Technology Options Research Articles

2773 Co-designing an intervention for older adults with multiple conditions, using changes in physical activities to predict decline

Abstract Introduction Multiple long-term conditions (MLTCs) are common in the population, which increase with age and are associated with increased hospital admissions. Identifying early signs of decline, such as restricted physical activity, could help reduce avoidable hospitalisations, however it is not clear how best to do this. Aim To co-design with patients, caregivers and primary care professionals (PCPs), an intervention aimed at identifying changes in activity in order to recognise decline in older adults with MLTCs. Methods The Person-Based Approach was followed to plan and develop this intervention. Qualitative interviews were conducted with older patients with MLTCs, caregivers, and PCPs to examine perspectives on an intervention measuring changes in physical activity. A prototype app was developed, using these results and patient and public involvement. This was further optimised through iterative think-aloud interviews with patients, caregivers, and PCPs. Results Thirty-six interviews were conducted comprising of 17 patients (mean age 79-years, 23% female), eight caregivers and 11 PCPs (GPs, nurses, occupational therapists, and pharmacists). Interviews were recorded, transcribed, and thematically analysed. Findings highlighted the importance of restricted activity as an indicator of decline. Patients often described their experiences of decline through non-specific symptoms, including changes in physical activity. PCPs emphasised the value of knowing about such changes to clinical decision-making. Different technology options for measuring activity were explored, considering data quality, and acceptability of passive/active data collection. The initial prototype intervention was designed for iterative testing and think-aloud interviews will be completed by November and presented. Conclusion This study highlights the utility of measuring changes in activity in older patients, and some benefits and lessons learned from co-design. A proactive approach to detecting early decline within community settings may provide opportunities to unplanned hospital admissions.

Whole Exome Sequencing in a Population of Fetuses With Structural Anomalies.

To investigate the exome sequencing (ES) detection rate among fetuses with congenital anomalies and describe the rates in the setting of multiple versus isolated anomalies, perinatal autopsy, and family history of a previously affected child. A single-center retrospective chart review was conducted on 397 anomalous fetuses that underwent ES from May 2012 through December 2023. Medical record review included demographics, imaging, and genetic testing. The overall ES diagnostic rate was 34.3%. The rate of diagnosis was 31.6% in fetuses with a single anomaly and 42.6% in fetuses with 4 or more major organ systems involved. Of the fetuses with a single anomaly, lymphatic, craniofacial, skeletal, and neurological anomalies had the highest diagnostic rate on ES. 38.6% of deceased fetuses who underwent autopsy had a genetic diagnosis. Additionally, families who had a previously affected child had a 45.5% diagnostic rate. ES is an important tool that should be offered in pregnancies affected with congenital abnormalities or at the time of fetal demise or termination. The diagnostic rate of ES in the prenatal setting is also highly dependent on comprehensive phenotyping. With diagnostic ES results, reproductive technology and testing options are available in subsequent pregnancies.

Technological and policy options for the defossilisation of chemical manufacturing

The chemical industry plays a pivotal role in modern society, providing essential products like plastics, consumer products, pharmaceuticals, speciality and agricultural chemicals.

Accelerating ASEAN's energy transition in the power sector through cross-border transmission and a net-zero 2050 view.

Faced with energy transition objectives, the ten countries of the Association of Southeast Asian Nations (ASEAN) have technology options to decarbonize power sector. This study investigates the hypothetical decarbonization pathways for ASEAN's power sector. Here, we present an integrated power system capacity expansion model for ASEAN over 2018-2050. The results identify different pathways by strategically pursuing renewable energy, carbon capture and sequestration, and cross-border transmission. Transmission, while accounting for a marginal share in total cost (up to 0.5%), can reduce cumulative system costs by 11.9% and help achieve net-zero emissions. Across scenarios, generation infrastructure will require a cumulative investment equivalent to 29.6%-44.6% of ASEAN's 2018 GDP (Gross Domestic Product). The investment requirements for the expansion plan, however, are unevenly distributed across countries, especially with the ambition to achieve a carbon-neutral power sector. Country-specific investments in decarbonization are a consideration for the region.

