Science Says

The response to the novel coronavirus outbreak in China suggests that many of the lessons from the 2003 SARS epidemic have been implemented and the response improved as a consequence. Nevertheless some questions remain and not all lessons have been successful. The national and international response demonstrates the complex link between public health, science and politics when an outbreak threatens to impact on global economies and reputations. The unprecedented measures implemented in China are a bold attempt to control the outbreak – we need to understand their effectiveness to balance costs and benefits for similar events in the future. McCloskey B, Heymann DL. SARS to novel coronavirus - old lessons and new lessons. Epidemiol Infect. 2020;148:e22. Published 2020 Feb 5. doi:10.1017/S0950268820000254 Published by Cambridge University Press. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited. Sections of the Abstract and Discussion are presented in the Podcast. Link to full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026896/ Science Says is supported by Leksi (https://Leksi.co): the best education and study app to convert your notes, articles, or any document to audio so you can listen and learn no matter where you.

There is a heated debate on whether markets erode social responsibility and moral behavior. However, it is a challenging task to identify and measure moral behavior in markets. Based on a theoretical model, we examine in an experiment the relation between trading volume, prices and moral behavior by setting up markets that either impose a negative externality on third parties or not. We find that moral behavior reveals itself in lower trading volume in markets with a negative externality, while prices mostly depend on the market structure. We further investigate individual characteristics that explain trading behavior in markets with negative externalities. Sutter M, Huber J, Kirchler M, Stefan M, Walzl M. Where to look for the morals in markets?. Exp Econ. 2020;23(1):30–52. doi:10.1007/s10683-019-09608-z This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. Sections of the Abstract, Introduction, and Discussion and Conclusion are presented in the Podcast. Link to full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6991999/ Science Says is supported by Leksi (https://Leksi.co): the best education and study app to convert your notes, articles, or any document to audio so you can listen and learn no matter where you.

The presence of delay of gratification (DG) in childhood is correlated with success later in a person's life. Is there any way of helping adults with a low level of DG to obtain similar success? The present research examines how social support helps those low in DG nonetheless to act similarly to those high in DG. This research includes both correlational studies and experiments that manipulate social support as well as both field studies and a laboratory study. The results show that with high social support, employees (Study 1) and university students (Study 2) low in DG report vocational and academic DG behavioral intentions, respectively, similar to those high in DG. Study 3 found that participants low in DG who were primed with high social support expressed job-choice DG similar to those high in the DG. Study 4 controlled for mood and self-image and found that participants low in DG who were primed with high social support expressed more money-choice DG than those high in the DG. Study 5 showed that social support moderated the relationship between DG and actual DG behaviors. These findings provide evidence for a moderating role of social support in the expression of DG behavior. Liu X, Wang L, Liao J. Enabling Delay of Gratification Behavior in Those Not So Predisposed: The Moderating Role of Social Support. Front Psychol. 2016;7:366. Published 2016 Mar 18. doi:10.3389/fpsyg.2016.00366. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Sections of the Abstract, Introduction, and General Discussion are presented in the Podcast. Link to full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4796028/.

Science Says is supported by Leksi (https://Leksi.co): the best education and study app to convert your notes and articles to audio so you can listen and learn anywhere, anytime. Objectives: Undergraduate medical students experience a considerable amount of stress and anxiety due to frequent exams. The goal of the present study was to examine the development of exam related anxiety and to test for a correlation between anxiety and learning approaches. Methods: A whole class of 212 medical students was invited to participate in the study. During their first term, trait anxiety and learning approaches were assessed by use of the state-trait-anxiety inventory (STAI-T) and the approaches-and-study-skills-inventory-for-students (ASSIST), respectively. Acute state anxiety was assessed twice in the course of the second term. To that extent, the STAI-S in combination with measuring salivary cortisol were employed immediately before two oral anatomy exams. Results: Our most important results were that a surface learning approach correlated significantly with anxiety as a trait and that students with a predominantly strategic approach to learning were the least anxious yet academically most successful. Conclusion: As surface learners are at risk of being academically less successful and because anxiety is a prerequisite for burn-out, we suggest that medical faculties place particular emphasis on conveying strategies for both, coping with stress and successful learning. Cipra C, Müller-Hilke B. Testing anxiety in undergraduate medical students and its correlation with different learning approaches. PLoS One. 2019;14(3):e0210130. Published 2019 Mar 13. doi:10.1371/journal.pone.0210130. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415780/

Science Says is supported by Leksi (https://Leksi.co): the best education and study app to convert your notes and articles to audio so you can listen and learn anywhere, anytime. Learning outcomes may be a result of several factors including the learning environment, students’ predispositions, study efforts, cultural factors and approaches towards studying. This study examined the influence of demographic variables, education-related factors, and approaches to studying on occupational therapy students’ Grade Point Average (GPA). Undergraduate occupational therapy students (n = 712) from four countries completed the Approaches and Study Skills Inventory for Students (ASSIST). Demographic background, education-related factors, and ASSIST scores were used in a hierarchical linear regression analysis to predict the students’ GPA. Being older, female and more time engaged in self-study activities were associated with higher GPA among the students. In addition, five ASSIST subscales predicted higher GPA: higher scores on ‘seeking meaning’, ‘achieving’, and ‘lack of purpose’, and lower scores on ‘time management’ and ‘fear of failure’. The full model accounted for 9.6% of the variance related to the occupational therapy students’ GPA. To improve academic performance among occupational therapy students, it appears important to increase their personal search for meaning and motivation for achievement, and to reduce their fear of failure. The results should be interpreted with caution due to small effect sizes and a modest amount of variance explained by the regression model, and further research on predictors of academic performance is required. Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Bonsaksen T, Brown T, K Fong. PApproaches to studying predict academic performance in undergraduate occupational therapy students: a cross-cultural study. 2017;17(1):76. Published 2017 May 2. doi: 10.1186/s12909-017-0914-3.S Sections of the Abstract, Introduction, and Conclusions are presented in the Podcast. Link to full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5414187/#__ffn_sectitle.

Science Says is supported by Leksi (https://Leksi.co): the best education and study app to convert your notes and articles to audio so you can listen and learn anywhere, anytime. Physical activity (PA) has been central in the life of our species for most of its history, and thus shaped our physiology during evolution. However, only recently the health consequences of a sedentary lifestyle, and of highly energetic diets, are becoming clear. It has been also acknowledged that lifestyle and diet can induce epigenetic modifications which modify chromatin structure and gene expression, thus causing even heritable metabolic outcomes. Many studies have shown that PA can reverse at least some of the unwanted effects of sedentary lifestyle, and can also contribute in delaying brain aging and degenerative pathologies such as Alzheimer’s Disease, diabetes, and multiple sclerosis. Most importantly, PA improves cognitive processes and memory, has analgesic and antidepressant effects, and even induces a sense of wellbeing, giving strength to the ancient principle of “mens sana in corpore sano” (i.e., a sound mind in a sound body). In this review we will discuss the potential mechanisms underlying the effects of PA on brain health, focusing on hormones, neurotrophins, and neurotransmitters, the release of which is modulated by PA, as well as on the intra- and extra-cellular pathways that regulate the expression of some of the genes involved. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Di Liegro CM, Schiera G, Proia P, Di Liegro I. Physical Activity and Brain Health. Genes (Basel). 2019;10(9):720. Published 2019 Sep 17. doi:10.3390/genes10090720. Sections of the Abstract, Introduction, and Conclusions and Perspectives are presented in the Podcast. Link to full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6770965/.

Science Says is supported by Leksi (https://Leksi.co): the best education and study app to convert your notes and articles to audio so you can listen anywhere, anytime. Two studies investigated associations between habits and identity, in particular what people consider as their “true self.” Habit-identity associations were assessed by within-participant correlations between self-reported habit and associated true self ratings of 80 behaviors. The behaviors were instantiations of 10 basic values. In Study 1, significant correlations were observed between individual differences in the strength of habit-identity associations, measures of cognitive self-integration (prioritizing self-relevant information), self-esteem, and an orientation toward an ideal self. Study 2 further tested the assumption that habits are associated with identity if these relate to important goals or values. An experimental manipulation of value affirmation demonstrated that, compared to a control condition, habit-identity associations were stronger if participants explicitly generated the habit and true self ratings while indicating which values the behaviors would serve. Taken together, the results suggest that habits may serve to define who we are, in particular when these are considered in the context of self-related goals or central values. When habits relate to feelings of identity this comes with stronger cognitive self-integration, higher self-esteem, and a striving toward an ideal self. Linking habits to identity may sustain newly formed behaviors and may thus lead to more effective behavior change interventions. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Verplanken B, Sui J. Habit and Identity: Behavioral, Cognitive, Affective, and Motivational Facets of an Integrated Self. Front Psychol. 2019;10:1504. Published 2019 Jul 10. doi:10.3389/fpsyg.2019.01504. Sections of the Abstract, Introduction, Genral Discussion, and Conclusion are presented in the Podcast. Link to full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6635880/

