A randomised evaluation of low-dose cytosine arabinoside plus lenalidomide versus single-agent low-dose cytosine arabinoside in older patients with acute myeloid leukaemia: Results from the LI-1 trial.

Improving outcomes for older patients with acute myeloid leukaemia remains an unmet need. As part of the LI-1 trial, we evaluated lenalidomide (LEN) in combination with low-dose cytosine arabinoside (LDAC) in patients aged >60 years unfit for intensive therapy and compared this to LDAC alone. Two hundred and two patients, randomised 1:1, were evaluable. Overall response rate (CR + CRi) was higher for LDAC + LEN versus LDAC (26% and 13.7% respectively p = 0.031). However, there was no difference in overall survival between the arms (14% and 11.5% at 2 years for LDAC + LEN and LDAC respectively). The addition of LEN was associated with increased toxicity and supportive care requirements.

Conservation genetics of endangered Trillium govanianum Wall. ex D. Don - A pharmaceutically prized medicinal plant from the Himalaya and implications for species recovery.

Understanding the genetic diversity and population structure of pharmaceutically important endangered plant species is crucial for their conservation and sustainable use. Despite the continuous population decline in Trillium govanianum Wall. ex D. Don, a highly prized medicinal plant endemic to the Himalaya, information regarding its conservation genetics has been lacking. Here, we employed a conservation genetics approach to investigate how drastically declining populations in natural habitats impact population genetic diversity and structure of this endangered species across the Kashmir Himalaya. We used Start codon targeted (SCoT) and Simple sequence repeat (SSR) markers to assess the intra- and inter-population genetic variation in seven sites across the study region. Based on these markers, we found a very low genetic diversity in T. govanianum populations. Very low levels of observed heterozygosity (Ho = 0.000) and that expected (He = 0.064) in the populations indicate high heterozygote deficiency and high levels of inbreeding depression (FIS = 1.000). A high genetic differentiation was observed among the populations for both SCoT (Gst = 0.719) and SSR (Fst = 0.707) markers. Both the markers showed low gene flow, SCoT (Nm = 0.195) and SSR (Nm = 0.119), depicting high among-population variation than within-population variation. Analysis of molecular variance also indicated a higher genetic variation between the populations than within populations. We also observed a significant positive correlation between genetic divergence and geographical distance, indicating that genetic differentiation in T. govanianum follows a pattern of isolation by distance. Bayesian structure and cluster analysis grouped the populations according to their geographical proximity. Further, redundancy analysis (RDA) revealed the presence of one polymorphic locus for each marker with high discriminatory power. Overall, our findings reveal a very low genetic diversity, high levels of inbreeding, and high genetic differentiation among the populations; likely resulting from habitat fragmentation, population isolation, bottleneck effect, low gene flow, and predominantly asexual reproduction currently operative in the species. Finally, based on the insights gained, we discuss the potential implications of our findings in guiding species recovery and habitat rehabilitation of T. govanianum in the Himalaya with conservation lessons for elsewhere in the world.

Design and Development of Robust, Daylight-Activated, and Rechargeable Biocidal Polymeric Films as Promising Active Food Packaging Materials.

The emerging infectious diseases have created one of the major practical needs to develop active packaging materials with durable antibacterial and antiviral properties for the food industry. To meet this demand, the development of new technologies applicable to food contact surfaces is highly desired but challenging. The recent discovery of the photoactive properties of vitamin K (VK) derivatives has raised great expectations as promising candidates in functional film development due to the generation of biocidal reactive oxygen species (ROS) by these compounds. Inspired by the excellent photoactivity of one of the light-stable VK derivatives, menadione (VK3), under visible daylight irradiation, we demonstrate a protocol for the fabrication of daylight-mediated biocidal packaging materials by incorporating VK3 into a poly (ethylene-co-vinyl acetate) (EVA) matrix. The VK3 (i.e., 1-5% w/w) incorporated EVA films successfully demonstrated the production of ROS and antibacterial and antiviral performance against Escherichia coli, Listeria innocua, and T7 bacteriophage, respectively, under daylight exposure conditions. The results revealed that the addition of a proper percentage of VK3 significantly enhanced the ROS productivity of the films and created a novel daylight-induced microbial killing performance on the films. The biocidal functions of the films are long-lasting and rechargeable when exposed to light repeatedly, making them a viable contender for replacing currently available conventional packaging films.

