bluuebunny/crossref_metadata_2025 huggingface dataset:
Nutrition and Physical Activity During British Army Officer Cadet Training: Part 1—Energy Balance and Energy Availability
Authors: Edwards Victoria C. , Myers Stephen D. , Wardle Sophie L. , Siddall Andrew G. , Powell Steven D. , Needham-Beck Sarah , Kefyalew Sarah S. , Singh Priya A. , Orford Elise R. , Venables Michelle C. , Jackson Sarah , Greeves Julie P. , Blacker Sam D.
Published: April 2022

Military training is characterized by high daily energy expenditures which are difficult to match with energy intake, potentially resulting in negative energy balance (EB) and low energy availability (EA). The aim of this study was to quantify EB and EA during British Army Officer Cadet training. Thirteen (seven women) Officer Cadets (mean ± SD: age 24 ± 3 years) volunteered to participate. EB and EA were estimated from energy intake (weighing of food and food diaries) and energy expenditure (doubly labeled water) measured in three periods of training: 9 days on-camp (CAMP), a 5-day field exercise (FEX), and a 9-day mixture of both CAMP and field-based training (MIX). Variables were compared by condition and gender with a repeated-measures analysis of variance. Negative EB was greatest during FEX (−2,197 ± 455 kcal/day) compared with CAMP (−692 ± 506 kcal/day; p < .001) and MIX (−1,280 ± 309 kcal/day; p < .001). EA was greatest in CAMP (23 ± 10 kcal·kg free-fat mass [FFM]−1·day−1) compared with FEX (1 ± 16 kcal·kg FFM−1·day−1; p = .002) and MIX (10 ± 7 kcal·kg FFM−1·day−1; p = .003), with no apparent difference between FEX and MIX (p = .071). Irrespective of condition, there were no apparent differences between gender in EB (p = .375) or EA (p = .385). These data can be used to inform evidenced-based strategies to manage EA and EB during military training, and enhance the health and performance of military personnel.
Obesity Is Associated With Gait Alterations and Gait Asymmetry in Older Adults
Authors: Meng Hao , Gorniak Stacey L.
Published: April 2022

Objectives: The prevalence of obesity (OB) has increased in the older adult (OA) population. However, it is not quite clear whether OB exaggerates gait instability and leads to a higher risk of falls in OAs. The first goal of this study was to investigate whether OB is associated with gait alterations and gait asymmetry in OAs. The second goal of this study was to examine relationships between various OB measures with gait measures and gait symmetry measures in OAs. Methods: A total of 30 OAs were included and categorized according to their body mass index (BMI) values into groups of persons with normal weight (NW), overweight (OW), and OB. Participants were required to complete an anthropometric assessment, a body composition assessment, and overground walking tests. Results: The group with OB had shorter swing phase, longer stance phase, and shorter single support phase than the NW group. Increased body weight, BMI, visceral adipose tissue mass, and android fat had correlations with shorter swing phase, longer stance phase, and shorter single support phase. Increased body weight and BMI had significantly positive correlations with symmetry index of knee range of motion. Conclusions: OB may impair gait automation capacity in OAs. Both body weight and BMI remain good measures in terms of establishing correlations with gait stability in OAs. However, the amount of fat mass surrounding the abdomen could be vital to interpreting the alterations in the gait of OAs with obesity.
Three-dimensional visualization of nanoparticle lattices and multimaterial frameworks
Authors: Michelson Aaron , Minevich Brian , Emamy Hamed , Huang Xiaojing , Chu Yong S. , Yan Hanfei , Gang Oleg
Published: April 2022

Advances in nanoscale self-assembly have enabled the formation of complex nanoscale architectures. However, the development of self-assembly strategies toward bottom-up nanofabrication is impeded by challenges in revealing these structures volumetrically at the single-component level and with elemental sensitivity. Leveraging advances in nano-focused hard x-rays, DNA-programmable nanoparticle assembly, and nanoscale inorganic templating, we demonstrate nondestructive three-dimensional imaging of complexly organized nanoparticles and multimaterial frameworks. In a three-dimensional lattice with a size of 2 micrometers, we determined the positions of about 10,000 individual nanoparticles with 7-nanometer resolution, and identified arrangements of assembly motifs and a resulting multimaterial framework with elemental sensitivity. The real-space reconstruction permits direct three-dimensional imaging of lattices, which reveals their imperfections and interfaces and also clarifies the relationship between lattices and assembly motifs.
Tuning T cell receptor sensitivity through catch bond engineering
Authors: Zhao Xiang , Kolawole Elizabeth M. , Chan Waipan , Feng Yinnian , Yang Xinbo , Gee Marvin H. , Jude Kevin M. , Sibener Leah V. , Fordyce Polly M. , Germain Ronald N. , Evavold Brian D. , Garcia K. Christopher
Published: April 2022

