Incentivising public transport use for physical activity gain: process evaluation of the COVID-19 disrupted trips4health randomised controlled trial.

BACKGROUND: Partnering with a public transport (PT) provider, state government, and local government, the single-blinded randomised controlled trial, trips4health, investigated the impact of PT use incentives on transport-related physical activity (PA) in Tasmania, Australia. The intervention involved 16-weeks of incentives (bus trip credits) for achieving weekly PT use targets, supported by weekly text messages. This study objective was to conduct a process evaluation of the COVID-19 disrupted trips4health study. METHODS: The Medical Research Council UK's framework for complex public health interventions guided the process evaluation. Participant reach, acceptability, fidelity and feasibility were evaluated. Administrative and post-intervention survey data were analysed descriptively. Semi-structured interviews with intervention participants (n = 7) and PT provider staff (n = 4) were analysed thematically. RESULTS: Due to COVID-19, trips4health was placed on hold (March 2020) then stopped (May 2020) as social restrictions impacted PT use. At study cessation, 116 participants (approximately one third of target sample) had completed baseline measures, 110 were randomised, and 64 (n = 29 in the intervention group; n = 35 in the control group) completed post-intervention measures. Participants were 18 - 80 years (average 44.5 years) with females (69%) and those with tertiary education (55%) over-represented. The intervention was delivered with high fidelity with 96% of bus trip credits and 99% of behavioural text messages sent as intended. Interviewed PT staff said implementation was highly feasible. Intervention participant acceptability was high with 90% reporting bus trip incentives were helpful and 59% reporting the incentives motivated them to use PT more. From a total of 666 possible bus trip targets, 56% were met with 38% of intervention participants agreeing and 41% disagreeing that 'Meeting the bus trip targets was easy'. Interviews and open-ended survey responses from intervention participants revealed incentives motivated bus use but social (e.g., household member commitments) and systemic (e.g., bus availability) factors made meeting bus trip targets challenging. CONCLUSIONS: trips4health demonstrated good acceptability and strong fidelity and feasibility. Future intervention studies incentivising PT use will need to ensure a broader demographic is reached and include more supports to meet PT targets. TRIAL REGISTRATION: ACTRN12619001136190 .

trips4health: Protocol of a single-blinded randomised controlled trial incentivising adults to use public transport for physical activity gain.

BACKGROUND: Public transport (PT) users typically accumulate more physical activity (PA) than private motor vehicle users yet redressing physical inactivity through transport-related PA (TRPA) interventions has received limited attention. Further, incentive-based strategies can increase leisure-time PA but their impact on TRPA, is unclear. This study's objective is to determine the impact of an incentive-based strategy on TRPA in a regional Australian setting. METHODS: trips4health is a single-blinded randomised controlled trial with a four-month intervention phase and subsequent six-month maintenance phase. Participants will be randomised to: an incentives-based intervention (bus trip credit for reaching bus trip targets, weekly text messages to support greater bus use, written PA guidelines); or an active control (written PA guidelines only). Three hundred and fifty adults (≥18 years) from southern Tasmania will be recruited through convenience methods, provide informed consent and baseline information, then be randomised. The primary outcome is change in accelerometer measured average daily step count at baseline and four- and ten-months later. Secondary outcomes are changes in: measured and self-reported travel behaviour (e.g. PT use), PA, sedentary behaviour; self-reported and measured (blood pressure, waist circumference, height, weight) health; travel behaviour perspectives (e.g. enablers/barriers); quality of life; and transport-related costs. Linear mixed model regression will determine group differences. Participant and PT provider level process evaluations will be conducted and intervention costs to the provider determined. DISCUSSION: trips4health will determine the effectiveness of an incentive-based strategy to increase TRPA by targeting PT use. The findings will enable evidence-informed decisions about the worthwhileness of such strategies. TRIAL REGISTRATION: ACTRN12619001136190. UNIVERSAL TRIAL NUMBER: U1111-1233-8050.

Note: Velocity map imaging the scattering plane of gas surface collisions.

The ability of gas-surface dynamics studies to resolve the velocity distribution of the scattered species in the 2D scattering plane has been limited by technical capabilities and only a few different approaches have been explored in recent years. In comparison, gas-phase scattering studies have been transformed by the near ubiquitous use of velocity map imaging. We describe an innovative means of introducing a dielectric surface within the electric field of a typical velocity map imaging experiment. The retention of optimum velocity mapping conditions was validated by measurements of iodomethane-d3 photodissociation and SIMION calculations. To demonstrate the system's capabilities, the velocity distributions of ammonia molecules scattered from a polytetrafluoroethylene surface have been measured for multiple product rotational states.

Reaction dynamics. Vibrational relaxation and microsolvation of DF after F-atom reactions in polar solvents.

