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BackgroundMultiple chronic conditions (MCCs) are common among older adults and expensive to manage. Two-thirds of Medicare beneficiaries have multiple conditions (eg, diabetes and osteoarthritis) and account for more than 90% of Medicare spending. Patients with MCCs also experience lower quality of life and worse medical and psychiatric outcomes than patients without MCCs. In primary care settings, where MCCs are generally treated, care often focuses on laboratory results and medication management, and not quality of life, due in part to time constraints. eHealth systems, which have been shown to improve multiple outcomes, may be able to fill the gap, supplementing primary care and improving these patients’ lives. ObjectiveThis study aims to assess the effects of ElderTree (ET), an eHealth intervention for older adults with MCCs, on quality of life and related measures. MethodsIn this unblinded study, 346 adults aged 65 years and older with at least 3 of 5 targeted high-risk chronic conditions (hypertension, hyperlipidemia, diabetes, osteoarthritis, and BMI ≥30 kg/m2) were recruited from primary care clinics and randomized in a ratio of 1:1 to one of 2 conditions: usual care (UC) plus laptop computer, internet service, and ET or a control consisting of UC plus laptop and internet but no ET. Patients with ET have access for 12 months and will be followed up for an additional 6 months, for a total of 18 months. The primary outcomes of this study are the differences between the 2 groups with regard to measures of quality of life, psychological well-being, and loneliness. The secondary outcomes are between-group differences in laboratory scores, falls, symptom distress, medication adherence, and crisis and long-term health care use. We will also examine the mediators and moderators of the effects of ET. At baseline and months 6, 12, and 18, patients complete written surveys comprising validated scales selected for good psychometric properties with similar populations; laboratory data are collected from eHealth records; health care use and chronic conditions are collected from health records and patient surveys; and ET use data are collected continuously in system logs. We will use general linear models and linear mixed models to evaluate primary and secondary outcomes over time, with treatment condition as a between-subjects factor. Separate analyses will be conducted for outcomes that are noncontinuous or not correlated with other outcomes. ResultsRecruitment was conducted from January 2018 to December 2019, and 346 participants were recruited. The intervention period will end in June 2021. ConclusionsWith self-management and motivational strategies, health tracking, educational tools, and peer community and support, ET may help improve outcomes for patients coping with ongoing, complex MCCs. In addition, it may relieve some stress on the primary care system, with potential cost implications. Trial RegistrationClinicalTrials.gov NCT03387735; https://www.clinicaltrials.gov/ct2/show/NCT03387735. International Registered Report Identifier (IRRID)DERR1-10.2196/25175

BackgroundDepressive symptoms are the most prevalent mental health concern among older adults (possibly heightened during the COVID-19 pandemic), which raises questions about how such symptoms can be lowered in this population. Existing research shows that offline social connectedness is a protective factor against depression in older adults; however, it is unknown whether web-based social connectedness can have similar effects. ObjectiveThis study investigates whether social connectedness on a support website protects older adults against depressive symptoms over the course of a year, above and beyond the protective effect of offline social connectedness. The secondary aim is to determine whether older adults with increased depressive symptoms are more likely to engage in social connectedness on this website. Thus, we examine depressive symptoms as both an outcome and predictor of web-based social connectedness to fully understand the chain of causality among these variables. Finally, we compare web-based social connectedness with offline social connectedness in their ability to lower depressive symptoms among older adults. MethodsA total of 197 adults aged 65 years or older were given access to a social support website, where they were able to communicate with each other via a discussion forum for a year. Participants’ social connectedness on the web-based platform, conceptualized as message production and consumption, was measured using behavioral log data as the number of messages participants wrote and read, respectively, during the first 6 months (t1) and the following 6 months (t2) of the study. Participants self-reported their offline social connectedness as the number of people in their support networks, and they reported their depressive symptoms using the Patient Health Questionnaire-8 both at baseline (t1) and at 12-month follow-up (t2). To ascertain the flow of causality between these variables, we employed a cross-lagged panel design, in which all variables were measured at t1 and t2. ResultsAfter controlling for the effect of offline support networks at t1, web-based message consumption at t1 decreased older adults’ depressive symptoms at t2 (β=−.11; P=.02), but web-based message production at t1 did not impact t2 depressive symptoms (β=.12; P=.34). Web-based message consumption had a larger effect (β=−.11; P=.02) than offline support networks (β=−.08; P=.03) in reducing older adults’ depressive symptoms over time. Higher baseline depressive symptoms did not predict increased web-based message consumption (β=.12; P=.36) or production (β=.02; P=.43) over time. ConclusionsThe more messages older adults read on the web-based forum for the first 6 months of the study, the less depressed they felt at the 1-year follow-up, above and beyond the availability of offline support networks at baseline. This pinpoints the substantial potential of web-based communication to combat depressive symptoms in this vulnerable population. International Registered Report Identifier (IRRID)RR2-10.1186/s13063-015-0713-2

