Who receives treatment for alcohol use disorders in the European Union? A cross-sectional representative study in primary and specialized health care

Background Alcohol use disorders (AUDs) are highly prevalent in Europe, but only a minority of those affected receive treatment. It is therefore important to identify factors that predict treatment in order to reframe strategies aimed at improving treatment rates. Methods Representative cross-sectional study with patients aged 18\u201364 from primary health care (PC, six European countries, n = 8476, data collection 01/13\u201301/14) and from specialized health care (SC, eight European countries, n = 1762, data collection 01/13\u201303/14). For descriptive purposes, six groups were distinguished, based on type of DSM-IV AUD and treatment setting. Treatment status (yes/no) for any treatment (model 1), and for SC treatment (model 2) were main outcome measures in logistic regression models. Results AUDs were prevalent in PC (12-month prevalence: 11.8%, 95% confidence interval (CI): 11.2\u201312.5%), with 17.6% receiving current treatment (95%CI: 15.3\u201319.9%). There were clear differences between the six groups regarding key variables from all five predictor domains. Prediction of any treatment (model 1) or SC treatment (model 2) was successful with high overall accuracy (both models: 95%), sufficient sensitivity (model 1: 79%/model 2: 76%) and high specificity (both models: 98%). The most predictive single variables were daily drinking level, anxiety, severity of mental distress, and number of inpatient nights during the last 6 months. Conclusions Variables from four domains were highly predictive in identifying treatment for AUD, with SC treatment groups showing very high levels of social disintegration, drinking, comorbidity and functional losses. Earlier intervention and formal treatment for AUD in PC should be implemented to reduce these high levels of adverse outcomes

Comparison of Target-Capture and Restriction-Site Associated DNA Sequencing for Phylogenomics: A Test in Cardinalid Tanagers (Aves, Genus: Piranga)

This is a pre-copyedited, author-produced version of an article accepted for publication in Systematic Biology following peer review. The version of record, Joseph D. Manthey, Luke C. Campillo, Kevin J. Burns, Robert G. Moyle; Comparison of Target-Capture and Restriction-Site Associated DNA Sequencing for Phylogenomics: A Test in Cardinalid Tanagers (Aves, Genus: Piranga), Systematic Biology, Volume 65, Issue 4, 1 July 2016, Pages 640–650, is available online at: ttps://doi.org/10.1093/sysbio/syw005.Restriction-site associated DNA sequencing (RAD-seq) and target capture of specific genomic regions, such as ultraconserved elements (UCEs), are emerging as two of the most popular methods for phylogenomics using reduced-representation genomic data sets. These two methods were designed to target different evolutionary timescales: RAD-seq was designed for population-genomic level questions and UCEs for deeper phylogenetics. The utility of both data sets to infer phylogenies across a variety of taxonomic levels has not been adequately compared within the same taxonomic system. Additionally, the effects of uninformative gene trees on species tree analyses (for target capture data) have not been explored. Here, we utilize RAD-seq and UCE data to infer a phylogeny of the bird genus Piranga. The group has a range of divergence dates (0.5–6 myr), contains 11 recognized species, and lacks a resolved phylogeny. We compared two species tree methods for the RAD-seq data and six species tree methods for the UCE data. Additionally, in the UCE data, we analyzed a complete matrix as well as data sets with only highly informative loci. A complete matrix of 189 UCE loci with 10 or more parsimony informative (PI) sites, and an approximately 80% complete matrix of 1128 PI single-nucleotide polymorphisms (SNPs) (from RAD-seq) yield the same fully resolved phylogeny of Piranga. We inferred non-monophyletic relationships of Pirangalutea individuals, with all other a priori species identified as monophyletic. Finally, we found that species tree analyses that included predominantly uninformative gene trees provided strong support for different topologies, with consistent phylogenetic results when limiting species tree analyses to highly informative loci or only using less informative loci with concatenation or methods meant for SNPs alone

Optimizing Lectures From a Cognitive Load Perspective

Lectures are a common instructional method in medical education. Understanding the cognitive processes and theories involved in learning is essential for lecturers to be effective. Cognitive load theory is one theory that is becoming increasingly recognized in medical education and addresses the appropriate use of one’s working memory. Memory is essential to knowledge acquisition. Two types of memory can be considered, working memory (processing of information) and long‐term memory (storage of information). Working memory has a limited capacity. Cognitive load refers to the amount of information processing activity imposed on working memory and can be divided into three domains: intrinsic, extraneous, and germane. By attending to cognitive load, educators can promote learning. This paper highlights various ways of improving cognitive load for learners during lecture‐based instruction by minimizing extraneous load, optimizing intrinsic load, and promoting germane load.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/156199/2/aet210389.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/156199/1/aet210389_am.pd

