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PurposeFood supply chain theory and practice generally assumes that the business practices and processes involved are ethical, legal and value-adding when this is not always so, as demonstrated by the ongoing 2013 horse-meat scandal. Although it is ostensibly a UK-based affair, it encompasses the meat processing industry across Europe. This study, thus, aims to examine supply chain criminality and to highlight “scandal scripts” which amplify underlying issues.Design/methodology/approachA systematic review of extant literature on the scandal adds to that body of work, updating the existing narrative to include a detailed analysis of convicted “industry insiders”, highlighting supply chain issues involved in the frauds. Micro-stories of businessmen involved are presented to enable an empirical exploration of their illegal involvement in the meat trade. Using storied data from accounts of the scandal as contemporary examples, emerging themes and issues are outlined through a mixed methods qualitative approach consisting of ethical covert research, using documentary research strategy underpinned by narrative inquiry.FindingsMedia coverage perpetuated various myths notably that the fraud was carried out by “shadowy”, Eastern European “mafia figures” exploiting the extended food supply chains. The analysis is aided by the use of media hypothesis. Far from being a mafia-inspired fraud, the criminal activity was organised in nature and committed by insider businessmen. The findings demonstrate that supply chains are complex and require an understanding of storied business practices, including the ethical and illegal.Research limitations/implicationsFrom an academic perspective, there are implications such as the dearth of academic research and policy-related studies into food fraud possibly because of the difficulty in obtaining data because of access to such enterprises and entrepreneurs necessitating reliance upon documentary sources and investigative journalism.Practical implicationsThere are distinct policy implications, particularly the need to legislate against international criminal conspiracies and everyday ordinary organised food frauds perpetuated. Lax penalties do little to prevent such crimes which need to be taken more seriously by the authorities, and treated as major crime. In formulating food laws, rules and regulations, greater cognisance should be taken to consider how supply chains in the food industry could be better protected from predatory criminal actions.Originality/valueThis novel qualitative study will enable academics and practitioners to better understand illegal enterprise, food fraud and risk management from both operational and supply chain perspectives and will be useful to investigators by furthering our understanding of entrepreneurial practice and morality in the food industry.

This article explores a new advanced nursing role within interventional cardiology. The role was jointly developed by the lead consultant and clinical nurse specialist, and has received the first official centre of excellence award in the world. As a result, the service will now deliver expert training programmes taught by the consultant team and specialist nurse. This service was created for patients with mitral valve disease. It has a dedicated and structured pathway, with the patient always at the centre of care. This article introduces the role of nurse second operator in complex valvular intervention, which allows the clinical nurse specialist to be fully involved in the entire patient journey from referral to discharge. The author describes how the role was established and the developments that have been made in the first 3 years of the post. The role encompasses both inpatient and outpatient care in a bespoke, nurse-led service, as well as responsibility for maintaining accurate data collection and adherence to the patient pathway throughout the service. This has facilitated a streamlined and tailored service that strives to deliver high-quality, equitable care to patients across the UK. It is hoped that this will encourage other centres to develop such roles for specialist nurses.

BACKGROUND: This study assessed the measurement properties of two commonly used self-report physical activity (PA) measures: the International Physical Activity Questionnaire-Short Form (IPAQ-SF) and the Physical Activity Scale for the elderly (PASE) in adults with osteoarthritis. METHODS: Secondary analysis of the MOSAICS cluster randomised controlled trial baseline and 3-month follow-up questionnaires, total scores and subdomains of the IPAQ-SF and PASE were compared. Intra-class correlations (ICC) were used to assess test-retest reliability, measurement error was assessed using standard error of measurement (SEM), smallest detectable change (SDC) and 95% limits of agreement (LoA). Responsiveness was assessed using effect size (ES), standard responsive measurement (SRM) and response ratio (RR). RESULTS: There was moderate correlation (r = 0.56) between the total IPAQ-SF scores (score ranges 0-16,398) and the total PASE scores (score ranges 0-400). Subdomain correlations were also moderate (ranges 0.39-0.57). The PASE showed greater reliability compared to the IPAQ-SF (ICC = 0.68; 0.61-0.74 95% CI and ICC = 0.64; 0.55-0.72, respectively). Measurement errors in both measures were large: PASE SEM = 46.7, SDC = 129.6 and 95% LoA ranges = -117 to 136, the IPAQ-SF SEM = 3532.2 METS-1 min-1 week , SDC = 9790.8 and 95% LoA ranges = -5222 to 5597. Responsiveness was poor: ES -0.14 and -0.16, SRM -0.21 and -0.21, and RR 0.12 and 0.09 for the IPAQ-SF and PASE, respectively. DISCUSSION: The IPAQ-SF and PASE appear limited in reliability, measurement error and responsiveness. Researchers and clinicians should be aware of these limitations, particularly when comparing different levels of PA and monitoring PA levels changes over time in those with osteoarthritis.

