Feasibility Assessment Research Articles

Improving recovery after bowel cancer surgery: mixed methods feasibility study of a co-produced information intervention (Recover Together).

Recovery after surgery for colorectal cancer is a complex process, involving numerous physiological, emotional, social and economic challenges. Good information is a key factor for enabling patients to recover well, but there is a paucity of evidence to guide how this should be done. A new information intervention (Recover Together) comprising a booklet, an online video and an inpatient goal board has been developed. This study explores its feasibility, as well as the feasibility of key study methods, during its first use in the United Kingdom National Health Service (NHS). This is a mixed methods, multi-centre, feasibility study of a complex intervention. A total of 105 participants undergoing oncological colorectal surgery will be recruited across three to four study sites in the UK. Participants will receive each component of the Recover Together intervention at defined timepoints before and during hospital admission. A series of patient-centred outcome instruments will be administered in hospital and during follow-up at 30 days and 6 months. Outcomes of feasibility will comprise the time taken to establish the intervention at participating sites, assessments of intervention fidelity and acceptability, as well as return rates of key clinical outcome instruments. The mixed methods design will comprise interviews and focus groups with patients and health professionals, non-participant observation in ward areas and clinics, user-specific video analytics and daily photographs of the goal boards. The findings of this study will provide a feasibility assessment of the Recover Together intervention when used for the first time in NHS practice. If shown to be feasible, this will guide the development of a future definitive study to explore the clinical and cost effectiveness of the Recover Together intervention to improve recovery after surgery. ISRCTN62430915.

Feasibility Study on Geothermal Dolomite Reservoir Reinjection with Surface Water in Tianjin, China

Reinjection is thought to be the most effective way to maintain reservoir pressure and production capacity for hydrothermal resources. The use of external water injection to replenish deep geothermal reservoirs is a new approach in China to addressing the problems of declining groundwater levels and energy depletion caused by the excessive and uneven exploitation of geothermal resources. However, the key challenge and focus of the feasibility assessment of this method lies in the chemical compatibility of the external water with the native geothermal reservoir water and surrounding rocks. In this paper, we discuss the geochemical response of a dolomite reservoir to lake water injection based on experiments on water–rock interaction in the Wumishan formation in the Dongli Lake area of Tianjin. The results show that after reactions with dolomite, the TDS of the reacted water decreases, indicating the occurrence of precipitation. According to the calculation results obtained using the PHQREEC program, the precipitation amount is found to be quite limited. Geochemical analysis indicates that at the initial stage of the reactions, plagioclase dissolves and releases alkaline metals like Ca-, Na-, SiO2- and Al-bearing compositions, leading to the oversaturation and precipitation of dolomite and calcite. As the reaction progresses, a portion of the dolomite dissolves, while the calcite continues to precipitate at a later stage. Illite precipitates and its effects on reservoir structure depend on its shape. Based on the experimental data, it can be concluded that the dolomite reservoir will be slightly affected by the reinjection of lake water; however, it is still a good method for the sustainable development of geothermal resources.

Sustainability assessment of granite cutting waste incorporated cement sand rendering mortar: Technical, Environmental, Cost, and Social parameters

The literature statistics unmistakably highlight the critical need to enhance the construction industry's sustainability to lower environmental damage and conserve natural resources. This study aims to evaluate the life cycle performance of mortar by assessing its ecological impacts, economic performance, and social feasibility, alongside a thorough technical performance evaluation. The technical performance evaluation performed through physio-mechanical performance revealed that 20% natural sand replaced by granite cutting waste (GCW) is best suitable for rendering application. The compatibility of GCW as natural sand is advocated by SEM and FTIR analysis. The three pillars of sustainability are evaluated as life cycle environmental impacts assessment (LCIA), life cycle cost analysis (LCCA) and social feasibility assessment (SLCA). For LCIA purposes, nine environmental impact (EI) categories have been studied. For LCCA, raw material procurement, transportation, repair, and maintenance have been utilized to obtain the life cycle costing. Social LCA (SLCA) was performed qualitatively through a five-point Likert scale-based questionnaire survey, and responses from 125 stakeholders were analyzed using mean item score (MIS). The finding revealed that for GP20 mortar, all the nine EI categories had shown 10-13% lower environmental impacts and 7.2% lower cost than the GP0 mortar mix. The SLCA, comprising five subcategories, i.e., access to material resources, social acceptance, employment creations, safe and healthy living conditions, and community engagement, has positively impacted society when 20% GCW is utilized in rendering mortar as sand. The consolidated index calculation with higher ECM values for the GP20 mortar mix strongly endorsed a sustainable and viable alternative.

