An open-source alignment method for multichannel infinite-conjugate microscopes using a ray transfer matrix analysis model.

Multichannel, infinite-conjugate optical systems easily allow implementation of multiple image paths and imaging modes into a single microscope. Traditional optical alignment methods which rely on additional hardware are not always simple to implement, particularly in compact open-source microscope designs. We present here an alignment algorithm and process to position the lenses and cameras in a microscope using only image magnification measurements. We show that the resulting positioning accuracy is comparable to the axial resolution of the microscope. Ray transfer matrix analysis is used to model the imaging paths when the optics are both correctly and incorrectly aligned. This is used to derive the corresponding image magnifications. We can then extract information about the lens positions using simple image-based measurements to determine whether there is misalignment of the objective lens to sample distance (working distance) and with what magnitude and direction the objective lens needs to be adjusted. Using the M4All open-source 3D printable microscope system in combination with the OpenFlexure microscope, we validate the alignment method and highlight its usability. We provide the model and an example implementation of the algorithm as an open-source Jupyter Notebook. This article is part of the Theo Murphy meeting issue 'Open, reproducible hardware for microscopy'.

The development and validation of a Multidimensional Perceived Work Ability Scale.

Research on the concept of existing unidimensional Perceived Work Ability scale (PWA) in organizational science has recently increased due to its prediction of important work, individual, and labor force outcomes. To date, PWA has been measured as a unidimensional construct. The present study outlines the need for the multidimensional conceptualization of PWA and its measurement. We describe the development and validation of the Multidimensional Perceived Work Ability Scale (M-PWAS), comprising four dimensions: physical, cognitive, interpersonal, and emotional. In line with Hinkin's (1998) approach to scale validation, we use four samples (total N = 1,152) to establish the M-PWAS as a reliable and valid measure of PWA. Through an iterative item generation and review process, we found evidence for content validity. Furthermore, each subscale demonstrated high internal consistency and factorial validity, and analysis of the PWA nomological network demonstrated evidence for convergent and discriminant validity. Finally, we found that the M-PWAS showed incremental validity over an existing unidimensional PWA measure in the prediction of perceived stress, emotional exhaustion, work engagement, and turnover. We discuss implications for theory, research, and workplace interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Understanding large scale sequencing datasets through changes to protein folding.

The expansion of high-quality, low-cost sequencing has created an enormous opportunity to understand how genetic variants alter cellular behaviour in disease. The high diversity of mutations observed has however drawn a spotlight onto the need for predictive modelling of mutational effects on phenotype from variants of uncertain significance. This is particularly important in the clinic due to the potential value in guiding clinical diagnosis and patient treatment. Recent computational modelling has highlighted the importance of mutation induced protein misfolding as a common mechanism for loss of protein or domain function, aided by developments in methods that make large computational screens tractable. Here we review recent applications of this approach to different genes, and how they have enabled and supported subsequent studies. We further discuss developments in the approach and the role for the approach in light of increasingly high throughput experimental approaches.

Modelling electrified railway signalling misoperations during extreme space weather events in the UK.

Space weather has the potential to impact ground-based technologies on Earth, affecting many systems including railway signalling. This study uses a recently developed model to analyse the impact of geomagnetically induced currents on railway signalling systems in the United Kingdom during the March 1989 and October 2003 geomagnetic storms. The March 1989 storm is also scaled to estimate a 1-in-100 year and a 1-in-200 year extreme storm. Both the Glasgow to Edinburgh line, and the Preston to Lancaster section of the West Coast Main Line are modelled. No "right side" failures (when unoccupied sections appear occupied) are suggested to have occurred during either storm, and the total number of potential "wrong side" failures (when occupied sections appear clear) is low. However, the modelling indicates "right side" and "wrong side" failures are possible on both routes during the 1-in-100 year and 1-in-200 year extreme storms, with the Glasgow to Edinburgh line showing more total misoperations than the Preston to Lancaster section of the West Coast Main Line. A 1-in-100 year or 1-in-200 year extreme storm would result in misoperations over an extended period of time, with most occurring over a duration of 2-3 h either side of the peak of the storm.

TLR7 promotes chronic airway disease in RSV-infected mice.

