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Background: Poor sleep quality has been associated with active inflammatory bowel disease (IBD) in several studies. This review examines sleep quality in people with active IBD and in those in remission, with a meta-analysis performed, considering subjective and objective sleep quality and IBD activity. Methods: Electronic databases were searched for publications from inception to December 1st 2020. Effect sizes were estimated to determine the association between sleep quality and IBD activity using a random effects model. Separate meta-analyses were performed for objective and subjective sleep and IBD activity, considering sleep quality in active and inactive IBD. Results: 19 studies were included in the qualitative review representing 4972 IBD patients. Subjective IBD activity was associated with subjective poor sleep quality with pooled odds ratio (OR) of 3.04 (95% CI 2.41-3.83). Sleep efficiency was lower in those self-reporting active IBD and, time awake post sleep onset was higher in those with active disease with acceptably heterogeneity. Objective IBD activity was associated with subjective poor sleep, with pooled OR of 6.64 95% CI (3.02 – 14.59). Insufficient data was available to consider objective IBD activity and objective sleep quality. Conclusion: IBD activity is associated with poor sleep using subjective and objective measures of sleep quality. This manifests as decreased sleep efficiency and increased number of waking episodes post sleep onset. This may be due to IBD symptoms, however emerging data suggests sleep quality remains poor in those with subclinical inflammation. The relationship between objective IBD activity and sleep requires further investigation. Funding: No funding sources were obtained for this study. Declaration of Interest: Conflicts of interest include speakers fees, and Ad Boards from : Abbott, AbbVie, Allergan, Anatara, AstraZeneca, Bayer, BMS 2020, Celegene, Celltrion, Falk, Ferring, Gilead, Hospira, Immuninc, ImmunsanT, Janssen, MSD, Nestle, Novartis, Progenity, Pfizer, Sandoz, Shire, Takeda, Vifor, RAH research Fund, The Hospital Research Fund 2020-2022, The Helmsley Trust 2020-2023

Subarctic communities are useful bellwethers of human adaptability to climate change. Previous studies have compared the socio ecological adaptations of culturally comparable but geographically separated communities such as medieval Greenland and Iceland. In the Shetland Islands during the Little Ice Age (LIA) unusual storminess in the 16th and 17th centuries deposited wind driven sand in the township of Broo, Dunrosssness, and on its surrounding estates. Documents, historical records and optically stimulated luminescence (OSL) dated sand layers show the history of deposition, and reveal two episodes of sand movement one from the mid 16th century, the second from the late 17th or early 18th century. Artifacts, records and stratigraphy suggest Broo's inhabitants successfully resisted the 16th century sand incursion, but were driven from their homes by the early 18th century. Adjacent communities embedded in the same socio economic culture survived the same events and remain viable settlements to the present day. Wind simulations demonstrate that storm conditions are likely to produce markedly lower wind velocities in the area around Broo than over the surrounding landscape making it singularly vulnerable to sand inundation. In this instance human ingenuity and resilience could not counter the misfortune of location. We conclude that in this marginal environment small geographical differences had profound and lasting impact on survivability during an episode of catastrophic environmental change.

A. Palotie on työryhmän Int IBD Genetics Consortium jäsen. One goal of human genetics is to understand the genetic basis of disease, a challenge for diseases of complex inheritance because risk alleles are few relative to the vast set of benign variants. Risk variants are often sought by association studies in which allele frequencies in case subjects are contrasted with those from population-based samples used as control subjects. In an ideal world we would know population-level allele frequencies, releasing researchers to focus on case subjects. We argue this ideal is possible, at least theoretically, and we outline a path to achieving it in reality. If such a resource were to exist, it would yield ample savings and would facilitate the effective use of data repositories by removing administrative and technical barriers. We call this concept the Universal Control Repository Network (UNICORN), a means to perform association analyses without necessitating direct access to individual-level control data. Our approach to UNICORN uses existing genetic resources and various statistical tools to analyze these data, including hierarchical clustering with spectral analysis of ancestry; and empirical Bayesian analysis along with Gaussian spatial processes to estimate ancestry-specific allele frequencies. We demonstrate our approach using tens of thousands of control subjects from studies of Crohn disease, showing how it controls false positives, provides power similar to that achieved when all control data are directly accessible, and enhances power when control data are limiting or even imperfectly matched ancestrally. These results highlight how UNICORN can enable reliable, powerful, and convenient genetic association analyses without access to the individual-level data.

