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Coaching scholarship (CS) sits at the intersection of multiple paradigms and disciplines. Despite the eclectic nature of the field, most scholars operate only within their preferred paradigm, which limits how coaching is conceptualized and practiced. To address this limitation, we used the dialectic stance to analyze bibliometric records of CS produced between 1970 and 2020 from both an interpretivist and poststructuralist perspective. Using Web of Science, we identified 2,522 coaching articles and organized the bibliometric data into a time-ordered matrix representing five decades of CS: (a) number of publications per year, (b) country of origin, (c) institution, (d) journal, (e) author, and (f) most cited articles. Two research groups analyzed the data concurrently and independently using their respective paradigm. Next, the two groups came together to engage in dialogue and discover areas of convergence and divergence. Through the paradigmatic dialogue, the interpretivist research group realized they were operating in a postpositivist paradigm. Nevertheless, both groups determined CS was heavily influenced by Western societies, sport psychology, and the topic of motivation. The postpositivists highlighted evolutionary trends in CS, while the poststructuralists elucidated relations of power, understudied problems, and the consequences of the dominant knowledge produced.

The Gut Microbiota and Metabolome and Brown Adipose Tissue Regulate the Enhanced Exercise Capacity in Mice with Disruption of the Regulator of G protein Signaling 14 (RGS14) Candace R. Longoria, Olufunmilola Ibironke, Lee J. Kerkhof, Marko Oydanich, Xiaoyang Su, Eric Chiles, Dorothy E. Vatner, Stephen F. Vatner, Sara C. Campbell, FACSM.Rutgers, The State University of New Jersey Disruption of the Regulator of G Protein Signaling 14 (RGS14 (knockout) KO) results in a mouse model of healthful longevity with enhanced exercise capacity. Running distance and work to exhaustion are increased by 60±9% and 54±6% respectively in the RGS14 KO mouse compared to wild type littermates (WTL). Our hypothesis was that the enhanced exercise capacity was mediated by brown adipose tissue (BAT), which was confirmed by BAT transplants from RGS14 KO mice to WTL, resulting in a reversal of phenotype with the RGS14 KO mice losing the enhanced exercise capacity and WTL gaining the enhanced exercise capacity. We further hypothesized that the mechanism mediating the enhanced exercise capacity in RGS14 KO mice involved the gut microbiota and metabolome. The gut microbiota is linked to BAT, but the mechanisms and microbes facilitating BAT function remain largely unknown. Twenty-four mice were used to identify gut microbes by ribosomal operon profiling and metabolites in BAT samples at baseline. Bacterial differential expression analysis (via DESeq2) showed significant bacterial community differences between wild-type (WT) and RGS14 KO mice. Specifically, five bacterial strains ( Acutalibacter muris KB18, Ureaplasma urealyticum 132, Ureaplasma parvum ATCC 33697, Ureaplasma parvum, and Mucispirillum schaedleri ASF457) were present in RGS14 KO mice and not in WT. RGS14 KO mice also housed two distinctive strains of A. muciniphilia (BIOML-A22 and A. muciniphilia AN78). Eleven metabolites were significantly higher in RGS14 KO BAT samples compared to WT, with significant metabolic pathways, which in turn, are related to mechanisms mediating enhanced exercise capacity. We then examined the effects of antibiotic treatment (ABX) in 8 mice. Following 1 week of ABX, the bacterial strains that were increased in RGS14 KO mice were no longer elevated and the enhanced exercise capacity in RGS14 KO mice was no longer elevated compared to WTL. Furthermore, 6 of the 7 metabolites related to glucose and amino acid metabolism were no longer increased in RGS14 KO BAT compared to WTL. Taken together, these studies show that RGS14 KO BAT, associated with specific microbes and metabolites known to be involved with BAT, mediate the increased metabolic pathways that are associated with enhanced exercise capacity in RGS14 KO mice. In conclusion, the gut microbiota appears to be linked to RGS14 KO BAT function, which mediates enhanced exercise capacity in RGS14 KO mice. ONR Grant #826640 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

OBJECTIVE The first aim of this study was to examine changes in freshman college students' health-enhancing physical activity (PA) and body composition across the first semester. Secondly, this study aimed to explore the role of socio-ecological variables on these processes. Methods: A sample of 166 participants (108 females, 58 males, Mage = 18.14[.96]) completed self-report pre-and posttest data on vigorous PA (VPA), moderate-to-vigorous PA (MVPA), and body mass index (BMI). Results: The results showed a statistically significant increase in BMI, but no statistically significant changes in VPA or MVPA. The findings revealed that our socio-ecological model predicted .71, .39, and .92 percent of the end of the year VPA, MVPA, and BMI, respectively. The findings highlighted the positive role of peer support, positive motivation, and university's Recreational Services on measured healthy behaviors. Conclusions: These findings suggest a need to increase college students' VPA.