Solvent-solute interactions influence the mechanisms of chemical reactions in solution, but the response of the solvent is often slower than the reactive event. Here, we report that exothermic reactions of fluorine (F) atoms in d3-acetonitrile and d2-dichloromethane involve efficient energy flow to vibrational motion of the deuterium fluoride (DF) product that competes with dissipation of the energy to the solvent bath, despite strong solvent coupling. Transient infrared absorption spectroscopy and molecular dynamics simulations show that after DF forms its first hydrogen bond on a subpicosecond time scale, DF vibrational relaxation and further solvent restructuring occur over more than 10 picoseconds. Characteristic dynamics of gas-phase F-atom reactions with hydrogen-containing molecules persist in polar organic solvents, and the spectral evolution of the DF products serves as a probe of solvent reorganization induced by a chemical reaction.

Reaction dynamics of CN radicals with tetrahydrofuran in liquid solutions.

Transient, broadband infra-red absorption spectroscopy with picosecond time resolution has been used to study the dynamics of reactions of CN radicals with tetrahydrofuran (THF) and d(8)-THF in liquid solutions ranging from neat THF to 0.5 M THF in chlorinated solvents (CDCl(3) and CD(2)Cl(2)). HCN and DCN products were monitored via their v(1) (C≡N stretching) and v(3) (C-H(D) stretching) vibrational absorption bands. Transient spectral features indicate formation of vibrationally excited HCN and DCN, and the onsets of absorption via the fundamental bands of HCN and DCN show short (5-15 ps) delays consistent with vibrational relaxation within the nascent reaction products. This interpretation is confirmed by non-equilibrium molecular dynamics simulations employing a newly derived analytic potential energy surface for the reaction in explicit THF solvent. The rate coefficient for reactive formation of HCN (as determined from measurements on both the 1(1)(0) and 3(1)(0) fundamental bands) decreases with increasing dilution of the THF in CDCl(3) or CD(2)Cl(2), showing pseudo-first order kinetic behaviour for THF concentrations in the range 0.5-4.5 M, and a bimolecular rate coefficient of (1.57 ± 0.12) × 10(10) M(-1) s(-1) is derived. Simultaneous analysis of time-dependent HCN 1(1)(0) and 3(1)(0) band intensities following reaction of CN with THF (3.0 M) in CD(2)Cl(2) suggests that C-H stretching mode excitation is favoured, and this deduction is supported by the computer simulations. The results extend our recent demonstration of nascent vibrational excitation of the products of bimolecular reactions in liquid solution to a different, and more strongly interacting class of organic solvents. They serve to reinforce the finding that dynamics (and thus the topology of the reactive potential energy surface) play an important role in determining the nascent product state distributions in condensed phase reactions.

Quasi-classical trajectory study of the dynamics of the Cl + CH4→ HCl + CH3 reaction.

We present an on-the-fly classical trajectory study of the Cl + CH(4)→ HCl + CH(3) reaction using a specific reaction parameter (SRP) AM1 Hamiltonian that was previously optimized for the Cl + ethane reaction [S. J. Greaves et al., J. Phys Chem A, 2008, 112, 9387]. The SRP-AM1 Hamiltonian is shown to be a good model for the potential energy surface of the title reaction. Calculated differential cross sections, obtained from trajectories propagated with the SRP-AM1 Hamiltonian compare favourably with experimental results for this system. Analysis of the vibrational modes of the methyl radical shows different scattering distributions for ground and vibrationally excited products.

Transcatheter closure of a complex postmyocardial infarction ventricular septal defect after surgical patch dehiscence.

Ventricular septal defect (VSD) complicating acute myocardial infarction is a rare but serious event carrying a high mortality. Residual shunting after emergency surgical repair is common, adversely affects prognosis and can necessitate reoperation. We describe the successful transcatheter VSD closure with the Amplatzer occluder in a 75-year old man after earlier emergency surgical repair of a VSD complicating an acute myocardial infarction. The technique and positioning of the device in a tortuous infero-apical VSD are described.

Thrombotic risk in patients with aortic bioprostheses.

Thrombosis of Mosaic aortic valve bioprostheses occurring at more than one month after surgery occurs in 0.8% (95% CI 0.33-1.67%) of patients. In the two cases reported here, each patient had risk factors for thrombus formation, namely severe left ventricular impairment in one patient, while the other patient was heterozygous for prothrombin variant G20210A. The cases were treated successfully, by thrombolytic therapy with streptokinase in the first case, and by repeat aortic valve replacement in the second case. Thrombosis of bioprosthetic valves in the aortic position is rare, and a period of anticoagulation postoperatively does not invariably protect against this serious complication. In conclusion, patients with risk factors for thrombus formation should be considered for long-term anticoagulation.

Angiogenic cytokines in patients with idiopathic interstitial pneumonia.

