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In this paper, we numerically and experimentally test the exploitability of the broadband non-contact flip-chip transmission line technique in studying the complex conductivity of ultra-thin, highly disordered superconducting films of molybdenum carbide. The complex conductivity of such films with various sheet resistances is calculated in the GHz frequency range by the Mattis-Bardeen model with finite broadening parameter and by the Nam model for Dynes superconductors. The transmission of the line in the vicinity of the superconducting thin film is modeled in electromagnetic simulation software, and is compared to experimental data. Evidence of sharp resonances is reported. [ABSTRACT FROM AUTHOR]

Background Family physicians (FPS) play a role in aspects of personalized medicine in cancer, including assessment of increased risk because of family history. Little is known about the potential role of FPS in supporting cancer patients who undergo tumour gene expression profile (GEP) testing. Methods We conducted a mixed-methods study with qualitative and quantitative components. Qualitative data from focus groups and interviews with FPS and cancer specialists about the role of FPS in breast cancer GEP testing were obtained during studies conducted within the pan-Canadian canimpact research program. We determined the number of visits by breast cancer patients to a FP between the first medical oncology visit and the start of chemotherapy, a period when patients might be considering results of GEP testing. Results The FPS and cancer specialists felt that ordering GEP tests and explaining the results was the role of the oncologist. A new FP role was identified relating to the fp-patient relationship: supporting patients in making adjuvant therapy decisions informed by GEP tests by considering the patient's comorbid conditions, social situation, and preferences. Lack of FP knowledge and resources, and challenges in fp-oncologist communication were seen as significant barriers to that role. Between 28% and 38% of patients visited a FP between the first oncology visit and the start of chemotherapy. Conclusions Our findings suggest an emerging role for FPS in supporting patients who are making adjuvant treatment decisions after receiving the results of GEP testing. For success in this new role, education and point-of-care tools, together with more effective communication strategies between FPS and oncologists, are needed. [ABSTRACT FROM AUTHOR]

Background Currently, the specific role of family physicians (FPS) in the care of people with cancer is not well defined. Our goal was to explore physician perspectives and contextual factors related to the coordination of cancer care and the role of FPS. Methods Using a constructivist grounded theory approach, we conducted telephone interviews with 58 primary and cancer specialist health care providers from across Canada. Results The participants--21 FPS, 15 surgeons, 12 medical oncologists, 6 radiation oncologists, and 4 general practitioners in oncology--were asked to describe both the role that FPS currently play and the role that, in their opinion, FPS should play in the future care of cancer patients across the cancer continuum. Participants identified 3 key roles: coordinating cancer care, managing comorbidities, and providing psychosocial care to patients and their families. However, FPS and specialists discussed many challenges that prevent FPS from fully performing those roles:  The FPS described communication problems resulting from not being kept "in the loop" because they weren't copied on patient reports and also the lack of clearly defined roles for all the various health care providers involved in providing care to cancer patients.  The specialists expressed concerns about a lack of patient access to FP care, leaving specialists to fill the care gaps. The FPS and specialists both recommended additional training and education for FPS in survivorship care, cancer screening, genetic testing, and new cancer treatments. Conclusions Better communication, more collaboration, and further education are needed to enhance the role of FPS in the care of cancer patients. [ABSTRACT FROM AUTHOR]

This experimental study investigates the swelling behaviour of an 80/20 sand/bentonite mixture and the associated fabric evolution under different hydro-chemo-mechanical loadings. Free and confined swelling tests are performed on specimens compacted to different dry densities and wetted with different pore fluids. Controlled suction confined swelling tests are performed to determine the suction-swelling pressure relationship for two different densities. An extensive microstructural characterisation is performed to relate the observed swelling behaviour to the evolution of the different pore networks during wetting. Based on the microstructural analysis, an expression is proposed to determine the relative dry density of the bentonite. This parameter enables comparisons of the data on the swelling of different bentonite-based materials prepared at different mixing ratios. A unique relationship is determined to fit all of the experimental data satisfactorily. The results reveal that the generated swelling pressure depends on the applied matric suction and on the chemical composition of the pore water. At a low dry density, the mixture in contact with aqueous solutions loses most of its swelling capacity. At a higher dry density, the swelling capacity of the mixture is better preserved. [ABSTRACT FROM AUTHOR]

