Use Of Multiple Types Research Articles

Novel approach to combining interview and register data – Case: social security and pediatric cancer

Abstract A parallel examination of interview data and register data provides a more holistic overall picture of social security needs and use than any one type of data alone. In our study, we aimed to build a comprehensive understanding of the benefit and service needs of parents whose child is diagnosed with cancer. Conducting solely interviews would have provided subjective perceptions of individuals in the midst of a challenging life situation, but the data would have lacked information of the participants’ documented use of social security benefits and services. On the other hand, utilizing solely register data, would have provided an objective overview of actual service use. However, register data alone would not have shed light on whether the benefits and services received were sufficient from the recipients’ point of view. In our study, parents’ interviews and their register data from the Social Insurance Institution of Finland (Kela) offered complementary perspectives on the same life situation. Parents’ interviews provided information on support needs, service experiences as well as service deficits. The same families’ register data was used with their permission producing exact data on the insurance benefits and services that the family had applied for and received. The interviews were analysed as chronologically progressing narratives while the data received from Kela was depicted on timelines. When conjoined, the interview and register data formed a comprehensive picture of the benefit and service needs and use of families, whose child had cancer. In addition, this kind of triangulation revealed service deficits that were acknowledged by the interviewees and identified also through the register data. We argue, that combining subjective interviews together with institutional register data allow researchers to identify issues in the service system, which require improvements from the recipients’ and the system’s perspective. Key messages • The use of multiple types of data allows researchers to construct a holistic understanding of individuals’ social security needs and use. • Combining interview and register data allows researchers to identify issues in the service system, which require improvements.

Exosomes and microRNAs: insights into their roles in thermal-induced skin injury, wound healing and scarring.

A burn is a type of injury to the skin or other tissues caused by heat, chemicals, electricity, sunlight, or radiation. Burn injuries have been proven to have the potential for long-term detrimental effects on the human body. The conventional therapeutic approaches are not able to effectively and easily heal these burn wounds completely. The main potential drawbacks of these treatments include hypertrophic scarring, contracture, infection, necrosis, allergic reactions, prolonged healing times, and unsatisfactory cosmetic results. The existence of these drawbacks and limitations in current treatment approaches necessitates the need to search for and develop better, more efficient therapies. The regenerative potential of microRNAs (miRNAs) and the exosomal miRNAs derived from various cell types, especially stem cells, offer advantages that outweigh traditional burn wound healing treatment procedures. The use of multiple types of stem cells is gaining interest due to their improved healing efficiency for various applications. Stem cells have several key distinguishing characteristics, including the ability to promote more effective and rapid healing of burn wounds, reduced inflammation levels at the wound site, and less scar tissue formation and fibrosis. In this review, we have discussed the stages of wound healing, the role of exosomes and miRNAs in improving thermal-induced wounds, and the impact of miRNAs in preventing the formation of hypertrophic scars. Research studies, pre-clinical and clinical, on the use of different cell-derived exosomal miRNAs and miRNAs for the treatment of thermal burns have been documented from the year 2000 up to the current time. Studies show that the use of different cell-derived exosomal miRNAs and miRNAs can improve the healing of burn wounds. The migration of exosomal miRNAs to the site of a wound leads to inhibition of apoptosis, induction of autophagy, re-epithelialization, granulation, regeneration of skin appendages, and angiogenesis. In conclusion, this study underscores the importance of integrating miRNA and exosome research into treatment strategies for burn injuries, paving the way for novel therapeutic approaches that could significantly improve patient outcomes and recovery times.

