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BackgroundThe Ten Top Tips (10TT) is an intervention based on the habit formation theory that promotes a set of weight management behaviors alongside advice about repetition in a consistent context. Overall, 3 studies have demonstrated that the 10TT can support individuals to lose weight when delivered in a leaflet format. Delivery of 10TT via new technology such as a mobile app could potentially improve its effectiveness and make it more convenient, appealing, and wide reaching. ObjectiveThis study aimed to provide preliminary indications of the usage, effectiveness, and acceptability of an Android app of the 10TT intervention (Top Tips only app) and a second version including self-regulatory strategies for dealing with tempting foods (Top Tips plus app). MethodsThe 3-month pilot randomized adults with overweight or obesity to (1) Top Tips only app, (2) Top Tips plus app, or (3) waiting list condition. Automated data from app users were collected. Validated questionnaires assessed self-regulatory skills, weight loss (kg), and behaviors at baseline and 3 months. Users’ feedback on their experience using the app was assessed using open questions. ResultsA total of 81 participants took part in the pilot; 28 participants were randomized to the Top Tips only app, 27 to the Top Tips plus app, and 26 to the waiting list condition. On average, participants viewed a mean of 43.4 (SD 66.9) screens during a mean of 24.5 (SD 44.07) log-ins and used the app for 124.2 (SD 240.2) min over the 3-month period. Participants randomized to the Top Tips only app reported the greatest improvement in self-regulatory skills (mean 0.59, SD 1.0), weight loss (mean 4.5 kg, SD 5.2), and adherence to the target behaviors (mean 0.59, SD 0.49) compared with the Top Tips plus (meanself-regulation 0.15, SD 0.42; meanweight −1.9, SD 3.9; and meanbehaviors 0.29, SD 0.29) and waiting list condition (meanself-regulation −0.02, SD 0.29; meanweight −0.01, SD 0.51; and meanbehaviors 0.08, SD 0.38). Participants who reported the largest improvements, on average, viewed pages 2 to 3 times more, had 2 to 3 times more log-ins, logged their weight 2 to 3 times more, and achieved the tips more than those who reported smaller changes in these outcomes. According to users’ feedback, engagement with the app could be increased by making the app more interactive and allowing more tailoring. ConclusionsThis study suggests that the Top Tips app could potentially be a useful intervention for promoting eating self-regulatory skills, weight loss, and weight management behaviors among adults with overweight or obesity. Future research should develop the app further based on user feedback and test it in larger sample sizes. Trial RegistrationISRCTN Registry ISRCTN10470937; http://www.isrctn.com/ISRCTN10470937 (Archived by Webcite at http://www.webcitation.org/76j6rQibI)

PurposeCT ventilation imaging (CTVI) is being used to achieve functional avoidance lung cancer radiation therapy in three clinical trials (NCT02528942, NCT02308709, NCT02843568). To address the need for common CTVI validation tools, we have built the Ventilation And Medical Pulmonary Image Registration Evaluation (VAMPIRE) Dataset, and present the results of the first VAMPIRE Challenge to compare relative ventilation distributions between different CTVI algorithms and other established ventilation imaging modalities.MethodsThe VAMPIRE Dataset includes 50 pairs of 4DCT scans and corresponding clinical or experimental ventilation scans, referred to as reference ventilation images (RefVIs). The dataset includes 25 humans imaged with Galligas 4DPET/CT, 21 humans imaged with DTPA-SPECT, and 4 sheep imaged with Xenon-CT. For the VAMPIRE Challenge, 16 subjects were allocated to a training group (with RefVI provided) and 34 subjects were allocated to a validation group (with RefVI blinded). Seven research groups downloaded the Challenge dataset and uploaded CTVIs based on deformable image registration (DIR) between the 4DCT inhale/exhale phases. Participants used DIR methods broadly classified into B-splines, Free-form, Diffeomorphisms, or Biomechanical modeling, with CT ventilation metrics based on the DIR evaluation of volume change, Hounsfield Unit change, or various hybrid approaches. All CTVIs were evaluated against the corresponding RefVI using the voxel-wise Spearman coefficient rS , and Dice similarity coefficients evaluated for low function lung ( DSClow ) and high function lung ( DSChigh ).ResultsA total of 37 unique combinations of DIR method and CT ventilation metric were either submitted by participants directly or derived from participant-submitted DIR motion fields using the in-house software, VESPIR. The rS and DSC results reveal a high degree of inter-algorithm and intersubject variability among the validation subjects, with algorithm rankings changing by up to ten positions depending on the choice of evaluation metric. The algorithm with the highest overall cross-modality correlations used a biomechanical model-based DIR with a hybrid ventilation metric, achieving a median (range) of 0.49 (0.27-0.73) for rS , 0.52 (0.36-0.67) for DSClow , and 0.45 (0.28-0.62) for DSChigh . All other algorithms exhibited at least one negative rS value, and/or one DSC value less than 0.5.ConclusionsThe VAMPIRE Challenge results demonstrate that the cross-modality correlation between CTVIs and the RefVIs varies not only with the choice of CTVI algorithm but also with the choice of RefVI modality, imaging subject, and the evaluation metric used to compare relative ventilation distributions. This variability may arise from the fact that each of the different CTVI algorithms and RefVI modalities provides a distinct physiologic measurement. Ultimately this variability, coupled with the lack of a "gold standard," highlights the ongoing importance of further validation studies before CTVI can be widely translated from academic centers to the clinic. It is hoped that the information gleaned from the VAMPIRE Challenge can help inform future validation efforts.