IoMT Meets Machine Learning: From Edge to Cloud Chronic Diseases Diagnosis System.

In conventional healthcare, real-time monitoring of patient records and information mining for timely diagnosis of chronic diseases under certain health conditions is a crucial process. Chronic diseases, if not diagnosed in time, may result in patients' death. In modern medical and healthcare systems, Internet of Things (IoT) driven ecosystems use autonomous sensors to sense and track patients' medical conditions and suggest appropriate actions. In this paper, a novel IoT and machine learning (ML)-based hybrid approach is proposed that considers multiple perspectives for early detection and monitoring of 6 different chronic diseases such as COVID-19, pneumonia, diabetes, heart disease, brain tumor, and Alzheimer's. The results from multiple ML models are compared for accuracy, precision, recall, F1 score, and area under the curve (AUC) as a performance measure. The proposed approach is validated in the cloud-based environment using benchmark and real-world datasets. The statistical analyses on the datasets using ANOVA tests show that the accuracy results of different classifiers are significantly different. This will help the healthcare sector and doctors in the early diagnosis of chronic diseases.

Meta-evaluation of a whole systems programme, ActEarly: A study protocol.

INTRODUCTION: Living in an area with high levels of child poverty predisposes children to poorer mental and physical health. ActEarly is a 5-year research programme that comprises a large number of interventions (>20) with citizen science and co-production embedded. It aims to improve the health and well-being of children and families living in two areas of the UK with high levels of deprivation; Bradford in West Yorkshire, and the London Borough of Tower Hamlets. This protocol outlines the meta-evaluation (an evaluation of evaluations) of the ActEarly programme from a systems perspective, where individual interventions are viewed as events in the wider policy system across the two geographical areas. It includes investigating the programme's impact on early life health and well-being outcomes, interdisciplinary prevention research collaboration and capacity building, and local and national decision making. METHODS: The ActEarly meta-evaluation will follow and adapt the five iterative stages of the 'Evaluation of Programmes in Complex Adaptive Systems' (ENCOMPASS) framework for evaluation of public health programmes in complex adaptive systems. Theory-based and mixed-methods approaches will be used to investigate the fidelity of the ActEarly research programme, and whether, why and how ActEarly contributes to changes in the policy system, and whether alternative explanations can be ruled out. Ripple effects and systems mapping will be used to explore the relationships between interventions and their outcomes, and the degree to which the ActEarly programme encouraged interdisciplinary and prevention research collaboration as intended. A computer simulation model ("LifeSim") will also be used to evaluate the scale of the potential long-term benefits of cross-sectoral action to tackle the financial, educational and health disadvantages faced by children in Bradford and Tower Hamlets. Together, these approaches will be used to evaluate ActEarly's dynamic programme outputs at different system levels and measure the programme's system changes on early life health and well-being. DISCUSSION: This meta-evaluation protocol presents our plans for using and adapting the ENCOMPASS framework to evaluate the system-wide impact of the early life health and well-being programme, ActEarly. Due to the collaborative and non-linear nature of the work, we reserve the option to change and query some of our evaluation choices based on the feedback we receive from stakeholders to ensure that our evaluation remains relevant and fit for purpose.

Unravelling diversity, drivers, and indicators of soil microbiome of Trillium govanianum, an endangered plant species of the Himalaya.

