Patient engagement in a Canadian health research funding institute: implementation and impact.

BACKGROUND: Patient engagement (PE) or involvement in research is when patient partners are integrated onto teams and initiatives (not participants in research). A number of health research funding organisations have PE frameworks or rubrics but we are unaware of them applying and reporting on their own internal PE efforts. We describe our work at the Canadian Institutes of Health Research's Institute of Musculoskeletal Health and Arthritis (CIHR IMHA) to implement, evaluate and understand the impact of its internal PE strategy. METHODS: A co-production model was used involving patient partners, a PE specialist and staff from IMHA. A logic model was co-developed to guide implementing and evaluating IMHA's PE strategy. Some of evaluating the PE strategy and understanding its impact was a collaboration between the Public and Patient Engagement Collaborative (McMaster University) and IMHA. RESULTS: IMHA convened a PE Research Ambassador (PERA) group which co-led this work with the support of a PE specialist. In doing so, PERA had a number of meetings since 2020, set its own priorities and co-produced a number of outputs (video, publications, webinars, blog and modules called the How-to Guide for PE in Research). This work to evaluate and measure impacts of IMHA's PE strategy revealed positive results, for example, on PERA members, Institute Advisory Board members and staff, as well as beyond the institute based on uptake and use of the modules. Areas for improvement are mainly related to increasing the diversity of PERA and to improving accessibility of the PE outputs (more languages and formats). CONCLUSIONS: Implementing a PE strategy within CIHR IMHA resulted in several PE activities and outputs with impacts within and beyond the institute. We provide templates and outputs related to this work that may inform the efforts of other health research funding organisations. We encourage health research funders to move beyond encouraging or requiring PE in funded projects to fully 'walk the talk' of PE by implementing and evaluating their own PE strategies.

Recent Advances in Non-Ti MXenes: Synthesis, Properties, and Novel Applications.

One of the most fascinating 2D nanomaterials (NMs) ever found is various members of MXene family. Among them, the titanium-based MXenes, with more than 70% of publication-related investigations, are comparatively well studied, producing fundamental foundation for the 2D MXene family members with flexible properties, familiar with a variety of advanced novel technological applications. Nonetheless, there are still more candidates among transitional metals (TMs) that can function as MXene NMs in ways that go well beyond those that are now recognized. Systematized details of the preparations, characteristics, limitations, significant discoveries, and uses of the novel M-based MXenes (M-MXenes), where M stands for non-Ti TMs (M = Sc, V, Cr, Y, Zr, Nb, Mo, Hf, Ta, W, and Lu), are given. The exceptional qualities of the 2D non-Ti MXene outperform standard Ti-MXene in several applications. There is many advancement in top-down as well as bottom-up production of MXenes family members, which allows for exact control of the M-characteristics MXene NMs to contain cutting-edge applications. This study offers a systematic evaluation of existing research, covering everything in producing complex M-MXenes from primary limitations to the characterization and selection of their applications in accordance with their novel features. The development of double metal combinations, extension of additional metal candidates beyond group-(III-VI)B family, and subsequent development of the 2D TM carbide/TMs nitride/TM carbonitrides to 2D metal boride family are also included in this overview. The possibilities and further recommendations for the way of non-Ti MXene NMs are in the synthesis of NMs will discuss in detail in this critical evaluation.

The recent advances in the approach of artificial intelligence (AI) towards drug discovery.

Artificial intelligence (AI) has recently emerged as a unique developmental influence that is playing an important role in the development of medicine. The AI medium is showing the potential in unprecedented advancements in truth and efficiency. The intersection of AI has the potential to revolutionize drug discovery. However, AI also has limitations and experts should be aware of these data access and ethical issues. The use of AI techniques for drug discovery applications has increased considerably over the past few years, including combinatorial QSAR and QSPR, virtual screening, and denovo drug design. The purpose of this survey is to give a general overview of drug discovery based on artificial intelligence, and associated applications. We also highlighted the gaps present in the traditional method for drug designing. In addition, potential strategies and approaches to overcome current challenges are discussed to address the constraints of AI within this field. We hope that this survey plays a comprehensive role in understanding the potential of AI in drug discovery.

