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Lack of Knowledge of Antibiotic Risks Contributes to Primary Care Patients Expectations of Antibiotics for Common Symptoms [Research Briefs]

Patient expectations of receiving antibiotics for common symptoms can trigger unnecessary use. We conducted a survey (n = 564) between January 2020 to June 2021 in public and private primary care clinics in Texas to study the prevalence and predictors of patients’ antibiotic expectations for common symptoms/illnesses. We surveyed Black patients (33%) and Hispanic/Latine patients (47%), and over 93% expected to receive an antibiotic for at least 1 of the 5 pre-defined symptoms/illnesses. Public clinic patients were nearly twice as likely to expect antibiotics for sore throat, diarrhea, and cold/flu than private clinic patients. Lack of knowledge of potential risks of antibiotic use was associated with increased antibiotic expectations for diarrhea (odds ratio [OR] = 1.6; 95% CI, 1.1-2.4) and cold/flu symptoms (OR = 2.9; 95% CI, 2.0-4.4). Lower education and inadequate health literacy were predictors of antibiotic expectations for diarrhea. Future antibiotic stewardship interventions should tailor patient education materials to include information on antibiotic risks and guidance on appropriate antibiotic indications.




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Digital Innovation to Grow Quality Care Through an Interprofessional Care Team (DIG IT) Among Underserved Patients With Hypertension [Original Research]

PURPOSE

The impact of digital health on medically underserved patients is unclear. This study aimed to determine the early impact of a digital innovation to grow quality care through an interprofessional care team (DIG IT) on the blood pressure (BP) and 10-year atherosclerotic cardiovascular disease (ASCVD) risk score of medically underserved patients.

METHODS

This was a 3-month, prospective intervention study that included patients aged 40 years or more with BP of 140/90 mmHg or higher who received care from DIG IT from August through December 2021. Sociodemographic and clinical outcomes of DIG IT were compared with historical controls (controls) whose data were randomly extracted by the University of California Data Warehouse and matched 1:1 based on age, ethnicity, and baseline BP of the DIG IT arm. Multiple linear regression was performed to adjust for potential confounding factors.

RESULTS

A total of 140 patients (70 DIG IT, 70 controls) were included. Both arms were similar with an average age (SD) of 62.8 (9.7) years. The population was dominated by Latinx (79.3%) persons, with baseline mean BP of 163/81 mmHg, and mean ASCVD risk score of 23.9%. The mean (SD) reduction in systolic BP at 3 months in the DIG IT arm was twice that of the controls (30.8 [17.3] mmHg vs 15.2 [21.2] mmHg; P <.001). The mean (SD) ASCVD risk score reduction in the DIG IT arm was also twice that of the controls (6.4% [7.4%] vs 3.1% [5.1%]; P = .003).

CONCLUSIONS

The DIG IT was more effective than controls (receiving usual care). Twofold improvement in the BP readings and ASCVD scores in medically underserved patients were achieved with DIG IT.




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A Cluster-Randomized Study of Technology-Assisted Health Coaching for Weight Management in Primary Care [Original Research]

PURPOSE

We undertook a trial to test the efficacy of a technology-assisted health coaching intervention for weight management, called Goals for Eating and Moving (GEM), within primary care.

METHODS

This cluster-randomized controlled trial enrolled 19 primary care teams with 63 clinicians; 9 teams were randomized to GEM and 10 to enhanced usual care (EUC). The GEM intervention included 1 in-person and up to 12 telephone-delivered coaching sessions. Coaches supported goal setting and engagement with weight management programs, facilitated by a software tool. Patients in the EUC arm received educational handouts. We enrolled patients who spoke English or Spanish, were aged 18 to 69 years, and either were overweight (body mass index 25-29 kg/m2) with a weight-related comorbidity or had obesity (body mass index ≥30 kg/m2). The primary outcome (weight change at 12 months) and exploratory outcomes (eg, program attendance, diet, physical activity) were analyzed according to intention to treat.

RESULTS

We enrolled 489 patients (220 in the GEM arm, 269 in the EUC arm). Their mean (SD) age was 49.8 (12.1) years; 44% were male, 41% Hispanic, and 44% non-Hispanic Black. At 12 months, the mean adjusted weight change (standard error) was –1.4 (0.8) kg in the GEM arm vs –0.8 (1.6) kg in the EUC arm, a nonsignificant difference (P = .48). There were no statistically significant differences in secondary outcomes. Exploratory analyses showed that the GEM arm had a greater change than the EUC arm in mean number of weekly minutes of moderate to vigorous physical activity other than walking, a finding that may warrant further exploration.

CONCLUSIONS

The GEM intervention did not achieve clinically important weight loss in primary care. Although this was a negative study possibly affected by health system resource limitations and disruptions, its findings can guide the development of similar interventions. Future studies could explore the efficacy of higher-intensity interventions and interventions that include medication and bariatric surgery options, in addition to lifestyle modification.