This study aimed to provide a quantitative synthesis on the effect of the Sport Education Model (SEM) on basic need satisfaction, intrinsic motivation, and prosocial attitudes in physical education (PE). We conducted a systematic review and meta-analysis on experimental studies conducted before August 2020. The initial search yielded 6061 articles, with 25 articles ( n = 2937) meeting the inclusion criteria. The articles were analyzed using five separate analyses using two- and three-level random-effects models and Hedges’ g effect size. The study showed the SEM to have a positive heterogeneous medium effect on autonomy ( g = 0.43; CI 95% [0.12, 0.74]), competence ( g = 0.42; CI 95% [0.17, 0.67]) and relatedness ( g = 0.57; CI 95% [0.28, 0.85]) need satisfaction, intrinsic motivation ( g = 0.63; CI 95% [0.37, 0.89]), and prosocial attitudes ( g = 0.46; CI 95% [0.09, 0.83]). All a priori categorical moderators were statistically insignificant. The analyses indicate that the SEM is more need-supportive and promotes intrinsic motivation and prosocial attitudes more compared to the skill-drill, direct, and traditional instructional styles used in PE. However, high-quality experimental and comparative trials testing the efficacy of the SEM on broad outcomes are needed. Specifically, the concept of novelty, potential negative outcomes, and essential behavioral outcomes, such as physical activity, should be included in the future. Further, the fidelity of the interventions should be measured and reported with more transparency and detail.

Coach developers provide education and support to coaches. Therefore, these individuals play an important role in coaching systems. However, the formal training of coach developers is a relatively new concept. Both practitioners and academics seem eager to understand how to effectively train these individuals. We had the opportunity to collect feedback from participants of an international coach developer training programme (CDTP). The primary purpose of this insights paper is to share this feedback and make recommendations for future CDTPs based on connections between participant feedback and relevant literature. A secondary purpose of this paper is to stimulate dialogue from programme participants and coordinators, who can offer additional insight regarding their experiences in CDTPs.

Placement of foreign bodies within the urethra has intrigued urologists for years. We present the case of a 30-year-old man who had self-inserted 6 kidney beans into his urethra for sexual pleasure. Conservative attempts at removal with bedside interventions were unsuccessful. The patient required operative intervention with cystoscopy and urethral foreign body retrieval. No additional trauma was appreciated and all beans were extracted. Management of patients with a urethral foreign body can be attempted with bedside extraction, however proximal or challenging objects may require surgical extraction via either endoscopic or open approaches.

Despite major setbacks to its health infrastructure and health workforce capacity, Liberia began its first post-graduate training program for physicians in 2013. Specialty training in Internal Medicine, Pediatrics, General Surgery and Obstetrics and Gynecology were the four inaugural Residency programs that recruited graduates from the country's only medical school, A.M. Dogliotti College of Medicine. The Obstetrics and Gynecology residency program was designed to combat the rising maternal mortality and strengthen health systems to improve maternal care. The program adapted in the face of challenges posed by limited financial support, lack of specialist-faculty and general physician shortages and the Ebola virus outbreak. The manuscript discusses the challenges and successes of the program and demonstrates how the shortage of teaching faculty was addressed by developing a collaboration between local government and educational communities, a United States (US) academic institution and volunteers from the Global Health Service Partnership.

