bluuebunny/crossref_metadata_2025 huggingface dataset:
Workforce Competencies in Syndromic Surveillance Practice at Local Health Departments
Authors: DeVore Katrina , Chughtai Sarah , Kan Lilly , Streichert Laura C.
Published: September 2016

Context:

As the science and practice of syndromic surveillance (SyS) evolve, it has increasing utility for public health surveillance at the local level. Local health departments (LHDs) require specific organizational and workforce capabilities to use SyS data. In 2013, more than half of the LHDs reported using SyS, although little has been reported about LHD workforce capabilities in SyS.

Objective:

To conduct an assessment of self-reported knowledge and skills in SyS tasks to effectively target technical assistance to different levels of LHD need.

Design, Setting, and Participants:

A stratified sampling design based on LHD jurisdiction population and SyS status was employed. Data were drawn from the 2015 Biosurveillance Needs Assessment Survey, which captured variables related to LHD use of SyS, management of systems, and self-reported proficiencies in a typology of SyS functionalities developed by a workgroup of subject matter experts in SyS. Respondents were US-based LHD public health practitioners. Estimation weights were applied during analysis to determine the national representation of the responses.

Main Outcome Measures:

Respondents self-reported proficiency in 26 SyS tasks within 5 categories, analyzed by LHD jurisdiction size and respondents' years of SyS experience.

Results:

SyS expertise varied widely across LHDs. Less than 50% of workers who have access to SyS demonstrated overall proficiency within any of the task areas: communication, data use, data analysis, quality monitoring and assurance, and system design and development. SyS users were strongest in data use tasks. Proficiency in SyS practice corresponded directly with respondents' years of SyS experience and the LHD jurisdiction size.

Conclusion:

SyS practitioners display a wide range of proficiencies both within and across SyS tasks. Considerable gaps in proficiencies of all areas of SyS practice indicate a need for technical assistance and knowledge dissemination to improve SyS practice as an important component of an LHD surveillance strategy.
Clinical Application of Prophylactic Ethanol Lock Therapy in Pediatric Patients With Intestinal Failure
Authors: Robbins Tighe Sheila L.
Published: September 2016

Patients with intestinal failure have an increased risk for catheter-related bloodstream infections that can necessitate central venous line replacement and result in morbidity, prolonged hospitalization, or mortality. For pediatric patients with intestinal failure, the severe loss of intestinal absorptive ability leads to reliance on parenteral nutrition to meet minimal needs required for growth and development. Reliance on parenteral nutrition, in turn, forces dependency on central venous lines. Recent research concentrating on the pediatric population with intestinal failure indicates that prophylactic ethanol lock therapy can reduce the rate of catheter-related bloodstream infections and decrease central venous line removal rates in this high-risk population. Prevention of catheter-related bloodstream infections is critical for patients with intestinal failure. Ethanol lock therapy policies and protocols are increasingly being developed in healthcare institutions. Despite these efforts, no standard guidelines currently exist for ethanol lock therapy, and research in this area, specifically involving the pediatric population, is limited. This article presents the evidence to date as a means for assisting nursing professionals to make informed clinical decisions regarding the use of ethanol lock therapy for pediatric patients with intestinal failure.
The Effects of a Self-Care Program on the Severity of Symptoms and Quality of Life of Patients With Irritable Bowel Syndrome
Authors: Ghiyasvandian Shahrzad , Ghorbani Mojtaba , Zakerimoghadam Masoumeh , Purfarzad Zahra , Kazemnejad Anoshirvan
Published: September 2016

Irritable bowel syndrome (IBS) is a chronic disease that needs special self-care strategies. The current study aimed at determining the effects of a self-care program on the severity of symptoms and quality of life of patients with IBS. In this randomized controlled clinical trial, 119 patients were randomly assigned to the experimental (n = 60) and control (n = 59) groups. Patients in both groups received the usual treatment of IBS by a gastroenterologist. The control group did not receive any intervention, whereas the experimental group was trained in the self-care program. The process of implementing the self-care program included designing and determining the content validity of the self-care training package, individual training, the first follow-up call, group training, and the second follow-up call. The instruments for collecting data were IBS-Quality of Life and IBS-Symptom Severity Scale. Two sets of evaluations (before and 2 months after the intervention) were done for both groups. The data were analyzed using SPSS software, Version 16. The results showed that there was not a significant difference between the two groups in the severity of symptoms and quality of life before the intervention (p > .05); however, the 2 groups were significantly different after the intervention (p < .0001). Implementation of the self-care program resulted in the improvement of quality of life and reduction in the symptom severity in the experimental group after the intervention (p < .0001), whereas no significant changes were observed in the control group (p > .05). Hence, the data supports that self-care program was effective in improving the quality of life and reducing the severity of symptoms in patients with IBS.
Seizures and Epileptiform Discharges in Patients With Acute Subdural Hematoma
Authors: Pollandt Sebastian , Ouyang Bichun , Bleck Thomas P. , Busl Katharina M.
Published: September 2016

Purpose:

Subdural hematomas (SDH) are associated with seizures and epileptiform discharges, but little is known about the prevalence and impact of seizures, status epilepticus (SE), and epileptiform discharges on outcomes in patients with isolated acute SDH (aSDH).

