MSCs biomimetic ultrasonic phase change nanoparticles promotes cardiac functional recovery after acute myocardial infarction.

Acute Myocardial Infarction (AMI) has seen rising cases, particularly in younger people, leading to public health concerns. Standard treatments, like coronary artery recanalization, often don't fully repair the heart's microvasculature, risking heart failure. Advances show that Mesenchymal Stromal Cells (MSCs) transplantation improves cardiac function after AMI, but the harsh microenvironment post-AMI impacts cell survival and therapeutic results. MSCs aid heart repair via their membrane proteins and paracrine extracellular vesicles that carry microRNA-125b, which regulates multiple targets, preventing cardiomyocyte death, limiting fibroblast growth, and combating myocardial remodeling after AMI. This study introduces ultrasound-responsive phase-change bionic nanoparticles, leveraging MSCs' natural properties. These particles contain MSC membrane and microRNA-125b, with added macrophage membrane for stability. Using Ultrasound Targeted Microbubble Destruction (UTMD), this method targets the delivery of MSC membrane proteins and microRNA-125b to AMI's inflamed areas. This aims to enhance cardiac function recovery and provide precise, targeted AMI therapy.

Reaction kinetics of CO2 capture into AMP/PZ/DME solid-liquid biphasic solvent.

The non-aqueous solid-liquid biphasic solvent of 2-amino-2-methyl-1-propanol (AMP)/piperazine (PZ)/dipropylene glycol dimethyl ether (DME) features a high CO2 absorption loading, favorable phase separation behavior and high regeneration efficiency. Different with the liquid-liquid phase change solvent, the reaction kinetics of CO2 capture into solid-liquid biphasic solvent was rarely studied. In the present work, the reaction kinetics of CO2 absorption into AMP/PZ/DME solid-liquid biphasic solvent was investigated into the double stirred kettle reactor. The absorption reaction followed a pseudo-first-order kinetic model according to the zwitterion mechanism. The overall reaction rate constant (kov) and the enhancement factor (E) of CO2 absorption both increased with increasing temperature. The total mass transfer resistance of the absorbent decreased with increasing temperature and increased with increasing absorption loading, so the higher reaction temperature was conducive to the absorption, and the liquid phase mass transfer resistance was the main factor affecting the absorption rate.

Changes in source contributions to the oxidative potential of PM2.5 in urban Xiamen, China.

The toxicity of PM2.5 does not necessarily change synchronously with its mass concentration. In this study, the chemical composition (carbonaceous species, water-soluble ions, and metals) and oxidative potential (dithiothreitol assay, DTT) of PM2.5 were investigated in 2017/2018 and 2022 in Xiamen, China. The decrease rate of volume-normalized DTT (DTTv) (38%) was lower than that of PM2.5 (55%) between the two sampling periods. However, the mass-normalized DTT (DTTm) increased by 44%. Clear seasonal patterns with higher levels in winter were found for PM2.5, most chemical constituents and DTTv but not for DTTm. The large decrease in DTT activity (84%-92%) after the addition of EDTA suggested that water-soluble metals were the main contributors to DTT in Xiamen. The increased gap between the reconstructed and measured DTTv and the stronger correlations between the reconstructed/measured DTT ratio and carbonaceous species in 2022 were observed. The decrease rates of the hazard index (32.5%) and lifetime cancer risk (9.1%) differed from those of PM2.5 and DTTv due to their different main contributors. The PMF-MLR model showed that the contributions (nmol/(min·m3)) of vehicle emission, coal + biomass burning, ship emission and secondary aerosol to DTTv in 2022 decreased by 63.0%, 65.2%, 66.5%, and 22.2%, respectively, compared to those in 2017/2018, which was consistent with the emission reduction of vehicle exhaust and coal consumption, the adoption of low-sulfur fuel oil used on board ships and the reduced production of WSOC. However, the contributions of dust + sea salt and industrial emission increased.

Biological variation of methylmalonic acid in urine in spanish population.

