bluuebunny/crossref_metadata_2025 huggingface dataset:
Construction of the first high-density genetic linkage map and QTL mapping of flavonoid and leaf-size related traits in Epimedium
Authors: Yu Dongyue , Huang Ruoqi , Yu Shuxia , Liang Qiong , Wang Ying , Dang Haishan , Zhang Yanjun
Published: May 2023

Background

Leaves are the main medicinal organ in Epimedium herbs, and leaf flavonoid content is an important criterion of Epimedium herbs. However, the underlying genes that regulate leaf size and flavonoid content are unclear, which limits the use of breeding for Epimedium development. This study focuses on QTL mapping of flavonoid and leaf-size related traits in Epimedium.

Results

We constructed the first high-density genetic map (HDGM) using 109 F1 hybrids of Epimedium leptorrhizum and Epimedium sagittatum over three years (2019–2021). Using 5,271 single nucleotide polymorphism (SNP) markers, an HDGM with an overall distance of 2,366.07 cM and a mean gap of 0.612 cM was generated by utilizing genotyping by sequencing (GBS) technology. Every year for three years, 46 stable quantitative trait loci (QTLs) for leaf size and flavonoid contents were discovered, including 31 stable loci for Epimedin C (EC), one stable locus for total flavone content (TFC), 12 stable loci for leaf length (LL), and two stable loci for leaf area (LA). For flavonoid content and leaf size, the phenotypic variance explained for these loci varied between 4.00 and 16.80% and 14.95 and 17.34%, respectively.

Conclusions

Forty-six stable QTLs for leaf size and flavonoid content traits were repeatedly detected over three years. The HDGM and stable QTLs are laying the basis for breeding and gene investigation in Epimedium and will contribute to accelerating the identification of desirable genotypes for Epimedium breeding.
Lung ultrasound to evaluate pulmonary changes in patients with cardiogenic shock undergoing extracorporeal membrane oxygenation: a retrospective study
Authors: Wang Rongguo , Zhou Meiyan , Man Yuanyuan , Zhu Yangzi , Ding Wenping , Liu Qian , Sun Bin , Yan Li , Zhang Yan , Zhou Hai , Wang Liwei
Published: May 2023

Purpose

The aim of the study was to evaluate the value of lung ultrasound (LUS) in patients with cardiogenic shock treated by venoarterial extracorporeal membrane oxygenation (VA-ECMO).

Methods

A retrospective study was conducted in Xuzhou Central Hospital from September 2015 to April 2022. Patients with cardiogenic shock who received VA-ECMO treatment were enrolled in this study. The LUS score was obtained at the different time points of ECMO.

Results

Twenty-two patients were divided into a survival group (n = 16) and a nonsurvival group (n = 6). The intensive care unit (ICU) mortality was 27.3% (6/22). The LUS scores in the nonsurvival group were significantly higher than those in the survival group after 72 h (P < 0.05). There was a significant negative correlation between LUS scores and PaO2/FiO2 and LUS scores and pulmonary dynamic compliance(Cdyn) after 72 h of ECMO treatment (P < 0.001). ROC curve analysis showed that the area under the ROC curve (AUC) of T72-LUS was 0.964 (95% CI 0.887 ~ 1.000, P < 0.01).

Conclusion

LUS is a promising tool for evaluating pulmonary changes in patients with cardiogenic shock undergoing VA-ECMO.

Trial registration

The study had been registered in the Chinese Clinical Trial Registry(NO.ChiCTR2200062130 and 24/07/2022).
Topical corticosteroid counselling among Malaysian community pharmacists: a qualitative interview study
Authors: Nathan Abigail Dayang , Shankar Pathiyil Ravi , Sreeramareddy Chandrashekhar T.
Published: May 2023

Background

Topical corticosteroids (TCS) are commonly available in community pharmacies and are used in skin conditions like atopic dermatitis and psoriasis among others. Problems such as overuse, use of potent steroids and steroid phobia have been identified in the use of TCS in the literature. The aim of the study was to obtain community pharmacists (CPs) views regarding factors influencing their counselling of patients about TCS; challenges associated, important problems, the counselling process, shared care with other healthcare professionals, and explore further the findings from the questionnaire-based study.

Methods

Seven licensed practicing community pharmacists (from the Klang Valley, Malaysia) were interviewed between 23rd September to 14th November 2021. These were CPs participating in the questionnaire study who agreed to be interviewed. NVIVO 11 software was used for data analysis. Codes and themes were generated and agreed on by the researchers.

Results

The major themes identified related to the process mentioned of providing information to patients, the issues addressed by CPs during the counselling (including steroid phobia, overuse of TCS, patients asking for a specific preparation by name), less counselling support material, language barriers, lesser knowledge about certain conditions, information sources used by CPs (material provided by Ministry of Health and Malaysian Pharmacists Association, MIMS) and suggestions to strengthen the quality of counselling (specialization in skin diseases, webinars, shared care models). For patients requesting a particular preparation by name, the pharmacist will decide whether the preparation requested is suitable or suggest an alternative. Steroid phobia was seen more commonly among parents of young children and young patients. MIMS was available as a smartphone application making it easier to use. Advanced training for CPs in the management of skin conditions like that provided for diabetes mellitus can be considered.

