Activity Levels Research Articles

Predictors of Successful Weight Loss in Extremely Obese Individuals Undergoing Roux-en-Y Gastric Bypass Surgery.

Roux-en-Y gastric bypass (RYGB) is a standard treatment for severe obesity, but some patients do not achieve the expected success in weight loss. The aim of this study was to evaluate possible predictors of weight loss after RYGB. Sixty-three patients were included. Pre- and postoperative data were collected from medical records, including comorbidities, anthropometry, energy/macronutrient intake, and physical activity level (PAL). Variants in the brain-derived neurotrophic factor (BDNF; rs6265) and lysophospholipase like 1 (LYPLAL1; rs4846567) genes were investigated. Excess weight loss (EWL) >50% was considered to be successful weight loss (SWL). Logistic regression models were used to verify predictor variables. Participants' median preoperative body mass index (BMI) was 53 kg/m2 (interquartile range, 46 to 58). At 12 and 24 months after surgery, EWL was 63% and 67%, and the failure rate was 19% and 16%, respectively. The individuals with insufficient weight loss (IWL) after 12 months had higher preoperative weight, BMI, and overweight. At 24 months, lowest frequency of individuals with SWL in the first year was found in the IWL group. No significant differences were found between the groups in dietary intake and PAL. In the logistic regression, high initial BMI was a predictor of the worst response in both periods, and high initial total weight loss was a predictor of a better response at 24 months. The polymorphism analysis did not show differences between groups in either gene. Lower preoperative BMI and greater weight loss at 12 months were predictors of SWL after RYGB.

Resting Heart Rate and Incident Atrial Fibrillation in Black Adults in the Jackson Heart Study

Resting heart rate (RHR) is a widely available measure of cardiovascular fitness that has been associated with several cardiovascular outcomes. RHR has previously been associated with the risk of atrial fibrillation (AF) among individuals of European ancestry, but little is known about this association in Black adults. To evaluate the association between RHR and incident AF in a large community-based sample of Black adults, independently of established risk factors. This cohort study uses data from the Jackson Heart Study, a prospective community-based cohort in Jackson, Mississippi. Participants without prevalent AF were included and were monitored for new-onset AF during follow-up, from 2000 through 2016. Data analysis was performed from August 1 to December 11, 2023. RHR was assessed from resting 12-lead electrocardiograms performed at examination 1 (2000-2004) and examination 3 (2009-2013). AF was identified from study electrocardiograms, hospitalization discharge diagnosis codes, and Medicare claims diagnosis codes. Cox regression was used to evaluate the association between baseline (examination 1) RHR and incident AF, adjusting for established AF risk factors. Among 4965 Black adults eligible for analysis, the mean (SD) age was 55 (13) years, 1830 (37%) were male, and the mean (SD) RHR at baseline was 65 (11) beats per minute (bpm). During a median (IQR) 14 (12-15) years of follow-up, there were 458 incident AF events, resulting in an incident rate of 7.5 per 1000 person-years (95% CI, 6.8-8.2 incidents per 1000 person-years). Each 10-bpm higher RHR was associated with a 9% higher risk of incident AF after adjustment for AF risk factors (hazard ratio, 1.09; 95% CI, 1.00-1.19). In a sensitivity analysis that excluded individuals with prior heart failure, prior myocardial infarction, and antiarrhythmic medication use at baseline, the hazard ratio was 1.14 (95% CI, 1.02-1.28). There was little evidence of effect modification of these associations by age, sex, body mass index, hypertension, or physical activity level. In this large prospective cohort study of Black adults, elevated baseline RHR was associated with increased risk of incident AF, consistent with findings from previous studies of European ancestry populations. Future research should focus on determining whether RHR can be used to screen patients at high risk of AF.

Balancing act: evaluating non-target risks of feral cat management in conservation reserves

