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A recent study found that only 23.8% of blood pressure (BP) devices available for purchase from Australian pharmacies were validated for accuracy. The extent to which pharmacists are aware of this, and other issues related to the accuracy of BP devices, is not known and gathering this information was the aim of this study. An online survey of Australian pharmacists was distributed via the Pharmaceutical Society of Australia between 1 October and 25 November 2020. Questions were focused on the views of pharmacists related to the accuracy of BP devices. Two hundred and ten pharmacists completed the survey. The accuracy of BP devices sold by pharmacists was considered ‘quite’ or ‘extremely important’ to most respondents (94%). However, most respondents (90%) were unaware that less than one-quarter of BP devices sold by Australian pharmacies were validated, and this was ‘quite’ or ‘extremely surprising’ to many (69%). Many respondents (64%) associated a particular brand of BP device with greater accuracy. There was low awareness on proper ways to identify accurate BP devices, such as checking reputable online databases (43%). BP devices were stocked in respondents’ pharmacies based on perceived quality (50%), accuracy (40%), or as determined by the pharmacy chain (36%). In conclusion, providing accurate BP devices to consumers is important to pharmacists, but they were generally unaware that most devices available from pharmacies were not validated for accuracy. Pharmacist education, alongside advocacy for policies including regulations and strategic action, is required to ensure only validated BP devices are sold in Australia.

Epidemiological studies have associated plasma galectin-4 (Gal-4) levels with prevalent and incident diabetes, and with an increased risk of coronary artery disease. To date, data regarding possible associations between plasma Gal-4 and stroke are lacking. Using linear and logistic regression analyses, we tested Gal-4 association with prevalent stroke in a population-based cohort. Additionally, in mice fed a high-fat diet (HFD), we investigated whether plasma Gal-4 increases in response to ischemic stroke. Plasma Gal-4 was higher in subjects with prevalent ischemic stroke, and was associated with prevalent ischemic stroke (odds ratio 1.52; 95% confidence interval 1.01–2.30; p = 0.048) adjusted for age, sex, and covariates of cardiometabolic health. Plasma Gal-4 increased after experimental stroke in both controls and HFD-fed mice. HFD exposure was devoid of impact on Gal-4 levels. This study demonstrates higher plasma Gal-4 levels in both experimental stroke and in humans that experienced ischemic stroke.

