Search

Abstract Introduction High-quality evidence is crucial for guiding effective humanitarian responses, yet conducting rigorous research, particularly randomised controlled trials, in humanitarian crises remains challenging. The TISA (“traitement intégré de la sous-nutrition aiguë”) trial aimed to evaluate the impact of a Water, Sanitation and Hygiene (WASH) intervention on the standard national treatment of uncomplicated Severe Acute Malnutrition (SAM) in children aged 6–59 months. Implemented in two northern Senegalese regions from December 22, 2021, to February 20, 2023, the trial faced numerous challenges, which this paper explores along with the lessons learned. Methods The study utilised trial documentation, including field reports, meeting minutes, training plans, operational monitoring data and funding proposals, to retrace the trial timeline, identify challenges and outline implemented solutions. Contributions from all TISA key staff—current and former, field-based and headquarters—were essential for collecting and interpreting information. Challenges were categorised as internal (within the TISA consortium) or external (broader contextual issues). Results The TISA trial, executed by a consortium of academic, operational, and community stakeholders, enrolled over 2000 children with uncomplicated SAM across 86 treatment posts in a 28,000 km2 area. The control group received standard outpatient SAM care, while the intervention group also received a WASH kit and hygiene promotion. Initially planned to start in April 2019 for 12 months, the trial faced a 30-month delay and was extended to 27 months due to challenges like the COVID-19 pandemic, national strikes, health system integration issues and weather-related disruptions. Internal challenges included logistics, staffing, data management, funding and aligning diverse stakeholder priorities. Discussion and conclusion Despite these obstacles, the trial concluded successfully, underscoring the importance of tailored monitoring, open communication, transparency and community involvement. Producing high-quality evidence in humanitarian contexts demands extensive preparation and strong coordination among local and international researchers, practitioners, communities, decision-makers and funders from the study’s inception. Trial registration Clinicaltrials.gov NCT04667767 .

Abstract Background Colon capsule endoscopy (CCE) is a non-invasive alternative to colonoscopy. The reported sensitivity and specificity of CCE for the detection of clinically significant colonic neoplasia is high. To date, there have been no reported cases of colorectal cancer (CRC) missed by CCE which were located in segments adequately visualised by the capsule. Case presentation We present the case of a 71-year-old female, who underwent CCE for new lower gastrointestinal symptoms. The CCE reported 17 polyps (largest size 10 mm) and angiodysplasia. A 40 mm caecal pole tumour, not detected by the CCE, was identified at follow up colonoscopy. Surgical resection was performed, and the pathology sample was reported as moderately differentiated adenocarcinoma, pT2 pN0 (0/19) M0, with no evidence of EMVI. The patient made an uneventful recovery. The caecal pole tumour was not definitively identified on retrospective review of the CCE images. Conclusion To date, this is the first published case of a CRC missed entirely by CCE. Further research is required to allow calculation of the post CCE interval CRC rate to allow comparison with colonoscopy and CT colonogram.

Seaweed cultivation is gaining interest world-wide for both food and non-food applications. Global seaweed aquaculture production currently exceeds 32 Mt WW per annum but is dominated (86% of total) by Asian countries. To meet future demand for seaweed products, regions beyond Asia with aquaculture production potential are being explored. The goal of this study was to assess the suitability of the native kelp Macrocystis pyrifera (Phaeophyceae, Laminariales), for aquaculture in Tasmania, south-eastern Australia. M. pyrifera was cultivated on seeded twine on loops (1 – 5 m depth) along 100-m longlines at two sites (Okehampton Bay and Great Taylor Bay) from April-November 2020. Temporal and spatial variability in (1) yield (kg m-1, WW), (2) biofouling (% coverage), and (3) biochemical composition (including proximate composition, fatty acids, dietary minerals, heavy metal profiling, C, N, H, S concentrations and C:N ratio, antioxidants (phenolic compounds), and pigments (Chl-a, Chl-c, fucoxanthin)) was compared amongst the two cultivation sites, at two depths (1 and 5 m) from harvests between July – November 2020. Yield (kg m-1, WW) did not significantly change across harvest times, but was greater at a depth of 1 m compared to 5 m. Biofouling on the kelp blades increased significantly in early spring (September). The biochemical composition of the cultured biomass varied over time, between sites and with depth for most of the compounds analysed. Higher lipid, protein and ash content was reported for cultures cultivated at Okehampton Bay compared to Great Taylor Bay and at 5 m compared to 1 m depth, and levels of these macronutrients decreased during the harvest period. The iodine content was slightly above the tolerable content for dried seaweed products in Australia and New Zealand. The combined results of yield, biofouling, and biochemical composition suggest that, for an April deployment at the sites investigated, M. pyrifera should be harvested in July-August (mid to late winter) to optimise yield and quality of the cultured kelp biomass. These findings provide a better understanding of the variation in growth and quality of cultivated M. pyrifera biomass in the region, and inform future management and development of kelp aquaculture in south-eastern Australia and in a global context.

