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Volcano Observatories (VOs) around the world are required to maintain surveillance of their volcanoes and inform civil protection and aviation authorities about impending eruptions. They often work through consolidated procedures to respond to volcanic crises in a timely manner and provide a service to the community aimed at reducing the potential impact of an eruption. Within the International Airways Volcano Watch (IAVW) framework of the International Civil Aviation Organisation, designated State Volcano Observatories (SVOs) are asked to operate a colour coded system designed to inform the aviation community about the status of a volcano and the expected threats associated. Despite the IAVW documentation defining the different colour-coded levels, operating the Aviation Colour Code (ACC) in a standardised way is not easy, as sometimes, different SVOs adopt different strategies on how, when, and why to change it. Following two European VOs and Volcanic Ash Advisory Centres (VAACs) workshops, the European VOs agreed to present an overview on how they operate the ACC. The comparative analysis presented here reveals that not all VOs in Europe use the ACC as part of their operational response, mainly because of a lack of volcanic eruptions since the ACC was officially established, or the absence of a formal appointment as an SVO. We also note that the VOs, which do regularly adopt ACC, operate differently depending on the frequency and styles of eruptions, the historical eruptive activity, the nature of the unrest, the monitoring level, and also on the agreement they may have with the local Air Transport Navigation providers. This study shows that even though the ACC system was designed to provide a standard, its usage strongly depends on the evaluation of the actors responding to the volcano emergencies. Some common questions have been identified across the different (S)VOs that will need to be addressed by ICAO in order to have a more harmonised approach and usage of the ACC.

Seismology is one of the main sciences used to monitor volcanic activity worldwide. Fast, efficient, and accurate seismicity detectors are crucial to assess the activity level of a volcano in near-real time and to issue timely warnings. Traditional real-time seismic processing software uses phase onset pickers followed by a phase association algorithm to declare an event and estimate its location. The pickers typically do not identify whether the detected phase is a P or S arrival, which can have a negative impact on hypocentral location quality and complicates phase association. We implemented the deep-neural-network-based method PhaseNet to identify in real time P and S seismic waves on data from one- and three-component seismometers. We tuned the Earthworm binder_ew associator module to use the phase identification from PhaseNet to detect and locate the events, which we archive in a SeisComP3 database. We assessed the performance of the algorithm by comparing the results with existing catalogs built to monitor seismic and volcanic activity in Mayotte and the Lesser Antilles region. Our algorithm, which we refer to as PhaseWorm, showed promising results in both contexts and clearly outperformed the previous automatic method implemented in Mayotte. This innovative real-time processing system is now operational for seismicity monitoring in Mayotte and Martinique.

Carrie R Howell,1 Caroline N Harada,2 Kevin R Fontaine,3 Michael J Mugavero,4 Andrea L Cherrington1 1Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, AL, USA; 2Department of Medicine, Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL, USA; 3Department of Health Behavior, School of Public Health, University of Alabama at Birmingham, Birmingham, Al, USA; 4Department of Medicine, Division of General Internal Medicine, University of Alabama at Birmingham, Birmingham, AL, USACorrespondence: Carrie R Howell, Department of Medicine, Division of Preventive Medicine, Medical Towers Suite 638, 1717 11th Avenue South, Birmingham, AL, 35294, USA, Email chowell@uabmc.eduAbstract: The evidence of suboptimal social determinants of health (SDoH) on poor health outcomes has resulted in widespread calls for research to identify ways to measure and address social needs to improve health outcomes and reduce disparities. While assessing SDoH has become increasingly important in diabetes care and prevention research, little guidance has been offered on how to address suboptimal determinants in diabetes-related clinical care, prevention efforts, medical education and research. Not surprisingly, many patients experience multiple social needs – some that are more urgent (housing) than others (transportation/resources), therefore the order in which these needs are addressed needs to be considered in the context of diabetes care/outcomes. Here we discuss how conceptualizing diabetes related health through the lens of Maslow’s hierarchy of needs has potential to help prioritize individual social needs that should be addressed to improve outcomes in the context of population-level determinants in the communities where people live.Keywords: social determinants of health, diabetes, clinical care, clinical education

International audience

SUMMARYThe brutal onset of seismicity offshore Mayotte island North of the Mozambique Channel, Indian Ocean, that occurred in May 2018 caught the population, authorities and scientific community off guard. Around 20 potentially felt earthquakes were recorded in the first 5 d, up to magnitude Mw 5.9. The scientific community had little pre-existing knowledge of the seismic activity in the region due to poor seismic network coverage. During 2018 and 2019, the MAYOBS/REVOSIMA seismology group was progressively built between four French research institutions to improve instrumentation and data sets to monitor what we know now as an on-going exceptional submarine basaltic eruption. After the addition of 3 medium-band stations on Mayotte island and 1 on Grande Glorieuse island in early 2019, the data recovered from the Ocean Bottom Seismometers were regularly processed by the group to improve the location of the earthquakes detected daily by the land network. We first built a new local 1-D velocity model and established specific data processing procedures. The local 1.66 low VP/VS ratio we estimated is compatible with a volcanic island context. We manually picked about 125 000 P and S phases on land and sea bottom stations to locate more than 5000 events between February 2019 and May 2020. The earthquakes outline two separate seismic clusters offshore that we named Proximal and Distal. The Proximal cluster, located 10 km offshore Mayotte eastern coastlines, is 20–50 km deep and has a cylindrical shape. The Distal cluster start 5 km to the east of the Proximal cluster and extends below Mayotte's new volcanic edifice, from 50 to 25 km depth. The two clusters appear seismically separated, however our data set is insufficient to firmly demonstrate this.

