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We use information derived from over 40K trials in the Cochrane Collaboration database of systematic reviews (CDSR) to compute the replication probability, or predictive power of an experiment given its observed (two‐sided) P$$ P $$‐value. We find that an exact replication of a marginally significant result with P=.05$$ P=.05 $$ has less than 30% chance of again reaching significance. Moreover, the replication of a result with P=.005$$ P=.005 $$ still has only 50% chance of significance. We also compute the probability that the direction (sign) of the estimated effect is correct, which is closely related to the type S error of Gelman and Tuerlinckx. We find that if an estimated effect has P=.05$$ P=.05 $$, there is a 93% probability that its sign is correct. If P=.005$$ P=.005 $$, then that probability is 99%. Finally, we compute the required sample size for a replication study to achieve some specified power conditional on the p$$ p $$‐value of the original study. We find that the replication of a result with P=.05$$ P=.05 $$ requires a sample size more than 16 times larger than the original study to achieve 80% power, while P=.005$$ P=.005 $$ requires at least 3.5 times larger sample size. These findings confirm that failure to replicate the statistical significance of a trial does not necessarily indicate that the original result was a fluke. [ABSTRACT FROM AUTHOR]

Traditional statistics instruction emphasizes a.05 significance level for hypothesis tests. Here, we investigate the consequences of this training for researchers' mental representations of probabilities — whether.05 becomes a boundary, that is, a discontinuity of the mental number line, and alters their reasoning about p‐values. Graduate students with statistical training (n = 25) viewed pairs of p‐values and judged whether they were "similar" or "different." After controlling for several covariates, participants were more likely and faster to judge p‐values as "different" when they crossed the.05 boundary (e.g.,.046 vs..052) compared to when they did not (e.g.,.026 vs..032). This result suggests a categorical perception‐like effect for the processing of p‐values. It may be a consequence of traditional statistical instruction creating a psychologically real divide between so‐called statistical "significance" and "nonsignificance." Such a distortion is undesirable given modern approaches to statistical reasoning that de‐emphasize dichotomizing the p‐value continuum. Traditional statistics instruction and practice emphasize a p <.05 categorical boundary. Our results suggest a categorical perception‐like effect for graduate students' processing of p‐values, creating a psychologically real divide between so‐called statistical 'significance' and 'non‐significance'. [ABSTRACT FROM AUTHOR]

Objective: Language that implies a conclusion not supported by the evidence is common in the medical literature. The hypothesis of the present study was that medical journal publications are more likely to use misleading language for the interpretation of a demonstrated null (i.e. chance or not statistically significant) effect than a demonstrated real (i.e. statistically significant) effect. Methods: This was an observational study of the medical literature with a systematic sampling method. Articles published in The Journal of the American Medical Association, The Lancet and The New England Journal of Medicine over the last two decades were eligible. The language used around the P‐value was assessed for misleadingness (i.e. either suggesting an effect existed when a real effect did not exist or vice versa). Results: There were 228 unique manuscripts examined, containing 400 statements interpreting a P‐value proximate to 0.05. The P‐value was between 0.036 and 0.050 for 303 (75.8%) statements and between 0.050 and 0.064 for 97 (24.3%) statements. Forty‐four (11%) of the statements were misleading. There were 40 (41.2%) false‐positive sentences, implying statistical significance when the P‐value was >0.05, and four (1.3%) false‐negative sentences, implying no statistical significance when the P‐value <0.05 (relative risk 31.2; 95% confidence interval 11.5–85.1; P < 0.0001). The proportion of included manuscripts containing at least one misleading sentence was 16.2% (95% confidence interval 12.0–21.6). Conclusions: Among a random selection of sentences in prestigious journals describing P‐values close to 0.05, 1 in 10 are misleading (n = 44, 11%) and this is more prevalent when the P‐values are above 0.05 compared to below 0.05. Caution is advised for researchers, clinicians and editors to align with the context and purpose of P‐values. [ABSTRACT FROM AUTHOR]

The article discusses the use of statistical analysis in research papers and highlights the potential for incorrect interpretations and misleading statements, particularly in studies with small sample sizes. The article emphasizes that p-values, which are often used to determine statistical significance, are not as reliable or objective as commonly believed. The importance of considering sample size and accurately interpreting p-values is illustrated through an example. The article concludes by suggesting that using larger studies, acknowledging bias, and calculating pre-study probabilities can improve the statistics within current literature. It also encourages the use of multiple statistical elements and reflection on desired significance levels and power. [Extracted from the article]

Null hypothesis significance testing (NHST) with its benchmark P value < 0.05 has long been a stalwart of scientific reporting and such statistically significant findings have been used to imply scientifically or clinically significant findings. Challenges to this approach have arisen over the past 6 decades, but they have largely been unheeded. There is a growing movement for using Bayesian statistical inference to quantify the probability that a scientific finding is credible. There have been differences of opinion between the frequentist (i.e., NHST) and Bayesian schools of inference, and warnings about the use or misuse of P values have come from both schools of thought spanning many decades. Controversies in this arena have been heightened by the American Statistical Association statement on P values and the further denouncement of the term "statistical significance" by others. My experience has been that many scientists, including many statisticians, do not have a sound conceptual grasp of the fundamental differences in these approaches, thereby creating even greater confusion and acrimony. If we let A represent the observed data, and B represent the hypothesis of interest, then the fundamental distinction between these two approaches can be described as the frequentist approach using the conditional probability pr(A | B) (i.e., the P value), and the Bayesian approach using pr(B | A) (the posterior probability). This paper will further explain the fundamental differences in NHST and Bayesian approaches and demonstrate how they can co‐exist harmoniously to guide clinical trial design and inference. [ABSTRACT FROM AUTHOR]

Objective: To determine the onset of preventive efficacy with eptinezumab in patients with migraine. Background: Eptinezumab is a monoclonal antibody inhibiting calcitonin gene‐related peptide approved as an intravenously administered treatment for the prevention of migraine. Methods: Patients who received eptinezumab 100 mg, eptinezumab 300 mg, or placebo in PROMISE7‐1 (episodic migraine; 100 mg, n = 221; 300 mg, n = 222; placebo, n = 222) or PROMISE7‐2 (chronic migraine; 100 mg, n = 356; 300 mg, n = 350; placebo, n = 366) were included. Testing of the percentage of patients with a migraine on day 1 after dosing was prespecified and alpha‐controlled. In further exploration of this prespecified endpoint, a post hoc closed testing procedure, which controlled the false‐positive (type 1) error rate, provided a statistically rigorous evaluation of migraine prevention onset. The procedure involved up to 84 tests of significance, all of which were performed in sequence until the first nonsignificant result. Results: For both studies, all tests for significance for eptinezumab 100 and 300 mg, from days 1‐84 through day 1 alone, achieved nominal significance (P <.05), indicating that eptinezumab was fully effective beginning on day 1. Over each interval, the treatment effect was comparable to the effect over weeks 1‐12. Mean changes from baseline in monthly migraine days for the primary endpoint period ranged from −3.9 to −4.9, −4.1 to −4.9, and −2.2 to −3.2 for eptinezumab 100, 300 mg, and placebo, respectively, in PROMISE7‐1 and from −7.2 to −8.0, −7.9 to −8.2, and −4.3 to −5.6, respectively, in PROMISE7‐2. The difference from placebo (95% confidence interval) in day 1 treatment effect was −2.2 (−4.1, −0.3) and −2.5 (−4.4, −0.6) days/month for eptinezumab 100 and 300 mg, respectively, in PROMISE7‐1, and was −3.8 (−5.6, −2.0) and −4.0 (−5.8, −2.1) days/month for 100 and 300 mg, respectively, in PROMISE7‐2. Conclusions: The migraine preventive effect of eptinezumab is rapid and sustained in patients with episodic or chronic migraine, with onset of optimal preventive efficacy observed on the day following the initial dose. [ABSTRACT FROM AUTHOR]

An editorial is presented on the confidence intervals represent a range of values that are plausible for an unknown parameter of interest. Topics include the confidence intervals have been increasing in popularity as a key element of research reporting and are routinely calculated by statistical software packages, and the confidence intervals are commonly seen in research reports are complex nature can make understanding and applying them difficult.

