Recommendations of the Blue Ribbon Committee II for the Optimization of Surgical Education and Training in the United States: The Surgical Trainee Perspective.

OBJECTIVE: This study aims to appraise recommendations from an expert panel of surgical educators on optimizing surgical education and training in the setting of contemporary challenges. BACKGROUND: The Blue Ribbon Committee (BRC II), a group of surgical educators, was convened to make recommendations to optimize surgical training considering the current changes in the landscape of surgical education. Surgical trainees were recruited to assess their impressions of the recommendations. METHODS: A mixed-methods study design was employed, with a survey, followed by focus group interviews. Participating residents and fellows were recruited through a purposeful sampling approach. Descriptive statistics were applied to analyze the survey data, and a thematic data analysis on interview transcripts was employed. RESULTS: The majority of trainee respondents (n=16) thought that all of the subcommittee recommendations should be included in the final BRC II recommendations and paper. According to the interviews, overall, the feedback from the trainees was positive, with particular excitement around work-life integration, education support and faculty development, and funding pitfalls. Some themes about concerns included a lack of clarity about the recommendations, concern about some recommendations being in conflict with one another, and a disconnect between the initial BRC II survey and the subsequent recommendations. CONCLUSIONS: The residents gathered for this focus group were encouraged by the thought, effort, and intention that gathered the surgical leaders across the country to make the recommendations. While there were areas the trainees wanted clarity on, the overall opinion was in agreement with the recommendations.

Unravelling the complexities of biotic homogenization and heterogenization in the British avifauna.

Biotic homogenization is a process whereby species assemblages become more similar through time. The standard way of identifying the process of biotic homogenization is to look for decreases in spatial beta-diversity. However, using a single assemblage-level metric to assess homogenization can mask important changes in the occupancy patterns of individual species. Here, we analysed changes in the spatial beta-diversity patterns (i.e. biotic heterogenization or homogenization) of British bird assemblages within 30 km × 30 km regions between two periods (1988-1991 and 2008-2011). We partitioned the change in spatial beta-diversity into extirpation and colonization-resultant change (i.e. change in spatial beta-diversity within each region resulting from both extirpation and colonization). We used measures of abiotic change in combination with Bayesian modelling to disentangle the drivers of biotic heterogenization and homogenization. We detected both heterogenization and homogenization across the two time periods and three measures of diversity (taxonomic, phylogenetic, and functional). In addition, both extirpation and colonization contributed to the observed changes, with heterogenization mainly driven by extirpation and homogenization by colonization. These assemblage-level changes were primarily due to shifting occupancy patterns of generalist species. Compared to habitat generalists, habitat specialists had significantly (i) higher average contributions to colonization-resultant change (indicating heterogenization within a region due to colonization) and (ii) lower average contributions to extirpation-resultant change (indicating homogenization from extirpation). Generalists showed the opposite pattern. Increased extirpation-resultant homogenization within regions was associated with increased urban land cover and decreased habitat diversity, precipitation, and temperature. Changes in extirpation-resultant heterogenization and colonization-resultant heterogenization were associated with differences in elevation between regions and changes in temperature and land cover. Many of the 'winners' (i.e. species that increased in occupancy) were species that had benefitted from conservation action (e.g. buzzard (Buteo buteo)). The 'losers' (i.e. those that decreased in occupancy) consisted primarily of previously common species, such as cuckoo (Cuculus canorus). Our results show that focusing purely on changes in spatial beta-diversity over time may obscure important information about how changes in the occupancy patterns of individual species contribute to homogenization and heterogenization.

A service mapping exercise of four health and social care staff mental health and wellbeing services, Resilience Hubs, to describe health service provision and interventions.

