Now showing items 21-40 of 829

    • Retention of cardiac rehabilitation services during the COVID-19 pandemic A joint position statement from the British Association for Cardiovascular Prevention and Rehabilitation (BACPR) British Cardiovascular Society (BCS) British Heart Foundation (BHF)

      Dawkes, Susan; Hughes, Sally; Ray, Simon; Nichols, Simon; Hinton, Sally; Roberts, Ceri; Butler, Thomas; Delal, Hayes; Docherty, Patrick; University of York/National Audit of Cardiac Rehabilitation
      The British Association for Cardiovascular Prevention and Rehabilitation (BACPR), the British Cardiovascular Society (BCS) and the British Heart Foundation (BHF) have issued a joint position statement ‘Retention of cardiac rehabilitation services during the COVID-19 pandemic’.
    • Open Carboniferous Limestone pavement grike microclimates in Great Britain and Ireland: understanding the present to inform the future

      Burek, Cynthia; Hosie, Lottie; Geary, Matt; York, Peter, J. (University of ChesterUniversity of Chester, 2020-04)
      Limestone pavements are a distinctive and irreplaceable geodiversity feature, in which are found crevices known as grikes. These grikes provide a distinct microclimate conferring a more stable temperature, higher relative humidity, lower light intensity and lower air speed than can be found in the regional climate. This stability of microclimate has resulted in an equally distinctive community of flora and fauna, adapted to a forest floor but found in an often otherwise barren landscape. This thesis documents the long-term study of the properties of the limestone pavement grike in order to identify the extent to which the microclimate may sustain its distinctive biodiversity, to provide recommendations for future research which may lead to more effective management. Over a five-year study, recordings of temperature, relative humidity, light intensity and samples of invertebrate biodiversity were collected from five limestone pavements situated in the Yorkshire Dales and Cumbria in Great Britain, and The Burren in the Republic of Ireland. An extensive description of the grike microclimate was undertaken using the data collected to understand the extent of the microclimate stability of the grike and the conditions for variation in the grike microclimate. Further insights into the grike microclimate were gained through simulation techniques more commonly used in engineering, to explore the effects of air flowing over a grike, the light from the sun entering the grike and regression analysis to simulate the temperature within the grike in the present and projected for the future. This study has indicated that although the whole of the grike confers a degree of microclimatic stability, it is made up of a less stable upper zone and a more stable lower zone. The instability of the upper zone is hypothesised to result from the extent to which the majority of light and external air can enter the grike, whereas the stability of the lower zone may be governed by the thermal stability of the limestone surrounding it. Based on this zonation and the projections for the grike temperature, it is hypothesised that climate change will have the most substantial effects in the upper grike zone where species obligated to this area could be most heavily impacted. This study recommends a range of areas in which research may be employed so that the limestone pavement habitat may be successfully managed in Great Britain and the Republic of Ireland.
    • The importance of long-term genetic monitoring of reintroduced populations: inbreeding in the natterjack toad (Epidalea calamita)

      Muir, Anna P; orcid: 0000-0002-6896-6915; Phillips, Susanna; Geary, Matt; email: m.geary@chester.ac.uk; Allmark, Matthew; Bennett, Sarah; Norman, Kim; Ball, Rachel J; Peters, Catherine; University of Chester; Cheshire Wildlife Trust; Eni UK Ltd (British Herpetological Society, 2020-07-31)
      Genetic monitoring is an important, but frequently lacking, component of management actions to support long-term persistence in reintroduced populations. Populations that remain small, due to demographic processes and genetic diversity, are more likely to experience a second extinction event. The natterjack toad (Epidelea calamita) is legally protected in Britain and was the subject of a reintroduction programme in the 1990s. However, subsequent genetic assessment has been mostly lacking. The aim of this study was to assess the genetic diversity of two reintroduced populations of natterjack toads in order to inform conservation management. Adults were sampled and nine microsatellites amplified to assess neutral genetic variation within each site and for comparison with the source population. Inbreeding was observed at the reintroduction sites, as evidenced by high FIS values (0.43 and 0.72), low observed compared to expected heterozygosities, and significant deviation from Hardy-Weinberg equilibrium. Observed heterozygosity is currently lower in the reintroduction sites than it was in the source population at the time of the reintroductions (Red Rocks: 0.15±0.20; Talacre: 0.12±0.20; Ainsdale (source): 0.29). Evidence for a bottleneck was not found, although this is likely a result of sampling overlapping generations. No within-site population structuring was observed. Such low genetic diversity has not previously been recorded in any natterjack population. Genetic rescue, combined with pool creation, is the most viable option for safeguarding the species at these sites into the future. Our work highlights the importance of ongoing genetic monitoring, in collaboration with conservation organisations, to support conservation management.
    • Factors influencing dietary behaviours in urban food environments in Africa: a systematic mapping review.

