Making the best use of new technologies in the National Diet and Nutrition Survey: a review

.Background Dietary assessment is of paramount importance for public health monitoring. Currently in the UK, the population’s diets are examined by the National Diet and Nutrition Survey Rolling Programme (NDNS RP). In the survey, diet is assessed by a four-day paper-based dietary diary, with accompanying interviews, anthropometric measurements and blood and urine sampling. However, there is growing interest worldwide in the potential for new technologies to assist in data collection for assessment of dietary intake. Published literature reviews have identified the potential of new technologies to improve accuracy, reduce costs, and reduce respondent and researcher burden by automating data capture and the nutritional coding process. However, this is a fast-moving field of research, with technologies developing at a rapid pace, and an updated review of the potential application of new technologies in dietary assessment is warranted. This review was commissioned to identify the new technologies employed in dietary assessment and critically appraise their strengths and limitations in order to recommend which technologies, if any, might be suitable to develop for use in the NDNS RP and other UK population surveys. Objectives The overall aim of the project was to inform the Department of Health of the range of new technologies currently available and in development internationally that have potential to improve, complement or replace the methods used in the NDNS RP. The specific aims were: to generate an itinerary of new and emerging technologies that may be suitable; to systematically review the literature and critically appraise new technologies; and to recommend which of these new technologies, if any, would be appropriate for future use in the NDNS RP. To meet these aims, the project comprised two main facets, a literature review and qualitative research. Literature review data sources The literature review incorporated an extensive search of peer-reviewed and grey literature. The following sources were searched: Cochrane Database of Systematic Reviews (CDSR), Database of Abstracts of Reviews of Effectiveness (DARE), Web of Science Core Collection, Ovid MEDLINE, Ovid MEDLINE In-Process, Embase, NHS EED (Economic Evaluation Database), National Cancer Institute (NCI) Dietary Assessment Calibration/Validation Register, OpenGrey, EPPI Centre (TRoPHI), conference proceedings (ICDAM 2012, ISBNPA 2013, IEEE Xplore, Nutrition Society Irish Section and Summer Meetings 2014), recent issues of journals (Journal of Medical Internet Research, International Journal of Medical Informatics), grants registries (ClinicalTrials.gov, BBSRC, report), national surveys, and mobile phone application stores. In addition, hand-searching of relevant citations was performed. The search also included solicitation of key authors in the field to enquire about Making the best use of new technologies in the NDNS: a review 4 as-yet unpublished articles or reports, and a Bristol Online Survey publicised via social media, society newsletters and meetings. Literature review eligibility criteria Records were screened for eligibility using a three-stage process. Firstly, keyword searches identified obviously irrelevant titles. Secondly, titles and abstracts were screened against the eligibility criteria, following which full-text copies of papers were obtained and, in the third stage of screening, examined against the criteria. Two independent reviewers screened each record at each stage, with discrepancies referred to a third reviewer. Eligibility criteria were pre-specified and agreed by the project Steering Group (Section 1.6). Eligible records included: studies involving technologies, new to the NDNS RP, which can be used to automate or assist the collection of food consumption data and the coding of foods and portion sizes, currently available or beta versions, public domain or commercial; studies that address the development, features, or evaluation of new technology; technologies appropriate for the requirements of the NDNS RP in terms of nutritional analysis, with capacity to collect quantifiable consumption data at the food level; primary sources of information on a particular technology; and journal articles published since the year 2000 or grey literature available from 2011 onwards. The literature search was not limited to Englishlanguage publications, which are included in the itinerary, although data were not extracted from non-English studies. Literature synthesis and appraisal New technologies were categorised into eleven types of technology, and an itinerary was generated of tools falling under each category type. Due to the volume of eligible studies identified by the literature searches, data extraction was limited to the literature focussing on selected exemplar tools of five technology categories (web-based diet diary, web-based 24- hour recall, handheld devices (personal digital assistants and mobile phones), nonautomated cameras to complement traditional methods, and non-automated cameras to replace traditional methods). For each category, at least two exemplars were chosen, and all studies involving the exemplar were included in data extraction and synthesis. Exemplars were selected on the basis of breadth of evidence available, using pre-specified criteria agreed by the Steering Group. Data were extracted by a single reviewer and an evidence summary collated for each exemplar. A quality appraisal checklist was developed to assess the quality of validation studies. The checklist was piloted and applied by two independent reviewers. Studies were not excluded on the basis of quality, but study quality was taken into account when judging the strength of evidence. Due to the heterogeneity of the literature, meta-analyses were not performed. References were managed and screened using the EPPI Reviewer 4 systematic review software. EPPI Reviewer was also used to extract data

