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• Evidence-based mental telehealth treatment for firefighters is effective. • Delivery of the unified protocol (UP) reduces posttraumatic stress disorder symptom severity in firefighters. • Delivery of the UP reduces alcohol use behaviors in firefighters. • The UP can be successfully applied to telehealth for firefighters. Firefighters protect the public despite significant risk to their health and well-being stemming from frequent trauma exposure and other occupational stressors. A minority of firefighters develop posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), or related mental health problems, such as depression or anxiety. These problems frequently co-occur and are linked with high neuroticism and difficulties with emotion regulation. Thus, efficient treatment for this population should be transdiagnostic and target neuroticism. Moreover, logistical challenges and stigma represent barriers to care in firefighters. We addressed these challenges by culturally adapting the Unified Protocol for Transdiagnostic Treatment of Emotional Disorders and delivering it to 61 firefighters via videoconferencing, of whom 49 completed treatment. The adaptation process is described, and two case vignettes are presented. In the total sample, large effect size improvements were observed in symptoms of PTSD, depression, and psychological aspects of quality of life at posttreatment and 1-month follow-up. For anxiety, improvements were medium at posttreatment and large at follow-up. Medium effects were observed on reductions in AUD symptoms and in the other aspects of quality of life (physical health, social relationships, and environmental) at posttreatment and follow-up. Reductions in suicide risk were small in the total sample and moderate among those who screened positive for being at suicide risk at pretreatment. Similarly promising results were observed in the subsamples of participants who screened positive for PTSD, AUD, and co-occurring PTSD–AUD at pretreatment, with large improvements in AUD symptoms observed in those who screened positive for AUD at pretreatment. This is the first study to report on the unified protocol delivered via telehealth. The treatment completion rate was high (80.3%). The current study contributes to the emerging literature on the unified protocol for PTSD and AUD. The current findings support the utility of this treatment for PTSD and AUD, consistent with the underlying approach of targeting neuroticism across diagnostic categories. [ABSTRACT FROM AUTHOR]

Range-based localization has received considerable attention in wireless sensor networks due to its ability to efficiently locate the unknown source of a signal. However, the localization accuracy with a single set of measurements may be inadequate, especially in dynamic and noisy environments. To mitigate this problem, received signal strength difference (RSSD) and time difference of arrival (TDOA) measurements are used to develop an efficient estimator to reduce the bias and improve localization accuracy. First, the RSSD/TDOA-based maximum likelihood (ML) localization problem is transformed into a hybrid information nonnegative constrained least squares (HI-NCLS) framework. Then, this framework is used to develop an effective bias-reduction localization approach (BRLA) with a two-step linearization process. The first step employs a linear solving method (LSM) which exploits an active set method to obtain a sub-optimal estimator. The second step uses a bias reduction method (BRM) to mitigate the correlation from linearization and a weighted instrumental variables matrix (IVM) which is weakly correlated with the noise but strongly correlated with the data matrix (DM) is used in place of the DM. Performance results are presented which demonstrate that the proposed BRLA provides better localization performance than state-of-the-art methods in the literature. [ABSTRACT FROM AUTHOR]

The accuracy of various lipid measurements, assays and calculations and their impact on clinical decision making is controversial. Equations for calculating LDL-C include Friedewald (FE), Martin Hopkins (MH), Sampson (S) as well as measuring direct LDL (d-LDL). Two Lp(a) assays, molar (nmol/L) and mass (mg/dL), exhibit inter-assay differences and variability in repeat measures due to lab or patient related factors. Non-HDL, apoB and hs-CRP are associated with residual risk, potentially optimizing risk stratification. This study aimed to assess the additional value of various assays and biomarkers at guiding treatment for residual risk. Baseline data from the Young Heart study of patients <60 years old with coronary artery disease (CAD) included total cholesterol, triglycerides, HDL, d-LDL, non-HDL, apoB, Lp(a) mass assay (mg/dL), Lp(a) molar assay (mmol/L) and LDL-C calculated using above equations. The median age of our 60 patients was 51, 70% male, with HTN (76.7%), HLD (91.7%) and obstructive CAD (88.3%). Triglycerides >150, >200 and >400 mg/dL were noted in 32%, 17% and 2% of patients, respectively. Only 42% of patients were at goal for LDL-C <70mg/dL (FE) and 48% for non-HDL <100 mg/dL (Table). When using the MH and S equations, and d-LDL, population at goal became 35%, 38% and 52% respectively. In patients at goal for LDL-C (<70 mg/dL), 9.7% had non-HDL >100 mg/dL and 6% had apoB >80 mg/dL. In those with non-HDL <100 mg/dL, apoB was also at goal at <80 mg/dL with no incremental value in recognizing residual risk. The two Lp(a) assays noted a median Lp(a) of 57.8 nmol/L and 46 mg/dL. Lp(a) above 75 or 125 nmol/L was recorded in 42% and 25% of patients respectively. With a mass assay, Lp(a) was above 30 or 50 mg/dL in 30% and 28% of patients respectively. A total of 13 patients (22%) with LDL <70 had hsCRP >2. Non-HDL and apoB similarly recognized a subgroup of patients not meeting goals despite achieving LDL-C targets. Hs-CRP recognized a substantial number of patients who may have an additional, independent component of risk. Newer LDL-C calculators identified more patients for intensified LDL-C lowering therapy. Despite assay differences regarding abnormal Lp(a) levels, high-risk identification was similar. Attention to laboratory accuracy and biomarkers of residual risk is crucial for optimizing treatment to improve cardiovascular outcomes. [ABSTRACT FROM AUTHOR]

