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Behavioural responses to pandemics are less shaped by actual mortality or hospitalization risks than they are by risk attitudes. We explore human mobility patterns as a measure of behavioural responses during the COVID-19 pandemic. Our results indicate a strong negative relationship between mobility reduction and risk-taking preferences. We find that the sharp decline in movement after the WHO (World Health Organization) declared COVID-19 to be a pandemic can be attributed to risk attitudes, especially for visits to places classified as retail and recreation, transit stations and workplaces. This suggests that individuals with risk-averse attitudes are more likely to adjust their behavioural activity in response to the declaration of a pandemic even prior to most official government lockdowns. We also find regions with higher risk aversion report a larger relative reduction in frequency of visits to places such as retail shops, grocery stores, parks, and public transport during the weekends compared to weekdays, whereas risk-loving regions are more likely to go to workplaces and less likely to stay at home during the weekends. There is also evidence to suggest that in areas with a larger share of older people in the population, risk-loving individuals are more likely to restrain themselves from taking public transport, engaging in non-essential retail shopping, going to workplaces, and staying home. Finally, we also find that the rate of behavioural adjustment, measured as the effect of mobility change after the first recorded death in the country, is sharper when the population have a larger risk pool population independent of government lockdowns.

Behavioural responses to pandemics are less shaped by actual mortality or hospitalisation risks than they are by risk attitudes. We explore human mobility patterns as a measure of behavioural responses during the COVID-19 pandemic. Our results indicate that risk-taking attitudes are a critical factor in predicting reductions in human mobility and social confinement around the globe. We find that the sharp decline in mobility after the WHO (World Health Organization) declared COVID-19 to be a pandemic can be attributed to risk attitudes. Our results suggest that regions with risk-averse attitudes are more likely to adjust their behavioural activity in response to the declaration of a pandemic even before official government lockdowns. Further understanding of the basis of responses to epidemics, e.g., precautionary behaviour, will help improve the containment of the spread of the virus.

Although science has been an incredibly powerful and revolutionary force, it is not clear whether science is suited to performance under pressure; generally, science achieves best in its usual comfort zone of patience, caution, and slowness. But if science is organized knowledge and acts as a guiding force for making informed decisions, it is important to understand how science and scientists perform as a reliable and valuable institution in a global crisis such as COVID-19. This paper provides insights and reflections looking at aspects such as speed, transparency, trust, data sharing, scientists in the political arena, and the psychology of scientists; all of which are areas inviting more detailed investigation by future studies conducting systematic empirical studies.

Behavioural responses to pandemics are less shaped by actual mortality or hospitalisation risks than they are by risk attitudes. We explore human mobility patterns as a measure of behavioural responses during the COVID-19 pandemic. Our results indicate that risk-taking attitudes are a critical factor in predicting reductions in human mobility and social confinement around the globe. We find that the sharp decline in mobility after the WHO (World Health Organization) declared COVID-19 to be a pandemic can be attributed to risk attitudes. Our results suggest that regions with risk-averse attitudes are more likely to adjust their behavioural activity in response to the declaration of a pandemic even before official government lockdowns. Further understanding of the basis of responses to epidemics, e.g., precautionary behaviour, will help improve the containment of the spread of the virus.

The current COVID-19 pandemic is a global exogenous shock, impacting individuals' decision making and behaviour allowing researchers to test theories of personality by exploring how traits, in conjunction with individual and societal differences affect compliance and cooperation. Study 1 used Google Mobility data and nation-level personality data from 31 countries, both before and after region-specific legislative interventions, finding that agreeable nations are most consistently compliant with mobility restrictions. Study 2 (N= 105,857) replicated these findings using individual-level data, showing that several personality traits predict sheltering in place behavior, but extraverts are especially likely to remain mobile. Overall, our analyses reveal robust relationships between traits and regulatory compliance (mobility behaviour) both before and after region specific legislative interventions, and the global declaration of the pandemic. Further, we find significant effects on reasons for leaving home, as well as age and gender differences, particularly relating to female agreeableness for previous and future social mobility behaviours.

Trust in the health care system requires being confident that sufficient and appropriate treatments will be provided if needed. The COVID-19 public health crisis is a significant, global, and (mostly) simultaneous test of the behavioral implications arising from this trust. We explore whether populations reporting low levels of confidence in the health care system exhibit a stronger behavioral reaction to the COVID-19 pandemic. We track the dynamic responses to the COVID-19 pandemic across 38 countries and 621 regions by exploiting a large dataset on human mobility generated between February 15 and June 5, 2020 and a broad range of contextual factors (e.g. deaths or policy implementations). Using a time-dynamic framework we find that societies with low levels of health care confidence initially exhibit a faster response with respect to staying home. However, this reaction plateaus sooner, and after the plateau it declines with greater magnitude than does the response from societies with high health care confidence. On the other hand, regions with higher confidence in the health care system are more likely to reduce mobility once the government mandates that its citizens are not to leave home except for essential trips, compared to those with lower health care system confidence. Regions with high trust in the government but low confidence in the health care system dramatically reduce their mobility, suggesting a correlation for trust in the state with respect to behavioral responses during a crisis.