In response to the COVID-19 pandemic, a temporary change in policy was implemented in 2020. Breast screening services in England were advised to change from timed appointments to an open invitation for invitees to contact the service and arrange an appointment. This change to invitation methodology had potential benefits and risks including impacting inequalities in uptake. Qualitative data were collected by online questionnaire from 23 service providers and routinely collected quantitative uptake data were analysed to investigate the impact of open invitations on the National Programme in the South of England. Office for National Statistics and general practitioner (GP) practice profile data enabled the modelling of sociodemographic characteristics of breast screening invitees at each GP practice. Most services changed to open invitations (17/23), 82% of which altered administrative capacity and/or procedures to accommodate this change. Logistic benefits were reported including a more consistent flow of participants, fewer long gaps and fewer wasted slots. The change to open invitations was associated with a 7.2% reduction in the percentage of participants screened, accounting for participant sociodemographics and historical screening provider uptake. The inequality in screening uptake experienced by participants of minority ethnic background was exacerbated by the change to open invitations. Open invitations, whilst affording logistic benefits in an unprecedented pandemic era, were associated with reduced overall uptake and exacerbation of existing health inequality experienced by women of minority ethnic background. The broader impact on services highlighted the need for sustainability of measures taken to accommodate such operational changes. [ABSTRACT FROM AUTHOR]

The Australian Bureau of Meteorology has developed a national hydrological projections (NHP) service for Australia. The NHP aimed to provide nationally consistent hydrological projections across jurisdictional boundaries to support planning of water-dependent industries. NHP is complementary to those previously produced by federal and state governments, universities, and other organisations for limited geographical domains. The projections comprise an ensemble of application-ready bias-corrected climate model data, derived hydrological projections at daily temporal and 0.05° × 0.05° spatial resolution for the period 1960–2099, and two emission scenarios (Representative Concentration Pathway (RCP) 4.5 and RCP8.5). The spatial resolution of the projections matches that of gridded historical reference data used to perform the bias correction and the Bureau of Meteorology's operational gridded hydrological model. Three bias correction techniques were applied to four CMIP5 global climate models (GCMs), and one method was applied to a regional climate model (RCM) forced by the same four GCMs, resulting in a 16-member ensemble of bias-corrected GCM data for each emission scenario. The bias correction was applied to fields of precipitation, minimum and maximum temperature, downwelling shortwave radiation, and surface winds. These variables are required inputs to the Bureau of Meteorology's landscape water balance hydrological model (AWRA-L), which was forced using the bias-corrected GCM and RCM data to produce a 16-member ensemble of hydrological output. The hydrological output variables include root zone soil moisture (moisture in the top 1 m soil layer), potential evapotranspiration, and runoff. Here we present an overview of the production of the hydrological projections, including GCM selection, bias correction methods and their evaluation, technical aspects of their implementation, and examples of analysis performed to construct the NHP service. The data are publicly available on the National Computing Infrastructure (10.25914/6130680dc5a51, Bureau of Meteorology, 2021), and a user interface is accessible at https://awo.bom.gov.au/products/projection/ (last access: 24 November 2023). [ABSTRACT FROM AUTHOR]

In response to flood risk, design flood estimation is a cornerstone of planning, infrastructure design, setting of insurance premiums, and emergency response planning. Under stationary assumptions, flood guidance and the methods used in design flood estimation are firmly established in practice and mature in their theoretical foundations, but under climate change, guidance is still in its infancy. Human-caused climate change is influencing factors that contribute to flood risk such as rainfall extremes and soil moisture, and there is a need for updated flood guidance. However, a barrier to updating flood guidance is the translation of the science into practical application. For example, most science pertaining to historical changes to flood risk focuses on examining trends in annual maximum flood events or the application of non-stationary flood frequency analysis. Although this science is valuable, in practice, design flood estimation focuses on exceedance probabilities much rarer than annual maximum events, such as the 1 % annual exceedance probability event or even rarer, using rainfall-based procedures, at locations where there are few to no observations of streamflow. Here, we perform a systematic review to summarize the state-of-the-art understanding of the impact of climate change on design flood estimation in the Australian context, while also drawing on international literature. In addition, a meta-analysis, whereby results from multiple studies are combined, is conducted for extreme rainfall to provide quantitative estimates of possible future changes. This information is described in the context of contemporary design flood estimation practice to facilitate the inclusion of climate science into design flood estimation practice. [ABSTRACT FROM AUTHOR]

Athletes report poor breast/bra knowledge, breast pain, sports bras causing lacerations and chafing, negatively affecting sports performance. No bra interventions to address these issues are reported. Working with 142 UK female athletes preparing for Tokyo Olympics/Paralympics (27 sports), this multi-phase intervention assessed breast/bra knowledge, preferences, issues via surveys and breast/bra assessments. Data were used to develop two sports bras. A total of 112 athletes were prescribed one of the new bras through individual assessments. After four weeks, wear athletes completed evaluations. Pre-intervention breast/bra knowledge was low (83% ≤average), multiple breast/bra issues were reported and most athletes wore ill-fitting, loose bras, offering limited support. Post-intervention, 63% reported improved knowledge and 97% reported their prescribed bra as better than their original bra. Eighty-seven per cent reported benefitting from this intervention, with 17% reporting improved performance. This intervention effectively assessed sports bra needs, developed and implemented solutions, which improved knowledge and potentially performance for some UK athletes. [ABSTRACT FROM AUTHOR]