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We document statistically significant relations between mutual fund betas and past market returns driven by fund feedback trading. Against this backdrop, evidence of "artificial" market timing emerges when standard market timing regressions are estimated across periods that span time variation in fund systematic risk levels, as is typical. Artificial timing significantly explains the inverse relation between timing model estimates of market timing and stock selectivity. A fund's feedback trading relates to its past performance and remains significant after accounting for trading on momentum. Fund flows suggest that investors value feedback trading, which helps hedge downside risk during bear markets. [ABSTRACT FROM AUTHOR]

Sepsis and septic shock remain global healthcare problems associated with high mortality rates despite best therapy efforts. Circulating biomarkers may identify those patients at risk for poor outcomes, however, current biomarkers, most prominently lactate, are non-specific and have an inconsistent impact on prognosis and/or disease management. Activation of the renin-angiotensin- system (RAS) is an early event in sepsis patients and elevated levels of circulating renin are more predictive of worse outcomes than lactate. The precursor protein Angiotensinogen is another key component of the circulating RAS; it is the only known substrate for renin and the ultimate source of the vasopressor Angiotensin II (Ang II). We postulate that lower Angiotensinogen concentrations may reflect a dysfunctional RAS characterized by high renin concentrations but attenuated Ang II generation, which is disproportionate to the high renin response and may compromise adequate support of blood pressure and tissue perfusion in septic patients. The current study compared the association between serum Angiotensinogen with mortality to that of lactate and renin in the VICTAS cohort of sepsis patients at baseline (day 0) by receiver operating characteristic (ROC) and Kaplan–Meier curve analyses. Serum concentration of Angiotensinogen was more strongly associated with 30-day mortality than either the serum concentrations of renin or lactate in sepsis patients. Moreover, the clinical assessment of Angiotensinogen may have distinct advantages over the typical measures of renin. The assessment of intact Angiotensinogen may potentially facilitate more precise therapeutic approaches (including exogenous angiotensin II) to restore a dysfunctional RAS and improve patient outcomes. Additional prospective validation studies are clearly required for this biomarker in the future. [ABSTRACT FROM AUTHOR]

Introduction: The properties of creative products–novelty and usefulness–are generally agreed upon by researchers. Yet, consensus is lacking on which personal and environmental factors contribute to an individual's creative potential, or to what extent. substantial research work has been conducted in this area, leading to the publication of many systematic reviews and meta-analyses collating the available evidence. However, many of these reviews have differing methodological and theoretical characteristics, and often report conflicting results. To summarize the current review literature on factors associated with creativity and better understand the similarities and discrepancies among reviews on the same topic, we plan to conduct an umbrella review of reviews. Methods: This protocol has been registered in Open Science Framework (DOI: 10.17605/OSF.IO/H78YS). We will search MEDLINE, PsycINFO, Web of Science, EMBASE, and Google Scholar for peer-reviewed reviews exploring factors associated with creativity. The quality of the included reviews will be assessed using the Risk of Bias Assessment Tool for Systematic Reviews (ROBIS), and the degree of study overlap across reviews assessed through calculation of the corrected covered area (CCA). Descriptive analyses will be performed to synthesize the results of the included reviews. We plan to use the results to create a holistic framework of the factors associated with creativity, which could be used to cross-validate existing creativity theories, or create new ones. Ethics and dissemination: The results of this umbrella review will be published in a relevant psychology-focused journal and presented at local, national and international conferences. As all data is peer-reviewed and presented in aggregate, we will not require ethics approval. [ABSTRACT FROM AUTHOR]

Background: While the effectiveness of patient-reported outcome measures (PROMs) as an intervention to impact patient pathways has been established for cancer care, it is unknown for other indications. We assessed the cost-effectiveness of a PROM-based monitoring and alert intervention for early detection of critical recovery paths following hip and knee replacement. Methods and findings: The cost-effectiveness analysis (CEA) is based on a multicentre randomised controlled trial encompassing 3,697 patients with hip replacement and 3,110 patients with knee replacement enrolled from 2019 to 2020 in 9 German hospitals. The analysis was conducted with a subset of 546 hip and 492 knee replacement cases with longitudinal cost data from 24 statutory health insurances. Patients were randomised 1:1 to a PROM-based remote monitoring and alert intervention or to a standard care group. All patients were assessed at 12-months post-surgery via digitally collected PROMs. Patients within the intervention group were additionally assessed at 1-, 3-, and 6-months post-surgery to be contacted in case of critical recovery paths. For the effect evaluation, a PROM-based composite measure (PRO-CM) was developed, combining changes across various PROMs in a single index ranging from 0 to 100. The PRO-CM included 6 PROMs focused on quality of life and various aspects of physical and mental health. The primary outcome was the incremental cost-effectiveness ratio (ICER). The intervention group showed incremental outcomes of 2.54 units PRO-CM (95% confidence interval (CI) [0.93, 4.14]; p = 0.002) for patients with hip and 0.87 (95% CI [−0.94, 2.67]; p = 0.347) for patients with knee replacement. Within the 12-months post-surgery period the intervention group had less costs of 376.43€ (95% CI [−639.74, −113.12]; p = 0.005) in patients with hip, and 375.50€ (95% CI [−767.40, 16.39]; p = 0.060) in patients with knee replacement, revealing a dominant ICER for both procedures. However, it remains unclear which step of the multistage intervention contributes most to the positive effect. Conclusions: The intervention significantly improved patient outcomes at lower costs in patients with hip replacements when compared with standard care. Further it showed a nonsignificant cost reduction in knee replacement patients. This reinforces the notion that PROMs can be utilised as a cost-effective instrument for remote monitoring in standard care settings. Trial registration: Registration: German Register for Clinical Studies (DRKS) under DRKS00019916. Lukas Schöner and team assess the cost-effectiveness of a patient-reported outcome measures-based monitoring and alert intervention for early detection of critical recovery paths following hip and knee replacement. Author summary: Why was this study done?: Hip and knee replacements are high volume treatments in most Western countries and represent a substantial driver for national healthcare expenditures. Evidence on the cost-effectiveness of using patient-reported outcome measures (PROMs) for monitoring in orthopaedics is very limited. The increased use of PROMs after orthopaedic surgery, the lack of standardised recovery follow-ups post-surgery combined with positive evidence from other treatment areas motivated the design of the "PROMoting Quality" trial. What did the researchers do and find?: We performed a cost-effectiveness analysis (CEA) based on a multicentre randomised controlled trial encompassing 546 patients with hip and 492 patients with knee replacement enrolled from 2019 to 2020 in 9 German hospitals. Patients were randomised to a PROM-based remote monitoring and alert intervention for early detection of critical recovery paths, or to a standard care group without monitoring. The intervention improved patient outcomes in hip replacements when compared with standard care and showed a cost reduction in both patients with hip and knee replacement. What do these findings mean?: Undetected critical recovery after surgery result in both undesired health outcomes and increased health care expenditures. In times of resource constraints and staff shortages, evidence from the "PROMoting Quality" trial can inform medical professionals and policy makers that the use of a PROM monitoring and alert system post-surgery can help to improve health outcomes for patients with hip replacement and reduce healthcare expenditures for both procedures, and thus be implemented on system level. It can give guidance to the discussions about advancing the digitalisation of the health care sector and further initiates research of using PROMs as monitoring and alert system for other conditions such as chronic diseases. However, it remains unclear exactly which step of the multistage intervention causes the positive effect. [ABSTRACT FROM AUTHOR]

