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Objectives Our aims were (a) to describe the prevalence and incidence of self-reported injuries and illnesses of amateur golfers over a 5-month period and (b) to investigate potential risk factors for injury.Methods We recruited 910 amateur golfers (733 males [81%] and 177 females [19%]) from golf clubs in the USA and Switzerland. The median age was 60 (IQR: 47–67) and the median golfing handicap was 12 (IQR: 6–18). Participants’ health was monitored weekly for 5 months using the Oslo Sports Trauma Research Centre Questionnaire on Health Problems. Players also completed a baseline questionnaire on personal and golf-specific characteristics and their medical history.Results We distributed 19 406 questionnaires and received 11 180 responses (57.6%). The prevalence of injuries was 11.3% (95% CI: 9.8 to 12.8) and of illnesses was 2% (95% CI 1.7 to 2.2). The incidence of injuries and illnesses was 3.79 (95% CI 3.54 to 4.06) and 0.94 (95% CI 0.81 to 1.07) per golfer per year, respectively. The injury regions with the highest burden of injury (time-loss days per player per year) were lumbosacral spine (5.93), shoulder (3.47) and knee (2.08). Injury risk was higher with increased age, osteoarthritis and previous injury.Conclusion The prevalence and incidence of injury and illness in amateur golf were low compared with many other sports. To further reduce the burden of injury, future research attention should be directed towards the lumbosacral spine, knee and shoulder.

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The aim of the present study was to examine the association between a comprehensive physical testing battery and measures of golf performance in elite female amateur players. Nineteen category one (handicap ≤ 5) or better golfers (age: 16.26 ± 1.28 years, height: 166.26 ± 3.62 cm, mass: 64.04 ± 11.27 kg, wingspan: 146.53 ± 15.59 cm, handicap: +1.45 ± 0.7) volunteered to participate in this investigation. All golfers attended a single 90 min testing session where golf shot data (clubhead speed [CHS], ball speed, carry distance, and smash factor) were measured with a Trackman 4 launch monitor and a battery of physical assessments were carried out. These included anthropometric data and assessments for seated thoracic rotation, the isometric mid-thigh pull (IMTP), isometric bench press, countermovement jump (CMJ), and seated medicine ball throws for distance. Pearson’s r correlations showed CHS was the golf metric that most commonly demonstrated large associations with physical testing data, most notably with force at 100 ms during the isometric bench press (r = 0.70). Median split analysis was also conducted for the IMTP (force at 200 ms), isometric bench press (force at 100 ms), and CMJ (positive impulse). The results showed that players who produced more force at 200 ms during the IMTP exhibited a greater CHS (g = 1.13), ball speed (g = 0.90), and carry distance (g = 1.01). In addition, players with a greater positive impulse during the CMJ showed a greater ball speed (g = 0.93), carry distance (g = 1.29), and smash factor (g = 1.27). Collectively, these results highlight the relevance of explosive force production capabilities in both the lower and upper body for female golfers. This information can be used by practitioners to better target key physical attributes during testing and training of female players.

Introduction The global burden of age-related cognitive decline is increasing, with the number of people aged 60 and over expected to double by 2050. This study compares the acute effects of age-appropriate cognitively demanding aerobic exercises involving walking, on cognitive functions and exerkine responses such as brain-derived neurotrophic factor (BDNF) and cathepsin B (CTSB) in older, healthy adults.Methods/design Healthy older golfers (n=25, 16 male and 9 female, 69±4 years) were enrolled in a 5-day randomised cross-over study and completed three different exercise trials (18-hole golf round, 6 km Nordic walking, 6 km walking) in a real-life environment, in random order and at a self-selected pace. Differences in cognition (the Trail-Making Test (TMT) AB) and exerkines (BDNF and CTSB) were analysed within groups using the Wilcoxon signed-rank test and between groups using the Kruskal-Wallis test.Results All exercise types resulted in a significant decrease in the TMT A-test (p

The aim of the present study was to assess the relationship between a comprehensive physical testing battery and golf performance, as quantified through a variety of previously determined usable metrics from launch monitor data. Twenty-six high-level, amateur golfers undertook a series of physical assessments, including anthropometry measurements, isometric mid-thigh pull (IMTP), isometric bench press, countermovement jump (CMJ), seated medicine ball throws for distance, and seated thoracic rotation tests. In addition, golf shot data were recorded in an indoor biomechanics laboratory, with a driver and 6-iron to quantify clubhead speed (CHS), ball speed, carry distance, and smash factor. Pearson’s r associative analyses showed that the strongest relationships with the golf shot data were with the isometric bench press for the upper body (r values up to 0.76) and countermovement jump for the lower body (r values up to 0.82). In addition, the median split analysis of the physical performance data revealed that players who were able to exhibit greater maximal and explosive strength capabilities in the IMTP, isometric bench press, and CMJ assessments had a significantly greater CHS (g range = 1.09–1.28; p < 0.05), ball speed (g range = 1.18–1.41; p < 0.05), carry distance (g range = 1.06–1.53; p < 0.05), and smash factor (g range = 0.81–1.17; p < 0.05). These data underscore the importance of superior physical capacity for golfers, especially for maximal force production in both the lower and upper body, as well as explosive force production for the lower body.