Conclusions

Counselling was conducted while dispensing TCS in the open area of the pharmacy. Challenges to counselling were lack of time, limited counselling materials, and language barriers. Steroid phobia requires attention. Initiatives to strengthen counselling were mentioned by respondents and appear feasible. Further research covering the entire country is required.
Healthcare seeking behaviour during illness among older adults in Ghana: does food security status matter?
Authors: Braimah Joseph Asumah , Agyemang-Duah Williams , Amoak Daniel , Sano Yujiro , Antabe Roger , Dassah Ebenezer
Published: May 2023

Background

Ghana’s growing older adult population raises critical questions regarding healthcare for these older adults. At the same time, food insecurity is high among older adults in Ghana. This underscores the need to investigate the issues of food security and healthcare seeking behaviour among older adults. However, research on the association between food security status and healthcare seeking behaviour among older adults is scant in the Ghanaian context. In this study, we advance the social gerontology literature by examining the association between food security status and healthcare seeking behaviors among older adults.

Methods

Using a multi-stage sampling framework, we collected data from a representative sample of older adults across three regions in Ghana. Data were analyzed using logistic regression technique. We determined the significance of the test at a probability value of 0.05 or less.

Results

Over two-thirds (69%) of respondents did not seek care during their last illness. Additionally, 36% of respondents were severely food insecure, 21% were moderately food insecure, 7% were mildly food insecure, and 36% were food secure. After controlling for theoretically relevant variables, our multivariable analysis revealed a statistically significant association between food security status and healthcare seeking behaviors with older people who are food secure (OR = 1.80, p < 0.01) and mildly food insecure (OR = 1.89, p < 0.05) being more likely to seek healthcare compared with their counterparts who are food insecure.

Conclusion

Our findings highlight the need for sustainable intervention programs to improve food access and health service use among older adults in Ghana and similar contexts.
Comparative study of polymyxin B and colistin sulfate in the treatment of severe comorbid patients infected with CR-GNB
Authors: Wang Jiale , Shah Binay Kumar , Zhao Jian , Xiong Jie , Wang Changhui , Xie Shuanshuan
Published: May 2023

Background

With the difficulties in choosing colistin sulfate and polymyxin B sulfate (PBS) for carbapenem-resistant gram-negative bacteria (CR-GNB), we compared the efficacy and safety of these two old polymyxins in treatment of critically ill patients infected with CR-GNB infection.

Methods

One hundred four patients infected with CR-GNB in ICU were retrospectively grouped by PBS (68 patients) or colistin sulfate (36 patients). Clinical efficacy including symptoms, inflammatory parameters, defervescence, prognosis and microbial efficacy were analyzed. Hepatotoxicity, nephrotoxicity, and hematotoxicity were evaluated by TBiL, ALT, AST, creatinine, and thrombocytes.

Results

Demographic characteristics between colistin sulfate and PBS were not significantly different. Most of the CR-GNB were cultured in respiratory tract (91.7% vs 86.8%), and almost all were polymyxin-sensitive (98.2% vs 100%, MIC ≤ 2 μg/ml). The microbial efficacy in colistin sulfate (57.1%) was significantly higher than PBS (30.8%) (p = 0.022), however, no significant difference in clinical success was seen in both groups (33.8% vs 41.7%), as well as mortality, defervescence, imaging remission, days in the hospital, microbial reinfections, and prognosis, and almost all patients defervesce within 7 days (95.6% vs 89.5%).

Conclusions

Both polymyxins can be administrated in critically ill patients infected with CR-GNB and colistin sulfate is superior to PBS in microbial clearance. These results highlight the necessity of identifying CR-GNB patients who may benefit from polymyxin and who are at higher risk of mortality.
Placental chorioangioma and pregnancy outcome: a ten-year retrospective study in a tertiary referral centre
Authors: Ma Hongwei , Liu Ziling , Ruan Jie
Published: May 2023

Background

Placental chorioangioma is a rare disorder in pregnancy. We retrospectively reviewed the perinatal complications and long-term outcomes in pregnancies with placental chorioangioma and evaluated the factors affecting disease prognosis.

Methods

We reviewed pregnant women who delivered at our hospital in the past decade and whose diagnosis of placental chorioangioma was confirmed by pathological diagnosis. Information on maternal demographics, prenatal sonographic findings and perinatal outcomes was obtained by reviewing the medical records. In the latter part of the study, follow-up of children was conducted by phone interview.

Results

In the 10 years from August 2008 to December 2018, 175 cases(0.17%) were identified as placental chorioangioma histologically and 44(0.04%) of them were large chorioangiomas. Nearly one-third of cases with large chorioangiomas were associated with severe maternal and fetal complications or required prenatal intervention. Although one-fifth of fetuses/newborns complicated with large chorioangiomas were lost perinatally, the long-term prognosis for surviving fetuses was generally good. Further statistical analysis revealed that tumor size and location affect prognosis.

