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This study examined whether supplementation with collagen peptides (CP) affects appetite and post-exercise energy intake in healthy active females.
In this randomised, double-blind crossover study, 15 healthy females (23 ± 3 y) consumed 15 g/day of CP or a taste matched non-energy control (CON) for 7 days. On day 7, participants cycled for 45 min at ∼55% Wmax, before consuming the final supplement. Sixty min post supplementation an ad libitum meal was provided, and energy intake recorded. Subjective appetite sensations were measured daily for 6 days (pre- and 30 min post-supplement), and pre (0 min) to 280 min post-exercise on day 7. Blood glucose and hormone concentrations (total ghrelin, glucagon-like peptide-1 (GLP-1), and peptide YY (PYY), cholecystokinin (CCK), dipeptidyl peptidase-4 (sDPP4), leptin, and insulin, were measured fasted at baseline (day 0), then pre-breakfast (0 min), post-exercise (100 min), post-supplement (115, 130, 145, 160 min) and post-meal (220, 280 min) on day 7.
Ad-libitum energy intake was ∼10% (∼41kcal) lower in the CP trial (P=0.037). There was no difference in gastrointestinal symptoms or subjective appetite sensations throughout the trial (P≥0.412). Total plasma GLP-1 (area under the curve, CON: 6369±2330; CP: 9064±3021 pmol/L; P<0.001) and insulin (+80% at peak) were higher after CP (P<0.001). Plasma ghrelin and leptin were lower in CP (condition effect; P≤0.032). PYY, CCK, sDPP4 and glucose were not different between CP and placebo (P≥0.100).
CP supplementation following exercise increased GLP-1 and insulin concentrations and reduced ad libitum energy intake at a subsequent meal in physically active females.
Variation between general practices in the rate of consultations for musculoskeletal pain conditions may signal important differences in access to primary care, perceived usefulness, or available alternative sources of care; however, it might also just reflect differences in underlying ‘need’ between practices’ registered populations. In a study of 30 general practices in Staffordshire, we calculated the proportion of adults consulting for a musculoskeletal pain condition, then examined this in relation to selected practice and population characteristics, including the estimated prevalence of self-reported musculoskeletal problems and chronic pain in each practices’ registered population. Between September 2021 and July 2022, 18,388 adults were consulted for a musculoskeletal pain condition. After controlling for length of recruitment, time of year, and age-sex structure, the proportion consulting varied up to two-fold between practices but was not strongly associated with the prevalence of self-reported long-term musculoskeletal problems, chronic pain, and high-impact chronic pain.
The stars of the Milky Way carry the chemical history of our Galaxy in their atmospheres as they journey through its vast expanse. Like barcodes, we can extract the chemical fingerprints of stars from high-resolution spectroscopy. The fourth data release (DR4) of the Galactic Archaeology with HERMES (GALAH) Survey, based on a decade of observations, provides the chemical abundances of up to 32 elements for 917 588 stars that also have exquisite astrometric data from the Gaia satellite. For the first time, these elements include life-essential nitrogen to complement carbon, and oxygen as well as more measurements of rare-earth elements critical to modern-life electronics, offering unparalleled insights into the chemical composition of the Milky Way. For this release, we use neural networks to simultaneously fit stellar parameters and abundances across the whole wavelength range, leveraging synthetic grids computed with Spectroscopy Made Easy. These grids account for atomic line formation in non-local thermodynamic equilibrium for 14 elements. In a two-iteration process, we first fit stellar labels to all 1 085 520 spectra, then co-add repeated observations and refine these labels using astrometric data from Gaia and 2MASS photometry, improving the accuracy and precision of stellar parameters and abundances. Our validation thoroughly assesses the reliability of spectroscopic measurements and highlights key caveats. GALAH DR4 represents yet another milestone in Galactic archaeology, combining detailed chemical compositions from multiple nucleosynthetic channels with kinematic information and age estimates. The resulting dataset, covering nearly a million stars, opens new avenues for understanding not only the chemical and dynamical history of the Milky Way but also the broader questions of the origin of elements and the evolution of planets, stars, and galaxies.