      Osei-Kwasi, Hibbah; orcid: 0000-0001-5084-6213; Mohindra, Aarti; Booth, Andrew; Laar, Amos; Wanjohi, Milka; Graham, Fiona; Pradeilles, Rebecca; Cohen, Emmanuel; orcid: 0000-0001-5643-1473; Holdsworth, Michelle; orcid: 0000-0001-6028-885X (2020-05-26)
      To identify factors influencing dietary behaviours in urban food environments in Africa and identify areas for future research. We systematically reviewed published/grey literature (protocol CRD4201706893). Findings were compiled into a map using a socio-ecological model on four environmental levels: individual, social, physical and macro. Urban food environments in Africa. Studies involving adolescents and adults (11-70 years, male/female). Thirty-nine studies were included (six adolescent, fifteen adolescent/adult combined and eighteen adult). Quantitative methods were most common (twenty-eight quantitative, nine qualitative and two mixed methods). Studies were from fifteen African countries. Seventy-seven factors influencing dietary behaviours were identified, with two-thirds at the individual level (45/77). Factors in the social (11/77), physical (12/77) and macro (9/77) environments were investigated less. Individual-level factors that specifically emerged for adolescents included self-esteem, body satisfaction, dieting, spoken language, school attendance, gender, body composition, pubertal development, BMI and fat mass. Studies involving adolescents investigated social environment-level factors more, for example, sharing food with friends. The physical food environment was more commonly explored in adults, for example, convenience/availability of food. Macro-level factors associated with dietary behaviours were food/drink advertising, religion and food prices. Factors associated with dietary behaviour were broadly similar for men and women. The dominance of studies exploring individual-level factors suggests a need for research to explore how social, physical and macro-level environments drive dietary behaviours of adolescents and adults in urban Africa. More studies are needed for adolescents and men, and studies widening the geographical scope to encompass all African countries.
    • Investigating the Prevalence of Anaemia in Rural Gambia, in Relation to Levels of Zinc Protoporphyrin, Haemoglobin and Haptoglobin (Phenotype and Genotype)

      Bah, Ebrima; Michelangeli, Frank (Oxford University Press (OUP), 2020-05-29)
      Abstract Objectives To find out the overlapping and correlating relationships between serum haptoglobin level, haptoglobin genotype and phenotype, blood haemoglobin level and zinc protoporphyrin (measured in washed RBCs) in association to prevalence of anaemia. It will focus on comparing all the mention components in contrast to each other. The study will also look for the frequency distribution of the major HP alleles. Methods 1278 participants were randomly selected. Blood samples collected by trained nurses. Data generation was done at the Medical research council (keneba field station) research site. Data Analysis was conducted at the university of Chester with the assistance of the computer department team. Results P = 0.000 indicating anaemia prevalence with HP 1 allele. P > 0.05 when ID, IDA and AI relates with HP genotype. Positive correlation between ZnPP and HP serum level, but negative between ZnPP and Hb. P = 0.000 between ZnPP and IDA. P = 0.024 between HP genotype and Hb level. P = 0.013 between HP genotype and HP serum. P = 0.100 between HP genotype and ZnPP. P = 0.000 between ZnPP and IDA. P = 0.024 between HP genotype and Hb. ZnPP shared a positive correlation with HP serum level, and a negative correlation with Hb level. The correlation significant = 0.01 level (2-tailed) P = 0.01. The correlation between HP genotype and HP serum level was significant with P = 0.013, but the correlation between HP genotype and ZnPP was not significant with P = 0.100. Conclusions HP genotype had association with anaemia prevalence and more occurrence was observed in carriers of the type ‘1’ allele. It had no association with ID, IDA and AI. HP genotype had association with HP serum level and Hb level but had no association with ZnPP level. ZnPP level was observed to have had association with HP serum level, Hb level and IDA; but had no association with ID and AI in the region. Funding Sources All the resources used in this study were from MRC Keneba (International Nutrition Group) which is supported by funds from the UK Medical Research Council (MRC) and the UK Department for International Development (DFID) under the MRC/DFID Concordat agreement (Hennig et al., 2015).
    • Patterns in island endemic forest-dependent bird research: the Caribbean as a case-study

