The three-dimensionally articulated oral apparatus of a Devonian heterostracan sheds light on feeding in Palaeozoic jawless fishes.

Attempts to explain the origin and diversification of vertebrates have commonly invoked the evolution of feeding ecology, contrasting the passive suspension feeding of invertebrate chordates and larval lampreys with active predation in living jawed vertebrates. Of the extinct jawless vertebrates that phylogenetically intercalate these living groups, the feeding apparatus is well-preserved only in the early diverging stem-gnathostome heterostracans. However, its anatomy remains poorly understood. Here, we use X-ray microtomography to characterize the feeding apparatus of the pteraspid heterostracan Rhinopteraspis dunensis (Roemer, 1855). The apparatus is composed of 13 plates arranged approximately bilaterally, most of which articulate from the postoral plate. Our reconstruction shows that the oral plates were capable of rotating around the transverse axis, but likely with limited movement. It also suggests the nasohypophyseal organs opened internally, into the pharynx. The functional morphology of the apparatus in Rhinopteraspis precludes all proposed interpretations of feeding except for suspension/deposit feeding and we interpret the apparatus as having served primarily to moderate the oral gape. This is consistent with evidence that at least some early jawless gnathostomes were suspension feeders and runs contrary to macroecological scenarios that envisage early vertebrate evolution as characterized by a directional trend towards increasingly active food acquisition.

Development and optimisation of a reception testing protocol designed to eliminate HCV in the UK prison population.

Background & Aims: Micro-elimination of hepatitis C virus (HCV) in high-risk populations is a feasible approach towards achieving the World Health Organization's targets for viral hepatitis elimination by 2030. Prisons represent an area of high HCV prevalence and so initiatives that improve testing and treatment of residents are needed to eliminate HCV from prisons. This initiative aimed to improve the HCV screening and treatment rates of new residents arriving at prisons in England. Methods: A rapid test and treat pathway was developed and implemented in 47 prisons in England between May 2019 and October 2021 as a healthcare service improvement initiative. Prison healthcare staff performed opt-out HCV testing for all new residents at each prison within 7 days of arrival, and those who were positive for HCV RNA were offered treatment with direct-acting antivirals (DAAs). The Hepatitis C Trust provided peer support for all residents on treatment and those who were released into the community. Results: Of 107,260 new arrivals, 98,882 (92.2%) were offered HCV antibody testing, 63,137 (63.9%) were tested and 1,848 were treated. Testing rates increased from 53.7% in Year 1 to 86.0% in Year 3. Between May 2020 and October 2021, 40,727 residents were tested, 2,286 residents were positive for HCV antibodies and 940 residents were HCV RNA positive, giving an antibody prevalence of 5.6% and an RNA prevalence of 2.3%. A total of 921 residents were referred for treatment and 915 initiated DAA treatment (97.3% of whom were HCV RNA positive). Conclusions: This initiative showed that an opt-out HCV test and treat initiative in prison receptions is feasible and can be adapted to the needs of individual prisons as a viable way to achieve HCV micro-elimination. Impact and implications: Prisons represent an area of high HCV prevalence and so initiatives that improve testing and treatment of residents are needed to eliminate HCV from prisons. The reception testing protocol improved HCV screening in new arrivals across 47 prisons in England and could be a viable way for countries to achieve HCV micro-elimination in their prison systems. The reception testing protocol presented here can be adapted to the individual needs of prisons, globally, to improve HCV screening and treatment in this setting.

How representative are clinical trial cohorts of the general CF population? Implications for trial planning.

Understanding the number of patients eligible to participate in research is important to design protocols and define research priorities. We reviewed the records of all patients with CF, age 12+, who receive care at our centre. We assessed their eligibility for trial participation based on common trial inclusion/exclusion criteria. 643 patients were included in the analysis, 31 were modulator ineligible(MI). Only 198(31 %) of the total cohort and 7(23 %) of the MI cohort were eligible for participation based on the hypothetical criteria. The most common reason for ineligibility was ppFEV1 ≥90 % followed by clinical instability, complex comorbidity and anticipated inability to adhere to the protocol. We suggest this would be a useful exercise for centres planning to either participate in, or refer subjects into, upcoming trials to undertake for their own cohort. We also make suggestions for protocol designs that optimise the number of patients who are eligible to participate.

