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Abstract Background A voluntary National Healthy Food and Drink Policy (the Policy) was introduced in public hospitals in New Zealand in 2016. This study assessed the changes in implementation of the Policy and its impact on providing healthier food and drinks for staff and visitors in four district health boards between 1 and 5 years after the initial Policy introduction. Methods Repeat, cross-sectional audits were undertaken at the same eight sites in four district health boards between April and August 2017 and again between January and September 2021. In 2017, there were 74 retail settings audited (and 99 in 2021), comprising 27 (34 in 2021) serviced food outlets and 47 (65 in 2021) vending machines. The Policy’s traffic light criteria were used to classify 2652 items in 2017 and 3928 items in 2021. The primary outcome was alignment with the Policy guidance on the proportions of red, amber and green foods and drinks (≥ 55% green ‘healthy’ items and 0% red ‘unhealthy’ items). Results The distribution of the classification of items as red, amber and green changed from 2017 to 2021 (p

Abstract Background In 2016, a voluntary National Healthy Food and Drink Policy was released to improve the healthiness of food and drinks for sale in New Zealand health sector organisations. The Policy aims to role model healthy eating and demonstrate commitment to health and well-being of hospital staff and visitors and the general public. This study aimed to understand the experiences of hospital food providers and public health dietitians/staff in implementing the Policy, and identify tools and resources needed to assist with the implementation. Methods A maximum variation purposive sampling strategy (based on a health district’s population size and food outlet type) was used to recruit participants by email. Video conference or email semi-structured interviews included 15 open-ended questions that focused on awareness, understanding of, and attitudes towards the Policy; level of support received; perceived customer response; tools and resources needed to support implementation; and unintended or unforeseen consequences. Data was analysed using a reflexive thematic analysis approach. Results Twelve participants (eight food providers and four public health dietitians/staff) were interviewed; three from small ( 300,000 people) health districts. There was agreement that hospitals should role model healthy eating for the wider community. Three themes were identified relating to the implementation of the Policy: (1) Complexities of operating food outlets under a healthy food and drink policy in public health sector settings; (2) Adoption, implementation, and monitoring of the Policy as a series of incoherent ad-hoc actions; and (3) Policy is (currently) not achieving the desired impact. Concerns about increased food waste, loss of profits and an uneven playing field between food providers were related to the voluntary nature of the unsupported Policy. Three tools could enable implementation: a digital monitoring tool, a web-based database of compliant products, and customer communication materials. Conclusions Adopting a single, mandatory Policy, provision of funding for implementation actions and supportive tools, and good communication with customers could facilitate implementation. Despite the relatively small sample size and views from only two stakeholder groups, strategies identified are relevant to policy makers, healthcare providers and public health professionals.

Abstract Background In 2016, a voluntary National Healthy Food and Drink Policy (hereafter, “the Policy”) was released to encourage public hospitals in New Zealand to provide food and drink options in line with national dietary guidelines. Five years later, eight (of 20) organisations had adopted it, with several preferring to retain or update their own institutional-level version. This study assessed staff and visitors’ awareness and support for and against the Policy, and collected feedback on perceived food environment changes since implementation of the Policy. Methods Cross-sectional electronic and paper-based survey conducted from June 2021 to August 2022. Descriptive statistics were used to present quantitative findings. Free-text responses were analysed following a general inductive approach. Qualitative and quantitative findings were compared by level of implementation of the Policy, and by ethnicity and financial security of participants. Results Data were collected from 2,526 staff and 261 visitors in 19 healthcare organisations. 80% of staff and 56% of visitors were aware of the Policy. Both staff and visitors generally supported the Policy, irrespective of whether they were aware of it or not, with most agreeing that “Hospitals should be good role models.” Among staff who opposed the Policy, the most common reason for doing so was freedom of choice. The Policy had a greater impact, positive and negative, on Māori and Pacific staff, due to more frequent purchasing onsite. Most staff noticed differences in the food and drinks available since Policy implementation. There was positive feedback about the variety of options available in some hospitals, but overall 40% of free text comments mentioned limited choice. 74% of staff reported that food and drinks were more expensive. Low-income staff/visitors and shift workers were particularly impacted by reduced choice and higher prices for healthy options. Conclusions The Policy led to notable changes in the healthiness of foods and drinks available in NZ hospitals but this was accompanied by a perception of reduced value and choice. While generally well supported, the findings indicate opportunities to improve implementation of food and drink policies (e.g. providing more healthy food choices, better engagement with staff, and keeping prices of healthy options low) and confirm that the Policy could be expanded to other public workplaces.

