Favorable Shift Research Articles

Outcomes following thrombectomy for acute large vessel occlusion beyond 24 hours or with unknown time of onset

BackgroundEndovascular thrombectomy (EVT) is recommended in medically eligible patients with large vessel occlusions (LVO) within 24 hours of symptom onset. While there is evidence that EVT ≥24h after last known well (LKW) is associated with favorable outcomes in patients who meet DAWN/DEFUSE-3 criteria, it is unknown if more liberal criteria can be applied. MethodsA single center, prospective observational cohort of consecutive adult stroke patients was queried for symptomatic occlusions of the internal carotid (ICA) or proximal middle cerebral (M1) arteries (October 2019-January 2022), with a National Institutes of Health Stroke Scale (NIHSS) ≥6, pre-stroke modified Rankin Scale (mRS) 0-2, and Alberta Stroke Program Early Computed Tomography Scale score 3-10. These inclusion criteria were extrapolated from recently published data indicating a benefit with EVT with more liberal patient selection. Patients who underwent EVT ≥24h after LKW were compared against those treated medically. The primary outcome was a good functional outcome (90-day mRS 0-2), which was evaluated using multivariable logistic regression. ResultsOf the 27 included patients, the median age was 65y (IQR 49-76) with a median NIHSS of 15 (IQR 8-26), and 17 (63.0%) underwent EVT (median LKW-to-puncture 35.5h (IQR 26.9-65.8h). The primary outcome was no different with EVT in unadjusted regression (OR 1.17, 95%CI 0.17-8.09), and there remained no association across all multivariable models tested. Age, pre-stroke disability, and M1 occlusions were non-significantly associated with the primary outcome (p>0.05). There was a non-significant trend indicating a favorable shift in 90-day mRS with EVT (proportional OR 2.04, 95%CI 0.44-9.48). ConclusionsUsing more liberal inclusion criteria for EVT in the ultra-extended window, there was no statistically significant difference in the rate of good functional outcome with EVT. Larger studies are called upon to evaluate outcomes when more liberal criteria are used to assess thrombectomy eligibility.

Sex differences in outcomes after endovascular treatment of patients with vertebrobasilar artery occlusion.

Current studies on the role of sex in the prognosis of acute vertebrobasilar artery occlusion (VBAO) are limited. We aimed to explore whether there are sex differences on outcomes in patients treated with endovascular therapy (EVT) for VBAO. Patients from December 2015 to December 2018 with acute VBAO within 24 h of the estimated occlusion time in 21 stroke centers in China were retrospectively analyzed. Baseline data between sexes were compared in the total population cohort and propensity score (PS)-matched cohort. Multivariate logistic regression and ordinal regression were used to analyze the association of sex with outcomes. Mixed-effects regression model was performed for changes in modified Rankin Scale (mRS) scores in men and women from 90 days to 1 year after discharge. A total of 577 patients (28.4% women) were finally included. Multivariate logistic regression showed that women had a lower probability of favorable outcome (mRS score 0-3 at 90 days; OR 0.544; 95% CI 0.329-0.899) and functional independence (mRS score 0-2 at 90 days; OR 0.391; 95% CI 0.228-0.670) as well as a higher possibility of shifting to worse mRS (OR 1.484; 95% CI 1.020-2.158) than men. After PS matching, 391 patients (39.4% women) were analyzed, confirming the same results regarding favorable outcome (OR 0.580; 95% CI 0.344-0.977), functional independence (OR 0.394; 95% CI 0.218-0.712), and shift mRS (OR 1.504; 95% CI 1.023-2.210). However, the results of repeated ANOVA showed that men and women had a comparable functional recovery from 90 days to 1 year. Stroke due to VBAO treated with EVT is associated with worse outcomes in women than in men. However, men and women showed similar long-term improvement trends.

