Policy Review Section

THE wide variety of clinical research presented in this issue of Journal of Small Animal Practice aptly demonstrates how progress in the diagnosis and treatment of clinical disease requires a multifacetted approach from both researchers and clinicians. There are five reports in this issue of Journal of Small Animal Practice detailing developmental and traumatic conditions of the canine and feline elbow, and each is worthy of note, containing information of clinical significance to all veterinarians with an interest in orthopaedics. Canine elbow dysplasia is a generic term describing a number of well-defined conditions of the cubital joint, such as fragmentation of the medial coronoid process (FCP), osteochondrosis dissecans of the medial part of the humeral condyle (OCD), and ununited anconeal process (UAP). There are strong breed associations with each of these diseases (LaFond and others 2002), suggesting a significant underlying genetic aetiology (or aetiologies). In this issue, Janutta and others (p. 75) publish important information on the heritability of elbow dysplasia. Estimates of heritability of different radiographic traits of elbow dysplasia were calculated in a pedigree of German shepherd dogs, using three radiographic scoring systems. Although the heritability estimates from their pedigree were relatively low, they do support previous work indicating that elbow dysplasia has a genetic origin. Indeed, the lack of consistent heritability estimates for such a disease reflects a number of different issues with canine genetic studies, such as population size, breed restriction, and difficulty in accurately phenotyping cases. This is especially true of studies considering elbow dysplasia through the use of radiographic phenotyping, where factors such as the radiographic view, the radiographic assessment criteria, and the age at radiography are rarely standardised between studies. However, perhaps a more fundamental observation of this article is that UAP and OCD appear to be inherited independently of other radiographic criteria of elbow dysplasia. This finding supports the view that bracketing a number of different conditions under the “umbrella” term canine elbow dysplasia may be convenient but is scientifically unsatisfactory because these conditions are likely to have partial or completely differing underlying genetic origins. So, if we are to make real progress in the understanding, diagnosis, treatment and eradication of elbow dysplasia from canine populations, has the time come to consider each of the individual component conditions separately? I believe so. Approaching elbow dysplasia from an anatomical standpoint, Gemmill and others (p. 66) evaluate the reliability of reconstructed computed tomography (rCT) for the assessment of elbow incongruity. Measurements of joint space width using rCT were found to correlate with anatomical (frozen section) measurements of the same parameters. This article verifies the methodology used by the same author in a previous publication in this journal (Gemmill and others 2005), detailing the presence of incongruency in some but not in all cases of FCP. The relevance of this work to the veterinarian treating FCP, but without facilities for computed tomography, is that it supports the theory suggesting that incongruency may be involved in the pathogenesis of canine FCP in some but not in all patients. Thus, careful preoperative evaluation and case selection are required for treatments that aim to address incongruency, such as osteotomies of the ulna. Meyer-Lindenberg and others (p. 61) provide a new slant on UAP by addressing the common perception that UAP and FCP rarely, if ever, occur in the same joint. By evaluating the medial part of the coronoid process with arthroscopy or arthrotomy in 155 clinical cases of UAP, they found that 16 per cent of joints contained an FCP. This article raises two important issues for clinicians treating cases of UAP. First, radiography was extremely poor at predicting the presence or absence of an FCP in canine elbows with UAP; thus, all cases of UAP should be evaluated for FCP either directly at surgery or through the use of more advanced imaging techniques, such as computed tomography. Secondly, incongruency (short ulna) was identified in nearly half the cases of UAP, both on preoperative radiographs and at surgery, including nearly a third of the FCP cases. This raises the inevitable question of how does the FCP occur in these joints, if the ulna is too short, and thus (theoretically) taking load off the medial coronoid process and presumably reducing its possibility for fracture? Clearly, there is much still to be learnt about both these conditions. Finally, two reports are published documenting unusual traumatic conditions of the feline elbow. Macias and others (p. 89) describe the presentation and treatment of five cats with Y-T humeral fractures. In contrast to dogs, this injury invariably appears to be caused by high-energy trauma and results in extremely comminuted fractures. The results obtained through the use of bilateral plate and transcondylar lag screw fixation of these fractures were considerably better than most veterinarians may have expected. Clinicians should note that these catastrophic fractures need not be given a poor prognosis, provided they are managed at the hands of a skilled surgeon. Finally, Liehmann and Lorinson (p. 94) publish the successful treatment of an extremely unusual condition, traumatic triceps tendon avulsion, in a cat. The publication deserves note, not only for its rarity and successful management but also for the author's ability to maintain a Spica splint on a feline patient for three weeks, which is truly a feat in itself! Dylan Clements graduated from the University of Liverpool in 1997 and then worked at the PDSA in Liverpool for three years before completing a surgical residency at the University of Glasgow Veterinary School. After his residency, he worked for a year as a registrar in Small Animal Orthopaedics at the University of Glasgow Veterinary School, during which he gained his RCVS diploma in small animal surgery (orthopaedics) and ECVS diploma in surgery. He is currently a BBSRC scholar at the University of Liverpool and The University of Manchester, where he is investigating the molecular genetics of canine osteoarthritis.

