Sport Participation for Adults Aged 50 + Years: A Socioecological Analysis

Sport participation can play a key role in older adults' successful aging as it provides an enjoyable opportunity for leisure-time physical activity. Research focusing on the benefits of sport participation in later life and facilitators for involvement has been increasing in the past several years. Drawing on the socioecological model, this study investigated select socioecological factors that predict older adults' sport participation from a holistic perspective. An online survey provided quantitative data from 1203 adults aged 50 and older across the United States. Results from logistic regression analyses showed that personal characteristics, individual behavior, environment/policy, and life course effects were significant predictors of sport participation in later life. The findings in this study enhance our understanding of factors related to older adults' sport participation and are also of value to practitioners seeking to promote sport participation among older adults.

Development and validation of a prognostic model for death 30 days after adult emergency laparotomy

The probability of death after emergency laparotomy varies greatly between patients. Accurate pre-operative risk prediction is fundamental to planning care and improving outcomes. We aimed to develop a model limited to a few pre-operative factors that performed well irrespective of surgical indication: obstruction; sepsis; ischaemia; bleeding; and other. We derived a model with data from the National Emergency Laparotomy Audit for patients who had emergency laparotomy between December 2016 and November 2018. We tested the model on patients who underwent emergency laparotomy between December 2018 and November 2019. There were 4077/40,816 (10%) deaths 30 days after surgery in the derivation cohort. The final model had 13 pre-operative variables: surgical indication; age; blood pressure; heart rate; respiratory history; urgency; biochemical markers; anticipated malignancy; anticipated peritoneal soiling; and ASA physical status. The predicted mortality probability deciles ranged from 0.1% to 47%. There were 1888/11,187 deaths in the test cohort. The scaled Brier score, integrated calibration index and concordance for the model were 20%, 0.006 and 0.86, respectively. Model metrics were similar for the five surgical indications. In conclusion, we think that this prognostic model is suitable to support decision-making before emergency laparotomy as well as for risk adjustment for comparing organisations.

Detection of the threatened snail darter Percina tanasi in the Tennessee River system using environmental DNA

The distribution of many fishes that occupy large rivers is poorly known, in part due to the difficulties of sampling for them. This is especially true for small-bodied or rare species, such as the snail darter Percina tanasi, 44, 469-488; 1976). This federally listed (threatened) species has a limited distribution in the Tennessee River system in Alabama and Tennessee, where it is known from a few large tributaries or small rivers. In Alabama, P. tanasi was previously known from only one locality, but has recently been found in two additional, widely separated systems. These new records raise questions regarding the accuracy of our current understanding of the range for this species. Particularly, is P. tanasi present throughout the main stem Tennessee River, and is this species dispersing into new areas from source populations in the river? To clarify the distribution of P. tanasi in Alabama, 83 unique sites were surveyed using environmental DNA analysis. This cost-effective detection tool reduces the difficulty associated with empirically sampling large rivers for small fishes. Approximately 42% of sites sampled were positive for P. tanasi DNA. This study confirmed the known localities of P. tanasi in the Bear Creek, Elk River and Paint Rock River. Several new localities were also discovered throughout the main stem Tennessee River and in Shoal Creek, near Florence, Alabama. These findings can inform biologists about where to prioritize conservation efforts and further could lead to studies assessing movement and relatedness between populations in this system.

Snap-shot assessment of adult mosquito (Diptera: Culicidae) densities on the Turks and Caicos Islands, February 2022

In many of the small island communities of the Caribbean, much of the vector surveillance effort is focussed on house-to-house peri-focal surveys to collect data on larval indices. Adult mosquito trapping is not always routine or affordable and is usually focussed on ad hoc biting issues or small-scale investigations. This makes understanding the relative importance and densities of the common urban mosquitoes, such as Aedes aegypti and Culex quinquefasciatus, problematic. This snap-shot survey in February 2022 using BG-Sentinel traps at 30 different locations across five islands of the Turks and Caicos, aimed to provide the first island-wide assessment of urban mosquito densities. In total, 2,820 adult mosquitoes were collected over 285 trap nights. Aedes aegypti was most common on the island of Providenciales, with very low densities recorded on South Caicos, North and Middle Caicos, with Ae. aegypti most highly abundant in the main commercial centres. The highest densities of Cx. quinquefasciatus were trapped on North Caicos. Small numbers of other species were also collected, including the first record of Anopheles in TCI. This established framework of trapping and initial assessment provides a platform for continued monitoring of mosquitoes in TCI to better inform mosquito-borne disease risk assessment and future vector control efforts.

Effect of increased water intake on uropathogenic bacterial activity of underhydrated menstruating young adult women: A randomized crossover trial

Background: Females are prone to urinary tract infections (UTIs) due to estrogen fluctuations affecting vaginal flora. While menstruating, increased fluid consumption to support urination frequency and void volume may be important, as the urethra and urinary tract are more predisposed to bacteria, particularly UTI pathogens. Aim: This study aimed to investigate the impact of hydration on urinary tract health during menstruation among underhydrated premenopausal women. Methods: Thirteen females participated in a 60-day 2 × 2 randomized crossover trial to evaluate the effectiveness of consuming ≥2.2 L of total beverage fluid intake, with 1.9 L being water, (intervention, INT) and maintaining habitual fluid intake (control, CON) on two subsequent menses. Participants completed fluid and urination diaries at days 2 and 5 after the onset of bleeding (day 1) to determine the fluid amount consumed and urination frequency. Urine concentration was assessed in afternoon (days 2 and 5) and uropathogenic bacterial activity in first-morning (days 3 and 6) urinations. General linear models assessed differences in bacterial and hydration outcomes. Results: The intervention led to a 62% mean total fluid increase, INT 3.0 ± 1.1 L and CON 1.9 ± 0.9 L, p < 0.001, η 2  = 0.459. Urination frequency was greater and urine concentration less in the INT to CON, all ps < 0.05, η 2 range = 0.023-0.019. Only four cultures detected uropathogenic bacteria, with no patterns between conditions or days, making it difficult to determine the intervention's effectiveness. Conclusion: Fluid intake increased, and hydration status improved. No differences in uropathogenic bacterial activity were seen between the hydration and control conditions.

Evaluation of prognostic risk models for postoperative pulmonary complications in adult patients undergoing major abdominal surgery: a systematic review and international external validation cohort study

BACKGROUND

Stratifying risk of postoperative pulmonary complications after major abdominal surgery allows clinicians to modify risk through targeted interventions and enhanced monitoring. In this study, we aimed to identify and validate prognostic models against a new consensus definition of postoperative pulmonary complications.

METHODS

We did a systematic review and international external validation cohort study. The systematic review was done in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched MEDLINE and Embase on March 1, 2020, for articles published in English that reported on risk prediction models for postoperative pulmonary complications following abdominal surgery. External validation of existing models was done within a prospective international cohort study of adult patients (≥18 years) undergoing major abdominal surgery. Data were collected between Jan 1, 2019, and April 30, 2019, in the UK, Ireland, and Australia. Discriminative ability and prognostic accuracy summary statistics were compared between models for the 30-day postoperative pulmonary complication rate as defined by the Standardised Endpoints in Perioperative Medicine Core Outcome Measures in Perioperative and Anaesthetic Care (StEP-COMPAC). Model performance was compared using the area under the receiver operating characteristic curve (AUROCC).

FINDINGS

In total, we identified 2903 records from our literature search; of which, 2514 (86·6%) unique records were screened, 121 (4·8%) of 2514 full texts were assessed for eligibility, and 29 unique prognostic models were identified. Nine (31·0%) of 29 models had score development reported only, 19 (65·5%) had undergone internal validation, and only four (13·8%) had been externally validated. Data to validate six eligible models were collected in the international external validation cohort study. Data from 11 591 patients were available, with an overall postoperative pulmonary complication rate of 7·8% (n=903). None of the six models showed good discrimination (defined as AUROCC ≥0·70) for identifying postoperative pulmonary complications, with the Assess Respiratory Risk in Surgical Patients in Catalonia score showing the best discrimination (AUROCC 0·700 [95% CI 0·683-0·717]).

