Retrospective, Real Life Study on the Effectiveness and Safety of a Depigmented-Polymerized Subcutaneous Vaccine Containing a Mixture of Grasses and Olea europaea.

INTRODUCTION: Allergen immunotherapy is the only modifying treatment of the natural course of respiratory allergic diseases; however, the lack of evidence leads to little inconclusive results. Real life studies are on the rise and are becoming a valuable tool to confirm and complement findings from clinical trials. The objective of this study was to evaluate the effectiveness and safety of a depigmented-polymerized undiluted subcutaneous extract of grass and olive pollen, under routine clinical practice conditions. METHODS: This was an observational, retrospective, longitudinal, single-center study on the use of a 2-pollen (grass mix and Olea europaea) undiluted subcutaneous extract over at least 3 consecutive years. Data were collected from 76 patients (n = 44 female; median age: 12.5 years old) diagnosed with allergic rhinoconjunctivitis with/without allergic asthma due to sensitization to both grasses and O. europaea. Primary and secondary effectiveness endpoints were symptom severity, concomitant medication, and immunological profile before and after completing the immunotherapy. A 2-year follow-up of patients' symptoms and medication history after completing the subcutaneous immunotherapy (SCIT) was performed. RESULTS: There was a significant improvement of symptoms and medication consumption after 3 years of SCIT treatment, and a significant decrease in specific IgE levels for grasses and O. europaea was observed after finishing the treatment. CONCLUSION: Three years treatment of allergic patients using an undiluted mixture of two allergen extracts was shown to be safe and effective for rhinitis and asthma, with efficacy maintained for at least 2 years after finishing SCIT. These results reinforce the importance of real life clinical data in addition to those from clinical trials, helping to individualize allergic treatments.

Task shifting for musculoskeletal disorders in Norwegian primary care: a qualitative interview study of general practitioners and specialist musculoskeletal physiotherapists.

OBJECTIVE: To explore the views of general practitioners and physiotherapists on the current model of care for patients with musculoskeletal disorders in Norwegian primary care, and if the English First Contact Practitioner model, where patients have access to multiple professional groups with musculoskeletal health expertise, could inform service development. DESIGN, SETTING, AND SUBJECTS: We analysed interviews with five GPs and 11 physiotherapists and used Lipsky's theories about street-level bureaucracy and Foucault's theories of mechanisms of power and institutional structures to explore task shifting and cooperation between different professions. RESULTS AND INTERPRETATION: The empirical material reflected a multi-faceted discourse about skill-mix in primary care, where financial factors, perceptions about competence, and task preferences moderated attitudes to task shifting. Competition and cooperation coexist between the professions, and the seemingly gradual blurring between historical hegemony and new models of care creates both alliances and rivalries. Examples of deviations from the Choosing Wisely principles and evidence-based practice indicate that both general practitioners and physiotherapists balance the roles of patient advocate, gatekeeper, and homo economicus, in a context where task shifting is challenged by established practice. It appears that the management of patients with musculoskeletal disorders is fragmented and to some extent reflects a supply-driven system.

The demand on primary care is placing increasing pressure on general practitioners.Multidisciplinary teamwork has potential to improve primary care, for both healthcare professionals and for patients.In this study, it appeared that both competition and cooperation exist between general practitioners and physiotherapists around the management of patients with musculoskeletal disorders in primary care.There is a case for change in service delivery for patients with musculoskeletal disorders in Norwegian primary care.

Comprehensive rheological and mechanistic evaluation of an asphalt binder and mixture modified with warm mix additives.