Adoptive cell therapy using engineered T cell receptors (TCRs) is a promising approach for targeting cancer antigens, but tumor-reactive TCRs are often weakly responsive to their target ligands, peptide–major histocompatibility complexes (pMHCs). Affinity-matured TCRs can enhance the efficacy of TCR–T cell therapy but can also cross-react with off-target antigens, resulting in organ immunopathology. We developed an alternative strategy to isolate TCR mutants that exhibited high activation signals coupled with low-affinity pMHC binding through the acquisition of catch bonds. Engineered analogs of a tumor antigen MAGE-A3–specific TCR maintained physiological affinities while exhibiting enhanced target killing potency and undetectable cross-reactivity, compared with a high-affinity clinically tested TCR that exhibited lethal cross-reactivity with a cardiac antigen. Catch bond engineering is a biophysically based strategy to tune high-sensitivity TCRs for T cell therapy with reduced potential for adverse cross-reactivity.
Mineralization generates megapascal contractile stresses in collagen fibrils
Authors: Ping Hang , Wagermaier Wolfgang , Horbelt Nils , Scoppola Ernesto , Li Chenghao , Werner Peter , Fu Zhengyi , Fratzl Peter
Published: April 2022

During bone formation, collagen fibrils mineralize with carbonated hydroxyapatite, leading to a hybrid material with excellent properties. Other minerals are also known to nucleate within collagen in vitro. For a series of strontium- and calcium-based minerals, we observed that their precipitation leads to a contraction of collagen fibrils, reaching stresses as large as several megapascals. The magnitude of the stress depends on the type and amount of mineral. Using in-operando synchrotron x-ray scattering, we analyzed the kinetics of mineral deposition. Whereas no contraction occurs when the mineral deposits outside fibrils only, intrafibrillar mineralization generates fibril contraction. This chemomechanical effect occurs with collagen fully immersed in water and generates a mineral-collagen composite with tensile fibers, reminiscent of the principle of reinforced concrete.
Enhancing strength in mineralized collagen
Authors: Nudelman Fabio , Kröger Roland
Published: April 2022

X-ray data reveal the role of prestress in hierarchical biocomposites at the nanoscale
There’s more to RNA viruses than diseases
Authors: Labonté Jessica M. , Campbell Kathryn L.
Published: April 2022

A simple, pervasive biological entity in the ocean sheds light on evolution
The quest for optimal plant architecture
Authors: van Esse G. Wilma
Published: April 2022

Changes in plant architecture can improve cereal crop yield
In Science Journals
Authors: Hodges Kip , Hines Pamela J. , Suleymanov Yury , Lavine Marc S. , Osborne Ian S. , Stajic Jelena , Purnell Beverly A. , Erkes Dan A. , Zahn Laura M. , Vinson Valda , Grocholski Brent , Nusinovich Yevgeniya , Malo Courtney S. , Ferrarelli Leslie K. , Ash Caroline
Published: April 2022

Highlights from the
Science
family of journals
In Other Journals
Authors: Hines Pamela J. , Purnell Beverly A. , Wible Brad , Ash Caroline , Hurtley Stella M. , Grocholski Brent , Osborne Ian S.
Published: April 2022

Editors’ selections from the current scientific literature
Staphylococcus aureus Overcomes Anaerobe-Derived Short-Chain Fatty Acid Stress via FadX and the CodY Regulon
Authors: Fletcher Joshua R. , Villareal Alex R. , Penningroth Mitchell R. , Hunter Ryan C.
Published: April 2022

Staphylococcus aureus
is an important CRS pathogen, and yet it is found in the upper airways of 30% to 50% of people without complications. The presence of strict and facultative anaerobic bacteria in CRS sinuses has recently spurred research into bacterial interactions and how they influence
S. aureus
physiology and pathogenesis.
The Ins and Outs of Susceptibility Testing for New β-Lactam/β-Lactamase Inhibitor Combinations for Gram-Negative Organisms
Authors: Dingle Tanis C. , Pitout Johann
Published: April 2022

Ceftazidime-avibactam, meropenem-vaborbactam, and imipenem-relebactam are among the newest β-lactam/β-lactamase inhibitors (BL/BLIs) introduced to the North American antibiotic market. All have broad Gram-negative activity, including against certain carbapenemases.
Identifying Factors That Influence Student Perceptions of Stress in Biology Courses with Online Learning Modalities
Authors: Jackson Jordan , Almos Hannah , Karibian Natalie , Lieb Connor , Butts-Wilmsmeyer Carrie , Aranda Maurina L.
Published: April 2022

Students in higher education encounter many factors both inside (academic) and outside (nonacademic) classrooms that can influence their perceptions of stress in their biology courses. These can include course learning modalities, coursework, grades, as well as time management outside of class.
Microbiology Laboratory Simulations: From a Last-Minute Resource during the Covid-19 Pandemic to a Valuable Learning Tool to Retain—A Semester Microbiology Laboratory Curriculum That Uses Labster as Prelaboratory Activity
Authors: Tripepi Manuela
Published: April 2022

As educators, we strive to provide the best delivery method to improve our students' learning experience. The Covid-19 shutdown posed an incredible challenge by forcing us to redesign the way we teach with no time to prepare.
Maximizing Academic Integrity While Minimizing Stress in the Virtual Classroom
Authors: Novick Peter A. , Lee Jacqueline , Wei Sujun , Mundorff Emily C. , Santangelo Jessica R. , Sonbuchner Timothy M.
Published: April 2022

The article documents students’ experiences with the shift online at the onset of the COVID-19 pandemic and provides informed recommendations to STEM instructors regarding academic integrity and student stress. Over 500 students were surveyed on these topics, including an open-ended question.
SARS-CoV-2 nsp5 Exhibits Stronger Catalytic Activity and Interferon Antagonism than Its SARS-CoV Ortholog
Authors: Chen Jiyao , Li Zhuang , Guo Jiahui , Xu Shangen , Zhou Junwei , Chen Qian , Tong Xue , Wang Dang , Peng Guiqing , Fang Liurong , Xiao Shaobo
Published: April 2022

