Active Measures Research Articles

TMS-induced plasticity improving cognitive control in OCD II: Task-based neural predictors of treatment response

ObjectiveRepetitive transcranial magnetic stimulation (rTMS) has the potential to increase the clinical effect of exposure with response prevention (ERP) psychotherapy for obsessive-compulsive disorder (OCD). We investigated the use of task-based functional MRI (tb-fMRI) for predicting clinical outcomes to different rTMS protocols combined with ERP in OCD. Method61 adults with OCD underwent rTMS and ERP and were randomized to different high frequency rTMS conditions: left dorsolateral prefrontal cortex (DLPFC; n=19), left pre-supplementary motor area (preSMA; n=23), and control stimulation at the vertex at low intensity (n=19). The Tower of London task and Stop-Signal Task were used to assess pretreatment activation during planning and inhibitory control, respectively. We adopted a Bayesian region-based approach to test whether clinical improvement can be predicted by tb-fMRI-derived measures of task-related brain activation or functional connectivity between task-relevant regions and the bilateral amygdala. ResultsFor the vertex group, but not the DLPFC/preSMA rTMS conditions, higher activation in several task-relevant regions during planning and response inhibition, and lower error-related activation, corresponded with better short-term clinical improvement. Lower precuneus activation with increased planning taskload correlated with symptom reduction in the DLPFC group. In the preSMA group, higher error-related activation and lower inhibition-related insular-amygdalar connectivity was associated with symptom reduction. ConclusionsPretreatment tb-fMRI-derived measures of activation and connectivity during planning and inhibition-related processes are associated with clinical response for specific rTMS conditions in OCD. Future placebo-controlled trials with larger sample sizes should combine clinical information and neural correlates to improve prediction of clinical outcome.

High repetition-rate 0.5 Hz broadband neutron source driven by the Advanced Laser Light Source

Neutron beams are an essential tool to investigate material structure and perform nondestructive analysis, as they give unique access to element composition, thus ideally complementing density analysis allowed by standard x-rays investigation. Laser-driven neutron sources, though compact and cost-effective, currently have lower average flux than conventional neutron sources, due to the limited repetition rate of the lasers used so far. However, advancements in laser technology allow nowadays to address this challenge. Here, we report results obtained at the Advanced Laser Light Source characterizing stable production of broadband (0.1–2 MeV) neutrons produced at a high repetition rate (0.5 Hz). The interaction of laser pulses of 22 fs duration and 3.2 J on-target energy with 2-μm-thick tantalum targets produced protons in the Target Normal Sheath Acceleration (TNSA) regime up to 7.3 MeV. These protons were subsequently converted into neutrons by (p,n) reactions in lithium fluoride (LiF). Activation measurements and bubble detectors were used to characterize neutron emissions, with a neutron fluence of up to ∼1.4×105 neutrons/shot/sr and energies mainly between a few hundred of kilo-electron volt and 2 MeV. The total neutron yield was ∼5×105 neutrons/shot. This paves the way for numerous applications, e.g., in homeland security, materials science, or cultural heritage.

Associations Between Neuropsychiatric Symptoms and Inflammation in Neurodegenerative Dementia: A Systematic Review.

Neuropsychiatric symptoms are common in dementia and linked to adverse outcomes. Inflammation is increasingly recognized as playing a role as a driver of early disease progression in Alzheimer's disease (AD) and related dementias. Inflammation has also been linked to primary psychiatric disorders, however its association with neuropsychiatric symptoms in neurodegenerative dementias remains uncertain. We conducted a systematic literature review investigating associations between inflammation and neuropsychiatric symptoms in neurodegenerative dementias, including AD, Lewy body, Frontotemporal, Parkinson's (PD) and Huntington's disease dementias. Ninety-nine studies met our inclusion criteria, and the majority (n = 59) investigated AD and/or mild cognitive impairment (MCI). Thirty-five studies included PD, and only 6 investigated non-AD dementias. Inflammation was measured in blood, CSF, by genotype, brain tissue and PET imaging. Overall, studies exhibited considerable heterogeneity and evidence for specific inflammatory markers was inconsistent, with lack of replication and few longitudinal studies with repeat biomarkers. Depression was the most frequently investigated symptom. In AD, some studies reported increases in peripheral IL-6, TNF-a associated with depressive symptoms. Preliminary investigations using PET measures of microglial activation found an association with agitation. In PD, studies reported positive associations between TNF-a, IL-6, CRP, MCP-1, IL-10 and depression. Central and peripheral inflammation may play a role in neuropsychiatric symptoms in neurodegenerative dementias; however, the evidence is inconsistent. There is a need for multi-site longitudinal studies with detailed assessments of neuropsychiatric symptoms combined with replicable peripheral and central markers of inflammation.

