Low Load Research Articles

Isothiourea‐Catalysed Acylative Kinetic Resolution of Tertiary Pyrazolone Alcohols

AbstractThe development of methods for the selective acylative kinetic resolution (KR) of tertiary alcohols is a recognised synthetic challenge with relatively few successful substrate classes reported to date. In this manuscript, a highly enantioselective isothiourea‐catalysed acylative KR of tertiary pyrazolone alcohols is reported. The scope and limitations of this methodology have been developed, with high selectivity observed across a broad range of substrate derivatives incorporating varying substitution at N(2)‐, C(4)‐ and C(5)‐, as well as bicyclic constraints within the pyrazolone scaffold (30 examples, selectivity factors (s) typically >100) at generally low catalyst loadings (1 mol %). The application of this KR method to tertiary alcohols derived directly from a natural product (geraniol), alongside pharmaceutically relevant drug compounds (indomethacin, gemfibrozil and probenecid), with high efficiency (s >100) is also described. The KR process is readily amenable to scale up using bench grade solvents and reagents, with effective resolution on a 50 g (0.22 mol) scale demonstrated. The key structural motif leading to excellent selectivity in this KR process has been probed through computation, with an NC=O⋅⋅⋅isothiouronium interaction from substrate to acylated catalyst observed within the favoured transition state. Similarly, the effect of C(5)‐aryl substitution that leads to reduced experimental selectivity is probed, with a competitive π–isothiouronium interaction identified as leading to reduced selectivity.

Cell aggregation mediated by ACE2 deletion in Candida auris modulates fungal colonization and host immune responses in the skin.

Candida auris is an emerging multi-drug-resistant fungal pathogen that colonizes the skin and causes invasive infections in hospitalized patients. Multi-cellular aggregative phenotype is widely reported in the C. auris isolates, but its role in skin colonization and host immune response is not yet known. In this study, we generated aggregative phenotype by deleting the ACE2 gene in C. auris and determined the fungal colonization and host immune response using an intradermal mouse model of C. auris skin infection. Our results indicate that mice infected with ace2Δ strain had significantly lower fungal load after 3 and 14 days post-infections compared to the non-aggregative wild-type and the ACE2 reintegrated strain. The colonization of ace2Δ is associated with increased recruitment of CD11b+ Ly6G+ neutrophils and decreased accumulation of CD11b+ Ly6 Chi inflammatory monocytes and CD11b+ MHCII+ CD64+ macrophages. Furthermore, Th17 cells and type 3 innate lymphoid cells (ILCs) were significantly increased in the skin tissue of ace2Δ infected mice. Our findings suggest that aggregative phenotype mediated by ACE2 deletion in C. auris induces potent neutrophil and IL-17-mediated immune response and reduces fungal colonization in the skin.IMPORTANCEC. auris is a rapidly emerging fungal pathogen that can colonize hospitalized patients, especially in skin tissue, and cause invasive infections. C. auris isolates exhibit morphological heterogeneity, and the multicellular aggregative phenotype of C. auris is reported frequently in clinical settings. Understanding the role of fungal morphotypes in colonization, persistence, and immune response in the skin microenvironment will have potential applications in clinical diagnosis and novel preventive and therapeutic measures. Here, we utilized the murine model of intradermal infection and determined that the aggregative phenotype of C. auris as the result of ACE2 gene deletion elicits potential innate and adaptive immune responses in mice. These observations will help explain the differences in the skin colonization and immune responses of the aggregative morphotype of C. auris and open the door to developing novel antifungal therapeutics.

Vascular occlusion for optimising the functional improvement in patients with knee osteoarthritis: a randomised controlled trial.

