• Waiting for Brexit: Crisis, conjuncture, method

      Hall, Sarah Marie; orcid: 0000-0002-6379-4544; email: sarah.m.hall@manchester.ac.uk (2021-10-20)
      Abstract: UK geopolitics for the last five years has been heavily dominated by Brexit. The lead up to the referendum, the result, negotiations, intervening general election, extensions, further negotiations, and impending exit from the European Union have captured both academic and public interest. This paper contributes to geographical and wider social science research on the everyday geographies of socio‐economic change, with a particular focus on Brexit and the temporal politics of waiting. Emerging analyses focus on Brexit as an event, as uncertainty, and a discrete period for and of research on public moods. I illustrate how exploring Brexit through the lens of waiting provides new ways of thinking through the time‐spaces of Brexit, by drawing on data collected during an ethnographic participatory project in Gorse Hill, Greater Manchester (2018–2020). Analysis of group discussions, peer‐led research projects, podcast recordings, vox pops, and ethnographic fieldnotes highlight the embodied, everyday, endured, and emplaced experience of waiting for Brexit. More specifically, findings make the case for this waiting as crisis, as conjuncture, and as method. The paper closes with a discussion of the pace and timeliness of research, and the implications of waiting for, in, and with Brexit and other forms of socio‐economic change.
    • Walking on Kendall’s Shape Space: Understanding Shape Spaces and Their Coordinate Systems

      Klingenberg, Christian Peter; orcid: 0000-0002-8117-6141; email: cpk@manchester.ac.uk (Springer US, 2020-08-18)
      Abstract: More and more analyses of biological shapes are using the techniques of geometric morphometrics based on configurations of landmarks in two or three dimensions. A fundamental concept at the core of these analyses is Kendall’s shape space and local approximations to it by shape tangent spaces. Kendall’s shape space is complex because it is a curved surface and, for configurations with more than three landmarks, multidimensional. This paper uses the shape space for triangles, which is the surface of a sphere, to explore and visualize some properties of shape spaces and the respective tangent spaces. Considerations about the dimensionality of shape spaces are an important step in understanding them, and can offer a coordinate system that can translate between positions in the shape space and the corresponding landmark configurations and vice versa. By simulation studies “walking” along that are great circles around the shape space, each of them corresponding to the repeated application of a particular shape change, it is possible to grasp intuitively why shape spaces are curved and closed surfaces. From these considerations and the available information on shape spaces for configurations with more than three landmarks, the conclusion emerges that the approach using a tangent space approximation in general is valid for biological datasets. The quality of approximation depends on the scale of variation in the data, but existing analyses suggest this should be satisfactory to excellent in most empirical datasets.
    • Water friction in nanofluidic channels made from two-dimensional crystals

      Keerthi, Ashok; Goutham, Solleti; You, Yi; Iamprasertkun, Pawin; orcid: 0000-0001-8950-3330; Dryfe, Robert A. W.; orcid: 0000-0002-9335-4451; Geim, Andre K.; orcid: 0000-0003-2861-8331; Radha, Boya; orcid: 0000-0003-1345-7029; email: radha.boya@manchester.ac.uk (Nature Publishing Group UK, 2021-05-25)
      Abstract: Membrane-based applications such as osmotic power generation, desalination and molecular separation would benefit from decreasing water friction in nanoscale channels. However, mechanisms that allow fast water flows are not fully understood yet. Here we report angstrom-scale capillaries made from atomically flat crystals and study the effect of confining walls’ material on water friction. A massive difference is observed between channels made from isostructural graphite and hexagonal boron nitride, which is attributed to different electrostatic and chemical interactions at the solid-liquid interface. Using precision microgravimetry and ion streaming measurements, we evaluate the slip length, a measure of water friction, and investigate its possible links with electrical conductivity, wettability, surface charge and polarity of the confining walls. We also show that water friction can be controlled using hybrid capillaries with different slip lengths at opposing walls. The reported advances extend nanofluidics’ toolkit for designing smart membranes and mimicking manifold machinery of biological channels.
    • Water friction in nanofluidic channels made from two-dimensional crystals.