Feasibility assessment of Low-Carbon methanol production through 4E analysis of combined cycle power generation and carbon capture Integration

Feasibility assessment of Low-Carbon methanol production through 4E analysis of combined cycle power generation and carbon capture Integration

Advanced Financial and Risk Feasibility Assessment of Indonesia’s Binary Geothermal Plant with Carbon Credit Integration

Advanced Financial and Risk Feasibility Assessment of Indonesia’s Binary Geothermal Plant with Carbon Credit Integration

The effectiveness of intramuscular dry needling stimulation in treating trigger points: A case series

Myofascial trigger points are a common presentation in clients with chronic spinal pain. Various techniques are used to manage trigger points and are considered a vital part of chronic spinal pain management. Reducing pain caused by trigger points may be effective in improving function. Case series can provide preliminary evidence and assist in feasibility assessment. The objective of this case series is to document the feasibility of intramuscular dry needling stimulation in managing trigger-point-induced chronic pain. Three individuals aged 35, 33, and 28 years presented to a private clinic with chief complaints of scapular region muscular pain, and their management is reported in this case series. Initial physical examination revealed tenderness over D6 and D8. There was a palpable para spinal muscle hypertonicity and reduced thoracic spine mobility to both sides in all the three clients. The presence of multiple trigger points bilateral to the spine indicated postural dysfunction, which altered pain on changing thoracic posture. Clients were treated with dry needling with intramuscular stimulation over trigger points, paraspinal muscle and inferior to scapula by a therapist trained in the technique. The frequency was kept at 1.5 Hz and intensity was as tolerated by the patient. Outcome measures were taken using VAS, RMDQ and digital inclinometer for thoracic spine rotation. Subject one reported a change of 22 mm in VAS after the first week and 40 mm in the fourth week. It also reported an improvement in mobility to both side rotations by 20 degrees in the first week and full towards the fourth week. Subject two and three improved VAS by 10 mm in week one and 35 mm towards the fourth week. Full mobility was achieved in the fourth week in both cases. RMDQ scores improved significantly in the three cases. The three cases demonstrate significant improvement in both symptoms and function based on outcome measures. This indicates the efficacy of treating thoracic spine myofascial trigger points with dry needling and intramuscular stimulation, but a large-scale study is recommended.

Exploring Smart Mobility Potential in Kinshasa (DR-Congo) as a Contribution to Mastering Traffic Congestion and Improving Road Safety: A Comprehensive Feasibility Assessment

The urban landscape of Kinshasa, Democratic Republic of Congo, faces significant mobility challenges, primarily stemming from rapid urbanization, overpopulation, and outdated infrastructure. These challenges necessitate the exploration of modern smart mobility concepts to improve traffic flow, road safety, and sustainability. This study investigates the potential of solutions such as Mobility-as-a-Service, car sharing, micro-mobility, Vehicle-as-a-Service, and electric vehicles in addressing these challenges. Through a comparative analysis of global implementations, this research identifies key success factors and barriers that inform the feasibility of integrating these solutions into Kinshasa’s unique socio-political and infrastructural context. The study presents a conceptual framework, supported by stakeholder analysis, for adapting these solutions locally. A detailed feasibility analysis considers technological, economic, social, environmental, and regulatory factors, offering a clear roadmap for implementation. Drawing on lessons from cities facing similar urban mobility challenges, the paper concludes with actionable recommendations and insights for policymakers and urban planners in Kinshasa. This research not only highlights the viability of smart mobility solutions in Kinshasa but also contributes to the broader discourse on sustainable urban development in rapidly growing cities. While smart mobility studies have largely focused on cities with developed infrastructure, there is a gap in understanding how these solutions apply to cities like Kinshasa with different infrastructural and socio-political contexts. Previous research has often overlooked the challenges of integrating smart mobility in rapidly urbanizing cities with underdeveloped transportation systems and financial constraints. This study fills that gap by offering a feasibility analysis tailored to Kinshasa, assessing smart mobility solutions for its traffic congestion and road safety issues. The smart mobility solutions studied—Mobility-as-a-Service (MaaS), car sharing, electric vehicles (EVs), and micro-mobility—were chosen for their ability to address Kinshasa’s key mobility challenges. MaaS reduces reliance on private vehicles, easing congestion and improving public transport. Car sharing offers affordable alternatives to vehicle ownership, essential in a city with income inequality. EVs align with sustainability goals by reducing emissions, while micro-mobility (bikes and e-scooters) improves last-mile connectivity, addressing public transit gaps. These solutions are adaptable to Kinshasa’s context and offer scalable, sustainable improvements for urban mobility.