BACKGROUND: NHS England funded 40 Mental Health and Wellbeing Hubs to support health and social care staff affected by the COVID-19 pandemic. We aimed to document variations in how national guidance was adapted to the local contexts of four Hubs in the North of England. METHODS: We used a modified version of Price's (2019) service mapping methodology. Service level data were used to inform the analysis. A mapping template was adapted from a range of tools, including the European Service Mapping Schedule, and reviewed by Hub leads. Key data included service model; staffing; and interventions. Data were collected between March 2021 - March 2022 by site research assistants. Findings were accuracy-checked by Hub leads, and a logic model developed to theorise how the Hubs may effect change. RESULTS: Hub goals and service models closely reflected guidance; offering: proactive outreach; team-based support; clinical assessment; onward referral, and rapid access to mental health support (in-house and external). Implementation reflected a service context of a client group with high mental health need, and high waiting times at external mental health services. Hubs were predominantly staffed by experienced clinicians, to manage these mental health presentations and organisational working. Formulation-based psychological assessment and the provision of direct therapy were not core functions of the NHS England model, however all Hubs incorporated these adaptations into their service models in response to local contexts, such as extensive waiting lists within external services, and/or client presentations falling between gaps in existing service provision. Finally, a standalone clinical records system was seen as important to reassure Hub users of confidentiality. Other more nuanced variation depended on localised contexts. CONCLUSION: This study provides a map for setting up services, emphasising early understandings of how new services will integrate within existing systems. Local and regional contexts led to variation in service configuration. Whilst additional Hub functions are supported by available literature, further research is needed to determine whether these functions should comprise essential components of staff wellbeing services moving forward. Future research should also determine the comparative effectiveness of service components, and the limits of permissible variation. STUDY REGISTRATION: researchregistry6303.

Latitudinal patterns of forest ecosystem stability across spatial scales as affected by biodiversity and environmental heterogeneity.

Our planet is facing a variety of serious threats from climate change that are unfolding unevenly across the globe. Uncovering the spatial patterns of ecosystem stability is important for predicting the responses of ecological processes and biodiversity patterns to climate change. However, the understanding of the latitudinal pattern of ecosystem stability across scales and of the underlying ecological drivers is still very limited. Accordingly, this study examines the latitudinal patterns of ecosystem stability at the local and regional spatial scale using a natural assembly of forest metacommunities that are distributed over a large temperate forest region, considering a range of potential environmental drivers. We found that the stability of regional communities (regional stability) and asynchronous dynamics among local communities (spatial asynchrony) both decreased with increasing latitude, whereas the stability of local communities (local stability) did not. We tested a series of hypotheses that potentially drive the spatial patterns of ecosystem stability, and found that although the ecological drivers of biodiversity, climatic history, resource conditions, climatic stability, and environmental heterogeneity varied with latitude, latitudinal patterns of ecosystem stability at multiple scales were affected by biodiversity and environmental heterogeneity. In particular, α diversity is positively associated with local stability, while ß diversity is positively associated with spatial asynchrony, although both relationships are weak. Our study provides the first evidence that latitudinal patterns of the temporal stability of naturally assembled forest metacommunities across scales are driven by biodiversity and environmental heterogeneity. Our findings suggest that the preservation of plant biodiversity within and between forest communities and the maintenance of heterogeneous landscapes can be crucial to buffer forest ecosystems at higher latitudes from the faster and more intense negative impacts of climate change in the future.

Response trait diversity and species asynchrony underlie the diversity-stability relationship in Romanian bird communities.

