Exploring individual's public trust in the NHS Test and Trace System - A pragmatic reflexive thematic analysis

Context

Digital contact tracing uses automated systems and location technology embedded on smartphone software for efficient identification of individuals exposed to COVID-19. Such systems are only effective with high compliance, yet compliance is mediated by public trust in the system. This work explored the perception of individual's trust and expectation of the broader Test and Trace system in the United Kingdom (UK) with the upcoming release of the National Health Service's (NHS) COVID-19 app as a case example.

Methods

Twelve adults underwent online semi-structured interviews in August 2020, prior to public availability of the COVID-19 app. Pragmatic reflexive thematic analysis was applied inductively to explore common themes between participants, using an organic and recursive process (Braun & Clarke, 2019).

Results

Themes highlighted features of the technology that would be perceived to be trustworthy (Theme 1), and concerns relating to i) whether users would comply with a T&T system (Theme 2) and ii) how a T&T system would handle user's personal data (Theme 3). Two further themes built on aspects of automation within a T&T system and its impact on trust (Theme 4) and how the media altered perceptions of the T&T system (Theme 5).

Conclusions

Participants outlined the need for different user requirements that could be built into the NHS COVID-19 app that would support increased adherence. Concurrently, participants raised questions surrounding personal data and privacy of their data, plus the level of automated versus manual tasks, which impacted perception of trust in the app and wider system. Additionally, themes highlighted that T&T systems do not happen within a vacuum, but within a pre-existing environment influenced by variables such as the media and perception of other's compliance to T&T.

Implications

Since it's roll-out, controversies surrounding the UK T&T system include concerns about privacy, stigma and uptake. Considering the current piece of work, which anticipated similar concerns prior to public access to COVID-19 app, engaging with the public may have been an important step in improving the perception and compliance with the app. Principles fundamental to patient and public involvement (PPI) and Responsible Research and Innovation (RRI) such as the inclusion of the public in the early development of research and aligning the outcomes of research and innovation with broader societal values and expectations would have been well-applied to this system and should be applied to future autonomous systems requiring high public uptake.

Identification of genomic regions associated with differences in fleece type in Huacaya and Suri alpacas (Vicugna pacos)

The difference in fleece type is the distinguishing trait between the two types of alpacas (Vicugna pacos), Huacaya and Suri. The Suri fleece type has been found to be inherited dominantly over the Huacaya type, resulting in offspring with the Suri phenotype. The aim of our study was to map genomic regions associated with the two different fleece types. In this study, 91 alpacas (54 Huacayas and 37 Suris) from Germany and Switzerland were genotyped using the 76k alpaca SNP array. Only 59k chromosome-localised markers map to the alpaca reference assembly VicPac3.1, and after quality control 49 866 SNPs, were retained for population structure assessment and to conduct a genome-wide association study. Both principal component and neighbour-joining tree analysis showed that the two fleece-type cohorts overlapped rather than forming two distinct clusters. Genome-wide significantly associated markers were observed in the scaffold region of chromosome 16 (NW_021964192.1), which contains a cluster of keratin genes. A haplotype predominantly found in Suri alpacas has been identified which supports dominant inheritance. Variant filtering of nine whole-genome sequenced alpacas from both fleece types in the critical interval of 0.4 Mb did not reveal perfect segregation of either fleece type for specific variants. To our knowledge, this is the first study to use the recently developed species-specific SNP array to identify genomic regions associated with differences in fleece type in alpacas. There are still some limitations, such as the preliminary status of the reference assembly and the incomplete annotation of the alpaca genome.

Deep learning-assisted radiomics facilitates multimodal prognostication for personalized treatment strategies in low-grade glioma

Determining the optimal course of treatment for low grade glioma (LGG) patients is challenging and frequently reliant on subjective judgment and limited scientific evidence. Our objective was to develop a comprehensive deep learning assisted radiomics model for assessing not only overall survival in LGG, but also the likelihood of future malignancy and glioma growth velocity. Thus, we retrospectively included 349 LGG patients to develop a prediction model using clinical, anatomical, and preoperative MRI data. Before performing radiomics analysis, a U2-model for glioma segmentation was utilized to prevent bias, yielding a mean whole tumor Dice score of 0.837. Overall survival and time to malignancy were estimated using Cox proportional hazard models. In a postoperative model, we derived a C-index of 0.82 (CI 0.79-0.86) for the training cohort over 10 years and 0.74 (Cl 0.64-0.84) for the test cohort. Preoperative models showed a C-index of 0.77 (Cl 0.73-0.82) for training and 0.67 (Cl 0.57-0.80) test sets. Our findings suggest that we can reliably predict the survival of a heterogeneous population of glioma patients in both preoperative and postoperative scenarios. Further, we demonstrate the utility of radiomics in predicting biological tumor activity, such as the time to malignancy and the LGG growth rate.