Energetická otázka představuje dlouhodobě jedno z nejčastěji diskutovaných témat v mezinárodních vztazích (MV), přičemž stranou pozornosti nezůstala ani pro Evropskou unii (EU) a Ruskou federaci (RF). Naopak oba aktéři věnují problematice energetiky dlouhodobě zvýšenou pozornost. Pro Evropskou unii jako jednoho z největších světových spotřebitelů a dovozců je energetika, resp. zajištění energetické bezpečnosti, tématem jak vnitřní politiky (liberalizace vnitřního trhu s elektřinou a plynem, propojení energetické infrastruktury členských států), tak vnější politiky (energetické vztahy s hlavními producentskými státy). Podobně pro Ruskou federaci jako jednoho z hlavních producentů, který je silně závislý na prodeji a vývozu energetických surovin, hraje energetika důležitou roli jak ve vnitřní politice (rozhodující determinanta ekonomického růstu) tak ve vnější politice (úzké propojení energetiky s bezpečnostní politikou a důležitý nástroj zahraničně-politického vlivu ve světě).

Objective: The objective of the review is to assess the association between health literacy levels and self-management behaviors in people with coronary heart disease., Introduction: Initiating and maintaining self-management behaviors following a coronary event can be challenging. The capacity to initiate behavioral changes requires adequate health literacy, which is the ability to understand and use health care information to make appropriate health decisions., Inclusion Criteria: This review will consider studies including individuals at any age who have been diagnosed with coronary heart disease. Studies that used a standardized measure of health literacy with the primary outcome of self-management behaviors or an element of self-management (eg, medication adherence) will be considered for inclusion., Methods: The review will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases to be searched include CINAHL, Embase, PubMed, APA PsycINFO, Cochrane, Scopus, ScienceDirect, ProQuest Dissertations and Theses, Google Scholar, and OpenGrey. This will be followed by a forward and backward search of relevant articles. Cross-sectional, case-control, cohort, and mixed methods studies (quantitative component only) will be included. Studies will be screened by 2 independent reviewers and undergo a critical appraisal process. Included studies will be assessed for methodological quality, and data will be extracted using a JBI data extraction tool in the JBI System for the Unified Management, Assessment and Review of Information. The results will be presented as a narrative synthesis and, where possible, a meta-analysis will be conducted. The Grading of Recommendations, Assessment, Development, and Evaluation approach will be used to assess the certainty of evidence., Systematic Review Registration Number: PROSPERO CRD42021257407., Competing Interests: The authors declare no conflict of interest., (Copyright © 2022 JBI.)

