• Projection of Impaired Life Expectancy in Individuals in the United Kingdom Using Mortality Ratios

      Jones, David Bowen; Gray, Nicole R.; Reid, Madeleine; Scott, William F. (American Academy of Insurance Medicine, 2021-08-02)
      Projections of life expectancy are widely used in medicine, actuarial practice, and in the medicolegal and insurance fields. For individuals considered to have average future survival, nationally-derived life expectancy tables are available, referred to as the Ogden Tables. In the United Kingdom, updated tables (the 8th edition) were published in July 2020. We have calculated impaired projected life expectancies for the United Kingdom based on age and gender, derived from the 8th edition of the Ogden Tables together with various assumed lifelong mortality ratios.
    • Projection of Impaired Life Expectancy in Individuals in the United Kingdom Using Mortality Ratios.

      Jones, David Bowen; Gray, Nicole R; Reid, Madeleine; Scott, William F (2021-08-02)
      Projections of life expectancy are widely used in medicine, actuarial practice, and in the medicolegal and insurance fields. For individuals considered to have average future survival, nationally-derived life expectancy tables are available, referred to as the Ogden Tables. In the United Kingdom, updated tables (the 8th edition) were published in July 2020. We have calculated impaired projected life expectancies for the United Kingdom based on age and gender, derived from the 8th edition of the Ogden Tables together with various assumed lifelong mortality ratios. [Abstract copyright: Copyright © 2021 Journal of Insurance Medicine.]
    • Prospective study on a fast-track training in psychiatry for medical students: the psychiatric hat game

      Clément, Anthony; Delage, Raphaël; Chollier, Marie; Josse, Laure; Gaudry, Stéphane; Zahar, Jean-Ralph; Baubet, Thierry; Degos, Bertrand; email: bertrand.degos@aphp.fr (BioMed Central, 2020-10-19)
      Abstract: Background: While medical students are losing interest in lectures in favor of other educational materials, many studies suggest the benefit of active learning, combined with gamified educational tools. The authors developed a psychiatric adaptation of the « Hat Game ». It was hypothesised that this game would increase both knowledge and motivation in medical students toward psychiatric semiology. The aim of the study was to assess the benefit of a Psychiatric Hat Game session for learning psychiatric symptoms in third-year medical students. Student performance was also evaluated at 3 months. Methods: This gamified fast-track training consists of two teams and each team has to guess as many psychiatric semiology terms as possible using different techniques (i.e. speech, mime). The study involved a pre- and post-evaluation of knowledge (Multiple Choice Questions) and a satisfaction survey. Baseline, post-immediate, and three-months scores were compared by using Friedman analysis for paired samples. Comparisons of mean scores at two different times were performed by using Wilcoxon test for paired samples. Results: One hundred and sixty-six students were proposed to take part in the study. Among them 129 completed the whole program (response rate = 77.7%). Mean scores measured at the three points in time were significantly different (p < 0.001, N = 129). Knowledge mean scores were significantly higher after the game than before (+ 28.6%, p < 0.001). Improvement was maintained 3 months after the game (+ 18.9%, p < 0.001). Satisfaction survey items highlighted that students enjoyed and would recommend this type of gamified training. Conclusions: The Psychiatric Hat Game improved knowledge of psychiatric semiology in medical students. Results suggest that it is a promising and efficient tool to playfully teach medical semiology, with transferable features, utility and acceptability from one medical field to another. This study contributes to the growing body of knowledge advocating for serious games and gamified training in medical education.
    • Prostate cancer evolution from multilineage primary to single lineage metastases with implications for liquid biopsy

