Typical Barriers Research Articles

Requirements of the Vapour Barrier in Wood-Frame Walls

This paper examines the water-vapour diffusion resistance (Z-value) of vapour versus wind barriers by determining their Z-value ratio in exterior wood-frame walls thermally insulated with six different materials to prevent mould growth. Using WUFI Pro, the water-vapour diffusion resistance requirements were determined for thermal insulation using mineral wool and biogenic materials: wood fibre, straw, flax, grass, and hemp. Hygrothermal simulations determine the minimum Z-value ratio between these materials with vapour versus wind barriers in temperate and cold climates. Wind barriers with Z-values between 1 and 8 GPa s m2/kg were used in walls with U-values of 0.15 and 0.10 W/m2 K. The indoor moisture load was defined from classes of 1 to 5 with a U-value of 0.15 W/m2 K and classes of 2 and 3 were used for a U-value of 0.10 W/m2 K. The Z-value ratio depends on the Z-values of the wind barrier and thermal insulation material, moisture load class, and U-value. The required Z-value ratio declines with an increased wind-barrier Z-value. The vapour-barrier Z-value approaches a fixed threshold for wind-barrier Z-values approaching lower values (1 GPa s m2/kg) and those approaching higher values (8 GPa s m2/kg), depending on the thermal insulation material. This parameter study examines wind barriers with a Z-value ranging between 1 and 8 GPa s m2/kg, which characterises typical wind barriers used in Denmark For the water-vapour diffusion resistance requirement of the vapour barrier, the Z-value increases for increased moisture load classes and thermally insulated walls with lower U-values. The conversion between the Z-value, the Sd-value, and the water-vapour resistance factor µ can be found in DS/EN ISO 12572:2016.

Abstract B064: Community-informed interventions to address cervical cancer disparities among people experiencing homelessness

Abstract Background: Cervical cancer incidence and mortality rates are up to four-fold higher among people experiencing homelessness (PEH) compared to the housed US population. Even beyond typical social and structural barriers to healthcare, homeless women experience high rates of sexual violence and trauma, often leading to discomfort with cervical cancer screening and delays/refusals of Pap tests. Despite these issues, strategies for appropriate cervical cancer screening in homeless communities are scarce, and no frameworks exist for routine screening in shelters. Methods: Leveraging an established multisectoral community-academic partnership addressing homelessness and health disparities in Indiana, USA, ongoing community-engaged research is examining barriers to cervical cancer screening among PEH and co-designing strategies to address them. Rapid assessment surveys were conducted with PEH at two large homeless service agencies in Indianapolis and Lafayette to document cervical cancer screening coverage and characteristics of individuals who are unscreened/overdue. In-depth interviews explored knowledge of cervical cancer, key barriers and facilitators to screening, and acceptability of shelter-based HPV self-sampling delivered by trusted community health workers (CHW). Results: Of n=167 survey respondents, 48% were white, 38% Black, 7% Hispanic, 7% other. Mean age was 43.18 years, and mean lifetime years of homelessness was 3.18. Nearly half of participants (49%) were unsheltered, 44% stayed at a shelter, the remainder couch-surfed. One third (32%) were unscreened or overdue for screening, far above state and national averages (24% and 22% respectively). The majority (84%) reported wanting to be screened and believing it is important for their health. Provider mistrust and competing priorities surrounding their homelessness were main reported barriers to screening. Qualitative findings identified key benefits, concerns, and preferences for HPV self-sampling, with many participants expressing interest and willingness to adopt this screening method. Conclusion: Despite a vast majority of PEH reporting a desire and willingness to be screened for cervical cancer, key identified barriers limit access for this uniquely vulnerable population. Ongoing qualitative analysis is directly informing community context-specific CHW-delivered cervical cancer education and HPV self- sampling interventions. This work will ultimately lead to broadly implementable strategies for shelter-based routine cancer screening and preventive healthcare delivery for PEH. Citation Format: Natalia M. Rodriguez, Lara Balian, Rebecca Ziolkowski, Xue Case, Kalesia Smith, Janelle Tipton. Community-informed interventions to address cervical cancer disparities among people experiencing homelessness [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr B064.

