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Congenital hyperinsulinism is the leading cause of persistent hypoglycaemia in infants and children; however, it is uncommon to be diagnosed in adulthood. We describe the cases of two sisters who presented with hyperinsulinaemic hypoglycaemia aged 47 and 57 years old, who were subsequently diagnosed with compound heterozygous likely pathogenic variants in the ABCC8 gene, a known cause of monogenic congenital hyperinsulinism. We discuss the typical presenting features, investigation findings, and treatment strategies for patients with this condition.

Bimodal bilingualism involves the use of a sign language and a spoken language, and offers a unique opportunity to explore the cognitive effects of growing up bilingual. The aim of this study was to investigate the relationship between bimodal bilingualism and executive function (EF) in hearing children who are native users of a sign language. We studied three groups of children: bimodal bilinguals (users of a sign language and a spoken language), unimodal bilinguals (users of two spoken languages), and monolinguals, performing three cognitive tasks to measure different components of EF: visuospatial working memory (Odd One Out task), cognitive flexibility (Children's Colored Trails Test) and conflict resolution (Simon task). All groups of children obtained similar scores on the Odd One Out task and the Children's Colored Trails Test. Bimodal bilinguals displayed distinct patterns of conflict resolution in comparison to monolingual children: bimodal bilinguals had better overall accuracy and slower overall reaction time in the Simon task. The subsequent analysis did not find a straightforward trade-off between speed and accuracy. These results suggest that bimodal language experience and/or visual-spatial language usage may explain the small bimodal bilingual advantage in the Simon task that we observed in hearing children who are native signers.

BackgroundThe prevalence of knee osteoarthritis (KOA) in the adult population is high and patients profit from individualized therapy approaches. Just-in-time adaptive interventions (JITAIs) are upcoming digital interventions for behavior change. ObjectiveThis systematic review summarizes the features and effectiveness of existing JITAIs regarding important physiological health outcomes and derives the most promising features for the use case of KOA. MethodsThe electronic databases PubMed, Web of Science, Scopus, and EBSCO were searched using keywords related to JITAIs, physical activity (PA), sedentary behavior (SB), physical function, quality of life, pain, and stiffness. JITAIs for adults that focused on the effectiveness of at least 1 of the selected outcomes were included and synthesized qualitatively. Study quality was assessed with the Quality Assessment Tool Effective Public Health Practice Project. ResultsA total of 45 studies with mainly weak overall quality were included in this review. The studies were mostly focused on PA and SB and no study examined stiffness. The design of JITAIs varied, with a frequency of decision points from a minute to a day, device-based measured and self-reported tailoring variables, intervention options including audible or vibration prompts and tailored feedback, and decision rules from simple if-then conditions based on 1 variable to more complex algorithms including contextual variables. ConclusionsThe use of frequent decision points, device-based measured tailoring variables accompanied by user input, intervention options tailored to user preferences, and simple decision rules showed the most promising results in previous studies. This can be transferred to a JITAI for the use case of KOA by using target variables that include breaks in SB and an optimum of PA considering individual knee load for the health benefits of patients.

The aim of this study is twofold: To examine if deafness is invariably associated with deficits in executive function (EF) and to investigate the relationship between sign language proficiency and EF in deaf children of deaf parents with early exposure to a sign language. It is also the first study of EF in children acquiring Polish Sign Language. Even though the mothers of the deaf children (N = 20) had lower levels of education compared with the mothers of a hearing control group, the children performed similarly to their hearing peers (N = 20) on a variety of EF task-based assessments. Only in the Go/No-go task were weaker inhibition skills observed in younger deaf children (6-9 years) compared with hearing peers, and this difference was not seen in older children (10-12 years). Hence, deafness does not necessarily impair EF; however, attentional and inhibition abilities may be acquired via a different route in deaf children. Sign language receptive skills predicted EF in deaf children. In conclusion, we highlight the importance of deaf parenting building the scaffolding for EF in deaf children.