Differences in Decision-Making Behavior Between Elite and Amateur Team-Handball Players in a Near-Game Test Situation

Athletic features distinguishing experts from non-experts in team sports are relevant for performance analyses, talent identification and successful training. In this respect, perceptual-cognitive factors like decision making have been proposed to be important predictor of talent but, however, assessing decision making in team sports remains a challenging endeavor. In particular, it is now known that decisions expressed by verbal reports or micro-movements in the laboratory differ from those actually made in on-field situations in play. To address this point, our study compared elite and amateur players’ decision-making behavior in a near-game test environment including sport-specific sensorimotor responses. Team-handball players (N = 44) were asked to respond as quickly as possible to representative, temporally occluded attack sequences in a team-handball specific defense environment on a contact plate system. Specifically, participants had to choose and perform the most appropriate out of four prespecified, defense response actions. The frequency of responses and decision time were used as dependent variables representing decision-making behavior. We found that elite players responded significantly more often with offensive responses (p < 0.05, odds ratios: 2.76–3.00) in left-handed attack sequences. Decision time decreased with increasing visual information, but no expertise effect was found. We suppose that expertise-related knowledge and processing of kinematic information led to distinct decision-making behavior between elite and amateur players, evoked in a domain-specific and near-game test setting. Results also indicate that the quality of a decision might be of higher relevance than the required time to decide. Findings illustrate application opportunities in the context of performance analyses and talent identification processes.

Associations between minerals and metabolic indicators in maternal blood pre- and postpartum with ewe body condition, methane emissions, and lamb body weight development

In sheep production, economic efficiency strongly depends on the maternal health and feed efficiency status and on weaning performances of their offspring. Accordingly, an optimal level for the supply with macro- and microelements and the ewe energy status has impact on the fetal development during gestation and on maternal milk production during lactation. Furthermore, this study addressed intergenerational aspects, i.e., on associations between maternal energy metabolism profiles considering the macro- and microelement status, metabolic indicators (e.g. β-hydroxybutyrate (BHB)), body condition and methane (CH4) emissions with lamb BW (LBW) in two sheep breeds. Traits were recorded at the beginning of gestation (ewe traits), at lambing, three weeks postpartum, and at weaning (ewe and lamb traits). Trait recording included CH4 emissions (recorded via laser methane detector (LMD)), ewe BW (EBW), backfat thickness (BFT), and body condition score (BCS) from 46 ewes (24 Merinoland- (ML), 22 Rhönsheep (RH)), and LBW of their 87 (35 ML, 52 RH) purebred lambs. Serum levels of the following ewe blood parameters were determined: calcium (Ca), sodium (Na), potassium (K), phosphate (P), nonesterified fatty acids (NEFA), BHB, glutamate dehydrogenase (GLDH), selenium (Se), copper (Cu), iron (Fe), zinc (Zn), and magnesium (Mg). Mixed models were applied to infer associations between ewe blood parameters with EBW, BFT, BCS, and CH4 and with LBW recorded in offspring. At weaning, a maternal serum Mg level > 1.0 mmol/L was significantly associated with an increase of 13% in LBW in ML, compared to offspring from ML ewes with a serum Mg concentration within the lower reference range (0.8 mmol/L). Furthermore, higher Cu levels were favorably associated with ewe BCS and BFT at weaning in both breeds. In RH ewes, a Se level > 2.4 μmol/l was significantly associated with increased BCS. In the ML breed, high Zn levels during lactation were associated with reduced CH4 emissions. Ewe EBW was significantly larger for ML ewes representing low Ca levels. A low BHB level was associated with decreasing CH4 emissions in RH and ML. Serum levels for Na, K, P, GLDH, and Fe did not significantly affect the traits of interest. Trait associations from the present study indicate the importance of the mineral supply and metabolic status of the ewe with regard to body condition, CH4 emissions, and LBW development, but depending on the breed. Identified associations might contribute to energy efficiency in sheep production systems.