Exploring the road to public healthcare accessibility: a qualitative study to understand healthcare utilization among hard-to-reach groups in Kerala, India

BackgroundKerala, a southern state in India, is known to be atypical due to its high literacy rate and advanced social development indicators. Facing competition from a dominant private healthcare system, recent government health system reforms have focused on providing free, high-quality universal healthcare in the public sector. We carried out an analysis to ascertain the initial impacts of these measures among ‘hard to reach groups’ as part of a larger health policy and systems research study, with a focus on public sector health service utilisation.MethodsWe conducted Focus Group Discussions (FGDs) among identified vulnerable groups across four districts of Kerala between March and August of 2022. The FGDs explored community perspectives on the use of public healthcare facilities including enablers and barriers to healthcare access. Transliterated English transcripts were coded using ATLAS.ti software and thematically analyzed using the AAAQ framework, supplemented with inductive code generation.ResultsA total of 34 FGDs were conducted. Availability and cost-effectiveness were major reasons for choosing public healthcare, with the availability of public insurance in inpatient facilities influencing this preference. However, accessibility of public sector facilities posed challenges due to long journeys and queues. Uneven roads and the non-availability of public transport further restricted access. Gaps in acceptability were also observed: participants noted the need for the availability of special treatments available, reduced waiting times for special groups like those from tribal communities or the elderly mindful of their relatively greater travel and need for prompt care. Although quality improvements resulting from health reform measures were acknowledged, participants articulated the need for further enhancements in the availability and accessibility of services so as to make public healthcare systems truly acceptable.ConclusionThe ‘Kerala Model of Development’ has been applauded internationally for its success in recent years. However, this has not inured the state from the typical barriers to public sector health care use articulated by participants in the study, which match global evidence. In order to deepen the impact of public sector reforms, the state must try to meet service user expectations– especially among those left behind. This requires attention to quality, timeliness, outreach and physical access. Longer term impacts of these reforms – as we move to a post-COVID scenario - should also be evaluated.

Genetic differentiation at extreme latitudes in the socially plastic sweat bee Halictus rubicundus.

The sweat bee Halictus rubicundus is an important pollinator with a large latitudinal range and many potential barriers to gene flow. Alongside typical physical barriers, including mountain ranges and oceans, the climate may also impose restrictions on gene flow in this species. The climate influences voltinism and sociality in H. rubicundus, which is bivoltine and can nest socially at warmer lower latitudes but tends to be univoltine and solitary in the cooler north. Variation in voltinism could result in phenological differences, potentially limiting gene flow, but a previous study found no evidence for this in H. rubicundus populations in mainland Britain. Here we extend the previous study to consider populations of H. rubicundus at extreme northern and southern latitudes in the UK. We found that bees from a population in the far north of Scotland were genetically differentiated from bees collected in Cornwall in the south-west of England. In contrast, bees collected across the Irish Sea in Northern Ireland showed slight genetic overlap with both the Scottish and Cornish bees. Our results suggest that when populations at extreme latitudes are considered, phenology and the climate may act alongside physical barriers such as the Scottish Highlands and the Irish Sea to restrict gene flow in H. rubicundus. We discuss the implications of our results for local adaptation in the face of rapidly changing selection pressures which are likely under climate change.

Farmer‐friendly delivery of veterinary services: Experimental insights from the Kenyan dairy sector

AbstractPoor health conditions of livestock cause sizeable losses for many farmers in the Global South. Veterinary services, including vaccinations, could help but often fail to reach farmers under typical smallholder conditions. Here, we examine how the provision of a vaccine against East Coast Fever (ECF)—a tick‐borne disease affecting cattle in Africa—can be designed to reduce typical adoption barriers. Using data from a choice experiment with dairy farmers in Kenya, we evaluate farmers' preferences and willingness to pay for various institutional innovations in vaccine delivery, such as a stronger role of dairy cooperatives, new payment modalities with a check‐off system, vaccination at farmers' homestead, and bundling vaccinations with discounts for livestock insurance. Our data reveal that farmers' awareness of the ECF vaccine is limited and adoption rates are low, largely due to institutional constraints. Results from mixed logit and latent class models suggest that suitable institutional innovations—tailored to farmers' heterogeneous conditions—could significantly increase adoption. This general finding likely also holds for other veterinary technologies and services in the Global South.

