Previous Users Research Articles

Risk of Major Cardiovascular and Cerebrovascular Events in Users of Lisdexamfetamine and Other Medications for Attention-Deficit/Hyperactivity Disorder in Denmark and Sweden: A Population-Based Cohort Study.

This study aimed to estimate risks of cardiovascular and cerebrovascular events in patients treated with lisdexamfetamine dimesylate (LDX) compared with patients previously treated with other attention-deficit/hyperactivity disorder (ADHD) medications (amphetamine, dexamphetamine, methylphenidate or atomoxetine). This population-based cohort study used data from Danish and Swedish medical and administrative national registers. The LDX cohort included adult patients initiating LDX with at least 12months' data preceding first LDX dispensing (index date). A random sample of patients treated with at least one non-LDX ADHD medication in the 6-24months (but not less than 6months) before index date (previous-users cohort) were matched to LDX users on age, sex, region and calendar year. The primary outcome, a composite of major adverse cardiovascular and cerebrovascular events (MACE), included first hospitalisation for acute myocardial infarction or stroke and out-of-hospital coronary heart disease or cerebrovascular disease death. Incidence rates (IRs) and IR ratios (IRRs) with 95% confidence intervals (CIs) of MACE were estimated using Poisson regression. From Denmark/Sweden, 5516/40,163 LDX users and 27,494/200,389 previous users were included. In Denmark, IRs of MACE/1000 person-years (95%CI) were similar for LDX (1.63 [0.85-3.14]) and previous users (1.61 [1.28-2.01]). In Sweden, IRs (95%CI) were 1.40 (1.09-1.79) in LDX users and 1.17 (1.00-1.38) in previous users. Adjusted MACE IRRs (95%CI) for LDX versus previous use were 1.01 (0.48-2.13) in Denmark, 1.13 (0.75-1.71) in Sweden, and 1.10 (0.77-1.58) in the pooled analysis. Our findings suggest little to no increased risk of cardiovascular and cerebrovascular events in patients treated with LDX compared with patients previously treated with other ADHD medications.

Creating a longitudinal dataset of care experienced children in Scotland – Administrative Data Research Scotland.

To create a dataset which describes the care experience of children in Scotland data. To share with analysts in a safe setting to allow linkage, and provide information on the strengths and weaknesses. To gather feedback on its use to inform future collections and improve experience of future users. The dataset was created by combining 11 years of data provided to Scottish Government by local authorities. The resulting longitudinal dataset includes details of the children, the periods of care including the type of care setting, along with the legal basis for this care, and information on the destination of the child following care. Detailed information about the dataset is provided along with a background document in how the dataset was constructed. Data quality flags are provided to highlight situations where there may be inconsistences, and code is shared to create a cleaned dataset for analysis. A longitudinal dataset has been created covering the period 2009 to 2019. This covers almost 60,000 children with details of the care setting and legal basis. The dataset has been indexed to a population spine, which enables it to be linked to other data. Additional derived variables have been added, and improvements made to data quality where possible. In other situations data quality is highlighted with guidance provided on how to deal with these issues. The results have been shared extensively with the data providers, and previous users providing valuable input. This has resulted in improved understanding of the data, and informed the practice of gathering data in future years, and plans for official statistics on health outcomes of care experienced children. This project has created an enduring resource which will improve evidence for policy making by allowing analysis to consider patterns of care experience and link it to outcomes. This is particularly relevant given a review of care experience in Scotland, and the commitment by Scottish Government to keep the Promise.

Psychoactive substance use, internet use and mental health changes during the COVID-19 lockdown in a French population: A study of gender effect.

