The gut microbiome is impacted by certain types of dietary fibre. However, the type, duration and dose needed to elicit gut microbial changes and whether these changes also influence microbial metabolites remain unclear. This study investigated the effects of supplementing healthy participants with two types of non-digestible carbohydrates (resistant starch (RS) and polydextrose (PD)) on the stool microbiota and microbial metabolite concentrations in plasma, stool and urine, as secondary outcomes in the Dietary Intervention Stem Cells and Colorectal Cancer (DISC) Study. The DISC study was a double-blind, randomised controlled trial that supplemented healthy participants with RS and/or PD or placebo for 50 d in a 2 × 2 factorial design. DNA was extracted from stool samples collected pre- and post-intervention, and V4 16S rRNA gene sequencing was used to profile the gut microbiota. Metabolite concentrations were measured in stool, plasma and urine by high-performance liquid chromatography. A total of fifty-eight participants with paired samples available were included. After 50 d, no effects of RS or PD were detected on composition of the gut microbiota diversity (alpha- and beta-diversity), on genus relative abundance or on metabolite concentrations. However, Drichlet’s multinomial mixture clustering-based approach suggests that some participants changed microbial enterotype post-intervention. The gut microbiota and fecal, plasma and urinary microbial metabolites were stable in response to a 50-d fibre intervention in middle-aged adults. Larger and longer studies, including those which explore the effects of specific fibre sub-types, may be required to determine the relationships between fibre intake, the gut microbiome and host health.

In 2016, the National Center for Advancing Translational Science launched the Trial Innovation Network (TIN) to address barriers to efficient and informative multicenter trials. The TIN provides a national platform, working in partnership with 60+ Clinical and Translational Science Award (CTSA) hubs across the country to support the design and conduct of successful multicenter trials. A dedicated Hub Liaison Team (HLT) was established within each CTSA to facilitate connection between the hubs and the newly launched Trial and Recruitment Innovation Centers. Each HLT serves as an expert intermediary, connecting CTSA Hub investigators with TIN support, and connecting TIN research teams with potential multicenter trial site investigators. The cross-consortium Liaison Team network was developed during the first TIN funding cycle, and it is now a mature national network at the cutting edge of team science in clinical and translational research. The CTSA-based HLT structures and the external network structure have been developed in collaborative and iterative ways, with methods for shared learning and continuous process improvement. In this paper, we review the structure, function, and development of the Liaison Team network, discuss lessons learned during the first TIN funding cycle, and outline a path toward further network maturity.

One challenge for multisite clinical trials is ensuring that the conditions of an informative trial are incorporated into all aspects of trial planning and execution. The multicenter model can provide the potential for a more informative environment, but it can also place a trial at risk of becoming uninformative due to lack of rigor, quality control, or effective recruitment, resulting in premature discontinuation and/or non-publication. Key factors that support informativeness are having the right team and resources during study planning and implementation and adequate funding to support performance activities. This communication draws on the experience of the National Center for Advancing Translational Science (NCATS) Trial Innovation Network (TIN) to develop approaches for enhancing the informativeness of clinical trials. We distilled this information into three principles: (1) assemble a diverse team, (2) leverage existing processes and systems, and (3) carefully consider budgets and contracts. The TIN, comprised of NCATS, three Trial Innovation Centers, a Recruitment Innovation Center, and 60+ CTSA Program hubs, provides resources to investigators who are proposing multicenter collaborations. In addition to sharing principles that support the informativeness of clinical trials, we highlight TIN-developed resources relevant for multicenter trial initiation and conduct.

How does the public respond to court-packing attempts? Longstanding accounts of public support for courts suggest voters retaliate against incumbents who seek to manipulate well-respected courts. Yet incumbents might strategically frame their efforts in bureaucratic terms to minimize the public’s outcry or use court-packing proposals to activate a partisan base of support. Drawing on a series of survey experiments, we demonstrate that strategic politicians can minimize electoral backlash by couching court reform proposals in apolitical language, and institutional legitimacy’s shielding effect dissolves in the face of shared partisanship. These results shed new light on how ambitious politicians might avoid electoral consequences for efforts to bend the judiciary to their will.

While panel effects—instances in which panel composition affects the votes cast by judges—have been widely documented, scholars are unsure why these patterns persist. We outline three possible mechanisms, acquiescence, deliberation, and strategy, through which panel effects might occur; develop indicators for each; and test them using a data set of search and seizure cases decided by the US courts of appeals between 1953 and 2010. Our analysis provides some evidence that counterjudge success stems from a combination of all three theories, although strategic considerations have the substantively strongest and most consistent effects.