Inner speech involvement in self-reflection was examined by reviewing 130 studies assessing brain activation during self-referential processing in key self-domains: agency, self-recognition, emotions, personality traits, autobiographical memory, and miscellaneous (e.g., prospection, judgments). The left inferior frontal gyrus (LIFG) has been shown to be reliably recruited during inner speech production. The percentage of studies reporting LIFG activity for each self-dimension was calculated. Fifty five percent of all studies reviewed indicated LIFG (and presumably inner speech) activity during self-reflection tasks; on average LIFG activation is observed 16% of the time during completion of non-self tasks (e.g., attention, perception). The highest LIFG activation rate was observed during retrieval of autobiographical information. The LIFG was significantly more recruited during conceptual tasks (e.g., prospection, traits) than during perceptual tasks (agency and self-recognition). This constitutes additional evidence supporting the idea of a participation of inner speech in self-related thinking. Morin A, Hamper B. Self-reflection and the inner voice: activation of the left inferior frontal gyrus during perceptual and conceptual self-referential thinking. Open Neuroimag J. 2012;6:78–89. doi:10.2174/1874440001206010078 This is an open access article licensed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted, non-commercial use, distribution and reproduction in any medium, provided the work is properly cited. Sections of the Abstract, Introduction, and Conclusion are presented in the Podcast. Link to full-text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3462327/

Generous behaviour is known to increase happiness, which could thereby motivate generosity. In this study, we use functional magnetic resonance imaging and a public pledge for future generosity to investigate the brain mechanisms that link generous behaviour with increases in happiness. Participants promised to spend money over the next 4 weeks either on others (experimental group) or on themselves (control group). Here, we report that, compared to controls, participants in the experimental group make more generous choices in an independent decision-making task and show stronger increases in self-reported happiness. Generous decisions engage the temporo-parietal junction (TPJ) in the experimental more than in the control group and differentially modulate the connectivity between TPJ and ventral striatum. Importantly, striatal activity during generous decisions is directly related to changes in happiness. These results demonstrate that top–down control of striatal activity plays a fundamental role in linking commitment-induced generosity with happiness. Park SQ, Kahnt T, Dogan A, Strang S, Fehr E, Tobler PN. A neural link between generosity and happiness. Nat Commun. 2017;8:15964. Published 2017 Jul 11. doi:10.1038/ncomms15964. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Sections of the Abstract, Introduction, and Discussion are presented in this Podcast. Link to full-text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5508200/

Background: The rising number of young people going to university has led to concerns about an increasing demand for student mental health services. We aimed to assess whether provision of mindfulness courses to university students would improve their resilience to stress. Methods: We did this pragmatic randomised controlled trial at the University of Cambridge, UK. Students aged 18 years or older with no severe mental illness or crisis (self-assessed) were randomly assigned (1:1), via remote survey software using computer-generated random numbers, to receive either an 8 week mindfulness course adapted for university students (Mindfulness Skills for Students [MSS]) plus mental health support as usual, or mental health support as usual alone. Participants and the study management team were aware of group allocation, but allocation was concealed from the researchers, outcome assessors, and study statistician. The primary outcome was self-reported psychological distress during the examination period, as measured with the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE–OM), with higher scores indicating more distress. The primary analysis was by intention to treat. This trial is registered with the Australia and New Zealand Clinical Trials Registry, number ACTRN12615001160527. Findings: Between Sept 28, 2015, and Jan 15, 2016, we randomly assigned 616 students to the MSS group (n=309) or the support as usual group (n=307). 453 (74%) participants completed the CORE–OM during the examination period and 182 (59%) MSS participants completed at least half of the course. MSS reduced distress scores during the examination period compared with support as usual, with mean CORE–OM scores of 0·87 (SD 0·50) in 237 MSS participants versus 1·11 (0·57) in 216 support as usual participants (adjusted mean difference −0·14, 95% CI −0·22 to −0·06; p=0·001), showing a moderate effect size (β −0·44, 95% CI −0·60 to −0·29; p

Introduction: Many medical education journals use Twitter to garner attention for their articles. The purpose of this study was to test the effects of tweeting on article page views and downloads. Methods: The authors conducted a randomized trial using Academic Medicine articles published in 2015. Beginning in February through May 2018, one article per day was randomly assigned to a Twitter (case) or control group. Daily, an individual tweet was generated for each article in the Twitter group that included the title, #MedEd, and a link to the article. The link delivered users to the article’s landing page, which included immediate access to the HTML full text and a PDF link. The authors extracted HTML page views and PDF downloads from the publisher. To assess differences in page views and downloads between cases and controls, a time-centered approach was used, with outcomes measured at 1, 7, and 30 days. Results: In total, 189 articles (94 cases, 95 controls) were analyzed. After days 1 and 7, there were no statistically significant differences between cases and controls on any metric. On day 30, HTML page views exhibited a 63% increase for cases (M = 14.72, SD = 63.68) when compared to controls (M = 9.01, SD = 14.34; incident rate ratio = 1.63, p = 0.01). There were no differences between cases and controls for PDF downloads on day 30. Discussion: Contrary to the authors’ hypothesis, only one statistically significant difference in page views between the Twitter and control groups was found. These findings provide preliminary evidence that after 30 days a tweet can have a small positive effect on article page views. Maggio LA, Leroux TC, Artino AR Jr. To tweet or not to tweet, that is the question: A randomized trial of Twitter effects in medical education. PLoS One. 2019;14(10):e0223992. Published 2019 Oct 16. doi:10.1371/journal.pone.0223992 This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6795488/

The practice of medicine is changing with the development of new Artificial Intelligence (AI) methods of machine learning. Coupled with rapid improvements in computer processing, these AI-based systems are already improving the accuracy and efficiency of diagnosis and treatment across various specializations. The increasing focus of AI in radiology has led to some experts suggesting that someday AI may even replace radiologists. These suggestions raise the question of whether AI-based systems will eventually replace physicians in some specializations or will augment the role of physicians without actually replacing them. To assess the impact on physicians this research seeks to better understand this technology and how it is transforming medicine. To that end this paper researches the role of AI-based systems in performing medical work in specializations including radiology, pathology, ophthalmology, and cardiology. It concludes that AI-based systems will augment physicians and are unlikely to replace the traditional physician–patient relationship. Ahuja AS. The impact of artificial intelligence in medicine on the future role of the physician. PeerJ. 2019;7:e7702. Published 2019 Oct 4. doi:10.7717/peerj.7702. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited. Sections of the Abstract, Introduction, and Conclusion are presented in the Podcast. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6779111/

Convergent creativity is a form of creative thinking that uses existing knowledge or traditional methods to analyze available information and generate an appropriate solution. The differences in the performance of participants in convergent creativity caused by bilingual learning is a popular research area in creativity. A final sample of 68 participants was asked to complete the remote associates test (RAT). The results indicate that a moderate positive correlation exists between bilingual learning and convergent creativity. Students who want to study abroad perform better on the RAT than those who do not, and this effect is mediated by second language proficiency. These findings suggest that improving students’ English proficiency and increasing their opportunities to study abroad may be effective ways to promoting convergent creativity. Zhao Y, Yuan Y, Shen W, Zhu C, Liu D. The relationships between bilingual learning, willingness to study abroad and convergent creativity. PeerJ. 2019;7:e7776. Published 2019 Sep 26. doi:10.7717/peerj.7776. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited. Sections of the Abstract, Introduction, Discussion, and Conclusion are presented in the Podcast. Link to the full-text article:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6766371/

Using artificial intelligence and machine learning techniques in different medical fields, especially emergency medicine is rapidly growing. In this paper, studies conducted in the recent years on using artificial intelligence in emergency medicine have been collected and assessed. These studies belonged to three categories: prediction and detection of disease; prediction of need for admission, discharge and also mortality; and machine learning based triage systems. In each of these categories, the most important studies have been chosen and accuracy and results of the algorithms have been briefly evaluated by mentioning machine learning techniques and used datasets. Shafaf N, Malek H. Applications of Machine Learning Approaches in Emergency Medicine; a Review Article. Arch Acad Emerg Med. 2019;7(1):34. Published 2019 Jun 3. This is an Open Access article distributed under the terms of the Creative Commons Attribution License, (http://creativecommons.org/licenses/by/3.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Sections of the Abstract, Introduction, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6732202/

