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Devasis N Reddy,1 Yoshihiro Yonekawa,1–4 Benjamin J Thomas,1,2,5 Eric D Nudleman,6 George A Williams1,2 1Oakland University William Beaumont School of Medicine, Rochester, MI, 2Associated Retinal Consultants, William Beaumont Hospital, Royal Oak, MI, 3Massachusetts Eye and Ear Infirmary, Boston, MA, 4Boston Children’s Hospital, Harvard Medical School, Boston, MA, 5Florida Retina Institute, Jacksonville, FL, 6Shiley Eye Institute, University of California San Diego School of Medicine, San Diego, CA, USA Purpose: The aim of the study was to present the long-term anatomical and visual outcomes of retinal detachment repair in patients with Stickler syndrome.Patients and methods: This study is a retrospective, interventional, consecutive case series of patients with Stickler syndrome undergoing retinal reattachment surgery from 2009 to 2014 at the Associated Retinal Consultants, William Beaumont Hospital.Results: Sixteen eyes from 13 patients were identified. Patients underwent a mean of 3.1 surgical interventions (range: 1–13) with a mean postoperative follow-up of 94 months (range: 5–313 months). Twelve eyes (75%) developed proliferative vitreoretinopathy. Retinal reattachment was achieved in 100% of eyes, with ten eyes (63%) requiring silicone oil tamponade at final follow-up. Mean preoperative visual acuity (VA) was 20/914, which improved to 20/796 at final follow-up (P=0.81). There was a significant correlation between presenting and final VA (P

Benjamin J Thomas, Yoshihiro Yonekawa, Jeremy D Wolfe, Tarek S Hassan Department of Vitreoretinal Surgery, William Beaumont Hospital, Royal Oak, MI, USA Objective: To compare the effects of intravitreal ranibizumab (RZB) or dexamethasone (DEX) intravitreal implant in cases of recalcitrant diabetic macular edema (DME).Methods: Retrospective, interventional study examining patients with symmetric bilateral, center-involved DME recalcitrant to treatment with RZB, who received DEX in one eye while the contralateral eye continued to receive RZB every 4–5 weeks for a study period of 3 months.Results: Eleven patients (22 eyes) were included: mean logarithm of the minimal angle of resolution (logMAR) visual acuity (VA) for the DEX arm improved from 0.415 (standard deviation [SD] ±0.16) to 0.261 (SD ±0.18) at final evaluation, and mean central macular thickness (CMT) improved from 461 µm (SD ±156) to 356 µm (SD ±110; net decrease: 105 µm, P=0.01). Mean logMAR VA for the RZB arm improved from 0.394 (SD ±0.31) to 0.269 (SD ±0.19) at final evaluation. Mean CMT improved from 421 µm (SD ±147) to 373 µm (SD ±129; net decrease: 48 µm, P=0.26).Conclusion: A subset of recalcitrant DME patients demonstrated significant CMT reduction and VA improvement after a single DEX injection. Keywords: aflibercept, bevacizumab, central macular thickness, macular edema, dexamethasone implant, diabetic macular edema, diabetic retinopathy, ranibizumab

Yoshihiro Yonekawa, Ashkan M Abbey, Ankoor R Shah, Benjamin J Thomas, Antonio Capone Jr Associated Retinal Consultants, Department of Ophthalmology, William Beaumont Hospital, Royal Oak, MI, USA Abstract: Phototoxic maculopathy caused by endoillumination during macular surgery is uncommon. Previously identified risk factors have included intensity of the light source, proximity to the retinal surface, and length of exposure. In the era of indocyanine green (ICG)-assisted internal limiting membrane (ILM) peeling, the use of ICG, and the technique of ILM peeling may both contribute to subsequent phototoxic maculopathy. We present cases of routine chromovitrectomy who developed phototoxic maculopathy in the precise discrete distribution of the ILM rhexes, and discuss potential mechanisms and implications. Keywords: ILM peeling, indocyanine green, vitrectomy, ERM

