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Abstract The development of the online meal-delivery industry is a double-edged sword, with potential to both hamper and drive progress towards achievement of the Sustainable Development Goals (SDGs). Yet most studies examining this industry have been conducted from the narrow perspective of specific academic fields, focusing on single issues or on individual cases. In this paper, by drawing upon the thematic foci of the SDGs as an analytical framework, we conducted a systematic and objective review to assess consequences of the online meal-delivery’s development for sustainable development. After selecting and reviewing 128 peer-reviewed articles identified on Web of Science, we systematically coded their contents, and examined key trends along with knowledge gaps. The review shows that direct consequences for the SDGs—for instance, human health, plastic waste, carbon emissions, and labor conditions—have been thoroughly discussed. Conversely, we found a lack of attention to other indirect but important consequences, including impacts on poverty, hunger, education, and gender equality, which are yet to be thoroughly investigated. Particularly, our findings point to a need for more knowledge on how the industry is impacting food access in light of the “digital divide” between IT-literate consumers and those possessing less familiarity with digital technologies, how employment opportunities contribute to poverty alleviation or exacerbation of class gaps, and how the meal-delivery industry can contribute to achieving zero hunger by increasing food access to vulnerable populations. Our findings generate important insights to guide the formulation of more targeted countermeasures to address issues that risk hindering achievement of sustainable development.

Abstract Most companies include carbon offsets in their net-zero strategy. However, many offset projects are poor quality and fail to reduce emissions as claimed. Here we focus on the twenty companies retiring the most offsets from the voluntary carbon market over 2020–2023. We examine if their offsets could be considered high quality and likely to benefit the climate. We curate an original company-level dataset to examine quality and climate benefits across four dimensions: (1) use of offsets from low/high-risk project types; (2) age of projects and credits; (3) price of credits; and (4) country of implementation. We find that companies have predominantly sourced low-quality, cheap offsets: 87% carry a high risk of not providing real and additional emissions reductions, with most offsets originating from forest conservation and renewable energy projects. Further, most offsets do not meet industry standards regarding age and country of implementation. These findings provide further evidence that the voluntary carbon market is not supporting effective climate mitigation. Particularly, we show that its persisting quality issues are exacerbated by the demand for low-quality offsets by individual companies.

Abstract Purpose Lung cancer is the leading cause of cancer deaths in Canada, and because early cancers are often asymptomatic screening aims to prevent mortality by detecting cancer earlier when treatment is more likely to be curative. These reviews will inform updated recommendations by the Canadian Task Force on Preventive Health Care on screening for lung cancer. Methods We will update the review on the benefits and harms of screening with CT conducted for the task force in 2015 and perform de novo reviews on the comparative effects between (i) trial-based selection criteria and use of risk prediction models and (ii) trial-based nodule classification and different nodule classification systems and on patients’ values and preferences. We will search Medline, Embase, and Cochrane Central (for questions on benefits and harms from 2015; comparative effects from 2012) and Medline, Scopus, and EconLit (for values and preferences from 2012) via peer-reviewed search strategies, clinical trial registries, and the reference lists of included studies and reviews. Two reviewers will screen all citations (including those in the previous review) and base inclusion decisions on consensus or arbitration by another reviewer. For benefits (i.e., all-cause and cancer-specific mortality and health-related quality of life) and harms (i.e., overdiagnosis, false positives, incidental findings, psychosocial harms from screening, and major complications and mortality from invasive procedures as a result of screening), we will include studies of adults in whom lung cancer is not suspected. We will include randomized controlled trials comparing CT screening with no screening or alternative screening modalities (e.g., chest radiography) or strategies (e.g., CT using different screening intervals, classification systems, and/or patient selection via risk models or biomarkers); non-randomized studies, including modeling studies, will be included for the comparative effects between trial-based and other selection criteria or nodule classification methods. For harms (except overdiagnosis) we will also include non-randomized and uncontrolled studies. For values and preferences, the study design may be any quantitative design that either directly or indirectly measures outcome preferences on outcomes pertaining to lung cancer screening. We will only include studies conducted in Very High Human Development Countries and having full texts in English or French. Data will be extracted by one reviewer with verification by another, with the exception of result data on mortality and cancer incidence (for calculating overdiagnosis) where duplicate extraction will occur. If two or more studies report on the same comparison and it is deemed suitable, we will pool continuous data using a mean difference or standardized mean difference, as applicable, and binary data using relative risks and a DerSimonian and Laird model unless events are rare (

Abstract Purpose To inform updated recommendations by the Canadian Task Force on Preventive Health Care on screening in a primary care setting for hypertension in adults aged 18 years and older. This protocol outlines the scope and methods for a series of systematic reviews and one overview of reviews. Methods To evaluate the benefits and harms of screening for hypertension, the Task Force will rely on the relevant key questions from the 2021 United States Preventive Services Task Force systematic review. In addition, a series of reviews will be conducted to identify, appraise, and synthesize the evidence on (1) the association of blood pressure measurement methods and future cardiovascular (CVD)-related outcomes, (2) thresholds for discussions of treatment initiation, and (3) patient acceptability of hypertension screening methods. For the review of blood pressure measurement methods and future CVD-related outcomes, we will perform a de novo review and search MEDLINE, Embase, CENTRAL, and APA PsycInfo for randomized controlled trials, prospective or retrospective cohort studies, nested case–control studies, and within-arm analyses of intervention studies. For the thresholds for discussions of treatment initiation review, we will perform an overview of reviews and update results from a relevant 2019 UK NICE review. We will search MEDLINE, Embase, APA PsycInfo, and Epistemonikos for systematic reviews. For the acceptability review, we will perform a de novo systematic review and search MEDLINE, Embase, and APA PsycInfo for randomized controlled trials, controlled clinical trials, and observational studies with comparison groups. Websites of relevant organizations, gray literature sources, and the reference lists of included studies and reviews will be hand-searched. Title and abstract screening will be completed by two independent reviewers. Full-text screening, data extraction, risk-of-bias assessment, and GRADE (Grading of Recommendations Assessment, Development and Evaluation) will be completed independently by two reviewers. Results from included studies will be synthesized narratively and pooled via meta-analysis when appropriate. The GRADE approach will be used to assess the certainty of evidence for outcomes. Discussion The results of the evidence reviews will be used to inform Canadian recommendations on screening for hypertension in adults aged 18 years and older. Systematic review registration This protocol is registered on PROSPERO and is available on the Open Science Framework (osf.io/8w4tz).

