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Energy drinks can cause cardiovascular, gastrointestinal, and other health disorders. These effects are particularly pronounced in youth. The aim of this study was to systematically review the literature on the consumption of energy drinks in European countries.
Design
A systematic bibliographic search was performed in November 2024 in EMBASE, MEDLINE (Ovid), Scopus and Cochrane databases with no restrictions on country, study period, study design and language.
Setting
Energy drinks are beverages high in caffeine, sugar, and other stimulants.
Participants
A total of 2008 studies were identified and reviewed by four researchers. Ninety-four met the inclusion criteria and were extracted in a table designed ad hoc.
Results
The included studies showed differences regarding their design, definition of consumption, and time frame under study. The most studied frequency of energy drink consumption was weekly consumption, and the most studied population was school students. An increase in prevalence of consumption was observed when tracking energy drink consumption over time. Variables most related to consumption were low socioeconomic status, alcohol and tobacco consumption, physical activity, age, and sex.
Conclusions
It is difficult to have a clear picture of the extent of energy drink consumption in Europe, mainly due to differences in the design of the studies and the lack of periodicity of the estimates in different countries. However, given the health problems that have been associated with energy drink consumption, regulation of these beverages is essential, especially in youth.
We provide an assessment of the Infinity Two fusion pilot plant (FPP) baseline plasma physics design. Infinity Two is a four-field period, aspect ratio $A = 10$, quasi-isodynamic stellarator with improved confinement appealing to a max-$J$ approach, elevated plasma density and high magnetic fields ($ \langle B\rangle = 9$ T). Here $J$ denotes the second adiabatic invariant. At the envisioned operating point ($800$ MW deuterium-tritium (DT) fusion), the configuration has robust magnetic surfaces based on magnetohydrodynamic (MHD) equilibrium calculations and is stable to both local and global MHD instabilities. The configuration has excellent confinement properties with small neoclassical transport and low bootstrap current ($|I_{bootstrap}| \sim 2$ kA). Calculations of collisional alpha-particle confinement in a DT FPP scenario show small energy losses to the first wall (${\lt}1.5 \,\%$) and stable energetic particle/Alfvén eigenmodes at high ion density. Low turbulent transport is produced using a combination of density profile control consistent with pellet fueling and reduced stiffness to turbulent transport via three-dimensional shaping. Transport simulations with the T3D-GX-SFINCS code suite with self-consistent turbulent and neoclassical transport predict that the DT fusion power$P_{{fus}}=800$ MW operating point is attainable with high fusion gain ($Q=40$) at volume-averaged electron densities $n_e\approx 2 \times 10^{20}$ m$^{-3}$, below the Sudo density limit. Additional transport calculations show that an ignited ($Q=\infty$) solution is available at slightly higher density ($2.2 \times 10^{20}$ m$^{-3}$) with $P_{{fus}}=1.5$ GW. The magnetic configuration is defined by a magnetic coil set with sufficient room for an island divertor, shielding and blanket solutions with tritium breeding ratios (TBR) above unity. An optimistic estimate for the gas-cooled solid breeder designed helium-cooled pebble bed is TBR $\sim 1.3$. Infinity Two satisfies the physics requirements of a stellarator fusion pilot plant.
In this work, we present a detailed assessment of fusion-born alpha-particle confinement, their wall loads, and stability of Alfvén eigenmodes driven by these energetic particles in the Infinity Two Fusion Pilot Plant Baseline Plasma Design, a 4-field-period quasiisodynamic stellarator to operate in deuterium-tritium fusion conditions. Using the Monte-Carlo codes SIMPLE, ASCOT5, and KORC-T, we study the collisionless and collisional dynamics of guiding-center and full-orbit alpha-particles in the core plasma. We find that core energy losses to the wall are less than 4%. Our simulations shows that peak power loads on the wall of this configuration are around 2.5 MW/m2 and are spatially localized, toroidally, and poloidaly in the vicinity of x-points of the magnetic island chain n/m = 4/5 outside the plasma volume. Also, an exploratory analysis using various simplified walls shows that shaping and distance of the wall from the plasma volume can help reduce peak power loads. Our stability assessment of Alfvén eigenmodes using the STELLGAP and FAR3d codes shows the absence of unstable modes driven by alpha-particles in Infinity Two due to the relatively low alpha-particle beta at the envisioned 800 MW operating scenario.