Respiratory syncytial virus (RSV) commonly infects the upper respiratory tract (URT) of humans, manifesting with mild cold or flu-like symptoms. However, in infants and the elderly, severe disease of the lower respiratory tract (LRT) often occurs and can develop into chronic airway disease. A better understanding of how an acute RSV infection transitions to a LRT chronic inflammatory disease is critically important to improve patient care and long-term health outcomes. To model acute and chronic phases of the disease, we infected wild-type C57BL/6 and toll-like receptor 7 knockout (TLR7 KO) mice with RSV and temporally assessed nasal, airway and lung inflammation for up to 42 days post-infection. We show that TLR7 reduced viral titers in the URT during acute infection but promoted pronounced pathogenic and chronic airway inflammation and hyperreactivity in the LRT. This study defines a hitherto unappreciated molecular mechanism of lower respiratory pathogenesis to RSV, highlighting the potential of TLR7 modulation to constrain RSV pathology to the URT.

The complexity of immunology: a rare adverse event following a Pfizer-BioNTech vaccine booster shot.

OBJECTIVE: Several mRNA vaccines have been developed to tackle the global pandemic. Despite their remarkable clinical efficacy, they are not devoid of severe short- and long-term adverse events. CASE PRESENTATION: In this paper, we describe a rare delayed adverse event (arterial and venous renal thrombosis with myocardial injury) in an otherwise healthy adult female, which occurred three months after she received a booster shot of Pfizer COVID-19 vaccine.  The patient was successfully treated for subacute renal ischemia with intra-arterial urokinase, and her myocardial injury was diagnosed with imaging (contrast-enhanced thoracic CT and cardiac magnetic resonance) and percutaneous coronary intervention. Deferred post-vaccine myocarditis was diagnosed and resolved with steroid therapy. CONCLUSIONS: In this paper, we report a useful clinical case for the pharmacovigilance database. Although scientific evidence confirms that the benefits of vaccination far outweigh the risk of adverse events, we would like to point out how important watchful observation is in the medium and long term, especially when the subject belongs to a specific risk category.

Factors Influencing Postoperative Experiences in Adult Cochlear Implant Recipients: A Multistakeholder Perspective.

OBJECTIVE: To explore factors influencing postoperative experiences of adult cochlear implant (CI) recipients, determine the impact of each factor, and conceptualize recipients' postoperative journey. STUDY DESIGN: Participatory mixed methods; concept mapping. SETTING: Tertiary care (private and public). PATIENTS: Ninety-three participated in the brainstorming activity. Eighty-nine completed the sorting tasks (96% retention rate): CI recipients (n = 44), significant others (n = 13), CI audiologists (n = 14) and surgeons (n = 5), CI clinics' administration staff (n = 5) and managers (n = 3), and CI manufactures' clinical support staff (n = 5). INTERVENTIONS: Rehabilitative (CIs). MAIN OUTCOME MEASURES: Statements were generated and rated by participants. Similarity of grouping of the statements informed the matrices used for cluster analysis to form concepts. RESULTS: Eighty-seven unique statements described the factors influencing adapting to, use, and maintenance of CIs after implantation. These were grouped, and five concepts were identified: financial considerations, complications, device usability and durability, device programming and adaptation, and patient motivation and supports. Although statements within the concepts financial considerations and complications were negatively rated, statements within the concepts device programming and adaptation, and patient motivation and supports were mostly rated as having positive influence in patients' postoperative journey. The concept device usability and durability contained both negatively and positively rated statements. CONCLUSIONS: Postoperative experience of adult CI recipients is a multifaceted journey with several challenges to address to improve services. Although support from and connection with family and clinicians, and simplicity of using a CI device facilitated the experience, medical and surgical complications, durability, and cost of maintaining the device challenged the postoperative experience.

Automatic Facial Palsy Diagnosis as a Classification Problem Using Regional Information Extracted from a Photograph.

The incapability to move the facial muscles is known as facial palsy, and it affects various abilities of the patient, for example, performing facial expressions. Recently, automatic approaches aiming to diagnose facial palsy using images and machine learning algorithms have emerged, focusing on providing an objective evaluation of the paralysis severity. This research proposes an approach to analyze and assess the lesion severity as a classification problem with three levels: healthy, slight, and strong palsy. The method explores the use of regional information, meaning that only certain areas of the face are of interest. Experiments carrying on multi-class classification tasks are performed using four different classifiers to validate a set of proposed hand-crafted features. After a set of experiments using this methodology on available image databases, great results are revealed (up to 95.61% of correct detection of palsy patients and 95.58% of correct assessment of the severity level). This perspective leads us to believe that the analysis of facial paralysis is possible with partial occlusions if face detection is accomplished and facial features are obtained adequately. The results also show that our methodology is suited to operate with other databases while attaining high performance, even though the image conditions are different and the participants do not perform equivalent facial expressions.