Erratum to: “Orbital prefrontal cortex volume correlates with social cognitive competence” by Powell, J.L. et al. [Neuropsychologia 48 (12) (2010) 3554–3562

The aim of the present study is to investigate the linkages between local economic development, innovation, and environmental sustainability inside urban areas. Can innovation affect the improvement of the quality of life inside urban areas? This research question comes from the consideration that usually innovation and growth in general are considered sources of conflict in affecting the livability of large cities. The objective of the paper is to design a model — the “SustaIn-Led” - to connect levels of environmental sustainability, quality of life, and economic development inside metropolitan areas, taking into account also innovation processes, activated by the innovation policies and by the knowledge economy. The study takes in consideration the 53 largest United States metropolitan areas with a population over 1 million, with a time series from the years 2000 through 2015. This has been done because of a two-fold reason: (1) the US among high-income countries is the one with the highest number of universities, patents, and citations; (2) several studies have shown that innovation occurs in large cities. The first part of the present study has carried out the identification of the variables to represent and significantly explain the phenomena – local economic development, innovation, and environmental sustainability – linked to the design of the SustaIn-LED model. Environmental sustainability in urban areas in this paper is represented by means of the Air Quality Index (AQI), while the number of workers synthetically quantifies local economic development. Correlation and multiple regression analyses are conducted in order to examine the relationship between the three main indicators. The multiple regressions for the year 2015 produced a low p-value, indicating that the predictors are significant in the regression analysis. Similar results of p-value are shown in all the years from 2000 to 2013. For 2015, the results showed that part of the variance in the measure of total workers of the metropolitan areas could be predicted by measures of innovation and air quality. Higher R² values have been registered for the years from 2000 through 2013. The development of the SustaIn-LED model could be utilized in urban regeneration processes to help in the design of new urban planning policies inside large cities by means of a better comprehension of environmental and economic implications caused by the implementation of innovation policies.

1Department of Comparative Molecular Medicine, School of Veterinary Science, The University of Liverpool, Liverpool, UK. 2Manchester Centre for Integrative Systems Biology, Manchester Interdisciplinary Biocentre, University of Manchester, Manchester, UK. 3Faculty of Life Sciences, University of Manchester, Oxford Road, Manchester, UK. 4National Institute for Biological Standards and Guidelines for reporting the use of column chromatography in proteomics

Constitutional and legislative requirements require traditional leaders to be involved in local economic development initiatives. However, there is a growing belief that traditional leadership institutions are not included in government attempts for Local economic development (LED). In most cases, a gap still exists and availing progress reports to the public. The study sought to examine the role and potential influence of traditional leaders in the economic development planning of their local areas to boost rural areas' economies. The study used an exploratory research design to ascertain the level of involvement by the national, provincial, and local governments of traditional leadership in economic development planning for their areas. The design was informed by qualitative methodology, where the researcher interviewed Chiefs and 20 elected community members in the Maphumulo area. This area was chosen because it was easily accessible to the researcher. Data were analyzed by applying qualitative thematic content analysis. The study is envisaged to promote local development by involving traditional institutions in local government planning and budgeting within the Maphumulo area. The findings show that traditional leaders play an advisory role in the municipality and that local LED engagement is made possible by these leaders' participation in these policies. The results highlight the variety of parties participating in LED, including councillors, ward committees, NGOs, government agencies, municipalities, residents, and traditional and religious leaders. The outcomes show that LED participative tactics have a limited amount of effectiveness. Participants lamented corruption and the municipality's delayed reaction. The study also demonstrated the need for institutionalized LED responses that include all relevant parties. Most participants believed the municipality had the key to collaborating with the necessary regional forces to promote LED.