The magnetohydrodynamic (MHD) equilibrium and stability properties of the Infinity Two fusion pilot plant baseline plasma physics design are presented. The configuration is a four-field period, aspect ratio $A = 10$ quasi-isodynamic stellarator optimised for excellent confinement at elevated density and high magnetic field $B = 9\,T$. Magnetic surfaces exist in the plasma core in vacuum and retain good equilibrium surface integrity from vacuum to an operational $\beta = 1.6 \,\%$, the ratio of the volume average of the plasma and magnetic pressures, corresponding to $800\ \textrm{MW}$ deuterium–tritium fusion operation. Neoclassical calculations show that a self-consistent bootstrap current of the order of ${\sim} 1\ \textrm{kA}$ slightly increases the rotational transform profile by less than 0.001. The configuration has a magnetic well across its entire radius. From vacuum to the operating point, the configuration exhibits good ballooning stability characteristics, exhibits good Mercier stability across most of its minor radius and it is stable against global low-n MHD instabilities up to $\beta = 3.2\,\%$.
During the past 30 yr an impasse has developed in the discovery and commercialization of synthetic herbicides with new molecular targets and novel chemistries. Similarly, there has been little success with bioherbicides, both microbial and chemical. These bioherbicides are needed to combat fast-growing herbicide resistance and to fulfill the need for more environmentally and toxicologically safe herbicides. In response to this substantial and growing opportunity, numerous start-up companies are utilizing novel approaches to provide new tools for weed management. These diverse new tools broaden the scope of discovery, encompassing advanced computational, bioinformatic, and imaging platforms; plant genome–editing and targeted protein degradation technologies; and machine learning and artificial intelligence (AI)-based strategies. This review contains summaries of the presentations of 10 such companies that took part in a symposium held at the WSSA annual meeting in 2024. Four of the companies are developing microbial bioherbicides or natural product–based herbicides, and the other six are using advanced technologies, such as AI, to accelerate the discovery of herbicides with novel molecular target sites or to develop non-GMO, herbicide-resistant crops.
The ability to remotely monitor cognitive skills is increasing with the ubiquity of smartphones. The Mobile Toolbox (MTB) is a new measurement system that includes measures assessing Executive Functioning (EF) and Processing Speed (PS): Arrow Matching, Shape-Color Sorting, and Number-Symbol Match. The purpose of this study was to assess their psychometric properties.
Method:
MTB measures were developed for smartphone administration based on constructs measured in the NIH Toolbox® (NIHTB). Psychometric properties of the resulting measures were evaluated in three studies with participants ages 18 to 90. In Study 1 (N = 92), participants completed MTB measures in the lab and were administered both equivalent NIH TB measures and other external measures of similar cognitive constructs. In Study 2 (N = 1,021), participants completed the equivalent NIHTB measures in the lab and then took the MTB measures on their own, remotely. In Study 3 (N = 168), participants completed MTB measures twice remotely, two weeks apart.
Results:
All three measures exhibited very high internal consistency and strong test-retest reliability, as well as moderately high correlations with comparable NIHTB tests and moderate correlations with external measures of similar constructs. Phone operating system (iOS vs. Android) had a significant impact on performance for Arrow Matching and Shape-Color Sorting, but no impact on either validity or reliability.
Conclusions:
Results support the reliability and convergent validity of MTB EF and PS measures for use across the adult lifespan in remote, self-administered designs.
