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Abstract We present a nation-wide network analysis of non-fatal opioid-involved overdose journeys in the United States. Leveraging a unique proprietary dataset of Emergency Medical Services incidents, we construct a journey-to-overdose geospatial network capturing nearly half a million opioid-involved overdose events spanning 2018–2023. We analyze the structure and sociological profiles of the nodes, which are counties or their equivalents, characterize the distribution of overdose journey lengths, and investigate changes in the journey network between 2018 and 2023. Our findings include that authority and hub nodes identified by the HITS algorithm tend to be located in urban areas and involved in overdose journeys with particularly long geographical distances.

Abstract Background Endogeneous and exogeneous sex hormones can impact the frequency and severity of migraine attacks, but the underlying mechanisms are poorly understood. In this study, we investigate the relationship between female sex hormones and Pituitary Adenylate Cyclase-Activating Polypeptide-38 (PACAP-38) concentrations in plasma of women with migraine and healthy controls, aiming to elucidate potential hormonal influences on PACAP dynamics and their relevance to migraine pathophysiology. Methods This analysis is part of a cross-sectional, matched-cohort study. We recruited two groups of women with episodic migraine: one with a regular menstrual cycle (M-RMC) and another undergoing combined oral contraceptive treatment (M-COC). Additionally, we included corresponding age-matched control groups without migraine for both categories (C-RMC and C-COC). For participants with a RMC, the study visits were scheduled during the perimenstrual period (menstrual cycle day 2 ± 2) and periovulatory period (day 13 ± 2). Participants using COC were examined at day 4 ± 2 of the hormone-free interval and between day 7–14 of the hormone intake phase. During these visits, PACAP-38 concentrations in plasma were measured using a commercial Enzyme-linked-immunosorbent assay (ELISA) kit. Results The study included 120 women, with 30 participants in each group. Women with migraine and a RMC had significantly higher PACAP-38 plasma concentrations compared to healthy controls at both study visits [day 2 ± 2: M-RMC: 2547.41 pg/ml (IQR 814.27 – 4473.48) vs. C-RMC: 1129.49 pg/ml (IQR 257.34 – 2684.88), p = 0.025; day 13 ± 2: M-RMC: 3098.89 pg/ml (IQR 1186.29 – 4379.47) vs. C-RMC: 1626.89 (IQR 383.83 – 3038.36), p = 0.028]. In contrast, PACAP-38 levels were comparable between migraine and control groups receiving COC. Women with migraine and a RMC exhibited higher PACAP-38 concentrations during menstruation compared to those using COC during the hormone-free interval. Conclusion Systemic PACAP-38 concentrations in women vary based on the presence of migraine diagnosis and their hormonal status.

The IR absorption mapping of two multiblock copolymers based on poly(ethylene glycol) and poly(ε-caprolactone) segments (PEG-b-PCL) in poly(acid lactic) and poly(ε-caprolactone) blends (PLA/PCL) was performed via AFM nanoscale IR spectroscopy. These copolymers, having the same number average molar masses (Mn‾) but varying block sizes, were added into the blend in different amounts (1 and 5 wt%) using a co-rotating twin-screw extrusion. The results revealed that copolymers with smaller blocks are preferentially located near the interface when incorporated in small quantities. Increasing the copolymer content led to preferential diffusion into the PLA matrix. Compatibilization with the longer block-size copolymers also led to preferential diffusion in the PLA matrix, albeit with a tendency to form micelles. This hampers the overall mechanical properties of the blend, making the compatibilized blend more brittle than neat PLA. Compatibilization with the short block-size copolymers showed no micellization and improved the mechanical behavior of PLA/PCL.

