Chances and barriers of building information modelling in wastewater management.

The advancing digitalisation is one of the great challenges of our times. Related activities also concern the wastewater sector. In the field of building construction, one emerging approach is building information modelling (BIM). The presented work investigates to which extent BIM practices have already found their way to wastewater management, and what kind of benefits and constraints are incorporated. Information is collected by means of a literature review and international expert surveys. Results indicate that several BIM-related key elements are already well established in the sector, but not necessarily in the intended manner. Consequently, the digital transition in the wastewater sector is not about replacing existing procedures and techniques but to rethink and optimise them. This primarily concerns data and information management in combination with the application of digital tools. Furthermore, wastewater management requires more integrated approaches, involving interdisciplinary/collaborative concepts and life cycle perspectives. Appropriate change management is necessary to give support and guidance to employees during the transition process. Furthermore, also from the political side, a clear definition and communication of the pursued digital vision is important. This article aims at stimulating discussion and research to optimise wastewater management from the digital perspective.

A master protocol to investigate a novel therapy acetyl-L-leucine for three ultra-rare neurodegenerative diseases: Niemann-Pick type C, the GM2 gangliosidoses, and ataxia telangiectasia.

BACKGROUND: The lack of approved treatments for the majority of rare diseases is reflective of the unique challenges of orphan drug development. Novel methodologies, including new functionally relevant endpoints, are needed to render the development process more feasible and appropriate for these rare populations and thereby expedite the approval of promising treatments to address patients' high unmet medical need. Here, we describe the development of an innovative master protocol and primary outcome assessment to investigate the modified amino acid N-acetyl-L-leucine (Sponsor Code: IB1001) in three separate, multinational, phase II trials for three ultra-rare, autosomal-recessive, neurodegenerative disorders: Niemann-Pick disease type C (NPC), GM2 gangliosidoses (Tay-Sachs and Sandhoff disease; "GM2"), and ataxia telangiectasia (A-T). METHODS/DESIGN: The innovative IB1001 master protocol and novel CI-CS primary endpoints were developed through a close collaboration between the Industry Sponsor, Key Opinion Leaders, representatives of the Patient Communities, and National Regulatory Authorities. As a result, the open-label, rater-blinded study design is considerate of the practical limitations of recruitment and retention of subjects in these ultra-orphan populations. The novel primary endpoint, the Clinical Impression of Change in Severity© (CI-CS), accommodates the heterogenous clinical presentation of NPC, GM2, and A-T: at screening, the principal investigator appoints for each patient a primary anchor test (either the 8-m walk test (8MWT) or 9-hole peg test of the dominant hand (9HPT-D)) based on his/her unique clinical symptoms. The anchor tests are videoed in a standardized manner at each visit to capture all aspects related to the patient's functional performance. The CI-CS assessment is ultimately performed by independent, blinded raters who compare videos of the primary anchor test from three periods: baseline, the end of treatment, and the end of a post-treatment washout. Blinded to the time point of each video, the raters make an objective comparison scored on a 7-point Likert scale of the change in the severity of the patient's neurological signs and symptoms from video A to video B. To investigate both the symptomatic and disease-modifying effects of treatment, N-acetyl-L-leucine is assessed during two treatment sequences: a 6-week parent study and 1-year extension phase. DISCUSSION: The novel CI-CS assessment, developed through a collaboration of all stakeholders, is advantageous in that it better ensures the primary endpoint is functionally relevant for each patient, is able to capture small but meaningful clinical changes critical to the patients' quality of life (fine-motor skills; gait), and blinds the primary outcome assessment. The results of these three trials will inform whether N-acetyl-L-leucine is an effective treatment for NPC, GM2, and A-T and can also serve as a new therapeutic paradigm for the development of future treatments for other orphan diseases. TRIAL REGISTRATION: The three trials (IB1001-201 for Niemann-Pick disease type C (NPC), IB1001-202 for GM2 gangliosidoses (Tay-Sachs and Sandhoff), IB1001-203 for ataxia telangiectasia (A-T)) have been registered at www.clinicaltrials.gov (NCT03759639; NCT03759665; NCT03759678), www.clinicaltrialsregister.eu (EudraCT: 2018-004331-71; 2018-004406-25; 2018-004407-39), and https://www.germanctr.de (DR KS-ID: DRKS00016567; DRKS00017539; DRKS00020511).

Prenatal cigarette smoke exposure slightly alters neurobehavioral development in neonatal rats: Implications for developmental origins of health and disease (DoHAD).