Objectives Aim of this study was to assess and compare health, quality of life, well-being, job satisfaction and job insecurity between nurses, in a tertiary hospital in Greece, working either under permanent or temporary contract. Material and Methods In this cross-sectional study, consecutively recruited nurses answered a structured questionnaire, the WHO-5 Well-being Index (WHO-5), the Job Insecurity Index (JII), the Work Ability Index (WAI), and the Well-Being at Work Scale (WBWS). Results Included were 323 nurses (87.6% women, age M±SD 43.68±8.10 years). Tem- porary contract employees had worse quality of life (p = 0.009) and higher job insecurity: both in cognitive dimension (p = 0.013) and emotional dimension (p < 0.001). They also scored worse in the positive affect (p < 0.001), negative affect (p = 0.002) and fulfillment of expectations in work environment (p < 0.001) domains of the WBWS. Additionally, they reported less frequently occupational accidents and injuries (p = 0.001), muscu - loskeletal disorders of the spine or neck (p = 0.007), cardiovascular (p = 0.017), and gastrointestinal (p = 0.010) disorders, while they reported more frequently mental disorders (p < 0.001). Multivariate linear regression analysis showed that temporary work predicted high cognitive (p = 0.010) and emotional (p < 0.001) insecurity, low positive emotions and mood index (p = 0.007), low achievement-fulfillment index (p = 0.047) and high index of negative emotions (p = 0.006), regardless of gender and age. Conclusions Temporary employment among nurses is associated with a lower sense of job security and well-being, and a higher prevalence of mental disorders, independently of age or gender without a significantly negative effect on their ability to work. Managers, as well as occupational physicians, should recognize the extent of nurses’ job insecurity and assess their ability to work, to provide them with the necessary support and to stimulate the sense of occupational security and work capacity, so that they can thrive in their workplace and therefore be more productive and provide high quality healthcare. Int J Occup Med Environ Health. 2024;37(1):98–109

In recent works, many industrial by-products were employed as solid precursors for the synthesis of alkali-activated binders and as alternatives to Portland cement for the immobilization of hazardous, toxic and nuclear wastes. Among industrial wastes, alkali-activated brick was found to be an interesting porous composite for removing very toxic heavy metals (Pb2+, Cd2+, Co2+) and radio-nuclides (Sr2+, Cs+, Rb+) from aqueous solutions. The starting material is very attractive due to the presence of metakaolinite as a geo-polymer precursor and silica for increasing material permeability and facilitating water filtration. The alkaline reaction gave rise to geo-polymerization followed by partial zeolitization. Elemental surface micro-analysis was performed by Scanning Electron Microscopy (SEM) equipped with an Energy-Dispersive X-ray Spectrometer (EDS). The formation of crystalline phases was corroborated by X-ray diffraction (XRD) analysis. Information about 29Si, 27Al and 1H nuclei environments in crystallized and amorphous aluminosilicates was obtained by 29Si, 27Al and 1H MAS NMR. 27Al–1H dipolar-mediated correlations were investigated by employing dipolar hetero-nuclear multiple quantum coherence (D-HMQC) NMR, highlighting Al–O–H bonds in bridging hydroxyl groups (Si–OH–Al) that are at the origin of adsorptive properties. Aqueous structural stability and cationic immobilization characteristics before and after material calcination were investigated from acid-leaching experiments.

Objective: To explore the association of sleep characteristics with cardiovascular disease (CVD) using self-reported questionnaires. Material and Methods: 957 adults between 19 and 86 years old were enrolled in this cross-sectional study. The participants were classified into three groups [short (8h) sleepers] by using multistage stratified cluster sampling. CVD was defined by a positive response to the questions: “Have you been told by a doctor that you have had a heart attack or angina or stroke or have you undergone bypass surgery?”. Sleep quality, utilizing Epworth sleepiness scale, Athens insomnia scale, Pittsburgh sleep quality index and Berlin questionnaire, was also examined. Results: Prevalence of CVD was 9.5%. Individuals with CVD exhibited reduced sleep duration by 33 min (p

The chemical and mineralogical surface properties of a brick-derived composite were examined by using an environmental scanning electron microscopy (ESEM) equipped with an energy dispersive X-ray spectrometer (EDS). Investigations revealed that the material could be assimilated to an adsorptive membrane having zeolites deposited onto quartz matrix. In our calculation, the membrane was considered as a diphase composite and its dielectric constant was evaluated from theoretical models developed in the literature. Electro-kinetic analysis showed that composite surfaces were hydroxylated with the formation of hydroxyl groups which behaved amphoterically. A theory-based approach was used for calculating thermodynamic constants relative to surface-protonation equilibriums. In the H-form of the composite, the occurrence of bridging Si–(OH)–Al sites were evidenced by mathematical calculations utilizing equations in direct relation to mineralogical, crystallographic and dielectric surface characteristics. 1H MAS NMR spectroscopy confirmed the existence of bridging Brønsted acid sites at acidified composite surfaces interacting with ammonium (as probe ions). Owing to advancements in brick-based composites research, this should lead more to the development of “ceramic” adsorptive membranes with natural clay materials.