The nsp5-encoded 3C-like protease is the main coronavirus protease, playing a vital role in viral replication and immune evasion by cleaving viral polyproteins and host immune-related molecules. We showed that both SARS-CoV-2 nsp5 and SARS-CoV nsp5 cleave the NEMO at multiple sites (E152, Q205, and Q231).
Region-Specific Hepatitis B Virus Genome Exposure from Nucleocapsid Modulated by Capsid Linker Sequence and Inhibitor: Implications for Uncoating
Authors: Xi Ji , Cui Xiuji , Liu Kuancheng , Liu Haitao , Wang Joseph , Hu Jianming
Published: April 2022

Disassembly of the hepatitis B virus (HBV) nucleocapsid (NC) to release its genomic DNA, in an ill-understood process called uncoating, is required to form the viral nuclear episome in the host cell nucleus, a viral DNA essential for establishing and sustaining HBV infection. The elimination of the HBV nuclear episome remains the holy grail for the development of an HBV cure.
BK Polyomavirus Requires the Mismatch Repair Pathway for DNA Damage Response Activation
Authors: Justice Joshua L. , Needham Jason M. , Verhalen Brandy , Jiang Mengxi , Thompson Sunnie R.
Published: April 2022

Since there are no therapeutics that target BKPyV reactivation in organ transplant patients, it is currently treated by decreasing immunosuppression to allow the natural immune system to fight the viral infection. Antivirals would significantly improve patient outcomes since reducing immunosuppression carries the risk of graft failure.
Evolution and Genetic Diversity of the Retroviral Envelope in Anamniotes
Authors: Chen Yicong , Wang Xiaojing , Liao Meng-En , Song Yuhe , Zhang Yu-Yi , Cui Jie
Published: April 2022

Although the retroviral envelope (Env) protein in amniotes has been well studied, its evolutionary history in anamniotic vertebrates is ambiguous. By analyzing more than 30,000 copies of ERV lineages with gamma-type Env (GTE) in anamniotes, several important evolutionary features were identified.
Nontoxigenic Vibrio cholerae Challenge Strains for Evaluating Vaccine Efficacy and Inferring Mechanisms of Protection
Authors: Fakoya Bolutife , Hullahalli Karthik , Rubin Daniel H. F. , Leitner Deborah R. , Chilengi Roma , Sack David A. , Waldor Matthew K.
Published: April 2022

Human challenge studies are a valuable method for testing the efficacy of cholera vaccines. However, challenge studies cannot be performed in countries of cholera endemicity due to safety concerns; also, contemporary pandemic
Vibrio cholerae
strains are not used in current challenge studies.
Simultaneous Measurement of IgM and IgG Antibodies to SARS-CoV-2 Spike, RBD, and Nucleocapsid Multiplexed in a Single Assay on the xMAP INTELLIFLEX DR-SE Flow Analyzer
Authors: Cameron Andrew , Bohrhunter Jessica L. , Porterfield Claire A. , Mangat Rupinder , Karasick Michael H. , Pearson Zachary , Angeloni Stephen , Pecora Nicole D.
Published: April 2022

The xMAP INTELLIFLEX DR-SE enabled simultaneous and semi-quantitative detection of both IgM and IgG to three different SARS-CoV-2 antigens in a single assay. The assay format is advantageous for rapid and medium-throughput profiling using a small volume of specimen.
Copper-histidine therapy in an infant with novel splice-site variant in theATP7Agene of Menkes disease: the first experience in South East Asia and literature review
Authors: Panichsillaphakit Ekkarit , Kwanbunbumpen Tanisa , Chomtho Sirinuch , Visuthranukul Chonnikant
Published: April 2022

Menkes disease (MD) is an X linked recessive multi-systemic disorder of copper metabolism, resulting from anATP7Agene mutation. We report a male infant aged 4 months who presented with kinky hair, hypopigmented skin, epilepsy and delayed development. Magnetic resonance imaging (MRI) of brain demonstrated multiple tortuosities of intracranial vessels and brain atrophy. Investigation had showed markedly decreased serum copper and ceruloplasmin. The novel c.2172+1G>T splice-site mutation in theATP7Agene confirmed MD. He was treated with subcutaneous administration of locally prepared copper-histidine (Cu-His). Following the therapy, hair manifestation was restored and serum ceruloplasmin was normalised 1 month later. Despite the treatment, epilepsy, neurodevelopment and osteoporosis still progressed. He died from severe respiratory tract infection at the age of 9.5 months. These findings suggest that the benefit of Cu-His in our case is limited which might be related to severe presentations and degree ofATP7Amutation.
Free vascularised osteochondral flap for the treatment of osteochondritis dissecans of the talus
Authors: Schalamon Georg , Bürger Heinz , Anoshina Maria , Mattiassich Georg
Published: April 2022