Abstract Background Empirical evidence supports the use of structured goals of care conversations and documentation of life-sustaining treatment (LST) preferences in durable, accessible, and actionable orders to improve the care for people living with serious illness. As the largest integrated healthcare system in the USA, the Veterans Health Administration (VA) provides an excellent environment to test implementation strategies that promote this evidence-based practice. The Preferences Elicited and Respected for Seriously Ill Veterans through Enhanced Decision-Making (PERSIVED) program seeks to improve care outcomes for seriously ill Veterans by supporting efforts to conduct goals of care conversations, systematically document LST preferences, and ensure timely and accurate communication about preferences across VA and non-VA settings. Methods PERSIVED encompasses two separate but related implementation projects that support the same evidence-based practice. Project 1 will enroll 12 VA Home Based Primary Care (HBPC) programs and Project 2 will enroll six VA Community Nursing Home (CNH) programs. Both projects begin with a pre-implementation phase during which data from diverse stakeholders are gathered to identify barriers and facilitators to adoption of the LST evidence-based practice. This baseline assessment is used to tailor quality improvement activities using audit with feedback and implementation facilitation during the implementation phase. Site champions serve as the lynchpin between the PERSIVED project team and site personnel. PERSIVED teams support site champions through monthly coaching sessions. At the end of implementation, baseline site process maps are updated to reflect new steps and procedures to ensure timely conversations and documentation of treatment preferences. During the sustainability phase, intense engagement with champions ends, at which point champions work independently to maintain and improve processes and outcomes. Ongoing process evaluation, guided by the RE-AIM framework, is used to monitor Reach, Adoption, Implementation, and Maintenance outcomes. Effectiveness will be assessed using several endorsed clinical metrics for seriously ill populations. Discussion The PERSIVED program aims to prevent potentially burdensome LSTs by consistently eliciting and documenting values, goals, and treatment preferences of seriously ill Veterans. Working with clinical operational partners, we will apply our findings to HBPC and CNH programs throughout the national VA healthcare system during a future scale-out period.

Abstract Background and Aims The COVID‐19 pandemic was associated with reduced physical activity and increased sedentary behavior. Golf is a health‐enhancing outdoor exercise and is associated with low risk of viral transmission. The purpose of this study was to describe the seasonal differences in physical activity and quality of life during the first wave of COVID‐19 pandemic in 2020 in Finnish older golfers. Methods Older golfers (n = 325) from eight golf clubs retrospectively responded to a questionnaire in summer 2020 on their physical activity and golf activity in winter 2019/20 (pre‐COVID‐19 winter season) and summer season 2020. In addition, they reported their quality of life after the first wave of pandemic in summer 2020. To evaluate the seasonal differences in physical activity, life quality and its association with golf activity, the data were analyzed using the Mann–Whitney U test, Wilcoxon signed‐rank test, Spearman's correlation test, and linear regression analysis. Results Despite COVID‐19 restrictions, golfers' physical activity increased by 24% (p

Objectives The primary aim was to describe the characteristics and prevalence of musculoskeletal complaints of a large group of non-professional golfers. Secondary aims were to compare golfers different in (A) skill-level, (B) presence of low back pain (LBP) and (C) performance of prevention exercises.Methods A sample of 1170 male golfers (mean age 54.98, SD=13.3) were surveyed online on personal and golf-specific characteristics, medical history and complaints in the preceding 7 days. Subgroups (A) with different golfing handicap (0 to 5, >5 to 10, >10), (B) with and without LBP and (C) who performed versus did not perform injury prevention exercises were compared using analysis of variance and χ2 test.Results The prevalence and severity of musculoskeletal complaints was similar in everyday life and when playing golf. More than one-third of the golfers (n=436; 37.3%) reported LBP in the preceding 7 days, while other frequently affected body parts were the shoulder and knee. Golfers with different skill level differed in age and most golf-related characteristics but not in prevalence and severity of musculoskeletal complaints. Golfers with and without LBP were similar in almost all variables. Golfers who performed prevention exercises (n=371; 27.1%) were older and had a higher prevalence of complaints.Conclusion The prevalence and severity of musculoskeletal complaints in golfers were similar to the wider population. It seems that injury prevention exercises were implemented after injury, rather than as primary prevention. Prospective studies looking at the epidemiology of injury, risk factors and interventions are required.

