CRY1 is involved in the take-off behaviour of migratory Cnaphalocrocis medinalis individuals.

BACKGROUND: Numerous insect species undertake long-distance migrations on an enormous scale, with great implications for ecosystems. Given that take-off is the point where it all starts, whether and how the external light and internal circadian rhythm are involved in regulating the take-off behaviour remains largely unknown. Herein, we explore this issue in a migratory pest, Cnaphalocrocis medinalis, via behavioural observations and RNAi experiments. RESULTS: The results showed that C. medinalis moths took off under conditions where the light intensity gradually weakened to 0.1 lx during the afternoon or evening, and the take-off proportions under full spectrum or blue light were significantly higher than that under red and green light. The ultraviolet-A/blue light-sensitive type 1 cryptochrome gene (Cmedcry1) was significantly higher in take-off moths than that of non-take-off moths. In contrast, the expression of the light-insensitive CRY2 (Cmedcry2) and circadian genes (Cmedtim and Cmedper) showed no significant differences. After silencing Cmedcry1, the take-off proportion significantly decreased. Thus, Cmedcry1 is involved in the decrease in light intensity induced take-off behaviour in C. medinalis. CONCLUSIONS: This study can help further explain the molecular mechanisms behind insect migration, especially light perception and signal transmission during take-off phases.

Abamectin exposure causes chronic toxicity and trypsin/chymotrypsin damages in Chironomus kiiensis Tokunaga (Diptera: Chironomidae).

Abamectin has been extensively used in paddy fields to control insect pests. However, little information is available regarding its effects on non-target insects. In this study, we performed acute (3rd instar larvae) and chronic toxicity (newly hatched larvae <24 h) to determine the toxicity effects of abamectin on Chironomus kiiensis. The median lethal concentration (LC50) values of 24 h and 10 d were 0.57 mg/L and 68.12 µg/L, respectively. The chronic exposure significantly prolonged the larvae growth duration and inhibited pupation and emergence. The transcriptome and biochemical parameters were measured using 3rd instar larvae exposed to acute LC10 and LC25 for 24 h. Transcriptome data indicated that five trypsin and four chymotrypsin genes were downregulated, and RT-qPCR verified a significant expression decrease in trypsin3 and chymotrypsin1 genes. Meanwhile, abamectin could significantly inhibit the activities of the serine proteases trypsin and chymotrypsin. RNA interference showed that silencing trypsin3 and chymotrypsin1 genes led to higher mortality of C. kiiensis to abamectin. In conclusion, these findings indicated that trypsin and chymotrypsin are involved in the abamectin toxicity against C. kiiensis, which provides new insights into the mechanism of abamectin-induced ecotoxicity to chironomids.

Identification and characterization of Prx5 and Prx6 in Chilo suppressalis in response to environmental stress.

The antioxidant proteins, peroxiredoxins (Prxs), function to protect insects from reactive oxygen species-induced toxicity. In this study, two Prx genes, CsPrx5, and CsPrx6, were cloned and characterized from the paddy field pest, Chilo suppressalis, containing open reading frames of 570 and 672 bp encoding 189 and 223 amino acid polypeptides, respectively. Then, we investigated the influence of various stresses on their expression levels using quantitative real-time PCR (qRT-PCR). The results showed expression of CsPrx5 and CsPrx6 in all developmental stages, with eggs having the highest level. CsPrx5 and CsPrx6 showed higher expression in the epidermis and fat body, and CsPrx6 also showed higher expression in midgut, fat body, and epidermis. Increasing concentrations of insecticides (chlorantraniliprole and spinetoram) and hydrogen peroxide (H2 O2 ) increased the expression levels of CsPrx5 and CsPrx6. In addition, the expression levels of CsPrx5 and CsPrx6 were almost markedly upregulated in larvae under temperature stress or fed by vetiver. Thus, CsPrx5 and CsPrx6 upregulation might increase the C. suppressalis defense response by reducing the impact of environmental stress, providing a better understanding of the relationship between environmental stresses and insect defense systems.

