From ornament to armament or loss of function? Breeding plumage acquisition in a genetically monogamous bird

The evolution of conspicuous male traits is thought to be driven by female mate choice or male-male competition. These two mechanisms are often viewed as distinct processes, with most studies focusing on female choice. However, both mechanisms of sexual selection can act simultaneously on the same trait (i.e., dual function) and/or interact in a synergistic or conflicting way. Dual-function traits are commonly assumed to originate through male-male competition before being used in female choice; yet, most studies focusing on such traits could not determine the direction of change, lacking phylogenetic information. We investigated the role of conspicuous male seasonal plumage in male-male competitive interactions in the purple-crowned fairy-wren Malurus coronatus, a cooperatively breeding bird. Male breeding plumage in most Malurus species is selected by female choice through extra-pair mate choice, but unlike its congeners, M. coronatus is genetically monogamous, and females do not seem to choose males based on breeding plumage acquisition. Our study shows that, within groups, subordinate males that were older, and therefore higher-ranked in the queue for breeder position inheritance, produced a more complete breeding plumage. In line with this, subordinate males that were older and/or displayed a more complete breeding plumage were more successful in competitively acquiring a breeder position. A role as a signal of competitive ability was experimentally confirmed by presenting models of males: in breeding colours, these received more aggression from resident breeder males than in nonbreeding colours, but elicited limited response from females, consistent with competitors in breeding plumage being perceived as a bigger threat to the breeder male. The role of the conspicuous breeding plumage in mediating male-male interactions might account for its presence in this genetically monogamous species. As phylogenetic reconstructions suggest a past female choice function in M. coronatus, this could represent a sexual trait that shifted functions, or a dual-function trait that lost one function. These evolutionary scenarios imply that intra- and intersexual functions of ornaments may be gained or lost independently and offer new perspectives in understanding the complex dynamics of sexual selection.

Spillover of avian haemosporidian parasites (Haemosporidia: Plasmodium) and death of captive psittacine species

CASE REPORT

During February 2014, a yellow-tailed black cockatoo (Calyptorhynchus funereus) and glossy black cockatoo (C. lathami) housed in aviaries on a property in Wamuran, Queensland, were submitted for postmortem. Histopathology and molecular diagnostics demonstrated the presence of Plasmodium sp. infection. The Plasmodium isolate identified has previously only been reported as infecting a healthy wild rufous fantail (Rhipidura rufifrons) in Australia.

CONCLUSION

To the authors' knowledge, these are the first reported cases of Plasmodium in Calyptorhynchus. We hypothesised that the maintenance of these two cockatoo species in ground level aviaries in a low-altitude geographic zone resulted in exposure of birds to mosquito vectors of endemic avian Plasmodium. Black cockatoos roost and forage in the mid to high canopy of forests in the wild, outside the likely spatiotemporal distribution of relevant haemosporidian vectors. It is therefore likely that these birds had immunological naivety and susceptibility to infection with Plasmodium circulating in wild passerines.

Diabetes Empowerment Council: Integrative Pilot Intervention for Transitioning Young Adults With Type 1 Diabetes

Background

The transition of young adults with type 1 diabetes (T1D) from pediatric to adult care is challenging and frequently accompanied by worsening of diabetes-related health. To date, there are no reports which prospectively assess the effects of theory-based psycho-behavioral interventions during the transition period neither on glycemic control nor on psychosocial factors that contribute to poor glycemic control. Therefore, the overall aim of this study was to develop and pilot test an integrative group intervention based on the underlying principles of self-determination theory (SDT), in young adults with T1D.

Methods

Fifty-one young adults with T1D participated in an education and case management-based transition program, of which 9 took part in the Diabetes Empowerment Council (DEC), a 12-week holistic, multimodality facilitated group intervention consisting of "council" process based on indigenous community practices, stress-reduction guided imagery, narrative medicine modalities, simple ritual, and other integrative modalities. Feasibility, acceptability, potential mechanism of effects, and bio-behavioral outcomes were determined using mixed qualitative and quantitative methods.

Results

The intervention was highly acceptable to participants, though presented significant feasibility challenges. Participants in DEC showed significant reductions in perceived stress and depression, and increases in general well-being relative to other control participants. Reduction in perceived stress, independent of intervention group, was associated with reductions in hemoglobin A1C. A theoretical model explaining the effects of the intervention included the promotion of relatedness and autonomy support, 2 important aspects of SDT.

