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An ever-increasing number of workplaces are becoming heat-exposed due to rising temperature extremes. However, a comprehensive review of Canadian safety materials available to support workplaces in managing this critical hazard has not previously been conducted. We undertook a review and a content analysis of heat stress materials on safety-based ministry, association, and agency websites in Canada (n = 155) to identify content related to heat stress (n = 595). Each document was qualitatively analyzed using NVivo. The most dominant components identified were heat stress control measures (n = 492, 83%), training and education (n = 414, 70%), workplaces and workers at risk (n = 361, 61%), exposure limits and monitoring practices (n = 344, 58%), and emergency response and reporting (n = 249, 42%). However, the content within these programming components was highly variable. While we found that organizations across Canada provide heat stress content, there was evidence of inconsistencies and considerable gaps in the availability of material and the strategies presented to control the critical risk posed by heat. [ABSTRACT FROM AUTHOR]

Objectives: The burden of perinatal mental illness is a significant global concern, affecting approximately 10–20% of women at this stage of life. It is well recognised that Rural Australia has far less health services and mental health specialists per capita than metropolitan regions. While women have more babies in rural settings, their access to maternal health care is conversely limited or absent. We highlight the urgent need for research, adaptation of clinical practice guidelines and service development to address the lack of specialist perinatal mental health services for women in rural Australia for emergency episodes of mental ill health in the perinatal period. While telehealth services have been utilised to bridge the gap in service provision, in this paper we articulate the need for innovative research to identify suitable and sustainable models of care in rural settings. Conclusion: Perinatal psychiatric emergencies represent a highly interventional area of psychiatry. Across the spectrum of psychiatric disorders, few can be attributed with such specificity in anticipated time of disease onset and severity of outcome. It is imperative that we address the lack of access to speciality perinatal psychiatric care for women who reside in rural Australia. [ABSTRACT FROM AUTHOR]

The Sc2.0 global consortium to design and construct a synthetic genome based on the Saccharomyces cerevisiae genome commenced in 2006, comprising 16 synthetic chromosomes and a new-to-nature tRNA neochromosome. In this paper we describe assembly and debugging of the 902,994-bp synthetic Saccharomyces cerevisiae chromosome synXVI of the Sc2.0 project. Application of the CRISPR D-BUGS protocol identified defective loci, which were modified to improve sporulation and recover wild-type like growth when grown on glycerol as a sole carbon source when grown at 37˚C. LoxPsym sites inserted downstream of dubious open reading frames impacted the 5' UTR of genes required for optimal growth and were identified as a systematic cause of defective growth. Based on lessons learned from analysis of Sc2.0 defects and synXVI, an in-silico redesign of the synXVI chromosome was performed, which can be used as a blueprint for future synthetic yeast genome designs. The in-silico redesign of synXVI includes reduced PCR tag frequency, modified chunk and megachunk termini, and adjustments to allocation of loxPsym sites and TAA stop codons to dubious ORFs. This redesign provides a roadmap into applications of Sc2.0 strategies in non-yeast organisms. The Sc2.0 project involved synthesis and debugging of 16 chromosomes, and a tRNA neochromosome. Here the authors descript the SynXVI project, accompanied by an analysis of how similar projects could operate with hindsight and newly available technologies, and lessons learned from Sc2.0. [ABSTRACT FROM AUTHOR]

