bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison Overview of Prehospital Errors Involving Road Traffic Fatalities in Victoria, Australia
Authors: Boyle Malcolm J.
Published: August 2016

Introduction:

Until early 2003, the Consultative Committee on Road Traffic Fatalities (CCRTF) in Victoria, Australia was the main body investigating and publishing data about prehospital errors resulting from road traffic fatalities. The objective of this study was to identify and interpret prehospital error rate trends associated with road traffic fatalities during a 10-year period of the CCRTF reports.

Methods:

This study is a review of the prehospital errors defined in Victorian CCRTF reports of preventable deaths of road traffic fatalities over a 10-year period.

Results:

Six CCRTF reports contained prehospital data for errors associated with road traffic fatalities. From 1992 to 1998, system errors decreased.However, over the same timeframe, management, technical, and diagnostic errors increased. There was a marked jump in system, technique, and diagnosis errors from 1998 to 2001–2003. However, management errors declined over the same timeframe. The jump in errors in the 1998 to 2001–2003 timeframe coincided with the introduction of advanced life support (ALS) for Victorian paramedics in 2000.The number of preventable deaths decreased from 1992 to 1998, however, there was an increase from 1999 onwards, coinciding with the introduction of the state trauma system and ALS for paramedics.

Conclusions:

This study demonstrates that there has been an increase in prehospital error rates, especially from 2000, which coincided with the introduction of ALS for paramedics and the state trauma system in Victoria, even though the state trauma system had an overall decrease in error rates.
Role of Air-Medical Evacuation in Mass-Casualty Incidents—A Train Collision Experience
Authors: Assa Amit , Landau Dan-Avi , Barenboim Erez , Goldstein Liav
Published: August 2016

Background:

On 21 June 2005, a passenger train collided with a truck near Revadim, Israel.The collision resulted in a multiple-scene mass-casualty incident in an area characterized by difficult access and a relatively long distance from trauma centers. A major disaster response was initiated by civilian and military medical forces including the Israeli Air Force (IAF) Search and Rescue teams. The air-medical evacuation from the accident site to the trauma centers, the activities of the airborne medical teams, and the lessons learned from this event are described in this report.

Methods:

A retrospective analysis of data gathered from relevant elements that participated in management, treatment, and evacuation from the accident site was conducted.

Results:

The accident resulted in 289 injured passengers and seven of the injured were killed. Six helicopters (performing nine sorties) participated. Helicopters evacuated trauma victims and aided in transporting air-medical teams to the site of the collision.Overall, 35 trauma victims (10 urgent) were evacuated by air to trauma centers. The length of time between the first helicopter landing and completion of the air evacuation was 83 minutes. The airmedical evacuation operation was controlled by the commander of the IAF Search and Rescue. Different crew compositions were set in real time.

Conclusions:

Air-medical evacuation during this unique event enabled prompt transportation of casualties from the scene to trauma centers and provided reasonable distribution of patients between various centers in the region.This operation highlighted the necessity for flexibility in medical decision-making and the need for non-conventional solutions regarding crew compositions during management of an airborne evacuation in similar settings. Air-medical evacuation should be considered as a part of responses to mass-casualty incidents, especially when the site is remote or characterized by accessibility difficulties.
Impact of the 2007 Ica Earthquake on Health Facilities and Health Service Provision in Southern Peru
Authors: Chapin Erica , Daniels Amy , Elias Rosa , Aspilcueta Daniel , Doocy Shannon
Published: August 2016

Introduction:

Few studies have examined post-disaster coping abilities of health facilities and hospitals. On 15 August 2007, a 7.9 (Richter) earthquake struck off the western coast of Peru near the Department of Ica that devastated the healthcare infrastructure. The impact of the earthquake on the health facilities in the four most affected provinces (Cañete, Chincha, Ica, and Pisco), the risk factors associated with the damages incurred, ability to provide services, and humanitarian assistance received were assessed.

Methods:

A stratified, systematic sampling design was used to interview a sample of 40 health facilities. The most senior healthcare provider at each facility was interviewed about the facility's experience with service provision following the earthquake.

Results:

Sixty percent of the facilities reported some damage due to the earthquake; four (10%) were completely destroyed. A total of 78% of the facilities reported providing medical care within the first 48 hours after the earthquake and public facilities were more likely to remain open than were private facilities (p = 0.030). Facilities with an emergency response plan were more likely to provide services than were those without a plan (p = 0.043). Six months after the earthquake, similar numbers of HIV and tuberculosis (TB) patients were receiving treatment at the sampled facilities as prior to the earthquake, and no difficulties were reported in obtaining medications. Some form of assistance, most commonly medications, was received by 60% of the facilities; receipt of assistance was not associated with the facility type, location, damage incurred, or post-disaster service provision.

