Search

Prolonged sitting is associated with an increased risk of musculoskeletal pain, especially in nightshift workers. However, research investigating effects of breaking up sitting on musculoskeletal pain during nightshifts is lacking. This study evaluated effects of prolonged sitting or breaking up sitting with short bouts of light-intensity physical activity on pain in healthy adults during simulated nightshifts. An in-laboratory randomised controlled trial was undertaken with 52 healthy adults completing five simulated nightshifts. Participants were randomised to prolonged sitting (Sit9; n = 26) or breaking up prolonged sitting (Break9; n = 26). Break9 group completed 3-min walking every 30 min during nightshifts, while Sit9 group remained seated. Musculoskeletal pain intensity and sensory/affective pain experiences were assessed. Linear mixed models examined pain within nights (pre-to post-shift) and across nights (pre-shift-night-1 to pre-shift-night-5). Musculoskeletal pain intensity increased within nights for both Sit9 (mean change [95%CI] points: 0.14 [0.05, 0.24]) and Break9 (0.09 [0.001, 0.19], but not across nights (Sit9: −0.13 [-0.33, 0.08]; Break9: 0.07 [-0.14, 0.29]). Sensory-pain experience improved across nights for Sit9 (−3.08 [-4.72, −1.45]), but not within nights (0.77 [-0.004, 1.55]). There was no change in affective-pain experience in either group. Between-group difference was observed favouring Sit9 for improving sensory-pain across nights (β: 3.71 [1.42, 5.99]). No other between-group difference was observed. Both prolonged sitting and breaking up sitting were associated with a within-night increase in musculoskeletal pain intensity. Compared to prolonged sitting, breaking up sitting did not induce benefits on pain in healthy adults working simulated nightshifts. ACTRN12619001516178. • Prolonged sitting during nightshifts associated with increase in musculoskeletal pain. • Breaking up sitting with 3-min walking every 30 min was insufficient to reduce musculoskeletal pain. • Findings would inform appropriate designs of workplace interventions. [ABSTRACT FROM AUTHOR]

We discuss the status and prospects of the Large Hadron Collider beauty (LHCb) experiment, one of the four large detectors based at the LHC. The physics programme of the experiment is discussed by highlighting the status of rare b-quark decays, charged current semileptonic decays and the searches for CP violation. These areas make a strong cases for a second upgrade of LHCb, which will fully harness the HL-LHC's potential as a flavour physics machine while maintaining a rich and diverse research programme. The upgrade also provides an opportunity for the development of novel detector technologies during an exciting period of anticipation in preparation for the future circular collider currently foreseen. [ABSTRACT FROM AUTHOR]

The classification of non-specific chronic low back pain (CLBP) according to multidimensional data could guide clinical management; yet recent systematic reviews show this has not been attempted. This was a prospective cross-sectional study of participants with CLBP (n = 21) and age-, sex- and height-matched pain-free controls (n = 21). Nervous system, lumbar spinal tissue and psychosocial factors were collected. Dimensionality reduction was followed by fuzzy c-means clustering to determine sub-groups. Machine learning models (Support Vector Machine, k-Nearest Neighbour, Naïve Bayes and Random Forest) were used to determine the accuracy of classification to sub-groups. The primary analysis showed that four factors (cognitive function, depressive symptoms, general self-efficacy and anxiety symptoms) and two clusters (normal versus impaired psychosocial profiles) optimally classified participants. The error rates in classification models ranged from 4.2 to 14.2% when only CLBP patients were considered and increased to 24.2 to 37.5% when pain-free controls were added. This data-driven pilot study classified participants with CLBP into sub-groups, primarily based on psychosocial factors. This contributes to the literature as it was the first study to evaluate data-driven machine learning CLBP classification based on nervous system, lumbar spinal tissue and psychosocial factors. Future studies with larger sample sizes should validate these findings. [ABSTRACT FROM AUTHOR]

Mitchell, UH, Owen, PJ, Rantalainen, T, and Belavý, DL. Increased joint mobility is associated with impaired transversus abdominis contraction. J Strength Cond Res 36(9): 2472–2478, 2022—Increased joint mobility is a risk factor for joint injury, but muscle function may be able to compensate for it. Current evidence suggests reduced force production capacity in people with hypermobility. However, little is known about the lumbar spine. The purpose of this cross-sectional study was to assess whether there was a link between joint mobility and transverse abdominis and multifidus muscles contraction, muscles ascribed a core-stability role. Using a modified quantitative version of the Beighton scale (BOM score), we measured joint mobility of 30 middle-aged individuals without low back pain. These scores were correlated with magnetic resonance imaging–derived measures of transverse abdominis and multifidus muscle contraction during a spinal loading maneuver. The level of significance was set for p ≤ 0.05. The results showed greater joint mobility (a higher BOM score) correlated (r = 0.468; p = 0.009) with reduced transversus abdominis (TrA) shortening during contraction (i.e., less muscle shortening in people with greater joint mobility). The trunk subdomain score exhibited a correlation of 0.354 with TrA length change, but this did not reach statistical significance (p = 0.055). The subdomains of the BOM score did not correlate significantly with each other (p ≥ 0.097). No association was seen between multifidus contraction and joint mobility. The results suggest that greater general joint mobility is associated with impaired contraction of the TrA muscle. This should be considered when coaching athletes or treating patients with (functional) spinal instability. The quantitative approach we developed to measure joint mobility could be used in the future studies of global flexibility. [ABSTRACT FROM AUTHOR]

A correction is presented to the article "Attempting to Separate Placebo Efects from Exercise in Chronic Pain."

Background: Pain is the most disabling characteristic of musculoskeletal disorders, and while exercise is promoted as an important treatment modality for chronic musculoskeletal conditions, the relative contribution of the specific effects of exercise training, placebo effects and non-specific effects such as natural history are not clear. The aim of this systematic review and meta-analysis was to determine the relative contribution of these factors to better understand the true effect of exercise training for reducing pain in chronic primary musculoskeletal pain conditions. Design: Systematic review with meta-analysis Data Sources: MEDLINE, CINAHL, SPORTDiscus, EMBASE and CENTRAL from inception to February 2021. Reference lists of prior systematic reviews. Eligibility Criteria: Randomised controlled trials of interventions that used exercise training compared to placebo, true control or usual care in adults with chronic primary musculoskeletal pain. The review was registered prospectively with PROSPERO (CRD42019141096). Results: We identified 79 eligible trials for quantitative analysis. Pairwise meta-analysis showed very low-quality evidence (GRADE criteria) that exercise training was not more effective than placebo (g [95% CI]: 0.94 [− 0.17, 2.06], P = 0.098, I2 = 92.46%, studies: n = 4). Exercise training was more effective than true, no intervention controls (g [95% CI]: 0.99 [0.66, 1.32], P < 0.001, I2 = 92.43%, studies: n = 42), usual care controls (g [95% CI]: 0.64 [0.44, 0.83], P < 0.001, I2 = 76.52%, studies: n = 33), and when all controls combined (g [95% CI]: 0.84 [0.64, 1.04], P < 0.001, I2 = 90.02%, studies: n = 79). Conclusions: There is very low-quality evidence that exercise training is not more effective than non-exercise placebo treatments in chronic pain. Exercise training and the associated clinical encounter are more effective than true control or standard medical care for reductions in pain for adults with chronic musculoskeletal pain, with very low quality of evidence based on GRADE criteria. [ABSTRACT FROM AUTHOR]

A novel approach to reconstruct inclusive B ¯ → X s ℓ + ℓ - decays is presented. The method relies on isopsin symmetry to extrapolate the semi-inclusive signature X b → K + ℓ + ℓ - X to the fully inclusive rate in B + and B 0 decays. We investigate the possibility to measure branching fractions and other observables such as lepton universality ratios and C P asymmetries. As a proof of concept, fast simulation is used to compare the X b → K + ℓ + ℓ - X signature with a fully inclusive approach. Several experimental advantages are seen which have the potential to make measurements of inclusive B ¯ → X s ℓ + ℓ - decays tractable at a hadron collider. [ABSTRACT FROM AUTHOR]

