Small‐stature emergent macrophytes and crepuscular sprinkler disturbance reduce mosquito abundance in wetland mesocosms

The impact of emergent macrophyte species and crepuscular sprinkler disturbance on mosquito abundance over a 2‐year period was measured in wetland mesocosms. Mosquito oviposition and abundance of immature mosquitoes and aquatic invertebrates were monitored in monotypic plots of small‐stature (height of mature stands <1.5 m) alkali bulrush (Schoenoplectus maritimus) and large‐stature (height of mature stands > 2 m) California bulrush (Schoenoplectus californicus) without or with daily sprinkler showers to deter mosquito egg laying. Relative to wetlands without operational sprinklers, oviposition by culicine mosquitoes was reduced by > 99% and immature mosquito abundance was reduced by > 90% by crepuscular sprinkler applications. Mosquito abundance or distribution in wetlands did not differ between the two bulrush species subjected to the sprinkler treatment. Alkali bulrush wetlands without daily sprinkler treatments contained more egg rafts but significantly fewer mosquito larvae than did California bulrush wetlands. Predaceous damselfly naiads were 3–5 times more abundant in alkali bulrush than in California bulrush. Stem density, rate of spread, and autumnal mortality of alkali bulrush were higher than for California bulrush. Replacement of large emergent macrophytes by smaller species may enhance the efficacy of integrated mosquito management programs to reduce mosquito‐transmitted disease cycles associated with multipurpose constructed wetlands used worldwide for water reclamation and habitat restoration.     

Comparison of positron emission tomography/computed tomography imaging and ultrasound in surveillance of head and neck cancer – The 3-year experience of the ENT Department in Poznan

Background

Posttreatment surveillance for the local and regional recurrence of the head and neck squamous cell carcinoma often requires a multimodality techniques that include PET combined with CT, MRI, US.

Aim

The purpose of this study is to compare the diagnostic performance of two imaging techniques (PET/CT and US), and their combined use for the detection of a subclinical regional recurrence in patients after HNSCC treatment.

Materials and methods

83 patients after completion of the HNSCC treatment underwent both US and PET/CT on the mean follow-up of 14 months after initial treatment.

Results

The sensitivity and specificity of PET/CT were 86% and 82%, respectively; US values reached 81% and 87%, respectively. PPV was 79% for PET/CT, and 83% for US. NPV was 89% for PET/CT, and 85% for US. The overall accuracy for PET/CT and US was 84% for both methods.

Conclusion

US could be regarded as complementary to PET/CT as the procedures with highest sensitivity, specificity and NPV for detecting subclinical regional recurrences after HNSCC treatment.     

Supported employment: cost-effectiveness across six European sites

A high proportion of people with severe mental health problems are unemployed but would like to work. Individual Placement and Support (IPS) offers a promising approach to establishing people in paid employment. In a randomized controlled trial across six European countries, we investigated the economic case for IPS for people with severe mental health problems compared to standard vocational rehabilitation. Individuals (n=312) were randomized to receive either IPS or standard vocational services and followed for 18 months. Service use and outcome data were collected. Cost‐effectiveness analysis was conducted with two primary outcomes: additional days worked in competitive settings and additional percentage of individuals who worked at least 1 day. Analyses distinguished country effects. A partial cost‐benefit analysis was also conducted. IPS produced better outcomes than alternative vocational services at lower cost overall to the health and social care systems. This pattern also held in disaggregated analyses for five of the six European sites. The inclusion of imputed values for missing cost data supported these findings. IPS would be viewed as more cost‐effective than standard vocational services. Further analysis demonstrated cost‐benefit arguments for IPS. Compared to standard vocational rehabilitation services, IPS is, therefore, probably cost‐saving and almost certainly more cost‐effective as a way to help people with severe mental health problems into competitive employment.     

The therapeutic relationship and adherence to antipsychotic medication in schizophrenia

Objective

Previous research has shown that a better therapeutic relationship (TR) predicts more positive attitudes towards antipsychotic medication, but did not address whether it is also linked with actual adherence. This study investigated whether the TR is associated with adherence to antipsychotics in patients with schizophrenia.

Methods

134 clinicians and 507 of their patients with schizophrenia or a related psychotic disorder participated in a European multi-centre study. A logistic regression model examined how the TR as rated by patients and by clinicians is associated with medication adherence, adjusting for clinician clustering and symptom severity.

Results

Patient and clinician ratings of the TR were weakly inter-correlated (r_s = 0.13, p = 0.004), but each was independently linked with better adherence. After adjusting for patient rated TR and symptom severity, each unit increase in clinician rated TR was associated with an increase of the odds ratio of good compliance by 65.9% (95% CI: 34.6% to 104.5%). After adjusting for clinician rated TR and symptom severity, for each unit increase in patient rated TR the odds ratio of good compliance was increased by 20.8% (95% CI: 4.4% to 39.8%).

