Search Results (2,996)

Background/Objectives: Suicide attempts represent a major global health problem. Traumatic suicide methods, such as falls from great heights, stab wounds, and gunshot wounds, frequently result in severe or fatal injuries. The COVID-19 pandemic, as well as broader societal stressors including economic uncertainty and geopolitical conflicts, has substantially increased psychological stress in the population and has been discussed as a potential influencing factor for suicidal behavior. The aim of this study was to analyze severe traumatic suicide attempts and to evaluate the potential influence of the COVID-19 pandemic in a multicenter analysis of the TraumaRegister (TR) DGU^®. Methods: This retrospective multicenter analysis is based on the TraumaRegister DGU^®, a standardized database for seriously injured patients. Patients from Germany, Austria, and Switzerland from 2010 to 2023 with an Injury Severity Score (ISS) ≥ 9, an age ≥ 10 years, and a documented suicide attempt, who arrived at the hospital alive, were included. Results: Among severely injured trauma patients recorded in the registry, 12,247 (4.4%) cases were classified as suspected traumatic suicide attempts. Severe traumatic suicide attempts showed a clear age-dependent distribution, with a marked increase from adolescence and a plateau between 20 and 55 years of age. Both the mean age of the general population and the age of patients with suicide attempts increased over the study period. This trend was reflected in the rise in the ≥70-year age group from 13.6% in 2010 to 19.6% in 2023. The most common method was jumping from a height greater than 3 m (65.3%), followed by stab wounds (11.9%) and gunshot wounds (8.0%). While a significant decline in severe traumatic suicide attempts was observed between 2010 and 2019, a significant increase to 4.5% occurred in 2020, remaining at a comparable level in the following years. Sex-specific differences were observed, with penetrating injuries occurring more frequently in men, whereas jumps from heights > 3 m were more common among women. The highest hospital mortality was observed in gunshot injuries (67.9%). Conclusions: This study demonstrates an increase in severe traumatic suicide attempts in 2020 that persisted at a similar level until 2023. Sex-specific differences in suicide methods highlight the need for targeted prevention strategies. In addition, demographic aging is reflected in the increasing proportion of suicide attempts among older individuals, emphasizing the need for age-specific prevention measures. The relatively high survival rate after certain methods, particularly after falls from height (77%), underlines the importance of structured postoperative psychiatric care pathways. These findings specifically reflect traumatic suicide attempts resulting in severe injury and requiring trauma center treatment. Full article

Background: Cardiovascular risk factors may emerge early in life and track into adulthood. Local data from inland and socioeconomically vulnerable regions remain limited. This study aimed to describe cardiovascular risk indicators in school-aged children from inland Portugal, focusing on body mass index (BMI), blood pressure (BP), and physical activity patterns. Methods: A cross-sectional school-based screening study was conducted in 101 children and adolescents aged 10–15 years. Anthropometric measurements and BP were obtained using standardized procedures. BMI categories were classified according to age- and sex-specific WHO references. BP was classified using European pediatric percentiles. Because measurements were obtained during a single visit, results were interpreted as elevated BP at screening. Associations between variables were explored using chi-square or Fisher’s exact tests and Spearman’s correlation. Results: The prevalence of underweight, normal weight, and overweight/obesity was 25.7%, 67.3%, and 6.9%, respectively. Overall, 24.8% of participants presented elevated BP at screening. The BMI category was significantly associated with BP classification (p = 0.003), and BMI correlated positively with systolic BP (ρ = 0.32; p = 0.001). Most children reported only school-based physical education. Conclusions: This school-based screening suggests a high proportion of elevated BP measurements and an unexpectedly high prevalence of underweight children, indicating the coexistence of different nutritional vulnerabilities. Findings should be interpreted cautiously due to the small, single-school sample and single-occasion BP assessment but support the importance of early cardiovascular risk monitoring in vulnerable settings. Full article