Purpose: Androgen deprivation therapy (ADT) for prostate cancer has multiple adverse effects on musculoskeletal health. This 12-month randomized controlled trial aimed to assess the effects of multicomponent exercise training combined with whey protein, calcium and vitamin D supplementation on bone mineral density (BMD), structure and strength, body composition, muscle strength, and physical function in ADT-treated men. Methods: Seventy ADT-treated men were randomized to exercise plus supplementation (Ex + Suppl; n = 34) or usual care (control; n = 36). Ex + Suppl involved thrice weekly progressive resistance training plus weight-bearing impact exercise with daily multinutrient supplementation. Primary outcomes were DXA hip and spine areal BMD. Secondary outcomes included the following: tibia and radius pQCT volumetric BMD, bone structure and strength, DXA body composition, pQCT muscle and fat cross-sectional area and muscle density, and muscle strength and physical function. Results: Sixty men (86%) completed the study. Mean exercise and supplement adherence were 56% and 77%, respectively. There were no effects of the intervention on bone or body composition outcomes. Ex + Suppl improved leg muscle strength (net difference, (95% confidence interval, or CI), 14.5% (-0.2 to 29.2); P = 0.007) and dynamic mobility (four-square-step test time, -9.3% (-17.3 to -1.3), P = 0.014) relative to controls. Per-protocol analysis of adherent participants (>66% exercise, >80% supplement) showed Ex + Suppl preserved femoral neck aBMD (1.9% (0.1 to 3.8), P = 0.026) and improved total body lean mass (1.0 kg (-0.23 to 2.22), P = 0.044) relative to controls. Conclusions: Exercise training combined with multinutrient supplementation had a limited effect on ameliorating the adverse musculoskeletal consequences of ADT, likely related to the modest intervention adherence. [ABSTRACT FROM AUTHOR]

Objective Methods Results Conclusions Mechanical restraints are known to be associated with many undesirable outcomes in clinical settings. Our objective was to examine the current literature to explore possible interventions that would reduce the use of mechanical restraints in the ED.In this scoping review, we searched online databases Embase, MEDLINE and Cochrane CENTRAL for any studies published between the databases from 1 January 2007 to 19 September 2023. Studies were included if interventions were hospital‐ or staff‐focused and reported measured outcomes before and after the introduction of the intervention. Risk of bias was assessed using the JBI Critical Appraisal Checklist for Cohort Studies.The search strategy yielded 1937 studies across the three databases, of which 13 studies were extracted and included in the review. Interventions were categorised into four groups: provision of staff training, addition of a de‐escalation team, creation of a dedicated unit and introduction of an agitation scale only. Most of the studies saw reduction in restraint rates or time in restraints. Only the two studies that used an agitation scale as a stand‐alone intervention saw no significant reduction. Only one study had low risk of bias, whereas the remainder had high risk.Evidence supports further exploration of interventions that include: designing an agitation guideline; training staff in assessment, attitudinal and de‐escalation skills; addition of a crisis team; and environmental changes in the form of adding a dedicated clinical space. Although these strategies may reduce mechanical restraint in the ED setting, further high‐quality studies are needed before definitive conclusions may be drawn. [ABSTRACT FROM AUTHOR]

There is evidence in animal populations that loading and exercise can positively impact the intervertebral disc (IVD). However, there is a paucity of information in humans. We examined the lumbar IVDs in 308 young athletes across six sporting groups (baseball, swimming, basketball, kendo, soccer, and running; mean age 19 years) and 71 nonathletic controls. IVD status was quantified via the ratio of IVD to vertebral body height (IVD hypertrophy) and ratio of signal intensity in the nucleus to that in the annulus signal (IVD nucleus hydration) on sagittal T2‐weighted magnetic resonance imaging. P values were adjusted via the false discovery rate method to mitigate false positives. In examining the whole collective, compared to referents, there was evidence of IVD hypertrophy in basketball (P ≤.029), swimming (P ≤.010), soccer (P =.036), and baseball (P =.011) with greater IVD nucleus hydration in soccer (P =.007). After matching participants based on back‐pain status and body height, basketball players showed evidence of IVD hypertrophy (P ≤.043) and soccer players greater IVD nucleus hydration (P =.001) than referents. Greater career duration and training volume correlated with less (ie, worse) IVD nucleus hydration, but explained less than 1% of the variance in this parameter. In this young collective, increasing age was associated with increased IVD height. The findings suggest that basketball and soccer may be associated with beneficial adaptations in the IVDs in young athletes. In line with evidence on other tissues, such as muscle and bone, the current study adds to evidence that specific loading types may beneficially modulate lumbar IVD properties. [ABSTRACT FROM AUTHOR]

Methodologies for the quantitative assessment of the spine tissues, in particular the intervertebral disc (IVD), have not been well established in terms of long-term reliability. This is required for designing prospective studies. 1H water T2 in the IVD ("T2") has attained wider use in assessment of the lumbar intervertebral discs via magnetic resonance imaging. The reliability of IVD T2 measurements are yet to be established. IVD T2 was assessed nine times at regular intervals over 368 days on six anatomical slices centred at the lumbar spine using a spin-echo multi-echo sequence in 12 men. To assess repeatability, intra-class correlation co-efficients (ICCs), standard error of the measurement, minimal detectable difference and co-efficients of variation (CVs) were calculated along with their 95% confidence intervals. Bland-Altman analysis was also performed. ICCs were above 0.93, with the exception of nuclear T2 at L5/S1, where the ICC was 0.88. CVs of the central-slice nucleus sub-region ranged from 4.3% (average of all levels) to 10.1% for L5/S1 and between 2.2% to 3.2% for whole IVD T2 (1.8% for the average of all levels). Averaging between vertebral levels improved reliability. Reliability of measurements was least at L5/S1. ICCs of degenerated IVDs were lower. Test-retest reliability was excellent for whole IVD and good to excellent for IVD subregions. The findings help to establish the long-term repeatability of lumbar IVD T2 for the implementation of prospective studies and determination of significant changes within individuals. [ABSTRACT FROM AUTHOR]

Background: Fear of pain and movement is an important factor in the development of hypervigilance and avoidance behaviours. Objective: We examined the effectiveness of exercise training on improving fear-avoidance beliefs. Methods: A systematic review (data sources: MEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL) and metaanalysis of randomised controlled/clinical trials of exercise training in adults versus relevant nonexercise comparators that quantified fear-avoidance was conducted. Results: After screening 4603 identified records, 17 (2014 participants) and 13 (1152 participants) studies were eligible for qualitative and quantitative synthesis, respectively. Pairwise meta-analysis showed exercise training was more effective than all non-exercise comparators (standardised mean difference (SMD) [95% CI] − 0.378 [− 0.623, − 0.133], P = 0.002, Grading of Recommendations Assessment, Development and Evaluation [GRADE]: very low) for reducing fear-avoidance. Exercise training was more effective than true control for reducing fear avoidance (− 0.407 [− 0.750, − 0.065], P = 0.020, GRADE: very low), however it was not more effective than other interventions (− 0.243 [− 0.614, 0.128], P = 0.199, GRADE: very low). In people with low back pain, exercise training was more effective than non-exercise comparator groups for reducing fear-avoidance (− 0.530 [− 0.755, − 0.304], P < 0.001, GRADE: very low). For individuals with neck pain, exercise training was not more effective than non-exercise comparator groups for reducing fear-avoidance (0.061 [− 0.360, 0.482], P = 0.777, GRADE: very low). Conclusion: There is very low to low-quality evidence that exercise training is effective for reducing fear-avoidance, including in people with low back pain. Exercise training may be more effective than no intervention for reducing fear avoidance, but there is very low-quality evidence that non-exercise interventions are as effective as exercise for fear avoidance. Few studies with low risk of bias is a limitation. Trail Registration: PROSPERO Registration Number: CRD42019139678. [ABSTRACT FROM AUTHOR]