Pragmatic Municipalism: Privatization and Remunicipalisation in the US

ABSTRACT At the local government level in the US, the process of privatisation has been a dynamic one of experimentation with market delivery and return to public delivery when privatisation fails to deliver. National survey data show what drives this experimentation are pragmatic concerns with service cost and quality. Service and market characteristics, local government capacity and regulatory framework matter. In contrast to current international debates about the potential of remunicipalization to be a political reassertion of the public sector, for US local governments it is primarily a process of pragmatic municipalism. While some shifts in private finance and state regulatory environment favour private actors at the expense of local government, federal investments since COVID-19 provide funding and policy preference for maintaining a public role.

Meso pyridinium BODIPY-based long wavelength infrared mitochondria-targeting fluorescent probe with high photostability.

Mito-tracker deep red (MTDR) as a commercially available mitochondria-targeting probe was easily bleached upon imaging. We designed and synthesized a family of meso-pyridinium BODIPY and introduced lipophilic methyl or benzyl as the head moiety to develop a mitochondria-targeting deep red probe. Moreover, we changed the substitution of the 3,5-phenyl moieties with the methoxy or methoxyethoxyethyl group to balance hydrophilicity. The designed BODIPY dyes possessed long absorption and good fluorescence emission. Among them, meso ortho-pyridinium BODIPYs with benzyl head and glycol substitution on phenyl moiety (3h) with favorable Stokes shift were found to have the best mitochondrial targeting performance. 3h was easily uptaken by cells and was less toxic and more photostable than MTDR. An immobilizable probe (3i) was further developed, and nice mitochondria targeting properties under the damaging condition of mitochondria membrane potential were maintained. BODIPY 3h or 3i may become alternative long-wavelength mitochondria targeting probes apart from MTDR and be suitable for long-term mitochondrial tracking studies.

The effect of physical exercise and dairy probiotics (Lactobacillus casei) on gut microbiome in childhood cancer survivors.

Gut microbial dysbiosis persists months after intensive cancer treatment in children and adolescents. This prospective study compared the intestinal microbiome of children 1-3 years after completion of Berlin-Frankfurt-Münster protocol (BFM)-based pediatric ALL (PALL) treatment and healthy controls. To induce a favorable shift in the bacterial composition of the intestines in PALL with gut microbiome disruptions, 8 weeks of physical activity and probiotic consumption were used. Blood analyses and 16S rRNA sequencing for the gut microbiome were performed on 16 pediatric cases and 16 healthy controls. Significant differences in bacterial diversity were found between pre- and post-intervention, respectively (Shannon index, 3.22±0.45 vs. 3.47±0.24, p=0.04; Simpson index, 0.10±0.05 vs. 0.06±0.02, p=0.02; and Chao1 index, 693.88±238.58 vs. 794.23±116.34, p=0.04). Furthermore, the increase in the relative abundance of Lactobacillus casei (5.04E-03±1.62E-02 vs. 2.92E-02±5.03E-02, p=0.04) and the increase in some strains of Veillonella, a bacterial genus recently linked to improved physical fitness, were identified. Promisingly, the exercise program combined with dairy probiotics increased bacterial richness and diversity.

Anti‐Corrosive SnS2/SnO2 Heterostructured Support for Pt Nanoparticles Enables Remarkable Oxygen Reduction Catalysis via Interfacial Enhancement

AbstractThe stability of Pt‐based catalysts for oxygen reduction reaction (ORR) in hydrogen fuel cells is seriously handicapped by the corrosion of their carbon supports at high potentials and acidic environments. Herein, a novel SnS2/SnO2 hetero‐structured support is reported for Pt nanoparticles (NPs) as the ORR catalyst, where Pt NPs are mainly deposited at the interfaces of SnS2 and SnO2 moieties. The Pt‐support interactions, which can be tuned by the concentration of the heterointerfaces, can accelerate the electronic transfer and enrich the electron density of Pt with a favorable shift of the d‐band center. In electrochemical measurements, the ORR mass activity (MA) of the optimal Pt‐SnS2/SnO2 catalyst at 0.9 V versus RHE (0.40 A mgPt−1) is four times higher than that of Pt/C. As for the stability, the electrochemical active surface area and MA of Pt‐SnS2/SnO2 are only decreased by 18.2% and 23.7% after 50 000 potential cycles at a high potential region (1.0–1.6 V), representing the best ORR stability among the reported Pt‐based catalysts. Density functional theory calculations indicate that the binding energy and migration barrier of Pt atom/cluster on the SnS2/SnO2 heterojunction are much higher relative to other supports, accounting for the outstanding stability of the catalyst.