Dye sensitized solar cells: Meta-analysis of effect sensitizer-type on photovoltaic efficiency.

Since Dye-Sensitized Solar Cells (DSSCs) was created, a versatile and cost-effective alternative among photovoltaic technology options for power generation and energy transition to combat climate change have emerged. The theoretical and experimental knowledge of DSSCs have increased in regard to their operation in the last three decades of development; it includes the device's components, as well as the most recent innovations in their application and forms of activation. In this work paper, we presented a meta-study of photovoltaic characterization parameters, 329 scientific reports of DSSCs were considered to compare three types of sensitizers (Organometallics, non-metal organic dyes and, natural dyes). The objective of this study is to compare DSSCs performance when using three different sensitizers. In general, the best reported results related to DSSCs are based on organic and organometallic sensitizers. DSSCs based on organometallic compounds have an average efficiency of approximately 9.1%, which displays the best average result; the maximum efficiency value recorded for DSSCs sensitized to organometallic compounds is 13.0 %. DSSCs based on synthetic organic sensitizers without the presence of metals in their structure, the average efficiency is approximately 7.1% and the maximum efficiency values is 15.2% (DSSCs utilize the co-photosensitization system and dye pre-adsorption treatment). DSSCs based on natural sensitizers indicated an average efficiency value about 0.5% and the maximum efficiency value recorded is 2.3%.

Studies of Fe<sub>3</sub>O<sub>4</sub> Nanoparticles Prepared by Co-Precipitation Method of FeSO<sub>4</sub> and FeCl<sub>3</sub> Solution

The magnetic properties of magnetite nanoparticles (Fe3O4 NPs) are being investigated. Fe3O4 NPs were prepared using the co-precipitation method and oven dried. The magnetic properties are influenced by the electron environments of the Fe3+ ions within the iron oxide structure. XPS spectra of Fe3+ (2p3/2) and (2p1/2) show peaks around 706.45 eV and 720.76 eV, respectively. Furthermore, magnetite NPs dried at 60 °C exhibited the largest hysteresis loop at 50K and less at 300K. In addition, the values of Ms and Mr indicate ferromagnetic behavior in Fe3O4 NPs. The result of this material shows high Ms (~38.638 emu/g) at 50K with Hc of 3.094K (near ferromagnetism) and ~33.843 emu/g at 300K with Hc of 0.000K (superparamagnetic). However, these magnetic properties are utilized for biomaterial applications such as separating biomolecules or coating core shells for nanoparticles, which presents an option for future biomedical technology.

Essays on Open Banking, Account Portability, Digitizing a Bank, Crypto Lending, and Social Commerce

This Paper Discusses Five Topics: Open Banking, Account Portability, Bank Digitization, Crypto Lending, And Social Commerce. In The First Section, Open Banking Is Defined, How Open Banking Works Is Described, The Advantages And Disadvantages Of Open Banking Are Highlighted, And Regulations And Open Banking Are Outlined. The Second Section Examines Account Portability. First, It Is Defined, And Its Characteristics Are Listed. Consumer Empowerment And Liquidity Risks Are Considered. The Fall Of Silicon Valley Bank And Signature Bank Are Then Reviewed. The Third Section Appraises Bank Digitization, Evaluating The Technological Options And Their Advantages And Disadvantages. The Financial Controls And The Regulatory Considerations Are Then Assessed. In The Fourth Section, Crypto Lending Is Studied. It Is First Defined, Followed By A Subsection On How Crypto Lending Works. The Third Subsection Shows How To Make Money With Crypto Lending, Indicates The Risks Associated With Crypto Lending, And Finally Illustrates The Differences Between Crypto Lending And Traditional Lending. The Final Section Talks About Social Commerce, Where The Controls To Enhance The Customer Experience And To Protect The Customer Are Disclosed.

Production of Novel Energy Gases in Bioprocesses Using Undefined Mixed Cultures.

