While the pathophysiology affecting patients after Fontan palliation versus those with orthostatic intolerance is quite different, a common therapeutic approach exists. Exercise training, specifically augmenting the lower extremity skeletal muscle pump, improves the suboptimal haemodynamics of “preload failure” and thus clinical outcomes for each patient group. In this review, we will describe the problematic physiology affecting these patients, examine the anatomy and haemodynamics of the skeletal muscle pump, and finally review how exercise benefits both groups of patients through augmentation of musculovenous force.

This review aims to highlight the relative importance of cardiovascular disease (CVD) lifestyle-associated risk factors among individuals with inflammatory bowel disease (IBD) and examine the effectiveness of lifestyle interventions to improve these CVD risk factors. Adults with IBD are at higher risk of CVD due to systemic and gut inflammation. Besides that, tobacco smoking, dyslipidaemia, hypertension, obesity, physical inactivity and poor diet can also increase CVD risk. Typical IBD behavioural modification including food avoidance and reduced physical activity, as well as frequent corticosteroid use, can further increase CVD risk. We reviewed seven studies and found that there is insufficient evidence to conclude the effects of diet and/or physical activity interventions on CVD risk outcomes among populations with IBD. However, the limited findings suggest that people with IBD can adhere to a healthy diet or Mediterranean diet (for which there is most evidence) and safely participate in moderately intense aerobic and resistance training to potentially improve anthropometric risk factors. This review highlights the need for more robust controlled trials with larger sample sizes to assess and confirm the effects of lifestyle interventions to mitigate modifiable CVD risk factors among the IBD population.

Collective synchrony refers to the simultaneous occurrence of behavior, cognition, emotion, and/or physiology within teams of three or more persons. It has been suggested that collective synchrony may emanate from the copresence of team members, from their engagement in a shared task, and from coordination enacted in pursuit of a collective goal. In this paper, a regime-switching dynamic factor analytical approach is used to examine interindividual similarities in a particular behavioral measure (i.e., speed) in a collegiate soccer team. First, the analytical approach is presented didactically, including the state space modeling framework in general, followed by the regime-switching dynamic factor model in particular. Next, an empirical application of the approach is presented. Speed similarity (covariation in speed, operationalized in two ways: running cadence and distance covered) during competitive women’s soccer games is examined. A key methodological aspect of the approach is that the collective is the unit of analysis, and individuals vary about collective dynamics and their evolution. Reporting on the results of this study, we show how features of substantive interest, such as the magnitude and prevalence of behavioral similarity, can be parameterized, interpreted, and aggregated. Finally, we highlight several key findings, as well as opportunities for future research, in terms of methodological and substantive aims for advancing the study of collective synchrony.

Cows’ milk (CM) and plant-based beverages (PBB), used as milk alternatives, are not nutritionally equivalent(1) and PBB composition is highly varied(2). However, assessing the potential nutritional risk for UK populations after dietary replacement of milk with PBB is challenging, because analytical determination of PBBs’ nutrient profiles is lacking(3). This study determined and compared the mineral concentrations of milk and PBB in the UK market.

Ultra-heat treated and pasteurised samples (n = 178), including 20 brands of semi-skimmed milks and 69 brands of fortified PBBs (based on almond (17; ALMO), coconut (14; COCO), oat (19; OAT) and soya (20; SOYA)) were collected in summer 2023 and winter 2024. All PBB samples had added Ca and Na, but only 62 were fortified with I. Minerals concentration was determined using microwave assisted digestion, inductively coupled plasma-optical emission spectrometry (for microminerals) and inductively coupled plasma and mass spectrometry (for trace elements and heavy metals). Data were analysed using Minitab®22.1, with linear mixed effects models using ingredient, thermal treatment and season, and their interactions, as fixed factors, and brand ID as a random factor.