      Devenish-Nelson, Eleanor S.; orcid: 0000-0002-9029-4772; email: ellie.devenish@ed.ac.uk; Weidemann, Douglas; Townsend, Jason; Nelson, Howard P. (Springer Netherlands, 2019-05-04)
      Abstract: Unequal patterns in research effort can result in inaccurate assessments of species extinction risk or ineffective management. A group of notable conservation concern are tropical island endemic birds, many of which are also forest-dependent, which increases their vulnerability to extinction. Yet, island bird species have received limited research attention compared to their continental congeners, despite this taxon being globally regarded as well-studied. We used the insular Caribbean, a globally important endemism hotspot with high rates of deforestation, to explore research bias of island and regional endemic forest-dependent birds. A review of the published literature (n = 992) found no significant increase in the number of studies over the search period. Research effort was significantly higher among species with threatened status, long generation time, wide habitat breadth and low to intermediate elevational distributions. Among family groups, the Psittacidae received the highest research effort, while the Cuculidae were the most underrepresented family (30-fold higher and six-fold less than expected, respectively). We found geographic biases in effort, with Jamaica having six-fold less and Puerto Rico eight times more research than expected for their level of endemism. These patterns likely reflect individual interests and limited capacity and funding, typical of Small Island Developing States. With over 50% of species in this review having declining population trends, we recommend prioritizing research that emphasises conservation- and management-relevant data across underrepresented families and islands, by fostering greater collaboration between researchers, practitioners and the existing local amateur ornithological community.
    • The Functionality of “Ogi” – a fermented cereal gruel made in Nigeria, in the Management of Gastrointestinal Disease

      Pickles, Neil; Weili, Li; Olayanju, Adetokunbo T (University of ChesterUniversity of Chester, 2019-04)
      Fermentation is an ancient food processing technique which has over the years had significant impact on food availability, production, economy and health. Fermented corn, ‘ogi’, is a popular meal in South and West African countries and is also traditionally administered to people, especially children, during the incidence of diarrhoea as it is believed to enhance gut health. Various authors have supported the advantageous health functions of fermented corn but have focussed on the possible health benefits that may be derived from the action of the fermentation organisms by investigating their probiotic potentials. Furthermore, in vivo studies have investigated effective functionality of fermented foods and where studies have suggested positive effect of the fermented food intervention, the component of the complex food matrix that may be responsible is often unknown. Though hypothesised, there has been little information on the possible effects of the end products of the fermentation on gut health. Therefore, this thesis aimed to explore the functionality potentials for ‘ogi’, to enhance gut health by investigating the mechanisms through which it may be able to confer the health benefits when consumed. An independent meta-analysis was undertaken to explore and review the analysis of the effectiveness of fermented foods to significantly reduce the duration of diarrhoea. The first experimental study was a comparison between spontaneously fermented vs controlled method of ‘ogi’ production with the aim to explore the possibility of achieving similar end products. The probiotic potential of fermentation organisms and antimicrobial effect of fermentation organisms against E. coli were also investigated. Colonic short chain fatty acids (SCFAs) are known to enhance immune function in the gut. The second experimental study explored the production of SCFAs in fermented corn with the theory that fermented corn may be a dietary source of SCFA and may produce a comparable effect in the gut as the colonic SCFA. It is established that one of the functions of endogenously synthesised nitric oxide (NO) in the body is to enhance immune functions. Therefore, the potential for ‘ogi’ to enhance immune response in the gut by being a dietary source of Nitric Oxide (NO) was explored in the third experimental study. The outcomes of this thesis suggest that it may not be possible to mimic the exact spontaneous fermentation process in a controlled setting. Weissella confuse, Pediococcus pentosaceus and Saccharomyces cerevisiae were the lactic acid bacteria (LAB) and yeast isolated from spontaneously fermented corn using 16S rRNA sequencing. The isolated organisms along with Lactobacillus plantarum were used as starter culture for controlled fermentation. There was a significant difference between the end products of both fermentations. All organisms except W. confuse showed probiotic potential. Acetate was produced during both fermentations but butyrate was produced during spontaneous fermentation only. There was however higher concentration of NO in controlled fermented corn than spontaneous fermentation with nitrate values of 30.54 µM and 23.21 µM and nitrite values of 17.50 µM and 10.11 µM respectively. These suggest that fermented corn may have probiotic potential and may be able to further enhance immune health in the gut by being a dietary source of SCFAs and NO.
    • An investigation of canine mesenchymal stem cells and their secretome in the context of spinal cord injury

