Profiling health professionals' personality traits, behaviour styles and emotional intelligence: a systematic review.

BACKGROUND: Non-cognitive traits have been theorised to predict characteristics, career choice and outcomes of health professionals and could represent a homogenous group. This study aims to profile and compare personality traits, behaviour styles and emotional intelligence of health practitioners across a variety of professions. METHODS: Empirical literature was systematically reviewed. A two-concept search strategy was applied to four databases (CINAHL, PubMed, Embase, ProQuest). Title/abstract and full text articles were screened against inclusion and exclusion criteria. Methodological quality was assessed using Mixed Methods Appraisal Tool. Data was synthesised narratively and meta-aggregated where feasible. RESULTS: Three hundred twenty-one studies representing 153 assessment tools of personality (n = 83 studies), behaviour (n = 8), and emotional intelligence (n = 62) were included. Most studies (n = 171) explored personality (medicine, nursing, nursing assistants, dentistry, allied health, paramedics), revealing variation in traits across professions. Behaviour styles were least measured with only ten studies exploring these across four health professions (nursing, medicine, occupational therapy, psychology). Emotional intelligence (n = 146 studies) varied amongst professions (medicine, nursing, dentistry, occupational therapy, physiotherapy, radiology) with all exhibiting average to above-average scores. CONCLUSION: Personality traits, behaviour styles and emotional intelligence are all key characteristics of health professionals reported in the literature. There is both heterogeneity and homogeneity within and between professional groups. The characterisation and understanding of these non-cognitive traits will aid health professionals to understand their own non-cognitive features and how these might be useful in predicting performance with potential to adapt these to enhance success within their chosen profession.

2,4-Dinitrophenol overdose - Everything old is new again.

A complete case example of a fatal 2,4-dinitrophenol (DNP) overdose involving a 23-year-old male is described. Included are details of not only the patient's presentation symptoms and treatment, but also the subsequent findings of the coronial investigation process including the autopsy, post-mortem computed tomography (PMCT) scanning and toxicological analysis and results. The patient presented with elevated temperature, heart rate and blood pressure. Multiple treatments were conducted to counteract these symptoms, however the patient died approximately 1.5 hours after hospital admission and some 4.5 hours after the DNP was initially consumed. Autopsy revealed the presence of cardiovascular disease that was contributory to death and post-mortem computed tomography showed evidence of decompositional intravascular gas in the neck, head, face, lower abdomen, heart and hepatic systems. Toxicological analysis was completed by protein precipitation with methanol and subsequent instrumental analysis by LC/MS/MS in negative ion mode. The antemortem blood specimen showed the presence of tadalafil, two anabolic steroids and a DNP concentration of 110 mg/kg which is consistent with other reported DNP fatalities. Despite the small amount of time between the antemortem specimen collection and death, the DNP concentration identified in the femoral blood post-mortem specimen was comparably low (5.5 mg/kg). DNP concentrations also reduced during an extended period of specimen storage prior to analysis indicating some instability in biological specimens even when refrigerated or frozen. DNP was found to be distributed primarily in the aqueous tissues (blood, vitreous, bile) rather than solid matrices (liver, kidney, muscle).

Metabolic engineering of Saccharomyces cerevisiae for the de novo production of psilocybin and related tryptamine derivatives.

Psilocybin is a tryptamine-derived psychoactive alkaloid found mainly in the fungal genus Psilocybe, among others, and is the active ingredient in so-called "magic mushrooms". Although its notoriety originates from its psychotropic properties and popular use as a recreational drug, clinical trials have recently recognized psilocybin as a promising candidate for the treatment of various psychological and neurological afflictions. In this work, we demonstrate the de novo biosynthetic production of psilocybin and related tryptamine derivatives in Saccharomyces cerevisiae by expression of a heterologous biosynthesis pathway sourced from Psilocybe cubensis. Additionally, we achieve improved product titers by supplementing the pathway with a novel cytochrome P450 reductase from P. cubensis. Further rational engineering resulted in a final production strain producing 627 ± 140 mg/L of psilocybin and 580 ± 276 mg/L of the dephosphorylated degradation product psilocin in triplicate controlled fed-batch fermentations in minimal synthetic media. Pathway intermediates baeocystin, nor norbaeocystin as well the dephosphorylated baeocystin degradation product norpsilocin were also detected in strains engineered for psilocybin production. We also demonstrate the biosynthetic production of natural tryptamine derivative aeruginascin as well as the production of a new-to-nature tryptamine derivative N-acetyl-4-hydroxytryptamine. These results lay the foundation for the biotechnological production of psilocybin in a controlled environment for pharmaceutical applications, and provide a starting point for the biosynthetic production of other tryptamine derivatives of therapeutic relevance.

