Highly Solubilized Urea as Effective Proton Donor-Acceptors for Durable Zinc-Ion Storage Beyond Single-Anion Selection Criteria.

Urea, as one of the most sustainable organic solutes, denies the high salt consumption in commercial electrolytes with its peculiar solubility in water. The bi-mixture of urea-H2O shows the eutectic feature for increased attention in aqueous Zn-ion electrochemical energy storage (AZEES) technologies. While the state-of-the-art aqueous electrolyte recipes are still pursuing the high-concentrated salt dosage with limited urea adoption and single-anion selection category. Here, a dual-anion urea-based (DAU) electrolyte composed of dual-Zn salts and urea-H2O-induced solutions is reported, contributing to a stable electric double-layer construction and in situ organic/inorganic SEI formation. The optimized ZT2S0.5-20U electrolytes show a high initial Coulombic efficiency of 93.2% and durable Zn-ion storage ≈4000 h regarding Zn//Cu and Zn//Zn stripping/plating procedures. The assembled Zn//activated carbon full cells maintain ≈100% capacitance over 50 000 cycles at 4 A g-1 in coin cell and ≈98% capacitance over 20 000 cycles at 1 A g-1 in pouch cell setups. A 12 × 12 cm2 pouch cell assembly illustrates the practicality of AZEES devices by designing the cheap, antifreezing, and nonflammable DAU electrolyte system coupling proton donor-acceptor molecule and multi-anion selection criteria, exterminating the critical technical barriers in commercialization.

The association between somatic cell count and selective dry cow therapy, milking routine, and dry cow management practices in early-lactation cows from 21 commercial grazing dairy herds.

This observational study aimed to explore the association of farmer-driven selective dry cow therapy (DCT), milking routine and dry cow management practices with SCC in early-lactation cows from 21 commercial dairy herds. Milking routine practices evaluated referred to cow preparation for milking, in-lactation mastitis management, and recording. Dry cow management practices related to dry cow environment and cleaning, dry-off procedure, milk cessation strategy and calving environment. Data from 2,016 multiparous cows in 21 commercial spring-calving grazing dairy herds were available for the study. Herd owners self-reported DCT (the assignment and administration of DCT was at the discretion of the herd owners with no involvement from the research team), management practices during milking and the dry period. Cow-level last test-day SCC records in 2020 (range = 105-285 DIM) and first test-day records in 2021 (range = 5-60 DIM) were obtained from milk recording databases. Quarter-level milk sampling was carried out on all cows in late lactation of 2020 (range = 240-261 DIM) for bacterial culturing. Bacteriological results were used to define cows with IMI when ≥1 quarter sample resulted in bacterial growth and there were no contaminated samples from that cow. Mixed model analyses were used to evaluate the association of selective DCT, milking routine, and dry cow management practices with cows' first test-day log 10 SCC (logSCC) in 2021. At dry-off in 2020, 47.6% of the cows were administered an internal teat sealant alone (ITS), while 52.4% were administered an antibiotic plus an internal teat sealant (AB+ITS). The mean herd-level percentage of cows with IMI was 19.7% (range = 9.8%-39.5%); Staphylococcus aureus accounted for the majority of cow-level IMI (89.9%, 357/397). Between herds, the proportion of cows administered ITS ranged from 17.7% (14/79; in a herd with an IMI prevalence of 10.1%) to 86.8% (66/76; in a herd with an IMI prevalence of 27.6%). In total, 11.8% (105/889) and 29.8% (292/980) of cows that were administered ITS or AB+ITS had an IMI in late lactation 2020, respectively. The mean untransformed SCC at the last test day in 2020 of cows administered ITS and AB+ITS was 55,000 and 197,200 cells/mL, respectively. The statistical analysis showed a significant interaction between selective DCT and milk yield at last test-day in 2020; cows with a milk yield of 15 kg and administered ITS had a 0.1 higher (untransformed SCC of 19,000 cells/mL higher) first test-day logSCC compared with cows administered AB+ITS. Additionally, greater parity, IMI in late lactation, higher logSCC at the last test-day in 2020 and longer dry periods were associated with higher logSCC at the first test-day in 2021. The current study identified cow- and herd-level management practices that could aid dairy farmers in improving the outcome of selective DCT and decrease early lactation SCC.

