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Eivind Schjelderup Skarpsno,1,2 Paul Jarle Mork,1 Tom Ivar Lund Nilsen,1 Andreas Holtermann3,4 1Department of Public Health and Nursing, Norwegian University of Science and Technology (NTNU), 2Liaison Committee between Central Norway Regional Health Authority and NTNU, Trondheim, Norway; 3National Research Centre for the Working Environment, Copenhagen, 4Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark Background: In order to establish normative values for body positions and movements during sleep, the objective of this study was to explore the distribution of sleep positions and extent of nocturnal body moments and the association with sex, age, body-mass index (BMI), smoking, alcohol consumption, and insomnia symptoms. Materials and methods: This cross-sectional study comprised data on a working population (363 men and 301 women) who participated in the Danish Physical Activity Cohort with Objective Measurements (DPHACTO). Measures of body position and movements were obtained from actigraph accelerometers on the thigh, upper back, and upper arm. Linear regression was used to estimate adjusted mean differences in movements among categories of demographic and lifestyle characteristics. Results: During their time in bed, participants spent 54.1% (SD 18.1%) in the side position, 37.5% (SD 18.2%) in the back position, and 7.3% (SD 12.3%) in the front position. Increasing age and BMI were associated with increased time in the side position and a proportional reduction in time in the back position. There were on average 1.6 (SD 0.7) position shifts per hour. Compared to males, females had fewer position shifts (–0.37, 95% CI –0.48 to –0.24) and fewer arm, thigh, and upper-back movements. Participants aged 20–34 years had more arm, thigh, and upper-back movements compared to participants ≥35 years. Obese participants had fewer shifts in body position (–0.15, 95% CI –0.27 to 0), but more arm, thigh, and upper-back movements compared to normal-weight participants. Smokers had fewer shifts in body position than nonsmokers (–0.27, 95% CI –0.4 to –0.13). Conclusion: The predominant sleep position in adults is on the side. This preference increases with age and BMI. The extent of nocturnal body movements is associated with sex, age, BMI, and smoking. Keywords: sleep, sleep positions, body movements, accelerometers, lifestyle

Abstract Background Most adults fail to meet the moderate to vigorous physical activity-based recommendations needed to maintain or improve health. Vigorous Intermittent Lifestyle Physical Activity (VILPA) refers to short (1–2 min) high-intensity activities that are integrated into activities of daily living. VILPA has shown strong potential to improve health and addresses commonly reported barriers to physical activity. However, it is unknown how VILPA can best be promoted among the adult population. This study aimed to evaluate the usability, user engagement, and satisfaction of a mobile application (MovSnax) designed to promote VILPA. Methods A concurrent mixed methods design was used. It comprised four parts. Part A was a survey with n = 8 mHealth and physical activity experts who had used the app over 7–10 days. Part B was think-aloud interviews with n = 5 end-users aged 40–65 years old. Part C was a survey with a new group of 40-65-year-old end-users (n = 35) who had used the MovSnax app over 7–10 days. Part D was semi-structured interviews with n = 18 participants who took part in Part C. Directed content analysis was used to analyze the results from Parts A, B, and D, and descriptive statistics were used to analyze findings from Part C. Results Participants reported positive views on the MovSnax app for promoting VILPA but also identified usability issues such as unclear purpose, difficulties in manual data entry, and limited customization options. Across the different data collections, they consistently emphasized the need for more motivational features, clearer feedback, and gamification elements to enhance engagement. Quantitative assessment showed satisfactory scores on objective measures but lower ratings on subjective aspects, possibly due to unfamiliarity with the VILPA concept and/or technical barriers. Conclusions The MovSnax app, tested in the present study, is the world’s first digital tool aimed specifically at increasing VILPA. The findings of the present study underscore the need for further app refinement, focusing on clarifying its purpose and instructions, boosting user engagement through personalization and added motivational elements, enhancing accuracy in detecting VILPA bouts, implementing clearer feedback mechanisms, expanding customization choices (such as font size and comparative data), and ensuring transparent and meaningful activity tracking.

