bluuebunny/crossref_metadata_2025 huggingface dataset:
What is harmful for male fertility: Cell phone or the wireless internet?
Authors: Yildirim Mehmet Erol , Kaynar Mehmet , Badem Huseyin , Cavis Mucahıt , Karatas Omer Faruk , Cimentepe Ersın
Published: July 2015

In this study, we aimed to assess the potential harmful effects of radiofrequency‐electromagnetic radiation on sperm parameters. We requested semen for analyses from the male patients coming to our infertility division and also asked them to fill out an anonymous questionnaire. We queried their mobile phone and wireless internet usage frequencies in order to determine their radiofrequency‐electromagnetic radiation exposure. A total of 1082 patients filled the questionnaire but 51 of them were excluded from the study because of azoospermia. There was no significant difference between sperm counts and sperm morphology excluding sperm motility, due to mobile phone usage period, (p = 0.074, p = 0.909, and p = 0.05, respectively). The total motile sperm count and the progressive motile sperm count decreased due to the increase of internet usage (p = 0.032 and p = 0.033, respectively). In line with the total motile sperm count, progressive motile sperm count also decreased with wireless internet usage compared with the wired internet connection usage (p = 0.009 and p = 0.018, respectively). There was a negative correlation between wireless internet usage duration and the total sperm count (r = −0.089, p = 0.039). We have also explored the negative effect of wireless internet use on sperm motility according to our preliminary results.
Voting, identity and security threats in Ukraine: who supports the Radical “Freedom” Party?
Authors: Bustikova Lenka
Published: July 2015

This article investigates voters and sympathizers of Ukraine’s radical right party, Svoboda. Using an original survey conducted in 2010, it shows that support for Svoboda was rooted less in extreme levels of xenophobia vis-à-vis Russians, and more in concerns about the support that the Russian minority receives from the state, fear of losing Ukrainian sovereignty, and economic anxiety. In contrast to the conventional view, the analysis suggests that support for Svoboda was not a function of inter-group ethnic hostilities; instead, it originated in perceived threats and anxieties about the character of the Ukrainian state.
Is late‐onset Alzheimer's disease really a disease of midlife?
Authors: Ritchie Karen , Ritchie Craig W. , Yaffe Kristine , Skoog Ingmar , Scarmeas Nikolaos
Published: July 2015

Introduction

Increasing evidence suggests that Alzheimer's disease (AD) may begin decades before evidence of dementia, indicating that it may be a disorder of midlife rather than old age.

Methods

In the absence of long‐term prospective studies from early adulthood specifically designed to address this question, a group of international experts examined evidence presently available from previous clinical and population studies to provide an evidence‐based opinion as to whether such a change in conceptualization may be justified.

Results

Although still lacking confirmation from dedicated prospective biomarker studies, there is already considerable evidence to suggest both risk factor exposure and brain changes may be already present in midlife.

Discussion

Current evidence suggests (1) that a change in clinical approach notably involving promotion of cardiovascular health in persons with a family history of AD may considerably reduce disease risk and (2) that the development of biomarkers at this early stage will lead to the possibility of clinical trials at a much earlier stage.
Delayed‐start analysis: Mild Alzheimer's disease patients in solanezumab trials, 3.5 years
Authors: Liu‐Seifert Hong , Siemers Eric , Holdridge Karen C. , Andersen Scott W. , Lipkovich Ilya , Carlson Christopher , Sethuraman Gopalan , Hoog Sharon , Hayduk Roza , Doody Rachelle , Aisen Paul
Published: July 2015

Introduction

Solanezumab is an anti‐amyloid monoclonal antibody in clinical testing for treatment of Alzheimer's disease (AD). Its mechanism suggests the possibility of slowing the progression of AD.

Methods

A possible disease‐modifying effect of solanezumab was assessed using a new statistical method including noninferiority testing. Performance differences were compared during the placebo‐controlled period with performance differences after the placebo patients crossed over to solanezumab in the delayed‐start period.

Results

Noninferiority of the 14‐item Alzheimer's Disease Assessment Scale‐Cognitive subscale (ADAS‐Cog14) and Alzheimer's Disease Cooperative Study Activities of Daily Living inventory instrumental items (ADCS‐iADL) differences was met through 132 weeks, indicating that treatment differences observed in the placebo‐controlled period remained, within a predefined margin, after the placebo group initiated solanezumab. Solanezumab was well tolerated, and no new safety concerns were identified.

Discussion

The results of this secondary analysis show that the mild subgroup of solanezumab‐treated patients who initiated treatment early, at the start of the placebo‐controlled period, retained an advantage at most time points in the delayed‐start period.
Stereotactic brain injection of human umbilical cord blood mesenchymal stem cells in patients with Alzheimer's disease dementia: A phase 1 clinical trial
Authors: Kim Hee Jin , Seo Sang Won , Chang Jong Wook , Lee Jung Il , Kim Chi Hun , Chin Juhee , Choi Soo Jin , Kwon Hunki , Yun Hyuk Jin , Lee Jong Min , Kim Sung Tae , Choe Yearn Seong , Lee Kyung‐Han , Na Duk L.
Published: July 2015

Introduction

We conducted a phase 1 clinical trial in nine patients with mild‐to‐moderate Alzheimer's disease to evaluate the safety and dose‐limiting toxicity of stereotactic brain injection of human umbilical cord blood–derived mesenchymal stem cells (hUCB‐MSCs).

