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Combining original historical research with literary analysis, Adam Barrows takes a provocative look at the creation of world standard time in 1884 and rethinks the significance of this remarkable moment in modernism for both the processes of imperialism and for modern literature. As representatives from twenty-four nations argued over adopting the Prime Meridian, and thereby measuring time in relation to Greenwich, England, writers began experimenting with new ways of representing human temporality. Barrows finds this experimentation in works as varied as Victorian adventure novels, high modernist texts, and South Asian novels—including the work of James Joyce, Virginia Woolf, H. Rider Haggard, Bram Stoker, Rudyard Kipling, and Joseph Conrad. Demonstrating the investment of modernist writing in the problems of geopolitics and in the public discourse of time, Barrows argues that it is possible, and productive, to rethink the politics of modernism through the politics of time.

ObjectivesTo describe new WHO 2020 guidelines on physical activity and sedentary behaviour.MethodsThe guidelines were developed in accordance with WHO protocols. An expert Guideline Development Group reviewed evidence to assess associations between physical activity and sedentary behaviour for an agreed set of health outcomes and population groups. The assessment used and systematically updated recent relevant systematic reviews; new primary reviews addressed additional health outcomes or subpopulations.ResultsThe new guidelines address children, adolescents, adults, older adults and include new specific recommendations for pregnant and postpartum women and people living with chronic conditions or disability. All adults should undertake 150–300 min of moderate-intensity, or 75–150 min of vigorous-intensity physical activity, or some equivalent combination of moderate-intensity and vigorous-intensity aerobic physical activity, per week. Among children and adolescents, an average of 60 min/day of moderate-to-vigorous intensity aerobic physical activity across the week provides health benefits. The guidelines recommend regular muscle-strengthening activity for all age groups. Additionally, reducing sedentary behaviours is recommended across all age groups and abilities, although evidence was insufficient to quantify a sedentary behaviour threshold.ConclusionThese 2020 WHO guidelines update previous WHO recommendations released in 2010. They reaffirm messages that some physical activity is better than none, that more physical activity is better for optimal health outcomes and provide a new recommendation on reducing sedentary behaviours. These guidelines highlight the importance of regularly undertaking both aerobic and muscle strengthening activities and for the first time, there are specific recommendations for specific populations including for pregnant and postpartum women and people living with chronic conditions or disability. These guidelines should be used to inform national health policies aligned with the WHO Global Action Plan on Physical Activity 2018–2030 and to strengthen surveillance systems that track progress towards national and global targets.

Poor water sanitation and hygiene (WASH) in health care facilities increases hospital-associated infections, and the resulting greater use of second-line antibiotics drives antimicrobial resistance. Recognising the existing gaps, the World Health Organisations' Water and Sanitation for Health Facility Improvement Tool (WASH-FIT) was designed for self-assessment. The tool was designed for small primary care facilities mainly providing outpatient and limited inpatient care and was not designed to compare hospital performance. Together with technical experts, we worked to adapt the tool for use in larger facilities with multiple inpatient units (wards), allowing for comparison between facilities and prompt action at different levels of the health system. We adapted the existing facility improvement tool (WASH-FIT) to create a simple numeric scoring approach. This is to illustrate the variation across hospitals and to facilitate monitoring of progress over time and to group indicators that can be used to identify this variation. Working with stakeholders, we identified those responsible for action to improve WASH at different levels of the health system and used piloting, analysis of interview data to establish the feasibility and potential value of the WASH Facility Survey Tool (WASH-FAST) to demonstrate such variability. We present an aggregate percentage score based on 65 indicators at the facility level to summarise hospitals' overall WASH status and how this varies. Thirty-four of the 65 indicators spanning four WASH domains can be assessed at ward level enabling within hospital variations to be highlighted. Three levels of responsibility for WASH service monitoring and improvement were identified with stakeholders: the county/regional level, senior hospital management and hospital infection prevention and control committees. We propose WASH-FAST can be used as a survey tool to assess, measure and monitor the progress of WASH in hospitals in resource-limited settings, providing useful data for decision making and tracking improvements over time.