Collective action plays a critical role in progressing efforts to protect the global environment. In this study we examined existing research that specified causal claims about the outcomes of sustained environmental collective action and analysed the collective action characteristics associated with the stated outcomes. Of the 640 studies identified in our literature search, 113 papers examined environmental collective action outcomes over a time period of one or more years. In total, 59 different environmental collective action outcomes were identified, including changing corporate/business practices (n = 16), achieving political outcomes (n = 12), fostering movement building (n = 8), development project-specific outcomes (n = 8), physical changes such as increased forest cover (n = 7), or changes in public opinion, values, or behaviours (n = 4). In terms of general outcomes (i.e., success of failure of environmental collective action) the most common outcome claimed was both success and failure (n = 44), followed by complete success (n = 37) and mostly failure (n = 18). All papers identified the use of normative collective action, while 36 papers mentioned non-violent non-normative action such as blockades and sit-ins. Across the dataset there was a lack of consistency in descriptive terminology, methodological approach and inclusion of empirical evidence in justifying causal claims. We close with recommendations for scholars' best practices for advancing research into environmental collective action outcomes, namely: consistent terminology, mapping outcomes against goals, increased studies of failure, and diversifying studies in non-WEIRD contexts. • A systematic review of 113 studies on environmental collective action outcomes. • 59 distinct outcomes are identified, including 16 corporate & 12 political. • Most studies claimed outcomes of both success & failure (n = 44) or success (n = 37). • Only 3 studies examined failed collective action & 76 focused on WEIRD contexts. • Four recommendations to guide collective action outcomes research are presented. [ABSTRACT FROM AUTHOR]

Background: Empirical evidence suggests a strong link between exposure to air pollution and heart failure incidence, hospitalizations, and mortality, but the biological basis of this remains unclear. We sought to determine the relationship between differential air pollution levels and changes in cardiac structure and function in patients with dilated cardiomyopathy.Methods and Results: We undertook a prospective longitudinal observational cohort study of patients in England with dilated cardiomyopathy (enrollment 2009-2015, n = 716, 66% male, 85% Caucasian) and conducted cross sectional analysis at the time of study enrollment. Annual average air pollution exposure estimates for nitrogen dioxide (NO2) and particulate matter with diameter of 2.5 µm or less (PM2.5) at enrolment were assigned to each residential postcode (on average 12 households). The relationship between air pollution and cardiac morphology was assessed using linear regression modelling. Greater ambient exposure to NO2 was associated with higher indexed left ventricular (LV) mass (4.3 g/m2 increase per interquartile range increase in NO2, 95% confidence interval 1.9-7.0 g/m2) and lower LV ejection fraction (-1.5% decrease per interquartile range increase in NO2, 95% confidence interval -2.7% to -0.2%), independent of age, sex, socioeconomic status, and clinical covariates. The associations were robust to adjustment for smoking status and geographical clustering by postcode area. The effect of air pollution on LV mass was greatest in women. These effects were specific to NO2 exposure.Conclusions: Exposure to air pollution is associated with raised LV mass and lower LV ejection fraction, with the strongest effect in women. Although epidemiological associations between air pollution and heart failure have been established and supported by preclinical studies, our findings provide novel empirical evidence of cardiac remodeling and exposure to air pollution with important clinical and public health implications. [ABSTRACT FROM AUTHOR]

Background: Hidradenitis suppurativa (HS) is associated with comorbidities that contribute to poor health, impaired life quality, and mortality risk.Objective: To provide evidence-based screening recommendations for comorbidities linked to HS.Methods: Systematic reviews were performed to summarize evidence on the prevalence and incidence of 30 comorbidities in patients with HS relative to the general population. The screening recommendation for each comorbidity was informed by the consistency and quality of existing studies, disease prevalence, and magnitude of association, as well as benefits, harms, and feasibility of screening. The level of evidence and strength of corresponding screening recommendation were graded by using the Strength of Recommendation Taxonomy (SORT) criteria.Results: Screening is recommended for the following comorbidities: acne, dissecting cellulitis of the scalp, pilonidal disease, pyoderma gangrenosum, depression, generalized anxiety disorder, suicide, smoking, substance use disorder, polycystic ovary syndrome, obesity, dyslipidemia, diabetes mellitus, metabolic syndrome, hypertension, cardiovascular disease, inflammatory bowel disease, spondyloarthritis, and sexual dysfunction. It is also recommended to screen patients with Down syndrome for HS. The decision to screen for specific comorbidities may vary with patient risk factors. The role of the dermatologist in screening varies according to comorbidity.Limitations: Screening recommendations represent one component of a comprehensive care strategy.Conclusions: Dermatologists should support screening efforts to identify comorbid conditions in HS. [ABSTRACT FROM AUTHOR]

A macroscopic model based on analogies with Little's Law is proposed. The relaxation time is employed to characterize changes in density. This change is large for a small relaxation time and large interactions between vehicles occur. The relaxation time encompasses driver behavior which includes the time to perceive and process traffic situations and the resulting actions. Thus, it incorporates the perception and reaction time of a driver. The proposed model is evaluated for a transition caused by a bottleneck on a road and is compared with Zhang model. Performance results are presented which show that traffic evolution with the proposed model is more realistic than with the Zhang model. [ABSTRACT FROM AUTHOR]

In this paper, the outage probability (OP) performance of mobile vehicle-to-vehicle (V2V) networks with incremental hybrid decode–amplify–forward (IHDAF) relaying is investigated. Exact closed-form expressions for the OP are derived. The impact of the power allocation on the OP is evaluated. Theoretical and Monte-Carlo simulation results are compared to validate the analysis. [ABSTRACT FROM AUTHOR]

