The development of an EU-wide nutrition and physical activity expert knowledge base to support a personalised mobile application across various EU population groups.

A healthy lifestyle comprising regular physical activity and an adequate diet is imperative for the prevention of non-communicable diseases such as hypertension and some cancers. Advances in information computer technology offer the opportunity to provide personalised lifestyle advice directly to the individual through devices such as smartphones or tablets. The overall aim of the PROTEIN project (Wilson-Barnes et al., 2021) was to develop a smartphone application that could provide tailored and dynamic nutrition and physical activity advice directly to the individual in real time. However, to create this mobile health (m-health) smartphone application, a knowledge base of reference ranges for macro-/micronutrient intake, anthropometry, biochemical, physiological and sleep parameters was required to underpin the parameters of the recommender systems. Therefore, the principal aim of this emerging research paper is to describe the process by which experts in nutrition and physiology from the PROTEIN consortium collaborated to develop the nutritional and physical activity requirements, based upon existing recommendations, for 10 separate population groups living within the EU including, but not limited to healthy adults, adults with type 2 diabetes mellitus, cardiovascular disease, excess weight, obesity and iron deficiency anaemia. A secondary aim is to describe the development of a library of 24-h meal plans appropriate for the same groups and also encompassing various dietary preferences and allergies. Overall, the consortium devised an extensive nutrition and physical activity knowledge base that is pertinent to 10 separate EU user groups, is available in 7 different languages and is practically implemented via a library of culturally appropriate, 24-h meal plans.

Examining the impact of interventions in reducing self-reported engagement in distracted driving: A systematic review.

Despite the implementation of legal countermeasures, distracted driving remains a prevalent concern for road safety. This systematic review (following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines) summarised the literature on the impact of interventions targeting attitudes/intentions towards, and self-reported engagement in, distracted driving. Studies were eligible for this review if they examined self-reported behaviour/attitudes/intentions pertaining to distracted driving at baseline and post-intervention. Databases searched included PubMed, ProQuest, Scopus, and TRID. The review identified 19 articles/interventions, which were categorised into three intervention types. First, all program-based interventions (n = 6) reduced engagement in distracted driving. However, there were notable limitations to these studies, including a lack of control groups and difficulties implementing this intervention in a real-world setting. Second, active interventions (n = 9) were commonly utilised, yet a number of studies did not find any improvements in outcomes. Finally, four studies used a message-based intervention, with three studies reporting reduced intention and/or engagement in distracted driving. There is opportunity for message-based interventions to be communicated effortlessly online and target high-risk driving populations. However, further research is necessary to address limitations highlighted in the review, including follow-up testing and control groups. Implications are discussed with particular emphasis on areas where further research is needed.

Do comparative judgements affect the perceived relevance of mobile phone road safety campaigns?

OBJECTIVE: Given the prevalence of illegal mobile phone use while driving and reliance upon messaging campaigns in deterring the behavior, there is a need to explore to what extent comparative judgements may influence desired outcomes of such campaigns. This exploratory study investigated (a) the perceived relevance and influence of different mobile phone road safety campaigns within a sample of Queensland motorists who reported using their mobile phone while driving and (b) if these varied depending on whether participants believed that their crash risk whilst using a phone was higher (comparative pessimism), lower (comparative optimism) or similar to the same-age and sex driver. METHODS: A total of 350 licensed drivers residing within Queensland (Australia) were included in this study, of which 200 reported using their hand-held phone on some occasion. Participation involved completing a 20-25 min online anonymous survey, which included viewing three mobile phone road safety campaigns (injury-based, sanction-based and humor) and responding to questions about the perceived relevance and impact of each campaign. RESULTS: A total of 64 (32%) participants displayed comparative optimism, 50 displayed similar judgements (25%) and 86 (43%) exhibited comparative pessimism. First, it was found that the injury-based campaign was perceived to be significantly more relevant than the humor campaign. Second, whilst the relevance of each campaign did not vary as a function of group membership, the campaigns were significantly less relevant to those displaying comparative optimism relative to those with similar judgements and comparative pessimism. Finally, the injury-based campaign was perceived to be significantly more influential than the other campaigns. However, overall, participants displaying comparative optimism believed that they would be less influenced by the campaigns compared to those with comparative pessimism. CONCLUSIONS: Although preliminary, these findings suggest that low perceptions of risk may dilute or extinguish the desired behavioral outcomes of mobile phone road safety campaigns. Nonetheless, experimental research is needed to examine these effects directly.

