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Occupational gender segregation is still a persistent problem in the labor market. This study investigates gender differences in gender typicality and prestige of occupational aspirations in early adolescence, as well as the role of agency and communion in these differences. In total, 2779 adolescents (age 11-15) reported their occupational aspirations, later coded for gender typicality and prestige. Participants also described themselves spontaneously with three attributes, then coded in terms of agency and communion. The results showed significant gender differences in a stereotypical direction for 40% of the occupations named, with boys expressing a clear preference for male-dominated and girls for female-dominated occupations. Conversely, the results revealed higher aspirations among girls regarding occupational prestige. Communion was found to be a significant mediator between gender and aspirations to typically feminine occupations, while agency mediated the relationship between gender and the prestige of aspirations. The findings' implications for theory and practice are discussed.

BackgroundThe prevalence of obesity has increased significantly in recent decades. Today, it is estimated that more than one-third of the world’s population has overweight or obesity, rendering it one of the most significant global health concerns. This article provides a current estimate of the direct costs associated with managing overweight and obesity, including treatment of related complications, among adolescents (≥15 years) and adults in Switzerland.MethodsPrevalence of overweight and obesity based on the BMI reported in the 2017 Swiss Health Survey was extrapolated to 2021. Systematic literature searches were performed to identify treatment costs and epidemiological data of obesity-related complications and costs were extrapolated to 2021. Costing methodology was based on available source data for individual related complications. Treatment costs for complications attributable to overweight and obesity were estimated by applying their population attributable fraction (PAF).ResultsMore than 3.1 million inhabitants of Switzerland aged ≥15 years met the criteria for overweight or obesity in 2021. The prevalence of overweight increase over the past decades from 30.4% in 1992 to 41.9% in 2017 while prevalence of obesity doubled from 5.4 to 11.3%. Overall, the total attributable costs of overweight and obesity caused by seven assessed obesity-related complications (asthma, coronary heart disease, depression, diabetes mellitus, hypertension, osteoarthritis, and stroke) are estimated at CHF 3657–5208 million with most of the costs (97–98%) caused by the assessed obesity-related complications. Only 2–3% of the total costs were attributable to the combined direct management of overweight and obesity by bariatric surgery (CHF 83 million), pharmacological therapy (CHF 26 million) and dietary counseling (CHF 18 million).ConclusionOverweight and obesity impose a significant cost impact on the Swiss healthcare system, accounting for 4.2–6.1% of total healthcare expenditures in 2021. Notably, direct treatment of overweight and obesity accounts for only 0.08–0.18% of the total healthcare expenditures. The analysis also revealed a significant lack of available health economic evidence, necessitating the use of assumptions and approximations in this estimation. This is noteworthy, as respective data would be available in healthcare systems but are either unpublished or inaccessible.

Data on implementation of school-based interventions adds highly valuable information to corresponding evaluation studies. Measuring implementation outcomes, such as fidelity or acceptability, provides information on how to improve current and future implementation processes. Moreover, analyzing intervention outcomes in combination with implementation outcomes sheds light onto the reasons for variabilities in an intervention's effectiveness in different schools. The present paper provides a brief introduction to evaluating the implementation of school-based interventions. First, different types of implementation outcomes and approaches for selecting appropriate outcomes are introduced. Subsequently, measurement issues associated with implementation evaluation in school settings are discussed. Finally, requirements and advantages associated with linking implementation outcomes to intervention outcomes in data analyses are presented. The information is expected to be useful for researchers who are evaluating school-based interventions and especially for those who are new to the field of implementation evaluation.

