bluuebunny/crossref_metadata_2025 huggingface dataset:
Direct imaging of topological edge states in cold-atom systems
Authors: Goldman Nathan , Dalibard Jean , Dauphin Alexandre , Gerbier Fabrice , Lewenstein Maciej , Zoller Peter , Spielman Ian B.
Published: April 2013

Detecting topological order in cold-atom experiments is an ongoing challenge, the resolution of which offers novel perspectives on topological matter. In material systems, unambiguous signatures of topological order exist for topological insulators and quantum Hall devices. In quantum Hall systems, the quantized conductivity and the associated robust propagating edge modes—guaranteed by the existence of nontrivial topological invariants—have been observed through transport and spectroscopy measurements. Here, we show that optical-lattice-based experiments can be tailored to directly visualize the propagation of topological edge modes. Our method is rooted in the unique capability for initially shaping the atomic gas and imaging its time evolution after suddenly removing the shaping potentials. Our scheme, applicable to an assortment of atomic topological phases, provides a method for imaging the dynamics of topological edge modes, directly revealing their angular velocity and spin structure.
Dengue structure differs at the temperatures of its human and mosquito hosts
Authors: Zhang Xinzheng , Sheng Ju , Plevka Pavel , Kuhn Richard J. , Diamond Michael S. , Rossmann Michael G.
Published: April 2013

We report on a conformational transition of dengue virus when changing the temperature from that present in its mosquito vectors to that of its human host. Using cryoelectron microscopy, we show that although the virus has a smooth surface, a diameter of ∼500 Å, and little exposed membrane at room temperature, the virions have a bumpy appearance with a diameter of ∼550 Å and some exposed membrane at 37 °C. The bumpy structure at 37 °C was found to be similar to the previously predicted structure of an intermediate between the smooth mature and fusogenic forms. As humans have a body temperature of 37 °C, the bumpy form of the virus would be the form present in humans. Thus, optimal dengue virus vaccines should induce antibodies that preferentially recognize epitopes exposed on the bumpy form of the virus.
Fishing and Natural Mortality Rates of Atlantic Halibut Estimated from Multiyear Tagging and Life History
Authors: den Heyer Cornelia E. , Schwarz Carl James , Trzcinski M. Kurtis
Published: April 2013

Fishing mortality and natural mortality rates for Atlantic HalibutHippoglossus hippoglossuson the Scotian Shelf and southern Grand Banks were estimated from a multiyear tagging study. Models that were used to estimate mortality rates incorporated tag loss. Between 2006 and 2008, 1,913 Atlantic Halibut were double‐tagged with t‐bar anchor tags; as of 26 August 2010, 368 of these fish had been recaptured. We estimated instantaneous fishing mortality (F) separately for each cohort in the first year (on average, 6 months) after release to allow newly tagged animals to mix with the population. A two‐parameter model was used to describe tag loss. Tag loss was estimated at 13% per year in the first year and 10% per year in the second and subsequent years. Using the multiyear model with incomplete mixing and assuming 90% tag reporting and 80% survival from tagging, average instantaneous natural mortality (M) of Atlantic Halibut was estimated to be 0.22 andFwas estimated to be 0.15 in 2007, 0.24 in 2008, and 0.18 in 2009. These estimates ofFwere comparable to those from the stock assessment population model. However, the estimates ofMwere higher than inferred estimates ofMbased on life history and growth. Estimates ofFandMwere sensitive to the minimum size of Atlantic Halibut at the time of release. An increase inFwith size is consistent with fishery size selectivity resulting from either gear selectivity or the distribution of fishing effort where there is spatial heterogeneity in the size composition. We suggest thatMmay have been overestimated because of emigration from the study area.
Comparative Dispersal Patterns for Recolonizing Cedar River Chinook Salmon above Landsburg Dam, Washington, and the Source Population below the Dam
Authors: Burton Karl D. , Lowe Larry G. , Berge Hans B. , Barnett Heidy K. , Faulds Paul L.
Published: April 2013

Anadromous salmonid populations are particularly vulnerable to migration blockages, such as dams and culverts, because access to historic spawning and rearing habitats is prevented. The process of salmonid recolonization has not been well documented for river systems where anthropogenic migration barriers have been removed or where fish passage facilities have been constructed. In September 2003, Seattle Public Utilities completed construction of a fish passage facility that circumvented Landsburg Dam on the Cedar River, Washington. Chinook Salmon Oncorhynchus tshawytscha spawned in newly available main‐stem habitats immediately after fish passage facility construction and in all subsequent years. Further dispersal into tributary habitats occurred 5 years after construction. Redds tended to be concentrated in the downstream third of the available habitat above the dam, although some fish did utilize suitable spawning sites throughout the main stem, even in the uppermost reaches of the newly available habitat. Median spawn timing for redds observed above the dam was not significantly different from spawn timing for the source population, indicating that migration delays through the fish passage facility were minimal. Male Chinook Salmon consistently outnumbered females, with annual sex ratios ranging from 1.3:1 to 4.7:1. Chinook Salmon spawning above the dam contributed between 2.7% and 14.7% of the total annual redd count (2003–2010) for Cedar River Chinook Salmon; upstream redds as a percentage of total redds increased over time, indicating that a new, naturally reproducing population above the dam was growing. The proportion of hatchery‐origin fish spawning above the dam decreased over the duration of the study but was consistently higher than the hatchery component observed below the dam.
Timing and Extent of Drift of Shortnose Sturgeon Larvae in the Saint John River, New Brunswick, Canada
Authors: Usvyatsov Sima , Picka Jeffrey , Taylor Andrew , Watmough James , Litvak Matthew Kenneth
Published: April 2013