A modular, multi-purpose, and cost-effective electrochemical biosensor based on a five-stranded four-way junction (5S-4WJ) system was developed for SARS-CoV-2 (genes S and N) and Influenza A virus (gene M) detection. The 5S-4WJ structure consists of an electrode-immobilized universal stem-loop (USL) strand, two auxiliary DNA strands, and a universal methylene blue redox strand (UMeB). This design allows for the detection of specific nucleic acid sequences using square wave voltammetry (SWV). The sequence-specific auxiliary DNA strands (m and f) ensure selectivity of the biosensor for target recognition utilizing the same USL and UMeB components. An important feature of this biosensor is the ability to reuse the USL-modified electrodes to detect the same or alternative targets in new samples. This is accomplished by a simple procedure involving rinsing the electrodes with water to disrupt the 5S-4WJ structure and subsequent re-hybridization of the USL strand with the appropriate set of strands for a new analysis. The biosensor exhibited minimal loss in signal after rehybridization, demonstrating its potential as a viable multiplex assay for both current and future pathogens, with a low limit of quantification (LOQ) of as low as 17 pM.

Objective While greater body mass index (BMI) is associated with increased risk of developing atrial fibrillation (AF), the impact of BMI on outcomes in newly diagnosed AF is unclear. We examine the influence of BMI on outcomes and whether this is modified by sex and evaluate the effect of non-vitamin K oral anticoagulants (NOACs) in patients with high BMI.Methods GARFIELD-AF is a prospective registry of 52 057 newly diagnosed AF patients. The study population comprised 40 482 participants: 703 underweight (BMI

Introduction: Older adults with serious illness frequently receive post-acute rehabilitative care in nursing homes (NH) under the Part A Medicare Skilled Nursing Facility (SNF) Benefit. Treatment is commonly focused on disease-modifying therapies with minimal consideration for goals of care, symptom relief, and other elements of palliative care. Intervention: The evidence-based Primary Palliative Care in Post-Acute Care (PPC-PAC) intervention for older adults is delivered by nurse practitioners (NP). PPC-PAC NPs assess and manage symptoms, conduct goals of care discussions and assist with decision making; they communicate findings with NH staff and providers. Implementation of PPC-PAC includes online and face-to-face training of NPs, ongoing facilitation, and a template embedded in the NH electronic health record to document PPC-PAC. Objectives: The objectives of this pilot pragmatic clinical trial are to assess the feasibility, acceptability, and preliminary effectiveness of the PPC-PAC intervention and its implementation for 80 seriously ill older adults newly admitted to a NH for post-acute care. Methods: Design is a two-arm nonequivalent group multi-site pilot pragmatic clinical trial. The unit of assignment is at the NP and unit of analysis is NH patients. Recruitment occurs at NHs in Pennsylvania, New Jersey, Delaware, and Maryland. Effectiveness (patient quality of life) data are collected at two times points—baseline and 14–21 days. Conclusion: This will be the first study to evaluate the implementation of an evidence-based primary palliative care intervention specifically designed for older adults with serious illness who are receiving post-acute NH care.

Objectives The aim of this study was to assess whether a risk assessment and managed risk approach to contact tracing was practical and feasible at the Gran Canaria Lopesan Open 2021 and could inform further pilot work regarding disease transmission during elite sporting events.Methods This prospective cohort study included all international attendees. All participants required a minimum of one negative reverse transcriptase PCR (RT-PCR) test prior to travelling to each tournament. High-risk contacts were isolated for 10 days. Moderate-risk contacts received education regarding enhanced medical surveillance, had daily rapid antigen testing for 5 days, with RT-PCR day 5, mandated mask use and access to outside space for work purposes only. Low-risk contacts received rapid antigen testing every 48 hours and PCR testing on day 5.Results A total of 550 persons were accredited and were required to undergo RT-PCR testing before the event. Two of these tests were positive (0.36%). Of these, case 1 had 1 high, 23 moderate and 48 low-risk contacts. Case 2 did not have any significant travel history within 2 days of positive test and had one high-risk contact. There were no further positive tests on site in the wider cohort of attendees, from a total of 872 RT-PCR and 198 rapid antigen tests.Conclusions This pilot study showed it is practical, feasible and well accepted to provide enhanced (daily) virus testing and risk-mitigating measures at a professional golf event. Further study is required to assess the efficacy of these interventions; however, no transmission was found in this pilot study.

