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Cosmopolitan habitat-forming taxa of algae such as the genus Corallina provide an opportunity to compare patterns of biodiversity over wide geographic scales. Nematode assemblages inhabiting Corallina turves were compared between the south coasts of the British Isles and South Korea. A fully nested design was used with three regions in each country, two shores in each region and replicate samples taken from three patches on each shore to compare differences in the taxonomic and biological trait composition of nematode assemblages across scales. A biological traits approach, based on functional diversity of nematodes, was used to make comparisons between countries, among regions, between shores and among patches. The taxonomic and biological trait compositions of nematode assemblages were significantly different across all spatial scales (patches, shores, regions and countries). There is greater variation amongst nematode assemblages at the scale of shore than at other spatial scales. Nematode assemblage structure and functional traits are influenced by the local environmental factors on each shore including sea-surface temperature, the amount of sediment trapped in Corallina spp. and tidal range. The sea-surface temperature and the amount of sediment trapped in Corallina spp. were the predominant factors determining nematode abundance and composition of assemblages and their functional diversity.
Lymphatic filariasis (LF) threatens nearly 20% of the world's population and has handicapped one-third of the 120 million people currently infected. Current control and elimination programs for LF rely on mass drug administration of albendazole plus diethylcarbamazine (DEC) or ivermectin. Only the mechanism of action of albendazole is well understood. To gain a better insight into antifilarial drug action in vivo, we treated gerbils harbouring patent Brugia malayi infections with 6 mg kg−1 DEC, 0.15 mg kg−1 ivermectin or 1 mg kg−1 albendazole. Treatments had no effect on the numbers of worms present in the peritoneal cavity of treated animals, so effects on gene expression were a direct result of the drug and not complicated by dying parasites. Adults and microfilariae were collected 1 and 7 days post-treatment and RNA isolated for transcriptomic analysis. The experiment was repeated three times. Ivermectin treatment produced the most differentially expressed genes (DEGs), 113. DEC treatment yielded 61 DEGs. Albendazole treatment resulted in little change in gene expression, with only 6 genes affected. In total, nearly 200 DEGs were identified with little overlap between treatment groups, suggesting that these drugs may interfere in different ways with processes important for parasite survival, development, and reproduction.
Introduction: Situational Awareness is the ability to identify, process, and comprehend the critical elements of information about the patient condition, stability, the operational environment and an appropriate clinical course. The Situational Awareness Global Assessment Tool (SAGAT) is a validated tool for measuring situational awareness. The SAGAT tool was measured during a series of standardized high fidelity advanced airway management simulations in multidisciplinary teams in New Brunswick Emergency Departments delivered by two simulation programs Methods: Thirty eight simulated emergency airway cases were performed in situ in Emergency Departments and in learning centers in Southern New Brunswick from September 2015 to October 2017. Eight standardized cases were used whose educational objectives were to develop the optimization of critically ill patients prior to induction, to deliver patient-centered anesthesia and to choose an appropriate airway strategy. Learner profiles collected. Cases were divided into two groups; those that contained critical errors and those that did not based on video assessment. Critical errors were defined as failure of 1) Oxygenation 2) Shock correction 3) Induction dose estimation 4) Choice of airway management paradigm. The SAGAT has a maximum score of 13 and was assessed by research nurses after each case for all participants. SAGAT scores were non-normally distributed, so results were expressed as medians with interquartile ranges. Mann Whitney U tests were used to calculate statistical significance. Results: Results. Of the 38 cases, 14 contained one more critical errors. The median SAGAT score in the group that contained critical errors was 8 +/− 2 (IQR). The median SAGAT Score in the group that contained no critical errors was 11 +/− 2 (IQR). The median scores we significantly different with a p-value of 0.02. Conclusion: In this study in simulated emergency cases, higher SAGAT scores were associated with teams leaders that did not commit safety critical errors. This work is the initial analysis to develop standards for Simulated team performance in Emergency Department teams.