Student engagement is regarded as a critical educational outcome. However, it has proven to be elusive to educators within technical domains, such as marketing research and analytics, which has inspired the exploration of experiential course design elements. Client-sponsored projects (CSPs) have become a popular tactic to meet this objective in such courses. The authors utilize a mixed-methods design to examine CSPs and their effectiveness in marketing research and analytics courses. In Study 1, qualitative research yields student insights regarding the desired characteristics of a CSP. Study 2 illustrates that CSPs boost student engagement through perceptions of course relevance. However, students’ subjective interest in the client represented a boundary condition for this effect. That is, CSPs did not offer value to students who lacked inherent interest in the client. In Study 3, a discrete choice model analysis outlined what attributes make clients interesting for students. Finally, Study 4 utilizes a field experiment to identify project-framing tactics that increase student interest through enhanced client familiarity. A series of recommendations are provided to maximize the efficacy of CSPs to marketing research and analytics courses.

Introduction Willingness to pay (WTP) is used to generate information about value. However, when comparing 2 or more services using standard WTP techniques, the amounts elicited from participants for the services are often similar, even when individuals state a clear preference for one service over another. An incremental approach has been suggested, in which individuals are asked to first rank interventions and provide a WTP value for their lowest-ranked intervention followed by then asking how much more they are willing to pay for their next preferred choice and so on. To date, evaluation of this approach has disregarded protest responses, which may give information on consistency between stated and implicit rankings. Methods A representative sample of the English population ( n = 790) were asked to value 5 dental services adopting a societal perspective, using a payment vehicle of additional household taxation per year. The sample was randomized to either the standard or the incremental approach. Performance for both methods is assessed on discrimination between values for interventions and consistency between implicit and stated ranks. The data analysis is the first to retain protest responses when considering consistency between ranks. Results The results indicate that neither approach provides values that discriminate between interventions. Retaining protest responses reveals inconsistencies between the stated and implicit ranks are present in both approaches but much reduced in the incremental approach. Conclusion The incremental approach does not improve discrimination between values, yet there is less inconsistency between ranks. The protest responses indicate that objections to giving values to the dental interventions are dependent on a multitude of factors beyond the elicitation process.

Protein therapeutics are often compromised by sub-optimal biodistribution contributing to poor efficacy and adverse events. Drug delivery mechanisms better able to target the disease site and provide localized, sustained drug release have the potential to transform therapeutic standards. PODS crystals (PCs) are natural-mimetic, micron-scale protein co-crystals engineered to incorporate a protein cargo that is sustainably released under the action of resident proteases. PCs are efficiently taken up by phagocytic cells and their cargo protein is subsequently released in a bioactive form. Since blood-circulating phagocytic cells, including monocytes, are actively recruited into the tumor microenvironment, we postulated that monocyte/macrophage-mediated PC delivery could be used as a molecular “Trojan horse” to efficiently deliver therapeutic proteins to target cells. This could improve the pharmacodynamics and pharmacokinetics of protein drug delivery to treat systemic and disseminated diseases. Interleukin-2 (IL-2) is notoriously toxic at the high doses required for therapeutic efficacy. Here, we demonstrate the therapeutic efficacy and tolerability of low doses of PC-IL-2 administered intravenously in a mouse model of melanoma. We further demonstrate the therapeutic benefit of PCs delivering low doses of IL-2, interleukin-15 (IL-15) and interferon-gamma (IFN-γ) in a mouse model of renal cell carcinoma. In all the treated mice, cachexia, a side effect of high-dose cytokine therapy, was notably absent. This study provides proof-of-concept for the utility of intravenously administered PCs to provide a generalised and widely applicable mechanism to effectively deliver protein drugs for the therapy of cancer and other diseases. Citation Format: Michael H. Jones, Nirk E. Quispe Calla, Callum Talbot-Cooper, Hong Zeng, Jonathan Best, Robert Smith. Low-dose crystalline cytokine macrophage mediated Trojan horse immunotherapy of solid cancers [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 2705.