Though warm mix asphalt (WMA) technology has been introduced for a long time, there is still reluctance in the industry to utilize it in practice. In regions like India, where WMA incorporation into road construction has been limited over the past two decades, building confidence in local binders is imperative for widespread adoption. Thus, the present study appraises the effect of three commonly used WMA additives in India, namely Sasobit®, Evotherm®, and Zycotherm®, with base binder VG-30 on the rheological and mixture performance parameters. Three dosages of each WMA additive were blended with the control binder to give ten binder combinations. Different binder evaluations such as Superpave grading and parameters, frequency sweep testing, multiple stress creep recovery test, and linear amplitude sweep test were conducted for comparative dynamic mechanical analysis. Based on the binder testing results, suitable dosages of WMA additives were established, and mixture testing was carried out using these specific additive dosages. Binder evaluations showed improvement in high-temperature characteristics with Sasobit® and better fatigue performance with Evotherm®, while Zycotherm® did not alter binder properties significantly. The asphalt mixture testing results indicated satisfactory performance with the three additives based on Marshall stability and flow testing. The WMA additives also showed enhancement in moisture susceptibility based on the modified Lottman test with Zycotherm® demonstrating the best performance. Overall, the study underscores promising effects of the three WMA additives across different parameters, signaling their potential for widespread application in real-world scenarios.

Land conflicts from overlapping claims in Brazil's rural environmental registry.

Satellite-based land use monitoring and farm-level traceability offer opportunities for targeted zero-deforestation interventions on private lands. Brazil's Rural Environmental Registry (Cadastro Ambiental Rural, or "CAR"), a land cadaster based on self-declaration of property boundaries, was created to monitor compliance with national forest laws. It has become an important enabling measure for sustainable supply chain initiatives like the Amazon Soy Moratorium. However, CAR enrollment is increasingly used to bolster illegal land claims, putting it at the heart of land grabbing dynamics. Self-declaration of properties in the CAR offers a unique situation to study land conflicts and their impact on land use decisions on a large scale. We quantified competing land claims among 846,420 registrations in the Brazilian Legal Amazon and applied a series of generalized linear mixed-effects models. We determined that CAR overlaps are more prevalent on larger registrations, in more densely settled areas, and in areas with less secure land tenure. We tested how landholders respond to land conflicts, finding significantly more deforestation and declared legal forest reserve on lands with multiple claims. CAR overlap results in an overestimation of forest reserves by up to 9.7 million hectares when considering double-counted and deforested areas of reserves, highlighting an overlooked form of Forest Code noncompliance. While the CAR continues to be used as evidence of land tenure, we conclude that the formalization of land claims through self-declarations is inadequate to decrease conflicts. CAR overlap information provides objective evidence of land conflict that authorities can leverage with field inspection to ensure peaceful occupation before issuing land titles.

Pilot implementation MitraTB application to strengthening district based public private mix tuberculosis control in Purwakarta district, Indonesia: A mixed-method study.

BACKGROUND: District-based public private mix (DPPM) tuberculosis in Purwakarta district was strengthened by the MitraTB application. This research is aimed to explore perception of user about MitraTB application and measure their perception of this application in dimensions; design, usefulness, ease of use, and acceptance. METHODS: This study was exploratory sequential mixed methods research. A qualitative study was first conducted in order to gain an in-depth understanding about user's perception of MitraTB application through in-depth interviews. Data were analyzed through coding and categorizing. Based on qualitative finding, a questionnaire was developed and used in the following quantitative study. A cross sectional study was then conducted in quantitative phase. Data were analyzed using Rasch modeling. RESULT: The design of the MitraTB application looks simple and attractive to users. This application is useful to make it easier for private practitioners to report TB cases and it is easy to use. Respondents can accept the MitraTB application well. Most respondents have good perception about MitraTB application in dimensions; design (56.25%), usefulness (69.79%), ease of use (55.20%), and acceptance (73.96%). CONCLUSIONS: MitraTB application has a good design feature, useful, easy to use, and acceptable. This application facilitates the private sector to be involved in the TB program by reporting TB cases. Follow-up and local regulations are required for the continued use of this application.

Exploring Maillard reaction markers and melanoidins to investigate toxicological and antioxidant profiles of optimized expanded snacks from corn/common bean mixtures.