IntroductionCOVID-19 has enormous impacts on each individual. The goals of our study were (1) to assess the rate of internet and psychoactive substance use, clinical depression and anxiety in a French population during the lockdown (2) to study the role of clinical and socio-demographic variables (especially, gender).Materials and methodsDuring lockdown, an online anonymous questionnaire was used to assess socio-demographic and health data, previous psychiatric history, anterior and current internet and psychoactive substance use, current anxiety, depression and suicidal ideation. The associations of socio-demographic, clinical variables with anxiety, depression, internet or psychoactive substance use were examined.ResultsThe study included 263 participants (aged 38.1 ± 15.3−197 males and 64 females). During the lockdown, internet use increased in 14.4% of cases, alcohol use in 20.2%, and tobacco use in 6.8%. In contrast, more participants reported a decrease in alcohol, tobacco or illicit drug use (25.9, 24, and 27.8% respectively). Anxiety was reported in 62.4% and depression in 20.2% of cases; 29.7% of participants reported an increase in anxiety and 25.5% an increase in depression. Depression was associated with an increase in internet and tobacco use. Tobacco and alcohol use were positively associated and an increase in use was more frequent in previous users of both substances. Maintaining a daily routine and relationships with family, being self-employed were associated to lower risks of depression and anxiety.ConclusionHigher rates of internet use, as well as depression and anxiety, were observed during the lockdown. Gender was not a significant associated factor.

Catalyst of hate? Ethnic insulting on YouTube in the aftermath of terror attacks in France, Germany and the United Kingdom 2014–2017

ABSTRACT In the last 20 years, several major terror attacks conducted in the name of political Islam hit Western Europe. We examine the impact of such terror attacks on hostile behaviour on social media from a cross-national perspective. To this end, we draw upon time-stamped, behavioural data from YouTube and focus on the frequency and popularity (‘likes’) of ethnically insulting comments among a corpus of approximately one hundred thousand comments. We study aggregate change and use individual-level panel data to investigate within-user change in ethnic insulting in periods leading up to and following major terror events in Germany, France and the UK. Results indicate that terror attacks boost interest in immigration-related topics in general, and lead to a disproportional increase in hate speech in particular. Moreover, we find that attack effects spill over to other countries in several, but not all, instances. Deeper analyses suggest, however, that this pattern is mainly driven by changes in the composition of users and not by changing behaviour of individual users. That is, a surge in ethnic insulting comes from hateful users newly entering online discussions, rather than previous users becoming more hateful following an attack.

Depression, anxiety and adjustment disorder among patients with psoriasis receiving systemic agents: A retrospective cohort study in Quebec, Canada

AbstractIntroductionPatients with psoriasis are at risk of depression, anxiety and adjustment disorder (DAAD). Randomized control trials reported improvement in depression and anxiety symptoms among patients with psoriasis receiving tumour necrosis factor inhibitors and ustekinumab (TNFi/UST) versus placebo and conventional systemic agents (CSA). The risk of DAAD among TNFi/UST versus CSA users was not assessed in real‐world settings.ObjectiveTo compare DAAD incidence among patients with psoriasis using CSA and subsequently received (vs. not) TNFi/UST.MethodsWe conducted a retrospective cohort study using the province of Quebec health administrative databases (1997–2015). Among adult patients with a diagnosis of psoriasis and initiating a CSA, we included those who later initiated a TNFi/UST, as a switch or add‐on, at the date of their first prescription fill (index‐date). We also included TNFi/UST nonusers at a date chosen to match the time between the first CSA and the index date of a random TNFi/UST user. TNFi/UST nonusers were classified into current or previous CSA users according to their last CSA received in the 90 days before or after their index date. Marginal structural Cox regression models weighted by the inverse probability of exposure compared the risk of DAAD between TNFi/UST, current and previous CSA users. Additional analyses were conducted by age group and sex.ResultsOur cohort included 1333 patients with psoriasis: 183 TNFi/UST users, 625 current CSA users and 525 previous CSA users. TNFi/UST users were at a lower risk of DAAD versus previous CSA users (hazard ratio 0.48, 95% confidence intervals: 0.28–0.94). The reduction in risk among TNFi/UST users was not statistically significant versus current CSA users. Similar results were observed across different age groups and sex.ConclusionAmong patients with psoriasis receiving CSA, those who were subsequently dispensed TNFi/UST were at a lower risk of DAAD compared to those who did not receive these agents.

