"I Really Don't Need You to Talk for Me. I Can Talk for Myself" -- A Phenomenology of Participating in Life Decisions While in Foster Care

This study explores the lived experiences of foster youth in participating in decisions about their lives while in care. Using a research methodology grounded in hermeneutic phenomenology, the study sought to identify the "essence" of this experience through careful analysis of the self-reported experiences of eight former foster youth. Fifteen themes emerged from the interviews with those young adults: (1) No Control; (2) Being Voiceless; (3) A Focus on Now; (4) Not Being Heard; (5) Settling; (6) Living a Public Life; (7) I Can Talk for Myself; (8) Being Spoken For; (9) Powerlessness; (10) Not Knowing; (11) No One Cares; (12) Alone; (13) Confidence; (14) Broken Promises; and (15) Acting Out. Some of these themes -- such as "No Control," "Being Voiceless," "Not Being Heard," "I Can Talk for Myself" and "Being Spoken For" -- echo findings from earlier literature that identified a lack of meaningful opportunities for foster youth to participate in important decisions about their lives while in care. A second group of themes -- "Settling" and "Acting Out" -- captured the study participants' experience in reacting to having few opportunities to contribute to decisions about their lives while in care. The themes in the final group -- "A Focus On Now," "Living a Public Life," "Powerlessness," "An Unclear System," "No One Cares," "Alone," "Confidence" and "Broken Promises" -- provide a more nuanced understanding of the experience of being involved in decisions about one's life while in foster care. Findings from this study suggest that foster children would benefit from having increased opportunities to be involved in decisions about their lives while they are in care. Such opportunities can be facilitated by ensuring frequent, meaningful interaction between foster children and their caseworkers and law guardians; encouraging foster children to attend court proceedings; moving toward a child-centered practice paradigm in child welfare services; respecting the due process right of children; and improving legal representation in dependency cases

Nieuwe composteerbare verpakkingsmaterialen voor voedseltoepassingen

Dit boekje heeft als doel een overzicht te schetsen over nieuwe composteerbare verpakkingsmaterialen. Het boekje is geschreven voor een breed publiek. Het boekje gaat in eerste instantie in op onderwerpen als: (1) wanneer is een materiaal composteerbaar en hoe is dat te zien, (2) milieubelasting van composteerbare materialen en (3) de wet en regelgeving rondom composteerbare producten. Vervolgens wordt meer materiaal technisch aandacht besteed aan de nieuwe composteerbare materialen die geschikt zijn om in te zetten als materiaal voor voedselverpakkingen. Daarbij wordt per materiaal ingegaan op specifieke aspecten wat betreft de herkomst, verwerking en beschikbaarheid. Tevens zal wordt ingegaan op specifieke eigenschappen en huidige toepassingsgebieden in het algemeen en als verpakkingsmateriaal in het bijzonder

The Hurricane Sandy Place Report: Evacuation Decisions, Housing Issues and Sense of Community

Hurricane Sandy was one of the largest storms on record, sweeping through the eastern seaboard of the United States with a massive diameter twice the size of Hurricane Katrina. Although wind speeds did not match those of Katrina, the combination of high tide at landfall and the lunar phase resulted in exceptionally high storm surges. Catastrophic storms such as Hurricane Sandy can have devastating effects on many aspects of human life and the environment, undermining economic activity, crippling critical infrastructure, and disrupting hundreds of thousands of lives for weeks, months, or even years. The Sandy Child and Family Health (S-CAFH) Study was designed to describe and analyze the impacts of the storm on the residents of New Jersey, identifying those needs which emerged and those which are still pressing. The research team – a partnership of faculty and research staff from Rutgers University, New York University, Columbia University, and Colorado State University – randomly selected and surveyed 1,000 residents of New Jersey’s “Disaster Footprint,” representing the experiences of 1 million New Jersey residents living in or near those coastal areas of the state most directly exposed to the storm. The primary focus of this Briefing Report, the first in a series of four thematic reports, is to document the storm’s impact on PLACE in New Jersey residents’ lives, with a particular emphasis on Sandy’s effect on people’s homes and housing decisions

The Hurricane Sandy Person Report: Disaster Exposure, Health Impacts, Economic Burden, and Social Well-Being

The impact a disaster has on the health of a population can be described as having a “dose-response” relationship: the larger the “dose” of the disaster, the greater the health impact or “response” among those individuals and communities exposed. This PERSON Briefing Report describes the impact of Hurricane Sandy (the dose) on the health and well-being of adults and children exposed to the storm (the response). Data for the report are drawn from the baseline survey of the Sandy Child and Family Health (S-CAFH) Study, an observational cohort study of nearly 1,000 randomly-selected New Jersey residents who were living in areas of the state exposed to the storm in 2012. Participants in the study represent over 1 million people living in Sandy’s “Disaster Footprint,” the hurricane-exposed portions of the state. This report describes and examines several critical aspects of individual health and well-being that may be associated with the storm, including: 1. Physical health of adults; 2. Psychological and emotional health of adults; 3. Social and economic health of adults; 4. Health and well-being of children; and 5. The association between disaster exposure and individual outcomes

Phosphorylcholine Monoclonal Antibody Therapy Decreases Intraplaque Angiogenesis and Intraplaque Hemorrhage in Murine Vein Grafts

Funding: This work was supported by the European Union Program Grant CVDIMMUNE [037227], CARDIMMUN [601728] and Marie Sklodowska Curie Actions joint doctoral project MoGlyNet [675527]. Acknowledgments: We would like to thank Raghed Halawani with help of quantifying histological images.Peer reviewedPublisher PD

