bluuebunny/crossref_metadata_2025 huggingface dataset:
Deadly Liver Mob: opening the door – improving sexual health pathways for Aboriginal people in Western Sydney
Authors: Biggs Karen , Walsh Jennifer , Ooi Catriona
Published: July 2016

Background: The Deadly Liver Mob project (DLM) is an incentive-based, peer-driven health promotion intervention for Aboriginal people, focusing on hepatitis C and offering education and screening for sexually transmissible infections (STI) and blood-borne viruses (BBV). This study aims to assess the DLM effect on attendance and STI/BBV screening, describe BBV risk factors and report infection rates among Aboriginal people attending Western Sydney Sexual Health Centre (WSSHC). Methods: A retrospective review of Aboriginal clients during the first year of the DLM project was compared with Aboriginal clients who attended during the 5.3 years before implementation of the project. Data on attendance, screening rates, demographics, lifestyle information and STI/BBV results were extracted. Results: There was a 10-fold increase in the number of Aboriginal people attending, via the DLM project (P < 0.01). The DLM group were more likely to be male (47 vs 28%), ≥ 35 years (46 vs 27%), report injecting drug use (IDU) (43 vs 26%), a history of incarceration (48 vs 24%) or unsafe tattooing (36 vs 16%) and have comprehensive STI/BBV testing (85 vs 54%); (P < 0.01 for all). There were 79 positive results and 30 commenced hepatitis B vaccination in the DLM period, compared with 15 and 19, in the non-DLM period. Conclusions: The DLM project effectively increased sexual healthcare attendance and screening for Aboriginal people in Western Sydney. The DLM has fostered ongoing care and facilitated service engagement for individuals at high risk of contracting STIs and BBVs.
Impact of reduced tillage and crop residue management on soil properties and crop yields in a long-term trial in western Kenya
Authors: Okeyo Jeremiah M. , Norton Jay , Koala Saidou , Waswa Boaz , Kihara Job , Bationo Andre
Published: July 2016

Sustainable farming practices are required to address the persistent problems of land degradation and declining crop productivity in Sub-Saharan Africa. Approaches such as reducing tillage and retaining crop residues as mulch are potential entry points for smallholder farmers to move towards sustainability. In this study, we assessed the impact of reduced tillage (RT) compared with conventional tillage (CT), each combined with crop residue reapplication, on soil quality indicators and crop yields under an 8-year trial in western Kenya. Our results indicate that RT combined with crop residue reapplication enhanced soil physical quality through increased macroaggregate (>2000µm) proportions and mean weight diameter. Similarly, lower respiratory quotient values indicate that soil microbes under RT have better substrate-use efficiency than those under CT. Nevertheless, soil organic carbon (C), potentially mineralisable C, microbial biomass C and mineral nitrogen contents were all higher under CT with crop residue incorporated into the soil. Maize grain yield and aboveground biomass were also higher under CT. Thus, despite RT showing potential to improve soil physical properties, CT performed better. A stepwise approach is proposed towards the practice of conservation agriculture under resource-constrained smallholder farming conditions, starting with increased biomass production to provide crop residue for soil cover, followed by RT approaches.
Emission estimation of nitrous oxide (N2O) from a wheat cropping system under varying tillage practices and different levels of nitrogen fertiliser
Authors: Bordoloi Nirmali , Baruah K. K. , Bhattacharyya P.
Published: July 2016

Nitrous oxide is a greenhouse gas with high global warming potential emitted from agricultural sources. The effects of tillage practices and different levels of N fertiliser on seasonal fluxes of N2O were investigated in a field planted with the wheat variety Sonalika. The experiment was conducted during 2012–13 and 2013–14 under conventional tillage (CT) and reduced tillage (RT) farming systems in combination with four different levels of nitrogen fertiliser (i.e. zero nitrogen (F1), 60kgNha–1 (F2), 80kgNha–1 (F3) and 100kgNha–1 (F4)). Both tillage practices and fertiliser significantly (P<0.01) affected seasonal cumulative N2O emissions and wheat yield. However, there was no significant difference in N2O emissions between RTF1 and CTF1 (zero nitrogen). Compared with RT, N2O emission decreased under the CT practice by 2.49%, 10.11%, 7.9% and 27.46% in CTF1, CTF2, CTF3 and CTF4 respectively. Highest and lowest seasonal cumulative fluxes were recorded in RTF4 (N 100kgha–1) and CTF1 (N 0kgha–1) respectively. During the wheat-growing period, nitrogen use efficiency decreased with increasing nitrogen levels and treatment with 60 kg-Nha–1 in the CT practice (CTF2) was found to be effective in increasing nitrogen use efficiency and decreasing yield-scaled N2O emissions.
Population dynamics of feral horses (Equus caballus) in an exotic coniferous plantation in Australia
Authors: Zabek Magdalena A. , Berman David M. , Blomberg Simon P. , Collins Christina W. , Wright John
Published: July 2016