The association between hyperactive behaviour and cognitive inhibition impairments in young children

Hyperactivity is one of the core features of attention-deficit hyperactivity disorder (ADHD), and yet there is evidence that hyperactive behavior in children with ADHD is not ubiquitous and could be a compensatory response to high cognitive demands. No research has yet objectively measured hyperactive behavior in young children who are demonstrating early signs of ADHD or examined the role of emotional state on hyperactivity levels.The current study measured motor activity using actigraphy during baseline, cognitive inhibition (Flanker task), and emotion arousing (Impossibly Perfect Circles task) conditions in 95 children aged 4–7 years old with developmental difficulties, including emerging symptoms of ADHD. We examined the relationship between objectively recorded activity, parent-rated hyperactivity problems, using the Strengths and Difficulties Questionnaire (SDQ), and cognitive inhibition task performance.Parent ratings of hyperactivity (but not inattention) symptoms were positively related to recorded hyperactivity, and this relationship was specific to activity measured during the cognitive inhibition task. Impaired cognitive inhibition performance was related to increased measured movement and this association was strongest in children who were rated as having the highest levels of hyperactive behavior.These findings confirm theoretically predicted associations between objectively recorded hyperactivity and impaired executive functioning and support the notion that hyperactivity in children emerges in response to high cognitive demands. The results encourage further investigation into the role of hyperactivity as a transdiagnostic dimension that can explain variation within and between different types of diagnostic classifications

Paternal attractiveness and the effects of differential allocation of parental investment

The differential allocation hypothesis (DAH) predicts that an individual should vary its reproductive investment according to the attractiveness of its mate. A recently revised version of the DAH makes explicit that investment can be positive, i.e. higher for the offspring of attractive males which should be of higher quality, or negative, i.e. higher for offspring of unattractive males, for example compensating for inheriting poor paternal genes. Moreover, investment can be made by the father and the mother. Here, we tested whether experimental manipulation of male attractiveness affected parental investment at different reproductive stages and thus influenced fitness-related traits in offspring. In two aviaries, all male zebra finches, Taeniopygia guttata, were given red leg rings to increase attractiveness and in two aviaries all males received green leg rings to decrease attractiveness. This controlled for assortative mating between treatments. Ring colour was merely an experimental manipulation of male attractiveness, not paternal quality, so we might expect additional investment to elevate offspring quality. Eggs were cross-fostered between and within treatments to allow differentiation of effects of investment in eggs and nestlings. Clutch and brood sizes were standardized. Both positive and negative investment were observed: Eggs from red-ringed fathers had higher yolk to albumen ratios than eggs from green-ringed fathers. Nestlings from eggs laid and incubated by parents in the red-ringed group had higher hatching masses than those in the green-ringed group. Both parents in the green-ringed group fed nestlings more frequently than red-ringed parents. Offspring performance was influenced by the treatment of both foster and biological parents, but combined effects of these different investment patterns on fitness-related traits were ambiguous. Male attractiveness appeared to affect patterns of reproductive investment but not consistently across all forms of reproductive investment suggesting that the costs and benefits of differential allocation vary among individuals and across contexts

Altered fibrinolysis in autosomal dominant thrombomodulin-associated coagulopathy