Due to the societal dissemination of digital technology, people are increasingly experiencing environmental topics through digital media channels such as social networks. Several researchers therefore have proposed these channels as a possibility to strengthen sustainable development based on their cost-efficient nature. But while prior studies have investigated isolated factors for understanding environmental social media behavior, there is still scarce understanding of the relevant underlying motivational factors and possible connections with more traditional environmental behaviors. Therefore, the present study applied the established socio-psychological model of goal-directed behavior and compared the desires for liking as a fundamental form of digital social media behavior with the desires for two traditional environmental behaviors (money donation and volunteering) in a cross-sectional research design. Within the biodiversity conservation case of the Andean bear (Tremarctos ornatus) in Ecuador, we compared the antecedents for the desires for the corresponding environmental behaviors (RQ1) as well as their connections between each other (RQ2). Within a sample of 407 Ecuadorian students (Mage = 20.94 years, SD = 2.25, 61.2% female), we found the marginal effect of perceived behavioral control on the desires for liking on social media as the main difference concerning the antecedents of the behaviors because money donation and volunteering largely depended on personal resources such as time or money. Furthermore, gender emerged as the second main difference between the behaviors due to it only being predictive for the liking motivation. Enjoyment was the only variable that coherently predicted all three behaviors. Finally, desires for liking on social media predicted both other behaviors in robust regression analyses, but were only predictive for volunteering in corresponding path models. The results illustrate how cost-efficient digital environmental behaviors such as liking may be suitable for sparking low-level environmental action, which may entail more pronounced forms of environmental activism, at least when they involve feasible personal costs. Overall, the findings are in line with prior research regarding the less demanding nature of liking, but further elaborate on the importance of gender for digital environmental behavior and correlates between digital and classical environmental behaviors. Büssing AG, Thielking A, Menzel S. Can a Like Save the Planet? Comparing Antecedents of and Correlations Between Environmental Liking on Social Media, Money Donation, and Volunteering. Front Psychol. 2019;10:1989. Published 2019 Aug 28. doi:10.3389/fpsyg.2019.01989. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6722222/

Adolescence is a period of life during which peers play a pivotal role in decision-making. The narrative of social influence during adolescence often revolves around risky and maladaptive decisions, like driving under the influence, and using illegal substances (Steinberg, 2005). However, research has also shown that social influence can lead to increased prosocial behaviors (Van Hoorn et al., 2017) and a reduction in risk-taking (Braams et al., 2019). While many studies support the notion that adolescents are more sensitive to peer influence than children or adults, the developmental processes that underlie this sensitivity remain poorly understood. We argue that one important reason for this lack of understanding is the absence of precisely formulated models. To make a first step toward formal models of social influence during adolescence, we first identify three prominent verbal models of social influence in the literature: (1) social motivation, (2) reward sensitivity, and (3) distraction. We then illustrate how these can be translated into formal models, and how such formal models can inform experimental design and help identify developmental processes. Finally, by applying our formal models to existing datasets, we demonstrate the usefulness of formalization by synthesizing different studies with seemingly disparate results. We conclude with a discussion on how formal modeling can be utilized to better investigate the development of peer influence in adolescence. Ciranka S, van den Bos W. Social Influence in Adolescent Decision-Making: A Formal Framework. Front Psychol. 2019;10:1915. Published 2019 Aug 29. doi:10.3389/fpsyg.2019.01915. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6727856/

Background: Public health and governmental organizations are expected to provide guidance to the public on emerging health issues in accessible formats. It is, therefore, important to examine how such organizations are discussing cannabis online and the information that is being provided to the public about this increasingly legal and available substance. Methods: This paper presents a concise thematic analysis of both the volume and content of cannabis-related health information from selected (n = 13) national-level public health and governmental organizations in Canada and the U.S. on Twitter. Results: There were eight themes identified in Tweets including 1) health-related topics; 2) legalization and legislation; 3) research on cannabis; 4) special populations; 5) driving and cannabis; 6) population issues; 7) medical cannabis, and 8) public health issues. The majority of cannabis-related Tweets from the organizations studied came from relatively few organizations and there were substantial differences between the topics covered by U.S. and Canadian organizations. The organizations studied provided limited information regarding how to use cannabis in ways that will minimize health-related harms. Conclusions: Authoritative organizations that deal with public health may consider designing timely social media communications with emerging cannabis-related information, to benefit a general public otherwise exposed to primarily pro-cannabis content on Twitter. van Draanen J, Krishna T, Tsang C, Liu S. Keeping up with the times: how national public health and governmental organizations communicate about cannabis on Twitter. Subst Abuse Treat Prev Policy. 2019;14(1):38. Published 2019 Sep 12. doi:10.1186/s13011-019-0224-3. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Sections of the Abstract, Introduction, Methods, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6739954/

American parents greatly value children’s happiness, citing it well above other possible priorities. This commitment to happiness, shared with parents in other Western societies but not elsewhere, is an important feature of popular emotional culture. But the commitment is also the product of modern history, emerging clearly only in the 19th century. This article explains the contrast between more traditional and modern views, and explains the origins but also the evolution of the idea of a happy childhood. Early outcomes, for example, included the novel practice of hosting parties for children’s birthdays, another mid-19th-century innovation that has expanded over time. Explaining the intensification of the happiness commitment also reveals some of the downsides of this aspect of popular emotional culture, for example in measurably complicating reactions to childish unhappiness. The basic goal of the essay is to use this important facet of modern emotional history to evaluate a commitment that many modern parents assume is simply natural. Stearns PN. Happy Children: A Modern Emotional Commitment. Front Psychol. 2019;10:2025. Published 2019 Sep 6. doi:10.3389/fpsyg.2019.02025. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6742924/

Background: Eating disorders among adolescents are an ongoing public health concern. Sustainable health promotion programmes require a thorough understanding of the social context in which minors engage. Initial studies show that young people make extensive use of social networks in order to exchange experiences and gather information. During this process their (buying) behaviour is significantly affected by so-called influencers. Methods: The exploratory research studies non-campaign driven health communication on dieting and exercise by influencers in social networks with a focus on content, techniques and visible impact. In a mixed methods approach, we initially analysed 1000 posts from influencers on Instagram quantitatively. Subsequently we conducted an in-depth content analysis of 9 extreme and 27 typical communication threads. Results: Influencers gain the trust and friendship of their followers by designing body-shape focused visual content and targeted communication techniques. They identify and define diet and exercise as factors to be controlled for body perfection. By consuming dietary supplements and wearing tight-fitting branded sportswear, influencers promise a simplified way of optimizing one’s appearance as the key to happiness. Direct and surreptitious advertising of industry-specific products constitutes the communicative focus. At the same time, minors identify with the roles and ideals demonstrated by influencers and their needs are satisfied on several different levels. This creates a relationship of dependency between influencers and their followers. Conclusions: The dynamics in the field of health communication by influencers on social networks will become increasingly important in the coming years. This is largely due to the targeted demand on the part of (mainly) underage users and the high attractiveness of influencer marketing on the part of companies. Influencers suggest a dependence on happiness, well-being, health and beauty. Only those who create a body shaped through control and discipline are healthy and beautiful - and can be happy. The indirectly communicated conclusions, which can be considered as extremely critical, illustrate the need for action in order to protect and positively accompany young people in their psychological and physical development. The shift of authority figures within Generation Z, as well as identified communication techniques, can be considered and may be harnessed by targeted, group-oriented campaign designs. Pilgrim K, Bohnet-Joschko S. Selling health and happiness how influencers communicate on Instagram about dieting and exercise: mixed methods research. BMC Public Health. 2019;19(1):1054. Published 2019 Aug 6. doi:10.1186/s12889-019-7387-8. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Sections of the Abstract, Introduction, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6683418

Investigating the mood-creativity relationship in everyday life is important for innovation promotion in organizational management. This study explores the relationship between mood states and everyday creativity using two different measurement methods. Both the experience sampling method (ESM) and the day reconstruction method (DRM) were simultaneously applied to conduct a 15-day follow-up study of the relationship between 10 typical positive and negative moods and creativity in daily situations. In total, 31 corporate employees participated in the study. Participants reported their mood states and creativity at three time points per day by using ESM; they also recalled and reported their mood states and creativity for at least three major events per day at the end of each day by using DRM. In total, we collected 935 valid measurements from ESM and 1260 valid measurements from DRM. The results revealed that highly active, positive moods including happiness, concentration, feeling active and interested had significant positive correlations with creativity, while the low-activity, negative mood states of feeling tired and sleepy were associated with low creativity. Both DRM-based and ESM-based results were largely consistent in measuring individual’s mood states and everyday creativity. To our knowledge, this is the first study to conduct DRM for mood-creativity relationship. The high consistency between the two daily research methods provides further empirical evidence toward a comprehensive understanding of mood and creativity. As DRM imposes a lessened respondent load on the participants as compared to ESM, our results suggest DRM as a promising tool for further mood-creativity research. Han W, Feng X, Zhang M, Peng K, Zhang D. Mood States and Everyday Creativity: Employing an Experience Sampling Method and a Day Reconstruction Method. Front Psychol. 2019;10:1698. Published 2019 Jul 19. doi:10.3389/fpsyg.2019.01698. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6658875/