Effect of optimizing cerebral oxygen saturation on postoperative delirium in older patients undergoing one-lung ventilation for thoracoscopic surgery.

This randomized controlled trial investigated whether the regional cerebral oxygenation saturation (rScO2)-guided lung-protective ventilation strategy could improve brain oxygen and reduce the incidence of postoperative delirium (POD) in patients older than 65 years. This randomized controlled trial enrolled 120 patients undergoing thoracic surgery who received one-lung ventilation (OLV). Patients were randomly assigned to the lung-protective ventilation group (PV group) or rScO2-oriented lung-protective ventilation group (TPV group). rScO2 was recorded during the surgery, and the occurrence of POD was assessed. The incidence of POD 3 days after surgery-the primary outcome-was significantly lower in the TPV group (23.3% versus 8.5%). Meanwhile, the levels of POD-related biological indicators (S100β, neuron-specific enolase, tumor necrosis factor-α) were lower in the TPV group. Considering the secondary outcomes, both groups exhibited a lower oxygenation index after OLV, whereas partial pressure of carbon dioxide and mean arterial pressure were significantly increased in the TPV group. In addition, minimum rScO2 during surgery and mean rScO2 were higher in the TPV group than in the PV group. Continuous intraoperative monitoring of brain tissue oxygenation and active intervention measures guided by cerebral oxygen saturation are critical for improving brain metabolism and reducing the risk of POD.

Fake Base Station Detection and Link Routing Defense

Fake base stations comprise a critical security issue in mobile networking. A fake base station exploits vulnerabilities in the broadcast message announcing a base station’s presence, which is called SIB1 in 4G LTE and 5G NR, to get user equipment to connect to the fake base station. Once connected, the fake base station can deprive the user of connectivity and access to the Internet/cloud. We discovered that a fake base station can disable the victim user equipment’s connectivity for an indefinite period of time, which we validated using our threat prototype against current 4G/5G practices. We designed and built a defense scheme which detects and blacklists a fake base station and then, informed by the detection, avoids it through link routing for connectivity availability. For detection and blacklisting, our scheme uses the real-time information of both the time duration and the number of request transmissions, the features of which are directly impacted by the fake base station’s threat and which have not been studied in previous research. Upon detection, our scheme takes an active measure called link routing, which is a novel concept in mobile/4G/5G networking, where the user equipment routes the connectivity request to another base station. To defend against a Sybil-capable fake base station, we use a history–reputation-based link routing scheme for routing and base station selection. We implemented both the base station and the user on software-defined radios using open-source 5G software (srsRAN v23.10 and Open5GS v2.6.6) for validation. We varied the base station implementation to simulate legitimate vs. faulty but legitimate vs. fake and malicious base stations, where a faulty base station notifies the user of the connectivity disruption and releases the session, while a fake base station continues to hold the session. We empirically analyzed the detection and identification thresholds, which vary with the fake base station’s power and the channel condition. By strategically selecting the threshold parameters, our scheme provides zero errors, including zero false positives, to avoid blacklisting a temporarily faulty base station that cannot provide connectivity at the time. Furthermore, our link routing scheme enables the base station to switch in order to restore the connectivity availability and limit the threat impact. We also discuss future directions to facilitate and encourage R&D in securing telecommunications and base station security.

Features of Ukrainian cultural sphere adaptation to the conditions of the Russo-Ukrainian War (based on data of UCF survey)

Since the problems of the Ukrainian cultural sphere in the context of war are usually studied in relation to consumers of cultural products, the article emphasizes the expediency of studying the state of culture from the point of view of its direct creators. Using the author’s methodology and on the basis of empirical study, the article highlights the peculiarities of the Ukrainian cultural organizations and cultural figures’ adaptation to the сrisis provoked by russia’s armed aggression. The key factors of cultural organizations and creative industries’ successful adaptation to the war conditions are identified. The survival strategy of cultural workers and institutions can be described as cost savings, along with maintaining activities, creating new products and services, and taking active measures to attract additional funding. It is concluded that adaptation does not always take active forms and is not necessarily associated with positive changes in the organization. Often, adaptability is only the result of passive adaptation to the conditions of war. Special attention is paid to the analysis of changes in the level of adaptability of cultural organizations in the dynamics (from November 2022 to December 2023). Despite the fact that the adaptability index tends to increase in comparison with 2022, there is an increase in neutral assessments of the prospects of their organizations and a decrease in positive expectations among respondents. Based on the respondents’ answers, matrices of motivational and demotivational factors of adaptability were constructed. This allowed us to distinguish adapted and non-adapted organizations and workers and the primary obstacles to adaptation. The results of the study show that cultural institutions need support from the state but the specifics of the request depend on the legal form of the organizations. Groups with high and low levels of adaptability were identified, which requires the development of additional support programs for vulnerable cultural organizations and cultural figures.