The impact of various curing methods on the curing process of polymer-fiber composites analyzed using analytical approach

Ti/Gf/Cf represents a novel form of hybrid fiber metal laminates (HFMLs) that successfully blend the benefits of titanium alloy, glass fiber reinforced plastic (GFRP), and carbon fiber reinforced plastic (CFRP). These materials have garnered attention in the field of engineering due to their exceptional levels of stiffness, strength, and shear resistance. The quality of HFMLs during the curing process was significantly impacted by the chosen curing method. Moreover, the use of multiple types of fibers complicated the optimization of curing parameters in HFMLs. A comprehensive study was conducted using a multi-physics field coupling finite element method to investigate the impact of various curing methods on the development of temperature distribution, curing degree, and curing stress in HFMLs during the curing process. By integrating thermal transmission equations, curing kinetics, and viscoelastic mechanical models, a detailed curing simulation model was established. Increasing the cooling rate from 1 °C to 5 °C was shown to raise the maximum curing stress by 4.7 MPa. Additionally, higher curing temperatures were found to induce internal curing stress due to variations in thermal properties. Insufficient insulation times were observed to exacerbate non-uniform temperature distribution and curing degree fields in HFMLs, potentially leading to increased internal stress. To mitigate the generation of large residual stress, it is recommended to lower the heating and cooling rates, reduce curing temperatures, and extend the insulation time appropriately during the curing process of HFMLs. The primary goal of this research was to accurately predict the evolution of curing parameters in HFMLs under different curing regimes, which were impacted by the chosen curing method. The results of the study demonstrated that rapid changes in temperature during heating and cooling stages can lead to uneven curing, resulting in the accumulation of residual stress within the laminates.

Social support utilization's effect on post-traumatic stress symptoms: a Danish cross-sectional study of 383 ambulance personnel.

Social support is considered an important factor in prevention of mental illness. However, little is known about the association between ambulance personnel's use of multiple types of social support and post-traumatic stress symptoms (PTSS). This study aims to assess if number of used social support types predicts PTSS for ambulance personnel. Apart from assessing the main effect of social support utilization, we were interested in investigating if social support utilization moderated the effect of frequency of critical events on PTSS. A total of 383 ambulance personnel completed a survey consisting of validated questionnaires. Hierarchical multiple linear regression analyses were performed to assess the association between frequency of traumatic exposure and utilization of social support and PTSS as outcome variable. Higher number of utilized social support types was associated with higher levels of PTSS (β = 0.15, p <.001). When serving as a moderator of the association between frequency of exposure to critical incidents and PTSS, social support utilization had a significant and positive interaction effect (β = 0.26, p = .049). 307 participants had used 2 or 3 types of informal support during the past year, whereas 81 had used 2 or 3 types of formal support. To our knowledge, this is the first study investigating the relationship between utilization of multiple, concurrent social support types and PTSS. This study suggests that to understand the effects of social support among ambulance personnel, it is necessary to assess the utilization of multiple concurrent support types, contributing factors to social support use, and different patterns of social support utilization that constitutes professional life in ambulance work.

Solid-state nuclear magnetic resonance in the structural study of polyglutamine aggregation.

The aggregation of proteins into amyloid-like fibrils is seen in many neurodegenerative diseases. Recent years have seen much progress in our understanding of these misfolded protein inclusions, thanks to advances in techniques such as solid-state nuclear magnetic resonance (ssNMR) spectroscopy and cryogenic electron microscopy (cryo-EM). However, multiple repeat-expansion-related disorders have presented special challenges to structural elucidation. This review discusses the special role of ssNMR analysis in the study of protein aggregates associated with CAG repeat expansion disorders. In these diseases, the misfolding and aggregation affect mutant proteins with expanded polyglutamine segments. The most common disorder, Huntington's disease (HD), is connected to the mutation of the huntingtin protein. Since the discovery of the genetic causes for HD in the 1990s, steady progress in our understanding of the role of protein aggregation has depended on the integrative and interdisciplinary use of multiple types of structural techniques. The heterogeneous and dynamic features of polyQ protein fibrils, and in particular those formed by huntingtin N-terminal fragments, have made these aggregates into challenging targets for structural analysis. ssNMR has offered unique insights into many aspects of these amyloid-like aggregates. These include the atomic-level structure of the polyglutamine core, but also measurements of dynamics and solvent accessibility of the non-core flanking domains of these fibrils' fuzzy coats. The obtained structural insights shed new light on pathogenic mechanisms behind this and other protein misfolding diseases.