Background/Objectives: Kidney transplantation is the standard of care for the majority of patients with end-stage kidney disease. Neurological complications are common, and among them, tremor is very frequent and usually attributed to immunosuppressive drug toxicity. Methods: In this retrospective study, we investigate the incidence and characteristics of tremor in kidney transplant patients and analyze its occurrence with respect to a multitude of demographic and clinical parameters, thereby aiming to confirm the role of calcineurin inhibitor-induced neurotoxicity and to identify other putative predictive factors. Furthermore, we characterize post-transplant tremor with the goal of identifying its clinical features and determining the impact on quality of life. Results: A total of 129 kidney transplant recipients were screened; six patients were excluded due to a history of movement disorders prior to kidney transplantation. In total, 123 patients were included in the final analysis—69 male (56%) and 54 female patients (44%), with a median age of 50. A total of 36% (46 patients) developed tremor in the post-transplant period. Using both univariable and multivariable analyses, we found that female sex and tacrolimus use were independently associated with the development of post-transplant tremor. In addition, multivariable analysis identified an association between younger age and post-transplant tremor. Furthermore, we observed a trend in the duration of symptoms in relation to the calcineurin inhibitor choice. Conclusions: Despite a relatively high prevalence (36%), post-transplant tremor does not significantly impact the QoL and spontaneously resolves within 1 year in adult kidney transplant recipients. Female sex and tacrolimus were identified as independent predictors of post-transplant tremor in renal transplant recipients. Full article

Background: Frontal lobe involvement represents an important but heterogeneously expressed feature across neurodegenerative and vascular cognitive disorders. While frontal atrophy has been described in Alzheimer’s disease (AD), detailed volumetric assessment of frontal subregions across Alzheimer’s disease, amnestic mild cognitive impairment (aMCI), and vascular dementia (VaD) remains insufficiently characterized. The aim of this study was to evaluate frontal lobe and frontal subregional volumetric alterations across these diagnostic groups using automated MRI-based volumetry. Methods: This cross-sectional study included 120 participants divided into four groups: AD, VaD, aMCI, and cognitively healthy controls (n = 30 per group). All participants underwent standardized neuropsychological assessment and 3T brain MRI. Automated volumetric analysis of the frontal lobe and its subregions was performed using the Vol2Brain pipeline. Group differences in total intracranial volume–adjusted frontal volumes were assessed using analysis of covariance, controlling for age and sex, followed by Bonferroni-corrected post hoc comparisons. False discovery rate (FDR) correction was applied across subregional comparisons. Results: A significant main effect of diagnostic group was observed for total frontal lobe volume, with lower adjusted volumes in patients with AD compared with aMCI and cognitively healthy controls. After correction for multiple comparisons, only total frontal lobe volume remained statistically significant. At the nominal level, group differences were observed in several frontal subregions, predominantly involving prefrontal and orbitofrontal areas. However, these findings did not survive FDR correction and should be interpreted as exploratory. No consistent frontal volumetric pattern was observed in VaD. Receiver operating characteristic analysis demonstrated moderate discriminatory ability of total frontal lobe volume for distinguishing AD from cognitively healthy controls. Conclusions: Automated MRI-based volumetry revealed global frontal lobe reduction in Alzheimer’s disease, whereas subregional findings were exploratory after correction for multiple testing. Frontal volumetric measures did not demonstrate a characteristic pattern in VaD. Global frontal volume may provide complementary structural information within clinically define cognitive disorders. Full article

Background: Facial expressions of pain are essential for pain assessment, yet subjective pain reports often vary between sexes. Traditional self-report measures are prone to bias, and objective methods are needed for more reliable pain evaluation. Objective: To develop and validate a subjectivity-free automated tool to assess acute low back pain using facial expressions recorded during a functional spinal extension task. Participants: Thirty healthy adults, aged 18–40 years. Methods: Participants received intramuscular injections of hypertonic (pain) and isotonic (placebo) saline in the lumbar region during separate sessions. Facial expressions were video-recorded during a submaximal lumbar extension task and analyzed using a custom software based on Haar Cascade and Local Binary Pattern Histogram algorithms, which are techniques that do not require neither training data nor subjective labeling, contrary to what happens in deep learning solutions. Results: The tool successfully detected significant differences in facial expressions between pain, placebo, and pain-free conditions (p < 0.001). Test–retest reliability was good (ICC = 0.85). While both sexes showed similar facial expression patterns during pain, males reported higher pain scores on the numeric rating scale (p < 0.01). Pain significantly reduced steadiness of force in both sexes. Conclusion: The automated tool objectively quantified facial expressions associated with acute low back pain and revealed sex-related differences in subjective pain perception. This multimodal approach integrating expression analysis, physical performance, and self-report may enhance the accuracy of pain assessment in physiotherapy settings. Full article