Abstract Non-technical summary We identify a set of essential recent advances in climate change research with high policy relevance, across natural and social sciences: (1) looming inevitability and implications of overshooting the 1.5°C warming limit, (2) urgent need for a rapid and managed fossil fuel phase-out, (3) challenges for scaling carbon dioxide removal, (4) uncertainties regarding the future contribution of natural carbon sinks, (5) intertwinedness of the crises of biodiversity loss and climate change, (6) compound events, (7) mountain glacier loss, (8) human immobility in the face of climate risks, (9) adaptation justice, and (10) just transitions in food systems. Technical summary The Intergovernmental Panel on Climate Change Assessment Reports provides the scientific foundation for international climate negotiations and constitutes an unmatched resource for researchers. However, the assessment cycles take multiple years. As a contribution to cross- and interdisciplinary understanding of climate change across diverse research communities, we have streamlined an annual process to identify and synthesize significant research advances. We collected input from experts on various fields using an online questionnaire and prioritized a set of 10 key research insights with high policy relevance. This year, we focus on: (1) the looming overshoot of the 1.5°C warming limit, (2) the urgency of fossil fuel phase-out, (3) challenges to scale-up carbon dioxide removal, (4) uncertainties regarding future natural carbon sinks, (5) the need for joint governance of biodiversity loss and climate change, (6) advances in understanding compound events, (7) accelerated mountain glacier loss, (8) human immobility amidst climate risks, (9) adaptation justice, and (10) just transitions in food systems. We present a succinct account of these insights, reflect on their policy implications, and offer an integrated set of policy-relevant messages. This science synthesis and science communication effort is also the basis for a policy report contributing to elevate climate science every year in time for the United Nations Climate Change Conference. Social media summary We highlight recent and policy-relevant advances in climate change research – with input from more than 200 experts.

Self-regulated learning (SRL) is critical for learning across tasks, domains, and contexts. Despite its importance, research shows that not all learners are equally skilled at accurately and dynamically monitoring and regulating their self-regulatory processes. Therefore, learning technologies, such as intelligent tutoring systems (ITSs), have been designed to measure and foster SRL. This paper presents an overview of over 10 years of research on SRL with MetaTutor, a hypermedia-based ITS designed to scaffold college students’ SRL while they learn about the human circulatory system. MetaTutor’s architecture and instructional features are designed based on models of SRL, empirical evidence on human and computerized tutoring principles of multimedia learning, Artificial Intelligence (AI) in educational systems for metacognition and SRL, and research on SRL from our team and that of other researchers. We present MetaTutor followed by a synthesis of key research findings on the effectiveness of various versions of the system (e.g., adaptive scaffolding vs. no scaffolding of self-regulatory behavior) on learning outcomes. First, we focus on findings from self-reports, learning outcomes, and multimodal data (e.g., log files, eye tracking, facial expressions of emotion, screen recordings) and their contributions to our understanding of SRL with an ITS. Second, we elaborate on the role of embedded pedagogical agents (PAs) as external regulators designed to scaffold learners’ cognitive and metacognitive SRL strategy use. Third, we highlight and elaborate on the contributions of multimodal data in measuring and understanding the role of cognitive, affective, metacognitive, and motivational (CAMM) processes. Additionally, we unpack some of the challenges these data pose for designing real-time instructional interventions that scaffold SRL. Fourth, we present existing theoretical, methodological, and analytical challenges and briefly discuss lessons learned and open challenges.

Purpose – In March 2020, with only two working days’notice the French national education system went online due to the coronavirus pandemic. This study explores the relationship between the move to distance learning, the teaching practices employed and the socio-economic context of the learners in French schools during this period. We ask how far the changes in teaching practices during the coronavirus crisis were influenced by the social context of teaching. And to what extent this context influenced the focus of the pedagogical continuity those teachers set up. Design/methodology/approach – A review of the literature situates the study within the field of mathematics teaching practices. The study was carried out through a multidimensional analysis using multiple correspondences of the responses of 368 French secondary school mathematics teachers to an online questionnaire. Findings – We found that the unprepared move to distance learning impeded the employment of dialogic practices. The socio-economic situation of the teaching was identified as a determining factor in the teachers' different interpretations of the term pedagogical continuity. Whilst those working in more deprived areas tended towards practices which focused on maintaining pupils' links with school, consolidation of knowledge and providing social/affective support, those teaching a more privileged public favoured tools and practices which allowed them to focus on the disciplinary content of their teaching. Practical implications – The challenge of maintaining dialogic activities – teacher education to combat inequalities. Originality/value – A quantitative study of mathematics teachers providing pedagogical continuity through distance learning for the duration of the crisis.

Abstract Purpose To inform recommendations by the Canadian Task Force on Preventive Health Care on screening in primary care for the prevention and early detection of cervical cancer by systematically reviewing evidence of (a) effectiveness; (b) test accuracy; (c) individuals’ values and preferences; and (d) strategies aimed at improving screening rates. Methods De novo reviews will be conducted to evaluate effectiveness and to assess values and preferences. For test accuracy and strategies to improve screening rates, we will integrate studies from existing systematic reviews with search updates to the present. Two Cochrane reviews will provide evidence of adverse pregnancy outcomes from the conservative management of cervical intraepithelial neoplasia. We will search Medline, Embase, and Cochrane Central (except for individuals’ values and preferences, where Medline, Scopus, and EconLit will be searched) via peer-reviewed search strategies and the reference lists of included studies and reviews. We will search ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. Two reviewers will screen potentially eligible studies and agree on those to include. Data will be extracted by one reviewer with verification by another. Two reviewers will independently assess risk of bias and reach consensus. Where possible and suitable, we will pool studies via meta-analysis. We will compare accuracy data per outcome and per comparison using the Rutter and Gatsonis hierarchical summary receiver operating characteristic model and report relative sensitivities and specificities. Findings on values and preferences will be synthesized using a narrative synthesis approach and thematic analysis, depending on study designs. Two reviewers will appraise the certainty of evidence for all outcomes using GRADE (Grading of Recommendations Assessment, Development and Evaluation) and come to consensus. Discussion The publication of guidance on screening in primary care for the prevention and early detection of cervical cancer by the Task Force in 2013 focused on cytology. Since 2013, new studies using human papillomavirus tests for cervical screening have been published that will improve our understanding of screening in primary care settings. This review will inform updated recommendations based on currently available studies and address key evidence gaps noted in our previous review.