We present a case report of a man in his 20s with osteochondritis dissecans of the talus, treated with autologous transplantation of a vascularised osteochondral flap. The patient with high level of activity presented to our orthopaedic outpatient department for progressive limping and pain, mainly related to sports. An osteochondritis dissecans grade IV of the medial talus was identified by MRI. A microvascular transfer of osteochondral tissue was performed successfully. At follow-up 1 year after surgery, the MRI examination revealed vital cartilage; the patient was free of pain and had returned to his previous level of activity.
Hereditary angio-oedema with C1 inhibitor deficiency type I, an unusual stroke mimic
Authors: Molina-Gil Javier , Azofra Julián , González-Fernández Lucía
Published: April 2022

Hereditary angio-oedema with C1 inhibitor deficiency (C1-INH-HAE) type I is a rare immune disorder characterised by a deficit of functional C1 esterase inhibitor (C1-INH). Recurrent C1-INH-HAE attacks typically present as generalised skin swelling and abdominal pain. Neurological involvement is very unusual, with a few reports of cephalea and recurrent dizziness. We describe a woman in her 30s diagnosed with C1-INH-HAE type I who was referred to the emergency department suffering from left hemisensory syndrome, with the initial suspicion of an ischaemic stroke. A few hours after hospital admission, she presented an acute attack of facial swelling and abdominal pain, receiving intravenous C1-INH concentrate with complete resolution of all symptoms, including neurological ones. A complete aetiological study ruled out a stroke. We pointed out that C1-INH-HAE attack can be an unusual stroke mimic that responds favourably to replacement therapy.
Lessons from the use of telemedicine in the austere military environment and the implications for deployed surgical teams
Authors: McKnight Gerard , O'Reilly D , Guthrie H , Aye Maung N , Bull J , Bartels O , Baxter D
Published: April 2022

Over the last 20 years, there have been significant changes in UK surgical training. Civilian surgical training may no longer prepare military surgeons for the range of skills they require on operations. One method to address gaps in knowledge or experience is to use telemedicine to facilitate specialist consultations from UK-based specialists to deployed medical teams. In the UK Defence Medical Services (DMS), this capability is called real-time clinical support (RTCS). RTCS provides a direct audio-visual link from a deployed location anywhere in the world to a supporting medical specialist in the UK. RTCS is currently delivered via a combination of off-the-shelf hardware and commercially available software. This article will outline the current use of RTCS, with emphasis on deployed surgical teams in austere environments, and discuss the advantages and limitations of this capability. However, it must be emphasised that no technology can be a substitute for clinical training and experience. Although several limitations remain, the authors believe that RTCS offers potential benefits for the DMS and could be an important tool aiding deployed clinicians. It can also be argued that by engaging with the concept now, the DMS can shape future developments in this sphere.
Evidence for overuse of cardiovascular healthcare services in high-income countries: protocol for a systematic review and meta-analysis
Authors: Roberts Derek J , Sypes Emma E , Nagpal Sudhir K , Niven Daniel , Mamas Mamas , McIsaac Daniel I , van Walraven Carl , Shorr Risa , Graham Ian D , Stelfox Henry Thomas , Grimshaw Jeremy
Published: April 2022

Introduction

Overuse of cardiovascular healthcare services, defined as the provision of low-value (ineffective, harmful, cost-ineffective) tests, medications and procedures, may be common and associated with increased patient harm and health system inefficiencies and costs. We seek to systematically review the evidence for overuse of different cardiovascular healthcare services in high-income countries.

Methods and analysis

We will search MEDLINE, EMBASE and Evidence-Based Medicine Reviews from 2010 onwards. Two investigators will independently review titles and abstracts and full-text studies. We will include published English-language studies conducted in high-income countries that enrolled adults (mean/median age ≥18 years) and reported the incidence or prevalence of overuse of cardiovascular tests, medications or procedures; adjusted risk factors for overuse; or adjusted associations between overuse and outcomes (reported estimates of morbidity, mortality, costs or lengths of hospital stay). Acceptable methods of defining low-value care will include literature review and multidisciplinary iterative panel processes, healthcare services with reproducible evidence of a lack of benefit or harm, or clinical practice guideline or Choosing Wisely recommendations. Two investigators will independently extract data and evaluate study risk of bias in duplicate. We will calculate summary estimates of the incidence and prevalence of overuse of different cardiovascular healthcare services across studies unstratified and stratified by country; method of defining low-value care; the percentage of included females, different races, and those with low and high socioeconomic status or cardiovascular risk; and study risks of bias using random-effects models. We will also calculate pooled estimates of adjusted risk factors for overuse and adjusted associations between overuse and outcomes overall and stratified by country using random-effects models. We will use the Grading of Recommendations, Assessment, Development and Evaluation to determine certainty in estimates.

Ethics and dissemination

No ethics approval is required for this study as it deals with published data. Results will be presented at meetings and published in a peer-reviewed journal.

PROSPERO registration number

CRD42021257490.
Understanding the surgeon’s behaviour during robot-assisted surgery: protocol for the qualitative Behav’Robot study
Authors: Cormi Clément , Parpex Guillaume , Julio Camille , Ecarnot Fiona , Laplanche David , Vannieuwenhuyse Geoffrey , Duclos Antoine , Sanchez Stéphane
Published: April 2022

Introduction

Robot-assisted surgery is spreading worldwide, accounting for more than 1.2 million procedures in 2019. Data are sparse in the literature regarding the surgeon’s mechanisms that mediate risk-taking during a procedure, especially robot-assisted. This study aims to describe and understand the behaviour of the surgeons during robot-assisted surgery and the change in their behaviour with increasing experience in using the robot.