Background: CrossFit^® has gained widespread popularity as a high-intensity training modality, yet evidence describing neuromuscular performance characteristics in this population remains limited. This study aimed to evaluate isometric and ballistic strength profiles in trained CrossFit^® athletes and to identify sex-based differences in absolute and relative neuromuscular performance. Methods: Seventy-two athletes participated (41 males and 31 females) participated in the study, completing two maximal isometric mid-thigh pull (IMTP) tests and three countermovement jump (CMJ) tests within a single testing session. Assessments were conducted using a dual force plate system (Hawkin Dynamics, Westbrook, ME, USA). Results: In the IMTP, males exhibited substantially higher absolute isometric force outputs, including peak force (3059 ± 576 vs. 1899 ± 324 N; p < 0.001) and relative peak force (36.34 ± 6.74 vs. 30.99 ± 4.41 N/kg; p < 0.001). Rates of force development were also greater in males for both early (0–50 ms: 7665 ± 5420 vs. 4001 ± 3021 N/s; p < 0.001) and late phases (0–250 ms: 5350 ± 1832 vs. 3035 ± 886 N/s; p < 0.001). However, no significant sex differences were detected in time to peak force (2.31 ± 1.27 vs. 1.94 ± 1.04 s) or dynamic strength index (0.72 ± 0.12 vs. 0.73 ± 0.12 a.u.). In ballistic performance using CMJ, males achieved higher jump height (0.33 ± 0.07 vs. 0.23 ± 0.05 m; p < 0.001), jump momentum (215 ± 27.9 vs. 131 ± 19.1 kg·m/s; p < 0.001), and modified reactive strength index (0.46 ± 0.11 vs. 0.32 ± 0.08 a.u.; p < 0.001). Relative propulsive and braking forces were also moderately greater in males. Notably, sex differences were reduced when variables were normalized to body mass or peak force, indicating comparable relative neuromuscular function across sexes. Conclusions: These findings provide descriptive neuromuscular performance data for CrossFit^® athletes and show that sex-based differences primarily reflect disparities in absolute force-production capacity rather than intrinsic neuromuscular efficiency. Such insights may support more precise, evidence-informed, and sex-specific training prescriptions to optimize performance. Full article

Background/Objectives: Real-world gastric cancer cohorts often show incomplete TNM documentation, which can affect the interpretation of stage, phenotype, and treatment allocation. We aimed to quantify staging completeness, describe advanced-disease phenotype, and examine treatment selection at diagnosis in a real-world gastric cancer cohort. Methods: We performed a retrospective observational study of consecutive patients diagnosed with gastric cancer at a tertiary referral center. Data included age, sex, TNM components, metastatic status, surgery (any vs. none), and available serum markers (CEA, CA19-9). Incomplete staging was defined a priori as Tx and/or Nx and/or Mx. The primary endpoint was metastatic disease at diagnosis (M1) among patients with defined M status. In TNM-complete cases, a composite locally advanced or metastatic endpoint (LAM: M1 or T4 or N2–N3) supported sensitivity analyses. Logistic regression assessed associations with M1 and treatment allocation without biomarker cut-offs (markers modeled as continuous covariates). Results: The cohort included 419 patients. Incomplete staging was observed in 36.8%. M status was defined in 89.5%, with M1 in 52.0% of M-defined cases. Surgery was less frequent in M1 than M0 patients (34.4% vs. 73.3%; p < 0.001). Phenotype stratification showed a marked difference in surgical allocation, which was highest in M0-LAM (89.1%) and lowest in M1 (48.4%). Marker associations were directionally coherent but not definitive. Conclusions: Incomplete staging is common and clinically relevant in real-world gastric cancer and should be reported explicitly. Phenotype-based summaries provide a pragmatic framework for interpreting advanced disease and treatment selection, while tumor markers should be interpreted cautiously without predefined cut-offs. Full article

