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Guanine crystal formation by the unicellular organism Phacotus lenticularis is part of a cellular stress response
Organic crystals, and in particular guanine crystals, are widely used by multicellular organisms for manipulating light and producing structural colors. Many single celled eukaryotic organisms also produce organic crystals, and guanine is the most abundant type produced. Their functions are thought to be related to the fact that guanine is nitrogen rich. Here we studied a freshwater unicellular eukaryotic alga, Phacotus lenticularis, and found that when the growth medium is depleted in phosphorus, the alga stops reproducing and produces intracellular birefringent particles inside vesicles. Cryo-SEM showed that these particles are faceted and are located within membranes inside the cell. Using Raman spectroscopy, we showed that these particles are β-guanine crystals. 3D tomograms produced using cryo-soft-X-ray-microscopy quantitatively documented the increase in cell volume and distribution of guanine crystals within the cells with increasing time of phosphorous deprivation. The tomograms also showed additional morphological changes in other cellular organelles, namely starch granules, chloroplasts, nuclear DNA and membranes. The combined observations all indicate that under phosphorous depletion, the algal cells undergo a massive stress response. As guanine crystal formation is part of this response, we conclude that guanine crystals are formed in response to stress, and this is not related to nitrogen availability. Upon addition of phosphate to the P-depleted media, the algal cells, with their guanine crystals, resume reproduction. From this we conclude that the guanine crystals somehow contribute to the recovery from stress.
Distribution of ilmenite minerals in placer deposits along the middle coast of Southern Brazil using spaceborne and ground-based remote sensing
Titanium oxide is of fundamental strategic importance in the global market as it is used as a raw material by several industries, such as medical prostheses, paints, pigments, and, more recently, electronic chips. The main source of titanium oxide is ilmenite, a mineral deposited in many coastal areas of the world, including the state of Rio Grande do Sul in Southern Brazil in its central coastal plain, under specific morphodynamic conditions. Some geological targets, such as mineral oxides, show distinct thermal spectral features. The present study evaluated the surface concentration of ilmenite in Southern Brazil using thermal spectroscopy (μFT-IR). The emissivity spectral signatures of pure ilmenite between 8 and 14 μm were determined and some indicative features were identified. The obtained emissivity spectrum has been employed as a reference for the Spectral Angle Mapper (SAM) and Linear Spectral Unmixing (LSU) image classification algorithms. An image from the Advanced Spaceborne Thermal Emission Radiometer (ASTER) sensor (AST_05 emissivity product) was used to recognize the occurrence and assess the richness of the ilmenite. The outcomes of the present study indicated pixels with ilmenite concentration between 0 and 29.6%, with the highest concentration occurring under the transgressive dune field. In contrast, a lower concentration is found in the backshore. To obtain the degree of purity of the ilmenite, a quantitative microanalysis of the samples was conducted in a scanning electron microscope (SEM), and the results indicated that 80% of the minerals were ilmenite. Qualitative microanalysis showed that ilmenite is in the primary alteration phase, with a low degree of weathering and a lower concentration of impurities. Integrated techniques for analyzing multispectral and hyperspectral data in the thermal infrared were able to identify and map minerals rich in titanium oxide (ilmenite) quickly, effectively, at low cost, and non-destructively.
Correction: Correlation between postmortem microbial signatures and substance abuse disorders
Lasting lockdown love? Problem behaviour and pandemic and non-pandemic related risk factors influencing the owner-dog relationship in a UK cohort of dogs reaching early adulthood
The owner-dog relationship is a critical component of sustained dog ownership. Increased understanding of risk factors for weak owner-dog relationships can identify owner-dog dyads at higher risk of poor welfare outcomes, including dog relinquishment and euthanasia. The internationally documented boom in puppy acquisition during the COVID-19 pandemic led to welfare concerns for this cohort of dogs, including impulsive purchasing of puppies to unsuitable homes, increased supply of puppies from poor-welfare sources, and deficits in early-life experiences for puppies. Combined, these changes were feared to lead to problem behaviours, weak owner-dog relationships and increased future relinquishment in this uniquely vulnerable generation. The Pandemic Puppies project longitudinally studied dogs bought as puppies aged < 16-weeks old during the 2020 phase of the COVID-19 pandemic by collecting owner-completed data during puppyhood and as adults. This study aimed to investigate factors associated with the owner-dog relationship in early-adulthood via a cross-sectional analysis of a subset of Pandemic Puppies data (n = 794). When dogs were 21-months old owners completed the Monash Dog-Owner Relationship Scale (MDORS), from which the Perceived Emotional Closeness (Closeness) and Perceived Costs subscales were established as reliable in this sample and were used as outcome variables in multivariable analyses to explore risk factors such as health, behaviour, and acquisition-related variables. Problem behaviours, including those related to lack of control, fear, separation, and aggression were the predominant risk factors associated with increased Perceived Costs score. The presence of most problem behaviours was not associated with reduced Closeness, suggesting a potential source of emotional conflict for owners. However, owners of dogs showing aggressive behaviours had lower Closeness scores. Puppy acquisitions explicitly motivated by the pandemic were associated with increased Perceived Costs. Support interventions targeted at owners of dogs with problem behaviours are of high importance if positive owner-dog relationships are to be maintained.
