IRIS and Fungal Infections: What Have We Learned?

Restoration of pathogen-specific immunity as a result of highly active antiretroviral therapy or reduction of immunosuppression in solid-organ transplant recipients can result in a destructive inflammatory response known as the immune reconstitution inflammatory syndrome (IRIS). Though immune reconstitution disorders can occur in the context of a number of infectious and neoplastic processes, IRIS associated with invasive mycoses, in particular cryptococcosis, is a highly prevalent and morbid entity worldwide. Recent consensus definitions and prospective analyses of cryptococcal IRIS, with particular attention to baseline clinical features, serum and cerebrospinal fluid biomarkers, and the evolution of these over time in individual patients have provided critical insights into pathogenesis. This review focuses on the current understanding of IRIS in the context of opportunistic mycoses, with particular attention to Cryptococcus infection, and discusses the basis for this understanding, including biomarkers as clues to pathogenesis and aids in diagnosis and novel approaches to prevention and management.     

Antibiotic Use in Animal Agriculture: What Have We Learned and Where are We Going?

Antibiotics are enormously important for the humane and efficient production of food animals. These benefits are somewhat offset by the human and animal health antibiotic resistance risks posed by their use in animals. This article provides an overview of what we have learned about antibiotic resistance as an issue in animal agriculture and where that knowledge could lead us in the future. To preserve the effectiveness of antibiotics, more action is needed to ensure their prudent use, particularly in the case of antibiotic growth promoters and antibiotics deemed critically important for human and animal health.     

Biodiversity of Coral Reefs: What are We Losing and Why?

SYNOPSIS. Coral reefs are threatened by numerous anthropogenicimpacts, some of which have already had major effects worldwide.These unique tropical environments harbor a high diversity ofcorals, reef invertebrates, fish and other animals and plants.In most taxa, the species diversity of reef-associated organismsis poorly understood because many of the species have yet tobe collected and described. High coral mortality has been associatedwith natural events such as hurricanes, predator outbreaks andperiods of high temperature, but has also resulted from excessnutrients in sewage and from specific pollutants. Reef coralsand associated organisms are also threatened by the possibilityof global warming which will result in rising sea levels andperiods of increased temperature stress, and which may alsobring increased storm frequency and intensity. Although therecent extensive episodes of coral bleaching in the Caribbeanand eastern Pacific cannot be causally related to global warmingat this time, the close link between bleaching and temperaturesuggests that global warming will result in severe changes incoral assemblages. Major reef destruction has followed outbreaksof the predatory seastar Acanthaster planci in the Pacific.Although this is considered part of a natural disturbance cycle,there are indications that altered land use patterns and reductionof predators on this seastar by human activities may have increasedthe severity of outbreaks. Recreational and commercial use ofreefs has also increased, and has caused extensive damage, especiallynear areas of high population density. One of the most obviousand widespread losses to reef biota is the reduction in fishpopulations from intense overfishing in most reef areas of theworld. Coasts without adequately managed reefs have sufferedintense overfishing for both local and export purposes, to thepoint where the positive effects of fish on those reefs havebeen compromised. The combination of these destructive factorshas altered reefs in all localities, and many that were onceconsidered protected by distance and low population densityare now being exploited as well. On the positive side, improvedunderstanding of ecological processes on reefs combined withconcerted conservation efforts have managed to protect someextensive areas of reef for the future.     

Do We Practice What We Preach? Goal Setting for Ecological Restoration

Over the last decade, several research and opinion pieces have challenged the tenets of restoration ecology but a lack of centralized data has impeded assessment of how scientific developments relate to on‐the‐ground restoration. In response, the Society for Ecological Restoration (SER) launched the Global Restoration Network (GRN) to catalog worldwide restoration efforts. We reviewed over 200 GRN projects to identify the goals governing restoration and the frequency with which they are measured. We used the SER Primer on Ecological Restoration to frame our analysis, categorizing goals by SER's attributes of restored ecosystems. We developed additional attributes to characterize goals not encompassed by the SER‐defined attributes. Nearly all projects included goals related to ecosystem form, namely similarity to reference conditions and the presence of indigenous species, and these goals were frequently measured. Most projects included goals related to ecosystem function, and many highlighted interactions between abiotic and biotic factors by either modifying abiotic conditions to support focal species or manipulating species to achieve desired ecosystem functions. Few projects had goals related to ecosystem stability, whereas the majority of projects had goals related to social values. Although less frequently measured, social goals were described as important for long‐term project success. In conclusion, science and practice frequently aligned on goals related to ecosystem composition and function, but scientific guidelines on resilience and self‐sustainability appear insufficient to guide practice. In contrast, the common inclusion of goals for human well‐being indicates that, if intended to advise practice, restoration guidelines should give direction on social goals.     