Abstract Objective Treatment of pediatric brain tumors is associated with potential long‐term cognitive sequelae. Patients treated with craniospinal irradiation for posterior fossa tumors are at high risk. New biomarkers that could help to differentiate treatment effects from other causes of cognitive dysfunction would be valuable in tailoring optimal survivorship care. Biomarkers that reflect biological mechanisms behind treatment‐associated cognitive decline would also be important in the evaluation of future treatment regimens for pediatric brain or skull base tumors. Methods In this biomarker‐finding study, 10 adult survivors of pediatric medulloblastoma, skull base tumors, and posterior fossa low‐grade glioma underwent study specific lumbar puncture at a minimum of 17 years following treatment. We analyzed cerebrospinal fluid biomarkers reflecting neuron and astrocyte integrity, amyloid metabolism, inflammation, extracellular matrix, synaptic integrity, and blood–brain barrier function. The values were compared with biomarker levels in healthy controls of comparable age. Results Biomarkers reflecting neuronal injury (neurofilament light chain protein), astrocyte injury or activation (glial fibrillary acidic protein) as well as inflammation (YKL‐40) were significantly elevated in cancer survivors compared to controls. Biomarkers reflecting amyloid metabolism showed a pattern of decrease in patients treated for medulloblastoma. Interpretation The results suggest a potential chronic low‐grade neurodegeneration and astrocyte activation in patients treated for pediatric brain or skull base tumors. Protein biomarkers of CNS disease could potentially be used to increase our understanding of the contribution from different tumor treatments with regard to long‐term symptoms in cancer patients.

Abstract Background Prosthetic joint infections (PJI) are recalcitrant, hard-to-treat infections and severe complications of joint arthroplasty. Therefore, there is a need to develop new effective treatment strategies, and animal models of high clinical relevance are needed. This study aimed to develop a detailed surgical protocol for hip hemiarthroplasty in Göttingen minipigs and a thorough post-mortem sampling protocol to pave the way for creating a minipig PJI model. Methods Three adult female Göttingen minipigs underwent surgery with insertion of a hip hemiarthroplasty, using the anterior approach to the hip joint. After surgery the minipigs were followed closely with daily clinical evaluation and gait scoring. Comprehensive post-mortem analyses were performed with evaluation of macroscopic lesions, microbiology, synovial fluid analysis and histology. Results The study resulted in the first Göttingen minipig with hip hemiarthroplasty and identified several points of awareness when inserting a hip prosthesis in minipigs, especially the high risk of joint dislocation. A spontaneous PJI occurred in one of the minipigs, revealing an impaired ability of the immune cells to reach the bacteria at the bone-prosthesis interface. Conclusion The present study provides a detailed description of surgical technique and post-mortem sampling and validates the suitability of the hip hemiarthroplasty minipig model for future experimental modeling of PJI.

Rotator interval tears are an uncommon, but clinically important subtype of rotator cuff tear. As MRI assumes an ever increasing role in the imaging evaluation of the painful shoulder, radiologists must be aware of this entity and appreciate the difficulty in diagnosing these tears with MRI. Differentiation of a true rotator interval tear from normal synovium and capsule in this space is most likely not possible with MRI, and symptoms may be referred and misleading. It is therefore important to correlate the MR findings with the clinical history and physical examination.

Abstract Background Canine coxofemoral joint osteoarthritis is a common, painful and debilitating condition. The objective of this study was to evaluate if any measurable changes in pain or lameness occurred in this patient group immediately after a single treatment with pulsed electromagnetic field therapy. Eight dogs with coxofemoral joint osteoarthritis presenting with signs of pain and lameness were prospectively recruited to this randomised, controlled, double blinded, cross-over study. Subjects attended the research facility on two occasions for one active and one placebo treatment with pulsed electromagnetic field therapy. The immediate effect of one pulsed electromagnetic field therapy treatment on pain and lameness was measured subjectively with the Helsinki Chronic Pain Index and Visual Analogue Scale and objectively using a pressure sensitive walkway. Results A statistically significant difference (P = 0.03) for change in stride length in the affected limb was recorded for subjects between the active and placebo treatments with pulsed electromagnetic field therapy. Within the active treatment results, there was a statistically significant change in the measurement for reach (P = 0.04) and stride length (P = 0.047) which got shorter in the affected limb post treatment. For the subjective outcome measures, there was no statistically significant difference between the active and placebo treatments for the evening of the treatment day or the next morning from pre-treatment values. Within the placebo treatment results a statistically significant change (improvement) was detected in Visual Analogue Score (P = 0.03) between pre-treatment and the next morning values. Conclusions The findings of this study do not show demonstrable improvement in owner assessed pain levels or temporospatial performance in dogs with coxofemoral joint osteoarthritis immediately after a single application of pulsed electromagnetic field therapy.