Recent progress in metal oxide-based electrode materials for safe and sustainable variants of supercapacitors.

A significant amount of energy can be produced using renewable energy sources; however, storing massive amounts of energy poses a substantial obstacle to energy production. Economic crisis has led to rapid developments in electrochemical (EC) energy storage devices (EESDs), especially rechargeable batteries, fuel cells, and supercapacitors (SCs), which are effective for energy storage systems. Researchers have lately suggested that among the various EESDs, the SC is an effective alternate for energy storage due to the presence of the following characteristics: SCs offer high-power density (PD), improvable energy density (ED), fast charging/discharging, and good cyclic stability. This review highlighted and analyzed the concepts of supercapacitors and types of supercapacitors on the basis of electrode materials, highlighted the several feasible synthesis processes for preparation of metal oxide (MO) nanoparticles, and discussed the morphological effects of MOs on the electrochemical performance of the devices. In this review, we primarily focus on pseudo-capacitors for SCs, which mainly contain MOs and their composite materials, and also highlight their future possibilities as a useful application of MO-based materials in supercapacitors. The novelty of MO's electrode materials is primarily due to the presence of synergistic effects in the hybrid materials, rich redox activity, excellent conductivity, and chemical stability, making them excellent for SC applications.

Consensus methods in patellofemoral pain: how rigorous are they? A scoping review.

OBJECTIVE: Clinicians treating patients with patellofemoral pain (PFP) rely on consensus statements to make the best practice recommendations in the absence of definitive evidence on how to manage PFP. However, the methods used to generate and assess agreement for these recommendations have not been examined. Our objective was to map the methods used to generate consensus-based recommendations for PFP and apply four novel questions to assess the rigour of consensus development. DESIGN: Scoping review. DATA SOURCES: We searched Medline, SPORTDiscus, CINAHL and Embase from inception to May 2022 to identify consensus-derived statements or practice guidelines on PFP. The Joanna Briggs Institute Manual for Evidence Synthesis was followed to map the existing evidence. We measured the consensus methods based on four sets of questions addressing the panel composition, application of the consensus method chosen, agreement process and the use of evidence mapping. ELIGIBILITY CRITERIA: All consensus statements or clinical guidelines on PFP were considered. RESULTS: Twenty-two PFP consensus statements were identified. Panel composition: 3 of the 22 (14%) consensus groups reported the panellists' experience, 2 (9%) defined a desired level of expertise, 10 (45%) reported panellist sex and only 2 (9%) included a patient. Consensus method: 7 of 22 (32%) reported using an established method of consensus measurement/development. Agreement process: 10 of 22 (45%) reported their consensus threshold and 2 (9%) acknowledged dissenting opinions among the panel. Evidence mapping: 6 of 22 (27%) reported using systematic methods to identify relevant evidence gaps. CONCLUSIONS: PFP consensus panels have lacked diversity and excluded key partners including patients. Consensus statements on PFP frequently fail to use recognised consensus methods, rarely describe how 'agreement' was defined or measured and often neglect to use systematic methods to identify evidence gaps.

How low back pain is managed-a mixed methods study in 32 countries. Part 2 of Low Back Pain in Low- and Middle-Income Countries Series.

BACKGROUND: The Lancet Series of Low Back Pain (LBP) highlighted the lack of LBP data from low- and middle-income countries (LMICs). The study aimed to describe (1) what LBP care is currently delivered in LMICs, and (2) how that care is delivered. METHODS: An online mixed-methods study. A Consortium for LBP in LMICs (n=65) was developed with an expert panel of leading LBP researchers (>2 publications on LBP) and multidisciplinary clinicians and patient partners with five years of clinical/lived LBP experience in LMICs. Quantitative data were analyzed using descriptive statistics. Two researchers independently analyzed qualitative data using deductive and inductive coding and developed a thematic framework. FINDINGS: Forty-seven (85%) of 55 invited panel members representing 32 LMICs completed the survey (38% women; 62% men). The panel included clinicians (34%), researchers (28%), educators (6%), and patient partners (4%). Pharmacotherapies and electrophysiological agents were the most used LBP treatments. The Thematic Framework comprised of eight themes: (1) Self-management is ubiquitous; (2) Medicines are the cornerstone; (3) Traditional therapies have a place; (4) Society plays an important role; (5) Imaging use is very common; (6) Reliance on passive approaches; (7) Social determinants influence LBP care pathway; and (8) Health systems are ill-prepared to address LBP burden. INTERPRETATION: LBP care in LMICs did not consistently align with the best available evidence. Findings will help research prioritization in LMICs and guide global LBP clinical guidelines. FUNDING: The lead author's Fellowship was supported by the International Association for the Study of Pain.