Spatial and temporal distribution characteristics and influencing factors of cultural heritage: A case of the Grand Canal (East Zhejiang section)-maritime silk road
The Grand Canal and the Maritime Silk Road in China are globally significant cultural routes, which have contributed a wealth of cultural heritage through their historical development. The study on the cultural heritage of the Grand Canal (East Zhejiang section)-Maritime Silk Road is of great significance for constructing the Grand Canal Cultural Belt and advancing the Belt and Road Initiative. Focusing on the Ningbo area, this study analyzes the spatial and temporal distribution of 1,755 cultural heritage sites over five historical periods and explores the influencing factors through spatial and statistical analysis. The results show that: (1) Ancient buildings, along with modern important historical sites and representative buildings, are the most numerous. The total number of cultural heritages shows an upward trend before the modern period, peaking in the Ming to Qing period. (2) The cultural heritage exhibits an overall aggregated spatial distribution, with varying patterns across different types. The Three-River Estuary is the high-density core area, with the number and density of cultural heritage decreasing as its distance increases. (3) Distribution characteristics of cultural heritage vary across different periods. More recent cultural heritage is increasingly concentrated around the Three-River Estuary. Over time, the center of gravity of cultural heritage has shifted sequentially to the south, southeast, west, and north. (4) The cultural heritage tends to be distributed in plain with low altitude and small slope, and shows strong hydrophilicity.
Optimisation of the preparation phase for orthopaedic surgery: Study protocol for a student-led multimodal prehabilitation feasibility trial (BoneFit)
Background Since the Covid-19 pandemic, a surgical backlog for total hip replacement (THR) and total knee replacement (TKR) surgery remains in the United Kingdom. Multimodal prehabilitation pathways (encompassing exercise, nutritional support and psychological wellbeing) can be utilised to ‘optimise” physical and mental resilience prior to the challenge of surgical intervention. BoneFit is an open-label, non-randomised feasibility trial to determine the recruitment and attendance/adherence rates, delivery and implementation challenges, fidelity, acceptability, and safety of a student-led multimodal prehabilitation intervention in people listed for THR/TKR surgery. We will also determine participant and clinician views of the intervention, and identify any challenges and enablers of inter-institutional partnership working. Methods Individuals listed for THR/TKR surgery aged between 18 to 75 years will be assigned to an intervention (n = 25) or usual-care control group (n = 25). The primary outcome measures will be feasibility of delivering the BoneFit intervention. Physical, psychological, quality of life and clinical outcomes will be assessed at three major time-points; T1 (baseline; 2 months from surgery), T2 (2–10 days from surgery), and T3 (3 months following surgery). We aim to show that the trial is feasible and that we can identify a signal of efficacy based on clinical outcomes collected compared to controls. The study was ethically approved by the Health Research Authority (London Bridge Research Ethics Committee: REC reference: 24/PR/0092) in March 2024. Discussion The development of a multimodal prehabilitation pathway could improve the physical and mental resilience of individuals awaiting orthopaedic surgery. We aim to determine if this translates to faster discharge and reduced complication rates, thus helping boost surgical throughput and potentially easing surgical backlog. It is likely that the concept of ‘waiting’ lists for surgery should be challenged, rather, individuals should be encouraged to use the time available to ‘prepare’ for surgery. Trial registration Registration details ClinicalTrials.gov registration number: NCT06341920.