Knee osteoarthritis (KOA) is a leading cause of global disability with conventional exercise yielding only modest improvements. Here we aimed to investigate the benefits of integrating blood flow restriction (BFR) into traditional exercise programmes to enhance treatment outcomes. The Vascular Occlusion for optimizing the Functional Improvement in patients with Knee Osteoarthritis randomised controlled trial enrolled 120 patients with KOA at Ghent University Hospital, randomly assigning them to either a traditional exercise programme or a BFR-enhanced programme over 24 sessions in 12 weeks. Assessments were conducted at baseline, 6 weeks, 12 weeks and 3 months postintervention using linear mixed models with Dunn-Sidak corrections for multiple comparisons. Primary outcome was the Knee injury and Osteoarthritis Outcome Score (KOOS) questionnaire at 3 months follow-up with knee strength, Pain Catastrophizing Scale questionnaire and functional tests as secondary outcomes. Analysis followed an intention-to-treat approach (NCT04996680). The BFR group showed greater improvements in KOOS pain subscale (effect size (ES)=0.58; p=0.0009), quadriceps strength (ES=0.81; p<0.0001) and functional tests compared with the control group at 12 weeks. At 3 months follow-up, the BFR group continued to exhibit superior improvements in KOOS pain (ES=0.55; p=0.0008), symptoms (ES=0.59; p=0.0004) and quality of life (QoL) (ES=0.66; p=0.0001) with sustained benefits in secondary outcomes. Drop-out rates were similar in both groups. Incorporating BFR into traditional exercise programmes significantly enhances short-term and long-term outcomes for patients with KOA demonstrating persistent improvements in pain, symptoms, QoL and functional measures compared with conventional exercise alone. These findings suggest that BFR can provide the metabolic stimulus needed to achieve muscle strength and functional gains with lower mechanical loads. Reduced pain and increased strength support a more active lifestyle, potentially maintaining muscle mass, functionality and QoL even beyond the supervised intervention period. NCT04996680.

Fatigue cracking prediction of cobblestone interlayer pavement using non-destructive testing and mechanistic-empirical analyses

Several non-destructive testing (NTD) methods have been used to measure surface deflection, which makes to determine the elastic moduli of pavement layers through the back-calculation process and assess the structural capacity of asphalt pavements. In this study was evaluated the back-calculated moduli of the cobblestone interlayer pavements and the load capacity of this type of pavement related to the fatigue cracking criterion based on a mechanistic-empirical analysis. The employed methodology included the performance of on-site trials using non-destructive testing with the Falling Weight Deflectometer (FWD) devices on 84 test points in granular and cobblestone interlayer pavements, determination of deflection basin parameters (DBP), back-calculation layers’ moduli, and estimate of the fatigue cracking performance of the pavements by mechanistic-empirical analyses in MeDiNa software. The pavements with a cobblestone base layer displayed greater deflection measurements on the load application point compared to those measured on pavements with a granular base layer, indicating that conventional pavement displayed more stiffness. Cobblestone interlayer pavement displayed greater amounts of cracked area compared to granular base layer pavements showing lower load capacity based on the fatigue criterion. The DBP-based method by FWD test was able to identify the structural differences between the layers of pavements evaluated and identify the cracking evolution.

Performance assessment of direct injection stoichiometric and lean burn compressed natural gas engine over port fuel gasoline and compressed natural gas engine

ABSTRACT A direct injection (DI) CNG engine was developed and evaluated under stoichiometric and lean burn conditions, emphasising high compression ratios (CRs). A comparative analysis of PFI gasoline and PFI CNG engines was conducted to provide comprehensive insights. Results showed that the DI CNG engine exhibited a shorter combustion duration, indicating higher combustion speed, and enhanced combustion stability, particularly at low load and speed conditions, with a reduced coefficient of variation of indicated mean effective pressure (COVIMEP) below 1%. The DI CNG engine demonstrated a relative increase in net indicated thermal efficiency by 4–5% compared to the PFI CNG engine. Furthermore, CNG engines operating at a high compression ratio of 16 could run at high loads without encountering knocking issues. Lean burn operation, combined with high compression ratios, improved thermal efficiency while minimising emissions; however, challenges such as combustion instability and increased emissions under lean burn conditions were observed.