Mo-based MXenes: Synthesis, properties, and applications.

Ti-MXene allows a range of possibilities to tune their compositional stoichiometry due to their electronic and electrochemical properties. Other than conventionally explored Ti-MXene, there have been ample opportunities for the non-Ti-based MXenes, especially the emerging Mo-based MXenes. Mo-MXenes are established to be remarkable with optoelectronic and electrochemical properties, tuned energy, catalysis, and sensing applications. In this timely review, we systematically discuss the various organized synthesis procedures, associated experimental tunning parameters, physiochemical properties, structural evaluation, stability challenges, key findings, and a wide range of applications of emerging Mo-MXene over Ti-MXenes. We also critically examined the precise control of Mo-MXenes to cater to advanced applications by comprehensively evaluating the summary of recent studies using artificial intelligence and machine learning tools. The critical future perspectives, significant challenges, and possible outlooks for successfully developing and using Mo-MXenes for various practical applications are highlighted.

The effects of eating frequency on changes in body composition and cardiometabolic health in adults: a systematic review with meta-analysis of randomized trials.

BACKGROUND: Eating frequency may affect body weight and cardiometabolic health. Intervention trials and observational studies have both indicated that high- and low-frequency eating can be associated with better health outcomes. There are currently no guidelines to inform how to advise healthy adults about how frequently to consume food or beverages. AIM: To establish whether restricted- (≤ three meals per day) frequency had a superior effect on markers of cardiometabolic health (primary outcome: weight change) compared to unrestricted-eating (≥ four meals per day) frequency in adults. METHODS: We searched Medline (Ovid), Embase, CINAHL (EBSCO), Cochrane Central Register of Controlled Trials (CENTRAL), CAB Direct and Web of Science Core Collection electronic databases from inception to 7 June 2022 for clinical trials (randomised parallel or cross-over trials) reporting on the effect of high or low-frequency eating on cardiometabolic health (primary outcome: weight change). Trial interventions had to last for at least two weeks, and had to have been conducted in human adults. Bias was assessed using the Cochrane Risk of Bias tool 2.0. Standardized mean differences (SMD) and 95% confidence intervals were calculated for all outcomes. Certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. RESULTS: Seventeen reports covering 16 trials were included in the systematic review. Data from five trials were excluded from meta-analysis due to insufficient reporting. 15 of 16 trials were at high risk of bias. There was very low certainty evidence of no difference between high- and low-frequency eating for weight-change (MD: -0.62 kg, CI95: -2.76 to 1.52 kg, p = 0.57). CONCLUSIONS: There was no discernible advantage to eating in a high- or low-frequency dietary pattern for cardiometabolic health. We cannot advocate for either restricted- or unrestricted eating frequency to change markers of cardiometabolic health in healthy young to middle-aged adults. PROTOCOL REGISTRATION: CRD42019137938.

Overview of Rheumatoid Arthritis and Scientific Understanding of the Disease.