Abstract Previous studies of DNA sequence and karyotypic data have revealed high genetic diversity in the Physalaemus cuvieri – Physalaemus ephippifer species complex—a group of small leptodactylid frogs in South America. To date, seven major genetic lineages have been recognized in this group, with species delimitation tests supporting four to seven of them as valid species. Among these, only P. ephippifer shows heteromorphic sex chromosomes, but the implications of cytogenetic divergence for the evolution of this group are unknown. We analyzed karyotypic, mitochondrial DNA, and 3RAD genomic data to characterize a putative contact zone between P. ephippifer and P. cuvieri Lineage 1, finding evidence for admixture and karyotypic evolution. We also describe preliminary evidence for admixture between two other members of this species complex—Lineage 1 and Lineage 3 of P. cuvieri. Our study sheds new light on evolutionary relationships in the P. cuvieri – P. ephippifer species complex, suggesting an important role of karyotypic divergence in its evolutionary history and underscoring the importance of hybridization as a mechanism of sex chromosome evolution in amphibians.

Background: Non-steroidal anti-inflammatory drugs (NSAIDs) are widely used in therapy due to their anti-inflammatory and analgesic properties. However, their clinical use is often associated with gastrointestinal complications. Thus, this study aimed to investigate the protective effect of a sulfated iota-carrageenan isolated from the marine alga Solieria filiformis (IC-Sf) against naproxen-induced gastrointestinal injury. Methods: Parameters of gastrointestinal injury, secretory and motor functions, and toxicity were evaluated. Results: The results demonstrated that IC-Sf significantly reduced naproxen-induced gastrointestinal macroscopic injury, with a maximum effect observed at 30 mg/kg. IC-Sf also preserved gastrointestinal antioxidant defense and prevented lipid peroxidation, with a reduction in the non-protein sulfhydryl group (NP-SH) and malondialdehyde (MDA) concentrations induced by naproxen. Additionally, IC-Sf mitigated naproxen-induced gastrointestinal inflammation, as evidenced by reduced myeloperoxidase (MPO) activity, tumor necrosis factor-alpha (TNF-α), and interleukin-1 beta (IL-1β). IC-Sf did not alter gastric secretion or gastrointestinal motility. In addition, the animals treated with IC-Sf did not present toxic effects. Conclusions: In conclusion, IC-Sf protected the gastrointestinal tract against the harmful effects of naproxen by inhibiting the inflammatory response and lipid peroxidation, suggesting its potential as a new therapeutic agent or food additive.

One of the sources of sustainable energy with great, still untapped potential is wind power. One way to harness such potential is to develop technology for offshore use, more specifically at high depths with floating turbines. It is always critical that their structural designs guarantee that their natural frequencies of vibration do not match the frequencies of the most important oscillatory loads to which they will be subjected. This avoids resonance and its excessive undesired oscillatory responses. Based on that, a 3D finite element model of a 15 MW semi-submersible floating offshore wind turbine was developed in the commercial software ANSYS Mechanical ® to study its dynamic behavior and contribute to the in-depth analysis of structural modeling of FOWTs. A tower and floating platform were individually modeled and coupled together. The natural frequencies and modes of vibration of the coupled system and of its components were obtained by modal analysis, not only to verify the resonance, but also to investigate the determinant factors affecting such behaviors, which are not extensively discussed in literature. It was found that there is strong coupling between the components and that the tower affects the system as a result of its stiffness, and the floater as a result of its rotational inertia. The platform’s inertia comes mainly from the ballast and the effects of added mass, which was considered to be a literal increase in mass and was modeled in two manners: first, it was approximately calculated and distributed along the submerged flexible platform members and then as a nodal inertial element with the floater being considered as a rigid body. The second approach allowed an iterative analysis for non-zero frequencies of vibration, which showed that a first approximation with an infinite period is sufficiently accurate. Furthermore, the effects of the mooring lines was studied based on a linear model, which showed that they do not affect the boundary conditions at the bottom of the tower in a significant way.