Context Predation by feral cats continues to place substantial pressure on native Australian wildlife, contributing to significant population declines and localised extirpations of susceptible species. In Western Australia (WA), the registration of the poison bait Eradicat® provides a tool to help manage these introduced predators, but only in areas where the risk to non-target species is considered acceptable. The red-tailed phascogale (Phascogale calura), a small carnivorous marsupial now restricted to vegetation remnants in the highly fragmented agricultural zone of south-western WA (i.e. the Wheatbelt), is one species that may be vulnerable to lethal ingestion. Aim To investigate the impact of repeated Eradicat® baiting, to control feral cats, on the activity levels of the red-tailed phascogale, focusing on populations in two Wheatbelt conservation reserves. Methods We established a novel approach to monitoring red-tailed phascogales by using tree-mounted camera trap arrays in an area with feral cat management using ground-delivered Eradicat® baits, and two control zones with no feral cat management. We examined changes in activity levels (detection rate and occupancy) based on camera trap detections, before and after Eradicat® application, across two autumn and two spring baiting events. We also investigated non-target bait uptake using camera traps. Key results Although a small number of baits (7/60) was removed by red-tailed phascogales from the field of view of a camera, our results showed no overall impact of Eradicat® on their activity levels within the study area. Tree-mounted camera traps proved to be highly effective and efficient at detecting red-tailed phascogales. To maximise camera detections, the optimal time for monitoring red-tailed phascogales is during autumn, prior to male die-off. Conclusions Our results suggested that the risk posed to red-tailed phascogale populations from the repeated use of Eradicat® baits is likely to be low. Implications Integrating the application of Eradicat® to control feral cats with existing fox control in conservation reserves that support populations of red-tailed phascogales is likely to pose minimal risk to the species.

Radionuclides' Dispersion from Coal-Fired Brick Kilns: Geo-Environmental Processes, Potential Risks and Management.

In order to investigate the distributions and possible dispersion mechanism(s) of naturally occurring radioactive materials (NORMs: 226Ra, 232Th, and 40K) from coal-based brick kilns, a systematic set (n = 60) of coal, ash, surface-soil, and subsurface soil samples were analyzed. High-quality analytical data of U, Th and K obtained from HPGe detector and TRIGA Mark-II research reactor-based neutron activation analysis were converted to the corresponding radioactivities. Average (n = 10) radioactivities of 226Ra, 232Th, and 40K in coal samples were 15.6, 16.7, and 145.5Bq.kg-1, respectively, where only 40K surpassed the corresponding global mean value. Average (n = 10) radioactivities of 226Ra, 232Th, and 40K in ash samples were 62.7, 88.5, and 521Bq.kg-1, respectively, where only 226Ra was within the established limit. In soil samples, average (n = 40) activities of 226Ra, 232Th, and 40K were 62.7, 95.1, and 641Bq.kg-1, respectively, which have surpassed the corresponding worldwide mean values. The observed differences in activity levels between soil samples collected near and far from the kilns, as well as between topsoil and subsoil samples, suggest the presence of distinct transport mechanisms for NORMs within the pedosphere. Dispersions of NORMs from the brick kilns to the ambient pedosphere are largely governed by aerodynamic convection and hydrodynamic leaching. These mechanisms are also influenced by geochemical mobility and relative solubility of NORMs, as well as factors such as rainfall patterns and wind-flow direction. Radiological indices invoke long-term carcinogenic-risks, whereas aerodynamic convection of finer particles (coal fly ash) from chimneys can cause significant health hazards to the nearby dwellers. Scientific processes as well as public awareness are essential to mitigate the risks.

Subclinical variability in visual function modulates visual dependence - independent of age

AbstractParadoxically visual dependence is reported to increase with age, contributing to falls risk, whereas visual function typically declines. This study assesses the relationship between age, objective and subjective measures of visual function and visual dependence, in healthy young and older adults. Forty-four healthy Young (YA; n = 32; 18 males, aged 26.2 ± 5.3 yrs.) and Older (OA; n = 12; 3 males, aged 62.4 ± 6.7 yrs.) adults were assessed for objective (visual acuity, contrast sensitivity, depth perception, and lower peripheral vision), and subjective visual function (VFQ-25) along with motion sickness susceptibility. Subjective Visual Vertical (SVV) and induced nausea and vection were assessed using the Rod and Disc Test (RDT). Groups were compared using Mann-Whitney U, whilst determinants of SVV variability were evaluated using Multiple regression modelling. Visual acuity (p < 0.01) and contrast sensitivity (p = 0.04) were lower in OA. Visual dependence (SVV tilt errors) was not associated with ageing (p = 0.46). YA experienced greater RDT-induced vection (p = 0.03). Visual acuity and contrast sensitivity accounted for modest proportions of variance in SVV tilt errors (VA; R2 = 0.14, F(1,42) = 8.00, p < 0.01; β = 6.37) and (CS; R2 = 0.06, F(1,42) = 3.93, p = 0.05; β = −4.97), respectively. Our findings suggest that subclinical differences in visual acuity and contrast sensitivity contribute to SVV tilt error variability, among both healthy young and older adults. Further studies are needed to define the inter-relationship between age-related visual function, non-visual factors (including vestibular and somatosensory fidelity, activity levels, fear of falling and cognitive function) and visual dependence.

