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Varenicline, the most efficacious smoking cessation monotherapy, produces abnormal dreams. Although genetic contributions to varenicline‐associated nausea and cessation have been identified, the role of genetics in abnormal dreams is unknown. We conducted a genomewide association study (GWAS) of abnormal dreams in 188 European ancestry smokers treated with varenicline (NCT01314001). Additive genetic models examined the likelihood of experiencing abnormal dreams 2 weeks following varenicline initiation. For the top locus, we tested for selectivity to varenicline, effects on cessation, replication, and generalizability to African ancestry (AA) individuals. The top GWAS variant associated with abnormal dreams was rs901886, mapping to intron 2 of ICAM5 on chromosome 19. The prevalence of abnormal dreams in those with rs901886 CC, CT, and TT genotypes was 15%, 36%, and 62%, respectively (odds ratio = 2.94 for T vs. C, 95% confidence interval = 1.92–4.55, P = 2.03e−7; T allele frequency = 52%). This rs901886 association was selective to varenicline (P values > 0.05 on nicotine patch and placebo). There were also positive associations for rs901886 T (vs. C allele, P = 0.03) and for abnormal dreams (P = 0.06) with varenicline‐aided cessation. Neither rs901886 (P = 0.40) nor abnormal dreams (P = 0.24) were associated with adherence. A similar direction of effect of rs901886 on abnormal dreams was observed in a second varenicline trial (NCT01836276). In AA individuals (n = 137), rs901886 was not associated with abnormal dreams (P = 0.41), but there was an association for a variant located ~ 74.4 kb 5′ of ICAM5 (P = 2.56e−3). Variation in ICAM5 may influence abnormal dreams and cessation on varenicline. These findings provide additional support for genetically optimized smoking cessation approaches. [ABSTRACT FROM AUTHOR]

Poor health conditions of livestock cause sizeable losses for many farmers in the Global South. Veterinary services, including vaccinations, could help but often fail to reach farmers under typical smallholder conditions. Here, we examine how the provision of a vaccine against East Coast Fever (ECF)—a tick‐borne disease affecting cattle in Africa—can be designed to reduce typical adoption barriers. Using data from a choice experiment with dairy farmers in Kenya, we evaluate farmers' preferences and willingness to pay for various institutional innovations in vaccine delivery, such as a stronger role of dairy cooperatives, new payment modalities with a check‐off system, vaccination at farmers' homestead, and bundling vaccinations with discounts for livestock insurance. Our data reveal that farmers' awareness of the ECF vaccine is limited and adoption rates are low, largely due to institutional constraints. Results from mixed logit and latent class models suggest that suitable institutional innovations—tailored to farmers' heterogeneous conditions—could significantly increase adoption. This general finding likely also holds for other veterinary technologies and services in the Global South. [ABSTRACT FROM AUTHOR]

Manganese (Mn) oxide‐coated sand has been suggested as an amendment for scrubbing metals in water filtration beds and also as a less concentrated medium for uniformly amending soils with Mn oxides in mesocosm scale studies. Earlier work at the lab bench scale, using potassium permanganate (KMnO4) solutions that were reduced with sodium (Na) lactate, resulted in sands coated with about 0.13% Mn. The goal of this project was to increase the amount of Mn oxide that could be coated on sand to make it a more useful amendment and also to attempt to scale up the procedure to produce larger (kg) quantities of coated sand. Titration experiments examined the effects of (1) varying the molar ratio of Na lactate to KMnO4, (2) varying the rate at which the titration was accomplished, and (3) varying the concentration (molarity) of the original KMnO4 solution. The results of this work led to an optimal approach utilizing 0.32 M KMnO4 solution that was titrated to a final lactate:permanganate ratio of ∼1.1 with 10% of the lactate being added every 10 min while the suspension was being stirred. The proportion of sand to an initial solution was also increased 5–20 fold to between 50 and 200 g per 100 mL of solution. Applying this method and using a large 20‐ to 30‐L reaction vessel yields sands coated with up to 0.7% Mn in batches 5–10 kg is size, which could be useful as an amendment in mesocosm scale studies, or as a component of treatment filter beds. The examination of various size fractions of the coated sands demonstrated that more Mn was coated on finer sand fractions, which appears to be a function of the particle surface area available for the coating of Mn oxides, and at a rate of 0.3–0.5 µg Mn mm−2 of the particle surface. Core Ideas: Manganese (Mn) oxide‐coated sands (MCS) can be synthesized with much higher Mn content (up to 0.5%–0.7% Mn).MSC can be produced in large batches (up to 5–10 kg).Scaled‐up production of MCS makes it feasible for use as an amendment or in treatment filter beds.As the Mn coating increases (up to 0.2% Mn), sand colors become progressively darker (lower Munsell value).A digital colorimeter (using Munsell value) can be used to accurately estimate % Mn oxide at levels <0.2%. [ABSTRACT FROM AUTHOR]

This article presents a global population-based study on the distribution and trends of salivary gland cancer. The study utilized data from the Global Cancer Observatory and the Cancer Incidence in Five Continents Plus. The findings reveal that salivary gland cancer burden is higher in regions with higher Human Development Index (HDI) and is associated with lifestyle factors such as smoking and alcohol consumption. The study also highlights a rising trend of salivary gland cancer among females, possibly linked to hormonal factors. However, the study acknowledges limitations in data availability and classification in low-income countries. Further research is needed to understand the complex relationship between socioeconomic factors and salivary gland cancer burden. [Extracted from the article]

Background: This study aims to investigate the global disease burden, risk factors, and temporal trends of eye cancer by sex and age group. Methods: Databases including Cancer Incidence in Five Continents volumes I–XI, the Nordic Cancer Registries, the Surveillance, Epidemiology, and End Results Program and the WHO IARC mortality database were accessed to extract incidence and mortality data. Joinpoint regression analyses were conducted to evaluate the Average Annual Percentage Change of the incidence and mortality. Results: The age‐standardised rates of eye cancer incidence and mortality were 0.49 and 0.08 globally in 2020. Higher incidence rates were observed in Sub‐Saharan Africa (ASR = 4.06), Western Europe (ASR = 0.89), and Northern Europe (ASR = 0.84), but higher mortality was observed only in Sub‐Saharan Africa (ASR = 1.59). Lower HDI, higher prevalence of UV exposure and lower prevalence of several lifestyle habits and metabolic syndromes were associated with higher incidence and mortality. There was an overall stable incidence trend and a decreasing mortality trend. Notably, all countries reporting decreasing trend in mortality were in the Asian or European region. Conclusions: Although higher incidence was observed in both African and European regions, only the Sub‐Saharan Africa region reported high mortality, indicating inequity in the access of healthcare and treatment resource. Higher prevalence of UV exposure was associated with both higher incidence and mortality. Education should be provided to increase the awareness of eye protection. An overall declining mortality trend was found, but it was limited to only Asian and European countries. [ABSTRACT FROM AUTHOR]

On February 28, 2021, a fireball dropped ∼0.6 kg of recovered CM2 carbonaceous chondrite meteorites in South‐West England near the town of Winchcombe. We reconstruct the fireball's atmospheric trajectory, light curve, fragmentation behavior, and pre‐atmospheric orbit from optical records contributed by five networks. The progenitor meteoroid was three orders of magnitude less massive (∼13 kg) than any previously observed carbonaceous fall. The Winchcombe meteorite survived entry because it was exposed to a very low peak atmospheric dynamic pressure (∼0.6 MPa) due to a fortuitous combination of entry parameters, notably low velocity (13.9 km s−1). A near‐catastrophic fragmentation at ∼0.07 MPa points to the body's fragility. Low entry speeds which cause low peak dynamic pressures are likely necessary conditions for a small carbonaceous meteoroid to survive atmospheric entry, strongly constraining the radiant direction to the general antapex direction. Orbital integrations show that the meteoroid was injected into the near‐Earth region ∼0.08 Myr ago and it never had a perihelion distance smaller than ∼0.7 AU, while other CM2 meteorites with known orbits approached the Sun closer (∼0.5 AU) and were heated to at least 100 K higher temperatures. [ABSTRACT FROM AUTHOR]

Background: Cameroon was among the most affected African countries during the first wave of the COVID‐19 pandemic; however, the true prevalence of SARS‐CoV‐2 remains unknown. Methods: From October to December 2020, we conducted a cross‐sectional, age‐stratified SARS‐CoV‐2 seroepidemiological survey at 30 purposively selected community‐based sites across Cameroon's 10 regional capitals, sampling 10,000 individuals aged 5 years or older. We employed a parallel SARS‐CoV‐2 antibody testing algorithm (WANTAI ELISA and Abbott Architect) to improve both the positive predictive value and negative predictive value of seroprevalence. Results: The overall weighted and adjusted seroprevalence of SARS‐CoV‐2 antibodies across the 10 urban capitals of Cameroon was 10.5% (95% CI: 9.1%–12.0%) among participants aged ≥5 years. Of the 9332 participants, 730 males (13.1%, 95% CI: 11.5%–14.9%) had SARS‐CoV‐2 antibodies compared to 293 females (8.0%, 95% CI: 6.8%—9.3%). Among those who reported a comorbidity at the time of testing, 15.8% (95% CI: 12.8%–19.4%) were seropositive. We estimated that over 2 million SARS‐CoV‐2 infections occurred in the 10 regional capitals of Cameroon between October and December 2020, compared to 21,160 cases officially reported at that time translating to one laboratory‐confirmed case being reported for every 110 SARS‐CoV‐2 infections across the 10 urban capitals. Conclusion: This study's findings point to extensive and under‐reported circulation of SARS‐CoV‐2 in Cameroon—an almost 100‐fold more cases compared to the number of cases reported to the World Health Organization. This finding highlights the importance of conducting serosurveys, especially in settings where access to testing may be limited and to repeat such surveys as part of pandemic tracking. [ABSTRACT FROM AUTHOR]