Understanding the processes that may be at the origin of major earthquakes in subduction zones is highly challenging, especially in the case of slowly converging areas such as the Lesser Antilles subduction zone. Our study reveals a recorded increase in seismicity rate and cumulative seismic moment over the last two decades offshore Martinique island and, particularly, in the presumed rupture area of the major historical 1839 earthquake. This sustained seismicity is shared between extensive intermediate depth activity since the 2007 Mw 7.4 earthquake that occurred about 20 km north of Martinique and a compressive seismic cluster located in the seismogenic zone of the subduction zone. We also observe a downward migration of the seismicity along the plate interface up to a 60–65 km depth and a recorded increase in the magnitudes of the earthquakes. All these observations may indicate ongoing changes along the plate boundary interface near the area of the historical major rupture of 1839, although more detailed statistical studies and additional data are necessary to confirm this trend.

Assess the feasibility, acceptability, and preliminary efficacy of a healthy lifestyle website, SurvivorSHINE ( www.survivorshine.org ), for cancer survivors using a mixed-methods approach. Formative research included a comprehensive literature review and four focus groups on website preferences with diagnosis-diverse cancer survivors (N = 17). Their feedback informed a web adaptation of a telephone counseling and mailed-print lifestyle intervention previously found effective for cancer survivors. The resulting web-based intervention was examined in a 3-week, single-arm trial among 41 cancer survivors. Assessments of physical activity, diet, body weight, and knowledge related to exercise and diet guidelines for cancer survivors occurred at baseline and 3 weeks later, along with exit interviews. Themes from focus groups indicated cancer survivors’ desire for easy-to-use, interactive web-based platforms to access credible diet and exercise information. The study sample was recruited within 12 months, and study retention was high (85.4%). Participants showed significant pre- to post-test improvements in diet and exercise knowledge (t = 5.31, p

Today, resilience in the face of cyclone risks has become a crucial issue for our societies. With climate change, the risk of strong cyclones occurring is expected to intensify significantly and to impact the way of life in many countries. To meet some of the associated challenges, the interdisciplinary ReNovRisk programme aims to study tropical cyclones and their impacts on the South-West Indian Ocean basin. This article is a presentation of the ReNovRisk programme, which is divided into four areas: study of cyclonic hazards, study of erosion and solid transport processes, study of water transfer and swell impacts on the coast, and studies of socio-economic impacts. The first transdisciplinary results of the programme are presented together with the database, which will be open access from mid-2021.

OBJECTIVE To define the risk of coronary artery disease (CAD) in adults with a history of juvenile arthritis (JA). METHODS We used the National Health and Nutrition Examination 2007-2014 surveys. Two comparison groups were identified: a random sample of patients without arthritis, and respondents with reported having rheumatoid arthritis (RA). CAD was defined as a "yes" response to the survey question, "Have you ever been told you had congestive heart failure, coronary heart disease, angina/angina pectoris, heart attack, or stroke?" Potential confounders for CAD included age, sex, race, smoking status, and any component of metabolic syndrome. RESULTS A total of 232 respondents reported having JA. We randomly selected 1,028 without arthritis and 1,105 who reported having RA. In simple logistic regression, the JA group had a 3-fold increased odds of CAD compared to those without arthritis (odds ratio [OR] 3.2 [95% confidence interval (95% CI) 2.1-4.8], P < 0.0001). Controlling for confounders, the odds of CAD in JA continued to be increased (OR 4.2 [95% CI 4.7-10.5], P = 0.002). When comparing the JA and RA groups, in simple logistic regression, the JA group had a lower odds of CAD (OR 0.7 [95% CI 0.5-0.9], P = 0.03). Controlling for confounders, there was no significant difference in the odds of CAD between groups (OR 0.8 [95% CI 0.5-1.3], P = 0.4). CONCLUSION Adults with a history of JA have a higher risk of CAD compared to adults without arthritis. Providers should be aware of the increased risk of CAD in adults with JA and aggressively screen these patients for modifiable risk factors.

Objective:The current study aims to describe the Mediterranean diet (MD) adherence across the US regions, and explore the predictive factors of MD adherence among US adults.Design:Cross-sectional secondary data analysis. MD adherence score (0–9) was calculated using the Block 98 FFQ. Hot spot analysis was conducted to describe the geospatial distribution of MD adherence across the US regions. Logistic regression explored predictors of MD adherence.Setting:Nationwide community-dwelling residency in the USA.Participants:Adults aged ≥45 years (n20 897) who participated in the REasons for Geographic and Racial Differences in Stroke study and completed baseline assessment during January 2003 and October 2007.Results:The mean of MD adherence score was 4·36 (sd1·70), and 46·5 % of the sample had high MD adherence (score 5–9). Higher MD adherence clusters were primarily located in the western and northeastern coastal areas of the USA, whereas lower MD adherence clusters were majorly observed in south and east-north-central regions. Being older, black, not a current smoker, having a college degree or above, an annual household income ≥ $US 75K, exercising ≥4 times/week and watching TV/video Conclusions:There were significant geospatial and population disparities in MD adherence across the US regions. Future studies are needed to explore the causes of MD adherence disparities and develop effective interventions for MD promotion in the USA.

International audience; Teleseismic receiver-functions and Rayleigh-wave dispersion curves are jointly inverted for quantifying S-wave velocity profiles beneath the active volcanic zone off Mayotte. We show that the lithosphere in the east-northeast quadrant is composed of four main layers, interpreted as the volcanic edifice, the crust with underplating, the lithospheric mantle, and the asthenosphere, the latter two presenting a main low-velocity zone. The depths of the old (10-11 km) and new Moho (28-31 km) coincide with the two magma reservoirs evidenced by recent seismological and petrological methods. We propose that the main magma reservoir composed of mush with an increasing amount of liquid extends down to 54 km depth. This magma storage develops from a rheological contrast between the ductile lower and brittle upper lithospheric mantle and accounts for most of the volcanic eruptionrelated seismicity. Finally, the abnormally small thickness of the lithospheric mantle (33 km) is likely a result of a thermal thinning since the onset of Cenozoic magmatism.

