8,751 research outputs found

    Urban heat mitigation by green and blue infrastructure: drivers, effectiveness, and future needs

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    The combination of urbanisation and global warming leads to urban overheating and compounds the frequency and intensity of extreme heat events due to climate change. Yet, the risk of urban overheating can be mitigated by urban green-blue-grey infrastructures (GBGI), such as parks, wetlands, and engineered greening, which have the potential to effectively reduce summer air temperatures. Despite many reviews, the evidence bases on quantified GBGI cooling benefits remains partial and the practical recommendations for implementation are unclear. This systematic literature review synthesises the evidence base for heat mitigation and related co-benefits, identifies knowledge gaps, and proposes recommendations for their implementation to maximise their benefits. After screening 27,486 papers, 202 were reviewed, based on 51 GBGI types categorised under 10 main divisions. Certain GBGI (green walls, parks, street trees) have been well-researched for their urban cooling capabilities. However, several other GBGI have received negligible (zoological garden, golf course, estuary) or minimal (private garden, allotment) attention. The most efficient air cooling was observed in botanical gardens (5.0±3.5°C), wetlands (4.9±3.2°C), green walls (4.1±4.2°C), street trees (3.8±3.1°C), and vegetated balconies (3.8±2.7°C). Under changing climate conditions (2070-2100) with consideration of RCP8.5, there is a shift in climate subtypes, either within the same climate zone (e.g., Dfa to Dfb and Cfb to Cfa) or across other climate zones (e.g., Dfb (continental warm-summer humid) to BSk (dry, cold semi-arid) and Cwa (temperate) to Am (tropical)). These shifts may result in lower efficiency for the current GBGI in the future. Given the importance of multiple services, it is crucial to balance their functionality, cooling performance, and other related co-benefits when planning for the future GBGI. This global GBGI heat mitigation inventory can assist policymakers and urban planners in prioritising effective interventions to reduce the risk of urban overheating, filling research gaps, and promoting community resilience

    Genotype by environment model predictive ability in Miscanthus

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    Abstract Miscanthus is a genus of perennial grasses native to East Asia that shows promise as a biofuel energy source. Breeding efforts for increasing biofuel capability in this genus have focused on two species, namely M. sinensis (Msi) and M. sacchariflorus (Msa). For these efforts to succeed, it is critical that both Msi and Msa, as well as their interspecific crosses, can be grown at a wide range of latitudes. Therefore, the purpose of this study was to investigate how well existing data from Msi and Msa trials grown at locations throughout the northern hemisphere can train state‐of‐the‐art genomic selection (GS) models to predict genomic estimated breeding values (GEBVs) of dry yield for untested Msi and Msa accessions in untested environments. We found that accounting for genotype by environment interaction in the GS model did not notably improve predictive ability. Additionally, we observed that locations at lower latitudes showed higher predictive ability relative to locations at higher latitudes. These results suggest that it is crucial to increase the number of trial locations at higher latitude locations to investigate the source of this correlation. This will make it possible to train GS models using data from environments that are similar to growing conditions at the locations targeted by Msi and Msa breeders. Such an increase of trial locations in target environments could pave the way toward advancing breeding efforts for overwintering ability in Msi and Msa, and ultimately support the potential of Miscanthus as a biofuel crop

    Impaired cholinergic integrity of the colon and pancreas in dementia with Lewy bodies

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    Dementia with Lewy bodies is characterized by a high burden of autonomic dysfunction and Lewy pathology in peripheral organs and components of the sympathetic and parasympathetic nervous system. Parasympathetic terminals may be quantified with [18F]fluoroetoxybenzovesamicol, a PET tracer that binds to the vesicular acetylcholine transporter in cholinergic presynaptic terminals. Parasympathetic imaging may be useful for diagnostics, improving our understanding of autonomic dysfunction, and for clarifying the spatiotemporal relationship of neuronal degeneration in prodromal disease. Therefore, we aimed to investigate the cholinergic parasympathetic integrity in peripheral organs and central autonomic regions of subjects with Dementia with Lewy bodies and its association with subjective and objective measures of autonomic dysfunction. We hypothesized that organs with known parasympathetic innervation, especially the pancreas and colon, would have impaired cholinergic integrity. To achieve these aims, we conducted a cross-sectional comparison study including 23 newly diagnosed non-diabetic subjects with Dementia with Lewy bodies (74 ± 6 years, 83% male) and 21 elderly controls (74 ± 6 years, 67% male). We obtained whole-body images to quantify PET uptake in peripheral organs and brain images to quantify PET uptake in regions of the brainstem and hypothalamus. Autonomic dysfunction was assessed with questionnaires and measurements of orthostatic blood pressure. Subjects with Dementia with Lewy bodies displayed reduced cholinergic tracer uptake in the pancreas (32% reduction, P = 0.0003) and colon (19% reduction, P = 0.0048), but not in organs with little or no parasympathetic innervation. Tracer uptake in a region of the medulla oblongata overlapping the dorsal motor nucleus of the vagus correlated with autonomic symptoms (rs = -0.54, P = 0.0077) and changes in orthostatic blood pressure (rs = 0.76, P &lt; 0.0001). Tracer uptake in the pedunculopontine region correlated with autonomic symptoms (rs = -0.52, P = 0.0104) and a measure of non-motor symptoms (rs = -0.47, P = 0.0230). In conclusion, our findings provide the first imaging-based evidence of impaired cholinergic integrity of the pancreas and colon in Dementia with Lewy bodies. The observed changes may reflect parasympathetic denervation, implying that this process is initiated well before the point of diagnosis. The findings also support that cholinergic denervation in the brainstem contributes to dysautonomia.</p

