Antenatal corticosteroids are given to pregnant people at risk of preterm birth to reduce newborn morbidity, including respiratory distress syndrome. However, there has been concern surrounding potential adverse effects on subsequent generations. Animal studies have demonstrated endocrine and metabolic changes in those exposed to corticosteroids in utero (F1) and in the second generation (F2). We aimed to assess the effects of parental antenatal corticosteroid exposure on health of the second generation (F2) of Auckland Steroid Trial (AST) participants. In the AST, women (F0) expected to birth between 24 and 36 weeks’ gestation were randomised to betamethasone or placebo. When their children (F1) were 50 years old, they and their children (F2) were followed up with a self-report questionnaire and data linkage. The primary outcome for this analysis was body mass index (BMI) z-score in the F2 generation. Secondary outcomes included respiratory, cardiovascular, neurodevelopmental, mental and general health, and social outcomes. Of the 213 F2 participants, 144 had BMI data available. There was no difference in BMI z-score between participants whose parent was exposed to betamethasone versus placebo (mean (SD) 0.63 (1.45), N = 77 vs 0.41 (1.28), N = 67, adjusted mean difference (95% confidence interval) = 0.16 (-0.37, 0.69)). There was no evidence of a difference in rates of overweight, diabetes, respiratory disease, cardiometabolic risk factors, neurodevelopmental difficulties, mental health difficulties and social outcomes between parental betamethasone versus placebo exposure groups, but confidence intervals were wide. These findings are reassuring regarding the intergenerational safety of antenatal corticosteroids.

The effect dietary FODMAPs (fermentable oligo-, di- and mono-saccharides and polyols) in healthy adults is poorly documented. This study compared specific effects of low and moderate FODMAP intake (relative to typical intake) on the faecal microbiome, participant-reported outcomes and gastrointestinal physiology. In a single-blind cross-over study, 25 healthy participants were randomised to one of two provided diets, ‘low’ (LFD) <4 g/d or ‘moderate’ (MFD) 14-18 g/d, for 3 weeks each, with ≥2-week washout between. Endpoints were assessed in the last week of each diet. The faecal bacterial/archaeal and fungal communities were characterised in 18 participants in whom high quality DNA was extracted by 16S rRNA and ITS2 profiling, and by metagenomic sequencing. There were no differences in gastrointestinal or behavioural symptoms (fatigue, depression, anxiety), or in faecal characteristics and biochemistry (including short-chain fatty acids). Mean colonic transit time (telemetry) was 23 (95% confidence interval: 15, 30) h with the MFD compared with 34 (24, 44) h with LFD (n=12; p=0.009). Fungal diversity (richness) increased in response to MFD, but bacterial richness was reduced, coincident with expansion of the relative abundances of Bifidobacterium, Anaerostipes, and Eubacterium. Metagenomic analysis showed expansion of polyol-utilising Bifidobacteria, and Anaerostipes with MFD. In conclusion, short-term alterations of FODMAP intake are not associated with symptomatic, stool or behavioural manifestations in healthy adults, but remarkable shifts within the bacterial and mycobiome populations were observed. These findings emphasise the need to quantitatively assess all microbial Domains and their interrelationships to improve understanding of consequences of diet on gut function.

The Hippoboscidae are ectoparasites of birds and mammals, which, as a group, are known to vector multiple diseases. Avipoxvirus (APV) is mechanically vectored by various arthropods and causes seasonal disease in wild birds in the United Kingdom (UK). Signs of APV and the presence of louse flies (Hippoboscidae) on Dunnocks Prunella modularis were recorded over a 16·5-year period in a rural garden in Somerset, UK. Louse flies collected from this site and other sites in England were tested for the presence of APV DNA and RNA sequences. Louse flies on Dunnocks were seen to peak seasonally three weeks prior to the peak of APV lesions, an interval consistent with the previously estimated incubation period of APV in Dunnocks. APV DNA was detected on 13/25 louse flies, Ornithomya avicularia and Ornithomya fringillina, taken from Dunnocks, both with and without lesions consistent with APV, at multiple sites in England. Collectively these data support the premise that louse flies may vector APV. The detection of APV in louse flies, from apparently healthy birds, and from sites where disease has not been observed in any host species, suggests that the Hippoboscidae could provide a non-invasive and relatively cheap method of monitoring avian diseases. This could provide advanced warnings of disease, including zoonoses, before they become clinically apparent.