On the Inverse Correlation Between the Thermosphere Winter Helium Bulge and Solar Activity: Impact of Gravity Wave Drag From the Mesosphere

AbstractUnderstanding the temporal and spatial variations in the ideal inert tracer helium can provide insight into the dynamic evolution of the thermosphere. The magnitude of the thermospheric winter helium bulge was inversely correlated with the level of solar activity. However, this feature has been found to be not reproduced by the Thermosphere‐Ionosphere Electrodynamic General Circulation Model (TIEGCM), and the associated physical mechanisms remain unknown. Using the Thermosphere‐Ionosphere‐Mesosphere Electrodynamic General Circulation Model (TIME‐GCM), we found that mesospheric gravity wave drag (GWD) is a factor contributing to this inverse correlation. Specifically, the summer‐to‐winter circulation in thermosphere becomes the main cause of the helium bulge, as mesospheric GWD can play a role in strengthening this circulation. The GWD contributions to temperature change below the lower thermosphere do not depend prominently on solar activity. However, because the temperature impacts on the pressure gradient force are height‐integrated according to the background temperature of the neutral gas, the higher background temperature in the thermosphere at the solar maximum corresponds to a relatively weaker response in pressure gradient force in the thermosphere. Therefore, the response of the thermospheric circulation that might be expected to accompany increasing solar activity is suppressed due to the influence of mesospheric GWD, which results in a decrease in the magnitude of the winter helium bulge with increasing solar activity. Thus, our results demonstrated that lower atmosphere forcing can play a significant role in the response of thermospheric helium to solar activity.

Dynamic Responses of Outer Radiation Belt Electron Phase Space Densities to Geomagnetic Storms: A Statistical Analysis Based on Van Allen Probes Observations

AbstractUsing Van Allen Probes observations from September 2012 to June 2019, we statistically investigate responses of the Earth's outer radiation belt electron phase space densities (PSDs) in the adiabatic invariant coordinates to isolated geomagnetic storms. Electron PSDs for μ = 50–5,000 MeV/G, covering energy range of seed, relativistic and ultra‐relativistic electrons, are calculated to evaluate three types of storm‐time PSD responses (i.e., enhancement, depletion, and no change). In statistics, the seed PSD variations are dominated by enhancement‐type events, the percentages of which increase from >50% for small storms (−50 nT < SYM‐Hmin ≤ −30 nT) to >70% for large storms (SYM‐Hmin ≤ −50 nT). The relativistic and ultra‐relativistic PSDs exhibit the three response types with comparable occurrence rates for small storms but present predominantly enhancement‐type variations (>50%) for large storms. Enhanced storm activity increases the enhancement‐type responses for seed PSDs at all L* and for relativistic and ultra‐relativistic PSDs at L* > 3.5. It also results in the increased depletion‐type response occurrence for relativistic and ultra‐relativistic PSDs at lower L*. Our results further indicate that the depletion‐type responses manifest evident dependence on the level of solar and geomagnetic activity and the μ‐value, implying complex physics accounting for outer zone electron losses. Improved knowledge of the storm‐time dynamics of outer radiation belt electron PSDs is valuable to in‐depth comprehension of various mechanisms responsible for the electron acceleration and loss. It has important implications for future simulations and forecasts of radiation belt electron variability, in particular, during geomagnetically disturbed periods.

Chronic Hyperhomocysteinemia Impairs CSD Propagation and Induces Cortical Damage in a Rat Model of Migraine with Aura