Permafrost region subsurface organic carbon (OC) pools are a major component of the terrestrial carbon cycle and vulnerable to a warming climate. Thermokarst lagoons are an important transition stage with complex depositional histories during which permafrost and lacustrine carbon pools are transformed along eroding Arctic coasts. The effects of temperature and salinity changes during thermokarst lake to lagoon transitions on thaw history and lagoon deposits are understudied. We analyzed two 30-m-long sediment cores from two thermokarst lagoons on the Bykovsky Peninsula, Northeast Siberia, using sedimentological, geochronological, hydrochemical, and biogeochemical techniques. Using remote sensing we distinguished between a semi-closed and a nearly closed lagoon. We (1) characterized the depositional history, (2) studied the impact of marine inundation on ice-bearing permafrost and taliks, and (3) quantified the OC pools for different stages of thermokarst lagoons. Fluvial and former Yedoma deposits were found at depth between 30 and 8.5 m, while lake and lagoon deposits formed the upper layers. The electrical conductivity of the pore water indicated hypersaline conditions for the semi-closed lagoon (max: 108 mS/cm), while fresh to brackish conditions were observed beneath a 5 m-thick surface saline layer at the nearly closed lagoon. The deposits had a mean OC content of 15 ± 2 kg/m3, with higher values in the semi-closed lagoon. Based on the cores we estimated a total OC pool of 5.7 Mt-C for the first 30 m of sediment below five mapped lagoons on the Bykovsky Peninsula. Our results suggest that paleo river branches shaped the middle Pleistocene landscape followed by late Pleistocene Yedoma permafrost accumulation and early Holocene lake development. Afterward, lake drainage, marine flooding, and bedfast ice formation caused the saline enrichment of pore water, which led to cryotic talik development. We find that the OC-pool of Arctic lagoons may comprise a substantial inventory of partially thawed and partially refrozen OC, which is available for microbial degradation processes at the Arctic terrestrial-marine interface. Climate change in the Arctic leading to sea level rise, permafrost thaw, coastal erosion, and sea ice loss may increase the rate of thermokarst lagoon formation and thus increase the importance of lagoons as biogeochemical processors of former permafrost OC.

Background: Learner profiles detected from digital trace data are typically triangulated with survey data to explain those profiles based on learners' internal conditions (e.g., motivation). However, survey data are often analysed with limited consideration of the interconnected nature of learners' internal conditions. Objectives: Aiming to enable a thorough understanding of trace-based learner profiles, this paper presents and evaluates a comprehensive approach to analysis of learners' self-reports, which extends conventional statistical methods with psychological networks analysis. Methods: The study context is a massive open online course (MOOC) aimed at promoting physical activity (PA) for health. Learners' (N = 497) perceptions related to PA, as well as their self-efficacy and intentions to increase the level of PA were collected before and after the MOOC, while their interactions with the course were logged as digital traces. Learner profiles derived from trace data were further examined and interpreted through a combined use of conventional statistical methods and psychological networks analysis. Results and Conclusions: The inclusion of psychological networks in the analysis of learners' self-reports collected before the start of the MOOC offers better understanding of trace-based learner profiles, compared to the conventional statistical analysis only. Likewise, the combined use of conventional statistical methods and psychological networks in the analysis of learners' self-reports before and after the MOOC provided more comprehensive insights about changes in the constructs measured in each learner profile. Major Takeaways: The combined use of conventional statistical methods and psychological networks presented in this paper sets a path for a comprehensive analysis of survey data. The insights it offers complement the information about learner profiles derived from trace data, thus allowing for a more thorough understanding of learners' course engagement than any individual method or data source would allow.

Objectives There is no published data on the incidence or risk of SARS-CoV-2 transmission when playing golf, a sport played outdoors where social distancing is possible. The purpose of this prospective study was to report incidence and transmission regarding SARS-CoV-2, of professional golfers competing on the PGA European Tour across 23 events in 11 countries.Methods Daily symptom and temperature checks and weekly reverse transcriptase PCR (RT-PCR) screening were performed to determine potential carriage of SARS-CoV-2. Onset and type of symptomology were analysed. Gene expression and cycle thresholds (Cts) were reviewed for all positive cases. Repeat PCR testing was performed on all positive players. RT-PCR analysis included human housekeeping genes and various RNA genes specific for SARS-CoV-2.Results During the study period, there were 2900 RT-PCR tests performed on 195 professional golfers competing on the European Tour. Four players tested positive on-site during the study period (0.14% of tests; positive results were declared with Ct

Background Golf is a sport played worldwide by >60 million people from a variety of backgrounds and abilities. Golf’s contribution to physical and mental health benefits are becoming increasingly recognised. Countries have adopted a range of restrictions to playing golf during the COVID-19 pandemic.Aims The purpose of this narrative review was to (1) explore the literature related to the possible health benefits and risks of playing golf during the COVID-19 pandemic and (2) provide recommendations on golf-related activity from the relevant available literature.Results Golf can provide health-enhancing physical activity. Regular physical activity is associated with physical/mental health, immune system and longevity benefits. Sense of belonging and life satisfaction significantly improved when golfing restrictions were relaxed after the first lockdown in the UK. Golf is an outdoor sport, where social distancing is possible, and if rules are followed, risk of COVID-19 transmission is likely to be low.Conclusions Policy-makers and governing bodies should support the promotion of golf because participation brings wide ranging benefits for physical health and mental well-being. When effective risk reduction measures are used, the benefits of playing golf in most circumstances outweigh the risk of transmission.