Abstract Cognitive impairment is a major determinant of functional outcomes in schizophrenia, however, understanding of the biological mechanisms underpinning cognitive dysfunction in the disorder remains incomplete. Here, we apply Genomic Structural Equation Modelling to identify latent cognitive factors capturing genetic liabilities to 12 cognitive traits measured in the UK Biobank. We identified three broad factors that underly the genetic correlations between the cognitive tests. We explore the overlap between latent cognitive factors, schizophrenia, and schizophrenia symptom dimensions using a complementary set of statistical approaches, applied to data from the latest schizophrenia genome-wide association study (Ncase = 53,386, Ncontrol = 77,258) and the Thematically Organised Psychosis study (Ncase = 306, Ncontrol = 1060). Global genetic correlations showed a significant moderate negative genetic correlation between each cognitive factor and schizophrenia. Local genetic correlations implicated unique genomic regions underlying the overlap between schizophrenia and each cognitive factor. We found substantial polygenic overlap between each cognitive factor and schizophrenia and biological annotation of the shared loci implicated gene-sets related to neurodevelopment and neuronal function. Lastly, we show that the common genetic determinants of the latent cognitive factors are not predictive of schizophrenia symptoms in the Norwegian Thematically Organized Psychosis cohort. Overall, these findings inform our understanding of cognitive function in schizophrenia by demonstrating important differences in the shared genetic architecture of schizophrenia and cognitive abilities.

Background: The diagnostic accuracy of colon capsule endoscopy (CCE) depends on a well-cleansed bowel. Evaluating the cleansing quality can be difficult with a substantial interobserver variation. Objectives: Our primary aim was to establish a standard of agreement for bowel cleansing in CCE based on evaluations by expert readers. Then, we aimed to investigate the interobserver agreement on bowel cleansing. Design: We conducted an interobserver agreement study on bowel cleansing quality. Methods: Readers with different experience levels in CCE and colonoscopy evaluated bowel cleansing quality on the Leighton–Rex scale and Colon Capsule CLEansing Assessment and Report (CC-CLEAR), respectively. All evaluations were reported on an image level. A total of 24 readers rated 500 images on each scale. Results: An expert opinion-based agreement standard could be set for poor and excellent cleansing but not for the spectrum in between, as the experts agreed on only a limited number of images representing fair and good cleansing. The overall interobserver agreement on the Leighton–Rex full scale was good (intraclass correlation coefficient (ICC) 0.84, 95% CI (0.82–0.85)) and remained good when stratified by experience level. On the full CC-CLEAR scale, the overall agreement was moderate (ICC 0.62, 95% CI (0.59–0.65)) and remained so when stratified by experience level. Conclusion: The interobserver agreement was good for the Leighton–Rex scale and moderate for CC-CLEAR, irrespective of the reader’s experience level. It was not possible to establish an expert-opinion standard of agreement for cleansing quality in CCE images. Dedicated training in using the scales may improve agreement and enable future algorithm calibration for artificial intelligence supported cleansing evaluation. Trial registration: All included images were derived from the CAREforCOLON 2015 trial (Registered with The Regional Health Research Ethics Committee (Registration number: S-20190100), the Danish data protection agency (Ref. 19/29858), and ClinicalTrials.gov (registration number: NCT04049357)).

