School food has a major influence on children’s diet quality and has the potential to reduce diet inequalities and non-communicable disease risk. Funded by the UK Prevention Research Partnership, we have established a UK school food system network. The overarching aim was to build a community to work towards a more health-promoting food and nutrition system in UK schools. The network has brought together a team from a range of disciplines, while the inclusion of non-academic users and other stakeholders, such as pupils and parents, has allowed the co-development of research priorities and questions. This network has used a combination of workshops, working groups and pump-priming projects to explore the school food system, as well as creating a systems map of the UK school food system and conducting network analysis of the newly established network. Through understanding the current food system and building network expertise, we hope to advance research and policy around food in schools. Further funding has been achieved based on these findings, working in partnership with policymakers and schools, while a Nutrition Society Special Interest Group has been established to ensure maximum engagement and future sustainability of the network. This review will describe the key findings and progress to date based on the work of the network, as well as a summary of the current literature, identification of knowledge gaps and areas of debate, according to key elements of the school food system.

Background: Near-infrared spectroscopy regional cerebral oxygen saturation (rSO2) has gained interest as a raw parameter and as a basis for measuring cerebrovascular reactivity (CVR). This study aimed to identify threshold values of rSO2 and rSO2 based CVR at which outcomes worsened following traumatic brain injury (TBI). Methods: A retrospective multi-institutional cohort study was performed. The cerebral oxygen indices, COx (using rSO2 and cerebral perfusion pressure) as well as COx_a (using rSO2 and arterial blood pressure) were calculated for each patient. 2x2 tables were created grouping patients by alive/dead and favorable/unfavorable outcomes at various thresholds of COx and COx_a as well as rSO2 itself. Chi-square values were calculated to identify the most discriminative significant threshold. Results: In the cohort of 129 patients rSO2 did not have any statistically significant threshold value. For COx and COx_a, an optimal threshold value of 0.2 was identified for both survival and favorable outcomes with values above this associated with worse outcomes. Conclusions: In this study, raw rSO2was found to contain no significant prognostic information. However, rSO2 based indices of CVR, were found to have a uniform threshold of 0.2, above which clinical outcomes worsened. This study lays the groundwork to transition to less invasive means of continuously measuring CVR.

Compact obscured nuclei (CONs) are relatively common in the centers of local (U)LIRGs, yet their nature remains unknown. Both AGN activity and extreme nuclear starbursts have been suggested as plausible nuclear power sources. The prevalence of outflows in these systems suggest that CONs represent a key phase in the nuclear feedback cycle, in which material is ejected from the central regions of the galaxy. Here, we present results from MUSE for the confirmed local CON galaxy NGC4418. For the first time we spatially map the spectral features and kinematics of the galaxy in the optical, revealing several previously unknown structures. In particular, we discover a bilateral outflow along the minor axis, an outflowing bubble, several knot structures and a receding outflow partially obscured by the galactic disk. Based on the properties of these features, we conclude that the CON in NGC4418 is most likely powered by an AGN.

Antibiotic prescribing errors at hospital discharge are common. We designed a pharmacist-driven antimicrobial stewardship program to evaluate prescriptions prior to being transmitted to community pharmacies. Drug-related problems were identified in prescriptions for 48 of 149 patients, resulting in 55 interventions. Review at discharge improves outpatient prescribing of antimicrobials.

Overconsumption of free sugars, particularly from sugar-sweetened beverages (SSB), has potential negative health impacts. Implementation of a range of public health strategies is needed to reduce intakes of free sugars, including reducing portion sizes, promoting healthier dietary choices and reformulating foods and beverages. Although low-calorie sweeteners (LCS) are a useful tool for reducing energy intake and control glucose response when consuming sweet foods and drinks, several opinions persist about the adverse health effects of LCS, many of which are based on poor, little or no scientific evidence. This symposium report summarises key messages of the presentations and related discussions delivered at a scientific symposium at the 13th European Nutrition Conference (FENS 2019). These presentations considered the scientific evidence and current recommendations about the use and potential benefits of LCS for human health, with a particular focus on current evidence in relation to body weight and glycaemic control. Many of the studies to date on LCS have focused on low-calorie sweetened beverages (LCSB); however, the psychological and behavioural factors influencing consumer beliefs and consumption of LCSB need to be further explored. Current recommendations for LCS use are described, including the conclusions from a recent expert consensus report identifying the challenges that remain with LCS research. Finally, existing knowledge gaps and future actions are described, as well as two large ongoing research projects: SWITCH and SWEET.