Sublethal effects of chlorantraniliprole on growth, biochemical and molecular parameters in two chironomids, Chironomus kiiensis and Chironomus javanus.

Pesticide residues have serious environmental impacts on rice-based ecosystems. In rice fields, Chironomus kiiensis and Chironomus javanus provide alternative food sources to predatory natural enemies of rice insect pests, especially when pests are low. Chlorantraniliprole is a substitute for older classes of insecticides and has been used extensively to control rice pests. To determine the ecological risks of chlorantraniliprole in rice fields, we evaluated its toxic effects on certain growth, biochemical and molecular parameters in these two chironomids. The toxicity tests were performed by exposing third-instar larvae to a range of concentrations of chlorantraniliprole. LC50 values at 24 h, 48 h, and 10 days showed that chlorantraniliprole was more toxic to C. javanus than to C. kiiensis. Chlorantraniliprole significantly prolonged the larval growth duration, inhibited pupation and emergence, and decreased egg numbers of C. kiiensis and C. javanus at sublethal dosages (LC10 = 1.50 mg/L and LC25 = 3.00 mg/L for C. kiiensis; LC10 = 0.25 mg/L and LC25 = 0.50 mg/L for C. javanus). Sublethal exposure to chlorantraniliprole significantly decreased the activity of the detoxification enzymes carboxylesterase (CarE) and glutathione S-transferases (GSTs) in both C. kiiensis and C. javanus. Sublethal exposure to chlorantraniliprole also markedly inhibited the activity of the antioxidant enzyme peroxidase (POD) in C. kiiensis and POD and catalase (CAT) in C. javanus. Expression levels of 12 genes revealed that detoxification and antioxidant abilities were affected by sublethal exposures to chlorantraniliprole. There were significant changes in the expression levels of seven genes (CarE6, CYP9AU1, CYP6FV2, GSTo1, GSTs1, GSTd2, and POD) in C. kiiensis and ten genes (CarE6, CYP9AU1, CYP6FV2, GSTo1, GSTs1, GSTd2, GSTu1, GSTu2, CAT, and POD) in C. javanus. These results provide a comprehensive overview of the differences in chlorantraniliprole toxicity to chironomids, indicating that C. javanus is more susceptible and suitable as an indicator for ecological risk assessment in rice ecosystems.

Sublethal and transgenerational effects of lufenuron on biological characteristics and expression of reproductive related genes in the fall armyworm, Spodoptera frugiperda.

The fall armyworm, Spodoptera frugiperda, is a notorious polyphagous pest that causes serious economic losses in crucial crops and has invaded Africa and Asia. Lufenuron is widely used for controlling S. frugiperda in China, owing to its high toxicity against this key pest, and less pollution and little impact on natural enemies. In the present study, the sublethal and transgenerational effects of lufenuron on S. frugiperda were investigated to provide in-depth information for the rational use of lufenuron. Results showed that the development time and pupae weight were not significantly affected following exposure of females to LC10 and LC25 and male S. frugiperda to the LC10 of lufenuron. However, LC25 exposure significantly reduced pupal and total development time and pupae weight of male S. frugiperda. The longevity of S. frugiperda adults was prolonged by lufenuron and the fecundity of S. frugiperda treated with LC10 of lufenuron was significantly increased by 40% compared to the control. In addition, our study demonstrated that the LC25 of lufenuron had transgenerational effects on the progeny generation. The development time of female S. frugiperda whose parents were exposed to LC25 of lufenuron was significantly decreased compared to the control. And then, the expression profiles of Vg, VgR, JHEH, JHE, JHAMT, JHBP, CYP307A1, CYP306A1, CYP302A1 and CYP314A1 genes involved in insect reproduction and development were analyzed using Quantitative Real-Time PCR (RT-qPCR). Results showed that Vg, VgR, JHE, JHAMT, and CYP306A1 were significantly upregulated at the LC10 of lufenuron, which revealed that these upregulated genes might be linked with increased fecundity of S. frugiperda. Taken together, these findings highlighted the importance of sublethal and transgenerational effects under laboratory conditions and these effects may change the population dynamics in the field. Therefore, our study provided valuable information for promoting the rational use of lufenuron for controlling S. frugiperda.