In an era of global environmental change, conservation of threatened biodiversity and ecosystem restoration are formidable ecological challenges. The forest understory strata and the belowground soil environment including rhizospheric microbial communities, which are crucial for ecosystem functioning and overall forest biodiversity maintenance, have remained understudied. Here, we investigate the soil microbiome of Trillium govanianum - an endangered Himalayan Forest herb, to unravel the underground diversity, drivers, and potential indicators of the microbial community. We collected rhizospheric and bulk soil samples for microbiome and physicochemical analysis at three sites along an elevation gradient (2500-3300 m) in Kashmir Himalaya. Amplicon sequencing of 16 S rRNA and ITS was used to identify the bacterial and fungal soil microorganisms. We found significant differences in the structure and diversity of microbial community (bacterial and fungal) between the rhizosphere and bulk soil along the altitudinal gradient, and noticeable shifts in the nutrient level in dominant microbial phyla associated with T. govanianum. A significant difference between soil physicochemical parameters and increasing altitude suggests that microbial community structure is determined by altitude and soil type. Similarly, the microbial communities showed a significant (P < 0.05) correlation with soil physicochemical variables along the altitudinal gradient. The moisture content in bacterial and total organic carbon in fungal communities showed the most substantial impact on the physiochemical drivers. We also identify potential bacterial and fungal plant growth promoter indicator species in the soil microbiome of T. govanianum. Overall, our findings provide novel research insights that can be pivotal in designing integrated species recovery programs and long-term restoration plans for T. govanianum, with learnings for biodiversity conservation elsewhere.

People powered research: what do communities identify as important for happy and healthy children and young people? A multi-disciplinary community research priority setting exercise in the City of Bradford, United Kingdom (UK).

BACKGROUND: Involving communities in research priority setting can increase the relevance and efficiency of research, leading to better health outcomes. However these exercises often lack clarity in how communities are involved and the extent to which priorities are acted upon is unclear. Seldom-heard groups, for example ethnic minorities may experience barriers to participation. We report methods and outcomes of an inclusive co-produced community research priority setting exercise within the multicultural and deprived city of Bradford, UK. The aim was to identify priorities for keeping children happy and healthy and was undertaken by the Born in Bradford (BiB) research programme to inform future research agendas. METHODS: A 12 member multi-disciplinary, multi-ethnic community steering group led the process using a modified James Lind Alliance approach between December 2018-March 2020. Research priorities were collected through a widely distributed paper and online survey. Respondents were asked to list three important things to keep children i) happy, ii) healthy and what needs to change to improve either health or happiness. Free text data were coded iteratively by community researchers, and shared priorities were co-produced in a series of workshops and meetings with the community steering group and community members. RESULTS: Five hundred eighty-eight respondents to the survey identified 5748 priorities, which were coded into 22 themes. These covered a range of individual, social and wider socioeconomic, environmental and cultural priorities. Diet/nutrition and exercise were most commonly identified as important for health, including what needs to change to improve health. For happiness, home life and family relationships, listening to children, and education/activities were the most commonly identified. Community assets were identified as important to change for both health and happiness. From the survey response the steering group developed 27 research questions. There were mapped onto existing and planned research agendas within BiB. CONCLUSIONS: Communities identified both structural and individual factors as important priorities for health and happiness. We demonstrate how communities can be involved in priority setting using a co-productive approach in the hope this can be used as a model for others. The resulting shared research agenda will shape future research to improve the health of families living in Bradford.

Nothing about us without us: A co-production strategy for communities, researchers and stakeholders to identify ways of improving health and reducing inequalities.