International audience; This work focuses on the use of thin-layer models for simulating fast gravitational flows for hazard assessment. Such simulations are sometimes difficult to carry out because of the uncertainty on initial conditions and on simulation parameters. In this study, we aggregate various field data to constrain realistic initial conditions and to calibrate the model parameters. By using the SHALTOP numerical code, we choose a simple and empirical rheology to model the flow (no more than two parameters), but we model more finely the geometrical interactions between the flow and the topography. We can thus model both a rock avalanche, and the subsequent remobilization of the deposits as a high discharge debris flow.Using the Prêcheur river catchment (Martinique, Lesser Antilles) as a case study, we focus on extreme events with a high potential to impact populations and infrastructures. We use geological and geomorphological data, topographic surveys, seismic recordings and granulometric analysis to define realistic simulation scenarios and determine the main characteristics of documented events. The latter are then reproduced to calibrate rheological parameters. With a single rheological parameter and the Coulomb rheology, we thus model the emplacement and main dynamic characteristics of a recent rock avalanche, as well as the travel duration and flooded area of a documented high discharge debris flow. Then, in a forward prediction simulation, we model a possible 1.9x10^6 m^3 rock avalanche, and the instantaneous remobilization of the resulting deposits as a high-discharge debris flow. We show that successive collapses allow to better reproduce the dynamics of the rock avalanche, but do not change the geometry of the final deposits, and thus do not influence the initial conditions of the subsequent debris flow simulation. A progressive remobilization of the materials slows down the debris flow and limits overflow, in comparison to instantaneous release. However, we show that high discharge debris flows, such as the one considered for model calibration, are better reproduced with an instantaneous initiation. The range of travel times measured for other significant debris flows in the Prêcheur river is consistent with our simulation results, with various rheological parameters and the Coulomb or Voellmy rheology.

Despite remarkable improvements in screening, diagnosis, and targeted therapies, cancer remains the second leading cause of death in the United States. It is increasingly clear that diet and lifestyle practices play a substantial role in cancer development and progression. As such, various dietary compositions have been proposed for reducing cancer risk and as potential adjuvant therapies. In this article, we critically assess the preclinical and human trials on the effects of the ketogenic diet (KD, i.e., high-fat, moderate-to-low protein, and very-low carbohydrate content) for cancer-related outcomes. The mechanisms underlying the hypothesized effects of KD, most notably the Warburg Effect, suggest that restricting carbohydrate content may impede cancer development and progression via several pathways (e.g., tumor metabolism, gene expression). Overall, although preclinical studies suggest that KD has antitumor effects, prolongs survival, and prevents cancer development, human clinical trials are equivocal. Because of the lack of high-quality clinical trials, the effects of KD on cancer and as an adjunctive therapy are essentially unknown. We propose a set of research recommendations for clinical studies examining the effects of KD on cancer development and progression.

A Vernier ring-oscillator-based time-to-digital converter (TDC) with a new prelogic is presented. Experimental results show that the proposed architecture achieve a 5.5 ps RMS timing jitter with a 5.1 ps LSB within an area of 0.00151 mm 2 . Thanks to the new prelogic circuit, the power consumption of the circuit was optimised to 22 μ W at a rate of 1 Mevents/s for a dynamic range of 4 ns. The area, timing jitter and power consumption make the TDC suitable for an array of electronic readout in a position emission tomography single photon avalanche diode based detectors.

We present the case of a 30-year-old man who developed chronic postsurgical pain (CPSP) after coloproctectomy with terminal ileostomy for severe inflammatory bowel disease refractory to medical treatments. CPSP was severe with negative impact on his quality of life and resistant to high doses of tramadol combined with antidepressants and benzodiazepine. Referred to our pain clinic he was first treated with repeated transversus abdominis plane (TAP) blocks which provided short-lasting pain relief. Because of the temporary effect of the infiltrations a catheter was then indwelled in the TAP under ultrasound guidance and local anesthetic was continuously infused for 10-days. Complete analgesia was reported during the infusion and persisted after removal of the catheter. Twelve months later, pain has markedly decreased, is reported as bearable and amenable with low doses of analgesics. A continuous TAP infusion was repeated twice separated by approximately one year. Thereafter no further infiltration was necessary.

Dairy has been described as everything from a superfood to a poison; yet, arguments, assumptions, and data justifying these labels are not always clear. We used an issue-based information system, “dialogue mapping™,” to summarize scientific points of a live panel discussion on the putative effects of dairy on cardiovascular diseases (CVD) from a day-long session among experts in nutrition and CVD. Dialogue mapping captures relations among ideas to explicitly, logically, and visually connect issues/questions, ideas, pro/con arguments, and agreements, even if discussed at different times. Experts discussed two propositions: for CVD risk, consumption of full-fat dairy products, 1) should be minimized, in part because of their saturated fat content, or 2) need not be minimized, despite their saturated fat content. The panel discussed the dairy-CVD relation through blood lipids, diabetes, obesity, energy balance, blood pressure, dairy bioactives, biobehavioral components, and other putative causal pathways. Associations and effects reported in the literature have varied by fat content of dairy elements considered, study design, intake methods, and biomarker versus disease outcomes. Two conceptual topics emerged from the discussion: 1) individual variability: whether recommendations should be targeted only to those at high CVD risk; 2) quality of evidence: whether data on dairy-CVD relations are strong enough for reliable conclusions – positive, negative, or null. Future procedural improvements for science dialog mapping include using singular rather than competing propositions for discussion.