Maximising research productivity is a major focus for universities world-wide. Graduate research programs are an important driver of research outputs. Choosing students with the greatest likelihood of success is considered a key part of improving research outcomes. There has been little empirical investigation of what factors drive the outcomes from a student's PhD and whether ranking procedures are effective in student selection. Here we show that, the research environment had a decisive influence: students who conducted research in one of the University's priority research areas and who had experienced, research-intensive, supervisors had significantly better outcomes from their PhD in terms of number of manuscripts published, citations, average impact factor of journals published in, and reduced attrition rates. In contrast, students' previous academic outcomes and research training was unrelated to outcomes. Furthermore, students who received a scholarship to support their studies generated significantly more publications in higher impact journals, their work was cited more often and they were less likely to withdraw from their PhD. The findings suggest that experienced supervisors researching in a priority research area facilitate PhD student productivity. The findings question the utility of assigning PhD scholarships solely on the basis of student academic merit, once minimum entry requirements are met. Given that citations, publication numbers and publications in higher ranked journals drive university rankings, and that publications from PhD student contribute approximately one-third of all research outputs from universities, strengthening research infrastructure and supervision teams may be more important considerations for maximising the contribution of PhD students to a university's international standing. [ABSTRACT FROM AUTHOR]

Background context: Muscle, bone and tendon respond anabolically to mechanical forces. Whether the intervertebral disc (IVD) can benefit from exercise is unclear. Purpose: To examine whether exercise can beneficially affect IVD characteristics. Study design/setting: This is a single-blinded 6-month randomised controlled trial (ACTRN12615001270505) in an exercise and physiotherapy clinic. Patient sample: Forty patients with chronic non-specific low back pain (NSCLBP) are included in this study. Outcome measures: The primary outcome was lumbar IVD T2 time (MRI). Secondary outcomes included IVD diffusion coefficient and IVD expansion with short-duration lying. Methods: Twenty patients progressively loaded their lumbar IVDs (exercise) via an exercise programme involving progressive upright aerobic and resistance exercises targeting the trunk and major muscle groups and were compared to twenty patients who performed motor control training and manual therapy (control). Testing occurred at baseline, 3 months and 6 months. Results: Seventeen exercise and fifteen control patients completed the interventions. There were no group-by-time differences in T2 time of the entire IVD (exercise 94.1 ± 10.0 ms vs. control 96.5 ± 9.3 ms, p = 0.549). Exercise patients had shorter T2 time in the posterior annulus at 6 months (82.7 ± 6.8 ms vs. 85.1 ± 8.0 ms, p = 0.028). Exercise patients showed higher L5/S1 apparent diffusion coefficients and decreased IVD height at 3 months (both p ≤ 0.050). After adjustments for multiple comparisons, differences lost statistical significance. Per-protocol and intent-to-treat analyses yielded similar findings. Conclusions: This trial found that 6 months of exercise did not benefit the IVD of people with NSCLBP. Based on this index study, future studies could investigate the effect of exercise on IVD in different populations, with different types, durations and/or intensities of exercise, and using different IVD markers. These slides can be retrieved under Electronic Supplementary Material. [ABSTRACT FROM AUTHOR]

Astronauts are at increased risk of spine injury. With a view to developing training approaches for the muscles of the spine in microgravity, this study examined the effects of axial loading and postural cues on the contraction of transversus abdominis and lumbar multifidus in supine lying using a novel exercise device (GravityFit). Thirty (18 males and 12 females) endurance-trained runners without a history of spinal pain aged 33–55 years were recruited. Magnetic resonance imaging (MRI) was performed under one rest and five exercise conditions, which involved variations in axial loading and postural cues. Whole volume of the abdominal and lumbar paraspinal muscles was imaged and transversus abdominis thickness and length and multifidus anteroposterior and mediolateral thickness measured. Transversus abdominis contraction was greatest in the 'stretch tall plus arm extension' (length, − 15%, P < 0.001; thickness, + 19%, P < 0.001) and 'stretch tall plus arm extension and thoracic cue' (length, − 16%, P < 0.001; thickness, + 18%, P < 0.001) conditions. The contraction of multifidus was the greatest in the 'arm extension and thoracic cue' (anteroposterior, + 3.0%, P = 0.001; mediolateral, − 4.2%, P < 0.001) and 'stretch tall plus arm extension and thoracic cue' (anteroposterior, + 6.0%, P < 0.001; mediolateral, − 2.1%, P = 0.022) conditions. This study provides proof-of-principle for an exercise approach that may be used to facilitate the automatically contraction of the transversus abdominis and multifidus muscles. Axial loading of the body, with or without arm loading, most consistently led to contraction of the transversus abdominis and lumbar multifidus muscles, and regional differences existed in the contraction within the muscles. [ABSTRACT FROM AUTHOR]

Androgen deprivation therapy (ADT) for prostate cancer (PCa) can compromise muscle health. Hence, we aimed to quantify the prevalence of sarcopenia (i.e., compromised lean mass, muscle strength, and physical function) in ADT-treated (> 12 week) men (n = 70) compared to similarly aged non-ADT-treated PCa (n = 52) and healthy controls (n = 70). Lean and fat mass were quantified by dual-energy X-ray absorptiometry. Muscle strength and function were measured using handgrip dynamometry and gait speed, respectively. Sarcopenia was defined as low adjusted appendicular lean mass [ALM; height-adjusted (ALMI), body mass index-adjusted (ALMBMI) and height and fat mass-adjusted (ALMHFM)] with weak handgrip strength and/or slow gait speed according to the following criteria: European Working Group on Sarcopenia in Older People [EWGSOP; both 2010 (EWGSOP1) and 2018 (EWGSOP2)], Foundation for the National Institutes of Health (FNIH) and International Working Group on Sarcopenia (IWGS). Overall the prevalence of sarcopenia was low and did not differ between the three groups. Only two (3.2%) ADT-treated men presented with sarcopenia as per EWGSOP1 and FNIH criteria, whereas no cases were observed using EWGSOP2 and IWGS criteria. The prevalence of low ALMBMI was greater in ADT-treated men (32%) compared to PCa (15%; P = 0.037) and healthy controls (7.1%; P < 0.001). Similarly, low ALMHFM was greater in ADT-treated men (29%) compared to healthy controls only (13%; P = 0.019). There was also a low prevalence of weak muscle strength and slow gait speed (0.0-11%) in all men, with no differences between the groups. Based on these findings, an adiposity-based adjustment of ALM is recommended to quantify risk of adverse outcomes associated with ADT in these men. [ABSTRACT FROM AUTHOR]

Background:Musculoskeletal (MSK) pain is the leading cause of disability worldwide. Telemedicine is of growing importance, yet impacts on treatment efficacy remain unclear. Objective:This umbrella review (CRD42022298047) examined the effectiveness of telemedicine interventions on pain intensity, disability, psychological function, quality of life, self-efficacy, and adverse events in MSK pain. Methods:PubMed, SPORTDiscus, Cochrane Library, EMBASE, and CINAHL were searched from inception to August 9, 2022, for systematic reviews with meta-analysis, including telemedicine-delivered exercise, education, and psychological interventions, in randomized controlled trials (RCTs). AMSTAR-2 was implemented. Standardized mean differences (SMDs; negative favors telemedicine) were extracted as effect estimates. Results:Of 1,135 records, 20 reviews (RCTs: n = 97, participants: n = 15,872) were included. Pain intensity SMDs were −0.66 to 0.10 for mixed pain (estimates: n = 16), −0.64 to −0.01 for low-back pain (n = 9), −0.31 to −0.15 for osteoarthritis (n = 7), −0.29 for knee pain (n = 1), −0.66 to −0.58 for fibromyalgia (n = 2), −0.16 for back pain (n = 1), and −0.09 for rheumatic disorders (n = 1). Disability SMDs were −0.50 to 0.10 for mixed pain (n = 14), −0.39 to 0.00 for low-back pain (n = 8), −0.41 to −0.04 for osteoarthritis (n = 7), −0.22 for knee pain (n = 1), and −0.56 for fibromyalgia (n = 1). Methodological quality was "critically low" for 17 reviews. Effectiveness tended to favor telemedicine for all secondary outcomes. Conclusions:Primary RCTs are required that compare telemedicine interventions with in-person delivery of the intervention (noninferiority trials), consider safety, assess videoconferencing, and combine different treatment approaches. [ABSTRACT FROM AUTHOR]