Biodiversity-stability relationships have frequently been studied in ecology, with the recent integration of traits to explain community stability over time. Classical theory underlying the biodiversity-stability relationship posits that different species' responses to the environment should stabilise community-level properties (e.g. biomass or abundance) through compensatory dynamics. However, functional response traits, which aim to predict how species respond to environmental change, are still rarely integrated into studies of ecological stability. Such traits should mechanistically drive community stability, both in terms of community abundance (functional variability) and composition (compositional variability). In turn, whether and how functional or compositional stability scales to affect temporal variation in functional effect traits (a proxy for ecosystem functioning) remains largely unknown, but is key to consistent ecosystem functioning under environmental change. Here, we explore the diversity-stability relationship in bird communities using annual survey data across 98 sites in central Romania, in combination with global trait databases and structural equation models. We show that higher response trait diversity promotes compositional variability directly, and functional variability indirectly via species asynchrony. In turn, functional variability impacts the temporal stability of effect trait diversity. Multiple facets of diversity and community stability differ between natural forests and agricultural or human-dominated survey sites, and the relationship between response diversity and functional variability is mediated by land cover. Further integration of response-and-effect trait frameworks into studies of community stability will enhance understanding of the drivers of biodiversity change, allowing targeted conservation decision-making with a focus on stable ecosystem functioning in the face of global environmental change.

Intravital Microscopy of Lipopolysaccharide-Induced Inflammatory Changes in Different Organ Systems-A Scoping Review.

Intravital microscopy (IVM) is a powerful imaging tool that captures biological processes in real-time. IVM facilitates the observation of complex cellular interactions in vivo, where ex vivo and in vitro experiments lack the physiological environment. IVM has been used in a multitude of studies under healthy and pathological conditions in different organ systems. IVM has become essential in the characterization of the immune response through visualization of leukocyte-endothelial interactions and subsequent changes within the microcirculation. Lipopolysaccharide (LPS), a common inflammatory trigger, has been used to induce inflammatory changes in various studies utilizing IVM. In this review, we provide an overview of IVM imaging of LPS-induced inflammation in different models, such as the brain, intestines, bladder, and lungs.

Antibacterial and Analgesic Properties of Beta-Caryophyllene in a Murine Urinary Tract Infection Model.

Beta-caryophyllene has demonstrated anti-inflammatory effects in a variety of conditions, including interstitial cystitis. These effects are mediated primarily via the activation of the cannabinoid type 2 receptor. Additional antibacterial properties have recently been suggested, leading to our investigation of the effects of beta-caryophyllene in a murine model of urinary tract infection (UTI). Female BALB/c mice were intravesically inoculated with uropathogenic Escherichia coli CFT073. The mice received either beta-caryophyllene, antibiotic treatment using fosfomycin, or combination therapy. After 6, 24, or 72 h, the mice were evaluated for bacterial burden in the bladder and changes in pain and behavioral responses using von Frey esthesiometry. In the 24 h model, the anti-inflammatory effects of beta-caryophyllene were also assessed using intravital microscopy. The mice established a robust UTI by 24 h. Altered behavioral responses persisted 72 h post infection. Treatment with beta-caryophyllene resulted in a significant reduction in the bacterial burden in urine and bladder tissues 24 h post UTI induction and significant improvements in behavioral responses and intravital microscopy parameters, representing reduced inflammation in the bladder. This study demonstrates the utility of beta-caryophyllene as a new adjunct therapy for the management of UTI.

The global impact of management on soil nematode abundances.

Research Highlight: Li, X., Liu, T., Li, H., Geisen, S., Hu, F., & Liu, M. (2022). Management effects on soil nematode abundance differ among functional groups and land-use types at a global scale. Journal of Animal Ecology, https://doi.org/10.1111/1365-2656.13744. Despite the well-documented decline of aboveground species abundances as a result of land-use intensification, there has been little attention on the effects of human activities on belowground species abundances. Li et al. analyse nematode data, the most abundant animal on the planet, from across the globe to determine whether their abundances vary between managed and unmanaged habitats. The authors show that, unlike aboveground biodiversity, nematode abundance is higher in managed than unmanaged primary and secondary habitats. Furthermore, responses to land management vary between trophic groups and they do not appear to follow the general hypothesis that higher trophic levels are more vulnerable to human activity than those further down the food chain, except in urban habitats. Finally, Li et al. show that the relationships between environmental predictors and species abundance were weakened (and sometimes reversed) in managed habitats. Together, their results reveal how land-use management is impacting the trophic composition of soil nematode communities and their relationships with the environment, which has implications for ecosystem functioning.