Background and aims: While cannabis use has been found to impair motor vehicle driving, the association between cannabis legalization and motor vehicle fatalities is unclear. In Uruguay in December 2013, cannabis for recreational purposes was legalized. This study assessed the association between implementation of this law and changes in traffic fatality rates. Design Interrupted time–series analysis of traffic fatality rates of light motor vehicle drivers and motorcyclists in urban and rural settings. Changes are reported as step and trend effects against modeled trends in the absence of legalization. Setting: Uruguay, Montevideo and four rural provinces (Colonia, Florida, Río Negro and San José) from 1 January 2012 to 31 December 2017. Cases and measurement Weekly traffic fatalities of light motor vehicle drivers and motorcyclists per type of vehicle. Data were gathered from the National Road Safety Agency of Uruguay and the Ministry of Transport and Public Works, respectively. Results: Cannabis legalization was associated with a 52.4% immediate increase [95% confidence interval (CI) = 11.6, 93.3, P = 0.012] in the light motor vehicle driver's fatality rate. However, no significant change in the motorcyclists' fatality rate was observed. In Montevideo the legislation was associated with an absolute increase in its light motor vehicle driver's fatality rate by 0.06 (95% CI = 0.01, 0.11, P = 0.025), but no significant associations were observed in rural settings. Conclusions: In Uruguay, the 2013 legislation legalizing recreational cannabis consumption may have been associated with an increase in fatal motor vehicle crashes, particularly in light motor‐vehicle drivers and urban settings. [ABSTRACT FROM AUTHOR]

Aim: This study aimed to assess the extent to which the association between recent alcohol consumption and risk of non‐traffic injury varies according to location at the time of the injury. Design Case–cross‐over design. Setting and participants: A total of 15 625 injury patients from 49 emergency departments (EDs) in 22 countries. Measurements Recent alcohol consumption and location at the time of the injury were assessed for when the injury occurred and for the same time 1 week prior to this. The confounding and interactive effects of location were examined by estimating the adjusted odds ratio (OR) of injury from alcohol consumption adjusting for location and then by examining the alcohol consumption × location interaction. Findings There were significant interactive effects of location and alcohol consumption on injury risk. For example, the ORs for volume 0.1–3.0 drinks and street/public place each were 3.0 and 14.2, respectively, whereas the OR for their joint effect was 44.1, suggesting a positive additive interaction [relative excess risk due to interaction (RERI) = 27.9, P < 0.05] and zero multiplicative interaction (OR = 1.0, P = 0.895). The interactions of alcohol consumption with drinking establishment location, work‐place and other locations were mostly additive and negative on the multiplicative scale (e.g. for interaction between volume 0.1–3.0 drinks and drinking establishment location: RERI = 1.19, P = 0.529; multiplicative interaction OR = 0.54, P < 0.05). Conclusions: Location appears to influence the relationship between alcohol consumption and risk of injury. The association between alcohol consumption and injury appears to be greater in locations such as streets and public places compared with private residences. [ABSTRACT FROM AUTHOR]

Objective: To assess the association of the quality of allocation concealment with heterogeneity in age, the P value of the primary outcome and statistical significance of the primary outcome. Study design and setting: We extracted data from articles published in four major medical journals in 2017 and 2018 that reported the results of randomized controlled trials. The outcome measures were the quality of allocation concealment used in the trial, the P value of the primary outcome, whether the P value of the primary outcome was statistically significant and the level of heterogeneity in age between the treatment groups (measured using the I2 statistic). The association between the quality of allocation concealment and the P value of the primary outcome was assessed using a kernel density plot, while the association between the quality of allocation concealment and whether the P value was statistically significant was assessed using logistic regression. Results: Trials that used inadequate concealment methods were more likely to report statistically significant findings than trials that used good or adequate methods (OR 1.90; 95% CI: 0.91 to 3.95; P =.09). The values of I2 for trials that used good, adequate, inadequate and unclear concealment methods were 0%, 1.0%, 32.6%, and 93.8%, respectively. Conclusion: There is evidence of an association between poor allocation concealment methods and statistical significance of the primary outcome. Trials that use inadequate allocation concealment methods are more likely to have statistically significant P values compared with trials using good or adequate allocation concealment methods. [ABSTRACT FROM AUTHOR]

The development of optimal human resource practices is often contingent on the accurate statistical testing of potential interventions. Testing the efficacy of HR interventions can be enhanced by taking additional measures to improve statistical power, but the traditional means of increasing power through sample size are often beyond the cost and ability of HR professionals to pursue. This article, therefore, focuses on measurement procedures as an alternative way to increase statistical power for detecting HR intervention effects. Selection of reliable and appropriate measures and subsequent instrumentation are examined as efficacious and cost-beneficial techniques that can be employed during the planning and designing stage of a study for augmenting statistical power to optimize business decision making. © 2012 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Motivated by the recent replication and reproducibility crisis, Gelman and Carlin (2014, Perspect. Psychol. Sci., 9, 641) advocated focusing on controlling for Type S/M errors, instead of the classic Type I/II errors, when conducting hypothesis testing. In this paper, we aim to fill several theoretical gaps in the methodology proposed by Gelman and Carlin (2014, Perspect. Psychol. Sci., 9, 641). In particular, we derive the closed‐form expression for the expected Type M error, and study the mathematical properties of the probability of Type S error as well as the expected Type M error, such as monotonicity. We demonstrate the advantages of our results through numerical and empirical examples. [ABSTRACT FROM AUTHOR]

Abstract: Background: Childhood nutrition is important in optimising growth, development and future health. The present study compared dietary intakes of Australian children aged 4–8 years with (i) Australian Guide to Healthy Eating (AGHE) food group recommendations and (ii) age‐specific Nutrient Reference Values (NRVs), in addition to (iii) describing food group intakes of children meeting key NRVs. Methods: Data were obtained from a representative sample of children (n = 789) from the National Nutrition and Physical Activity Survey between May 2011 and June 2012. Parent‐reported 24‐h recall dietary data were disaggregated into five core food groups, along with energy‐dense, nutrient‐poor (EDNP) foods, with intakes being compared with AGHE recommendations. Food group intakes were compared for children meeting the NRVs for 10 nutrients used for the development of AGHE food groups. Chi‐squared and t‐tests were performed to determine differences in food group intakes with P < 0.05 considered statistically significant. Results: Only one child met the recommended daily servings for all AGHE core food groups and none met both core and energy‐dense, nutrient‐poor (EDNP) food group recommendations. The lowest level of alignment (percentage meeting recommendations) was for vegetables (4.6%) and the highest was for fruit (47.7%). Mean (SD) daily intake of EDNP foods [4.7 (3.2) serves day−1] accounted for 38.4% of total energy intakes. Children meeting key NRVs (n = 395) consumed greater daily servings of fruit [2.2 (1.7)], dairy [2.2 (1.2)] and EDNP foods [5.0 (3.4)] compared to the total sample (n = 789). Conclusions: Significant discrepancies exist between contemporary dietary patterns of Australian children and national recommendations. Future AGHE revisions should incorporate greater diversity of consumption patterns, including sub‐categories of EDNP foods. [ABSTRACT FROM AUTHOR]

Abstract: Background: The ability to achieve optimal glycaemic control varies widely among individuals with type 1 diabetes. The present study aimed to explore the factors that are associated with optimal glycaemic control compared to suboptimal control. Methods: An observational study design was used to explore the association of various factors with glycaemic control. Surveys were completed by individuals who attended the type 1 diabetes clinic at a tertiary hospital in New South Wales (NSW), Australia. Clinical and demographic information and attendance at dietary review were also collected. Results: One hundred and three individuals completed the survey. Those with optimal control [glycated haemoglobin ≤7.0% (53 mmol mol−1)] had a significantly shorter mean (SD) duration of diabetes [10.1 (12.6) years versus 18.8 (12.8) years, P = 0.005), were less likely to omit basal and bolus insulin (18.2% versus 47.5%, P = 0.016; 36.4% versus 61.8%, P = 0.034, respectively), and were less likely to report low confidence in managing their diabetes (9.1% versus 35.4%, P = 0.017). Participants who were able to identify carbohydrate sources were significantly more likely to have attended dietary review in the past 12 months (60.5% versus 20.0%, P = 0.001). However, they were not more likely to have better glycaemic control. Conclusions: The present study identified that consistency in taking insulin and confidence in self‐management was associated with better glycaemic control. An association was also found between recent dietary review and better carbohydrate knowledge, although this did not translate into better glycaemic control. Future investigation into the application of carbohydrate knowledge is required. [ABSTRACT FROM AUTHOR]

Abstract: Background: Nonresponsive maternal child‐feeding interactions, such as restricting, pressurising and emotional feeding, can affect the ability of a child to self‐regulate intake and increase the risk of becoming overweight. However, despite findings that South Asian and Black children living in the UK are more likely to be overweight, UK research has not considered how maternal child‐feeding style might differ between ethnic groups. The present study aimed to explore variations in maternal child‐feeding style between ethnic groups in the UK, taking into account associated factors such as deprivation and parenting style. Methods: Six hundred and fifty‐nine UK mothers with a child who was aged 5–11 years old completed a questionnaire. Items included ethnicity and demographic data, as well as copies of the Child Feeding Questionnaire, Parental Feeding Styles Questionnaire and Parenting Styles and Dimensions Questionnaire. Results: Significant differences in perceived responsibility (P = 0.002), restriction (P = 0.026), pressure to eat (P = 0.045), instrumental feeding (P = 0.000) and emotional feeding (P = 0.000) were found between the groups. Mothers from South Asian backgrounds reported higher levels of pressure to eat, emotional feeding and indulgent feeding styles, whereas mothers from Chinese backgrounds reported greater perceived responsibility and restriction. Mothers from Black and White British backgrounds were not significantly higher with respect to any behaviour. Maternal child‐feeding style was also associated with deprivation and parenting style, although these did not fully explain the data. Conclusions: Understanding cultural factors behind maternal child‐feeding style, particularly around pressurising and indulgent feeding behaviours, may play an important part in reducing levels of children who are overweight and obese in the UK. [ABSTRACT FROM AUTHOR]

