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Traditionally, bioenterprise has been dominated by drug development and medical technology. Today, we are experiencing an unprecedented surge in opportunities for life scientists of all backgrounds, and many are joining the sector from other areas. Hear from stakeholders across the bioenterprise community about how you can make the most of it.

For many transgender individuals, researchers, and practitioners, an eco-development framework provides unique insights on the social influences that dynamically interact, influence, conflict, and ...

When the COVID-19 pandemic struck US hospitals in early 2020, many nurse leaders went into crisis mode management. As the pandemic ensued, shared governance endured at hospitals with well-established models, even without council meetings. At other hospitals, clinical nurses began to wonder what happened to shared governance. This article offers advice and lessons learned from the interplay between the COVID-19 pandemic and shared governance at American hospitals.

The study aim was to determine if a targeted redesign of shared decision making improved shared governance (SG).Nursing SG is collaborative decision making between nurses at every level; it improves quality of care, empowers nurses, and enhances nurse satisfaction.Using a quasi-experimental, pretest/posttest design, researchers electronically distributed the Index of Professional Nursing Governance (IPNG) to an inclusive, convenience sample of RNs in a Magnet®-designated 377-bed community medical center. Preintervention scores were used to tailor a redesign of shared decision making, and postintervention data were collected within 1 year to measure outcomes.IPNG overall score and 5 of 6 subscale scores significantly increased after the redesign.Changes to an SG structure can take 2 to 5 years to be realized. Our findings corroborate that the IPNG is a valuable tool in promoting setting-specific SG.

Aircraft electric propulsion concepts have been enabled by a number of technologies, including the increase in cell specific energy and volumetric density, and reductions in the cost per kilowatt-hour (kWh) of batteries. Cell technology based around Li Sulfur (LiS) chemistry promises increased specific energy and is a candidate for vehicle electric propulsion. Such technology has been used for specialized airborne applications, such as high-altitude, long-endurance aircraft. In this work, its suitability for as a source of power for electric propulsion for a general aviation aircraft is presented.

A 35-year-old woman with a history of substance abuse and a seizure disorder presented to the emergency department with altered mental status. According to her family, she was behaving oddly for the past several days, including standing and staring throughout the day, not speaking and resisting

“Chirp”-style sidescan sonar systems, which use pulse-compressed signals, provide advantages over pulsed continuous-wave sidescan sonar systems, including increased imaging range, resolution, and image fidelity. Marine Sonics (Yorktown, VA) has recently released a system, the “Arc Scout”, using modern electronics in a form factor suitable for installation on small autonomous underwater vehicles (AUVs). A number of these systems have been integrated into REMUS 100 AUVs, and their performance imaging archaeological targets on the seabed has been evaluated. Targets were surveyed under a variety of conditions at four different sonar center frequencies: 600 kHz, 900 kHz, 1200 kHz, and 1800 kHz. The results were analyzed to provide performance assessments for selecting the sonar operating characteristics based on area search rate and target size. The hardware and software integration required for the retrofit installation of these sonar systems the REMUS 100 vehicle is detailed.

The true value of a battery energy storage system (BESS) can only be established when multiple technically and operationally compatible services rendered by the BESS are ‘stacked’ and valued. This paper makes an attempt towards estimating the stacked value of a BESS providing multiple services such as peak shaving, frequency regulation, and reserve support etc. in an Arizona-based test system. This has been achieved by developing a mixed-integer programming (MIP) based optimization model that captures the operation of the BESS in the test system. The obtained results suggest that BESS with stacked benefits yield significantly more value than BESS delivering a single primary service in isolation.

Objective To evaluate the costs of using dextrose gel as a primary treatment for neonatal hypoglycemia in the first 48 hours after birth compared with standard care. Study design We used a decision tree to model overall costs, including those specific to hypoglycemia monitoring and treatment and those related to the infant's length of stay in the postnatal ward or neonatal intensive care unit, comparing the use of dextrose gel for treatment of neonatal hypoglycemia with placebo, using data from the Sugar Babies randomized trial. Sensitivity analyses assessed the impact of dextrose gel cost, neonatal intensive care cost, cesarean delivery rate, and costs of glucose monitoring. Results In the primary analysis, treating neonatal hypoglycemia using dextrose gel had an overall cost of NZ$6863.81 and standard care (placebo) cost NZ$8178.25; a saving of NZ$1314.44 per infant treated. Sensitivity analyses showed that dextrose gel remained cost saving with wide variations in dextrose gel costs, neonatal intensive care unit costs, cesarean delivery rates, and costs of monitoring. Conclusions Use of buccal dextrose gel reduces hospital costs for management of neonatal hypoglycemia. Because it is also noninvasive, well tolerated, safe, and associated with improved breastfeeding, buccal dextrose gel should be routinely used for initial treatment of neonatal hypoglycemia. Trial registration Australian New Zealand Clinical Trials Registry: ACTRN12608000623392.