Objectives/Goals: Glucagon-like peptide-1 (GLP1) use prior to bariatric surgery may represent a novel approach to treating obesity. The objectives of this study were to describe trends in pre-bariatric GLP1 use, investigate social and clinical factors associated with their use, and evaluate differences in clinical outcomes based on preoperative GLP1RA use. Methods/Study Population: Patients who underwent bariatric surgery at three Indiana hospitals from 2018 to 2023 were identified. Patients who utilized GLP1 in the year preceding surgery were compared to those who did not. Social determinants of health included insurance, income, and unemployment. Outcomes included rates of GLP1 use, 30-day postoperative readmissions, ED visits, and percent total weight lost (%TWL) at one year. Associations between preoperative GLP1 use and outcomes of interest were evaluated using multivariable logistic and linear regressions. Results/Anticipated Results: Of 2,169 patients who underwent surgery, 293 (13.5%) utilized GLP1 preoperatively. The rate of GLP1 utilization increased threefold from 2018 to 2023. Males were more likely to receive preoperative GLP1 (20.1% vs, 12.2%, p<0.001). There were no significant differences in social determinants of health or 30-day postoperative outcomes between patients who did and did not use GLP1RA preoperatively. Similarly, there were no significant differences in %TWL at one year postoperatively between groups (median 25.5% vs. 27.3%, coefficient: -0.78, 95%CI: -2.26–0.70). Discussion/Significance of Impact: Utilization of GLP1 in the year prior to bariatric surgery has significantly increased. Preoperative GLP1 use is not associated with worse 30-day outcomes or differences in %TWL at one year postoperatively. Further work is needed to evaluate whether GLP1 dosing and duration of treatment impact postoperative outcomes.

We construct a Divisia money measure for U.K. households and private non-financial corporations and a corresponding dual user cost index employing a consistent methodology from 1977 up to the present. Our joint construction of both the Divisia quantity index and the Divisia price dual facilitates an investigation of structural vector autoregresssion models (SVARs) over a long sample period of the type of non-recursive identifications explored by Belongia and Ireland (2016, 2018), as well as the block triangular specification advanced by Keating et al. (2019). An examination of the U.K. economy reveals that structures that consider a short-term interest rate to be the monetary policy indicator generate unremitting price puzzles. In contrast, we find sensible economic responses in various specifications that treat our Divisia measure as the indicator variable.

The North American Heritage at Risk (NAHAR) collaborative, which formed during the COVID-19 pandemic, allowed for heritage-at-risk partners to shift from reactive to proactive strategies. The result was the creation of the NAHAR research pipeline to respond to landscapes at risk. The pipeline includes modeling of environmental changes to the landscape; monitoring sites to verify location and assess condition; meeting with the public, descendant community, land managers, and transdisciplinary experts in their field to discuss climate change impacts to their heritage in the next 10 years; methodizing by means of a workflow organizer using data from the modeling, monitoring, and meeting; and when appropriate, mitigating areas identified during the methodizing process. In 2020, the Florida Public Archaeology Network—along with partners in Georgia, South Carolina, Washington, Texas, and Louisiana—began the Science Collaborative People of Guana project at the Guana Tolomato Matanzas Estuarine Research Reserve (GTM NERR) north of St. Augustine, Florida. Using a collaborative science mindset, the project team applied the NAHAR pipeline to gain a better sense of how resources were used in the past and how they currently are being used by communities to ensure responsive resource management and relationship building with visitors, descendants, and other community stakeholders, such as the Gullah/Geechee Nation. This article will provide the building blocks for other collaborative teams to follow the NAHAR pipeline and share lessons learned from the two-year project.

Children with congenital heart defects (CHD) are often short/lightweight relative to peers. Limited growth, particularly height, may reflect energy deficits impacting physical activity. Latent class analyses of growth from birth and Bruce treadmill exercise data retrospectively identified for height, weight, and body mass index z-scores growth trajectories. Linear regression models examined exercise parameters by growth trajectory, adjusting for age/sex/CHD severity. A total of 213 children with CHD (39% female, 12.1 ± 2.9 years) achieved 85.8 ± 10.1% of the predicted peak heart rate. Peak heart rate among children whose height was consistently below average (class 1) was 15.2 ± 4.9 beats/min lower than children with other height trajectories. These children also attained a lower percentage of predicted peak heart rate. Children whose weight (p = 0.03) or body mass index (p < 0.001) z-score increased throughout childhood had significantly lower exercise duration (mean difference 1–2 min) than children whose growth trajectories were stable or declined. Children with above-average weight or an increasing body mass index also used a higher percentage of their heart rate reserve at each submaximal exercise stage. A very low height z-score trajectory is associated with decreased exercise capacity that may increase the risk for morbidities associated with a sedentary lifestyle. Future studies should examine potential mechanisms for the observed height deficits, such as an inadequate energy supply that could impact physical activity participation, congestive heart failure, cyanosis, pubertal stage, supplemental feeding history, or familial growth patterns. Prospective studies examining growth in relation to objective measures of daily physical activity are required.