Hyperhomocysteinemia (hHCY) is a metabolic disorder characterized by elevated levels of homocysteine in plasma. hHCY correlates with a high risk of migraine headaches, especially migraine with aura. Cortical spreading depression (CSD) is a wave of depolarization passing through neurons and glial cells of the cortex and is considered an electrophysiological correlate of migraine aura. The aim of the present study was to analyze neuronal activity and CSD in the somatosensory cortex of rats in vivo with prenatal hHCY and to assess cortex viability after 2 h of CSD generation. Female rats were fed a diet high in methionine, and their offspring with high homocysteine levels in plasma were further used in experiments. Recurrent CSD was evoked by local KCl application on the dura surface. Neuronal viability was assessed by measuring the activity of lactate dehydrogenase (LDH) in the brain and 2,3,5-triphenyltetrazolium chloride staining of the somatosensory cortex after two hours of CSD generation. Animals with hHCY exhibited higher neuronal activity, and more CSDs were generated in response to KCl, indicating higher cortical excitability. Propagation of recurrent CSD was impaired in supragranular cortical layers, and the recovery of multiple unit activity and evoked sensory potentials after CSD was delayed in the hHCY group. Finally, in animals with prenatal hHCY, an ischemic focus was identified as a consequence of multiple CSDs, along with elevated levels of LDH activity in brain tissues, suggestive of diminished neuronal viability. These findings imply that prolonged elevated levels of homocysteine may not only predispose to migraine with aura but also potentially elevate the risk of migrainous infarction.

Twisted clustered pinhole collimation for improved high-energy preclinical SPECT/PET

Abstract Objective: Advanced pinhole collimation geometries optimized for preclinical high-energy ɣ imaging facilitate applications such as ɑ and ß emitter imaging, simultaneous multi-isotope PET and PET/SPECT, and positron range-free PET. These geometries replace each pinhole with a group of clustered pinholes (CP) featuring smaller individual pinhole opening angles (POAs), enabling sub-mm resolution imaging up to ~1 MeV. Further narrowing POAs while retaining field-of-view (FOV) may enhance high-energy imaging but faces geometrical constraints. Here, we detail how the novel Twisted Clustered Pinholes (TCP) address this challenge.
Approach: We compared TCP and CP collimator sensitivity at equal system resolution and system resolution at matched sensitivity by tuning pinhole diameters for 18F (511 keV) and 89Zr (909 keV). Additionally, simulated Derenzo phantoms at low activity (LA: 12 MBq/ml) and high activity (HA: 190 MBq/ml) levels, along with uniformity images, were compared to assess image resolution and uniformity.
Main results: At equal system resolution, TCP increased average central FOV sensitivity by 15.6% for 18F and 29.4% for 89Zr compared to CP. Image resolution was comparable, except for 89Zr at LA, where TCP resolved 0.80 mm diameter rods compared to 0.90 mm for CP. Image uniformity was equivalent for 18F, while for 89 Zr TCP granted a 10.4% improvement. For collimators with matched sensitivity, TCP improved system resolution by 6.6% for 18F and 17.7% for 89Zr while also enhancing image resolution; for 18F, rods distinguished were 0.65 mm (CP) and 0.60 mm (TCP) for HA, and 0.70 mm (CP and TCP) for LA. For 89Zr, image resolutions were 0.75 mm (CP) and 0.65 mm (TCP) for HA, and 0.90 mm (CP) and 0.80 mm (TCP) for LA. Image uniformity with TCP decreased by 18.3% for 18F but improved by 20.1% for 89Zr.
Significance: This study suggests that the TCP design has potential to improve high-energy ɣ imaging.

S-palmitoylation of MAP kinase is essential for fungal virulence.

S-palmitoylation is an important reversible protein post-translational modification in organisms. However, its role in fungi is uncertain. Here, we found the treatment of the rice false fungus Ustilaginoidea virens with S-palmitoylation inhibitor 2 BP resulted in a significant decrease in fungal virulence. Comprehensive identification of S-palmitoylation sites and proteins in U. virens revealed a total of 4,089 S-palmitoylation sites identified among 2,192 proteins and that S-palmitoylated proteins were involved in diverse biological processes. Among the five palmitoyltransferases, UvPfa3 and UvPfa4 were found to regulate the pathogenicity of U. virens. We then performed quantitative proteomic analysis of ∆UvPfa3 and ∆UvPfa4 mutants. Interestingly, S-palmitoylated proteins were significantly enriched in the mitogen-activated protein kinase and autophagy pathways, and MAP kinase UvSlt2 was confirmed to be an S-palmitoylated protein which was palmitoylated by UvPfa4. Mutations of S-palmitoylation sites in UvSlt2 resulted in significantly reduced fungal virulence and decreased kinase enzymatic activity and phosphorylation levels. Simulations of molecular dynamics demonstrated mutation of S-palmitoylation sites in UvSlt2 causing decreased hydrophobic solvent-accessible surface area, thereby weakening the bonding force with its substrate UvRlm1. Taken together, S-palmitoylation promotes U. virens virulence through palmitoylation of MAP kinase UvSlt2 by palmitoyltransferase UvPfa4. This enhances the enzymatic phosphorylation activity of the kinase, thereby increasing hydrophobic solvent-accessible surface area and binding activity between the UvSlt2 enzyme and its substrate UvRlm1. Our studies provide a framework for dissecting the biological functions of S-palmitoylation and reveal an important role for S-palmitoylation in regulating the virulence of the pathogen.IMPORTANCES-palmitoylation is an important post-translational lipid modification of proteins. However, its role in fungi is uncertain. In this study, we found that S-palmitoylation promotes virulence of rice false smut fungus U. virens through palmitoylation of MAP kinase UvSlt2 by palmitoyltransferase UvPfa4. This enhances the enzymatic phosphorylation activity of the kinase, thereby increasing hydrophobic solvent-accessible surface area and binding activity between the UvSlt2 enzyme and its substrate UvRlm1. Our studies provide a framework for dissecting the biological functions of S-palmitoylation and reveal an important role for S-palmitoylation in regulating the virulence of the pathogen. This is the first functional study to reveal the role of S-palmitoylation in fungal virulence.