The main ingredient affected all mineral concentrations (p<0.001), except Ca and Co. SOYA had more Mg than milk (+27.5mg/kg), and milk had more Mg than ALMO, COCO, and OAT (+41.783.3mg/kg). Milk and SOYA had more P and K than other PBB (P, +411 mg/kg and +381mg/kg; K, +920 mg/kg, and +631 mg/kg, respectively). Milk had less Na than PBB (-126-64 mg/kg) with the exception of COCO. Milk contained more I (+157-200.4 µg/kg) and Zn (+1.41-3.71 mg/kg) than PBB. SOYA contained more Cu, Mg, and Mo than other PBB (for Cu 65-70 mg/kg; for Mn +1.00-1.06 mg/kg; for Mo +46-93.5 µg/kg, respectively) and milk (Cu +0.77 mg/kg; Mn +1.44 mg/kg; Mo +84.1 µg/kg). Overall, SOYA contained the most Cd, Cr, and Ni (although difference to OAT was not significant for Cr and Ni), while milk had the lowest concentration of Cd. Concentrations of Mg, P, Cu, I, Mn, Mo, and Co varied according to season (P<0.05). When compared with summer, winter PBB and milk had more Mg (+4.4 mg/kg), Cu (+0.04 mg/kg), I (+41 µg/kg), and Mo (+9.8 µg/kg), but less P (-76 mg/kg), Mn (−0.08 mg/kg), Zn (−0.21 mg/kg), and Co (-5.21 μg/kg). There were no differences in mineral concentrations due to thermal processing (UHT, pasteurisation; P>0.05).

The minerals composition of fortified PBB varied between main ingredient, and compared to milk, and seasonal variation was high. To prevent micronutrient inadequacies from the substitution of milk for PBB (in particular for I and Zn), consumers should be aware of differences in the intrinsic nutrient composition between PBB derived from different ingredients and milk, as this study showed and adopt suitable dietary and supplementation adjustments.

Patients with inflammatory bowel disease (IBD) have higher risk of developing cardiometabolic diseases due to chronic gut and systemic inflammation which promotes atherogenesis. Adopting healthy lifestyle habits can prevent development of cardiometabolic diseases, but can be challenging for people with IBD. The IBD exercise and diet (IBDeat) habits study describes the lifestyle habits and cardiometabolic disease risk factors of adults with IBD in Aotearoa, New Zealand (NZ).

This is a cross-sectional study including adult NZ IBD patients recruited online via Crohn’s and Colitis NZ and Dunedin hospital from 2021 to 2022. An online questionnaire collected demographics, smoking status, comorbidities, medications, disease severity scores, quality of life, physical activity, and dietary intake. The Dunedin cohort had physical measurements taken including anthropometrics, handgrip strength, blood pressure, body composition (bioelectrical impedance), blood nutritional markers, and faecal calprotectin. Data were compared to established reference values and linear regression analysis investigated associations between lifestyle habits and cardiometabolic risk factors. The study received University of Otago ethical approval (reference: H21/135). A total of 213 adults with IBD (54% Crohn’s disease; 46% ulcerative colitis) completed the online questionnaire and a subset of 102 from Dunedin provided physical measurements. Participants characteristics were: median age 37 (IQR 25, 51) years, 71% female, 82% NZ European, 4% smokers, and 1.4% had active IBD. Thirty-five percent of participants had at least one comorbidity and 34% of participants had poor quality of life. Known dietary risk factors associated with cardiometabolic diseases were common: low intakes of vegetables (77%), fruit (51%), fibre (35%) and high intakes of total fat (84%) and saturated fat (98%). Physical activity recommendations were met by 61% of participants and 63% reported barriers to being more active from fatigue (63%) and joint pain (54%). Other cardiometabolic risk factors were common in the Dunedin cohort: high LDL (79%) and total cholesterol (76%), central adiposity (64%), high body fat percentage (44%), high blood pressure (26%), and low handgrip strength (25%). Regression analysis showed that vegetable (per serve) and carbohydrate (per 5% of total daily energy intake (TE)) were associated with 0.22 mmol/L (95%CI 0.43, 0.013) and 0.20 mmol/L (95%CI 0.34, 0.057) lower LDL cholesterol. Discretionary food items were associated with higher LDL cholesterol, 0.11 mmol/L per daily serve (95%CI 0.028, 0.19). A 5% difference in TE intake from carbohydrate was associated with 1.11% (95%CI 2.22%, 0.0038%) lower body fat percentage while protein was associated with 3.1% (95%CI 0.81%, 5.39%) higher body fat percentage. Physical activity had weak associations with cardiometabolic disease risk factors. Adults with IBD have multiple modifiable risk factors for cardiometabolic diseases. Vegetable and carbohydrate intake were associated with lower LDL cholesterol concentration while discretionary food items showed otherwise. Protein intake was associated with higher body fat percentage.

Sustainability of DBT programmes and the factors which potentially influence this has received little attention from researchers. In this article, we review the literature reporting on sustainability of DBT programmes in outpatient settings. We also seek to advance the limited knowledge on this topic by reporting on the sustainability of DBT programmes delivered by teams that trained via a coordinated implementation approach in Ireland. As part of this perspective piece we conducted a systematic literature search which identified four studies reporting on DBT programme sustainability. All four reported on programmes delivered by teams that had received training as per the DBT Intensive Training Model. The findings of these studies are summarised and we consider the effect on DBT programme sustainability of introducing a coordinated implementation approach in Ireland.