Background: Previous studies have reported impaired performance, sleepiness and sleep deprivation among night workers. The purpose of this study was to investigate the effect of color screen Light Filtering software on cognitive performance, alertness and sleep quality among night shift operators of a medical emergency operations center. Methods: This field trial interventional study was carried out among 30 nightshift operators of shiraz emergency control center. The baseline assessments were carried out under the existing computer screen light conditions in the week preceding the installation of f.lux software. The same measurements were repeated again 4 weeks after installing the software. The cognitive performance of the participants was measured using continuous performance test (CPT) and n-back, while their sleep quality was assessed through Pietersburg Sleep Quality Index (PSQI). Further, to assess their subjective and objective alertness, Stanford sleepiness index and go/nogo test were used, respectively. Results: The results of this study showed that Screen Light Filtering software significantly increased subjective (P

In recent years, digital communication and social media have taken an indispensable role in human society. Social interactions are no longer bound to real-life encounters, but more often happen from behind a screen. Mimicking an online communication platform, we developed a new, fMRI compatible, social threat paradigm to investigate sex differences in reactions to social rejection. During the Verbal Interaction Social Threat Task (VISTTA), participants initiate 30 short conversations by selecting one of four predefined opening sentences. Two computerized interlocutors respond to the opening sentence mostly with negative comments and rejections toward the participant, which should induce social-evaluative threat. Physiological and subjective responses were measured, before, during, and after the VISTTA in 61 (29 male and 32 female) first year students who received either mostly negative (n = 31; threat group) or neutral comments (n = 30; control group). Two-level behavioral validation included social threatinduced mood changes in participants, and interlocutor evaluation. The latter consisted of multiple variables such as “willingness to cooperate” after every conversation, an overall fairness evaluation of interlocutors, and evaluations per reaction indicating how positive or negative it was received. We acquired additional physiological measures including cortisol assays via saliva samples, heart rate, and blood pressure. Confirming our hypotheses, peer rejection and exclusion during the VISTTA led to less willingness to cooperate and lower fairness evaluation of interlocutors. It also induced feelings of anger and surprise and lower happiness in the social-threat group. Women showed overall higher emotion ratings compared to men. Contrary to our a priori hypothesis, the VISTTA did not induce cortisol and heart rate increases. However, the stable cortisol response in women in the threat group does not follow the circadian decline and might reflect an endocrinological response. The decline in cortisol response in men in both the threat and control group could indicate faster habituation to the VISTTA. Taken together, these findings indicate effects of social-evaluative threat on a behavioral level, and more moderate effects on the emotional and physiological level. Sex differences in affective and cortisol responses may indicate that women are more susceptible for the social-evaluative threat than men. With a realistic implementation of verbal, interactive, and social components, the VISTTA is designed as an fMRI paradigm that can be applied to elucidate the neural representation of social-evaluative threat. Tops S, Habel U, Abel T, Derntl B, Radke S. The Verbal Interaction Social Threat Task: A New Paradigm Investigating the Effects of Social Rejection in Men and Women. Front Neurosci. 2019;13:830. Published 2019 Aug 7. doi:10.3389/fnins.2019.00830. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Associated Data. Sections of Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6692967/

Raising public awareness of sepsis, a potentially life-threatening dysregulated host response to infection, to hasten its recognition has become a major focus of physicians, investigators, and both non-governmental and governmental agencies. While the internet is a common means by which to seek out healthcare information, little is understood about patterns and drivers of these behaviors. We sought to examine traffic to Wikipedia, a popular and publicly available online encyclopedia, to better understand how, when, and why users access information about sepsis. Utilizing pageview traffic data for all available language localizations of the sepsis and septic shock pages between July 1, 2015 and June 30, 2018, significantly outlying daily pageview totals were identified using a seasonal hybrid extreme studentized deviate approach. Consecutive outlying days were aggregated, and a qualitative analysis was undertaken of print and online news media coverage to identify potential correlates. Traffic patterns were further characterized using paired referrer to resource (i.e. clickstream) data, which were available for a temporal subset of the pageviews. Of the 20,557,055 pageviews across 65 linguistic localizations, 47 of the 1,096 total daily pageview counts were identified as upward outliers. After aggregating sequential outlying days, 25 epochs were examined. Qualitative analysis identified at least one major news media correlate for each, which were typically related to high-profile deaths from sepsis and, less commonly, awareness promotion efforts. Clickstream analysis suggests that most sepsis and septic shock Wikipedia pageviews originate from external referrals, namely search engines. Owing to its granular and publicly available traffic data, Wikipedia holds promise as a means by which to better understand global drivers of online sepsis information seeking. Further characterization of user engagement with this information may help to elucidate means by which to optimize the visibility, content, and delivery of awareness promotion efforts. Jabaley CS, Groff RF, Barnes TJ, Caridi-Scheible ME, Blum JM, O'Reilly-Shah VN. Sepsis information-seeking behaviors via Wikipedia between 2015 and 2018: A mixed methods retrospective observational study. PLoS One. 2019;14(8):e0221596. Published 2019 Aug 22. doi:10.1371/journal.pone.0221596. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of Abstract, Introduction, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6705833

Registered Dietitian Nutritionists (RDNs) are clinicians trained in the application of food, nutrition, and dietetics. Vegetarians and vegans have a lower risk of many nutrition-related chronic diseases that are epidemic while vegetarian and vegan diets are associated with reduced environmental impact. Despite this strong diet-disease and diet-environment connection, it is not known if dietetics students are taught the principles of vegetarian and vegan nutrition. The overarching goal of our study was to investigate curricular practices in accredited dietetics training programs in the United States (U.S.) including (1) the prevalence and perceived importance of vegetarian and vegan nutrition instruction and (2) if program directors connect vegetarian and vegan diets to climate change mitigation and resource conservation. Primary data were collected by way of a cross-sectional, Internet-based survey. All Accreditation Council for Education in Nutrition and Dietetics (ACEND) program directors in the U.S. (N = 574) were sent a 37-question survey and invited to participate in the study. Outcome measures included the prevalence of vegetarian and vegan nutrition instruction, quantifying if relationships exist among variables, and the frequency of connecting vegetarian and vegan diets to environmental impact. Descriptive and inferential statistics were utilized. Respondents (n = 205) indicated that over 51% of programs teach vegetarian nutrition while 49% teach vegan nutrition. There were significant differences between program type and the prevalence of vegetarian (p = 0.00005) and vegan (p = 0.00005) nutrition instruction. Over 90% of program directors believe that vegetarian and vegan nutrition should be taught. Over 50% of programs identify the connection between vegetarian and vegan diets in climate change mitigation and resource conservation. Most ACEND program directors believe vegetarian and vegan nutrition should be taught and half connect diet to environmental concern. Nevertheless, there is a discrepancy between beliefs and practice behaviors. These results suggest the need for increased collaboration and the use of novel techniques that better incorporate vegan and vegetarian nutrition throughout dietetics education. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Hawkins IW, Mangels AR, Goldman R and Wood RJ (2019) Dietetics Program Directors in the United States Support Teaching Vegetarian and Vegan Nutrition and Half Connect Vegetarian and Vegan Diets to Environmental Impact. Front. Nutr. 6:123. doi: 10.3389/fnut.2019.00123. Sections of Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.frontiersin.org/articles/10.3389/fnut.2019.00123/full

Stress and anxiety have intertwined behavioral and neural underpinnings. These commonalities are critical for understanding each state, as well as their mutual interactions. Grasping the mechanisms underlying this bidirectional relationship will have major clinical implications for managing a wide range of psychopathologies. After briefly defining key concepts for the study of stress and anxiety in pre-clinical models, we present circuit, as well as cellular and molecular mechanisms involved in either or both stress and anxiety. First, we review studies on divergent circuits of the basolateral amygdala (BLA) underlying emotional valence processing and anxiety-like behaviors, and how norepinephrine inputs from the locus coeruleus (LC) to the BLA are responsible for acute-stress induced anxiety. We then describe recent studies revealing a new role for mitochondrial function within the nucleus accumbens (NAc), defining individual trait anxiety in rodents, and participating in the link between stress and anxiety. Next, we report findings on the impact of anxiety on reward encoding through alteration of circuit dynamic synchronicity. Finally, we present work unravelling a new role for hypothalamic corticotropin-releasing hormone (CRH) neurons in controlling anxiety-like and stress-induce behaviors. Altogether, the research reviewed here reveals circuits sharing subcortical nodes and underlying the processing of both stress and anxiety. Understanding the neural overlap between these two psychobiological states, might provide alternative strategies to manage disorders such as post-traumatic stress disorder (PTSD). Daviu N, Bruchas MR, Moghaddam B, Sandi C, Beyeler A. Neurobiological links between stress and anxiety. Neurobiol Stress. 2019;11:100191. Published 2019 Aug 13. doi:10.1016/j.ynstr.2019.100191. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Sections of Abstract, Introduction, and Perspective are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6712367

