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https://www.massolit.io/courses/brain-imaging \

https://www.slideshare.net/kunalmahajan50/basics-of-ct-head-by-dr-kunal-mahajan

https://www.brainline.org/slideshow/brain-imaging-what-are-different-types

https://www.cell.com/fulltext/S0896-6273%2806%2900634-9

https://www.radiologymasterclass.co.uk/tutorials/mri/mri_signal

https://geekymedics.com/the-basics-of-mri-interpretation/

https://today.duke.edu/2020/06/studies-brain-activity-aren’t-useful-scientists-thought

https://ocw.mit.edu/courses/9-71-functional-mri-of-high-level-vision-fall-2007/484d80b0eddc696e1d6386342cd9df0e_lec1_intro.pd

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https://docs.google.com/forms/d/e/1FAIpQLSfpL2DBoFttmRVJF9C3EgOxUhP8KHurf-4RhrFt8fO3xV9JSA/viewform?usp=sf_link

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Before next session please develop a topic/idea/question that is:

1. Important

2. Relevant

3. Novel

Email them (and why this is important, relevant and novel) to amber.corrigan1@nhs.net

Or (preferably) put them on the Padlet with your name attached

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If you don't read anything else - READ THIS - Great nature read on a good scientific presentation! 

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If you don't read anything else - READ THIS - Great nature read on a good scientific presentation! 

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https://www.nature.com/articles/d41586-021-03603-2

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Scientific presentations are too often boring and ineffective. Their focus on techniques and data do not make it easy for the audience to understand the main point of the research.

If you want to reach beyond the narrow group of scientists who work in your specific area, you need to tell your audience members why they should be interested. Three things can help you to be engaging and convey the importance of your research to a wide audience. I had been teaching scientific communication for several years when I was approached to write a book about improving scientific presentations. These are my three most important tips.

State your main finding in your title

The best titles get straight to the point. They tell the audience what you found, and they let them know what your talk will be about. Throughout this article, I will use titles from Nature papers published in the past two years as examples that will stand in for presentation titles. This is because Nature articles have a similar goal of attempting to make discipline-specific research available to a broader audience of scientists. Take, for example: 'Supply chain diversity buffers cities against food shocks'.

A great title tells the reader exactly what's new and precisely conveys the main result, as this one demonstrates. A more conventional title would have been 'Effect of supply chain diversity on food shocks', which omits the direction of the effect - so mainly scientists who are interested in your research area will be attracted to the talk. Others will wonder whether the talk will be a waste of time: maybe there was no effect at all.

Another example of a good title is: 'Organic management promotes natural pest control through altered plant resistance to insects'.

This title ensures that the audience members know that the talk will be about the beneficial effects of organic crop management before they hear it. They also know that organic management increases plant resistance to insects. This title is much better than one such as: 'Effects of organic pest management on plant insect resistance'. This title tells the audience the general area of the talk but does not give them the main result.

Finally, look at: 'A highly magnetized and rapidly rotating white dwarf as small as the Moon'.

Good titles can just as easily be written for descriptive work as for experimental results. All you need to do is tell your audience what you found. Be as specific as possible. Compare this title with a more conventional one for the same work: 'Use of the Zwicky Transient Facility to search for short period objects below the main white dwarf cooling sequence'. This title might be of interest to astronomers interested in using this facility, but is unlikely to attract anyone beyond them.

'But' is good - use it for dramatic effect

The contradiction implied by the word 'but' is one of the most powerful tools a scientist can use. Contradictions introduce problems and provide dramatic effect, tension and a reason to keep listening.

Without such contradictions, the talk will consist of a bunch of results strung together in a seemingly endless and mind-numbing list. We can think of this list as a series of 'and' statements: "We did this and this and ran this experiment and found this result and . . . and . . . and."

Contrast this with a structure that begins with a few important facts, tethered by ands, and then introduces the problem to be solved. Finally, 'therefore' can introduce results or subsequent actions. That structure would look like this: 'X is the current state of knowledge, and we know Y. But Z problem remains. Therefore, we carried out ABC research.' The introduction of even one contradiction wakes up people in the audience and helps them to focus on the results.

A paper published earlier this year on SARS-CoV-2 and host protein synthesis provides an excellent example of the narrative form using 'and', 'but' and 'therefore'. In the example below, I have shortened the abstract and simplified the transitions, but maintained the authors' original structure. Although they did not use 'but' or 'therefore' in their abstract, the existence of these terms is clearly implied. I have made them explicit in the following rendition.

"Coronaviruses have developed a variety of mechanisms to repress host messenger RNA translation and to allow the translation of viral mRNA and block the cellular immune response. But a comprehensive picture of the effects of SARS-CoV-2 infection on cellular gene expression is lacking. Therefore, we combine RNA sequencing, ribosome profiling and metabolic labelling of newly synthesized RNA to comprehensively define the mechanisms that are used by SARS-CoV-2 to shut off cellular protein synthesis."

In this example, background information is given in the first sentence, linked by a series of conjunctions. Then the problem is introduced - this is the contradiction that comes with 'but'. The solution to this problem is given in the next sentence (and introduced by using 'therefore'). This structure makes the text interesting. It will do the same for your presentations.

Use repeated problems and solutions to create a story

Use the power of contradiction to maintain audience engagement throughout your talk. You can string together a series of problems and solutions (buts and therefores) to create a story that leads to your main result. The result highlighted in your title will help you to focus your talk so that the solutions you present lead to this overarching result.

Here is the general pattern:

1. Present the first part of your results.

2. Introduce a problem that remains.

3. Provide a solution to this problem by presenting more results.

4. Introduce the next problem.

5. Present the results that address this problem.

6. Continue this 'problem and solution' process through your presentation.

7. End by restating your main finding and summarize how it arises from your intermediate results.

The SARS-CoV-2 abstract uses this pattern of repeated problems (buts) and solutions (therefores). I have modified the wording to clarify these sections.

1. Result 1: SARS-CoV-2 infection leads to a global reduction in translation, but we found that viral transcripts are not preferentially translated.

2. Problem 1: How then does viral mRNA comes to dominate the mRNA pool?

3. Solution 1: Accelerated degradation of cytosolic cellular mRNAs facilitates viral takeover of the mRNA pool in infected cells.

4. Problem 2: How is the translation of induced transcripts affected by SARS-CoV-2 infection?

5. Solution 2: The translation of induced transcripts (including innate immune genes) is impaired.

6. Problem 3: How is translation impaired? What is the mechanism?

7. Solution 3: Impairment is probably mediated by inhibiting the export of nuclear mRNA from the nucleus, which prevents newly transcribed cellular mRNA from accessing ribosomes.