Human capital theory suggests that work experience acquired through on-the-job-training primes people to be more successful. Empirical validations of this hypothesis are numerous, but limited evidence of the relevance of human capital for courtroom advocacy exists. We examine whether the outcomes obtained by experienced attorneys are significantly better than the outcomes they would have obtained as novices. Adopting a strategy for credible causal inference that could be applied to almost any peak court, the analysis shows that attorneys with experience, relative to first timers, are significantly and consistently more likely to win their cases and capture the votes of judges.

In 2011, Bolivia became the first modern country to directly elect national judges. Reformers heralded the adoption of judicial elections as a “democratization of justice,” by which institutional independence would be assured, public confidence in the judiciary might be expanded, and various maladies of the judicial system would find resolution. We evaluate the elections in light of these objectives. We show candidates were advantaged when voters shared their partisan and demographic traits, resulting in unprecedented diversity on the national courts. Also, public confidence in the judiciary increased among government supporters but declined overall. We offer preliminary reflections for would-be reformers.

Do elected judges and prosecutors change their behavior to reflect public opinion after they receive information about constituent preferences? In this article I use a unique measure of public opinion—votes on an initiative to legalize marijuana—to examine the responsiveness of prosecutors and trial court judges to a strong, issue-specific, constituency-level opinion signal. I find that, at least in recent drug cases in Colorado, both prosecutors and judges changed their sentencing behavior after receiving that signal. Prosecutors responded only to local-level opinion, while judges responded to both local and statewide opinion.

Conventional wisdom suggests that judicial legitimacy should be relatively unaffected by satisfaction with the ideological direction of judicial policy making. Recent studies challenge this assertion. The key to resolving this conundrum is estimating individual-level satisfaction with the ideological direction of judicial policy making reliably and validly. We examine the accuracy of several common measures of the concept. We find that 40% of the respondents repudiate their own scores on these measures. With this much systematic measurement error in such an important independent variable, the question of whether the Supreme Court’s institutional legitimacy is conditional on ideological agreement with its decisions must be reexamined.

The Hierarchical Taxonomy of Psychopathology (HiTOP) has emerged out of the quantitative approach to psychiatric nosology. This approach identifies psychopathology constructs based on patterns of co-variation among signs and symptoms. The initial HiTOP model, which was published in 2017, is based on a large literature that spans decades of research. HiTOP is a living model that undergoes revision as new data become available. Here we discuss advantages and practical considerations of using this system in psychiatric practice and research. We especially highlight limitations of HiTOP and ongoing efforts to address them. We describe differences and similarities between HiTOP and existing diagnostic systems. Next, we review the types of evidence that informed development of HiTOP, including populations in which it has been studied and data on its validity. The paper also describes how HiTOP can facilitate research on genetic and environmental causes of psychopathology as well as the search for neurobiologic mechanisms and novel treatments. Furthermore, we consider implications for public health programs and prevention of mental disorders. We also review data on clinical utility and illustrate clinical application of HiTOP. Importantly, the model is based on measures and practices that are already used widely in clinical settings. HiTOP offers a way to organize and formalize these techniques. This model already can contribute to progress in psychiatry and complement traditional nosologies. Moreover, HiTOP seeks to facilitate research on linkages between phenotypes and biological processes, which may enable construction of a system that encompasses both biomarkers and precise clinical description.

Mixed flora in urine cultures usually occur due to preanalytic contamination. In our outpatient urology clinic, we detected a high prevalence of mixed flora (46.2%), which was associated with female sex and older age. Patient education did not influence the rate of mixed flora. Future efforts should target high-risk patients.

Neuroimaging offers great potential to clinicians and researchers for a host of mental and physical conditions. The use of imaging has been trumpeted for forensic psychiatric and psychological evaluations to allow greater insight into the relationship between the brain and behavior. The results of imaging certainly can be used to inform clinical diagnoses; however, there continue to be limitations in using neuroimaging for insanity cases due to limited scientific backing for how neuroimaging can inform retrospective evaluations of mental state. In making this case, this paper reviews the history of the insanity defense and explains how the use of neuroimaging is not an effective way of improving the reliability of insanity defense evaluations.