Introduction Chronic wounds affect 1%–2% of the global population, with rising incidence due to ageing and lifestyle-related diseases. Bacterial biofilms, found in 80% of chronic wounds, and scattered single-cell bacteria may hinder healing. Microbes are believed to negatively impact healing by exacerbating inflammation and host immune response.Methods and analysis The primary objective of the chronic wound characterisation (CWC) study is to investigate chronic wounds through a prospective observational cohort study exploring bacterial community composition, inflammatory responses and the influence of bacteria on wound-healing trajectories. The CWC study will be investigated through two cohorts: the predictive and in-depth.The predictive cohort includes patients with a chronic wound scheduled for mechanical debridement. The debrided material will be collected for dual RNA sequencing and 16s ribosomal RNA gene sequencing, as well as samples for microbial culturing and a photo to assess the wound. Clinical data is recorded, and healing and/or other clinical endpoints are established through medical records.The in-depth cohort includes and follows patients undergoing split-thickness skin grafting. Extensive sampling (ESwabs, biopsies, tape strips, debrided material and a sample of the skin graft) will be performed on surgery and patients will be seen at two follow-up visits. Samples will be analysed through culturing and next-generation sequencing methods. A biobank will be established comprising longitudinal clinical samples and clinical data.Ethics and dissemination The study has been approved by the board of health ethics, Capital Region of Denmark, under protocol number H-20032214. The study findings will be disseminated through peer-reviewed publications and showcased at both national and international conferences and meetings within the domains of microbiology, wound healing and infection.

Objective Population-based, organised prostate cancer testing (OPT) programmes were started in Sweden in 2020. The influence of socioeconomic factors on prostate cancer testing in this setting is not known. We examined associations between socioeconomic factors and (1) participation in OPT and (2) unorganised prostate-specific antigen (PSA) testing.Methods and analysis Region Västra Götaland’s OPT programme invited 21 174 men aged 50 years in 2020–2021. Regional data on unorganised testing in 2013–2014 of men aged 50–52 years were retrieved from Western Sweden Study of Opportunistic Prostate Cancer Screening database. Data on income, education, cohabitation and country of birth were collected from Statistic Sweden. Univariable and multivariable Poisson regression was used to calculate incidence rate ratios (IRRs) with CIs for PSA testing by socioeconomic category.Results Participation in OPT was associated with all investigated socioeconomic factors; multivariable IRRs: low versus non-low income 0.63 (95% CI 0.58 to 0.68), single versus non-single household 0.78 (95% CI 0.75 to 0.81), low versus average education 0.84 (95% CI 0.78 to 0.90) and non-Nordic versus Nordic country of birth 0.88 (95% CI 0.84 to 0.92). Unorganised PSA testing was negatively associated with low income 0.83 (95% CI 0.78 to 0.90) and single household 0.87 (95% CI 0.82 to 0.92), but not with low education 1.00 (95% CI 0.92 to 1.08) or non-Nordic country of birth 0.98 (95% CI 0.91 to 1.06).Conclusion Socioeconomic factors influenced PSA testing among 50-year-old men, both in an organised testing programme and in unorganised, clinical testing. An active offer of testing is not enough to achieve socioeconomic equality in the early detection of prostate cancer.

Summary: Background: Despite the widely reported success of knee arthroplasty, studies show that 1.6–3 % of patients undergo revision within the first postoperative year predominantly due to infection. Preoperative skin preparation may potentially decrease the bacterial load and consequently, the risk of periprosthetic joint infections. The effects of hair removal on prosthetic joint infection are inconsistent. Our primary aim was to investigate if hair removal with a clipper influenced skin colonisation and bacterial composition. Methods: Forty Caucasian male participants who were planned to undergo knee arthroplasty, (mean age 63.8 years), were included. Patients were randomised to hair removal in a within-person study design. As a control, the opposite leg of the patient was used. Swabs were collected prior to hair removal (baseline), immediately after hair removal (Day 0), and with follow-up after one and seven days. Results: The intervention showed significant decrease in mean log colony-forming units per. cm2 from baseline 2.97 to 2.67 (P