Abstract Background The first wave of the COVID-19 pandemic reached Germany between March and May 2020. In order to contain the spread of the virus and particularly protect vulnerable people, the government imposed a lockdown in March 2020. In addition to infection control measures, such as hygiene and social distancing requirements, a general ban on access to nursing homes for relatives and external service providers was issued. Methods To investigate the challenges and consequences of the enacted infection prevention measures and specific strategies for nursing homes in Germany, a multicentre cross-sectional qualitative interview study with nursing home managers and ward managers was conducted. Recorded audio data were transcribed, analysed using thematic framework analysis and reflected in peer debriefings. Results Seventy-eight interviews with 40 nursing home managers and 38 ward managers from 43 German nursing homes were conducted. At organisational level, the following six themes were identified: Appointing a multi-professional crisis task force, reorganizing the use of building and spatial structures, continuous adaption and implementation of hygiene plans, adapting staff deployment to dynamically changing demands, managing additional communicative demands and relying on and resorting to informal networks. To deal with the pandemic challenges also six themes can be described for the direct care level: Changed routines, taking over non-nursing tasks, increased medical responsibility, increased documentation demands, promoting social participation and increased communication demands. Also various negative consequences were identified (four themes): Psychological stress, negative emotional consequences, permanent feeling of responsibility and increased potential for conflicts. Positive emotional consequences were also reported (two themes): resources for the challenges and positive emotional consequences for home managers and staff. Conclusions The results of the described challenges, strategies and consequences allow recommendations as basis for possible approaches and successful adaptation processes in nursing home care in the future. In particular, there is a need for local networks to act in a coordinated way and a need for quantitative and qualitative support for nurses, such as staff support as well as advanced nursing practice, to cope with the challenges of the pandemic.

In line with gender stereotypes, girls are expected to take on communal roles and boys to take on agentic roles. Based on gender intensification theory, the present cross-sectional study investigated girls' and boys' gender role identity and corresponding age differences across adolescence using the spontaneous self-description method. In total, 3423 adolescents aged between 11 and 15 years were asked to describe themselves with three attributes later coded in terms of agency and communion. ANOVA results showed expected but small gender differences in agency and communion, and no evidence for gender intensification. Moreover, significant gender differences were found in only 17% of the named attributes. The results thus indicate greater gender similarities than gender differences in adolescents' self-descriptions.

Understanding the needs of emergent bilingual learners (EBLs) is important for consultants working to promote inclusive, affirming school environments. Thirty-three school professionals, including teachers, counselors, and social workers (70% female, 20% persons of color, 18% bilingual) shared their perceptions of experiences of EBLs attending high schools in the United States. In this pre-consultation qualitative data collection, themes were identified from six focus groups. Analyses revealed school, family, peer, and individual influences tied to EBLs' well-being. Participants recommended that schools institute culturally-specific structures to support EBLs, but also intervene with non-EBLs, general education teachers, and mainstream curriculum. Findings suggest that schools revise how they support the academic needs of EBLs. While English as a Second Language programs are commonplace in high school EBLs' language development, participants recommended that such programs should not isolate students from their non-EBL counterparts. Participants also recommended increased access to advanced classes. Implications for systems-level consultation are discussed.

Introduction To evaluate awareness and knowledge of diabetic ketoacidosis (DKA), a common and potentially life-threatening complication in people living with type 1 diabetes (T1D).Research design and methods A survey was developed to assess individuals’ current knowledge, management, and unmet needs regarding DKA. The study was conducted in six Swiss and three German endocrine outpatient clinics specialized in the treatment of diabetes.Results A total of 333 participants completed the questionnaire (45.7% female, mean age of 47 years, average duration of T1D at 22 years). Surprisingly, 32% of individuals were not familiar with the term ‘diabetic ketoacidosis’. Participants rated their own knowledge of DKA significantly lower than their physicians (p