Optimizing selection strategy for enhancing reproduction efficiency in Indian crossbred goats using milk productivity as a selection criterion.

The present study was aimed at optimizing the selection strategy for enhancing reproductive efficiency and milk productivity of Alpine × Beetal crossbred goats. The data set included 2949 milk trait records across parities and 1389 milk records from first parity and corresponding reproductive traits. The traits included for analysis were 150-day milk yield (150DMY), days in milk (DIM), peak yield (PY) and total milk yield (TMY). The litter size (LS) and litter weight (LW) were used for specifically formulating selection plan using indirect selection. The least squares mean for lactation traits during the first parity were 150DMY: 195.32 ± 2.09 kg, DIM: 236.42 ± 3.04 days, PY: 1.82 ± 0.02 kg, TMY: 269.62 ± 4.52 kg. Notably, Alpine × Beetal goats demonstrated genetic superiority pan India for milk productivity as compared to other native goat breeds. The least squares mean for 150DMY across all parities was 236 ± 3.13 kg. An animal model employing average information restricted maximum likelihood was used for (co)variance component estimation to get the genetic parameters. The analysis revealed total heritability estimates for 150DMY, DIM, PY and TMY as 0.18 ± 0.06, 0.04 ± 0.04, 0.12 ± 0.06 and 0.08 ± 0.05, respectively. Repeatability estimates for 150DMY, DIM, and TMY were 0.28 ± 0.04, 0.21 ± 0.03 and 0.37 ± 0.03, respectively. Bivariate analysis of 150DMY with reproductive traits revealed heritability for LS and LW as 0.05 ± 0.01 and 0.10 ± 0.01, respectively using Gibbs sampling. Strong and positive genetic correlations of 150DMY with other production and reproduction traits was observed, such as DIM (0.72), PY (0.98), TMY (0.88), LS (0.57) and LW (0.33). Moderate heritability and repeatability estimate of 150DMY, along with its positive correlation with production and reproductive traits suggested it as a suitable selection criterion for early selection and overall genetic progress of lactation traits. The genetic trend analysis showed an overall improvement in all these traits, with observed gain of 98.4 g per year for 150DMY, 0.04 days per year for DIM, 0.5 g per year for PY and 220.5 g per year for TMY. We observed that selecting based on 150DMY would lead to a favourable indirect improvement for LW as 79 g and LS 0.04 units per generation. We, therefore, recommend employing 150DMY as the single trait selection criteria to enhance both milk productivity and reproductive potential of Alpine × Beetal goats.

Liver transplantation as an alternative for the treatment of neuroendocrine liver metastasis: Appraisal of the current evidence.

BACKGROUND: Liver transplantation (LT) for neuroendocrine liver metastases (NELM) is still in debate. Studies comparing LT with liver resection (LR) for NELM are scarce, as patient selection is heterogeneous and experience is limited. The goal of this review was to provide a critical analysis of the evidence on LT versus LR in the treatment of NELM. DATA SOURCES: A scoping literature search on LT and LR for NELM was performed with PubMed, including English articles up to March 2023. RESULTS: International guidelines recommend LR for NELM in resectable, well-differentiated tumors in the absence of extrahepatic metastatic disease with superior results of LR compared to systemic or liver-directed therapies. Advanced liver surgery has extended resectability criteria whilst entailing increased perioperative risk and short disease-free survival. In highly selected patients (based on the Milan criteria) with unresectable NELM, oncologic results of LT are promising. Prognostic factors include tumor biology (G1/G2) and burden, waiting time for LT, patient age and extrahepatic spread. Based on low-level evidence, LT for low-grade NELM within the Milan criteria resulted in improved disease-free survival and overall survival compared to LR. The benefits of LT were lost in patients beyond the Milan NELM-criteria. CONCLUSIONS: With adherence to strict selection criteria especially tumor biology, LT for NELM is becoming a valuable option providing oncologic benefits compared to LR. Recent evidence suggests even stricter selection criteria with regard to tumor biology.

