Applying system dynamics modeling to foster a cause-and-effect perspective in dealing with behavioral distortions associated with a city's performance measurement programs

This paper aims to show how applying system dynamics methodology to performance management can provide a powerful modeling perspective enabling public sector organizations to prevent, detect, and counteract behavioral distortions associated with performance measurement. A dynamic performance management approach is able to support performance management system designers in outlining and implementing a consistent set of measures that can allow public sector decision-makers to pursue sustainable organizational learning and development. This perspective implies a major shift from a static to a dynamic picture of organizational processes and results. It means framing delays between causes and effects, feedback loops, and trade-offs in time and space associated with alternative scenarios. It also means understanding how different policy levers impact the accumulation and depletion of strategic resources over time, and determining how performance drivers affect end results. An exemplar application of this perspective is outlined in relation to municipal crime-control policies. Unintended behavioral consequences generated by the implementation of the CompStat program (New York Police Department) on reward and performance management systems are framed through the "lenses" of dynamic performance management

Coordinated assembly and release of adhesions builds apical junctional belts during de novo polarisation of an epithelial tube

Using the zebrafish neural tube as a model, we uncover the in vivo mechanisms allowing the generation of two opposing apical epithelial surfaces within the centre of an initially unpolarised, solid organ. We show that Mpp5a and Rab11a play a dual role in coordinating the generation of ipsilateral junctional belts whilst simultaneously releasing contralateral adhesions across the centre of the tissue. We show that Mpp5a and Rab11a-mediated resolution of cell-cell adhesions are both necessary for midline lumen opening and contribute to later maintenance of epithelial organisation.We propose that these roles for both Mpp5a and Rab11a operate through the transmembrane protein Crumbs. In light of a recent conflicting publication, we also clarify that the junction-remodelling role of Mpp5a is not specific to dividing cells

Identification, characterization and heparin binding capacity of a spore-wall, virulence protein from the shrimp microsporidian, Enterocytozoon hepatopenaei (EHP)

This is the final version of the article. Available from the publisher via the DOI in this record.BACKGROUND: The microsporidian Enterocytozoon hepatopenaei (EHP) is a spore-forming, intracellular parasite that causes an economically debilitating disease (hepatopancreatic microsporidiosis or HPM) in cultured shrimp. HPM is characterized by growth retardation and wide size variation that can result in economic loss for shrimp farmers. Currently, the infection mechanism of EHP in shrimp is poorly understood, especially at the level of host-parasite interaction. In other microsporidia, spore wall proteins have been reported to be involved in host cell recognition. For the host, heparin, a glycosaminoglycan (GAG) molecule found on cell surfaces, has been shown to be recognized by many parasites such as Plasmodium spp. and Leishmania spp. RESULTS: We identified and characterized the first spore wall protein of EHP (EhSWP1). EhSWP1 contains three heparin binding motifs (HBMs) at its N-terminus and a Bin-amphiphysin-Rvs-2 (BAR2) domain at its C-terminus. A phylogenetic analysis revealed that EhSWP1 is similar to an uncharacterized spore wall protein from Enterospora canceri. In a cohabitation bioassay using EHP-infected shrimp with naïve shrimp, the expression of EhSWP1 was detected by RT-PCR in the naïve test shrimp at 20 days after the start of cohabitation. Immunofluorescence analysis confirmed that EhSWP1 was localized in the walls of purified, mature spores. Subcellular localization by an immunoelectron assay revealed that EhSWP1 was distributed in both the endospore and exospore layers. An in vitro binding assay, a competition assay and mutagenesis studies revealed that EhSWP1 is a bona fide heparin binding protein. CONCLUSIONS: Based on our results, we hypothesize that EhSWP1 is an important host-parasite interaction protein involved in tethering spores to host-cell-surface heparin during the process of infection.This project was supported by the Agricultural Research Development Agency (ARDA) of Thailand under project CRP5905020530, by the Thailand Research Fund (TRF) under project IRG5980008 and TRG5780032, by the Newton Institutional Links (IL) program to BIOTEC, Thailand and Cefas, UK, and by Mahidol University. PJ would like to thank the Science Achievement Scholarship of Thailand (SAST) for a PhD scholarshi