Accurate estimations of extreme precipitation return levels are critical for many hydrological applications. Extreme precipitation is highly variable in both space and time; therefore, to better understand and manage the related risks, knowledge of their probability at different spatial–temporal scales is crucial. We employ a novel non-asymptotic framework to estimate extreme return levels (up to 100 years) at multiple spatial–temporal scales from weather radar precipitation estimates. The approach reduces uncertainties and enables the use of relatively short archives typical of weather radar data (12 years in this case). We focus on the eastern Mediterranean, an area of high interest due to its sharp climatic gradient, containing Mediterranean, semi-arid, and arid areas across a few tens of kilometres, and its susceptibility to flash flood. At-site intensity–duration–area–frequency relations are derived from radar precipitation data at various scales (10 min–24 h, 0.25–500 km2) across the study area, using ellipses of varying axes and orientations to account for the spatial component of storms. We evaluate our analysis using daily rain gauge data over areas for which sufficiently dense gauge networks are available. We show that extreme return levels derived from radar precipitation data for 24 h and 100 km2 are generally comparable to those derived from averaging daily rain gauge data over a similar areal scale. We then analyse differences in multi-scale extreme precipitation over coastal, mountainous, and desert regions. Our study reveals that the power-law scaling relationship between precipitation and duration (simple scaling) weakens for increasing area sizes. This finding has implications for temporal downscaling. Additionally, precipitation intensity varies significantly for different area sizes at short durations but becomes more similar at long durations, suggesting that, in the region, areal reduction factors may not be necessary for computing return levels over long durations. Furthermore, the reverse orographic effect, which causes decreased precipitation for hourly and sub-hourly durations, diminishes for larger areas. Finally, we discuss the effects of orography and coastline proximity on extreme precipitation intensity over different spatial–temporal scales.

Abstract Collagen is the most abundant protein in mammals and a major structural component of the extracellular matrix (ECM). Changes to ECM composition occur as a result of numerous physiological and pathophysiological causes, and a common means to evaluate these changes is the collagen 3 (Col3) to collagen 1 (Col1) ratio. Current methods to measure the Col3/1 ratio suffer from a lack of specificity and often under- or over-estimate collagen composition and quantity. This manuscript presents a targeted liquid chromatography tandem mass spectrometry (LC–MS/MS) method for quantification of Col3 and Col1 in FFPE tissues. Using surrogate peptides to generate calibration curves, Col3 and Col1 are readily quantified in FFPE tissue sections with high accuracy and precision. The method is applied to several tissue types from both human and reindeer sources, demonstrating its generalizability. In addition, the targeted LC–MS/MS method permits quantitation of the hydroxyprolinated form of Col3, which has significant implications for understanding not only the quantity of Col3 in tissue, but also understanding of the pathophysiology underlying many causes of ECM changes. This manuscript presents a straightforward, accurate, precise, and generalizable method for quantifying the Col3/1 ratio in a variety of tissue types and organisms.