Abstract Objectives To examine the longitudinal associations between fitness and metabolic syndrome (MetS) in community-dwelling adults over 29 years of follow-up. Design Ongoing, population-based cohort study of adults aged ≥ 33 years at baseline residing in the city of Bad Schönborn, Germany. Methods The sample comprised 89 persons (41 females; mean age 40.1 years at baseline) who participated at baseline (in the year 1992) and 29-years follow-up (in the year 2021). Fitness (predictor variable) was assessed using 15 standardized and validated tests that measured strength, gross motor coordination, mobility/ flexibility and cardiorespiratory fitness/ endurance, and a z-transformed fitness score was calculated for analysis. MetS (outcome of interest) was assessed through five criteria related to waist circumference, blood glucose, HDL cholesterol, triglycerides, and blood pressure, and a sum score was created for analysis. We ran partial correlations to examine the association between fitness score at baseline and MetS score at 29-years follow-up, adjusted for age, sex, socio-economic status, smoking status, sleep quality, and physical activity engagement in minutes/ week. Results A higher fitness score at baseline was significantly associated with a lower MetS score indicative of better metabolic health at 29-years follow-up (r=-0.29; p = 0.011). These associations were present in participants aged ≤ 40 years (r=-0.33; p = 0.025) as well as those aged > 40 years (r=-0.43; p = 0.045). Conclusions Fitness may be a predictor of longitudinal metabolic health, and potentially also mediates previously reported longitudinal associations between physical activity and metabolic health. More research is needed to confirm these observations, and to also explore underlying mechanisms.

PurposeThe aim of this study was to assess the concurrent validity of a contact mat against force plates to measure jump height in countermovement jump (CMJ) and squat jump (SJ) in professional soccer players.Methods23 male professional soccer players performed the CMJ and SJ, which were concurrently recorded using a portable contact mat (SmartJump) and a portable dual force plate system (ForceDecks). Equivalence testing between both systems (contact mat vs. force plate) and the two methods (impulse-momentum vs. flight-time and flight-time vs. flight-time) was performed compared to equivalence bounds of ±1.1 cm for the CMJ and ±1.6 cm for the SJ. Additionally, 95% Limits of Agreement (LoA) and intraclass correlation coefficients (ICC) were computed.ResultsMean differences for the impulse-momentum vs. flight-time comparison for CMJ [3.2 cm, 95% CI (2.3–4.1)] and SJ [2.7 cm, (1.8–3.6)] were non-equivalent between both systems. LoA were larger than the equivalence bunds for CMJ and SJ, while ICCs were good [CMJ, 0.89, (0.76–0.95)] and excellent [SJ, 0.91, (0.79–0.96)]. As for the flight-time vs. flight-time comparison, mean differences were non-equivalent for the CMJ [1.0 cm (0.8 to 1.2 cm)] and equivalent for the SJ [0.9 cm (0.7–1.1 cm)]. LoA were narrower than the equivalence bounds for CMJ and SJ, while ICCs were excellent [CMJ, 0.995, 95% CI (0.989–0.998); SJ, 0.997, 95% CI (0.993–0.997)].ConclusionOur findings indicate that the SmartJump contact mat cannot be used interchangeably with the ForceDecks force platform to measure jump height for the CMJ and SJ.

Abstract Milk fat globules and casein micelles are the dispersed particles of milk that are responsible for its typical white turbid appearance and usually make it difficult to treat with modern ultraviolet light (UV) preservation techniques. The translucency of milk depends largely on the refractive indices of the dispersed particles, which are directly affected by temperature changes, as incorporated triglycerides can crystallize, melt or transition into other polymorphs. These structural changes have a significant effect on the scattering properties and thus on the UV light propagation in milk, especially by milk fat globules. In this study, a temporary minimum in the optical density of milk was observed within UV wavelength at 14 °C when heating the milk from 6 to 40 °C. This anomaly is consistent with structural changes detected by a distinct endothermic peak at 14 °C using differential scanning calorimetry. Apparently, the optical density anomaly between 10 and 20 °C disappears when the polymorphic transition already has proceeded through previous isothermal equilibration. Thus, melting of equilibrated triglycerides may not affect the RI of milk fat globules at ca. 14 °C as much as melt-mediated polymorphic transitioning. An increased efficiency of UV-C preservation (254 nm) at the translucency optimum was demonstrated by temperature-dependent microbial inactivation experiments.