Traumatic brain injury (TBI) can lead to persistent adverse outcomes, including cognitive and emotional dysfunction, with recent estimates indicating that up to 50% of individuals with mild TBI experience long-term symptoms. Growing evidence suggests that biological sex influences TBI outcomes and recovery trajectories; however, the molecular underpinnings driving these sex-specific differences remain poorly understood. In this study, a preclinical TBI model was used to directly compare chronic glutamatergic alterations in adult male and female Sprague Dawley rats. To define frontocortical molecular signatures associated with sex-specific glutamatergic dysfunction, proteomic analyses were conducted. Proteomic data revealed dysregulation of key pathways, cellular processes, and molecular regulators involved in excitatory signaling and synaptic function in both sexes. Biomarker profiling identified a single common biomarker between males and females, along with multiple biomarkers unique to each sex. Furthermore, two key brain regions highly susceptible to TBI, the prefrontal cortex and hippocampal subregions, were examined for chronic alterations in key glutamatergic signaling proteins, including N-methyl-D-aspartate (NMDA) receptors and the excitatory synaptic marker postsynaptic density protein 95 (PSD95). Immunofluorescence analyses revealed both sex- and region-specific alterations in the expression of NMDA receptor subunits, as well as in PSD95. Notably, many of these changes were concentrated within the hippocampal subregions, suggesting long-term dysregulation of hippocampal glutamatergic circuitry following injury. Together, these findings indicate the emergence of chronic sex-specific pathophysiology in glutamate signaling after TBI and highlight the importance of incorporating sex as a biological variable in the development of precision medicine-based therapeutic strategies for TBI. Full article

Background and Objectives: Emphysema and coronary artery calcium (CAC) share common lifestyle-related risk factors, yet their association in Chinese populations remains understudied. This study investigated how lifestyle factors influence the association between emphysema and CAC score in an urban Chinese general population. Methods: The study included 1000 participants from the Chinese Nelcin-B3 urban general population study originating in 2017 who underwent low-dose CT (LDCT) screening and comprehensive CT assessment. Emphysema was visually assessed by subtype and severity. CAC was measured using the Agatston method and categorized as 0, 1–100, and >100. Questionnaire-based lifestyle factors (smoking, BMI, diet, physical activity, alcohol consumption and environmental exposures) were categorized based on number of unfavorable behaviors. Multivariable multinomial logistic regression adjusted for age, sex, education and cardiovascular risk factors examined the associations between emphysema and CAC, with interactions and stratified analyses for lifestyle effects. Results: Emphysema was present in 62.3% of the participants, with centrilobular being the most common subtype (61.5%). Paraseptal emphysema was associated with both CAC 1–100 (OR: 2.07 [1.03–4.15]) and CAC > 100 (OR: 2.94 [1.26–6.84]). Severe emphysema was linked to CAC > 100 (OR: 3.50 [1.38–8.84]). These associations were stronger in the intermediate unhealthy lifestyle group for paraseptal (OR: 5.41 [1.70–17.22] and moderate and severe emphysema (OR: 9.64 [1.64–56.55]; OR: 3.73 [1.07–13.06]), respectively, but not significantly different. Conclusions: While paraseptal and severe emphysema are associated with higher CAC scores, there is no modifying effect of lifestyle factors. These findings suggest that cardiovascular risk assessment could be of importance in individuals with emphysema. Further longitudinal studies are needed to clarify the clinical implications. Full article

Background/Objectives: Sport-related concussion (SRC) elicits multi-systemic symptoms, including nausea, fatigue, and cognitive changes. Gastrointestinal (GI) symptoms are not well captured in current concussion assessments and may be under-recognised in clinical follow-up. GI disturbances may influence intake tolerance and day-to-day fuelling during post-SRC recovery. This study investigated the prevalence and severity of self-reported GI symptoms in Irish athletes after their most recent SRC, examined sex-based patterns, and evaluated the rationale for integrating GI symptom checks into standard concussion tools (e.g., SCAT6) and post-injury monitoring. Methods: An online survey was completed by recreational, competitive, and elite athletes who retrospectively self-reported concussion history, GI symptoms, and bowel function post-SRC and at the time of survey completion (ToSC; 0.03–216 months post-injury). The survey used the Bristol Stool Chart, Rivermead Post-Concussion Symptoms Questionnaire, and validated GI symptom measures. Descriptive statistics and chi-square tests examined timepoint- and sex-based differences. Results: A total of 106 athletes participated (55.7% female; mean age 26.4 ± 7.7 years), of whom 90.6% reported ≥1 GI symptom post-SRC, with greater severity observed for appetite loss, bloating, and abdominal discomfort. Bowel habits shifted bidirectionally for 42.5%, and 26.4% were experiencing ongoing symptoms at ToSC. Conclusions: Self-reported GI symptoms were common and appear under-recognised post-SRC. These findings support greater attention to GI symptom assessment and suggest that brief GI checks and facilitated access to nutrition advice where symptoms persist may be feasible within multidisciplinary, athlete-centred care. Prospective studies are needed to determine clinical relevance and to evaluate nutrition-related strategies. Full article