Volcanic hotspot islands are thought to be surface manifestations of mantle plumes that rise from the core–mantle boundary. When mantle plumes approach the surface, their mostly vertical rise must be deflected into near-horizontal flow beneath tectonic plates. This creates an opportunity to constrain their dynamics and their interactions with lithospheric plates and mid-ocean ridges. Seafloor observations have been used to propose that a focused flow in the asthenosphere transports plume heat to the nearest mid-ocean ridge, where it efficiently dissipates through formation of lithosphere. Here we present imaging results from a seismological survey of a proposed plume-to-ridge flow channel between the Reunion hotspot and the Central Indian Ridge. Rayleigh-wave tomography and shear-wave splitting confirm the presence of a channelized flow of shallow asthenosphere, eastward from the hotspot to the spreading ridge. At a larger scale, a deeper reservoir of hot asthenosphere fills vast tracts of the Indian Ocean basin east and north of Reunion Island. Its flows, decoupled from overlying lithospheres, are also directed towards the Central Indian Ridge but extend well beyond, tapped but not significantly depleted by the spreading ridge. Based on seismic and geochemical observations, we suggest that this hidden heat reservoir is generated and driven by the mantle plume, which buffers more heat near the surface than expected. A large, deep reservoir of asthenosphere flows eastward from the Reunion hotspot and interacts with the Indian spreading ridge, suggests seismological imaging.

Ketogenic diets (KDs) are emerging as effective therapies for several chronic diseases, including cancer. However, concerns regarding safety and adherence may prevent clinicians from prescribing KDs. We hypothesized that a KD does not negatively affect blood lipid profile compared to a lower-fat diet in ovarian and endometrial cancer patients, and that KD subjects would demonstrate acceptable adherence. Subjects were randomized to either a KD (70% fat, 25% protein, 5% carbohydrate), or the American Cancer Society diet (ACS; high-fiber and lower-fat). Blood lipids and ketones were measured at baseline and after 12 weeks of the assigned intervention. Adherence measures included urinary ketones in the KD and 4 days' diet records. Diet records were also examined to identify general patterns of consumption. Differences between the diets on blood lipids and dietary intake were assessed with Analysis of covariance and independent

Background: Juvenile idiopathic arthritis (JIA) is an inflammatory autoimmune disease that can cause severe impairment and disability. Exercise is recommended to preserve joint mobility and function. Our objectives were to assess the safety, feasibility, and effects of slow speed resistance exercise in children with polyarticular JIA. Methods: Patients were recruited from a pediatric rheumatology clinic at an urban hospital and randomized to exercise or control groups. In the intervention group, slow speed resistance exercise with individualized instruction by a certified trainer was performed 1-2 times per week for 12 weeks. The control group performed home-based aerobic exercise 3 days per week for 12 weeks. Pre and post-body composition measurements by dual-energy X-ray absorptiometry; aerobic fitness by peak oxygen uptake during cycle ergometry; isometric muscle strength; and quality of life measures were obtained. Results: In the exercise group, 9/17 (53%) completed any exercise training. Of these nine subjects, five (55%) completed all 12 weeks of the protocol. In the control group, 8/16 (50%) reported compliance with the recommended aerobic exercise training at least one time per week. Only 2 subjects (12%) reported exercising more than once per week. There was no significant difference between pre- and post-measurements in any category in the exercise group. There was also significantly elevated body fat in both groups with only 17% in the control group and 23% in the exercise group meeting recommended

Transcranial direct current stimulation (tDCS) is a neuromodulation technique with potential to treat eating disorders and obesity. As for any potential treatment, it is important to assess the degree to which expectation effects contribute to its reported efficacy. This study assessed the effect of tDCS on amount of food craving and eating while tightly controlling treatment expectation. N=74 adults with overweight or obesity were informed of the known effects of tDCS to suppress craving and eating. Once electrodes were on the head, half of the participants were told they were receiving real, and the other half sham tDCS. Within these groups, approximately half actually received real and the other half sham tDCS. Stimulation parameters used were those previously found to reduce craving and eating, including in our lab: 2mA, anode right/cathode left targeting the dorsolateral prefrontal cortex for 20 minutes (real), or only for the first and last minute (sham). Analyses controlled for demographics, hunger, trait impulsiveness, eating motives, dieting, binge eating, suggestibility, and baseline craving and eating. Participants told they were receiving real tDCS craved and ate less than participants told they were receiving sham tDCS (both p

International audience; Starting in May 2018, a volcano-tectonic crisis occurred in the vicinity of Mayotte, a volcanic island in the Comoros Archipelago in the Mozambique Channel. The origin of the volcanism but also the subsurface architecture and nature of the crust, remain unknown. Here, based on receiver function analyses that provide S-wave velocity profiles, we determine the depth of Mohorovičić discontinuity (Moho) and V P /V S ratios for volcanic islands in the Mozambique Channel. We propose that the crust beneath Mayotte and Juan de Nova islands is of continental nature, while it appears to be of oceanic origin beneath Europa and Grande Glorieuse islands. Our results suggest that Mayotte edifice grew on an isolated continental block abandoned during the Gondwana breakup and the opening of the Mozambique Channel. The continental crust is underlain by a thick (9-10 km) and fast layer, interpreted as magmatic underplating which may result from the 20-Myr-long duration of the volcanism. The new velocity model determined from the seismic station on Mayotte can be used to relocate the seismicity related to the ongoing volcano-tectonic crisis.

