“…not some young tourist”: The male overseas-acquired HIV social research study

As with the trend in the rest of Australia, the majority of HIV diagnoses in Western Australia (WA) over the past 20 years have been amongst men who have sex with men in Australia. However, a differing trend seen more recently in WA has been the number of HIV diagnoses among heterosexual and homosexual men who acquired HIV while overseas compared to other states. The number of Western Australians acquiring HIV overseas has increased from 41 people in 2002-2004 to 91 people in 2005-2007. The upward trend of overseas acquired notifications continued in 2008-2009 (Combs and Giele 2009; DoH (WA) 2009). While the epidemiological data clearly showed an increase in overseas acquired HIV, there was little information on why the increase was occurring. The Male Overseas Acquired HIV Social Research Study investigated the social, cultural, behavioural and cognitive factors which may have contributed to the overseas-acquisition of HIV by male WA residents. The study used a qualitative approach to collecting and analysing data from in depth interviews with men who had acquired HIV while travelling or working overseas. The study was a joint project of the WA Centre for Health Promotion Research, National Centre in HIV Social Research, National Centre in HIV Epidemiology and Clinical Research and the Australian Research Centre in Sex, Health and Society and funded by the Western Australian Department of Health, Sexual Health and Blood Borne Virus Program. Men were recruited through the WA AIDS Council, Royal Perth Hospital, Fremantle Hospital, Northern Territory AIDS and Hepatitis Council and Clinic 34, Darwin. Fourteen men participated in the study during 2008 and 2009

“…not some young tourist”: The male overseas-acquired HIV social research study

As with the trend in the rest of Australia, the majority of HIV diagnoses in Western Australia (WA) over the past 20 years have been amongst men who have sex with men in Australia. However, a differing trend seen more recently in WA has been the number of HIV diagnoses among heterosexual and homosexual men who acquired HIV while overseas compared to other states. The number of Western Australians acquiring HIV overseas has increased from 41 people in 2002-2004 to 91 people in 2005-2007. The upward trend of overseas acquired notifications continued in 2008-2009 (Combs and Giele 2009; DoH (WA) 2009). While the epidemiological data clearly showed an increase in overseas acquired HIV, there was little information on why the increase was occurring. The Male Overseas Acquired HIV Social Research Study investigated the social, cultural, behavioural and cognitive factors which may have contributed to the overseas-acquisition of HIV by male WA residents. The study used a qualitative approach to collecting and analysing data from in depth interviews with men who had acquired HIV while travelling or working overseas. The study was a joint project of the WA Centre for Health Promotion Research, National Centre in HIV Social Research, National Centre in HIV Epidemiology and Clinical Research and the Australian Research Centre in Sex, Health and Society and funded by the Western Australian Department of Health, Sexual Health and Blood Borne Virus Program. Men were recruited through the WA AIDS Council, Royal Perth Hospital, Fremantle Hospital, Northern Territory AIDS and Hepatitis Council and Clinic 34, Darwin. Fourteen men participated in the study during 2008 and 2009

The role of octadecanoids and functional mimics in soybean defense responses

Oxylipins of the jasmonate pathway and synthetic functional analogs have been analyzed for their elicitor like activities in an assay based on the induced accumulation of glyceollins, the phytoalexins of soybean (Glycine max L.), in cell suspension cultures of this plant. Jasmonic acid (JA) and its methyl ester showed weak phytoalexininducing activity when compared to an early jasmonate biosynthetic precursor, 12-oxophytodienoic acid (OPDA), as well as to the bacterial phytotoxin coronatine and certain 6-substituted indanoylLisoleucine methyl esters, which all were highly active. Interestingly, different octadecanoids and indanoyl conjugates induced the accumulation of transcripts of various defenserelated genes to different degrees, indicating distinct induction competencies. Therefore, these signaling compounds and mimics were further analyzed for their effects on signal transduction elements, such as the transient enhancement of the cytosolic Ca2+ concentration and MAP kinase activation, which are known to be initiated by a soybean pathogenderived {[}beta]glucan elicitor. In contrast to the {[}beta]glucan elicitor, none of the other compounds tested triggered these early signaling elements. Moreover, endogenous levels of OPDA and JA in soybean cells were shown to be unaffected after treatment with {[}beta]glucans. Thus, OPDA and JA, which are functionally mimicked by coronatine and a variety of 6-substituted derivatives of indanoylLisoleucine methyl ester, represent highly efficient signaling compounds of a lipidbased pathway not deployed in the {[}beta]glucan elicitorinitiated signal transduction

Diazoxide-responsive hyperinsulinemic hypoglycemia caused by HNF4A gene mutations