There is a pressing need for novel approaches to help address climate change and for a workforce that is equipped with a combination of new and different types of knowledges. The One Health (OH) core competencies perhaps offer the new knowledges, skills and attitudes that will be needed in a future generation of practitioners that does not shy away from complexity. The objective of this research was to identify overlapping and transferable OH-climate change competencies that are needed of professionals working to address climate change. Using focus groups and qualitative content analysis, 23 professionals from across Canada whose employment positions had a key focus on climate change were brought together across five sessions. Participants agreed that the OH competencies were applicable to their employment roles and responsibilities, but they identified four key missing areas that are important for graduates: evaluative and reflective practice, personal resilience, turning knowledge into action and having an openness to other knowledges (particularly Indigenous and non-Western viewpoints). This work also provided a first iteration of a process that should be continually used to bridge the gap between theory and practice, as employer needs are a key consideration during the development of educational programs.

Wearable technology and daily diaries offer insights into everyday behaviors that can further health research and treatment globally. However, the use of these methodologies outside of high-income settings has been limited. We conducted two pilot studies that enrolled 60 young women in the urban slums of Kampala, Uganda to understand design considerations associated with using wearable technology and daily diaries in this context. Each participant in the pilot studies was asked to wear a wearable activity tracker and complete daily diary questionnaires for 5 days. Based on our experiences, we identified several lessons that may be beneficial to others interested in implementing wearable technology and daily self-reports in their research and interventions, particularly when working in low-resource contexts. We discuss the importance of designing solutions tailored to the available resources, building validation for the most critical measures, investing in data management efforts and providing transparent and culturally accessible information to participants. Examples from our study are provided. These lessons may reduce the barriers and improve data quality for future researchers and practitioners interested in using these data collection methods globally.

In September 2023, the UK Health Security Agency’s (UKHSA) South West Health Protection Team received notification of patients with Pseudomonas aeruginosa perichondritis. All five cases had attended the same cosmetic piercing studio and a multi-disciplinary outbreak control investigation was subsequently initiated. An additional five cases attending the same studio were found. Seven of the ten cases had isolates available for Variable Number Tandem Repeat (VNTR) typing at the UKHSA national reference laboratory. Clinical and environmental P. aeruginosa isolates from the patients, handwash sink, tap water and throughout the wall-mounted point-of-use water heater (including outlet water) were indistinguishable by VNTR typing (11,6,2,2,1,3,6,3,11). No additional cases were identified after control measures were implemented, which included replacing the sink and point-of-use heater.

The lack of specific recommendations to control for P. aeruginosa within Council-adopted ear-piercing byelaws or national guidance means that a cosmetic piercing artist could inadvertently overlook the risks from this bacterial pathogen despite every intention to comply with the law and follow industry best practice advice. Clinicians, Environmental Health Officers and public health professionals should remain alert for single cases of Pseudomonas perichondritis infections associated with piercings and have a low threshold for notification to local health protection teams.

We evaluated herbicides for controlling the annual grass ventenata [Ventenata dubia (Leers) Coss.], with particular interest in indaziflam, a preemergence cellulose biosynthesis inhibitor. In 2016, indaziflam was applied postemergence alone and in mixture with glyphosate, imazapic, propoxycarbazone-sodium, or rimsulfuron to an improved pasture in southwestern Montana. A non-sprayed control was included for comparison purposes. Canopy cover of each species was assessed annually for 7 yr; cover was grouped by life-form and longevity, and species richness was calculated. Five years (2021) after treatment, the seedbank was assessed. Our results indicated that treatments including indaziflam reduced V. dubia cover 1 to 3 yr and even up to 6 yr after application, with V. dubia cover being zero or close to zero. However, at 7 yr (2023) after treatment, V. dubia was low across all treatments, including the non-sprayed control. Perennial grasses and forbs and annual forbs were generally unaffected by any treatment and did not increase in cover over the 7 yr, even though V. dubia decreased. Two years after treatment, species richness was lowest in treatments that included indaziflam, but at 7 yr, species richness was similar across all treatments. Indaziflam depleted the monocot and dicot seedbank, with fewer than 5 seedlings of any species emerging from treatments that included indaziflam, while other treatments resulted in 60 to 165 seedlings per sample (40 cm3 of soil). In summary, at our study site, a single application of indaziflam controlled V. dubia for 6 yr, appeared to deplete the seedbank at 5 yr, and cover of perennial and annual vegetation and species richness was unaffected. By the end of the study, though, V. dubia cover appeared to be influenced by factors other than herbicide treatments, possibly variable precipitation over time, an exclusion of grazing, and competitive perennial grasses dominating the site.