Minimum Wage, Unemployment Insurance and Universal Basic Income in a Wealth Concentration Process: A Theoretical Approach

Abstract: Ortiz and Castillo (2020) built a multisector economic model where concentration of capital ownership diminishes the society´s purchasing power capacity. After some concentration threshold is overcome, labour unemployment rises due to the lack of effective demand, the wage rate must be set to the minimum, and distribution of income shifts in favour of capital. Based on that approach, this paper analyses two alternative policies: an unemployment insurance and a universal basic income. The unemployment insurance program is fairer than the competitive outcome but it is not efficient, whilst the optimal universal basic income is fairer and efficient. An minimum wage rate that minimizes the unemployment rate is also found.

Impact of Phenol-Enriched Olive Oils on Serum Metabonome and Its Relationship with Cardiometabolic Parameters: A Randomized, Double-Blind, Cross-Over, Controlled Trial.

Phenol-rich foods consumption such as virgin olive oil (VOO) has been shown to have beneficial effects on cardiovascular diseases. The broader biochemical impact of VOO and phenol-enriched OOs remains, however, unclear. A randomized, double-blind, cross-over, controlled trial was performed with thirty-three hypercholesterolemic individuals who ingested for 3-weeks (25 mL/day): (1) an OO enriched with its own olive oil phenolic compounds (PCs) (500 ppm; FOO); (2) an OO enriched with its own olive oil PCs (250 ppm) plus thyme PCs (250 ppm; FOOT); and (3) a VOO with low phenolic content (80 ppm). Serum lipid and glycemic profiles, serum 1H-NMR spectroscopy-based metabolomics, endothelial function, blood pressure, and cardiovascular risk were measured. We combined OPLS-DA with machine learning modelling to identify metabolites discrimination of the treatment groups. Both phenol-enriched OO interventions decreased the levels of glutamine, creatinine, creatine, dimethylamine, and histidine in comparison to VOO one. In addition, FOOT decreased the plasma levels of glycine and DMSO2 compared to VOO, while FOO decreased the circulating alanine concentrations but increased the plasma levels of acetone and 3-HB compared to VOO. Based on these findings, phenol-enriched OOs were shown to result in a favorable shift in the circulating metabolic phenotype, inducing a reduction in metabolites associated with cardiometabolic diseases.

Stage Migration and Lung Cancer Incidence After Initiation of Low-Dose Computed Tomography Screening

IntroductionDespite evidence from clinical trials of favorable shifts in cancer stage and improvements in lung cancer-specific mortality, the effectiveness of lung cancer screening (LCS) in clinical practice has not been clearly revealed. MethodsWe performed a multicenter cohort study of patients diagnosed with a primary lung cancer between January 1, 2014, and September 30, 2019, at one of four U.S. health care systems. The primary outcome variables were cancer stage distribution and annual age-adjusted lung cancer incidence. The primary exposure variable was receipt of at least one low-dose computed tomography for LCS before cancer diagnosis. ResultsA total of 3678 individuals were diagnosed with an incident lung cancer during the study period; 404 (11%) of these patients were diagnosed after initiation of LCS. As screening volume increased, the proportion of patients diagnosed with lung cancer after LCS initiation also rose from 0% in the first quartile of 2014 to 20% in the third quartile of 2019. LCS did not result in a significant change in the overall incidence of lung cancer (average annual percentage change [AAPC]: −0.8 [95% confidence interval (CI): −4.7 to 3.2]) between 2014 and 2018. Stage-specific incidence rates increased for stage I cancer (AAPC = 8.0 [95% CI: 0.8–15.7]) and declined for stage IV disease (AAPC = −6.0 [95% CI: −11.2 to −0.5]). ConclusionsImplementation of LCS at four diverse health care systems has resulted in a favorable shift to a higher incidence of stage I cancer with an associated decline in stage IV disease. Overall lung cancer incidence did not increase, suggesting a limited impact of overdiagnosis.