Feasibility and efficacy assessment of a novel size-adjustable cryoballoon for ablation of atrial fibrillation in a multicenter clinical setting

Abstract Background The POLARx-FIT cryoballoon (CB) system introduces a unique feature, allowing the selection of two distinct balloon sizes within a single catheter. This innovation holds promise for treating larger pulmonary veins (PV), providing increased flexibility to achieve optimal occlusions. However, there is a scarcity of clinical data supporting its application in this context. Purpose To compare the benefits and safety of the new POLARx-FIT system to those of the existing POLARx system currently in use for PV isolation (PVI) in patients with atrial fibrillation (AF). Methods The first 140 consecutive patients who underwent CB-based PVI with the POLARx-FIT system were retrospectively compared with 300 consecutive patients treated with the POLARx system. Protocol-directed cryoablation was delivered for 180 sec or 240 sec according to operator’s preference for isolation achieved in ≤60 sec, or 240 sec if isolation occurred >60 sec or when time to isolation was not available. The ablation endpoint was PVI as assessed by entrance and exit block. In the POLARx-FIT group the choice of balloon size (28 or 31 mm) was determined during the procedure while attempting to occlude each vein. Results Two-thousand one-hundred fifty-five cryo-applications (CBA) from 440 patients were analysed (300, 68.2% POLARx; 140, 31.8% POLARx-FIT). PVI was achieved with cryoablation only in all patients. The mean number of freeze applications per patient was similar between groups (5.0±1.4 in the POLARx-FIT vs 5.3±1.8 in the POLARx group, p=0.207) whereas the number of PVs treated in a single-shot fashion was higher in the POLARx-FIT group (444, 80.7% with one shot; 75, 13.7% with 2 shots; 31, 5.6% with more than 2 shots) than in the POLARx one (1168, 70.2% with one shot, p=0.0002; 294, 17.7% with two shots and 143, 8.6% with more than two shots). Among the POLARx-FIT cases, in 54.2% (n=298) of applications, the 31-mm diameter was employed as a first choice, while in the remaining 45.8% (n=252) of applications, the 28-mm diameter was adopted. A switch to a different balloon diameter was applied in 11.6% of cases. The first pass isolation (i.e. a single shot CBA to achieve PVI) was slightly higher when using a 31 mm diameter (n=250, 83.9%) than a 28 mm diameter (n=194, 77.0%, p=0.05). Three (0.7%) transient phrenic nerve palsy were observed (all in the POLARx group, 0.9%, p=0.554), with full recovery in the 48-h post procedure; no major procedure-related adverse events were reported at 30 days post-procedure. Conclusion In this first multicentric experience in a clinical practice setting, this novel cryo-balloon system proved to be safe and effective and resulted in a high proportion of successful single-freeze isolation. The intraprocedural flexibility of balloon size contributed to its versatility, leading to a variation in balloon diameter in about 12% of freeze applications.