Journal of Education and Training Studies (JETS) would like to acknowledge the following reviewers for their assistance with peer review of manuscripts for this issue. Many authors, regardless of whether JETS publishes their work, appreciate the helpful feedback provided by the reviewers. Their comments and suggestions were of great help to the authors in improving the quality of their papers. Each of the reviewers listed below returned at least one review for this issue.Reviewers for Volume 11, Number 2 Chris Mutseekwa, Bindura University of Science Education, ZimbabweJane Liang, California Department of Education, USAJohn Cowan, Edinburgh Napier University, UKJohn Mark Asio, Gordon College, PhilippinesKendall Hartley, University of Nevada, USANiveen M. Zayed, MENA College of Management, JordanRichard H. Martin, Mercer University, USARichard Penny, University of Washington Bothell, USA Robert SmithEditorial AssistantOn behalf of,The Editorial Board of Journal of Education and Training StudiesRedfame Publishing9450 SW Gemini Dr. #99416Beaverton, OR 97008, USAE-mail 1: jets@redfame.comE-mail 2: jets@redfame.orgURL: http://jets.redfame.com

Approximately half of primary breast cancers exhibit low levels of human epidermal growth factor receptor 2 (HER2), defined as a score of 1+ on immunohistochemical (IHC) analysis or a score of 2+ on IHC and lack of HER2 gene amplification on in situ hybridization (ISH). Tumors classified as HER2-low represent a target for novel antibody-drug conjugates. In addition, HER2-low expression accounts for about 60% of HER2-negative breast cancers (BC). Real-world studies noted that HER2-low represents 47-54% of hormone positive (HR-positive)/HER2-negative breast cancers, a percentage higher than in the triple negative subgroup, reported at 35%. The goal of this study was to determine the frequency of HER2-low expression in patients with HR-positive/HER2-negative and triple-negative breast cancers (TNBCs) in the real-world and compare it with the published literature. The IntegraConnect (IC) real-world database of 330 thousand breast cancer patients was used for this analysis. Within the IC database, a subgroup of 387 patients with HR-positive/HER2-negative breast cancer and 618 patients with TNBC were abstracted with medical chart curation. The mean age at diagnosis for each group was 56 years and most patients had an ECOG performance status of 0-1. The statistical tests used were the Mann-Whitney test for age at diagnosis and the Chi-squared test for race, major stage, and ECOG at diagnosis. Differences were considered significant at P < .05. In the HR-positive/HER2-negative subgroup (n=387), 327 patients were tested by IHC and ISH. Sixty patients were tested by ISH only and were removed as they did not fit the definition of HER2-low. Of the 327 HER2-negative patients, 199 patients exhibited low HER2 expression (IHC1+, n=138 patients; IHC2+/ISH-negative, n=61), accounting for 61% (199/327) of HR-positive/HER2-negative breast cancers. In this group, numerically more patients were HER2-low than HER2-negative across all race subgroups. In the TNBC patient group (n=618), 546 patients tested HER2-negative by ICH and ISH. Patients testing HER2-negative by ISH only were removed (n=72) from the analysis. Of 546 patients with TNBC, HER2-low expression accounted for 42% (227/546) [IHC1+, n=168; IHC2+/ISH-negative, n=59]. In the Black or AA patients with TNBC subgroup, 37.2% (N=129) were HER2-low compared with 44% (N=353) in White patients. In all TNBC race subgroups, numerically more patients were HER2-negative compared with HER2-low. In addition, the proportion of HER2-low expression was higher in the HR+/HER2-negative subgroup (N=327) than in TNBC (N=546) (61% vs 42%, respectively), corroborating literature reports. In conclusion, analysis of the IC database showed HER2-low expression in 61% of HR-positive/HER2-negative breast cancers and in 42% of TNBC patients. Approximately 37% of Black or African Americans (AA) patients with TNBC expressed low levels of HER2. The frequency of HER2-low expression in TNBC in the IC database at 42% is slightly higher than previous studies that estimate HER2-low expression at 35% of TNBC. The percentage of HER2-low in HR+/HER2-negative breast cancers at 61% is higher than previous reports, which estimate low HER2 expression in patients with primary and recurrent HR+/HER2-negative breast cancers at 47 and 54%, respectively. Citation Format: Marielle Fares, Mike Gart, Simon Blanc, Jia Zheng, William Saunders, Robert Smith, Anupama Vasudevan, Sandy English. Incidence of HER2-low Expression in HR-positive/HER2-negative and Triple-Negative Breast Cancers in the Integra Connect Database [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P5-02-43.