Midday measurements of leaf water potential and stomatal conductance are highly correlated with daily water use of Thompson Seedless grapevines

A study was conducted to determine the relationship between midday measurements of vine water status and daily water use of grapevines measured with a weighing lysimeter. Water applications to the vines were terminated on August 24th for 9 days and again on September 14th for 22 days. Daily water use of the vines in the lysimeter (ETLYS) was approximately 40 L vine−1 (5.3 mm) prior to turning the pump off, and it decreased to 22.3 L vine−1 by September 2nd. Pre-dawn leaf water potential (ΨPD) and midday Ψl on August 24th were −0.075 and −0.76 MPa, respectively, with midday Ψl decreasing to −1.28 MPa on September 2nd. Leaf g s decreased from ~500 to ~200 mmol m−2 s−1 during the two dry-down periods. Midday measurements of g s and Ψl were significantly correlated with one another (r = 0.96) and both with ETLYS/ETo (r = ~0.9). The decreases in Ψl, g s, and ETLYS/ETo in this study were also a linear function of the decrease in volumetric soil water content. The results indicate that even modest water stress can greatly reduce grapevine water use and that short-term measures of vine water status taken at midday are a reflection of daily grapevine water us

In vitro interaction of chronic wound bacteria in biofilms

Objective: To use in vitro biofilm models of wound bacterial isolates and compare the biofilms produced for different combinations of wound bacterial species. Method: In vitro biofilms, generated by Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus oralis and Micrococcus luteus in microtitre plates and a constant depth film fermentor (CDFF), were studied. The tested isolates all originated from chronic venous leg ulcers. Biofilms of individual and dual combinations of these species were generated in microtitre plate wells at 37°C for 24-96 hours and also in the CDFF for 7 days. The extent of biofilm formation from these systems was then measured using crystal violet staining and/or total viable counts. Results: All the chronic wound bacteria formed biofilms (both individually and in mixed culture) in these models. In mixed species microtitre plate biofilms, both P. aeruginosa and S. aureus appeared to antagonise biofilm formation by S. oralis and M. luteus, with P. aeruginosa completely inhibiting the growth of these organisms. Similar effects were evident in the CDFF model, when all four bacterial species were added simultaneously, with M. luteus being 'out-competed' by the other organisms present and occurring at numbers at the limits of detection; however, there was an apparent increase in the numbers of S. oralis compared with its single culture equivalent. Conclusion: The study highlighted differences in biofilm formation ability for the tested species in both closed and open model systems. Using dual species biofilms, distinct species antagonism was observed with apparent antagonism of pathogenic species over 'commensal' ones. Such a finding provides insight into possible bacterial interactions during development of 'non-healing' wound biofilms

Ethnically diverse urban transmission networks of Neisseria gonorrhoeae without evidence of HIV serosorting

Objective We aimed to characterise gonorrhoea transmission patterns in a diverse urban population by linking genomic, epidemiological and antimicrobial susceptibility data. Methods Neisseria gonorrhoeae isolates from patients attending sexual health clinics at Barts Health NHS Trust, London, UK, during an 11-month period underwent whole-genome sequencing and antimicrobial susceptibility testing. We combined laboratory and patient data to investigate the transmission network structure. Results One hundred and fifty-eight isolates from 158 patients were available with associated descriptive data. One hundred and twenty-nine (82%) patients identified as male and 25 (16%) as female; four (3%) records lacked gender information. Self-described ethnicities were: 51 (32%) English/Welsh/Scottish; 33 (21%) white, other; 23 (15%) black British/black African/black, other; 12 (8%) Caribbean; 9 (6%) South Asian; 6 (4%) mixed ethnicity; and 10 (6%) other; data were missing for 14 (9%). Self-reported sexual orientations were 82 (52%) men who have sex with men (MSM); 49 (31%) heterosexual; 2 (1%) bisexual; data were missing for 25 individuals. Twenty-two (14%) patients were HIV positive. Whole-genome sequence data were generated for 151 isolates, which linked 75 (50%) patients to at least one other case. Using sequencing data, we found no evidence of transmission networks related to specific ethnic groups (p=0.64) or of HIV serosorting (p=0.35). Of 82 MSM/bisexual patients with sequencing data, 45 (55%) belonged to clusters of ≥2 cases, compared with 16/44 (36%) heterosexuals with sequencing data (p=0.06). Conclusion We demonstrate links between 50% of patients in transmission networks using a relatively small sample in a large cosmopolitan city. We found no evidence of HIV serosorting. Our results do not support assortative selectivity as an explanation for differences in gonorrhoea incidence between ethnic groups