A NEW PARADIGM FOR LED? Local Economic Development (LED) is a discipline still coming into its own, with competing strands of argumentation still generating conflict. At the root of the conflict is debate over whether traditional types of local strategies a) are working, and b) are generating ‘pro-poor’ economic development, or simply more ‘uneven development’. The latter term refers to a structured, systematic mode of capital accumulation at one pole, and the ‘development of underdevelopment’ at another. Although it was once associated with ‘dependency theory’, it is a far more subtle conceptual approach to understanding ingrained poverty and inequality (Bond, 1998, 1999, 2000a, 2000b). The past two decades have, after all, witnessed extraordinary pressure on local authorities, especially formal municipalities, to become more entrepreneurial. These pressures have accompanied the overall slow-down in growth in the international economy that began during the late 1970s, and reflect shifting power relations. In short, urban entrepreneurialism became a feature of virtually all LED strategies as competition for investment intensified. The term ‘smokestack chasing’ emerged to characterise the most ambitious attempts to ‘place-market’ a given municipality. The tide has probably turned on this epoch, which was called the period of the ‘Washington Consensus’ because it entailed rigid nation-state adherence to ‘neoliberal’ (free-market) dictates, often enforced by the International Monetary Fund, World Bank, and the discipline of international financial markets. These included:  government budget cuts, increases in user-fees for public services and privatisation of state enterprises;  the lifting of price controls, subsidies and any other distortions of market forces;  liberalisation of currency controls and currency devaluation;  higher interest rates and deregulation of local finance;  removal of import barriers (trade tariffs and quotas); and  an emphasis on promotion of exports, above all other economic priorities.

Figure 5.1 Percentage change in county population, 1990-2000 status (those with populations greater than one million) and, for the first time in U.S. history, a majority of the population lived in these major metros (Frey 1995). The growth in metropolitan counties during the last decade, a period of population growth in most of the country’s metropolitan areas, is clearly seen in Fig. 5.1. In 2000, 80 per cent of the U.S. population lived in metropolitan areas. The continuing concentration of the nation’s population in large urban centers is one of the most notable and enduring trends in the demography of the United States (Frey 1995). Other than during a period in the 1970s, when many non-metropolitan areas grew faster than metropolitan areas, this trend toward population concentration was strong throughout the twentieth century. In the 1990s, the majority of U.S. metropolitan areas experienced population growth. While growth in these areas was widespread, it was particularly fast, an average of 19 per cent, in metropolitan areas with populations between one million and five million (Kent et al. 2001). In Figure 5.1 we can clearly see the very rapid growth (30 per cent and above) in the counties around large cities, such as Atlanta and Augusta, Georgia., Charlotte and Raleigh-Durham, North Carolina, Orlando and Naples, Florida, Phoenix, Arizona, Las Vegas and Reno, Nevada, Boise, Idaho, Provo and Salt Lake City, Utah, Bolder, Denver and Fort Collins, Colorado, and San Bernardino county, east of Los Angeles, California. Reflecting overall growth in the last decade, the metropolitan areas in the South and West grew the most rapidly – 20 per cent on average compared to less than ten per cent in metropolitan areas in the Midwest and Northeast. The desertcities of Las Vegas and Phoenix continued their spectacular growth at 83.3 and 45.3 per cent respectively, while retirement meccas in Florida, such as Naples, registered growth of 65.3 per cent. Population declines during the same period were widespread but concentrated primarily in the Midwest. North Dakota and Nebraska recorded the largest number of counties experiencing negative growth during the decade at 89 and 57 per cent, respectively (U.S. Department of Commerce, Bureau of the Census 2001b). Kansas, South Dakota, West Virginia, Iowa and Montana had, respectively, 54, 48, 47, 44 and 39 per cent of their counties experiencing negative growth during the 1990s. The Shaping of Metropolitan Growth The forces behind these rapidly expanding metropolitan areas vary from region to region, as do the patterns of metropolitan growth. A major force in the growth of the United States, and, in particular, metropolitan areas, has been international migration. Of the total U.S. population increase between 1990 and 1998, about 30 per cent was contributed by immigration (Martin and Midgley 1999). International immigration has proceeded at the rate of just over one million per year during the last two decades, but the selected flow of immigrants has contributed substantially to the growth of these metropolitan areas (Chiswick and Sullivan 1995). For instance, all of the 1985-1990 migration gains for Los Angeles, New York, and San Francisco were due to international migration. In the early 1990s, international migration continued as a more significant force than rural to urban migration for these large metropolitan areas. In contrast to these cities, the majority of migration gains for Atlanta, Seattle, and Phoenix came from internal migrants from other parts of the U.S. (Frey 1995) It has been the flow of domestic migrants which has shaped the broader pattern of urbanization. Some cities, such as Charlotte and Raleigh-Durham, have grown as people have moved away from older, more congested areas in the Northeast and Midwest. These cities have developed with the new economy of the South and offer a lifestyle more akin to traditional suburbs than the urban areas in the Frost Belt. Similarly, cities in the Mountain West, such as Boise, Idaho, have attracted Californians disenchanted with dense, congested, and hectic urban centers in their home state (Kent et al. 2001). Shorter distance migration has given rise to a notable phenomenon of the last two decades, namely the growth of edge cities: those residential, rural or mixed-use areas on the perimeters of large cities, which were initially the locus of homes and malls for those who worked in the central cities and, eventually, became the areas where new jobs were created and emerged as cities in their own right. Garreau (1991, 1994) identified 203 edge cities inside 36 large metropolitan areas. Examples include the Interstate-95 loop encircling Boston, Massachusetts, interstate highways 287 and 78 in New Jersey, and the ‘bedroom community’ of Irvine, California, south of Los Angeles.