BACKGROUND: Angiogenesis has been implicated in the pathogenesis of idiopathic interstitial pneumonia (IIP). The aim of this study was to examine the relationship between plasma concentrations of the angiogenic cytokines interleukin 8 (IL-8), vascular endothelial growth factor (VEGF), and endothelin-1 (ET-1) and clinical parameters of disease progression over a 6 month period to identify potential aetiological mediators and prognostic markers of disease activity in patients with IIP. METHODS: Forty nine patients with IIP (40 men) were recruited to the study. Plasma cytokine measurements, pulmonary function tests, and high resolution computed tomography (HRCT) scans were performed on recruitment and after 6 months. Plasma cytokine measurements were also performed in 15 healthy volunteers for control purposes. RESULTS: Patients with IIP had significantly higher median (IQR) baseline concentrations of IL-8 and ET-1 than controls (155 (77-303) pg/ml v 31 (0-100) pg/ml, p<0.001) and (1.21 (0.91-1.88) pg/ml v 0.84 (0.67-1.13) pg/ml, p<0.01), respectively. Baseline concentrations of IL-8, ET-1, and VEGF were significantly related to the baseline HRCT fibrosis score (r = 0.42, p<0.005; r = 0.39, p<0.01; and r = 0.42, p<0.005, respectively). Patients with IIP who developed progressive disease had significantly higher baseline levels of IL-8 (345 (270-497) pg/ml v 121 (73-266) pg/ml, p = 0.001) and VEGF (1048 (666-2149) pg/ml v 658 (438-837) pg/ml, p = 0.019). Over 6 months the change in VEGF was significantly related to the change in HRCT fibrosis score (r = 0.565, p = 0.035) and negatively related to the change in forced vital capacity (r = -0.353, p = 0.035).

Synthesis of hydrophilic polymer-grafted ultrafine inorganic oxide particles in protic media at ambient temperature via atom transfer radical polymerization: use of an electrostatically adsorbed polyelectrolytic macroinitiator.

A new approach for the surface grafting of polymer chains to colloidal substrates is described. A cationic macroinitiator has been designed for the surface polymerization of a wide range ofhydrophilic methacrylates from ultrafine inorganic oxide sols by atom transfer radical polymerization in protic media at ambient temperature. One advantage of this approach is that it allows one-pot syntheses: the macroinitiator is adsorbed onto the sol, followed by an in situ polymerization. Nonionic, cationic, and betaine monomers can be polymerized directly by this protocol, with reasonably high conversions being obtained, as judged by 1H NMR spectroscopy. Anionic monomers such as sodium 4-styrenesulfonate cannot be polymerized directly due to incompatibility problems with the cationic macroinitiator-coated sol. However, hydroxylated monomers such as glycerol monomethacrylate can be surface-polymerized and then converted to anionic polyelectrolytes by reaction with succinic anhydride under mild conditions. This derivatization was confirmed by diffuse reflectance infrared Fourier transform (DRIFT) spectroscopic analysis. Thermogravimetry was used to assess the degree of polymer grafting. Higher target degrees of polymerization led to increased grafted polymer loadings, as expected. Particle morphologies and relative degrees of dispersion in aqueous solution were assessed by transmission electron microscopy and dynamic light scattering, respectively. Surface characterization of the polymer-grafted sols was achieved by X-ray photoelectron spectroscopy and aqueous electrophoresis measurements. Most of the data reported in this study concern surface polymerizations from ultrafine silica sols, but some preliminary data for ultrafine tin(IV) oxide sols are also presented. Since most surfaces are negatively charged, this cationic macroinitiator approach can, in principle, be extended to include a wide range of sols, latexes, and planar substrates without requiring a separate surface functionalization step.

Synthesis of vinyl polymer-silica colloidal nanocomposites prepared using commercial alcoholic silica sols.

The surfactant-free synthesis of vinyl polymer-silica nanocomposite particles has been achieved in aqueous alcoholic media at ambient temperature in the absence of auxiliary comonomers. Styrene, methyl methacrylate, methyl acrylate, n-butyl acrylate, and 2-hydroxypropyl methacrylate were homopolymerized in turn in the presence of three commercially available ultrafine alcoholic silica sols. Stable colloidal dispersions with reasonably narrow size distributions were obtained, with silica contents of up to 58% by mass indicated by thermogravimetric analysis. Particle size distributions were assessed using both dynamic light scattering and disk centrifuge photosedimentometry. The former technique indicated that the particle size increased for the first 1-2 h at 25 degrees C and thereafter remained constant. Particle morphologies were studied using electron microscopy. Most of the colloidal nanocomposites comprised approximately spherical particles with relatively narrow size distributions, but in some cases more polydisperse or nonspherical particles were obtained. Selected acrylate-based nanocomposites were examined in terms of their film formation behavior. Scanning electron microscopy studies indicated relatively smooth films were obtained on drying at 20 degrees C, with complete loss of the original particle morphology. The optical clarity of solution-cast 10 microm nanocomposite films was assessed using visible absorption spectrophotometry, with 93-98% transmission being obtained from 400 to 800 nm; the effect of long-term immersion of such films in aqueous solutions was also examined. X-ray photoelectron spectroscopy studies indicated that the surface compositions of these nanocomposite particles are invariably silica-rich, which is consistent with their long-term colloidal stability and also with aqueous electrophoresis measurements. FT-IR studies suggested that in the case of the poly(methyl methacrylate)-silica nanocomposite particles, the carbonyl ester groups in the polymer are hydrogen-bonded to the surface silanol groups. According to differential scanning calorimetry studies, the glass transition temperatures of several poly(methyl methacrylate)-silica and polystyrene-silica nanocomposites can be either higher or lower than those of the corresponding homopolymers, depending on the nature of the silica sol.

