A giant parastomal hernia in a high risk patient: preparation to make surgery worthwhile.

BACKGROUND: Parastomal hernia (PH) is a frequent and well-known complication of stoma placement. Most PHs are asymptomatic and those who are not are usually well tolerated by patients. Thus, watchful waiting is a common practice. Nevertheless, this management policy is associated with a risk of complications and with an inevitable risk of hernia enlargement, complicating its subsequent surgery. Moreover, PH can affect body image and alter the quality of life. METHODS: We herein present a complex case of a 67-year-old man with multiple comorbidities, who presented with an uncommon, below knee, giant PH, which was managed in a two-steps surgery by a multidisciplinary team comprising a senior digestive surgeon, experienced in abdominal wall repair, cardiologist, pulmonologist, anesthesiologist, psychiatrist, dietitian and physiotherapist. RESULT: Treatment started with 8 months hygienic measures comprising smoking cessation, strict control of diabetes and hypertension, a strict diet, and a physical fitness and pulmonary rehabilitation program. Two steps surgery started by colostomy transposition along with pre-peritoneal mesh repair to the right side and the second step consisted of a prophylactic PH repair using a Key-hole preperitoneal polypropelene mesh. CONCLUSION: PH is a common and sometimes inevitable complication of stoma creation. The success achieved by operating a heavily morbid patient, is only possible through the combined efforts of the multidisciplinary team and a preoperative rigorous management.

[Specialised educator and socio-cultural animator in a cancer centre]. / Éducateur spécialisé et animateur socioculturel en centre de lutte contre le cancer.

The multidisciplinary teams dedicated to adolescents and young adults in cancer centres include professionals from special education or socio-cultural activities. These two professions are often unknown in the hospital environment. The educational approach implemented and the support offered by these professionals differ in their objectives, but have the common goal of improving the patient's well-being.

Immunoglobulin G (IgG) and IgG subclass reference intervals in children, using Optilite® reagents.

BACKGROUND: Immunoglobulin G (IgG) and IgG subclass assays are indicated in patients with suspected primary immunodeficiency (PID). Commercially available assays for IgG subclass determination are calibrated against various preparations, and so specific reference values are required for each of them. Using Optilite® reagents from The Binding Site Group Ltd., we sought to determine the pediatric IgG and IgG subclass reference intervals with respect to the ERM-DA470k certified reference material. METHODS: Levels of IgG and IgG subclasses were analyzed in serum samples collected from a large cohort of PID-free children and adolescents. Reference intervals were calculated for previously published age groups (6-12 months, 12-18 months, 18 months-2 years, 2-3 years, 3-4 years, 4-6 years, 6-9 years, 9-12 years and 12-18 years), according to the Clinical and Laboratory Standards Institute's C28-A3c protocol. RESULTS: A total of 456 serum samples were analyzed. The correlation between the total IgG and the sum of the IgG subclasses was good (r2=0.96). No statistically significant gender-specific differences were observed. Our results for the changes over time in IgG and IgG subclass levels are consistent with previous reports. The differences between our lower/upper reference limits and those in the literature are probably due to variations in calibration. CONCLUSIONS: Our present results provide a reliable basis for the diagnosis of PIDs in childhood and for the accreditation of laboratories using Optilite® immunoturbidimetric reagents for IgG subclass measurement. Laboratory scientists and clinicians should be aware of the need for manufacturer-specific IgG subclass reference intervals.

Promoting the place of the allied health professions in clinical research.

Clinical research is of major importance to today's society, as scientific evidence is increasingly demanded as a basis for progress, whether this involves developing new healthcare products, improving clinical practice and care protocols or progress in prevention. Clinical research therefore requires professionals who are both experienced and increasingly well trained. Against this background, allied health professionals are becoming involved more and more, both as team members supporting clinical research projects and as managers or coordinators of projects in their own field. Clinical research activities provide an ideal opportunity for continuing professional development. All of this means that the professional skills of the allied health professions and clinical research support professions must be enhanced, their role promoted in the context of lecturer status and in the longer term, their status recognised by the supervisory authorities.

Impact of intraspecific variation in insect microbiomes on host phenotype and evolution.

Microbes can be an important source of phenotypic plasticity in insects. Insect physiology, behaviour, and ecology are influenced by individual variation in the microbial communities held within the insect gut, reproductive organs, bacteriome, and other tissues. It is becoming increasingly clear how important the insect microbiome is for insect fitness, expansion into novel ecological niches, and novel environments. These investigations have garnered heightened interest recently, yet a comprehensive understanding of how intraspecific variation in the assembly and function of these insect-associated microbial communities can shape the plasticity of insects is still lacking. Most research focuses on the core microbiome associated with a species of interest and ignores intraspecific variation. We argue that microbiome variation among insects can be an important driver of evolution, and we provide examples showing how such variation can influence fitness and health of insects, insect invasions, their persistence in new environments, and their responses to global environmental changes. A and B are two stages of an individual or a population of the same species. The drivers lead to a shift in the insect associated microbial community, which has consequences for the host. The complex interplay of those consequences affects insect adaptation and evolution and influences insect population resilience or invasion.