Dynamic Balance Evaluation: Reliability and Validity of a Computerized Wobble Board

Fusco, A, Giancotti, GF, Fuchs, PX, Wagner, H, Varalda, C, Capranica, L, and Cortis, C. Dynamic balance evaluation: reliability and validity of a computerized wobble board. J Strength Cond Res 34(6): 1709-1715, 2020-Computerized wobble boards (WBs) are inexpensive, transportable, and user-friendly devices to objectively quantify the dynamic balance performances out of laboratory settings, although it has not been established if they are reliable and valid tools. Therefore, the purpose of this study was to determine the reliability and validity of a computerized WB. Thirty-nine (18 females and 21 males) young adults (age: 23.3 ± 2.1 years; body mass: 65.9 ± 1.8 kg; height: 168.2 ± 8.8 cm; leg length: 78.8 ± 5.7 cm; and body mass index: 23.2 ± 2.1 kg·m) participated in the study. Subjects were assessed during 3 separate sessions on different days with a 48-hour rest in between. A total number of 2 WB single limb tests and 1 Y Balance Test (YBT) were performed. The WB performance was registered using the proprietary software and represented by the time spent in the target zone, which represented the 0° tilt angle measured by the triaxial accelerometer in the WB. YBT normalized reach distances were recorded for the anterior, posteromedial, and posterolateral directions. Intraclass correlation coefficient, 95% confidence interval, SEM, minimal detectable change, and Bland-Altman plots were used to evaluate intrasession and intersession reliability, whereas Pearson product moment correlation was used to determine concurrent validity. Reliability ranged from fair to excellent, showing acceptable levels of error and low minimal detectable change. However, all correlation coefficients between WB and YBT outcomes were poor. Despite the 2 methods addressing different aspects of balance performance, WB seems to validly serve its purpose and showed good reliability. Therefore, computerized WBs have the potential to become essential devices for dynamic balance assessment.

A novel approach to measuring wobble board performance in individuals with chronic ankle instability

Computerized wobble boards (WB) are used to objectively assess balance in healthy and chronic ankle instability individuals. As in field setting health professionals might not own WB, objective evaluations are not always feasible. Therefore, the aim of this tudy was to investigate the contribution of sagittal plane joints angular-displacement and anthropometrics to predict equations to estimate WB performance by portable two-dimensional motion analysis (2D-MA) and cross-validate the developed equations in chronic ankle instability individuals. Thirty-nine healthy and twenty chronic ankle instability individuals stood on a WB in single stance position. The balance test consisted of three 30s trials per limb keeping the platform flat at 0°. Trials were video recorded, and three time-segments joints angular-displacement analyzed with 2D-MA: segment 1 (T1) including 30s data, segment 2 (T2) from second 0 to 10, segment 3 (T3) only the first 5s. Mixed regression for multilevel models was used to estimate WB performance for each time-segment and to examine limb differences for the predicted WB performance in chronic ankle instability sample. The accuracy of the equations to detect injured limbs was calculated via area under the curve for receiver operating characteristic. Ankle and knee angular-displacement parameters, body height and lower limb length were the major predictors of WB performance for the extrapolated models (p < 0.05; R² = 0.83-0.56). The measured WB performance and T1 model showed significant (p < 0.05) performance differences between the injured and uninjured limbs. Receiver operating characteristic analysis showed an asymptotic significance of 0.03 for T1 equation with area under the curve of 0.70. The proposed models provide different methods to quantify the performance and accurately detect the injured limb in individuals with unilateral chronic ankle instability, when measuring balance via WB might not be feasible. App-makers may use the equations to provide an automatic all-in-one system to monitor the performance status and progress.

Long-term application potential of urban air mobility complementing public transport: an upper Bavaria example

In this paper, the required models and methods to analyze and quantify the potential demand for urban air mobility (UAM) complementing public transport and possible impacts were defined and applied to the Munich Metropolitan region. An existing agent-based transport model of the study area were used and extended to cover socio-demographic changes up to the year 2030 and intermodal UAM services. An incremental logit model for UAM was derived to simulate demand for this new mode. An airport access model was developed as well. Three different UAM networks with different numbers of vertiports were defined. Sensitivity studies of ticket fare and structure, flying vehicle cruise speed, passenger process times at vertiports and different Urban Air Mobility networks sizes were performed. For the reference case, UAM accounts for a modal share of 0.5%. The absolute UAM demand is concentrated on very short routes; hence, UAM vehicle flight speed variation shows low UAM demand impacts. Kilometer-based fare, number of UAM vehicles per vertiport and passenger process times at vertiports show a significant impact on UAM demand.

Effect of Differential Training on Female Volleyball Spike-Jump Technique and Performance

PURPOSE

To determine the effect of in-season differential training on volleyball spike-jump technique and performance in elite-level female players.