A teaching protocol demonstrating the use of EasyClone and CRISPR/Cas9 for metabolic engineering of Saccharomyces cerevisiae and Yarrowia lipolytica.

We present a teaching protocol suitable for demonstrating the use of EasyClone and CRISPR/Cas9 for metabolic engineering of industrially relevant yeasts Saccharomyces cerevisiae and Yarrowia lipolytica, using ß-carotene production as a case study. The protocol details all steps required to generate DNA parts, transform and genotype yeast, and perform a phenotypic screen to determine ß-carotene production. The protocol is intended to be used as an instruction manual for a two-week practical course aimed at M.Sc. and Ph.D. students. The protocol details all necessary steps for students to engineer yeast to produce ß-carotene and serves as a practical introduction to the principles of metabolic engineering including the concepts of boosting native precursor supply and alleviating rate-limiting steps. It also highlights key differences in the metabolism and heterologous production capacity of two industrially relevant yeast species. The protocol is divided into daily experiments covering a two-week period and provides detailed instructions for every step meaning this protocol can be used 'as is' for a teaching course or as a case study for how yeast can be engineered to produce value-added molecules.

The relationship between motor proficiency and reading ability in Year 1 children: a cross-sectional study.

BACKGROUND: Movement and physical activity is crucial to brain development and has a positive impact on the ability to learn. With children spending a large portion of their time in the school setting, physical activity and the development of motor skills in this environment may not only impact their overall development but may also influence their learning. The aim of this study was to investigate relationships between motor proficiency and reading skills in Year-1 children. METHODS: A cross-sectional study with a single class of Year-1 students (n = 24: mean age = 6.07 ± 0.35 years). Assessments included; a) Process Assessment of the Learner (PAL-II) - Diagnostics for Reading and Writing (reading components only); b) Bruininks-Oseretsky-Test-of-Motor-Proficiency (BOT2); c) parent-reported height/weight and; d) Preparatory Year academic reports. The PAL-II was individually administered. The BOT2 was administered in small groups. Parent-reported height and weight measurements as well as Preparatory Year reports provided by the school Principal were obtained for each participant. RESULTS: Significant negative relationships were obtained between Year-1 children's total motor proficiency and silent reading ability (r = -.53 to -.59, p ≤ .01). While not significant for female students, the relationships were significant and strongly correlated for male students (r = -.738 to -.810, p ≤ .001). Children with low-average English grades demonstrated a strong positive relationship between motor proficiency and pre-reading skills, essential to functional reading (r = .664., p = .04 to r = .716, p = .04). CONCLUSION: For children with low-average English grades, the strong, positive relationship between motor proficiency and pre-reading skills suggests that this population may benefit from additional motor proficiency skills. Blending of motor skills within the English curriculum may benefit both of these sub-groups within a classroom environment.

Hereditary angioedema: death after a dental extraction.

Hereditary angioedema (HAE) is a group of three uncommon and potentially fatal conditions, each of which is transmitted as a somatic dominant trait. A recognized trigger to attacks is dental treatment, with tooth extraction frequently reported in the published work. The clinical symptoms may not manifest for many hours or even days after the procedure. We describe a recent case in Australia in which death resulted from HAE following dental extraction, and we discuss its post-mortem presentation and diagnosis, highlighting the need for dental practitioners to be aware of this condition.

Excessive by-product formation: A key contributor to low isobutanol yields of engineered Saccharomyces cerevisiae strains.