Aims: This study aimed to devise and validate a clinical scoring system for risk prediction of bladder cancer to guide urgent cystoscopy evaluation among people with diabetes. Methods: People with diabetes who received cystoscopy from a large database in the Chinese population (2009–2018). We recruited a derivation cohort based on random sampling from 70% of all individuals. We used the adjusted odds ratios (aORs) for independent risk factors to devise a risk score, ranging from 0 to 5: 0–2 'average risk' (AR) and 3–5 'high risk' (HR). Results: A total of 5905 people with diabetes, among whom 123 people with BCa were included. The prevalence rate in the derivation (n = 4174) and validation cohorts (n = 1731) was 2.2% and 1.8% respectively. Using the scoring system constructed, 79.6% and 20.4% in the derivation cohort were classified as AR and HR respectively. The prevalence rate in the AR and HR groups was 1.57% and 4.58% respectively. The risk score consisted of age (18–70: 0; >70: 2), male sex (1), ever/ex‐smoker (1) and duration of diabetes (≥10 years: 1). Individuals in the HR group had 3.26‐fold (95% CI = 1.65–6.44, p = 0.025) increased prevalence of bladder than the AR group. The concordance (c‐) statistics was 0.72, implying a good discriminatory capability of the risk score to stratify high‐risk individuals who should consider earlier cystoscopy. Conclusions: The risk prediction algorithm may inform urgency of cystoscopy appointments, thus allowing a more efficient use of resources and contributing to early detection of BCa among people planned to be referred. [ABSTRACT FROM AUTHOR]

Background and Aims: Unhealthy diets were found to be the main contributor to the overweight problem among adolescents. In this study, we aim to identify the factors causing unhealthy eating habits in adolescents. Methods: School‐aged children and adolescents participated in this cross‐sectional observational study with additional school and parental consent. A self‐administered survey was conducted by 30 primary schools and 25 secondary schools. Participants were asked about the frequency of consuming unhealthy food and the types of unhealthy food consumed. A descriptive analysis was performed to demonstrate the proportions of characteristics. The prevalence of the outcome among participants of various factors was also analyzed using separate binary regression models. Results: A total of 4884 responses were collected. Among primary school students (grade 4, mean age: 10.06), people who (1) were actively gaining weight (aOR: 1.651, 95% CI 1.006–2.708, p = 0.047), (2) went to bed after 11 p.m. (aOR: 1.652, 95% CI 1.065–2.563, p = 0.025), (3) had more than 2 h of gaming (aOR: 2.833, 95% CI 1.913–4.195, p < 0.001), (4) suffered from self‐report depressive symptoms (aOR: 1.753, 95% CI 1.233–2.493, p = 0.002) was more likely to consume unhealthy food. As for secondary school students (grade 3, mean age: 15.28), (1) males (aOR: 1.266, 95% CI 1.0004–1.601, p = 0.0496), (2) average‐to‐high socioeconomic status (Average: aOR: 1.471, 95% CI 1.115–1.941, p = 0.006; High: aOR: 2.253, 95% CI 1.585–3.202. p < 0.001), (3) having more than 2 h of gaming (aOR: 1.342, 95% CI 1.069–1.685, p = 0.011), (4) suffering from psychological distress (aOR: 1.395, 95% CI 1.051–1.852, p = 0.021) were associated with the increased odds of consuming unhealthy food. Conclusion: Several lifestyle and health factors were significantly associated with unhealthy eating behaviors in school‐aged children and adolescents in Hong Kong, sharing similarities with many other countries. In conjunction with implementing a policy that addresses factors for unhealthy eating habits, further research should investigate potential interventions targeting these factors to ultimately tackle the overweight and obesity concern for children and adolescents in Hong Kong. Highlights: Unhealthy eating habits continue to be an important public health concern among young students in Hong Kong, a fifth of whom were recently reported as overweight or obese in Hong Kong.The current study has identified factors and quantitatively measured the strengths of their associations with unhealthy eating behaviors in school‐aged children and adolescents in Hong Kong.The factors identified in this study can help relevant authorities make targeted interventions or policy decisions to solve the problem of overweight or obesity among school students. [ABSTRACT FROM AUTHOR]

Background: Non‐Hodgkin lymphoma (NHL) accounts for 90% of all malignant lymphomas. This study aimed to evaluate the global incidence, mortality, associated risk factors, and temporal trends of NHL by sex, age, and country. Methods: Data from 185 countries globally were used for analysis. NHL incidence and mortality were collected via the GLOBOCAN (2020), CI5 series I‐X, WHO mortality database, the Nordic Cancer Registries, and the SEER Program. The WHO Global Health Observatory provided country‐level, age‐standardized prevalence of lifestyle and metabolic risk factors. Trends were examined and reported based on average annual percentage change (AAPC) calculated using Joinpoint regression analysis. Incidence and AAPC are based on data for the last 10 years across countries. Results: Globally, age‐standardized incidence and mortality rates for NHL were recorded at 5.8 and 2.6 per 100,000 individuals, respectively. At country‐level, NHL incidence was significantly associated with various factors, including HDI (Human Development Index), GDP per capita, prevalence of tobacco and alcohol consumption, sedentary lifestyle, obesity, hypertension, diabetes and hypercholesterolaemia. Rising trend in NHL incidence was observed, with the highest increase recorded in Estonia (AAPCmale = 4.15, AAPCfemale = 5.14), Belarus (AAPCfemale = 5.13), and Lithuania (AAPCfemale = 4.68). While overall NHL mortality has been decreasing, certain populations experienced increased mortality over the decade. In Thailand, AAPC for mortality was 31.28% for males and 30.26% for females. Estonia saw an AAPC of 6.46% for males, while Slovakia experienced an AAPC of 4.24% for females. Colombia's AAPC was 1.29% for males and 1.51% for females. Conclusions: This study indicates a rising trend of NHL incidence over the past decade‐ particularly in developed countries, older males, and younger populations. Further research should investigate deeper insights into specific etiology and prognosis of NHL across subtypes, and potential contributors towards these epidemiologic trends. [ABSTRACT FROM AUTHOR]

Genetic variation in CYP2B6 and CYP2A6 is known to impact interindividual response to antiretrovirals, nicotine, and bupropion, among other drugs. However, the full catalogue of clinically relevant pharmacogenetic variants in these genes is yet to be established, especially across African populations. This study therefore aimed to characterize the star allele (haplotype) distribution in CYP2B6 and CYP2A6 across diverse and understudied sub‐Saharan African (SSA) populations. We called star alleles from 961 high‐depth full genomes using StellarPGx, Aldy, and PyPGx. In addition, we performed CYP2B6 and CYP2A6 star allele frequency comparisons between SSA and other global biogeographical groups represented in the new 1000 Genomes Project high‐coverage dataset (n = 2,000). This study presents frequency information for star alleles in CYP2B6 (e.g., *6 and *18; frequency of 21–47% and 2–19%, respectively) and CYP2A6 (e.g., *4, *9, and *17; frequency of 0–6%, 3–10%, and 6–20%, respectively), and predicted phenotypes (for CYP2B6), across various African populations. In addition, 50 potentially novel African‐ancestry star alleles were computationally predicted by StellarPGx in CYP2B6 and CYP2A6 combined. For each of these genes, over 4% of the study participants had predicted novel star alleles. Three novel star alleles in CYP2A6 (*54, *55, and *56) and CYP2B6 apiece, and several suballeles were further validated via targeted Single‐Molecule Real‐Time resequencing. Our findings are important for informing the design of comprehensive pharmacogenetic testing platforms, and are highly relevant for personalized medicine strategies, especially relating to antiretroviral medication and smoking cessation treatment in Africa and the African diaspora. More broadly, this study highlights the importance of sampling diverse African ethnolinguistic groups for accurate characterization of the pharmacogene variation landscape across the continent. [ABSTRACT FROM AUTHOR]