Background: Mental health disorders, social stress, and poor health-related quality of life are commonly reported among people with tuberculosis (TB). We conducted a systematic review and meta-analysis to quantify mental health disorders, social stressors, and health-related quality of life in patients with multidrug-resistant tuberculosis (MDR-TB).Methods: We searched PubMed, SCOPUS, ProQuest, Web of Science, and PsycINFO databases for studies that reported data on mental health disorders, social stressors, and health-related quality of life among MDR-TB patients. Hand-searching the reference lists of included studies was also performed. Studies were selected according to pre-defined selection criteria and data were extracted by two authors. Pooled prevalence and weighted mean difference estimates were performed using random-effects meta-analysis. Heterogeneity was explored using meta-regression, and subgroup analyses were performed.Results: We included a total of 40 studies that were conducted in 20 countries. Depression, anxiety, and psychosis were the most common mental health disorders reported in the studies. The overall pooled prevalence was 25% (95% confidence interval (CI): 14, 39) for depression, 24% (95% CI: 2, 57) for anxiety, and 10% (95% CI: 7, 14) for psychosis. There was substantial heterogeneity in the estimates. The stratified analysis showed that the prevalence of psychosis was 4% (95% CI: 0, 22) before MDR-TB treatment commencement, and 9% (95% CI: 5, 13) after MDR-TB treatment commencement. The most common social stressors reported were stigma, discrimination, isolation, and a lack of social support. Health-related quality of life was significantly lower among MDR-TB patients when compared to drug-susceptible TB patients (Q = 9.88, p = 0.01, I2 = 80%).Conclusions: This review found that mental health and social functioning are compromised in a significant proportion of MDR-TB patients, a finding confirmed by the poor health-related quality of life reported. Thus, there is a substantial need for integrating mental health services, social protection and social support into the clinical and programmatic management of MDR-TB. [ABSTRACT FROM AUTHOR]

[Display omitted] • Sulforaphane is a key antioxidant and anti-inflammatory compound. • Sulforaphane increases the growth of Escherichia coli EPEC ECE2348/69. • Proteomics shows EPEC ECE2348/69 increases anaerobic respiration in sulforaphane. • Sulforaphane alters metabolites that are correlated with anti-inflammatory effects. Sulforaphane is a naturally occurring, potent antioxidant, found in Brassicaceae plants such as broccoli, and is being considered for use in the treatment of fibrosis, cancer and preeclampsia. As sulforaphane is orally administered and has been shown to demonstrate antimicrobial properties in aerobic conditions, there is also the potential for impact on the gut microbiome under anaerobic conditions. Here, we have determined the effect of sulforaphane on the growth of 43 common human gastrointestinal microbiota, representing common commensals and pathogens. The enteropathogenic Escherichia coli strain EPEC E2348/69 showed the most significant increases in growth in the presence of sulforaphane. Proteomic analysis of this isolate showed that sulforaphane increased anaerobic respiration, whilst metabolomics identified differentially produced metabolites that can decrease inflammation in human cells. Therefore, sulforaphane can increase growth of specific gastrointestinal microbiota, correlating with increased production of anti-inflammatory metabolites. Thus, providing a novel mechanism for modulating inflammatory states in patients. [ABSTRACT FROM AUTHOR]

This paper develops an improved algorithm for life detection based on ultra-wide band (UWB) impulse radars in through-wall condition. Usually, the cardiac–respiratory movement is the most significant sign of a living person, which can be extracted from the collected pulses. The proposed algorithm analyzes the variances of the collected pulses, which are mixed with various clutters. The time of arrival (TOA) between UWB radar and human target can be calculated by performing the wavelet packet decomposition on the calculated variances. The rates of human cardiac–respiratory movement are acquired based on the variable time-window (VTW) method. Compared with several well-known algorithms, the developed method can provide competitive performance in life detection. Results acquired from different sites prove the efficiency and reliability of the method. [ABSTRACT FROM AUTHOR]

Summary Background There is little evidence about the long-term donor site outcome of latissimus dorsi breast reconstruction and no patient-reported outcome measures designed specifically for the procedure. Methods A prospective cohort of breast cancer patients having latissimus dorsi reconstruction after a mastectomy was recruited from 270 hospitals in the United Kingdom. An 18-month follow up questionnaire containing two novel scales was sent to consenting patients. The prevalence of aesthetic and functional morbidity at the donor site was described. The two new scales were refined using the Rasch measurement model and subsequently validated. Results 1,096 women completed the new scales. 78% of patients reported that no back appearance issues had bothered them “most of the time” or “all of the time” in the past two weeks. The equivalent figure for functional morbidity was 60%. Four items were eliminated following initial psychometric testing. This produced an 8-item Back Appearance scale and an 11-item Back and Shoulder Function scale. Both scales showed adequate fit to the Rasch measurement model. Higher levels of aesthetic and functional bother were observed for completely autologous procedures versus those where latissimus dorsi reconstruction was used to cover an implant ( p  <   0.05). Higher levels of aesthetic bother were observed in women who had suffered a perioperative complication at the donor site ( p  = 0.003). Conclusion These results can inform patients of the morbidity associated with latissimus dorsi reconstruction. The new scales can be used to compare groups undergoing different variations of the procedure and to monitor individual patients. [ABSTRACT FROM AUTHOR]

Household Air Pollution (HAP) from biomass cooking fuels is a major cause of morbidity and mortality in low-income settings worldwide. In Nepal the use of open stoves with solid biomass fuels is the primary method of domestic cooking. To assess patterns of domestic air pollution we performed continuous measurement of carbon monoxide (CO) and particulate Matter (PM 2.5 ) in 12 biomass fuel households in Janakpur, Nepal. We measured kitchen PM 2.5 and CO concentrations at one-minute intervals for an approximately 48-h period using the TSI DustTrak II 8530/SidePak AM510 (TSI Inc, St. Paul MN, USA) or EL-USB-CO data logger (Lascar Electronics, Erie PA, USA) respectively. We also obtained information regarding fuel, stove and kitchen characteristics and cooking activity patterns. Household cooking was performed in two daily sessions (median total duration 4 h) with diurnal variability in pollutant concentrations reflecting morning and evening cooking sessions and peak concentrations associated with fire-lighting. We observed a strong linear relationship between PM 2.5 measurements obtained by co-located photometric and gravimetric monitoring devices, providing local calibration factors of 4.9 (DustTrak) and 2.7 (SidePak). Overall 48-h average CO and PM 2.5 concentrations were 5.4 (SD 4.3) ppm (12 households) and 417.6 (SD 686.4) μg/m 3 (8 households), respectively, with higher average concentrations associated with cooking and heating activities. Overall average PM 2.5 concentrations and peak 1-h CO concentrations exceeded WHO Indoor Air Quality Guidelines. Average hourly PM 2.5 and CO concentrations were moderately correlated (r = 0.52), suggesting that CO has limited utility as a proxy measure for PM 2.5 exposure assessment in this setting. Domestic indoor air quality levels associated with biomass fuel combustion in this region exceed WHO Indoor Air Quality standards and are in the hazardous range for human health. [ABSTRACT FROM AUTHOR]