Health technology assessment (HTA) agencies in Spain have an important role in informing decisions about the introduction and use of health technologies in the Spanish National Health System. However, although different approaches have been taken to measure and improve their impact, no study to date has explored the perceived impact of HTA products at the national level. The aim of this study was to explore the perspectives of macro-, meso-, and micro-level decision makers on how to improve the impact of HTA.
Methods
Three online focus groups were conducted with policy makers, healthcare managers, clinicians, and patients. The transcripts were evaluated using a deductive thematic analysis based on a multidimensional framework to explore mechanisms of impact.
Results
Four key themes were identified:
(i) Timeliness and use of HTA assessments: Although the quality of the reports was recognized, the time taken for the elaboration and extension of reports negatively affected their use. Participants considered that reports should be tailored to the needs of end users (e.g., briefer versions available for meso-and micro-level use);
(ii) Effective engagement and external communications: The engagement of multiple stakeholders (policy makers, manufacturers, clinicians, and patients) in the elaboration process was considered crucial to improve HTA impact and ensure adequate communication of results;
(iii) Good institutional reputation and fit within the healthcare and policy making system: Stakeholders agreed on the need to strengthen collaboration at the national level and increase public understanding of the value of HTA and its use in healthcare decision-making; and
(iv) Effective implementation of policy change regarding health technologies: Stakeholders were very receptive to the results and recommendations of HTA reports when new technologies are demanded, but the identification and selection process should be improved to guarantee that these reports are available on time.
Conclusions
This study has identified different proposals and mechanisms that could improve the impact of HTA in Spain.
The Vulnerable marsh deer Blastocerus dichotomus, the largest native cervid in South America, is declining throughout its range as a result of the conversion of wetlands and overhunting. Estimated densities in open wetlands of several types are 0.1–6.8 individuals per km2. We undertook the first unmanned aerial vehicle (UAV) survey of the marsh deer to estimate the density of this species in a 113.6 km2 area under forestry management in the lower delta of the Paraná River, Argentina. During 6–8 August 2019, at a time of year when canopy cover is minimal, we surveyed marsh deer using Phantom 4 Pro UAVs along 94 transects totalling 127.8 km and 8.6 km2 (8.1% of the study area). The 5,506 photographs obtained were manually checked by us and by a group of 39 trained volunteers, following a standardized protocol. We detected a total of 58 marsh deer, giving an estimated density of 6.90 individuals per km2 (95% CI 5.26–8.54), which extrapolates to 559–908 individuals in our 113.6 km2 study area. As it has generally been assumed that marsh deer prefer open habitats, this relatively high estimate of density within a forestry plantation matrix is unexpected. We discuss the advantages of using UAVs to survey marsh deer and other related ungulates.
This study aimed to assess individual preference, symptoms and compliance between habitual use of Provox XtraFlow and the combination of Provox XtraFlow during the day and Provox Luna during the night for heat and moisture exchanger therapy in laryngectomised patients.
Method
This was an open, randomised, crossover trial for 25 days. After this first study period and a 5-day wash-out period, treatments were switched for another 25 days.
Results
A total of 28 patients were enrolled. Differences were found (p = 0.009) in the incidence of dermatological problems with XtraFlow (46.4 per cent) versus Provox Luna (14.3 per cent), as well as in the need to abandon the use of adhesives (46.4 per cent vs 10.7 per cent; p = 0.003). A total of 60.7 per cent of the patients preferred the Provox Luna system as their preference for heat and moisture exchanger therapy.
Conclusion
The Provox Luna system is a viable additive to heat and moisture exchanger therapy, especially in the setting of compliance concerns and in patients who desire dermatological relief overnight.