      Woodcock, D. J.; orcid: 0000-0003-0576-044X; Riabchenko, E.; Taavitsainen, S.; Kankainen, M.; orcid: 0000-0002-4714-9481; Gundem, G.; orcid: 0000-0002-0070-9859; Brewer, D. S.; orcid: 0000-0003-4753-9794; Ellonen, P.; Lepistö, M.; Golubeva, Y. A.; Warner, A. C.; orcid: 0000-0001-6023-1423; et al. (Nature Publishing Group UK, 2020-10-08)
      Abstract: The evolutionary progression from primary to metastatic prostate cancer is largely uncharted, and the implications for liquid biopsy are unexplored. We infer detailed reconstructions of tumor phylogenies in ten prostate cancer patients with fatal disease, and investigate them in conjunction with histopathology and tumor DNA extracted from blood and cerebrospinal fluid. Substantial evolution occurs within the prostate, resulting in branching into multiple spatially intermixed lineages. One dominant lineage emerges that initiates and drives systemic metastasis, where polyclonal seeding between sites is common. Routes to metastasis differ between patients, and likely genetic drivers of metastasis distinguish the metastatic lineage from the lineage that remains confined to the prostate within each patient. Body fluids capture features of the dominant lineage, and subclonal expansions that occur in the metastatic phase are non-uniformly represented. Cerebrospinal fluid analysis reveals lineages not detected in blood-borne DNA, suggesting possible clinical utility.
    • Protecting noncommunicable disease prevention policy in trade and investment agreements.

      Thow, Anne Marie; Garde, Amandine; Winters, L Alan; Johnson, Ellen; Mabhala, Andi; Kingston, Paul; Barlow, Pepita (2022-02-28)
      Preventing noncommunicable diseases is a global priority, for which the World Health Organization has recommended policies to reduce the consumption of tobacco products, alcohol and unhealthy foods. However, regulation has been strongly opposed by affected industries, who have invoked the provisions of legally binding trade and investment agreements. The aim of this analysis of the legal, economic and public health literature was to present a short primer on the relationship between noncommunicable disease prevention policy and trade and investment agreements to help public health policy-makers safeguard public health policies. The analysis identified opportunities for protecting, and even promoting, public health in trade and investment agreements, including: (i) ensuring exceptions for public health measures are included in agreements; (ii) committing to good regulatory practice that balances transparency and cooperation with the need for governments to limit the influence of vested interests; (iii) ensuring trade and investment agreement preambles acknowledge the importance of public health; (iv) excluding investor-state dispute settlement mechanisms from agreements; and (v) limiting the scope and definition of key provisions on investor protection to reduce the risk of investment disputes. This synthesis of the multidisciplinary literature also provides support for greater strategic and informed engagement between the health and trade policy sectors. In addition, ensuring a high level of health protection in trade and investment agreements requires cooperation between disciplines, engagement with experts in law, economics and public health policy, and fully transparent policy processes and governance structures. [Abstract copyright: (c) 2022 The authors; licensee World Health Organization.]
    • Proton-coupled electron transfer reactivities of electronically divergent heme superoxide intermediates: a kinetic, thermodynamic, and theoretical study.

      Mondal, Pritam; orcid: 0000-0002-7071-1970; Ishigami, Izumi; Gérard, Emilie F; Lim, Chaeeun; Yeh, Syun-Ru; de Visser, Sam P; orcid: 0000-0002-2620-8788; Wijeratne, Gayan B; orcid: 0000-0001-7609-6406 (2021-05-27)
      Heme superoxides are one of the most versatile metallo-intermediates in biology, and they mediate a vast variety of oxidation and oxygenation reactions involving O . Overall proton-coupled electron transfer (PCET) processes they facilitate may proceed several different mechanistic pathways, attributes of which are not yet fully understood. Herein we present a detailed investigation into concerted PCET events of a series of geometrically similar, but electronically disparate synthetic heme superoxide mimics, where unprecedented, PCET feasibility-determining electronic effects of the heme center have been identified. These electronic factors firmly modulate both thermodynamic and kinetic parameters that are central to PCET, as supported by our experimental and theoretical observations. Consistently, the most electron-deficient superoxide adduct shows the strongest driving force for PCET, whereas the most electron-rich system remains unreactive. The pivotal role of these findings in understanding significant heme systems in biology, as well as in alternative energy applications is also discussed. [Abstract copyright: This journal is © The Royal Society of Chemistry.]
    • Psychometric Validation of the Psoriasis Symptoms and Impacts Measure (P-SIM), a Novel Patient-Reported Outcome Instrument for Patients with Plaque Psoriasis, Using Data from the BE VIVID and BE READY Phase 3 Trials.