Plasmonic structures, such as bowtie nanoantennas, may be used in Surface Enhanced Raman Spectroscopy (SERS). Nanoantennas can be employed to amplify the biomolecular and chemical reactions, which is useful for biomedical applications. The electric field created by nanoantennas are optimized when the resonant wavelength of the probed laser light closely matches the resonant wavelength of the plasmonic structure. In this work, we fabricated several bowtie nanoantennas with varying geometric spacing for use with a 532 nm wavelength laser line in Raman Spectroscopy. The fabrication utilized nanolithography by electron beam lithography on a Raith Voyager, development, deposition, and metal lift-off. This study explored a specific bowtie nanoantenna geometry of 270 nm equilateral sides triangle pairs with 3 varying gap sizes, 50 nm, 20 nm, and 10 nm, and the effect of varying electron beam doses on the final structure of the nanoantenna. The results presented here, will show that the working dose factor range is 6.5–10.3 (650–10,300 μC/cm2) for 120 nm thick polymethyl methacrylate (PMMA), and with a 44.78% increase in dose, the footprint area increases between 5.9% and 10.7%.

Fuel cell electric vehicles (FCEVs) can play a key role in accelerating the electrification of road transport. Specifically, they offer longer driving ranges and shorter refuelling times relative to Battery Electric Vehicles (BEVs) while reducing needs for space-intensive public charging infrastructure. Although the maturity and market penetration of hydrogen is currently trailing batteries, transport planners in several countries are looking to both technologies to reduce carbon emissions and air pollution. Home to the world’s largest on-road fleet of FCEVs, California is one such jurisdiction. Experiences in California provide an ideal opportunity to address a gap in literature whereby barriers to FCEV diffusion are well understood, but knowledge on actual strategies to overcome these has lacked. This study thus examines governance strategies in California to accelerate the production and diffusion of FCEVs, key outcomes, lessons learned and unresolved challenges. Evidence is sourced from 19 expert interviews and an examination of diverse documents. Strategies are examined from four perspectives: (i) supply-side (i.e. stimulation of vehicle production), (ii) infrastructure (i.e. construction of refuelling stations and hydrogen production), (iii) demand-side (i.e. stimulation of vehicle adoption) and (iv) institutional (i.e. cross-cutting measures to facilitate collaboration, innovation and cost-reduction). Findings reveal a comprehensive mix of stringent regulation, market and consumer incentives, and public–private collaboration. However, significant challenges remain for spurring the development of fuel cell transport in line with initial ambitions. Highlighting these provides important cues for public policy to accelerate the deployment of FCEVs and hydrogen in California and elsewhere.

Large-scale, unbiased proteomics studies of biological samples like plasma are constrained by the complexity of the proteome. Herein, the authors develop a highly parallel protein quantitation platform leveraging multi nanoparticle protein coronas for deep proteome sampling and biomarker discovery.

Background In embryological culture dishes, there is a temperature decline when they are removed outside incubators. This study aimed at investigating the effects of this temperature decline within a certain time frame, the type of culture dish with or without the use of laminar air flow and whether it is possible to achieve a sufficient thermal control with the use of a heating stage. Materials and Methods In this experimental study, the temperatures of four different types of polystyrene dishes [50 mm intracytoplasmic sperm injection (ICSI), 35 mm, 60 mm, 90 mm], filled with culture medium and oil were recorded for a period of 10 minutes outside the incubator. Temperature was measured with an infrared thermographic camera. The reference temperature was 37°C. Four parameters were analyzed: the type of dishes, air flow, a heating stage at 37°C and 38.5°C. Results There was a time-dependant significant temperature decline outside the incubator in all types of dishes and under all experimental conditions. Under air flow temperature decline increased compared to the no air flow condition. The use of a heating stage at either 37°C or 38.5°C slightly improved the situation in most cases. After three minutes out of the incubator without a heating stage and air flow, the temperature was

Consumption of raw materials, energy, manufactured goods, and services is increasingly concentrated in cities, as urbanization accelerates globally. Such consumption is influenced by complex interactions arising between the various socio-technical and natural systems that make up cities. To improve understanding of the interlinked factors that can perpetuate—or “lock-in”—unsustainable consumption, we build an explanatory framework that conceptually joins the literature on socio-technical systems and on urban consumption. Two questions guide our study: (1) What are the principal socio-technical systems in cities that influence consumption behavior? (2) How do these systems interact to lock urban dwellers into unsustainable consumption behavior? The resulting framework incorporates theories of socio-technical lock-in with factors relating to both “structure” and “agency” in consumption literature. Specifically, it describes the influence and interactions of physical, non-physical, and human systems on two interlinked scales: macro-scale (structure and collectively shared conditions) and micro-scale (agency and individually shaped conditions). To demonstrate the practical value of this framework, we apply it to a case study on mobility in Bangkok, Thailand. This allows us to systematically identify the interlinked mechanisms contributing to the growing dependence on and lock-in to individually owned passenger vehicles. Our study thus provides a comprehensive understanding of the multiplex drivers of consumption behavior, taking into account both structure and agency. The framework also provides a tool for other scholars to empirically identify lock-in mechanisms that hamper the adoption of more sustainable consumption behavior in other sectors and geographies.

The energy products of oil and gas majors have contributed significantly to global greenhouse gas emissions (GHG) and planetary warming over the past century. Decarbonizing the global economy by mid-century to avoid dangerous climate change thus cannot occur without a profound transformation of their fossil fuel-based business models. Recently, several majors are increasingly discussing clean energy and climate change, pledging decarbonization strategies, and investing in alternative energies. Some even claim to be transforming into clean energy companies. Given a history of obstructive climate actions and “greenwashing”, there is a need to objectively evaluate current and historical decarbonization efforts and investment behavior. This study focuses on two American (Chevron, ExxonMobil) and two European majors (BP, Shell). Using data collected over 2009–2020, we comparatively examine the extent of decarbonization and clean energy transition activity from three perspectives: (1) keyword use in annual reports (discourse); (2) business strategies (pledges and actions); and (3) production, expenditures and earnings for fossil fuels along with investments in clean energy (investments). We found a strong increase in discourse related to “climate”, “low-carbon” and “transition”, especially by BP and Shell. Similarly, we observed increasing tendencies toward strategies related to decarbonization and clean energy. But these are dominated by pledges rather than concrete actions. Moreover, the financial analysis reveals a continuing business model dependence on fossil fuels along with insignificant and opaque spending on clean energy. We thus conclude that the transition to clean energy business models is not occurring, since the magnitude of investments and actions does not match discourse. Until actions and investment behavior are brought into alignment with discourse, accusations of greenwashing appear well-founded.

