Search

Abstract Stress in sea urchins leads to high mortality and economic losses in both the environment and aquaculture. The green sea urchin Strongylocentrotus droebachiensis has been documented emitting complex biofluorescence, yet how this responds to external stressors is unknown. Adult sea urchins (n = 210) were divided between control (n = 30) and experimental groups (n = 180), using three transport variables: out of water, in water at elevated temperatures, (warm-water) and in water at seawater temperature (cold-water). Hyperspectral imaging of external fluorescence and fluorospectrometric analysis on coelomic fluid was measured at five intervals (hour 0,3,6,9,12). External green emissions (∼580 nm) responded to all treatments, peaking at h9. External red emissions (∼680–730 nm) in the cold-water remained low until an h9 peak. The warm water increased emissions at each interval, peaking at h9. The out of water gradually increased, with the highest at h12. The coelomic fluid fluorescence (∼680 nm) was low to nonexistent except in warm-water, whose elevated levels suggest that fluorescent emissions are a measurable byproduct of internal adaptation(s) to stress. Early detection of fluorescent emissions (broken spines, lesions) may prevent economic losses. The observed link between fluorescence and the applied stressors provides a baseline for developing non-invasive technology for improving echinoderm welfare.

Abstract High resolution force measurements of molecules on surfaces, in non-contact atomic force microscopy, are often only performed at cryogenic temperatures, due to needing a highly stable system, and a passivated probe tip (typically via CO-functionalisation). Here we show a reliable protocol for acquiring three-dimensional force map data over both single organic molecules and assembled islands of molecules, at room temperature. Isolated cobalt phthalocyanine and islands of C60 are characterised with submolecular resolution, on a passivated silicon substrate (B:Si(111)- $$(\sqrt{3}\times \sqrt{3})R3{0}^{\circ }$$ ( 3 × 3 ) R 3 0 ∘ ). Geometries of cobalt phthalocyanine are determined to a ~ 10 pm accuracy. For the C60, the protocol is sufficiently robust that areas spanning 10 nm × 10 nm are mapped, despite the difficulties of room temperature operation. These results provide a proof-of-concept for gathering high-resolution three-dimensional force maps of networks of complex, non-planar molecules on surfaces, in conditions more analogous to real-world application.

Climate change is considered the most pressing environmental challenge of our time, being transport one of the major contributors. Consequently, transport models are required to test different urban mobility policies that can shift travel to more sustainable transport modes (e.g., active modes). This paper focuses on the development of a validated agent-based model (MATSim) applying a novel open-source methodology to generate the main input datasets, easily transferrable to any region in England. Required input datasets (synthetic population and network) are described with a high level of detail, identifying the datasets and tools used to develop them, with special interest in the simulation of cycling routes. A new attribute (quietness) ranking roads for cycling depending on their built-environment characteristics was incorporated into the MATSim bicycle extension. The results obtained in this paper show the baseline transport model of the Tyne and Wear region (England), where discrepancies up to 3.5% in transport mode shares and minimal differences in vehicle counts in urban areas were obtained, and a realistic representation of the routes chosen by the agents using bicycles is obtained. This provides the basis for the development of similar MATSim implementation in other UK regions.

Ecosystem Accounting provides a framework to measure and value relationships amongst ecosystems, society and the economy. The accounts measure ecosystem extent, condition and services, providing the means to identify and internalise ecological degradation, as well as understanding the risks and dependencies of economic activities on the environment and tracking progress towards sustainable development. The OSPAR Convention, which concerns the protection of the Marine Environment for the North-East Atlantic, has committed to accounting for natural capital and ecosystem services, where the UN System of Environmental Economic Accounting – Ecosystem Accounting (SEEA EA) provides an international accounting standard for guidance in compiling accounts. Here, we describe the first attempt in compiling accounts aligned with SEEA EA at a Regional Sea scale. We: (i) identified existing open access data, (ii) produced accounts for selected ecosystems and valued their services and asset value and (iii) identified challenges and lessons learned. For ecosystem services, we measured fish provisioning, carbon sequestration and outdoor recreation from coastal and marine environments across OSPAR contracting parties. The exercise identified lack of fitting data at regional level, spatially-explicit linkages and harmonisation need to be overcome to further expand accounts. This work represents an initial step to progress on ecosystem accounting and demonstrates that even with limited data and incomplete time-series, accounts can start being compiled to identify data gaps and prioritising next steps.

Abstract The diverse aquaculture sector makes important contributions toward achieving the Sustainable Development Goals (SDGs)/Agenda 2030, and can increasingly do so in the future. Its important role for food security, nutrition, livelihoods, economies, and cultures is not clearly visible in the Agenda 21 declaration. This may partly reflect the state of development of policies for aquaculture compared with its terrestrial counterpart, agriculture, and possibly also because aquaculture production has historically originated from a few key hotspot regions/countries. This review highlights the need for better integration of aquaculture in global food system dialogues. Unpacking aquaculture's diverse functions and generation of values at multiple spatiotemporal scales enables better understanding of aquaculture's present and future potential contribution to the SDGs. Aquaculture is a unique sector that encompasses all aquatic ecosystems (freshwater, brackish/estuarine, and marine) and is also tightly interconnected with terrestrial ecosystems through, for example, feed resources and other dependencies. Understanding environmental, social, and economic characteristics of the multifaceted nature of aquaculture provides for more context‐specific solutions for addressing both opportunities and challenges for its future development. This review includes a rapid literature survey based on how aquaculture links to the specific SDG indicators. A conceptual framework is developed for communicating the importance of context specificity related to SDG outcomes from different types of aquaculture. The uniqueness of aquaculture's contributions compared with other food production systems are discussed, including understanding of species/systems diversity, the role of emerging aquaculture, and its interconnectedness with supporting systems. A selection of case studies is presented to illustrate: (1) the diversity of the aquaculture sector and what role this diversity can play for contributions to the SDGs, (2) examples of methodologies for identification of aquaculture's contribution to the SDGs, and (3) trade‐offs between farming systems’ contribution to meeting the SDGs. It becomes clear that decision‐making around resource allocation and trade‐offs between aquaculture and other aquatic resource users needs review of a wide range of established and emergent systems. The review ends by highlighting knowledge gaps and pathways for transformation that will allow further strengthening of aquaculture's role for contributing to the SDGs. This includes identification and building on already existing monitoring that can enable capturing SDG‐relevant aquaculture statistics at a national level and discussion of how a cohesive and comprehensive aquaculture strategy, framed to meet the SDGs, may help countries to prioritize actions for improving well‐being.