International medical graduates (IMGs) matching into US orthopaedic surgery residency: a fifteen year analysis of trends in applications and geographical distribution.

PURPOSE: International Medical Graduates (IMGs) face challenges in securing orthopaedic surgery residencies in the U.S. This study examines residency matching trends and geographic distribution for U.S. and non-U.S. citizen IMGs. METHODS: The National Resident Matching Program (NRMP) data from 2008 to 2022 were analyzed for USMLE scores, publication counts, and match rates, using linear regression. The proportion of non-US IMGs in orthopaedic surgery residency was compared with the foreign-born population of each region based on the 2021 American Community Survey. RESULTS: The overall IMG fill rate decreased significantly from 2.04% in 2008 to 1.26% in 2022 (P = 0.002). The number of publications for matched US IMGs was at least three times that of matched MD seniors and about two times that of unmatched US IMGs. Matched non-US IMGs had approximately five and three times the number of publications as matched MD seniors and unmatched non-US IMGs, respectively. Mississippi had the highest IMG-to-all-filled-position ratio (6.7%) and New York matched the most IMGs (36 residents). Although the foreign-born population comprises approximately 13.72% of the US population, non-US IMGs accounted for less than 1% of total matched residents. When compared to the foreign-born population, non-US IMGs were underrepresented in the US. This underrepresentation was observed in all nine geographic divisions, particularly in the West South Central and Pacific regions. CONCLUSIONS: While IMGs constitute a low percentage of matched MDs in orthopaedic surgery, they show three to five times more publications than MD seniors. IMGs should recognize the importance of higher publication numbers in the matching process as well as states with higher IMG matching rates.

Participatory investigation of goat farmers' breeding practices, trait preference, and selection criteria in Burkina Faso.

The community-based breeding program (CBBP) is an innovative approach recommended for genetic improvement and sustainable use of animal genetic resources in extensive farming systems. Successful implementation of this approach requires an understanding of the characteristics of production systems, breeding objectives, and farmers' trait preference. This study aimed to identify the selection criteria of goat farmers in rural areas of Burkina Faso and their potential implications in establishing CBBP. Following focus group discussions, a well-structured questionnaire was designed and administered to 372 randomly selected goat farmers in two different agro-ecological zones. A list of traits obtained during focus group discussions was provided to farmers individually, and they were asked to rank the ones they preferentially use to select breeding animals. Statistical tests were conducted to compare data between the two agro-ecological zones. The results showed that the average goat flock per household was higher (P < 0.05) in the Sudanian (15.68 ± 13.76), compared to the Sudano-Sahelian area (12.93 ± 13.3). Adult females were the dominant age-sex group in both areas. Reasons for culling, keeping breeding bucks, and castration practice were significantly different (P < 0.05) among agro-ecological zones. The most important common criterion for selection in the two zones was body size, coat color, and growth rate for the bucks and does, while fertility (0.06) parameters including twining ability (0.18), kidding frequency (0.11), and mothering ability (0.15) were furthermore considered for breeding does selection. These findings provide valuable insights for developing CBBPs tailored to goat production in the study areas.

Guided bone regeneration in implant dentistry: Basic principle, progress over 35 years, and recent research activities.

