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Introduction In the UK there are 3500 individuals detained in medium secure forensic psychiatry units. Service users in such settings have complex and serious mental illness (SMI), often with co-morbid physical health problems and a life expectancy of at least 10 years shorter than the general population. They often have low levels of physical activity. There is little evidence about physical activity interventions for medium secure service users in the United Kingdom. Objectives Our objective is to co-produce, with medium secure service users, the content and delivery of an intervention to increase physical activity. We shall assess feasibility, acceptability, and pilot data collection methods for outcomes relevant for a future randomised controlled trial. Methods This is a 30-month mixed-methods project that will follow the Medical Research Council (MRC) framework Developing and Evaluating Complex Interventions. The study has 4 phases. Phases 1-2 will gather information required to co-develop an evidence-based intervention in Phase 3. Phase 4 will assess the intervention in a feasibility study, evaluating and testing the intervention for a future pilot study. Study settings: Two NHS Medium Secure In-Patient Psychiatric Hospitals in the UK. Results This paper presents the preliminary findings from Phase 4 and also offers a highlight into the results from the Women’s Services from both study sites. A total of thirty-three service users from both study sites participated in Phase 4 of the study and twenty-six completed the physical activity intervention, known as the IMPACT Intervention. Between both study sites, there were two Women’s Standard Medium Secure Services and one Women’s Enhanced Medium Secure Service, involved in this study. A total of nine female service users participated in Phase 4. Conclusions The preliminary findings of Phases 4 are allowing the team to move forward and evaluate the effect of the IMPACT Intervention. Disclosure of Interest None Declared

Introduction In the UK there are 3500 individuals detained in medium secure forensic psychiatry units. Service users in such settings have complex and serious mental illness (SMI), often with co-morbid physical health problems and a life expectancy of at least 10 years shorter than the general population. They often have low levels of physical activity. There is little evidence about physical activity interventions for medium secure service users in the United Kingdom. Objectives Our objective is to co-produce, with medium secure service users, the content and delivery of an intervention to increase physical activity. We shall assess feasibility, acceptability and pilot data collection methods for outcomes relevant for a future randomised controlled trial. Methods This is a 24-month mixed-methods project that will follow the Medical Research Council (MRC) framework Developing and Evaluating Complex Interventions. The study has 4 phases. - Phases 1-2 will gather information required to co-develop an evidence based intervention in Phase 3. - Phase 4 will assess the intervention in a feasibility study, evaluating and testing the intervention for a future pilot study. Study settings: Two NHS Medium Secure In-Patient Psychiatric Hospitals in the UK. Results This paper presents the findings from the Phase 1 questionnaire and focus groups with service users and hospital staff that identified the barriers and facilitators to physical activity in such settings. The results are then discussed in relation to the Phase 2 qualitative results that explored stakeholders’ and service users’ opinions into how to increase physical activity among medium secure service users by identifying potential elements for inclusion in a physical activity intervention, to gain insight into how we can establish engagement of this group with the intervention, maintain commitment, avoid drop-out and develop the intervention design. All findings are presented using the Capability, Opportunity, and Motivation Model of Behaviour (COM-B model), which is widely used to identify what needs to change for a behaviour change intervention to be effective. Conclusions The findings of Phases 1-2 are allowing the team to move forward with Phase 3 that is currently developing an intervention to increase physical activity for adult inpatient service users in the medium secure units. This phase will be guided by the MRC framework and the COM-B model to define the target behaviours and select the most suitable intervention components (functions and techniques) and implementation approach. Disclosure of Interest None Declared