Numerous studies indicate that smoking during pregnancy exerts harmful effects on fetal brain development. The aim of this study was to determine the influence of maternal smoking during pregnancy on the early physical and neurobehavioral development of newborn rats. Wistar rats were subjected to whole-body smoke exposure for 2 × 40 min daily from the day of mating until day of delivery. For this treatment, a manual closed-chamber smoking system and 4 research cigarettes per occasion were used. After delivery the offspring were tested daily for somatic growth, maturation of facial characteristics and neurobehavioral development until three weeks of age. Motor coordination tests were performed at 3 and 4 weeks of age. We found that prenatal cigarette smoke exposure did not alter weight gain or motor coordination. Critical physical reflexes indicative of neurobehavioral development (eyelid reflex, ear unfolding) appeared significantly later in pups prenatally exposed to smoke as compared to the control group. Prenatal smoke exposure also resulted in a delayed appearance of reflexes indicating neural maturity, including hind limb grasping and forelimb placing reflexes. In conclusion, clinically relevant prenatal exposure to cigarette smoke results in slightly altered neurobehavioral development in rat pups. These findings suggest that chronic exposure of pregnant mothers to cigarette smoke (including passive smoking) results in persisting alterations in the developing brain, which may have long-lasting consequences supporting the concept of developmental origins of health and disease (DoHAD).

Prioritization of stormwater management sites in urban areas.

Multiple pressures as urbanization, densification and climate change lead to the need for adaptation of sewer systems within urban environments. To increase the adaptive capacity of stormwater management systems, there is a shift towards decentralized nature-based solutions (NBS). Especially in densely built areas the availability of land can be a limiting factor for the implementation of NBS. To consider the spatial framework conditions in planning we developed an integrated modelling framework for prioritizing sites for NBS implementation for stormwater management within built urban structures. The implementation potential of NBS from a settlement structure model and a street typology model are combined with the discharge reduction potential from a sewer model. In effectiveness matrices priorities for stormwater management sites for individual NBS are identified. This modelling framework offers a transparent and flexible approach to decision making for the implementation of NBS.

The neurological update: therapies for cerebellar ataxias in 2020.

Cerebellar ataxias (CAs) represent a heterogeneous group of sporadic or inherited disorders. The clinical spectrum of CAs is continuously expanding. Our understanding of the mechanisms leading to the clinical deficits has improved over these last decades, in particular thanks to progress in genetics, neuroimaging and the advent of relevant animal models allowing the identification of the pathophysiological pathways leading to CAs. The rationale behind treatments is now established for most of the CAs encountered during daily practice worldwide. In this update, we will discuss the symptomatic, physical and occupational therapies now being trialled along with individualized exercises, and present key emerging issues on immune-mediated cerebellar ataxias, hereditary cerebellar ataxias. Finally, we will discuss novel therapeutic approaches, including cerebellar non-invasive stimulation and treatments acting on RNA/proteins. So far, no state-of-the art randomized placebo-controlled clinical trial has shown a convincing clinically relevant efficacy of any drug, with the exception of 4-aminopyridine for the symptomatic treatment of episodic ataxia type 2 and downbeat nystagmus (placebo-controlled trials).

Nitrous oxide emissions of a mesh separated single stage deammonification reactor.

It is widely accepted that partial nitrification by ANAMMOX has the potential to become one of the key processes in wastewater treatment. However, large greenhouse gas emissions have been panobserved in many cases. A novel mesh separated reactor, developed to allow continuous operation of deammonification at smaller scale without external biomass selection, was compared to a conventional single-chamber deammonification sequencing batch reactor (SBR), where both were equally-sized pilot-scale reactors. The mesh reactor consisted of an aerated and an anoxic zone separated by a mesh. The resulting differences in the structure of the microbial community were detected by next-generation sequencing. When both systems were operated in a sequencing batch mode, both systems had comparable nitrous oxide emission factors in the range of 4% to 5% of the influent nitrogen load. A significant decrease was observed after switching from sequencing batch mode to continuous operation.

Examination of PACAP38-like immunoreactivity in different milk and infant formula samples.