Methods:

Continuous EEG reports from 76 adult patients admitted to Rush University Medical Center with aSDH between January 2009 and March 2012 were reviewed. Clinical and radiographic findings, comorbidities, treatment, and outcome parameters, such as mortality, discharge destination, need for tracheostomy/percutaneous endoscopic gastrostomy placement, and length of stay (LOS), were assessed. Univariate and multivariate analyses were performed to assess the impact of clinical seizures, SE, and epileptiform EEG on outcomes.

Results:

Of 76 patients with aSDH who underwent EEG monitoring, 74 (97.4%) received antiseizure prophylaxis. Thirty-two (41.1%) patients had seizures, most of which were clinical seizures. Twenty-four (32%) patients had epileptiform EEG findings. Clinical or nonconvulsive SE was diagnosed in 12 (16%) patients. Clinical seizures were not associated with outcome parameters. Epileptiform EEG findings were independently associated with longer hospital LOS (13 vs. 8 days, P = 0.04) and intensive care unit LOS (10 vs. 4 days, P = 0.002). The SE also predicted longer intensive care unit LOS (10 vs. 4 days, P = 0.002). Neither epileptiform EEG nor SE was significantly related to mortality, discharge destination, or need for tracheostomy/percutaneous endoscopic gastrostomy placement.

Conclusions:

Seizures and epileptiform EEG findings are very common in patients with aSDH despite antiseizure prophylaxis. While clinical seizures did not affect outcomes, the presence of epileptiform EEG findings and SE was independently associated with longer intensive care unit LOS and hospital LOS.
pyMAP: a Python package for small and large scale analysis of Illumina 450k methylation platform
Authors: Mahpour Amin
Published: September 2016

PyMAP is a native python module for analysis of 450k methylation platform and is freely available for public use. The package can be easily deployed to cloud platforms that support python scripting language for large-scale methylation studies. By implementing fast parsing functionality, this module can be used to analyze large scale methylation datasets. Additionally, command-line executables shipped with the module can be used to perform common analysis tasks on personal computers.

Availability and implementation: PyMAP is implemented in Python and the source code is available under GPL v2 license fromhttp://aminmahpour.github.io/PyMAP/.
MAGNDATA: towards a database of magnetic structures. I. The commensurate case
Authors: Gallego Samuel V. , Perez-Mato J. Manuel , Elcoro Luis , Tasci Emre S. , Hanson Robert M. , Momma Koichi , Aroyo Mois I. , Madariaga Gotzon
Published: September 2016

A free web page under the nameMAGNDATA, which provides detailed quantitative information on more than 400 published magnetic structures, has been developed and is available at the Bilbao Crystallographic Server (http://www.cryst.ehu.es). It includes both commensurate and incommensurate structures. This first article is devoted to explaining the information available on commensurate magnetic structures. Each magnetic structure is described using magnetic symmetry,i.e.a magnetic space group (or Shubnikov group). This ensures a robust and unambiguous description of both atomic positions and magnetic moments within a common unique formalism. A non-standard setting of the magnetic space group is often used in order to keep the origin and unit-cell orientation of the paramagnetic phase, but a description in any desired setting is possible. Domain-related equivalent structures can also be downloaded. For each structure its magnetic point group is given, and the resulting constraints on any macroscopic tensor property of interest can be consulted. Any entry can be retrieved as a magCIF file, a file format under development by the International Union of Crystallography. An online visualization tool usingJmolis available, and the latest versions ofVESTAandJmolsupport the magCIF format, such that these programs can be used locally for visualization and analysis of any of the entries in the collection. The fact that magnetic structures are often reported without identifying their symmetry and/or with ambiguous information has in many cases forced a reinterpretation and transformation of the published data. Most of the structures in the collection possess a maximal magnetic symmetry within the constraints imposed by the magnetic propagation vector(s). When a lower symmetry is realized, it usually corresponds to an epikernel (isotropy subgroup) of one irreducible representation of the space group of the parent phase. Various examples of the structures present in this collection are discussed.
Physiological maturity at a critical life‐history transition and flight ability at fledging
Authors: Cornell Allison , Gibson Kate F. , Williams Tony D.
Published: September 2016

Developmental maturity (e.g. body condition, body mass) at major life‐history transitions is known to affect fitness across a wide range of taxa.

Fledging (leaving the nest), a major life‐history transition in birds, is associated with high post‐fledging mortality and is widely assumed to be related to poor initial flight ability of fledglings, which, in turn, might be related to developmental maturity at fledging.

