Caffeinated energy drinks and effects in UK young people

International systematic review evidence indicates an association of caffeinated energy drink use with physical symptoms and lifestyle but is unclear about associations with mental health and behavioural outcomes. The design of studies included in the reviews and the quality of the systematic reviews themselves limits the strength of the conclusions. The lack of UK research in the reviews prompted our analysis of UK population-level data. Our analysis of UK data suggests that many children in the UK consume CEDs with higher consumption reported by older children, by boys, and by those living in northern areas or in more deprived regions. Findings also suggest associations between consumption and physical, psychological, social and educational symptoms, behaviours and wellbeing. A lack of studies that measure these variables over time meant we were unable to determine whether CED consumption is the cause of associated symptoms, behaviours and wellbeing. Future research on this topic should employ longitudinal methods to examine whether CED consumption is responsible for poorer health and wellbeing. Research should also examine the influence of geographic region and deprivation on children’s caffeinated energy drink consumption. The measurement of caffeinated energy drink consumption in the future needs to be consistent across surveys, so that a clearer picture of the frequency, timing and dosage can be established. UK-wide exploration of the context and reasons for caffeinated energy drink consumption is needed and should include examining consumption of CEDs with alcohol in older children aged 16 to 17 years

Population tobacco control interventions and their effects on social inequalities in smoking: systematic review

OBJECTIVE: To assess the effects of population tobacco control interventions on social inequalities in smoking. DATA SOURCES: Medical, nursing, psychological, social science and grey literature databases, bibliographies, hand-searches and contact with authors. STUDY SELECTION: Studies were included (n = 84) if they reported the effects of any population-level tobacco control intervention on smoking behaviour or attitudes in individuals or groups with different demographic or socioeconomic characteristics. DATA EXTRACTION: Data extraction and quality assessment for each study were conducted by one reviewer and checked by a second. DATA SYNTHESIS: Data were synthesised using graphical ("harvest plot") and narrative methods. No strong evidence of differential effects was found for smoking restrictions in workplaces and public places, although those in higher occupational groups may be more likely to change their attitudes or behaviour. Smoking restrictions in schools may be more effective in girls. Restrictions on sales to minors may be more effective in girls and younger children. Increasing the price of tobacco products may be more effective in reducing smoking among lower-income adults and those in manual occupations, although there was also some evidence to suggest that adults with higher levels of education may be more price-sensitive. Young people aged under 25 are also affected by price increases, with some evidence that boys and non-white young people may be more sensitive to price. CONCLUSIONS: Population-level tobacco control interventions have the potential to benefit more disadvantaged groups and thereby contribute to reducing health inequalities