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A Few Doctors Will See Some of You: The Critical Role of Underrepresented in Medicine (URiM) Family Physicians in the Care of Medicaid Beneficiaries [Original Research]

PURPOSE

Despite being key to better health outcomes for patients from racial and ethnic minority groups, the proportion of underrepresented in medicine (URiM) physicians remains low in the US health care system. This study linked a nationally representative sample of family physicians (FPs) with Medicaid claims data to explore the relative contributions to care of Medicaid populations by FP race and ethnicity.

METHODS

This descriptive cross-sectional study used 2016 Medicaid claims data from the Transformed Medicaid Statistical Information System and from 2016-2017 American Board of Family Medicine certification questionnaire responses to examine the diversity and Medicaid participation of FPs. We explored the diversity of FP Medicaid patient panels and whether they saw ≥150 beneficiaries in 2016. Using logistic regression models, we controlled for FP demographics, practice characteristics, and characteristics of the communities in which they practiced.

RESULTS

Of 13,096 FPs, Latine, Hispanic, or of Spanish Origin (LHS) FPs and non-LHS Black FPs saw more Medicaid beneficiaries compared with non-LHS White and non-LHS Asian FPs. The patient panels of URiM FPs had a much greater proportion of Medicaid beneficiaries from racial and ethnic minority groups. Overall, non-LHS Black and LHS FPs had greater odds of seeing ≥150 Medicaid beneficiaries in 2016.

CONCLUSIONS

These findings clearly show the critical role URiM FPs play in caring for Medicaid beneficiaries, suggesting physician race and ethnicity are correlated with Medicaid participation. Diversity in the health care workforce is essential for addressing racial health inequities. Policies need to address problems in pathways to medical education, including failures to recruit, nurture, and retain URiM students.




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Challenges in Receiving Care for Long COVID: A Qualitative Interview Study Among Primary Care Patients About Expectations and Experiences [Original Research]

BACKGROUND

For many patients with post–COVID-19 condition (long COVID), primary care is the first point of interaction with the health care system. In principle, primary care is well situated to manage long COVID. Beyond expressions of disempowerment, however, the patient’s perspective regarding the quality of long COVID care is lacking. Therefore, this study aimed to analyze the expectations and experiences of primary care patients seeking treatment for long COVID.

METHODS

A phenomenological approach guided this analysis. Using purposive sampling, we conducted semistructured interviews with English-speaking, adult primary care patients describing symptoms of long COVID. We deidentified and transcribed the recorded interviews. Transcripts were analyzed using inductive qualitative content analysis.

RESULTS

This article reports results from 19 interviews (53% female, mean age = 54 years). Patients expected their primary care practitioners (PCPs) to be knowledgeable about long COVID, attentive to their individual condition, and to engage in collaborative processes for treatment. Patients described 2 areas of experiences. First, interactions with clinicians were perceived as positive when clinicians were honest and validating, and negative when patients felt dismissed or discouraged. Second, patients described challenges navigating the fragmented US health care system when coordinating care, treatment and testing, and payment.

CONCLUSION

Primary care patients’ experiences seeking care for long COVID are incongruent with their expectations. Patients must overcome barriers at each level of the health care system and are frustrated by the constant challenges. PCPs and other health care professionals might increase congruence with expectations and experiences through listening, validating, and advocating for patients with long COVID.

Annals Early Access article




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Palliative care in lung cancer: tumour- and treatment-related complications in lung cancer and their management

Palliative care pertains to the holistic multidimensional concept of "patient-centred" care. It is an interprofessional specialty, primarily aiming to improve quality of care for cancer patients and their families, from the time of diagnosis of malignant disease, over the continuum of cancer care, and extending after the patient's death to the period of bereavement to support the patient's family. There are various complex and frequently unmet needs of lung cancer patients and their families/caregivers, not only physical but also psychological, social, spiritual and cultural. Systematic monitoring of patients’ symptoms using validated questionnaires and patient-reported outcomes (PROs), on a regular basis, is highly encouraged and recommended in recent guidelines on the role of PRO measures in the continuum of cancer clinical care. It improves patient–physician communication, physician awareness of symptoms, symptom control, patient satisfaction, health-related quality of life and cost-effectiveness. This implies that all treating physicians should improve their skills in communication with lung cancer patients/relatives and become more familiar with this multidimensional assessment, repeatedly screening patients for palliative care needs. Therefore, they should receive education and training to develop palliative care knowledge, skills and attitudes. This review is dedicated to lung cancer palliative care essentials that should be within the competences of treating physicians, i.e. pneumologists/thoracic oncologists.




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Cartwright is ready to fire

Bryce Cartwright admits he has something of a split personality in his first NSW State of Origin camp.




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Dundee ice hockey player jailed for rape of teen girl in his car

A Dundee ice hockey player has been jailed after being found guilty of raping a teenage girl in his car.