Studies examining the neurocognitive and circuit-based etiology of psychiatric illness are moving toward inclusive, global designs. A potential confounding effect of these associations is general intelligence; however, an internationally validated, harmonized intelligence quotient (IQ) measure is not available. We describe the procedures used to measure IQ across a five-site, multinational study and demonstrate the harmonized measure’s cross-site validity. Culturally appropriate intelligence measures were selected: four short-form Wechsler intelligence tests (Brazil, Netherlands, South Africa, United States) and the Binet Kamat (India). Analyses included IQ scores from 255 healthy participants (age 18–50; 42% male). Regression analyses tested between-site differences in IQ scores, as well as expected associations with sociodemographic factors (sex, socioeconomic status, education) to assess validity. Harmonization (e.g., a priori selection of tests) yielded the compatibility of IQ measures. Higher IQ was associated with higher socioeconomic status, suggesting good convergent validity. No association was found between sex and IQ at any site, suggesting good discriminant validity. Associations between higher IQ and higher years of education were found at all sites except the United States. Harmonized IQ scores provide a measure of IQ with evidence of good validity that can be used in neurocognitive and circuit-based studies to control for intelligence across global sites.

In low-resource settings, valid mental health screening tools for non-specialists can be used to identify patients with psychiatric disorders in need of critical mental health care. The Mental Wellness Tool-13 (mwTool-13) is a 13-item screener for identifying adults at risk for common mental disorders (CMDs) alcohol-use disorders (AUDs), substance-use disorders (SUD), severe mental disorders (SMDs), and suicide risk (SR). The mwTool-13 is administered in two steps, specifically, only those who endorse any of the initial three questions receive the remaining ten questions. We evaluated the performance of mwTool-13 in South Africa against a diagnostic gold standard. We recruited a targeted, gender-balanced sample of adults, aged ≥18 years at primary and tertiary healthcare facilities in Eastern Cape Province. Of the 1885 participants, the prevalence of CMD, AUD, SMD, SR, and SUD was 24.4%, 9.5%, 8.1%, 6.0%, and 1.6%, respectively. The mwTool-13 yielded high sensitivities for CMD, SMD, and SR, but sub-optimal sensitivities for AUD and SUD (56.7% and 64.5%, respectively). Including a single AUD question in the initial question set improved the tool’s performance in identifying AUD and SUD (sensitivity > 70%), while maintaining brevity, face-validity, and simplicity in the South African setting.

Research has suggested that childhood-onset conduct problems (CPs) are more strongly related to individual predispositions, whereas adolescent-onset CP is more strongly associated with social factors, such as peer delinquency. Neighborhood disadvantage (ND) increases the risk for associating with deviant peers. Thus, peer delinquency could mediate the relationship between ND and adolescent-onset CP. This mediational hypothesis has not been tested previously. We tested this hypothesis in 1,127 justice-involved adolescent males using self-reported delinquency and official arrest records over 3 years after the youth’s first arrest as outcomes. Predictors were self-reported and census-derived indicators of ND and self-reported peer delinquency. Age of onset moderated the associations between self-reported ND and arrests and between self-report of peer delinquency and arrests. In both cases, the association was stronger for those with adolescent-onset CP. Peer delinquency mediated all relationships between ND and CP. Our results also showed some unexpected differences in associations depending on whether self-reported ND or census-derived indicators were used as predictors. Specifically, census-derived ND was negatively related to self-reported offending, which could be due to the use of an arrested sample and the need for youth in more advantaged neighborhoods to show a more severe pattern of antisocial behavior to be arrested.

Background: Following craniotomy, there is widespread agreement that post-operative neurological impairments require specialized evaluation to evaluate fitness to drive. However, for patients who had a craniotomy and do not have neurological deficits or known seizures, there is less consensus as to when return to driving is safe. In this study, we aim to review existing guidelines regarding driving post-craniotomy and assess the current practices for post-craniotomy recommendations in Canada. Methods: Our study has three components: 1) systematic review of existing guidelines for return to driving after cranial procedure; 2) review of primary evidence (cohort studies) regarding seizure risk following a craniotomy, depending of the underlying pathology; 3) online questionnaire distributed to Canadian neurosurgeons by the Canadian Neurosurgery Collaborative (CNRC) network. Results: Our systematic review unveiled various sets of guidelines for driving after a craniotomy. For instance, UK Driving and Vehicle Licensing Agency writes into law specific guidelines for return to driving varying based on underlying pathology. Their results were drawn from large cohort studies measuring the occurrence of post-operative seizures after craniotomy for a variety of conditions. The questionnaire is currently being distributed to Canadian neurosurgeons. Conclusions: Our study lays the first steps towards the development of Canadian guidelines for return to driving post-craniotomy.