The island of La Réunion is made up of two main shield volcanoes: Piton des Neiges and Piton de la Fournaise. A wide variety of seismic events is observed, including but not limited to: tectonic events, volcano-tectonic earthquakes, volcanic tremors, long-period and very-long-period earthquakes. The seismicity of La Réunion island illuminates different levels of its volcanic plumbing system. In the shallowest part of Piton de la Fournaise, earthquakes are clustered below the volcano summit area and often occur as intense seismic swarms during magma intrusions. Seismic activity is also observed below the East flank of Piton de la Fournaise, shaping an eastward dipping structure possibly accommodating seaward displacements of the volcano. At larger depths, episodes of upward seismicity migrations indicate magmatic recharges of the shallow reservoir from deeper parts of the volcano plumbing system. Earthquakes are also observed below the oceanic crust in a zone of underplating between Piton des Neiges and Piton de la Fournaise. A major event at Piton de la Fournaise was the collapse of its summit caldera in April 2007. This activity resulting in a summital depression of 330 m was accompanied by very-long-period earthquakes with magnitudes ranging from MW = 4.4 to MW = 5.4. Another noticeable activity in La Réunion island is an active seismic swarm located within the oceanic crust under the North flank of Piton des Neiges. The origin of this sustained seismic activity is still unclear and is currently investigated, thanks to the deployments of additional stations in the region., Comptes Rendus Geoscience, 353 (S1), ISSN:1778-7025, ISSN:1631-0713

Key Points Question To what extent is cannabis use associated with magnetic resonance imaging–measured cerebral cortical thickness development during adolescence? Findings In this cohort study, linear mixed-effects model analysis using 1598 magnetic resonance images from 799 participants revealed that cannabis use was associated with accelerated age-related cortical thinning from 14 to 19 years of age in predominantly prefrontal regions. The spatial pattern of cannabis-related cortical thinning was significantly associated with a positron emission tomography–assessed map of cannabinoid 1 receptor availability. Meaning Results suggest that cannabis use during middle to late adolescence may be associated with altered cerebral cortical development, particularly in regions rich in cannabinoid 1 receptors., Importance Animal studies have shown that the adolescent brain is sensitive to disruptions in endocannabinoid signaling, resulting in altered neurodevelopment and lasting behavioral effects. However, few studies have investigated ties between cannabis use and adolescent brain development in humans. Objective To examine the degree to which magnetic resonance (MR) imaging–assessed cerebral cortical thickness development is associated with cannabis use in a longitudinal sample of adolescents. Design, Setting, and Participants Data were obtained from the community-based IMAGEN cohort study, conducted across 8 European sites. Baseline data used in the present study were acquired from March 1, 2008, to December 31, 2011, and follow-up data were acquired from January 1, 2013, to December 31, 2016. A total of 799 IMAGEN participants were identified who reported being cannabis naive at study baseline and had behavioral and neuroimaging data available at baseline and 5-year follow-up. Statistical analysis was performed from October 1, 2019, to August 31, 2020. Main Outcomes and Measures Cannabis use was assessed at baseline and 5-year follow-up with the European School Survey Project on Alcohol and Other Drugs. Anatomical MR images were acquired with a 3-dimensional T1-weighted magnetization prepared gradient echo sequence. Quality-controlled native MR images were processed through the CIVET pipeline, version 2.1.0. Results The study evaluated 1598 MR images from 799 participants (450 female participants [56.3%]; mean [SD] age, 14.4 [0.4] years at baseline and 19.0 [0.7] years at follow-up). At 5-year follow-up, cannabis use (from 0 to >40 uses) was negatively associated with thickness in left prefrontal (peak: t785 = –4.87, cluster size = 1558 vertices; P = 1.10 × 10−6, random field theory cluster corrected) and right prefrontal (peak: t785 = –4.27, cluster size = 1551 vertices; P = 2.81 × 10−5, random field theory cluster corrected) cortices. There were no significant associations between lifetime cannabis use at 5-year follow-up and baseline cortical thickness, suggesting that the observed neuroanatomical differences did not precede initiation of cannabis use. Longitudinal analysis revealed that age-related cortical thinning was qualified by cannabis use in a dose-dependent fashion such that greater use, from baseline to follow-up, was associated with increased thinning in left prefrontal (peak: t815.27 = –4.24, cluster size = 3643 vertices; P = 2.28 × 10−8, random field theory cluster corrected) and right prefrontal (peak: t813.30 = –4.71, cluster size = 2675 vertices; P = 3.72 × 10−8, random field theory cluster corrected) cortices. The spatial pattern of cannabis-related thinning was associated with age-related thinning in this sample (r = 0.540; P, This cohort study examines the degree to which magnetic resonance imaging–assessed cerebral cortical thickness development is associated with cannabis use in a longitudinal sample of adolescents.

Previous studies have identified the gene, catechol-O-methyltransferase (COMT), as a primary regulator of sympathetic function. Although the COMT SNP rs4680 and rs4818, are well-studied, little is known about their influence on cancer-related fatigue (CrF) and placebo response. In this study, we examined whether genetic variation in COMT, at the functional SNP rs4680 and rs4818, influenced open-label placebo (OLP) responses found in cancer survivors reporting moderate to severe CrF and whether those responses differed by allele variation. We randomized cancer survivors (N=74) reporting moderate-to-severe CrF to receive OLP or to treatment-as-usual (TAU) and assessed if rs4680 and rs4818 were associated with changes in fatigue severity and fatigue-distressed quality of life. At the end of the initial 21 days, the treatments were crossed over and both groups were re-assessed. Decreases in fatigue symptom severity and fatigue-distressed quality of life across both genotypes (rs4680 and rs4818) were reported by participants when taking placebos. However, across all participants, only those with the high-activity G-allele (rs4680) and those with the rs4818 C/G combination reported significant decreases in fatigue severity and improvements in fatigue-distressed quality of life. Both COMT rs4680 high-activity G-allele and COMT rs4818 C/G were significantly associated with decreases in fatigue severity and improvements fatigue-distressed quality of life.

Background Daily self-weighing (DSW) may be an effective harm-reduction intervention to disrupt continued weight gain. S elf- W eighing for O besity Management in P rimary Care (SWOP) is a 24-month randomized controlled trial in 400 adults with obesity (BMI: kg/m2 ≥ 30) receiving primary care through a clinical network affiliated with an academic medical center. Objective To test DSW as a potentially scalable way to deter age-related weight gain among primary care patients with obesity. Methods Randomized-controlled trial with two conditions: DSW (instruction to weigh daily and provision of a web-enabled digital scale with graphical weight feedback) or Standard Care (receive a monetary gift card equivalent to value of the scale). Both groups receive standardized weight management educational material. SWOP will test the causal effect of assignment to DSW (Aim 1) and adherence to DSW (Aim 2) on weight (primary outcome) and adoption of weight management practices (secondary outcomes), as well as evaluate the cost-effectiveness of DSW compared to standard care (Aim 3). Findings may inform clinical guidelines for weight management by providing evidence that DSW attenuates continued age-related weight gain among adults with obesity. This trial is registered with ClinicalTrials.gov (NCT04044794).