Methods and analysis

This is a qualitative study using semistructured interviews with surgeons who perform robot-assisted surgery. An interview guide comprising open questions will be used to ensure that the points to be discussed are systematically addressed during each interview (ie, (1) difference in behaviour and preparation of the surgeon between a standard procedure and a robot-assisted procedure; (2) the influence of proprioceptive modifications, gain in stability and cognitive biases, inherent in the use of a surgical robot and (3) the intrinsic effect of the learning curve on the behaviour of the surgeons. After transcription, interviews will be analysed with the help of NVivo software, using thematic analysis.

Ethics and dissemination

Since this project examines professional practices in the field of social and human sciences, ethics committee was not required in accordance with current French legislation (Decree no 2017-884, 9 May 2017). Consent from the surgeons is implied by the fact that the interviews are voluntary. Surgeons will nonetheless be informed that they are free to interrupt the interview at any time.

Results will be presented in peer-reviewed national and international congresses and submitted to peer-reviewed journals for publication. The communication and publication of the results will be placed under the responsibility of the principal investigator and publications will be prepared in compliance with the ICMJE uniform requirements for manuscripts.

Trial registration number

NCT04869995.
Descriptive epidemiology of the prevalence of adolescent active travel to school in Asia: a cross-sectional study from 31 countries
Authors: Maulida Rizka , Ikeda Erika , Oni Tolu , van Sluijs Esther M F
Published: April 2022

Objective

This study aimed to examine the prevalence of adolescent active travel to school (ATS) across 31 countries and territories in Asia, overall and by age group, sex and body mass index (BMI) category.

Design

Cross-sectional study.

Setting

31 Asian countries.

Participants

152 368 adolescents aged 13–17 years with complete data for age, sex, measured weight and height and active travel to school from 31 Asian countries from the Global School-based student Health Survey (GSHS).

Primary outcome

Self-reported active travel to school categorised into passive (0 days) and active (1–7 days).

Results

Overall prevalence of adolescent ATS in Asia based on random-effect meta-analysis was 55%, ranging from 18% (UAE) to 84% (Myanmar). There was limited subregional variation: 47% in the Eastern Mediterranean (EM), 56% in the South East Asia and 64% in the Western Pacific. Summarised by random-effect meta-analysis, being an older adolescent aged 16 years and older (vs younger age below 16 years: OR: 1.08; 95% CI: 1.00 to 1.16) was positively associated with ATS. This association was strongest in EM countries. Summarised by random-effect meta-analysis, females (vs males: OR: 0.79; 95% CI: 0.71 to 0.89) and adolescents with overweight/obesity (vs underweight and normal BMI: OR: 0.92; 95% CI: 0.86 to 0.99) were less likely to use ATS. Association with sex was strongest in EM countries. Heterogeneity was considerable in all meta-analyses.

Conclusion

The prevalence of adolescent ATS in Asia varies substantially. Overall, older and male adolescents, and adolescents with underweight and normal BMI category are more likely to actively travel to school. However, the main contributor to differences in ATS between and within regions remain unknown. Although there is substantial scope for improving ATS rates in Asia, any policy actions and interventions should be cognisant of local built, social and natural environmental contexts that may influence active travel behaviour.
Enabling work participation for people with musculoskeletal conditions: lessons from work changes imposed by COVID-19: a mixed-method study
Authors: Morton LaKrista , Stelfox Kevin , Beasley Marcus , Jones Gareth T , Macfarlane Gary J , Walker-Bone Karen , Hollick Rosemary J
Published: April 2022

Objectives

To understand what we can learn from the impact of the COVID-19 pandemic and lockdown about what enables work participation for people with inflammatory arthritis and chronic pain conditions.

Design

Qualitative interviews embedded within an observational questionnaire study of individuals with musculoskeletal (MSK) conditions.

Setting

UK primary care (general practices), and secondary care-based rheumatology services.

Participants

Individuals with axial spondyloarthritis, psoriatic arthritis and MSK pain from three established cohorts completed an online/paper-based questionnaire (July–December 2020). A subset of respondents were selected for semistructured interviews.

Primary and secondary outcome measures

The survey quantified the effects of lockdown on work circumstances. Qualitative interviews explored the impacts of these changes and the advantages and disadvantages of changes in work circumstances.

Results

491 people (52% female, median age 49 years) who were employed at the time of lockdown responded to the questionnaire. The qualitative analysis included 157 free-text comments on work from the questionnaire and data collected within 18 interviews.

Participants reported impacts on mental and physical health, and significant financial anxieties. The impact of work changes varied depending on individual and home circumstances. Some felt forced to ignore advice to shield and continue working. The flexibility offered by home working and changes in commuting enabled greater physical activity for some, while others missed the exercise normally undertaken as part of their commute. Others reported a constant need to be ‘present’ online, which heightened anxiety and worsened MSK symptoms.

Conclusion

Lockdown showed that flexible working arrangements, which consider the positive and negative aspects of commuting, posture, movement, and work environment matter for work participation, and can have wider benefits in terms of health and well-being for those with long-term MSK conditions. Incorporating these into new models of work will help make the workplace more equitable and inclusive for people with long-term MSK conditions.
Long-term mortality of patients ablated for atrial fibrillation: a retrospective, population-based epidemiological study in Apulia, Italy
Authors: Di Monaco Antonio , Vitulano Nicola , Troisi Federica , Quadrini Federico , Guida Piero , Grimaldi Massimo
Published: April 2022

Objectives

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia associated with substantial morbidity and mortality. Data on long-term risk and mortality after catheter ablation for AF are lacking. The aim of this study was to evaluate all-cause mortality and the long-term risk of death in patients who underwent catheter ablation for AF compared with the general population.