Synthesis and Antibacterial Activity of Alkylamine-Linked Pleuromutilin Derivatives

In an effort to expand the spectrum of the antibacterial activity of pleuromutilin, a series of amine- and polyamine-linked analogues were prepared and evaluated for activities against a panel of microorganisms. Simple C-22-substituted amino esters or diamines 16, 17, 18, and 22, as well as two unusual amine-linked bis-pleuromutilin examples 20 and 23, displayed variable levels of activity towards Staphylococcus aureus ATCC 25923 and methicillin-resistant S. aureus, but with no detectable activities towards Gram-negative bacteria. Fortunately, the incorporation of a longer-chain triamine or polyamine (spermine) at C-22 did afford analogues (30, 31) that exhibited activity towards both S. aureus ATCC 25923 and Escherichia coli ATCC 25922 with MIC 6.1–13.4 µM. Spermine–pleuromutilin analogue 31 was also able to enhance the action of doxycycline towards Pseudomonas aeruginosa ATCC 27853 by eight-fold, highlighting it as a useful scaffold for the development of new antibacterial pleuromutilin analogues that exhibit a broader spectrum of activity.

Around the clock: unveiling giraffe rest-activity rhythms and social dynamics

Understanding the daily activity patterns and social dynamics of giraffes (Giraffa camelopardalis) is crucial for their management and conservation. In this study, a comprehensive 24-hour observational analysis of three female reticulated giraffes kept for three weeks at the Opel-Zoo in Kronberg, Germany, was conducted. Using infrared-sensitive cameras, the study captured behavioral data across baseline and two intervention phases involving changes in group composition. Social network analysis was performed using the Mantel test to assess changes in social interactions between day and night and across different study periods, while the MRQAP was applied to evaluate the influence of individual subtypes on the social structure. During the day, the giraffes exhibited a high level of activity, primarily engaging in walking, standing, and feeding behaviors. Diurnal resting was minimal, with sporadic lying phases. Night-time behavior was markedly different, with the giraffes spending most of the night lying down, interspersed with periods of feeding. The presence of a male giraffe during one intervention phase significantly altered diurnal activity patterns, increasing standing behaviors and decreasing feeding time. Social interactions, including nearest neighbor preferences, varied across day and night periods and changed with alterations in group composition. The study highlights the complexity of giraffe social dynamics and their adaptation to different social contexts. These findings provide valuable insights into the natural behavioral rhythms and social behaviors of giraffes, which are essential for effective zoo management and conservation strategies.

Motivation for Physical Activity in Low-Income Adults: An Integrative Literature Review.

To explore, review and assess the literature on motivation for physical activity in low-income adults to inform future research and clinical interventions. An integrative review of the literature on motivation for physical activity in low-income adults. Whittemore and Knaul's five-stage methodological approach for integrative reviews was utilised. Studies written in English that focused primarily on low-income adults discussed physical activity and included a component of motivation or drive were included. The Johns Hopkins Evidence Level and Quality Guide was used to assess the quality of the studies. PubMed, CINAHL, PsycINFO, SPORTDiscuss and Google Scholar from 1 January 2018 - 23 August 2024. A total of 20 studies met the inclusion criteria. Three main categories of factors impacting physical activity in low-income adults were identified: (1) motivators for physical activity, (2) barriers for physical activity (3) and items that were both a motivator and a barrier. Despite the key role nurses play in promoting health and wellness, studies conducted by nurses or employing nursing interventions were notably absent. This integrative literature review highlights the need for more information about what motivates low-income adults to be more physically active. Understanding the experience of low-income adults with physical activity is integral to meeting their needs and facilitating increased physical activity. Future research should utilise nursing theories and interventions to improve physical activity levels among low-income adults. This study addressed physical inactivity in low-income adults. More information is needed about motivation for physical activity. This information will impact researchers and clinicians. The search strategy and reporting method were consistent with PRISMA guidelines. No Patient or Public Contribution.