IntroductionOccupational physical activity (OPA), including occupational lifting (OL), seems to increase the risk of cardiovascular disease (CVD). Knowledge about the association between OL and risk of CVD is sparse, but repeated OL is assumed to result in prolonged raised blood pressure and heart rate (HR) eventually augmenting the risk of CVD. To disentangle parts of the mechanisms behind the raised 24-hour ambulatory blood pressure measurement (24h-ABPM), by exposure to OL, this study aimed to explore the acute differences in 24h-ABPM, relative aerobic workload (RAW) and OPA across workdays with and without OL, and secondary to assess the feasibility and rater agreement of direct field observations of the frequency and load of occupational lifting.MethodsThis controlled cross-over study investigates associations between moderate to high OL and 24h-ABPM, RAW in per cent of heart rate reserve (%HRR) and level of OPA. This included 2x24h monitoring of 24h-ABPM (Spacelabs 90217), PA (Axivity) and HR (Actiheart), comprising a workday containing OL and a workday without. The frequency and burden of OL were directly observed in field. The data were time synchronized and processed in the Acti4 software. Differences across workdays with and without OL in 24h-ABPM, RAW and OPA were evaluated using repeated 2 × 2 mixed-models among 60 blue-collar workers in Denmark.. Exposure to OL was estimated by direct manual field observation, registering burden and frequency of OL. Interrater reliability tests were performed across 15 participants representing 7 occupational groups. Interclass correlation coefficient (ICC) estimates of total burden lifted and frequency of lifts were calculated, based on a mean-rating (k = 2), absolute-agreement, 2 way mixed-effects model, indicating the raters as fixed effects.ResultsOL led to non-significant increases in ABPM during work-time (systolic Δ1.79 mmHg, 95%CI −4.49–8.08, diastolic Δ0.43 mmHg, 95%CI −0.80–1.65), and on 24-hours basis (systolic Δ1.96 mmHg, 95%CI −3.80–7.72, diastolic Δ0.53 mmHg, 95%CI −3.12–4.18), significant increases in RAW during work (Δ7.74 %HRR, 95%CI 3.57–11.91) as well as a raised level of OPA (Δ4156.88 steps, 95%CI 1898.83–6414.93, Δ−0.67 hours of sitting time, 95%CI −1.25–0.10, Δ−0.52 hours of standing time, 95%CI −1.03–0.01, Δ0.48 hours of walking time, 95%CI 0.18–0.78). ICC estimates were 0.998 (95% CI 0.995–0.999) for total burden lifted and 0.992 (95% CI 0.975–0.997) for frequency of lift.DiscussionOL increased both intensity and volume of OPA among blue-collar workers, which supposedly to contributes to an augmented risk of CVD. Although this study finds hazardous acute effects, further investigations are needed to evaluate the long-term effects of OL on ABPM, HR and volume of OPA, also effects of cumulative exposure to OL would be relevant to investigate.ConclusionOL significantly raised the intensity and volume of OPA. Direct field observation of occupational lifting showed an excellent interrater reliability. Introduction Occupational physical activity (OPA), including occupational lifting (OL), seems to increase the risk of cardiovascular disease (CVD). Knowledge about the association between OL and risk of CVD is sparse, but repeated OL is assumed to result in prolonged raised blood pressure and heart rate (HR) eventually augmenting the risk of CVD. To disentangle parts of the mechanisms behind the raised 24-hour ambulatory blood pressure measurement (24h-ABPM), by exposure to OL, this study aimed to explore the acute differences in 24h-ABPM, relative aerobic workload (RAW) and OPA across workdays with and without OL, and secondary to assess the feasibility and rater agreement of direct field observations of the frequency and load of occupational lifting. Methods This controlled cross-over study investigates associations between moderate to high OL and 24h-ABPM, RAW in per cent of heart rate reserve (%HRR) and level of OPA. This included 2x24h monitoring of 24h-ABPM (Spacelabs 90217), PA (Axivity) and HR (Actiheart), comprising a workday containing OL and a workday without. The frequency and burden of OL were directly observed in field. The data were time synchronized and processed in the Acti4 software. Differences across workdays with and without OL in 24h-ABPM, RAW and OPA were evaluated using repeated 2 x 2 mixed-models among 60 blue-collar workers in Denmark.. Exposure to OL was estimated by direct manual field observation, registering burden and frequency of OL. Interrater reliability tests were performed across 15 participants representing 7 occupational groups. Interclass correlation coefficient (ICC) estimates of total burden lifted and frequency of lifts were calculated, based on a mean-rating (k = 2), absolute-agreement, 2 way mixed-effects model, indicating the raters as fixed effects. Results OL led to non-significant increases in ABPM during work-time (systolic Delta 1.79 mmHg, 95%CI -4.49-8.08, diastolic Delta 0.43 mmHg, 95%CI -0.80-1.65), and on 24-hours basis (systolic Delta 1.96 mmHg, 95%CI -3.80-7.72, diastolic Delta 0.53 mmHg, 95%CI -3.12-4.18), significant increases in RAW during work (Delta 7.74 %HRR, 95%CI 3.57-11.91) as well as a raised level of OPA (Delta 4156.88 steps, 95%CI 1898.83-6414.93, Delta-0.67 hours of sitting time, 95%CI -1.25-0.10, Delta-0.52 hours of standing time, 95%CI -1.03-0.01, Delta 0.48 hours of walking time, 95%CI 0.18-0.78). ICC estimates were 0.998 (95% CI 0.995-0.999) for total burden lifted and 0.992 (95% CI 0.975-0.997) for frequency of lift. Discussion OL increased both intensity and volume of OPA among blue-collar workers, which supposedly to contributes to an augmented risk of CVD. Although this study finds hazardous acute effects, further investigations are needed to evaluate the long-term effects of OL on ABPM, HR and volume of OPA, also effects of cumulative exposure to OL would be relevant to investigate. Conclusion OL significantly raised the intensity and volume of OPA. Direct field observation of occupational lifting showed an excellent interrater reliability.

Additional file 2. Power estimations of exploratory outcomes.

We introduce an exact framework to compute the positive frequency moments $M^{(\alpha)}(\mathbf{q})=\braket{\omega^\alpha}$ of different dynamic properties from imaginary-time quantum Monte Carlo data. As a practical example, we obtain the first five moments of the dynamic structure factor $S(\mathbf{q},\omega)$ of the uniform electron gas at the electronic Fermi temperature based on \emph{ab initio} path integral Monte Carlo simulations. We find excellent agreement with known sum rules for $\alpha=1,3$, and, to our knowledge, present the first results for $\alpha=2,4,5$. Our idea can be straightforwardly generalized to other dynamic properties such as the single-particle spectral function $A(\mathbf{q},\omega)$, and will be useful for a number of applications, including the study of ultracold atoms, exotic warm dense matter, and condensed matter systems.