Background: Few studies have examined the associations between pregnancy and birth complications and long‐term (>12 months) maternal mental health outcomes. Objectives: To review the published literature on pregnancy and birth complications and long‐term maternal mental health outcomes. Search strategy: Systematic search of Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (Embase), PsycInfo®, PubMed® and Web of Science from inception until August 2022. Selection criteria: Three reviewers independently reviewed titles, abstracts and full texts. Data collection and analysis: Two reviewers independently extracted data and appraised study quality. Random‐effects meta‐analyses were used to calculate pooled estimates. The Meta‐analyses of Observational Studies in Epidemiology (MOOSE) guidelines were followed. The protocol was prospectively registered on the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022359017). Main results: Of the 16 310 articles identified, 33 studies were included (3 973 631 participants). Termination of pregnancy was associated with depression (pooled adjusted odds ratio, aOR 1.49, 95% CI 1.20–1.83) and anxiety disorder (pooled aOR 1.43, 95% CI 1.20–1.71). Miscarriage was associated with depression (pooled aOR 1.97, 95% CI 1.38–2.82) and anxiety disorder (pooled aOR 1.24, 95% CI 1.11–1.39). Sensitivity analyses excluding early pregnancy loss and termination reported similar results. Preterm birth was associated with depression (pooled aOR 1.37, 95% CI 1.32–1.42), anxiety disorder (pooled aOR 0.97, 95% CI 0.41–2.27) and post‐traumatic stress disorder (PTSD) (pooled aOR 1.75, 95% CI 0.52–5.89). Caesarean section was not significantly associated with PTSD (pooled aOR 2.51, 95% CI 0.75–8.37). There were few studies on other mental disorders and therefore it was not possible to perform meta‐analyses. Conclusions: Exposure to complications during pregnancy and birth increases the odds of long‐term depression, anxiety disorder and PTSD. [ABSTRACT FROM AUTHOR]

The role of biomarkers in risk-based early detection of lung cancer may enable screening to become cost effective and widely accessible. EarlyCDT-Lung is an example of such a blood-based autoantibody biomarker which may improve accessibility to Low dose Computed Tomography (LDCT) screening for those at highest risk. We randomized 12 208 individuals aged 50–75 at high risk of developing lung cancer to either the test or to standard clinical care. Outcomes were ascertained from Register of Deaths and Cancer Registry. Cox proportional hazards models were used to estimate the hazard ratio of the rate of deaths from all causes and lung cancer. Additional analyses were performed for cases of lung cancer diagnosed within two years of the initial test. After 5 years 326 lung cancers were detected (2.7% of those enrolled). The total number of deaths reported from all causes in the intervention group was 344 compared to 388 in the control group. There were 73 lung cancer deaths in the intervention arm and 90 in the controls (Adjusted HR 0.789 (0.636, 0.978). An analysis of cases of lung cancer detected within 2 years of randomization in the intervention group showed that there were 34 deaths from all causes and 29 from lung cancer. In the control group there were 56 deaths with 49 from lung cancer. In those diagnosed with lung cancer within 2 years of randomization the hazard ratio for all cause mortality was 0.615 (0.401,0.942) and for lung cancer 0.598 (0.378, 0.946). Further large-scale studies of the role of biomarkers to target lung cancer screening, in addition to LDCT, are likely to provide additional value. [ABSTRACT FROM AUTHOR]

Objectives: Posttraumatic growth (PTG) is of increased theoretical and clinical interest. However, less is known about PTG in older adults specifically. This systematic review aimed to identify domains where PTG is studied for older adults; investigate factors associated with PTG in older adults; consider how these might differ between historical and later life traumas. Methods: Online databases were searched for quantitative studies examining PTG outcomes in adults aged ≥ 60 years. Results: 15 studies were subject to a narrative synthesis. Conclusions: Older adults can experience substantial levels of PTG, from traumas during later life or across the lifespan, and historical wartime traumas. Traumas can be diverse, some studies found equivalent levels of PTG from different traumas across the lifespan. Social processes may be a key variable for older adults. Additional psychosocial factors are found; however, diverse findings reflect no overall model, and this may be consistent with variations found in other PTG literature. Clinical Implications: Clinical considerations are discussed. As diverse studies, findings may not be widely generalizable and directions for further research are highlighted. PROSPERO: CRD42020169318. [ABSTRACT FROM AUTHOR]