Methods

The low‐ (n = 3) and high‐dose (n = 6) groups received a total of 3.0 × 106 cells/60 μL and 6.0 × 106 cells/60 μL, respectively, into the bilateral hippocampi and right precuneus.

Results

No patient showed serious adverse events including fever during the 24‐month follow‐up period. During the 12‐week follow‐up period, the most common acute adverse event was wound pain from the surgical procedure (n = 9), followed by headache (n = 4), dizziness (n = 3), and postoperative delirium (n = 3). There was no dose‐limiting toxicity.

Discussion

Administration of hUCB‐MSCs into the hippocampus and precuneus by stereotactic injection was feasible, safe, and well tolerated. Further trials are warranted to test the efficacy.

Clinical Trial Registration

ClinicalTrial.gov identifier NCT01297218 and NCT01696591.
Conserving and managing mosaics in Libya (CaMMiL): the final project review
Authors: Wootton William T. , El-Habashi Alaa , Stewart John D. , Walda Hafed
Published: July 2015

This is a review of a project aimed at assisting the Libyan Department of Archaeology with the conservation and management of their mosaic heritage. Over the course of a year we undertook an evaluation trip along the coast of Libya and then put on two workshops for the Department's staff to help build capacity. The workshops disseminated complementary content on the protection of mosaics and their management to two different contingents: managers and technicians. The teaching was intended to empower Libyans by giving them the confidence to make simple and sound decisions, and to encourage them to join more formal training courses run by major international organisations. The project was a collaboration with the Department and was supported by the Getty Foundation, King's College London and the Society for Libyan Studies.
Effect of Bifidobacterium thermophilum RBL67 and fructo-oligosaccharides on the gut microbiota in Göttingen minipigs
Authors: Tanner Sabine A. , Lacroix Christophe , Del’Homme Christophe , Jans Christoph , Zihler Berner Annina , Bernalier-Donadille Annick , Chassard Christophe
Published: July 2015

Modulating the gut microbiota via dietary interventions is a common strategy to enhance the natural defence mechanisms of the host. Several in vitro studies have highlighted the probiotic potential of Bifidobacterium thermophilum RBL67 (RBL67) selected for its anti-Salmonella effects. The present study aimed to investigate the impact of RBL67 alone and combined with fructo-oligosaccharides (FOS) on the gut microbiota of Göttingen minipigs. Minipigs were fed a basal diet supplemented with 8 g/d probiotic powder (1×109 CFU/g in skim milk matrix) (probiotic diet (PRO)), 8 g/d probiotic powder plus 8 g/d FOS (synbiotic diet (SYN)) or 8 g/d skim milk powder (control), following a cross-sectional study design. Faecal and caecal microbiota compositions were analysed with pyrosequencing of 16S rRNA genes and quantitative PCR. Metabolic activity in the caecum and colon was measured by HPLC. 16S rRNA gene amplicon sequencing revealed that minipig faeces show close similarity to pig microbiota. During the treatments and at the time of killing of animals, RBL67 was consistently detected in faeces, caecum and colon at numbers of 105–106 16S rRNA copies/g content after feeding PRO and SYN diets. At the time of killing of animals, significantly higher Bifidobacterium numbers in the caecum and colon of SYN-fed minipigs were measured compared with PRO. Our data indicate that the Göttingen minipig may be a suitable model for gut microbiota research in pigs. Data from this first in vivo study of RBL67 colonisation suggest that the combination with FOS may represent a valuable symbiotic strategy to increase probiotic bacteria levels and survival in gastrointestinal tracts for feed and food applications.
UNIQUENESS FOR SINGULAR SEMILINEAR ELLIPTIC BOUNDARY VALUE PROBLEMS II
Authors: HAI D. D. , SMITH R. C.
Published: July 2015

We prove uniqueness of positive solutions for the boundary value problem

\begin{equation*}
\left\{
\begin{array}{l}
-\Delta u=\lambda f(u)\text{ in }\Omega , \\
\ \ \ \ \ \ \ u=0\text{ on }\partial \Omega ,
\end{array}
\right.
\end{equation*}

where Ω is a bounded domain in $\mathbb{R}$n with smooth boundary ∂ Ω, λ is a large positive parameter, f:(0,∞) → [0,∞) is nonincreasing for large t and is allowed to be singular at 0.
Quality of preimplantation embryos recovered in vivo from dairy cows in relation to their body condition
Authors: Makarevich A.V. , Stádník L. , Kubovičová E. , Hegedüšová Z. , Holásek R. , Louda F. , Beran J. , Nejdlová M.
Published: July 2015