Background Short-term markers of successful visceral adipose tissue (VAT) loss are needed. Urinary F2-isoprostanes might serve as a marker for intensified lipid metabolism, whereas circulating IL-6 might stimulate fat oxidation and enhance mobilization of VAT. Objectives This pilot study was designed to explore the hypotheses that 1) reduction in VAT is associated with increase in IL-6, and 2) that increases in urinary F2-isoprostanes are associated with increases in IL-6 and reduction in VAT. Methods Eighteen participants (aged 60–75 y, BMI 30–40 kg/m2) were randomly assigned to either a very-low-carbohydrate diet (VLCD; 65% energy from carbohydrate:protein:fat) or a low-fat diet (LFD; 55:25:20%) for 8 wk. Changes in fat distribution were assessed by MRI. Four urinary F2-isoprostane isomers were quantified in 24-h urine collection using LC-MS/MS analyses. Changes in 4 F2-isoprostane isomers were summarized using factor analysis (Δ-F2-isoprostane factor). Statistical significance was set at P

This work focuses on the use of thin-layer models for simulating fast gravitational flows for hazard assessment. Such simulations are sometimes difficult to carry out because of the uncertainty on initial conditions and on simulation parameters. In this study, we aggregate various field data to constrain realistic initial conditions and to calibrate the model parameters. By using the SHALTOP numerical code, we choose a simple and empirical rheology to model the flow (no more than two parameters), but we model more finely the geometrical interactions between the flow and the topography. We can thus model both a rock avalanche, and the subsequent remobilization of the deposits as a high discharge debris flow.Using the Prêcheur river catchment (Martinique, Lesser Antilles) as a case study, we focus on extreme events with a high potential to impact populations and infrastructures. We use geological and geomorphological data, topographic surveys, seismic recordings and granulometric analysis to define realistic simulation scenarios and determine the main characteristics of documented events. The latter are then reproduced to calibrate rheological parameters. With a single rheological parameter and the Coulomb rheology, we thus model the emplacement and main dynamic characteristics of a recent rock avalanche, as well as the travel duration and flooded area of a documented high discharge debris flow. Then, in a forward prediction simulation, we model a possible 1.9x106 m3 rock avalanche, and the instantaneous remobilization of the resulting deposits as a high-discharge debris flow. We show that successive collapses allow to better reproduce the dynamics of the rock avalanche, but do not change the geometry of the final deposits, and thus do not influence the initial conditions of the subsequent debris flow simulation. A progressive remobilization of the materials slows down the debris flow and limits overflow, in comparison to instantaneous release. However, we show that high discharge debris flows, such as the one considered for model calibration, are better reproduced with an instantaneous initiation. The range of travel times measured for other significant debris flows in the Pr\^echeur river is consistent with our simulation results, with various rheological parameters and the Coulomb or Voellmy rheology.

This essay explores the socially restrictive traditions that cause scriptural groups to reject the idea of universal rights and equal access to economic, social and cultural rights. This hermeneutical situation is difficult to tolerate, as our multicultural planet is seeking survival. Ethical issues and the principles of a culture’s morality are often partly religious in nature. The UNDUHR recognizes the right to believe and to promote one’s own beliefs, and it considers these particular rights as being part of a cultural “right to affiliate.” Nevertheless, international human rights law has not successfully promoted full human rights in countries of “Religions of the Book.” The essay thus suggests that appeals to the Bible grounded in human rights must be woven into contextual exegetical work, human rights discourse, and feminist critique. Even so, for women, foreigners, and “Others,” the Bible will remain a serious obstacle for enjoying full economic, social, and cultural rights.

Being able to draw accurate conclusions from childhood obesity trials is important to make advances in reversing the obesity epidemic. However, obesity research sometimes is not conducted or reported to appropriate scientific standards. To constructively draw attention to this issue, we present 10 errors that are commonly committed, illustrate each error with examples from the childhood obesity literature, and follow with suggestions on how to avoid these errors. These errors are as follows: using self-reported outcomes and teaching to the test; foregoing control groups and risking regression to the mean creating differences over time; changing the goal posts; ignoring clustering in studies that randomize groups of children; following the forking paths, subsetting, p-hacking, and data dredging; basing conclusions on tests for significant differences from baseline; equating "no statistically significant difference" with "equally effective"; ignoring intervention study results in favor of observational analyses; using one-sided testing for statistical significance; and stating that effects are clinically significant even though they are not statistically significant. We hope that compiling these errors in one article will serve as the beginning of a checklist to support fidelity in conducting, analyzing, and reporting childhood obesity research.