The film Sunset Limited is an HBO adaptation of Cormac McCarthy’s play of the same name, and it is an in-depth character study of two individuals: Black (played by Samuel L. Jackson) and White (played by Tommy Lee Jones). In the beginning of the film, Black has already saved White from committing suicide and they are sitting together at a small, round kitchen table; viewers learn that Black was going to work when he saw White on the train platform about ready to jump in front of the Sunset Limited. Black is a religious Christian and White is an outright atheist; one believes in Jesus Christ and one believes in nothing; one has faith and one has no faith in anything. These ideological standpoints (the lack of an ideology is still an ideology) are the foundation of this text. The focus of Suset Limited is the push and pull between religious belief (Black) and philosophical thought (White), which ultimately will determine whether White stays and decides to live, or goes and decides to take his life. In essence, Sunset Limited is an exercise in rhetoric, in the art of persuasion, and how this artform can be used in both religious and secular conversation. This study of Sunset Limited will devote time to Cormac McCarthy’s connections to religion and philosophy using research about his work; then, there will be an in-depth textual analysis of the film, which will speak to not only who these characters are but also what they want to relay to one another about what they know (rather than what they believe) about the world. Black and White are polar opposites of each other (black and white); what this essay intends to prove is that there are similarities to their thought processes, even if they may not recognize it.

Introduction: Behaviour change interventions have the potential to improve sanitation and hygiene practices in urban settings. However, evidence on which behaviour change interventions have successfully improved sanitation and hygiene practices in urban settings is unclear., Methods: We performed electronic searches across five databases and one grey literature database to identify relevant studies published between January 1, 1990 and November 20, 2023 in English. Eligible study designs included randomised and non-randomised controlled trials with a concurrent control. Studies were eligible for inclusion if they reported a behaviour change intervention for improving sanitation and/or hygiene practices in an urban setting. Individual behaviour change intervention components were mapped to one of nine intervention functions of the capabilities, opportunities, motivations, and behaviour (COM-B) framework. Risk of bias was assessed for each study using an adapted Newcastle-Ottawa scale., Results: After de-duplication, 8249 documents were screened by abstract and title, with 79 documents retrieved for full-text screening. We included 13 studies ranging from low- to high-quality. The behaviour change interventions had mixed effects on sanitation and hygiene practices in urban settings. Specifically, interventions improved latrine quality but not safe child faeces disposal. Interventions often improved handwashing with soap at key times and sometimes increased the presence of soap and water at the handwashing facility, used as a proxy measure for handwashing. There is limited evidence on food hygiene practices. Most behavioural outcomes were measured between 6 and 12 months after intervention implementation, which may undermine the sustainability of behaviour change interventions., Conclusion: Despite overall mixed behavioural effects on sanitation and hygiene practices, behaviour change interventions can improve certain behaviours in urban settings, such as latrine quality improvements and handwashing with soap at the household or compound level. More ambitious behaviour change interventions are needed to reduce disparities in sanitation and hygiene access in urban areas globally., Competing Interests: Declaration of competing interest The authors declare they have no competing interests., (Copyright © 2025. Published by Elsevier GmbH.)