The increased risk for psychopathology associated with interpersonal violence exposure (IPV, e.g., physical abuse, sexual assault) is partially mediated by neurobiological alterations in threat-related processes. Evidence supports parsing neural circuitry related to transient and sustained threat, as they appear to be separable processes with distinct neurobiological underpinnings. Although childhood is a sensitive period for neurodevelopment, most prior work has been conducted in adult samples. Further, it is unknown how IPV exposure may impact transient-sustained threat neural interactions. The current study tested the moderating role of IPV exposure on sustained vmPFC-transient amygdala co-activation during an fMRI task during which threat and neutral cues were predictably or unpredictably presented. Analyses were conducted in a sample of 212 community-recruited youth (M/SDage = 11.77/2.44 years old; 51.9% male; 56.1% White/Caucasian). IPV-exposed youth evidenced a positive sustained vmPFC-transient amygdala co-activation, while youth with no IPV exposure did not show this association. Consistent with theoretical models, effects were specific to unpredictable, negative trials and to exposure to IPV (i.e., unrelated to non-IPV traumatic experiences). Although preliminary, these findings provide novel insight into how childhood IPV exposure may alter neural circuity involved in specific facets of threat processing.

Inappropriate antibiotic use is a key driver of antibiotic resistance and one that can be mitigated through stewardship. A better understanding of current prescribing practices is needed to develop successful stewardship efforts. This study aims to identify factors that are associated with human cases of enteric illness receiving an antibiotic prescription. Cases of laboratory-confirmed enteric illness reported to the FoodNet Canada surveillance system between 2015 and 2019 were the subjects of this study. Laboratory data were combined with self-reported data collected from an enhanced case questionnaire that included demographic data, illness duration and symptoms, and antibiotic prescribing. The data were used to build univariable logistic regression models and a multivariable logistic regression model to explore what factors were associated with a case receiving an antibiotic prescription. The final multivariable model identified several factors as being significantly associated with cases being prescribed an antibiotic. Some of the identified associations indicate that current antibiotic prescribing practices include a substantial level of inappropriate use. This study provides evidence that antibiotic stewardship initiatives targeting infectious diarrhoea are needed to optimize antibiotic use and combat the rise of antibiotic resistance.

The expensive-tissue hypothesis (ETH) posited a brain–gut trade-off to explain how humans evolved large, costly brains. Versions of the ETH interrogating gut or other body tissues have been tested in non-human animals, but not humans. We collected brain and body composition data in 70 South Asian women and used structural equation modelling with instrumental variables, an approach that handles threats to causal inference including measurement error, unmeasured confounding and reverse causality. We tested a negative, causal effect of the latent construct ‘nutritional investment in brain tissues’ (MRI-derived brain volumes) on the construct ‘nutritional investment in lean body tissues’ (organ volume and skeletal muscle). We also predicted a negative causal effect of the brain latent on fat mass. We found negative causal estimates for both brain and lean tissue (−0.41, 95% CI, −1.13, 0.23) and brain and fat (−0.56, 95% CI, −2.46, 2.28). These results, although inconclusive, are consistent with theory and prior evidence of the brain trading off with lean and fat tissues, and they are an important step in assessing empirical evidence for the ETH in humans. Analyses using larger datasets, genetic data and causal modelling are required to build on these findings and expand the evidence base.

The washing of synthetic materials has been named as the largest contributor of microplastic pollution to our oceans. With the consumption of petrochemical-based synthetic materials expected to grow, due to an increased demand, the release of microplastic fibres to our environments is expected to also accelerate. To combat microplastic fibre release, this study explores source-directed interventions within the design and manufacturing process of textiles to reduce the amount of pollution released from the surface and the edges of the fabric structure. Using standardised wash tests and polyester fabric swatches that were created in-house with systematic structural adjustments, single jersey knit fabrics were shown to release over three times more microplastic pollution than twill woven fabric. This illustrates that increasing the tightness of a fabric could be implemented within the design of fabrics for environmental benefits. Additionally, the laser cutting technique reduced microplastic fibres released by over a third compared to scissor cutting and overlock serging, showing that the edge of the fabric is a significant source of microplastic pollution released during laundering. This research highlights the adaptable and innovative eco-design approaches to clothing production which is necessary to help the sector reach international sustainability targets and regulations.