Pluralising the European energy landscape: Collective renewable energy prosumers and the EU's clean energy vision

To fulfil the European Union's (EU) goal of providing ‘Clean Energy for All Europeans', a transformative shift from centralised, fossil-fuel based systems to decentralised systems based on renewable energy sources (RES) is envisaged. Keen to lead the clean energy transition while embedding technological innovation and elements of justice and equitability into the envisioned ‘Energy Union’, EU Member States need their citizens on board as active participants. Prosumerism or self-consumption is an important part of this citizen involvement. While the new EU regulatory framework for energy now recognises civic-inspired prosumer initiatives such as energy communities, little is known about the full range and diversity of collective actors in renewable energy self-consumption as well as how they engage with the changing energy system. This paper presents an exploratory categorisation of the different collective social actors that produce and consume energy from renewable sources, referred to as ‘collective RES prosumers’, aiming to clarify their participation in the energy landscape. We find six categories with different engagement and needs, which we relate to the EU's current framing of collective energy actors. We recommend fine-tuning policies to the different actors to support a true-to-vision transposition of the recently completed Clean Energy Package (CEP).info:eu-repo/semantics/publishedVersio

The Effect of Unimodal, Non-pharmacological, Preoperative Psychological Prehabilitation Interventions on Preoperative Anxiety and Stress:A Systematic Review

Background: Prehabilitation is a novel clinical strategy to optimize patients’ health in the waiting period before surgery. Objectives: This article aims to gather the evidence for the effectiveness of unimodal, non-pharmacological psychological prehabilitation interventions on preoperative anxiety and stress before surgery. Design: This is a PRISMA-guided systematic review and narrative synthesis of randomized controlled trials. Methods: The online databases Medline, Embase, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, PsycINFO and Google Scholar were searched on March 20th 2023. The search strategy led to 13,667 records screened and five records of randomized controlled trials included for full-text analysis. A risk-of-bias assessment was performed using the Revised Cochrane Risk of Bias 2 tool. Results: Significant reduction in preoperative anxiety was seen in three studies comprising 337 participants. Two studies did not find that unimodal psychological prehabilitation reduces preoperative anxiety. Only one study assessed preoperative stress and reported a significant reduction. Intervention types used included guided imagery, stress management training, virtual reality experience and computer cognitive behavioral therapy. Conclusions: There is contradictory evidence whether unimodal, non-pharmacological psychological prehabilitation can reduce preoperative anxiety. There is little evidence that non-pharmacological prehabilitation can reduce preoperative stress. Suggestions to improve the research in this field are discussed.</p

The Effect of Unimodal, Non-pharmacological, Preoperative Psychological Prehabilitation Interventions on Preoperative Anxiety and Stress:A Systematic Review

Background: Prehabilitation is a novel clinical strategy to optimize patients’ health in the waiting period before surgery. Objectives: This article aims to gather the evidence for the effectiveness of unimodal, non-pharmacological psychological prehabilitation interventions on preoperative anxiety and stress before surgery. Design: This is a PRISMA-guided systematic review and narrative synthesis of randomized controlled trials. Methods: The online databases Medline, Embase, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, PsycINFO and Google Scholar were searched on March 20th 2023. The search strategy led to 13,667 records screened and five records of randomized controlled trials included for full-text analysis. A risk-of-bias assessment was performed using the Revised Cochrane Risk of Bias 2 tool. Results: Significant reduction in preoperative anxiety was seen in three studies comprising 337 participants. Two studies did not find that unimodal psychological prehabilitation reduces preoperative anxiety. Only one study assessed preoperative stress and reported a significant reduction. Intervention types used included guided imagery, stress management training, virtual reality experience and computer cognitive behavioral therapy. Conclusions: There is contradictory evidence whether unimodal, non-pharmacological psychological prehabilitation can reduce preoperative anxiety. There is little evidence that non-pharmacological prehabilitation can reduce preoperative stress. Suggestions to improve the research in this field are discussed.</p

The Potential Added Value of Novel Hearing Therapeutics: An Early Health Economic Model for Hearing Loss

OBJECTIVE: To construct an early health economic model to assess the potential added value of novel hearing therapeutics, compared with the current standard of care. We use idiopathic sudden sensorineural hearing loss (ISSNHL) as a case example, because it is a lead indication for several emerging hearing therapeutics. METHODS: A decision analytic model was developed to assess the costs and effects of using novel hearing therapeutics for patients with ISSNHL. This was compared to the current standard of care. Input data were derived from literature searches and expert opinion. The study adopted a healthcare perspective of the UK National Health Service. Four analyses were conducted: 1) headroom, 2) scenario, 3) threshold, 4) sensitivity. RESULTS: The decision analytic model showed that novel therapeutics for ISSNHL have potential value both in terms of improved patient outcomes, as well as incremental net monetary benefit (iNMB). The base case analysis revealed an iNMB of £39,032 for novel therapeutics compared with the current standard of care. Results of the threshold and scenario analysis revealed that age of treatment and severity of ISSNHL are major determinants of iNMB for novel therapeutics. CONCLUSION: This article describes the first health economic model for novel therapeutics for hearing loss; and shows that novel hearing therapeutics can be cost-effective under NICE's cost-effectiveness threshold, with considerable room for improvement in the current standard of care. Our model can be used to inform the development of cost-effective hearing therapeutics; and help decision makers decide which therapeutics represent value for money