Ion release and biocompatibility of Co-Cr alloy fabricated by selective laser melting from recycled Co-Cr powder: An in vitro study.

STATEMENT OF PROBLEM: As the cobalt chromium (Co-Cr) powder used in selective laser melting (SLM) is costly, reusing the remaining powder after multiple cycles provides an economic and environmental benefit. However, knowledge of the cytotoxic effect of the alloy fabricated from recycled powder is lacking. PURPOSE: The purpose of this in vitro study was to evaluate the biological effects of the Co-Cr ions released from the alloy fabricated from the recycled powder on the human gingival fibroblasts (HGFs) and normal oral keratinocytes (NOKs). MATERIAL AND METHODS: Disk-shaped Co-Cr specimens were fabricated by using the SLM technique from powders with different proportions of recycled to unused and from different recycling times. Co and Cr ions released from the disks immersed in the Dulbecco Modified Eagle Medium (DMEM) for 24 hours or 7 days were measured by inductively coupled plasma mass spectrometry (ICP-MS). Biocompatibility of Co-Cr alloy was detected by incubation of HGFs and NOKs in DMEM containing Co and Cr ions for 24 hours. The ANOVA test was used to evaluate statistically significant differences among different groups (α=.05). RESULTS: Compared with the alloy fabricated from 100% unused powder, the concentrations of Co and Cr ions increased with the increase of recycled to unused powder ratio or with the increase in the recycling times. HGFs and NOKs showed an increase in apoptosis, intracellular oxidative stress (ROS), hypoxia-inducing factor1α (HIF-1α), and proinflammatory cytokines (tumor necrosis factor alpha [TNF- α], interleukin 6 [IL-6], interleukin 8 [IL-8], and vascular endothelial growth factor [VEGF]) with the increase of Co-Cr ions in a concentration-dependent manner. A significant reduction in cell proliferation was found with the increase in the concentrations of Co and Cr ions (P<.05). CONCLUSIONS: The results of this study indicated that Co-Cr alloy fabricated from partially recycled powder or powder with different recycling times released significantly more Co and Cr ions and showed higher cytotoxicity to HGFs and NOKs than the alloy fabricated from unused powder.

External Human-Machine Interfaces for Autonomous Vehicles from Pedestrians' Perspective: A Survey Study.

With the increasing number of automated vehicles (AVs) being tested and operating on roads, external Human-Machine Interfaces (eHMIs) are proposed to facilitate interactions between AVs and other road users. Considering the need to protect vulnerable road users, this paper addresses the issue by providing research evidence on various designs of eHMIs. Ninety participants took part in this experiment. Six sets of eHMI prototypes-Text, Arrowed (Dynamic), Text and Symbol, Symbol only, Tick and Cross and Traffic Lights, including two sub-designs (Cross and Do Not Cross)-were designed. The results showed that 65.1% of participants agreed that external communication would have a positive effect on pedestrians' crossing decisions. Among all the prototypes, Text, and Text and Symbol, eHMIs were the most widely accepted. In particular, for elderly people and those unfamiliar with traffic rules, Text, and Text and Symbol, eHMIs would lead to faster comprehension. The results confirmed that 68.5% of participants would feel safer crossing if the eHMI had the following features: 'Green', 'Text', 'Symbol', or 'Dynamic'. These features are suggested in the design of future systems. This research concluded that eHMIs have a positive effect on V2X communication and that textual eHMIs were clear to pedestrians.

Uncovering the overcapacity feature of China's industry and the environmental & health co-benefits from de-capacity.