Purpose: The purpose of this study is to explore teen-adult dialogic interactions during the co-design of data literacy activities in order to determine the nature of teen thinking, their emotions, level of engagement, and the power of relationships between teens and adults in the context of data literacy. This study conceives of co-design as a learning space for data literacy. It investigates the teen - adult dialogic interactions and what these interactions say about the nature of teen thinking, their emotions, level of engagement and the power relationships between teens and adults. Design/methodology/approach: The study conceives of co-design as a learning space for teens. Linguistic Inquiry and Word Count (LIWC-22), a natural language processing (NLP) software tool, was used to examine the linguistic measures of Analytic Thinking, Clout, Authenticity, and Emotional Tone using transcriptions of recorded Data Labs with teens and adults. Linguistic Inquiry and Word Count (LIWC-22), a natural language processing (NLP) software tool, was used to examine the linguistic measures of Analytic Thinking, Clout, Authenticity and Emotional Tone using transcriptions of recorded Data Labs with teens and adults. Findings: LIWC-22 scores on the linguistic measures Analytic Thinking, Clout, Authenticity and Emotional Tone indicate that teens had a high level of friendly engagement, a relatively low sense of power compared with the adult co-designers, medium levels of spontaneity and honesty and the prevalence of positive emotions during the co-design sessions. Practical implications: This study provides a concrete example of how to apply NLP in the context of data literacy in the public library, mapping the LIWC-22 findings to STEM-focused informal learning. It adds to the understanding of assessment/measurement tools and methods for designing data literacy education, stimulating further research and discussion on the ways to empower youth to engage more actively in informal learning about data. Originality/value: This study applies a novel approach for exploring teen engagement within a co-design project tasked with the creation of youth-oriented data literacy activities.

Among the various repositories of soil spectral data, the Brazilian Soil Spectral Library (BSSL, https://bibliotecaespectral.wixsite.com/english), created and maintained by the GeoCiS research group, is representative of the pedodiversity of the region, since it combines soil spectra from agricultural and environmental research. The BSSL database contains 16,084 observations with soil-harmonized surface layer physicochemical and spectral data in the visible, near-infrared, short-wave infrared (Vis-NIR-SWIR, 350–2,500 nm) and mid-infrared (MIR, 4,000–600 cm-¹) ranges from all 26 Brazilian states and the Federal District. The idea of creating the BSSL was born in 1995, completed in 2019 and opened to users in 2023. This database is currently available online at https://zenodo.org/records/8361419. During oppening process, data filtering was performed to ensure reliable and valuable information provided to society. Then consistency and quality assessments were executed using Pearson's correlation and the Cubist algorithm in the R environment. Modeling analysis revealed the robust predictive power of the spectral database, facilitating the modeling of key soil attributes. An open-access BSSL will help researchers validate their results by comparing measured data with predicted data, enabling the development of new models or the improvement of existing ones. The BSSL is a globally significant spectral library due to its broad coverage and representation of different tropical soil classes. Soil spectral data can help governments and corporations by providing information to decision-makers regarding the conservation or exploitation of natural resources to monitor soil health.

Due to the increase in the frequency and intensity of natural disasters such as heavy rainfall events, the evaluation of the vulnerability of the built environment is becoming increasingly important. Evaluation techniques for each separate building often require detailed geometric models of the supporting structures and time-consuming simulations. One possibility to overcome this problem is to categorize the buildings in a first step and use representative building models for each category. This paper presents a semi-automated approach for categorizing buildings and creating parametric models for the respective building categories. Using these models, the buildings of a category can be collectively examined for their vulnerability to various impacts. First, this paper introduces open geodata that can be used for this process. For the categorization of the buildings, the collected data is further processed to extract additional information such as building age classes or floor plan geometries of the buildings. This results in a data set, with the help of which the buildings can be categorized. However, information about the load-bearing structure is often missing in the different data sources. By including information on typical construction methods that are associated with the previously determined characteristics (age, floor plan geometry, usage), representative models can be created for individual building categories. In this study, the approach was tested in a selected reference area in Berlin. The results indicate that the presented approach is a promising first step towards deriving geometrical models from open geodata that can be used to evaluate the vulnerability of buildings.