Introduction Low back pain (LBP) is commonly treated with opioid analgesics despite evidence that these medicines provide minimal or no benefit for LBP and have an established profile of harms. International guidelines discourage or urge caution with the use of opioids for back pain; however, doctors and patients lack practical strategies to help them implement the guidelines. This trial will evaluate a multifaceted intervention to support general practitioners (GPs) and their patients with LBP implement the recommendations in the latest opioid prescribing guidelines.Methods and analysis This is a cluster randomised controlled trial that will evaluate the effect of educational outreach visits to GPs promoting opioid stewardship alongside non-pharmacological interventions including heat wrap and patient education about the possible harms and benefits of opioids, on GP prescribing of opioids medicines dispensed. At least 40 general practices will be randomised in a 1:1 ratio to either the intervention or control (no outreach visits; GP provides usual care). A total of 410 patient–participants (205 in each arm) who have been prescribed an opioid for LBP will be enrolled via participating general practices. Follow-up of patient–participants will occur over a 1-year period. The primary outcome will be the cumulative dose of opioid dispensed that was prescribed by study GPs over 1 year from the enrolment visit (in morphine milligram equivalent dose). Secondary outcomes include prescription of opioid medicines, benzodiazepines, gabapentinoids, non-steroidal anti-inflammatory drugs by study GPs or any GP, health services utilisation and patient-reported outcomes such as pain, quality of life and adverse events. Analysis will be by intention to treat, with a health economics analysis also planned.Ethics and dissemination The trial received ethics approval from The University of Sydney Human Research Ethics Committee (2022/511). The results will be disseminated via publications in journals, media and conference presentations.Trial registration number ACTRN12622001505796.

Introduction In Australia, only 22% of male and 8% of female adolescents meet the muscle-strengthening physical activity guidelines, and few school-based interventions support participation in resistance training (RT). After promising findings from our effectiveness trial, we conducted a state-wide dissemination of the ‘Resistance Training for Teens’ (RT4T) intervention from 2015 to 2020. Despite high estimated reach, we found considerable variability in programme delivery and teachers reported numerous barriers to implementation. Supporting schools when they first adopt evidence-based programmes may strengthen programme fidelity, sustainability, and by extension, programme impact. However, the most effective implementation support model for RT4T is unclear.Objective To compare the effects of three implementation support models on the reach (primary outcome), dose delivered, fidelity, sustainability, impact and cost of RT4T.Methods and analysis We will conduct a hybrid type III implementation–effectiveness trial involving grade 9 and 10 (aged 14–16 years) students from 90 secondary schools in New South Wales (NSW), Australia. Schools will be recruited across one cohort in 2023, stratified by school type, socioeconomic status and location, and randomised in a 1:1:1 ratio to receive one of the following levels of implementation support: (1) ‘low’ (training and resources), (2) ‘moderate’ (training and resources+external support) or ‘high’ (training and resources+external support+equipment). Training includes a teacher workshop related to RT4T programme content (theory and practical sessions) and the related resources. Additional support will be provided by trained project officers from five local health districts. Equipment will consist of a pack of semiportable RT equipment (ie, weighted bars, dumbbells, resistance bands and inverted pull up bar stands) valued at ~$A1000 per school. Study outcomes will be assessed at baseline (T0), 6 months (T1) and 18 months (T2). A range of quantitative (teacher logs, observations and teacher surveys) and qualitative (semistructured interviews with teachers) methods will be used to assess primary (reach) and secondary outcomes (dose delivered, fidelity, sustainability, impact and cost of RT4T). Quantitative analyses will use logistic mixed models for dichotomous outcomes, and ordinal or linear mixed effects regression models for continuous outcomes, with alpha levels set at p

Introduction: Biofungicides with low toxicity and high efficiency are a global priority for sustainable agricultural development. Phytohormone salicylic acid (SA) is an ancient medicine against various diseases in humans and activates the immune system in plants, but little is known of its function as a biofungicide. Objectives: Here, Fusarium oxysporum, the causal agent of devastating Fusarium wilt and immunodepressed patients, was used as a model system to explore whether SA can enter the pathogen cells and suppress key targets of the pathogen. Methods: Oxford Nanopore MinION sequencing and high-throughput chromosome conformation capture (Hi-C) sequencing were used to analyzed the genome of F. oxysporum. In addition, RNA-seq, qRT-PCR, and western blotting were conducted to detect gene and protein expression levels. Results: We isolated and sequenced the genome of F. oxysporum from potato dry rot, and the F. oxysporum included 12 chromosomes and 52.3 Mb genomic length. Pharmacological assays showed that exogenous application of SA can efficiently arrest hyphal growth, spore production, and pathogenicity of F. oxysporum, whereas endogenous salicylate hydroxylases significantly detoxify SA. The synergistic growth inhibition of F. oxysporum was observed when SA was combined with rapamycin. Kinase assays showed that SA inhibits FoTOR complex 1 (FoTORC1) by activating FoSNF1 in vivo. Transgenic potato plants with the interference of FoTOR1 and FoSAH1 genes inhibited the invasive growth of hyphae and significantly prevented the occurrence of Fusarium wilt. Conclusion: This study revealed the underlying mechanisms of SA against F. oxysporum and provided insights into SA in controlling various fungal diseases by targeting the SNF1-TORC1 pathway of pathogens.

Abstract There is a large amount of coproduct generated by the sea urchin fisheries around the world as well as a growing interest in removing large quantities of undersize and low value sea urchins from barren areas in the northern Atlantic and Pacific coasts as well as other areas around the world. The authors believe there is scope to develop a hydrolysate product from this and this study gives preliminary observations on the characteristics of hydrolysate from the sea urchin Strongylocentrotus droebachiensis. The biochemical composition for S. droebachiensis is moisture 64.1%, protein 3.4%, oil 0.9%, and ash 29.8%. Amino acid composition, molecular weight distribution, lipid‐class, and fatty acid composition are also presented. The authors suggest a sensory‐panel mapping be undertaken on future sea urchin hydrolysates. Possible uses for the hydrolysate are unclear at this stage but the combination of amino acids and the relatively high levels of glycine, aspartic acid, and glutamic acid should be further investigated.