Abstract 3253: CD30 is a marker of activated effector regulatory T cells in solid tumors providing clinical rationale for the combination of brentuximab vedotin and PD-1 inhibitors

Abstract Regulatory T cells (Tregs) play an important role in maintaining immune homeostasis by preventing excessive inflammation in normal tissues. In cancer, Tregs hamper antitumor immunosurveillance and may be a resistance mechanism to anti-PD-1 therapies. In preclinical cancer models, Treg depletion enhances antitumor cytotoxic immune responses, but systemic and persistent Treg removal can elicit immunopathology. Therapeutic strategies that selectively deplete highly suppressive activated intratumoral Tregs may avoid immune-related toxicities and amplify the activity of antitumor CD8 T cells during PD-1 blockade. CD30 is a member of the TNF receptor superfamily and is expressed by a subset of activated lymphocytes and various lymphomas. Here, transcriptomics and flow cytometry data from tumor and peripherally derived Tregs demonstrated CD30 is enriched on intratumoral Tregs. Among peripheral Tregs, CD30 expression was associated with an activated effector phenotype (FoxP3hiCD45RA-, fraction II). Further, treatment of dissociated NSCLC tumor spheroids with anti-PD-1 resulted in upregulated CD30 expression by Tregs but not intratumoral CD4 or CD8 T cells, which is consistent with Treg reactivation and supports CD30 as an activated Treg target. In vitro, CD30 expression on Tregs was dependent on signaling through the TCR and was significantly amplified by IL-2 and IL-15, suggesting CD30 may identify a subpopulation of activated antigen-specific Tregs. Brentuximab vedotin (BV) is an antibody-drug conjugate approved for clinical use in multiple types of lymphomas including cHL and PTCL. BV consists of a CD30-directed monoclonal antibody conjugated to the highly potent microtubule-disrupting agent monomethyl auristatin E (MMAE). The activity of BV in lymphomas is thought to primarily result from tumor-directed intracellular MMAE release leading to apoptosis, though multiple immunomodulatory effects of BV have also been suggested. We have demonstrated through in vitro and in vivo preclinical model systems of human T cell activation that BV can selectively deplete CD30-expressing Tregs, amplifying cytotoxic CD8 T cell expansion. These and Treg CD30 expression data motivated the clinical exploration of BV plus pembrolizumab in metastatic PD-1 refractory melanoma and NSCLC (NCT04609566). Consistent with preclinical data, preliminary biomarker analysis from these studies showed a small but significant decrease in Tregs (CD4+CD25+CD127low/-) in peripheral blood after treatment with BV plus pembrolizumab. Further, limited on-treatment biopsies showed a trend toward increased intratumoral CD8:Treg (FoxP3) ratio in some patients receiving combination therapy. These data support the ongoing evaluation of BV in combination with PD-1 inhibitors in solid tumors and a potential additional mechanism of action for BV. Citation Format: Ryan A. Heiser, Bryan M. Grogan, Reice D. James, Michelle L. Ulrich, Jason D. Berndt, Brian P. O'Connor, Shyra J. Gardai, Hailing Lu, Scott M. Knowles. CD30 is a marker of activated effector regulatory T cells in solid tumors providing clinical rationale for the combination of brentuximab vedotin and PD-1 inhibitors [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 3253.

FishGET: A fish gene expression and transcriptome database with improved accuracy and visualization

With the rapid expansion of transcriptome studies in many fishes, a great number of RNA-seq data have been published, allowing for a more systematic understanding of the general profiles and details of gene expression in fish. FishGET is dedicated to gathering and curating fish RNA-seq data to discover more new RNAs, including mRNA and lncRNA, thereby getting a more complete reference transcriptome and providing more comprehensive and accurate transcriptome annotations. We obtained a total of 1362 RNA-seq paired-end data of 8 fishes from 97 different studies, and then we performed transcript assembly, meta-assembly, weighted gene co-expression network analysis (WGCNA), functional annotations, neighbor location annotation, lncRNA type annotation, homology annotation. To promote research into fish genes at the transcriptional level, we developed a user-friendly web interface that allows users to view all information and makes use of multiple types of dynamic interactive visualization services.