INTERPRETATION

In the pre-COVID-19 pandemic data, variability in the risk of pulmonary complications (StEP-COMPAC definition) following major abdominal surgery was poorly described by existing prognostication tools. To improve surgical safety during the COVID-19 pandemic recovery and beyond, novel risk stratification tools are required.

FUNDING

British Journal of Surgery Society.

Effects of Palmitoylethanolamide on Proinflammatory Markers in Adults Recently Diagnosed With COVID-19

Objectives

Inflammation is at the core of many chronic conditions and exacerbates infectious conditions, including the severity of COVID-19 infections. The aim of this study was to examine the effects of a novel food supplement, palmitoylethanolamide, specifically Levagen+™ (LEV), versus placebo (CON) on proinflammatory biomarkers in an adult population recently diagnosed with COVID-19 who were non-hospitalized.

Methods

This study was a double-blind randomized placebo-controlled trial conducted October 2020-March 2021. Participants (n = 30/group) were unvaccinated and recently infected with COVID-19 as indicated by a positive test per RT-PCR or antigen test (antigen tests accepted upon symptomatic infection consistent with COVID-19 symptoms per the CDC) and reported to the test site following diagnosis as allowed by the CDC's return to work policy. Participants were stratified by age, sex, and BMI and randomized by coin toss to receive LEV (600 mg BID) or CON tablets twice daily for four weeks. Participants completed health histories, 24-hour dietary recalls, anthropometrics, and non-fasting blood sampling at baseline and week four. Blood samples were analyzed for inflammatory biomarkers.

Results

There were no baseline differences by group for age, sex, weight, BMI, type or total number of COVID symptoms reported, nutritional profiles, or interval between date of COVID-19 diagnosis and study enrollment. Following the 4-week trial, change in serum concentration did not differ between groups for IL-6, TNFα, or CRP. However, IL-1β, IL-2, and P-selectin showed reductions in the LEV group after four weeks compared to the CON group which saw increases in these markers (p &lt; .05), though only P-selectin remained significant after Bonferroni correction for multiple comparisons (p &lt; .05).

Conclusions

Though inflammatory mechanisms are crucial to an optimal immune response, unchecked secretion of cytokines and thrombo-inflammatory markers can promote the development of the inflammatory response in unresolved disease states and are implicated in COVID-19 complications. Therefore, the reduction in inflammatory markers noted herein suggests that PEA may exert anti-inflammatory actions, and possibly reduce the severity of COVID-19 disease.

Funding Sources

This research was funded by Gencor Lifestage Solutions.

Relationships Between Erythrocyte Osmotic Fragility and Vitamin C Nutriture in Adults With or Without Type 2 Diabetes

Objectives

Erythrocyte osmotic fragility is noted in Gulo−/− knockout mice unable to synthesize vitamin C, likely due to the decreased production of cytoskeletal β-spectrin, which affects cell deformability. Individuals with type 2 diabetes (T2D) commonly display marginal vitamin C nutriture, a consequence of reduced cellular uptake and recycling of dehydroascorbic acid. This cross-sectional study examined the relationships between vitamin C status and erythrocyte osmotic fragility in adults with or without T2D.

Methods

Participants did not report unresolved disease conditions or supplementation with vitamin C for the previous three months. T2D diagnosis occurred ≥1 year before study enrollment. Participants provided a fasting venous blood sample for erythrocyte osmotic fragility testing based on erythrocyte lysis with varying concentrations of sodium chloride. In addition, plasma was extracted and mixed with equal volume of 10% (w/v) metaphosphoric acid in 2 mmol/L disodium EDTA and centrifuged at 4°C. The supernatant was stored at −80°C until analysis using isocratic reverse-phase UV-HPLC separation. All participants provided written informed consent and the study was approved by the local Institutional Review Board.

Results

Participant characteristics did not differ significantly between groups with the exception of age (P < 0.01) and HbA1c (p = 0.002). Data are presented for adults with T2D (n = 14; 36% female; 55.5 ± 8.2 y; 31.5 ± 9.0 kg/m²; HbA1c: 7.4 ± 1.9%; plasma vitamin C: 36.0 ± 12.2 mM) and adults without T2D (n = 16; 69% female; 38.7 ± 13.5 y; 26.8 ± 6.6 kg/m²; A1c: 5.4 ± 0.3%; plasma vitamin C: 34.8 ± 10.9 mM). Compared to adults with T2D, erythrocyte osmotic fragility was significantly elevated in adults without T2D at 0.35% saline (+4.4%, p = 0.021). Vitamin C status did not impact erythrocyte osmotic fragility in adults with T2D; however, in adults without T2D, erythrocyte osmotic stability was linked to high vitamin C status at 0.35% saline (p = 0.054 unadjusted and p = 0.022 adjusted for age and gender).

Conclusions

In this small pilot trial, T2D was not related to increased erythrocyte osmotic fragility or marginal vitamin C status. However, vitamin C nutriture was directly linked to erythrocyte osmotic stability in adults without T2D.

Funding Sources

This research received no external funding.

Mosquito Magnet® traps as a potential means of monitoring blackflies of medical and veterinary importance

Mosquito Magnet® traps, deployed in widespread parts of England as part of nationwide mosquito surveillance projects, also caught blackflies. As many as 1242 blackflies were caught in a trapping session lasting 4 days. Principal among the species caught were Simulium equinum, Simulium lineatum and Simulium ornatum s.l. As S. ornatum s.l. is a vector that transmits Onchocerca linealis to cattle and S. equinum is responsible for dermatitis ('sweet itch') in cattle and horses, it is suggested that Mosquito Magnet® traps could be used to monitor and partially control these pests, as well as nuisance anthropophilic blackflies such as Simulium posticatum that can cause simuliidosis in southern England.

An Eight-Week Time-Restricted Feeding Study Reduces Body Weight in College Students: A Pilot Study

Objectives

College students’ dietary patterns may predispose them to weight gain and risk for cardiometabolic conditions later in life. Time-restricted feeding (TRF), a type of intermittent fasting, may confer health benefits, including reductions in body weight. Currently, it is unknown if TRF might impact diet quality. The objective of this randomized controlled study was to assess the feasibility of a TRF protocol versus a control (CON) protocol for eight weeks on dietary patterns, anthropometric measures, and cardiometabolic indices in college students. We hypothesized that dietary patterns, anthropometric measures, and cardiometabolic indices would improve for participants in the TRF group.

Methods

Healthy college students were randomly assigned to a TRF intervention group (six-hour daily eating window) or a CON (16-hour daily eating window) for eight weeks. One ‘cheat’ day was permitted each week, and outcomes were measured at weeks zero, four, and eight. Due to COVID-19 restrictions, data collection at week eight was incomplete and these data were not viable; hence, only change data at week four are reported. The Rapid Eating Assessment for Participants [shortened version] questionnaire was used to assess shifts in dietary patterns.

Results

Of the 25 initial participants, 17 completed the study (TRF group; n = 7; CON group; n = 10; age, 23 ± 4 years; BMI, 23.2 ± 2.3 kg/m2). Six TRF participants withdrew from the trial (43%) due to study-related side effects, including excess hunger and poor energy; additionally, in each group, a single participant was lost to follow-up. Change in body weight at week four was significantly different between the TRF group (−1.1 ± 1.6 kg) and the CON group (0.7 ± 1.3 kg); (P = 0.016). There were no between-group differences for change in dietary patterns and cardiometabolic indices (P &gt; 0.05).