Chronic hepatitis C elimination prison initiative: HCV-intensive test and treat, a whole prisoner population HCV test-and-treat program in England.

Background and Aim: Prison residents are at high risk for hepatitis C virus (HCV) infection. HCV test-and-treat initiatives within prisons provide an opportunity to engage with prison residents and achieve HCV micro-elimination. The aim of the prison HCV-intensive test and treat initiative was to screen over 95% of all prison residents for HCV infection within a defined number of days determined by the size of the prison population and to initiate treatment within 7-14 days of a positive HCV RNA diagnosis. Methods: An HCV-intensive test and treat toolkit was developed based on learnings from pilot HCV-intensive test and treat events. From January 2020 to September 2021, 13 HCV-intensive test and treat events took place at prisons in England selected based on high levels of reception blood-borne virus testing and good access to peers from The Hepatitis C Trust. Results: Among a total of 8487 residents, 8139 (95.9%) underwent testing for HCV. Across the 13 prisons included, HCV antibody and RNA prevalence was 8.2% and 1.5%, respectively. The treatment initiation rate among HCV RNA-positive individuals (n = 124) was 79.0%. Conclusion: The HCV-intensive test and treat initiative presented here provides a feasible and rapid test-and-treat process to achieve HCV elimination within individual prisons. The HCV-intensive test and treat toolkit can be adapted for rapid HCV testing and treatment events at other prisons in the United Kingdom and worldwide.

The cross-sectional associations of chronic conditions and disability with self-reported physical activity among adults in England.

OBJECTIVE: Using cross-sectional data from the 2018 Health Survey for England, this study describes the types of impairment reported by people with chronic conditions and the association of chronic conditions and impairments with physical activity(PA). METHODS: Participants self-reported the presence of seven chronic health conditions (diabetes; stroke/ischemic heart disease; hypertension; chronic obstructive pulmonary disease (COPD); asthma; arthritis/rheumatism/fibrositis; back problems), 11 types of impairment (vision, hearing, mobility, dexterity; learning; memory; mental health; stamina; social or behavioural; other; none); and their PA using the International Physical Activity Questionnaire. Multivariable Poisson regression was used to estimate the association of a)impairment type, b)number of impairments, and c)impairment type and chronic condition (mutually adjusted) with PA. RESULTS: In total, 2243 adults (55% female, 44% age > 55 yrs) reported having a chronic condition. PA volume (MET minutes per week: median (IQR)) was highest in participants with asthma (2093 (693-4479)), and lowest in those with COPD (454 (0-2079)). There was a negative association between number of impairments and levels of PA. After adjustment for age, sex, ethnicity and education, and mutually adjusting for all other conditions and impairments, diabetes (Incident rate ratio (95% confidence interval): 0.83 (0.73-0.94)), COPD (0.76 (0.59-0.99)), a mobility impairment (0.63 (0.56-0.72)), a dexterity impairment (0.86 (0.75-0.98)), or a memory impairment (0.84 (0.72-0.99)) was negatively associated with PA. CONCLUSION: Future PA research requires consideration of the number and types of impairments that individuals experience, as well as assessing chronic conditions. This will improve understanding of the barriers to PA participation and inform interventions.

The oldest three-dimensionally preserved vertebrate neurocranium.