Multi-parameter approaches for improved ensemble prediction accuracy in hydrology and water quality modeling

Ensemble approaches can be a quick way to improve hydrological prediction accuracy by considering multiple plausible modeling representations of a system. Previous studies showed that the use of multiple types of models could increase prediction accuracy, but model selection subjectivity and parameter equifinality issues remain unsolved. This study proposes to consider multiple parameter sets identified in the model calibration process and information on their performance for improved accuracy of ensemble hydrological prediction. In this study, we investigate whether multi-parameter ensemble (MP) compared to multi-model ensemble (MM) approaches can improve the accuracy of hydrology and water quality prediction. A variety of ensemble methods, including simple averaging, median filtering, weighted averaging, Bayesian model averaging (BMA), and their variants, were tested in watershed modeling implemented to predict daily water discharge and total phosphorus (TP) loads of a study watershed. The parameter spaces of two watershed loading models, Soil and Water Assessment Tool (SWAT) and Hydrological Simulation Program-FORTRAN (HSPF), were sampled using a multi-objective heuristic optimization algorithm, namely A Multi-Algorithm Genetically Adaptive Multiobjective (AMALGAM). The modeling experiment showed that the MP approach more effectively improved modeling accuracy statistics compared to the MM of both models as well as single-model and single-parameter approaches. The ensemble approaches did not always improve modeling accuracy, and their efficiency depended on ways to determine weights for ensemble members. The BMA method outperformed the other weighting schemes tested in this study, and its performance was responsive to the number and diversity (or variance) of ensemble member candidates and the computational cost to create the candidates. The findings demonstrate how the information of parameter sets sampled in model calibration and their performance statistics could help improve hydrological prediction accuracy.

Review on Wearable Sensors of the Medical System

A framework known as "smart healthcare" makes use of technologies like wearable's, and the Internet of Medical Things (IoT), In order to intelligently manage and respond to the needs of the health environment, we need to combine data, machine learning algorithms, wireless communication technology, and the Internet of Things (IoT) to link people, resources, and organizations; make health records easily accessible; and share the data widely. Medical sensors, or IoT, are one of the key components of smart healthcare. Due to the complexity of illnesses, Disease diagnosis often necessitates the use of multiple types of medical signals. The most crucial concern when employing multimodal signals is how to fuse them, which is a topic of growing interest among researchers. The newest generation of personal portable gadgets for telemedicine practice is wearable health monitoring systems. However, due to the inapplicability of the building process used for standard semiconductor equipment, wearable healthcare equipment research and commercialization are currently progressing at a very sluggish rate. Despite these obstacles, developments in materials flag, chemical analysis techniques, apparatus, and manufacturing processes created a groundwork for whole new wearable technology, which has continued to evolve. &nbsp

An analysis of the use of visual elements in workplace diversity disclosure

PurposeThe purpose of this study is to examine how visual elements along with textual narratives are used to disclose workplace diversity-related information in corporate social and environmental reports.Design/methodology/approachA qualitative content analysis is used to examine the workplace diversity-related information in the 2016 standalone sustainability/corporate responsibility reports of 47 Fortune companies. A total of 539 tables, figures and photographs and their related textual narratives are analysed through an impression management lens.FindingsThe study finds that multiple types of visual elements are used to supplement textual narratives to communicate workplace diversity-related messages. The positive and often non-verifiable workplace diversity-related information is symbolically suggestive of the companies’ workplace diversity commitment and success. While tables and figures are typically presented using numbers, percentages and words to enhance and promote the positive information, the “feel-good” photographs are used to arouse positive feelings in the readers. These visual elements are presented in either a single-visual or mixed-visual presentation form.Practical implicationsThis study has the potential to inform and assist preparers in the use of multiple visual elements and textual narratives to promote an impartial and substantive reporting of workplace diversity-related information. Understanding the motivation behind the usage and presentation of visual elements can be useful for the promulgation of guidelines for workplace diversity disclosure, and make readers aware that the visual elements can be exploited for impression management and symbolic legitimacy.Originality/valueThis study provides empirical evidence on the use of multiple types of visual elements in the reporting of workplace diversity-related information. It demonstrates how these visual elements are strategically used and presented to deliver an impression of workplace diversity to the readers.

