BACKGROUND:Sex differences in the escalation of drinking after brief abstinence have been documented. The possibility that changes in alcohol metabolism may explain these differences has not been previously examined. We tested whether short-term abstinence alters the alcohol elimination rate (AER) across sex and compared three methods for its estimation. METHODS:Sixty-six adults (56% female) aged 21-35 years reporting moderate-to-heavy drinking completed two counterbalanced intravenous alcohol clamp sessions under two conditions: one during a period of usual drinking and one after two weeks of monitored abstinence. AER was quantified with three approaches: a manual steady-state method, a deterministic infusion rate profile-based curve-fitting algorithm, and an automated, model-based parameter identification procedure (PID). The effects of condition, method, and sex were examined using linear mixed-effects models, and agreement among methods was examined with concordance statistics. RESULTS:Short-term abstinence did not consistently change AER, overall or differently across sex. A significant abstinence effect (p = 0.01) was observed in females with the PID method only. Males exhibited higher AER than females across both conditions (p < 0.001). The PID method yielded lower alcohol elimination estimates than Manual (p < 0.001) and Deterministic AER approaches, whereas the manual and deterministic methods did not differ. CONCLUSIONS:Sex differences in alcohol consumption following short-term abstinence are likely not explained by changes in AER. When comparing methodologies, the selection of a methodology should be consistent within analyses and selected based on experimental design.

Sex differences in stress-induced alcohol-seeking are well documented. The overarching goal of this study is to examine how sex may moderate the relationship between depression and anxiety symptoms and stress-induced alcohol-seeking and to identify mechanisms of this relationship. We explore subjective alcohol responses and the resting-state functional connectivity of the amygdala and the hippocampus, regions implicated in anxiety and depression, as potential sex-dependent mediators. This secondary analysis draws from a recently published trial of 84 adults aged 21 to 55 (54.8% female, mean age = 32, SD = 10.68; 58.3% White, 88.1% non-Hispanic/Latino) who endorsed moderate-to-heavy alcohol use. All participants completed two counterbalanced intravenous alcohol administration sessions, and 54 completed optional neuroimaging. Generalized anxiety symptoms were significantly associated with greater stress-induced alcohol-seeking in women but not in men. Depression symptoms showed a similar pattern, though the results did not reach statistical significance. Across men and women, blunted state stimulation, but not state anxiety, in response to alcohol was associated with greater stress-induced alcohol-seeking. In men, anxiety symptoms were linked with heightened state stimulation effects, which appeared to buffer against stress-induced alcohol-seeking. State stimulation findings may suggest a possible mechanism for sex differences concerning anxiety pathways to alcohol-seeking. Subjective alcohol responses did not mediate the relationship between depression symptoms and stress-induced alcohol-seeking. Resting-state network connectivity findings identified several potential sex-dependent neural mechanisms that warrant further investigation. Although this study was not originally designed as a direct test of competing subjective response and low-level response to alcohol theoretical models, our findings are consistent with Schuckit's low level of response to alcohol theory. Our findings showed that blunted stimulation may contribute to stress-induced alcohol-seeking among men. Identifying mechanisms that underlie sex-specific relationships with stress-induced alcohol-seeking can inform the development of tailored intervention approaches, ultimately enhancing treatment efficacy for both men and women.

IntroductionBreast cancer incidence rates are rising due to early detection, improved screening methods and advances in treatment options. As mortality rates reduce, there is a growing population living longer with treatment side-effects who require assistance. Prevalent issues arising after breast cancer treatment include pain, fatigue, lymphoedema and arm and shoulder mobility issues. Evidence demonstrates that upper limb exercises help reduce these common side effects and improve day-to-day functioning and quality of life. However, access to physiotherapy and rehabilitation services remains limited due to resource and access constraints. Despite a growing interest in digital health resources, little is known about the effectiveness of using digital exercise interventions to help resolve this problem.Methods and analysisA scoping review of available literature will be undertaken to explore what digital or online prehabilitation or rehabilitation interventions exist for people with breast cancer that incorporate an exercise component aimed at improving physical function or mobility. Peer-reviewed studies in English will be eligible for inclusion. A systematic search of Medline ALL, Embase, CINAHL, and Web of Science will be conducted and any relevant grey literature form trusted sources will also be included in our review. The Arksey and O'Malley framework will be applied together with updated guidance from other authors. To enhance rigour, the Joanna Briggs Institute methodology for scoping reviews will also be used to ensure accurate reporting. Articles will be screened by title and abstract against eligibility criteria before independent full text screening by two researchers. Arising conflicts will be resolved by consulting a third reviewer. To summarise the available evidence, data will be extracted using a tailored charting template and a descriptive narrative synthesis will follow.Ethics and disseminationAs this research involves the analysis of already published, peer-reviewed literature, ethical approval is not required. The results of this scoping review will be submitted for publication in a peer-reviewed journal. Any significant deviations from the original protocol will be transparently reported and justified.