8. Final summary: Our results demonstrate a multipronged strategy used by SARS-CoV-2 to take over the translation machinery and suppress host defences.

Using these three basic tips, you can create engaging presentations that will hold the attention of your audience and help them to remember you. For young scientists, especially, that is the most important thing the audience can take away from your talk.
doi: https://doi.org/10.1038/d41586-021-03603-2

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How to tell a compelling story in scientific presentations

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Scientific presentations are too often boring and ineffective. Their focus on techniques and data do not make it easy for the audience to understand the main point of the research. If you want to reach beyond the narrow group of scientists who work in your specific area, you need to tell your audience members why they should be interested.

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https://forms.gle/UqUgvJejcZmkd6qk6

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ishta.sharma1@nhs.net

amber.corrigan1@nhs.net

Please do not use KCL email

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You can also email or place questions in the google form.

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MIT lecture series for more in detail explanation of fMRI by Prof Rebecca Saxe:

Lecture 1 is the most useful - beyond that explores more analysis of fMRI

https://ocw.mit.edu/courses/res-9-005-fmri-bootcamp-fall-2017/

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https://docs.google.com/presentation/d/1I1EKYHsXreQ6H6XI3aIJXOWC0kUGrcFPfLIA1qQrx4A/edit?usp=sharing

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MSc Clinical Neurosciences masterclass:  I +III 

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https://docs.google.com/forms/d/e/1FAIpQLSfpL2DBoFttmRVJF9C3EgOxUhP8KHurf-4RhrFt8fO3xV9JSA/viewform

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Additional detail in the presenter notes

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Cranial nerves masters teaching 27.10.23

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Abstracts I

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Randomized, double-blind, placebo-controlled trial of rapamycin in amyotrophic lateral sclerosis - Nature Communications

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Neuroinflammation and autophagy are two pillars of ALS pathogenesis targeted by rapamycin. Here, in a randomized, double-blind, phase 2 clinical trial, the authors find rapamycin to be safe and well tolerated in ALS patients, supporting further studies.

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Abstract II

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Introduction

Based on the latest estimates and according to the World Health Organization, overweight and obesity affects almost 60% of adults in the European Union countries1. In the US the situation is even more severe, with an estimated prevalence of overweight and obesity of 74% among adults2. Overweight and obesity are responsible for causing at least 2.8 million premature deaths worldwide each year3.

Weight loss regimes rely on creating an energy deficit-where energy intake is lower than energy expenditure. However, this approach proves challenging for many individuals to effectively put into practice. Even though there are effective weight loss treatment such as pharmacological treatment and surgery for individuals with obesity, persons with overweight are usually deemed to handle their overweight themselves despite that overweight also is associated with long-term health hazards4. Hence, safe and well tolerable food supplements may be one way to further improve the effect of lifestyle modification both for treatment of obesity and for obesity prevention in already overweight subjects.

In humans, individuals with overweight exhibit a decreased gut bacterial diversity and an altered composition of bacterial species5,6. Bacteroidetes and Firmicutes are the two predominant phyla in human microbiota and an altered ratio of these is associated with several diseases, e.g. obesity is associated with a decrease in Bacteroidetes and an increase in Firmicutes 7. Since the link between metabolic health and gut microbiota was discovered, there has been increasing interest in exploring the potential use of biological agents such as probiotics as an active therapeutic or preventive strategy in managing metabolic diseases. A meta-analysis revealed that certain species, namely Lactobacillus gasseri and Lactobacillus plantarum, exhibit positive effects on weight loss, while other species in the Lactobacillus genus, such as Lactobacillus acidophilus, Lactobacillus fermentum, and Lactobacillus ingluviei, are associated with weight gain8. Additionally, evidence indicate that probiotics may modify the secretion of hormones, neurotransmitters, and inflammatory factors, thereby preventing triggers for excessive food intake that could contribute to weight gain9,10. Further, Bacillus subtilis and Bacillus coagulans are species that have exhibited favorable effects on obesity-related inflammation, metabolic disturbances, and weight control in rodent models featuring obesity11,12,13. The full mechanism of probiotics on weight is unclear, but may involve altered metabolism of short-chain fatty acids in the gut and reduced leakage of proinflammatory molecules14. Nevertheless, the spectra of available probiotics in the open market is extensive, and therefore, this study aimed to investigate whether different doses of the probiotic supplement AB001 can reduce weight and if an increased dose of AB001 is tolerated and safe. Secondary aims were to study changes in; BMI, waist circumference, blood pressure, blood lipids, glucose metabolism, liver enzymes, vitamin levels, and bowel habits.

We hypothesized that probiotics would yield a greater weight loss than placebo and that there would be a dose-dependent relationship between the dose of probiotics consumed and weight loss.

Methods

Design

This was a single-center, double-blind, three parallel group, block randomized, placebo-controlled trial, followed by an open phase conducted at Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden, between October 2021 and February 2022. The study was conducted according to the Declaration of Helsinki and ethically approved by the Swedish Ethical Review Authority in May 2021 (file no. 2021-02383 with amendment no. 2021-06174-02) and registered at ClinicalTrials.gov (NCT04897698) on 21/05/2021. The study followed CONSORT guidelines for trials.

Subjects

Voluntary individuals who were 18-45 years old and met the criteria of BMI 26.0 to less than 30 kg/m ² and were willing to lose weight were eligible. Exclusion criteria was active weight loss in the last 3 months, the desire for or planned pregnancy upcoming months, chronic somatic diseases that may affect metabolic and/or intestinal function (e.g. diabetes, hypertension, dyslipidemia, Irritable Bowel Disease, gluten intolerance, pancreatic dysfunction, other conditions of malabsorption, neoplastic disease), allergies with previous anaphylactic reactions, abdominal surgery within 6 months prior to inclusion, current or history of eating disorders, extreme or unusual diets for the last 3 months which the investigator considered negatively could affect the outcome of the study (e.g. ketogenic diet and intermittent fasting), psychiatric disorders (e.g., schizophrenia, and other diagnoses that may influence compliance), drug or alcohol abuse, pharmacological treatment that may influence the study outcomes (e.g. systemic corticosteroid treatment and anti-obesity treatment, but not well-controlled treatment for hyperthyroidism), present or recent usage of other probiotic agents, and other conditions which the investigator considers could negatively affect the outcome of the study or study compliance (e.g. social vulnerability such as homelessness).

Participants were provided economic compensation for their participation.