Conclusion

Placental chorioangioma may cause an unfavorable perinatal outcome. Regular ultrasound monitoring can provide the tumor characteristics which can be referred to for predicting the tendency of those complications and indicate when intervention may be necessary. It is not clear which factors lead to complications with fetal damage as the main manifestation or polyhydramnios as the main manifestation.
Can the parkland grading scale predict the difficulty of laparoscopic cholecystectomy? A new approach to validation
Authors: Liu Ya-qi , Wang Chao , Cai Xuan , Zheng Zhi-xue , Bi Jing-tao
Published: May 2023

Background

The Parkland Grading Scale (PGS) is an intraoperative grading scale to stratify gallbladder disease severity during laparoscopic cholecystectomy (LC). We evaluated the usefulness of the PGS in predicting the difficulty levels of LC procedures using a novel approach.

Methods

A total of 261 patients diagnosed with cholelithiasis and cholecystitis who underwent LC were assessed. The PGS and the surgical difficulty grading system were used to evaluate surgical procedures by reviewing the operation videos. Clinical baseline characteristics and post-treatment outcomes were also recorded. Differences between the five PGS grades in terms of surgical difficulty scores were analyzed using the Jonckheere-Terpstra test. The relationship between PGS grades and surgical difficulty scores was assessed using Spearman’s Rank correlation. Finally, the linear trends between morbidity scores and PGS grades were evaluated using the Mantel-Haenszel test.

Results

There was a significant difference in the surgical difficulty scores for the five PGS grades (p < 0.001). In pairwise comparison, each grade (1–5) was significantly different from the others (p < 0.05) in terms of surgical difficulty, except Grade 2 vs. 3 (p = 0.07) and Grade 3 vs. 4 (p = 0.08). There was a significant correlation between PGS grades and surgical difficulty scores (rs = 0.681, p < 0.001). There was also a significant linear association between morbidity and PGS grades (p < 0.001). Spearman’s R value was 0.176 (p = 0.004).

Conclusion

The PGS can accurately assess the surgical difficulty level of LC. The precision and conciseness of the PGS make it suitable for use in future research.
Predicting missed health care visits during the COVID-19 pandemic using machine learning methods: evidence from 55,500 individuals from 28 European countries
Authors: Reuter Anna , Smolić Šime , Bärnighausen Till , Sudharsanan Nikkil
Published: May 2023

Background

Pandemics such as the COVID-19 pandemic and other severe health care disruptions endanger individuals to miss essential care. Machine learning models that predict which patients are at greatest risk of missing care visits can help health administrators prioritize retentions efforts towards patients with the most need. Such approaches may be especially useful for efficiently targeting interventions for health systems overburdened during states of emergency.

Methods

We use data on missed health care visits from over 55,500 respondents of the Survey of Health, Ageing and Retirement in Europe (SHARE) COVID-19 surveys (June – August 2020 and June – August 2021) with longitudinal data from waves 1–8 (April 2004 – March 2020). We compare the performance of four machine learning algorithms (stepwise selection, lasso, random forest, and neural networks) to predict missed health care visits during the first COVID-19 survey based on common patient characteristics available to most health care providers. We test the prediction accuracy, sensitivity, and specificity of the selected models for the first COVID-19 survey by employing 5-fold cross-validation, and test the out-of-sample performance of the models by applying them to the data from the second COVID-19 survey.

Results

Within our sample, 15.5% of the respondents reported any missed essential health care visit due to the COVID-19 pandemic. All four machine learning methods perform similarly in their predictive power. All models have an area under the curve (AUC) of around 0.61, outperforming random prediction. This performance is sustained for data from the second COVID-19 wave one year later, with an AUC of 0.59 for men and 0.61 for women. When classifying all men (women) with a predicted risk of 0.135 (0.170) or higher as being at risk of missing care, the neural network model correctly identifies 59% (58%) of the individuals with missed care visits, and 57% (58%) of the individuals without missed care visits. As the sensitivity and specificity of the models are strongly related to the risk threshold used to classify individuals, the models can be calibrated depending on users’ resource constraints and targeting approach.

Conclusions

Pandemics such as COVID-19 require rapid and efficient responses to reduce disruptions in health care. Based on characteristics available to health administrators or insurance providers, simple machine learning algorithms can be used to efficiently target efforts to reduce missed essential care.
Multi-omic assessment shows dysregulation of pulmonary and systemic immunity to e-cigarette exposure
Authors: Scieszka David P. , Garland Devon , Hunter Russell , Herbert Guy , Lucas Selita , Jin Yan , Gu Haiwei , Campen Matthew J. , Cannon Judy L.
Published: May 2023

Electronic cigarette (Ecig) use has become more common, gaining increasing acceptance as a safer alternative to tobacco smoking. However, the 2019 outbreak of Ecig and Vaping-Associated Lung Injury (EVALI) alerted the community to the potential for incorporation of deleterious ingredients such as vitamin E acetate into products without adequate safety testing. Understanding Ecig induced molecular changes in the lung and systemically can provide a path to safety assessment and protect consumers from unsafe formulations. While vitamin E acetate has been largely removed from commercial and illicit products, many Ecig products contain additives that remain largely uncharacterized. In this study, we determined the lung-specific effects as well as systemic immune effects in response to exposure to a common Ecig base, propylene glycol and vegetable glycerin (PGVG), with and without a 1% addition of phytol, a diterpene alcohol that has been found in commercial products. We exposed animals to PGVG with and without phytol and assessed metabolite, lipid, and transcriptional markers in the lung. We found both lung-specific as well as systemic effects in immune parameters, metabolites, and lipids. Phytol drove modest changes in lung function and increased splenic CD4 T cell populations. We also conducted multi-omic data integration to better understand early complex pulmonary responses, highlighting a central enhancement of acetylcholine responses and downregulation of palmitic acid connected with conventional flow cytometric assessments of lung, systemic inflammation, and pulmonary function. Our results demonstrate that Ecig exposure not only leads to changes in pulmonary function but also affects systemic immune and metabolic parameters.
Racial microaggressions and interculturality in remote Central Australian Aboriginal healthcare
Authors: Wicks Mary , Hampshire Christine , Campbell Jeannie , Maple-Brown Louise , Kirkham Renae
Published: May 2023