Little is known about the dispersal of Shortnose Sturgeon Acipenser brevirostrum larvae in the wild. In the Saint John River, New Brunswick, we captured a total of 2,251, 460, 2,100, and 2,083 larvae in 2008–2011, respectively; abundance estimates ranged between 21,000 (2009) and 244,687 larvae (2008). A substantial reduction in larval numbers (49–76%) was recorded over the 4.5‐km distance between the two sampling transects deployed in 2008–2010. We found no consistent pattern of larval distribution across the channel, but we recorded a consistent, significant preference for nighttime (dusk to dawn) over daytime dispersal. Generalized linear models were used to examine the timing and extent of larval migration in the Saint John River during the study period. Logistic models incorporating water temperature and Mactaquac Dam discharge provided good predictions of the timing of larval migration. The probability of larval presence was highest when water temperature reached 15°C. At this temperature, larvae were predicted to disperse when nighttime total dam discharge was 20 106 to 30 106 m3. The extent of larval migration was described using negative binomial models, which indicated that dam discharge and transect location significantly influenced the number of drifting larvae. However, data variability was high, reducing predictive capability. Our findings include the first report of Shortnose Sturgeon larval abundances in the Saint John River. The predictions of timing and extent of drift provide information for future sampling and conservation efforts during this vulnerable period as well as insight into the relationships between environmental variables and larval drift in this protected species.
Basins for Fish and Ecoregions for Macroinvertebrates: Different Spatial Scales Are Needed to Assess Louisiana Wadeable Streams
Authors: Kaller Michael D. , Murphy Catherine E. , Kelso William E. , Stead Mark R.
Published: April 2013

We targeted wadeable streams in six USEPA Level III ecoregions spanning eight major study basins in northern Gulf of Mexico coastal plains and terraces to identify appropriate spatial frameworks for the assessment of stream quality, as well as fish species and macroinvertebrate families that were characteristic of least disturbed conditions. We analyzed previously collected (1990–2006) and recently collected (2005–2010) stream fish and macroinvertebrate data with mean similarity analysis to identify spatial frameworks, either basins or ecoregions, appropriate for the assessment of stream fish and macroinvertebrates. We also conducted partial redundancy analysis of fish and macroinvertebrates separately, controlling for differences in stream size, and variance partitioning to identify the variation attributable to ecoregion or basin as a measure of the importance of spatial influence. Our results indicated that fish distributions were better described by basins, with anticipated strong dissimilarities in fish community composition between river basins west and east of the Mississippi River. In addition, we found unexpected differences in Pearl River and Red River basin fish communities relative to neighboring study basins and unexpected similarities among the geographically distant fish communities in the Western Gulf Coastal Plain and Mississippi Alluvial Plain Ecoregions. Conversely, once we accounted for the expected dissimilarity caused by the Mississippi River, macroinvertebrate data were better explained by ecoregion than basin. Our analyses indicated that the incorporation of both spatial classifications for assessment will be necessary in this region.
Intraspecific Differences in Thermal Biology among Inland Lake Trout Populations
Authors: McDermid Jenni L. , Wilson Chris C. , Sloan William N. , Shuter Brian J.
Published: April 2013

The ability of coldwater species and populations to respond to the predicted temperature increases associated with climate change will largely depend on existing adaptive potential within and among populations. Southern inland populations of Lake Trout Salvelinus namaycush are broadly characterized by two ecotypes (small and large bodied) which differ in their trophic ecology, life history traits, and body size. Using common‐garden experiments, we investigated population‐specific differences in thermal performance (growth, temperature tolerance, and temperature preference) and whether the differences were consistent between ecotypes. We further explored the role of acclimation temperature on growth and thermal performance in two representative ecotypic populations. The evidence from this study indicated that the differences were population specific rather than ecotype specific. A strong inverse relationship between early growth rate and temperature preference suggests that the differences in early growth among Lake Trout populations are driven by adaptive variation in temperature preference. Acclimation temperature had a greater effect than source population on growth and temperature tolerance, although both significantly influenced temperature preferences. Small‐bodied ecotypes were less tolerant of elevated temperatures and exhibited less within‐population variation, potentially indicating their greater vulnerability to changing ecological conditions under climate change scenarios.
Body Condition Correlates with Instantaneous Growth in Stream‐Dwelling Rainbow Trout and Arctic Grayling
Authors: Bentley Kale T. , Schindler Daniel E.
Published: April 2013