Supraventricular tachycardia (SVT), being atrioventricular reentry the underlying mechanism, is the most frequently tachyarrhythmia requiring a medical treatment in infants with no cardiac disease. The acute treatment of a single episode of SVT has generally an excellent prognosis. An antiarrhythmic prophylaxis of SVT recurrences is usually recommended during the first year of life. Although many efficient drugs are available for the SVT treatment, a careful risk-benefit analysis of each single case should suggest the correct drug choice. [ABSTRACT FROM AUTHOR]

The measurement of temperature in a combustion chamber, using conventional devices such as thermocouples, can be misleading. An infrared thermographic camera can achieve a non-intrusive measure. Having acquired a still image of, for example, a klin, it can be used to produce a map of the effective temperature of the waste bed, walls, and combustion gases. This paper describes a technique for processing an infrared image to identify what really happens within such a combustion chamber. The use of a thermographic camera, to produce a temperature map of a combustion chamber, can be helpful, particularly for control purposes. This paper addresses the criteria adopted in the selection of the thermographic system, in terms of both wavelength sensitivity and geometric location within the chamber. Moreover, a detailed description of the zonal method is reported, together with the identification procedure adopted to infer the temperature map from an infrared image. As a matter of fact, the presence of soot and fly-ash within the combustion chamber does complicate the radiative model, because a gray gas analogy must be accounted for. Soot and fly-ash give rise to a foggy and diffusive effect on the image with a consequent apparent homogeneous temperature profile. To simulate the effective radiative energy flux entering the camera lens and impinging on the CCD photoelectric cell, a raytracing technique has been developed. Each discrete area and volume, within the combustion chamber, emits a pencil of radiation, which after passing through the hot gases, reaches the CCD device. Such a light pencil is generated by the energy emitted and reflected from the discrete surfaces, plus all the energies emitted by the volumes of gas distributed along the path, minus any attenuation. The total energy balance equations, coming from the zonal method, must be coupled with the temperature-energy maps acquired by the infrared camera to identify the unknown effective temperatures. Once the temperatures of the walls and bed are known, it is possible to use them to improve the control strategy by means of a set of new measures and combustion efficiency indexes, which are usually unavailable when conventional thermocouples are adopted. Finally, a validation of the proposed procedure is presented with an online application to an incinerator for industrial solid waste. The combustion dynamics within the primary kiln is analyzed and quantified, in terms of both absolute temperatures and characteristic times. [Copyright &y& Elsevier]

Background: The Building on Existing Tools to Improve Chronic Disease Prevention and Screening (BETTER) intervention has improved uptake of chronic disease prevention and screening activities in primary care. The BETTER intervention consists of 1:1 visits between prevention practitioners (PPs) and patients (40-65 years). It is unknown if an adapted BETTER could be effective in the community with public health nurses as PPs. Aim: The presentation objective is to describe community engagement strategies in a cluster RCT in low income neighborhoods with low cancer screening rates and low uptake of primary care. Methods: Principles of community-based participatory research were used to design the community engagement strategy in Durham region, Ontario. Key elements included close collaboration with public health partners to identify stakeholders and creating a community advisory committee (CAC) and a primary care engagement group to provide advice. Results: We identified 15 community stakeholder groups (∼47 subgroups) including service organizations, faith groups, and charitable organizations representing diverse constituents. Community outreach activities included in-person meetings and information displays at local events. The CAC is comprised of members of the public and representatives from primary care, social services, and community organizations. The CAC and primary care engagement groups have provided advice on trial recruitment strategies and on the design of the PP visit. Conclusion: The partnership between public health, primary care, and the study team has been crucial to connect with community stakeholders. Community engagement is essential in raising awareness about the study and will contribute to successful recruitment. Trial Registration: NCT03052959 [ABSTRACT FROM AUTHOR]

We investigate the complex conductivity of a highly disordered MoC superconducting film with kFl ≈ 1, where kF is the Fermi wave number and l is the mean free path, derived from experimental transmission characteristics of coplanar waveguide resonators in a wide temperature range below the superconducting transition temperature τc. We find that the original Mattis-Bardeen model with a finite quasiparticle lifetime, τ, offers a perfect description of the experimentally observed complex conductivity. We show that τ is appreciably reduced by scattering effects. Characteristics of the scattering centers are independently found by scanning tunneling spectroscopy and agree with those determined from the complex conductivity. [ABSTRACT FROM AUTHOR]