Additional file 1. Echocardiographic analysis principles.

ObjectiveTo assess the beneficial and harmful effects of adding exercise to usual care for people with hypertension, type 2 diabetes mellitus and/or cardiovascular disease.DesignSystematic review with meta-analysis and trial sequential analysis of randomised clinical trials.Data sourcesThe CENTRAL, MEDLINE, EMBASE, Science Citation Index Expanded on Web of Science and BIOSIS searched from inception to July 2020.Eligibility criteria for selecting studiesWe included all randomised clinical trials adding any form of trialist defined exercise to usual care versus usual care in participants with either hypertension, type 2 diabetes or cardiovascular disease irrespective of setting, publication status, year and language.Outcome and measuresThe primary outcomes were all-cause mortality, serious adverse events and quality of life.Data extraction and synthesisFive independent reviewers extracted data and assessed risk of bias in pairs. Our methodology was based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses, Grading of Recommendations Assessment, Development and Evaluation and Cochrane Risk of Bias-version 1.ResultsWe included 950 trials, of which 248 trials randomising 21 633 participants reported on our predefined outcomes. All included trials were at high risk of bias. The major types of exercise reported were dynamic aerobic exercise (126/248 trials), dynamic resistance exercise (25/248 trials), and combined aerobic and resistance exercise (58/248 trials). The study participants were included due to cardiovascular diseases (189/248 trials), type 2 diabetes (41/248 trials) or hypertension (16/248 trials). The median intervention period was 3 months (IQR: 2–4 months) and the median follow-up period was 6 months (IQR: 3–8 months) after randomisation. Meta-analyses and trial sequential analyses showed evidence of a beneficial effect of adding exercise to usual care when assessing all-cause mortality (risk ratio (RR) 0.82; 95% CI 0.73 to 0.93; I2=0%, moderate certainty of evidence) and serious adverse events (RR 0.79; 95% CI 0.71 to 0.88; I2=0%, moderate certainty of evidence). We did not find evidence of a difference between trials from different economic regions, type of participants, type of exercise or duration of follow-up. Quality of life was assessed using several different tools, but the results generally showed that exercise improved quality of life, but the effect sizes were below our predefined minimal important difference.ConclusionsA short duration of any type of exercise seems to reduce the risk of all-cause mortality and serious adverse events in patients with either hypertension, type 2 diabetes or cardiovascular diseases. Exercise seems to have statistically significant effects on quality of life, but the effect sizes seem minimal.PROSPERO registration numberCRD42019142313.

The possibility of a manned mission to Mars is gaining traction. But how do you create the oxygen necessary for the astronauts to remain on the planet and, more importantly, how do you develop the rocket fuel necessary to bring them back? MOXIE is the answer.

Background:Long-term weight loss in people living with obesity can reduce the risk and progression of noncommunicable diseases. Observational studies suggest that digital coaching can lead to long-term weight loss.Objective:We investigated whether an eHealth lifestyle coaching program for people living with obesity with or without type 2 diabetes led to significant, long-term (12-month) weight loss compared to usual care.Methods:In a randomized controlled trial that took place in 50 municipalities in Denmark, 340 people living with obesity with or without type 2 diabetes were enrolled from April 16, 2018, to April 1, 2019, and randomized via an automated computer algorithm to an intervention (n=200) or a control (n=140) group. Patients were recruited via their general practitioners, the Danish diabetes organization, and social media. The digital coaching intervention consisted of an initial 1-hour face-to-face motivational interview followed by digital coaching using behavioral change techniques enabled by individual live monitoring. The primary outcome was change in body weight from baseline to 12 months.Results:Data were assessed for 200 participants, including 127 from the intervention group and 73 from the control group, who completed 12 months of follow-up. After 12 months, mean body weight and BMI were significantly reduced in both groups but significantly more so in the intervention group than the control group (–4.5 kg, 95% CI –5.6 to –3.4 vs –1.5 kg, 95% CI –2.7 to –0.2, respectively; P.46).Conclusions:Compared to usual care, digital lifestyle coaching can induce significant weight loss for people living with obesity, both with and without type 2 diabetes, after 12 months. Background: Long-term weight loss in people living with obesity can reduce the risk and progression of noncommunicable diseases. Observational studies suggest that digital coaching can lead to long-term weight loss. Objective: We investigated whether an eHealth lifestyle coaching program for people living with obesity with or without type 2 diabetes led to significant, long-term (12-month) weight loss compared to usual care. Methods: In a randomized controlled trial that took place in 50 municipalities in Denmark, 340 people living with obesity with or without type 2 diabetes were enrolled from April 16, 2018, to April 1, 2019, and randomized via an automated computer algorithm to an intervention (n=200) or a control (n=140) group. Patients were recruited via their general practitioners, the Danish diabetes organization, and social media. The digital coaching intervention consisted of an initial 1-hour face-to-face motivational interview followed by digital coaching using behavioral change techniques enabled by individual live monitoring. The primary outcome was change in body weight from baseline to 12 months. Results: Data were assessed for 200 participants, including 127 from the intervention group and 73 from the control group, who completed 12 months of follow-up. After 12 months, mean body weight and BMI were significantly reduced in both groups but significantly more so in the intervention group than the control group (-4.5 kg, 95% CI -5.6 to -3.4 vs -1.5 kg, 95% CI -2.7 to -0.2, respectively; P.46). Conclusions: Compared to usual care, digital lifestyle coaching can induce significant weight loss for people living with obesity, both with and without type 2 diabetes, after 12 months.