Cognitive correlates of reduced driving performance in healthy older adults: A meta-analytic review.

AIMS / OBJECTIVES: This meta-analytic review examines the evidence for the relationship between cognitive function and driving performance in older adults. The primary aims of this review were: (a) to identify cognitive correlates of reduced driving performance in older adults and (b) to determine whether such measures reliably predict reductions in driving performance over time. METHODS: This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Peer reviewed studies that examined the (cross-sectional or longitudinal) relationship between standardised neuropsychological test performance measures and driving performance (e.g., via an on-road test, in-vehicle monitoring system, hazard perception test or driving simulator) in healthy adults aged 60 years and older, were included. RESULTS/DISCUSSION: Eighteen studies were eligible for inclusion, of which 12 met requirements for meta-analysis. The results indicated that reaction time and Trail Making Test (TMT) A scores exhibited small-to-moderate correlations with driving performance, with moderate effects identified for block design, TMT B, Useful Field of View (UFOV) 2 and 3 tests. Further, no significant relationships were observed between the Mini-Mental State Examination and UFOV 1 with driving performance. Due to a paucity of data, the longitudinal relationship between such measures and driving could not be identified. The findings highlight (a) the potential of cognitive assessments to identify older adults at risk of driving impairment (as part of a larger diagnostic assessment), and (b) the urgent need for prospective longitudinal studies in investigating the impact of age-related changes in cognition on driving performance over time.

Community narratives on Facebook regarding mobile phone use while driving and road policing technologies.

Objective: Mobile phone use while driving is a major cause of distraction and area for concern. Numerous factors have been shown to be associated with engagement in mobile phone use while driving, including peer influences and social media content encouraging the behavior. Phone detection cameras are being increasingly utilized to enforce the hand-held mobile phone use while driving ban in Australia, yet this has been accompanied by an emergence of camera location pages on social media platforms such as Facebook. Research is clearly needed to explore the nature and extent of this online content, since such information can be used to counteract any negative effects on enforcement.Methods: Accordingly, this exploratory study analyzed content on Facebook pertaining to mobile phone use while driving, enforcement of the behavior and legal penalties associated with the behavior.Results: A total of 167 public Facebook posts shared within Australia in January to October 2021 were examined. Overall, it was found that: (a) a large proportion (74%) of posts focused on the location of mobile phone cameras, (b) whilst most discussions centered around discouraging mobile phone use while driving, a large number also aimed to facilitate avoiding detection for the behavior. Finally, very few posts/comments acknowledged the risks associated with the behavior, including the risk of being caught.Conclusions: This research provides preliminary evidence that social media platforms appear to provide an avenue to reduce the likelihood of apprehension. Avenues for future research are discussed.

Perceptions matter: speeding behavior varies as a function of increasing perceived exposure to content encouraging the behavior.

OBJECTIVE: Speeding is a high-risk behavior that accounts for a significant number of crashes and fatalities across the globe. Prior research indicates that a relationship exists between exposure to speeding behavior (via one's peers or mass media) and subsequent engagement in the behavior. However, no study to date has quantified the perceived extent to which individuals are exposed to such content. Further, the impact of social media content on speeding behavior, relative to peer engagement and mass media sources, has not been investigated. Accordingly, this exploratory study aimed to: (a) quantify the self-reported extent to which the sample believe they were exposed to content encouraging speeding on social media, mass media and peer engagement in the behavior, and (b) examine whether speeding behavior varied as a function of increasing exposure to the behavior via these mediums. METHODS: A total of 628 Queensland motorists with a Facebook account were included in this study. Participation involved completing an online survey of 20-25 minutes duration. RESULTS: Consistent with previous research, half of the sample reported speeding more than 10% of the time they drive (n = 315). On average, participants believed they were exposed to content encouraging speeding behavior 40% of the time via mass media (e.g., television, movies or gaming) and 29% of the time on social media. In addition, they perceived their friends to exceed the speed limit 39% of the time. Finally, self-reported speeding behavior varied as a function of exposure, such that exposure levels were significantly higher in speeders than non-speeders. CONCLUSIONS: The findings from this study suggest that perceptions concerning the frequency with which individuals are exposed to material encouraging speeding via mass media or social media, and their perceptions regarding their peers' engagement in the behavior, all correspond with engagement in speeding behavior. Future research is needed to disentangle the relative impact of such mediums on speeding behavior, and the levels of exposure required to induce behavior change on the road.