BACKGROUND-AIM: Methylmalonic acid (MMA) is currently the best biomarker of functional vitamin B12 deficiency. However, for a correct interpretation of the patient's results it is necessary to know its biological variation (BV). No BV data are available for urine MMA values, as measured by mass spectrometry. Hence, the aim of this study was to estimate the within- and between-person coefficients of variation (CVw, CVg) for MMA in a healthy population, and the associated index of individuality (II), as well as to define quality specifications based on BV and the reference change value (RCV). METHODS: Random urine samples from 34 healthy volunteers were collected over four consecutive weeks. Samples were stored at -80 °C until analysis in a single analytical run. MMA excretion was quantified by tandem liquid chromatography coupled to mass spectrometry (HPLC-MS/MS). Results were normalized to urine creatinine. The coefficients of variation were estimated by CV-ANOVA. Confidence intervals (95 %) were calculated. Quality specifications were defined according to international recommendations. RESULTS: A total of 128 samples were included. The coefficients of variation were CVw = 35.7 % (26.1-45.3) and CVg = 67.7 % (58.3-77.0). The associated II was 0.5 and the RCV was 88.1 %. CONCLUSION: Considering the II obtained, MMA in urine has high individuality, therefore, RCV is better to evaluate serial clinical results. Our results will contribute to a better clinical interpretation of this biomarker and will represent a great aid when defining analytical performance specifications for this magnitude.

Development of a coupled model to simulate and assess arsenic contamination and impact factors in the Jinsha River Basin, China.

With the increasing severity of arsenic (As) pollution, quantifying the environmental behavior of pollutant based on numerical model has become an important approach to determine the potential impacts and finalize the precise control strategies. Taking the industrial-intensive Jinsha River Basin as typical area, a two-dimensional hydrodynamic water quality model coupled with Soil and Water Assessment Tool (SWAT) model was developed to accurately simulate the watershed-scale distribution and transport of As in the terrestrial and aquatic environment at high spatial and temporal resolution. The effects of hydro-climate change, hydropower station construction and non-point source emissions on As were quantified based on the coupled model. The result indicated that higher As concentration areas mainly centralized in urban districts and concentration slowly decreased from upstream to downstream. Due to the enhanced rainfall, the As concentration was significantly higher during the rainy season than the dry season. Hydro-climate change and the construction of hydropower station not only affected the dissolved As concentration, but also affected the adsorption and desorption of As in sediment. Furthermore, As concentration increased with the input of non-point source pollution, with the maximum increase about 30%, resulting that non-point sources contributed important pollutant impacts to waterways. The coupled model used in pollutant behavior analysis is general with high potential application to predict and mitigate water pollution.

Environmental sympatry through time: spatio-temporal distribution and conservation status of two sympatric anuran species (Leptodactylidae) in South America / Simpatría ambiental a través del tiempo: distribución espacio-temporal y estado de conservación de dos especies de anuros simpátricos (Leptodactylidae) en América del Sur

Abstract Introduction: Leptodactylus latinasus and Physalaemus cuqui are sympatric anuran species with similar environmental requirements and contrasting reproductive modes. Climatic configuration determines distribution patterns and promotes sympatry of environmental niches, but specificity/selectivity determines the success of reproductive modes. Species distribution models (SDM) are a valuable tool to predict spatio-temporal distributions based on the extrapolation of environmental predictors. Objectives: To determine the spatio-temporal distribution of environmental niches and assess whether the protected areas of the World Database of Protected Areas (WDPA) allow the conservation of these species in the current scenario and future. Methods: We applied different algorithms to predict the distribution and spatio-temporal overlap of environmental niches of L. latinasus and P. cuqui within South America in the last glacial maximum (LGM), middle-Holocene, current and future scenarios. We assess the conservation status of both species with the WDPA conservation units. Results: All applied algorithms showed high performance for both species (TSS = 0.87, AUC = 0.95). The L. latinasus predictions showed wide environmental niches from LGM to the current scenario (49 % stable niches, 37 % gained niches, and 13 % lost niches), suggesting historical fidelity to stable climatic-environmental regions. In the current-future transition, L. latinasus would increase the number of stable (70 %) and lost (20 %) niches, suggesting fidelity to lowland regions and a possible trend toward microendemism. P. cuqui loses environmental niches from the LGM to the current scenario (25 %) and in the current-future transition (63 %), increasing the environmental sympathy between both species; 31 % spatial overlap in the current scenario and 70 % in the future. Conclusion: Extreme drought events and rainfall variations, derived from climate change, suggest the loss of environmental niches for these species that are not currently threatened but are not adequately protected by conservation units. The loss of environmental niches increases spatial sympatry which represents a new challenge for anurans and the conservation of their populations.