Women who develop gestational diabetes mellitus (GDM) have an elevated lifetime risk of type 2 diabetes mellitus. Recently, a series of studies has suggested that women with GDM also have an increased risk of cardiovascular disease (CVD). However, it is unclear if this risk is dependent upon the intercurrent development of type 2 diabetes. Thus, we conducted a systematic review and meta-analysis to evaluate the impact of GDM on future risk of incident CVD and to ascertain the role of type 2 diabetes in this regard. We systematically searched the PubMed and EMBASE databases for observational studies that evaluated the association of GDM with subsequent CVD, with publication between 1 January 1950 and 30 August 2018. Two independent reviewers extracted data and the analysis was performed in accordance with Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. RRs were calculated using a random-effects model to assess the predictive value of GDM for future cardiovascular events. To evaluate whether incident type 2 diabetes in the GDM population influenced the association with CVD, we used meta-regression models followed by sensitivity analyses restricted to women who did not develop type 2 diabetes during follow-up. A pooled analysis of nine studies yielded data from 5,390,591 women (101,424 cardiovascular events). Compared with those who did not have GDM, women with GDM had a twofold higher risk of future cardiovascular events (RR 1.98 [95% CI 1.57, 2.50]). Meta-regression analysis showed that the rates of incident type 2 diabetes across the studies did not affect this risk (p = 0.34). Moreover, when restricted to women who did not develop type 2 diabetes, GDM remained associated with a 56% higher risk of future cardiovascular events (RR 1.56 [95% CI 1.04, 2.32]). GDM conferred a 2.3-fold increased risk of cardiovascular events in the first decade postpartum (RR 2.31 [95% CI 1.57, 3.39]). The diagnosis of GDM identifies young women who have a twofold higher risk of cardiovascular events postpartum compared with their peers. This risk is not dependent upon intercurrent type 2 diabetes and is apparent within the first decade after pregnancy. Thus, even without progressing to type 2 diabetes, women with GDM comprise an at-risk population for CVD and hence a potential opportunity for early risk factor surveillance and risk modification.

Objectives The authors conducted a systematic review and network meta-analysis of placebo-controlled, randomized clinical trials in the post–Food and Drug Administration (FDA) guidance era to formally compare the effects of 3 new classes of glucose-lowering drugs on hospitalization for heart failure (HF) in type 2 diabetes mellitus. Background The 2008 FDA Guidance for Industry launched an era of cardiovascular outcome trials for new glucose-lowering drugs in T2DM, including glucagon-like peptide (GLP)-1 agonists, dipeptidyl peptidase (DPP)-4 inhibitors, and sodium glucose co-transporter (SGLT)-2 inhibitors. Methods We searched Embase, PubMed, Cochrane Library, and clinicaltrials.gov between December 1, 2008, and November 24, 2017, for randomized placebo-controlled trials, and performed network meta-analyses by Bayesian approach using Markov-chain Monte Carlo simulation method to compare the effects of glucose-lowering drugs on risk of HF hospitalization and estimate the probability that each treatment is the most effective. Results Nine studies were identified, yielding data on 87,162 participants. In the network meta-analysis, SGLT-2 inhibitors yielded the greatest risk reduction for HF hospitalization compared with placebo (relative risk [RR]: 0.56; 95% CrI [credibility interval]: 0.43 to 0.72). Moreover, SGLT-2 inhibitors were associated with significant risk reduction in pairwise comparisons with both GLP-1 agonists (RR: 0.59; 95% CrI: 0.43 to 0.79) and DPP-4 inhibitors (RR: 0.50; 95% CrI: 0.36 to 0.70). Ranking of the classes revealed 99.6% probability of SGLT-2 inhibitors being the optimal treatment for reducing the risk of this outcome, followed by GLP-1 agonists (0.27%) and DPP-4 inhibitors (0.1%). Conclusions Current evidence suggests that SGLT-2 inhibitors are more effective than either GLP-1 agonists or DPP-4 inhibitors for reducing the risk of hospitalization for HF in type 2 diabetes mellitus.

The main objective of this study is to explore the spatial and temporal variability of demand for emergency health service vehicles, measured at the 1 km-by-1 km grid level in Halifax, Nova Scotia, Canada. This study utilizes and compares a Poisson regression and Poisson hurdle regression model that examine the effects of neighborhood characteristics on emergency health service vehicle demand. It also develops a time-segmented model to investigate the temporal variability of the effects of factors considered in relation to demand. It analyzes the Nova Scotia emergency health service administrative database for the period from January 2012 to December 2012. A comprehensive set of socio-demographic attributes, land use characteristics, and measures of accessibility to services are used to achieve the objectives of this research. Results found that demand for emergency health service vehicles was higher in areas where there was higher population density, more heterogeneous land uses, and a larger proportion of the population aged 40 years and above. The time-segmented model shows demand was highest during morning peak periods for residential areas, afternoon peak for commercial areas, and morning peak and midday for members of the population aged over 75 years. An assessment of the time-segmented model suggests that the generic model is sufficient for predicting how neighborhood characteristics relate to the demand for emergency health service vehicles. The findings of this study will be beneficial for urban planners and health professionals in designing healthy cities and targeting health promotions to reduce the need for emergency services.

