Search

Objective . Bragg peak measurements play a key role in the beam quality assurance in proton therapy. Used as base data for the treatment planning softwares, the accuracy of the data is crucial when defining the range of the protons in the patient. Approach . In this paper a protocol to reconstruct a Pristine Bragg Peak exploring the direct correlation between the particle flux and the dose deposited by particles is presented. Proton flux measurements at the HollandPTC and FLUKA Monte Carlo simulations are used for this purpose. This new protocol is applicable to plastic scintillator detectors developed for Quality Assurance applications. In order to obtain the Bragg curve using a plastic fiber detector, a PMMA phantom with a decoupled and moveable stepper was designed. The step phantom allows to change the depth of material in front of the fiber detector during irradiations. The Pristine Bragg Peak reconstruction protocol uses the measured flux of particles at each position and multiplies it by the average dose obtained from the Monte Carlo simulation at each position. Main results . The results show that with this protocol it is possible to reconstruct the Bragg Peak with an accuracy of about 470 µ m, which is in accordance with the tolerances set by the AAPM. Significance . It has the advantage to be able to overcome the quenching problem of scintillators in the high ionization density region of the Bragg peak., (© 2024 Institute of Physics and Engineering in Medicine. All rights, including for text and data mining, AI training, and similar technologies, are reserved.)

Background: Diet and exercise interventions have been associated with improved body composition and physical fitness. However, evidence regarding their combined effects in older adults is scarce. This study aimed to investigate the impact of a combined 12-week Mediterranean diet-based sustainable healthy diet (SHD) and multicomponent training (MT) intervention on body composition, anthropometry, and physical fitness in older adults., Methods: Diet intervention groups received a weekly SHD food supply and four sessions, including a SHD culinary practical workshop. The exercise program included MT 50 min group session, three times a week, on non-consecutive days. Body composition and physical fitness variables were assessed through dual X-ray absorptiometry, anthropometric measurements, and senior fitness tests. Repeated measures ANOVA, with terms for group, time, and interaction, was performed., Results: Our results showed that a combined intervention significantly lowered BMI and total fat. Also, significant differences between assessments in all physical fitness tests, except for aerobic endurance, were observed. Adjusted models show significant differences in BMI ( p = 0.049) and WHR ( p = 0.037) between groups and in total fat ( p = 0.030) for the interaction term. Body strength ( p < 0.001), balance tests ( p < 0.001), and aerobic endurance ( p = 0.005) had significant differences amongst groups. Considering the interaction term, differences were observed for upper body strength ( p = 0.046) and flexibility tests ( p = 0.004 sit and reach, p = 0.048 back scratch)., Conclusions: Our intervention study demonstrates the potential of implementing healthy lifestyle and sustainable models to promote healthy and active aging.

This study examined the effects of game schedule, travel demands and contextual factors on team game-related statistics during a full season. The top 10 teams competing in the 2020-2021 Euroleague basketball season were included where game-related statistics from their respective national competitions and the Euroleague competition were retrieved (761 games). Hierarchical linear regression models were computed to evaluate the effects of distance travelled, game schedule and contextual factors for the previous and current games (league, season phase, opponent level, game outcome, score differential) on key performance indicators (points, shooting, rebounds, assists, turnovers, fouls). Several significant models ( p  < 0.05) yielded R 2 values ranging from 0.05 to 0.22 with small -to- medium effect magnitudes. Analyses revealed significant associations between longer durations separating games and less free-throws being made and between further distances travelled and worse 3-point shooting, more offensive rebounds and more fouls. Regarding contextual factors, favourable outcomes for shooting, assists, steals, fouling and turnovers were significantly associated with team success. Playing higher-level teams and competing in playoffs or finals was associated with several diminished outcomes. These results emphasize the multi-factorial nature of performance in elite European basketball, with game schedule, travel and various contextual factors requiring consideration in developing holistic operational plans for teams.