High Oxygen Reduction Efficiency and Durability of Nano-Honeycomb Pt3(NiFeCo) Replenished by High-Entropy Metallic Glass Support.

Developing low-Pt oxygen reduction reaction (ORR) catalysts with high efficiency and robustness is critical for practical fuel cells. The most advanced ORR catalysts either feature high percentages of Pt (>70 at.%) or exhibit poor durability when reducing Pt loading. Herein, a multicomponent solid-solution Pt3(FeCoNi) honeycomb nano-framework supported by the specially designed high-entropy metallic glass (MG) is reported for efficient ORR. This hybrid catalyst with a low surface Pt loading of 5.79µgcm-2 displays exceptional mass and specific activities of 7.02Amgpt -1 and 8.15mAcmPt -2 at 0.9V, respectively, which are ≈15 and 22 times higher compared with commercial Pt/C. The analyses reveal the weakened chemisorption of oxygenated species, which is induced by the strong strain and ligand effects originating from the synergistic multicomponent alloying. This in turn enhances the intrinsic ORR activity. Moreover, benefiting from a unique replenishment behavior, the hybrid catalyst delivers ultra-high durability with negligible activity decay even after 50 000 potential cycles. This mechanism is achieved by sacrificing the interior MG supplementary support to dynamically compensate for the loss of catalytically active surface. The work provides an alternative way to design more efficient and durable low-Pt electrocatalysts for electrochemical devices.

Polyalkenamers as Drop-In Additives for Ring-Opening Metathesis Polymerization: A Promising Upcycling Paradigm.

We report a distinct strategy to upcycle waste polyalkenamers such as polybutadiene into new, performance-advantaged materials by using them as drop-in additives for ring-opening metathesis polymerization (ROMP). The polyalkenamers serve as competent chain-transfer agents in ROMPs of common classes of cyclic olefin monomers, facilitating good molecular weight control, allowing low Ru catalyst loadings, and enabling efficient incorporation of the polyalkenamer into the synthesized polymeric material. We successfully demonstrate ROMP using model polyalkenamers and translate these learnings to leverage commercial polybutadiene and acrylonitrile butadiene styrene (ABS) as chain transfer agents for ROMP copolymerizations. Critically, our strategy is shown to be highly efficient and operationally simple, quantitatively incorporating the polyalkenamer and inheriting aspects of its thermomechanical performance. Our results highlight a promising pathway for the upcycling of polyalkenamers and provide an alternative to existing deconstruction and functional upcycling strategies.

Analytical and Experimental Study of the Start of the Chip Removal in Rotational Turning

The present challenges in the automotive industry require the development and practical implication of novel machining procedures, which will provide appropriate solutions. These procedures should still meet the requirements of productivity, surface quality and energy efficiency. The further development of novel machining procedures introduces new problems that did not occur (or occurred to a lesser extent) with traditionally applied procedures. Rotational turning has come to the attention of production engineers in the previous decade since it can be used to machine ground-like surfaces in an ecologically friendly and highly productive manner. However, the chip removal characteristic is slightly different from traditional turning due to the applied special kinematic relation and complex tool edge geometry. The run-in phase will take longer, which is the time period between the first contact of the tool and the formation of a constant chip cross-sectional area. The clarification of the chip formation is important in any machining procedure. To achieve this goal, the geometric parameters of the chip must be determined. Since the start of the chip removal is a crucial stage in rotational turning due to its length, the chip height, chip width and the cross-sectional area of the chip should be separately defined in the initial stage. Therefore, in this paper, the initial phase of chip removal in rotational turning is studied. The increasing cross-sectional area of the chip is determined analytically by the application of the previously elaborated equation of the cut surface. Calculating formulas are defined for the different stages of the start of the chip removal, which could be used in the forthcoming studies to analyze the chip formation. The effects of different determining parameters are analyzed theoretically by the deduced formulas of the run-in phase and practical experiments are also carried out. The analytical and experimental analyses showed that increasing feed also increases the dynamic load on the cutting edge, while the depth of cut lowers the growth of the characteristic parameters of the chip, which results in a lower dynamic load on the tool.