Introduction: Situational awareness (SA) is the team understanding patient stability, presenting illness and future clinical course. Losing SA has been shown to increase safety-critical events in multiple industries. SA can be measured by the previously validated Situational Awareness Global Assessment Tool (SAGAT). Checklists are used in many safety-critical industries to reduce errors of omission and commission. An RSI checklist was developed from case review and published evidence.The New Brunswick Trauma Program supports an inter-professional simulation-based medical education program Methods: Simulations were facilitated in three hospitals in New Brunswick from April 2017 to October 2017. Learner profiles were collected. The SAGAT tool was completed by a research nurse at the end of each scenario. SAGAT scores were non-normally distributed, so results were expressed as medians and interquartile ranges. Mann Whitney U tests were used to calculate statistical significance. To understand the effect of the of an RSI checklist a comparison was made between SAGAT scores at baseline in scenario 1, and the same first scenario completed after a washout period. A Poisson regression analysis will be used to account for the effect of confounding variables in further analyses. Results: The group was composed of Registered Nurses (8), Physicians (7), and Respiratory Therapists (2). Situational awareness increased significantly with the use of an RSI checklist after 1 day of 4 simulations. The washout period ranged between 5 weeks and 8 weeks. The baseline situational awareness of the whole group during scenario 1 was 9 +/− 0.5 (median, IQR), and with the RSI checklist was 12 +/−1 (median, IQR). The difference was highly statistically significant, p=< 0.001. This level of situational awareness using checklist is comparable to the SAGAT scores after 10 scenarios. Conclusion: In this provisional analysis, the use of an RSI checklist was associated with an increase in measured situational awareness. Higher levels of situational awareness are associated with greater patient safety. A Poisson regression model will be used to understand the confounding effects of user expertise and the likely interaction with simulation exposure.
Caring for patients with personality disorder is one of the biggest challenges in psychiatric work. We investigated whether mentalisation-based treatment skills (MBT-S) teaching improves clinicians' understanding of mentalising and attitudes towards personality disorder. Self-report questionnaires (Knowledge and Application of MBT (KAMQ) and Attitudes to Personality Disorder (APDQ)) were completed at baseline and after a 2-day MBT-S workshop.
Ninety-two healthcare professionals completed questionnaires before and after training. The mean within-participant increase in scores from baseline to end-of-programme was 11.6 points (95% CI 10.0–13.3) for the KAMQ and 4.0 points (1.8–6.2) for the APDQ.
MBT-S is a short intervention that is effective in improving clinicians' knowledge of personality disorder and mentalisation. That attitudes to personality disorder improved overall is encouraging in relation to the possibility of deeper learning in staff and, ultimately, improved care for patients with personality disorder.
The transport of relativistic electron beam in compressed cylindrical targets was studied from a numerical and experimental point of view. In the experiment, cylindrical targets were imploded using the Gekko XII laser facility of the Institute of Laser Engineering. Then the fast electron beam was created by shooting the LFEX laser beam. The penetration of fast electrons was studied by observing Kα emission from tracer layers in the target.
Tuberous sclerosis complex (TSC) is associated with intellectual disability, but the risk pathways are poorly understood.
The Tuberous Sclerosis 2000 Study is a prospective longitudinal study of the natural history of TSC. One hundred and twenty-five UK children age 0–16 years with TSC and born between January 2001 and December 2006 were studied. Intelligence was assessed using standardized measures at ≥2 years of age. The age of onset of epilepsy, the type of seizure disorder, the frequency and duration of seizures, as well as the response to treatment was assessed at interview and by review of medical records. The severity of epilepsy in the early years was estimated using the E-Chess score. Genetic studies identified the mutations and the number of cortical tubers was determined from brain scans.
TSC2 mutations were associated with significantly higher cortical tuber count than TSC1 mutations. The extent of brain involvement, as indexed by cortical tuber count, was associated with an earlier age of onset and severity of epilepsy. In turn, the severity of epilepsy was strongly associated with the degree of intellectual impairment. Structural equation modelling supported a causal pathway from genetic abnormality to cortical tuber count to epilepsy severity to intellectual outcome. Infantile spasms and status epilepticus were important contributors to seizure severity.
The findings support the proposition that severe, early onset epilepsy may impair intellectual development in TSC and highlight the potential importance of early, prompt and effective treatment or prevention of epilepsy in tuberous sclerosis.