Abstract Background People with physical disabilities and/or chronic diseases tend to have an inactive lifestyle. Monitoring physical activity levels is important to provide insight on how much and what types of activities people with physical disabilities and/or chronic diseases engage in. This information can be used as input for interventions to promote a physically active lifestyle. Therefore, valid and reliable physical activity measurement instruments are needed. This scoping review aims 1) to provide a critical mapping of the existing literature and 2) directions for future research on measurement properties of device-based instruments assessing physical activity behavior in ambulant adults with physical disabilities and/or chronic diseases. Methods Four databases (MEDLINE, CINAHL, Web of Science, Embase) were systematically searched from 2015 to April 16th 2023 for articles investigating measurement properties of device-based instruments assessing physical activity in ambulatory adults with physical disabilities and/or chronic diseases. For the majority, screening and selection of eligible studies were done in duplicate. Extracted data were publication data, study data, study population, device, studied measurement properties and study outcome. Data were synthesized per device. Results One hundred three of 21566 Studies were included. 55 Consumer-grade and 23 research-grade devices were studied on measurement properties, using 14 different physical activity outcomes, in 23 different physical disabilities and/or chronic diseases. ActiGraph (n = 28) and Fitbit (n = 39) devices were most frequently studied. Steps (n = 68) was the most common used physical activity outcome. 97 studies determined validity, 11 studies reliability and 6 studies responsiveness. Conclusion This scoping review shows a large variability in research on measurement properties of device-based instruments in ambulatory adults with physical disabilities and/or chronic diseases. The variability highlights a need for standardization of and consensus on research in this field. The review provides directions for future research.

Covering: 2019 to 2023. Even with the advent of modern and complementary spectroscopy techniques, comprehensive characterization of natural product continues to represent an onerous and time-consuming task, being far away to become rather “routine”. Mainly due to their highly complex structures and small amount of isolated sample, in milligram or sub-milligram quantities, structural misassignment of natural products are still a recurrence theme in the modern literature. Since the seminal paper from Nicolau and Snider, in 2005, evaluating the various cases of reassignment of natural products, from the present era, in which NMR parameters calculations play such an important role in the structural elucidation of natural products, helping to uncover and ultimately revise the structure of previously reported compounds, a pertinent question arises: are we still chasing molecules that were never there? In this minireview, we intent to discuss the current state of computational NMR parameter calculations, with a particular focus on their application in the structural determination of natural products. Additionally, we have conducted a comprehensive survey of the literature spanning the years 2019–2023, in order to select and discuss recent noteworthy cases of incorrectly assigned structures that were revised through NMR calculations. Therefore, our main goal is to show what can be done through computational simulations of NMR parameters, currently user-friendly and easily implemented by non-expert users with basic skills in computational chemistry, before venturing into complex and time-consuming total synthesis projects. In conclusion, we anticipate a promising future for NMR parameter calculations, fueled by the ongoing development of user-friendly tools and the integration of artificial intelligence. The emergence of these advancements is poised to broaden the applications of NMR simulations, offering a more accessible and reliable means to address the persistent challenge of structural misassignments in natural product chemistry.

Endometrial and cervical cancer are among the most frequently diagnosed malignancies globally. Nitric oxide receptor-soluble guanylyl cyclase (sGC) is a heterodimeric enzyme composed of two subunits, α1 and β1. Previously we showed that sGCα1 subunit promotes cell survival, proliferation, and migration, but the role of sGCβ1 subunit has not been addressed. The aim of the present work was to study the impact of sGCβ1 restoration in proliferation, survival, migration, and cell signaling in endometrial and cervical cancer cells. We found that sGCβ1 transcript levels are reduced in endometrial and cervical tumors vs normal tissues. We confirmed nuclear enrichment of sGCβ1, unlike sGCα1. Overexpression of sGCβ1 reduced cell viability and augmented apoptotic index. Cell migration and invasion were also negatively affected. All these sGCβ1-driven effects were independent of sGC enzymatic activity. sGCβ1 reduced the expression of epithelial-to-mesenchymal transition factors such as N-cadherin and β-catenin and increased the expression of E-cadherin. sGCβ1 impacted signaling in endometrial and cervical cancer cells through significant downregulation of Akt pathway affecting some of its main targets such as GSK-3β and c-Raf. Our results show for the first time that sGCβ1 exerts several antiproliferative actions in ECC-1 and HeLa cell lines by targeting key regulatory pathways.