Understanding the variation in Borrelia burgdorferi s.l. infection rates in Ixodes ricinus ticks is important for assessing the potential for Lyme borreliosis transmission. This study aimed to investigate infection rates of B. burgdorferi s.l. bacteria in I. ricinus across 24 field sites in England and Wales, focussing on protected recreational areas in National Parks (NPs) and Areas of Outstanding Natural Beauty (AONBs), to provide comparable data across multiple years to assess spatio-temporal changes in B. burgdorferi s.l. infection. Working with park rangers, questing ticks were collected each spring from 2014 to 2019. A subset of ticks, 4104 nymphs, were analysed using a pan-Borrelia qPCR assay, as well as a Borrelia miyamotoi-specific qPCR, and sequenced to determine Borrelia burgdorferi s.l. genospecies. Site-specific B. burgdorferi s.l. infection rates in I. ricinus nymphs varied from 0% to 24%, with overall infection rates ranging from 2.5% to 5.1% across the years. Genospecies composition of sequenced samples was 62.5% B. garinii, 20.3% B. valaisiana and 17.2% B. afzelii. Borrelia miyamotoi was detected in 0.2% of ticks. This study increases our knowledge on B. burgdorferi s.l.. infection in areas used by the public for outdoor activity across England and Wales, highlighting the spatial and temporal variability which can impact the changing risk to humans from infected tick bites.

Context, including social class is an emerging topic of interest in entrepreneurship studies. According to prevailing orthodoxy, to be upper-class is to be anti-enterprise. Aristocrats are defined through their ownership of land and rentier status and portrayed as conservative being focused on stewardship of their estates, rather than engaging with enterprising activities. This case challenges this traditional perception arguing that aristocrats can pursue an entrepreneurial approach to stewardship in contrast with traditional, low-risk, estate management. The focus is upon aristocrat Charlie Gladstone to explore this phenomenon. Charlie is both rentier and serial entrepreneur who engages his entrepreneurial efforts on the economic reinvigoration of his estates and expanding portfolio of entrepreneurial ventures. The case demonstrates that the enriched human, social and economic capital available to the upper-class can be exploited in an entrepreneurial manner.

Understanding and classifying nonequilibrium many-body phenomena, analogous to the classification of equilibrium states of matter into universality classes, is an outstanding problem in physics. Any many-body system, from stellar matter to financial markets, can be out of equilibrium in a myriad of ways; since many are also difficult to experiment on, it is a major goal to establish universal principles that apply to different phenomena and physical systems. At the heart of the classification of equilibrium states is the universality seen in the self-similar spatial scaling of systems close to phase transitions. Recent theoretical work, and first experimental evidence, suggest that isolated many-body systems far from equilibrium generically exhibit dynamic (spatiotemporal) self-similar scaling, akin to turbulent cascades and the Family-Vicsek scaling in classical surface growth. Here we observe bidirectional dynamic scaling in an isolated quench-cooled atomic Bose gas; as the gas thermalises and undergoes Bose-Einstein condensation, it shows self-similar net flows of particles towards the infrared (smaller momenta) and energy towards the ultraviolet (smaller lengthscales). For both infrared (IR) and ultraviolet (UV) dynamics we find that the scaling exponents are independent of the strength of the interparticle interactions that drive the thermalisation., 5 pages, 4 figures

Heavy alcohol use can induce skeletal muscle dysfunction referred to as alcoholic myopathy. Likewise, peripheral artery disease (PAD) is characterized by an acquired skeletal muscle metabolic myopathy in ischemic muscles of the lower extremity. Although epidemiological studies have shown that heavy alcohol consumption is associated with a greater risk of PAD, data are lacking on the contribution of alcohol-related myopathy on PAD-associated skeletal muscle pathology. We compared myofiber morphometrics, mitochondrial respiration, and oxidative stress measures in gastrocnemius biopsies from PAD patients with heavy alcohol use (>7 or >14 drinks per week, for females and males, respectively) (n=13) to PAD patients (n=13) and non-PAD controls (n=17) consuming moderate to low/no alcohol. Myofiber area and diameter were lower in heavy-drinking PAD patients compared to low/moderate drinkers (p=0.03 and p=0.04, respectively) and non-PAD controls (p=0.02 and p

Nemaline myopathy (NM) is a congenital skeletal muscle disorder that typically results in muscle weakness and the presence of rod-like structures (nemaline bodies) in the sarcoplasma and/or in the nuclei of myofibres. Two induced pluripotent stem cell (iPSC) lines were generated from the lymphoblastoid cells of a 1-month-old male with severe NM caused by a homozygous recessive mutation in the ACTA1 gene (c.121C T, p.Arg39Ter). The iPSC lines demonstrated typical morphology, expressed pluripotency markers, exhibited trilineage differentiation potential and displayed a normal karyotype. These isogenic lines represent a potential resource to investigate and model recessive ACTA1 disease in a human context.

