An investigation on physical activity engagement in people before and after total hip replacement

Background: Total hip replacement (THR), is one of the most common elective surgical operations performed in the United Kingdom. There is however little evidence examining physical activity in this population or interventions to increase it. Study 1: A systematic review examined physical activity change in the THR population pre- compared to up to one year post-THR. Studies were eligible for inclusion if they presented a pre-operative and post-operative measure of physical activity. A total of 17 studies were included. The quality of the included studies was rated as low to moderate. There was no significant difference in pre- versus post-operative physical activity (p>0.05). The lack of significant physical activity difference should be considered in the light of the poor to moderate methodological quality. Study 2: No previous studies have assessed change in physical activity pre- compared to more than one year post-THR. A secondary data set analysis was undertaken to assess this, and examine if having a THR significantly predicted physical activity. This showed a significant decrease in physical activity pre- compared to post-THR (p0.05). Study 3: A feasibility randomised control trial was undertaken to examine the feasibility of a pedometer-prescribed walking intervention post-THR. The primary outcome measure was the Oxford Hip Score. Secondary measures were physical activity and quality of life. There was no significant between group differences for any measure (p>0.05). The intervention was poorly adhered to. There is a need to better understand the barriers to physical activity intervention adherence in this population. Conclusions: These studies have contributed new knowledge to the field. The lack of improvement in physical activity pre- compared to post-THR and the results of the feasibility RCT highlighted the need to better understand barriers to physical activity in this population

Versatile regularisation toolkit for iterative image reconstruction with proximal splitting algorithms

Ill-posed image recovery requires regularisation to ensure stability. The presented open-source regularisation toolkit consists of state-of-the-art variational algorithms which can be embedded in a plug-and-play fashion into the general framework of proximal splitting methods. The packaged regularisers aim to satisfy various prior expectations of the investigated objects, e.g., their structural characteristics, smooth or non-smooth surface morphology. The flexibility of the toolkit helps with the design of more advanced model-based iterative reconstruction methods for different imaging modalities while operating with simpler building blocks. The toolkit is written for CPU and GPU architectures and wrapped for Python/MATLAB. We demonstrate the functionality of the toolkit in application to Positron Emission Tomography (PET) and X-ray synchrotron computed tomography (CT)

Cardiovascular disease risk marker responses to breaking up prolonged sedentary time in individuals with paraplegia: the Spinal Cord Injury Move More (SCIMM) randomised crossover laboratory trial protocol

Introduction: Sedentary behaviour is a distinct risk factor for cardiovascular disease (CVD) and could partly explain the increased prevalence of CVD in people with spinal cord injury (SCI). Interrupting prolonged sitting periods with regular short bouts of walking acutely suppresses postprandial glucose and lipids in able-bodied individuals. However, the acute CVD risk marker response to breaking up prolonged sedentary time in people with SCI has not been investigated. Methods and analysis: A randomised two-condition laboratory crossover trial will compare: 1) breaking up prolonged sedentary time with 2 min moderate-intensity arm crank activity every 20 min, with 2) uninterrupted prolonged sedentary time (control) in people with SCI. Outcomes will include acute effects on postprandial glucose, insulin, lipids and blood pressure. Blood samples will be collected and blood pressure measured at regular intervals during each 5.5 h condition. Ethics and dissemination: This study was approved by the Cambridge South NHS Research Ethics Committee. This research will help determine if breaking up prolonged sedentary time could be effective in lowering CVD risk in people with SCI. The findings of the research will be published in a peer review journal and disseminated to relevant user groups. Trial registration: The study is registered as a clinical trial on the ISRCTN register (trial ID: ISRCTN51868437)

Nutrient stripping: the global disparity between food security and soil nutrient stocks

1. The Green Revolution successfully increased food production but in doing so created a legacy of inherently leaky and unsustainable agricultural systems. Central to this are the problems of excessive nutrient mining. If agriculture is to balance the needs of food security with the delivery of other ecosystem services, then current rates of soil nutrient stripping must be reduced and the use of synthetic fertilisers made more efficient. 2. We explore the global extent of the problem, with specific emphasis on the failure of macronutrient management (e.g. nitrogen, phosphorus) to deliver continued improvements in yield and the failure of agriculture to recognise the seriousness of micronutrient depletion (e.g. copper, zinc, selenium). 3. Nutrient removals associated with the relatively immature, nutrient-rich soils of the UK are contrasted with the mature, nutrient-poor soils of India gaining insight into the emerging issue of nutrient stripping and the long-term implications for human health and soil quality. Whilst nutrient deficiencies are rare in developed countries, micronutrient deficiencies are commonly increasing in less-developed countries. Increasing rates of micronutrient depletion are being inadvertently accomplished through increasing crop yield potential and nitrogen fertiliser applications. 4. Amongst other factors, the spatial disconnects caused by the segregation and industrialisation of livestock systems, between rural areas (where food is produced) and urban areas (where food is consumed and human waste treated) are identified as a major constraint to sustainable nutrient recycling. 5. Synthesis and applications. This study advocates that agricultural sustainability can only be accomplished using a whole-systems approach that thoroughly considers nutrient stocks, removals, exports and recycling. Society needs to socially and environmentally re-engineer agricultural systems at all scales. It is suggested that this will be best realised by national-scale initiatives. Failure to do so will lead to an inevitable and rapid decline in the delivery of provisioning services within agricultural systems