Tested compound

Dietary supplement consisting of capsules withholding bacteria with probiotic properties called AB001 (de Faire Medical AB, Stockholm Sweden). It contains strains of Bacillus subtilis (LMG P-32899) and Bacillus coagulans (LMG P-32921) with a concentration of 13 million colony forming units (cfu) per gram. Other ingredients (including stabilization) include fermented rice bran which has prebiotic properties, L-Cysteine, and Dextrin. The capsule shell is made of vegetable hydroxypropyl metylcellulosa (HPMC). Each capsule has a weight of 0.4 g, corresponding to 5.2 million cfu.

Due to ethical reasons, all participants received a pamphlet with general advice regarding recommended food and eating pattern based on Swedish guidelines.

Procedures

If inclusion criteria were fulfilled, no exclusion criteria were identified, and written informed consent was obtained, the individual was included in the study. Participants were randomized to (a) double dose probiotics (four capsules probiotic per day), (b) single dose probiotics (two capsules probiotic per day and two capsules of placebo), or (c) placebo (four capsules of placebo). At the 3-month visit, participants who had single or double dose probiotics were offered to continue the study for three additional months, an open phase, with triple dose probiotics (six capsules per day).

Study participants were instructed to take half of the dose before breakfast and half of the dose before dinner each day. A schematic figure of the study process is shown in Fig. 1.

Schematic drawing of the study design.

Clinical investigation was scheduled at baseline (date of inclusion), at 3-month follow-up (90 days after inclusion), and at 6-month follow-up (180 days after inclusion). At baseline, all participants filled in a questionnaire including demographics, well-being, and gastrointestinal function and habits, see Supplementary file S1. During the intervention, study participants were given access to a digital research support system (Evira AB, Stockholm, Sweden) consisting of a mobile phone application and a digital scale connected with Bluetooth to the app15. The app was connected to a database wherefrom the study coordinator could follow the study participants and communicate with them. Participants were given weekly questionnaires in the app regarding adherence to intervention, potential adverse events, well-being, changes in the daily life of diet, physical activity, and alcohol consumption, see Supplementary file S2. Further, they were instructed to weigh themselves at least weekly on the scale connected to the application in the phone. Further, all study participants had scheduled personal contact with the study coordinator via the app at week 2, 4, 8, 14, 16, and 20.

Randomization and masking

Participants were randomly assigned (1:1:1) to single dose probiotics, double dose probiotics, or placebo using a fixed block size of nine participants and stratified for sex. Participants were randomized to (a) four capsules of probiotics per day or (b) two capsules of probiotics per day and two capsules of placebo, or (c) four capsules of placebo. Hence, all participants were to take four capsules per day, two before breakfast and two before dinner. The funder, which produced the product, packed the probiotics and placebo into pouches for morning and evening respectively, and labeled them group A-B (morning and evening), C-D, and E-F. At delivery of the study product, the labeling key was in a sealed envelope and kept in a locked space at the study center. The study was blinded during the first phase for both the researchers and the study participants. Type of received treatment was revealed to researcher and study participant at the 3-month follow-up, before statistical analyses. During the second phase of study, all participants received six capsules of probiotics per day (triple dose). This phase was non-blinded. Any participant that required extra capsules of probiotics/placebo due to prolonged follow-up time (e.g. due to current Covid-19 restrictions) were provided so by regular mail.

Clinical investigation

Clinical investigation was performed at baseline and at 3-month, and 6-month follow-up and included a medical examination that included cardiorespiratory and abdominal examinations was performed. In addition, weight was measured with a digital scale (Tanita BWB-800, Tanita Corp., Japan), height was measured with a wall-mounted stadiometer (SECA model 264, Seca, Germany) (only at baseline), waist circumference was measured using a measuring tape, and blood pressure was measured with a digital automatic monitor (Omron M3 Comfort, Omron, Japan).

Blood samples

Clinical laboratory tests were drawn at fasting state at baseline, 3-month follow-up, and 6-month follow-up and included; leukocyte concentration, MCH, platelets, mean cell [erythrocytes] volume (MCV), erythrocyte concentration, erythrocyte volume fraction (EVF), hemoglobin, high-sensitivity C-reactive protein (hs-CRP), glucose, hemoglobin (Hb) A1C, insulin, total cholesterol, triglycerides, low-density lipoprotein (LDL) cholesterol, and high-density lipoprotein (HDL) cholesterol, alanine aminotransferase (ALT), retinol (vitamin A), 25-hydroxyvitamin D, Tocopherol (vitamin E), thyroid stimulating hormone (TSH), thyroxine (T4), and triiodothyronine (T3). All blood samples were analyzed at Karolinska University Laboratory, Sweden.

Occasionally missing data of biomarkers occurred due to that blood samples were compromised at the laboratory, preanalytical factors such as hemolysis, or blood sample volume was not enough to be analyzed. Also, two high values of CRP, due to confirmed recent infection (Covid-19 and sinusitis) of 25 and 30 mg/L, were excluded from statistical analyses.

Statistical analyses

Power calculation

Sample size calculation for this three-armed placebo-controlled study is performed in STATA software based on alpha = 0.0500 and power = 0.8000. Estimated change in body weight; Mean change in the placebo group = 0.00 kg, Mean change in single dose probiotic group = − 2.00 kg, Mean change in double dose probiotic group = − 4.00 kg. A within-group variance of 18.3 was anticipated. Depending on the estimated standard division within each group, 20-24 participants are needed per group, which means a total number of 60-72. We assumed a dropout rate of about 4-6 participants per group and therefore aimed to include 75-90 participants in total for randomization.

Descriptive and outcome statistics

Data was checked for normality and presented with mean and standard deviation or median and interquartile range whenever appropriate. Descriptive data are presented with both measures with a marking of whether data was considered as normally distributed or not. Categorical variables are presented with frequencies and proportions.

Primary and secondary aims were investigated by comparing absolute changes between groups. Also, within group changes were analyzed, hence data was stratified by group. The results were based on observed cases and measures only. Hence, no data was imputed.

Unadjusted analyses were performed with t-test or ANOVA for normally distributed variables. Multiple comparisons were handled with Bonferroni correction. Wilcoxon test and Kruskal-Wallis were used as non-parametric test. To perform analysis of the inflammatory marker CRP, levels that were denoted at "< 1" from the laboratory was assigned a value of 0.5.

All analyses other than sample-size calculations were performed using SAS statistical software (version 9.4, Cary, North Carolina). All P-values presented were two-sided and a p-value less than 0.050 was denoted statistically significant.