Perovskite‐based triple‐junction solar cells offer the potential for highly efficient and cost‐effective photovoltaic energy conversion. This article aims to provide a roadmap for the optical properties of perovskite/perovskite/silicon triple‐junction cells. A comprehensive optoelectrical model for the perovskite/perovskite/silicon structure is developed in Sentaurus TCAD. The optical part of the model is validated by measurements of a triple‐junction solar cell. As the electrical characterization is an ongoing process, the electrical properties are assumed to be nonlimiting, which enables us to translate the optical improvement steps into efficiency potentials. A first improvement step lies in adjusting the thicknesses of the perovskite layers to achieve current matching between both perovskite subcells. Using perovskites with bandgaps optimized for planar surfaces, it would be possible to increase the photocurrent density to 13.3 mA cm−2 and the efficiency to 41.9%. It is shown that by implementing a fully textured structure and using the best available materials, a short‐circuit current of 14.1 mA cm−2 and an open‐circuit voltage of 3.48 V with an efficiency of 44.3% are possible assuming idealized electrical properties. This can be regarded as a practical efficiency potential for this kind of triple‐junction technology. [ABSTRACT FROM AUTHOR]

Background: Recent therapeutic advances and screening technologies have improved survival among patients with lung cancer, who are now at high risk of developing second primary lung cancer (SPLC). Recently, an SPLC risk‐prediction model (called SPLC‐RAT) was developed and validated using data from population‐based epidemiological cohorts and clinical trials, but real‐world validation has been lacking. The predictive performance of SPLC‐RAT was evaluated in a hospital‐based cohort of lung cancer survivors. Methods: The authors analyzed data from 8448 ever‐smoking patients diagnosed with initial primary lung cancer (IPLC) in 1997–2006 at Mayo Clinic, with each patient followed for SPLC through 2018. The predictive performance of SPLC‐RAT and further explored the potential of improving SPLC detection through risk model‐based surveillance using SPLC‐RAT versus existing clinical surveillance guidelines. Results: Of 8448 IPLC patients, 483 (5.7%) developed SPLC over 26,470 person‐years. The application of SPLC‐RAT showed high discrimination area under the receiver operating characteristics curve: 0.81). When the cohort was stratified by a 10‐year risk threshold of ≥5.6% (i.e., 80th percentile from the SPLC‐RAT development cohort), the observed SPLC incidence was significantly elevated in the high‐risk versus low‐risk subgroup (13.1% vs. 1.1%, p < 1 × 10–6). The risk‐based surveillance through SPLC‐RAT (≥5.6% threshold) outperformed the National Comprehensive Cancer Network guidelines with higher sensitivity (86.4% vs. 79.4%) and specificity (38.9% vs. 30.4%) and required 20% fewer computed tomography follow‐ups needed to detect one SPLC (162 vs. 202). Conclusion: In a large, hospital‐based cohort, the authors validated the predictive performance of SPLC‐RAT in identifying high‐risk survivors of SPLC and showed its potential to improve SPLC detection through risk‐based surveillance. Plain Language Summary: Lung cancer survivors have a high risk of developing second primary lung cancer (SPLC).However, no evidence‐based guidelines for SPLC surveillance are available for lung cancer survivors.Recently, an SPLC risk‐prediction model was developed and validated using data from population‐based epidemiological cohorts and clinical trials, but real‐world validation has been lacking.Using a large, real‐world cohort of lung cancer survivors, we showed the high predictive accuracy and risk‐stratification ability of the SPLC risk‐prediction model.Furthermore, we demonstrated the potential to enhance efficiency in detecting SPLC using risk model‐based surveillance strategies compared to the existing consensus‐based clinical guidelines, including the National Comprehensive Cancer Network. Given the rapidly growing number of lung cancer survivors who are now at high risk of developing second primary lung cancer (SPLC), previous studies have identified SPLC risk factors and developed SPLC risk‐prediction models, but they lack insight into real‐world validation to help improve clinical decision‐making in SPLC surveillance for lung cancer survivors. Using a large, hospital‐based real‐world cohort of lung cancer survivors, the authors validated the predictive accuracy of an SPLC risk‐prediction model (area under the curve of 0.81), that can identify high‐risk lung cancer survivors for SPLC and can be incorporated into clinical decision‐making for SPLC surveillance to improve the systematic management of lung cancer survivors. [ABSTRACT FROM AUTHOR]

Alzheimer's disease (AD) is the most common type of neurodegenerative disease and a health challenge with major social and economic consequences. In this review, we discuss the therapeutic potential of gamma stimulation in treating AD and delve into the possible mechanisms responsible for its positive effects. Recent studies reveal that it is feasible and safe to induce 40 Hz brain activity in AD patients through a range of 40 Hz multisensory and noninvasive electrical or magnetic stimulation methods. Although research into the clinical potential of these interventions is still in its nascent stages, these studies suggest that 40 Hz stimulation can yield beneficial effects on brain function, disease pathology, and cognitive function in individuals with AD. Specifically, we discuss studies involving 40 Hz light, auditory, and vibrotactile stimulation, as well as noninvasive techniques such as transcranial alternating current stimulation and transcranial magnetic stimulation. The precise mechanisms underpinning the beneficial effects of gamma stimulation in AD are not yet fully elucidated, but preclinical studies have provided relevant insights. We discuss preclinical evidence related to both neuronal and nonneuronal mechanisms that may be involved, touching upon the relevance of interneurons, neuropeptides, and specific synaptic mechanisms in translating gamma stimulation into widespread neuronal activity within the brain. We also explore the roles of microglia, astrocytes, and the vasculature in mediating the beneficial effects of gamma stimulation on brain function. Lastly, we examine upcoming clinical trials and contemplate the potential future applications of gamma stimulation in the management of neurodegenerative disorders. [ABSTRACT FROM AUTHOR]

Precise solar cell measurements become more and more challenging due to the increasing complexity of metallization patterns and the sensitivity to rear side illumination for bifacial cell concepts. In this context, the measurement conditions under which conversion efficiencies are determined need to be closely examined: Different efficiency values can occur for the same solar cell because of different measurement conditions. To provide more transparency, a notation has recently been published, which unambiguously characterizes the measurement conditions used and which is included in the calibration documents of the calibration laboratories ISFH CalTeC and Fraunhofer ISE CalLab PV Cells. As this notation is held rather technical and no quantitative assessment is given so far, herein, the effects associated with different measurement conditions are analyzed and quantified in detail for typical industrial‐type solar cells. It is shown that varying the measurement conditions as well as the busbar concept can lead to significant differences in measured efficiency of 0.5%abs. The power gains coming from different cell measurement configurations do not occur in the same manner on the module level though and can lead to considerable variations in cell‐to‐module power factors. Several hints to increase the significance of solar cell measurements are given. [ABSTRACT FROM AUTHOR]

Spectrometric characterization allows for accurate determination of the current matching point and investigation of sub‐cell properties of multi‐junction solar cells. It is widely used for dual‐junction solar cells. Although the concept is suggested for triple‐junction solar cells, it is only applied for the variation of two sub‐cells. In this work, the applicability and evaluation procedure for a systematic variation of all three sub‐cells of a triple‐junction solar cell are presented. Clearly defined measurement conditions are derived which allow for meaningful characterization and comparisons of different triple‐junction devices. The presented procedure is exemplarily tested on a III–V on silicon triple‐junction solar cell using an light‐emitting diode‐based solar simulator where all needed spectral conditions can be calculated in advance and accordingly adjusted. Spectral conditions around the air mass 1.5 global spectrum are chosen and a fit routine to determine the current matching point from the discrete measurement points is proposed and validated by a measurement with a higher resolution around the current matching point. Finally, it is shown that the spectral conditions applied during the measurement also reflect outdoor conditions. This highlights the relevance of the presented procedure beyond the determination of the current‐matching conditions. [ABSTRACT FROM AUTHOR]

Background: Health literacy is essential in the promotion of healthy lifestyle habits and chronic disease prevention. Objective: To assess the health literacy level among Hong Kong adolescents; to evaluate the association between access of an online health information platform (GoSmart Channel) and health literacy level; and to examine the association between health literacy level and various unhealthy behaviours. Design: This study recruited students from 10 local secondary schools in Hong Kong to assess the health literacy level among adolescents. Settings and Participants: Participants were required to complete a self‐administered questionnaire on health behaviours and health literacy using the Health Literacy Measure for Adolescents (HELMA). Main Outcome Measure: Data were analysed using descriptive statistics and multivariate regression modelling. Results: A total of 777 responses were collected. Overall, most (74.4%) of the adolescents in Hong Kong have limited health literacy (HELMA score <66). The majority (63.7%) of adolescents relied on their parents for health information, while 11.4% of the respondents sought information from the GoSmart Channel. The intervention of GoSmart Channel was significantly associated with better health literacy in almost all aspects among adolescents. Desired levels of health literacy were significantly associated with better perceived health (adjusted odds ratio: 2.04, p =.001) and negatively associated with a range of unhealthy and risky behaviours including unhealthy dietary habits, poor hygienic measures and physical inactivity. Discussion and Conclusion: This study highlights the importance of improving health literacy among Hong Kong adolescents and the potential of technology‐based interventions. The findings suggest the need for continued efforts to promote health literacy and healthy behaviours among adolescents, especially given the limited health literacy levels observed in the study. Patient or Public Contribution: Members of the GoSmart.Net Built‐on Project patient and public involvement and engagement group advised about survey development. [ABSTRACT FROM AUTHOR]

