Globally, the burden of skin diseases is considerable, being the fourth largest cause of disability (1). Diet is a modifiable risk factor for many dermatological conditions and one of the mechanisms by which nutrition influences skin health is via the gut microbiome. Oral probiotics, prebiotics and synbiotics may have the potential to improve functional indicators of skin health and delay skin ageing (2).

This scoping review aimed to map the body of literature on the role of oral probiotics, prebiotics and synbiotics in maintaining and optimising skin health and function, and preventing and managing skin conditions, through the life course. The first stage of the scoping review, reported here, was the mapping of systematic reviews. The ongoing second stage involves the mapping of experimental and observational studies.

The scoping review was conducted in accordance with the JBI methodology for scoping reviews (3). Six electronic databases (MEDLINE, EMBASE, CENTRAL, CINAHL, Scopus and Web of Science) were systematically searched without limits on language or date, along with sources of grey literature. All sources were considered for inclusion by two reviewers based on previously established criteria using the participants, concept and context framework.

The titles and abstracts of 8,972 studies were screened and subsequently 1,034 full texts were retrieved. Finally, 521 studies were included in the scoping review of which 72 were systematic reviews and are analysed here.

Most reviews analysed the efficacy of oral probiotics (93%), with 13% and 18% of reviews considering oral prebiotics and oral synbiotics respectively. These interventions were most reviewed in infants aged 0-12 months (78%), pregnant mothers (47%), and/or younger children (43%) inclusively. Only 28% and 19% of reviews considered adults up to, and above, 60 years respectively. Most systematic reviews included participants who were either diagnosed with (42%), or at risk of a skin disease (28%) with just 4% reviewing effects in primarily healthy populations (24% did not confirm the included populations).

Outcomes related to preventing and managing a skin condition were studied by 97% of reviews; just 2 reviews examined optimising skin health and function (namely skin hydration, and epidermal thickness) in healthy populations. Atopic dermatitis (AD) was the most studied skin disease; 33 of 36 meta-analyses indicated a positive effect on its prevention, compared to 19 of 26 meta-analyses on AD severity. The remaining reviews investigated psoriasis (n=2), urticaria (n=2), and acne (n=2).

This review has identified a plethora of evidence synthesis on oral probiotics, prebiotics and synbiotics in AD, particularly in infants and children, and a paucity of evidence synthesis in healthy populations. The second stage of the review considering the underlying experimental and observational evidence will determine the scope for further evidence synthesis or confirm gaps in the experimental data to inform future research.

Lithofacies and biostratigraphical analysis has enabled the establishment of a stratigraphic event framework for Ludfordian and Pridoli strata in south Wales and the Welsh Borderland. In SW Wales, the Golden Grove Axis acted as a structural hinge separating the shallow marine storm-influenced Cae’r mynach Seaway from a pediment surface above which Ludfordian colluvium (Abercyfor Formation) was deposited. The Axis seeded four NW-derived river-influenced delta progrades of Leintwardinian to early Pridoli age (Tilestones Formation). A NE-sourced early Pridoli wave-influenced delta deposited the Downton Castle Sandstone Formation (DCSF), coeval to the youngest Tilestones prograde, with a lateral interface existing between Mynydd Epynt and the Clun Forest area. Except for the Malverns area, the DCSF is no longer recognized south of the Neath Disturbance. Early Pridoli forced regression promoted widespread subaerial exposure north of the Neath Disturbance, with incision into tracts close to the Welsh Borderland Fault System. The basinward-shift in facies belts resulted in marine erosion and deposition of a phosphatic ravinement pebble lag. The wave-influenced Clifford’s Mesne Sandstone Formation delta subsequently seeded on the Gorsley Axis with tidally influenced Rushall Formation accumulating in a back-barrier setting. The Pwll-Mawr Formation records the easterly advance of coeval coastal deposits on the western side of the remnant Cae’r mynach Seaway. Behind migrating delta coastlines, green muds accumulated on coastal plains (Temeside Mudstone Formation) with better drained red dryland alluvium (Moor Cliffs Formation) charting expansion of Old Red Sandstone lithofacies. Mid-Pridoli incision preserves the Pont ar Llechau Formation estuarine valley fill.

This paper provides an up-to-date review of the problems related to the generation, detection and mitigation of strong electromagnetic pulses created in the interaction of high-power, high-energy laser pulses with different types of solid targets. It includes new experimental data obtained independently at several international laboratories. The mechanisms of electromagnetic field generation are analyzed and considered as a function of the intensity and the spectral range of emissions they produce. The major emphasis is put on the GHz frequency domain, which is the most damaging for electronics and may have important applications. The physics of electromagnetic emissions in other spectral domains, in particular THz and MHz, is also discussed. The theoretical models and numerical simulations are compared with the results of experimental measurements, with special attention to the methodology of measurements and complementary diagnostics. Understanding the underlying physical processes is the basis for developing techniques to mitigate the electromagnetic threat and to harness electromagnetic emissions, which may have promising applications.