Pituitary adenylate cyclase activating polypeptide (PACAP) is a neuropeptide with special importance in reproductive and developmental processes. PACAP is found in two bioactive forms: PACAP27 and PACAP38. Recently, we have described that PACAP38 is present in high levels in the milk of human and ruminant animals. Breastfeeding is of utmost importance in proper nutrition of the newborn, but artificial nursing with infant formulas is necessary when breastfeeding is not available. Composition of the breast milk varies during the whole period of nursing and it shows differences at the beginning (foremilk) and the end of an actual suckling (hindmilk). The aim of this study was to investigate PACAP38-like immunoreactivity (PACAP38-LI) in different milk and infant formula samples by radioimmunoassay and to prove the presence of PACAP38 in the infant formula by mass spectrometry. We found similar PACAP38-LI in human mature foremilk and hindmilk samples, in the fresh and pasteurized cow milk and also in formulas. However, we found significantly higher PACAP38-LI in the hypoantigenic formula undergoing extensive hydrolysis compared to the non-hypoantigenic ones. Our results suggest that PACAP38 is relatively stable in the milk and it can withstand the manufacturing processes.

Visualization of Temporal Similarity in Field Data.

This paper presents a visualization approach for detecting and exploring similarity in the temporal variation of field data. We provide an interactive technique for extracting correlations from similarity matrices which capture temporal similarity of univariate functions. We make use of the concept to extract periodic and quasiperiodic behavior at single (spatial) points as well as similarity between different locations within a field and also between different data sets. The obtained correlations are utilized for visual exploration of both temporal and spatial relationships in terms of temporal similarity. Our entire pipeline offers visual interaction and inspection, allowing for the flexibility that in particular time-dependent data analysis techniques require. We demonstrate the utility and versatility of our approach by applying our implementation to data from both simulation and measurement.

Visualization of Electrostatic Dipoles in Molecular Dynamics of Metal Oxides.

Metal oxides are important for many technical applications. For example alumina (aluminum oxide) is the most commonly-used ceramic in microelectronic devices thanks to its excellent properties. Experimental studies of these materials are increasingly supplemented with computer simulations. Molecular dynamics (MD) simulations can reproduce the material behavior very well and are now reaching time scales relevant for interesting processes like crack propagation. In this work we focus on the visualization of induced electric dipole moments on oxygen atoms in crack propagation simulations. The straightforward visualization using glyphs for the individual atoms, simple shapes like spheres or arrows, is insufficient for providing information about the data set as a whole. As our contribution we show for the first time that fractional anisotropy values computed from the local neighborhood of individual atoms of MD simulation data depict important information about relevant properties of the field of induced electric dipole moments. Iso surfaces in the field of fractional anisotropy as well as adjustments of the glyph representation allow the user to identify regions of correlated orientation. We present novel and relevant findings for the application domain resulting from these visualizations, like the influence of mechanical forces on the electrostatic properties.

Visual Classifier Training for Text Document Retrieval.

Performing exhaustive searches over a large number of text documents can be tedious, since it is very hard to formulate search queries or define filter criteria that capture an analyst's information need adequately. Classification through machine learning has the potential to improve search and filter tasks encompassing either complex or very specific information needs, individually. Unfortunately, analysts who are knowledgeable in their field are typically not machine learning specialists. Most classification methods, however, require a certain expertise regarding their parametrization to achieve good results. Supervised machine learning algorithms, in contrast, rely on labeled data, which can be provided by analysts. However, the effort for labeling can be very high, which shifts the problem from composing complex queries or defining accurate filters to another laborious task, in addition to the need for judging the trained classifier's quality. We therefore compare three approaches for interactive classifier training in a user study. All of the approaches are potential candidates for the integration into a larger retrieval system. They incorporate active learning to various degrees in order to reduce the labeling effort as well as to increase effectiveness. Two of them encompass interactive visualization for letting users explore the status of the classifier in context of the labeled documents, as well as for judging the quality of the classifier in iterative feedback loops. We see our work as a step towards introducing user controlled classification methods in addition to text search and filtering for increasing recall in analytics scenarios involving large corpora.

Chemokine response induced by Chlamydia trachomatis in prostate derived CD45+ and CD45- cells.