Local economic development analysis typically emphasizes the metropolitan area, rather than municipalities, because it is the basic economic space, but it is not a strong unit of local government. Brief reference is made here to parallel research published elsewhere on a coordinated metropolitan development model and then focus shifts to a municipal model that evaluates the position, prospects, and potential of a given piece of space within the local economy. Three basic municipal economic roles—on occasion alternatives, complementary, or sequential—are itentified: (1) a site for export production contrasting goods and services), (2) a center for metropolitan trade and services (for business or households), and (3) as a preferred place of residence (for high or low income households). The central city of Cleveland is compared to its metropoltan area, using readily available Census data for the 32 largest metropolitan areas and their central cities. Other Census data on the age distribution of housing and residential relocation between central cities and suburbs (disaggregated by occupation, education, and income) are examined as additional examples of the kind of data that can and will be integrated into this three-path muncipal model. The ultimate objective is to link that metropolitan (economic) model and this municipal (policy) model into a broad decision-making framework for local economic development policy and planning.

In this issue of the Policy Review Section, Keith Shaw of the Department of Economics and Government, University of Northumbria at Newcastle, drawing on experience in the North East of England examines the value of the “urban growth coalition” model and the concept of “new urban corporatism” in explaining the power structure underlying contemporary urban regeneration strategies. In the second Article, John Tuppen of the Department of Economics, École Supérieure de Commerce de Lyon, examines the French government's experience in establishing enterprise zones to address the problems arising from the withdrawal of state subsidies to the shipbuilding industry. In the third Article, Martyn Andrews of the University of Manchester And Steve Bradley of the Department of Economics, Lancaster University, argue that the career services are a valuable source of local labour market information arising from their role in providing vocational guidance and placement services. Drawing on a survey in the North West region they make suggestions as to how Training and Enterprise Councils and other agencies could utilize this potentially valuable data source. In the fourth Article, Mike Campbell And Simon Baldwin of the Policy Research Unit at Leeds Metropolitan University examine the distinction between recruitment difficulties and skills shortages in labour market analysis based on a survey of the position in Yorkshire and Humberside. They argue that it is possible, drawing on survey data used to produce the CALLMI system, to provide useful information concerning these factors and that it would be desirable to undertake an annual analysis which would greatly facilitate the formulation and implementation of Training and Enterprise Council programmes. Finally, Mike Coombes, Stan Openshaw, Cecilia Wong And Simon Raybould of the Centre for Urban and Regional Development Studies, University of Newcastle upon Tyne, examine the value of a geographical information system to aid the Local Government Commission in its work in establishing appropriate Local government boundaries.