Designing of a multiepitope-based vaccine against echinococcosis utilizing the potent Ag5 antigen: Immunoinformatics and simulation approaches
Echinococcosis is a significant parasitic zoonotic disease with severe implications for human and animal health. To date, there has been no effective vaccine candidate available for echinococcosis. Therefore, we employed computational approaches to develop a multiepitope-based vaccine using the most potent epitopes of MHC-I, MHC-II, and B-cell derived from the Ag5 protein of Echinococcus spp. The final vaccine construct containing the epitopes, linkers, and adjuvant exhibited potent antigenicity (score > 0.1) with no evidence of allergenicity (score < 0) and toxicity (score < 0) in several computational platforms. The vaccine also exhibited favorable physicochemical characteristics such as being highly soluble (SOLpro score of 0.781243) and hydrophilic (Grand average of hydropathy of -0.433). Moreover, the tertiary structure of the vaccine was also found to be structurally stable, with a Z score of -5.71. Further, the molecular docking analysis confirmed the vaccine’s significant binding affinity to the RP-105 (docking score of -1252.7) and TLR-9 (docking score of -970.9). The molecular dynamic simulations confirmed the structural stability of the docked complexes under a virtual physiological system. The negative ΔTOTAL values derived from the MM-PBSA and MM-GBSA analyses confirmed a spontaneous and thermodynamically favorable binding process between the vaccine and receptors. Moreover, the vaccine demonstrated high potentiality to elicit both innate (natural killer cell, dendritic and macrophage) and adaptive (B-cell, helper T cell and cytotoxic T cell) immune responses with sustained humoral immune responses evidenced by increased IFN-γ and IL-2 levels. Following codon optimization and in silico cloning, the vaccine was successfully expressed (CAI value of 0.9607 and average GC content of 52.34%) after being inserted into the pET-28a (+) plasmid of E. coli. These findings highlight the potential of the designed vaccine candidate to combat echinococcosis and lay the groundwork for future preclinical and clinical studies.
Health-promoting text messages to patients with hypertension—A randomized controlled trial in Swedish primary healthcare
Due to the high prevalence and great cardiovascular risks of hypertension, we need effective and evidence-based treatment strategies. Health-promoting one-way text messages could be a beneficial complement to antihypertensive drugs. However, this has yet to be proven in a primary healthcare setting. The purpose of this study was to investigate if health-promoting text messages could improve patients’ blood pressure in primary care. The PUSHME (Primary care Usage of Health promoting Messages) randomized controlled trial included 401 patients from 10 primary health care centers in southern Sweden. Patients in the intervention group received four text messages weekly for six months along with treatment as usual. The PUSHME study was registered on clinicaltrials.gov (NCT04407962). Patients in both the control group and the intervention group lowered their blood pressure during the study, but there was no significant difference in change between the groups. However, subgroup analyses showed that there was a significantly larger reduction in diastolic blood pressure favoring the intervention for patients with poor self-rated health: -4.5 mmHg vs -1.4 mmHg (p = 0.019), and patients with a sedentary lifestyle: -5.2 mmHg vs -2.4 mmHg (p = 0.034). Our findings indicate that text messages with lifestyle advice to a general hypertensive population do not have any significant effect on blood pressure. However, it could be an effective complement to conventional antihypertensive drug treatment for specific patient groups.
The impact of rural revitalization talent cultivation on farm household part-time farming: Evidence from the “One Village, One University Student” program
The key to rural revitalization lies in talent revitalization. Cultivating a workforce that understands agriculture, loves rural areas, and cares for farmers, while retaining talent in rural regions, is of greater significance for comprehensively advancing rural revitalization. From the perspective of farm household part-time farming, this study takes the One Village, One University Student program as an example. Using survey data from 2552 farm households across 12 counties (cities and districts) in Jiangxi Province, China, and employing the ESR model, this study empirically analyzes the impact of rural revitalization talent cultivation on farm household part-time farming. It further explores the differentiated effects of various educational levels and learning modes of talent cultivation on the part-time farming. The results show that rural revitalization talent cultivation significantly reduces the degree of part-time farming, with higher-level education and correspondence education having particularly pronounced effects in enhancing agricultural skills and production efficiency. Based on these findings, this paper proposes policy recommendations to intensify rural revitalization talent cultivation, improve the educational levels and content, optimize educational modes, and strengthen the policy advocacy, aiming to further promote rural economic development and increase farmers’ income.