Intrauterine insemination with donor sperm: only the number of motile spermatozoa inseminated influences both pregnancy and live-birth rates.

Intrauterine insemination with donor sperm (IUI-D) is an assisted reproductive technology (ART) offered to couples with definitive male infertility or risk of genetic disease transmission. Here, we sought to evaluate our practice in IUI-D and identify factors that influenced the success rate. We performed a retrospective, single-center study of all IUI-D procedures performed at Lille University Medical Center (Lille, France) between January 1, 2007, and December 31, 2017. Single and multivariate analyses with a mixed logistic model were used to identify factors associated with clinical pregnancies and live births. We included 322 couples and 1179 IUI-D procedures. The clinical pregnancy rate was 23.5%, and the live birth rate was 18.9% per IUI-D. In a multivariate analysis, the women's age was negatively associated with the live birth rate. The number of motile spermatozoa inseminated was the only factor associated with both clinical pregnancies and live births, with a chosen threshold of 0.75 million. The clinical pregnancy and live birth rates were, respectively, 17.3% and 13.0% below the number of motile spermatozoa inseminated threshold and 25.9% and 21.0% at or above the threshold (all P = 0.005). The number of motile spermatozoa inseminated was the only factor that significantly influenced both pregnancies and live-birth rates after IUI-D. Indeed, below a threshold of 0.75 million motile spermatozoa inseminated, those rates were significantly lower. Application of this number of motile spermatozoa inseminated threshold may help centers to allocate donations more effectively while maintaining reasonable waiting times for patients.

[Care until the end of life]. / Des soins jusqu'à la fin de la vie.

When there is no more hope of a cure during a child's treatment, the curative period makes way for a palliative phase through to the last moments of the child's life. This phase is both difficult and fundamental for the child and his/her family, as well as for the caregivers, who must continue to provide care without any hope of curing the child. This phase determines how the period of mourning which follows the loss of a loved one is experienced, particularly for the family.

[A new approach to cancer in 15-25 year olds]. / Une nouvelle dynamique face au cancer des 15-25 ans.

The specificity of adolescence and early adulthood with people suffering from cancer requires adapted and specific care by nursing teams. The paediatric oncology and medical oncology teams at the Institut Curie in Paris, faced with such issues, have been working more closely together to create a special unit for 15-25 year olds.

Ecological and pest-management implications of sex differences in scarab landing patterns on grape vines.

BACKGROUND: Melolonthinae beetles, comprising different white grub species, are a globally-distributed pest group. Their larvae feed on roots of several crop and forestry species, and adults can cause severe defoliation. In New Zealand, the endemic scarab pest Costelytra zealandica (White) causes severe defoliation on different horticultural crops, including grape vines (Vitis vinifera). Understanding flight and landing behaviours of this pest can help inform pest management decisions. METHODS: Adult beetles were counted and then removed from 96 grape vine plants from 21:30 until 23:00 h, every day from October 26 until December 2, during 2014 and 2015. Also, adults were removed from the grape vine foliage at dusk 5, 10, 15, 20 and 25 min after flight started on 2015. Statistical analyses were performed using generalised linear models with a beta-binomial distribution to analyse proportions and with a negative binomial distribution for beetle abundance. RESULTS: By analysing C. zealandica sex ratios during its entire flight season, it is clear that the proportion of males is higher at the beginning of the season, gradually declining towards its end. When adults were successively removed from the grape vines at 5-min intervals after flight activity begun, the mean proportion of males ranged from 6-28%. The male proportion suggests males were attracted to females that had already landed on grape vines, probably through pheromone release. DISCUSSION: The seasonal and daily changes in adult C. zealandica sex ratio throughout its flight season are presented for the first time. Although seasonal changes in sex ratio have been reported for other melolonthines, changes during their daily flight activity have not been analysed so far. Sex-ratio changes can have important consequences for the management of this pest species, and possibly for other melolonthines, as it has been previously suggested that C. zealandica females land on plants that produce a silhouette against the sky. Therefore, long-term management might evaluate the effect of different plant heights and architecture on female melolonthine landing patterns, with consequences for male distribution, and subsequently overall damage within horticultural areas.

Percentage-based Author Contribution Index: a universal measure of author contribution to scientific articles.

