Why We Can't Wait.
Ontology highlight
ABSTRACT:
SUBMITTER: Solola J
PROVIDER: S-EPMC7901623 | biostudies-literature | 2021 Feb
REPOSITORIES: biostudies-literature
Publications
Why We Can't Wait.
Solola Jasmine J McQueen Alisa A Naylor Rochelle R Okuneye Victoria V Vela Monica M
Journal of graduate medical education 20210122 1
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Project description:Two-sex populations are usually studied through frequency-dependent models that describe how sex ratio affects mating, recruitment and population growth. However, in two-sex populations, mating and recruitment should also be affected by density and by its interactions with the sex ratio. Density may have positive effects on mating (Allee effects) but negative effects on other demographic processes. In this study, we quantified how positive and negative inter-sexual interactions balance in two-sex populations. Using a dioecious grass (Poa arachnifera), we established experimental field populations that varied in density and sex ratio. We then quantified mating success (seed fertilization) and non-mating demographic performance, and integrated these responses to project population-level recruitment. Female mating success was positively density-dependent, especially at female-biased sex ratios. Other demographic processes were negatively density-dependent and, in some cases, frequency-dependent. Integrating our experimental results showed that mate-finding Allee effects dominated other types of density-dependence, giving rise to recruitment that increased with increasing density and peaked at intermediate sex ratios, reflecting tension between seed initiation (greater with more females) and seed viability (greater with more males). Our results reveal, for the first time, the balance of positive and negative inter-sexual interactions in sex-structured populations. Models that account for both density- and sex ratio dependence, particularly in mating, may be necessary for understanding and predicting two-sex population dynamics.
| S-EPMC5666111 | biostudies-literature
Project description:The COVID-19 outbreak and related public health guidelines have changed the daily lives of Canadians and restricted opportunities for healthy movement behaviours for children. The purpose of this study was to explore how parents experienced the pandemic-related restrictions and how they impacted their children's movement behaviours. Methods: Twenty-nine semi-structured one-on-one interviews were conducted (June-July 2020) with parents of children (5-11 years old) in Ontario and British Columbia. Interviews lasted between 24-104 min, were audio-recorded, transcribed verbatim, and thematically analyzed. Results: Findings emphasized various individual (e.g., motivation), interpersonal (e.g., parent work schedule), built (e.g., closure of parks) and natural environment (e.g., weather) factors related to children's movement behaviours. The findings highlighted the loss of structured activities and destinations for children's physical activity, and restricted opportunities for outdoor play exacerbated by shrinking childhood independent mobility. Conclusion: Families are adapting to many pandemic-related challenges including adhering to public health restrictions, parents juggling multiple roles, conducting work and school from home, as well as exacerbating factors like weather. It will be important to continue to encourage outdoor time, support policies and practice that facilitate independent mobility, and develop centralized resources that help families in the maintenance of healthy movement behaviours.
| S-EPMC8000735 | biostudies-literature
Project description:BackgroundGraduating US medical students must build strong skills in caring for older adults, necessitated by shifting population demographics. Little is known, however, about current medical student exposure to geriatrics on a national scale. This systematic website review characterizes geriatrics opportunities at US medical schools, seen through the lens of publicly available information online.MethodsReviewers searched for 18 online Geriatrics Elements, in the domains of Information Prevalence, Geriatrics Environment, and Geriatrics Education, for all 191 US medical schools accredited as of January 2020. Latent Class Analysis was used to classify schools according to their publicly visible geriatrics opportunities.ResultsSchools had a median of 7 Geriatrics Elements identified online [IQR 4-10]. Optional geriatrics clinical activity was the most prevalent (76%), while fewer than half of all schools had online evidence of required geriatrics clinical activity (45%). A profile of the three groups of schools identified by Latent Class Analysis, termed Geriatrics Online-Visibility groups (High n = 39, 20%; Medium n = 90, 47%; Low n = 62, 32%), is presented. Online evidence of geriatrics-specific funding was the greatest distinguishing factor among the groups.ConclusionsExamining US medical school websites collectively and comparatively across Geriatrics Online-Visibility groups can ground discussions of geriatrics education in current national data. Though many school websites present optional geriatrics activities, far fewer specify geriatrics requirements. High Geriatrics Online-Visibility schools present an array of both optional and required geriatrics opportunities on their websites, but this cohort comprises only 20% of schools. Recommended next steps are proposed to guide schools inspired to enhance their Geriatrics Online-Visibility.