Context Understanding population dynamics of invasive species is crucial for the development of management strategies. Feral horses (Equus caballus) are a growing problem in the Tuan–Toolara State Forest (TTSF), a coniferous plantation in south-eastern Queensland, Australia. Aim The population dynamics of the TTSF feral horses was not known. Therefore, the study was designed to characterise the major vital parameters of this population and, using these data, develop a long-term management plan. Methods The study was conducted over 3 years (2011–14) involving 522 individually identified horses. Foaling rates were used to calculate fecundity. Body fat distribution was estimated using body condition score (BCS), which reflects the nutritional, metabolic and general health of individual animals. Multi state mark–capture population models were used to estimate age-specific survival, and the Leslie age-structured projection matrix model was used to determine the annual rate at which the population increased. Key results The mean annual fecundity was low (0.23 ± 0.07 s.d.). The mean BCS of the population was mid-range (2.55 ± 0.51 s.d.) with adult females having lower scores than other age and gender groups. Survival estimates were consistently high (0.92–0.95) across all age groups. The average annual finite rate of population increase (λ) for the 3 years of the study was 1.09. Sensitivity analysis demonstrated that the population growth rate was almost seven times more sensitive to changes in adult survival compared with juvenile survival, and almost twice as sensitive to changes in fecundity. Key conclusions Population dynamics of the TTSF feral horses were comparable to other feral horse populations similarly challenged by environmental nutritional limitations. Implications Defining population dynamics of the TTSF feral horses permits the formulation of management goals that can be audited and adapted as required. The most effective strategy for controlling population growth in the TTSF would involve the continuing removal of substantial numbers of adult females or manipulation of survival and/or fecundity. As selective removal will likely alter the adult sex ratio and age structure of the population, ongoing assessment is necessary to minimise adverse welfare outcomes.
Effective field-based methods to quantify personality in brushtail possums (Trichosurus vulpecula)
Authors: Mella Valentina S. A. , Krucler Jordan , Sunderasan Lakshmi , Hawkins Jason , Herath Anushika P. H. M. , Johnstone Kyla C. , Troxell-Smith Sandra M. , Banks Peter B. , McArthur Clare
Published: July 2016

Context
There is growing recognition of the importance of animal personality in wildlife ecology and management. Individuals that differ consistently in their behaviours from others of the same population are considered to exhibit different personalities. Personality can be easily quantified with repeat tests on animals held in captivity. However, captive-based tests may not always be possible for logistical reasons and tests conducted in captivity can alter naturally occurring behaviours. Development of methods to assess personality in the field over short-term capture is an important alternative to long-term captive tests.

Aims
To develop and refine field-based tests that can be used to easily define personality traits of wild common brushtail possum (Trichosurus vulpecula), eliminating the need to bring individuals into captivity for an extended period of time.

Methods
We developed a series of short-term capture protocols to quantify personality traits of the common brushtail possum in the field, using handling-bag tests, modified open-field tests, trap-behaviour tests and release tests.

Key results
Personality traits of brushtail possums could be measured in several different ways, but refining methods was crucial to reveal traits efficiently. Behaviours related to several personality traits (boldness, docility and activity/exploration) could be measured rapidly in the field with our methods, and were repeatable over time.

Conclusions
Rapid, reliable and easy-to-perform quantification of personality of brushtail possums in the field is possible. This may sometimes be the only available option, and has advantages over long captive trials in terms of animal welfare and cost.

Implications
The present study provides a baseline for future research on the personality of common brushtail possums and its application to management and control strategies for the species.
Space use by female agile antechinus: are teat number and home-range size linked?
Authors: Beckman Juliey , Lill Alan
Published: July 2016

Context The number of teats that a female agile antechinus (Antechinus agilis) possesses effectively determines her initial litter size. In the Otway Ranges, south-eastern Australia, numerous separate populations in which all females have either six or 10 teats occur fairly close together in similar, contiguous forest at comparable altitudes and latitudes. Six-teat and 10-teat females have a similar mean mass, but the latter have a 1.7 × greater reproductive potential and so should have a greater nutritional requirement while raising young than do six-teat females. Theoretically, they could meet this requirement by occupying larger and/or more exclusive home ranges during breeding than do six-teat females do (provided that their food-resource abundance is comparable), albeit at a greater energetic cost. Aims The aim of the study was to determine whether 10-teat A. agilis females occupied larger and less overlapping home ranges than did six-teat females. To interpret the findings more meaningfully, it was necessary to compare food abundance and habitat characteristics in areas occupied by the two phenotypes. Methods The investigation was conducted in six-teat and 10-teat A. agilis areas in cool temperate forest over 22 months. Population density was determined by mark–recapture methods and arthropod prey biomass and abundance by pitfall trapping. Vegetation structure and plant-taxa abundance and diversity were determined by standard plant-survey methods. Female home-range estimates determined by radio-tracking were based on 95% minimal convex polygons (MCP) and kernel analysis. Home-range overlap was based on 80% MCP range determinations and core areas were calculated from utilisation plots. Key results Female population density was 2.5 × lower in exclusively 10-teat than in exclusively six-teat populations. Radio-tracked 10-teat females’ home ranges less commonly overlapped those of identified female neighbours and, on average, were 1.5 × larger than ranges of six-teat females. Food abundance and composition was similar in six-teat and 10-teat areas, but ground cover was denser and more complex in the latter areas. Conclusions Food-resource availability was similar in the six-teat and 10-teat phenotype areas, so the larger, and probably more exclusive, home ranges of 10-teat females could reflect greater nutritional requirements resulting from having larger litters, and account for their lower population density. Implications The A. agilis teat-number variation pattern in the Otways may be a rare, visible example of ongoing incipient speciation. This makes it of great scientific and conservation value and it is important to document how the phenomenon operates.
Dexter energy transfer pathways
Authors: Skourtis Spiros S. , Liu Chaoren , Antoniou Panayiotis , Virshup Aaron M. , Beratan David N.
Published: July 2016