Resumen Introducción: Leptodactylus latinasus y Physalaemus cuqui son especies de anuros simpátricos con requerimientos ambientales similares y modos reproductivos contrastantes. La configuración climática determina los patrones de distribución y promueve la simpatría de los nichos ambientales, pero la especificidad/selectividad determina el éxito de los modos reproductivos. Los modelos de distribución de especies (MDE) son una herramienta valiosa para predecir distribuciones espacio-temporales basadas en la extrapolación de predictores ambientales. Objetivos: Determinar la distribución espacio-temporal de los nichos ambientales y evaluar si las áreas protegidas de la base de Datos Mundial de Áreas Protegidas (DMAP) permiten la conservación de estas especies en el escenario actual y futuro. Métodos: Aplicamos diferentes algoritmos para predecir la distribución y superposición espacio-temporal de nichos ambientales de L. latinasus y P. cuqui dentro de América del Sur en el último máximo glacial (UGM), Holoceno medio, actual y futuro. Evaluamos el estado de conservación de ambas especies con las unidades de conservación de la DMAP. Resultados: Todos los algoritmos aplicados mostraron un alto rendimiento para ambas especies (TSS = 0.87, AUC = 0.95). Las predicciones de L. latinasus mostraron amplios nichos ambientales desde LGM hasta el escenario actual (49 % de nichos estables, 37 % de nichos ganados y 13 % de nichos perdidos), sugiriendo fidelidad histórica por regiones climático-ambientales estables. En la transición actual-futura L. latinasus incrementaría la cantidad de nichos estables (70 %) y perdidos (20 %), sugiriendo fidelidad por regiones de tierras bajas y la posible tendencia hacia el microendemismo. P. cuqui pierde nichos ambientales desde el LGM al escenario actual (25 %) y en la transición actual-futura (63 %), incrementando la simpatría ambiental entre ambas especies; 31 % de superposición espacial en el escenario actual y 70 % en el futuro. Conclusión: Los eventos de sequía extrema y las variaciones de precipitaciones, derivados del cambio climático, sugieren la pérdida de nichos ambientales para estas especies, actualmente no se encuentran amenazadas, pero no están adecuadamente protegidas por las unidades de conservación. La pérdida de nichos ambientales aumenta la simpatría espacial que representa un nuevo desafío para estos anuros y la conservación de sus poblaciones.

Effectiveness of Changing Drug Classes in Patients With Refractory Laryngopharyngeal Reflux Disease.

OBJECTIVE: To investigate the effectiveness of drug class changes in patients with refractory laryngopharyngeal reflux disease (LPRD). STUDY DESIGN: Retrospective case series with prospective data. SETTING: Multicenter study. METHODS: The data of patients treated for a refractory LPRD from September 2017 to December 2023 were collected. The effectiveness of drug class changes was assessed through the reflux symptom score (RSS) change. Signs were evaluated with the Reflux Sign Assessment. The RSS reduction was used to categorize the therapeutic responses as mild (20%-40% RSS reduction), moderate (40.1%-60% RSS reduction), high (60.1%-80%), and complete (>80%). RESULTS: Among the 334 medical records, 74 (22.2%) patients had refractory LPRD defined as no RSS change in the pre- to 3-month posttreatment. The mean age was 52.6 ± 15.5 years. Changing drug class was associated with significant 3- to 6-month posttreatment reductions of RSS and RSA. Thirty patients (39%) did not experience symptom reduction after changing drugs. Changing alginate to magaldrate and magaldrate to alginate was associated with the highest responder rate (76.9%). Changing PPI and alginate/magaldrate molecules led to a response rate of 62.5%. In patients initially treated with a combination of PPI and alginate or magaldrate, changing PPI without changing alginate/magaldrate led to a 37.5% response rate. The baseline RSS was predictive of the 3- and 6-month RSS (therapeutic response). CONCLUSION: Changing drug class, especially alginate-to-magaldrate, may be an effective therapeutic approach for patients with a refractory LPRD.