    <b>Supplemental Material - Engaging health care professionals in quality improvement: A qualitative study exploring the synergies between projects of professionalisation and institutionalisation in quality improvement collaborative implementation in Denmark</b>

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    Supplemental Material for Engaging health care professionals in quality improvement: A qualitative study exploring the synergies between projects of professionalisation and institutionalisation in quality improvement collaborative implementation in Denmark by Kathrine Carstensen, Joanne Goldman, Anne Mette Kjeldsen, Stina Lou, and Camilla Palmhøj Nielsen in Journal of Health Services Research & Policy.</p

    Medication Dispensing by Pharmacy Technicians Improves Efficiency and Patient Safety at a Geriatric Ward at a Danish Hospital: A Pilot Study

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    Background: This study aims to evaluate medication dispensing by pharmacy technicians at a geriatric inpatient ward at a Danish hospital. Methods: Four pharmacy technicians were trained in delivering a dispensing service at a geriatric ward. At baseline, the ward nurses recorded the time spent dispensing the medication and the number of interruptions. Similar recordings were completed twice during the period in which the pharmacy technicians delivered the dispensing service. Satisfaction among the ward staff with the dispensing service was assessed by a questionnaire. Reported medication errors were collected during the dispensing service period and compared to a similar time period during the previous two years. Results: The time spent on dispensing medications was on average reduced with 1.4 h per day ranging from 4.7 to 3.3 h per day when the pharmacy technicians performed the service. Interruptions during the dispensing process decreased from a daily average of more than 19 times to an average of 2–3 per day. The nursing staff reported positive feedback on the medication dispensing service provided, especially about easing their workload. There was a tendency toward decreased reporting of medication errors. Conclusion: The medication dispensing service performed by the pharmacy technicians reduced time spent on dispensing medication and increased patient safety by reducing interruptions during the process and decreasing the number of medication errors reported

    TCR-engaging scaffolds selectively expand antigen-specific T-cells with a favorable phenotype for adoptive cell therapy

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    Background Adoptive cell therapy (ACT) has shown promising results for the treatment of cancer and viral infections. Successful ACT relies on ex vivo expansion of large numbers of desired T-cells with strong cytotoxic capacity and in vivo persistence, which constitutes the greatest challenge to current ACT strategies. Here, in this study, we present a novel technology for ex vivo expansion of antigen-specific T-cells; artificial antigen-presenting scaffolds (Ag-scaffolds) consisting of a dextran-polysaccharide backbone, decorated with combinations of peptide-Major Histocompatibility Complex (pMHC), cytokines and co-stimulatory molecules, enabling coordinated stimulation of antigen-specific T-cells.Methods The capacity of Ag-scaffolds to expand antigen-specific T-cells was explored in ex vivo cultures with peripheral blood mononuclear cells from healthy donors and patients with metastatic melanoma. The resulting T-cell products were assessed for phenotypic and functional characteristics.Results We identified an optimal Ag-scaffold for expansion of T-cells for ACT, carrying pMHC and interleukin-2 (IL-2) and IL-21, with which we efficiently expanded both virus-specific and tumor-specific CD8+ T cells from peripheral blood of healthy donors and patients, respectively. The resulting T-cell products were characterized by a high frequency of antigen-specific cells with high self-renewal capacity, low exhaustion, a multifunctional cytokine profile upon antigen-challenge and superior tumor killing capacity. This demonstrates that the coordinated stimuli provided by an optimized stoichiometry of TCR engaging (pMHC) and stimulatory (cytokine) moieties is essential to obtain desired T-cell characteristics. To generate an ‘off-the-shelf’ multitargeting Ag-scaffold product of relevance to patients with metastatic melanoma, we identified the 30 most frequently recognized shared HLA-A0201-restricted melanoma epitopes in a cohort of 87 patients. By combining these in an Ag-scaffold product, we were able to expand tumor-specific T-cells from 60–70% of patients with melanoma, yielding a multitargeted T-cell product with up to 25% specific and phenotypically and functionally improved T cells.Conclusions Taken together, the Ag-scaffold represents a promising new technology for selective expansion of antigen-specific CD8+ T cells directly from blood, yielding a highly specific and functionally enhanced T-cell product for ACT