BACKGROUND Gay, bisexual, and other cisgender men who have sex with men (GBMSM) are disproportionately affected by the HIV pandemic. Traditionally, GBMSM have been deemed less relevant in HIV epidemics in low- and middle-income settings where HIV epidemics are more generalized. This is due (in part) to how important population size estimates regarding the number of individuals who identify as GBMSM are to informing the development and monitoring of HIV prevention, treatment, and care programs and coverage. However, pervasive stigma and criminalization of same-sex practices and relationships provide a challenging environment for population enumeration, and these factors have been associated with implausibly low or absent size estimates of GBMSM, thereby limiting knowledge about the dynamics of HIV transmission and the implementation of programs addressing GBMSM. OBJECTIVE This study leverages estimates of the number of members of a social app geared towards gay men (Hornet) and members of Facebook using self-reported relationship interests in men, men and women, and those with at least one reported same-sex interest. Results were categorized by country of residence to validate official size estimates of GBMSM in 13 countries across five continents. METHODS Data were collected through the Hornet Gay Social Network and by using an a priori determined framework to estimate the numbers of Facebook members with interests associated with GBMSM in South Africa, Ghana, Nigeria, Senegal, Côte d'Ivoire, Mauritania, The Gambia, Lebanon, Thailand, Malaysia, Brazil, Ukraine, and the United States. These estimates were compared with the most recent Joint United Nations Programme on HIV/AIDS (UNAIDS) and national estimates across 143 countries. RESULTS The estimates that leveraged social media apps for the number of GBMSM across countries are consistently far higher than official UNAIDS estimates. Using Facebook, it is also feasible to assess the numbers of GBMSM aged 13-17 years, which demonstrate similar proportions to those of older men. There is greater consistency in Facebook estimates of GBMSM compared to UNAIDS-reported estimates across countries. CONCLUSIONS The ability to use social media for epidemiologic and HIV prevention, treatment, and care needs continues to improve. Here, a method leveraging different categories of same-sex interests on Facebook, combined with a specific gay-oriented app (Hornet), demonstrated significantly higher estimates than those officially reported. While there are biases in this approach, these data reinforce the need for multiple methods to be used to count the number of GBMSM (especially in more stigmatizing settings) to better inform mathematical models and the scale of HIV program coverage. Moreover, these estimates can inform programs for those aged 13-17 years; a group for which HIV incidence is the highest and HIV prevention program coverage, including the availability of pre-exposure prophylaxis (PrEP), is lowest. Taken together, these results highlight the potential for social media to provide comparable estimates of the number of GBMSM across a large range of countries, including some with no reported estimates.

Background: Professional nursing governance refers to the processes and structures that influence nursing practice within an organisation. This study measured the effect of structured meeting communication processes on nurses' perceptions of professional governance. Method: The intervention was implemented in eight hospital wards. After 3 months, nurses on the intervention wards and eight matched-control wards completed the Index of Professional Nursing Governance (N = 225). Data were compared with a sample of Magnet (R) (N = 3) and non-Magnet (N = 46) hospitals. Results: There was substantial variation in nurses' perceptions of governance across the 16 wards, irrespective of the intervention. Compared to non-Magnet hospitals, the overall score and three of the six subscales scores were higher in this study. Magnet hospitals scores, however, were typically higher suggesting greater progress towards shared governance. Conclusions: Professional nursing governance can be highly variable across individual wards and tailored interventions should be considered. Refereed/Peer-reviewed

The objective of this study was to examine RNs' experiences with health information technology (HIT) and their perceptions of the effect of this technology on quality of care and daily work. The adoption and use of HIT are expected to increase substantially over the next 5 years because of policy efforts at the federal and state levels. Given the size of the RN workforce and their critical role in healthcare delivery, their experiences with HIT could help adoption efforts. The method used was a nationally representative survey of 1500 nurses with a 56% response rate. Findings suggest wide variation in the availability of HIT functionality, with functions more likely available to hospital RNs. Overall, RNs perceived the effect of these technologies on quality of care and their daily work as positive. Ensuring that HIT systems are relevant to and usable for RNs will be a critical component in achieving the meaningful use of these systems.