Background: Risk prediction models can identify individuals at high risk of chronic liver disease (CLD), but there is limited evidence on the performance of various models in diverse populations. We aimed to systematically review CLD prediction models, meta-analyze their performance, and externally validate them in 0.5 million Chinese adults in the China Kadoorie Biobank (CKB)., Methods: Models were identified through a systematic review and categorized by the target population and outcomes (hepatocellular carcinoma [HCC] and CLD). The performance of models to predict 10-year risk of CLD was assessed by discrimination (C-index) and calibration (observed vs predicted probabilies)., Results: The systematic review identified 57 articles and 114 models (28.4% undergone external validation), including 13 eligible for validation in CKB. Models with high discrimination (C-index ≥ 0.70) in CKB were as follows: (1) general population: Li-2018 and Wen 1-2012 for HCC, CLivD score (non-lab and lab) and dAAR for CLD; (2) hepatitis B virus (HBV) infected individuals: Cao-2021 for HCC and CAP-B for CLD. In CKB, all models tended to overestimate the risk (O:E ratio 0.55-0.94). In meta-analysis, we further identified models with high discrimination: (1) general population (C-index ≥ 0.70): Sinn-2020, Wen 2-2012, and Wen 3-2012 for HCC, and FIB-4 and Forns for CLD; (2) HBV infected individuals (C-index ≥ 0.80): RWS-HCC and REACH-B IIa for HCC and GAG-HCC for HCC and CLD., Conclusions: Several models showed good discrimination and calibration in external validation, indicating their potential feasibility for risk stratification in population-based screening programs for CLD in Chinese adults., Competing Interests: Declarations. Ethics approval and consent to participate: Central ethical approvals were obtained from Oxford University and the China National CDC. Approvals were also obtained from institutional research boards at the local CDCs in the ten areas: Qingdao, Qingdao CDC; Heilongjiang, Provincial CDC; Hainan, Provincial CDC; Jiangsu, Provincial CDC; Guangxi, Provincial CDC; Sichuan, Provincial CDC; Gansu, Provincial CDC; Henan, Provincial CDC; Zhejiang, Provincial CDC; and Hunan, Provincial CDC. The study protocol of the resurvey was approved by the Peking University Institutional Review Board (No. IRB00001052-20040), and separate written informed consent was obtained from all participants before accelerometer data collection. Consent for publication: Not applicable. Competing interests: The authors declare that they have no competing interests., (© 2024. The Author(s).)

Soil-transmitted helminths (STHs) are among the most common human infections worldwide and a major cause of morbidity. They are caused by different species of parasitic worms and transmitted by eggs released in faeces or when hookworm larvae penetrate the skin. The main control strategy in endemic regions is periodic treatment with deworming medication. In the last 10 years, there has been a scale-up of prevention and control activities with a focus on community-based interventions (CBIs). This review aims to systematically analyse the impact of CBIs on the prevalence and infection intensity of STHs. A systematic review was published on this topic in 2014, but there have subsequently been several new studies published which are included in this review. Electronic database search of MEDLINE (Ovid), Global Health Online (Ovid), Cochrane Library, Embase (Ovid) and Web of Science was conducted. Titles, abstracts, and full texts were screened by two independent reviewers according to predefined eligibility criteria. Data were extracted and a meta-analysis of included studies was conducted. A total of 11,954 de-duplicated titles were screened, and 33 studies were included in the review. 14 focussed on community-wide treatment, 11 studies investigated school-based interventions, and 3 studies investigating both. Results suggest that CBIs are effective in reducing the prevalence of Hookworm, Trichuris trichiura and Ascaris lumbricoides. School-based treatment and community-wide treatment, as well as annual and semi-annual deworming, all reduce STH prevalence significantly. Mass drug administration was effective in reducing the infection intensity of Hookworm (Mean difference: -211.36 [95% CI: -519.12, 96.39]), Trichuris trichiura (-736.69 [-1349.97, -123.42]) and Ascaris lumbricoides (-2723.34 [-5014.85, -431.84]). The results suggest that CBIs are effective in reducing the prevalence and intensity of STH infections. While most studies delivered preventive chemotherapy (PC), few studies explored the impact of interventions such as water, sanitation, and hygiene (WASH) or health education, which may be essential in preventing reinfection after PC., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Ugwu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Background: We have previously demonstrated that dietary saturated fatty acids (SFA), when compared to polyunsaturated fatty acids (PUFA), are preferentially partitioned into oxidation pathways. However, it remains unclear if this preferential handling is maintained when hepatocellular metabolism is shifted toward fatty acid (FA) esterification and away from oxidation, such as when hepatic de novo lipogenesis (DNL) is upregulated., Aim: To investigate whether an acute upregulation of hepatic DNL influences dietary FA partitioning into oxidation pathways., Methods: 20 healthy volunteers (11 females) underwent a fasting baseline visit followed by two study days, 2-weeks apart. Prior to each study day, participants consumed an isocaloric high-carbohydrate diet (to upregulate hepatic DNL) for 3-days. On the two study days, participants consumed an identical standardised test meal that contained either [U 13 C]palmitate or [U 13 C]linoleate, in random order, to trace the fate of dietary FA. Blood and breath samples were collected over a 6h postprandial period and 13 C enrichment in breath CO 2 and plasma lipid fractions were measured using gas-chromatography-combustion-isotope ratio mass spectrometry., Results: Compared to the baseline visit, fasting plasma triglyceride concentrations and markers of hepatic DNL, the lipogenic and stearyl-CoA desaturase indices, were significantly (p < 0.05) increased after consumption of the high-carbohydrate diet. Appearance of 13 C in expired CO 2 and tracer recovery were significantly (p < 0.05) higher after consumption of the meal containing [U 13 C]linoleate compared to [U 13 C]palmitate (5.1 ± 0.5% vs. 3.7 ± 0.4%), respectively. Incorporation of 13 C into the plasma triglyceride and non-esterified fatty acid pool was significantly (p < 0.001) greater for [U 13 C]palmitate compared to [U 13 C]linoleate., Conclusion: Dietary PUFA compared to SFA appear to be preferentially partitioned into oxidation pathways during an acute upregulation of hepatic DNL, thus consumption of a PUFA-enriched diet may help mitigate intrahepatic triglyceride accumulation in individuals at risk of cardiometabolic disease., Competing Interests: Conflict of interest All authors declare no conflict of interest., (Copyright © 2024 Elsevier Ltd and European Society for Clinical Nutrition and Metabolism. All rights reserved.)