Bone augmentation procedures are frequent today in implant patients, since an implant should be circumferentially anchored in bone at completion of bone healing to have a good long-term stability. The best documented surgical technique to achieve this goal is guided bone regeneration (GBR) utilizing barrier membranes in combination with bone fillers. This clinical review paper reflects 35 years of development and progress with GBR. In the 1990s, GBR was developed by defining the indications for GBR, examining various barrier membranes, bone grafts, and bone substitutes. Complications were identified and reduced by modifications of the surgical technique. Today, the selection criteria for various surgical approaches are much better understood, in particular, in post-extraction implant placement. In the majority of patients, biodegradable collagen membranes are used, mainly for horizontal bone augmentation, whereas bioinert PTFE membranes are preferred for vertical ridge augmentation. The leading surgeons are using a composite graft with autogenous bone chips to accelerate bone formation, in combination with a low-substitution bone filer to better maintain the augmented bone volume over time. In addition, major efforts have been made since the millenium change to reduce surgical trauma and patient morbidity as much as possible. At the end, some open questions related to GBR are discussed.

Selecting patients for early interdisciplinary rehabilitation during neurointensive care after moderate to severe traumatic brain injury.

BACKGROUND: Early interdisciplinary rehabilitation (EIR) in neurointensive care is a limited resource reserved for patients with moderate to severe traumatic brain injury (TBI) believed to profit from treatment. We evaluated how key parameters related to injury severity and patient characteristics were predictive of receiving EIR, and whether these parameters changed over time. METHODS: Among 1003 adult patients with moderate to severe TBI admitted over 72 h to neurointensive care unit during four time periods between 2005 and 2020, EIR was given to 578 and standard care to 425 patients. Ten selection criteria thought to best represent injury severity and patient benefit were evaluated (Glasgow Coma Scale, Head Abbreviated Injury Scale, New-Injury-Severity-Scale, intracranial pressure monitoring, neurosurgery, age, employment, Charlson Comorbidity Index, severe psychiatric disease, and chronic substance abuse). RESULTS: In multivariate regression analysis, patients who were employed (adjOR 1.99 [95% CI 1.41, 2.80]), had no/mild comorbidity (adjOR 3.15 [95% CI 1.72, 5.79]), needed neurosurgery, had increasing injury severity and were admitted by increasing time period were more likely to receive EIR, whereas receiving EIR was less likely with increasing age (adjOR 0.97 [95% CI 0.96, 0.98]) and chronic substance abuse. Overall predictive ability of the model was 71%. Median age and comorbidity increased while employment decreased from 2005 to 2020, indicating patient selection became less restrictive with time. CONCLUSION: Injury severity and need for neurosurgery remain important predictors for receiving EIR, but the importance of age, employment, and comorbidity have changed over time. Moderate prediction accuracy using current clinical criteria suggest unrecognized factors are important for patient selection.

Determining acceptance and perceptions of chemotherapy dose banding in an ambulatory cancer centre.

INTRODUCTION: Despite the advantages of dose banding (DB) and numerous plans to adopt this practice, uptake of DB is still poor. As opinions of healthcare professionals were deemed essential in DB's acceptance, this study surveyed key stakeholders to determine the acceptance, facilitators, and barriers of DB in chemotherapy to improve its implementation. METHODS: A cross-sectional study at the National Cancer Centre Singapore, involving physicians, nurses, and pharmacy staff, was conducted in February 2022. The Theory of Planned Behaviour was adapted to design a survey questionnaire to obtain the acceptance, facilitators, and barriers of DB. Additional questions on maximum acceptable dose variance and essential criteria for selecting drugs for DB were included. RESULTS: A total of 93 participants responded, with a mean 9.75 ± 7.37 years of clinical experience. Less than half have heard of DB while few had prior experience. Drug cost was the top selection criteria for DB, followed by toxicity, therapeutic index, frequency of use and drug wastage. Acceptance rate of DB was 41.9%, with majority agreeing to use DB in various drugs but to determine patient suitability before usage. Being greatly affected by subjective norms, having a positive outlook for DB's impacts, and no effect on toxicity significantly influenced acceptance. CONCLUSION: Prior to implementing DB at the institutional level, educational training addressing concerns over toxicity, and providing technological support can help improve acceptance. Future studies can involve patients' perspectives and more institutions for greater diversity in opinions.

