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AbstractThe co-design approach is increasingly popular in facilitating the interchange of knowledge among multiple stakeholders. However, a new challenge emerged during the post-pandemic era when working from home became normal: how to facilitate co-design workshops remotely? The gamification tools, which involve the use of game elements in non-game contexts, appear to be a promising solution for re-engaging teams in online co-design workshops. To investigate this potential, we conducted an explorative experiment in an educational co-design setting with 46 Master’s students participating. By comparing the use of an online gamification tool ‘ideaGardener’ in the gamified workshops with an ad hoc‘non-game’ tool in the comparison non-game workshops, we found that participants experiencing gamified workshops reported significantly higher levels of engagement. Moreover, we invited five experts to rate all the developed concepts from these workshops regarding the students’ performance of creativity. The results indicated that the concepts developed from the gamified workshops were acknowledged by the experts as having more novelty. This article provides practical implications that suggest the use of gamification tools in remote co-design workshops to achieve a higher level of participant engagement and more novel outcomes. It also discusses several educational implications based on the educational experimental context.

Driving profitable refinery operations often requires owner-operators to balance production flexibility and product optimization with asset availability and equipment reliability. Many refineries face periods of severe corrosion and fouling in [...]

This article marks the 40th year of including statistical information on World Christianity and mission in the InternationalBulletin ofMissionResearch. This year’s focus is on organizations that address the global fragmentation of Christianity by promoting dialogue among Christians. We identify here some of the larger umbrella organizations that seek to represent or bring together portions of four traditions (Catholics, Independents, Orthodox, Protestants), two movements within these traditions (Evangelicals, Pentecostals/Charismatics), and 47,000 denominations. These include the World Council of Churches, the World Evangelical Alliance, the Lausanne Movement, the World Pentecostal Fellowship, Empowered21, and the Global Christian Forum.

Women in the Mission of the Church: Their Opportunities and Obstacles throughout Christian History LEANNE M. DZUBINSKI AND ANNEKE H. STASSON In many places around the world, women represent more [...]

Home-care Enteral Nutrition (HEN) is used when patients are unable to feed orally, ensuring the correct and complete administration of essential substances for the health of the body. In Italy, a total of 16,400 patients with HEN have been estimated through a survey carried out in 2012 and the 2005–2012 period saw a significant rise in the number of people needing artificial nutrition. A consensus work involving some of the major Italian HEN experts and stakeholders has been carried out using the Nominal Focus Group technique and Delphi method to discuss HEN and explore the general clinical advantages of commercial preparation. The resulting document presented here focuses on bolus administration with commercial preparations and consequently on the potential advantages of a new bolus administration with a 250 ml Smartflex technology, which simplifies administration by allowing the direct connection of the bottle to the feeding tube.This work has highlighted how bolus administration with commercial preparations can represent a valid tool for the delivery of HEN, improving QoL and psychological well-being, limiting the impact of the disease on social life and eventually bringing pharmaco-economic benefits for the national health system due to waste reduction of both product and devices.

Genomics has greatly improved how patients with cancer are being treated; however, clinical-grade genomic biomarkers for chemotherapies are currently lacking. Using whole-genome analysis of 37 patients with metastatic colorectal cancer (mCRC) treated with the chemotherapy trifluridine/tipiracil (FTD/TPI), we identified KRAScodon G12 (KRASG12) mutations as a potential biomarker of resistance. Next, we collected real-world data of 960 patients with mCRC receiving FTD/TPI and validated that KRASG12mutations were significantly associated with poor survival, also in analyses restricted to the RAS/RAFmutant subgroup. We next analyzed the data of the global, double-blind, placebo-controlled, phase 3 RECOURSE trial (n= 800 patients) and found that KRASG12mutations (n= 279) were predictive biomarkers for reduced overall survival (OS) benefit of FTD/TPI versus placebo (unadjusted interaction P= 0.0031, adjusted interaction P= 0.015). For patients with KRASG12mutations in the RECOURSE trial, OS was not prolonged with FTD/TPI versus placebo (n= 279; hazard ratio (HR) = 0.97; 95% confidence interval (CI) = 0.73–1.20; P= 0.85). In contrast, patients with KRASG13mutant tumors showed significantly improved OS with FTD/TPI versus placebo (n= 60; HR = 0.29; 95% CI = 0.15–0.55; P< 0.001). In isogenic cell lines and patient-derived organoids, KRASG12mutations were associated with increased resistance to FTD-based genotoxicity. In conclusion, these data show that KRASG12mutations are biomarkers for reduced OS benefit of FTD/TPI treatment, with potential implications for approximately 28% of patients with mCRC under consideration for treatment with FTD/TPI. Furthermore, our data suggest that genomics-based precision medicine may be possible for a subset of chemotherapies.