METHODS

During the season, spike jumps of 12 elite female players (Austrian Volleyball League Women) were recorded by 13 Qualisys Oqus cameras (250 Hz) and an AMTI force plate (1000 Hz). First measurement was made at the beginning of the investigation. Two identical measurements were repeated after a first and a second interval. The first interval served as control phase. The second interval was comparable in length and regular program but included differential training (6 wk, 8 sessions of 15-20 min) as a modified warm-up. It addressed specific performance determinants. Analyses of variances were calculated for the 3 measurements and for the development during control and intervention phase.

RESULTS

Initial jump height (0.44 [0.09] m) changed by -4.5% during the control phase and +11.9% during the intervention (P < .001, ηp2=.70). All approach variables, arm backswing, and velocity-conversion strategy improved compared with the control phase (Δ%: 6.1-51.2%, P < .05, ηp2=.40-.80). Joint angles, countermovement depth, maximal angular velocities, and torso incline were not affected (Δ%: -2.9-9.1%, P = .066-.969, ηp2=.00-.27).

CONCLUSIONS

In-season differential training led to technical adaptations and increased spike-jump height in elite female players. The differential training program allowed players to experience a range of adaptability and to adjust toward an individual optimum in technical components of performance determinants. Coaches are encouraged to apply technical differential training to elite athletes and to target biomechanical performance factors specifically.

P1540 Imaging parameters vs. operator dependence of global longitudinal strain values

Background

Speckle tracking based global longitudinal strain (GLS) values have proven useful in the assessment of subtle changes in left ventricular function. From a clinical point of view, robustness and reliability of measured values are critical to ensure a valid patient assessment and follow-up. However, it is still a matter of debate if imaging parameters systematically alter measured strain values and if these changes are relevant as compared with GLS fluctuations that are caused by different operators or different studies by the same operator.

Methods

In a consecutive everyday patient population (n = 35), we recorded the apical four chamber view several times in each patient with different ultrasound machine settings (modification of gain, frame rate, sector depth, and transducer frequencies) using a commercially available ultrasound imaging system. Furthermore, apical four chamber views with ‘optimized’ imaging settings at the operators’ discretion were recorded by two different observers (obA/obB) in each subject to compute inter- and intra-observer variability. GLS values were calculated offline with a dedicated software. We fitted a linear mixed effects model with random intercept and slope to assess the effect of imaging parameters on GLS and compared the two investigators with Bland-Altman plots.

Results

Ejection fraction ranged between 10% and 76% and was correlated well with GLS (r = -0.78). Neither gain settings (range: -24 to 24 arbitrary units, p = 0.68) nor frame rate (range: 51-113 sec-1, p = 0.77) systematically changed measured GLS values. Conversely, higher sector depth increased (range: 12 to 24 cm, mean effect: -0.16%/cm; 95% CI -0.24% to -0.07%, p &lt; 0.01), and higher transducer imaging frequencies decreased absolute GLS values (range for harmonic imaging: 1.5/3.1 MHz to 2.0/4.3 MHz, mean effect 1.10%/MHz; 95% CI 0.61% to 1.59%, p &lt; 0.01). According to our data, a 12 cm increase of sector depth would translate into an average change of -1.87% GLS (95% CI: -2.87% to -0.86%), whereas a switch of the second harmonic imaging frequency from 3.1 MHz to 4.3 MHz would cause a 1.32% GLS change (95% CI: 0.73% to 1.91%). Intra- and inter-observer variability showed good correlation and limits of agreement (obA: mean difference [MD]: -0.20%; 95% limits of agreement [LOA]: -2.42% to 2.02%, p = 0.86, obB: MD: -0.10%; 95% LOA: -4.28% to 4.07%, p = 0.12, obA vs. obB: MD: -0.53%; 95% LOA: -3.68% to 2.62%, p = 0.92).

Conclusion

Overall, GLS values were robust and reproducible in our cohort of patients. In comparison, potential systematic changes of GLS values caused by modification of imaging parameters (sector depth/transducer frequency) were much less in number than GLS variations caused by different operators or different studies by the same operator.

Y balance test: Are we doing it right?

OBJECTIVES

The multifaceted characteristic and task-specificity of postural control clearly reflects the need of knowing which factors could influence the balance measures in order to provide reliable and unbiased information. Therefore, this study aimed to investigate the effects of selected anthropometric characteristics, sex, lower limb's strength and dominance on the Y balance test (YBT).

DESIGN

Descriptive laboratory study.

METHODS

Forty-two young adults performed the YBT. The raw and normalized reach distances values were recorded. ANOVA was used to examine differences between sex and limb dominance, whereas multiple linear regression models were built to identify variables associated with better postural control.