Nitrogen dioxide (NO 2) is an important air pollutant due to its adverse effects on human health. Yet, current evidence on the association between NO 2 and the risk of breast cancer lacks consistency. In this study, we investigated the association between long-term exposure to NO 2 and breast cancer risk in the French E3N cohort study. Association of breast cancer risk with NO 2 exposure was assessed in a nested case-control study within the French E3N cohort including 5222 breast cancer cases identified over the 1990–2011 follow-up period and 5222 matched controls. Annual mean concentrations of NO 2 at participants' residential addresses for each year from recruitment 1990 through 2011, were estimated using a land use regression (LUR) model. Multivariable conditional logistic regression models were used to compute odds ratios (ORs) and their 95% confidence intervals (CIs). Additional analyses were performed using NO 2 concentrations estimated by CHIMERE, a chemistry transport model. Overall, the mean NO 2 exposure was associated with an increased risk of breast cancer. In all women, for each interquartile range (IQR) increase in NO 2 levels (LUR: 17.8 μg/m3), the OR of the model adjusted for confounders was 1.09 (95% CI: 1.01–1.18). The corresponding OR in the fully adjusted model (additionally adjusted for established breast cancer risk factors) was 1.07 (95% CI: 0.98–1.15). By menopausal status, results for postmenopausal women were comparable to those for all women, while no association was observed among premenopausal women. By hormone receptor status, the OR of estrogen receptor positive breast cancer = 1.07 (95% CI: 0.97–1.19) in the fully adjusted model. Additional analyses using the CHIMERE model showed slight differences in ORs estimates. The results of this study indicate an increased risk of breast cancer associated with long-term exposure to NO 2 air pollution. Observing comparable effects of NO 2 exposure estimated by two different models, reinforces these findings. [Display omitted] • NO 2 levels were estimated over a 22 years period, by two exposure assessment models. • Breast cancer risk was increased in association with exposure to NO 2 air pollution. • By menopausal status, the associations appear to be limited to postmenopausal women. • NO 2 air pollution was positively associated with risk of ER + breast cancer. • Consistent associations were observed for the two exposure assessment methods. [ABSTRACT FROM AUTHOR]

Address-level estimates of exposure to road traffic noise for epidemiological studies are dependent on obtaining data on annual average daily traffic (AADT) flows that is both accurate and with good geographical coverage. National agencies often have reliable traffic count data for major roads, but for residential areas served by minor roads, especially at national scale, such information is often not available or incomplete. Here we present a method to predict AADT at the national scale for minor roads, using a routing algorithm within a geographical information system (GIS) to rank roads by importance based on simulated journeys through the road network. From a training set of known minor road AADT, routing importance is used to predict AADT on all UK minor roads in a regression model along with the road class, urban or rural location and AADT on the nearest major road. Validation with both independent traffic counts and noise measurements show that this method gives a considerable improvement in noise prediction capability when compared to models that do not give adequate consideration to minor road variability (Spearman’s rho. increases from 0.46 to 0.72). This has significance for epidemiological cohort studies attempting to link noise exposure to adverse health outcomes. [ABSTRACT FROM AUTHOR]

Long-term exposure to primary traffic pollutants may be harmful for health but few studies have investigated effects on mortality. We examined associations for six primary traffic pollutants with all-cause and cause-specific mortality in 2003–2010 at small-area level using linear and piecewise linear Poisson regression models. In linear models most pollutants showed negative or null association with all-cause, cardiovascular or respiratory mortality. In the piecewise models we observed positive associations in the lowest exposure range (e.g. relative risk (RR) for all-cause mortality 1.07 (95% credible interval (CI) = 1.00–1.15) per 0.15 μg/m 3 increase in exhaust related primary particulate matter ≤2.5 μm (PM 2.5 )) whereas associations in the highest exposure range were negative (corresponding RR 0.93, 95% CI: 0.91–0.96). Overall, there was only weak evidence of positive associations with mortality. That we found the strongest positive associations in the lowest exposure group may reflect residual confounding by unmeasured confounders that varies by exposure group. [ABSTRACT FROM AUTHOR]

Evidence on the effects of long-term exposure to traffic pollution on health is inconsistent. In Greater London we examined associations between traffic pollution and emergency hospital admissions for cardio-respiratory diseases by applying linear and piecewise linear Poisson regression models in a small-area analysis. For both models the results for children and adults were close to unity. In the elderly, linear models found negative associations whereas piecewise models found non-linear associations characterized by positive risks in the lowest and negative risks in the highest exposure category. An increased risk was observed among those living in areas with the highest socioeconomic deprivation. Estimates were not affected by adjustment for traffic noise. The lack of convincing positive linear associations between primary traffic pollution and hospital admissions agrees with a number of other reports, but may reflect residual confounding. The relatively greater vulnerability of the most deprived populations has important implications for public health. [ABSTRACT FROM AUTHOR]