e19014 Background: Genetic testing (GT) has significant implications for cancer management. Its implementation is difficult in small rural practices (RP). We examined an electronic risk Score questionnaire (ERSQ) that blends genetic risk factors with clinical and cancer family history to determine its feasibility. Methods: Clinic encounters between Oct 18 - Jan 20 were evaluated. Prior to Oct 19 patients were screening based on physician recommendation (PRBS) without an established screening questionnaire. Between Oct 19 - Jan 20 an ERSQ on a tablet identified patients meeting either USPSTF (US preventative Task force), NCCN (National comprehensive cancer center) or ASBS (American Society of Breast Surgeons) guidelines for GT. Statistical analysis was performed using paired t-test. Out of pocket costs (OOP$), prevalence, patient care impact, High risk negative (HRN) requiring change in screening recommendation (CSR) were evaluated. Genetic telephonic genetic counselling was offered to patients. Results: Pre-ESRQ cohort covering 12 months included 3520 patient encounters; with 1024 encounters post-ESRQ lasting 90 days. Forty three GT’s were performed over 16 months. Pre-ESRQ, seventy three patients were offered PRBS. Sixteen were tested (22% compliance), 13 reported out with two positive results (15% prevalence) and one HRN requiring CSR in 23% (3/13). Post ESRQ, 257 patients were offered GT; 68/131 (51% compliance) (p < 0.0001) screened with the ESRQ met at least one criteria for GT with one positive GT (1/18; 5% prevalence) and 4 HRN; CSR 5/18 (28% CSR)(p < 0.0003). In the Post ESRQ cohort GT was cancelled due to cost burden to patients in 6/27 (22%) and in 2/18 (11%) of the pre ESRQ group (p < 0.0001). Out of 26 patients with OOP$ information 23/26 (88%) incurred a zero OOP$. ESRQ took a median of 8 minutes in the office. Conclusions: An effective tablet based ESRQ may be feasible to adapt in a busy RP and help address disparity in access to genetic screening. There may be a beneficial effect on compliance with limited cost burden to patients that needs further study. ESRQ can improve CSR. A larger prospective cohort may help confirm these findings.

Women who develop gestational diabetes mellitus (GDM) have an elevated lifetime risk of type 2 diabetes mellitus. Recently, a series of studies has suggested that women with GDM also have an increased risk of cardiovascular disease (CVD). However, it is unclear if this risk is dependent upon the intercurrent development of type 2 diabetes. Thus, we conducted a systematic review and meta-analysis to evaluate the impact of GDM on future risk of incident CVD and to ascertain the role of type 2 diabetes in this regard.We systematically searched the PubMed and EMBASE databases for observational studies that evaluated the association of GDM with subsequent CVD, with publication between 1 January 1950 and 30 August 2018. Two independent reviewers extracted data and the analysis was performed in accordance with Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. RRs were calculated using a random-effects model to assess the predictive value of GDM for future cardiovascular events. To evaluate whether incident type 2 diabetes in the GDM population influenced the association with CVD, we used meta-regression models followed by sensitivity analyses restricted to women who did not develop type 2 diabetes during follow-up.A pooled analysis of nine studies yielded data from 5,390,591 women (101,424 cardiovascular events). Compared with those who did not have GDM, women with GDM had a twofold higher risk of future cardiovascular events (RR 1.98 [95% CI 1.57, 2.50]). Meta-regression analysis showed that the rates of incident type 2 diabetes across the studies did not affect this risk (p = 0.34). Moreover, when restricted to women who did not develop type 2 diabetes, GDM remained associated with a 56% higher risk of future cardiovascular events (RR 1.56 [95% CI 1.04, 2.32]). GDM conferred a 2.3-fold increased risk of cardiovascular events in the first decade postpartum (RR 2.31 [95% CI 1.57, 3.39]).The diagnosis of GDM identifies young women who have a twofold higher risk of cardiovascular events postpartum compared with their peers. This risk is not dependent upon intercurrent type 2 diabetes and is apparent within the first decade after pregnancy. Thus, even without progressing to type 2 diabetes, women with GDM comprise an at-risk population for CVD and hence a potential opportunity for early risk factor surveillance and risk modification.