Early gut microbiome development may impact brain and behavioral development. Using a nonhuman primate model (Macaca mulatta), we investigated the association between social environments and the gut microbiome on infant neurodevelopment and cognitive function. Infant rhesus monkeys (n = 33) were either mother-peer-reared (MPR) or nursery-reared (NR). Neurodevelopmental outcomes, namely emotional responsivity, visual orientation, and motor maturity, were assessed with the Primate Neonatal Neurobehavioral Assessment (PNNA) at 14–30 days. Cognitive development was assessed through tasks evaluating infant reward association, cognitive flexibility, and impulsivity at 6–8 months. The fecal microbiome was quantified from rectal swabs via 16S rRNA sequencing. Factor analysis was used to identify “co-abundance factors” describing patterns of microbial composition. We used multiple linear regressions with AIC Model Selection and differential abundance analysis (MaAsLin2) to evaluate relationships between co-abundance factors, microbiome diversity, and neuro-/cognitive development outcomes. At 30 days of age, a gut microbiome co-abundance factor, or pattern, with high Prevotella and Lactobacillus (β = −0.88, p = 0.04, AIC Weight = 68%) and gut microbiome alpha diversity as measured by Shannon diversity (β = −1.33, p = 0.02, AIC Weight = 80%) were both negatively associated with infant emotional responsivity. At 30 days of age, being NR was also associated with lower emotional responsivity (Factor 1 model: β = −3.13, p < 0.01; Shannon diversity model: β = −3.77, p < 0.01). The infant gut microbiome, along with early-rearing environments, may shape domains of neuro-/cognitive development related to temperament.
The main question of this Element is whether God has a personality. The authors show what the question means, why it matters, and that good sense can be made of an affirmative answer to it. A God with personality - complete with particular, sometimes peculiar, and even seemingly unexplainable druthers - is not at war with maximal perfection, nor is the idea irredeemably anthropomorphic. And the hypothesis of divine personality is fruitful, with substantive consequences that span philosophical theology. But problems arise here too, and new perspectives on inquiry itself. Our cosmos is blessed with weirdness aplenty. To come to know it is nothing less than to encounter a strange and untamed God.
For 50 years, the Thomas Wickham-Jones (TWJ) Foundation has promoted the advancement of otology and audiology in the UK and Republic of Ireland through a series of overseas Fellowships and other grants.
Methods:
The paper examines the history of the Foundation since its establishment in 1974, drawing upon the Foundation's archives and personal recollections. The analysis is located within a framework concerning the factors that shape the success or failure of a foundation including vision, strategy, information, leadership and finance.
Results:
The activities of the TWJ Foundation are charted over five decades, and the governance of the Foundation is detailed. Particular attention is given to the Major Fellowships offered, at first in North America, and to their subsequent development into the Foundation's current rotation.
Conclusion:
The paper offers an assessment of the TWJ Foundation's impact on the training of otologists in the British Isles and concludes with a brief self-reflective analysis.
This chapter provides an overview of the impacts of crisis and trauma on the LGBTQ+ populations. Additionally, the authors review barriers to seeking mental health services as they particularly apply to sexual and gender-expansive clients. Discussion of suicide and self-harm and of individual, group, and community violence are also provided. Finally, as a specific example, a case study from the Pulse nightclub shooting is presented.
Almost four decades of study of Desmoinesian strata of Middle Pennsylvanian age in south-central Iowa and north-central Missouri have provided the stratigraphic control required to test the variation of clay mineralogy vertically and laterally within various paralic clay and shale facies. Local and regional variations in clay mineralogy within Desmoinesian strata are generally predictable and are in agreement with current knowledge of deltaic deposition. A principal environmental variation within a deltaic system is the change from normal marine salinities in deltaic marine environments to brackish- and fresh-water conditions in the marshy delta plains, in upper interdistributary bays, and within flanking interdeltaic embayments. Changes from marine to nonmarine facies coincide with a decrease in illite, and an increase in kaolin, mixed-layer clays, and in the percentage of expansible layers in the mixed-layer clay. The principal clay detritus entering the area was illite, which underwent various degrees of alteration in different aqueous and subaerial environments within deltaic and interdeltaic areas. Clay-mineral composition alone does not provide unique environmental answers. The distribution of clay-mineral suites within these systems, however, both supports the deltaic-interdeltaic depositional model and can be understood within the context of this framework.
The crystal structure of nacrite from Pike’s Peak district, Colorado, has been refined by least squares and electron density difference maps utilizing ten levels of data. Complete refinement was inhibited by thick domains involving a/3 interlayer shifts in the “wrong direction”. The ideal structure is based on a 6R stacking sequence of kaolin layers, in which each successive layer is shifted relative to the layer below by −1/3 of the 8·9 Å lateral repeat. This direction is X in nacrite, contrary to the usual convention for layer silicates, because of the positioning of the (010) symmetry planes normal to the 5·1 Å repeat direction. Alternate layers are also rotated by 180°. The pattern of vacant octahedral sites reduces the symmetry to Cc and permits description of the structure as a 2-layer form with an inclined Z axis.