Both obesity and type 2 diabetes mellitus have been associated with excessive free sugar consumption. Increasingly, LCS are used to replace free sugar to reduce the energy density of the diet, whilst maintaining diet palatability. However, while experimental data suggest a beneficial effect of LCS on weight management and glycaemic control, data from free-living populations are contradictory and primarily use reported intakes of low-calorie sweetened beverages as a marker of overall LCS consumption. Therefore, a dietary assessment tool that reliably assesses overall LCS consumption and is applicable in large-scale epidemiological studies is desirable. This study aimed to validate an LCS-focused food frequency questionnaire (FFQ) for assessing habitual dietary intake of the LCS using the method of triads. Healthy adults were recruited at Ulster University, Coleraine (n = 120). A 65-item FFQ and a 4-day food diary (FD) were used to assess dietary intake of LCS with amounts based on maximum permitted levels for foods and beverages as per EU legislation. A novel urinary biomarker approach, developed by this research group, was used to objectively assess consumption of 5 commonly used LCS(1). The method of triads was used to validate the FFQ by evaluating the correlations between the FFQ, FD and the urinary biomarkers (reference method). A total of 110 participants (51 males, 59 females) completed all analyses. Median (IQR) total LCS consumption estimated from the FFQ, FD and urinary biomarker was 116.8 (24.9–303.3) mg/d, 27.8 (0.0–247.3) mg/d and 5.0 (0.6–34.9) mg/d respectively. Moderate correlations were observed between the FD and urinary biomarker (r = 0.471; P < 0.001) and between the FFQ and FD (r = 0.471; P < 0.001). There was a low correlation between the FFQ and urinary biomarker (r = 0.291; P < 0.001). Using the method of triads, the overall validity co-efficient for the FFQ was moderate (0.54). These preliminary results indicate potential for this LCS-focused FFQ as a method of assessing LCS consumption in free-living populations. However, as maximum permitted levels of LCS in foods and beverages were used to estimate LCS consumption from the FFQ and FD, they are likely to significantly overestimate actual LCS intakes as compared to the more reliable biomarker approach. Therefore, the FFQ ability to categorise individuals into low-, medium- and high LCS consumers will be tested. Further analysis is ongoing to assess the completeness of urine collections using PABA analysis and will also focus on individual LCS intake.

Sleep has been shown to impact on both physical and mental health, and sleep problems present a considerable burden for individuals and society. There appears to be a complex bidirectional relationship between sleep disturbance and psychiatric symptoms, each potentially influencing the other. In particular, sleep disorders have been associated with more severe symptoms and are predictive of relapse in those with psychotic disorders. This article discusses the relationship between psychosis and insomnia, sleep apnoea, nightmares, circadian rhythm abnormalities and the impact of medications on these relationships. We also discuss the clinical implications of the relationship between sleep disturbance and psychotic disorders along with potential targets for intervention.

The classic problem of stability and transition to turbulence of an incompressible flow over a flat plate subjected to uniform suction through the surface is considered. This is an important “model” problem for laminar flow control and the results have direct application to the design of low drag aerofoils. Detailed mean boundary layer calculations are presented and the flow stability is determined by obtaining numerical solutions of the Orr-Somerfield equation. Transition conditions are estimated by using the semi-empirical en method. Accurate values have been obtained for the levels of suction necessary to delay instability and transition indefinitely. Consideration has also been given to the effect of surface suction upon the plate drag.