Conclusions

The DEC is a promising group intervention for young adults with T1D going through transition to adult care. Future investigations will be necessary to resolve feasibility issues, optimize the multimodality intervention, determine full intervention effects, and fully test the role of the underlying theoretical model of action.ClinicalTrials.gov Registration Number NCT02807155; Registration date: June 15, 2016 (retrospectively registered).

Diagnosis of Glaucoma by Indirect Classifiers

Objectives: Demonstration of the applicability of a framework called indirect classification to the example of glaucoma classification. Indirect classification combines medical a priori knowledge and statistical classification methods. The method is compared to direct classification approaches with respect to the estimated misclassification error.

Methods: Indirect classification is applied using classification trees and the diagnosis of glaucoma. Misclassification errors are reduced by bootstrap aggregation. As direct classification methods linear discriminant analysis, classification trees and bootstrap aggregated classification trees are utilized in the problem of glaucoma diagnosis. Misclassification rates are estimated via 10-fold cross-validation.

Results: Indirect classification techniques reduce the misclassification error in the context of glaucoma classification compared to direct classification methods.

Conclusions: Embedding a priori knowledge into statistical classification techniques can improve misclassification results. Indirect classification offers a framework to realize this combination.

Conspicuous plumage colours are highly variable

Elaborate ornamental traits are often under directional selection for greater elaboration, which in theory should deplete underlying genetic variation. Despite this, many ornamental traits appear to remain highly variable and how this essential variation is maintained is a key question in evolutionary biology. One way to address this question is to compare differences in intraspecific variability across different types of traits to determine whether high levels of variation are associated with specific trait characteristics. Here we assess intraspecific variation in more than 100 plumage colours across 55 bird species to test whether colour variability is linked to their level of elaboration (indicated by degree of sexual dichromatism and conspicuousness) or their condition dependence (indicated by mechanism of colour production). Conspicuous colours had the highest levels of variation and conspicuousness was the strongest predictor of variability, with high explanatory power. After accounting for this, there were no significant effects of sexual dichromatism or mechanisms of colour production. Conspicuous colours may entail higher production costs or may be more sensitive to disruptions during production. Alternatively, high variability could also be related to increased perceptual difficulties inherent to discriminating highly elaborate colours. Such psychophysical effects may constrain the exaggeration of animal colours.

Comparison of Classifiers Applied to Confocal Scanning Laser Ophthalmoscopy Data

Objectives: Comparison of classification methods using data of one clinical study. The tuning of hyperparameters is assessed as part of the methods by nested-loop cross-validation.

Methods: We assess the ability of 18 statistical and machine learning classifiers to detect glaucoma. The training data set is one case-control study consisting of confocal scanning laser ophthalmoscopy measurement values from 98 glaucoma patients and 98 healthy controls. We compare bootstrap estimates of the classification error by the Wilcoxon signed rank test and box-plots of a bootstrap distribution of the estimate.

Results: The comparison of out-of-bag bootstrap estimators of classification errors is assessed by Spearman’s rank correlation, Wilcoxon signed rank tests and box-plots of a bootstrap distribution of the estimate. The classification methods random forests 15.4%, support vector machines 15.9%, bundling 16.3% to 17.8%, and penalized discriminant analysis 16.8% show the best results.

Conclusions: Using nested-loop cross-validation we account for the tuning of hyperparameters and demonstrate the assessment of different classifiers. We recommend a block design of the bootstrap simulation to allow a statistical assessment of the bootstrap estimates of the misclassification error. The results depend on the data of the clinical study and the given size of the bootstrap sample.

Low-field magnetic resonance imaging offers potential for measuring tibial component migration

BACKGROUND

Roentgen stereophotogrammetric analysis (RSA) is used to measure early prosthetic migration and to predict future implant failure. RSA has several disadvantages, such as the need for perioperatively inserted tantalum markers. Therefore, this study evaluates low-field MRI as an alternative to RSA. The use of traditional MRI with prostheses induces disturbing metal artifacts which are reduced by low-field MRI. The purpose of this study is to assess the feasibility to use low-field (0.25 Tesla) MRI for measuring the precision of zero motion. This was assessed by calculating the virtual prosthetic motion of a zero-motion prosthetic reconstruction in multiple scanning sessions. Furthermore, the effects of different registration methods on these virtual motions were tested.