Mental health conditions pose a major challenge to healthcare providers and society at large. The World Health Organization predicts that by 2030 mental illnesses will be the leading disease burden globally. Mental health services are struggling to meet the needs of users and arguably fail to reach large proportions of those in need. According to New Zealand Mental Health Foundation, one in five will experience a serious mood disorder, including depression, at some time in their life. Games for Health including those supporting mental health have recently gained a lot of attention. However, game interface preferences for users with a history of mental health conditions have not been systematically studied, making it difficult to determine what game features may attract and further engage users affected by mental health conditions. We present MoodJumper, a prototype Android mobile game, which enables players to jump to the top of the level by steering the avatar from platform to platform, gradually gaining height and collecting coins on the way up. We conducted a preliminary study (n = 25), in which participants were able to modify different settings of the game (background color, dark/light, character movement, gender, and music), while their gaming behavior was tracked. The results show that regardless of self-reported history of mood disorder, the majority of participants prefer the dark and colored layout setting and there were no differences in gaming variables including session duration and high scores. This represents a first indication that history of mood disorder does not affect user preferences for game interface settings. It will be important to follow up with data on users currently affected by low mood. Systematic study of game interface preferences in users with mood disorder constitutes a vital step in being able to harness the potential power of games for supporting mental health. Baghaei N, Hach S, Liang H-N and Brucker M (2019) MoodJumper: An Exploration of Game Interface Preferences in Users With/Out Mood Disorder. Front. Public Health 7:220. doi: 10.3389/fpubh.2019.00220 This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Sections of Abstract, Introduction, Games for Health, MoodJumper Design, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.frontiersin.org/articles/10.3389/fpubh.2019.00220/full

Background: During the reproductive age, the human brain becomes a target for gonadal steroid hormones. Estrogens influence neural function through effects on neurons and affects indirectly the oxidative stress, inflammation, the cerebral vascular and the immune system. Objective: To evaluate the effect of the traditional hormone replacement therapy (HRT) on the cognitive function in postmenopausal women. Materials and Methods: In this randomized clinical trial, 140 postmenopausal women, from November 2014 to February 2015, were included. Women were randomly divided into two groups. Each woman in the case group took traditional HRT (0.625mg conjugated equine estrogens+2.5mg medroxyprogesterone acetate daily) plus one Cal+D tablet (500 mg calcium+200 IU vitamin D) daily for four months. Women in the control group received only one Cal+D tablet (500 mg calcium+200 IU vitamin D) daily for four months period. The Montreal Cognitive Assessment (MoCA) and Green Climacteric Scale (GCS) questionnaires filled out after the intervention and compared between the two groups. Results: The mean points of the MoCA after the intervention indicate that all MoCA domains except for the orientation improved in the case group. There was a significant difference in the memory domain after the treatment between the two groups. MoCA domains and GCS were negatively correlated after the intervention (r=−0.235,p=0.006). Conclusion: The HRT has affected some of the MoCA factors. The effects of HRT on cognitive function should be studied in a large prospective study in a group of women in their early and late menopausal ages with periodic assessment of their cognitive function during these follow-up years. Moradi F, Jahanian Sadatmahalleh S, Ziaei S. The effect of hormone replacement therapy on cognitive function in postmenopausal women: An RCT. Int J Reprod Biomed (Yazd). 2019;16(12):ijrm.v16i12.3682. Published 2019 Jan 28. doi:10.18502/ijrm.v16i12.3682. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Sections of Abstract, Introduction, Materials and Methods, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6600282/

Ensuring quality of care in nursing homes is a public health priority, yet how nursing home quality relates to cost is not well understood. This paper addresses this relationship for 132 VA community living centers (nursing homes), for fiscal years 2014 and 2015. We estimated cost models using the VA Decision Support System which tracks total direct costs and nursing direct costs for individual resident segments of care. We summed residents’ total costs and nursing costs to the community living center level for each year. Annual facility costs then were regressed on quality of care measured with composite scores based on 13 distinct adverse events. Results indicated that higher quality was associated with higher predicted cost. However, we did not find evidence that higher costs were driven by high nurse staffing levels. Carey K, Zhao S, Snow AL, Hartmann CW. The relationship between nursing home quality and costs: Evidence from the VA. PLoS One. 2018;13(9):e0203764. Published 2018 Sep 19. doi:10.1371/journal.pone.0203764. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6145531/

Personal health systems (PHS) are designed to provide the individual with tailored care while enabling the healthcare system to deliver high-quality care to large populations and maintain a sustainable system. Solutions using electronic health records (EHRs) that include predictive models for the risk of disease onset and deterioration enable the care provider to better identify and treat patients with chronic disease and provide personalized prevention. These tools are well-accepted by doctors and have been proven to improve health outcomes and reduce costs. Integrated telecare programs were implemented for comorbid patients showing improved clinical outcomes self-management and quality of life (QoL). However, different patient populations benefit in different ways from these care plans, and thus, continuous evaluation, service adaptation in a real-life environment set with clear outcome measures, is required for best results. The challenge of the PHS today is to acquire patient-generated data (PGD) and behavioral and patient-reported outcomes (PROs) for PHS development that can be combined with existing clinical data. Some initiatives of healthcare organizations [health maintenance organizations (HMOs)] in Israel demonstrate how this goal can be achieved with relatively small efforts by using a stepwise and agile approach to service implementation that improve service by enabling adoption and adaptation of the service in the short term while collecting data for advanced PHS development in the long term. This approach, combined with programs and incentive payments at the national level, creates an environment and infrastructure for collaboration between healthcare, academia, and industry for research, development, and implementation of future PHS. This article presents examples of PHS development and implementation from the Israeli healthcare system. We discuss the lessons learned and suggest new approaches for research, development implementation, and evaluation of PHS that will address the needs of future healthcare. Lewy H, Barkan R, Sela T. Personalized Health Systems-Past, Present, and Future of Research Development and Implementation in Real-Life Environment. Front Med (Lausanne). 2019;6:149. Published 2019 Jul 31. doi:10.3389/fmed.2019.00149. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Sections of Abstract, Background, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6684784/

Graphics are becoming increasingly important for scientists to effectively communicate their findings to broad audiences, but most researchers lack expertise in visual media. We suggest collaboration between scientists and graphic designers as a way forward and discuss the results of a pilot project to test this type of collaboration. Khoury CK, Kisel Y, Kantar M, et al. Science-graphic art partnerships to increase research impact. Commun Biol. 2019;2:295. Published 2019 Aug 6. doi:10.1038/s42003-019-0516-1. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Sections of Abstract, Introduction, Test Project Overview, and Recommendations are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6684576/

Aims/Hypothesis: Early recognition of those at high risk for diabetes as well as diabetes itself can permit preventive management, but many Americans with diabetes are undiagnosed. We sought to determine whether routinely available outpatient random plasma glucose (RPG) would be useful to facilitate the diagnosis of diabetes. Methods: Retrospective cohort study of 942,446 U.S. Veterans without diagnosed diabetes, ≥3 RPG in a baseline year, and ≥1 primary care visit/year during 5-year follow-up. The primary outcome was incident diabetes (defined by diagnostic codes and outpatient prescription of a diabetes drug). Results: Over 5 years, 94,599 were diagnosed with diabetes [DIAB] while 847,847 were not [NONDIAB]. Baseline demographics of DIAB and NONDIAB were clinically similar, except DIAB had higher BMI (32 vs. 28 kg/m2) and RPG (150 vs. 107 mg/dl), and were more likely to have Black race (18% vs. 15%), all p

Chronic stress is a major underlying origin of the top leading causes of death, globally. Yet, the mechanistic explanation of the association between stress and disease is poorly understood. This stems from the inability to adequately measure stress in its naturally occurring state and the extreme heterogeneity by inter and intraindividual characteristics. The growth and availability of digital technologies involving wearable devices and mobile phone apps afford the opportunity to dramatically improve measurement of the biological stress response in real time. In parallel, the advancement and capabilities of artificial intelligence (AI) and machine learning could discern heterogeneous, multidimensional information from individual signs of stress, and possibly inform how these signs forecast the downstream consequences of stress in the form of end-organ damage. The marriage of these tools could dramatically enhance the field of stress research contributing to impactful and empowering interventions for individuals bridging knowledge to practice, and intervention to real-world use. Here we discuss this potential, anticipated challenges, and emerging opportunities. Goodday SM, Friend S. Unlocking stress and forecasting its consequences with digital technology. NPJ Digit Med. 2019;2:75. Published 2019 Jul 31. doi:10.1038/s41746-019-0151-8. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Sections of the Abstract, Introduction, Defining Stress, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6668457/