Abstract: Improving infant and young child feeding practices is critical for improving growth and reducing child mortality and morbidity. This paper aims to compare predictors of minimum dietary diversity, an important indicator of adequate complementary feeding practices, in Bangladesh in 2011 and 2014. The 2011 and 2014 Bangladesh Demographic and Health Survey were used to examine predictors of minimum dietary diversity among 6–23 months. An additional analysis was conducted for the 18–23‐month group, because a significant increase in meeting minimum dietary diversity recommendations was seen in this age group only. Factors found to be associated with practices were compared across time points. In 2011, minimum dietary diversity was 23.8% and increased to 28.8% in 2014. Among children 18–23 months, in 2011, minimum dietary diversity was 32.5% and increased to 42.8% in 2014. Among all children, wealth, education, exposure to media, and antenatal care were significant predictors of dietary diversity. In the 18–23‐month age group, significant predictors in 2011 were wealth and decision making. In 2014, significant predictors were education and exposure to media. Demographic trends indicated a significant increase in education and exposure to media between 2011 and 2014. As these were significant for minimum dietary diversity in 2014 overall and for 18–23 months, they might be important targets of future interventions, specifically utilizing media channels and tailoring special strategies for women with low education and limited exposure to media. [ABSTRACT FROM AUTHOR]

Nowadays, fixed gear competitions on outdoor circuits such as criteriums are regularly organized worldwide. To date, no study has investigated this alternative form of cycling. The purpose of the present study was to examine fixed gear performance indexes and to characterize physiological determinants of fixed gear cyclists. This study was carried out in two parts. Part 1 (n = 36) examined correlations between performance indexes obtained during a real fixed gear criterium (time trial, fastest laps, averaged lap time during races, fatigue indexes) and during a sprint track time trial. Part 2 (n = 9) examined correlations between the recorded performance indexes and some aerobic and anaerobic performance outputs (VO2max, maximal aerobic power, knee extensor and knee flexor maximal voluntary torque, vertical jump height and performance during a modified Wingate test). Results from Part 1 indicated significant correlations between fixed gear final performance (i.e. average lap time during the finals) and single lap time (time trial, fastest lap during races and sprint track time trial). In addition, results from Part 2 revealed significant correlations between fixed gear performance and aerobic indicators (VO2max and maximal aerobic power). However, no significant relationship was obtained between fixed gear cycling and anaerobic qualities such as strength. Similarly to traditional cycling disciplines, we concluded that fixed gear cycling is mainly limited by aerobic capacity, particularly criteriums final performance. However, specific skills including technical competency should be considered. [ABSTRACT FROM AUTHOR]

Physiological or performance tests are routinely utilised to assess athletes’ recovery. At present, the ideal tool to assess recovery remains unknown. Therefore, the aim of this systematic review was to examine the change in creatine kinase (CK) and neuromuscular function as measured via a countermovement jump (CMJ) following a match in the contact codes of football. A comprehensive search of databases was undertaken with RevMan (V 5.3) used for statistical analysis. Our results demonstrated that CK pre- versus post-match (standardised mean difference (SMD) = 0.90, 95% CI = 0.50 to 1.31, p < .0001), CK pre- versus 24 h post-match (SMD = 1.50, 95% CI = 1.12 to 1.88, p < .00001), and CK pre- versus 48 h post-match all increased significantly (SMD = 0.90, 95% CI = 0.50 to 1.31, p < .0001), while CMJ peak power (PP) pre- versus post-match (SMD = −0.59, 95% CI = −1.12 to −0.06, p = .03), and pre- versus 24 h post-match (SMD = −0.80, 95% CI = −1.31 to −0.28, p = .002) decreased significantly. There was a significant relationship between the change in CK and the change in CMJ PP from immediately pre to immediately post (r = −0.924, p = .025), and between CMJ immediately following a match and 24 h CK change (r = −0.983, p = .017). In conclusion, CK levels increase and performance in the CMJ decreases following a match of a contact code of football. The identification of this relationship may allow coaching staff to implement a standalone measure of recovery. [ABSTRACT FROM AUTHOR]

The aims of this study were to (1) propose a method for evaluating shot-putters mechanical power, (2) investigate the relationship between mechanical work of hand action force (WHAF), peak power output (PPO) of different limbs and shot-put performance and (3) show which of these two parameters (WHAF, PPO) were the most appropriate to characterize the explosive abilities of the shot-putter. Twelve junior right-handed shot-putters, practised glide technique shot-put throwers (personal best = 13.57  ±  1.72 m), participated in this study. Arm and leg force-velocity tests were performed to measure PPO. Kinematic analysis was conducted during a shot-putting event in regular conditions to quantify the WHAF at the release moment and shot-put performance. Significant correlations were found between absolute arm and leg PPO with upper and lower muscle volumes (r = .67; p = .03; r = .76; p = .01; r = .74, p = .01; r = .65, p = .04). Positive relationships were recorded between absolute arm and leg PPO and shot-put performance (r = .67, p = .02; r = .81, p = .004, respectively). Shot-put performance was also closely related to the WHAF (r = .93, p = .0001) and release velocity parameter (r = .86, p = .001). The present results confirm that force-velocity test and WHAF constitute useful tools for assessing mechanical power in throwing. The WHAF could be considered as more suitable than force-velocity test. [ABSTRACT FROM AUTHOR]

Abstract: Background: Little is known about whether and to what extent gender differences affect the stimulation children receive at home, which is crucial to child development. The aim of this study was to document the differences, if any, in the quality of psychosocial stimulation boys and girls receive at home in middle childhood in rural Bangladesh. Methods: This study was done as a part of a long‐term follow‐up study of a cluster randomized controlled trial in 2015. The Middle Childhood‐Home Observation for Measurement of the Environment (MC‐HOME) was adapted and used to measure the quality of home stimulation. Post hoc analysis of the long‐term follow‐up study was done. Data were analysed using t‐test and chi‐squared test for continuous and dichotomous variables, respectively. Multiple regression analysis was conducted to control for confounders. Results: A total of 372 child–mother dyads participated in the study. Socio‐economic and anthropometric characteristics of the boys and girls did not differ except that more girls had electricity at home (p = .027). Girls were found significantly advantaged over boys in total MC‐HOME scores (p = .014) at age around 8 years. Conclusions: These findings will play a role for child development policy formulation in Bangladesh. However, though the difference is statistically significant, the strength of relationship is very weak and may not be of functional importance. [ABSTRACT FROM AUTHOR]

Objective: Systemic lupus erythematosus (SLE) has limited monozygotic twin concordance, implying a role for pathogenic factors other than genetic variation, such as epigenetic changes. Using the disease‐discordant twin model, we investigated genome‐wide DNA methylation changes in sorted CD4+ T cells, monocytes, granulocytes, and B cells in twin pairs with at least 1 SLE‐affected twin. Methods: Peripheral blood obtained from 15 SLE‐affected twin pairs (6 monozygotic and 9 dizygotic) was processed using density‐gradient centrifugation for the granulocyte fraction. CD4+ T cells, monocytes, and B cells were further isolated using magnetic beads. Genome‐wide DNA methylation was analyzed using Infinium HumanMethylation450K BeadChips. When comparing probes from SLE‐affected twins and co‐twins, differential DNA methylation was considered statistically significant when the P value was less than 0.01 and biologically relevant when the median DNA methylation difference was >7%. Findings were validated by pyrosequencing and replicated in an independent case–control sample. Results: In paired analyses of twins discordant for SLE restricted to the gene promoter and start region, we identified 55, 327, 247, and 1,628 genes with differentially methylated CpGs in CD4+ T cells, monocytes, granulocytes, and B cells, respectively. All cell types displayed marked hypomethylation in interferon‐regulated genes, such as IFI44L, PARP9, and IFITM1, which was more pronounced in twins who experienced a disease flare within the past 2 years. In contrast to what was observed in the other cell types, differentially methylated CpGs in B cells were predominantly hypermethylated, and the most important upstream regulators included TNF and EP300. Conclusion: Hypomethylation of interferon‐regulated genes occurs in all major cellular compartments in SLE‐affected twins. The observed B cell promoter hypermethylation is a novel finding with potential significance in SLE pathogenesis. [ABSTRACT FROM AUTHOR]