The WHO recently released a BK virus (BKV) international standard. This study evaluated the WHO international standard and commercially available BKV standards by quantitative real-time PCR (qPCR) and droplet digital PCR (ddPCR). WHO, Exact Diagnostics, Acrometrix, and Zeptometrix BKV standards were tested by qPCR and ddPCR. Two preparations of NIST BKV clones were also tested. Nucleic acid was extracted with the Roche MP96 and MPLC, followed by quantification in duplicate. To resolve discrepancies, we sequenced the WHO and NIST materials. Manufacturers' expected copies/mL were close to WHO IU/mL: linear regression of qPCR data revealed 1.12 Exact copies/IU, 0.76 Acrometrix copies/IU, and 0.70 Zeptometrix copies/IU. For ddPCR, similar concentrations were measured when either the VP1 region or the T region was targeted, and concentrations were almost 2-fold higher when both regions were targeted simultaneously. ddPCR results for the VP1 and T regions were similar for all commercial standards, but targeting the T region of the WHO standard led to a 4-fold lower result than the VP1 region. Next-generation sequencing revealed no primer or probe mismatches. However, large differences in coverage across the WHO standard and junctional reads were observed, indicating subpopulations of the WHO standard with deletions in the T region. BKV standards showed concordance among providers, but the WHO standard contains subpopulations of viruses with various deletions in the T region. PCR results will vary depending on which region of the WHO standard is targeted.

The Global Physical Activity Questionnaire (GPAQ) was originally designed to be interviewer-administered by the World Health Organization in assessing physical activity. The main aim of this study was to compare the psychometric properties of a self-administered GPAQ with the original interviewer-administered approach. Additionally, this study explored whether using different accelerometry-based physical activity bout definitions might affect the questionnaire's validity. A total of 110 participants were recruited and randomly allocated to an interviewer- (n = 56) or a self-administered (n = 54) group for test-retest reliability, of which 108 participants who met the wear time criteria were included in the validity study. Reliability was assessed by administration of questionnaires twice with a one-week interval. Criterion validity was assessed by comparing against seven-day accelerometer measures. Two definitions for accelerometry-data scoring were employed: (1) total-min of activity, and (2) 10-min bout. Participants had similar baseline characteristics in both administration groups and no significant difference was found between the two formats in terms of validity (correlations between the GPAQ and accelerometer). For validity, the GPAQ demonstrated fair-to-moderate correlations for moderate-to-vigorous physical activity (MVPA) for self-administration (rs = 0.30) and interviewer-administration (rs = 0.46). Findings were similar when considering 10-min activity bouts in the accelerometer analysis for MVPA (rs = 0.29 vs. 0.42 for self vs. interviewer). Within each mode of administration, the strongest correlations were observed for vigorous-intensity activity. However, Bland-Altman plots illustrated bias toward overestimation for higher levels of MVPA, vigorous- and moderate-intensity activities, and underestimation for lower levels of these measures. Reliability for MVPA revealed moderate correlations (rs = 0.61 vs. 0.63 for self vs. interviewer). Our findings showed comparability between both self- and interviewer-administration modes of the GPAQ. The GPAQ in general but especially the self-administered version may offer a relatively inexpensive method for measuring physical activity of various types and at different domains. However, there may be bias in the GPAQ measurements depending on the overall physical activity. It is advisable to incorporate accelerometers in future studies, particularly when measuring different intensities of physical activity.

An example of a large-scale collaboration that applies a red-team approach is the Psychological Science Accelerator (PSA), a global network of more than 500 psychology laboratories. The PSA has solicited research projects on questions related to the COVID-19 pandemic and has offered to assist with data collection. After researchers develop protocols, the PSA assembles a red team of experts in research ethics, measurement, data analysis and the project's field to offer criticism and to allow researchers to revise their protocols.

During the early phase of the coronavirus disease 2019 (COVID-19) pandemic, design, development, validation, verification and implementation of diagnostic tests were actively addressed by a large number of diagnostic test manufacturers. Hundreds of molecular tests and immunoassays were rapidly developed, albeit many still await clinical validation and formal approval. In this Review, we summarize the crucial role of diagnostic tests during the first global wave of COVID-19. We explore the technical and implementation problems encountered during this early phase in the pandemic, and try to define future directions for the progressive and better use of (syndromic) diagnostics during a possible resurgence of COVID-19 in future global waves or regional outbreaks. Continuous global improvement in diagnostic test preparedness is essential for more rapid detection of patients, possibly at the point of care, and for optimized prevention and treatment, in both industrialized countries and low-resource settings.In this Review, Vandenberg et al. explore the crucial role of diagnostic tests during the first global wave of coronavirus disease 2019 (COVID-19) and the technical and implementation problems encountered during the early phase of the pandemic, and they define future directions for the progressive and better use of diagnostics during a possible resurgence of COVID-19 in future global waves or regional outbreaks.