We introduce a Multi-mOdel Multi-cOnstituent Chemical data assimilation (MOMO-Chem) framework that directly accounts for model error in transport and chemistry, and we integrate a portfolio of data assimilation analyses obtained using multiple forward chemical transport models in a state-of-the-art ensemble Kalman filter data assimilation system. The data assimilation simultaneously optimizes both concentrations and emissions of multiple species through ingestion of a suite of measurements (ozone, NO2, CO, HNO3) from multiple satellite sensors. In spite of substantial model differences, the observational density and accuracy was sufficient for the assimilation to reduce the multi-model spread by 20 %–85 % for ozone and annual mean bias by 39 %–97 % for ozone in the middle troposphere, while simultaneously reducing the tropospheric NO2 column biases by more than 40 % and the negative biases of surface CO in the Northern Hemisphere by 41 %–94 %. For tropospheric mean OH, the multi-model mean meridional hemispheric gradient was reduced from 1.32±0.03 to 1.19±0.03, while the multi-model spread was reduced by 24 %–58 % over polluted areas. The uncertainty ranges in the a posteriori emissions due to model errors were quantified in 4 %–31 % for NOx and 13 %–35 % for CO regional emissions. Harnessing assimilation increments in both NOx and ozone, we show that the sensitivity of ozone and NO2 surface concentrations to NOx emissions varied by a factor of 2 for end-member models, revealing fundamental differences in the representation of fast chemical and dynamical processes. A systematic investigation of model ozone response and analysis increment in MOMO-Chem could benefit evaluation of future prediction of the chemistry–climate system as a hierarchical emergent constraint.

BACKGROUND: Tuberculosis (TB) and HIV are major causes of morbidity and mortality worldwide. Abdominal ultrasound and Chest X-ray may reveal suggestive features of TB disease in hospitalized sputum AFB negative patients treated for TB. This study describes the pathological features seen on Chest X-ray and abdominal ultrasound in inpatients treated for TB and their association with bacteriological TB diagnosis and HIV co-infection. METHODS: All patients being initiated on TB treatment during hospitalization were included. TB was confirmed when acid-fast bacilli were found in sputum or elsewhere, and probable when composite clinical, laboratory and radiological findings were consistent with TB disease. Disseminated TB was defined on medical imaging criteria. HIV testing was done in all. RESULTS: Of 199 patients included, TB was confirmed in 80 (40%) and 125 people (63%) were co-infected with HIV. Lesions consistent with TB were seen in 148/187 (87%) on Chest X-ray and in 156/183 (85%) on abdominal ultrasound. Pulmonary TB and/or concurrent pulmonary/extrapulmonary TB was seen in 130 (65%), and isolated extrapulmonary TB in the remaining 69 (35%) patients. Disseminated TB was seen in 121/199 (61%) patients. HIV co-infection was associated with disseminated TB, abdominal TB and miliary TB, but inversely associated with TB pleurisy. Bacteriological TB confirmation was not associated with HIV co-infection nor with TB dissemination. CONCLUSION: Pathological features on medical imaging were seen in the vast majority of hospitalized patients treated for TB, and disseminated TB in more than half. TB dissemination is more frequently seen in HIV co-infection. Abdominal ultrasound is essential to reveal the true extent of TB dissemination.

Little is known about the implications of cannabis legalization on adolescent health behaviors. This study sought to examine the relationship between recreational cannabis legalization and adolescent sexual risk behaviors. Data on 371,487 respondents who have ever had sexual intercourse from 41 states in the 2005 to 2019 Youth Risk Behavior Survey was linked with data on state-level cannabis policies. Difference-in-differences logistic regression models were conducted. Recreational cannabis legalization was associated with a reduced likelihood of respondents having 2+ sexual partners (adjusted OR [aOR] 0.63, 95% CI [0.47, 0.84]), but had no association with condom use (aOR 0.94, 95% CI [0.80, 1.11]). Changing social norms around cannabis is a potential pathway linking cannabis legalization to a reduction in sexual risk behaviors.

