We compared cycling injury risks of 14 route types and other route infrastructure features.
We recruited 690 city residents injured while cycling in Toronto or Vancouver, Canada. A case-crossover ...design compared route infrastructure at each injury site to that of a randomly selected control site from the same trip.
Of 14 route types, cycle tracks had the lowest risk (adjusted odds ratio OR = 0.11; 95% confidence interval CI = 0.02, 0.54), about one ninth the risk of the reference: major streets with parked cars and no bike infrastructure. Risks on major streets were lower without parked cars (adjusted OR = 0.63; 95% CI = 0.41, 0.96) and with bike lanes (adjusted OR = 0.54; 95% CI = 0.29, 1.01). Local streets also had lower risks (adjusted OR = 0.51; 95% CI = 0.31, 0.84). Other infrastructure characteristics were associated with increased risks: streetcar or train tracks (adjusted OR = 3.0; 95% CI = 1.8, 5.1), downhill grades (adjusted OR = 2.3; 95% CI = 1.7, 3.1), and construction (adjusted OR = 1.9; 95% CI = 1.3, 2.9).
The lower risks on quiet streets and with bike-specific infrastructure along busy streets support the route-design approach used in many northern European countries. Transportation infrastructure with lower bicycling injury risks merits public health support to reduce injuries and promote cycling.
Summary
Outer membrane vesicles (OMVs) are asymmetrical single bilayer membranous nanostructures produced by Gram‐negative bacteria important for bacterial interaction with the environment. ...Porphyromonas gingivalis, a keystone pathogen associated with chronic periodontitis, produces OMVs that act as a virulence factor secretion system contributing to its pathogenicity. Despite their biological importance, the mechanisms of OMV biogenesis have not been fully elucidated. The ~14 times more curvature of the OMV membrane than cell outer membrane (OM) indicates that OMV biogenesis requires energy expenditure for significant curvature of the OMV membrane. In P. gingivalis, we propose that this may be achieved by upregulating the production of certain inner or outer leaflet lipids, which causes localized outward curvature of the OM. This results in selection of anionic lipopolysaccharide (A‐LPS) and associated C‐terminal domain (CTD) ‐family proteins on the outer surface due to their ability to accommodate the curvature. Deacylation of A‐LPS may further enable increased curvature leading to OMV formation. Porphyromonas gingivalis OMVs that are selectively enriched in CTD‐family proteins, largely the gingipains, can support bacterial coaggregation, promote biofilm development and act as an intercessor for the transport of non‐motile bacteria by motile bacteria. The P. gingivalis OMVs are also believed to contribute to host interaction and colonization, evasion of immune defense mechanisms, and destruction of periodontal tissues. They may be crucial for both micro‐ and macronutrient capture, especially heme and probably other assimilable compounds for its own benefit and that of the wider biofilm community.
Background
During the last two decades, an increasing number of bariatric surgical procedures have been performed worldwide. There is no consensus regarding optimal perioperative care in bariatric ...surgery. This review aims to present such a consensus and to provide graded recommendations for elements in an evidence-based “enhanced” perioperative protocol.
Methods
The English-language literature between January 1966 and January 2015 was searched, with particular attention paid to meta-analyses, randomised controlled trials and large prospective cohort studies. Selected studies were examined, reviewed and graded. After critical appraisal of these studies, the group of authors reached a consensus recommendation.
Results
Although for some elements, recommendations are extrapolated from non-bariatric settings (mainly colorectal), most recommendations are based on good-quality trials or meta-analyses of good-quality trials.
Conclusions
A comprehensive evidence-based consensus was reached and is presented in this review by the enhanced recovery after surgery (ERAS) Society. The guidelines were endorsed by the International Association for Surgical Metabolism and Nutrition (IASMEN) and based on the evidence available in the literature for each of the elements of the multimodal perioperative care pathway for patients undergoing bariatric surgery.