Introduction Rugby football (Union and League) provides physical activity (PA) with related physical and mental health benefits. However, as a collision sport, rugby research and media coverage predominantly focus on injuries in elite players while the overall impact on health and well-being remains unclear. This study aims to provide a greater understanding of the risks and benefits of rugby participation in a diverse sample of men and women, current and former rugby Union and League players from recreational to the elite level of play. We will explore: (1) joint-specific injuries and concussion; (2) joint pain and osteoarthritis (OA); (3) medical and mental health conditions; (4) PA and sedentary behaviour and (5) well-being (quality of life, flourishing and resilience).Methods and analysis The Rugby Health and Well-being Study is designed in two phases: (1) a UK-wide cross-sectional survey and (2) cross-validation using health register data from Scotland. Participants will be at least 16 years old, current or former rugby players who have played rugby for at least one season. We will report standardised, level of play-, sex- and age-stratified prevalence of joint injury, concussion, medical conditions and PA. We will describe injury/concussion prevention expectations and protective equipment use. Rugby-related factors associated with injury, pain, OA, PA, health and well-being will be explored in regression models. We will compare joint pain intensity and duration, elements of pain perception and well-being between recreational and elite players and further investigate these associations in regression models while controlling for confounding variables. In the second phase, we will validate self-reported with health register data, and provide further information on healthcare use.Ethics and dissemination The Yorkshire and the Humber—Leeds East Research Ethics Committee (REC reference: 19/HY/0377) has approved this study (IRAS project ID 269424). The results will be disseminated through scientific publications, conferences and social media.

During successive Pleistocene ice ages, Finnish Lapland lay under the cold-based centre of the Fennoscandian Ice Sheet (FIS). This area largely escaped deep glacial erosion by the fast-flowing wet-based ice streams that developed toward the periphery of successive ice sheets. Low erosion is evident from the preservation of Neogene weathered bedrock and a significant record of tills of the pre-Weichselian sediments. To date, some 250 locations are known where sediments occur beneath and within last glaciation deposits (Weichselian). An ongoing challenge is to determine absolute ages for old sediments and to establish regional stratigraphic correlations from one site to another. At Äältövittikot, lacustrine silts and rippled sands are found as rafts and inter-till layers within the Weichelian tills. The results indicate an age range of 190–235 ka identifying a likely MIS 7 age i.e., an early or mid Saalian Stage for the older sediments and a couple of younger OSL ages representing Weichselian interstadials as an indication for the multiphase deposition of the Äältövittikot sediment complex. Overlying Weichselian tills contain large amounts of glaciotectonically-deformed and reworked Saalian material. The reworking of Saalian sediment in an up-ice position from the headward erosion zone of the Salla ice stream is important for understanding the polycyclic origins of tills found in similar locations and for interpretation of tracer minerals found in mineral exploration surveys in similar glaciated terrains.

Sister chromatid cohesion essential for mitotic chromosome segregation is thought to involve the co-entrapment of sister DNAs within cohesin rings. Although cohesin can load onto chromosomes throughout the cell cycle, it only builds cohesion during S phase. A key question is whether cohesion is generated by conversion of cohesin complexes associated with un-replicated DNAs ahead of replication forks into cohesive structures behind them, or from nucleoplasmic cohesin that is loaded de novo onto nascent DNAs associated with forks, a process that would be dependent on cohesin’s Scc2 subunit. We show here that in S. cerevisiae, both mechanisms exist and that each requires a different set of replisome-associated proteins. Cohesion produced by cohesin conversion requires Tof1/Csm3, Ctf4 and Chl1 but not Scc2 while that created by Scc2-dependent de novo loading at replication forks requires the Ctf18-RFC complex. The association of specific replisome proteins with different types of cohesion establishment opens the way to a mechanistic understanding of an aspect of DNA replication unique to eukaryotic cells.

Abstract Background Recombinant human erythropoietin (rHuEpo) can improve human performance and is therefore frequently abused by athletes. As a result, the World Anti-Doping Agency (WADA) introduced the Athlete Biological Passport (ABP) as an indirect method to detect blood doping. Despite this progress, challenges remain to detect blood manipulations such as the use of microdoses of rHuEpo. Methods Forty-five whole-blood transcriptional markers of rHuEpo previously derived from a high-dose rHuEpo administration trial were used to assess whether microdoses of rHuEpo could be detected in 14 trained subjects and whether these markers may be confounded by exercise (n = 14 trained subjects) and altitude training (n = 21 elite runners and n = 4 elite rowers, respectively). Differential gene expression analysis was carried out following normalisation and significance declared following application of a 5% false discovery rate (FDR) and a 1.5 fold-change. Adaptive model analysis was also applied to incorporate these markers for the detection of rHuEpo. Results ALAS2, BCL2L1, DCAF12, EPB42, GMPR, SELENBP1, SLC4A1, TMOD1 and TRIM58 were differentially expressed during and throughout the post phase of microdose rHuEpo administration. The CD247 and TRIM58 genes were significantly up- and down-regulated, respectively, immediately following exercise when compared with the baseline both before and after rHuEpo/placebo. No significant gene expression changes were found 30 min after exercise in either rHuEpo or placebo groups. ALAS2, BCL2L1, DCAF12, SLC4A1, TMOD1 and TRIM58 tended to be significantly expressed in the elite runners ten days after arriving at altitude and one week after returning from altitude (FDR > 0.059, fold-change varying from 1.39 to 1.63). Following application of the adaptive model, 15 genes showed a high sensitivity (≥ 93%) and specificity (≥ 71%), with BCL2L1 and CSDA having the highest sensitivity (93%) and specificity (93%). Conclusions Current results provide further evidence that transcriptional biomarkers can strengthen the ABP approach by significantly prolonging the detection window and improving the sensitivity and specificity of blood doping detection. Further studies are required to confirm, and if necessary, integrate the confounding effects of altitude training on blood doping.

