Preexercise Carbohydrate Feeding and High-Intensity Exercise Capacity: Effects of Timing of Intake and Carbohydrate Concentration

The present study aimed to investigate the influence of timing of pre-exercise carbohydrate feeding (Part A), and carbohydrate concentration (Part B), on short-duration high-intensity exercise capacity. In Part A, seventeen males, and in Part B ten males, performed a peak power output (PPO) test, two familiarisation trials at 90% of PPO, and 4 (for Part A) or 3 (for Part B) experimental trials involving exercise capacity tests at 90% PPO. In Part A, the 4 trials were conducted following ingestion of a 6.4% carbohydrate/electrolyte sports drink ingested 30 (C30) or 120 (C120) minutes before exercise, or a flavour-matched placebo administered either 30 (P30) or 120 (P120) minutes before exercise. In Part B, the 3 trials were performed 30 minutes after ingestion of 0%, 2% or 12% carbohydrate solutions. All trials were performed in a double blind cross-over design following and overnight fast. Dietary intake and activity in the two days before trials was recorded and replicated on each visit. Glucose, lactate, heart rate and mood/arousal were recorded at intervals during the trials. In Part A, C30 produced the greatest exercise capacity (mean±SD; 9.0±1.9 min, P<0.01) compared with all other trials (7.7±1.5 min P30, 8.0±1.7 min P120, 7.9±1.9 min C120). In Part B, exercise capacity (min) following ingestion of the 2% solution (9.2±2.1) compared with 0% (8.2±0.7) and 12% (8.0±1.3) solutions approached significance (p=0.09). This study provides new evidence to suggest that timing of carbohydrate intake is important in short duration high-intensity exercise tasks, but a concentration effect requires further exploration

Impacts of increasing anthropogenic soluble iron and nitrogen deposition on ocean biogeochemistry

Author Posting. © American Geophysical Union, 2009. This article is posted here by permission of American Geophysical Union for personal use, not for redistribution. The definitive version was published in Global Biogeochemical Cycles 23 (2009): GB3016, doi:10.1029/2008GB003440.We present results from transient sensitivity studies with the Biogeochemical Elemental Cycling (BEC) ocean model to increasing anthropogenic atmospheric inorganic nitrogen (N) and soluble iron (Fe) deposition over the industrial era. Elevated N deposition results from fossil fuel combustion and agriculture, and elevated soluble Fe deposition results from increased atmospheric processing in the presence of anthropogenic pollutants and soluble Fe from combustion sources. Simulations with increasing Fe and increasing Fe and N inputs raised simulated marine nitrogen fixation, with the majority of the increase in the subtropical North and South Pacific, and raised primary production and export in the high-nutrient low-chlorophyll (HNLC) regions. Increasing N inputs alone elevated small phytoplankton and diatom production, resulting in increased phosphorus (P) and Fe limitation for diazotrophs, hence reducing nitrogen fixation (∼6%). Globally, the simulated primary production, sinking particulate organic carbon (POC) export. and atmospheric CO2 uptake were highest under combined increase in Fe and N inputs compared to preindustrial control. Our results suggest that increasing combustion iron sources and aerosol Fe solubility along with atmospheric anthropogenic nitrogen deposition are perturbing marine biogeochemical cycling and could partially explain the observed trend toward increased P limitation at station ALOHA in the subtropical North Pacific. Excess inorganic nitrogen ([NO3 −] + [NH4 +] − 16[PO4 3−]) distributions may offer useful insights for understanding changing ocean circulation and biogeochemistry.This work was supported by funding from NSF grant OCE-0452972 to J. K. Moore and C. S. Zender. Computations were supported by the Earth System Modeling Facility at UCI (NSFATMO321380) and by the Climate Simulation Laboratory at National Center for Atmospheric Research. The National Center for Atmospheric Research is sponsored by the U.S. National Science Foundation. N.M. would like to acknowledge the assistance of NSF– Carbon and Water (ATM-0628472), and N.M., S.D., and C.L. would like to acknowledge the assistance of NASA-IDS (NNX07AL80G)

Emerging issues and current trends in assistive technology use 2007-1010: practising, assisting and enabling learning for all