Residual fragments can remain after kidney stone extraction which may necessitate another intervention. A new approach needs to be developedis needed to lower the risk of disease severe side effects caused by these fragments. Magnetic nanoparticles can be applied due to their properties of being able to bind to residual fragments and to be extracted by an external magnetic field. Fractals and magnetic nanoparticles have been synthesized and characterized thoroughly. The small nanoparticles bind covalently to the kidney stones and a magnetic extraction of calcium oxalate fractals with magnetic nanoparticles is possible. The aggregation of nanoscale iron oxide nanoparticles can be induced with the addition of salt which improves the extraction process. The separation is validated by simulation and experimentally in a porcine kidney as well as in artificial kidney models. This proof-of-concept study successfullyis the fundament for a new waydemonstrated of extracting kidney stones extraction and including their fractals and might pave the way for new procedures in urology. [ABSTRACT FROM AUTHOR]

The role of eosinophils in airway inflammation and asthma pathogenesis is well established, with raised eosinophil counts in blood and sputum associated with increased disease severity and risk of asthma exacerbation. Conversely, there is also preliminary evidence suggesting antiviral properties of eosinophils in the airways. These dual roles for eosinophils are particularly pertinent as respiratory virus infections contribute to asthma exacerbations. Biologic therapies targeting key molecules implicated in eosinophil‐associated pathologies have been approved in patients with severe asthma and, therefore, the effects of depleting eosinophils in a clinical setting are of considerable interest. This review discusses the pathological and antiviral roles of eosinophils in asthma and exacerbations. We also highlight the significant reduction in asthma exacerbations seen with biologic therapies, even at the height of the respiratory virus season. Furthermore, we discuss the implications of these findings in relation to the role of eosinophils in inflammation and antiviral responses to respiratory virus infection in asthma. [ABSTRACT FROM AUTHOR]

Tin‐based halide perovskite solar cells can be efficient and environmentally friendly substitutions to lead‐based halide perovskite solar cells, but they have a drawback due to oxidation from Sn2+ to Sn4+. Using vacuum deposition, epitaxially aligned CsSnBr3 ultrathin films are prepared on Au(111) and Au(100) and characterized with scanning tunneling microscopy (STM), low‐energy electron diffraction (LEED), and X‐ray photoelectron spectroscopy (XPS). By co‐evaporation of the precursor molecules CsBr and SnBr2, few monolayers of perovskite are obtained. On Au(111), CsSnBr3 grows in three differently oriented domains due to the hexagonal symmetry of the substrate. On Au(100), which has square symmetry, identical to CsSnBr3, but with about half the lattice constant of the perovskite, a (2×2) superstructure is observed. The perovskite is terminated with the (001) facet showing a square surface structure in agreement with density functional theory (DFT) calculations. Chemical analysis is performed in ultra‐high vacuum (UHV) conditions and no indication of a tin oxidation state higher than Sn2+ is found in the films. However, after exposure to air, rapid and severe changes in the films are observed, highlighting the importance of preparing tin perovskites in a controlled environment to maintain their stability and avoid oxidation‐related issues. [ABSTRACT FROM AUTHOR]

Chronic heart failure (CHF) is one of the most common diseases with a prevalence of 1–2% in adults, disproportionately affecting the elderly. Despite consistent drug therapy, physical activity (PA) is an integral part of current guidelines. Yet adherence to regular PA and exercise interventions is poor and potential predictors and barriers to PA remain elusive. We examined the effects of a telemonitoring-based exercise intervention in 699 CHF patients in a prospective, randomized-controlled (1:1), multicenter trial. The study was registered in the German Clinical Trials Register under DRKS00019022 on 28.05.2020. For both, the exercise and control group, self-reported PA (MET*h/week) increased and sedentary behavior declined during the 12-month intervention period. In the exercise group, daily step count as analyzed via activity trackers remained stable (pre: 6459 [4016] steps/day, post: 6532 [3858] steps/day; p = 0.621). The average number of completed exercise instruction videos provided via an online application was 1.50 [1.44] videos/week at the beginning and gradually decreased to 1.00 [1.50] videos/week; p < 0.001). Multivariate regression model revealed that exercise-related PA (MET*h/week) and exercise capacity (Wmax) at baseline, CHF severity, atrial fibrillation and age predicted changes in self-reported exercise-related PA (R2 = 0.396). Furthermore, the BMI and the average number of completed videos per week at baseline were associated with the change in completed videos over the course of the study (R2 = 0.251). Our results show the influence of certain baseline characteristics as barriers and predictors of PA progression. Therefore, exercise programs should pay attention to patients' individual conditions to set achievable goals, and eventually affect the adherence and sustainability of exercise-focused interventions. [ABSTRACT FROM AUTHOR]

Novel fluorinated, pyrrolidinium‐based dicationic ionic liquids (FDILs) as high‐performance electrolytes in energy storage devices have been prepared, displaying unprecedented electrochemical stabilities (up to 7 V); thermal stability (up to 370 °C) and ion transport (up to 1.45 mS cm−1). FDILs were designed with a fluorinated ether linker and paired with TFSI/FSI counterions. To comprehensively assess the impact of the fluorinated spacer on their electrochemical, thermal, and physico‐chemical properties, a comparison with their non‐fluorinated counterparts was conducted. With a specific focus on their application as electrolytes in next‐generation high‐voltage lithium‐ion batteries, the impact of the Li‐salt on the characteristics of dicationic ILs was systematically evaluated. The incorporation of a fluorinated linker demonstrates significantly superior properties compared to their non‐fluorinated counterparts, presenting a promising alternative towards next‐generation high‐voltage energy storage systems. [ABSTRACT FROM AUTHOR]

The influence of symmetry-breaking effects of ridge-type roughness on secondary currents in turbulent channel flow is investigated using direct numerical simulations. The ridges have triangular cross-section, which is systematically varied from isosceles to right-angled triangle, introducing an imbalance to the slopes of the ridges' lateral surfaces while the streamwise homogeneity of the surfaces is maintained. In all cases, secondary current vortices are produced, but asymmetric ridge cross-sections break the symmetry of these vortices. As a result of the asymmetry-induced misalignment and imbalance in the secondary current vortices, net spanwise flow emerges. The magnitude of the spanwise flow increases with the slope ratio of the ridge lateral surfaces and significantly modifies the mean flow topology, leading to the merging of critical points in the case of the right-angled triangular ridge shape. Within the cavities, the net spanwise flow is accompanied by a non-zero mean spanwise pressure gradient, while from the perspective of the outer flow, the scalene ridge surfaces have a similar effect as a wall that is slowly moving in the spanwise direction. Overall, the present results suggest the existence of a special type of Prandtl's secondary currents of the second kind, namely those that result in net spanwise flow. [ABSTRACT FROM AUTHOR]

