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Introduction MRI and MR spectroscopy (MRS) provide early biomarkers of brain injury and treatment response in neonates with hypoxic-ischaemic encephalopathy). Still, there are challenges to incorporating neuroimaging biomarkers into multisite randomised controlled trials. In this paper, we provide the rationale for incorporating MRI and MRS biomarkers into the multisite, phase III high-dose erythropoietin for asphyxia and encephalopathy (HEAL) Trial, the MRI/S protocol and describe the strategies used for harmonisation across multiple MRI platforms.Methods and analysis Neonates with moderate or severe encephalopathy enrolled in the multisite HEAL trial undergo MRI and MRS between 96 and 144 hours of age using standardised neuroimaging protocols. MRI and MRS data are processed centrally and used to determine a brain injury score and quantitative measures of lactate and n-acetylaspartate. Harmonisation is achieved through standardisation—thereby reducing intrasite and intersite variance, real-time quality assurance monitoring and phantom scans.Ethics and dissemination IRB approval was obtained at each participating site and written consent obtained from parents prior to participation in HEAL. Additional oversight is provided by an National Institutes of Health-appointed data safety monitoring board and medical monitor.Trial registration number NCT02811263; Pre-result.

Despite strong evidence for health benefits from active travel, levels remain low in many countries. Changes to the physical and social workplace environment might encourage active travel but evaluation has been limited.We explored associations between changes in the physical and social workplace environment and changes in commute mode over one year among 419 participants in the Commuting and Health in Cambridge study.In adjusted analyses, an increase in the presence of one physical characteristic (e.g. bicycle parking or shower facilities) was associated with a 3.3% (95% confidence interval 1.0–5.6) reduction in the proportion of commutes by private motor vehicle and a 4.4% (95% CI 1.2–7.7) increase in the proportion of trips including active modes among men. These associations were not seen in women.A change to a more favourable social environment for walking or cycling among workplace management was associated with an increased proportion of commutes including active modes in women (4.5%, 95% CI 1.4–7.5) but not men. However, in both genders a change to more a favourable social environment for cycling among colleagues was associated with a reduced proportion of commutes by exclusively active modes (−2.8%, 95% CI −5.0 to −0.6).This study provides longitudinal evidence for gender differences in the associations between workplace environment and commute mode. A more supportive physical environment was associated with more active commuting in men, while the social environment appeared to have more complex associations that were stronger among women.