Is there a difference in physical activity levels in patients before and up to one year after unilateral total hip replacement? A systematic review and meta-analysis

Objective: To determine if there is a difference in physical activity levels before and up to one year after unilateral primary total hip replacement. Data sources: A search was performed on 13th July 2016. Studies were eligible for inclusion if they presented pre-operative and up to one year post-operative measures of physical activity for patients who had undergone unilateral primary total hip replacement. Review methods: Any paper that used a measure of physical activity pre and up to one year post unilateral primary total hip replacement. Data was synthesised using a meta-analysis with 95% confidence intervals (CI), if appropriate. The Critical Appraisal Skills Programme cohort study checklist was used to assess the quality of evidence. Results: From 6024 citations, nine studies were analysed in a meta-analysis and eight studies were analysed qualitatively. The quality of the evidence was ‘low’ to ‘moderate’. There was no statistically significant difference in physical activity pre- to post-total hip replacement when assessed using: movement-related activity (mean difference (MD): -0.08; 95% CI: 1.60, 1.44; I2=0%; n=77), percentage of 24-hours spent walking (MD: -0.21; 95% CI: -1.36, 0.93; I2=12%; n=65), six-minute walk test (MD: -60.85; 95% CI: -122.41, 0.72; I2=84%; n=113) or the cardiopulmonary exercise test (MD: -0.24; 95% CI: -1.36, 0.87; I2=0%;n=76). Conclusion: There is no statistically significant difference in physical activity levels before and up to one year after unilateral primary total hip replacement. However the low to moderate methodological quality of the included papers should be taken into consideration when drawing conclusions

Conservation Status of the Southern Appalachian Herpetofauna

Seventy one species of amphibians (55 salamanders, 16 anurans) and 46 species of reptiles (15 turtles, 8 lizards, 23 snakes) inhabit a five state area (Kentucky, North Carolina, Tennessee, Virginia, West Virginia) in the southern Appalachian region bordered by the Potomac River, the Blue Ridge Mountains, and the western margin of the Appalachian Plateau. Of these, 47.9 % of the amphibian fauna and 52.2 % of the reptilian fauna are listed as being of conservation concern by federal, state, and Natural Heritage programs in all or a portion of their ranges of this region. The Shenandoah salamander (Plethodon Shenandoah) is listed as Endangered and the Cheat Mountain salamander (Plethodon Shenandoah) is listed as Endangered and the Cheat Mountain salamander (Plethodon nettingi) is listed as Threatened under the U.S. Endangered Species Act. Nine others are classified as federal species at risk. State endangered species number 1-3 (per state), threatened 1-4, and special concern or declining 6-19. Three to 6 species per state are additionally listed as natural heritage S1 and 2-13 as S2. We review the existing and potential threats to species and populations (e.g., timbering, urbanization, collection for the wildlife trade, acid precipitation, introduced species) and provide an assessment of the conservation status of the southern Appalachian herpetofauna based on land ownership

A Global Perspective on Phosphorus Management Decision Support in Agriculture: Lessons Learned and Future Directions

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Evolutionary conservation of regulated longevity assurance mechanisms

Short abstract: A multi-level cross-species comparative analysis of gene-expression changes accompanying increased longevity in mutant nematodes, fruit flies and mice with reduced insulin/IGF-1 signaling revealed candidate conserved mechanisms

Financial diversification before modern portfolio theory: UK financial advice documents in the late nineteenth and the beginning of the twentieth century

The paper offers textual evidence from a series of financial advice documents in the late nineteenth century and the early twentieth century of how UK investors perceived of and managed risk. In the world’s largest financial centre of the time, UK investors were familiar with the concept of correlation and financial advisers’ suggestions were consistent with the recommendations of modern portfolio theory in relation to portfolio selection strategies. From the 1870s, there was an increased awareness of the benefits of financial diversification - primarily putting equal amounts into a number of different securities - with much of the emphasis being on geographical rather than sectoral diversification and some discussion of avoiding highly correlated investments. Investors in the past were not so naïve as mainstream financial discussions suggest today