Conclusions

A better TR is associated with better adherence to medication among patients with schizophrenia. Patients'' and clinicians'' perspectives of the TR are both important, but may reflect distinct aspects.     

The dentition of a well-preserved specimen of <Emphasis Type="Italic">Camarasaurus</Emphasis> sp.: implications for function,tooth replacement,soft part reconstruction,and food intake

The basal macronarian genus Camarasaurus was the most common sauropod in the Upper Jurassic Morrison Formation of North America and is known from several complete and partial skeletons. The specimen used for this study is Camarasaurus sp. SMA 0002 from the Sauriermuseum Aathal, Switzerland. This specimen was found in the Howe-Stephens Quarry, Bighorn Basin, WY, USA. In this study, the dental morphology, characterized by the spatulate, broad-crowned teeth, the tooth replacement pattern, and the function of the dentition and its implications for food intake is described. Features such as the absence of denticles, the wrinkled pattern of the enamel, and the occurrence of large wear facets on older teeth are characteristic for Camarasaurus sp. A slab of sediment with soft tissue impressions ranging up to the middle part of the crown suggests the presence of a gingival soft tissue structure partially covering the teeth. The wrinkled enamel on the crown of the teeth of Camarasaurus sp. and other sauropods is interpreted as indication of this cover of gingival connective tissue. In addition, there possibly was a keratinous beak, which together with the gingiva held the teeth in the jaw and provided stability for teeth in which the root is almost completely resorbed.     

Evidence That Transition from Health to Psychotic Disorder Can Be Traced to Semi-Ubiquitous Environmental Effects Operating against Background Genetic Risk

Background

In order to assess the importance of environmental and genetic risk on transition from health to psychotic disorder, a prospective study of individuals at average (n = 462) and high genetic risk (n = 810) was conducted.

Method

A three-year cohort study examined the rate of transition to psychotic disorder. Binary measures indexing environmental exposure (combining urban birth, cannabis use, ethnicity and childhood trauma) and proxy genetic risk (high-risk sibling status) were used to model transition.

Results

The majority of high-risk siblings (68%) and healthy comparison subjects (60%) had been exposed to one or more environmental risks. The risk of transition in siblings (n = 9, 1.1%) was higher than the risk in healthy comparison subjects (n = 2, 0.4%; OR_adj  = 2.2,95%CI:5–10.3). All transitions (100%) were associated with environmental exposure, compared to 65% of non-transitions (p = 0.014), with the greatest effects for childhood trauma (OR_adj  = 34.4,95%CI:4.4–267.4), cannabis use (OR = 4.1,95%CI:1.1, 15.4), minority ethnic group (OR = 3.8,95%CI:1.2,12.8) and urban birth (OR = 3.7,95%CI:0.9,15.4). The proportion of transitions in the population attributable to environmental and genetic risk ranged from 28% for minority ethnic group, 45% for urban birth, 57% for cannabis use, 86% for childhood trauma, and 50% for high-risk sibling status. Nine out of 11 transitions (82%) were exposed to both genetic and environmental risk, compared to only 43% of non-transitions (p = 0.03).

Conclusion

Environmental risk associated with transition to psychotic disorder is semi-ubiquitous regardless of genetic high risk status. Careful prospective documentation suggests most transitions can be attributed to powerful environmental effects that become detectable when analysed against elevated background genetic risk, indicating gene-environment interaction.     

The influence of flow on the metabolism of perfused benzo[a]pyrene by isolated rat lung

In order to investigate the influence of flow and, thus, substrate delivery, on the ability of lung to metabolize foreign compounds, the disappearance of circulating [3H]benzo[a]pyrene ([3H]B[a]P) and the appearance of B[a]P metabolites was monitored in isolated rat lungs from control and 3-methylcholanthrene (3-MC) pretreated rats perfused at low (10 ml/min) and high (45 ml/min) flows. Increasing the flow or 3-MC pretreatment hastened the disappearance of B[a]P from the perfusion medium reservoir and increased the rate of appearance of total metabolites. However, these manipulations affected the appearance of individual metabolites in the medium in different ways. For example, in lungs from control rats the rate of appearance of 7,8-dihydrodiol (7,8-dihydroxy-7,8-dihydro-B[a]P) (7,8-DHD) in the perfusion medium was markedly increased by increasing flow while that of B[a]P-1,6-quinone was minimally affected. In addition, increasing flow increased the concentration of some B[a]P metabolites, such as 4,5-dihydrodiol (4,5-dihydroxy-4,5-dihydro-B[a]P) (4,5-DHD) in the lung tissue of control rats at the end of the perfusion period, but did not effect much change in the concentration of these metabolites in lungs from 3-MC-pretreated rats. The results show that flow, as well as 3-MC pretreatment, may alter the rate at which metabolism of foreign compounds occurs and the temporal profile of metabolites produced by the intact lung.