Background: Posterior spinal fusion (PSF) for adolescent idiopathic scoliosis causes significant postoperative pain and high opioid requirements. Methadone, with dual μ- and κ-opioid agonism and NMDA antagonism, provides long-acting analgesia and may reduce perioperative opioid use. This study evaluated whether perioperative low-dose methadone (0.1 mg/kg) improves postoperative pain and opioid outcomes after pediatric PSF. Methods: In this single-center retrospective cohort study (January 2019–June 2023), pediatric patients <23 years old undergoing PSF were categorized by perioperative methadone exposure (intraoperative and/or postoperative) versus no methadone. The primary outcome was total postoperative opioid consumption (morphine milligram equivalents per kilogram, MME/kg) over postoperative days (POD) 0–3. Secondary outcomes were average daily pain scores and hospital length of stay (LOS). Inverse probability weighting (IPW) adjusted for age, sex, and protocol period. Results: A total of 339 patients (51% no methadone, 49% methadone; mean age 14.6 ± 2.5 years; 76% female) were analyzed. Methadone patients had longer anesthesia (392 vs. 372 min, p = 0.042) and surgery times (287 vs. 266 min, p = 0.01). IPW-adjusted associations show postoperative opioid use was significantly higher in the methadone group on POD 0 (median 2.5 vs. 2.1 MME/kg in no methadone group; p = 0.005). No significant differences were found in postoperative average pain scores (e.g., mean NRS: 2.3 vs. 2.5 on POD 0, p = 0.12) and LOS (3.3 vs. 3.1 days, p = 0.38) between methadone group and no methadone group. Discussion: Perioperative methadone provided similar analgesia for pain management and recovery without prolonging hospitalization, despite higher early opioid use on POD 0. Retrospective design limits causal inference, and residual confounding may persist despite propensity score-based adjustments. Further prospective trials are required to establish safety and dosing. Conclusions: In this retrospective cohort, perioperative low-dose methadone was associated with higher early postoperative opioid use but no significant differences in pain scores or length of stay compared with standard regimens. Methadone did not demonstrate an opioid-sparing effect in this real-world setting. Prospective studies are needed to better define its role and safety in pediatric posterior spinal fusion. Full article

Background: Chronic obstructive pulmonary disease (COPD) is increasingly recognized as a disorder linked to increased cardiovascular risk, often coexisting with coronary artery disease (CAD), yet angiographic data on coronary involvement in COPD remain limited. This study aimed to evaluate whether COPD is associated with a distinct angiographic pattern of CAD, focusing on vessel distribution. Methods: We retrospectively enrolled 94 patients who underwent coronary angiography between 2023 and 2024 for suspected or known CAD. Clinical data, comorbidities, laboratory testing, pulmonary function, electrocardiography, echocardiography, and angiography were collected. Participants were stratified into two groups: COPD (n = 47) and non-COPD (n = 47). Coronary vessels were classified by number, location, and diameter. The normality of continuous variables was assessed using the Shapiro–Wilk test. Non-normally distributed variables were compared using the Mann–Whitney U test, while Fisher’s exact test was used for categorical comparisons. A multivariable logistic regression model was performed to identify independent predictors of left main coronary artery (LMCA) disease at the patient level. The primary endpoint was the association between COPD and CAD severity. Results: Baseline characteristics, including age, sex, BMI, and smoking history, were comparable between groups. The overall extent of CAD, expressed as the number of diseased vessels, did not differ significantly (p = 0.1436). However, vessel-based analysis revealed a distinct pattern: COPD patients showed a significantly higher prevalence of left main coronary artery (LMCA) disease compared to non-COPD patients (14% vs. 4.7%, p < 0.001). At the patient level, LMCA disease was present in 15/47 (31.9%) COPD patients compared with 6/47 (12.8%) non-COPD patients (p = 0.046). Multivariable logistic regression confirmed that COPD was an independent predictor of LMCA disease (OR = 3.56, 95% CI: 1.12–11.29, p = 0.031) after adjustment for age, sex, smoking, diabetes, and chronic kidney disease. Intermediate-caliber vessels were most frequently affected in both groups, while small-caliber branches were less commonly involved in COPD patients. Conclusions: COPD is an independent predictor of LMCA disease despite a similar overall angiographic extent of CAD. These findings suggest a distinct, high-risk coronary phenotype in COPD and highlight the need for enhanced cardiovascular vigilance and integrated cardiopulmonary management in this population. Full article