Shigellosis, traditionally a foodborne and waterborne infection, causes substantial morbidity globally. It is now a leading cause of sexually transmitted gastroenteritis among gay, bisexual, and other men who have sex with men (MSM). We describe an ongoing outbreak of extensively drug-resistant (XDR) Shigella sonnei in the UK.Routine laboratory surveillance (Second Generation Surveillance System, Gastrointestinal Data Warehouse) identified an exceedance of S sonnei clade 5 in England, first detected in September, 2021. Cases within this clade were subsequently reported from Scotland, Wales, and Northern Ireland. Confirmed cases in this outbreak were defined as individuals diagnosed with S sonnei clade 5 in the UK, with a specimen date between Sept 1, 2021, and Feb 9, 2022, who were genomically confirmed as part of a ten-single nucleotide polymorphism (SNP) linkage cluster. We used whole-genome sequencing with SNP typing to identify genomic clusters and antimicrobial-resistance determinants, analysing cases across the UK. We collected demographic, epidemiological, and clinical data from people infected with S sonnei clade 5 in England using questionnaires (standard and bespoke outbreak questionnaires). We used descriptive summary statistics to characterise cases.72 cases (70 [97%] male, median age 34 years [IQR 27-39]) belonging to the ten-SNP single linkage cluster of S sonnei clade 5 were identified between Sept 4, 2021, and Feb 9, 2022. Isolates were predominantly XDR, with 66 (92%) of 72 harbouring blasubCTX-M-27/sub, a plasmid-mediated gene for production of extended-spectrum β-lactamases (ESBLs). Of 33 cases with clinical data, 19 (58%) received antibiotics and eight (24%) were hospitalised. 21 (78%) of 27 cases with completed bespoke outbreak questionnaires were HIV-negative MSM taking HIV pre-exposure prophylaxis (PrEP) who reported sexual contacts in the UK and Europe within the incubation period.We highlight the rapid dissemination of XDR ESBL-producing S sonnei in sexual networks of MSM. We recommend strengthening shigella testing where clinically indicated, antimicrobial-resistance surveillance, and integrated health promotion messaging among all MSM, including PrEP users, to reduce the burden of shigellosis.National Institute for Health Research Health Protection Research Unit in Gastrointestinal Infections at the University of Liverpool in partnership with the UK Health Security Agency.

Purpose: The cardiac T-wave peak-to-end interval (Tpe) is thought to reflect dispersion in ventricular repolarisation, with abnormalities in Tpe associated with increased risk of arrhythmia. Extracellular K+ modulates cardiac repolarisation, and since arterial plasma K+ concentration ([K+]) rapidly increases during and declines following exercise, we investigated the relationship between [K+] and Tpe with exercise. Methods: Serial ECGs (Tpe, Tpe/QT ratio) and [K+] were obtained from 8 healthy, normokalaemic volunteers and 22 patients with end-stage renal disease (ESRD), at rest, during, and after exhaustive exercise. Results: Post-exercise [K+] nadir was 3.1 ± 0.1, 5.0 ± 0.2 and 4.0 ± 0.1 mmol.L−1 (mean ± SEM) for healthy participants and ESRD patients before and after haemodialysis, respectively. In healthy participants, compared to pre-exercise, recovery-induced low [K+] was associated with a prolongation of Tpe (110 ± 8 vs. 87 ± 5 ms, respectively, p = 0.03) and an increase in Tpe/QT ratio (0.28 ± 0.01 vs. 0.23 ± 0.01, respectively, p = 0.01). Analyses of serial data revealed [K+] as a predictor of Tpe in healthy participants (β = -0.54 ±0.05, p < 0.0001), in ESRD patients (β = -0.75 ± 0.06, p < 0.0001) and for all data pooled (β = -0.61 ± 0.04, p < 0.0001). The [K+] was also a predictor of Tpe/QT ratio in healthy participants and ESRD patients. Conclusions: Tpe and Tpe/QT ratio are predicted by [K+] during exercise. Low [K+] during recovery from exercise was associated with increased Tpe and Tpe/QT, indicating accentuated dispersion of ventricular repolarisation. The findings suggest that variations in [K+] with physical exertion may unmask electrophysiological vulnerabilities to arrhythmia.

