eMental Health Bridges Project: A Web Site Development Project to Provide Needed Mental and Physical Health Information to People with Serious Mental Illness [English and Spanish versions]

A Spanish translation of this publication is available to download under Additional Files below. The eMental Health Bridges project will promote health literacy by developing, testing, and implementing: 1) eMH4me training modules to provide guidance for individuals with SMI on web-based information searching, judging source and site credibility, and interpreting data; and 2) web site prototypes that will serve as a connection to essential physical health information for individuals living with SMI. eMental Health Bridges will embrace user experience and design accommodations required for individuals with SMI to benefit fully from eHealth resources

The Anisotropic Spatial Distribution of Hypervelocity Stars

We study the distribution of angular positions and angular separations of unbound hypervelocity stars (HVSs). HVSs are spatially anisotropic at the 3-sigma level. The spatial anisotropy is significant in Galactic longitude, not in latitude, and the inclusion of lower velocity, possibly bound HVSs reduces the significance of the anisotropy. We discuss how the observed distribution of HVSs may be linked to their origin. In the future, measuring the distribution of HVSs in the southern sky will provide additional constraints on the spatial anisotropy and the origin of HVSs.Comment: 4 pages, accepted to ApJ Letter

Separating the direct effects of traits on atherosclerotic cardiovascular disease from those mediated by type 2 diabetes

AIMS/HYPOTHESIS: Type 2 diabetes and atherosclerotic CVD share many risk factors. This study aimed to systematically assess a broad range of continuous traits to separate their direct effects on coronary and peripheral artery disease from those mediated by type 2 diabetes. METHODS: Our main analysis was a two-step Mendelian randomisation for mediation to quantify the extent to which the associations observed between continuous traits and liability to atherosclerotic CVD were mediated by liability to type 2 diabetes. To support this analysis, we performed several univariate Mendelian randomisation analyses to examine the associations between our continuous traits, liability to type 2 diabetes and liability to atherosclerotic CVD. RESULTS: Eight traits were eligible for the two-step Mendelian randomisation with liability to coronary artery disease as the outcome and we found similar direct and total effects in most cases. Exceptions included fasting insulin and hip circumference where the proportion mediated by liability to type 2 diabetes was estimated as 56% and 52%, respectively. Six traits were eligible for the analysis with liability to peripheral artery disease as the outcome. Again, we found limited evidence to support mediation by liability to type 2 diabetes for all traits apart from fasting insulin (proportion mediated: 70%). CONCLUSIONS/INTERPRETATION: Most traits were found to affect liability to atherosclerotic CVD independently of their relationship with liability to type 2 diabetes. These traits are therefore important for understanding atherosclerotic CVD risk regardless of an individual’s liability to type 2 diabetes. GRAPHICAL ABSTRACT: [Image: see text] SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00125-022-05653-1

A retrospective description of primary immuno­deficiency diseases at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa, 1975 - 2017

Background. The primary immunodeficiency diseases (PIDs) constitute a diverse and ever-expanding group of inborn errors affecting a wide range of immune functions. They are not well documented in sub-Saharan Africa.Objectives. To describe the spectrum of PIDs at a tertiary paediatric hospital.Methods. A retrospective descriptive study of PIDs diagnosed at Red Cross War Memorial Children’s Hospital, Cape Town, South Africa (SA), between 1975 and 2017 was undertaken.Results. We identified 252 children with PIDs, spanning eight of the nine categories listed in the 2017 classification of the International Union of Immunological Societies. Predominantly antibody deficiencies, combined immunodeficiencies with associated syndromic features, and immunodeficiencies affecting cellular and humoral immunity accounted for most children with PIDs (n=199, 79.0%). The mean age (standard deviation) at diagnosis was 46 (50) months, and the male/female ratio was 1.5:1. There was a history of parental consanguinity in 3 cases (1.2%). Recurrent infection was the most prevalent presenting phenotype, manifesting in 177 patients (70.2%). Genetic or chromosomal confirmation was obtained in 42/252 cases (16.7%). Common interventions used to prevent infection were antimicrobial prophylaxis and immunoglobulin replacement therapy, administered to 95 (37.7%) and 93 (36.9%) of the patients, respectively. Six of 7 children who underwent haematopoietic stem cell transplantation (HSCT) had successful outcomes. The 7th patient died 2 months after HSCT from overwhelming infection. Although we could not account for the children lost to follow-up during the study period, 53 deaths were confirmed (21.0%).Conclusions. Several challenges exist in the recognition and treatment of children with PIDs in our setting. These include limited access to genetic diagnostics and HSCT. Suboptimal treatment options contribute to the overall mortality of PIDs in SA.

Ending malnutrition in all its forms requires scaling up proven nutrition interventions and much more: a 129-country analysis.