This study examined the impact of cow body condition on the quality of bovine preimplantation embryos. The embryos (n = 107) were flushed from dairy cows and classified according to a five-point scale body condition score (BCS2 n = 17; BCS3 n = 31; BCS4 n = 11) on the 7th day after insemination and then analyzed for development, dead cell index (DCI), cell number and actin cytoskeleton quality. The highest embryo recovery rate (P < 0.05) was recorded in the BCS3 group and the lowest in the BCS4 group. More transferable (morula, blastocyst) embryos were obtained from the BCS4 cows (79%), compared with the BCS2 (64%) or BCS3 (63%) animals. However, cell numbers were higher in the BCS2 and BCS3 groups (P < 0.05) compared with the BCS4 embryos. Conversely, the DCI was lowest in the BCS2 (3.88%; P < 0.05) and highest in the BCS4 (6.56%) embryos. The proportion of embryos with the best actin quality (grade I) was higher in the BCS2 and BCS3 cows compared with the BCS4 group. Almost 25% of all embryos showed fragmented morphology and a higher DCI (5.65%) than normal morulas (1.76%). More fragmented embryos were revealed in the BCS2 (28.6%) and BCS4 (31.25%) groups, and less (19.15%) in the BCS3 group. The cell numbers in such embryos were lower in the BCS4 (22.57) than in the BCS2 (46.25) or BCS3 (42.4) groups. In conclusion, the body condition of dairy cows affects the quality of preimplantation embryos. A BCS over 3.0 resulted in a higher incidence of poor (fragmented) embryos.
Surgically treated pulmonary stenosis: over 50 years of follow-up
Authors: Nielsen Eva A. , Hjortdal Vibeke E.
Published: July 2015

Background

Surgical correction was the treatment of choice for pulmonary stenosis until three decades ago, when balloon valvuloplasty was implemented. The natural history of surgically relieved pulmonary stenosis has been considered benign but is actually unknown, as is the need for re-intervention.

The objective of this study was to investigate the morbidity and mortality of patients with surgically treated pulmonary stenosis operated at Aarhus University Hospital between 1957 and 2000.

Results

The total study population included 80 patients. In-hospital mortality was 2/80 (2.5%), and an additional four patients died after hospital discharge; therefore, the long-term mortality was 5%. The maximum follow-up period was 57 years, with a median of 33 years. In all, 16 patients (20%) required at least one re-intervention. Pulmonary valve replacement due to pulmonary regurgitation was the most common re-intervention (67%). Freedom from re-intervention decreased >20 years after the initial repair. In addition, 45% of patients had moderate/severe pulmonary regurgitation, 38% had some degree of right ventricular dilatation, and 40% had some degree of tricuspid regurgitation, which did not require re-intervention at the present stage.

Conclusion

Surgical relief for pulmonary stenosis is efficient in relieving outflow obstruction; however, this efficiency is achieved at the cost of pulmonary regurgitation, leading to right ventricular dilatation and tricuspid regurgitation. When required, pulmonary valve replacement is performed most frequently >20 years after the initial surgery. Lifelong follow-up of patients treated surgically for pulmonary stenosis is emphasised in this group of patients, who might otherwise consider themselves cured.
Sudden cardiac death associated with premature atheroma in the young: an autopsy study emphasising single-vessel lesions
Authors: Green Anna C. , Sheppard Mary N.
Published: July 2015

Aims

This is the first autopsy study in the United Kingdom to analyse the demographic and pathological characteristics of atheroma associated with sudden cardiac death in young people.

Methods

An observational retrospective study of referred cases of sudden cardiac death in the young (⩽35 years) associated with premature atheroma was carried out.

Results

In total, 46 cases were referred, with a median age of 30 years (27, 32); 72% of the referred cases were male, with a mean body mass index of 30 kg/m2. Circumstances of death were as follows: at rest (n=21), exertion (n=7), in bed (n=7), related to drugs/alcohol (n=4), and unknown (n=7). A previous cardiac history was provided in 10 cases. A history of class A/B drug use was found in eight cases. There was macroscopic evidence of infarction in 10 cases (acute, n=3 and chronic, n=7). Microscopically, 10 cases demonstrated contraction band necrosis, 11 acute infarction, and 11 chronic infarction. Single-vessel disease predominated (n=28). The left anterior descending coronary artery was involved in 39/46 cases. Thrombosis was seen in 16 cases, mainly due to erosion; one case showed dual pathology with arrhythmogenic right ventricular cardiomyopathy and another showed left ventricular hypertrophy.

Conclusions

This study highlights premature atheroma mainly in a single vessel in young people with or without evidence of ischaemic damage in the ventricle. Dual pathology may occur. The role of arrhythmias and channelopathies are important considerations. Premature atheroma should prompt investigation for dyslipidaemias in family members.
Export of environmental goods: India's potential and constraints
Authors: Nguyen Van Son , Kalirajan Kaliappa
Published: July 2015

Using data from the period 1996–2010, this paper identifies the nature of constraints that make India, which is one of the emerging environmental goods and services (EGS) exporters, unable to realize its export potential of environmental goods (EG). The empirical results show that the growth of India's exports of EG was negatively affected by ‘behind the border’ constraints such as weak infrastructure and institutions, while the effect of ‘explicit beyond the border’ constraints such as partner countries' tariffs and exchange rates on the exports of EG was relatively small. The reduction of India's trading partners' ‘implicit beyond the border’ constraints such as weak infrastructure and institutions significantly contributed toward India's exports of EG, especially during the period 2005–2010.
Stakeholder perspectives on the new sickness certificate in Victoria: results from a mixed-methods qualitative study
Authors: Brijnath Bianca , Singh Nabita , Mazza Danielle
Published: July 2015

Objective
The aim of this study was to present the views of four stakeholder groups, namely general practitioners (GP), employers (EMP), injured workers (IW) and compensation agents (CA), about the content and usability of the draft of the new Victorian sickness certificate.