RESULTS

No significant sex differences were observed, except for the normalized anterior direction (p=0.0324). No significant differences between limbs emerged. Regression models significantly explained between 8-49% of the variance. Trunk length, strength, and the interaction between sex with strength were the major predictors of the raw measures. Unexpectedly, lower limb length explained only 0.08% of the raw anterior direction variance. Strength and its interaction with sex were positively associated with normalized measures. Surprisingly, the relative lower limb length variable was negatively associated with the normalized measures. Each % point increase in relative lower limb length was associated with a decrease in normalized performance ranging from 1.73 to 4.91%.

CONCLUSIONS

Anthropometric characteristics, sex and lower limb strength differently influenced the YBT measures, regardless of limb dominance. Consequently, these variables should be controlled to limit the variability for an accurate evaluation of postural balance, especially if different YBT measures are used.

Spike jump biomechanics in male versus female elite volleyball players

There are well-known biological differences between women and men, especially in technical-coordinative variations that contribute to sex differences in performance of complex movements like the most important offensive action in volleyball, the spike jump. The aim of this study was to investigate sex-dependent performance and biomechanical characteristics in the volleyball spike jump. Thirty female and male sub-elite volleyball players were analysed while striking a stationary ball with maximal spike jump height. Twelve MX13 Vicon cameras with a cluster marker set, two AMTI force plates, surface EMG, and a Full-Body 3D model in Visual3D were used. Main findings include sex differences (P< .05) in jump height (pη² = .73), approach [speed (pη² = .61), step length], transition strategy [plant angle, neuromuscular activation (pη² = .91), horizontal force maxima and impulses], acceleration distances [centre of mass displacement (pη² = .21), minimal knee and hip angles], use of torso and arms [incline, angular velocity (pη² = .23)]. Correlations support that the results cannot be explained fully by strength and power differences between sexes but represent the product of technical-coordinative variations. Their relevance is acknowledged for both sexes and numerous performance determinants displayed sex differences. The integration of such attributes into sex-specific training seems promising but its effect requires further investigation.

Wobble board balance assessment in subjects with chronic ankle instability

BACKGROUND

Wobble boards (WBs), commonly used to train postural control, have been recently equipped with accelerometers connected to a computer displaying real-time balance performances. However, little is known about their ability to detect balance deficits in subjects with unilateral chronic ankle instability (CAI).

OBJECTIVE

To determine if computerized WBs can detect balance deficits in subjects with unilateral CAI.

METHODS

Fifteen subjects with unilateral CAI and fifteen uninjured subjects performed one WB test and one Y Balance Test (YBT) during two separate randomized sessions. WB performance was assessed as the time (s) spent on the platform by keeping it flat at 0° during three 30-s trials for each limb. Normalized (%) reach distances values for anterior, posteromedial, posterolateral directions and composite were recorded for YBT.

RESULTS

WB has been shown to be a reliable and accurate device for detecting balance deficits between and within subjects with unilateral CAI. The area under the curve for receiver operating characteristic was 0.80 (asymptotic significance 0.001), suggesting that WBs have the capability to accurately discriminate between injured and uninjured limbs.

SIGNIFICANCE

Computerized WBs can fill the gap caused by limitations between subjective-based clinical assessment and laboratory-based testing, especially in field-based settings, where specificity, transportability and time constraints are crucial. The results of the present study suggest that WBs may facilitate the detection of balance impairments in subjects with unilateral CAI, without complexity in its use or data interpretation.

Physical Performance in Elite Male and Female Team-Handball Players

PURPOSE

Biological differences between men and women are well known; however, literature addressing knowledge about the influence of sex on specific and general performance in team handball is almost nonexistent. Consequently, the aim of the study was to assess and compare specific and general physical performance in male and female elite team-handball players, to determine if the differences are consequential for general compared with specific physical performance characteristics and the relationship between general and specific physical performance.

METHODS

Twelve male and 10 female elite team-handball players performed a game-based performance test, upper- and lower-body strength and power tests, a sprinting test, and an incremental treadmill running test.

RESULTS

Significant differences (P < .05) between male and female players were found for peak oxygen uptake and total running time during the treadmill test, 30-m sprinting time, leg-extension strength, trunk- and shoulder-rotation torque, and countermovement-jump height, as well as offense and defense time, ball velocity, and jump height in the game-based performance test. An interaction (sex × test) was found for time and oxygen uptake, and except shoulder-rotation torque and ball velocity in women, the authors found only a low relationship between specific and general physical performance.

CONCLUSION

The results of the study revealed that male players are heavier, taller, faster, and stronger; jump higher; and have better aerobic performance. However, female players performed relatively better in the team-handball-specific tests than in the general tests. The findings also suggest that female players should focus more on strength training.