Pacing tools that support small animals and can serve as models for pathogenesis of cardiovascular diseases are currently not available. Here, the authors report a miniaturized wireless battery-free implantable multimodal and multisite pacemaker that provides unlimited stimulation to test subjects.

Abstract Background The prevalence and outcomes of non-alcoholic fatty liver disease (NAFLD) among elderly have not been well described. Our aim was to assess the prevalence, risk factors and mortality of NAFLD in individuals older than 60 years. Methods The data from the Third National Health and Nutrition Examination Survey with linked mortality files were utilized. NAFLD was defined by United States Fatty Liver Index in the absence of other causes of liver disease. Cox proportional hazards models were used to assess all-cause and cardiovascular (CV) mortality. All analyses were performed using SAS software. Results Three thousand two hundred seventy-one NHANES-III participants were included. The prevalence rates from NAFLD were 40.3% (95% CI: 37.2–43.5%) and 39.2% (95% CI: 34.4–44.0%) among 60–74 and > 74 years old. Among aged 60–74, the risks for 5-year and 10-year all-cause mortality were associated with presence of NAFLD [adjusted hazard ratios: 1.60 (95% CI: 1.24–1.96) for 5-year and 1.22 (95%CI: 1.01–1.49) for 10-year]. CV mortality were higher in this group were (aHR: 2.12 (95% CI: 1.20–3.75) for 5-year and 1.06 (95%CI: 0.73–1.52) for 10-year]. In contrast, in individuals > 74 years old, diagnosis of NAFLD was not associated with all-cause or CVD mortality. Conclusions NAFLD is common among elderly population. Although NAFLD is associated with increased risk of mortality for 60–74-year-old individuals, this risk was not increased in those older than 74 years.

Abstract Background Tobacco smoking is the leading cause of cancer, preventable death, and disability. Smoking cessation can increase life expectancy by nearly a decade if achieved in the third or fourth decades of life. Various stop smoking interventions are available including pharmacotherapies, electronic cigarettes, behavioural support, and alternative therapies. This protocol outlines an evidence review which will evaluate the benefits and harms of stop smoking interventions in adults. Methods The evidence review will consist of two stages. First, an overview of systematic reviews evaluating the benefits and harms of various stop smoking interventions delivered in or referred from the primary care setting will be conducted. The second stage will involve updating a systematic review on electronic cigarettes identified in the overview; randomized controlled trials will be considered for outcomes relating to benefits while randomized controlled trials, non-randomized controlled trials, and comparative observational studies will be considered for evaluating harms. Search strategies will be developed and peer-reviewed by medical information specialists. The search strategy for the updated review on e-cigarettes will be developed using that of the candidate systematic review. The MEDLINE®, PsycINFO, Embase, and the Cochrane Library electronic databases will be searched as of 2008 for the overview of reviews and from the last search date of the selected review for the updated review. Organizational websites and trial registries will be searched for unpublished or ongoing reviews/studies. Two reviewers will independently screen the title and abstracts of citations using the liberal accelerated method. Full-text screening will be performed independently by two reviewers. Extracted data will be verified by a second reviewer. Disagreements regarding full-text screening and data extraction will be resolved by consensus or third-party adjudication. The methodological quality of systematic reviews, risk of bias of randomized and non-randomized trials, and methodological quality of cohort studies will be evaluated using AMSTAR 2, the Cochrane risk of bias tool, and a modified version of the Scottish Intercollegiate Guidelines Network critical appraisal tool, respectively. The GRADE framework will be used to assess the quality of the evidence for outcomes. Discussion The evidence review will evaluate the benefits and harms of various stop smoking interventions for adults. Findings will be used to inform a national tobacco cessation guideline by the Canadian Task Force on Preventive Health Care. Systematic review registration PROSPERO (CRD42018099691, CRD42018099692)

‘Phase-out’ is increasingly mobilised in research and policymaking as an approach to catalyse the gradual decline of technologies, substances and practices that compromise environmental sustainability objectives. This trend is particularly pronounced in the context of climate change, demonstrated by the accumulation of a vast body of scholarship over multiple decades. Our work provides the first systematic review of the state of this knowledge, mapping out how phase-out is studied and employed as a policy tool for mitigating climate change. We systematically review over 400 publications, spanning three decades (1990–2021) and diverse scientific fields. Our review asks: how has scholarly work discussed phase-out as an approach to mitigate climate change, and how has this changed over time? We tackle this question from five perspectives: (a) elements targeted by phase-outs, (b) policy instruments, (c) affected industries, (d) geographic context, and (e) benefits besides climate change mitigation. Results reveal that phase-out has widely proliferated as a decarbonisation approach, developing into a bridging concept that links diverse communities of contemporary science and practice. This is reflected by engagement with manifold phase-out targets—stretching well beyond the usual suspects related to fossil fuels and end-use technologies—as well as discussion of a growing diversity of industries, policy instruments and geographies in the literature. This global proliferation of phase-outs is propelled by expectations of diverse co-benefits. Aside from gains for the environment, economy, society and health, we find widespread acknowledgment that phase-out can drive innovation and systemic change beyond the mere substitution of problematic technologies and materials. Our study also identifies several underdeveloped and underrepresented directions meriting further study. These notably include phase-out activity beyond Europe, North America and China, hard-to-abate industry sectors and non-fossil fuel targets. We conclude by carving out broader implications for scholars and practitioners to inform future research directions and climate mitigation efforts.