Understanding the Morphology and Cross‐Link Density in Silicone Rubber‐Multiwalled Carbon Nanotube Composites via Solvent Transport Studies

ABSTRACTThe diffusion characteristics of silicone rubber‐based nanocomposites have not been extensively studied in the literature. This study aims to provide a comprehensive analysis of the solvent transport properties of these materials, incorporating detailed dissolution modeling. This study reported a novel approach to elucidate the morphological and diffusion characteristics of silicone rubber‐MWCNT (multiwalled carbon nanotube) composites. FESEM micrograph analysis reveals structural changes with the lower loadings forming continuous networks and higher loadings leading to agglomeration of the fillers. Diffusion studies highlight reduced solvent uptake over time due to compact physical networks, while Kraus plot analysis confirms MWCNTs' reinforcing ability. Dissolution modeling using Korsmeyer–Peppas and Peppas–Sahlin models indicates the type of solvent release behavior, with the latter offering a superior fit. Mode of transport analysis suggests a less Fickian mode influenced by MWCNT loading, while swelling parameters demonstrate hindered solvent transport with increasing MWCNT content. The molecular mass between successive cross‐links and the cross‐link density decreases with rising MWCNT loading, which is theoretically predicted by the affine model. This study also focused on the complex interplay between filler loading, composite structure, and solvent transport behavior in silicone rubber‐MWCNTs composites, offering valuable insights for their potential applications in various fields.

Revised Hospital Survey on Patient Safety Culture (HSOPSC 2.0): cultural adaptation, validity and reliability of the Malay version

BackgroundSurveys on Patient Safety Culture™ Hospital Survey (HSOPSC) developed by the U.S. Agency for Healthcare Research and Quality (AHRQ) has been adopted worldwide. The Hospital Survey on Patient Safety Culture (HSOPSC) version 2.0 was released in 2019, but there have been no publications to date of its translation and validation for use in Malaysia. This study aimed to translate and cross-culturally adapt the revised HSOPSC 2.0 into the Malay language and determine its psychometric properties including the content, face, and construct validity, and reliability analyses.MethodsThis study was conducted from April – June 2023 and divided into three stages: translation and cultural adaptation; content and face validation; and construct validation using confirmatory factor analysis and reliability testing among 319 healthcare personnel from a public university hospital in Malaysia.ResultsThe translated instrument demonstrated excellent content validity (I-CVI = 0.80 ~ 1.0, SCVI-average = 0.96) and face validity (I-FVI = 0.80 ~ 1.0, SFVI-average = 0.98). Reliability testing was acceptable (Cronbach’s α = 0.60 ~ 0.80) but indicated that reverse-coded items were poorly perceived. Confirmatory factor analysis showed a satisfactory model fit for the translated instrument (RMSEA = 0.08, GFI = 0.80, CFI = 0.80, and χ2/df = 2.96). Six items had very low factor loadings (< 0.40), with two constructs “Staffing and Work Pace” and “Response to Error” having AVE < 0.4, but acceptable CR ≥ 0.6. No items were removed from the questionnaire despite low factor loadings following a consensus from an expert panel.ConclusionThe Malay version of the HSOPSC 2.0 containing ten domains and 32 items demonstrated satisfactory psychometric properties following expert consensus, with acceptable reliability and construct validity for measuring patient safety culture. Given factor loadings smaller than 0.40 in six items, broader validation is suggested to support the use of the translated instrument in the Malaysian healthcare setting.

Rethinking max-min planning on energy-efficient software-defined networking for 5G networks.