Abstract: This paper presents a mathematical model for the unsteady evaporation, ignition, and combustion of isolated fuel droplets under microgravity. The model consists of a large structured system of differential algebraic equations, where the numerical complexity is due both to the stiff nature of the kinetic mechanism and to the flame structure around the droplet. A very general, detailed kinetic scheme, consisting of ∼200 species and over 5000 reactions, is used to describe the gas-phase combustion of different fuels. Several comparisons with experimental measurements, carried out under various operating conditions, confirm that the proposed model is a useful tool for characterizing low-temperature and high-temperature ignition delay times. The predicted explosion diagrams of n-alkanes, as well as their ignition delay times, agree with the experimental measurements; the various oxidation regions are closely reproduced too. In addition to this, recent experimental results, relating to the influence of the initial diameter on droplet burning rates in cold and hot environments, are also presented and discussed. Lastly, an analysis of the extinction diameters for the combustion of n-heptane droplets allows a discussion of the role of radiative heat transfer, as well as further emphasizing the importance of the low-temperature oxidation mechanisms. [Copyright &y& Elsevier]

Background: The original 'BETTER' (Building on Existing Tools To Improve Chronic Disease Prevention and Screening in Primary Care) approach consisted of a prevention-focused visit between participants aged 40-65 years and a "Prevention Practitioner" (PP), who empowered the participant to set achievable prevention and screening goals for cancers and chronic diseases. BETTER was successfully adapted for economically deprived communities (BETTER HEALTH) in Canada. Our objective was to conduct a review of guidelines in preparation for adapting the 'BETTER HEALTH' approach for younger adults aged 18-39 years living with lower income, a group known to have earlier mortality due to a higher prevalence of preventable chronic diseases than their peers with higher income., Methods: We searched multiple electronic databases and grey literature for clinical practice guidelines on prevention/screening and included those that met the following criteria: published in English from 2008-2020 in Canada or any of the following countries (Australia, Ireland, New Zealand, Scotland, United States and England); and addressed prevention or screening. We assessed quality using the Appraisal of Guidelines for Research and Evaluation (AGREE) II tool and extracted data (publication details, recommendations, and Quality/Level of evidence as reported by authors) from sources with overall scores of 5 or higher. Final recommendations were compiled after harmonization with input from diverse stakeholders (co-investigators, PPs, and the Community Advisory Committee)., Results: We included a total of 85 guidelines, and developed a final list of 42 recommendations for 18-39 year-olds across 21 topics. Specific recommendations fell under the following topics: cancers, cardiovascular disease, diabetes, obesity, lifestyle (alcohol; healthy nutrition/physical activity); healthy relationships and healthy sexuality, immunization, oral health, social determinants of health, and substance use., Conclusion: We identified evidence-based guidelines on individual-level prevention/screening actions for adults 18-39 years old and relevant for those living with lower income which will directly inform development and implementation of the BETTER LIFE intervention., (© 2024. The Author(s).)