      Johnson, Eustace; Wood, Chelsea R (University of Chester, 2020-05-26)
      Spinal cord injury (SCI) is a condition that has devastating effects on both humans and animals alike. Damage inflicted causes loss of neural tissue and secondary inflammatory mechanisms produce an inhibitory environment that results in partial or complete loss of motor and sensory functions. Additionally, SCI can cause multisystem issues such as organ failures, infections, muscle atrophy and decrease in mental health. Coupled with emotional and financial burdens, these effects can reduce quality of life. Mesenchymal Stem Cells (MSC) are known to have immunomodulatory, angiogenic and paracrine activity, all of which are beneficial to wound healing following SCI. Pre-clinical studies have shown encouraging results of MSC therapy for SCI, however replication of results has been difficult to achieve in the clinic. Dogs also suffer from SCI and show the same heterogenous nature and pathophysiology of SCI as humans. This provides a good potential clinical model for MSC therapies for SCI, as well as providing benefit in the veterinary clinic. Therefore, the overall aim of this study was to assess if canine MSC (cMSC) and cMSC secretome (conditioned medium; CM) could potentially be used for treatment of SCI in veterinary clinics, simultaneously providing model data that could be translated into the human clinic. It was first required to confirm efficacy of cMSC when used to treat other conditions in dogs, such as arthritis, along with safety of autologous transplantation. Characterisation of both cMSC phenotype and paracrine (angiogenic and neurogenic) activity was confirmed using ISCT criteria and the established cell lines EA.hy926 and SH-SY5Y. Further examination showed that exposure to certain elements of the injured spinal cord, such as CSPG which are found within the inhibitory glial scar, exerted some effects on cMSC and cMSC angiogenic and neurogenic paracrine activity. To finish, the study aimed to assess the effect of cMSC CM on an ex vivo model of the spinal cord, a multicellular environment and it was found that cMSC CM increased astrocyte reactivity but reduced neuronal maturation and growth, suggesting that cMSC paracrine activity depends in part on the spinal cord microenvironment. Overall, this study has shown that cMSC, in particular cMSC CM, could be used as complete or partial treatment for SCI in dogs.
    • Mangrove or mudflat: Prioritising fish habitat for conservation in a turbid tropical estuary

      Marley, Guy; Deacon, Amy; Philip, Dawn; Lawrence, Andrew; University of the West Indies, University of the West Indies, University of the West Indies, University of Chester
      Mangrove habitats are typically the focus of conservation efforts in tropical estuaries because their structural complexity is thought to support greater biodiversity and nursery function than unvegetated habitats. However, evidence for this paradigm has been equivocal in turbid tropical estuaries where unvegetated mudflats are also highly productive. The present study compared the community composition, biodiversity, nursery-role and commercial fish biomass in two mangrove habitats and one mudflat habitat in the Gulf of Paria, Trinidad. A total of 12 705 fishes, comprising 63 species from 26 families, were sampled in mangrove creeks, seaward mangrove fringe and the subtidal margin of an intertidal mudflat from June 2014 to June 2015. The composition of the creek and mudflat communities were distinct, while the community of the mangrove fringe more closely resembled the mudflat than the mangrove creeks. Mean species richness (MSR), total species richness (TSR) extrapolated from species accumulation curves, and juvenile species richness (JSR) were significantly greater in the mudflat (MSR = 11.4 ± 1.0; TSR = 75 ± 14; JSR = 9.1 ± 0.8) than mangrove creeks (MSR = 9.0 ± 0.5; TSR = 49 ± 3; JSR = 6.1 ± 0.4) and the seaward mangrove fringe (MSR = 6.4 ± 0.7; TSR = 58 ± 14; JSR = 5.2 ± 0.4). Meanwhile, Shannon Weiner diversity, juvenile fish abundance and commercial fish biomass were comparable between habitats. These findings caution against the generalisation that mangroves are the most important habitat for fishes in turbid tropical estuaries. There is now a growing body of evidence that mudflats warrant consideration as important repositories of biodiversity and nursery function for juvenile fishes.
    • Methadone‐Assisted Opiate Withdrawal and Subsequent Heroin Abstinence: The Importance of Psychological Preparedness

      Jones, Steven; Jack, Barbara; Kirby, Julie; Wilson, Thomas; Murphy, Philip; University of Chester
      Background and Objectives: Treatment guidelines emphasize patients’ readiness for transitioning from opiate substitution treatment (OST) to opiate withdrawal and abstinence. Psychological preparedness indicators for this transition were examined. Methods: Patients (all male) were recruited from three treatment settings: prison, an inpatient detoxification unit, and an outpatient clinic. Time 1 (T1) was admission to methadone‐assisted withdrawal in all settings. Time 2 (T2) was a 6‐month follow‐up. With n = 24 at T1 for each group (N = 72), a battery of instruments relevant to psychological preparedness was administered. Results: At T1, inpatients had higher self‐efficacy beliefs for successful treatment completion than prison patients. For patients contactable at T2, T1 self‐efficacy positively predicted T2 opiate abstinence. No other variable improved prediction. T1 SOCRATES (Stages of Change Readiness and Treatment Eagerness Scale) ambivalence scores, age, and lifetime heroin use duration predicted maintenance of contact or not with treatment services and contactability by the researcher. Measures of mood did not differ between groups at T1 or predict T2 outcomes. Discussion and Conclusions: Self‐efficacy beliefs are a potentially useful indicator of readiness for transitioning from OST to a medically assisted opiate withdrawal and subsequent abstinence. Ambivalence regarding change, age, and lifetime heroin use duration are potentially useful predictors of patients maintaining contact with services, and of being retained in research. Scientific Significance: These findings advance existing literature and knowledge by highlighting the importance of self‐efficacy in psychological preparedness for opiate abstinence, and the predictive utility to clinicians of this and other variables measurable at admission, in the clinical management of opiate users
    • From public issues to personal troubles: individualising social inequalities in health within local public health partnerships