This study intended to identify the perception of quality of life (QoL) among architects, how architecture can impact QoL, and which barriers architects perceive to impact QoL. Numerous studies have emphasized the significance of the built environment in determining QoL, especially in institutional buildings. However, there has been less focus on how architects perceive QoL and how the concept is applied in their planning and design for residential buildings. The contribution of this study is to provide an increasingly important awareness of how to improve the architects’ considerations to build for QoL. The study is based on qualitative data from in-depth interviews with ten architects and one workshop with seven architects. The participants were selected by quota sampling and were all partners or owners of Danish architectural firms that provide housing services and are representative of the Danish architectural industry. The results reveal that the perceptions of QoL among architects are linked to three primary dimensions: health, a sense of harmony, and the experience of enchantment. The participants perceived that architectural design could impact QoL in three primary dimensions: the environment, the experience of enchantment, and health. The most frequent perceived barriers are linked to the economy and resources, building codes and regulations, and knowledge and communication.

Background: Transcatheter aortic valve implantation (TAVI) is a percutaneous catheter-based treatment of aortic stenosis as an alternative to open heart valve surgery. In cases of TAVI endocarditis, the treatment possibilities may be limited as surgical removal of the infected valve may be associated with a high risk in elderly, comorbid or frail patients. The propensity of bacteria to form a biofilm on foreign material is assumed to be of importance part of the disease process in TAVI endocarditis, but no studies on biofilm formation on TAVI valves have been conducted. We hypothesize that Staphylococcus aureus and Enterococcus faecalis biofilm formation on TAVI valves may have an impact on antibiotic tolerance and non-surgical cure rates. Methods: TAVI valves (pieces including part of the metal frame, approximately 1 cm wide) were exposed to either species in vitro in LB-Krebs Ringer medium at 37 °C, with the bacterial count being assessed by culturing of sonicated TAVI pieces and broth at 0, 4, 18 and 24 h after bacterial exposure. Scanning electron microscopy (SEM) was performed. Effects of ampicillin, gentamicin, moxifloxacin, rifampicin (for S. aureus), and ceftriaxone (for E. faecalis) at 5 times minimal inhibitory concentration were tested alone and in combination with ampicillin. Antibiotics were added to biofilm aged 0 or 24 h and the effects assessed. Results: Exposure for 15 min established attachment to all of valve pieces. SEM findings were consistent with biofilm formation and suggested lower amounts of bacteria on the metal compared to the tissue part of the TAVI valves. The number of bacteria attached to the TAVI valves increased until 24 h of incubation from less than 10^1 to a level of approximately 10^9 CFU/g. The bacteria became more tolerant to antibiotics on the TAVI valves over time, with the bactericidal effect against 24-h old biofilm being significantly less effective than against 0-h old biofilm depending on antibiotic. Conclusions: The results indicate that bacteria can adhere to metal and tissue parts of the TAVI valves within minutes after an exposure which is comparable to transient bacteremia in vivo, and that the bacteria rapidly gain biofilm properties, associated with significantly reduced antibiotic effect.

Introduction: There is an increase in demand for Radiotherapy (RT) and it is a time critical treatment with a complex scheduling process. RT workflow is inter-dependent and involves various steps including pre-treatment and treatment-related tasks which adds to these challenges. Globally, scheduling delays are reported as one of the most common issues in RT. We aim to create and evaluate an automated strategy which generates a patient allocation list to assist the scheduling staff to create an efficient scheduling process. Methods and Materials: We used historical data from a large RT department in Sweden from January to December 2022 with 11–13 operational linear accelerators. The algorithm was developed in C# language. It utilizes patient and treatment-related characteristics including the patient timeline (referral date, preferred treatment start dates), booking category, diagnosis group and intent. Based on this, the algorithm assigns patient priority individually. Results: The algorithm’s output resulted in a scheduling list sorted by high to low patient priority per week. We evaluated the algorithm with historical manual allocations from the same year. The comparison between manual and algorithm allocations showed that the number of delayed patients reduced by 10 % in the algorithm suggestion with an average delay reduction of 2 weeks. Furthermore, the focus on patient-related characteristics resulted in diagnosis groups being better balanced. Conclusion: The algorithm’s ability to produce quick results may save significant time that the scheduling staff otherwise need to assess individual patient profiles. RT departments can incorporate such algorithms to accelerate their scheduling decisions and enhance their overall scheduling performance before going through major organizational changes.