Antimicrobial activity of novel mouthrinses against planktonic cells and biofilms of pathogenic microorganisms

Background: Oral diseases pose major public health problems on a global scale. Such diseases have considerable impact on individuals and communities by causing pain and suffering, impairment of function and reduced quality of life. The objective of this study was to evaluate the antimicrobial activity of five mouthrinses against a variety of microorganisms associated with infections of the oral cavity and other body sites. Methods: Mouthrinse formulations were Chlorhexidine (0.2%), Citrox (1%; PerioplusTM/Hyaluronic acid (0.2%)®, Chlorhexidine (0.2%)/Citrox (1%; PerioplusTM), Chlorhexidine (0.2%)/Phenoxetol (0.1%)® and Citrox (1%; Oralclens)TM (Oraldent Ltd; UK). The test microorganisms were the bacteria, Actinomyces viscosus ATCC 1598; Actinomyces odontolyticus NCTC 9935, Clostridium difficile R8651, Prevotella intermedia NCTC 13070T, Prevotella denticola R20771, Porphyromonas gingivalis NCTC 11834T, Streptococcus gordonii ATCC 10558T, Streptococcus sanguinis NCTC 7863, and the fungi, Candida albicans ATCC 90028, Candida dubliniensis CD36, Candida krusei ATCC 6258, Candida glabrata ATCC 2001, Candida tropicalis ATCC 750 and Candida parapsilosis ATCC 22019. Determination of mouthwash antifungal and antibacterial properties was done using a microtitre plate assay. In vitro biofilms were constructed using 96-well plates and exposed to a range of mouthrinse concentrations. The minimum biofilm eradication concentration (MBEC) was established by examining subsequent re-growth of biofilm cells. Results were compared with the minimum inhibitory concentrations (MICs) obtained for planktonic cells cultured in 96-wells plates in various mouthrinse concentrations. Results: Planktonic cells of aerobic microorganisms were inhibited by all mouthrinses at concentrations ≤2% (v/v) of the stock preparation. Chlorhexidine (0.2%)/Citrox (1%)TM had the highest antimicrobial activity, followed by Citrox (1%)TM, 0.2% Chlorhexidine, Chlorhexidine (0.2%)/Phenoxetol (0.1%)® and Citrox (1%)/Hyaluronic acid (0.2%)®. Some anaerobic bacteria (Actinomyces odontolyticus, Clostridium difficile, Prevotella intermedia) exhibited higher MICs for all 5 mouthwashes. There was a noticeable increase (up to 16-fold) in tolerance to the mouthwashes by the majority of aerobic microorganisms when the minimum biofilm eradication concentration was compared to the minimum inhibitory concentration. Conclusion: The results highlight enhanced antimicrobial activity using a combined preparation of Chlorhexidine/Citrox compared with Chlorhexidine alone