Bacillus pumilus SAFR-032, an endospore-forming bacterial strain, was investigated to determine its methylation pattern (methylome) change, compared to ground control, after direct exposure to space conditions onboard the International Space Station (ISS) for 1.5 years. The resulting ISS-flown and non-flown strains were sequenced using the Nanopore MinION and an in-house method and pipeline to identify methylated positions in the genome. Our analysis indicated genomic variants and m6A methylation increased in the ISS-flown SAFR-032. To complement the broader omics investigation and explore phenotypic changes, ISS-flown and non-flown strains were compared in a series of laboratory-based chamber experiments using an X-ray irradiation source (doses applied at 250, 500, 750, 1000 and 1250 Gy); results show a potentially higher survival fraction of ISS-flown DS2 at the two highest exposures. Taken together, results from this study document lasting changes to the genome by methylation, potentially triggered by conditions in spaceflight, with functional consequences for the resistance of bacteria to stressors expected on long-duration missions beyond low Earth orbit.
Previous studies attest that early bilinguals can modify their perceptual identification according to the fine-grained phonetic detail of the language they believe they are hearing. Following Gonzales et al. (2019), we replicate the double phonemic boundary effect in late learners (LBs) using conceptual-based cueing. We administered a forced choice identification task to 169 native English adult learners of Spanish in two sessions. In both sessions, participants identified the same /b/-/p/ voicing continuum, but language context was cued conceptually using the instructions. The data were analyzed using Bayesian multilevel regression. Learners categorized the continuum in a similar manner when they believed they were hearing English. However, when they believed they were hearing Spanish, “voiceless” responses increased as a function of L2 proficiency. This research demonstrates the double phonemic boundary effect can be conceptually cued in LBs and supports accounts positing selective activation of independent perception grammars in L2 learning.
Musical hallucinations are a rare phenomenon in clinical practice. The purpose of this study was to analyze the clinical spectrum of musical hallucinations.
Method:
We analysed demographic and clinical features of cases published in English, Italian, French or Spanish between 1991 and 2006 registered in MEDLINE, including three of our own cases. The cases were separated into four groups according to their main diagnoses (hearing impairment; psychiatric disorder; neurological disorder; toxic or metabolic disorder).
Results:
115 patients with musical hallucinations were included, of which 63.5% were female. The mean age was 57,25 years. Main diagnoses were: psychiatric disorder (46.1%; schizophrenia 30.4%), neurological disorder (21,7%), hearing impairment (17,4%), toxic or metabolic disorder (12.2%) and 2.6% other diagnoses.
61.7% patients presented simple diagnoses while 36.5% presented two or more diagnoses. 2.1% of patients didn't receive any diagnoses. 35.7% of patients and 60.9% of non psychiatric patients presented hearing impairment.
Both instrumental and vocal were the more frequent musical hallucinations and most of the patients had insight about the abnormality of their perceptions. Another kind of hallucinations was present in 40.9% of patients, auditory hallucinations being the most common. Also, 38,3% of the global sample had abnormalities in brain structural image (MRI, CT).
Conclusions:
Musical hallucinations are a heterogeneous phenomenon in clinical practice. published cases describe them as more common in women and in psychiatric and neurological patients. Hearing impairment seem to be an important risk factor in the development of musical hallucinations.
Prevalence of cardiovascular disease is high in schizophrenia. Our aim is to estimate the prevalence of cardiovascular risk factors (CVRF) among schizophrenia patients.
Method
National cross-sectional study in patients diagnosed with schizophrenia under treatment with second generation antipsychotics and admitted to short-stay hospitalisation units.
Results
A sample of 733 consecutively admitted patients was enrolled; the most prevalent CVRFs were smoking 71% (95% CI: 67–74%) and hypercholesterolemia 66% (61–70%) followed by hypertriglyceridemia 26% (26–32%), hypertension 18% (15–21%) and diabetes 5% (4–7%). Metabolic syndrome showed 19% (95% CI: 16–23%) prevalence or, according to updated definitions (Clin Cornerstone 7 [2005] 36–45), 24% (95% CI: 20–28%). The rate of patients within the high-risk range of a 10-year fatal cardiovascular event was 6.5%. CVRFs under routine management were diabetes (60%), hypertension (28%) and, to a lesser extent, dyslipemia (14%). Treatment for CVRFs was associated to gender, men for hypertension OR = 25.34, p < 0.03 and women for diabetes OR = 0.02, p < 0.03.
