Do mental health professionals use diagnostic classifications the way we think they do? A global survey

We report on a global survey of diagnosing mental health professionals, primarily psychiatrists, conducted as a part of the development of the ICD‐11 mental and behavioural disorders classification. The survey assessed these professionals' use of various components of the ICD‐10 and the DSM, their attitudes concerning the utility of these systems, and usage of “residual” (i.e., “other” or “unspecified”) categories. In previous surveys, most mental health professionals reported they often use a formal classification system in everyday clinical work, but very little is known about precisely how they are using those systems. For example, it has been suggested that most clinicians employ only the diagnostic labels or codes from the ICD‐10 in order to meet administrative requirements. The present survey was conducted with clinicians who were members of the Global Clinical Practice Network (GCPN), established by the World Health Organization as a tool for global participation in ICD‐11 field studies. A total of 1,764 GCPN members from 92 countries completed the survey, with 1,335 answering the questions with reference to the ICD‐10 and 429 to the DSM (DSM‐IV, DSM‐IV‐TR or DSM‐5). The most frequent reported use of the classification systems was for administrative or billing purposes, with 68.1% reporting often or routinely using them for that purpose. A bit more than half (57.4%) of respondents reported often or routinely going through diagnostic guidelines or criteria systematically to determine whether they apply to individual patients. Although ICD‐10 users were more likely than DSM‐5 users to utilize the classification for administrative purposes, other differences were either slight or not significant. Both classifications were rated to be most useful for assigning a diagnosis, communicating with other health care professionals and teaching, and least useful for treatment selection and determining prognosis. ICD‐10 was rated more useful than DSM‐5 for administrative purposes. A majority of clinicians reported using “residual” categories at least sometimes, with around 12% of ICD‐10 users and 19% of DSM users employing them often or routinely, most commonly for clinical presentations that do not conform to a specific diagnostic category or when there is insufficient information to make a more specific diagnosis. These results provide the most comprehensive available information about the use of diagnostic classifications of mental disorders in ordinary clinical practice.     

Chemical,biochemical, preclinical and clinical studies of Ganoderma lucidum polysaccharide as an approved drug for treating myopathy and other diseases in China

Ganoderma lucidum is an edible medicinal mushroom known as “Lingzhi” in China and “Reishi or Manetake” in Japan. It is a highly prized vitality‐enhancing herb for more than 2000 years. G. lucidum polysaccharide (GLPS) has been identified as one of the major bioactive components and developed into a drug named “Ji 731 Injection” in China since 1973. The large‐scale production of the drug began in 1985 and approved by the Chinese FDA as “Polysaccharidum of G. lucidum Karst Injection” (Ling Bao Duo Tang Zhu She Ye) in 2000, which is applied intramuscularly. After more than forty years of clinical use, its efficacy, safety and long‐term tolerability have been recognized by neurologists. It is one of a few non‐hormonal drugs used for treating refractory myopathy. It is also used for combination therapy, which reduces the amount of glucocorticoid required for myopathy patient who is in remission. In addition, it reduces adverse reactions and improves the quality of life for cancer patients during chemotherapy. We found 81 qualified chemical, biochemical, preclinical and clinical studies of GLPS both in English and in Chinese spanning from 1973 to 2017 by searching CNKI (China National Knowledge Infrastructure), Wanfang database and PubMed. The molecular mechanisms underlying GLPS's antioxidant, anti‐tumour, immune‐modulatory, hypoglycaemic, hypolipidaemic and other activities are discussed. Both preclinical and clinical studies are either deliberated or indexed in the current article. We aimed at providing a molecular picture as well as a clinical basis to comprehend GLPS as one of few polysaccharide‐based modern medicines with complicated chemical and pharmacological properties that prevent it from entering the world's market.     