Seven new abietane diterpenoids, comprising medusanthol A–G (1–3, 5, 7–9) and two previously identified analogs (4 and 6), were isolated from the hexane extract of the aerial parts of Medusantha martiusii. The structures of the compounds were elucidated by HRESIMS, 1D/2D NMR spectroscopic data, IR spectroscopy, NMR calculations with DP4+ probability analysis, and ECD calculations. The anti-neuroinflammatory potential of compounds 1–7 was evaluated by determining their ability to inhibit the production of nitric oxide (NO) and the proinflammatory cytokine TNF-α in BV2 microglia stimulated with LPS and IFN-γ. Compounds 1–4 and 7 exhibited decreased NO levels at a concentration of 12.5 µM. Compound 1 demonstrated strong activity with an IC50 of 3.12 µM, and compound 2 had an IC50 of 15.53 µM; both compounds effectively reduced NO levels compared to the positive control quercetin (IC50 11.8 µM). Additionally, both compounds significantly decreased TNF-α levels, indicating their potential as promising anti-neuroinflammatory agents.

Abstract The current study focuses on the investigation of AVPR2 (VTR2C) protein-coupled receptor variants specific to different primate taxa. AVPR2 is activated by the neurohormone AVP, which modulates physiological processes, including water homeostasis. Our findings reveal positive selection at three AVPR2 sites at positions 190, 250, and 346. Variation at position 250 is associated with human Congenital Nephrogenic Diabetes Insipidus (cNDI), a condition characterized by excessive water loss. Other 13 functional sites with potential adaptive relevance include positions 185, 202, 204, and 252 associated with cNDI. We identified SH3-binding motifs in AVPR2’s ICL3 and N-terminus domains, with some losses observed in clades of Cercopithecidae, Callitrichinae, and Atelidae. SH3-binding motifs are crucial in regulating cellular physiology, indicating that the differences may be adaptive. Co-evolution was found between AVPR2 residues and those in the AVP signal peptide/Neurophysin-2 and AQP2, other molecules in the same signaling cascade. No significant correlation was found between these Primates’ taxon-specific variants and the bioclimatic variables of the areas where they live. Distinct co-evolving amino acid sequences in functional sites were found in Platyrrhini and Catarrhini, which may have adaptive implications involving glucocorticoid hormones, suggesting varied selective pressures. Further studies are required to confirm these results.

Abstract Background Clinical trials and real-world studies revealed a spectrum of response to CGRP(-receptor) monoclonal antibodies (mAbs) in migraine prophylaxis, ranging from no effect at all to total migraine freedom. In this study, we aimed to compare clinical characteristics between super-responders (SR) and non-responders (NR) to CGRP(-receptor) mAbs. Methods We performed a retrospective cohort study at the Headache Center, Charité – Universitätsmedizin Berlin. The definition of super-response was a ≥ 75% reduction in monthly headache days (MHD) in the third month after treatment initiation compared to the month prior to treatment begin (baseline). Non-response was defined as ≤ 25% reduction in MHD after three months of treatment with a CGRP-receptor mAb and subsequent three months of treatment with CGRP mAb, or vice versa. We collected demographic data, migraine disease characteristics, migraine symptoms during the attacks in both study groups (SR/NR) as well as the general medical history. SR and NR were compared using Chi-square test for categorical variables, and t-test for continuous variables. Results Between November 2018 and June 2022, n = 260 patients with migraine received preventive treatment with CGRP(-receptor) mAbs and provided complete headache documentation for the baseline phase and the third treatment month. Among those, we identified n = 29 SR (11%) and n = 26 NR (10%). SR reported more often especially vomiting (SR n = 12/25, 48% vs. NR n = 4/22, 18%; p = 0.031) and typical migraine characteristics such as unilateral localization, pulsating character, photophobia and nausea. A subjective good response to triptans was significantly higher in SR (n = 26/29, 90%) than in NR (n = 15/25, 60%, p = 0.010). NR suffered more frequently from chronic migraine (NR n = 24/26, 92% vs. SR n = 15/29, 52%; p = 0.001), medication overuse headache (NR n = 14/24, 58% versus SR n = 8/29, 28%; p = 0.024), and concomitant depression (NR n = 17/26, 65% vs. SR n = 8/29, 28%; p = 0.005). Conclusion Several clinical parameters differ between SR and NR to prophylactic CGRP(-R) mAbs. A thorough clinical evaluation prior to treatment initiation might help to achieve a more personalized management in patients with migraine.