Conclusion
We found that CVRFs in schizophrenia were prevalent and under-diagnosed, and thus with insufficient therapeutic management.
Eye movement recordings can provide information about higher-level processing of visual information. Recent evidence shows a novel role for eye vergence in orienting attention (Solé Puig et al., 2013). Based on such eye tracking data, the BGaze method (Braingaze; Spain) detects visual attention. The outcomes of the BGaze method have been applied to classify ADHD patients from healthy controls.
Aim
In this study, we validated the BGaze method.
Objective
We therefore recorded eye movements in children while performing a visual detection task.
Methods
We evaluated the BGaze method using 4 types of supervised machine learning algorithms. In total, 138 different trained models were tested. Nineteen ADHD diagnosed patients (children 7–14 years of age) and 19 healthy age matched controls were used to build the 138 models. We performed 30 times repeated random sub-sampling validation. In each repeated random split, training set consisted of 80% of the data and test set of the remaining 20%. Finally, all the 138 models were tested with a validation set consisting of 232 children, including 22 ADHD patients.
Results
Across all the 138 models, BGaze method showed an average accuracy of 90.84% (minimum 86.21%; maximum, 95.26%) and an average AUC of 0.95 (minimum 0.90; maximum, 0.97). Best models gave accuracies of 92%, AUCs of 0.96 and FN and FP rates of 4.3% and 7.5%, respectively. Mean scores during the training-testing phase averaged 99.63%.
Conclusion
The BGaze method is robust, accurate, and can provide an objective tool supporting the clinical diagnosis of ADHD.
Disclosure of interest
The authors have not supplied their declaration of competing interest.
In Mexico, physicians have become part of public service prehospital care. Head injured patients are a sensitive group that can benefit from early advanced measures to protect the airway, with the objective to reduce hypoxia and maintain normocapnia.
Problem:
The occurrence of endotracheal intubation to patients with severe head injuries by prehospital physicians working at Mexico City’s Service of Emergency Medical Care (SAMU) is unknown.
Methods:
A retrospective analysis of five-year data (2012-2016) from Mexico City’s Medical Emergencies Regulation Center was performed. Only SAMU ambulance services were analyzed. Adult patients with a prehospital diagnosis of head injury based on mechanism of injury and physical examination with a Glasgow Coma Scale (GCS) <nine were included.
Results:
A total of 293 cases met the inclusion criteria; the mean GCS was five points. Of those, 150 (51.1%) patients were intubated. There was no difference in the occurrence of intubation among the different GCS scales, or if the patient was considered to have isolated head trauma versus polytrauma. Fifteen patients were intubated using sedation and neuromuscular blockage. Four patients were intubated with sedation alone and six patients with neuromuscular blockage alone. One patient was intubated using opioid analgesia, sedation, and neuromuscular blockage.
Conclusions:
Patients with severe head injuries cared by prehospital physicians in Mexico City were intubated 51.1% of the time and were more likely to be intubated without the assistance of anesthetics.
Non-noble metal bifunctional nanocatalysts based on CoFe2O4/C were synthetized by the electrospinning method and evaluated for the Oxygen Evolution Reaction (OER) and the Oxygen Reduction Reaction (ORR). The effect of annealing at different temperatures (T=300, 600 and 900°C) on their morphological and structural features was characterized by XRD, EDS, Raman, FESEM, HRTEM and XPS. The nanofibers annealed at 300 °C (CoFe2O4-300) showed a cubic spinel structure and an average diameter of 42 nm. The CoFe2O4-300/C nanocatalyst demonstrated the highest catalytic activity towards the OER, outperforming the benchmark commercial 20 wt. % Pt/C. Meanwhile all CoFe2O4-based nanocatalysts showed fair catalytic activity for the ORR (Eonset ≈ 0.801 V/RHE, n≈ 3.56, %HO2- ≈ 21-39). In addition, the CoFe2O4/C nanocatalysts demonstrated a higher electrochemical stability than Pt/C for both the ORR and the OER.