Background and Aims: Healthy dietary patterns and exercise practices have been associated with improved metabolic and inflammatory profiles. However, studies regarding the combined effect of these interventions on plasma biomarkers and metabolome in older adults are sparser. The primary aim of this study was to investigate the impact of a combined Mediterranean Diet-based Sustainable Healthy Diet (SHD) and Multicomponent Training (MT) intervention on the plasma biomarkers and metabolome and how dietary intake and exercise could modulate these effects., Methods: SHD intervention included a weekly supply of Mediterranean Diet-based SHD food and four nutrition sessions involving a Mediterranean-Diet culinary workshop, and the exercise program included 50-min MT group sessions, held three times a week, lasting both 12 weeks. Plasma biomarkers were obtained through standard biochemical analysis. A proton ( 1 H) nuclear magnetic resonance (NMR) spectroscopy-based metabolomics approach was used to study the metabolome in blood plasma. Repeated measures ANOVA were performed and adjusted for confounders., Results: SHD + MT intervention significantly decreased HDL-C and calcium. SHD + MT showed some changes in common with the SHD and MT group, namely a significant decrease in citrate levels (p = 0.009 for SHD + MT; p = 0.037 for SHDT) and an increase in pyruvate (p < 0.001 for MT and SHD + MT). The SHD + MT group also revealed specific changes in the levels of some amino acids (decrease in alanine, glutamine and lysine: p = 0.026; p < 0.001; p = 0.038, respectively). Increases in formate (p = 0.025) and unsaturated lipids (p = 0.011) are consistent with changes in energy and lipoprotein metabolism., Conclusion: Our data show that a combined lifestyle intervention program, including a Mediterranean Diet-based SHD and MT, could modulate biomarker and metabolome and there seems to be a metabolic path associated to these interventions in older adults. Due to its wide-ranging relevance, it is pertinent to assess to what extent combined SHD and MT can contribute to better clinical profiles., Competing Interests: Conflict of interest The authors declare that they have no competing interests., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The design of complex health systems interventions, such as pay for performance (P4P), can be critical to determining such programmes' success. In P4P programmes, the design of financial incentives is crucial in shaping how these programmes work. However, the design of such schemes is usually homogenous across providers within a given scheme. Consequently, there is a limited understanding of the strengths and weaknesses of P4P design elements from the implementers' perspective. This study takes advantage of the unique context of Brazil, where municipalities adapted the federal incentive design, resulting in variations in incentive design across municipalities. The study aims to understand why municipalities in Brazil chose certain P4P design features, the associated challenges and the local adaptations made to address problems in scheme design. This study was a multiple case study design relying on qualitative data from 20 municipalities from two states in Northeastern Brazil. We conducted two key informant interviews with municipal-level stakeholders and focus group discussions with primary care providers. We also reviewed municipal Primary Care Access and Quality laws in each municipality. We found substantial variation in the design choices made by municipalities regarding 'who was incentivized', the 'payment size' and 'frequency'. Design choices affected relationships within municipalities and within teams. Challenges were chiefly associated with fairness relating to 'who received the incentive', 'what is incentivized' and the 'incentive size'. Adaptations were made to improve fairness, mostly in response to pressure from the healthcare workers. The significant variation in design choices across municipalities and providers' response to them highlights the importance of considering local context in the design and implementation of P4P schemes and ensuring flexibility to accommodate local preferences and emerging needs. Attention is needed to ensure that the choice of 'who is incentivized' and the 'size of incentives' are inclusive and fair and the allocation and 'use of funds' are transparent., (© The Author(s) 2024. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)

Introduction: This study aimed to describe the fixation location and the time of the longer fixation of expert and novice futsal coaches before the ball was in play in futsal set pieces., Methods: A total of 10 experts (ages 48 ± 5) and 10 novice coaches (ages 40 ± 7) participated in the study. They observed that 38 video clips were created to mimic the attack and defensive set-piece moments of the game. Data were collected in a standardized video analysis task using the pupil invisible eye tracker and processed through the pupil cloud platform. The Mann-Whitney test was conducted to evaluate differences in gaze duration between game moments (attack and defense set pieces) and groups (expert vs. novice). Gaze duration was also compared for gaze location between groups. For further comparisons, the game moments (attack and defense set pieces) and the gaze location were summarized in two-dimensional graphics using correspondence analysis., Results and Discussion: The results revealed higher values of gaze duration for attack and defense set pieces for the group of experts than for novices. When considering gaze duration, expert coaches had higher values than novices for the attacker 3, defender 3, barrier 1st, and barrier 2nd gaze locations. The correspondence analysis showed different strategies of visual search and, consequently, gaze locations for attack and defense set pieces. In particular, there was different correspondence for free kicks between the level of expertise and gaze location, while corner and sideline kicks revealed some correspondence between the groups and the gaze location. In free kicks, coaches should be particularly concerned about the relationship between attacker and defender three and the barrier 1st and 2nd line positions. In corner and sideline kicks, coaches should be particularly aware of the relationship between attackers' and defenders' positions., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Rodrigues, Leite, Ribeiro, Sampaio, Araújo and Travassos.)