Background: Musculoskeletal pain conditions are the largest contributors to disability and healthcare burden globally. Exercise interventions improve physical function and quality of life in individuals with musculoskeletal pain, yet optimal exercise prescription variables (e.g. duration, frequency, intensity) are unclear. Objective: We aimed to examine evidence gaps, methodological quality and exercise prescription recommendations in systematic reviews of exercise for musculoskeletal pain. Methods: In our prospectively registered umbrella review, PubMed, SPORTDiscus, Cochrane Database of Systematic Reviews, EMBASE, and CINAHL were searched from inception to 14 February 2023. Backward citation tracking was performed. We included peer-reviewed, English language, systematic reviews and meta-analyses of randomized controlled trials (RCTs) and controlled clinical trials (CCTs) that compared exercise with conservative treatment, placebo or other exercise interventions in adults with musculoskeletal pain. Data were extracted from the following groups of reviews based on their reporting of exercise prescription data and analysis of the relationship between prescription variables and outcomes: (1) those that did not report any exercise prescription data, (2) those that reported exercise prescription data but did not perform a quantitative analysis and (3) those that performed a quantitative analysis of the relationship between exercise prescription variables and outcomes. Outcome measures were physical function, pain, mental health, adverse effects and adherence to treatment. AMSTAR-2 (A MeaSurement Tool to Assess systematic Reviews) was used to assess methodological quality. Results: From 6757 records, 274 systematic reviews were included. 6.6% of reviews did not report any exercise prescription data, and only 10.9% quantitatively analyzed the relationship between prescription variables and the outcome(s). The overall methodological quality was critically low in 85% of reviews. Conclusion: High methodological quality evidence is lacking for optimal exercise training prescription variables in individuals with musculoskeletal pain. To better inform practice and evidence gaps, future systematic reviews should (1) identify optimum exercise prescription variables, for example, via dose–response (network) meta-analysis, (2) perform high-quality reviews per AMSTAR-2 criteria and (3) include outcomes of mental health, adverse events and exercise adherence. PROSPERO registration number: CRD42021287440 (https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021287440). [ABSTRACT FROM AUTHOR]

The importance of contextual effects and their roles in clinical care controversial. A Cochrane review published in 2010 concluded that placebo interventions lack important clinical effects overall, but that placebo interventions can influence patient-reported outcomes such as pain and nausea. However, systematic reviews published after 2010 estimated greater contextual effects than the Cochrane review, which stems from the inappropriate methods employed to quantify contextual effects. The effects of medical interventions (i.e., the total treatment effect) can be divided into three components: specific, contextual, and non-specific. We propose that the most effective method for quantifying the magnitude of contextual effects is to calculate the difference in outcome measures between a group treated with placebo and a non-treated control group. Here, we show that other methods, such as solely using the placebo control arm or calculation of a 'proportional contextual effect,' are limited and should not be applied. The aim of this study is to provide clear guidance on best practices for estimating contextual effects in clinical research. [ABSTRACT FROM AUTHOR]

The importance of contextual effects and their roles in clinical care controversial. A Cochrane review published in 2010 concluded that placebo interventions lack important clinical effects overall, but that placebo interventions can influence patient-reported outcomes such as pain and nausea. However, systematic reviews published after 2010 estimated greater contextual effects than the Cochrane review, which stems from the inappropriate methods employed to quantify contextual effects. The effects of medical interventions (i.e., the total treatment effect) can be divided into three components: specific, contextual, and non-specific. We propose that the most effective method for quantifying the magnitude of contextual effects is to calculate the difference in outcome measures between a group treated with placebo and a non-treated control group. Here, we show that other methods, such as solely using the placebo control arm or calculation of a 'proportional contextual effect,' are limited and should not be applied. The aim of this study is to provide clear guidance on best practices for estimating contextual effects in clinical research. [ABSTRACT FROM AUTHOR]

Background: Prostate cancer is the most commonly diagnosed cancer in men in developed countries. Androgen deprivation therapy (ADT) is a systemic treatment shown to increase survival in selected patients with prostate cancer. The use of ADT continues to increase for all stages and grades of prostate cancer despite known treatment-induced adverse effects. The primary aim of this study is to examine the efficacy of a targeted, multi-component resistance and impact-loading exercise programme together with a daily protein-, calcium- and vitamin D-enriched supplement on bone health in men treated with ADT for prostate cancer. Secondary aims are to determine the effects of this intervention on measures of total body and regional body composition, cardiometabolic risk, inflammatory markers, health-related quality of life and cognitive function.Methods: This study is a two-arm randomised controlled trial. Men currently treated with ADT for prostate cancer will be randomised to either a 52-week, community-based, exercise training and nutritional supplementation intervention (n = 51) or usual care control (n = 51). Participants will be assessed at baseline, 26 weeks and 52 weeks for all measures. The primary outcome measures are proximal femur and lumbar spine areal bone mineral density (BMD). Secondary outcomes comprise: changes in tibial and radial bone structure and strength, total body and regional body composition, muscle strength and function, as well as cardiometabolic health, catabolic/inflammatory and anabolic/anti-inflammatory cytokines, health-related quality of life and cognitive function.Discussion: This study investigates whether a multi-component intervention incorporating a targeted bone and muscle-loading programme in combination with a protein-, calcium- and vitamin D-enriched supplement can ameliorate multiple adverse effects of ADT when compared to usual care. The results will contribute to the development of exercise training and nutrition guidelines for optimising overall health in men treated with ADT for prostate cancer.Trial Registration: Australia New Zealand Clinical Trial Registry (ANZCTR), ID: ACTRN12614000317695 . Registered on 25 march 2014. [ABSTRACT FROM AUTHOR]

We examined the suitability of an invasive Asian earthworm, Amynthas agrestis (Asian Crazy Worm or Alabama Jumper), as a prey item for a variety of native and naturalized North American predators. We conducted no-choice feeding trials with three edaphic predators—the nonindigenous Bipalium adventitium (Wandering Broadhead Planarian), Scolopocryptops sexspinosus (Eastern Red Centipede), and Desmognathus monticola (Seal Salamander)—and two aquatic predators, Nephelopsis obscura (Ribbon Leech) and Oronectes rusticus (Rusty Crayfish). During feeding trials, Am. agrestis exhibited a variety of novel defensive strategies, including apparent distastefulness, autotomization of posterior body segments, secretion of a yellow fluid, and thrashing. Planarians, leeches, and salamanders were more likely to capture lumbricid earthworm prey than Am. agrestis prey. Rusty Crayfish showed limited differences in capture rates among the earthworm species, while Eastern Red Centipedes were equally adept at capturing all earthworm species tested. Our results suggest that endemic arthropods may provide a measure of biological resistance against incipient Am. agrestis invasions. [ABSTRACT FROM AUTHOR]

Abstract: As significant contributors to the generation, dissemination and publication of scientific knowledge, graduate students have considerable leverage on publication trends and the future direction of ethnopharmacology. The rigid discipline-oriented framework of academia is often cited as responsible for impeding interdisciplinarity, particularly for fields such as ethnopharmacology which span both the natural and social science domains. Funding opportunities, funding eligibility periods, time-to-degree patterns and departmental expectations and requirements for graduate students enrolled in the natural sciences are considerably different than for those in the social sciences. Consequently, adequate acquisition of ethnographic data is often compromised. Encouraging students to think across disciplines, cross-disciplinary collaboration, and flexibility in regards to the time and financial constraints imposed by departments and funding agencies would increase the likelihood of contextualizing bioscientific data with adequate traditional empirical knowledge, and ultimately embrace the core objectives on which the JEP was conceived. [ABSTRACT FROM AUTHOR]

Abstract: As significant contributors to the generation, dissemination and publication of scientific knowledge, graduate students have considerable leverage on publication trends and the future direction of ethnopharmacology. The rigid discipline-oriented framework of academia is often cited as responsible for impeding interdisciplinarity, particularly for fields such as ethnopharmacology which span both the natural and social science domains. Funding opportunities, funding eligibility periods, time-to-degree patterns and departmental expectations and requirements for graduate students enrolled in the natural sciences are considerably different than for those in the social sciences. Consequently, adequate acquisition of ethnographic data is often compromised. Encouraging students to think across disciplines, cross-disciplinary collaboration, and flexibility in regards to the time and financial constraints imposed by departments and funding agencies would increase the likelihood of contextualizing bioscientific data with adequate traditional empirical knowledge, and ultimately embrace the core objectives on which the JEP was conceived. [Copyright &y& Elsevier]