Background: This cross‐sectional study aimed to investigate the association between negative mental health conditions and demographic characteristics, socioeconomic background and health‐related parameters in both Hong Kong's primary and secondary school students. Methods: A self‐administrated survey was conducted and investigated the prevalence of negative mental health conditions (psychological stress, depression and suicidality) in students from 30 primary schools and 25 secondary schools in Hong Kong in 2017. The Kessler Psychological Distress Scale (K6) was chosen as the instrument to evaluate non‐specific psychological distress. Depression was evaluated using the prolonged feeling of despair as a proxy. Suicidality was measured by four questions on whether they had ever intentionally injured themselves, seriously considered attempting suicide, planned how they would attempt suicide and had attempted suicide. Multiple logistic regression models examined the explanatory factors' association with mental health conditions after adjusting for confounding, using the enter method. Results: A total of 4884 responses were collected. It is found that both very high and low parent expectations were risk factors for multiple conditions, namely suicidality and psychological distress among primary school students, and psychological distress among secondary school students. As for primary school students, the experience of being bullied was a significant risk factor for all conditions. A significant association was found between having one's own bedroom and suicidality amongst primary school students; whilst having three close friends or more and higher life satisfaction levels were significantly associated with a lower risk of negative mental health conditions among secondary school students. Conclusions: It was found that having one's own bedroom was a risk factor for suicidality among primary school student. Parents should be alert to the risky behaviours of children, have more involvement in children's daily life and build a supportive and caring family environment for children. For secondary school students, as the importance of friends is greatly increased, teachers should encourage students to engage in extra‐curricular activities in school. [ABSTRACT FROM AUTHOR]

The management and conservation of tuna and other transboundary marine species have to date been limited by an incomplete understanding of the oceanographic, ecological and socioeconomic factors mediating fishery overlap and interactions, and how these factors vary across expansive, open ocean habitats. Despite advances in fisheries monitoring and biologging technology, few attempts have been made to conduct integrated ecological analyses at basin scales relevant to pelagic fisheries and the highly migratory species they target. Here, we use vessel tracking data, archival tags, observer records, and machine learning to examine inter‐ and intra‐annual variability in fisheries overlap (2013–2020) of five pelagic longline fishing fleets with North Pacific albacore tuna (Thunnus alalunga, Scombridae). Although progressive declines in catch and biomass have been observed over the past several decades, the North Pacific albacore is one of the only Pacific tuna stocks primarily targeted by pelagic longlines not currently listed as overfished or experiencing overfishing. We find that fishery overlap varies significantly across time and space as mediated by (1) differences in habitat preferences between juvenile and adult albacore; (2) variation of oceanographic features known to aggregate pelagic biomass; and (3) the different spatial niches targeted by shallow‐set and deep‐set longline fishing gear. These findings may have significant implications for stock assessment in this and other transboundary fishery systems, particularly the reliance on fishery‐dependent data to index abundance. Indeed, we argue that additional consideration of how overlap, catchability, and size selectivity parameters vary over time and space may be required to ensure the development of robust, equitable, and climate‐resilient harvest control rules. [ABSTRACT FROM AUTHOR]

Patterns composed of micron‐sized surface structures can abruptly change the properties of an optical wave front, including its phase, amplitude, polarization, and dispersion. Optical components featuring surface micro‐gratings not only possess optical functionalities that can rival or exceed those of traditional bulky components but can also significantly improve the compactness of optical systems. Herein, the design and fabrication process of As2S3 glass‐based micro‐gratings as well as their resulting optical functionality in the infrared regime are reported. The novel two‐step photochemical process consists of spatially controlled direct laser writing and subsequent selective solution etching. The process yields surface micro‐gratings that possess arbitrarily tunable geometries and design patterns on large‐area flat and curved optical surfaces or substrates, offering a potential new avenue for developing aberration‐corrected infrared‐imaging systems. [ABSTRACT FROM AUTHOR]

Optimally enhancing the performance of perovskite silicon tandem solar cells comes with accurate identification of loss origins in the device in combination with optoelectrical device simulations assessing the respective efficiency gains to prioritize optimization pathways. Herein, various characterization methods, namely, spectrally resolved photoluminescence (PL), transient-PL, PL-based implied opencircuit voltage (iVOC) imaging, spectrometric characterization, and Suns-VOC measurements are combined to quantify current density-voltage (jV) photovoltaic metric losses of a fully-textured perovskite silicon tandem solar cell (26.7% efficiency). The extracted device characteristic parameters are then used as a reference for the comprehensive optoelectrical Sentaurus simulation model which precisely reproduces the experimentally obtained optical and electrical solar cell characteristics, considering mobile ion dynamics. Subsequently, starting from the current device design, the authors alleviate one step at a time the loss constraints and show the impact of each loss channel on the efficiency, identifying the three major ones to be at the: 1) perovskite/C60 interface (-4.6%abs), 2) the series resistance (-2.9%abs), and 3) light management (-2.1%abs), which limit the VOC, fill factor, and jSC of the device, respectively. Furthermore, it is demonstrated that a practical efficiency potential of 39.5% can be regarded as a practical limit for the presented tandem device architecture. [ABSTRACT FROM AUTHOR]

Background and Aim: Colorectal cancer (CRC) is one of the commonest cancers, especially among the Asian populations. We compared the recurrence rate of advanced colorectal neoplasia (ACN) at 5 year vs 7–10 years among individuals with non‐advanced adenoma (NAA) detected and polypectomized at baseline colonoscopy in a large Chinese population. Methods: We extracted data of a large Chinese population with NAA polypectomized who received surveillance colonoscopy after 5 or 7–10 years from a large database (2008–2018). The outcome variable included recurrence of ACN at surveillance colonoscopy. We examined the association between length of surveillance and the outcome variable, whilst controlling for risk factors of colorectal cancer. Results: We include 109 768 subjects who have received a baseline colonoscopy from our dataset. They were aged 67.35 (SD 9.84) years, and 60.9% of them were male subjects. The crude 5‐year and 10‐year recurrence rate of ACN was 1.50% and 2.42%, respectively (crude odds ratio = 1.629, 95% CI 1.362 to 1.949, P < 0.001). From the binary logistic regression model, individuals with surveillance colonoscopy performed at 10 years had a statistically higher recurrence rate of ACN than those followed‐up at 5 year (adjusted odds ratio [aOR] = 1.544, 95% CI 1.266 to 1.877, P < 0.001), but the effect size of aOR is small. Conclusions: There is a small difference in recurrence of ACN between individuals who received colonoscopy workup at 5 years vs 7–10 years. These findings support a 7–10 years surveillance period after baseline NAA was polypectomized. [ABSTRACT FROM AUTHOR]

Life cycle assessment (LCA) and techno‐economic analysis (TEA) models are developed for a tertiary wastewater treatment system that employs a biochar‐integrated reactive filtration (RF) approach. This innovative system incorporates the utilization of biochar (BC) either in conjunction with or independently of iron‐ozone catalytic oxidation (CatOx)—resulting in two configurations: Fe‐CatOx‐BC‐RF and BC‐RF. The technology demonstrates 90%–99% total phosphorus removals, adsorption of phosphorus to biochar for recovery, and >90% destructive removal of observed micropollutants. In this work, we conduct an ISO‐compliant LCA of a 49.2 m3/day (9 gpm) field pilot‐scale Fe‐CatOx‐BC‐RF system and a 1130 m3/day (0.3 MGD) water resource recovery facility (WRRF)‐installed RF system, modeled with BC addition at the same rate of 0.45 g/L to quantify their environmental impacts. LCA results indicated that the Fe‐CatOx‐BC‐RF pilot system is a BC dose‐dependent carbon‐negative technology at −1.21 kg CO2e/m3, where biochar addition constitutes a −1.53 kg/m3 CO2e beneficial impact to the process. For the WRRF‐installed RF system, modeled with the same rate of BC addition, the overall process changed from 0.02 kg CO2e/m3 to a carbon negative −1.41 kg CO2e/m3, demonstrating potential as a biochar dose‐dependent negative emissions technology. Using the C100 100‐year carbon accounting approach rather than Cnet reduces these CO2e metrics for the process by about 25%. A stochastic TEA for the cost of water treatment using this combinatorial P removal/recovery, micropollutant destructive removal, and disinfection advanced technology shows that at scale, the mean cost for treating 1130 m3/day (0.3 MGD) WRRF secondary influent water with Fe‐CatOx‐BC‐RF using the C100 metric is US$0.18 ± US$0.01/m3 to achieve overall process carbon neutrality. Using the same BC dose in an estimation of a 3780 m3/day (1 MGD) Fe‐CatOx‐BC‐RF facility, the carbon neutral cost of treatment is reduced further to US$0.08 ± $0.01 with added BC accounting for US$0.03/m3. Overall, the results demonstrate the potential of carbon negativity to become a water treatment performance standard as important and attainable as pollutant and pathogen removal. Practitioner Points: Life cycle assessment (LCA) of a pilot scale tertiary biochar water treatment process with or without catalytic ozonation at a WRRF shows a carbon negative global warming potential of −1.21‐kg CO2e/m3 while removing 90%–99% TP and >90% of detected micropollutants.Biochar‐integrated reactive filtration use can aid in long‐term carbon sequestration by reducing the carbon footprint of advanced water treatment in a dose‐dependent manner, allowing an overall carbon‐neutral or carbon‐negative process.A companion paper to this work (Yu et al., 2023) presents the details related to the process operation and mechanism and evaluates the pollutant removal performance of this Fe‐CatOx‐BC‐RF process in engineering laboratory pilot research and field WRRF pilot‐scale water resource recovery trials.Techno‐economic analysis (TEA) of this biochar catalytic oxidation reactive filtration process using Monte Carlo stochastic modeling shows a forecasted carbon‐neutral process cost with low P and micropollutant removal as US$0.11/m3 ± 0.01 for a 3780‐m3/day (1 MGD) scale installation with BC cost at US$0.03/m3 of that total.The results demonstrate the potential of carbon negativity to become a water treatmentperformance standard as important and attainable as pollutant and pathogen removal. [ABSTRACT FROM AUTHOR]