We investigated individual variation in developmental maturity of both somatic and physiological traits at this critical life‐history transition in different ecological contexts (year, first or second broods) to determine the importance of physiological traits related to oxygen‐carrying capacity (haematocrit, haemoglobin) for individual variation in initial flight ability at fledging.

Haemoglobin concentration and haematocrit at fledging had much higher variance than somatic traits and were more variable across ecological contexts. Furthermore, fledgling haemoglobin concentration was the least developmentally mature of all traits (on average, only 78% of adult concentration).

Fledglings from second broods, which are known to have lower post‐fledging survival, were less developmentally mature than fledglings from first broods for all traits (except tarsus), with haematocrit and haemoglobin concentration being the most developmentally immature traits (in first vs. second broods, haematocrit: 47·1% vs. 40·9%; haemoglobin: 13·3 vs. 11·6 g dL−1).

Models predicting individual variation in two aspects of initial flight ability (total energy gain, take‐off angle) were significantly improved when physiological traits (in particular haemoglobin) were incorporated into models based on somatic traits.

A lay summary is available for this article.
Slopes of an airborne electromagnetic resistivity model interpolated jointly with borehole data for 3D geological modelling
Authors: Reninger P.‐A. , Martelet G. , Perrin J. , Deparis J. , Chen Y.
Published: September 2016

We investigate a novel way to introduce resistivity models deriving from airborne electromagnetic surveys into regional geological modelling. Standard geometrical geological modelling can be strengthened using geophysical data. Here, we propose to extract information contained in a resistivity model in the form of local slopes that constrain the modelling of geological interfaces. The proposed method is illustrated on an airborne electromagnetic survey conducted in the region of Courtenay in France. First, a resistivity contrast corresponding to the clay/chalk interface was interpreted confronting the electromagnetic soundings to boreholes. Slopes were then sampled on this geophysical model and jointly interpolated with the clay/chalk interface documented in boreholes using an implicit 3D potential‐field method. In order to evaluate this new joint geophysical–geological model, its accuracy was compared with that of both pure geological and pure geophysical models for various borehole configurations. The proposed joint modelling yields the most accurate clay/chalk interface whatever the number and location of boreholes taken into account for modelling and validation. Compared with standard geological modelling, the approach introduces in between boreholes geometrical information derived from geophysical results. Compared with conventional resistivity interpretation of the geophysical model, it reduces drift effects and honours the boreholes. The method therefore improves what is commonly obtained with geological or geophysical data separately, making it very attractive for robust 3D geological modelling of the subsurface.
Capital Inflows and Economic Growth in Nigeria: The Role of Macroeconomic Policies
Authors: Nwosa Philip Ifeakachukwu , Akinbobola Temidayo Oladiran
Published: September 2016

This study examined the role of macroeconomic policies (monetary, fiscal and trade policies) in the relationship between capital inflows (proxy by foreign direct investment, foreign aid and international workers’ remittances) and economic growth in Nigeria for the period 1970 to 2013. The study employed Autoregressive Distributed Lag (ARDL) Bound co‐integration technique. The study found that macroeconomic policy plays a fundamental role in the relationship between capital inflows and economic growth in Nigeria.
Technical Change and Total Factor Productivity Growth in the Tunisian Manufacturing Industry: A Malmquist Index Approach
Authors: Kalai Maha , Helali Kamel
Published: September 2016

The main objective of this study is to measure technical change and total factor productivity in the Tunisian manufacturing sector using the Malmquist index approach. Applying non‐parametric frontiers techniques, we found that total factor productivity is decomposed on the basis of the technical efficiency variation and technological change for six manufacturing sectors. The results indicate that most sectors had very poor performance in terms of technological progress rate. In addition, any efficiency gain was proved to be, in large part, due to the improvement of technical rather than scale efficiency. Moreover, the total factor productivity improvement achieved, at an average rate of 1.93 per cent per year for the whole of the sample, is mainly due to the agricultural, food and chemical industries.
Comparison of methods used to quantify general practice‐type patients in the emergency department: A tertiary paediatric perspective
Authors: Borland Meredith , Skarin Dmitry , Nagree Yusuf
Published: September 2016

Objective

The aim of this study was to compare methods for quantifying general practice‐type (GP‐type) patients in a paediatric ED to determine the robustness of current identification methods.

Methods

Data was sourced from the ED Information System for 5 years (2010–2014) from the tertiary paediatric hospital in Perth, Western Australia, Australia. A further detailed analysis of 2014 presentations established an independent sample for valid statistical comparison of the three methods used to identify GP‐type patients: Australian Institute of Health and Welfare, ACEM and the Diagnosis.

Results

A total of 348 020 patients presented in 2010–2014, with the percentage of GP‐type patients identified varying from 38% to 68% by the three methods. Fewer GP‐type presentations occurred over each consecutive year and had significantly lower median medical consultation times and ED length of stay when compared with the total presentation sample. GP‐type presentations were evenly spread across the days and times of the week, with ACEM demonstrating only fewer presentations during office hours (P = 0.02). In 2014 there was only overlap in 36.6% cases for all three methods – 6.9% exclusively flagged by ACEM, 22.7% by Australian Institute of Health and Welfare and 0.2% by the Diagnosis method.