Design

Retrospective, population-based epidemiological study.

Setting

We analysed data from patients residing in Apulia region who underwent AF ablation between January 2009 and June 2019.

Participants

1260 patients (914 male, mean age 60±11 years).

Outcomes

Vital status and dates of death to 31 December 2019 were obtained by using regional Health Information System. The expected number of deaths was derived using mortality rates from the general regional population by considering age-specific and gender-specific death probability provided for each calendar year by the Italian National Institute of Statistics. Standardised mortality ratios (SMRs) were calculated by dividing the observed number of deaths among patients by the expected number of deaths estimated from the general population.

Results

During follow-up (6449 person-years), 95 deaths were observed (1.47 deaths per 100 person-years). Although overall long-term mortality after AF ablation was not different to that of the general population (SMR 1.05 (95% CI 0.86 to 1.28; p=0.658)), the number of observed events was significantly increased in patients with heart failure (HF) at baseline or who developed HF during follow-up (SMR 2.40 (1.69 to 3.41; p<0.001) and 1.75 (1.17 to 2.64; p=0.007), respectively) and reduced in those without (SMR 0.63 (0.47 to 0.86; p=0.003)).

Conclusion

Long-term mortality of patients undergoing AF ablation is similar to that of the general population. Patients with HF had an increased risk while those without seem to have a better risk profile.
Mechanisms linking physical activity with psychiatric symptoms across the lifespan: a protocol for a systematic review
Authors: Nguyen Ho Phuong Thuy , Ha Pham Bich Tram , Tong Thao , Bramer Wichor M , Hofman Amy , Lubans David Revalds , Vernooij Meike W , Rodriguez-Ayllon María
Published: April 2022

Introduction

Persistent psychiatric symptomatology during childhood and adolescence predicts vulnerability to experience mental illness in adulthood. Physical activity is well-known to provide mental health benefits across the lifespan. However, the underlying mechanisms linking physical activity and psychiatric symptoms remain underexplored. In this context, we aim to systematically synthesise evidence focused on the mechanisms through which physical activity might reduce psychiatric symptoms across all ages.

Methods and analysis

With the aid of a biomedical information specialist, we will develop a systematic search strategy based on the predetermined research question in the following electronic databases: MEDLINE, Embase, Web of Science, Cochrane and PsycINFO. Two independent reviewers will screen and select studies, extract data and assess the risk of bias. In case of inability to reach a consensus, a third person will be consulted. We will not apply any language restriction, and we will perform a qualitative synthesis of our findings as we anticipate that studies are scarce and heterogeneous.

Ethics and dissemination

Only data that have already been published will be included. Then, ethical approval is not required. Findings will be published in a peer-reviewed journal and presented at conferences. Additionally, we will communicate our findings to healthcare providers and other sections of society (eg, through regular channels, including social media).

PROSPERO registration number

CRD42021239440.
Understanding engagement with Brown Buttabean Motivation, an Auckland grassroots, Pacific-led holistic health programme: a qualitative study
Authors: Savila F’asisila , Leakehe Paea , Bagg Warwick , Harwood Matire , Letele Dave , Bamber Anele , Swinburn Boyd , Goodyear-Smith Felicity
Published: April 2022

Objectives

The aim was to understand how participants engage with Brown Buttabean Motivation (BBM) a grassroots, Pacific-led holistic health programme and the meaning it has in their lives. The objectives were to explore the impact BBM had on all aspects of their health and well-being, what attracted them, why they stayed, identify possible enablers and barriers to engagement, and understand impact of COVID-19 restrictions.

Design

Qualitative study with thematic analysis of semi-structured interviews of BBM participants, followed by theoretical deductive analysis of coded data guided by Pacific Fonofale and Māori Te Whare Tapa Whā health models. In this meeting-house metaphor, floor is family, roof is culture, house-posts represent physical, mental, spiritual and sociodemographic health and well-being, with surroundings of environment, time and context.

Setting

Interviews of BBM members conducted in South Auckland, New Zealand, 2020.

Participants

22 interviewees (50% female) aged 24–60 years of mixed Pacific and Māori ethnicities with a mixture of regular members, attendees of the programme for those morbidly obese and trainers.

Results

Two researchers independently coded data with adjudication and kappa=0.61 between coders. Participants identified the interactive holistic nature of health and well-being. As well as physical, mental and spiritual benefits, BBM helped many reconnect with both their family and their culture.