Deaf professionals, whom we term Deaf Language Specialists (DLS), are frequently employed to work with children and young people who have difficulties learning sign language, but there are few accounts of this work in the literature. Through questionnaires and focus groups, 23 DLSs described their work in this area. Deductive thematic analysis was used to identify how this compared to the work of professionals (typically Speech and Language Therapists/Pathologists, SLPs) working with hearing children with difficulties learning spoken language. Inductive thematic analysis resulted in the identification of two additional themes: while many practices by DLSs are similar to those of SLPs working with hearing children, a lack of training, information, and resources hampers their work; additionally, the cultural context of language and deafness makes this a complex and demanding area of work. These findings add to the limited literature on providing language interventions in the signed modality with clinical implications for meeting the needs of deaf and hard-of-hearing children who do not achieve expectations of learning a first language in their early years. The use of these initial results in two further study phases to co-deliver interventions and co-produce training for DLSs is briefly described.

BackgroundNumerous smartphone apps are targeting physical activity (PA) and healthy eating (HE), but empirical evidence on their effectiveness for the initialization and maintenance of behavior change, especially in children and adolescents, is still limited. Social settings influence individual behavior; therefore, core settings such as the family need to be considered when designing mobile health (mHealth) apps. ObjectiveThe purpose of this study was to evaluate the effectiveness of a theory- and evidence-based mHealth intervention (called SMARTFAMILY [SF]) targeting PA and HE in a collective family–based setting. MethodsA smartphone app based on behavior change theories and techniques was developed, implemented, and evaluated with a cluster randomized controlled trial in a collective family setting. Baseline (t0) and postintervention (t1) measurements included PA (self-reported and accelerometry) and HE measurements (self-reported fruit and vegetable intake) as primary outcomes. Secondary outcomes (self-reported) were intrinsic motivation, behavior-specific self-efficacy, and the family health climate. Between t0 and t1, families of the intervention group (IG) used the SF app individually and collaboratively for 3 consecutive weeks, whereas families in the control group (CG) received no treatment. Four weeks following t1, a follow-up assessment (t2) was completed by participants, consisting of all questionnaire items to assess the stability of the intervention effects. Multilevel analyses were implemented in R (R Foundation for Statistical Computing) to acknowledge the hierarchical structure of persons (level 1) clustered in families (level 2). ResultsOverall, 48 families (CG: n=22, 46%, with 68 participants and IG: n=26, 54%, with 88 participants) were recruited for the study. Two families (CG: n=1, 2%, with 4 participants and IG: n=1, 2%, with 4 participants) chose to drop out of the study owing to personal reasons before t0. Overall, no evidence for meaningful and statistically significant increases in PA and HE levels of the intervention were observed in our physically active study participants (all P>.30). ConclusionsDespite incorporating behavior change techniques rooted in family life and psychological theories, the SF intervention did not yield significant increases in PA and HE levels among the participants. The results of the study were mainly limited by the physically active participants and the large age range of children and adolescents. Enhancing intervention effectiveness may involve incorporating health literacy, just-in-time adaptive interventions, and more advanced features in future app development. Further research is needed to better understand intervention engagement and tailor mHealth interventions to individuals for enhanced effectiveness in primary prevention efforts. Trial RegistrationGerman Clinical Trials Register DRKS00010415; https://drks.de/search/en/trial/DRKS00010415 International Registered Report Identifier (IRRID)RR2-10.2196/20534

Abstract Objectives Hyperpyrexia has been associated with a greater prevalence of bacterial infections in the pediatric population, which prior to routine childhood vaccinations, has led to invasive testing and empiric antibiotic use for urinary tract infections, bacterial pneumonia, bacteremia, and bacterial meningitis. Since the implementation of routine childhood vaccinations, the prevalence of serious bacterial infections (SBIs) has declined. This study aims to determine if there is an association between hyperpyrexia and serious bacterial infections in well‐appearing febrile pediatric patients presenting to the emergency department (ED). Methods This is a cross‐sectional study conducted between January 1, 2019, and December 31, 2019, at a single urban tertiary care pediatric ED. Patients were included if they were between 61 days and ≤18 years old presenting with a chief complaint of fever. Patients were excluded if they received antibiotics within 3 days of presentation, underwent surgical procedures within 2 weeks of presentation, had an ED visit for febrile illness within 2 weeks of study visit, were transferred from another institution, or were ill appearing. Prevalence of SBI was described and compared by presence of hyperpyrexia, age group, chronic medical condition, gender, and vaccination status. Logistic regression was used to analyze the association between SBIs and hyperpyrexia. Results Of the 3862 charts reviewed, 2565 patients were included. The prevalence of SBI was 5.6%. A total of 413 patients presented with hyperpyrexia. Of the patients with hyperpyrexia, 31 (7.5%) had a serious bacterial infection. Hyperpyrexia was not significantly associated with SBIs in our logistic regression models (adjusted Odds Ratio 1.40, 95% confidence interval 0.92–2.12). Conclusions Serious bacterial infections were uncommon in our population. There is no statistically significant association between hyperpyrexia and SBIs in well‐appearing pediatric patients presenting to the ED with fever. The lack of a statistically significant association between hyperpyrexia and SBIs argues that clinicians should be cautious using hyperpyrexia as an independent risk factor for SBIs. More research is needed to identify independent and grouped SBI risk factors in well‐appearing pediatric patients presenting to the ED.