Three phases of matter intermingle in various environments. The phenomena behind these fluctuations provide microbial cultures with beneficial interphase on the borderlines. Correspondingly, a bioreactor broth usually consists of a liquid phase but also contains solid particles, gas bubbles, technical surfaces, and other niches, both on a visible scale and microscopically. The diffusion limitation in the suspension is a remarkable hindrance to the reaction sequence during production. It must be overcome technically. Gas flow into the reactor could serve this purpose, and the outgoing stream or bubbling contains volatile products. The various mixing elements or gas flows should be moderated if shear forces disturb the cell growth, biochemical production, enzymatic activity, or any other crucial biological or physicochemical parameters. The focus is to optimize energy production in the form of liberated gases or their mixtures. Many combustible flows need to get purified, depending on their purpose, for example, for various engines. They provide novel sources for traffic in the air, streets, roads, and waterways, not forgetting space technology dimensions.On the other hand, industrial fuels are often used as mixtures of gases or gases with other substances. This approach may facilitate the utilization of side streams. Also, municipal energy needs can be fulfilled by microbial gases. Microbial mixed cultures could play an essential role in the big picture of sustainable industries,living and agriculture, exhibiting an excessive total effect on societies' multifactorial development. The gas phase is the key to realizing their potential.Gaseous emissions are inherent part of all forms of microbial metabolism, both aerobic and anoxic ones. Carbon dioxide is liberated both in respiration and fermentation, but the microbiota also binds volatile carbon compounds. CO2 is also a raw material for plant cultivation, e.g., in greenhouses or in algal pools which both represent the first steps of food chains. Additionally, they produce biomass to produce energy, biochemicals, nutrition, and soil improvement. Gaseous products of the mixed microbial cultures are valuable sources for energy production as purified gases (e.g., biomethane, biohydrogen) or as mixtures (e.g., bio-hythane, volatiles). These relatively simple molecules also serve as supplies for other hydrocarbons (e.g., methanol). Also, many microbial metabolites serve as fuel sources (e.g., bio-oil) and substrates for further biosynthesis. This versatility of potential technological options in energy making and for industrial processes could offer huge opportunities for green energies and sustainable industries, transportation, or municipalities. In the agriculture sector, the complete recycling also includes the consideration of gas phase. This aspect provides increasing sources for clean food production. Moreover, the chemoautotrophic bacteria, including the archaeal strains, could emanate novel streams of biobased products for human use.The bioprocess always consists of a biological component and a reactor or vessel solution, plus its control and adjustment means. Some project examples are taken up introducing the combinations of these two technological mainstreams, which should be in "symbiosis" for the best results. This novel approach could lead the human activities in industries, agriculture, and municipalities into "no waste" situations. At the same time, new global resources for economically feasible and sustainable raw material sources and processes thereof will emerge. In this novel technological ecosystem, connectivity to biosphere will return and remain our societies on healthy foundations, thanks to the microbes and their communities. This chapter introduces some of the potentials.

Marginal oil and gas field development using stranded and flaring gas

Indonesia’s abundant natural gas reserves present an opportunity to transition towards natural gas as a primary energy source due to its efficiency and industrial versatility. However, stranded gas and flare gas remain underutilized, especially in remote and challenging areas like Papua, Indonesia. This research investigates the utilization of such limited gas resources through technical and economic evaluations. This region is characterized by logistical challenges and a scarcity of natural gas users, making it a representative example for similar cases across Indonesia. The study assessed product and technology options for utilizing feed gas with an average volume of 2.5 MMSCFD over a 15-year production lifetime. The findings indicate that converting the gas into CNG and LPG is the most viable solution, yielding an average of 1,264 MMBTU/day of CNG and 4 MT/day of LPG. Economic analysis shows a net present value (NPV) of USD 1.83 million, an internal rate of return (IRR) of 13.01%, and a payback period (POT) of 6.31 years. The use of skid-mounted transportation modules and barges aligns well with the geographical complexities of Eastern Indonesia, offering a scalable and commercially viable approach to stranded gas utilization. This research highlights a sustainable pathway for monetizing marginal gas fields.

