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Little is known about who would benefit from Internet-based personalised nutrition (PN) interventions. This study aimed to evaluate the characteristics of participants who achieved greatest improvements (i.e. benefit) in diet, adiposity and biomarkers following an Internet-based PN intervention. Adults (n 1607) from seven European countries were recruited into a 6-month, randomised controlled trial (Food4Me) and randomised to receive conventional dietary advice (control) or PN advice. Information on dietary intake, adiposity, physical activity (PA), blood biomarkers and participant characteristics was collected at baseline and month 6. Benefit from the intervention was defined as ≥5 % change in the primary outcome (Healthy Eating Index) and secondary outcomes (waist circumference and BMI, PA, sedentary time and plasma concentrations of cholesterol, carotenoids and omega-3 index) at month 6. For our primary outcome, benefit from the intervention was greater in older participants, women and participants with lower HEI scores at baseline. Benefit was greater for individuals reporting greater self-efficacy for ‘sticking to healthful foods’ and who ‘felt weird if [they] didn’t eat healthily’. Participants benefited more if they reported wanting to improve their health and well-being. The characteristics of individuals benefiting did not differ by other demographic, health-related, anthropometric or genotypic characteristics. Findings were similar for secondary outcomes. These findings have implications for the design of more effective future PN intervention studies and for tailored nutritional advice in public health and clinical settings.
The field of in situ nanomechanics is greatly benefiting from microelectromechanical systems (MEMS) technology and integrated microscale testing machines that can measure a wide range of mechanical properties at nanometer scales, while characterizing the damage or microstructure evolution in electron microscopes. This article focuses on the latest advances in MEMS-based nanomechanical testing techniques that go beyond stress and strain measurements under typical monotonic loadings. Specifically, recent advances in MEMS testing machines now enable probing key mechanical properties of nanomaterials related to fracture, fatigue, and wear. Tensile properties can be measured without instabilities or at high strain rates, and signature parameters such as activation volume can be obtained. Opportunities for environmental in situ nanomechanics enabled by MEMS technology are also discussed.
Individual organisms on land and in the ocean sequester massive amounts of the carbon emitted into the atmosphere by humans. Yet the role of ecosystems as a whole in modulating this uptake of carbon is less clear. Here, we study several different mechanisms by which climate change and ecosystems could interact. We show that climate change could cause changes in ecosystems that reduce their capacity to take up carbon, further accelerating climate change. More research on – and better governance of – interactions between climate change and ecosystems is urgently required.
Hill (Twin Research and Human Genetics, Vol. 21, 2018, 84–88) presented a critique of our recently published paper in Cell Reports entitled ‘Large-Scale Cognitive GWAS Meta-Analysis Reveals Tissue-Specific Neural Expression and Potential Nootropic Drug Targets’ (Lam et al., Cell Reports, Vol. 21, 2017, 2597–2613). Specifically, Hill offered several interrelated comments suggesting potential problems with our use of a new analytic method called Multi-Trait Analysis of GWAS (MTAG) (Turley et al., Nature Genetics, Vol. 50, 2018, 229–237). In this brief article, we respond to each of these concerns. Using empirical data, we conclude that our MTAG results do not suffer from ‘inflation in the FDR [false discovery rate]’, as suggested by Hill (Twin Research and Human Genetics, Vol. 21, 2018, 84–88), and are not ‘more relevant to the genetic contributions to education than they are to the genetic contributions to intelligence’.
Although childhood adversity is a potent determinant of psychopathology, relatively little is known about how the characteristics of adversity exposure, including its developmental timing or duration, influence subsequent mental health outcomes. This study compared three models from life course theory (recency, accumulation, sensitive period) to determine which one(s) best explained this relationship.
Prospective data came from the Avon Longitudinal Study of Parents and Children (n = 7476). Four adversities commonly linked to psychopathology (caregiver physical/emotional abuse; sexual/physical abuse; financial stress; parent legal problems) were measured repeatedly from birth to age 8. Using a statistical modeling approach grounded in least angle regression, we determined the theoretical model(s) explaining the most variability (r2) in psychopathology symptoms measured at age 8 using the Strengths and Difficulties Questionnaire and evaluated the magnitude of each association.