This article marks the 39th year of including statistical information on World Christianity and mission in the International Bulletin of Mission Research. This year’s focus is on women in World Christianity, highlighting results of the Women in World Christianity Project from the Center for the Study of Global Christianity (2019–2021). Although women make up the majority in Christian congregations worldwide, massive data gaps still exist that hinder women’s full recognition in Christian organizations. World Christianity can be considered a women’s movement because women are more likely than men to self-identify as Christian, participate in Christian activities, and actively pass the faith to the next generation. However, a chronic lack of gender-conscious data collection makes it extremely difficult to provide a nuanced picture of women’s full participation in Christian communities worldwide.

Background: Since the incidence of cancer increases with age, in older cancer patients important information may be missed without a Comprehensive Geriatric Assessment (CGA). On the other side, CGA is a time-consuming and complex instrument, so that Geriatric 8 (G8) has been proposed as a more feasible screening tool to identify patients who could benefit from a CGA evaluation. G8 consists of 8 questions (patient age + 7 items derived from the Mini Nutritional Assessment questionnaire). A G8 score ≤ 14 is considered associated with frailty and risk of malnutrition. Another screening test is Bioelectrical Impedance Analysis (Bioimpedentiometry, BIA), which enables to evaluate the nutritional status through a specific parameter known as Phase angle (PhA). This study is aimed at assessing the ability of G8 alone or in combination with PhA to detect elderly cancer patients at higher risk for malnutrition who cannot undergo immediate anticancer treatments. Methods: A total of 289 cancer patients (168 men and 121 women) aged ≥ 70 years old were enrolled and performed both G8 test, body mass index (BMI) and BIA assessments. A concurrent G8 score ≤ 14 and PhA &lt; 5 defined subjects most exposed to the risk of malnutrition. Results: An association between BMI and G8 (p &lt; 0.001, OR 1.54) and a clinically significant relationship between G8 and PhA (p = 0.013) were observed. Conclusion: G8 can be used to identify patients at risk for malnutrition who would benefit from comprehensive CGA. The concurrent use of G8 and BIA presents a higher power in discriminating subjects at higher risk of malnutrition than a single test. This study suggests the need for routine assessment of nutritional status in cancer patients using combinations of methods, in order to implement strategies for individually-tailored care before starting any treatment.

In this paper we study the structural robustness of the Italian business system, using the Covid-19 pandemic as an exogenous event to test it. To this aim, we use the ROC (Receiver Operating Characteristics) methodology, quite new for economics, to classify Italian firms according to their economic solidity, obtaining a taxonomy based on a wide set of characteristics. Our results show that the number of “Solid” firms is less than one-fifth of all Italian enterprises but they represent the lion’s share in terms of employment and value added. “Fragile” and “At Risk” firms, albeit much less relevant for the creation of value added, account for over one-third of total employment, so they may be a worrisome issue for policymakers. Solidity conditions have clearly both a size and sector-related dimension: At Risk and Fragile conditions prevail among firms of smaller economic size (a broad definition of firm size) and among those operating in Construction and Other services. Finally, we find that factors such as firms’ performance, and internal and external organization, although significant, play a less relevant role than economic size and digitalization/innovation in determining Italian firms’ resilience to exogenous shocks such as the Covid-19 one.

In this paper we study the direct and indirect contributions of firms to the co-movements between Italian business cycle and those of the 10 main trading partners. In doing so, we follow the approach developed by di Giovanni et al.(Am Econ Rev 108(1): 82–108, 2018) considering the 2005–2017 period, during which Italian economy experienced two different crises. Moreover, we propose a refinement in the estimation methodology originally used in the related literature by applying fractional response models for panel data, in order to take into account the bounded nature of data. Our findings show that firms’ trade linkages largely prevail over productive ones to explain the correlation between Italian firms’ value added and trading partners GDP growth. Furthermore, in presence of a small group of internationalized firms and a large group of small and not internationalized firms, the Italian business cycle correlation is mainly explained by the former group, because of both their direct links and indirect activation effects on the rest of the system. Our empirical approach also shows that using a linear FE estimator would result in a biased estimation of both indirect and direct effects.

