Demographics by depth: spatially explicit life-history dynamics of a protogynous reef fish

Distribution and demographics of the hogfish (Lachnolaimus maximus) were investigated by using a combined approach of in situ observations and life history analyses. Presence, density, size, age, and size and age at sex change all varied with depth in the eastern Gulf of Mexico. Hogfish (64–774 mm fork length and 0–19 years old) were observed year-round and were most common over complex, natural hard bottom habitat. As depth increased, the presence and density of hogfish decreased, but mean size and age increased. Size at age was smaller nearshore (<30 m). Length and age at sex change of nearshore hogfish were half those of offshore hogfish and were coincident with the minimum legal size limit. Fishing pressure is presumably greater nearshore and presents a confounding source of increased mortality; however, a strong red tide occurred the year before this study began and likely also affected nearshore demographics. Nevertheless, these data indicate ontogenetic migration and escapement of fast-growing fish to offshore habitat, both of which should reduce the likelihood of fishing-induced evolution. Data regarding the hogfish fishery are limited and regionally dependent, which has confounded previous stock assessments; however, the spatially explicit vital rates reported herein can be applied to future monitoring efforts

Robert Wood Johnson Foundation Nurse Faculty Scholars program leadership training

Background The Robert Wood Johnson Foundation Nurse Faculty Scholars program was created to address the nursing shortage via development of the next generation of national leaders in academic nursing. Purpose The leadership training combined development at the scholar's home institution with in-person didactic and interactive sessions with notable leaders in nursing and other disciplines. Methods A curriculum matrix, organized by six domains, was evaluated quantitatively and qualitatively. Discussion What set this program apart is that it immersed junior faculty in concerted leadership development with regard to all aspects of the faculty role so that teaching interactively, making use of the latest in information technology, giving testimony before a policy-making group, participating in strategic planning, and figuring out how to reduce the budget without jeopardizing quality were all envisioned as part of the faculty role. Conclusion The domains covered by this program could easily be used as the framework to plan other leadership-development programs for the next generation of academic leader

Ultrasound and microbubble gene delivery for targeting altered placental microRNAs in preeclampsia

Ultrasound (US) and microbubble (MB) gene delivery has attracted growing interest as a clinically applicable gene therapy (GT). Though preclinical studies have investigated the system in various tissues, there is limited research in targeting the placenta. This is a potential therapeutic strategy for preeclampsia (PE), which has an underlying genetic basis and ineffective management strategies. Differentially expressed placental microRNAs (miRNAs) in PE may represent suitable targets for GT. Microbubbles (SonoVue) and plasmid (pGL3 or pGL4.13) were administered systemically to CD1 mice, followed by exposure of the heart to US (H14, 1.8 M.I., 1cm focal depth, 2 minutes), using Siemens Acuson Sequoia-512 system and 15L8 probe. Luciferase assays were performed to evaluate gene transfection. Significantly differentially expressed placental miRNAs in PE patients were identified as candidates based on detection by three or more screening studies. Expression of candidate miRNAs was measured by qRT-PCR in PE rat model placentas. In trial 1, low levels of luciferase activity were detected in the heart of treatment mouse 1, 2 and 3. In trial 2, luciferase activity was evident in the atria of treatment mouse 2. In trial 3, higher luciferase activity was detected in the ventricles of the treatment mouse and activity was also detected in the atria. The literature review identified eight candidate miRNAs. MiR-223 (1.46-fold increase) and miR-181a (0.81-fold decrease) were significantly differentially expressed in PE rat model placentas. MiR-223 and -181a may represent targets for US and MB gene delivery. Future studies will apply the US and MB gene delivery protocol for translation to targeting the placenta in our PE rodent model

Meal and food preferences of nutritionally at-risk inpatients admitted to two Australian tertiary teaching hospitals

