Intermittent fasting for the prevention of cardiovascular disease: implications for clinical practice

In this commentary, Oliver Hamer and colleagues critically appraise a Cochrane systematic review that synthesised the potential benefits of intermittent fasting for the prevention of cardiovascular disease

A synthesis of strategies to recruit adults of ethnic minorities into clinical trials.

There is a long history of BAME under-representation in medical research. Underrepresentation of minority ethnic groups have been assessed by several studies, showing that black and minority ethnic groups were less likely to participate and engage in medical research when compared to white British groups (in relation to education, occupation, health, belief, and attitudes to medical research).There may be several strategies that improve inclusivity, including translation of participant information, culturally specific recruitment, and adaptations to the invitation process. However, with a dearth of literature in the area, there is now a need to contextualise these strategies in relation to renal research

Biomarkers as diagnostic or prognostic indicators of delirium: examining the current evidence

Delirium is a substantial global health concern. Delirium can lead to longer hospital stays and increased healthcare costs. Effective detection and prevention of delirium is still a major challenge for health-care organisations globally. This is largely because the cause(s) of the condition are still unknown. There are multiple factors which may contribute to the aetiology of delirium and a range of neurobiological processes that may be associated with its pathophysiology. With this said, evidencing these processes is a significant challenge as there is a dearth of existing methods of identification. Recently, the use of biomarkers has become a popular method in the identification of delirium and its risk of development. The identification of biomarkers associated with delirium may provide insight into its pathophysiology and aid in diagnosis and management. However, there is a lack of research that has synthesised the diagnostic and prognostic value of biomarkers associated with delirium, and how they can be employed to improve patient outcomes. A systematic review by Dunne et al. 2021 was undertaken to explore this association of biomarkers and delirium. This commentary aims to critically appraise the methods used within the review by Dunne et al. (2021) and expand upon the findings in the context of clinical practice

Location Modeling of Final Palaeolithic Sites in Northern Germany

Location modeling, both inductive and deductive, is widely used in archaeology to predict or investigate the spatial distribution of sites. The commonality among these approaches is their consideration of only spatial effects of the first order (i.e., the interaction of the locations with the site characteristics). Second-order effects (i.e., the interaction of locations with each other) are rarely considered. We introduce a deductive approach to investigating such second-order effects using linguistic hypotheses about settling behavior in the Final Palaeolithic. A Poisson process was used to simulate a point distribution using expert knowledge of two distinct hunter–gatherer groups, namely, reindeer hunters and elk hunters. The modeled points and point densities were compared with the actual finds. The G-, F-, and K-function, which allow for the identification of second-order effects of varying intensity for different periods, were applied. The results reveal differences between the two investigated groups, with the reindeer hunters showing location-related interaction patterns, indicating a spatial memory of the preferred locations over an extended period of time. Overall, this paper shows that second-order effects occur in the geographical modeling of archaeological finds and should be taken into account by using approaches such as the one presented in this paper

Beyond BMI: a synthesis of other lifestyle factors which may influence IVF outcomes.

There are several lifestyle factors that are thought to potentially impact on IVF outcomes, including BMI, smoking, alcohol consumption, caffeine, dietary patterns, and physical activity. Eligibility criteria for IVF within England often requires individuals to be none-smokers, drug free, and have a BMI below 30kg/m2. Some researchers have questioned the scientific and ethical basis for the use of BMI thresholds in fertility treatment, citing evidence that other factors may have a greater effect on the chance of success of IVF. This article aims to briefly synthesise the current evidence on how other factors such as smoking, alcohol, recreational drugs, smoking, caffeine, dietary patterns, and physical activity may impact on IVF outcomes

Prehabilitation exercise therapy ahead of elective abdominal aortic aneurysm repair: A commentary of existing evidence to inform clinical practise

Abdominal aortic aneurysm (AAA) is a condition in which the abdominal aorta becomes enlarged, posing a risk of rupture and life-threatening haemorrhage. Abdominal aortic aneurysm accounts for a substantial number of fatalities worldwide, with mortality rates of up to 80 percent. Abdominal aortic aneurysms are often asymptomatic and are frequently discovered incidentally during tests for unrelated conditions. Surgery is required for aneurysms exceeding 5.5cm in men and 5cm in women, but post-surgical complications such as intra-abdominal adhesions, limb ischaemia and renal failure are common. There is some evidence showing that exercise, including prehabilitation, may be effective in improving patient outcomes post-surgery. However, there is a dearth of literature that has synthesised existing evidence related to the effectiveness of prehabilitation on patient outcomes post-surgery, and which has expanded upon its implications for clinical practise. This commentary aims to critically appraise the most recent Cochrane review in this area, and expand upon these findings to inform clinical practice

Transforming landscapes: Modeling land-use patterns of environmental borderlands

How did socio-cultural transformation processes change land-use patterns? Throughout the last 50 years, outstanding comprehensive geographic, archaeobiological, and archaeological data have been produced for the area of Oldenburger Graben, Schleswig-Holstein, Germany. Based on this exceptional data set, we are able to study the land-use patterns for a period ranging from the Final Mesolithic until the Late Neolithic (4600–1700 BCE). By application of fuzzy modeling techniques, these patterns are investigated diachronically in order to assess the scale of transformations between the different archaeological phases. Based on nutrient requirements and proposed dietary composition estimates derived from empirical archaeobotanical, archaeozoological, and stable isotope data, the required extent of the areas for different land-use practices are modeled. This information is made spatially explicit using a fuzzy model that reconstructs areas of potential vegetation and land-use for each transformation phase. Pollen data are used to validate the type and extent of land-use categories. The model results are used to test hypotheses on the dynamics of socio-cultural transformations: can we observe a diversification of land-use patterns over time or does continuity of land-use practices prevail? By integrating the different lines of evidence within a spatially explicit modeling approach, we reach a new quality of data analysis with a high degree of contextualization. This allows testing of hypotheses about Neolithic transformation processes by an explicit adjustment of our model assumptions, variables, and parameters