BACKGROUND: Extrusion cooking of cereal-legume flour mixture is an innovative strategy to introduce nutrient-enriched ready-to-eat snacks to the market. However, this thermal process triggers the formation of compounds that could impact safety aspects of these products. Maillard reaction markers and the end products known as melanoidins were evaluated to assess the toxicological and bioactive profiles of extruded snacks from corn-plus-common-bean-flour combinations. Different molecular weight fractions were isolated and purified to analyze their antioxidant activity and to investigate the role of melanoidins. RESULTS: The snack formulated with an 84:16 ratio of corn:common bean flours exhibited an enhanced toxicological profile. It displayed the lowest levels of acrylamide and furanic compounds, along with reduced blockage of lysine residues in the protein. Extrusion increased the antioxidant activity of uncooked flours (30 to 64%) and total phenolic compounds (26 to 50%), and decreased the available lysine (-72.7 to -79.5%). During the fractionation process, it was established that compounds within the range of 3-10 kDa made the greatest contribution to antioxidant activity. The fraction greater than 10 kDa, which included melanoidins, displayed 7 to 33% lower antioxidant activity. The purification of the fraction greater than 10 kDa revealed that pure melanoidins represented approximately one-third of the antioxidant activity in that fraction. Non-covalent adducts linked to the melanoidin core therefore had a relevant role in the antioxidant action of formulated snacks. CONCLUSION: This investigation illustrates the importance of considering both potential risks and associated benefits of compounds formed during the Maillard reaction while developing new extruded snacks. © 2024 The Author(s). Journal of The Science of Food and Agriculture published by John Wiley & Sons Ltd on behalf of Society of Chemical Industry.

Impact of the COVID-19 pandemic on the self-care and health condition of the older adults. CUIDAMOS+75. A mixed methods study protocol.

Aims: To assess the impact of the COVID-19 pandemic on the health condition of people ≥75 years of age and on their family caregivers in Spain. Design: Multicentric, mixed method concurrent study. Methods: This work, which will be conducted within the primary care setting in 11 administrative regions of Spain, will include three coordinated studies with different methodologies. The first is a population-based cohort study that will use real-life data to analyze the rates and evolution of health needs, care provision, and services utilization before, during, and after the pandemic. The second is a prospective cohort study with 18 months of follow-up that will evaluate the impact of COVID-19 disease on mortality, frailty, functional and cognitive capacity, and quality of life of the participants. Finally, the third will be a qualitative study with a critical social approach to understand and interpret the social, political, and economic dimensions associated with the use of health services during the pandemic. We have followed the SPIRIT Checklist to address trial protocol and related documents. This research is being funded by the Instituto de Salud Carlos III since 2021 and was approved by its ethics committee (June 2022). Discussion: The study findings will reveal the long-term impact of the COVID-19 pandemic on the older adults and their caregivers. This information will serve policymakers to adapt health policies to the needs of this population in situations of maximum stress, such as that produced by the COVID-19 pandemic. Trial Registration: Identifier: NCT05249868 [ClinicalTrials.gov].

Assessing the combination efficiency of some unconventional feed resources with concentrates and Chloris gayana grass in mitigating ruminal methane production in vitro.