Conclusions:

Response plans were an important factor in the ability to provide services immediately following an earthquake. While a facility's ability to provide services can be determined by structural impacts of the precipitating event, response plans help the staff to continue to provide services and care for affected populations, and appropriately arrange referrals when care cannot be provided at the facility. The findings suggest that health facilities in disasterprone areas should invest in developing and implementing disaster response plans in order to improve health service provision capacity during disasters.
Driver-Related Risk Factors in Commercial Motorcycle (Okada) Crashes in Benin City, Nigeria
Authors: Iribhogbe Pius Ehiawaguan , Odai Emeka Danielson
Published: August 2016

Introduction:

There has been global concern regarding road traffic injuries. Motorcyclists constitute a high proportion of fatalities in road traffic crashes. Commercial motorcyclists (Okadas) constitute a unique group in this regard. The purpose of this study was to evaluate driver-related risk factors in Okada accidents in Benin City, Nigeria.

Methods:

This was a prospective study. Interviewers administered questionnaires that were used to assess Okada drivers during a two-month period (November–December 2006).

Results:

A total of 996 Okada drivers were interviewed, 995 males and one female. Their ages ranged from 16–80 years with a mean age of 36.4 ±2.4 years. In the majority of cases, the maximum educational level achieved was primary or secondary. The majority of Okada drivers (82.8%) took to the Okada business as a last resort. Driver's licenses for Okada operation were possessed by 73.5% of drivers, but only 27.2% had taken a road test before being given a license. No form of training on the use of Okadas was received by 45% of drivers before they commenced operations. Crash helmets were owned by 56.4%, but they did not use them on a regular basis. Inconvenience was the reason provided for poor compliance by 52.7% of drivers. Regular intake of alcohol was present in 39.8% of drivers.

Conclusions:

Okada drivers are mainly young males with a low level of education who are ill-prepared and ill-equipped for the road. This is a recipe for traffic crash-related injuries and fatal motorcycle crashes. There is an urgent need for job creation, better licensing procedures, road safety education, national legislation, and enforcement of crash helmet laws as well as alcohol breath tests for Okada drivers in Nigeria.
Inter-Agency Communication and Operations Capabilities during a Hospital Functional Exercise: Reliability and Validity of a Measurement Tool
Authors: Savoia Elena , Biddinger Paul D. , Burstein Jon , Stoto Michael A.
Published: August 2016

Introduction:

As proxies for actual emergencies, drills and exercises can raise awareness, stimulate improvements in planning and training, and provide an opportunity to examine how different components of the public health system would combine to respond to a challenge. Despite these benefits, there remains a substantial need for widely accepted and prospectively validated tools to evaluate agencies' and hospitals' performance during such events. Unfortunately, to date, few studies have focused on addressing this need. The purpose of this study was to assess the validity and reliability of a qualitative performance assessment tool designed to measure hospitals' communication and operational capabilities during a functional exercise.

Methods:

The study population included 154 hospital personnel representing nine hospitals that participated in a functional exercise in Massachusetts in June 2008. A 25-item questionnaire was developed to assess the following three hospital functional capabilities: (1) inter-agency communication; (2) communication with the public; and (3) disaster operations. Analyses were conducted to examine internal consistency, associations among scales, the empirical structure of the items, and inter-rater agreement.

Results:

Twenty-two questions were retained in the final instrument, which demonstrated reliability with alpha coefficients of 0.83 or higher for all scales. A three-factor solution from the principal components analysis accounted for 57% of the total variance, and the factor structure was consistent with the original hypothesized domains. Inter-rater agreement between participants' self-reported scores and external evaluators' scores ranged from moderate to good.

Conclusions:

The resulting 22-item performance measurement tool reliably measured hospital capabilities in a functional exercise setting, with preliminary evidence of concurrent and criterion-related validity.
Differences in the Sources of Information and Acquaintance with Instructions between Dimona and the General Population after a Suicide Bomber Event
Authors: Richman Aaron , Shohat Galit , Soffer Yechiel , Bar-Dayan Yaron
Published: August 2016

A telephone survey among two randomly selected, representative samples of adults was conducted two days after a suicide bomber event in Dimona, Israel. Television, radio, Internet, and newspapers were more common sources of information in the general population, whereas friends, family, and the local authorities were the more common sources of information in Dimona. Higher acquaintance with police instructions and higher knowledge of the exact location of the event were found in the population of Dimona. Authorities must pay attention to this phenomenon and use the correct sources of information in each area in order to achieve better exposure of the target population to the police instructions after a terrorist event.
Emergency Airway Placement by EMS Providers: Comparison between the King LT Supralaryngeal Airway and Endotracheal Intubation
Authors: Burns J. Bracken , Branson Richard , Barnes Stephen L. , Tsuei Betty J.
Published: August 2016

Introduction:

The ever-present risk of mass casualties and disaster situations may result in airway management situations that overwhelm local emergency medical services (EMS) resources. Endotracheal intubation requires significant user education/training and carries the risk of malposition. Furthermore, personal protective equipment (PPE) required in hazardous environments may decrease dexterity and hinder timely airway placement. Alternative airway devices may be beneficial in these situations.

