BACKGROUND: Nearly all insectivorous bats (Chiroptera) are strictly nocturnal, flying and feeding only between sunset and sunrise despite lower insect availability than by day, most likely to avoid predation by diurnal birds. This may represent a great challenge to bats living north of the Arctic Circle, which are exposed to bright nights in the period of the midnight sun. The northern bat Eptesicus nilssonii was studied at different latitudes in Norway (69, 66 and 58°N) by three techniques; visual counts of exits from and returns to roosts, infrared detection with a datalogger and an ultrasound data recorder, to reveal how their activity varied across latitude, season, and night, as well as across light levels. How does a nocturnal bat adjust to perpetual light and what light levels are tolerated?
RESULTS: In the north the bats\' active season lasted 2.5 months, 1.5 months shorter than in the south. The bats only flew in 3-4 weeks of midnight sun, and hardly ever left the roost until the sun went behind a hill in the evening. In addition, the timing of their nightly hunting was highly influenced by the darkness of the sky, and they very rarely flew in light levels above 200 foot-candles (FC). As the night became darker than twilight from early August, the bats restricted their activity to between sunset and sunrise. This was the normal situation in southern Norway, where the bats tracked sunset and sunrise throughout the entire season. Those bats appeared to prefer light levels below 100-50 FC and hence, also did fly in twilight conditions.
CONCLUSIONS: The willingness to fly in twilight by the southern population may be a prerequisite to the northern bat\'s survival in the land of the midnight sun. These bats must accept short nights in the first part of their summer season and must be willing to fly in light levels 2-4 times higher than in the south. Most likely, this depends on a reduced predation risk and good abundance of insects at night.

To determine the incidence of inflammatory bowel disease (IBD) in the Mackay-Isaac-Whitsunday region in Northern Queensland (-21.14° S) and to allow a comparison with Southern Australian and New Zealand data (Geelong, Australia -38.14° S; Tasmania -41.43° S and -42.88° S (Launceston and Hobart) and Canterbury, New Zealand -43.46 °S).
A prospective observational community population-based IBD study was conducted between 1 June 2017 and 31 May 2018.
Primary includes the crude annual incidence rate of IBD, Crohn\'s disease (CD), ulcerative colitis (UC) and inflammatory bowel disease-unclassified (IBDU), while secondary includes disease phenotype and behaviour.
Fifty-six new cases of IBD were identified. Twenty-three were CD, 30 were UC and 3 were IBDU. The crude annual incidence rate per 100 000 for IBD, CD, UC and IBDU were 32.2 (95% confidence interval (CI): 24.78-41.84), 13.23 (95% CI: 8.79-19.90), 17.25 (95% CI: 12.06-24.67) and 1.73 (95% CI: 0.56-5.35). When directly age-standardised to the World Health Organisation Standard Population Distribution, the overall CD, UC and IBDU incidence were 13.19, 17.34 and 1.85 per 100 000, with an overall age-standardised IBD incidence of 32.38.
This is the first study to define the incidence of IBD in a Northern Australian cohort and to allow a comparison between North and Southern Australia. The IBD crude is the highest reported in Australia. Like others, we found a high and low incidence of upper gastrointestinal Crohn\'s disease and complicated disease at diagnosis respectively, likely reflective of the increased availability and early uptake of endoscopic procedures.

During the coronavirus disease-2019 (COVID-19) pandemic there were several barriers to treatment access and medication adherence in rheumatoid arthritis (RA) patients. There is no information regarding the RA patient health status in Egypt during the COVID-19. Thus,the aim of this work was to study the impact of the pandemic on RA patients through a patient-reported questionnaire and to determine the influence of gender, geographic regions. This multi-centre study initiated by the Egyptian College of Rheumatology (ECR) was conducted on 1037 RA patients attending rheumatology clinics from 10 governorates. The questionnaire provided covered socio-demographic data, health/disease status, information/knowledge about COVID-19 and medical/family history of the infection. Patients mean age was 44.2 ± 12.3 years;855 females and 182 males; 539(52%) from rural and 497(48%) from urban areas. 41.8% reported a striking difficulty to obtain hydroxychloroquine during the pandemic. The majority (70%) considered maintaining a regular visit to the rheumatologist in addition to remote contact mainly by phone (44.4%) or via WhatsApp (33.1%), in particular among male and urban patients. Urban patients were more likely to be infected by COVID-19 (12.9% vs 6.2%; p < 0.0001) than rural. Northern cities had more patients with suspected COVID-19 (13.9% vs 6.1%; p < 0.0001); was significantly associated with more disease flares (30.8% vs 5.8%) with subsequent change in the RA treatment (20.9% vs 6.4%; p < 0.0001). Patients with RA faced remarkable difficulty to obtain their medications with subsequent change in their disease status. The challenges of the pandemic have hastened changes in the way we deliver health care.

BACKGROUND: We report on the correlation between the proportion of people who fulfil the recommended amount of aerobic physical activity in the general population and the prevalence of frailty or prefrailty in the population ≥65 years in 11 European countries (Austria, Czech Republic, Denmark, Estonia, France, Germany, Italy, Luxembourg, Slovenia, Spain and Sweden). In a subgroup analysis, it was assessed if people who do aerobic physical activity also do strength training.
METHODS: Aggregated physical activity data were taken from the European Health Interview Survey with the minimum effective sample size of 90,036 participants. Data on frailty status were taken from the Survey of Health Ageing and Retirement in Europe (SHARE) study (N = 24,590). For the subgroup analysis, data of the Austrian Health Interview Survey (ATHIS) (N = 15,770) were included.
RESULTS: The results indicate a significant negative correlation between the proportion of people fulfilling the minimal aerobic physical activity recommendations (≥150 min/week) and the proportion of prefrail or frail people (R = -0.745; p = 0.008). The correlation between the optimal aerobic physical activity recommendations (≥300 min/week) and the proportion of prefrail or frail individuals was R = -0.691 (p = 0.019). In both data sets a north-south gradient was seen. Austrian data showed that 52.0% of the participants fulfilled the minimal aerobic physical activity recommendations and conducted strength training, whereas 18.4% did not fulfil the aerobic recommendations but performed strength training (p < 0.001).
CONCLUSIONS: By taking into account that the number of people ≥65 years will increase in the future these results may be relevant in planning public health interventions for the whole population with the goal of reducing frailty in the elderly.