Conclusions

Although dietary patterns and cardiometabolic indices were not altered between groups over the course of the trial, body weight was reduced in the TRF participants compared to the CON participants. These preliminary data suggest that an 18-hour TRF protocol may be useful for weight reduction; however, this protocol is difficult to follow. Future studies should identify modifications to make TRF more acceptable to users and focus on diet quality.

Funding Sources

Arizona State University.

The Carbon Isotope Ratio of Breath Is Elevated by Short and Long-Term Added Sugar and Animal Protein Intake in a Controlled Feeding Study

Objectives

Objective biomarkers would help to clarify relationships between added sugar (AS) intake and chronic disease. A recent study identified the breath carbon isotope ratio (CIR) as a potential short-term AS biomarker. To further evaluate the biomarker potential of the breath CIR, we evaluate the effects of both short and longer-term intakes of AS in the context of normal dietary intake patterns, and also evaluate animal protein (AP), another dietary factor known to influence CIR.

Methods

We conducted a 15-d controlled feeding study of 100 adults (age 18–70, 55% women) in Phoenix, AZ. Participants were provided individualized diets that approximated habitual food intakes and recorded the time that all foods were consumed throughout each day. Three breath samples were collected on each of 3 nonconsecutive, randomly selected study days: one fasting sample, one “morning” sample (collected 10:00–14:00) and one “evening” sample (collected 14:00–20:00). We used a linear mixed model to evaluate the effects of AS and AP intake in each of 8 hours preceding collection of the breath sample (t1 = 0–1 hour prior, t2 = 1–2 hours prior, etc.). Besides daily intake, models also included 15-d mean AS and AP intake, as well as sex, age and BMI. Coefficients are presented as (β (SE), P).

Results

Mean (±SD) intakes of AS and AP in our study were 67 ± 34 and 73 ± 30 g/d, respectively. The breath CIR was increased by AS consumed 1–4 hours prior to sample collection (βt2 = 0.014 (0.005), P = 0.0025; βt3 = 0.0094 (0.004), P = 0.02; βt4 = 0.012 (0.005), P = 0.02) and AP consumed 3–6 hours prior to sample collection (βt4 = 0.012 (0.005), P = 0.03; βt5 = 0.0092 (0.004), P = 0.03; βt6 = 0.010 (0.006), P = 0.09). In addition, the breath CIR increased with higher 15-d intakes of both AS and AP (βAS = 0.012 (0.003), P &lt; 0.0001 and βAP = 0.014 (0.004), P = 0.0003, respectively).

Conclusions

Both short-term and longer-term intakes of AS and AP increased the breath CIR. Short-term AS intake had a more rapid effect on the breath CIR than short-term AP intake, although effects were of similar size. Furthermore, the size of short-term effects were similar to the size of long-term effects. Thus, breath CIR is influenced by both short and long-term intakes of AS and AP and could have potential for evaluating dietary patterns.

Funding Sources

This work was funded by NIH U01 CA197902.

Evaluating the Serum Carbon Isotope Ratio as a Biomarker for Animal Protein Ratio in a Controlled Feeding Study of US Adults

Objectives

Recent studies have identified the serum natural abundance carbon isotope ratio (CIR) as a candidate biomarker of animal protein intake in postmenopausal women. Such a biomarker would help clarify the contribution of dietary protein source (animal vs. vegetable) to chronic disease risk. Here we evaluate biomarker performance and develop a biomarker calibration equation in a mixed-age and – gender cohort.

Methods

We conducted a 15-d feeding study of 100 adults (age 18–70, 55% women) in Phoenix, AZ. Participants were provided individualized diets that approximated habitual food intakes. Total CIR and nitrogen isotope ratio (NIR) were measured in sera collected at the end of the feeding period. We expressed animal protein as a ratio of total protein intake (APratio). We evaluated a model of serum CIR based on APratio, the serum NIR, gender, age and body weight, and the resulting regression equation was inverted to develop an equation for the APratio that we call the calibrated biomarker. We evaluated the association of the calibrated biomarker with actual APratio using Pearson correlation and 5-fold cross validation.

Results

Animal protein intake in this study was 73 ± 30 g/d (mean ± SD) and the APratio was 0.63 ± 0.13. Our model explained a large proportion of the variation in serum CIR (R2 = 0.77) and APratio was the only significant model effect (coefficient = 6.22, SE = 0.44, P &lt; 0.0001). Inverting that model generated the following biomarker calibration equation: APratio = (CIR – 26.35 – 0.06 (gender) + 0.068 * In age – 0.215 * In body weight – 0.204 * serum NIR)/6.22, where gender = 1,0 (male, female). There was a strong correlation between model-predicted and actual APratio (rP = 0.85, P &lt; 0.0001), with the mean model-predicted APratio differing from mean actual APratio by 0.0015 (SE = 0.0077). The standard deviation of the prediction error was 0.076. The 5-fold cross validation procedure produced very similar model R2, effects, and prediction errors.

Conclusions

These data suggest that the serum CIR has potential as a predictive biomarker of APratio, providing a useful tool for objectively assessing dietary protein intake patterns. Such a tool could help resolve the contribution of dietary patterns favoring animal protein intake to chronic disease risk.

Funding Sources

This work was funded by NIH U01 CA197902.

Maternal Education and Early Childhood Education across Affluent English-Speaking Countries

Women who attain more education tend to have children with more educational opportunities, a transmission of educational advantages across generations that is embedded in the larger structures of families' societies. Investigating such country-level variation with a life course model, this study estimated associations of mothers' educational attainment with their young children's enrollment in early childhood education and engagement in cognitively stimulating activities in a pooled sample of 36,400 children (n = 17,900 girls, 18,500 boys) drawn from nationally representative datasets from Australia, Ireland, United Kingdom, and United States. Results showed that having a mother with a college degree generally differentiated young children on these two outcomes more in the United States, potentially reflecting processes related to strong relative advantage (i.e., maternal education matters more in populations with lower rates of women's educational attainment) and weak contingent protection (i.e., it matters more in societies with less policy investment in families).

A 5-day Heat Acclimation Program Improves Heat Stress Indicators While Maintaining Exercise Capacity

ABSTRACT

Wardenaar, FC, Ortega-Santos, CP, Vento, K, Beaumont, JS, Griffin, SC, Johnston, C, and Kavouras, SA. A 5-day heat acclimation program improves heat stress indicators while maintaining exercise capacity. J Strength Cond Res 35(5): 1279-1286, 2021-This study aimed to evaluate whether a daily 60 minutes isothermic biking protocol during a 5-day period could improve physiological heat acclimation and exercise performance capacity in partially acclimated subjects. A quasi-experimental study consisted of an intervention (INT, n = 7) and control (CON, n = 7) group completing 2 12 minutes Cooper tests (pre-CT on day 1 and post-CT on day 7) and a heat stress test (HST, on day 9). INT performed additional intensive exercise 1 hour per day on days 1-5, whereas CON did not. During CTs and HST, core temperature (Tc, telemetric capsule), skin temperature (Tsk, sensors at neck, right shoulder, left hand, and right shin), and heart rate (HR, chest strap) were continuously monitored and baseline, average, peak, and increment were calculated. During the HST, the INT group showed a smaller baseline-peak Tc increment (INT 0.88 ± 0.27 vs. CON 1.64 ± 0.90° C, p = 0.02), a lower HR peak (150.2 ± 12.6 vs. 173.0 ± 16.8 b·min-1, p = 0.02), and lower Tsk peak (36.47 ± 0.62 vs. 36.54 ± 0.46° C, p = 0.04). There was a nonsignificant, but practical difference based on a moderate effect size for change in pre-CT to post-CT performance of nearly +2.7 ± 12.3% in INT and -3.0 ± 8.5% in CON (p = 0.32 and d = 0.51), and HST distance covered resulting in a nonsignificant difference of 464 ± 849 m between INT and CON (p = 0.38 and d = 0.44). In conclusion a short-term 5-day heat acclimation program including 300 minutes of extra exercise resulted in positive physiological adaptions to heat stress, as indicated by lower core temperature and HR in comparison with a control group.