Rheumatoid arthritis (RA), a chronic inflammatory autoimmune disorder, is characterised by persistent synovial inflammation, erosion of bones and cartilage, leading to joint destruction. Clinical manifestations are morning stiffness, pain in shoulder, neck and pelvic girdle, loss of mobility with fever, fatigue, malaise, loss of body weight, and development of rheumatoid nodules. Environmental and genetic factors are important contributors in its susceptibility. Association between RA and diet, cigarette smoking, hormones, alcohol, microbiota, infection, and coffee have also been reported. To diagnose patients with RA, American college of rheumatology (ACR, 2010) criteria, developed by European league against rheumatism (EULAR). Inflammation produced in RA patients is due to cell-mediated immune response. The rheumatoid synovium consists of a large number of CD4+ T cells suggesting pathogenic nature of T cells in this disorder. B-cells may also participate in the pathogenesis by several means such as autoantibodies, by instigation of T-cells through expression of co-stimulatory molecules, by generating pro-inflammatory and anti-inflammatory cytokines and by organisation of other inflammatory cells. The conventional management of RA usually focuses over reducing pain and limiting the disability by medical therapies which include a number of classes of agents such as non-steroidal anti-inflammatory drugs (NSAIDs), non-biological and biological agents, disease-modifying anti rheumatic drugs (DMARDs), immunosuppressants, and corticosteroids. However, only proper rehabilitation can promote the objective to achieve the joint functionality and ease of motion which improves independence as well as quality of life in patient suffering from Rheumatoid Arthritis.

Ranking versus rating in peer review of research grant applications.

The allocation of public funds for research has been predominantly based on peer review where reviewers are asked to rate an application on some form of ordinal scale from poor to excellent. Poor reliability and bias of peer review rating has led funding agencies to experiment with different approaches to assess applications. In this study, we compared the reliability and potential sources of bias associated with application rating with those of application ranking in 3,156 applications to the Canadian Institutes of Health Research. Ranking was more reliable than rating and less susceptible to the characteristics of the review panel, such as level of expertise and experience, for both reliability and potential sources of bias. However, both rating and ranking penalized early career investigators and favoured older applicants. Sex bias was only evident for rating and only when the applicant's H-index was at the lower end of the H-index distribution. We conclude that when compared to rating, ranking provides a more reliable assessment of the quality of research applications, is not as influenced by reviewer expertise or experience, and is associated with fewer sources of bias. Research funding agencies should consider adopting ranking methods to improve the quality of funding decisions in health research.

Effect of growth temperature on self-rectifying BaTiO3/ZnO heterojunction for high-density crossbar arrays and neuromorphic computing.

In the quest for high-density integration and massive scalability, ferroelectric-based devices provide an achievable approach for nonvolatile crossbar array (CBA) architecture and neuromorphic computing. In this report, ferroelectric-semiconductor (Pt/BaTiO3/ZnO/Au) heterojunction-based devices are demonstrated to exhibit nonvolatile and synaptic characteristics. In this study, the ferroelectric (BaTiO3) layer was modulated at various growth temperatures of 350 °C, 450 °C, 550 °C and 650 °C. Growing temperature in the ferroelectric layer has a significant impact on resistive switching. The ferroelectricity of the BaTiO3 thin film enhanced by increasing temperature causes a substantial shift in the interface state density at heterojunction interface, which is crucial for self-rectification. Furthermore, this self-rectifying property advances to reduce the crosstalk problem without any selector device. Enhanced resistive switching and neuromorphic applications have been demonstrated using BaTiO3 heterostructure devices at 550 °C. The dynamic ferroelectric polarization switching in this heterojunction demonstrated linear conductance change in artificial synapses with 91 % recognition accuracy. Ferroelectric polarization reversal with a depletion region at the heterojunction interface is the responsible mechanism for the switching in these devices. Thus, these findings pave the way for designing low power high-density crossbar arrays and neuromorphic application based on ferroelectric-semiconductor heterostructures.

What is the 'voltage drop' when an effective health promoting intervention for older adults-Choose to Move (Phase 3)-Is implemented at broad scale?