Introduction Rugby union is played by over eight million people across the world and is considered a form of moderate-to-vigorous physical activity. Consequently, playing rugby may confer health benefits; however, to date, the principal focus of research has been on associated injuries and potential detrimental long-term health sequelae. This protocol outlines the methods behind studying any potential associations between rugby union and both physical and mental health.Methods and analysis Best practice methodological frameworks (Arksey and O'Malley, Levac et al and the Joanna Briggs Institute) and previously published scoping review protocols in sport informs the methodology of this protocol. This protocol enables us to map the key concepts and evidence available, summarise and share existing research findings, and identify research gaps in the current literature. A three-step search strategy will identify reviews, original research, and published and grey literature. An initial search will identify suitable search terms, followed by a search using keyword and index terms. Two reviewers will independently screen identified studies for final inclusion.Dissemination When publishing the scoping review, we will map key concepts and evidence both numerically and thematically, as well as identify key research priorities for further studies. The review will subsequently be disseminated to stakeholder groups, practitioners and policymakers through a variety of peer-reviewed and non-peer-reviewed publications, conferences and via multimedia platforms.

OBJECTIVES Recent studies have reported that playing golf has overall physical and mental health benefits. Through being placed in the sun for extended periods of time, the golfing population faces an increased risk of ultraviolet radiation (UVR) associated skin problems, most importantly skin cancer. Our aim was to collate and summarise current literature on the relationship between golf and skin cancer. METHODS We searched multiple web-based, health-focused databases (Medline, Embase, Cinahl, Web of science, Scopus, Sportdiscus, UK clinical trials, Current controlled trials and Prospero) to identify records. Relevant papers were critically appraised and reported using a descriptive analysis. RESULTS A total of 11 studies are included in the review. Golf is associated with relatively more UVR exposure than other outdoor activities such as fishing, tennis, pool swimming, cricket, gardening, ‘sun-worshipping’ and sailing. Calculated relative risk of non- melanoma skin cancer, based on cumulative UV exposure, is higher in golfers than non-golfers. Mid morning tee-times or playing golf between 11am -3pm associated with highest UVR exposures. Golfers can be exposed to potentially harmful levels of UVR during play in winter at some latitudes. Vertex (scalp), shoulders, back, back of neck and posterior arms exposed to more UVR than front of body during play. Common golf attire is of limited value in protecting the neck. Targeted skin cancer skin cancer prevention and early detection campaigns are well received among the golfing population. CONCLUSIONS Overall, playing golf is associated with longevity and both physical and mental health benefits. Studies to date indicate that golfers (professionals > recreational players) are exposed to potentially harmful levels of UVR during play, but the true morbidity/mortality associated with this exposure is not known. Playing golf should be encouraged in all age groups, though golfers, the golf industry and policy makers should act to minimize the harmful effects of UVR exposure, and have they have ability to also be hugely influential on an important public health message.

Encounters with water shape the Middle English romances of The Awntyrs off Arthure and Sir Isumbras. In the latter, rivers and the ‘Greek Sea’ serve to distinguish separate sections of the narrative: the river marks the point at which the titular hero’s family unit begins to break down, while the beach of the sea marks the lowest point of his social power. Yet his later traversal of the Greek Sea itself allows him to reassemble his family and reclaim his aristocratic power. In Awntyrs, the Tarn Wathelene (or Wadling) ties the actions of the romance’s first episode onto a specific spot in the real-world English landscape, while connecting the text to a number of other Arthurian romances that also mention or take place near the tarn. This article, then, argues that the waterscapes in these two texts illustrate a late-medieval understanding of tarns, rivers, and seas as explicitly alien, yet intimately physical embodiments of divine power in the natural world. Taken together, these poems—one a metrical romance, the other alliterative—show how interests in waterscapes crossed boundaries within the muddy genre of romance itself, and reveal that water upsets such human categories as family and property. Tarns, rivers, and seas turn human bodies, instead, into their possessions; the disturbing experience of that dehumanizing process should, these texts imply, wear the world, its history, and its bonds away, until even the greatest knights or ladies are left alone with watery forms beyond the pale of human understanding.