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Fire engine crashes with two cars while travelling under blue lights

A fire engine on its way to a callout has been involved in a collision with two cars on a road junction in Edinburgh.




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Motorists urged to plan ahead with Kincardine Bridge due to close

Motorists have been urged to plan ahead with a major bridge due to close for work is carried out.  




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Limogate: Neil Gray to address use of ministerial car for football trips

Health Secretary Neil Gray will address concerns around his use of a ministerial car to attend football games at Hampden.




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RPG Cast – Episode 575: “You Only Press F for Things You Care About”

Chris really wants a giant salad in a bread bowl, Anna Marie says no to Poké-non theories. Kelley is having all the Crises because Chris won't let her read the news in peace, and Alex is quietly contemplating a Final Fantasy VII: Belt Edition while everyone argues.

The post RPG Cast – Episode 575: “You Only Press F for Things You Care About” appeared first on RPGamer.



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RPG Cast – Episode 619: “That One Time I Got Reincarnated as a Canadian Yankee in King Arthur’s Court”

Kelley graduates from Canada. Josh discovers Tactics Advance is an isekai. Meanwhile Chris calculates the skill check for suplexing a train.

The post RPG Cast – Episode 619: “That One Time I Got Reincarnated as a Canadian Yankee in King Arthur’s Court” appeared first on RPGamer.



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Card-en-Ciel (NS)

Inti Creates has made a living creating 2D side-scrolling action-platformers. So when it officially revealed Card-en-Ciel, a dungeon-diving, roguish card-collector that draws its inspiration from games like Slay the Spire and Mega Man Battle Network, it turned some heads. Indeed, this latest production represents a fairly significant departure for the independent developer, even as it embraces a familiar philosophy when it comes to art direction, music, and character design. The question remains: is this the start of something special for Inti Creates or still a work in progress?

The story in Card-en-Ciel takes place in the not-too-distant future, where citizens increasingly turn to "full-dive" games, fully immersive virtual reality experiences. As these games became more popular and ubiquitous, criminal activity within the virtual space exploded. This activity, referred to collectively as "full-dive crimes", became such a problem that ordinary citizens took it upon themselves to fight back. One such crusader is Neon Nanashiki, the self-described Gaming Chair Detective. When Neon receives a suspicious email with the subject line "Please save the world", he logs into the virtual space, which turns out to be the back-end of the full-dive game Rust Tactics. There he meets a strange girl named Ancie, who explains that data from some game worlds is leaking into others, creating monsters and dungeons. Soon, Neon and Ancie team up to resolve the errors and anomalies.

Despite a very promising premise, Card-en-Ciel doesn't do enough with its story. Ultimately, it's difficult to get invested in the stakes or the characters. Neon is your boilerplate archetypal hero, Ancie is frustratingly submissive, and the mystery villain generic and forgettable. There's also a some fan service here, which feels out of place. To be fair, there are some amusing conversations inside dungeons where Neon and Ancie talk about the type of game they're exploring, leading to several self-deprecating meta jokes at Inti Creates' expense, but for the most part there isn't a lot to latch on to. It hurts also that the studio dropped the ball in terms of visual storytelling. You select dungeons from a menu list, instead of traveling to them physically, and each dungeon — despite representing a wildly different game and genre — has roughly the same layout and look.

It's strange that dungeons are so alike, because every one of the 300 collectible cards is entirely unique, with its own statistics, portrait art, and voice sample. As a result, collecting and experimenting with different cards is quite fun. Clearly, a lot of time, energy, and attention-to-detail went into the audiovisual design of each and every card.

The same can be said for the card-battling mechanics. Inti Creates obviously took the time to sort out the various rules and synergies of each card type, allowing for many different approaches and strategies. At the simplest level, each card can be used to produce an effect or for movement along each battle map's 6x3 grid. The effects fall into three general categories of break, damage, and support. Using a card with a break effect will reduce a monster's attack power and chip away at its balance. If you reduce the enemy's balance to zero, it will enter breakdown, rendering it unable to act for one turn and opening it up to double the output from damage cards. In addition, triggering a breakdown will recover your cost by one. You only have three cost (action points) at the start of each turn, and each card has an individual cost between zero and three.

Things get even more interesting with the introduction of muse cards and special skills. Once you recruit a muse card, you can activate it by fulfilling certain conditions, for example by forging three zero-cost cards. The muse will then begin their performance, bestowing unique effects during battle. Not only that, but the performance will award Neon Special Skill energy, which allows him to convert any card to a significantly more powerful variant for a turn. Consequently, in each dungeon it's important to unlock muses and then recruit cards likely to trigger the muse and/or reap the rewards of a performance. When you do this right, and lay waste efficiently to the monsters and bosses in a dungeon, it feels amazing.