Abstract: Background: Postpartum weight retention (PPWR) increases the risk for obesity and complications during subsequent pregnancies. Few interventions have been successful in limiting PPWR in mothers. The present study assessed the effectiveness of the mums OnLiNE (Online, Lifestyle, Nutrition & Exercise) intervention with respect to reducing PPWR and improving diet, physical activity and sedentary behaviour. Methods: A subsample of first‐time mothers enrolled in the Extended Melbourne Infant Feeding Activity and Nutrition Trial (InFANT Extend) completed the nonrandomised mums OnLiNE intervention. Women in the intervention (I) group (n = 28) received access to an online calorie tracking program, smartphone app, three telephone counselling calls with a dietitian and written material. Women in two comparison groups (CI and C2) (n = 48; n = 43) were from the control (C1) and intervention (C2) arms of InFANT Extend and received no additional support. Weight and waist circumference were measured objectively. Written surveys assessed diet and physical activity. Sedentary behaviour was self‐reported. Linear and logistic regression assessed changes in outcomes between groups from 9 to 18 months postpartum. Results: Mean PPWR decreased in the (I) group (−1.2 kg) and the C2 group (−1.2 kg), although the changes were not significant. Mean waist circumference for all groups exceeded recommendations at baseline but decreased to below recommendations for women in the (I) group (78.3 cm) and significantly for the (I) group (−6.4 cm) compared to C1 (−1.1 cm; P = 0.002) and C2 (−3.3 cm; P = 0.001). Changes in diet, physical activity or sedentary behaviour were not significant. Conclusions: The online intervention reported in the present study shows promise with respect to reducing waist circumference in postpartum women. Further evidence of strategies that may improve weight and related behaviours in this target group is needed. [ABSTRACT FROM AUTHOR]

Abstract: Background: We assessed the nutritional risks among children hospitalised with acute burn injuries and their associated clinical outcomes using three nutritional risk screening (NRS) tools: Screening Tool for Risk of Impaired Nutritional Status and Growth (STRONGKIDS), Pediatric Yorkhill Malnutrition Score (PYMS) and Screening Tool for the Assessment for Malnutrition in Pediatrics (STAMP). Methods: This prospective cross‐sectional study was conducted from October 2015 to November 2016, in a regional burn centre. Patients were screened by two independent observers, using the three NRS tools. Results: A total of 100 children aged 3 months to 16.5 years were included. STRONGKIDS identified 16% of patients as having high risk, with being identified 45% by PYMS and 44% by STAMP. After adjustment for confounding factors in multivariate regression analysis, patients in the high‐risk group had significantly longer median (SD) lengths of stay [medium versus high risk: STRONGKIDS, 9.5 (6.6) versus 15.0 (24.2) days; PYMS, 8.5 (4.4) versus 13.0 (16.1) days; STAMP, 9.0 (5.7) versus 11.0 (17.4) days] and greater median (SD) weight loss [medium versus high risk: STRONGKIDS, 0.15 (0.8) versus ‐0.35 (0.8) kg; STAMP, 0.5 (0.7) versus 0 (0.1) kg] than patients in the medium‐risk group (P < 0.05). The strengths of agreement in the nutritional risk classification between the two observers were good (κ for STRONGKIDS = 0.61; PYMS = 0.79; STAMP = 0.75) (P < 0.01). Conclusions: The STRONGKIDS, PYMS and STAMP tools could be useful and practical for determining which hospitalised children with acute burn injuries will need additional nutritional intervention. [ABSTRACT FROM AUTHOR]

Children change their body size, shape, and gross motor coordination (GMC) as they grow. Further, GMC is expected to link to changes in children's body size, physical activity (PA), and physical fitness (PF). The objective was to model GMC changes in children followed longitudinally and to investigate associations between these changes and PA and PF levels. A total of 245 children (122 girls) were observed at 6 years of age and followed annually until 9 years. A sequence of allometric models was fitted, that is, 1. body mass, stature, and PA; 2. addition of four PF tests; 3. addition of four more PF tests. In Model 1, changes in GMC are nonlinear, and body mass (−0.60 ± 0.07, P < .001) and stature (2.91 ± 0.35, P < .001) parameter estimates were significant suggesting children with a more linear body size/shape showed higher GMC performances. Girls tend to outperform boys across time, and PA was not associated with GMC changes. Model 2 fitted the data better, and the PF tests (handgrip, standing long jump, 50‐yard dash, and shuttle run) were significantly linked to GMC change. In Model 3, adding the remaining PF tests did not change the order of any factors importance. The greatest GMC changes were achieved by children whose body size/shape has an ectomorphic dominance across the years. Considering that leaner and physically fitter children tended to be more coordinated, physical education should also focus on PF development in components related to muscular strength, speed, agility, and aerobic capacity, along with nutritional education to reduce fat mass. [ABSTRACT FROM AUTHOR]

The purpose of this investigation was to determine whether the magnitude of adaptation to integrated ballistic training is influenced by initial strength level. Such information is needed to inform resistance training guidelines for both higher‐ and lower‐level athlete populations. To this end, two groups of distinctly different strength levels (stronger: one‐repetition‐maximum (1RM) squat = 2.01 ± 0.15 kg·BM−1; weaker: 1.20 ± 0.20 kg·BM−1) completed 10 weeks of resistance training incorporating weightlifting derivatives, plyometric actions, and ballistic exercises. Testing occurred at pre‐, mid‐, and post‐training. Measures included variables derived from the incremental‐load jump squat and the 1RM squat, alongside muscle activity (electromyography), and jump mechanics (force‐time comparisons throughout the entire movement). The primary outcome variable was peak velocity derived from the unloaded jump squat. It was revealed that the stronger group displayed a greater (P = .05) change in peak velocity at mid‐test (baseline: 2.65 ± 0.10 m/s, mid‐test: 2.80 ± 0.17 m/s) but not post‐test (2.85 ± 0.18 m/s) when compared to the weaker participants (baseline 2.43 ± 0.09, mid‐test. 2.47 ± 0.11, post‐test: 2.61 ± 0.10 m/s). Different changes occurred between groups in the force‐velocity relationship (P = .001‐.04) and jump mechanics (P ≤ .05), while only the stronger group displayed increases in muscle activation (P = .05). In conclusion, the magnitude of improvement in peak velocity was significantly influenced by pre‐existing strength level in the early stage of training. Changes in the mechanisms underpinning performance were less distinct. [ABSTRACT FROM AUTHOR]

Abstract: There is over 60 years of discussion in the statistical literature concerning the misuse and limitations of null hypothesis significance tests (NHST). Based on the prevalence of NHST in biological anthropology research, it appears that the discipline generally is unaware of these concerns. The p values used in NHST usually are interpreted incorrectly. A p value indicates the probability of the data given the null hypothesis. It should not be interpreted as the probability that the null hypothesis is true or as evidence for or against any specific alternative to the null hypothesis. P values are a function of both the sample size and the effect size, and therefore do not indicate whether the effect observed in the study is important, large, or small. P values have poor replicability in repeated experiments. The distribution of p values is continuous and varies from 0 to 1.0. The use of a cut‐off, generally p ≤ 0.05, to separate significant from nonsignificant results, is an arbitrary dichotomization of continuous variation. In 2016, the American Statistical Association issued a statement of principles regarding the misinterpretation of NHST, the first time it has done so regarding a specific statistical procedure in its 180‐year history. Effect sizes and confidence intervals, which can be calculated for any data used to calculate p values, provide more and better information about tested hypotheses than p values and NHST. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To identify gestational diabetes mellitus exposure‐associated DNA methylation changes and assess whether such changes are also associated with adiposity‐related outcomes. Methods: We performed an epigenome‐wide association analysis, using Illumina 450k methylation arrays, on whole blood collected, on average, at 10.5 years of age from 81 gestational diabetes‐exposed and 81 unexposed offspring enrolled in the EPOCH (Exploring Perinatal Outcomes in Children) study, and on the cord blood of 31 gestational diabetes‐exposed and 64 unexposed offspring enrolled in the Colorado Healthy Start cohort. Validation was performed by pyrosequencing. Results: We identified 98 differentially methylated positions associated with gestational diabetes exposure at a false discovery rate of <10% in peripheral blood, with 51 loci remaining significant (plus additional 40 loci) after adjustment for cell proportions. We also identified 2195 differentially methylation regions at a false discovery rate of <5% after adjustment for cell proportions. We prioritized loci for pyrosequencing validation and association analysis with adiposity‐related outcomes based on strengths of association and effect size, network and pathway analysis, analysis of cord blood, and previous publications. Methylation in six out of nine (67%) gestational diabetes‐associated genes was validated and we also showed that methylation of SH3PXD2A was significantly (P<0.05) associated with multiple adiposity‐related outcomes. Conclusions: Our findings suggest that epigenetic marks may provide an important link between in utero exposure to gestational diabetes and obesity in childhood, and add to the growing body of evidence that DNA methylation is affected by gestational diabetes exposure. [ABSTRACT FROM AUTHOR]