      Keerthi, Ashok; Goutham, Solleti; You, Yi; Iamprasertkun, Pawin; orcid: 0000-0001-8950-3330; Dryfe, Robert A W; orcid: 0000-0002-9335-4451; Geim, Andre K; orcid: 0000-0003-2861-8331; Radha, Boya; orcid: 0000-0003-1345-7029; email: radha.boya@manchester.ac.uk (2021-05-25)
      Membrane-based applications such as osmotic power generation, desalination and molecular separation would benefit from decreasing water friction in nanoscale channels. However, mechanisms that allow fast water flows are not fully understood yet. Here we report angstrom-scale capillaries made from atomically flat crystals and study the effect of confining walls' material on water friction. A massive difference is observed between channels made from isostructural graphite and hexagonal boron nitride, which is attributed to different electrostatic and chemical interactions at the solid-liquid interface. Using precision microgravimetry and ion streaming measurements, we evaluate the slip length, a measure of water friction, and investigate its possible links with electrical conductivity, wettability, surface charge and polarity of the confining walls. We also show that water friction can be controlled using hybrid capillaries with different slip lengths at opposing walls. The reported advances extend nanofluidics' toolkit for designing smart membranes and mimicking manifold machinery of biological channels.
    • We See Data Everywhere Except in the Productivity Statistics

      Goodridge, Peter; email: peter.goodridge@manchester.ac.uk; Haskel, Jonathan; Edquist, Harald (2021-09-28)
      This paper uses Labor Force Survey data for European countries to estimate national investment in data assets, where the asset boundary is extended beyond that for software and databases as currently defined in the System of National Accounts. We find that: (a) in 2011–2018, 1.4 percent of EU‐28 employment was engaged in the formation of (software and) data assets, with a mean growth rate of 5 percent per annum; (b) on average in 2011–2016, expanding the asset boundary raises the level of own‐account GFCF in software and databases in the EU‐16 by 61 percent, and mean growth in real investment in own‐account software and data assets to 6.9 percent pa, compared to 2.7 percent pa in national accounts; (c) in 2011–2016, expansion of the asset boundary raises labor productivity growth in the EU‐13 from 0.79 percent to 0.83 percent pa, and the contribution of software and data capital deepening over three‐fold, from 0.03 percent to 0.10 percent pa.
    • Weak Vestibular Response in Persistent Developmental Stuttering

      Gattie, Max; email: max.gattie@manchester.ac.uk; Lieven, Elena V. M.; Kluk, Karolina (Frontiers Media S.A., 2021-09-01)
      Vibrational energy created at the larynx during speech will deflect vestibular mechanoreceptors in humans (Todd et al., 2008; Curthoys, 2017; Curthoys et al., 2019). Vestibular-evoked myogenic potential (VEMP), an indirect measure of vestibular function, was assessed in 15 participants who stutter, with a non-stutter control group of 15 participants paired on age and sex. VEMP amplitude was 8.5 dB smaller in the stutter group than the non-stutter group (p = 0.035, 95% CI [−0.9, −16.1], t = −2.1, d = −0.8, conditional R2 = 0.88). The finding is subclinical as regards gravitoinertial function, and is interpreted with regard to speech-motor function in stuttering. There is overlap between brain areas receiving vestibular innervation, and brain areas identified as important in studies of persistent developmental stuttering. These include the auditory brainstem, cerebellar vermis, and the temporo-parietal junction. The finding supports the disruptive rhythm hypothesis (Howell et al., 1983; Howell, 2004) in which sensory inputs additional to own speech audition are fluency-enhancing when they coordinate with ongoing speech.
    • Weight loss during intrauterine progestin treatment for obesity-associated atypical hyperplasia and early stage cancer of the endometrium.