The problem, as mentioned before, is that each dungeon feels like the exact same thing. Apart from a specific final boss, who represents the protagonist of the fictional game world, almost everything is identical. Neon crosses the same generic square rooms & bridges and fights the same monsters over and over. It just gets boring after a while. Inti Creates really should have designed each dungeon with a layout and aesthetic unique to the IP on display.

Then there's the issue with Grand Battle dungeons. These are climactic dungeons at the end of each chapter where you face off against the mystery villain. Regrettably, the rules here are different. No cards and muses can be obtained in these areas; rather you bring with you every card and muse you've accumulated to that point. The problem here is threefold: one, it removes the rogue-like flavor of standard dungeons, where you need to build a powerful deck from square one; two, it creates a lot of bloat in your deck; and three, it opens up the opportunity for irksome chain reactions, where a single card might trigger a half dozen muse performances one after the other.

Card-en-Ciel partially makes up for some samey, tiresome dungeons with a huge amount of replay value. Indeed, the game is incredibly generous when it comes to content and replayability. Not only are there 300+ cards to collect, but there are 12 total main dungeons, each of which can be experienced at 11(!) different difficulty levels. And once you beat the game, you'll begin to unlock four secret dungeons. Moreover, there are daily & weekly dungeons, plus online network battles where you can fight opponents from around the world using a randomly generated starting deck. If you're someone who loves the core gameplay, you could spend dozens of hours with Card-en-Ciel. If you're more of a one-and-done sort of player, expect roughly 15 hours. Note: Inti Creates announced last week that the game will receive new content, including post-game dungeons, each month for at least five months starting this November.

For a new IP, Card-en-Ciel shows potential. The premise is intriguing, the core rules and mechanics provide a strong foundation for tactical decision-making, and the replay value is absurdly high. Regrettably, the campaign that houses everything is a slight letdown, due to clichéd storytelling, forgettable characters, and generic, tedious dungeons. By retaining the core card-collecting system and enhancing the narrative and structural pieces, Inti Creates could have something special on its hands. 

Full Article - https://www.vgchartz.com/article/462883/card-en-ciel-ns/




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‘Anora’: The Screwball Stripper Odyssey That Should Win All the Oscars

NEON

Movies can’t, by definition, be all things to all people, and yet Anora—winner of the Cannes Film Festival’s highest honor, the Palme d’Or—manages to vacillate between assorted registers with stunning, and ultimately affecting, aplomb.

Another of The Florida Project and Red Rocket writer/director Sean Baker’s tales of marginalized individuals struggling to survive and find themselves in an often-unforgiving world, the film is a character study, romance, crime saga, screwball comedy, and vérité drama all wrapped into one unique and dexterous package. More impressive than its nimbleness, however, is its poise and empathy, the latter of which is chiefly bestowed upon its protagonist, whose life is thrown for a rollercoaster-grade loop-di-loop thanks to a chance introduction.

Ani (Mikey Madison, in a star-making turn) is a Brighton Beach 23-year-old who lives with her sister and earns a living stripping at a local club. Anora, which hits theaters Oct. 18, introduces her at the end of a long pan along a bench where men are receiving lap dances from erotic professionals. Fixating on Ani’s face as she flashes the fake smile that her customers crave and her superiors demand, Baker’s camera creates immediate, intimate engagement with the young woman, and that continues as it presents snapshots of her daily (or, rather, nightly) routine at her place of employment.

Read more at The Daily Beast.




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The Forever Winter devs answer complaints about water scarcity... by adding thieves who invade your HQ and steal your water

When nightmarish sci-fi extraction shooter The Forever Winter launched into early access in September it was somewhat messy. Bugs and maddening enemy spawns diminished the tension of being a fleshy human scavenger in a mech battlefield. But one feature annoyed some players much more - fresh water. See, you need to keep your headquarters stocked with water, as it gets steadily used by your settlement's inhabitants. The catch being that this water diminishes even while you're not playing the game. If it runs out completely, then everything you've collected gets wiped. The developers have listened to complaints about this most Farmville of mechanics, and they've answered in an interesting way. Water thieves! Now, on top of the usual downward trickle, burglars will come to steal your H2O as well.

It's not as bad as it sounds.

Read more



  • Shooter: Third Person
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  • Fun Dog Studios

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Great God Grove review: play mail carrier and god wrangler in this wonderfully weird puzzle adventure

Great God Grove is, in a word, bonkers. I’ve stopped a small community from completing a blood ritual, played the role of matchmaker to a group of lonely hearts that involved organising a date with god, and plastered a statue with paint as part of a revolutionary movement to uplift the power of art. My time with GGG has been a pick n’ mix of colourful escapades, and together with its story of godly woes, striking art style, vacuum-based puzzle-solving, and nightmare-inducing puppet work, I’m now a die-hard LimboLane devotee.