Abstract: Aim: To explore factors associated with negative insulin appraisals among adults with Type 2 diabetes, including perceived and experienced diabetes stigma. Methods: The second Diabetes MILES – Australia study (MILES‐2) is a national survey of adults with diabetes, focused on behavioural and psychosocial issues. Subgroup analyses were conducted on the responses of 456 adults with insulin‐treated Type 2 diabetes (38% women; mean ± sd age: 61.2 ± 8.8 years; diabetes duration: 14.5 ± 7.5 years; years using insulin: 6.4 ± 5.5). Participants completed validated measures of perceived and experienced diabetes stigma (Type 2 Diabetes Stigma Assessment Scale), insulin appraisals [Insulin Treatment Appraisal Scale (ITAS)] and known correlates of insulin appraisals: diabetes‐specific distress (Problem Areas In Diabetes scale) and diabetes‐specific self‐efficacy (Confidence in Diabetes Self‐care scale). A multiple linear regression was conducted (N = 279) to determine the contribution of those variables found to be associated with ITAS Negative scores. Results: Univariable analyses revealed negative insulin appraisals were associated with demographic and self‐care characteristics (age, employment status, BMI, years using insulin, injections per day), self‐efficacy, diabetes‐specific distress and diabetes stigma (all P < 0.01). Number of injections per day [regression coefficient [95% confidence interval]: 0.74 [0.08, 1.40]; P = 0.028], self‐efficacy [−0.12 [−0.19, −0.06]; P < 0.001] and diabetes stigma [0.39 (0.31, 0.46); P < 0.001) significantly and independently contributed to the final multivariable model, explaining 58% of the variance in ITAS Negative scores. The independent contribution of diabetes‐specific distress was suppressed following the inclusion of diabetes stigma. Conclusions: This study represents the first step in understanding the relationship between perceived and experienced diabetes stigma and negative insulin appraisals, and provides quantitative evidence for the strong, independent relationship between these two important constructs. [ABSTRACT FROM AUTHOR]

Abstract: Aims: To assess the predictive ability of a genetic risk score for the incidence of Type 2 diabetes in a general Japanese population. Methods: This prospective case–control study, nested within a Japan Public Health Centre‐based prospective study, included 466 participants with incident Type 2 diabetes over a 5‐year period (cases) and 1361 control participants, as well as 1463 participants with existing diabetes and 1463 control participants. Eleven susceptibility single nucleotide polymorphisms, identified through genome‐wide association studies and replicated in Japanese populations, were analysed. Results: Most single nucleotide polymorphism loci showed directionally consistent associations with diabetes. From the combined samples, one single nucleotide polymorphism (rs2206734 at CDKAL1) reached a genome‐wide significance level (odds ratio 1.28, 95% CI 1.18–1.40; P = 1.8 × 10–8). Three single nucleotide polymorphisms (rs2206734 in CDKAL1, rs2383208 in CDKN2A/B, and rs2237892 in KCNQ1) were nominally significantly associated with incident diabetes. Compared with the lowest quintile of the total number of risk alleles, the highest quintile had a higher odds of incident diabetes (odds ratio 2.34, 95% CI 1.59–3.46) after adjusting for conventional risk factors such as age, sex and BMI. The addition to the conventional risk factor‐based model of a genetic risk score using the 11 single nucleotide polymorphisms significantly improved predictive performance; the c‐statistic increased by 0.021, net reclassification improved by 6.2%, and integrated discrimination improved by 0.003. Conclusions: Our prospective findings suggest that the addition of a genetic risk score may provide modest but significant incremental predictive performance beyond that of the conventional risk factor‐based model without biochemical markers. [ABSTRACT FROM AUTHOR]

Abstract: Aim: We aimed to determine the prospective association between baseline triglyceridaemic–waist phenotypes and diabetic mellitus incidence in individuals with impaired fasting glucose seen in primary care. Methods: A cohort of 1101 participants (84.4% of the recruited individuals) with impaired fasting glucose were recruited from three primary care clinics during regular follow‐ups to monitor their chronic conditions. Baseline triglyceridaemic–waist phenotypes were divided into four groups: (1) normal waistline and triglyceride level (n = 252); (2) isolated central obesity (n = 518); (3) isolated high triglyceride level (n = 80); and (4) central obesity with high triglyceride level (i.e. hypertriglyceridaemic–waist phenotype) (n = 251). The presence of diabetes at follow‐up was determined by fasting plasma glucose (≥ 7.0 mmol/l) and/or 2‐h 75‐g oral glucose tolerance test (≥ 11.1 mmol/l) and/or HbA1c (47.5 mmol/mol; ≥ 6.5%) according to American Diabetes Association diagnostic criteria. Multivariable Cox proportional hazards regressions were established to assess the impact of different triglyceridaemic–waist phenotypes on time to diabetes onset. Results: After a mean follow‐up period of 6.5 months ( sd 4.7 months), the number of diabetes cases was significantly higher in the group with hypertriglyceridaemic–waist phenotype (52.2%) compared with the other three phenotype groups (group 1: 28.2%; group 2: 34.6%; group 3: 30.0%). Only the hypertriglyceridaemic–waist phenotype showed an increased risk of developing diabetes (hazard ratio 1.581, 95% CI 1.172–2.134; P = 0.003) compared with the group with normal waistline and triglyceride level after controlling for confounders. Conclusions: The combination of central obesity and hypertriglyceridaemia is associated with > 50% risk of progression to diabetes within 6 months among individuals with impaired fasting glucose seen in primary care. [ABSTRACT FROM AUTHOR]

Abstract: Aim: The aim of this study was to verify the effects of a multisensory exercise programme on the cognition and functionality of institutionalized older adults. Methods: Forty‐five volunteers were randomly allocated to 2 groups, the multisensory exercise programme (n = 24) and the control group that received no treatment (n = 21). The programme consisted of 3 50‐min sessions of progressive exercises per week for 16 weeks that challenged their strength, balance, coordination, multisensory stimulation, and flexibility in different tasks. Cognition (Montreal Cognitive Assessment), balance (Berg Scale), mobility (Timed Up and Go), and functional performance (Physical Performance Test) were measured preintervention and postintervention. Statistical analyses were performed using Student's t test and 2‐way ANOVA. Results: The multisensory exercise programme showed statistically significant improvements (p < .05) on cognition (effect size [ES]: 0.92), balance (ES: 0.77), mobility (ES: 0.51), and functional performance (ES: 0.86) as compared with the control group, which showed no statistical significant differences at the postintervention time point. Conclusions: The multisensory exercise programme improved the cognition and functionality of institutionalized older adults. The introduction of a motor and multisensory‐based approach in care routines may improve residents' health and engagement to the environment. [ABSTRACT FROM AUTHOR]

Abstract: Background: Low‐carbohydrate diets are becoming increasingly popular, although their dietary quality outside of clinical studies is unknown. A previous study analysed the dietary intake in people consuming a reduced‐carbohydrate diet (<40% calories). However, it is not clear what foods people consume when carbohydrate is reduced to below 26% of total calories. Methods: In the present cross‐sectional study, the dietary and nutrient intake collected via up to five consecutive 24‐h dietary recalls and a food frequency questionnaire of 444 individuals (aged 46‐79 years) consuming <26% of calories from carbohydrate (LCHO) was compared with that of 131 897 individuals consuming ≥45% calories from carbohydrate (NCHO) using the UK Biobank Dataset. Absolute cut‐offs to define the low‐carbohydrate group (<130 g day–1; n = 1953 versus ≥225 g day–1, n = 113 036) were also used. Results: Both NCHO (>45% calories and ≥225 g) groups consumed significantly more high‐sugar, high‐fat snacks [median 6.0, interquartile range (IQR) = 2.0–11.0 and median 6.0, IQR = 3.0–11.8, respectively) compared to the LCHO (<26% calories and <130 g) groups (median 0, IQR = 0–2.8 and median 1, IQR = 0–3.8, respectively) (P < 0.0001). Both LCHO groups reported consuming significantly more red meat, oily fish, nuts and seeds but fewer fruits, vegetables and pulses compared to the NCHO groups. In general, the consumption of oily fish, nuts, seeds and pulses was low across the whole cohort and differences in intake between the LCHO and NCHO groups were small. After adjusting for socio‐economic status, most differences remained. Conclusions: Carbohydrate restriction is associated with both beneficial and potentially deleterious dietary changes compared to a normal carbohydrate intake. [ABSTRACT FROM AUTHOR]