Controle biológico de Biomphalaria, hospedeiro intermediário do Schistosoma spp.: uma revisão sistemática

ABSTRACT: Schistosomiasis is an important vector-borne disease transmitted by an intermediate host: a freshwater mollusk. Control of these snail vectors is one of the strategies of the World Health Organization against the disease. The present study was based on a systematic review of published scientific papers concerning the biological control of snails (genus Biomphalaria), and identified the ongoing challenges and propose future perspectives. The review methodology was based on the PRISMA statement, the international databases Web of Science and Scopus for the period 1945-2021. In total, 47 papers were analyzed, published by authors from 14 different countries, the majority being from: France, Brazil, the United States, and Egypt. The most widely used strategy for biological control was predation by fish (12 studies). Fourteen papers were published in the most prolific decade 2010-2019; during which there was also a greater diversity of biological control agents in studies. In this context, we believed that one of the principal challenges of this approach is the successful simultaneous use of multiple types of biological control agent: predators, competitors, and/or microbial agents. This new approach may provide important insights for the development of new biological control agents or microbial-based products, with the potential to reduce the parasite load carried by schistosomiasis snail vector and control its transmission in a sustainable way.

Changes in Breastfeeding and Lactation Support Experiences During COVID.

Background: We surveyed parents who gave birth from 2019 to 2021 to examine changes in breastfeeding experiences and professional and lay breastfeeding support services due to the coronavirus disease 2019 (COVID-19) pandemic. We also examined racial and ethnic disparities in breastfeeding support. Materials and Methods: A cross-sectional opt-in survey of 1,617 parents was administered on Ovia's parenting app in January 2022. Respondents were 18-45 years of age and delivered in one of three birth cohorts: August-December 2019, March-May 2020, or June-August 2021. We fit linear and logistic regression models wherein the outcomes were six breastfeeding support and experience measures, adjusting for birth cohort and respondent demographics. Results: Parents who gave birth in the early pandemic versus those in the prepandemic had reduced odds of interacting with lactation consultants (odds ratio [OR]: 0.63; 95% confidence interval [CI]: 0.44-0.90), attending breastfeeding classes (OR: 0.71; 95% CI: 0.54-0.94), meeting breastfeeding goals (OR: 0.65; 95% CI: 0.46-0.92), and reporting it was easy to get breastfeeding help (estimate: -0.36; 95% CI: -0.55 to -0.17). Birth cohort was not associated with use of donor milk or receipt of in-hospital help. The later pandemic cohort differed from the prepandemic cohort for one outcome: they were less likely to meet their breastfeeding goals (OR: 0.67; 95% CI: 0.48-0.95). There were racial and ethnic disparities in the use of multiple types of breastfeeding support. Although one-third of respondents felt that the pandemic facilitated breastfeeding because of more time at home, 18% felt the pandemic posed additional challenges including disruptions to lactation support. Conclusions: Parents who gave birth in the later pandemic did not report significant disruptions to professional breastfeeding support, likely as a result of the growth of virtual services. However, disparities in receipt of support require policy attention and action.

Experimental investigations on mechanical and water absorption properties of epoxy resin matrix treated sugarcane and tamarind shell powder reinforced bio-Composites

Synthesizing hybrid bio-composites has come a long way thanks to the use of multiple types of natural materials as reinforcement and filler in recent years. To test the mechanical and water-absorbing properties of a composite, this experiment blended epoxy resin with powdered tamarind shell and short, chemically-treated sugarcane fibres. Powdered tamarind shell and short, chemically processed sugarcane fibres are employed as reinforcing elements. By adjusting the percentage of epoxy resin used while changing the amounts of the reinforcing components, scientists created hybrid bio-composite samples. To make hybrid bio composites boards, manufacturers turned to hot injection moulding. Specimens of hybrid bio-composite are cut from the boards using water jet machining to undergo a variety of mechanical and water absorption tests in accordance with ASTM standards. The aforementioned studies demonstrate that the mechanical stress resistance and water absorption capabilities of hybrid bio-composites can be enhanced by the addition of very small amounts of fine sugarcane powder and tamarind shell powder to an epoxy resin matrix. Experimental results showed that the maximum compressive, flexural, ultimate tensile, and yield strengths for C4 composite specimens were 36.17, 38.53, and 34.63 MPa, respectively. These specimens contained 50 wt% epoxy resin, 35 wt% treated sugarcane fibre, and 15 wt% tamarind shell particles. Similarly, the maximum flexural modulus (10.96 GPa), elongation percentage (3.3%), impact strength (13.51 kJ/m2) and water absorption percentage (7.15%) were noticed in C4 composite specimens accordingly.