Abstract Background The Canadian Assessment of Physical Literacy (CAPL) is divided into four domains (Physical Competence, Daily Behaviour, Motivation and Confidence, and Knowledge and Understanding) and provides a robust and comprehensive assessment of physical literacy. As weight status is known to influence health-related behaviours such as physical fitness and activity, it is important to investigate whether the associations between the domains of physical literacy vary among children of different weight status. The aim of this study was to determine the associations among the four domains of physical literacy stratified by weight status. Methods Canadian children aged 8 to 12 years (n = 8343, 63.6% healthy-weight) completed the CAPL. Differences in domain scores and overall physical literacy score by weight status (children of healthy weight versus children with overweight/obese) were assessed using MANOVA (multivariate analysis of variance). Partial correlations between the four domains were calculated, adjusting for gender and age, and correlation coefficients of both weight status groups were compared using the Steiger test. Results For all four domains as well as overall physical literacy, healthy-weight children had higher scores than their overweight/obese peers (Cohen’s d ranged from 0.05 to 0.44). Weak to moderate correlations were found between all of the domains for both groups. Correlation coefficients for Physical Competence and Daily Behaviour as well as for Physical Competence and Knowledge and Understanding were generally stronger in the healthy-weight children (r = 0.29 and 0.22, respectively) compared with the overweight/obese children (r = 0.23 and 0.17, respectively). Conclusions All of the domains of the CAPL correlate positively with each other regardless of weight status, with a trend for these correlation coefficients to be slightly stronger in the healthy-weight children. The overall weak to moderate correlations between the domains in both groups suggest that the CAPL domains are not measuring the same constructs, thus providing support for CAPL’s psychometric architecture in both healthy-weight and overweight/obese children.

Background: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors. Despite the important progress observed in liver surgery, the survival rates are discouraging. The aim of this study was to investigate the expression of autotaxin in hepatocellular carcinoma. Materials and Methods: Liver tissues from 28 human hepatocellular carcinomas were evaluated for the expression of autotaxin by immunohistochemistry. The gender, age, histological grade, lymphovascular invasion, number of tumors, levels of serum alpha-fetoprotein (aFP), presence of liver cirrhosis, hepatitis, surgery and survival rates were recorded. Results: Immunohistochemistry confirmed the expression of autotaxin in hepatocellular carcinoma. The histological grade seems to be the only independent predictor of stronger autotaxin expression, as significantly higher levels of autotaxin were detected in histological grades II and III. In addition, levels of autotaxin seem to be the most important independent prognostic factor related to poor survival. There was an eight-fold higher risk of death in patients with high levels of autotaxin compared to patients with low levels. Conclusions: Autotaxin expression in hepatocellular carcinoma could be of great importance. High autotaxin expression in HCC is detected in patients with histological grade II and III. Further, patients with elevated expression levels were found to possess an eight-fold higher risk of death. Autotaxin role in HCC should be further elucidated.

Phytochromes are red-light photoreceptors that were first characterized in plants, with homologs in photosynthetic and non-photosynthetic bacteria known as bacteriophytochromes (BphPs). Upon absorption of light, BphPs interconvert between two states denoted Pr and Pfr with distinct absorption spectra in the red and far-red. They have recently been engineered as enzymatic photoswitches for fluorescent-marker applications in non-invasive tissue imaging of mammals. This article presents cryo- and room-temperature crystal structures of the unusual phytochrome from the non-photosynthetic myxobacterium Stigmatella aurantiaca (SaBphP1) and reveals its role in the fruiting-body formation of this photomorphogenic bacterium. SaBphP1 lacks a conserved histidine (His) in the chromophore-binding domain that stabilizes the Pr state in the classical BphPs. Instead it contains a threonine (Thr), a feature that is restricted to several myxobacterial phytochromes and is not evolutionarily understood. SaBphP1 structures of the chromophore binding domain (CBD) and the complete photosensory core module (PCM) in wild-type and Thr-to-His mutant forms reveal details of the molecular mechanism of the Pr/Pfr transition associated with the physiological response of this myxobacterium to red light. Specifically, key structural differences in the CBD and PCM between the wild-type and the Thr-to-His mutant involve essential chromophore contacts with proximal amino acids, and point to how the photosignal is transduced through the rest of the protein, impacting the essential enzymatic activity in the photomorphogenic response of this myxobacterium.

Abstract Background Esophageal carcinoma is the third most common gastrointestinal malignancy worldwide and is largely unresponsive to therapy. African-Americans have an increased risk for esophageal squamous cell carcinoma (ESCC), the subtype that shows marked variation in geographic frequency. The molecular architecture of African-American ESCC is still poorly understood. It is unclear why African-American ESCC is more aggressive and the survival rate in these patients is worse than those of other ethnic groups. Methods To begin to define genetic alterations that occur in African-American ESCC we conducted microarray expression profiling in pairs of esophageal squamous cell tumors and matched control tissues. Results We found significant dysregulation of genes encoding drug-metabolizing enzymes and stress response components of the NRF2- mediated oxidative damage pathway, potentially representing key genes in African-American esophageal squamous carcinogenesis. Loss of activity of drug metabolizing enzymes would confer increased sensitivity of esophageal cells to xenobiotics, such as alcohol and tobacco smoke, and may account for the high incidence and aggressiveness of ESCC in this ethnic group. To determine whether certain genes are uniquely altered in African-American ESCC we performed a meta-analysis of ESCC expression profiles in our African-American samples and those of several Asian samples. Down-regulation of TP53 pathway components represented the most common feature in ESCC of all ethnic groups. Importantly, this analysis revealed a potential distinctive molecular underpinning of African-American ESCC, that is, a widespread and prominent involvement of the NRF2 pathway. Conclusion Taken together, these findings highlight the remarkable interplay of genetic and environmental factors in the pathogenesis of African-American ESCC.

Phytochromes (PHYs) are photoreceptor proteins first discovered in plants, where they control a variety of photomorphogenesis events. PHYs as photochromic proteins can reversibly switch between two distinct states: a red light (Pr) and a far-red light (Pfr) absorbing form. The discovery of Bacteriophytochromes (BphPs) in nonphotosynthetic bacteria has opened new frontiers in our understanding of the mechanisms by which these natural photoswitches can control single cell development, although the role of BphPs in vivo remains largely unknown. BphPs are dimeric proteins that consist of a photosensory core module (PCM) and an enzymatic domain, often a histidine kinase. The PCM is composed of three domains (PAS, GAF, and PHY). It holds a covalently bound open-chain tetrapyrrole (biliverdin, BV) chromophore. Upon absorption of light, the double bond between BV rings C and D isomerizes and reversibly switches the protein between Pr and Pfr states. We report crystal structures of the wild-type and mutant (His275Thr) forms of the canonical BphP from the nonphotosynthetic myxobacterium Stigmatella aurantiaca (SaBphP2) in the Pr state. Structures were determined at 1.65 Å and 2.2 Å (respectively), the highest resolution of any PCM construct to date. We also report the room temperature wild-type structure of the same protein determined at 2.1 Å at the SPring-8 Angstrom Compact free electron LAser (SACLA), Japan. Our results not only highlight and confirm important amino acids near the chromophore that play a role in Pr-Pfr photoconversion but also describe the signal transduction into the PHY domain which moves across tens of angstroms after the light stimulus.