Summary: Listeria monocytogenes infection is an important cause of illness and hospitalization in vulnerable individuals. In the present study, we describe a community outbreak of Listeria monocytogenes in the North-East region of Scotland, which was epidemiologically, environmentally and microbiologically linked to a local meat product and ready-to-eat product manufacturer. Infected individuals were interviewed, and an environmental investigation was conducted. Clinical and environmental samples were tested by culture, and isolates were typed by fluorescent amplified fragment length polymorphism (fAFLP). Three cases of Listeria monocytogenes were linked geographically, had the same serotype (1/2a) and were indistinguishable by fAFLP type XII.6. The human, food and environmental isolates were of the same serotype and were indistinguishable by molecular typing.This is the first community outbreak of L. monocytogenes reported in Scotland since the current outbreak surveillance was established in 1996. Epidemiological and laboratory evidence indicated poor hand hygiene, unhygienic practices and cross-contamination throughout the manufacturing process of ready-to-eat foods as a possible cause of the outbreak. More stringent control of commercial food establishments that provide ready-to-eat food and the need to advise specifically vulnerable groups, e.g., pregnant women, of the risk of L. monocytogenes in ready-to-eat food is urgently needed. Keywords: Listeria monocytogenes, Outbreak, Foodborne, Community acquired infection, Listeriosis

Non-glaciated mountain headwater catchments feature high-resolution geomorphic archives, which provide important insight into erosive processes and sediment dynamics in mountain ranges. As such the Valle de la Fueva catchments in the southern Pyrenees present high-lying talus remnants, extensive denudation surfaces (pediments), deeply incised tributary ravines, and low-lying fluvial-cut terraces. Based on geomorphic analyses and absolute dating using terrestrial cosmogenic nuclides and optically stimulated luminescence, a (late stage) catchment erosion model for the Valle de la Fueva was elaborated and indicates successive development stages of (i) lasting pedimentation under cold-climate conditions during Marine Isotope Stages 4−2, (ii) rapid fluvial dissection, sediment remobilization and downcutting of ravines in response to the last major climate transition and establishing interglacial conditions, and (iii) late stage fluvial incision after 3−4 ka due to regionally increased flood magnitudes, and/or intensification of agriculture and forest management. Valle de la Fueva headwater catchment analysis indicated that the styles and magnitudes of basin surface processes were directly correlated with the amplitude and nature of paleoclimatic changes, modified by the interplay of environmental parameters. In contrast to large-scale fluvial systems, mountain headwater catchments seemed to be less afflicted with temporal and spatial averaging biases. They are thus useful targets for investigating direct climate change effects, surface process coupling, and non-linear response mechanisms in Quaternary fluvial systems.

Budding yeast cells exist in two mating types, a and α, which use peptide pheromones to communicate with each other during mating. Mating depends on the ability of cells to polarize up pheromone gradients, but cells also respond to spatially uniform fields of pheromone by polarizing along a single axis. We used quantitative measurements of the response of a cells to α-factor to produce a predictive model of yeast polarization towards a pheromone gradient. We found that cells make a sharp transition between budding cycles and mating induced polarization and that they detect pheromone gradients accurately only over a narrow range of pheromone concentrations corresponding to this transition. We fit all the parameters of the mathematical model by using quantitative data on spontaneous polarization in uniform pheromone concentration. Once these parameters have been computed, and without any further fit, our model quantitatively predicts the yeast cell response to pheromone gradient providing an important step toward understanding how cells communicate with each other.

The stratigraphy and sedimentology of a diamicton-stratified sand deposit have been studied in the Veskoniemi area, near Lake Inarijärvi in central Finnish Lapland. Test pit excavations were used for stratigraphical investigations. Till-covered laminar and cross-bedded sands were dated using optically stimulated luminescence (OSL). Ages range between 21.0 ± 1.5 and 22.4 ± 1.6 ka for laminated sands at upper levels and 39 ± 3 and 46 ± 3 ka for sands at deeper levels. These dating results strengthen the evidence for a Middle Weichselian interstadial in northern Finland during oxygen isotope stage 3, and can be compared with other results in eastern and southern Lapland. This is the first time that sediments from the Middle and Late Weichselian contact have been identified in Finland. These new dating results indicate that an ice-free period could have lasted from halfway through the Middle Weichselian to the beginning of the Late Weichselian about 22–25 ka ago in northern Finland.

Objective: Oxygen availability falls with ascent to altitude and also as a consequence of critical illness. Because cellular sequelae and adaptive processes may be shared in both circumstances, high altitude exposure (‘physiological hypoxia’) assists in the exploration of the response to pathological hypoxia. We therefore studied the response of healthy participants to progressive hypobaric hypoxia at altitude. The primary objective of the study was to identify differences between high altitude inhabitants (Sherpas) and lowland comparators. Methods: We performed an observational cohort study of human responses to progressive hypobaric hypoxia (during ascent) and subsequent normoxia (following descent) comparing Sherpas with lowlanders. Studies were conducted in London (35m), Kathmandu (1300m), Namche Bazaar (3500m) and Everest Base Camp (5300m). Of 180 healthy volunteers departing from Kathmandu, 64 were Sherpas and 116 were lowlanders. Physiological, biochemical, genetic and epigenetic data were collected. Core studies focused on nitric oxide metabolism, microcirculatory blood flow and exercise performance. Additional studies performed in nested subgroups examined mitochondrial and metabolic function, and ventilatory and cardiac variables. Of the 180 healthy participants who left Kathmandu, 178 (99%) completed the planned trek. Overall, more than 90% of planned testing was completed. Forty-four study protocols were successfully completed at altitudes up to and including 5300m. A subgroup of identical twins (all lowlanders) was also studied in detail. Conclusion: This programme of study (Xtreme Everest 2) will provide a rich dataset relating to human adaptation to hypoxia, and the responses seen on re-exposure to normoxia. It is the largest comprehensive high altitude study of Sherpas yet performed. Translational data generated from this study will be of relevance to diseases in which oxygenation is a major factor.