IntroductionDespite predicted efficacy, immunotherapy in epithelial ovarian cancer (EOC) has limited clinical benefit and the prognosis of patients remains poor. There is thus a strong need for better identifying local immune dynamics and immune-suppressive pathways limiting T-cell mediated anti-tumor immunity.MethodsIn this observational study we analyzed by immunohistochemistry, gene expression profiling and flow cytometry the antigenic landscape and immune composition of 48 EOC specimens, with a focus on tumor-infiltrating lymphocytes (TILs).ResultsActivated T cells showing features of partial exhaustion with a CD137+CD39+PD-1+TIM-3+CD45RA-CD62L-CD95+ surface profile were exclusively present in EOC specimens but not in corresponding peripheral blood or ascitic fluid, indicating that the tumor microenvironment might sustain this peculiar phenotype. Interestingly, while neoplastic cells expressed several tumor-associated antigens possibly able to stimulate tumor-specific TILs, macrophages provided both co-stimulatory and inhibitory signals and were more abundant in TILs-enriched specimens harboring the CD137+CD39+PD-1+TIM-3+CD45RA-CD62L-CD95+ signature.ConclusionThese data demonstrate that EOC is enriched in CD137+CD39+PD-1+TIM-3+CD45RA-CD62L-CD95+ T lymphocytes, a phenotype possibly modulated by antigen recognition on neoplastic cells and by a combination of inhibitory and co-stimulatory signals largely provided by infiltrating myeloid cells. Furthermore, we have identified immunosuppressive pathways potentially hampering local immunity which might be targeted by immunotherapeutic approaches.

High school students labeled as English learners, referred to in this article as emergent bilinguals, participated in a mixed-methods study of their social and emotional well-being. Relationships with school personnel, peer relations, and involvement in support activities were connected to well-being while experiences of microaggressions from teachers and peers, lack of access to advanced curricula, and poor integration with mainstream peers were related to negative well-being. A variety of school, peer, and family themes both promoted and compromised well-being. Students' sense of connection to mainstream students was positively related to school belonging and positive affect. A sense of connection to ethnic peers and a positive ethnic identity were related to positive affect but not school belonging. This pattern of findings suggests that connecting with members of both one's ethnic and the mainstream community may lead to greater well-being but integrating into the mainstream community prompts greater school belonging. Implications for practice and policy are discussed.

Abstract It is challenging to determine whether datasets are findable, accessible, interoperable, and reusable (FAIR) because the FAIR Guiding Principles refer to highly idiosyncratic criteria regarding the metadata used to annotate datasets. Specifically, the FAIR principles require metadata to be “rich” and to adhere to “domain-relevant” community standards. Scientific communities should be able to define their own machine-actionable templates for metadata that encode these “rich,” discipline-specific elements. We have explored this template-based approach in the context of two software systems. One system is the CEDAR Workbench, which investigators use to author new metadata. The other is the FAIRware Workbench, which evaluates the metadata of archived datasets for their adherence to community standards. Benefits accrue when templates for metadata become central elements in an ecosystem of tools to manage online datasets—both because the templates serve as a community reference for what constitutes FAIR data, and because they embody that perspective in a form that can be distributed among a variety of software applications to assist with data stewardship and data sharing.