Controlling many-body interactions in two-dimensional systems remains a formidable task from the perspective of both fundamental physics and application. Here, we explore remarkable electronic structure alterations of MoS2 monolayer islands on graphene on Ir(111) induced by non-invasive self-intercalation. This introduces significant differences in morphology and strain of MoS2 as a result of the modified interaction with the substrate. Consequently, considerable changes of the band gap and non-rigid electronic shifts of valleys are detected, which are a combined effect of the screening of the many-body interactions and strain in MoS2. Furthermore, theory shows that each substrate leaves a unique stamp on the electronic structure of two-dimensional material in terms of those two parameters, restricted by their correlation. [ABSTRACT FROM AUTHOR]

Background: In recent studies, receipt of chiropractic care has been associated with lower odds of receiving prescription opioids and, among those already prescribed, reduced doses of opioids among patients with non-cancer spine pain. These findings suggest that access to chiropractic services may reduce reliance on opioids for musculoskeletal pain. Objective: To assess the impact of chiropractic care on initiation, or continued use, of prescription opioids among patients with non-cancer spine pain. Methods: We will search for eligible randomized controlled trials (RCTs) and observational studies indexed in MEDLINE, Embase, AMED, CINAHL, Web of Science, and the Index to Chiropractic Literature from database inception to June 2024. Article screening, data extraction, and risk-of-bias assessment will be conducted independently by pairs of reviewers. We will conduct separate analyses for RCTs and observational studies and pool binary outcomes (e.g. prescribed opioid receipt, long-term opioid use, and higher versus lower opioid dose) as odds ratios (ORs) with associated 95% confidence intervals (CIs). When studies provide hazard ratios (HRs) or relative risks (RRs) for time-to-event data (e.g. time-to-first opioid prescription) or incidence rates (number of opioid prescriptions over time), we will first convert them to an OR before pooling. Continuous outcomes such as pain intensity, sleep quality, or morphine equivalent dose will be pooled as weighted mean differences with associated 95% CIs. We will conduct meta-analyses using random-effects models and explore sources of heterogeneity using subgroup analyses and meta-regression. We will evaluate the certainty of evidence of all outcomes using the GRADE approach and the credibility of all subgroup effects with ICEMAN criteria. Our systematic review will follow the PRISMA statement and MOOSE guidelines. Discussion: Our review will establish the current evidence informing the impact of chiropractic care on new or continued prescription opioid use for non-cancer spine pain. We will disseminate our results through peer-reviewed publication and conference presentations. The findings of our review will be of interest to patients, health care providers, and policy-makers. Trial registration: Systematic review registration: PROSPERO CRD42023432277. [ABSTRACT FROM AUTHOR]

Training helps to maintain and improve sufficient muscle function, body control, and body coordination. These are important to reduce the risk of fracture incidents caused by falls, especially for the elderly or people recovering from injury. Virtual reality training can offer a cost-effective and individualized training experience. We present an application for the HoloLens 2 to enable musculoskeletal training for elderly and impaired persons to allow for autonomous training and automatic progress evaluation. We designed a virtual downhill skiing scenario that is controlled by body movement to stimulate balance and body control. By adapting the parameters of the ski slope, we can tailor the intensity of the training to individual users. In this work, we evaluate whether the movement data of the HoloLens 2 alone is sufficient to control and predict body movement and joint angles during musculoskeletal training.We record the movements of 10 healthy volunteers with external tracking cameras and track a set of body and joint angles of the participant during training. We estimate correlation coefficients and systematically analyze whether whole body movement can be derived from the movement data of the HoloLens 2. No participant reports movement sickness effects and all were able to quickly interact and control their movement during skiing. Our results show a high correlation between HoloLens 2 movement data and the external tracking of the upper body movement and joint angles of the lower limbs. [ABSTRACT FROM AUTHOR]

Copyright of Innere Medizin (2731-7080) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Innere Medizin (2731-7080) is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Aim: To compare the effectiveness of strength versus endurance training on reducing visceral fat in individuals with obesity. Materials and Methods: For the STrength versus ENdurance (STEN) 24‐month randomized clinical trial, we assigned 239 participants with abdominal obesity to either strength or endurance training (two to three times a week, 60 min/training session) in addition to standard nutritional counselling to promote a healthy diet. Changes in abdominal visceral adipose tissue (VAT) area quantified by magnetic resonance imaging after 12 months were defined as a primary endpoint. Results: Participants (aged 44 years, 74% women, body mass index: 37 kg/m2, mean VAT volume: 4050 cm3) had an approximately 50% retention rate and a 30% good training programme adherence at 12 months. There was no difference between strength and endurance training in VAT volume dynamics after 12 and 24 months (p =.13). Only in the good adherence group did we find a trend for reduced VAT volume in both training regimens. Independently of the exercise programme, there was a continuous trend for moderate loss of abdominal subcutaneous AT volume, body fat mass, body mass index and improved parameters of insulin sensitivity. Although parameters of physical fitness improved upon both exercise interventions, the dynamics of resting energy expenditure, glucose and lipid metabolism parameters were not different between the intervention groups and did not significantly improve during the 2‐year trial (p >.05). Conclusions: Despite heterogeneous individual training responses, strength and endurance training neither affected VAT volume nor key secondary endpoints differently. [ABSTRACT FROM AUTHOR]

Background: The Peruvian population does not meet the recommended guidelines for daily consumption of fruits and vegetables and, thus, social marketing approaches are needed in order to improve this behavior. Focus of the Article: The focus of this study was on changing intentions to engage in a recommended health behavior by experimentally testing one component of a social marketing strategy, namely the effect of messages to motivate mothers to increase the fruit consumption of their children. Research Question: What type of messages, either those communicating the advantages of engaging in the recommended behavior or those communicating the norms about the behavior, are better at increasing mothers' intentions to give 3 daily fruits to their children? Importance to the Social Marketing Field: This study identifies methodological steps that can guide future social marketing approaches to test the effect of messages in the area of behavior change. Methods: A total of 285 mothers completed an online survey with an experiment built in. Mothers were randomly assigned to one of three conditions: a gain-framed messages condition, a normative messages condition and a no message condition (control condition) and then answered questions about the dependent variables. Results: Results showed that exposure to messages communicating information about the advantages of engaging in the behavior increased mothers' attitudes and intentions to give 3 daily fruits to their children; however, messages communicating information about descriptive norms did not increase mothers' perceived norms or intentions. Recommendations for Research or Practice: Social marketing approaches that address low levels of fruit consumption among children can benefit from message strategies that target mothers and that focus on communicating the advantages of giving more fruits to their children. [ABSTRACT FROM AUTHOR]

Multiple sclerosis (MS) is associated with alterations in neuroendocrine function, primarily the hypothalamic–pituitary–adrenal axis, including lower expression of the glucocorticoid receptor (GR) and its target genes in peripheral blood mononuclear cells (PBMC) or full blood. We previously found reduced mineralocorticoid receptor (MR) expression in MS patients' peripheral blood. MS is being treated with a widening variety of disease-modifying treatments (DMT), some of which have similar efficacy but different mechanisms of action; body-fluid biomarkers to support the choice of the optimal initial DMT and/or to indicate an unsatisfactory response before clinical activity are unavailable. Using cell culture of volunteers' PBMCs and subsequent gene expression analysis (microarray and qPCR validation), we identified the mRNA expression of OTUD1 to represent MR signaling. The MR and MR target gene expression levels were then measured in full blood samples. In 119 MS (or CIS) patients, the expression of both MR and OTUD1 was lower than in 42 controls. The expression pattern was related to treatment, with the MR expression being particularly low in patients treated with fingolimod. While MR signaling may be involved in the therapeutic effects of some disease-modifying treatments, MR and OTUD1 expression can complement the neuroendocrine assessment of MS disease course. If confirmed, such assessment may support clinical decision-making. [ABSTRACT FROM AUTHOR]