Abstract Background Anaemia in pregnancy remains prevalent in Nepal and causes severe adverse health outcomes. Methods This non-blinded cluster-randomised controlled trial in the plains of Nepal has two study arms: (1) Control: routine antenatal care (ANC); (2) Home visiting, iron supplementation, Participatory Learning and Action (PLA) groups, plus routine ANC. Participants, including women in 54 non-contiguous clusters (mean 2582; range 1299–4865 population) in Southern Kapilbastu district, are eligible if they consent to menstrual monitoring, are resident, married, aged 13–49 years and able to respond to questions. After 1–2 missed menses and a positive pregnancy test, consenting women

In order to effectively balance enforced guidance/regulation during a pandemic and limit infection transmission, with the necessity for public transportation services to remain safe and operational, it is imperative to understand and monitor environmental conditions and typical behavioural patterns within such spaces. Social distancing ability on public transport as well as the use of advanced computer vision techniques to accurately measure this are explored in this paper. A low-cost depth-sensing system is deployed on a public bus as a means to approximate social distancing measures and study passenger habits in relation to social distancing. The results indicate that social distancing on this form of public transport is unlikely for an individual beyond a 28% occupancy threshold, with an 89% chance of being within 1–2 m from at least one other passenger and a 57% chance of being within less than one metre from another passenger at any one point in time. Passenger preference for seating is also analysed, which clearly demonstrates that for typical passengers, ease of access and comfort, as well as seats having a view, are preferred over maximising social-distancing measures. With a highly detailed and comprehensive set of acquired data and accurate measurement capability, the employed equipment and processing methodology also prove to be a robust approach for the application.

Earthquakes are one of the most catastrophic natural phenomena. After an earthquake, earthquake reconnaissance enables effective recovery by collecting data on building damage and other impacts. This paper aims to identify state-of-the-art data sources for building damage assessment and provide guidance for more efficient data collection. We have reviewed 39 articles that indicate the sources used by different authors to collect data related to damage and post-disaster recovery progress after earthquakes between 2014 and 2021. The current data collection methods have been grouped into seven categories: fieldwork or ground surveys, omnidirectional imagery (OD), terrestrial laser scanning (TLS), remote sensing (RS), crowdsourcing platforms, social media (SM) and closed-circuit television videos (CCTV). The selection of a particular data source or collection technique for earthquake reconnaissance includes different criteria depending on what questions are to be answered by these data. We conclude that modern reconnaissance missions cannot rely on a single data source. Different data sources should complement each other, validate collected data or systematically quantify the damage. The recent increase in the number of crowdsourcing and SM platforms used to source earthquake reconnaissance data demonstrates that this is likely to become an increasingly important data source.

Abstract A trial of three nutrition‐sensitive agriculture interventions with participatory videos and women's group meetings in rural Odisha, India, found improvements in maternal and child dietary diversity, limited effects on agricultural production, and no effects on women and children's nutritional status. Our process evaluation explored fidelity, reach, and mechanisms behind interventions' effects. We also examined how context affected implementation, mechanisms, and outcomes. We used data from intervention monitoring systems, review notes, trial surveys, 32 case studies with families (n = 91 family members), and 20 group discussions with women's group members and intervention workers (n = 181 and 32, respectively). We found that interventions were implemented with high fidelity. Groups reached around half of the mothers of children under 2 years. Videos and meetings increased women's knowledge, motivation and confidence to suggest or make changes to their diets and agricultural production. Families responded in diverse ways. Many adopted or improved rainfed homestead garden cultivation for consumption, which could explain gains in maternal and child dietary diversity seen in the impact evaluation. Cultivation for income was less common. This was often due to small landholdings, poor access to irrigation and decision‐making dominated by men. Interventions helped change norms about heavy work during pregnancy, but young women with little family support still did considerable work. Women's ability to shape cultivation, income and workload decisions was strongly influenced by support from male relatives. Future nutrition‐sensitive agriculture interventions could include additional flexibility to address families’ land, water, labour and time constraints, as well as actively engage with spouses and in‐laws.

Abstract Critical services depend on infrastructure networks for their operation and any disruption to these networks can have significant impacts on society, the economy, and quality of life. Such networks can be characterised as graphs which can be used to understand their structural properties, and the effect on their behaviour and robustness to hazards. Using a suite of graphs and critical infrastructure networks, this study aims to show that networks which exhibit a hierarchical structure are more likely to be less robust comparatively to non-hierarchical networks when exposed to failures, including those which supply critical services. This study investigates the properties of a hierarchical structure through identifying a set of key characteristics from an ensemble of graph models which are then used in a comparative analysis against a suite of spatial critical infrastructure networks. A failure model is implemented and applied to understand the implications of hierarchical structures in real world networks for their robustness to perturbations. The study concludes that a set of three graph metrics, cycle basis, maximum betweenness centrality and assortativity coefficient, can be used to identify the extent of a hierarchy in graphs, where a lack of robustness is linked to the hierarchical structure, a feature exhibited in both graph models and infrastructure networks.

Low-cost Particulate Matter (PM) sensors offer an excellent opportunity to improve our knowledge about this type of pollution. Their size and cost, which support multi-node network deployment, along with their temporal resolution, enable them to report fine spatio-temporal resolution for a given area. These sensors have known issues across performance metrics. Generally, the literature focuses on the PM mass concentration reported by these sensors, but some models of sensors also report Particle Number Concentrations (PNCs) segregated into different PM size ranges. In this study, eight units each of Alphasense OPC-R1, Plantower PMS5003 and Sensirion SPS30 have been exposed, under controlled conditions, to short-lived peaks of PM generated using two different combustion sources of PM, exposing the sensors’ to different particle size distributions to quantify and better understand the low-cost sensors performance across a range of relevant environmental ranges. The PNCs reported by the sensors were analysed to characterise sensor-reported particle size distribution, to determine whether sensor-reported PNCs can follow the transient variations of PM observed by the reference instruments and to determine the relative impact of different variables on the performances of the sensors. This study shows that the Alphasense OPC-R1 reported at least five size ranges independently from each other, that the Sensirion SPS30 reported two size ranges independently from each other and that all the size ranges reported by the Plantower PMS5003 were not independent of each other. It demonstrates that all sensors tested here could track the fine temporal variation of PNCs, that the Alphasense OPC-R1 could closely follow the variations of size distribution between the two sources of PM, and it shows that particle size distribution and composition are more impactful on sensor measurements than relative humidity.

Abstract Background Bioinformatic genome surveys indicate that self-cleaving ribonucleic acids (ribozymes) appear to be widespread among all domains of life, although the functions of only a small number have been validated by biochemical methods. Alternatively, cell-based reporter gene assays can be used to validate ribozyme function. However, reporter activity can be confounded by phenomena unrelated to ribozyme-mediated cleavage of RNA. Results We established a ribozyme reporter system in Escherichia coli in which a significant reduction of reporter activity is manifest when an active ribozyme sequence is fused to the reporter gene and the expression of a foreign Bacillus subtilis RNaseJ1 5′ exonuclease is induced from a chromosomally-integrated gene in the same cell. Conclusions The reporter system could be useful for validating ribozyme function in candidate sequences identified from bioinformatics.