How do viruses use oxidative stress?

Oxygen is a vital element for all living beings to continue their life activities and is the main component of oxidant–antioxidant metabolism, which should be in balance. The free radicals formed as a result of this metabolic process in the organism constitute a source of oxidants; external factors (radiation, exposure to sunlight, environmental pollution, cigarettes, etc.), inflammation and microbial agents also cause the formation of oxidants. Oxidative stress occurs when the balance between free radicals and antioxidants (which have an eliminating effect against them) shifts in favour of free radicals. Many studies have reported that oxidative stress may affect the virulence of pathogens during infection. Viruses use a pathological pathway that causes the production of reactive oxygen species (ROS) and the consumption of antioxidants. Thus, after viral infections, higher levels of ROS are often formed. Not only DNA-containing but also RNA-containing viruses were found to be associated with severe oxidative stress supporting DNA damage, high mutagenicity, initiation and/or progression of neoplasia. This review focuses on the relationship between oxidative stress and viruses.

Time-dependent effects of metoprolol in patients with coronary heart disease and grade II–III angina pectoris

BACKGROUND: This study focused on the topical problem of studying the time-dependent effects of the cardioselective -adrenergic receptor blocking agent metoprolol in patients with coronary heart disease (CHD) and grade IIIII angina pectoris.
 AIM: This study aimed to analyze the effect of metoprolol when used at different times of the day based on the concept of chronopharmacology, which is based on the variability of adrenoreceptor sensitivity depending on the day-night cycle.
 MATERIALS AND METHODS: Acute clinical and pharmacological tests were performed in 20 patients with CHD and grade IIIII angina pectoris to determine the time-dependent effects of metoprolol. All patients underwent a study of the parameters of central and peripheral hemodynamics, as well as electrocardiography and echocardiography. The study results were subjected to statistical analysis.
 RESULTS: Metoprolol at 100 mg at different hours of the day causes a persistent negative chrono- and inotropic, hypotensive effect. The clinical and pharmacological test results registered the listed effects with favorable shifts in the first instance when taking the drug in the morning and midday hours. Circadian rhythms of sensitivity of several indicators of the cardiovascular system to metoprolol have been established.
 CONCLUSIONS: The study results on the time-dependent hemodynamic effects of metoprolol using acute pharmacological tests enabled to establish the presence of a circadian organization of several hemodynamic parameters with an acrophase of sensitivity to metoprolol at 15:00 and 14:00 h.

Prediction modelling the impact of onset to treatment time on the modified Rankin Scale score at 90 days for patients with acute ischaemic stroke

IntroductionShortening the time from stroke onset to treatment increases the effectiveness of endovascular stroke therapies.AimThis study aimed to predict the modified Rankin Scale score at 90 days post-stroke (mRS-90d score)...

Anti-work, TVET and employer engagement

ABSTRACT The paper brings together a range of debates on the left that address TVET’s future in current context. At the heart of these debates rest two issues. The first addresses competing views of capital and the second focuses on the contradiction between the interests of capital and workers. The paper argues that capital is not all of a piece and that decent work that validates human flourishing is not completely unknown. However, as with other forms of waged labour, such work is predicated on capitalist relations and interests and it is important not to overlook waged labour as a site of struggle and contestation. Consequently, when circumstances alter as a result of the development of new technology, itself is a social process, or when the balance of power shifts in favour of capital, such labour may be dispensed with or become so deskilled that it is hardly recognisable. The paper is structured in the following way. The initial sections address the paper’s genesis, a discussion of corporate social responsibility and anti-work that enables an engagement with differing conceptualisations of capital. The subsequent sections, Restrictive and Expansive Learning and Thinking about TVET focus on the contradictory interests of workers and capital. The paper closes with a discussion of TVET and considers responses to current conditions that necessitate an engagement with an earlier tradition of adult and community education.

Stenting and Angioplasty in Neurothrombectomy: Matched Analysis of Rescue Intracranial Stenting Versus Failed Thrombectomy.