Background: Patients with co-occurring chronic pain and opioid use disorder (OUD) have unique needs that may present challenges for clinicians and health care systems. Primary care providers’ (PCPs) capacity to deliver high quality, research-informed care for this population is unknown. The objective of this study was to develop and test a questionnaire of factors influencing PCP capacity to treat co-occurring chronic pain and OUD. Methods: Capacity to Treat Co-Occurring Chronic Pain and Opioid Use Disorder (CAP-POD) questionnaire items were developed over a 2-year process including literature review, semi-structured interviews, and expert panel review. In 2018, a national sample of 509 PCPs was recruited through email to complete a questionnaire including the initial 44-item draft CAP-POD questionnaire. CAP-POD items were analyzed for dimensionality, inter-item reliability, and construct validity. Results: Principal component analysis resulted in a 22-item questionnaire. Twelve more items were removed for parsimony, resulting in a final 10-item questionnaire with the following 4 scales: (1) Motivation to Treat patients with chronic pain and OUD (α = .87), (2) Trust in Evidence (α = .87), (3) Assessing Risk (α = .82), and (4) Patient Access to therapies (α = .79). These scales were associated with evidence-based practice attitudes, knowledge of pain management, and self-reported behavioral adherence to best practice recommendations. Conclusion: We developed a brief, 10-item questionnaire that assesses factors influencing the capacity of PCPs to implement best practice recommendations for the treatment of co-occurring chronic pain and OUD. The questionnaire demonstrated good reliability and initial evidence of validity, and may prove useful in future research as well as clinical settings. Plain language abstract Patients with co-occurring chronic pain and opioid use disorder (OUD) have unique needs that may present challenges for clinicians and health care systems. Primary care providers’ (PCPs) ability to deliver high quality, research-informed care for this population is unknown. There are no validated instruments to assess factors influencing PCP capacity to implement best practices for treating these patients. The objective of this study was to develop and test a questionnaire of factors influencing PCP capacity to treat co-occurring chronic pain and OUD. We recruited 509 PCPs to participate in an online questionnaire that included 44 potential items that assess PCP capacity. Analyses resulted in a 10-item questionnaire that assesses factors influencing capacity to implement best practice recommendations for the treatment of co-occurring chronic pain and OUD. PCPs reported moderately high confidence in the strength and quality of evidence for best practices, and in their ability to identify patients at risk. However, PCPs reported low motivation to treat co-occurring chronic pain and OUD, and perceived patients’ access to relevant services as suboptimal, highlighting two areas that should be targeted with tailored implementation strategies. The 10-item Capacity to Treat Chronic Pain and Opioid Use Disorder (CAP-POD) questionnaire can be used for two purposes: (1) to assess factors influencing PCP capacity before implementation and identify areas that may require improvement for implementation and (2) to evaluate implementation interventions aimed at increasing PCP capacity to treat this population.

SUMMARY La Réunion Island in the southwest Indian Ocean is seasonally affected by austral swells among which some extreme events may have strong impacts on coastal infrastructures. The very limited number of sensors available on and around the island and in the whole SW Indian Ocean impedes any direct monitoring of the swell activity. In this study, we analyse direct observations of the ocean swell by combining terrestrial measurements of the microseismic noise with in situ oceanographic observations issued from two pressure gauges and an Acoustic Doppler Current Profiler (ADCP), together with swell numerical modelling. The reliability of the terrestrial seismic station to characterize the ocean activity in both the primary and secondary microseisms peaks (PM and SM, respectively), and also in the long period secondary microseismic peak (LPSM) for the case of La Réunion Island is presented and discussed here. By computing the hourly RMS of the PM and LP(SM) amplitudes, we establish a transfer function between the PM and (LP)SM amplitude and the maximum wave height, which appears to be valid for any PM and LPSM amplitudes >0.15 μm and >1.0 μm, respectively. The correlation coefficient between the PM amplitude and the wave height is >0.92. It suggests that the PM amplitude can be used as a robust proxy for the swell height and may help calibrating the wave heights from other independent observable. For some swell events, we observe LPSM that correlate well (>0.91) with the local wave height suggesting a generation by coastal swell reflection. From polarization and spectral analyses, directions and periods of swells are also well retrieved from seismic data. Finally, continuous measure of the SM amplitude shows that it can be used as precursor information for distant swells that may hit La Réunion Island a few days after their generation in the southern Indian Ocean.

Background The glycolytic nature of cancer cells presents a potential treatment target that may be addressed by a ketogenic diet (KD). Objective We hypothesized that a KD would improve body composition and lower serum insulin and insulin-like growth factor-I (IGF-I) in women with ovarian or endometrial cancer. Methods In this randomized controlled trial, women with ovarian or endometrial cancer [age: ≥19 y; body mass index (kg/m2): ≥18.5] were randomly assigned to a KD (70:25:5 energy from fat, protein, and carbohydrate) or the American Cancer Society diet (ACS; high-fiber, low-fat). Body composition (DXA) and fasting serum insulin, IGF-I, and β-hydroxybutyrate were obtained at baseline and at 12 wk; urinary ketones were also measured throughout the intervention. We assessed differences between the diets with ANCOVA and independent t tests. We used correlation analyses to estimate associations between changes in serum analytes and body composition. Results After 12 wk, the KD (compared with ACS) group had lower adjusted total (35.3 compared with 38.0 kg, P

Objective Epidemiologic analyses indicate a lack of association between body mass index (BMI: kg/m2) and mortality among Hispanic adults. Because BMI provides only a surrogate for the real variable of interest (adiposity), we evaluated associations between measures of body composition and mortality. Methods Using data from US-residing Mexican-Americans in the National Health and Nutrition Examination Survey (NHANES) III (n=4,480) and NHANES 1999–2010 (n=5,849), we examined the association between seven measures of body composition measured via anthropometry and bio-electrical impedance analysis (i.e., waist circumference, waist-to-height ratios (WHtR), skinfolds, lean mass, fat mass, percent body fat and BMI) and all-cause and cardiovascular and diabetes mortality. We conducted additional analyses stratified by gender. Results Waist circumference (hazard ratio [HR] 1.04, 95% Confidence Interval (CI): 1.01, 1.07) and WHtR (HR: 1.08, 95% CI: 1.03–1.14) were weakly associated with an increased all-cause mortality, while WHtR was associated with an increased risk of diabetes-related death (HR: 1.26, 95% CI: 1.07–1.49). In gender stratified analyses, we observed increases in risk of mortality in females who had increases in WHtR and waist circumference for all-cause mortality and cardiovascular deaths. Conclusion Waist circumference and WHtR were associated with increased risk of all-cause and diabetes-related mortality in US-residing Mexican-American adults.