Petroleum-based microplastic particles (MPs) are carriers of antimicrobial resistance genes (ARGs) in aquatic environments, influencing the selection and spread of antimicrobial resistance. This research characterized MP and natural organic particle (NOP) bacterial communities and resistomes in the Tyrrhenian Sea, a region impacted by plastic pollution and climate change. MP and NOP bacterial communities were similar but different from the free-living planktonic communities. Likewise, MP and NOP ARG abundances were similar but different (higher) from the planktonic communities. MP and NOP metagenome-assembled genomes contained ARGs associated with mobile genetic elements and exhibited co-occurrence with metal resistance genes. Overall, these findings show that MPs and NOPs harbor potential pathogenic and antimicrobial resistant bacteria, which can aid in the spread of antimicrobial resistance. Further, petroleum-based MPs do not represent novel ecological niches for allochthonous bacteria; rather, they synergize with NOPs, collectively facilitating the spread of antimicrobial resistance in marine ecosystems., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Introduction/aims: The global incidence and prevalence of myasthenia gravis (MG) range between 6-31/million and 10-37/100,000, respectively. Sardinia is a high-risk region for different immune-mediated disorders, but the epidemiology of MG remains unclear. We determined the epidemiology of MG with acetylcholine receptor (AChR)-immunoglobulin G (IgG) and muscle-specific tyrosine kinase (MuSK)-IgG in the district of Sassari (North-Western Sardinia; population, 325,288)., Methods: From the laboratory of the University Hospital of Sassari (reference for AChR/MuSK-IgG testing in Sardinia since 1998) and the main neurology units in Sardinia, we retrospectively identified MG patients with (1) AChR-IgG and/or MuSK-IgG positivity by radioimmunoprecipitation assay; and (2) residency in the district of Sassari. Incidence (January 2010-December 2019) and prevalence (December 31, 2019) were calculated., Results: A total of 202 patients were included (incident, 107; prevalent, 180). Antibody specificities were AChR (n = 187 [93%]) and MuSK (n = 15 [7%]). The crude MG incidence (95% confidence interval) was 32.6 (26.8-39.2)/million, while prevalence was 55.3 (47.7-63.9)/100,000. After age-standardization to the world population, incidence decreased to 18.4 (14.3-22.5)/million, while prevalence decreased to 31.6 (26.1-37.0)/100,000. Among incident cases, age strata (years) at MG onset were: <18 (2%), 18-49 (14%), 50-64 (21%), and ≥65 (63%)., Discussion: Sardinia is a high-risk region for MG, with a prevalence that exceeds the European threshold for rare disease. Identification of the environmental and genetic determinants of this risk may improve our understanding of disease pathophysiology., (© 2024 Wiley Periodicals LLC.)

Background: The BETTER intervention is an effective comprehensive evidence-based program for chronic disease prevention and screening (CDPS) delivered by trained prevention practitioners (PPs), a new role in primary care. An adapted program, BETTER HEALTH, delivered by public health nurses as PPs for community residents in low income neighbourhoods, was recently shown to be effective in improving CDPS actions. To obtain a nuanced understanding about the CDPS needs of community residents and how the BETTER HEALTH intervention was perceived by residents, we studied how the intervention was adapted to a public health setting then conducted a post-visit qualitative evaluation by community residents through focus groups and interviews., Methods: We first used the ADAPT-ITT model to adapt BETTER for a public health setting in Ontario, Canada. For the post-PP visit qualitative evaluation, we asked community residents who had received a PP visit, about steps they had taken to improve their physical and mental health and the BETTER HEALTH intervention. For both phases, we conducted focus groups and interviews; transcripts were analyzed using the constant comparative method., Results: Thirty-eight community residents participated in either adaptation (n = 14, 64% female; average age 54 y) or evaluation (n = 24, 83% female; average age 60 y) phases. In both adaptation and evaluation, residents described significant challenges including poverty, social isolation, and daily stress, making chronic disease prevention a lower priority. Adaptation results indicated that residents valued learning about CDPS and would attend a confidential visit with a public health nurse who was viewed as trustworthy. Despite challenges, many recipients of BETTER HEALTH perceived they had achieved at least one personal CDPS goal post PP visit. Residents described key relational aspects of the visit including feeling valued, listened to and being understood by the PP. The PPs also provided practical suggestions to overcome barriers to meeting prevention goals., Conclusions: Residents living in low income neighbourhoods faced daily stress that reduced their capacity to make preventive lifestyle changes. Key adapted features of BETTER HEALTH such as public health nurses as PPs were highly supported by residents. The intervention was perceived valuable for the community by providing access to disease prevention., Trial Registration: #NCT03052959, 10/02/2017., (© 2024. The Author(s).)

