Northern Ireland Office

Objectives Our multisite randomized controlled trial reported that police body-worn cameras (BWCs) had, on average, no effect on recorded incidents of police use of force. In some sites, rates of use of force decreased and in others increased. We wanted to understand these counter-intuitive findings and report pre-specified subgroup analyses related to officers' discretion on activating the BWCs. Methods Using pre-established criteria for experimental protocol breakdown in terms of treatment integrity, ten experimental sites were subgrouped into Bhigh-compliance( no officer discretion applied to when and where BWCs should be used; n = 3), Bno-compliance^(treatment integrity failure in both treatment and control conditions; n = 4),

Among 16 chronic schizophrenic in-patients, all had at least one neurological soft sign (NSS), and 6 (40%) had definite neurodysfunction. NSS and TD scores were highly intercorrelated, and NSS were significantly correlated with neuroleptic drug exposure. NSS correlated positively with both positive and negative symptoms and cognitive impairment but not with cerebral ventricular size on CT. Patients with neurodysfunction had more positive and negative psychopathology, cognitive impairment and TD than those without. Cerebral ventricular sizes and family histories of schizophrenia were similar in both NSS groups. The presence of NSS may be a simple but important way of identifying a subgroup of schizophrenics with neurodevelopmental predisposing abnormalities, and vulnerability to TD.

BACKGROUND: Machine-learning algorithms and big data analytics, popularly known as 'artificial intelligence' (AI), are being developed and taken up globally. Patient and public involvement (PPI) in the transition to AI-assisted health care is essential for design justice based on diverse patient needs. OBJECTIVE: To inform the future development of PPI in AI-assisted health care by exploring public engagement in the conceptualization, design, development, testing, implementation, use and evaluation of AI technologies for mental health. METHODS: Systematic scoping review drawing on design justice principles, and (i) structured searches of Web of Science (all databases) and Ovid (MEDLINE, PsycINFO, Global Health and Embase); (ii) handsearching (reference and citation tracking); (iii) grey literature; and (iv) inductive thematic analysis, tested at a workshop with health researchers. RESULTS: The review identified 144 articles that met inclusion criteria. Three main themes reflect the challenges and opportunities associated with PPI in AI-assisted mental health care: (a) applications of AI technologies in mental health care; (b) ethics of public engagement in AI-assisted care; and (c) public engagement in the planning, development, implementation, evaluation and diffusion of AI technologies. CONCLUSION: The new data-rich health landscape creates multiple ethical issues and opportunities for the development of PPI in relation to AI technologies. Further research is needed to understand effective modes of public engagement in the context of AI technologies, to examine pressing ethical and safety issues and to develop new methods of PPI at every stage, from concept design to the final review of technology in practice. Principles of design justice can guide this agenda.

The 2021-2022 highly pathogenic avian influenza (HPAI) epidemic season is the largest HPAI epidemic so far observed in Europe, with a total of 2,467 outbreaks in poultry, 47.7 million birds culled in the affected establishments, 187 outbreaks in captive birds, and 3,573 HPAI virus detections in wild birds with an unprecedent geographical extent reaching from Svalbard islands to South Portugal and Ukraine, affecting 37 European countries. Between 11 June and 9 September 2022, 788 HPAI virus detections were reported in 16 European countries in poultry (56), captive (22) and wild birds (710). Several colony-breeding seabird species exhibited widespread and massive mortality from HPAI A(H5N1) virus along the northwest coast of Europe. This resulted in an unprecedentedly high level of HPAI virus detections in wild birds between June and August 2022 and represents an ongoing risk of infection for domestic birds. HPAI outbreaks were still observed in poultry from June to September with five-fold more infected premises than observed during the same period in 2021 and mostly distributed along the Atlantic coast. Response options to this new epidemiological situation include the definition and rapid implementation of suitable and sustainable HPAI mitigation strategies such as appropriate biosecurity measures and surveillance strategies for early detection in the different poultry production systems. The viruses currently circulating in Europe belong to clade 2.3.4.4b with seven genotypes, three of which identified for the first time during this time period, being detected during summer. HPAI A(H5) viruses were also detected in wild mammal species in Europe and North America and showed genetic markers of adaptation to replication in mammals. Since the last report, two A(H5N6), two A(H9N2) and one A(H10N3) human infections were reported in China. The risk of infection is assessed as low for the general population in the EU/EEA, and low to medium for occupationally exposed people.