Background

An epidemic of type 2 diabetes in remote Aboriginal people in Central Australia, contributes to high rates of morbidity and mortality. Remote non-Aboriginal Health Care Workers (HCW) and the Aboriginal people they serve inhabit a complex cultural interface. This study aimed to recognise racial microaggressions in the everyday discourse of HCWs. It proposes a model of interculturality for remote HCWs that avoids racialisation and essentialising of Aboriginal people’s identities and cultures.

Methods

Semi-structured in-depth interviews were undertaken with HCWs from two Primary Health Care services in very remote Central Australia. Fourteen interviews were analysed from seven Remote Area Nurse, five Remote Medical Practitioners and two Aboriginal Health Practitioners. Discourse analysis was employed to explore racial microaggressions and power relations. NVivo software assisted in the thematic organisation of microaggressions according to a predefined taxonomy.

Results

Seven microaggression themes were identified - racial categorization and sameness, assumptions about intelligence and competence, false colour blindness, criminality and dangerousness, reverse racism and hostility, treatment as second-class citizens and pathologizing culture. A model of interculturality for remote HCWs was based on concepts of the third space, deCentred hybrid identities and small culture formation on-the-go combined with a duty-conscious ethic, cultural safety and humility.

Conclusions

Racial microaggressions are common in the discourse of remote HCWs. The model of interculturality proposed could improve intercultural communication and relationships between HCWs and Aboriginal people. This improved engagement is required to address the current diabetes epidemic in Central Australia.
Psychosocial factors influencing quality of life in patients with primary brain tumors in Pakistan: an analytical cross-sectional study
Authors: Zahid Nida , Martins Russell Seth , Brown Nick , Zahid Wajeeha , Azam Iqbal , Hassan Aneesa , Ahmad Khabir , Bhamani Shireen Shehzad , Jabbar Adnan Abdul , Asad Nargis , Shamim Muhammad Shahzad , Khan Rashid Jooma , Javed Gohar , Bari Ehsan , Enam Syed Ather
Published: May 2023

Objective

Despite quality of life (QoL) being recognized as an important outcome in neuro-oncology, there is a lack of research from Pakistan where sociocultural differences may influence QoL. This study aimed to measure the QoL in patients with primary brain tumors (PBTs) and assess its association with mental health outcomes and social support.

Results

Our study included a total of 250 patients, with a median age of 42 years (range 33–54 years). The commonest brain tumors were glioma (46.8%) and meningioma (21.2). The mean global QoL of the sample was 75.73 ± 14.9. The majority of patients had high social support (97.6%) and were not depressed (90%) or anxious (91.6%).

On multivariable linear regression, global QoL was inversely associated with no or low income (beta coefficients: −8.75 to −11.84), having hypertension (−5.53), currently using a urine catheter (−13.55), having low social support (−28.16) suffering from mild (−15.31) or symptomatic (−23.84) depression, or mild anxiety (−13.22).
DNA sequencing reveals high arbuscular mycorrhizal fungi diversity in the rhizosphere soil of Prunus africana trees in fragmented Afromontane forests
Authors: Tchiechoua Yves H. , Odee David W. , Ngonkeu Eddy L. M. , Kinyua Johnson , Ngumi Victoria W. , Machuka Eunice M. , Waweru Bernice , Le Roux Marcellous , Pelle Roger
Published: May 2023

Purpose

Arbuscular mycorrhizal fungi (AMF) play a key role in medicinal plant species, besides their ecological role in shaping plant communities. Knowledge about the diversity and structure of AMF communities associated with the endangered Prunus africana is valuable in the conservation and domestication of the species for its medicinal products.

Methods

We investigated the diversity and structure of AMF species communities in the rhizosphere soils of P. africana trees occurring in four fragmented Afromontane forests found in Cameroon (Mount Cameroon and Mount Manengouba) and Kenya (Chuka and Malava) using Illumina Miseq sequencing of 18S rRNA gene amplicons.

Results

A total of 64 virtual taxa (VT) belonging to eight genera were detected, namely Glomus (43 VT), Claroideoglomus (6 VT), Paraglomus (5 VT), Acaulospora (4 VT), Diversispora (3 VT), and Archaeospora, Pacispora, and Scutellospora with 1 VT each. Scutellospora heterogama VTX00286 was the most abundant and common species in all four sites (49.62%). Glomeraceae and Gigasporaceae were the most abundant families found across the sites, while Acaulosporaceae, Pacisporaceae, and Archaeosporaceae were rare, represented by < 1% of all the detected taxa.

