Target Product Profiles (TPPs) outline the characteristics that new health technologies require to address an unmet clinical need. To date, published TPPs for medical tests have focused on infectious diseases, mostly in the context of low- and middle-income countries. Recently, there have been calls for a broader use of TPPs as a mechanism to ensure that diagnostic innovation is aligned with clinical needs, yet the methodology underpinning TPP development remains suboptimal. Here, we propose that early economic evaluation (EEE) should be integrated within the TPP methodology to create a more rigorous framework for the development of “fit-for-purpose” tests. We discuss the potential benefits that EEE could bring to the core activities underpinning TPP development—scoping, drafting, consensus building, and updating—and argue that using EEE to help inform TPPs provides a more objective, evidence-based, and transparent approach to defining test specifications.

Ultraviolet disinfection (UV-C), though effective, has not been thoroughly evaluated at the level of the clinical end user. We assessed behavioral outcomes related to environmental hygiene among 60 nursing staff in a medical-surgical section after introduction of a UV-C tool aimed at disinfecting 4 high-touch surfaces, and we noted limited changes.

After more than 80 years in predicting organizational performance, empirical evidence reveals a science of teams that seems unable to consistently implement solutions for teams performing in real work settings –outside and away from the isolated teams breeding in research laboratories in the academic context. To bridge this growing practitioners-researchers divide, we first identify five main challenges involved in working with teams today (purposeful team staffing; proper task design and allocation; task and interaction process functionality; appropriate affective tone; and suitable team assessment). And second, we offer a toolbox of interventions (empowering and restorative) to help practitioners to transform the potential threats inherent in these challenges into opportunities for team effectiveness. Our five-challenge diagnosis and proposed intervention toolbox contribute to better address research questions and theoretical falsifiability using teams performing in real work settings, and to assess and intervene in teams by adjusting their internal functioning to contextual conditions and constraints.

Diets varying in SFA and MUFA content can impact glycaemic control; however, whether underlying differences in genetic make-up can influence blood glucose responses to these dietary fatty acids is unknown. We examined the impact of dietary oils varying in SFA/MUFA content on changes in blood glucose levels (primary outcome) and whether these changes were modified by variants in the stearoyl-CoA desaturase (SCD) gene (secondary outcome). Obese men and women participating in the randomised, crossover, isoenergetic, controlled-feeding Canola Oil Multicenter Intervention Trial II consumed three dietary oils for 6 weeks, with washout periods of ˜6 weeks between each treatment. Diets studied included a high SFA/low MUFA Control oil (36·6 % SFA/28·2 % MUFA), a conventional canola oil (6·2 % SFA/63·1 % MUFA) and a high-oleic acid canola oil (5·8 % SFA/74·7 % MUFA). No differences in fasting blood glucose were observed following the consumption of the dietary oils. However, when stratified by SCD genotypes, significant SNP-by-treatment interactions on blood glucose response were found with additive models for rs1502593 (P = 0·01), rs3071 (P = 0·02) and rs522951 (P = 0·03). The interaction for rs3071 remained significant (P = 0·005) when analysed with a recessive model, where individuals carrying the CC genotype showed an increase (0·14 (sem 0·09) mmol/l) in blood glucose levels with the Control oil diet, but reductions in blood glucose with both MUFA oil diets. Individuals carrying the AA and AC genotypes experienced reductions in blood glucose in response to all three oils. These findings identify a potential new target for personalised nutrition approaches aimed at improving glycaemic control.

In this paper, we compile estimates of cod size distributions based on zooarchaeological data and contemporary length-frequency data to look at variability in size composition through time across the North Pacific, from the northern Kuril Islands through the Aleutian Islands to southeast Alaska. The results suggest that a strong longitudinal trend in cod size has remained consistent over time, with the largest cod found to the west. We find that five of nine sites show that overall cod length and distribution of the largest fish remain relatively unchanged. Two sites where we find truncation of the length distributions—or loss of the largest fish—are places where the modern fisheries have the longest history and have been most intense, suggesting a potential for anthropogenic impacts on these local populations. We acknowledge two limitations in these data: (1) there are differences in selectivity between the ancient and modern fisheries; and (2) seasonal variability in fish availability was observed to be an important explanatory variable in the modern data set, but the season of harvest is poorly understood for the ancient collections. Therefore, while differences observed between the two data sets suggest possible anthropogenic influence on the size structure of Pacific cod, they are not conclusive.

Maternal systemic inflammation during pregnancy may restrict embryo−fetal growth, but the extent of this effect remains poorly established in undernourished populations. In a cohort of 653 maternal−newborn dyads participating in a multi-armed, micronutrient supplementation trial in southern Nepal, we investigated associations between maternal inflammation, assessed by serum α1-acid glycoprotein and C-reactive protein, in the first and third trimesters of pregnancy, and newborn weight, length and head and chest circumferences. Median (IQR) maternal concentrations in α1-acid glycoprotein and C-reactive protein in the first and third trimesters were 0.65 (0.53–0.76) and 0.40 (0.33–0.50) g/l, and 0.56 (0.25–1.54) and 1.07 (0.43–2.32) mg/l, respectively. α1-acid glycoprotein was inversely associated with birth size: weight, length, head circumference and chest circumference were lower by 116 g (P = 2.3 × 10−6), and 0.45 (P = 3.1 × 10−5), 0.18 (P = 0.0191) and 0.48 (P = 1.7 × 10−7) cm, respectively, per 50% increase in α1-acid glycoprotein averaged across both trimesters. Adjustment for maternal age, parity, gestational age, nutritional and socio-economic status and daily micronutrient supplementation failed to alter any association. Serum C-reactive protein concentration was largely unassociated with newborn size. In rural Nepal, birth size was inversely associated with low-grade, chronic inflammation during pregnancy as indicated by serum α1-acid glycoprotein.