The role of innate cells and their receptors within the male genital tract remains poorly understood. Much less is known about the relative contribution of different genital tract cells such as epithelial/stromal cells and resident leucocytes. In this study, we examined innate immune responses to Chlamydia trachomatis by prostate epithelial/stromal cells and prostate resident leucocytes. Murine prostate primary cultures were performed and leucocyte and epithelial/stromal cells were sorted based on surface protein expression of CD45 by magnetism-activated cell sorting or fluorescence-activated cell sorting. Prostate derived CD45- and CD45+ cells were infected with C. trachomatis and chemokine secretion assayed by ELISA. Similar experiments were performed using prostate CD45+ and CD45- cells from myeloid differentiation factor 88 (Myd88(-/-)) mice or toll-like receptor (Tlr2(-/-)) and Tlr4(mutant) double-deficient mice. Moreover, a TLR-signalling pathway array was used to screen changes in different genes involved in TLR-signalling pathways by real-time PCR. Prostate derived CD45- and CD45+ cells responded to chlamydial infection with the production of different chemokines. Both populations expressed genes involved in TLR signalling and required to respond to pathogen-associated molecular patterns and to C. trachomatis infection. Both populations required the adaptor molecule MYD88 to elicit chemokine response against C. trachomatis. TLR2-TLR4 was essential for chemokine production by CD45+ prostate derived cells, but in their absence, CD45- cells still produced significant levels of chemokines. We demonstrate that C. trachomatis is differentially recognised by prostate derived CD45+ and CD45- cells and suggest that diverse strategies are taking place in the local microenvironment of the host in response to the infection.

Iterative Integration of Visual Insights during Scalable Patent Search and Analysis.

Patents are of growing importance in current economic markets. Analyzing patent information has, therefore, become a common task for many interest groups. As a prerequisite for patent analysis, extensive search for relevant patent information is essential. Unfortunately, the complexity of patent material inhibits a straightforward retrieval of all relevant patent documents and leads to iterative, time-consuming approaches in practice. Already the amount of patent data to be analyzed poses challenges with respect to scalability. Further scalability issues arise concerning the diversity of users and the large variety of analysis tasks. With "PatViz", a system for interactive analysis of patent information has been developed addressing scalability at various levels. PatViz provides a visual environment allowing for interactive reintegration of insights into subsequent search iterations, thereby bridging the gap between search and analytic processes. Because of its extensibility, we expect that the approach we have taken can be employed in different problem domains that require high quality of search results regarding their completeness.

Alterations of pituitary adenylate cyclase-activating polypeptide-like immunoreactivity in the human plasma during pregnancy and after birth.

BACKGROUND: Since its discovery, several distinct effects of pituitary adenylate cyclase activating polypeptide (PACAP) have been established - predominantly in animal studies - in the nervous system, various peripheral organs as well as in the endocrine regulation. It is unknown whether PACAP has any effect on human pregnancy regarding either utero-maternal or perinatal aspects of the gestation. AIM: We investigated alterations of PACAP38-like immunoreactivity (PACAP38-LI) in the human plasma throughout normal pregnancy, during and after delivery, and its level in the umbilical vessels, as well as in the peripheral blood of term healthy newborns. MATERIALS AND METHODS: A 2 ml blood sample was used for each test, PACAP38-LI was determined by radioimmunoassay. RESULTS: In the 2nd and 3rd trimester significant elevation was observed in the PACAP38-LI compared to the earlier gestation and non-pregnant conditions. During delivery its level significantly decreased and returned to the original values 3 days after birth. In the neonates PACAP38-LI level of the peripheral blood was similar to that of healthy adults, but umbilical arteries and veins contained significantly lower concentrations of PACAP38-LI. Besides, the levels were lower in the umbilical vein compared to the artery. CONCLUSIONS: PACAP38-LI levels show sensitive change during normal pregnancy and delivery. Our findings suggest that the fetal organs actively synthesize PACAP. Further investigations are required to elucidate the physiological importance of the alterations observed.

[The non-functioning chaperonin GroEL stimulates protein aggregation].

To clarify the role of chaperones in the development of amyloid diseases, the interaction of the chaperonin GroEL with misfolded proteins and recombinant prions has been studied. The efficiency of the chaperonin-assisted folding of denatured glyceraldehyde-3-phosphate dehydrogenase (GAPDH) was shown to decrease in the presence of prions. Prions are capable of binding to GroEL immobilized on Sepharose, but this does not prevent the interaction between GroEL and other denatured proteins. The sizes of individual proteins (GroEL, GAPDH, and the recombinant prion), as well as aggregates formed after their mixing, were determined by the dynamic light scattering method. It was shown that at 25 degrees C the non-functioning chaperonin (equimolar mixture of GroEL and GroES in the absence of Mg-ATP) bound prion yielding large aggregates (greater than 400 nm). The addition of Mg-ATP decreased significantly the aggregate size to 70-80 nm. On the blocking of one of the chaperonin centers by oxidized denatured GAPDH, the aggregate size increased to 1200 nm, and the addition of Mg-ATP did not prevent the aggregation. These data indicate the significant role of chaperonins in the formation of amyloid structures and demonstrate the acceleration of aggregation in the presence of functionally inactive chaperonins. The suggested model can be used for the analysis of the efficiency of antiaggregants in the system containing chaperonins.