The EU-FP7-funded BioSHaRE project is using individual-level data pooled from several national cohort studies in Europe to investigate the relationship of road traffic noise and health. The detailed input data (land cover and traffic characteristics) required for noise exposure modelling are not always available over whole countries while data that are comparable in spatial resolution between different countries is needed for harmonised exposure assessment. Here, we assess the feasibility using the CNOSSOS-EU road traffic noise prediction model with coarser input data in terms of model performance. Starting with a model using the highest resolution datasets, we progressively introduced lower resolution data over five further model runs and compared noise level estimates to measurements. We conclude that a low resolution noise model should provide adequate performance for exposure ranking (Spearman's rank = 0.75; p < 0.001), but with relatively large errors in predicted noise levels (RMSE = 4.46 dB(A)). [ABSTRACT FROM AUTHOR]

Summary Cell-mediated immunity has been exploited historically in the diagnosis of mycobacterial diseases through elicitation of a delayed-type hypersensitivity (DTH) reaction following intradermal injection of an antigen. Here we describe the histopathological features of the cutaneous DTH reaction and its association with intestinal pathology and systemic immune responses in sheep with Mycobacterium avium subspecies paratuberculosis (MAP) infection. A mixed mononuclear cellular infiltrate dominated the DTH reaction and was present in perivascular and periadnexal patterns. Multiple multinucleate giant cells were present in the cellular infiltrate in one sheep while plasma cells were an obvious feature in six others. Sheep with paucibacillary intestinal lesions had the greatest degrees of cutaneous induration, more severe cellular infiltration in DTH lesions and high systemic interferon (IFN)-γ production. In contrast, sheep with multibacillary intestinal lesions, and particularly those with dissemination of MAP to extra-intestinal tissues, had minimal cutaneous induration, nil to mild cellular infiltration in DTH lesions and high serum anti-MAP antibody levels. Systemic IFN-γ production generally was augmented following skin sensitization. In general, the gross and histopathological features of the cutaneous DTH response matched the stage of paratuberculosis reflected by intestinal pathology and systemic measures of humoral and cellular immunity. [ABSTRACT FROM AUTHOR]

Objectives Currently, little is known about the prevalence of mental disorders in athletes. This study aims to investigate Australian elite athletes’ symptoms of general psychological distress and common mental disorders. Design A cross-sectional survey design was employed to assess self-reported symptom prevalence. Methods A total of 224 elite athletes (118 female, 106 male) from national sporting organisations in Australia were administered a self-report internet-based survey comprising measures of demographic status and mental health symptoms. Results Overall, 46.4% of athletes were experiencing symptoms of at least one of the mental health problems assessed. Percentages meeting criteria for mental disorders were similar to previous epidemiological studies of both international athlete and community samples: depression (27.2%), eating disorder (22.8%), general psychological distress (16.5%), social anxiety (14.7%), generalised anxiety disorder (7.1%), and panic disorder (4.5%). Injured athletes had higher levels of both symptoms of depression ( t = 3.23, p = .001) and generalised anxiety disorder ( t = 2.26, p = .025). Conclusions The level of symptoms of mental health problems reported by elite athletes appears similar to that observed in the community. However, caution must be exercised in interpreting the findings, as possible demographic differences between athletes and comparison population datasets may exist. Furthermore, self-selection of respondents in the present study may have reduced the representativeness of the sample and the validity of the comparisons. Athletes, particularly those currently injured, should be well-supported to seek help for mental disorders through access to mental health professionals. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To determine the extent to which ICD-10 alcohol intoxication codes are used for serious hospitalised injury and the distribution of these codes according to gender, age, injury mechanism and intent, severity of injury, and whether the patient was treated in an Intensive Care Unit. Design: Cross-sectional study. Setting: New Zealand. Participants: All injury hospital discharges in 2010 that met specified severity criteria. Measurements: Cases which had a measurement of BAC (Y90) coded, or only a subjective assessment of alcohol intoxication (F10.0). Findings: 2.5% had a blood alcohol recorded (Y90) and a further 3% were coded as being intoxicated but there was no blood alcohol code. All factors investigated were shown to be independently associated with the assignation of codes. Notable findings were the elevated odds of an alcohol code for males, assault and the more severe injuries. Conclusions: Assessment of alcohol intoxication among seriously injured persons appears to be very uncommon. The development of a standardised instrument for clinical judgement of intoxication would be highly desirable. [Copyright &y& Elsevier]

Abstract: Objective: The purpose of this study was to describe the driving experiences of learner licensed drivers and examine the association between these driving experiences, associated factors, and on-road car crash involvement during the unsupervised restricted license stage. Methods: Data were drawn from a cohort investigation of newly licensed drivers. Information on demographic characteristics, personality, and risk behaviors was collected at the baseline interview. At the first follow-up interview (restricted license stage) study members were asked details about their experiences as a learner licensed driver: professional driving lessons, supervised driving, unsupervised driving, and driving courses in which they participated. During the second follow-up interview (full license stage), data were collected on crash involvement and driving exposure during the restricted license stage. Regression analysis was used to determine independent relationships between learner license driving experience variables and crash involvement. Results: After adjusting for demographic, personality factors, and driving exposure at the restricted license stage, increased time spent on the learner license was associated with a reduced risk of crash involvement during the unsupervised restricted license stage. Conclusion: Results presented in this paper suggest that learner drivers in New Zealand should be encouraged to spend more time on their learner license to enable them to gain skills and experience to help reduce their crash risk when they are allowed to drive unsupervised. Impact on Industry: Compared with novice drivers who are on their learner license for the least amount of time, those who spend the most amount of time on their learner license have reduced risk of on-road crash involvement as an unsupervised driver. Learner drivers and their supervisors need to be aware of the length of time required for practice in order to reduce the risks of crash involvement when they are able to drive unsupervised (O'Brien et al., 2012). The recently introduced increase in the minimum driver licensing age in NZ, tougher restricted license stage driving test (aimed at encouraging 120hours of supervised driving), and the Safe Teen driver campaign (NZ Transport Agency, 2012) are all strategies targeted at improving the safety of learner drivers. These strategies need to be evaluated to ensure they are achieving their goals. [Copyright &y& Elsevier]

