Profiling transcriptomic responses of human stem cell-derived medium spiny neuron-like cells to exogenous phasic and tonic neurotransmitters.

Transcriptomic responses to neurotransmitters contribute to the complex processes driving memory and addiction. Advances in both measurement methods and experimental models continue to improve our understanding of this regulatory layer. Here we focus on the experimental potential of stem cell derived neurons, currently the only ethical model that can be used in reductionist and experimentally perturbable studies of human cells. Prior work has focused on generating distinct cell types from human stem cells, and has also shown their utility in modeling development and cellular phenotypes related to neurodegeneration. Here we seek an understanding of how stem cell derived neural cultures respond to perturbations experienced during development and disease progression. This work profiles transcriptomic responses of human medium spiny neuron-like cells with three specific goals. We first characterize transcriptomic responses to dopamine and dopamine receptor agonists and antagonists presented in dosing patterns mimicking acute, chronic, and withdrawal regimens. We also assess transcriptomic responses to low and persistent tonic levels of dopamine, acetylcholine, and glutamate to better mimic the in vivo environment. Finally, we identify similar and distinct responses between hMSN-like cells derived from H9 and H1 stem cell lines, providing some context for the extent of variability these types of systems will likely pose for experimentalists. The results here suggest future optimizations of human stem cell derived neurons to increase their in vivo relevance and the biological insights that can be garnered from these models.

Validation of a sports nutrition knowledge questionnaire for athletes in the United Kingdom and Ireland.

Sound general and sports nutrition knowledge in athletes is essential for making appropriate dietary choices. Assessment of nutrition knowledge enables evaluation and tailoring of nutrition education. However, few well-validated tools are available to assess nutrition knowledge in athletes. The objective of the present study was to establish the validity of the Platform to Evaluate Athlete Knowledge Sports - Nutrition Questionnaire (PEAKS-NQ) for use in the United Kingdom and Irish (UK-I) athletes. To confirm content validity, twenty-three sports nutritionists (SNs) from elite, UK-I sports institutes provided feedback on the PEAKS-NQ via a modified Delphi method. After minor changes, the UK-I version of the PEAKS-NQ was administered to UK-I SN from the British Dietetic Association Sport and Exercise Nutrition Register, and elite athletes (EA) training at elite sports institutes in the UK and Ireland. Independent samples t-test and independent samples median tests were used to compare PEAKS-NQ total and subsection scores between EA and SN (to assess construct validity). Cronbach's alpha (good ≥ 0⋅7) was used to establish internal consistency. The SN achieved greater overall [SN (n 23) 92⋅3 (9⋅3) v. EA (n 154): 71⋅4 (10⋅0)%; P < 0⋅001] and individual section scores (P < 0⋅001) except Section B, Identification of Food Groups (P = 0⋅07). Largest knowledge differences between SN and EA were in Section D, Applied Sports Nutrition [SN: 88⋅5 (8⋅9) v. EA: 56⋅7 (14⋅5)%; P < 0⋅00]. Overall ES was large (2⋅1), with subsections ranging from 0⋅6 to 2⋅3. Cronbach's alpha was good (0⋅83). The PEAKS-NQ had good content and construct validity, supporting its use to assess nutrition knowledge of UK-I athletes.

Human Pluripotent Stem Cell-Derived Medium Spiny Neuron-like Cells Exhibit Gene Desensitization.

Gene desensitization in response to a repeated stimulus is a complex phenotype important across homeostatic and disease processes, including addiction, learning, and memory. These complex phenotypes are being characterized and connected to important physiologically relevant functions in rodent systems but are difficult to capture in human models where even acute responses to important neurotransmitters are understudied. Here through transcriptomic analysis, we map the dynamic responses of human stem cell-derived medium spiny neuron-like cells (hMSN-like cells) to dopamine. Furthermore, we show that these human neurons can reflect and capture cellular desensitization to chronic versus acute administration of dopamine. These human cells are further able to capture complex receptor crosstalk in response to the pharmacological perturbations of distinct dopamine receptor subtypes. This study demonstrates the potential utility and remaining challenges of using human stem cell-derived neurons to capture and study the complex dynamic mechanisms of the brain.

Recent Developments in the Assessment of Nutrition Knowledge in Athletes.