Cervical cancer is the leading cause of cancer death among women in Ghana. Cost-effective tools for the primary and secondary prevention of cervical cancer, such as the Pap test, the HPV DNA test, and the HPV vaccine, are available in hospitals and clinics throughout Ghana. However, participation in cervical cancer prevention behaviors is low among Ghanaian women. Our objective was to determine if there were significant differences in cervical cancer awareness and stigmatizing beliefs about women with cervical cancer between Ghanaian women of different education levels. We surveyed 288 Ghanaian women who were at least 18 years old. Data on the participants' demographic characteristics, awareness of cervical cancer, cervical cancer screening, and the HPV vaccine, beliefs about cervical cancer screening, and stigmatizing beliefs about women with cervical cancer was collected. Chi-square tests for independence and Fisher's exact test of independence were preformed to determine if education level was associated with those factors. Participation in cervical cancer screening and uptake of the HPV vaccine was significantly lower among women with less than a senior high school education. Awareness about cervical cancer, cervical cancer screening, and the HPV vaccine was lower among women with less education. Women with lower levels of education were more likely to agree with the negative statements about cervical cancer screening and stigmatizing beliefs about women with cervical cancer. Cervical cancer education interventions that are tailored for Ghanaian women with different educational levels are needed to increase awareness of and participation in cervical cancer prevention strategies.

BACKGROUND: With the increasing prevalence of childhood obesity, nonalcoholic fatty liver disease (NAFLD) has emerged as the most common cause of pediatric chronic liver disorder. Factors underlying the pathophysiology of NAFLD remain poorly defined. OBJECTIVE: This study aimed to describe the metabolic characteristics of children with NAFLD differing in race/ethnicity and to test associations between dyslipidemia and NAFLD. METHODS: A retrospective chart review was conducted at a tertiary referral university hospital among 309 children with a diagnosis of NAFLD. RESULTS: Participants (mean age 12.5 ± 3.4 years) were 64% male, 63% white, 23% Hispanic, and 14% black. Hispanic children were diagnosed with NAFLD at a significantly younger age (10.6 ± 3.1 years, P < .0001) and lower body mass index (31.5 ± 6.8 kg/m(2), P < .0001) than their white and black counterparts. For the entire cohort, prevalence of systolic hypertension was 41%, diabetes 14%, elevated cholesterol 42%, elevated non–high-density lipoprotein cholesterol (non–HDL-C) 58%, elevated low-density lipoprotein cholesterol 36%, elevated triglycerides (TG) 88%, and low high-density lipoprotein cholesterol 77%. Whites had elevated non–HDL-C, low-density lipoprotein cholesterol, and TG compared to blacks or Hispanics. Serum TG and non–HDL-C were significantly correlated to alanine aminotransferase (r = 0.18, P = .01; r = 0.16, P = .02), respectively, and persisted after adjusting for age and body mass index. CONCLUSION: Cardiometabolic derangements, especially dyslipidemia, are highly prevalent in children with NAFLD and differ based on race/ethnicity. Serum TG and non–HDL-C may play an important role in the pathophysiology of pediatric NAFLD.

Blinded randomized controlled trials (RCT) require participants to be uncertain if they are receiving a treatment or placebo. Although uncertainty is ideal for isolating the treatment effect from all other potential effects, it is poorly suited for estimating the treatment effect under actual conditions of intended use-when individuals are certain that they are receiving a treatment. We propose an experimental design, randomization to randomization probabilities (R2R), which significantly improves estimates of treatment effects under actual conditions of use by manipulating participant expectations about receiving treatment. In the R2R design, participants are first randomized to a value, π, denoting their probability of receiving treatment (vs. placebo). Subjects are then told their value of π and randomized to either treatment or placebo with probabilities π and 1-π, respectively. Analysis of the treatment effect includes statistical controls for π (necessary for causal inference) and typically a π-by-treatment interaction. Random assignment of subjects to π and disclosure of its value to subjects manipulates subject expectations about receiving the treatment without deception. This method offers a better treatment effect estimate under actual conditions of use than does a conventional RCT. Design properties, guidelines for power analyses, and limitations of the approach are discussed. We illustrate the design by implementing an RCT of caffeine effects on mood and vigilance and show that some of the actual effects of caffeine differ by the expectation that one is receiving the active drug. (PsycINFO Database Record

Sangeeta Sule,1 Kevin Fontaine2 1Department of Pediatric, Pediatric Rheumatology, Johns Hopkins University, Baltimore, MD, USA; 2Department of Health Behavior, University of Alabama at Birmingham, Birmingham, AL, USA Objective: The objective of this study was to determine the risk of obesity and metabolic syndrome in adults with a history of juvenile arthritis (JA). Methods: Using the National Health and Nutrition Examination Survey (NHANES), we compared the characteristics of respondents with arthritis (JA vs rheumatoid arthritis [RA]) to those of the control group without arthritis. We used logistic regression analyses, controlling for age, race, and gender, to determine the ORs for metabolic syndrome. Results: Obesity was increased in the JA group with 67% respondents having body mass index ≥30kg/m2 vs 55% respondents in the no arthritis cohort (p=0.004). In unadjusted analyses, there was increased odds of metabolic syndrome in JA (OR 6.2, p=0.001) and RA groups compared to those without arthritis (OR 7.7, p=0.001). After adjusting for age, gender, and race, the odds of metabolic syndrome remained increased in JA (OR 5.2, p=0.001) and RA (OR 3.2, p=0.001) groups. Conclusion: Adults with a history of JA have a significantly increased risk of metabolic syndrome compared to those without arthritis. These findings are important because metabolic syndrome has been associated with an increased risk of cardiovascular disease and death in other populations. Keywords: juvenile arthritis, outcomes research, cardiovascular disease