Conclusions

BBM’s primary aim is weight-loss motivation. Many weight loss studies provide programmes to improve physical exercise and nutrition, but seldom address sustainability and other core factors such as mental health. Programmes are often designed by researchers or authorities. BBM is a community-embedded intervention, with no reliance external authorities for its ongoing implementation. It addresses many factors impacting participants’ lives and social determinants of health as well as its core business of exercise and diet change. Our results indicate that BBM’s holistic approach and responsiveness to perceived community needs may contribute to its sustained success.
Context, classification and study methodologies in research into nature-based therapies: protocol for a scoping review
Authors: Moyers Samantha I , Abildso Christiaan G , Kelley George A
Published: April 2022

Introduction

Nature provides an array of health benefits, and recent decades have seen a resurgence in nature-based interventions (NBI). While NBI have shown promise in addressing health needs, the wide variety of intervention approaches create difficulty in understanding the efficacy of NBI as a whole. This scoping review will (1) identify the different nomenclature used to define NBI, (2) describe the interventions used and the contexts in which they occurred and (3) describe the methodologies and measurement tools used in NBI studies.

Methods and analysis

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols Extension for Scoping Reviews, four databases will be searched (PubMed, Web of Science, Scopus, ProQuest Dissertations and Theses Global) as well as cross-referencing for published and unpublished (masters theses and dissertations) studies on NBI in humans. Eligible studies must employ intervention or observational designs, and an English-language abstract will be required. Database searches will occur from inception up to the date of the search. Animal-based therapies and virtual-reality therapies involving simulated nature will be excluded. Independent dual screening and data abstraction will be conducted. Results will be analysed qualitatively as well as with simple descriptive statistics (frequencies and percentages).

Ethics and dissemination

Since this is a scoping review of previously published summary data, ethical approval for this study is not needed. Findings will be published in a peer-reviewed journal. This protocol has been registered with Open Science Framework (https://osf.io/mtzc8).
Improving hand hygiene in a medical ward: a multifaceted approach
Authors: Poulose Vijo , Punithavathi A , Ali Marlini , Mohamad Assalam Faridah , Phyo Khine Khine , Soh Amanda , Tan Shi Hua , Li Jie , Ang Woo Boon , Chew Alvin
Published: April 2022

Background

Hand hygiene is a fundamental action which is simple, inexpensive and an effective tool in reducing hospital-acquired infections, yet compliance remains low in healthcare settings. In 2014, Changi General Hospital embarked on a pilot project to improve hand hygiene compliance in a pilot ward with the intention to eventually spread a multifaceted set of interventions hospital wide.

Methods

A before and after interventional study of a pilot project. Hand hygiene data collection was through direct observations by auditors using WHO monitoring standards and techniques based on the five-moment model.

Setting

A medical ward in an acute hospital in Singapore.

Results

Overall hand hygiene compliance improved from a median of 53% in 2015 to 80% by end of 2017. Hand hygiene compliance of doctors increased from 43% to 60% (p=0.00), nurses from 62% to 89% (p=0.014) and allied health staff from 67% to 83% (p=0.002).

Conclusions

A multifaceted set of interventions developed by the project team was effective in improving hand hygiene compliance of doctors, nurses and allied health staff.
Evaluation of the NHS England evidence-based interventions programme: a difference-in-difference analysis
Authors: Anderson Michael , Molloy Aoife , Maynou Laia , Kyriopoulos Ilias , McGuire Alistair , Mossialos Elias
Published: April 2022

Background

The NHS England evidence-based interventions programme (EBI), launched in April 2019, is a novel nationally led initiative to encourage disinvestment in low value care.

Method

We sought to evaluate the effectiveness of this policy by using a difference-in-difference approach to compare changes in volume between January 2016 and February 2020 in a treatment group of low value procedures against a control group unaffected by the EBI programme during our period of analysis but subsequently identified as candidates for disinvestment.

Results

We found only small differences between the treatment and control group after implementation, with reductions in volumes in the treatment group 0.10% (95% CI 0.09% to 0.11%) smaller than in the control group (equivalent to 16 low value procedures per month). During the month of implementation, reductions in volumes in the treatment group were 0.05% (95% CI 0.03% to 0.06%) smaller than in the control group (equivalent to 7 low value procedures). Using triple difference estimators, we found that reductions in volumes were 0.35% (95% CI 0.26% to 0.44%) larger in NHS hospitals than independent sector providers (equivalent to 47 low value procedures per month). We found no significant differences between clinical commissioning groups that did or did not volunteer to be part of a demonstrator community to trial EBI guidance, but found reductions in volume were 0.06% (95% CI 0.04% to 0.08%) larger in clinical commissioning groups that posted a deficit in the financial year 2018/19 before implementation (equivalent to 4 low value procedures per month).

Conclusions

Our analysis shows that the EBI programme did not accelerate disinvestment for procedures under its remit during our period of analysis. However, we find that financial and organisational factors may have had some influence on the degree of responsiveness to the EBI programme.
Arrhythmia prevalence and sudden death risk in adults with the m.3243A>G mitochondrial disorder
Authors: Bourke John P , Ng Yi Shiau , Tynan Margaret , Bates Matthew G D , Mohiddin Saidi , Turnbull Doug , Gorman Grainne S
Published: April 2022

Aims

To define the prevalence of non-sustained tachyarrhythmias and bradyarrhythmias in patients with the m.3243A>G mitochondrial genotype and a previously defined, profile, associated with ‘high sudden-death risk’.