Background: Some individuals with autism find it challenging to use and understand language in conversation, despite having good abilities in core aspects of language such as grammar and vocabulary. This suggests that pragmatic skills (such as understanding implied meanings in conversation) are separable from core language skills. However, it has been surprisingly difficult to demonstrate this dissociation in the general population. We propose that this may be because prior studies have used tasks in which different aspects of language are confounded. Methods: The present study used novel language tasks and factor analysis to test whether pragmatic understanding of implied meaning, as part of a broader domain involving social understanding, is separable from core language skills. 120 adult participants were recruited online to complete a 7-task battery, including a test assessing comprehension of conversational implicature. Results: In confirmatory analysis of a preregistered model, we compared whether the data showed better fit to a two-factor structure (including a “social understanding” and “core language” factor) or a simpler one-factor structure (comprising a general factor). The two-factor model showed significantly better fit. Conclusions: This study supports the view that interpreting context-dependent conversational meaning is partially distinct from core language skills. This has implications for understanding the pragmatic language impairments reported in autism. Wilson AC, Bishop DVM. If you catch my drift...: ability to infer implied meaning is distinct from vocabulary and grammar skills. Wellcome Open Res. 2019;4:68. Published 2019 Jul 10. doi:10.12688/wellcomeopenres.15210.2. This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Sections of the Abstract, Introductions, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6589929/

Background: This research is an investigation into the role of expert quotes in health news, specifically whether news articles containing a quote from an independent expert are less often exaggerated than articles without such a quote. Methods: Retrospective quantitative content analysis of journal articles, press releases, and associated news articles was performed. The investigated sample are press releases on peer-reviewed health research and the associated research articles and news stories. Our sample consisted of 462 press releases and 668 news articles from the UK (2011) and 129 press releases and 185 news articles from The Netherlands (2015). We hand-coded all journal articles, press releases and news articles for correlational claims, using a well-tested codebook. The main outcome measures are types of sources that were quoted and exaggeration of correlational claims. We used counts, 2x2 tables and odds ratios to assess the relationship between presence of quotes and exaggeration of the causal claim. Results: Overall, 99.1% of the UK press releases and 84.5% of the Dutch press releases contain at least one quote. For the associated news articles these percentages are: 88.6% in the UK and 69.7% in the Netherlands. Authors of the study are most often quoted and only 7.5% of UK and 7.0% of Dutch news articles contained a new quote by an expert source, i.e. one not provided by the press release. The relative odds that an article without an external expert quote contains an exaggeration of causality is 2.6. Conclusions: The number of articles containing a quote from an independent expert is low, but articles that cite an external expert do contain less exaggeration. Bossema FG, Burger P, Bratton L, et al. Expert quotes and exaggeration in health news: a retrospective quantitative content analysis. Wellcome Open Res. 2019;4:56. Published 2019 Jul 8. doi:10.12688/wellcomeopenres.15147.2. This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Sections of the Abstract, Introduction, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6619368/#ref-24

Objectives: To explore if short term, high dose vitamin D supplementation is safe and improves balance in persons with Parkinson's disease (PD). Methods: A pilot randomized, double-blind intervention trial to measure the effects of 16 weeks of high dose vitamin D (10,000 IU/day) on balance as well as other motor and non-motor features of PD. We measured balance, gait, strength, falls, cognition, mood, PD severity, and quality of life before and after 16 weeks of high dose vitamin D supplementation or placebo. All participants also received 1000 mg calcium once daily. Results: Fifty-one randomized participants completed sixteen weeks of high dose vitamin D supplementation or placebo. The intervention resulted in a rise in serum concentrations of vitamin D (25-OH) (30.2 ng/ml to 61.1 ng/ml) and was well tolerated with no serious adverse events. Serum vitamin D (25-OH) levels rose steadily and did not suggest a leveling off at the end of the 16 weeks. There was not an improvement in the primary endpoint, balance as measured by the Sensory Organization Test (p = 0.43). A post hoc analysis examining treatment effects in younger (ages 52–66) versus older (ages 67–86) participants found a significant improvement in the SOT of 10.6 points in the younger half of the cohort (p = 0.012). Conclusions: Short term, high dose vitamin D supplementation appears safe in persons with PD, but did not significantly improve balance as measured with the Sensory Organization Test in this pilot study population. A post hoc analysis suggests that vitamin D may have potential for improving balance in a younger population with PD. High dose vitamin D supplementation in PD needs further study especially in light of new research suggesting that mega doses and even moderate doses (as low as 4000IU a day) may increase falls in an older populations. Hiller AL, Murchison CF, Lobb BM, O'Connor S, O'Connor M, Quinn JF. A randomized, controlled pilot study of the effects of vitamin D supplementation on balance in Parkinson's disease: Does age matter?. PLoS One. 2018;13(9):e0203637. Published 2018 Sep 26. doi:10.1371/journal.pone.0203637. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6157857/

Introduction: The Dutch Pharmacogenetics Working Group (DPWG) indicated a list of actionable genotypes that affect patients’ response to more 50 drugs; these drugs which show variable effects based on patients’ genetic traits were named as pharmacogenetics (PGX) drugs. Preemptive genetic testing before using these drugs may protect certain patients from serious adverse reactions and could help in avoiding treatment failures. The objectives of this study include identifying the rate of PGX drug usage among Dutch population, estimating the level of users who carry the actionable genotypes and determining the main genes involved in drug’s effect variability. Methods: Usage of PGX drugs over 2011–2017 by the insured population (an average of 11.4 million) in outpatient clinics in Netherlands was obtained from the publically available GIP databank. The data of 45 drugs were analyzed and their interactions with selected pharmacogenes were estimated. Frequency of actionable genotypes of 249 Dutch parents was obtained from the public database: Genome of Netherlands (GoNL), to identify the pattern of genetic characteristics of Dutch population. Results: Over a 7 year period, 51.3 million exposures of patients to PGX drugs were reported with an average of 5.3 exposures per each drug user. One quarterof the exposures (12.4 million) are predicted to be experienced by individuals with actionable genotypes (risky exposures). Up to 60% of the risky exposures (around 7.5 million) were related to drugs metabolized by CYP2D6. SLCO1B1, and CYP2C19 were also identified among the top genes affecting response of drugs users (involved in about 22 and 12.4% of the risky exposures, respectively). Cardiovascular medications were the top prescribed PGX drug class (43%), followed by gastroenterology (29%) and psychiatry/neurology medications (15%). Women use more PGX drugs than men (55.8 vs. 44.2%, respectively) with the majority (84%) of users in both sexes are above 45 years. Conclusion: PGX drugs are commonly used in Netherlands. Preemptive panel testing for CYP2D6, SLCO1B1, and CYP2C19 only could be useful to predict 95% of vulnerable patients’ exposures to PGX drugs. Future studies to assess the economic impact of preemptive panel testing on patients of older age are suggested. Alshabeeb MA, Deneer VHM, Khan A, Asselbergs FW. Use of Pharmacogenetic Drugs by the Dutch Population. Front Genet. 2019;10:567. Published 2019 Jul 2. doi:10.3389/fgene.2019.00567. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614185/

Background: Reducing diet costs may lead to the selection of energy-dense foods, such as refined grains or foods high in added sugars and/or fats, which can lower overall dietary quality. We examined the longitudinal association between the monetary value of the diet (MVD) and the overall dietary quality across sex, race and income groups. Methods and findings: Longitudinal data from 1,466 adult urban participants from Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study were used. Healthy Eating Index–2010 (HEI–2010) and Mean Adequacy Ratio (MAR) were computed and a national food price database was used to estimate MVD. Multiple linear regression analyses were conducted linking annual rates of change (Δ) in MVD to ΔHEI-2010 and ΔMAR, stratifying by sex, race and income groups. Among key findings, ΔHEI-2010 was comparable across socio-demographic groups, while ΔMAR was higher among women and individuals above poverty. Adjusting for key covariates, ΔMVD was positively associated with both ΔHEI-2010 and ΔMAR, and with a consistently stronger association among individuals above poverty, specifically for the total proteins and empty calories components of HEI-2010 and several nutrient adequacy ratios (NARs: vitamins C, E, B-6 and Zinc). ΔMVD-ΔMAR association was stronger in women, mainly influenced by ΔMVD’s positive associations with B-vitamins, copper, calcium, magnesium and phosphorus NARs. ΔMVD-Δvitamin D NAR’s positive relationship was stronger among Whites, while ΔMVD-Δvitamin B-12 NAR’s association was stronger among African-Americans. Conclusions: In sum, a potential increase in MVD may have a stronger impact on dietary quality among urban adult women and above-poverty individuals. Beydoun MA, Fanelli-Kuczmarski MT, Poti J, et al. Longitudinal change in the diet's monetary value is associated with its change in quality and micronutrient adequacy among urban adults. PLoS One. 2018;13(10):e0204141. Published 2018 Oct 12. doi:10.1371/journal.pone.0204141. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of the Abstract, Introduction, Methods, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6193582/