Overcapacity is regarded as an inevitable problem for rapid economic developing countries like China, which also causes serious adverse impacts on the environment and public health. However, few studies have quantified the overcapacity feature and corresponding co-benefit from de-capacity policy. To fill such research gaps, this study constructed a comprehensive assessment model by combining the Data Envelopment Analysis (DEA) model, the GAINS-China (Greenhouse gas - Air pollution Interactions and Synergies) model, and a meta-analysis and health impact assessment module, to measure the capacity utilization rate of 41 industrial sectors in 31 Chinese provinces and forecast the environmental and health co-benefits from de-capacity policy in 2050. Results showed that the capacity utilization rate of China's industry is 64.13% in 2018, which is much lower than the threshold value of 75%, indicating serious overcapacity in China's industry. Capacity utilization rates of light industries are higher (around 70%) than heavy industries (50%-60%), and the capacity utilization rate in East and South-Central China is higher (70%-96%) than West China (below 40%). Under a de-capacity scenario in 2050, China's CO2 and PM2.5 emissions are reduced by 1.05 billion tons (9.6%) and 57.8 kilotons (5.8%), respectively. This reduction in PM2.5 emissions results in a substantial health co-benefit, reducing national premature mortality cases by approximately 792,100 (1.6%). Finally, it is recommended that de-capacity priority be given to industries with low capacity utilization rate, as well as regions with intensive heavy industry or high levels of greenhouse gas emissions, severe air pollution, and dense population.

Effect of roughness and acidic medium on wear behavior of dental resin composite.

BACKGROUND: The aim of the study was to investigate whether the citric acid and rough surface have a synergistic effect leading to severe wear behavior of resin composite. MATERIALS AND METHODS: Disk-shaped (Ø15 × 1.5 mm) specimens of resin composite (n = 12) with different initial roughness were prepared. Reciprocating ball-on-flat wear tests were performed under distilled water and citric acid (pH = 5.5) respectively. The coefficient of friction (COF), wear volume loss, and duration of the running-in period were quantified to assess the wear performance. And the values were analyzed with one-way ANOVA (α = 0.05). Regression analysis was applied to examine the influence of Ra values and mediums on the wear data. The wear morphology was analyzed by scanning electron microscopy and a 3D profilometer. RESULTS: The average COF was higher in distilled water than in citric acid but was independent of the surface roughness. For the composite, the volume loss of worn area and running-in period increased with surface roughness when tested under distilled water. However, these increasing trends were not found in citric acid. All specimens exhibited mild wear behavior with low COF and less superficial abrasion in acidic medium. CONCLUSIONS: The effect of initial roughness on wear behavior depends on the medium. In distilled water, resin composites with high initial roughness exhibit a longer running-in time, which eventually leads to a significant increase in material loss. The adverse effects of high roughness can be alleviated by the lubrication of citric acid, which can maintain a mild wear behavior regardless of initial surface roughness.

A Scoping Review and Content Analysis of Common Depressive Symptoms of Young People.

School nurses are the most accessible health care providers for many young people including adolescents and young adults. Early identification of depression results in improved outcomes, but little information is available comprehensively describing depressive symptoms specific to this population. The aim of this study was to develop a taxonomy of depressive symptoms that were manifested and described by young people based on a scoping review and content analysis. Twenty-five journal articles that included narrative descriptions of depressive symptoms in young people were included. A total of 60 depressive symptoms were identified and categorized into five dimensions: behavioral (n = 8), cognitive (n = 14), emotional (n = 15), interpersonal (n = 13), and somatic (n = 10). This comprehensive depression symptom taxonomy can help school nurses to identify young people who may experience depression and will support future research to better screen for depression.

Text Analysis of Suicide Risk in Adolescents and Young Adults.