Read more




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Martin Lewis issues warning to anyone with a Tesco Clubcard as £18m savings at risk



Martin Lewis has warned Tesco customers of a piece of small print that could see £18m worth of Clubcard points wasted.




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Complex form of carbon spotted outside solar system for first time

Complex carbon-based molecules crucial to life on Earth originated somewhere in space, but we didn't know where. Now, huge amounts of them have been spotted in a huge, cold cloud of gas




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A simple driving trick could make a big dent in cars' carbon emissions

An AI-powered model found that approaching intersections more slowly could lower yearly US carbon emissions by up to around 123 million tonnes




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Electric vehicles race combustion cars in 'battle of technologies'

‘Battle of Technologies’ sees electric vehicles and combustion cars compete at the highest level. Who will win?




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AI helps driverless cars predict how unseen pedestrians may move

A specialised algorithm could help autonomous vehicles track hidden objects, such as a pedestrian, a bicycle or another vehicle concealed behind a parked car




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Finally, A Flying Car(t)



Where’s your flying car? I’m sorry to say that I have no idea. But here’s something that is somewhat similar, in that it flies, transports things, and has “car” in the name: it’s a flying cart, called the Palletrone (pallet+drone), designed for human-robot interaction-based aerial cargo transportation.


The way this thing works is fairly straightforward. The Palletrone will try to keep its roll and pitch at zero, to make sure that there’s a flat and stable platform for your preciouses, even if you don’t load those preciouses onto the drone evenly. Once loaded up, the drone relies on you to tell it where to go and what to do, using its IMU to respond to the slightest touch and translating those forces into control over the Palletrone’s horizontal, vertical, and yaw trajectories. This is particularly tricky to do, because the system has to be able to differentiate between the force exerted by cargo, and the force exerted by a human, since if the IMU senses a force moving the drone downward, it could be either. But professor Seung Jae Lee tells us that they developed “a simple but effective method to distinguish between them.”

Since the drone has to do all of this sensing and movement without pitching or rolling (since that would dump its cargo directly onto the floor) it’s equipped with internal propeller arms that can be rotated to vector thrust in any direction. We were curious about how having a bunch of unpredictable stuff sitting right above those rotors might affect the performance of the drone. But Seung Jae Lee says that the drone’s porous side structures allow for sufficient airflow and that even when the entire top of the drone is covered, thrust is only decreased by about 5 percent.

The current incarnation of the Palletrone is not particularly smart, and you need to remain in control of it, although if you let it go it will do its best to remain stationary (until it runs out of batteries). The researchers describe the experience of using this thing as “akin to maneuvering a shopping cart,” although I would guess that it’s somewhat noisier. In the video, the Palletrone is loaded down with just under 3 kilograms of cargo, which is respectable enough for testing. The drone is obviously not powerful enough to haul your typical grocery bag up the stairs to your apartment. But, it’s a couple of steps in the right direction, at least.

We also asked Seung Jae Lee about how he envisions the Palletrone being used, besides as just a logistics platform for either commercial or industrial use. “By attaching a camera to the platform, it could serve as a flying tripod or even act as a dolly, allowing for flexible camera movements and angles,” he says. “This would be particularly useful in environments where specialized filming equipment is difficult to procure.”

And for those of you about to comment something along the lines of, “this can’t possibly have enough battery life to be real-world useful,” they’re already working to solve that, with a docking system that allows one Palletrone to change the battery of another in-flight:

One Palletrone swaps out the battery of a second Palletrone.Seoul Tech

The Palletrone Cart: Human-Robot Interaction-Based Aerial Cargo Transportation,” by Geonwoo Park, Hyungeun Park, Wooyong Park, Dongjae Lee, Murim Kim, and Seung Jae Lee from Seoul National University of Science and Technology in Korea, is published in IEEE Robotics And Automation Letters.




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New Pokemon card only launched last week - and it's already worth £420



Pikachu ex, found in the new Pokemon TCG set Surging Sparks, has seen its value soar with players spending over $500 for the latest card. Here's why.




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Oceans could be used for carbon capture on a big scale

In this week's issue of our environment newsletter, we look at the carbon capture potential of the world's oceans and what effect beavers are having in the Arctic (spoiler: it's not good).




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Cement is everywhere. The industry is turning to carbon capture to curb emissions, and it's not alone

Cement is ubiquitous, but the process of making it emits carbon into the atmosphere. The industry says there's no easy way to avoid that, which is why it's turning to carbon capture and storage technology as a way to decarbonize.



  • News/Canada/Calgary

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Hashtag Trending Mar.1- HP debacle; Humanoid robots closer to hitting our workplaces; Apple blew $10 billion on the electric car before pulling the plug

If rumours are true and this one should be, I started it, we have a special edition of the Weekend show where we talk about the evolution of the role of the CIO with two incredible CIOs as the CIO Association of Canada turns 20. Don’t miss it.  MUSIC UP Can HP make you love […]

The post Hashtag Trending Mar.1- HP debacle; Humanoid robots closer to hitting our workplaces; Apple blew $10 billion on the electric car before pulling the plug first appeared on ITBusiness.ca.