Adjacent tetrahedra are twisted by 7·3° in opposite directions so that the basal oxygens approach more closely both the Al cations in the same layer and the surface hydroxyls of the layer below. Interlocking corrugations in the oxygen and hydroxyl surfaces of adjacent layers run alternately parallel to the [110] and [11̄0] zones in successive layers. The upper and lower anion triads in each Al-octahedron are rotated by 5·4° and 7·0° in opposite directions as a result of shared edge shortening. Nacrite has a greater interlayer separation and smaller lateral dimensions than dickite and kaolinite, and the observed β angle deviates by 1½° from the ideal value. These features, as well as its overall lesser stability, are believed due to the less favorable positioning in nacrite of the basal oxygens relative to the directed interlayer hydrogen bonds.
Use of a platy internal standard that will orient to the same degree as clay minerals preserves the relative diffraction intensities between the basal reflections from the platy components, regardless of degree of orientation. The method is illustrated with basic zinc chloride and pyrophyllite as the internal standards for quantitative clay mineral analysis in the systems kaolinite-1Md illite and 2M1 muscovite-montmorillonite. Ulite does not orient to the same degree as kaolinite at high illite concentrations. In such nonlinear systems empirical working curves are more reliable than fixed ratios of the scattering powers of the clay minerals present. Random interstratification of 10/15.4Å layers causes a minimum in 001/001 peak height at about 33% of the 15.4Å component. Peak width varies in a similar but inverse pattern, so that the integrated intensity increases in a smooth curve from muscovite to montmorillonite. The major error in application of this quantitative method arises from uncertainty as to the correct allocation of peak areas in cases of overlap of the mixed-layer peak with those of discrete 10 Å and 14 Å clays also present.
OBJECTIVES/GOALS: Clinical indicators predictive of venous thromboembolism (VTE) in trauma patients at multiple time points are not well outlined, particularly at time of discharge. We aimed to describe and predict inpatient and post-discharge risk factors of VTE after trauma using a multi-variate regression model and best of class machine learning (ML) models. METHODS/STUDY POPULATION: In a prospective, case-cohort study, all trauma patients (pts) who arrived as level 1 or 2 trauma activations, from June 2018 to February 2020 were considered for study inclusion. A subset of pts who developed incident, first time, VTE and those who did not develop VTE within 90 days of discharge were identified. VTE were confirmed either by imaging or at autopsy during inpatient stay or post-discharge. Outcomes were defined as the development of symptomatic VTE (DVT and/or PE) within 90 days of discharge.A multi-variate Cox regression model and a best in class of a set of 5 different ML models (support-vector machine, random-forest, naives Bayes, logistic regression, neural network]) were used to predict VTE using models applied a) at 24 hours of injury date or b) on day of patient discharge. RESULTS/ANTICIPATED RESULTS: Among 393 trauma pts (ISS=12.0, hospital LOS=4.0 days, age=48 years, 71% male, 96% with blunt mechanism, mortality 2.8%), 36 developed inpatient VTE and 36 developed VTE after discharge. In a weighted, multivariate Cox model, any type of surgery by day 1, increased age per 10 years, and BMI per 5 points were predictors of overall symptomatic VTE (C-stat 0.738). Prophylactic IVC filter placement (4.40), increased patient age per 10 years, and BMI per 5 points were predictors of post-discharge symptomatic VTE (C-stat= 0.698). A neural network ML model predicted VTE by day 1 with accuracy and AUC of 0.82 and 0.76, with performance exceeding those of a Cox model. A naīve Bayesian ML model predicted VTE at discharge, with accuracy and AUC of 0.81 and 0.77 at time of discharge, with performance exceeding those of a Cox model. DISCUSSION/SIGNIFICANCE: The rate of inpatient and post-discharge VTEs remain high. Limitations: single institution study, limited number of patients, internal validation only, with the use of limited number of ML models. We developed and internally validated a ML based tool.Future work will focus on external validation and expansion of ML techniques.
To evaluate temporal trends in the prevalence of gram-negative bacteria (GNB) with difficult-to-treat resistance (DTR) in the southeastern United States. Secondary objective was to examine the use of novel β-lactams for GNB with DTR by both antimicrobial use (AU) and a novel metric of adjusted AU by microbiological burden (am-AU).
Design:
Retrospective, multicenter, cohort.
Setting:
Ten hospitals in the southeastern United States.
Methods:
GNB with DTR including Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter spp. from 2015 to 2020 were tracked at each institution. Cumulative AU of novel β-lactams including ceftolozane/tazobactam, ceftazidime/avibactam, meropenem/vaborbactam, imipenem/cilastatin/relebactam, and cefiderocol in days of therapy (DOT) per 1,000 patient-days was calculated. Linear regression was utilized to examine temporal trends in the prevalence of GNB with DTR and cumulative AU of novel β-lactams.