Addressing tropical deforestation in the palm oil sector involves a diverse range of stakeholders who engage or disengage with each other. Palm oil global value chain (GVC) firms (plantation companies, traders and processors, and consumer goods manufacturers and retailers), as well as nongovernmental organisations, financial institutions, consultancies and certification bodies, pursue their respective organisations' agendas through engagement practices, including through coalitions, in a palm oil sustainability network (POSN). Building on interviews with different stakeholder groups, this qualitative study characterises and critically analyses 'stakeholder engagement' by examining (1) the priority targets for engagement among different POSN stakeholders, (2) how mechanisms and tools are used in POSN stakeholder engagement or disengagement for addressing deforestation, and (3) the implications of stakeholder engagement or disengagement for addressing deforestation. Engagement and disengagement practices are shaped by and reshape GVC governance, with powerful stakeholders emerging as knowledge brokers and norm setters, raising important challenges for how deforestation is addressed. [ABSTRACT FROM AUTHOR]

Vulvar cancer is an uncommon malignancy. Vulvar cancer alarmed the public health problem in terms of the cost of diagnostic and medical treatments and psychical health of females. Our study aims to provide a thorough analysis of the global disease burden, related risk factors and temporal incidence trends of vulvar cancer in population subgroups. Data from Global Cancer Observatory and the Cancer Incidence in Five Continents Plus were used for the vulvar cancer incidence. Age‐standardized rates (ASR) were used to depict the incidence of vulvar cancer. The 10‐year trend of incidence was assessed using joinpoint regression with average annual percentage change and 95% confidence intervals in various age groups, while its correlations with risk factors were investigated using linear regression. Higher ASR were found in Western Europe (2.4), Northern America (1.9), Northern Europe (1.9), Australia and New Zealand (1.8) and Eastern Africa (1.4). The associated risk factors of higher vulvar cancer incidence were gross domestic product per capita, Human Development Index, higher prevalence of smoking, alcohol drinking, unsafe sex and human immunodeficiency virus infection. The overall trend of vulvar cancer incidence was increasing. An increasing trend was found in older females while a mixed trend was observed in younger females. The disease burden of vulvar cancer follows a bimodal pattern according to its two histologic pathways, affecting women in both developed and developing regions. Smoking cessation, sex education and human papillomavirus vaccination programs should be promoted among the general population. Subsequent studies can be done to explore the reasons behind the increasing trend of vulvar cancer. [ABSTRACT FROM AUTHOR]

Background: Worldwide, gastric cancer is a leading cause of cancer incidence and mortality. This study aims to devise and validate a scoring system based on readily available clinical data to predict the risk of gastric cancer in a large Chinese population. Methods: We included a total of 6,209,697 subjects aged between 18 and 70 years who have received upper digestive endoscopy in Hong Kong from 1997 to 2018. A binary logistic regression model was constructed to examine the predictors of gastric cancer in a derivation cohort (n = 4,347,224), followed by model evaluation in a validation cohort (n = 1,862,473). The algorithm's discriminatory ability was evaluated as the area under the curve (AUC) of the mathematically constructed receiver operating characteristic (ROC) curve. Results: Age, male gender, history of Helicobacter pylori infection, use of proton pump inhibitors, non‐use of aspirin, non‐steroidal anti‐inflammatory drugs (NSAIDs), and statins were significantly associated with gastric cancer. A scoring of ≤8 was designated as "average risk (AR)". Scores at 9 or above were assigned as "high risk (HR)". The prevalence of gastric cancer was 1.81% and 0.096%, respectively, for the HR and LR groups. The AUC for the risk score in the validation cohort was 0.834, implying an excellent fit of the model. Conclusions: This study has validated a simple, accurate, and easy‐to‐use scoring algorithm which has a high discriminatory capability to predict gastric cancer. The score could be adopted to risk stratify subjects suspected as having gastric cancer, thus allowing prioritized upper digestive tract investigation. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this study is to investigate inter‐planner plan quality variability using a manual forward planning (MFP)‐ or fast inverse planning (FIP, Lightning)‐approach for single brain lesions treated with the Gamma Knife® (GK) Icon™. Methods: Thirty patients who were previously treated with GK stereotactic radiosurgery or radiotherapy were selected and divided into three groups (post‐operative resection cavity, intact brain metastasis, and vestibular schwannoma [10 patients per group]). Clinical plans for the 30 patients were generated by multiple planners using FIP only (1), a combination of FIP and MFP (12), and MFP only (17). Three planners (Senior, Junior, and Novice) with varying experience levels re‐planned the 30 patients using MFP and FIP (two plans per patient) with planning time limit of 60 min. Statistical analysis was performed to compare plan quality metrics (Paddick conformity index, gradient index, number of shots, prescription isodose line, target coverage, beam‐on‐time (BOT), and organs‐at‐risk doses) of MFP or FIP plans among three planners and to compare plan quality metrics between each planner's MFP/FIP plans and clinical plans. Variability in FIP parameter settings (BOT, low dose, and target max dose) and in planning time among the planners was also evaluated. Results: Variations in plan quality metrics of FIP plans among three planners were smaller than those of MFP plans for all three groups. Junior's MFP plans were the most comparable to the clinical plans, whereas Senior's and Novice's MFP plans were superior and inferior, respectively. All three planners' FIP plans were comparable or superior to the clinical plans. Differences in FIP parameter settings among the planners were observed. Planning time was shorter and variations in planning time among the planners were smaller for FIP plans in all three groups. Conclusions: The FIP approach is less planner dependent and more time‐honored than the MFP approach. [ABSTRACT FROM AUTHOR]

Aim: To retrospectively evaluate clinical and microbiological outcomes after combined surgical and medical therapy for diabetic foot infections (DFIs), stratifying between the empirical versus the targeted nature, and between an empirical broad versus a narrow‐spectrum, antibiotic therapy. Methods: We retrospectively assessed the rate of ultimate therapeutic failures for each of three types of initial postoperative antibiotic therapy: adequate empirical therapy; culture‐guided therapy; and empirical inadequate therapy with a switch to targeted treatment based on available microbiological results. Results: We included data from 332 patients who underwent 716 DFI episodes of surgical debridement, including partial amputations. Clinical failure occurred in 40 of 194 (20.6%) episodes where adequate empirical therapy was given, in 77 of 291 (26.5%) episodes using culture‐guided (and correct) therapy from the start, and in 73 of 231 (31.6%) episodes with switching from empirical inadequate therapy to culture‐targeted therapy. Equally, a broad‐spectrum antibiotic choice could not alter this failure risk. Group comparisons, Kaplan–Meier curves and Cox regression analyses failed to show either statistical superiority or inferiority of any of the initial antibiotic strategies. Conclusions: In this study, the microbiological adequacy of the initial antibiotic regimen after (surgical) debridement for DFI did not alter therapeutic outcomes. We recommend that clinicians follow the stewardship approach of avoiding antibiotic de‐escalation and start with a narrow‐spectrum regimen based on the local epidemiology. [ABSTRACT FROM AUTHOR]

Toll‐Like Receptors (TLRs) play a pivotal role in immunity by recognising conserved structural features of pathogens and initiating the innate immune response. TLR signalling is subject to complex regulation that remains poorly understood. Here we show that two small type I transmembrane receptors, TMED2 and 7, that function as cargo sorting adaptors in the early secretory pathway are required for transport of TLRs from the ER to Golgi. Protein interaction studies reveal that TMED7 interacts with TLR2, TLR4 and TLR5 but not with TLR3 and TLR9. On the other hand, TMED2 interacts with TLR2, TLR4 and TLR3. Dominant negative forms of TMED7 suppress the export of cell surface TLRs from the ER to the Golgi. By contrast TMED2 is required for the ER‐export of both plasma membrane and endosomal TLRs. Together, these findings suggest that association of TMED2 and TMED7 with TLRs facilitates anterograde transport from the ER to the Golgi. [ABSTRACT FROM AUTHOR]