Successful reperfusion is one of the strongest predictors of functional outcomes after mechanical thrombectomy (MT). Despite continuous advancements in MT technology and techniques, reperfusion failure still occurs in ≈15% to 30% of patients with large vessel occlusion strokes undergoing MT. We aim to evaluate the safety and efficacy of rescue intracranial stenting for large vessel occlusion stroke after failed MT. The SAINT (Stenting and Angioplasty in Neurothrombectomy) Study is a retrospective analysis of prospectively collected data from 14 comprehensive stroke centers through January 2015 to December 2020. Patients were included if they had anterior circulation large vessel occlusion stroke due to intracranial internal carotid artery and middle cerebral artery-M1/M2 segments and failed MT. The cohort was divided into 2 groups: rescue intracranial stenting and failed recanalization (modified Thrombolysis in Cerebral Ischemia score 0-1). Propensity score matching was used to balance the 2 groups. The primary outcome was the shift in the degree of disability as measured by the modified Rankin Scale at 90 days. Secondary outcomes included functional independence (90-day modified Rankin Scale score 0-2). Safety measures included symptomatic intracranial hemorrhage and 90-day mortality. A total of 499 patients were included in the analysis. Compared with the failed reperfusion group, rescue intracranial stenting had a favorable shift in the overall modified Rankin Scale score distribution (acOR, 2.31 [95% CI, 1.61-3.32]; P<0.001), higher rates of functional independence (35.1% versus 7%; adjusted odds ratio [aOR], 6.33 [95% CI, 3.14-12.76]; P<0.001), and lower mortality (28% versus 46.5%; aOR, 0.55 [95% CI, 0.31-0.96]; P=0.04) at 90 days. Rates of symptomatic intracerebral hemorrhage were comparable across both groups (7.1% versus 10.2%; aOR, 0.99 [95% CI, 0.42-2.34]; P=0.98). The matched cohort analysis demonstrated similar results. Specifically, rescue intracranial stenting (n=107) had a favorable shift in the overall modified Rankin Scale score distribution (acOR, 3.74 [95% CI, 2.16-6.57]; P<0.001), higher rates of functional independence (34.6% versus 6.5%; aOR, 10.91 [95% CI, 4.11-28.92]; P<0.001), and lower mortality (29.9% versus 43%; aOR, 0.49 [95% CI, 0.25-0.94]; P=0.03) at 90 days with similar rates of symptomatic intracerebral hemorrhage (7.5% versus 11.2%; aOR, 0.87 [95% CI, 0.31-2.42]; P=0.79) compared with patients who failed to reperfuse (n=107). There was no heterogeneity of treatment effect across the prespecified subgroups for improvement in functional outcomes. Acute intracranial stenting appears to be a safe and effective rescue strategy in patients with large vessel occlusion stroke who failed MT. Randomized multicenter trials are warranted.

Dialogue in athletics: A program evaluation of a social justice education initiative in high school sports

Inclusive spaces and relationships that honor athletes’ unique identities are vital to ensure adaptive sport experiences (e.g., Coakley; Kochanek & Erickson). Youth athletes and adult leaders need to possess awareness and skills to foster inclusive sport environments and act as agents who can contribute to positive individual and social change. The prevalence and increased visibility of contemporary social justice issues have underscored the importance of developing such critical competencies. Scholars have recently called for exploratory and collaborative efforts to help athletes and adult leaders develop such critical competencies and carry out evaluation research that examines the effectiveness of programs. The purpose of this utilization-focused evaluation was to assess the impact and relevant processes of a social justice education initiative, Dialogue in Athletics, which used intergroup dialogue pedagogy. The lead author (and program facilitator-facilitator-evaluator) delivered and assessed the effectiveness of Dialogue in Athletics within one interscholastic sports community. A mixed methods convergent evaluation design was used to collect data at the session-specific, pre/post-program, and follow-up time points. Integrated analyses of data from student-athletes (n = 7) and adult leaders (n = 13) revealed that adults showed more marked increases in critical awareness and skills development/transference relative to student-athletes who showed some, though less pronounced, gains following the program. Results revealed favorable shifts in participants’ attitudes, with some variation between athletes and adults. Findings on participants’ program process helped elucidate meaningful aspects of their dialogue experience alongside various sources of discomfort, and barriers to learning transference.