Digital sandbox games such as "Minecraft" can be used to assess and support creativity. Doing so, however, requires an understanding of what is deemed creative in this game context. One approach is to understand how Minecrafters describe creativity in their communities, and how much those descriptions overlap with the established definitions of creativity in the literature. Based on prior work, we used a modified rubric for assessing a creative product in this study. We investigated the evaluation of a total of 52 "Minecraft" builds (i.e., structures that are created by the Minecrafters) from five YouTube videos. In addition to qualitatively coding the video transcripts, we also used natural language processing (NLP) for automatic coding of our data at scale. Our qualitative analysis of the YouTube transcripts revealed evidence for all but one dimension (i.e., humor) of the creativity rubric we used in our dataset. In addition, two new dimensions of creativity emerged in our qualitative coding process (i.e., realism and effort). Finally, the NLP model that we developed achieved about 80% accuracy in distinguishing the sentences that showed evidence of creativity. This study provides insights for research and educational practices of creativity in "Minecraft" or similar game or simulation environments.

Background: Travel-related strategies to reduce the spread of COVID-19 evolved rapidly in response to changes in the understanding of SARS-CoV-2 and newly available tools for prevention, diagnosis, and treatment. Modeling is an important methodology to investigate the range of outcomes that could occur from different disease containment strategies. Methods: We examined 43 articles published from December 2019 through September 2022 that used modeling to evaluate travel-related COVID-19 containment strategies. We extracted and synthesized data regarding study objectives, methods, outcomes, populations, settings, strategies, and costs. We used a standardized approach to evaluate each analysis according to 26 criteria for modeling quality and rigor. Results: The most frequent approaches included compartmental modeling to examine quarantine, isolation, or testing. Early in the pandemic, the goal was to prevent travel-related COVID-19 cases with a focus on individual-level outcomes and assessing strategies such as travel restrictions, quarantine without testing, social distancing, and on-arrival PCR testing. After the development of diagnostic tests and vaccines, modeling studies projected population-level outcomes and investigated these tools to limit COVID-19 spread. Very few published studies included rapid antigen screening strategies, costs, explicit model calibration, or critical evaluation of the modeling approaches. Conclusion: Future modeling analyses should leverage open-source data, improve the transparency of modeling methods, incorporate newly available prevention, diagnostics, and treatments, and include costs and cost-effectiveness so that modeling analyses can be informative to address future SARS-CoV-2 variants of concern and other emerging infectious diseases (e.g., mpox and Ebola) for travel-related health policies.

Helminths cause great economic loss in livestock in Africa, and can be categorized as either direct or indirect losses. Arid and semi-arid lands (ASAL) in Kenya comprise 71 % of total land area and harbour the largest population of cattle, sheep and goats. However, little information on the distribution and impact of gastro-intestinal (GIT) parasitism in these animals is available. This survey was conducted to establish the prevalence of GIT parasites infecting calves, sheep and goats and their relative importance in Magadi division, which is semi-arid. Faecal samples were obtained directly from the rectum of 109 calves, 133 goats and 20 sheep and submitted to the laboratory for faecal worm egg counts, and coccidial oocysts examination using a modified McMaster method. The significance of differences in mean egg count per gram (epg) between animal species and herds (farms) were assessed using analysis of variance. The overall prevalence of nematodes in the calves, sheep and goats was 69.2 %, 80 % and 82 %, respectively. About 10 % of sheep and goats had epgs higher than 1 000, the remainder having light to moderate infections. The overall prevalence of coccidial oocysts in calves, sheep and goats was 30 %, 44 % and 45 %, respectively. Poor productivity in ASAL areas, where nutrition is often poor, is likely to be pronounced in the presence of parasite infections. These findings indicate that viable internal parasite control should be implemented in the study area in order to increase the productivity of the livestock there.