Summary: Postoperative systemic inflammation is strongly associated with surgical outcomes, but its relationship with patient‐centred outcomes is largely unknown. Detection of excessive inflammation and patient and surgical factors associated with adverse patient‐centred outcomes should inform preventative treatment options to be evaluated in clinical trials and current clinical care. This retrospective cohort study analysed prospectively collected data from 3000 high‐risk, elective, major abdominal surgery patients in the restrictive vs. liberal fluid therapy for major abdominal surgery (RELIEF) trial from 47 centres in seven countries from May 2013 to September 2016. The co‐primary endpoints were persistent disability or death up to 90 days after surgery, and quality of recovery using a 15‐item quality of recovery score at days 3 and 30. Secondary endpoints included: 90‐day and 1‐year all‐cause mortality; septic complications; acute kidney injury; unplanned admission to intensive care/high dependency unit; and total intensive care unit and hospital stays. Patients were assigned into quartiles of maximum postoperative C‐reactive protein concentration up to day 3, after multiple imputations of missing values. The lowest (reference) group, quartile 1, C‐reactive protein ≤ 85 mg.l‐1, was compared with three inflammation groups: quartile 2 > 85 mg.l‐1 to 140 mg.l‐1; quartile 3 > 140 mg.l‐1 to 200 mg.l‐1; and quartile 4 > 200 mg.l‐1 to 587 mg.l‐1. Greater postoperative systemic inflammation had a higher adjusted risk ratio (95%CI) of persistent disability or death up to 90 days after surgery, quartile 4 vs. quartile 1 being 1.76 (1.31–2.36), p < 0.001. Increased inflammation was associated with increasing decline in risk‐adjusted estimated medians (95%CI) for quality of recovery, the quartile 4 to quartile 1 difference being ‐14.4 (‐17.38 to ‐10.71), p < 0.001 on day 3, and ‐5.94 (‐8.92 to ‐2.95), p < 0.001 on day 30. Marked postoperative systemic inflammation was associated with increased risk of complications, poor quality of recovery and persistent disability or death up to 90 days after surgery. [ABSTRACT FROM AUTHOR]

Background: Roughly 5% of metastatic cancers present with uncertain origin, for which molecular classification could influence subsequent management; however, prior studies of molecular diagnostic classifiers have reported mixed results with regard to clinical impact. In this retrospective study, we evaluated the utility of a novel molecular diagnostic classifier by assessing theoretical changes in treatment and additional testing recommendations from oncologists before and after the review of classifier predictions. Methods: We retrospectively analyzed de‐identified records from 289 patients with a consensus diagnosis of cancer of uncertain/unknown primary (CUP). Two (or three, if adjudication was required) independent oncologists separately reviewed patient clinical information to determine the course of treatment before they reviewed results from the molecular diagnostic classifier and subsequently evaluated whether the predicted diagnosis would alter their treatment plan. Results: Results from the molecular diagnostic classifier changed the consensus oncologist‐reported treatment recommendations for 235 out of 289 patients (81.3%). At the level of individual oncologist reviews (n = 414), 64.7% (n = 268) of treatment recommendations were based on CUP guidelines prior to review of results from the molecular diagnostic classifier. After seeing classifier results, 98.1% (n = 207) of the reviews, where treatment was specified (n = 211), were guided by the tissue of origin‐specific guidelines. Overall, 89.9% of the 414 total reviews either expressed strong agreement (n = 242) or agreement (n = 130) that the molecular diagnostic classifier result increased confidence in selecting the most appropriate treatment regimen. Conclusions: A retrospective review of CUP cases demonstrates that a novel molecular diagnostic classifier could affect treatment in the majority of patients, supporting its clinical utility. Further studies are needed to prospectively evaluate whether the use of molecular diagnostic classifiers improves clinical outcomes in CUP patients. [ABSTRACT FROM AUTHOR]

The top cell of a perovskite silicon tandem solar cell requires several material layers on each side of the perovskite absorber to efficiently extract electrons and holes, respectively. These layers must meet multiple requirements simultaneously, namely, low interface recombination, good charge carrier selectivity, low contact resistivity, and high optical transparency. Due to the complex architecture, characterization techniques are required in material and process optimization to identify loss mechanisms. Spatial resolution of the characterization is gaining importance along with the upscaling of the perovskite technology. Herein, electro‐ and photoluminescence (EL and PL) imaging is combined with illuminated lock‐in thermography (ILIT) for a comprehensive electro‐optical characterization of both subcells in perovskite silicon tandem devices with state‐of‐the‐art cell architecture. Thereby, the combination of the presented characterization methods together with numerical simulation models enables to carry out holistic investigations of device limitations. The strength of this approach is showcased by one particularly remarkable feature that is observed in the investigated tandem device, showing a low PL but high EL signal at local spots. Together with multidimensional optoelectrical device simulations, the measurements are explained and the root cause of this feature to originate from the perovskite/C60 interface is suggested. [ABSTRACT FROM AUTHOR]

Summary: International recommendations encourage liberal administration of oxygen to patients having surgery under general anaesthesia, ostensibly to reduce surgical site infection. However, the optimal oxygen regimen to minimise postoperative complications and enhance recovery from surgery remains uncertain. The hospital operating theatre randomised oxygen (HOT‐ROX) trial is a multicentre, patient‐ and assessor‐blinded, parallel‐group, randomised clinical trial designed to assess the effect of a restricted, standard care, or liberal peri‐operative oxygen therapy regimen on days alive and at home after surgery in adults undergoing prolonged non‐cardiac surgery under general anaesthesia. Here, we report the findings of the internal vanguard feasibility phase of the trial undertaken in four large metropolitan hospitals in Australia and New Zealand that included the first 210 patients of a planned overall 2640 trial sample, with eight pre‐specified endpoints evaluating protocol implementation and safety. We screened a total of 956 participants between 1 September 2019 and 26 January 2021, with data from 210 participants included in the analysis. Median (IQR [range]) time‐weighted average intra‐operative FiO2 was 0.30 (0.26–0.35 [0.20–0.59]) and 0.47 (0.44–0.51 [0.37–0.68]) for restricted and standard care, respectively (mean difference (95%CI) 0.17 (0.14–0.20), p < 0.001). Median time‐weighted average intra‐operative FiO2 was 0.83 (0.80–0.85 [0.70–0.91]) for liberal oxygen therapy (mean difference (95%CI) compared with standard care 0.36 (0.33–0.39), p < 0.001). All feasibility endpoints were met. There were no significant patient adverse events. These data support the feasibility of proceeding with the HOT‐ROX trial without major protocol modifications. [ABSTRACT FROM AUTHOR]

Background and Aim: Worldwide, colorectal cancer (CRC) is the third most common cancer and ranks second among the leading causes of cancer death. This study aims to devise and validate a scoring system based on metabolic parameters to predict the risk of advanced colorectal neoplasia (ACN) in a large Chinese population. Methods: This was a cohort study of 495 584 symptomatic subjects aged 40 years or older who have received colonoscopy in Hong Kong from 1997 to 2017. The algorithm's discriminatory ability was evaluated as the area under the curve (AUC) of the mathematically constructed receiver operating characteristic curve. Results: Age, male gender, inpatient setting, abnormal aspartate transaminase/alanine transaminase, white blood cell, plasma gamma‐glutamyl transferase, high‐density lipoprotein cholesterol, triglycerides, and hemoglobin A1c were significantly associated with ACN. A scoring of < 2.65 was designated as "low risk (LR)." Scores at 2.65 or above had prevalence higher than the overall prevalence and hence were assigned as "high risk (HR)." The prevalence of ACN was 32% and 11%, respectively, for HR and LR groups. The AUC for the risk score in the derivation and validation cohort was 70.12%. Conclusions: This study has validated a simple, accurate, and easy‐to‐use scoring algorithm, which has a high discriminatory capability to predict ACN in symptomatic patients. Future studies should examine its predictive performance in other population groups. [ABSTRACT FROM AUTHOR]

Removal of manganese (Mn) and iron (Fe) oxide coatings from indicators of reduction in soil (IRIS) is considered a function of microbial reduction of these elements under sufficiently reducing conditions, but there may be situations where removal is abiotic. We examined whether abiotic removal of Mn and Fe oxide coatings may be facilitated by organic acids and whether loss of Mn can take place via chemical reduction by ferrous iron (Fe2+) in vitro. Loss of color from Mn‐IRIS in citric acid solution was highest at 1 and 10 mM regardless of pH, with no loss observed at lower concentrations. Effects of citric acid on Fe‐IRIS were also limited to 1 and 10 mM, but color loss only occurred at pH 4.5 and the rate and extent of loss were lower than for Mn‐IRIS. Color loss from Mn‐IRIS in oxalic acid was highest at 1 and 10 mM and increased with decreasing pH. Effects of oxalic acid on loss of color from Fe‐IRIS were limited to 1 and 10 mM. Loss of color from Mn‐IRIS was limited to 10 mM salicylic acid and pH 4.5, with no effect on Fe‐IRIS regardless of concentration and pH. Only the two highest concentrations of Fe2+ (50 and 100 mM) resulted in reduction of the Mn‐IRIS coating and subsequent deposition of an Fe oxide coating. Organic acids and pH have a differential effect on color loss from Mn‐ and Fe‐IRIS, with only high concentrations of organic acids at low pH possibly interfering with interpretation. Core Ideas: Indicators of reduction in soil (IRIS) are used to assess redox conditions in soils, particularly in wetland soils.We assessed the role of organic acids and Fe2+ as interferences in lab experiments.Interference with IRIS is unlikely except for soil with mM concentrations of the organic acids or Fe2+. [ABSTRACT FROM AUTHOR]