Background: Acute abdominal pain (AAP) is a major driver for capacity-use in emergency departments (EDs) worldwide. Yet, the health care utilization of patients with AAP before and after the ED remains unclear. The primary objective of this study was to describe adult patients presenting to the ED with AAP and their outpatient care (OC) use before and after the ED. Secondary objectives included description of hospitalization rates, in-hospital mortality, ED re-visits, and exploration of potential risk factors for hospitalization and ED re-visits. Methods: For the analysis, we combined routine hospital data from patients who visited 15 EDs in Germany in 2016 with their statutory health insurance OC claims data from 2014 to 2017. Adult patients were included based on a chief complaint or an ED diagnosis indicating unspecific AAP or the Manchester Triage System indicator "Abdominal pain in adults". Baseline characteristics, ED diagnosis, frequency and reason of hospitalization, frequency and type of prior-OC (prOC) use up to 3 days before and of post-OC use up to 30 days after the ED visit. Main results: We identified 28,085 adults aged ≥ 20 years with AAP. 39.8% were hospitalized, 33.9% sought prOC before the ED visit (48.6% of them were hospitalized) and 62.7% sought post-OC up to 30 days after the ED visit. Hospitalization was significantly more likely for elderly patients (aged 65 and above vs. younger; adjusted OR 3.05 [95% CI 2.87; 3.25]), prOC users (1.71 [1.61; 1.90]) and men (1.44 [1.37; 1.52]). In-hospital mortality rate was 3.1% overall. Re-visiting the ED within 30 days was more likely for elderly patients (1.32 [1.13; 1.55) and less likely for those with prOC use (0.37 [0.31; 0.44]). Conclusions: prOC use was associated with more frequent hospitalizations but fewer ED re-visits. ED visits by prOC patients without subsequent hospitalization may indicate difficulties of OC resources to meet the complex diagnostic requirements and expectations of this patient population. Fewer ED re-visits in prOC users indicate effective care in this subgroup. [ABSTRACT FROM AUTHOR]

Background: Despite comparatively low rates of COVID-19 admissions and recorded deaths in sub-Saharan Africa (SSA), the pandemic still had significant impact on health service utilization (HSU). The aim of this scoping review is to synthesize the available evidence of HSU in SSA during the pandemic, focusing on types of studies, changes in HSU compared with the pre-pandemic period, and changes among specific patient groups. Methods: The scoping review was guided by the methodological framework for conducting scoping reviews developed by Arksey and O'Malley. We identified relevant studies through a search of PubMed (MEDLINE), Embase, Scopus, and Web of Science. We then provided a general descriptive overview of the extracted data focusing on the types of studies, patient groups, and change in HSU. Results: We identified 262 studies reporting on HSU in 39 SSA countries. Studies were mainly quantitative (192; 73.3%), involving multiple centers (163; 62.2%), conducted in hospitals (205; 78.2%), and in urban settings (121; 46.2%). The median number of participants was 836.5 (IQR: 101.5–5897) involving 62.5% females. Most studies (92; 35.1%) focused on communicable diseases and mainly among outpatients (90; 34.2%). Maternal and child health studies formed the largest patient group (58; 22.1%) followed by people living with HIV (32; 12.2%). Change in HSU was reported in 249 (95.0%) studies with 221 (84.4%) studies reporting a decrease in HSU. The median decrease in HSU was 35.6% (IQR: 19.0–55.8) and median increase was 16.2% (IQR: 9.1–31.9). The patient group with the largest percentage decrease was cardiovascular diseases (68.0%; IQR: 16.7–71.1) and the lowest percentage decrease was in patients with infections (27.0%; IQR: 16.6–45.6). Conclusions: A large body of literature is available on the effects of the pandemic on HSU in SSA. Most studies report decreases in HSU during the pandemic. However, patterns differ widely across disease categories, patient groups, and during different time periods of the pandemic. [ABSTRACT FROM AUTHOR]

Background: Despite comparatively low rates of COVID-19 admissions and recorded deaths in sub-Saharan Africa (SSA), the pandemic still had significant impact on health service utilization (HSU). The aim of this scoping review is to synthesize the available evidence of HSU in SSA during the pandemic, focusing on types of studies, changes in HSU compared with the pre-pandemic period, and changes among specific patient groups. Methods: The scoping review was guided by the methodological framework for conducting scoping reviews developed by Arksey and O'Malley. We identified relevant studies through a search of PubMed (MEDLINE), Embase, Scopus, and Web of Science. We then provided a general descriptive overview of the extracted data focusing on the types of studies, patient groups, and change in HSU. Results: We identified 262 studies reporting on HSU in 39 SSA countries. Studies were mainly quantitative (192; 73.3%), involving multiple centers (163; 62.2%), conducted in hospitals (205; 78.2%), and in urban settings (121; 46.2%). The median number of participants was 836.5 (IQR: 101.5–5897) involving 62.5% females. Most studies (92; 35.1%) focused on communicable diseases and mainly among outpatients (90; 34.2%). Maternal and child health studies formed the largest patient group (58; 22.1%) followed by people living with HIV (32; 12.2%). Change in HSU was reported in 249 (95.0%) studies with 221 (84.4%) studies reporting a decrease in HSU. The median decrease in HSU was 35.6% (IQR: 19.0–55.8) and median increase was 16.2% (IQR: 9.1–31.9). The patient group with the largest percentage decrease was cardiovascular diseases (68.0%; IQR: 16.7–71.1) and the lowest percentage decrease was in patients with infections (27.0%; IQR: 16.6–45.6). Conclusions: A large body of literature is available on the effects of the pandemic on HSU in SSA. Most studies report decreases in HSU during the pandemic. However, patterns differ widely across disease categories, patient groups, and during different time periods of the pandemic. [ABSTRACT FROM AUTHOR]

Objective The aim of this work was the development of an augmented reality system including the functionality of conventional surgical navigation systems. Methods An application software for the Augmented Reality System HoloLens 2 from Microsoft was developed. It detects the position of the patient as well as position of surgical instruments in real time and displays it within the two-dimensional (2D) magnetic resonance imaging or computed tomography (CT) images. The surgical pointer instrument, including a pattern that is recognized by the HoloLens 2 sensors, was created with three-dimensional (3D) printing. The technical concept was demonstrated at a cadaver skull to identify anatomical landmarks. Results With the help of the HoloLens 2 and its sensors, the real-time position of the surgical pointer instrument could be shown. The position of the 3D-printed pointer with colored pattern could be recognized within 2D-CT images when stationary and in motion at a cadaver skull. Feasibility could be demonstrated for the clinical application of transsphenoidal pituitary surgery. Conclusion The HoloLens 2 has a high potential for use as a surgical navigation system. With subsequent studies, a further accuracy evaluation will be performed receiving valid data for comparison with conventional surgical navigation systems. In addition to transsphenoidal pituitary surgery, it could be also applied for other surgical disciplines. [ABSTRACT FROM AUTHOR]