Objective : The objective of the study was to compare perceptions of RNs employed in Magnet®, in-process (ie, hospitals seeking Magnet recognition), and non-Magnet hospitals using data from the 2010 National Survey of Registered Nurses (NSRN). Background : The NSRN is administered biennially and measures nurses' perceptions about their profession, workplace environment, and professional relationships. Methods : Self-administered mail survey to a national sample of 1,500 RNs was used. Bivariate statistical techniques were used to analyze responses from 518 nurses who indicated their employer's Magnet status and to examine associations between Magnet status and the nurses' perceptions of career satisfaction, the nursing shortage, work environment, opportunities to influence the workplace, and professional relationships. Results : Nurses employed in all 3 groups (Magnet, in-process, and non-Magnet hospitals) were uniformly satisfied with being a nurse, although significantly more Magnet and in-process nurses would recommend nursing as a career than would non-Magnet RNs. Views of workplace safety were similar across groups, with no significant differences in violence, verbal abuse, discrimination, or harassment; however, Magnet nurses reported significantly more musculoskeletal injuries. Magnet and in-process nurses rated opportunities to influence decisions about workplace organization and participate in shared governance and employer-paid continuing education, and relationships with advanced practice nurses and nursing faculty higher than did non-Magnet nurses; relationships with new nurses and physicians were not different across groups. Conclusions : The Magnet program continues to have a positive influence on nurses, their decision making, and their professional relationships. The paucity of other differences suggests that Magnet, in-process, and non-Magnet organizations are increasingly guided by a shared set of principles that define a positive professional environment derived not only by the Magnet program, but also by other professional organizations and forces.

A new doctor of nursing practice (DNP), Cynthia, was distraught. "I'm going to lose my job, Bob. My chief nurse told me to implement shared governance, and I didn't." Cynthia's capstone program included measuring governance in her hospital after a period of implementation, and the score fell short of the shared governance zone. "But Cynthia," I insisted, "Surely, you and she were in this together. She had a role in this, too." "No, Bob. She told me she was too busy, and it was my job." I called several months later, and Cynthia answered the phone. I said, "I guess you didn't get fired. You're still there." "Yes. It's a funny thing. The chief nurse was fired."

When we graduated from veterinary school, we thought homework would finally end. Little did we know that even after we became full-fledged veterinarians, homework would never end. Veterinary medicine is constantly evolving. Because new medical treatments and surgeries are constantly being developed in all fields of veterinary medicine, it is our responsibility, even our obligation, to ourselves, our clients, and our patients to keep abreast of these developments. Making time and resources available to obtain continuing education (CE) can be challenging given the demands of our work and families. In veterinary school, new information was spoon-fed to us in a classroom. But as graduate veterinarians, we have to actively join organizations, spend hard-earned salaries, and often travel long distances to obtain CE. We also must be knowledgeable of CE requirements demanded by the various states in which we practice and by the various specialty colleges to which many of us belong.Veterinarians handle CE in different ways. Some look forward to CE; others dread it. To address this issue, I invited 6 practitioners working in different states to comment on their feelings and approaches to CE. The participants are William Benner, MS, DVM, VCA South Hadley Animal Hospital, South Hadley, MA, USA; Kenneth D. Dazen, VMD, Dipl ABVP (Avian Practice), Animal and Bird Health Care Center, Cherry Hill, NJ, USA; Robert Hess, Jr, DVM, Winter Park Veterinary Hospital, Winter Park, FL, USA; Michael Lutz, DVM, West Meade Veterinary Clinic, LLC, Nashville, TN, USA; Robert Ness, DVM, Ness Exotic Wellness Center, Lisle, IL, USA; and Rhoda Stevenson, DVM, Dipl ABVP (Avian Practice), Exotic Bird Hospital, Jacksonville, FL, USA. I hope this discussion will make you aware not only of how your colleagues approach CE but also of how you think about CE, so that you can stay on top of new developments in veterinary medicine.

Aim To determine the accuracy of caregivers’ recall of hospital admissions in early childhood. Methods Prospective cohort study of babies born at risk of neonatal hypoglycaemia at Waikato Hospital, New Zealand, a regional public hospital and sole provider of acute inpatient care to over 100,000 children. Caregivers’ recall of children's hospital admissions up to 4.5 years was compared with medical records. Accuracy of recall was related to neonatal and socio-demographic characteristics. Results Of 267 children, 179 (67%) visited hospital and 106 (40%) were admitted at least once. The most frequent reasons for admission were for respiratory (29%) and gastrointestinal (18%) problems. Of 106 children admitted to hospital, 27 (25%) caregivers did not recall the admission and only 37 (35%) accurately recalled the number of admissions. The accuracy of recall was lower for gastrointestinal (38%) and surgical (40%) problems, while recall of respiratory (64%) and ear, nose and throat (60%) admissions was more accurate. Low socio-economic status and multiple admissions were associated with less accurate recall of number of admissions. Conclusion Caregivers do not accurately report hospital admissions. Questionnaire data about use of hospital facilities should be interpreted cautiously and may not be sufficiently accurate for use in research studies.