Spanking is common in the United States but less common in many European countries in which it has been outlawed. Being spanked has been associated with child abuse victimization, poor self-esteem, impaired parent-child relationships, and child and adult mental health, substance abuse, and behavioral consequences. Being spanked as a child has also been shown to increase the likelihood of abusing one’s own children or spouse as an adult. Spanking of very young children less than two is almost never recommended even among experts that consider spanking as reasonable in some circumstances. Using a cross-sectional anonymous telephone survey, we describe spanking rates among a representative sample of North Carolina mothers of children less than two years old and the association of spanking with demographic characteristics.A substantial proportion of mothers admit to spanking their very young children. The rate of spanking in the last year among all maternal respondents was 30%. Over 5% of the mothers of three month olds reported spanking. Over 70% of the mothers of 23 month olds reported spanking. Increased spanking was associated with higher age of the child and lower maternal age. With every month of age, a child had 27% increased odds of being spanked. Early spanking has been shown to be associated with poor cognitive development in early childhood. Further, early trauma has been shown to have significant effects on the early developing brain. It is therefore critical that health and human services professionals addres the risk of corporal punishment as a method of discipline early in the life of the child. The spanking of very young children may be an appropriate locus for policy and legislative debates regarding corporal punishment.

Brazeau et al. use a statistical modelling approach to estimate COVID-19 infection fatality ratios from seroprevalence data. The authors’ model accounts for seroreversion over the course of the pandemic, as well as other important uncertainties such as serologic test characteristics.

Summary Bacterial cellulose is a strong and flexible biomaterial produced at high yields by Acetobacter species and has applications in health care, biotechnology and electronics. Naturally, bacterial cellulose grows as a large unstructured polymer network around the bacteria that produce it, and tools to enable these bacteria to respond to different locations are required to grow more complex structured materials. Here, we introduce engineered cell‐to‐cell communication into a bacterial cellulose‐producing strain of Komagataeibacter rhaeticus to enable different cells to detect their proximity within growing material and trigger differential gene expression in response. Using synthetic biology tools, we engineer Sender and Receiver strains of K. rhaeticus to produce and respond to the diffusible signalling molecule, acyl‐homoserine lactone. We demonstrate that communication can occur both within and between growing pellicles and use this in a boundary detection experiment, where spliced and joined pellicles sense and reveal their original boundary. This work sets the basis for synthetic cell‐to‐cell communication within bacterial cellulose and is an important step forward for pattern formation within engineered living materials.

Marine turtles are of conservation concern throughout their range, with past population declines largely due to exploitation through both legal and illegal take, and incidental capture in fisheries. Whilst much research effort has been focused on nesting beaches and elaborating migratory corridors, these species spend the vast majority of their life-cycle in foraging grounds, which are, in some species, quite discrete. To understand and manage these populations, empirical data are needed on distribution, space-use, and habitats to best inform design of protective measures. Here we describe space-use, occupancy, and wide-ranging movements derived from conventional flipper tagging and satellite tracking of sub-adult green turtles (Chelonia mydas) within the coastal waters of the Turks and Caicos Islands (TCI; 2011–2017). 623 turtles were fitted with flipper tags, with 69 subsequently recaptured, five of which in international waters. Sixteen individual turtles of between 63 and 81 cm curved carapace length were satellite tracked for a mean 226 days (range: 38–496). Data revealed extended periods of occupancy in the shallow coastal waters within a RAMSAR protected area. Satellite tracking and flipper tagging showed wide-ranging movements, with flipper tag recaptures occurring in waters off Nicaragua (n = 4), and Venezuela (n = 1). Also, four of 16 satellite tracked turtles exhibiting directed movements away (displaced >450 km) from TCI waters traveling through nine geo-political zones within the Caribbean-Atlantic basin, as well as on the High Seas. One turtle traveled to the Central American coast before settling on inshore habitat in Colombia’s waters for 162 days before transmission ceased, indicating ontogenetic dispersal to a distant foraging habitat. These data highlight connectivity throughout the region, displaying key linkages between countries that have previously only been linked by genetic evidence. This study also provides evidence of the importance of the Turks and Caicos Islands marine protected area network and importance of effective management of the sea turtle fishery for regional green turtle populations.