      Barr, Chloe E; Ryan, Neil Aj; Derbyshire, Abigail E; Wan, Y Louise; MacKintosh, Michelle L; McVey, Rhona J; Bolton, James; Fitzgerald, Cheryl; Awad, Dina; Slade, Richard J; et al. (2021-08-04)
      Intrauterine progestin is a treatment option for women with atypical hyperplasia or low-risk endometrial cancer who wish to preserve their fertility, or whose poor surgical fitness precludes safe hysterectomy. We hypothesized that in such women with obesity, weight loss during progestin treatment may improve oncological outcomes. We conducted a prospective non-randomized study of women with obesity and atypical hyperplasia or low-grade stage 1a endometrial cancer undergoing progestin treatment. Women with a BMI{greater than or equal to}35kg/m2 were offered bariatric surgery; those who declined and those with BMI 30-34.9kg/m2 were encouraged to lose weight by low-calorie diet. We assessed uptake of bariatric surgery; weight lost during progestin treatment; and the impact of >10% total body weight loss on progestin treatment response at 12 months. 71 women [median age 58years-(IQR 35-65); mean BMI 48kg/m2-(SD 9.3)] completed the study. 23 women (32%) had bariatric surgery, on average 5 months (IQR 3-8) after progestin treatment commenced. Weight change during progestin treatment was -33.4kg (95%CI -42.1, -24.7) and -4.6kg (95%CI -7.8, -1.4) in women receiving bariatric surgery and low-calorie diet, respectively (p<0.001). 43 women (61%) responded to progestin, while 23(32%) showed stabilized and 5(7%) progressive disease. Response at 12 months was not predicted by age or baseline BMI, but women who lost >10% of their total body weight were more likely to respond to progestin than those who did not (adjusted odds ratio 3.95; 95%CI 1.3, 12.5; p=0.02). Thus weight loss may improve oncological outcomes in women with obesity-associated endometrial neoplastic abnormalities treated with progestin.
    • "Welsh obscurity to notoriety" - Lloyd George, the Boer War, and the North Wales Press

      Peters, Lisa; University of Chester (Oak Knoll Press & The British Library, 2008-05)
      This book chapter discusses the actions of David Lloyd George (MP for the Carnarvon Boroughs and future Prime Minister) during the Boer War of 1899-1902 as seen by the local North Wales press, The chapter seeks to cast light upon local views of Lloyd George's stance and explain why he was re-elected with an increased majority in the 1900 general election, despite accusations of treason. Newspapers analysed include the Carnarvon & Denbigh Herald, the North Wales Times, Yr Herald Cymraeg, the North Wales Chronicle, the Wrexham Advertiser, the North Wales Guardian, the Holyhead Mail and Anglesey Herald, and Y Baner ac Amserau Cymru.
    • Welsh periodicals in the nineteenth century

      Peters, Lisa; University of Chester (2014-05-27)
      This presentation places the developing Welsh periodical press within the changing economic, political, and social nature of nineteenth century Wales.
    • Were the Early Christians Really Persecuted?

      Middleton, Paul (Amsterdam University Press, 2021-06-25)
      The long-held image of early Christ-believers persecuted by an intolerant state has been called into question by a “minimalist” view, which, in contrast, understands Christian obstinacy as intolerance of a largely tolerant Roman state. This article seeks to balance these two extremes by offering a new model of “modified minimalism,” which accounts for both Christian and Roman viewpoints.
    • What are the benefits and harms of risk stratified screening as part of the NHS breast screening Programme? Study protocol for a multi-site non-randomised comparison of BC-predict versus usual screening (NCT04359420)