Electrochemical CO2 Fixation and Release Cycle Featuring a Trinuclear Zinc Complex for Direct Air Capture

AbstractCO2 capture technology can mitigate greenhouse gas emissions and global warming. CO2 capture driven by electrochemical reactions is attractive because the operation is carried out at normal temperature and pressure and involves a simple input system using electrical energy. Although promising metal complexes with high CO2 fixation performance have been reported, there are few studies on systems that combine electrochemical reactions and metal complexes. Here, we demonstrated stable CO2 fixation‐release cycles using an electrochemical system with trinuclear Zn(II) complex (Zn3L) as the CO2 fixative and an ionic liquid as a supporting electrolyte for the stable operation. This system showed a faster CO2 fixation rate than that of an aqueous alkaline solution at the same concentration. Continuous release and refixation of CO2 were achieved by decomposition and reconstruction of the complex structure induced by H+ and OH− supplied from a bipolar membrane equipped in the electrolytic cell. The CO2 fixation‐release cycle was demonstrated even for dilute CO2 (450 ppm) in air, where the CO2 capture rate reached approximately 46 % of CO2 contained in the air under an air flow condition of 200 mL ⋅ min−1. This case, combining electrochemical drive and metal complexes, will provide a new option for CO2 capture technology.

Electrochemical CO2 Fixation and Release Cycle Featuring a Trinuclear Zinc Complex for Direct Air Capture.

CO2 capture technology can mitigate greenhouse gas emissions and global warming. CO2 capture driven by electrochemical reactions is attractive because the operation is carried out at normal temperature and pressure and involves a simple input system using electrical energy. Although promising metal complexes with high CO2 fixation performance have been reported, there are few studies on systems that combine electrochemical reactions and metal complexes. Here, we demonstrated stable CO2 fixation-release cycles using an electrochemical system with trinuclear Zn(II) complex (Zn3L) as the CO2 fixative and an ionic liquid as a supporting electrolyte for the stable operation. This system showed a faster CO2 fixation rate than that of an aqueous alkaline solution at the same concentration. Continuous release and refixation of CO2 were achieved by decomposition and reconstruction of the complex structure induced by H+ and OH- supplied from a bipolar membrane equipped in the electrolytic cell. The CO2 fixation-release cycle was demonstrated even for dilute CO2 (450 ppm) in air, where the CO2 capture rate reached approximately 46 % of CO2 contained in the air under an air flow condition of 200 mL ⋅ min-1. This case, combining electrochemical drive and metal complexes, will provide a new option for CO2 capture technology.

Development of Technological Options for the Use of Various Wastes as Alternative Energy Sources Based on Multicomponent Compositions of Solid Fuels

The article considers promising areas for solving problems of energy and resource conservation, as well as issues of rational use of natural and secondary resources generated in industrial and communal activities. The aspects of research and development of technological options for the use of various wastes based on multicomponent compositions of solid fuels as alternative energy sources are presented. Also presented are the main stages of the developed and applied technologies for briquetting and incineration of multicomponent mixtures based on various combustible waste. The developed algorithm for solving the problem under consideration which makes it possible to rationally use substandard combustible industrial municipal waste to obtain multicomponent solid fuel that meets the quality criteria for energy and environmental indicators is reviewed. The results of the applied research directly related to the qualitative assessment of multicomponent briquetted fuels and facilitating achievement of the best production and consumer indicators values of energy quality and environmental friendliness are presented.

Impact of the European proposal to restrict PFAS on modern medical technology and treatment options

Abstract Functionality of state-of-the-art medical devices often depends on high-end materials. Today, a large spectrum of medical devices like heart valves, vascular grafts, sutures or endoscopic devices consist of or incorporate fluoropolymers like polytetrafluoroethylene (PTFE). Fluoropolymers offer unique mechanical, electrical and chemical properties. Based on their chemical constitution, fluoropolymers are assigned to the group of per- and polyfluorinated substances (PFAS). The aim of the current restriction proposal within Europe (EU) is to limit and/or fully ban the persistent PFAS substances known as forever chemicals. The restriction proposal concerns all PFAS substances beyond further subdividing and evaluating their hazardous potential and with just short-term derogations depending on the application. The consequences of the impending restriction proposal on PFAS is shown from a medical device industry viewpoint. Literature data on annual material consumption and supply chain are collected and evaluated, especially pointing to future problems assuming an entry into force of the pending restriction proposal. Furthermore, the short derogation times are contextualized with current timelines of Medical Device Regulation (MDR) approval processes to highlight the impact on product availability assuming a PFAS ban. Selected examples of affected products illustrate, how patient treatment options are limited by the PFAS restriction. It can be clearly shown that the PFAS restriction will critically affect the medical device sector through collapsed supply chain and insufficient derogation times for product approvals, thus limiting the availability of medical products and setting back the gold standards in medical treatment.