Women’s use of non-conventional herbal uterotonic in pregnancy and labour: evidence from birth attendants

BackgroundOver the years, governments and stakeholders have implemented various policies/programmes to improve maternal health outcomes in low-middle-income countries. In Ghana, Community Health Officers were trained as midwives to increase access to skilled maternal healthcare. The government subsequently banned traditional birth attendants from providing direct maternal healthcare in 2000. Despite these, there is an unprecedented utilisation of TBAs’ services, including herbal uterotonics. This has attempted to defeat stakeholders’ campaigns to improve maternal health outcomes. Thus, we explored and highlighted herbal uterotonic consumption in pregnancy and birth and the implications on maternal and newborn health outcomes in North-Western Ghana.MethodsThis was an exploratory qualitative study that investigated traditional birth attendants (n = 17) and healthcare providers' (n = 26) perspectives on the intake of herbal uterotonics in pregnancy and childbirth in rural Ghana, using in-depth interviews. A combination of convenience, purposive and snowball sampling procedures were employed in selecting participants.ResultsFindings were captured in two domains: (1) perceived rationale for herbal uterotonic intake, and (2) potential adverse impacts of herbal uterotonic intake in pregnancy and labour, and nine topics: (i) confidence in unskilled attendance at birth, (ii) cost and a shortage of essential medicines, (iii) herbal uterotonics as a remedy for obstetric problems, (iv) herbal uterotonics facilitate birth, (v) attraction of home birth for cultural reasons, (vi) affordability of herbal uterotonics, (vii) unintended consequences and adverse outcomes, (viii) risks using herbal uterotonics to manage fertility and (ix) risks using herbal uterotonics to facilitate home birth.ConclusionThe findings have suggested that the intake of non-conventional herbal uterotonic is widespread in the study area, although the constituents of the herb are unknown. However, complex and multiple factors of healthcare cost, desire for homebirth, unawareness of the negative effects of such substances, perceived way of addressing obstetric problems and cultural undertones, among others, accounted for herbal uterotonics consumption. We also encourage research into the constituents of ‘mansugo’ and the potential benefits and adverse effects. We recommend qualitative studies involving previous users of this herbal uterotonic to inform policy and healthcare provision.

Patient views regarding cannabis use in chronic kidney disease and kidney failure: a survey study.

Cannabis is frequently used recreationally and medicinally, including for symptom management in patients with kidney disease. We elicited the views of Canadian adults with kidney disease regarding their cannabis use. Participants were asked whether they would try cannabis for anxiety, depression, restless legs, itchiness, fatigue, chronic pain, decreased appetite, nausea/vomiting, sleep, cramps and other symptoms. The degree to which respondents considered cannabis for each symptom was assessed with a modified Likert scale ranging from 1 to 5 (1, definitely would not; 5, definitely would). Multilevel multivariable linear regression was used to identify respondent characteristics associated with considering cannabis for symptom control. Of 320 respondents, 290 (90.6%) were from in-person recruitment (27.3% response rate) and 30 (9.4%) responses were from online recruitment. A total of 160/320 respondents (50.2%) had previously used cannabis, including smoking [140 (87.5%)], oils [69 (43.1%)] and edibles [92 (57.5%)]. The most common reasons for previous cannabis use were recreation [84/160 (52.5%)], pain alleviation [63/160 (39.4%)] and sleep enhancement [56/160 (35.0%)]. Only 33.8% of previous cannabis users thought their physicians were aware of their cannabis use. More than 50% of respondents probably would or definitely would try cannabis for symptom control for all 10 symptoms. Characteristics independently associated with interest in trying cannabis for symptom control included symptom type (pain, sleep, restless legs), online respondent {β=0.7 [95% confidence interval (CI) 0.1-1.4]} and previous cannabis use [β=1.2 (95% CI 0.9-1.5)]. Many patients with kidney disease use cannabis and there is interest in trying cannabis for symptom control.

Implementasi Scrum Pada Perancangan System Mobile Taking Order Coffee Aplikasi Berbasis Mobile

System mobile taking order coffee is a mobile-based application that aims to be a bridge in the coffee distribution process from coffee farmers to distributors, coffee farmers to consumers, and also distributors to consumers. Through this system, coffee farmers, distributors, and consumers can make coffee transactions via smartphones. The design of this system uses the concept of an approach with the Scrum method. Scrum is a framework with various processes and techniques in it that focuses on breaking down major goals into smaller goals to make them easier to achieve. The use of the scrum method approach is considered capable of designing quality software that suits existing needs. In addition, it can facilitate the adoption of any changes. Scrum also has several systematic and iterative stages, so that if the product int the first sprint does not meet the required needs, then the next sprint can be developed according to the evaluation results from the previous system users. The design of this system is to facilitate coffee farmers in the process of distributing coffee with a wider market reach.