Conclusions

We demonstrated that current models to quantify perceived GP‐type presentations were inconsistent in paediatric patients. All methods flagged a high proportion of GP‐type presentations, and although the reasons for these presentations are multifactorial and not easily explained by access to GP services alone, they do represent a significant workload in the paediatric ED.
Water Management Decision Making in the Face of Multiple Forms of Uncertainty and Risk
Authors: Burnham Morey , Ma Zhao , Endter‐Wada Joanna , Bardsley Tim
Published: September 2016

In the Wasatch Range Metropolitan Area of Northern Utah, water management decision makers confront multiple forms of uncertainty and risk. Adapting to these uncertainties and risks is critical for maintaining the long‐term sustainability of the region's water supply. This study draws on interview data to assess the major challenges climatic and social changes pose to Utah's water future, as well as potential solutions. The study identifies the water management adaptation decision‐making space shaped by the interacting institutional, social, economic, political, and biophysical processes that enable and constrain sustainable water management. The study finds water managers and other water actors see challenges related to reallocating water, including equitable water transfers and stakeholder cooperation, addressing population growth, and locating additional water supplies, as more problematic than the challenges posed by climate change. Furthermore, there is significant disagreement between water actors over how to best adapt to both climatic and social changes. This study concludes with a discussion of the path dependencies that present challenges to adaptive water management decision making, as well as opportunities for the pursuit of a new water management paradigm based on soft‐path solutions. Such knowledge is useful for understanding the institutional and social adaptations needed for water management to successfully address future uncertainties and risks.
Reduced metabolic function and structural alterations in inherited retinal dystrophies: investigating the effect of peripapillary vessel oxygen saturation and vascular diameter on the retinal nerve fibre layer thickness
Authors: Bojinova Rossiana I. , Türksever Cengiz , Schötzau Andreas , Valmaggia Christophe , Schorderet Daniel F. , Todorova Margarita G.
Published: September 2016

Purpose

To evaluate the relationship between the peripapillary metabolic alterations [retinal vessel Oximetry (RO)] and the structural findings [retinal vessel diameter and retinal nerve fibre layer thickness (RNFL)] in patients with inherited retinal dystrophies (IRD).

Methods

Patients with IRD [24 patients with rod‐cone dystrophy (RCD), 15 patients with cone‐rod dystrophy, 13 patients with inherited maculopathy] and 18 age‐matched controls, who underwent RO imaging and spectral domain optical coherence tomography, were included. The average and quadrant oxygen saturation in all four major peripapillary retinal arterioles (A‐SO2) and venules (V‐SO2) were measured, and their difference (A‐V SO2) was calculated. The corresponding retinal vessel diameter of these arterioles (D‐A) and venules (D‐V) was measured. The data were compared to the peripapillary RNFL thickness within the IRD subgroups and to the data obtained in the controls.

Results

In general, patients with IRD had higher average V‐SO2 values when compared to controls (p ≤ 0.029). Rod‐cone dystrophy (RCD) patients differed from controls, but also from patients with other IRDs, when the average and quadrant oxygen saturation values (A‐SO2 and V‐SO2) were evaluated (p ≤ 0.026). Within the RCD group, the correlations of RNFL thickness to V‐SO2, A‐V SO2, D‐A and D‐V were significant (p ≤ 0.030), thus indicating a different relationship between the RNFL thickness and the examined parameters, when compared to the other groups.

Conclusion

It becomes evident from our combined metabolic–structural approach that a prediction model, to identify which individual is at risk of developing a photoreceptor degeneration of RCD type, can be proposed. It will take into account the peripapillary retinal oxygen saturation, the retinal vessel diameter and the RNFL thickness values.
Development of Expectancies About Own‐ and Other‐Gender Group Interactions and Their School‐Related Consequences
Authors: Andrews Naomi C. Z. , Martin Carol L. , Field Ryan D. , Cook Rachel E. , Lee Jieun
Published: September 2016

This study examined children's expectancies about interactions with own‐ and other‐gender peers. Goals were to examine expectancies about the outcomes related to own‐ versus other‐gender group interactions, assess cohort and temporal changes in expectancies, and assess the effect of expectancies on school‐related outcomes. Students in second and fourth grades (N = 412, 47% girls,Mage = 7.15 and 9.10 years, respectively) were followed longitudinally for 1 year. Results supported hypotheses that social costs and inclusion–enjoyment that children expect in interactions with own‐ and other‐gender peers represent four constructs. Expectancies varied by gender, age, and differentially predicted school outcomes with inclusion expectancies more strongly relating to outcomes than cost expectancies. Implications of children's expectancies about gendered contexts are discussed.
BSACI guideline: prescribing an adrenaline auto‐injector
Authors: Ewan Pamela , Brathwaite Nicola , Leech Susan , Luyt David , Powell Richard , Till Stephen , Nasser Shuaib , Clark Andrew
Published: September 2016

