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Epidemiology of injury and illness across all the competitive cycling disciplines:A systematic review and meta-analysis
Get PDFIntroduction The Union Cycliste Internationale, the world cycling governing body, has highlighted its mission to promote and support research in cycling epidemiology and medicine, especially for the benefit of lesser-known disciplines within its 2030 Agenda. This systematic review aimed to comprehensively analyse and synthesise the existing literature about cycling-related injuries and illnesses across all competitive disciplines.Design Systematic review and meta-analysis of epidemiological studies.Data sources PubMed (Medline), Embase and SPORTDiscus were searched in August 2024.Eligibility criteria All epidemiological studies including information on injuries and/or illness in competitive cycling from inception to August 2024.Results Forty-four studies were included across the competitive cycling disciplines of Mountain Bike (MTB), road, track, bicycle motocross (BMX) and para cycling. No studies were found for cyclocross, gravel, indoor, trials and esports cycling disciplines. BMX had the highest injury incidence overall, with 4.59 injuries per 365 days (95% CI 4.34 to 4.85), while para-cyclists had the highest illness prevalence at 3.89 illnesses per 365 days (95% CI 3.42 to 4.36). The most common injuries were upper limb injuries, particularly in BMX (65.21% (95% CI 54.50 to 74.65)), followed by road cycling (48.32% (95% CI 46.51 to 50.14)) and track cycling (44.18% (95% CI 43.28 to 45.09)). In road cycling, 14.36% (95% CI 13.12 to 15.69) of injuries were head, neck or face-related. Skin lacerations, abrasions and lesions were the most common injury types across disciplines, with bone fractures being the second most common. Despite a higher prevalence of head, neck and face injuries, road cycling had the lowest incidence of concussions (4.68% (95% CI 4.04 to 5.42)). Gastrointestinal illness had the highest prevalence overall in road cycling (17.90% (95% CI 14.4 to 22.0)), while respiratory illness was most prevalent in Track (31.82% (95% CI 22.29 to 42.61)) and MTB (31.82% (95% CI 22.29 to 42.61)).Conclusion This systematic review highlights the high prevalence of upper limb injuries across competitive cycling disciplines, particularly in BMX, road and track cycling. Skin lacerations, abrasions and bone fractures were the most common injury types. These findings help inform future injury and illness surveillance studies in cycling disciplines where high-quality epidemiological data are currently lacking and support the development of future injury and illness prevention strategies
Community-based testing of migrants for infectious diseases (COMBAT-ID):observational cohort study measuring the effectiveness of routine testing for infectious diseases among migrants attending primary care
Get PDFBACKGROUND: Migrants are at increased risk of chronic infections and have poorer outcomes, being more likely to present late. Early diagnosis and management can reduce morbidity, mortality and onward infection transmission.METHODS: We evaluated the effectiveness of an integrated approach to screening migrants for exposure to tuberculosis (TB) with an interferon gamma release assay (IGRA) test, HIV, hepatitis B virus (HBV, using hepatitis B surface antigen testing) and hepatitis C virus (HCV, using antibody testing with confirmatory PCR test) infection when patients first registered with general practices (GPs) in Leicester, UK, using test yields (test positivity rates), numbers of new diagnoses and numbers linked to care.FINDINGS: Of 4004 migrant GP patients referred for testing 2016-2019, test yields were 0.48% (17/3545, 95% CI 0.30-0.77%, HIV), 3.34% (117/3502, 95% CI 2.80-3.99%, HBV), 0.18% (6/3402, 95% CI 0.08-0.38%, HCV) and 19.38% (496/2560, 95% CI 17.89-20.95%, IGRA). Of IGRA-positive patients attending clinic, 7% (31/437) had active TB and 92% (403/437) had latent TB infection. Seventeen (55%) active TB, 397 (99%) latent TB, 71 (61%) HBV, six (35%) HIV and five (83%) HCV infections were new diagnoses. There were high rates of linkage to care for those newly diagnosed. 98% (390/397) of new latent TB patients were offered chemoprophylaxis, of whom 94% (366/390) started treatment and of these, 95% (346/366) completed the course. 100% (6/6), 97% (69/71) and 100% (5/5) of newly HIV-, HBV- and HCV-diagnosed patients attended follow-up, respectively.INTERPRETATION: This first primary care-based combined infection testing programme for recent migrants found high test yields for latent/active TB, HBV and HIV, substantial numbers of new diagnoses for these infections and excellent linkage to care. To influence UK screening guidelines, its cost-effectiveness and acceptability to other primary care settings must be evaluated.FUNDING: NIHR, Gilead Sciences.</p
World knowledge resolves some aspectual ambiguity