Rapid increase in the incidence of type 2 diabetes (DM2) in Papua New Guinea, coupled with compelling epidemiological evidence supporting a diabetogenic association with betel quid (BQ) chewing has lead us to investigate dietary strategies that might offer protection from developing DM2. We investigated the dietary habits of Kalo residents from coastal Central Province who are avid BQ chewers yet have a relatively low incidence of DM2 compared to the ethnically similar and adjacent Wanigelans who abstain from BQ yet have an unusually high incidence of DM2. In Kalo, guava bud (Psidium guajava L) and noni (Morinda citrifolia L) were consumed much more frequently than in Wanigela, whereas the inverse was observed for mangrove bean (Bruguiera gymnorrhiza (L) Lam.). These plants, along with BQ and its component ingredients areca nut (Areca catechu L) and Piper betle L inflorescence, were assessed for their ability to mediate insulin-dependent and insulin-independent glucose transport in cultured 3T3-L1 adipocytes. A dose-dependent inhibition of glucose uptake from methanolic extracts of BQ, areca nut and P. betle inflorescence supports previous reports of pro-diabetic activity. Conversely, guava bud extract displayed significant insulin-mimetic and potentiating activity. Noni fruit, noni leaf, commercial noni juice and mangrove bean all displayed insulin-like activity but had little or no effect on insulin action. Habitual intake of guava and noni is proposed to offer better protection against DM2 development and/or betel quid diabetogenicity than cooked mangrove bean. These findings provide empirical support that DM2 risk reduction can be accomplished using traditional foods and medicines. [ABSTRACT FROM AUTHOR]

We studied the courtship behavior of two species of chorus frogs, Pseudacris illinoensis and P. tseriata, in western Illinois. We report observations of courtship behavior and describe courtship calls for each species. These calls were given in response to both male and female conspecifics entering the calling spaces of resident males. Courtship calls given in response to an intruder were never followed by aggressive behaviors from the resident or the intruder, and courtship calls were never given in response to playbacks of conspecific advertisement calls. Thus, these calls do not appear to be used in an aggressive context. Courtship calls of P. illinoensis are longer in duration than advertisement calls. Courtship calls in P. triseriata consist of multiple notes compared to single note advertisement calls. These courtship calls have higher pulse rates and lower dominant frequencies, and they are given at faster calling rates than advertisement calls. Courtship calls of both species are more variable in structure within males than advertisement calls. Like two other species of chorus frogs for which courtship culls have been reported, courtship calls in P. illinoensis and P. triseriata are modifications of the advertisement call. Courtship calls in the genus that have been described so far do not appear to share a common structure. The recognition of courtship calls in a chorus may play a useful role in long-term monitoring of anuran breeding activity, especially in remotely determining the presence of gravid females. [ABSTRACT FROM AUTHOR]

Dietary and medicinal phytochemicals may contribute to the reportedly low incidence of cardiovascular disease (CVD) among Tibetan highlanders, despite elevated hematocrit levels and a diet high in saturated fat and low in fruits and vegetables. Antioxidant activity was measured in 14 plant species most commonly incorporated in Tibetan medicines prescribed for the treatment of cardiovascular related disease according to indigenous pharmacopoeias. Methanol extracts of Terminalia chebula, Syzygium aromaticum, Aquilaria agallocha, Santalum album, Amomutn subulatum, Justicia adhatoda and Myristica fragrans displayed strong free radical scavenging activity using the 1,1-diphenyl-2-picrylhydrazyl (DPPH) radical. These plants were further partitioned into a hexane, chloroform, ethyl acetate, and water fraction, and re-tested with DPPH assay. Fractions displaying strongest activity were examined in vitro for their ability to protect human low-density lipoprotein (LDL) from Cu[sup 2+]catalyzed oxidation measured using thiobarbimric acid reactive substances (TBARS) production and formation of conjugated dienes. The hexane fraction of S. aromaticum displayed an ability to reduced LDL susceptibility to oxidation (1339.96 ± 7.01 min lag time) three-times longer than Trolox® (431.02 ± 21.9 min lag time), a hydrophilic analog of α-tocopherol. Approximately half of all plants included in this study contained fractions that displayed significant antioxidant activity. Our results suggest that these spices and medicinal plants may provide a therapeutic benefit towards CVD prevention and treatment, and reinforces the merits of traditional Tibetan medicine. [ABSTRACT FROM AUTHOR]

Background and Aims: Exercise is recommended for the management of metabolic dysfunction‐associated steatotic liver disease (MASLD), yet effects on liver histology remain unknown, especially without significant weight loss. We aimed to examine changes in surrogate measures of liver histological response with exercise training. Methods: We conducted a post hoc pooled analysis of three randomised controlled trials (duration: 12–20 weeks) comparing aerobic exercise interventions with controls. The primary outcome measure was a ≥30% relative reduction in (MRI‐measured) liver fat, as a surrogate measure of liver histological response (the threshold necessary for fibrosis improvement). Secondary outcome measures were changes in other biomarkers of liver fibrosis, anthropometry, body composition and aerobic fitness. Results: Eighty‐eight adults (exercise: 54, control: 34; male: 67%) were included with mean (SD) age 51 (11) years and body mass index 33.3 (5.2) kg/m2. Following the intervention, exercise had ~5‐fold (OR [95%CI]: 4.86 [1.72, 13.8], p =.002) greater odds of ≥30% relative reduction in MRI‐measured liver fat compared with control. This paralleled the improvements in anthropometry (waist and hip circumference reduction), body composition (body fat, visceral and subcutaneous adipose tissue) and aerobic fitness (V̇O2peak, ventilatory threshold and exercise capacity). Importantly, these effects were independent of clinically significant body weight loss (<3% body weight). Conclusion: Exercise training led to clinically meaningful improvements in surrogate serum‐ and imaging‐based measures of liver histological change, without clinically meaningful body weight reduction. These data reinforce the weight‐neutral benefit of exercise training and suggest that aerobic training may improve liver fibrosis in patients with MASLD. [ABSTRACT FROM AUTHOR]

Abstract: Brain structure, psychosocial, and physical factors underpin back pain conditions; however, less is known about how these factors differ based on pain duration and location. We examined, cross-sectionally, 11,106 individuals from the UK Biobank who (1) were pain-free (n = 5616), (2) had acute back pain (n = 1746), (3) had chronic localised back pain (CBP; n = 1872), or (4) had chronic back pain and additional chronic pain sites (CWP; n = 1872). We found differences in structural brain measures in the chronic pain groups alone. Both CBP and CWP groups had lower primary somatosensory cortex {CBP mean difference (MD) (95% confidence interval [CI]): -250 (-393, -107) mm3, P < 0.001; CWP: -170 (-313, -27)mm3, P = 0.011} and higher caudate gray matter volumes (CBP: 127 [38,216]mm3, P = 0.001; CWP: 122 [33,210]mm3, P = 0.002) compared with pain-free controls. The CBP group also had a lower primary motor cortex volume (-215 [-382, -50]mm3, P = 0.005), whereas the CWP group had a lower amygdala gray matter volume (-27 [-52, -3]mm3, P = 0.021) compared with pain-free controls. Differences in gray matter volumes in some regions may be moderated by sex and body mass index. Psychosocial factors and body mass index differed between all groups and affected those with widespread pain the most (all, P < 0.001), whereas grip strength was only compromised in individuals with widespread pain (-1.0 [-1.4, -0.5] kg, P < 0.001) compared with pain-free controls. Longitudinal research is necessary to confirm these interactions to determine the process of pain development in relation to assessed variables and covariates. However, our results suggest that categorised pain duration and the number of pain sites warrant consideration when assessing markers of brain structure, psychosocial, and physical health. [ABSTRACT FROM AUTHOR]