True-MAD and pseudo-MAD in consecutive patients undergoing cardiovascular magnetic resonance

Abstract Background Mitral annulus disjunction (MAD) is a controversial imaging entity with uncertain clinical significance, which has been either considered a pathological entity potentially related to mitral valve prolapse (MVP) and sudden cardiac death or, on the contrary, a benign finding in normal hearts. Cardiovascular magnetic resonance (CMR) is poised to be the ideal imaging modality to assess MAD. Recently, a distinction between pseudo-MAD, present only in systole and secondary to juxtaposition of the billowing posterior leaflet on the adjacent left atrial wall, and true-MAD, where the insertion of the posterior leaflet is clearly displaced on the atrial wall either in diastole or in systole, has been suggested. Purpose We aimed to investigate the prevalence of pseudo-MAD and true-MAD in consecutive patients undergoing clinically-referred CMR. Methods This was a single-center retrospective study including consecutive patients referred to CMR from September 2023 to November 2023. Patients with feasible MAD assessment were included. MAD was defined as a ≥1 mm displacement between the left atrial wall-mitral valve leaflet junction hinge and the top of the left ventricular wall, measured from cine-CMR images in the three long-axis views. Pseudo-MAD and true-MAD were defined according to the presence of MAD only in systole or both in systole and diastole, respectively. MVP was defined as a systolic displacement ≥2 mm of one or both mitral valve leaflets above the annulus in 3-chamber view. Results Two-hundred-ninety patients (mean age 57±18 years; 181 men, 62%) were included. MVP and MAD were respectively found in 24 (8%) and 145 (50%) patients, of which 98 (34%) with true-MAD and 47 (16%) with pseudo-MAD. In all measurements, systolic MAD (2.6±1.3 mm) resulted equal to or greater than diastolic MAD (2.2±1.1 mm). The most frequent MAD location was the inferior wall in the two-chamber view (42%), whereas the rarest one was the inferolateral wall in the three-chamber view (17%). In patients with MVP, the prevalence of MAD was higher when considering all long-axis views (22 patients, 92%), of which 50% presented with true-MAD and 50% with pseudo-MAD. The extent of pseudo-MAD and true-MAD were both greater in patients with MVP (4.2±1.5 mm and 3.0±1.6 mm, respectively) than in those without MVP (2.3±1.0 and 2.1±0.9 mm; p<0.001 and p=0.007, respectively) in all locations. At the level of the inferolateral wall, the prevalence of MAD was 71% vs. 12% (p<0.001) in patients with vs. without MVP. Conclusions The presence of true-MAD was a common imaging finding in consecutive patients undergoing CMR, thus not resulting in a distinctive abnormal feature related to MVP or sudden cardiac death. Patients with MVP showed higher prevalence and extent of true-MAD and pseudo-MAD in all locations, in line with greater degeneration of the mitral annulus. Larger studies are needed to identify potential malignant characteristics of MAD.True-MAD (A,B) and pseudo-MAD (C,D).

Development of Online-Based Learning Media with Massive Open Online Courses Method on Instructor Methodology Competency in the Directorate of Competency Standardization and Training Programs, Ministry of Manpower of the Republic of Indonesia

This study aims for Vocational and Productivity Training Centers throughout Indonesia to implement the development of online-based learning media with the MOOC method on instructor methodology competency. This study integrates the Borg and Gall development method with ADDIE Learning Design. Data analysis uses qualitative and quantitative descriptive analysis. The results shown are the feasibility assessment by media experts obtained a score of 99.13%. The feasibility assessment by design experts obtained a score of 61.67% and the feasibility assessment by material experts obtained a score of 88.04%. Based on this assessment, it is considered feasible to use. The response of participants in the small group test was considered feasible with a score of 79.63%. In the large group trial, a score of 92.42% was shown which was categorized as very feasible. The effectiveness test was assessed by the test according to Donald Kick Patrick, namely the reaction level and learning level, the reaction level was tested with a cut-off point where the value was 96%, it can be seen that the value is above the cut-off point so that it can be categorized as very satisfied, thus the reaction test of this product is very effective. The learning level is calculated by looking at the significance between the values before and after the trial, the results show that the significance value is less than the specified value, which is at 0.001 <0.05 significance value so that there is a significant difference, thus this learning media can be categorized as effective.