A novel vibration barrier for low-frequency surface waves in the ground

As for certain engineering scenarios, such as open-air quarries and underground pipeline areas, vibration barriers are in urgent need. However, their design and construction face various challenges, especially for attenuating surface waves with low frequencies. Inspired by the topography of hills and periodic phononic crystal structures, a novel vibration barrier consisting of periodic soil strips is proposed. Firstly, utilizing the finite element method and the theory of periodic structures, the dispersion band diagram is calculated for the periodic soil strips. The corresponding band gap mechanisms are discussed by the displacement field of modes in the lower boundary of band gaps. Besides, a simplified model and a theoretical expression are proposed to analyze the minimum frequency of the band gaps. Through frequency domain analysis, the influence of the damping of soil strips on isolation effects is examined, and the dissipated energy is also quantified using a spatial Fast Fourier Transform. Finally, a comparison of the isolation effect between soil strip barriers and typical trench barriers is conducted. The results show that periodic soil strips can exhibit several band gaps, within which surface waves (SWs) can be effectively isolated. Soil strip barriers exhibit similar or even better vibration isolation effects compared to trench barriers, especially for isolating low-frequency vibrations. This study enhances our understanding of surface wave mitigation using periodic barriers and provides fresh insights for designing seismic metamaterials.

Generation of High-Lying Vibrational States in Carbon Dioxide through Coherent Ladder Climbing.

Mid-infrared laser excitation of molecules into high-lying vibrational states offers a novel route to realize controlled ground-state chemistry. Here we successfully demonstrate vibrational ladder climbing in the antisymmetric stretch of CO2 in the condensed phase by using intense down-chirped mid-infrared pulses. Spectrally resolved pump-probe measurements directly observe excited-state absorptions attributed to vibrational populations up to the v = 9 state, whose corresponding energy of 2.5 eV is 46% of the dissociation energy. By the use of global fitting analysis, important spectroscopic parameters in the high-lying vibrational states, such as transition frequencies and relaxation times, are quantitatively characterized. Remarkably, our analysis shows that 40% of the molecules are excited above the typical activation barriers in the metal-catalyzed CO2 conversions. These results not only demonstrate the promising ability of infrared excitation to produce elevated vibrational states but also represent a significant step toward accelerating CO2 conversions and other chemical processes via mode-specific vibrational excitation.

Assessment of Performance Measurement Systems’ Ability to Mitigate or Eliminate Typical Barriers Compromising Organisational Sustainability

This paper aims to identify the main performance measurement systems (PMSs) documented in the literature and assess their ability to overcome/mitigate a set of 19 specific barriers (identified in a previous paper) to their effectiveness. It also aims to understand what makes each PMS capable of or not capable of dealing with these barriers (i.e., what traits it has) and to explore their connection to some sustainable development goals (SDG). The PRISMA methodology was used to identify the relevant publications, which were then subjected to a detailed content analysis with statistical treatment, followed by the assessment of the potential of each PMS to deal with the barriers. The results made it possible to identify the PMSs most referred to in the literature (ordered list), quantitatively classify the PMSs according to their ability to overcome/mitigate barriers, and identify the barriers most and least addressed by the PMSs. While no single PMS offers a comprehensive solution, certain common traits contribute significantly to overcoming prevalent barriers. The complex interplay between barriers means that some traits can effectively address multiple barriers either directly or indirectly. Regarding implications, these findings provide important inputs (e.g., key recommendations) for developing or improving PMS frameworks that are able to comprehensively address the barriers, thus contributing to organisational effectiveness and, consequently, to the achievement of the SDGs. This constitutes the innovative contribution of this paper. As for limitations, this work is based on the analysis of 28 PMSs resulting from the systematic literature review in two databases (Scopus and Web of Science).

An Assessment of Individual Preference for a Novel Capillary Blood Collection System.