There is no doubt that FAIR Data and Services (GO FAIR Foundation 2019b) are needed to enable data intensive research and innovation. While the FAIR Guiding Principles (Wilkinson et al. 2016) specify the expected behaviors of digital artifacts they do not specify the technology choices actualizing these behaviors, leaving maximum freedom to operate for communities of practices. In recent years, EU research funding including projects associated with the European Open Science Cloud (European Commission 2020) have been coupled to the FAIRness of the actual data and service landscape and promote the development of FAIR implementation roadmaps. Begining in 2019, ENVRI-FAIR (ENVRI Community 2019) used a text-based questionnaire approach with more than 50 questions aiming to capture details on how the FAIR Principles were implemented in the Research Infrastructure data architectures. The responses however, were not directly usable for downstream analysis without substantial post-processing and harmonization (Magagna et al. 2020). At the same time, the GO FAIR Foundation (GO FAIR Foundation 2022) was leading the development of the FAIR Implementation Profile (FIP) concept. A FAIR Implementation Profile is a list of declared technology choices intended to implement each of the FAIR Guiding Principles, made as a collective decision by the members of a particular community of practice (Sustkova et al. 2020, Schultes et al. 2020). The FIP provided a more structured and efficient way of cataloging FAIR-realted implementations, but to scale the approach it was necessary to develop an ontology linked to machine-actionable questionnaires.In a collaborative effort, the FIP ontology (Kuhn et al. 2020) was developed in order to specify questions prompting FAIR Implementation Communities (FICs) to explicitly declare for each of the FAIR Principles, the FAIR Enabling Resources (FER) that the community uses to implement them. FERs are defined as digital objects that provide functions needed to achieve some aspect of FAIRness. Twelve different types of FERs were identified (Magagna and Schultes 2022), such as identifier service type (FAIR Principle F1), lookup-service type (F4) or structured vocabulary type (I2). The FIP as a whole is interpreted as community specific metadata and as such suitable for addressing the directive to reuse "domain-relevant community standards" given in Principle R1.3. To meet the requirement explicitly expressed by the ENVRI communities the FER concept has been extended to include its status as: already available for deployment or are under development; deployed currently or are planned to be deployed in the future; planned replacement of one FER by another in future. The Data Stewardship Wizard (DSW, ds-wizard.org), initially developed as a data management planning (DMP) tool in ELIXIR (Hooft et al. 2016), was desinged with all the required features providing a machine-actionable questionnaire (Pergl et al. 2019). Using knowledge models (KMs, Codevence 2020b) and Jinja2-based document templates (Anonymous 2007), it provides a versatile way to define decision trees in the form of smart questionnaires as well as their transformations to practically any textual and machine-readable document, for example, JSON or RDF or even FAIR Digital Object-like nanopublications. These capabilties were leveraged to build the FAIR Implementation Profile Wizard (FIP Wizard, Codevence 2020) where different KMs were used to create nanopublications within the Wizard environment for 1) FAIR Enabling Resources, 2) FAIR Implementation Communities, 3) Metadata Longevity Plans (the FER type for Principle A2), and 4) the FAIR Implementation Profiles themselves. Users open a questionnaire, fill it in, and then they can preview and publish a nanopublication. The relationships between these FIP-related nanopublications are made by linking the Uniform Resource Identifiers (URI, W3C 2001) of the nanopublications via drop-down lists and autocomplete features in the FIP Wizard questionnaire interface. This functionality is achieved using real-time API calls to a nanopublication querying service as the user types. As curatorial feedback, the user can see various metadata related to the matching nanopublications (e.g. description, timestamp, or approval badge). A custom submission service allows the submission of the nanopubs to a FIP triple store (Kuhn 2020). SPARQL queries can then help to produce the FIP matrix, a cross table for FERs and Communities illuminating convergence opportunitesd by FER reuse over the technological and community landscapes.In this way FIPs are published by the FIP Wizard as FAIR (machine-readable) and Open data, which can then serve as a reference for practical FAIR data stewardship activities conducted by members of that, and other communities. A FIP Wizard module linking the FIP to the DMP based on a mapping of the underlying KMs is under development and will translate the FIP into clear community-specific directives that data stewards can subsequently implement. FIP publication also encourages FIP reuse and repurposing by other communities, which saves time ‘reinventing the wheel’ and simultaneously drives convergence on FAIR implementation choices. Over time, FIPs need to be updated to fit the purposes of the community and to accomodate the ongoing development of FAIR technologies, such as FAIR Digital Objects. The FIP Wizard supports systematic versioningand it is anticipated that this revision legacy can later be mined for insights into FAIR-related technology trends. The FAIR Implementation Profiles and Practice (FIPP) working group (GO FAIR Foundation 2019) focuses on the role of FAIR Implementation Profiles (FIP) in the FAIR Digital Object (FDO) space. FIPs impact the FDO development in 2 principal ways:FIPs provide a socio-technical approach for driving the explicit and systematic community agreements on the use of FAIR implementations including domain-relevant community standards and emerging technologies like FDOs. Hence, FIPs can catalyze FAIR convergence both within and between disciplinary domains. The FIPP WG activities have leveraged FIPs in gaining commitment to FAIR practices, and in some cases, early interest in the deployment of FDOs among circumscribed communities.Once a community of practice declares a FIP (in machine-readable format), the FIP itself becomes a type of FAIR metadata that describes the technical and semantic composition of FDOs that will be subsequently created within that community following FAIR Principle R1.3. The FIPP WG explores how FIPs may be used to instruct computation agents to interpret, interoperate with, and perform operations on FDOs as they are constructed under given FIPs.