Relationship of literacy and heart failure in adults with diabetes

<p>Abstract</p> <p>Background</p> <p>Although reading ability may impact educational strategies and management of heart failure (HF), the prevalence of limited literacy in patients with HF is unknown.</p> <p>Methods</p> <p>Subjects were drawn from the Vermont Diabetes Information System Field Survey, a cross-sectional study of adults with diabetes in primary care. Participants' self-reported characteristics were subjected to logistic regression to estimate the association of heart failure and literacy while controlling for social and economic factors. The Short Test of Functional Health Literacy was used to measure literacy.</p> <p>Results</p> <p>Of 172 subjects with HF and diabetes, 27% had limited literacy compared to 15% of 826 subjects without HF (OR 2.05; 95% CI 1.39, 3.02; <it>P </it>< 0.001). Adjusting for age, sex, race, income, marital status and health insurance, HF continued to be significantly associated with limited literacy (OR 1.55, 95% CI 1.00, 2.41, <it>P </it>= .05).</p> <p>After adjusting for education, however, HF was no longer independently associated with literacy (OR 1.31; 95% CI 0.82 – 2.08; <it>P </it>= 0.26).</p> <p>Conclusion</p> <p>Over one quarter of diabetic adults with HF have limited literacy. Although this association is no longer statistically significant when adjusted for education, clinicians should be aware that many of their patients have important limitations in dealing with written materials.</p

Gate-controlled Guiding of Electrons in Graphene

Ballistic semiconductor structures have allowed the realization of optics-like phenomena in electronics, including magnetic focusing and lensing. An extension that appears unique to graphene is to use both n and p carrier types to create electronic analogs of optical devices having both positive and negative indices of refraction. Here, we use gate-controlled density with both p and n carrier types to demonstrate the analog of the fiber-optic guiding in graphene. Two basic effects are investigated: (1) bipolar p-n junction guiding, based on the principle of angle-selective transmission though the graphene p-n interface, and (2) unipolar fiber-optic guiding, using total internal reflection controlled by carrier density. Modulation of guiding efficiency through gating is demonstrated and compared to numerical simulations, which indicates that interface roughness limits guiding performance, with few-nanometer effective roughness extracted. The development of p-n and fiber-optic guiding in graphene may lead to electrically reconfigurable wiring in high-mobility devices.Comment: supplementary materal at http://marcuslab.harvard.edu/papers/OG_SI.pd

Validation of Self-Reported Health Literacy Questions Among Diverse English and Spanish-Speaking Populations

BackgroundLimited health literacy (HL) contributes to poor health outcomes and disparities, and direct measurement is often time-intensive. Self-reported HL questions have not been validated among Spanish-speaking and diverse English-speaking populations.ObjectiveTo evaluate three self-reported questions: 1 "How confident are you filling out medical forms?"; 2 "How often do you have problems learning about your medical condition because of difficulty understanding written information?"; and 3 "How often do you have someone help you read hospital materials?" Answers were based on a 5-point Likert scale.DesignThis was a validation study nested within a trial of diabetes self-management support in the San Francisco Department of Public Health.ParticipantsEnglish and Spanish-speaking adults with type 2 diabetes receiving primary care.MethodsUsing the Test of Functional Health Literacy in Adults (s-TOFHLA) in English and Spanish as the reference, we classified HL as inadequate, marginal, or adequate. We calculated the C-index and test characteristics of the three questions and summative scale compared to the s-TOFHLA and assessed variations in performance by language, race/ethnicity, age, and education.Key resultsOf 296 participants, 48% were Spanish-speaking; 9% were White, non-Hispanic; 47% had inadequate HL and 12% had marginal HL. Overall, 57% reported being confident with forms "somewhat" or less. The "confident with forms" question performed best for detecting inadequate (C-index = 0.82, (0.77-0.87)) and inadequate plus marginal HL (C index = 0.81, (0.76-0.86); p&lt;0.01 for differences from other questions), and performed comparably to the summative scale. The "confident with forms" question and scale also performed best across language, race/ethnicity, educational attainment, and age.ConclusionsA single self-reported HL question about confidence with forms and a summative scale of three questions discriminated between Spanish and English speakers with adequate HL and those with inadequate and/or inadequate plus marginal HL. The "confident with forms" question or the summative scale may be useful for estimating HL in clinical research involving Spanish-speaking and English-speaking, chronically-ill, diverse populations