Understanding the growth response of fish to varying environmental and biological conditions is important for the management and conservation of populations and communities. However, obtaining growth data at time scales shorter than those provided by annual size‐at‐age relationships is costly and labor intensive and can be logistically impractical. We assessed the ability of a body condition index to serve as a proxy for individual instantaneous growth rates in two species of mostly subadult stream‐dwelling salmonids in southwestern Alaska. We found that relative body condition, as measured by the residuals around a length–mass regression, was strongly correlated with direct measures of individual instantaneous growth (day−1) from mark–recapture data. Further, body condition was significantly correlated with growth accumulated over a period of roughly 2–10 weeks in both Rainbow Trout Oncorhynchus mykiss and Arctic Grayling Thymallus arcticus, while the relationship was typically weaker for time periods of less than 2 weeks and greater than 1 year. Despite the limitations of using body condition indices to infer the physiological status of individuals, our results demonstrate that, when applied judiciously, body condition can be used as a surrogate for recent individual instantaneous growth rate.
Search and You Will Find: Detecting Extended-Spectrumβ-Lactamase–ProducingKlebsiella pneumoniaefrom a Patient's Immediate Environment
Authors: Judge Christopher , Galvin Sandra , Burke Liam , Thomas Toney , Humphreys Hilary , Fitzgerald-Hughes Deirdre
Published: April 2013

Contamination of inanimate surfaces contributes to the transmission of healthcare-associated infection, a phenomenon that is well documented for methicillin-resistantStaphylococcus aureus(MRSA) and vancomycin-resistant enterococci (VRE). The high rate of skin colonization with these bacteria among healthcare workers increases the risk of cross contamination via high-touch surfaces. Since gram-negative bacteria are believed to survive poorly on surfaces, their role in the transmission of infection has not been investigated as widely. Extended-spectrumβ-lactamase-producing Enterobacteriaceae (ESBL-PE) are widespread and endemic in nosocomial settings. Given the increasing prevalence of infections involving ESBL-PE, the role of the environment in ESBL-PE transmission should be explored. This study reports the evaluation of 2 ESBL-PE recovery methods from typical hospital surface materials and their application for recovery of ESBL-PE adjacent to an ESBL-positive patient.
Copper Surfaces Reduce the Rate of Healthcare-Acquired Infections in the Intensive Care Unit
Authors: Salgado Cassandra D. , Sepkowitz Kent A. , John Joseph F. , Cantey J. Robert , Attaway Hubert H. , Freeman Katherine D. , Sharpe Peter A. , Michels Harold T. , Schmidt Michael G.
Published: April 2013

Objective.

Healthcare-acquired infections (HAIs) cause substantial patient morbidity and mortality. Items in the environment harbor microorganisms that may contribute to HAIs. Reduction in surface bioburden may be an effective strategy to reduce HAIs. The inherent biocidal properties of copper surfaces offer a theoretical advantage to conventional cleaning, as the effect is continuous rather than episodic. We sought to determine whether placement of copper alloy-surfaced objects in an intensive care unit (ICU) reduced the risk of HAI.

Design.

Intention-to-treat randomized control trial between July 12, 2010, and June 14, 2011.

Setting.

The ICUs of 3 hospitals.

Patients.

Patients presenting for admission to the ICU.

Methods.

Patients were randomly placed in available rooms with or without copper alloy surfaces, and the rates of incident HAI and/or colonization with methicillin-resistant Staphylococcus aureus (MRSA) or vancomycin-resistant Enterococcus (VRE) in each type of room were compared.

Results.

The rate of HAI and/or MRSA or VRE colonization in ICU rooms with copper alloy surfaces was significantly lower than that in standard ICU rooms (0.071 vs 0.123; P = .020). For HAI only, the rate was reduced from 0.081 to 0.034 (P = .013).

Conclusions.

Patients cared for in ICU rooms with copper alloy surfaces had a significantly lower rate of incident HAI and/or colonization with MRSA or VRE than did patients treated in standard rooms. Additional studies are needed to determine the clinical effect of copper alloy surfaces in additional patient populations and settings.
Acinetobacter baumannii: Association between Environmental Contamination of Patient Rooms and Occupant Status
Authors: Munoz-Price L. Silvia , Namias Nicholas , Cleary Timothy , Fajardo-Aquino Yovanit , DePascale Dennise , Arheart Kristopher L. , Rivera Jesabel I. , Doi Yohei
Published: April 2013

We aimed to determine the association between the presence ofAcinetobacter baumanniiin patient rooms and the carrier status of the occupants. Fifty-six (39%) of 143 rooms withA. baumannii– positive patients had results positive forA. baumannii.Only 49 (10%) of 485 rooms withA. baumannii-negative patients were positive (odds ratio, 5.72 [95% confidence interval, 3.66–8.96];P< .0001). Clinical and environmental isolates shared pulsed-field gel electrophoresis patterns.
The Type, Level, and Distribution of Microorganisms within the Ward Environment: A Zonal Analysis of an Intensive Care Unit and a Gastrointestinal Surgical Ward
Authors: Moore Ginny , Muzslay Monika , Wilson A. Peter R.
Published: April 2013

Objective.

To investigate the distribution of hospital pathogens within general and critical care ward environments and to determine the most significant bacterial reservoirs within each ward type.

Design.

Prospective 4-month microbiological survey.

Setting.

The intensive care unit (ICU) and gastrointestinal (GI) surgical ward of a London teaching hospital.

Patients.

Sampling was conducted in and around the bed space of 166 different patients (99 in the ICU and 67 in the GI ward).

Methods.