Relationship between selection criteria and trainee performance in medical specialty training: A retrospective longitudinal study.

BACKGROUND: Investigation of tools used for candidate selection as predictors of future performance in medical education has been primarily undertaken within the undergraduate setting, but little is known about the selection to medical specialist programs. This retrospective longitudinal study aims to explore correlations between selection tools and the performance of trainees enrolled in the Australasian College of Dermatologists (ACD), the accredited specialist medical college for training in dermatology in Australia. METHODS: Data were collected from consecutive cohorts of ACD trainees commencing from 2007 to 2015. Predictive variables were trainee demographics and selection tools (prior academic qualification; research experience; clinical experience; curriculum vitae [CV] rating; interview scores). The outcome variables were exam performance. First Year ([Pharmacology and Clinical Sciences] and Fellowship Exam [Written, Clinical, and Overall Score]). Statistical analyses included: descriptive statistics summaries; bivariate correlation of selection criteria and demographic data with exam performance; and linear regression analysis to identify predictors of exam performance. RESULTS: Demographic analysis (N = 172) showed that 64% of trainees were female, the average age was 30.5 years (± 3.47) and trainees living in high socioeconomic status (SES) areas were over-represented. Using Pearson correlation analysis, interview scores were significantly positively correlated with First Year Pharmacology results (p = 0.018), Fellowship Written results (p = 0.002), and Fellowship Overall Scores (p = 0.006). First Year Pharmacology Exam performance was most highly correlated with Fellowship Exam performance (p = 0.000). No association was identified between exam performance and gender, SES, prior academic qualification, research experience or CV rating. Linear regression analysis showed that interview score (p = 0.012), entry age (p = 0.026) and First Year Pharmacology score (p = 0.002) were predictors of Fellowship exam performance. CONCLUSION: These results suggest that the comprehensive selection tools used by ACD are effective, with interviews being a highly valid tool linked to exam performance. These findings have important practical implications for assessing the selection process in specialist dermatology training.

What is the evidence for biology as the 'heart of eligibility' to study medicine? A retrospective analysis.

The first, sometimes the only, selection tool for entry into undergraduate medicine is prior educational attainment (PEA). This is often further specified to include certain subjects, for example, biology is a prerequisite for entry into medicine in many Asian countries. However, there seems no clear evidence base for this prerequisite. Our aim, therefore, was to carry out a retrospective quantitative study comparing the performances of five cohorts of students (2015-2019 entry; n = 588) with and without biology PEA in Years 1 and 2 Bachelor of Medicine and Bachelor of Surgery (MBBS) integrated written assessments (n = 3) and anatomy practical examinations (APE) (n = 5). The study was conducted at one of Singapore's three medical schools. Data were analyzed using independent t-tests and Mann-Whitney U with p values of less than 0.05 were considered significant. There were no significant differences in performance on any Years 1 or 2 integrated written assessments. Similarly, in one of the APE, a significant difference was found for one cohort (academic year [AY] 2015-2016) out of five assessments. These results suggest that having a prior biology qualification does not make a difference in assessment performance in the early years of medical school. This information may help stakeholders and admissions committees decide whether biology is required for medical school entrance.

Threats to external validity in the neuroprediction of substance use treatment outcomes.