Following an earlier review in 2007, a further review of the academic literature relating to the uses of assistive technology (AT) by children and young people was completed, covering the period 2007-2011. As in the earlier review, a tripartite taxonomy: technology uses to train or practise, technology uses to assist learning and technology uses to enable learning, was used in order to structure the findings. The key markers for research in this field and during these three years were user involvement, AT on mobile mainstream devices, the visibility of AT, technology for interaction and collaboration, new and developing interfaces and inclusive design principles. The paper concludes by locating these developments within the broader framework of the Digital Divide

Differential responses of grasses and forbs led to marked reduction in below-ground productivity in temperate steppe following chronic N deposition

Enhanced deposition of atmospheric nitrogen (N) has profound impacts on ecosystem processes such as above-ground productivity and community structure in grasslands across the globe. But how N deposition affects below-ground processes of grasslands is less well known. Here, we evaluated the effects of chronic N amendment at a relatively low rate (20 kg ha-1 year-1) on root traits (root productivity, root biomass, root/shoot ratio) in Inner Mongolia steppes by rhizotron and ingrowth core and soil monolith techniques at levels of individual species, functional groups and ecosystem. For 8 years, N amendment suppressed above-ground net primary production (ANPP), photosynthetic rates and root biomass of forbs, but enhanced ANPP and root biomass of grasses. This led to an overall reduction in below-ground productivity of the grassland by 24-33%, while ANPP remained unchanged. Nitrogen amendment acidified soil and subsequently increased extractable soil manganese (Mn) concentration. Nitrogen amendment increased foliar Mn concentrations in forb, but not grass species, leading to a significant inhibition of photosynthetic rates in forb species. Synthesis. These findings highlight the importance of the differentiating responses of plant functional groups to long-term N deposition and the important consequences of these responses for below-ground productivity and long-term soil C sequestration

SurgiCal Obesity Treatment Study (SCOTS) : a prospective, observational cohort study on health and socioeconomic burden in treatment-seeking individuals with severe obesity in Scotland, UK

Objectives: There is a lack of evidence to inform the delivery and follow-up of bariatric surgery for people with severe obesity. The SurgiCal Obesity Treatment Study (SCOTS) is a national longitudinal cohort of people undergoing bariatric surgery. Here, we describe characteristics of the recruited SCOTS cohort, and the relationship between health and socioeconomic status with body mass index (BMI) and age. Participants/Methods: 445 participants scheduled for bariatric surgery at any of 14 centres in Scotland, UK, were recruited between 2013 and 2016 for this longitudinal cohort study (1 withdrawal); 249 completed health-related preoperative patient-reported outcome measures. Regression models were used to estimate the effect of a 10-unit increase in age or BMI, adjusting for sex, smoking and socioeconomic status. Results: Mean age was 46 years and median BMI was 47 kg/m2. For each 10 kg/m2 higher BMI, there was a change of −5.2 (95% CI −6.9 to –3.5; p<0.0001) in Rand 12-item Short Form Survey Physical Component Summary (SF-12 PCS), −0.1 (95% CI −0.2 to –0.1; p<0.0001) in EuroQoL 5-level EQ-5D version index score and 14.2 (95% CI 10.7 to 17.7; p<0.0001) in Impact of Weight on Quality of Life-Lite Physical Function Score. We observed a 3.1 times higher use of specialist aids and equipment at home (OR: 3.1, 95% CI 1.9 to 5.0; p<0.0001). Broadly, similar results were seen for each 10-year higher age, including a change of −2.1 (95% CI −3.7 to –0.5; p<0.01) in SF-12 PCS. Conclusions: A higher BMI combined with older age is associated with poor physical functioning and quality of life in people seeking bariatric surgery treatment. Policy-makers must consider the health and care needs of these individuals and invest to provide increased access to effective weight management. Trial registration number: ISRCTN47072588

Adaptations to the British Society of Gastroenterology guidelines on the management of acute severe UC in the context of the COVID-19 pandemic: a RAND appropriateness panel