Conventional agar contact methodology was used to sample 123 predetermined sites twice a week for 17 weeks. Sixty-one surfaces were located within the ICU, and 62 were located within the GI ward. Each surface was located within a theoretical zone of increasing distance from the patient. Aerobic colony counts were determined, and confirmatory testing was conducted on all presumptive pathogens.

Results.

Regardless of ward type, surfaces located closest to the patient, specifically those associated with the bed (side rails, bed control, and call button), were the most heavily contaminated. Elsewhere, the type of surfaces contaminated differed with ward type. In the ICU, bacteria were most likely to be on surfaces that were regularly touched by healthcare workers (eg, telephones and computer keyboards). In the GI ward, where the patients were mobile, the highest numbers of bacteria (including potential nosocomial pathogens) were on surfaces that were mainly touched by patients, particularly their toilet and shower facilities.

Conclusions.

In terms of cleaning, a hospital should not be considered a single entity. Different ward types should be treated as separate environments, and cleaning protocols should be adjusted accordingly.
Copper Continuously Limits the Concentration of Bacteria Resident on Bed Rails within the Intensive Care Unit
Authors: Schmidt Michael G. , Attaway Hubert H. , Fairey Sarah E. , Steed Lisa L. , Michels Harold T. , Salgado Cassandra D.
Published: April 2013

Cleaning is an effective way to lower the bacterial burden (BB) on surfaces and minimize the infection risk to patients. However, BB can quickly return. Copper, when used to surface hospital bed rails, was found to consistently limit surface BB before and after cleaning through its continuous antimicrobial activity.
Comparison of Static End-expiratory and Effective Lung Volumes for Gas Exchange in Healthy and Surfactant-depleted Lungs
Authors: Albu Gergely , Wallin Mats , Hallbäck Magnus , Emtell Per , Wolf Andrew , Lönnqvist Per-Arne , Göthberg Sylvia , Peták Ferenc , Habre Walid
Published: April 2013

Background:

Effective lung volume (ELV) for gas exchange is a new measure that could be used as a real-time guide during controlled mechanical ventilation. The authors established the relationships of ELV to static end-expiratory lung volume (EELV) with varying levels of positive end-expiratory pressure (PEEP) in healthy and surfactant-depleted rabbit lungs.

Methods:

Nine rabbits were anesthetized and ventilated with a modified volume-controlled mode where periods of five consecutive alterations in inspiratory/expiratory ratio (1:2–1.5:1) were imposed to measure ELV from the corresponding carbon dioxide elimination traces. EELV and the lung clearance index were concomitantly determined by helium wash-out technique. Airway and tissue mechanics were assessed by using low-frequency forced oscillations. Measurements were collected at PEEP 0, 3, 6, and 9 cm H2O levels under control condition and after surfactant depletion by whole-lung lavage.

Results:

ELV was greater than EELV at all PEEP levels before lavage, whereas there was no evidence for a difference in the lung volume indices after surfactant depletion at PEEP 6 or 9 cm H2O. Increasing PEEP level caused significant parallel increases in both ELV and EELV levels, decreases in ventilation heterogeneity, and improvement in airway and tissue mechanics under control condition and after surfactant depletion. ELV and EELV exhibited strong and statistically significant correlations before (r = 0.84) and after lavage (r = 0.87).

Conclusions:

The parallel changes in ELV and EELV with PEEP in healthy and surfactant-depleted lungs support the clinical value of ELV measurement as a bedside tool to estimate dynamic changes in EELV in children and infants.
Social environment influences the relationship between genotype and gene expression in wild baboons
Authors: Runcie Daniel E. , Wiedmann Ralph T. , Archie Elizabeth A. , Altmann Jeanne , Wray Gregory A. , Alberts Susan C. , Tung Jenny
Published: April 2013

Variation in the social environment can have profound effects on survival and reproduction in wild social mammals. However, we know little about the degree to which these effects are influenced by genetic differences among individuals, and conversely, the degree to which social environmental variation mediates genetic reaction norms. To better understand these relationships, we investigated the potential for dominance rank, social connectedness and group size to modify the effects of genetic variation on gene expression in the wild baboons of the Amboseli basin. We found evidence for a number of gene–environment interactions (GEIs) associated with variation in the social environment, encompassing social environments experienced in adulthood as well as persistent effects of early life social environment. Social connectedness, maternal dominance rank and group size all interacted with genotype to influence gene expression in at least one sex, and either in early life or in adulthood. These results suggest that social and behavioural variation, akin to other factors such as age and sex, can impact the genotype–phenotype relationship. We conclude that GEIs mediated by the social environment are important in the evolution and maintenance of individual differences in wild social mammals, including individual differences in responses to social stressors.
Intraspecific variation in social organization by genetic variation, developmental plasticity, social flexibility or entirely extrinsic factors
Authors: Schradin Carsten
Published: April 2013