Intact HIV Proviruses Persist in the Brain Despite Viral Suppression with ART.

OBJECTIVE: Human immunodeficiency virus (HIV) persistence in blood and tissue reservoirs, including the brain, is a major barrier to HIV cure and possible cause of comorbid disease. However, the size and replication competent nature of the central nervous system (CNS) reservoir is unclear. Here, we used the intact proviral DNA assay (IPDA) to provide the first quantitative assessment of the intact and defective HIV reservoir in the brain of people with HIV (PWH). METHODS: Total, intact, and defective HIV proviruses were measured in autopsy frontal lobe tissue from viremic (n = 18) or virologically suppressed (n = 12) PWH. Total or intact/defective proviruses were measured by detection of HIV pol or the IPDA, respectively, through use of droplet digital polymerase chain reaction (ddPCR). HIV-seronegative individuals were included as controls (n = 6). RESULTS: Total HIV DNA was present at similar levels in brain tissues from untreated viremic and antiretroviral (ART)-suppressed individuals (median = 22.3 vs 26.2 HIV pol copies/106 cells), reflecting a stable CNS reservoir of HIV that persists despite therapy. Furthermore, 8 of 10 viremic and 6 of 9 virally suppressed PWH also harbored intact proviruses in the CNS (4.63 vs 12.7 intact copies/106 cells). Viral reservoirs in CNS and matched lymphoid tissue were similar in the composition of intact and/or defective proviruses, albeit at lower levels in the brain. Importantly, CNS resident CD68+ myeloid cells in virally suppressed individuals harbored HIV DNA, directly showing the presence of a CNS resident HIV reservoir. INTERPRETATION: Our results demonstrate the first evidence for an intact, potentially replication competent HIV reservoir in the CNS of virally suppressed PWH. ANN NEUROL 2022;92:532-544.

Towards Facial Gesture Recognition in Photographs of Patients with Facial Palsy.

Humans express their emotions verbally and through actions, and hence emotions play a fundamental role in facial expressions and body gestures. Facial expression recognition is a popular topic in security, healthcare, entertainment, advertisement, education, and robotics. Detecting facial expressions via gesture recognition is a complex and challenging problem, especially in persons who suffer face impairments, such as patients with facial paralysis. Facial palsy or paralysis refers to the incapacity to move the facial muscles on one or both sides of the face. This work proposes a methodology based on neural networks and handcrafted features to recognize six gestures in patients with facial palsy. The proposed facial palsy gesture recognition system is designed and evaluated on a publicly available database with good results as a first attempt to perform this task in the medical field. We conclude that, to recognize facial gestures in patients with facial paralysis, the severity of the damage has to be considered because paralyzed organs exhibit different behavior than do healthy ones, and any recognition system must be capable of discerning these behaviors.

Anterior approach ptosis surgery: comparison of absorbable polyglactin sutures and non-absorbable polyester sutures. Does Vicryl stand the test of time?

PURPOSE: To determine whether the long-term success of ptosis surgery is influenced by the use of absorbable or non-absorbable sutures to advance the levator aponeurosis onto the tarsal plate. METHODS: Multi-centre retrospective comparative study of re-operation rates in primary anterior approach ptosis surgery using absorbable polyglactin sutures (Vicryl) and non-absorbable polyester sutures (Ethibond). The Medisoft audit tool was used to identify all patients who underwent primary ptosis surgery for aponeurotic ptosis, performed by five oculoplastic consultants within a 7-year period, across two NHS Ophthalmology departments. The electronic patient records were reviewed for each patient. Basic demographics, suture material, and post-operative complications were recorded. All patients requiring repeat surgery between the study dates and the present day were recorded, allowing a minimum postoperative period of 3 years and 10 months. Re-operation rates in surgery using absorbable Vicryl sutures and non-absorbable Ethibond sutures were compared using Fisher's exact test. RESULTS: Four hundred and fifty-five operations in 330 patients were performed within the study period that met the inclusion and exclusion criteria. Fifty-seven percent of the patients were female, with an average age of 68.8 years. One hundred and sixty-nine operations in 128 patients were performed using absorbable Vicryl sutures. Of these, 22 (13.0%) required repeat operations. Two hundred and eighty-six operations in 202 patients were performed using non-absorbable Ethibond sutures. Of these, 17 (5.9%) required repeat operations. The two-tailed P-value was 0.0143. CONCLUSION: The use of non-absorbable Ethibond sutures to advance the levator aponeurosis onto the tarsal plate in primary ptosis surgery is associated with improved long-term success and reduced need for secondary surgery.

