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Background: General practitioners play a pivotal role in the diagnosis attention-deficit/hyperactivity disorder (ADHD) in adults. This systematic review aims to determine the effectivity and feasibility of screening tools for ADHD in adults in primary care. Method: A literature search was performed in PubMed, Cochrane Library, Ovid, ERIC, PsycInfo, PSYNDEX and Embase in November 2022. Sensitivity and specificity were considered as primary outcomes. Further psychometric properties, feasibility in general practice as well as digital practicability were evaluated as secondary outcomes. Risk of bias was assessed via QUADAS-2/C. A narrative data synthesis and meta-analysis was performed (PROSPERO: CRD42022374597). Results: A total of fifty-eight studies were included in data analysis. These studies referred to eighty-four various screening tools. ASRS-6 (DSM-V), WURS-25, CAARS-s:sV and TRAQ10 are suitable instruments for screening of ADHD in adults in primary care. The highest test accuracy was shown by ASRS 6 (DSM-V) (Sensitivity=0.83 [0.67–0.92], Specificity=0.87 [0.93–0.8], AUC=0.92, I2=8.6–12.3 %). Limitations: Included studies used rating scales as reference standard. Some studies compared study groups to control groups with an unknown ADHD status and there is a large degree of heterogeneity between the populations. Some studies referred to the best-balanced results of sensitivity and specificity under a certain cut-off, that has not been determined before. Conclusion: Feasibility studies are needed to provide more evidence for WURS-25 and CAARS-s:sV. The determination of sufficient cut-offs is important, to improve the identification of ADHD in adults by general physicians.

Abstract Background Surveillance testing within healthcare facilities provides an opportunity to prevent severe outbreaks of coronavirus disease 2019 (COVID-19). However, the quantitative impact of different available surveillance strategies and their potential to decrease the frequency of outbreaks are not well-understood. Methods We establish an individual-based model representative of a mental health hospital yielding generalizable results. Attributes and features of this facility were derived from a prototypical hospital, which provides psychiatric, psychosomatic and psychotherapeutic treatment. We estimate the relative reduction of outbreak probability for three test strategies (entry test, once-weekly test and twice-weekly test) relative to a symptom-based baseline strategy. Based on our findings, we propose determinants of successful surveillance measures. Results Entry Testing reduced the outbreak probability by 26%, additionally testing once or twice weekly reduced the outbreak probability by 49% or 67% respectively. We found that fast diagnostic test results and adequate compliance of the clinic population are mandatory for conducting effective surveillance. The robustness of these results towards uncertainties is demonstrated via comprehensive sensitivity analyses. Conclusions We conclude that active testing in mental health hospitals and similar facilities considerably reduces the number of COVID-19 outbreaks compared to symptom-based surveillance only.

Abstract Background Evidence-based psychological interventions for posttraumatic stress disorder (PTSD) are available in specialized settings, but adequate care in primary care is often lacking. The aim of this systematic review was to determine the effectiveness of psychological interventions for PTSD involving primary care physicians (PCPs) and to characterize these interventions as well as their providers. Method A systematic review and meta-analyses of randomized controlled trials (RCTs). Primary outcome were symptoms of PTSD. Results Four RCTs with a total of 774 patients suffering from PTSD symptoms were included, all applying cognitive behavioural based interventions. Three studies with psychological interventions being conducted by case managers were pooled in a meta-analysis. Interventions were not effective in the short term (0–6 months; SMD, − 0.1; 95% CI, − 0.24-0.04; I2 = 0%). Only two studies contributed to the meta-analysis for long term (12–18 months) outcomes yielding a small effect (SMD, − 0.23; 95% CI, − 0.38- -0.08; I2 = 0%). Conclusions Psychological interventions for PTSD in primary care settings may be effective in the long term but number and quality of included studies was limited so the results should be interpreted with caution.

This paper studies the economics of carbon-neutral synthetic fuel production from renewable electricity in remote areas where high-quality renewable resources are abundant. To this end, a graph-based optimisation modelling framework directly applicable to the strategic planning of remote renewable energy supply chains is proposed. More precisely, a hypergraph abstraction of planning problems is introduced, wherein nodes can be viewed as optimisation subproblems with their own parameters, variables, constraints and local objective. Nodes typically represent a subsystem such as a technology, a plant or a process. Hyperedges, on the other hand, express the connectivity between subsystems. The framework is leveraged to study the economics of carbon-neutral synthetic methane production from solar and wind energy in North Africa and its delivery to Northwestern European markets. The full supply chain is modelled in an integrated fashion, which makes it possible to accurately capture the interaction between various technologies on an hourly time scale. Results suggest that the cost of synthetic methane production and delivery would be slightly under 150 €/MWh (higher heating value) by 2030 for a system supplying 10 TWh annually and relying on a combination of solar photovoltaic and wind power plants, assuming a uniform weighted average cost of capital of 7%. A comprehensive sensitivity analysis is also carried out in order to assess the impact of various techno-economic parameters and assumptions on synthetic methane cost, including the availability of wind power plants, the investment costs of electrolysis, methanation and direct air capture plants, their operational flexibility, the energy consumption of direct air capture plants, and financing costs. The most expensive configuration (around 200 €/MWh) relies on solar photovoltaic power plants alone, while the cheapest configuration (around 88 €/MWh) makes use of a combination of solar PV and wind power plants and is obtained when financing costs are set to zero.

[This corrects the article DOI: 10.1371/journal.pone.0148496.].

BACKGROUND:Research on sleep after stroke has focused mainly on sleep disordered breathing. However, the extend to which sleep physiology is altered in stroke survivors, how these alterations compare to healthy volunteers, and how sleep changes might affect recovery as well as physical and mental health has yet to be fully researched. Motivated by the view that a deeper understanding of sleep in stroke is needed to account for its role in health and well-being as well as its relevance for recovery and rehabilitation, we conducted a systematic review and meta-analysis of polysomnographic studies comparing stroke to control populations. METHOD:Medline and PsycInfo databases were searched using "stroke" and words capturing polysomnographic parameters as search terms. This yielded 1692 abstracts for screening, with 15 meeting the criteria for systematic review and 9 for meta-analysis. Prisma best practice guidelines were followed for the systematic review; the Comprehensive Meta-Analysis software was used for random effects modelling. RESULTS:The meta-analysis revealed that patients with stroke have poorer sleep than controls. Patients had lower sleep efficiency (mean 75% vs 84%), shorter total-sleep-time (309.4 vs 340.3 min) and more wake-after-sleep-onset (97.2 vs 53.8 min). Patients also spend more time in stage 1 (13% vs 10%) and less time in stage 2 sleep (36% vs 45%) and slow-wave-sleep (10% vs 12%). No group differences were identified for REM sleep. The systematic review revealed a strong bias towards studies in the early recovery phase of stroke, with no study reporting specifically on patients in the chronic state. Moreover, participants in the control groups included community samples as well as other patients groups. CONCLUSIONS:These results indicate poorer sleep in patients with stroke than controls. While strongly suggestive in nature, the evidence base is limited and methodologically diverse, and hands a clear mandate for further research. A particular need regards polysomnographic studies in chronic community-dwelling patients compared to age-matched individuals.