Significance

Controlling the dynamics of excitons—including their transport, fission, fusion, and free carrier generation—presents a central challenge in energy science, optoelectronics, and photobiology. We develop a coupling-pathway theory for triplet energy transfer, a process controlled by the structure of the medium between donor and acceptor sites, and find two competing coupling pathway mechanisms. At shorter distances or high tunneling gaps, the electron and hole move sequentially from donor to acceptor, accessing donor–acceptor charge-transfer exciton virtual states; at longer distances or lower tunneling gaps, virtual exciton states of the bridge mediate the transport. Molecular design strategies can leverage these competing mechanisms and their distinctive dependences on molecular structure.
Temperate phages both mediate and drive adaptive evolution in pathogen biofilms
Authors: Davies Emily V. , James Chloe E. , Williams David , O’Brien Siobhan , Fothergill Joanne L. , Haldenby Sam , Paterson Steve , Winstanley Craig , Brockhurst Michael A.
Published: July 2016

Significance

During chronic infection, bacterial pathogens undergo rapid evolutionary adaptation and extensive genetic diversification affecting patient symptoms and treatment outcomes. Temperate phages are common in pathogen genomes, and phage particles can reach high abundance in human infections, but their role in pathogen evolution is unclear. Using experimental evolution and population genomics, we show that temperate phages found in human infections accelerated pathogen evolution by increasing the supply of beneficial mutations and imposing strong selection on bacterial populations. Notably, phages accelerated the loss of clinically important virulence-related bacterial traits, including motility and quorum sensing. Temperate phages are likely therefore to facilitate rapid evolution of bacterial pathogens and contribute to their adaptation to the host environment and clinical treatments.
Ascorbate attenuates pulmonary emphysema by inhibiting tobacco smoke and Rtp801-triggered lung protein modification and proteolysis
Authors: Gupta Indranil , Ganguly Souradipta , Rozanas Christine R. , Stuehr Dennis J. , Panda Koustubh
Published: July 2016

Significance

Tobacco smoking causes emphysema, a fatal disease involving extensive structural damage of the lung. Besides directly oxidizing lung proteins, tobacco smoke activates Rtp801, a proinflammatory cellular factor that induces overproduction of NO by inducible NOS and consequent lung protein nitration and damage. Such oxidized or nitrated lung proteins become susceptible to breakdown by lung proteases causing emphysema. On interacting with the antioxidant vitamin C, tobacco smoke loses its ability to cause lung protein oxidation or damage, indicating that its oxidant(s) are primarily responsible for triggering lung injury. Vitamin C provides comprehensive protection against tobacco smoke-induced emphysema by attenuating direct damage of the lung by its oxidant(s) and their ability to activate cellular damage machineries including Rtp801 and lung proteases.
In situ characterization of the mTORC1 during adipogenesis of human adult stem cells on chip
Authors: Wu Xuanye , Schneider Nils , Platen Alina , Mitra Indranil , Blazek Matthias , Zengerle Roland , Schüle Roland , Meier Matthias
Published: July 2016

Significance

Adipogenesis is vital for animals to maintain energy balance by storing lipid. As a crucial integrator of nutrient, energy, and metabolite signals, mammalian target of rapamycin (mTOR) reportedly regulates adipogenesis. However, conventional cell cultures are limited to mimicking in vivo conditions, and previous reports do not provide the localization information of mTOR during adipogenesis. Here, we developed an automated microfluidic large-scale integration platform for differentiating human adult stem cells into mature adipocytes with standardized nutrient availability over weeks. With an integrated multiplexed immunoassay, we detected interaction, phosphorylation, and abundance changes of mTOR under the defined conditions. High-content analysis of single-cell data revealed that mTOR complex 1 changes its subcellular position in a temporally synchronized process with lysosomes during adipogenesis.
Large scale, synchronous variability of marine fish populations driven by commercial exploitation
Authors: Frank Kenneth T. , Petrie Brian , Leggett William C. , Boyce Daniel G.
Published: July 2016

Significance

Large-scale synchronous variation in the abundance of marine fish populations has generally been viewed as a response to coupled atmosphere–ocean forcing. The possibility that commercial exploitation could contribute significantly to these variations has been largely dismissed. We demonstrate, using data from 22 Atlantic cod stocks distributed across the North Atlantic, that fishing pressure can cause synchronous changes in stock abundance at spatial and temporal scales comparable to those attributed to climate forcing. We conclude that an understanding of the underlying causes of the large-scale, often synchronous variability of exploited marine fish populations and their underlying food chains will require greater acceptance of the potential importance of exploitation than has been evident to date.
Nematic quantum critical point without magnetism in FeSe

1−
x

S

x

superconductors
Authors: Hosoi Suguru , Matsuura Kohei , Ishida Kousuke , Wang Hao , Mizukami Yuta , Watashige Tatsuya , Kasahara Shigeru , Matsuda Yuji , Shibauchi Takasada
Published: July 2016

Significance

The electronic nematic order that spontaneously breaks rotational symmetry of the system is perhaps one of the most surprising states of matter. A key issue is the relationship between the fluctuations of such nematic order and high-temperature superconductivity in cuprates and iron pnictides. However, because of coexisting antiferromagnetic or charge density wave orders, it is difficult to pinpoint the impact of nematic fluctuations on superconductivity. Here we report a quantum critical point (QCP) of pure nematic order without accompanying other orders in FeSe