Proximal pulmonary arterial and intrapulmonary radiologic features of Eisenmenger syndrome and primary pulmonary hypertension.

Extrapulmonary and intrapulmonary radiologic features of Eisenmenger syndrome and primary pulmonary hypertension (PPH) and the clinical expressions that coincide with the radiologic features of these 2 forms of pulmonary hypertension have not previously been characterized. Computed tomography (CT) and pulmonary CT angiography (CTA) utilized GE High Speed Advantage or Siemens Evolution electron beam tomographic (EBT) scanners in 31 patients with cyanotic pulmonary vascular disease (PVD) (group A: 12 men and 19 women; mean age 38 +/- 4 years) and in 13 women with PPH-acyanotic PVD (group B: mean age 30 +/- 3 years). Ten group A and 3 group B patients underwent imaging twice, yielding 57 studies. Group A patients' extrapulmonary radiologic features included proximal pulmonary arteries that were consistently enlarged, and were aneurysmal in 13%, causing bronchial compression and atelectasis. Thromboses were uniformly present and mild in 71% and moderate to massive in 29% of patients. Massive proximal thromboses caused asphyxic death and augmented right-to-left shunts by increasing flow resistance. Mild to extensive mural calcific deposits occurred in 26% of patients. Intrapulmonary radiologic features included intrapulmonary embolic infarction, intrapulmonary hemorrhage, bronchial/systemic arterial collaterals, and neovascularity. Group B patients' extrapulmonary radiologic features included proximal pulmonary arteries that were consistently enlarged but not aneurysmal and devoid of thromboses. Mild to extensive mural calcific deposits occurred in 23% of these patients. Intrapulmonary radiologic features were confined to mosaic attenuation and bronchial/systemic collaterals.

Bilateral temporomandibular joint pseudogout.

Pseudogout is an acute presentation of one type of crystal deposition disease in which calcium pyrophosphate dihydrate crystals are found in the joint spaces of synovial joints. In this case, a 56-year-old caucasian male presented with right sided preauricular swelling, temporomandibular joint arthralgia and restricted mouth opening; he developed identical symptoms on the left side two days later.

Changes in vasoconstrictive hormones, natriuretic peptides, and left ventricular remodeling soon after anterior myocardial infarction.

OBJECTIVE: Our purpose was to study the changes in vasoconstrictive neurohormones, N-terminal proatrial natriuretic peptide (Nt-proANP), and brain natriuretic peptide (BNP) and their relationship with left ventricular (LV) remodeling soon after anterior myocardial infarction (MI). BACKGROUND: The Healing and Afterload Reducing Therapy (HEART) trial has shown that early use of ramipril improves left ventricular ejection fraction (LVEF) and attenuates LV remodeling when initiated soon after MI. This neurohumoral substudy of HEART investigates the changes in vasoconstrictive and natriuretic peptides and their relationship with LV remodeling. METHODS: One hundred twenty-two patients had blood drawn for the measurement of catecholamines, endothelin-I, angiotensin II, Nt-proANP and BNP, and prostacyclins within 24 hours of an MI, and at 3, 14, and 90 days after the MI. Quantitative echocardiograms were performed at baseline and at 14 days. RESULTS: All neurohormones except angiotensin II (P =.12) and prostaglandins were significantly elevated at baseline. Vasoconstrictive neurohormones decreased significantly over time but remained elevated at 14 days. Both Nt-proANP and BNP were elevated within the first 14 days. BNP decreased significantly by 90 days, whereas Nt-proANP exhibited no change between 14 and 90 days. Ramipril decreased plasma levels of angiotensin II at 3 days but had no effect on the other neurohormones. CONCLUSIONS: Neurohumoral activation occurs and persists in patients with anterior MI and overall preserved LV function. Ramipril had only a modest impact on neurohormones despite its significant benefits on LV remodeling soon after MI.