Previously, it was widely believed that each species has a specific social organization, but we know now that many species show intraspecific variation in their social organization. Four different processes can lead to intraspecific variation in social organization: (i) genetic variation between individuals owing to local adaptation (between populations) or evolutionarily stable strategies within populations; (ii) developmental plasticity evolved in long-term (more than one generation) unpredictable and short-term (one generation) predictable environments, which is mediated by organizational physiological effects during early ontogeny; (iii) social flexibility evolved in highly unpredictable environments, which is mediated by activational physiological effects in adults; (iv) entirely extrinsic factors such as the death of a dominant breeder. Variation in social behaviour occurs between individuals in the case of genetic variation and developmental plasticity, but within individuals in the case of social flexibility. It is important to study intraspecific variation in social organization to understand the social systems of species because it reveals the mechanisms by which species can adapt to changing environments, offers a useful tool to study the ultimate and proximate causes of sociality, and is an interesting phenomenon by itself that needs scientific explanation.
Cancer translocations in human cells induced by zinc finger and TALE nucleases
Authors: Piganeau Marion , Ghezraoui Hind , De Cian Anne , Guittat Lionel , Tomishima Mark , Perrouault Loic , René Oliver , Katibah George E. , Zhang Lei , Holmes Michael C. , Doyon Yannick , Concordet Jean-Paul , Giovannangeli Carine , Jasin Maria , Brunet Erika
Published: April 2013

Chromosomal translocations are signatures of numerous cancers and lead to expression of fusion genes that act as oncogenes. The wealth of genomic aberrations found in cancer, however, makes it challenging to assign a specific phenotypic change to a specific aberration. In this study, we set out to use genome editing with zinc finger (ZFN) and transcription activator-like effector (TALEN) nucleases to engineer, de novo, translocation-associated oncogenes at cognate endogenous loci in human cells. Using ZFNs and TALENs designed to cut precisely at relevant translocation breakpoints, we induced cancer-relevant t(11;22)(q24;q12) and t(2;5)(p23;q35) translocations found in Ewing sarcoma and anaplastic large cell lymphoma (ALCL), respectively. We recovered both translocations with high efficiency, resulting in the expression of the EWSR1–FLI1 and NPM1–ALK fusions. Breakpoint junctions recovered after ZFN cleavage in human embryonic stem (ES) cell–derived mesenchymal precursor cells fully recapitulated the genomic characteristics found in tumor cells from Ewing sarcoma patients. This approach with tailored nucleases demonstrates that expression of fusion genes found in cancer cells can be induced from the native promoter, allowing interrogation of both the underlying mechanisms and oncogenic consequences of tumor-related translocations in human cells. With an analogous strategy, the ALCL translocation was reverted in a patient cell line to restore the integrity of the two participating chromosomes, further expanding the repertoire of genomic rearrangements that can be engineered by tailored nucleases.
The Montastraea faveolata microbiome: ecological and temporal influences on a Caribbean reef‐building coral in decline
Authors: Kimes Nikole E. , Johnson Wesley R. , Torralba Manolito , Nelson Karen E. , Weil Ernesto , Morris Pamela J.
Published: April 2013

Coral‐associated microbial communities, including protists, bacteria, archaea and viruses, are important components of the coral holobiont that influence the health of corals and coral reef ecosystems. Evidence suggests that the composition of these microbial communities is affected by numerous parameters; however, little is known about the confluence of these ecological and temporal effects. In this study, we used ribosomal RNA gene sequencing to identify the zooxanthellae, bacteria and archaea associated with healthy and yellow band diseased (YBD) colonies in the Media Luna reef of La Parguera, Puerto Rico, in order to examine the influence of YBD on the Montastraea faveolata microbiome. In addition, we evaluated the influence of season on the differences between healthy and YBD M. faveolata microbiomes by sampling from the same tagged colonies in both March and September of 2007. To the best of our knowledge, this is the first coral microbiome study to examine sequences from the zooxanthellar, bacterial and archaeal communities simultaneously from individual coral samples. Our results confirm differences in the M. faveolata zooxanthellar, bacterial and archaeal communities between healthy and YBD colonies in March; however, the September communities do not exhibit the same differences. Moreover, we provide evidence that the differences in the M. faveolata microbiomes between March and September are more significant than those observed between healthy and YBD. This data suggest that the entire coral microbiome, not just the bacterial community, is a dynamic environment where both disease and season play important roles.
Community structure of soil phototrophs along environmental gradients in arid Himalaya
Authors: Janatková Kateřina , Řeháková Klára , Doležal Jiří , Šimek Miloslav , Chlumská Zuzana , Dvorský Miroslav , Kopecký Martin
Published: April 2013

The well‐developed biological soil crusts cover up to 40% of the soil surface in the alpine and subnival zones of the Tibetan Plateau, accounting for a vast area of Asia. We investigated the diversity and biomass of the phototrophic part (Cyanobacteria) of the microbial community inhabiting biological soil crusts and uncrusted soils in their surroundings on the elevation gradient of 5200–5900 m a.s.l. The influence of soil physico‐chemical properties on phototrophs was studied. The ability of high‐altitude phototrophs to fix molecular nitrogen was also determined under laboratory conditions. The biological soil crust phototroph community did not differ from that living in uncrusted soil in terms of the species composition, but the biomass is three‐to‐five times higher. An increasing trend in the cyanobacterial biomass from the biological soil crusts with elevation was observed, with the genera Nostoc spp., Microcoleus vaginatus and Phormidium spp. contributing to this increase. Based on the laboratory experiments, the highest nitrogenase activity was recorded in the middle elevations, and the rate of nitrogen fixation was not correlated with the cyanobacterial biomass.
Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement
Authors: Husereau D , Drummond M , Petrou S , Carswell C , Moher D , Greenberg D , Augustovski F , Briggs AH , Mauskopf J , Loder E
Published: April 2013