RESULTS

The precision of zero motion for low-field MRI was between 0.584 mm and 1.974 mm for translation and 0.884° and 3.774° for rotation. The manual registration method seemed most accurate, with μ ≤ 0.13 mm (σ ≤ 0.931 mm) for translation and μ ≤ 0.15° (σ ≤ 1.63°) for rotation.

CONCLUSION

Low-field MRI is not yet as precise as today's golden standard (marker based RSA) as reported in the literature. However, low-field MRI is feasible of measuring the relative position of bone and implant with comparable precision as obtained with marker-free RSA techniques. Of the three registration methods tested, manual registration was most accurate. Before starting clinical validation further research is necessary and should focus on improving scan sequences and registration algorithms.

Genome sequence of an Australian strain of canid alphaherpesvirus 1

OBJECTIVE

Characterisation of a complete genome sequence of an Australian strain of canid alphaherpesvirus 1 (CHV-1) and its phylogenetic relationship with other varicellovirus species.

METHODS

Standard pathology and PCR methods were used to initially detect herpesvirus in hepatic tissue from an infected 4-week-old Labrador Retriever puppy. The complete CHV-1 genome was sequenced using next-generation sequencing technology followed by de novo and reference assembly, and genome annotation.

RESULTS

The CHV-1 genome was 125 kbp in length and contained 74 predicted open reading frames encoding functional proteins, all of which have counterparts in other alphaherpesviruses. Phylogenetic analysis using the DNA polymerase gene revealed that the newly sequenced CHV-1 clustered with canid alphaherpesvirus isolated from the UK and shared a 99% overall nucleotide sequence similarity.

CONCLUSION

This is the first complete genome of an Australian strain of CHV-1, which will contribute to our understanding of the genetics and evolution of herpesvirus.

Bright birds are cautious: seasonally conspicuous plumage prompts risk avoidance by male superb fairy-wrens

Increased predation risk is considered a cost of having conspicuous colours, affecting the anti-predator behaviour of colourful animals. However, this is difficult to test, as individual factors often covary with colour and behaviour. We used alarm call playback and behavioural observations to assess whether individual birds adjust their response to risk according to their plumage colour. Male superb fairy-wrens (Malurus cyaneus) change from a dull brown to conspicuous blue plumage each year, allowing the behaviour of different coloured birds to be compared while controlling for within-individual effects. Because the timing of colour change varies among males, blue and brown birds can also be compared at the same time of year, controlling for seasonal effects on behaviour. While blue, fairy-wrens fled more often in response to alarm calls, and took longer to emerge from cover. Blue fairy-wrens also spent more time foraging in cover and being vigilant. Group members appeared to benefit from the presence of blue males, as they reduced their response to alarms, and allocated less time to sentinel behaviour when a blue male was close by. We suggest that fairy-wrens perceive themselves to be at a higher risk of predation while in conspicuous plumage and adjust their behaviour accordingly.

Effects of Sotagliflozin Added to Insulin in Patients with Type 1 Diabetes

BACKGROUND

In most patients with type 1 diabetes, adequate glycemic control is not achieved with insulin therapy alone. We evaluated the safety and efficacy of sotagliflozin, an oral inhibitor of sodium-glucose cotransporters 1 and 2, in combination with insulin treatment in patients with type 1 diabetes.

METHODS

In this phase 3, double-blind trial, which was conducted at 133 centers worldwide, we randomly assigned 1402 patients with type 1 diabetes who were receiving treatment with any insulin therapy (pump or injections) to receive sotagliflozin (400 mg per day) or placebo for 24 weeks. The primary end point was a glycated hemoglobin level lower than 7.0% at week 24, with no episodes of severe hypoglycemia or diabetic ketoacidosis after randomization. Secondary end points included the change from baseline in glycated hemoglobin level, weight, systolic blood pressure, and mean daily bolus dose of insulin.