Performance of carbon felt as cathodes in magnesium corrosion method to recover phosphate from swine wastewater

With the large-scale development of the livestock and poultry breeding industries, swine wastewater with high nitrogen and phosphorus concentrations has become an urgent problem. Given the continuous demand for phosphorus resources in industrial production, the study of phosphate recovery in phosphorus-rich wastewater is of great value for the sustainable utilization of phosphorus resources and for alleviating the eutrophication of aquatic ecosystems. In this study, a magnesium metal corrosion method was used to recover phosphorus resources from swine wastewater using carbon felt as the cathode instead of traditional cathode materials such as graphite and titanium plates. The effects of different cathode materials on the corrosion potential of magnesium metal plates were compared, and the effects of carbon felt as a cathode plate on the removal rate and pH of phosphate from wastewater were discussed. Additionally, the economic feasibility of phosphate recovery from swine wastewater was evaluated. The experimental results showed that the effect of carbon felt on the corrosion potential of the magnesium metal plate was more evident than that of the graphite and titanium plates (Ecorr = −1.74676). When carbon felt was used as the cathode plate, the most energy-saving reaction conditions were as follows: reaction time T = 30 min, ratio of wastewater volume to plate area V: S = 500 cm3:50 cm2, aeration rate Re = 8 L/min, stirring rate r = 400 rpm, phosphate recovery rate = 92.3%, and pH = 8.83. The economic feasibility assessment shows that the proposed method is $2.047 g-1 PO4-P without considering the reuse of carbon felt. Carbon felt has good stability and can be recycled eight times or more, and the proposed method achieves a more efficient phosphate recovery rate at a relatively low cost.

Days at Home After Traumatic Brain Injury: Moving Beyond Mortality to Evaluate Patient-Centered Outcomes Using Population Health Data.

Administrative data are invaluable for assessing outcomes at the population level. However, there are few validated patient-centered outcome measures that capture morbidity following traumatic brain injury (TBI) using these data. We sought to characterize and validate days at home (DAH) as a measure to quantify population-level outcomes after moderate to severe TBI. We additionally assessed the earliest feasible outcome assessment period for patients with TBI using this outcome measure. This multicenter retrospective cohort study used linked health administrative data sources to identify adults with moderate to severe TBI presenting to trauma centers in Ontario, Canada, between 2009 and 2021. DAH at 180 days (DAH180 days) reflects the total number of days spent alive and at home excluding the days spent institutionalized across care settings. Construct validity was determined using hierarchical quantile regression to assess the associations between clinical and injury covariates with DAH180 days. Predictive validity was assessed using Spearman rank correlation. We estimated minimally important difference (MID) in DAH180 days to aid with outcome measure interpretability. There were 6,340 patients who met inclusion criteria. Median DAH180 days was 70 days (interquartile range 0-144). Mortality occurred in 2,162 (34.1%) patients within 90 days following injury. Patients in the lower DAH180 days group were more commonly older (absolute standardized difference [ASD] = 0.68) with higher preinjury health resource utilization (ASD = 0.36) and greater injury severity (ASD = 0.81). Increased baseline health resource utilization (-10.1 days, 95% CI -17.4 to -2.8, p = 0.0041), older age (-4.6 days, 95% CI -5.7 to -3.4, p < 0.001), higher cranial injury severity (-84.6 days, 95% CI -98.3 to -71.0, p < 0.001), and major extracranial injuries (-14.2 days, 95% CI -19.5 to -8.93, p < 0.001) were significantly associated with fewer DAH180 days. DAH180 days was positively correlated with DAH at up to 3 years (r = 0.91, 95% CI 0.90-0.92) and negatively correlated with direct health care expenditure (rs = -0.89, 95% CI -0.88 to -0.90). The average MID estimated from anchor-based and distribution-based methods was 18 days. We validate DAH180 days as a potentially useful outcome measure with construct, predictive, and face validity in a population with moderate to severe TBI. Given the intensity of acute care requirements for patients with TBI, our work highlights DAH180 days as a feasible and sufficiently responsive outcome measure.