Abstract: Let be the maximum possible minimum Hamming distance of a linear [] code over . Tables of best known linear codes exist for small fields. In this paper, linear codes over are constructed for k up to 6. The codes constructed are from the class of quasi-cyclic codes. The number of circulant matrices over is enumerated. In addition, the minimum distance of the extended quadratic residue code of length 44 is determined. [Copyright &y& Elsevier]

Abstract: Background and aims: Nearly 25% of normal weight individuals display abnormal metabolic profiles associated with obesity. As a wide range in body fat percentage (%BF) exists for BMI-defined normal weight individuals, we investigated whether elevated %BF (determined using DXA) was associated with cardiometabolic dysregulation among 977 normal weight subjects (192 men, 785 women) from the Canadian province of Newfoundland and Labrador. Methods and results: BMI and %BF were measured after a 12-h fasting period. Cardiometabolic abnormalities considered included elevated triglyceride, glucose and hsCRP levels, decreased HDL cholesterol, insulin resistance, and hypertension. Subjects were classified as metabolically healthy (0 or 1 cardiometabolic abnormality) or abnormal (≥2 cardiometabolic abnormalities) and divided into sex-specific %BF tertiles as follows: low (≤15.2% men, ≤29.7% women), medium (15.3–20.7%% men, 29.8–34.9%% women) and high (≥20.8% men, ≥35.0% women). The prevalence of the metabolically abnormal phenotype was higher among medium and high %BF subjects (12.0% and 19.5%, respectively) compared to the low group (7.4%; p < 0.05). Furthermore, the odds of being metabolically abnormal were 1.61 (95% CI 0.94–2.77) for medium %BF subjects compared to the low group and nearly tripled for high %BF subjects (OR 2.73, 95% CI 1.63–4.86). ORs remained significant after further adjustment for waist circumference. Conclusion: Our findings indicate that those with elevated %BF are at increased risk of developing cardiometabolic disease despite having a normal BMI. Future development of adequate screening tools to identify these individuals is crucial to the prevention of obesity-associated disease. [Copyright &y& Elsevier]

Objective: To investigate the relative contribution of various risk factors to the surgical outcome of adenotonsillectomy for obstructive sleep apnea syndrome in children. Study design: Children (n = 110; mean age, 6.4 ± 3.9 years) underwent two polysomnographic evaluations before and after adenotonsillectomy. In addition, 22 control children were studied. History for allergy and family history of sleep-disordered breathing was taken before each polysomnographic evaluation. Results: Significant changes in sleep stage percentages and sleep fragmentation were found in the postsurgery study compared with the presurgery study; 25% of the children had apnea/hypopnea index (AHI) ≤1, 46% had AHI >1 and <5, and 29% had AHI ≥5 in the postsurgery study. The frequency of subjects with AHI ≤1 after surgery was significantly lower among obese subjects (P < .05). Comparison between the children who had AHI ≤1 after surgery and 22 control children showed complete normalization of sleep architecture after surgery. Conclusions: Adenotonsillectomy yields improvements in respiratory abnormalities in children with obstructive sleep apnea syndrome. Complete normalization occurs in only 25% of the patients. Obesity and AHI at diagnosis are the major determinant for surgical outcome. When normalization of respiratory measures occurs after surgery, normalization of sleep architecture will also ensue. [Copyright &y& Elsevier]

Estimates of the prevalence of alcohol dependence among Americans approach 14% (Read, Kahler, & Stevenson, 2001). Alcohol dependence was once considered among the most recalcitrant of problem behaviors, with only 20% to 30% attaining sustained abstinence (Hunt Barnett & Branch 1971). Although current definitions of treatment success now consider lapses and recycling (e.g., DiClemente, 2003), sustained abstinence remains the gold standard and is achieved in up to 60% of people in efficacy trials of current psychosocial treatments (e.g., Project MATCH). This article describes our efforts to develop the next-generation CBT treatment manuals for patients in early abstinence from alcohol, Broad Spectrum Treatment (BST). BST attempts to simultaneously address two seemingly incompatible treatment research goals. First, BST is a flexible but manual-guided treatment that can be standardized and used in the field with the broad spectrum of alcohol abusers. Second, BST seeks to maximize treatment effectiveness by tailoring the specific treatment package to the individual patient''s needs and capacities. Use of explicitly defined a priori decision trees is the vehicle through which these goals can be accomplished. This article describes the manual in its current form, and discusses the manner in which we are presently testing the efficacy of the manual as it stands. [Copyright &y& Elsevier]

Response to smoking cessation treatment programs sharply decreases when applied to smokers with psychiatric comorbidities. Consequently, the development of smoking cessation treatments that address the needs of psychiatric patients is greatly needed. The primary purpose of this article is to detail the process of development of an empirically informed, theoretically driven treatment program designed to aid multiply diagnosed smokers in their attempts to become tobacco free. Issues related to treating tobacco dependence in the persistently mentally ill are described. Our initial experience providing manualized, cognitive-behavioral smoking cessation treatment with adjunctive nicotine replacement therapy is detailed, along with the iterative process of manual development. Our current treatment program is illustrated with examples of clinical interactions, as well as a description of our ongoing evaluation of the utility and success of the clinic. [Copyright &y& Elsevier]