Biochar (BC) use in water treatment is a promising approach that can simultaneously help address societal needs of clean water, food security, and climate change mitigation. However, novel BC water treatment technology approaches require operational testing in field pilot‐scale scenarios to advance their technology readiness assessment. Therefore, the objective of this study is to evaluate the system performance of BC integrated into hydrous ferric oxide reactive filtration (Fe‐BC‐RF) with and without catalytic ozonation (CatOx) process in laboratory and field pilot‐scale scenarios. For this investigation, Fe‐BC‐RF and Fe‐CatOx‐BC‐RF pilot‐scale trials were conducted on synthetic lake water variants and at three municipal water resource recovery facilities (WRRFs) at process flows of 0.05 and 0.6 L/s, respectively. Three native and two iron‐modified BCs were used in these studies. The commercially available reactive filtration process (Fe‐RF without BC) had 96%–98% total phosphorus (TP) removal from 0.075‐ and 0.22‐mg/L TP, as orthophosphate process influent in these trials. With BC integration, phosphorus removal yielded 94%–98% with the same process‐influent conditions. In WRRF field pilot‐scale studies, the Fe‐CatOx‐BC‐RF process removed 84%–99% of influent total phosphorus concentrations that varied from 0.12 to 8.1 mg/L. Nutrient analysis on BC showed that the recovered BC used in the pilot‐scale studies had an increase in TP from its native concentration, with the Fe‐amended BC showing better P recovery at 110% than its unmodified state, which was 16%. Lastly, the field WRRF Fe‐CatOx‐BC‐RF process studies showed successful destructive removals at >90% for more than 20 detected micropollutants, thus addressing a critical human health and environmental water quality concern. The research demonstrated that integration of BC into Fe‐CatOx‐RF for micropollutant removal, disinfection, and nutrient recovery is an encouraging tertiary water treatment technology that can address sustainable phosphorus recycling needs and the potential for carbon‐negative operation. Practitioner Points: A pilot‐scale hydrous ferric oxide reactive sand filtration process integrating biochar injection typically yields >90% total phosphorus removal to ultralow levels.Biochar, modified with iron, recovers phosphorus from wastewater, creating a P/N nutrient upcycled soil amendment.Addition of ozone to the process stream enables biochar‐iron‐ozone catalytic oxidation demonstrating typically excellent (>90%) micropollutant destructive removals for the compounds tested.A companion paper to this work explores life cycle assessment (LCA) and techno‐economic analysis (TEA) to explore biochar water treatment integrated reactive filtration impacts, costs, and readiness.Biochar use can aid in long‐term carbon sequestration by reducing the carbon footprint of advanced water treatment in a dose‐dependent manner, including enabling an overall carbon‐negative process. [ABSTRACT FROM AUTHOR]

Non‐hydrogenative Para‐Hydrogen Induced Hyperpolarization (nhPHIP) is a Nuclear Magnetic Resonance (NMR) hyperpolarization technique which has experimentally been used to analyze complex biological samples containing amino acids using the Ir‐IMes hyperpolarization transfer catalyst. A computational study based on Density Function Theory (DFT) was performed on all relevant stereoisomers of [Ir(H)2(IMes)(AA)(Py)] (with AA=glycine, alanine, valine; Py=pyridine), for which R/S chirality and orientation of the amino acid chelation (C/A) were considered. A total of 30 structures were calculated comprising of 6 stereoisomers for achiral glycine, and 12 stereoisomers for each of the chiral amino acids. The abundances derived from the DFT energies confirmed the trends observed in thermal (non‐hyperpolarized) NMR experiments. Additionally, theoretical calculations of electronic (Wiberg bond indices, Natural Bond Orders, Frontier Orbital Analysis), bond dissociation energies, transition states, and activation energies related to interconversion between binding modes, and steric factors (Solid angle) were performed to provide detailed explanations for NMR experimental observations. [ABSTRACT FROM AUTHOR]

Background: Fecal immunochemical test (FIT) is a commonly used initial test for colorectal cancer (CRC) screening. Parallel use of FIT with risk assessment (RA) could improve the detection of non‐bleeding lesions, but at the expense of compromising sensitivity. In this study, we evaluated the accuracy of FIT and/or RA in the Shanghai CRC screening program, and systematically reviewed the relevant evaluations worldwide. Methods: RA and 2‐specimen FIT were used in parallel in the Shanghai screening program, followed by a colonoscopy among those with positive results. Sensitivity, specificity, detection rate of CRC, positive predictive value (PPV), and other measures with their 95% confident intervals were calculated for each type of tests and several assumed combined tests. We further searched PubMed, Embase, Web of Science, and Cochrane Library for relevant studies published in English up to January 5, 2022. Results: By the end of 2019, a total of 1,901,360 participants of the screening program completed 3,045,108 tests, with 1,901,360 first‐time tests and 1,143,748 subsequent tests. Parallel use of RA and 2‐specimen FIT achieved a sensitivity of 0.78 (0.77–0.80), a specificity of 0.78 (0.78–0.78), PPV of 0.89% (0.86–0.92), and a detection rate of 1.99 (1.93–2.05) for CRC per 1000 among participants enrolled in the first screening round, and performed similarly among those who participated for several times. A meta‐analysis of 103 published observational studies demonstrated a higher sensitivity [0.76 (0.36, 0.94)] but a much lower specificity [0.59 (0.28, 0.85)] of parallel use of RA and FIT for detecting CRC in average‐risk populations than in our subjects. One‐specimen FIT, the most commonly used initial test, had a pooled specificity comparable to the Shanghai screening program (0.92 vs. 0.91), but a much higher pooled sensitivity (0.76 vs. 0.57). Conclusion: Our results indicate the limitation of FIT only as an initial screening test for CRC in Chinese populations, and highlight the higher sensitivity of parallel use of RA and FIT. Attempts should be made to optimize RA to improve effectiveness of screening in the populations. [ABSTRACT FROM AUTHOR]

Background: Lip, oral and pharyngeal cancers make up a small percentage of total cancer cases worldwide and have reported lower rates of cancer‐related deaths globally in 2020, but their 5‐year survival rate in either early or advanced stages is different. The study evaluated the global incidence, mortality, risk factors, and temporal trends by age, gender, and geographical locations of lip, oral cavity, and pharyngeal cancer. Methods: Incidence and mortality rates were extracted from Cancer Incidence in Five Continents (CI5) volumes I‐XI, the Nordic Cancer Registries (NORDCAN), the Surveillance, Epidemiology, and End Results (SEER) Program, and the WHO IARC mortality database. Joinpoint regression was used to calculate the Average Annual Percentage Change to examine trends. Results: The highest incidence rates were found in Melanesia and South‐Central Asia and mortality rates were 8.2 and 7.5. Risk factors associated with incidence and mortality included HDI, tobacco use, alcohol consumption, poor diet, and chronic health conditions such as hypertension. Increasing trends of incidence and mortality were observed in females from Malta; males aged 50 and above from the United Kingdom, and females aged 50 and above from Slovakia reporting the largest increase. Conclusions: Although global incidence and mortality trends reported an overall decrease, significant increases were found for older age groups and female subjects. Incidence increase may be due to the growing prevalence of lifestyle, metabolic risk factors, and HPV infections, especially in developed countries. [ABSTRACT FROM AUTHOR]

Species distribution models (SDMs) are becoming an important tool for marine conservation and management. Yet while there is an increasing diversity and volume of marine biodiversity data for training SDMs, little practical guidance is available on how to leverage distinct data types to build robust models. We explored the effect of different data types on the fit, performance and predictive ability of SDMs by comparing models trained with four data types for a heavily exploited pelagic fish, the blue shark (Prionace glauca), in the Northwest Atlantic: two fishery dependent (conventional mark‐recapture tags, fisheries observer records) and two fishery independent (satellite‐linked electronic tags, pop‐up archival tags). We found that all four data types can result in robust models, but differences among spatial predictions highlighted the need to consider ecological realism in model selection and interpretation regardless of data type. Differences among models were primarily attributed to biases in how each data type, and the associated representation of absences, sampled the environment and summarized the resulting species distributions. Outputs from model ensembles and a model trained on all pooled data both proved effective for combining inferences across data types and provided more ecologically realistic predictions than individual models. Our results provide valuable guidance for practitioners developing SDMs. With increasing access to diverse data sources, future work should further develop truly integrative modeling approaches that can explicitly leverage the strengths of individual data types while statistically accounting for limitations, such as sampling biases. [ABSTRACT FROM AUTHOR]

Due to its excellent bioactivity profile, which is increasingly utilized in pharmaceutical and synthetic chemistry, spirooxindole is an important core scaffold. We herein describe an efficient method for the construction of highly functionalized new spirooxindolocarbamates via a gold‐catalyzed cycloaddition reaction of terminal alkynes or ynamides with isatin‐derived ketimines. This protocol has a good functional group compatibility, uses readily available starting materials, mild reaction conditions, low catalyst loadings and no additives. It enables the transformation of various functionalized alkyne groups into cyclic carbamates. Gram‐scale synthesis was achieved and DFT calculations verify the feasibility of the mechanistic proposal. Some of the target products exhibit good to excellent antiproliferative activity on human tumor cell lines. In addition, one of the most active compounds displayed a remarkable selectivity towards tumor cells over normal ones. [ABSTRACT FROM AUTHOR]