PURPOSE OF REVIEW: Adequate nutrition knowledge may influence dietary behaviour, and the performance and health of athletes. Assessment of the nutrition knowledge of athletes can inform practice and provide a quantitative way to evaluate education interventions. This article aims to review nutrition knowledge questionnaires published in the last 5 years to identify advances, possible improvements in questionnaire development and design, and challenges that remain. RECENT FINDINGS: Twelve new or modified questionnaires were identified. All had undergone validity and reliability testing. Advancements included quantitative measures of content validity and Rasch analysis. Online questionnaires were common, with at least seven using this format. Advances included use of images (n = 2), automated scored feedback (n = 1), and use of applied questions. While advancements have been made in validation and reliability testing and electronic delivery, new questionnaires would benefit from interactive and attractive features including images, provision of electronic feedback, and applied questions.

Measuring the sports nutrition knowledge of elite Australian athletes using the Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire.

AIMS: To evaluate the nutrition knowledge of elite Australian athletes, and to obtain feedback from sports dietitians on the Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaires' (PEAKS-NQ) suitability. METHODS: Sports dietitians from the National Institute Network across Australia recruited athletes to complete the online, 50-item PEAKS-NQ which contained two sections (General Nutrition and Sports Nutrition). Sports dietitians provided feedback on the PEAKS-NQ using a 14-item questionnaire (with two open-ended items). The main outcome measures were nutrition knowledge score and tool suitability (usefulness, acceptability and feasibility) scores. For knowledge scores, independent t-tests, ANOVA and Chi-square tests were used to evaluate differences between groups. Suitability was evaluated using descriptive statistics. RESULTS: Twelve sports dietitians from the National Institute Network in Australia recruited a convenience sample of 240 athletes (21.3 ± 4.3 years, 63.5% female, 63.3% competed internationally). Athletes scored 70.7 ± 10.5%, with better general vs sports nutrition knowledge. Females had higher overall scores (P < .001) with no differences for age or sport played. University-educated athletes scored higher than non-tertiary educated athletes (P = .004). Knowledge gaps were identified in fats (role and food sources), recovery nutrition and managing body composition. Sports dietitians rated suitability of PEAKS-NQ positively with complete agreement on 8 of 12 items. CONCLUSIONS: Athletes have greater understanding of general nutrition compared to sports nutrition concepts and may benefit from education on applying nutrition in sports-specific contexts. Sports dietitians' responses showed PEAKS-NQ was a highly acceptable, feasible and useful measure.

The effectiveness of nutrition education programmes on improving dietary intake in athletes: a systematic review.

Nutrition education programmes for athletes aim to enhance nutrition knowledge and more importantly support positive dietary change to enhance performance, health and well-being. This systematic review assessed changes in the dietary intakes of athletes in response to nutrition education programmes. A search was conducted which included studies providing quantitative dietary intake assessment of athletes of any calibre aged between 12 and 65 years in response to a nutrition education programme. Standardised differences (effect sizes) were calculated (when possible) for each dietary parameter. The search yielded 6285 papers with twenty-two studies (974 participants (71·9 % female)) eligible for inclusion. Studies described athletes competing at high school (n 3) through to college level or higher (n 19). Study designs were either single arm with an intervention-only group (twelve studies; n 241) or double arm including an intervention and control group (ten studies; n 689). No control groups received an alternative or 'sham' intervention. Face-to-face lectures (9/22) and individual nutrition counselling (6/22) were the most common education interventions. Non-weighed, 3-d diet records (10/22) were the most frequently utilised dietary assessment method. Although 14/22 studies (n 5 single and n 9 double) reported significant change in at least one nutrition parameter, dietary changes were inconsistent. Poor study quality and heterogeneity of methods prohibit firm conclusions regarding overall intervention success or superior types of educational modalities. Of note, carbohydrate intakes 'post-intervention' when assessed often failed to meet recommended guidelines (12/17 studies). Given the substantial investment made in nutrition education interventions with athletes, there is a need for well-designed and rigorous research to inform future best practice.

The Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire: a reliable and valid electronic sports nutrition knowledge questionnaire for athletes.