Combining sampling gear to optimally inventory species highlights the efficiency of eDNA metabarcoding

AbstractBiodiversity surveys may require the use of multiple types of sampling gear to maximize the efficiency of species detections, yet few studies have investigated how to optimally distribute effort among gear. In this study, we conducted eDNA metabarcoding and capture‐based sampling surveys (electrofishing, fyke netting, gillnetting, and seining) to sample fish species richness in a large northern temperate lake. We evaluated the success of the sampling methods individually and in combination to determine the allocation of effort and cost across sampling gear that provides the optimal approach for lake‐wide species inventories. We found that eDNA metabarcoding detected more species than any other sampling method, including 11 species that were not detected with any capture‐based approach. Optimal gear combination analyses revealed that detected species richness is maximized when most of the effort or budget is allocated to eDNA metabarcoding, with smaller allocations to seining and fyke netting. eDNA metabarcoding and capture sampling gear showed similar patterns of spatial heterogeneity in the fish community across habitat types, with pelagic samples forming a group that was distinct from nearshore samples. Our results indicate that eDNA metabarcoding is a rapid and cost‐efficient tool for biodiversity monitoring and that assessing the complementarity of multiple sampling types can inform the development of optimal approaches for measuring fish species richness.

Navigating the uncertainties of next-generation sequencing in the genetics clinic.

This study explores the different manifestations and navigations of uncertainty in the practice of diagnostic next-generation sequencing (NGS) testing. Drawing upon multi-sited fieldwork conducted at a large Centre for Human Genetics in Belgium, we analyse how uncertainty takes shape and is managed in the different steps of the diagnostic process: starting from the testing offer, to the analysis in the lab, the multidisciplinary team meetings (MDTs) and ending with the consultation with the patient. Building on interviews with genetic healthcare professionals and their patients and observations in consultations and MDTs, our empirical work underlines the duality of uncertainty as both burdensome and productive. Building on the existing literature on uncertainty in medicine and NGS, our analysis shows the ontological politics at play in the everyday uncertainty work in this CHG. We show how the, at times, contrasting ways of dealing with uncertainty lead to friction but also result in constructive negotiation and collaboration between actors, making use of multiple types of evidence and expertise. By not only minimising but also sustaining or inviting uncertainty, genetic healthcare professionals are able to advance the practices around NGS in a way that matches their multidisciplinary understandings, considerations and more normative stances.

Validation of the Motivational Inventory Underlying Substance Use Engagement (MI-USE)

Given the growing number of fatalities associated with the use of multiple types of drugs, there is an urgent need for a tool that allows clinicians and researchers to quickly assess diverse reasons for substance use. Here, we sought to validate the Motivational Inventory Underlying Substance Engagement (MI-USE), a new measure that assesses motivations for use across different types of substances. Participants were 538 adults ages 18-60 (48% women) who reported substance use problems and past-year drug or alcohol use. Analyses were conducted to discover and validate the factor structure of the MI-USE and evaluate its construct validity. A 30-item model best fit the MI-USE, with one General Factor capturing overall motivation to engage in substance use and eight motive-specific factors that indexed unique motivations for substance use: Emotional Coping (relief from unpleasant emotions), Pleasure-Seeking (feel pleasurable or exciting emotions and sensations), Dependence Severity (avoid withdrawal and cravings), Expansion (enhance self-insight and spirituality), Social Coping (increase confidence and attractiveness), Advantage (gain a physical or mental advantage), Physical Coping (relief from unpleasant bodily sensations), and Sleep (mitigate sleep problems). Evaluation of the measure’s construct validity and internal consistency support the chosen model and interpretation of the motive-specific factors. Results provide initial validation of the MI-USE as a reliable and valid tool for assessing diverse substance use motivations. It improves upon existing measures by allowing clinicians and researchers to simultaneously evaluate motivations for multiple forms of substance use, which facilitates personalized treatment planning and research on polysubstance use.