Energy efficiency plays an important role in intelligent networking for 5G networks, which concerns environmental, financial, and performance aspects of intelligent networking for 5G networks. To this end, network designers propose energy-efficient approaches to reduce energy consumption of networks and to raise network performance by switching off the links/nodes with low loads or at idle status. The existing energy-efficient approaches can be formulated as a max-min optimal problem, namely maximizing network/node/port throughput via minimum energy consumption. The max-min planning investigates energy efficiency only from the links/nodes perspective. The max-min planning for energy-efficient networking, if not carefully designed from the network-wide standpoint, can lead to lower energy efficiency for the whole network due to lack of global planning, which in turn results in the degraded performance due to network un-connectivity after closing the nodes/links. In this paper we rethink the max-min planning framework on energy-efficient software-defined networking for intelligent networking of 5G networks, which takes in account combining network connectivity and maximum network flow with minimum energy consumption. Our framework aims at how to deliver dynamic end-to-end traffic demands with the appropriate network topology by building data forwarding plane with maximum network flow and control plane with network connectivity. We discuss the associated challenges and implementation issues. A dynamic max-min planning framework depending on dynamic end-to-end traffic demands is presented to achieve network-wide energy efficiency. Numerical results show the improved energy efficiency performance for the whole network.

Validity of Force and Power Measures from an Integrated Rotary Encoder in a HandyGym Portable Flywheel Exercise Device

Introduction: This study aimed to evaluate the validity of the HandyGym portable flywheel device with an integrated rotary encoder in measuring force and power during iso-inertial exercises compared to a traditional reference system. Methods: In total, 10 trained volunteers (3 women, 7 men; age 25.2 ± 3.8 years) performed half-squats with five different load configurations using the HandyGym device. Concurrent measurements were obtained from HandyGym’s rotary encoder and a criterion system (MuscleLab 6000 strain gauge and linear encoder). Five load configurations were tested, with 15 repetitions recorded per condition. The validity of the HandyGym measurements was assessed through mean bias, typical error of estimation (TEE), and Pearson correlation coefficients, with Bland–Altman plots used to analyze the agreement between the two systems. Results: The HandyGym showed high correlations with the reference system for both force (r = 0.76–0.90) and power (r = 0.60–0.94). However, systematic biases were observed, with the HandyGym consistently underestimating force and power at lower loads and overestimating power at higher loads. The TEE values indicated moderate to large errors, particularly in power measurements. Conclusion: The HandyGym provides valid force measurements with moderate bias, suitable for general monitoring. However, power measurements are less consistent, especially at higher loads, limiting the device’s utility for precise assessments. Adjustments or corrections may be necessary for accurate application in professional contexts.

Predictors of ventricular and atrial feature tracking-derived global longitudinal strain in healthy athletes and volunteers

Abstract Background Feature tracking (FT) strain analysis provides insights into the mechanics of the heart and carries essential prognostic and diagnostic information without prolonging image acquisition during cardiac magnetic resonance (CMR) scans. However, data regarding CMR-derived FT strain in athletes is scarce, especially in the atria. We explored the determinants of FT global longitudinal strain (GLS) values concerning all four cardiac chambers in healthy competitive athletes and less active volunteers. Methods Long- and short-axis cine sequences were analyzed with Medis Suite v4.0 (Leiden, The Netherlands) to assess FT strain. After excluding individuals with preexisting pathologies and images with quality issues, subjects were classified by sport types following the 2020 ESC Sports Cardiology Guidelines. Multiple linear regression models were constructed to assess the impact of age, sex (male=0, female=1), weekly training hours, and sports category (power coded as 0, mixed as 1, endurance as 2) on GLS values. Atrial strain values are positive, and ventricular ones are negative. Intercepts/constants are denoted as "baseline" for easier comprehension. Results Native CMR scans acquired at a tertiary cardiac centre of 596 healthy Caucasian subjects (411 athletes: 145 females, mean age 21±6, range 14-36 years; and 185 volunteers: 86 females, mean age 24±5, range 13-35 years) were included. Athletes had a high exercise load versus the controls who performed no or maximum recreational physical activity (19±7 vs. 3±2 hours/week, p&amp;lt;.001). When assessing athletes (weekly training≥6h), RA GLS (baseline: 34%, p&amp;lt;.001) is increased in females (β=2.0) but is expected to decrease with every one-hour increase in training hours (β=-0.2). LA GLS is notably affected by sex alone (baseline: 37%, β=3.6, p&amp;lt;.001), suggesting markedly higher values for females. RV GLS (baseline: -30%, p&amp;lt;.001) is associated with both age and training hours (β=0.1 for each), making it less negative. Conversely, LV GLS (baseline: -25%, p&amp;lt;.0001) is significantly modulated by all studied factors, with sports category (β=0.5), age, and training hours (β=0.1 each) increasing values and sex decreasing them (β=-0.9). In less active volunteers (weekly training&amp;lt;6h), sex (β=4.7) is the only significant factor for RA GLS (baseline: 33%, p=.04), and sports category (β=2.7, the group included 98 recreational athletes with low training loads) for LA GLS (baseline: 38%, p=.04). No variables were retained in the model for RV GLS, but sex (β=-1.4) remained a predictor in the LV GLS model (baseline: -21%, p=.002). Conclusion GLS shows significant variations influenced by age, sex, sports category, and training hours across all four heart chambers in athletes. These effects appear mostly inconclusive among less active individuals. This data calls for further advanced analyses of athlete's hearts to refine differentiation methods between healthy adaptation and cardiac pathologies.Left atrial FT analysisModel outputs for GLS predictions