This guidance for the prescription of an adrenaline auto‐injector has been prepared by the Standards of Care Committee (SOCC) of the British Society for Allergy and Clinical Immunology (BSACI). There is insufficient quality evidence‐based data in some areas, including the question of how often a second dose is required, and the optimal dose and absorption after subcutaneous vs. intramuscular injection. Thus, indications for adrenaline (which are partly opinion based) in guidelines from different countries vary slightly. The guideline is based on evidence as well as on expert opinion and is for use by both adult physicians and paediatricians practising allergy. During the development of these guidelines, all BSACI members were included in the consultation process using a web‐based system. Their comments and suggestions were carefully considered by the SOCC. Evidence from randomized controlled trials is lacking in anaphylaxis for ethical reasons. Consensus was reached by the experts on the committee. Included in this guideline are aetiology, risk of recurrence and management of anaphylaxis (after treatment of the acute episode), including allergen avoidance and written treatment plans. There are sections on dose and absorption of adrenaline, and adrenaline auto‐injectors, including indications for their prescription, risk assessment for the number required and training in their use. The guidelines are not intended to be prescriptive, and clinicians should use their clinical judgement. Finally, we have made recommendations for potential areas of future research.
Modeling spatiotemporal dynamics of krill aggregations: size, intensity, persistence, and coherence with seabirds
Authors: Santora Jarrod A. , Dorman Jeffrey G. , Sydeman William J.
Published: September 2016

Understanding aggregation dynamics of forage species is important for evaluating biophysical scaling in marine ecosystems and heterogeneity of trophic interactions. In particular, zooplankton aggregations are fundamental units of many pelagic systems, but are difficult to observe continuously through space and time. Using an established modeling framework that encompasses a coupled regional oceanographic and individual‐based modeling system, we test the hypothesis that persistence (duration) of krill aggregations is dependent on their size, intensity, and location of formation within the coastal upwelling region of the California Current. In support of this hypothesis, we found that aggregation size is positively related to intensity, whereas persistence has a parabolic response to aggregation size and intensity, indicating the likelihood that large and highly persistent aggregations are rare. Persistence of krill aggregations also depends on formation location within coastal upwelling areas. We found that krill aggregations were more likely to form near a major seabird colony and that some coastal upwelling areas act as sources of aggregations for other areas. Observations of seabird aggregations were used to evaluate the potential structural realism of predicted krill aggregations. Seabird aggregations displayed marked coherence with predicted krill aggregations in space, providing important criteria on the scaling and availability of krill aggregations to breeding and migratory species. Predicting scales of krill aggregation dynamics will benefit ecosystem assessments, and numerical modeling of predator foraging and marine spatial management aimed at ensuring protection of ecologically important areas.
Global patterns of drought deciduous phenology in semi‐arid and savanna‐type ecosystems
Authors: Dahlin Kyla M. , Ponte Dominick Del , Setlock Emily , Nagelkirk Ryan
Published: September 2016

Seasonal variations in vegetation have direct and indirect impacts on biogeochemical cycling, net primary productivity, and the global climate. While leaf phenology in many high latitude ecosystems can be predicted based on a four‐season cycle, semi‐arid and savanna‐type (SAST) ecosystems are thought to be much less consistent and interannual variability can be quite large. While leaf phenology in SAST ecosystems is often attributed to soil moisture availability, different plants appear to respond to different signals, and predicting drought deciduous phenology, especially at large scales, as in land surface models (LSMs), continues to be a challenge. Here we undertook a meta‐analysis of published research on leaf phenology in SAST ecosystems to assess whether any consistent patterns would be revealed across the SAST regions of the world. After reviewing 188 papers and correlating green‐up and brown‐down dates with a number of possible drivers, including latitude, temperature, precipitation, continent, and plant functional type (PFT), we found that latitude, then continent and PFT, were the best predictors of phenological timing. This result suggests that solar radiation may be an important driver of phenology even in the low latitudes, and that biogeographic differences among continents and PFTs may be critical to improving our predictions of SAST phenology. All global LSMs lump plant species into functional groups, and these groups typically span continents despite known physiological differences between species on different continents. Our review suggests that more research is needed into SAST phenology at both field and remotely sensed scales, but that LSM predictions could be improved by simply developing continent‐ and latitude‐specific model parameterizations. With a large fraction of the world's human population living in and relying on services from SAST ecosystems, it is critical that we focus more attention on these understudied systems and improve their representations in global models.
Anatomy of a cline: dissecting anti‐predatory adaptations in a marine gastropod along the U.S. Atlantic coast
Authors: Kosloski Mary E. , Dietl Gregory P. , Handley John C.
Published: September 2016