Background The primary objective of this study was to gain a better understanding of the associations of health-related quality of life (HRQoL) and psychosocial factors (e.g., satisfaction with life, level of self-esteem, anxiety, depression) with resistance training and sedentary behavior profiles. Methods For this cross-sectional study, 358 older adults (≥ 55 years of age) across Alberta, Canada, completed self-reported measures of resistance training behavior, sedentary time, HRQoL, and psychosocial health (e.g., depression, anxiety, self-esteem, satisfaction with life). Participants were placed into one of four profiles with respect to their sedentary and resistance training behaviors. Data were collected in Alberta, Canada between August 2013 and January 2014. Results Pairwise comparisons indicated that those in the low SED/low RT group had a higher mental health composite (MHC) score compared to those in the high SED/low RT group (Mdiff = 3.9, p = 0.008). Compared to those in the high SED/low RT group, those in the low SED/high RT groups had significantly higher MHC scores (Mdiff = 4.8, p, Highlights • No studies have considered resistance training and sedentary behaviors. • High sedentary time was related to poorer HRQoL and psychosocial health. • Older adults should limit time spent in sedentary pursuits.

Question What are clinical physiotherapists' perceptions about delivering two interventions during a randomised trial: the MOBILISE trial? Design Mixed methods study using semi-structured interviews involving closed- and open-ended questions. Participants Thirteen physiotherapists involved in delivering the intervention for the trial. Results All thirteen physiotherapists (100%) had a preference for their patients to get one of the interventions, mostly dependent on the individual patient. Most were frustrated if their patients were not allocated to their preferred intervention but 62% were satisfied with the intervention they delivered and 100% would be happy to be involved in future research. Two significant themes emerged from the open-ended data: that there were both positive and negative aspects of being involved in the trial. The positive aspects included the trial's value as a way of participating in research and as a way of providing evidence for practice. The negative aspects were that the design of the trial was not always reflective of usual clinical practice and the trial's impact on departments, therapists and patients. Conclusion Clinical physiotherapists had both positive and negative perceptions about delivering two different interventions in a clinical trial. However, they were all interested in participating in future research, suggesting that the positive aspects outweighed the negative. [Bampton J, Vargas J, Wu R, Potts S, Lance A, Scrivener K, Ada L, Dean C (2012) Clinical physiotherapists had both positive and negative perceptions about delivering two different interventions in a clinical trial: a mixed methods study. Journal of Physiotherapy 58: 255–260]

Objective To examine the relationship between stores selling calorie-dense food near schools and student obesity risk, with the hypothesis that high availability predicts increased risk. Methods Mail surveys determined height, weight, and calorie-dense food consumption for 552 students at 11 Maine high schools. Driving distance from all food stores within 2 km (1.24 miles) of schools (or the closest store) was computed, and the impact of food store density and proximity to schools on student body mass index was determined by logistic regression. Results Ten schools had ≥ 1 store selling soda, and 8 schools had ≥1 fast-food restaurant within 1 km (0.62 miles). There were no significant relationships between the proximity or density of food stores around schools and student obesity risk. Students obtained sugar-sweetened beverages in many locations including at school. Conclusions and Implications Unhealthful food choices are ubiquitous. Consequently, stores selling these food items near schools have no significant affect on student obesity.

Our previous study identified osteonectin (ON) in a screen of factors made by Schwann cells (SCs) which promoted peripheral and central neurons survival and neuritogenesis, however, the mechanisms of ON promoting effects are largely unknown. In the present study, we investigated the effects of ON-deficient SC-conditioned medium (SCCM) and molecular mechanisms of ON, in regulating retinal ganglion cells (RGCs) survival and neurite outgrowth. Neonatal rat RGCs and SCs were purified by immunopanning technique. RGC survival and neuritogenesis reduced significantly when treated with either ON-null mice SCCM or ON-immunodepleted (IP) SCCM (P

High-resolution fluorescent imaging of mitochondrial-targeted probes was used to examine the ability of mitochondria to decode complex spatial and temporal Ca 2+ signals evoked in synaptically active networks of hippocampal neurons. Green-to-red photoconversion of the mitochondrial-targeted probe, mito-Kaede, demonstrated that mitochondria were present as discrete organelles 2–6 μm in length. Real-time imaging of mitochondrial-targeted ratiometric pericam (2 mtRP) visualised rapid, repetitive, transient mitochondrial Ca 2+ fluxes in response to periods of synaptic activation. Mitochondrial Ca 2+ fluxes within cellular compartments were dependent on the extent of synaptic recruitment, but independent of cross-talk with the endoplasmic reticulum or the presence of an interconnected mitochondrial network. Mitochondria in dendritic regions demonstrated a greater sensitivity to synaptic activation compared with somatic mitochondria. Temporal decoding of synaptic signals was rate-limited by the activity of the mitochondrial Na + /Ca 2+ exchanger. Spatial regulation of mitochondrial Ca 2+ uptake was determined by the magnitude of the cytosolic Ca 2+ rise in each cellular compartment.