Methods
A cross-sectional mixed-methods qualitative study was conducted in GP clinics and community settings in Melbourne, Australia. Interviews were conducted with GPs, EMPs and IWs and one focus group discussion was completed with CAs (n = 29). Data were collected between October and December 2013. Thematic analysis was performed.

Results
All stakeholders viewed the new draft certificate as an improvement on the old one. GPs saw the certificate as a form of communication, whereas EMPs and CAs saw it as a therapeutic device. GPs continued to certify based on incapacity and provided little information about what IWs could do on return to work. All groups said that assessments for mental health needed more clarity and specificity. GPs, EMPs and CAs also said that the new certificates must be electronically available and integrated into existing medical software to streamline uptake.

Conclusions
To ensure appropriate use of the new certificate, stakeholders must share a common understanding about its purpose and the certificate must be incorporated into existing medical software. Content on mental health assessment, an area of continued difficulty, needs additional refinement. The new certificate replaced the old certificate in March 2015; after it has been established in clinical practice, an impact evaluation should be completed to determine whether GPs are certifying capacity and earlier return to work.

What is known about the topic?
When it comes to sickness certification, GPs tend to focus on what injured patients cannot do, rather than what they can do. The new sickness certificate aims to change GP behaviour by focusing the certificate more on capacity (i.e. what the injured patient can do).

What does this paper add?
Four stakeholder groups agreed that the content and usability of the new certificate has improved. However, they agreed that the assessment of mental health capacity needs further specificity. Dissonances also remain between the stakeholders on the purpose of the certificate.

What are the implications for practitioners?
Appropriate use of the new certificate requires a common understanding about the purpose of the certificate, training on its appropriate use, incorporation into existing medical software and clarity on mental health assessment.
Reviewing public policy for promoting population oral health in Victoria, Australia (2007–12)
Authors: Heilbrunn-Lang Adina Y. , Carpenter Lauren M. , Powell Seona M. , Kearney Susan L. , Cole Deborah , de Silva Andrea M.
Published: July 2015

Objective Government policy and planning set the direction for community decisions related to resource allocation, infrastructure, services, programs, workforce and social environments. The aim of the present study was to examine the policy and planning context for oral health promotion in Victoria, Australia, over the period 2007–12. Methods Key Victorian policies and plans related to oral health promotion in place during the 2007–12 planning cycle were identified through online searching, and content analysis was performed. Inclusion of oral health (and oral health-related) promotion initiatives was assessed within the goals, objectives and strategies sections of each plan. Results Six of the 223 public health plans analysed (3%) included oral health ‘goals’ (including one plan representing nine agencies). Oral health was an ‘objective’ in 10 documents. Fifty-six plan objectives, and 70 plan strategies related to oral health or healthy eating for young children. Oral health was included in municipal plans (44%) more frequently than the other plans examined. Conclusion There is a policy opportunity to address oral health at a community level, and to implement population approaches aligned with the Ottawa Charter that address the social determinants of health. What is known about the topic? Poor oral health is a significant global health concern and places a major burden on individuals and the healthcare system, affecting approximately 50% of all children and 75%–95% of adults in Australia. The Ottawa Charter acknowledges the key role of policy in improving the health of a population; however, little is known about the policy emphasis placed on oral health by local government, primary care partnerships and community health agencies in Victoria, Australia. What does this paper add? This is a review of oral health content within local government (municipal) and community health plans in Victoria, Australia. What are the implications for practitioners? The findings identify several opportunities for public health and community health practitioners and policy makers to place greater emphasis on prevention and improvement of the oral health of Victorians through policy development.
Training a system-literate care coordination workforce
Authors: Naccarella Lucio , Osborne Richard H. , Brooks Peter M.
Published: July 2015

People with chronic complex conditions continue to experience increasing health system fragmentation and poor coordination. To reverse these trends, one solution has been an investment in effective models of care coordination that use a care coordinator workforce. Care coordinators are not a homogenous workforce – but an applied professional role, providing direct and indirect care, and is often undertaken by nurses, allied health professionals, social workers or general practitioners. In Australia, there is no training curriculum nor courses, nor nationally recognised professional quality standards for the care coordinator workforce. With the growing complexity and fragmentation of the health care system, health system literacy – shared understanding of the roles and contributions of the different workforce professions, organisations and systems, among patients and indeed the health workforce is required. Efforts to improve health system literacy among the health workforce are increasing at a policy, practice and research level. However, insufficient evidence exists about what are the health system literacy needs of care coordinators, and what is required for them to be most effective. Key areas to build a health system literate care coordination workforce are presented. Care coordination is more than an optional extra, but one of the only ways we are going to be able to provide equitable health services for people with chronic complex conditions. People with low health literacy require more support with the coordination of their care, therefore we need to build a high performing care coordinator workforce that upholds professional quality standards, and is health literacy responsive.
Allied health: integral to transforming health
Authors: Lizarondo Lucylynn , Turnbull Catherine , Kroon Tracey , Grimmer Karen , Bell Alison , Kumar Saravana , McEvoy Maureen , Milanese Steve , Russell Mary , Sheppard Lorraine , Walters Julie , Wiles Louise
Published: July 2015