OBJECTIVES: Both high and low levels of occupational physical activity are associated with back pain. Thus, there might be a “sweet- and sour-spot” of occupational physical activity for back pain. Our aim was to investigate if there exists an occupational physical activity “sweet- (lowest risk) and sour-spot” (highest risk) for back pain. METHODS: A total of 396 eldercare workers from 20 Danish nursing homes participated. Occupational physical activity was measured between 1–4 working days using thigh-worn accelerometry. Back pain intensity was reported monthly on a scale from 0–10 over 1-year. A zero-inflated mixed-effects model was developed regressing occupational physical activity against back pain, adjusted for confounders. The “sweet- and sour-spot” were defined as the occupational physical activity compositions (sitting, standing, light, and moderate-to-vigorous) associated with the 5% lowest and highest risk for back pain, respectively. RESULTS: The composition associated with the lowest risk of back pain – the “sweet-spot”– consisted of 71% worktime spent sitting, 18% spent standing, 5% spent on light physical activity and 6% spent on moderate-to-vigorous physical activity. The composition associated with highest risk for back pain –the “sour-spot”– consisted of 8% worktime spent sitting, 66% spent standing, 4% spent on light physical activity, and 21% spent on moderate-to-vigorous physical activity. CONCLUSIONS: The “sweet-spot” of occupational physical activity for back pain among eldercare workers involves more sitting and light physical activity time, while the “sour-spot” involves more standing and moderate-to-vigorous physical activity time. Research on the occupational physical activity “sweet- and sour-spot” is needed.

Background: Evidence on the health benefits of occupational physical activity (OPA) is inconclusive. We examined the associations of baseline OPA and OPA changes with all-cause, cardiovascular disease (CVD), and cancer mortality and survival times. Methods: This study included prospective and longitudinal data from the MJ Cohort, comprising adults over 18 years recruited in 1998–2016, 349,248 adults (177,314 women) with baseline OPA, of whom 105,715 (52,503 women) had 2 OPA measures at 6.3 ± 4.2 years (mean ± SD) apart. Exposures were baseline OPA, OPA changes, and baseline leisure-time physical activity. Results: Over a mean mortality follow-up of 16.2 ± 5.5 years for men and 16.4 ± 5.4 years for women, 11,696 deaths (2033 of CVD and 4631 of cancer causes) in men and 8980 deaths (1475 of CVD and 3689 of cancer causes) in women occurred. Combined moderately heavy/heavy baseline OPA was beneficially associated with all-cause mortality in men (multivariable-adjusted hazard ratio (HR) = 0.93, 95% confidence interval (95%CI): 0.89–0.98 compared to light OPA) and women (HR = 0.86, 95%CI: 0.79–0.93). Over a mean mortality follow-up of 12.5 ± 4.6 years for men and 12.6 ± 4.6 years for women, OPA decreases in men were detrimentally associated (HR = 1.16, 95%CI: 1.01–1.33) with all-cause mortality, while OPA increases in women were beneficially (HR = 0.83, 95%CI: 0.70–0.97) associated with the same outcome. Baseline or changes in OPA showed no associations with CVD or cancer mortality. Conclusion: Higher baseline OPA was beneficially associated with all-cause mortality risk in both men and women. Our longitudinal OPA analyses partly confirmed the prospective findings, with some discordance between sex groups.

Abstract Turbulent mixing in the ocean, lakes and reservoirs facilitates the transport of momentum, heat, nutrients, and other passive tracers. Turbulent fluxes are proportional to the rate of turbulent kinetic energy dissipation per unit mass, ε. A common method for ε measurements is using microstructure profilers with shear probes. Such measurements are now widespread, and a non-expert practitioner will benefit from best practice guidelines and benchmark datasets. As a part of the Scientific Committee on Oceanographic Research (SCOR) working group on “Analysing ocean turbulence observations to quantify mixing” (ATOMIX), we compiled a collection of five benchmark data of ε from measurements of turbulence shear using shear probes. The datasets are processed using the ATOMIX recommendations for best practices documented separately. Here, we describe and validate the datasets. The benchmark collection is from different types of instruments and covers a wide range of environmental conditions. These datasets serve to guide the users to test their ε estimation methods and quality-assurance metrics, and to standardize their data for archiving.