Retrieving Yang–Mills–Higgs fields in Minkowski space from active local measurements

Retrieving Yang–Mills–Higgs fields in Minkowski space from active local measurements

Does patient activation matter? An examination of the relationships between patient activation and healthcare use in older adults with mild frailty after discharge from an emergency department.

ObjectivePatient engagement, as measured by the Patient Activation Measure (PAM®), has been used to assess patients' ability to manage their own care. This study aimed to determine whether the PAM® could predict healthcare use in older adults aged >70years, living independently in the community with mild frailty, within 30days after emergency department (ED) discharge.MethodsA prospective single-centre observational cohort study was completed including older adults who presented to an ED. The 13-item PAM® and selected International Consortium for Health Outcomes Measures were completed prior to ED discharge.ResultsTwo hundred patients were recruited with a mean age of 84.8years (s.d. 6.9). The mean PAM® score was 58.6 (s.d. 13.3), with 12.5% at Level 1 (n=25), 40% at Level 2 (n=80), 34.5% at Level 3 (n=69) and 13.0% at Level 4 (n=26). The PAM® level was significantly associated with ED presentations in the past 6months (P=0.030). The PAM® level did not predict healthcare use within 30days of discharge consisting of time until ED representation (P=0.557), number of ED representations (P=0.560), number of hospital admissions (P=0.499), length of stay in hospital (P=0.254) and number of post-discharge contacts (P=0.667).ConclusionsOverall, the PAM® did not predict prospective short-term healthcare use. However, the PAM® was significantly associated with 6-month previous ED use. With more than 50% of patients at Level 1 or 2, indicating lower capacity for self-management, tailored interventions are required to assist mildly frail patients to manage discharge care plans and engage in preventative strategies.

Multiple-charging effects on the CCN activity and hygroscopicity of surrogate black carbon particles

Accurate measurements of cloud condensation nuclei (CCN) activity and hygroscopicity of black carbon (BC)-containing particles are particularly important because of the positive climate forcing from these particles. Such measurements are typically conducted on particles selected by a Differential Mobility Analyzer (DMA), which in addition to singly charged particles transmits multiply charged larger particles that have the same electrical mobility. These larger particles activate at lower supersaturations than the singly charged particles, biasing measurements and resulting in overestimation of CCN activity and hygroscopicity parameter (κ). Here, we measure the CCN activity and determine κ for different BC surrogates with electrical mobility diameters from 100 to 200 nm selected 1) only by electrical mobility with a DMA, and 2) by both electrical mobility and mass using a DMA and a Centrifugal Particle Mass Analyzer (CPMA), thus allowing selection of only singly charged particles. We demonstrate the use of the DMA-CPMA system in resolving biases caused by multiply charged particles, and we show that the effect of multiple charging on the CCN activity of the BC particles is strongly influenced by morphology dispersion, i.e., the variability due to the range of morphologies of particles that have the same electrical mobility and mass. Our findings show that electrical mobility-based methods alone are unlikely to lead to accurate results in measurements of CCN activation and hygroscopicity of BC particles, even for those with a more compact morphology.

Analysis of Evolving Technologies and Impact of Smart Shipping on the Future Workforce in the Maritime Industry