Abstract: Background: Evidence from healthcare professionals suggest that consumer compliance to healthy diet and lifestyle changes is often poor. The present study investigated the effect of advice provided by a physician or dietitian on consumer adherence to these measures combined with consuming foods with added plant sterols (PS) with the aim of lowering low‐density lipoprotein cholesterol (LDL‐C). Methods: One hundred mildly‐to‐moderately hypercholesterolaemic individuals were enrolled into a parallel, randomised, placebo‐controlled study. Dietitians (dietitian group; DG) advised 50 individuals in six weekly face‐to‐face behavioural therapy sessions, whereas the other 50 received standard advice from physicians (physician group, PG). Both groups consumed foods with added PS (three servings a day) for 6 weeks. Subsequently, all individuals were followed‐up for another 6 weeks under real‐life conditions. Blood lipids were measured at baseline and weeks 6 and 12 and 3‐day diet diaries were taken at weeks 1, 6 and 12. Results: Individuals in the DG significantly improved their dietary habits, physical activity and increased PS intake compared to the PG. After 6 weeks, LDL‐C decreased in both groups compared to baseline without any significant differences between groups. At week 12, LDL‐C was further significantly improved only in the DG (P = 0.006) compared to week 6. Total cholesterol, LDL‐C and triglycerides were significantly lower in the DG compared to the PG at week 12 after adjusting for levels at week 6 (P < 0.001, P < 0.001 and P = 0.009, respectively). Conclusions: Although structured counselling by dietitians and common standard advice by physicians were equally effective with respect to improving blood cholesterol after 6 weeks, dietitians were more effective in the longer‐term (i.e. 6 weeks after the end of the intervention period). [ABSTRACT FROM AUTHOR]

Purpose: To investigate the effect of sodium bicarbonate (NaHCO3) on performance and estimated energy system contribution during simulated taekwondo combat. Methods: Nine taekwondo athletes completed two experimental sessions separated by at least 48 h. Athletes consumed 300 mg/kg body mass of NaHCO3 or placebo (CaCO3) 90 min before the combat simulation (three rounds of 2 min separated by 1 min passive recovery), in a double-blind, randomized, repeated-measures crossover design. All simulated combat was filmed to quantify the time spent fighting in each round. Lactate concentration [La-] and rating of perceived exertion (RPE) were measured before and after each round, whereas heart rate (HR) and the estimated contribution of the oxidative (WOXI), ATP (adenosine triphosphate)-phosphocreatine (PCr) (WPCR), and glycolytic (W[La-]) systems were calculated during the combat simulation. Results: [La-] increased significantly after NaHCO3 ingestion, when compared with the placebo condition (+14%, P = 0.04, d = 3.70). NaHCO3 ingestion resulted in greater estimated glycolytic energy contribution in the first round when compared with the placebo condition (+31%, P = 0.01, d = 3.48). Total attack time was significantly greater after NaHCO3 when compared with placebo (+13%, P = 0.05, d = 1.15). WOXI, WPCR, VO2, HR and RPE were not different between conditions (P > 0.05). Conclusion: NaHCO3 ingestion was able to increase the contribution of glycolytic metabolism and, therefore, improve performance during simulated taekwondo combat [ABSTRACT FROM AUTHOR]

Biophysical loading of the elbow and wrist is a potential reason for chronic lesions in gymnastics and present a real concern for coaches, scientist and clinicians. Previous research has identified injury risk factors during round-off (RO) skills in elite female gymnasts. The aim of this study was to investigate key elbow and wrist joint injury risk factors during different techniques of fundamental cartwheel (CW) and RO skills performed by young female artistic gymnasts. Seventeen active young female gymnasts performed 30 successful trials of both CW and RO from a hurdle step with three different hand positions (parallel (10), T-shape (10) and reverse (10)). Synchronised kinematic (240 Hz) and kinetic (1200 Hz) data were collected for each trial. One-way repeated measures ANOVA and effect size (ES) were used for statistical analysis. The results showed statistically significant differences (P < .05) and large ES (>0.8) among hand positions for peak vertical ground reaction force (VGRF), peak elbow compression force, peak wrist compression force, elbow internal adduction moment and wrist dorsiflexion angle. In conclusion, the parallel and reverse techniques increase peak VGRF, elbow and wrist compression forces, and elbow internal adduction moment. These differences indicate that the parallel and reverse techniques may increase the potential of elbow and wrist injuries in young gymnasts compared with the T-shape technique; this is of particular importance with the high frequency of the performance of these fundamental skills. [ABSTRACT FROM AUTHOR]

Exercise has been demonstrated to have considerable effects upon haemostasis, with activation dependent upon the duration and intensity of the exercise bout. In addition, markers of coagulation and fibrinolysis have been shown to possess circadian rhythms, peaking within the morning (0600-1200 h). Therefore, the time of day in which exercise is performed may influence the activation of the coagulation and fibrinolytic systems. This study aimed to examine coagulation and fibrinolytic responses to short-duration high-intensity exercise when completed at different times of the day. Fifteen male cyclists (VO2max: 60.3 ± 8.1 ml kg-1 min-1) completed a 4-km cycling time trial (TT) on five separate occasions at 0830, 1130, 1430, 1730 and 2030. Venous blood samples were obtained pre- and immediately post-exercise, and analysed for tissue factor (TF), tissue factor pathway inhibitor (TFPI), thrombin-anti-thrombin complexes (TAT) and D-Dimer. Exercise significantly increased plasma concentrations of TF (p < .0005), TFPI (p < .0006), TAT complexes (p < .0012) and D-Dimer (p < .0003). There was a time-of-day effect in pre-exercise TF (p = .004) and TFPI (p = .031), with 0830 greater than 1730 (p .001), while 1730 was less than 2030 h (p = .008), respectively. There was no significant effect of time of day for TAT (p = .364) and D-Dimer (p = .228). Power output, TT time and heart rate were not significantly different between TTs (p > .05); however, percentage VO2max was greater at 1730 when compared to 2030 (p = .04). Due to a time-of-day effect present within TF, peaking at 0830, caution should be applied when prescribing short-duration high-intensity exercise bout within the morning in populations predisposed to hypercoagulability. [ABSTRACT FROM AUTHOR]

Mouth rinsing using a carbohydrate (CHO) solution has been suggested to improve physical performance in fasting participants. This study examined the effects of CHO mouth rinsing during Ramadan fasting on running time to exhaustion and on peak treadmill speed (Vpeak). In a counterbalanced crossover design, 18 sub-elite male runners (Age: 21 ± 2 years, Weight: 68.1 ± 5.7 kg, VO2max: 55.4 ± 4.8 ml/kg/min) who observed Ramadan completed a familiarization trial and three experimental trials. The three trials included rinsing and expectorating a 25 mL bolus of either a 7.5% sucrose solution (CHO), a flavour and taste matched placebo solution (PLA) for 10 s, or no rinse (CON). The treatments were performed prior to an incremental treadmill test to exhaustion. Three-day dietary and exercise records were obtained on two occasions and analysed. Anthropometric characteristics were obtained and recorded for all participants. A main effect for mouth rinse on peak velocity (Vpeak) (CHO: 17.6 ± 1.5 km/h; PLA: 17.1 ± 1.4 km/h; CON: 16.7 ± 1.2 km/h; P < .001, ηp2 = 0.49) and time to exhaustion (CHO: 1282.0 ± 121.3 s; PLA: 1258.1 ± 113.4 s; CON: 1228.7 ± 98.5 s; P = .002, ηp2 = 0.41) was detected, with CHO significantly higher than PLA (P < .05) and CON (P < .05). Oxygen consumption, heart rate, respiratory exchange ratio, and rating of perceived exertion were not significantly different between treatments or trials (P > .05). Energy availability from dietary analysis, body weight, and fat-free mass did not change during the last two weeks of Ramadan (P > .05). This study concludes that carbohydrate mouth rinsing improves running time to exhaustion and peak treadmill speed under Ramadan fasting conditions. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine whether estimates of the speed-duration relationship are affected using different timetrial (TT) field-based testing protocols, where exhaustive times were located within the generally recommended durations of 2-15 min. Ten triathletes (mean ± SD age: 31.0 ± 5.7 years; height: 1.81 ± 0.05 m; body mass: 76.5 ± 6.8 kg) performed two randomly assigned field tests to determine critical speed (CS) and the total distance covered above CS (D'). CS and D' were obtained using two different protocols comprising three TT that were interspersed by 60 min passive rest. The TTs were 12, 7, and 3 min in Protocol I and 10, 5, and 2 min in Protocol II. A linear relationship of speed vs. the inverse of time (s = D'×1/t + CS) was used to determine parameter estimates. Significant differences were found for CS (p = 0.026), but not for D' (p = 0.123). The effect size for CS (d = 0.305) was considered small, while that for D' was considered moderate (d = 0.742). CS was significantly correlated between protocols (r = 0.934; p < 0.001), however, no correlation was found for D' (r = 0.053; p = 0.884). The 95% limits of agreement were ±0.28m s-1and ±73.9 m for CS and D', respectively. These findings demonstrate that the choice of exhaustive times within commonly accepted durations results in different estimates of CS and D', and thus protocols cannot be used interchangeably. The use of a consistent protocol is therefore recommended, when investigating or monitoring the speed-duration relationship estimates in well-trained athletes. [ABSTRACT FROM AUTHOR]