Adjustment of Electronic (OMe and NO2) and Steric (CHPh2) Effects in Bis(imino)pyridinyliron Precatalysts for Producing High Molecular Weight Linear PE

AbstractBased on variations in steric and electronic substituents in the N‐aryl unit, a set of five 2‐[1‐(arylimino)ethyl]‐6‐[1‐(2‐benzhydryl‐4‐nitro‐6‐methoxyphenylimino)ethyl]pyridyliron dichloride complexes (where aryl=2,6‐dimethylphenyl (Fe‐Me2), 2,6‐diethylphenyl (Fe‐Et2), 2,6‐diisopropyl (Fe‐iPr2), 2,4,6‐trimethylphenyl (Fe‐Me3), 2,6‐diethyl‐4‐methylphenyl (Fe‐Et2Me)) were synthesized and investigated for ethylene polymerization. Their structures and compositions were confirmed by FTIR, elemental analysis, and X‐ray diffraction analysis (Fe‐Et2 and Fe‐iPr2), revealing a distorted square pyramidal geometry around the iron center. When activated in situ with MAO or MMAO, these iron complexes acted as highly active precatalysts, achieving activity levels up to 29.0×106 gPE molFe−1 h−1 for a 5‐min reaction at 60 °C. A notable characteristic of these precatalysts is their high thermal stability, maintaining significant activity (2.0×106 gPE molFe−1 h−1) at temperatures up to 100 °C. Importantly, the incorporation of strong electron‐withdrawing groups in the ligand structure favored the production of polyethylene with high molecular weights (up to 407.5 kg mol−1) across various reaction conditions, surpassing those of most previously reported iron complexes. Moreover, less hindered iron precatalysts showed higher activity compared to more hindered ones. However, the trend reversed when comparing the molecular weight of obtained polyethylene: more sterically hindered precatalysts yielded higher molecular weight polymers. The molecular weight distributions ranged from monomodal to bimodal with broad dispersity. DSC thermograms and 1H/13C NMR spectra of the polyethylene confirmed its highly linear microstructure, evidenced by sharp endothermic peaks and pronounced singlets for the −(CH2)n− repeating units.

National census of UK endoscopy services in 2023

BackgroundThe Joint Advisory Group on Gastrointestinal Endoscopy (JAG) conducts a biennial census of UK endoscopy services. The 2023 census aimed to assess the current status of endoscopy services and compare them with pre-pandemic census benchmark data.MethodsAn electronic survey was sent to all JAG participating services in April 2023. Key domains included activity, waiting times, workforce and safety. Whole census and service level paired comparison was made with 2019 census data.ResultsThere were 334 census responses representing 443 JAG-participating services (86.7% response rate). NHS services were operating at 110% of pre-pandemic activity levels. In the first 3 months of 2023, 53.6% of NHS services met urgent suspected cancer waiting time targets, 26.5% met routine waits and 26.2% met surveillance waits. The proportion of NHS services meeting all three targets decreased from 40.9% to 21.9% between 2019 and 2023. Compared with 2019, the proportion of independent sector activity has significantly increased. Insourcing activity has significantly increased and is being used by 57.9% of NHS services. Staff shortages were the most cited reasons for services not meeting waiting time targets or providing training. Absence through sickness rates for Band 2–6 nursing and healthcare support workers were significantly higher in 2023 compared with 2019 (p<0.001).ConclusionThe 2023 census presents a system under strain. While overall activity is above pre-pandemic levels, this is set against workforce concerns, increasing staff absences and reliance on insourcing for additional activity. This census re-emphasises the need to proactively plan for rising demand, while maximising all current available resources.

A profile approach to physical activity levels: what’s intensity got to do with reasons and motives for exercise?