Aim: To determine preferences for meals and snack of long-stay patients and hospitalised patients with increased energy and protein requirements.----- Methods: Using consistent methodology across two tertiary teaching hospitals, a convenience sample of adult public hospital inpatients with increased energy and protein requirements or longer stays (seven days or more) were interviewed regarding meal and snack preferences. Descriptive reporting of sample representativeness, preferred foods and frequency of meals and between meal snacks.----- Results: Of 134 respondents, 55% reported a decreased appetite and 28% rated their appetite as 'poor'. Most felt like eating either nothing (42%) or soup (15%) when unwell. The most desired foods were hot meal items, including eggs (31%), meat dishes (20%) and soup (69%). Of items not routinely available, soft drink (7.6%) and alcohol (6.7%) were most commonly desired during admission. Almost half (49%) reported difficulty opening packaged food and a majority (81%) indicated finger foods were easy to eat.----- Conclusion: Appetites during admission were frequently lower than usual. Responses encourage consideration of eggs, meat dishes and soups for long-stayers or those with high-energy, high-protein needs. Easy to consume but not routinely offered, between meal items, such as soup, juice, cake, soft drink or Milo could be explored further to enhance oral intakes

Motivations, facilitators and barriers to accessing hepatitis C treatment among people who inject drugs in two South African cities

Background Treatment of hepatitis C (HCV) among people who inject drugs (PWID) is a critical component of efforts to eliminate viral hepatitis. A recent study found high HCV prevalence among PWID in two cities, Pretoria (84%) and Cape Town (44%). Very few (< 5%) HCV-infected individuals attended follow-up appointments. This sub-study explores differences between stated desire for cure and appointment attendance in light of perceived facilitators and barriers to HCV treatment and care access among PWID. Method Two sets of semi-structured interviews were implemented in a group of HCV-infected participants opportunistically sampled and recruited at harm reduction service sites. Initial interviews, conducted before the planned hospital appointment date, asked participants (N = 17, 9 in Pretoria and 8 in Cape Town) about past experiences of healthcare provision, plans to attend their referral appointment and perceived barriers and facilitators to seeking hepatitis treatment. Second interviews (n = 9, 4 in Pretoria, 5 in Cape Town), conducted after the planned referral appointment date, asked about appointment attendance and treatment experience. Trained social scientists with experience with PWID conducted the interviews which were recorded in detailed written notes. Data was thematically analysed in NVivo 11. Results Despite routine experiences of being stigmatised by the healthcare system in the past, most participants (n = 16, 94%) indicated a desire to attend their appointments. Attendance motivators included the desire to be cured, fear of dying and the wish to assist the research project. Perceived barriers to appointment attendance included fear of again experiencing stigmatisation and concerns about waiting periods and drug withdrawal. Perceived facilitators included the knowledge they would be treated quickly, and with respect and access to opioid substitution therapy. In the end, very few participants (n = 5) went to their appointment. Actual barriers to attendance included lack of finances, lack of urgency and forgetting and fatalism about dying. Conclusions South Africa can learn from other countries implementing HCV treatment for PWID. Successful linkage to care will require accessible, sensitive services where waiting time is limited. Psychosocial support prior to initiating referrals that focuses on building and maintaining a sense of self-worth and emphasising that delayed treatment hampers health outcomes is needed

MicroRNA-143 activation regulates smooth muscle and endothelial cell crosstalk in pulmonary arterial hypertension

Rationale: The pathogenesis of PAH remains unclear. The four microRNAs representing the miR-143 and miR-145 stem loops are genomically clustered. Objective: To elucidate the transcriptional regulation of the miR-143/145 cluster, and the role of miR-143 in PAH. Methods and Results: We identified the promoter region that regulates miR-143/145 miRNA expression in pulmonary artery smooth muscle cells (PASMCs). We mapped PAH-related signalling pathways, including estrogens receptor (ER), liver X factor/retinoic X receptor (LXR/RXR), TGF-β (Smads), and hypoxia (HRE) that regulated levels of all pri-miR stem loop transcription and resulting miRNA expression. We observed that miR-143-3p is selectively upregulated compared to miR-143-5p during PASMC migration. Modulation of miR-143 in PASMCs significantly altered cell migration and apoptosis. In addition, we found high abundance of miR-143-3p in PASMCs-derived exosomes. Using assays with pulmonary arterial endothelial cells (PAECs) we demonstrated a paracrine pro-migratory and pro-angiogenic effect of miR-143-3p enriched exosomes from PASMC. Quantitative PCR and in situ hybridisation showed elevated expression of miR-143 in calf models of PAH as well as in samples from PAH patients. Moreover, in contrast to our previous findings that had not supported a therapeutic role in vivo, we now demonstrate a protective role for miR-143 in experimental PH in vivo in miR-143-/- and antimiR143-3p-treated mice exposed to chronic hypoxia in both preventative and reversal settings. Conclusions: MiR-143-3p modulated both cellular and exosome-mediated responses in pulmonary vascular cells, while inhibition of miR-143-3p blocked experimental PH. Taken together these findings confirm an important role for the miR-143/145 cluster in PAH pathobiology