Objective: To describe the approach and outcomes from two cancer centres in Southern and Northern Europe during the first wave of coronavirus disease 2019 (COVID-19) of patients with head and neck cancer (HNC).Methods: Data collection was performed on a retrospective cohort of patients surgically treated for primary HNC between March and May 2020, using data from two tertiary hospitals: the European Institute of Oncology (Milan) and Guy’s & St Thomas’ NHS Foundation Trust (London).Results: We included 77 patients with HNC. More patients with COVID-19 were taking angiotensin-converting enzyme (ACE) inhibitors and had Clavien-Dindo Classification grade I compared to negative patients, respectively (60% vs 22% [p= 0.058] and 40% vs 8% [p= 0.025]). Multivariate logistic regression analyses confirmed our data (p= 0.05 and 0.03, respectively). Sex and age were statistically significantly different (p= 0.05 and <0.001 respectively), showing more male patients (75% vs 53.66%, respectively) and more elderly patients in Italy than in the United Kingdom (patients aged >63 years: 69.44% vs 29.27%).Conclusions: This study presents a large cohort of patients with HNC with nasopharyngeal swab during the first peak of the COVID-19 pandemic in Europe. Patients with HNC with COVID-19 appeared more likely to develop postsurgical complications and to be taking ACE inhibitors. The preventive measures adopted guaranteed the continuation of therapeutic surgical intervention.

A powerful and robust control system is a crucial, often neglected, pillar of any modern, complex physics experiment that requires the management of a multitude of different devices and their precise time synchronisation. The AEḡIS collaboration presents CIRCUS, a novel, autonomous control system optimised for time-critical experiments such as those at CERN’s Antiproton Decelerator and, more broadly, in atomic and quantum physics research. Its setup is based on Sinara/ARTIQ and TALOS, integrating the ALPACA analysis pipeline, the last two developed entirely in AEḡIS. It is suitable for strict synchronicity requirements and repeatable, automated operation of experiments, culminating in autonomous parameter optimisation via feedback from real-time data analysis. CIRCUS has been successfully deployed and tested in AEḡIS; being experiment-agnostic and released open-source, other experiments can leverage its capabilities.

Size regulation in living organisms is a major unsolved problem in developmental biology. This is due to the intrinsic complexity of biological growth, which simultaneously involves genetic, biochemical, and mechanical factors. In this article, we propose a novel theoretical framework that explores the role of incompatibility, the geometric source of residual stress in a growing body, as a possible regulator of size termination during development. We explore this paradigm both at the level of a model 2D cell, and at the level of continuous tissues. After establishing a parallel between incompatibility and the shape parameter of vertex models, we show that incompatibility-driven growth leads to size control in a model 2D cell. We then extend the same paradigm to the level of continuous bodies, where incompatibility is measured by the Ricci curvature of the growth tensor. By using the model 2D cell as a template, we now derive an evolutionary law for the growth tensor with curvature fixed at a physiological value. When the analysis is specialised to radial symmetry (discs and spheres), this model captures the salient features observed in Drosophila wing discs and multicellular spheroids: these systems have a target size and build up residual stresses that cause the tissue to open in response to a radial cut, with the cut edges curling outward. The theory proposed in this work suggests that incompatibility in a growing biological tissue is potentially controllable at the cell level, and that incompatibility-driven growth provides an effective method of controlling global information (stress, size) through local geometric controls. [ABSTRACT FROM AUTHOR]

Forty years ago, David B. Barrett, then based in Nairobi, Kenya, put the finishing touches on the first edition of the World Christian Encyclopedia. A second edition was produced in 2001, and now a third edition is in circulation, prepared between 2015 and 2019. This special issue of the IBMR reflects a core part of the methodology of the World Christian Encyclopedia, namely, interaction with World Christianity from different disciplinary perspectives and geographic locations. This introduction to the issue features reflection on articles on global Catholicism, missions, women and gender studies, religious freedom, Christianity in the Middle East, and refugees.