RESULTS

A significantly larger proportion of patients in the sotagliflozin group than in the placebo group achieved the primary end point (200 of 699 patients [28.6%] vs. 107 of 703 [15.2%], P<0.001). The least-squares mean change from baseline was significantly greater in the sotagliflozin group than in the placebo group for glycated hemoglobin (difference, -0.46 percentage points), weight (-2.98 kg), systolic blood pressure (-3.5 mm Hg), and mean daily bolus dose of insulin (-2.8 units per day) (P≤0.002 for all comparisons). The rate of severe hypoglycemia was similar in the sotagliflozin group and the placebo group (3.0% [21 patients] and 2.4% [17], respectively). The rate of documented hypoglycemia with a blood glucose level of 55 mg per deciliter (3.1 mmol per liter) or below was significantly lower in the sotagliflozin group than in the placebo group. The rate of diabetic ketoacidosis was higher in the sotagliflozin group than in the placebo group (3.0% [21 patients] and 0.6% [4], respectively).

CONCLUSIONS

Among patients with type 1 diabetes who were receiving insulin, the proportion of patients who achieved a glycated hemoglobin level lower than 7.0% with no severe hypoglycemia or diabetic ketoacidosis was larger in the group that received sotagliflozin than in the placebo group. However, the rate of diabetic ketoacidosis was higher in the sotagliflozin group. (Funded by Lexicon Pharmaceuticals; inTandem3 ClinicalTrials.gov number, NCT02531035 .).

Standardizing Clinically Meaningful Outcome Measures Beyond HbA1c for Type 1 Diabetes: A Consensus Report of the American Association of Clinical Endocrinologists, the American Association of Diabetes Educators, the American Diabetes Association, the Endocrine Society, JDRF International, The Leona M. and Harry B. Helmsley Charitable Trust, the Pediatric Endocrine Society, and the T1D Exchange

OBJECTIVE

To identify and define clinically meaningful type 1 diabetes outcomes beyond hemoglobin A1c (HbA1c) based upon a review of the evidence, consensus from clinical experts, and input from researchers, people with type 1 diabetes, and industry. Priority outcomes include hypoglycemia, hyperglycemia, time in range, diabetic ketoacidosis (DKA), and patient-reported outcomes (PROs). While priority outcomes for type 1 and type 2 diabetes may overlap, type 1 diabetes was the focus of this work.

RESEARCH AND METHODS

A Steering Committee-comprising representatives from the American Association of Clinical Endocrinologists, the American Association of Diabetes Educators, the American Diabetes Association, the Endocrine Society, JDRF International, The Leona M. and Harry B. Helmsley Charitable Trust, the Pediatric Endocrine Society, and the T1D Exchange-was the decision-making body for the Type 1 Diabetes Outcomes Program. Their work was informed by input from researchers, industry, and people with diabetes through Advisory Committees representing each stakeholder group. Stakeholder surveys were used to identify priority outcomes. The outcomes prioritized in the surveys were hypoglycemia, hyperglycemia, time in range, DKA, and PROs. To develop consensus on the definitions of these outcomes, the Steering Committee relied on published evidence, their clinical expertise, and feedback from the Advisory Committees.

RESULTS

The Steering Committee developed definitions for hypoglycemia, hyperglycemia, time in range, and DKA in type 1 diabetes. The definitions reflect their assessment of the outcome's short- and long-term clinical impact on people with type 1 diabetes. Knowledge gaps to be addressed by future research were identified. The Steering Committee discussed PROs and concluded that further type 1 diabetes-specific development is needed.

CONCLUSIONS

The Steering Committee recommends use of the defined clinically meaningful outcomes beyond HbA1c in the research, development, and evaluation of type 1 diabetes therapies.

The haematoma and its role in bone healing

Fracture treatment is an old endeavour intended to promote bone healing and to also enable early loading and regain of function in the injured limb. However, in today's clinical routine the healing potential of the initial fracture haematoma is still not fully recognized. The Arbeitsgemeinschaft für Osteosynthesefragen (AO) formed in Switzerland in 1956 formulated four AO principles of fracture treatment which are still valid today. Fracture treatment strategies have continued to evolve further, as for example the relatively new concept of minimally invasive plate osteosynthesis (MIPO). This MIPO treatment strategy harbours the benefit of an undisturbed original fracture haematoma that supports the healing process. The extent of the supportive effect of this haematoma for the bone healing process has not been considered in clinical practice so far. The rising importance of osteoimmunological aspects in bone healing supports the essential role of the initial haematoma as a source for inflammatory cells that release the cytokine pattern that directs cell recruitment towards the injured tissue. In reviewing the potential benefits of the fracture haematoma, the early development of angiogenic and osteogenic potentials within the haematoma are striking. Removing the haematoma during surgery could negatively influence the fracture healing process. In an ovine open tibial fracture model the haematoma was removed 4 or 7 days after injury and the bone that formed during the first two weeks of healing was significantly reduced in comparison with an undisturbed control. These findings indicate that whenever possible the original haematoma formed upon injury should be conserved during clinical fracture treatment to benefit from the inherent healing potential.