Comorbidity in mental and physical illness

Comorbidity refers to the presence of two or more conditions at the same time. In the 2007 report in this series, comorbidity between mental disorders was examined. In this chapter comorbidity across mental disorders, chronic physical conditions, psychological wellbeing and intellectual impairment is profiled. • Physical health conditions were measured by showing participants a list of health conditions and asking whether a health professional had diagnosed them. Five chronic conditions were considered. Mental wellbeing was assessed using the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), where a higher score indicates greater psychological wellbeing. Intellectual impairment was also included, assessed using the Natonal Adult Reading Test (NART). • Overall, just over a quarter of adults (27.7%) reported having at least one of the five chronic physical conditions considered in this chapter diagnosed, and present in the last 12 months. High blood pressure was the most common, followed by asthma, diabetes, and cancer. A relatively small number of participants (52; 0.7% of adults) reported epilepsy; analysis by this group should therefore be treated with caution. • There was an association between common mental disorder (CMD) and chronic physical conditions. In people with severe CMD symptoms (revised Clinical Interview Schedule (CIS-R) score 18 or more) over a third (37.6%) reported a chronic physical condition, compared with a quarter (25.3%) of those with no or few symptoms of CMD (CIS-R score 0 to 5). • This pattern held for each of the chronic conditions examined. For xample, people with severe symptoms of CMD (CIS-R score 18+) were twice as likely to have asthma as people with no or few symptoms (CIS-R score 0–5): 14.5% compared with 7.2%. • Having a chronic physical condition was associated with lower levels of mental wellbeing. Overall, the mean WEMWBS score was 51.0 in people with at least one of the five chronic conditions considered, compared with 53.2 in people without a chronic physical condition. • Both the presence of self-reported diagnosed asthma and high blood pressure were associated with a wide range of different mental disorders, including depression, anxiety disorders (such as generalised anxiety disorder (GAD) and phobias), CMD Not Otherwise Specified (NOS), and posttraumatic stress disorder (PTSD). Asthma and high blood pressure were the most common chronic physical conditions examined; the larger sample of people with these conditions meant that statistically significant differences were more likely to be detectable. • Cancer and diabetes were also strongly associated with CMD-NOS, but higher rates of most other mental disorders were not statistically significant for these chronic physical conditions. • Adults with low wellbeing (with the lowest 15% of WEMWBS scores) experienced extremely high levels of psychiatric morbidity, including 21.0% screening positive for PTSD, 25.9% for attention-deficit/hyperactivity disorder (ADHD) and 6.0% for drug dependence. 20.6% of this group had made a suicide attempt. These rates were between 8 and 30 times higher than those for people with the highest mental wellbeing scores. • People with lower intellectual ability were more likely to have poorer mental health than those with average or above average intellectual functioning. • The results indicate that people with one condition tend to be more likely to have another, and that even subthreshold symptoms of common mental disorder are associated with having a chronic physical condition. These findings provide evidence to support the bringing of physical and mental health care provision closer together

Automatic Detection of B-lines in Lung Ultrasound Videos From Severe Dengue Patients

Lung ultrasound (LUS) imaging is used to assess lung abnormalities, including the presence of B-line artefacts due to fluid leakage into the lungs caused by a variety of diseases. However, manual detection of these artefacts is challenging. In this paper, we propose a novel methodology to automatically detect and localize B-lines in LUS videos using deep neural networks trained with weak labels. To this end, we combine a convolutional neural network (CNN) with a long short-term memory (LSTM) network and a temporal attention mechanism. Four different models are compared using data from 60 patients. Results show that our best model can determine whether one-second clips contain B-lines or not with an F1 score of 0.81, and extracts a representative frame with B-lines with an accuracy of 87.5%.Comment: 5 pages, 2 figures, 2 table

International Service in the Context of Globalization: Research Conference Summary Report

International Service in the Context of Globalization: Research Conference Summary Repor