Background Autosomal dominant tubulointerstitial kidney disease (ADTKD) caused by mutations in the UMOD gene (ADTKD-UMOD) is considered rare and often remains unrecognised. We aimed to establish the prevalence of genetic kidney diseases, ADTKD and ADTKD-UMOD in adult chronic kidney disease (CKD) patients, and to investigate characteristic features. Methods We sent questionnaires on family history to all patients with CKD stages 3–5 in our tertiary renal centre to identify patients with inherited renal disease. Details on clinical and family history were obtained from patient interviews and clinical records. Sanger sequencing of the UMOD gene was performed from blood or saliva samples. Results 2027 of 3770 sent questionnaires were returned. 459 patients reported a family history, which was consistent with inherited kidney disease in 217 patients. 182 non-responders with inherited kidney diseases were identified through a database search. Of these 399 individuals, 252 had autosomal dominant polycystic kidney disease (ADPKD), 28 had ADTKD, 25 had Alports, and 44 were unknown, resulting in 11% of CKD 3–5 patients and 19% of end-stage renal disease patients with genetic kidney diseases. Of the unknown, 40 were genotyped, of whom 31 had findings consistent with ADTKD. 30% of unknowns and 39% of unknowns with ADTKD had UMOD mutations. Altogether, 35 individuals from 18 families were found to have ten distinct UMOD mutations (three novel), making up 1% of patients with CKD 3–5, 2% of patients with end-stage renal disease, 9% of inherited kidney diseases and 56% with ADTKD. ADTKD-UMOD was the most common genetic kidney disease after ADPKD with a population prevalence of 9 per million. Less proteinuria and haematuria, but not hyperuricaemia or gout were predictive of ADTKD-UMOD. The main limitations of the study are the single-centre design and a predominantly Caucasian population. Conclusions The prevalence of genetic kidney diseases and ADTKD-UMOD is significantly higher than previously described. Clinical features poorly predicted ADTKD-UMOD, highlighting the need for genetic testing guided by family history alone. Electronic supplementary material The online version of this article (10.1186/s12882-018-1107-y) contains supplementary material, which is available to authorized users.

We implement imaging spectroscopy of the optical clock transition of lattice-trapped degenerate fermionic Sr in the Mott-insulating regime, combining micron spatial resolution with submillihertz spectral precision. We use these tools to demonstrate atomic coherence for up to 15 s on the clock transition and reach a record frequency precision of 2.5×10^{-19}. We perform the most rapid evaluation of trapping light shifts and record a 150 mHz linewidth, the narrowest Rabi line shape observed on a coherent optical transition. The important emerging capability of combining high-resolution imaging and spectroscopy will improve the clock precision, and provide a path towards measuring many-body interactions and testing fundamental physics.

Background This study aimed to examine the agreement between sexually transmitted infection (STI) screening using self-collected specimens and physician-collected specimens, and to investigate the acceptability of self-collection for screening in an 18-month study of female sex workers in a high-risk, low-resource setting. Methods A total of 350 female sex workers in Nairobi, Kenya, participated in a prospective study from 2009 to 2011. Women self-collected a cervicovaginal specimen. Next, a physician conducted a pelvic examination to obtain a cervical specimen. Physician- and self-collected specimens were tested for Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, and Mycoplasma genitalium (MG) using Aptima nucleic acid amplification assays (Hologic). Specimens were collected at 3-month intervals over 18-month follow-up. κ Statistics measured agreement of positivity between self-collection and physician collection. Results Baseline STI prevalence was 2.9% for N. gonorrhoeae, 5.2% for C. trachomatis, 9.2% for T. vaginalis, and 20.1% for MG in self-collected samples, and 2.3%, 3.7%, 7.2%, and 12.9%, respectively, in physician-collected samples. κ Agreement was consistently strong (range, 0.66-1.00) for all STIs over the 18-month study period, except for MG, which had moderate agreement (range, 0.50-0.75). Most participants found self-collection easy (94%) and comfortable (89%) at baseline, with responses becoming modestly more favorable over time. Conclusions Self-collected specimen screening results showed strong agreement to clinical-collected specimens, except for MG, which was consistently detected more commonly in self-collected than in physician-collected specimens. Acceptability of the self-collection procedure was high at baseline and increased modestly over time. In high-risk, low-resource settings, STI screening with self-collected specimens provides a reliable and acceptable alternative to screening with physician-collected specimens.