Reliable and valid assessment of sports nutrition knowledge can inform athlete nutrition education to address knowledge gaps. This study aimed to test the reliability and validity of an electronically administered sports nutrition knowledge tool - Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire (PEAKS-NQ). A 94-item PEAKS-NQ was piloted to 149 developmental athletes (DA) in New Zealand, with a subset invited to complete the PEAKS-NQ again to assess reliability. Reliability was evaluated using sign test, intraclass correlation and Cronbach's α. Accredited sports dietitians (ASD; n 255) completed the PEAKS-NQ to establish construct validity via known-groups methodology and provided relevance scores to determine the scale content validity index (S-CVI). Rasch analysis was conducted to identify potentially problematic items and test reliability. Score differences between DA and ASD were analysed using independent t or non-parametric tests. DA (n 88) were 17·8 (sd 1·4) years, 61·4 % female and mostly in high school (94·3 %). ASD (n 45) were 37·8 (sd 7·6) years, 82·2 % female, with >5 years of dietetic experience (59·1 %). ASD scored higher than DA in all sections and overall (91·5 (sd 3·4) v. 67·1 (sd 10·5) %) (P < 0·001). There were no differences between retests (n 18; P = 0·14). Cronbach's α was 0·86. S-CVI indicated good content validity (0·88). Rasch analysis resulted in a fifty-item PEAKS-NQ with high item (0·91) and person (0·92) reliability. The PEAKS-NQ is reliable and valid for assessing sports nutrition knowledge which could assist practitioners effectively tailor and evaluate nutrition education.

Development of an Electronic Questionnaire to Assess Sports Nutrition Knowledge in Athletes.

Background: Sports nutrition knowledge (SNK) is essential for athletes to support selection of a diet to optimize sports performance. Unfortunately, assessment of SNK is limited by a lack of well-validated instruments. Valid assessment of SNK would assist in identifying gaps in athlete knowledge, as well as tailoring and evaluating nutrition education interventions.Objectives: The aim of this study was to develop and conduct content validation on a SNK questionnaire for athletes.Methods: Focus groups (FG) with experienced sports nutritionists at four elite sporting institutions in Australia and New Zealand were conducted to inform instrument development. FGs were recorded, transcribed verbatim and broad themes identified. Draft items for the Platform to Evaluate Athlete Knowledge of Sports Nutrition Questionnaire (PEAKS-NQ) were developed using FG themes, the scientific literature, and a sports nutrition position stand. FG participants were subsequently invited to review the PEAKS-NQ using a modified Delphi process to refine draft items and inform content validity.Results: Participants (n = 16; median experience 11.5 years) identified key assessment domains including general nutrition knowledge along with SNK and supported development of an electronic instrument with food images. The electronic PEAKS-NQ was subsequently developed and reviewed by a subset of FG participants (n = 11/16). This informed changes to 41/94 items with none removed. The final PEAKS-NQ assessed knowledge of food groups, macro- and micronutrients, competition nutrition, dietary supplements and skills in adjusting dietary intake to different situations.Conclusion: Minor adaptation to incorporate local foods would facilitate international use of the PEAKS-NQ. Further validation, including athlete performance on the instrument, is warranted.

Diet Quality of Elite Australian Athletes Evaluated Using the Athlete Diet Index.

While athletes' nutrient intakes have been widely reported, few studies have assessed the diet quality of athletes. This is the first study to evaluate the diet quality of athletes using the purpose-built Athlete Diet Index (ADI). A convenience sample of 165 elite athletes from Australian sporting institutions completed the ADI online, with subsequent automated results provided to their respective accredited sports dietitians (ASDs). At the completion of athlete participation, ASDs (n = 12) responded to a range of survey items using a Likert scale (i.e., 1 = strongly agree to 5 = strongly disagree) to determine the suitability of the ADI in practice. Differences in ADI scores for demographics and sport-specific variables were investigated using independent t-tests, analysis of variance (ANOVA) and Bonferroni multiple comparisons. Spearman's rank correlation was used to assess the association between total scores and demographics. The mean total ADI score was 91.4 ± 12.2 (range 53-117, out of a possible 125). While there was no difference in total scores based on demographics or sport-specific variables; team sport athletes scored higher than individual sport athletes (92.7 vs. 88.5, P < 0.05). Athletes training fewer hours (i.e., 0-11 h/week) scored higher on Dietary Habits sub-scores compared with athletes training more hours (> 12 h/week; P < 0.05), suggesting that athletes who train longer may be at risk of a compromised dietary pattern or less than optimal nutrition practices that support training. Most (75%) ASDs surveyed strongly agreed with the perceived utility of the ADI for screening athletes and identifying areas for nutrition support, confirming its suitability for use in practice.