Inhibition of AlkB Nucleic Acid Demethylases: Promising New Epigenetic Targets.

The AlkB family of nucleic acid demethylases is currently of intense chemical, biological, and medical interest because of its critical roles in several key cellular processes, including epigenetic gene regulation, RNA metabolism, and DNA repair. Emerging evidence suggests that dysregulation of AlkB demethylases may underlie the pathogenesis of several human diseases, particularly obesity, diabetes, and cancer. Hence there is strong interest in developing selective inhibitors for these enzymes to facilitate their mechanistic and functional studies and to validate their therapeutic potential. Herein we review the remarkable advances made over the past 20 years in AlkB demethylase inhibition research. We discuss the rational design of reported inhibitors, their mode-of-binding, selectivity, cellular activity, and therapeutic opportunities. We further discuss unexplored structural elements of the AlkB subfamilies and propose potential strategies to enable subfamily selectivity. It is hoped that this perspective will inspire novel inhibitor design and advance drug discovery research in this field.

Comprehensive molecular profiling of UV-induced metastatic melanoma in Nme1/Nme2-deficient mice reveals novel markers of survival in human patients.

Hepatocyte growth factor-overexpressing mice that harbor a deletion of the Ink4a/p16 locus (HP mice) form melanomas with low metastatic potential in response to UV irradiation. Here we report that these tumors become highly metastatic following hemizygous deletion of the Nme1 and Nme2 metastasis suppressor genes (HPN mice). Whole-genome sequencing of melanomas from HPN mice revealed a striking increase in lung metastatic activity that is associated with missense mutations in eight signature genes (Arhgap35, Atp8b4, Brca1, Ift172, Kif21b, Nckap5, Pcdha2, and Zfp869). RNA-seq analysis of transcriptomes from HP and HPN primary melanomas identified a 32-gene signature (HPN lung metastasis signature) for which decreased expression is strongly associated with lung metastatic potential. Analysis of transcriptome data from The Cancer Genome Atlas revealed expression profiles of these genes that predict improved survival of patients with cutaneous or uveal melanoma. Silencing of three representative HPN lung metastasis signature genes (ARRDC3, NYNRIN, RND3) in human melanoma cells resulted in increased invasive activity, consistent with roles for these genes as mediators of the metastasis suppressor function of NME1 and NME2. In conclusion, our studies have identified a family of genes that mediate suppression of melanoma lung metastasis, and which may serve as prognostic markers and/or therapeutic targets for clinical management of metastatic melanoma.

The Beighton Score as a measure of generalised joint hypermobility.

The Beighton Score (BS) is a set of manoeuvres in a nine-point scoring system, used as the standard method of assessment for Generalised Joint Hypermobility (GJH). It was originally developed as an epidemiological tool used in screening large populations for GJH, but later adopted as a clinical tool for diagnostic purposes. Its ability to truly reflect GJH remains controversial, as joints within the scoring system are predominantly of the upper limb and disregard many of the major joints, preventing a direct identification of GJH. Furthermore, a consistent finding in the literature whereby the BS failed to identify hypermobility in joints outside the scoring system suggests its use as an indirect indicator of GJH is also not viable. As such, the collective findings of this review demonstrate a need for a change in clinical thinking. The BS should not be used as the principle tool to differentiate between localised and generalised hypermobility, nor used alone to exclude the presence of GJH. Greater emphasis should be placed on a clinician's judgement to identify or exclude GJH, according to its full definition.

A Comparison of Training Modality and Total Genotype Scores to Enhance Sport-Specific Biomotor Abilities in Under 19 Male Soccer Players.