Accuracy of the Modified Finnish Diabetes Risk Score (Modified FINDRISC) for detecting metabolic syndrome: Findings from the Indonesian national health survey
Background This study evaluated the diagnostic accuracy of the Modified Finnish Diabetes Risk Score (Modified FINDRISC) for detecting individuals with metabolic syndrome in Indonesia. Methods A dataset from the 2018 Indonesian National Basic Health Survey was analysed, and cases of metabolic syndrome were identified in accordance with both National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) and International Diabetes Federation (IDF) guidelines. Diagnostic accuracy of the Modified FINDRISC tool was evaluated using the Area Under the Receiver Operating Characteristic (AUC) curve, while optimal cut-off scores were determined by Youden’s Index. Results From 25,432 participants, the mean and standard deviation of the Modified FINDRISC score was 5.7 (SD 4.1). The prevalence of metabolic syndrome was 32.1% and 24.8% based on NCEP-ATP III and IDF criteria, respectively. Based on NCEP-ATP III criteria alone, the AUC of the Modified FINDRISC was 80.9% (80.3%-81.5%) with 74.0% sensitivity and 75.5% specificity. Similarly, based on IDF criteria, AUC was 88.9% (88.5%-89.3%) with 89.8% sensitivity and 75.8% specificity. The optimal cut-off score was 6 for both criteria, with 41.2% of the total participants above the cut-off who would require further confirmation tests. Conclusion Metabolic syndrome is prevalent in Indonesia, and the Modified FINDRISC tool offers good diagnostic accuracy for detecting such cases. Utilising Modified FINDRISC as a first-instance screening modality will reduce the number of people requiring further confirmation tests. Modified FINDRISC has the potential for use in daily clinical practice, and the cost-effectiveness of Modified FINDRISC should be further evaluated.
Clinical status and cytokine profiles in patients with asthma or chronic obstructive pulmonary disease vaccinated against influenza
Background Influenza vaccine is a tool for preventing infection and reducing exacerbations in patients with asthma and chronic obstructive pulmonary disease (COPD). However, the associations between clinical outcomes and changes in the levels of inflammation markers have not been fully delineated. The purpose of this study was to investigate the clinical course and the changes in the levels of inflammation markers in patients with asthma or chronic obstructive pulmonary disease for one year after vaccination against influenza. Methods The prospective study for one year included 34 patients with asthma, 20 patients with COPD vaccinated against influenza, both groups being under a basic maintenance therapy, and 26 healthy individuals vaccinated with the trivalent polymer-subunit (adjuvanted) vaccine, containing 5 μg of influenza virus strains and 500 μg of azoximer bromide. The levels of C-reactive protein (CRP) and serum cytokines (IL-2, IL-6, IL-10, and IL-17) were measured by enzyme-linked immunosorbent assay (ELISA) at baseline and 6 and 12 months after vaccination. Results Over a year after vaccination against influenza, the frequency and duration of bronchopulmonary exacerbations significantly decreased both in patients with asthma and those with COPD: by 1.9–2 and 2.2–2.5 times, respectively. There was also a significant reduction in the frequency and duration of hospitalization (by 2.0–2.5 and 2.3–3 times, respectively). Other changes observed over the one-year follow-up period included a 1.6-fold reduction (р<0.01) in the need for outpatient care and a reduction in the number of courses of systemic corticosteroids (by 16.7%; р<0.05) in asthma patients; and a 3.6-fold decrease (р<0.05) in the number of courses of antibiotics in COPD patients. Twelve months after vaccination against influenza, the study participants had significantly lower IL-6 levels, and COPD patients, additionally, showed a reduction in IL-10 levels compared to baseline. Our study identified certain correlations between positive clinical outcomes of vaccination and levels of inflammation markers. Discussion Analysis of the immunological, clinical and functional parameters in asthma and COPD patients showed that vaccination not only reduces the risk of influenza and other respiratory infections due to activation of non-specific protection, but also improves the clinical course of asthma and COPD.