This article marks the thirty-eighth year of including statistical information on World Christianity and mission in the International Bulletin of Mission Research. This year it includes details on the growth of world religions, increasing religious diversity, and personal contact between Christians and people of other religions. The world is becoming more religious, and the world’s countries have become more religiously diverse, yet Christians have inadequate personal contact with members of other religions. Solidarity, including friendship, love, and hospitality, is posited as the way forward in addressing these trends.

Background: Health outcomes of older subjects with hip fracture (HF) may be negatively influenced by multiple comorbidities and frailty. An integrated multidisciplinary approach (i.e. the orthogeriatric model) is, therefore, highly recommended, but its implementation in clinical practice suffers from the lack of shared management protocols and poor awareness of the problem. The present consensus document has been implemented to address these issues. Aim: To develop evidence-based recommendations for the orthogeriatric co-management of older subjects with HF. Methods: A 20-member Expert Task Force of geriatricians, orthopaedics, anaesthesiologists, physiatrists, physiotherapists and general practitioners was established to develop evidence-based recommendations for the pre-, peri-, intra- and postoperative care of older in-patients (≥ 65 years) with HF. A modified Delphi approach was used to achieve consensus, and the U.S. Preventive Services Task Force system was used to rate the strength of recommendations and the quality of evidence. Results: A total of 120 recommendations were proposed, covering 32 clinical topics and concerning preoperative evaluation (11 topics), perioperative (8 topics) and intraoperative (3 topics) management, and postoperative care (10 topics). Conclusion: These recommendations should ease and promote the multidisciplinary management of older subjects with HF by integrating the expertise of different specialists. By providing a convenient list of topics of interest, they might assist in identifying unmet needs and research priorities.

* Objective: To determine the clinical significance of cytomegalovirus (CMV) blood and urine cultures in patients with human immunodeficiency virus (HIV) infection. * Design: Inception cohort of patients with HIV infection and CMV culture data. * Setting: Government referral-based research hospital. * Patients: A total of 322 HIV-infected patients who had a CMV blood culture and 293 HIV-infected patients who had a CMV urine culture within 7 days of a CD4 determination. * Measurements: Cytomegalovirus blood and urine culture results; circulating CD4 lymphocyte counts; pathologic or retinopathic findings of CMV disease. * Results: Nine of 26 patients (34.6%) with CMV viremia subsequently developed CMV end-organ disease compared with 11 of 74 (14.9%) patients without viremia, (difference, 19.7%; 95% CI, -0.3% to 39.7%). Fifteen of 47 patients (31.9%) with CMV viruria developed end-organ disease compared with 4 of 43 (9.3%) patients without viruria, (difference, 22.6%; CI, 6.7% to 38.5%). Cytomegalovirus culture positivity had poor predictive value for the subsequent development of end-organ disease (35% for viremia and 28% for viruria). Further, patients with proven end-organ disease were often not viremic (45%), but most were viruric (88%). Cytomegalovirus viremia did not correlate with the presence of either fever or weight loss in this patient group. Both blood culture positivity and urine culture positivity varied inversely with the CD4 count (P = 0.0001 for both associations). * Conclusions: The likelihood that a blood or urine culture will be positive in a patient with HIV infection correlates better with immunologic status than with current or future clinical status. Although the absence of CMV viruria may suggest that CMV disease is not present, CMV blood and urine cultures have poor diagnostic and predictive value and therefore should be used primarily for research purposes or drug susceptibility testing and not for making clinical decisions., HIV-infected individuals who have a positive blood or urine culture for cytomegalovirus (CMV) may not be more likely to develop CMV end-organ disease than those who do not. End-organ diseases often caused by CMV in HIV-positive individuals include retinitis, enteritis and pneumonitis. Among 615 HIV-infected patients, 322 underwent a blood culture for CMV and 293 underwent a urine culture for CMV. Thirty-five percent of the patients with a positive blood culture for CMV subsequently developed CMV end-stage disease. Thirty-two percent of the patients with a positive urine culture developed CMV end-organ disease. Of the 29 patients who underwent a blood or urine test within seven days of developing CMV end-organ disease, 55% had a positive blood culture for CMV and 88% had a positive urine culture for CMV. A positive blood culture for CMV was not associated with a fever or weight loss among these patients.