Book Reviews Rendezvous With Destiny. A History of The 101st Airborne Division. By Leonard Rapport and Arthur Northwood, Jr. Washington. Infantry Journal Press. 810 pages. $7.50.The Story of The Ship. By Charles E. Gibson, 272 pages, 27 illustrations, Henry Schuman, New York, N.Y. 1948. Price $4.00.A Treatise On Contemporary Jurisprudence. By I. H. Rubenstein of the Illinois Bar. The Waldain Press, P.O. Box 97, Chicago, 1948. 120 pages. $2.50.Diseases of The Skin. By Oliver S. Ormsby, M.D., Rush Professor of Dermatology Emeritus, University of Illinois; Attending Dermatologist to the Presbyterian Hospital of Chicago; Member of the American Dermatologicai Association and the American Academy of Dermatology and Syphilology, etc., and Hamilton Montgomery, M.D., M.S., Associate Professor of Dermatology and Syphilology, Mayo Foundation for Medical Education and Research, Graduate School, University of Minnesota, Rochester, Minnesota; Associate in Section on Dermatology and Syphilology, Mayo Clinic, etc. Seventh Edition Thoroughly Revised with 683 Figures Containing 764 Illustrations and 18 Colored Illustrations on 11 Plates. Lea & Febiger, Philadelphia, 1948.The Epithelia of Woman'S Reproductive Organs. By George N. Papanicolaou, M.D., Herbert F. Traut, M.D., Andrew A. Marchetti, M.D. $10.00— 1947. N.Y.: The Commonwealth Fund.Histopathologic Technic. By R. D. Lillie, Med. Dir. U.S.P.H.S., Chief, Pathology Laboratory, National Institute of Health. Numerous Tables. 300 pages. Philadelphia: The Blakiston Co., 1948. Price $4.75.Oral And Dental Diseases: Aetiology, Histopathology, Clinical Features And Treatment. A textbook for Dental Students and a Reference Book for Dental and Medical Practitioners. By Hubert H. Stones, M.D., M.D.S., F.D.S.R.CS. Eng. Professor of Dental Surgery and Director of Dental Education, University of Liverpool; Hon. Director, Liverpool Dental Hospital; Consultant, E.M.S. Maxillo-facial Centre, Broad Green Hospital, Liverpool. Formerly External Examiner in Dental Subjects, Universities of Bristol, Cambridge, Leeds and Manchester; External Expert in Dentistry, University of London; Hon. Dental Surgeon, University College Hospital Dental Department, London. Nine-hundred-twentysix illustrations with many in color. The Williams and Wilkins Company, Baltimore, 1948. Price $18.00.Introduction To Medical Psychology. By L. Erwin Wexberg, M.D., Director, Bureau of Mental Hygiene, District of Columbia; published by Grune & Stratton, New York, 1947. Price $3.50.A Synopsis of Anesthesia. By J. Alfred Lee, M.R.C.S., L.R.C.P., M.M.S.A., D.A. Consultant Anaesthetist to Southend General Hospital; Southend Municipal Hospital, Rochford. Anaesthetist to Tilbury Hospital; Runwell Hospital; East Ham Memorial Hospital; Essex County Council. Assistant Anaesthetist to King George Hospital, Ilford. Late Whole-time Anaesthetic Specialist, E.M.S. The Williams & Wilkins Co., Baltimore, Maryland. 