INTRODUCTION: Co-production with communities is increasingly seen as best practice that can improve the quality, relevance and effectiveness of research and service delivery. Despite this promising position, there remains uncertainty around definitions of co-production and how to operationalize it. The current paper describes the development of a co-production strategy to guide the work of the ActEarly multistakeholder preventative research programme to improve children's health in Bradford and Tower Hamlets, UK. METHODS: The strategy used Appreciative Inquiry (AI), an approach following a five-step iterative process: to define (Step 1) scope and guide progress; to discover (Step 2) key issues through seven focus groups (N = 36) and eight in-depth interviews with key stakeholders representing community groups, and the voluntary and statutory sectors; to dream (Step 3) best practice through two workshops with AI participants to review findings; to design (Step 4) a co-production strategy building on AI findings and to deliver (Step 5) the practical guidance in the strategy. RESULTS: Nine principles for how to do co-production well were identified: power should be shared; embrace a wide range of perspectives and skills; respect and value the lived experience; benefits should be for all involved parties; go to communities and do not expect them to come to you; work flexibly; avoid jargon and ensure availability of the right information; relationships should be built for the long-term; co-production activities should be adequately resourced. These principles were based on three underlying values of equality, reciprocity and agency. CONCLUSION: The empirical insights of the paper highlight the crucial importance of adequate resources and infrastructure to deliver effective co-production. This documentation of one approach to operationalizing co-production serves to avert any misappropriations of the term 'co-production' by listening to service users, stakeholders and other relevant groups, to develop trust and long-term relationships, and build on the learning that already exists amongst such groups. PATIENT OR PUBLIC CONTRIBUTION: The work was overseen by a steering group (N = 17) of individuals, both professional and members of the public with experience in undertaking co-production, and/or with some knowledge of the context of the two ActEarly field sites, who provided regular oversight and feedback on the AI process.

Compliant citizens, defiant rebels or neither? Exploring change and complexity in COVID-19 vaccine attitudes and decisions in Bradford, UK: Findings from a follow-up qualitative study.

BACKGROUND: COVID-19 vaccines have been the central pillar of the public health response to the pandemic, intended to enable us to 'live with Covid'. It is important to understand change and complexity of COVID-19 vaccines attitudes and decisions to maximize uptake through an empathetic lens. OBJECTIVE: To explore the factors that influenced people's COVID-19 vaccines decisions and how their complex attitudes towards the vaccines had changed in an eventful year. DESIGN AND PARTICIPANTS: This is a follow-up study that took place in Bradford, UK between October 2021 and January 2022, 1 year after the original study. In-depth phone interviews were conducted with 12 (of the 20 originally interviewed) people from different ethnic groups and areas of Bradford. Reflexive thematic analysis was conducted. RESULTS: Eleven of the 12 participants interviewed had received both doses of the COVID-19 vaccine and most intended to have a booster dose. Participants described a variety of reasons why they had decided to have the vaccines, including the following: feeling at increased risk at work; protecting family and others in their communities; unrestricted travel and being influenced by the vaccine decisions of family, friends and colleagues. All participants discussed ongoing interaction with COVID-19 misinformation and for some, this meant they were uneasy about their decision to have the vaccine. They described feeling overloaded by and disengaged from COVID-19 information, which they often found contradictory and some felt mistrustful of the UK Government's motives and decisions during the pandemic. CONCLUSIONS: The majority of participants had managed to navigate an overwhelming amount of circulating COVID-19 misinformation and chosen to have two or more COVID-19 vaccines, even if they had been previously said they were unsure. However, these decisions were complicated, demonstrating the continuum of vaccine hesitancy and acceptance. This follow-up study underlines that vaccine attitudes are changeable and contextual. PATIENT OR PUBLIC CONTRIBUTION: The original study was developed through a rapid community and stakeholder engagement process in 2020. Discussion with the Bradford Council Public Health team and the public through the Bradford COVID-19 Community Insights Group was undertaken in 2021 to identify important priorities for this follow-up study.

Properties of galactomannans and their textile-related applications-A concise review.

Galactomannans are reserve carbohydrates in legume plants and are primarily extracted from their seeds. They contain galactose side chains throughout the mannose backbone and have unique features such as emulsifying, thickening, and gelling together with biodegradability, biocompatibility, and non-toxicity, which make them an appealing material. Guar gum and locust bean gum mainly are used in all galactomannan needed applications. Nonetheless, tara gum and fenugreek gum have also attracted considerable attention in recent decades. Despite the increased usage of galactomannans in the textile-related fields in recent years, there is no review article published yet. To fill this gap and to demonstrate the striking and increasing importance of galactomannans, a concise summary of the properties of common galactomannans and their comparisons is given first, followed by an account of recent developments and applications of galactomannans in the textile-related fields. The associated potential opportunities are also provided at the end of this review.