Purpose: There is a shift in phase within the maritime industry toward smart shipping, where IoT and AI are used. The real question revolved around these technologies' impact on future employees in ships and shipping. The reason is to understand how this rapidly changing technological world affects these maritime professionals. Study design/methodology/approach: A systematic review was performed according to the system of Preferred Reporting Items for Systematic Reviews and Meta−Analyses (PRISMA). The literature review aimed at analysing a comprehensive spectrum from academic publications to industry reports and white papers in order… The Smart Shipping case studies were studied to provide practical knowledge on the integration of IoT and AI in maritime operations. Findings: The resulting analysis was a diverse and changing technological environment, including blockchain, AI, IoT, autonomous vessels, and innovations that are driven by sustainability. The use of blockchain applications allows for achieving increased transparency, while AI-based developments bring improvements in navigation, logistics and maintenance. The introduction of IoT allows industries to transform via the collection of data in real time. Autonomous vessels offer both challenges and opportunities designed to impact seafaring jobs. Sustainability innovations aim at clean energies and more ecological applications. Smart Shipping case studies demonstrated various positive outcomes on the deployment of IoT and AI applications that are realised in terms of operational efficiency gains up to issues with workforce adaptation. Originality/value: The paper sheds light on the maritime environment as well as its potential impact on determining the future workforce. The strategies to deal with the changes, such as job role change, workforce adaptation strategy and overcoming challenges, should be considered essential. Whereas merits arising from technical development enable the companies to benefit as far as efficiency is concerned, missing opportunities for careers in seafaring imply that active measures to build workforce capacities have become inevitable. The paper ends with recommendations for policy-makers, industrial representatives, and researchers who can help take successful steps in the face of changing fields associated with technology use encompassing maritime operations.

Modelling climate change impacts on lake ice and snow demonstrates breeding habitat decline of the endangered Saimaa ringed seal

Snowdrifts on lake ice provide vital breeding habitats for the endangered Saimaa ringed seal. In this study, a lake ice model of Watershed Simulation and Forecasting System (WSFS-Ice) was developed for improved estimation of ice and snow conditions in Lake Saimaa during the pupping season of the Saimaa ringed seal. The WSFS-Ice model is based on energy balance, enabling reliable estimation of the ice cover evolution in current and future climate. In addition, a simple snowdrift model was used to simulate formation of snowdrifts, which are essential for the seals breeding success in Lake Saimaa. The model was calibrated against ice thickness, ice type and snow depth measurements. According to our results based on climate scenarios with intermediate representative concentration pathway (RCP4.5), the breeding habitat of the Saimaa ringed seal is significantly deteriorating during the twenty-first century. The mean depth of the snowdrifts is projected to decrease approximately to half from the 1981–2010 to 2070–99 period and at the same time the ice-covered period is reduced by one and a half months. During the mildest winters the ice cover is projected to melt even before the pupping season has ended. The results highlight the importance of climate change mitigation and active conservation measures to enhance seal population growth, enabling it to survive in a changing climate.

Association of Limited Health Literacy With Clinical and Patient-Reported Outcomes in Individuals With Systemic Lupus Erythematosus.

Health literacy is an important social determinant of health, with limited health literacy associated with worse health outcomes. This study examined the associations between limited health literacy with patient-reported outcomes and disease activity/damage among 267 Black women with active systemic lupus erythematosus (SLE) enrolled in the Peer Approaches to Lupus Self-Management (PALS) program. The three-item Chew Health Literacy Screening was used to dichotomize those reporting in the "limited" range on any item with outcomes compared via generalized linear models. Baseline surveys and assessments obtained at study entry as part of the PALS study were used. Primary outcomes included disease activity and lupus damage; other secondary outcomes included patient activation, self-efficacy, physician/patient communication, and quality of life. The study included 267 Black women with SLE. In covariate-adjusted analyses, participants with limited health literacy (88 [33%]) were more likely to have lower patient activation (Patient Activation Measure P < 0.0001), lower self-efficacy (Lupus Self-Efficacy P < 0.0001), higher lupus damage (self-administered Brief Index of Lupus Damage P=.016), higher disease activity (Systemic Lupus Activity Questionnaire symptom severity P=0.006), and worse physician/patient communication (patient-centered care P < 0.0001) compared to those with adequate health literacy. Those with limited health literacy also reported worse lupus quality of life (P=0.0004) and greater levels of stress (Perceived Stress Scale-4 P < 0.0001) and were 2.4 times more likely to have probable major depression (Patient Health Questionnaire Depression Scale-8 of ≥10 P=0.004) and probable anxiety disorder (General Anxiety Disorder-7 of ≥10 P=0.007) compared to those with adequate health literacy. Black women with SLE and limited health literacy have worse clinical outcomes and represent a particularly vulnerable population with significantly disparate health outcomes. These findings suggest health literacy and complexities of managing SLE may impair clinical care in multiple domains, ultimately contributing to higher disease activity and death/damage, and are important to address in clinical care and future interventions in patients with SLE.