      French, David P.; orcid: 0000-0002-7663-7804; email: David.French@manchester.ac.uk; Astley, Susan; Brentnall, Adam R.; Cuzick, Jack; Dobrashian, Richard; Duffy, Stephen W.; Gorman, Louise S.; Harkness, Elaine F.; Harrison, Fiona; Harvie, Michelle; et al. (BioMed Central, 2020-06-18)
      Abstract: Background: In principle, risk-stratification as a routine part of the NHS Breast Screening Programme (NHSBSP) should produce a better balance of benefits and harms. The main benefit is the offer of NICE-approved more frequent screening and/ or chemoprevention for women who are at increased risk, but are unaware of this. We have developed BC-Predict, to be offered to women when invited to NHSBSP which collects information on risk factors (self-reported information on family history and hormone-related factors via questionnaire; mammographic density; and in a sub-sample, Single Nucleotide Polymorphisms). BC-Predict produces risk feedback letters, inviting women at high risk (≥8% 10-year) or moderate risk (≥5 to < 8% 10-year) to have discussion of prevention and early detection options at Family History, Risk and Prevention Clinics. Despite the promise of systems such as BC-Predict, there are still too many uncertainties for a fully-powered definitive trial to be appropriate or ethical. The present research aims to identify these key uncertainties regarding the feasibility of integrating BC-Predict into the NHSBSP. Key objectives of the present research are to quantify important potential benefits and harms, and identify key drivers of the relative cost-effectiveness of embedding BC-Predict into NHSBSP. Methods: A non-randomised fully counterbalanced study design will be used, to include approximately equal numbers of women offered NHSBSP (n = 18,700) and BC-Predict (n = 18,700) from selected screening sites (n = 7). In the initial 8-month time period, women eligible for NHSBSP will be offered BC-Predict in four screening sites. Three screening sites will offer women usual NHSBSP. In the following 8-months the study sites offering usual NHSBSP switch to BC-Predict and vice versa. Key potential benefits including uptake of risk consultations, chemoprevention and additional screening will be obtained for both groups. Key potential harms such as increased anxiety will be obtained via self-report questionnaires, with embedded qualitative process analysis. A decision-analytic model-based cost-effectiveness analysis will identify the key uncertainties underpinning the relative cost-effectiveness of embedding BC-Predict into NHSBSP. Discussion: We will assess the feasibility of integrating BC-Predict into the NHSBSP, and identify the main uncertainties for a definitive evaluation of the clinical and cost-effectiveness of BC-Predict. Trial registration: Retrospectively registered with clinicaltrials.gov (NCT04359420).
    • What does safety in mental healthcare transitions mean for service users and other stakeholder groups: An open‐ended questionnaire study

      Tyler, Natasha; orcid: 0000-0001-8257-1090; email: natasha.tyler@manchester.ac.uk; Wright, Nicola; Panagioti, Maria; orcid: 0000-0002-7153-5745; Grundy, Andrew; Waring, Justin (2021-01-20)
      Abstract: Background: Historically, safety mental health research has tended to focus on risks of homicide, suicide and deaths. Although wider safety issues are now recognized in regards to mental health services, the safety of mental health transitions, a key research and policy priority according to World Health Organisation, has not been explored. Objective: The purpose of this study was to investigate perceptions of safety in mental health transitions (hospital to community) amongst five stakeholder groups. Design and setting: An online, international cross‐sectional, open‐ended questionnaire. Participants: There were five stakeholder participant groups: service users; families/carers; mental health‐care professionals; researchers; and end users of research. Results: Ninety‐three participants from 12 different countries responded. Three overarching themes emerged: ‘individual/clinical’, ‘systems/services’ and ‘human, behavioural and social’ elements of safe mental health transitions. Whilst there was a great focus on clinical elements from researchers and healthcare professionals, service users and carers considered safety in terms of human, behavioural and social elements of transitional safety (ie loneliness, emotional readiness for discharge) and systems/services (ie inter‐professional communication). Discussion: Safety in mental health‐care transitions is perceived differently by service users and families compared to healthcare professionals and researchers. Traditional safety indicators for care transitions such as suicide, self‐harm and risk of adverse drug events are raised as important. However, service users and families in particular have a much wider perception of transitions safety. Conclusion: Future quality and safety research and policy should consider including a service user voice and consider integration of psychosocial elements in discharge interventions.
    • What influences people's responses to public health messages for managing risks and preventing infectious diseases? A rapid systematic review of the evidence and recommendations.