Conclusion

Our data shows a high diversity of AMF species associated with P. africana and variable community structure partially shaped by local edaphic factors.
MSCs’ conditioned media cytokine and growth factor profiles and their impact on macrophage polarization
Authors: Peshkova Maria , Korneev Alexander , Suleimanov Shakir , Vlasova Irina I. , Svistunov Andrey , Kosheleva Nastasia , Timashev Peter
Published: May 2023

Background

There is a growing body of evidence that multipotent mesenchymal stromal cells’ (MSCs’) remarkable therapeutic potential is attributed not only to their differentiation and regenerative capacity, but also to the paracrine effect, underlying their immunomodulatory properties. MSCs’ secretome (i.e., cytokines, growth factors, and extracellular vesicles) is therefore increasingly discussed in the context of their ability to modulate inflammatory response and promote regeneration. There is evidence that 2D or 3D culturing conditions have an impact on the cells’ secretome, and here we aimed to compare the secretion of cytokines and growth factors in human MSCs from different sources cultured in 2D and 3D conditions and assess their effect on human macrophages polarization in vitro.

Methods

MSCs were derived from human adipose tissue, bone marrow, gingiva, placenta, and umbilical cord, cultured as monolayers or as cell spheroids. Their cytokine profiles were analyzed, and data standardization was carried out using a z-score. Human peripheral blood mononuclear cells-derived macrophages were then treated with umbilical cord-derived MSCs’ conditioned media and their effect on macrophages polarization was assessed.

Results

Our findings suggest that umbilical cord-derived MSCs’ conditioned media demonstrated the highest cytokine and growth factor levels and despite mostly pro-inflammatory cytokine profile were able to promote anti-inflammatory macrophage polarization.

Conclusions

Umbilical cord-derived MSCs’ conditioned media hold great potential for therapeutic use, demonstrating significant anti-inflammatory effect on human macrophages.
Dual titration of minute ventilation and sweep gas flow to control carbon dioxide variations in patients on venovenous extracorporeal membrane oxygenation
Authors: Masi Paul , Bagate François , Tuffet Samuel , Piscitelli Mariantonietta , Folliguet Thierry , Razazi Keyvan , De Prost Nicolas , Carteaux Guillaume , Mekontso Dessap Armand
Published: May 2023

Background

The implantation of venovenous extracorporeal membrane oxygenation (VV-ECMO) support to manage severe acute respiratory distress syndrome generates large variations in carbon dioxide partial pressure (PaCO2) that are associated with intracranial bleeding. We assessed the feasibility and efficacy of a pragmatic protocol for progressive dual titration of sweep gas flow and minute ventilation after VV-ECMO implantation in order to limit significant PaCO2 variations.

Patients and methods

A protocol for dual titration of sweep gas flow and minute ventilation following VV-ECMO implantation was implemented in our unit in September 2020. In this single-centre retrospective before-after study, we included patients who required VV-ECMO from March, 2020 to May, 2021, which corresponds to two time periods: from March to August, 2020 (control group) and from September, 2020 to May, 2021 (protocol group). The primary endpoint was the mean absolute change in PaCO2 in consecutive arterial blood gases samples drawn over the first 12 h following VV-ECMO implantation. Secondary endpoints included large (> 25 mmHg) initial variations in PaCO2, intracranial bleedings and mortality in both groups.

Results

Fifty-one patients required VV-ECMO in our unit during the study period, including 24 in the control group and 27 in the protocol group. The protocol was proved feasible. The 12-h mean absolute change in PaCO2 was significantly lower in patients of the protocol group as compared with their counterparts (7 mmHg [6–12] vs. 12 mmHg [6–24], p = 0.007). Patients of the protocol group experienced less large initial variations in PaCO2 immediately after ECMO implantation (7% vs. 29%, p = 0.04) and less intracranial bleeding (4% vs. 25%, p = 0.04). Mortality was similar in both groups (35% vs. 46%, p = 0.42).

Conclusion

Implementation of our protocol for dual titration of minute ventilation and sweep gas flow was feasible and associated with less initial PaCO2 variation than usual care. It was also associated with less intracranial bleeding.
Influencing residential electricity consumption with tailored messages: long-term usage patterns and effects on user experience
Authors: Schrammel Johann , Diamond Lisa M. , Fröhlich Peter , Mor Gerard , Cipriano Jordi
Published: May 2023

Background

To transition our energy system toward sustainable production and consumption, it is important to successfully engage consumers to become active participants in this process. One form this can take is manual demand response, where end users respond to fluctuations in energy production and help balance the grid through adjustment of their consumption. This paper presents a trial of such a system that took place with tenants in subsidized housing in Catalonia, Spain. The aim of the trial was to motivate the load shifting behavior of the participants by forecasting expected consumption curves and tailoring suggestions for optimized behavior. The forecasts and suggestions were based on the users’ past consumption patterns and the hourly day-ahead electricity prices. This information was made available to the users on a web-based platform, and participants were actively informed with text messages sent to their mobile phones in case of attractive saving potentials for the following day. The trial was carried out in 2 phases from November 2019 to May 2020 (Phase 1) and from August to October 2020 (Phase 2). Data were collected on interaction with the platform, the perceived user experience of the platform and text messages, and the perceived energy saving success.