Harnessing the Synergistic Interplay between Atomic-Scale Vacancies and Ligand Effect to Optimize the Oxygen Reduction Activity and Tolerance Performance.

Defect engineering is an effective strategy for regulating the electrocatalysis of nanomaterials, yet it is seldom considered for modulating Pt-based electrocatalysts for the oxygen reduction reaction (ORR). In this study, we designed Ni-doped vacancy-rich Pt nanoparticles anchored on nitrogen-doped graphene (Vac-NiPt NPs/NG) with a low Pt loading of 3.5 wt . % and a Ni/Pt ratio of 0.038 : 1. Physical characterizations confirmed the presence of abundant atomic-scale vacancies in the Pt NPs induces long-range lattice distortions, and the Ni dopant generates a ligand effect resulting in electronic transfer from Ni to Pt. Experimental results and theoretical calculations indicated that atomic-scale vacancies mainly contributed the tolerance performances towards CO and CH3OH, the ligand effect derived from a tiny of Ni dopant accelerated the transformation from *O to *OH species, thereby improved the ORR activity without compromising the tolerance capabilities. Benefiting from the synergistic interplay between atomic-scale vacancies and ligand effect, as-prepared Vac-NiPt NPs/NG exhibited improved ORR activity, sufficient tolerance capabilities, and excellent durability. This study offers a new avenue for modulating the electrocatalytic activity of metal-based nanomaterials.

Facial and dental arch shape in individuals with different bite force levels : A pilot study using geometric morphometrics.

This pilot study aimed to assess the relationship between bite force variation and dental arch and facial shape using geometric morphometrics, an advanced method of statistical analysis that provides adetailed shape analysis of astructure considering the spatial relationship of its parts. The sample consisted of 16German adult men and women. For each individual, maximum bite force was recorded in four positions: maximum intercuspation, protrusion, laterotrusion to the right and to the left. Facial and three-dimensional (3D) dental reconstructions were obtained from 3D facial photographs and 3D scans of dental stone models. Atotal of 51landmarks were placed. General shape variation was assessed by principal component analysis. Partial least squares analyses were performed to evaluate the covariation between bite force, facial shape, and dental shape. There was no clear pattern or statistically significant covariation between our variables. Our results suggest aweak relationship between bite force, dental arch, and facial shape. Considering previous work in this field, we propose that low masticatory loads, characteristic in Western urban populations, may explain this. Further studies should, therefore, address this issue, taking into account effect size, the mechanical properties of the diet, and other relevant variables.