ABSTRACTExtensive research has explored the role of gut microbiota in colorectal cancer (CRC). Nonetheless, metatranscriptomic studies investigating the in situ functional implications of host-microbe interactions in CRC are scarce. Therefore, we characterized the influence of CRC core pathogens and biofilms on the tumor microenvironment (TME) in 40 CRC, paired normal, and healthy tissue biopsies using fluorescence in situ hybridization (FISH) and dual-RNA sequencing. FISH revealed that Fusobacterium spp. was associated with increased bacterial biomass and inflammatory response in CRC samples. Dual-RNA sequencing demonstrated increased expression of pro-inflammatory cytokines, defensins, matrix-metalloproteases, and immunomodulatory factors in CRC samples with high bacterial activity. In addition, bacterial activity correlated with the infiltration of several immune cell subtypes, including M2 macrophages and regulatory T-cells in CRC samples. Specifically, Bacteroides fragilis and Fusobacterium nucleatum correlated with the infiltration of neutrophils and CD4+ T-cells, respectively. The collective bacterial activity/biomass appeared to exert a more significant influence on the TME than core pathogens, underscoring the intricate interplay between gut microbiota and CRC. These results emphasize how biofilms and core pathogens shape the immune phenotype and TME in CRC while highlighting the need to extend the bacterial scope beyond CRC pathogens to advance our understanding and identify treatment targets.

Background: Social inequalities in colorectal cancer screening participation are evident. Barriers to screening participation include discomfort from diagnostic modalities. We aimed to describe the discomfort experienced from colonoscopy and colon capsule endoscopy (CCE) and investigate the discrepancy between expected and experienced discomfort stratified by socioeconomic status. Methods: A randomised controlled trial was conducted offering half of the colorectal cancer screening invitees the choice between CCE and colonoscopy after a positive faecal immunochemical test. This paper includes those who elected to undergo CCE. A positive CCE elicited referral for a therapeutic colonoscopy. Participants reported their discomfort from CCE and from any following colonoscopies in electronically distributed questionnaires. Discomfort was measured using visual analogue scales and compared between socioeconomic subgroups determined by educational level and income. Results: The experienced discomfort from CCE and colonoscopy differed significantly between educational levels but not income levels. The bowel preparation contributed the most to the experienced discomfort in both CCE and colonoscopy. The discrepancy between expected and experienced discomfort from colonoscopy increased with increasing educational and income levels. A similar trend was seen in CCE between educational levels but not income levels. Conclusions: None of the results indicated a higher discomfort in lower socioeconomic subgroups. Regardless of the investigation modality, the bowel preparation was the main contributor to experienced discomfort. The discrepancy between expected and experienced discomfort did not seem to be larger in lower socioeconomic subgroups, indicating that this is not a major barrier causing inequalities in screening uptake. This is the first study investigating individual discomfort discrepancy in both CCE and colonoscopy, while being able to stratify by socioeconomic status.

Previous studies have highlighted a strong relationship between mechanical lower limb muscle function and TeamGym performance, specifically in terms of difficulty scores in trampette and tumbling disciplines. To date, no intervention study has explored whether enhancing lower limb muscle function can translate to improved TeamGym performance. We recruited eleven national-level TeamGym athletes (four males, seven females) for a quasi-experimental intervention spanning six weeks. The regimen comprised strength training sessions thrice weekly, emphasizing power and maximum strength. Pre- and post-intervention assessments included countermovement jumps, drop jumps, leg press power, 20m sprints, jump and reach, as well as video analyses of trampoline and tumbling performances. In line with prior research, our study uncovers significant correlations between physical test outcomes and TeamGym performance. Notably, leg press power exhibited a robust association with trampoline performance (r=0.95, p