Role of funding

The funder, de Faire Medical AB (Sweden), manufacturer of the studied probiotic AB001 and provided matching placebo at no cost. Further, the funder provided Karolinska Institutet financial compensation for study-related expenses such as costs for analyses of blood samples and study subject reimbursement. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Results

Of the 81 included participants (57% females), the average age was 33.2 years, weight 83.9 kg, BMI 28.3 kg/m ². The majority (94%) were employed or students and 68% were born in Sweden. The demographic and baseline characteristics for each study group, and in total, are provided in Table 1.

Generally, the randomization worked well, and no differences in sex, weight, BMI, waist circumference and blood pressure at baseline were observed. However, the group with single dose probiotics were on average 4.4 years older than the placebo group, p = 0.034. Further, the baseline levels of all biomarkers were similar across the groups except for vitamin E, where the placebo group had 4.3-5.0 µmol/L higher levels compared with single dose and double dose probiotics respectively. Over the study period, 1596 questionnaires were received. During the first 3 months 1033 questionnaires were received from 81 participants, and during months four through six, 563 questionnaires were received from 45 participants.

Adherence

All 81 included participants remained to the 3-month follow-up. At the 3-month follow-up, 54 participants identified from the single or double dose of probiotic groups in the blinded phase were asked to continue with a higher dose of probiotics. Six participants declined further participation, two participants started the second phase, but dropped out, and one participant was excluded due to adverse event (obstipation concurrent with vomiting and gastrointestinal pain). Hence, 45 participants attended the 6-month follow-up visit.

Weekly electronic questionnaires asked if capsules had been missed, and if so, how many. During the first 3 months, all participants responded to at least 11 out of 12-14 weekly questionnaires (depending upon follow-up date). During months four through six, all participants responded to at least 11 out of 12-14 weekly questionnaires (depending upon follow-up date). Responses are presented at an aggravated level in Table 2.

Primary aim

The median (range) 3-month follow-up time was 91 (87-105) days, and the median 6-month follow-up was 182 (178-195) days. The longer follow-up time for some participants was due to current Covid-19 restrictions.

On average, all studied participants (n = 81) lost 0.6 kg in weight during the blinded 3-month phase. There was no difference in weight changes between the investigated groups (p = 0.89), Table 3. Analyses within groups revealed that none of the groups changed their weight statistically significant from baseline to follow-up, all p > 0.05.

After 6 months, the participating individuals (n = 45) had an average weight loss from baseline of 1.4 kg, p = 0.033, Table 4. When investigating each arm separately the 6-month weight loss in the group with single + triple dose probiotics (n = 24) was 0.94 kg, which was not a statistically significant weight loss from baseline, p = 0.34. However, the group that received double + triple dose probiotics (n = 21 47% of the available participants) had a statistically significant weight loss from baseline of 1.93 kg, p = 0.027, Fig. 2. There was no difference in weight changes between the investigated groups after 6 months (p = 0.44), Table 4.

Average change in weight from baseline stratified by group. Error bars represent standard error.

Secondary aims

Changes in secondary aim variables and differences between groups after 3 and 6 months are provided in Tables 3 and 4 respectively.

BMI

After 3 months were there no differences in BMI changes between the investigated groups (p = 0.89), nor within each group (all p > 0.05). After 6 months there was a decrease in BMI from baseline to 6-month follow-up of 0.48 kg/m ², p = 0.027. The change in BMI did not differ statistically significant between the groups, p = 0.38. After stratification for initial probiotic dose, the group that started with double dose followed by triple dose (n = 21) decreased their BMI of 0.67 kg/m ², p = 0.027, whereas the group that started with single dose followed by triple dose (n = 24) decreased their BMI of 0.30 kg/m ², p = 0.33.

Waist circumference

There were no differences in change in waist circumference after 3 months between the investigated groups (p = 0.41). For those who continued with triple dose probiotics (n = 45), the waist circumference decreased from baseline to 6-month follow-up by 2.8 cm, p = 0.002.

Blood pressure

All groups decreased their blood pressure from baseline to 3-month follow-up, all p < 0.05, but the decrease was not different between the groups, both p > 0.75. Fort those who continues with triple dose probiotics (n = 45), the systolic and diastolic blood pressure decreased from baseline to 6-month follow-up by 6.9 mmHg and 5.8 mmHg respectively, both p < 0.0001.

Blood lipids

There were no changes in the levels of total cholesterol, LDL after 3 and 6 months, and no differences between the groups, all p > 0.05.

Both the placebo and the double dose probiotic group decreased the level of HDL from baseline to the 3-month follow-up with a mean (SD) of 0.10 (0.14) mmol/L, p < 0.001 and 0.11 (0.23) mmol/L, p = 0.023, respectively. However, there was no change in the level of HDL cholesterol from baseline to 6-month follow-up (− 0.03 mmol/L, p = 0.46). No differences between the groups were observed, all p > 0.05.

No group changed on average the level of triglycerides from baseline to the 3-month follow-up (all p > 0.05), and no changes between the groups were observed (p = 0.29). For those who continued with triple dose probiotics, the triglycerides decreased from baseline to 6-month follow-up by 0.22 mmol/L, p = 0.036.

Glucose metabolism

During the first 3 months, no group changed on average the level of fasting glucose, HbA1c or insulin from baseline, and no changes between the groups were observed (all p > 0.05). For those who continued with triple dose probiotics, there was a borderline statistically significant decrease from baseline in fasting glucose (− 0.10 mmol/L, p = 0.057) and HbA1c (− 0.40 mmol/mol, p = 0.056), whereas there were no changes in the level of fasting insulin from baseline to 6-month follow-up (− 0.45 mIU/L, p = 0.43.

Liver enzymes

No group changed on average the level of ALT from baseline to the 3-month follow-up (all p > 0.05), and no changes between the groups were observed (p = 0.79). At the 6-month follow-up, a minor increase in ALT levels from baseline was observed, + 0.07 µkat/L (p = 0.038). There were no differences between the groups, p = 0.82.

Inflammatory marker

There were no changes in hsCRP after 3 or 6 months, and no differences between the groups, all p > 0.05.

Vitamins

There were no changes in fat-soluble vitamins at 3-month not 6-month follow-up.

Blood cell composition

No changes in blood cell composition, neither between nor within groups, were observed after 3 months. After 6 months there was no change in the levels of leukocytes, mean corpuscular volume, mean corpuscular hemoglobin, or thrombocytes. However, there was a marginal decrease in the levels of erythrocytes, hemoglobin, and hematocrit. When the analyses were stratified for sex, the decrease was only observed among women (data now shown).