Development of a reliable, sensitive, and convenient assay for the discovery of new eIF5A hypusination inhibitors
eIF5A is a translation factor dysregulated in several pathologies such as cancer and diabetes. eIF5A activity depends upon its hypusination, a unique post-translational modification catalyzed by two enzymes: DHPS and DOHH. Only a few molecules able to inhibit hypusination have been described, and none are used for the treatment of patients. The scarcity of new inhibitors is probably due to the challenge of measuring DHPS and DOHH activities. Here, we describe the Hyp’Assay, a convenient cell-free assay to monitor eIF5A hypusination. Hypusination is performed in 96-well plates using recombinant human eIF5A, DHPS, and DOHH and is revealed by an antibody against hypusinated eIF5A. Pharmacological values obtained with the Hyp’Assay, such as the EC50 of DHPS for spermidine or the IC50 of GC7 for DHPS, were similar to published data, supporting the reliability of the Hyp’Assay. As a proof of concept, we synthesized four new GC7 analogs and showed, using the Hyp’Assay, that these derivatives inhibit hypusination. In summary, we present the Hyp’Assay; a reliable and sensitive assay for new hypusination inhibitors. This assay could be of interest to researchers wanting an easier way to study hypusination, and also a valuable tool for large-scale screening of chemical libraries for new hypusination inhibitors.
Association between mixed venous oxygen saturation and serum uric acid levels in patients with heart failure
Hypoxia leads to increased purine metabolism in tissues, resulting in increased serum uric acid levels, and may also cause impaired uric acid excretion in the kidneys and intestinal tract. However, the relationship between hypoxia and serum uric acid levels in patients with heart failure remains largely unexplored. Because mixed venous oxygen saturation is an acute indicator of systemic oxygenation, in this study, we investigated the relationship between mixed venous oxygen saturation and serum uric acid levels. This retrospective analysis included 386 patients with heart failure who underwent cardiac catheterization at our institution. The relationship between mixed venous oxygen saturation and serum uric acid levels was examined by single regression analysis. Stratified regression analysis, structural equation modeling, and partial correlation analysis were used to examine the effects of eight factors known to influence mixed venous oxygen saturation and serum uric acid levels. The single regression analysis showed a significant negative correlation between mixed venous oxygen saturation and serum uric acid levels (P<0.001). Significant negative correlations were also observed in many subgroups in the stratified analysis, in the path diagram based on structural equation modeling, and in the partial correlation analysis. These results suggest that there may be a direct relationship between mixed venous oxygen saturation and serum uric acid levels that is not mediated by any known factor.
Monkeys can identify pictures from words
Humans learn and incorporate cross-modal associations between auditory and visual objects (e.g., between a spoken word and a picture) into language. However, whether nonhuman primates can learn cross-modal associations between words and pictures remains uncertain. We trained two rhesus macaques in a delayed cross-modal match-to-sample task to determine whether they could learn associations between sounds and pictures of different types. In each trial, the monkeys listened to a brief sound (e.g., a monkey vocalization or a human word), and retained information about the sound to match it with one of 2–4 pictures presented on a touchscreen after a 3-second delay. We found that the monkeys learned and performed proficiently in over a dozen associations. In addition, to test their ability to generalize, we exposed them to sounds uttered by different individuals. We found that their hit rate remained high but more variable, suggesting that they perceived the new sounds as equivalent, though not identical. We conclude that rhesus monkeys can learn cross-modal associations between objects of different types, retain information in working memory, and generalize the learned associations to new objects. These findings position rhesus monkeys as an ideal model for future research on the brain pathways of cross-modal associations between auditory and visual objects.
HypE-GA based study on optimal design of standard floor facade windowing of high-rise office buildings facing energy saving in heating, cooling and lighting
The quantitative design on area and location of building façade’s windows has a significant impact on interior light and heat environment, which is also very instructive for preliminary and remodeling design of buildings. However, previous studies paid more attention to the thermal insulation construction and shading based on design parameters from the perspective of designers, but neglected the fact that the geometric properties of the windows themselves are equally important for building energy efficiency. Secondly, the weak interactivity and algorithmic limitations of traditional simulation platforms prevent rapid access to ideal design strategies. Therefore, this paper takes the standard floor of a high-rise office building as the research object in cold region−Yantai, facing façade windowing design, the three building performance objectives of each office unit−Annual Cooling Energy Consumption (AC), Annual Heating Energy Consumption (AH) and Annual Lighting Energy Consumption (AL)−are simulated and single/multi-objective optimized by relying on Ladybug and Honeybee (LB + HB) platform and Hypervolume Estimation Genetic Algorithm (HypE-GA) to obtain the genome of Pareto−Window-to-Wall Ratio (WWR), Window Height (WH) and Sill Height (SH)−at the lowest of each performance objective in order to determine the most energy-efficient façade windowing expression. The results show that AH and AC, their sum of quantities remains stable, are main energy consumption sources of office buildings, while the change of AL is more likely to have an impact than the others’ on Annual Totaling Energy Consumption (AT). The analysis points out that different windowing strategies can be adopted for different performance objectives. To reduce AC, priority is given to windowing on the east and north facade, with East Window-to-Wall Ratio (WWRE) at 0.2 ~ 0.3 and North Window-to-Wall Ratio (WWRN) at 0.3 ~ 0.5; to reduce AH, windows on the west and north facade should not be opened, and the remaining facades should be opened in small areas; to reduce AL, WWR> 0.7 is appropriate for each facade, and should be considered to matching a higher SH or WH; From AT, the average WWR in the single-objective and multi-objective optimization results are similar, so it is suggested that the WWR of each facade of office buildings in Yantai area is WWRE = 0.47, North South Window-to-Wall Ratio (WWRS) = 0.46, West Window-to-Wall Ratio (WWRW) = 0.18 and WWRN = 0.54. In addition, this paper proposes a method that can quickly find the Pareto optimal solution by clustering analysis on optimized results through Origin in multi-objective HypE-GA optimization study.
