact RCF testing machine was developed, and a 4D analysis scheme was applied to the dataobtained by SRCL. RCF tests were carried out near the measurement hatch of the beam line used SRCL toenable the successive observation of crack initiation and growth behaviors. Specimens before and after theoccurrence of flaking were observed by SRCL, and flaking defects and cracks under the surface weresuccessfully detected. As a result, details of the crack initiation and flaking process in RCF could be discussed.Shear-type horizontal cracks were found to initiate after the initiation and propagation of tensile-type verticalcracks along inclusions, where the face of the vertical cracks was perpendicular to the rolling direction androlling surface. Therefore, the formation of vertical cracks is considered to affect shear-type crack formationand flaking, where the shape and length of inclusions also affect the initiation and propagation of verticalcracks

Doing more with less: Teacher professional learning communities in resource-constrained primary schools in rural China.

Teacher professional learning communities provide environments in which teachers engage in regular research and collaboration. They have been found effective as a means for connecting professional learning to the day-to-day realities faced by teachers in the classroom. In this article, the authors draw on survey data collected in primary schools serving 71 villages in rural Gansu Province as well as transcripts from in-depth interviews with 30 teachers. Findings indicate that professional learning communities penetrate to some of China’s most resource-constrained schools but that their nature and development are shaped by institutional supports, principal leadership, and teachers’ own initiative

Interests, trust and security in US-Jordanian nuclear relations

This article explores the relationship between Jordan and the United States (US) in the field of nuclear energy cooperation. Since 2010 the Jordanian government has accelerated its plans for a nuclear energy program and has engaged with multiple partners around the world in order to agree terms for cooperation in technology exchange, monitoring, and the construction of infrastructure. Bilateral negotiations between the US and Jordan for a "123" nuclear cooperation agreement were underway by early 2008, but were suspended in 2011 without an agreement being reached. Jordanian nuclear energy policy has been spurred by energy security considerations (as it currently imports 97 percent of its energy needs) and the discovery of up to 120,000 tonnes of uranium ore in Jordan. At the same time, the US is primarily interested in management of nuclear technology proliferation. This work considers the perceptions of self and other in Jordanian and US policymaking in order to understand why bilateral cooperation has not materialized and what this means for nuclear proliferation in Jordan. This study finds that the US–Jordanian negotiations have been impeded by contradictory objectives and perceptions, and a "123" agreement is not likely in the short to medium term, but that development of Jordan’s nuclear energy program will likely continue regardless

American power and identities in the age of Obama

Although the election of Barack Obama to the US presidency represents a landmark event in the history of that country, questions remain over its broader political significance. What is the likelihood of Obama's foreign and national security policies differing fundamentally from those of the Bush administrations Does Obama's election signal a post-racial phase in American national life What are the factors that suggest opportunities to change and expand American identities as opposed to those that limit Obama's sphere of action This article introduces the special issue and suggests that although Obama's room for manoeuvre is limited by legacies inherited from the Bush administration, Obama's own appointments to high office as well as other actions, despite the availability of alternative courses, indicate that he is not the transformational president he claimed to be. American identities, therefore, are deeply embedded and remain heavily imbued with racial, religious and imperial features

Genomic surveillance enables the identification of co-infections with multiple SARS-CoV-2 lineages in equatorial Guinea

COVID-19 disease caused by SARS-CoV-2 represents an ongoing global public health emergency. Rapid identification of emergence, evolution, and spread of SARS-CoV-2 variants of concern (VOC) would enable timely and tailored responses by public health decision-making bodies. Yet, global disparities in current SARS-CoV-2 genomic surveillance activities reveal serious geographical gaps. Here, we discuss the experiences and lessons learned from the SARS-CoV-2 monitoring and surveillance program at the Public Health Laboratory on Bioko Island, Equatorial Guinea that was implemented as part of the national COVID-19 response and monitoring activities. We report how three distinct SARS-CoV-2 variants have dominated the epidemiological situation in Equatorial Guinea since March 2020. In addition, a case of co-infection of two SARS-CoV-2 VOC, Beta and Delta, in a clinically asymptomatic and fully COVID-19 vaccinated man living in Equatorial Guinea is presented. To our knowledge, this is the first report of a person co-infected with Beta and Delta VOC globally. Rapid identification of co-infections is relevant since these might provide an opportunity for genetic recombination resulting in emergence of novel SARS-CoV-2 lineages with enhanced transmission or immune evasion potential

(Re)Storying Obama: An Examination of Recently Published Informational Texts

American publishers have published numerous children’s books about Barack Obama over the past several years; most take the form of informational biographies. This article reports on a research project aimed at how these books incorporate sociohistorical narratives, particularly those related to the civil rights movement. Though the features of the books might cause the reader to presume political neutrality, the books link readers to distinct Discourses (Gee, 1996), suggesting particular ideologies. In this article, we identified the following differences: (1) specific happenings from Obama’s life were included in some texts while omitted in others; (2) when the events were included, how they were framed differed; and (3) the narrative constructions of the events varied. We use the differences amongst these texts to argue for the importance of critical literacy in elementary classrooms