This study aimed to describe the effect of compression garments on middle cerebral artery blood flow velocity (MCAv) in relation to cognitive and exercise performance whilst cycling. In a randomised-controlled-cross-over design, 15 welltrained male cyclists were recruited to participate in three identical trials wearing loose fitting shorts (control), low-grade, or medium-grade compression garments. The protocol involved four 8 min increments of cycling at 30%, 50%, 70%, and 85% maximal power output and a 4 km time-trial. Participants undertook a cognitive Stroop task at baseline and at the midpoint of each increment. MCAv was monitored with Transcranial Doppler Ultrasonography. Mean arterial pressure (MAP) and partial pressure of end-tidal CO2 (PetCO2) were measured throughout. MCAv, MAP, PetCO2, and reaction time of the complex Stroop task were influenced by exercise intensity, but not compression garments. Compression garments significantly affected cognitive accuracy in the complex Stroop task such that low-grade compression appeared to enhance cognitive accuracy in comparison to the control condition at the highest intensity (p = .010). Time-trial performance did not differ between the control (338.0 ± 17.3 s), low-grade (338.7 ± 18.7 s), or medium-grade (342.2 ± 19.3 s) conditions (p = .114). Compression garments did not affect MCAv during exercise or time-trial performance, but compression may be beneficial for improved cognitive accuracy during high-intensity exercise. Further research is required to elucidate the potential impact on cognitive performance. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the effects of gallium‐aluminum‐arsenium (GaAlAs) (670 nm) laser therapy on neoangiogenesis and fibroplasia during tissue remodelling. Forty male Wistar rats underwent cutaneous surgery and were divided into 2 experimental groups: the Control and Laser group (9 mW, 670 nm, 0.031 W/cm2, 4 J/cm2). After 14, 21, 28, and 35 days, the animals were euthanised. Descriptive and quantitative analyses were performed in sections stained with haematoxylin‐eosin and Sirius Red, respectively. The amounts of VEGF+ and CD31+ cells were evaluated by immunohistochemistry and histomorphometric analysis, respectively. Statistical analysis was performed using the Mann‐Whitney, Friedman, and Spearman correlation test, P < 0.05. The collagen expression was significantly higher in the laser group compared with the control group on days 14 and 21 after the creation of the skin wound (P = 0.008; P = 0.016) and in the control group between 14 and 28 and 14 and 35 days (P = 0.001; P = 0.007). There were more blood vessels in three periods of the study only in the (Laser) treated group, with statistical significance at day 14 (P = 0.016). There was no statistically significant difference in VEGF+ cell count in the different experimental groups throughout the study, although a positive correlation was shown with the area of collagen on days 14 and 28 (P = 0.037). Laser treatment had a positive effect in the late course of healing, particularly with regards to collagen expression and the number of newly formed vessels. VEGF+ cells were present in both experimental groups, and VEGF appeared to influence fibroplasia in the treated group. [ABSTRACT FROM AUTHOR]

Preventing intraoperatively acquired pressure ulcers (IAPUs) in patients undergoing spinal surgery in the prone position using a Relton‐Hall frame is challenging. We investigated the efficacy of soft silicone foam dressings in preventing IAPUs. A prospective dual‐center sham study was conducted among patients undergoing elective spinal surgery in a general hospital and a university hospital in Japan. The incidence of IAPUs that developed when soft silicone foam dressings and polyurethane film dressings were used was compared on two sides in the same patient. IAPUs developed on the chest in 11 of 100 patients (11%). Polyurethane film dressings were associated with a significantly higher rate of IAPUs than soft silicone foam dressings (11 versus 3, P = 0·027). A multivariate logistic regression analysis revealed that a diastolic blood pressure of <50 mmHg (P = 0·025, OR 3·74, 95% confidence interval [CI] 1·18–13·08) and the length of surgery (by 1 hour: P = 0·038, OR 1·61, 95% CI 1·03–2·64) were independently associated with the development of IAPUs. The use of soft silicone foam dressings reduced the risk of IAPUs (P = 0·019, OR 0·23, 95% CI 0·05–0·79) and was more effective than film dressings for preventing IAPUs in spinal surgery patients. [ABSTRACT FROM AUTHOR]

Concurrent plyometric and running training has the potential to improve running economy (RE) and performance through increasing muscle strength and power, but the possible effect on spatiotemporal parameters of running has not been studied yet. The aim of this study was to compare the effect of 8 weeks of concurrent plyometric and running training on spatiotemporal parameters and physiological variables of novice runners. Twenty-five male participants were randomly assigned into two training groups; running group (RG) (n = 11) and running + plyometric group (RPG) (n = 14). Both groups performed 8 weeks of running training programme, and only the RPG performed a concurrent plyometric training programme (two sessions per week). Anthropometric, physiological (VO2max, heart rate and RE) and spatiotemporal variables (contact and flight times, step rate and length) were registered before and after the intervention. In comparison to RG, the RPG reduced step rate and increased flight times at the same running speeds (P < .05) while contact times remained constant. Significant increases in pre- and post-training (P < .05) were found in RPG for squat jump and 5 bound test, while RG remained unchanged. Peak speed, ventilatory threshold (VT) speed and respiratory compensation threshold (RCT) speed increased (P < .05) for both groups, although peak speed and VO2max increased more in the RPG than in the RG. In conclusion, concurrent plyometric and running training entails a reduction in step rate, as well as increases in VT speed, RCT speed, peak speed and VO2max. Athletes could benefit from plyometric training in order to improve their strength, which would contribute to them attaining higher running speeds. [ABSTRACT FROM AUTHOR]

The positive effects of caffeine ingestion on aerobic performance are well-established; however, recent findings are suggesting that caffeine ingestion might also enhance components of anaerobic performance. A commonly used test of anaerobic performance and power output is the 30-second Wingate test. Several studies explored the effects of caffeine ingestion on Wingate performance, with equivocal findings. To elucidate this topic, this paper aims to determine the effects of caffeine ingestion on Wingate performance using meta-analytic statistical techniques. Following a search through PubMed/MEDLINE, Scopus, and SportDiscus®, 16 studies were found meeting the inclusion criteria (pooled number of participants = 246). Random-effects meta-analysis of standardized mean differences (SMD) for peak power output and mean power output was performed. Study quality was assessed using the modified version of the PEDro checklist. Results of the meta-analysis indicated a significant difference (p = .005) between the placebo and caffeine trials on mean power output with SMD values of small magnitude (0.18; 95% confidence interval: 0.05, 0.31; +3%). The meta-analysis performed for peak power output indicated a significant difference (p = .006) between the placebo and caffeine trials (SMD = 0.27; 95% confidence interval: 0.08, 0.47 [moderate magnitude]; +4%). The results from the PEDro checklist indicated that, in general, studies are of good and excellent methodological quality. This meta-analysis adds on to the current body of evidence showing that caffeine ingestion can also enhance components of anaerobic performance. The results presented herein may be helpful for developing more efficient evidence-based recommendations regarding caffeine supplementation. [ABSTRACT FROM AUTHOR]

For fencing, speed of the lunge is considered critical to success. The aim of this study is to investigate determinants of lunge speed based on biomechanics. Ground reaction force (GRF) and three-dimensional kinematic data were collected from 7 elite fencers and 12 intermediate-level fencers performing maximum-effort lunges. The results showed that elite fencers acquired a higher horizontal peak velocity of the centre of gravity (HPV) and concomitantly a higher horizontal peak GRF exerted by rear leg (PGRF) than intermediate-level fencers (P < .01). Studying the affecting factors, elite fencers obtained higher joint peak power, joint peak moment, and range of motion of rear knee than intermediate-level fencers (P < .05) during the lunge, and these parameters were significantly correlated with both HPV and PGRF (P < .05). Both elite and intermediate-level fencers had joint flexion before the extension in forward knee; however, the latter showed greater flexion, higher peak angular velocity and less time for extension compared to the former (P ≤ .05). Our findings suggest that training aimed at enhancing strength and power of rear knee extensors is important for fencers to improve speed of the lunge. Also, increasing the extension of rear knee during the lunge, at the same time decreasing the flexion of the forward knee before extension are positive for lunge performance. [ABSTRACT FROM AUTHOR]