Aircraft gas turbine engines produce Particulate Matter (PM) emissions that have been linked to human health and climate issues, leading to the introduction of regulatory sampling and measurement standards for nonvolatile PM (nvPM) by the International Civil Aviation Organization (ICAO). Due to the significant nvPM losses within the prescribed sampling systems, loss corrections are used. Currently, based on sampling assumptions, electrostatic losses are not included in the standardized loss tool, as it is estimated to account for less than 3% of the total nvPM loss. This study experimentally investigated electrostatic loss of unipolar, bipolar, and naturally charged salt, silver, and carbon black particles at sizes (4–150 nm) and through sampling tubes representative of aircraft nvPM sampling. A unipolar and bipolar charger, along with a tandem SMPS-CPC measurement methodology, were employed to explore the impacts of tube material, Reynolds Number, tube diameter, residence time, and particle charge state on electrostatic loss. Minimal electrostatic loss was measured for conductive stainless steel and extensively bedded-in (above 300 h) carbon-loaded PTFE. However, an additional loss of up to 50% was observed within new cPTFE (with approximately 30 min of bedding-in), attributed to precipitation in an electric field. Furthermore, it was found that electrostatic dispersion could cause significant additional losses at high concentrations of unipolar or bipolar asymmetrically charged particles. Therefore, further research is required to determine the charge state of aircraft nvPM across different aircraft engine conditions to determine if unquantified electrostatic loss could occur within the probe section of the sampling system. [ABSTRACT FROM AUTHOR]

To determine if gender impacts associations between social relationships, socioeconomic, health, and behavioral factors with resilience among older Taiwanese adults. The data were obtained from a National Mental Health Survey conducted in Taiwan. The sample was created using multistage proportional probability. A questionnaire was used to interview participants at their homes. Study participants were ≥65 years. Predictor variables and the outcome, resilience, were clearly defined followed by statistical analysis. High- and low-resilience outcomes of older adults were determined based on the median value of the Friborg's Resilience Scale. An independent-sample t test, χ2, and multivariate logistic regression were used to examine predictors for resilience which were then stratified by gender. Older women were less likely to be resilient than older men. Social relationships, socioeconomic, health, and behavioral factors had both similar and differential impacts on resilience when stratified for gender. The relationships between gender, socioeconomics, health, and social and behavioral factors with resilience provide unique insights into how culture shapes trends in data. [ABSTRACT FROM AUTHOR]

Background: Positive, negative and disorganised psychotic symptom dimensions are associated with clinical and developmental variables, but differing definitions complicate interpretation. Additionally, some variables have had little investigation. Aims: To investigate associations of psychotic symptom dimensions with clinical and developmental variables, and familial aggregation of symptom dimensions, in multiple samples employing the same definitions. Method: We investigated associations between lifetime symptom dimensions and clinical and developmental variables in two twin and two general psychosis samples. Dimension symptom scores and most other variables were from the Operational Criteria Checklist. We used logistic regression in generalised linear mixed models for combined sample analysis (n = 875 probands). We also investigated correlations of dimensions within monozygotic (MZ) twin pairs concordant for psychosis (n = 96 pairs). Results: Higher symptom scores on all three dimensions were associated with poor premorbid social adjustment, never marrying/cohabiting and earlier age at onset, and with a chronic course, most strongly for the negative dimension. The positive dimension was also associated with Black and minority ethnicity and lifetime cannabis use; the negative dimension with male gender; and the disorganised dimension with gradual onset, lower premorbid IQ and substantial within twin-pair correlation. In secondary analysis, disorganised symptoms in MZ twin probands were associated with lower premorbid IQ in their co-twins. Conclusions: These results confirm associations that dimensions share in common and strengthen the evidence for distinct associations of co-occurring positive symptoms with ethnic minority status, negative symptoms with male gender and disorganised symptoms with substantial familial influences, which may overlap with influences on premorbid IQ. [ABSTRACT FROM AUTHOR]

Democratic forms of enterprise and economic governance are needed to help address urgent societal challenges where hierarchical decision‐making and governance approaches are clearly failing. There is insufficient understanding, however, of the capabilities needed by enterprises to implement and sustain organizational democracy in pressurized operational contexts. We focus on the role of collective capabilities, which arise from interactions between individuals to create collaboration and collective benefits. Interview evidence from 12 mutual social enterprises – organizations that trade with a social purpose – is used to explore the learning processes that underpin the generation of collective capabilities for organizational democracy. The analysis leads us to a theoretical model of collective capabilities development that responds to three fundamental areas of challenge: (i) Adaptive design of governance structures and processes, to balance 'bottom‐up' democracy with 'top‐down' stewardship control; (ii) Embedding, extending and revitalizing democracy, by supporting the voice, capabilities and confidence of workers and users to participate in collaborative governance; and (iii) Fostering deliberative learning, to navigate tensions and conflict between plural perspectives and achieve collective aims. In concluding, we reflect on some institutional and cultural barriers to organizational democracy and the case for more concerted policy action to realize its potential as a crucial component of economic democracy. [ABSTRACT FROM AUTHOR]