The scope of anti‐predatory adaptation is expected to be greater in warm than in cold environments. High temperatures lower the costs associated with the production and maintenance of energetically expensive traits and enable ecological interactions to intensify. We tested this hypothesis by characterizing the expression of anti‐predatory morphology within a marine gastropod species (the knobbed whelk Busycon carica) over a large (> 1400 km) geographic area that spans more than 10°C annual temperature variation. We also conducted experimental predation studies with a powerful durophagous predator, the stone crab Menippe, to verify the anti‐predatory advantages of a heavily ornamented shell morphology (e.g. increased thickness, pronounced spines), and we used repair scar data to assess clinal variation in selective pressure from predators. We predicted that repair scar rates would be greatest in warm southernmost latitudes, and that expression of energetically costly anti‐predatory morphology would peak in concert with elevated predation pressures.

Experiments confirmed that whelks with energetically costly, heavily ornamented shells had higher survivorship rates than those with weakly ornamented shells. As predicted, we also found that the expression of anti‐predatory traits was greatest in the southern part of B. carica's range. After standardizing shells for size, shape, and exposure time to enemies, repair scar rates also peaked to the south. Taken together, these results suggest that the expression of anti‐predatory traits along the geographic cline is governed by the interaction of two selective factors: temperature and predation, with the former acting as the ultimate control on the scope of adaptation both by escalating predation pressure in the southern part of B. carica's range and by physically limiting (to the north) and facilitating (to the south) the production of anti‐predatory traits. Feedbacks between temperature and predation thus causally interact to enable and drive, respectively, the observed geographic cline in energy‐intensive anti‐predatory shell traits.
Structural uncertainty in models projecting the consequences of habitat loss and fragmentation on biodiversity
Authors: Leroux Shawn J. , Albert Cécile H. , Lafuite Anne‐Sophie , Rayfield Bronwyn , Wang Shaopeng , Gravel Dominique
Published: September 2016

Ecological theory is essential to predict the effects of global changes such as habitat loss and fragmentation on biodiversity. Species–area relationships (SAR), metapopulation models (MEP) and species distribution models (SDM) are commonly used tools incorporating different ecological processes to explain biodiversity distribution and dynamics. Yet few studies have compared the outcomes of these disparate models and investigated their complementarity. Here we show that the processes underlying SAR (patch area), MEP (patch isolation) and SDM (environmental conditions) models can be compared with a common statistical framework. Our approach allows for species and community‐level predictions under current and future landscape scenarios, facilitates multi‐model comparison and provides the machinery for integrating multiple mechanisms into one model. We apply this framework to the distribution of eight focal vertebrate species in current and future projected landscapes where 10% of the landscape is lost to land‐use change in southwestern, Quebec, Canada. Based on a model selection approach, we found that a model including patch area was the top ranked model for four of our focal species and models including patch isolation and environmental conditions were the top ranked models for two focal species each. Community‐level predictions of models based on patch area, patch isolation and environmental conditions for both current and future landscapes showed high spatial overlap, however, patch area models always predicted a reduction of species richness per patch whereas both the patch isolation and environmental conditions models predicted an increase or decrease in species richness per patch following habitat loss and fragmentation. Our comparative tool will allow ecologists and conservation practitioners to relate structural uncertainty to key mechanisms underlying each model. Ultimately, this approach is one step in the direction of deriving robust predictions for the change and loss of biodiversity under global change, which is key for informing conservation plans.
Premorbid adjustment in individuals at ultra‐high risk for developing psychosis: a case–control study
Authors: Dannevang Anders L. , Randers Lasse , Gondan Matthias , Krakauer Kristine , Nordholm Dorte , Nordentoft Merete
Published: September 2016

Aim

Deterioration in premorbid adjustment is related to ultra‐high risk (UHR) individuals developing psychosis, but it has not been examined how UHR individuals’ development differs compared to healthy controls. This study investigates differences in premorbid adjustment between UHR individuals and a healthy control group.

Method

A total of 48 UHR individuals and 50 healthy controls matched on group level for age, gender and parents’ socio‐economic status were included in the study. Both groups were assessed with the Premorbid Adjustment Scale (PAS). Based on the PAS scores, composite social and academic scales were computed.

Results

Compared to the healthy controls the UHR individuals’ social and academic premorbid adjustment declined across age periods. Social premorbid adjustment declined particularly between late adolescence and adulthood. Academic premorbid adjustment declined particularly between childhood and early adolescence. The UHR individuals had more premorbid adjustment difficulties on both the social and academic scale, and on the individual PAS scales.

Conclusion

From childhood UHR individuals have lower levels of social and academic premorbid adjustment compared to healthy controls, and the difficulties increase with age. As such, social and academic premorbid adjustment could be an important focus for early intervention.
Clinical and genetic characterization of adult‐onset leukoencephalopathy with axonal spheroids and pigmented glia associated with CSF1R mutation
Authors: Konno T. , Yoshida K. , Mizuno T. , Kawarai T. , Tada M. , Nozaki H. , Ikeda S.‐I. , Nishizawa M. , Onodera O. , Wszolek Z. K. , Ikeuchi T.
Published: September 2016

Background and purpose

The clinical characteristics of colony stimulating factor 1 receptor (CSF1R) related adult‐onset leukoencephalopathy with axonal spheroids and pigmented glia (ALSP) have been only partially elucidated.