      Ghio, Daniela; orcid: 0000-0002-0580-0205; Lawes-Wickwar, Sadie; Tang, Mei Yee; Epton, Tracy; email: tracy.epton@manchester.ac.uk; Howlett, Neil; orcid: 0000-0002-6502-9969; Jenkinson, Elizabeth; Stanescu, Sabina; Westbrook, Juliette; Kassianos, Angelos P; Watson, Daniella; et al. (2021-11-11)
      Individual behaviour changes, such as hand hygiene and physical distancing, are required on a population scale to reduce transmission of infectious diseases such as COVID-19. However, little is known about effective methods of communicating risk reducing information, and how populations might respond. To synthesise evidence relating to what (1) characterises effective public health messages for managing risk and preventing infectious disease and (2) influences people's responses to messages. A rapid systematic review was conducted. Protocol is published on Prospero CRD42020188704. Electronic databases were searched: Ovid Medline, Ovid PsycINFO and Healthevidence.org, and grey literature (PsyarXiv, OSF Preprints) up to May 2020. All study designs that (1) evaluated public health messaging interventions targeted at adults and (2) concerned a communicable disease spread via primary route of transmission of respiratory and/or touch were included. Outcomes included preventative behaviours, perceptions/awareness and intentions. Non-English language papers were excluded. Due to high heterogeneity studies were synthesised narratively focusing on determinants of intentions in the absence of measured adherence/preventative behaviours. Themes were developed independently by two researchers and discussed within team to reach consensus. Recommendations were translated from narrative synthesis to provide evidence-based methods in providing effective messaging. Sixty-eight eligible papers were identified. Characteristics of effective messaging include delivery by credible sources, community engagement, increasing awareness/knowledge, mapping to stage of epidemic/pandemic. To influence intent effectively, public health messages need to be acceptable, increase understanding/perceptions of health threat and perceived susceptibility. There are four key recommendations: (1) engage communities in development of messaging, (2) address uncertainty immediately and with transparency, (3) focus on unifying messages from sources and (4) frame messages aimed at increasing understanding, social responsibility and personal control. Embedding principles of behavioural science into public health messaging is an important step towards more effective health-risk communication during epidemics/pandemics. [Abstract copyright: © Author(s) (or their employer(s)) 2021. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.]
    • What influences practitioners’ readiness to deliver psychological interventions by telephone? A qualitative study of behaviour change using the Theoretical Domains Framework

      Faija, Cintia L.; orcid: 0000-0002-6497-9196; email: Cintia.faija@manchester.ac.uk; Connell, Janice; Welsh, Charlotte; Ardern, Kerry; Hopkin, Elinor; Gellatly, Judith; Rushton, Kelly; Fraser, Claire; Irvine, Annie; Armitage, Christopher J.; et al. (BioMed Central, 2020-07-16)
      Abstract: Background: Contemporary health policy is shifting towards remotely delivered care. A growing need to provide effective and accessible services, with maximal population reach has stimulated demand for flexible and efficient service models. The implementation of evidence-based practice has been slow, leaving many services ill equipped to respond to requests for non-face-to-face delivery. To address this translation gap, and provide empirically derived evidence to support large-scale practice change, our study aimed to explore practitioners’ perspectives of the factors that enhance the delivery of a NICE-recommended psychological intervention, i.e. guided self-help by telephone (GSH-T), in routine care. We used the Theoretical Domains Framework (TDF) to analyse our data, identify essential behaviour change processes and encourage the successful implementation of remote working in clinical practice. Method: Thirty-four psychological wellbeing practitioners (PWPs) from the UK NHS Improving Access to Psychological Therapies (IAPT) services were interviewed. Data were first analysed inductively, with codes cross-matched deductively to the TDF. Results: Analysis identified barriers to the delivery, engagement and implementation of GSH-T, within eight domains from the TDF: (i) Deficits in practitioner knowledge, (ii) Sub-optimal practitioner telephone skills, (iii) Practitioners’ lack of beliefs in telephone capabilities and self-confidence, (iv) Practitioners’ negative beliefs about consequences, (v) Negative emotions, (vi) Professional role expectations (vii) Negative social influences, and (viii) Challenges in the environmental context and resources. A degree of interdependence was observed between the TDF domains, such that improvements in one domain were often reported to confer secondary advantages in another. Conclusions: Multiple TDF domains emerge as relevant to improve delivery of GSH-T; and these domains are theoretically and practically interlinked. A multicomponent approach is recommended to facilitate the shift from in-person to telephone-based service delivery models, and prompt behaviour change at practitioner, patient and service levels. At a minimum, the development of practitioners’ telephone skills, an increase in clients’ awareness of telephone-based treatment, dilution of negative preconceptions about telephone treatment, and robust service level guidance and standards for implementation are required. This is the first study that provides clear direction on how to improve telephone delivery and optimise implementation, aligning with current mental health policy and service improvement.
    • ‘What I’m not gonna buy’: Algorithmic culture jamming and anti-consumer politics on YouTube