Two Decades of Research on Euthanasia from the Netherlands. What Have We Learnt and What Questions Remain?

Two decades of research on euthanasia in the Netherlands have resulted into clear insights in the frequency and characteristics of euthanasia and other medical end-of-life decisions in the Netherlands. These empirical studies have contributed to the quality of the public debate, and to the regulating and public control of euthanasia and physician-assisted suicide. No slippery slope seems to have occurred. Physicians seem to adhere to the criteria for due care in the large majority of cases. Further, it has been shown that the majority of physicians think that the euthanasia Act has improved their legal certainty and contributes to the carefulness of life-terminating acts. In 2005, eighty percent of the euthanasia cases were reported to the review committees. Thus, the transparency envisaged by the Act still does not extend to all cases. Unreported cases almost all involve the use of opioids, and are not considered to be euthanasia by physicians. More education and debate is needed to disentangle in these situations which acts should be regarded as euthanasia and which should not. Medical end-of-life decision-making is a crucial part of end-of-life care. It should therefore be given continuous attention in health care policy and medical training. Systematic periodic research is crucial for enhancing our understanding of end-of-life care in modern medicine, in which the pursuit of a good quality of dying is nowadays widely recognized as an important goal, in addition to the traditional goals such as curing diseases and prolonging life.     

What Shall We Talk about in Farsi?

Previous empirical studies have suggested that language is primarily used to exchange social information, but our evidence on this derives mainly from English speakers. We present data from a study of natural conversations among Farsi (Persian) speakers in Iran and show that not only are conversation groups the same size as those observed in Europe and North America, but people also talk predominantly about social topics. We argue that these results reinforce the suggestion that language most likely evolved for the transmission of information about the social world. We also explore sex differences in conversational behavior: while the pattern is broadly similar between the sexes, men may be more sensitive than women are to discussing some topics in the presence of many other people.     

Plant Breeding and Drought in C3 Cereals: What Should We Breed For?

Drought is the main abiotic constraint on cereal yield. Analysingphysiological determinants of yield responses to water may helpin breeding for higher yield and stability under drought conditions.The traits to select (either for stress escape, avoidance ortolerance) and the framework where breeding for drought stressis addressed will depend on the level and timing of stress inthe targeted area. If the stress is severe, breeding under stress-freeconditions may be unsuccessful and traits that confer survivalmay become a priority. However, selecting for yield itself understress-alleviated conditions appears to produce superior cultivars,not only for optimum environments, but also for those characterizedby frequent mild and moderate stress conditions. This impliesthat broad avoidance/tolerance to mild–moderate stressesis given by constitutive traits also expressed under stress-freeconditions. In this paper, we focus on physiological traitsthat contribute to improved productivity under mild–moderatedrought. Increased crop performance may be achieved throughimprovements in water use, water-use efficiency and harvestindex. The first factor is relevant when soil water remainsavailable at maturity or when deep-rooted genotypes access waterin the soil profile that is not normally available; the twolatter conditions become more important when all available wateris exhausted by the end of the crop cycle. Independent of themechanism operating, a canopy able to use more water than anotherwould have more open stomata and therefore higher canopy temperaturedepression, and ¹³C discrimination (¹³C) in plant matter. Thesame traits would also seem to be relevant when breeding forhot, irrigated environments. Where additional water is not availableto the crop, higher water-use efficiency (WUE) appears to bean alternative strategy to improve crop performance. In thiscontext ¹³C constitutes a simple but reliable measure of WUE.However, in contrast to lines performing better because of increasedaccess to water, lines producing greater biomass due to superiorWUE will have lower ¹³C values. WUE may be modified not onlythrough a decrease in stomatal conductance, but also throughan increase in photosynthetic capacity. Harvest index is stronglyreduced by terminal drought (i.e. drought during grain filling).Thus, phenological traits increasing the relative amount ofwater used during grain filling, or adjusting the crop cycleto the seasonal pattern of rainfall may be useful. Augmentingthe contribution of carbohydrate reserves accumulated duringvegetative growth to grain filling may also be worthwhile inharsh environments. Alternatively, extending the duration ofstem elongation without changing the timing of anthesis wouldincrease the number of grains per spike and the harvest indexwithout changing the amount of water utilized by the crop.     