Automated Deep Learning-Based Classification of Wilms Tumor Histopathology

(1) Background: Histopathological assessment of Wilms tumors (WT) is crucial for risk group classification to guide postoperative stratification in chemotherapy pre-treated WT cases. However, due to the heterogeneous nature of the tumor, significant interobserver variation between pathologists in WT diagnosis has been observed, potentially leading to misclassification and suboptimal treatment. We investigated whether artificial intelligence (AI) can contribute to accurate and reproducible histopathological assessment of WT through recognition of individual histopathological tumor components. (2) Methods: We assessed the performance of a deep learning-based AI system in quantifying WT components in hematoxylin and eosin-stained slides by calculating the Sørensen–Dice coefficient for fifteen predefined renal tissue components, including six tumor-related components. We trained the AI system using multiclass annotations from 72 whole-slide images of patients diagnosed with WT. (3) Results: The overall Dice coefficient for all fifteen tissue components was 0.85 and for the six tumor-related components was 0.79. Tumor segmentation worked best to reliably identify necrosis (Dice coefficient 0.98) and blastema (Dice coefficient 0.82). (4) Conclusions: Accurate histopathological classification of WT may be feasible using a digital pathology-based AI system in a national cohort of WT patients

Clinical Validation of the Analysis of Fluconazole in Oral Fluid in Hospitalized Children

Fluconazole is a first-line antifungal agent for the treatment and prophylaxis of invasive candidiasis in pediatric patients. Pediatric patients are at risk of suboptimal drug exposure, due to developmental changes in gastrointestinal and renal function, metabolic capacity, and volume of distribution. Therapeutic drug monitoring (TDM) can therefore be useful to prevent underexposure of fluconazole in children and infants. Children, however, often fear needles and can have difficult vascular access. The purpose of this study was to develop and clinically validate a method of analysis to determine fluconazole in oral fluid in pediatric patients. Twenty-one paired serum and oral fluid samples were obtained from 19 patients and were analyzed using a validated liquid chromatography-tandem mass spectrometry (LC–MS-MS) method after cross-validation between serum and oral fluid. The results were within accepted ranges for accuracy and precision, and samples were stable at room temperature for at least 17 days. A Pearson correlation test for the fluconazole concentrations in serum and oral fluid showed a correlation coefficient of 0.960 (P < 0.01). The mean oral fluid-to-serum concentration ratio was 0.99 (95% confidence interval [CI], 0.88 to 1.10) with Bland-Altman analysis. In conclusion, an oral fluid method of analysis was successfully developed and clinically validated for fluconazole in pediatric patients and can be a noninvasive, painless alternative to perform TDM of fluconazole when blood sampling is not possible or desirable. When patients receive prolonged courses of antifungal treatment and use fluconazole at home, this method of analysis can extend the possibilities of TDM for patients at home

Contribution of Cell Elongation to the Biofilm Formation of Pseudomonas aeruginosa during Anaerobic Respiration

Pseudomonas aeruginosa, a gram-negative bacterium of clinical importance, forms more robust biofilm during anaerobic respiration, a mode of growth presumed to occur in abnormally thickened mucus layer lining the cystic fibrosis (CF) patient airway. However, molecular basis behind this anaerobiosis-triggered robust biofilm formation is not clearly defined yet. Here, we identified a morphological change naturally accompanied by anaerobic respiration in P. aeruginosa and investigated its effect on the biofilm formation in vitro. A standard laboratory strain, PAO1 was highly elongated during anaerobic respiration compared with bacteria grown aerobically. Microscopic analysis demonstrated that cell elongation likely occurred as a consequence of defective cell division. Cell elongation was dependent on the presence of nitrite reductase (NIR) that reduces nitrite (NO2−) to nitric oxide (NO) and was repressed in PAO1 in the presence of carboxy-PTIO, a NO antagonist, demonstrating that cell elongation involves a process to respond to NO, a spontaneous byproduct of the anaerobic respiration. Importantly, the non-elongated NIR-deficient mutant failed to form biofilm, while a mutant of nitrate reductase (NAR) and wild type PAO1, both of which were highly elongated, formed robust biofilm. Taken together, our data reveal a role of previously undescribed cell biological event in P. aeruginosa biofilm formation and suggest NIR as a key player involved in such process

Systematic analysis of the ability of Nitric Oxide donors to dislodge biofilms formed by Salmonella enterica and Escherichia coli O157:H7

Biofilms in the industrial environment could be problematic. Encased in extracellular polymeric substances, pathogens within biofilms are significantly more resistant to chlorine and other disinfectants. Recent studies suggest that compounds capable of manipulating nitric oxide-mediated signaling in bacteria could induce dispersal of sessile bacteria and provide a foundation for novel approaches to controlling biofilms formed by some microorganisms. In this work, we compared the ability of five nitric oxide donors (molsidomine, MAHMA NONOate, diethylamine NONOate, diethylamine NONOate diethylammonium salt, spermine NONOate) to dislodge biofilms formed by non-typhoidal Salmonella enterica and pathogenic E. coli on plastic and stainless steel surfaces at different temperatures. All five nitric oxide donors induced significant (35-80%) dispersal of biofilms, however, the degree of dispersal and the optimal dispersal conditions varied. MAHMA NONOate and molsidomine were strong dispersants of the Salmonella biofilms formed on polystyrene. Importantly, molsidomine induced dispersal of up to 50% of the pre-formed Salmonella biofilm at 4 degrees C, suggesting that it could be effective even under refrigerated conditions. Biofilms formed by E. coli O157:H7 were also significantly dispersed. Nitric oxide donor molecules were highly active within 6 hours of application. To better understand mode of action of these compounds, we identified Salmonella genomic region recA-hydN, deletion of which led to an insensitivity to the nitric oxide donors