Validation of the e-NutLit, an Electronic Tool to Assess Nutrition Literacy.

OBJECTIVE: To validate an electronic nutrition literacy assessment tool (e-NutLit). DESIGN: Cross-sectional. SETTING: An Australian teaching hospital obesity clinic (clinical cohort) and university (dietetic cohort). PARTICIPANTS: A convenience sample of patients with obesity (body mass index > 35 kg m-2) (obese participants [OP]) and dietetic interns (DI). INTERVENTIONS: The e-NutLit was administered to OP and scores were compared with performance on the Newest Vital Sign and e-NutLit scores of the DI to establish construct validity. A subset of OP completed the e-NutLit again to examine instrument temporal stability. Internal consistency was assessed using Cronbach α. MAIN OUTCOME MEASURES: Construct validity, temporal stability, and internal consistency. ANALYSIS: Parametric and nonparametric tests and general linear modeling were used as appropriate. RESULTS: A total of 103 participants completed the study (OP: n = 59; 64.4% female; DI: n = 44; 86.4% female). Newest Vital Sign and e-NutLit scores were significantly and positively associated (rs = 0.66; P <.001). The DI performed significantly better than the OP (OP: 59.7 ± 13.1 percentage points; DI: 83.9 ±â€¯5.5 percentage points; P <.001), further supporting construct validity. The e-NutLit Cronbach α was >0.9 indicating a good level of internal consistency. The OP test and retest scores were not significantly different, supporting instrument temporal stability. CONCLUSION AND IMPLICATIONS: The results support the validity of the e-NutLit, for both clinicians and researchers.

Effectiveness of Education Interventions Designed to Improve Nutrition Knowledge in Athletes: A Systematic Review.

BACKGROUND: A range of nutrition education strategies are used to assist athletes to improve nutrition knowledge. Evaluation of nutrition education interventions guides the delivery of efficacious nutrition education for athletes. AIM: Our aim was to systematically review sport/general nutrition education interventions delivered to athletes, and to evaluate their effectiveness. METHODS: A search was conducted using terms related to nutrition knowledge, athletes, education, and intervention. Included studies had to be conducted in athletes (all calibres), use a scored nutrition knowledge assessment tool, and measure knowledge before and after a nutrition education intervention. Peer-reviewed and unpublished theses were included. RESULTS: Thirty-two manuscripts (randomised controlled trial, n = 13; single-arm pre/post design, n = 19) met the inclusion criteria. Participants (n = 2180; mean age 17.4 ± 1.7 years) were mostly female (66.1%), university-level (56.3%) athletes based in the US (75%). Comparison of different education methods was limited since the majority of interventions (n = 28/36, 77.8%) used face-to-face education. Most intervention conditions (n = 19) had a total contact time of < 300 min (5 h). The majority of interventions (n = 30, 85.7%) reported significant knowledge improvement, with a mean increase of 16.1 ± 0.7% (mean effect size 1.72; range 0.4-17.1). Only 15.6% of studies used well-validated knowledge assessment tools (more than three types of validity or reliability testing). CONCLUSIONS: Most interventions reported a significant improvement in nutrition knowledge. Unfortunately, the wide range of knowledge assessment tools with limited validation, and the predominant use of face-to-face interventions, prohibits identification of the most effective modality and dose for nutrition education in athletes.

University students' on-campus food purchasing behaviors, preferences, and opinions on food availability.