Diagnostic Accuracy of the Frontotemporal Dementia Consensus Criteria in the Late-Onset Frontal Lobe Syndrome

BACKGROUND/AIMS

We aimed to prospectively assess the diagnostic accuracy of the revised criteria for behavioural variant frontotemporal dementia (bvFTD) among subjects presenting with a frontal lobe syndrome in middle-late adulthood.

METHODS

Patients were included based on a predominant behavioural clinical presentation, a Frontal Behavioural Inventory (FBI) score of ≥11 and/or a Stereotypy Rating Inventory (SRI) score of ≥10. At baseline, the fulfilment of the international consensus criteria for behavioural variant FTD (FTDC) was systematically recorded. The 2-year follow-up consensus diagnosis was used as the gold standard to calculate sensitivity and specificity of the FTDC criteria for possible and probable bvFTD.

RESULTS

Two-year follow-up data were available for 116 patients (85%). Two-year follow-up consensus diagnoses consisted of probable/definite bvFTD (n = 27), other dementia (n = 30), psychiatric disorders (n = 46) and other neurological disorders (n = 13). Sensitivity for possible bvFTD was 85% (95% CI 70-95%) at a specificity of 27% (95% CI 19-37%). Sensitivity for probable bvFTD was 85% (95% CI 69-95%), whereas their specificity was 82% (95% CI 73-89%).

CONCLUSIONS

We found a good diagnostic accuracy for FTDC probable bvFTD. However, the specificity for FTDC possible bvFTD was low. Our results reflect the symptomatic overlap between bvFTD, other neurological conditions and psychiatric disorders, and the relevance of adding neuroimaging to the diagnostic process.

Posttransplant Lymphoproliferative Disorder After Clinical Islet Transplantation: Report of the First Two Cases

We report the first two cases of posttransplant lymphoproliferative disorder (PTLD) in recipients of islet transplants worldwide. First, a 44-year-old recipient of three islet infusions developed PTLD 80 months after his initial transplantation, presenting with abdominal pain and diffuse terminal ileum thickening on imaging. He was treated with surgical excision, reduction of immunosuppression, and rituximab. Seven months later, he developed central nervous system PTLD, presenting with vertigo and diplopia; immunosuppression was discontinued, resulting in graft loss, and he was given high-dose methotrexate and underwent consolidative autologous stem cell transplantation. He remains in remission 37 months after the initial diagnosis. Second, a 58-year-old female recipient of two islet infusions developed PTLD 24 months after initial islet infusion, presenting with pancytopenia secondary to extensive bone marrow involvement. Immunosuppression was discontinued, resulting in graft loss, and she received rituximab and chemotherapy, achieving complete remission. Both patients were monomorphic B cell PTLD subtype by histology and negative for Epstein-Barr virus in tissue or blood. These cases document the first occurrences of this rare complication in islet transplantation, likely secondary to prolonged, intensive immunosuppression, and highlight the varying clinical manifestations of PTLD. Further studies are needed to determine incidence rate and risk factors in islet transplantation.

POSTPRANDIAL DOSING OF BOLUS INSULIN IN PATIENTS WITH TYPE 1 DIABETES: A CROSS-SECTIONAL STUDY USING DATA FROM THE T1D EXCHANGE REGISTRY

OBJECTIVE

To assess the prevalence and characteristics of patients with type 1 diabetes (T1D) who dose bolus insulin postprandial (PostP) versus preprandial (PreP).

METHODS

Data for this cross-sectional study were obtained from 21,533 participants in the T1D Exchange Registry. Data were drawn from the enrollment questionnaire. Patients who dosed 'immediately before meal' or 'several minutes before meal' were classified as PreP. Patients who dosed 'during meal' or 'after meal' were classified as PostP. Data reported (PostP vs. PreP) are mean ± SD and percentage, as appropriate.

