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BACKGROUND: Most smartphones and wearables are currently equipped with location sensing (using GPS and mobile network information), which enables continuous location tracking of their users. Several studies have reported that various mobility metrics, as well as home stay, that is, the amount of time an individual spends at home in a day, are associated with symptom severity in people with major depressive disorder (MDD). Owing to the use of small and homogeneous cohorts of participants, it is uncertain whether the findings reported in those studies generalize to a broader population of individuals with MDD symptoms.; OBJECTIVE: The objective of this study is to examine the relationship between the overall severity of depressive symptoms, as assessed by the 8-item Patient Health Questionnaire, and median daily home stay over the 2 weeks preceding the completion of a questionnaire in individuals with MDD.; METHODS: We used questionnaire and geolocation data of 164 participants with MDD collected in the observational Remote Assessment of Disease and Relapse-Major Depressive Disorder study. The participants were recruited from three study sites: King's College London in the United Kingdom (109/164, 66.5%); Vrije Universiteit Medisch Centrum in Amsterdam, the Netherlands (17/164, 10.4%); and Centro de Investigacion Biomedica en Red in Barcelona, Spain (38/164, 23.2%). We used a linear regression model and a resampling technique (n=100 draws) to investigate the relationship between home stay and the overall severity of MDD symptoms. Participant age at enrollment, gender, occupational status, and geolocation data quality metrics were included in the model as additional explanatory variables. The 95% 2-sided CIs were used to evaluate the significance of model variables.; RESULTS: Participant age and severity of MDD symptoms were found to be significantly related to home stay, with older (95% CI 0.161-0.325) and more severely affected individuals (95% CI 0.015-0.184) spending more time at home. The association between home stay and symptoms severity appeared to be stronger on weekdays (95% CI 0.023-0.178, median 0.098; home stay: 25th-75th percentiles 17.8-22.8, median 20.9 hours a day) than on weekends (95% CI -0.079 to 0.149, median 0.052; home stay: 25th-75th percentiles 19.7-23.5, median 22.3 hours a day). Furthermore, we found a significant modulation of home stay by occupational status, with employment reducing home stay (employed participants: 25th-75th percentiles 16.1-22.1, median 19.7 hours a day; unemployed participants: 25th-75th percentiles 20.4-23.5, median 22.6 hours a day).; CONCLUSIONS: Our findings suggest that home stay is associated with symptom severity in MDD and demonstrate the importance of accounting for confounding factors in future studies. In addition, they illustrate that passive sensing of individuals with depression is feasible and could provide clinically relevant information to monitor the course of illness in patients with MDD. ©Petroula Laiou, Dzmitry A Kaliukhovich, Amos A Folarin, Yatharth Ranjan, Zulqarnain Rashid, Pauline Conde, Callum Stewart, Shaoxiong Sun, Yuezhou Zhang, Faith Matcham, Alina Ivan, Grace Lavelle, Sara Siddi, Femke Lamers, Brenda WJH Penninx, Josep Maria Haro, Peter Annas, Nicholas Cummins, Srinivasan Vairavan, Nikolay V Manyakov, Vaibhav A Narayan, Richard JB Dobson, Matthew Hotopf, RADAR-CNS. Originally published in JMIR mHealth and uHealth (https://mhealth.jmir.org), 28.01.2022.

BACKGROUND: Major Depressive Disorder (MDD) is prevalent, often chronic, and requires ongoing monitoring of symptoms to track response to treatment and identify early indicators of relapse. Remote Measurement Technologies (RMT) provide an opportunity to transform the measurement and management of MDD, via data collected from inbuilt smartphone sensors and wearable devices alongside app-based questionnaires and tasks. A key question for the field is the extent to which participants can adhere to research protocols and the completeness of data collected. We aimed to describe drop out and data completeness in a naturalistic multimodal longitudinal RMT study, in people with a history of recurrent MDD. We further aimed to determine whether those experiencing a depressive relapse at baseline contributed less complete data. METHODS: Remote Assessment of Disease and Relapse - Major Depressive Disorder (RADAR-MDD) is a multi-centre, prospective observational cohort study conducted as part of the Remote Assessment of Disease and Relapse - Central Nervous System (RADAR-CNS) program. People with a history of MDD were provided with a wrist-worn wearable device, and smartphone apps designed to: a) collect data from smartphone sensors; and b) deliver questionnaires, speech tasks, and cognitive assessments. Participants were followed-up for a minimum of 11 months and maximum of 24 months. RESULTS: Individuals with a history of MDD (n = 623) were enrolled in the study,. We report 80% completion rates for primary outcome assessments across all follow-up timepoints. 79.8% of people participated for the maximum amount of time available and 20.2% withdrew prematurely. We found no evidence of an association between the severity of depression symptoms at baseline and the availability of data. In total, 110 participants had > 50% data available across all data types. CONCLUSIONS: RADAR-MDD is the largest multimodal RMT study in the field of mental health. Here, we have shown that collecting RMT data from a clinical population is feasible. We found comparable levels of data availability in active and passive forms of data collection, demonstrating that both are feasible in this patient group.