In a preliminary in vitro study, leaves of Acacia nilotica, Prosopis juliflora, Cajanus cajan, Leucaena leucocephala and seed kernel of Mangifera indica were identified as potential candidates in mitigating ruminal methane (CH4) production. The objective of the current study was to investigate the combination efficiency of these unconventional feeds with concentrate mix (CM) or Chloris gayana grass in CH4 reduction. Two feed combinations in different proportions were incubated in vitro with buffered rumen fluid at Hohenheim Gas test. In combination 1, C. gayana and CM were included as basal substrates, while in combination 2, A. nilotica, P. juliflora, C. cajan, L. leucocephala or M. indica seed kernel were included as CH4 reducing supplements at different proportions. The CH4 reducing potentials of feed combinations were presented as the ratio of CH4 to net gas production and expressed as percentage (pCH4). The pCH4 for CM and C. gayana was 16.7% and 16.9%, respectively, while it ranged from 3.18% in A. nilotica to 13.1% in C. cajan. The pCH4 was reduced (p < 0.05) from 14.6% to 9.39% when A. nilotica was combined with CM. In combination of L. leucocephala or C. cajan with CM, the pCH4 (p < 0.05) was reduced from 16.5% and 16.6% with the lowest proportion to 15.1% and 15.2% with the highest inclusion rate respectively. The combination of C. gayana with L. leucocephala or C. cajan reduced (p < 0.05) the pCH4 from 16.3% and 16.4% to 15.1% and 14.9% respectively. The pCH4 was reduced (p < 0.05) from 13.4% to 7.60% when A. nilotica was combined with C. gayana. Estimated digestible organic matter (dOM) and metabolizable energy (ME) increased (p < 0.05) with increasing proportions of M. indica seed kernel with CM or C. gayana. In conclusion, the combination of the basal substrates with unconventional supplements resulted in CH4 reduction without affecting the dOM and ME at lower inclusion rates. Animal-based experiments await to validate in vitro findings.

Signal, detection and estimation using a hybrid quantum circuit.

We investigate a hybrid device allowing a photon-phonon coupling of a transmission line radiation (TLR) and a nanoeletromechanical system (NEMS), mediated by a superconducting qubit population imbalance. We demonstrate the derivation of an effective Hamiltonian for the strongly dispersive regime for this system. The qubit works as a quantum switch, allowing a conditioned transfer of excitations between the TLR and NEMS. We show that this regime allows the system to be employed for signal processing and force estimation. Additionally, we explore the ability of the quantum switch to generate non-classical states.

Proposed simplified methodological approach for designing geopolymer concrete mixtures.

The development of geopolymer concrete offers promising prospects for sustainable construction practices due to its reduced environmental impact compared to conventional Portland cement concrete. However, the complexity involved in geopolymer concrete mix design often poses challenges for engineers and practitioners. In response, this study proposes a simplified approach for designing geopolymer concrete mixtures, drawing upon principles from Portland cement concrete mix design standards and recommended molar ratios of oxides involved in geopolymer synthesis. The proposed methodology aims to streamline the mix design process while optimizing key factors such as chemical composition, alkali activation solution, water content, and curing conditions to achieve desired compressive strength and workability. By leveraging commonalities between Portland cement concrete and geopolymer concrete, this approach seeks to facilitate the adoption of geopolymer concrete in practical construction applications. The proposed mix design guidelines have been validated through examples for concrete cured under different conditions, including outdoor and oven curing. Future research should focus on validating the proposed methodology through experimental studies and exploring cost-effective alternatives for alkali activation solutions to enhance the feasibility and scalability of geopolymer concrete production. Overall, the proposed simplified approach holds promise for advancing the utilization of geopolymer concrete as a sustainable alternative in the construction industry.

A social enterprise model for TB detection and treatment through the private sector in Pakistan.

BACKGROUND: Existing models to increase TB case notifications from the private sector in Pakistan are financially unsustainable and have achieved modest success due to limited coverage. OBJECTIVE: To evaluate the impact of a social enterprise model (SEM) intervention on TB case detection in Karachi, Pakistan, and to assess its financial sustainability. METHODS: Purpose-built centres were established within the private sector that integrated TB screening, diagnostics and treatment and operated 12 hours per day with convenient locations to improve access. TB services were offered free of cost, and revenue generation took place through user fees from other diagnostics. Private providers with a focus on the informal sector were engaged through community workers to generate screening referrals. RESULTS: Overall 171,488 people were screened and 18,683 cases were notified, including 197 individuals with drug-resistant TB. Annual TB notifications in Karachi increased from 18,105 in 2014 to a maximum of 25,840 (40% increase). The proportion of cases in Karachi notified by the centres grew to 27% in 2020. Commercial revenue reached USD288,065 and enabled operating cost recovery of 15%. Average cost per TB case notified was USD203. CONCLUSION: The SEM intervention contributed a large proportion of notifications in Karachi and achieved modest cost recovery.