Metabolomics profile of 5649 users and nonusers of hormonal intrauterine devices in Finland

Use of hormonal intrauterine devices has grown during the last decades. Although hormonal intrauterine devices act mostly via local effects on the uterus, measurable concentrations of levonorgestrel are absorbed into the systemic circulation. The possible metabolic changes and large-scale biomarker profiles associated with hormonal intrauterine devices have not yet been studied in detail. To examine through the metabolomics approach the metabolic profile of patients using hormonal intrauterine devices and how this metabolic profile is affected by duration and discontinuation of use. The study consisted of cross-sectional analyses of 5 population-based surveys (FINRISK and FinHealth studies), spanning from 1997 to 2017. All fertile-aged participants (18-49 years) in the surveys with available information on hormonal contraceptive use and metabolomics data (n=5649) were included in the study. Altogether, 211 metabolic measures of users of hormonal intrauterine devices (n=1006) were compared with those of nonusers of hormonal contraception (n=4643) via multivariable linear regression models. To allow comparison across multiple measures, association magnitudes were reported in standard deviation units of difference in biomarker concentration compared with the reference group. After adjustment for covariates, levels of 141 metabolites differed in current users of hormonal intrauterine devices compared with nonusers of hormonal contraception (median difference in biomarker concentration, 0.09 standard deviation): lower levels of particle concentration of larger lipoprotein subclasses, triglycerides, cholesterol and derivatives, apolipoproteins A and B, fatty acids, glycoprotein acetyls, and aromatic amino acids. The metabolic pattern of hormonal intrauterine device use did not change according to duration of use. When comparing previous users and never-users of hormonal intrauterine devices, no significant metabolic differences were observed. The use of hormonal intrauterine devices was associated with several moderate metabolic changes previously associated with reduced arterial cardiometabolic risk. The metabolic effects were independent of duration of use of the hormonal intrauterine devices. Moreover, the metabolic profiles were similar after discontinuation of hormonal intrauterine device use and in never-users.

800-P: Real-World Use of Do-It-Yourself Artificial Pancreas Systems in Adults with Type 1 Diabetes

Background and Aims: Members of the diabetes community have started developing their own Do-It-Yourself Artificial Pancreas Systems (DIY APS) , also known as Open-Source Automated Insulin Delivery (AID) Systems and use the online hashtag “#WeAreNotWaiting” to promote the development of it. DIY APS systems inclued OpenAPS, Loop and AndroidAPS. The aim of the study was to evaluate retrospectively glycemic outcomes with the use of DIY APS in adults with T1D. Methods: Subjects with T1D started using open-source AID systems (AndroidAPS with Insight insulin pump and Dexcom G6 or FreeStyle Libre 2 CGM and Loop with Minimed Paradigm and Dexcom G6) . Glycemic outcomes at baseline on open-loop and after 12 months on DIY APS were compared including time in different glucose ranges, management indicator (GMI) , mean glucosa levels, glycemic variability and Patient Glycaemic Status (PGS) . Results: Patients with T1D users open-source AID systems (22 AndroidAPS and 1 Loop) were included (age 38.4±years, 56.5% females, diabetes duration 20.8±10.6 years and capillary HbA1c 6.6±0.5%) . 18 patients previous insulin pump users with a use 3.5±4 years, 5 patients previously treated with multidose and CGM use 2.6±2.1 years. GMI decreased from 6,6±0.6% to 6±0.5% (p<0.001) . At 12 months, time in range (TIR) 70-180 mg/dL increased from 69.9±11.5% at baseline to 87.5±7.8% (p<0.001) , time in hyperglycemia >180 and >250 mg/dL were reduced from 23.5±11,5% to 9.6±7.5% and from 5.1% (2-9) to 0.6% (0-3) , respectively (p<0.001) and time in hypoglycemia <70 and <54 mg/dL decreased from 5±3.6% to 2.8±2.1% (p=0.006) and from 1.3±1.5% to 0.4±0.5% (p=0.014) . Improvements in glycemic variability from 35.7±6% to 30.3±6.2% (p=0.001) . At 12 months, PGS and sensor glucose were reduced from 54.4±36% to 23±19.6% and from 144.7±18.3% to 127±14% (p<0.001) . Conclusions: Open-source AID systems is safe and improved outcomes glycemic after 12 months of use in a real-world clinical setting in adults with T1D. Disclosure S.Amuedo: None. M.Antequera: None. S.Azriel: None.