Bowel habits

Individuals who reported changes in bowel habits any time during the study were prevalent and similar between the groups; Placebo group 70.4%, single dose probiotic group 66.6%, double dose probiotic group 66.6%, triple dose probiotic group 68.9% (p = 0.99). The most common reported changes in bowel habits were changes in stool consistency and frequency of defecation. Nor were there any statistically significant differences in reported gastrointestinal problems between the groups. Frequencies of individuals that at some time reported gastrointestinal problems were 33.3% in the placebo group, 55.6% in the single dose probiotic group, 59.3% in the double dose probiotic group, and 55.6% in the triple dose probiotic group, p = 0.20. The most common reported gastro-intestinal problems included flatulence, upset stomach, and feeling of nausea.

Bowel habits were retrieved from weekly electronic questionnaires. During months four through six, all individuals responded to at least 11 out of 12-14 weekly questionnaires (depending upon follow-up date). No statistically significant changes in bowel habits or gastro-intestinal problems were observed between consumed dosage, neither for number of individuals that reported them, or number of weeks reported. Number of individuals and frequencies of reported answers are presented in Tables 5 and 6. The most common reported changes in bowel habits were changes in stool consistency and frequency of defecation. The most common reported gastro-intestinal problems included flatulence, upset stomach, and feeling of nausea.

Excluded participant

One individual, a male, who received double dose AB001 during phase one, was excluded due to adverse events. He reported on day 159 that he had severe stomachache, obstipation, and concurrent vomiting. There was no gastroenteritis observed among friends and family. The study team instructed him to stop taking probiotics and thereby discontinue the study participation. He did not require any medical assistance. Four to five days after stop taking probiotics, he reported that he had a normal gastrointestinal function again. As a safety precaution he was taken back for a check-up. Approximately 1 month after not taking the probiotic compound he had no gastrointestinal symptoms. From baseline, the individual had lost 2.3 kg in weight, corresponding to a decrease in BMI of 0.69 kg/m ². Overall, the biochemical profile remained unchanged. At follow-up, CRP remained low (1 mg/L). Total cholesterol and LDL were borderline high (6.1mmol/L and 4.4 mmol/L respectively). HDL, triglycerides, glucose, insulin, HbA1c, and ALT remained normal.

Discussion

In this study, we assess the impact of the probiotic compound AB001 on weight loss among individuals with overweight. During the initial 3-month double-blinded placebo-controlled phase, no difference in weight was observed between the groups using placebo, single dose, or double dose of the compound. During the second phase, individuals who were administrated a, high dose probiotic, i.e. first double and then triple dose, experienced a statistically significant weight reduction from their baseline of approximately 2 kg.

Some probiotic compounds have demonstrated an advantage over placebos in facilitating weight loss among both adult and pediatric populations with excessive weight, suggesting a potential beneficial role of probiotics in weight management strategies7,8,16,17. It should be noted, though, that this outcome is not a consensus, as some studies have reported contrasting findings18. In the present study, a modest reduction in weight was observed from baseline to the 6-month follow-up among participants who completed the full study. Even though it is possible that the provided pamphlet of dietary habits may have contributed to this effect, there is a possibility that an association exists between AB001 dosage and time, indicative of a potential dose-response relationship. This is supported by the fact that the impact on weight (and BMI) was more pronounced in cases where individuals consumed a double dose, followed by a triple dose, over an additional 3-month period. The observed weight reduction, though statistically significant, is below the clinically relevant threshold of an annual decrease of 5%, known to enhance cardiometabolic health in individuals with obesity19. Notably, our study focused on otherwise healthy overweight participants over 6 months, potentially impacting the magnitude of observed effects.

Probiotics, whether residing in the gut or passing through, have diverse effects on the host. They modulate gut functions, bolster immune responses, influence metabolism, and regulate food intake signals20. Interestingly, probiotics' interactions with host epithelial cells can lead to beneficial changes in their behavior, enhancing their symbiotic relationship with the host20. Bacillus coagulans, which is one of the major strains in AB001, has been shown to improve the utilization of consumed foods, mainly due to its capacity to produce a range of enzyme, such as lipases and galactosidases21. Individuals with a normal weight harbor a distinct gut bacterial composition compared to those with overweight or obesity, which may be of importance for the understanding of the variable effects observed in different studies22,23. The modulation of the bacterial strains in the digestive tract may help to reshape the metabolic profile in humans with obesity as suggested by several data from animal and human studies20,23. Moreover, the effectiveness of probiotic supplements in facilitating weight loss has been linked with specific dosages and types of probiotics, highlighting that the beneficial impacts are not universally observed and may depend on several factors including the choice of probiotic strains24,25,26. Thus, further investigations into the dose-dependency and strain-specific effects of probiotics are warranted to elucidate their potential role in managing obesity and optimizing metabolic health.

The aim of the second phase was primarily to evaluate safety and potential side effects. Potential harm of probiotics is rarely discussed, and it is therefore warranted to investigating side effects of probiotic supplementation20,28. We could not observe any gastro-intestinal harm of increased probiotic dose. About 2/3 reported changes in bowel habits and between 55 and 60% reported intermittent gastro-intestinal problems regardless of probiotic dose or placebo consumed. Given that the triple dose was preceded with either single or double dose of AB001, we cannot exclude that there was an adaptation to the higher consumed dose of probiotics. One individual reported severe stomach pains after 5 months, but whether it was caused by the tested compound is unclear as no similar signs were observed among the other participants.

The compliance and adherence to the study protocol was very good. The study coordinator had regular contact with the participants via the digital support system and as the weekly weight measurements were automatically transferred to the database. Via the study app reminders could be sent out if data was missing. Together this probably contributed to the low dropout rate.

The effect of probiotics on biomarkers have been investigated with mixed findings16,21. We found some beneficial changes of clinical investigations and biomarkers. Both systolic and diastolic blood pressure decreased over the six investigated months. Further, in the total sample a minor, yet statistically significant decrease in triglycerides was observed. Both fasting glucose and HbA1c decreased with borderline statistical significance in the full sample. A slight increase in ALT was observed over the studied period. If the observed changes are due to the probiotic supplement or secondary to lifestyle changes remains to be evaluated in a long-term high dose placebo controlled clinical trial.

The minor changes in erythrocytes, hemoglobin and hematocrit were only observed among women. Since other biomarkers of diet and inflammation (e.g. lipid profile, vitamins, and CRP) remained normal, it is likely that the observed minor change was due to physiological alterations caused by menstruation.