Beginning in 1995, early Internet pioneers proposed Digital Objects as encapsulations of data and metadata made accessible through persistent identifier resolution services (Kahn and Wilensky 2006). In recent years, this Digital Object Architecture has been extended to include the FAIR Guiding Principles (Wilkinson et al. 2016), resulting in the concept of a FAIR Digital Object (FDO), a minimal, uniform container making any digital resource machine-actionable. Intense effort is currently underway by a global community of experts to clarify definitions around an FDO Framework (FDOF) and to provide technical specifications (FAIR DO group 2020, FAIR Digital Object Forum 2020 , Bonino da Silva Santos (2021)) regarding their potential implementation.Beginning in 2009, nanopublications were independently conceived (Groth et al. 2010) as a minimal, uniform container making individual semantic assertions and their associated provenance metadata, machine-actionable. They represent minimal units of structured data as citable entities (Mons and Velterop 2009). A nanopublication consists of an assertion, the provenance of the assertion, and the provenance of the nanopublication (publication info). Nanopublications are implemented in and aligned with Semantic Web technologies such as RDF, OWL, and SPARQL (World Wide Web Consortium (W3C) 2015) and can be permanently and uniquely identified using resolvable Trusty URIs (Groth et al. 2021). The existing Nanopublication Server Network provides vital services orchestrating nanopublications (Kuhn et al. 2021) including identifier resolution, storage, search and access. Nanopublications can be used to expose quantitative and qualitative data, as well as hypotheses, claims, negative results, and opinions that are typically unavailable as structured data or go unpublished altogether. The first practical application of nanopublications occurred in 2014, with the publication of millions of nanopublications as part of the FANTOM5 Project (The FANTOM Consortium and the RIKEN PMI and CLST (DGT) 2014, Lizio et al. 2015). Since then, millions of real-world examples spanning diverse knowledge domains are now available on the nanopublication server network.Like nanopublication, the FDOF also posits an ultra-minimal approach to structured, self-contained, machine-readable data and metadata. An FDO consists of: the object itself (subsequently referred to here as the resource to avoid confusion with other meanings of the term “object”); the metadata describing the resource; and a globally unique and persistent identifier with predictable resolution behaviors. These two technologies share the same vision of a data infrastructure, and act as instances of Machine-Actionable Containers (MACs) that make use of minimal uniform standards to enable FAIR operations. Here, we compare the structure and computational behaviors of the existing nanopublication infrastructure, to those in the proposed FAIR Digital Object Framework. Although developed independently there are clear parallels between the vision and the approach of nanopublication and FDOF. Each aspires to minimal standards for the encapsulation of digital information into free-standing, publishable (citable, referenceable) entities. The minimal standards involve globally unique and persistent identifiers that resolve to standardized semantically enabled metadata descriptions that include machine actionable paths to the resource itself.At the same time, there are also differences. The scope of nanopublications is limited to the assertional data type and, as the name suggests, nanopublications should remain small in size (limited to single assertions as individual triples or small RDF graphs). In contrast FDOs are unlimited in their scope, accommodating digital resources of arbitrarily large size, type and complexity, so long as their type can be ontologically described. Furthermore, whereas nanopublications represent a moderately mature technology, the FDOF is a specification still under development. If it were possible to formally draw points of contact between the two approaches, then it would be possible to leverage the vast practical experience gained in the nanopublishing of assertions for the FDO community.Here, inspired by recent applications of nanopublications in the FIP Wizard tool (Schultes et al. 2020), and their extension to research claims (Kuhn 2022, McNamara 2022) and data using Schultes (2022a), Schultes (2022b), we attempt a point-by-point comparison of the specifications between nanopublication and FDOs. We find a remarkable congruence between the currently proposed FDO requirements and the existing nanopublication infrastructure, including several FDO-like qualities already embodied in the nanopublication ecosystem.