Abstract Background The SARS-CoV-2 pandemic led to unprecedented testing demands, causing major testing delays globally. One strategy used for increasing testing capacity was pooled-testing, using a two-stage technique first introduced during WWII. However, such traditional pooled testing was used in practice only when positivity rates were below 2%. Methods Here we report the development, validation and clinical application of P-BEST - a single-stage pooled-testing strategy that was approved for clinical use in Israel. Results P-BEST is clinically validated using 3636 side-by-side tests and is able to correctly detect all positive samples and accurately estimate their Ct value. Following regulatory approval by the Israeli Ministry of Health, P-BEST was used in 2021 to clinically test 837,138 samples using 270,095 PCR tests - a 3.1fold reduction in the number of tests. This period includes the Alpha and Delta waves, when positivity rates exceeded 10%, rendering traditional pooling non-practical. We also describe a tablet-based solution that allows performing manual single-stage pooling in settings where liquid dispensing robots are not available. Conclusions Our data provides a proof-of-concept for large-scale clinical implementation of single-stage pooled-testing for continuous surveillance of multiple pathogens with reduced test costs, and as an important tool for increasing testing efficiency during pandemic outbreaks.

Abstract Conventional type 1 dendritic cells (cDC1) are the essential antigen-presenting DC subset in antitumor immunity. Suppressing B-cell lymphoma 9 and B-cell lymphoma 9-like (BCL9/BCL9L) inhibits tumor growth and boosts immune responses against cancer. However, whether oncogenic BCL9/BCL9L impairs antigen presentation in tumors is still not completely understood. Here, we show that targeting BCL9/BCL9L enhanced antigen presentation by stimulating cDC1 activation and infiltration into tumor. Pharmacological inhibition of BCL9/BCL9L with a novel inhibitor hsBCL9z96 or Bcl9/Bcl9l knockout mice markedly delayed tumor growth and promoted antitumor CD8+ T cell responses. Mechanistically, targeting BCL9/BCL9L promoted antigen presentation in tumors. This is due to the increase of cDC1 activation and tumor infiltration by the XCL1-XCR1 axis. Importantly, using single-cell transcriptomics analysis, we found that Bcl9/Bcl9l deficient cDC1 were superior to wild-type (WT) cDC1 at activation and antigen presentation via NF-κB/IRF1 signaling. Together, we demonstrate that targeting BCL9/BCL9L plays a crucial role in cDC1-modulated antigen presentation of tumor-derived antigens, as well as CD8+ T cell activation and tumor infiltration. Targeting BCL9/BCL9L to regulate cDC1 function and directly orchestrate a positive feedback loop necessary for optimal antitumor immunity could serve as a potential strategy to counter immune suppression and enhance cancer immunotherapy.

OBJECTIVES: Acute care ophthalmic clinics often suffer from inefficient triage, leading to suboptimal patient access and resource utilization. This study reports the preliminary results of a novel, symptom-based, patient-directed, online triage tool developed to address the most common acute ophthalmic diagnoses and associated presenting symptoms. METHODS: A retrospective chart review of patients who presented to a tertiary academic medical centers urgent eye clinic after being referred for an urgent, semi-urgent, or nonurgent visit by the ophthalmic triage tool between January 1, 2021 and January 1, 2022 was performed. Concordance between triage category and severity of diagnosis on the subsequent clinic visit was assessed. RESULTS: The online triage tool was utilized 1,370 and 95 times, by the call center administrators (phone triage group) and patients directly (web triage group), respectively. Of all patients triaged with the tool, 8.50% were deemed urgent, 59.2% semi-urgent, and 32.3% nonurgent. At the subsequent clinic visit, the history of present illness had significant agreement with symptoms reported to the triage tool (99.3% agreement, weighted kappa = 0.980, p