Abstract Background Physical behaviors such physical activity, sedentary behavior, and sleep are associated with mortality, but there is a lack of epidemiological data and knowledge using device-measured physical behaviors. Purpose To assess the feasibility of baseline data collection using the Prospective Physical Activity, Sitting, and Sleep consortium (ProPASS) protocols in the specific context of Saudi Arabia. ProPASS is a recently developed global platform for collaborative research that aims to harmonize retrospective and prospective data on device-measured behaviors and health. Using ProPASS methods for collecting data to perform such studies in Saudi Arabia will provide standardized data from underrepresented countries. Method This study explored the feasibility of baseline data collection in Saudi Arabia between November and December 2022 with a target recruitment of 50 participants aged ≥ 30 years. Established ProPASS methods were used to measure anthropometrics, measure blood pressure, collect blood samples, carry out physical function test, and measure health status and context of physical behaviors using questionnaires. The ActivPal™ device was used to assess physical behaviors and the participants were asked to attend two sessions at (LHRC). The feasibility of the current study was assessed by evaluating recruitment capability, acceptability, suitability of study procedures, and resources and abilities to manage and implement the study. Exit interviews were conducted with all participants. Result A total of 75 participants expressed an interest in the study, out of whom 54 initially agreed to participate. Ultimately, 48 participants were recruited in the study (recruitment rate: 64%). The study completion rate was 87.5% of the recruited participants; 95% participants were satisfied with their participation in the study and 90% reported no negative feelings related to participating in the study. One participant reported experiencing moderate skin irritation related to placement of the accelerometer. Additionally, 96% of participants expressed their willingness to participate in the study again. Conclusion Based on successful methodology, data collection results, and participants’ acceptability, the ProPASS protocols are feasible to administer in Saudi Arabia. These findings are promising for establishing a prospective cohort in Saudi Arabia.

OBJECTIVE: Poor cardiorespiratory fitness and health is common among childcare workers. We designed the `Goldilocks-games` according to the Goldilocks Work principle to provide high-intensity physical activity for childcare workers. We investigated the effectiveness of this Goldilocks Work intervention in increasing occupational high-intensity physical activity and improving work-related health. METHODS: In a two-arm cluster randomized trial, 16 childcare institutions with 142 workers were randomly allocated to either an 8-week Goldilocks Work intervention or a control group. The primary outcome was occupational time in high-intensity physical activity. Secondary outcomes were occupational time in active physical behaviors, heart rate during sleep, pain, physical exhaustion, energy at work, work productivity, and need for recovery. RESULTS: The intervention was successfully delivered and received. Both groups had a low amount of occupational high-intensity physical activity at baseline, and the intervention group reported playing the games 3.1 [standard deviation (SD) 1.5] times/week for a duration of 112.2 (SD 175.0) min/week. However, the intervention did not increase high-intensity physical activity or the secondary outcomes, except for energy at work, measured on a scale from 0–10, increasing 0.65 [95% confidence interval (CI) 0.08–1.21], and need for recovery, measured on a scale from 1–5, decreasing -0.32 (95% CI, -0.54– -0.09). CONCLUSION: The intervention was successfully delivered and received, but did not increase high-intensity physical activity. The intervention group increased their energy at work and decreased their need for recovery, but not the other health-related outcomes. Further research on how to design and implement health-promoting work environment interventions in childcare is needed.