Research on proactive and reactive aggression has identified covariates unique to each function of aggression, but hypothesized correlates have often not been tested with consideration of developmental changes in or the overlap between the types of aggression. The present study examines the unique developmental trajectories of proactive and reactive aggression over adolescence and young adulthood and tests these trajectories’ associations with key covariates: callous–unemotional (CU) traits, impulsivity, and internalizing emotions. In a sample of 1,211 justice-involved males (ages 15–22), quadratic growth models (i.e., intercepts, linear slopes, and quadratic slopes) of each type of aggression were regressed onto quadratic growth models of the covariates while controlling for the other type of aggression. After accounting for the level of reactive aggression, the level of proactive aggression was predicted by the level of CU traits. However, change in proactive aggression over time was not related to the change in any covariates. After accounting for proactive aggression, reactive aggression was predicted by impulsivity, both at the initial level and in change over time. Results support that proactive and reactive aggression are unique constructs with separate developmental trajectories and distinct covariates.

Optimum nutrition plays a major role in the achievement and maintenance of good health. The Nutrition Society of the UK and Ireland and the Sabri Ülker Foundation, a charity based in Türkiye and focused on improving public health, combined forces to highlight this important subject. A hybrid conference was held in Istanbul, with over 4000 delegates from sixty-two countries joining the proceedings live online in addition to those attending in person. The primary purpose was to inspire healthcare professionals and nutrition policy makers to better consider the role of nutrition in their interactions with patients and the public at large to reduce the prevalence of non-communicable diseases such as obesity and type 2 diabetes. The event provided an opportunity to share and learn from different approaches in the UK, Türkiye and Finland, highlighting initiatives to strengthen research in the nutritional sciences and translation of that research into nutrition policy. The presenters provided evidence of the links between nutrition and disease risk and emphasised the importance of minimising risk and implementing early treatment of diet-related disease. Suggestions were made including improving health literacy and strengthening policies to improve the quality of food production and dietary behaviour. A multidisciplinary approach is needed whereby Governments, the food industry, non-governmental groups and consumer groups collaborate to develop evidence-based recommendations and appropriate joined-up policies that do not widen inequalities. This summary of the proceedings will serve as a gateway for those seeking to access additional information on nutrition and health across the globe.

In porcine in vitro production (IVP) systems, the use of oocytes derived from prepubertal gilts, whilst being commercially attractive, remains challenging due to their poor developmental competence following in vitro maturation (IVM). Follicular fluid contains important growth factors and plays a key role during oocyte maturation; therefore, it is a common supplementation for porcine IVM medium. However, follicular fluid contains many poorly characterized components, is batch variable, and its use raises biosecurity concerns. In an effort to design a defined IVM system, growth factors such as cytokines have been previously tested. These include leukaemia inhibitory factor (LIF), fibroblast growth factor 2 (FGF2), and insulin-like growth factor 1 (IGF1), the combination of which is termed ‘FLI’. Here, using abattoir-derived oocytes in a well established porcine IVP system, we compared follicular fluid and FLI supplementation during both IVM and embryo culture to test the hypothesis that FLI can substitute for follicular fluid without compromising oocyte nuclear and cytoplasmic maturation. We demonstrate that in oocytes derived from prepubertal gilts, FLI supplementation enhances oocyte meiotic maturation and has a positive effect on the quality and developmental competence of embryos. Moreover, for the first time, we studied the effects of follicular fluid and FLI combined showing no synergistic effects.

For 20 years the UK Government has recognised that food advertising plays a part in food choices and hence diets of the population, particularly for children. In 2007 the UK brought in regulations to stop the advertising of less healthy foods on television (TV) during child-specific programming. Less healthy foods were defined using the 2004/2005 nutrient profiling model (NPM) as products high in saturated fat, salt and sugar (HFSS). Evaluations showed that children were still seeing and being affected by the adverts for less healthy foods. To try to mitigate childhood obesity, in 2018, the UK Government announced its intention to consult on further restrictions on the advertising of HFSS products on TV and online. Two years later, the intention to implement a 9pm advertising ban on TV and a further consultation on restricting online advertising of HFSS products was announced. New legislative controls on the advertising of HFSS foods are expected to be brought into legislation in the UK in January 2024. In the present paper, the history of advertising restrictions in the UK and the evidence informing them is reviewed. There will also be a reflection on where further actions might be needed in due course.