Objective Management of acute severe UC (ASUC) during the novel COVID-19 pandemic presents significant dilemmas. We aimed to provide COVID-19-specific guidance using current British Society of Gastroenterology (BSG) guidelines as a reference point. Design We convened a RAND appropriateness panel comprising 14 gastroenterologists and an IBD nurse consultant supplemented by surgical and COVID-19 experts. Panellists rated the appropriateness of interventions for ASUC in the context of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection. Median scores and disagreement index (DI) were calculated. Results were discussed at a moderated meeting prior to a second survey. Results Panellists recommended that patients with ASUC should be isolated throughout their hospital stay and should have a SARS-CoV-2 swab performed on admission. Patients with a positive swab should be discussed with COVID-19 specialists. As per BSG guidance, intravenous hydrocortisone was considered appropriate as initial management; only in patients with COVID-19 pneumonia was its use deemed uncertain. In patients requiring rescue therapy, infliximab with continuing steroids was recommended. Delaying colectomy because of COVID-19 was deemed inappropriate. Steroid tapering as per BSG guidance was deemed appropriate for all patients apart from those with COVID-19 pneumonia in whom a 4–6 week taper was preferred. Post-ASUC maintenance therapy was dependent on SARS-CoV-2 status but, in general, biologics were more likely to be deemed appropriate than azathioprine or tofacitinib. Panellists deemed prophylactic anticoagulation postdischarge to be appropriate in patients with a positive SARS-CoV-2 swab. Conclusion We have suggested COVID-19-specific adaptations to the BSG ASUC guideline using a RAND panel

Environmental effects of ozone depletion, UV radiation and interactions with climate change : UNEP Environmental Effects Assessment Panel, update 2017

Peer reviewe

BHPR research: qualitative1. Complex reasoning determines patients' perception of outcome following foot surgery in rheumatoid arhtritis

Background: Foot surgery is common in patients with RA but research into surgical outcomes is limited and conceptually flawed as current outcome measures lack face validity: to date no one has asked patients what is important to them. This study aimed to determine which factors are important to patients when evaluating the success of foot surgery in RA Methods: Semi structured interviews of RA patients who had undergone foot surgery were conducted and transcribed verbatim. Thematic analysis of interviews was conducted to explore issues that were important to patients. Results: 11 RA patients (9 ♂, mean age 59, dis dur = 22yrs, mean of 3 yrs post op) with mixed experiences of foot surgery were interviewed. Patients interpreted outcome in respect to a multitude of factors, frequently positive change in one aspect contrasted with negative opinions about another. Overall, four major themes emerged. Function: Functional ability & participation in valued activities were very important to patients. Walking ability was a key concern but patients interpreted levels of activity in light of other aspects of their disease, reflecting on change in functional ability more than overall level. Positive feelings of improved mobility were often moderated by negative self perception ("I mean, I still walk like a waddling duck”). Appearance: Appearance was important to almost all patients but perhaps the most complex theme of all. Physical appearance, foot shape, and footwear were closely interlinked, yet patients saw these as distinct separate concepts. Patients need to legitimize these feelings was clear and they frequently entered into a defensive repertoire ("it's not cosmetic surgery; it's something that's more important than that, you know?”). Clinician opinion: Surgeons' post operative evaluation of the procedure was very influential. The impact of this appraisal continued to affect patients' lasting impression irrespective of how the outcome compared to their initial goals ("when he'd done it ... he said that hasn't worked as good as he'd wanted to ... but the pain has gone”). Pain: Whilst pain was important to almost all patients, it appeared to be less important than the other themes. Pain was predominately raised when it influenced other themes, such as function; many still felt the need to legitimize their foot pain in order for health professionals to take it seriously ("in the end I went to my GP because it had happened a few times and I went to an orthopaedic surgeon who was quite dismissive of it, it was like what are you complaining about”). Conclusions: Patients interpret the outcome of foot surgery using a multitude of interrelated factors, particularly functional ability, appearance and surgeons' appraisal of the procedure. While pain was often noted, this appeared less important than other factors in the overall outcome of the surgery. Future research into foot surgery should incorporate the complexity of how patients determine their outcome Disclosure statement: All authors have declared no conflicts of interes