BACKGROUND: Deciphering the amount of work provided by different co-authors of a scientific paper has been a recurrent problem in science. Despite the myriad of metrics available, the scientific community still largely relies on the position in the list of authors to evaluate contributions, a metric that attributes subjective and unfounded credit to co-authors. We propose an easy to apply, universally comparable and fair metric to measure and report co-authors contribution in the scientific literature. METHODS: The proposed Author Contribution Index (ACI) is based on contribution percentages provided by the authors, preferably at the time of submission. Researchers can use ACI to compare the contributions of different authors, describe the contribution profile of a particular researcher or analyse how contribution changes through time. We provide such an analysis based on contribution percentages provided by 97 scientists from the field of ecology who voluntarily responded to an online anonymous survey. RESULTS: ACI is simple to understand and to implement because it is based solely on percentage contributions and the number of co-authors. It provides a continuous score that reflects the contribution of one author as compared to the average contribution of all other authors. For example, ACI(i) = 3, means that author i contributed three times more than what the other authors contributed on average. Our analysis comprised 836 papers published in 2014-2016 and revealed patterns of ACI values that relate to career advancement. CONCLUSION: There are many examples of author contribution indices that have been proposed but none has really been adopted by scientific journals. Many of the proposed solutions are either too complicated, not accurate enough or not comparable across articles, authors and disciplines. The author contribution index presented here addresses these three major issues and has the potential to contribute to more transparency in the science literature. If adopted by scientific journals, it could provide job seekers, recruiters and evaluating bodies with a tool to gather information that is essential to them and cannot be easily and accurately obtained otherwise. We also suggest that scientists use the index regardless of whether it is implemented by journals or not.

Can ecosystem-scale translocations mitigate the impact of climate change on terrestrial biodiversity? Promises, pitfalls, and possibilities: Ecosystem-scale translocations.

Because ecological interactions are the first components of the ecosystem to be impacted by climate change, future forms of threatened-species and ecosystem management should aim at conserving complete, functioning communities rather than single charismatic species. A possible way forward is the deployment of ecosystem-scale translocation (EST), where above- and below-ground elements of a functioning terrestrial ecosystem (including vegetation and topsoil) are carefully collected and moved together. Small-scale attempts at such practice have been made for the purpose of ecological restoration. By moving larger subsets of functioning ecosystems from climatically unstable regions to more stable ones, EST could provide a practical means to conserve mature and complex ecosystems threatened by climate change. However, there are a number of challenges associated with EST in the context of climate change mitigation, in particular the choice of donor and receptor sites. With the aim of fostering discussion and debate about the EST concept, we  1) outline the possible promises and pitfalls of EST in mitigating the impact of climate change on terrestrial biodiversity and 2) use a GIS-based approach to illustrate how  potential source and receptor sites, where EST could be trialed and evaluated globally, could be identified.

Preference of a native beetle for "exoticism," characteristics that contribute to invasive success of Costelytra zealandica (Scarabaeidae: Melolonthinae).

Widespread replacement of native ecosystems by productive land sometimes results in the outbreak of a native species. In New Zealand, the introduction of exotic pastoral plants has resulted in diet alteration of the native coleopteran species, Costelytra zealandica (White) (Scarabaeidae) such that this insect has reached the status of pest. In contrast, C. brunneum (Broun), a congeneric species, has not developed such a relationship with these 'novel' host plants. This study investigated the feeding preferences and fitness performance of these two closely related scarab beetles to increase fundamental knowledge about the mechanisms responsible for the development of invasive characteristics in native insects. To this end, the feeding preference of third instar larvae of both Costelytra species was investigated using an olfactometer device, and the survival and larval growth of the invasive species C. zealandica were compared on native and exotic host plants. Costelytra zealandica, when sampled from exotic pastures, was unable to fully utilise its ancestral native host and showed higher feeding preference and performance on exotic plants. In contrast, C. zealandica sampled from native grasslands did not perform significantly better on either host and showed similar feeding preferences to C. brunneum, which exhibited no feeding preference. This study suggests the possibility of strong intraspecific variation in the ability of C. zealandica to exploit native or exotic plants, supporting the hypothesis that such ability underpins the existence of distinct host-races in this species.

The PGI enzyme system and fitness response to temperature as a measure of environmental tolerance in an invasive species.