Based on various diagnostics and corrections established in the framework of several Sunspot Number Workshops and described by Clette et al. ( Space Sci. Rev. 186 , 35, 2014 ), we now assembled all separately derived corrections to produce a new standard version of the reference sunspot-number time series. We explain here the three main corrections and the criteria used to choose a final optimal version of each correction factor or function, given the available information and published analyses. We then discuss the differences between the new corrected series and the original sunspot number, including the disappearance of any significant rising secular trend in the solar-cycle amplitudes after this recalibration. We also introduce the new version management scheme now implemented at the World Data Center Sunspot Index and Long-term Solar Observations (WDC-SILSO), which reflects a major conceptual transition: beyond the rescaled numbers, this first revision of the sunspot number also transforms the former static data archive into a living observational series open to future improvements.

Background Although guideline-directed medical therapy (GDMT) improves outcomes in patients with heart failure with reduced ejection fraction (HFrEF), multiple real-world studies - such as CHAMP-HF (USA) and ASIAN-HF (Asia-Pacific) - have reported that a large proportion of patients fail to reach target doses. This global gap between recommendations and practice highlights the need to better understand country-specific barriers, particularly in low- and middle-income settings such as Vietnam. Methods This cross-sectional study included adult outpatients diagnosed with HFrEF who had received at least three months of continuous therapy at the Heart Failure Clinic, University Medical Center Ho Chi Minh City, between February and August 2023, and aimed to (1) determine the prevalence of use, (2) evaluate typical dosages, and (3) examine the sequence of initiation of foundational therapies in this population. Findings Among 181 patients, 98.9% were prescribed at least one foundational drug class, and 74.6% received all four classes. Patients who did not receive all four therapies were typically older females with higher systolic blood pressure and reduced renal function. SGLT2 inhibitors and MRAs had the highest rates of target dose achievement, whereas ARNI and beta-blockers were more frequently underdosed. Dose escalation was commonly limited by hypotension, advanced age, renal impairment, and low body weight. Notably, 82% of patients were initiated on three or four drug classes concurrently at the start of treatment, most commonly including RAS inhibitors, MRAs, and beta-blockers, with a preference for ARNI over ACE inhibitors or ARBs. Interpretation Foundational therapies were widely prescribed and frequently initiated concurrently in the management of HFrEF at a tertiary care hospital in Vietnam. However, achieving target doses remains a challenge, highlighting the gap between clinical guidelines and real-world practice due to factors such as low blood pressure, advanced age, and renal dysfunction.

The prolonged persistence of toxic arsenic (As) in environment is due to its non-biodegradable characteristic. Meanwhile, several studies have reported higher concentrations of As in Langat River. However, it is the first study in Langat River Basin, Malaysia, that As concentrations in drinking water supply chain were determined simultaneously to predict the health risks of As ingestion. Water samples collected in 2015 from the four stages of drinking water supply chain were analysed for As concentration by inductively coupled plasma mass spectrometry. Determined As concentrations along with the time series data (2004–2015) were significantly within the maximum limit 0.01 mg/L of drinking water quality standard set by World Health Organization. The predicted As concentration by auto-regression moving average was 3.45E−03 mg/L in 2020 at 95% level based on time series data including climatic control variables. Long-term As ingestion via household filtration water at Langat Basin showed no potential lifetime cancer risk (LCR) 9.7E−06 (t = 6.68; p = 3.37E−08) as well as non-carcinogenic hazard quotient (HQ) 4.8E−02 (t = 6.68; p = 3.37E−08) risk at 95% level. However, the changing landscape, ex-mining ponds and extensive use of pesticides for palm oil plantation at Langat Basin are considered as the major sources of increased As concentration in Langat River. Therefore, a two-layer water filtration system at Langat Basin should be introduced to accelerate the achievement of sustainable development goal of getting safe drinking water supply.