Drugs used to treat bacterial infection of the blood and certain types of blood and solid tissue cancers are now being considered for treatment of infection with human immunodeficiency virus type I (HIV-I), which causes AIDS. The combined use of agents with different mechanisms of action, side effects, or patterns of resistance may be effective in eliminating HIV-I infection. If the antiviral actions of drugs are synergistic, or greater when combined than when used alone, it may be possible to administer lower doses of each drug. In addition, optimal doses of drugs with similar mechanisms of actions, but different toxic effects can be used in combined regimens. Viral resistance to a drug may develop less readily with combined regimens than with single drug therapy. The antiviral agent zidovudine interferes with the production of genetic material of HIV-I, whereas interferon-alpha (IFN-alpha) prevents the production of the virus. Zidovudine and IFN-alpha were reported to be synergistic, but cause neutropenia, a severe decrease in the number of neutrophils (a type of white blood cell). Recombinant human granulocyte-macrophage colony-stimulating factor (GM-CSF) is a growth factor that can be produced artificially in large amounts using recombinant technology. GM-CSF was shown to improve neutropenia in patients with cancer, AIDS, or bone marrow suppression. The side effects of GM-CSF are mild, related to dosage, and include fever and bone pain. The effectiveness of GM-CSF in treating neutropenia associated with combined zidovudine and IFN-alpha treatment was assessed in 24 HIV-I-infected patients. The blood levels of p24 antigen, a measure of HIV-I infection, decreased by more than 70 percent in five patients with this antigen. Combined treatment with zidovudine, IFN-alpha, and GM-CSF was associated with lymphokine-like side effects: loss of appetite, weight loss, fatigue, and a decrease in red blood cells. However, GM-CSF improved neutropenia without reducing the antiviral action of zidovudine and IFN-alpha. (Consumer Summary produced by Reliance Medical Information, Inc.)

During the aging process, changes occur in the levels of physical activity, the amount of energy expended, and the basal metabolic rate (BMR, the rate at which calories are burned to maintain basic physiological processes). Gains in body weight are common with increasing age, as energy intake exceeds the amount of energy expended. Previous studies have indicated that BMR decreases with increasing age, and that this decrease in BMR is related to a loss of lean body mass (including muscle) that occurs during aging. Other studies have shown that the total daily caloric intake decreases with age, but the reduction in food intake is often not great enough to prevent weight gain. To examine the relationship between the aging process and energy expenditure, the BMR, energy expenditure over a 24-hour period (24EE), and physical activity were measured in 38 elderly (over 60 years of age) and 64 young (age 18 to 30) caucasian males and females were studied. The elderly subjects had a lower average body weight, height, lean body mass, 24EE, and BMR, and a greater percentage of body fat than the young subjects. When age differences in fat and lean body mass were taken into account, only BMR was still lower in the elderly subjects. However, the lower 24EE observed in the elderly subjects was only related to smaller body size and not to a lower BMR, which suggests that lower energy intake in the elderly may be primarily due to reduced levels of physical activity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Objectives: To evaluate the possibility of predicting the risk of progression from mild cognitive impairment (MCI) to dementia using a combination of clinical/demographic parameters. Methods: A total of 462 MCI elderly patients (follow-up: 33 months). Variable measured included cognitive functions, age, gender, MCI type, education, comorbidities, clinical chemistry, and functional status. Results: Amnestic type (aMCI) represented 63% of the sample, non-amnestic (naMCI) 37%; 190 subjects progressed to dementia, 49% among aMCI, and 28% among naMCI. At Cox multivariate regression analysis, only MMSE (one point increase HR 0.84; 95% CI 0.79–0.90), aMCI (HR 2.35; 95% CI 1.39–3.98), and age (1 year increase HR 1.05; 95% CI 1.01–1.10) were independently associated with progression to dementia. A score was created based on these dichotomized variables (score 0–3): age (≥ or &lt; 78 years), MMSE score (≥ or &lt; 25/30) and aMCI type. The conversion rate progressed from 6% in subjects with score 0 (negative predictive value: 0.94), to 31% in individuals with score 1, to 53% in subjects with score 2, to 72% in individuals with score 3 (positive predictive value: 0.72). ROC curve analysis showed an area under the curve of 0.72 (95% CI 0.66–0.75, p0.0001). Conclusions: We have described a simple score, based on previously recognized predictors such as age, MMSE, and MCI type, which may be useful for an initial stratification of the risk of progression to dementia in patients affected by MCI. The score might help the clinicians to evaluate the need for more expansive/invasive examinations and for a closer follow-up in MCI patients.