Despite the importance of our sense of balance we still know remarkably little about the central control of the peripheral balance system. While previous work has shown that activation of the efferent vestibular system results in modulation of afferent vestibular neuron discharge, the intrinsic and synaptic properties of efferent neurons themselves are largely unknown. Here we substantiate the location of the efferent vestibular nucleus (EVN) in the mouse, before characterizing the input and output properties of EVN neurons in vitro. We made transverse serial sections through the brainstem of 4-week-old mice, and performed immunohistochemistry for calcitonin gene-related peptide (CGRP) and choline acetyltransferase (ChAT), both expressed in the EVN of other species. We also injected fluorogold into the posterior canal and retrogradely labelled neurons in the EVN of ChAT:: tdTomato mice expressing tdTomato in all cholinergic neurons. As expected the EVN lies dorsolateral to the genu of the facial nerve (CNVII). We then made whole-cell current-, and voltage-clamp recordings from visually identified EVN neurons. In current-clamp, EVN neurons display a homogeneous discharge pattern. This is characterized by a high frequency burst of action potentials at the onset of a depolarizing stimulus and the offset of a hyperpolarizing stimulus that is mediated by T-type calcium channels. In voltage-clamp, EVN neurons receive either exclusively excitatory or inhibitory inputs, or a combination of both. Despite this heterogeneous mixture of inputs, we show that synaptic inputs onto EVN neurons are predominantly excitatory. Together these findings suggest that the inputs onto EVN neurons, and more specifically the origin of these inputs may underlie EVN neuron function.

We analyzed 27 established and new simple and therefore perhaps portable satellite phycocyanin pigment reflectance algorithms for estimating cyanobacterial values in a temperate 8.9 km2 reservoir in southwest Ohio using coincident hyperspectral aircraft imagery and dense coincident water surface observations collected from 44 sites within 1 h of image acquisition. The algorithms were adapted to real Compact Airborne Spectrographic Imager (CASI), synthetic WorldView-2, Sentinel-2, Landsat-8, MODIS and Sentinel-3/MERIS/OLCI imagery resulting in 184 variants and corresponding image products. Image products were compared to the cyanobacterial coincident surface observation measurements to identify groups of promising algorithms for operational algal bloom monitoring. Several of the algorithms were found useful for estimating phycocyanin values with each sensor type except MODIS in this small lake. In situ phycocyanin measurements correlated strongly (r2 = 0.757) with cyanobacterial sum of total biovolume (CSTB) allowing us to estimate both phycocyanin values and CSTB for all of the satellites considered except MODIS in this situation.

Tuolumne County retail merchants think that they are not capturing the lion's share of local sales, but they are! County residents do not go out of the county to shop as much as businesses think. A survey conducted in 1997 by the UC Cooperative Extension Office in Tuolumne County surveyed shoppers and checked perceptions of local business owners. The survey found that the proportion of money that is spent out of the county is not as high as businesses surmised. This follow-up to a similar study conducted in 1989 also showed that businesses are capturing more local dollars than they were 8 years earlier.

The interpretation of the use and contextual meaning of fossil agrarian forms is connected with their age. In this article we discuss the dating and interpretation of a field wall in Öggestorp, situated on the northern rim of the southern Swedish uplands in the province of Småland. Öggestorp is a complex archaeological site dating from the early Iron Age (500 BC to AD 550). The site was also used for various forms of agriculture during the Middle Ages and in early modern times, a fact which complicates the dating and the interpretation of the agrarian features. We discuss the possibility and practical issue of dating agrarian sediments by optically stimulated luminescence (OSL). By combining OSL and other methods, a reliable estimation of age can be established. The paper also deals with the possible implications of the OSL-method in relation to the current state of knowledge of agrarian structures. We show that a serious dating of agricultural remains must be based upon a critically used combination ofmethods. Without a well-argued date, it is difficult to relate any agrarian form chronologically to other remains in a fossil landscape of multilayered complexity.

The opinion of the CJEU Attorney General on mass data retention has been long awaited by anyone interested in privacy rights, and more generally the relationship between states and their citizens during this period of an extended “war on terror”. While some civil rights groups have already claimed victory, on closer look the opinion of the AG is not an unmitigated success for privacy activists: It gives considerable discretion to member states to enact data retention provisions providing they meet the Digital Rights Ireland standard.