Action Medical Research and the Chartered Society of Physiotherapy Charitable Trust; The Henry Smith Charity (GN2340).

Clinical trial registration number ISRCTN90378161. © 2019 The Authors. Published by Elsevier Ltd on behalf of Chartered Society of Physiotherapy. Objectives The aim of this study was to examine the validity of the International Physical Activity Questionnaire Short Form (IPAQ-SF) as a measure of physical activity (PA) in young people with cerebral palsy (CP). Design Cross-sectional. Setting Participants were recruited through 8 National Health Service (NHS) trusts, one school, one university and through organisations that provide services for people with disabilities in England. Participants Sixty-four, ambulatory young people aged 10-19 years with CP [Gross Motor Function Classification System (GMFCS) levels I–III] participated in this study. Main outcome measure The IPAQ-SF was administered to participants. Participants were then asked to wear a wGT3X-BT triaxial accelerometer (ActiGraph, Pensacola, FL) for 7 days to objectively assess PA. Time spent in sedentary behaviour, in moderate to vigorous PA (MVPA) and in total PA (TPA) was compared between measures. Results Young people with CP self-reported less time in sedentary behaviour and underestimated the time spent in TPA,when compared to accelerometer measurements. Bland-Altman plots demonstrated poor agreement between the measures for MVPA, with upper and lower 95% limits of agreement of -147.23 to 148.9 min. After adjusting for gender and GMFCS level, age was a predictor of the difference between measures for MVPA (p

Objectives: The purpose of this study was to explore experiences of people with multiple sclerosis (MS) who participated in iStep-MS, a feasibility randomized controlled trial of a behaviour-change intervention that aimed to increase physical activity and reduce sedentary behaviour. Design: A qualitative approach was undertaken embedded in the feasibility randomised controlled trial. One-to-one semi-structured interviews were conducted and analysed using Framework analysis. Setting: Participants were recruited from a single MS therapy centre in the southeast of England, UK. Participants: Sixty people with MS were randomly allocated in a 1:1 ratio to the intervention or usual care. Following a purposive sampling strategy, 15 participants from the intervention arm undertook 1:1 semi-structured interviews. Interventions: The iStep-MS intervention consisted of four therapist-led sessions over 12 weeks, supported by a handbook and pedometer. Results: Three themes were identified from the data. “I can do this”: Developing competence in physical activity (PA) highlights the enhanced physical activity confidence gained through goal setting and accomplishment. I felt valued”: the nurturing culture provides an overview of the supportive and non-judgemental environment created by the programme structure and therapeutic relationship. Finally, “What can I do?”: empowered enactment describes the transition from the supported iStep-MS intervention to intrinsically motivated physical activity enactment. Conclusions:Overall, this study supports the acceptability of the iStep-MS intervention and identified key areas that supported participants to be physically active. Changing physical activity behaviour in people with MS through increasing steps: iSTEP-MS

INTRODUCTION:Muscle volume (MV) is an important parameter for understanding muscle morphology and adaptations to training, growth and pathology. In this study, we assessed the validity of freehand 3D ultrasound (3DUS) for measuring medial gastrocnemius MV in adults, typically developing children (TD) and children with cerebral palsy (CP). We also assessed the validity between our direct measures of MV and estimates derived from anatomical cross sectional area (ACSA) and muscle length (ML), using previously outlined methods. MATERIALS AND METHODS:The medial gastrocnemius of all groups was scanned with 3DUS and MRI. Images from both methods were digitised to derive MV, ACSA and ML. Measured MV was compared between methods and compared to estimated MV derived from recently published algorithms. RESULTS:MV had a mean difference of -0.13% (standard error of estimate (SEE)=2.23%, R2 =0.99) between MRI and 3DUS and 19.82% (SEE=4.73% and R2 =0.99) and -3.11% (SEE=6.55%, R2 =0.99) mean differences between the measured and estimated MV from two methods of estimation. CONCLUSIONS:The 3DUS is a valid method for the measurement of MV in adults, TD children and those with CP. Estimation methods of MV may be useful in clinical practise, but require further replication on various populations and careful methodological consideration. This article is protected by copyright. All rights reserved.