OBJECTIVE: Suicide is of primary public concern for adolescents and young adults (AYAs) who commonly use social media platforms to express their suicidal thoughts and behaviors. Understanding how AYAs communicate their suicide-related thoughts and behaviors in texts can support early detection of suicide risk from their social media posts. Therefore, this study sought to identify themes relevant to suicide risk in AYAs and explore words or terms used by AYAs when they described suicidal thoughts and behaviors. METHOD: This secondary data analysis utilized an existing data set collected from 255 AYAs between 12 and 25 years of age, who provided brief descriptions of how they and their peers expressed their experiences of self-harm, suicidal thinking, and attempts. Text analysis was conducted using KH Coder software. Three-step theory of suicide was used to guide a content analysis to explore the key themes from the narratives. RESULTS: A word co-occurrence network with 24 clusters of words was generated from the text analysis. These word clusters were further grouped into pain or hopelessness, connectedness, and capacity to attempt suicide in the content analysis. Six subthemes corresponding to these three themes were identified to provide detailed information: psychological or physical pain, hopelessness, relationship, help seeking, methods, and outcomes. Moreover, several slang terms and acronyms (e.g., Kermit Sewage Slide, KMS) were also identified. CONCLUSIONS: The findings of this study, including themes and slang terms and acronyms, are valuable to facilitate the use of terms or phrases within social media texts to identify suicide risk in AYAs.

Discovery of new tranylcypromine derivatives as highly potent LSD1 inhibitors.

Tranylcypromine (TCP)-based structural modifications lead to the discovery of new LSD1 inhibitors, of which compounds 26b and 29b effectively inhibit LSD1 with the IC50 values of 17 and 11 nM, respectively and also show good selectivity over MAO-B. Mechanistic studies showed that compound 29b concentration-dependently induced H3K4me1/2 accumulation in LSD1 overexpressed MGC-803 cells and also inhibited metastasis of MGC-803 cells. Collectively, both compounds could be promising lead compounds for further investigation.

Biological nitrogen removal capability and pathways analysis of a novel low C/N ratio heterotrophic nitrifying and aerobic denitrifying bacterium (Bacillus thuringiensis strain WXN-23).

A novel heterotrophic nitrification and aerobic denitrification (HNAD) bacteria, identified as Bacillus thuringiensis strain WXN-23, was isolated from husk feed filtrate of a pig farm. It was the first report of Bacillus thuringiensis with the capability for HNAD and could adapt to the condition of low Carbon/Nitrogen (C/N) ratio. Nitrogen could be efficiently removed by the strain WXN-23 in simulated wastewater, be it in single or mixed form nitrogen sources. The nitrogen balance revealed that 63.5% of the initial nitrogen (5.32 mg) was lost in the form of N2. The conditions for maximum total nitrogen (TN) removal efficiency (95.996%) were shaking speed of 126.89 r/min, a carbon C/N ratio of 5.91, the temperature of 32.81 °C, and a pH value of 8.17. The nitrification-denitrification metabolic pathway (NH4+-N→NH2OH→NO2--N→NO3--N→NO2--N→NO→N2O→N2) under aerobic conditions was determined on the basic of characteristic of N removal, N balance analysis, enzyme assay and functional genes amplification results. Strain WXN-23 was effective at wastewater treatment, with TN, NH4+-N, NO3--N and NO2--N removal efficiencies of 82.12%, 86.74%, 90.74% and 100%, respectively.

Exploring experiences of COVID-19-positive individuals from social media posts.

AIMS: This study aimed to explore the experience of individuals who claimed to be COVID-19 positive via their Twitter feeds. BACKGROUND: Public social media data are valuable to understanding people's experiences of public health phenomena. To improve care to those with COVID-19, this study explored themes from Twitter feeds, generated by individuals who self-identified as COVID-19 positive. DESIGN: This study utilized a descriptive design for text analysis for social media data. METHODS: This study analysed social media text retrieved by tweets of individuals in the United States who self-reported being COVID-19 positive and posted on Twitter in English between April 2, 2020, and April 24, 2020. In extracting embedded topics from tweets, we applied topic modelling approach based on latent Dirichlet allocation and visualized the results via LDAvis, a related web-based interactive visualization tool. RESULTS: Three themes were mined from 721 eligible tweets: (i) recognizing the seriousness of the condition in COVID-19 pandemic; (ii) having symptoms of being COVID-19 positive; and (iii) sharing the journey of being COVID-19 positive. CONCLUSION: Leveraging the knowledge and context of study themes, we present experiences that may better reflect patient needs while experiencing COVID-19. The findings offer more descriptive support for public health nursing and other translational public health efforts during a global pandemic.