Objective:

The objective of this study was to evaluate the time needed to place the King LT Supralaryngeal Airway compared to endotracheal intubation when performed by community EMS personnel with and without PPE.

Methods:

Following training, 47 EMS personnel were timed placing both endotracheal tubes and the King LT supralaryngeal airway in a simulator mannikin. The study participants then repeated this exercise wearing PPE.

Results:

The EMS personnel wearing PPE took significantly longer to place an endotracheal tube than they did without protective equipment (53.4 seconds and 39.5 seconds, p <0.002). The time to place the King LT was significantly faster than the placement of the endotracheal tube without protective equipment (18.4 seconds and 39.5 seconds, respectively, p<0.00003). There also were statistically significant differences between the time required to place the King LT and endotracheal tube in EMS personnel wearing protective equipment (19.7 seconds and 53.4 seconds, p <0.000007).

Conclusions:

The King LT Supralaryngeal Airway device may be advantageous in prehospital airway management situations involving multiple patients or hazardous environments. In this study, its insertion was faster than endotracheal intubation when performed by community EMS providers.
Lessons Learned at World Youth Day: Collecting Data and Using Postcards at Mass Gatherings
Authors: Hutton Alison , Roderick Allison , Munt Rebecca
Published: August 2016

Introduction:

World Youth Day (WYD) and its associated activities were held in Sydney, Australia from 15–20 July 2008. The aims of this research were to pilot the use of postcards at mass gatherings and to collect baseline data of how young people (age 16–25 years) identify factors that may affect their health and safety when attending mass gatherings.

Hypothesis:

The concerns of young people in relation to their health and safety at mass gatherings are poorly understood. It was decided that postcards would be an effective method of data collection in the mobile mass gathering environment.

Methods:

The research setting was the Pilgrim Walk at WYD. Participants on this walk were young people. To measure their health and safety concerns, a postcard was developed using a Likert scale to rank their attitudes on a continuum.

Results:

Young people stated that staying hydrated, having enough to eat, and being safe in a crowd were important to them. They also indicated that they perceived, overcrowding, getting to and from an event, and violent behavior as the greatest risks to their health and safety at a mass gathering.

Conclusions:

The problems with postcard distribution at a “mobile” mass gathering have been identified. Even so, results gathered showed that young people were focused on “in the moment” aspects of their health; such as access to food and water. They also had concerns for their safety due to potential overcrowding and/or violent behavior.
H1N1: Communication Patterns among Emergency Department Staff during the H1N1 Outbreak, April 2009
Authors: Klein Kelly R. , Cohen Hillary , Baseluos Cindy , Marshall John , Likourezos Antonios , Jain Ashika , Davidson Steven
Published: August 2016

Introduction:

The H1N1 influenza virus has been described by the World Health Organization (WHO) and the media as a disease that could rival the 1918 Spanish Influenza epidemic in deaths. During the spring of 2009, emergency departments across the world saw a spike in the number of influenza cases and by June 2009, the WHO had declared H1N1 a pandemic. In order to prevent emergency department staff from becoming ill and to provide upto-date medical care to patients, information had to be disseminated quickly to emergency department staff.

Methods:

An anonymous Internet survey was utilized to query emergency department staff regarding communication methods and overall attitudes regarding safety and treatment during the spring of 2009.

Results:

The majority of emergency department staff (263; 88.3%) used multiple sources to obtain information about the H1N1 virus. There were 258 respondents (88.9%) that felt that the hospital was supplying them with the necessary information to protect themselves and their families and 280 (98.5%) felt confident that their emergency department was treating patients by the government-recommended guidelines. Statistically significant differences were noted in communication patterns between direct and indirect patient care providers.

Conclusions:

In general, H1N1 communication to emergency department staff was perceived as good during the initial H1N1 outbreak. However, because of the limitations associated with an online survey, these results do not allow for generalization to the total emergency department staff population. Hospital administrators may need to consider the differences in communication preferences of direct patient care providers and indirect patient care providers when distributing important information to emergency department staff during crisis and emergency situations.
Collaboration between Civilian and Military Healthcare Professionals: A Better Way for Planning, Preparing, and Responding to All Hazard Domestic Events
Authors: Marklund LeRoy A. , Graham Adrienne M. , Morton Patricia G. , Hurst Charles G. , Motola Ivette , Robinson Donald W. , Kelley Vivian A. , Elenberg Kimberly J. , Russler Michael F. , Boehm Daniel E. , Higgins Dawn M. , McAndrew Patrick E. , Williamson Hope M. , Atwood Rodney D. , Huebner Kermit D. , Brotons Angel A. , Miller Geoffrey T. , Rimpel Laukton Y. , Harris Larry L. , Santiago Manuel , Cantrell LeRoy
Published: August 2016

Collaboration is used by the US National Security Council as a means to integrate inter-federal government agencies during planning and execution of common goals towards unified, national security. The concept of collaboration has benefits in the healthcare system by building trust, sharing resources, and reducing costs. The current terrorist threats have made collaborative medical training between military and civilian agencies crucial.