Q methodology was used to enable the identification of discourses among stakeholders to the environmental and resource dimensions of sustainability policies and to gain an understanding of the usefulness of Q methodology in informing sustainability policy development. The application of Q methodology has been useful in identifying shared discourses between different stakeholder groups, and providing insights into how stakeholders ‘frame’ or understand policy issues; and recommendations are made for ongoing research priorities. These insights, in turn, informed the choice of scenarios for an in parallel process of policy evaluation using Ecological and Carbon Footprinting.

Abstract A laboratory study has been used to investigate relationships between salts and contour scaling—a weathering feature commonly observed on rock surfaces in salt‐rich environments. Surface disaggregation and essentially surface‐parallel cracks were produced in sandstone blocks using 10 per cent solutions of sodium sulphate and magnesium sulphate applied daily to single exposed surfaces for sixty days. A control block soaked once in saturated magnesium sulphate and subsequently wetted daily with distilled water showed extensive surface disaggregation, but no cracking. Both surface disaggregation and subsurface cracking were associated with relative concentrations of microcrystalline salt. A tentative model of contour scaling is proposed, which involves linking together potential cracks by salt‐induced fracturing of intervening, crack‐stopping grains. Further control blocks treated respectively with 10 per cent and saturated sodium chloride showed no evidence of subsurface cracking and only limited surface disaggregation of the ‘saturated’ block.

Artificial intelligence (AI) in medicine has gained a lot of momentum in the last decades and has been applied to various fields of medicine. Advances in computer science, medical informatics, robotics, and the need for personalized medicine have facilitated the role of AI in modern healthcare. Similarly, as in other fields, AI applications, such as machine learning, artificial neural networks, and deep learning, have shown great potential in andrology and reproductive medicine. AI-based tools are poised to become valuable assets with abilities to support and aid in diagnosing and treating male infertility, and in improving the accuracy of patient care. These automated, AI-based predictions may offer consistency and efficiency in terms of time and cost in infertility research and clinical management. In andrology and reproductive medicine, AI has been used for objective sperm, oocyte, and embryo selection, prediction of surgical outcomes, cost-effective assessment, development of robotic surgery, and clinical decision-making systems. In the future, better integration and implementation of AI into medicine will undoubtedly lead to pioneering evidence-based breakthroughs and the reshaping of andrology and reproductive medicine.

Biosurfactants are naturally produced molecules that demonstrate potentially useful properties such as the ability to reduce surface tensions between different phases. Besides having similar properties to their artificial chemical counterparts, they are regarded as environmental friendly, biodegradable and less toxic, which make them desirable candidates for downstream applications. The structure-activity-related properties of the biosurfactants which are directly correlated with potency of the biosurfactants as antimicrobial agents, the ability of the biosurfactants to alter surface energies and their ability to increase bioavailability are particularly what attract researchers to exploit their potential use in the oral-related health applications. Current research into biosurfactant indicates significant future potential for use in cosmetic and therapeutic oral hygiene product formulations and related medical device treatments.

Research and anecdotal evidence suggests that coming to terms with the suicide of a patient can be extremely distressing for front-line professionals. Some research also suggests that exposure to such situations can undermine professionals' functioning and feelings of competence, cause them to question their professional standing and ultimately contribute to burnout. A survey of 447 front-line professionals' experiences of patient suicide was undertaken to further explore these issues. Thematic analysis of open-ended questionnaire items revealed that concerns for the bereaved family, feelings of responsibility for the death and having a close therapeutic relationship with the client are key factors that influence the adjustment and coping of a health professional in the aftermath of the death of a client by suicide. The results are discussed with a focus on the impact of suicide on front-line staff, the need for ongoing support and training and the development of specific post-suicide protocols.

