Wrestling with the complexity of evaluation for organizations at the boundary of science, policy, and practice.

Boundary organizations are situated between science, policy, and practice and have a goal of supporting communication and collaboration among these sectors. They have been promoted as a way to improve the effectiveness of conservation efforts by building stronger relationships between scientists, policy makers, industry, and practitioners (Cook et al. 2013). Although their promise has been discussed in theory, the work of and expectations for boundary organizations are less defined in practice. Biodiversity conservation is characterized by complexity, uncertainty, dissent, and tight budgets, so boundary organizations face the challenging task of demonstrating their value to diverse stakeholders. We examined the challenges boundary organizations face when seeking to evaluate their work and thus aimed to encourage more productive conversations about evaluation of boundary organizations and their projects. Although no off-the-shelf solution is available for a given boundary organization, we identified 4 principles that will support effective evaluation for boundary organizations: engage diverse stakeholders, support learning and reflection, assess contribution to change, and align evaluation with assumption and values.

Iatrogenic kwashiorkor after distal gastric bypass surgery: the consequences of receiving multinational treatment.

Protein-calorie malnutrition or kwashiorkor is extremely rare after gastric bypass surgery. We report a case of a woman referred to a weight management clinic in the United Kingdom who developed bilateral leg oedema 2 years after gastric bypass surgery in Tunisia. Her serum albumin concentration was 24 g/l, and her body mass index was 16.2 kg/m(2). A review of the postoperative report of her bariatric surgery revealed that she had undergone a distal bypass with anastomosis of the intestine at 1 m proximal to the ileocaecal valve. She required gastrostomy feeding for 6 months before undergoing revisional surgery to a proximal Roux-en-Y gastric bypass in order to restore healthy weight. We recommend that if patients are having their bariatric surgery outside of their country of residence, they should always obtain a copy of the operative notes so that these are readily available if complications arise.

pH dependence of the redox potential of Pseudomonas aeruginosa cytochrome c-551.

The redox potential of Ps. aeruginosa cytochrome c-551 varies with pH between pH 5 and 8. The pH dependence can be analysed in terms of a pKa of 6.2 in the oxidised form and a pKa of 7.3 in the reduced form. The same pKa values are also observed in NMR spectra of the two oxidation states and the pKa of 7.3 is observed in titration of the visible absorption spectrum of the ferrocytochrome. From the NMR studies these pKa values have been assigned to the ionisation of one of the haem propionic acid groups. pH dependence of redox potential is of variable occurrence among cytochromes and the possible significance and basis of this variation is discussed.

The severity of pedestrian injuries in children: an analysis of the Pedestrian Injury Causation Study.

We reanalyzed data from the Pedestrian Injury Causation Study (PICS) for 1035 urban pedestrian injuries to children and youth less than 20 years of age. Analysis of variance with the Injury Severity Score (ISS) as the dependent variable was used to evaluate variables describing the characteristics of the pedestrian, the vehicle, the driver, and the circumstances under which the collision occurred. The mean injury severity score was 5.6. Nearly 80% of pedestrians had a minor injury, 13% moderate, and 7% severe; 4.5% of these pedestrian were killed. Multivariate analysis revealed that vehicle travel speed greater than 30 mph, pedestrian age less than 5 years, time of day either early morning or late afternoon, residential zone, type of road including collectors and major roads, and center travel lanes were associated with greater severity of injury. Attempts by the driver to avoid the collision by braking or other avoidance maneuvers were associated with reduced injury severity. Even on local streets and in residential zones, nearly 20% of children were struck by vehicles exceeding 30 mph, and these children were injured much more severely than children struck by more slowly moving vehicles.

Use of in vitro gas production models in ruminal kinetics.

Physiological systems models for ruminant animals are used to predict the extent of ruminal carbohydrate digestion, based on rates of intake, digestion, and passage to the lower tract. Digestion of feed carbohydrates is described in these models by a first-order rate constant. Recently, an in vitro gas production technique has been developed to determine the digestion kinetics in batch fermentation, and nonlinear mathematical models have been fitted to the cumulative gas production data from these experiments. In this paper, we present an analysis that converts these gas production models to an effective first-order rate constant that can be used directly in rumen systems models. The analysis considers the digestion of an incremental mass of substrate entering the rumen. The occurrence of passage is represented probabilistically, and integration through time gives the total mass of substrate and total rate of digestion in the rumen. To demonstrate the analysis, several gas production models are fitted to a sample data set for corn silage, and the effective first-order rate constants are calculated. The rate constants for digestion depend on ruminal passage rate, an interaction that arises from the nonlinearity of the gas production models.