Iron metabolism in obesity: How interaction between homoeostatic mechanisms can interfere with their original purpose. Part II: Epidemiological and historic aspects of the iron/obesity interaction

The change from a mainly vegetarian fare to meat consumption went along with brain growth and increased insulin resistance to improve brain's glucose supply. Meat consumption increased iron bioavailability and, thus, physical and mental fitness. The “predation-release-hypothesis” proposes that group coordination, arms and fire abolished the survival advantage of lean individuals from predation. The “thrifty gene-hypothesis”, in contrast, proposes that surviving repeated episodes of starvation increased efficiency of food utilization in the offspring; they learned to utilize every available calorie. As a consequence of either mechanism, improved food security will increase prevalence of obesity along with that of its fatal consequences, such as diabetes, hypertension, heart diseases, and cancer. Thus, improved food security collides with the biologically evolved mechanisms to store excessive calories in preparation for a famine that never came. The crash between homoeostatic mechanisms and human intervention caused the presently observed pandemia of obesity and explains why it is so difficult to avoid, in spite of its well known and often fatal consequences.     

Fatal mushroom poisoning in Barcelona, 1986–1988

In 1986–88, 46 poisonings (4 of which were fatal) caused by amatoxin mushroom were reported. The fatalities were males aged between 7 and 65 years. They all had gastrointestinal symptoms and three of the patients died of acute hepatic insufficiency. The fourth died as a result of an intestinal perforation. The clinical and pathological alterations are compared with the findings of other authors.     

Higher contribution of globally rare bacterial taxa reflects environmental transitions across the surface ocean

Microbial taxa range from being ubiquitous and abundant across space to extremely rare and endemic, depending on their ecophysiology and on different processes acting locally or regionally. However, little is known about how cosmopolitan or rare taxa combine to constitute communities and whether environmental variations promote changes in their relative abundances. Here we identified the Spatial Abundance Distribution (SpAD) of individual prokaryotic taxa (16S rDNA‐defined Operational Taxonomic Units, OTUs) across 108 globally‐distributed surface ocean stations. We grouped taxa based on their SpAD shape (“normal‐like”‐ abundant and ubiquitous; “logistic”‐ globally rare, present in few sites; and “bimodal”‐ abundant only in certain oceanic regions), and investigated how the abundance of these three categories relates to environmental gradients. Most surface assemblages were numerically dominated by a few cosmopolitan “normal‐like” OTUs, yet there was a gradual shift towards assemblages dominated by “logistic” taxa in specific areas with productivity and temperature differing the most from the average conditions in the sampled stations. When we performed the SpAD categorization including additional habitats (deeper layers and particles of varying sizes), the SpAD of many OTUs changed towards fewer “normal‐like” shapes, and OTUs categorized as globally rare in the surface ocean became abundant. This suggests that understanding the mechanisms behind microbial rarity and dominance requires expanding the context of study beyond local communities and single habitats. We show that marine bacterial communities comprise taxa displaying a continuum of SpADs, and that variations in their abundances can be linked to habitat transitions or barriers that delimit the distribution of community members.     

Blood,sweat, and tears: a review of the hematophagous,sudophagous, and lachryphagous Lepidoptera

Although adult Lepidoptera are not often considered medically relevant, some butterflies and moths are notorious for their consumption of mammalian body fluids. These Lepidoptera can be blood‐feeding (hematophagous), tear‐feeding (lachryphagous), or sweat‐feeding (we use the term “sudophagous”). Blood‐feeding Lepidoptera have been observed piercing the skin of their hosts during feeding, while tear‐feeding Lepidoptera have been observed frequenting the eyes of hosts in order to directly obtain lachrymal fluid. These behaviors have negative human health implications and some potential for disease transmission. In this study, articles concerning feeding behavior of blood, sweat, and tear‐feeding Lepidoptera were reviewed, with emphasis on correlations between morphological characters and feeding behaviors. Harmful effects and vector potential of these Lepidoptera are presented and discussed.     

Agaricus subrufescens: A review

Medicinal mushrooms have currently become a hot issue due to their various therapeutic properties. Of these, Agaricus subrufescens, also known as the “almond mushroom”, has long been valued by many societies (i.e., Brazil, China, France, and USA). Since its discovery in 1893, this mushroom has been cultivated throughout the world, especially in Brazil where several strains of A. subrufescens have been developed and used as health food and alternative medicine. This article presents up-to-date information on this mushroom including its taxonomy and health promoting benefits. Medicinal properties of A. subrufescens are emphasized in several studies which are reviewed here. In addition, safety issues concerning the use of this fungus will be discussed.     