Climate Change and American Bullfrog Invasion: What Could We Expect in South America?

Background

Biological invasion and climate change pose challenges to biodiversity conservation in the 21^st century. Invasive species modify ecosystem structure and functioning and climatic changes are likely to produce invasive species'' range shifts pushing some populations into protected areas. The American Bullfrog (Lithobates catesbeianus) is one of the hundred worst invasive species in the world. Native from the southeast of USA, it has colonized more than 75% of South America where it has been reported as a highly effective predator, competitor and vector of amphibian diseases.

Methodology/Principal Findings

We modeled the potential distribution of the bullfrog in its native range based on different climate models and green-house gases emission scenarios, and projected the results onto South America for the years of 2050 and 2080. We also overlaid projected models onto the South American network of protected areas. Our results indicate a slight decrease in potential suitable area for bullfrog invasion, although protected areas will become more climatically suitable. Therefore, invasion of these sites is forecasted.

Conclusion/Significance

We provide new evidence supporting the vulnerability of the Atlantic Forest Biodiversity Hotspot to bullfrog invasion and call attention to optimal future climatic conditions of the Andean-Patagonian forest, eastern Paraguay, and northwestern Bolivia, where invasive populations have not been found yet. We recommend several management and policy strategies to control bullfrog invasion and argue that these would be possible if based on appropriate articulation among government agencies, NGOs, research institutions and civil society.     

Thirty Years of Studies of Qβ Replicase: What Have We Learned and What Is Yet to Be Learned?

Qβ replicase (RNA-directed RNA polymerase of bacteriophage Qβ) has an unsurpassed capacity to amplify polynucleotides in vitro. In 1986, the Group of Viral RNA Biochemistry was organized at the Institute of Protein Research in order to exploit this property for the synthesis of messenger RNAs to be used in cell-free translation systems. Although the task has not been implemented in full, this work has led to a number of unexpected important results including uncovering the nature of the “template-free” RNA synthesis by Qβ replicase, discovering the ability of RNA molecules for spontaneous recombination, revealing the unusual mechanism Qβ replicase uses to discriminate between its proper and improper templates, and discovering a new function of the largest ribosomal protein S1, that is also one of the replicase subunits. Finally, our work resulted in the invention of the molecular colonies technique that has become the basis for the next generation sequencing methods and provided a new insight into the origin of life. However, Qβ replicase has not yet revealed all its secrets, and its studies promise further interesting findings.     

Interpreting the Earliest Metazoan Fossils: What Can We Learn?

SYNOPSIS. The Ediacaran fossils of the latest Precambrian haveat one time or another been grouped with almost every extantkingdom, and also lumped into separate kingdom-level taxa. Thishas often been based on the facile use of a few characters,or on some sort of "overall similarity." This has not been avery fruitful approach; if anything, it has held back understandingof the Ediacaran organisms and of their significance for laterhistory. While many of the simpler forms remain problematic,careful study of the more complex forms gives good reasons toplace at least some of them with the Animalia. A complementaryapproach is to use sources of information such as the distributionof fossils across space, time, and paleoenvironments. The resultsmay feed back into systematic work, allowing us to constructand test more robust hypotheses of these organisms' evolutionaryrelationships.     

Health Outcome after Major Trauma: What Are We Measuring?

Importance

Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients.

Objective

To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma.

Data Sources

MEDLINE, EMBASE, and CINAHL (from 2006–2012) were searched for studies evaluating health outcome after traumatic injuries.

Study selection and data extraction

Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts.

Results

34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%).

Conclusion

Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.     