Precision public health – A critical review of the opportunities and obstacles

The term ‘precision public health’ (PPH) refers to a new approach in public health which involves the use of novel data sources and/or computer science-driven methods of data analysis to predict risk or outcomes, in order to improve how interventions are targeted or tailored, with the aim of making them more individualised and therefore more effective and cost-effective than methods currently in use. These data may include, for example, information from social media or devices, genomic or clinical data, and information from healthcare services. In this critical review, which was conducted between March and October 2019, we outline key assumptions underpinning the PPH approach and identify potential challenges in its application. We adopted a pragmatic, non-systematic review methodology to examine: (i) the general principles underlying PPH; (ii) the validity of claims made about PPH in empirical studies and commentaries; and (iii) the potential opportunities and challenges of adopting a PPH approach through examining two case studies: health checks and community-based interventions. Non-empirical studies (commentaries and think-pieces) were included in this review because PPH represents an emerging approach and many of the ideas around the potential of PPH are only described in such studies Commentary studies emphasise that precision can be achieved in targeting interventions towards narrow social profiles of people through the incorporation of data reflecting micro-level day-to-day insights into the lives of individuals. Structured analysis of commentary studies shows that (i) the PPH field may be highly influenced by commentary and non-systematic review pieces that lack transparent methods but make claims about the potential of PPH; (ii) commentators on PPH often attempt to provide evidence for claims but the link between the evidence and the claim is often unsubstantiated when critically examined; and (iii) many of the assumptions underlying PPH are not supported by empirical evidence suggesting that there needs to be a measured approach to adopting PPH approaches. Claims around the effectiveness of PPH and around PPH being an advance on current public health approaches tended not to be supported by empirical evidence. As a relatively new concept therefore, there is limited direct empirical evidence showing PPH to be effective, and the theoretical arguments in its favour are often not well supported by evidence. The more ambitious claims made for PPH in the literature often rest on questionable readings of the evidence – for example, citing the possibility of identifying subgroups of the population through better targeting as though this automatically promises greater effectiveness among interventions targeting those subgroups. In practice, it seems that PPH is less a radically new paradigm and more a range of incremental improvements to public health interventions. Hypothetical case studies outlining the potential of a PPH approach applied to health checks and community-based interventions indicate several ways in which new data or tools could be productively used to inform the design and implementation of public health interventions. Current evidence suggests the impact of these is likely to be fairly modest, although further focused research (e.g. exploring the utility of strategies for targeting or involving communities using PPH) may merit further exploration and evaluation. Defining PPH is contentious and our findings reflect the difficulty in assessing and operationalising the broad ambition of using emerging data and technologies to better understand profiles, predict risk and outcomes, and act upon this evidence. Future work in this area should seek to introduce more focus around the concept of PPH, including being clearer about the goals and breaking down the concept into a series of components that can each be evaluated. The bulk of the work presented here took place between March and October 2019. There is scope for further analysis to understand the potential of PPH in the future, as the number of studies adopting a PPH approach grows. This larger pool of studies may also lend itself to more systematic approaches to reviewing the evidence, particularly if there is an interest in evaluating a particular component or principle of PPH. In addition, the evidence examined in this report predates the COVID-19 global pandemic, and many of the measures taken to mitigate the spread of the pandemic may provide a further source of evidence and data to understand the potential role of PPH in public health decision-making

Effects of Pacing When Using Material Handling Manipulators

Common manipulator-assisted materials handling tasks were performed in a laboratory simulation at self-selected and faster (paced) speeds. The effects of pacing on peak hand forces, torso kinematics, spine moments and forces, and muscle antagonism were determined, along with any influences of several task variables on these effects. The faster trials were performed 20% more rapidly than the self-paced trials. It was found that (a) achieving this level of performance required 10% higher hand forces and 5%-10% higher torso moments, (b) consistent torso postures and motions were used for both speed conditions, and (c) the faster trials resulted in 10% higher spine forces and 15% higher levels of lumbar muscle antagonism. On whole, these results suggest a higher risk of musculoskeletal injury associated with performance of object transfers at faster than self-selected speeds with and without a manipulator. Further analysis provided evidence that the use of manipulators involves higher levels of motor coordination than do manual tasks. Several implications regarding the use of material handling manipulators in paced operations are discussed. Results from this investigation can be used in the design, evaluation, and selection of material handling manipulators.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/67067/2/10.1518_001872099779591240.pd

The Bivariate Normal Copula

We collect well known and less known facts about the bivariate normal distribution and translate them into copula language. In addition, we prove a very general formula for the bivariate normal copula, we compute Gini's gamma, and we provide improved bounds and approximations on the diagonal.Comment: 24 page

Isolation of Human Photoreceptor Precursors via a Cell Surface Marker Panel from Stem Cell-derived Retinal Organoids and Fetal Retinae