Aufgrund seines hervorragenden Bioaktivitätsprofils, das zunehmend in der pharmazeutischen und synthetischen Chemie genutzt wird, ist Spirooxindol ein wichtiger Grundbaustein. Wir beschreiben hier eine effiziente Methode zum Aufbau hochfunktionalisierter neuer Spirooxindolocarbamate über eine Gold‐katalysierte Cycloadditionsreaktion von terminalen Alkinen oder Inamiden mit von Isatin abgeleiteten Ketiminen. Dieses Protokoll weist eine gute Kompatibilität mit funktionellen Gruppen auf, verwendet leicht verfügbare Ausgangsstoffe, milde Reaktionsbedingungen, geringe Katalysatorbeladungen und keine Additive. Es ermöglicht die Umwandlung verschiedener funktionalisierter Alkingruppen in zyklische Carbamate. Es gelang eine Synthese im Grammmaßstab und DFT‐Berechnungen bestätigen die Machbarkeit des mechanistischen Ansatzes. Einige der Zielprodukte zeigen eine gute bis ausgezeichnete antiproliferative Aktivität auf menschlichen Tumorzelllinien. Darüber hinaus zeigte eine der aktivsten Verbindungen eine bemerkenswerte Selektivität für Tumorzellen gegenüber normalen Zellen. [ABSTRACT FROM AUTHOR]

Ectothermy and endothermy in extant fishes are defined by distinct integrated suites of characters. Although only ⁓0.1% of fishes are known to have endothermic capacity, recent discoveries suggest that there may still be uncommon pelagic fish species with yet to be discovered endothermic traits. Among the most rarely encountered marine fishes, the louvar Luvarus imperialis is a remarkable example of adaptive evolution as the only extant pelagic species in the order Acanthuriformes (including surgeonfishes, tangs, unicornfishes and Moorish idol). Magnetic resonance imaging and gross necropsy did not yield evidence of cranial or visceral endothermy but revealed a central‐posterior distribution of myotomal red muscle that is a mixture of the character states typifying ectotherms (lateral‐posterior) and red muscle endotherms (central‐anterior). Dissection of a specimen confirmed, and an osteological proxy supported, that L. imperialis has not evolved the vascular rete that is vital to retaining heat in the red muscle. The combination of presumably relying on caudal propulsion while exhibiting internal red muscle without associated retia is unique to L. imperialis among all extant fishes, raising the macroevolutionary question of whether this species – in geologic timescales – will remain an ectotherm or evolve red muscle endothermy. [ABSTRACT FROM AUTHOR]

Objectives: The objective of this study is to evaluate the user‐defined optimization settings in the Fast Inverse Planning (FIP) optimizer in Leksell GammaPlan® and determine the parameters that result in the best stereotactic radiosurgery (SRS) plan quality for brain metastases, benign tumors, and arteriovenous malformations (AVMs). Methods: Thirty patients with metastases and 30 with benign lesions—vestibular schwannoma, AVMs, pituitary adenoma, and meningioma‐treated with SRS were evaluated. Each target was planned by varying the low dose (LD) and beam‐on‐time (BOT) penalties in increments of 0.1, from 0 to 1. The following plan quality metrics were recorded for each plan: Paddick conformity index (PCI), gradient index (GI), BOT, and maximum organ‐at‐risk (OAR) doses. A novel objective score matrix was calculated for each target using a linearly weighted combination of the aforementioned metrics. A histogram of optimal solutions containing the five best scores was extracted. Results: A total of 7260 plans were analyzed with 121 plans per patient for the range of LD/BOT penalties. The ranges of PCI, GI, and BOT across all metastatic lesions were 0.58–0.97, 2.1–3.8, and 8.8–238 min, respectively, and were 0.13–0.97, 2.1–3.8, and 8.8–238 min, respectively, for benign lesions. The objective score matrix showed unique optimal solutions for metastatic lesions and benign lesions. Additionally, the plan metrics of the optimal solutions were significantly improved compared to the clinical plans for metastatic lesions with equivalent metrics for all other cases. Conclusion: In this study, FIP optimizer was evaluated to determine the optimal solution space to maximize PCI and minimize GI, BOT and OAR doses simultaneously for single metastatic/benign/non‐neoplastic targets. The optimal solution chart was determined using a novel objective score which provides novice and expert planners a roadmap to generate the most optimal plans efficiently using FIP. [ABSTRACT FROM AUTHOR]

Three events are presented where high‐resolution measurements from the Swarm satellites coincided with excellent F‐region ionospheric coverage from The Super Dual Auroral Radar Network (SuperDARN). Large‐scale ionospheric convection patterns from SuperDARN, together with field‐aligned‐current patterns from he Active Magnetosphere and Planetary Response Experiment (AMPERE), provide information on quasi‐static ionospheric dynamics traversed by Swarm. Because the Swarm observations and orbital path coincided with favorable SuperDARN/AMPERE observing conditions, it was possible to filter the Swarm electric field observations into a quasi‐static component that agreed with the SuperDARN electric field. The residual electric field from Swarm is thus indicative of small‐ and mesoscale dynamics not captured by the convection and field‐aligned current (FAC) patterns. Calculations of the Poynting flux between the different instruments show that dynamics on small‐to mesoscales can be highly variable within structures like FACs. In the events shown, small‐ and medium‐scale Poynting fluxes occasionally dominate over those from large‐scale processes. Plain Language Summary: A significant amount of energy from the solar wind deposited into the upper atmosphere of Earth (above ∼100 km altitude) is contained within small‐scale (on the order of kilometers) fluctuations of the electric field. This kind of variability is difficult to measure do the sparse resolution (both in space and time) of instruments like ground‐based instruments, or the global fitting procedures of satellite constellations. Those instruments, which tend to focus on observing large‐scale "big picture" dynamics, do however excel at providing important information about the global state of the upper atmosphere. Small‐scale (∼1 km) data from the Swarm satellites is used in this letter, in conjunction with ground‐based radars and a satellite constellation, to obtain a complete picture of how space weather energy dissipation is spread across all scale sizes. It is found that small features that only Swarm can see occasionally dominate in terms of energy balance. Key Points: Filtered electric fields from the Swarm satellites agree with SuperDARNVariable and high‐magnitude Poynting flux structures are embedded in and between field‐aligned currentsPoynting flux from sub‐quasi‐static dynamics can comprise as much as half of the total [ABSTRACT FROM AUTHOR]

Iron–ozone catalytic oxidation (CatOx) shows promise in addressing challenging wastewater pollutants. This study investigates a CatOx reactive filtration (Fe-CatOx-RF) approach with two 0.4L/s field pilot studies and an 18-month, 18L/s full-scale municipal wastewater deployment. We apply ozone to leverage common sand filtration and iron metal salts used in water treatment into a next-generation technology. The process combines micropollutant and pathogen destructive removal with high-efficiency phosphorus removal and recycling as a soil amendment, clean water recovery, and the potential for carbon-negative operation with integrated biochar water treatment. A key process innovation is converting a continuously renewed iron oxide coated, moving bed sand filter into a “sacrificial iron” d-orbital catalyst bed after adding O3 to the process stream. Results for the Fe-CatOx-RF pilot studies show >95% removal efficiencies for almost all >5× LoQ detected micropollutants, with removal rates slightly increasing with biochar addition. Phosphorus removal for the pilot site with the most P-impacted discharge was >98% with serial reactive filters. The long-term, full-scale Fe-CatOx-RF optimization trials showed single reactive filter 90% TP removal and high-efficiency micropollutant removals for most of the compounds detected, but slightly less than the pilot site studies. TP removal decreased to a mean of 86% during the 18L/s, 12-month continuous operation stability trial, and micropollutant removals remained similar to the optimization trial for many detected compounds but less efficient overall. A >4.4 log reduction of fecal coliforms and E. coli in a field pilot sub-study suggests the ability of this CatOx approach to address infectious disease concerns. Life cycle assessment modeling suggests that integrating biochar water treatment into the Fe-CatOx-RF process for P recovery as a soil amendment makes the overall process carbon-negative at −1.21 kg CO2e/m³. Results indicate positive Fe-CatOx-RF process performance and technology readiness in full-scale extended testing. Further work exploring operational variables is essential to establish site-specific water quality limitations and responsive engineering approaches for process optimization. Practitioners Points • Adding ozone to WRRF secondary influent flows into tertiary ferric/ferrous salt dosed sand filtration amplifies a mature reactive filtration technology into a catalytic oxidation process for micropollutant removal and disinfection. • Expensive catalysts are not used. • Iron oxide compounds used to remove phosphorus and other pollutants act as sacrificial catalysts with ozone, and these rejected iron compounds can be returned upstream to aid in secondary process TP removal. • Biochar addition to the CatOx process improves CO2e sustainability and phosphorus removal/recovery for long-term soil and water health. • Short duration field pilot scale and 18-month full-scale operation at three WRRFs with good results demonstrate technology readiness. [ABSTRACT FROM AUTHOR]