This paper presents a study on residual stress measurement in wire-arc additively manufactured (WAAM) titanium samples using the non-destructive method of phased array ultrasonics. The contour method (CM) was used for the verification of the phased array ultrasonic results. This allowed for a comparison of measurement methods to understand the effects on the distribution of residual stress (RS) within Ti-6Al-4V samples and the effectiveness of measurement of residual stress using phased array ultrasonics. From the results of the experiments, the phased array ultrasonic data were found to be in good agreement with the CM results and displayed similar residual stress distributions in the samples. The results of the individual elements of the phased array were also compared and an improvement in accuracy was found. From per-element results, anomalies were found and could be mitigated with the ability to average the results by using phased array ultrasonics. Therefore, based on these results, there is a strong case for the benefits of using phased array ultrasonics as a method of residual stress measurement for WAAM Ti-6Al-4V components over other existing residual stress measurement techniques.

Measles is a highly contagious but vaccine-preventable airborne-transmitted viral infection of which there has been a recent resurgence of cases worldwide over the past year, including in countries such as the UK, which had previously successfully achieved endemic measles elimination through vaccination programmes. Measles is typically a self-limiting illness, but can rarely cause severe, life-threatening disease, particularly when complicated by respiratory or neurological involvement. These severe complications are not typically seen in the absence of immunosuppression. We describe a rare case of severe measles with pneumonitis in an immunocompetent adult necessitating admission to an intensive care unit (ICU)., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Background: Resilience refers to the process of demonstrating better outcomes than would be expected based on the adversity one experienced. Resilience is increasingly measured using a residual approach, which typically assesses adversity and mental health outcomes over a longitudinal timeframe. It remains unknown to what extent such a residual-based measurement of resilience is sensitive to variation in acute stress resilience, a candidate resilience factor., Methods: Fifty-seven emerging adults enrolled in tertiary education completed measures of adversity and emotional experiences. To assess stress recovery, participants were exposed to a lab-based adverse event from which a Laboratory Stress Resilience Index was derived., Results: We derived a residual-based measure of emotional resilience from regressing emotional experience scores onto adversity scores. This residual-based measure of emotional resilience predicted variance in the Laboratory Stress Resilience Index over and above that predicted by both a traditional resilience measure and the emotional experiences measure. These findings suggest that acute stress resilience may be a factor underpinning variation in emotional resilience, and that the residual-based approach to measuring resilience is sensitive to such variation in stress resilience., Competing Interests: Lies Notebaert is an Academic Editor for PeerJ., (© 2024 Notebaert et al.)

Community-led total sanitation (CLTS) is embraced as a key strategy to achieve universal sanitation coverage (Sustainable Development Goal 6.2). Although inclusion is identified as a predictor of CLTS success, people living with disabilities are often excluded from community sanitation programmes and there is limited research exploring CLTS participation amongst people living with disabilities. This study aims to explore the extent to which people living with disabilities participated in a CLTS intervention delivered in rural Malawi using standard approaches. This cross-sectional study was conducted in the Chiradzulu district of Malawi. A household questionnaire was administered to collect information about CLTS participation. Multivariable logistic regression was performed to compare participation in different CLTS activities between households with (n = 80) and without a member with a disability (n = 167), and between household members with (n = 55) and without a disability (n = 226). No difference in CLTS participation was observed at the household-level, but there were marked differences in CLTS participation between household members with and without a disability. Household members without a disability felt they could give more input in triggering activities (OR = 3.72, 95%CI 1.18-11.73), and reported higher participation in the transect walk (OR = 4.03, 95%CI 1.45-11.18), community action planning (OR = 2.89, 95%CI 1.36-6.13), and follow-up visits (OR = 3.37, 95%CI 1.78-6.40) compared to household members with disabilities. There was no difference in the likelihood of being invited to triggering (OR = 0.98, 95%CI 0.41-2.36), attending triggering (OR = 2.09, 95%CI 0.98-4.46), or participating in community mapping (OR = 2.38, 95%CI 0.71-7.98) between household members with and without a disability. This study revealed intra-household inequalities in CLTS participation. To improve participation in CLTS interventions, facilitators should be trained on action steps to make CLTS more inclusive. Further research could include an in-depth analysis of predictors of CLTS participation amongst people living with disabilities, including disability types, severity and age., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Davies et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