Perceived Barriers and Facilitators of Behavioral-Health Modality Change Adoption During the COVID-19 Pandemic: A Systematic Review.

During the Coronavirus Disease 2019 pandemic, there was a surge in demand for mental health services worldwide, presenting challenges for healthcare institutions as they navigated changes in policy and safety regulations. In the United States, this resulted in many behavioral health modality changes to remain in compliance with the Center for Disease Control guidelines. A growing body of literature has documented these, yet few explored barriers and facilitators affecting the adoption of these modality delivery changes. The researchers conducted a systematic review using the PRISMA method, focusing on service delivery changes across healthcare systems in the United States from March 2020 to May 2022. The study objective was to identify barriers and facilitators affecting the adoption of changes to modality delivery of behavioral health services due to pandemic restrictions. This was a systematic review that utilized the PRISMA method. The researchers identified 445 initial articles from eight databases using predetermined keywords and implemented a three-round screening process to select the most pertinent articles for this review. The researchers used a thematic analysis focused on user-related, program-related, technology, and environment-related constructs relevant to engagement with digital mental health interventions, and also addressed provider and administrative-related barriers and facilitators of virtual behavioral health modality changes. Barriers and facilitators were operationalized using the Borghouts Model. This systematic review revealed several common barriers and facilitators, including underdeveloped technology infrastructure, privacy and confidentiality concerns, poor technology literacy, availability of diverse technology options, provider technology training, and ease of integration into everyday life. This review provides insights into barriers and facilitators of modality change adoption, which could inform the development and implementation of virtual mental healthcare services and may help optimize the application of these services by improving our understanding and ability to overcome barriers influencing their adoption.

(Invited) Mobility Enhancement Technology of Extremely-Thin Body Ge-on-Insulator Channel Mosfets

The progress in the technology nodes demands the reduction of channel film thickness in nanosheet FETs. Here, one of the biggest challenges is the significant reduction in channel mobility. Thus, an extremely-thin body (ETB) Ge-On-Insulator (GOI) channel is promising for the nanosheet channels from the viewpoint of mobility enhancement. Here, we discuss possible options of the mobility enhancement technology in GOI channels experimentally and theoretically. Mobility in ETB channel MOSFETs is limited by surface roughness and resulting thickness fluctuation scattering. Under the dominance of this scattering mechanism carriers with lighter effective mass parallel to the MOS interface and heavier effective mass perpendicular to it are desirable. From this viewpoint, the Δ2 valley on (100) Ge and the L1 valley on (111) Ge are promising for n-MOSFET channels [1-4]. Particularly, it is shown here under our modified thickness fluctuation scattering model [5] that (111) GOI channels are the most promising channels for n-MOSFETs among the conventional semiconductor materials. In addition, tensile strain is effective in improving the electron mobility of (100) GOI n-MOSFETs, because tensile strain increases the occupancy of the Δ2 valley with the appropriate anisotropy in the effective mass. We have experimentally found that tensile strain can be introduced into (100) GOI channels by oxidizing GOI substrates [6, 7]. We have demonstrated the enhancement of electron mobility of fabricated tensile-strain ETB GOI n-MOSFETs in the GOI thickness range of 12.5 nm to 2.5 nm [6]. To realize (111) GOI MOSFETs, on the other hand, high-quality (111) GOI substrates need to be prepared. We realized (111) GOI wafers on Si substrates by using the smart-cut technology [8-10]. High quality (111) GOI substrates can be achieved by choosing appropriate annealing temperatures. (111) GOI nMOSFETs fabricated on this substrate have been found to have higher electron mobility than (100) GOI ones [9], as previously found on bulk Ge substrates. The high electron mobility is expected even in ultra-thin films less than 10 nm, as theoretically predicted [3, 4], by improving interfacial properties at the bonded interface. In order to improve this back interface quality, we have performed a GOI wafer flipping process [11], where GOI layers formed by the smart-cut process is transferred to another Si substrate. We have demonstrated the electron mobility improvement in GOI n-MOSFETs fabricated on this flipped substrate [12].For GOI p-MOSFETs, the introduction of compressive strain can lead to a significant increase in mobility even in the extremely-thin film region [13-15]. Also, the mobility in pMOSFETs is known to be further improved by using uniaxial compressive strain rather than biaxial compressive strain [16]. Therefore, we introduced quasi-uniaxial strain by patterning the biaxial-strain GOI structure into narrow wire shapes and relaxing the strain along the channel width direction, which can introduce highly uniaxial compressive strain along the <110> direction [17, 18]. It has been experimentally shown that this asymmetric strain can further improve the hole mobility in GOI pMOSFETs, attributable to the reduction of effective mass. Also, another strategy to boost hole mobility in GOI p-MOSFETs is to use (110) surface orientation. (110)-oriented SiGe-On-Insulator (SGOI) substrates with asymmetric compressive strain were realized [19] by applying the Ge condensation technique [20] to (110) SiGe/SOI structures and the body thickness was thinned down to 3.2 nm. A (110) SGOI pMOSFET with a Ge content of 60 % provided 1.9x higher hole mobility than the one fabricated on a (100) GOI substrate.This work was supported by JSPS KAKENHI (17H06148, 22H00208).