Methods

Clinical data from CSF1R mutation carriers who had been seen at our institutions or reported elsewhere were collected and analysed using a specific investigation sheet to standardize the data.

Results

In all, 122 cases from 90 families with CSF1R mutations were identified. The mean age of onset was 43 years (range 18–78 years), the mean age at death was 53 years (range 23–84 years) and the mean disease duration was 6.8 years (range 1–29 years). Women had a significantly younger age of onset than men (40 vs. 47 years, P = 0.0006, 95% confidence interval 3.158–11.177). There was an age‐dependent penetrance that was significantly different between the sexes (P = 0.0013). Motor dysfunctions were the most frequent initial symptom in women whose diseases began in their 20s. Thinning of the corpus callosum, abnormal signalling in pyramidal tracts, diffusion‐restricted lesions and calcifications in the white matter were characteristic imaging findings of ALSP. The calcifications were more frequently reported in our case series than in the literature (54% vs. 3%). Seventy‐nine per cent of the mutations were located in the distal part of the tyrosine kinase domain of CSF1R (102 cases). There were no apparent phenotype−genotype correlations.

Conclusions

The characteristics of ALSP were clarified. The phenotype of ALSP caused by CSF1R mutations is affected by sex.
Severe hypophosphataemia associated with the management of hyperlipaemia in a miniature pony
Authors: Bamford N. J. , Rosales C. M. , Williamson A. J. , Steel C. M. , Tennent‐Brown B. S.
Published: September 2016

This report describes a case of severe hypophosphataemia associated with the management of hyperlipaemia in a miniature pony following colic surgery. Clinical signs attributed to hypophosphataemia included obtundation, anorexia, tachycardia, tachypnoea and generalised muscle fasciculations. Hyperlipaemia was managed with enteral and partial parenteral nutrition; insulin was also administered to control hyperglycaemia after the initiation of caloric support. Specific therapy for hypophosphataemia consisted of parenteral potassium phosphate at 0.03 mmol/kg bwt/h (i.v.). The pony made a full recovery without further complications. Hypophosphataemia may be an under‐recognised clinical problem in certain populations of critically ill equids, such as those with hyperlipaemia and receiving insulin as part of their management. The routine measurement of phosphate concentration in these cases is recommended.
Crystal structure of β1→6‐galactosidase from Bifidobacterium bifidum S17: trimeric architecture, molecular determinants of the enzymatic activity and its inhibition by α‐galactose
Authors: Godoy Andre Schutzer , Camilo Cesar Moises , Kadowaki Marco Antonio , Muniz Heloisa dos S. , Espirito Santo Melissa , Murakami Mario Tyago , Nascimento Alessandro S. , Polikarpov Igor
Published: September 2016

In a search for better comprehension of β‐galactosidase function and specificity, we solved the crystal structures of the GH42 β‐galactosidase BbgII from Bifidobacterium bifidum S17, a well‐adapted probiotic microorganism from the human digestive tract, and its complex with d‐α‐galactose. BbgII is a three‐domain molecule that forms barrel‐shaped trimers in solution. BbgII interactions with d‐α‐galactose, a competitive inhibitor, showed a number of residues that are involved in the coordination of ligands. A combination of site‐directed mutagenesis of these amino acid residues with enzymatic activity measurements confirmed that Glu161 and Glu320 are fundamental for catalysis and their substitution by alanines led to catalytically inactive mutants. Mutation Asn160Ala resulted in a two orders of magnitude decrease of the enzyme kcat without significant modification in its Km, whereas mutations Tyr289Phe and His371Phe simultaneously decreased kcat and increased Km values. Enzymatic activity of Glu368Ala mutant was too low to be detected. Our docking and molecular dynamics simulations showed that the enzyme recognizes and tightly binds substrates with β1→6 and β1→3 bonds, while binding of the substrates with β1→4 linkages is less favorable.