This review summarizes the long and rich history of collaboration between civilians and the military in various countries and provides support for the continuation and improvement of collaborative efforts. Through collaboration, advances in the treatment of injuries have been realized, deaths have been reduced, and significant strides in the betterment of the Emergency Medical System have been achieved. This review promotes collaborative medical training between military and civilian medical professionals and provides recommendations for the future based on medical collaboration.
Estimation of Healthcare Resources at Sporting Events
Authors: Khorram-Manesh Amir , Berner A. , Hedelin A. , Örtenwall P.
Published: August 2016

Background:

The consequences of a major incident at a sporting event could be catastrophic. Therefore, there should be an estimation of the healthcare resources at such events as part of the planning. Although there are National guidelines (e.g., Planning Safe Public Events: Practical Guidelines in Australia) defining the role of the healthcare system at sporting events, these guidelines either lack a simple calculating method to estimate the need for healthcare resources or the methods are complex and impractical to use. The objective of this study was to find a safe and easy method for the estimation of healthcare resources at sporting events.

Methods:

A model for the estimation of healthcare resources at music events recently has been approved in Sweden. After minor adjustments, this model was used at sport events by a number of planning officers. The models' accuracy and usability was evaluated by analyzing its outcome in a pilot and a controlled study using different sporting and non-sporting scenarios.

Results:

The pilot study showed that the model was valid and easily could be used for various sporting events. The obtained estimations were consistent with the methods used by experienced planning officers in 97% of cases. The results of the controlled study showed that by using this model, the minimum amount of resources required easily could be calculated at sporting events and by people with different backgrounds.

Conclusions:

This model safely can be used at sporting events.
Chain of Survival at Mass Gatherings: A Case Series of Resuscitation Events
Authors: Ranse Jamie , Zeitz Kathryn
Published: August 2016

Background:

At a large public event, or mass gathering, various factors influence patient presentations that brings challenges to patient care. The chain of survival has been investigated in the prehospital setting. However, this has not explicitly included the mass-gathering environment.

Objective:

This study sought to determine the facilitators and barriers to the chain of survival at mass gatherings.

Methods:

This case-series research was exploratory and descriptive, using the analysis of personal experiences of resuscitation. Participants were members of St John Ambulance Australia who had participated actively in a resuscitation event in 2007. Telephone interviews were used as a means of data collection. Participant narrative was recorded electronically, transcribed verbatim, and analyzed thematically using a well established human science approach.

Results:

The thematic analysis revealed five main themes and a number of sub-themes. Four of the main themes were aligned easily with the four chain of survival links. The remaining main theme outlined a new link in the chain of survival of specific importance to mass gatherings, ‘early planning’. Additionally, a number of sub-themes were identified, which exemplified various facilitators and barriers to the chain of survival in this environment.

Conclusions:

This research highlights various barriers and facilitators to the chain of survival in the mass-gathering environment. Additionally, the unique “early planning” link in the chain of survival as described in this research highlights the importance of a preparatory phase for responders at mass gatherings.
Integrated Response to the Dynamic Threat of School Violence
Authors: Callaway David W. , Westmoreland Ted C. , Baez Alejandro A. , McKay Sean A. , Raja Ali S.
Published: August 2016

A terrorist attack on US schools no longer can be considered a Black Swan event. Mounting evidence suggests that extremist organizations actively are targeting US schools. Equally disturbing are data suggesting that schools, universities, and communities are unprepared for large-scale violence. The Operational Medicine Institute Conference on an Integrated Response to the Modern Urban Terrorist Threat revealed significant variations in the perceived threats and critical response gaps among emergency medical providers, law enforcement personnel, politicians, and security specialists. The participants recommended several steps to address these gaps in preparedness, training, responses, and recovery.
Chinese Disasters and Just-in-Time Education
Authors: Yang Yingyun , Chen Yanwen , Chotani Rashid A. , LaPorte Ronald E. , Ardalan Ali , Shubnikov Eugene , Linkov Faina , Huang Jesse
Published: August 2016

Just-in-time ( JIT) Educational Strategy has been applied successfully to share scientific knowledge about disasters in several countries. This strategy was introduced to China in 2008 with the hopes to quickly disseminate accurate scientific data to the population, and it was applied during the Sichuan Earthquake and Influenza A (H1N1) outbreak. Implementation of this strategy likely educated between 10,000 and 20,000,000 people. The efforts demonstrated that an effective JIT strategy impacted millions of people in China after a disaster occurs as a disaster mitigation education method. This paper describes the Chinese JIT approach, and discusses methodologies for implementing JIT lectures in the context of China's medical and public health system.
Trained Lay First Responders Reduce Trauma Mortality: A Controlled Study of Rural Trauma in Iraq
Authors: Murad Mudhafar Karim , Husum Hans
Published: August 2016

Introduction:

Recent studies demonstrate that early, in-field, basic life support by paramedics improves trauma survival where prehospital transport times are long. So far, no case-control studies of the effect of layperson trauma first responders have been reported. It was hypothesized that trained layperson first responders improve trauma outcomes where prehospital transit times are long.