Dietary assessment in older adults can be challenging. The Novel Assessment of Nutrition and Ageing (NANA) method is a touch-screen computer-based food record that enables older adults to record their dietary intakes. The objective of the present study was to assess the relative validity of the NANA method for dietary assessment in older adults. For this purpose, three studies were conducted in which a total of ninety-four older adults (aged 65–89 years) used the NANA method of dietary assessment. On a separate occasion, participants completed a 4 d estimated food diary. Blood and 24 h urine samples were also collected from seventy-six of the volunteers for the analysis of biomarkers of nutrient intake. The results from all the three studies were combined, and nutrient intake data collected using the NANA method were compared against the 4 d estimated food diary and biomarkers of nutrient intake. Bland–Altman analysis showed a reasonable agreement between the dietary assessment methods for energy and macronutrient intake; however, there were small, but significant, differences for energy and protein intake, reflecting the tendency for the NANA method to record marginally lower energy intakes. Significant positive correlations were observed between urinary urea and dietary protein intake using both the NANA and the 4 d estimated food diary methods, and between plasma ascorbic acid and dietary vitamin C intake using the NANA method. The results demonstrate the feasibility of computer-based dietary assessment in older adults, and suggest that the NANA method is comparable to the 4 d estimated food diary, and could be used as an alternative to the food diary for the short-term assessment of an individual's dietary intake.
The objective of this study was to determine the genetic parameters of methane (CH4) emissions and their genetic correlations with key production traits. The trial measured the CH4 emissions, at 5-min intervals, from 1225 sheep placed in respiration chambers for 2 days, with repeat measurements 2 weeks later for another 2 days. They were fed in the chambers, based on live weight, a pelleted lucerne ration at 2.0 times estimated maintenance requirements. Methane outputs were calculated for g CH4/day and g CH4/kg dry matter intake (DMI) for each of the 4 days. Single trait models were used to obtain estimates of heritability and repeatability. Heritability of g CH4/day was 0.29 ± 0.05, and for g CH4/kg DMI 0.13 ± 0.03. Repeatability between measurements 14 days apart were 0.55 ± 0.02 and 0.26 ± 0.02, for the two traits. The genetic and phenotypic correlations of CH4 outputs with various production traits (weaning weight, live weight at 8 months of age, dag score, muscle depth and fleece weight at 12 months of age) measured in the first year of life, were estimated using bivariate models. With the exception of fleece weight, correlations were weak and not significantly different from zero for the g CH4/kg DMI trait. For fleece weight the phenotypic and genetic correlation estimates were −0.08 ± 0.03 and −0.32 ± 0.11 suggesting a low economically favourable relationship. These results indicate that there is genetic variation between animals for CH4 emission traits even after adjustment for feed intake and that these traits are repeatable. Current work includes the establishment of selection lines from these animals to investigate the physiological, microbial and anatomical changes, coupled with investigations into shorter and alternative CH4 emission measurement and breeding value estimation techniques; including genomic selection.
Multilocus recombination frequencies are expressed in terms of pairwise recombination frequencies for paracentric and pericentric intervals. Applications of this theory to mapping and genetic counselling are discussed.
Data from Neurospora, Drosophila, and the mouse support the mapping parameter conventionally used for man, exclude the Haldane, Kosambi, and Carter—Falconer functions, and suggest a refinement for centromere mapping. Different sexes, chromosome arms, and types of data are surprisingly consistent. Double recombination frequencies are accurately predicted, but triple recombination frequencies are overestimated. The centromere appears to act on interference as an obligatory chiasma. Recombination across the centromere conforms to a simple approximation, based on the interval Markov assumption with a common mapping parameter. These results imply that mapping of n loci requires estimation of at most n parameters, and the relation between map distances and all recombination frequencies is explicit.
The Yabelo–Mega region of southern Ethiopia's Borana region holds two threatened endemic and restricted-range species, the White-tailed Swallow Hirundo megaensis (‘Vulnerable’) and Ethiopian Bush-crow Zavattariornis stresemanni (‘Endangered’). Concern about these species’ conservation status has recently increased owing to rapid alterations to their thornbush savanna habitat. This six-week field study aimed to identify the specific habitat requirements of each species, with a view to understanding how they are likely to be affected by these changes, and to provide baseline quantitative abundance data using simple and repeatable methods. White-tailed Swallows were recorded on an overall 4.7% of transects and point counts, and in all habitats (including villages and farmland) except broadleaved Combretum–Terminalia woodland. Line transects indicated that swallows avoided dense scrub and tree cover, but this was not detected during point counts. Bush-crows were recorded on an overall 16.6% of transects and point counts, and like swallows showed a strong preference for thornbush (Acacia and Commiphora) over broadleaved woodland, avoided dense scrub cover, and were particularly frequent in the vicinity of villages. During point-counts, bush-crows were more frequently encountered inside the nominally protected Yabelo Sanctuary, whereas the reverse was true for White-tailed Swallows. Recent concern about dramatic declines in bush-crow numbers revealed by roadside counts may have been exacerbated by habitat alteration along roads alone, but the species remains under threat from habitat transformation through agricultural expansion, tree felling and bush encroachment.