Recency was the best fitting theoretical model for the effect of physical/sexual abuse (girls r2 = 2.35%; boys r2 = 1.68%). Both recency (girls r2 = 1.55%) and accumulation (boys r2 = 1.71%) were the best fitting models for caregiver physical/emotional abuse. Sensitive period models were chosen alone (parent legal problems in boys r2 = 0.29%) and with accumulation (financial stress in girls r2 = 3.08%) more rarely. Substantial effect sizes were observed (standardized mean differences = 0.22–1.18).
Child psychopathology symptoms are primarily explained by recency and accumulation models. Evidence for sensitive periods did not emerge strongly in these data. These findings underscore the need to measure the characteristics of adversity, which can aid in understanding disease mechanisms and determining how best to reduce the consequences of exposure to adversity.
Training for the clinical research workforce does not sufficiently prepare workers for today’s scientific complexity; deficiencies may be ameliorated with training. The Enhancing Clinical Research Professionals’ Training and Qualifications developed competency standards for principal investigators and clinical research coordinators.
Clinical and Translational Science Awards representatives refined competency statements. Working groups developed assessments, identified training, and highlighted gaps.
Forty-eight competency statements in 8 domains were developed.
Training is primarily investigator focused with few programs for clinical research coordinators. Lack of training is felt in new technologies and data management. There are no standardized assessments of competence.
The translation of discoveries to drugs, devices, and behavioral interventions requires well-prepared study teams. Execution of clinical trials remains suboptimal due to varied quality in design, execution, analysis, and reporting. A critical impediment is inconsistent, or even absent, competency-based training for clinical trial personnel.
In 2014, the National Center for Advancing Translational Science (NCATS) funded the project, Enhancing Clinical Research Professionals’ Training and Qualifications (ECRPTQ), aimed at addressing this deficit. The goal was to ensure all personnel are competent to execute clinical trials. A phased structure was utilized.
This paper focuses on training recommendations in Good Clinical Practice (GCP). Leveraging input from all Clinical and Translational Science Award hubs, the following was recommended to NCATS: all investigators and study coordinators executing a clinical trial should understand GCP principles and undergo training every 3 years, with the training method meeting the minimum criteria identified by the International Conference on Harmonisation GCP.
We anticipate that industry sponsors will acknowledge such training, eliminating redundant training requests. We proposed metrics to be tracked that required further study. A separate task force was composed to define recommendations for metrics to be reported to NCATS.
Catheter-associated urinary tract infections (CAUTIs) are among the most common hospital-acquired infections (HAIs). Reducing CAUTI rates has become a major focus of attention due to increasing public health concerns and reimbursement implications.
To implement and describe a multifaceted intervention to decrease CAUTIs in our ICUs with an emphasis on indications for obtaining a urine culture.
A project team composed of all critical care disciplines was assembled to address an institutional goal of decreasing CAUTIs. Interventions implemented between year 1 and year 2 included protocols recommended by the Centers for Disease Control and Prevention for placement, maintenance, and removal of catheters. Leaders from all critical care disciplines agreed to align routine culturing practice with American College of Critical Care Medicine (ACCCM) and Infectious Disease Society of America (IDSA) guidelines for evaluating a fever in a critically ill patient. Surveillance data for CAUTI and hospital-acquired bloodstream infection (HABSI) were recorded prospectively according to National Healthcare Safety Network (NHSN) protocols. Device utilization ratios (DURs), rates of CAUTI, HABSI, and urine cultures were calculated and compared.
The CAUTI rate decreased from 3.0 per 1,000 catheter days in 2013 to 1.9 in 2014. The DUR was 0.7 in 2013 and 0.68 in 2014. The HABSI rates per 1,000 patient days decreased from 2.8 in 2013 to 2.4 in 2014.
Effectively reducing ICU CAUTI rates requires a multifaceted and collaborative approach; stewardship of culturing was a key and safe component of our successful reduction efforts.