Observable Weight Distributions and Children's Individual Weight Assessment

Social networks theory suggests obesity is “contagious” within peer groups in that known friends highly influence weight. On the other hand, an alternative model suggests that observable weight distributions affect perception of one's own obesity level. We examine whether the BMI levels of the most obese classmates in the individual student's grade by gender is positively associated with “under‐assessment” of obesity and overweight (i.e., independently measured obesity or overweight, but subjective self‐assessment of normal weight). The data are the 2004–2005 School Physical Activity and Nutrition III (SPAN), a stratified, multistage probability sample of 4th, 8th, and 11th grade public school children in Texas. We used logistic regression to test whether the gender‐specific 85th percentile BMI level within the individual student's grade at their school is positively associated with “under‐assessment” of obesity and overweight. The results show that students are much more likely to under‐assess their own weight if the gender‐specific 85th percentile BMI level is higher in their grade at their school. These data suggest that observable weight distributions play a key role in the obesity epidemic.     

Experimentally comparing the attractiveness of domestic lights to insects: Do LEDs attract fewer insects than conventional light types?

LED lighting is predicted to constitute 70% of the outdoor and residential lighting markets by 2020. While the use of LEDs promotes energy and cost savings relative to traditional lighting technologies, little is known about the effects these broad‐spectrum “white” lights will have on wildlife, human health, animal welfare, and disease transmission. We conducted field experiments to compare the relative attractiveness of four commercially available “domestic” lights, one traditional (tungsten filament) and three modern (compact fluorescent, “cool‐white” LED and “warm‐white” LED), to aerial insects, particularly Diptera. We found that LEDs attracted significantly fewer insects than other light sources, but found no significant difference in attraction between the “cool‐” and “warm‐white” LEDs. Fewer flies were attracted to LEDs than alternate light sources, including fewer Culicoides midges (Diptera: Ceratopogonidae). Use of LEDs has the potential to mitigate disturbances to wildlife and occurrences of insect‐borne diseases relative to competing lighting technologies. However, we discuss the risks associated with broad‐spectrum lighting and net increases in lighting resulting from reduced costs of LED technology.     

Disturbed Sleep in Shift Workers,Day Workers,and Insomniacs

Very little is known about differences in sleep between day and shift workers in representative samples of the population. This study compared a national representative sample (N=3400) of shift (with night shifts) and day workers regarding the different types of sleep disturbances and also the level of sleep symptoms with that of insomnia patients. The results showed very few differences between shift and day workers; only “too little sleep” and “nodding off at work” were marginally higher among shift workers. The results also showed that the complaints of insomnia patients for most sleep disturbances corresponded to the 2nd–16th percentile of the shift workers' levels of complaints. The results suggest, at least with the present questionnaire methodology, that shift work does not appear to be a major source of sleep disturbances and that their complaint levels bear no resemblance to those seen in insomniac patients.     

“Capacity”, “best interests”, “will and preferences” and the UN Convention on the Rights of Persons with Disabilities

The United Nations (UN) Convention on the Rights of Persons with Disabilities (CRPD) is the most up‐to‐date international legal instrument concerning the rights of persons with disabilities. Such persons are taken to include those with serious mental disorders. According to an authoritative interpretation of a crucial Article (Article 12 ‐ Equal recognition before the law) by the UN CRPD Committee, involuntary detention and treatment of people with mental health disabilities are prohibited under the Convention. Both conventional mental health law and “capacity‐based” law are deemed to violate the Convention. However, some other UN bodies are not in full agreement (for example, the UN Human Rights Committee and the Subcommittee on Prevention of Torture and Other Cruel, Inhuman or Degrading Treatment or Punishment), while others are less explicitly absolutist (for example, the Human Rights Council). Furthermore, strong criticisms of the position of the CRPD Committee have been mounted from a number of academic quarters. These criticisms center on whether the role of a person's ability to make a decision can be ignored, no matter the circumstances. Much of the above debate turns on the concept of “legal capacity” and the now often‐repeated precept that one must always respect the “will and preferences” of the person with a disability. However, “will and preferences” remains undefined. In this paper, I offer an analysis of “will and preferences” that can clarify interventions that may be acceptable or non‐acceptable under the terms of the UN Convention.     