RESULTS

After exclusion of patients who did not answer the dose-timing question or who selected 'not given regularly' or 'depends on glucose level prior to meal,' (4,229 of 25,762), 21,533 patients were included in the study. Ninety-nine percent of patients used rapid-acting insulin analogues; 32% dosed insulin PostP. Compared to PreP, children <18 years of age dosing PostP were characterized by higher glycated hemoglobin (HbA1c) (8.7 ± 1.5% [72 ± 16.4 mmol/mol] vs. 8.4 ± 1.7% [68 ± 18.6 mmol/mol]), larger insulin dose (1.2 ± 0.7 IU/kg/day vs. 1.1 ± 0.7 IU/kg/day), greater prevalence of history of hypoglycemia, and diabetic ketoacidosis. Adults who dosed PostP were characterized by younger age (33.0 ± 15.3 years vs. 39.5 ± 16.6 years), higher HbA1c (8.3 ± 1.5% [67 ± 16.4 mmol/mol] vs. 7.8 ± 1.5% [62 ± 16.4 mmol/mol]), and larger insulin dose (1.0 ± 0.6 IU/kg/day vs. 0.9 ± 0.5 IU/kg/day) than PreP.

CONCLUSION

This study reveals that a large proportion of patients dose bolus insulin PostP. Despite the use of current rapid-acting insulin analogues, patients who dose PostP are characterized by poorer glycemic control in all patients and a greater prevalence of history of severe hypoglycemia and diabetic ketoacidosis in children.

ABBREVIATIONS

BMI = body mass index; CGM = continuous glucose monitoring; DKA = diabetic ketoacidosis; HbA1c = glycated hemoglobin; PostP = postprandial; PreP = preprandial; SMBG = self-monitored blood glucose; T1D = type 1 diabetes.

Are long-term widespread avian body size changes related to food availability? A test using contemporaneous changes in carotenoid-based color

Recent changes in global climate have been linked with changes in animal body size. While declines in body size are commonly explained as an adaptive thermoregulatory response to climate warming, many species do not decline in size, and alternative explanations for size change exist. One possibility is that temporal changes in animal body size are driven by changes in environmental productivity and food availability. This hypothesis is difficult to test due to the lack of suitable estimates that go back in time. Here, we use an alternative, indirect, approach and assess whether continent-wide changes over the previous 100 years in body size in 15 species of Australian birds are associated with changes in their yellow carotenoid-based plumage coloration. This type of coloration is strongly affected by food availability because birds cannot synthesize carotenoids and need to ingest them, and because color expression depends on general body condition. We found significant continent-wide intraspecific temporal changes in body size (wing length) and yellow carotenoid-based color (plumage reflectance) for half the species. Direction and magnitude of changes were highly variable among species. Meta-analysis indicated that neither body size nor yellow plumage color showed a consistent temporal trend and that changes in color were not correlated with changes in size over the past 100 years. We conclude that our data provide no evidence that broad-scale variation in food availability is a general explanation for continent-wide changes in body size in this group of species. The interspecific variability in temporal changes in size as well as color suggests that it might be unlikely that a single factor drives these changes, and more detailed studies of museum specimens and long-term field studies are required to disentangle the processes involved.

Effect of a long-term intensive lifestyle intervention on prevalence of cognitive impairment

OBJECTIVE

To assess whether an average of 10 years of lifestyle intervention designed to reduce weight and increase physical activity lowers the prevalence of cognitive impairment among adults at increased risk due to type 2 diabetes and obesity or overweight.

METHODS

Central adjudication of mild cognitive impairment and probable dementia was based on standardized cognitive test battery scores administered to 3,802 individuals who had been randomly assigned, with equal probability, to either the lifestyle intervention or the diabetes support and education control. When scores fell below a prespecified threshold, functional information was obtained through proxy interview.