Even though the study was well conducted, there are some limitations that should be acknowledged. We did not collect any objective measures of mediators for weight gain or weight loss, e.g. amount of physical activity or dietary changes. However, we did collect objectively measured weight throughout the study. Further, despite the relatively large sample size, the heterogeneity prevented us from making post-hoc analyses to investigate potential effects in subgroups, e.g. having heredity for overweight or obesity. Moreover, due to the study design allowing participant continuation of probiotics from the initial phase, randomization unblinding took place before data analysis. The robust nature of the exclusion criteria, such as the deliberate exclusion of weight-related comorbidities, might potentially limit the extent to which these findings can be extrapolated to a broader population.

Conclusion

In this trial testing probiotics for weight loss, no effect was observed after the double-blinded 3-month phase. For those who received double dose for 3 months who continued with triple dose for another 3 months in the open study phase, a modest but significant weight loss of approximately 2 kg or 0.7 BMI units was observed. A reduction in blood pressure was also noted. The current study provides evidence that a double and triple dose of the probiotic compound AB001 is well tolerated and can be consumed safely by adults. Further studies are required to certify to which extent this compound can facilitate weight loss and metabolic benefits.

Acknowledgements

We would like to thank all study individuals for their participation in the trial. Also, a great acknowledgement to our research nurse Monika Grzeskowiak for your phenomenal engagement.

Funding

Open access funding provided by Karolinska Institute. The funder, de Faire Medical AB (Sweden), manufacturer of the studied probiotics and provided matching placebo at no cost. Further, the funder provided Karolinska Institutet financial compensation for study-related expenses such as costs for analyses of blood samples and study subject reimbursement. The funder of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the report. The corresponding author had full access to all the data in the study and had final responsibility for the decision to submit for publication.

Author information

Authors and Affiliations

Division of Pediatrics, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Solna, Sweden

Pernilla Danielsson, Resthie R. Putri, Claude Marcus & Emilia Hagman

Contributions

Conceptualization: P.D., C.M., E.H. Investigation: P.D., R.R.P., C.M., E.H. Data curation: E.H. Formal analyses: E.H. Project administration: E.H. Resources: P.D., R.R.P., C.M., E.H. Writing-original draft: E.H. Writing-review and editing: P.D., R.R.P., C.M.

Corresponding author

Correspondence to Emilia Hagman.

Ethics declarations

Competing interests

CM is acting as a scientific advisor for the sponsoring company de Faire Medical AB. EH have reviewed research data from other trials sponsored by de Faire Medical AB. PD and RRP declare no competing interests.

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Danielsson, P., Putri, R.R., Marcus, C. et al. Evaluating probiotic efficacy on weight loss in adults with overweight through a double-blind, placebo-controlled randomized trial. Sci Rep 13, 18200 (2023). https://doi.org/10.1038/s41598-023-45395-7
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DOI: https://doi.org/10.1038/s41598-023-45395-7

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Evaluating probiotic efficacy on weight loss in adults with overweight through a double-blind, placebo-controlled randomized trial - Scientific Reports

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The aim was to assess the weight-reducing effects of various doses of a probiotic dietary supplement and evaluate the tolerance and safety of increased dosage. A 3-month double-blinded, randomized, placebo-controlled trial, followed by a 3-month open phase, was conducted at Karolinska Institutet, Sweden.

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1. Identify Knowledge Gaps and Areas of Interest:

Review existing literature to identify gaps in current knowledge.

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Consider interdisciplinary perspectives to uncover novel intersections and potential research avenues. Ie Look at other disciplines - can you apply different areas of knowledge to your topic

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O-linked N-acetylglucosamine (O-GlcNAc) is an endogenous form of glycosylation that alters the structure of α-synuclein amyloid fibrils and attenuates their pathogenetic properties. The modified fibrils have a significantly reduced ability to seed the aggregation of endogenous α-synuclein in cultured neurons and in mice brains in vivo, which results in reduced pathology.

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Neuroscience - Latest research and news | Nature

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O-linked N-acetylglucosamine (O-GlcNAc) is an endogenous form of glycosylation that alters the structure of α-synuclein amyloid fibrils and attenuates their pathogenetic properties. The modified fibrils have a significantly reduced ability to seed the aggregation of endogenous α-synuclein in cultured neurons and in mice brains in vivo, which results in reduced pathology.

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A short read from Harvard business insider on what makes a good presentation...

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A little more than a year ago, on a trip to Nairobi, Kenya, some colleagues and I met a 12-year-old Masai boy named Richard Turere, who told us a fascinating story. His family raises livestock on the edge of a vast national park, and one of the biggest challenges is protecting the animals from lions-especially at night. Richard had noticed that placing lamps in a field didn't deter lion attacks, but when he walked the field with a torch, the lions stayed away. From a young age, he'd been interested in electronics, teaching himself by, for example, taking apart his parents' radio. He used that experience to devise a system of lights that would turn on and off in sequence-using solar panels, a car battery, and a motorcycle indicator box-and thereby create a sense of movement that he hoped would scare off the lions. He installed the lights, and the lions stopped attacking. Soon villages elsewhere in Kenya began installing Richard's "lion lights."

A version of this article appeared in the June 2013 issue of Harvard Business Review.

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For more than 30 years, the TED conference series has presented enlightening talks that people enjoy watching. In this article, Anderson, TED's curator, shares five keys to great presentations: Frame your story (figure out where to start and where to end).

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Introduction

The "presentation slide" is the building block of all academic presentations, whether they are journal clubs, thesis committee meetings, short conference talks, or hour-long seminars. A slide is a single page projected on a screen, usually built on the premise of a title, body, and figures or tables and includes both what is shown and what is spoken about that slide. Multiple slides are strung together to tell the larger story of the presentation. While there have been excellent 10 simple rules on giving entire presentations [ 1, 2], there was an absence in the fine details of how to design a slide for optimal effect-such as the design elements that allow slides to convey meaningful information, to keep the audience engaged and informed, and to deliver the information intended and in the time frame allowed. As all research presentations seek to teach, effective slide design borrows from the same principles as effective teaching, including the consideration of cognitive processing your audience is relying on to organize, process, and retain information. This is written for anyone who needs to prepare slides from any length scale and for most purposes of conveying research to broad audiences. The rules are broken into 3 primary areas. Rules 1 to 5 are about optimizing the scope of each slide. Rules 6 to 8 are about principles around designing elements of the slide. Rules 9 to 10 are about preparing for your presentation, with the slides as the central focus of that preparation.