Preclinical studies posit that habitual behaviour is an important mechanism in the development of alcohol use disorder (AUD), but human findings are unclear. The goals of this study were to test a behavioural measure of habit formation, the Slips of Action Task (SOAT), in humans and identify brain-based mechanisms explaining the relationship between habit and alcohol use. Thirty-six participants (63.9% female, mean age = 30.58, SD = 9.73, 69.4% White, 83.3% Not Hispanic/Latino) who endorsed heavy drinking completed self-report measures, the SOAT (lower scores = higher habit formation), a 2.5-h intravenous alcohol self-administration session, and a resting-state functional magnetic resonance imaging scan. Three seed regions-bilateral ventral caudate, nucleus accumbens and dorsal caudate-were assessed for significant whole brain functional connectivity (FC) associations with SOAT (cluster-level pFWE < 0.05 at a cluster-forming threshold p = 0.001). Two clusters survived Bonferroni correction (cluster pFWE = 0.008): FC between the left ventral caudate and the left middle frontal gyrus correlated negatively, while FC between the left NAc and the right central operculum correlated positively, with SOAT score. SOAT score was unrelated to drinking outcomes; however, there was a significant indirect relationship between SOAT and average drinks per drinking day through FC between the left ventral caudate and the left middle frontal gyrus. A similar trend seen with cumulative work for alcohol fell short of significance. Habit formation's relationship with alcohol use may function through neuroadaptations in the ventral caudate. More work is needed to better characterize objective habit formation in the human alcohol laboratory with additional laboratory-, alcohol-specific, imaging- and ambulatory-based alcohol use metrics.

Background Prolonged alcohol use is associated with neuroadaptations that may contribute to continued alcohol consumption, even in the presence of adverse consequences. Although well studied in preclinical models, the neural mechanisms of aversion-resistant alcohol-seeking in humans are understudied. Purpose The goal of this study was to examine whether altered amygdala resting state functional connectivity (rsFC) is a mechanism for how lifetime drinking history and alcohol use disorder symptoms relate with objectively measured neutral and aversion-resistant alcohol-seeking in the human laboratory. Methods A sample of 55 adults (age 21-55, mean=32.18 years, 56.4% female, 60.0% White) completed two counterbalanced intravenous alcohol progressive-ratio self-administration sessions (pairing alcohol-seeking with aversive or neutral stimuli) and a resting state fMRI scan. Two bilateral a priori amygdala seed regions were selected. Results rsFC strength of the left basolateral amygdala and dorsal anterior cingulate cortex mediated the relationships between both lifetime alcohol use and alcohol use disorder symptom severity with alcohol-seeking in the aversive session. rsFC between the right centromedial amygdala and occipital regions was associated with, but not specific to, alcohol-seeking during the neutral session; this connectivity mediated the association with alcohol use disorder symptom severity, but not the association with lifetime alcohol use. Conclusions This study provides evidence linking the basolateral amygdala to human aversion-resistant alcohol-seeking. Identification of brain mechanisms underlying aversion-resistant alcohol-seeking can facilitate translational research and identify physiological mechanisms of alcohol use disorder progression.