Applying the community readiness model to identify and address inequity in end-of-life care in South Asian communities.

BACKGROUND: Individuals from minoritised ethnic backgrounds are less likely than individuals from the dominant ethnic group to access palliative care services and to have documented Advance Care Plans. They are more likely to be admitted to hospital in the last months of life. AIM: To use the Community Readiness Model to identify the barriers that influence how South Asian communities access and use two new palliative care services. DESIGN: The Community Readiness Model is a validated tool that measures the readiness of a community. Key stakeholders were asked to: (i) complete a questionnaire to assess South Asian communities' readiness to engage in advance care planning and, (ii) attend a focus group to explore their views on the communities' understandings of palliative and end-of-life care. SETTING/PARTICIPANTS: Ten key stakeholders who held a variety of occupations within palliative and end-of-life care services were recruited from the community. FINDINGS: The South Asian communities were found to be at the 'pre-planning' stage of readiness, despite initiatives to improve awareness. The readiness of the health system was found to be limited, with a narrow medical focus during advance care planning, poor integration of voluntary and community services and limited understanding of what people consider a 'good' death. CONCLUSIONS: The Community Readiness Model allowed insight into the South Asian communities' awareness of and readiness (to use) palliative care services. Using the Community Readiness Model before service implementation allowed steps to be taken to avoid widening inequities in access and use of new services.

Study Protocol. Evaluating the life-course health impact of a city-wide system approach to improve air quality in Bradford, UK: A quasi-experimental study with implementation and process evaluation.

BACKGROUND: Air quality is a major public health threat linked to poor birth outcomes, respiratory and cardiovascular disease, and premature mortality. Deprived groups and children are disproportionately affected. Bradford will implement a Clean Air Zone (CAZ) as part of the Bradford Clean Air Plan (B-CAP) in 2022 to reduce pollution, providing a natural experiment. The aim of the current study is to evaluate the impact of the B-CAP on health outcomes and air quality, inequalities and explore value for money. An embedded process and implementation evaluation will also explore barriers and facilitators to implementation, impact on attitudes and behaviours, and any adverse consequences. METHODS: The study is split into 4 work packages (WP). WP1A: 20 interviews with decision makers, 20 interviews with key stakeholders; 10 public focus groups and documentary analysis of key reports will assess implementation barriers, acceptability and adverse or unanticipated consequences at 1 year post-implementation (defined as point at which charging CAZ goes 'live'). WP1B: A population survey (n = 2000) will assess travel behaviour and attitudes at baseline and change at 1 year post-implementation). WP2: Routine air quality measurements will be supplemented with data from mobile pollution sensors in 12 schools collected by N = 240 pupil citizen scientists (4 within, 4 bordering and 4 distal to CAZ boundary). Pupils will carry sensors over four monitoring periods over a 12 month period (two pre, and two post-implementation). We will explore whether reductions in pollution vary by CAZ proximity. WP3A: We will conduct a quasi-experimental interrupted time series analysis using a longitudinal routine health dataset of > 530,000 Bradford residents comparing trends (3 years prior vs 3 years post) in respiratory health (assessed via emergency/GP attendances. WP3B: We will use the richly-characterised Born in Bradford cohort (13,500 children) to explore health inequalities in respiratory health using detailed socio-economic data. WP4: will entail a multi-sectoral health economic evaluation to determine value for money of the B-CAP. DISCUSSION: This will be first comprehensive quasi-experimental evaluation of a city-wide policy intervention to improve air quality. The findings will be of value for other areas implementing this type of approach. TRIAL REGISTRATION: ISRCTN67530835 https://doi.org/10.1186/ISRCTN67530835.

Exploring the Interactions between Housing and Neighbourhood Environments for Enhanced Child Wellbeing: The Lived Experience of Parents Living in Areas of High Child Poverty in England, UK.