No full textAnnotating event descriptions with their aspectual features is often seen as a pre-requisite to temporal reasoning. However, a recent study by Prus et al. (2024) has shown that non-experts’ annotations of the aspectual class of English verb phrases can disagree with both expert linguistic annotations and each another. They hypothesised that people use their world knowledge to tacitly conjure their own contexts, leading to disagreement between them. In this paper, we test that hypothesis by adding context to Prus et al.’s examples and mirroring their experiment. Our results show that whilst their hypothesis explains some of the disagreement, some examples continue to yield divided responses even with the additional context. Finally, we show that outputs from GPT-4, despite to some degree capturing the aspectual class division, are not an accurate predictor of human answers
Baseline characteristics of people experiencing homelessness in the PHOENIx community pharmacy multicentre pilot randomised controlled trial
No full textBackgroundPeople experiencing homelessness (PEH) are amongst the most marginalised populations in the society. Despite facing extreme health inequalities and poorer outcomes than the general population, they are under-represented in clinical trials. Little is hence known about the physical, mental health and social characteristics of PEH as clinical trial participants. Cross-sectoral complex interventions aiming to mitigate health, wellbeing and wider inequalities faced by PEH are urgently needed.MethodsThis paper reports on baseline characteristics of PEH from the PHOENIx Community Pharmacy multicentre Pilot randomised controlled trial (RCT) with recruitment from community pharmacies in Glasgow and Birmingham, UK. Participants were randomised 1:1 to receive PHOENIx (collaboration between National Health Service pharmacist independent prescribers and third sector workers) intervention in addition to usual care (UC) or UC only. Data were collected using face-to-face patient questionnaires which included validated tools (e.g. Equation 5D), direct clinical observations (e.g. blood pressure, grip strength) and healthcare utilisation records (e.g. hospital admissions).ResultsA total of 100 participants were recruited as planned from five community pharmacies. Participants (n = 99 baseline records for one were lost) were on average 42 years old, mostly white (87, 88%), and male (81, 82%). Most had recently slept rough (57, 58%), were registered with an Alcohol and Drug Recovery Service (79, 81%), and prescribed opioid substitute therapy (74, 75%). A minority reported having a recent street substance-related overdose (15, 15%). Most participants reported one or more chronic physical health condition (83, 85%). Fifteen (15%) participants rated severity of breathlessness as 4. Thirty-four (44%) participants were deemed pre-frail and 43 (56%) as frail. Participants had an average EQ-5D-5L health-related quality of life score of 42.2 (SD 24.7).Seventy-six (77%) participants reported having a mental health condition or difficulty; depression (n = 56, 56%), anxiety (n = 47, 47%), self-harm/suicide attempt (n = 21, 21%). Only half were known to housing/casework services. Moreover, half walked to appointments and a minority of those diagnosed with a blood borne virus were in receipt of treatment. Over three quarters had been imprisoned in the past.ConclusionsBaseline characteristics of PEH who participated in the PHOENIx Community Pharmacy pilot RCT demonstrates multiple, complex and unmet health, social and practical needs. The data emphasises the need to engage, support, refer and treat PEH through integrated and bespoke pathways to promote people’s engagement with care, prevent repeat homelessness and early deaths.Trial registrationInternational Clinical Trials Registration ISRCTN88146807. Date of registration 18/07/2022
Dark trading and stock-based CEO pay
No full textDoes trading away from public exchanges affect the way top executives are paid? Yes, our study finds that companies with a higher proportion of shares traded in “dark” (i.e., off-exchange) venues tend to offer more stock-based compensation to their CEOs. This relationship is primarily driven by enhanced price informativeness in lit (i.e., on-exchange/public) markets resulting from dark trading activities, making stock-based compensation a more attractive and effective tool for aligning executive incentives with shareholder returns. Consistent with this explanation, we show that the effect is most pronounced in firms where the impact of dark trading is likely greatest on price informativeness (firms with opaque information environments) and where compensation committees are more likely to extract information from stock prices (committees possessing greater financial expertise, higher equity ownership, and fewer external commitments). To address endogeneity concerns, we employ a treatment effects model and a difference-in-differences framework using the SEC's Tick Size Pilot Program as an exogenous shock to dark trading.</p
Polygenic prediction of body mass index and obesity through the life course and across ancestries