Adenovirus infections are ubiquitous in commercially farmed birds, and probably in all avian species. There is a wide range of virulence, in some cases even within the same serotype. While many infections are subclinical and appear to be of little economic or welfare importance, significant outbreaks of disease associated with adenovirus do occur. These diseases are not of public health significance.

This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: PRIMARY: To determine if physical treatment interventions are effective in preventing or minimising activity limitation and participation restrictions in those patients developing spasticity post stroke. SECONDARY: 1. To determine if physical treatment interventions are effective in preventing or minimising impairment, burden of care, patient quality of life and economic burden in those patients developing spasticity post stroke. 2. To identify any adverse effects of physical treatment interventions for spasticity post stroke. 3. To determine whether, in stroke patients with established spasticity: a. standing is more effective than control, placebo or no intervention at managing spasticity; b. active exercise is more effective than control, placebo or no intervention at managing spasticity; c. passive exercising/stretching is more effective than control, placebo or no intervention at managing spasticity; d. positioning is more effective than control, placebo or no intervention at managing spasticity; and e. adjuncts to a physical programme are more effective than control, placebo or no intervention at managing spasticity. 4. To explore the relationship between stroke characteristics, the extent of the established spasticity, acute (one to 12 months post stroke) versus chronic (greater than 12 months post stroke) spasticity, and the effect of physical interventions aimed at managing established spasticity post stroke, using subgroup analysis. 1. standing is more effective than control, placebo or no intervention at managing spasticity; 2. active exercise is more effective than control, placebo or no intervention at managing spasticity; 3. passive exercising/stretching is more effective than control, placebo or no intervention at managing spasticity; 4. positioning is more effective than control, placebo or no intervention at managing spasticity; and 5. adjuncts to a physical programme are more effective than control, placebo or no intervention at managing spasticity.

BACKGROUND: Interleukin (IL)-18 is a marker of inflammasome activation, and high baseline plasma IL-18 is associated with increased mortality in patients with sepsis-induced ARDS. The aim of this analysis was to determine if simvastatin was associated with benefit in patients with ARDS and high plasma IL-18. METHODS: In this secondary analysis of the HARP-2 study, we compared 28-day mortality and response to simvastatin according to baseline plasma IL-18 using cox proportional hazards analysis. Separately, monocyte-derived macrophages from healthy volunteers were pre-incubated with simvastatin or rosuvastatin before stimulation with ATP and LPS, and the effect on secreted IL-18 and IL-1β compared. RESULTS: 511 patients from HARP-2 had available data. High baseline plasma IL-18 (≥ 800 pg/ml) was associated with increased 28-day mortality (high IL-18 30.6% vs. low IL-18 17.5%; HR 1.89 [95% CI 1.30-2.73]; p = 0.001). Allocation to simvastatin in patients with high baseline plasma IL-18 was associated with a lower probability of 28-day mortality compared with placebo (24.0% vs 36.8%; p = 0.01). Finally, simvastatin, but not rosuvastatin, reduced stimulated macrophage secretion of IL-18 and IL-1β. CONCLUSION: In patients with high baseline plasma IL-18, simvastatin is associated with a higher probability of survival, and this effect may be due to reduced inflammasome activation. These data suggest that baseline plasma IL-18 may allow a personalised treatment approach by identifying patients with ARDS who could benefit from simvastatin therapy.

ABSTRACT: The female athlete is seen as a specialist population meaning female considerations, such as pelvic floor dysfunction, are not widely taught within sports medicine. Females have unique anatomical characteristics compared with males including a wider pelvic diameter and an additional orifice in the form of the vagina. Furthermore, symptoms of pelvic floor dysfunction are prevalent among female athletes and transitional periods in their lifespan. They also are a barrier to training and performance. Therefore, it is essential that sports medicine practitioners understand how to identify and manage pelvic floor dysfunction. This report aims to describe the anatomy and function of the pelvic floor, outline the types and rates of pelvic floor dysfunction, discuss evidence-based management, and raise awareness of perinatal bodily changes. Practical recommendations are made to aid sports organizations and sports medicine practitioners in supporting the female athlete and in using a proactive approach to manage the perinatal athlete.