Nanoscale Electronic Order in Iron Pnictides

The charge distribution in RFeAs (R=La, Sm) iron pnictides is probed using As NQR. Whereas undoped and optimally-doped/overdoped compounds feature a single charge environment, two charge environments are detected in the underdoped region. Spin- lattice relaxation measurements show their coexistence at the nanoscale. Together with the quantitative variations of the spectra with doping, they point at a local electronic order in the iron layers, where low- and high-doping-like regions would coexist. Implications for the interplay of static magnetism and superconductivity are discussed

Limited natural regeneration of unique Scalesia forest following invasive plant removal in Galapagos

More than 60% of the flora of the Galapagos Islands is introduced and some of these species have become invasive, severely altering ecosystems. An example of an affected ecosystem is the Scalesia forest, originally dominated by the endemic giant daisy tree Scalesia pedunculata (Asteraceae). The remnant patches of this unique forest are increasingly being invaded by introduced plants, mainly by Rubus niveus (blackberry, Rosaceae). To help large-scale restoration of this ecologically important forest, we seek to better understand the natural regeneration of S. pedunculata after invasive plant control. We monitored naturally recruited S. pedunculata saplings and young trees over five years in an area where invasive plant species are continuously being removed by manual means. We measured survival, height and growth of S. pedunculata saplings and young trees along permanent transects. Percent cover of surrounding plant species and of canopy shade directly above each S. pedunculata individual were determined, as well as distance to the next mature S. pedunculata tree. We identified potential factors influencing initial sapling survival and growth by applying generalized linear models. Results showed a rapid growth of saplings and young trees of up to 0.45 cm per day and a high mortality rate, as is typical for pioneer species like S. pedunculata. Sapling survival, growth and mortality seemed to be influenced by light availability, surrounding vegetation and distance to the next adult S. pedunculata tree. We concluded that natural regeneration of S. pedunculata was high only five months after the last herbicide application but that 95% of these recruits had died over the 5-year period. Further studies are needed to corroborate whether the number of surviving trees is sufficient to replace the aging adult trees and this way maintain remnants of the Scalesia forest. Urgent action is needed to help improve future restoration strategies to prevent further degradation of this rapidly shrinking threatened forest ecosystem

Elevated endogenous expression of the dominant negative basic helix-loop-helix protein ID1 correlates with significant centrosome abnormalities in human tumor cells

<p>Abstract</p> <p>Background</p> <p>ID proteins are dominant negative inhibitors of basic helix-loop-helix transcription factors that have multiple functions during development and cellular differentiation. Ectopic (over-)expression of ID1 extends the lifespan of primary human epithelial cells. High expression levels of ID1 have been detected in multiple human malignancies, and in some have been correlated with unfavorable clinical prognosis. ID1 protein is localized at the centrosomes and forced (over-)expression of ID1 results in errors during centrosome duplication.</p> <p>Results</p> <p>Here we analyzed the steady state expression levels of the four ID-proteins in 18 tumor cell lines and assessed the number of centrosome abnormalities. While expression of ID1, ID2, and ID3 was detected, we failed to detect protein expression of ID4. Expression of ID1 correlated with increased supernumerary centrosomes in most cell lines analyzed.</p> <p>Conclusions</p> <p>This is the first report that shows that not only ectopic expression in tissue culture but endogenous levels of ID1 modulate centrosome numbers. Thus, our findings support the hypothesis that ID1 interferes with centrosome homeostasis, most likely contributing to genomic instability and associated tumor aggressiveness.</p

MaxPre : An Extended MaxSAT Preprocessor

We describe MaxPre, an open-source preprocessor for (weighted partial) maximum satisfiability (MaxSAT). MaxPre implements both SAT-based and MaxSAT-specific preprocessing techniques, and offers solution reconstruction, cardinality constraint encoding, and an API for tight integration into SAT-based MaxSAT solvers.Peer reviewe