Objective: The phenotype associated with heterozygous HNF4A gene mutations has recently been extended to include diazoxide responsive neonatal hypoglycemia in addition to maturity-onset diabetes of the young (MODY). To date, mutation screening has been limited to patients with a family history consistent with MODY. In this study, we investigated the prevalence of HNF4A mutations in a large cohort of patients with diazoxide responsive hyperinsulinemic hypoglycemia (HH). Subjects and methods: We sequenced the ABCC8, KCNJ11, GCK, GLUD1, and/or HNF4A genes in 220 patients with HH responsive to diazoxide. The order of genetic testing was dependent upon the clinical phenotype. Results: A genetic diagnosis was possible for 59/220 (27%) patients. KATP channel mutations were most common (15%) followed by GLUD1 mutations causing hyperinsulinism with hyperammonemia (5.9%), and HNF4A mutations (5%). Seven of the 11 probands with a heterozygous HNF4A mutation did not have a parent affected with diabetes, and four de novo mutations were confirmed. These patients were diagnosed with HI within the first week of life (median age 1 day), and they had increased birth weight (median +2.4 SDS). The duration of diazoxide treatment ranged from 3 months to ongoing at 8 years. Conclusions: In this large series, HNF4A mutations are the third most common cause of diazoxide responsive HH. We recommend that HNF4A sequencing is considered in all patients with diazoxide responsive HH diagnosed in the first week of life irrespective of a family history of diabetes, once KATP channel mutations have been excluded

Transdiagnostic treatment of bipolar disorder and comorbid anxiety using the Unified Protocol for Emotional Disorders: A pilot feasibility and acceptability trial

BACKGROUND Comorbid anxiety in bipolar disorder (BD) is associated with greater illness severity, reduced treatment response, and greater impairment. Treating anxiety in the context of BD is crucial for improving illness course and outcomes. The current study examined the feasibility, acceptability and preliminary efficacy of the Unified Protocol (UP), a transdiagnostic cognitive behavioral therapy, as an adjunctive treatment to pharmacotherapy for BD and comorbid anxiety disorders. METHODS Twenty-nine patients with BD and at least one comorbid anxiety disorder were randomized to pharmacotherapy treatment-as-usual (TAU) or TAU with 18 sessions of the UP (UP+TAU). All patients completed assessments every four weeks to track symptoms, functioning, emotion regulation and temperament. Linear mixed-model regressions were conducted to track symptom changes over time and to examine the relationship between emotion-related variables and treatment response. RESULTS Satisfaction ratings were equivalent for both treatment groups. Patients in the UP+TAU group evidenced significantly greater reductions over time in anxiety and depression symptoms (Cohen's d's>0.80). Baseline levels of neuroticism, perceived affective control, and emotion regulation ability predicted magnitude of symptom change for the UP+TAU group only. Greater change in perceived control of emotions and emotion regulation skills predicted greater change in anxiety related symptoms. LIMITATIONS This was a pilot feasibility and acceptability trial; results should be interpreted with caution. CONCLUSIONS Treatment with the UP+TAU was rated high in patient satisfaction, and resulted in significantly greater improvement on indices of anxiety and depression relative to TAU. This suggests that the UP may be a feasible treatment approach for BD with comorbid anxiety.This work was supported by a Postdoctoral National Research Service Award from the National Institutes of Health [F32 MH098490] to K. Ellard. (F32 MH098490 - Postdoctoral National Research Service Award from the National Institutes of Health)Accepted manuscrip

Dynamics of natural populations of the dertitivorous mudsnail Potamopyrgus antipodarum (Gray) (Hydrobiidae) in two interconnected Lakes differing in trophic state

Here we investigate the allocation of resources between growth and reproduction by surveying the dynamics of natural populations of the aquatic detritivorous mudsnail Potamopyrgus antipodarum from two interconnected lakes that differ in trophic state. The size distributions and reproductive output of the snail populations was analyzed monthly by field surveys spanning 3 years, and in a controlled microcosm experiment to evaluate the reproductive potential under laboratory conditions. Snails in the meso-oligotrophic lake showed reduced growth and a smaller size compared to snails in the eutrophic lake. However, the numbers of eggs and nearly-neonates per adult snail did not differ significantly between the two populations. It is speculated that P. antipodarum populations living under meso-oligotrophic conditions may consistently invest more internal energy in reproduction at the expense of growth and that food quantity may be an important driver for macro-invertebrate resource allocation in detrital food webs. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/2193-1801-3-736) contains supplementary material, which is available to authorized users

Partitioning the impact of environmental drivers and species interactions in dynamic aquatic communities

