Increasing the Effectiveness and Efficiency of Existing Public Investments in Early Childhood Education: Recommendations to Boost Program Outcomes and Efficiency

Proposes ten reforms to maximize the impact of Head Start, Child Care Development Block Grants, and other existing funding streams, including working with states to align standards, improving provider quality, and enhancing data collection and reporting

The Campus Debit Card Trap: Are Bank Partnerships Fair to Students?

Examines partnerships between colleges and financial firms on campus ID, prepaid, debit, and financial aid disbursement cards and questions about fees, aggressive marketing strategies, and consumer protection. Lists best practices and recommendations

Social Finance: A Primer: Understanding Innovation Funds, Impact Bonds, and Impact Investing

This brief offers a primer on innovation funds, impact bonds, and impact investing, and describes how investors, foundations, service providers, and government leaders can bring these tools to bear on tackling social challenges, making government  work more efficiently, and harnessing the profits of the private sector as forces of good. Also examines how they are being used, and where policy changes can help them reach their full potential. With bibliographical references

Complete sequences of two Staphylococcus aureus plasmids carrying genes for resistance to antibiotics, heavy-metals, biocides and/or virulence

[P292]Aim: To gain detailed insight into the genetic organization of two multidrug resistance plasmids, pSM31 and pSM39, from clinical S. aureus isolates collected in a hospital in Lisbon, Portugal, and to identify factors that may explain their selection and persistence. Methods: Plasmid pSM31 was sequenced by Sanger sequencing using cloning and primer walking whereas pSM39 was sequenced by next generation sequencing. Sequence analysis was carried out using the BlastN and BlastP programs and the ORF Finder software from NCBI.Results: The two plasmids fully characterized in this work were non-conjugative multiresistance plas-mids. pSM31 (27,424 bp) is closely related to the family of globally dispersed plasmids from the pGSA23 group harbouring determinants for resistance to β-lactams and cadmium as well several enterotoxin genes. pSM39 (26,036 bp) is a newly described member of the pGSA11 group that carries genes con-ferring resistance to β-lactams, biocides, cadmium, zinc and mercury and comprises a region that may have been acquired by recombination with a S. epidermidis plasmid. Conclusions: The sequence analysis of these two plasmids confirmed their involvement in antimicrobial resistance among S. aureus strains isolated from a clinical setting. It also provided genetic evidence for the potential risk of co-selection of antibiotic resistance genes and/or virulence genes by selective pressure of antibiotics, biocides and/or heavy metals.otherpublishe

Changes in Exercise Capacity and Ventricular Function in Arrhythmogenic Right Ventricular Cardiomyopathy: The Impact of Sports Restriction during Follow-Up

(1) Background: Physical exercise has been suggested to promote disease progression in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). We aimed to investigate the exercise performance and ventricular function of ARVC patients during follow-up, while taking into account their adherence to exercise restriction recommendations. (2) Methods: This retrospective study included 49 patients (33 male, 67%) who had an exercise test at baseline and after 4.2 ± 1.6 years. Of the 49 ARVC patients, 27 (55%) were athletes, while 22 (45%) were non-athletes. Of the athletes, 12 (44%) continued intensive sports activity (non-adherent), while 15 (56%) stopped intensive physical activity upon recommendation (adherent). The maximum workload in Watts (W), percentage of the target workload (W%), and double product (DP) factor were measured for all patients. (3) Results: The non-adherent cohort had a significant decrease in physical performance (W at baseline vs. follow-up, p = 0.012; W% at baseline vs. follow-up, p = 0.025; DP-factor at baseline vs. follow-up, p = 0.012) over time. Left ventricular (LV) function (LV ejection fraction at baseline vs. follow-up, p = 0.082) showed a decreasing trend in the non-adherent cohort, while the performance of the adherent cohort remained at a similar level. (4) Conclusions: If intensive sports activities are not discontinued, exercise capacity and left ventricular function of athletes with ARVC deteriorates during follow-up. All patients with ARVC need to strictly adhere to the recommendation to cease intense sports activity in order to halt disease progression

Proposal of Epidemiological Cutoff Values for Apramycin 15 μg and Florfenicol 30 μg Disks Applicable to Staphylococcus aureus

Funding Information This study was supported by Project BIOSAFE funded by FEDER through the Programa Operacional Factores de Competitividade–COMPETE and by Fundação para a Ciência e a Tecnologia (FCT, Portugal)—Grant LISBOA-01-0145-FEDER-030713, PTDC/CAL-EST/30713/2017 and by FCT through funds to GHTM (UID/04413/2020), CIISA Project (UID/CVT/00276/2020), and Project PTDC/CVT-CVT/28469/2017. The contributions of Andrea T. Feßler and Stefan Schwarz were financially supported by the German Federal Ministry of Education and Research (BMBF) under project numbers 01KI1727D and 01KI2009D as part of the Research Network Zoonotic Infectious Diseases. Part of this research was supported by Cost Action CA18217: European Network for Optimization of Veterinary Antimicrobial Treatment (ENOVAT).Apramycin and florfenicol are two antimicrobial agents exclusively used in veterinary medicine. Resistance determinants to these antimicrobial agents have been described in several staphylococci, yet no inhibition zone-based epidemiological cutoff (ECOFF) values are available to detect populations harboring resistance mechanisms. In this study, we propose disk diffusion inhibition zone ECOFF values of Staphylococcus aureus for apramycin and florfenicol. The susceptibility to apramycin and florfenicol was evaluated by disk diffusion of five S. aureus collections, comprising 352 isolates of animal (n = 265) and human (n = 87) origin. The aggregated distributions of inhibition zone diameters were analyzed by the normalized resistance interpretation method to obtain normalized wild-type (WT) population distributions and corresponding ECOFF values. The putative WT populations of S. aureus were characterized by an inhibition zone ≥15 mm (ECOFF = 15 mm) for apramycin and ≥21 mm for florfenicol (ECOFF = 21 mm). Five nonwild-type (NWT) isolates were detected for apramycin, all without inhibition zone and harboring the apmA gene, whereas five NWT isolates were identified for florfenicol, all carrying the fexA gene. The proposed ECOFF values for apramycin and florfenicol may be a valuable tool in future antimicrobial resistance monitoring and surveillance studies to identify S. aureus NWT populations toward these antimicrobial agents.publishersversionpublishe