Objective Hyperglycaemia in type 2 diabetes is caused by varying degrees of two defects: low insulin sensitivity and beta-cell dysfunction. We assessed if subgrouping of patients into three pathophysiological phenotypes according to these defects could identify individuals with high or low risk of future cardiovascular events. Design This is a prospective cohort study. Methods We assessed estimates of insulin sensitivity and beta-cell function from the homeostasis model assessment-2 in 4209 individuals with recently diagnosed type 2 diabetes enrolled from general practitioners and outpatient clinics in Denmark. Individuals were followed for a composite cardiovascular endpoint (either atherosclerotic outcomes (myocardial infarction, unstable angina pectoris, stroke, coronary or peripheral revascularization), heart failure, or cardiovascular death) and all-cause mortality. Results Totally 417 individuals with the insulinopenic phenotype (high insulin sensitivity and low beta-cell function) had substantially lower risk of cardiovascular events (5-year cumulative incidence: 4.6% vs 10.1%; age-/sex-adjusted hazard ratio (aHR): 0.49; 95% CI: 0.30–0.82) compared with 2685 individuals with the classical phenotype (low insulin sensitivity and low beta-cell function), driven by atherosclerotic events. Conversely, 1107 individuals with the hyperinsulinaemic phenotype (low insulin sensitivity and high beta-cell function) had more cardiovascular events (5-year cumulative incidence: 12.6%; aHR: 1.33; 95% CI: 1.05–1.69), primarily driven by increased heart failure and cardiovascular death and increased all-cause mortality. Conclusions Simple phenotyping based on insulin sensitivity and beta-cell function predicts distinct future risks of cardiovascular events and death in patients with type 2 diabetes. These results suggest that precision medicine according to underlying type 2 pathophysiology potentially can reduce diabetes complications.

BACKGROUND Long-term weight loss among subjects with obesity can reduce the risk and progression of noncommunicable diseases (NCDs). Observational studies suggest that digital coaching can lead to long-term weight loss. OBJECTIVE We investigated whether an eHealth lifestyle coaching program (LIVA) for subjects with obesity with or without type 2 diabetes (T2D) leads to significant long-term (more than 6 months) weight loss compared to usual care. METHODS In a randomized controlled trial that took place in 50 municipalities in Denmark, 340 subjects with obesity with or without T2D were enrolled from April 16, 2018, to April 1, 2019, and randomized via an automated computer algorithm to an intervention (200) or a control (140) group. Patients were recruited via their general practitioners, the Danish diabetes organization, and social media. The digital coaching intervention comprised of an initial one-hour face-to-face motivational interview followed by digital coaching using behavioral change techniques enabled by individual live monitoring. Primary outcome was change in body weight from baseline to 6 and 12 months. RESULTS Data were assessed for 235 participants, 149 from the intervention group and 86 from the control group who completed 6 and/or 12 months follow-up. After 12 months mean body weight and body mass index were reduced significantly in both groups but significantly more in the intervention group (–4.6 (-5.7; -3.4) kg vs. -1.4 (-2.6; -0.1) kg, P CONCLUSIONS Compared to usual care, digital lifestyle coaching can induce significant weight loss in obese subjects both with and without T2D after 12 months. CLINICALTRIAL ClinicalTrials.gov NCT03788915; https://clinicaltrials.gov/ct2/show/NCT03788915