Aim: The 5:2 diet (two non‐consecutive days of 2460 KJ (600 calories) and 5 days of ad libitum eating per week) is becoming increasingly popular. This pilot study aimed to determine whether the 5:2 diet can achieve ≥5% weight loss and greater improvements in weight and biochemical markers than a standard energy‐restricted diet (SERD) in obese male war veterans. Methods: A total of 24 participants were randomised to consume either the 5:2 diet or a SERD (2050 KJ (500 calorie) reduction per day) for 6 months. Weight, waist circumference (WC), fasting blood glucose, blood lipids, blood pressure and dietary intake were measured at baseline, 3 and 6 months by a blinded investigator. Results: After 6 months, participants in both groups significantly reduced body weight (P = <0.001), WC (P = <0.001) and systolic blood pressure (P = 0.001). Mean weight loss was 5.3 ± 3.0 kg (5.5 ± 3.2%) for the 5:2 group and 5.5 ± 4.3 kg (5.4 ± 4.2%) for the SERD group. Mean WC reduction for the 5:2 group was 8.0 ± 4.5 and 6.4 ± 5.8 cm for the SERD group. There was no significant difference in the amount of weight loss or WC reduction between diet groups. There was no significant change in diastolic blood pressure, fasting blood glucose or blood lipids in either dietary group. Conclusions: Results suggest that the 5:2 diet is a successful but not superior weight loss approach in male war veterans when compared to a SERD. Future research is needed to determine the long‐term effectiveness of the 5:2 diet and its effectiveness in other population groups. [ABSTRACT FROM AUTHOR]

Aim: Malnutrition has a significant impact on patient outcomes and duration of inpatient stay. However, conducting timely nutrition assessments can be challenging for rural dietitians. A solution could be for allied health assistants (AHAs) to assist with these assessments. The present study aimed to assess the accuracy and confidence of AHAs trained to conduct the subjective global assessment (SGA) compared with dietitians. Methods: A non‐inferiority study design was adopted. Forty‐five adult inpatients admitted to a rural and remote health service were assessed independently by both a trained AHA and dietitian within 24 hours. The order of assessment was randomised, with the second assessor blind to the outcome of the initial SGA. Levels of agreement were examined using kappa and percent exact agreement (PEA; set a priori at ≥80%). Rater confidence after each assessment was assessed using a 10‐point scale. Results: Agreement for overall SGA ratings was high (kappa = 0.84; PEA 84.4%). PEA for individual sub‐components of the SGA ranged from 66.4 to 86.7%. Where discrepancies were identified in global SGA ratings, AHAs provided a more severe rating of malnutrition than dietitians. AHAs reported significantly lower confidence than dietitians (t = 4.49, P < 0.001), although mean confidence for both groups was quite high (AHA=7.5, dietitians = 9.0). Conclusions: Trained AHAs completed the SGA with similar accuracy to dietitians. Using AHAs may help facilitate timely nutrition assessment in rural health services when a dietitian is not physically present. Further investigation is required to determine the benefits of incorporating this extended role into rural and remote health‐care services. [ABSTRACT FROM AUTHOR]

Aim: Derangements in blood lipid and lipoprotein metabolism are one of the leading causes of coronary heart disease (CHD). Therapeutic lifestyle changes such as diet and exercise are often prescribed to improve blood lipid and lipoprotein characteristics, but the efficacy of a telephone‐based health coaching program has not been thoroughly explored. Our purpose was to examine effects of the Our Healthy Heart (OHH) Program on blood lipid and lipoprotein characteristics of individuals with mixed dyslipidaemia. Methods: Cholesterol content of serum very low‐density lipoprotein (VLDL), low‐density lipoprotein (LDL) and high‐density (HDL) subfractions and apolipoprotein concentrations were measured by vertical‐density ultracentrifugation (Vertical Auto Profile (VAP)) from 1522 individuals with mixed dyslipidaemia (age 18–99 years, body mass index (BMI) 25–40, 62.7% female). Telephone‐based health coaching (OHH, n = 722) or standard care (Control, n = 800) was provided for six months followed by VAP to evaluate changes in lipid and lipoprotein concentrations. Controls were obtained from individuals with similar blood lipid/lipoprotein characteristics who did not participate in the OHH Program. Coaches collected baseline self‐reported data on anthropometrics, food intake and exercise. Participants in the OHH group were then prescribed a hypocaloric 500 kcal/day caloric deficit with encouragement to participate in physical activity. A two‐way ANOVA was used to examine differences between groups over time, with results presented as means ± standard deviation. Results: Health coaching significantly decreased serum concentrations of apoB100 (104.5 ± 25.8–94.3 ± 24.8 mg/dL), shifted LDL pattern size from B to A or A/B in over 60% of the OHH group and decreased cholesterol content of all VLDL subfractions (P < 0.05) compared to the control. Conclusions: Telephone‐based health coaching recommendations to reduce dietary energy intake and increase physical activity produced significant improvements in cholesterol content of atherogenic lipoproteins, which are known to increase CHD risk. [ABSTRACT FROM AUTHOR]

Aim: Recent evidence favours a move away from delaying postoperative nutrition towards early feeding practices for better patient outcomes after gastrointestinal surgery. The aim of the present study was to investigate postoperative diet progression and patient outcomes in a secondary hospital with a view to inform future practice. Methods: This was a retrospective study of gastrointestinal surgery patients (n = 69) at a Western Australian general hospital. Demographic data and outcomes were collected from patient records and included presence or absence of prolonged postoperative ileus, length of stay in hospital, days on minimal nutrition and days until first flatus or stool. Results: A significant positive association was observed between number of days a patient remained on minimal nutrition and length of stay in the overall group (r = 0.66, P < 0.01). Patients who developed prolonged postoperative ileus (n = 18, 26%) had a greater number of days on minimal nutrition (20.0 vs 8.0 days, P < 0.01), longer stay in hospital (15.0 vs 8.0 days, P < 0.01) and increased number of days to first flatus or stool (4.0 vs 2.4 days, P < 0.01) compared with those who did not develop prolonged postoperative ileus (n = 51, 74%). Conclusions: This retrospective study of current practice in a secondary‐care general hospital highlights the gap between traditional care and the improved outcomes reported in the literature when early feeding practices are adopted after GI surgery. Further investigation of barriers and enablers is necessary to provide insight into developing the most appropriate strategy to achieve this. [ABSTRACT FROM AUTHOR]

Aim: Assessing changes in dietetic perceptions, attitudes and knowledge regarding the Nutrition Care Process Terminology (NCPT) is important to determine implementation effectiveness. This study aimed to investigate changes in the perceptions and attitudes of Australian dietitians over a three‐year period, identify changes in benefits and barriers to support successful NCPT implementation and determine future directions for NCPT progression. Methods: An online survey was performed in 2011 and repeated in 2014 by recruiting members of the Dietitians Association of Australia (DAA) through an email link. The survey assessed familiarity, knowledge, attitudes, benefits, barriers, concerns and use of educational enablers around the NCPT. Results: The survey was completed by 218 respondents in 2011 and 205 respondents in 2014. Survey respondents from both years were representative of overall DAA membership. Respondent knowledge of NCPT increased significantly over the three‐years, as did confidence, preparation, access to support and training and NCPT usage. Respondent's identification of benefits to implementation increased whilst barriers reduced. Attitudes regarding NCPT implementation were conflicting. Conclusions: Over three years, improvements were evident in NCPT knowledge, attitudes and usage. However, not all dietitians saw reason to implement NCPT in their practice, and some attitudes have become less supportive. A collective vision is required to foster positive attitudes towards the transformational professional benefits possible from NCPT. With ongoing uptake of electronic health records, the potential for NCPT to evaluate and justify dietetic interventions is increasing. [ABSTRACT FROM AUTHOR]

Abstract: Background: The Patient‐Generated Subjective Global Assessment (PG‐SGA) is an instrument used to assess malnutrition and its risk factors. Some items of the PG‐SGA may be perceived as hard to comprehend or as difficult by healthcare professionals. The present study aimed to determine whether and how dietitians’ perceptions of comprehensibility and difficulty of the PG‐SGA change after a single training in PG‐SGA use. Methods: In this prospective evaluation study, Dutch PG‐SGA‐naïve dietitians completed a questionnaire regarding perceived comprehensibility and difficulty of the PG‐SGA before (T0) and after (T1) receiving a single training in the use of the instrument. Perceived comprehensibility and difficulty were operationalised by calculating item and scale indices for comprehensibility (I‐CI, S‐CI) and difficulty (I‐DI, S‐DI) at T0 and T1. An item index of 0.78 was considered acceptable, a scale index of 0.80 was considered acceptable and a scale index of 0.90 was considered excellent. Results: A total of 35 participants completed the questionnaire both at T0 and T1. All item indices related to comprehensibility and difficulty improved, although I‐DI for the items regarding food intake and physical examination remained below 0.78. Scale indices for difficulty and comprehensibility of the PG‐SGA changed significantly (P < 0.001) from not acceptable at T0 (S‐CI = 0.69; S‐DI = 0.57) to excellent for comprehensibility (S‐CI = 0.95) and acceptable for difficulty (S‐DI = 0.86) at T1. Conclusions: The findings of the present study suggest that significant improvement in PG‐SGA‐naïve dietitians’ perception of comprehensibility and difficulty of the PG‐SGA can be achieved quickly by providing a 1 day of training in the use of the PG‐SGA. [ABSTRACT FROM AUTHOR]