Abstract Background Patients with sarcopenia have a higher risk of poor recovery after coronary artery bypass grafting (CABG). Little is known about the impact of changes in muscle strength (the primary indicator for sarcopenia) on health-related quality of life (HR-QoL). This study aimed to (1) identify subgroups with different muscle strength trajectories, (2) identify differences in preoperative risk factors among trajectory group membership, and (3) explore their prognostic value on postoperative HR-QoL in patients undergoing CABG. Methods In this prospective observational study 131 patients undergoing elective CABG completed grip strength tests and HR-QoL questionnaires. Latent Class Growth Mixture Modelling (LCGMM) was used to identify clinically relevant trajectories (> 5% of study population) for weight-normalised grip strength, measured at admission, 3 days, and 6 months after surgery. Differences between trajectory group membership at baseline were evaluated. The impact of trajectory group membership on postoperative HR-QoL was evaluated with multiple linear regression models. Results Due to low numbers (n = 15), female patients were excluded from LCGMM and subsequent statistical analyses. In males (n = 116), we identified two main weight-normalised grip strength trajectories: a “stable average” trajectory with a slight decline immediately post-surgery and recovery to preoperative levels (n = 85) and a “high” trajectory with a considerable immediate decline after surgery but followed towards a higher level of recovery compared to preoperative level (n = 27). The “stable average” patients were older (68 vs. 57 years; P = 0.003), had more diabetes (27% vs. 4%; P = 0.01) and had a higher BMI (27.8 vs. 24.8; P = 0.005) compared to the “high” group. After correction for age, diabetes, and baseline HR-QoL, group trajectory membership was not associated with postoperative HR-QoL, yet an increase in individual change scores of weight-normalised grip strength was associated with a better postoperative HR-QoL. We also identified one small trajectory group (n = 4, ≤ 5%). Conclusions This study showed two relevant weight-normalised grip strength trajectories in male patients undergoing CABG, varying in important preoperative risk factors. While change scores of grip strength per weight did predict postoperative HR-QoL, the trajectory subgroups could not predict postoperative HR-QoL. Future research should focus on female patients, reacting potentially different on CABG and/or rehabilitation treatment. Trial registration NCT03774342, 12-12-2018.

Electric induction motors are the type of motor most commonly operated in industry, and for this reason technologies that predict faults and reduce the corrective maintenance are of great interest. In this context, this paper presents a predictive maintenance tool of electric motors using the concepts of Digital Twin (DT) and Industrial Internet of Things (IIoT). The proposed system is innovative, as it monitors the motor current and temperature by means of sensors and a low-cost acquisition module, and these measurements are sent via Wi-Fi to a database. The concept of DT was leveraged by providing the measurements as inputs to a high-fidelity strongly-coupled model of the monitored monitor, using the Finite Element Method (FEM). The results obtained are satisfactory, because the sensors used presented acceptable errors that do not interfere with the reliability of the results. The computer simulation showed relative errors below 4% in the conductivity analysis and 10% in the temperature analysis. In addition, the simulation allows verifying the internal temperature of the motor, its resistive losses, and the intensity of the magnetic flux at each pole. It is worth pointing out that the internal analysis performed is only possible due to the combination of IIoT and computer simulations. Therefore, they allow a better diagnosis of the motor’s operational status and also a time estimate for the next maintenance service, thus being ideal for the industrial sector.