Prevalence and emergence of steroidal and non-steroidal anabolic agents in the Australian community measured through wastewater analysis

Develop and validate a method for the detection of performance- and image-enhancing drugs (PIEDs) in wastewater. Investigate prevalence of steroidal and non-steroidal anabolic agents in around 45% of the Australian population during Census week in August 2021. Explore changes and patterns in use over a 13-year period (2009–2021) and emergence of non-steroidal anabolic agents, e.g., selective androgen receptor modulators (SARMs), within one Australian wastewater treatment plant (WWTP) catchment. Performance- and image-enhancing drugs include, inter alia, steroidal (anabolic-androgenic steroids) and non-steroidal anabolic agents [e.g., SARMs, peroxisome proliferator-activated receptor delta (PPAR-δ) agonists, growth hormone secretagogues]. Despite known serious negative health side effects, these substances are misused by athletes and non-athletes to boost physical performance as well as appearance. Due to their misuse, often at concentrations significantly higher than for medical purposes, easy access through the internet, and lack of quality controls, PIED use has become a public health problem. The extent of this issue is difficult to quantify and is currently monitored through the combination of multiple data sources such as surveys, seizures, and anti-doping. To fully understand the prevalence of these substances, especially among the general population, a broader monitoring tool is needed to complement current sources of data. In the past two decades, wastewater-based epidemiology has been developed to investigate exposure to, use, and prevalence of chemicals within entire populations and has potential to be a useful additional tool for PIED monitoring. A solid-phase extraction (SPE) liquid chromatography tandem mass spectrometry (LC-MS/MS) method was developed and validated for the detection and quantification of around 50 anabolic agents and metabolites in wastewater. This method was applied to wastewater samples collected in August 2021 from 51 WWTPs across Australia, covering roughly 11.6 million people. This method was also used for temporal analysis of anabolic agents in wastewater from one catchment collected from 2009 to 2021. Limits of quantification (LOQs) were, with few exceptions, in the low ng/L with steroids and their metabolites generally having higher LOQs than the non-steroidal anabolic agents. Spatial wastewater analysis showed the use of multiple types of PIEDs within the Australian population in August 2021. Results of temporal samples indicated no clear trends for detected steroidal anabolic agents. However, they showed that the first non-steroidal anabolic agent was detected as early as 2011, with others following in later years. After their first detection, all non-steroidal anabolic agent concentrations increased almost linearly until 2021, often with a peak in concentration in 2018. LOQs are suitable for the detection of trace amounts of PIEDs in wastewater, especially for SARMs and other non-steroidal anabolic agents. As the method is semi-quantitative, concentrations only give an indication of anabolic agent levels, however, these estimates are likely conservative. The analysis of wastewater across 51 Australian WWTPs revealed widespread use of multiple types of steroidal and non-steroidal anabolic agents. The steady increase of concentrations of non-steroidal anabolic agents in the temporal wastewater samples demonstrates the growing popularity of these substances within the general community. A suitable SPE LC-MS/MS method was developed for the analysis of steroidal and non-steroidal anabolic agents in wastewater influent and was successfully applied to spatial and temporal wastewater samples. Many non-steroidal anabolic agents were detected in wastewater for the first time. Spatial analysis showed the prevalence of anabolic agents and temporal analysis revealed the first detections and subsequent emergence of non-steroidal anabolic agents within an Australian WWTP catchment. Results demonstrated that wastewater analysis is a useful complementary tool to further our understanding of PIED use within the general population and that wastewater data may be useful to public health and PIED researchers.