Results:
The overall prevalence of GNB with DTR was 0.85% (1,223/143,638) with numerical increase from 0.77% to 1.00% between 2015 and 2020 (P = .06). There was a statistically significant increase in DTR Enterobacterales (0.11% to 0.28%, P = .023) and DTR Acinetobacter spp. (4.2% to 18.8%, P = .002). Cumulative AU of novel β-lactams was 1.91 ± 1.95 DOT per 1,000 patient-days. When comparing cumulative mean AU and am-AU, there was an increase from 1.91 to 2.36 DOT/1,000 patient-days, with more than half of the hospitals shifting in ranking after adjustment for microbiological burden.
Conclusions:
The overall prevalence of GNB with DTR and the use of novel β-lactams remain low. However, the uptrend in the use of novel β-lactams after adjusting for microbiological burden suggests a higher utilization relative to the prevalence of GNB with DTR.
The emergence and dissemination of new legal ideas can play an important role in sparking change in the way activists in marginalized communities understand their rights and pursue their objectives. How and why do the legal beliefs of such communities evolve? We argue that the vigorous advocacy of new legal ideas by entrepreneurs and the harnessing of specialized media to help disseminate those ideas are important mechanisms in this evolution. We use the rise of marriage equality as a central legal priority in the mainstream American LGBTQ+ rights movement as a case study to illustrate this phenomenon. Using a mixed-methods analysis of Evan Wolfson’s legal advocacy and an examination of The Advocate, we investigate how Wolfson developed and disseminated legal ideas about same-sex marriage. We show how this advocacy eventually dominated discussion of the issue among elite LGBTQ+ legal actors and the nation’s largest LGBTQ+ publication. However, Wolfson’s advocacy tended to emphasize LGBTQ+ integration into “mainstream” American culture and prioritized the interests and values of relatively privileged subgroups within the LGBTQ+ community. Our research informs our understanding of the interplay between legal advocacy and media reporting in the development of LGBTQ+ rights claims and the strategies adopted to achieve them.
Scholars have long questioned whether and how courts influence society. We contribute to this debate by investigating the ability of judicial decisions to shape issue attention and affect toward courts in media serving the LGBTQ+ community. To do so, we compiled an original database of LGBTQ+ magazine coverage of court cases over an extended period covering major decisions, including Lawrence v. Texas (2003), Goodridge v. Massachusetts Department of Public Health (2003), and Lofton v. Secretary of Department of Children & Family Services (2004). We argue these cases influence the volume and tone of LGBTQ+ media coverage. Combining computational social science techniques with qualitative analysis, we find increased attention to same-sex marriage after the decisions in Lawrence, Goodridge, and Lofton, and the coalescence of discussions of courts around same-sex marriage after Lawrence. We also show how LGBTQ+ media informed readers about the political and legal implications of struggles over marriage equality.
To improve contact tracing for healthcare workers, we built and configured a Bluetooth low-energy system. We predicted close contacts with great accuracy and provided an additional contact yield of 14.8%. This system would decrease the effective reproduction number by 56% and would unnecessarily quarantine 0.74% of employees weekly.
Exploring the work of writers, illuminators, and craftspeople, this volume demonstrates the pervasive nature of architecture as a category of medieval thought. The architectural remnants of the past - from castles and cathedrals to the lowliest village church - provide many people with their first point of contact with the medieval period and its culture. Such concrete survivals provide a direct link to both the material experience of medieval people and the ideological and imaginative worldview which framed their lives. The studies collected in this volume show how attention to architectural representation can contribute to our understanding of not only the history of architectural thought but also the history of art, the intersection between textual and material culture, and the medieval experience of space and place.
For bilinguals, lexical access in one language may affect, or be affected by, activation of words in another language. Research to date suggests seemingly contradictory effects of such cross-linguistic influence (CLI): in some cases CLI facilitates lexical access while in others it is a hindrance. Here we provide a comprehensive review of CLI effects drawn from multiple disciplines and paradigms. We describe the contexts within which CLI gives rise to facilitation and interference and suggest that these two general effects arise from separate mechanisms that are not mutually exclusive. Moreover, we argue that facilitation is ubiquitous, occurring in virtually all instances of CLI, while interference is not always present and depends on levels of cross-language lexical competition. We discuss three critical factors – language context, direction, and modality of CLI – which appear to modulate facilitation and interference. Overall, we hope to provide a general framework for investigating CLI in future research.