To determine neurodevelopmental outcome at 2 years' corrected age in children randomized to treatment with dextrose gel or placebo for hypoglycemia soon after birth (The Sugar Babies Study).This was a follow-up study of 184 children with hypoglycemia (2.6 mM [47 mg/dL]) in the first 48 hours and randomized to either dextrose (90/118, 76%) or placebo gel (94/119, 79%). Assessments were performed at Kahikatea House, Hamilton, New Zealand, and included neurologic function and general health (pediatrician assessed), cognitive, language, behavior, and motor skills (Bayley Scales of Infant and Toddler Development, Third Edition), executive function (clinical assessment and Behaviour Rating Inventory of Executive Function-Preschool Edition), and vision (clinical examination and global motion perception). Coprimary outcomes were neurosensory impairment (cognitive, language or motor score below -1 SD or cerebral palsy or blind or deaf) and processing difficulty (executive function or global motion perception worse than 1.5 SD from the mean). Statistical tests were two sided with 5% significance level.Mean (± SD) birth weight was 3093 ± 803 g and mean gestation was 37.7 ± 1.6 weeks. Sixty-six children (36%) had neurosensory impairment (1 severe, 6 moderate, 59 mild) with similar rates in both groups (dextrose 38% vs placebo 34%, relative risk 1.11, 95% CI 0.75-1.63). Processing difficulty also was similar between groups (dextrose 10% vs placebo 18%, relative risk 0.52, 95% CI 0.23-1.15).Dextrose gel is safe for the treatment of neonatal hypoglycemia, but neurosensory impairment is common among these children.Australian New Zealand Clinical Trials Registry: ACTRN 12608000623392.

Upon ingestion ethylene glycol (EG, monoethylene glycol) is rapidly absorbed from the gastrointestinal tract, and depending on the severity of exposure signs of toxicity may progress through three stages. Neurological effects characterize the first step consisting of central nervous depression (intoxication, lethargy, seizures, and coma). The second stage, usually 12-24 h after ingestion, is characterized by metabolic acidosis due to the accumulation of acidic metabolites of EG, primarily glycolic acid (GA), contributing to the ensuing osmolal and anion gaps. Stage 3, generally 24-72 h after ingestion, is determined mainly by oxalic acid excretion, nephropathy, and eventual renal failure. Because the toxicity of EG is mediated principally through its metabolites, adequate analytical methods are essential to provide the information necessary for diagnosis and therapeutic management. The severe metabolic acidosis and multiple organ failure caused by ingestion of high doses of EG is a medical emergency that usually requires immediate measures to support respiration, correct the electrolyte imbalance, and initiate hemodialysis. Since metabolic acidosis is not specific to EG, whenever EG intoxication is suspected, every effort should be made to determine EG as well as its major metabolite GA in plasma to confirm the diagnosis and to institute special treatment without delay. A number of specific and sensitive analytical methods (GC, GC-MS, or HPLC) are available for this purpose. Due to the rapid metabolism of EG, the plasma concentration of GA may be higher than that of EG already upon admission. As toxicity is largely a consequence of metabolism of EG to GA and oxalic acid, the simultaneous quantification of EG and GA is important. Formation of calcium oxalate monohydrate in the urine may be a useful indicator of developing oxalate nephrosis although urine crystals can result without renal injury. The pathways involved in the metabolism of EG are qualitatively similar in humans and laboratory animals, although quantitative differences have been reported. Comparison between species is difficult, however, because the information on humans is derived mainly from acute poisoning cases whereas the effects of repeated exposures have been investigated in animal experiments. Based on published data the minimum human lethal dose of EG has been estimated at approx. 100 ml for a 70-kg adult or 1.6 g/kg body weight (calculation of dose in ml/kg to mg/kg based in EG density=1.11 g/l). However, human data from case reports are generally insufficient for the determination of a clear dose-response relationship and quantification of threshold doses for systemic toxicity, in particular renal effects, is limited. As toxicity is largely a consequence of metabolism of EG to GA, it is important to note that no signs of renal injury have developed at initial plasma glycolate concentrations of up to 10.1 mM (76.7 mg/dl). Plasma EG levels of 3.2 mM (20 mg/dl) are considered the threshold of toxicity for systemic exposure, if therapeutic strategy is based on the EG concentration alone.