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Venomous creatures wash up on popular North Carolina beaches

Venomous Blue Sea Dragons are washing up on the sandy shores of the Outer Banks in North Carolina, and National Park officials advise to admire them from a distance.



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Three hospitalised as car 'mounts pavement' and smashes into Piccadilly Circus restaurant



Three people have been taken to hospital after a car mounted the pavement and smashed into a restaurant in Piccadilly Circus, the Metropolitan Police have said.




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Pub landlady took her own life after relationship left her scared to leave the house



Jill Parton, 46, suffered fatal injuries when she was hit by a freight train in Heaton Chapel in the early hours of June 3 this year, an inquest heard




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AMD partners launch Radeon RX 6600 graphics cards

$329/£300 graphics card is said to be "future ready" for your 1080p gaming needs.




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Next-generation technology is a critical mid-step in dementia care

New technologies will radically change the experience of living with and caring for someone with Alzheimer's, says Professor Fiona Carragher, chief policy and research officer at Alzheimer's Society, UK




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Dazzling images illuminate research on cardiovascular disease

The British Heart Foundation’s Reflections of Research competition showcases beautiful images captured by researchers studying heart and circulatory disease




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Republican Gabe Evans wins Colorado's 8th Congressional District, beating incumbent Yadira Caraveo

The Associated Press has declared a winner in Colorado's 8th Congressional District which has been one of the most closely watched races in the country.



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GREG GUTFELD: Trump's incoming 'border czar' doesn't care what people think of him

'Gutfeld!' panelists react to President-elect Trump's choice for 'border czar.'



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New Carrier Fluid Makes Hydrogen Way Easier to Transport



Imagine pulling up to a refueling station and filling your vehicle’s tank with liquid hydrogen, as safe and convenient to handle as gasoline or diesel, without the need for high-pressure tanks or cryogenic storage. This vision of a sustainable future could become a reality if a Calgary, Canada–based company, Ayrton Energy, can scale up its innovative method of hydrogen storage and distribution. Ayrton’s technology could make hydrogen a viable, one-to-one replacement for fossil fuels in existing infrastructure like pipelines, fuel tankers, rail cars, and trucks.

The company’s approach is to use liquid organic hydrogen carriers (LOHCs) to make it easier to transport and store hydrogen. The method chemically bonds hydrogen to carrier molecules, which absorb hydrogen molecules and make them more stable—kind of like hydrogenating cooking oil to produce margarine.

A researcher pours a sample of Ayrton’s LOHC fluid into a vial.Ayrton Energy

The approach would allow liquid hydrogen to be transported and stored in ambient conditions, rather than in the high-pressure, cryogenic tanks (to hold it at temperatures below -252 ºC) currently required for keeping hydrogen in liquid form. It would also be a big improvement on gaseous hydrogen, which is highly volatile and difficult to keep contained.

Founded in 2021, Ayrton is one of several companies across the globe developing LOHCs, including Japan’s Chiyoda and Mitsubishi, Germany’s Covalion, and China’s Hynertech. But toxicity, energy density, and input energy issues have limited LOHCs as contenders for making liquid hydrogen feasible. Ayrton says its formulation eliminates these trade-offs.

Safe, Efficient Hydrogen Fuel for Vehicles

Conventional LOHC technologies used by most of the aforementioned companies rely on substances such as toluene, which forms methylcyclohexane when hydrogenated. These carriers pose safety risks due to their flammability and volatility. Hydrogenious LOHC Technologies in Erlanger, Germany and other hydrogen fuel companies have shifted toward dibenzyltoluene, a more stable carrier that holds more hydrogen per unit volume than methylcyclohexane, though it requires higher temperatures (and thus more energy) to bind and release the hydrogen. Dibenzyltoluene hydrogenation occurs at between 3 and 10 megapascals (30 and 100 bar) and 200–300 ºC, compared with 10 MPa (100 bar), and just under 200 ºC for methylcyclohexane.

Ayrton’s proprietary oil-based hydrogen carrier not only captures and releases hydrogen with less input energy than is required for other LOHCs, but also stores more hydrogen than methylcyclohexane can—55 kilograms per cubic meter compared with methylcyclohexane’s 50 kg/m³. Dibenzyltoluene holds more hydrogen per unit volume (up to 65 kg/m³), but Ayrton’s approach to infusing the carrier with hydrogen atoms promises to cost less. Hydrogenation or dehydrogenation with Ayrton’s carrier fluid occurs at 0.1 megapascal (1 bar) and about 100 ºC, says founder and CEO Natasha Kostenuk. And as with the other LOHCs, after hydrogenation it can be transported and stored at ambient temperatures and pressures.