Thrombomodulin-associated coagulopathy (TM-AC) is a newly recognised dominant bleeding disorder in which a p.Cys537Stop variant in the thrombomodulin (TM) gene THBD, results in high plasma TM levels and protein C-mediated suppression of thrombin generation. Thrombin in complex with TM also activates thrombin activatable fibrinolysis inhibitor (TAFI). However, the effect of the high plasma TM on fibrinolysis in TM-AC is unknown. Plasma from TM-AC cases and high-TM model control samples spiked with recombinant soluble TM showed reduced tissue factor-induced thrombin generation. Lysis of plasma clots from TM-AC cases was significantly delayed compared to controls, but was completely restored when TM/thrombin-mediated TAFI activation was inhibited. Clots formed in blood from TM-AC cases had the same viscoelastic strength as controls but also showed a TAFI-dependent delay in fibrinolysis. Delayed fibrinolysis was reproduced in high-TM model plasma and blood samples. Partial restoration of thrombin generation with rFVIIa or aPCC did not alter the delayed fibrinolysis in high-TM model blood. Our finding of a previously unrecognised fibrinolytic phenotype indicates that bleeding in TM-AC has a complex pathogenesis and highlights the pivotal role of TM as a regulator of haemostasis

Federating structural models and data:Outcomes from a workshop on archiving integrative structures

Structures of biomolecular systems are increasingly computed by integrative modeling. In this approach, a structural model is constructed by combining information from multiple sources, including varied experimental methods and prior models. In 2019, a Workshop was held as a Biophysical Society Satellite Meeting to assess progress and discuss further requirements for archiving integrative structures. The primary goal of the Workshop was to build consensus for addressing the challenges involved in creating common data standards, building methods for federated data exchange, and developing mechanisms for validating integrative structures. The summary of the Workshop and the recommendations that emerged are presented here

The role of hydrogen and fuel cells in the global energy system

Hydrogen technologies have experienced cycles of excessive expectations followed by disillusion. Nonetheless, a growing body of evidence suggests these technologies form an attractive option for the deep decarb onisation of global energy systems, and that recent improvements in their cost and performance point towards economic viability as well. This paper is a comprehensive review of the potential role that hydrogen could play in the provision of electricity, h eat, industry, transport and energy storage in a low - carbon energy system, and an assessment of the status of hydrogen in being able to fulfil that potential. The picture that emerges is one of qualified promise: hydrogen is well established in certain nic hes such as forklift trucks, while mainstream applications are now forthcoming. Hydrogen vehicles are available commercially in several countries, and 225,000 fuel cell home heating systems have been sold. This represents a step change from the situation of only five years ago. This review shows that challenges around cost and performance remain, and considerable improvements are still required for hydrogen to become truly competitive. But such competitiveness in the medium - term future no longer seems an unrealistic prospect, which fully justifies the growing interest and policy support for these technologies around the world

Does process flow make a difference to mortality and cost? An observational study

Purpose The purpose of the paper is to investigate the potential relationships between emergency-care flow, patient mortality and healthcare costs using a patient-flow model. Design/methodology/approach The researchers used performance data from one UK NHS trust collected over three years to identify periods where patient flow was compromised. The delays’ root causes in the entire emergency care system were investigated. Event time-lines that disrupted patient flow and patient mortality statistics were compared. Findings Data showed that patient mortality increases at times when accident and emergency (A&E) department staff were struggling to admit patients. Four delays influenced mortality: first, volume increase and mixed admissions; second, process delays; third, unplanned hospital capacity adjustments and finally, long-term capacity restructuring downstream. Research limitations/implications This is an observational study that uses process control data to find times when mortality increases coincide with other events. It captures contextual background to whole system issues that affect patient mortality. Practical implications Managers must consider cost-decisions and flow in the whole system. Localised, cost-focused decisions can have a detrimental effect on patient care. Attention must also be paid to mortality reports as existing data-presentation methods do not allow correlation analysis. Originality/value Previous studies correlate A&E overcrowding and mortality. This method allows the whole system to be studied and increased mortality root causes to be understood