The UK implemented a lockdown in Spring (2020) to curtail the person-to-person transmission of the SARS-CoV-2 virus. Measures restricted movements to one outing per day for exercise and shopping, otherwise most people were restricted to their dwelling except for key workers (e.g. medical, supermarkets, and transport). In this study, we quantified changes to air quality across the United Kingdom from 30/03/2020 to 03/05/2020 (weeks 14–18), the period of most stringent travel restrictions. Daily pollutant measurements of NO 2 , O 3 and PM 2.5 from the national network of monitoring sites during this period were compared with measurements over the same period during 2017–19. Comparisons were also made with predicted concentrations for the 2020 period from business-as-usual (BAU) modelling, where the contributions of normal anthropogenic activities were estimated under the observed meteorological conditions. During the lockdown study period there was a 69% reduction in traffic overall (74% reduction in light and 35% in heavy vehicles). Measurements from 129 monitoring stations, identified mean reductions in NO 2 of 38.3% (−8.8 μg/m3) and PM 2.5 of 16.5% (−2.2 μg/m3). Improvements in NO 2 and PM 2.5 were largest at urban traffic sites and more modest at background locations where a large proportion of the population live. In contrast, O 3 concentrations on average increased by 7.6% (+4.8 μg/m3) with the largest increases at roadside sites due to reductions in local emissions of NO. A lack of VOC monitoring limited our capacity to interpret changes in O 3 at urban background locations. BAU models predicted comparable NO 2 reductions and O 3 gains, although PM 2.5 episodes would have been more prominent without lockdown. Results demonstrate the relatively modest contribution of traffic to air quality, suggesting that sustained improvements in air quality require actions across various sectors, including working with international and European initiatives on long-range transport air pollutants, especially PM 2.5 and O 3. Image 1 • Monthly-average daily traffic counts in April-2020 fell by 69% compared to April-2019. • NO 2 and PM 2.5 concentrations fell respectively by 38.3% (8.8 μg/m3) and 16.5% (2.2 μg/m3). • O 3 increased by 7.6% overall as the atmospheric chemistry changed. • NO 2 and PM 2.5 improvements were largest at urban traffic sites. • Weather conditions contributed to particulate episodes that were seen despite traffic reductions. [ABSTRACT FROM AUTHOR]

Road traffic noise is the most pervasive source of ambient outdoor noise pollution in Europe. Traffic noise prediction models vary in parameterisation and therefore may produce different estimates of noise levels depending on the geographical setting in terms of emissions sources and propagation field. This paper compares three such models: the European standard, Common Noise Assessment Methods for the EU Member States (hereafter, CNOSSOS), Nord2000 and Traffic Noise Exposure (TRANEX) model based on the UK methodology, in terms of their source and propagation characteristics. The tools are also compared by analysing estimated noise (L Aeq) from CNOSSOS, Nord2000 (2006 version), and TRANEX for more than one hundred test cases (N = 111) covering a variety of source and receiver configurations (e.g. varying source to receiver distance). The main aim of this approach was to investigate the potential pattern in differences between models' performance for certain types of configurations. Discrepancies in performance may thus be linked to the differences in parameterisations of the CNOSSOS, Nord2000, and TRANEX (e.g. handling of diffraction, refraction). In most cases, both CNOSSOS and TRANEX reproduced L Aeq levels of Nord2000 (2006 version) within three to five dBA (CNOSSOS: 87%, TRANEX: 94%). The differences in L Aeq levels of CNOSSOS, compared to Nord2000, can be related to several shortcomings of the existing CNOSSOS algorithms (e.g. ground attenuation, multiple diffractions, and mean ground plane). The analyses show that more research is required in order to improve CNOSSOS for its implementation in the EU. In this context, amendments for CNOSSOS proposed by an EU Working Group hold significant potential. Overall, both CNOSSOS and TRANEX produced similar results, with TRANEX reproducing Nord2000 L Aeq values slightly better than the CNOSSOS. The lack of measured noise data highlights one of the significant limitations of this study and needs to be addressed in future work. Image 1 • First-time in-depth comparison of CNOSSOS-EU, Nord2000 and TRANEX. • Evaluation of source and propagation features as well as noise estimates. • CNOSSOS and TRANEX reproduced L Aeq levels of Nord2000 (2006 version) within 3–5 dBA. • Correlation was R = 0.96 (CNOSSOS vs Nord2000), and R = 0.97 (TRANEX vs Nord2000). • Significant potential to further improve CNOSSOS for its implementation in Denmark. [ABSTRACT FROM AUTHOR]

Abstract: In this paper, we introduce a new quantum bit commitment protocol which is secure against entanglement attacks. A general cheating strategy is examined and shown to be practically ineffective against the proposed approach. [Copyright &y& Elsevier]

An increasing number of findings from epidemiological studies support associations between exposure to air pollution and the onset of several diseases, including pulmonary, cardiovascular and neurodegenerative diseases, and malignancies. However, intermediate, and potentially mediating, biological mechanisms associated with exposure to air pollutants are largely unknown. Previous studies on the human exposome have shown that the expression of certain circulating microRNAs (miRNAs), regulators of gene expression, are altered upon exposure to traffic-related air pollutants. In the present study, we investigated the relationship between particulate matter (PM) smaller than 2.5 μm (PM 2.5), PM 2.5 absorbance (as a proxy of black carbon and soot), and ultrafine-particles (UFP, smaller than 0.1 μm), measured in healthy volunteers by 24 h personal monitoring (PEM) sessions and global expression levels of peripheral blood miRNAs. The PEM sessions were conducted in four European countries, namely Switzerland (Basel), United Kingdom (Norwich), Italy (Turin), and The Netherlands (Utrecht). miRNAs expression levels were analysed using microarray technology on blood samples from 143 participants. Seven miRNAs, hsa-miR-24-3p, hsa-miR-4454, hsa-miR-4763-3p, hsa-miR-425-5p, hsa-let-7d-5p, hsa-miR-502-5p, and hsa-miR-505-3p were significantly (FDR corrected) expressed in association with PM 2.5 personal exposure, while no significant association was found between miRNA expression and the other pollutants. The results obtained from this investigation suggest that personal exposure to PM 2.5 is associated with miRNA expression levels, showing the potential for these circulating miRNAs as novel biomarkers for air pollution health risk assessment. Image 1 • Seven miRNAs measured in peripheral blood were significantly (FDR corrected) expressed in association with personal exposure to PM 2.5. • 368 target genes were identified for the seven miRNAs associated with PM 2.5 personal exposure levels and p53 signaling pathways, pathways in cancer, and JAK-STAT signaling pathway were identified as significantly enriched. • The results from this study suggest that miRNA expression levels are be related to exposure. [ABSTRACT FROM AUTHOR]