Introduction: One in nine (11.7%) people in Saskatchewan identifies as First Nations. In Canada, First Nations people experience a higher burden of cardiovascular disease when compared to the general population, but it is unknown whether they have different outcomes in out of hospital cardiac arrest (OHCA). Methods: We reviewed pre-hospital and inpatient records of patients sustaining an OHCA between January 1st, 2015 and December 31st, 2017. The population consisted of patients aged 18 years or older with OHCA of presumed cardiac origin occurring in the catchment area of Saskatoon's EMS service. Variables of interest included, age, gender, First Nations status (as identified by treaty number), EMS response times, bystander CPR, and shockable rhythm. Outcomes of interest included return of spontaneous circulation (ROSC), survival to hospital admission, and survival to hospital discharge. Results: In all, 372 patients sustained OHCA, of which 27 were identified as First Nations. First Nations patients with OHCA tended to be significantly younger (mean age 46 years vs. 65 years, p < 0.0001) and had shorter EMS response times (median times 5.3 minutes vs. 6.2 minutes, p = 0.01). There were no differences between First Nations and non-First Nations patients in terms of incidence of shockable rhythms (24% vs. 26%, p = 0.80), ROSC (42% vs. 41%, p = 0.87), survival to admission (27% vs 33%, p = 0.53), and survival to hospital discharge (15% vs. 12%, p = 0.54). Conclusion: In Saskatoon, First Nations patients sustaining OHCA appear to have similar survival rates when compared with non-First Nations patients, suggesting similar baseline care. Interestingly, First Nations patients sustaining OHCA were significantly younger than their non-First Nations counterparts. This may reflect a higher burden of cardiovascular disease, suggesting a need improved prevention strategies.

Eta Carinae is the most massive active binary within 10,000 light-years. While famous for the largest non-terminal stellar explosion ever recorded, observations reveal a supermassive (∼120 M⊙) binary consisting of an LBV and either a WR or extreme O star in a very eccentric orbit (e=0.9) with a 5.54-year period. Dramatic changes across multiple wavelengths are routinely observed as the stars move about in their highly elliptical orbits, especially around periastron when the hot (∼40 kK) companion star delves deep into the denser and much cooler (∼15 kK) extended wind photosphere of the LBV primary. Many of these changes are due to a dynamic wind-wind collision region (WWCR) that forms between the stars, plus expanding radiation-illuminated fossil WWCRs formed one, two, and three 5.54-year orbital cycles ago. These fossil WWCRs have been spatially and spectrally resolved by the Hubble Space Telescope/Space Telescope Imaging Spectrograph (HST/STIS) at multiple epochs, resulting in data cubes that spatially map Eta Carinae’s innermost WWCRs and follow temporal changes in several forbidden emission lines (e.g. [Fe iii] 4659 Å, [Fe ii] 4815 Å) across the 5.54-year cycle. We present initial results of 3D time-dependent hydrodynamical and radiative-transfer simulations of the Eta Carinae binary and its WWCRs with the goal of producing synthetic data cubes of forbidden emission lines for comparison to the available HST/STIS observations. Comparison of the theoretical models to the observations reveals important details about the binary’s orbital motion, photoionization properties, and recent (5–15year) mass loss history. Such an analysis also provides a baseline for following future changes in Eta Carinae, essential for understanding the late-stage evolution of a nearby supernova progenitor. Our modeling methods can also be adapted to a number of other colliding wind binary systems (e.g. WR 140) that are scheduled to be studied with future observatories (e.g. the James Webb Space Telescope).

Devonian rocks from the Orcadian Basin show an extreme range of organic maturity. Mean vitrinite reflectance ranges from 0·6 to 10·5% and spore colour from yellow-orange to black. Illite/smectite (I/S) is abundant in the clay fraction of lacustrine mudrocks and shows variation in expandability from 30 to <5%. A correlation is observed between expandability and vitrinite reflectance, but the specific relationship is different in the Moray Firth and the Caithness-Orkney areas. Illite ‘crystallinity’ measurements in the Caithness-Orkney area are also correlated with vitrinite reflectance. Geological evidence favours an I/S origin from precursor smectite, and mineral and chemical analyses of lacustrine shales show no evidence for regional differences in composition that might affect illitization rates. The different relationships within each region are believed to result from the different relative response of organic maturity indicators and clay minerals to temperature and reaction time. The lower I/S expandabilities in the Caithness-Orkney region at a given vitrinite reflectance are attributed to relatively longer burial times.