No full textPolygenic scores (PGSs) for body mass index (BMI) may guide early prevention and targeted treatment of obesity. Using genetic data from up to 5.1 million people (4.6% African ancestry, 14.4% American ancestry, 8.4% East Asian ancestry, 71.1% European ancestry and 1.5% South Asian ancestry) from the GIANT consortium and 23andMe, Inc., we developed ancestry-specific and multi-ancestry PGSs. The multi-ancestry score explained 17.6% of BMI variation among UK Biobank participants of European ancestry. For other populations, this ranged from 16% in East Asian-Americans to 2.2% in rural Ugandans. In the ALSPAC study, children with higher PGSs showed accelerated BMI gain from age 2.5 years to adolescence, with earlier adiposity rebound. Adding the PGS to predictors available at birth nearly doubled explained variance for BMI from age 5 onward (for example, from 11% to 21% at age 8). Up to age 5, adding the PGS to early-life BMI improved prediction of BMI at age 18 (for example, from 22% to 35% at age 5). Higher PGSs were associated with greater adult weight gain. In intensive lifestyle intervention trials, individuals with higher PGSs lost modestly more weight in the first year (0.55 kg per s.d.) but were more likely to regain it. Overall, these data show that PGSs have the potential to improve obesity prediction, particularly when implemented early in life.</p
Understanding off-target growth defects introduced to influenza A virus by synonymous recoding
No full textCpG dinucleotides are underrepresented in the genomes of most RNA viruses. Synonymously increasing CpG content of a range of RNA virus genomes reliably causes replication defects due to the recognition of CpG motifs in RNA by cellular zinc-finger antiviral protein (ZAP). Prior to the discovery of ZAP as a CpG sensor, we described an engineered influenza A virus (IAV) enriched for CpGs in segment 5 that displays the expected replication defects. However, we report here that this CpG-high ("CpGH") mutant is not attenuated by ZAP. Instead, a pair of compensatory nucleotide changes, resulting in a stretch of eight consecutive adenosines (8A), were found to be responsible. Viral polymerase slippage occurs at this site, resulting in the production of aberrant peptides and type I interferon induction. When the nucleotides in either one of these two positions were restored to wild-type sequence, no viral attenuation was seen, despite the 86 extra CpGs encoded by this virus. Introduction of these two adenosines into wild-type virus (thereby introducing the 8A tract) resulted in viral attenuation, polymerase slippage, aberrant peptide production and type I interferon induction. That a single nucleotide change can offset the growth defects in a virus designed to have a formidable barrier to wild-type reversion highlights the importance of understanding the processes underlying viral attenuation. Poly(A) tracts are a correlate for the emergence of polybasic cleavage sites in avian IAV hemagglutinins to produce highly pathogenic strains. These results thereby uncover possible insights into the intermediary events of this important evolutionary process.</p
Designing better gene therapies for lysosomal storage disorders using engineered enzymes
No full textMarked Gender Inequity in the Invited Speakers at the European College of Veterinary Surgeons Annual Scientific Congress 2012-2022
No full textThe objective of this retrospective study was to explore gendered equity for invited speakers at the European College of Veterinary Surgery (ECVS) Annual Scientific Meeting between 2012-2022 when compared to speciality demographics for ECVS membership. Our sample populations included the European College of Veterinary Surgeons (ECVS) Diplomate membership, and all invited speakers at their Annual Scientific Meetings between 2012-2022.Data was extracted from Meeting Programs including year, speaker name, session type, and frequency of invitation. Authors were assigned a binary gender using a web-based algorithm to determine gender by a first name. The number and gender of new Diplomates each year between 1993-2023 was obtained from the ECVS Office and used as a comparison group to assess proportional representation amongst invited speakers. We found that women comprised 27% (249/924) of ECVS Diplomates in 2012 and 33.82% (312/924) in 2022. In this decade, there were 913 invited lectures delivered at ECVS Annual Scientific Meetings, 21% (188/913) were delivered by women. Women were particularly under-represented for higher prestige lectures including State of the Art (0%), Pre-Congress wet labs (0%) and Pre-Congress expert-led sessions (15.8%, 15/95). In conclusion, the proportion of invited speakers that were women at ECVS Scientific Meetings between 2012-2022 was 21%, despite women comprising >25% of ECVS Diplomate membership since 2012. Higher prestige sessions were heavily biased towards speakers being men. We suggest proactive commitment is needed to achieve gender equity in speaker invitations across all session types at ECVS Annual Scientific Meetings.<br/
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