      Wood, Rachel; orcid: 0000-0002-0053-2969 (SAGE Publications, 2020-07-08)
      This article is based on an analysis of ‘anti-haul’ videos on YouTube, where a vlogger explains which beauty products they plan not to buy. Anti-haul vloggers have much in common with ‘culture jamming’ movements, which use the communicative practices and materials of promotional culture against itself to spread an anti-consumerist agenda. The article argues that anti-hauls should be understood as the reinvention of ‘culture jamming’ techniques for a contemporary promotional culture that is platform based, algorithmically governed, and mobilised through the affective, authentic performance of the ‘influencer’. I refer to this manipulation of the platform’s visibility mechanisms to spread anti-consumer messages as ‘algorithmic culture jamming’. The anti-consumer politics of anti-hauls are contradictory and ambivalent. At the same time, I argue that anti-hauls also offer important possibilities for political learning, personal and collective transformation, and alternative creative pleasures outside of continual consumer accumulation.
    • What passive euthanasia is

      Brassington, Iain; orcid: 0000-0002-1097-0567; email: iain.brassington@manchester.ac.uk (BioMed Central, 2020-05-14)
      Abstract: Background: Euthanasia can be thought of as being either active or passive; but the precise definition of “passive euthanasia” is not always clear. Though all passive euthanasia involves the withholding of life-sustaining treatment, there would appear to be some disagreement about whether all such withholding should be seen as passive euthanasia. Main text: At the core of the disagreement is the question of the importance of an intention to bring about death: must one intend to bring about the death of the patient in order for withholding treatment to count as passive euthanasia, as some sources would indicate, or does withholding in which death is merely foreseen belong to that category? We may expect that this unclarity would be important in medical practice, in law, and in policy. The idea that withholding life-sustaining treatment is passive euthanasia is traced to James Rachels’s arguments, which lend themselves to the claim that passive euthanasia does not require intention to end life. Yet the argument here is that Rachels’s arguments are flawed, and we have good reasons to think that intention is important in understanding the moral nature of actions. As such, we should reject any understanding of passive euthanasia that does not pay attention to intent. Short conclusion: James Rachels’s work on active and passive euthanasia has been immensely influential; but this is an influence that we ought to resist.
    • What’s so naïve about naïve realism?

      Raineri, Carlo; orcid: 0000-0003-2011-0322; email: Carlo.raineri@manchester.ac.uk (Springer Netherlands, 2021-03-08)
      Abstract: Naïve Realism claims that veridical perceptual experiences essentially consist in genuine relations between perceivers and mind-independent objects and their features. The contemporary debate in the philosophy of perception has devoted little attention to assessing one of the main motivations to endorse Naïve Realism–namely, that it is the only view which articulates our ‘intuitive’ conception of perception. In this paper, I first clarify in which sense Naïve Realism is supposed to be ‘naïve’. In this respect, I argue that it is put forward as the only view which can take our introspective knowledge of perception at face value, and I identify the two (alleged) key features of such introspective knowledge. Second, I challenge the claim that one of these features-namely, that it seems as one could not be in the same perceptual state unless the putative objects of perception existed and were perceived–is introspectively evident. Consequently, I argue that a view of perceptual experience–such as Intentionalism–which denies that this feature is true of perception can still take introspection at face value. This undermines the claim that Naïve Realism is the only account which accommodates our intuitions on the nature of perception.
    • Where is toxicity located? Side glances through fieldwork in a toxic place