Factors associated with the use of dental services in older adults in Peru
Background The use of dental services by older adults in Peru faces various challenges that impact both their oral and overall health. Several factors play a crucial role in obtaining adequate dental care. Aims To evaluate the factors associated with the use of dental services in older adults in Peru. Methods This study was an observational, analytical, and cross-sectional investigation that utilized data from multiple years (2018–2022) of the Demographic and Family Health Survey (ENDES, by its Spanish acronym). The use of dental services was assessed through a specific survey question and analyzed in association with various socio-demographic variables, employing both descriptive and analytical statistical methods. Results In the multivariable analysis, the likelihood of not utilizing dental services was higher among men aPR: 1.53 (95% CI: 1.45–1.61), those without health insurance aPR: 1.44 (95% CI: 1.36–1.53), those who self-identified as other races aPR: 1.22 (95% CI: 1.13–1.33), Afro-descendants aPR: 1.10 (95% CI: 1.01–1.19), whites aPR: 1.12 (95% CI: 1.01–1.25) according to education level, those with a physical limitation aPR: 1.24 (95% CI: 1.15–1.33), and increased as they were poorer; it was lower among the rich but more pronounced among the middle-income, poor, and very poor, adjusted for five variables. Conclusion It was reported that 15% of older adults did not use dental services, and this was associated with significant socio-demographic variables.
Correction: Cover crops support the climate change mitigation potential of agroecosystems
Deciphering the role of cuproptosis in the development of intimal hyperplasia in rat carotid arteries using single cell analysis and machine learning techniques
Participant experiences receiving acupuncture for acute musculoskeletal pain in an emergency department: A qualitative evaluation
Objective Acupuncture is an evidence-based pain treatment in clinic settings, but its optimal delivery has not been established in emergency departments (EDs). As part of an adaptive pragmatic randomized controlled trial of ED acupuncture for acute musculoskeletal pain (NCT04290741), we embedded a qualitative evaluation of acupuncture treatment acceptability and suggestions for improvement from study participants receiving acupuncture in the ED. Methods Semi-structured interviews conducted remotely evaluated factors impacting patients’ perspectives, willingness to participate in, and experiences with ED acupuncture. The codebook was iteratively developed, and recruitment and analysis continued until information saturation was reached. Results Twenty-eight participants receiving ED acupuncture between February 2020-March 2021 were interviewed, with median age 44 years, 46.4% female, and 61% having never previously received acupuncture. Overall, ED patients with acute musculoskeletal pain expressed interest in acupuncture and reported an overall positive experience. Most reported acupuncture met their expectations for pain improvement, and many reported additional improvements in stress, anxiety, and sleep quality. Participants with a positive experience were more likely to recommend acupuncture to others. Key positive aspects included open communication with compassionate and knowledgeable acupuncturists. Participants found the ED setting acceptable and convenient for receiving acupuncture. Furthermore, participants provided actionable feedback like addressing fear of needles to improve the ED acupuncture experience. Conclusions In conclusion, ED patients with acute musculoskeletal pain were interested in and had positive experiences with acupuncture treatment for pain and found the ED setting acceptable and convenient. Participant feedback can be used to improve acupuncture treatment in the ED.