Summary Background Salmonella spp are a major cause of food-borne outbreaks in Europe. We investigated a large multi-country outbreak of Salmonella enterica serotype Enteritidis in the EU and European Economic Area (EEA). Methods A confirmed case was defined as a laboratory-confirmed infection with the outbreak strains of S Enteritidis based on whole-genome sequencing (WGS), occurring between May 1, 2015, and Oct 31, 2018. A probable case was defined as laboratory-confirmed infection with S Enteritidis with the multiple-locus variable-number tandem repeat analysis outbreak profile. Multi-country epidemiological, trace-back, trace-forward, and environmental investigations were done. We did a case-control study including confirmed and probable cases and controls randomly sampled from the population registry (frequency matched by age, sex, and postal code). Odds ratios (ORs) for exposure rates between cases and controls were calculated with unmatched univariable and multivariable logistic regression. Findings 18 EU and EEA countries reported 838 confirmed and 371 probable cases. 509 (42%) cases were reported in 2016, after which the number of cases steadily increased. The case-control study results showed that cases more often ate in food establishments than did controls (OR 3·4 [95% CI 1·6–7·3]), but no specific food item was identified. Recipe-based food trace-back investigations among cases who ate in food establishments identified eggs from Poland as the vehicle of infection in October, 2016. Phylogenetic analysis identified two strains of S Enteritidis in human cases that were subsequently identified in salmonella-positive eggs and primary production premises in Poland, confirming the source of the outbreak. After control measures were implemented, the number of cases decreased, but increased again in March, 2017, and the increase continued into 2018. Interpretation This outbreak highlights the public health value of multi-country sharing of epidemiological, trace-back, and microbiological data. The re-emergence of cases suggests that outbreak strains have continued to enter the food chain, although changes in strain population dynamics and fewer cases indicate that control measures had some effect. Routine use of WGS in salmonella surveillance and outbreak response promises to identify and stop outbreaks in the future. Funding European Centre for Disease Prevention and Control; Directorate General for Health and Food Safety, European Commission; and National Public Health and Food Safety Institutes of the authors' countries (see Acknowledgments for full list).

Child pornography is one of the most pernicious crimes amongst the various forms of cybercrime. Offensive materials can be quickly disseminated over the internet with no respect for international borders. ASEAN leaders undertook at their 31st ASEAN Summit to prevent and tackle cybercrime including harmonising their laws. This paper is based on an analysis of the cybercrime legislation of all ten ASEAN countries to determine how the offence of child pornography is covered in their legislation. As the offence has extra-territorial consequences the analysis includes a discussion of the extraterritorial reach of the legislation. It was found that most of the jurisdictions have specific statutes or specific articles in their Criminal Codes concerning the crime of child pornography. They do not necessarily refer to cybercrime or computer-related crime. Mutual cooperation is essential in combating cybercrime as is legislation that clearly defines the offence and is agreed across all jurisdictions. The paper analyses the current status of harmonization of laws in ASEAN and discusses a possible way forward in the harmonization of anti-child pornography legislation across ASEAN.

Minority patients taking prescription drugs for diabetes mellitus and hypertension are sick and vulnerable. They should not be subjected to poor quality medications that can make them worse. The purpose of this review is to present data fortifying an argument that Covid-19 will continue to disproportionally effect minorities who suffer with Type 2 Diabetes Mellitus, Hypertension, and GI ulcer disease by limiting drug safety for pharmaceuticals that are imported from oversea manufacturers even after the pandemic is over. As a foundation an overview of the Food and Drug Administration (FDA) overseas inspection process that have been validated by previously published reports will be offered to accent the procedural process. Limitations and challenges to the overseas drug inspection process as documented by congressional leadership and the FDA are offered. An accurate scientific description of N-nitrosodimethylamine (NDMA) will be presented to emphasize its danger to these patients. Five key points or initiatives recently published by the FDA to assist in food and drug safety from overseas manufacturers during the Covid-19 pandemic will be presented