Judges described [Ayrton's approach] as a critical technology for the deployment of hydrogen at large scale.” —Katie Richardson, National Renewable Energy Lab

Ayrton’s LOHC fluid is as safe to handle as margarine, but it’s still a chemical, says Kostenuk. “I wouldn’t drink it. If you did, you wouldn’t feel very good. But it’s not lethal,” she says.

Kostenuk and fellow Ayrton cofounder Brandy Kinkead (who serves as the company’s chief technical officer) were originally trying to bring hydrogen generators to market to fill gaps in the electrical grid. “We were looking for fuel cells and hydrogen storage. Fuel cells were easy to find, but we couldn’t find a hydrogen storage method or medium that would be safe and easy to transport to fuel our vision of what we were trying to do with hydrogen generators,” Kostenuk says. During the search, they came across LOHC technology but weren’t satisfied with the trade-offs demanded by existing liquid hydrogen carriers. “We had the idea that we could do it better,” she says. The duo pivoted, adjusting their focus from hydrogen generators to hydrogen storage solutions.

“Everybody gets excited about hydrogen production and hydrogen end use, but they forget that you have to store and manage the hydrogen,” Kostenuk says. Incompatibility with current storage and distribution has been a barrier to adoption, she says. “We’re really excited about being able to reuse existing infrastructure that’s in place all over the world.” Ayrton’s hydrogenated liquid has fuel-cell-grade (99.999 percent) hydrogen purity, so there’s no advantage in using pure liquid hydrogen with its need for subzero temperatures, according to the company.

The main challenge the company faces is the set of issues that come along with any technology scaling up from pilot-stage production to commercial manufacturing, says Kostenuk. “A crucial part of that is aligning ourselves with the right manufacturing partners along the way,” she notes.

Asked about how Ayrton is dealing with some other challenges common to LOHCs, Kostenuk says Ayrton has managed to sidestep them. “We stayed away from materials that are expensive and hard to procure, which will help us avoid any supply chain issues,” she says. By performing the reactions at such low temperatures, Ayrton can get its carrier fluid to withstand 1,000 hydrogenation-dehydrogenation cycles before it no longer holds enough hydrogen to be useful. Conventional LOHCs are limited to a couple of hundred cycles before the high temperatures required for bonding and releasing the hydrogen breaks down the fluid and diminishes its storage capacity, Kostenuk says.

Breakthrough in Hydrogen Storage Technology

In acknowledgement of what Ayrton’s nontoxic, oil-based carrier fluid could mean for the energy and transportation sectors, the U.S. National Renewable Energy Lab (NREL) at its annual Industry Growth Forum in May named Ayrton an “outstanding early-stage venture.” A selection committee of more than 180 climate tech and cleantech investors and industry experts chose Ayrton from a pool of more than 200 initial applicants, says Katie Richardson, group manager of NREL’s Innovation and Entrepreneurship Center, which organized the forum. The committee based its decision on the company’s innovation, market positioning, business model, team, next steps for funding, technology, capital use, and quality of pitch presentation. “Judges described Ayrton’s approach as a critical technology for the deployment of hydrogen at large scale,” Richardson says.

As a next step toward enabling hydrogen to push gasoline and diesel aside, “we’re talking with hydrogen producers who are right now offering their customers cryogenic and compressed hydrogen,” says Kostenuk. “If they offered LOHC, it would enable them to deliver across longer distances, in larger volumes, in a multimodal way.” The company is also talking to some industrial site owners who could use the hydrogenated LOHC for buffer storage to hold onto some of the energy they’re getting from clean, intermittent sources like solar and wind. Another natural fit, she says, is energy service providers that are looking for a reliable method of seasonal storage beyond what batteries can offer. The goal is to eventually scale up enough to become the go-to alternative (or perhaps the standard) fuel for cars, trucks, trains, and ships.




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Oceans Lock Away Carbon Slower Than Previously Thought



Research expeditions conducted at sea using a rotating gravity machine and microscope found that the Earth’s oceans may not be absorbing as much carbon as researchers have long thought.

Oceans are believed to absorb roughly 26 percent of global carbon dioxide emissions by drawing down CO2 from the atmosphere and locking it away. In this system, CO2 enters the ocean, where phytoplankton and other organisms consume about 70 percent of it. When these organisms eventually die, their soft, small structures sink to the bottom of the ocean in what looks like an underwater snowfall.

This “marine snow” pulls carbon away from the surface of the ocean and sequesters it in the depths for millennia, which enables the surface waters to draw down more CO2 from the air. It’s one of Earth’s best natural carbon-removal systems. It’s so effective at keeping atmospheric CO2 levels in check that many research groups are trying to enhance the process with geoengineering techniques.