Is it time to rethink the inoculum of animal models of implant-associated infections (IAI)? Traditionally, animal models of IAI are based on inoculation with metabolically active overnight cultures of planktonic bacteria or pre-grown surface-attached biofilms. However, such inoculums do not mimic the clinical initiation of IAI. Therefore, the present study aimed to develop a clinically relevant inoculum of low metabolic micro-aggregated bacteria. The porcine Staphylococcus aureus strain S54F9 was cultured in Tryptone Soya Broth (TSB) for seven days to facilitate the formation of low metabolic micro-aggregates. Subsequently, the aggregated culture underwent filtration using cell strainers of different pore sizes to separate micro-aggregates. Light microscopy was used to evaluate the aggregate formation and size in the different fractions, while isothermal microcalorimetry was used to disclose a low metabolic activity. The micro-aggregate fraction obtained with filter size 5–15 μm (actual measured mean size 32 μm) was used as inoculum in a porcine implant-associated osteomyelitis (IAO) model and compared to a standard overnight planktonic inoculum and a sham inoculum of 0.9 % saline. The micro-aggregate and planktonic inoculums caused IAO with the re-isolation of S. aureus from soft tissues, bones, and implants. However, compared to their planktonic counterpart, neither of the micro-aggregate inoculated animals showed signs of osteomyelitis, i.e., sequester, osteolysis, and pus at gross inspection. Furthermore, inoculation with low metabolic micro-aggregates resulted in a strong healing response with pronounced osteoid formation, comparable to sham animals. In conclusion, the formation and separation of low metabolic bacterial micro-aggregates into various size fractions is possible, however, planktonic bacteria were still seen in all size fractions. Inoculation with micro-aggregates caused a less-aggressive osteomyelitis i.e. combination of infected tissue and strong healing response. Therefore, the use of low metabolic micro-aggregates could be a relevant inoculum for animal models of less-aggressive and thereby slower developing IAI and add in to our understanding of the host-implant-bacteria interactions in slow-onset low-grade infections.

Abstract There is substantial cognitive heterogeneity among patients with schizophrenia (SZ) and bipolar disorders (BD). More knowledge about the magnitude and clinical correlates of performance variability could improve our understanding of cognitive impairments. Using double generalized linear models (DGLMs) we investigated cognitive mean and variability differences between patients with SZ (n = 905) and BD spectrum disorders (n = 522), and healthy controls (HC, n = 1170) on twenty-two variables. The analysis revealed significant case-control differences on 90% of the variables. Compared to HC, patients showed larger intra-individual (within subject) variability across tests and larger inter-individual (between subject) variability in measures of fine-motor speed, mental processing speed, and inhibitory control (SZ and BD), and in verbal learning and memory and intellectual functioning (SZ). In SZ, we found that lager intra -and inter (on inhibitory control and speed functions) individual variability, was associated with lower functioning and more negative symptoms. Inter-individual variability on single measures of memory and intellectual function was additionally associated with disorganized and positive symptoms, and use of antidepressants. In BD, there were no within-subject associations with symptom severity. However, greater inter-individual variability (primarily on inhibitory control and speeded functions) was associated with lower functioning, more negative -and disorganized symptoms, earlier age at onset, longer duration of illness, and increased medication use. These results highlight larger individual differences in patients compared to controls on various cognitive domains. Further investigations of the causes and correlates of individual differences in cognitive function are warranted.

PurposeThis study aimed to explore whether a meaningful improvement in physical performance following an in-season strength training intervention can be related to external load match parameters at an individual level in professional male football players.MethodsEight male professional football players (25.4 ± 3.1 years, 184.1 ± 3.4 cm, 79.3 ± 2.2 kg) completed a 10-week strength intervention period in addition to football-specific training and matches. Commonly used physical and external load measures were assessed before and after intervention. Physical performance improvements had to exceed the measurement’s typical error and the smallest worthwhile difference (SWD) to be considered meaningful. External load match parameters were assessed before and after the intervention period using SWD and non-overlap of all pairs (NAP) analysis. A Bayesian pairwise correlation analysis was performed to evaluate relationships between changes in physical performance and external load match parameters.ResultsThree players displayed meaningful improvements in two to five physical performance measures. However, positive changes exceeding the SWD and positive effects in NAP results were observed for all players in external load match parameters. Kendall's tau correlation analysis showed evidence (base factor >3) for only one correlation (maximum speed − decelerations, τ = −0.62) between the changes in physical performance and external load measures, while the remaining comparisons exhibited no relation.ConclusionsThe findings suggest that improvements in physical performance may not necessarily translate to improvements in external load match parameters. Further research, with larger sample sizes, is needed to understand potential mechanisms between acute and chronic physical performance changes and football external load parameters during training and matches.