The neurocranium is an integral part of the vertebrate head, itself a major evolutionary innovation1,2. However, its early history remains poorly understood, with great dissimilarity in form between the two living vertebrate groups: gnathostomes (jawed vertebrates) and cyclostomes (hagfishes and lampreys)2,3. The 100 Myr gap separating the Cambrian appearance of vertebrates4-6 from the earliest three-dimensionally preserved vertebrate neurocrania7 further obscures the origins of modern states. Here we use computed tomography to describe the cranial anatomy of an Ordovician stem-group gnathostome: Eriptychius americanus from the Harding Sandstone of Colorado, USA8. A fossilized head of Eriptychius preserves a symmetrical set of cartilages that we interpret as the preorbital neurocranium, enclosing the fronts of laterally placed orbits, terminally located mouth, olfactory bulbs and pineal organ. This suggests that, in the earliest gnathostomes, the neurocranium filled out the space between the dermal skeleton and brain, like in galeaspids, osteostracans and placoderms and unlike in cyclostomes2. However, these cartilages are not fused into a single neurocranial unit, suggesting that this is a derived gnathostome trait. Eriptychius fills a major temporal and phylogenetic gap in our understanding of the evolution of the gnathostome head, revealing a neurocranium with an anatomy unlike that of any previously described vertebrate.

A Scoping Review of Disability Assessment in Prospective and Cross-Sectional Studies That Included Device-Based Measurement of Physical Activity.

BACKGROUND: Evidence on the prevalence, determinants, and health outcomes of physical activity in disabled people is limited. It is possible that the limited availability of high-quality scientific evidence is due to the extent and nature of disability assessment in physical activity research. This scoping review explores how disability has been measured in epidemiological studies that included accelerometer-based measurement of physical activity. METHODS: Data sources: MEDLINE (Ovid), Embase, PsychINFO, Health Management Information Consortium, Web of Science, SPORTDiscus, and CINAHL. ELIGIBILITY CRITERIA: Prospective and cross-sectional studies that included an accelerometer measurement of physical activity. Survey instruments used in these studies were obtained, and questions relating to the International Classification of Functioning, Disability and Health domains of (1) health conditions, (2) body functions and structures, and (3) activities and participation, were extracted for analysis. RESULTS: Eighty-four studies met the inclusion criteria, from which complete information on the 3 domains was obtained for 68. Seventy-five percent of studies (n = 51) captured whether a person had at least one health condition, 63% (n = 43) had questions related to body functions and structures, and 75% (n = 51) included questions related to activities and participation. CONCLUSION: While most studies asked something about one of the 3 domains, there was substantial diversity in the focus and style of questions. This diversity indicates a lack of consensus on how these concepts should be assessed, with implications for the comparability of evidence across studies and subsequent understanding of the relationships between disability, physical activity, and health.

A Review of Sedentary Behavior Assessment in National Surveillance Systems.

BACKGROUND: Temporal changes in sedentary behavior patterns reflect the evolving nature of our built and social environments, particularly the expanding availability of electronic media. It is important to understand what types of sedentary behavior are assessed in national surveillance to determine whether, and to what extent, they reflect contemporary patterns. The aims of this review were to describe the characteristics of questionnaires used for national surveillance of sedentary behavior and to identify the types of sedentary behaviors being measured. METHOD: We reviewed questionnaires from national surveillance systems listed on the Global Observatory for Physical Activity (GoPA!) country cards to locate items on sedentary behavior. Questionnaire characteristics were categorized using the Taxonomy of Self-reported Sedentary Behavior Tools (TASST). The purpose and type of sedentary behaviors captured were classified using the Sedentary Behavior International Taxonomy (SIT). RESULTS: Overall, 346 surveillance systems were screened for eligibility, of which 93 were included in this review. Most questionnaires used a single-item direct measure of sitting time (n = 78, 84%). Work and domestic were the most frequently captured purposes of sedentary behavior, while television viewing and computer use were the most frequently captured types of behaviors. CONCLUSION: National surveillance systems should be periodically reviewed in response to evidence on contemporary behavior patterns in the population and the release of updated public health guidelines.

Pragmatic Evaluation of a Low-Threshold Sports Program for Older Adults in Group Homes.

Physical activity (PA) reduces with older age, ill health, and disability. For these groups, guidance recognizes the benefit of small increases in PA and low-intensity PA. This study evaluated a low-threshold intervention that addressed known barriers to older people's participation in PA in residential care and sheltered housing. Ten, competitive sport sessions were delivered by coaches at 49 sites with the aim that they be sustained in-house. Using quasi-experimental methods, participants reported reduced sitting time, increased moderate/vigorous PA, increased participation in sports and improved scores for both health quality of life and fear of falling at 6 months. The program engaged 29% of residents and was sustained at 50% of sites at 8 months. The findings suggest that low-threshold sports programs that overcome known barriers to older people's participation in PA have the potential to provide a gateway to increased PA in group homes and to be sustained in-house.