As public health advertisements move online, it becomes possible to run inexpensive randomized-controlled trials (RCTs) thereof. Here we report the results of an online RCT to improve food choices and integrate exercise into daily activities of internet users. People searching for pre-specified terms were randomized to receive one of several professionally developed campaign advertisements or the “status quo” (ads that would otherwise have been served). For 1-month pre-intervention and post-intervention, their searches for health-promoting goods or services were recorded. Our results show that 48% of people who were exposed to the ads made future searches for weight loss information, compared with 32% of those in the control group—a 50% increase. The advertisements varied in efficacy. However, the effectiveness of the advertisements may be greatly improved by targeting individuals based on their lifestyle preferences and/or sociodemographic characteristics, which together explain 49% of the variation in response to the ads. These results demonstrate that online advertisements hold promise as a mechanism for changing population health behaviors. They also provide researchers powerful ways to measure and improve the effectiveness of online public health interventions. Finally, we show that corporations that use these sophisticated tools to promote unhealthy products can potentially be outbid and outmaneuvered. Yom-Tov E, Shembekar J, Barclay S, Muennig P. The effectiveness of public health advertisements to promote health: a randomized-controlled trial on 794,000 participants [published correction appears in NPJ Digit Med. 2018 Aug 16;1:38]. NPJ Digit Med. 2018;1:24. Published 2018 Jun 27. doi:10.1038/s41746-018-0031-7. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6550260/

Relationship problems among school children can lead to bullying situations. In this regard, it should be noted that, among healthy lifestyle habits, sports practice (non-competitive) promotes responsibility and improves coexistence. The objective of the present study was to analyze the incidence of the frequency of practice of healthy physical activity on the risks of students directly involved in school bullying (harasser and victim) by gender. The participants of the study were 1,248 students of Compulsory Secondary Education with ages between 11 and 18 (M = 14.42, SD = 1.43), being 50.8% males. The results of the study indicated that students who practiced physical activity in the recommended frequency rated as healthy, at least four or more times per week, had higher values in the indicators of aggressiveness than students who practiced with a lower frequency, appreciating a greater relationship between both variables in male rather than in female students. The study will make progress in preventive and intervention programs whose central axis is the promotion of physical activity and healthy sport (non-competitive) among students involved in situations of bullying. Likewise, teacher training in the recognition of bullying is considered a priority, providing them with guidelines for action. Méndez I, Ruiz-Esteban C, Ortega E. Impact of the Physical Activity on Bullying. Front Psychol. 2019;10:1520. Published 2019 Jul 2. doi:10.3389/fpsyg.2019.01520. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6614442/.

Climate change impacts on health—including increased exposures to heat, poor air quality, extreme weather events, altered vector-borne disease transmission, reduced water quality, and decreased food security—affect men and women differently, depending on local geographic and socioeconomic factors. Climate change threatens to widen existing gender-based health disparities, especially in low- and middle-income countries. Health impacts, and gender differences in those impacts, are mediated through socioeconomic, cultural, and physiologic factors. Policy action targeted towards these factors, which are often modifiable, can decrease negative health outcomes. Integration of a gendered perspective into existing climate, development, and disaster-risk reduction policy frameworks requires improvement in data acquisition, monitoring of gender-specific targets, coordination between sectors, and equitable stakeholder engagement. Empowering women as educators, caregivers, holders of knowledge, and agents of social change can improve mitigation and adaptation policy interventions. Sorensen C, Murray V, Lemery J, Balbus J. Climate change and women's health: Impacts and policy directions. PLoS Med. 2018;15(7):e1002603. Published 2018 Jul 10. doi:10.1371/journal.pmed.1002603. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of the Summary, Introduction, Health Imacts, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038986/

Purpose: Cardiologists are known to consider patients' race when treating heart failure, but their views on the benefits and harms of this practice are largely undocumented. We set out to explore cardiologists' perspectives on the benefits and harms of race-based drug labels and guidelines. Specifically, we focused on isosorbide dinitrate and hydralazine hydrochloride (sold in a patented form as BiDil), a combination of drugs recommended for the treatment of black patients receiving optimal medical therapy for symptomatic heart failure and reduced ejection fraction. Methods: We conducted 81 semistructured interviews at an American College of Cardiology Annual meeting to assess cardiologists' and cardiology fellows' attitudes toward the use of race in drug prescribing. Investigators reviewed and coded the interviews using inductive qualitative analysis techniques. Results: Many participants believed that race-based drug labels might help doctors prescribe effective medications to patients sooner. More than half of the participants expressed concerns, however, that considering race within the context of treating heart failure could potentially harm patients as well. Harms identified included the likelihood that patients who could benefit from a drug may not receive it because of their race; insufficient understanding about gene–drug–environment interactions; and simplistic applications of race in the clinic. Conclusions: Few participants expressed approval of using race in drug prescribing without recognizing the potential harms, yet most participants stated that they continue to consider race when prescribing isosorbide dinitrate and hydralazine hydrochloride. Within the context of treating heart failure, more open discussions about the benefits and harms of race-based drug labels and prescribing are needed to address cardiologists' concerns. Callier SL, Cunningham BA, Powell J, McDonald MA, Royal CDM. Cardiologists' Perspectives on Race-Based Drug Labels and Prescribing Within the Context of Treating Heart Failure. Health Equity. 2019;3(1):246–253. Published 2019 May 22. doi:10.1089/heq.2018.0074. This Open Access article is distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6608680/

Background: In order to improve interventions for problem gambling, there is a need for studies that can highlight psychological factors that support the desire to reduce gambling. Objective: To explore online problem gamblers' motivation for change by studying participants' reactions to an online treatment referral website designed to motivate at-risk gamblers to seek help. Design: A qualitative evaluation study, combining focus groups and in-depth interviews. Data were analyzed using the general inductive approach. Informants: The informants included 19 male, treatment- and non-treatment seeking, online gamblers who played a variety of games, including poker, sports betting and online casino. Results: Motivation to change emerged as two processes including (a) empathy with others, which included projection of their thoughts and feelings onto others, and (b) dissonance between gambling behavior and ideal self-image. Dissonance included two subthemes: (i) dissonance due to positive feelings towards sports and athletics, and (ii) dissonance due to gambling among family. Conclusions: The findings have implications for interventions designed to evoke motivation early in treatment of online problem gambling. Inducing problem gamblers to reflect on the thoughts and feelings of concerned significant others, real or fictional, could be a viable strategy to motivate online problem gamblers to consider change. Johansen AB, Helland PF, Wennesland DK, Henden E, Brendryen H. Exploring online problem gamblers' motivation to change. Addict Behav Rep. 2019;10:100187. Published 2019 Jun 17. doi:10.1016/j.abrep.2019.100187 This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/). Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6597935/

As the sport of outdoor rock climbing rapidly grows, there is increasing pressure to understand how it can affect communities of organisms in cliff habitats. To that end, we surveyed 32 cliff sites in Boulder, Colorado, USA, and assessed the relative roles of human recreation and natural habitat features as drivers of bird diversity and activity. We detected only native avian species during our observations. Whereas avian abundance was not affected by climbing, avian species diversity and community conservation value were higher at low-use climbing formations. Models indicated that climber presence and cliff aspect were important predictors of both avian diversity and avian cliff use within our study area, while long-term climbing use frequency has a smaller, but still negative association with conservation value and cliff use by birds in the area. In contrast, the diversity of species on the cliff itself was not affected by any of our measured factors. To assess additional community dynamics, we surveyed vegetation and arthropods at ten site pairs. Climbing negatively affected lichen communities, but did not significantly affect other vegetation metrics or arthropods. We found no correlations between avian diversity and diversity of either vegetation or arthropods. Avian cliff use rate was positively correlated with arthropod biomass. We conclude that while rock climbing is associated with lower community diversity at cliffs, some common cliff-dwelling birds, arthropods and plants appear to be tolerant of climbing activity. An abiotic factor, cliff aspect strongly affected patterns of both avian diversity and cliff use, suggesting that the negative effects of rock climbing may be mitigated by informed management of cliff habitat that considers multiple site features. Covy N, Benedict L, Keeley WH. Rock climbing activity and physical habitat attributes impact avian community diversity in cliff environments. PLoS One. 2019;14(1):e0209557. Published 2019 Jan 16. doi:10.1371/journal.pone.0209557. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of the Abstract, Introduction, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6334907/