1−
x

S

x

superconductors. We find that the nematic fluctuations are divergently enhanced at the nematic QCP. This discovery opens up a new avenue to study the unconventional superconductivity mediated by exotic mechanisms different from the well-studied spin fluctuations.
Cardiolipin binds selectively but transiently to conserved lysine residues in the rotor of metazoan ATP synthases
Authors: Duncan Anna L. , Robinson Alan J. , Walker John E.
Published: July 2016

Significance

ATP, the fuel of life, is produced by a molecular machine consisting of two motors linked by a rotor. One motor generates rotation by consuming energy derived from oxidative metabolism or photosynthesis; the other uses energy transmitted by the rotor to put ATP molecules together from their building blocks ADP and phosphate. The anionic lipid cardiolipin, a component of bacterial membranes and the inner membranes of mitochondria where the machine is found, is an essential component of the enzyme. It interacts specifically, transiently, and repeatedly with the rotor of the machine, possibly lubricating its rotation or participating directly in the generation of rotation from the transmembrane proton motive force.
Board Games in Boat Burials: Play in the Performance of Migration and Viking Age Mortuary Practice
Authors: Hall Mark A
Published: July 2016

This contribution explores an aspect of boat burials in the second half of the first millennium AD across Northern Europe, specifically boat burials that included equipment for board games (surviving variously as boards and playing pieces, playing pieces only, or dice and playing pieces). Entangled aspects of identity, gender, cosmogony, performance, and commemoration are considered within a framework of cultural citation and connection between death and play. The crux of this article's citational thrust is the notion of quoting life in the rituals surrounding death. This was done both in the service of the deceased and in the service of those wanting to remember the deceased, the argument distills around the biographical trajectories or the different social and individual uses to which people put ostensibly simple things such as gaming pieces.
More Theory for Mortuary Research of the Viking World
Authors: Danielsson Ing-Marie Back
Published: July 2016

This themed journal issue provides many examples of ways forward in the study of death and memory in the Viking world. While all contributions demonstrate that there are exciting new ways to study remains from funerary contexts that focus on different forms of citation involving material culture and monuments, this article will very briefly discuss dimensions that have not been addressed here. Specifically, it showcases how the mortuary citations approach can also use post-humanist theory for further development and exploration of mortuary practices in the Viking world. Although short, this article discusses rune stones, particularly rune stones with kuml inscriptions, which I have examined elsewhere. The term kuml appears on contemporary rune stones; it refers to different material entities such as rune stones, mounds/cairns, and other standing stones. The being and becoming of kuml is briefly discussed through the concepts of intra-action and agential cuts championed by Karen Barad.
Dependence and independence of survival parameters on linear energy transfer in cells and tissues
Authors: Ando Koichi , Goodhead Dudley T.
Published: July 2016

Carbon-ion radiotherapy has been used to treat more than 9000 cancer patients in the world since 1994. Spreading of the Bragg peak is necessary for carbon-ion radiotherapy, and is designed based on the linear–quadratic model that is commonly used for photon therapy. Our recent analysis using in vitro cell kills and in vivo mouse tissue reaction indicates that radiation quality affects mainly the alpha terms, but much less the beta terms, which raises the question of whether this is true in other biological systems. Survival parameters alpha and beta for 45 in vitro mammalian cell lines were obtained by colony formation after irradiation with carbon ions, fast neutrons and X-rays. Relationships between survival parameters and linear energy transfer (LET) below 100 keV/μm were obtained for 4 mammalian cell lines. Mouse skin reaction and tumor growth delay were measured after fractionated irradiation. The Fe-plot provided survival parameters of the tissue reactions. A clear separation between X-rays and high-LET radiation was observed for alpha values, but not for beta values. Alpha values/terms increased with increasing LET in any cells and tissues studied, while beta did not show a systematic change. We have found a puzzle or contradiction in common interpretations of the linear-quadratic model that causes us to question whether the model is appropriate for interpreting biological effectiveness of high-LET radiation up to 500 keV/μm, probably because of inconsistency in the concept of damage interaction. A repair saturation model proposed here was good enough to fit cell kill efficiency by radiation of wide-ranged LET. A model incorporating damage complexity and repair saturation would be suitable for heavy-ion radiotherapy.
Does Stenting as a Bridge to Surgery in Left-Sided Colorectal Cancer Obstruction Really Worsen Oncological Outcomes?
Authors: Kwak Min Seob , Kim Wan Soo , Lee Jeong-Mi , Yang Dong-Hoon , Yoon Yong Sik , Yu Chang Sik , Kim Jin Cheon , Byeon Jeong-Sik
Published: July 2016

BACKGROUND:

Although self-expandable metal stents are used as a bridge to surgery in patients with colorectal cancer obstruction, their long-term oncological outcomes are unclear.

OBJECTIVE:

The aim of this study was to investigate long-term oncological outcomes of self-expandable metal stents as a bridge to surgery (stent group) compared with direct surgery (direct operation group) in patients with left-sided colorectal cancer obstruction.

DESIGN:

This was a retrospective chart review.

SETTINGS:

This study was conducted at a single tertiary academic center.