Pulp histology after Er:YAG laser cavity preparation in subhuman primates--a pilot study.

UNLABELLED: The aim of the study was to make a direct comparison of the pulpal effects of laser and turbine preparations in subhuman primates. One female baboon (Papio Ursinus ursinus), weighing 15 kg, was used. General anaesthesia was administered (ketamine 100 mg/ml/kg body weight) and maintained with acepromazine (10 mg/ml/kg body weight). Class V cavities were prepared buccally in a total of 28 teeth (7 in each quadrant). Teeth in the upper right and lower left quadrants were prepared using a conventional 330 carbide bur in a high-speed fibre-optic handpiece with copious water spray. Teeth in the upper left and lower right quadrants were prepared using an Er:YAG laser drill (Fotona Twinlight, Llubljana, Slovenia) delivering 500 mJ at a pulse rate of 10 Hz and a wavelength of 2940 nm. The animal was sacrificed after 25 days. After general anaesthesia as described before, perfusion fixation of the head was accomplished with 10% neutral buffered formalin, pumped through a catheter inserted into the left carotid artery. The jaws were removed and, using a 330 carbide bur in a high speed handpiece, a continuous groove was cut through the bone and the roots at the level of the middle third of all the roots to promote thorough fixation of pulpal tissue. Decalcification and grading of the severity of the pulpal responses were conducted according to standard procedures. RESULTS: Owing to procedural errors seven teeth, FDI numbers 23, 24, 31, 34, 35, 44 and 45, had to be eliminated. The turbine-prepared teeth (N = 11) had a mean remaining dentine thickness (RDT) of 0.77 mm (SD = 0.42) and the laser-prepared teeth (N = 10) had a mean RDT of 0.81 mm (SD = 0.60). All pulps appeared normal except in one turbine-prepared tooth (12 with RDT = 0.20) and one laser-prepared tooth (27 with RDT = 0.30, where irreversible damage was caused. The only other deviations from normal were seen in the laser-treated 41 (RDT = 0.69) and the turbine-treated 36 (RDT = 0.77) where moderate hyperaemia was seen. Within the limitations of this study it can be concluded that there is no significant difference between dental pulp of teeth where Class V cavities were prepared with an Er:YAG laser drill compared with those prepared with a standard turbine drill.

Influence of a partner's HIV serostatus, use of highly active antiretroviral therapy, and viral load on perceptions of sexual risk behavior in a community sample of men who have sex with men.

OBJECTIVE: To assess the perceptions of gay and bisexual men concerning the risk of HIV transmission through various sexual practices with a new sex partner depending on that partner's disclosed HIV status, antiretroviral treatment status, and viral load. METHODS: Study participants read four different scenarios describing sexual situations with a new partner and rated each scenario for risk of HIV transmission. HIV status and antiretroviral treatment status disclosed by the new sex partner were varied across four scenarios: unknown HIV status; HIV-negative; HIV-positive and not taking highly active antiretroviral therapy (HAART); and HIV-positive and taking HAART with an undetectable viral load. RESULTS: Study participants were 472 men attending a gay pride festival who reported that they were HIV-negative. Eighty-nine percent of the men were white, and the mean age of the study participants was 35.8 years. Of the four scenarios, sex with an HIV-positive partner not taking HAART was rated as posing the greatest risk. Sex with an HIV-positive partner taking HAART who had an undetectable viral load was not consistently viewed as riskier than sex with an HIV-negative partner or a man with an unknown HIV status. CONCLUSIONS: The current study provides preliminary evidence for the effect of disclosure of HIV serostatus, use of HAART, and the presence of an undetectable viral load on the perceptions of sexual risk for HIV-negative men. The findings suggest that some gay and bisexual men judge risk based on the perceived HIV status of their sex partners and not on the general assumption that all sex partners entail equal risk, as many prevention campaigns have emphasized.

Local and remote visualization techniques for interactive direct volume rendering in neuroradiology.