Liposomal formulations are hypothesized to alleviate anthracycline cardiotoxicity, although this has only been documented clinically for doxorubicin. We developed an in vitro multiparametric model using human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) to assess the relative toxicity of anthracyclines across formulations. Proof of concept was established by treating hiPSC-CM with equivalent concentrations of free and liposomal doxorubicin. The study was then repeated with free daunorubicin plus cytarabine and CPX-351, a dual-drug liposomal encapsulation of daunorubicin/cytarabine. hiPSC-CM were treated with free-drug or liposomal formulations for 24 h on Days 1, 3, and 5 at equivalent concentrations ranging from 0 to 1000 ng/mL and assessed on subsequent days. Free-drug treatment resulted in concentration-dependent cumulative cytotoxicity (microscopy), more profound decrease in ATP levels, and significant time- and concentration-dependent decreases in oxygen consumption versus liposomal formulations (p < 0.01). Repeated free-drug exposure also resulted in greater release of biomarkers (cardiac troponin I, FABP3) and lactate dehydrogenase, as well as in a biphasic rhythmicity response (initial increase followed by slowing/quiescence of beating) indicating significant injury, which was not observed after repeated exposure to liposomal formulations. Overall, liposomal formulations were considerably less toxic to hiPSC-CM than their free-drug counterparts. Clinical data will be needed to confirm findings for CPX-351., (© 2023. The Author(s).)

Objective: Documenting cannabis use is important for patient care, but no formal requirements for consistent reporting exist in primary care. The objective of this study was to understand how cannabis use is documented in primary care electronic medical record (EMR) data., Results: This was a cross-sectional study using de-identified EMR data from over 398,000 patients and 333 primary care providers in Alberta, Canada. An automated pattern-matching algorithm was developed to identify text and ICD-9 diagnostic codes indicating cannabis use in the EMR. There was a total of 11,724 records indicating cannabis use from 4652 patients, representing approximately 1.2% of the patient sample. Commonly used terms and ICD-9 codes included cannabis, marijuana/marihuana, THC, 304.3 and 305.2. Nabilone was the most frequently prescribed cannabinoid medication. Slightly more males and those with a chronic condition had cannabis use recorded more often. Overall, very few patients have cannabis use recorded in primary care EMR data and this is not captured in a systematic way. We propose several strategies to improve the documentation of cannabis use to facilitate more effective clinical care, research, and surveillance., (© 2023. The Author(s).)

In some sectors of the water resources management, the digital revolution process is slowed by some blocking factors such as costs, lack of digital expertise, resistance to change, etc. In addition, in the era of Big Data, many are the sources of information available in this field, but they are often not fully integrated. The adoption of different proprietary solutions to sense, collect and manage data is one of the main problems that hampers the availability of a fully integrated system. In this context, the aim of the project is to verify if a fully open, cost-effective and replicable digital ecosystem for lake monitoring can fill this gap and help the digitalization process using cloud based technology and an Automatic High-Frequency Monitoring System (AHFM) built using open hardware and software components. Once developed, the system is tested and validated in a real case scenario by integrating the historical databases and by checking the performance of the AHFM system. The solution applied the edge computing paradigm in order to move some computational work from server to the edge and fully exploiting the potential offered by low power consuming devices.

Lesack et al. recently published a cross-sectional study that focused on human papillomavirus (HPV) self-sampling in the screened population, a population not conventionally thought of for HPV self-sampling. They found 52% of well-screened, highly educated women who participated in the Human Papillomavirus For Cervical Cancer (HPV FOCAL) screening trial in British Columbia, Canada, would be willing to self-collect an HPV sample. We published a similar study in 2021 on well-screened, highly educated women affiliated with a family medicine clinic in Edmonton, Alberta, Canada, and found that 60% of these women preferred to have the option of HPV self-sampling. Our findings reinforce Lesack et al.'s results and together provide evidence for offering HPV self-sampling as an option for the well-screened population.

Background: Sodium-glucose cotransporter-2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1RA) have shown benefits in patients with diabetes and cardiovascular disease (CVD), heart failure (HF), and chronic kidney disease (CKD)., Objective: We assessed benchmark outcomes (Hemoglobin A1c, LDL-C, and blood pressure), identified the prevalence of cardiorenal indications for SGLT2i and GLP-1RA, and compared prescribing rates of GLP1-RA and SGLT2i in those with and without cardiorenal indications., Methods: We analyzed data from January 2018-June 2019 for 7168 patients with diabetes using electronic medical records from the Northern Alberta Primary Care Research Network, a regional network of the Canadian Primary Sentinel Surveillance Network (CPCSSN). Patients with and without cardiorenal comorbidities were compared using descriptive statistics and two proportion Z tests., Results: Hemoglobin A1c ≤ 7.0% was met by 56.8%, blood pressure < 130/80 mmHg by 62.1%, LDL-C ≤ 2.0 mmol/L by 45.3% of patients. There were 4377 patients on glucose lowering medications; metformin was most common (77.7%), followed by insulin (24.6%), insulin secretagogues (23.6%), SGLT2i (19.7%), dipeptidyl peptidase-4 inhibitor (19.3%), and GLP-1RA (9.4%). A quarter of patients had cardiorenal indications for SGLT2i or GLP-1RA. Use of SGLT2i in these patients was lower than in patients without cardiorenal comorbidities (14.9% vs 21.2%, p < 0.05). GLP-1RA use in these patients was 4.6% compared with 11% in those without cardiorenal comorbidities (p < 0.05)., Discussion: Contrary to current evidence and recommendations, SGLT2i and GLP1-RA were less likely to be prescribed to patients with pre-existing CVD, HF, and/or CKD, revealing opportunities to improve prescribing for patients with diabetes at high-risk for worsening cardiorenal complications., (© 2022. The Author(s).)