Investigations into the synthesis of a nucleotide dimer via mechanochemical phosphoramidite chemistry

Liquid-assisted mechanochemistry as a versatile approach for the coupling of a nucleoside phosphoramidite with a 5'-OH partially protected nucleoside has been investigated. Noted advantages over reported methods were a simplified reaction protocol, a drastic reduction in the use of toxic solvents, the facilitation of mechanochemical reactions through the improved mixing of solid reagents, and low hydrolytic product formation.

Reliability of Three Urine Specific Gravity Meters Measuring Brix and Urine Solutions at Different Temperatures

CONTEXT

The measurement of urine specific gravity should be performed at room temperature (20 °C) but sample temperature is not always taken in consideration.

OBJECTIVE

Evaluate the effect of sample temperature on the measurement accuracy of a digital (DIG) and optical (MAN) refractometer and a hydrometer (HYD).

DESIGN

Quantitative comparison between measurement outcomes for a reference solution (sucrose, degrees Brix) and fresh collected urine samples.

SAMPLES

Experiment 1 used a 24 Brix (°Bx) samples and experiment 2 used 33 fresh urine samples.

MAIN OUTCOME MEASURE

Urine specific gravity (USG).

RESULTS

Experiment 1 showed DIG and MAN did not differ from reference, but HYD reported lower or inconsistent values compared to Bx, while highly correlating with Bx solutions (r: > 0.89). The overall diagnostic ability of elevated USG (≥ 1.020; ≥ 1.025; ≥ 1.030) was high for all tools (AUC > 0.92). Misclassification of samples increased from 0 to 2 at 1.020 to 1 to 3 samples at cutoff 1.025 and 1.030 USG. Bland-Altman analysis showed DIG 5 °C underreports slightly without reporting bias (r: -0.344, P = 0.13); all other plots for DIG, MAN, and HYD showed considerably larger underreporting at higher concentrations (r ranging from -0.21 to -0.97 with P > .02) at all temperatures. The outcomes of experiment 2 using DIG 20°C as standard, showed only negligible differences between DIG and MAN at all temperatures, but larger differences using HYD.

CONCLUSIONS

All tools showed reporting bias when compared to °Bx solutions which can impact classification of low and high urine concentration at higher USG cutoff values, especially at a sample temperature of 37 °C.

The influence of exercise during pregnancy on racial/ethnic health disparities and birth outcomes

Background

Non-Hispanic black (NHB) pregnant women disproportionately experience adverse birth outcomes compared to Non-Hispanic white (NHW) pregnant women. The positive effects of prenatal exercise on maternal and neonatal health may mitigate these disparities. This study evaluated the influence of prenatal exercise on racial/ethnic disparities in gestational age (GA), birthweight (BW), and risks of preterm birth (PTB), cesarean section (CS), and low-birthweight (LBW) neonates.

Methods

This study performed a secondary data analysis using data from a 24-week, two-arm exercise intervention trial (ENHANCED by Mom). Women with singleton pregnancies (< 16 weeks), aged 18–40 years, BMI between 18.5–34.99 kg/m², and no preexisting health conditions were eligible. The aerobic exercisers (EX) participated in 150 min of moderate-intensity weekly exercise while non-exercising controls (CON) attended low-intensity stretching/breathing sessions. Data on GA, PTB (< 37 weeks), BW, LBW (< 2.5 kg), and delivery mode were collected. Poisson, median and linear regressions were performed.

Results

Participants with complete data (n = 125) were eligible for analyses (EX: n = 58, CON: n = 67). NHB pregnant women delivered lighter neonates (β = − 0.43 kg, 95% CI: − 0.68, − 0.18, p = 0.001). After adjusting for prenatal exercise, racial/ethnic disparities in BW were reduced (β = − 0.39 kg, 95% CI: − 0.65, − 0.13, p = 0.004). Prenatal exercise reduced borderline significant racial/ethnic disparities in PTB (p = 0.053) and GA (p = 0.07) with no effects found for CS and LBW.

Conclusions

The findings of this study demonstrate that prenatal exercise may attenuate the racial/ethnic disparities observed in neonatal BW, and possibly GA and PTB. Larger, diverse samples and inclusion of maternal biomarkers (e.g., cytokines) are encouraged to further evaluate these relationships.

Phosphorus stocks and flows in an intensive livestock dominated food system

Current use and management of phosphorus (P) in our food systems is considered unsustainable and considerable improvements in the efficiency of P use are required to mitigate the environmental impact of poor P stewardship. The inherent low P use efficiency of food production from animals means food systems dominated by livestock agriculture can pose unique challenges for improving P management. This paper presents the results of a substance flow analysis for P in the Northern Ireland (NI) food system for the year 2017 as a case study for examining P stewardship in a livestock dominated agricultural system. Imported livestock feed was by far the largest flow of P into the NI food system in 2017 (11,700 t ± 1300 t) and P from livestock excreta the largest internal flow of P (20,400 ± 1900t). The P contained in livestock slurries and manures alone that were returned to agricultural land exceeded total crop and grass P requirement by 20% and were the largest contributor to an annual excess soil P accumulation of 8.5 ± 1.4 kg ha^-1. This current livestock driven P surplus also limits the opportunities for P circularity and reuse from other sectors within the food system, e.g. wastewater biosolids and products from food processing waste. Management of livestock P demand (livestock numbers, feed P content) or technological advancements that facilitate the processing and subsequent export of slurries and manures are therefore needed.

Health Care Workers and Patients as Trojan Horses: a COVID19 ward outbreak

Background

Transmission in healthcare settings can result in significant infections in healthcare workers and patients. Understanding infection dynamics has important implications for methods employed in hospitals to prevent nosocomial transmission events.

Methods

In this case series report we describe a cluster of COVID-19 (Coronavirus disease 2019) in a tertiary care university hospital, in the early phases of the epidemic, after hospital visiting had been stopped and when the UK lockdown was in place.

Findings

A 48 year old patient developed COVID-19 31 days post-admission and four days after admission to a medical ward from ITU. Infection was likely acquired from an asymptomatic or minimally symptomatic healthcare worker (HCW). Subsequent investigation over a 14 day period revealed symptoms in 23 staff members and five linked cases in patients on the same ward.

Nine of the 23 affected staff members provided care for and had direct exposure with the index case. Four staff reported caring for the index case without use of personal protective equipment. One was coughed on directly by the patient 24 hours prior to the onset of symptoms.

Conclusion

SARS CoV2 infection can be introduced to a ward area by asymptomatic and minimally symptomatic healthcare workers. Staff members and patients can act as Trojan horses carrying infection into and around the hospital, setting up unexpected transmission events.

Transmission of infection from pre-symptomatic, asymptomatic and minimally symptomatic individuals means that universal use of measures to prevent transmission is required for successful reduction of transmission events in the hospital setting.

Vitamin B6 Supplementation Reduces Depression in College Women Taking Oral Contraceptives: A Randomized, Double-Blind Cross-Over Trial

Objectives

Oral contraception (OC) use has been linked to an increased risk of depression in college women and to poor micronutrient status. Of note, when compared to non-OC users, OC users have a heightened risk of low plasma concentrations of vitamin B6, a cofactor in the tryptophan-serotonin pathway critical to mood regulation. The purpose of this crossover study was to determine whether vitamin B6 supplementation impacted mood states and depression in college women using OC.