Rationale and design of ASTEROID 2, a randomized, placebo- and active comparator-controlled study to assess the efficacy and safety of vilaprisan in patients with uterine fibroids

Background: Uterine fibroids (UFs) may be treated with progesterone receptor modulators (PRMs), which have been shown to reduce heavy menstrual bleeding and the size of UFs. To date, one PRM (ulipristal acetate) has received regulatory approval for the treatment of UFs; therapy comprises intermittent treatment courses of up to 3 months each, followed by a break to allow two menstruations to occur. We report the design of ASTEROID (Assess Safety and efficacy of vilaprisan in patients with uTERine fibrOIDs) 2, a phase 2 study examining the efficacy and safety of a novel PRM, vilaprisan, in women with UFs. Methods/design: In this randomized multi-arm study, vilaprisan (2 mg daily) will be administered in different regimens: continuous treatment for 12 or 24 weeks, or two 12-week treatment periods separated by a break to allow one menstruation to occur. Efficacy and safety will be compared with that of ulipristal acetate (5 mg daily) and placebo. Patients randomized to receive placebo for 12 weeks will also be given active treatment for 12 weeks. The primary measure of efficacy will be amenorrhoea rate; secondary measures include time to normalized menstrual bleeding and percentage change in UF volume. Endometrial changes will be monitored throughout the study. Discussion: The placebo- and active comparator-controlled trial ASTEROID 2 is the first study to evaluate systematically the efficacy and safety of different treatment regimens of PRMs in women with UFs. The findings of this study will direct the planning of future clinical trials of vilaprisan. (C) 2017 Bayer AG. Published by Elsevier Inc.Peer reviewe

Prospective assessment of daily patterns of mood-related symptoms

Background: The Mood Rhythm Instrument (MRI) is a new self-report questionnaire that aims to assess, the presence, and timing of daily patterns of mood-related symptoms. Here, we examined the reliability of the MRI against a prospective daily investigation over the course of 15 days. As a secondary aim, we examined whether the number of items with a perceived daily pattern correlated with severity of depressive symptoms and psychological well-being. Methods: Thirty-two participants recruited from the general population were asked to prospectively fill out a daily version of the MRI (MRI-d) for 15 days. On the 16th day, they filled out the MRI, the Beck Depression Inventory (BDI) and the World Health Organization 5-item well-being index (WHO-5). Results: The MRI showed high agreement with the MRI-d, which suggests that the MRI is a valid tool to assess daily patterns of mood symptoms. The number of mood symptoms perceived as having daily peaks correlated positively with BDI scores and negatively with WHO-5 scores. Conclusions: The MRI might be a valid tool to investigate the presence of daily patterns and the timing of mood-related factors.The MRI does not seem to be influenced by recall or recency biases. Future studies should test the usefulness of this new clinical instrument in individuals with mood disorders, as well as its ability to detect changes in the daily timing of mood symptoms before and after treatment

ESAC Opinion on the BASF-coordinated Performance Standards-based validation of the LuSens test method for skin sensitisation testing

ESAC, the EURL ECVAM Scientific Advisory Committee, advises EURL ECVAM on scientific issues. Its main role is to conduct independent peer review of validation studies of alternative test methods and to assess their scientific validity for a given purpose. The committee reviews the appropriateness of study design and management, the quality of results obtained and the plausibility of the conclusions drawn. ESAC peer reviews are formally initiated with a EURL ECVAM Request for ESAC Advice, which provides the necessary background for the peer-review and establishes its objectives, timelines and the questions to be addressed. The peer review is normally prepared by specialised ESAC Working Groups. These are typically composed of ESAC members and other external experts relevant to the test method under review. These experts may be nominated by ESAC, EURL ECVAM and partner organisations within the International Cooperation on Alternative Test Methods (ICATM). ESAC ultimately decides on the composition of these Working Groups. ESAC's advice to EURL ECVAM is formally provided as 'ESAC Opinions' and 'Working Group Reports' at the end of the peer review. ESAC may also issue Opinions on other scientific issues of relevance to the work and mission of EURL ECVAM but not directly related to a specific alternative test method. The ESAC Opinion expressed in this report relates to the peer-review of the BASF-coordinated Performance Standards-based validation of the LuSens test method for skin sensitisation testing.JRC.F.3-Chemicals Safety and Alternative Method