Distinct circular dichroism spectroscopic signatures of polyproline II and unordered secondary structures: Applications in secondary structure analyses

Circular dichroism (CD) spectroscopy is a valuable method for defining canonical secondary structure contents of proteins based on empirically‐defined spectroscopic signatures derived from proteins with known three‐dimensional structures. Many proteins identified as being “Intrinsically Disordered Proteins” have a significant amount of their structure that is neither sheet, helix, nor turn; this type of structure is often classified by CD as “other”, “random coil”, “unordered”, or “disordered”. However the “other” category can also include polyproline II (PPII)‐type structures, whose spectral properties have not been well‐distinguished from those of unordered structures. In this study, synchrotron radiation circular dichroism spectroscopy was used to investigate the spectral properties of collagen and polyproline, which both contain PPII‐type structures. Their native spectra were compared as representatives of PPII structures. In addition, their spectra before and after treatment with various conditions to produce unfolded or denatured structures were also compared, with the aim of defining the differences between CD spectra of PPII and disordered structures. We conclude that the spectral features of collagen are more appropriate than those of polyproline for use as the representative spectrum for PPII structures present in typical amino acid‐containing proteins, and that the single most characteristic spectroscopic feature distinguishing a PPII structure from a disordered structure is the presence of a positive peak around 220nm in the former but not in the latter. These spectra are now available for inclusion in new reference data sets used for CD analyses of the secondary structures of soluble proteins.     

Heritabilities,social environment effects and genetic correlations of social behaviours in a cooperatively breeding vertebrate

Social animals interact frequently with conspecifics, and their behaviour is influenced by social context, environmental cues and the behaviours of interaction partners, allowing for adaptive, flexible adjustments to social encounters. This flexibility can be limited by part of the behavioural variation being genetically determined. Furthermore, behaviours can be genetically correlated, potentially constraining independent evolution. Understanding social behaviour thus requires carefully disentangling genetic, environmental, maternal and social sources of variations as well as the correlation structure between behaviours. Here, we assessed heritability, maternal, common environment and social effects of eight social behaviours in Neolamprologus pulcher, a cooperatively breeding cichlid. We bred wild‐caught fish in a paternal half‐sibling design and scored ability to defend a resource against conspecifics, to integrate into a group and the propensity to help defending the group territory (“helping behaviour”). We assessed genetic, social and phenotypic correlations within clusters of behaviours predicted to be functionally related, namely “competition,” “aggression,” “aggression‐sociability,” “integration” and “integration‐help.” Helping behaviour and two affiliative behaviours were heritable, whereas there was little evidence for a genetic basis in all other traits. Phenotypic social effects explained part of the variation in a sociable and a submissive behaviour, but there were no maternal or common environment effects. Genetic and phenotypic correlation within clusters was mostly positive. A group's social environment influenced covariances of social behaviours. Genetic correlations were similar in magnitude but usually exceeding the phenotypic ones, indicating that conclusions about the evolution of social behaviours in this species could be provisionally drawn from phenotypic data in cases where data for genetic analyses are unobtainable.     