Abstract The concept of precision cell therapy targeting tumor-specific mutations is appealing but requires surface-exposed neoepitopes, which is a rarity in cancer. B cell receptors (BCR) of mature lymphoid malignancies are exceptional in that they harbor tumor-specific-stereotyped sequences in the form of point mutations that drive self-engagement of the BCR and autologous signaling. Here, we use a BCR light chain neoepitope defined by a characteristic point mutation (IGLV3-21R110) for selective targeting of a poor-risk subset of chronic lymphocytic leukemia (CLL) with chimeric antigen receptor (CAR) T cells. We develop murine and humanized CAR constructs expressed in T cells from healthy donors and CLL patients that eradicate IGLV3-21R110 expressing cell lines and primary CLL cells, but neither cells expressing the non-pathogenic IGLV3-21G110 light chain nor polyclonal healthy B cells. In vivo experiments confirm epitope-selective cytolysis in xenograft models in female mice using engrafted IGLV3-21R110 expressing cell lines or primary CLL cells. We further demonstrate in two humanized mouse models lack of cytotoxicity towards human B cells. These data provide the basis for advanced approaches of resistance-preventive and biomarker-guided cellular targeting of functionally relevant lymphoma driver mutations sparing normal B cells.

Turbulent diapycnal mixing is important for the estuarine circulation between basins of the Baltic Sea as well as for its local ecosystems, in particular with regard to eutrophication and anoxic conditions. While the interior of the basins is overall relatively calm, stratified flow over steep bathymetric features is known as a source of strong turbulent mixing. Yet, current in situ observations often cannot capture the spatio-temporal development of dynamic and intermittent turbulent mixing related to overflows over rough bathymetry. We present observational oceanographic data together with openly accessible high-resolution bathymetry from a prototypical sill and an adjacent deep channel in the sparsely sampled Southern Quark located in the Åland Sea, connecting the northern Baltic Proper with the Bothnian Sea. Our data were acquired during two 1-week cruises on R/V Electra in February–March 2019 and 2020. We collected high-resolution broadband acoustic observations of turbulent mixing together with in situ microstructure profiler measurements, and current velocities from acoustic Doppler current profilers. We found that a temporally reversing non-tidal stratified flow over the steep bathymetric sill created a dynamic and extremely energetic environment. The observed flow reversed during both cruises on timescales of a few days. Saltier, warmer, and less oxygenated deep water south of the sill was partly blocked, the reversing flow was at times hydraulically controlled with hydraulic jumps occurring on both sides of the sill, and high spatial variability occurred in the surface layer on small scales. Dissipation rates of turbulent kinetic energy, vertical turbulent diffusivities, and vertical salt flux rates were increased by 3–4 orders of magnitude in the entire water column in the vicinity of the sill compared to reference stations not directly influenced by the overflow with average dissipation rates near the sill between 10−7 and 10−6 W kg−1, average vertical diffusivities of 0.001 m2 s−1 in the halocline and up to 0.1 m2 s−1 below the halocline, and average vertical salt flux rates around 0.01 g m−2 s−1 in the halocline and between 0.1 and 1 g m−2 s−1 below the halocline. We suggest, based on acoustic observations and in situ measurements, that the underlying mechanism for the highly increased mixing across the halocline is a combination of shear and topographic lee waves breaking at the halocline interface. We anticipate that the resulting deep- and surface-water modification in the Southern Quark directly impacts exchange processes between the Bothnian Sea and the northern Baltic Proper and that the observed mixing is likely important for oxygen and nutrient conditions in the Bothnian Sea.

As a part of the Scientific Committee on Oceanographic Research (SCOR) Working Group #160 “Analyzing ocean turbulence observations to quantify mixing” (ATOMIX), we have developed recommendations on best practices for estimating the rate of dissipation of kinetic energy, ε, from measurements of turbulence shear using shear probes. The recommendations provided here are platform-independent and cover the conceivable range of dissipation rates in the ocean, seas, and other natural waters. They are applicable to commonly deployed platforms that include vertical profilers, fixed and moored instruments, towed profilers, submarines, self-propelled ocean gliders, and other autonomous underwater vehicles. The procedure for preparing the shear data for spectral estimation is discussed in detail, as are the quality control metrics that should accompany each estimate of ε. The methods are illustrated using a high-quality ‘benchmark’ dataset, while potential pitfalls are demonstrated with a second dataset containing common faults.