PATIENTS:

Of 113 patients who underwent curative surgery for left-sided colorectal cancer obstruction at Asan Medical Center between 2005 and 2011, 42 underwent direct surgery and 71 underwent self-expandable metal stent insertion followed by elective surgery. After 1:1 propensity-score matching, 42 patients were enrolled in both groups, and their postsurgical outcomes were compared.

MAIN OUTCOME MEASURES:

The primary outcomes of this study were long-term oncological outcomes, including overall survival and recurrence-free survival of patients in both groups.

RESULTS:

Three- and 5-year overall survival rates were similar in the stent (87.0% and 71.0%) and direct operation (76.4% and 76.4%) groups (p = 0.931). Three- and 5-year recurrence-free survival rates were also similar in the stent (91.9% and 66.4%) and direct operation (81.2% and 71.2%) groups (p = 0.581), as were postsurgical complication rates (9.5% and 16.7%; p = 0.344). No patient in either group experienced a permanent stoma.

LIMITATIONS:

This study was limited by its small patient numbers and retrospective nature.

CONCLUSIONS:

The long-term oncological outcomes of self-expandable metal stents as a bridge to surgery may not be inferior to those of direct surgery for left-sided colorectal cancer obstruction.
Characteristics of Antibiotic Prophylaxis and Risk of Surgical Site Infections in Open Colectomies
Authors: Poeran Jashvant , Wasserman Isaac , Zubizarreta Nicole , Mazumdar Madhu
Published: July 2016

BACKGROUND:

Despite numerous trials assessing optimal antibiotic prophylaxis strategies for colorectal surgery, few studies have assessed real-world practice on a national scale with respect to risk of surgical site infections.

OBJECTIVE:

Using a large national claims database we aimed to describe current use of prophylactic antibiotics (type and duration) and associations with surgical site infection after open colectomies.

DESIGN:

This was a retrospective study using the Premier Perspective database.

SETTINGS:

Included were patient hospitalizations nationwide from January 2006 to December 2013.

PATIENTS:

A total of 90,725 patients who underwent an open colectomy in 445 different hospitals were included in the study.

MAIN OUTCOME MEASURES:

Multilevel, multivariable logistic regressions measured associations between surgical site infection and type of antibiotic used and duration (day of surgery only, day of surgery and the day after, and >1 day after surgery).

RESULTS:

Overall surgical site infection prevalence was 5.2% (n = 4750). Most patients (41.8%) received cefoxitin for prophylaxis; other choices were ertapenem (18.2%), cefotetan (10.3%), metronidazole with cefazolin (9.9%), and ampicillin with sulbactam (7.6%), whereas 12.2% received other antibiotics. Distribution of prophylaxis duration was 51.6%, 28.5%, and 19.9% for day of surgery only, day of surgery and the day after, and >1 day after surgery, respectively. Compared with cefoxitin, lower odds for surgical site infection were observed for ampicillin with sulbactam (OR = 0.71 (95% CI, 0.63–0.82)), ertapenem (OR = 0.65 (95% CI, 0.58–0.71)), metronidazole with cefazolin (OR = 0.56 (95% CI, 0.49–0.64)), and “other” (OR = 0.81 (95% CI, 0.73–0.90)); duration was not significantly associated with altered odds for surgical site infection. Sensitivity analyses supported the main findings.

LIMITATIONS:

The study was limited by its lack of detailed clinical information in the billing data set used.

CONCLUSIONS:

In this national study assessing real-world use of prophylactic antibiotics in open colectomies, the type of antibiotic used appeared to be associated with up to 44% decreased odds for surgical site infections. Although there are numerous trials on optimal prophylactic strategies, studies that particularly focus on factors that influence the choice of prophylactic antibiotic might provide insights into ways of reducing the burden of surgical site infections in colorectal surgeries.
Psychological Symptom Amplification: Are Psychological Symptoms Subject to “Somatization”-Like Processes?
Authors: Kontos Nicholas , Querques John , Freudenreich Oliver
Published: July 2016

Many patients demonstrate amplified somatic symptom experiences that are felt by providers to cause excessive distress and functional impairment, and that can be diagnostically misleading. Terms attached to these presentations include somatization, medically unexplained symptoms, and, most recently, somatic symptom disorder. The analogous amplification of psychological symptoms has not been considered. Accordingly, this column makes a case for discussion and investigation of psychological symptom amplification (PSA), a process made possible by the medical legitimization of certain types of human suffering. As various forms of psychological suffering gain greater medical legitimacy, PSA becomes increasingly relevant. Circumstantial evidence suggests that unrecognized PSA may distort research findings and clinical efficacy in psychiatry. The largely symptom-based nature of psychiatric diagnosis makes PSA a challenging, but necessary, object of further scientific and clinical scrutiny.
Posttraumatic Stress Disorder, Overweight, and Obesity: A Systematic Review and Meta-analysis
Authors: Suliman Sharain , Anthonissen Lise , Carr Jonathan , du Plessis Stefan , Emsley Robin , Hemmings Sian M. J. , Lochner Christine , McGregor Nathaniel , van den Heuvel Leigh , Seedat Soraya
Published: July 2016