Results

Our results showed that there is a general interest of the participants in the concept, but that there are also important barriers to integrating load shifting behavior into everyday life. The biggest barriers here are limitations in the flexibility potential of households and limited perceived benefits. Feedback from our participants also suggests high acceptance and relevance of more automated demand-side management (DSM) concepts.

Conclusions

Based on this, we recommend paying special attention to the accommodation of varying flexibility potential in manual demand response (DR) programs, ensuring that communicated benefits are sufficiently attractive to motivate behavior change, and consideration of a phase of manual DR as an entry point to automated DSM.
The struggle of energy communities to enhance energy justice: insights from 113 German cases
Authors: Hanke Florian , Guyet Rachel
Published: May 2023

Background

Energy communities provide access to energy services, such as affordable clean energy and energy-efficiency measures. Some of these services are of particular benefit for vulnerable households struggling with high energy prices and low incomes. European energy policy stipulates an enabling framework to support energy communities offering such services to all households, explicitly soliciting the inclusion of vulnerable and low-income groups enhancing energy justice and democracy. With transposition still pending in Germany, the question remains as to what extent vulnerable groups benefit in practice.

Results

Based on the data from an online survey among 113 German energy communities, this paper investigates the extent to which energy communities enhance energy justice and democracy in the German energy transition. We have therefore to ask how energy communities reach out to vulnerable groups and describe the hurdles energy communities face. Even though some energy communities successfully reach vulnerable households, we show that the majority struggle to truely reach out to these groups. In the absence of regulatory support for engaging with vulnerable groups and confronted with a competitive energy market, energy communities are focussing on remaining in business. In this context, it should also be mentioned that some energy communities do not reach out to vulnerable groups to offer beneficial services that are of particular interest for the majority of them.

Conclusion

Based on these findings, we would like to underline the need for enabling regulations to support energy communities’ contribution to justice and democracy. An ‘enabling framework’ demands a clear taxonomy, which distinguishes different organisational and social energy community characteristics to acknowledge their social welfare-enhancing role and avoid misinterpretations and potential misuse.
Timing of hepatitis C treatment initiation and retention in office-based opioid treatment with buprenorphine: a retrospective cohort study
Authors: Geist Mary L. , Radick Andrea C. , Tsui Judith I. , Blalock Kendra L. , Adwell Addy , Tamru Elsabeth , Connolly Nancy C. , James Jocelyn R.
Published: May 2023

Background

This study examined associations between receipt of hepatitis C (HCV) treatment and retention in office-based opioid treatment (OBOT) care.

Methods

We conducted a retrospective cohort study of HCV-infected patients who initiated OBOT treatment between December 2015 and March 2021 to characterize HCV treatment and assess associations with OBOT retention. HCV treatment was characterized as no treatment, early treatment (< 100 days since OBOT initiation) or late treatment (≥ 100 days). We evaluated associations between HCV treatment and cumulative days in OBOT. A secondary analysis using Cox Proportional Hazards regression was done to determine the rate of discharge over time when comparing those who did versus did not receive HCV treatment as a time-varying covariate. We also analyzed a subset of patients retained at least 100 days in OBOT care and evaluated whether HCV treatment during that period was associated with OBOT retention beyond 100 days.

Results

Of 191 HCV-infected OBOT patients, 30% initiated HCV treatment, of whom 31% received early treatment and 69% received late treatment. Median cumulative duration in OBOT was greater among those who received HCV treatment (any: 398 days, early: 284 days and late: 430 days) when compared to those who did not receive treatment (90 days). Compared to no HCV treatment, there were 83% (95% CI: 33–152%, P < 0.001), 95% (95% CI: 28%-197%, p = 0.002 and 77% (95% CI: 25–153%, p = 0.002) more cumulative days in OBOT for any, early and late HCV treatment, respectively. HCV treatment was associated with a lower relative hazard for discharge/drop-out, although results did not meet statistical significance (aHR = 0.59;95% CI: 0.34–1.00; p = 0.052). Among the subset of 84 patients retained in OBOT at least 100 days, 18 received HCV treatment during that period. Compared to those who did not receive treatment within the first 100 days, those who received treatment had 57% (95% CI: -3%-152%, p = 0.065) more subsequent days in OBOT.

Conclusions

A minority of HCV-infected patients received HCV treatment after initiating OBOT treatment, but those who did had better retention. Further efforts are needed to facilitate rapid HCV treatment and evaluate whether early HCV treatment improves OBOT engagement.
Conflict resolution in the case of convective weather cell circumvention
Authors: Bogdanovic Vojislav , Mao Zhi-Hong
Published: May 2023