Aim: Fluoride is widely used in dentistry for its caries prevention. To reduce dental caries, the optimal fluoride concentration of public water supplies in the United States is 0.7 ppm. However, excessive systemic fluoride consumption can lead to dental/enamel fluorosis. Numerous studies have explored the effects of fluoride on enamel and enamel‐forming cells. However, research on systemic fluoride's impact on dentine is limited, particularly the effect of fluoride on the structure of the dentine–pulp complex. Therefore, this study aimed to identify how excessive fluoride affects dentine microstructure using an experimental mouse model. Methodology: C57BL6/J male mice (6–9 weeks old) were randomized into four groups (Fluoride at 0, 50, 100, or 125 ppm in drinking water) (n = 4/group). Mice were provided water ad libitum for 6 weeks along with fluoride‐free food. Thereafter, mandibular incisors were analysed. Enamel phenotypes were evaluated using light microscopy and quantitative light‐induced fluorescence (QLF) to measure fluorosis levels. Dentine morphology was evaluated using micro‐CT, scanning electron microscopy (SEM), SEM–EDX (energy‐dispersive X‐ray), microhardness test and histological imaging. Data were analysed using one‐way ANOVA with Dunnett's multiple comparisons as a post hoc test and the Kruskal–Wallis test with Dunn's multiple comparisons post hoc test (p <.05). Results: Mice treated with fluoride at 50–125 ppm developed enamel hypoplasia in their erupting incisors and micro‐CT imaging revealed that fluoride 125 ppm caused external resorption of the growing incisor. Dentine mineral density, dentine volume decreased compared with the 0 ppm control, while pulp volume increased compared with the 0 ppm control group. SEM showed wider predentine layer and abnormalities in calcified matrix vesicles derived from odontoblasts in fluoride 100 and 125 ppm groups. Vickers microhardness of dentine significantly decreased in the high‐dose group. Fluoride‐induced dentine hypoplasia in a dose‐dependent manner. Histological evaluation showed excessive fluoride 125 ppm induced micro abscess formation and inflammatory cell infiltration. Fluoride induced dentine dysplasia with a dentine microstructure resembling hypophosphatasia. Conclusions: High doses of systemic fluoride can cause dentine dysplasia. Both three‐dimensional and microstructural analyses showed the structural, chemical and mechanical changes in the dentine and the mineralized tissue components, along with external resorption and pulp inflammation. [ABSTRACT FROM AUTHOR]

Introduction: Due to rising temperature extremes, workplaces are seeking new solutions, such as using personal cooling garments (PCG) to mitigate and manage workplace heat exposure. This systematic review sought to assess the physiological and perceptual effects of PCGs on workers in standard work clothing performing moderate‐to‐heavy intensity tasks in hot environments. Methods: A peer‐reviewed search strategy was conducted in MEDLINE, Embase, CINAHL, Scopus, Global Health, and Business Source Complete with no language or time limits. A meta‐analysis using a realist evaluation framework was then performed to evaluate the effectiveness of the PCGs. Results: Thirty‐three studies with 764 participants (98% male; average 21 ± 34 participants per study), conducted primarily in a laboratory setting (76%) were included. The studies were 193 ± 190 min in duration and consisted of a moderate‐to‐heavy work effort of 3.3 ± 1.0 METs in hot ambient conditions (temperature: 35.9 ± 3.3°C, 51.4 ± 12.1% relative humidity, wet bulb globe temperature [WBGT] 31.2 ± 2.6°C). The PCGs (n = 67) facilitated heat exchange through conduction (n = 39), evaporation (n = 4), convection (n = 2), radiation (n = 2), or hybrid combinations (n = 20). Conductive and hybrid PCGs offered the greatest thermoregulatory benefit, whereby core temperature (Tc) and heart rate (HR) reductions were consistently observed (Conductive: Tc: −0.3°C, HR: −12 bpm; Hybrid: Tc:−0.2°C, HR: −10 bpm), while PCGs directed at enhancing evaporative and radiative heat exchange had no or minimal effect on the physiological outcomes assessed (i.e., TC < 0.1°C, HR: < 0.7 bpm). Conclusion: While the PCGs had a positive overall effect, conductive options offered the most consistent benefit to workers. WBGT, clothing insulation, and duration of wear significantly affected some physiological and perceptual outcomes. [ABSTRACT FROM AUTHOR]