CONTEXTE: Les modèles existants visant à augmenter les notifications de cas de TB par le secteur privé au Pakistan ne sont pas viables financièrement et n'ont obtenu qu'un succès modeste en raison d'une couverture limitée. OBJECTIF: Évaluer l'impact d'un modèle déntreprise sociale (SEM, pour l'anglais « social entreprise model ¼) sur la détection des cas de TB à Karachi, au Pakistan, et évaluer sa viabilité financière. MÉTHODES: Des centres spécialisés ont été créés dans le secteur privé. Ils intègrent le dépistage, le diagnostic et le traitement de la TB et fonctionnent 12 heures par jour dans des lieux adaptés afin dén faciliter l'accès. Les services de lutte contre la TB étaient gratuits et les recettes provenaient des frais d'utilisation des autres diagnostics. Des prestataires privés, axés sur le secteur informel, ont été engagés par l'intermédiaire d'agents communautaires pour orienter les patients vers les services de dépistage. RÉSULTATS: Au total, 171 488 personnes ont été dépistées et 18 683 cas ont été notifiés, dont 197 personnes atteintes de TB résistante aux médicaments. Les notifications annuelles de TB à Karachi sont passées de 18 105 en 2014 à un maximum de 25 840 (augmentation de 40%). La proportion de cas à Karachi notifiés par les centres est passée à 27% en 2020. Les recettes commerciales ont atteint 288 065 USD et ont permis un recouvrement des coûts déxploitation de 15%. Le coût moyen par cas de TB notifié était de 203 USD. CONCLUSION: L'intervention SEM a contribué à une grande proportion de notifications à Karachi et a permis un modeste recouvrement des coûts.

A novel "mix-response" biosensor for colorimetric and photothermal dual-mode detection of sulfide ions in food based on silver-doping Prussian blue nanoparticle.

Effective identification of sulfur ions (S2-) in foodstuff is crucial for food safety and human health, but it remains challenging. Traditional single-mode colorimetric sensing methods are simple and sensitive, but are prone to interference from colored substances which can lead to false positives or negatives results. Herein, we develop a novel "mix-response" biosensor for colorimetric and photothermal dual-mode detection of S2- with good simplicity, sensitivity and portability. In this biosensor, silver-doping Prussian blue nanoparticle (SPB NPs) was used as signal output component, which not only exhibits blue color characteristics, but also has photothermal conversion properties activated by near-infrared (NIR) laser. Upon increasing the S2- concentration, the prepared SPB NPs undergo etching, leading to the formation of new silver sulfide precipitation (Ag2S), along with different colorimetric and photothermal response signals. For the portable visualization of S2-, the color information was recorded by a smartphone in combination with RGB (red channel) analysis and the evolution of the photothermal signal was documented by a thermal imager. The introduction of smartphone and handheld thermal imager in this "mix-response" biosensor makes it suitable for on-site quantitative detection of S2- without sophisticated instrument. Moreover, the development of this "mix-response" biosensor does not need the use of recognition probes (e.g. aptamers and reaction intermediates), thereby simplifying the construct procedures of sensing strategies and improving the economic efficiency of detection. More importantly, the photothermal response signals can overcome the interference of colored substances in foods, thereby reducing the false positives or negatives of the detection results.

[Rapid Start-up of Continuous Autotrophic Nitrogen Removal Reactor by Hybrid-inoculating PN and PN/A Granular Sludges].