Assessment of knowledge and activation measures in patients referred for familial hypercholesterolemia

Assessment of knowledge and activation measures in patients referred for familial hypercholesterolemia

Glial reactivity is linked to synaptic dysfunction across the aging and Alzheimer's disease spectrum.

Previous studies have shown that glial and neuronal changes may trigger synaptic dysfunction in Alzheimer's disease(AD). However, the link between glial and neuronal markers and synaptic abnormalities in the living brain is poorly understood. Here, we investigated the association between biomarkers of astrocyte and microglial reactivity and synaptic dysfunction in 478 individuals across the aging and AD spectrum from two cohorts with available CSF measures of amyloid-β(Aβ), phosphorylated tau(pTau181), astrocyte reactivity(GFAP), microglial activation(sTREM2), and synaptic biomarkers(GAP43 and neurogranin). Elevated CSF GFAP levels were linked to presynaptic and postsynaptic dysfunction, regardless of cognitive status or Aβ presence. CSF sTREM2 levels were associated with presynaptic biomarkers in cognitively unimpaired and impaired Aβ + individuals and postsynaptic biomarkers in cognitively impaired Aβ + individuals. Notably, CSF pTau181 levels mediated all associations between GFAP or sTREM2 levels and synaptic dysfunction biomarkers. These results suggest that neuronal-related synaptic biomarkers could be used in clinical trials targeting glial reactivity in AD.

Simplified Ftacv Model to Quantify the Electrochemically Active Sitedensity in PGM-Free ORR Catalysts

The development of platinum group metal-free catalysts is considered the most prominent path for reducing thecost of low-temperature fuel cells (LTFC). Despite the great advancement in the field, its further progress iscurrently limited by the ability to understand and mitigate the catalysts’ degradation mechanisms, which up torecent years was limited by the lack of activity descriptors. Recent work showed that this could be solved usingFourier-transformed alternating current voltammetry that enables to deconvolute Faradaic currents arising fromthe redox reaction of the active sites from the capacitive currents, and by that accurately measure the electrochemicallyactive site density of these catalysts in situ fuel cells. However, the analysis of the results can becomplex, requiring simulation software for accurate parameter extraction. Herein, a simplified analysis ofFourier-transformed alternating current voltammetry is presented. This was done by mapping the influence ofvarious variables, such as resistivity, capacitance, and thermodynamic and kinetic dispersion, on the accuracy ofelectrochemically active site density measurements. Under specific, yet realistic, operating conditions, a singleequation with the peak current of the 5th harmonic as the only variable can be used to quantify electrochemicallyactive site density with high accuracy. This approach was demonstrated using molecular catalysts, iron phthalocyanine,as a model molecule, and a commercial, heat-treated catalyst.

Non-invasive investigation of a submerged medieval harbour, a case study from Puck Lagoon

This study presents an innovative approach to underwater archaeological prospection using non-invasive methods of seabed exploration. The research focuses on the Puck medieval harbour, a cultural heritage site, and utilises acoustic and optical underwater remote-sensing technology. The primary objectives include optimising the use of Airborne Laser Bathymetry in underwater archaeology, enhancing the filtration process for mapping underwater sites, and utilising data from both multibeam echosounder and bathymetric LiDAR for detailed archaeological research. A systematic approach to data processing is advocated to maximise the value of collected data and inform subsequent investigations. The study demonstrates the high accuracy of bathymetric datasets from optical and acoustic sources, with an R-squared correlation coefficient of 0.9853. The application of these techniques is demonstrated, underscoring the compatibility and effective combination of these methods in underwater archaeological exploration. This research provides valuable insights and directions for future archaeological prospections based on active remote-sensing measurements.

Abstract We123: Cardiomyocyte Specific Sustained Atg7 Overexpression Activates Mitochondrial Autophagy in the Heart