Methods:

A rural prehospital trauma system was established in the mine and war zones in Iraq, consisting of 135 paramedics and 7,000 layperson trauma first responders in the villages. In a non-randomized clinical study, the outcomes of patients initially managed in-field by first-responders were compared to patients not receiving first-responder support.

Results:

The mortality rate was significantly lower among patients initially managed in-field by first responders (n = 325) compared to patients without first-responder support (n = 1,016), 9.8% versus 15.6%, 95% CI = 1.3−10.0%.

Conclusions:

Trained layperson first responders improve trauma outcomes where prehospital evacuation times are long. This finding demonstrates that simple interventions done early—by any type of trained care provider—are crucial for trauma survival. Where the prevalence of severe trauma is high, trauma first-responders should be an integral element of the trauma system.
Prehospital Care Algorithm for Blast Injuries due to Bombing Incidents
Authors: Kapur G. Bobby , Pillow M. Tyson , Nemeth Ira
Published: August 2016

Terrorist bombings continue to remain a risk for local jurisdictions, and retrospective data from the United States show that bombings occur in residential and business areas due to interpersonal violence without political motives. In the event of a mass-casualty bombing incident, prehospital care providers will have the responsibility for identifying and managing blast injuries unique to bombing victims. In a large-scale event, emergency medical services personnel should be required to provide prolonged medical care in the prehospital setting, and they will be able to deliver improved care with a better understanding of blast injuries and a concise algorithm for managing them. Blast injuries are categorized as primary, secondary, tertiary, and quaternary, and these injuries are related to the mechanism of injury from the blast event. After an initial evaluation, the emergency healthcare provider should consider following a universal algorithm to identify and treat blast injuries within these categories to prevent further morbidity or mortality in the prehospital setting.
Focus on Smoke Inhalation—The Most Common Cause of Acute Cyanide Poisoning
Authors: Eckstein Marc , Maniscalco Paul M.
Published: August 2016

The contribution of smoke inhalation to cyanide-attributed morbidity and mortality arguably surpasses all other sources of acute cyanide poisoning. Research establishes that cyanide exposure is: (1) to be expected in those exposed to smoke in closed-space fires; (2) cyanide poisoning is an important cause of incapacitation and death in smoke-inhalation victims; and (3) that cyanide can act independently of, and perhaps synergistically with, carbon monoxide to cause morbidity and mortality. Effective prehospital management of smoke inhalation-associated cyanide poisoning is inhibited by: (1) a lack of awareness of fire smoke as an important cause of cyanide toxicity; (2) the absence of a rapidly returnable diagnostic test to facilitate its recognition; and (3) in the United States, the current unavailability of a cyanide antidote that can be used empirically with confidence outside of hospitals. Addressing the challenges of the prehospital management of smoke inhalation-associated cyanide poisoning entails: (1) enhancing the awareness of the problem among prehospital responders; (2) improving the ability to recognize cyanide poisoning on the basis of signs and symptoms; and (3) expanding the treatment options that are useful in the prehospital setting.
The Health Impacts of Climate Change: Getting Started on a New Theme
Authors: Ebi Kristie L. , Helmer Madeleen , Vainio Jari
Published: August 2016

Climate change is widely acknowledged as a key global challenge for the 21st century, and is projected to significantly affect population health and human well-being. All of the climate change-related changes in weather patterns will affect human health, from boosting mental well-being to mortality from largescale disasters. Human health can be affected both directly and indirectly.

For various reasons, the health sector has been slow in responding to the projected health impacts of climate change. To effectively prepare for and cope with climate change impacts, public health must move from a focus on surveillance and response to a greater emphasis on prediction and prevention.

The targeted agenda program dialogue identified three priorities for climate change related health actions: heat waves, vector-borne diseases; and malnutrition.
Surveillance beyond Camp Settings in Humanitarian Emergencies: Findings from the Humanitarian Health Information Management Working Group
Authors: Purdin Susan , Spiegel Paul , Mack Katelyn P. , Millen Jennifer
Published: August 2016

Introduction:

Surveillance is an essential component of health and nutrition information management during humanitarian situations. Changes in the nature and scope of humanitarian assistance activities have created new challenges in health surveillance, particularly outside of camp-based settings.

Objectives:

The primary aim of the Humanitarian Health Information Management Working Group was to identify challenges and areas that need further elucidation in a range of non-camp settings, including urban and rural as well as low-and middle-income countries.

Results:

Three major themes emerged: (1) standardization of measures and methodologies; (2) context in data collection and management; and (3) hidden populations and the purpose of surveillance in urban settings. Innovative examples of data collection and management in community-based surveillance were discussed, including task-shifting, health worker to community member ratio, and literacy needs.