      Warren, Richard B; email: richard.warren@manchester.ac.uk; Gottlieb, Alice B; Merola, Joseph F; Garcia, Llenalia; Cioffi, Christopher; Peterson, Luke; Pelligra, Christopher; Ciaravino, Valerie (2021-07-14)
      Plaque psoriasis can significantly impact patients' quality of life. We assessed psychometric properties of the Psoriasis Symptoms and Impacts Measure (P-SIM), developed to capture patients' experiences of signs, symptoms and impacts of psoriasis. Pooled, blinded, 16-week data from 1002 patients in the BE VIVID and BE READY bimekizumab phase 3 trials were analysed. The suitability of the P-SIM missing score rule (weekly scores considered missing if ≥ 4 daily scores were missing) was assessed. Test-retest reliability was evaluated using intraclass correlation coefficients (ICCs). Convergent validity was assessed between P-SIM and relevant patient-reported outcome (PRO) (Dermatology Life Quality Index [DLQI], DLQI item 1 [skin symptoms], Patient Global Assessment of Psoriasis) and clinician-reported outcome (ClinRO) scores (Psoriasis Area and Severity Index [PASI], Investigator's Global Assessment [IGA]) at baseline and week 16. Known-groups validity was assessed, comparing P-SIM scores between patient subgroups predefined using PASI/IGA scores. Sensitivity to change over 16 weeks was evaluated; responder definition (RD) thresholds were explored. The missing score rule used did not impact P-SIM scores. Test-retest reliability analyses demonstrated excellent score reproducibility (ICC 0.91-0.98). Inter-item correlations at baseline and week 16 were strong (> 0.5), apart from "choice of clothing" with "skin pain" and "burning" at baseline (both 0.49). All P-SIM scores were moderately to strongly correlated with other outcomes, demonstrating convergent validity, apart from ClinROs (PASI, IGA) at baseline that had low variability. P-SIM scores discriminated known groups at week 16, confirming known-groups validity. Changes from baseline to week 16 in P-SIM and other clinically relevant outcomes were strongly correlated (> 0.5; weaker with ClinROs), establishing sensitivity to change. Anchor-based RD analyses determined a four-point P-SIM item score decrease as indicative of marked clinically meaningful improvement. P-SIM scores demonstrated good reliability, validity and sensitivity to change. A four-point RD threshold could be used to assess 16-week treatment effects. BE VIVID: NCT03370133; BE READY: NCT03410992. [Abstract copyright: © 2021. The Author(s).]
    • Psychosocial stress has weaker than expected effects on episodic memory and related cognitive abilities: a meta-analysis.

      McManus, Elizabeth; Talmi, Deborah; Haroon, Hamied; Muhlert, Nils; email: nils.muhlert@manchester.ac.uk (2021-11-05)
      The impact of stress on episodic memory and related cognitive abilities is well documented in both animal and human literature. However, it is unclear whether the same cognitive effects result from all forms of stress - in particular psychosocial stress. This review systematically explored the effects of psychosocial stress on episodic memory and associated cognitive abilities. PubMed, PsycInfo, and Web of Science databases were searched. Fifty-one studies were identified and compared based on the timing of stress induction. A small positive effect of post-learning psychosocial stress with a long retention interval was shown. No other effects of psychosocial stress were seen. Re-analysis of previous meta-analyses also showed no significant effect of psychosocial stress on episodic memory, highlighting potentially different effects between stressor types. Psychosocial stress also had a moderately different effect when emotional vs. neutral stimuli were compared. Finally, psychosocial stress also decreased performance on executive function, but not working memory tasks. Our findings demonstrate that psychosocial stress may not have the clear effects on episodic memory previously ascribed to it. [Abstract copyright: Copyright © 2021. Published by Elsevier Ltd.]
    • Public affairs in a time of coronavirus.

      Moss, Danny; harris, Phil (2020-08-10)
    • Public Health Scotland - the first year: successes and lessons.