Transformation of forests into agricultural lands threatens biodiversity and ecosystem functions globally. In the biodiversity hotspot Madagascar, key ecosystem functions along with highly endemic flora and fauna are under threat. Comprehensive studies identifying determinants of biodiversity and ecosystem function losses are lacking, with no studies accounting for endemic species richness across multiple taxa. We assess how plot-scale stand structural attributes (basal area, leaf area index, diameter diversity, and tree species richness) and landscape-scale forest cover influence biodiversity (species richness of butterflies, ants, birds, reptiles, amphibians, herbaceous plants, and multidiversity) and ecosystem functions (soil organic carbon, predation rate, acoustic diversity, and multifunctionality) in the tropical mosaic landscape of northeastern Madagascar. Complexly structured stands with a larger basal area and/or a higher tree species richness promoted greater endemic multidiversity (R² = 0.70), soil organic carbon, and acoustic diversity. However, our models did not indicate significant explanatory variables for multidiversity (R² = 0.25) and multifunctionality (R² = 0.43). Landscape-scale forest cover significantly favored endemic bird species richness. Our findings highlight that a simplified stand structure, resulting from land-use change, substantially reduces endemic biodiversity and ecosystem functions in this historically forested region. Conservation actions should aim at maintaining complex stand structure in forests and agroforests, while restoration interventions should focus on re-building such structures.

A criopreservação do sêmen bovino contribui para as cadeias produtivas do leite e da carne, melhorando a eficiência dos rebanhos e, consequentemente, sua lucratividade. Neste contexto, diferentes métodos e aditivos são utilizados para melhorar a resistência espermática à criopreservação. O objetivo deste trabalho foi avaliar o uso de ácido ascórbico (vitamina C) e Trolox (vitamina E sintética) como antioxidantes no meio diluidor de sêmen para preservar a viabilidade do sêmen no processo de congelamento-descongelamento. Oito touros, cinco Bos taurus indicus e três Bos taurus taurus, foram selecionados e submetidos a três coletas de sêmen em intervalos de 48 horas. Os ejaculados foram submetidos a uma análise prévia de motilidade, vigor e concentração, a seguir colocados em palhetas de 0,25 mL na proporção de 25×106 de espermatozoides viáveis, e distribuídos em quatro grupos: GI (sêmen diluído sem adição de vitaminas), GII (sêmen diluído com 250 μmoL mL-1 de Trolox), GIII (sêmen diluído com 0,60 mg mL-1 de vitamina C) e GIV (sêmen diluído com 0,60 mg mL-1 de vitamina C + 250 μmoL mL-1 de Trolox); posteriormente, foram submetidos à criopreservação. Os movimentos e a cinética dos espermatozoides descongelados foram analisados por Computer-Assisted Semen Analysis (CASA), não havendo diferença (p0,05). A interação entre Trolox e vitamina C gerou resultados significativos para a motilidade espermática após o descongelamento quando avaliada pelo TRT, e a viabilidade espermática quando avaliada pelo HOST, sendo superiores aos encontrados no grupo controle e no grupo com adição de vitamina C.

The p14ARF-Hdm2-p53 signaling pathway targets tumor growth suppression, inhibits clonal proliferation, and maintains genome stability. It is inactivated in most human malignancies. The p14ARF protein is one of the main participants in the cascade. The aim of the study was to determine the prognostic value of the number of p14ARF-expressing tumor cells in biopsies of patients with diffuse large B cell lymphoma (DLBCL). Material and methods. The formalin-fixed paraffin embedded samples of tumor tissue of 104 patients with newly diagnosed DLBCL were included to the study. The relative number of cells expressing p14ARF was determined by immunohistochemical and morphometric methods. Differences in the content of p14ARF-positive tumor cells between groups of patients divided according to clinical and laboratory parameters were determined using the Mann–Whitney U test. Prediction of an unfavorable response to therapy was carried out using binary logistic regression with calculation of the odds ratio and 95 % confidence interval; variables were selected using Wald backward elimination method. The risk of an event occurring was calculated using Cox regression analysis. Results. The content of p14ARF-positive cells is higher in tumor biopsies of patients with high and high-intermediate risk according to the international prognostic index than in patients with low and lowintermediate risk. A relationship between an increase in the number of p14ARF-positive tumor cells, the absence of a complete response to first-line R-CHOP therapy, and an increased risk of death in patients with DLBCL has been established. Conclusions. The studied marker p14ARF can be used as an additional morphological predictor of the unfavorable course of DLBCL.