It is theoretically possible to engineer Saccharomyces cerevisiae strains in which isobutanol is the predominant catabolic product and high-yielding isobutanol-producing strains are already reported by industry. Conversely, isobutanol yields of engineered S. cerevisiae strains reported in the scientific literature typically remain far below 10% of the theoretical maximum. This study explores possible reasons for these suboptimal yields by a mass-balancing approach. A cytosolically located, cofactor-balanced isobutanol pathway, consisting of a mosaic of bacterial enzymes whose in vivo functionality was confirmed by complementation of null mutations in branched-chain amino acid metabolism, was expressed in S. cerevisiae. Product formation by the engineered strain was analysed in shake flasks and bioreactors. In aerobic cultures, the pathway intermediate isobutyraldehyde was oxidized to isobutyrate rather than reduced to isobutanol. Moreover, significant concentrations of the pathway intermediates 2,3-dihydroxyisovalerate and α-ketoisovalerate, as well as diacetyl and acetoin, accumulated extracellularly. While the engineered strain could not grow anaerobically, micro-aerobic cultivation resulted in isobutanol formation at a yield of 0.018±0.003 mol/mol glucose. Simultaneously, 2,3-butanediol was produced at a yield of 0.649±0.067 mol/mol glucose. These results identify massive accumulation of pathway intermediates, as well as overflow metabolites derived from acetolactate, as an important, previously underestimated contributor to the suboptimal yields of 'academic' isobutanol strains. The observed patterns of by-product formation is consistent with the notion that in vivo activity of the iron-sulphur-cluster-requiring enzyme dihydroxyacid dehydratase is a key bottleneck in the present and previously described 'academic' isobutanol-producing yeast strains.

Comparative assessment of native and heterologous 2-oxo acid decarboxylases for application in isobutanol production by Saccharomyces cerevisiae.

BACKGROUND: Decarboxylation of α-ketoisovalerate to isobutyraldehyde is a key reaction in metabolic engineering of Saccharomyces cerevisiae for isobutanol production with published studies relying on overexpression of either the native ARO10 gene or of the Lactococcus lactis kivD decarboxylase gene resulting in low enzymatic activities. Here, we compare relevant properties for isobutanol production of Aro10, KivD and an additional, less studied, L. lactis decarboxylase KdcA. RESULTS: To eliminate interference by native decarboxylases, each 2-oxo acid decarboxylase was overexpressed in a 'decarboxylase-negative' (pdc1Δ pdc5Δ pdc6Δ aro10Δ) S. cerevisiae background. Kinetic analyses in cell extracts revealed a superior V max/K m ratio of KdcA for α-ketoisovalerate and a wide range of linear and branched-chain 2-oxo acids. However, KdcA also showed the highest activity with pyruvate which, in engineered strains, can contribute to formation of ethanol as a by-product. Removal of native decarboxylase genes eliminated growth on valine as sole nitrogen source and subsequent complementation of this growth impairment by expression of each decarboxylase indicated that based on the increased growth rate, the in vivo activity of KdcA with α-ketoisovalerate was higher than that of KivD and Aro10. Moreover, during oxygen-limited incubation in the presence of glucose, strains expressing kdcA or kivD showed a ca. twofold higher in vivo rate of conversion of α-ketoisovalerate into isobutanol than an ARO10-expressing strain. Finally, cell extracts from cultures grown on different nitrogen sources revealed increased activity of constitutively expressed KdcA after growth on both valine and phenylalanine, while KivD and Aro10 activity was only increased after growth on phenylalanine suggesting a difference in the regulation of these enzymes. CONCLUSIONS: This study illustrates important differences in substrate specificity, enzyme kinetics and functional expression between different decarboxylases in the context of isobutanol production and identifies KdcA as a promising alternative decarboxylase not only for isobutanol production but also for other branched-chain and linear alcohols.

Functional expression of a heterologous nickel-dependent, ATP-independent urease in Saccharomyces cerevisiae.