BackgroundThere is a large number of research studies about the prevention of non-communicable diseases (NCD), with findings taking several years to be translated into practice. One reason for this lack of translation is a limited understanding of how to best disseminate NCD research findings to user-groups in a way that is salient and useful. An understanding of barriers and facilitators to dissemination is key to informing the development of strategies to increase dissemination. Therefore, this review aims to identify and synthesise the barriers and facilitators to dissemination of NCD research findings.MethodsA mixed studies systematic review was performed following JBI (formerly known as Joanna Briggs Institute) methodology. The search included articles from January 2000 until May 2021. We conducted a comprehensive search of bibliographic and grey literature of five databases to identify eligible studies. Studies were included if they involved end-users of public health research that were decision-makers in their setting and examined barriers/facilitators to disseminating research findings. Two pairs of reviewers mapped data from included studies against the Framework of Knowledge Translation (FKT) and used a convergent approach to synthesise the data.ResultsThe database search yielded 27,192 reports. Following screening and full text review, 15 studies (ten qualitative, one quantitative and four mixed methods) were included. Studies were conducted in 12 mostly high-income countries, with a total of 871 participants. We identified 12 barriers and 14 facilitators mapped to five elements of the FKT. Barriers related to: (i) the user-group (n = 3) such as not perceiving health as important and (ii) the dissemination strategies (n = 3) such as lack of understanding of content of guidelines. Several facilitators related to dissemination strategies (n = 5) such as using different channels of communication. Facilitators also related to the user-group (n = 4) such as the user-groups’ interest in health and research.ConclusionResearchers and government organisations should consider these factors when identifying ways to disseminate research findings to decision-maker audiences. Future research should aim to build the evidence base on different strategies to overcome these barriers.Systematic review registrationThe protocol of this review was deposited in Open Science Framework (https://doi.org/10.17605/OSF.IO/5QSGD).

Purpose: To describe inequalities in the Monitoring for Neovascular Age-related Macular Degeneration Reactivation at Home (MONARCH) diagnostic test accuracy study for: recruitment; participants’ ability to self-test; and adherence to testing using digital applications during follow-up. Methods: Home-monitoring vision tests included two tests implemented as software applications (apps: MyVisionTrack and MultiBit) on an iPod Touch device. Patients were provided with all hardware required to participate (iPod and MIFI device) and trained to use the apps. Regression models estimated associations of age, sex, Index of Multiple Deprivation, strata of time since first diagnosis, and baseline visual acuity at study entry on outcomes of willingness to participate, ability to perform tests, and adherence to weekly testing. Results: A minority of patients who were approached were willing-in-principle to participate. Increasing age was associated with being unwilling-in-principle to participate. Patients from the most deprived areas had a 47% decrease in odds of being willing compared to those from the middle quintile deprived areas (odds ratio, 0.53; 95% confidence interval = 0.32, 0.88). Increasing age and worse deprivation were not consistently associated either with ability to self-monitor with the index tests, or adherence to weekly testing. Conclusions: Associations of increasing age and worse deprivation index were associated with unwillingness-in-principle to participate despite the provision of hardware’ highlighting the potential for inequality with interventions of the kind evaluated. Translational Relevance: The clear evidence of inequalities in participation should prompt future research on ways to encourage adoption of mobile health technologies by underserved populations.

Background:Most neovascular age-related macular degeneration treatments involve long-term follow-up of disease activity. Home monitoring would reduce the burden on patients and those they depend on for transport, and release clinic appointments for other patients. The study aimed to evaluate three home-monitoring tests for patients to use to detect active neovascular age-related macular degeneration compared with diagnosing active neovascular age-related macular degeneration by hospital follow-up. Objectives:There were five objectives: Estimate the accuracy of three home-monitoring tests to detect active neovascular age-related macular degeneration. Determine the acceptability of home monitoring to patients and carers and adherence to home monitoring. Explore whether inequalities exist in recruitment, participants' ability to self-test and their adherence to weekly testing during follow-up. Provide pilot data about the accuracy of home monitoring to detect conversion to neovascular age-related macular degeneration in fellow eyes of patients with unilateral neovascular age-related macular degeneration. Describe challenges experienced when implementing home-monitoring tests. Design:Diagnostic test accuracy cohort study, stratified by time since starting treatment. Setting:Six United Kingdom Hospital Eye Service macular clinics (Belfast, Liverpool, Moorfields, James