Children's health can be affected by the interrelated characteristics of the physical and social environment where they live, including housing quality, neighbourhood characteristics and the local community. Following a systems-based approach, this exploratory project sought to understand how the needs and aspirations associated with the home environment can work in synergy with, or be exacerbated by, other aspects of the local area. The study recruited parents of children aged 2-12 years old from two local authorities in England with high levels of child poverty: Tower Hamlets in East London, and Bradford District in West Yorkshire. Thematic analysis of participant interviews highlighted ten themes and opportunities for improvements. The evidence presented in this research emphasises how environmental quality issues within and outside the home, compounded further by delays in repairs and reduction in service standards, as well as affordability issues, are likely to deeply affect the wellbeing of an entire generation of disadvantaged children whose parents can feel disempowered, neglected and often isolated when attempting to tackle various dimensions of inequalities. Interventions which can improve the quality of housing, and access to space and services, are urgently needed, including initiatives to support and empower families and local communities, especially those prioritising opportunities for action.

The art of Patient and Public Involvement: exploring ways to research and reduce air pollution through art-based community workshops - a reflective paper.

In this reflective paper we outline and discuss our art-based Patient and Public Involvement (PPI) approach.  This exercise held two broad objectives. Firstly, to assist policy makers in understanding the types of interventions communities will find acceptable to address the problem of poor air quality, and secondly, to ascertain community views about our research plans to explore the impact of the planned interventions on neighbourhoods.  We reflect on both our approach and the emergent conversations from the PPI activity.  Attendees contributed to the process and stressed the importance of not burdening poor neighbourhoods with costly charges as that would ameliorate one health problem but generate others as a consequence of additional financial burden.  Equally, they stressed the need to conduct research on matters which they could connect with such as the impact of clean air plans on young children and how information about air pollution is disseminated in their neighbourhoods as and when research findings emerge.  This paper offers a conceptual analysis of the art-based PPI method and uniquely draws a connection to the philosophical traditions of Ludwig Wittgenstein.  Specifically, we demonstrate how art is conducive to creating a dialogue which is specifically helpful for PPI purposes for both researchers and implementers, and conversely, why traditional conversational approaches may have fallen short of the adequacy mark in this regard.

The role of plant-associated rhizobacteria in plant growth, biocontrol and abiotic stress management.

The rhizosphere is the region around the plant roots where maximum microbial activities occur. In the rhizosphere, microorganisms' beneficial and harmful activities affect plant growth and development. The mutualistic rhizospheric bacteria which improve plant growth and health are known as plant growth-promoting rhizobacteria (PGPR). They are very important due to their ability to help the plant in diverse ways. PGPR such as Pseudomonas, Bacillus, Azospirillum, Azotobacter, Arthrobacter, Achromobacter, Micrococcus, Enterobacter, Rhizobium, Agrobacterium, Pantoea and Serratia are now very well known. Rhizomicrobiome plays critical roles in nutrient acquisition and assimilation, improved soil texture, secreting and modulating extracellular molecules such as hormones, secondary metabolites, antibiotics and various signal compounds, all leading to the enhancement of plant growth and development. The microbes and compounds they secrete constitute valuable biostimulants and play pivotal roles in modulating plant stress responses. In this review, we highlight the rhizobacteria diversity and cutting-edge findings focusing on the role of a PGPR in plant growth and development. We also discussed the role of PGPR in resisting the adverse effects arising from various abiotic (drought, salinity, heat, heavy metals) stresses.

Nothing about us, without us: is for us.