This research analyzes the area required for the conflict resolution between aircraft in two flows impacted by a convective weather cell (CWC). The CWC is introduced as a constrained area, forbidden to flight through, which affects the air traffic flows. Prior the conflict resolution, two flows and their intersection are relocated away from the CWC area (thus enabling circumvention of the CWC), which is followed by a tuning of the relocated flows intersection angle in order to create the minimal size of the conflict zone (CZ—a circular area centered at the intersection of two flows, which provides aircraft enough space to completely resolve the conflict within). Therefore, the essence of the proposed solution is in providing conflict free trajectories for the aircraft in intersecting flows that are affected by the CWC, with the goal of minimizing the CZ size, so the finite occupied airspace for the conflict resolution and the CWC circumvention could be reduced. Compared to the best solutions and current industry practice, this article is focused in reduction of the airspace required for aircraft to aircraft and aircraft to weather conflict resolution, and not to distance travelled, time savings, and fuel consumption minimization. The conducted analysis in the MicrosoftExcel2010 confirmed the relevance of the proposed model and demonstrated variations in efficiency of the utilized airspace. The proposed model's transdisciplinary nature makes it potentially applicable in other fields of study, such as the conflict resolution between unmanned aerial vehicles (UAVs) and fixed objects like buildings. Building on this model and taking in consideration large and complex data sets, such as weather related data and flight data (aircraft position, speed, and altitude), we believe it is possible to conduct more sophisticated analyses that would take advantage of Big Data.
A simple and rapid extraction of lipids in plasma using spin column with superabsorbent polymer beads for mass spectrometry
Authors: Choi Jung Hoon , Bang Geul , Kim Jeong Ah , Kim Young Hwan
Published: May 2023

The efficient extraction of lipid species in plasma was developed for quick sample preparation and accurate lipid analysis, using spin column with superabsorbent polymer beads (SAP), as the improvement of previous SAP method reported before. The modified SAP (mSAP) method is composed of simple steps, including sample loading, swelling, solvent addition, centrifugation, and drying of the resulting lipid solution. The mSAP method offers several advantages over the conventional and the previous SAP methods for lipid analysis in plasma sample. The mSAP method was approximately 10 times faster than the modified Folch protocol (Matyash method), methyl-tert-butyl ether based extraction method. The mSAP method offered an excellent recovery rate for most all major classes in the lipid standard mixture, outperforming the Matyash method. The limit of detection (LOD) of 1,2-diheptadecanoyl-sn-glycero-3-phophocholine (PC 17:0/17:0) spiking in plasma by the mSAP method is about seven times lower than those of the conventional methods. The relative standard deviation (RSD) values for inter- and intra-day variability of the mSAP method over a 5-day period were significantly lower than those of the previous SAP and Matyash methods. The mSAP method has been shown to be more time-saving, sensitive, reproducible and reliable, as evidence by its faster processing time, lower LOD, lower RSD values and high recovery rate for different lipid classes. Overall, these findings suggest that this method may be a promising approach for the application of total lipid analysis in lipidomic research in future.
A pilot randomised trial comparing individualised physiotherapy versus shockwave therapy for proximal hamstring tendinopathy: a protocol
Authors: Rich Aidan Lindsay Fenner , Cook Jillianne Leigh , Hahne Andrew John , Ford Jon Joseph
Published: May 2023

Purpose

Proximal hamstring tendinopathy (PHT) presents as localised lower buttock pain with tasks such as squatting and sitting. It is a condition that occurs at all ages and levels of sporting participation and can cause disability with sport, work, and activities of daily living.

This paper details a pilot trial protocol for investigating the effectiveness of individualised physiotherapy compared to extracorporeal shockwave therapy (ESWT) on pain and strength in people with PHT.

Methods

The study is an assessor‐blinded, pilot randomised controlled trial (RCT). One hundred participants with PHT will be recruited from the local community and sporting clubs. Participants will be randomised to receive six sessions of either individualised physiotherapy or ESWT, with both groups also receiving standardised education and advice.

Primary outcomes will be global rating of change on a 7‐point Likert scale, and the Victorian Institute of Sport—Hamstring (VISA‐H) scale, measured at 0, 4, 12, 26 and 52 weeks. Secondary outcomes will include sitting tolerance, the modified Physical Activity Level Scale, eccentric hamstring strength, modified Tampa scale for kinesiophobia, the Örebro Musculoskeletal Pain Screening Questionnaire Short Form (ÖMPSQ‐SF), Numerical Pain Rating Scale (NPRS) for average and worst pain, participant adherence, the Pain Catastrophizing scale, satisfaction scores, and quality of life. Data will be analysed on an intention to treat basis, with between‐group effects estimated using linear mixed models for continuous data and Mann Whitney U tests for ordinal data.

Conclusions

This pilot RCT will compare individualised physiotherapy versus ESWT for PHT. The trial will determine feasibility and estimated treatment effects to inform a definitive trial in the future.