BackgroundSustainable Development Goal (SDG) 2.2 calls for an end to all forms of malnutrition, with 2025 targets of a 40% reduction in stunting (relative to 2012), for wasting to occur in less than 5% of children, and for a 50% reduction in anaemia in women (15-49 years). We assessed the likelihood of countries reaching these targets by scaling up proven interventions and identified priority interventions, based on cost-effectiveness.MethodsFor 129 countries, the Optima Nutrition model was used to compare 2019-2030 nutrition outcomes between a status quo (maintained intervention coverage) scenario and a scenario where outcome-specific interventions were scaled up to 95% coverage over 5 years. The average cost-effectiveness of each intervention was calculated as it was added to an expanding package of interventions.ResultsOf the 129 countries modelled, 46 (36%), 66 (51%) and 0 (0%) were on track to achieve the stunting, wasting and anaemia targets respectively. Scaling up 18 nutrition interventions increased the number of countries reaching the SDG 2.2 targets to 50 (39%), 83 (64%) and 7 (5%) respectively. Intermittent preventative treatment of malaria during pregnancy (IPTp), infant and young child feeding education, vitamin A supplementation and lipid-based nutrition supplements for children produced 88% of the total impact on stunting, with average costs per case averted of US$103, US$267, US$556 and US$1795 when interventions were consecutively scaled up, respectively. Vitamin A supplementation and cash transfers produced 100% of the total global impact on prevention of wasting, with average costs per case averted of US$1989 and US$19,427, respectively. IPTp, iron and folic acid supplementation for non-pregnant women, and multiple micronutrient supplementation for pregnant women produced 85% of the total impact on anaemia prevalence, with average costs per case averted of US$9, US$35 and US$47, respectively.ConclusionsPrioritising nutrition investment to the most cost-effective interventions within the country context can maximise the impact of funding. A greater focus on complementing nutrition-specific interventions with nutrition-sensitive ones that address the social determinants of health is critical to reach the SDG targets

Author Correction: Bacteriological diagnosis of childhood TB: a prospective observational study.

A correction to this article has been published and is linked from the HTML and PDF versions of this paper. The error has been fixed in the paper

Evolution of circular, non-equatorial orbits of Kerr black holes due to gravitational-wave emission: II. Inspiral trajectories and gravitational waveforms

The inspiral of a ``small'' ($\mu \sim 1-100 M_\odot$) compact body into a ``large'' ($M \sim 10^{5-7} M_\odot$) black hole is a key source of gravitational radiation for the space-based gravitational-wave observatory LISA. The waves from such inspirals will probe the extreme strong-field nature of the Kerr metric. In this paper, I investigate the properties of a restricted family of such inspirals (the inspiral of circular, inclined orbits) with an eye toward understanding observable properties of the gravitational waves that they generate. Using results previously presented to calculate the effects of radiation reaction, I assemble the inspiral trajectories (assuming that radiation reacts adiabatically, so that over short timescales the trajectory is approximately geodesic) and calculate the wave generated as the compact body spirals in. I do this analysis for several black hole spins, sampling a range that should be indicative of what spins we will encounter in nature. The spin has a very strong impact on the waveform. In particular, when the hole rotates very rapidly, tidal coupling between the inspiraling body and the event horizon has a very strong influence on the inspiral time scale, which in turn has a big impact on the gravitational wave phasing. The gravitational waves themselves are very usefully described as ``multi-voice chirps'': the wave is a sum of ``voices'', each corresponding to a different harmonic of the fundamental orbital frequencies. Each voice has a rather simple phase evolution. Searching for extreme mass ratio inspirals voice-by-voice may be more effective than searching for the summed waveform all at once.Comment: 15 pages, 11 figures, accepted for publication in PRD. This version incorporates referee's comments, and is much less verbos

Two-dimensional Dirac fermions in a topological insulator: transport in the quantum limit

Pulsed magnetic fields of up to 55T are used to investigate the transport properties of the topological insulator Bi_2Se_3 in the extreme quantum limit. For samples with a bulk carrier density of n = 2.9\times10^16cm^-3, the lowest Landau level of the bulk 3D Fermi surface is reached by a field of 4T. For fields well beyond this limit, Shubnikov-de Haas oscillations arising from quantization of the 2D surface state are observed, with the \nu =1 Landau level attained by a field of 35T. These measurements reveal the presence of additional oscillations which occur at fields corresponding to simple rational fractions of the integer Landau indices.Comment: 5 pages, 4 figure

A new conceptual framework for revenge firesetting

Revenge has frequently been acknowledged to account for a relatively large proportion of motives in deliberate firesetting. However, very little is actually known about the aetiology of revenge firesetting. Theoretical approaches to revenge-seeking behaviour are discussed. A brief review of how revenge is accounted for in existing theoretical explanations of deliberate firesetting and the known characteristics of revenge firesetters are provided. On this basis, the authors suggest, as a motive, revenge firesetting has to date been misconceptualised. A new conceptual framework is thus proposed, paying particular attention to the contextual, affective, cognitive, volitional and behavioural factors which may influence and generate a single episode of revenge firesetting. Treatment implications and suggestions for future research are also provided