Economic evaluations of health interventions pose a particular challenge for reporting. There is also a need to consolidate and update existing guidelines and promote their use in a user friendly manner. TheConsolidatedHealthEconomicEvaluationReportingStandards (CHEERS) statement is an attempt to consolidate and update previous health economic evaluation guidelines efforts into one current, useful reporting guidance.The primary audiences for theCHEERSstatement are researchers reporting economic evaluations and the editors and peer reviewers assessing them for publication. The need for new reporting guidance was identified by a survey of medical editors. A list of possible items based on a systematic review was created. A two round, modified Delphi panel consisting of representatives from academia, clinical practice, industry, government, and the editorial community was conducted. Out of 44 candidate items, 24 items and accompanying recommendations were developed. The recommendations are contained in a user friendly, 24 item checklist. A copy of the statement, accompanying checklist, and this report can be found on theISPOR HealthEconomicEvaluationsPublicationGuidelinesTaskForce website (www.ispor.org/TaskForces/EconomicPubGuidelines.asp). We hopeCHEERSwill lead to better reporting, and ultimately, better health decisions. To facilitate dissemination and uptake, theCHEERSstatement is being co‐published across 10 health economics and medical journals. We encourage other journals and groups, to endorseCHEERS. The author team plans to review the checklist for an update in 5 years.
Effects of obesity on patient experience in the emergency department
Authors: Ngui Bryan , McDonald Taylor David , Shill Jessica
Published: April 2013

Objective

The study aims to determine if obesity (body mass index ≥30.0 kg/m2) adversely affects the patients' ED experience in terms of flow variables and rates of assistance, investigation and procedure.

Methods

This was a prospective, analytical, observational study in a large tertiary referral ED. Consecutive patients, presenting during data collection periods, were enrolled after they had received ≥3 h of care. Height and weight data were collected from the patient; demographics, presenting complaint, triage category, time to be seen and modes of arrival and disposition from the Emergency Department Information System, and investigations from the electronic pathology and radiology records. Data on a wide range of procedures and management variables were collected directly from the ED staff using a specifically designed survey instrument.

Results

Seven hundred and eleven patients were enrolled (mean age 64.3 ± 18.6 years, 375 [52.7%] male). One hundred and ninety‐one (26.9%, 95% confidence interval 23.7–30.3) patients were obese. Obese patients were significantly younger than non‐obese patients (median 63 vs 70 years, P < 0.001). They had significantly more intravenous cannulation attempts, liver function tests (69.1% vs 60.2%), cardiac enzyme tests (40.8% vs 30.0%) and abdominal X‐rays (17.8% vs 8.7%) (P < 0.05). There were no differences between the groups in time to be seen, monitoring, other procedures, assistance required, place of disposition or ED length of stay (P > 0.05). Obese patients had a lower death rate in the ED or hospital than non‐obese patients (1.6% vs 7.5%, P < 0.01).

Conclusion:

In this single‐centre study, obesity did not appear to adversely affect ED treatment. The observed differences in some investigation rates might relate to suspected morbidities and difficulties in physical examination.
Channelling of Statin Use towards Low‐Risk Population and Patients with Diabetes
Authors: Rikala Maria , Huupponen Risto , Helin‐Salmivaara Arja , Korhonen Maarit Jaana
Published: April 2013

This study based on nationwide comprehensive health registers analysed trends in characteristics of statin users in the whole community‐dwelling population of Finland between 1999 and 2008. The annual number of incident users (defined as those purchasing statins for the first time ever) increased 1.6‐fold from 50,125 to 78,058 and that of ongoing users (including continuous users and re‐initiators) increased 4.6‐fold from 114,091 to 521,211. The proportion of incident users without cardiovascular disease (CVD) or diabetes increased from 23.6% to 27.8%, while the proportion of those with diabetes increased from 15.7% to 19.5%. An increasing proportion of ongoing users had diabetes (from 13.8% to 22.8%). The proportion of ongoing users without CVD or diabetes remained below one‐fifth; however, their number increased five‐fold. Over the study period, there was an obvious shift towards prescribing of higher statin doses both among incident and ongoing users. In conclusion, statin use is expanding to individuals with low cardiovascular risk despite the fact that clinical guidelines emphasize interventions other than pharmacotherapy for this population. At the same time, statin use is increasingly targeted to patients with diabetes, a high‐risk group that is likely to benefit from it.
Clinical assessment and crisis intervention for the suicidal bipolar disorder patient
Authors: Saunders Kate EA , Hawton Keith
Published: April 2013

Objective

Suicidal behaviour is common in people suffering with bipolar disorder, and suicide is a leading cause of death in this group. Our aim in this review is to provide an overview of key assessment and management strategies, highlight research findings relevant to suicide prevention, and identify important areas for future research.

Methods

We reviewed the published literature regarding the risk factors for and management of suicida\l behaviour in individuals with bipolar disorder using the Pubmed and PsychINFO databases. Where available, we focused our search on systematic reviews.