Typical barriers to venous blood collection for wellness testing include discomfort, time spent, and collection site accessibility. This study assessed individuals' experience, satisfaction, and preference associated with a FDA-cleared blood-collection device, the BD MiniDraw™ Capillary Blood Collection System (BD MiniDraw), in retail locations. A total of 113 individuals (≥18 years) with venous blood collection experience were enrolled; 107 completed the study. A pre-collection survey gathered information on demographics and past experiences with healthcare and venous blood collection settings. BD MiniDraw collection was conducted at three retail sites (two pharmacies and one grocery store) by trained healthcare workers using the Babson BetterWay blood testing service model. A follow up survey was performed two weeks later to determine experience with, and preference for, BD MiniDraw in terms of staff professionalism, blood collection location, blood collection time, and staff trustworthiness. Among the 107 participants, 74 (69%) were female and 33 (31%) were male; the mean age was 49 years (range=18-71 years). Sixty-six (62%) participants viewed their prior venipuncture experience as "somewhat" or "very" positive. Following capillary collection, 96 (90%) participants expressed a "somewhat" or "very" positive experience with BD MiniDraw at a retail location. In particular, "very satisfied" responses were given for location (87/107; 81%) and collection time (78/1407; 73%). In a subset of respondents (n=89), those reasons (location and time savings) were most frequent for likelihood of future use. Ninety-nine participants (92%) rated the retail blood collection team as "very" or "extremely" trustworthy. Overall, 90 participants (84%) "strongly preferred" (56/107; 52%), "somewhat preferred" (14/107; 13%), or had "no preference" (20/107; 19%) for BD MiniDraw, compared to traditional venous blood collection. Most participants conveyed a preference for BD MiniDraw, primarily based on the blood collection retail location, perceived time savings, and professionalism and trustworthiness of the staff.

Free Energy Barriers for Passive Drug Transport through the Mycobacterium tuberculosis Outer Membrane: A Molecular Dynamics Study.

The emergence of multi-drug-resistant tuberculosis strains poses a significant challenge to modern medicine. The development of new antituberculosis drugs is hindered by the low permeability of many active compounds through the extremely strong bacterial cell wall of mycobacteria. In order to estimate the ability of potential antimycobacterial agents to diffuse through the outer mycolate membrane, the free energy profiles, the corresponding activation barriers, and possible permeability modes of passive transport for a series of known antibiotics, modern antituberculosis drugs, and prospective active drug-like molecules were determined using molecular dynamics simulations with the all-atom force field and potential of mean-force calculations. The membranes of different chemical and conformational compositions, density, thickness, and ionization states were examined. The typical activation barriers for the low-mass molecules penetrating through the most realistic membrane model were 6-13 kcal/mol for isoniazid, pyrazinamide, and etambutol, and 19 and 25 kcal/mol for bedaquilin and rifampicin. The barriers for the ionized molecules are usually in the range of 37-63 kcal/mol. The linear regression models were derived from the obtained data, allowing one to estimate the permeability barriers from simple physicochemical parameters of the diffusing molecules, notably lipophilicity and molecular polarizability.

Reconciling Heritage Buildings’ Preservation with Energy Transition Goals: Insights from an Italian Case Study

The construction industry in Europe significantly contributes to energy consumption and carbon dioxide emissions, and this has prompted the European Union to issue directives for renovating and decarbonizing the existing building stock to meet 2050’s energy and environmental targets. However, achieving nearly zero-energy building (nZEB) standards in historic buildings is a complex challenge, as heritage values cannot be compromised for the sake of energy improvements. Our research advocates for a “whole building approach”, integrating various disciplines to achieve low-energy retrofitting while preserving historical material authenticity. The proposed methodology, inspired by the EN16883:2017 standard, involves a comprehensive building survey and assessment, the definition of conservation-compatible design solutions, and a performance analysis of these selected measures in relation to nZEB standards. This method was then applied to an ongoing project on a small, listed building in Genoa, demonstrating the feasibility of achieving conservation and high energy savings and, in these specific circumstances, the possibility of approaching nZEB parameters. This best practice example highlights the importance of adopting a cross-disciplinary, structured method to balance different values and needs in retrofitting projects, and it shows how creative and innovative solutions can break down the typical barriers encountered when implementing retrofitting solutions for built heritage.

Multistage Self-Assembled Nanomaterials for Cancer Immunotherapy

Advances in nanotechnology have brought innovations to cancer therapy. Nanoparticle-based anticancer drugs have achieved great success from bench to bedside. However, insufficient therapy efficacy due to various physiological barriers in the body remains a key challenge. To overcome these biological barriers and improve the therapeutic efficacy of cancers, multistage self-assembled nanomaterials with advantages of stimuli-responsiveness, programmable delivery, and immune modulations provide great opportunities. In this review, we describe the typical biological barriers for nanomedicines, discuss the recent achievements of multistage self-assembled nanomaterials for stimuli-responsive drug delivery, highlighting the programmable delivery nanomaterials, in situ transformable self-assembled nanomaterials, and immune-reprogramming nanomaterials. Ultimately, we perspective the future opportunities and challenges of multistage self-assembled nanomaterials for cancer immunotherapy.