Abstract Study question Does paternal pre-conception consumption of caloric or non-caloric sweeteners (NCS) coupled with high fat diets (HFD) predispose offspring to early puberty onset in mice? ...Summary answer Paternal prenatal consumption of the NCS Rebaudioside A(RebA) resulted in early puberty onset in female offspring only compared to water and caloric sweetener groups. What is known already A growing body of evidence suggests that the paternal diet also influences health and disease onset in offspring. Early puberty onset is associated with metabolic syndrome, type 2 diabetes, and cardiovascular disease later in adulthood. NCS are often promoted as heathier alternatives to caloric sweeteners. Evidence examining the impact of NCS on male reproductive function and offspring health outcomes, including pubertal timing are lacking. Few studies have shown maternal HFD can contribute to early puberty onset in female offspring however to our knowledge this is the first study to investigate paternal diet and offspring reproductive outcomes. Study design, size, duration 32 6-week-old C57/BL6 male mice were randomly assigned to receive a control diet (CD) or HF plus water (Con), fructose (Fr), Acesulfame K (Ak) or RebA). After 8 weeks, mice were mated. Litters were standardised to 2 males and 2 females per group and fed a standard laboratory diet. Participants/materials, setting, methods Puberty onset was measured in females by vaginal opening (from postnatal day (PN28) and in males by preputial separation (from PN35). Oral glucose tolerance tests were carried out at PN70. Mice were culled from PN80. Data were analysed by repeated measures or 2-way ANOVA. Main results and the role of chance There were no significant differences in birth weight, sex ratio or organ weights across groups. There was an overall effect of paternal NCS on male but not female offspring weightCR1 at cull(p < 0.05), with male CDRebA offspring having increased BW (29.52g±1.5) compared with CDAk at PN80 (26.4g±3; p < 0.05). Females from paternal HF and CD RebA group CR2 entered puberty significantly earlier (31.8d±1) than Fr (34d±1;p<0.01) and Con (34±1;p<0.05) groups. Male offspring from HFAk had lower glucose AUC (913±31) compared with CDCon (1289±48;p<0.001). Female offspring from CDRebA (1263±84) and CDFr (1273±67) groups had lower glucose AUC compared with CDCon group (1445±56;p<0.05). Limitations, reasons for caution This study was carried out on mice therefore direct translatability to humans is limited. examining the impact of paternal NCS intakes on molecular pathways in the ovary and testes to assess offspring reproductive health later in life and to evaluate pregnancy success following mating would essential for providing further insight. Wider implications of the findings The present study adds to the experimental evidence to date suggesting that NCS may not be beneficial alternatives to sugar-sweetened products consumed preconceptionally on the health of the offspring. This study also highlights the importance of including paternal diet in research when looking at transgenerational effects. Trial registration number not applicable
As SARS-CoV-2 vaccines are deployed worldwide, a comparative evaluation is important to underpin decision-making. We here report a systematic literature review and meta-analysis of Phase I/II/III ...human trials and non-human primates (NHP) studies, comparing reactogenicity, immunogenicity and efficacy across different vaccine platforms for comparative evaluation (updated to March 22, 2021). Twenty-three NHP and 32 human studies are included. Vaccines result in mostly mild, self-limiting adverse events. Highest spike neutralizing antibody (nAb) responses are identified for the mRNA-1273-SARS-CoV and adjuvanted NVX-CoV2373-SARS-CoV-2 vaccines. ChAdOx-SARS-CoV-2 produces the highest T cell ELISpot responses. Pre-existing nAb against vaccine viral vector are identified following AdH-5-SARS-CoV-2 vaccination, halving immunogenicity. The mRNA vaccines depend on boosting to achieve optimal immunogenicity especially in the elderly. BNT162b2, and mRNA-1273 achieve >94%, rAd26/5 > 91% and ChAdOx-SARS-CoV-2 > 66.7% efficacy. Across different vaccine platforms there are trade-offs between antibody binding, functional nAb titers, T cell frequency, reactogenicity and efficacy. Emergence of variants makes rapid mass rollout of high efficacy vaccines essential to reduce any selective advantage.
Question: Plant–soil feedback (PSF) has emerged as a ubiquitous phenomenon and a potentially important predictor of plant community structure and dynamics. However, the predictive power of PSF in ...field contexts is mixed, and ecologists do not yet understand its relative importance compared to other factors that structure communities. Further progress requires a more nuanced understanding of how PSF interacts with other biotic and abiotic factors. Environmental factors (e.g. natural enemies, moisture, light, nutrients) are known to affect plant interactions with soil and soil organisms, leading to an expectation of environmental context dependence in plant–soil feedback. Such context dependence could explain when PSF is expected to be an important driver of community dynamics, and under what conditions PSF is likely to be positive (destabilizing) vs negative (stabilizing). Methods: We conducted a literature review of studies that examined PSF across biotic and abiotic gradients. Results: Although few relevant studies have been conducted in this emerging research area, results to date suggest that plant–soil feedback is sensitive to biotic factors, such as above- and below-ground herbivory, and abiotic factors, such as nutrients and light. Conclusions: We develop a conceptual framework to predict variation in the direction and strength of PSF depending on the biotic or abiotic drivers of feedback (e.g. pathogens, nutrients) and the environmental context (e.g. intensity of herbivory, soil fertility). We explore the utility of our predictive framework through discussion of case studies from the literature on context dependence in PSF. We also consider how different experimental approaches might yield different insights about PSF–environment interactions, and suggest key future research directions.