Methods

Participants were healthy and between 18–25 y, did not smoke or use dietary supplements, and used OC (estrogen with progestin) consistently for at least one year prior to the start of the study. The 12-week, randomized, double-blind crossover trial (4-week treatment periods [B6: 100 mg/d or control: placebo pill/d] separated by a 4-week washout [no pills taken]) was approved by the university Institutional Review Board, and participants provided written consent. Anthropometric measures, blood sampling, and diet and mood assessments were completed at the start of the trial and at weeks 4, 8, and 12. Participants (n = 8) maintained normal exercise and eating patterns the duration of the study and recorded pill consumption daily. The Profile of Mood States (POMS) and Beck Depression Inventory were used to assess affect. Plasma pyridoxal 5′ phosphate (PLP) concentrations were quantified by enzymatic assay. Repeated measures ANOVA was used to assess treatment effects.

Results

Plasma PLP concentrations averaged 66 ± 32 nmol/L at the start of the trial; one participant presented with marginal vitamin B6 status (20–30 nmol/L). Average vitamin B6 intakes did not vary during the trial (1.2–1.4 mg/d); whereas, vitamin B6 status rose significantly following the B6 supplementation period compared to the other three timepoints. POMS scores were not impacted by treatment; however, Beck Depression Inventory scores were reduced 30% by B6 supplementation in comparison to the control treatment (P = 0.047).

Conclusions

These preliminary data support a growing literature suggesting the benefits of B6 supplementation for reducing depression in young women using OC.

Funding Sources

This study was supported in part by the Graduate and Professional Students Association and the Office of the Vice Provost for Research.

"Can we talk?": A longitudinal analysis of Latino & non-Hispanic parent-child connectedness & adolescent ideation

BACKGROUND

Over 16 million U.S. adults report a major depressive episode each year. Hispanic females comprise the highest number of U.S. births compared to other race/ethnicities and are expected to remain as the Hispanic population grows. Research postulates that depression often co-occurs within families and is passed down to future generations but has yet to determine racial/ethnic disparities for depression and more acute forms including ideation.

METHODS

Using data from the Fragile Families and Child Wellbeing Study, latent class analyses examined the association of primary caregiver's (PCG) depressive symptoms and how their child's perceived level of parent-child closeness is related to their now-adolescent's (age 15) likelihood of ideation (N = 4,898 families).

RESULTS

Hispanic PCG's reported a lower rate of depressive symptoms (37%) than non-Hispanic PCG's (45%). Hispanic PCG's depressive symptoms were more likely to be chronic throughout their adolescent's lifetime (15%). Regardless of race/ethnicity, PCG's chronic depressive symptoms negatively affected parental closeness and increased suicidal risk for adolescents. These associations were found at ages 9 and 15 for non-Hispanic families, and at age 15 for Hispanic families.

LIMITATIONS

While this is an important first step, parental closeness and ideation can wax and wane. Asking teens about ideation before adolescence could have strengthened our study.

CONCLUSIONS

Suicide prevention must be family system focused, and not solely adolescent focused. Impressing upon individuals who serve children (i.e. teachers) and adults (i.e. physicians) to include yearly depression and suicide screens/assessments is crucial given PCG's different wave presentations and how ideation can present as early as middle school.

Diagnostic accuracy of SUVmax in predicting malignancy of supraclavicular lymph nodes from primary oesophageal cancer

PURPOSE

To determine the diagnostic accuracy and optimum cut-off value of SUVmax on PET to predict malignancy of supraclavicular lymph nodes (SCLNs) in patients with oesophageal carcinoma.

MATERIAL AND METHODS

All diagnosed cases of oesophageal cancer were retrospectively reviewed (2010-2016). Patients that had a confirmed diagnosis of oesophageal cancer with avid SCLNs on staging PET were included in the study. 33 SCLNs that subsequently underwent ultrasound guided biopsy for staging were analysed. The maximum uptake values (SUVmax) of the SCLNs and primary tumours were measured. A receiver operating characteristic (ROC) analysis was performed to determine the optimum cut off of SUVmax in predicting malignancy.

RESULTS

24/33 PET-detected SCLNs were malignant. ROC analysis identified the best nodal SUVmax cut-off to be 3.0. The diagnostic accuracy of PET was 76.0 % (sensitivity = 78.9 %, specificity = 66.6 %). For SCLNs with SUVmax > 3.0, PET showed a positive predictor value of 88.2 %; for SCLNs < 3.0, PET showed a negative predictor value of 50 %. The median SUVmax of pathologically negative and positive nodes were 2.8 (range 1.8-6.0) and 5.3 (range 1.9-13.4). The median primary tumour SUVmax was 13.8 (range 3.7-30.0). The SUVmax of metastatic lymph nodes were significant higher than those of benign lesions (p < 0.05).

CONCLUSION

Our study revealed an accuracy rate of 76 % for PET detected SCLNs in patients with oesophageal carcinoma. For SCLNs with SUVmax > 3.0, PET had a high PPV (88 %), which can minimize the need for further diagnostic tests.

Gluten-free Products with Non-traditional Ingredients Favorably Impact Postprandial Glycemia in Healthy Adults (P08-082-19)

Objectives

Postprandial glycemia is an important contributor to hemoglobin A1c (HbA1c) concentrations in healthy individuals and those diagnosed with pre-diabetes. It is also an independent risk factor for cardiovascular disease and is linked to obesity and certain cancers. Hence, dietary strategies to minimize postprandial glycemia should be identified. Grain products are common dietary glucose sources, and white bread consumption has been linked to risk for type 2 diabetes. The popularity of gluten-free products has risen dramatically in recent years; yet some research suggests that gluten-free products have a higher glycemic response compared to traditional products, which can have adverse consequences for consumers with hyperglycemia. In these trials, the gluten-free product ingredients were grain-based flours. Products made from non-traditional, non-grain ingredients may produce more favorable glycemic responses.

Methods

Utilizing a Latin squares, crossover study design, we conducted two separate trials to examine the 2-h postprandial glycemic responses to (a) gluten-free nutrition bars and (b) gluten-free breads in comparison to the traditional products in healthy adults (19–35 y; 19–36 kg/m2). The novel, substitute ingredients for the gluten-free products were dates for the nutrition bar and a mix of potato, fava bean, garbanzo bean, teff, corn, chia seed, flax seeds or a mix of brown rice flour, tapioca flour, whole grain sorghum flour for the breads.

Results

Gluten-free nutrition bar consumption was associated with a 52% reduction in the 2-h glycemic response in comparison to the traditional bar (iAUC: 39.0 ± 6.0 and 82.0 ± 18.0 mg min/dL; P = 0.013). Gluten-free bread (bean and seed based ingredients) was associated with a 23% reduction in the 2-h glycemic response in comparison to wheat bread (iAUC: 112.4 ± 15.7 and 145.3 ± 20.0 mg min/dL; P = 0.004). However, the 2-h glycemic response to the grain-based gluten-free bread product did not differ from wheat bread.

Conclusions

The data suggest that the substitute ingredients used in gluten-free products influence the glycemic response to ingestion.

Funding Sources

Graduate Education Research and Support Program of the Graduate and Professional Student Association of Arizona State University.

Effects of Physical Activity on the Performance of 24-h Urinary Sucrose and Fructose as a Biomarker of Total Sugars Intake (P18-128-19)

Objectives

Urinary sucrose and fructose has been suggested as a predictive biomarker of total sugars intake based on research involving UK adults. The purpose of this study was to determine the association between sugars consumption and 24-hour urinary sucrose and fructose (24uSF) in US adult population and to investigate the effect of physical activity on this association.

Methods

Fifty seven free-living healthy subjects 20 to 68 years old, participated in a 15-day highly controlled feeding study, consuming their habitual diet, provided by the research metabolic kitchen. Dietary sugars were estimated using Nutrition Data System for Research (NDSR). Subjects collected eight 24-hour urine samples measured for urinary sucrose and fructose. Physical activity was assessed daily using a validated 15-day log that inquired about 38 physical activities across six domains; home activities, transportation, occupation, conditioning, sports and leisure.