Previous reports have suggested a high prevalence of overweight and obesity among individuals with posttraumatic stress disorder (PTSD). Few studies, however, systematically analyze the relationship between PTSD and body mass index (BMI). We conducted a systematic review and meta-analysis aimed at estimating the association between PTSD and BMI. Fifty-four articles were reviewed, 30 of which (with 191,948 individuals with PTSD and 418,690 trauma-exposed individuals or healthy controls) were eligible for inclusion in the meta-analysis. The pooled standard mean difference, based on a random-effects model, was 0.41 (95% confidence interval, 0.28–0.54; z = 6.26; p < .001). Statistical heterogeneity between the included studies was high (p < .001; I2 = 99%). Despite limitations, the findings of this systematic review and meta-analysis suggest an association between PTSD and BMI. Furthermore, longitudinal studies tentatively indicate that PTSD may lead to an increase in BMI and, as such, to the development of overweight/obesity, particularly in women. Further prospective studies and research elaborating the nature and etiology of the association are required.
Effects of topical combinations of clonidine and pentoxifylline on capsaicin-induced allodynia and postcapsaicin tourniquet-induced pain in healthy volunteers: a double-blind, randomized, controlled study
Authors: Ragavendran J. Vaigunda , Laferrière André , Bennett Gary J. , Ware Mark A. , Gandhi Wiebke , Bley Keith , Schweinhardt Petra , Coderre Terence J.
Published: July 2016

This double-blind randomized controlled study was designed to evaluate the analgesic effects of topical treatments with clonidine (CLON) and pentoxifylline (PTX) tested alone or as low- and high-dose combinations in a human experimental model of pain. Of 69 healthy subjects aged 18 to 60 years, 23 each were randomly allocated to low-dose (0.04% + 2%) and high-dose (0.1% + 5%) CLON + PTX groups. Both of these groups also received their corresponding placebos in one of 2 treatment periods separated by at least 48 hours. Twenty-three additional subjects received either CLON (0.1%) or PTX (5%) as single drug treatments, in each of 2 treatment periods. Assessment of analgesic efficacy was based on allodynic effects of previous intraepidermal capsaicin injection, as well as postcapsaicin tourniquet-induced pain 50 minutes following capsaicin injection. Visual Analogue Scale (VAS) ratings of pain intensity and the area of dynamic mechanical allodynia were the primary outcome measures, whereas area of punctate mechanical allodynia (PMA) served as a secondary outcome measure. Topical treatments with high- or low-dose combinations significantly reduced VAS ratings compared with corresponding placebo treatments throughout the period of postcapsaicin tourniquet-induced pain. Importantly, the high-dose combination produced lower VAS ratings than CLON alone, which were lower than PTX alone. Results also revealed significant inhibition of postcapsaicin dynamic mechanical allodynia and PMA for the high-dose combination compared with placebo, and of PMA for CLON compared with the low-dose combination. Hence, the present data are supportive of further clinical investigation of the high-dose topical combination of CLON + PTX in complex regional pain syndrome and neuropathic pain patients, for which our preclinical data predict efficacy.
Emergencies and acute diseases in the collected works of Hippocrates: observation, examination, prognosis, therapy
Authors: Askitopoulou Helen , Stefanakis Georgios , Astyrakaki Elisabeth E. , Papaioannou Alexandra , Agouridakis Panagiotis
Published: July 2016

The collected works οf Hippocrates include a wealth of references to emergencies and acute conditions; if the physician could treat these, he would be considered superior to his colleagues. Works most relevant to current Emergency Medicine are presented. They indicate Hippocrates’ remarkable insight and attention to the value of close observation, meticulous clinical examination, and prognosis. Hippocrates and his followers disdained mystery and were not satisfied until they had discovered a rational cause to diseases. They assigned great significance to distressing signs and symptoms – the famous Hippocratic face, the breathing pattern, pain, seizures, opisthotonus – pointing to a fatal outcome, which they reported to their patient. The principles of treatment of emergencies, such as angina, haemorrhage, empyema, ileus, shoulder dislocations and head injuries, are astonishingly similar to the ones used nowadays.
Work out by Walking
Authors: Browne Julia , Penn David L. , Battaglini Claudio L. , Ludwig Kelsey
Published: July 2016

The health benefits of exercise are well documented, yet annual health care costs related to physical inactivity are well within the billions. Furthermore, individuals with schizophrenia spectrum disorders (SSDs) are more likely to lead sedentary lives, exercise less than the general population, and die prematurely from preventable causes. Previous research examining the effects of exercise on individuals with SSDs has been encouraging yet limited in creating accessible and sustainable interventions. The current pilot study developed and evaluated the impact of Work out by Walking (WOW), a multicomponent group walking intervention on the health of 16 individuals with SSDs. Results indicated improvements in indicators of physical health, activity level, social support, and mental health and a high level of program satisfaction. Future research should examine multicomponent group walking programs for individuals with SSDs in larger samples and with the inclusion of a comparison condition.
Development of the Contact Lens User Experience: CLUE Scales
Authors: Wirth R. J. , Edwards Michael C. , Henderson Michael , Henderson Terri , Olivares Giovanna , Houts Carrie R.
Published: July 2016

Purpose

The field of optometry has become increasingly interested in patient-reported outcomes, reflecting a common trend occurring across the spectrum of healthcare. This article reviews the development of the Contact Lens User Experience: CLUE system designed to assess patient evaluations of contact lenses. CLUE was built using modern psychometric methods such as factor analysis and item response theory.

Methods

The qualitative process through which relevant domains were identified is outlined as well as the process of creating initial item banks. Psychometric analyses were conducted on the initial item banks and refinements were made to the domains and items. Following this data-driven refinement phase, a second round of data was collected to further refine the items and obtain final item response theory item parameters estimates.