Urban biodiversity performance determining model (UrBioPDeM): The case of Isparta, Türkiye

Identifying, protecting, and developing biodiversity in urban environments contributes to ecosystem integrity. Although there are studies addressing biodiversity in natural areas in Türkiye, there has been no study specifically measuring the biodiversity of city centers. Adapting existing methods for measuring city biodiversity to Turkish cities is challenging due to their unique local dynamics. Therefore, there is a need to identify indicators that can be used to monitor and evaluate biodiversity performance for the protection and sustainability of urban areas in Türkiye and to develop a feasible, reliable, and measurable biodiversity performance assessment approach. The developed UrBioPDeM has 4 main factors and 32 sub-factors. Indicators for the assessment and management of urban biodiversity performance in Isparta, Türkiye, were identified and analyzed, and it was found that Isparta’s urban biodiversity has low potential. Therefore, suggestions were made to increase the urban biodiversity of Isparta. The developed approach is an appropriate and effective biodiversity performance model that can be applied in Turkish cities. The factors and sub-factors used in this method can be adjusted and revised according to the potential biodiversity characteristics of a city.

Comparative efficacy and safety of talazoparib plus enzalutamide and other first-line treatments for metastatic castration-resistant prostate cancer.

Talazoparib plus enzalutamide (TALA + ENZA) has demonstrated antitumor activity in the phase 3 clinical trial (TALAPRO-2; NCT03395197) as first-line (1L) therapy in men with asymptomatic or mildly symptomatic metastatic castration-resistant prostate cancer (mCRPC). Although many active interventions are available, randomized controlled trials (RCTs) involving talazoparib have only been conducted to assess its efficacy and safety compared to enzalutamide. To estimate comparisons between all relevant interventions, indirect comparisons are needed. To estimate the comparative efficacy and safety of TALA + ENZA in 1L patients with mCRPC by conducting a systematic literature review and network meta-analyses (NMAs). Databases were searched using Ovid, along with several gray literature sources to identify RCTs evaluating treatments in 1L mCRPC (PROSPERO registration: CRD42021283512). Feasibility assessment evaluated trial suitability for NMA inclusion and Bayesian or frequentist NMAs were conducted for evaluable efficacy and safety outcomes, respectively. Thirty-three RCTs met the eligibility criteria and were feasible for NMAs. Across multiple efficacy outcomes assessed, except for overall survival (OS), TALA + ENZA was ranked the most efficacious treatment. For OS, TALA + ENZA showed the second-highest probability of being the most effective treatment; second to docetaxel 50mg plus prednisolone 10mg. With respect to safety outcomes, TALA + ENZA, in general, showed increased rates of hematological adverse events. TALA + ENZA showed favorable results across multiple efficacy endpoints, but not across hematological toxicities compared with other 1L treatments in asymptomatic or mildly symptomatic mCRPC in the all-comers patient population.

Jitegemee (rely on yourself): a multi-phase process of co-creating a personal savings intervention with female sex workers in western Kenya to reduce their HIV risk

BackgroundHIV prevalence among female sex workers (FSW) is significantly higher than among women in the general population. Studies have shown that FSW engage in unprotected sex which provides higher compensation when they face emergency situations. We co-created a savings intervention – Jitegemee (rely on yourself) – with FSW to encourage them to save part of their earnings to withdraw in emergency situations in order to reduce risk.MethodsWe undertook a five-phase intervention development process between February 2021 and July 2023: 1) qualitative interviews with FSW to identify essential intervention features; 2) pilot trial to assess intervention feasibility; 3) literature review of studies on economic empowerment of FSW; 4) scoring of key components of Phases 1–3 on a scale of 1–5 (1 = definitely exclude, 5 = definitely include), for inclusion in the intervention package; 5) workshops with FSW and other key stakeholders to co-design the intervention.ResultsIn phase 1, nearly all participants (99%) found the intervention acceptable to them and 95% believed it would be acceptable to other FSW. Participants suggested inclusion of financial literacy (75%), savings groups (38%) and goal-setting (24%). In the feasibility assessment, 41% saved, of whom 46% withdrew some savings. Condom use was higher among FSW who withdrew their savings compared to those who did not (χ2 7.52; p = 0.006). In Phase 3, we identified 14 intervention components. In phase 4, all suggested intervention components scored 4.5 on average. In phase 5, we held 3 workshops with FSW to co-design the intervention, which included instructions for how to save and make withdrawals, financial literacy training, and formation of savings groups.ConclusionsA savings intervention for and by FSW was highly acceptable and feasible. Involving end-users in the design process is likely to result in greater economic security among FSW and lower engagement in higher risk transactional sex.