Chronic Oral Anticoagulation Therapy and Prognosis of Patients Admitted to Hospital for COVID-19: Insights from the HOPE COVID-19 Registry.

Background Most evidence regarding anticoagulation and COVID-19 refers to the hospitalization setting, but the role of oral anticoagulation (OAC) before hospital admission has not been well explored. We compared clinical outcomes and short-term prognosis between patients with and without prior OAC therapy who were hospitalized for COVID-19. Methods Analysis of the whole cohort of the HOPE COVID-19 Registry which included patients discharged (deceased or alive) after hospital admission for COVID-19 in 9 countries. All-cause mortality was the primary endpoint. Study outcomes were compared after adjusting variables using propensity score matching (PSM) analyses. Results 7698 patients were suitable for the present analysis (675 (8.8%) on OAC at admission: 427 (5.6%) on VKAs and 248 (3.2%) on DOACs). After PSM, 1276 patients were analyzed (638 with OAC; 638 without OAC), without significant differences regarding the risk of thromboembolic events (OR 1.11, 95% CI 0.59–2.08). The risk of clinically relevant bleeding (OR 3.04, 95% CI 1.92–4.83), as well as the risk of mortality (HR 1.22, 95% CI 1.01–1.47; log-rank p value = 0.041), was significantly increased in previous OAC users. Amongst patients on prior OAC only, there were no differences in the risk of clinically relevant bleeding, thromboembolic events, or mortality when comparing previous VKA or DOAC users, after PSM. Conclusion Hospitalized COVID-19 patients on prior OAC therapy had a higher risk of mortality and worse clinical outcomes compared to patients without prior OAC therapy, even after adjusting for comorbidities using a PSM. There were no differences in clinical outcomes in patients previously taking VKAs or DOACs. This trial is registered with NCT04334291/EUPAS34399.

Long-term drug effectiveness and survival for reference rituximab in rheumatoid arthritis patients in an ordinary outpatient clinic

To explore the long-term drug effectiveness and survival of reference rituximab (ref-RTX)-treated rheumatoid arthritis (RA) patients in an ordinary outpatient clinic. Second, we explored baseline predictors of drug effectiveness and survival, and third, we clarified reasons for stopping treatment. RA patients treated with ref-RTX between 2006 and 2020 in Norway were examined and monitored using recommended measures for disease activity and patient-reported outcomes (PROs). Drug effectiveness was assessed with random intercept linear mixed models; drug survival was assessed with Kaplan–Meier survival analysis. Reasons for discontinuation were ascertained. Baseline predictors of drug effectiveness and survival were estimated. Among 246 RA patients, at baseline, 17.1% were biologic disease-modifying anti-rheumatic drugs (bDMARDs) naïve, and 51.6% were currently using conventional synthetic DMARDs (csDMARDs). During the five-year follow-up, all disease activity and PRO measures improved significantly (p < 0.01), with more substantial changes noted in the second year. Drug survival was 83% after one year and declined to 34% after five years. The two most frequently reported reasons for discontinuation were the doctor’s decision (36.2%) and lack or loss of effectiveness (19.2%). No significant difference was found between naïve and previous users of bDMARDs or between concomitant and nonconcomitant users of csDMARDs when analysing drug effectiveness and survival. Our real-life data show that ref-RTX-treated RA patients had satisfactory treatment responses; drug survival declined linearly over time. There was no significant difference between naïve and previous users of bDMARDs or between concomitant and nonconcomitant users of csDMARDs, both for drug effectiveness and survival.

Trainable segmentation for transmission electron microscope images of inorganic nanoparticles.