Abstract Background There is a growing body of literature supporting positive associations between natural environments and better health. The type, quality and quantity of green and blue space (‘green-space’) in proximity to the home might be particularly important for less mobile populations, such as for some older people. However, considerations of measurement and definition of green-space, beyond single aggregated metrics, are rare. This constitutes a major source of uncertainty in current understanding of public health benefits derived from natural environments. We aimed to improve our understanding of how such benefits are conferred to different demographic groups through a comprehensive evaluation of the physical and spatial characteristics of urban green infrastructure. Methods We employed a green infrastructure (GI) approach combining a high-resolution spatial dataset of land-cover and function with area-level demographic and socio-economic data. This allowed for a comprehensive characterization of a densely populated, polycentric city-region. We produced multiple GI attributes including, for example, urban vegetation health. We used a series of step-wise multi-level regression analyses to test associations between population chronic morbidity and the functional, physical and spatial components of GI across an urban socio-demographic gradient. Results GI attributes demonstrated associations with health in all socio-demographic contexts even where associations between health and overall green cover were non-significant. Associations varied by urban socio-demographic group. For areas characterised by having higher proportions of older people (‘older neighbourhoods’), associations with better health were exhibited by land-cover diversity, informal greenery and patch size in high income areas and by proximity to public parks and recreation land in low income areas. Quality of GI was a significant predictor of good health in areas of low income and low GI cover. Proximity of publicly accessible GI was also significant. Conclusions The influence of urban GI on population health is mediated by green-space form, quantity, accessibility, and vegetation health. People in urban neighbourhoods that are characterised by lower income and older age populations are disproportionately healthy if their neighbourhoods contain accessible, good quality public green-space. This has implications for strategies to decrease health inequalities and inform international initiatives, such as the World Health Organisation’s Age-Friendly Cities programme.

The smart city term has been widely used for a number of years and many pilot projects and limited scale, sector independent initiatives have been progressed, but comprehensive, long-term, city wide, multi-sector systems are much less evident. This paper examines one such case study in Newcastle, UK highlighting the challenges and opportunities that realizing “smart city” concepts at scale present. The paper provides the background to the Newcastle Urban Observatory project and discusses the socio-technical and practical challenges of developing and maintaining smart city networks of sensors in the plurality that is a modern city. We discuss the organizational requirements, governance, data quality and volume issues, big data management and discuss the current and future needs of decision makers and other city stakeholders. Finally, we propose areas where smart cities can have a positive impact on public outcomes through the discussion of two case studies related to COVID-19 and pedestrianization initiatives.

Introduction Several clinical trials comparing the efficacy and safety of transarterial chemoembolisation (TACE) plus molecular-targeted agents versus TACE alone revealed no clinical benefits in progression-free survival (PFS) or overall survival (OS). Here, we report the final OS analysis from the TACTICS trial, which previously demonstrated significant improvement in PFS with TACE plus sorafenib in patients with unresectable hepatocellular carcinoma (HCC) (NCT01217034). Methods Patients with unresectable HCC were randomised to a TACE plus sorafenib group(N=80) or a TACE alone group(N=76). Patients in the combination treatment group received sorafenib 400 mg once daily for 2–3 weeks before TACE, followed by 800 mg once daily during on-demand conventional TACE sessions until time to untreatable progression. In this trial, TACE-specific PFS was used. TACE-specific PFS is defined as the time from randomization to progressive disease (PD) or death from any cause, and PD was defined as untreatable (UnTACEable) progression, caused by the inability of a patient to further receive or benefit from TACE for reasons that include intrahepatic tumor progression (25% increase vs baseline) according to RECICL, the detection of extrahepatic spread, vascular invasion or transient deterioration of liver function to Child-Pugh C after TACE. Results At the cut-off date of 31 July 2020, 131 OS events were observed. The median OS was 36.2 months with TACE plus sorafenib and 30.8 months with TACE alone (hazard ratio [HR]=0.861; 95% confidence interval [CI), 0.607–1.223; P=0.40, ΔOS, 5.4 months). The updated PFS was 22.8 months with TACE plus sorafenib and 13.5 months with TACE alone (HR=0.661; 95% CI, 0.466–0.938; P=0.02). Post-trial treatments with active procedures/agents were received by 47 (58.8%) patients in the TACE plus sorafenib group and 58 (76.3%) in the TACE alone group (P=0.01). In post hoc analysis, PFS and OS benefit were shown in HCC patients with tumor burden beyond up-to-7 criteria. Conclusions In TACTICS trial, TACE plus sorafenib did not show significant OS benefit over TACE alone; however, clinical meaningful OS prolongation and significantly improved PFS was observed. Thus, the TACE plus sorafenib can be considered a choice of treatment in intermediate stage HCC, especially in patients with high tumor burden. Trial Registration: NCT01217034

Abstract Maternal anaemia prevalence in low‐income countries is unacceptably high. Our research explored the individual‐, family‐ and community‐level factors affecting antenatal care uptake, iron folic acid (IFA) intake and consumption of micronutrient‐rich diets among pregnant women in the plains of Nepal. We discuss how these findings informed the development of a home visit and community mobilisation intervention to reduce anaemia in pregnancy. We used a qualitative methodology informed by the socio‐ecological framework, conducting semi‐structured interviews with recently pregnant women and key informants, and focus group discussions with mothers‐in‐law and fathers. We found that harmful gender norms restricted women's access to nutrient‐rich food, restricted their mobility and access to antenatal care. These norms also restricted fathers' role to that of the provider, as opposed to the caregiver. Pregnant women, mothers‐in‐law and fathers lacked awareness about iron‐rich foods and how to manage the side effects of IFA. Fathers lacked trust in government health facilities affecting access to care and trust in the efficacy of IFA. Our research informed interventions by (1) informing the development of intervention tools and training; (2) informing the intervention focus to engaging mothers‐in‐law and men to enable behaviour change; and (3) demonstrating the need to work in synergy across individual, family and community levels to address power and positionality, gender norms, trust in health services and harmful norms. Participatory groups and home visits will enable the development and implementation of feasible and acceptable strategies to address family and contextual issues generating knowledge and an enabling environment for behaviour change.