Potassium-bentonites have been found in the Courceyan Lower Limestone Shales near Burrington Combe and Oakhill, Somerset, consisting of thin, greenish yellow, plastic clays interbedded within a mudrock and limestone sequence. Mineralogically, the clay fraction is composed of virtually monomineralic interstratified illite-smectite containing 7–10% smectite layers. The clay fraction of the surrounding mudrocks, however, consists of an illite-chlorite dominated assemblage. Their mineral composition, trace element content, and the relative abundance of zircon crystals suggest an origin from burial of montmorillonite originally formed from volcanic ash. The presence of anomalously high trace element contents with both euhedral and rounded zircon grains in the Oakhill K-bentonites suggests a secondary or reworked origin for these samples. In contrast, the presence of a non-anomalous trace element content and large (>100 μm) euhedral zircon grains suggests that the Burrington K-bentonite is primary in origin. Modelling of whole-rock rare-earth element (REE) patterns shows that the Oakhill REE pattern can be derived from the Burrington pattern by the addition of small contributions from zircon and monazite, two major heavy minerals present. These K-bentonites probably represent the oldest Carboniferous K-bentonites so far recorded in the British Isles.

Introduction/Innovation Concept: Estimates suggest that up to eighty-seven percent of human trafficking victims have come into contact with a healthcare provider during their exploitation and yet less than ten percent of emergency medicine (EM) physicians feel confident in identifying a victim. When provided with the relevant tools, medical personnel can aid in the recognition of victims and take the necessary steps in providing appropriate care when they present to the emergency department. Identifying this need for increased awareness in the urgent care setting, a module on human trafficking was implemented into the undergraduate medical education and departmental grand rounds. Methods: After identifying gaps in current medical education regarding screening for victims of human trafficking, a literature review was completed on the topic in medical education and utilized in constructing a list of objectives. These were then reviewed by community organizations that aid victims of trafficking and the Canadian Alliance of Medical Students Against Human Trafficking. Undergraduate medical students completed surveys prior to and following the learning module, in order to evaluate improvement in acquired knowledge. Curriculum, Tool, or Material: A one-hour lecture from ACT Alberta was given to undergraduate medical students as well as to residents and staff in departmental grand rounds. The session met the following objectives: defining human trafficking, recognition of victims, and identification of next steps in providing care. Additionally, an online module from Fraser Health was made available as an additional resource with case studies specific to emergency departments. The surveys consisted of 13 questions evaluating students’ knowledge on human trafficking and its prevalence in emergency medicine. The questions were a combination of a Likert scale, multiple choice, and short answer. There was a large amount of positive feedback from the students and comparison of the surveys showed that their knowledge in identifying victims had significantly improved. Conclusion: Medical students, residents, and staff may come into contact with victims of trafficking in the emergency department and yet less than three percent of emergency physicians have had training on how to recognize a victim. Implementing human trafficking awareness will impact EM medical education by providing victims a greater chance of being recognized and offered help when they present to the emergency room.

Eta Carinae is one of the most massive observable binaries. Yet determination of its orbital and physical parameters is hampered by obscuring winds. However the effects of the strong, colliding winds changes with phase due to the high orbital eccentricity. We wanted to improve measures of the orbital parameters and to determine the mechanisms that produce the relatively brief, phase-locked minimum as detected throughout the electromagnetic spectrum. We conducted intense monitoring of the He ii λ4686 line in η Carinae for 10 months in the year 2014, gathering ~300 high S/N spectra with ground- and space-based telescopes. We also used published spectra at the FOS4 SE polar region of the Homunculus, which views the minimum from a different direction. We used a model in which the He ii λ4686 emission is produced by two mechanisms: a) one linked to the intensity of the wind-wind collision which occurs along the whole orbit and is proportional to the inverse square of the separation between the companion stars; and b) the other produced by the ‘bore hole’ effect which occurs at phases across the periastron passage. The opacity (computed from 3D SPH simulations) as convolved with the emission reproduces the behavior of equivalent widths both for direct and reflected light. Our main results are: a) a demonstration that the He ii λ4686 light curve is exquisitely repeatable from cycle to cycle, contrary to previous claims for large changes; b) an accurate determination of the longitude of periastron, indicating that the secondary star is ‘behind’ the primary at periastron, a dispute extended over the past decade; c) a determination of the time of periastron passage, at ~4 days after the onset of the deep light curve minimum; and d) show that the minimum is simultaneous for observers at different lines of sight, indicating that it is not caused by an eclipse of the secondary star, but rather by the immersion of the wind-wind collision interior to the inner wind of the primary.