Rule 1: Include only one idea per slide

Each slide should have one central objective to deliver-the main idea or question [ 3- 5]. Often, this means breaking complex ideas down into manageable pieces (see Fig 1 , where "background" information has been split into 2 key concepts). In another example, if you are presenting a complex computational approach in a large flow diagram, introduce it in smaller units, building it up until you finish with the entire diagram. The progressive buildup of complex information means that audiences are prepared to understand the whole picture, once you have dedicated time to each of the parts. You can accomplish the buildup of components in several ways-for example, using presentation software to cover/uncover information. Personally, I choose to create separate slides for each piece of information content I introduce-where the final slide has the entire diagram, and I use cropping or a cover on duplicated slides that come before to hide what I'm not yet ready to include. I use this method in order to ensure that each slide in my deck truly presents one specific idea (the new content) and the amount of the new information on that slide can be described in 1 minute (Rule 2), but it comes with the trade-off-a change to the format of one of the slides in the series often means changes to all slides.

Rule 2: Spend only 1 minute per slide

When you present your slide in the talk, it should take 1 minute or less to discuss. This rule is really helpful for planning purposes-a 20-minute presentation should have somewhere around 20 slides. Also, frequently giving your audience new information to feast on helps keep them engaged. During practice, if you find yourself spending more than a minute on a slide, there's too much for that one slide-it's time to break up the content into multiple slides or even remove information that is not wholly central to the story you are trying to tell. Reduce, reduce, reduce, until you get to a single message, clearly described, which takes less than 1 minute to present.

Rule 3: Make use of your heading

When each slide conveys only one message, use the heading of that slide to write exactly the message you are trying to deliver. Instead of titling the slide "Results," try "CTNND1 is central to metastasis" or "False-positive rates are highly sample specific." Use this landmark signpost to ensure that all the content on that slide is related exactly to the heading and only the heading. Think of the slide heading as the introductory or concluding sentence of a paragraph and the slide content the rest of the paragraph that supports the main point of the paragraph. An audience member should be able to follow along with you in the "paragraph" and come to the same conclusion sentence as your header at the end of the slide.

Rule 4: Include only essential points

While you are speaking, audience members' eyes and minds will be wandering over your slide. If you have a comment, detail, or figure on a slide, have a plan to explicitly identify and talk about it. If you don't think it's important enough to spend time on, then don't have it on your slide. This is especially important when faculty are present. I often tell students that thesis committee members are like cats: If you put a shiny bauble in front of them, they'll go after it. Be sure to only put the shiny baubles on slides that you want them to focus on. Putting together a thesis meeting for only faculty is really an exercise in herding cats (if you have cats, you know this is no easy feat). Clear and concise slide design will go a long way in helping you corral those easily distracted faculty members.

Rule 5: Give credit, where credit is due

An exception to Rule 4 is to include proper citations or references to work on your slide. When adding citations, names of other researchers, or other types of credit, use a consistent style and method for adding this information to your slides. Your audience will then be able to easily partition this information from the other content. A common mistake people make is to think "I'll add that reference later," but I highly recommend you put the proper reference on the slide at the time you make it, before you forget where it came from. Finally, in certain kinds of presentations, credits can make it clear who did the work. For the faculty members heading labs, it is an effective way to connect your audience with the personnel in the lab who did the work, which is a great career booster for that person. For graduate students, it is an effective way to delineate your contribution to the work, especially in meetings where the goal is to establish your credentials for meeting the rigors of a PhD checkpoint.

Rule 6: Use graphics effectively

As a rule, you should almost never have slides that only contain text. Build your slides around good visualizations. It is a visual presentation after all, and as they say, a picture is worth a thousand words. However, on the flip side, don't muddy the point of the slide by putting too many complex graphics on a single slide. A multipanel figure that you might include in a manuscript should often be broken into 1 panel per slide (see Rule 1). One way to ensure that you use the graphics effectively is to make a point to introduce the figure and its elements to the audience verbally, especially for data figures. For example, you might say the following: "This graph here shows the measured false-positive rate for an experiment and each point is a replicate of the experiment, the graph demonstrates ..." If you have put too much on one slide to present in 1 minute (see Rule 2), then the complexity or number of the visualizations is too much for just one slide.

Rule 7: Design to avoid cognitive overload

The type of slide elements, the number of them, and how you present them all impact the ability for the audience to intake, organize, and remember the content. For example, a frequent mistake in slide design is to include full sentences, but reading and verbal processing use the same cognitive channels-therefore, an audience member can either read the slide, listen to you, or do some part of both (each poorly), as a result of cognitive overload [ 4]. The visual channel is separate, allowing images/videos to be processed with auditory information without cognitive overload [ 6] (Rule 6). As presentations are an exercise in listening, and not reading, do what you can to optimize the ability of the audience to listen. Use words sparingly as "guide posts" to you and the audience about major points of the slide. In fact, you can add short text fragments, redundant with the verbal component of the presentation, which has been shown to improve retention [ 7] (see Fig 1 for an example of redundant text that avoids cognitive overload). Be careful in the selection of a slide template to minimize accidentally adding elements that the audience must process, but are unimportant. David JP Phillips argues (and effectively demonstrates in his TEDx talk [ 5]) that the human brain can easily interpret 6 elements and more than that requires a 500% increase in human cognition load-so keep the total number of elements on the slide to 6 or less. Finally, in addition to the use of short text, white space, and the effective use of graphics/images, you can improve ease of cognitive processing further by considering color choices and font type and size. Here are a few suggestions for improving the experience for your audience, highlighting the importance of these elements for some specific groups:

Use high contrast colors and simple backgrounds with low to no color-for persons with dyslexia or visual impairment.

Use sans serif fonts and large font sizes (including figure legends), avoid italics, underlining (use bold font instead for emphasis), and all capital letters-for persons with dyslexia or visual impairment [ 8].

Use color combinations and palettes that can be understood by those with different forms of color blindness [ 9]. There are excellent tools available to identify colors to use and ways to simulate your presentation or figures as they might be seen by a person with color blindness (easily found by a web search).

In this increasing world of virtual presentation tools, consider practicing your talk with a closed captioning system capture your words. Use this to identify how to improve your speaking pace, volume, and annunciation to improve understanding by all members of your audience, but especially those with a hearing impairment.