Introduction: Accumulating evidence indicates that autophagy-related protein 7 (Atg7) is essential in cellular autophagy. Our earlier studies showed that Atg7 is required to promote macro-autophagy in the heart. However, it is unknown if the activation of Atg7 has a role in the heart to regulate selective mitochondrial autophagy (mitophagy). Objectives: We employed in vitro and in vivo approaches to delineate the molecular function and mechanisms of Atg7-mediated activation of mitophagy in the heart. Methods and Results: Subcellular fractionation and quantum dot-labeled electron microscopy revealed Atg7’s localization on the mitochondrial fraction in the heart. Atg7 co-localization to Mitotracker-labeled mitochondria was confirmed using isolated heart mitochondria. To quantitate the mitophagy, we overexpressed Atg7 in cultured primary cardiomyocytes, treated with cyanide 3-chlorophenylhydrazone (CCCP) to induce mitophagy, and stained with pH-sensitive fluorescent mitophagy dye to enumerate mitophagy dots by microscopy. We found significantly increased mitophagy dots in Atg7 overexpressed cardiomyocytes than in β-gal expressing control. To assess the activation of mitophagy in vivo , we treated the cardiac-specific Atg7 overexpressing transgenic (αMHC-Atg7 Tg) and their littermate non-transgenic (Ntg) mice with CCCP. We found an increased accumulation of mature autophagolysosomal marker protein LC3-II in isolated mitochondria from Atg7 Tg mice hearts post-CCCP treatment. To assess the extent of mitochondrial lysosomal delivery in Atg7 overexpressing hearts, we crossed αMHC-Atg7 Tg mice with cardiac-specific Mito-Keima transgenic (Mt-Keima Tg) mice. Mt-Keima Tg mice bear mitochondria-targeted pH-dependent fluorescent lysosomal protease-resistance Keima protein, enabling the measurement of mitophagy activation in vivo . We observed increased Mt-Keima high red-to-green areas in αMHC-Atg7xMt-Keima Tg mice hearts compared to Mt-Keima mice. Conclusions: Our biochemical and genetic approaches revealed that Atg7 localizes to the mitochondria, leading to the recruitment and initiation of mitophagy machinery. Our data further confirm that genetic activation of Atg7 leads to increased mitophagy activity in the heart.

Towards equitable renal care: Strategies for enhancing kidney transplantation in Africa

Chronic kidney disease (CKD) is defined as the presence of kidney damage persisting for 3 months or more. Kidney transplantation stands as a vital intervention for individuals grappling with end-stage renal disease (ESRD) in Africa, offering the promise of extended life and improved quality of life. However, numerous challenges hinder its widespread implementation across the continent. This paper explored kidney transplantation in Africa, aiming to illuminate key strategies for bridging gaps and building pathways to enhanced renal care. There is a disproportionate burden of CKD on the region's population. Therefore, there is a critical need for early diagnosis and intervention. This paper outlines comprehensive strategies for improving kidney transplantation in Africa. Results indicate that financial support systems, infrastructure enhancement, public awareness campaigns, and legal frameworks are essential for addressing renal care barriers. Active measures such as government subsidy programs, international funding collaboration, and engagement with community leaders are highlighted as effective approaches. Drawing from global standards and best practices, the paper shows the importance of tailored approaches that address Africa's unique socio-economic and healthcare landscape. By leveraging collaborative efforts, regulatory frameworks, and public engagement, African nations can overcome barriers to kidney transplantation and pave the way for equitable access to life-saving treatment.

Potential distribution prediction of Pomacea canaliculata in China based on the Biomod2.

Pomacea canaliculata is a globally significant invasive species that poses substantial threats to agricultural production, ecosystems, and human health in China. To evaluate its habitat suitability in China, we collected and collated 741 county-level occurrence points of P. canaliculata in China through database query, literature search and news reports, and obtained the five most important climatic factors by variance inflation factor and Pearson correlation coefficient from 19 bioclimatic factors. We investigated the potential suitable distribution areas of P. canaliculata under current and future climate scenarios using the Biomod2 ensemble model, and identified the primary environmental variables influencing their distributions. The results showed that under the current climate, the suitable habitat areas were concentrated in southern provinces or municipalities, such as Zhejiang, Shanghai, Fujian, Jiangxi, Guangdong, Guangxi, Hainan, and Yunnan. Under different climate scenarios in the future, the suitable habitat area would show large-scale expansion in the southern provinces or municipalities, and spread to the northern region. The most two important environmental factors affecting the distribution of suitable habitat areas were precipitation of wettest month and mean temperature of wettest quarter. A combination model to predict the potential distribution of P. canaliculata under current and future climate conditions would help manage the risk of its invasion and spread, and provide a reference for relevant regions and departments to take active measures in advance to prevent the spread, monitor and mitigate its invasion.

PEER CONNECT: a pragmatic feasibility randomised controlled trial of peer coaching for adults with long-term conditions

ObjectiveTo test the feasibility of a targeted peer coaching intervention on the health and well-being of people with long-term health conditions and low activation attending outpatient clinics at a UK...