How are large-scale One Health initiatives targeting infectious diseases and antimicrobial resistance evaluated? A scoping review

While One Health initiatives are gaining in popularity, it is unclear if and how they are evaluated when implementation at scale is intended. The main purpose of this scoping review was to describe how One Health initiatives targeting infectious diseases and antimicrobial resistance at a large scale are evaluated. Secondary objectives included identifying the main facilitators and barriers to the implementation and success of these initiatives, and how their impacts were assessed. Twenty-three studies evaluating One Health initiatives were eligible. Most studies included the human (n = 22) and animal (n = 15) sectors; only four included the environment sector. The types of evaluated initiative (non-exclusive) included governance (n = 5), knowledge (n = 6), protection (n = 17), promotion (n = 16), prevention (n = 9), care (n = 8), advocacy (n = 10) and capacity (n = 10). Studies used normative (n = 4) and evaluative (n = 20) approaches to assess the One Health initiatives, the latter including impact (n = 19), implementation (n = 8), and performance (n = 7) analyses. Structural and economic, social, political, communication and coordination-related factors, as well as ontological factors, were identified as both facilitators and barriers for successful One Health initiatives. These results identified a wide range of evaluation methods and indicators used to demonstrate One Health's added values, strengths, and limitations: the inherent complexity of the One Health approach leads to the use of multiple types of evaluation. The strengths and remaining gaps in the evaluation of such initiative highlight the relevance of comprehensive, mixed-method, context-sensitive evaluation frameworks to inform and support the implementation of One Health initiatives by stakeholders in different governance settings.

Association between Complementary and Alternative Medicine Use and Fear of Cancer Recurrence among Breast Cancer Survivors.

BackgroundThis study aimed to evaluate the association between complementary and alternative medicine (CAM) use and fear of cancer recurrence (FCR) among breast cancer survivors, using a validated multidimensional FCR-assessing instrument. Despite the debate over its medical effects, the use of CAM in breast cancer survivors is increasing.MethodsWe recruited 326 breast cancer survivors who had completed the primary cancer treatment. Information on CAM use was obtained using a self-administered questionnaire, and FCR was assessed using the Korean version of the FCR Inventory (FCRI). Multivariate linear regression analysis was performed to evaluate the association between CAM use and FCR.ResultsCAM users had higher total FCR scores than CAM non-users after covariate adjustment (CAM users: 74.6 vs. CAM non-users: 68.7; P=0.047). Among the FCRI subscales, CAM users showed higher coping strategy scores (CAM users: 22.3 vs. CAM non-users: 20.6; P=0.034) in the multivariable adjusted analysis. The use of multiple types of CAM was associated with increased FCR in a dose-dependent manner (P=0.002).ConclusionBreast cancer survivors who used CAM had a higher FCR than CAM non-users. The dose-response relationship between the use of multiple types of CAM and FCR suggests that breast cancer survivors who use multiple types of CAM should be provided with appropriate psychological interventions to decrease FCR.

Model Predictive Control for Multi-Port Modular Multilevel Converters in Electric Vehicles Enabling HESDs

In this paper, the authors propose a model predictive control (MPC) algorithm for multi-port modular multilevel converters (MP-MMCs). MP-MMCs are used to enable the use of hybrid energy storage devices (HESDs) in a scalable energy management system (EMS) for electric vehicle (EV) applications. HESDs refer to the use of multiple types of energy storage cells in an EV drivetrain system. In this paper, battery cells are sized for the EV energy density, while ultra-capacitor cells are used for high acceleration periods. This system reduces the EV drivetrain's weight and size due to eliminating high-power inverters and their filtering components. Using MPC, this system can achieve the following control objectives: 1) extend the battery cells lifetime and driving range by shielding them from high power pulses, 2) balance the state of charge levels of every storage cell, 3) increase the system efficiency through optimizing the supplied motor voltage and reducing the switching losses. Moreover, the proposed solution provides means for onboard high-power charging of EV storage cells. Finally, validation results are provided in the paper using a developed hardware prototype, co-simulations, and hardware in the loop system to verify the system's effectiveness.