Aim: Comprehensive, global information on species' occurrences is an essential biodiversity variable and central to a range of applications in ecology, evolution, biogeography and conservation. Expert range maps often represent a species' only available distributional information and play an increasing role in conservation assessments and macroecology. We provide global range maps for the native ranges of all extant mammal species harmonised to the taxonomy of the Mammal Diversity Database (MDD) mobilised from two sources, the Handbook of the Mammals of the World (HMW) and the Illustrated Checklist of the Mammals of the World (CMW)., Location: Global., Taxon: All extant mammal species., Methods: Range maps were digitally interpreted, georeferenced, error-checked and subsequently taxonomically aligned between the HMW (6253 species), the CMW (6431 species) and the MDD taxonomies (6362 species)., Results: Range maps can be evaluated and visualised in an online map browser at Map of Life (mol.org) and accessed for individual or batch download for non-commercial use., Main Conclusion: Expert maps of species' global distributions are limited in their spatial detail and temporal specificity, but form a useful basis for broad-scale characterizations and model-based integration with other data. We provide georeferenced range maps for the native ranges of all extant mammal species as shapefiles, with species-level metadata and source information packaged together in geodatabase format. Across the three taxonomic sources our maps entail, there are 1784 taxonomic name differences compared to the maps currently available on the IUCN Red List website. The expert maps provided here are harmonised to the MDD taxonomic authority and linked to a community of online tools that will enable transparent future updates and version control., Competing Interests: CONFLICT OF INTEREST The authors declare no competing interests.

Review Objective: The objective of this review was to investigate the effectiveness of nurse-led cardiac rehabilitation programs following coronary artery bypass graft surgery on patients' health-related quality of life and hospital readmission., Introduction: Coronary heart disease is a major cause of death and disability worldwide, putting a great strain on healthcare resources. For the past two decades, population-wide primary prevention and individual healthcare approaches have resulted in a dramatic decline in overall cardiac mortality. Over the intervening years, surgical techniques in cardiology have also improved substantially. As a result, long-term outcomes in patients treated with coronary artery bypass graft surgery have established the treatment's effectiveness and survival benefit. Furthermore, participating in cardiac rehabilitation following coronary artery bypass graft surgery has also demonstrated a significant decrease in all-cause cardiac mortality in these patients., Inclusion Criteria: This review included studies with participants aged 18 years and over, post coronary artery bypass graft surgery that evaluated nurse-led cardiac rehabilitation (CR) programs compared with usual care or other forms of CR. The outcomes of interest were the health-related quality of life and hospital readmissions following coronary artery bypass graft surgery and measured using validated scales. Randomized controlled trials reported in English between 2000 to June 2017 were considered for inclusion., Methods: The search strategy aimed to find both published and unpublished studies using a three-step search strategy. An initial search of MEDLINE, CINAHL and Scopus was undertaken, followed by a search for unpublished studies including Dissertation Abstracts International, ProQuest Dissertations and Theses, Google Scholar, MedNar and ClinicalTrials.gov. Papers selected for retrieval were assessed by two independent reviewers for methodological validity prior to inclusion in the review using the standardized critical appraisal tools from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI SUMARI). Quantitative data was extracted from papers included in the review using the standardized data extraction tool from JBI-SUMARI. No meta-analysis was undertaken due to heterogeneity of the outcome measures. All results were subject to double data entry. Effect sizes expressed as risk ratio (for categorical data) and weighted mean differences (for continuous data) and their 95% confidence intervals were calculated for analysis., Results: Three trials involving 329 patients were included in the final review. The trials that investigated the effect of home based cardiac rehabilitation programs compared to usual care at six weeks, three months and six months follow-up demonstrated no statistically significant difference in health-related quality of life at any of the follow-up periods. However, one study demonstrated significantly higher scores related to health-related quality of life among those who received nurse-led home based cardiac rehabilitation (154.93 ± 4.6) compared to those who received usual care (134.20 ± 8.2) at two months follow-up. No trials were identified that compared the effectiveness of nurse-led cardiac rehabilitation programs following coronary artery bypass graft surgery on readmissions to hospital., Conclusion: There is not enough evidence to support or discourage nurse-led cardiac rehabilitation programs on health-related quality of life in patients following coronary artery bypass graft surgery. However, the sparse data available suggests improvements in health-related quality of life at two months follow-up among those who received a nurse-led program. Further large-scale multicenter trials with standardized methodology are needed to determine the effect of nurse-led cardiac rehabilitation programs on health-related quality of life and rates of readmission to hospital following coronary artery bypass graft surgery.