Impacts investigation of gas barrier on effective thermal conductivity and service life of vacuum insulation panel

Vacuum Insulation Panels (VIPs) are highly efficient thermal insulation materials with extremely low thermal conductivity based on the vacuum principle. With the sealing properties of the gas barrier envelopes, a long service life of the VIP is obtained. The mechanism and influence factors of gas and water vapor permeability were mathematically analyzed to explore the influence of gas barrier envelopes on the thermal performance of VIPs. Three typical gas barriers were studied, and the selection of the gas barrier and other aspects of optimization were involved. The relationships among temperature, humidity, solubility coefficient, diffusion coefficient, and permeability were concluded, which shows that temperature has a much greater effect on the permeability of the gas barrier relative to humidity. The numerical analysis and influencing factors of VIPs’ service life were also exemplified with three different types of gas barrier envelopes. The experimental results show that depending on the environment, the temperature has a major impact on the effective thermal conductivity and service life of VIP. The research was significant in the selection of gas barriers, the optimization of the performance, and the development of vacuum insulation material.

Feeding after congenital heart surgery: a mixed-methods study of the caregiver experience.

Feeding difficulties after congenital heart surgery are a common concern for caregivers of children with CHD. Insight into the intricacies of their experience is lacking. With a better understanding, healthcare providers can continue to optimize the approach and support mechanisms for these families. This study will explore the psychosocial impacts on caregivers, define barriers to care, and identify areas to improve their care. This mixed-methods study combined semi-structured interviews with surveys. Purposive sampling targeted caregivers of a child who underwent heart surgery and was discharged with alternative enteral feeding access. A hybrid inductive-deductive methodology was used to analyse interview transcripts. Survey scores were compared to interview content for concordance. Fifteen interviews were conducted with socio-demographically diverse caregivers. Feeding difficulties were often identified as their greatest challenge, with the laborious feeding schedule, sleep deprivation, and tube management being common contributors. Most caregivers described feeling overwhelmed and worried. Time-intensive feeding schedules and lack of appropriate childcare options precluded caregivers' ability to work. Barriers to care included imperfect feeding education, proximity of specialist clinics, and issues with medical supply companies. Caregiver proposals for improved care addressed easing the transition home, improving emotional support mechanisms, and intensifying feeding therapy for expedited tube removal. This study describes the psychosocial toll on the caregiver, typical barriers to care, and ideas for improved provision of care. These themes and ideas can be used to advance the family-centered approach to feeding difficulties after heart surgery.

Optimising ePrescribing in hospitals through the interoperability of systems and processes: a qualitative study in the UK, US, Norway and the Netherlands

BackgroundInvestment in the implementation of hospital ePrescribing systems has been a priority in many economically-developed countries in order to modernise the delivery of healthcare. However, maximum gains in the safety, quality and efficiency of care are unlikely to be fully realised unless ePrescribing systems are further optimised in a local context. Typical barriers to optimal use are often encountered in relation to a lack of systemic capacity and preparedness to meet various levels of interoperability requirements, including at the data, systems and services levels. This lack of systemic interoperability may in turn limit the opportunities and benefits potentially arising from implementing novel digital heath systems.MethodsWe undertook n = 54 qualitative interviews with key stakeholders at nine digitally advanced hospital sites across the UK, US, Norway and the Netherlands. We included hospitals featuring ‘standalone, best of breed’ systems, which were interfaced locally, and multi-component and integrated electronic health record enterprise systems. We analysed the data inductively, looking at strategies and constraints for ePrescribing interoperability within and beyond hospital systems.ResultsOur thematic analysis identified 4 main drivers for increasing ePrescribing systems interoperability: (1) improving patient safety (2) improving integration & continuity of care (3) optimising care pathways and providing tailored decision support to meet local and contextualised care priorities and (4) to enable full patient care services interoperability in a variety of settings and contexts. These 4 interoperability dimensions were not always pursued equally at each implementation site, and these were often dependent on the specific national, policy, organisational or technical contexts of the ePrescribing implementations. Safety and efficiency objectives drove optimisation targeted at infrastructure and governance at all levels. Constraints to interoperability came from factors such as legacy systems, but barriers to interoperability of processes came from system capability, hospital policy and staff culture.ConclusionsAchieving interoperability is key in making ePrescribing systems both safe and useable. Data resources exist at macro, meso and micro levels, as do the governance interventions necessary to achieve system interoperability. Strategic objectives, most notably improved safety, often motivated hospitals to push for evolution across the entire data architecture of which they formed a part. However, hospitals negotiated this terrain with varying degrees of centralised coordination. Hospitals were heavily reliant on staff buy-in to ensure that systems interoperability was built upon to achieve effective data sharing and use. Positive outcomes were founded on a culture of agreement about the usefulness of access by stakeholders, including prescribers, policymakers, vendors and lab technicians, which was reflected in an alignment of governance goals with system design.