The authors conducted a systematic review and network meta-analysis of placebo-controlled, randomized clinical trials in the post-Food and Drug Administration (FDA) guidance era to formally compare the effects of 3 new classes of glucose-lowering drugs on hospitalization for heart failure (HF) in type 2 diabetes mellitus.The 2008 FDA Guidance for Industry launched an era of cardiovascular outcome trials for new glucose-lowering drugs in T2DM, including glucagon-like peptide (GLP)-1 agonists, dipeptidyl peptidase (DPP)-4 inhibitors, and sodium glucose co-transporter (SGLT)-2 inhibitors.We searched Embase, PubMed, Cochrane Library, and clinicaltrials.gov between December 1, 2008, and November 24, 2017, for randomized placebo-controlled trials, and performed network meta-analyses by Bayesian approach using Markov-chain Monte Carlo simulation method to compare the effects of glucose-lowering drugs on risk of HF hospitalization and estimate the probability that each treatment is the most effective.Nine studies were identified, yielding data on 87,162 participants. In the network meta-analysis, SGLT-2 inhibitors yielded the greatest risk reduction for HF hospitalization compared with placebo (relative risk [RR]: 0.56; 95% CrI [credibility interval]: 0.43 to 0.72). Moreover, SGLT-2 inhibitors were associated with significant risk reduction in pairwise comparisons with both GLP-1 agonists (RR: 0.59; 95% CrI: 0.43 to 0.79) and DPP-4 inhibitors (RR: 0.50; 95% CrI: 0.36 to 0.70). Ranking of the classes revealed 99.6% probability of SGLT-2 inhibitors being the optimal treatment for reducing the risk of this outcome, followed by GLP-1 agonists (0.27%) and DPP-4 inhibitors (0.1%).Current evidence suggests that SGLT-2 inhibitors are more effective than either GLP-1 agonists or DPP-4 inhibitors for reducing the risk of hospitalization for HF in type 2 diabetes mellitus.

A novel series of bis-indoles derived from naturally occurring marine alkaloid 4 were synthesized and evaluated as inhibitors of methicillin-resistant Staphylococcus aureus (MRSA) pyruvate kinase (PK). PK is not only critical for bacterial survival which would make it a target for development of novel antibiotics, but it is reported to be one of the most highly connected 'hub proteins' in MRSA, and thus should be very sensitive to mutations and making it difficult for the bacteria to develop resistance. From the co-crystal structure of cis-3-4-dihydrohamacanthin B (4) bound to S. aureus PK we were able to identify the pharmacophore needed for activity. Consequently, we prepared simple direct linked bis-indoles such as 10b that have similar anti-MRSA activity as compound 4. Structure-activity relationship (SAR) studies were carried out on 10b and led us to discover more potent compounds such as 10c, 10d, 10k and 10 m with enzyme inhibiting activities in the low nanomolar range that effectively inhibited the bacteria growth in culture with minimum inhibitory concentrations (MIC) for MRSA as low as 0.5 μg/ml. Some potent PK inhibitors, such as 10b, exhibited attenuated antibacterial activity and were found to be substrates for an efflux mechanism in S. aureus. Studies comparing a wild type S. aureus with a construct (S. aureus LAC Δpyk::Erm(R)) that lacks PK activity confirmed that bactericidal activity of 10d was PK-dependant.