Pneumonia due to COVID-19 can lead to respiratory failure and death due to the development of the acute respiratory distress syndrome. Tocilizumab, a monoclonal antibody targeting the interleukin-6 receptor, is being administered off-label to some patients with COVID-19, and although early small studies suggested a benefit, there are no conclusive data proving its usefulness.

This article marks the thirty-seventh year of including statistical information on World Christianity and mission in the International Bulletin of Mission Research. This year it includes details on some of the most frequently asked questions in quantifying mission and global Christianity: the number of missionaries worldwide, global access to the gospel, and the burgeoning Pentecostal/Charismatic movement. The article also provides brief methodological reflections on how the future of this kind of research might change, given the realities of COVID-19.

Background: Hip fractures (HF) are a major issue worldwide. We aimed at evaluating the practices in delivering care to patients with HF among several Italian Orthogeriatric centers. Methods: The study took place from February 2016 to July 2018. Seven performance indicators (pre-surgical cognitive assessment, surgery performed ≤ 48 h from fracture, removal of urinary catheter/absence of delirium/start of physiotherapy on the first post-operative day, prescription of bone protection at discharge, and discharge toward rehabilitation) were collected. Results: The 14 participating hospitals totally recruited 3.017 patients. Patients were old (median age 86 years; Inter Quartile Range [IQR] 80–90), mostly females (77%). Nearly 55% of them were already impaired in mobility and about 10% were nursing home residents. Median time-to-surgery was 41 h (IQR 23–62). Models of care greatly varied among centers, only 49.3% of patients being co-managed by geriatricians and orthopedics. There was high variability across centers in four indicators (“pre-surgical cognitive assessment”, “bone protection prescription”, “use of urinary catheter” and “start of physiotherapy”), moderate in two indicators (“surgery performed ≤ 48 h from fracture” and “discharge toward rehabilitation” and low in one (“absence of delirium on day following surgery”). Comparison with international studies suggests very different ways of providing care to HF Italian patients. Conclusions: The study results suggest high inter-center variability in the key-performance indicators, and different approaches in providing care to our HF patients in comparison to other countries. A National debate on the topic is required in Italy to harmonize practices of orthogeriatric care.

Background: Hip fracture (HF) is a burdening health problem in older people. The orthogeriatric approach has been shown to favour functional recovery and reduce mortality, but its implementation in clinical practice cannot rely upon shared management protocols and greatly varies among different healthcare systems. Here, we present the rationale and design of the Italian consensus document on the management of HF in older people. Methods: A panel of multidisciplinary experts from ten Italian scientific societies involved in the care of HF and including geriatricians, orthopaedics, anaesthesiologists, physiatrists and general practitioners, will join to establish the content validity of a list of statements. A Delphi consensus methodology will be applied to obtain the opinions of the panel and to provide the final recommendations. Objectives: The document will include indications on the following relevant topics: (1) optimal care path of older subjects with HF; (2) management of comorbidities and pre-operative alteration of physiological parameters; (3) management of selected categories of patients at expected increased risk of adverse outcomes; (4) continuity of care out of hospital; (5) screening and correction of risk factors for HF in older subjects; (6) information and divulgation of shared management strategies. The objective of the consensus will be to inform clinicians, patients, researchers, and health policy makers about the best management strategies for HF in older people and their inherent limitations, thus facilitating communication between stakeholders and promoting the most cost/effective models of care.

This article marks the thirty-sixth year of including statistical information on World Christianity and mission in the International Bulletin of Mission Research. We report on some of the major findings of the new World Christian Encyclopedia, 3rd edition (Edinburgh University Press, 2019), including the fall and rise of the world’s Christian population, the continued shift of Christianity to the Global South, the decline of religious liberty, and complicating trends in mission.