Purpose of Review: Quantification of the morphology of osteocyte lacunae has become a powerful tool to investigate bone metabolism, pathologies and aging. This review will provide a brief overview of 2D and 3D imaging methods for the determination of lacunar shape, orientation, density, and volume. Deviations between 2D-based and 3D-based lacunar volume estimations are often not sufficiently addressed and may give rise to contradictory findings. Thus, the systematic error arising from 2D-based estimations of lacunar volume will be discussed, and an alternative calculation proposed. Further, standardized morphological parameters and best practices for sampling and segmentation are suggested. Recent Findings: We quantified the errors in reported estimation methods of lacunar volume based on 2D cross-sections, which increase with variations in lacunar orientation and histological cutting plane. The estimations of lacunar volume based on common practice in 2D imaging methods resulted in an underestimation of lacunar volume of up to 85% compared to actual lacunar volume in an artificial dataset. For a representative estimation of lacunar size and morphology based on 2D images, at least 400 lacunae should be assessed per sample. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the effectiveness of subcutaneous (SC) and sublingual (SL) formulations of apomorphine for the treatment of motor fluctuations in Parkinson's disease using a pharmacokinetics (PK)/pharmacodynamics (PD) modeling approach. The PK of SC and SL apomorphine are best described by a one-compartment model with first-order absorption and a two-compartment model with delayed absorption, respectively. The PK/PD model relating apomorphine plasma concentrations to the Unified Parkinson's Disease Rating Scale (UPDRS) motor scores was described by a sigmoidal Emax model assuming effective concentration = drug concentration in an effect compartment. Apomorphine concentrations and UPDRS motor scores were simulated from the PK/PD models using 500 hypothetical subjects. UPDRS motor score change from baseline was evaluated using time to clinically relevant response, response duration, area under the curve, maximal response, and time to maximal response. Higher doses of each apomorphine formulation were associated with shorter time to response, longer response duration, and greater maximal response. Although the mean maximal responses to SC and SL apomorphine were comparable, the time to response was four times shorter (7 vs. 31 min) and time to maximal response was two times shorter (27 vs. 61 min) for 4 mg SC vs. 50 mg SL. Thus, faster onset of action was observed for the SC formulation compared to SL. These data may be useful for physicians when selecting "on demand" therapy for patients with Parkinson's disease experiencing motor fluctuations. [ABSTRACT FROM AUTHOR]

Background: Delirium is a neuropathological syndrome that is characterised by fluctuating impairments in attention, cognitive performance, and consciousness. Since delirium represents a medical emergency, it can be associated with adverse clinical and economic outcomes. Although nursing home residents face a high risk of developing delirium, health care professionals in this field appear to have limited knowledge of delirium despite the critical role they play in the prevention, diagnosis, and treatment of delirium in nursing homes. Objective: The purpose of this realist review is to develop an initial programme theory with the goal of understanding how, why, and under what circumstances educational interventions can improve the delirium-specific knowledge of health care professionals in nursing homes. Methods: This realist review was conducted in accordance with the RAMESES (Realist And Meta-narrative Evidence Synthesis: and Evolving Standards) guidelines and includes the following steps: (1) search strategy and literature review; (2) study selection and assessment; (3) data extraction; (4) data synthesis; and (5) development of an initial programme theory. It also included stakeholder discussions with health care professionals recruited from nursing home care, which focused on their experiences with delirium. Results: From a set of 1703 initially identified publications, ten publications were included in this realist review. Based on these publications, context-mechanism-outcome configurations were developed; these configurations pertained to (1) management support, (2) cognitive impairments among residents, (3) familiarity with residents, (4) participatory intervention development, (5) practical application, (6) case scenarios, (7) support from experts and (8) relevance of communication. Conclusions: Educational interventions aimed at improving the delirium-specific knowledge of health care professionals should feature methodological diversity if they are to enhance health care professionals' interest in delirium and highlight the fundamental contributions they make to the prevention, diagnosis, and treatment of delirium. Educational interventions should also take into account the multidimensional contextual factors that can have massive impacts on the relevant mode of action as well as the responses of health care professionals in nursing homes. The identification of delirium in residents is a fundamental responsibility for nursing home staff. Trial registration: This review has been registered at Open Science Framework https://doi.org/10.17605/OSF.IO/6ZKM3 [ABSTRACT FROM AUTHOR]

The commercial recycling of spent FCC catalyst typically focuses on recovering only 1–3 % of rare‐earth elements, with the remaining residues often disposed of in landfills. Here, we present a novel method to close a recycling loop for spent FCC catalyst. The method involves a series of leaching steps: Firstly, the spent catalyst material is leached with HNO3 to remove rare‐earth elements such as La; second, solvothermal leaching with HCl removes most of Al and impurities like Fe, Ni and V; finally, a third leaching with H2SO4 removes Ti. The solid residues are then used to synthesize ZSM‐5 without the addition of any extra silicon or aluminum sources after mild activation. The impurities in the synthesis gel strongly modify the properties of the zeolite, with ZSM‐5 crystals containing higher levels of impurities exhibiting lower crystallinities, surface areas, acidities, cracking activities, as well as larger particle sizes. [ABSTRACT FROM AUTHOR]

Background: Health System Performance Assessments (HSPA) and analyses of unwarranted regional variation in health care both aim at identifying strengths and weaknesses of health systems to improve care. Applying HSPA's conceptual approach of interrelated health system dimensions (e.g., access, quality) to regional levels might help to better understand variation in care to reduce inequity and improve performance. Methods: We use four indicators identified and analysed in a pilot study for a German HSPA to assess variation in access to and quality of acute stroke care between Germany's 16 federal states and urban vs. rural regions from 2014 to 2020. Stroke unit (SU) density, share of the population reaching a SU within 30 min by car, share of inpatient stroke cases treated in a hospital with a SU, and inpatient mortality were computed based on hospital quality reports and discharge data covering all acute care hospitals. Inpatient mortality was adjusted for age, sex, stroke type, and comorbidities. Results: About 500 SU were identified, i.e., 2.0 per 1,000 inpatient stroke cases. Almost 95% of Germans could reach a SU hospital within 30 min (rural: 90%; urban: 99%; > 88% in all states but one). The share of inpatient stroke cases treated in a SU hospital increased to 93% with a decreasing span between rural (92%) and urban (95%) regions and between states (74–98%). Inpatient mortality stagnated around 8.5% and increased to 9.0% in 2020 (rural: 8.7%; urban: 9.2%; states: 7.0–9.7%, one outlier of 13.3%). Conclusions: The results especially revealed varying performance patterns in access to and quality of acute stroke care between the federal states, indicating different areas for improvement which might be addressed by more targeted policy measures in the future. [ABSTRACT FROM AUTHOR]

Background: Clinical guidelines recommend that people with Huntington's disease (HD) should exercise to maintain/improve fitness and motor function, yet physical activity levels remain low in this group. Promotion of physical activity is often via care partners with little evidence that they are supported in this role. Objective: The aim was to co-design a resource for care partners of people with HD to support promotion of physical activity. Methods: A four-step co-design approach was used to develop a care partner resource. Five care partners took part in an online workshop exploring experiences and the knowledge, support and skills needed by care partners to promote physical activity. A co-design team (n = 7) developed a prototype that was user tested by three people who had attended the workshop. Findings from user testing were used to develop the final resource. Results: An easy to read, image-based prototype was developed that contained tips on planning activity, safety and activity examples. User testing identified the need for grouping of activities suitable for 10, 20, and 30 minutes of available time, information on maintaining and improving activity and re-organization of information to support engagement of activity. Conclusions: A resource for care partners that has been translated into seven languages was developed to promote physical activity. User testing indicated confidence in using the resource and appreciation of the autonomy provided to the person with HD to plan activities. Further work is needed to evaluate the impact of the resource in promotion of physical activity and the impact on care partner burden. [ABSTRACT FROM AUTHOR]