      Mead, Rebecca; Thurston, Miranda; Bloyce, Daniel; University of Lancaster; Inland Norway University of Applied Sciences; University of Chester (Taylor and Francis, 2020-05-20)
      This paper explores public health policy implementation through partnership working at the local level by examining how local actors from public health and the wider workforce, make sense of and work on social inequalities in health. An ethnographic case study was used to examine policy implementation in one local strategic partnership in north-west England during a period of significant resource constraint. Semi-structured interviews were the primary method of data generation. Sensitising concepts from figurational sociology were used to develop a theoretical account of how local policy implementation directed at narrowing social inequalities in health tended to give rise to relatively fragmented and short-term services, projects and practices, which focused on lifestyle factors and behaviour change. Theorising partnership work as figurations goes some way to explaining the apparent paradox among participants who expressed a relatively detached appreciation of wider social influences, alongside emotional involvement in their work. This process of individualisation explains how local professionals tended to conceptualise health inequality and the social determinants of health as personal troubles. Individualisation meant that the social reality of working in partnerships on difficult issues was simplified. Thus, any scope for working on the social determinants of health tended to be overlooked. The extent to which this was intentional or a matter of struggling to see opportunities, or a mixture of the two, was difficult to discern. Although the policy landscape has changed, the findings give some insight into understanding how local collaborative processes reproduce local public health work underpinned by lifestyle choices.
    • Adherence to Pre-operative Exercise and the Response to Prehabilitation in Oesophageal Cancer Patients

      Halliday, Laura; Doganay, Emre; Winter-Blyth, Venetia; Osbourne, Hayley; Buckley, John P; Moorthy, Krishna; Imperial College London, University Centre Shrewsbury/Chester
      BACKGROUND: Prehabilitation is thought to reduce post-operative respiratory complications by optimising fitness before surgery. This prospective, single-centre study aimed to establish the effect of pre-operative exercise on cardiorespiratory fitness in oesophageal cancer patients and characterise the effect of adherence and weekly physical activity on response to prehabilitation. METHODS: Patients received a personalised, home-based pre-operative exercise programme and self-reported their adherence each week. Cardiorespiratory fitness (pVO2max and O2 pulse) was assessed at diagnosis, following completion of neoadjuvant chemotherapy (NAC) and immediately before surgery. Study outcomes included changes in fitness and post-operative pneumonia. RESULTS: Sixty-seven patients with oesophageal cancer underwent prehabilitation followed by surgery between January 2016 and December 2018. Fitness was preserved during NAC and then increased prior to surgery (pV02max Δ = +2.6 ml min-1, 95% CI 1.2-4.0 p = 0.001; O2 pulse Δ = +1.4 ml beat-1 95% CI 0.5-2.3 p = 0.001). Patients with higher baseline fitness completed more physical activity. Regression analyses found adherence was associated with improvement in fitness immediately before surgery (p = 0.048), and the amount of physical activity completed was associated with the risk of post-operative pneumonia (p = 0.035). CONCLUSION: Pre-operative exercise can maintain cardiorespiratory fitness during NAC and facilitate an increase in fitness before surgery. Greater exercise volumes were associated with a lower risk of post-operative pneumonia, highlighting the importance progressing exercise programmes throughout prehabilitation. Patients with high baseline fitness completed more physical activity and may require less supervision to reach their exercise goals. Further research is needed to explore stratified approaches to prehabilitation. KEYWORDS: Exercise therapy; Oesophageal cancer; Pre-operative care; Surgery
    • Lamin A/C dysregulation contributes to cardiac pathology in a mouse model of severe spinal muscular atrophy