We present a trainable segmentation method implemented within the python package ParticleSpy. The method takes user labelled pixels, which are used to train a classifier and segment images of inorganic nanoparticles from transmission electron microscope images. This implementation is based on the trainable Waikato Environment for Knowledge Analysis (WEKA) segmentation, but is written in python, allowing a large degree of flexibility and meaning it can be easily expanded using other python packages. We find that trainable segmentation offers better accuracy than global or local thresholding methods and requires as few as 100 user-labelled pixels to produce an accurate segmentation. Trainable segmentation presents a balance of accuracy and training time between global/local thresholding and neural networks, when used on transmission electron microscope images of nanoparticles. We also quantitatively investigate the effectiveness of the components of trainable segmentation, its filter kernels and classifiers, in order to demonstrate the use cases for the different filter kernels in ParticleSpy and the most accurate classifiers for different data types. A set of filter kernels is identified that are effective in distinguishing particles from background but that retain dissimilar features. In terms of classifiers, we find that different classifiers perform optimally for different image contrast; specifically, a random forest classifier performs best for high-contrast ADF images, but that QDA and Gaussian Naïve Bayes classifiers perform better for low-contrast TEM images.

English Textbook Selection in Taiwan: Voices of Two Book Sales Representatives

This qualitative case study explores the experiences of two book sales representatives when introducing textbooks to university English teachers in Taiwan. The participants were two experienced book sales representatives working for two large book companies. Analysis of semistructured interviews showed that the two sales representatives had considerable influence on teachers’ decision-making concerning textbook evaluation and selection. These two representatives not only used information from previous users and publishers to introduce textbooks to teachers and students, but they also used their professional positions and social networks to connect teachers across institutions. They collected feedback from previous users (teachers and students) to aid their introduction of textbooks to prospective users. By analyzing the needs of students and teachers across institutions, the two representatives helped teachers choose the right textbooks for students. This study sheds new light on research investigating the views and experiences of key stakeholders in English textbook evaluation, promotion, and consumption.

Abstract 559: Left Atrial Enlargement In Primary Cryptogenic Strokes Without Atrial Fibrillation

The relationship between left atrial enlargement (LAE) and primary cryptogenic stroke (PCS) remains a mystery. Previous literature found the severity of LAE to be an independent risk factor in cases of PCS, recurrent ischemic strokes, and paroxysmal atrial fibrillation. Our study seeks to further characterize potential risk factors for patients with PCS in the absence of atrial fibrillation. Our multi-center retrospective study constructed a database of 646 patients identified with a diagnosis of cerebral infarction over a three year period. Detailed chart review excluded all patients with known etiologies for PCS including: atrial fibrillation, atrial flutter, prior stroke, systolic heart failure, carotid artery stenosis, thromboembolic disease, previous anticoagulation, or an active cancer diagnosis. Diagnosis of LAE utilized a composite of criteria for transthoracic echocardiogram (TTE) measurements including left atrial diameter (LAD) and left atrial volume index (LAVI). All study criteria were met by 154 patients (24%) for analysis, where baseline characteristics included: 79 (51%) male, 104 (67.5%) Caucasian, 108 (70%) diagnosis of hypertension, 80 (52%) previous or current tobacco users, and 47 (31%) diagnosis of diabetes. Our preliminary analysis found 74 (48%) of patients met at least one criteria for LAE. The mean LAD for patients with and without LAE was 4.1cm and 3.4 cm, respectively (SD .87 vs .55, p&lt;.0001). The mean LAVI for patients with and without LAE was 29.68 mL/m 2 and 18.44 mL/m 2 , respectively (SD 7.37 vs 5.13, p&lt;.0001). Our findings support the significance of LAE as a risk factor for cases of PCS. Multiple risk factors were identified in our study population that reflect the importance of preventative counseling for patients with hypertension, hyperlipidemia, histories of tobacco use, and diabetes. Further research may elucidate whether LAE alone or in the setting of comorbidities warrant universal screening practices or prophylactic therapies to prevent cases of PCS.

AutozygosityMapper: Identification of disease-mutations in consanguineous families.