In microbial processes for production of proteins, biomass and nitrogen-containing commodity chemicals, ATP requirements for nitrogen assimilation affect product yields on the energy producing substrate. In Saccharomyces cerevisiae, a current host for heterologous protein production and potential platform for production of nitrogen-containing chemicals, uptake and assimilation of ammonium requires 1 ATP per incorporated NH3. Urea assimilation by this yeast is more energy efficient but still requires 0.5 ATP per NH3 produced. To decrease ATP costs for nitrogen assimilation, the S. cerevisiae gene encoding ATP-dependent urease (DUR1,2) was replaced by a Schizosaccharomyces pombe gene encoding ATP-independent urease (ure2), along with its accessory genes ureD, ureF and ureG. Since S. pombe ure2 is a Ni(2+)-dependent enzyme and Saccharomyces cerevisiae does not express native Ni(2+)-dependent enzymes, the S. pombe high-affinity nickel-transporter gene (nic1) was also expressed. Expression of the S. pombe genes into dur1,2Δ S. cerevisiae yielded an in vitro ATP-independent urease activity of 0.44±0.01 µmol min(-1) mg protein(-1) and restored growth on urea as sole nitrogen source. Functional expression of the Nic1 transporter was essential for growth on urea at low Ni(2+) concentrations. The maximum specific growth rates of the engineered strain on urea and ammonium were lower than those of a DUR1,2 reference strain. In glucose-limited chemostat cultures with urea as nitrogen source, the engineered strain exhibited an increased release of ammonia and reduced nitrogen content of the biomass. Our results indicate a new strategy for improving yeast-based production of nitrogen-containing chemicals and demonstrate that Ni(2+)-dependent enzymes can be functionally expressed in S. cerevisiae.

An evaluation of clinical risk factors for estimating fracture risk in postmenopausal osteoporosis using an electronic medical record database.

SUMMARY: Many of the clinical risk factors used in fracture risk assessment (FRAX) calculator are available in electronic medical record (EMR) databases and are good sources of osteoporosis risk factor information. The EPIC EMR database showed a lower prevalence of FRAX risk factors and, consequently, proportion of patients who would be deemed "high risk." INTRODUCTION: The FRAX tool is underutilized for osteoporosis screening. Many of the clinical risk factors for FRAX may be available in EMR databases and may enable health systems to perform fracture risk assessments. We intended to identify variables in an EMR database for calculating FRAX score in a cohort of postmenopausal women, to estimate absolute fracture risk, and to determine the proportions of women whose absolute fracture risks exceed the National Osteoporosis Foundation (NOF) thresholds. METHODS: Our cohort was selected using an EMR database with demographic, inpatient, outpatient, and clinical information for female patients age≥50 in a family practice, internal medicine, or obstetrics/gynecology clinic in 2007-2008. The latest physician encounter was the index date. Variables, problem and medication lists, diagnosis codes, and histories from the EMR were used to populate the 11 clinical risk factor variables used in the FRAX. These risk factor prevalence and treatment-eligible proportions were compared to those of published epidemiology studies. RESULTS: The study included 345 patients. Mean (SD) 10-year risk for any major fracture was 11.1% (6.8) when bone mineral density (BMD) was used and 11.2% (6.5) when BMI was used. About 10.1% of the cohort exceeded the NOF's 20% major fracture risk threshold and 32.5% exceeded the NOF's 3% hip fracture risk threshold when BMD was used. Overall, the number of treatment-eligible patients was slightly lower when FRAX was calculated using BMD versus BMI (13.6 and 36.8%). CONCLUSION: Our cohort using EMR data most likely underestimated the mean 10-year probability of any major fracture compared to other cohorts in published literature. The difference may be in the nature of EMRs for supporting only passive data collection of risk factor information.

The cutest little baby face: a hormonal link to sensitivity to cuteness in infant faces.

We used computer image manipulation to develop a test of perception of subtle gradations in cuteness between infant faces. We found that young women (19-26 years old) were more sensitive to differences in infant cuteness than were men (19-26 and 53-60 years old). Women aged 45 to 51 years performed at the level of the young women, whereas cuteness sensitivity in women aged 53 to 60 years was not different from that of men (19-26 and 53-60 years old). Because average age at menopause is 51 years in Britain, these findings suggest the possible involvement of reproductive hormones in cuteness sensitivity. Therefore, we compared cuteness discrimination in pre- and postmenopausal women matched for age and in women taking and not taking oral contraceptives (progestogen and estrogen). Premenopausal women and young women taking oral contraceptives (which raise hormone levels artificially) were more sensitive to variations of cuteness than their respective comparison groups. We suggest that cuteness sensitivity is modulated by female reproductive hormones.