Training studies typically investigate the cumulative rather than the analytically challenging immediate effect of exercise on cognitive outcomes. We investigated the dynamic interplay between single‐session exercise intensity and time‐locked recognition speed‐accuracy scores in older adults with Alzheimer's dementia (N = 17) undergoing a 24‐week dual‐task regime. We specified a state‐of‐the‐art hierarchical Bayesian continuous‐time dynamic model with fully connected state variables to analyze the bi‐directional effects between physical and recognition scores over time. Higher physical performance was dynamically linked to improved recognition (−1.335, SD = 0.201, 95% Bayesian credible interval [BCI] [−1.725, −0.954]). The effect was short‐term, lasting up to 5 days (−0.368, SD = 0.05, 95% BCI [−0.479, −0.266]). Clinical scores supported the validity of the model and observed temporal dynamics. Higher physical performance predicted improved recognition speed accuracy in a day‐by‐day manner, providing a proof‐of‐concept for the feasibility of linking exercise training and recognition in patients with Alzheimer's dementia. Highlights: Hierarchical Bayesian continuous‐time dynamic modeling approachA total of 72 repeated physical exercise (PP) and integrated recognition speed‐accuracy (IRSA) measurementsPP is dynamically linked to session‐to‐session variability of IRSAHigher PP improved IRSA in subsequent sessions in subjects with Alzheimer's dementiaShort‐term effect: lasting up to 4 days after training session [ABSTRACT FROM AUTHOR]

X‐rays can penetrate deeply into biological cells and thus allow for examination of their internal structures with high spatial resolution. In this study, X‐ray phase‐contrast imaging and tomography is combined with an X‐ray‐compatible optical stretcher and microfluidic sample delivery. Using this setup, individual cells can be kept in suspension while they are examined with the X‐ray beam at a synchrotron. From the recorded holograms, 2D phase shift images that are proportional to the projected local electron density of the investigated cell can be calculated. From the tomographic reconstruction of multiple such projections the 3D electron density can be obtained. The cells can thus be studied in a hydrated or even living state, thus avoiding artifacts from freezing, drying or embedding, and can in principle also be subjected to different sample environments or mechanical strains. This combination of techniques is applied to living as well as fixed and stained NIH3T3 mouse fibroblasts and the effect of the beam energy on the phase shifts is investigated. Furthermore, a 3D algebraic reconstruction scheme and a dedicated mathematical description is used to follow the motion of the trapped cells in the optical stretcher for multiple rotations. [ABSTRACT FROM AUTHOR]

Background Mental health problems, particularly anxiety and depression, are common in patients with chronic kidney disease (CKD) and negatively impact quality of life, treatment adherence and mortality. However, the degree to which mental health and addiction services are utilized by those with CKD is unknown. We examined the history of mental health and addiction service use of individuals across levels of kidney function. Methods We performed a population-based cross-sectional study using linked healthcare databases from Ontario, Canada from 2009 to 2017. We abstracted the prevalence of individuals with mental health and addiction service use within the previous 3 years across levels of kidney function [estimated glomerular filtration rate (eGFR) ≥60, 45 to <60, 30 to <45, 15 to <30, <15 ml/min/1.73 m2 and maintenance dialysis]. We calculated prevalence ratios (PRs) to compare prevalence across kidney function strata, while adjusting for age, sex, year of cohort entry, urban versus rural location, area-level marginalization and Charlson comorbidity index. Results Of 5 956 589 adults, 9% (n  = 534 605) had an eGFR <60 ml/min/1.73 m2 or were receiving maintenance dialysis. Fewer individuals with an eGFR <60 ml/min/1.73 m2 had a history of any mental health and addiction service utilization (crude prevalence range 28–31%) compared with individuals with an eGFR ≥60 ml/min/1.73 m2 (35%). Compared with an eGFR ≥60 ml/min/1.73 m2, the lowest prevalence of individuals with any mental health and addiction service utilization was among those with an eGFR of 15 to <30 ml/min/1.73 m2 {adjusted PR 0.86 [95% confidence interval (CI) 0.85 to 0.88]}, an eGFR <15 ml/min/1.73 m2 [adjusted PR 0.81 (95% CI 0.76–0.86)] and those receiving maintenance dialysis [adjusted PR 0.83 (95% CI 0.81–0.84)]. Less use of outpatient services accounted for differences in service utilization. Conclusions Mental health and addiction service utilization is common but less so in individuals with advanced CKD in Ontario, Canada. [ABSTRACT FROM AUTHOR]

Although calls for responding to migration-related diversity in education are not novel, few studies have examined linguistic and affective outcomes of diversity-sensitive approaches for vocabulary teaching. This article reports on an intervention study in which beginner English-foreign-language learners (N = 51, Mage = 8.67 years) worked on one textbook unit (five 45-min lessons). Teachers supplemented the unit with translingual scaffolds and encouraged students to draw on and use their linguistic resources (plurilingual group), or stimulated appreciation of plurilingualism and positive language attitudes (motivation group). We assessed language gains through pre-, post-, and follow-up tests, and measured affect after each lesson. Both intervention groups outperformed the control group, which worked only with the textbooks, regarding productive vocabulary learning. Translingual scaffolding was beneficial for sustaining vocabulary gains. The data further indicate that motivational activities stimulate positive affect, but only the plurilingual group showed lower negative affect than the control group. Overall, the data suggest that intervention activities can augment productive vocabulary and support student well-being. We argue that future studies should pay more attention to affective outcomes when exploring ways of addressing migration-related diversity in the classroom. [ABSTRACT FROM AUTHOR]

People with rare neurological conditions (RNCs) struggle to achieve regular physical activity (PA). This study explored experiences of people with RNC engaging in PA, their carers, and health care professionals (HCPs) working with them. We developed three surveys: for individuals living with RNCs, their carers, and HCPs working with them. Themes from interviews with RNC charity representatives were used to co-design questions, together with people living with RNCs, their representatives, and an expert panel. Surveys were disseminated via charity mailing lists, social media accounts, and professional networks (HCPs). We received 436 responses (225 people with RNC, 94 carers, 117 HCPs). Most respondents with RNC achieved some level of regular PA but needed motivation to maintain it. Many felt they lacked knowledge on starting and staying active, with scarce resources and support. Most HCP respondents worked in specialist services, and overwhelmingly agreed that people with RNC should be physically active, while acknowledging lack of evidence and resources. We identified key barriers at environmental/organisational, interpersonal, and intrapersonal levels, highlighting a critical lack of support for people with RNC across UK health services. These factors can be targeted to increase engagement in PA. People living with rare neurological conditions experience barriers to engaging in physical activity, with some common to more prevalent neurological diseases, e.g. access and facilities, but some notable differences due to the rarity of the condition For people living with rare neurological conditions, and their carers, there is a lack of knowledge on safe and appropriate engagement in physical activity Increasing the knowledge of health and exercise professionals may improve how they support people with rare neurological disease to engage with physical activity. Evidence based resources and recommendations for people living with rare neurological conditions, and professionals working with them, may facilitate engagement in physical activity [ABSTRACT FROM AUTHOR]