Results

The 15-d mean total sugars and added sugars intake (SD) of the study population was 112.2 (33.1) g/day and 65.8 (29.0) g/day (9.7%EI), respectively. Significant moderate positive correlation was found between 15-d mean total sugars intake and 8-day mean 24uSF (r = 0.56, P < 0.001). Similarly, added sugars were moderately correlated with 24uSF (r = 0.56, P < 0.001), while no correlation was found between naturally-occurring sugars and 24uSF (r = 0.070, P < 0.001). In a linear multiple regression, total and added sugars each explained 30% of variability in 24uSF (Adjusted R2, p value; total sugars: 0.297, 0.001; added sugars: 0.301, P < 0.001). We found no effect of physical activity on the association between dietary and urinary sugars in neither the correlation nor the linear regression analysis.

Conclusions

24uSF showed moderate association with both total and added sugars consumption in US adults. No evidence was found showing that physical activity levels affect the association between 24uSF and sugars intake in US adults.

Funding Sources

National Cancer Institute.

Association between surgeon special interest and mortality after emergency laparotomy

Background

Approximately 30 000 emergency laparotomies are performed each year in England and Wales. Patients with pathology of the gastrointestinal tract requiring emergency laparotomy are managed by general surgeons with an elective special interest focused on either the upper or lower gastrointestinal tract. This study investigated the impact of special interest on mortality after emergency laparotomy.

Methods

Adult patients having emergency laparotomy with either colorectal or gastroduodenal pathology were identified from the National Emergency Laparotomy Audit database and grouped according to operative procedure. Outcomes included all-cause 30-day mortality, length of hospital stay and return to theatre. Logistic and Poisson regression were used to analyse the association between consultant special interest and the three outcomes.

Results

A total of 33 819 patients (28 546 colorectal, 5273 upper gastrointestinal (UGI)) were included. Patients who had colorectal procedures performed by a consultant without a special interest in colorectal surgery had an increased adjusted 30-day mortality risk (odds ratio (OR) 1·23, 95 per cent c.i. 1·13 to 1·33). Return to theatre also increased in this group (OR 1·13, 1·05 to 1·20). UGI procedures performed by non-UGI special interest surgeons carried an increased adjusted risk of 30-day mortality (OR 1·24, 1·02 to 1·53). The risk of return to theatre was not increased (OR 0·89, 0·70 to 1·12).

Conclusion

Emergency laparotomy performed by a surgeon whose special interest is not in the area of the pathology carries an increased risk of death at 30 days. This finding potentially has significant implications for emergency service configuration, training and workforce provision, and should stimulate discussion among all stakeholders.

Plant-Based Diets: Considerations for Environmental Impact, Protein Quality, and Exercise Performance

Plant-based diets provide well-established physical and environmental health benefits. These benefits stem in part from the degree of restriction of animal-derived foods. Historically, meat and other animal-derived proteins have been viewed as an integral component of athletes' diets, leading some to question the adequacy of vegetarian or vegan diets for supporting athletic performance. The purpose of this review is to examine the impact of plant-based diets on human physical health, environmental sustainability, and exercise performance capacity. Based on currently available literature, it is unlikely that plant-based diets provide advantages, but do not suffer from disadvantages, compared to omnivorous diets for strength, anaerobic, or aerobic exercise performance. However, plant-based diets typically reduce the risk of developing numerous chronic diseases over the lifespan and require fewer natural resources for production compared to meat-containing diets. As such, plant-based diets appear to be viable options for adequately supporting athletic performance while concurrently contributing to overall physical and environmental health. Given the sparse literature comparing omnivore, vegetarian, and vegan athletes, particularly at the elite level, further research is warranted to ascertain differences that might appear at the highest levels of training and athletic performance.

Outcomes of growing rod surgery for severe compared with moderate early-onset scoliosis: a matched comparative study

Aims

The aim of this study was to compare the outcomes of surgery using growing rods in patients with severe versus moderate early-onset scoliosis (EOS).

Patients and Methods

A review of a multicentre EOS database identified 107 children with severe EOS (major curve ≥ 90°) treated with growing rods before the age of ten years with a minimum follow-up of two years and three or more lengthening procedures. From the same database, 107 matched controls with moderate EOS were identified.

Results

The mean preoperative major curve was 101° (90 to 139) in the severe group and 67° (33° to 88°) in the moderate group (p < 0.001), which was corrected at final follow-up to 57° (10° to 96°) in the severe group and 40° (3° to 85°) in the moderate group (p < 0.001). T1-S1 height increased by a mean of 54 mm (-8 to 131) in the severe group and 27 mm (-4 to 131) in the moderate group at the initial surgery (p < 0.001), and by 50 mm (-17 to 200) and 54 mm (-11 to 212), respectively, during distraction (p = 0.84). The mean number of complications per patient was 2.6 (0 to 14) in the severe group and 1.9 (0 to 10) in the moderate group (p = 0.040). Five patients (4.7%) in the severe group and three (2.8%) in the moderate group developed a neurological deficit postoperatively (p = 0.47).

Conclusion

Severe EOS can be treated effectively using growing rods, but the risk of complications is high. Cite this article: Bone Joint J 2018;100-B:772-9.

Hyponatraemia and Moduretic-Grand Mal Seizures: A Review

Three cases are presented which emphasize the importance of hyponatraemia as a cause of grand mal seizures. The combination of hydrochlorothiazide and amiloride appears to increase the risk of hyponatraemia. We discuss the aetiology and treatment of hyponatraemia and review the necessity for such combination therapy. We recommend caution in prescribing diuretics and preparations such as Moduretic should be used only in those few patients shown to need potassium supplementation.

What do Key Stakeholders Think About HIV Self-Testing in Canada? Results from a Cross-Sectional Survey

Human immunodeficiency virus (HIV) self-testing presents an empowering alternative to facility-based testing for reaching undiagnosed HIV infected individuals, but is not currently available in Canada. We surveyed stakeholders (clinical providers, public health professionals, researchers) engaged in HIV testing initiatives nationwide to identify the concerns, opportunities and challenges to implementing HIV self-testing in Canada. An online cross-sectional survey was disseminated by the Canadian Institutes of Health Research Centre for REACH 2.0 National HIV & sexually transmitted and blood borne infections working group to stakeholders nationwide, with a target sample size of 200. Quantitative and qualitative data were analyzed using a mixed-methods, respondent-informed approach, to inform subsequent HIV self-testing in a country where self-testing is not yet accessible. A total of 183 responses were received. A majority (70.7%) (128/181) felt that self-testing was a necessary investment to reach the undiagnosed. 64.6% (117/181) felt that self-tests should be made available to their clients and 71.5% (128/179) of respondents agreed that self-test instructions required improvements. However, 50% (90/180) felt that self-testing will pose an economic challenge to current HIV testing models. Regardless, 21% urged for timely action and availability of HIV self-tests. Thematic analyses reflected the following concerns: (a) need for affordable self-tests, (b) need for expedited, customized, and accessible linkages to counselling, (c) concern for patients to cope with positive self-test results, (d) accuracy of self-tests to detect acute HIV and (e) liability in the context of non-disclosure. Stakeholders agreed to the provision of an option of HIV self-testing to reach the undiagnosed individuals. Concerns regarding costs and accuracy of self-tests, expedited linkages to counselling, and integration of self-test within prevailing HIV testing models, will need to be addressed before their widespread implementation.

Stakeholders' views of the introduction of assistive technology in the classroom: How family-centred is Australian practice for students with cerebral palsy?

BACKGROUND

With family-centred care widely recognized as a cornerstone for effective assistive technology service provision, the current study was undertaken to investigate to what extent such approaches were used by schools when assistive technology assessments and implementation occurred in the classroom.