Previous studies on genetics of hoary bats produced differing conclusions on the timing of their colonization of the Hawaiian Islands and whether or not North American (Aeorestes cinereus) and Hawaiian (A. semotus) hoary bats are distinct species. One study, using mtDNA COI and nuclear Rag2 and CMA1, concluded that hoary bats colonized the Hawaiian Islands no more than 10,000 years ago based on indications of population expansion at that time using Extended Bayesian Skyline Plots. The other study, using 3 mtDNA and 1 Y-chromosome locus, concluded that the Hawaiian Islands were colonized about 1 million years ago. To address the marked inconsistencies between those studies, we examined DNA sequences from 4 mitochondrial and 2 nuclear loci in lasiurine bats to investigate the timing of colonization of the Hawaiian Islands by hoary bats, test the hypothesis that Hawaiian and North American hoary bats belong to different species, and further investigate the generic level taxonomy within the tribe. Phylogenetic analysis and dating of the nodes of mtDNA haplotypes and of nuclear CMA1 alleles show that A. semotus invaded the Hawaiian Islands approximately 1.35 Ma and that multiple arrivals of A. cinereus occurred much more recently. Extended Bayesian Skyline plots show population expansion at about 20,000 years ago in the Hawaiian Islands, which we conclude does not represent the timing of colonization of the Hawaiian Islands given the high degree of genetic differentiation among A. cinereus and A. semotus (4.2% divergence at mtDNA Cytb) and the high degree of genetic diversity within A. semotus. Rather, population expansion 20,000 years ago could have resulted from colonization of additional islands, expansion after a bottleneck, or other factors. New genetic data also support the recognition of A. semotus and A. cinereus as distinct species, a finding consistent with previous morphological and behavioral studies. The phylogenetic analysis of CMA1 alleles shows the presence of 2 clades that are primarily associated with A. semotus mtDNA haplotypes, and are unique to the Hawaiian Islands. There is evidence for low levels of hybridization between A. semotus and A. cinereus on the Hawaiian Islands, but it is not extensive (<15% of individuals are of hybrid origin), and clearly each species is able to maintain its own genetic distinctiveness. Both mtDNA and nuclear DNA sequences show deep divergence between the 3 groups (genera) of lasiurine bats that correspond to the previously recognized morphological differences between them. We show that the Tribe Lasiurini contains the genera Aeorestes (hoary bats), Lasiurus (red bats), and Dasypterus (yellow bats).

Motivation: High-throughput molecular profiling has greatly improved patient stratification and mechanistic understanding of diseases. With the increasing amount of data used in translational medicine studies in recent years, there is a need to improve the performance of data warehouses in terms of data retrieval and statistical processing. Both relational and Key Value models have been used for managing molecular profiling data. Key Value models such as SeqWare have been shown to be particularly advantageous in terms of query processing speed for large datasets. However, more improvement can be achieved, particularly through better indexing techniques of the Key Value models, taking advantage of the types of queries which are specific for the high-throughput molecular profiling data., Results: In this article, we introduce a Collaborative Genomic Data Model (CGDM), aimed at significantly increasing the query processing speed for the main classes of queries on genomic databases. CGDM creates three Collaborative Global Clustering Index Tables (CGCITs) to solve the velocity and variety issues at the cost of limited extra volume. Several benchmarking experiments were carried out, comparing CGDM implemented on HBase to the traditional SQL data model (TDM) implemented on both HBase and MySQL Cluster, using large publicly available molecular profiling datasets taken from NCBI and HapMap. In the microarray case, CGDM on HBase performed up to 246 times faster than TDM on HBase and 7 times faster than TDM on MySQL Cluster. In single nucleotide polymorphism case, CGDM on HBase outperformed TDM on HBase by up to 351 times and TDM on MySQL Cluster by up to 9 times., Availability and Implementation: The CGDM source code is available at https://github.com/evanswang/CGDM., Contact: y.guo@imperial.ac.uk., (© The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)