      Soltic, Darija; Shorrock, Hannah K; Allardyce, Hazel; Wilson, Emma L; Holt, Ian; Synowsky, Silvia A; Shirran, Sally L; Parson, Simon H; Gillingwater, Thomas H; Fuller, HR; et al.
      Cardiac pathology is emerging as a prominent systemic feature of spinal muscular atrophy (SMA), but little is known about the underlying molecular pathways. Using quantitative proteomics analysis, we demonstrate widespread molecular defects in heart tissue from the Taiwanese mouse model of severe SMA. We identify increased levels of lamin A/C as a robust molecular phenotype in the heart of SMA mice and show that lamin A/C dysregulation is also apparent in SMA patient fibroblast cells and other tissues from SMA mice. Lamin A/C expression was regulated in vitro by knockdown of the E1 ubiquitination factor ubiquitin-like modifier activating enzyme 1, a key downstream mediator of SMN-dependent disease pathways, converging on β-catenin signaling. Increased levels of lamin A are known to increase the rigidity of nuclei, inevitably disrupting contractile activity in cardiomyocytes. The increased lamin A/C levels in the hearts of SMA mice therefore provide a likely mechanism explaining morphological and functional cardiac defects, leading to blood pooling. Therapeutic strategies directed at lamin A/C may therefore offer a new approach to target cardiac pathology in SMA.
    • Pro-Inflammatory Priming of Umbilical Cord Mesenchymal Stromal Cells Alters the Protein Cargo of Their Extracellular Vesicles

      Hyland, Mairead; Mennan, Claire; Wilson, Emma; Clayton, Aled; Kehoe, Oksana; School of Medicine, Keele University, School of Pharmacy and Bioengineering at the RJAH Orthopaedic Hospital, Chester Medical School, School of Medicine, Cardiff
      Umbilical cord mesenchymal stromal cells (UCMSCs) have shown an ability to modulate the immune system through the secretion of paracrine mediators, such as extracellular vesicles (EVs). However, the culture conditions that UCMSCs are grown in can alter their secretome and thereby affect their immunomodulatory potential. UCMSCs are commonly cultured at 21% O2 in vitro, but recent research is exploring their growth at lower oxygen conditions to emulate circulating oxygen levels in vivo. Additionally, a pro-inflammatory culture environment is known to enhance UCMSC anti-inflammatory potential. Therefore, this paper examined EVs from UCMSCs grown in normal oxygen (21% O2), low oxygen (5% O2) and pro-inflammatory conditions to see the impact of culture conditions on the EV profile. EVs were isolated from UCMSC conditioned media and characterised based on size, morphology and surface marker expression. EV protein cargo was analysed using a proximity-based extension assay. Results showed that EVs had a similar size and morphology. Differences were found in EV protein cargo, with pro-inflammatory primed EVs showing an increase in proteins associated with chemotaxis and angiogenesis. This showed that the UCMSC culture environment could alter the EV protein profile and might have downstream implications for their functions in immunomodulation.
    • Submaximal Exercise Testing in Cardiovascular Rehabilitation Settings (BEST Study)

      Reed, Jennifer L; Cotie, LM; Cole, CA; Harris, Jennifer; Moran, B; Scott, K; Buckley, John P; Pipe, Andrew L; University of Ottawa, University Centre Shrewsbury/Chester
      Abstract BACKGROUND: This study compared changes in measured versus predicted peak aerobic power (V̇O2 peak) following cardiovascular rehabilitation (CR). Peak cardiopulmonary exercise testing (CPET) results were compared to four V̇O2 peak estimation methods: the submaximal modified Bruce treadmill, Astrand-Ryhming cycle ergometer, and Chester step tests, and the Duke Activity Status Index (DASI). METHODS: Adults with cardiovascular disease (CVD) who completed a 12-week CR program were assessed at baseline and 12 weeks follow-up. CPET, the DASI and three subsequent submaximal exercise tests were performed in a random order. RESULTS: Of the 50 adults (age: 57 ± 11 years) who participated, 46 completed the 12-week CR program and exercise tests. At baseline 69, 68, and 38% of the treadmill, step and cycle tests were successfully completed, respectively. At follow-up 67, 80, and 46% of the treadmill, step and cycle tests were successfully completed, respectively. No severe adverse events occurred. Significant improvements in V̇O2 peak were observed with CPET (3.6 ± 5.5 mL.kg-1.min-1, p < 0.001) and the DASI (2.3 ± 4.2 mL.kg-1.min-1, p < 0.001). Bland-Altman plots of the change in V̇O2 peak between CPET and the four V̇O2 peak estimation methods revealed the following: a proportional bias and heteroscedastic 95% limits of agreement (95% LoA) for the treadmill test, and for the cycle and step tests and DASI, mean bias' and 95% LoA of 1.0 mL.kg-1.min-1 (21.3, -19.3), 1.4 mL.kg-1.min-1 (15.0, -12.3) and 1.0 mL.kg-1.min-1 (13.8, -11.8), respectively. CONCLUSION: Given the greater number of successful tests, no serious adverse events and acceptable mean bias, the step test appears to be a valid and safe method for assessing group-level mean changes in V̇O2 peak among patients in CR. The DASI also appears to be a valid and practical questionnaire. Wide limits of agreement, however, limit their use to predict individual-level changes. Copyright © 2020 Reed, Cotie, Cole, Harris, Moran, Scott, Terada, Buckley and Pipe. KEYWORDS: cardiovascular diseases; exercise test; physiology; rehabilitation; submaximal
    • A comparison of self-reported and device measured sedentary behaviour in adults: a systematic review and meta-analysis.