BackgroundDespite the well-known benefits of physical activity (PA), non-communicable disease and premature mortality rates among adults continue to rise. The relationship between adults’ goals and exercise-specific motivation on the type of PA intensity one engages remains unclear. The purpose of this study was to identify physical activity (PA) profiles based on frequency and intensity (i.e., levels of PA) in an adult sample. A secondary purpose was to examine how the PA profiles differ on the reasons people have for exercising and behavioral regulation.MethodsA Cross-sectional survey was conducted with 1,169 (46.8 ± 16.7 years) participants solicited from a hospital-affiliated wellness center, social media promotions, and a research volunteer registry. The International PA Questionnaire (IPAQ) was used to determine frequency, intensity, and time spent engaging in PA. Additionally, the Reasons to Exercise (REX-2) scale, the Behavioral Regulation in Exercise Questionnaire-3 (BREQ-3), and demographics were assessed. K-cluster analyses were performed to identify profiles based on PA levels using the IPAQ guidelines. Multivariate analysis of variance (MANOVA) was used to assess profile differences.ResultsFive distinct PA clusters were derived, and defined as: a Low, Walking, Moderate Intensity, High Intensity, and Sitting cluster (p < .001). These clusters differed significantly (p < .001) from each other with respect to motivation, the reasons adults have for exercise, and PA levels.ConclusionThe results from this study support the important role of psychological factors such as motivation and reasons for exercise on behavioral outcomes (i.e., physical activity). For future research investigating adults PA- related behaviors, whether it be on adults starting a new exercise program or for PA maintenance, it may be beneficial to develop programs that encourage participants to reflect on the reasons they identify as important for exercising, and how such reasons contribute to their overall PA engagement behaviors.

A healthcare workforce assessment model using reimbursement data in Luxembourg

Abstract Background The assessment of the healthcare professional (HCP) headcount and level of activity is a real challenge for policy makers. In Luxembourg, there is no uniform definition of practicing HCP. This work focused on identifying a method to assess HCP headcount and their level of activity in Luxembourg, while finding national consensus. Methods A thorough literature review was conducted to find methods that assess practicing HCP and identify their level of activity. Eligible were scientific papers or national reports discussing methods on employed and self-employed HCP. National reimbursement data were used for preliminary data explorations conducted alongside the ‘General Inspectorate of Social Security’ in Luxembourg and discussed with the ‘Institut national d’assurance maladie-invalidité (INAMI)’ in Belgium. Two working groups were planned with national stakeholders to discuss HCP assessment methodologies. Both the collaborations and the working groups led to a preliminary validated HCP assessment method. To reach national consensus, a Delphi study is planned in June 2024, using the eDelphi.org platform. Invited panelists include researchers, professionals, healthcare practitioners, decision makers and policy makers, patient representatives, and insurers. Results The literature review found 16 eligible papers on HCP headcount and HCP’ level of activity. Finally, the Belgian method, developed by experts from INAMI, using reimbursement data and establishing a median reimbursement for each medical specialty was retained for Luxembourg. The results of the Delphi study will inform on the level of agreement on relevance, clarity and completeness of the proposed methodology for Luxembourg. Discussion Finding national consensus represents a strong foundation for efforts to advance the use of the proposed methodology in healthcare workforce assessment and planning. Key messages • Counting something as simple as healthcare professionals requires a strong methodology that held the buy-in of all major stakeholder. • As working behavior of HCP evolves over time, it is crucial to not only count professionals but also full-time equivalents for policy makers to plan ahead in an accurate manner.

Dose-response associations between physical activity and mental health among USA adolescents

Abstract Background Adolescent mental health is a critical public health concern. Physical activity has been shown to reduce risk of negative mental health outcomes. However, in adolescents little is known about the dose-response nature of this relationship. This study aims to fill this gap by examining the association between varying levels of self-reported physical activity and the odds of reporting depressive symptoms and poor mental health, among US high school students. Methods This is a cross-sectional study using data from the 2021 Youth Risk Behavior Survey. Physical activity exposure was assessed as students’ self-reported weekly frequency of ≥ 60min moderate-to-vigorous physical activity (MVPA), as well as frequency of participation in muscle-strengthening activities, sports teams, and physical education (PE) classes. For the dose-response analysis three categories were created for each item. Depressive symptoms and poor mental health were measured using established survey items. Multivariate logistic regression risk models were used. Results A total of 8,015 high-school students were included. Depressive symptoms were reported by 43% of students, and 28% reported poor mental health. Moderate doses (1-4 days) of muscle-strengthening activities reduced the odds of depressive symptoms by 23% and the odds of poor mental health by 38% compared to low doses (0 days). Higher reductions were observed for higher doses (5-7 days). Similar results were observed for sports teams (1 vs 0 teams). Moderate doses (1-4 days) of MVPA ≥60min showed a significant reduction in the odds for poor mental health (38%) but not depressive symptoms compared to low doses (0 days). No effect was observed for any dose of PE attendance. Conclusions The findings suggest a dose-response pattern in the association between physical activity and mental health in adolescents. Any increase in physical activity levels among young adults would be valuable in preventing poor mental health. Key messages • A dose-response pattern was observed between self-reported mental health and physical activity exposure in adolescents. • Moderate levels of physical activity significantly reduced the risk of self-reported poor mental health among adolescents.