Overview and Perspective of Integrated Photovoltaics with a Focus on the European Union

The global cumulative installed PV capacity is anticipated to surpass 2 TWp by the end of 2024, which is an increase in three orders of magnitude from the 1 GWp at the end of 2004. Depending on the energy transition scenarios, up to 8 kWp per capita have to be operational by 2050 globally. In Europe, this capacity could even be 50% higher, and this will have consequences on the decisions regarding where to install this capacity; thus, these decisions will be significantly impacted. This paper gives an overview of the technology options for installing PV systems in areas already used for other human activities as well as integrating them into ships and vehicles without the acquisition of extra land. The focus of this paper is on the situations within the European Union, such as land competition, and presents innovative solutions.

Handling Complexity in Virtual Battery Development with a Simplified Systems Modeling Approach

Lithium-ion battery systems are a core component for electric mobility, which has become increasingly important in the last decade. The rising number of new manufacturers and model variants also increases competitive pressure. Competition is shortening development times. At the same time, the range of technology options for batteries is growing steadily. Fast and well-founded concept development is becoming even more essential in this increasingly complex environment. For this purpose, various model-based systems engineering (MBSE) methods are analyzed and evaluated. Based on this, the battery modeling framework is derived and described, tailored to the needs of battery development. The validation of the methodological approach is demonstrated by the simulation workflow from an electrical cell characterization to the thermal evaluation of different cooling methods.

Abstract 4143224: Feasibility of Left Atrial Appendage Occlusion with Dual-Seal Technology without Pre-Procedural CT: Early Single-Center Experience