The aim was to investigate the vector‐cardiographic effects in patients submitted to dental extraction under local anesthesia. Twenty‐one patients aged 36.6 ± 12.4 years with a clinical and radiographic indication of mandibular or maxillary tooth extraction were enrolled. The intervention was a local or mandibular nerve block anesthesia with 4% articaine hydrochloride containing epinephrine (1 : 100,000; 40 mg/ml + 10 μg/ml). Blood pressure (BP), heart rate (HR), pulse wave transit time, and vector‐cardiography data were recorded throughout 3 min before and 5 min after injection. QRS‐ and T‐wave area under the curve (QRSAUC/TAUC) were calculated from the X/Y/Z QRS‐vector or T‐vector. T‐wave amplitude (TAM), TAUC values, and diastolic BP decreased, and HR significantly increased 4 min after injection. A transient moderate HR drop and a corresponding small increase in TAM and TAUC immediately after the injection procedure may be explained by a decreased sympathetic tone due to psychological relief. In dental anesthesia, the systemic epinephrine effects are represented by a decrease in TAUC. These effects are most pronounced in the X‐ and Y‐leads. The 3D determination of vector planes or amplitudes is a simple method to register the sympathetic tone in local anesthesia independently of possible effects on T‐wave characteristics in single leads. In conclusion, T‐wave determination may help to detect even small increases in systemic adrenaline concentration in case of accidental intravascular injection. At the same time, full rhythm and spatial ischemia control is provided. [ABSTRACT FROM AUTHOR]

Background: Aneurysmal subarachnoid hemorrhage (aSAH) is frequently complicated by delayed cerebral ischemia (DCI), leading to poor outcomes. Early diagnosis of DCI is crucial for improving survival and outcomes but remains challenging in comatose patients. In this study, we aimed to evaluate computed tomography with angiography and perfusion (P-CT) as a screening modality on postictal days four and eight for impending DCI after aSAH in comatose patients using vasospasm with hypoperfusion (hVS) as a surrogate and DCI-related infarction as an outcome measure. Two objectives were set: (1) to evaluate the screening's ability to accurately risk stratify patients and (2) to assess the validity of P-CT screening. Methods: We conducted a retrospective review of the records of comatose patients with aSAH from January 2019 to December 2021 who were monitored with P-CT scans on days four and eight. The event rates of DCI-related infarction, hVS, and endovascular rescue therapy (ERT) were analyzed, and the sensitivity, specificity, negative predictive value (NPV), and positive predictive value (PPV) for DCI were calculated. DCI-related infarction was defined as new secondary cerebral infarction > 48 h < 6 weeks post aSAH not attributable to other causes, and hVS was defined as arterial narrowing with corresponding hypoperfusion on P-CT. Results: Fifty-six comatose patients were included, and 98 P-CT scans were performed. The incidence of DCI-related infarction was 40%. Screening P-CT on days four and eight found vasospasm in 23% of all patients, including 11% with hVS. A positive hVS on day four or eight revealed a relative risk of 2.4 [95% confidence interval (CI) 1.13–5.11, p = 0.03], sensitivity of 23% (95% CI 8–45, p = 0.03), specificity of 95% (95% CI 36–100, p = 0.03), PPV of 0.83 (95% CI 0.36–1.00, p = 0.03), and NPV of 0.65 (95% CI 0.50–0.78). Six positive P-CT scans led to digital subtraction angiography in five patients, three of whom received ERT. All ERT-intervened patients developed DCI-related infarction. Conclusions: P-CT resulted in few interventions and often resulted in late detection of DCI at an irreversible stage. Although a positive P-CT result accurately predicts impending DCI-related infarction, screening on days four and eight alone in comatose patients with aSAH often fails to timely detect impending DCI. Based on our analysis, we cannot recommend P-CT as a screening modality. P-CT is likely best used as a confirmatory test prior to invasive interventions when guided by continuous multimodal monitoring; however, prospective studies with comparison groups are warranted. The need for a reliable continuous screening modality is evident because of the high rate of deterioration and narrow treatment window. [ABSTRACT FROM AUTHOR]

In recent years there has been a renewed interest in benchtop NMR. Given their lower cost of ownership, smaller footprint, and ease of use, they are especially suited as an educational tool. Here, a new experiment targeted at upper‐year undergraduates and first‐year graduate students follows the conversion of D‐glucose into ethanol at low‐field. First, high and low‐field data on D‐glucose are compared and students learn both the Hz and ppm scales and how J‐coupling is field‐independent. The students then acquire their own quantitative NMR datasets and perform the quantification using an Electronic Reference To Access In Vivo Concentration (ERETIC) technique. To our knowledge ERETIC is not currently taught at the undergraduate level, but has an advantage in that internal standards are not required; ideal for following processes or with future use in flow‐based benchtop monitoring. Using this quantitative data, students can relate a simple chemical process (fermentation) back to more complex topics such as reaction kinetics, bridging the gaps between analytical and physical chemistry. When asked to reflect on the experiment, students had an overwhelmingly positive experience, citing agreement with learning objectives, ease of understanding the protocol, and enjoyment. Each of the respondents recommended this experiment as a learning tool for others. This experiment has been outlined for other instructors to utilize in their own courses across institutions, with the hope that a continued expansion of low‐field NMR will increase accessibility and learning opportunities at the undergraduate level. [ABSTRACT FROM AUTHOR]

Benchtop NMR provides improved accessibility in terms of cost, space, and technical expertise. In turn, this encourages new users into the field of NMR spectroscopy. Unfortunately, many interesting samples in education and research, from beer to whole blood, contain significant amounts of water that require suppression in 1H NMR in order to recover sample information. However, due to the significant reduction in chemical shift dispersion in benchtop NMR systems, the sample signals are much closer to the water resonance compared to those in a corresponding high‐field NMR spectrum. Therefore, simply translating solvent suppression experiments intended for high‐field NMR instruments to benchtop NMR systems without careful consideration can be problematic. In this study, the effectiveness of several popular water suppression schemes was evaluated for benchtop NMR applications. Emphasis is placed on pulse sequences with no, or few, adjustable parameters making them easy to implement. These fall into two main categories: (1) those based on Pre‐SAT including Pre‐SAT, PURGE, NOESY‐PR, and g‐NOESY‐PR and (2) those based on binomial inversion including JRS and W5‐WATERGATE. Among these schemes, solvent suppression sequences based on Pre‐SAT offer a general approach for easy solvent suppression for samples with higher analyte concentrations (sucrose standard and Redbull™). However, for human urine, binomial‐like sequences were required. In summary, it is demonstrated that highly efficient water suppression approaches can be implemented on benchtop NMR systems in a simple manner, despite the limited spectral dispersion, further illustrating the potential for widespread implementation of these approaches in education and research. [ABSTRACT FROM AUTHOR]