Strontium optical lattice clocks have the potential to simultaneously interrogate millions of atoms with a high spectroscopic quality factor of $4 \times 10^{-17}$. Previously, atomic interactions have forced a compromise between clock stability, which benefits from a large atom number, and accuracy, which suffers from density-dependent frequency shifts. Here, we demonstrate a scalable solution which takes advantage of the high, correlated density of a degenerate Fermi gas in a three-dimensional optical lattice to guard against on-site interaction shifts. We show that contact interactions are resolved so that their contribution to clock shifts is orders of magnitude lower than in previous experiments. A synchronous clock comparison between two regions of the 3D lattice yields a $5 \times 10^{-19}$ measurement precision in 1 hour of averaging time., Comment: 19 pages, 4 figures; Supplementary Materials

To describe a cohort of women receiving care after abnormal Pap smears and to assess predictors of follow-up in a cohort of women with cervical intraepithelial neoplasia (CIN) 2-3.This was a retrospective cohort study of women attending a colposcopy clinic in 2011. Data was collected by chart review and a bivariate analysis was performed to identify predictors of follow-up.In 2011, 21% (156/745) of women attending a colposcopy clinic at a tertiary medical center were diagnosed with CIN 2-3. Of those women 79% returned to the clinic for their recommended follow-up procedures within 8 months. Of the following factors-severity of diagnosis, age, race/ethnicity, health insurance status, language, distance to clinic, and tobacco/contraception! condom use-only young age (29 years) was associated with late or lack of follow-up in bivariate analysis (odds ratio 2.67, 95% confidence interval 1.10-6.83). When women under age 21 were excluded, this association was no longer observed (OR 2.31, 95% CI 0.92-6.06).In this cohort of mostly uninsured women, overall follow-up for a CIN 2-3 diagnosis was high. No single factor predictive for follow-up was identified in appropriately screened women.

The pursuit of better atomic clocks has advanced many research areas, providing better quantum state control, new insights in quantum science, tighter limits on fundamental constant variation and improved tests of relativity. The record for the best stability and accuracy is currently held by optical lattice clocks. Here we take an important step towards realizing the full potential of a many-particle clock with a state-of-the-art stable laser. Our 87Sr optical lattice clock now achieves fractional stability of 2.2 × 10−16 at 1 s. With this improved stability, we perform a new accuracy evaluation of our clock, reducing many systematic uncertainties that limited our previous measurements, such as those in the lattice ac Stark shift, the atoms' thermal environment and the atomic response to room-temperature blackbody radiation. Our combined measurements have reduced the total uncertainty of the JILA Sr clock to 2.1 × 10−18 in fractional frequency units., Atomic clocks are increasingly important for many applications in scientific research and technology. Here, Nicholson et al. present a series of developments allowing them to achieve a new record in atomic clock performance, with a systematic uncertainty of just 2.1 × 10−18 for their 87Sr atomic clock.

Carbon credits can be created on rangelands at costs that are competitive with credits from cropland and forestry, revealing that ranchers could play a role in reducing climate change. DOI:10.2458/azu_rangelands_v26i4_campbell

Methicillin-resistant Staphylococcus aureus pyruvate kinase (MRSA PK) has recently been identified as a target for development of novel antibacterial agents. Testing a series of 1,2-bis(3-indolyl)ethanes against MRSA PK has led to the discovery of a potent inhibitor that is selective over human isoforms.

Many-particle optical lattice clocks have the potential for unprecedented measurement precision and stability due to their low quantum projection noise. However, this potential has so far never been realized because clock stability has been limited by frequency noise of optical local oscillators. By synchronously probing two ^{87}Sr lattice systems using a laser with a thermal noise floor of 1×10(-15), we remove classically correlated laser noise from the intercomparison, but this does not demonstrate independent clock performance. With an improved optical oscillator that has a 1×10(-16) thermal noise floor, we demonstrate an order of magnitude improvement over the best reported stability of any independent clock, achieving a fractional instability of 1×10(-17) in 1000 s of averaging time for synchronous or asynchronous comparisons. This result is within a factor of 2 of the combined quantum projection noise limit for a 160 ms probe time with ~10(3) atoms in each clock. We further demonstrate that even at this high precision, the overall systematic uncertainty of our clock is not limited by atomic interactions. For the second Sr clock, which has a cavity-enhanced lattice, the atomic-density-dependent frequency shift is evaluated to be -3.11×10(-17) with an uncertainty of 8.2×10(-19).

The typical clinical features of uremic medullary cystic disease—anemia, polyuria, polydypsia, and uremia—were observed in three young siblings (the typical setting of familial juvenile nephronophthisis). Renal juxtemedullary cysts were found at autopsy in one sibling, confirming the concept that these two diseases are truly rehated. The mother of the siblings studied in this paper demonstrated an inability to concentrate urine.