The energetic cost of walking varies with mass and speed; however, the metabolic cost of carrying loads has not consistently increased proportionally to the mass carried. The cost of carrying mass, and the speed at which human walkers carry this mass, has been shown to vary with load position and load description (e.g. child vs. groceries). Additionally, the preponderance of women carriers around the world, and the tendency for certain kinds of population-level sexual dimorphism has led to the hypothesis that women might be more effective carriers than men. Here, I investigate the energetic cost and speed changes of women (N = 9) and men (N = 6) walking through the woods carrying their own babies (mean baby mass = 10.6 kg) in three different positions – on their front, side and back using the same Ergo fabric baby sling. People carrying their babies on their backs are able to maintain their unloaded walking speed (1.4 m/s) and show the lowest increase in metabolic cost per distance (J/m, 17.4%). Women carry the babies for a lower energetic cost than men at all conditions (p < 0.01). Further energetic and kinematic evidence elucidates the preponderance of back-carrying cross-culturally, and illustrates the importance of relatively wider bi-trochanteric breadths for reducing the energetic costs of carrying.

On soils dominated by high proportions of clay and organic matter, soil acidity and poor nutrient use efficiency have a major impact on output potential. Due to the inherent chemical properties of these soils, reducing soil acidity and the prevalence of undesirable metallic cations poses challenges. As a result, these soils have a large capacity for phosphorus (P) fixation, therefore reducing plant P availability. Limestone (CaCO3 or MgCO3) is applied to agricultural soils to counteract soil acidity and reduce P fixation. The current study investigates the effects of four contrasting annual P application rates (0, 50, 100, 150 kg P/ha); split (50:50) between spring and summer, across soils with a range of soil pH values from a previous liming trial. The effect of soil pH ranges and P treatment rates on seasonal herbage growth and herbage P concentration was investigated over three years. Soil nutrient status was also investigated. Soil pH had a significant impact on the rate of mineralization and soil P concentration across each site. A soil pH of 6.2 caused a 1.8 mg/l increase in soil test P. An annual P application was necessary to maintain sufficient herbage P concentration for animal dietary requirements (0.35% DM), however there was no effect of P application or liming rate on herbage productivity across the three sites as all sites possessed sufficient soil P reserves. The current experiment has shown that despite optimal soil fertility status, ensuring sufficient plant available P is a problem on these particular soils.

OBJECTIVES/GOALS: #NAME? METHODS/STUDY POPULATION: Cell culture & protein identification: human T cells were purified from healthy blood, then activated & cultured for 5d. CAR-T cells were collected from infusion bags of cancer patients undergoing CAR-T. Silver staining of naive & activated healthy T-cell lysates was compared; B-II spectrin was upregulated and confirmed by Western blot. Migration assays: naive & activated T-cells were imaged during migration on ICAM-1 and ICAM-1 + CXCL12 coated plates. T-cells were transfected with BII-spectrin cDNA & the chemokine dependence of migration was compared with controls. In-vivo studies: in a melanoma mouse model, BII-spectrin transfected or control T-cells were injected; tumors were followed with serial imaging. Human patient records were examined to correlate endogenous BII-spectrin levels and CAR-T response. RESULTS/ANTICIPATED RESULTS: Activated T-cells downregulate the cytoskeletal protein B-II spectrin compared to naive cells, leading to chemokine-independent migration in in vitro assays and off-target trafficking when CAR-T cells are given in vivo. Restoration of B-II spectrin levels via transfection restores chemokine-dependence of activated T-cells. In a mouse melanoma model, control mice injected with standard activated T-cells showed fewer cells in the tumor site and more cells in the off-target organs (spleen, lungs) when compared to mice injected with B-II spectrin transfected cells. Furthermore, among 3 human patients undergoing CAR-T therapy, those with higher endogenous B-II spectrin levels experienced fewer side-effects, measured by the neurotoxicity and cytokine release syndrome grades. DISCUSSION/SIGNIFICANCE: A major hurdle to widespread CAR-T therapy for cancer is significant, often fatal side-effects. Our work shows that the protein B-II spectrin is downregulated during CAR-T production, and that restoring B-II spectrin levels decreases side-effects while increasing tumor clearance--hopefully translating to better CAR-T regimens for the future.