Exploring protein biomarkers of physical activity and cardiovascular disease

Abstract Background The beneficial effects of physical activity on cardiovascular risk are well documented. Yet, the underlying mechanisms by which physical activity prevents cardiovascular disease remain unclear (1). Advancements of omics technology enables us to explore novel biomarkers of this complex molecular relationship and potentially unravel underlying molecular mechanisms involved in the progression of cardiovascular events. Purpose To investigate associations between long term physical activity and plasma proteins. As a second step investigate associations between identified plasma proteins and future myocardial infarction and mortality. Methods In the population based prospective cohort Uppsala Longitudinal Study of Adult Men (ULSAM), men were repeatedly investigated with a validated questionnaire on physical activity at ages 50, 60 and 70. 720 plasma proteins were analyzed at age 70 (n=782) with follow up on mortality data for 30 years. In the case-cohort MIMI (Markers of Imminent Myocardial Infarction study) the same plasma proteins were measured in disease-free individuals from six European cohorts. Individuals with acute myocardial infarction within 6 months from baseline were defined as cases (n=420) and up tto four cohort representatives per case were defined as controls (n=1598). Results Higher level of physical activity during 20 years was significantly associated with 12 plasma proteins, in a linear regression model adjusted for age, education and smoking after Bonferroni correction for multiple testing (p&amp;lt;0.000069). After additional adjustment for known cardiovascular risk factors (education, smoking status, BMI, blood pressure, low-density lipoprotein, diabetes diagnosis, and hypertensive-, lipid- or diabetes-treatment), all 12 proteins remained negatively associated with higher level of physical activity in the ULSAM cohort (p&amp;lt;0,05). Two proteins of the 12 proteins associated with physical activity were also significantly associated with future myocardial infarction in the MIMI study (FGF21 and IL6, p&amp;lt;0.05 for both) and 10 proteins were associated with increased mortality risk in the ULSAM cohort (p&amp;lt;0.05 for all). Moreover, proteins that were more negatively associated with physical activity were generally more positively associated with the risk of myocardial infarction in MIMI (Figure). Conclusion Multiple novel associations were found between long-term physical activity and plasma proteins. Some proteins were also associated with future myocardial infarction in an independent cohort which could suggest that the cardioprotective effects of physical activity to some degree may be mediated via the circulating proteome. Our findings encourage additional studies in order to understand the underlying causal mechanisms of these associations.

Metabolic rates of different demographics in the sand fiddler crab Leptuca pugilator.

Studies on animal energetics often focus on standardized metabolic rates to facilitate comparison across systems. Yet these standardized measurements often do not capture the realistic demographic and environmental variation that is common in natural settings. Rather, individuals included in these studies are often non-reproducing, uninjured, resting adults that have not recently eaten-far from a representative sample. We measured the respiratory rates of the sand fiddler crab Leptuca pugilator in air immediately after capture in the field, and compared rates between males, females of different reproductive states, and juveniles. As expected, we show that metabolic rates were influenced by body mass and activity level. We also show that being vitellogenic or gravid had only minor impacts on metabolic costs of females. Importantly, we demonstrate how considering demographics allows for the detection of phenomena that would otherwise go unnoticed. We found that field metabolic rates of L. pugilator in air are as much as an order of magnitude higher than previous standard metabolic rates measured on post-prandial, quiescent individuals. These higher rates may reflect a combination of high activity and active digestion, as fiddler crabs actively feed during low tide periods. Our results highlight the importance of considering differences in sex, life history stage, and reproductive state of organisms in fluctuating environments, such as intertidal habitats, when assessing energy expenditure.