Objective South Australia is taking an innovative step in transforming the way its healthcare is organised and delivered to better manage current and future demands on the health system. In an environment of transforming health services, there are clear opportunities for allied health to assist in determining solutions to various healthcare challenges. A recent opinion piece proposed 10 clinician-driven strategies to assist in maximising value and sustainability of healthcare in Australia. The present study aimed to seek the perspectives of allied health clinicians, educators, researchers, policy makers and managers on these strategies and their relevance to allied health. Methods A survey of allied health practitioners was undertaken to capture their perspectives on the 10 clinician-driven strategies for maximising value and sustainability of healthcare in Australia. Survey findings were then layered with evidence from the literature. Results Highly relevant across allied health are the strategies of discontinuation of low value practices, targeting clinical interventions to those getting greatest benefit, active involvement of patients in shared decision making and self-management and advocating for integrated systems of care. Conclusions Allied health professionals have been involved in the South Australian healthcare system for a prolonged period, but their services are poorly recognised, often overlooked and not greatly supported in existing traditional practices. The results of the present study highlight ways in which healthcare services can implement strategies not only to improve the quality of patient outcomes, but also to offer innovative solutions for future, sustainable healthcare. The findings call for concerted efforts to increase the utilisation of allied health services to ensure the ‘maximum value for spend’ of the increasingly scarce health dollar. What is known about the topic? In medicine, clinician-driven strategies have been proposed to minimise inappropriate and costly care and maximise highly appropriate and less expensive care. These strategies were developed based on clinical experiences and with supporting evidence from scientific studies. What does this paper add? Major changes to the health system are required to slow down the growth in healthcare expenditure. This paper describes opportunities in which allied health practitioners can implement similar strategies not only to improve the quality of patient outcomes, but also to offer cost-effective solutions for a sustainable healthcare. What are the implications for practitioners? Allied health practitioners can provide solutions to healthcare challenges and assist in the transformation of healthcare in Australia. However, for this to happen, there should be concerted efforts to increase recognition of and support for the use of allied health services.
Accuracy of rapid disposition by emergency clinicians
Authors: Backay Andrew , Bystrzycki Adam , Smit De Villiers , Keogh Martin , O'Reilly Gerard , Mitra Biswadev
Published: July 2015

Objectives Rapid disposition protocols are increasingly being considered for implementation in emergency departments (EDs). Among patients presenting to an adult tertiary referral hospital, this study aimed to compare prediction accuracy of a rapid disposition decision at the conclusion of history and examination, compared with disposition following standard assessment. Methods Prospective observational data were collected for 1 month between October and November 2012. Emergency clinicians (including physicians, registrars, hospital medical officers, interns and nurse practitioners) filled out a questionnaire within 5 min of obtaining a history and clinical examination for eligible patients. Predicted patient disposition (representing ‘rapid disposition’) was compared with final disposition (determined by ‘standard assessment’). Results There were 301 patient episodes included in the study. Predicted disposition was correct in 249 (82.7%, 95% confidence interval (CI) 78.0–86.8) cases. Accuracy of predicting discharge to home appeared highest among emergency physicians at 95.8% (95% CI 78.9–99.9). Overall accuracy at predicting admission was 79.7% (95% CI 67.2–89.0). The remaining 20.3% (95% CI 11.0–32.8) were not admitted following standard assessment. Conclusion Rapid disposition by ED clinicians can predict patient destination accurately but was associated with a potential increase in admission rates. Any model of care using rapid disposition decision making should involve establishment of inpatient systems for further assessment, and a culture of timely inpatient team transfer of patients to the most appropriate treating team for ongoing patient management. What is known about the topic? In response to the National Emergency Access Targets, there has been widespread adoption of rapid-disposition-themed care models across Australia. Although there is emerging data that clinicians can predict disposition accurately, this data is currently limited. What does this paper add? Results of this study support the previously limited evidence that ED practitioners can accurately predict disposition early in the patient journey through ED, and that accuracy is similar across clinician groups. In addition to overall prediction accuracy, admission, discharge and treating team predictions were separately measured. These additional outcomes lend insight into safety and performance aspects relating to a rapid disposition model of care. What are the implications for practitioners? This study offers practical insights that could aid safe and efficient implementation of a rapid disposition model of care.
Use of a capacity audit tool in a mental health setting
Authors: Zeitz Kathryn , Hester Paul
Published: July 2015

Objective
This paper reports on a pilot applying the capacity audit tool (CAT) in a mental health environment and what the tool reveals regarding mental health in-patient capacity issues.