© The Author(s), 2019. This article is distributed under the terms of the Creative Commons Attribution License. The definitive version was published in Musters, C. J. M., Ieromina, O., Barmentlo, S. H., Hunting, E. R., Schrama, M., Cieraad, E., Vijver, M. G., & van Bodegom, P. M. Partitioning the impact of environmental drivers and species interactions in dynamic aquatic communities. Ecosphere, 10(11), (2019): e02910, doi:10.1002/ecs2.2910.Temperate aquatic communities are highly diverse and seasonally variable, due to internal biotic processes and environmental drivers, including human‐induced stressors. The impact of drivers on species abundance is supposed to differ fundamentally depending on whether populations are experiencing limitations, which may shift over the season. However, an integrated understanding of how drivers structure communities seasonally is currently lacking. In order to partition the effect of drivers, we used random forests to quantify interactions between all taxa and environmental factors using macrofaunal data from 18 agricultural ditches sampled over two years. We found that, over the agricultural season, taxon abundance became increasingly better predicted by the abundances of co‐occurring taxa and nutrients compared to other abiotic factors, including pesticides. Our approach provides fundamental insights in community dynamics and highlights the need to consider changes in species interactions to understand the effects of anthropogenic stressors.The authors are grateful to B. Schaub of Water Board Rijnland for his help, E. Gertenaar for assistance in the fieldwork, M. Wouterse for DOC measurements, and B. Koese for help with taxonomic identification of macrofaunal samples. CM designed the study, did the statistical modeling and analyses, and wrote the draft paper; OI did field sampling and taxonomic identification and constructed the datasets; OI and HB structured the data; EH, MS, ES, MV, and PvB contributed to the study design and the conceptual improvement of the manuscript; all authors substantially revised the subsequent drafts

HIV risk among Australian men travelling overseas: networks and context matter

Increasing international mobility presents a risk for communicable disease transmissions. Overseas-acquired HIV infections have been increasingly observed across Australian jurisdictions. This includes a mix of men emigrating from countries with high HIV prevalence and men travelling abroad. There is currently little research exploring international mobility and HIV risk and as a consequence the increase of men acquiring HIV while travelling overseas is poorly understood. This article draws on data from a qualitative study exploring the risk perspectives and experiences of 14 Australian men who acquired HIV while travelling overseas in the years between 2000-2009. Participants articulated a strong desire to distance themselves from the identity of a tourist. Social networks were highlighted as important entry points to engage with other foreign travellers and expatriates. These networks were highly influential and were understood by the participants to provide guidance on how they should negotiate the local scene, including where to meet sex partners. Limited discussion of safe sex and HIV was mentioned in these contexts. The findings suggest that prevalent social norms and social networks play an influential role in how participants negotiate sex and social relations in overseas settings. These networks could potentially provide sites for effective HIV prevention programs. Keywords: male tourists; HIV transmission; social networks; behaviour; sexual risk; HIV preventio

Improved genetic testing for monogenic diabetes using targeted next-generation sequencing

addresses: Institute for Biomedical and Clinical Science, University of Exeter Medical School, Barrack Road, Exeter EX2 5DW, UK. [email protected]: PMCID: PMC3737433types: Journal Article; Research Support, Non-U.S. Gov'tOpen Access ArticleCurrent genetic tests for diagnosing monogenic diabetes rely on selection of the appropriate gene for analysis according to the patient's phenotype. Next-generation sequencing enables the simultaneous analysis of multiple genes in a single test. Our aim was to develop a targeted next-generation sequencing assay to detect mutations in all known MODY and neonatal diabetes genes

The impact of training non-physician clinicians in Malawi on maternal and perinatal mortality : a cluster randomised controlled evaluation of the enhancing training and appropriate technologies for mothers and babies in Africa (ETATMBA) project

Background: Maternal mortality in much of sub-Saharan Africa is very high whereas there has been a steady decline in over the past 60 years in Europe. Perinatal mortality is 12 times higher than maternal mortality accounting for about 7 million neonatal deaths; many of these in sub-Saharan countries. Many of these deaths are preventable. Countries, like Malawi, do not have the resources nor highly trained medical specialists using complex technologies within their healthcare system. Much of the burden falls on healthcare staff other than doctors including non-physician clinicians (NPCs) such as clinical officers, midwives and community health-workers. The aim of this trial is to evaluate a project which is training NPCs as advanced leaders by providing them with skills and knowledge in advanced neonatal and obstetric care. Training that will hopefully be cascaded to their colleagues (other NPCs, midwives, nurses). Methods/design: This is a cluster randomised controlled trial with the unit of randomisation being the 14 districts of central and northern Malawi (one large district was divided into two giving an overall total of 15). Eight districts will be randomly allocated the intervention. Within these eight districts 50 NPCs will be selected and will be enrolled on the training programme (the intervention). Primary outcome will be maternal and perinatal (defined as until discharge from health facility) mortality. Data will be harvested from all facilities in both intervention and control districts for the lifetime of the project (3–4 years) and comparisons made. In addition a process evaluation using both quantitative and qualitative (e.g. interviews) will be undertaken to evaluate the intervention implementation. Discussion: Education and training of NPCs is a key to improving healthcare for mothers and babies in countries like Malawi. Some of the challenges faced are discussed as are the potential limitations. It is hoped that the findings from this trial will lead to a sustainable improvement in healthcare and workforce development and training. Trial registration: ISRCTN6329415