What Do We Really Know about Cognitive Inhibition? Task Demands and Inhibitory Effects across a Range of Memory and Behavioural Tasks

Our study explores inhibitory control across a range of widely recognised memory and behavioural tasks. Eighty-seven never-depressed participants completed a series of tasks designed to measure inhibitory control in memory and behaviour. Specifically, a variant of the selective retrieval-practice and the Think/No-Think tasks were employed as measures of memory inhibition. The Stroop-Colour Naming and the Go/No-Go tasks were used as measures of behavioural inhibition. Participants completed all 4 tasks. Task presentation order was counterbalanced across 3 separate testing sessions for each participant. Standard inhibitory forgetting effects emerged on both memory tasks but the extent of forgetting across these tasks was not correlated. Furthermore, there was no relationship between memory inhibition tasks and either of the main behavioural inhibition measures. At a time when cognitive inhibition continues to gain acceptance as an explanatory mechanism, our study raises fundamental questions about what we actually know about inhibition and how it is affected by the processing demands of particular inhibitory tasks.     

Global Epidemiology of Mental Disorders: What Are We Missing?

Background

Population-based studies provide the understanding of health-need required for effective public health policy and service-planning. Mental disorders are an important but, until recently, neglected agenda in global health. This paper reviews the coverage and limitations in global epidemiological data for mental disorders and suggests strategies to strengthen the data.

Methods

Systematic reviews were conducted for population-based epidemiological studies in mental disorders to inform new estimates for the global burden of disease study. Estimates of population coverage were calculated, adjusted for study parameters (age, gender and sampling frames) to quantify regional coverage.

Results

Of the 77,000 data sources identified, fewer than 1% could be used for deriving national estimates of prevalence, incidence, remission, and mortality in mental disorders. The two major limitations were (1) highly variable regional coverage, and (2) important methodological issues that prevented synthesis across studies, including the use of varying case definitions, the selection of samples not allowing generalization, lack of standardized indicators, and incomplete reporting. North America and Australasia had the most complete prevalence data for mental disorders while coverage was highly variable across Europe, Latin America, and Asia Pacific, and poor in other regions of Asia and Africa. Nationally-representative data for incidence, remission, and mortality were sparse across most of the world.

Discussion

Recent calls to action for global mental health were predicated on the high prevalence and disability of mental disorders. However, the global picture of disorders is inadequate for planning. Global data coverage is not commensurate with other important health problems, and for most of the world''s population, mental disorders are invisible and remain a low priority.     

The Diversity of Coral Reefs: What Are We Missing?

Tropical reefs shelter one quarter to one third of all marine species but one third of the coral species that construct reefs are now at risk of extinction. Because traditional methods for assessing reef diversity are extremely time consuming, taxonomic expertise for many groups is lacking, and marine organisms are thought to be less vulnerable to extinction, most discussions of reef conservation focus on maintenance of ecosystem services rather than biodiversity loss. In this study involving the three major oceans with reef growth, we provide new biodiversity estimates based on quantitative sampling and DNA barcoding. We focus on crustaceans, which are the second most diverse group of marine metazoans. We show exceptionally high numbers of crustacean species associated with coral reefs relative to sampling effort (525 species from a combined, globally distributed sample area of 6.3 m(2)). The high prevalence of rare species (38% encountered only once), the low level of spatial overlap (81% found in only one locality) and the biogeographic patterns of diversity detected (Indo-West Pacific>Central Pacific>Caribbean) are consistent with results from traditional survey methods, making this approach a reliable and efficient method for assessing and monitoring biodiversity. The finding of such large numbers of species in a small total area suggests that coral reef diversity is seriously under-detected using traditional survey methods, and by implication, underestimated.     

An Inquiry Safari: What Can We Learn From Skulls?

In this article, we describe an 8- to 10-day inquiry safari designed for middle/high school students to investigate hominid evolution using replica skulls of extant and extinct vertebrates. Students begin the unit using their own skulls and proceed to use the replica skulls of extant vertebrates to construct an understanding of how skulls can be used to interpret and infer diets, dentition, dental formulae, bipedal or quadrupedal locomotion, and the social structure of animals. They are then able to use this knowledge to construct similar inferences for extinct fossil hominids. Using radiometric dating data, the students develop possible phylogenetic pathways for hominid evolution. The lessons promote the use of inquiry skills including journaling, observing, drawing, puzzle-making, using taxonomic keys, and investigating into deep geological time.     

What Was Socialism, and What Comes Next?

What Was Socialism, and What Comes Next? Katherine Verdery. Princeton, NJ: Princeton University Press, 1996. 298 pp.