This study examines a unique case of a 61-year-old male with a 5-year history of a progressively growing mass above his right shoulder, diagnosed as a dedifferentiated pleomorphic liposarcoma. Using computerized tomography-guided core needle biopsy, the tumour was identified as intermediate to high grade. Surgical removal required preoperative radiotherapy to reduce the size of the tumour. Several unique characteristics set apart this particular case of liposarcoma: its substantial size, its unpredictable growth pattern, its absence of metastasis, and notably, its prolonged period of being untreated. This case report outlines the clinical background, diagnostic procedures, and treatment modalities employed in managing this condition, emphasizing a localized dual therapy approach combining radiotherapy and surgery. Emphasis is placed on distinguishing liposarcoma from lipoblastoma, a benign adipocyte tumour, to facilitate accurate diagnosis and appropriate treatment selection. The positive result achieved in this case could provide valuable insights for the future treatment and management of similarly sized aggressive tumours., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2024 Camilla Linhart and Craig MacLeod.)

Introduction: Medications for opioid use disorder (MOUD) including methadone (MMT), buprenorphine (BUP), and naltrexone (NTX) are safe and effective. However, there are significant negative perceptions surrounding MOUD, creating barriers to uptake. While research on MOUD stigma has largely focused on provider and patient experiences, fewer studies have explored MOUD perceptions among the general public. Given that MOUD stigma expressed by social ties surrounding individuals with OUD can influence treatment choices, we assessed MOUD perceptions among U.S. adults to determine how beliefs impacted treatment preference. We further explored how MOUD perceptions may be amplified among racialized groups with histories of experiencing drug-related discrimination., Methods: The study collected survey data from a diverse sample of U.S. adults (n = 1508) between October 2020 and January 2021. The survey measured knowledge of MOUD and non-medication treatments, relative agreement with common MOUD perceptions, and treatment preferences. Multinomial logistic regression analysis tested associations with treatment preference, stratified by race/ethnicity., Results: Descriptive results indicated that across groups, many respondents (66.8 %) had knowledge of MOUD, but believed MOUD was a "substitute" for opioids and had some degree of concern about misuse. Multivariable results showed knowledge of non-medication treatments was positively associated with MOUD preference among White (MMT OR = 3.16, 95 % CI = 1.35-7.39; BUP OR = 2.69, CI = 1.11-6.47), Black (MMT OR = 3.91, CI = 1.58-9.69), and Latino/a (MMT OR = 5.12, CI = 1.99-13.2; BUP OR = 3.85, CI = 1.5-9.87; NTX OR = 4.51, CI = 1.44-14.06) respondents. Among White respondents, we identified positive associations between MOUD experience and buprenorphine preference (OR = 4.33, CI = 1.17-16.06); non-medication treatment experience and preference for buprenorphine (OR = 2.86, CI = 1.03-7.94) and naltrexone (OR = 3.17, CI = 1.08-9.28). Concerns around misuse of methadone were negatively associated with methadone preference among White (OR = 0.65, CI = 0.43-0.98) and Latino/a (OR = 0.49, CI = 0.34-0.7), and concerns around misuse of buprenorphine was negatively associated with preference for MOUD among White (MMT OR = 0.62, CI = 0.39-0.99; BUP OR = 0.48, CI = 0.3-0.77; NTX OR = 0.6, CI = 0.36-0.99) and Latino/a (BUP OR = 0.59, CI = 0.39-0.89) respondents., Conclusions: This analysis offers critical insights into treatment perceptions beyond the patient population, finding that negative beliefs around MOUD are common and negatively associated with preferences for medication-based treatment. These findings highlight implications for public support of evidence-based treatment and lay the groundwork for future interventions addressing public stigma toward MOUD., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Pooja Lagisetty reports financial support was provided by National Institute on Drug Abuse. Amy Bohnert reports financial support was provided by Blue Cross Blue Shield of Michigan. Amy Bohnert reports financial support was provided by Michigan Department of Health and Human Services. Amy Bohnert reports a relationship with State of Michigan that includes: paid expert testimony. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