A new species of the genus Plagiorhynchus Lühe, 1911 from the intestine of the long-billed curlew (Numenius americanus) from northern Mexico is described. Plagiorhynchus (Plagiorhynchus) aznari n. sp. is morphologically distinguished from other congeneric species from the Americas by having a trunk expanded anteriorly and a cylindrical proboscis, armed with 19 longitudinal rows of hooks, with 14–15 hooks each row. Nearly complete sequences of the small subunit and large subunit of the nuclear ribosomal DNA of the new species were determined and compared with available sequences from GenBank. Phylogenetic analyses inferred from the two molecular markers consistently showed that P. (Plagiorhynchus) aznari n. sp. is closely related to P. (Plagiorhynchus) allisonae, and this clade is sister to a clade formed by P. (Prosthorhynchus) transversus and P. (Prosthorhynchus) cylindraceus from Plagiorhynchidae. The new species represents the second record of the genus in Mexico and the fourth species in the Americas. The phylogenetic relationships among the members of the order Polymorphida in this study provide significant insights into the evolution of ecological associations between parasites and their definitive hosts. Our analyses suggest that the colonization of marine mammals, fish-eating birds and waterfowl in Polymorphidae might have occurred independently, from a common ancestor of Centrorhynchidae and Plagiorhynchidae that colonized terrestrial birds and mammals.
Cephalopods are important prey in the diet of top predators, such as marine mammals and seabirds. However, detailed information on their trophic relationships in the Patagonian marine ecosystem is scarce, including those cephalopod species with commercial interest. The aims of this study were to evaluate the composition of the cephalopod component in the diet of Otaria byronia and determine the habitat use and trophic levels of their main cephalopod prey by measuring the stable isotopic signature of cephalopod beaks. Between May 2005 and February 2009, fresh faecal samples were collected from two sea lions rookeries in San Matias Gulf. Cephalopods occurred in 39.4% of the 1112 samples collected during the whole period of study. The dominant prey species was Octopus tehuelchus, which occurred in 45.8% of scats containing cephalopod remains, and represented 58.7% in terms of numerical abundance and 52.0% in mass of cephalopods consumed. The second species most consumed was the myopsid Doryteuthis gahi. The significant higher δ15N values of O. tehuelchus beaks in comparison with those of D. gahi showed that these two species have different trophic levels while occupying similar habitat (δ13C values) in neritic waters of the Patagonian shelf.
The Centro de Laseres Pulsados in Salamanca, Spain has recently started operation phase and the first user access period on the 6 J 30 fs 200 TW system (VEGA 2) already started at the beginning of 2018. In this paper we report on two commissioning experiments recently performed on the VEGA 2 system in preparation for the user campaign. VEGA 2 system has been tested in different configurations depending on the focusing optics and targets used. One configuration (long focal length $F=130$ cm) is for underdense laser–matter interaction where VEGA 2 is focused onto a low density gas-jet generating electron beams (via laser wake field acceleration mechanism) with maximum energy up to 500 MeV and an X-ray betatron source with a 10 keV critical energy. A second configuration (short focal length $F=40$ cm) is for overdense laser–matter interaction where VEGA 2 is focused onto a $5~\unicode[STIX]{x03BC}\text{m}$ thick Al target generating a proton beam with a maximum energy of 10 MeV and temperature of 2.5 MeV. In this paper we present preliminary experimental results.
The clinical and pathologic characterisation of two fatal cases of tick-borne rickettsiosis in rural (El Valle) and urban (City of Panama) Panama are described. Clinical and autopsy findings were non-specific, but the molecular analysis was used to identify Rickettsia rickettsii in both cases. No ticks were collected in El Valle, while in the urban case, R. rickettsii was detected in Rhipicephalus sanguineus s.l., representing the first molecular finding in this tick in Panama and Central America.