Methods
The CAT was modified to create an electronic mental health-relevant tool to audit acute in-patient capacity. This tool was then piloted across nine bedded units, within a single Local Health Network, covering a total of 153 mental health beds.

Results
The application of the mental health CAT resulted in 100% compliance in completion. The findings revealed that 16% (25 beds) of the 153 beds surveyed were occupied by patients who did not need to occupy the bed or the bed was vacant. Of these 25 beds, 10 had patients awaiting transfer to another facility or service, nine were empty and six were occupied by patients ready for discharge but for whom there were delays.

Conclusion
The CAT was successfully applied to the mental health setting and identified a set of opportunities to improve processes and practices to reduce the identified delays or barriers in order to improve patient flow.

What is known about the topic?
Capacity management and, in particular, timely discharge are key components to optimise patient flow and improve access block for emergency departments. The CAT has been successfully applied in general health settings to identify key delays and barriers to discharge.

What does this paper add?
This article reports on the applicability of the CAT in a mental health setting and the ability of the tool to improve our understanding of bed capacity by identifying key reasons for the use of mental health in-patient beds across a stepped model of care and quantifying the most frequent causes of discharge delay.

What are the implications for practitioners?
This paper describes the modifications of the CAT to make it applicable to the mental health setting and the associated results obtained using the CAT in a mental health setting. The project demonstrated applicability of the tool to the mental health setting. It can be used in other jurisdictions to identify key discharge delays to underpin targeted improvement work within local mental health environments.
Sunflower meal and spring pea ruminal degradation protection using malic acid or orthophosphoric acid-heat treatments
Authors: Díaz-Royón F. , Arroyo J. M. , Sánchez-Yélamo M. D. , González J.
Published: July 2015

The effects of solutions of malic or orthophosphoric acids (0.752 Eqg/kg of feed) and heat to protect proteins of sunflower meal (SFM) and spring pea (SP) against ruminal degradation were studied using particle transit, 15N infusion, in situ and electrophoretic techniques. Three wethers fitted with rumen and duodenum cannulae were successively fed three isoproteic diets including SFM and SP, untreated or treated with malic or orthophosphoric acids. Incubations of tested meals were only performed while feeding the respective diet. Estimates of the ruminally undegraded fraction (RU) and its intestinal digestibility of dry matter, organic matter (only for RU), crude protein and starch (only in SP) were obtained considering ruminal microbial contamination and particle comminution and outflow rates. When corrected for microbial contamination, estimates of RU and intestinal digestibility decreased in all tested fractions for both feeds. All RU estimates increased with the protective treatments, whereas intestinal digestibility-dry matter also increased in SFM. Low intestinal digestibility-crude protein values suggested the presence of antitrypsin factors in SP. Protective treatments of both feeds led to consistent increases in the intestinal digested fraction of dry matter and crude protein, being only numerically different for SP-starch (60.5% as average). However, treatments also reduced the organic matter fermentation, which may decrease ruminal microbial protein synthesis. Electrophoretic studies showed albumin disappearance in both SFM and SP, whereas changes in other RU proteins were more pronounced in SP than SFM.
Effects of supplementing a milk replacer with sodium butyrate or tributyrin on performance and metabolism of Holstein calves
Authors: Araujo G. , Terré M. , Mereu A. , Ipharraguerre I. R. , Bach A.
Published: July 2015

The effects of butyrate supplementation in diets of calves are inconsistent in the literature. Fifty-one Holstein calves (45.7 ± 5.8 kg of bodyweight and 11.8 ± 3.1 days of age; mean ± s.d.) were randomly allocated to three treatments to assess the effects of supplementing the milk replacer at 0.3% dry matter with butyrate in the form of sodium butyrate or tributyrin compared with no supplementation (CTR). Calves were fed 4 L/day of milk replacer (25% crude protein and 19.2% ether extract) and starter feed (20% crude protein and 3.8% ether extract) ad libitum over a period of 6 weeks. Individual intake was measured daily and bodyweight and blood β-hydroxybutyrate, glucose-like peptide-1, glucose and insulin were measured fortnightly. A glucose tolerance test was performed on Days 0 and 35 of the study. No effects of butyrate supplementation were found on starter and total dry matter intake. CTR calves had greater average daily gain than tributyrin calves. CTR calves tended to have greater final bodyweight than tributyrin and sodium butyrate calves. Gain : feed ratio tended to be greater for CTR calves. There were no differences in plasma glucose, insulin, β-hydroxybutyrate and glucose-like peptide-1 concentrations throughout among treatments the study. During the glucose tolerance test, no differences on insulin sensitivity were found among treatments. In conclusion, no apparent advantages of supplementing milk replacer with sodium butyrate or tributyrin were found on performance and glucose metabolism in calves.
Immunisation against gonadotrophin-releasing hormone (GnRH) reduces agonistic behaviours in male rangeland goats
Authors: Bishop Catherine C. , Fleming Patricia A. , Barnes Anne L. , Collins Teresa , Miller David W.
Published: July 2015