Easy-to-pilot unmanned aerial vehicles (UAVs) are now readily available off the shelf. This has created the problem of micro unmanned aerial vehicle (MUAV) in private or sensitive areas which can represent a personal or public threat. An improved MUAV detection method is proposed in this paper using artificial neural network (ANN) based feature extraction and reconstruction. The clutters form static/non-static objects in the collected radio frequency (RF) signals are suppressed via employing the background estimate method and suppressing the linear trend. Then principal component of the RF signals are extracted based on the singular value decomposition (SVD) method. The higher order cumulant (HOC) algorithm is utilized to improve the signal to noise ratio (SNR) of the RF signals, which can make Gaussian noise prone to zero. Hilbert spectrums of the analyzed features are considered to determine if one MUAV is present in the detection area using ANN. Finally, the region of interest (ROI) containing RF signals is defined to estimate the azimuth and first frequency of MUAV. Detection results in real-life scenarios are obtained which show the effectiveness of the proposed technique in detecting MUAV. [ABSTRACT FROM AUTHOR]

Recent observations have identified increased mass loss from Greenland marine-terminating outlet glaciers (MTOG) with implications for global sea-level rise and wider ocean circulation. The flow of Atlantic-sourced waters to the Greenland margin is thought to be a major control on MTOG behaviour. Investigation of longer-term records of the role of Atlantic-sourced waters on MOTG dynamics are needed to improve understanding of potential future trends in MTOG behaviour. Here we present a multi-proxy study (benthic and planktic foraminifera, dinoflagellate cysts, diatoms, stable isotopes, sea ice biomarkers and sedimentological analyses) from core PS100-198 on the northeast Greenland shelf to investigate the interaction between the Northeast Greenland Ice Stream (NEGIS) and ocean circulation through the Holocene. Proximal glaciomarine conditions at the base of the core indicate deglaciation before 10.9 ka cal BP with the relatively warm Atlantic Water present through advection of the Return Atlantic Current (RAC) across the shelf. The advection of RAC increased through the early Holocene reaching peak subsurface warmth from 8 to 9 ka cal BP. Surface conditions at this time were characterised by heavy sea-ice cover. During the mid-to late Holocene (c. 7–2 ka cal BP) advection of RAC weakened with cooler subsurface waters, but with an amelioration of surface conditions characterised by seasonal sea ice. From c. 2 ka cal BP, during the late Holocene, surface conditions continued to improve with continued seasonal sea-ice cover while subsurface proxies record an increase in RAC advection. The last c. 100 years represent the most ameliorated surface conditions through the Holocene and with subsurface conditions as warm as the early Holocene peak. This coincided with the final break up of ice within 79N fjord and retreat of NEGIS to the Holocene minimum position. Current conditions, therefore, suggest the present-day ice shelf within 79N fjord is most likely susceptible to collapse in the near future. This study highlights the critical influence of Atlantic-sourced waters on the dynamics of major Greenland MTOGs. • Surface and bottom water multi-proxy reconstruction of NE Greenland paleoceanography. • Dynamics of the NE Greenland ice stream strongly linked to inflow of Atlantic Water. • Modern ocean conditions as warm as peak Holocene when the ice shelf disintegrated. • Current ice shelf susceptible to disintegration based on ameliorated ocean conditions. [ABSTRACT FROM AUTHOR]

In this paper we adopt a quantitative biostratigraphic approach to establish a 1000-year-long coastal record of megathrust earthquake and tsunami occurrence in south central Chile. Our investigations focus on a site in the centre of the rupture segment of the largest instrumentally recorded earthquake, the AD 1960 magnitude 9.5 Chile earthquake. At Chucalén coseismic subsidence in 1960 is recorded in the lithostratigraphy and biostratigraphy of coastal marshes, with peat overlain by minerogenic sediment and changes in the assemblages of diatoms (unicellular algae) indicating an abrupt increase in relative sea level. In addition to the 1960 earthquake, the stratigraphy at Chucalén records three earlier earthquakes, the historically documented earthquake of 1575 and two prehistoric earthquakes, radiocarbon dated to AD 1270-1450 and 1070-1220. Laterally extensive sand sheets containing marine or brackish diatom assemblages suggest tsunami deposition associated with at least two of the three pre-1960 earthquakes. The record presented here suggests a longer earthquake recurrence interval, averaging 270 years, than the historical recurrence interval, which averages 128 years. The lack of geologic evidence at Chucalén of two historically documented earthquakes, in 1737 and 1837, supports the previously suggested hypothesis of variability in historical earthquake characteristics. Our estimates of coseismic land-level change for the four earthquakes range from meter-scale subsidence to no subsidence or slight uplift, suggesting earthquakes completing each ~270 year cycle may not share a common, characteristic slip distribution. The presence of buried soils at elevations below their modern equivalents implies net relative sea-level rise over the course of the Chucalén paleoseismic record, in contrast to relative sea-level fall over preceding millennia inferred from sites on the mainland. Sea-level rise may contribute to the preservation of evidence for multiple earthquakes during the last millennium, while net relative sea-level fall over the last 2000-5000 years may explain the lack of evidence for older earthquakes. [ABSTRACT FROM AUTHOR]