Anaerobic and aerobic bacteria were quantitated in respiratory samples across three cystic fibrosis (CF) centres using extended culture methods. Subjects aged 1–69 years who were clinically stable provided sputum (n=200) or bronchoalveolar lavage (n=55). 18 anaerobic and 39 aerobic genera were cultured from 59% and 95% of samples, respectively; 16 out of 57 genera had a 5% prevalence across centres. Analyses of microbial communities using co-occurrence networks in sputum samples showed groupings of oral, including anaerobic, bacteria, whereas typical CF pathogens formed distinct entities. Pseudomonas was associated with worse nutrition and F508del genotype, whereas anaerobe prevalence was positively associated with pancreatic sufficiency, better nutrition and better lung function. A higher total anaerobe/ total aerobe CFU ratio was associated with pancreatic sufficiency and better nutrition. Subjects grouped by factor analysis who had relative dominance of anaerobes over aerobes had milder disease compared with a Pseudomonas-dominated group with similar proportions of subjects that were homozygous for F508del. In summary, anaerobic bacteria occurred at an early age. In sputum-producing subjects anaerobic bacteria were associated with milder disease, suggesting that targeted eradication of anaerobes may not be warranted in sputum-producing CF subjects.

Copyright © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. Introduction: Although physical activity may reduce disease burden, fatigue and disability, and improve quality of life among people with multiple sclerosis (MS) many people with MS are physically inactive and spend significant time in sedentary behaviour. Behaviour-change interventions may assist people with MS to increase physical activity and reduce sedentary behaviour. However, few studies have investigated their effectiveness using objective measures of physical activity, particularly in the long-term. Further, interventions that have proven effective in the short-term may not be feasible in clinical practice because of the large amount of support provided. The iStep-MS trial aims to determine the safety, feasibility and acceptability of a behaviour-change intervention to increase physical activity and reduce sedentary behaviour among people with MS. Methods and analysis: Sixty people with MS will be randomised (1:1 ratio) to receive a 12-week intervention or usual care only. The intervention consists of four physical activity consultations with a physiotherapist supported by a handbook and pedometer. Outcomes assessed at baseline, 12 weeks and 9 months are physical activity (Actigraph GT3x-BT accelerometer), sedentary behaviour (activPAL3µ), self-reported activity and sitting time, walking capability, fatigue, self-efficacy, participation, quality of life, health service use. The safety of the intervention will be determined by assessing change in pain and fatigue and the incidence of adverse events during the follow-up period. A parallel process evaluation will assess the feasibility and acceptability of the intervention through assessment of fidelity to the programme and semi-structured interviews exploring participants’ and therapists’ experiences of the intervention. The feasibility of conducting an economic evaluation will be determined by collecting data on quality of life and resource use. Ethics and dissemination: Research Ethics Committee approval has been granted from Brunel University London. Results of the trial will be submitted for publication in journals, and distributed to people with MS and physiotherapists. This study is funded by a project grant from the MS Society, UK (award reference: 53).

Our study aimed to assess resting state modifications across known brain networks after an extensive period of physical exercise and to investigate their correlations with behavioural measures of mood state and perceived health.

The pathogenicity of mouse hepatitis virus (MHV-1) was studied following treatment with triolein and cortisone which, respectively, stimulated and suppressed phagocytic activity of the reticuloendothelial system (RES) as measured by clearance of colloidal carbon. When inoculated i.p., triolein moderately enhanced RES activity of germfree mice, while exerting no significant effect in conventional mice. In both groups of mice, however, protection was found against an i.p. challenge of virus. Cortisone greatly suppressed RES activity and significantly increased susceptibility of germfree and conventional mice to MHV-1. Triolein also was found to protect mice against the combined challenge of cortisone plus virus. However, triolein, whether injected i.p. or i.v., failed to protect against an i.v. challenge of virus. These data support two conclusions: (1) triolein exerted its protective effect at some site other than the macrophages of the liver; (2) protection against MHV-1 infection following triolein treatment was not related to the carbon clearing activity of the RES.