There is broad acceptance that FAIR data (Wilkinson et al. 2016) reuse is desirable, with considerable interest and energy being devoted to its realization, but many questions remain on the part of prospective implementers. Fundamental to explaining how best to implement FAIR is an overview of how the many FAIR models (and the technologies that support them) fit together into a coherent "FAIR ecosystem". How do FAIR Implementation Profiles (FIPs) (Schultes et al. 2020) relate to FAIR Data Points (FDPs) (Bonino da Silva Santo et al. 2022), and how do these relate to the concept of FAIR Digital Objects (FDOs) (Hudson et al. 2018)? What is their relationship to other diverse FAIR resources and digital assets (metadata, datasets, repositories, and the complex web of services that run them)? How are these novel and legacy systems intended to interoperate? These questions are often encountered by those involved in the growing number of projects looking at FAIR implementation (ENVRI-FAIR 2019, CODATA 2022, SciDataCon 2022, Seoul Korea 2022b, Health-Holland Project 2021, Health-Holland Project 2022, Swiss Personalized Health Network 2022, Maxwell 2021, VODAN 2020).Such an overview could also inform the development of specifications for the different models involved in a FAIR ecosystem, such as FIPs, FDPs, and the description of digital resources (data and services) at various levels. With an agreed picture of the FAIR-reuse ecosystem, the points of contact and "hand-off" would be easier to describe and coordinate.This presentation looks at questions from FAIR implementation across various settings, and proposes a view of the overall ecosystem which could be agreed and communicated to prospective implementers. It suggests the relationship between various artefacts being discussed in the FAIR community today (FIPs, FDPs, FDOs, and other digital assets) and looks at how these can be connected to the business layer to support the development of services and applications within the envisioned FAIR ecosystem. Notably, this includes how the Cross-Domain Interoperability Framework (CDIF) being developed through the WorldFAIR project can connect to the underlying FAIR ecosystem in practical terms (Weise et al. 2022).The presentation will address high-level considerations around the major technology components of a FAIR ecosystem, their roles within a range of common user scenarios (often having unavoidable legacy technology), and their relationship to each other and to the set of models needed to provide practical services for FAIR interoperation at the business level.Three basic scenarios are examined, in order to understand the practical requirements of different communities. The first scenario is one which has received a good deal of attention during initial efforts to implement the FAIR principles, a domain or user community without a strong pre-existing culture of data sharing and resume, wishes to become FAIR. The second scenario is one where a community with a strong existing culture of data sharing and reuse is looking to integrate its current approaches with those advocated by the FAIR community. The third scenario looks at FAIR from the perspective of the implementer of FAIR services from an “industrial” perspective: how does FAIR provide the kind of market which is needed to support full-scale services and application development?Each of these scenarios provide valid, but different views of what it will take to implement the FAIR in practical terms. In order to understand them, we can draw parallels with other large-scale data-sharing efforts in other communities - the Internet and the Web itself can be understood as a useful example of how vision, standards, and implementation combine to provide successful infrastructure at this scale. Indeed, the concept of Digital Objects (and now FAIR Digital Objects) has its roots in this analogy (Kahn and Wilensky 2006). Other, smaller examples also exist, which focus more specifically on the exchange of data and metadata: for example the Statistical Data and Metadata Exchange (SDMX) Initiative (SDMX community 2022) or the emerging Cross-Domain Interoperability Framework (SciDataCon 2022, Seoul Korea 2022a). Although implemented within targeted communities, these efforts exchange a wide range of data and metadata not entirely dissimilar to what is envisioned in FAIR. There is currently no single exact parallel for FAIR ecosystems, but there are examples from which we can learn in terms of making large-scale data reuse a practical reality.Core to these is a vision of all of the component pieces, and how they can act in concert to provide a scalable infrastructure which will address the needs of the many different communities of users. Such a common vision may be implicitly agreed among those working on FAIR implementation today, but in the interests of clear communication, it is time to document it - and in keeping with FAIR, this documentation should be itself machine-actionable. As we move toward the specification of the many components of the FAIR ecosystem, it seems only common sense to have an agreed roadmap.