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Project description:Objective: Community addiction treatment agencies have utilized Network for the Improvement of Addiction Treatment (NIATx), a proven implementation strategy, to reduce appointment wait-times. However, its effectiveness at reducing medication access wait-times has not been explored. Thus, we conducted an exploratory analysis to evaluate the impact of the NIATx implementation strategies on reduced wait-times to addiction, psychotropic or both medications for individuals with co-occurring disorders (COD). Methods: In a cluster-randomized waitlist control group design, community addiction treatment agencies (n = 49) were randomized to receive the NIATx strategy (Cohort 1, n = 25) or to a Waitlist control (Cohort 2, n = 24). All agencies had a 12-month active intervention period. The primary outcome was the medication encounter wait-time. A univariate general linear model analysis utilizing a logarithmic (log10) transformation examined medication wait-times improvements. Results: The intent-to-treat analysis for psychotropic medications and both medications (reflecting integrated treatment) showed significant main effects for intervention and time, especially comparing Baseline and Year 1 to Year 2. Conversely, only the main effect for time was significant for addiction medications. Wait-time reductions in Cohort 1 agencies was delayed and occurred in the sustainment phase. Wait-times to a psychotropic, addiction, or both medications encounter declined by 3 days, 4.9 days, and 6.8 days, respectively. For Cohort 2 agencies, reduced wait-times were seen for psychotropic (3.4 days), addiction (6 days), and both medications (4.9 days) during their active implementation period. Same- or next-day medication access also improved. Conclusions: NIATx implementation strategies reduced medication encounter wait-times but timing of agency improvements varied. Despite a significant improvement, a three-week wait-time to receive integrated pharmacological interventions is clinically suboptimal for individuals with a COD in need of immediate intervention. Community addiction treatment agencies should identify barriers and implement changes to improve medication access so that their patients "wait no longer" to receive integrated treatment and medications for their COD.
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Project description:eLife editors and reviewers consult with one another before sending out a decision after peer review. This means that authors do not have to spend time responding to confusing or conflicting requests for revisions.
| S-EPMC5619945 | biostudies-other
Project description:Objective: We analyzed changes in A. fumigatus gene expression profile at various stages of an in vitro model of aspergillosis to study the adaptation of A. fumigatus to the blood environment. Results: Most of virulence factors described to be involved in aspergillosis were not activated during the blood phase. We found three active processes to be activated in the later phase that may help to the adaptation: Iron homeostasis, a partial secondary metabolite cluster and the formation of detoxification enzymes. Conclusions: We propose that A. fumigatus is unable to grow in blood and it requires a metabolic change that allows the organism to shut down all uptake and energy-consume mechanisms, resulting in a resting mycelial stage.
2015-11-24 | GSE70227 | GEO
Project description:We lack a comprehensive understanding of evolutionary pattern and process because short-term and long-term data have rarely been combined into a single analytical framework. Here we test alternative models of phenotypic evolution using a dataset of unprecedented size and temporal span (over 8,000 data points). The data are body-size measurements taken from historical studies, the fossil record, and among-species comparative data representing mammals, squamates, and birds. By analyzing this large dataset, we identify stochastic models that can explain evolutionary patterns on both short and long timescales and reveal a remarkably consistent pattern in the timing of divergence across taxonomic groups. Even though rapid, short-term evolution often occurs in intervals shorter than 1 Myr, the changes are constrained and do not accumulate over time. Over longer intervals (1-360 Myr), this pattern of bounded evolution yields to a pattern of increasing divergence with time. The best-fitting model to explain this pattern is a model that combines rare but substantial bursts of phenotypic change with bounded fluctuations on shorter timescales. We suggest that these rare bursts reflect permanent changes in adaptive zones, whereas the short-term fluctuations represent local variations in niche optima due to restricted environmental variation within a stable adaptive zone.
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Project description:The administration of neoadjuvant chemoradiotherapy (nCRT) followed by total mesorrectal excision (TME) and selective use of adjuvant chemotherapy can still be considered the standard of care in locally advanced rectal cancer (LARC). However, avoiding sequelae of TME and entering a narrow follow-up program of watch and wait (W&W), in select cases that achieve a comparable clinical complete response (cCR) to nCRT, is now very attractive to both patients and clinicians. Many advances based on well-designed studies and long-term data coming from big multicenter cohorts have drawn some important conclusions and warnings regarding this strategy. In order to safely implement W&W, it is important consider proper selection of cases, best treatment options, surveillance strategy and the attitudes towards near complete responses or even tumor regrowth. The present review offers a comprehensive overview of W&W strategy from its origins to the most current literature, from a practical point of view focused on daily clinical practice, without losing sight of the most important future prospects in this area.
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