Female genital tract microbiota affecting the risk of preterm birth: What do we know so far? A review.

Spontaneous Preterm birth (SPTB) is a common obstetric complication affecting 12.9 million births worldwide and is the leading cause of neonatal morbidity and mortality. Disruption in the vaginal microbiota has an impact on the maternal immunological profile leading to SPTBs. Scientists have struggled to link maternal infectious agents with the dysregulation of the maternal immune response in cases of SPTBs. Throughout the last decade, important findings regarding the role of microbiota and its genome, the so-called microbiome, have linked alterations within the population of the microorganisms in our bodies with changes in nutrition, immunity, behaviour and diseases. In this review, evidence regarding the female genital tract microbiota and microbiome has been examined to help further our understanding of its role in disrupting the maternal immune system resulting in spontaneous preterm birth.

Impact assessment of agricultural driven stressors on benthic macroinvertebrates using simulated data.

Agricultural land use poses a significant threat to the ecological integrity of rivers in Europe. Particularly in the Mediterranean, water abstraction and nutrient application are anthropogenic pressures that have a significant impact on aquatic habitats and biodiversity. In this article, we assessed the effects of agricultural management practices on benthic macroinvertebrates in a large river basin of central Greece using simulated data based on the application of SWAT (Soil Water Assessment Tool) model. Physicochemical and hydrological output variables of the model were used as predictors of the ASPT (Average Score Per Taxon) metric based on a correlated component regression analysis (CCR) built on empirical data. The estimation of ASPT was performed for the wet and dry seasons within a 20-year period for a total of 47 subbasins under the baseline conditions and after implementing three management scenarios that reduced: a) irrigation water applied to crops by 30%, b) chemical fertilization applied to crops by 30% and c) both irrigation and fertilization by 30%. The results revealed that application of the reduced irrigation resulted to a slight increase of the simulated dissolved inorganic nitrogen concentration (DIN), which in turn decreased the mean ASPT in 21 of the 47 subbasins implying a negative effect on the macroinvertebrate communities. On the contrary, the reduction of fertilization as well as the combined scenario decreased both the simulated DIN and phosphate concentration causing an increase of the mean ASPT for a total of 40 of the 47 subbasins. Based on these results, we suggest that the best management option is a combined practice of deficit irrigation and fertilization reduction since it improved water quality, increased ASPT values and saved a considerable amount of water. Overall, this work demonstrates a simple methodology that can efficiently assess the effects of agricultural management practices on biotic indicators.

A rare presentation of colonic duplication cyst: report of a case and review of literature.

Duplication cyst is an uncommon congenital abnormality of the alimentary tract. It can occur anywhere in the alimentary tract with the ileum and the jejunum representing the most common sites of duplication. Most often the patients are asymptomatic and colonic duplication cysts remain undiagnosed for years. In this case report we present an unusual case of colonic duplication cyst with a transverse colon location. We present the radiological findings of this rare congenital malformation in order to be included in the differential diagnosis of cystic masses of the gastrointestinal tract.

Exercise and sedentary habits among adolescents with PCOS.