Fusion of Hydrophobic Anchor Peptides Promotes the Hydrolytic Activity of PETase but not the Extent of PET Depolymerization

Enzymatic recycling of polyethylene terephthalate (PET) has attracted significant attention in recent years. While the fusion of anchor peptides to PET hydrolases is believed to enhance PET hydrolytic activity, a quantitative analysis is yet lacking. Here, we construct four fusion enzymes by fusing anchor peptides (including hydrophobic LCI, LCIM1 and TA2, and hydrophilic EK4) to the C terminus of HotPETase, one of the most active PET hydrolases for high‐crystallinity PET (HC‐PET). Single‐molecule force spectroscopy (SMFS) demonstrates that hydrophobic anchor peptides promote adhesive interactions between the fusion enzymes and the PET surface. This is also validated by the adsorption kinetics and isotherms, and the saturated adsorption capacity remains unaltered compare to HotPETase. At low substrate loadings, the apparent hydrolytic activity of these fusion enzymes is positively related to the hydrophobicity of the anchor peptides. Among them, HotPETase‐LCI stands out as the most effective enzyme for HC‐PET degradation, demonstrating a 1.5‐fold increase in hydrolytic activity. At high substrate loadings, the advantages of fusion with anchor peptides diminish. We conclude that fusion enzymes only facilitate the hydrolytic rates of HC‐PET but have little effect on the final conversion extent.

Low HIV Viral Load Suppression and Its Implications for Controlling HIV among Refugee Adolescents and Youth Living in Refugee Settlements in Uganda: A Cross-sectional Analysis.

Viral load suppression (VLS) is considered crucial in the global efforts to end the HIV/AIDS pandemic and young people lag behind adults in this important indicator. However, little is known about VLS among refugee adolescents and youth (RAY), a vulnerable group, often ignored by research, with multiple intersecting risk factors and unique challenges. The goal of this study was to determine the prevalence of VLS and examine associated risk and protective factors among RAY in refugee settlements in Uganda, a country severely affected by the HIV/AIDS pandemic and currently hosting the most refugees in sub-Saharan Africa (SSA). We analyzed cross-sectional data from a pilot cluster randomized trial with 180 participants (ages 13-30) recruited from 20 health centers in three refugee settlements between July and December 2023. We employed a hierarchical (mixed-effects) logistic regression model to examine the association between selected demographic, psychosocial, and economic factors and VLS. The prevalence of VLS among RAY was very low at just 52%. Factors associated with VLS included financial stability, adherence self-efficacy, and HIV status disclosure. Having financial savings was associated with VLS (adjusted odds ratio:2.68; 95% CI: 1.48-5.11; p = 0.003). Treatment support from others including teachers and health care providers had five-fold odds of VLS (5.0, 1.64-15.24; p = 0.005). Conversely, older age and interactions between stigma/self-efficacy and stigma/HIV status disclosure were associated with viral load non-suppression. This study highlights the urgent need for tailored interventions targeting economic and psychosocial hardships like poverty, stigma, and food insecurity to enhance HIV VLS and other treatment outcomes among RAY.

CULTURAL adaptation and validation of the Indonesian version of the Roland-Morris disability questionnaire: A psychometric analysis

BACKGROUND: Epidemiological evidence underscores low back pain (LBP) as a prevalent and consequential musculoskeletal disorder, posing a significant public health challenge. Patient-reported outcome measures (PROMs) play a crucial role in the diagnostic process for LBP, with the Roland-Morris Disability Questionnaire (RMDQ) being a commonly utilized tool in evaluating LBP. OBJECTIVE: This cross-sectional study aimed to cross-culturally adapt and validate the Indonesian version of the 24-item-RMDQ among nonspecific LBP (NSLBP) patients. METHODS: The RMDQ scales underwent forward-backwards translation, readability, and content validity assessments with NSLBP patients (n = 137), with a mean age of 38.6±11.8 years (59% female). Psychometric testing included assessments of internal consistency and 1-week test-retest reliability, convergent validity with pain numeric rating scale (PNRS), and the Physical Component Summary (PCS) and Mental Component Summary (MCS) of quality of life (Short Form 12). The construct validity using confirmatory factor analyses (CFA). RESULTS: The findings of this study indicated a good internal consistency (Cronbach α= 0.80) of the translated instrument. Moderate to good repeatability estimates of all RMDQ items were demonstrated with the total ICC of the total RMDQ score of 0.90 [95%CI (0.85–0.94)]. The instrument correlations with PNRS, PCS, and MCS were 0.54, 0.60, and 0.23, respectively. The goodness-of-fit test further affirmed an acceptable fit of the data, although low factor loadings were found in several RMDQ items. CONCLUSION: Although the factor structure of the RMDQ scale warrants further investigation, the overall findings support its suitability for clinical application in Indonesian NSLBP patients.