Results

Extensive qualitative work identified three key areas patients consider important when describing their experience with contact lenses. Based on item content and psychometric dimensionality assessments, the developing CLUE instruments were ultimately focused around four domains: comfort, vision, handling, and packaging. Item response theory parameters were estimated for the CLUE item banks (377 items), and the resulting scales were found to provide precise and reliable assignment of scores detailing users’ subjective experiences with contact lenses.

Conclusions

The CLUE family of instruments, as it currently exists, exhibits excellent psychometric properties.
Expression of CDX2 and Thyroid Transcription Factor-1 in Oropharyngeal Undifferentiated Carcinomas: A Potential Diagnostic Pitfall
Authors: Chernock Rebecca D. , Bibbey Scott , El-Mofty Samir K. , Carpenter Danielle H. , Lewis James S.
Published: July 2016

Oropharyngeal undifferentiated carcinomas are rare and most are human papillomavirus related. Morphologically, they overlap with undifferentiated carcinomas from other organ sites, including the nasopharynx, lung, and gastrointestinal tract. Most have lymph node metastases at presentation and, especially when initially encountered in a lymph node, immunostains may be performed to determine the most likely primary site. We recently reviewed a case in consultation that strongly and diffusely expressed both thyroid transcription factor-1 (TTF-1, SPT24 clone) and CDX2, 2 widely used markers that are considered relatively lineage specific for lung/thyroid and intestinal differentiation, respectively. Unexpected expression of these markers could be misleading. However, they have not been previously assessed in oropharyngeal undifferentiated carcinoma. Here, we performed immunohistochemistry for CDX2 and TTF-1 (8G7G3/1 clone) on primary tumors and/or lymph node metastases from 11 in-house patients with previously characterized undifferentiated carcinoma of the oropharynx from 1992 to 2008. All were male with an average age of 56.7 years, and 5 (46%) initially presented with a neck mass. All were Epstein-Barr virus negative and 9 (82%) were human papillomavirus and p16 positive. CDX2 was positive in 6 of the 11 (55%) cases. However, staining was generally weak to moderate and/or nondiffuse. TTF-1 was negative in all the in-house cases and showed only rare, weakly positive cells in the consult case when TTF-1 was repeated using the 8G7G3/1 clone. Thus, CDX2 immunoreactivity is common, whereas TTF-1 expression is rare in oropharyngeal undifferentiated carcinomas. As a result, one should not rely on CDX2 as evidence of intestinal differentiation or origin in metastatic undifferentiated carcinomas in the neck, particularly when staining is not strong and diffuse. In addition, TTF-1 should be interpreted with caution especially when using the SPT24 clone.
Timely Hemodynamic Resuscitation and Outcomes in Severe Pediatric Traumatic Brain Injury
Authors: Kannan Nithya , Wang Jin , Mink Richard B. , Wainwright Mark S. , Groner Jonathan I. , Bell Michael J. , Giza Christopher C. , Zatzick Douglas F. , Ellenbogen Richard G. , Boyle Linda Ng , Mitchell Pamela H. , Rivara Frederick P. , Rowhani-Rahbar Ali , Vavilala Monica S.
Published: July 2016

Objectives

Early resuscitation may improve outcomes in pediatric traumatic brain injury (TBI). We examined the association between timely treatment of hypotension and hypoxia during early care (prehospital or emergency department locations) and discharge outcomes in children with severe TBI.

Methods

Hypotension was defined as systolic blood pressure less than 70 + 2 (age in years), and hypoxia was defined as Pao
2 less than 60 mm Hg or oxygen saturation less than 90% in accordance with the 2003 Brain Trauma Foundation guidelines. Timely treatment of hypotension and hypoxia during early care was defined as the treatment within 30 minutes of a documented respective episode. Two hundred thirty-six medical records of children younger than 18 years with severe TBI from 5 regional pediatric trauma centers were examined. Main outcomes were in-hospital mortality and discharge Glasgow Outcome Scale (GOS) score.

Results

Hypotension occurred in 26% (60/234) during early care and was associated with in-hospital mortality (23.3% vs 8.6%; P = 0.01). Timely treatment of hypotension during early care occurred in 92% (55/60) by use of intravenous fluids, blood products, or vasopressors and was associated with reduced in-hospital mortality [adjusted relative risk (aRR), 0.46; 95% confidence interval, 0.24–0.90] and less likelihood of poor discharge GOS (aRR, 0.54; 95% confidence interval, 0.39–0.76) when compared to children with hypotension who were not treated in a timely manner. Early hypoxia occurred in 17% (41/236) and all patients received timely oxygen treatment.

Conclusions

Timely resuscitation during early care was common and associated with lower in-hospital mortality and favorable discharge GOS in severe pediatric TBI.
Multisite Single-Blinded Randomized Control Study of Transfer and Retention of Knowledge and Skill Between Nurses Using Simulation and Online Self-Study Module
Authors: Rutherford-Hemming Tonya , Kelsey Nichole C. , Grenig Deanna L. , Feliciano Michelle , Simko Leslie , Henrich Christina M.
Published: July 2016

Introduction

Obstetric (OB) nurses must be proficient in performing a basic neurologic examination to assess and detect changes in a patients’ neurologic status. This study aimed to compare knowledge and skill acquisition for a basic neurologic examination between OB nurses who participated in simulation and those who participated in an online self-study module. Short- and long-term knowledge retention and skill transfer between groups were evaluated.