1947.Acrylics And Other Synthetic Resins Used In Dentistry. By Stanley D. Tylman, M.S., D.D.S., Professor of Prosthetics and Head of Crown and Bridge Department, University of Illinois, College of Dentistry, Chicago, Illinois, and Floyd A. Peyton, Ph.D., Assistant Professor of Dentistry, Department of Metallurgy, University of Texas, School of Dentistry, Houston, Texas, with 440 illustrations and 2 plates in color. J. B. Lippincott Company, Philadelphia, 1946. Price $10.00.A Physiologic And Clinical Study of Cardiovascular Disease. By Aldo A. Luisada, M.D. The Williams and Wilkins Company, Baltimore, 1948, $10.00.A Manual of Clinical Therapeutics. By Windson C. Cutting, M.D., 2nd ed., Philadelphia and London: W. B. Saunders Co., 1948. Price $5.00.Symptoms And Signs In Clinical Medicine, An Introduction To Medical Diagnosis. By E. Noble Chamberlain, M.D., M.Sc, F.R.C.P.; Lecturer in Medicine, University of Liverpool; Physician to Out-patients, Royal Liverpool United Hospital, Royal Infirmary Branch; Visiting Physician, Smithdown Road Hospital, Liverpool; Formerly Beit Memorial Research Fellow; Fourth Edition, with 346 Illustrations. Published by The Williams and Wilkins Company, Baltimore, Maryland. Year: 1947. Price: $8.00.Minor Surgery. By Frederick Christopher, B.S., M.D., F.A.C.S. Associate Professor of Surgery, Northwestern University Medical School. Chief Surgeon Evanston Hospital. Sixth edition. Cloth. Pp. 1058 with 937 illustrations. Price $12.00. Philadelphia: W. B. Saunders Co., 1948.An Atlas of Anatomy. By J. C. Boileau Grant, M.C, M.B., Ch.B., F.R.C.S. (Edin.) ; Professor of Anatomy in the University of Toronto. By Regions— Upper Limb, Abdomen, Perineum, Pelvis, Lower Limb, Vertebrae, Vertebral Column, Thorax, Head and Neck; Second Edition. Published by The Williams and Wilkins Company, Baltimore, Maryland. Year: 1947. Price: $11.00. James M. Phalen, James M. Phalen Colonel U. S. Army, Retired Search for other works by this author on: Oxford Academic Google Scholar Louis H. Roddis, Louis H. Roddis Captain U. S. Navy, Ret. Search for other works by this author on: Oxford Academic Google Scholar Edward A. Coates, Jr., Edward A. Coates, Jr. Colonel M.C., U. S. Army Search for other works by this author on: Oxford Academic Google Scholar J. C. Kimbrough, M.C., J. C. Kimbrough, M.C. Search for other works by this author on: Oxford Academic Google Scholar Alfred Golden, M.D., Alfred Golden, M.D. Search for other works by this author on: Oxford Academic Google Scholar Hugh W. Jones, M.C., Hugh W. Jones, M.C. Search for other works by this author on: Oxford Academic Google Scholar Jos. L. Bernier, D.C., Jos. L. Bernier, D.C. U. S. Army Search for other works by this author on: Oxford Academic Google Scholar Beverly E. Smith, Beverly E. Smith Medical Corps Search for other works by this author on: Oxford Academic Google Scholar John Gardiner, M.C., John Gardiner, M.C. Search for other works by this author on: Oxford Academic Google Scholar Jos. L. Bernier, D.C., Jos. L. Bernier, D.C. U. S. Army Search for other works by this author on: Oxford Academic Google Scholar ... Show more James S. Taylor, James S. Taylor Medical Corps Search for other works by this author on: Oxford Academic Google Scholar H. P. Marvin, H. P. Marvin U. S. Army, Ret. Search for other works by this author on: Oxford Academic Google Scholar Charles R. Mueller, Charles R. Mueller Medical Corps Search for other works by this author on: Oxford Academic Google Scholar Gustavus M. Blech, Gustavus M. Blech N. G. Ret. Search for other works by this author on: Oxford Academic Google Scholar Charles R. Mueller Charles R. Mueller Medical Corps Search for other works by this author on: Oxford Academic Google Scholar The Military Surgeon, Volume 104, Issue 1, January 1949, Pages 74–78, https://doi.org/10.1093/milmed/104.1.74 Published: 01 January 1949