ABSTRACT: Suraci, BR, Quigley, C, Thelwell, RC, and Milligan, GS. A comparison of training modality and total genotype scores to enhance sport-specific biomotor abilities in under 19 male soccer players. J Strength Cond Res 35(1): 154-161, 2021-Soccer-specific training (SST) and small-sided games (SSGs) have been shown to develop physical proficiency in soccer. Research on genetics and epigenetics in the prescription of training is limited. The aims of this study were to compare the impact of 3 different SST/SSG methods and investigate if a total genotype score (TGS) influences training response. Subjects (n = 30 male soccer players, mean ± SD; age 17.2 ± 0.9 years, stature = 172.6 ± 6.2 cm; body mass = 71.7 ± 10.1 kg) were stratified into a "power" (PG) or "endurance" (EG) gene profile group, where a 15 single nucleotide polymorphism panel was used to produce an algorithmically weighted TGS. Training 1 (T1-SSGs only), training 2 (T2-SSGs/SST), and training 3 (T3-SST only) were completed (in that respective order), lasting 8 weeks each, interspersed by 4-week washouts. Acceleration (10-m sprint) was improved by T2 only (1.84 ± 0.09 seconds vs. 1.73 ± 0.05 seconds; Effect Size [ES] = 1.59, p < 0.001). Speed (30-m sprint) was improved by T2 (4.46 ± 0.22 seconds vs. 4.30 ± 0.19 seconds; ES = 0.81, p < 0.001) and T3 (4.48 ± 0.22 seconds vs. 4.35 ± 0.21 seconds; ES = 0.58, p < 0.001). Agility (T-test) was improved by T1 (10.14 ± 0.40 seconds vs. 9.84 ± 0.42 seconds; ES = 0.73, p < 0.05) and T3 (9.93 ± 0.38 seconds vs. 9.66 ± 0.45 seconds; ES = 0.66, p < 0.001). Endurance (Yo-Yo level 1) was improved by T1 (1,682.22 ± 497.23 m vs. 2,028.89 ± 604.74 m; ES = 0.63, p < 0.05), T2 (1,904.35 ± 526.77 m vs. 2,299.13 ± 606.97 m; ES = 0.69, p < 0.001), and T3 (1,851.76 ± 490.46 m vs. 2,024.35 ± 588.13 m; ES = 0.35, p < 0.05). Power (countermovement jump) was improved by T3 only (36.01 ± 5.73 cm vs. 37.14 ± 5.62 cm; ES = 0.20, p < 0.05). There were no differences in T1, T2, and T3 combined when comparing PG and EG. The PG reported significantly (χ2(20) = 4.42, p = 0.035, ES = 0.48) better training responses to T3 for power than the EG. These results demonstrate the efficacy of SSGs and SSTs in developing biomotor abilities. Although these results refute talent identification through the use of a TGS, there may be use in aligning the training method to TGS to develop power-based qualities in soccer.

Nme1 and Nme2 genes exert metastasis-suppressor activities in a genetically engineered mouse model of UV-induced melanoma.

NME1 is a metastasis-suppressor gene (MSG), capable of suppressing metastatic activity in cell lines of melanoma, breast carcinoma and other cancer origins without affecting their growth in culture or as primary tumours. Herein, we selectively ablated the tandemly arranged Nme1 and Nme2 genes to assess their individual impacts on metastatic activity in a mouse model (HGF:p16-/-) of ultraviolet radiation (UVR)-induced melanoma. Metastatic activity was strongly enhanced in both genders of Nme1- and Nme2-null mice, with stronger activity in females across all genotypes. The study ascribes MSG activity to Nme2 for the first time in an in vivo model of spontaneous cancer, as well as a novel metastasis-suppressor function to Nme1 in the specific context of UVR-induced melanoma.

What Influences Decision-Making for Cochlear Implantation in Adults? Exploring Barriers and Drivers From a Multistakeholder Perspective.