Highly Stable SnO2-Based Quantum-Dot Light-Emitting Diodes with the Conventional Device Structure

ZnO-based electron-transporting layers (ETLs) have been universally used in quantum-dot light-emitting diodes (QLEDs) for high performance. The active surface chemistry of ZnO nanoparticles (NPs), however, leads to QLEDs with positive aging and unacceptably poor shelf stability. SnO2 is a promising candidate for ETLs with less reactivity, but NP agglomeration in nonionic solvents makes the conventional device structure abandoned, resulting in QLEDs with extremely low operational lifetimes. The large barrier for electron injection also limits the electroluminescence efficiency. Here, we report one solution to all the above-mentioned problems. Owing to the strong HO-SnO2 coordination and the steric effect provided by the hydrocarbon groups, tetramethylammonium hydroxide can stabilize SnO2 NPs in alcohol, while its intrinsic dipole induces a favorable electronic-level shift for charge injection. The SnO2-based devices, with the conventional structure, exhibit not only the most efficient electroluminescence among ZnO-free QLEDs but also an operational lifetime (T95) over 3200 h at 1000 cd m-2, which is comparable with that of state-of-the-art ZnO-based devices. More importantly, the superior shelf stability means that the TMAH-SnO2 NPs are promising to enable QLEDs with real stability.

Stroke in the stroke unit: Recognition, treatment and outcomes in a single-centre cohort.

In-hospital strokes (IHS) are associated with longer diagnosis times, treatment delays and poorer outcomes. Strokes occurring in the stroke unit have seldom been studied. Our aim was to assess the management of in-stroke-unit ischaemic stroke (ISUS) by analysing ISUS characteristics, delays in diagnosis, treatments and outcomes. Consecutive patients from the Acute Stroke Registry and Analysis of Lausanne (ASTRAL), from January 2003 to June 2019, were classified as ISUS, other-IHS or community-onset stroke (COS). Baseline and stroke characteristics, time to imaging and time to treatment, missed treatment opportunities, treatment rates and outcomes were compared using multivariate analysis with adjustment for relevant clinical, imaging and laboratory data available in ASTRAL. Amongst the 3456 patients analysed, 138 (4.0%) were ISUS, 214 (6.2%) other-IHS and 3104 (89.8%) COS. In multivariate analysis, patients with ISUS more frequently had known stroke onset time than other-IHS (adjusted odds ratio [aOR] 2.44; 95% confidence interval [CI] 1.39-4.35) or COS (aOR 2.56; 95% CI 1.59-4.17), had fewer missed treatment opportunities than other-IHS (aOR 0.22; 95% CI 0.06-0.86) and higher endovascular treatment (EVT) rates than COS (aOR 3.03; 95% CI 1.54-5.88). ISUS was associated with a favourable shift in the modified Rankin Scale at 3 months in comparison with other-IHS (aOR 1.73; 95% CI 1.11-2.69) or COS (aOR 1.46; 95% CI 1.00-2.12). In-stroke-unit ischaemic stroke more frequently had known stroke onset time than other-IHS or COS, fewer missed treatment opportunities than other-IHS and a higher EVT rate than COS. This readiness to identify and treat patients in the stroke unit may explain the better long-term outcome of ISUS.

Attitudinal behaviour of agriculturalists towards pesticide use in Pir Panjal Range of Kashmir Himalayas.