Trial registration

The trial has been prospectively registered with the Australia & New Zealand Clinical Trials Registry (ACTRN12621000846820), registered 1 July 2021, https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=373085
When there is noise on Sherlock Holmes: mind wandering increases with perceptual processing difficulty during reading and listening
Authors: Steindorf Lena , Pink Sebastian , Rummel Jan , Smallwood Jonathan
Published: May 2023

We investigated whether increased perceptual processing difficulty during reading or listening to a Sherlock Holmes novella impacts mind wandering as well as text comprehension. We presented 175 participants with a novella in either a visual or an auditory presentation format and probed their thoughts and motivational states from time to time during reading/listening. For half of the participants in each presentation-format condition (visual or auditory), the story was superimposed by Gaussian noise. For both presentation formats, the participants who were exposed to noise while processing the story mind-wandered more and performed worse in a later comprehension test than the participants who processed the story without added noise. These negative effects of increased perceptual processing difficulty on task focus and comprehension were partly driven by motivational factors: reading/listening motivation mediated the relationship between perceptual processing difficulty and mind wandering.
Effects of pneumococcal conjugate vaccines on reducing the risk of respiratory disease associated with coronavirus infection
Authors: Dunne Eileen M. , Nunes Marta C. , Slack Mary P. E. , Theilacker Christian , Gessner Bradford D.
Published: May 2023

Pneumococcal conjugate vaccines (PCVs) provide protection against vaccine-type pneumococcal disease in both children and adults. Growing evidence suggests that PCVs also reduce pneumonia and lower respiratory tract infections (LRTIs) more broadly, including protecting against viral-associated respiratory diseases. In this short narrative review, we highlight clinical studies investigating whether PCVs might have a role in reducing coronavirus disease, both those caused by endemic human coronaviruses (HCoVs) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). These studies include two randomized controlled trials assessing HCoV-associated pneumonia, one each in children and older adults, and two observational studies of PCV13 effectiveness against HCoV-associated LRTI and COVID-19 in adults. We discuss possible mechanisms for PCV protection including preventing viral pneumococcal co-infections and the possibility that pneumococci in the upper respiratory tract might modify the host immune response to SARS-CoV-2. Lastly, we identify knowledge gaps and further questions on the potential role of PCVs during the COVID-19 pandemic.
Study protocol: Type III hybrid effectiveness-implementation study implementing Age-Friendly evidence-based practices in the VA to improve outcomes in older adults
Authors: Piazza Kirstin Manges , Ashcraft Laura Ellen , Rose Liam , Hall Daniel E. , Brown Rebecca T. , Bowen Mary Elizabeth , Mavandadi Shahrzad , Brecher Alison C. , Keddem Shimrit , Kiosian Bruce , Long Judith A. , Werner Rachel M. , Burke Robert E.
Published: May 2023

Background

Unmet care needs among older adults accelerate cognitive and functional decline and increase medical harms, leading to poorer quality of life, more frequent hospitalizations, and premature nursing home admission. The Department of Veterans Affairs (VA) is invested in becoming an “Age-Friendly Health System” to better address four tenets associated with reduced harm and improved outcomes among the 4 million Veterans aged 65 and over receiving VA care. These four tenets focus on “4Ms” that are fundamental to the care of older adults, including (1) whatMatters (ensuring that care is consistent with each person’s goals and preferences); (2)Medications (only using necessary medications and ensuring that they do not interfere with what matters, mobility, or mentation); (3)Mentation (preventing, identifying, treating, and managing dementia, depression, and delirium); and (4)Mobility (promoting safe movement to maintain function and independence). The Safer Aging through Geriatrics-Informed Evidence-Based Practices (SAGE) Quality Enhancement Research Initiative (QUERI) seeks to implement four evidence-based practices (EBPs) that have shown efficacy in addressing these core tenets of an “Age-Friendly Health System,” leading to reduced harm and improved outcomes in older adults.

Methods

We will implement four EBPs in 9 VA medical centers and associated outpatient clinics using a type III hybrid effectiveness-implementation stepped-wedge trial design. We selected four EBPs that align with Age-Friendly Health System principles: Surgical Pause, EMPOWER (Eliminating Medications Through Patient Ownership of End Results), TAP (Tailored Activities Program), and CAPABLE (Community Aging in Place – Advancing Better Living for Elders). Guided by the Pragmatic Robust Implementation and Sustainability Model (PRISM), we are comparing implementation as usual vs. active facilitation. Reach is our primary implementation outcome, while “facility-free days” is our primary effectiveness outcome across evidence-based practice interventions.

Discussion

To our knowledge, this is the first large-scale randomized effort to implement “Age-Friendly” aligned evidence-based practices. Understanding the barriers and facilitators to implementing these evidence-based practices is essential to successfully help shift current healthcare systems to become Age-Friendly. Effective implementation of this project will improve the care and outcomes of older Veterans and help them age safely within their communities.

Trial registration

Registered 05 May 2021, at ISRCTN #60,657,985.

Reporting guidelines

Standards for Reporting Implementation Studies (see attached).
A Brain, A Heart, and the Courage: Balancing Benefit and Toxicity of Immunotherapy in Melanoma
Authors: Chen Yen-Chou , Jaffer Muhammad , Zhou Lylybell , Moslehi Javid , Forsyth Peter A. , Fecher Leslie A.
Published: May 2023

The overall survival of advanced melanoma has improved dramatically. Immunotherapies, specifically checkpoint inhibitors, have played a large role in this improvement. These agents have also shown benefit in the adjuvant setting, are approved for treatment of resected stage II, III, and IV melanoma, and play an evolving role in the neoadjuvant setting. Although generally well tolerated, immune-related adverse events occur and can be severe. Here we focus on some severe and potentially long term toxicities, including cardiovascular and neurologic toxicities. Our understanding of the acute and long-term toxicities of immune checkpoint inhibitors continues to evolve. Oncologists must continue to balance cancer risk and treatment-related toxicities.