Abstract There has been considerable research into the understanding of the healthy skin microbiome. Similarly, there is also a considerable body of research into whether specific microbes contribute to skin disorders, with atopic dermatitis (AD) routinely linked to increased Staphylococcus aureus (S. aureus) colonisation. In this study, the epidermal surface of participants was sampled using swabs, while serial tape-stripping (35 tapes) was performed to sample through the stratum corneum. Samples were taken from AD patients and healthy controls, and the bacterial communities were profiled by metabarcoding the universal V3-V4 16S rRNA region. Results show that the majority of bacterial richness is located within the outermost layers of the stratum corneum, however there were many taxa that were found almost exclusively at the very outermost layer of the epidermis. We therefore hypothesise that tape-stripping can be performed to investigate the ‘core microbiome’ of participants by removing environmental contaminants. Interestingly, significant community variation between AD patients and healthy controls was only observable at the epidermal surface, yet a number of individual taxa were found to consistently differ with AD status across the entire epidermis (i.e. both the epidermal surface and within the epidermis). Sampling strategy could therefore be tailored dependent on the hypothesis, with sampling for forensic applications best performed using surface swabs and outer tapes, while profiling sub-surface communities may better reflect host genome and immunological status.

Abstract Background The effectiveness of strength training with free-weight vs. machine equipment is heavily debated. Thus, the purpose of this meta-analysis was to summarize the data on the effect of free-weight versus machine-based strength training on maximal strength, jump height and hypertrophy. Methods The review was conducted in accordance with the preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, and the systematic search of literature was conducted up to January 1st, 2023. Studies that directly compared free-weight vs. machine-based strength training for a minimum of 6 weeks in adults (18–60 yrs.) were included. Results Thirteen studies (outcomes: maximal strength [n = 12], jump performance [n = 5], muscle hypertrophy [n = 5]) with a total sample of 1016 participants (789 men, 219 women) were included. Strength in free-weight tests increased significantly more with free-weight training than with machines (SMD: -0.210, CI: -0.391, -0.029, p = 0.023), while strength in machine-based tests tended to increase more with machine training than with free-weights (SMD: 0.291, CI: -0.017, 0.600, p = 0.064). However, no differences were found between modalities in direct comparison (free-weight strength vs. machine strength) for dynamic strength (SMD: 0.084, CI: -0.106, 0.273, p = 0.387), isometric strength (SMD: -0.079, CI: -0.432, 0.273, p = 0.660), countermovement jump (SMD: -0.209, CI: -0.597, 0.179, p = 0.290) and hypertrophy (SMD: -0.055, CI: -0.397, 0.287, p = 0.751). Conclusion No differences were detected in the direct comparison of strength, jump performance and muscle hypertrophy. Current body of evidence indicates that strength changes are specific to the training modality, and the choice between free-weights and machines are down to individual preferences and goals.

Abstract Cases with schizophrenia (SCZ) and healthy controls show differences in white blood cell (WBC) counts and blood inflammation markers. Here, we investigate whether time of blood draw and treatment with psychiatric medications are related to differences in estimated WBC proportions between SCZ cases and controls. DNA methylation data from whole blood was used to estimate proportions of six subtypes of WBCs in SCZ patients (n = 333) and healthy controls (n = 396). We tested the association of case-control status with estimated cell-type proportions and the neutrophil-to-lymphocyte ratio (NLR) in 4 models: with/without adjusting for time of blood draw, and then compared results from blood samples drawn during a 12-h (07:00–19:00) or 7-h (07:00-14:00) period. We also investigated WBC proportions in a subgroup of medication-free patients (n = 51). Neutrophil proportions were significantly higher in SCZ cases (mean=54.1%) vs. controls (mean=51.1%; p =