Rangeland goat bucks were used to evaluate the efficacy of a commercially available anti-gonadotrophin-releasing hormone vaccine, Improvac (Zoetis Australia, West Ryde, NSW, Australia). The hypothesis tested was that immunisation would suppress testosterone secretion by the testis and agonistic behaviour between male goats. We also compared intervals of 2 and 4 weeks between primary and booster immunisations and monitored responses over a 2-month period. The 45 goats were split into three groups (n = 15): one group receiving the vaccination booster on Day 14, one group receiving the vaccination booster on Day 28, and the Control group receiving sterile saline injections. Body mass, body condition score and scrotal circumference were measured fortnightly, and blood was collected at 2-week intervals and analysed for testosterone concentration. Behavioural interaction tests of 2-min duration were also conducted fortnightly. There was a significant decrease in paired testicular circumference (P < 0.05) and testosterone concentration (P < 0.01) in both vaccination groups by the end of the experiment at Day 60, compared with the Control group. Agonistic interactions measured at Day 60 were significantly reduced in both vaccination groups (P < 0.05) compared with the Control group. These results support the efficacy of Improvac in reducing agonistic behaviours in rangeland goat bucks and suggest that the use of the vaccine may assist in reducing social stress and possible injury in groups of confined male goats.
The motivation and actions of Australians concerning brain health and dementia risk reduction
Authors: Smith Ben J. , Ali Suha , Quach Henry
Published: July 2015

Issue addressed

Alzheimer's disease and dementia are recognised as critical public health priorities. This study investigated intentions and behaviours concerning brain health and dementia risk reduction among Australians.

Methods

A cross‐sectional survey of 1000 persons aged 20–75 years measured knowledge, beliefs, intentions and behaviours concerning brain health and dementia. The demographic, experiential and cognitive factors associated with intentions and actions were examined.

Results

Around half of respondents were motivated to improve brain health. Behaviours most often reported were mental activity (19%), physical activity (9.6%) and dietary action (6.5%). Actions were most likely among women (OR 1.59, 95% CI 1.19–2.14), those aged 60 years and over (OR 3.07, 95% CI 2.01–2.58), with university education (OR 1.67, 95% CI 1.08–2.58) or with prior contact with a person with dementia (OR 1.99, 95% CI 1.12–3.56). Both intentions and actions were associated with moderate to high knowledge, and beliefs and confidence that favoured dementia risk reduction.

Conclusions

A lower proportion of Australians reported taking action to improve brain health than who expressed intentions in this regard. Strategies are needed to improve knowledge about the range of behaviours that contribute to dementia risk reduction and to increase confidence that this outcome is personally achievable.
Attendance patterns and chlamydia and gonorrhoea testing among young people in Aboriginal primary health centres in New South Wales, Australia
Authors: Graham Simon , Wand Handan C. , Ward James S. , Knox Janet , McCowen Debbie , Bullen Patricia , Booker Julie , O'Brien Chris , Garrett Kristine , Donovan Basil , Kaldor John , Guy Rebecca J.
Published: July 2015

Background To inform a sexual health quality improvement program we examined chlamydia and gonorrhoea testing rates among 15–29 year olds attending Aboriginal Community Controlled Health Services (ACCHS) in New South Wales, Australia, and factors associated with chlamydia and gonorrhoea testing. Methods: From 2009 to 2011, consultation and testing data were extracted from four ACCHS. Over the study period, we calculated the median number of consultations per person and interquartile range (IQR), the proportion attending (overall and annually), the proportion tested for chlamydia and gonorrhoea, and those who tested positive. We examined factors associated with chlamydia and gonorrhoea testing using logistic regression. Results: Overall, 2896 15–29-year-olds attended the ACCHSs, 1223 were male and 1673 were female. The median number of consultations was five (IQR 2–12), four (IQR 1–8) for males and seven (IQR 3–14) for females (P < 0.001). Nineteen percent of males and 32% of females attended in each year of the study (P < 0.001). Overall, 17% were tested for chlamydia (10% of males and 22% of females, P < 0.001), and 7% were tested annually (3% of males and 11% of females, P < 0.001). Findings were similar for gonorrhoea testing. In the study period, 10% tested positive for chlamydia (14% of males and 9% of females, P < 0.001) and 0.6% for gonorrhoea. Factors independently associated with chlamydia testing were being female (adjusted odds ratio (AOR) 2.64, 95% confidence interval (CI) 2.07–3.36), being 20–24 years old (AOR: 1.58, 95% CI: 1.20–2.08), and having >3 consultations (AOR: 16.97, 95% CI: 10.32–27.92). Conclusions: More frequent attendance was strongly associated with being tested for chlamydia and gonorrhoea. To increase testing, ACCHS could develop testing strategies and encourage young people to attend more frequently.
Advances in the captive breeding and reproductive biology of the short-beaked echidna (Tachyglossus aculeatus)
Authors: Wallage Andrea , Clarke Lauren , Thomas Lindy , Pyne Michael , Beard Lyn , Ferguson Arthur , Lisle Allan , Johnston Stephen
Published: July 2015