The Great Horned Owl (Bubo virginianus) inhabits myriad habitats throughout the Americas and shows complex patterns of individual and geographic morphological variation. The owl family Strigidae is known to follow ecogeographic rules, such as Gloger’s rule. Although untested at the species level, these ecogeographic rules may affect B. virginianus plumage coloration and body size. Previous studies have indicated that, despite this species’ morphological variability, little genetic differentiation exists across parts of their range. This study uses reduced representation genome-wide nuclear and complete mitochondrial DNA sequence data to assess range-wide relationships among B. virginianus populations and the disputed species status of B. v. magellanicus (Magellanic or Lesser Horned Owl) of the central and southern Andes. We found shallow phylogenetic relationships generally structured latitudinally to the north of the central Andes, and a deep divergence between a southern and northern clade close to the Marañón Valley in the central Andes, a common biogeographic barrier. We identify evidence of gene flow between B. v. magellanicus and other subspecies based on mitonuclear discordance and F-branch statistics. Overall differences in morphology, plumage coloration, voice, and genomic divergence support species status for B. v. magellanicus.

Abstract Background Hand-rim wheelchair propulsion is straining and mechanically inefficient, often leading to upper limb complaints. Previous push–pull lever propulsion mechanisms have shown to perform better or equal in efficiency and physiological strain. Propulsion biomechanics have not been evaluated thus far. A novel push–pull central-lever propulsion mechanism is compared to conventional hand-rim wheelchair propulsion, using both physiological and biomechanical outcomes under low-intensity steady-state conditions on a motor driven treadmill. Methods In this 5 day (distributed over a maximum of 21 days) between-group experiment, 30 able-bodied novices performed 60 min (5 × 3 × 4 min) of practice in either the push–pull central lever wheelchair (n = 15) or the hand-rim wheelchair (n = 15). At the first and final sessions cardiopulmonary strain, propulsion kinematics and force production were determined in both instrumented propulsion mechanisms. Repeated measures ANOVA evaluated between (propulsion mechanism type), within (over practice) and interaction effects. Results Over practice, both groups significantly improved on all outcome measures. After practice the peak forces during the push and pull phase of lever propulsion were considerably lower compared to those in the handrim push phase (42 ± 10 & 46 ± 10 vs 63 ± 21N). Concomitantly, energy expenditure was found to be lower as well (263 ± 45 vs 298 ± 59W), on the other hand gross mechanical efficiency (6.4 ± 1.5 vs 5.9 ± 1.3%), heart-rate (97 ± 10 vs 98 ± 10 bpm) and perceived exertion (9 ± 2 vs 10 ± 1) were not significantly different between modes. Conclusion The current study shows the potential benefits of the newly designed push–pull central-lever propulsion mechanism over regular hand rim wheelchair propulsion. The much lower forces and energy expenditure might help to reduce the strain on the upper extremities and thus prevent the development of overuse injury. This proof of concept in a controlled laboratory experiment warrants continued experimental research in wheelchair-users during daily life.

Non-native species can have profound implications on the survival of native ones. This is especially true for some invasive crabs, such as the green crab Carcinus maenas, a native species to the Northern Hemisphere that has been introduced into southern Argentina, from where it could expand through Argentina, Chile, and the Antarctic Peninsula. Hence, there is interest in forecasting changes in C. maenas habitat suitability through time to predict if potential future invasions might occur. Here, by using a Species Distribution Model (SDM) approach, we estimated the habitat suitability for C. maenas along southern South America and the Antarctic Peninsula under two future climate-change scenarios. Our results reveal that under current conditions, habitat suitability for C. maenas along the Antarctic Peninsula is null and very restricted in Argentina and Chile. Habitat suitability along the Antarctic Peninsula remained null in the short-term (30 years) and long-term future (80 years), despite the climate-change scenario considered. Surprisingly, when considering future conditions, habitat suitability along the coast of Argentina and Chile decreased and became nil for some currently occupied locations. Thus, the SDM results suggest that climate change could have a negative effect on the habitat suitability of C. maenas leading to potential local extinctions.