Background: Postoperative infection is a significant cause of morbidity and mortality in traumatic brain injury (TBI) patients who undergo craniotomy and/or craniectomy. Data on the rates of infections associated with these procedures are limited. We present a single-center retrospective study on the rates of infection in post-traumatic craniotomies, craniectomies and cranioplasties. Methods: Data on 100 TBI adult patients who underwent a craniotomy, craniectomy and/or cranioplasty from 2011-2015 will be analyzed. Demographic and perioperative data including open/closed TBI, peri/postoperative infections, duration of procedure, type and mode of bone flap preservation will be retrieved. Results: Following our data collection (to be completed by the end of February), we expect infection rates of 3-20% in our study. Upon instituting a protocol similar to the Hydrocephalus Clinical Research Network’s (HCRN) ventriculoperitoneal shunt (VP) protocol, we hope to reduce our post-TBI craniotomy/craniectomy/cranioplasty infections rates to less than 10%. Our projection is based on the HCRN protocol’s 3.15% absolute risk reduction of VP shunt infections. Conclusions: The results of this study will emphasize the need for instituting robust perioperative protocols to reduce infections. Further research will be pursued following this study to establish a protocol similar to the VP shunt protocol from the HCRN, in an attempt to reduce perioperative rates of infection.

Low-calorie sweeteners (LCS) are commonly used as sugar substitutes in the diet to provide a desired sweet taste without increased energy intake. The number of LCS available on the market has increased considerably over the years and despite extensive evaluation of their safety prior to approval, debate continues around the effects of consumption on health. In Europe, Member States are obligated to monitor exposure to LCS and methods currently used tend to rely on self-reported dietary intake data alongside LCS concentrations in products. However, the acquisition of accurate data can be costly in terms of resources and time and are inherently imprecise. Although LCS are intensely sweet, they are chemically diverse and a limitation of many studies investigating the health effects of consumption is that they often fail to discern intakes of individual LCS. An approach which objectively assesses intakes of individual LCS would therefore allow robust investigations of their possible effects on health. Biomarker approaches have been utilised for the objective investigation of intakes of a range of dietary components and the feasibility of any such approach depends upon its validity as well as its applicability within the target population. This review aims to provide an overview of current understanding of LCS intake and explore the possibility of implementing a biomarker approach to enhance such understanding. Several commonly used LCS, once absorbed into the body, are excreted via the kidneys; therefore a urinary biomarker approach may be possible for the investigation of short-term exposure to these compounds.

The aim of this study was to examine cross-sectionally whether higher cardiorespiratory fitness (CRF) might favorably modify amyloid-β (Aβ)-related decrements in cognition in a cohort of late-middle-aged adults at risk for Alzheimer’s disease (AD). Sixty-nine enrollees in the Wisconsin Registry for Alzheimer’s Prevention participated in this study. They completed a comprehensive neuropsychological exam, underwent 11C Pittsburgh Compound B (PiB)-PET imaging, and performed a graded treadmill exercise test to volitional exhaustion. Peak oxygen consumption (VO2peak) during the exercise test was used as the index of CRF. Forty-five participants also underwent lumbar puncture for collection of cerebrospinal fluid (CSF) samples, from which Aβ42 was immunoassayed. Covariate-adjusted regression analyses were used to test whether the association between Aβ and cognition was modified by CRF. There were significant VO2peak*PiB-PET interactions for Immediate Memory (p=.041) and Verbal Learning & Memory (p=.025). There were also significant VO2peak*CSF Aβ42 interactions for Immediate Memory (p<.001) and Verbal Learning & Memory (p<.001). Specifically, in the context of high Aβ burden, that is, increased PiB-PET binding or reduced CSF Aβ42, individuals with higher CRF exhibited significantly better cognition compared with individuals with lower CRF. In a late-middle-aged, at-risk cohort, higher CRF is associated with a diminution of Aβ-related effects on cognition. These findings suggest that exercise might play an important role in the prevention of AD. (JINS, 2015, 21, 841–850)