The Association of Contemporary Screen Behaviours with Physical Activity, Sedentary Behaviour and Sleep in Adolescents: a Cross-sectional Analysis of the Millennium Cohort Study.

BACKGROUND: Screen behaviours are highly prevalent in adolescents and may be adversely associated with physical and mental health. Understanding how screen behaviours inter-relate with physical activity and sleep may help to clarify pathways through which they impact health and potential routes to behaviour change. This cross-sectional study examines the association of contemporary screen behaviours with physical activity, sedentary behaviour and sleep in adolescents. METHOD: Data are from sweep 6 (2015/2016) of the Millennium Cohort Study, conducted when participants were aged 14 years. Outcome variables were accelerometer-assessed overall physical activity and moderate-to-vigorous physical activity (MVPA), self-reported sedentary behaviour and sleep duration. Screen behaviours were assessed using a 24-h time-use diary. Multivariable regression was used to examine the association between screen behaviours and each outcome variable separately for weekdays and weekend days. RESULTS: The use of social network sites was associated with (beta coefficient, 95% confidence interval (CI); minutes/day) less time in MVPA (weekdays: - 5.2 (- 10.3, - 0.04); weekend: - 10.0 (- 15.5, - 4.5)), and sedentary behaviours (weekdays: - 19.8 (- 31.0, - 8.6); weekend: - 17.5 (- 30.9, - 4.1)). All screen behaviours were associated with shorter sleep duration on weekdays, whereas only the use of email/texts and social network sites was associated with shorter sleep duration on weekend days. The association of using social network sites with overall physical activity was stronger in girls than in boys; the association of internet browsing with sedentary behaviour was stronger in boys than in girls. CONCLUSION: Intervention strategies to enhance MVPA and sleep duration by limiting screen-based activities may be warranted.

Cluster randomised control trial protocol for estimating the effectiveness and cost-effectiveness of a complex intervention to increase care home staff influenza vaccination rates compared to usual practice (FLUCARE).

The care home staff influenza vaccination rate in England is significantly lower than the 75% World Health Organisation recommendation. This represents a substantial potential for resident harm. Barriers to staff vaccination stem from individual and organisational levels. Existing interventions address some but not all barriers and are not underpinned by behavioural science theory. This study aims to estimate the effectiveness and cost-effectiveness of a theory-informed intervention to improve care home staff vaccination rates compared to routine practice.Set in care homes with both nursing and residential focus, and a range of ownership status, only homes providing long stay care to older people with a staff vaccination rate below 40% are eligible to participate. Participation expressions of interest will be sought using a variety of approaches prior to seeking consent.The primary outcome measure is the proportion of staff vaccinated at 6 months, with secondary outcome measures being proportion vaccinated at 3 months, numbers of staff sick days, general practitioner and nurse visits to care home, care home resident hospitalisations and mortality.Based on the assumptions that the mean cluster (care home) size is 54 staff, a coefficient of variation of 0.48, control vaccination rate is 55%, intervention 75%, intra-cluster correlation coefficient of 0.2 and with 90% power, and 20% attrition, we require 39 care homes per arm.Blocked randomisation will be at the level of care home, stratified by the proportion of non-white care home staff, and implemented by Norwich Clinical Trials Unit.The intervention comprises co-designed information videos and posters, provision of in-house staff vaccination clinics, and incentive scheme and monthly data collection on trial outcomes. Beyond usual practice, the control arm will additionally contribute monthly data.Data will be collected at the start, monthly and at 6 months, and analysis will be blind to allocation. Statistical analysis will use the intention-to-treat principle with the difference in vaccination rates between groups compared using a random effect logistic regression model at the staff-level.This will be the first study to use a theory-informed intervention designed to comprehensively address identified barriers to care home staff influenza vaccination.Trial registration: ISRCTN ISRCTN22729870 . Registered on 24 August 22. Secondary identifiers: R209939, IRAS 316820, CPMS 53812.