BACKGROUND: Choose to Move (CTM), an effective health-promoting intervention for older adults, was scaled-up across British Columbia, Canada. Adaptations that enable implementation at scale may lead to 'voltage drop'-diminished positive effects of the intervention. For CTM Phase 3 we assessed: i. implementation; ii. impact on physical activity, mobility, social isolation, loneliness and health-related quality of life (impact outcomes); iii. whether intervention effects were maintained; iv) voltage drop, compared with previous CTM phases. METHODS: We conducted a type 2 hybrid effectiveness-implementation pre-post study of CTM; older adult participants (n = 1012; mean age 72.9, SD = 6.3 years; 80.6% female) were recruited by community delivery partners. We assessed CTM implementation indicators and impact outcomes via survey at 0 (baseline), 3 (mid-intervention), 6 (end-intervention) and 18 (12-month follow-up) months. We fitted mixed-effects models to describe change in impact outcomes in younger (60-74 years) and older (≥ 75 years) participants. We quantified voltage drop as percent of effect size (change from baseline to 3- and 6-months) retained in Phase 3 compared with Phases 1-2. RESULTS: Adaptation did not compromise fidelity of CTM Phase 3 as program components were delivered as intended. PA increased during the first 3 months in younger (+1 days/week) and older (+0.9 days/week) participants (p<0.001), and was maintained at 6- and 18-months. In all participants, social isolation and loneliness decreased during the intervention, but increased during follow-up. Mobility improved during the intervention in younger participants only. Health-related quality of life according to EQ-5D-5L score did not change significantly in younger or older participants. However, EQ-5D-5L visual analog scale score increased during the intervention in younger participants (p<0.001), and this increase was maintained during follow-up. Across all outcomes, the median difference in effect size, or voltage drop, between Phase 3 and Phases 1-2 was 52.6%. However, declines in social isolation were almost two times greater in Phase 3, compared with Phases 1-2. CONCLUSION: Benefits of health-promoting interventions-like CTM-can be retained when implemented at broad scale. Diminished social isolation in Phase 3 reflects how CTM was adapted to enhance opportunities for older adults to socially connect. Thus, although intervention effects may be reduced at scale-up, voltage drop is not inevitable.

Are family medicine residents trained to counsel patients on physical activity? The Canadian experience and a call to action.

Physical inactivity is a leading risk factor for non-communicable diseases (NCDs) and early mortality. Family physicians have an important role in providing physical activity counselling to patients to help prevent and treat NCDs. Lack of training on physical activity counselling is a barrier in undergraduate medical education, yet little is known regarding physical activity teaching in postgraduate family medicine residency. We assessed the provision, content and future direction of physical activity teaching in Canadian postgraduate family medicine residency programs to address this data gap. Fewer than half of Canadian Family Medicine Residency Programme directors reported providing structured physical activity counselling education to residents. Most directors reported no imminent plans to change the content or amount of teaching. These results reflect significant gaps between the recommendations of WHO, which calls on doctors to prescribe physical activity, and the current curricular content and needs of family medicine residents. Almost all directors agreed that online educational resources developed to assist residents in physical activity prescription would be beneficial. By describing the provision, content and future direction of physical activity training in family medicine, physicians and medical educators can develop competencies and resources to meet this need. When we equip our future physicians with the necessary tools, we can improve patient outcomes and do our part to reduce the global epidemic of physical inactivity and chronic disease.

Optically Reconfigurable Complementary Logic Gates Enabled by Bipolar Photoresponse in Gallium Selenide Memtransistor.

To avoid the complexity of the circuit for in-memory computing, simultaneous execution of multiple logic gates (OR, AND, NOR, and NAND) and memory behavior are demonstrated in a single device of oxygen plasma-treated gallium selenide (GaSe) memtransistor. Resistive switching behavior with RON /ROFF ratio in the range of 104 to 106 is obtained depending on the channel length (150 to 1600 nm). Oxygen plasma treatment on GaSe film created shallow and deep-level defect states, which exhibit carriers trapping/de-trapping, that lead to negative and positive photoconductance at positive and negative gate voltages, respectively. This distinguishing feature of gate-dependent transition of negative to positive photoconductance encourages the execution of four logic gates in the single memory device, which is elusive in conventional memtransistor. Additionally, it is feasible to reversibly switch between two logic gates by just adjusting the gate voltages, e.g., NAND/NOR and AND/NAND. All logic gates presented high stability. Additionally, memtransistor array (1×8) is fabricated and programmed into binary bits representing ASCII (American Standard Code for Information Interchange) code for the uppercase letter "N". This facile device configuration can provide the functionality of both logic and memory devices for emerging neuromorphic computing.

A Wrinkle in Measuring Time Use for Cognitive Health: How should We Measure Physical Activity, Sedentary Behaviour and Sleep?