Methods and results

Patients at high risk of sudden death because of combinations of ventricular hypertrophy, mitochondrial encephalopathy, lactic acidosis and stroke-like episodes family phenotype, epilepsy or high mutation load, due to the m.3243A>G mutation, were identified from a mitochondrial cohort of 209 patients. All recruited had serial ECG and echo assessments previously according to schedule, had an ECG-loop recorder implanted and were followed for as long as the device allowed. Devices were programmed to detect non-sustained brady- or tachy-arrhythmias. This provided comprehensive rhythm surveillance and automatic downloads of all detections to a monitoring station for cardiology interpretation. Those with sinus tachycardia were treated with beta-blockers and those with ventricular hypertrophy received a beta-blocker and ACE-inhibitor combination.

Nine consecutive patients, approached (37.2±3.9 years, seven males) and consented, were recruited. None died and no arrhythmias longer than 30s duration occurred during 3-year follow-up. Three patients reported palpitations but ECGs correlated with sinus rhythm. One manifest physiological, sinus pauses >3.5 s during sleep and another had one asymptomatic episode of non-sustained ventricular tachycardia.

Conclusions

Despite ‘high-risk’ features for sudden death, those studied had negligible prevalence of arrhythmias over prolonged follow-up. By implication, the myocardium in this genotype is not primarily arrhythmogenic. Arrhythmias may not explain sudden death in patients without Wolff-Parkinson-White or abnormal atrioventricular conduction or, it must require a confluence of other, dynamic, proarrhythmic factors to trigger them.
Characterisation and pore structure analysis of mortar incorporating valorised rice husk ash
Authors: Singh Arshdeep , Singh Bhupinder , Mangat P.S.
Published: April 2022

Physical, chemical, and mineralogical characterisation of as-received rice husk ash (RHA) samples sourced from four rice-growing regions (North, South, East, and West) of India is presented. Valorised RHA was obtained through controlled combustion at two temperature ranges (600–700 °C and 650–700 °C) of husks from the North in an industry set up. Valorisation efficacy has been tested through comparative characterisation of the valorised RHAs with the as-received RHAs from the four regions. Blending of 15% valorised RHA (in the beneficiated state) by weight of cement had no adverse effect on compressive strength even though water–binder ratio of the blended mortar had to be increased by 14% to achieve flow of the control cement mortar. Compared with the control cement mortar, porosity of the mortar blended with the beneficiated RHA measured using mercury intrusion porosimetry (MIP) increased by up to 10% primarily due to an increase in the number of large mesopores (0.01–0.05 µm).
Pure Gauss–Bonnet NUT black hole solution: I
Authors: Mukherjee Sajal , Dadhich Naresh
Published: April 2022

We obtain an exact $$\Lambda $$
Λ
-vacuum solution in the pure Gauss–Bonnet gravity with NUT charge in six dimension, with horizon having the product topology of $$S^{(2)} \times S^{(2)}$$

S

(
2
)

×

S

(
2
)

. We discuss its horizon and singularity structure, and consequently arrive at parameter windows for its physical viability. It turns out that for the curvatures to remain function of r alone for NUT black hole spacetime, horizon topology has to be product of $$S^{(2)}$$

S

(
2
)

spheres. This is true for Einstein as well as for pure Gauss–Bonnet gravity, and perhaps would hold good for higher order pure Lovelock as well.
Scheduling High Multiplicity Jobs on Parallel Multi-Purpose Machines with Setup Times and Machine Available Times
Authors: Jing Caixia , Huang Wanzhen , Zhang Lei , Zhang Heng
Published: April 2022

In this paper, we consider the scheduling of high multiplicity jobs on parallel multi-purpose machines with setup times and machine available times, with the objective of minimizing makespan. High multiplicity means that jobs are partitioned into several groups and in each group all jobs are identical. Whenever there is a switch from processing a job of one group to a job of another group, a setup time is needed. Multi-purpose machine implies that each job can only be processed by a specific subset of all the machines, called processing set. A mixed integer programming is formulated for this NP-hard problem. A heuristic is proposed to solve the problem. Lower bounds are developed to evaluate the heuristic algorithm. Extensive numerical computations are performed and the results show that the heuristic generates solutions with makespan within 2% above the lower bounds in average, and outperforms CPLEX 12.6 for large scale and complex problems.
SMOTE-LMKNN: A Synthetic Minority Oversampling Technique Based on Local Means-Based k-Nearest Neighbor
Authors: Liu Shuang
Published: April 2022

Traditional classifiers are trapped by the class-imbalanced problem due to the fact that they are biased toward the majority class. Oversampling methods can improve imbalanced classification by creating synthetic minority class samples. Noise generation has been a great challenge in oversampling methods. Filtering-based and direction-change methods are proposed against noise generation. Yet, the adopted noise filters in filtering-based methods are biased to the majority class. Besides, the [Formula: see text]-nearest neighbor (KNN)-based interpolation in filtering-based and direction-change methods is susceptible to abnormal samples (e.g. outliers, noise or unsafe borderline samples). To overcome noise generation while solving the above shortcomings of filtering-based and direction-change methods, this work presents a new synthetic minority oversampling technique based on local means-based KNN (SMOTE-LMKNN). In SMOTE-LMKNN, the local mean-based KNN (LMKNN) is first introduced to describe the local characteristic of imbalanced data. Second, a new LMKNN-based noise filter is proposed to remove noise and unsafe borderline samples. Third, the interpolation between a base sample and its LMKNN is proposed to create synthetic minority class samples. Empirical results of extensive experiments with 18 data sets show that SMOTE-LMKNN is competent compared with seven popular oversampling methods in training KNN classifier and classification and regression tree (CART).