Climate change and human activities have a strong impact on lakes and their catchments, so to understand ongoing processes it is fundamental to monitor environmental variables with a spatially well-distributed and high frequency network and efficiently share data. An effective sharing and interoperability of environmental information between technician and end-user fosters an in-depth knowledge of the territory and its critical environmental issues. In this paper, we present the approaches and the results obtained during the PITAGORA project (Interoperable Technological Platform for Acquisition, Management and Organization of Environmental data, related to the lake basin). PITAGORA was aimed at developing both instruments and data management, including pre-processing and quality control of raw data to ensure that data are findable, accessible, interoperable, and reusable (FAIR principles). The main results show that the developed instrumentation is low-cost, easily implementable and reliable, and can be applied to the measurement of diverse environmental parameters such as meteorological, hydrological, physico-chemical, and geological. The flexibility of the solutions proposed make our system adaptable to different monitoring purposes, research, management, and civil protection. The real time access to environmental information can improve management of a territory and ecosystems, safety of the population, and sustainable socio-economic development.

Background: The Edmonton Obesity Staging System (EOSS) combined with body mass index (BMI) enables improved functional and prognostic assessment for patients. To facilitate application of the EOSS in practice, we aimed to create tools for capturing comorbidity assessments in electronic medical records and for automating the calculation of a patient's EOSS stage., Methods: In this feasibility study, we used cross-sectional data to create a clinical dashboard to calculate and display the relation between BMI and EOSS and the prevalence of related comorbidities. We obtained data from the Northern Alberta Primary Care Research Network and the Canadian Primary Care Sentinel Surveillance Network (CPCSSN). We included patients at least 18 years of age with BMI between 30 and 60 who visited a network clinic between July 2016 and July 2019. We calculated descriptive statistics and used stepwise ordinary least squares regression to assess the contributions of age, sex and BMI to EOSS variation., Results: We created a clinical dashboard using the CPCSSN data presentation tool. Of the total 31 496 patients included in the study, 23 460 had a BMI of at least 30; BMI was unavailable for 8036 patients. Within each EOSS disease severity stage, there were similar proportions of patients from each BMI class (e.g., patients with EOSS stage 2 included 51.8% of those with BMI class I, 55.3% of those with BMI class II and 58.8% of those with BMI class III)., Interpretation: Using data from primary care electronic medical records, it was feasible to create a clinical dashboard for obesity that highlighted the severity and stage of obesity. Making this information easily accessible for individual clinical care and practice-level quality improvement may advance obesity care., Competing Interests: Competing interests: For activities outside the scope of the current study, Karen Lee has received consulting fees from Alberta Health Services, United Network Studio, Christenson Group of Companies and International WELL Building Institute, as well as honoraria for conference presentations and panels from the Canadian Society of Hospital Pharmacists, the Canadian Cardiovascular Pharmacists Network and the Canadian Institute of Public Health Inspectors; Arya Sharma has received personal fees from Novo Nordisk and Bausch Pharmaceuticals; Denise Campbell-Scherer has received an unrestricted educational grant from Novo Nordisk and has served on an obesity-related advisory panel for Pfizer; and Roseanne Yeung has received personal fees from Merck, Diabetes Canada, Novo Nordisk and Sanofi, as well as grants from Astra Zeneca and Allergen. No other competing interests were declared., (© 2021 CMA Joule Inc. or its licensors.)