Results

Suicide is usually associated with a depressive phase, although mixed affective states also convey increased risk. All individuals with bipolar disorder should have an up‐to‐date crisis management plan which outlines the action to be taken should suicidal behaviour emerge. Timely clinical assessment is essential in ensuring that those at high risk are identified. This should include mental state examination, consideration of risk factors, and evaluation of issues such as access to means, preparatory acts before suicide, and also protective factors. While pharmacological approaches are the mainstay of management, less specific measures, such as the removal of access to means, are also important in ensuring safety in the acute situation. Intensifying the clinical support of both patients and relatives, and the sharing of risk information with other health agencies are essential in management. Specific psychological treatments are likely to be helpful in preventing crises, although the evidence base is limited.

Conclusions

The aetiology of suicidal behaviour in bipolar disorder is multifactorial and requires proactive crisis planning and management. A range of issues need to be addressed in the assessment of at‐risk patients. Determining the efficacy of interventions specific to reducing suicidality in bipolar disorder should be a research priority.
Live birth rates following in vitro fertilization in women with thyroid autoimmunity and/or subclinical hypothyroidism
Authors: Chai Joyce , Yeung Wing‐Yee T. , Lee Chi‐Yan V. , Li Hang‐Wun R. , Ho Pak‐Chung , Ng Hung‐Yu E.
Published: April 2013

Objective

To investigate whether the live birth rate following in vitro fertilization (IVF) is affected by thyroid autoimmunity (TAI) and/or subclinical hypothyroidism in subfertile women.

Design and setting

Retrospective study in a university infertility clinic.

Patients

A total of 627 women without past or current history of thyroid disorder undergoing their first IVF cycle.

Intervention

Pre‐IVF archived blood serum samples were tested for TAI and thyroid function tests.

Main outcome measure

Live birth rate.

Results

The clinical pregnancy rate, live birth rate and miscarriage rate were similar among women with or without TAI and/or subclinical hypothyroidism using a TSH threshold 4·5 mIU/l. Thyroid autoantibody level did not affect these IVF outcomes.

Conclusion

The live birth rate and miscarriage rate of women with TAI and/or subclinical hypothyroidism following IVF were not impaired.
PAX6 mutation in association with ptosis, cataract, iris hypoplasia, corneal opacification and diabetes: a new variant of familial aniridia?
Authors: Peter Neena M , Leyland Martin , Mudhar Hardeep S , Lowndes Jo , Owen Katharine R , Stewart Helen
Published: April 2013

Background

We report a family with ptosis, cataract, iris hypoplasia and gradual corneal opacification occurring in association with a PAX6 mutation.

Design

Case‐series.

Participants

Fourteen family members – 8 affected, 6 unaffected controls.

Methods

All participants underwent ophthalmological assessment, including best‐corrected visual acuity, slit‐lamp‐examination, pachymetry, endothelial cell‐count, tonometry and dilated fundoscopy. All subjects underwent anthropometry and assessment of glycaemic status. Genetic analysis of the PAX6 gene was performed.

Main Outcome Measures

Presence of ptosis, corneal, iris and lenticular changes, gycaemic and PAX6 status.

Results

All eight affected subjects had ptosis with reduced levator function, anterior polar cataracts, and corneal changes of variable severity – two patients had undergone penetrating keratoplasties, with graft histology revealing conjunctival cells on the cornea and severe fibroinflammatory change. Five patients had iris hypoplasia. One patient had aphakic glaucoma and another had hypoplastic optic discs. Four of the six controls had no ocular features of this syndrome, and two had isolated mild ptosis. There was no difference in height or body mass index between cases and family controls (p > 0.05), but Haemoglobin A1c was greater in the cases (median [interquartile range] 5.6(0.8) vs 5.1(0.3), p = 0.028). Genetic analysis confirmed a pathogenic PAX6 mutation in exon 12 (c1439delC) in all eight patients, but none of the controls.

Conclusion

This is the first report of this particular constellation of ocular signs occurring in association with a PAX6 mutation. There was no association with anthropometric features, but affected subjects had worse glycaemia than controls, which may be related to the known role of PAX6 in development of the pancreas.
The impact of POSSUM score on the long‐term outcome of patients with rectal cancer
Authors: Cheung H. , Poon J. T. C. , Law W.‐L.
Published: April 2013

Aim

The TMN staging system is the most important tool for predicting the long‐term survival of colorectal cancer patients. However, physiological conditions and the operation may also influence survival. This study evaluated the impact of the Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM) and the colorectal version (CR‐POSSUM) on the long‐term survival of patients with rectal cancer.

Method

Prospectively collected data were included of consecutive patients who underwent rectal cancer resection between 2000 and 2004. The relationship between the POSSUM and CR‐POSSUM scores and the physiological components with outcomes and survivals was analysed.

Results

The study included 343 patients (196 men, 263 open resections, 74 laparoscopic resections, six local resections) with a mean follow‐up of 56.5 months. Thirty‐five patients had had neoadjuvant chemoradiation and 115 had adjuvant chemotherapy. Their median POSSUM score was 34 (interquartile range 31–39) and the median CR‐POSSUM score was 19 (interquartile range 18–21). The log rank test showed a significant difference (P < 0.05) in long‐term survival for patients who belonged to different POSSUM score groups and POSSUM physiological score groups. Factors found on multivariate analysis to have significant association with long‐term survival included TNM stage, perineural invasion, local invasion, obstruction, emergency operation, POSSUM score and POSSUM physiological score.