Background: Tools predicting individual relapse risk would invaluably inform clinical decision-making (e.g. level-of-care) in substance use treatment. Studies of neuroprediction - use of neuromarkers to predict individual outcomes - have the dual potential to create such tools and inform etiological models leading to new treatments. However, financial limitations, statistical power demands, and related factors encourage restrictive selection criteria, yielding samples that do not fully represent the target population. This problem may be further compounded by a lack of statistical optimism correction in neuroprediction research, resulting in predictive models that are overfit to already-restricted samples.Objectives: This systematic review aims to identify potential threats to external validity related to restrictive selection criteria and underutilization of optimism correction in the existing neuroprediction literature targeting substance use treatment outcomes.Methods: Sixty-seven studies of neuroprediction in substance use treatment were identified and details of sample selection criteria and statistical optimism correction were extracted.Results: Most publications were found to report restrictive selection criteria (e.g. excluding psychiatric (94% of publications) and substance use comorbidities (69% of publications)) that would rule-out a considerable portion of the treatment population. Furthermore, only 21% of publications reported optimism correction.Conclusion: Restrictive selection criteria and underutilization of optimism correction are common in the existing literature and may limit the generalizability of identified neural predictors to the target population whose treatment they would ultimately inform. Greater attention to the inclusivity and generalizability of addiction neuroprediction research, as well as new opportunities provided through open science initiatives, have the potential to address this issue.

Diagnostic value of preoperative measures in selecting post-lingually deafened candidates for cochlear implantation - a different approach.

OBJECTIVES: We examined which preoperative diagnostic measure is most suited to serve as a selection criterion to determine adult cochlear implantation (CI) candidacy. DESIGN: Preoperative diagnostic measures included pure tone audiometry (PTA; 0.5, 1, 2, 4 kHz), speech perception tests (SPT) unaided with headphones and with best-aided hearing aids (in quiet and in noise). Gain in speech perception was used as outcome measure. Performance of preoperative measures was analysed using the area under the curve (AUC) of receiver operating characteristic (ROC) curves. STUDY SAMPLE: This retrospective longitudinal cohort study included 552 post-lingually deafened adults with CI in a tertiary referral centre in the Netherlands. RESULTS: Best-aided SPT in quiet was the most accurate in defining which CI candidates improved their speech perception in quiet postoperatively. For an improvement in speech perception in noise, the best-aided SPT in noise was the most accurate in defining which adult would benefit from CI. PTA measures performed lower compared to the SPT measures. CONCLUSIONS: SPT is better than PTA for selecting CI candidates who will benefit in terms of speech perception. Best-aided SPT in noise was the most accurate for indicating an improvement of speech perception in noise but was only evaluated in high performers with residual hearing. These insights will assist in formulating more effective selection criteria for CI.

The Impact of Functional Form Complexity on Model Overfitting for Nonlinear Mixed-Effects Models.

Nonlinear mixed-effects models (NLMEMs) allow researchers to model curvilinear patterns of growth, but there is ambiguity as to what functional form the data follow. Often, researchers fit multiple nonlinear functions to data and use model selection criteria to decide which functional form fits the data "best." Frequently used model selection criteria only account for the number of parameters in a model but overlook the complexity of intrinsically nonlinear functional forms. This can lead to overfitting and hinder the generalizability and reproducibility of results. The primary goal of this study was to evaluate the performance of eight model selection criteria via a Monte Carlo simulation study and assess under what conditions these criteria are sensitive to model overfitting as it relates to functional form complexity. Results highlighted criteria with the potential to capture overfitting for intrinsically nonlinear functional forms for NLMEMs. Information criteria and the stochastic information complexity criterion recovered the true model more often than the average or conditional concordance correlation. Results also suggest that the amount of residual variance and sample size have an impact on model selection for NLMEMs. Implications for future research and recommendations for application are also provided.

Assessing Available Open-Source PACS Options.