College students may be particularly stressed as they struggle to balance college life, work, family, and relationships, while engaging in career exploration and attempting to find meaning and purpose in their lives. The current practitioner action research project explored incorporating mindfulness and contemplative practices into the higher education classroom to uncover students' perceptions of how useful the activities might be for managing their personal stress and anxiety. Thirty-two freshman and sophomore students from a regional campus of a large university consented to participate in the semester-long study, where brief, weekly mindfulness activities were integrated into in-class and out-of-class assignments during an introductory Personal Health course. Study findings indicated that the majority of student participants found mindfulness practices were helpful when it came to decreasing stress and anxiety or relaxing. Making time outside the classroom to practice mindfulness behaviors, however, was a barrier. These findings have both practical and positive implications for future higher education classroom interventions. As such, the authors contend that college-level instructors should incorporate mindfulness and contemplative activities into the curricula of their health education courses to help college students master mindfulness strategies and encourage their use in reducing stress and anxiety. [ABSTRACT FROM AUTHOR]

Background: There is a high prevalence of mental illness in nursing home residents compared to older adults living in the community. This was highlighted in the most recent comprehensive systematic review on the topic, published in 2010. In the context of a rapidly aging population and increased numbers of older adults requiring residential care, this study aims to provide a contemporary account of the prevalence of mental illness among nursing home residents. Methods: This protocol was prepared in line with the PRISMA-P 2015 Statement. Systematic searches will be undertaken across six electronic databases: PubMed, Embase, Web of Science, PsycNET, CINAHL, and Abstracts in Social Gerontology. Peer-reviewed studies published from 2009 onwards which report the prevalence of mental illness within nursing home populations will be included. Database searches will be supplemented by forward and backward citation searching. Titles and abstracts of records will be screened using a semi-automated process. The full text of selected records will be assessed to confirm inclusion criteria are met. Study selection will be recorded in a PRISMA flowchart. A pilot-tested form will be used to extract data from included studies, alongside the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data. A study characteristics and results table will be prepared to present key details from each included study, supported by a narrative synthesis. Random-effects restricted maximum likelihood meta-analyses will be performed to compute pooled prevalence estimates for mental illnesses represented in the identified studies. Heterogeneity will be assessed using Cochran's Q and Higgins' I2 statistics. A Funnel plot and Egger's test will be used to assess publication bias. The GRADE approach will be used to assess the quality of the body of evidence identified. Discussion: The study will provide a comprehensive and contemporary account of the prevalence of mental illness among nursing home residents. Meta-analyses will provide robust prevalence estimates across a range of presentations. Key insights will be highlighted, including potential sources of heterogeneity. Implications for residents, researchers, care providers, and policymakers will be noted. Systematic review registration: PROSPERO: CRD42023456226. [ABSTRACT FROM AUTHOR]

Nonspecific chronic low back pain (CLBP) is a common clinical condition that has impacts at both the individual and societal level. Pain intensity is a primary outcome used in clinical practice to quantify the severity of CLBP and the efficacy of its treatment; however, pain is a subjective experience that is impacted by a multitude of factors. Moreover, differences in effect sizes for pain intensity are not observed between common conservative treatments, such as spinal manipulative therapy, cognitive behavioral therapy, acupuncture, and exercise training. As pain science evolves, the biopsychosocial model is gaining interest in its application for CLBP management. The aim of this article is to discuss our current scientific understanding of pain and present why additional factors should be considered in conservative CLBP management. In addition to pain intensity, we recommend that clinicians should consider assessing the multidimensional nature of CLBP by including physical (disability, muscular strength and endurance, performance in activities of daily living, and body composition), psychological (kinesiophobia, fear‐avoidance, pain catastrophizing, pain self‐efficacy, depression, anxiety, and sleep quality), social (social functioning and work absenteeism), and health‐related quality‐of‐life measures, depending on what is deemed relevant for each individual. This review also provides practical recommendations to clinicians for the assessment of outcomes beyond pain intensity, including information on how large a change must be for it to be considered "real" in an individual patient. This information can guide treatment selection when working with an individual with CLBP. [ABSTRACT FROM AUTHOR]

We present, for the first time, the six-fold differential decay density expression for Λ b 0 → Λ c + μ ℓ − v ¯ ℓ , taking into account the polarisation of the Λ b 0 baryon and a complete basis of new physics operators. Using the expected yield in the current dataset collected at the LHCb experiment, we present sensitivity studies to determine the experimental precision on the Wilson coefficients of the new physics operators with Λ b 0 → Λ c + μ − v ¯ μ decays in two scenarios. In the first case, unpolarised Λ b 0 → Λ c + μ − v ¯ μ decays with Λ c + → pK + π− are considered, whereas polarised Λ b 0 → Λ c + μ − v ¯ μ decays with Λ c + → p K S 0 are studied in the second. For the latter scenario, the experimental precision that can be achieved on the de-termination of Λ b 0 polarisation and Λ c + weak decay asymmetry parameter is also presented. [ABSTRACT FROM AUTHOR]

Androgen deprivation therapy (ADT) improves survival in men with advanced prostate cancer (PCa), but has been associated with compromised skeletal health and increased fracture risk. However, limited previous research has investigated determinants of bone strength beyond DXA-derived areal bone mineral density (aBMD) in this population group. The aim of this cross-sectional study was to investigate the effects of ADT in men with PCa on BMD, bone structure, estimates of whole bone strength and cortical bone distribution. A total of 70 ADT-treated men, 52 PCa controls and 70 healthy controls had DXA lumbar spine and proximal femur aBMD and pQCT distal (4%) and proximal (66%) tibia and radius cortical and trabecular volumetric BMD (vBMD), bone structure, strength and cortical bone distribution assessed. Analyses included BMI and/or tibia/radius length as covariates. On average, ADT-treated men had a higher BMI than PCa (P < 0.05) but not healthy controls. ADT-treated men had 7.2–7.8% lower lumbar spine aBMD than PCa (P = 0.037) and healthy controls (P = 0.010), with a trend for a lower total hip aBMD in the ADT-treated men (P = 0.07). At the distal tibia, total bone area was 6.2–7.3% greater in ADT-treated men than both controls (P < 0.01), but total vBMD was 8.4–8.7% lower in ADT-treated men than both controls (P < 0.01). Moreover, bone strength index (BSI) was 10.8% lower relative to healthy controls only (P < 0.05). At the distal radius, ADT-treated men had lower total and trabecular vBMD (10.7–14.8%, P < 0.05) and BSI (23.6–27.5%, P < 0.001) compared to both controls. There were no other differences in bone outcomes at the proximal tibia or radius. In conclusion, ADT treatment for PCa was associated with lower BMD and estimated compressive bone strength, particularly at trabecular skeletal sites (lumbar spine, and distal tibia and radius), compared to controls, but there were no consistent differences in cortical bone structure, distribution or bending strength. • Bone density, structure, strength and distribution were compared between prostate cancer men treated with androgen deprivation therapy (ADT) and controls. • ADT treated men had lower bone density and estimated compressive strength at trabecular skeletal sites compared to controls. • Cortical bone structure, strength and distribution did not differ between ADT treated men and controls. [ABSTRACT FROM AUTHOR]

This prospectively registered systematic review and meta-analysis examines whether exercise (EX) training has an additive effect to osteoanabolic and/or antiresorptive pharmacological therapy (PT) in people with osteoporosis on bone mineral density (BMD), bone turnover markers (BTMs), fracture healing, and fractures. Four databases (inception to 6 May 2022), 5 trial registries, and reference lists were searched. Included were randomized controlled trials comparing the effect of EX + PT vs. PT with regard to BMD, BTM, fracture healing, and fractures. Risk of bias was assessed using the Cochrane RoB2 and certainty of evidence by the GRADE approach. Random-effects meta-analysis with Hartung-Knapp-Sidik-Jonkman adjustment was used to estimate standardized mean differences and 95% confidence intervals. Out of 2593 records, five RCTs with 530 participants were included. Meta-analysis showed with very low certainty evidence and wide confidence intervals that EX + PT compared to PT had larger effect sizes for BMD at 12 months at the hip (SMD [95%CI]: 0.18 [− 1.71; 2.06], n = 3 studies), tibia (0.25 [− 4.85; 5.34], n = 2), lumbar spine (0.20 [− 1.15; 1.55], n = 4), and forearm (0.05 [− 0.35; 0.46], n = 3), but not femoral neck (− 0.03 [− 1.80; 1.75], n = 3). Furthermore, no improvement was revealed for BTM such as bone ALP (− 0.68 [− 5.88; 4.53], n = 3), PINP (− 0.74 [− 10.42; 8.93], n = 2), and CTX-I (− 0.69 [− 9.61; 8.23], n = 2), but with very wide confidence intervals. Three potentially relevant ongoing trials were identified via registries. No data were found for fracture healing or fracture outcomes. It remains unclear whether EX has an additive impact to PT in people with osteoporosis. High-quality, adequately powered, targetted RCTs are required. Protocol Registration: PROSPERO CRD42022336132. [ABSTRACT FROM AUTHOR]