Patterns of stress and support in social support networks of in-home hospice cancer family caregivers.

Family caregivers of home hospice cancer patients often experience burden and distress, which can be mitigated by perceived social support. However, less attention has been paid to the non-family sources of support within social networks, or to how sources of support may also be sources of stress. We describe support and stress in social networks of hospice family caregivers and identify caregiving characteristics associated with classes identified in our data. We collected demographic and psychosocial self-report data from family caregivers providing in-home hospice care for advanced cancer patients (N = 90). Caregivers also reported perceived support and stress from specific family and non-family relationships. We identified three classes with unique patterns of stress and support within caregivers' support networks using a latent class analysis. Classes include: 1) high support, low stress across family and non-family network members ("supportive"; 53% of caregivers); 2) high support, high stress across family and non-family network ("ambivalent maximizers"; 26%); and 3) high support, high stress across family network only ("family-focused ambivalent"; 21%). Caregivers in the ambivalent maximizer class reported more burden than caregivers in the supportive class (p = .024). This is one of the first studies to systematically explore the role of non-family support, as well as how stress and support co-occur within relationships and across networks. As informal support networks of hospice family caregivers are complex and multifaceted, understanding the patterns of support and stress across various network members is essential to offer services to more effectively manage caregiver burden.

Psychometric properties of a brief self-reported health-related quality of life measure (HRQoL-IDD) for persons with intellectual and developmental disabilities.

BACKGROUND: To encourage self-determination and address health disparities among persons with intellectual and developmental disabilities, clinicians and researchers rely on self-reported measures like health-related quality of life (HRQoL). This study evaluated the psychometric properties of a theory-driven self-reported HRQoL measure for adults requiring mild to moderate support related to intellectual and developmental disabilities. METHOD: 224 volunteers completed 42 quality of life items developed with extensive input from persons with intellectual and developmental disabilities, family members/caregivers, and providers. The 5-point Likert scale format with visual images of fluid-filled cups represented the range of responses. RESULTS: Exploratory and Unrestricted Factor Analyses yielded 16 HRQoL items with 4 subscales: Functional Well-Being, Emotional Well-Being, Social Well-Being, and Healthy Decision-making. The HRQoL-IDD explained 62.8% of variance, had satisfactory internal consistency (0.73-0.83), stability of reponses, and reading level (2nd grade, ages 7-8). CONCLUSIONS: The HRQoL-IDD is a promising measure of self-reported HRQoL for use in community-based settings for persons requiring mild to moderate support related to intellectual and developmental disabilities.

Implementing a Social Determinants Screening and Referral Infrastructure During Routine Emergency Department Visits, Utah, 2017-2018.

PURPOSE AND OBJECTIVES: Emergency departments see a disproportionate share of low-income and uninsured patients. We developed and evaluated a process for identifying social needs among emergency department patients, for facilitating access to community-based resources, and for integrating clinical and community-based data. INTERVENTION APPROACH: We leveraged an academic-community partnership to develop a social needs screening tool and referral process. EVALUATION METHODS: In a 25-day feasibility trial incorporating rapid improvement cycles, emergency department staff screened 210 patients for social needs. Observational and interview notes were analyzed, and data were linked from patient screenings, the United Way of Salt Lake 2-1-1 consumer information system, and electronic health records. RESULTS: Domains uncovered during pilot testing included screening based on appearance or insurance; discomfort asking stigmatizing questions; and lack of clarity regarding the screening's purpose. During the trial, 61% (n = 129) of patients reported 1 or more need, 52% (n = 67) of whom wanted follow-up. Of the 65 patients with complete data who wanted referrals, 49% (n = 32) were ultimately reached by 2-1-1, which provided an average of 4 community referrals (eg, pharmacy programs, utility assistance). Service usage 3 months before versus 3 months after emergency department index dates demonstrated that patients with social needs experienced a significant increase in emergency department use compared with those without needs (1.07 vs 1.36, P = .03), while patients with no needs experienced increases in primary care visits compared with those patients with unmet needs (0.24 vs 0.56, P = .03). IMPLICATIONS FOR PUBLIC HEALTH: We demonstrated the ability to systematically screen and refer for emergency department patients' unmet social needs by using existing resources and to link screening results, service referral details, and health service data. However, our experiences demonstrate that widespread implementation efforts should thoughtfully address staff perceptions and patient communication challenges.