Elderly patients with major depression, including those having a first episode, are at high risk for recurrence of depression, disability, and death.
We tested the efficacy of maintenance paroxetine ...and monthly interpersonal psychotherapy in patients 70 years of age or older who had depression (55 percent of whom were having a first episode) in a 2-by-2, randomized, double-blind, placebo-controlled trial. Among patients with a response to treatment with paroxetine and psychotherapy, 116 were randomly assigned to one of four maintenance-treatment programs (either paroxetine or placebo combined with either monthly psychotherapy or clinical-management sessions) for two years or until the recurrence of major depression. Clinical-management sessions, conducted by the same nurses, social workers, and psychologists who provided psychotherapy, involved discussion of symptoms.
Major depression recurred within two years in 35 percent of the patients receiving paroxetine and psychotherapy, 37 percent of those receiving paroxetine and clinical-management sessions, 68 percent of those receiving placebo and psychotherapy, and 58 percent of those receiving placebo and clinical-management sessions (P=0.02). After adjustment for the effect of psychotherapy, the relative risk of recurrence among those receiving placebo was 2.4 times (95 percent confidence interval, 1.4 to 4.2) that among those receiving paroxetine. The number of patients needed to be treated with paroxetine to prevent one recurrence was 4 (95 percent confidence interval, 2.3 to 10.9). Patients with fewer and less severe coexisting medical conditions (such as hypertension or cardiac disease) received greater benefit from paroxetine (P=0.03 for the interaction between treatment with paroxetine and baseline severity of medical illness).
Patients 70 years of age or older with major depression who had a response to initial treatment with paroxetine and psychotherapy were less likely to have recurrent depression if they received two years of maintenance therapy with paroxetine. Monthly maintenance psychotherapy did not prevent recurrent depression. (ClinicalTrials.gov number, NCT00178100.).
ABSTRACT
Axion-like particles (ALPs) are predicted by several Beyond the Standard Model theories, in particular, string theory. In the presence of an external magnetic field perpendicular to the ...direction of propagation, ALPs can couple to photons. Therefore, if an X-ray source is viewed through a magnetized plasma, such as a luminous quasar in a galaxy cluster, we may expect spectral distortions that are well described by photon–ALP oscillations. We present a 571 ks combined high- and low-energy transmission grating Chandra observation of the powerful radio-quiet quasar H1821+643, hosted by a cool-core cluster at redshift 0.3. The spectrum is well described by a double power-law continuum and broad+narrow iron line emission typical of type-1 active galactic nuclei (AGNs), with remaining spectral features ${\lt}2.5{{\ \rm per\ cent}}$. Using a cell-based approach to describe the turbulent cluster magnetic field, we compare our spectrum with photon–ALP mixing curves for 500 field realizations, assuming that the thermal-to-magnetic pressure ratio β remains constant up to the virial radius. At $99.7{{\ \rm per\ cent}}$ credibility and taking β = 100, we exclude all couplings gaγ > 6.3 × 10−13 GeV−1 for most ALP masses <10−12 eV. Our results are moderately more sensitive to constraining ALPs than the best previous result from Chandra observations of the Perseus cluster, albeit with a less constrained field model. We reflect on the promising future of ALP studies with bright AGNs embedded in rich clusters, especially with the upcoming Athena mission.
White-nose syndrome (WNS) is an emerging disease affecting hibernating bats in eastern North America that causes mass mortality and precipitous population declines in winter hibernacula. First ...discovered in 2006 in New York State, WNS is spreading rapidly across eastern North America and currently affects seven species. Mortality associated with WNS is causing a regional population collapse and is predicted to lead to regional extinction of the little brown myotis (Myotis lucifugus), previously one of the most common bat species in North America. Novel diseases can have serious impacts on naïve wildlife populations, which in turn can have substantial impacts on ecosystem integrity.
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