Summary: Background: Almost a quarter of the world's undernourished people live in India. We tested the effects of three nutrition-sensitive agriculture (NSA) interventions on maternal and child nutrition in India. Methods: We did a parallel, four-arm, observer-blind, cluster-randomised trial in Keonjhar district, Odisha, India. A cluster was one or more villages with a combined minimum population of 800 residents. The clusters were allocated 1:1:1:1 to a control group or an intervention group of fortnightly women's groups meetings and household visits over 32 months using: NSA videos (AGRI group); NSA and nutrition-specific videos (AGRI-NUT group); or NSA videos and a nutrition-specific participatory learning and action (PLA) cycle meetings and videos (AGRI-NUT+PLA group). Primary outcomes were the proportion of children aged 6–23 months consuming at least four of seven food groups the previous day and mean maternal body-mass index (BMI). Secondary outcomes were proportion of mothers consuming at least five of ten food groups and child wasting (proportion of children with weight-for-height Z score SD

The energy consumption and its related carbon emission of non-domestic complex buildings in an urban context are complicated due to their wide variety of functions and services. A detailed assessment of the carbon emission of such buildings can contribute to decision making for in-operation building management and schematic designs of future proposals. Concurrently, advances in smart meter data analytics and sensor-enabled operational data streams offer the opportunity to investigate this problem at a finer temporal resolution. This research developed a daily carbon emission benchmarking system of a mixed-use building in a UK university. The research period was set at an annual range from 1 January 2019 to 31 December 2019 and was segmented by strategic periods in line with the operation schedule of the building. The daily benchmark revealed the fluctuation of the building’s energy consumption and associated carbon emissions. Based on this, a digital twin framework was developed to identify the possible time periods when the building is less carbon efficient and potential building characters that can lead to increased carbon emission in the operational stage compared with what originally expected at the design stage. We discuss how these insights can offer actionable knowledge for user groups such as asset managers and architects.

Abstract Objective To compare levels of immunity in children recovering from severe acute malnutrition (cases) against those of community controls (controls). Results At baseline children recovering from severe acute malnutrition had lower, mid upper arm circumference (122 mm for cases and 135 mm for controls; p

Abstract Background Animal studies have shown that nutritional exposures during pregnancy can modify epigenetic marks regulating fetal development and susceptibility to later disease, providing a plausible mechanism to explain the developmental origins of health and disease. Human observational studies have shown that maternal peri-conceptional diet predicts DNA methylation in offspring. However, a causal pathway from maternal diet, through changes in DNA methylation, to later health outcomes has yet to be established. The EMPHASIS study (Epigenetic Mechanisms linking Pre-conceptional nutrition and Health Assessed in India and Sub-Saharan Africa, ISRCTN14266771) will investigate epigenetically mediated links between peri-conceptional nutrition and health-related outcomes in children whose mothers participated in two randomized controlled trials of micronutrient supplementation before and during pregnancy. Methods The original trials were the Mumbai Maternal Nutrition Project (MMNP, ISRCTN62811278) in which Indian women were offered a daily snack made from micronutrient-rich foods or low-micronutrient foods (controls), and the Peri-conceptional Multiple Micronutrient Supplementation Trial (PMMST, ISRCTN13687662) in rural Gambia, in which women were offered a daily multiple micronutrient (UNIMMAP) tablet or placebo. In the EMPHASIS study, DNA methylation will be analysed in the children of these women (~1100 children aged 5–7 y in MMNP and 298 children aged 7–9 y in PMMST). Cohort-specific and cross-cohort effects will be explored. Differences in DNA methylation between allocation groups will be identified using the Illumina Infinium MethylationEPIC array, and by pyrosequencing top hits and selected candidate loci. Associations will be analysed between DNA methylation and health-related phenotypic outcomes, including size at birth, and children’s post-natal growth, body composition, skeletal development, cardio-metabolic risk markers (blood pressure, serum lipids, plasma glucose and insulin) and cognitive function. Pathways analysis will be used to test for enrichment of nutrition-sensitive loci in biological pathways. Causal mechanisms for nutrition-methylation-phenotype associations will be explored using Mendelian Randomization. Associations between methylation unrelated to supplementation and phenotypes will also be analysed. Conclusion The study will increase understanding of the epigenetic mechanisms underpinning the long-term impact of maternal nutrition on offspring health. It will potentially lead to better nutritional interventions for mothers preparing for pregnancy, and to identification of early life biomarkers of later disease risk.

BACKGROUND:An estimated 49.5 million children under five years of age are wasted. There is a lack of robust studies on effective interventions to prevent wasting. The aim of this study was to identify and prioritise the main outstanding research questions in relation to wasting prevention to inform future research agendas. METHOD:A research prioritisation exercise was conducted following the Child Health and Nutrition Research Initiative method. Identified research gaps were compiled from multiple sources, categorised into themes and streamlined into forty research questions by an expert group. A survey was then widely circulated to assess research questions according to four criteria. An overall research priority score was calculated to rank questions. FINDINGS:The prioritised questions have a strong focus on interventions. The importance of the early stages of life in determining later experiences of wasting was highlighted. Other important themes included the identification of at-risk infants and young children early in the progression of wasting and the roles of existing interventions and the health system in prevention. DISCUSSION:These results indicate consensus to support more research on the pathways to wasting encompassing the in-utero environment, on the early period of infancy and on the process of wasting and its early identification. They also reinforce how little is known about impactful interventions for the prevention of wasting. CONCLUSION:This exercise provides a five-year investment case for research that could most effectively improve on-the-ground programmes to prevent child wasting and inform supportive policy change.

This research paper aims first to present in a digital map a class information about surface temperature in domestic buildings by means of thermal imagery. The classes are relative to the particular temperature distribution and for the particular night of the survey. Classification assigns every pixel into one of five classes based on where the pixel falls in the histogram, into an integer between 1 and 5, with 1 representing being the “coolest” pixels and 5 being the “hottest” resolution, based on a case study acquired over Newcastle upon Tyne (United Kingdom). The ultimate aim is combine this information with building level data set for Newcastle and adds on the energy modelling aspect through linking with the English House Survey (EHS) as input to the Cambridge Housing Model (CHM). This provides the means to produce building level energy use estimates and surface temperature, which in turn can be analysed both spatially and aspatially. This building level approach provides the potential for energy planners and other bodies to model energy interventions measures with flexibility in scale and to potentially adapt plans to the spatial variability of the local area characteristics.