A tungsten-supplemented diet delivered by transplacental and breast-feeding routes lowers intestinal xanthine oxidase activity and affords cytoprotection in ischemia-reperfusion injury to the small intestine.

Ischemia-reperfusion injury has been implicated as playing a major role in the development of necrotizing enterocolitis, a major cause of morbidity and mortality in the newborn. A tungsten-supplemented molybdenum-free diet can reduce xanthine oxidase (XO) enzyme activity in the intestine, which in turn reduces the generation of oxygen radicals after an ischemia-reperfusion insult. This study evaluated the ability of this diet to be effective by indirect means, ie, transplacental and breast-feeding routes. XO activity of the intestine was measured in three groups of CD-1 white rats: I, weanlings fed the tungsten diet or standard chow for 1 week; II, 1-day-old rat pups whose mothers were maintained on the tungsten or standard chow for 7 to 10 days prior to term; and III, rat pups at 1 and 3 weeks after birth whose lactating mothers were maintained on the tungsten or standard chow. Some animals from group III also underwent either a 30- or 60-minute episode of occlusion of the superior mesenteric artery (SMA) to evaluate the protective effects of the diet. XO activity was significantly reduced in all groups receiving the tungsten diet (P less than .0001). Blinded histopathologic studies of the entire small bowel showed significantly less villar necrosis (P less than .05) and fibrosis (P less than .0001) in the tungsten-treated group than in the controls. In the 60-minute occlusion study all tungsten-group animals survived, whereas 7 of 12 in the control group died of intestinal infarction within 24 hours (P less than .001).(ABSTRACT TRUNCATED AT 250 WORDS)

Fractal-based image texture analysis of trabecular bone architecture.

Fractal-based image analysis methods are investigated to extract textural features related to the anisotropic structure of trabecular bone from the X-ray images of cubic bone specimens. Three methods are used to quantify image textural features: power spectrum, Minkowski dimension and mean intercept length. The global fractal dimension is used to describe the overall roughness of the image texture. The anisotropic features formed by the trabeculae are characterised by a fabric ellipse, whose orientation and eccentricity reflect the textural anisotropy of the image. Tests of these methods with synthetic images of known fractal dimension show that the Minkowski dimension provides a more accurate and consistent estimation of global fractal dimension. Tests on bone x-ray (eccentricity range 0.25-0.80) images indicate that the Minkowski dimension is more sensitive to the changes in textural orientation. The results suggest that the Minkowski dimension is a better measure for characterising trabecular bone anisotropy in the x-ray images of thick specimens.

Audiological management in the recovery phase of bacterial meningitis.

During a specified 12-month period, a prospective study of all children admitted to a 139-bed city children's hospital with confirmed bacterial meningitis enabled assessment audiologically at 48 h, 6 weeks and 12 weeks post-admission using a test battery approach including auditory brainstem evoked responses and tympanometry. Results suggested conductive dysfunction to be a major cause of fluctuating hearing loss within the group. The incidence of sensori-neural loss was 16.6% of ears tested at final outcome. Results are discussed with reference to their implications for audiological management.

A mechanics model of the compression of cells with finite initial contact area.

The effect of intercellular bonding on the stress-strain behavior of soft plant tissue is considered. In our mechanical model, a conglomerate of identical cells is arranged in a regular array. Each cell is pressurized and bonded across flat contact areas with adjacent cells in the direction of the applied load. The cell wall is a finitely-deformed mechanical membrane bounding an incompressible fluid (the cytoplasm). A nonlinear elastic constitutive law is presented that describes data for apple parenchyma. Results show that intercellular bonding has a strong effect on the macroscopic properties of the whole tissue. A larger intercellular contact area increases tissue stiffness and magnifies the effect of initial turgor pressure on tissue stiffness.

Cell wall elastic constitutive laws and stress-strain behavior of plant vegetative tissue.

The appropriateness of several elastic constitutive laws for apple and potato cell walls is tested using uniform cell inflation data. Whole-tissue stress-strain behavior under uniaxial loading is predicted from an analysis of the compression of a conglomerate of cells in a simple arrangement.

Elastic constitutive laws for cow teat tissue undergoing finite deformations.

Five constitutive laws are investigated to model the effect of machine milking. A nonlinear least squares procedure is employed to estimate material constants from in vivo teat inflation data. An exponential form is found to be statistically adequate as a constitutive law, and is used to determine the mechanical stresses in teat tissue during finite deformations.

Kinetics of fiber digestion from in vitro gas production.