A retrospective case notes review of the effectiveness and tolerability of metoclopramide in the treatment of clozapine-induced hypersalivation (CIH).

OBJECTIVE: The objective of the study is to explore the long-term effectiveness and tolerability of metoclopramide in the treatment of CIH. METHOD: This study is a retrospective, observational cohort study of patients prescribed metoclopramide for CIH at the South London & Maudsley (SLaM) NHS Foundation Trust. RESULTS: Of the 96 patients identified, 14 patients were eligible for inclusion in our study. Five patients continued treatment with a mean duration of 27 months (SD = 17.8), and one patient continued until transfer with a duration of 3 months. Eight patients discontinued treatment after a mean duration of 8 months. CONCLUSION: Metoclopramide may be an effective and tolerated drug in CIH, but more data is required to establish its place in the pharmacotherapy of this condition.

Evaluating automatic creaky voice detection methods.

There is growing interest in research on the non-modal voice quality, creaky voice; however, its identification often relies on time-consuming manual annotation, leading to a recent focus on automatic creak detection methods. Various automatic methods have been proposed, which rely on varying types and combinations of acoustic cues for creak detection. In this paper, we compare the performance of three automatic tools, the AntiMode method, the Creak Detector algorithm, and the Roughness algorithm, against manual annotation of creak using data from 80 Australian English speakers. We explore the possibility that tools used in combination may yield more accurate creak detection than individual tools used alone. Based on method comparisons, we present options for researchers, including an "out-of-the-box" approach, which supports combining automatic tools, and propose additional steps to further improve creak detection. We found restricting analysis to sonorant segments significantly improves automatic creak detection, and tools performed consistently better on female speech than male speech. Findings support previous work showing detection may be optimised by performing a creak probability threshold sweep on a subset of data prior to applying the Creak Detector algorithm on new datasets. Results provide promising solutions for advancing efficient large-scale research on creaky voice.

Average fixation duration in infancy: Stability and predictive utility.

The current study examined the stability, consistency, and predictive utility of average fixation durations in infancy. In Study 1, infants' (N = 80) average fixation duration when viewing social stimuli was found to show strong relative stability from 3.5 to 9 months of age. In Study 2, strong within-infant consistency was found in 3.5-month-old infants' (N = 73) average fixation durations to social and nonsocial stimuli. In Study 3, 3.5- to 9-month-old infants' (N = 89) average fixation duration was found to systematically vary with parent-reported symptoms of attention deficit hyperactivity disorder (ADHD) at 4-6 years of age. These results suggest that average fixation duration serves as a stable and systematic measure of individual differences in cognitive development beginning early in life.

Observer Gaze Patterns of Patient Photographs Before and After Facial Feminization.

BACKGROUND: Human interaction begins with visual evaluation of others, and this often centers on the face. Objective measurement of this evaluation gives clues to social perception. OBJECTIVES: The objective of this study was to use eye-tracking technology to evaluate if there are scanpath differences when observers view faces of cisgender men, cisgender women, and transgender women before and after facial feminization surgery (FFS) including when assigning tasks assessing femininity, attractiveness, and likability. METHODS: Undergraduate psychology students were prospectively recruited as observers at a single institution. Their eye movements were recorded by eye-tracking technology when they were presented with frontal photographs of prototypical male, prototypical female, and pre- and post-FFS faces in a random order and then with prompting to assess femininity, attractiveness, and likability. RESULTS: Twenty-seven observers performed the tasks. Participants focused their attention more on the central triangle of post-FFS and prototypical female images and on the forehead of pre-FFS and prototypical male images. Higher femininity ratings were associated with longer proportional fixations to the central triangle and lower proportional fixations to the forehead. CONCLUSIONS: This preliminary study implies the scanpath for viewing a post-FFS face is closer to that for viewing a prototypical female than a prototypical male based on differences viewing the forehead and brow vs the central triangle.