The present study examined cognitive mechanisms underpinning the increased tendency of individuals with high trait anxiety to experience inflation of negative affect when approaching potential stressors. Specifically, the roles of (1) disproportionately negative relative to positive expectancies (i.e., negative expectancy bias) and (2) disproportionately interrogating negative relative to positive information (i.e., negative interrogation bias), each concerning the potential stressor, were examined. High and low trait anxiety participants (N = 286) completed the experimental session, in which they were informed they may view a potentially stressful film. As participants approached the putative film viewing, participants' negative and positive affect, as well as their negative and positive expectancies were assessed. Additionally, negative interrogation bias was assessed by providing participants the opportunity to selectively interrogate information from a larger pool of negative and positive information concerning the putative film viewing. Our findings provide evidence indirect associations between trait anxiety and inflation of negative affect is serially mediated via negative interrogation bias and, in turn, negative expectancy bias. Findings are discussed with regards to limitations and potential implications for public health campaigns, and cognitive interventions for anxiety, highlighting the utility of further examining negative interrogation bias as an avenue for improving the efficacy of each., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Cognitive bias modification (CBM) has evolved from an experimental method testing cognitive mechanisms of psychopathology to a promising tool for accessible digital mental health care. While we are still discovering the conditions under which clinically relevant effects occur, the dire need for accessible, effective, and low-cost mental health tools underscores the need for implementation where such tools are available. Providing our expert opinion as Association for Cognitive Bias Modification members, we first discuss the readiness of different CBM approaches for clinical implementation, then discuss key considerations with regard to implementation. Evidence is robust for approach bias modification as an adjunctive intervention for alcohol use disorders and interpretation bias modification as a stand-alone intervention for anxiety disorders. Theoretical predictions regarding the mechanisms by which bias and symptom change occur await further testing. We propose that CBM interventions with demonstrated efficacy should be provided to the targeted populations. To facilitate this, we set a research agenda based on implementation frameworks, which includes feasibility and acceptability testing, co-creation with end-users, and collaboration with industry partners., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This study explores the inspection of bolted connections in wind turbines, specifically focusing on the application of Phased Array Ultrasonic Testing (PAUT). The research comprises four sections: Acoustoelastic Constant calibration, high tension investigation on bolts, blind tests on larger bolts, and Finite Element Analysis (FEA) verification. The methodology shows accurate results for stress while the bolt is under operative loads, and produces a clear indication of when it is above these loads and beginning to deform. PAUT emerges as a promising tool for bolt inspection, offering multiple imaging modes for simultaneous stress monitoring and defect detection. The study advocates for PAUT as a robust method to enhance wind turbine safety, longevity, and future in-situ testing., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background: Photography could be used to train individuals to diagnose trachomatous inflammation-follicular (TF) as trachoma prevalence decreases and to ensure accurate field TF grading in trachoma prevalence surveys. We compared photograph and field TF grading and determined the acceptability and feasibility of eyelid photography to community members and trachoma survey trainers., Methods: A total of 100 children ages 1-9 y were examined for TF in two Maasai villages in Tanzania. Two images of the right everted superior tarsal conjunctiva of each child were taken with a smartphone and a digital single-lens reflex (DSLR) camera. Two graders independently graded all photos. Focus group discussions (FGDs) were conducted with community members and Tropical Data trainers., Results: Of 391 photos, one-fifth were discarded as ungradable. Compared with field grading, photo grading consistently underdiagnosed TF. Compared with field grading, DSLR photo grading resulted in a higher prevalence and sensitivity than smartphone photo grading. FGDs indicated that communities and trainers found photography acceptable and preferred smartphones to DSLR in terms of practicalities, but image quality was of paramount importance for trainers., Conclusions: Photography is acceptable and feasible, but further work is needed to ensure high-quality images that enable accurate and consistent grading before being routinely implemented in trachoma surveys., (© The Author(s) 2023. Published by Oxford University Press on behalf of Royal Society of Tropical Medicine and Hygiene.)