With the shift from SNP arrays to high-throughput sequencing, most researchers studying diseases in consanguineous families do not rely on linkage analysis any longer, but simply search for deleterious variants which are homozygous in all patients. AutozygosityMapper allows the fast and convenient identification of disease mutations in patients from consanguineous pedigrees by focussing on homozygous segments shared by all patients. Users can upload multi-sample VCF files, including WGS data, without any pre-processing. Genome-wide runs of homozygosity and the underlying genotypes are presented in graphical interfaces. AutozygosityMapper extends the functions of its predecessor, HomozygosityMapper, to the search for autozygous regions, in which all patients share the same homozygous genotype. We provide export of VCF files containing only the variants found in homozygous regions, this usually reduces the number of variants by two orders of magnitude. These regions can also directly be analysed with our disease mutation identification tool MutationDistiller. The application comes with simple and intuitive graphical interfaces for data upload, analysis, and results. We kept the structure of HomozygosityMapper so that previous users will find it easy to switch. With AutozygosityMapper, we provide a fast web-based way to identify disease mutations in consanguineous families. AutozygosityMapper is freely available at https://www.genecascade.org/AutozygosityMapper/.

College students’ motivations for using fitness related technology

Objective: The purpose was to understand college students’ motivations for the use and discontinued use of fitness related technology (FRT) in relation to their physical activity behaviors. Participants: Participants were undergraduate students (n = 22) who were eligible if they were between 18–24 years of age (emerging adulthood) and current or previous users of FRT. Methods: Qualitative descriptive design was used with semi-structured interviews conducted virtually. Thematic analysis was used to analyze the data. Results: Participants discussed four themes; (1) Motivations for physical activity, (2) Motivations for using FRT, (3) Social connection improves accountability for physical activity, and (4) The ups and downs of FRT goal setting and data display. Conclusions: Best practice guidelines need to be established for the use of FRT along with approaches to promote physical activity among this population. Additional research is needed to identify reasons for discontinuation of use and to develop potential interventions to promote sustained engagement with FRT.

What the public in England know about antibiotic use and resistance in 2020: a face-to-face questionnaire survey

ObjectivesTo describe public attitudes and knowledge around antibiotic activity, resistance and use.DesignFace-to-face household 18 question survey using computer-assisted data collection undertaken by Ipsos Market and Opinion Research International.SettingRandomly selected households...

‘When you delete Tinder it’s a sign of commitment’: leaving dating apps and the reproduction of romantic, monogamous relationship practices

In recent years there has been increasing academic attention to forms and practices of disconnection to social networking sites. However, there has been limited attention to non-use/departures, particularly with dating apps. In this article I draw on 27 interviews with previous and current users of dating apps to explore their practices of leaving/deleting their dating apps. For the majority of participants, leaving a dating app was due to ‘success’ in finding a relationship. For others, it was the ‘failure’ to find a relationship. I suggest that this highlights not only the centrality of finding/not finding a relationship to dating app use and departure, but also a particular construction of relationships: romantic, sexually exclusive/monogamous and life-long. This was the case for the majority of participants who identified as heterosexual, gay, lesbian, bisexual and queer and indicates the reproduction and valuing of a particular relationship form and practice for diverse users.

Overprescription of opioid analgesia is common following ambulatory Otolaryngology-Head and Neck surgery procedures: A multicenter study.

BackgroundThe rise in the use of prescription opioids for postoperative analgesia within surgery has mirrored an increased trend of opioid‐related morbidity within Canada and the United States. This study prospectively studied daily pain levels and medication requirements postoperatively in patients undergoing elective Otolaryngology—Head and Neck surgery procedures.MethodsPatients were asked to prospectively document their pain level and medication use daily for 7 days postoperatively. A final survey was used to quantify unused medication left at home and clarify each patient's disposal plan. We included patients undergoing elective outpatient or short stay surgeries from three tertiary care centers in Toronto, Ontario from September 2016 to September 2017. Previous opioids users or patients suffering from chronic pain were excluded.ResultsA final cohort of 56 eligible adult patients were included in the study. The most common procedures were thyroidectomy (n = 19), endoscopic sinus surgery (n = 10), tympanoplasty/ossiculoplasty (n = 7), and cochlear implant (n = 5). Most patients received a prescription for acetaminophen/codeine (n = 29, 51.8%) or acetaminophen/oxycodone (n = 22, 39.3%) and used on average 29% of their initial prescription. Patients most commonly opted to keep their unused narcotics at home (n = 23, 41%). A total of 710 tablets of narcotics were overprescribed in our study population, 351 of which were kept in patients' home for future use.ConclusionThere is a clear tendency to overestimate postoperative pain resulting in significant overprescription of opioids among Otolaryngologists.