Development and Validation of the Perceived Interpersonal Relevancy Scales: A New Measure of Perceived Threat, Opportunity, and Invisibility Appraisals for Use Across the Adult Life-Course.

OBJECTIVES: Interpersonal relevancy appraisals are a dynamic and understudied aspect of human social cognition. Despite their importance, there are no existing measures. This study developed and validated a new measure of self-perceived interpersonal threat, opportunity, and invisibility appraisals among a life-course sample of adults. We also explored the relationships between relevance appraisals, social connectedness, loneliness, age, and sex-assigned-at-birth. METHOD: Items were developed based on a theoretical model of multi-domain interpersonal relevance appraisals and refined following feedback from five experts in social psychology. Cross-sectional data were obtained online from a sample of 1,079 adults (age 18-90 years), recruited from the general population of Australia. Data were split into two pseudo-random samples used for 1) scale development and evaluation, and 2) assessment of internal consistency, construct validity, convergent validity with social connectedness and loneliness, and exploratory analysis with age and sex. RESULTS: Results support the factor structure and internal consistency of 17- and 9-item versions of the Perceived Interpersonal Relevancy Scales (PIRS) and measurement invariance across younger and older age groups. Higher self-perceived threat and invisibility appraisals were associated with decreased social network size, increased loneliness, younger age, and male sex. Higher self-perceived opportunity appraisals were associated with increased social network size and decreased loneliness. DISCUSSION: Results support this new measure of perceived interpersonal relevance appraisals, which shows relationships between the way we believe others perceive us, loneliness, and social isolation. The PIRS likely has wide utility for studies that seek to understand the intersections between human social cognition, well-being, and health across the lifespan.

How to Cope With Stress in the Desert-The Date Palm Approach.

Increasing desertification constitutes a global environmental problem, mainly driven by climate change and inappropriate land-use that limits agriculture, forestry and human colonization. The selection of suitable plant species to mitigate desertification is particularly challenging, as it usually requires simultaneous counteraction against a whole set of unfavourable environmental conditions, including heat, drought, high tropospheric ozone and salinity. It therefore seems useful to identify the survival strategies of plants native in desert environments. Date palm constitutes a plant species native in desert environments and cultivated worldwide in arid regions that have been studied intensively for stress defence during the last decade. The present review summarizes the current state of biochemical stress defence mechanisms including avoidance, osmotic and metabolic adjustments and reactive oxygen species scavenging, addresses whole-plant regulations and trade-off between stress compensation/defence and growth of date palms. The review advances our knowledge about how this typical desert species copes with both individual and multiple environmental stresses at the cellular to the whole-plant level, and identifies areas of future research required to fully understand the strategies of this plant species to survive in the desert, thereby contributing to efforts for the mitigation of climate change and desertification.

The Fertility Transition in Sub-Saharan Africa: The Role of Structural Change.

Despite recent economic growth and reductions in child mortality in many African countries, the region has experienced a slow fertility transition. In this study, we explore whether the slow structural economic change on the continent can explain this discrepancy. We construct a unique panel dataset combining Demographic and Health Surveys and nighttime light intensity data (an indicator of industrialization) from 57 countries at the subnational region level over three decades to analyze the drivers of fertility transitions across low- and middle-income countries. Our results confirm that household wealth, reduced child mortality, and female primary education are crucial for fertility declines. However, our analysis also highlights the importance of indicators of structural economic change, including the share of labor in nonagricultural occupations, industrialization, the share of women with higher education, and the formalization of the economy. Our simulations suggest that if high-fertility countries in sub-Saharan Africa underwent structural economic transformations comparable to those of other low- and middle-income countries with low fertility rates, their fertility levels could fall by 1 to 1.6 children.