Harnessing the Synergistic Interplay between Atomic‐Scale Vacancies and Ligand Effect to Optimize the Oxygen Reduction Activity and Tolerance Performance

AbstractDefect engineering is an effective strategy for regulating the electrocatalysis of nanomaterials, yet it is seldom considered for modulating Pt‐based electrocatalysts for the oxygen reduction reaction (ORR). In this study, we designed Ni‐doped vacancy‐rich Pt nanoparticles anchored on nitrogen‐doped graphene (Vac‐NiPt NPs/NG) with a low Pt loading of 3.5 wt . % and a Ni/Pt ratio of 0.038 : 1. Physical characterizations confirmed the presence of abundant atomic‐scale vacancies in the Pt NPs induces long‐range lattice distortions, and the Ni dopant generates a ligand effect resulting in electronic transfer from Ni to Pt. Experimental results and theoretical calculations indicated that atomic‐scale vacancies mainly contributed the tolerance performances towards CO and CH3OH, the ligand effect derived from a tiny of Ni dopant accelerated the transformation from *O to *OH species, thereby improved the ORR activity without compromising the tolerance capabilities. Benefiting from the synergistic interplay between atomic‐scale vacancies and ligand effect, as‐prepared Vac‐NiPt NPs/NG exhibited improved ORR activity, sufficient tolerance capabilities, and excellent durability. This study offers a new avenue for modulating the electrocatalytic activity of metal‐based nanomaterials.

How to measure the general Environmental Health Literacy

Abstract Background Many environmental factors, both natural or man-made, are associated with health risks. To make informed decisions about these potential risks, certain skills and competencies are necessary. The concept of Environmental Health Literacy (EHL) which integrates aspects of Science Literacy, Health Literacy and Environmental Literacy encompasse these competencies. To assess to what extent individuals or groups are environmental health literate, a general Environmental Health Literacy Scale is necessary. To the best of our knowledge, there is no validated instrument to measure general EHL. Methods Two phases of scale construction were conducted: 1) Item development with deductive methods which includes a literature review and assessment of existing scales resulting in two suitable studies for scale construction. Included items were translated to German language. 2) Scale development with pre-testing of items followed by applying potential items (n = 38) to a sample of of 454 students. Internal consistency (Cronbach’s alpha), Kaiser-Meyer-Olkin Criterion (KMO), Bartlett’s test, Velicer’s minimum average partial (MAP) test for number of underlying factors and Exploratory Factor Analysis using Principal Component Analysis with oblimin rotation and stepwise item reduction were assessed. Results Velicer’s MAP identified 3 factors, Cronbach’s alpha = .92, KMO = .92, Bartlett’s Test revealed significant correlation. Seven items were removed from the scale due to low factor loadings (&amp;lt; .3). Factor 1 (access) explains 18% of variance, factor 2 (knowledge) 12% and factor 3 (reflection) 10%, respectively. Overall, the model explains 40% of variance. Model fit represented by RMSEA index = .05. Conclusions A new general EHL scale has been developed and proven to be suitable for a students sample. This marks the first step towards a validated tool for multiple purposes. Cultural adaptation as well as multiple language validations are in process. Key messages • The process towards a general Environmental Health Scale has started. • The development of a validated EHL scale will improve understanding on whether the general population or subgroups are able to gain, understand and act upon information regarding environmental health.