Methods

Nurses were randomized to either simulation or online self-study module and assessed by direct observation and completion of a standardized instrument by the observer at 3 time points: baseline (time 1), within 7 days of baseline in the clinical setting (time 2), and at 2 months (time 3) using a validated12-item Neurologic Knowledge Assessment and a 14-item performance skill checklist.

Results

Among OB nurses, those in the simulation group demonstrated higher levels in both short-term (time 2) [mean (SD), 67.6 (20.2) vs. 29.6 (19.0); P < 0.001] and long-term (time 3) [mean (SD), 46.1 (17.6) vs. 27.5 (15.9); P < 0.001] skill performance compared with nurses in the online self-study module. Nurses in the simulation and online self-study module groups had similar mean levels on Neurologic Knowledge Assessment scores at time 2 (P = 0.86) and time 3 (P = 0.59), but these mean scores were not significant.

Conclusions

The greater transfer of skills by nurses who received simulation education is an important finding because few studies have addressed this level of translation with practicing nurses. There was a lack of differences in short- and long-term knowledge acquisition between nurses in the simulation and online self-study module groups. More research is needed to determine the timing of simulation-based education repetition over time to aid in knowledge and skills retention.
Wavelength-specific forward scattering of light by Bragg-reflective iridocytes in giant clams
Authors: Ghoshal Amitabh , Eck Elizabeth , Gordon Michael , Morse Daniel E.
Published: July 2016

A surprising recent discovery revealed that the brightly reflective cells (‘iridocytes’) in the epithelia of giant clams actually send the majority of incident photons ‘forward’ into the tissue. While the intracellular Bragg reflectors in these cells are responsible for their colourful back reflection, Mie scattering produces the forward scattering, thus illuminating a dense population of endosymbiotic, photosynthetic microalgae. We now present a detailed micro-spectrophotometric characterization of the Bragg stacks in the iridocytes in live tissue to obtain the refractive index of the high-index layers (1.39 to 1.58, average 1.44 ± 0.04), the thicknesses of the high- and low-index layers (50–150 nm), and the numbers of pairs of layers (2–11) that participate in the observed spectral reflection. Based on these measurements, we performed electromagnetic simulations to better understand the optical behaviour of the iridocytes. The results open a deeper understanding of the optical behaviour of these cells, with the counterintuitive discovery that specific combinations of iridocyte diameter and Bragg-lamellar spacing can produce back reflection of the same colour that is also scattered forward, in preference to other wavelengths that are scattered at higher angles. We find for all values of size and wavelength investigated that more than 90% of the incident energy is carried by the photons that are scattered in the forward direction; while this forward scattering from each iridocyte shows very narrow angular dispersion (ca±6°), the multiplicative scattering from a layer ofca20 iridocytes broadens this dispersion to a cone of approximately ±90°. This understanding of the complex biophotonic dynamics enhances our comprehension of the physiologically, ecologically and evolutionarily significant light environment inside the giant clam, which is diffuse and nearly white at small tissue depths and downwelling, relatively monochromatic, and can be the same colour as the back-reflected light at greater depths in the tissue. Originally thought to be unique, cells of similar structure and photonic activity are now recognized in other species, where they serve other functions. The behaviour of the iridocytes opens possible new considerations for conservation and management of the valuable giant clam resource and new avenues for biologically inspired photonic applications.
A single amino acid substitution in a chitinase of the legume
Medicago truncatula
is sufficient to gain Nod-factor hydrolase activity
Authors: Zhang Lan-Yue , Cai Jie , Li Ru-Jie , Liu Wei , Wagner Christian , Wong Kam-Bo , Xie Zhi-Ping , Staehelin Christian
Published: July 2016

The symbiotic interaction between nitrogen-fixing rhizobia and legumes depends on lipo-chitooligosaccharidic Nod-factors (NFs). The NF hydrolase MtNFH1 of
Medicago truncatula
is a symbiotic enzyme that hydrolytically inactivates NFs with a C16 : 2 acyl chain produced by the microsymbiont
Sinorhizobium meliloti
1021
.
MtNFH1 is related to class V chitinases (glycoside hydrolase family 18) but lacks chitinase activity. Here, we investigated the substrate specificity of MtNFH1-related proteins. MtCHIT5a and MtCHIT5b of
M. truncatula
as well as LjCHIT5 of
Lotus japonicus
showed chitinase activity, suggesting a role in plant defence. The enzymes failed to hydrolyse NFs from
S. meliloti.
NFs from
Rhizobium leguminosarum
with a C18 : 4 acyl moiety were neither hydrolysed by these chitinases nor by MtNFH1. Construction of chimeric proteins and further amino acid replacements in MtCHIT5b were performed to identify chitinase variants that gained the ability to hydrolyse NFs. A single serine-to-proline substitution was sufficient to convert MtCHIT5b into an NF-cleaving enzyme. MtNFH1 with the corresponding proline-to-serine substitution failed to hydrolyse NFs. These results are in agreement with a substrate-enzyme model that predicts NF cleavage when the C16 : 2 moiety is placed into a distinct fatty acid-binding cleft. Our findings support the view that
MtNFH1
evolved from the ancestral
MtCHIT5b
by gene duplication and subsequent symbiosis-related neofunctionalization.