Despite being a global sport, there is a paucity of research investigating competition-related factors contributing to World Championship powerlifting success. Therefore, the aim of this study was to determine competition strategies that underpin gold medalists' (GMs) and silver or bronze medalists' (SBMs) performances. Data collected from open-age International Powerlifting Federation (IPF) World Championship events 2013-2019 were analyzed (1,312 competitors [males n = 734, females n = 578]). Attempt weight and success for the squat (SQ), bench press (BP), and deadlift (DL); 'total' competition scores; category (age, weight class, and sex); and placing were categorized into 3 groups: GMs, SBMs, and nonwinners (fourth place or lower). One-way analysis of variances determined between group differences. Odds ratios (ORs) for the likelihood of winning and placing (i.e., GMs or SBMs) were also calculated. The odds of winning a competition were increased 5.9 times for men and by 1.5 times for women, when successfully completing 8 or 9 of 9 lift attempts. These findings provide comprehensive insight into intracompetition-related factors that contribute to World Championship powerlifting success to directly inform coach and athlete strategies. This information may also hold relevance for competitive state or national competitions and extend to other similarly structured strength-based sports. [ABSTRACT FROM AUTHOR]

We propose a new method based on machine learning to play the devil's advocate and investigate the impact of unknown systematic effects in a quantitative way. This method proceeds by reversing the measurement process and using the physics results to interpret systematic effects under the Standard Model hypothesis. We explore this idea with two alternative approaches: the first one relies on a combination of gradient descent and optimisation techniques, its application and potentiality is illustrated with an example that studies the branching fraction measurement of a heavy-flavour decay. The second method employs reinforcement learning and it is applied to the determination of the P 5 ′ angular observable in B 0 → K ∗ 0 μ + μ - decays. We find that for the former, the size of a hypothetical hidden systematic uncertainty strongly depends on the kinematic overlap between the signal and normalisation channel, while the latter is very robust against possible mismodellings of the efficiency. [ABSTRACT FROM AUTHOR]

In patients presenting with low back pain (LBP), once specific causes are excluded (fracture, infection, inflammatory arthritis, cancer, cauda equina and radiculopathy) many clinicians pose a diagnosis of non-specific LBP. Accordingly, current management of non-specific LBP is generic. There is a need for a classification of non-specific LBP that is both data- and evidence-based assessing multi-dimensional pain-related factors in a large sample size. The "PRedictive Evidence Driven Intelligent Classification Tool for Low Back Pain" (PREDICT-LBP) project is a prospective cross-sectional study which will compare 300 women and men with non-specific LBP (aged 18–55 years) with 100 matched referents without a history of LBP. Participants will be recruited from the general public and local medical facilities. Data will be collected on spinal tissue (intervertebral disc composition and morphology, vertebral fat fraction and paraspinal muscle size and composition via magnetic resonance imaging [MRI]), central nervous system adaptation (pain thresholds, temporal summation of pain, brain resting state functional connectivity, structural connectivity and regional volumes via MRI), psychosocial factors (e.g. depression, anxiety) and other musculoskeletal pain symptoms. Dimensionality reduction, cluster validation and fuzzy c-means clustering methods, classification models, and relevant sensitivity analyses, will classify non-specific LBP patients into sub-groups. This project represents a first personalised diagnostic approach to non-specific LBP, with potential for widespread uptake in clinical practice. This project will provide evidence to support clinical trials assessing specific treatments approaches for potential subgroups of patients with non-specific LBP. The classification tool may lead to better patient outcomes and reduction in economic costs. [ABSTRACT FROM AUTHOR]

The article reports on the 2008 annual meeting of The Herpetologists' League on July 25 in Quebec. David Cundall was elected president, replacing Linda Ford. The Joint Meeting of the American Elasmobranch Society, the America Society of Ichthyologists and Herpetologists and the League was discussed. Also tackled during the meeting were matters pertaining to in-house information resources.

The article provides information on issues discussed during the annual meeting of the Herpetologists' League held in New Orleans, Louisiana on July 12-17, 2006. A motion was approved to accept offers for joining meeting locations for 2009, 2010 and 2011. Strategies were presented to recruit new members as well as to retain the old ones. Two year advance payments of dues will be eliminated as a membership option.

Background: There are growing concerns about the mental health of university students in Australia and internationally, with universities, governments and other stakeholders actively developing new policies and practices. Previous research suggests that many students experience poor mental health while at university, and that the risk may be heightened for international students. Mental health-related knowledge, attitudes and behaviours are modifiable determinants of mental health and thus suitable targets for intervention. This study assessed the mental health-related knowledge, stigmatising attitudes, helping behaviours, and self-reported experiences of mental health problems in the student population of a large multi-campus Australian university, and conducted a comparative assessment of international and domestic students. Methods: Participants were 883 international and 2,852 domestic students (overall response rate 7.1%) who completed an anonymous voluntary online survey that was sent to all enrolled students in July 2019 (n = ~ 52,341). Various measures of mental health-related knowledge, attitudes and helping behaviours were assessed. A comparative analysis of international and domestic students was conducted, including adjustment for age and sex. Results: Overall, there was evidence of improvements in mental health-related knowledge, attitudes and behaviours relative to previous studies, including higher depression recognition, intentions to seek help, and reported help-seeking behaviour. Comparative analysis indicated that international students scored predominantly lower on a range of indicators (e.g., depression recognition, awareness of evidence-based forms of help); however, differences were narrower difference between the two groups compared to what has been reported previously. Finally, some indicators were more favourable among international students, such as higher help-seeking intentions, and lower prevalence of self-reported mental health problems compared to domestic students. Conclusion: Though there were some important differences between domestic and international students in this study, differences were narrower than observed in previous studies. Study findings are informing the on-going implementation and refinement of this university's student mental health strategy, and may be used to inform evolving policy and practice in the university sector. [ABSTRACT FROM AUTHOR]

Purpose: Examine the effectiveness of interventions to approach guideline-adherent surgical referrals for low back pain assessed via systematic review and meta-analysis. Methods: Five databases (10 September 2021), Google Scholar, reference lists of relevant systematic reviews were searched and forward and backward citation tracking of included studies were implemented. Randomised controlled/clinical trials in adults with low back pain of interventions to optimise surgery rates or referrals to surgery or secondary referral were included. Bias was assessed using the Cochrane ROB2 tool and evidence certainty via Grading of Recommendations Assessment, Development and Evaluation (GRADE). A random effects meta-analysis with a Paule Mandel estimator plus Hartung–Knapp–Sidik–Jonkman method was used to calculate the odds ratio and 95% confidence interval, respectively. Results: Of 886 records, 6 studies were included (N = 258,329) participants; cluster sizes ranged from 4 to 54. Five studies were rated as low risk of bias and one as having some concerns. Two studies reporting spine surgery referral or rates could only be pooled via combination of p values and gave evidence for a reduction (p = 0.021, Fisher's method, risk of bias: low). This did not persist with sensitivity analysis (p = 0.053). For secondary referral, meta-analysis revealed a non-significant odds ratio of 1.07 (95% CI [0.55, 2.06], I2 = 73.0%, n = 4 studies, Grading of Recommendations Assessment, Development and Evaluation [GRADE] evidence certainty: very low). Conclusion: Few RCTs exist for interventions to improve guideline-adherent spine surgery rates or referral. Clinician education in isolation may not be effective. Future RCTs should consider organisational and/or policy level interventions. PROSPERO registration: CRD42020215137. [ABSTRACT FROM AUTHOR]