In recent decades, the field of sports science has emerged as a discipline characterised by a substantial accumulation of data at the intersection of social and natural sciences. This wealth of data has contributed significantly to our understanding of human performance, training methods, health and well-being and other sport-related phenomena. Data on motor performance have been collected in numerous national and international projects over several decades. The Institute of Sports and Sports Science (IfSS) at the Karlsruhe Institute of Technology (KIT) is one of the largest research centres for human motor performance testing and has funded the Competence Centre for Motor Performance and Motor Testing (KOMET). In 2013, the project group of Klaus Bös and Claudia Niessner registered the need of data management for motor test data in sports science. They started the project “eResearch infrastructure for motor research data”, which was funded by the German Research Foundation in two funding periods from 2014 to 2023. The MO|RE data1 repository emerged from this project. MO|RE data is the first disciplinary repository in sports science and offers these features: publication, search, citation, storage, mapping and harmonisation. During its development and subsequent implementation, it has raised many questions. In general, the basic functions of a repository are well understood, as its overall purpose is clear. However, it is crucial to address the specific needs of the sports science community and different target groups to ensure the repository’s practical utility post-publication. This includes considerations such as data harmonisation through standardisation to a common unit, linking datasets from different surveys, and other measures to enhance usability. With the development of MO|RE data, the project group started an experiment on how specific a repository can be in order to have a defined target group and to address a specific need, and at the same time to be used by enough users to still be relevant and used in the future. Now, MO|RE data has to make the step from project object to routine operation.

Background: Urban and rural areas have been experiencing major demographic and structural changes, characterized by an aging population in rural areas and a growth of cities in number and size. However, it is poorly researched how children's physical activity and screen time developed in urban and rural areas. To address this deficit, we investigated physical activity and screen-time trends in Germany's pediatric population across four urbanicity levels (rural, small town, medium-sized town, city). Method: We obtained weighted data at three cross-sectional timepoints between 2003 and 2017, representative for Germany's child and adolescent population. Physical activity and screen time were self-reported. We analyzed trends using a structural equation modeling framework for the overall sample and calculated interactions between the trends and age and gender, respectively. Results: In total, 12,161 children and adolescents between 4 and 17 years participated in the study. Children and adolescents in rural areas experienced a downward trend in total physical activity. Outdoor play and leisure-time physical activity decreased across all areas, with the strongest decline in rural areas. Computer and gaming time increased across all areas except for cities, with the sharpest increase in rural areas. The decline in outdoor play and the incline in computer and gaming time were driven by adolescents. Females showed stronger increases in computer and gaming time than males. Conclusion: Our findings suggest that in a representative sample of children and adolescents in Germany, detrimental trends in children's physical activity and screen time occur at a higher rate in rural areas compared with urban environments. This provides critical information for health policy: While all children and adolescents should be targeted for physical activity promotion, a special focus should be on tailoring interventions for rural areas to prevent and mitigate inequalities in physical activity across urban and rural areas.