      Perczel, Julia; email: julia.perczel@manchester.ac.uk (2021-08-01)
      Despite the notorious invisibility of toxicity, an aesthetic narrative has developed around the threat of e‐waste. In reports about toxicity in New Delhi, India, the dirt, grime and discarded remnants of electronics are presented in a particular visual manner to instil horror among readers and viewers. Such a representation has far‐reaching influences on policy. The seven pictures and the accompanying text in this article seek to challenge such a linear narrative of e‐waste's toxicity and offer fragments of other untold stories that challenge the established narrative and evoke the rich social life entwined with e‐waste.
    • Which interventions increase hearing protection behaviors during noisy recreational activities? A systematic review

      Loughran, Michael T.; orcid: 0000-0002-1158-1096; email: michael.loughran@manchester.ac.uk; Lyons, Stephanie; Plack, Christopher J.; Armitage, Christopher J. (BioMed Central, 2020-09-13)
      Abstract: Background: Hearing loss and tinnitus are global concerns that can be reduced through hearing protection behaviors (e.g., earplug use). Little is known about the effectiveness of interventions to increase hearing protection use in recreational domains. For the first time we review systematically the effectiveness of such interventions. Methods: Systematic searches of nine databases, as well as grey literature and hand-searching, were conducted. Any study design was included if it assessed quantitatively a purposeful attempt to increase hearing protection in recreational settings. Studies were excluded if they assessed noise exposure from occupational sources and headphones/earphones, as these have been reviewed elsewhere. PROSPERO protocol: CRD42018098573. Results: Eight studies were retrieved following the screening of 1908 articles. Two pretest-posttest studies detected a small to medium effect (d ≥ 0·3 ≤ 0·5), one a small effect (d ~ =0·2) and two no real effect. Three posttest experimental studies detected small to medium effects (d ≥ 0·3 ≤ 0·5). Studies were rated as “poor quality” and 17 out of a possible 93 behavior change techniques were coded, with the majority targeting the intervention function ‘education’. Conclusions: Hearing loss and tinnitus due to recreational noise exposure are major public health concerns yet very few studies have examined preventive interventions. The present systematic review sets the agenda for the future development and testing of evidence-based interventions designed to prevent future hearing loss and tinnitus caused by noise in recreational settings, by recommending systematic approaches to intervention design, and implementation of intervention functions beyond education, such as incentivization, enablement and modeling.
    • Whole-genome analysis of Nigerian patients with breast cancer reveals ethnic-driven somatic evolution and distinct genomic subtypes

      Ansari-Pour, Naser; orcid: 0000-0003-0908-0484; Zheng, Yonglan; orcid: 0000-0001-6597-7072; Yoshimatsu, Toshio F.; orcid: 0000-0003-2674-8159; Sanni, Ayodele; Ajani, Mustapha; orcid: 0000-0001-5758-5773; Reynier, Jean-Baptiste; Tapinos, Avraam; Pitt, Jason J.; Dentro, Stefan; Woodard, Anna; et al. (Nature Publishing Group UK, 2021-11-26)
      Abstract: Black women across the African diaspora experience more aggressive breast cancer with higher mortality rates than white women of European ancestry. Although inter-ethnic germline variation is known, differential somatic evolution has not been investigated in detail. Analysis of deep whole genomes of 97 breast cancers, with RNA-seq in a subset, from women in Nigeria in comparison with The Cancer Genome Atlas (n = 76) reveal a higher rate of genomic instability and increased intra-tumoral heterogeneity as well as a unique genomic subtype defined by early clonal GATA3 mutations with a 10.5-year younger age at diagnosis. We also find non-coding mutations in bona fide drivers (ZNF217 and SYPL1) and a previously unreported INDEL signature strongly associated with African ancestry proportion, underscoring the need to expand inclusion of diverse populations in biomedical research. Finally, we demonstrate that characterizing tumors for homologous recombination deficiency has significant clinical relevance in stratifying patients for potentially life-saving therapies.