Conclusion

The mortality of patients after rectal cancer surgery can be predicted by POSSUM, P‐POSSUM (a subsequent version of POSSUM) or CR‐POSSUM with no significant difference between them. Both POSSUM and the POSSUM physiological score were significantly related to survival. The POSSUM score was one of the factors that independently predicted long‐term survival.
A long‐term study on the clinical effects of mechanical widening of cheek teeth diastemata for treatment of periodontitis in 202 horses (2008–2011)
Authors: Dixon P. M. , Ceen S. , Barnett T. , O'Leary J. M. , Parkin T. D. , Barakzai S.
Published: April 2013

Reason for performing study

Cheek teeth diastemata are a common cause of painful periodontal disease in horses, but there is limited objective information on their treatment.

Objective

To assess the long‐term response to diastema widening in clinically affected horses.

Study design

Retrospective study.

Method

Medical records from cases of cheek teeth diastemata treated by diastema widening referred to the University of Edinburgh Equine Hospital from 2008 to 2011 were analysed.

Results

During this period, 302 horses were diagnosed with clinically significant cheek teeth diastemata, of which 202, median age 11 years, with severe associated periodontitis were treated by widening of 674 problematic diastemata; 89.8% between mandibular cheek teeth and 10.2% between maxillary cheek teeth, with a mean of 1.5 treatments performed per case. These 202 cases showed quidding in 76.2%; weight loss in 33.2%; bitting problems in 20.1% and halitosis in 10.9%, with 5.4% being asymptomatic. Follow‐up of 92% of treated cases, a mean of 20.8 months after their initial treatment, showed that 72.6% had complete remission of clinical signs that was permanent (for the duration of this study) in 50.5% and temporary in 22%. A partial response was obtained in 17.2%, no response was obtained in 4.3%, and owners were unsure of response in 5.9%. Clinical improvement was sometimes delayed, with 19% taking >4 weeks following treatment for improvement. Inappropriate sites were burred in individual teeth of 6 horses, causing iatrogenic pulpar exposure in 2 cases, but following treatment none developed clinical signs of apical infection.

Conclusions

Diastema widening is an effective but potentially invasive treatment for horses with cheek teeth diastemata with severe periodontitis.

Potential relevance

Diastema widening by trained personnel is suitable for advanced cases of cheek teeth diastema, but many cases require repeated treatments.
Antisecretory effect of prescribed appetite stimulator drug cyproheptadine in rat intestine
Authors: Meddah Bouchra , Limas‐Nzouzi Nicolas , Mamadou Godefroy , Miantezila Joe , Soudy Imar Djibrine , Eto Bruno
Published: April 2013

Cyproheptadine (Cph) is an antiserotoninergic and antihistaminergic agent with alpha‐blocking activity and central sedative effect. Cph has been found to be effective in stimulating appetite, but to our knowledge, its direct effects on the intestine have not been documented. We aimed to assess the antisecretory effects of Cph in rat proximal colon using Ussing chambers' technique. In basal and serotonin (5‐HT)‐stimulated conditions, Cph induced a dose‐dependent reduction in short‐circuit current (Isc). This effect was different in fed vs. fasted rats (EC50 = 1.9 × 10−5 m and 4.9 × 10−5 m, respectively). As expected, Cph induced a marked dose‐dependent rightward shift of the concentration–response curve to 5‐HT (pA2 = 5.4). The effect of Cph was found to be close to that of antisecretory agents in the following sequence: peptide YY > somatostatin > clonidine > Cph > C7‐sorbin. To our knowledge, this is the first demonstration that Cph has a direct effect on the inhibition of electrogenic ionic secretion in intestinal epithelium in vitro. Our results indicate that Cph can modulate the intestinal transport of electrolytes and provide a new insight into the peripheral effects of this drug, which is frequently prescribed as appetite stimulator in developing countries.
British general practitioners' attitudes towards and usage of homeopathy: a systematic review of surveys
Authors: Perry Rachel , Watson Leala K , Terry Rohini , Onakpoya Igho , Ernst Edzard
Published: April 2013

Background

General practitioners (GPs) often refer patients to complementary and alternative medicine practitioners. One of the more popular yet controversial therapies for patients to request is homeopathy.

Objectives

To assess GP/primary care physician involvement with and attitudes towards homeopathy.

Methods

Seven electronic databases were searched to identify all relevant UK surveys of GPs/primary care physicians conducted between 1995 and 2013. Data extraction of all included trials was conducted by three independent reviewers.

Results

Thirteen surveys (from 15 articles) met the inclusion criteria. Less than 10% of GPs treated patients with homeopathy directly; referral rates ranged from 4–73%. Views on the effectiveness of homeopathy ranged from 29–48.7%, and opinions on whether it should be funded by the UK National Health Service ranged from 19–64%. Three surveys reported on GP professional training levels in homeopathy and two investigated GP knowledge of the evidence base of homeopathy.

Conclusions

Homeopathy is currently being utilised by the UK medical profession to a minor degree. Referral rates vary considerably nationally but, on average, are low.