The rapid cultivation of partial nitritation/ANAMMOX （PN/A） granular sludge in a continuous-flow mode is one of the key technologies for efficient biological nitrogen removal in domestic wastewater treatment. Compared with that in PN/A granular sludge, PN granular sludge demonstrates a shorter incubation period and suitability for batch culture. It is also a good carrier for enriching ANAMMOX （AMX） bacteria. In this study, we established a continuous-flow autotrophic nitrogen removal process in three continuously stirred tank reactors （CSTR） （R1-R3） by hybrid-inoculating PN/A and PN granular sludge at the mass ratios of 3∶1, 1∶1, and 1∶3, respectively. By implementing high ammonium nitrogen loading and short hydraulic retention time, continuous autotrophic nitrogen removal processes were successfully started up in the three CSTRs. The results showed that compared with that of R1 and R2, R3 had a longer start-up time but a similar steady-state nitrogen removal performance. The total nitrogen removal load of R3 could be more than 2.6 kg·ï¼ˆm3·d）-1. Intriguingly, the inoculated PN granular sludge served as a precursor for PN/A granular sludge cultivation. This approach facilitated the enrichment of anaerobic ammonia-oxidizing bacteria （AMX） by introducing abundant ammonium-oxidizing bacteria （AOB） and nitrite nitrogen substrates into the CSTR. According to the results of high-throughput sequencing, the microbial abundance and diversity of the mature granules in R1-R3 were significantly higher than those of the inoculation sludge. AOB （genus Nitrosomonas）, AMX （genera Candidatus Kuenenia and Candidatus Brocadia）, and symbiotic heterotrophs, such as Chloroflexi, Bacteroidetes, and Chlorobi, drove the autotrophic nitrogen removal process and maintained the stability of the granular structure. In summary, a novel start-up strategy of hybrid-inoculating granular sludge was provided for a continuous-flow autotrophic nitrogen removal in engineering application.

Valorization of corn silk through incorporation in instant mix and analyzing its shelf life by kinetic modelling.

Corn silk (Zea mays L.), an abundant agricultural waste, contains various bioactive compounds that exhibit promising health benefits. The current study focuses on development and optimization of corn silk-based instant mix using response surface methodology. The optimized product, with 14.66% corn silk, 10% sugar and 0.22% xanthan gum in a skim milk powder base, scored 0.925 desirability. The physico-chemical and sensory parameters of optimized mix closely aligned with expected values. The instant mix packaged in metallised polyester yielded superior preservation of quality indicators over 120 days compared to low-density polyethylene (LDPE) and high-density polyethylene (HDPE). The microbial load in corn silk instant mix was observed across packaging materials and highlighting hydroxyl methyl furfural (HMF) as the primary predictor of product stability, the study calculated a 94.95 days half-life at 10 °C. Corn silk's rich bioactive compound supports its integration into nutraceuticals and instant mixes, mitigating food waste while enhancing nutritional value. Novelty statement. In this study, corn silk powder was utilized for the development of the instant mix. This innovative approach transforms corn silk, typically discarded as agricultural waste, into a commercially sustainable product that delivers the nutrients of corn silk to a broader population. Despite fresh corn silk being a perishable commodity, it has very low storage shelf life. The developed instant mix effectively preserves its nutritional value for up to six months, offering a sustainable and nutritious option for consumers.

Leveraging Global Fund's investments to expand innovative public-private provider engagement in TB.

BACKGROUND: TB remains a significant global health threat, claiming 1.3 million lives annually. The COVID-19 pandemic disrupted progress in the global TB response. Most patients with TB initially seek care from private providers, whereas only a small proportion are engaged by national programmes. The Global Fund is the major international source of funding for TB responses and supports the scale-up of innovative private-public mix (PPM) models in TB. METHODS: We collected programmatic and financial data on TB from 11 priority countries implementing PPM activities. Country examples and trends in the budget of Global Fund grants were analysed. RESULTS: These countries account for 60% of the global TB burden and Global Fund TB portfolio. PPM contributed 29% of national TB notifications in 2022 (range: 8% to 49%). During 2021-2023, US$1.4 billion was allocated for TB and US$155 million (11%) for PPM, while PPM contributed to 35% of national TB notification targets. PPM budgets increased over time from US$43 million (2002 to 2014) to US$129 million (2024 to 2026). CONCLUSION: The Global Fund's investments facilitated the expansion of innovative PPM models, improved access, and enhanced TB responses. Our indicative analysis underscores the need for evidence-based planning, collaboration, and increased domestic investment to accelerate the end of TB.