Captive breeding of the short-beaked echidna (Tachyglossus aculeatus) has proven a difficult challenge; as recently as 2009, there were fewer than 10 echidnas born in captivity. We present observations of captive reproductive behaviour following video surveillance and measurements of body temperature collected from six captive female echidnas over a six-year period. In the first series of observations (2009–10) we examined the efficacy of artificial burrow boxes as possible aids for reproductive success. Females with access to burrow boxes had significantly higher levels of reproductive activity (P = 0.001), there was coincidental improvement in the production of eggs or pouch young (two eggs, one unhatched and one offspring). During 2009–10, a range of reproductive behaviours (courtship, copulation and postcopulation) were documented and analysed, as were new observations of oestrous cycle activity. Female body temperature was characteristically stable during egg incubation during this study and has the potential to be used as a tool for the assessment of reproductive status. Following initial observations, burrow boxes and infrared lamps were implemented as standard husbandry in our echidna breeding facility and the effects on reproductive success were monitored, albeit less intensively, for a further four years (2011–14). Although no direct causal effect could be ascribed, the use of burrow boxes and heat lamps coincided with a total of 13 young being born to four females in the last four years (2011–14). These female echidnas were found to be receptive at intervals throughout the breeding season, both before and after presumed incubation phases, suggesting that captive animals exhibit polyoestry. In 2012 and 2014, the same female showed evidence of producing two young from one breeding event.
Spaced seeds improvek-mer-based metagenomic classification
Authors: Břinda Karel , Sykulski Maciej , Kucherov Gregory
Published: July 2015

Motivation: Metagenomics is a powerful approach to study genetic content of environmental samples, which has been strongly promoted by next-generation sequencing technologies. To cope with massive data involved in modern metagenomic projects, recent tools rely on the analysis of k-mers shared between the read to be classified and sampled reference genomes.

Results: Within this general framework, we show that spaced seeds provide a significant improvement of classification accuracy, as opposed to traditional contiguous k-mers. We support this thesis through a series of different computational experiments, including simulations of large-scale metagenomic projects.

Availability and implementation, Supplementary information: Scripts and programs used in this study, as well as supplementary material, are available from http://github.com/gregorykucherov/spaced-seeds-for-metagenomics.

Contact:  gregory.kucherov@univ-mlv.fr
Mapping networks of light–dark transition in LOV photoreceptors
Authors: Kaur Grewal Rajdeep , Mitra Devrani , Roy Soumen
Published: July 2015

Motivation: In optogenetics, designing modules of long or short signaling state lifetime is necessary for control over precise cellular events. A critical parameter for designing artificial or synthetic photoreceptors is the signaling state lifetime of photosensor modules. Design and engineering of biologically relevant artificial photoreceptors is based on signaling mechanisms characteristic of naturally occurring photoreceptors. Therefore identifying residues important for light–dark transition is a definite first step towards rational design of synthetic photoreceptors. A thorough grasp of detailed mechanisms of photo induced signaling process would be immensely helpful in understanding the behaviour of organisms.

Results: Herein, we introduce the technique of differential networks. We identify key biological interactions, using light-oxygen-voltage domains of all organisms whose dark and light state crystal structures are simultaneously available. Even though structural differences between dark and light states are subtle (other than the covalent bond formation between flavin chromophore and active site Cysteine), our results successfully capture functionally relevant residues and are in complete agreement with experimental findings from literature. Additionally, using sequence-structure alignments, we predict functional significance of interactions found to be important from network perspective yet awaiting experimental validation. Our approach would not only help in minimizing extensive photo-cycle kinetics procedure but is also helpful in providing first-hand information on the fundamentals of photo-adaptation and rational design of synthetic photoreceptors in optogenetics.

Contact:  devrani.dbs@presiuniv.ac.in or soumen@jcbose.ac.in

Supplementary information:  Supplementary data are available at Bioinformatics online.
Statistically identifying tumor suppressors and oncogenes from pan-cancer genome-sequencing data
Authors: Kumar Runjun D. , Searleman Adam C. , Swamidass S. Joshua , Griffith Obi L. , Bose Ron
Published: July 2015

Motivation: Several tools exist to identify cancer driver genes based on somatic mutation data. However, these tools do not account for subclasses of cancer genes: oncogenes, which undergo gain-of-function events, and tumor suppressor genes (TSGs) which undergo loss-of-function. A method which accounts for these subclasses could improve performance while also suggesting a mechanism of action for new putative cancer genes.

Results: We develop a panel of five complementary statistical tests and assess their performance against a curated set of 99 HiConf cancer genes using a pan-cancer dataset of 1.7 million mutations. We identify patient bias as a novel signal for cancer gene discovery, and use it to significantly improve detection of oncogenes over existing methods (AUROC = 0.894). Additionally, our test of truncation event rate separates oncogenes and TSGs from one another (AUROC = 0.922). Finally, a random forest integrating the five tests further improves performance and identifies new cancer genes, including CACNG3, HDAC2, HIST1H1E, NXF1, GPS2 and HLA-DRB1.

Availability and implementation  : All mutation data, instructions, functions for computing the statistics and integrating them, as well as the HiConf gene panel, are available at www.github.com/Bose-Lab/Improved-Detection-of-Cancer-Genes.

Contact:  rbose@dom.wustl.edu

Supplementary information:  Supplementary data are available at Bioinformatics online.