FSscore: A Personalized Machine Learning‐Based Synthetic Feasibility Score

AbstractDetermining whether a molecule can be synthesized is crucial in chemistry and drug discovery, as it guides experimental prioritization and molecule ranking in de novo design tasks. Existing scoring approaches to assess synthetic feasibility struggle to extrapolate to new chemical spaces or fail to discriminate based on subtle differences such as chirality. This work addresses these limitations by introducing the Focused Synthesizability score (FSscore), which uses machine learning to rank structures based on their relative ease of synthesis. First, a baseline trained on an extensive set of reactant‐product pairs is established, which is then refined with expert human feedback tailored to specific chemical spaces. This targeted fine‐tuning improves performance on these chemical scopes, enabling more accurate differentiation between molecules that are hard and easy to synthesize. The FSscore showcases how a human‐in‐the‐loop framework can be utilized to optimize the assessment of synthetic feasibility for various chemical applications.

Multi-Scale Risk-Informed Comprehensive Assessment Methodology for Lithium-Ion Battery Energy Storage System

Lithium-ion batteries (LIB) are prone to thermal runaway, which can potentially result in serious incidents. These challenges are more prominent in large-scale lithium-ion battery energy storage system (Li-BESS) infrastructures. The conventional risk assessment method has a limited perspective, resulting in inadequately comprehensive evaluation outcomes, which impedes the provision of dependable technical support for the scientific appraisal of intricate large-scale Li-BESS systems. This study presents a novel Li-BESS-oriented multi-scale risk-informed comprehensive assessment framework, realizing the seamless transmission of assessment information across various scales. The findings from a previous smaller-scale analysis serve as inputs for a larger scale. The evaluation process of this method is more scientifically rigorous and yields more comprehensive results compared to assessment technologies just relying on a single perspective. By utilizing the proposed comprehensive assessment methodology, this study utilized the emergency power supply of nuclear power plants (NPPs) as an application scenario, demonstrating the complete implementation process of the framework and conducting a comprehensive assessment of Li-BESS feasibility as an emergency power source for NPPs. Our findings propose a novel paradigm for the comprehensive assessment of Li-BESS, which is expected to serve as a scientific foundation for decision-making and technical guidance in practical applications.

Assessment of validity, reliability, and feasibility of OMERACT ultrasound knee osteoarthritis scores in Egyptian patients with primary knee osteoarthritis.

Ultrasound (US) can evaluate all joint components affected by knee osteoarthritis (KOA); however, standardized scoring of US-detected pathology is needed to improve its diagnostic and monitoring capabilities. To examine the validity, reliability, and feasibility of the Outcome Measures in Rheumatology (OMERACT) ultrasound scoring for KOA, comparing with clinical and radiography measures, using predefined cutoff values. This cross-sectional study included 75 Egyptian patients with primary KOA. All patients had Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, bilateral knee radiography, and ultrasonography. Inter-observer reliability of ultrasound was evaluated in 30 knees by another newly trained operator. Most of the OMERACT-US KOA scores showed significant associations with WOMAC clinical scores, except for femoral cartilage damage and effusion. The synovitis score was significantly associated with WOMAC-pain score (p-value 0.046), while medial meniscus extrusion (MME) and medial osteophytes were significantly associated with WOMAC-stiffness score (p-value 0.009 and 0.023, respectively). MME and synovitis were significantly associated with WOMAC-physical score (p-value 0.035 and 0.020, respectively). The ultrasound scores also showed a strong correlation with radiographic scoring. Inter-observer reliability ranged from moderate to excellent agreement (k = 0.58 to k = 0.83); it was highest for lateral osteophytes (k = 0.83), good agreement for synovitis (k = 0.72), any osteophytes (k = 0.71), damage of femoral cartilage (k = 0.70), and moderate agreement for medial osteophytes (k = 0.58) and MME (k = 0.59). OMERACT-US scoring system for KOA demonstrated validity, reliability, and feasibility for evaluating both structural and inflammatory components. Using cutoff values improved the scoring reliability for osteophytes and MME. Key Points • OMERACT-US scores provide a valid assessment of inflammatory and structural components of knee osteoarthritis. • The following changes may improve the performance of the OMERACT-US scores. a. The binary score for effusion and synovial hypertrophy can be omitted, as they have no added value. b. A semi-quantitative grading for effusion may capture the impact of effusion on clinical outcomes. c. Added cutoff values to score medial meniscal extrusion, osteophytes, and pathological effusion improved the respective scores' reliability. d. Applying the updated OMERACT definition of synovitis. • OMERACT-US scores are reliable to be used with a newly trained operator, particularly when cutoff values are included, and proper training time is provided. • The OMERACT-US score is feasible to be used in clinical practice, as the time taken to perform was short, even for a newly trained operator.