Minimal change glomerular disease associated with solid neoplasms: a systematic review.

BACKGROUND: Paraneoplastic minimal change disease (MCD) has been associated with hematological malignancies, whereas solid malignancies are commonly associated with membranous glomerulonephritis. In this systematic review of the literature, we describe the clinical features, treatment and outcome of MCD associated with solid neoplasms. METHODS: We performed a systematic review of the MEDLINE, COCHRANE, EMBASE and SCOPUS databases, including case reports of adult patients with biopsy-proven MCD and solid malignancy, without language or time restrictions. RESULTS: Sixty-seven papers were included, presenting 86 cases with a mean age of 57.8 ± 14.7 years; 41.0% were women. Nephrotic syndrome was the initial presentation in 96.2% of patients; 67.2% had kidney function impairment, and 21.2% required kidney replacement therapy. The most frequent malignancies were malignant thymoma (34.9%), kidney (14.0%), lung (12.8%), and gastrointestinal tumors (12.8%). In 40.7% of cases, the neoplasm diagnosis preceded MCD by 33.8 ± 46.1 months, while in 31.4%, it followed diagnosis of MCD by 12.4 ± 22.6 months. In 27.9%, the neoplasm and kidney disease were diagnosed simultaneously. Immunosuppressive therapy was started in 79.1% of cases and tumor-specific treatment in 83.7%. Remission of MCD was achieved in 80.2% of patients: 38.2% responded to immunosuppressive treatment alone and 29.6% to oncological treatment alone. CONCLUSIONS: The association between MCD and solid neoplasms is well-documented. Immunosuppressive therapy alone induced nephrotic syndrome remission in over one-third of cases; most others responded to tumor-specific treatment. Solid tumor screening should be considered in MCD independently of the steroid response, though more data on solid tumor-associated MCD prevalence are needed for a definitive statement. PROSPERO TRIAL REGISTRATION NUMBER: CRD42024521854.

Climate Anxiety: Current Evidence and Future Directions.

PURPOSE OF REVIEW: Challenging cognitive, somatic, and behavioral responses to climate change are often conceptualized as climate anxiety (CA). Due to the increased recognition of the impacts of climate change on mental health, a growing body of scientific literature is developing. The purpose of this manuscript is to review the current evidence base for CA and propose future research needs for this emerging construct. RECENT FINDINGS: Early evidence supports underlying psychological mechanisms in the development and maintenance of CA, which are similar to other anxiety-related conditions. However, the study of CA poses unique challenges to researchers. The psychological impacts that occur in the context of climate change may be adaptive depending on the imminent threat of natural disasters, forced migration, or other climate-related challenges. Due to the potentially adaptive nature of CA and limited current evidence, a coordinated research program of climate-related distress is necessary. A review of the extant literature identified current gaps in understanding the epidemiology and individual differences that promote CA. Current evidence supports the prominent role of neuroticism, intolerance of uncertainty, and rumination. The development of evidence-based models of climate-related distress may provide a more valid and comprehensive depiction of the impacts of climate change on mental health. Transdiagnostic treatment methods are likely the most appropriate intervention for climate-related distress. As models, measures, and treatments of climate-related distress are developed, it is crucial to incorporate studies of populations most at risk for climate change-related mental health effects.

The Effect of Temperature Variability on Biological Responses of Ectothermic Animals-A Meta-Analysis.