Medical Student Milestones in Emergency Medicine

Objectives Medical education is a continuum from medical school through residency to unsupervised clinical practice. There has been a movement toward competency‐based medical education prompted by the Accreditation Council for Graduate Medical Education ( ACGME ) using milestones to assess competence. While implementation of milestones for residents sets specific standards for transition to internship, there exists a need for the development of competency‐based instruments to assess medical students as they progress toward internship. The objective of this study was to develop competency‐based milestones for fourth‐year medical students completing their emergency medicine ( EM ) clerkships (regardless of whether the students were planning on entering EM ) using a rigorous method to attain validity evidence. Methods A literature review was performed to develop a list of potential milestones. An expert panel, which included a medical student and 23 faculty members (four program directors, 16 clerkship directors, and five assistant deans) from 19 different institutions, came to consensus on these milestones through two rounds of a modified Delphi protocol. The Delphi technique builds content validity and is an accepted method to develop consensus by eliciting expert opinions through multiple rounds of questionnaires. Results Of the initial 39 milestones, 12 were removed at the end of round 1 due to low agreement on importance of the milestone or because of redundancy with other milestones. An additional 12 milestones were revised to improve clarity or eliminate redundancy, and one was added based on expert panelists' suggestions. Of the 28 milestones moving to round 2, consensus with a high level of agreement was achieved for 24. These were mapped to the ACGME EM residency milestone competency domains, as well as the Association of American Medical Colleges ( AAMC ) core entrustable professional activities for entering residency to improve content validity. Conclusions This study found consensus support by experts for a list of 24 milestones relevant to the assessment of fourth‐year medical student performance by the completion of their EM clerkships. The findings are useful for development of a valid method for assessing medical student performance as students approach residency. Resumen Objetivos La formación médica es un continuo que va desde la universidad, pasando por la residencia, hasta la práctica clínica no supervisada. Ha habido un movimiento hacia la formación médica basada en la adquisición de competencias promovido por el Accreditation Council for Graduate Medical Education ( ACGME ) mediante los hitos para evaluar la competencia. Mientras la implementación de los hitos para los residentes establece normas específicas para la transición a residente, existe necesidad de desarrollar instrumentos basados en la competencia para evaluar a los estudiantes de medicina según progresan hacia la residencia. El objetivo de este estudio fue desarrollar los hitos basados ​​en competencias para los estudiantes de medicina de cuarto año al completar sus prácticas clínicas en Medicina de Urgencias y Emergencias ( MUE ) (indistintamente si el estudiante planeaba acceder a la MUE ) utilizando un método riguroso para lograr evidencia válida. Metodología Se realizó una revisión de la literatura para desarrollar una lista de hitos potenciales. Un panel de expertos, que incluyó 23 profesores de la facultad cuyas responsabilidades eran directores de programa (4), directores de prácticas clínicas (16), vicedecanos (5) y un estudiante de medicina de 19 instituciones diferentes, llegaron a un consenso sobre estos hitos a través de 2 rondas del protocolo de Delphi modificado. La técnica Delphi construye un contenido válido y es un método aceptado para desarrollar un consenso mediante la obtención de opiniones de expertos a través de múltiples rondas de preguntas. Resultados De los 39 hitos iniciales, se eliminaron 12 al final de la primera ronda debido al bajo acuerdo sobre la importancia del hito o debido a su redundancia con otros hitos. Se revisaron 12 hitos adicionales para mejorar la claridad o eliminar la redundancia, y se añadió uno basado en las sugerencias del panel de expertos. De los 28 hitos que llegaron a la segunda ronda, se alcanzó un consenso con un alto nivel de acuerdo para 24 de los hitos. Estos hitos se esquematizaron a los dominios de competencia de los hitos de la residencia de MUE del ACGME , así como a las actividades profesionales recomendadas para acceder a la residencia de la Association of American Medical Colleges ( AAMC ) para mejorar la validez de contenido. Conclusiones Este estudio llegó a un consenso apoyado por expertos para una lista de 24 hitos relevantes para evaluar el rendimiento de los estudiantes de medicina de cuarto año al finalizar su práctica clínica en MUE . Los hallazgos son útiles para el desarrollo de un método válido para evaluar el rendimiento de los estudiantes de medicina a medida que éstos se acercan a la residencia.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108261/1/acem12443-sup-0002-DataSupplementS2.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/108261/2/acem12443.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/108261/3/acem12443-sup-0001-DataSupplementS1.pd