Attainment of safety during pesticide spraying relies on the farmer's knowledge of pesticide use, attitude and sense of safety. However, such investigations are insufficient in the current study area. The study is based on a primary survey of 384 orchardists about the myriad of aspects affecting the use of pesticides and their subsequent effects. The study revealed that knowledge, attitude, and perception had a weighted average index (WAI) and a standard deviation (SD) of 2.85 ± 1.17, 3.55 ± 1.34, and 3.81 ± 0.98 correspondingly. The findings reflect the farmers have a low to moderate level of knowledge, a moderate attitude toward pesticides, and a favourable perception on their utilization. Thus, for farmer personal protective equipment (PPE) use, it scored 2.77 ± 0.90 on the WAI scale, indicating that most farmers use PPEs 'rarely to occasionally' and that none use full protective gear. Furthermore, attitude and PPE usage exhibited a negative relationship with age, as younger people use PPE more than older ones. The findings were consistent for both farming experience and PPE usage. Moreover, there exists a positive association between age with perception and farming experience, knowledge with perception and PPE use, and attitude with perception. The coefficient of determination (R2) shows that 67.2% of the variability in farmers' PPE use was attributed to factors including knowledge, attitude, perception, and education. A favorable behavioral shift in pesticide usage may be achieved by enhancing farmers' knowledge, attitudes and perceptions, and adequate PPE usage.

Digital Information Services Needed for a Sustainable Inland Waterway Transportation Business

Inland waterway transportation (IWT) is highly efficient in terms of greenhouse gas emissions but lacks economic competitiveness when compared to other modes of transport. Digital information services that foster efficiency and sustainability of IWT are considered important elements for improving its attractiveness and thereby reducing greenhouse gas emissions of the transportation sector as a whole. Therefore, this paper addresses the question of what kind of digital information services are actually needed and should be provided, e.g., by port and waterway authorities, to stimulate a modal shift in favour of IWT. Though the concept of river information services (RIS) already provides a harmonised approach to information services in the sector, the current political and scientific discourse still lacks insight into what degree the currently available information services actually meet industry needs. Equally, possibilities to provide practical recommendations are limited. Therefore, this contribution fills this knowledge gap by providing data from the field gathered through a combination of qualitative and quantitative research methods. After elaborating on the underlying problem as well as the current state of research and practice, we will lay out observed information-relevant challenges to business actors and their respective needs. Based on this, practical recommendations for improvements of digital services and further avenues for research are derived.

Microbiota Composition and Diversity in Weight Loss Population After the Intake of IQP-AE-103 in a Double-Blind, Randomized, Placebo-Controlled Study.

The effect of the novel IQP-AE-103 (proprietary combination of dehydrated okra powder and inulin) on body weight reduction and the association with changes in microbiota composition were investigated in a double-blind, randomized, placebo-controlled trial. A total of seventy-two overweight or moderately obese subjects with a body mass index of ≥25 and <35 kg/m2 were randomly allocated to receive IQP-AE-103 or placebo; each group received two IQP-AE-103 or placebo capsules three times daily, respectively. Body weight, body fat, waist circumference, and hip circumference were measured, and fecal samples were collected at baseline and after 12 weeks of intervention. Using 16S rRNA gene sequencing on the fecal samples, the microbiota dissimilarity, diversity, and differences in relative abundance between or within groups were analyzed. At the end of the study, body weight was significantly reduced in the IQP-AE-103 group compared with the placebo group, 5.16 ± 2.39 kg vs. 0.97 ± 2.09 kg (p < 0.001). Subjects from the IQP-AE-103 group who achieved a reduction of ≥5% of total body weight from baseline (hereafter referred to as 5% responders or IQP5) had a mean body weight reduction of 6.74 ± 1.94 kg, significantly greater than the placebo group (p < 0.001). Using Lefse and statistical analysis, subjects in the IQP-AE-103 group had a significantly lower relative abundance of Firmicutes than the placebo group (p < 0.05) after 12 weeks of intervention. The 5% responders from the IQP-AE-103 group had a remarkable 4.6-fold higher relative abundance of Akkermansia muciniphila than the placebo group (p < 0.05). As the significant differences between groups were only observed post-intervention, the overall differences in microbiota profile suggest that the weight loss in overweight and moderately obese subjects who consumed IQP-AE-103 for 12 weeks is accompanied by a positive change in microbiota composition. These changes might be linked to the beneficial effects of microbiome modulations in alleviating obesity and metabolic syndrome. To the best of our knowledge, we are the first to report over-the-counter (OTC) supplementation that results in both significant changes in weight and favorable shifts on the subject microbiota profile. The trial is registered under ClinicalTrials.gov Identifier no. NCT03058367.