Climate change is altering temperature means and variation, and both need to be considered in predictions underpinning conservation. However, there is no consensus in the literature regarding the effects of temperature fluctuations on biological functions. Fluctuations may affect biological responses because of inequalities from non-linear responses, endocrine regulation or exposure to damaging temperatures. Here we establish the current state of knowledge of how temperature fluctuations impact biological responses within individuals and populations compared to constant temperatures with the same mean. We conducted a meta-analysis of 143 studies on ectothermic animals (1492 effect sizes, 118 species). In this study, 89% of effect sizes were derived from diel cycles, but there were no significant differences between diel cycles and shorter (<8 h) or longer (>48 h) cycles in their effect on biological responses. We show that temperature fluctuations have little effect overall on trait mean and variance. Nonetheless, temperature fluctuations can be stressful: fluctuations increased 'gene expression' in aquatic animals, which was driven mainly by increased hsp70. Fluctuating temperatures also decreased longevity, and increased amplitudes had negative effects on population responses in aquatic organisms. We conclude that mean temperatures and extreme events such as heat waves are important to consider, but regular (particularly diel) temperature fluctuations are less so.

Developing an initial explanatory theory for Partnering for Change using realist evaluation.

INTRODUCTION: Partnering for Change (P4C) is an innovative practice model for school-based occupational therapy developed in Canada and informed by a program of research spanning nearly two decades. National and international interest in P4C necessitated development of an explanatory theory to guide implementation in varied contexts. The purpose of this study is to document the process of theory development and to provide an overview of the initial P4C explanatory theory. METHODS: Realist evaluation was used to construct an initial explanatory theory of P4C drawing on P4C developers' conceptualisations of the model, document analysis, and analysis of transcripts from interviews and focus groups. CONSUMER AND COMMUNITY INVOLVEMENT: No consumers were involved in the study design or analysis. FINDINGS: Four sets of premises expressed as context-mechanism-outcome configurations (CMOCs) comprise the initial explanatory theory of P4C. An abstracted summary of these four sets along with contexts, mechanisms, and outcomes central to the P4C initial explanatory theory is presented. An exemplar CMOC is shared to illustrate how theoretical premises are developed and expressed using realist evaluation. CONCLUSION: This study advances knowledge regarding the hypothesised core elements of P4C and provides an example of using realist evaluation to advance knowledge in occupational therapy. Preliminary implications for clinical practice are discussed. PLAIN LANGUAGE SUMMARY: Partnering for Change (P4C) is a way of providing occupational therapy services in schools that helps all children to learn and participate successfully. P4C was created in Ontario, Canada, and has been researched for almost 20 years. People in different parts of Canada and other countries are interested in trying P4C. As the researchers who created P4C, we think there is a need to explain how it works so it can be used in different places. This study explains how we created a theory to describe P4C. To develop this theory, we used a method called realist evaluation that would help us explain how, why, and in what situations P4C works best. To do this, we analysed documents and transcripts of interviews and focus groups. Our findings are organised into four main ideas, each explained in terms of contexts (the situations), mechanisms (how and why P4C works), and outcomes (the impacts of P4C). One detailed example is given to show how these ideas were formed and work together. In conclusion, our study helps us understand the key parts of P4C and shows how realist evaluation can be used to improve knowledge in occupational therapy. The study also suggests some early ideas on how P4C can be used in practice.

Asymmetric responses of EVI and tree ring growth to extreme climate on the northeastern margin of the Tibetan Plateau.

Extreme climate events have increased in terms of their amplitudes, frequency and severity, greatly affecting ecosystem functions and the balance of the global carbon cycle. However, there are still uncertainties about how extreme climate change will affect tree growth. This study characterized the responses of tree growth to extreme climate on the northeastern Tibetan Plateau from 2000 to 2020. Meanwhile, a back propagation neural network was used to predict tree growth trends under two future emission scenarios from 2020 to 2050. This study revealed that: (1) the tree-ring width index (RWI) showed a decreasing trend (- 0.04/decade) in the eastern region, but the enhanced vegetation index (EVI) showed an increasing trend (0.05/decade) from 2000 to 2020. While both RWI and EVI in the middle and western regions showed increasing trends. (2) The responses of RWI and EVI to extreme climate were regionally asymmetric. In the eastern region, extreme precipitation inhibited tree radial growth, while extreme warm nights promoted tree canopy growth. In two other regions, both extreme precipitation and extreme warm nights promoted tree growth. (3) The model predicts that there was no significant change in RWI and EVI in the western region, but both RWI and EVI showed an increasing trend in the middle and eastern regions under the low emission scenario. Under the high emission scenario, the growth of tree stem and canopy in all three regions shows a general decreasing trend. The results of this study both improved the understanding of the differences in carbon allocation between tree stem (RWI) and canopy (EVI) and identified vulnerability thresholds for tree populations.

