Toward optimal implementation of cancer prevention and control programs in public health: A study protocol on mis-implementation

Abstract Background Much of the cancer burden in the USA is preventable, through application of existing knowledge. State-level funders and public health practitioners are in ideal positions to affect programs and policies related to cancer control. Mis-implementation refers to ending effective programs and policies prematurely or continuing ineffective ones. Greater attention to mis-implementation should lead to use of effective interventions and more efficient expenditure of resources, which in the long term, will lead to more positive cancer outcomes. Methods This is a three-phase study that takes a comprehensive approach, leading to the elucidation of tactics for addressing mis-implementation. Phase 1: We assess the extent to which mis-implementation is occurring among state cancer control programs in public health. This initial phase will involve a survey of 800 practitioners representing all states. The programs represented will span the full continuum of cancer control, from primary prevention to survivorship. Phase 2: Using data from phase 1 to identify organizations in which mis-implementation is particularly high or low, the team will conduct eight comparative case studies to get a richer understanding of mis-implementation and to understand contextual differences. These case studies will highlight lessons learned about mis-implementation and identify hypothesized drivers. Phase 3: Agent-based modeling will be used to identify dynamic interactions between individual capacity, organizational capacity, use of evidence, funding, and external factors driving mis-implementation. The team will then translate and disseminate findings from phases 1 to 3 to practitioners and practice-related stakeholders to support the reduction of mis-implementation. Discussion This study is innovative and significant because it will (1) be the first to refine and further develop reliable and valid measures of mis-implementation of public health programs; (2) bring together a strong, transdisciplinary team with significant expertise in practice-based research; (3) use agent-based modeling to address cancer control implementation; and (4) use a participatory, evidence-based, stakeholder-driven approach that will identify key leverage points for addressing mis-implementation among state public health programs. This research is expected to provide replicable computational simulation models that can identify leverage points and public health system dynamics to reduce mis-implementation in cancer control and may be of interest to other health areas

Identification of Novel Linear Megaplasmids Carrying a ß-Lactamase Gene in Neurotoxigenic Clostridium butyricum Type E Strains

Since the first isolation of type E botulinum toxin-producing Clostridium butyricum from two infant botulism cases in Italy in 1984, this peculiar microorganism has been implicated in different forms of botulism worldwide. By applying particular pulsed-field gel electrophoresis run conditions, we were able to show for the first time that ten neurotoxigenic C. butyricum type E strains originated from Italy and China have linear megaplasmids in their genomes. At least four different megaplasmid sizes were identified among the ten neurotoxigenic C. butyricum type E strains. Each isolate displayed a single sized megaplasmid that was shown to possess a linear structure by ATP-dependent exonuclease digestion. Some of the neurotoxigenic C. butyricum type E strains possessed additional smaller circular plasmids. In order to investigate the genetic content of the newly identified megaplasmids, selected gene probes were designed and used in Southern hybridization experiments. Our results revealed that the type E botulinum neurotoxin gene was chromosome-located in all neurotoxigenic C. butyricum type E strains. Similar results were obtained with the 16S rRNA, the tetracycline tet(P) and the lincomycin resistance protein lmrB gene probes. A specific mobA gene probe only hybridized to the smaller plasmids of the Italian C. butyricum type E strains. Of note, a ß-lactamase gene probe hybridized to the megaplasmids of eight neurotoxigenic C. butyricum type E strains, of which seven from clinical sources and the remaining one from a food implicated in foodborne botulism, whereas this ß-lactam antibiotic resistance gene was absent form the megaplasmids of the two soil strains examined. The widespread occurrence among C. butyricum type E strains associated to human disease of linear megaplasmids harboring an antibiotic resistance gene strongly suggests that the megaplasmids could have played an important role in the emergence of C. butyricum type E as a human pathogen

Flexible and Semi-Transparent Silicon Solar Cells as a Power Supply to Smart Contact Lenses

Supplying electric power to wearable IoT devices, particularly smart contact lenses (SCLs), is one of the main obstacles to widespread adoption and commercialization. In the present study, we have successfully designed, fabricated, and characterized semi-transparent, self-supported, and flexible single crystalline silicon solar cells using a single-sided micromachining procedure. Optical, mechanical, and electrical simulations, together with the practical measurements, verify the application of our developed solar cells to be mounted on a limited-footprint and flexible SCL. The 15 μm-thick silicon solar cells conformally fit on a dome-shaped contact lens (ROC = 8 mm) without any mechanical and electrical degradation. This homojunction photovoltaic device containing an array of micro-holes exhibits a Voc, Jsc, and maximum power density of 504 mV, 6.48 mA cm–2, and 1.67 mW cm–2, respectively, at 25% visible light transparency under an AM1.5 one sun condition. Furthermore, the measurements were conducted under low-intensity indoor light conditions and resulted in a maximum power output of 25 and 42 μW cm–2 for the 50 and 25% transparent solar cells, respectively

Flexible and Semi-Transparent Silicon Solar Cells as a Power Supply to Smart Contact Lenses

Supplying electric power to wearable IoT devices, particularly smart contact lenses (SCLs), is one of the main obstacles to widespread adoption and commercialization. In the present study, we have successfully designed, fabricated, and characterized semi-transparent, self-supported, and flexible single crystalline silicon solar cells using a single-sided micromachining procedure. Optical, mechanical, and electrical simulations, together with the practical measurements, verify the application of our developed solar cells to be mounted on a limited-footprint and flexible SCL. The 15 μm-thick silicon solar cells conformally fit on a dome-shaped contact lens (ROC = 8 mm) without any mechanical and electrical degradation. This homojunction photovoltaic device containing an array of micro-holes exhibits a Voc, Jsc, and maximum power density of 504 mV, 6.48 mA cm–2, and 1.67 mW cm–2, respectively, at 25% visible light transparency under an AM1.5 one sun condition. Furthermore, the measurements were conducted under low-intensity indoor light conditions and resulted in a maximum power output of 25 and 42 μW cm–2 for the 50 and 25% transparent solar cells, respectively