      Phin, Nick; email: nicholas.phin@phs.scot (2021-06)
      Over its first year Public Health Scotland (PHS) played a key role in the national vaccination programme by providing professional leadership and expertise. We expedited the reporting of all aspects of the pandemic, and accelerated rapid evidence reviews. We contributed to rigorous research showing that: vaccination reduced hospitalisation by 90%, and the transmission of COVID-19 within households by 55%; hence vaccination works. Lessons for the future included strengthening whole genome sequencing to manage COVID-19 and to prepare for future pathogens. COVID-19 also stimulated the redesign of many health and social care services: by exploiting digital media; by implementing evidence on reducing barriers to service delivery; and by greater integration - of projects rather than organisations - enabling groups who had not worked together to address common issues. PHS and partners soon recognised the need to mitigate the adverse impact of the pandemic on existing inequalities. So we aim to 'build back fairer' as the pandemic recedes, by pursuing PHS's four priorities: poverty; children and young people; place and community; and mental health and well-being.
    • Publisher Correction: The blue hue of einsteinium.

      Natrajan, Louise S; orcid: 0000-0002-9451-3557; email: louise.natrajan@manchester.ac.uk; Faulkner, Stephen; email: stephen.faulkner@keble.ox.ac.uk (2021-06-08)
    • A qualitative study exploring midlife women’s stages of change from domestic violence towards freedom

      Keeling, June J.; Smith, Debra; Fisher, Colleen; University of Chester; University of Central Lancashire; The University of Western Australia (BioMed Central, 2016-03-08)
      Background Domestic Violence (DV) remains a significant global health problem for women in contemporary society. Existing literature on midlife women’s experiences of domestic violence is limited and focuses on health implications. Leaving a violent relationship is a dynamic process that often requires multiple attempts and separations prior to final termination. The aim of this study was to explore the process of leaving a violent relationship for midlife women. Methods This qualitative study involved fifteen women aged between 40–55 who had accessed residential and non-residential community support services for domestic violence within the UK. Community-based support agencies provided these women with access to letters of invitation and participant information sheet explaining the study. The women notified agency staff who contacted the research team to arrange a mutually convenient time to meet within a safe place for both the women and researchers. It was stressed to all potential participants that no identifiable information would be shared with the agency staff. Women were considered survivors of DV if they defined themselves as such. Data were gathered through semi structured interviews, transcribed verbatim and thematically analysed. Results Midlife women appear to differ from younger women by transitioning quickly though the stages of change, moving rapidly through the breaking free onto the maintenance stage. This rapid transition is the resultant effect of living with long-term violence causing a shift in the women’s perception towards the violent partner, with an associated reclamation of power from within the violent relationship. A realisation that rapid departure from the violence may be critical in terms of personal safety, and the realisation that there was something ‘wrong’ within the relationship, a ‘day of dawning’ that had not been apparent previously appears to positively affect the trajectory of leaving. Conclusions Midlife women appeared to navigate through the stages of change in a rapid linear process, forging ahead and exiting the relationship with certainty and without considering options. Whilst these findings appear to differ from younger women’s process of leaving, further research is needed to explore and understand the optimum time for intervention and support to maximise midlife women’s opportunities to escape an abusive partner, before being reflected appropriately in policy and practice.
    • Quantifying Cooperation Benefits for New Dams in Transboundary Water Systems Without Formal Operating Rules

      Gonzalez, Jose M.; Matrosov, Evgenii S.; Obuobie, Emmanuel; Mul, Marloes; Pettinotti, Laetitia; Gebrechorkos, Solomon H.; Sheffield, Justin; Bottacin-Busolin, Andrea; Dalton, James; Smith, D. Mark; et al. (Frontiers Media S.A., 2021-05-07)
      New dams impact downstream ecosystems and water infrastructure; without cooperative and adaptive management, negative impacts can manifest. In large complex transboundary river basins without well codified operating rules and extensive historical data, it can be difficult to assess the benefits of cooperating, in particular in relation to new dams. This constitutes a barrier to harmonious development of river basins and could contribute to water conflict. This study proposes a generalised framework to assess the benefits of cooperation on the management of new dams in water resource systems that do not have formal sharing arrangements. Benefits are estimated via multi-criteria comparison of historical reservoir operations (usually relatively uncooperative) vs. adopting new cooperative rules which would achieve the best results for riparian countries as evaluated by a water resources simulator and its performance metrics. The approach is applied to the Pwalugu Multipurpose Dam (PMD), which is being built in Ghana in the Volta river basin. The PMD could impact downstream ecosystems and infrastructure in Ghana and could itself be impacted by how the existing upstream Bagre Dam is managed in Burkina Faso. Results show that with cooperation Ghana and Burkina Faso could both increase energy production although some ecosystem services loss would need to be mitigated. The study confirms that cooperative rules achieve higher overall benefits compared to seeking benefits only for individual dams or countries.
    • Quantized Vortex Rings and Loop Solitons