8 - The New Pattern of Nonmetropolitan Population Change

Pressure ulcers, also known as bed sores, are injury to the skin mainly caused by prolonged pressure, for example in someone who is bedridden. Pressure ulcers occur in 470 to 3,210 per 10,000 patients in hospitals in the U.K., U.S.A., and Canada. Their severity is graded from stage 1 (the least severe) to stage 4 (the most severe). For patients and carers, it is important to know what normal skin is and to regularly check skin changes over the common places where pressure ulcers may appear (e.g. the bottom, heels, and lower back). Non‐blanching erythema – skin redness that does not turn white when pressed – is an important skin change. This study, undertaken by researchers from the University of Manchester and University of Liverpool, U.K., aimed to find out whether people with non‐blanching erythema are more likely to develop pressure ulcers in future than those without non‐blanching erythema. The authors used systematic review and individual‐level data analysis methods to summarise evidence from thirteen studies (with 68,077 people), and to analyse individual‐level data of 3,223 patients. Their analysis showed that people with non‐blanchable erythema had 2.72 times the odds of developing a new pressure ulcer of Stage 2 or above within 28 days, compared with those without non‐blanchable erythema. This means that if 73 people per 1,000 without non‐blanchable erythema develop new pressure ulcers of Stage 2+ within 28 days, 176 people per 1,000 with non‐blanchable erythema will probably develop new ulcers. The authors conclude that people with non‐blanching erythema are more likely to develop new pressure ulcers of Stage 2 or above within 28 days, than people without non‐blanching erythema. It is important for medical staff to identify non‐blanchable erythema and to intervene appropriately to prevent pressure ulcers. This summary relates to the study: Nonblanchable erythema for predicting pressure ulcer development: a systematic review with an individual participant data meta‐analysis

Computing: Paradigm shifts, adoption, new digital professionals rising Dr Joanna Leng, School of Computing, University of Leeds, UK and Dr Phillip Brooker, School of Sociology, University of Liverpool, Emeritus and Prof Wes Sharrock, School of Sociology, University of Manchester, focus on computing: paradigm shifts, charting the adoption and the rise of new digital professions. The historical lineage of research software delivery models is visualised in Fig 1, showing that research software delivery in universities is now cyclic, breaking approximately every ten years. In recent cycles, the research software delivery model in universities has been systematically centralised and administratively unified, making the model similar to Hick’s model of pre-1960s computing labour where programming was gendered towards women as sub-clerical support work, as opposed to being foundational to academic teaching and research practice.

The construction of the new LHCb Vertex Locator (VELO) detector is presented. The upgraded subsystem will play a crucial role in the tracking during data-taking runs starting in 2021, its main objective locating primary and secondary vertices. Compared to its predecessor, the main advantages are better resolution together with trigger-less readout at the maximal rate of 40MHz. In total, VELO consists of 52 modules positioned in vacuum along the LHC beam-pipe, surrounding the interaction point. The modules are populated with 4 hybrid silicon pixel detectors with pixel pitch of 55µm. Each of the sensors is read out by 3 VeloPix ASICs with 256x256 pixels. For experiment control and data propagation, sets of front-end hybrids and GBTx ASICs are utilized. The data are then sent through a vacuum feed-through board to an opto-and-power (OPB) board, which is connected to the rest of the experiment via optical fibres. Cooling of the whole module is achieved by phase transition of liquid CO 2 using a custom-made silicon micro-channel substrate.The assembly of modules at both University of Manchester (Manchester, UK) and Nikhef (Amsterdam, NL) requires high precision in many aspects, therefore extensive procedures for the large-scale construction and its quality assurance have been deployed. The information during each step is uploaded to the online database and automatically analyzed, providing instantaneous information about quality of both components, performed tasks and whole modules. Final assembly of the whole system then takes place at University of Liverpool (Liverpool, UK) and is then transported to CERN (Geneva, CH).

Even as economic incentives are increasingly used by policy makers to spur state and local economic development, their use is controversial among the public and academics. The authors examine whether state and local incentives lead to higher rates of business start-ups in metropolitan counties. Existing research indicates that start-ups are important for supporting (net) job creation, long-term growth, innovation, and development. The authors find that incentives have a statistically significant, negative relationship with start-up rates in total and for some industries including export-based and others that often receive incentives. The findings support critics who contend that incentives crowd out other economic activity, potentially reducing long-term growth. The authors also find that greater intersectoral job flows are positively linked to total start-ups, consistent with claims of those who advocate for policies that enhance labor market flexibility through reducing barriers to job mobility.