BACKGROUND: The value of cardiac rehabilitation (CR) after a transient ischaemic attack (TIA) or minor stroke is untested despite these conditions sharing similar pathology and risk factors to coronary heart disease. We aimed to evaluate the feasibility of conducting a trial of an adapted home-based CR programme, 'The Healthy Brain Rehabilitation Manual', for patients following a TIA/minor stroke, participants' views on the intervention and, to identify the behaviour change techniques (BCTs) used. METHODS: Clinicians were asked to identify patients attending the Ulster Hospital, Belfast within 4 weeks of a first TIA or minor stroke. Those who agreed to participate underwent assessments of physical fitness, cardiovascular risk, quality of life and mental health, before random allocation to: Group (1) standard/usual care; (2) rehabilitation manual or (3) manual plus pedometer. All participants received telephone support at 1 and 4 weeks, reassessment at 6 weeks and an invitation to a focus group exploring views regarding the study. Two trained review authors independently assessed the manual to identify the BCTs used. RESULTS: testing, which all declined. The manual and telephone contact were viewed positively, as credible sources of advice. Pedometers were valued highly, particularly for goal-setting. Overall, 36 individual BCTs were used, the commonest being centred around setting goals and planning as well as social support. CONCLUSION: Recruitment and retention rates suggest that a trial to evaluate the effectiveness of a novel home-based CR programme, implemented within 4 weeks of a first TIA/minor stroke is feasible. The commonest BCTs used within the manual revolve around goals, planning and social support, in keeping with UK national guidelines. The findings from this feasibility work have been used to further refine the next stage of the intervention's development, a pilot study. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02712385 . This study was registered prospectively on 18/03/2016.

This is the Editorial Introduction for Open Issue 9/2

PURPOSE: Sperm DNA fragmentation (SDF) testing was recently added to the sixth edition of the World Health Organization laboratory manual for the examination and processing of human semen. Many conditions and risk factors have been associated with elevated SDF; therefore, it is important to identify the population of infertile men who might benefit from this test. The purpose of this study was to investigate global practices related to indications for SDF testing, compare the relevant professional society guideline recommendations, and provide expert recommendations. MATERIALS AND METHODS: Clinicians managing male infertility were invited to take part in a global online survey on SDF clinical practices. This was conducted following the CHERRIES checklist criteria. The responses were compared to professional society guideline recommendations related to SDF and the appropriate available evidence. Expert recommendations on indications for SDF testing were then formulated, and the Delphi method was used to reach consensus. RESULTS: The survey was completed by 436 experts from 55 countries. Almost 75% of respondents test for SDF in all or some men with unexplained or idiopathic infertility, 39% order it routinely in the work-up of recurrent pregnancy loss (RPL), and 62.2% investigate SDF in smokers. While 47% of reproductive urologists test SDF to support the decision for varicocele repair surgery when conventional semen parameters are normal, significantly fewer general urologists (23%; p=0.008) do the same. Nearly 70% would assess SDF before assisted reproductive technologies (ART), either always or for certain conditions. Recurrent ART failure is a common indication for SDF testing. Very few society recommendations were found regarding SDF testing. CONCLUSIONS: This article presents the largest global survey on the indications for SDF testing in infertile men, and demonstrates diverse practices. Furthermore, it highlights the paucity of professional society guideline recommendations. Expert recommendations are proposed to help guide clinicians.