The aim of this study was to prepare various sized nano-pits on 316 L stainless steel and examine their effects on the attachment and proliferation of fibroblasts. In this study, 316L stainless steel with tunable pit sizes (0, 25, 50, and 60 nm) were fabricated by an anodization procedure in an ethylene glycol electrolyte solution containing 5 vol.% perchloric acid. The surface morphology of 316L stainless steel were characterized by scanning electron microscopy (SEM). The nano-pit arrays on all the 316L stainless steel samples were in a regular arrangement. The surface properties of the 316L stainless steel nano-pit surface showed improved wettability properties as compared to the untreated 316L stainless steel. The nano-pit surfaces with 50 nm and 60 nm diameter were rougher at the nanoscale than other samples. The attachment and proliferation of fibroblasts were investigated for up to 3 days in culture using MTT assays. Compared to unanodized (that is, nano-smooth) and smooth surfaces, 50 and 60 nm diameter nano-pit surfaces dramatically enhanced the initial fibroblast attachment and growth up to 3 days in culture. The results reported in this study showed that the 50 and 60 nm nano-pit surfaces promoted fibroblast adhesion and proliferation by increasing the surface roughness and adsorption of fibronectin. Such nano-pit surfaces can be designed to support fibroblast growth and be important for improving the use of 316L stainless steel for various implant applications (such as for improved skin healing for amputee devices or for percutaneous implants).
The behavior genetic literature suggests that genetically influenced characteristics of the child elicit specific behaviors from the parent. However, little is known about the processes by which genetically influenced child characteristics evoke parental responses. Interpersonal theory provides a useful framework for identifying reciprocal behavioral processes between children and mothers. The theory posits that, at any given moment, interpersonal behavior varies along the orthogonal dimensions of warmth and control and that the interpersonal behavior of one individual tends to elicit corresponding or contrasting behavior from the other (i.e., warmth elicits warmth, whereas control elicits submission). The current study thus examined these dimensions of interpersonal behavior as they relate to the parent–child relationship in 546 twin families. A computer joystick was used to rate videos of mother–child interactions in real time, yielding information on mother and child levels of warmth and control throughout the interaction. Analyses indicated that maternal control, but not maternal warmth, was influenced by evocative gene–environment correlational processes, such that genetic influences on maternal control and child control were largely overlapping. Moreover, these common genetic influences were present both cross-sectionally and over the course of the interaction. Such findings not only confirm the presence of evocative gene–environment correlational processes in the mother–child relationship but also illuminate at least one of the specific interpersonal behaviors that underlie this evocative process.
Genistein and daidzein are isoflavones which are reported to influence the reproductive system in a variety of mammalian species. This pilot study aimed to determine if dietary isoflavones could potentially influence reproductive parameters in domestic cats, when consumed during the postnatal development period. Cats (n = 12) were maintained on either a treatment (150 µg/g DM genistein and 150 µg/g DM daidzein, n = 4) or control (isoflavone free, n = 8) diet from weaning, up to 414 (±17.2) days post-weaning. Vaginal smears were taken thrice weekly and examined for oestrogen-induced cellular degradation in all cats. Behavioural indicators of oestrous were routinely scored for the presence or absence of six key behaviours. Genistein and daidzein did not alter puberty onset or oestrous cycle parameters in these cats (P > 0.05). Behavioural scores were higher in cats in the treatment group than control. Incidence of apparent spontaneous ovulation (inferred from extended inter-oestrous periods) was greater in treated cats than control cats, although serum hormone profiles were not available to confirm this observation. Further testing is warranted.
To explore how hand hygiene observer scheduling influences the number of events and unique individuals observed.
We deployed a mobile sensor network to capture detailed movement data for 6 categories of healthcare workers over a 2-week period.
University of Iowa Hospital and Clinic medical intensive care unit (ICU).
We recorded 33,721 time-stamped healthcare worker entries to and exits from patient rooms and considered each entry or exit to be an opportunity for hand hygiene. Architectural drawings were used to derive 4 optimal line-of-sight placements for observers. We ran simulations for different observer movement schedules, all with a budget of 1 hour of total observation time. We considered observation times of 1–15, 15–30, 30, and 60 minutes per station. We stochastically generated healthcare worker hand hygiene compliance on the basis of all data and recorded the total unit compliance as it would be reported by each simulated observer.
Considering a 60-minute total observation period, aggregate simulated observers captured 1.7% of the average total number of opportunities per day at best and 0.5% at worst. The 1–15-minute schedule captures, on average, 16% fewer events than does the 60-minute (ie, static) schedule, but it samples 17% more unique individuals. The 1–15-minute schedule also provides the best estimator of compliance for the duration of the shift, with a mean standard deviation of 17%, compared with 23% for the 60-minute schedule.
Our results show that observations are sensitive to different observers' schedules and suggest the importance of using data-driven approaches to schedule hand hygiene audits.