Outcome evaluation of Active Herts: A community-based physical activity programme for inactive adults at risk of cardiovascular disease and/or low mental wellbeing.

Background: A high proportion of UK adults are inactive, which can lead to a range of physical and mental health concerns. Active Herts is a community-based physical activity programme for inactive adults at risk of cardiovascular disease and/or low mental wellbeing. This paper provides a pragmatic evaluation of this programme. Method: This longitudinal study observed 717 adults (68% female, mean age = 56.9 years) from the "Active Herts" programme. Programme users were provided with a 45-min consultation with a "Get Active Specialist," who talked them through an Active Herts self-help booklet and then signposted them to free or subsidized local exercise sessions. Programme users were followed up with a booster call 2 weeks later. The Get Active Specialist was a registered exercise professional (REPS Level 3), with additional training from the study team in motivational interviewing, health coaching, COM-B behavioral diagnosis and delivery of behavior change techniques (BCTs) in practice. The Active Herts booklet contained theoretically-driven and evidence-based BCTs to translate behavioral science into public health practice. Physical activity (Metabolic Equivalent Time [METs], measured using the International Physical Activity Questionnaire (IPAQ), perceived health (EQ-5D-5L) and mental wellbeing (Warwick-Edinburgh Mental Wellbeing Scale: WEMWBS) were measured at baseline, 3, 6 and 12 months. Results: At the end of the 12-month programme, users showed sustained improvements in physical activity (by +1331 METS), exceeding weekly recommendations. Sitting (reducing by over an hour per day), sporting participation, and perceptions of health were also improved, with improvements in mental wellbeing in the first 3 months. Conclusion: Designing and delivering a community-based physical activity programme that is theoretically-driven and evidence-based with frequent behavior change training and supervision can yield a significant increase in self-reported physical activity, reduction in sitting behavior and improvements to perceived health and mental wellbeing. Future research should extend this approach, utilizing a real-world, pragmatic evaluation. Trial registration: ClinicalTrials.gov, identifier (NCT number): NCT03153098.

Australian wildfires cause the largest stratospheric warming since Pinatubo and extends the lifetime of the Antarctic ozone hole.

Global mean lower stratosphere temperatures rose abruptly in January 2020 reaching values not experienced since the early 1990s. Anomalously high lower stratospheric temperatures were recorded for 4 months at highly statistically significant levels. Here, we use a combination of satellite and surface-based remote sensing observations to derive a time-series of stratospheric biomass burning aerosol optical depths originating from intense SouthEastern Australian wildfires and use these aerosol optical depths in a state-of-the-art climate model. We show that the S.E. Australian wildfires are the cause of this lower stratospheric warming. We also investigate the radiatively-driven dynamical response to the observed stratospheric ozone perturbation and find a significant strengthening of the springtime Antarctic polar vortex suggesting that biomass burning aerosols play a significant role in the observed anomalous longevity of the ozone hole in 2020.

The diurnal pattern and social context of screen behaviours in adolescents: a cross-sectional analysis of the Millennium Cohort Study.