Severe acute malnutrition (SAM) is the most serious form of acute malnutrition and is associated with high mortality risk among children under 5. While the Community-based Management of Acute Malnutrition (CMAM) approach, recommended for treating cases of uncomplicated SAM, has increased treatment coverage and recovery outcomes, high relapse rates have been reported. Several risk factors for SAM relapse, such as insufficient food intake and high infectious disease burden in the community, have been identified. However, the role of household water, sanitation and hygiene (WASH) conditions remains unclear. This systematic review: (1) assesses the effectiveness of WASH interventions on preventing SAM relapse and (2) identifies WASH-related conditions associated with relapse to SAM among children aged 6-59 months discharged as recovered following SAM CMAM treatment. We performed electronic searches of six databases to identify relevant studies published between 1 January 2000 and 6 November 2023 and assessed their quality. After deduplication, 10,294 documents were screened by title and abstract, with 13 retrieved for full-text screening. We included three studies ranging from low- to medium-quality. One intervention study found that providing a WASH kit during SAM outpatient treatment did not reduce the risk of relapse to SAM. Two observational studies found inconsistent associations between household WASH conditions-unimproved sanitation and unsafe drinking water-and SAM relapse. Despite the paucity of evidence, the hypothesised causal pathways between WASH conditions and the risk of relapse remain plausible. Further evidence is needed to identify interventions for an integrated postdischarge approach to prevent relapse., (© 2024 The Authors. Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Background and Objectives: Following engagement in a social event people with heightened vulnerability to social anxiety report elevated levels of negative thinking about the event, and this post-event negative thinking is implicated in the maintenance of social anxiety vulnerability. It has also been established that heightened social anxiety vulnerability is associated with disproportionately negative expectations of upcoming social events. However, contribution of social anxiety-linked pre-event negative expectancy to post-event negative thinking has not been directly investigated. The objective of the present study was to test the hypothesis that the relationship between social anxiety vulnerability and post-event negative thinking is mediated by pre-event negative expectancies that drive increased state anxiety at the time of encountering the event., Methods: One-hundred and ten participants who varied in social anxiety vulnerability completed a simulated job interview. Participants reported negativity of expectancies before the event, state anxiety experienced at the time of encountering the event, and post-event negative thinking across the seven days following the event., Results: Analyses revealed elevated social anxiety predicted increased negative post-event thinking. The association between social anxiety and post-event negative thinking was fully mediated by a mediation pathway involving pre-event negative expectancies and state anxiety at the time of encountering the interview event., Limitations: The study used a laboratory-based social experience, and conclusions could usefully be tested in the context of natural social events., Conclusions: The findings suggest that social anxiety-linked variation in pre-event negative expectancy may contribute to post-event negative thinking following a social event via its impact on state anxiety., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

This study experimentally investigated the role of anticipated enjoyment and effort in mediating dysphoria-related deficit in activity engagement behavioural choice. Using a novel activity information processing task (about a fictional "new" Nintendo Wii sports game called "Tornado Ball"), N = 249 participants (n = 95 High Dysphoria; n = 154 Low Dysphoria) were presented information about the benefits (enjoyable features) and costs (mental and physical effort barriers) as product reviews from another player. The order of cost vs. benefit information was manipulated such that participants either heard cost information before benefit information, or vice versa. They then rated what their anticipated enjoyment and effort will be if they were to play Tornado Ball, before being given the opportunity to choose to try it themselves or not. The High Dysphoria group reported lower anticipated enjoyment (but not higher effort) relative to the Low Dysphoria group, but only when cost information was presented first. Importantly, a moderated mediation showed that the High Dysphoria group reported lower tendency to choose activity engagement (game play) as a function of having lower anticipated enjoyment, but only when cost information was presented first. The present finding indicate that reduced anticipated enjoyment may causally contribute to dysphoria-linked deficits in activity engagement behavioural choice., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Purpose: Negative perceptions around medications for opioid use disorder (MOUD) amongst the public could deter patients with opioid use disorder (OUD) from engaging with MOUD. Thus, we evaluated whether a brief intervention could improve preferences for MOUD in people who may or may not use opioids., Methods: We employed a pre-post design to assess the effect of a brief educational intervention on preferences for methadone, buprenorphine, naltrexone, and non-medication treatment in an online sample of US adults stratified by race, who may or may not use opioids. Respondents ranked their preferences in OUD treatment before and after watching four one-minute educational videos about treatment options. Changes in treatment preferences were analyzed using Bhapkar's test and post hoc McNemar's tests. A binary logistic generalized estimating equation (GEE) assessed factors associated with preference between treatments., Results: The sample had 530 responses. 194 identified as White, 173 Black, 163 Latinx. Treatment preferences changed significantly towards MOUD (p<.001). This effect was driven by changes toward buprenorphine (OR=2.38; p<.001) and away from non-medication treatment (OR=0.20; p<.001). There was no significant difference in effect by race/ethnicity. People with lower opioid familiarity were significantly more likely to change their preferences towards MOUD following the intervention., Conclusion: Respondent preferences for MOUD increased following the intervention suggesting that brief educational interventions can change treatment preferences towards MOUD. These findings offer insights into perceptions of OUD treatment in a racially stratified sample and serve as a foundation for future educational materials that target MOUD preferences in the general public., Competing Interests: There are no conflicts or competing interests to declare., (© 2024 The Authors.)