BACKGROUND: Public Participation Involvement Engagement (PPIE) is now strongly encouraged across health policy and research. Coproduction, although linked to PPIE is a way of working that can be applied to work collaboratively with participants in health. However, a lack of definition which leads to interchangeable terminology, limited guidance and examples of good practice on how to facilitate the process impedes progress. The Born in Bradford (BiB) research programme consists of a family of observational and longitudinal birth cohort studies (Raynor et al. in BMC Public Health 8:1-13, 2008; Dickerson et al. in BMC Public Health 16(1):1-14, 2016) which include participants from multi-ethnic and socially diverse backgrounds (Uphoff et al. in Int J Equity Health 12:1-12, 2013). METHODS: This paper aims to highlight our approach to PPIE and coproduction methodologies, to provide an outline of the methods we have utilised to work collaboratively with our cohort populations from diverse communities and how we have managed to overcome challenges to achieve successful PPIE.A secondary aim of this paper is to demonstrate the value of PPIE and coproduction and how it can enhance research.  Some examples from recent years are provided to demonstrate how useful the approach has been for BiB community engagement and community participation. In addition, we discuss the methods we have used and how this methodology has now been embedded into protocol and practice in our research. RESULTS: Successful and productive PPIE and coproduction occur where stakeholders are taken on board and realise the impact that their involvement can have in terms of policy design and delivery. CONCLUSIONS: The involvement of participants and the community in research about them becomes more credible when equal partnerships are formed and they are involved in the whole process leading to community ownership of research. Hence, nothing about us, without us-is for us.

Born in Bradford (BiB) is following the lives of more than 36,000 individuals to see why some families are healthier and others are not so. The children in the original study are aged range between 10 and 15 years, all born at the Bradford Royal Infirmary. Parents consented to take part in the study part prior to the birth of the child/ren (some families have more than one child in the study). BiB has been working successfully with grassroots communities for several years to increase community involvement in the research programme using various methods ranging from community engagement to coproduction. "There has always been a balance, even earlier stages of the study when the focus was medical­it had to be plain (for the community). Everything we thought about did have an impact on BiB." The recruitment and establishment of proactive lay research groups is necessary to aid and shape our research. We believe that researchers need to ensure that they encourage community participation from all the various communities that make up the local population. Our approach serves a dual purpose as we want our communities to contribute to our research but at the same time, we want to offer local people skills development and confidence building so that they can articulate their views at various networks and events.We wrote this paper to highlight some challenges, good practices and methods we have achieved to work with local communities.

Lichens as a repository of bioactive compounds: an open window for green therapy against diverse cancers.

Lichens, algae and fungi-based symbiotic associations, are sources of many important secondary metabolites, such as antibiotics, anti-inflammatory, antioxidants, and anticancer agents. Wide range of experiments based on in vivo and in vitro studies revealed that lichens are a rich treasure of anti-cancer compounds. Lichen extracts and isolated lichen compounds can interact with all biological entities currently identified to be responsible for tumor development. The critical ways to control the cancer development include induction of cell cycle arrests, blocking communication of growth factors, activation of anti-tumor immunity, inhibition of tumor-friendly inflammation, inhibition of tumor metastasis, and suppressing chromosome dysfunction. Also, lichen-based compounds induce the killing of cells by the process of apoptosis, autophagy, and necrosis, that inturn positively modulates metabolic networks of cells against uncontrolled cell division. Many lichen-based compounds have proven to possess potential anti-cancer activity against a wide range of cancer cells, either alone or in conjunction with other anti-cancer compounds. This review primarily emphasizes on an updated account of the repository of secondary metabolites reported in lichens. Besides, we discuss the anti-cancer potential and possible mechanism of the most frequently reported secondary metabolites derived from lichens.

Measuring the Built Environment in Studies of Child Health-A Meta-Narrative Review of Associations.

Although the built environment (BE) is important for children's health, there is little consensus about which features are most important due to differences in measurement and outcomes across disciplines. This meta-narrative review was undertaken by a multi-disciplinary team of researchers to summarise ways in which the BE is measured, and how this links to children's health. A structured search of four databases across the relevant disciplines retrieved 108 relevant references. The most commonly addressed health-related outcomes were active travel, physical activity and play, and obesity. Many studies used objective (GIS and street audits) or standardised subjective (perceived) measurements of the BE. However, there was a wide variety, and sometimes inconsistency, in their definition and use. There were clear associations between the BE and children's health. Objective physical activity and self-reported active travel, or obesity, were positively associated with higher street connectivity or walkability measures, while self-reported physical activity and play had the strongest association with reduced street connectivity, indicated by quieter, one-way streets. Despite the high heterogeneity found in BE measures and health outcomes, the meta-narrative approach enabled us to identify ten BE categories that are likely to support children's health and be protective against some non-communicable disease risk factors. Future research should implement consistent BE measures to ensure key features are explored. A systems approach will be particularly relevant for addressing place-based health inequalities, given potential unintended health consequences of making changes to the BE.