BACKGROUND: Screen behaviours are highly prevalent in young people and excessive screen use may pose a risk to physical and mental health. Understanding the timing and social settings in which young people accumulate screen time may help to inform the design of interventions to limit screen use. This study aimed to describe diurnal patterns in adolescents' screen-based behaviours and examine the association of social context with these behaviours on weekdays and weekend days. METHODS: Time use diary data are from the sixth wave (2015/2016) of the Millennium Cohort Study, conducted when participants were aged 14 years. Outcome variables were electronic games/Apps, TV-viewing, phone calls and emails/texts, visiting social networking sites and internet browsing. Social context was categorised as alone only, parents only, friends only, siblings only, parents and siblings only. Multilevel multivariable logistic regression was used to examine the association between social contexts and screen activities. RESULTS: Time spent in TV-viewing was greatest in the evening with a peak of 20 min in every hour between 20:00 and 22:00 in both sexes on weekdays/weekend days. Time spent using electronic games/Apps for boys and social network sites for girls was greatest in the afternoon/evening on weekdays and early afternoon/late evening on weekend days. Screen activities were mainly undertaken alone, except for TV-viewing. Compared to being alone, being with family members was associated with (Odds Ratio (95% Confidence Interval)) more time in TV-viewing in both boys and girls throughout the week (Weekdays: Boys, 2.84 (2.59, 3.11); Girls, 2.25 (2.09, 2.43); Weekend days: Boys, 4.40 (4.16, 4.67); Girls, 5.02 (4.77, 5.27)). Being with friends was associated with more time using electronic games on weekend days in both sexes (Boys, 3.31 (3.12, 3.51); Girls, 3.13 (2.67, 3.67)). CONCLUSIONS: Reductions in screen behaviours may be targeted throughout the day but should be sensitive to differing context. Family members, friends, and adolescent themselves may be important target groups in behaviour change interventions. Future research to address the complex interplay between social context, content and quality of screen behaviours will aid the design of behaviour change interventions.

Food Sales and Adult Weight Status: Results of a Cross-Sectional Study in England.

Ecological studies often use supermarket location as a proxy measure of the food environment. In this study, we used data on sales at a leading mainstream supermarket chain to explore how area-level supermarket use is associated with overweight and obesity in English adults. Sales data were aggregated to local authority level and joined to a national dataset describing self-reported height and weight and fruit and vegetable consumption. Regression models showed a modest association between higher levels of unhealthy food sales relative to health food sales and increased odds of being overweight and obese. Although effect sizes were small, they persisted after adjustment for area-level deprivation. Supermarket sales data provide additional understanding in the study of food environments and their impact on increasing weight status. Future health policies should consider using 'big data' combined with other research methods to address the increasing consumption of unhealthy and highly processed foods.

'People don't get cancer, families do': Co-development of a social physical activity intervention for people recently affected by a cancer diagnosis.

OBJECTIVE: This research took a co-design approach to develop a social intervention to support people affected by a cancer diagnosis to be physically active. METHODS: We conducted semi-structured interviews with five key stakeholder groups: (1) adults with a recent breast or prostate cancer diagnosis; (2) family and friends of cancer patients; (3) healthcare professionals; (4) physical activity providers; and (5) cancer charity representatives. Inductive content analysis was used to identify themes in the data. We then worked with a subset of participants to co-develop the intervention. RESULTS: Participants welcomed the idea of a social approach to a physical activity intervention. Input was received on the timing and format of delivery, how to communicate about physical activity to cancer patients and their family and friends and the types of physical activity that would be appropriate. Our findings suggest that interventions need to be flexible in terms of timing and delivery and offer a wide range of physical activity options. These findings directly informed the co-development of 'All Together Active'. CONCLUSION: All Together Active is designed to support cancer patients and their family and friends to be active throughout treatment and beyond, benefiting their physical and mental health.

International trends in screen-based behaviours from 2012 to 2019.

Many adults accumulate considerable time in screen-based behaviours, some of which have been associated with negative physical and psychological health outcomes. The aims of this study were to characterise contemporary patterns of screen-based behaviours and describe their temporal trends by global region, age, sex and education. Data covering the period 2012-2019 were obtained in aggregated form from GWI (previously known as Global Web Index), a global market research company. Temporal trends in the duration of adults' (16-64 years) self-reported personal computer, laptop and tablet use, mobile phone use, broadcast television viewing, online television viewing and games console use were described using data from over 2 million participants from 46 countries. For each activity, participants selected from response options ranging from less than 30 min to more than 10 h. Internationally, daily screen time increased from approximately 9 h in 2012 to 11 h in 2019, with notable increases in mobile phone use (approx. 2 h), online television viewing (approx. 37 min) and games console use (approx. 26 min). Differences were seen in the duration of time spent engaging in screen-based behaviours across regions and between socio-demographic groups, with Latin America, the Middle East and Africa and younger age groups seeing greater increases in overall screen time. The findings have important implications for health behaviour surveillance and for research exploring the links between screen-based behaviours and health.