Introduction: This protocol describes the myTBI study which aims to: (1) develop an online psychoeducation platform for people with traumatic brain injury (TBI), their family members/caregivers, and healthcare staff to improve psychosocial adjustment to TBI across different phases of injury (acute, postacute, and chronic), and (2) undertake an evaluation of efficacy, acceptability, and feasibility., Methods and Analysis: A three-stage mixed-methods research design will be used. The study will be undertaken across four postacute community-based neurorehabilitation and disability support services in Western Australia. Stage 1 (interviews and surveys) will use consumer-driven qualitative methodology to: (1) understand the recovery experiences and psychosocial challenges of people with TBI over key stages (acute, postacute, and chronic), and (2) identify required areas of psychosocial support to inform the psychoeducation platform development. Stage 2 (development) will use a Delphi expert consensus method to: (1) determine the final psychoeducation modules, and (2) perform acceptance testing of the myTBI platform. Finally, stage 3 (evaluation) will be a randomised stepped-wedge trial to evaluate efficacy, acceptability, and feasibility. Outcomes will be measured at baseline, postintervention, follow-up, and at final discharge from services. Change in outcomes will be analysed using multilevel mixed-effects modelling. Follow-up surveys will be conducted to evaluate acceptability and feasibility., Ethics and Dissemination: Ethics approval was granted by North Metropolitan Health Service Mental Health Research Ethics and Governance Office (RGS0000005877). Study findings will be relevant to clinicians, researchers, and organisations who are seeking a cost-effective solution to deliver ongoing psychoeducation and support to individuals with TBI across the recovery journey., Trial Registration Number: ACTRN12623000990628., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

Background and Objectives: Cognitive theories propose that individuals with heightened depression are characterized by biases in memory and interpretation, favoring the processing of negative information. Individuals with heightened depression exhibit a negative memory bias, and this bias is disproportionately evident when emotional information is processed in a self-referential manner. In studies investigating whether individuals with heightened depression exhibit a negative interpretative bias, the measures employed have often been compromised by serious methodological limitations. When interpretation has been measured using an eye-blink modulation approach, which overcomes these limitations, evidence of depression-linked negative interpretive bias has emerged. However, the important issue of whether this bias depends upon self-referential processing has gone unresolved., Method: In the present study, we assessed interpretation using the eye blink modulation approach, in participants scoring high or low on the Beck Depression Inventory-II. A simple manipulation ensured that ambiguous information either was, or was not, processed in a self-referential manner., Results: The results showed that, when ambiguous information was processed in a self-referential manner, participants scoring high on the BDI-II displayed blink magnitudes indicating greater negative interpretative bias compared to participants scoring low on the BDI-II. This was not the case when ambiguous information was processed in an other-referential manner., Limitations: The present findings do not permit the inference that this negative interpretive bias causally contributes to depressive symptomatology., Conclusions: The results support the hypothesis that people with high levels of depression display greater negative interpretive bias than people with low levels of depression, but only when ambiguous information is processed in a self-referential manner., Competing Interests: Declaration of competing interest None., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Recent work has served to dissociate two dimensions of trait body dissatisfaction: body dissatisfaction frequency and body dissatisfaction duration. The present study sought to evaluate whether body dissatisfaction frequency and body dissatisfaction duration are each associated with distinct patterns of appearance-related cognitive processing. It was hypothesized that speeded attentional engagement with idealized bodies is associated with higher frequency of body dissatisfaction episodes, while slowed attentional disengagement from such information may instead be associated with higher duration of body dissatisfaction episodes. Participants (238 women, 149 men) completed an attentional task capable of independently assessing attentional engagement with, and attentional disengagement from, idealized bodies. Participants also completed both trait and in vivo (i.e., ecological momentary assessment) measures of body dissatisfaction frequency and duration. Results showed that neither engagement nor disengagement bias index scores predicted variance in either body dissatisfaction frequency measures or body dissatisfaction duration measures. Findings suggest that either biased attentional engagement with, and disengagement from, idealized bodies do not associate with the frequency and duration of body dissatisfaction episodes, or there are other key moderating factors involved in the expression of body dissatisfaction-linked attentional bias., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)