Rule 8: Design the slide so that a distracted person gets the main takeaway

It is very difficult to stay focused on a presentation, especially if it is long or if it is part of a longer series of talks at a conference. Audience members may get distracted by an important email, or they may start dreaming of lunch. So, it's important to look at your slide and ask "If they heard nothing I said, will they understand the key concept of this slide?" The other rules are set up to help with this, including clarity of the single point of the slide (Rule 1), titling it with a major conclusion (Rule 3), and the use of figures (Rule 6) and short text redundant to your verbal description (Rule 7). However, with each slide, step back and ask whether its main conclusion is conveyed, even if someone didn't hear your accompanying dialog. Importantly, ask if the information on the slide is at the right level of abstraction. For example, do you have too many details about the experiment, which hides the conclusion of the experiment (i.e., breaking Rule 1)? If you are worried about not having enough details, keep a slide at the end of your slide deck (after your conclusions and acknowledgments) with the more detailed information that you can refer to during a question and answer period.

Rule 9: Iteratively improve slide design through practice

Well-designed slides that follow the first 8 rules are intended to help you deliver the message you intend and in the amount of time you intend to deliver it in. The best way to ensure that you nailed slide design for your presentation is to practice, typically a lot. The most important aspects of practicing a new presentation, with an eye toward slide design, are the following 2 key points: (1) practice to ensure that you hit, each time through, the most important points (for example, the text guide posts you left yourself and the title of the slide); and (2) practice to ensure that as you conclude the end of one slide, it leads directly to the next slide. Slide transitions, what you say as you end one slide and begin the next, are important to keeping the flow of the "story." Practice is when I discover that the order of my presentation is poor or that I left myself too few guideposts to remember what was coming next. Additionally, during practice, the most frequent things I have to improve relate to Rule 2 (the slide takes too long to present, usually because I broke Rule 1, and I'm delivering too much information for one slide), Rule 4 (I have a nonessential detail on the slide), and Rule 5 (I forgot to give a key reference). The very best type of practice is in front of an audience (for example, your lab or peers), where, with fresh perspectives, they can help you identify places for improving slide content, design, and connections across the entirety of your talk.

Rule 10: Design to mitigate the impact of technical disasters

The real presentation almost never goes as we planned in our heads or during our practice. Maybe the speaker before you went over time and now you need to adjust. Maybe the computer the organizer is having you use won't show your video. Maybe your internet is poor on the day you are giving a virtual presentation at a conference. Technical problems are routinely part of the practice of sharing your work through presentations. Hence, you can design your slides to limit the impact certain kinds of technical disasters create and also prepare alternate approaches. Here are just a few examples of the preparation you can do that will take you a long way toward avoiding a complete fiasco:

Save your presentation as a PDF-if the version of Keynote or PowerPoint on a host computer cause issues, you still have a functional copy that has a higher guarantee of compatibility.

In using videos, create a backup slide with screen shots of key results. For example, if I have a video of cell migration, I'll be sure to have a copy of the start and end of the video, in case the video doesn't play. Even if the video worked, you can pause on this backup slide and take the time to highlight the key results in words if someone could not see or understand the video.

Avoid animations, such as figures or text that flash/fly-in/etc. Surveys suggest that no one likes movement in presentations [ 3, 4]. There is likely a cognitive underpinning to the almost universal distaste of pointless animations that relates to the idea proposed by Kosslyn and colleagues that animations are salient perceptual units that captures direct attention [ 4]. Although perceptual salience can be used to draw attention to and improve retention of specific points, if you use this approach for unnecessary/unimportant things (like animation of your bullet point text, fly-ins of figures, etc.), then you will distract your audience from the important content. Finally, animations cause additional processing burdens for people with visual impairments [ 10] and create opportunities for technical disasters if the software on the host system is not compatible with your planned animation.

Conclusions

These rules are just a start in creating more engaging presentations that increase audience retention of your material. However, there are wonderful resources on continuing on the journey of becoming an amazing public speaker, which includes understanding the psychology and neuroscience behind human perception and learning. For example, as highlighted in Rule 7, David JP Phillips has a wonderful TEDx talk on the subject [ 5], and "PowerPoint presentation flaws and failures: A psychological analysis," by Kosslyn and colleagues is deeply detailed about a number of aspects of human cognition and presentation style [ 4]. There are many books on the topic, including the popular "Presentation Zen" by Garr Reynolds [ 11]. Finally, although briefly touched on here, the visualization of data is an entire topic of its own that is worth perfecting for both written and oral presentations of work, with fantastic resources like Edward Tufte's "The Visual Display of Quantitative Information" [ 12] or the article "Visualization of Biomedical Data" by O'Donoghue and colleagues [ 13].

Acknowledgments

I would like to thank the countless presenters, colleagues, students, and mentors from which I have learned a great deal from on effective presentations. Also, a thank you to the wonderful resources published by organizations on how to increase inclusivity. A special thanks to Dr. Jason Papin and Dr. Michael Guertin on early feedback of this editorial.

Funding Statement

The author received no specific funding for this work.

References

4. Kosslyn SM, Kievit RA, Russell AG, Shephard JM. PowerPoint® presentation flaws and failures: A psychological analysis. Front Psychol. 2012;3:1-22. doi: 10.3389/fpsyg.2012.00001 [[ PubMed] [ CrossRef] PMC free article] [ Google Scholar]

5. Phillips DJ. How to avoid death by PowerPoint. TEDxStocholmSalon. 2014. [ Google Scholar]

6. Mayer RE, Moreno R. Nine Ways to Reduce Cognitive Load in Multimedia Learning. Educ Psychol. 2003;38:43-52. doi: 10.1007/s10509-010-0328-8 [[ CrossRef] Google Scholar]

7. Mayer RE, Johnson CI. Revising the Redundancy Principle in Multimedia Learning. J Educ Psychol. 2008;100:380-6. doi: 10.1037/0022-0663.100.2.380 [[ CrossRef] Google Scholar]

11. Reynolds G. Presentation Zen: Simple Ideas on Presentation Design and Delivery. 2nd ed. New Riders Pub; 2011. [ Google Scholar]

12. Tufte ER. The Visual Display of Quantitative Information. 2nd ed. Graphics Press; 2001. [ Google Scholar]

13. O'Donoghue SI, Baldi BF, Clark SJ, Darling AE, Hogan JM, Kaur S, et al. Visualization of Biomedical Data. Annu Rev Biomed Data Sci. 2018;1:275-304. doi: 10.1146/annurev-biodatasci-080917-013424 [[ CrossRef] Google Scholar]

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Ten simple rules for effective presentation slides

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The "presentation slide" is the building block of all academic presentations, whether they are journal clubs, thesis committee meetings, short conference talks, or hour-long seminars. A slide is a single page projected on a screen, usually built on the premise of a title, body, and figures or tables and includes both what is shown and what is spoken about that slide.

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https://www.nejm.org/doi/full/10.1056/NEJMe2314434?query=neurology-neurosurgery&cid=DM2328424_Non_Subscriber&bid=2135493185

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