But the new study, published on 11 October in Science, found that the sinking particles don’t fall to the ocean floor as quickly as researchers thought. Using a custom gravity machine that simulated marine snow’s native environment, the study’s authors observed that the particles produce mucus tails that act like parachutes, putting the brakes on their descent—sometimes even bringing them to a standstill.

The physical drag leaves carbon lingering in the upper hydrosphere, rather than being safely sequestered in deeper waters. Living organisms can then consume the marine snow particles and respire their carbon back into the sea. Ultimately, this impedes the rate at which the ocean draws down and sequesters additional CO2 from the air.

The implications are grim: Scientists’ best estimates of how much CO2 the Earth’s oceans sequester could be way off. “We’re talking roughly hundreds of gigatonnes of discrepancy if you don’t include these marine snow tails,” says Manu Prakash, a bioengineer at Stanford University and one of the paper’s authors. The work was conducted by researchers at Stanford, Rutgers University in New Jersey, and Woods Hole Oceanographic Institution in Massachusetts.

Oceans Absorb Less CO2 Than Expected

Researchers for years have been developing numerical models to estimate marine carbon sequestration. Those models will need to be adjusted for the slower sinking speed of marine snow, Prakash says.

The findings also have implications for startups in the fledgling marine carbon geoengineering field. These companies use techniques such as ocean alkalinity enhancement to augment the ocean’s ability to sequester carbon. Their success depends, in part, on using numerical models to prove to investors and the public that their techniques work. But their estimates are only as good as the models they use, and the scientific community’s confidence in them.

“We’re talking roughly hundreds of gigatonnes of discrepancy if you don’t include these marine snow tails.” —Manu Prakash, Stanford University

The Stanford researchers made the discovery on an expedition off the coast of Maine. There, they collected marine samples by hanging traps from their boat 80 meters deep. After pulling up a sample, the researchers quickly analyzed the contents while still on board the ship using their wheel-shaped machine and microscope.

The researchers built a microscope with a spinning wheel that simulates marine snow falling through sea water over longer distances than would otherwise be practical.Prakash Lab/Stanford

The device simulates the organisms’ vertical travel over long distances. Samples go into a wheel about the size of a vintage film reel. The wheel spins constantly, allowing suspended marine-snow particles to sink while a camera captures their every move.

The apparatus adjusts for temperature, light, and pressure to emulate marine conditions. Computational tools assess flow around the sinking particles and custom software removes noise in the data from the ship’s vibrations. To accommodate for the tilt and roll of the ship, the researchers mounted the device on a two-axis gimbal.

Slower Marine Snow Reduces Carbon Sequestration

With this setup, the team observed that sinking marine snow generates an invisible halo-shaped comet tail made of viscoelastic transparent exopolymer—a mucus-like parachute. They discovered the invisible tail by adding small beads to the seawater sample in the wheel, and analyzing the way they flowed around the marine snow. “We found that the beads were stuck in something invisible trailing behind the sinking particles,” says Rahul Chajwa, a bioengineering postdoctoral fellow at Stanford.

The tail introduces drag and buoyancy, doubling the amount of time marine snow spends in the upper 100 meters of the ocean, the researchers concluded. “This is the sedimentation law we should be following,” says Prakash, who hopes to get the results into climate models.

The study will likely help models project carbon export—the process of transporting CO2 from the atmosphere to the deep ocean, says Lennart Bach, a marine biochemist at the University of Tasmania in Australia, who was not involved with the research. “The methodology they developed is very exciting and it’s great to see new methods coming into this research field,” he says.

But Bach cautions against extrapolating the results too far. “I don’t think the study will change the numbers on carbon export as we know them right now,” because these numbers are derived from empirical methods that would have unknowingly included the effects of the mucus tail, he says.

Marine snow may be slowed by “parachutes” of mucus while sinking, potentially lowering the rate at which the global ocean can sequester carbon in the depths.Prakash Lab/Stanford

Prakash and his team came up with the idea for the microscope while conducting research on a human parasite that can travel dozens of meters. “We would make 5- to 10-meter-tall microscopes, and one day, while packing for a trip to Madagascar, I had this ‘aha’ moment,” says Prakash. “I was like: Why are we packing all these tubes? What if the two ends of these tubes were connected?”

The group turned their linear tube into a closed circular channel—a hamster wheel approach to observing microscopic particles. Over five expeditions at sea, the team further refined the microscope’s design and fluid mechanics to accommodate marine samples, often tackling the engineering while on the boat and adjusting for flooding and high seas.

In addition to the sedimentation physics of marine snow, the team also studies other plankton that may affect climate and carbon-cycle models. On a recent expedition off the coast of Northern California, the group discovered a cell with silica ballast that makes marine snow sink like a rock, Prakash says.

The crafty gravity machine is one of Prakash’s many frugal inventions, which include an origami-inspired paper microscope, or “foldscope,” that can be attached to a smartphone, and a paper-and-string biomedical centrifuge dubbed a “paperfuge.”




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