Taking a deep breath: a qualitative study exploring acceptability and perceived unintended consequences of charging clean air zones and air quality improvement initiatives amongst low-income, multi-ethnic communities in Bradford, UK.

BACKGROUND: Poor air quality is the one of the biggest causes of early death and illness across the lifespan. In the UK, 28 local authorities with illegal pollution levels have been mandated by the Government to develop plans to rapidly reduce pollution to legal limits. These plans include consideration of implementing one of four of charging 'Clean Air Zone' (CAZ) classes in areas of high pollution which would charge older polluting vehicles a daily charge to enter. While this offers a potential to improve air quality, the extent to which CAZ might impact (for example, economically) on socio-economically deprived groups and local businesses is unclear. AIMS: To explore the acceptability and perceived unintended consequences of a CAZ and other initiatives to improve air quality with seldom-heard communities living in deprived, multi-ethnic areas within the city of Bradford, UK. METHODS: Ten semi-structured focus groups were conducted with people who live in areas of high pollution and deprivation. A total of 87 people participated from a diverse range of ethnic backgrounds with the majority of Pakistani origin. Recorded data were transcribed, coded and analysed using thematic analysis. FINDINGS: As poor air quality was not always visible it was seen as a hidden issue by many, and not prioritised over other more visible environmental issues (e.g. fly-tipping, littering). There was resistance to proposals which included charging private vehicles. Many felt that low-income families did not have the resources to purchase compliant vehicles or pay daily charges, placing a disproportionate burden on them. It was also felt that low-income taxi drivers would be disproportionately affected financially by proposals. Public transport infrastructure was felt to be inadequate. Other traffic management or emission reduction activities were also explored. Views towards these initiatives were more positive if they did not directly affect individuals financially. CONCLUSION: Air quality initiatives such as CAZs were felt to be likely to financially disadvantage communities already living in socio-economic and environmental poverty. Policy makers need to carefully consider appropriate mitigation strategies to ensure that health and economic inequalities are not increased by implementation of CAZ. Given air quality is low priority for some groups, careful engagement and communication will be required to increase acceptance interventions such as CAZs.

Understanding COVID-19 misinformation and vaccine hesitancy in context: Findings from a qualitative study involving citizens in Bradford, UK.

BACKGROUND: COVID-19 vaccines can offer a route out of the pandemic, yet initial research suggests that many are unwilling to be vaccinated. A rise in the spread of misinformation is thought to have played a significant role in vaccine hesitancy. To maximize uptake, it is important to understand why misinformation has been able to take hold at this time and why it may pose a more significant problem within certain contexts. OBJECTIVE: To understand people's COVID-19 beliefs, their interactions with (mis)information during COVID-19 and attitudes towards a COVID-19 vaccine. DESIGN AND PARTICIPANTS: Bradford, UK, was chosen as the study site to provide evidence to local decision makers. In-depth phone interviews were carried out with 20 people from different ethnic groups and areas of Bradford during Autumn 2020. Reflexive thematic analysis was conducted. RESULTS: Participants discussed a wide range of COVID-19 misinformation they had encountered, resulting in confusion, distress and mistrust. Vaccine hesitancy could be attributed to three prominent factors: safety concerns, negative stories and personal knowledge. The more confused, distressed and mistrusting participants felt about their social worlds during the pandemic, the less positive they were about a vaccine. CONCLUSIONS: COVID-19 vaccine hesitancy needs to be understood in the context of the relationship between the spread of misinformation and associated emotional reactions. Vaccine programmes should provide a focused, localized and empathetic response to counter misinformation. PATIENT OR PUBLIC CONTRIBUTION: A rapid community and stakeholder engagement process was undertaken to identify COVID-19 priority topics important to Bradford citizens and decision makers.