To assess the overall relative risk of diabetes in individuals with prediabetes based on updated diagnostic criteria, as compared with individuals with normoglycaemia; and to identify the study characteristics associated with the heterogeneity between studies.Meta-analysis, meta-regression.PubMed, CINAHL, British Nursing Index. Search time frame: December 1998-December 2018.The pooled relative risk of developing diabetes among individuals with prediabetes compared with those with normoglycaemia was calculated under a random effects model. Studies reported the natural progression from prediabetes to diabetes were included in this review. Sources of study heterogeneity were examined by a meta-regression.Fifty-nine eligible studies were systematically identified. The pooled relative risk for diabetes among individuals with prediabetes as compared with normoglycaemia was 5.88 (95% CI: 5.02-6.89). The annualized incidence rate (per 1,000 person-year) for diabetes among individuals with prediabetes defined by different criteria varied from 2.20-212.15, with high heterogeneity between studies (IIndividuals with prediabetes had higher risk of developing diabetes than those with normoglycaemia. Races and diagnostic criteria of prediabetes were associated with the magnitude of the estimated risk.Prediabetes is a precursor of diabetes. To screen people with prediabetes as early as possible, practitioners could consider haemoglobin A1c test as an alternative to fasting plasma glucose test. Nurses should educate people especially Asians with prediabetes for the prevention of progression to diabetes.目的: 根据更新的诊断标准,与正常血糖的个体相比,评估糖尿病前期个体患糖尿病的总体相对风险;并确定与研究间异质性相关的研究特征。 设计: 荟萃分析、荟萃回归。 数据来源: PubMed、CINAHL、英国护理学索引。搜索时间范围:1998年12月至2018年12月。 审查方法: 在随机效应模型下,计算了与正常血糖个体相比,糖尿病前期个体患糖尿病的合并相对风险度。研究报告指出,从糖尿病前期发展为糖尿病的自然发展被纳入本审查中。通过荟萃回归检查了研究的异质性来源。 结果: 系统化地确定了59项符合条件的研究。与正常血糖个体相比,糖尿病前期个体患糖尿病的合并相对风险度为5.88(95%置信区间:5.02-6.89)。按不同标准定义的糖尿病前期个体的糖尿病年发病率(每1000人-年)在2.20-212.15不等,研究间异质性较高(I2=96.64%,Q检验:P.001)。在多变量荟萃回归分析中,与白种人相比,亚洲人的相对风险度显著增加。此外,‘糖化血红蛋白A1c升高或空腹血糖受损’的人群与其他类型的糖尿病前期人群相比,相对风险度最高。 结论: 糖尿病前期个体患糖尿病的风险血糖正常个体。糖尿病前期的个体类别和诊断标准与估计的风险量级有关。 影响: 糖尿病前期是糖尿病的前兆。为了尽早筛查糖尿病前期人群,医生可以考虑用血红蛋白A1c测试来代替空腹血糖检测。护士应提醒人们,尤其是糖尿病前期的亚洲人,以防止发展成糖尿病。.

This case study reports on a 5-year project which has been running in Hawkhill, a deprived area in central Scotland where violent crime was also of concern. It highlights the steps necessary to move from theory to implementation: the process and impact of change of a unique, innovative police/partnership policy within the framework of Scottish Policing. Through auto-ethnography it reports on utilising an asset-based approach for reducing offending, improving health, well-being and local community conditions by supporting and building on its assets, connecting people and creating conditions for respectful, meaningful, partnership working where all partners can make a valuable contribution.

Much academic ink has been spilt over the way in which female subjectivities and sexualities are constructed in the public domain. Issues of female sexuality form a huge part of queer studies and feminist accounts. Surprisingly enough, the construction of female sexualities and more specifically bisexuality has never been worth mentioning in the accounts of subcultures. The transition from subcultures to neo-tribes and neo-tribal sociality has paid scant attention to the construction of female sexualities. Even more importantly, most academic accounts deal with the construction of female sexuality as usually being strictly kept within the limitations of the familiar, familial and predominantly straight sexuality. This article examines the ways in which female subjectivities and sexualities are constructed on celluloid canvas through an examination of a recent movie called “Disobedience” by the Chilean director Sebastian Lelio as forming an integral part of neo-tribes. It takes a different view on the construction of female sexualities as it locates this construction within the transition from subcultures to neo-tribes. This paper puts forward the suggestion that female sexuality apart from being a product of a number of different socio-cultural relationships, norms and laws, it mainly exposes the dynamics of not just subcultures but also neo-tribes at play. The first part of the article places the formation of female sexuality within the transition from subcultures to neo-tribes. The second part of the paper discusses the way in which class informs female sexuality within the context of neo-tribes. The final part of the article places the discussion on the construction of female sexualities within the overall context of juxtaposing neo-tribal lifestyle choices.

Low-income economies are experiencing potential serious threats in terms of long-term sustainability and social development. At the same time, most developing economies are grappling with possible disruptions from the Fourth Industrial Revolution and the current COVID-19 pandemic and its economic consequences. However, every economy has the same goal of elevating its status to that of a developed country. This research uses the narrative/case study approach to examine cross-border development and the role that universities can play as important actors in the development of society. Moreover, this research combines observations and literature analysis. Universities are clearly best placed to play an important role in helping the development of a country and assisting less-developed neighboring countries. However, this role will require continuous long-term commitment. In numerous cases, universities must make significant internal changes to meet the challenges posed by the Fourth Industrial Revolution. Three issues are identified as priority areas to be addressed: the quality of higher education, complex government bureaucracies, and ineffective on-the-job training. These issues will require universities to provide high-quality offerings that are relevant to their community and the broad world market. Moreover, universities must improve the foreign language skills of students and staff to enable them to communicate and learn from worldwide developments. Finally, universities should be proactive in creating opportunities rather than reactive and waiting for others to provide them with opportunities.