Chronic back pain (CBP) is heterogenous and identifying sub-groups could improve clinical decision making. Machine learning can build upon prior sub-grouping approaches by using a data-driven approach to overcome clinician subjectivity, however, only binary classification of pain versus no-pain has been attempted to date. In our cross-sectional study, age- and sex-matched participants with CBP (n = 4156) and pain-free controls (n = 14,927) from the UkBioBank were included. We included variables of body mass index, depression, loneliness/social isolation, grip strength, brain grey matter volumes and functional connectivity. We used fuzzy c-means clustering to derive CBP sub-groups and Support Vector Machine (SVM), Naïve Bayes, k-Nearest Neighbour (kNN) and Random Forest classifiers to determine classification accuracy. We showed that two variables (loneliness/social isolation and depression) and five clusters were optimal for creating sub-groups of CBP individuals. Classification accuracy was greater than 95% for when CBP sub-groups were assessed only, while misclassification in CBP sub-groups increased to 35–53% across classifiers when pain-free controls were added. We showed that individuals with CBP could sub-grouped and accurately classified. Future research should optimise variables by including specific spinal, psychosocial and nervous system measures associated with CBP to create more robust sub-groups that are discernible from pain-free controls. [ABSTRACT FROM AUTHOR]

Animal and human cross-sectional data suggest that bone marrow adipose tissue (MAT) may respond to mechanical loads and exercise. We conducted the first randomised controlled trial of exercise on MAT modulations in humans. Forty patients with chronic non-specific low back pain (NSCLBP) were enrolled in a six-month single-blinded randomised controlled trial (ACTRN12615001270505). Twenty patients loaded their spines via progressive upright aerobic and resistance exercises targeting major muscle groups (Exercise). Twenty patients performed non-weightbearing motor control training and manual therapy (Control). Testing occurred at baseline, 3-months (3mo) and 6-months (6mo). Lumbar vertebral fat fraction (VFF) was measured using magnetic resonance imaging axial mDixon sequences. When compared to baseline (percent change), lumbar vertebral fat fraction (VFF; measured using magnetic resonance imaging axial mDixon sequences) was lower in Exercise at 3mo at L2 (−3.7[6.8]%, p = 0.033) and L4 (−2.6[4.1]%, p = 0.015), but not in Control. There were no between-group effects. The effects of Exercise on VFF were sex-specific, with VFF lower in men at L2, L3, L4 at 3mo and at L1, L2, L3 and L4 at 6mo (p all ≤ 0.05), but not in women. Leg and trunk lean mass were increased at 3mo in Exercise. Changes in VFF correlated significantly with changes in total fat (ρ = 0.40) and lean (ρ = −0.41) masses, but not with lumbar BMD (ρ = −0.10) or visceral adipose tissue volume (ρ = 0.23). This trial provided first prospective evidence in humans that a moderate exercise intervention may modulate lumbar VFF as a surrogate measure of MAT at 3mo, yet not 6mo. The effect of exercise on MAT may be more prominent in males than females. • Cross-sectional data suggest bone marrow adipose tissue may respond to exercise. • Marrow adipose tissue modulates bone homeostasis and hemopoiesis. • Exercise may modulate marrow adipose tissue in adults with chronic low back pain. • Exercise appears to modulate marrow adipose tissue more prominently in males. [ABSTRACT FROM AUTHOR]

Background: A critical challenge in current acute lymphoblastic leukemia (ALL) therapy is treatment intensification in order to reduce the relapse rate in the subset of patients at the highest risk of relapse. The year-long maintenance phase is essential in relapse prevention. The Thiopurine Enhanced ALL Maintenance (TEAM) trial investigates a novel strategy for ALL maintenance.Methods: TEAM is a randomized phase 3 sub-protocol to the ALLTogether1 trial, which includes patients 0-45 years of age with newly diagnosed B-cell precursor or T-cell ALL, and stratified to the intermediate risk-high (IR-high) group, in 13 European countries. In the TEAM trial, the traditional methotrexate (MTX)/6-mercaptopurine (6MP) maintenance backbone (control arm) is supplemented with low dose (2.5-12.5 mg/m2/day) oral 6-thioguanine (6TG) (experimental arm), while the starting dose of 6MP is reduced from 75 to 50 mg/m2/day. A total of 778 patients will be included in TEAM during ~ 5 years. The study will close when the last included patient has been followed for 5 years from the end of induction therapy. The primary objective of the study is to significantly improve the disease-free survival (DFS) of IR-high ALL patients by adding 6TG to 6MP/MTX-based maintenance therapy. TEAM has 80% power to detect a 7% increase in 5-year DFS through a 50% reduction in relapse rate. DFS will be evaluated by intention-to-treat analysis. In addition to reducing relapse, TEAM may also reduce hepatotoxicity and hypoglycemia caused by high levels of methylated 6MP metabolites. Methotrexate/6MP metabolites will be monitored and low levels will be reported back to clinicians to identify potentially non-adherent patients.Discussion: TEAM provides a novel strategy for maintenance therapy in ALL with the potential of improving DFS through reducing relapse rate. Potential risk factors that have been considered include hepatic sinusoidal obstruction syndrome/nodular regenerative hyperplasia, second cancer, infection, and osteonecrosis. Metabolite monitoring can potentially increase treatment adherence in both treatment arms.Trial Registration: EudraCT, 2018-001795-38. Registered 2020-05-15, Clinicaltrials.gov , NCT04307576 . Registered 2020-03-13, https://clinicaltrials.gov/ct2/show/NCT04307576. [ABSTRACT FROM AUTHOR]

In order to understand the evolution of the interstellar medium (ISM) of a galaxy, we have analysed the gas and dust budget of the Small Magellanic Cloud (SMC).Using the Spitzer Space Telescope, we measured the integrated gas mass-loss rate across asymptotic giant branch (AGB) stars and red supergiants (RSGs) in the SMC, and obtained a rate of 1.4 × 10−3 M⊙ yr−1. This is much smaller than the estimated gas ejection rate from Type II supernovae (SNe) (2–4 × 10−2 M⊙ yr−1). The SMC underwent an increase in star formation rate in the last 12 Myr, and consequently the galaxy has a relatively high SN rate at present. Thus, SNe are more important gas sources than AGB stars in the SMC. The total gas input from stellar sources into the ISM is 2–4 × 10−2 M⊙ yr−1. This is slightly smaller than the ISM gas consumed by star formation (∼8 × 10−2 M⊙ yr−1). Star formation in the SMC relies on a gas reservoir in the ISM, but eventually the star formation rate will decline in this galaxy, unless gas infalls into the ISM from an external source.The dust injection rate from AGB and RSG candidates is 1 × 10−5 M⊙ yr−1. Dust injection from SNe is in the range 0.2–11 × 10−4 M⊙ yr−1, although the SN contribution is rather uncertain. Stellar sources could be important for ISM dust (3 × 105 M⊙) in the SMC, if the dust lifetime is about 1.4 Gyr.We found that the presence of poly-aromatic hydrocarbons (PAHs) in the ISM cannot be explained entirely by carbon-rich AGB stars. Carbon-rich AGB stars could inject only 7 × 10−9 M⊙ yr−1 of PAHs at most, which could contribute up to 100 M⊙ of PAHs in the lifetime of a PAH. The estimated PAH mass of 1800 M⊙ in the SMC cannot be explained. Additional PAH sources, or ISM reprocessing should be needed. [ABSTRACT FROM PUBLISHER]

In this article we examine the current status of Rorschach assessment. School psychologists are provided with an introduction to the Rorschach Inkblot Method (RIM), the types of information that the test provides, and guidelines for evaluating the RIM. We also address criticisms that have served to discourage the use of the RIM. When administered, coded, and interpreted within guidelines provided by Exner's Comprehensive System, the Rorschach clearly meets ethical and professional standards for psychological test usage. The RIM can provide unique and important information concerning the emotional and social functioning of children and adolescents that aids in developing individualized educational programming including behavior intervention plans. © 2007 Wiley Periodicals, Inc. Psychol Schs 44: 281–291, 2007. [ABSTRACT FROM AUTHOR]