Database

Structural data are available in the PDB under the accession numbers 4UZS and 4UCF
On Becoming Creatures: Being Called to Presence in a Distracted World
Authors: Brock Brian
Published: September 2016

In the biblical creation story human beings are depicted as beings ejected from the true home given to them in creation and entrapped in the dynamics of their flight from God. Franz Rosenzweig suggested that modern life is best understood as a type of chronic living death characterized by an animate but nevertheless sterile experience of loss. Following Eric Santner's presentation of this theme in Rosenzweig, this article will explore what it might mean to recover a sense of the goodness of place and particularity. I will examine Santner's suggestion that to become present to ‘place’ is to have undergone the ‘undeadening’ intervention of another person, who offers us an exit route in the midst of the tangle of our lived lives. I will then show how the main lines of his analysis both parallel and offer ways to sharpen important aspects of Dietrich Bonhoeffer's account in Creation and Fall of the dynamics of the Fall and the healing of creatures. Human beings are depicted by Bonhoeffer as in need of being transformed into creatures, a theological insight resting on a complex account of creation, and which I will suggest, in conclusion, is a particularly important theme of a Christian gospel that can speak to a world saturated by the desire to be elsewhere.
Subsidiarity and social citizenship: Social assistance schemes in Austria, Belgium, Switzerland and Norway
Authors: Leibetseder Bettina , Gubrium Erika , Dierckx Danielle , Fluder Robert , Hauri Roland , Raeymaeckers Peter
Published: September 2016

Previous research has emphasised that conditionality impinges on social citizenship. However, a systematic assessment examining the impact of functional and territorial subsidiarity has been overlooked. Developing seven operational criteria – rights, means testing, conditionality, voice and choice, discretion, benefit's adequacy and supplementary system – we determined levels of subsidiarity and social citizenship in social assistance schemes. Analysing the benefit reform trajectories of Austria, Belgium, Norway and Switzerland, we conclude that social assistance schemes have not improved. Low benefits, means testing and work linkage have strengthened functional subsidiarity, whereas questions of voice and choice are rarely on the agenda. Caseworkers’ discretion and local administration have sustained territorial subsidiarity. Therefore, considering the potential role that benefits could play in the welfare state, low up‐take minimises the redistributive potential and, in general, risk has substantially shifted towards social assistance.
Development of a decision aid for children faced with the decision to undergo dental treatment with sedation or general anaesthesia
Authors: Hulin Joe , Baker Sarah R. , Marshman Zoe , Albadri Sondos , Rodd Helen D.
Published: September 2016

Background

Decision aids are tools used to help individuals faced with difficult healthcare decisions. They help patients further understand the treatment options available and encourage the sharing of information between patients and clinicians.

Aim

To develop a decision aid for young patients faced with the decision to undergo dental treatment with inhalation sedation, intravenous sedation, or general anaesthesia (GA).

Design

Qualitative interviews with dental patients (aged 10–16 years), and their parents/guardians were used to inform the content of a draft decision aid. Following further revisions, a pilot evaluation of the decision aid was conducted. Patients referred for dental treatment with sedation or GA were recruited from a UK dental hospital. Patients (n = 15) and parents/guardians (n = 13) assigned to the intervention group received the decision aid and routine clinical counselling, whereas patients (n = 17) and parents/guardians (n = 13) in the control group only received routine clinical counselling. Participants completed measures of knowledge, decisional conflict, and dental anxiety.

Results

Knowledge scores were significantly higher for participants who received the decision aid when compared to standard care. There were no other significant differences between groups.

Conclusions

A decision aid was successfully developed, and initial findings suggest such tools could be beneficial to dental sedation or GA patients and their parents/guardians. Further research is required on the use of such tools in primary care settings, with particular attention to the impact of the decision aid on attendance and completion rates of treatment.
Nurses', midwives' and key stakeholders' experiences and perceptions on requirements to demonstrate the maintenance of professional competence
Authors: Casey Mary , Cooney Adeline , O' Connell Rhona , Hegarty Josephine‐Mary , Brady Anne‐Marie , O' Reilly Pauline , Kennedy Catriona , Heffernan Elizabeth , Fealy Gerard , McNamara Martin , O' Connor Laserina
Published: September 2016

Aim

To present the qualitative findings from a study on the development of scheme(s) to give evidence of maintenance of professional competence for nurses and midwives.

Background

Key issues in maintenance of professional competence include notions of self‐ assessment, verification of engagement and practice hours, provision of an evidential record, the role of the employer and articulation of possible consequences for non‐adherence with the requirements. Schemes to demonstrate the maintenance of professional competence have application to nurses, midwives and regulatory bodies and healthcare employers worldwide.

Design

A mixed methods approach was used. This included an online survey of nurses and midwives and focus groups with nurses and midwives and other key stakeholders. The qualitative data are reported in this study.

Methods

Focus groups were conducted among a purposive sample of nurses, midwives and key stakeholders from January–May 2015. A total of 13 focus groups with 91 participants contributed to the study.

Findings

Four major themes were identified: Definitions and Characteristics of Competence; Continuing Professional Development and Demonstrating Competence; Assessment of Competence; The Nursing and Midwifery Board of Ireland and employers as regulators and enablers of maintaining professional competence.

Conclusion

Competence incorporates knowledge, skills, attitudes, professionalism, application of evidence and translating learning into practice. It is specific to the nurse's/midwife's role, organizational needs, patient's needs and the individual nurse's/midwife's learning needs. Competencies develop over time and change as nurses and midwives work in different practice areas. Thus, role‐specific competence is linked to recent engagement in practice.