Modern advances in DNA sequencing hold the promise of facilitating descriptions of new organisms at ever finer precision but have come with challenges as the major Codes of bionomenclature contain poorly defined requirements for species and subspecies diagnoses (henceforth, species diagnoses), which is particularly problematic for DNA-based taxonomy. We, the commissioners of the International Commission on Zoological Nomenclature, advocate a tightening of the definition of "species diagnosis" in future editions of Codes of bionomenclature, for example, through the introduction of requirements for specific information on the character states of differentiating traits in comparison with similar species. Such new provisions would enhance taxonomic standards and ensure that all diagnoses, including DNA-based ones, contain adequate taxonomic context. Our recommendations are intended to spur discussion among biologists, as broad community consensus is critical ahead of the implementation of new editions of the International Code of Zoological Nomenclature and other Codes of bionomenclature.

Hypoglycemia is a particular problem in people with diabetes while it can also occur in other clinical circumstances. Hypoglycemia unawareness describes a condition in which autonomic and neuroglycopenic symptoms of hypoglycemia decrease and hence are hardly perceivable. A failure to recognize hypoglycemia in time can lead to unconsciousness, seizure, and even death. The risk factors include intensive glycemic control, prior episodes of severe hypoglycemia, long duration of diabetes, alcohol consumption, exercise, renal failure, and sepsis. The pathophysiological mechanisms are manifold, but mainly concern altered brain glucose sensing, cerebral adaptations, and an impaired hormonal counterregulation with an attenuated release of glucagon, epinephrine, growth hormone, and other hormones, as well as impaired autonomous and neuroglycopenic symptoms. Physiologically, this counterregulatory response causes blood glucose levels to rise. The impaired hormonal counterregulatory response to recurrent hypoglycemia can lead to a vicious cycle of frequent and poorly recognized hypoglycemic episodes. There is a shift in glycemic threshold to trigger hormonal counterregulation, resulting in hypoglycemia-associated autonomic failure and leading to the clinical syndrome of hypoglycemia unawareness. This clinical syndrome represents a particularly great challenge in diabetes treatment and, thus, prevention of hypoglycemia is crucial in diabetes management. This mini-review provides an overview of hypoglycemia and the associated severe complication of impaired hypoglycemia awareness and its symptoms, pathophysiology, risk factors, consequences, as well as therapeutic strategies.

Education in implementation science, which involves the training of health professionals in how to implement evidence-based findings into health practice systematically, has become a highly relevant topic in health sciences education. The present study advances education in implementation science by compiling a competence profile for implementation practice and research and by exploring implementation experts' sources of expertise. The competence profile is theoretically based on educational psychology, which implies the definition of improvable and teachable competences. In an online-survey, an international, multidisciplinary sample of 82 implementation experts named competences that they considered most helpful for conducting implementation practice and implementation research. For these competences, they also indicated whether they had acquired them in their professional education, additional training, or by self-study and on-the-job experience. Data were analyzed using a mixed-methods approach that combined qualitative content analyses with descriptive statistics. The participants deemed collaboration knowledge and skills most helpful for implementation practice. For implementation research, they named research methodology knowledge and skills as the most important ones. The participants had acquired most of the competences that they found helpful for implementation practice in self-study or by on-the-job experience. However, participants had learned most of their competences for implementation research in their professional education. The present results inform education and training activities in implementation science and serve as a starting point for a fluid set of interdisciplinary implementation science competences that will be updated continuously. Implications for curriculum development and the design of educational activities are discussed.