Wood‐rotting basidiomycetes associated with declining native trees in timber‐harvesting compartments of the Garden Route National Park of South Africa

Trees in the Garden Route National Park (GRNP) indigenous forests in South Africa are selectively harvested for timber based on criteria that include signs and symptoms induced by wood‐rotting fungi. However, virtually nothing is known regarding the identity and host associations of these macro‐fungi in this natural ecosystem. Surveys were conducted in three harvesting compartments in the GRNP to investigate the taxonomic affiliation and species richness of these fungi on standing and recently harvested trees. Samples were collected from basidiomes on infected trees and tree stumps, and from diseased tissues on symptomatic trees. Phylogenetic analyses using ITS sequences characterized the isolates obtained into 26 Operational Taxonomic Units (OTUs) belonging to 17 genera after clustering the sequences at a 97% identity threshold. Ganoderma (Ganodermataceae) and Inonotus (Hymenochaetaceae) were the most species‐rich genera and the Bloukrans compartment, with 22 OTUs, showed the highest species richness. A fungus (OTU1) affiliated with Ganoderma pfeifferi was the most abundant in the surveyed areas. Its predominance was also evidenced on host trees since it occurred on 15 of the 20 tree species sampled, with Olea capensis subsp. macrocarpa (Oleaceae) being the most colonized host. Given the wide variety of wood‐rotting basidiomycetes revealed by this study and particularly the preponderance of species with pathogenic potential, more attention should be given to better understand their ecological role in this natural ecosystem as well as the effects of logging that may enhance their dissemination or negatively affect their diversity and the health of trees in the region.     

Goeldi's monkeys: A primate paradox?

“A primate with the skull of a Callicebus, the mandible and feet of a marmoset and the tail and teeth of Pseudocebus [=Cebus] ….” (Riberio, 1941 as cited in Hershkovitz 1 p. 866). Goeldi's monkeys are the least understood species of platyrrhine. The monkeys' small body size, black coloration, tendency to forage in the low forest understory, and cryptic nature, make them difficult to observe in the wild. Until recently, they had never been the focus of a long‐term field study and as a result, little was known of the monkeys' behavior and ecology. Goeldi's monkeys comprise only one recognized species, Callimico goeldii, and have an unusual suite of anatomical and reproductive traits. These traits have created considerable confusion for taxonomists and physical anthropologists.     

Progress in scaffold‐free bioprinting for cardiovascular medicine

Biofabrication of tissue analogues is aspiring to become a disruptive technology capable to solve standing biomedical problems, from generation of improved tissue models for drug testing to alleviation of the shortage of organs for transplantation. Arguably, the most powerful tool of this revolution is bioprinting, understood as the assembling of cells with biomaterials in three‐dimensional structures. It is less appreciated, however, that bioprinting is not a uniform methodology, but comprises a variety of approaches. These can be broadly classified in two categories, based on the use or not of supporting biomaterials (known as “scaffolds,” usually printable hydrogels also called “bioinks”). Importantly, several limitations of scaffold‐dependent bioprinting can be avoided by the “scaffold‐free” methods. In this overview, we comparatively present these approaches and highlight the rapidly evolving scaffold‐free bioprinting, as applied to cardiovascular tissue engineering.     

The influence of dead time related distortions on live cell fluorescence lifetime imaging (FLIM) experiments

Recent developments in the field of fluorescence lifetime imaging microscopy (FLIM) techniques allow the use of high repetition rate light sources in live cell experiments. For light sources with a repetition rate of 20–100 MHz, the time‐correlated single photon counting (TCSPC) FLIM systems suffer serious dead time related distortions, known as “inter‐pulse pile‐up”. The objective of this paper is to present a new method to quantify the level of signal distortion in TCSPC FLIM experiments, in order to determine the most efficient laser repetition rate for different FLT ranges. Optimization of the F ‐value, which is the relation between the relative standard deviation (RSD) in the measured FLT to the RSD in the measured fluorescence intensity (FI), allows quantification of the level of FI signal distortion, as well as determination of the correct FLT of the measurement. It is shown that by using a very high repetition rate (80 MHz) for samples characterized by high real FLT's (4–5 ns), virtual short FLT components are added to the FLT histogram while a F ‐value that is higher than 1 is obtained. For samples characterized with short real FLT's, virtual long FLT components are added to the FLT histogram with the lower repetition rate (20–50 MHz), while by using a higher repetition rate (80 MHz) the “inter‐pulse pile‐up” is eliminated as the F ‐value is close to 1. (© 2014 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)     