Conclusions:

Surveillance in non-camp settings can be informed by surveillance activities in camp-based settings, but requires additional consideration of new methods and population needs to achieve its objectives.
Applied Technologies in Humanitarian Assistance: Report of the 2009 Applied Technology Working Group
Authors: Greenough P.G. , Chan J.L. , Meier P. , Bateman L. , Dutta S.
Published: August 2016

Information and communication technologies, especially in the forms of mobile telecommunications, satellite imaging, and geographical information systems, promise to significantly improve the practice of humanitarian relief. A working group convened at the Humanitarian Action Summit 2009, has begun investigating the challenges to implementing these technologies in field operations, keeping in mind the ethical considerations of linking people to place, and pledging to build a community of practice among academics, practitioners, and developers.
Mental Health and Psychosocial Support in Crisis and Conflict: Report of the Mental Health Working Group
Authors: Allden K. , Jones L. , Weissbecker I. , Wessells M. , Bolton P. , Betancourt T.S. , Hijazi Z. , Galappatti A. , Yamout R. , Patel P. , Sumathipala A.
Published: August 2016

Introduction:

The Working Group on Mental Health and Psychosocial Support was convened as part of the 2009 Harvard Humanitarian Action Summit. The Working Group chose to focus on ethical issues in mental health and psychosocial research and programming in humanitarian settings. The Working Group built on previous work and recommendations, such as theInter-Agency Standing Committee's Guidelines on Mental Health and Psychosocial Support in Emergency Settings.

Objectives:

The objective of this working group was to address one of the factors contributing to the deficiency of research and the need to develop the evidence base on mental health and psychosocial support interventions during complex emergencies by proposing ethical research guidelines. Outcomes research is vital for effective program development in emergency settings, but to date, no comprehensive ethical guidelines exist for guiding such research efforts.

Methods:

Working Group members conducted literature reviews which included peer-reviewed publications, agency reports, and relevant guidelines on the following topics: general ethical principles in research, cross-cultural issues, research in resource-poor countries, and specific populations such as trauma and torture survivors, refugees, minorities, children and youth, and the mentally ill. Working Group members also shared key points regarding ethical issues encountered in their own research and fieldwork.

Results:

The group adapted a broad definition of the term “research”, which encompasses needs assessments and data gathering, as well as monitoring and evaluation. The guidelines are conceptualized as applying to formal and informal processes of assessment and evaluation in which researchers as well as most service providers engage. The group reached consensus that it would be unethical not to conduct research and evaluate outcomes of mental health and psychosocial interventions in emergency settings, given that there currently is very little good evidence base for such interventions. Overarching themes and issues generated by the group for further study and articulation included: purpose and benefits of research, issues of validity, neutrality, risk, subject selection and participation, confidentiality, consent, and dissemination of results.

Conclusions:

The group outlined several key topics and recommendations that address ethical issues in conducting mental health and psychosocial research in humanitarian settings. The group views this set of recommendations as a living document to be further developed and refined based on input from colleagues representing different regions of the globe with an emphasis on input from colleagues from low-resource countries.
Scientists Map Temperature and Density in Earth's Exosphere
Authors: Yan Wudan
Published: August 2016

Data from multiple orbiters give a clearer picture of how density and temperature interact and what that could mean for future satellite missions.
Resting and injury‐induced inflamed periosteum contain multiple macrophage subsets that are located at sites of bone growth and regeneration
Authors: Alexander Kylie Anne , Raggatt Liza‐Jane , Millard Susan , Batoon Lena , Chiu‐Ku Wu Andy , Chang Ming‐Kang , Hume David Arthur , Pettit Allison Robyn
Published: August 2016

Better understanding of bone growth and regeneration mechanisms within periosteal tissues will improve understanding of bone physiology and pathology. Macrophage contributions to bone biology and repair have been established but specific investigation of periosteal macrophages has not been undertaken. We used an immunohistochemistry approach to characterize macrophages in growing murine bone and within activated periosteum induced in a mouse model of bone injury. Osteal tissue macrophages (osteomacs) and resident macrophages were distributed throughout resting periosteum. In tissues collected from 4‐week‐old mice, osteomacs were observed intimately associated with sites of periosteal diaphyseal and metaphyseal bone dynamics associated with normal growth. This included F4/80+Mac‐2−/low osteomac association with extended tracks of bone formation (modeling) on diphyseal periosteal surfaces. Although this recapitulated endosteal osteomac characteristics, there was subtle variance in the morphology and spatial organization of periosteal modeling‐associated osteomacs, which likely reflects the greater structural complexity of periosteum. Osteomacs, resident macrophages and inflammatory macrophages (F4/80+Mac‐2hi) were associated with the complex bone dynamics occurring within the periosteum at the metaphyseal corticalization zone. These three macrophage subsets were also present within activated native periosteum after bone injury across a 9‐day time course that spanned the inflammatory through remodeling bone healing phases. This included osteomac association with foci of endochondral ossification within the activated native periosteum. These observations confirm that osteomacs are key components of both osteal tissues, in spite of salient differences between endosteal and periosteal structure and that multiple macrophage subsets are involved in periosteal bone dynamics.
Dissecting the precise role of H3K9 methylation in crosstalk with DNA maintenance methylation in mammals
Authors: Zhao Qian , Zhang Jiqin , Chen Ruoyu , Wang Lina , Li Bo , Cheng Hao , Duan Xiaoya , Zhu Haijun , Wei Wei , Li Jiwen , Wu Qihan , Han Jing-Dong J. , Yu Wenqiang , Gao Shaorong , Li Guohong , Wong Jiemin
Published: August 2016