Medical imaging technology is producing a growing number of medical images types as well as patient-related information. The benefits of using modern medical imaging systems in healthcare are undeniable. Picture archiving and communication system (PACS) have revolutionized medical imaging practice. PACS have widely impacted the accessibility of medical images, reduced imaging costs, eliminated the physical storage of films, improved time management of radiologists, and allowed automated decision-making and diagnosis. Many health organizations and manufacturers have invested on developing commercial PACS. However, commercial PACS are not affordable for all hospitals while open-source PACS are increasingly becoming a viable option. Our research project is looking for an open-source PACS for the Donka University hospital of Guinea. Open-source PACS are currently available and are offering varying functionalities, documentation, and technical support from their developer communities. Selecting an open-source PACS is not an easy task and not only depends on the hospital requirements but also requires assessing each open-source PACS to find the best match. In this paper, the most popular open-source PACS are evaluated using a simple comparison approach based on four criteria. The result of this assessment shows that Orthanc, DCM4CHE, DCMTK, and Dicoogle are the most mature open-source PACS according to our criteria and the needs of Donka.

Results of the Protocolization of a Telepharmacy Program: Patient Selection and Dispensation Interruption Criteria.

Objective: To analyze the impact of applying criteria for patient selection and interruption of dispensation in a telepharmacy program. Secondary objective: to conduct a socioeconomic analysis of requests for telepharmacy after applying the criteria. Methods: A retrospective observational study was conducted. We applied the criteria from September 1, 2021 to December 31, 2021 and reviewed the impact of their application by comparing the prior period (October 14, 2020-August 31, 2021) with the period when the criteria were applied. We analyzed the evolution of applications over time, the number of users, the evolution over time of rejected applications, and the associated reasons. Finally, we studied how the average income and distance to hospital are related to the number of requests. This study was reviewed by the authors' institutional ethics committee and was considered exempted from further review. Results: We applied the criteria to 2,379 patients. Dispensations by telepharmacy increased progressively. We provided telepharmacy services to 41.7% of all outpatients and rejected 962 applications (65% after the criteria were applied). The main pre- and postcriteria reasons for rejecting applications were refusal without express reason and the patient having sufficient medication, respectively. All patients corrected the situation that caused rejection. Telepharmacy requests and distance to hospital were not related, although the number of requests and average income were related. Conclusions: We provided pharmaceutical care with this protocol and encouraged patients to correct the reasons for interrupted dispensations. The new criteria render telepharmacy available to all patients, regardless of where they live or their purchasing power. Lower-income individuals use telepharmacy more often.

User preferences and consumer acceptability of boiled plantain in rural and urban localities in Cameroon.

BACKGROUND: An understanding of the preferences of different stakeholders in the plantain value chain in rural and urban segments in Cameroon is important for the selection and adoption of new plantain cultivars. Boiled plantain is one of the most commonly consumed food products from this crop in Cameroon. Gendered food mapping and consumer testing with two plantain landraces (Batard and Big Ebanga) and a plantain-like hybrid (CARBAP K74) was carried out in rural and urban areas in the West and Littoral regions of Cameroon. RESULTS: Plantain users in these two regions were categorized into producers, traders, processors, and consumers. Preferences indicated that raw plantain should bear long and large fruits, with heavy bunches, and an orange pulp color, whereas boiled plantain should present with a yellow color and a soft and mealy pulp, with a good plantain aroma. Batard and Big Ebanga were liked moderately by consumers, whereas CARBAP K74 was liked slightly. CARBAP K74 was on par with Batard and Big Ebanga for some attributes, except for color and sweetness. CONCLUSION: More emphasis should be given to attributes such as color, firmness, and taste for the development of new plantain clones to be adopted by end users consuming boiled green plantain. © 2023 The Authors. Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Defining Complex Patient Populations: Implications for Population Size, Composition, Utilization, and Costs.