During the COVID-19 pandemic, governments have struggled to find the right balance between restrictive measures to contain the spread of the virus, and the effects of these measures on people's psychological wellbeing. This paper investigates the relationship between limitations to mobility and mental health for British population during the COVID-19 pandemic, combining the use of high frequency mobility data from Google and longitudinal monthly data collected during the pandemic. We show that more time spent at home predicts a worsening of mental wellbeing even when we account for the prevalence of COVID-19 in the region and the general stringency of the lockdown. There is some heterogeneity in these effects, with young healthy people, living alone, with an active working life, showing particularly high levels of distress.

BACKGROUND: Insulinemia and type 2 diabetes (T2D) have been associated with endometrial cancer risk in numerous observational studies. However, the causality of these associations is uncertain. Here we use a Mendelian randomization (MR) approach to assess whether insulinemia and T2D are causally associated with endometrial cancer. METHODS: We used single nucleotide polymorphisms (SNPs) associated with T2D (49 variants), fasting glucose (36 variants), fasting insulin (18 variants), early insulin secretion (17 variants), and body mass index (BMI) (32 variants) as instrumental variables in MR analyses. We calculated MR estimates for each risk factor with endometrial cancer using an inverse-variance weighted method with SNP-endometrial cancer associations from 1287 case patients and 8273 control participants. RESULTS: Genetically predicted higher fasting insulin levels were associated with greater risk of endometrial cancer (odds ratio [OR] per standard deviation = 2.34, 95% confidence internal [CI] = 1.06 to 5.14, P = .03). Consistently, genetically predicted higher 30-minute postchallenge insulin levels were also associated with endometrial cancer risk (OR = 1.40, 95% CI = 1.12 to 1.76, P = .003). We observed no associations between genetic risk of type 2 diabetes (OR = 0.91, 95% CI = 0.79 to 1.04, P = .16) or higher fasting glucose (OR = 1.00, 95% CI = 0.67 to 1.50, P = .99) and endometrial cancer. In contrast, endometrial cancer risk was higher in individuals with genetically predicted higher BMI (OR = 3.86, 95% CI = 2.24 to 6.64, P = 1.2x10(-6)). CONCLUSION: This study provides evidence to support a causal association of higher insulin levels, independently of BMI, with endometrial cancer risk. ; This study was supported by MRC grant MC_UU_12015/1 and by the Innovative Medicines Initiative Joint Undertaking under EMIF grant agreement n° 115372 (contributions from the European Union's Seventh Framework Programme (FP7/2007-2013) and EFPIA companies). ANECS recruitment was supported by project grants from the National Health and Medical Research Council of Australia (ID#339435), The Cancer Council Queensland (ID#4196615) and Cancer Council Tasmania (ID#403031 and ID#457636). SEARCH recruitment was funded by a programme grant from Cancer Research UK [C490/A10124]. Case genotyping was supported by the National Health and Medical Research Council (ID#552402). Control data was generated by the Wellcome Trust Case Control Consortium (WTCCC), and a full list of the investigators who contributed to the generation of the data is available from the WTCCC website. We acknowledge use of DNA from the British 1958 Birth Cohort collection, funded by the Medical Research Council grant G0000934 and the Wellcome Trust grant 068545/Z/02. Funding for this project was provided by the Wellcome Trust under award 085475. Recruitment of the QIMR controls was supported by the National Health and Medical Research Council of Australia (NHMRC). The University of Newcastle, the Gladys M Brawn Senior Research Fellowship scheme, The Vincent Fairfax Family Foundation, the Hunter Medical Research Institute and the Hunter Area Pathology Service all contributed towards the costs of establishing the Hunter Community Study. K.T.N. was supported by the Gates Cambridge Trust. R.K.S. is supported by the Wellcome Trust (grant number WT098498). A.B.S. is supported by the National Health and Medical Research Council (NHMRC) Fellowship Scheme. D.F.E. is a Principal Research Fellow of Cancer Research UK. A.M.D is supported by the Joseph Mitchell Trust. ; This is the final version of the article. It first appeared from Oxford University Press via http://dx.doi.org/10.1093/jnci/djv178