The balance of sympathetic and parasympathetic tone provides exquisite control of heart rate and contractility and has also been shown to modulate coronary flow and inflammation. Understanding how autonomic balance is altered by cardiac disease is an active area of research, and developing new ways to control this balance provides insights into disease therapies. However, achieving acute neuron-specific stimulation of autonomic neurons can be difficult in experiments that measure the acute effects of nerve stimulation on the heart. Conventional electrical and pharmacological approaches can be spatially and temporally non-selective. Cell-specific expression of light-activated channels (channelrhodopsin, ChR2) is a powerful approach that enables control of the timing and distribution of cellular stimulation using light. We present such an optogenetic approach where parasympathetic cardiac neurons are selectively photoactivated at high temporal precision to initiate cholinergic-mediated slowing of heart rate. Mice were crossbred to express ChR2 in peripheral cholinergic neurons using Cre-Lox recombination driven by a choline acetyltransferase (ChAT) promoter. Hearts from adult mice were excised, perfused, and the epicardium was illuminated (peak 460–465 nm) to photoactivate ChR2. In one set of studies, hearts were illuminated using a large-field LED light source. In other studies, a micro LED was placed on the right atrium to selectively illuminate the junction of the superior vena cava (SVC) and right atrium. The ECG was acquired before, during, and after tissue illumination to measure changes in heart rate. Upon illumination, hearts exhibited sudden and dramatic reductions in heart rate with restoration of normal heart rate after cessation of illumination. Delays in atrioventricular conduction were also observed. Heart rate reductions at the highest irradiance levels were similar to heart rate reductions caused by application of bethanechol (10 μM) or acetylcholine (800 μM). Atropine (50 nM) completely blocked the effect of ChR2 photoactivation, confirming cholinergic mediation. Optogenetic activation of intrinsic parasympathetic neurons reduced heart rate in an immediate, dose-dependent fashion, resembling the slowing of sinus rate in response to acetylcholine. Our results demonstrate a new approach for controlling parasympathetic modulation of cardiac function by selectively activating the endogenous release of acetylcholine from intrinsic cardiac cholinergic neurons.Key Message: Optogenetic photoactivation of intrinsic cardiac neurons provides immediate, tissue-specific stimulation with minimal cross-reactivity. Our results demonstrate that selective expression of channelrhodopsin within cardiac cholinergic neurons enables photoactivated release of acetylcholine, thereby instantaneously slowing sinus rate and altering atrioventricular conduction. This provides for in-depth examination of the endogenous interplay between cardiac autonomic neurons and the functional outcomes of downstream post-synaptic receptor activation.

As policymakers and automotive stakeholders around the world seek to accelerate the electrification of road transport with hydrogen, this study focuses on the experiences of Germany, a world leader in fuel cell technology. Specifically, it identifies and compares the drivers and barriers influencing the production and market penetration of privately-owned fuel cell electric passenger vehicles (FCEVs) and fuel cell electric buses (FCEBs) in public transit fleets. Using original data collected via a survey and 17 interviews, we elicited the opinions of experts to examine opportunities and obstacles in Germany from four perspectives: (i) the supply of vehicles (ii) refuelling infrastructure, (iii) demand for vehicles, and (iv) cross-cutting institutional issues. Findings indicate that despite multiple drivers, there are significant challenges hampering the growth of the hydrogen mobility market. Several are more pronounced in the passenger FCEV market. These include the supply and cost of production, the lack of German automakers producing FCEVs, the profitability and availability of refuelling stations, and low demand for vehicles. In light of these findings, we extract implications for international policymakers and future studies. This study provides a timely update on efforts to spur the deployment of hydrogen mobility in Germany and addresses the underrepresentation of studies examining both buses and passenger vehicles in tandem.

This review will show how solid state nuclear magnetic resonance (NMR) has contributed to a better understanding of the borophosphate glass structure. Over the last fifteen years, 1D and 2D magic angle spinning (MAS)-NMR has been used to produce key information about both local and medium range organization in this type of glass. After a brief presentation on borophosphate glasses, the paper will focus on the description of the local order of phosphate and borate species obtained by 1D 31P-and 11B-MAS-NMR experiments, with a special emphasis on the improvements obtained at high magnetic fields on the borate speciation description. The last part of this review will show how correlation NMR provided new insights into the intermediate length scale order. Special attention will be paid to the quantitative data retrieved from 11B/31P REDOR-based NMR sequences and to the qualitative connectivity schemes observed on the 2D 11B/31P maps edited with the heteronuclear multiple quantum coherence (HMQC) NMR techniques.

Background. A surgical operation in pediatric patients is a rather stressful experience for both children and their parents. The aim of this study was to assess the effect of specific demographic characteristics in parent’s and children’s preoperative anxiety. Methods. The sample was composed of 128 Greek-speaking children (1–14 years of age) who had to undergo minor surgery in a University General Hospital. Before surgical operation, the Spielberger State-Trait Anxiety Inventory (STAI) questionnaire and a questionnaire for the social-demographic characteristics were completed by the parents. Children’s preoperative anxiety was evaluated using the Modified Yale Preoperative Anxiety Scale (m-YPAS). Results. The independent predictors of increased anxiety levels in parents are child’s age (p=0.024) and gender (girls: p=0.008), living in rural areas (parents: p

Junctional ectopic tachycardia (JET) and atrial fibrillation (AF) occur in patients recovering from open-heart surgery (OHS). Pharmacologic treatment is used for the control of post-operative atrial arrhythmias (POAA), but is associated with side effects. There is a need for a reversible, modulated solution to rate control. We propose a non-pharmacologic technique that can modulate AV nodal conduction in a selective fashion. Ten mongrel dogs underwent OHS. Stimulation of the anterior right (AR) and inferior right (IR) fat pad (FP) was done using a 7-pole electrode. The IR was more effective in slowing the ventricular rate (VR) to AF (52 +/- 20 vs. 15 +/- 10%, p = 0.003) and JET (12 +/- 7 vs. 0 +/- 0%, p = 0.02). Selective site stimulation within a FP region could augment the effect of stimulation during AF (57 +/- 20% (maximum effect) vs. 0 +/- 0% (minimum effect), p