A Pilot and Feasibility Study on a Mindfulness-Based Intervention Adapted for LGBTQ+ Adolescents.

(1) Background: Lesbian, gay, bisexual, transgender, queer and other gender and sexual minority-identified (LGBTQ+) adolescents face mental and physical health disparities compared to their heterosexual and cisgender counterparts. Mindfulness-based interventions (MBIs) may be a potential method to intervene upon health disparities in this population. This pilot study explores the initial acceptability and feasibility, along with the descriptive health changes of an online MBI, Learning to Breathe-Queer (L2B-Q), which was adapted to meet the needs of LGBTQ+ adolescents. (2) Methods: Twenty adolescents completed baseline and post-intervention assessments of mental health, stress-related health behaviors, physical stress, and LGBTQ+ identity indicators. In addition, the adolescents participated in a post-intervention focus group providing qualitative feedback regarding the acceptability of L2B-Q. (3) Results: L2B-Q demonstrated feasible recruitment and assessment retention, acceptability of content with areas for improvement in delivery processes, and safety/tolerability. From baseline to post-intervention, adolescents reported decreased depression and anxiety and improved intuitive eating, physical activity, and LGBTQ+ identity self-awareness with moderate-to-large effects. (4) Conclusions: These findings underscore the need and the benefits of adapted interventions among LGBTQ+ youth. L2B-Q warrants continued optimization and testing within the LGBTQ+ adolescent community.

DESIGN AND SET UP OF A RANDOMISED CONTROLLED TRIAL OF MEDICINAL CANNABINOIDS IN RECURRENT GLIOBLASTOMA - THE ARISTOCRAT TRIAL

Abstract AIMS ARISTOCRAT is a unique, randomised, double-blind, placebo-controlled phase II trial of cannabinoids (nabixo- mols) alongside temozolomide in patients with MGMT-methylated recurrent GBM and is open to recruitment in 12 centres across the UK. It was rapidly funded through a crowdfunding campaign organised by The Brain Tumour Charity during the COVID-19 pandemic. METHOD This pragmatic phase II randomised trial was designed and set up by a multi-disciplinary team of co-applicants and trial management group (TMG) members comprising of clinicians, statisticians, trialists, Patient &amp; Public Involvement (PPI), pharmacists and quality of life (QoL) researchers. The protocol randomises on a 2:1 ratio between nabiximols or matched placebo with standard dose temozolomide in patients at first recurrence of IDH wild-type GBM. Unique aspects include self-titration of nabiximols based on individual tolerance, and fully blinded randomisation with matched placebo. The primary outcome measure is overall survival time with key secondary outcomes including survival at 6, 12 and 24 months, progression-free survival time, health-related QoL and adverse events. Intermediate assessment of feasibility to confirm safety, compliance and achievability of recruitment will be undertaken after 40 patients are randomised. PPI input has been critical in the trial and patient-facing information design. RESULTS The trial has promoted a high level of patient and public interest, including press coverage. The trial aims to recruit a total of 234 patients over an 18 month period. CONCLUSION ARISTOCRAT will provide unique, robust clinical data on the role of nabiximols (combined with temozolomide) in improving overall survival and the impact on QoL for patients with recurrent GBM and is the first of its kind in cancer patients.