Deglutition disorders (dysphagia) are common following total laryngectomy. As the aetiology of the disorder is poorly understood, its incidence is probably under-estimated. Dysphagia may result from many factors, including the type of laryngectomy surgery employed and the use of adjuvant treatments (e.g. radiotherapy and chemotherapy). Dysphagia may also be compounded by other co-morbid factors, such as ageing and depression.
To investigate the methods of surgical closure used by Australian ENT and head and neck surgeons after undertaking total laryngectomy surgery.
In order to audit surgical variation, 56 short questionnaires were sent to all Australian ENT and head and neck surgeons who were registered members of the Australia and New Zealand Head and Neck Society. Twenty-eight questionnaires (50 per cent) were completed and returned.
Respondents reported using a variety of different reconstructive methods after total laryngectomy surgery. Specifically, there were differences in the type and levels of pharyngeal closure employed and the suturing techniques used.
Currently, there is no scientific evidence to direct surgeons to the optimal pharyngeal reconstruction technique(s) ensuring for good swallowing results post-laryngectomy. An analysis of the effect of surgical reconstruction technique on laryngectomees' post-operative swallowing ability is needed, in order to provide evidence to determine optimal surgical techniques.
The Horn of Africa as Common Homeland: The State and
Self-Determination in the Era of Heightened Globalization, Leenco
Lata, Waterloo: Wilfrid Laurier University Press, 2004, pp. xi, 219.
The author of this book describes himself as a political activist who
earned his credentials to write about self-determination in the Horn of
Africa largely through his experiences in helping to form the Oromo
Liberation Front (OLF) in Ethiopia in the 1970s. He also draws on two
decades of political activities, work and travel throughout the entire
region. The result is a text that is rich in “lived
experiences.” Yet the author is a scholar as much as he is an
activist and keen observer of events. Drawing on different theoretical
perspectives and exploring alternative theories of state, nation,
self-determination and democracy, Lata has produced a coherent and nuanced
analysis of current state-building processes in the Horn of Africa.
This study evaluated the efficacy and safety of three doses of botulinum toxin A (BTX-A; Dysport®) in 125 patients (mean age 5.2 years, SD 2; 54% male)with dynamic equinus spasticity during walking. Participants were randomized to receive Dysport (10, 20, or 30 units/kg) or placebo to the gastrocnemius muscle of both legs. Muscle length was calculated from electrogoniometric measurements and the change in the dynamic component of gastrocnemius shortening at four weeks was prospectively identified as the primary outcome measure. All treatment groups showed statistically significant decreases in dynamic component compared with placebo at 4 weeks. Mean improvement in dynamic component was most pronounced in the 20 units/kg group, being equivalent to an increase in dorsiflexion with the knee extended at 19°, and was still present at 16 weeks. The safety profile of the toxin appears satisfactory.
Background. Several examinations have detected a relation between depressive symptoms and medical utilization. However, selection biases have been involved in most previous examinations. We sought to test the association between depressive symptoms and prospective, increased medical care utilization, in a population-based Canadian sample, while controlling for utilization due to medical illness and controlling for selection bias.
Methods. Data from the Nova Scotia Health Survey 1995, an age- and sex-stratified random sampling of 3227 Nova Scotian adults, included the Center for Epidemiological Studies-Depression scale and items assessing chronic medical conditions and current limitations in daily activities resulting from medical illness. We linked survey data with medical care utilization measures for the year following the survey, including out-patient visits, reimbursement for out-patient services, hospitalizations, and hospitalization days.
Results. After controlling for age, sex, count of medical diagnoses and current medical severity, those with a greater level of depressive symptoms were at greater risk of having increased medical care utilization in the following year. These results remained after removing mental health care utilization costs.
Conclusions. In a population-based sample, depressive symptoms predicted greater medical care utilization, independent of a number of medical severity measures. Whether depressive symptoms are a risk marker or a causal risk factor for increased medical utilization remains to be explored.