METHOD

In this cross-sectional study, we compare survey results from parents (n = 76), school staff (n = 33) and allied health professionals (n = 65) with experience in the use of high-tech assistive technology. Demographic characteristics and the stakeholders' perceived helpfulness and frequency attending assessment and set-up sessions were captured. To evaluate how family-centred the assistive technology services were perceived to be, the parents filled out the Measure of Processes of Care for Caregivers, and the professionals completed the Measure of Processes of Care for Service Providers. Descriptive statistics and one-way analysis of variance were used to conduct the data analysis.

RESULTS

Findings show that parents are more involved during the assessment stage than during the implementation and that classroom teachers are often not involved in the initial stage. Speech pathologists in particular are seen to be to a great extent helpful when implementing assistive technology in the classroom. This study found that family-centred service is not yet fully achieved in schools despite being endorsed in early intervention and disability services for over 20 years. No statistically significant differences were found with respect to school staff and allied health professionals' roles, their years of experience working with students with cerebral palsy and the scales in the Measure of Processes of Care for Service Providers.

CONCLUSION

To enhance the way technology is matched to the student and successfully implemented, classroom teachers need to be fully involved in the whole assistive technology process. The findings also point to the significance of parents' involvement, with the support of allied health professionals, in the process of selecting and implementing assistive technology in the classroom.

Proceedings of the Thirteenth International Society of Sports Nutrition (ISSN) Conference and Expo

P1 Impact of antioxidant-enriched nutrient bar supplementation on the serum antioxidant markers and physical fitness components of track and field athletes

Lalitha Ramaswamy, Supriya Velraja

P2 The effects of phosphatidic acid supplementation on fitness levels in resistance trained women

Guillermo Escalante, Phil Harvey, Michelle Alencar, Bryan Haddock

P3 The effects of phosphatidic acid supplementation on cardiovascular risk factors in resistance trained men

Phil Harvey, Guillermo Escalante, Michelle Alencar, Bryan Haddock

P4 The efficacy of sodium bicarbonate supplementation on physical capacity and selected biochemical markers in elite wrestlers

Krzysztof Durkalec-Michalski, Jan Jeszka, Bogna Zawieja, Tomasz Podgórski

P5 Effects of different nutritional strategies in hydration and physical performance in healthy well-trained males

Ana Paula Trussardi Fayh, Alexandre Hideki Okano, Amanda Maria de Jesus Ferreira

P6 Reduction of plasma creatine concentrations as an indicator of improved bioavailability

Ralf Jäger, Martin Purpura, Roger C Harris

P7 Effect of three different breakfast meals on energy intake and nutritional status in college-age women

Molly M. Krause, Kiley A. Lavanger, Nina O. Allen, Allison E. Lieb, Katie A. Mullen, Joan M. Eckerson

P8 Accuracy of the ASA24® Dietary Recall system for assessing actual dietary intake in normal weight college-age women.

Kiley A. Lavanger, Molly M. Krause, Nina O. Allen, Allison E. Lieb, Katie A. Mullen, Joan M. Eckerson

P9 β-aminoisobutyric acid does not regulate exercise induced UCP-3 expression in skeletal muscle

Elisa Morales, Jeffrey Forsse, Thomas Andre, Sarah McKinley, Paul Hwang, Grant Tinsley, Mike Spillane, Peter Grandjean, Darryn Willoughby

P10 The ability of collegiate football athletes to adhere to sport-specific nutritional recommendations

A. Jagim, G. Wright, J. Kisiolek, M. Meinking, J. Ochsenwald, M. Andre, M.T. Jones, J. M. Oliver

P11 A single session of low-volume high intensity interval exercise improves appetite regulation in overweight men

Victor Araújo Ferreira, Daniel Costa de Souza, Victor Oliveira Albuquerque dos Santos, Rodrigo Alberto Vieira Browne, Eduardo Caldas Costa, Ana Paula Trussardi Fayh

P12 Acute effects of oral peppermint oil ingestion on exercise performance in moderately-active college students

Suresh T. Mathews, Haley D. Bishop, Clara R. Bowen, Yishan Liang, Emily A. West, Rebecca R. Rogers, Mallory R. Marshall, John K. Petrella

P13 Associations in body fat and liver triglyceride content with serum health markers in sedentary and exercised rats fed a ketogenic diet, Western diet or standard chow over a 6-week period

A. Maleah Holland, Wesley C. Kephart, Petey W. Mumford, C. Brooks Mobley, Ryan P. Lowery, Jacob M. Wilson, Michael D. Roberts

P14 Physiological changes following competition in male and female physique athletes: A pilot study

Eric T. Trexler, Katie R. Hirsch, Bill I. Campbell, Meredith G. Mock, Abbie E. Smith-Ryan

P15 Relationship between cognition and hydration status in college students at a large Southwestern university

Kate Zemek, Carol Johnston

P16 Whey protein-derived exosomes increase protein synthesis in C2C12 myotubes

C. Brooks Mobley, Petey W. Mumford, David D. Pascoe, Christopher M. Lockwood, Michael E. Miller, Michael D. Roberts

P17 The effect of three different energy drinks on 1.5-mile running performance, oxygen consumption, and perceived exertion

Gabriel J. Sanders, Willard Peveler, Brooke Warning, Corey A. Peacock

P18 The Ketogenic diet improves rotarod performance in young and older rats

Wesley C. Kephart, Petey W. Mumford, Ryan P. Lowery, Michael D. Roberts, Jacob M. Wilson

P19 Absorption of bonded arginine silicate compared to individual arginine and silicon components

David Sandler, Sara Perez Ojalvo, James Komorowski

P20 Effects of a high (2.4 g/kg) vs. low/moderate (1.2 g/kg) protein intake on body composition in aspiring female physique athletes engaging in an 8-week resistance training program

Bill I. Campbell, Danielle Aguilar, Andres Vargas, Laurin Conlin, Amey Sanders, Paola Fink-Irizarry, Layne Norton, Ross Perry, Ryley McCallum, Matthew R. Wynn, Jack Lenton

P21 Effects of a high (2.4 g/kg) vs. low/moderate (1.2 g/kg) protein intake on maximal strength in aspiring female physique athletes engaging in an 8-week resistance training program

Bill I. Campbell, Chris Gai, Seth Donelson, Shiva Best, Daniel Bove, Kaylee Couvillion, Jeff Dolan, Dante Xing, Kyshia Chernesky, Michael Pawela, Andres D. Toledo, Rachel Jimenez

P22 Monitoring of female collegiate athletes over a competitive season reveals changes in nutritional biomarkers

M. Rabideau, A. Walker, J. Pellegrino, M. Hofacker, B. McFadden, S. Conway, C. Ordway, D. Sanders, R. Monaco, M. S. Fragala, S. M. Arent

P23 Comparison of prediction equations to indirect calorimetry in men and women athletes

Jason D. Stone, Andreas Kreutzer, Jonathan M. Oliver, Jacob Kisiolek, Andrew R. Jagim

P24 Regional variations in sweat-based electrolyte loss and changes in plasma electrolyte content in Division I female athletes over the course of a competitive season

M. Hofacker, A. Walker, J. Pellegrino, M. Rabideau, B. McFadden, S. Conway, D. Sanders, C. Ordway, R. Monaco, M. S. Fragala, S. M. Arent

P25 In-season changes in plasma amino acid levels in Division I NCAA female athletes

Ozlem Tok, Joseph K. Pellegrino, Alan J. Walker, David J. Sanders, Bridget A. McFadden, Meaghan M. Rabideau, Sean P. Conway, Chris E. Ordway, Marissa Bello, Morgan L. Hofacker, Nick S. Mackowski, Anthony J. Poyssick, Eddie Capone, Robert M. Monaco, Maren S. Fragala, Shawn M. Arent

P26 Effects of a ketogenic diet with exercise on serum markers of bone metabolism, IGF-1 and femoral bone mass in rats