      Green, P. J.; Grant, M. J.; Nevin, J. W.; Walmsley, P. M.; email: paul.walmsley@manchester.ac.uk; Golov, A. I.; orcid: 0000-0002-7244-5899 (Springer US, 2020-08-29)
      Abstract: The vortex filament model is used to investigate the interaction of a quantized vortex ring with a straight vortex line and also the interaction of two solitons traveling in opposite directions along a vortex. When a ring reconnects with a line, we find that a likely outcome is the formation of a loop soliton. When they collide, loop solitons reconnect as they overlap each other producing either one or two vortex rings. These simulations are relevant for experiments on quantum turbulence in the zero temperature limit where small vortex rings are expected to be numerous. It seems that loop solitons might also commonly occur on vortex lines as they act as transient states between the absorption of a vortex ring before another ring is emitted when the soliton is involved in a reconnection.
    • Quotidian Science Fiction: Posthuman Dreams of Emancipation

      Hay, Jonathan (The University of Iowa, 2019-06-13)
    • ‘Radial force’ of colonic stents: A parameter without consistency, definition or standard

      Laasch, Hans-Ulrich; orcid: 0000-0003-3109-6933; Milward, Graham D.; orcid: 0000-0002-0980-6567; Edwards, Derek W.; orcid: 0000-0001-6192-5056 (Society of Gastrointestinal Intervention, 2020-07-31)
    • Radical hydroxymethylation of alkyl iodides using formaldehyde as a C1 synthon.

      Caiger, Lewis; orcid: 0000-0001-5156-9684; Sinton, Conar; orcid: 0000-0002-5588-7548; Constantin, Timothée; orcid: 0000-0001-5376-1557; Douglas, James J; Sheikh, Nadeem S; Juliá, Fabio; orcid: 0000-0001-8903-4482; Leonori, Daniele; orcid: 0000-0002-7692-4504 (2021-07-06)
      Radical hydroxymethylation using formaldehyde as a C1 synthon is challenging due to the reversible and endothermic nature of the addition process. Here we report a strategy that couples alkyl iodide building blocks with formaldehyde through the use of photocatalysis and a phosphine additive. Halogen-atom transfer (XAT) from α-aminoalkyl radicals is leveraged to convert the iodide into the corresponding open-shell species, while its following addition to formaldehyde is rendered irreversible by trapping the transient O-radical with PPh<sub>3</sub>. This event delivers a phosphoranyl radical that re-generates the alkyl radical and provides the hydroxymethylated product.
    • Radical hydroxymethylation of alkyl iodides using formaldehyde as a C1 synthon.

      Caiger, Lewis; orcid: 0000-0001-5156-9684; Sinton, Conar; orcid: 0000-0002-5588-7548; Constantin, Timothée; orcid: 0000-0001-5376-1557; Douglas, James J; Sheikh, Nadeem S; Juliá, Fabio; orcid: 0000-0001-8903-4482; Leonori, Daniele; orcid: 0000-0002-7692-4504 (2021-07-06)
      Radical hydroxymethylation using formaldehyde as a C1 synthon is challenging due to the reversible and endothermic nature of the addition process. Here we report a strategy that couples alkyl iodide building blocks with formaldehyde through the use of photocatalysis and a phosphine additive. Halogen-atom transfer (XAT) from α-aminoalkyl radicals is leveraged to convert the iodide into the corresponding open-shell species, while its following addition to formaldehyde is rendered irreversible by trapping the transient O-radical with PPh . This event delivers a phosphoranyl radical that re-generates the alkyl radical and provides the hydroxymethylated product. [Abstract copyright: This journal is © The Royal Society of Chemistry.]