In vitro gas production, measured by computer-interfaced pressure sensors, was used to follow the digestion of a crystalline processed cellulose, a bacterial cellulose, and mixtures of these substrates by mixed ruminal bacteria. A first-order, substrate limited model (simple exponential with lag) and two bacterial growth models (logistic, Gompertz) were tested to fit these data. No single pool model gave an optimal fit to all substrates, but dual pool versions of both the logistic and Gompertz models fitted the data extremely well. Derivations of these models in the context of gas production are presented. The dual pool version of the exponential model commonly used to analyze fiber digestion was not able to reproduce the slope variations seen with mixed substrates. A modified dual pool logistic equation, with a single lag value, was selected to model the in vitro digestion of these substrates. The model was able to predict adequately both the input composition and the kinetic parameters for a defined mixture and gave a good fit (r2 > .995) to data from all the single and mixed substrates tested. This model may be useful for interpreting gas accumulation from natural feedstuffs.

Application of the Cornell Net Carbohydrate and Protein model for cattle consuming forages.

Accurate prediction of forage biological values and performance with animals fed forages requires accurately accounting for factors that influence animal requirements and feedstuff utilization. The Cornell Net Carbohydrate and Protein System (CNCPS) is an application model that uses a combination of mechanistic and empirical approaches to account for the effects of variation in animal factors and feed carbohydrate and protein fractions on animal performance. Thus, accurate animal and environmental descriptions, DMI, feed carbohydrate, and protein fractions and their digestion rates are required inputs. In 25 growth periods with calves fed high-forage diets, the CNCPS accounted for 74, 81, and 83%, respectively, of the variation in ADG predicted to be supported by the ME, metabolizable protein, and essential amino acid intake, the first-limiting of all three accounting for 81% of the variation with a -1% bias. Thus, the CNCPS can be used to accurately describe forage quality and the effects of changes in forage composition on animal performance. The model was sensitive to variations in NDF, CP, protein solubility, NDF and starch digestion rates, feed and microbial amino acid composition, maintenance protein requirement, body protein amino acid content, and the coefficient of efficiency of use of absorbed protein. Analysis of several trials indicates an improved efficiency of ME use with improved amino acid balances. Uses of the CNCPS discussed include interpreting, planning and applying research, teaching, developing tables of requirements and biological values for feeds, complex nutritional accounting, and predicting performance and profits.

Prediction of ruminal volatile fatty acids and pH within the net carbohydrate and protein system.

A steady-state model of the production, absorption, passage, and concentration of ruminal VFA and pH is developed from published literature data and is structured to use the feed descriptions and inputs from the net carbohydrate and protein system. Included are the effects of pH on growth rate and yield of structural and non-structural carbohydrate-fermenting bacteria; production of acetate, propionate, butyrate, lactate, and methane; conversion of lactate to VFA; ruminal absorption of acids; and prediction of ruminal pH from dietary measures and from ruminal buffering and acidity. The root mean square error of predicted total VFA concentration was 12 mM. Individual VFA fractions were inadequately predicted. In a review of literature data, effective NDF (eNDF) provided a better correlation with ruminal pH than forage or NDF. Digestion rate of NDF remained at normal levels above pH 6.2, which corresponds to a minimum eNDF of 20% of dietary DM. Further research is needed to determine the individual VFA produced from carbohydrate fractions at various pH, the appropriateness of partitioning the starch and pectin carbohydrate pool into slowly and rapidly degraded fractions, and the effect on microbial yield, total tract digestibility, and predicted energy values of feeds.

Common paediatric emergencies.

A medical emergency can be defined as an acute change in physiological or psychological status likely to result in death, disability, or delayed recovery without prompt and appropriate treatment. Clinical deterioration in children develops more rapidly than in adults, but with correct treatment the child has a greater capacity for quick and complete recovery.

Presentation of clinically suspected persistent chlamydial infection: a case series.

In vivo antimicrobial resistance has yet to be documented in Chlamydia trachomatis; however, there have been anecdotal reports of persistent infection. The purpose of this case series was to describe a group of patients who have persistent chlamydia infection despite adequate treatment and where re-infection was considered unlikely. Patients were selected using a clinical questionnaire. For inclusion patients had to have tested positive for C. trachomatis, at least twice, using a nucleic acid amplification test despite having been fully compliant with at least two rounds of recommended therapy and be deemed to be at low risk of re-infection. Patients were grouped into categories based on sexual behaviour. Twenty-eight patients are included in this case series; 46% declared no sexual contact since initial diagnosis (category 1), a further 36% declaring contact that was considered low risk of re-infection (categories 2-4); 61% showed signs and symptoms at initial presentation increasing to 75% at re-attendance. Thirty-nine percent of patients received azithromycin only while 48% received doxycycline also. This case series identifies patients with persistent chlamydia despite receiving treatment. There is a need for a case definition of clinical treatment failure, development of susceptibility testing methods and guidance on appropriate treatment for patients with persistent infection.