OBJECTIVE: Emerging adulthood (18-24 y) where >50% of young adults attend tertiary education, is a transitional period that may provide an opportunity to influence future eating behaviors. The aim of this study was to identify possible strategies for encouraging healthy eating in university food environments. METHOD: Over 4 wk, students from a large university completed an anonymous researcher-designed survey with both closed (n = 41) and open-ended (n = 3) questions assessing food purchasing, food choice behaviors, and opinions of the campus food environment. Results were reported as proportions (%) or mean ± SD. Chi-square analysis was used to determine differences between sex and campuses. The study took place at an Australian urban university with seven campuses. We recruited 653 currently enrolled students by convenience sampling. RESULTS: Respondents were mostly women (77%), aged <25 y (83%), and enrolled full time (96%). Almost all participants purchased food or beverages on campus (93%), with the most frequently purchased items being hot beverages and sandwiches. The greatest determinants of food choice were taste, value, convenience, and cost. Female students placed more importance on health-related factors and followed more special dietary behaviors than male students. The most common improvements suggested were lowering the cost and increasing the variety of food. CONCLUSION: As most students purchase food on campus, there are opportunities to intervene to improve diet quality. Our results indicate demand for healthy food and that price manipulation is an important lever for change. This information will be used for changing the local university food environment but may be useful for planning interventions at other universities.

Implementation of an Emergency Department Sepsis Bundle and System Redesign: A Process Improvement Initiative.

BACKGROUND: In 2008-2009, the Canadian Institute for Health Information reported over 30,000 cases of sepsis hospitalizations in Canada, an increase of almost 4,000 from 2005. Mortality rates from severe sepsis and septic shock continue to remain greater than 30% in Canada and are significantly higher than other critical conditions treated in the emergency department (ED). Our group formed a multidisciplinary sepsis committee, conducted an ED process of care analysis, and developed a quality improvement protocol. The objective of this study was to evaluate the effects of this sepsis management bundle on patient mortality. METHODS: This before and after study was conducted in two large Canadian tertiary care EDs and included adult patients with suspected severe infection that met at least two systemic inflammatory response syndrome (SIRS) criteria. We studied the implementation of a sepsis bundle including triage flagging, RN medical directive, education campaign, and a modified sepsis protocol. The primary outcomes were 30-day all-cause mortality and sepsis protocol use. RESULTS: We included a total of 167 and 185 patients in the pre- and post-intervention analysis, respectively. Compared to the pre-intervention group, mortality was significantly lower in the post-intervention group (30.7% versus 17.3%; absolute difference, 13.4%; 95% CI 9.8-17.0; p=0.006). There was also a higher rate of sepsis protocol use in the post-intervention group (20.3% versus 80.5%, absolute difference 60.2%; 95% CI 55.1-65.3; p<0.001). Additionally, we found shorter time-intervals from triage to MD assessment, fluid resuscitation, and antibiotic administration as well as lower rates of vasopressor requirements and ICU admission. Interpretation The implementation of our multidisciplinary ED sepsis bundle, including improved early identification and protocolized medical care, was associated with improved time to achieve key therapeutic interventions and a reduction in 30-day mortality. Similar low-cost initiatives could be implemented in other EDs to potentially improve outcomes for this high-risk group of patients.

Template electrosynthesis of tailored-made helical nanoswimmers.

We demonstrate a template electrosynthesis for large-scale low-cost preparation of remarkably small magnetically driven tailored-made helical nanoswimmers that display efficient propulsion behavior and hold considerable promise for future miniature devices in the human body.

Bioinspired helical microswimmers based on vascular plants.

Plant-based bioinspired magnetically propelled helical microswimmers are described. The helical microstructures are derived from spiral water-conducting vessels of different plants, harnessing the intrinsic biological structures of nature. Geometric variables of the spiral vessels, such as the helix diameter and pitch, can be controlled by mechanical stretching for the precise fabrication and consistent performance of helical microswimmers. Xylem vessels of a wide variety of different plants have been evaluated for the consistency and reproducibility of their helical parameters. Sequential deposition of thin Ti and Ni layers directly on the spiral vessels, followed by dicing, leads to an extremely simple and cost-efficient mass-production of functional helical microswimmers. The resulting plant-based magnetic microswimmers display efficient propulsion, with a speed of over 250 µm/s, as well as powerful locomotion in biological media such as human serum. The influence of actuation frequencies on the swimming velocity is investigated. Such use of plant vessels results in significant savings in the processing costs and provides an extremely simple, cost-effective fabrication route for the large-scale production of helical magnetic swimmers.