Petey W. Mumford, A. Maleah Holland, Wesley C. Kephart, Ryan P. Lowery, C. Brooks Mobley, Romil K. Patel, Annie Newton, Darren T. Beck, Michael D. Roberts, Jacob M. Wilson, Kaelin C. Young

P27 Casein supplementation in trained men and women: morning versus evening

Tobin Silver, Anya Ellerbroek, Richard Buehn, Leo Vargas, Armando Tamayo, Corey Peacock, Jose Antonio

P28 A high protein diet has no harmful effects: a one-year crossover study in resistance-trained males

Anya Ellerbroek, Tobin Silver, Richard Buehn, Leo Vargas, Armando Tamayo, Corey Peacock, Jose Antonio

P29 SUP (Stand-up Paddling) athletes: nutritional intake and body composition

Adam Pollock, Anya Ellerbroek, Tobin Silver, Corey Peacock, Jose Antonio

P30 The effects of 8 weeks of colostrum and bio-active peptide supplementation on body composition in recreational male weight lifters

A. Kreutzer, P. Zavala, S. Fleming, M. Jones, J. M. Oliver, A. Jagim

P31 Effects of a Popular Women’s Thermogenic Supplement During an Energy-Restricted High Protein Diet on Changes in Body Composition and Clinical Safety Markers

Cody T. Haun, Petey W. Mumford, Parker N. Hyde, Ciaran M. Fairman, Wesley C. Kephart, Darren T. Beck, Jordan R. Moon, Michael D. Roberts, Kristina L. Kendall, Kaelin C. Young

P32 Three days of caffeine consumption following caffeine withdrawal yields small strength increase in knee flexors

Geoffrey M Hudson, Tara Hannings, Kyle Sprow, Loretta DiPietro

P33 Comparison of cellular nitric oxide production from various sports nutrition ingredients

Doug Kalman, Sara Perez Ojalvo, James Komorowski

P34 The effects of 8 weeks of bio-active peptide supplementation on training adaptations in recreational male weight lifters

P. Zavala, S. Fleming, M. Jones, J. Oliver, A. Jagim

P35 Effects of MusclePharm Assault Black^TM on lower extremity spinal excitability and postactivation potentiation: A pilot study

Brian Wallace, Haley Bergstrom, Kelly Wallace

P36 Effects of four weeks of Ketogenic Diet alone and combined with High intensity Interval Training or Continuous-Moderate intensity on body composition, lipid profile and physical performance on healthy males

Matias Monsalves-Alvarez, Sebastian Oyharçabal, Victoria Espinoza

P37 Effect of branched-chain amino acid supplementation on creatine kinase, muscular performance, and perceived muscle soreness following acute eccentric exercise

Trisha A. VanDusseldorp, Kurt A. Escobar, Kelly E. Johnson, Nathan Cole, Terence Moriarty, Matthew Stratton, Marvin R. Endito, Christine M. Mermier, Chad M. Kerksick

P38 Effects of endurance training on markers of ribosome biogenesis in rodents fed a high fat diet

Matthew A. Romero, C. Brooks Mobley, Melissa Linden, Grace Margaret-Eleanor Meers, R. Scott Rector, Michael D. Roberts

P39 The effects of acute citrulline-malate on lower-body isokinetic performance in recreationally active individuals

Joshua L Gills, Hocheng Lu, Kimberly Parker, Chris Dobbins, Joshua N Guillory, Braden Romer, David Szymanski, Jordan Glenn

P40 The effect pre-ingested L-isoleucine and L-leucine on blood glucose responses and glycemic hormones in healthy inactive adults: Preliminary data.

Daniel E. Newmire, Eric Rivas, Sarah E. Deemer, Robert Wildman, Victor Ben-Ezra

P41 Does protein and source impact substrate oxidation and energy expenditure during and after moderate intensity treadmill exercise?

C Kerksick, B Gieske, R Stecker, C Smith, K Witherbee

P42 Effects of a pre-workout supplement on peak power and power maintenance during lower and upper body testing

Michael T. Lane, M. Travis Byrd, Zachary Bell, Emily Frith, Lauren M.C. Lane

P43 Effects of a pre-workout supplement on peak power production during lower and upper body testing in college-age females

Michael T. Lane, M. Travis Byrd, Zachary Bell, Emily Frith, Lauren M.C. Lane

P44 A comparison of whey versus casein protein supplementation on resting metabolic rate and body composition: a pilot study

Corey A. Peacock, Tobin A. Silver, Megan Colas, Mauricio Mena, Winter Rodriguez, Gabriel J. Sanders, Jose Antonio

P45 A novel mixed-tocotrienol intervention enhances recovery after eccentric exercise: preliminary findings

Andrea Vansickle, Brittany DiFiore, Stephanie Stepp, Grant Slack, Bridget Smith, Kayla Ruffner, Ronald Mendel, Lonnie Lowery

P46 The effects of post-exercise ingestion of a high molecular weight glucose on cycle performance in female cyclists

Katie R. Hirsch, Meredith G. Mock, Malia M.N. Blue, Eric T. Trexler, Erica J. Roelofs, Abbie E. Smith-Ryan

P47 Inclusive vs. exclusive dieting and the effects on body composition in resistance trained individuals

Laurin Conlin, Danielle Aguilar, Bill I. Campbell, Layne Norton, Katie Coles, Eric T. Trexler, Nic Martinez

P48 A whey protein hydrolysate may positively augment resting metabolism compared to intact whey protein

Jordan M. Joy, Roxanne M. Vogel, Thomas H. Hoover, K. Shane Broughton

P49 Seven days of high and low dose creatine nitrate supplementation I: hepatorenal, glucose and muscle enzyme function

R Dalton, R Sowinski, T Grubic, PB Collins, A Colletta, A Reyes, B Sanchez, M Kozehchain, YP Jung, C Rasmussen, P Murano, CP Earnest, M Greenwood, RB Kreider

P50 Seven days of high and low dose creatine nitrate supplementation II: performance

T Grubic, R Dalton, R Sowinski, PB Collins, A Colletta, A Reyes, B Sanchez, M Kozehchain, YP Jung, C Rasmussen, P Murano, CP Earnest, M Greenwood, RB Kreider

P51 Seven days of high and low dose creatine nitrate supplementation III: hemodynamics

R Sowinski, R Dalton, T Grubic, PB Collins, A Colletta, A Reyes, B Sanchez, M Kozehchain, YP Jung, C Rasmussen, P Murano, CP Earnest, M Greenwood, RB Kreider

P52 The efficacy of a β-hydroxy-β-methylbutyrate supplementation on physical capacity, body composition and biochemical markers in highly-trained combat sports athletes

Krzysztof Durkalec-Michalski, Jan Jeszka, Tomasz Podgórski

P53 Does protein and source impact substrate oxidation and energy expenditure during and after moderate intensity treadmill exercise?

C Kerksick, B Gieske, R Stecker, C Smith, K Witherbee

P54 Effects of 30 days of Cleanse™ supplementation on measure of body composition, waist circumference, and markers of gastrointestinal distress in females

Stacie Urbina, Emily Santos, Katelyn Villa, Alyssa Olivencia, Haley Bennett, Marissa Lara, Cliffa Foster, Colin Wilborn, Lem Taylor

P55 The effects of moderate- versus high-load training on body composition, muscle growth, and performance in college aged females

Jason M Cholewa, Amy Hewins, Samantha Gallo, Ashley Micensky, Christian De Angelis, Christopher Carney, Bill Campbell, Laurin Conlin, Layne Norton, Fabricio Rossi

P56 Effect of a multi-ingredient preworkout supplement on cognitive function and perceptions of readiness to perform

MS Koozehchian, PB Collins, R Sowinski, T Grubic, R Dalton, A O’Connor, SY Shin, Y Peter Jung, BK Sanchez, A Coletta, M Cho, A Reyes, C Rasmussen, CP Earnest, PS Murano, M Greenwood, RB Kreider