Paget, Southampton, Gloucester). Participants:Patients with at least one study eye being monitored by hospital follow-up. Reference standard:Detection of active neovascular age-related macular degeneration by an ophthalmologist at hospital follow-up. Index tests:KeepSight Journal: paper-based near-vision tests presented as word puzzles. MyVisionTrack®: electronic test, viewed on a tablet device. MultiBit: electronic test, viewed on a tablet device. Participants provided test scores weekly. Raw scores between hospital follow-ups were summarised as averages. Results:Two hundred and ninety-seven patients (mean age 74.9 years) took part. At least one hospital follow-up was available for 317 study eyes, including 9 second eyes that became eligible during follow-up, in 261 participants (1549 complete visits). Median testing frequency was three times/month. Estimated areas under receiver operating curves were < 0.6 for all index tests, and only KeepSight Journal summary score was significantly associated with the lesion activity (odds ratio = 3.48, 95% confidence interval 1.09 to 11.13, p = 0.036). Older age and worse deprivation for home address were associated with lower participation (χ2 = 50.5 and 24.3, respectively, p < 0.001) but not ability or adherence to self-testing. Areas under receiver operating curves appeared higher for conversion of fellow eyes to neovascular age-related macular degeneration (0.85 for KeepSight Journal) but were estimated with less precision. Almost half of participants called a study helpline, most often due to inability to test electronically. Limitations:Pre-specified sample size not met; participants' difficulties using the devices; electronic tests not always available. Conclusions:No index test provided adequate test accuracy to identify lesion diagnosed as active in follow-up clinics. If used to detect conversion, patients would still need to be monitored at hospital. Associations of older age and worse deprivation with study participation highlight the potential for inequities with such interventions. Provision of reliable electronic testing was challenging. Future work:Future studies evaluating similar technologies should consider: Independent monitoring with clear stopping rules based on test performance. Deployment of apps on patients' own devices since providing devices did not reduce inequalities in participation and complicated home testing. Alternative methods to summarise multiple scores over the period preceding a follow-up. Trial registration:This trial is registered as ISRCTN79058224. Funding:This award was funded by the National Institute of Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 15/97/02) and is published in full in Health Technology Assessment; Vol. 28, No. 32. See the NIHR Funding and Awards website for further award information.

ImportanceMost neovascular age-related macular degeneration (nAMD) treatments involve long-term follow-up of disease activity. Home-monitoring would reduce the burden on patients and their caregivers and release clinic capacity.ObjectiveTo evaluate 3 vision home-monitoring tests for patients to use to detect active nAMD compared with diagnosing active nAMD at hospital follow-up during the after-treatment monitoring phase.Design, Setting, and ParticipantsThis was a diagnostic test accuracy study wherein the reference standard was detection of active nAMD by an ophthalmologist at hospital follow-up. The 3 home-monitoring tests evaluated included the following: (1) the KeepSight Journal (KSJ [International Macular and Retinal Foundation]), which contains paper-based near-vision tests presented as word puzzles, (2) the MyVisionTrack (mVT [Genentech]) vision-monitoring mobile app, viewed on an Apple mobile operating system–based device, and (3) the MultiBit (MBT [Visumetrics]) app, viewed on an Apple mobile operating system–based device. Participants were asked to test weekly; mVT and MBT scores were transmitted automatically, and KSJ scores were returned to the research office every 6 months. Raw scores between hospital follow-ups were summarized as averages. Patients were recruited from 6 UK hospital eye clinics and were 50 years and older with at least 1 eye first treated for active nAMD for at least 6 months or longer to a maximum of 42 months before approach. Participants were stratified by time since starting treatment. Study data were analyzed from May to September 2021.ExposuresThe KSJ, mVT, and MBT were compared with the reference standard (in-hospital ophthalmologist examination).Main Outcomes and MeasuresEstimated area under receiver operating characteristic curve (AUROC). The study had 90% power to detect a difference of 0.06, or 80% power to detect a difference of 0.05, if the AUROC for 2 tests was 0.75.ResultsA total of 297 patients (mean [SD] age, 74.9 [6.6] years; 174 female [58.6%]) were included in the study. At least 1 hospital follow-up was available for 312 study eyes in 259 participants (1549 complete visits). Median (IQR) home-monitoring testing frequency was 3 (1-4) times per month. Estimated AUROC was less than 0.6 for all home-monitoring tests, and only the KSJ summary score was associated with lesion activity (odds ratio, 3.48; 95% CI, 1.09-11.13; P = .04).Conclusions and RelevanceResults suggest that no home-monitoring vision test evaluated provided satisfactory diagnostic accuracy to identify active nAMD diagnosed in hospital eye service follow-up clinics. Implementing any of these evaluated tests, with ophthalmologists only reviewing test positives, would mean most active lesions were missed, risking unnecessary sight loss.