In this work, a study of the chemical composition of the compound Sb₂(S_1−xSe_x)₃ used in thin-film solar cell fabrication, based on correlating data obtained from XRD and XPS analyses, is presented. This approach enables us to propose a mathematical expression for evaluating stoichiometric variations in the material, showing how the variable x evolves as a function of the diffraction angle 2θ. To establish this model, we analyzed the most intense diffraction peak, corresponding to the (221) plane. To validate the proposed method, a series of Sb₂(S_1−xSe_x)₃ thin films with different compositions were synthesized using RF-magnetron sputtering followed by conventional heat treatments in a controlled-atmosphere reaction furnace. The XRD results reveal a systematic 2θ shift in the crystalline diffraction peaks toward the positions of the binary precursor phases—from Sb₂Se₃ to Sb₂S₃—caused by the increased sulfur content during synthesis. XPS measurements confirm the presence of Sb, Se, and S, and high-resolution spectra indicate a decrease in selenium content as the sulfur fraction increases. These results allowed us to elucidate the stoichiometric behavior of antimony sulfoselenide Sb₂(S_1−xSe_x)₃ using trend curves fitted to the characterization data. Full article

The sense of smell is the first sense by which horses determine the suitability of feed for consumption. The aim of the study was to assess the influence of the degree of familiarity with the smell and taste of plants on horses’ olfactory exploration. Behavioural responses of twenty adult horses to nine herbs of three degrees of familiarity—least familiar (unknown in the first trial), known only by smell, and known by smell and taste—were investigated. During the tests, the horses were allowed to explore the individual herbs placed in a crib constructed to prevent them from eating the contents. Horses’ pre-consuming behaviour towards olfactory cues of plants was mainly expressed by different times of exploration. The horses explored herbs known by smell and taste less intensively than those initially unfamiliar, but not less intensively than herbs known only by smell. Thus, having more sensory experience (taste and olfactory) with a plant in the past, horses are often quicker to recognise plants based solely on the sense of smell in the future. The sex and type of the horse (warmblood, pony) may influence responses towards herbs of different levels of familiarity. Full article

Background: Standard accelerometer summaries obscure meaningful differences in how people move while upright. We introduce an operational two-class Ambulatory Behaviour Framework that separates Ambulatory Tasks—periods of standing and short continuous stepping bouts (<1 min) that are indicative of activity in a single locus—from Ambulatory Journeys—long continuous stepping bouts (≥1 min) that are indicative of movement between locations. Methods: We analysed thigh-worn activPAL3 data from 3545 participants in the age-46 sweep of the 1970 British Cohort Study (24,815 valid monitor-days). Event-based algorithms grouped upright events and classified them as an Ambulatory Task or Journey; linear models examined associations with sitting time and differences by sex and BMI. Results: Mean upright time averaged 6.50 h day⁻¹; Ambulatory Tasks dominated (5.91 h; 90.6% of upright exposure), whereas Ambulatory Journeys contributed 0.61 h (9.4%). Each additional hour of Ambulatory Tasks corresponded to 0.61 h less sitting (β = −0.61 h; 95% CI: −0.63 to −0.61), while an extra hour of Ambulatory Journeys displaced only 0.04 h of sitting (β = −0.04 h; 95% CI: −0.044 to −0.039). Women accumulated significantly more time in Ambulatory Tasks and less sitting time than men. Both upright behaviours declined with increasing BMI. Conclusions: Ambulatory Tasks substantially replace sitting time, whereas Ambulatory Journeys leave sitting essentially unchanged. Interventions to displace sitting should concentrate on fostering frequent, brief, context-embedded tasks throughout the day. This novel framework yields interpretable, sensor-agnostic metrics to target behaviour change and standardise reporting of free-living mobility. Full article