The Role of Relevance in Shaping Perceptions of Sleep Hygiene Games Among University Students: Mixed Methods Study.

BACKGROUND: Sleep games are an emerging topic in the realm of serious health game research. However, designing features that are both enjoyable and effective at engaging users, particularly university students, to develop healthy sleep habits remains a challenge. OBJECTIVE: This study aims to investigate user preferences for 3 sleep game prototypes, that is, Hero's Sleep Journey, Sleep Tamagotchi, and Sleepland, and to explore their popularity and perceived utility in promoting sleep health. METHODS: A mixed methods approach was used in this study. Quantitative and qualitative data were collected through a co-design workshop involving 47 university students. Participants were presented with storyboard cards of game features and were asked to provide an overall rating on each game, as well as ratings for individual features. They were also encouraged to provide free-form comments on the features and suggest improvements. In addition, participants were asked to express their preferences among the 3 games regarding which game they would most like to play and which one they found most useful for promoting sleep health. RESULTS: Surprisingly, while Hero's Sleep Journey was the most popular choice among participants, Sleep Tamagotchi was perceived as the most beneficial for improving sleep health. Relevance emerged as an overarching theme in the qualitative data analysis, with 3 interconnected dimensions: psychological relevance to users' personal lives, logical relevance to sleep health, and situational relevance to users' circumstantial context. We discussed how the 3 dimensions of relevance address the autonomy and relatedness constructs outlined in the self-determination theory and proposed 3 design recommendations. CONCLUSIONS: Our serious sleep game prototypes demonstrated the potential to engage university students to develop healthy sleep hygiene. Future sleep game designs should aim to create a sense of relevance to users' personal lives, sleep health goals, and situational contexts. Rather than a one-size-fits-all approach, it is essential to develop a wide range of game genres and features to cater to diverse users. Aligning game features with sleep health goals and educating users on the design rationale through sleep knowledge are also important aspects. Furthermore, allowing users to customize their game experience and manage technology boundaries is necessary to nurture a sense of control and autonomy in the process of forming good sleep hygiene.

A Behavioral Change-Based Mobile Intervention for Promoting Regular Physical Activity in Medical Rehabilitation Maintenance of Patients With Coronary Artery Disease: Controlled Trial.

BACKGROUND: Cardiac rehabilitation is known to reduce coronary artery disease (CAD) severity and symptoms, but adoption of a healthy postrehabilitation lifestyle remains challenging. Innovative eHealth solutions could help, but behavioral change-based eHealth maintenance programs for patients with CAD are scarce. RehaPlus+ aims to improve postrehabilitation outcomes with a personalized eHealth intervention built on behavioral change concepts emphasizing healthy lifestyle changes, especially regular physical activity (PA). OBJECTIVE: This study aims to evaluate the effectiveness of the personalized eHealth program RehaPlus+ for promoting regular PA against usual care. METHODS: A total of 169 patients with CAD who had undergone stent implantation or bypass surgery were recruited after completing center-based phase II rehabilitation. They were then divided, without blinding, into 2 groups using a quasi-experimental approach: a case manager-assisted 24-week eHealth program (RehaPlus+; n=84) and a conventional physician-assisted outpatient program (usual care; n=85). The study was designed as a noninferiority trial. RehaPlus+ participants received motivational messages twice weekly for 6 months, and the usual care group engaged in a 6-month outpatient program (twenty-four 90-minute strength and endurance training sessions). The primary outcomes, evaluated using the self-assessed Bewegungs- und Sportaktivität questionnaire, were regular PA (≥150 min/wk) and weekly activities of daily living (ADLs) 6 months after rehabilitation. Secondary outcomes involved PA during work and floors climbed weekly (measured by Bewegungs- und Sportaktivität questionnaire), psychological well-being (assessed by the 5-item World Health Organization Well-Being Index), cardiac self-efficacy, health-related quality of life (measured by the 36-Item Short Form Survey), and work ability (using the Work Ability Index). RESULTS: Data of 105 patients (RehaPlus+: n=44, 41.9%; usual care: n=61, 58.1%; male patients: n=80, 76.2%; female patients: n=25, 23.8%; mean age 56.0, SD 7.3 years) were available at the 6-month follow-up. At 6 months after discharge from phase II cardiac rehabilitation, the RehaPlus+ group exhibited 182 (SD 208) minutes per week of PA and the usual care group exhibited 119 (SD 175) minutes per week of PA (P=.15), with no interaction effect (P=.12). The RehaPlus+ group showed an ADL level of 443 (SD 538) minutes per week compared to the usual care group with 308 (SD 412) minutes per week at the 6-month follow-up, with no interaction effect (P=.84). The differences observed in PA and ADL levels between the RehaPlus+ and usual care groups were within the predefined 1-sided noninferiority margin, indicating that the RehaPlus+ intervention is not inferior to usual care based on these outcomes. There were no differences between the groups for all secondary outcomes (P>.05). CONCLUSIONS: RehaPlus+ is not inferior to the usual care program, as both groups improved PA and ADLs to a similar extent. These findings emphasize the potential of eHealth interventions to assist in maintaining healthy lifestyles after rehabilitation. TRIAL REGISTRATION: ClinicalTrials.gov NCT06162793; https://clinicaltrials.gov/study/NCT06162793.