Application of the Coupling Angle to Investigate Upper Limb Interjoint Coordination After Stroke

Objective: Interjoint coordination after stroke is affected, which limits the use of the upper limb. Current methods to determine interjoint coordination lack the ability to visualize and quantify the movement. Therefore we investigated if the coupling angle can be used to visualize and interpret upper limb interjoint coordination following a stroke. Methods: Seven chronic stroke patients trained six weeks with an assistive home-training system (MERLIN). Kinematic outcomes, i.e. elbow and shoulder range of motion, movement duration, and angle-angle plots were determined in a retrieving task. Interjoint coordination between elbow flexion and shoulder abduction angles was expressed as the coupling angle phases and the number of phase transitions: proximal/distal joint leading phase, in-phase and anti-phase. Comparisons were made within sides: pre-test versus post-test, and between sides: most-affected (MA) versus least-affected (LA). Results: Smaller elbow flexion angles were found PreMA versus PreLA, and smaller shoulder abduction angles in PostMA versus PostLA. A general coordination pattern was revealed on the LA side, but not on the MA side. A trend showed less phase transitions at the MA side after training, suggesting a smoother movement. Quantification of the movement phases indicated more involvement of the shoulder joint involvement in the MA side during pre-test. After training, these differences were not apparent, which might reveal an increased independent control of the elbow joint. Conclusions: The coupling angle and the movement phases provide a promising tool to investigate post-stroke interjoint coordination patterns. Significance: A new visualisation of the interjoint coordination may benefit rehabilitation of stroke survivors. Registration: This trial was registered at the Netherlands Trial Register (NL7535) https://www.trialregister.nl/trial/7535.</p

Early Health Economic Modeling of Novel Therapeutics in Age-Related Hearing Loss

Background: Health systems face challenges to accelerate access to innovations that add value and avoid those unlikely to do so. This is very timely to the field of age-related sensorineural hearing loss (ARHL), where a significant unmet market need has been identified and sizeable investments made to promote the development of novel hearing therapeutics (NT). This study aims to apply health economic modeling to inform the development of cost-effective NT. Methods: We developed a decision-analytic model to assess the potential costs and effects of using regenerative NT in patients ≥50 with ARHL. This was compared to the current standard of care including hearing aids and cochlear implants. Input data was collected from systematic literature searches and expert opinion. A UK NHS healthcare perspective was adopted. Three different but related analyses were performed using probabilistic modeling: (1) headroom analysis, (2) scenario analyses, and (3) threshold analyses. Results: The headroom analysis shows an incremental net monetary benefit (iNMB) of £20,017[£11,299–£28,737] compared to the standard of care due to quality-adjusted life-years (QALY) gains and cost savings. Higher therapeutic efficacy and access for patients with all degrees of hearing loss yields higher iNMBs. Threshold analyses shows that the ceiling price of the therapeutic increases with more severe degrees of hearing loss. Conclusion: NT for ARHL are potentially cost-effective under current willingness-to-pay (WTP) thresholds with considerable room for improvement in the current standard of care pathway. Our model can be used to help decision makers decide which therapeutics represent value for money and are worth commissioning, thereby paving the way for urgently needed NT

Water bottle flipping physics

The water bottle flipping challenge consists of spinning a bottle, partially filled with water, and making it land upright. It is quite a striking phenomenon, since at first sight, it appears rather improbable that a tall rotating bottle could make such a stable landing. Here, we analyze the physics behind the water bottle flip, based on experiments and an analytical model that can be used in the classroom. Our measurements show that the angular velocity of the bottle decreases dramatically, enabling a nearly vertical descent and a successful landing. The reduced rotation is due to an increase in the moment of inertia, caused by the in-flight redistribution of the water mass along the bottle. Experimental and analytical results are compared quantitatively, and we demonstrate how to optimize the chances for a successful landing.</p

Letter from the Citizens of Ommen to the Governor of Overijssel

Sixteen citizens of Ommen sent a communication to the Governor of the Province that they saw no need for him to send a military detachment to Ommen now that the disturbances had ended. Besides, a relatively few people were the troublemakers. The billeting of military people will be a great burden to the citizens of Ommen.https://digitalcommons.hope.edu/vrp_1830s/1048/thumbnail.jp