Loss of photoreceptor cells due to retinal degeneration is one of the main causes of blindness in the developed world. Although there is currently no effective treatment, cell replacement therapy using stem-cell-derived photoreceptor cells may be a feasible future treatment option. In order to ensure safety and efficacy of this approach, robust cell isolation and purification protocols must be developed. To this end, we previously developed a biomarker panel for the isolation of mouse photoreceptor precursors from the developing mouse retina and mouse embryonic stem cell cultures. In the current study we applied this approach to the human pluripotent stem cell (hPSC) system, and identified novel biomarker combinations that can be leveraged for the isolation of human photoreceptors. Human retinal samples and hPSC-derived retinal organoid cultures were screened against 242 human monoclonal antibodies using a high through-put flow cytometry approach. We identified 46 biomarkers with significant expression levels in the human retina and hPSC differentiation cultures. Human retinal cell samples, either from fetal tissue or derived from embryonic and induced pluripotent stem cell cultures, were FAC-sorted using selected candidate biomarkers that showed expression in discrete cell populations. Enrichment for photoreceptors and exclusion of mitotically active cells was demonstrated by immunocytochemical analysis with photoreceptor-specific antibodies and Ki-67. We established a biomarker combination, which enables the robust purification of viable human photoreceptors from both human retinae and hPSC-derived organoid cultures. This article is protected by copyright. All rights reserved

Cost-effectiveness of Microsoft Academic Graph with machine learning for automated study identification in a living map of coronavirus disease 2019 (COVID-19) research

BACKGROUND: Conventionally, searching for eligible articles to include in systematic reviews and maps of research has relied primarily on information specialists conducting Boolean searches of multiple databases and manually processing the results, including deduplication between these multiple sources. Searching one, comprehensive source, rather than multiple databases, could save time and resources. Microsoft Academic Graph (MAG) is potentially such a source, containing a network graph structure which provides metadata that can be exploited in machine learning processes. Research is needed to establish the relative advantage of using MAG as a single source, compared with conventional searches of multiple databases. This study sought to establish whether: (a) MAG is sufficiently comprehensive to maintain our living map of coronavirus disease 2019 (COVID-19) research; and (b) eligible records can be identified with an acceptably high level of specificity. METHODS: We conducted a pragmatic, eight-arm cost-effectiveness analysis (simulation study) to assess the costs, recall and precision of our semi-automated MAG-enabled workflow versus conventional searches of MEDLINE and Embase (with and without machine learning classifiers, active learning and/or fixed screening targets) for maintaining a living map of COVID-19 research. Resource use data (time use) were collected from information specialists and other researchers involved in map production. RESULTS: MAG-enabled workflows dominated MEDLINE-Embase workflows in both the base case and sensitivity analyses. At one month (base case analysis) our MAG-enabled workflow with machine learning, active learning and fixed screening targets identified n=469 more new, eligible articles for inclusion in our living map – and cost £3,179 GBP ($5,691 AUD) less – than conventional MEDLINE-Embase searches without any automation or fixed screening targets. CONCLUSIONS: MAG-enabled continuous surveillance workflows have potential to revolutionise study identification methods for living maps, specialised registers, databases of research studies and/or collections of systematic reviews, by increasing their recall and coverage, whilst reducing production costs

Reliability of the Charcot-Marie-Tooth functional outcome measure

The CMT‐FOM is a 13‐item clinical outcome assessment (COA) that measures physical ability in adults with Charcot‐Marie‐Tooth disease (CMT). Test‐retest reliability, internal consistency and convergent validity have been established for the CMT‐FOM. This current study sought to establish inter‐rater reliability. Following an in‐person training of six international clinical evaluators we recruited 10 participants with genetically diagnosed CMT1A, (aged 18‐74 years, 6 female). Participants were evaluated using the CMT‐FOM over 2 days. Participants were given at least a 3 hour rest between evaluations, and were assessed twice each day. Following the provision of training by master trainers, all 13 items of the CMT‐FOM exhibited excellent inter‐rater reliability for raw scores (ICC1,1 0.825‐0.989) and z‐scores (ICC1,1 0.762‐0.969). Reliability of the CMT‐FOM total score was excellent (ICC1,1 0.983, 95% CI 0.958‐0.995). The CMT‐FOM is a reliable COA used by clinical evaluators internationally. The next steps are to establish further validation through psychometric evaluation of the CMT‐FOM in the Accelerate Clinical Trials in CMT (ACT‐CMT) study