Abstract The research of new electrode materials such as sodium intercalation compounds is key to meet the challenges of future demands of sustainable energy storage. For these batteries, the intercalation behavior on the micro-scale is governed by a complex interplay of chemical, electrical and mechanical forces strongly influencing the overall cell performance. The multiphase-field method is a suitable tool to study these multi-physics and bridge the scale from ab-initio methods to the cell level. In this work, we follow a combined approach of experiments, density functional theory (DFT) calculations and multiphase-field simulations to predict thermodynamic and kinetic properties for the P2-type Na X Ni1/3Mn2/3O2 sodium-ion cathode material. Experimentally, we obtain the thermodynamic potential and diffusion coefficients at various sodium contents using electrochemical techniques and discuss limitations of the experimentally applied methods. DFT is used to identify stable phases by calculating an energy hull curve. Then, the influence of long-range dispersion interactions and the exchange-correlation functional on the voltage curve is investigated by comparison with experimental results. Finally, multiphase-field simulations are performed based on inputs from experiments and DFT. The fitting of phase-specific chemical free energies from DFT calculations and experimental data is discussed. Our results highlight the thermodynamic consistency of all three approaches close to thermodynamic equilibrium. Furthermore, the phase-field method accurately describes the kinetics of the system including multiple phase transitions, by which we unravel the mechanism of the P2-O2 phase transition in a single crystal under the influence of intercalation reaction, bulk diffusion and elastic deformation. The model is able to predict the kinetic capacity loss depending on charging rate in agreement with C-rate experiments.

Abstract The β-catenin dependent canonical Wnt signaling pathway plays a crucial role in maintaining normal homeostasis. However, when dysregulated, Wnt signaling is closely associated with various pathological conditions, including inflammation and different types of cancer. Here, we show a new connection between the leukocyte inflammatory response and the Wnt signaling pathway. Specifically, we demonstrate that circulating human primary monocytes express distinct Wnt signaling components and are susceptible to stimulation by the classical Wnt ligand—Wnt-3a. Although this stimulation increased the levels of β-catenin protein, the expression of the classical Wnt-target genes was not affected. Intriguingly, treating circulating human monocytes with Wnt-3a induces the secretion of cytokines and chemokines, enhancing monocyte migration. Mechanistically, the enhanced monocyte migration in response to Wnt stimuli is mediated through CCL2, a strong monocyte-chemoattractant. To further explore the physiological relevance of these findings, we conducted ex-vivo experiments using blood samples of patients with rheumatic joint diseases (RJD) – conditions where monocytes are known to be dysfunctional. Wnt-3a generated a unique cytokine expression profile, which was significantly distinct from that observed in monocytes obtained from healthy donors. Thus, our results provide the first evidence that Wnt-3a may serve as a potent stimulator of monocyte-driven immune processes. These findings contribute to our understanding of inflammatory diseases and, more importantly, shed light on the role of a core signaling pathway in the circulation.

Abstract Grid stability can be affected by the large‐scale utilisation of renewable energy sources because there are fluctuations in generation and load. These issues can be effectively addressed by grid‐scale battery energy storage systems (BESS), which can respond quickly and provide high energy density. Different roles of grid‐scale BESS in power systems are addressed, following optimal operation approaches classification. Furthermore, integrating BESSs into distribution grids is discussed to manage challenges from distributed generation. BESSs aid in voltage control, enhance frequency regulation, and offer black‐start services. Aggregating distributed BESSs can provide ancillary services and improve grid economics. For consumers, BESSs optimise energy costs, enhance reliability, and support self‐consumption from renewables. Novel BESS services include congestion relief, system adequacy, and power quality enhancement. Moreover, the ancillary services provided in different European countries through BESS are analysed. Finally, a case study was conducted among three Baltic DSOs to analyse the required amendments to Grid Codes and Electricity Market Acts for the integration of grid scale BESS.