The family of sputter deposited granular metal-based carbon-containing sensor films is known for their high sensitivity transforming force-dependent strain into electrical resistance change. Among them nickel–carbon thin films possess a gauge factor of up to 30, compared to only 2 for traditional sensor films of metal alloys. This high sensitivity is based on disordered interparticle tunneling through barriers of graphite-like carbon walls between metal–carbon particles of columnar shape. Force and pressure sensors would benefit a lot from the elevated piezoresistivity. A disadvantage, however, is a disturbing temporal creep and drift of the resistance under load and temperature. This contribution shows how to stabilize such sensor films. A significant stabilization is achieved by partially replacing nickel with chromium, albeit at the expense of sensitivity. The more chromium used in these NixCr1−x-C layers, the higher the optimum annealing temperature can be selected and the better the electrical stabilization. A good compromise while maintaining sensitivities well above the standard of 2 is identified for films with x=0.5 to 0.9, stabilized by optimized temperature treatments. The stabilizing effect of chromium is revealed by transmission electron microscopy with elemental analysis. The post-annealing drives segregation processes in the layer material. While the interior of the layer is depleted of chromium and carbon, boundary layers are formed. Chromium is enriched near the surface boundary, oxidized in air and forms chromium-rich oxide sub-layers, which are chemically very stable and protect against further reactions and corrosion. As a result, creep and drift errors are greatly reduced, so that the optimized sensor coatings are now suitable for widespread use.

Abstract Objective In sub-Saharan Africa, 45% of the rural population uses boreholes (BHs). Despite recent gains in improved water access and coverage, parallel use of unimproved sources persists. Periodic infrastructure disrepair contributes to non-exclusive use of BHs. Our study describes functionality of BHs in 2014, 2015, and 2016 in 15 rural towns in the Eastern Region of Ghana sourced from three groundwater quality clusters (high iron, high salinity, and control). We also assess factors affecting cross-sectional and longitudinal functionality using logistic regression. Results BH functionality rates ranged between 81 and 87% and were similar across groundwater quality clusters. Of 51 BHs assessed in all three years, 34 (67%) were consistently functional and only 3 (6%) were consistently broken. There was a shift toward proactive payment for water over the course of the study in the control and high-salinity clusters. Payment mechanism, population served, presence of nearby alternative water sources, and groundwater quality cluster were not significant predictors of cross-sectional or longitudinal BH functionality. However, even in the high iron cluster, where water quality is poor and no structured payment mechanism for water exists, BHs are maintained, showing that they are important community resources.

Cytochrome P450 monooxygenases are recognized as versatile biocatalysts due to their broad reaction capabilities. One important reaction is the hydroxylation of non-activated C–H bonds. The subfamily CYP153A is known for terminal hydroxylation reactions, giving access to functionalized aliphatics. Whilst fatty derivatives may be converted by numerous enzyme classes, midchain aliphatics are seldomly accepted, a prime property of CYP153As. We report here on a new CYP153A member from the genome of the mesophilic actinobacterium Gordonia rubripertincta CWB2 as an efficient biocatalyst. The gene was overexpressed in Escherichia coli and fused with a surrogate electron transport system from Acinetobacter sp. OC4. This chimeric self-sufficient whole-cell system could perform hydroxylation and epoxidation reactions: conversions of C6–C14 alkanes, alkenes, alcohols and of cyclic compounds were observed, yielding production rates of, e.g., 2.69 mM h−1 for 1-hexanol and 4.97 mM h−1 for 1,2-epoxyhexane. Optimizing the linker compositions between the protein units led to significantly altered activity. Balancing linker length and flexibility with glycine-rich and helix-forming linker units increased 1-hexanol production activity to 350 % compared to the initial linker setup with entirely helical linkers. The study shows that strategic coupling of efficient electron supply and a selective enzyme enables previously challenging monooxygenation reactions of midchain aliphatics. [ABSTRACT FROM AUTHOR]