The increasing capabilities of magnetic resonance (MR) imaging and multisection spiral computed tomography (CT) to acquire volumetric data with near-isotropic voxels make three-dimensional (3D) postprocessing a necessity, especially in studies of complex structures like intracranial vessels. Since most modern CT and MR imagers provide limited postprocessing capabilities, 3D visualization with interactive direct volume rendering requires expensive graphics workstations that are not available at many institutions. An approach has been developed that combines fast visualization on a low-cost PC system with high-quality visualization on a high-end graphics workstation that is directly accessed and remotely controlled from the PC environment via the Internet by using a Java client. For comparison of quality, both techniques were applied to several neuroradiologic studies: visualization of structures related to the inner ear, intracranial aneurysms, and the brainstem and surrounding neurovascular structures. The results of pure PC-based visualization were comparable with those of many commercially available volume-rendering systems. In addition, the high-end graphics workstation with 3D texture-mapping capabilities provides visualization results of the highest quality. Combining local and remote 3D visualization allows even small radiologic institutions to achieve low-cost but high-quality 3D visualization of volumetric data.

Sources and behaviour of bismuth active substances (BiAS) in a municipal sewage treatment plant.

Non-ionic surfactants are widely used for household and industrial purposes. For different reasons the metabolites, e.g. 4-nonylphenol, nonylphenol monoethoxylate, nonylphenol diethoxylate and 4-tert-octylphenol, are especially considered to be endocrine disruptive and thus potentially harmful for the environment. In this study, field samples of raw wastewater from different point sources, including industrial effluents, household effluents, the influent and secondary effluent of a wastewater treatment plant that treats this wastewater were monitored simultaneously. Composite samples were taken five times over periods of 1 week at nine sample sites. The results showed that the concentrations and fluxes were varying. In addition industrial, influent and effluent samples were investigated for nonylphenol (NP). The highest concentrations of bismuth active substances (BiAS) were obtained by wastewater samples from a chemical and a cloth washing company ranging from 10,200 to 65,600 microg/l and 14,600 to 33,900 microg/l BiAS, respectively. Although the concentration of BiAS in the wastewater of the paper production was only between 460 and 1200 microg/l BiAS, the NP/BiAS ratio of 0.51% was considerably higher than in other industrial effluents. The BiAS concentration in wastewater samples from households ranged from 2200 to 7900 microg/l BiAS, but the NP concentration was quite low, 0.01% of BiAS. This could be due to the effort within the EU to phase out nonylphenol polyethoxylates in household detergents. Influent concentrations between 700 and 2200 microg/l BiAS with removal rates in the WWTP ranging from 70.7 to 99.4% with an average of 92.2% could be measured.

Hyponatremia and sensorineural hearing loss in preterm infants.

In a case-control study the role of hyponatremia in the hearing loss of preterm infants was investigated. One hundred and sixty-four premature infants treated at the neonatal intensive care unit were screened with transient evoked otoacoustic emission (TEAOE). In 32 infants TEAOE results indicated the need for further investigations. Auditory brainstem response was performed and 22 of 32 cases had bilateral hearing impairment (HI). The birth weight and gestational age in the HI group were 1,425 +/- 528 g and 30.4 +/- 3.7 weeks. The matched control group consisted of 25 infants with a mean birth weight and gestational age of 1,410 +/- 280 g and 31.1 +/- 2.1 weeks. Significant differences were found between the HI and control groups: Apgar score (p < 0.05), pH value (p < 0.01) and pO(2) level (p < 0.05) were lower; the total dose of aminoglycosides (p < 0.01), furosemide usage (p < 0.01), the maximum pCO(2) level (p < 0.01), incubator stay (p < 0.05) and hyponatremia (p < 0.01) were higher, and the duration of hyponatremia (p < 0.05) was longer in the HI group. Multivariate logistic regression revealed that aminoglycoside treatment and hyponatremia were the two most significant factors in the development of hearing impairment. These results suggest that hyponatraemia is an additional risk factor for hearing loss in preterm infants.

Transfer of research-based HIV prevention interventions to community service providers: fidelity and adaptation.

HIV prevention research interventions usually follow protocols with specific procedures. If a community-delivered intervention uses the same procedures with the same populations as those in the original research, the behavior change effects should be similar. However, community-based providers may not replicate an intervention exactly as it was conducted in the effectiveness study. Adaptation may be needed to better meet the needs of the clients, community, or organization. We propose that interventions can be defined in terms of core elements likely to be responsible for effectiveness. These core elements cannot be changed without fundamentally changing the intervention, whereas other characteristics may be modified without altering effectiveness. HIV prevention researchers and service providers can collaborate to develop interventions that not only are effective but can also be successfully implemented by service organizations. If researchers actively involve service providers and community members in intervention planning, technology transfer goals can be better achieved.