The iMPAKT App has been developed as a digital tool for implementing and measuring person- centredness in nursing and midwifery practice. Despite its potential usefulness for the collection of person-centred measures, appropriate strategies are required to enhance the implementation of the app. To better understand the factors affecting adoption and maintenance, this protocol describes a multi-methods study to examine the experience of using the iMPAKT App in different contexts and settings. A convergent, multiple-methods approach will be used. Nurses and midwifes working in teams at different study sites in the UK and Australia will use the app during two, six-week cycles of data collection. Qualitative interviews and focus groups, guided by the Consolidated Framework for Implementation Research (CFIR) will be used to explore individual responses, views and experiences around acceptability and engagement with the app, and to examine variations in contexts. Quantitative data will be gathered on the number of person-centred measures recorded during the data collection cycles and using the System Usability Scale. Results will help to develop an understanding of the determinants and processes underpinning successful implementation, and inform further research to develop tailored implementation strategies, aimed at facilitating large scale collection of data on person- centred measures using the iMPAKT App.### Competing Interest StatementThe authors have declared no competing interest.### Funding StatementYes### Author DeclarationsI confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.YesThe details of the IRB/oversight body that provided approval or exemption for the research described are given below:Ethical approval for the study Approval for the study was granted by the Nursing and Health Research Ethics Filter Committee at Ulster University (Reference: FCNUR-24-011).I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.YesI understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).YesI have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.YesDeidentified research data will be made publicly available when the study is completed and published.

ObjectivesRemote monitoring of health has the potential to reduce the burden to patients of face-to-face appointments and make healthcare more efficient. Apps are available for patients to self-monitor vision at home, for example, to detect reactivation of age-related macular degeneration (AMD). Describing the challenges when implementing apps for self-monitoring of vision at home was an objective of the MONARCH study to evaluate two vision-monitoring apps on an iPod Touch (Multibit and MyVisionTrack).DesignDiagnostic Test Accuracy study.SettingSix UK hospitals.MethodsThe study provides an example of the real-world implementation of such apps across health sectors in an older population. Challenges described include the following: (1) frequency and reason for incoming calls made to a helpline and outgoing calls made to participants; (2) frequency and duration of events responsible for the tests being unavailable; and (3) other technical and logistical challenges.ResultsPatients (n=297) in the study were familiar with technology; 252/296 (85%) had internet at home and 197/296 (67%) had used a smartphone. Nevertheless, 141 (46%) called the study helpline, more often than anticipated. Of 435 reasons for calling, all but 42 (10%) related to testing with the apps or hardware, which contributed to reduced adherence. The team made at least one call to 133 patients (44%) to investigate why data had not been transmitted. Multibit and MyVisionTrack apps were unavailable for 15 and 30 of 1318 testing days for reasons which were the responsibility of the app providers. Researchers also experienced technical challenges with a multiple device management system. Logistical challenges included regulations for transporting lithium-ion batteries and malfunctioning chargers.ConclusionsImplementation of similar technologies should incorporate a well-resourced helpline and build in additional training time for participants and troubleshooting time for staff. There should also be robust evidence that chosen technologies are fit for the intended purpose.Trial registration numberISRCTN79058224.

