Does intermittent nutrition enterally normalise hormonal and metabolic responses to feeding in critically ill adults? A protocol for the DINE-Normal proof-of-concept randomised parallel-group study.

Introduction: Over half of patients who spend >48 hours in the intensive care unit (ICU) are fed via a nasogastric (NG) tube. Current guidance recommends continuous delivery of feed throughout the day and night. Emerging evidence from healthy human studies shows that NG feeding in an intermittent pattern (rather than continuous) promotes phasic hormonal, digestive and metabolic responses that are important for effective nutrition.

Circadian rhythms, feeding patterns and metabolic regulation: implications for critical care.

Endogenous biological rhythms synchronise human physiology with daily cycles of light-dark, wake-sleep and feeding-fasting. Proper circadian alignment is crucial for physiological function, reflected in the rhythmic expression of molecular clock genes in various tissues, especially in skeletal muscle. Circadian disruption, such as misaligned feeding, dysregulates metabolism and increases the risk of metabolic disorders like type 2 diabetes.

Understanding the motivational mechanisms for smoking and vaping among dual users and exclusive smokers.

Background: Understanding the motivational processes that influence e-cigarette use in a laboratory setting may help elucidate mechanisms that support long-term ecigarette use, which could have significant clinical and public health consequences.

Methods: Secondary analyses were conducted on data from exclusive smokers (N=47) and dual users (N=88) who underwent a laboratory ad lib use session. Participants were given 10minutes to smoke (exclusive smokers) or vape (dual users) as much as they wanted.

Exogenous Glucose Oxidation During Exercise Is Positively Related to Body Size.

There is little evidence that body size alters exogenous glucose oxidation rates during exercise. This study assessed whether larger people oxidize more exogenous glucose during exercise than smaller people. Fifteen cyclists were allocated into two groups based on body mass (SMALL, <70 kg body mass, n = 9, two females) or (LARGE, >70 kg body mass, n = 6) matched for lactate threshold (SMALL: 2.

A theoretical framework for polarization as the gradual fragmentation of a divided society.

We propose a framework integrating insights from computational social science, political, and social psychology to explain how extreme polarization can occur in deeply divided societies. Extreme polarization in a society emerges through a dynamic and complex process where societal, group, and individual factors interact. Dissent at different levels of analysis represents the driver of this process, where societal-level ideological dissent divides society into opposing camps, each with contrasting collective narratives.

Are there interindividual differences in the reactive hypoglycaemia response to breakfast? A replicate crossover trial.

Background: Following consumption of a meal, circulating glucose concentrations can rise and then fall briefly below the basal/fasting concentrations. This phenomenon is known as reactive hypoglycaemia but to date no researcher has explored potential inter-individual differences in response to meal consumption.

Objective: We conducted a secondary analysis of existing data to examine inter-individual variability of reactive hypoglycaemia in response to breakfast consumption.

Ketogenic diet but not free-sugar restriction alters glucose tolerance, lipid metabolism, peripheral tissue phenotype, and gut microbiome: RCT.

Restricted sugar and ketogenic diets can alter energy balance/metabolism, but decreased energy intake may be compensated by reduced expenditure. In healthy adults, randomization to restricting free sugars or overall carbohydrates (ketogenic diet) for 12 weeks reduces fat mass without changing energy expenditure versus control. Free-sugar restriction minimally affects metabolism or gut microbiome but decreases low-density lipoprotein cholesterol (LDL-C).

The effect of an acute bout of exercise on circulating vitamin D metabolite concentrations: a randomised crossover study in healthy adults.

The effect of acute exercise on circulating concentrations of vitamin D metabolites is unclear. To address this knowledge gap, we examined the effect of a bout of treadmill-based exercise versus rest on circulating concentrations of 25(OH)D, 25(OH)D, 3-epi-25(OH)D, 24,25(OH)D, 1,25(OH)D, and vitamin D and D in healthy men and women. Thirty-three healthy adults (14 females, 41 (15) years, body mass index 26.

Proteomic signatures improve risk prediction for common and rare diseases.

For many diseases there are delays in diagnosis due to a lack of objective biomarkers for disease onset. Here, in 41,931 individuals from the United Kingdom Biobank Pharma Proteomics Project, we integrated measurements of ~3,000 plasma proteins with clinical information to derive sparse prediction models for the 10-year incidence of 218 common and rare diseases (81-6,038 cases). We then compared prediction models developed using proteomic data with models developed using either basic clinical information alone or clinical information combined with data from 37 clinical assays.

Characterising 24-h skeletal muscle gene expression alongside metabolic & endocrine responses under diurnal conditions.

Context: Skeletal muscle plays a central role in the storage, synthesis, and breakdown of nutrients, yet little research has explored temporal responses of this human tissue, especially with concurrent measures of systemic biomarkers of metabolism.