Combined elevated sputum eosinophils+neutrophils in asthma associated with lowest lung function, greater healthcare utilization, and longitudinally, further spirometric loss, implicating cell-cell interactions or overlapping inflammatory pathways while increased eosinophils or neutrophils alone show less effect.

We have studied the reliability of a near-field transducer (NFT) embedded in a magnetic recording slider used for heat-assisted magnetic recording (HAMR) in hard disk drives with a linear velocity of 20 m/s. The NFT head structure and the disk are separated by an air film of 2 nm thickness. In this article, the magnetic write width and amplitude of the written magnetic signal on the disk are used as a “health monitor” for the reliability of the NFT under long-term thermal exposure. The results show that the reliability of the NFT head structure sharply decreases with increasing temperature of the NFT but depends only slightly on the media temperature.

Leadership has been increasingly distributed away from formal leaders towards more shared arrangements in Western educational contexts, wherein the vast majority of the existing research literature...

In heat-assisted magnetic recording, minimization of optical laser power is important for the reliability of the head-disk interface. In this paper, a prototype heat-assisted magnetic recording system is used to investigate the relationship between the needed optical laser power and disk drive design parameters. In particular, the change of optical laser power, which is a function of the laser current, is investigated for different disk radii and write head flying heights while keeping the write width of the recorded signal constant. In addition, the dependence of laser power during writing is studied as a function of the thickness and material properties of a very thin “capping layer” on the top of the recording magnetic layer. The results show that laser power and media design parameters play a crucial role in heat-assisted magnetic recording devices.

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link. The growing scale and persistence of humanitarian crises constitute a critical problem for nation-states, aid organizations, and crisis-affected people around the world. Many in the fields of disaster response and humanitarian aid continue to focus on material aid, providing essential supplies and services during these crises, followed by restoration of physical infrastructure. We believe decision-makers and aid workers are overlooking the pivotal nature of horizontal and vertical ties within and between communities. Using qualitative and quantitative data from Uganda and Nigeria we show how social capital matters even during the most severe humanitarian crises. Through interviews and regression analyses based on survey data, we find that deeper reservoirs of bridging social capital are significantly associated with the preparedness of individuals affected by the terror group Boko Haram in Nigeria and that bonding and linking social capital are correlated to positive resilience outcomes for individuals affected by foodinsecurity stresses in the Karamoja region of Uganda. Our paper brings a number of concrete policy recommendations for aid agencies, decision-makers, and residents alike, especially for agencies willing to invest in building social infrastructure in affected or vulnerable populations

Recently, research has focused on developing efficient wave-guided THz system-on-chip (TSoC) components to reduce physical bulk, loss and cost of free-space THz systems. We recently demonstrated a TSoC platform using a coplanar-stripline (CPS) transmission-line on a $1~\mu \text{m}$ -thin membrane to generate and detect THz-bandwidth pulses with low loss and low dispersion up to 1.5 THz. In this paper, we demonstrate experimentally an in-phase THz power divider (TPD) at frequency 0.65 THz using the CPS transmission line defined by photolithography on a thin membrane. Measured pulses show close agreement with simulation results. The spectral power density of the measured THz-bandwidth pulses at the output ports are identical at the frequency of 0.65 THz with less than 1 dB power imbalance over a wide spectrum up to 1 THz.

Cerebral small vessel diseases (CSVDs) are a set of conditions that affect the small blood vessels in the brain and can cause severe neurological pathologies such as stroke and vascular dementia. The most common monogenic CSVD is cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) which is caused by mutations in NOTCH3. However, only 15-20% of CADASIL cases referred for genetic testing have pathogenic mutations in NOTCH3. Investigation of other monogenic forms of CSVD caused by HTRA1, COL4A1, COL4A2, CTSA, TREX1 and GLA were rarely requested as follow-up to CADASIL diagnostic testing. We performed whole exome sequencing for 50 individuals suspected of having CADASIL, but did not exhibit a disease-causing mutation in NOTCH3, and applied targeted analysis of all monogenic forms of CSVD including NOTCH3, HTRA1, COL4A1, COL4A2, CTSA, TREX1 and GLA to look for rare, protein-altering mutations. We identified three mutations affecting the Collagen type IV genes in three individuals likely to be causative of CSVD. This suggests that screening for all monogenic forms of CSVD when one monogenic form is clinically suspected may improve diagnosis in clinically suspected monogenic CSVD. However, despite these findings, the majority of NOTCH3 negative CSVD cases did not have candidate mutations in known CSVD genes, suggesting that additional genetic factors contributing to the disease are yet to be identified.