Tumor Abnormality-Oriented Nanomedicine Design.

Anticancer nanomedicines have been proven effective in mitigating the side effects of chemotherapeutic drugs. However, challenges remain in augmenting their therapeutic efficacy. Nanomedicines responsive to the pathological abnormalities in the tumor microenvironment (TME) are expected to overcome the biological limitations of conventional nanomedicines, enhance the therapeutic efficacies, and further reduce the side effects. This Review aims to quantitate the various pathological abnormalities in the TME, which may serve as unique endogenous stimuli for the design of stimuli-responsive nanomedicines, and to provide a broad and objective perspective on the current understanding of stimuli-responsive nanomedicines for cancer treatment. We dissect the typical transport process and barriers of cancer drug delivery, highlight the key design principles of stimuli-responsive nanomedicines designed to tackle the series of barriers in the typical drug delivery process, and discuss the "all-into-one" and "one-for-all" strategies for integrating the needed properties for nanomedicines. Ultimately, we provide insight into the challenges and future perspectives toward the clinical translation of stimuli-responsive nanomedicines.

Development of [225Ac]Ac-DOTA-C595 as radioimmunotherapy of pancreatic cancer: in vitro evaluation, dosimetric assessment and detector calibration

BackgroundPancreatic ductal adenocarcinoma (PDAC) is an aggressive malignancy which may benefit from radioimmunotherapy. Previously, [177Lu]Lu-DOTA-C595 has been developed as a beta-emitting radioimmunoconjugate to target cancer-specific mucin 1 epitopes (MUC1-CE) overexpressed on PDAC. However, the therapeutic effect may be enhanced by using an alpha-emitting radionuclide such as Actinium-225 (Ac-225). The short range and high linear energy transfer of alpha particles provides dense cellular damage and can overcome typical barriers related to PDAC treatment such as hypoxia. Despite the added cytotoxicity of alpha-emitters, their clinical implementation can be complicated by their complex decay chains, recoil energy and short-range impeding radiation detection. In this study, we developed and evaluated [225Ac]Ac-DOTA-C595 as an alpha-emitting radioimmunotherapy against PDAC using a series of in vitro experiments and conducted a preliminary dosimetric assessment and cross-calibration of detectors for the clinical implementation of Ac-225.ResultsCell binding and internalisation of [225Ac]Ac-DOTA-C595 was rapid and greatest in cells with strong MUC1-CE expression. Over 99% of PDAC cells had positive yH2AX expression within 1 h of [225Ac]Ac-DOTA-C595 exposure, suggesting a high level of DNA damage. Clonogenic assays further illustrated the cytotoxicity of [225Ac]Ac-DOTA-C595 in a concentration-dependent manner. At low concentrations of [225Ac]Ac-DOTA-C595, cells with strong MUC1-CE expression had lower cell survival than cells with weak MUC1-CE expression, yet survival was similar between cell lines at high concentrations irrespective of MUC1-CE expression. A dosimetric assessment was performed to estimate the dose-rate of 1 kBq of [225Ac]Ac-DOTA-C595 with consideration to alpha particles. Total absorption of 1 kBq of Ac-225 was estimated to provide a dose rate of 17.5 mGy/h, confirmed via both detector measurements and calculations.Conclusion[225Ac]Ac-DOTA-C595 was shown to target and induce a therapeutic effect in MUC1-CE expressing PDAC cells.