Keeping commitments to others can be difficult, and we know that people sometimes fail to keep them. How does a speaker’s ability to keep commitments affect children’s practical decisions to trust and their epistemic decisions to learn? An amassing body of research documents children’s trust in testimonial learning decisions, which can be moved in the face of epistemic and moral evidence about an agent. However, other bases for trust go largely unexplored in this literature, such as interpersonal reasons to trust. Here, we investigated how direct bids for interpersonal trust in the form of making commitments, or obligations to the listener, influence a range of decisions toward that agent. We found that 3- and 4-year-olds’ (N = 75) practical decisions to wait and to share were moved as a function of a person’s commitment-keeping ability, but epistemic decisions to learn were not. Keeping one’s commitments may provide children with interpersonal reasons to trust, reasons that may function in ways distinct from the considerations that bear on accepting a claim. Pesch A, Koenig MA. Varieties of trust in preschoolers' learning and practical decisions. PLoS One. 2018;13(8):e0202506. Published 2018 Aug 20. doi:10.1371/journal.pone.0202506. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6101396/

We studied whether medical conditions across 21 broad categories were predictable from social media content across approximately 20 million words written by 999 consenting patients. Facebook language significantly improved upon the prediction accuracy of demographic variables for 18 of the 21 disease categories; it was particularly effective at predicting diabetes and mental health conditions including anxiety, depression and psychoses. Social media data are a quantifiable link into the otherwise elusive daily lives of patients, providing an avenue for study and assessment of behavioral and environmental disease risk factors. Analogous to the genome, social media data linked to medical diagnoses can be banked with patients’ consent, and an encoding of social media language can be used as markers of disease risk, serve as a screening tool, and elucidate disease epidemiology. In what we believe to be the first report linking electronic medical record data with social media data from consenting patients, we identified that patients’ Facebook status updates can predict many health conditions, suggesting opportunities to use social media data to determine disease onset or exacerbation and to conduct social media-based health interventions. Sections of the Abstract, Introduction, and Results and discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6576767/

Rationale & objective: As the prevalence of obesity continues to rise in the United States, it is important to understand its impact on the lifetime risk of chronic kidney disease (CKD). Study design: The CKD Health Policy Model was used to simulate the lifetime risk of CKD for those with and without obesity at baseline. Model structure was updated for glomerular filtration rate (GFR) decline to incorporate new longitudinal data from the Chronic Renal Insufficiency Cohort (CRIC) study. Setting and population: The updated model was populated with a nationally representative cohort from National Health and Nutrition Examination Survey (NHANES). Outcomes: Lifetime risk of CKD, highest stage and any stage. Model, perspective, & timeframe: Simulation model following up individuals from current age through death or age 90 years. Results: Lifetime risk of any CKD stage was 32.5% (95% CI 28.6%–36.3%) for persons with normal weight, 37.6% (95% CI 33.5%–41.7%) for persons who were overweight, and 41.0% (95% CI 36.7%–45.3%) for persons with obesity at baseline. The difference between persons with normal weight and persons with obesity at baseline was statistically significant (p

Continuity is a critical but often neglected function of high-quality primary care and has three core domains: relational, informational and managerial continuity. Improving continuity is feasible in low-income and middle-income country health systems by using comprehensive empanelment systems or community-based follow-up programmes to improve retention in care. Continuity must receive more attention, measurement and improvement efforts, in order to achieve equitable, high-quality health for all. Schwarz D, Hirschhorn LR, Kim JH, Ratcliffe HL, Bitton A. Continuity in primary care: a critical but neglected component for achieving high-quality universal health coverage. BMJ Glob Health. 2019;4(3):e001435. Published 2019 May 23. doi:10.1136/bmjgh-2019-001435. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See: http://creativecommons.org/licenses/by/4.0/. Sections of the Summary, Introduction, You cannot improve what you do not see, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6570977/

Dietary intake of adult vegetarians from large prospective studies has been well-characterized but is rarely reported in vegetarian adolescents. Our objective was to describe and compare the dietary intake of vegetarian adolescents with their non-vegetarian counterparts in a population known to espouse healthy living. Adolescents (n = 534) aged 12–18 years old from middle and high schools near major Adventist universities in Michigan and Southern California provided dietary, demographic, and anthropometric data. Dietary intake was measured with a validated 151-item self-administered web-based food frequency questionnaire; weight and height were measured during school visits. Vegetarian was defined as the combined intake of meat, meat derivatives, poultry, and fish of

Exposure to media coverage of mass violence has been shown to predict poorer mental health symptomology. However, it is unknown whether such media coverage can have ubiquitous effects on average community members, extending to biological and perceptual processes that underlie everyday decision making and behavior. Here, we used a repeated-measures design over the first anniversary of the Boston Marathon bombings to track participants’ self-reported distress, their eye blink startle reactivity while viewing images of the bombings, and their ability to perceptually distinguish armed from unarmed individuals in a behavioral shooting task. We leveraged a computational linguistics method in which we sampled news content from the sources our participants most commonly self-reported reading, and then quantified both the extent of news coverage about the marathon and the affective tone of that news coverage. Results revealed that participants experienced greater current distress, greater physiological reactivity to threats, and poorer perceptual sensitivity when recent news coverage of the marathon contained more affectively negative words. This is the first empirical work to examine relationships between the media’s affective tone in its coverage of mass violence and individuals’ threat perception and physiological threat reactivity. Wormwood JB, Lin YR, Lynn SK, Barrett LF, Quigley KS. Psychological impact of mass violence depends on affective tone of media content. PLoS One. 2019;14(4):e0213891. Published 2019 Apr 1. doi:10.1371/journal.pone.0213891. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6443148/

Early life adversity (ELA) contributes to behavioral impulsivity along with risk for substance use disorders, both accompanied by blunted stress-axis reactivity. However, the biological contributors to blunted stress reactivity are not known. We took advantage of the fact that women have significant opioid inhibition of cortisol output by using the opioid antagonist, naltrexone, to unmask opioid interactions due to ELA. We administered 50 mg of naltrexone or placebo to 72 healthy women (23 years of age) in a double-blind crossover study and observed deviations in cortisol secretion from placebo over the next 180 minutes. ELA was assessed by reported exposure to physical and sexual abuse or neglect and low socioeconomic status and scored as Low, Medium, or High (0, 1–2, and 3+). The ELA groups all had identical placebo-day cortisol secretion, indicating normal basal regulation of the hypothalamic-pituitary-adrenocortical axis. Cortisol rises to naltrexone were largest in the Low-ELA group and strongly blunted in the High-ELA group (F = 3.51, p = 0.035), indicating a lack of opioid function in women with high degrees of ELA. The Low-ELA women reported dysphoric responses to naltrexone (F = 4.05, p = .022) indicating a mild opioid withdrawal, an effect that was absent in the High-ELA group. Women exposed to ELA have blunted cortisol responses to naltrexone, indicating reduced opioid regulation of the stress axis. Central opioid changes may be one pathway linking ELA to blunted stress reactivity in adulthood. Lovallo WR, Acheson A, Vincent AS, Sorocco KH, Cohoon AJ. Early life adversity diminishes the cortisol response to opioid blockade in women: Studies from the Family Health Patterns project. PLoS One. 2018;13(10):e0205723. Published 2018 Oct 12. doi:10.1371/journal.pone.0205723. This is an open access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication. Sections of the Abstract, Introduction, and Conclusion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6185842/

We investigated the effect of snacking habits in childhood on changes in body mass index (BMI) and high BMI in adolescence and adulthood. In total, 2141 Japanese children from the Ibaraki Children’s Cohort Study were evaluated at age 6 years (baseline), then at ages 12 and 22 years. We examined associations between snacking (scheduled times, when children wanted, and freely) at age 6 years and changes in BMI over time and the proportion of high BMI at ages 12 and 22 years, using time-dependent mixed-effects and logistic regression models. Compared with children who snacked at scheduled times, those provided snacks when they wanted experienced larger increases in BMI over time between ages 6 and 22 years (multivariable time-dependent effect: 0.03 kg/m2 for boys, p = 0.047; 0.04 kg/m2 for girls, p = 0.019). No differences were observed in children who snacked freely. A higher proportion of high BMI was found in boys who were provided snacks when they wanted compared with those who snacked at scheduled times. The multivariable odds ratio (95% confidence interval) was 1.52 (1.04–2.23) at age 12 years and 2.23 (1.12–4.45) at age 22 years. No differences were observed for girls at either age. Children who were provided snacks when they wanted showed larger increases in BMI over time compared with those who snacked at scheduled times. Boys who were provided snacks when they wanted showed the higher proportion of high BMI at follow-up. Sata M, Yamagishi K, Sairenchi T, et al. Long-term effect of feeding snacks at age 6 years on body mass index at ages 12 and 22 years. Sci Rep. 2019;9(1):8627. Published 2019 Jun 13. doi:10.1038/s41598-019-40730-3. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/. Sections of the Abstract, Introduction, and Discussion are presented in the Podcast. Link to the full-text article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6565708/