Geometric morphometric study of population variation in indigenous southern African crania.

Much of our understanding of population variation in southern Africa is derived from traditional morphometric research. In the search for new perspectives, this paper reports on new geometric morphometric data examining cranial variation in 12 modern human populations from southern Africa. In total, 298 male Bantu-speaking individuals were studied. In addition, a small Khoisan (Khoikhoi and San) series was also examined. The purpose of this study was to investigate Khoisan-Bantu morphological similarities and differences, and to examine variation within both the Bantu-speaking and Khoisan populations. The three-dimensional coordinates of 96 landmarks were analyzed, using the shape-analysis software morphologika. Interpopulation variation was examined by calculating Procrustes distances between groups; a cluster analysis was then used to summarize phenetic relationships. A principal components analysis explored the relationships between populations; shape differences were visualized and explored using three-dimensional rendered models, and further interpreted using thin-plate splines. Morphological differences are present within and between the crania of Bantu-speaking and Khoisan individuals. The Khoisan demonstrate features (e.g., a pentagonoid vault, more rounded forehead contour, and a small and less prognathic face) that clearly distinguish them from Bantu-speaking populations. Although southern African Bantu-speaking populations are clearly closely related, they show population-specific features (e.g., the crania of more southerly populations (Xhosa, Southern Sotho, and Zulu) are characteristically more brachycephalic and less prognathic). This study suggests that differential admixture with adjacent Khoisan peoples has contributed to diversity within southern African Bantu-speaking populations.

Three-dimensional technology for linear morphological studies: a re-examination of cranial variation in four southern African indigenous populations.

In order to compare linear dimensions made by traditional anthropometric techniques, and those obtained from three-dimensional coordinates, samples of four indigenous southern African populations were analysed. Linear measurements were obtained using mathematically transformed, three-dimensional landmark data on 207 male crania of Cape Nguni, Natal Nguni, Sotho and Shangaan. Univariate comparisons for accuracy of the transformed linear data were made with those in a traditional linear study by de Villiers (The Skull of the South African Negro: A Biometrical and Morphological Study. Witwatersrand University Press, Johannesburg) on similar samples and equivalent landmarks. Comparisons were not made with her Penrose (Ann Eugenics 18 (1954) 337) analysis as an apparently anomalous 'shape'-'size' statistic was found. The univariate comparisons demonstrated that accurate linear measurements could be derived from three-dimensional data, showing that it is possible to simultaneously obtain data for three-dimensional geometric 'shape' and linear interlandmark analyses. Using Penrose and canonical variates analyses of the transformed three-dimensional interlandmark measurements, similar population distances were found for the four indigenous southern African populations. The inter-population distance relationships took the form of three separated pairs of distances, with the within-pair distances very similar in size. The cranial features of the four populations were found to be overall very similar morphometrically. However the populations were each shown by CVA to have population specific features, and using discriminant analyses 50% or more of the individual crania (with the exception of the Sotho) could be referred to their correct populations.

Sexual dimorphism and discriminant function sexing in indigenous South African crania.

This study aimed to examine sexual dimorphism in, and to produce a practical discriminant function for determining the sex of indigenous, Bantu-speaking, South African crania. The types of data to be used were a small number of traditional, or mathematically transformed three-dimensional, linear measurements, comparable to those in use by most physical and forensic anthropologists. The samples to be examined, separately and pooled, were of the Cape Nguni, Natal Nguni and Sotho subgroups. In addition, three local populations ('tribes'--Zulu, Xhosa and Southern Sotho) within these subgroups were also studied. Univariate male/female ratios indicate significant sexual dimorphism in the pooled South African crania. Canonical variates analysis of the pooled sample showed that facial width is the strongest discriminating morphometric variable; cranial length and basi-bregmatic height are the next most significant features. Eight measurements derived from the three-dimensional data were used to produce a series of discriminant functions for sex determination in the pooled sample, for which an accuracy of 77-80% was attained. Analysis of the calvaria and face, separately, has shown that the sex of damaged material can be diagnosed with a reasonable degree of accuracy (75-76%). The new functions for the pooled indigenous South African sample provide improved sex discrimination accuracy compared to those obtained by employing the commonly utilised statistics of Giles & Elliot (1963), even when a modified sectioning point is used. Functions calculated for the separate local populations gave variable and fairly low improvements in sexing accuracy. As the subdivisions at all levels are at present quite rapidly disappearing in South Africa, for most purposes it is now best to simply apply the pooled data functions for sexing crania.