Objectives: We performed a multicentre study (2020-2022) to compare the in vitro activity of ozenoxacin and comparator agents against Staphylococcus aureus and Streptococcus pyogenes clinical isolates from skin and soft-tissue infections (SSTI)., Methods: A total of 1725 isolates (1454 S. aureus and 271 S. pyogenes ) were collected in 10 centres from eight countries between January 2020 and December 2022. Antimicrobial susceptibility testing was determined (microdilution-SENSITITRE). Results were interpreted following European Committee on Antimicrobial Susceptibility Testing (EUCAST) 2023 (clinical breakpoints, ECOFF) and CLSI criteria., Results: Ozenoxacin exhibited high in vitro activity against S. aureus (MIC 50/90  = 0.002/0.12 mg/L) and S. pyogenes (MIC 50/90  = 0.015/0.03 mg/L), inhibiting 99% of the isolates at MIC ≤ 0.5 mg/L and at MIC ≤ 0.06, respectively. The most active comparators against S. aureus were retapamulin (MIC 90  = 0.12 mg/L), fusidic acid (MIC 90  = 0.25 mg/L) and mupirocin (MIC 90  = 0.5 mg/L); and against S. pyogenes were retapamulin (MIC 90  = 0.03 mg/L), clindamycin (MIC 90  = 0.12 mg/L) and mupirocin (MIC 90  = 0.25 mg/L). Ciprofloxacin and methicillin resistant rates for S. aureus were 31.3% (455/1454) and 41% (598/1454), respectively. Additionally, 62% (373/598) of the MRSA were also ciprofloxacin non-susceptible, whereas only 10% (23/271) of the MSSA were ciprofloxacin resistant. Ozenoxacin was more active against ciprofloxacin-susceptible S. aureus than against ciprofloxacin-resistant isolates, and showed a slightly higher MIC in MRSA isolates than in MSSA. However, ozenoxacin activity was comparable in both ciprofloxacin-resistant MSSA and MRSA subsets. On the other hand, ozenoxacin had similar activity in ciprofloxacin-susceptible and resistant S. pyogenes isolates., Conclusions: Ozenoxacin is a potent antimicrobial agent of topic use against Gram-positive bacteria causing SSTI, including MRSA isolates non-susceptible to ciprofloxacin., (© The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.)

Pay-for-performance (P4P) schemes have been shown to have mixed effects on health care outcomes. A challenge in interpreting this evidence is that P4P is often considered a homogenous intervention, when in practice schemes vary widely in their design. Our study contributes to this literature by providing a detailed depiction of incentive design across municipalities within a national P4P scheme in Brazil [Primary Care Access and Quality (PMAQ)] and exploring the association of alternative design typologies with the performance of primary health care providers. We carried out a nation-wide survey of municipal health managers to characterize the scheme design, based on the size of the bonus, the providers incentivized and the frequency of payment. Using OLS regressions and controlling for municipality characteristics, we examined whether each design feature was associated with better family health team (FHT) performance. To capture potential interactions between design features, we used cluster analysis to group municipalities into five design typologies and then examined associations with quality of care. A majority of the municipalities included in our study used some of the PMAQ funds to provide bonuses to FHT workers, while the remaining municipalities spent the funds in the traditional way using input-based budgets. Frequent bonus payments (monthly) and higher size bonus allocations (share of 20-80%) were strongly associated with better team performance, while who within a team was eligible to receive bonuses did not in isolation appear to influence performance. The cluster analysis showed what combinations of design features were associated with better performance. The PMAQ score in the 'large bonus/many workers/high-frequency' cluster was 8.44 points higher than the 'no bonus' cluster, equivalent to a difference of 21.7% in the mean PMAQ score. Evidence from our study shows how design features can potentially influence health provider performance, informing the design of more effective P4P schemes., (© The Author(s) 2024. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.)

Tools for accessing and studying organelles remain underdeveloped. Here, we present a method by which giant organelle vesicles (GOVs) are generated by submitting cells to a hypotonic medium followed by plasma membrane breakage. By this means, GOVs ranging from 3 to over 10 µm become available for micromanipulation. GOVs are made from organelles such as the endoplasmic reticulum, endosomes, lysosomes and mitochondria, or in contact with one another such as giant mitochondria-associated ER membrane vesicles. We measure the mechanical properties of each organelle-derived GOV and find that they have distinct properties. In GOVs procured from Cos7 cells, for example, bending rigidities tend to increase from the endoplasmic reticulum to the plasma membrane. We also found that the mechanical properties of giant endoplasmic reticulum vesicles (GERVs) vary depending on their interactions with other organelles or the metabolic state of the cell. Lastly, we demonstrate GERVs' biochemical activity through their capacity to synthesize triglycerides and assemble lipid droplets. These findings underscore the potential of GOVs as valuable tools for studying the biophysics and biology of organelles., (© 2024. The Author(s).)

Two isolates representing a novel species of the genus Wickerhamiella were obtained in India from nectar of flowers of Lantana camara , an ornamental exotic species native to Central and South America. Phylogenetic analyses of the D1/D2 domain of the 26S large subunit (LSU) rRNA gene, internal transcribed spacer (ITS) region, and physiological characteristics, supported the recognition of the novel species, that we designate Wickerhamiella lachancei sp. nov (MycoBank no. MB851709), with MCC 9929 T as the holotype and PYCC 10003 T as the isotype. Considering pairwise sequence similarity, the type strain of the novel species differs from the type strain of the most closely related species, Wickerhamiella drosophilae CBS 8459 T , by 16 nucleotide substitutions and two gaps (3.9 % sequence variation) in the D1/D2 region (560 bp compared) and 28 nucleotide substitutions and five gaps (7.22 % sequence variation) in the ITS region (444 bp compared).