Family mealtime emotions and food parenting practices among mothers of young children: Development of the Mealtime Emotions Measure for Parents (MEM-P).

Family mealtimes can be important for supporting children's healthy development, yet the emotional context of mealtimes can vary considerably, likely impacting their overall success and enjoyment. Yet, despite having an important role, little is known about how parents emotionally experience mealtimes with their family. The first aim of the current study was to assess the factor structure of a novel self-report measure to assess parents' emotional responses experienced during family mealtimes (Mealtime Emotions Measure for Parents; MEM-P). The second aim was to examine relationships between maternal mealtime emotions and their food parenting practices. Mothers of children aged between 1.5 and 6 years participated in this study. Mothers were invited to complete an online questionnaire measuring family mealtime emotions, anxiety, depression and food parenting practices. Exploratory factor analysis produced a three-factor solution comprising both positive and negative emotion subscales: MEM-P Efficacy; MEM-P Anxiety; MEM-P Stress and Anger. Mothers' positive mealtime emotions (mealtime efficacy) were related to greater use of practices promoting autonomy, providing a healthy home food environment, and modelling healthy eating. Higher anxiety about mealtimes was related to greater reports of child control over eating, and mealtime stress and anger was associated with greater use of food to regulate emotions. These findings highlight novel relationships between how mothers emotionally experience family mealtimes and the food parenting practices they use with their children. It is important to develop resources to help promote positive maternal experiences of family mealtimes and food-based interactions.

Global effects of land use on local terrestrial biodiversity.

Human activities, especially conversion and degradation of habitats, are causing global biodiversity declines. How local ecological assemblages are responding is less clear--a concern given their importance for many ecosystem functions and services. We analysed a terrestrial assemblage database of unprecedented geographic and taxonomic coverage to quantify local biodiversity responses to land use and related changes. Here we show that in the worst-affected habitats, these pressures reduce within-sample species richness by an average of 76.5%, total abundance by 39.5% and rarefaction-based richness by 40.3%. We estimate that, globally, these pressures have already slightly reduced average within-sample richness (by 13.6%), total abundance (10.7%) and rarefaction-based richness (8.1%), with changes showing marked spatial variation. Rapid further losses are predicted under a business-as-usual land-use scenario; within-sample richness is projected to fall by a further 3.4% globally by 2100, with losses concentrated in biodiverse but economically poor countries. Strong mitigation can deliver much more positive biodiversity changes (up to a 1.9% average increase) that are less strongly related to countries' socioeconomic status.

Waist-to-Hip Ratio Sensitivity in Early Infancy.

The waist-to-hip ratio (WHR) is correlated with health and associated with sex, attractiveness, and age judgments by adults. We examined the development of sensitivity to the WHR by testing 3.5-month-old infants' (N = 71) preference between images depicting different WHRs. Female 3.5-month-olds exhibited a preference for the WHR associated with attractiveness and mate value by adults (0.7) over a larger WHR (0.9). This preference was exhibited when infants were tested on upright stimuli but not when they were tested on inverted stimuli, indicating that low-level differences (e.g., curviness) were not driving performance. This sensitivity to WHR may lay the foundation for more explicit preferences and categorical associations later in life. In contrast to females, male infants failed to exhibit a significant preference for the 0.7 WHR in either orientation, replicating previous findings of female infants' superior processing of social stimuli. Implications for theories of the development of body knowledge and sex differences in social information processing are discussed.

Sex-specific scanning in infancy: Developmental changes in the use of face/head and body information.

The current investigation sought to differentiate between contrasting perspectives of body knowledge development by determining whether infants' adult-like scanning of male and female bodies is dependent on relevant information from the face/head alone, the body alone, or a combination of both sources. Scanning patterns of 3.5-, 6.5-, and 9-month-olds (N = 80) in response to images that contained information relevant to sex classification in either the face/head or the body were examined. The results indicate that sex-specific scanning in the presence of only one source of relevant information (i.e., face/head or body) is present only at 9 months. Thus, although sex-specific scanning of bodies emerges as early as 3.5 months, information from both faces/heads and bodies is required until sometime between 6.5 and 9 months of age. These findings constrain theories of the development of social perception by documenting the complex interplay between body and face/head processing early in life.