Objective: To characterise temporal profiles in skeletal muscle expression of genes involved in carbohydrate metabolism, lipid metabolism, circadian clocks, and autophagy and descriptively relate them to systemic metabolites and hormones during a controlled laboratory protocol.

Methods: Ten healthy adults (9M/1F, mean ± SD: age: 30 ± 10 y; BMI: 24.

Myths and Methodologies: Standardisation in Human Physiology Research-Should We Control the Controllables?

The premise of research in human physiology is to explore a multifaceted system whilst identifying one or a few outcomes of interest. Therefore, the control of potentially confounding variables requires careful thought regarding the extent of control and complexity of standardisation. One common factor to control prior to testing is diet, as food and fluid provision may deviate from participants' habitual diets, yet a self-report and replication method can be flawed by under-reporting.

Myths and Methodologies: Standardisation in human physiology research-should we control the controllables?

The premise of research in human physiology is to explore a multifaceted system whilst identifying one or a few outcomes of interest. Therefore, the control of potentially confounding variables requires careful thought regarding the extent of control and complexity of standardisation. One common factor to control prior to testing is diet, as food and fluid provision may deviate from participants' habitual diets, yet a self-report and replication method can be flawed by under-reporting.

The FAM13A Long Isoform Regulates Cilia Movement and Coordination in Airway Mucociliary Transport.

Single nucelotide polymorphisms (SNPs) at the locus are among the most commonly reported risk alleles associated with chronic obstructive pulmonary disease (COPD) and other respiratory diseases; however, the physiological role of FAM13A is unclear. In humans, two major protein isoforms are expressed at the locus: "long" and "short," but their functions remain unknown, partly because of a lack of isoform conservation in mice. We performed in-depth characterization of organotypic primary human airway epithelial cell subsets and show that multiciliated cells predominantly express the FAM13A long isoform containing a putative N-terminal Rho GTPase-activating protein (RhoGAP) domain.

Mapping the scientific knowledge and approaches to defining and measuring hate crime, hate speech, and hate incidents: A systematic review.

Background: The difficulties in defining hate crime, hate incidents and hate speech, and in finding a common conceptual basis constitute a key barrier toward operationalisation in research, policy and programming. Definitions disagree about issues such as the identities that should be protected, the types of behaviours that should be referred to as hateful, and how the 'hate element' should be assessed. The lack of solid conceptual foundations is reflected in the absence of sound data.

Are there sex differences in the variability of fasting metabolism?

There is evidence across species and across many traits that males display greater between-individual variance. In contrast, (premenopausal) females display large within-individual variance in sex hormone concentrations, which can increase within-individual variance in many other parameters. The latter may contribute to the lower representation of females in metabolic research.

Substituting carbohydrate at lunch for added protein increases fat oxidation during subsequent exercise in healthy males.

Context: How pre-exercise meal composition influences metabolic and health responses to exercise later in the day is currently unclear.

Objective: Examine the effects of substituting carbohydrate for protein at lunch on subsequent exercise metabolism, appetite, and energy intake.

Methods: Twelve healthy males completed three trials in randomized, counterbalanced order.

Review: Mechanisms of TIMP-3 accumulation and pathogenesis in Sorsby fundus dystrophy.

Sorsby fundus dystrophy (SFD) is a rare, inherited form of macular degeneration caused by mutations in the gene encoding tissue inhibitor of metalloproteinases 3 (TIMP-3). There are 21 mutations currently associated with SFD, with some variants (e.g.

Integrating Clinical Judgment Into the Entry-Level Nursing: A Confirmatory Factor Analytic Study.

Clinical judgement (CJ) is a complex variable that utilizes higher level cognitive processing related to clinical reasoning, decision-making, and critical thinking. As CJ is a vital aspect of nursing, the current study evaluated the extent to which the current NCLEX item bank assesses CJ and a critical aspect of measuring new constructs using a dimensionality analysis. A Confirmatory Factor Analysis was completed to evaluate the factor structure of items written to the National Council of State Boards of Nursing Clinical Judgment Measurement Model (CJMM) that directly measures CJ with respect to extant NCLEX items.

Evaluating the Importance of Clinical Judgment in Entry-Level Nursing.

Background: This study investigated the extent to which clinical judgment is important in entry-level nursing practice.

Method: A task analysis linkage study methodology based on a large-scale, comprehensive practice analysis was used for the study. The practice analysis validated more than 200 entry-level nursing tasks, and the linkage study sought to evaluate the importance of clinical judgment overall and for each specific task expectation.

Psychopathology and psychosocial functioning among young people with first-episode psychosis and/or first-presentation borderline personality disorder.

Background: One in five young people with first-episode psychosis (FEP) also presents with borderline personality disorder (BPD) features. Among people diagnosed with BPD, auditory verbal hallucinations occur in 29-50 % and delusions in 10-100 %. Co-occurrence of psychotic symptoms and BPD is associated with greater clinical severity and greater difficulty accessing evidence based FEP care.