Poorly-controlled hyperglycaemia reduces peripheral nerve regeneration in diabetes through ill-understood mechanisms. Apoptosis is one proposed primary response. We examined how hyperglycaemia affects regeneration of axons and Schwann cells (SC) from cultured adult mouse Dorsal Root Ganglia (DRG) to separate cell-autonomous responses from systemic influences. Hyperglycaemia reduced neurite growth rate by 20-30% without altering growth cone density, indicating neuronal apoptosis was negligible. Moderate hyperglycaemia also profoundly retarded SC migration from DRG explants. This effect was independent of neuritogenesis and was reversible, indicating that SC had not died. In purified SC, even mild hyperglycaemia inhibited neuregulin-beta1-induced bromodeoxyuridine-incorporation and phosphorylation of retinoblastoma protein, indicating a block at the G1-S boundary. Moreover, migration of purified SC was inhibited by >90%. Thus, SC proliferation and migration, and axon regeneration from DRG neurons, are impaired by hyperglycaemia cell autonomously, while apoptosis is negligible. Impairment of these functions over time may exacerbate nerve injury-related diabetic neuropathy.

This paper employs GIS (geographic information systems) technology to visually display the locations of massacres associated with Guatemala’s civil war. While there have been other, more general maps published depicting the spatial dimensions of violence in Guatemala, few other maps depict this information at the department level, nor have they included information on indigenous populations and physical geography. These maps are part of the emerging field of human rights GIS. For example, over the past two decades, maps have become tools of empowerment in Central America and elsewhere, maps usually made with GIS technology. Indigenous groups in many countries in particular have embraced GIS technology and have begun to use maps as tools in their fight for land and marine resources, as well as greater political autonomy. In the case of massacres in Guatemala, displaying exactly where violent acts took place is one way to educate the Guatemalan public regarding the terrible violence of the recent past. Knowing the name of a specific town where a massacre took place is more concrete, potentially leading to perception of place and people, rather than simply being aware of violence in the countryside.

Background & Aims: The pathophysiology of constipation in the syndrome of obstructed defecation is unknown. Using 24-hour pancolonic manometric recordings of the unprepared colon to record basal pressures and spontaneous defecation episodes, we tested the hypothesis that the frequency, timing, or spatial distribution of propagating colonic pressure waves is abnormal in patients with obstructed defecation. Methods: In 11 patients with obstructed defecation and 16 healthy controls, pressures were recorded using a nasocolonic catheter that was positioned such that 16 recording sites spanned the unprepared colon at 7.5-cm intervals. Results: The overall frequency of propagating sequences (PS) in the colon did not differ between patients and controls. When compared with controls, patients had a significant increase in the frequency of retrograde and antegrade PS (P < 0.05) in the left colon and a significant reduction in the amplitude of propagating pressure waves throughout the entire colon (P < 0.03). Defecation occurred in 6 of 11 patients and 9 of 16 controls. In the 15 minutes before defecation, controls showed a highly significant increase in frequency (P = 0.001) and amplitude (P = 0.01) of PS. In contrast, patients did not demonstrate this or the typical spatiotemporal organization of PS normally observed before expulsion of stool. Conclusions: Patients with obstructed defecation lack the normal predefecatory augmentation in frequency and amplitude of propagating pressure waves and lack the normal stereotypic spatiotemporal patterning of colonic pressure waves that would normally culminate in effective expulsion of stool.

Ada L, Dean CM, Hall JM, Bampton J, Crompton S. A treadmill and overground walking program improves walking in persons residing in the community after stroke: a placebo-controlled, randomized trial. Arch Phys Med Rehabil 2003;84:1486–91. Objective To evaluate the effectiveness of a treadmill and overground walking program in reducing the disability and handicap associated with poor walking performance after stroke. Design Randomized, placebo-controlled clinical trial with a 3-month follow-up. Setting General community. Participants A volunteer sample of 29 ambulatory individuals (less 2 dropouts) who were living in the community after having suffered a stroke more than 6 months previously. Interventions The experimental group participated in a 30-minute treadmill and overground walking program, 3 times a week for 4 weeks. The control group received a placebo consisting of a low-intensity, home exercise program and regular telephone contact. Main outcome measures Walking speed (over 10m), walking capacity (distance over 6min), and handicap (stroke-adapted 30-item version of the Sickness Impact Profile) measured by a blinded assessor. Results The 4-week treadmill and overground walking program significantly increased walking speed ( P =.02) and walking capacity ( P P =.85) compared with the placebo program. These gains were largely maintained 3 months after the cessation of training ( P ≤.05). Conclusions The treadmill and overground walking program was effective in improving walking in persons residing in the community after stroke. This suggests that the routine provision of accessible, long-term, community-based walking programs would be beneficial in reducing disability after stroke.