Color duplex sonographic findings in human vertebral arteries during cervical rotation.

PURPOSE: The aims of this study were to determine whether vertebral artery blood flow velocity changes during contralateral cervical rotation, to determine the extent of rotation necessary to affect the velocity, and to find direct evidence of stretching or compression of the vertebral arteries during cervical rotation. METHODS: Color duplex sonography was used to measure the blood flow velocities and diameters of the vertebral arteries in 20 patients. Measurements were taken with the patients' heads in the neutral position and at 10 degrees increments of contralateral neck rotation (determined using a cervical range of motion goniometer) to the end-range. RESULTS: The data showed no significant change in the mean blood flow velocity for the entire study population during cervical rotation. However, there were marked changes in the blood flow velocities in 7 vertebral arteries toward the end-range of rotation. No arteries displayed any evidence of major stretching of the arterial walls, although localized compression of 2 arteries was observed. CONCLUSIONS: The results of this study suggest that vertebral arteries are usually unaffected by contralateral cervical rotation and that Doppler sonography may provide an indirect assessment of mechanical stresses to the arterial wall.

Relative sensitivity of Tc-99m WBC versus In-111 WBC in a patient with Crohn disease and steroid use.

Numerous studies have shown that chemotaxis is affected by certain antibiotics and steroids. The authors present the case of a patient with Crohn disease relapse with multiple small-bowel fistulae and mesenteric abscesses. Whereas the Tc-99m WBC scan failed to show the intra-abdominal inflammatory foci, an In-111 WBC scan performed within a week delineated the abscesses very well, and these were later confirmed at surgery. This case is presented not only to illustrate the relative sensitivities of a Tc-99m WBC versus an In-111 WBC scan, but also to discuss the impediment to polymorphonuclear chemotaxis by steroids, which may be a contributory factor to the sensitivities of the different radiopharmaceuticals selected for detection of intra-abdominal septic foci.

Relative sensitivity of Tc-99m WBC versus In-111 WBC in a patient with Crohn's disease on steroids.

Numerous studies have shown that chemotaxis is affected by certain antibiotics and steroids. A patient had Crohn's disease in relapse with multiple small bowel fistulae and mesenteric abscesses. Although the Tc-99m WBC scan did not show the intra-abdominal inflammatory foci, an In-111 WBC scan performed within a week delineated the abscesses and these were later confirmed at surgery. This case is being presented not only to show the relative sensitivities of a Tc-99m WBC vs. an In-111 WBC scan, but also to discuss the impediment to polymorphonuclear leukocyte chemotaxis by steroids, which may be a contributory factor to the sensitivities of the different radiopharmaceuticals selected for detection of intra-abdominal septic foci.

Adaptation in the vertebral column: a comparative study of patterns of metameric variation in mice and men.

In this paper we examine metamerism in the vertebral column of certain mammals from the perspectives of development and adaptation. To this end we examine the patterns of metameric variation of dimensions of the neural (vertebral) canal, vertebral body and spinous process in man and inbred strains of mice. The data from inbred strains of mice indicate that variability in dimensions within a strain reflects the temporal ordering and nature of developmental influences on vertebral morphogenesis. Differences between strains parallel the within-strain findings. These findings are attributed to somatic and neural influences on morphogenesis. Comparisons between mice and man indicate that these same influences can be invoked to explain and interpret the mosaic nature of vertebral column evolution. These findings lead us to conclude that different vertebral elements and levels are subject to different interactions of evolutionary and morphogenetic influences. The study of these influences and their interactions should prove fruitful in developing an understanding of the relationship between adaptation, development, growth and function in the skeleton generally.