STUDY OBJECTIVE: The purpose of this study was the recording of physical activity and sedentary habits of adolescents with polycystic ovarian syndrome (PCOS). METHODS: We performed a structured interview to assess the level of physical activity and sedentary habits of girls with PCOS. We used a group of healthy adolescents as controls. All girls had their age, height, weight, hip and waist circumference measured and their BMI calculated. RESULTS: 81 girls (35 with PCOS and 46 controls) participated in the study. Girls with PCOS engaged in physical activities less than controls. Even when they did, the frequency and intensity of exercise was less. Also, girls with PCOS were less likely to be aware of the positive effects of exercise on their health. Girls in both groups were sedentary in excess of the 4 hours per day limit, which has been linked with obesity. CONCLUSION: Healthy teenagers were involved in a sporting activity more often and more frequently than the PCOS group. Athletic and sedentary habits of adolescents with PCOS may interact with other factors leading to obesity.

Contrast-enhanced ultrasound for imaging blunt abdominal trauma - indications, description of the technique and imaging review.

Patients with blunt abdominal trauma are initially imaged with ultrasound (US) for the evaluation of free abdominal fluid. However, lacerations of solid organs can be overlooked. Although computed tomography (CT) is the gold standard technique for abdominal trauma imaging, overutilization, ionizing radiation, need to transport the patient and potential artifacts are well known disadvantages. Contrast-enhanced US (CEUS) can be used as an imaging tool between the two methods. It can easily and reliably reveal solid abdominal organ injuries in patients with low-energy localized trauma and decrease the number of CT scans performed. It can be rapidly performed at the patient's bedside with no need for transportation. There are only very few contraindications and anaphylactoid reactions are extremely rare. Altogether, CEUS has proved to be very helpful for the initial imaging of traumatic lesions of the liver, kidney and spleen, as well as for patient follow-up.

Causes of infertility in men with Down syndrome.

Men with Down syndrome are considered as infertile although the causes of infertility are not known in detail yet. Although this constitutes a general rule there are three confirmed cases of parenting by fathers with Down syndrome. Many investigators have addressed the causes of infertility and their studies indicate that the causes may be hormonal deficits, morphological alterations of the gonads, abnormal spermatogenesis, psychological and social factors related to the mental retardation. It is obvious that the extra chromosome 21 has a detrimental direct and indirect effect on the reproductive capacity of the affected male patient. But the definite cause of the insufficient and inadequate spermatogenesis remains to be discovered.

Alexithymia is positively associated with the outcome of in vitro fertilization (IVF) treatment.

The goal was to examine prospectively the relation of psychological factors to the outcome after in vitro fertilization (IVF) in a sample of Greek women. Previous studies investigating the relation of IVF outcome to anxiety and depression have yielded contradictory results; other psychological dimensions have not been studied. 81 women who followed an IVF program during a 6-mo. period were prospectively evaluated. Demographic and gynecological data were assessed and women completed questionnaires measuring anxiety, depression, narcissistic traits, over-dependency, self-esteem, hostility, and alexithymia. Multiple logistic regression analysis showed that successful IVF outcome correlated with more alexithymic characteristics and younger age. Correlation between alexithymia and successful IVF outcome is demonstrated. This might be explained by the "operational" nature of IVF techniques, to which alexithymic individuals would respond better.

The role of three-dimensional imaging in the investigation of IUD malposition.

OBJECTIVES: The aim of this study was to present a systematic review of the use of three-dimensional ultrasound for the detection and evaluation of intrauterine device malposition in a patient of our department. BACKGROUND: Transvaginal sonography failed to detect IUD misplacement in about 9% of cases. Whereas the three-dimensional ultrasound (3D), a new emerging technology, that could provide precise evaluation of IUD malposition. METHODS: The data were extracted from the literature using computerised Medline system. The use-effectiveness and acceptance of three-dimensional imaging in the detection of IUD malposition was examined as an alternative method to two-dimensional ultrasound. RESULTS: Three-dimensional ultrasound was more accurate than two-dimensional for the identifying IUD device. Three-dimensional technique enables assessment of IUD length in the longitudinal section synchronically with imaging arms of the device. Examination with 2D ultrasound is limited to transverse views of the shaft. The arms or other smaller parts cannot be investigated completely because of the frontal view of an IUD is rarely presented. CONCLUSION: Three-dimensional ultrasound is a new and promising imaging tool which provides much better view of the endometrial cavity. This is especially useful in uterus examination and in the detection of IUDs because structures that are not located in one single plane can be imaged simultaneously. Three-dimensional ultrasound is considered to be more secure and safer diagnostic technique to determine the location of IUDs than hysteroscopic evaluation (Fig. 2, Ref. 17). Full Text (Free, PDF) www.bmj.sk.