OBJECTIVES: To explore the factors influencing the uptake of cochlear implants in adults, determine the impact of each factor, and to conceptualize the journey to implantation from a multistakeholder perspective. DESIGN: Concept mapping was used to integrate input from multiple stakeholders, each with their own experience and expertise. This mixed participatory method collects qualitative and quantitative data collection and enables further quantitative analysis. There were two participant cohorts: clients (cochlear implant recipients, candidates, and family members) and professionals (cochlear implant audiologists, ear, nose, and throat surgeons, administration staff, managers. and manufacturer representatives). A total of 93 people participated in the study: client cohort (n = 60, M age = 66.60 years) and professional cohort (n = 33, M age = 45.24 years). Participants brainstormed statements in response to the question "What influences people's decision to get/not get a cochlear implant?" They subsequently grouped the statements and named each group. They rated each statement as to its impact on the decision and prioritized the need for each to be changed/improved using a five-point Likert scale. Multidimensional scaling was used to produce a visual representation of the ideas and their relationship in the form of concepts. Further analysis was conducted to determine the differences between the cohorts, subcohorts, and concepts. RESULTS: One hundred ten unique statements were generated and grouped into six concepts which either directly affected the client or their environment. These concepts were: external influences (awareness and attitude of non-implant professionals about uptake, cost, logistics, the referral pathway, public awareness); uncertainties, beliefs, and fears (fears, negative effect of word of mouth, unsuccessful previous ear surgery, cosmetics of the device, misunderstanding of how a cochlear implant functions, eligibility for an implant and outcomes after implantation); health problems (mental and physical health); hearing difficulties (social, emotional, and communication impacts of hearing loss, severity of hearing loss, benefit from and experience with hearing aids); implant professionals (implant team's attitude, knowledge and relationship with clients, quality of overall service); and goals and support (clients 'hearing desires and goals, motivation, positive impact of word of mouth, family support, having a cochlear implant mentor. The six concepts fell into two overarching domains: the client-driven domain with four concepts and the external domain with two concepts. The mean rating of concepts in terms of impact on a client's decision to get an implant ranged from 2.24 (external influences, the main barrier) to 4.45 (goals and support, the main driver). Ratings significantly differed between the client and professional cohorts. CONCLUSIONS: This study increases our understanding of the factors, which influence a client's decision choose a cochlear implant as a hearing treatment. It also provides new information on the influence of the other stakeholders on the client journey. The magnitude of the generated statements in the client-driven domain highlights the pivotal role of individualized care in clinical settings in influencing a client's decision and the need for the professionals to understand a client's needs and expectations. A client's persistent hearing difficulties, goals, and support network were identified as drivers to the uptake of cochlear implants. However, the barriers identified highlight the need for a collaborative multi- and interdisciplinary approach to raise awareness in and educate non-implant hearing professionals about the cochlear implant process, as well as providing information to empower clients to make educated decisions and consider a cochlear implant as a hearing management option.

Pseudophakic negative dysphotopsia and intraocular lens orientation: a prospective double-masked randomized controlled trial.

PURPOSE: To determine whether horizontal orientation of the intraocular lens optic-haptic junctions has an effect on the incidence of pseudophakic negative dysphotopsia. METHODS: Single-centre prospective double-masked randomized controlled trial. 220 eyes of 201 participants undergoing routine cataract surgery were randomized to receive their intraocular lens either orientated with the optic-haptic junctions at 180° ('horizontal') or without manipulation following implantation (control). Patients were excluded according to age (<19 and > 99 years), coexisting eye disease affecting visual function and insufficient cognitive function to complete the study. In the fourth postoperative week, a telephone interview was conducted to determine rates of negative dysphotopsia. The data were analysed to provide the relative risk of negative dysphotopsia with horizontal orientation of the intraocular lens (IOL) optic-haptic junctions compared with standard treatment. RESULTS: Orientating the IOL optic-haptic junctions horizontally halved the incidence of pseudophakic negative dysphotopsia in the fourth postoperative week (9/110 in the intervention group; 18/110 in the control group; RR: 0.50, 95% confidence interval: 0.235-1.064, p = 0.072). The overall incidence of negative dysphotopsia was 12.2% (27/220 participating eyes). No intraoperative adverse effects of intraocular lens rotation were reported. CONCLUSION: The simple intraoperative manoeuvre of rotating the intraocular lens to orientate the optic-haptic junctions at 180° may be a safe and effective measure to reduce the risk of developing postoperative pseudophakic negative dysphotopsia in the first postoperative month. This is the first report that demonstrates the benefit of horizontal optic-haptic junction positioning to be sustained beyond the first postoperative day.

An ergonomics assessment of three simulated 120 m ladder ascents: A comparison of novice and experienced climbers.

This study investigated the ergonomics of three simulated 120 m vertical ladder ascents and differences between novice (NC) and experienced climbers (EC). Seven EC and 10 NC undertook three 120 m climbs; comprising of four 30 m climbs. Ascending 120 m was reported as a high physical demand, supported by high peak HRs (~173 b.min-1 across the three climbs) and V˙ O2 (~3.1 L.min-1 across the three climbs). Grip strength and endurance were significantly (p < 0.05) impaired by ascents. With multiple ascents, toe clearance was reduced (Climb 1 - 0.0515 m; Climb 3 - 0.046 m), and participants reached higher with their arms (shoulder angle: Climb 1 - 117°; Climb 3 - 136°). NC demonstrated less range of movement through the hips (NC - 46°; EC - 58°), and higher muscle activation in the upper body (NC - 60%; EC - 49%). Experience reduced cumulative climbing times (exercise + rest), whilst maintaining the same physiological demand as NC and maintained optimised movement patterns for longer.