Categorical Perception of Facial Emotions in Infancy.

Categorical perception, indicated by superior discrimination between stimuli that cross categorical boundaries than between stimuli within a category, is an efficient manner of classification. The current study examined the development of categorical perception of emotional stimuli in infancy. We used morphed facial images to investigate whether infants find contrasts between emotional facial images that cross categorical boundaries to be more salient than those that do not, while matching the degree of differences in the two contrasts. Five-month-olds exhibited sensitivity to the categorical boundary between sadness and disgust, between happiness and surprise, as well as between sadness and anger but not between anger and disgust. Even 9-month-olds failed to exhibit evidence of a definitive category boundary between anger and disgust. These findings indicate the presence of discrete boundaries between some, but not all, of the basic emotions early in life. Implications of these findings for the major theories of emotion representation are discussed.

Contribution of local rarity and climatic suitability to local extinction and colonization varies with species traits.

Changes in species distributions through local extinction and colonization events are a major consequence of climate change. The mechanisms underlying these processes, however, are yet to be fully understood. We investigate the effects of climatic suitability and local rarity on local extinction and colonization of British birds. We test the hypothesis that local extinction and colonization on decadal scales are driven by both climatic suitability and the prevalence of the species within an area and that the balance between these two is affected by species traits. We use spatially explicit conditional autoregressive models to determine the effect size of local rarity and climatic suitability (extracted from climate envelope models) on local extinction and colonization events. We then use phylogenetically constrained, generalized least-square models to estimate the association of extinction and colonization predictors with body mass, clutch size and national range of each species. Both local rarity and climatic suitability of an area contributed to local extinctions and colonizations, but the importance of these predictors varied between species. This interspecific variation was explained, in part, by species traits, in particular national range, which influenced the importance of local rarity and climatic suitability to both local extinction and colonization. These results further our knowledge of the mechanisms underlying changes in species occupancy due to climate change. This can inform predictive models as well as contribute to more focussed avian conservation efforts.

Visual scanning of male and female bodies in infancy.

This study addressed the development of attention to information that is socially relevant to adults by examining infants' (N=64) scanning patterns of male and female bodies. Infants exhibited systematic attention to regions associated with sex-related scanning by adults, with 3.5- and 6.5-month-olds looking longer at the torsos of females than of males and looking longer at the legs of males than of females. However, this pattern of looking was not found when infants were tested on headless bodies in Experiment 2, suggesting that infants' differential gaze pattern in Experiment 1 was not due to low-level stimulus features, such as clothing, and also indicating that facial/head information is necessary for infants to exhibit sex-specific scanning. We discuss implications for models of face and body knowledge development.

Parental strategies used in the family meal session of family-based treatment for adolescent anorexia nervosa: Links with treatment outcomes.

OBJECTIVE: Examine relationships between parental mealtime strategies used in the family meal session of family-based treatment (FBT) and adolescent outcomes at EOT (session 20). METHOD: Eighteen families with an adolescent receiving FBT-AN participated. Parental strategies during videoed family meals were assessed using a family mealtime coding system. Change scores were calculated for both adolescent %EBW and EDE scores. RESULTS: Increased use of parental direct and non-direct eating prompts during the family meal was associated with greater adolescent weight gain at EOT. Use of parental mealtime strategies was not associated with any significant change in adolescent eating psychopathology at EOT. DISCUSSION: Parental verbal eating prompts during the family meal may be effective in promoting short-term weight gain. During the family meal session, parents should be encouraged to maintain a direct focus on their adolescent child's eating behaviour which may assist their child with food consumption and potential weight gain. Further research examining food-based interactions among parents and their adolescent child with AN is needed. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:433-436).