Prospects of blockchain governance: Understanding key public values, principles, challenges, and opportunities

AbstractThe article elaborates on the potential of blockchain technology to transform governance in different sectors of economy. The research primarily relies on rich empirical data that have been collected from semistructured interviews and focus group studies with professional blockchain developers. In this regard, the article aims to answer the following questions: How could blockchain governance conceptually work? How could one illustrate schematically key principles of its implementation? What are the key features of blockchain governance? Why are they important? What benefits could the concept bring to different sectors of economy if its potential is realized? What are the typical barriers and limitations of blockchain governance? What could be recommended to overcome them?

Exercise snacking to improve physical function in pre-frail older adult memory clinic patients: a 28-day pilot study

BackgroundFinding innovative yet feasible ways of preventing physical and cognitive decline in those at risk is a critical global challenge, with exercise being championed as a key precursor to robust health in later life. Exercise snacking, here defined as short bouts of sporadic [muscle-strengthening] exercise, is one such strategy designed to overcome typical participation barriers observed in older adults. This study examined the acceptability of exercise snacking amongst pre-frail older adults and explored the efficacy of this approach in improving physical function.MethodsIn this single group design, 21 pre-frail outpatients with mild-cognitive impairment were recruited from a UK memory clinic. To be eligible, participants were aged ≥ 65-years who scored 3–8 (inclusive) on the short physical performance battery (SPPB) and were not regularly engaging in sport or exercise. Participants completed a 28-day, twice daily, exercise snacking intervention, consisting of five muscle-strengthening exercises, with the aim being to complete as many repetitions as possible of each exercise in a minute. Acceptability of the intervention was measured quantitatively and qualitatively using a survey and topic guide informed by the Theoretical Framework of Acceptability. Pre- and post-intervention physical function was measured using the SPPB, timed up-and-go (TUG), and 60s standing balance and sit-to-stand tests.ResultsEighteen participants provided follow-up data and showed 85% adherence to the exercise snacking intervention, measured as the proportion of all sessions completed out of a possible 56. Participants rated the intervention as highly acceptable (4.6/5) suggesting it supported their self-efficacy (4.3/5) was enjoyable (4.1/5) and had a low burden (2.1/5). Qualitative findings suggested the ease of use, flexibility of the programme, and perceived effectiveness was important, and particularly useful for non-exercisers. Changes in SPPB score (8(1) vs. 9(3), p < 0.01), TUG (11.32(4.02) vs. 9.18(5.25) seconds, p < 0.01) and in the 60-second sit-to-stand test (17 ± 5 vs. 23 ± 7 repetitions, p < 0.01) were seen between baseline and follow-up.ConclusionsExercise snacking is an acceptable and potentially efficacious format of exercise for pre-frail memory clinic attendees who are at heightened risk of falling and frailty. Large scale randomised controlled trials are required to confirm whether exercise snacking is effective in the short and long term.ClinicalTrials.gov registrationNCT05439252 (30/06/2022)

The acceptability of homebased exercise snacking and Tai-chi snacking amongst high and low function UK and Taiwanese older adults.

Introduction: Exercise "snacking" and Tai-chi 'snacking' protocols are designed to overcome typical barriers to older adults' participation in muscle strength and balance exercise, using short bouts of home-based exercise. This study aimed to investigate the acceptability of homebred exercise- and Tai-chi snacking in British and Taiwanese older adults of high and low physical function. Methods: Thirty-three British and Thirty Taiwanese older adults took part in semi-structured interviews, after trying 1-week of exercise- and Tai-chi snacking. The interview schedule and deductive framework analysis was based on the seven components of the Theoretical Framework of Acceptability (TFA). Differences between the Taiwanese and United Kingdom participants and those considered high versus low physical function were also analysed. Results: Both snacking regimes were found to be convenient and easy to implement. Participants reported that no activity had to be given up, and considered the programmes would be beneficial to their physical and mental health. Interestingly, more UK-based participants preferred the elegant and relaxing movements of Tai-chi snacking, yet participants with low physical function experienced difficulties when mastering Tai-chi movements. A few high physical function participants perceived exercise snacking to be tedious. Discussion: Overall, the snacking exercise was found to be acceptable and useful. Personal affective attitude and different cultural backgrounds may affect exercise participation. Nevertheless, it is important to consider individuals' physical function when designing exercise regime. The findings indicate that making Tai-chi snacking easier to master initially, building in progression and adding some upper body movements in the exercise snacking may further enhance acceptability.