Purpose: The effect of combined lifestyle interventions (LSI) including dietary and physical activity on metabolic health, energy metabolism and VO2max in diabetic patients has provided mixed results. We evaluated the impact of 1-year caloric restriction (CR), and 12-week supervised structured exercise training (SSET) on metabolic health, RMR and VO2max in obese adults with type 2 diabetes. Methods: After 1-month education for LSI, 33 participants had anthropometric, biochemical and metabolic assessments. They then started CR based on RMR, and 3-month SSET during the months 1–3 (Early-SSET) or 4–6 (Late-SSET). Reassessments were planned after 3, 6 and 12 months. Using a per-protocol analysis, we evaluated parameter changes from baseline and their associations for the 23 participants (11 Early-SSET, 12 Late-SSET) who completed the study. RMR was adjusted (adjRMR) for age, sex, fat-free mass (FFM) and fat mass (FM). Results: Compared with baseline, after 6 months we found significant increases in VO2max (+?14%) and HDL-cholesterol (+?13%), and reduction in body mass index (-?3%), FM (-?8%) and glycated hemoglobin (HbA1c, -?7%). Training-related caloric expenditure negatively correlated with changes in body weight (p?&lt;?0.001), FM (p?&lt;?0.001) and HbA1c (p?=?0.006). These results were confirmed at the 12-month follow-up. Pooling together all follow-up data, adjRMR changes correlated with changes in glycemia (r?=?0.29, p?=?0.02), total-cholesterol (r?=?0.29, p?=?0.02) and VO2max (r?=?-?0.26,p?=?0.02). No significant differences emerged between the Early- and Late-SSET groups. Conclusions: Combined intervention with SSET and CR improved metabolic control. Changes in metabolic health and fitness correlated with changes of adjRMR, which was reduced improving fitness, glycemia and cholesterolemia. Clinical trial registry: Trial registration number: NCT03785379. URL of registration: http://clinicaltrials.gov.

Byline: Zurlo, J. The alkanolamine system in a refinery, better known as the amine unit, is used to remove hydrogen sulfide (H2S), carbon dioxide (CO2) and mercaptans (collectively referred to [...]

Protein-based biopharmaceutical drugs, such as monoclonal antibodies, account for the majority of the best-selling drugs globally in recent years. For bioprocesses, key performance indicators are the concentration and aggregate level for the product being produced. In water NMR (wNMR), the use of the water transverse relaxation rate [R2(1H2O)] has been previously used to determine protein concentration and aggregate level; however, it cannot be used to separate between them without using an additional technique. This work shows that it is possible to “decouple” these two key characteristics by recording the water diffusion coefficient [D(1H2O)] in conjunction with R2(1H2O), even in the event of overlap in either D(1H2O) or R2(1H2O). This method is demonstrated on three different systems, following appropriate D(1H2O) or R2(1H2O) calibration data acquisition for a protein of interest. Our method highlights the potential use of benchtop NMR as an at-line process analytical technique.

New indigenous movements to Christ are taking place in many parts of the world today, especially in Asia and Africa, generally described as church-planting movements or disciple-making movements. There is significant diversity among these movements in terms of their origins, worship, practices, and languages. Movement leaders have come to different conclusions about the most appropriate ministry roles for women. Although it is impossible to know what share of movements are led by women, a significant number have women leaders as part of the movement’s natural growth and immediate needs. This article offers a descriptive analysis of women’s roles in emerging movements by considering examples from history and the present. How might women’s leadership within emerging movements today be challenged as these movements grow and potentially institutionalize? This article aims to provide historical context to that question to help Christians think clearly about the future as it relates to women’s leadership roles in new indigenous movements.

The article offers travel tips for Milan, Italy and includes recommendations for hotels in the area, such as the Senato boutique hotel, shopping destinations, such as Fornasetti and Nonostante Marras, and dining, such as Berton restaurant and Backdoor 43 bar.