BACKGROUND: Interventions to support patients with complex needs have proliferated in recent years, but the question of how to identify patients with complex needs has received relatively little attention. There are innumerable ways to structure inclusion and exclusion criteria for complex care interventions, and little is known about the implications of choices made in designing patient selection criteria. OBJECTIVE: To provide insights into the design of patient selection criteria for interventions, by implementing criteria sets within a large health plan member population and comparing the characteristics of the resulting complex patient cohorts. DESIGN: Retrospective observational descriptive study. SUBJECTS: Patients identified as having complex needs, within the membership population of Kaiser Permanente Southern California, a large, population-based health plan with more than 4 million members. We characterize five commonly used archetypes of complex needs: high-cost patients, patients with multiple chronic conditions, frail elders, emergency department high-utilizers, and inpatient high-utilizers. MEASURES: We selected an initial set of criteria for identifying patients in each of the archetypical complex populations, based on available administrative data. We then tested multiple variants of each definition. We compared the resulting patient cohorts using univariate and bivariate descriptive statistics. KEY RESULTS: Overall, 32.7% of the 3,112,797 adults in our population-based sample were selected by at least one of the 25 definitions of complexity we tested. Across definitions the total number of patients identified as complex ranged from 622,560 to 1583 and complex patient cohorts varied widely in demographic characteristics, chronic conditions, healthcare utilization, spending, and survival. CONCLUSIONS: Choice of patient population is critical to the design of complex care programs. Exploratory analyses of population criteria can provide useful information for program planning in the setting of limited resources for interventions. Data such as these should be generated as a key step in program design.

HIV incidence and related risks among gay, bisexual, and other men who have sex with men in Montreal, Toronto, and Vancouver: Informing blood donor selection criteria in Canada.

BACKGROUND: An individualized behavior-based selection approach has potential to allow for a more equitable blood donor eligibility process. We collected biological and behavioral data from urban gay, bisexual, and other men who have sex with men (GBM) to inform the use of this approach in Canada. STUDY DESIGN AND METHODS: Engage is a closed prospective cohort of sexually active GBM, aged 16+ years, recruited via respondent-driven-sampling (RDS) in Montreal, Toronto, and Vancouver, Canada. Participants completed a questionnaire on behaviors (past 6 months) and tested for HIV and sexually transmitted and blood-borne infections at each visit. Rate ratios for HIV infection and predictive values for blood donation eligibility criteria were estimated by RDS-adjusted Poisson regression. RESULTS: Data on 2008 (study visits 2017-02 to 2021-08) HIV-negative participants were used. The HIV incidence rate for the three cities was 0.4|100 person-years [95%CI:0.3, 0.6]. HIV seroconversion was associated with age <30 years: adjusted rate ratio (aRR) 9.1 [95%CI:3.2, 26.2], 6-10 and >10 anal sex partners versus 1-6 aRR: 5.3 [2.1,13.5] and 8.4 [3.4, 20.9], and use of crystal methamphetamine during sex: 4.2 [1.5, 11.6]. Applying the combined selection criteria: drug injection, ≥2 anal sex partners, and a new anal sex partner, detected all participants who seroconverted (100% sensitivity, 100% negative predictive value), and would defer 63% of study participants from donating. CONCLUSION: Using three screening questions regarding drug injection and sexual behaviors in the past 6 months would correctly identify potential GBM donors at high risk of having recently contracted HIV. Doing so would reduce the proportion of deferred sexually active GBM by one-third.

Semantic interference and facilitation in picture naming: The effects of type of impairment and compensatory strategies.

We assessed effects of semantic interference in people with aphasia (PWA). Two naming tasks (continuous naming and cyclic blocking) were contrasted with tasks which required suppression of competitors but minimized lexical access (probe task) or required extra-lexical mechanisms of control (Stroop task). In continuous naming, some PWA showed increased interference compared to control participants, with slower RTs and increased omissions. Others showed normal or weaker interference effects in terms of RTs but increased semantic errors. Patterns were consistent only between naming tasks. We explain results by assuming that some PWA are slow at implementing mechanisms of control/selection which weed-out competitors. Others, instead, will have activation difficulties which will induce them to lower the threshold needed for selection. Results highlight how different kinds of brain damage may induce different compensatory strategies and how semantic relatedness may induce both interference and facilitation. Implications for models of lexical selection are discussed.