Introduction: Between 1980 and 2008, survival rates following an out-of-hospital cardiac arrest (OHCA) have remained unchanged, averaging 7.6%. Despite the use of new and emerging technologies, new medications, and automated external defibrillators, survival remains low. Recently, a new focus in cardiopulmonary resuscitation (CPR) has shown dramatic improvements in survival post OHCA. This new model, called pit-crew CPR, focuses on minimizing interruptions in chest compressions and has each team member playing a specific role in the resuscitation, akin to the pit-crew of a car race. Certain districts in the United States and Canada have adopted the pit-crew, or a similar, high quality, maximum time-on-chest CPR model, with much success. We aim to determine whether the pit-crew model of CPR improves survival following OHCA in Saskatoon, SK. Methods: In Saskatoon, EMS and Fire crews respond to OHCAs and have been exclusively using the pit-crew model of CPR since Jan 1st, 2015. This study is a before and after retrospective chart analysis, comparing two groups - pre and post implementation of the pit-crew CPR model. The primary outcome is survival to hospital discharge post OHCA. Secondary outcomes include survival to admission and any return of spontaneous circulation (as per the Utstein definition). The inclusion criteria are patients >18 years old with a witnessed OHCA of presumed cardiac origin who receive CPR by EMS/Fire within the Saskatoon Ambulance service (MD Ambulance) catchment area. Patients were excluded if the OHCA was unwitnessed, or if there was a presumed non-cardiac cause for the arrest, e.g. trauma. Results: In the pre-pit-crew model cohort, between Jan 1st, 2011 and Sept 31st, 2014, 455 OHCAs were analyzed. In this cohort 10.5% survived to discharge, 31.9% survived to admission and ROSC was achieved in 39% of cases. The percentage of patients with initial rhythms of VF/VT, asystole or PEA were 28.5% (26%), 41.5% (1%) and 23.6% (10%) respectively, with survival to discharge shown in parentheses. The post-pit-crew cohort is still in the data collection phase. Conclusion: Our pre-pit crew cohort data has been collected and analyzed. With ongoing data acquisition for the post-pit crew cohort, we hope to have the full data set complete by the end of 2018. It will be at that time when we are able to determine whether the pit-crew model of CPR improves survival to discharge following OHCA in Saskatoon.

Cucullia umbratica Linnaeus (Lepidoptera: Noctuidae), Agnippe prunifoliella Chambers (Lepidoptera: Gelechiidae), and Bryotropha plantariella Tengstrom (Lepidoptera: Gelechiidae), were significant bycatch in pheromone-based trapping systems for red-striped fireworm, Aroga trialbamaculella Chambers (Lepidoptera: Gelechiidae), in Nova Scotia, Canada. Cucullia umbratica is a European introduced species and a new macrolepidopteran recorded in continental Canada. The only previous record of this moth in North America was from the Magdalen Islands (Québec, Canada). Potential attractants for B. plantariella, A. prunifoliella, and C. umbratica are a result of this bycatch investigation.

The present paper deals with the results of an investigation on a serious and common disorder of cider, generally known as cider sickness. The account here given is concerned with its characteristic features, its cause, and, as far as present knowledge permits, methods for its prevention. The disorder is due to the action of a bacterium. It is proposed to give a detailed account of the organism and its chemical activities in a supplementary paper.

We present results of two studies aiming at better understanding the properties of massive stars in the Galactic Center. We focus on the youngest and oldest of the three massive clusters harboring this region, namely the Arches and central cluster. We show that the development of powerful observational techniques in the near infrared spectral range (mainly 3D spectroscopy) allows to uncover the entire massive star population in these clusters. Using CMFGEN models, we derive the classical stellar and wind properties of 46 stars, as well as their surface abundances. The latter allow us to investigate in detail their evolutionary status and to identify evolutionary sequences between different types of stars. We thus constrain stellar evolution in the upper part of the HR diagram.

Ninety-three patients with histolofically or radiolofically confiemd unilateral vestibular schwannomas were recruited. Audiological testing for retrocochelar pathology was undertaken. Patients' hospital records were examined for previous audiological and radiological results.

The audiometric configuration was designated as one of the following normal, sloping, low frequency, peak, through or falt. A sloping sensorneural audiometric configuration was present in 68 pec cent of cases. No significant correlation was found between tumour size and average pure tone threshold 500 HZ to 4000 HZ, optimum discrimination score or interaural differences for wave V. Ninety-one per cent of cases had abnoramalities on auditory evoked potential; 92 per cent of cases showed abnormalities on stapedial reflex testing.

The limitations of audiologica testing in the investigation of patients with suspected unilateral vestibular schwannomas are discussed. A protocol for the investigation of such patients is presented.