In the field of invasion ecology, the determination of a species' environmental tolerance, is a key parameter in the prediction of its potential distribution, particularly in the context of global warming. In poikilothermic species such as insects, temperature is often considered the most important abiotic factor that affects numerous life-history and fitness traits through its effect on metabolic rate. Therefore the response of an insect to challenging temperatures may provide key information as to its climatic and therefore spatial distribution. Variation in the phosphoglucose-6-isomerase (PGI) metabolic enzyme-system has been proposed in some insects to underlie their relative fitness, and is recognised as a key enzyme in their thermal adaptation. However, in this context it has not been considered as a potential mechanism contributing to a species invasive cability. The present study aimed to compare the thermal tolerance of an invasive scarabaeid beetle, Costelytra zealandica (White) with that of the closely related, and in part sympatrically occurring, congeneric non-invasive species C. brunneum (Broun), and to consider whether any correlation with particular PGI genotypes was apparent. Third instar larvae of each species were exposed to one of three different temperatures (10, 15 and 20 °C) over six weeks and their fitness (survival and growth rate) measured and PGI phenotyping performed via cellulose acetate electrophoresis. No consistent relationship between PGI genotypes and fitness was detected, suggesting that PGI may not be contributing to the invasion success and pest status of C. zealandica.

Invasion success of a scarab beetle within its native range: host range expansion versus host-shift.

Only recently has it been formally acknowledged that native species can occasionally reach the status of 'pest' or 'invasive species' within their own native range. The study of such species has potential to help unravel fundamental aspects of biological invasions. A good model for such a study is the New Zealand native scarab beetle, Costelytra zealandica (White), which even in the presence of its natural enemies has become invasive in exotic pastures throughout the country. Because C. zealandica still occurs widely within its native habitat, we hypothesised that this species has only undergone a host range expansion (ability to use equally both an ancestral and new host) onto exotic hosts rather than a host shift (loss of fitness on the ancestral host in comparison to the new host). Moreover, this host range expansion could be one of the main drivers of its invasion success. In this study, we investigated the fitness response of populations of C. zealandica from native and exotic flora, to several feeding treatments comprising its main exotic host plant as well as one of its ancestral hosts. Our results suggest that our initial hypothesis was incorrect and that C. zealandica populations occurring in exotic pastures have experienced a host-shift rather than simply a host-range expansion. This finding suggests that an exotic plant introduction can facilitate the evolution of a distinct native host-race, a phenomenon often used as evidence for speciation in phytophagous insects and which may have been instrumental to the invasion success of C. zealandica.

Spider: an R package for the analysis of species identity and evolution, with particular reference to DNA barcoding.

Spider: SPecies IDentity and Evolution in R is a new R package implementing a number of useful analyses for DNA barcoding studies and associated research into species delimitation and speciation. Included are functions essential for generating important summary statistics from DNA barcode data, assessing specimen identification efficacy, and for testing and optimizing divergence threshold limits. In terms of investigating evolutionary and taxonomic questions, techniques for assessing diagnostic nucleotides and probability of reciprocal monophyly are also provided. Additionally, a sliding window function offers opportunities to analyse information across a gene, essential for marker design in degraded DNA studies. Spider capitalizes on R's extensible ethos and offers an integrated platform ideal for the analysis of both nucleotide and morphological data. The program can be obtained from the comprehensive R archive network (CRAN, http://cran.r-project.org) and from the R-Forge package development site (http://spider.r-forge.r-project.org/).

Sliding window analyses for optimal selection of mini-barcodes, and application to 454-pyrosequencing for specimen identification from degraded DNA.

DNA barcoding remains a challenge when applied to diet analyses, ancient DNA studies, environmental DNA samples and, more generally, in any cases where DNA samples have not been adequately preserved. Because the size of the commonly used barcoding marker (COI) is over 600 base pairs (bp), amplification fails when the DNA molecule is degraded into smaller fragments. However, relevant information for specimen identification may not be evenly distributed along the barcoding region, and a shorter target can be sufficient for identification purposes. This study proposes a new, widely applicable, method to compare the performance of all potential 'mini-barcodes' for a given molecular marker and to objectively select the shortest and most informative one. Our method is based on a sliding window analysis implemented in the new R package SPIDER (Species IDentity and Evolution in R). This method is applicable to any taxon and any molecular marker. Here, it was tested on earthworm DNA that had been degraded through digestion by carnivorous landsnails. A 100 bp region of 16 S rDNA was selected as the shortest informative fragment (mini-barcode) required for accurate specimen identification. Corresponding primers were designed and used to amplify degraded earthworm (prey) DNA from 46 landsnail (predator) faeces using 454-pyrosequencing. This led to the detection of 18 earthworm species in the diet of the snail. We encourage molecular ecologists to use this method to objectively select the most informative region of the gene they aim to amplify from degraded DNA. The method and tools provided here, can be particularly useful (1) when dealing with degraded DNA for which only small fragments can be amplified, (2) for cases where no consensus has yet been reached on the appropriate barcode gene, or (3) to allow direct analysis of short reads derived from massively parallel sequencing without the need for bioinformatic consolidation.