CONTEXTE: La TB reste une menace importante pour la santé mondiale, faisant 1,3 million de morts chaque année. La pandémie de COVID-19 a perturbé les progrès de la riposte mondiale à la TB. La plupart des patients atteints de TB recherchent d'abord des soins auprès de prestataires privés, tandis que seule une petite proportion est engagée par des programmes nationaux. Le Fonds mondial est la principale source internationale de financement de la lutte contre la TB et soutient l'extension de modèles innovants de partenariats public-privé (PPM, pour l'anglais « public-private mix ¼) dans le domaine de la TB. MÉTHODES: Nous avons recueilli des données programmatiques et financières sur la TB dans 11 pays prioritaires mettant en œuvre des activités de PPM. Des exemples de pays et les tendances du budget des subventions du Fonds mondial ont été analysés. RÉSULTATS: Ces pays représentent 60% de la charge mondiale de morbidité de la TB et du portefeuille du Fonds mondial de lutte contre la TB. La PPM a contribué à 29% des notifications nationales de TB en 2022 (fourchette : 8­49%). Au cours de la période 2021­2023, 1,4 milliard de dollars US ont été alloués à la TB et 155 millions de dollars US (11%) à la PPM, tandis que la PPM a contribué à 35% des cibles nationales de notification de la TB. Les budgets PPM ont augmenté au fil du temps, passant de 43 millions de dollars US (2002 à 2014) à 129 millions de dollars américains (2024 à 2026). CONCLUSION: Les investissements du Fonds mondial ont facilité l'expansion de modèles PPM innovants, l'amélioration de l'accès et le renforcement des ripostes à la TB. Notre analyse indicative souligne la nécessité d'une planification fondée sur des données probantes, d'une collaboration et d'une augmentation des investissements nationaux pour accélérer l'éradication de la TB.

Effects of storage conditions on the stability of qPCR reagents: implications for environmental DNA detection.

OBJECTIVE: Environmental DNA (eDNA) detection is a transformative tool for ecological surveys which in many cases offers greater accuracy and cost-effectiveness for tracking low-density, cryptic species compared to conventional methods. For the use of targeted quantitative PCR (qPCR)-based eDNA detection, protocols typically require freshly prepared reagents for each sample, necessitating systematic evaluation of reagent stability within the functional context of eDNA standard curve preparation and environmental sample evaluation. Herein, we assessed the effects of long-term storage and freeze-thaw cycles on qPCR reagents for eDNA analysis across six assays. RESULTS: Results demonstrate qPCR plates (containing pre-made PCR mix, primer-probe, and DNA template) remain stable at 4 °C for three days before thermocycling without fidelity loss irrespective of qPCR assay used. Primer-probe mixes remain stable for five months of - 20 °C storage with monthly freeze-thaw cycles also irrespective of qPCR assay used. Synthetic DNA stocks maintain consistency in standard curves and sensitivity for three months under the same conditions. These findings enhance our comprehension of qPCR reagent stability, facilitating streamlined eDNA workflows by minimizing repetitive reagent preparations.

[Complex optical systems for individualized correction of presbyopia]. / Komplexe Optiksysteme für eine individualisierte Presbyopiekorrektur.

A multitude of available intraocular lens (IOL) models enable a personalized approach to presbyopia correction in order to meet each patient's needs. This review article discusses more complex approaches which can be useful in selected cases. The concept of reversible trifocality enables correction of presbyopia using a supplementary intraocular lens (IOL), which can be removed if necessary (e.g., intolerance to multifocal optics). The use of capsulotomy-fixated IOLs enables high precision for positioning of the lens and better stability compared to conventional capsular bag-fixated IOLs, which can be particularly advantageous in multifocal optics. The mix and match concept enables a combination of different IOLs with various optical principles to achieve the desired binocular effect. Binocular IOL systems, which consist of two complementary IOLs, can be seen as a further development of the mix and match concept. Knowledge of the available options and their application can further improve correction of presbyopia.