Traffic cameras are a widely available source of open data that offer tremendous value to public authorities by providing real-time statistics to understand and monitor the activity levels of local populations and their responses to policy interventions such as those seen during the COrona VIrus Disease 2019 (COVID-19) pandemic. This paper presents an end-to-end solution based on the Google Cloud Platform with scalable processing capability to deal with large volumes of traffic camera data across the UK in a cost-efficient manner. It describes a deep learning pipeline to detect pedestrians and vehicles and to generate mobility statistics from these. It includes novel methods for data cleaning and post-processing using a Structure SImilarity Measure (SSIM)-based static mask that improves reliability and accuracy in classifying people and vehicles from traffic camera images. The solution resulted in statistics describing trends in the ‘busyness’ of various towns and cities in the UK. We validated time series against Automatic Number Plate Recognition (ANPR) cameras across North East England, showing a close correlation between our statistical output and the ANPR source. Trends were also favorably compared against traffic flow statistics from the UK’s Department of Transport. The results of this work have been adopted as an experimental faster indicator of the impact of COVID-19 on the UK economy and society by the Office for National Statistics (ONS).

There is an increasing interest in the use of Saccharina latissima (sugar kelp) as food, but the high iodine content in raw sugar kelp limits the daily recommended intake to relatively low levels. Processing strategies for iodine reduction are therefore needed. Boiling may reduce the iodine content effectively, but not predictably, since reductions from 38–94% have been reported. Thus, more information on which factors affect the reduction of iodine are needed. In this paper, sugar kelp cultivated at different depths were rinsed and boiled, to assess the effect of cultivation depth on the removal efficacy of potentially toxic elements (PTEs), especially iodine, cadmium, and arsenic, during processing. Raw kelp cultivated at 9 m contained significantly more iodine than kelp cultivated at 1 m, but the difference disappeared after processing. Furthermore, the content of cadmium and arsenic was not significantly affected by cultivation depth. The average reduction during rinsing and boiling was 85% for iodine and 43% for arsenic, but no significant amount of cadmium, lead, or mercury was removed. Cultivation depths determined the relative effect of processing on the iodine content, with a higher reduction for kelp cultivated at 9 m (87%) compared to 1 m (82%). When not taken into consideration, cultivation depth could mask small reductions in iodine content during rinsing or washing. Furthermore, since the final content of PTEs was not dependent on the cultivation depth, the type and extent of processing determines whether cultivation depth should be considered as a factor in cultivation infrastructure design and implementation, or alternatively, in product segmentation.

Social media has played a significant role in disaster management, as it enables the general public to contribute to the monitoring of disasters by reporting incidents related to disaster events. However, the vast volume and wide variety of generated social media data create an obstacle in disaster management by limiting the availability of actionable information from social media. Several approaches have therefore been proposed in the literature to cope with the challenges of social media data for disaster management. To the best of our knowledge, there is no published literature on social media data management and analysis that identifies the research problems and provides a research taxonomy for the classification of the common research issues. In this paper, we provide a survey of how social media data contribute to disaster management and the methodologies for social media data management and analysis in disaster management. This survey includes the methodologies for social media data classification and event detection as well as spatial and temporal information extraction. Furthermore, a taxonomy of the research dimensions of social media data management and analysis for disaster management is also proposed, which is then applied to a survey of existing literature and to discuss the core advantages and disadvantages of the various methodologies.

Within urban landscape planning, debate continues around the relative merits of land-sharing (sprawl) and land-sparing (compaction) scenarios. Using three of the ten districts in Greater Manchester (UK) as a case-study, we present a landscape approach to mapping green infrastructure and variation in social-ecological-environmental conditions as a function of land sharing and sparing. We do so for the landscape as a whole and in a more focussed approach for areas of high and low urbanity. Results imply potential trade-offs between land-sharing-sparing scenarios relevant to characteristics critical to urban resilience such as landscape connectivity and diversity, air quality, surface temperature, and access to green space. These trade-offs are complex due to the parallel influence of patch attributes such as land-cover and size and imply that both ecological restoration and spatial planning have a role to play in reconciling tensions between land-sharing and sparing strategies.

Urban soils are subject to anthropogenic influences and, reciprocally, provide benefits and disbenefits to human wellbeing; for example carbon storage, nutrient cycling and the regulation trace element and contaminant mobility. Collective stewardship of urban green commons provides contemporary examples of the diversity of uses and management of green space in cities and represents a growing movement in user participation in, and awareness of, the importance of urban ecological health. Exploring the range of social-ecological benefits exemplified in the urban environment has generally focused on above-ground processes, with few studies examining the potential for (dis)benefits arising from edaphic characteristics of collectively-managed spaces. An investigation into the influence of formal and informal green space management on carbon fluxes and heavy metal concentrations in urban soils was carried out in Manchester (UK) finding that carbon storage in soils of collectively managed urban green commons (7.15 ± 1.42 kg C m−2) was significantly greater than at formally managed sites (for example city parks: 5.08 ± 0.69 kg C m−2), though the latter exhibited reduced losses through CO2 emission. Variation in heavy metal concentrations and mobility were likewise observed, exemplified by the acidification of surface soils by leaf litter at orchard sites, and the resultant increase in the mobility of lead (Pb) and zinc (Zn). The results of this study indicate the importance of small-scale contemporary urban green space management on selected ecosystem services provided by the limited soil resource of cities. Thus, a greater consideration of the effects of horticultural and amenity activities with regards to soil quality/functionality is required to ensure available urban green commons retain or increase their ecological quality over time.

Airborne particulate matter (PM) exposure has been identified as a key environmental risk factor, associated especially with diseases of the respiratory and cardiovascular system and with almost 9 million premature deaths per year. Low-cost optical sensors for PM measurement are desirable for monitoring exposure closer to the personal level and particularly suited for developing spatiotemporally dense city sensor networks. However, questions remain over the accuracy and reliability of the data they produce, particularly regarding the influence of environmental parameters such as humidity and temperature, and with varying PM sources and concentration profiles. In this study, eight units each of five different models of commercially available low-cost optical PM sensors (40 individual sensors in total) were tested under controlled laboratory conditions, against higher-grade instruments for: lower limit of detection, response time, responses to sharp pollution spikes lasting min , and the impact of differing humidity and PM source. All sensors detected the spikes generated with a varied range of performances depending on the model and presenting different sensitivity mainly to sources of pollution and to size distributions with a lesser impact of humidity. The sensitivity to particle size distribution indicates that the sensors may provide additional information to PM mass concentrations. It is concluded that improved performance in field monitoring campaigns, including tracking sources of pollution, could be achieved by using a combination of some of the different models to take advantage of the additional information made available by their differential response.