In mammals it is unclear if UHRF1-mediated DNA maintenance methylation by DNMT1 is strictly dependent on histone H3K9 methylation. Here we have generated an Uhrf1 knockin (KI) mouse model that specifically abolishes the H3K9me2/3-binding activity of Uhrf1. The homozygous Uhrf1 KI mice are viable and fertile, and exhibit ∼10% reduction of DNA methylation in various tissues. The reduced DNA methylation occurs globally in the genome and does not restrict only to the H3K9me2/3 enriched repetitive sequences. In vitro UHRF1 binds with higher affinity to reconstituted nucleosome with hemi-methylated CpGs than that with H3K9me2/3, although it binds cooperatively to nucleosome with both modifications. We also show that the nucleosome positioning affects the binding of methylated DNA by UHRF1. Thus, while our study supports a role for H3K9 methylation in promoting DNA methylation, it demonstrates for the first time that DNA maintenance methylation in mammals is largely independent of H3K9 methylation.
A rheostat mechanism governs the bifurcation of carbon flux in mycobacteria
Authors: Murima Paul , Zimmermann Michael , Chopra Tarun , Pojer Florence , Fonti Giulia , Dal Peraro Matteo , Alonso Sylvie , Sauer Uwe , Pethe Kevin , McKinney John D.
Published: August 2016

Fatty acid metabolism is an important feature of the pathogenicity of Mycobacterium tuberculosis during infection. Consumption of fatty acids requires regulation of carbon flux bifurcation between the oxidative TCA cycle and the glyoxylate shunt. In Escherichia coli, flux bifurcation is regulated by phosphorylation-mediated inhibition of isocitrate dehydrogenase (ICD), a paradigmatic example of post-translational mechanisms governing metabolic fluxes. Here, we demonstrate that, in contrast to E. coli, carbon flux bifurcation in mycobacteria is regulated not by phosphorylation but through metabolic cross-activation of ICD by glyoxylate, which is produced by the glyoxylate shunt enzyme isocitrate lyase (ICL). This regulatory circuit maintains stable partitioning of fluxes, thus ensuring a balance between anaplerosis, energy production, and precursor biosynthesis. The rheostat-like mechanism of metabolite-mediated control of flux partitioning demonstrates the importance of allosteric regulation during metabolic steady-state. The sensitivity of this regulatory mechanism to perturbations presents a potentially attractive target for chemotherapy.
Spontaneous perception of numerosity in humans
Authors: Cicchini Guido Marco , Anobile Giovanni , Burr David C.
Published: August 2016

Humans, including infants, and many other species have a capacity for rapid, nonverbal estimation of numerosity. However, the mechanisms for number perception are still not clear; some maintain that the system calculates numerosity via density estimates—similar to those involved in texture—while others maintain that more direct, dedicated mechanisms are involved. Here we show that provided that items are not packed too densely, human subjects are far more sensitive to numerosity than to either density or area. In a two-dimensional space spanning density, area and numerosity, subjects spontaneously react with far greater sensitivity to changes in numerosity, than either area or density. Even in tasks where they were explicitly instructed to make density or area judgments, they responded spontaneously to number. We conclude, that humans extract number information, directly and spontaneously, via dedicated mechanisms.
Linear ubiquitination is involved in the pathogenesis of optineurin-associated amyotrophic lateral sclerosis
Authors: Nakazawa Seshiru , Oikawa Daisuke , Ishii Ryohei , Ayaki Takashi , Takahashi Hirotaka , Takeda Hiroyuki , Ishitani Ryuichiro , Kamei Kiyoko , Takeyoshi Izumi , Kawakami Hideshi , Iwai Kazuhiro , Hatada Izuho , Sawasaki Tatsuya , Ito Hidefumi , Nureki Osamu , Tokunaga Fuminori
Published: August 2016