Rationale and design of a randomized placebo-controlled nutritional trial embracing a citizen science approach.

Modulation of the gut microbiota through specific dietary interventions shows potential for maintenance and optimization of health. A dietary fiber diet and fermented foods diet appear to alter the gut microbiota, but evidence is limited. Therefore, we designed the Gut Health Enhancement by Eating Favorable Food study, a 21-week randomized controlled trial studying effects of dietary fibers and fermented foods on gut microbiota diversity and composition, while also stimulating dietary behavior changes through a citizen science (CS) approach. We hypothesized that a high-fermented food diet would increase microbial diversity, whereas a high-dietary fiber diet would stimulate the growth of specific fiber-degrading bacteria. The following elements of CS were adopted: education on the gut microbiota, tailored dietary intervention, remote data collection by participants, sharing of personal gut microbiota outcomes with participants, and vlogs by participants for dissemination of results. Here we describe the study protocol and report the flow of participants, baseline characteristics, and compliance rates. Completed in March 2024, the trial included 147 healthy adults randomized to a high-dietary fiber intervention, high-fermented food intervention, or control group. Each group received an additional study product after 2 weeks: dried chicory root, a fermented beverage, or maltodextrin (placebo). A 3-month follow-up assessed the participants' ability to sustain dietary changes. The recruitment of participants was successful, reflected by 1448 applications. The compliance with the dietary guidelines and study products was >90%. This study shows that including elements of CS in an randomized controlled trial is feasible and may help recruitment and compliance.

Historical and theoretical roots of the big events framework.

This article traces the evolution of the Big Events framework since it began as an attempt to understand why sociopolitical transitions in the Former Soviet Union, South Africa, and Indonesia were followed by HIV outbreaks. Big Events frameworks have evolved over time, but all versions try to concretize how macrosocial changes lead to social, personal and environmental changes that shape risk environments and drug use or other behavioral patterns in ways that may lead to epidemics. Important stages in the evolution of the Big Events framework included understanding that the sequelae of Big Events were contingent rather than deterministic, and the development of new survey measures to understand pathways through which Big Events affect social and epidemiologic outcomes. On a broader level, the Big Events framework is a useful crystallization and application of more abstract sociological, social epidemiologic and Marxist frameworks about upstream/downstream relationships and how major social changes are related to epidemics. As such, they raise issues of how to conduct research on dialectical interaction processes. On another level, this article traces the Big Events "style of thought" as Mannheim (Mannheim, 1971) termed it, within the historical context of changes in public health and social science theory, particularly during and after the 1960s.