Cardiovascular risk assessments at occupational health services: employee experiences

Background: Across England in the UK, population screening for cardiovascular disease (CVD) primarily takes place within general practice in the form of the National Health Service Health Check. Additional screening sites such as occupational health are advocated to improve the population impact. Aims: To investigate participant experiences with cardiovascular and type 2 diabetes risk assessment (RA) at occupational health and subsequent support-seeking at general practice. Methods: Face-to-face interviews were conducted for this qualitative study. Participants were recruited at three workplaces; a steel works and two hospital sites. Using interpretive phenomenological analyses, themes were drawn from salient narratives and categorically organized. Results: There were 29 participants. Themes (n = 16) were organized into two domains; factors that facilitated (n = 9) or thwarted (n = 7) participant engagement with the RA and general practice. All participants described the RA as worthwhile and strongly valued RA at occupational health. Those with obesity and high CVD risk highlighted their difficulties in making lifestyle changes. Participants reported confusion and anxiety when GP advice about medication appeared to contradict what participants had interpreted during RA at occupational health. Conclusions: This study highlights factors that facilitate or thwart engagement in cardiovascular RA at occupational health services and general practice follow-up. Stakeholders can integrate these factors into standard operating procedures to enhance participant engagement and enable safeguards that minimize potential harm to participants

Environmental DNA can act as a biodiversity barometer of anthropogenic pressures in coastal ecosystems

Loss of biodiversity from lower to upper trophic levels reduces overall productivity and stability of coastal ecosystems in our oceans, but rarely are these changes documented across both time and space. The characterisation of environmental DNA (eDNA) from sediment and seawater using metabarcoding offers a powerful molecular lens to observe marine biota and provides a series of ‘snapshots’ across a broad spectrum of eukaryotic organisms. Using these next-generation tools and downstream analytical innovations including machine learning sequence assignment algorithms and co-occurrence network analyses, we examined how anthropogenic pressures may have impacted marine biodiversity on subtropical coral reefs in Okinawa, Japan. Based on 18 S ribosomal RNA, but not ITS2 sequence data due to inconsistent amplification for this marker, as well as proxies for anthropogenic disturbance, we show that eukaryotic richness at the family level significantly increases with medium and high levels of disturbance. This change in richness coincides with compositional changes, a decrease in connectedness among taxa, an increase in fragmentation of taxon co-occurrence networks, and a shift in indicator taxa. Taken together, these findings demonstrate the ability of eDNA to act as a barometer of disturbance and provide an exemplar of how biotic networks and coral reefs may be impacted by anthropogenic activities

Tactile Presentation of Network Data: Text, Matrix or Diagram?

Visualisations are commonly used to understand social, biological and other kinds of networks. Currently, we do not know how to effectively present network data to people who are blind or have low-vision (BLV). We ran a controlled study with 8 BLV participants comparing four tactile representations: organic node-link diagram, grid node-link diagram, adjacency matrix and braille list. We found that the node-link representations were preferred and more effective for path following and cluster identification while the matrix and list were better for adjacency tasks. This is broadly in line with findings for the corresponding visual representations.Comment: To appear in the ACM CHI Conference on Human Factors in Computing Systems (CHI 2020

Quantum corrections for spinning particles in de Sitter

We compute the one-loop quantum corrections to the gravitational potentials of a spinning point particle in a de Sitter background, due to the vacuum polarisation induced by conformal fields in an effective field theory approach. We consider arbitrary conformal field theories, assuming only that the theory contains a large number N of fields in order to separate their contribution from the one induced by virtual gravitons. The corrections are described in a gauge-invariant way, classifying the induced metric perturbations around the de Sitter background according to their behaviour under transformations on equal-time hypersurfaces. There are six gauge-invariant modes: two scalar Bardeen potentials, one transverse vector and one transverse traceless tensor, of which one scalar and the vector couple to the spinning particle. The quantum corrections consist of three different parts: a generalisation of the flat-space correction, which is only significant at distances of the order of the Planck length; a constant correction depending on the undetermined parameters of the renormalised effective action; and a term which grows logarithmically with the distance from the particle. This last term is the most interesting, and when resummed gives a modified power law, enhancing the gravitational force at large distances. As a check on the accuracy of our calculation, we recover the linearised Kerr-de Sitter metric in the classical limit and the flat-space quantum correction in the limit of vanishing Hubble constant

LAY summaries for Cortex articles

Force-directed layout algorithms produce graph drawings by resolving a system of emulated physical forces. We present techniques for using social gravity as an additional force in force-directed layouts, together with a scaling technique, to produce drawings of trees and forests, as well as more complex social networks. Social gravity assigns mass to vertices in proportion to their network centrality, which allows vertices that are more graph-theoretically central to be visualized in physically central locations. Scaling varies the gravitational force throughout the simulation, and reduces crossings relative to unscaled gravity. In addition to providing this algorithmic framework, we apply our algorithms to social networks produced by Mark Lombardi, and we show how social gravity can be incorporated into force-directed Lombardi-style drawings.Comment: GD201

Drug resistance beyond extensively drugresistant tuberculosis: Individual patient data meta-analysis

The broadest pattern of tuberculosis (TB) drug resistance for which a consensus definition exists is extensively drug-resistant (XDR)-TB. It is not known if additional drug resistance portends worsened patient outcomes. This study compares treatment outcomes of XDR-TB patients with and without additional resistance in order to explore the need for a new definition. Individual patient data on XDR-TB outcomes were included in a meta-analysis comparing outcomes between XDR alone and three nonmutually exclusive XDR-TB patient groups: XDR plus resistance to all the second-line injectables (sli) and capreomycin and kanamycin/amikacin (XDR+2sli) XDR plus resistance to second-line injectables and to more than one group 4 drug, i.e. ethionamide/protionamide, cycloserine/ terizidone or para-aminosalicylic acid (XDR+sliG4) and XDR+sliG4 plus resistance to ethambutol and/or pyrazinamide (XDR+sliG4EZ). Of 405 XDR-TB cases, 301 were XDR alone, 68 XDR+2sli, 48 XDR+sliG4 and 42 XDR+sliG4EZ. In multivariate analysis, the odds of cure were significantly lower in XDR+2sli (adjusted OR 0.4, 95%CI 0.2- 0.8) compared to XDR alone, while odds of failure and death were higher in all XDR patients with additional resistance (adjusted OR 2.6-2.8). Patients with additional resistance beyond XDR-TB showed poorer outcomes. Limitations in availability, accuracy and reproducibility of current drug susceptibility testing methods preclude the adoption of a useful definition beyond the one currently used for XDR-TB. Copyright © ERS 2013.Y