Comic woman,victim woman: Pushing gender and genre boundaries in popular Hindi Cinema

“Women's film” in Hollywood is associated both with the genre of melodrama, the “weepie”, and with female spectatorship. In the Indian context of popular Hindi cinema, first, genre analysis itself is a questionable line of inquiry since several genres, the melodrama, musical, gangster, or mystery, combine in a single film, known locally as the masala (spicy) film; and second, films are scarcely divided by a gendered viewership. Yet I identify “women's films” as a distinct category in Hindi cinema, emerging around the ‘70s. These women's films typically center on female protagonists, dramatize their victimization and vindication; by the ‘80s under a range of influences these films mutated into rape‐revenge narratives.

However, another strain emerged within the ‘70s’ “women's film,” which drew on cinema's rich visual iconographic tradition of the sight gag, promulgating the comedic/tomboy heroine figure. It favored laughing and mocking patriarchal structures rather than surrendering to them in tears. Focusing on Ramesh Sippy's Sita aur Gita [1972] emblematic of this trend I explore theoretical concerns about associating genres with gender. In keeping with recent poststructuralist theories about gender and media ‘consumption I show how the film destabilized clear‐cut gender identification and stood for a promising trend that was sadly undercut. Thus, while genre might still be a useful analytical tool for Hindi cinema, defining women's film as female‐centered narratives is a viable category as long as we appreciate the instability in gendered viewer identification.     

Antioxidant,Cytotoxic and Antimicrobial Activity of Chitosan Preparations Extracted from Ganoderma Lucidum Mushroom

Two chitosan extracts were prepared by chemical and enzymatic treatment of Ganoderma lucidum mushroom, as an alternative source to crustacean shells. The molecular weight of the enzymatic extract was lower than that of the chemical one and of shrimp chitosan, as determined by viscosity measurements. Characteristic signals were identified in the ¹H‐NMR spectra and high deacetylation degree indicated good physico‐chemical properties for both mushroom chitosan extracts. The scavenging capacity of mushroom chitosan extracts was moderate against the synthetic radicals of 2,2′‐azinobis(3‐ethylbenzothiazoline‐6‐sulfonic acid) (ABTS) and 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH), but higher values were observed for the enzymatic extract, compared to the chemical extract and shrimp chitosan. In vitro cytotoxicity was evaluated in L929 mouse fibroblast cell lines and the results of MTT assay showed good cytocompatibility in the tested range of concentrations. The growth of Gram‐positive bacteria was inhibited more than Gram‐negative bacteria in the presence of mushroom chitosan extracts, in particular by the chemical one, indicating their efficiency as antimicrobial agents. All these results strengthen the evidence of mushroom polysaccharide preparations availability for biomedical applications.     

No species is an island: testing the effects of biotic interactions on models of avian niche occupation

Traditionally, the niche of a species is described as a hypothetical 3D space, constituted by well‐known biotic interactions (e.g. predation, competition, trophic relationships, resource–consumer interactions, etc.) and various abiotic environmental factors. Species distribution models (SDMs), also called “niche models” and often used to predict wildlife distribution at landscape scale, are typically constructed using abiotic factors with biotic interactions generally been ignored. Here, we compared the goodness of fit of SDMs for red‐backed shrike Lanius collurio in farmlands of Western Poland, using both the classical approach (modeled only on environmental variables) and the approach which included also other potentially associated bird species. The potential associations among species were derived from the relevant ecological literature and by a correlation matrix of occurrences. Our findings highlight the importance of including heterospecific interactions in improving our understanding of niche occupation for bird species. We suggest that suite of measures currently used to quantify realized species niches could be improved by also considering the occurrence of certain associated species. Then, an hypothetical “species 1” can use the occurrence of a successfully established individual of “species 2” as indicator or “trace” of the location of available suitable habitat to breed. We hypothesize this kind of biotic interaction as the “heterospecific trace effect” (HTE): an interaction based on the availability and use of “public information” provided by individuals from different species. Finally, we discuss about the incomes of biotic interactions for enhancing the predictive capacities on species distribution models.