Wheelchair tennis players are prone to develop shoulder injuries, due to the combination of wheelchair propulsion, overhead activities and daily wheelchair activities. A methodical literature search was conducted to identify articles on shoulder complaints in wheelchair tennis, wheelchair sports and tennis. The aims were to identify (1) type of shoulder complaints; (2) possible risk factors for the development of shoulder injuries; (3) musculoskeletal adaptations in the shoulder joint in wheelchair tennis players. Fifteen papers were included in this review, five on wheelchair tennis, three on wheelchair sports and seven on tennis. Type of shoulder complaints were acromioclavicular pathology, osteoarthritic changes, joint effusion and rotator cuff tears. Possible risk factors for the development of shoulder injuries in wheelchair tennis are overhead movements, repetitive activation of the anterior muscle chain and internal rotators, as well as a higher spinal cord injury level. Muscular imbalance with higher values for the internal rotators, increase in external range of motion, decrease in internal range of motion and reduced total arc of motion were the most common proposed musculoskeletal adaptations due to an unbalanced load. These presented risk factors and musculoskeletal adaptations might help researchers, coaches and wheelchair tennis players to prevent shoulder injuries.

Objectives Despite the many proven advantages of a physically active lifestyle in patient populations, prescription of exercise is currently not widely implemented in routine clinical practice. The aims of this study were twofold: (1) to assess perceptions of clinicians on the current practice of exercise is medicine (E=M) prescription in two Dutch university medical centres and (2) to determine their perceived barriers and facilitators for the implementation of E=M in routine clinical care in Dutch university medical centres.Design A mixed methodologies study, using both online questionnaires and semi-structured interviews.Setting Dutch university medical centres.Participants Clinicians working within the departments of medical oncology, orthopaedics and rehabilitation medicine of two university medical centres.Results Forty-five clinicians (response rate of 51%) completed the questionnaire, and 19 clinicians were interviewed. The results showed that even though clinicians had a positive attitude towards prescribing E=M, only a few reported to regularly prescribe E=M to their patients. The 52 identified facilitators and barriers for implementation of E=M were categorised into four main themes: (1) beliefs toward the implementation of E=M (eg, clinicians knowledge and skills, and social support), (2) factors related to the patient perspective (eg, patient priorities or motivation), (3) factors related to the referral options (eg, knowledge of and trust in local referral options) and (4) practical considerations when implementing E=M (eg, time constraints).Conclusions Our study showed that even though many clinicians have a positive attitude toward an active lifestyle, many are not prescribing E=M on a regular basis. In order for clinicians to effectively implement E=M, strategies should focus on increasing clinicians E=M referral skills, improving clinicians knowledge of E=M referral options and develop a support system to ensure that E=M is high on the priority list of clinicians.

This study aims to evaluate whether a test protocol with standardized and individualized resistance settings leads to valid wheelchair Wingate tests (WAnT) and graded exercise tests (GXT) in healthy novices. Twenty able-bodied individuals (10M/10F, age 23 ± 2 years, body mass 72 ± 11 kg) performed an isometric strength test, sprint test, WAnT and GXT on a wheelchair ergometer. Using a previously developed set of regression equations, individuals' isometric strength outcome was used to estimate the WAnT result (P30est), from which an effective individual WAnT resistance was derived. The subsequently measured WAnT outcome (P30meas) was used to estimate the GXT outcome (POpeakest) and to scale the individual GXT resistance steps. Estimated and measured outcomes were compared. The WAnT protocol was considered valid when maximal velocity did not exceed 3 m·s-1; the GXT protocol was considered valid when test duration was 8-12 min. P30est did not significantly differ from P30meas, while one participant did not have a valid WanT, as maximal velocity exceeded 3 m·s-1. POpeakest was 10% higher than POpeakmeas, and six participants did not reach a valid GXT: five participants had a test duration under 8 min and one participant over 12 min. The isometric strength test can be used to individually scale the WAnT protocol. The WAnT outcome scaled the protocol for the GXT less accurately, resulting in mostly shorter-than-desired test durations. In conclusion, the evaluated standardized and individualized test protocol was valid for the WAnT but less valid for the GXT among a group of novices. Before implementing the standardized individual test protocol on a broader scale, e.g. among paralympic athletes, it should be evaluated among different athletic wheelchair-dependent populations.

