ObjectiveExamine the effectiveness of specific modes of exercise training in non-specific chronic low back pain (NSCLBP).DesignNetwork meta-analysis (NMA).Data sourcesMEDLINE, CINAHL, SPORTDiscus, EMBASE, CENTRAL.Eligibility criteriaExercise training randomised controlled/clinical trials in adults with NSCLBP.ResultsAmong 9543 records, 89 studies (patients=5578) were eligible for qualitative synthesis and 70 (pain), 63 (physical function), 16 (mental health) and 4 (trunk muscle strength) for NMA. The NMA consistency model revealed that the following exercise training modalities had the highest probability (surface under the cumulative ranking (SUCRA)) of being best when compared with true control: Pilates for pain (SUCRA=100%; pooled standardised mean difference (95% CI): −1.86 (–2.54 to –1.19)), resistance (SUCRA=80%; −1.14 (–1.71 to –0.56)) and stabilisation/motor control (SUCRA=80%; −1.13 (–1.53 to –0.74)) for physical function and resistance (SUCRA=80%; −1.26 (–2.10 to –0.41)) and aerobic (SUCRA=80%; −1.18 (–2.20 to –0.15)) for mental health. True control was most likely (SUCRA≤10%) to be the worst treatment for all outcomes, followed by therapist hands-off control for pain (SUCRA=10%; 0.09 (–0.71 to 0.89)) and physical function (SUCRA=20%; −0.31 (–0.94 to 0.32)) and therapist hands-on control for mental health (SUCRA=20%; −0.31 (–1.31 to 0.70)). Stretching and McKenzie exercise effect sizes did not differ to true control for pain or function (p>0.095; SUCRA<40%). NMA was not possible for trunk muscle endurance or analgesic medication. The quality of the synthesised evidence was low according to Grading of Recommendations Assessment, Development and Evaluation criteria.Summary/conclusionThere is low quality evidence that Pilates, stabilisation/motor control, resistance training and aerobic exercise training are the most effective treatments, pending outcome of interest, for adults with NSCLBP. Exercise training may also be more effective than therapist hands-on treatment. Heterogeneity among studies and the fact that there are few studies with low risk of bias are both limitations.

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Background: Many studies have attempted to identify the sources of interindividual variability in response to theta-burst stimulation (TBS). However, these studies have been limited by small sample sizes, leading to conflicting results. Objective/Hypothesis: This study brought together over 60 TMS researchers to form the 'Big TMS Data Collaboration', and create the largest known sample of individual participant TBS data to date. The goal was to enable a more comprehensive evaluation of factors driving TBS response variability. Methods: 118 corresponding authors of TMS studies were emailed and asked to provide deidentified individual TMS data. Mixed-effects regression investigated a range of individual and study level variables for their contribution to iTBS and cTBS response variability. Results: 430 healthy participants' TBS data was pooled across 22 studies (mean age ¼ 41.9; range ¼ 17 e82; females ¼ 217). Baseline MEP amplitude, age, target muscle, and time of day significantly predicted iTBS-induced plasticity. Baseline MEP amplitude and timepoint after TBS significantly predicted cTBSinduced plasticity. Conclusions: This is the largest known study of interindividual variability in TBS. Our findings indicate that a significant portion of variability can be attributed to the methods used to measure the modulatory effects of TBS. We provide specific methodological recommendations in order to control and mitigate these sources of variability.

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BAS 662H, a 1:2.5 combination of the semicarbazone-type auxin transport inhibitor diflufenzopyr and the auxin herbicide dicamba, is used as a post-emergence herbicide in corn. The combination has been observed to provide more effective broadleaf weed control and improved tolerance in corn than typical rates of dicamba used alone. In order to analyze this phenomenon, the uptake, translocation, metabolism and action of both compounds, applied alone and in combination, were investigated in Amaranthus retroflexus L, Galium aparine L and corn (Zea mays L). When plants at the third-leaf stage were foliarly treated with diflufenzopyr and dicamba equivalent to field rates of 100 and 250 gha-1, respectively, diflufenzopyr synergistically increased dicamba-induced 1-aminocyclopropane-1-carboxylic acid (ACC) synthase activity and ethylene formation in G aparine and even more in A retroflexus, followed by accumulations of (+)-abscisic acid (ABA) in the shoot tissue within 20 h. This correlated with subsequent growth inhibition, hydrogen peroxide overproduction and progressive tissue damage. Diflufenzopyr also enhanced the activity of other auxin herbicides, such as quinclorac and picloram, and of the synthetic auxin, 1-naphthaleneacetic acid. After foliar and root application of [14C]diflufenzopyr, alone or as BAS 662H, considerably lower tissue concentrations and systemic translocation of radioactivity beyond treated plant parts were found in corn, compared to G aparine and particularly A retroflexus. Furthermore, diflufenzopyr decreased foliar uptake of [14C]dicamba by c 50% selectively in corn, compared to the treatment alone. Metabolism of [14C]diflufenzopyr was more rapid in corn than in the weed species. In combination, the two compounds had no mutual effect on their metabolic degradation. In BAS 662H, diflufenzopyr synergizes the herbicidal activity of dicamba in sensitive weed species. In corn this effect is prevented by a more rapid metabolism of diflufenzopyr, coupled with lower uptake and translocation. Selectivity of BAS 662H is additionally favoured by a higher crop tolerance to dicamba because of reduced foliar uptake of this herbicide in corn under the influence of diflufenzopyr.

ObjectivesTo examine associations of three diet quality indices and a polygenic risk score with incidence of all-cause mortality, cardiovascular disease (CVD) mortality, myocardial infarction (MI) and stroke.DesignProspective cohort study.SettingUK Biobank, UK.Participants77 004 men and women (40–70 years) recruited between 2006 and 2010.Main outcome measuresA polygenic risk score was created from 300 single nucleotide polymorphisms associated with CVD. Cox proportional HRs were used to estimate independent effects of diet quality and genetic risk on all-cause mortality, CVD mortality, MI and stroke risk. Dietary intake (Oxford WebQ) was used to calculate Recommended Food Score (RFS), Healthy Diet Indicator (HDI) and Mediterranean Diet Score (MDS).ResultsNew all-cause (n=2409) and CVD (n=364) deaths and MI (n=1141) and stroke (n=748) events were identified during mean follow-ups of 7.9 and 7.8 years, respectively. The adjusted HR associated with one-point higher RFS for all-cause mortality was 0.96 (95% CI: 0.94 to 0.98), CVD mortality was 0.94 (95% CI: 0.90 to 0.98), MI was 0.97 (95% CI: 0.95 to 1.00) and stroke was 0.94 (95% CI: 0.91 to 0.98). The adjusted HR for all-cause mortality associated with one-point higher HDI and MDS was 0.97 (95% CI: 0.93 to 0.99) and 0.95 (95% CI: 0.91 to 0.98), respectively. The adjusted HR associated with one-point higher MDS for stroke was 0.93 (95% CI: 0.87 to 1.00). There was little evidence of associations between HDI and risk of CVD mortality, MI or stroke. There was evidence of an interaction between diet quality and genetic risk score for MI.ConclusionHigher diet quality predicted lower risk of all-cause mortality, independent of genetic risk. Higher RFS was also associated with lower risk of CVD mortality and MI. These findings demonstrate the benefit of following a healthy diet, regardless of genetic risk.