Elubiol (dichlorophenyl imidazoldioxolan) is used as a cosmetic ingredient for the conditioning of oily skin. It was found in controlled and open clinical trials to control sebum output effectively at the skin surface. In vitro testing has indicated a potential of reducing cholesterol biosynthesis, thus modulating the lipid composition of sebum; of antimicrobial activity against organisms associated with dandruff or seborrhea; and of scavenging free radicals. Elubiol is well tolerated and no systemic toxicity is observed on dermal application. There is no evidence of sensitization potential in vivo, nor of specific irritancy or phototoxicity in vitro. A standard battery of tests revealed no genotoxic potential. Topical Elubiol hardly penetrates into the epidermis and there is no evidence that percutaneous absorption occurs, as confirmed by studies in animals and humans. In the absence of systemic exposure, Elubiol is considered to be a safe ingredient for cosmetic use.

Based on the published literature, the assessment of nonclinical and clinical data on retinol indicates absence of any systemic effects after topical or cosmetic use. Hypervitaminosis A that may be...

Quantitative risk assessments can be performed on coal tar by determining the values for specific coal tar polyaromatic hydrocarbons (PAHs) in relationship to an established No Significant Risk Level (NSRL). When evaluating the safety of coal tar itself as an ingredient, quantifying the amount of coal tar, and limiting a specific PAH such as benzo(a)pyrene, a safety assessment can be made. This paper documents such as assessment for the use of coal tar in shampoo products.

Overuse and abuse of phenacetin-containing mixed analgesics has contributed to end-stage renal disease. Combination analgesics, especially those coformulated with caffeine, have been implicated as imparting a greater risk of analgesic-associated nephropathy (AAN) than single or coformulated analgesics without caffeine. This has led to a recommendation that the sale of "two plus caffeine" analgesic mixtures be reclassified from over-the-counter to prescription only availability. There is a rational basis for coformulating acetylsalicylic acid (ASA) and acetaminophen (paracetamol) as this reduces the dose of each, without altering efficacy. The coformulation of caffeine with these analgesics has a significant adjuvant effect and increases analgesic efficacy 1.4-1.6-fold. Currently available animal and human data do not support the notion that the nephrotoxic risk from coformulated ASA and acetaminophen is higher than the risk from either ASA or acetaminophen alone, in equivalent analgesic doses. There are no epidemiological data that implicate caffeine in AAN, and only limited evidence that links excessive acetaminophen usage to renal disease. There is no evidence that caffeine increases analgesics papillotoxicity directly. The presence of caffeine in mixtures of analgesics are no more addictive than other sources of caffeine. There is no evidence to suggest that adding caffeine to analgesic mixtures enhances the potential for promoting analgesic misuse in the general population. Thus distinct therapeutic benefits of ASA, acetaminophen and caffeine appear to outweigh any known risk. It is doubtful if preventing the availability of these products will significantly affect the role of analgesic abuse/overuse in end-stage renal disease. Better risk management would come from a focused educational program, developed in a close collaboration between industry, healthcare professionals and consumer organizations, such a program must warn against the potential dangers of analgesic and non-steroidal anti-inflammatory drug misuse.

The interest in the Magnet Journey extends to the Middle East. The results of this study revealed nurses in hospitals that are on the Journey to Magnet perceive that decision making is shared between nursing management/administration and staff nurses. Nurses in these hospitals positively attribute their involvement and engagement in every aspect of the nursing profession. This scheme of shared governance promotes professional accountability and enhances individual autonomy, authority, and control. The growth of health care in the Middle East region with rising expectations for patient care outcomes will challenge the nursing profession in the future. Shared governance will certainly help nurses take ownership in making decisions for patient care and as a result achieve better patient outcomes.

As health care delivery organizations react to the changes brought about by public and private sector reform initiatives, RNs can anticipate that, in addition to intended outcomes, there will be unpredictable pressures and unintended consequences arising from reform. Biennial national surveys of RNs conducted over the past decade have explored various changes in the nursing workforce, quality of the workplace environment, staffing and payment policies, and RNs' views of health policy, including their expectations of health reform. The latest survey results offer a picture of RNs' capacity to practice successfully in a care delivery environment that, over the current decade, is expected to emphasize teams, care coordination, and become driven increasingly by payment incentives that reward quality, safety, and efficiency. If RNs are provided with strong clinical leadership, participate in developing an achievable vision of the future, and if supported to take risks and innovate to improve the quality and efficiency of care delivery, then the profession is likely to thrive rather than struggle during the health reform years that lie ahead. Increasing the education and preparation of nursing leaders, and particularly unit-level managers, will be increasingly vital for nursing to prosper in the future.