One new case of dementia is detected every 4 seconds and no effective drug therapy exists. Effective behavioural strategies to promote healthy cognitive ageing are thus essential. Three behaviours related to cognitive health which we all engage in daily are physical activity, sedentary behaviour and sleep. These time-use activity behaviours are linked to cognitive health in a complex and dynamic relationship not yet fully elucidated. Understanding how each of these behaviours is related to each other and cognitive health will help determine the most practical and effective lifestyle strategies for promoting healthy cognitive ageing. In this review, we discuss methods and analytical approaches to best investigate how these time-use activity behaviours are related to cognitive health. We highlight four key recommendations for examining these relationships such that researchers should include measures which (1) are psychometrically appropriate; (2) can specifically answer the research question; (3) include objective and subjective estimates of the behaviour and (4) choose an analytical method for modelling the relationships of time-use activity behaviours with cognitive health which is appropriate for their research question.

Recent Progress in Emerging Novel MXenes Based Materials and their Fascinating Sensing Applications.

Early transition metals based 2D carbides, nitrides and carbonitrides nanomaterials are known as MXenes, a novel and extensive new class of 2D materials family. Since the first accidently synthesis based discovery of Ti3 C2 in 2011, more than 50 additional compositions have been experimentally reported, including at least eight distinct synthesis methods and also more than 100 stoichiometries are theoretically studied. Due to its distinctive surface chemistry, graphene like shape, metallic conductivity, high hydrophilicity, outstanding mechanical and thermal properties, redox capacity and affordable with mass-produced nature, this diverse MXenes are of tremendous scientific and technological significance. In this review, first we'll come across the MXene based nanomaterials possible synthesis methods, their advantages, limitations and future suggestions, new chemistry related to their selected properties and potential sensing applications, which will help us to explain why this family is growing very fast as compared to other 2D families. Secondly, problems that help to further improve commercialization of the MXene nanomaterials based sensors are examined, and many advances in the commercializing of the MXene nanomaterials based sensors are proposed. At the end, we'll go through the current challenges, limitations and future suggestions.

Salt-Assisted Low-Temperature Growth of 2D Bi2 O2 Se with Controlled Thickness for Electronics.

Bi2 O2 Se is the most promising 2D material due to its semiconducting feature and high mobility, making it propitious channel material for high-performance electronics that demands highly crystalline Bi2 O2 Se at low-growth temperature. Here, a low-temperature salt-assisted chemical vapor deposition approach for growing single-domain Bi2 O2 Se on a millimeter scale with thicknesses of multilayer to monolayer is presented. Because of the advantage of thickness-dependent growth, systematical scrutiny of layer-dependent Raman spectroscopy of Bi2 O2 Se from monolayer to bulk is investigated, revealing a redshift of the A1g mode at 162.4 cm-1 . Moreover, the long-term environmental stability of ≈2.4 nm thick Bi2 O2 Se is confirmed after exposing the sample for 1.5 years to air. The backgated field effect transistor (FET) based on a few-layered Bi2 O2 Se flake represents decent carrier mobility (≈287 cm2  V-1 s-1 ) and an ON/OFF ratio of up to 107 . This report indicates a technique to grow large-domain thickness controlled Bi2 O2 Se single crystals for electronics.

Innovations in the synthesis of graphene nanostructures for bio and gas sensors.

Sensors play a significant role in modern technologies and devices used in industries, hospitals, healthcare, nanotechnology, astronomy, and meteorology. Sensors based upon nanostructured materials have gained special attention due to their high sensitivity, precision accuracy, and feasibility. This review discusses the fabrication of graphene-based biosensors and gas sensors, which have highly efficient performance. Significant developments in the synthesis routes to fabricate graphene-based materials with improved structural and surface properties have boosted their utilization in sensing applications. The higher surface area, better conductivity, tunable structure, and atom-thick morphology of these hybrid materials have made them highly desirable for the fabrication of flexible and stable sensors. Many publications have reported various modification approaches to improve the selectivity of these materials. In the current work, a compact and informative review focusing on the most recent developments in graphene-based biosensors and gas sensors has been designed and delivered. The research community has provided a complete critical analysis of the most robust case studies from the latest fabrication routes to the most complex challenges. Some significant ideas and solutions have been proposed to overcome the limitations regarding the field of biosensors and hazardous gas sensors.