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Sarcopenia screening tools have a low capacity to predict adverse outcomes that are consequences of sarcopenia in the elderly population. This study aimed to evaluate the ability of a new sarcopenia screening tool SARC-GLOBAL to predict negative clinical outcomes in the elderly. A total of 395 individuals were evaluated in a 42-month period. The screening tools SARC-GLOBAL, SARC-F, and SARC-CalF and the diagnosis of sarcopenia according to European Working Group on Sarcopenia in Older Persons (EWGSOP2) were performed at the beginning of the study. Logistic and Poisson regression models were applied to assess the predictive value of the tools for the odds and risks of negative clinical outcomes, respectively. The most common negative clinical outcome in the followed population was falls (12.9%), followed by infections (12.4%), hospitalizations (11.8%), fractures (4.3%), and deaths (2.7%). Both SARC-GLOBAL and SARC-F were similar in predicting the odds of falls and hospitalizations during the follow up period, however SARC-CalF only predicted the odds of hospitalizations at 42 months. [ABSTRACT FROM AUTHOR]

The streamwise effective slope ( ES x ), which is the mean absolute streamwise gradient of the roughness, is considered to be a key parameter in predicting the drag penalty of rough-wall turbulent boundary-layers. However, many real-world rough surfaces are multi-scaled. For such surfaces, ES x can be unbounded and its value can be dominated by scales of the topography that are invisible to the flow. To illustrate this, a campaign of drag balance measurements was conducted with a set of machined surfaces. A baseline surface is prepared with fine machining parameters. By coarsening the machining precision, artefacts called 'scallops' are introduced which increases the 'measured' ES x without changing other geometrical statistics. The drag of the 'scalloped' surfaces is higher than the baseline surface, with the relative drag increase scaling with the viscous scaled scallop height, but only when their height exceeds 2 ∼ 3 times the viscous length scale. Further, the drag of one of the 'scalloped' cases, even when the scallop height is O (10) viscous units, is seen to be much lower ( ∼ 28 %) than a case with matched ES x , but where the ES x results from larger scale features. These findings confirm that for multi-scaled surfaces, ES x may be a misleading topographical metric for drag (or k s ) prediction and one must consider which scales contribute to the average slope of a surface. [ABSTRACT FROM AUTHOR]

Introduction: Many Covid‐19 survivors are living with unresolved, relapsing and remitting symptoms and no 'one size' of treatment is likely to be effective for everyone. Supported self‐management for the varied symptoms of Long Covid (LC) is recommended by the National Institute for Health and Care Excellence in the United Kingdom. We aimed to develop a new personalised support intervention for people living with LC using a structured co‐design framework to guide replication and evaluation. Methods: We used the improvement methodology, Experience‐Based Co‐Design, in an accelerated form to harness the collective experiences of people with LC. Incorporating evidence from 'Bridges Self‐Management' (Bridges) an approach in which healthcare professionals (HCPs)are trained to support knowledge, confidence and skills of individuals living with long term conditions. Co‐designed resources are also central to Bridges. Adults who self‐identified as living with or recovered from LC, from England or Wales, aged 18 years and over were recruited, and HCPs, with experience of supporting people with LC. Participants took part in a series of small co‐design group meetings and larger mixed meetings to agree priorities, core principles and generate resources and intervention content. Results: People with LC (n = 28), and HCPs (n = 9) supported co‐design of a book (hard‐copy and digital form) to be used in 1:1 support sessions with a trained HCP. Co‐design stages prioritised stories about physical symptoms first, and psychological and social challenges which followed, nonlinear journeys and reconceptualising stability as progress, rich descriptions of strategies and links to reputable advice and support for navigating healthcare services. Co‐design enabled formulation of eight core intervention principles which underpinned the training and language used by HCPs and fidelity assessments. Conclusion: We have developed a new personalised support intervention, with core principles to be used in one‐to‐one sessions delivered by trained HCPs, with a new co‐designed book as a prompt to build personalised strategies and plans using narratives, ideas, and solutions from other people with LC. Effectiveness and cost effectiveness of the 'LISTEN' intervention will be evaluated in a randomised controlled trial set within the context of the updated Framework for Developing and Evaluating Complex Interventions. Patient and Public Contribution: The LISTEN Public and Patient Involvement (PPI) group comprised seven people living with LC. They all contributed to the design of this study and five members were part of a larger co‐design community described in this paper. They have contributed to this paper by interpreting stages of intervention design and analysis of results. Three members of our PPI group are co‐authors of this paper. [ABSTRACT FROM AUTHOR]

Purpose of Review: The purpose of this review is to outline the principles of clinical genetic testing and to provide practical guidance to clinicians in navigating genetic testing for patients with suspected monogenic forms of osteoporosis. Recent Findings: Heritability assessments and genome-wide association studies have clearly shown the significant contributions of genetic variations to the pathogenesis of osteoporosis. Currently, over 50 monogenic disorders that present primarily with low bone mass and increased risk of fractures have been described. The widespread availability of clinical genetic testing offers a valuable opportunity to correctly diagnose individuals with monogenic forms of osteoporosis, thus instituting appropriate surveillance and treatment. Summary: Clinical genetic testing may identify the appropriate diagnosis in a subset of patients with low bone mass, multiple or unusual fractures, and severe or early-onset osteoporosis, and thus clinicians should be aware of how to incorporate such testing into their clinical practices. [ABSTRACT FROM AUTHOR]

The species-specific and age-related autumn migration strategies of the sedge, reed and great reed warbler were investigated at stopover sites between central Europe and north-eastern Africa during autumn. Adult reed warblers accumulated larger fat reserves than juveniles and consequently were able to cover longer distances from most stopover sites. Juvenile sedge warblers, on the other hand, left Europe with significantly larger fat reserves than adults as opposed to the populations migrating along the western route. Both juvenile and adult great reed warblers were potentially able to make long flights without refuelling from the northern part of the Mediterranean region onwards. It was the proximity of large ecological barriers that had the most prominent influence on the potential flight distances of adult and juvenile Acrocephalus warblers during their southward migration. In reed and sedge warblers, the differences in mean flight distances covered by adults and juveniles were the largest (ca. 600 km) just before the crossing of the Mediterranean Sea, but smaller (ca. 200 and 400 km, respectively) in front of the Sahara Desert. Juvenile and adult great reed warblers were potentially able to cover 1660 km from Turkey, which was also supported by very low numbers of individuals caught at the Egyptian ringing sites. The results of this study carried out in the key regions of the eastern European–African flyway documented that migration strategies differed between adults and juveniles of three long-distance migrant species, yet this variation depended on the migration stage and the proximity of natural ecological barriers. [ABSTRACT FROM AUTHOR]

We use the dynamic conditional correlation (DCC) model to estimate daily frequency mutual fund betas. Compared with traditional estimates, daily betas better capture changes in fund risk stemming from daily fund trading activity. Based on these beta estimates and a two-stage estimation procedure, we find significant evidence of market timing ability among actively managed U.S. equity funds that is not apparent via standard approaches. Unlike traditional measures, our timing estimates correlate positively with fund performance. Market timing is especially evident during down markets, with successful timers exhibiting low downside risk. Timing ability persists across time and attracts investor flows. This paper was accepted by David Sraer, finance. Funding: This work was supported by the National Natural Science Foundation of China [Grants 72173127 and 72121001] and by the Institute for Industrial Innovation and Finance at Tsinghua University. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2023.4857. [ABSTRACT FROM AUTHOR]