Optineurin (OPTN) mutations cause neurodegenerative diseases, including amyotrophic lateral sclerosis (ALS) and glaucoma. Although the ALS-associated E478G mutation in the UBAN domain of OPTN reportedly abolishes its NF-κB suppressive activity, the precise molecular basis in ALS pathogenesis still remains unclear. Here we report that the OPTN-UBAN domain is crucial for NF-κB suppression. Our crystal structure analysis reveals that OPTN-UBAN binds linear ubiquitin with homology to NEMO. TNF-α-mediated NF-κB activation is enhanced in OPTN-knockout cells, through increased ubiquitination and association of TNF receptor (TNFR) complex I components. Furthermore, OPTN binds caspase 8, and OPTN deficiency accelerates TNF-α-induced apoptosis by enhancing complex II formation. Immunohistochemical analyses of motor neurons from OPTN-associated ALS patients reveal that linear ubiquitin and activated NF-κB are partially co-localized with cytoplasmic inclusions, and that activation of caspases is elevated. Taken together, OPTN regulates both NF-κB activation and apoptosis via linear ubiquitin binding, and the loss of this ability may lead to ALS.
Severe NDE1-mediated microcephaly results from neural progenitor cell cycle arrests at multiple specific stages
Authors: Doobin David J. , Kemal Shahrnaz , Dantas Tiago J. , Vallee Richard B.
Published: August 2016

Microcephaly is a cortical malformation disorder characterized by an abnormally small brain. Recent studies have revealed severe cases of microcephaly resulting from human mutations in the NDE1 gene, which is involved in the regulation of cytoplasmic dynein. Here using in utero electroporation of NDE1 short hairpin RNA (shRNA) in embryonic rat brains, we observe cell cycle arrest of proliferating neural progenitors at three distinct stages: during apical interkinetic nuclear migration, at the G2-to-M transition and in regulation of primary cilia at the G1-to-S transition. RNAi against the NDE1 paralogue NDEL1 has no such effects. However, NDEL1 overexpression can functionally compensate for NDE1, except at the G2-to-M transition, revealing a unique NDE1 role. In contrast, NDE1 and NDEL1 RNAi have comparable effects on postmitotic neuronal migration. These results reveal that the severity of NDE1-associated microcephaly results not from defects in mitosis, but rather the inability of neural progenitors to ever reach this stage.
LncSox4 promotes the self-renewal of liver tumour-initiating cells through Stat3-mediated Sox4 expression
Authors: Chen Zhen-zhen , Huang Lan , Wu Ya-hong , Zhai Wen-jie , Zhu Ping-ping , Gao Yan-feng
Published: August 2016

Liver cancer has a tendency to develop asymptomatically in patients, so most patients are diagnosed at a later stage. Accumulating evidence implicates that liver tumour-initiating cells (TICs) as being responsible for liver cancer initiation and recurrence. However, the molecular mechanism of liver TIC self-renewal is poorly understood. Here we discover that a long noncoding RNA (lncRNA) termed LncSox4 is highly expressed in hepatocellular carcinoma (HCC) tissues and in liver TICs. We find that LncSox4 is required for liver TIC self-renewal and tumour initiation. LncSox4 interacts with and recruits Stat3 to the Sox4 promoter to initiate the expression of Sox4, which is highly expressed in liver TICs and required for liver TIC self-renewal. The expression level of Sox4 correlates with HCC development, clinical severity and prognosis of patients. Altogether, we find that LncSox4 is highly expressed in liver TICs and is required for their self-renewal.
Ribosomal 18S rRNA base pairs with mRNA during eukaryotic translation initiation
Authors: Martin Franck , Ménétret Jean-François , Simonetti Angelita , Myasnikov Alexander G. , Vicens Quentin , Prongidi-Fix Lydia , Natchiar S. Kundhavai , Klaholz Bruno P. , Eriani Gilbert
Published: August 2016

Eukaryotic mRNAs often contain a Kozak sequence that helps tether the ribosome to the AUG start codon. The mRNA of histone H4 (h4) does not undergo classical ribosome scanning but has evolved a specific tethering mechanism. The cryo-EM structure of the rabbit ribosome complex with mouse h4 shows that the mRNA forms a folded, repressive structure at the mRNA entry site on the 40S subunit next to the tip of helix 16 of 18S ribosomal RNA (rRNA). Toe-printing and mutational assays reveal that an interaction exists between a purine-rich sequence in h4 mRNA and a complementary UUUC sequence of helix h16. Together the present data establish that the h4 mRNA harbours a sequence complementary to an 18S rRNA sequence which tethers the mRNA to the ribosome to promote proper start codon positioning, complementing the interactions of the 40S subunit with the Kozak sequence that flanks the AUG start codon.
Variation in helper effort among cooperatively breeding bird species is consistent with Hamilton’s Rule
Authors: Green Jonathan P. , Freckleton Robert P. , Hatchwell Ben J.
Published: August 2016

Investment by helpers in cooperative breeding systems is extremely variable among species, but this variation is currently unexplained. Inclusive fitness theory predicts that, all else being equal, cooperative investment should correlate positively with the relatedness of helpers to the recipients of their care. We test this prediction in a comparative analysis of helper investment in 36 cooperatively breeding bird species. We show that species-specific helper contributions to cooperative brood care increase as the mean relatedness between helpers and recipients increases. Helper contributions are also related to the sex ratio of helpers, but neither group size nor the proportion of nests with helpers influence helper effort. Our findings support the hypothesis that variation in helping behaviour among cooperatively breeding birds is consistent with Hamilton’s rule, indicating a key role for kin selection in the evolution of cooperative investment in social birds.