An adaptive heuristic clustering algorithm for influence maximization in complex networks.

Influence maximization research in the real world allows us to better understand, accelerate spreading processes for innovations and products, and effectively analyze, predict, and control the spread of diseases, rumors, and computer viruses. In this paper, we first put forward a new path-based node similarity measure, named the dynamic local similarity index, which can be dynamically adjusted to the optimal mode according to network topology characteristics. Compared to the Katz index with high complexity and an LP index with a limited application range, the proposed index achieves an excellent balance between complexity and precision. Second, combining the extended neighborhood coreness with the minimum distance, a novel strategy is presented for selecting initial centers of clusters, which is helpful for speeding up clustering convergence and avoiding local optimum, especially in non-connected networks. Subsequently, we present an adaptive heuristic clustering algorithm, which can find the seed set with maximum collective influence through clustering. The empirical results on four real datasets show the effectiveness and efficiency of the proposed algorithm, which compares favorably to several state-of-the-art algorithms.

The transition experiences of adolescents with type 1 diabetes from paediatric to adult care providers.

PURPOSE: Emerging adults with type 1 diabetes (T1D) are at increased risk for poor health outcomes as they transition from paediatric to adult healthcare providers. This is in part due to the complexities of young adult life as individuals with T1D enter the workforce, leave home or start college while learning to manage the disease on their own. We sought to identify the barriers and facilitators adolescents face during their emerging adult years with T1D. METHODS: Young adults, aged 24-35, who lived with T1D during their adolescent years were recruited online to complete a survey regarding their experience with care transition. Categorical data were analysed using descriptive statistics. A thematic analysis, guided by the Framework for Emerging Adults with T1D, was used to explore the free-text data. RESULTS: In total, 25 adults (84% female) with mean age of 28 ± 3.2 years participated. Themes that arose from the analysis of the paediatric to adult care transition experiences included (1) importance of support from key players, (2) challenges navigating the healthcare system, (3) mental health needs of emerging adults with T1D, (4) managing day-to-day life with T1D and (5) early independence to ease transition. CONCLUSION: Individuals with T1D face a variety of challenges as they transition from paediatric to adult care providers. A proactive approach in educating adolescents is needed.

Mining twitter to explore the emergence of COVID-19 symptoms.

BACKGROUND: The Centers for Disease Control and Prevention (CDC) in United States initially alerted the public to three COVID-19 signs and symptoms-fever, dry cough, and shortness of breath. Concurrent social media posts reflected a wider range of symptoms of COVID-19 besides these three symptoms. Because social media data have a potential application in the early identification novel virus symptoms, this study aimed to explore what symptoms mentioned in COVID-19-related social media posts during the early stages of the pandemic. METHODS: We collected COVID-19-related Twitter tweets posted in English language between March 30, 2020 and April 19, 2020 using search terms of COVID-19 synonyms and three common COVID-19 symptoms suggested by the CDC in March. Only unique tweets were extracted for analysis of symptom terms. RESULTS: A total of 36 symptoms were extracted from 30,732 unique tweets. All the symptoms suggested by the CDC for COVID-19 screening in March, April, and May were mentioned in tweets posted during the early stages of the pandemic. DISCUSSION: The findings of this study revealed that many COVID-19-related symptoms mentioned in Twitter tweets earlier than the announcement by the CDC. Monitoring social media data is a promising approach to public health surveillance.