Improving body image at scale among Brazilian adolescents: study protocol for the co-creation and randomised trial evaluation of a chatbot intervention.

BACKGROUND: Body image concerns are prevalent among Brazilian adolescents and can lead to poor psychological and physical health. Yet, there is a scarcity of culturally-appropriate, evidence-based interventions that have been evaluated and made widely available. Chatbot technology (i.e., software that mimics written or spoken human speech) offers an innovative method to increase the scalability of mental health interventions for adolescents. The present protocol outlines the co-creation and evaluation of a body image chatbot for Brazilian adolescents via a partnership between academics, industry organisations and the United Nations Children's Fund (UNICEF). METHODS: A two-armed fully remote randomised controlled trial will evaluate the chatbot's effectiveness at improving body image and well-being. Adolescent girls and boys (N = 2800) aged 13-18 years recruited online will be randomly allocated (1:1) into either: 1) a body image chatbot or 2) an assessment-only control condition. Adolescents will engage with the chatbot over a 72-hour period on Facebook Messenger. Primary outcomes will assess the immediate and short-term impact of the chatbot on state- and trait-based body image, respectively. Secondary outcomes will include state- and trait-based affect, trait self-efficacy and treatment adherence. DISCUSSION: This research is the first to develop an evidence-informed body image chatbot for Brazilian adolescents, with the proposed efficacy trial aiming to provide support for accessible, scalable and cost-effective interventions that address disparities in body image prevalence and readily available resources. TRIAL REGISTRATION NUMBER: NCT04825184 , registered 30th March 2021.

Nitrate flux in the Mississippi River.

Increased delivery of biologically available nitrogen to estuaries and coastal oceans in recent decades has been linked to eutrophication and seasonal hypoxia in the northern Gulf of Mexico and elsewhere. We have developed a model that accounts for 95% of annual variation in delivery of nitrate to the Gulf of Mexico by the Mississippi River in 1960-98. Retrospective analysis indicates that this nitrate flux could have been reduced by 33% if the use of nitrogen-containing fertilizer in the Mississippi River basin had been cut by 12%.

Bungee cord-associated ocular trauma.

PURPOSE: To discuss the incidence and to characterize the clinical features of ocular trauma associated with bungee cord injuries. DESIGN: Retrospective case series. PARTICIPANTS: The authors identified 67 subjects (60 males) treated at Wills Eye Hospital for ocular trauma resulting from bungee cords between September 1, 1994, and September 1, 1999. METHODS: The authors reviewed subjects' records from Wills Eye Hospital, records from outside physicians involved in the subjects' care, and conducted telephone interviews when additional information was needed. MAIN OUTCOME MEASURES: Each chart was reviewed for demographic information, mechanism of injury, presenting visual acuity, anterior segment, posterior segment and periocular injuries, medical and surgical intervention, final visual acuity, and length of follow-up. RESULTS: Mean visual acuity on presentation was 20/150. The most common anterior, posterior, and periocular injuries were hyphema (42/67, 63%), commotio retinae (30/55, 55%), and eyelid edema/ecchymosis (40/67, 60%), respectively. Seven subjects (10%) sustained open globe injuries, three (4%) of whom required enucleation. Eighteen subjects (27%) required medical treatment, and 4 subjects (6%) required surgical treatment for increased intraocular pressure. A total of 21 subjects (31%) required some form of surgical intervention. Mean final visual acuity was 20/60, with an average follow-up of 34 weeks. CONCLUSIONS: This series, the largest to date, demonstrates a wide spectrum of serious ocular injuries related to bungee cord use. Medical and surgical treatments are commonly necessary to manage these injuries. We advocate a modification in the design of these cords and appropriate printed warnings directed to the users of bungee cords regarding the potential for severe ocular trauma.

Pregnancy in lung transplant recipients.

Eight female lung transplant recipients, all of whom became pregnant after transplant, were reported to the National Transplantation Pregnancy Registry from US transplant centers. Outcomes of the 8 pregnancies were 4 live births, 3 therapeutic abortions, and 1 spontaneous abortion. Three of the 4 newborns were premature, with low birth weight (< 2500 grams). Rejection during pregnancy occurred in 3 pregnancies (38%). All 8 transplant recipients reported at least 1 complication during pregnancy, including shortness of breath, rejection, and infection. Two of the 4 deliveries were by cesarean section. At follow-up, all children were developing well with no residual problems. Female lung transplant recipients may face higher risks during pregnancy than other solid organ transplant recipients.

Population Changes in Heterodera glycines and Its Bacterial Parasite Pasteuria sp. in Naturally Infested Soil.

A two-year soil sampling study was conducted on four microplots naturally infested with Heterodera glycines and an undescfibed species of Pasteuria. The objectives of the study were to investigate the population dynamics of both organisms and to assess the potential of Pasteuria sp. as a biological control agent of H. glycines. Seasonal fluctuations were observed in numbers of cysts, eggs per cyst, second-stage juveniles (J2) of H. glycines, number of Pasteuria endospores attached per J2, and percentages of endospore-encumbered J2. Percentages of endospore-encumbered J2, Y, increased with the mean numbers of endospores per J2, X, according to the equation Y = 87.0(1 - e(-0.53X)). In contrast, numbers of J2 per 250 cm(3) soil, Y, decreased with the numbers of endospores per J2, X, according to the exponential decay model Y= 67.4 + 220.1e(-1.2X). The equilibrium J2 density (67.4 +/- 3.3) derived from this function was consistent with the predictions of the Lotka-Volterra model of population dynamics based on the equation 0.0195ln(y) - 0.000336y = 0.000049x - 0.00285ln(x) + 0.06589, where x and y represent the biweekly means of J2 densities and the percentages of endospore-encumbered J2, respectively. In all cases, predicted equilibrium densities of J2 were below the damage threshold reported from field studies. These results indicate that, given sufficient time following introduction into a field, Pasteuria may increase to levels that would be effective as one component in an integrated pest management proglmn to control H. glycines.