We previously observed greater ozone-induced lung function decrements in obese than non-obese women. Animal models suggest that obesity enhances ozone-induced airway reactivity and inflammation. In a controlled exposure study, we compared the acute effect of randomized 0.4ppm ozone and air exposures (2 h with intermittent light exercise) in obese (N = 20) (30

We report properties of zero birefringent xZnO–(67–x)SnO–(33–y)P2O5–y B2O3 glasses, within 18.5 ≤ x ≤ 22 and y = 0, 3, and 10 mol. %. These compositions of boro-phosphate glasses provide both zero photoelastic constant (PEC) and improved water durability. x = 19 and y = 3 compositions show minimum PEC of −0.002 × 10−12 Pa−1, which can contribute to candidate material for fiber current sensor devise without lead. The structures of zero photoelastic glasses were investigated by Raman scattering and nuclear magnetic resonance spectroscopies. Compositions of zero PEC glasses are explained by the empirical model proposed by Zwanziger et al. [Chem. Mater. 19, 286-290 (2007)].

An automated design approach using an evolutionary algorithm for the development of quantum cascade lasers (QCLs) is presented. Our algorithmic approach merges computational intelligence techniques with the physics of device structures, representing a design methodology that reduces experimental effort and costs. The algorithm was developed to produce QCLs with a three-well, diagonal-transition active region and a five-well injector region. Specifically, we applied this technique to Al x Ga 1 - x As/In y Ga 1 - y As strained active region designs. The algorithmic approach is a non-dominated sorting method using four aggregate objectives: target wavelength, population inversion via longitudinal-optical (LO) phonon extraction, injector level coupling, and an optical gain metric. Analysis indicates that the most plausible device candidates are a result of the optical gain metric and a total aggregate of all objectives. However, design limitations exist in many of the resulting candidates, indicating need for additional objective criteria and parameter limits to improve the application of this and other evolutionary algorithm methods.

Planning, conducting, and reporting leading-edge research requires professionals who are capable of highly skilled reading. This study reports the development of an empirically informed computer-based learning environment designed to foster the acquisition of reading comprehension strategies that mediate expertise in the social sciences. Empirical data were gathered in a mixed-methods explanatory sequential design that examined the reading comprehension strategies used by an expert social scientist while reading a professional-level text. Process data were collected through a concurrent think-aloud protocol and coded according to reading comprehension processes. We combined both quantitative and qualitative analyses to identify, describe, and explain patterns in the expert’s use of reading strategies. Our findings indicate that highly-skilled reading is characterized by critiquing text information, relating information to prior knowledge, and evaluating one’s own understanding of text information. Findings are used to inform the design of worked-examples and a pedagogical agent embedded within the Highly-Skilled Reading Tutor. Le type de planification, de réalisation et l’analyse qui caractérise une recherche d’avant-garde nécessite des professionnels en mesure d’effectuer des lectures hautement spécialisées. La présente étude dresse un rapport sur l’élaboration d’un milieu d’apprentissage informatisé conçu pour favoriser l’acquisition de stratégies de compréhension en lecture permettant d’assurer la transmission des connaissances spécialisées en sciences sociales. La collecte de données empiriques s’est effectuée suivant une conception séquentielle explicative fondée sur une méthode mixte, qui étudiait les stratégies de compréhension de lecture utilisées par un expert en sciences sociales lors de sa lecture d’un texte de calibre professionnel. La collecte des données sur le processus s’est effectuée suivant un protocole concurrent de réflexion à haute voix, et les données ont été codées conformément aux processus de compréhension de la lecture. Nous avons combiné les analyses quantitatives et qualitatives afin d’identifier, décrire et expliquer les tendances de cet expert dans l’utilisation des stratégies de lecture. Nos résultats indiquent que la lecture hautement spécialisée se caractérise par la critique des informations présentées dans le texte, la mise en relation des informations présentées et des connaissances antérieures et l’autoévaluation de la compréhension de ces informations. Les résultats obtenus sont utilisés pour formuler des exemples façonnés et créer un agent pédagogique intégré au Tuteur de lecture hautement spécialisée.

Objective: To investigate the potential association between sleep pathology and diabetes mellitus (DM) using self-reported questionnaires. Material and Methods: 957 adults aged between 19 and 86 years old were enrolled in this cross-sectional study. Multistage stratified cluster sampling was used and subjects were classified into three groups [short (8h) sleep duration]. Individuals were classified as diabetics if they responded positively to the questions: “Have you ever been told that you are diabetic or have high blood sugar by a health professional?” or “Are you on antidiabetic medication?”. Sleep quality, utilizing Epworth sleepiness scale, Athens insomnia scale, Pittsburgh sleep quality index and Berlin questionnaire, was also examined. Results: DM prevalence was higher among expatriated and Muslim Greeks (23.1% and 18.7%, respectively) compared to indigenous Greek Christians (4.4%). DM prevalence was significantly associated with short sleep duration (aOR=2.82, p

Objective: To investigate the potential association between sleep insufficiency and dyslipidemia (DL) in the primary care setting using self-reported questionnaires. Material and Methods: 957 adults aged between 19 and 86 years old from the rural area of Thrace, Greece were enrolled in this cross-sectional study. Multistage stratifed cluster sampling was used and the subjects were classifed into three groups according to sleep duration [short (8h) sleep duration]. DL was defined by a positive response to the question “Have you ever been told by a doctor or health professional that your blood cholesterol or triglyceride levels were high?”, or if they were currently taking antilipidemic agents. Sleep quality, utilizing Epworth sleepiness scale, Athens insomnia scale, Pittsburgh sleep quality index and Berlin questionnaire, was also examined. Results: DL prevalence was significantly associated with short sleep duration (aOR=2.18, p