AbstractBackgroundThe COVID‐19 pandemic, caused by the SARS‐CoV‐2 virus, has resulted in illness, deaths and societal disruption on a global scale. Societies have implemented various control measures to reduce transmission of the virus and mitigate its impact. Individual behavioural changes are crucial to the successful implementation of these measures. One commonly recommended measure to limit risk of infection is face covering. It is important to identify those factors that can predict the uptake and maintenance of face covering.ObjectivesWe aimed to identify and synthesise the evidence on malleable psychological and psychosocial factors that determine uptake and adherence to face covering aimed at reducing the risk of infection or transmission of COVID‐19.Search MethodsWe searched various literature sources including electronic databases (Medline ALL, Child Development & Adolescent Studies, ERIC, PsycInfo, CINAHL & Web of Science), web searches, conference proceedings, government reports, other repositories of literature and grey literature. The search strategy was built around three concepts of interest including (1) context (terms relating to COVID19), (2) behaviour of interest and (3) terms related to psychological and psychosocial determinants of COVID Health‐Related Behaviours and adherence or compliance with face covering, to capture malleable determines. Searches capture studies up until October 2021.Selection CriteriaEligibility criteria included observational studies (both retrospective and prospective) and experimental studies that measure and report malleable psychological and psychosocial determinants and handwashing at an individual level, amongst the general public. Screening was supported by the Cochrane Crowd. Studies titles and abstracts were screened against the eligibility criteria by three independent screeners. Following this, all potentially relevant studies were screened at full‐text level by the research team. All conflicts between screeners were resolved by discussion between the core research team.Data Collection and AnalysisAll data extraction was managed in EPPI‐Reviewer software. All eligible studies, identified through full‐text screening were extracted by one author. We extracted data on study information, population, determinant, behaviour and effects. A second author checked data extraction on 20% of all included papers. All conflicts were discussed by the two authors until consensus was reached. We assessed methodological quality of all included studies using an adapted version of the Joanna Briggs Institute Quality appraisal tool for cross‐sectional studies.Main ResultsOur initial searches yielded 23,587 results, of which 23 were included in this review. The included studies were cross‐sectional in design, came from nine countries and had a combined sample of 54,401 participants. The vast majority of studies had samples from the general public, with five of the studies focusing on specific samples. All included studies considered people over the age of 18. The quality of 10 of the studies was rated as unclear, 10 were rated as low, and 3 rated high risk of bias, predominately due to lack of reporting of recruitment, sample characteristics and methodology. Ten studies were included in the meta‐analysis and 16 in the narrative synthesis. Findings from the meta‐analysis indicated that knowledge of COVID‐19 (0.341, 95% confidence interval [CI] = 0.06, 0.530, I2 = 100%) was the malleable determinant most associated with face covering behaviour. Perceived susceptibility of COVID‐19 (r = 0.088, 95% CI = −0.004, 0.180, I2 = 80%) and COVID‐related worry and anxiety (r = 0.064, 95% CI = −0.066, 0.191, I2 = 93% had little to no effect on face covering behaviour. In the narrative synthesis, the strongest association was found between perceived benefits and effectiveness of behaviours and mask wearing behaviour.Authors' ConclusionsUnderstanding the effects of various malleable determinants on COVID‐related face covering can aid in the development and implementation of interventions and public health campaigns to promote face covering behaviour in potential new waves of COVID‐19 or other respiratory infections. Knowledge of COVID and perceived benefits of face coverings warrant further consideration in future research and policy.

Abstract Background The COVID‐19 pandemic, caused by the SARS‐CoV‐2 virus, has resulted in illness, deaths and societal disruption on a global scale. Societies have implemented various control measures to reduce transmission of the virus and mitigate its impact. Individual behavioural changes are crucial to the successful implementation of these measures. Common recommended measures to limit risk of infection include frequent handwashing, reducing the frequency of social interactions and the use of face coverings. It is important to identify those factors that can predict the uptake and maintenance of these protective behaviours. Objectives We aimed to identify and map the existing evidence (published and unpublished) on psychological and psychosocial factors that determine uptake and adherence to behaviours aimed at reducing the risk of infection or transmission of COVID‐19. Search Methods Our extensive search included electronic databases (n = 12), web searches, conference proceedings, government reports, other repositories including both published peer reviewed, pre‐prints and grey literature. The search strategy was built around three concepts of interest including (1) context (terms relating to COVID‐19), (2) behaviours of interest and (3) terms related to psychological and psychosocial determinants of COVID Health‐Related Behaviours and adherence or compliance with recommended behaviours, to capture both malleable and non‐malleable determinants (i.e. determinants that could be changed and those that could not). Selection Criteria This Evidence and Gap Map (EGM) includes all types of studies examining determinants of common recommended behaviours aimed at mitigating human‐to‐human spread of COVID‐19. All potential malleable and non‐malleable determinants of one or more behaviours are included in the map. As part of the mapping process, categories are used to group determinants. The mapping categories were based on a previous rapid review by Hanratty 2021. These include: ‘behaviour’, ‘cognition’, ‘demographics’, ‘disease’, ‘emotions’, ‘health status’, ‘information’, ‘intervention’, and ‘knowledge’. Those not suitable for categorisation in any of these groups are included in the map as ‘other’ determinants. Data Collection and Analysis Results were imported to a bibliographic reference manager where duplications of identical studies gathered from multiple sources were removed. Data extraction procedures were managed in EPPI‐Reviewer software. Information on study type, population, behaviours measured and determinants measured were extracted. We appraised the methodological quality of systematic reviews with AMSTAR‐2. We did not appraise the quality of primary studies in this map. Main Results As of 1 June 2022 the EGM includes 1034 records reporting on 860 cross‐sectional, 68 longitudinal, 78 qualitative, 25 reviews, 62 interventional, and 39 other studies (e.g., mixed‐methods approaches). The map includes studies that measured social distancing (n = 487), masks and face coverings (n = 382), handwashing (n = 308), physical distancing (n = 177), isolation/quarantine (n = 157), respiratory hygiene/etiquette (n = 75), cleaning surfaces (n = 59), and avoiding touching the T‐zone (n = 48). There were 333 studies that assessed composite measures of two or more behaviours. The largest cluster of determinants was ‘demographics’ (n = 730 studies), followed by ‘cognition’ (n = 496 studies) and determinants categorised as ‘other’ (n = 447). These included factors such as ‘beliefs’, ‘culture’ and ‘access to resources’. Less evidence is available for some determinants such as ‘interventions’ (n = 99 studies), ‘information’ (n = 101 studies), and ‘behaviour’ (149 studies). Authors' Conclusions This EGM provides a valuable resource for researchers, policy‐makers and the public to access the available evidence on the determinants of various COVID‐19 health‐related behaviours. The map can also be used to help guide research commissioning, by evidence synthesis teams and evidence intermediaries to inform policy during the ongoing pandemic and potential future outbreaks of COVID‐19 or other respiratory infections. Evidence included in the map will be explored further through a series of systematic reviews examining the strength of the associations between malleable determinants and the uptake and maintenance of individual protective behaviours.

Alcohol: Clinical and Experimental ResearchAccepted Articles COMMENTARY Response to commentary on: “Fat-free mass accounts for most of the variance in alcohol elimination rate in women” Neda Seyedsadjadi, Neda Seyedsadjadi orcid.org/0000-0002-4231-7001 Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois, USASearch for more papers by this authorVijay A. Ramchandani, Vijay A. Ramchandani orcid.org/0000-0003-2474-2183 Human Psychopharmacology Laboratory, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, USASearch for more papers by this authorMartin H. Plawecki, Martin H. Plawecki orcid.org/0000-0003-0708-9514 Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USASearch for more papers by this authorAnn E. K. Kosobud, Ann E. K. Kosobud Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USASearch for more papers by this authorSean O'Connor, Sean O'Connor orcid.org/0000-0001-5427-243X Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USASearch for more papers by this authorBlair Rowitz, Blair Rowitz Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA Department of Surgery, Carle Foundation Hospital, Urbana, Illinois, USASearch for more papers by this authorMarta Yanina Pepino, Corresponding Author Marta Yanina Pepino [email protected] orcid.org/0000-0003-2381-1095 Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA Correspondence Marta Yanina Pepino, Ph.D., Department of Food Science and Human Nutrition and Division of Nutritional Sciences, College of Agricultural, Consumer and Environmental Sciences, Health Innovation Professor Carle Illinois College of Medicine; University of Illinois at Urbana-Champaign, 905 South Goodwin Avenue, Urbana, IL 61801, USA. Email: [email protected]Search for more papers by this author Neda Seyedsadjadi, Neda Seyedsadjadi orcid.org/0000-0002-4231-7001 Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois, USASearch for more papers by this authorVijay A. Ramchandani, Vijay A. Ramchandani orcid.org/0000-0003-2474-2183 Human Psychopharmacology Laboratory, Division of Intramural Clinical and Biological Research, National Institute on Alcohol Abuse and Alcoholism, Bethesda, Maryland, USASearch for more papers by this authorMartin H. Plawecki, Martin H. Plawecki orcid.org/0000-0003-0708-9514 Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USASearch for more papers by this authorAnn E. K. Kosobud, Ann E. K. Kosobud Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USASearch for more papers by this authorSean O'Connor, Sean O'Connor orcid.org/0000-0001-5427-243X Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana, USASearch for more papers by this authorBlair Rowitz, Blair Rowitz Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA Department of Surgery, Carle Foundation Hospital, Urbana, Illinois, USASearch for more papers by this authorMarta Yanina Pepino, Corresponding Author Marta Yanina Pepino [email protected] orcid.org/0000-0003-2381-1095 Department of Food Science and Human Nutrition, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA Division of Nutritional Sciences, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA Carle Illinois College of Medicine, University of Illinois at Urbana-Champaign, Urbana, Illinois, USA Correspondence Marta Yanina Pepino, Ph.D., Department of Food Science and Human Nutrition and Division of Nutritional Sciences, College of Agricultural, Consumer and Environmental Sciences, Health Innovation Professor Carle Illinois College of Medicine; University of Illinois at Urbana-Champaign, 905 South Goodwin Avenue, Urbana, IL 61801, USA. Email: [email protected]Search for more papers by this author First published: 05 July 2023 https://doi.org/10.1111/acer.15142 This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi:10.1111/acer.15142. AboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Accepted ArticlesAccepted, unedited articles published online and citable. 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BACKGROUND:Understanding how blood alcohol concentrations (BAC) achieved after drinking are determined is critical to predicting alcohol exposure to the brain and other organs and alcohol's effects. However, predicting end-organ exposures is challenging, as there is wide variation in BAC achieved after drinking a specified volume of alcohol. This variation is partly due to differences in body composition and alcohol elimination rates (AER), but there are limited data on how obesity affects AER. Here, we assess associations between obesity, fat-free mass (FFM), and AER in women and examine whether bariatric surgeries, which are linked to an increased risk of alcohol misuse, affect these associations. METHODS:We analyzed data from three studies that used similar intravenous alcohol clamping procedures to estimate AER in 143 women (21 to 64 years old) with a wide range of body mass index (BMI; 18.5 to 48.4 kg/m2 ). Body composition was measured in a subgroup using dual-energy X-ray absorptiometry (n = 42) or Bioimpedance (n = 60), and 19 of the women underwent bariatric surgery 2.1 ± 0.3 years before participation. We analyzed data using multiple linear regression analyses. RESULTS:Obesity and older age were associated with a faster AER (BMI: rs  = 0.70 and age: rs  = 0.61, both p < 0.001). Compared to women with normal weight, AER was 52% faster (95% Confidence Interval: 42% to 61%) in women with obesity. However, BMI lost predictive value when adding fat-free mass (FFM) to the regression model. Age, FFM, and its interaction explained 72% of individual variance in AER (F (4, 97) = 64.3, p < 0.001). AER was faster in women with higher FFM, particularly women in the top tertile of age. After controlling for FFM and age, bariatric surgery was not associated with differences in AER (p = 0.74). CONCLUSIONS:Obesity is associated with a faster AER, but this association is mediated by an obesity-related increase in FFM, particularly in older women. Previous findings of a reduced alcohol clearance following bariatric surgery compared with prior to surgery are likely explained by a reduction in FFM post-surgery.

Tennis is a multidirectional high-intensity intermittent sport for male and female individuals played across multiple surfaces. Although several studies have attempted to characterise the physical demands of tennis, a meta-analysis is still lacking. We aimed to describe and synthesise the physical demands of tennis across the different court surfaces, performance levels and sexes. PubMed, Embase, CINAHL and SPORTDiscus were searched from inception to 19 April, 2022. A backward citation search was conducted for included articles using Scopus. The PECOS framework was used to formulate eligibility criteria. Population: tennis players of regional, national or international playing levels (juniors and adults). Exposure: singles match play. Comparison: sex (male/female), court surface (hard, clay, grass). Outcome: duration of play, on-court movement and stroke performance. Study design: cross-sectional, longitudinal. Pooled means or mean differences with 95 https://doi.org/10.17605/OSF.IO/MDWFY ).