The networked micro-decision context: a new lens on transformative urban governance.

Recent large-scale societal disruptions, from the COVID-19 pandemic to intensifying wildfires and weather events, reveal the importance of transforming governance systems so they can address complex, transboundary, and rapidly evolving crises. Yet current knowledge of the decision-making dynamics that yield transformative governance remains scant. Studies typically focus on the aggregate outputs of government decisions, while overlooking their micro-level underpinnings.

Stacked conservation practices reduce nitrogen loss: A paired watershed study.

Combinations of best management practices (BMPs) are needed to achieve nutrient reduction goals in the Mississippi/Atchafalaya River Basin (MARB), but field results are crucial to encourage stacked adoption of BMPs. A paired catchment-scale study (2015-18) was done to assess the impact of (i) BMPs, (ii) precipitation patterns, and (iii) seasonality on nitrogen (N) export. Flow-weighted samples were collected and analyzed for total ammonia nitrogen (TAN), nitrate (NO-N), and total nitrogen (TN).

Identifying Electronic Medication Administration Record (eMAR) Usability Issues from Patient Safety Event Reports.

Background: Improving our understanding of the association between medication errors and health information technology (health IT) usability has the potential to reduce errors and improve patient safety. This study used patient safety event reports (PSEs) to investigate the contribution of usability challenges associated with the electronic medication administration record (eMAR) to medication errors.

Methods: Free-text descriptions of 849 medication-related PSEs selected from 2.

Global climate change, diet, and the complex relationship between human host and microbiome: Towards an integrated picture.

Dietary changes can alter the human microbiome with potential detrimental consequences for health. Given that environment, health, and evolution are interconnected, we ask: Could diet-driven microbiome perturbations have consequences that extend beyond their immediate impact on human health? We address this question in the context of the urgent health challenges posed by global climate change. Drawing on recent studies, we propose that not only can diet-driven microbiome changes lead to dysbiosis, they can also shape life-history traits and fuel human evolution.

Impact of stacked conservation practices on phosphorus and sediment export at the catchment scale.

Best management practices (BMPs) are effective in reducing nutrient and sediment export, but further understanding of the benefits of the stacked BMPs is needed. This catchment-scale study was established to evaluate the impact of hydrology and BMPs on phosphorus (P) and sediment losses. Two adjacent catchments, one with a lower level of BMP adoption (Low-BMP #11) and one with a higher level (High-BMP #12), were compared for total P (TP) and total suspended solids (TSS) export.

Long-term impact of poultry manure on crop yield, soil and water quality, and crop revenue.

A long-term poultry manure fertilizer study was initiated in 1998 and continued until 2009 under corn-soybean (CS) rotation. To match changing landscape trends, the plots were switched to continuous corn (CC) from 2010 to 2017. In both CS and CC phases, poultry manure (PM) was applied at the crop rotation recommended agronomic N rate and either half (CC phase) or double (CS phase) the recommended rate.

Catchment-scale Phosphorus Export through Surface and Drainage Pathways.

The site-specific nature of P fate and transport in drained areas exemplifies the need for additional data to guide implementation of conservation practices at the catchment scale. Total P (TP), dissolved reactive P (DRP), and total suspended solids (TSS) were monitored at five sites-two streams, two tile outlets, and a grassed waterway-in three agricultural subwatersheds (221.2-822.

Digital Technologies for Health Workforce Development in Low- and Middle-Income Countries: A Scoping Review.

The collection of journal articles, systematic reviews, and reports published over the last decade that attest to the potential of digital technologies to achieve health workforce improvements across all aspects of the health system is vast. As a capacity-building mechanism, digital technology has potential for low- and middle-income countries (LMICs) to support development of the health workforce, including those health workers based in remote or rural areas, to train, motivate, support, monitor, and pay them. The purpose of this scoping review to present, at a high level, the state of the evidence and best practices in digital strategies for human resources for health and to propose a roadmap for a research agenda to fill identified gaps in the evidence.

Evaluation of the efficacy of rezafungin, a novel echinocandin, in the treatment of disseminated Candida auris infection using an immunocompromised mouse model.