Abstract Background Interdisciplinary cooperation among university actors and resulting intersectoral synergies are considered cornerstones in the process of incorporating health promotion practices in everyday university life in order to break down barriers and provide better access to health promotion services. To date, no network of a health-promoting university has been examined regarding the processes underlying tie formation, network emergence, and maintenance. Objectives and methods The goals of this study are to obtain insight into the mechanisms of cooperation between university actors in a health-promoting network and to identify the structural and attributive factors associated with establishing cooperation between actors in the observed network in order to better understand how to build and develop successful networks in the future. For this purpose, a social network analysis was carried out and exponential random graph models were estimated to test corresponding hypotheses. Results The network at hand consists of 33 actors (e.g. University Sports Center, General Student Committee) and shows a flat, non-hierarchical structure. Data reveal that attributed competence predicts cooperation (0.32; p

I denne artikkelen undersøker vi beboeres erfaringer med en omfattende rehabiliteringsprosess i en kommunal leiegård under koronapandemien. Gjennom kvalitative intervjuer med beboerne utforsker vi hvordan de har opplevd denne tiden, og hvordan det å være leieboer kan ha påvirket opplevelser og tolkningen av prosessen. Ved hjelp av symbolsk antropologi fokuserer analysen på forskjellige grenser som ble utfordret, og hvordan opprettholdelsen av disse grensene påvirket beboernes livskvalitet, trygghet og verdighet under rehabiliteringsprosessen. Beboerne opplevde prosessen som særlig utfordrende under den sosiale nedstengningen. De levde uten dagslys i flere måneder, og de opplevde at de ble frarøvet trygghet og kontroll over sitt hjem og privatliv. Kaos trengte inn i hjemmene i form av støy, støv og arbeidere. Beboernes sosioøkonomiske situasjon gjorde at det var ekstra utfordrende å skjerme seg fra situasjonen. Beboerne var i liten grad involvert i prosessen, noe som bidro til en opplevelse av mindreverdighet, fremmedgjøring og avmakt. Analysen viser at bolig og hjem ikke kan sees uavhengig av materielle, sosiale, symbolske og følelsesmessige relasjoner.

Emotion dysregulation has long been considered a key symptom in multiple psychiatric disorders. Difficulties in emotion regulation have been associated with neural dysregulation in fronto-limbic circuits. Real-time fMRI-based neurofeedback (rt-fMRI-NFB) has become increasingly popular as a potential treatment for emotional dysregulation in psychiatric disorders, as it is able to directly target the impaired neural circuits. However, the clinical impact of these rt-fMRI-NFB protocols in psychiatric populations is still largely unknown. Here we provide a comprehensive overview of primary studies from 2010 to 2023 that used rt-fMRI-NFB to target emotion regulation. We assessed 41 out of 4001 original studies for methodological quality and risk of bias and synthesised concerning the frequency of significant rt-fMRI-NFB-related effects on the neural and behaviour level. Successful modulation of brain activity was reported in between 25 and 50 percent of study samples, while neural effects in clinical samples were more diverse than in healthy samples. Interestingly, the frequency of rt-fMRI-NFB-related behavioural improvement was over 75 percent in clinical samples, while healthy samples showed behavioural improvements between 0 and 25 percent. Concerning clinical subsamples, rt-fMRI-NFB-related behavioural improvement was observed in up to 100 percent of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) samples. Substance use samples showed behavioural benefits ranging between 50 and 75 percent. Neural effects appeared to be less frequent than behavioural improvements: most neural outcomes ranged between 25 and 50 percent for MDD and substance use and between 0 and 25 percent for PTSD. Using multiple individualised regions of interest (ROIs) for rt-fMRI-NFB training resulted in more frequent behavioural benefits than rt-fMRI-NFB solely based on the amygdala or the prefrontal cortex. While a significant improvement in behavioural outcomes was reported in most clinical studies, the study protocols were heterogeneous, which limits the current evaluation of rt-fMRI-NFB as a putative treatment for emotional dysregulation.