The labyrinth is a simple geometric form with one path leading to the center and out. It is often used in religious and health-related institutions for quiet walking and meditation. It is considered a convenient tool for decreasing psychological and physical stress. This study sought to better understand and characterize the short-term physiological responses of the autonomic nervous system associated with walking a projected light labyrinth by measuring respiratory sinus arrhythmia (RSA) and salivary alpha amylase (sAA) in 25 young adults and youth. Our objective was to examine the physiology of labyrinth walking as a potential clinical tool for use by individuals who are experiencing psychological stress. Three hypotheses were put forward: 1) walking the labyrinth would result in physiological arousal as indicated by a decrease in RSA and an increase in sAA; 2) physiological relaxation would be indicated by an increase in RSA after the labyrinth walk; and 3) participants would self-report calmness and relaxation following the labyrinth. Consistent with hypotheses, participants experienced immediate physiological arousal while walking the labyrinth, and heightened physiological and self-reported relaxation during and after the labyrinth walk.

Abstract Urinary retention is commonly diagnosed based on history and examination along with bedside bladder scan. However, in patients where clinical examination is unreliable (patients with obesity, anasarca, and ascites) and diagnosis is uncertain, the bladder scan findings should be interpreted with caution and definitive imaging is mandatory before further intervention is instituted.

The Soil Nitrogen Availability Predictor (SNAP) model predicts daily and annual rates of net N mineralization (NNM) based on daily weather measurements, daily predictions of soil water and soil temperature, and on temperature and moisture modifiers obtained during aerobic incubation (basal rate). The model was based on in situ measurements of NNM in Australian soils under temperate climate. The purpose of this study was to assess this model for use in tropical soils under eucalyptus plantations in São Paulo State, Brazil. Based on field incubations for one month in three, NNM rates were measured at 11 sites (0-20 cm layer) for 21 months. The basal rate was determined in in situ incubations during moist and warm periods (January to March). Annual rates of 150-350 kg ha-1 yr-1 NNM predicted by the SNAP model were reasonably accurate (R2 = 0.84). In other periods, at lower moisture and temperature, NNM rates were overestimated. Therefore, if used carefully, the model can provide adequate predictions of annual NNM and may be useful in practical applications. For NNM predictions for shorter periods than a year or under suboptimal incubation conditions, the temperature and moisture modifiers need to be recalibrated for tropical conditions.

BACKGROUND:Severe acute malnutrition (SAM) is a major global health problem affecting some 16.9 million children under five. Little is known about what happens to children 6-24 months post-discharge as this window often falls through the gap between studies on SFPs and those focusing on longer-term effects. METHODS:A protocol was registered on PROSPERO (PROSPERO 2017:CRD42017065650). Embase, Global Health and MEDLINE In-Process and Non-Indexed Citations were systematically searched with terms related to SAM, nutritional intervention and follow-up between June and August 2017. Studies were selected if they included children who experienced an episode of SAM, received a therapeutic feeding intervention, were discharged as cured and presented any outcome from follow-up between 6-24 months later. RESULTS:3,691 articles were retrieved from the search, 55 full-texts were screened and seven met the inclusion criteria. Loss-to-follow-up, mortality, relapse, morbidity and anthropometry were outcomes reported. Between 0.0% and 45.1% of cohorts were lost-to-follow-up. Of those discharged as nutritionally cured, mortality ranged from 0.06% to 10.4% at an average of 12 months post-discharge. Relapse was inconsistently defined, measured, and reported, ranging from 0% to 6.3%. Two studies reported improved weight-for-height z-scores, whilst three studies that reported height-for-age z-scores found either limited or no improvement. CONCLUSIONS:Overall, there is a scarcity of studies that follow-up children 6-24 months post-discharge from SAM treatment. Limited data that exists suggest that children may exhibit sustained vulnerability even after achieving nutritional cure, including heightened mortality and morbidity risk and persistent stunting. Prospective cohort studies assessing a wider range of outcomes in children post-SAM treatment are a priority, as are intervention studies exploring how to improve post-SAM outcomes and identify high-risk children.

Transport accessibility is an important driver of urban growth and key to the sustainable development of cities. This paper presents a simple GIS-based tool developed to allow the rapid analysis of accessibility by different transport modes. Designed to be flexible and use publicly-available data, this tool (built in ArcGIS) uses generalized cost to measure transport costs across networks including monetary and distance components. The utility of the tool is demonstrated on London, UK, showing the differing patterns of accessibility across the city by different modes. It is shown that these patterns can be examined spatially, by accessibility to particular destinations (e.g., employment locations), or as a global measure across a whole city system. A number of future infrastructure scenarios are tested, examining the potential for increasing the use of low-carbon forms of transport. It is shown that private car journeys are still the least cost mode choice in London, but that infrastructure investments can play a part in reducing the cost of more sustainable transport options.

Purpose To compare dynamic hip screw (DHS) fixation with multiple screw fixation for intracapsular hip fractures in terms of complications and conversion to hemiarthroplasty or total hip arthroplasty (THA). Methods Records of 52 884 patients aged ≥50 years who underwent internal fixation using a dynamic hip screw (n=18 014, 34.1%) or multiple screws (n=34 870, 65.9%) for intracapsular femoral neck fracture from September 2007 to September 2013 were extracted from the hospital admission database that covers all admissions to the National Health Service hospitals in England using the ICD-10 and OPCS-4 codes. Gender, age, and Charlson comorbidity score of each patient were recorded, as were complications at specific time intervals and revision to hemiarthroplasty or THA at one and 4 years. Results Compared with DHS fixation, multiple screw fixation resulted in shorter hospital stay (15 vs. 13 days, p

The ever increasing burden of an ageing population and pandemic of metabolic syndrome worldwide demands further understanding of the modifiable risk factors in reducing disability and morbidity associated with these conditions. Disuse skeletal muscle atrophy (sometimes referred to as simple atrophy) and insulin resistance are ‘non-pathological’ events resulting from sedentary behaviour and periods of enforced immobilization e.g. due to fractures or elective orthopaedic surgery. Yet, the processes and drivers regulating disuse atrophy and insulin resistance and the associated molecular events remain unclear – especially in humans. The aim of this review is to present current knowledge of relationships between muscle protein turnover, insulin resistance and muscle atrophy during disuse, principally in humans. Immobilisation lowers fasted state muscle protein synthesis (MPS) and induces fed-state ‘anabolic resistance’. While a lack of dynamic measurements of muscle protein breakdown (MPB) precludes defining a definitive role for MPB in disuse atrophy, some proteolytic marker studies (e.g. MPB genes) suggest a potential early elevation. Immobilisation also induces muscle insulin resistance (IR). Moreover, the trajectory of muscle atrophy appears to be accelerated in persistent IR states (e.g. Type II diabetes), suggesting IR may contribute to muscle disuse atrophy under these conditions. Nonetheless, the role of differences in insulin sensitivity across distinct muscle groups and its effects on rates of atrophy remains unclear. Multifaceted time-course studies into the collective role of insulin resistance and muscle protein turnover in the setting of disuse muscle atrophy, in humans, are needed to facilitate the development of appropriate countermeasures and efficacious rehabilitation protocols.