Producers often contemplate expanding or contracting production to take advantage of cyclical cattle price trends. This study quantifies profitability and risk implications of (1) constant herd size, (2) dollar cost averaging, and (3) price signal-based, anticipatory countercyclical expansion/contraction strategies. Weather simulation on forages with different calving season and land use intensity showed fall calving herds with added hay sales from greater fertilizer use and the countercyclical herd size management strategy to be most profitable regardless of weather or time period analyzed. Income risk was comparable to least fertilizer use. Overall, holding herd size constant led to little regret.

This article analyzes economic tradeoffs among harvest date, fertilizer applied, nutrient removal, and switchgrass yield as they vary with respect to input and output prices. Economic sensitivity analyses suggest that higher biomass prices lead to earlier harvest. Optimal harvest time occurs beyond time of maximum yield because nutrient removal in the biomass is an important economic consideration. Switchgrass price premia that reflect the cost of non-optimal harvest time are driven by standing crop yield loss, nutrient removal, storage loss, and opportunity cost. These price premia could provide a mechanism to compensate producers for alternative harvest times and aid with logistics management.

In situ and operando measurement techniques combined with nanoscale resolution have proven invaluable in multiple fields of study. We argue that evaluating device performance as well as material behavior by correlative X-ray microscopy with <100 nm resolution can radically change the approach for optimizing absorbers, interfaces and full devices in solar cell research. In this article, we thoroughly discuss the measurement technique of X-ray beam induced current and point out fundamental differences between measurements of wafer-based silicon and thin-film solar cells. Based on reports of the last years, we showcase the potential that X-ray microscopy measurements have in combination with in situ and operando approaches throughout the solar cell lifecycle: from the growth of individual layers to the performance under operating conditions and degradation mechanisms. Enabled by new developments in synchrotron beamlines, the combination of high spatial resolution with high brilliance and a safe working distance allows for the insertion of measurement equipment that can pave the way for a new class of experiments. Applied to photovoltaics research, we highlight today’s opportunities and challenges in the field of nanoscale X-ray microscopy, and give an outlook on future developments.

Bushkiller was evaluated under inter- and intraspecific competition. In experiment 1, bushkiller, trumpetcreeper, and wild grape were greenhouse-grown alone and in two or three species mixtures in pots. Of the three species, bushkiller grew the tallest and had the greatest final biomass when grown alone. When all three species were grown together, bushkiller grew over twice the height of trumpetcreeper, over three times the height of wild grape, and over four times the biomass of either competing species. Plots of height over time showed that competition did not affect bushkiller or wild grape growth rate, but trumpetcreeper growth was reduced when grown with bushkiller. In experiment 2, bushkiller was grown in cultures of one, two, and three plants per pot to determine intraspecific competition effects on growth. Final height of bushkiller was not affected by intraspecific competition; however, bushkiller biomass decreased with increasing competition.

Since cow-calf operations are large contributors of agricultural greenhouse gas (GHG) emissions in North America, consequences of pasture species composition, weaning age, and stocking rate decisions were examined by operation size, calving season, and pasture fertility. Fixed resource use and seasonal prices affected the mix of forage and beef production. Overall, adding fertilizer to pasture was unprofitable, resulting in increased stocking rates and greater emissions. Calving season and attendant breeding failure rates influenced the relative profitability of the analyzed beef-production strategies, which in turn affected farm GHG emissions. More-efficient practices led to greater amounts of beef sold per bred cow.

Transsphenoidal surgery is currently performed extensively for lesions of the sella turcica. The mortality and morbidity of this surgical approach are minimal, and the results satisfactory overall. Only a few studies have addressed the complications of this approach. The authors present a retrospective study of 200 transsphenoidal procedures in 196 patients over an eleven year period. There was one death due to meningitis. Major morbidity consisted of intraventricular hemorrhage in three patients, false aneurysm of the internal carotid artery in one patient and thalamic infarction in another patient. Minor morbidity details are presented. The pathogenesis of the most serious of these complications along with possible preventive measures are discussed.

We describe eight cases of primary cerebral lymphoma seen in Manitoba from 1980 to 1985.

The clinical presentation is similar to other primary brain tumors. The diagnosis should be considered when single or multiple, often deep lesions, show dense enhancement on computerized tomographic (CT) scan, but are avascular at angiography. These tumors are histologically indistinguishable from non-Hodgkins lymphomas arising outside the CNS.

The prognosis is poor. However, radiotherapy with or without surgery may offer significant palliation. Although there is no consensus on the value of chemotherapy, corticosteroids alone or multiagent chemotherapy have shown promise in a few cases. For these reasons, histologic diagnosis should be sought in all cases and surgery, radiotherapy, and chemotherapy should be considered, as prolonged survival is possible.

Although carotid endarterectomy is a common surgical procedure in North America, controversies exist regarding the type of anesthesia, the use of indwelling shunts and the need for intraoperative cerebral monitoring. We present a prospective study of 100 carotid endarterectomies performed over a three year period by a single surgeon without the use of indwelling shunts, patch grafts, or EEG monitoring. The combined stroke and mortality rate was 1%. Our results confirm those of other authors; that indwelling shunts and EEG monitoring are not absolutely essential for a satisfactory outcome in carotid endarterectomies.

This is a report of a giant cystic craniopharyngioma which escaped diagnosis for nine years in spite of seemingly thorough neuroradiological investigation, prior to the advent of the CT scan.