Background: Left Atrial Appendage (LAA) Occlusion with Amulet has shown promising results in achieving complete closure with minimal periprocedural leak. Amulet’s dual-sealed technology and numerous sizing options provide versatility for different LAA morphologies. Pre-procedural CT is routinely recommended for pre-procedural planning. However, this brings risks including use of contrast, risk of renal failure, radiation exposure, and patient inconvenience. Here, we share initial results of our Amulet implantation protocol without pre-procedural CT: 83 cases were reviewed; number of devices used, procedural time, periprocedural bleeding complications, success in coming off oral anticoagulation, and incidences of stroke and embolism were followed. Methods: We followed 83 AF patients who underwent LAA closure with Amulet, implanted with intraprocedural TEE, intracardiac left atrial echocardiography, and intraprocedural angiography. Pre-procedural CT was not used. Patients were followed to assess safety and efficacy of this protocol. Safety endpoints included rates of procedural and bleeding complications. Efficacy endpoints included rates of stroke and embolism, and number of devices used. Results: All 83 procedures were successfully completed with no perioperative procedural complications and no documented leaks on follow-up TEE. Patients had early ambulation with closure. On average, 1.14 devices were used per case: 88% of cases required 1 device, and nine cases required 2 devices; one case required 4 devices to fit as patient was noted to have an interrupted IVC, requiring implantation via right IJV. There were no cases of stroke or embolism following implantation, and all patients were safely able to come off oral anticoagulation. Conclusions: Results demonstrate that Amulet with its dual-sealed technology can be effectively and safely implanted without pre-procedural CT. No perioperative complications were observed. 88% of cases closed with single device usage. No post-procedure leaks were noted on follow-up TEE. Safety endpoints revealed minimal adverse events, with 2 cases of late pericardial effusion managed without long-term consequences. This protocol demonstrated high efficacy, as all patients were successfully able to come off oral anticoagulation with no reported strokes or embolic events. Intraprocedural TEE, intracardiac left atrial echocardiography, and intraprocedural angiography are typically appropriate for periprocedural sizing of the device.

Diabetes prevention after gestational diabetes: challenges and opportunities.

Gestational diabetes mellitus (GDM) poses significant health concerns for women and their offspring, with implications that extend beyond pregnancy. While GDM often resolves postpartum, a diagnosis of GDM confers a greater risk of future type 2 diabetes (T2D) and other chronic illnesses. Furthermore, the intergenerational impact of GDM predisposes offspring to increased chronic disease risk. Despite the awareness of the short- and long-term consequences of GDM, translating this knowledge into prevention strategies remains challenging. Challenges arise from a lack of clarity among health professionals regarding roles and responsibilities in chronic disease prevention and women's lack of awareness of the magnitude of associated health risks. These challenges are compounded by changes in the circumstances of new mothers as they adjust to balance the demands of infant and family care with their own needs. Insights into behaviour change strategies, coupled with advances in technology and digital healthcare delivery options, have presented new opportunities for diabetes prevention among women with a history of GDM. Additionally, there is growing recognition of the benefits of adopting an implementation science approach to intervention delivery, which seeks to enhance the effectiveness and scalability of interventions. Effective prevention of T2D following GDM requires a comprehensive person-centred approach that leverages technology, targeted interventions and implementation science methodologies to address the complex needs of this population. Through a multifaceted approach, it is possible to improve the long-term health outcomes of women with prior GDM.

Participatory research at scale: A comparative analysis of four approaches to large-scale agricultural technology testing with farmers

Tailoring agricultural technology options to the diverse conditions of smallholder farmers requires innovative approaches for testing these technologies with farmers across varied contexts, while incorporating their feedback into learning and decision-making processes. This study compares four such approaches: the Farmer Field School on Participatory Plant Breeding (FFS-PPB), Farmer Research Network (FRN), Crowdsourcing–Triadic comparisons of technologies (Tricot), and adapted Mother–Baby Trial (MBT) as implemented by four concrete projects. The objectives are to provide detailed descriptions of these approaches and their project-specific implementations, identify and analyze common aspects and differences, and derive insights to guide future farmer-inclusive projects aiming at contextual scaling of agricultural technologies. A literature review, key informant interviews, and a systematic content analysis were conducted for the analysis. Common features include cascade training models, simple farmer-managed experiments, and the use of digital tools for data collection. Major differences lie in the extent of farmer–researcher collaboration and decision-making, as well as how technology option-by-context interactions are addressed. The FRN, FFS-PPB, and adapted MBT approaches involve farmers in decision-making throughout most stages of research, including co-learning cycles that adapt the research design and technology options to farmers’ needs. Although these approaches require more training and expertise, they increase the likelihood of achieving relevant results that farmers can implement in practice. In contrast, more standardized approaches like the Crowdsourcing–Tricot streamline the implementation, data management and analysis of large-scale trials, but have limitations in capturing the underlying reasons for farmers’ preferences. Among the studied approaches, the FRN as implemented by the Women's Fields project in Niger is particularly effective in identifying which options best suit specific farming contexts.