Background: Cerebral small vessel disease (CSVD) causes between 25% and 30% of all ischemic strokes. In acute lacunar ischemic stroke, despite often mild initial symptoms, early neurological deterioration (END) occurs in approximately 15–20% of patients and is associated with poor functional outcome, yet its mechanisms are not well understood. Aims: In this review, we systematically evaluated data on: (1) definitions and incidence of END, (2) mechanisms of small vessel occlusion, (3) predictors and mechanisms of END, and (4) prospects for the prevention or treatment of patients with END. Summary of review: We identified 67 reports (including 13,407 participants) describing the incidence of END in acute lacunar ischemic stroke. The specified timescale for END varied from <24 h to 3 weeks. The rate of END ranged between 2.3% and 47.5% with a pooled incidence of 23.54% (95% confidence interval (CI) = 21.02–26.05) but heterogeneity was high (I 2 = 90.29%). The rates of END defined by National Institutes of Health Stroke Scale (NIHSS) decreases of ⩾1, ⩾2, ⩾3, and 4 points were as follows: 24.17 (21.19–27.16)%, 22.98 (20.48–25.30)%, 23.33 (16.23–30.42)%, and 10.79 (2.09–23.13)%, respectively, with lowest heterogeneity and greatest precision for a cutoff of ⩾2 points. Of the 20/67 studies (30%) reporting associations of END with clinical outcome, 19/20 (95%) reported worse outcomes (usually measured using the modified Rankin score at 90 days or at hospital discharge) in patients with END. In a meta-regression analysis, female sex, hypertension, diabetes, and smoking were associated with END. Conclusions: END occurs in more than 20% of patients with acute lacunar ischemic stroke and might provide a novel target for clinical trials. A definition of an NIHSS ⩾2 decrease is most used and provides the best between-study homogeneity. END is consistently associated with poor functional outcome. Further research is needed to better identify patients at risk of END, to understand the underlying mechanisms, and to carry out new trials to test potential interventions. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the efficacy of advanced hybrid closed-loop (AHCL) therapy in a high-risk cohort of youth on continuous subcutaneous insulin infusion (CSII) with or without continuous glucose monitoring (CGM) with suboptimal glycemia. RESEARCH DESIGN AND METHODS: In a 6-month multicenter clinical trial, youth with type 1 diabetes with mean and most recent HbA1c >8.5% (65 mmol/mol) were randomly assigned 1:1 to AHCL or treatment as usual (CSII ± CGM). The primary outcome was the 24-week between-group difference in HbA1c. Secondary outcomes included CGM metrics from masked CGM and psychological measures (youth-reported problem areas in diabetes [PAID], quality of life, anxiety, depression, and hypoglycemia fear) assessed using validated questionnaires. RESULTS: A total of 42 participants were randomized (mean [SD] age 16.2 [2.5] years, HbA1c 9.8 [1.1]% or 84 [12] mmol/mol, PAID score 50.3 [19.8]). At study end, the mean (SD) HbA1c was 8.8 (1.1)% or 73 (12) mmol/mol with AHCL and 9.9 (1.2)% or 85 (13.1) mmol/mol with CSII ± CGM, with mean adjusted group difference of −0.77% (95% CI −1.45 to −0.09) or −8.4 mmol/mol (−15.8 to −1.0); P = 0.027. AHCL increased time in range 70–180 mg/dL (difference 19.1%; 95% CI 11.1 to 27.1), reduced time >180 mg/dL (difference −17.7%; 95% CI −26.6 to −8.8), with no increase in time spent <70 mg/dL (difference −0.8%; 95% CI −2.7 to 0.6). There was no evidence for difference in psychosocial outcomes between the two groups at study end. CONCLUSIONS: AHCL should be encouraged in youth with suboptimal glycemia, as AHCL improves glycemia. However, psychological support remains vital, as technology alone may not be able to reduce the burden of diabetes care in this subgroup. [ABSTRACT FROM AUTHOR]