Recognition of enantiomers is one of the most arduous challenges in chemical sensor development. Although several chiral systems exist, their effective exploitation as the sensitive layer in chemical sensors is hampered by several practical implications that hinder stereoselective recognition in solid state. In this paper, we report a new methodology to efficiently prepare chiral solid films, by using a hybrid material approach where chiral porphyrin derivatives are grafted onto zinc oxide nanoparticles. Circular dichroism (CD) evidences that the solid-state film of the material retains supramolecular chirality due to porphyrin interactions, besides an additional CD feature in correspondence of the absorbance of ZnO (375 nm), suggesting the induction of chirality in the underlying zinc oxide nanoparticles. The capability of hybrid material to detect and recognize vapors of enantiomer pairs was evaluated by fabricating gas sensors based on quartz microbalances. Chiral films of porphyrin on its own were used for comparison. The sensor based on functionalized nanostructures presented a remarkable stereoselectivity in the recognition of limonene enantiomers, whose ability to intercalate in the porphyrin layers makes this terpene an optimal chiral probe. The chiroptical and stereoselective properties of the hybrid material confirm that the use of porphyrin-capped ZnO nanostructures is a viable route for the formation of chiral selective surfaces.

Cardiac troponin I (cTnI) has been poorly studied in elderly inpatients. This study wanted to assess factors influencing the increase in cTnI and its prognostic value in hospitalized elderly patients. 354 elderly (mean age of 84.8 ± 6.9 years) patients consecutively admitted in the Geriatrics Division in Padua were tested for cTnI levels assay during the hospital stay. Number of subsequent patient deaths at 6 months and 2 years were registered. Of the 354 patients, 27 (7.6%) died in hospital; their levels were not significantly higher or more frequently positive on cTnI than those of the remainder of the sample. 71 (20.01%) patients died within 6 months of being discharged, and in-hospital positive cTnI levels emerged as a mortality risk factor in this group [unadjusted HR 1.13 (1.04–1.23); p= 0.004]. At 2 years, a total of 174 patients (49.2%) had died, but in-hospital pathological cTnI levels were not a mortality risk factor in this group. It should be noted that cTnI level was a risk factor for mortality at 6 months but no longer at 2 years after an elderly patient’s hospitalization. This finding may relate to patients’ limited physiological reserves or be driven by the fact that the elderly tend to receive fewer evidence-based treatments, and to be managed more conservatively than younger patients. In the multidimensional analysis of older patients, troponin I can be used to stratify patients and assess mortality risk at 6 months, but not at 2 years.

This article marks the thirty-fifth year of presenting statistical information on world Christianity and mission. This year, we report on three gaps in the literature, concerning women in world Christianity and mission, the status of short-term mission (STM), and missions and money. There are few quantitative studies on women in world Christianity; there remains a dearth in the literature on the magnitude and impact of STM (which is particularly US-centric); and Christian finance, now $60 trillion in personal income, is vastly under-researched in global studies.

Materials with negative Poisson’s ratio, also known as auxetic materials, display exotic properties such as expansion in all directions under uni-axial tension. For their unique properties, these materials find a broad range of applications in robotic, structural, aerospace, and biomedical engineering.

Sandwiched in between top pick Telebras and third-place Telefonica de Argentina, Zurlo says she likes Chile's CTC despite the fact that the stock was down 40% since June, representing the [...]

Planar solid oxide fuel cells (SOFC) with CuO/gadolinium‐doped ceria (GDC) supporting anode were produced and tested in H2and in CH4/CO2mixture at 650 °C. The electrolyte densification at 900 °C was promoted by compressive strains induced by larger anodic thickness. The reduction behaviour of CuO/GDC anodic powders was preliminarily evaluated. The electrochemical measurements showed an increasing power density with the anode thickness (from ≈500 μm to ≈1.4 mm) reaching a maximum value of 227 mW cm−2at 650 °C in pure H2. Power density of 29 mW cm−2was measured in wet CH4/CO2biogas mixture at 650 °C. Catalytic activity measurements towards methane dry reforming showed limited conversion at all investigated temperatures, this suggesting that the actual anodic reaction is the methane combustion. Scanning electron microscope observations and energy dispersive X‐ray analyses of the cell tested in CH4/CO2mixture did not show any carbon deposit, thus pointing out that the Cu/GDC cermet can be considered a stable and reliable anodic substrate for IT‐SOFC fed by CH4/CO2mixture. Cosintering: Planar CuO/GDC based IT‐SOFCs are produced with different anodic thickness and a full dense electrolyte can be achieved at 900 °C. This is due to the compressive stresses induced by an optimised anodic thickness on the electrolyte layer upon sintering. Optimised cell produces power outputs in H2or in CH4/CO2anodic fuels.