Color information is a useful attribute to include in a building's description to assist the listener in identifying the intended target. Often this information is only available as image data, and not readily accessible for use in constructing referring expressions for verbal communication. The method presented uses a GIS building polygon layer in conjunction with street-level captured imagery to provide a method to automatically filter foreground objects and select pixels which correspond to building facades. These selected pixels are then used to define the most appropriate color term for the building, and corresponding fuzzy color term histogram. The technique uses a single camera capturing images at a high frame rate, with the baseline distance between frames calculated from a GPS speed log. The expected distance from the camera to the building is measured from the polygon layer and refined from the calculated depth map, after which building pixels are selected. In addition significant foreground planar surfaces between the known road edge and building facade are identified as possible boundary walls and hedges. The output is a dataset of the most appropriate color terms for both the building and boundary walls. Initial trials demonstrate the usefulness of the technique in automatically capturing color terms for buildings in urban regions.

There is an increasing impetus for the use of digital city models and sensor network data to understand the current demand for utility resources and inform future infrastructure service planning across a range of spatial scales. Achieving this requires the ability to represent a city as a complex system of connected and interdependent components in which the topology of the electricity, water, gas, and heat demand-supply networks are modelled in an integrated manner. However, integrated modelling of these networks is hampered by the disparity between the predominant data formats and modelling processes used in the Geospatial Information Science (GIS) and Building Information Modelling (BIM) domains. This paper presents a software systems approach to scale-free, multi-format, integrated modelling of evolving cross-domain utility infrastructure network topologies, and the analysis of the spatiotemporal dynamics of their resource flows. The system uses a graph database to integrate the topology of utility network components represented in the CityGML UtilityNetwork Application Domain Extension (ADE), Industry Foundation Classes (IFC) and JavaScript Object Notation (JSON) real-time streaming messages. A message broker is used to disseminate the changing state of the integrated topology and the dynamic resource flows derived from the streaming data. The capability of the developed system is demonstrated via a case study in which internal building and local electricity distribution feeder networks are integrated, and a real-time building management sensor data stream is used to simulate and visualise the spatiotemporal dynamics of electricity flows using a dynamic web-based visualisation.

BACKGROUND:Children with moderate acute malnutrition (MAM) have an increased risk of mortality, infections and impaired physical and cognitive development compared to well-nourished children. In parts of Ethiopia not considered chronically food insecure there are no supplementary feeding programmes (SFPs) for treating MAM. The short-term outcomes of children who have MAM in such areas are not currently described, and there remains an urgent need for evidence-based policy recommendations. METHODS:We defined MAM as mid-upper arm circumference (MUAC) of ≥11.0 cm and

Common approaches to mapping green infrastructure in urbanised landscapes invariably focus on measures of land use or land cover and associated functional or physical traits. However, such one-dimensional perspectives do not accurately capture the character and complexity of the landscapes in which urban inhabitants live. The new approach presented in this paper demonstrates how open-source, high spatial and temporal resolution data with global coverage can be used to measure and represent the landscape qualities of urban environments. Through going beyond simple metrics of quantity, such as percentage green and blue cover, it is now possible to explore the extent to which landscape quality helps to unpick the mixed evidence presented in the literature on the benefits of urban nature to human well-being. Here we present a landscape approach, employing remote sensing, GIS and data reduction techniques to map urban green infrastructure elements in a large U.K. city region. Comparison with existing urban datasets demonstrates considerable improvement in terms of coverage and thematic detail. The characterisation of landscapes, using census tracts as spatial units, and subsequent exploration of associations with social–ecological attributes highlights the further detail that can be uncovered by the approach. For example, eight urban landscape types identified for the case study city exhibited associations with distinct socioeconomic conditions accountable not only to quantities but also qualities of green and blue space. The identification of individual landscape features through simultaneous measures of land use and land cover demonstrated unique and significant associations between the former and indicators of human health and ecological condition. The approach may therefore provide a promising basis for developing further insight into processes and characteristics that affect human health and well-being in urban areas, both in the United Kingdom and beyond.

Domestic energy modelling is complex, in terms of user input and the approach used to define the model; therefore, there is an increase in the sources of uncertainties. Previous efforts to perform sensitivity and uncertainty analyses have focused on national energy models, while in this research, the objective is to extend traditional sensitivity analysis and use a local framework combining principal component regression and Monte Carlo Simulation. Therefore, in our method the total amount of the energy output’s variance is decomposed, in relative terms, according to the contribution of the different predictor parameters. Our framework provides compelling evidence that local area characteristics are important in energy modelling and those national and regional indexes and values may not properly reflect the local conditions, resulting in programmes and interventions that will be sub-optimal. Furthermore, our uncertainty methodology uses a three dimensional integrative taxonomy and a concept map. The concept map identified concrete terminal causes of uncertainty within the taxonomic framework of sources, issues, sub-issues and a further abstraction of those quantities in terms of accuracy and precision. Understanding uncertainties in this way provides a possible framework for modellers, policy makers and data collectors to improve practice in key areas and to reduce uncertainty.

Purpose: The primary aim is to describe the development and implementation of a smartphone application (app) designed to promote physical activity and reduce screen-time in adolescent boys ‘at risk’ of obesity from low-income communities.Methods: An app was developed to support the delivery of a face-to-face school-based obesity prevention program known as the ‘Active Teen Leaders Avoiding Screen-time’ (ATLAS) program. ATLAS was guided by self-determination theory and social cognitive theory and evaluated using a cluster randomized controlled trial with 361 boys (12.7± 0.5 years) in 14 secondary schools. Following the completion of the study, participants in the intervention group completed a process evaluation questionnaire and focus groups were conducted with 42 students to explore their general perceptions of the ATLAS program and their experience with the smartphone app. Barriers and challenges encountered in the development, implementation and evaluation of the app are also described.Results: Participation in the study was not contingent on ownership of a smartphone, but 70% of participants in the intervention group reported having access to a smartphone or tablet device. Focus group participants reported an enjoyment of the program, and felt that it had provided them with new skills, techniques, and routines for the future. However, their engagement with the smartphone app was limited, due to a variety of reasons. Barriers to the implementation and evaluation of the app included limited access to smartphone devices, technical problems with the push notifications, lack of access to usage data and the challenges of maintaining participants’ interest in using the app.Conclusions: Although participants reported high levels of satisfaction with the ATLAS program in general, the smartphone app was not used extensively. Additional strategies and features may be needed to enhance engagement in adolescent boys.