      Cardilli, Luca; Reed, Jennifer L; Saunders, Travis J; Kite, Chris; Douilette, K; Fournier, K; Buckley, John P; University of Ottawa
      Abstract BACKGROUND: Sedentary behaviour (SB) is a risk factor for chronic disease and premature mortality. While many individual studies have examined the reliability and validity of various self-report measures for assessing SB, it is not clear, in general, how self-reported SB (e.g., questionnaires, logs, ecological momentary assessments (EMAs)) compares to device measures (e.g., accelerometers, inclinometers). OBJECTIVE: The primary objective of this systematic review was to compare self-report versus device measures of SB in adults. METHODS: Six bibliographic databases were searched to identify all studies which included a comparable self-report and device measure of SB in adults. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses. RESULTS: The review included 185 unique studies. A total of 123 studies comprising 173 comparisons and data from 55,199 participants were used to examine general criterion validity. The average mean difference was -105.19 minutes/day (95% CI: -127.21, -83.17); self-report underestimated sedentary time by ~1.74 hours/day compared to device measures. Self-reported time spent sedentary at work was ~40 minutes higher than when assessed by devices. Single item measures performed more poorly than multi-item questionnaires, EMAs and logs/diaries. On average, when compared to inclinometers, multi-item questionnaires, EMAs and logs/diaries were not significantly different, but had substantial amount of variability (up to 6 hours/day within individual studies) with approximately half over-reporting and half under-reporting. A total of 54 studies provided an assessment of reliability of a self-report measure, on average the reliability was good (ICC = 0.66). CONCLUSIONS: Evidence from this review suggests that single-item self-report measures generally underestimate sedentary time when compared to device measures. For accuracy, multi-item questionnaires, EMAs and logs/diaries with a shorter recall period should be encouraged above single item questions and longer recall periods if sedentary time is a primary outcome of study. Users should also be aware of the high degree of variability between and within tools. Studies should exert caution when comparing associations between different self-report and device measures with health outcomes. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42019118755. KEYWORDS: Self-report; device; sedentary behaviour; systematic review
    • A review of tropical dry forest ecosystem service research in the Caribbean – gaps and policy-implications

      Nelson, Howard; Devenish-Nelson, Eleanor; Rusk, Bonnie; Geary, Matthew; Lawrence, Andrew; University of Chester;University of Edinburgh; Grenada Dove Conservation Programme
      Tropical dry forests (TDFs) are globally threatened, yet remain poorly studied. In the Caribbean, the most biodiverse of island biodiversity hotspots, TDFs have structural properties distinct from the Neotropical mainland and are important to local communities for ecosystem services. We undertook a systematic review (n = 186) of ecosystem services literature of Caribbean TDF. Only 19.89% qualified for inclusion, with the majority (56.76%) from primary literature. Research on supporting services (31.14%), particularly primary production was predominant. Most studies (70.97%) took a biophysical perspective and quantification focused on the supply of ecosystem services (43.00%), while measurement of wellbeing benefits were uncommon. Geographic coverage of all studies was patchy originating from only nine of 28 independent countries and dependent territories. Our findings highlight a lack of research, while accentuating the value of grey literature in quantifying cultural services. Of concern, are gaps in air- and water-related services and the importance of TDF to human health. To move from biophysical assessments to a broader portfolio of ecosystem services studies, research on Caribbean TDF should be collaborative and strategic. Such gaps and research biases suggest opportunities for evidence-led policy-making. These lessons are relevant for mainstreaming ecosystem services into decision-making in Small Island Developing States.
    • Age-related degeneration of the lumbar paravertebral muscles: Systematic review and three-level meta-regression