Risk management of electric power transmission lines requires knowledge from different areas such as the environment, land, investors, regulations, and engineering. Despite the widespread availability of databases for most of those areas, integrating them into a single database or model is a challenging problem. Instead, in this paper, we propose a novel method to calculate risk probabilities on the implementation of transmission lines based on unstructured text from a single source. It uses the Brazilian National Electric Energy Agency’s (ANEEL) weekly reports, which contain decisions about the electrical grid comprising most of the aforementioned areas. Since the data are unstructured (text), we employed NLP techniques such as stemming and tokenization to identify keywords related to common causes of risks provided by an expert group on energy transmission. Then, we used models to estimate the probability of each risk. This method differs from previous works, which were based on structured data (numerical or categorical) from single or multiple sources. Our results show that we were able to extract relevant keywords from the ANEEL reports that enabled our proposed method to estimate the probability of 97 risks out of 233 listed by an expert.

This article presents a novel method for predicting the sugarcane harvesting date and productivity using a three-band imaging radar. Taking advantage of working with a multi-band radar, this system was employed to estimate the above-ground biomass (AGB), achieving a root-mean-square error (RMSE) of 2 kg m−2 in sugarcane crops, which is an unprecedented result compared with other works based on the Synthetic Aperture Radar (SAR) system. By correlating the field measurements of the ripening index (RI) with the AGB measurements by radar, an indirect estimate of the RI by the radar is obtained. It is observed that the AGB reaches its maximum approximately 280 days after planting and the maximum RI, which defines the harvesting date, approximately 360 days after planting for the species IACSP97-4039. Starting from an AGB map collected by the radar, it is then possible to predict the harvesting date and the corresponding productivity with competitive average errors of 8 days and 10.7%, respectively, with three months in advance, whereas typical methods employed on a test site achieve an average error of 30 days with three months in advance. To the best of our knowledge, it is the first time that a multi-band radar is employed for productivity prediction in sugarcane crops.

Understanding the source of non-native introduced populations is crucial for forecasting geographic invasion potential and understanding the ecological consequences of potential establishment. Here we use genomics to identify the source populations and invasion dynamics of two non-native introduced populations from the iconic avian lineage of ‘great speciators’ known as white-eyes (genus Zosterops). We established confidently for the first time that introduced Zosterops populations in Hawaii and southern California are completely unrelated and derived from independent introductions of the species Z. japonicus and Z. simplex, respectively. We used descriptive population genetic statistics to identify a reduction in genetic diversity and increase in private alleles in the southern California population supporting a recent, potentially ongoing, genetic bottleneck in this population. In contrast, the introduced population in Hawaii showed no such characteristics, likely due to a larger founding population size and repeated introductions in this intentionally introduced population. Ecological niche modeling indicated that there is little environmentally suitable habitat for Z. simplex across the continent of North America, suggesting limited invasion potential, assuming niche conservatism. Yet, portions of the introduced Z. simplex population have already surpassed areas projected as suitable, likely because the urbanized environment of southern California offers biotic resources and microhabitats not captured by our model. Because Z. simplex appears to have overcome both the ‘invasion paradox’ of low founding genetic diversity and relatively unfamiliar environmental conditions in southern California, we suggest that this population may continue expanding beyond our environmental niche model projections in other temperate, urban regions.