$\textbf{BACKGROUND}$: Higher circulating levels of the branched-chain amino acids (BCAAs; i.e., isoleucine, leucine, and valine) are strongly associated with higher type 2 diabetes risk, but it is not known whether this association is causal. We undertook large-scale human genetic analyses to address this question. $\textbf{METHODS AND FINDINGS}$: Genome-wide studies of BCAA levels in 16,596 individuals revealed five genomic regions associated at genome-wide levels of significance (p < 5 × 10-8). The strongest signal was 21 kb upstream of the PPM1K gene (beta in standard deviations [SDs] of leucine per allele = 0.08, p = 3.9 × 10-25), encoding an activator of the mitochondrial branched-chain alpha-ketoacid dehydrogenase (BCKD) responsible for the rate-limiting step in BCAA catabolism. In another analysis, in up to 47,877 cases of type 2 diabetes and 267,694 controls, a genetically predicted difference of 1 SD in amino acid level was associated with an odds ratio for type 2 diabetes of 1.44 (95% CI 1.26-1.65, p = 9.5 × 10-8) for isoleucine, 1.85 (95% CI 1.41-2.42, p = 7.3 × 10-6) for leucine, and 1.54 (95% CI 1.28-1.84, p = 4.2 × 10-6) for valine. Estimates were highly consistent with those from prospective observational studies of the association between BCAA levels and incident type 2 diabetes in a meta-analysis of 1,992 cases and 4,319 non-cases. Metabolome-wide association analyses of BCAA-raising alleles revealed high specificity to the BCAA pathway and an accumulation of metabolites upstream of branched-chain alpha-ketoacid oxidation, consistent with reduced BCKD activity. Limitations of this study are that, while the association of genetic variants appeared highly specific, the possibility of pleiotropic associations cannot be entirely excluded. Similar to other complex phenotypes, genetic scores used in the study captured a limited proportion of the heritability in BCAA levels. Therefore, it is possible that only some of the mechanisms that increase BCAA levels or affect BCAA metabolism are implicated in type 2 diabetes. $\textbf{CONCLUSIONS}$: Evidence from this large-scale human genetic and metabolomic study is consistent with a causal role of BCAA metabolism in the aetiology of type 2 diabetes. ; MRC Epidemiology Unit, Fenland study, EPIC-InterAct study, EPIC-Norfolk case-cohort study funding: this study was funded by the United Kingdom's Medical Research Council through grants MC_UU_12015/1, MC_UU_12015/5, MC_PC_13046, MC_PC_13048 and MR/L00002/1. We acknowledge support from the National Institute for Health Research Biomedical Research Centre. The research leading to these results has received support from the Innovative Medicines Initiative Joint Undertaking under EMIF grant agreement number 115372, resources of which are composed of financial contribution from the European Union's Seventh Framework Programme (FP7/2007-2013) and EFPIA companies' in kind contribution. EPIC-InterAct Study funding: funding for the InterAct project was provided by the EU FP6 programme (grant number LSHM_CT_2006_037197). MRC Human Nutrition Research funding: This research was supported by the Medical Research Council (MC_UP_A090_1006) and Cambridge Lipidomics Biomarker Research Initiative (G0800783). The SABRE study was funded at baseline by the UK Medical Research Council, Diabetes UK and the British Heart Foundation and at follow-up by a programme grant from the Wellcome Trust (WT082464) and British Heart Foundation (SP/07/001/23603); Diabetes UK funded the metabolomics analyses (13/0004774). RJOS, EN, JRZ and AK received funding from the Swedish Research Council, Stockholm County Council, Novo Nordisk Foundation and Diabetes Wellness. DBS is supported by the Wellcome Trust grant number 107064. MIM is a Wellcome Trust Senior Investigator and is supported by the following grants from the Wellcome Trust: 090532 and 098381. IB is supported by the Wellcome Trust grant WT098051.

Changing collective behaviour and supporting non-pharmaceutical interventions is an important component in mitigating virus transmission during a pandemic. In a large international collaboration (Study 1, N = 49,968 across 67 countries), we investigated selfreported factors associated with public health behaviours (e.g., spatial distancing and stricter hygiene) and endorsed public policy interventions (e.g., closing bars and restaurants) during the early stage of the COVID-19 pandemic (April-May 2020). Respondents who reported identifying more strongly with their nation consistently reported greater engagement in public health behaviours and support for public health policies. Results were similar for representative and non-representative national samples. Study 2 (N = 42 countries) conceptually replicated the central finding using aggregate indices of national identity (obtained using the World Values Survey) and a measure of actual behaviour change during the pandemic (obtained from Google mobility reports). Higher levels of national identification prior to the pandemic predicted lower mobility during the early stage of the pandemic (r = −0.40). We discuss the potential implications of links between national identity, leadership, and public health for managing COVID-19 and future pandemics.