      Dallaway, Alexander; Kite, Chris; Griffin, Corbyn; Duncan, Michael; Tallis, J; Renshaw, D; Hattersley, John; Coventry University, University Hospitals Coventry and Warwickshire, Aston University, University of Chester
      Background Morphological changes of the lumbar spine muscles are not well characterised with ageing. To further the understanding of age-related degeneration of the lumbar spine musculature, normative morphological changes that occur within the paravertebral muscles must first be established. Methods A systematic review and meta-regressions were conducted adhering to PRISMA guidelines. Searches for published and unpublished data were completed in June 2019. Results Searches returned 4781 articles. 34 articles were included in the quantitative analysis. Three-level meta-analyses showed age-related atrophy (r = −0.26; 95% CI: −0.33, −0.17) and fat infiltration (r = 0.39; 95% CI: 0.28, 0.50) in the lumbar paravertebral muscles. Degenerative changes were muscle-specific and men (r = −0.32; 95% CI: −0.61, 0.01) exhibited significantly greater muscle atrophy than women (r = −0.24; 95% CI: −0.47, 0.03). Imaging modality, specifically ultrasound, also influenced age-related muscle atrophy. Measurements taken across all lumbar levels revealed the greatest fat infiltration with ageing (r = 0.58, 95% CI: 0.35, 0.74). Moderators explained a large proportion of between-study variance in true effects for muscle atrophy (72.6%) and fat infiltration (79.8%) models. Conclusions Lumbar paravertebral muscles undergo age-related degeneration in healthy adults with muscle, lumbar level and sex-specific responses. Future studies should use high-resolution imaging modalities to quantify muscle atrophy and fat infiltration.
    • A comparison of self-reported and device measured sedentary behaviour in adults: a systematic review and meta-analysis.

      Prince, Stephanie; Cardilli, Luca; Reed, Jennifer; Saunders, Travis; Kite, Chris; Douillette, Kevin; Fournier, Karine; Buckley, John; University of Ottawa Heart Institute, Public Health Agency of Canada, Birmingham Community Healthcare NHS Foundation Trust, University of Chester, University of Ottawa, University of Prince Edward Island, Aston University
      Background Sedentary behaviour (SB) is a risk factor for chronic disease and premature mortality. While many individual studies have examined the reliability and validity of various self-report measures for assessing SB, it is not clear, in general, how self-reported SB (e.g., questionnaires, logs, ecological momentary assessments (EMAs)) compares to device measures (e.g., accelerometers, inclinometers). Objective The primary objective of this systematic review was to compare self-report versus device measures of SB in adults. Methods Six bibliographic databases were searched to identify all studies which included a comparable self-report and device measure of SB in adults. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses. Results The review included 185 unique studies. A total of 123 studies comprising 173 comparisons and data from 55,199 participants were used to examine general criterion validity. The average mean difference was -105.19 minutes/day (95% CI: -127.21, -83.17); self-report underestimated sedentary time by ~1.74 hours/day compared to device measures. Self-reported time spent sedentary at work was ~40 minutes higher than when assessed by devices. Single item measures performed more poorly than multi-item questionnaires, EMAs and logs/diaries. On average, when compared to inclinometers, multi-item questionnaires, EMAs and logs/diaries were not significantly different, but had substantial amount of variability (up to 6 hours/day within individual studies) with approximately half over-reporting and half under-reporting. A total of 54 studies provided an assessment of reliability of a self-report measure, on average the reliability was good (ICC = 0.66). Conclusions Evidence from this review suggests that single-item self-report measures generally underestimate sedentary time when compared to device measures. For accuracy, multi-item questionnaires, EMAs and logs/diaries with a shorter recall period should be encouraged above single item questions and longer recall periods if sedentary time is a primary outcome of study. Users should also be aware of the high degree of variability between and within tools. Studies should exert caution when comparing associations between different self-report and device measures with health outcomes.
    • Stochastic ordering of simulated rugby match activity produces reliable movements and associated measures of subjective task load, cognitive and neuromuscular function

      Mullen, Thomas; Twist, Craig; Highton, Jamie; University of Chester (Taylor and Francis, 2019-07-31)
      The study assesses the test–retest reliability of movement and physiological measures during a simulated rugby match that employed activities performed in a stochastic order. Twenty male rugby players (21.4 ± 2.1 y) completed two trials of a 2 × 23 min rugby movement simulation protocol during which the order of events was performed in a stochastic order, with 7–10 days between trials. Movement characteristics, heart rate (HR), RPE, maximum voluntary contraction (MVC), voluntary activation (VA%) of the quadriceps, Stroop test and subjective task load rating (NASA-TLX) were measured. The most reliable measures of external load was relative distance (typical error [TE] and CV% = 1.5–1.6 m min−1 and 1.4–1.5%, respectively), with all other movement characteristics possessing a CV% <5%. The most reliable measure of internal load, neuromuscular function and perceptual measures were for %HRmax (TE and CV% = 1.4–1.7% and 1.4–2.1%, respectively), MVC before (TE and CV% = 10.8–14.8 N·m and 3.8–4.6%, respectively), and average RPE (TE and CV% = 0.5–0.8 AU and 3.6–5.5%, respectively). The Stroop test, NASA-TLX and blood lactate produced the least reliable measures (CV% >5%). Future studies can confidently examine changes in several perceptual, neuromuscular, physiological and movement measures related to rugby activity using stochastic movements.