MRI investigation for neurofibromatosis type 1 lesions during pregnancy--a case report.

BACKGROUND: Neurofibromatosis type 1 (NF1) is a genetic disorder of the nervous system that causes tumor growth on the nerves, skin changes and bone deformities, and it is reported to be associated with adverse perinatal outcome in pregnant women. CASE: We report a case of MRI investigation of a pregnant woman with a known NF1 disease who showed exacerbation of skin lesions during pregnancy. No dangerous lesions that could compromise pregnancy outcome were detected, thus allowing the pregnancy to continue to term uneventfully. CONCLUSION: MRI has strong indications for the follow-up of pregnant patients with neurofibromatosis as it can detect lesions that can serve as risk factors for pregnancy complications.

Saline contrast hysterosonography in infertile patients and in women with abnormal uterine bleeding.

OBJECTIVE: We conducted this prospective study to evaluate saline contrast hysterosonography (SCHS) as a diagnostic modality for intrauterine lesions in comparison to hysteroscopy and endometrial biopsy. MATERIALS AND METHODS: We included 135 patients, of whom 70 presented with abnormal uterine bleeding and 65 with subfertility problems. All cases were examined with conventional transvaginal sonography and were further investigated with SCHS using saline as contrast medium, and finally hysteroscopy with endometrial biopsy that was used as the reference test. RESULTS: SCHS revealed the presence of intrauterine pathology in 23 cases and failed in three (4.2%). SCHS had a sensitivity of 94%, a specificity of 71%, a positive predictive value of 76% and a negative predictive value of 95% in the abnormal uterine group. In subfertile patients, SCHS revealed the presence of intrauterine pathology in 34 cases and had a sensitivity of 96%, a specificity of 74%, a positive predictive value of 79% and a negative predictive value of 95%. CONCLUSIONS: We found that SCHS is an extremely accurate modality for the diagnosis of focal endometrial pathology, compared to diagnostic hysteroscopy.

Comparison between "short" and "long" protocols in an ICSI programme.

In the present retrospective study we compare the efficacy of gonadotropin-releasing hormone (GnRH) agonist in a long protocol and a GnRH agonist in a short protocol administration for controlled ovarian hyperstimulation (COH) in an ICSI program. A total of 424 consecutive patients with a history of male factor were included in the present study. Three hundred and three patients were included in the long protocol and 121 in the short protocol. Patients treated with the short protocol were stimulated in a shorter time and achieved lower estradiol levels. A significantly higher percentage of oocytes transferred were found in the long protocol. The clinical pregnancy rate per embryo transfer was 39.3% in the long protocol and 19.2% in the short protocol (p=0.001).

Results of controlled ovarian stimulation for ART in poor responders according to the short protocol using different gonadotrophins combinations.

INTRODUCTION: Improving pregnancy rates in intricate cases of ovarian stimulation remains a challenge during IVF and intracytoplasmic sperm injection (ICSI). Different protocols of ovulation induction have been proposed. METHODS: The short protocol of ovarian stimulation using recombinant follicle-stimulating hormone (rFSH) with or without the use of luteinizing hormone (LH) in IVF or ICSI outcome in patients with many failed attempts and maternity age > or = 37 years was investigated. The prognostic significance of high but normal values of day 3 serum FSH concentrations was also evaluated. RESULTS: Results show that FSH levels of >9 mIU/ml are associated with poor results even with the use of human menopausal gonadotrophin (HMG). Results were generally comparable when rFSH was used alone or in combination with HMG, except for the quality and the number of embryos transferred, the later being better in the rFSH + HMG group. CONCLUSION: In conclusion intricate cases have good chances for achieving a pregnancy using the short protocol and the outcome is further improved when LH is added from the beginning of ovarian stimulation. A slight elevation of day 3 FSH seems to be a strong prognostic factor for a poor outcome.