BACKGROUND: Susceptibility to aggressive periodontitis (AgP) is influenced by genetic as well as environmental factors. Studies linking gene variants to AgP have been mainly centred in developed countries with limited data from Africa. AIM: To investigate whether previously reported candidate gene associations with AgP could be replicated in a population from Sudan. METHODS: The investigation was a case-control design. Cases with AgP (n = 132) and controls (n = 136) were identified from patients attending the Periodontal Department in Khartoum Dental Hospital. Genotyping was performed using the Sequenom MassARRAY iPLEX platform. Analysis focused on gene variants with a minor allele frequency (MAF) > 25% in the Sudanese subjects that had previously been reported to be associated with AgP. RESULTS: One candidate gene rs1537415 (GLT6D1) was significantly associated with AgP, OR = 1.50 (95% CI 1.04-2.17), p = 0.0295 (increasing to p = 0.09 after correction for multiple testing). The association strengthened to OR = 1.56 (95% CI 1.15-2.16), p = 0.0042 when the controls were supplemented with data from the Hap map for the Yoruba in Ibadan (n = 147) and remained significant (p = 0.013) after correction for multiple testing. CONCLUSION: The study independently replicated the finding that rs1537415, a variant in glycosyl transferase gene GLT6D1, is associated with AgP and provided the first report of genetic associations with AgP in a Sudanese population.

PURPOSE: Sperm DNA fragmentation (SDF) is a functional sperm abnormality that can impact reproductive potential, for which four assays have been described in the recently published sixth edition of the WHO laboratory manual for the examination and processing of human semen. The purpose of this study was to examine the global practices related to the use of SDF assays and investigate the barriers and limitations that clinicians face in incorporating these tests into their practice. MATERIALS AND METHODS: Clinicians managing male infertility were invited to complete an online survey on practices related to SDF diagnostic and treatment approaches. Their responses related to the technical aspects of SDF testing, current professional society guidelines, and the literature were used to generate expert recommendations via the Delphi method. Finally, challenges related to SDF that the clinicians encounter in their daily practice were captured. RESULTS: The survey was completed by 436 reproductive clinicians. Overall, terminal deoxynucleotidyl transferase deoxyuridine triphosphate Nick-End Labeling (TUNEL) is the most commonly used assay chosen by 28.6%, followed by the sperm chromatin structure assay (24.1%), and the sperm chromatin dispersion (19.1%). The choice of the assay was largely influenced by availability (70% of respondents). A threshold of 30% was the most selected cut-off value for elevated SDF by 33.7% of clinicians. Of respondents, 53.6% recommend SDF testing after 3 to 5 days of abstinence. Although 75.3% believe SDF testing can provide an explanation for many unknown causes of infertility, the main limiting factors selected by respondents are a lack of professional society guideline recommendations (62.7%) and an absence of globally accepted references for SDF interpretation (50.3%). CONCLUSIONS: This study represents the largest global survey on the technical aspects of SDF testing as well as the barriers encountered by clinicians. Unified global recommendations regarding clinician implementation and standard laboratory interpretation of SDF testing are crucial.

ABSTRACT Water quality, measured on a fisheries ecosystem scale of 1 (good/salmonid) to 6 (bad/fish absent), of forty‐two lowland streams in two Northern Ireland river catchments was inversely correlated with the stocking rate of grazing animals. A decrease in water quality of one class was associated with an increase in the combined grazing/stocking rate of cattle and sheep of 0.6 dairy cow equivalents/ha. This dairy cow equivalent stocking rate was significantly correlated with maximum BOD and total amm.N concentrations and minimum dissolved‐oxygen levels. The worst pollution events, with BOD concentrations in excess of 100 mg/1, occurred at the end of May and were caused by discharges of silage effluent. Smaller BOD peaks, which occurred in late winter and early spring, were related to the land spreading of animal slurries. It was concluded that poultry and pig farms were not having a major impact on water quality.

Abstract This study presents an attempt to integrate two theories about ritual: the theory that McCauley and Lawson developed in Bringing Ritual to Mind; Psychological Foundations of Cultural Forms and the theory that Boyer and Lienard presented in a target article in Behavioral and Brain Sciences, 'Why ritualized behavior in humans? Precaution systems and action‐parsing in developmental, pathological and cultural rituals' and in another article published in the American Anthropologist, 'Whence collective rituals? A cultural selection model of ritualized behavior'. Keywords: Ritualizationreligious ritualsHazard Precaution SystemRitual Form HypothesisCultural SelectionAgency Detection Notes E‐mail addresses: plienard@wustl.edu (P. Lienard), t.lawson@qub.ac.uk (E.T. Lawson).