Background: Multiple cases of Candida auris infection have been reported with high mortality rates owing to its MDR nature. Rezafungin (previously CD101) is a novel echinocandin with enhanced stability and pharmacokinetics that achieves high plasma drug exposure and allows for once weekly dose administration.

Objectives: Evaluate the efficacy of rezafungin in the treatment of disseminated C.

Promoting Social Learning at Recess for Children with ASD and Related Social Challenges.

The school playground provides an ideal opportunity for social inclusion; however, children with autism spectrum disorder (ASD) often struggle to engage in appropriate social interactions in this unstructured environment. Thus, they may spend recess time alone. The FRIEND Playground Program is a structured, play-based intervention aimed at improving social interactions of children with ASD and other social challenges during recess.

Evidence on feasibility and effective use of mHealth strategies by frontline health workers in developing countries: systematic review.

Objectives: Given the large-scale adoption and deployment of mobile phones by health services and frontline health workers (FHW), we aimed to review and synthesise the evidence on the feasibility and effectiveness of mobile-based services for healthcare delivery.

Methods: Five databases - MEDLINE, EMBASE, Global Health, Google Scholar and Scopus - were systematically searched for relevant peer-reviewed articles published between 2000 and 2013. Data were extracted and synthesised across three themes as follows: feasibility of use of mobile tools by FHWs, training required for adoption of mobile tools and effectiveness of such interventions.

Students with brain tumors: their post-treatment perceptions of teachers, peers, and academics and retrospective views on school during treatment.

The purpose of this pilot study was: (1) to determine how students surviving brain tumors (BTs) perceive their teachers' responses to them, their own academic performance, and their interactions with peers at school using a new measure; and (2) to describe students' retrospective perceptions of schooling while undergoing treatment. Using a sample of 22 students treated for a BT (ages 9-18) and 22 comparison (ages 8-19), no significant BT-control group differences regarding perceptions of teacher response, academic performance, and interactions with peers at school were found. Generally, students with BTs reported positive school experiences during treatment including favorable perceptions of their teachers' effectiveness, enjoyment of schoolwork, and the quality of their schooling.

Rabbit model of Candida albicans biofilm infection: liposomal amphotericin B antifungal lock therapy.

Catheter-related infections due to Candida albicans biofilms are a leading cause of fungal nosocomial bloodstream infection. In this paper, we describe the development of a model of catheter-associated infection with C. albicans biofilms and show that antifungal lock therapy with liposomal amphotericin B is an effective treatment strategy for these infections.

Efficacy of caspofungin combined with amphotericin B against azole-resistant Candida albicans.

The activity of caspofungin (CFG) combined with amphotericin B (AMB) against azole-resistant Candida albicans was evaluated in vitro (chequerboard) and in vivo (murine). CFG+AMB resulted in positive interactive effects in vitro (fractional inhibitory concentration index 0.75).

Complication rates for the esophageal obturator airway and endotracheal tube in the prehospital setting.

Purpose: The purpose of this study was to determine the complication rates associated with the use of the endotracheal tube (ET) and the use of the esophageal obturator airway/esophageal gastric tube airway (EOA/EGTA) during the treatment of patients with prehospital cardiac arrest.

Methods: A descriptive, quasi-experimental study of 509 consecutive adults, cardiac arrest patients was conducted. Patients were examined prospectively for airway intervention type and complications.

Esophageal gastric tube airway vs endotracheal tube in prehospital cardiopulmonary arrest.

We evaluated the efficacy of the esophageal airway (EA) by prospectively randomizing 175 prehospital cardiopulmonary arrest patients to receive either an esophageal gastric tube airway (EGTA) or an endotracheal tube (ET). If attempts with the initial airway failed, the alternate airway was attempted. The cost of training paramedics in EA use was considerably less than the ET ($80 vs $1,000).

Feasibility of simulating physicians' judgments of patient severity.

This article reports on adopting Gustafson's multiattribute utility method to develop a specific momentary severity index (vis-à-vis severity over time) for nontraumatic chest pain patients. A panel of physicians identified an appropriate set of indicators for the index. Three mathematic models were generated on the basis of these indicators with each model predicting no less than 81% of the variance in overall scores of 96 simulated patients with chest pain.