Use of antioxidants to retard aging of bitumen: A review.

Oxidative aging of bitumen is an inevitable and irreversible phenomenon. Exposure to detrimental factors such as sunlight, oxygen, and UV radiations accelerates the aging of bitumen and bituminous pavement. The aging process induces hardening and embrittlement in bitumen, leading to premature pavement failure. Therefore, for constructing sustainable long-lasting pavements anti-aging additives are used. Among the available additives, the use of antioxidants has emerged as a promising solution to mitigate the aging of bitumen. The current review aims to summarise the existing literature for a comprehensive understanding of the effectiveness of these additives as aging inhibitors. It provides an overview of the chemical pathway involved during bitumen oxidation and various quantification techniques to measure the effect of aging. This review also highlights the potential use of antioxidants in bitumen and elaborates on the working mechanism of different types of antioxidants to prevent bitumen aging. Further, the effect of modification in bitumen at micro, macro, and mixture levels are discussed. Additionally, cost analysis and future prospects on the use of antioxidants for bitumen are presented.

The impact of nursing workforce skill-mix on patient outcomes in intensive care units in Victoria, Australia.

Objective: This article aims to examine the impact of nursing workforce skill-mix (percentage of critical care registered nurses [CCRN]) in the intensive care unit (ICU) during a patient's stay. Design: Registry linked cohort study of the Australian and New Zealand Intensive Care Society Adult Patient Database and the Critical Health Resources Information System using real-time nursing workforce data. Settings: Fifteen public and 5 private hospital ICUs in Victoria, Australia. Participants: There were 16,618 adult patients admitted between 1 December 2021 and 30 September 2022. Main outcome measures: Primary outcome: in-hospital mortality. Secondary outcomes: in-ICU mortality, development of delirium, pressure injury, duration of stay in-ICU and hospital, after-hours discharge from ICU and readmission to ICU. Results: In total, 6563 (39.5%) patients were cared for in ICUs with >75% CCRN, 7695 (46.3%) in ICUs with 50-75% CCRN, and 2360 (14.2%) in ICUs with <50% CCRN. In-hospital mortality was 534 (8.1%) vs. 859 (11.2%) vs. 252 (10.7%) respectively. After adjusting for confounders, patients cared for in ICUs with 50-75% CCRN (adjusted OR 1.21 [95% CI 1.02-1.45]) were more likely to die compared to patients in ICUs with >75% CCRN. A similar but non-significant trend was seen in ICUs with <50% CCRN (adjusted OR 1.21 [95% CI 0.94-1.55]), when compared to patients in ICUs with >75% CCRN. In-ICU mortality, delirium, pressure injuries, after-hours discharge and ICU length of stay were lower in ICUs with CCRN>75%. Conclusion: The nursing skill-mix in ICU impacts outcomes and should be routinely monitored. Health system regulators, hospital administrators and ICU leaders should ensure nursing workforce planning and education align with these findings to maximise patient outcomes.

Predictor Selection for Case Complexity Based on Routine Data for Needs-Based and Competence-Based Staff Planning.

Due to nursing staff shortage and growing nursing care demand, resource allocation and optimal task distribution have become primary concerns of nursing management. Grade mix analysis based on nursing interventions and nurse qualifications from routine patient documentation can support this. Case complexity is a key linking factor of nursing interventions, workload, and grade mix. This study determined case complexity predictors based on one year of routine patient documentation (n = 3,373 cases) from a Swiss hospital and predicted the patient clinical complexity level via weighted cumulative logistic regression models. Significant predictors were sex, age, pre-admission residence, admission type, self- care index, pneumonia risk, and number of nursing interventions. The models' accuracy is limited yet appropriate for applications such as needs- and competence- based staff-planning. After calibration via in-hospital data it could support nursing management in these tasks. The next step is now to test the model in a clinical setting.