Abstract Background Fitness has important implications for physical activity behavior and is associated with various health-related outcomes. It can be assessed through a test battery or a self-reported questionnaire. One example is the FFB-Mot (Funktionsfragebogen Motorik; engl. functional fitness questionnaire) which consist of 28 items to assess four components of fitness in adults: cardiorespiratory fitness/ endurance, muscular strength, gross motor coordination, and flexibility. The aims of this manuscript were to (1) provide an English-version of the FFB-Mot questionnaire (developed from the German-version using translation and back-translation) to the international community of researchers in the areas of physical activity, fitness and health in adults, and (2) examine the predictive validity of the FFB-Mot questionnaire in a large sample of community-dwelling adults. Methods We used data from a longitudinal study in Germany with four measurement waves over a period of 18 years, with samples ranging between 310 and 437 participants (1572 adults in total, mean ages 46–58 years). To assess predictive validity, we calculated Pearson correlations between FFB-Mot data collected in 1997 and external health-related criteria (i.e., subjective health status, physician-rated health status, back pain, physical complaints and physical activity in minutes per week) collected in 2002, 2010, and 2015, and separately for males and females. Results We observed correlations between higher FFB-Mot scores with better subjective health status (in 2002: males, r = 0.25; females, r = 0.18; in 2010: males, r = 0.29; females, r = 0.28; in 2015: males, r = 0.40), and higher physical activity (in 2002: males, r = 0.24; females, r = 0.25; in 2010: males, r = 0.30; females, r = 0.38; in 2015: females, r = 0.27). Higher FFB-Mot scores were also correlated with lower back pain (in 2002: males, r = -0.23; females, r = -0.25; in 2010: females, r = -0.22), less physical complaints (in 2002: males, r = -0.36; females, r = -0.24), and better physician-rated health status (in 2002: males, r = -0.41; females, r = -0.29, 2010: males, r = -0.38; females, r = -0.44; in 2015: males, r = -0.47). Conclusions Our results suggest that the FFB-Mot to assess fitness in adults has predictive validity for health-related outcomes as indicated by significant correlations, albeit some effect sizes are small. The FFB-Mot may be used as one-time assessment of self-reported fitness, or for repeated testing to assess change of self-reported fitness over time and in different settings (e.g., public health research).

Abstract Background Platelets and erythrocytes constitute over 95% of all hematopoietic stem cell output. However, the clonal dynamics of HSC contribution to these lineages remains largely unexplored. Results We use lentiviral genetic labeling of mouse hematopoietic stem cells to quantify output from all lineages, nucleate, and anucleate, simultaneously linking these with stem and progenitor cell transcriptomic phenotypes using single-cell RNA-sequencing. We observe dynamic shifts of clonal behaviors through time in same-animal peripheral blood and demonstrate that acute platelet depletion shifts the output of multipotent hematopoietic stem cells to the exclusive production of platelets. Additionally, we observe the emergence of new myeloid-biased clones, which support short- and long-term production of blood cells. Conclusions Our approach enables kinetic studies of multi-lineage output in the peripheral blood and transcriptional heterogeneity of individual hematopoietic stem cells. Our results give a unique insight into hematopoietic stem cell reactivation upon platelet depletion and of clonal dynamics in both steady state and under stress.

Abstract Background Wearable technology is used by consumers and researchers worldwide for continuous activity monitoring in daily life. Results of high-quality laboratory-based validation studies enable us to make a guided decision on which study to rely on and which device to use. However, reviews in adults that focus on the quality of existing laboratory studies are missing. Methods We conducted a systematic review of wearable validation studies with adults. Eligibility criteria were: (i) study under laboratory conditions with humans (age ≥ 18 years); (ii) validated device outcome must belong to one dimension of the 24-hour physical behavior construct (i.e., intensity, posture/activity type, and biological state); (iii) study protocol must include a criterion measure; (iv) study had to be published in a peer-reviewed English language journal. Studies were identified via a systematic search in five electronic databases as well as back- and forward citation searches. The risk of bias was assessed based on the QUADAS-2 tool with eight signaling questions. Results Out of 13,285 unique search results, 545 published articles between 1994 and 2022 were included. Most studies (73.8% (N = 420)) validated an intensity measure outcome such as energy expenditure; only 14% (N = 80) and 12.2% (N = 70) of studies validated biological state or posture/activity type outcomes, respectively. Most protocols validated wearables in healthy adults between 18 and 65 years. Most wearables were only validated once. Further, we identified six wearables (i.e., ActiGraph GT3X+, ActiGraph GT9X, Apple Watch 2, Axivity AX3, Fitbit Charge 2, Fitbit, and GENEActiv) that had been used to validate outcomes from all three dimensions, but none of them were consistently ranked with moderate to high validity. Risk of bias assessment resulted in 4.4% (N = 24) of all studies being classified as “low risk”, while 16.5% (N = 90) were classified as “some concerns” and 79.1% (N = 431) as “high risk”. Conclusion Laboratory validation studies of wearables assessing physical behaviour in adults are characterized by low methodological quality, large variability in design, and a focus on intensity. Future research should more strongly aim at all components of the 24-hour physical behaviour construct, and strive for standardized protocols embedded in a validation framework.