RESULTS

Compared with control, the intensive lifestyle intervention induced and maintained marked differences in weight loss and self-reported physical activity throughout follow-up. At an average (range) of 11.4 (9.5-13.5) years after enrollment, when participants' mean age was 69.6 (54.9-87.2) years, the prevalence of mild cognitive impairment and probable dementia was 6.4% and 1.8%, respectively, in the intervention group, compared with 6.6% and 1.8%, respectively, in the control group (p = 0.93). The lack of an intervention effect on the prevalence of cognitive impairment was consistent among individuals grouped by cardiovascular disease history, diabetes duration, sex, and APOE ε4 allele status (all p ≥ 0.50). However, there was evidence (p = 0.03) that the intervention effect ranged from benefit to harm across participants ordered from lowest to highest baseline BMI.

CONCLUSIONS

Ten years of behavioral weight loss intervention did not result in an overall difference in the prevalence of cognitive impairment among overweight or obese adults with type 2 diabetes.

CLINICALTRIALSGOV IDENTIFIER

NCT00017953 (Action for Health in Diabetes).

LEVEL OF EVIDENCE

This study provides Class II evidence that for overweight adults with type 2 diabetes, a lifestyle intervention designed to reduce weight and increase physical activity does not lower the risk of cognitive impairment.

Physical activity, muscular strength, and polypharmacy among older multimorbid persons: Results from the KORA-Age study

The purpose of this study was to examine whether physical activity (PA) and muscular strength (MS) are related to polypharmacy. Our cross-sectional analysis was based on 711 patients with multimorbidity (MMB), aged 65-94 years, who participated in the KORA-Age study. Participants underwent a face-to-face interview and extensive physical examinations including anthropometric measurements, registration of chronic diseases, determination of health-related behaviors (smoking, alcohol intake, physical activity, etc.), collection of blood samples and measurement of hand-grip strength. PPha was defined as the use of >4 drugs and MMB as having ≥2 of 13 chronic diseases. Prevalence of PPha was 44.6% (n=317), and a significant difference was found in the number of drugs used between participants with and without PPha (7.2±2.1 vs 2.5±1.2, P<.001). Patients in the lower compared to the upper tertile of physical activity had a significantly increased odds to be on PPha (OR: 1.64, 95% CI: 1.05-2.56, P=.031) after controlling for age, gender, BMI, family status, education, alcohol intake, smoking habits, number of diseases, hs-CRP, and telomere length. On the contrary, no significant association between muscular strength and PPha was found (OR: 1.04, 95% CI: 0.66-1.63, P=.873) after multivariable adjustment. Among older persons with MMB, lower levels of physical activity, but not low muscular strength, are associated with higher odds of PPha. Increasing the levels of physical activity appears to be highly recommended in order to potentially reduce the risk of PPha among multimorbid persons aged 65 and older.

Transparency and Due Process: A Systematic Approach to Educational Decision-making and Appeals

Introduction

Transparency and due process are inseparable principles that should underpin any educational and administrative decision made within an organization.

Objectives

It is considered best practice for organizations to place the processes and structures surrounding reviews of decisions made by their organization at arm's length to the committee or group that made the original decision. This ensures there is and that due process is followed.

Aims

An independent appeal process is an integral part of any fair system of assessment and decision making.

Methods

The Royal Australian and New Zealand College of psychiatrists has undertaken several reviews of its current processes to examine its practices as both substantive and procedural issues arise in decisions with regard to the provision of psychiatric training. The reconsideration and appeal policy was developed to set out a clear and fair process for applicants to request decisions of the RANZCP to be reconsidered and appealed. This ensures that an applicant has a fair and reasonable opportunity to challenge the original decision whilst receiving support from the RANZCP to minimize any stress that may be experienced during this process.

Results

The RANZCP has observed that the three phase process has enabled matters to be resolved at an earlier stage of the appeal cycle and do not require progression to a formal appeal.

Conclusion

This presentation will identify best practice methods in educational decision-making and conducting appeals.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.

Owning the brand of psychiatry

In Australia and New Zealand, conversations around mental health are playing out in the public space with increasing frequency. Mental health promotion campaigns and organizations are embraced by mainstream and other forms of media, and supported by government. Whilst public knowledge of mental illness is increasing, the profile of psychiatrists as leaders and medical experts in mental illness is a more difficult brand to sell. With a somewhat tarnished history behind us, the modern evidence-based practice of psychiatry is not always at the forefront of public impression. Furthermore, in Australia, more than half of the population (56%) is unaware that psychiatrists have undertaken medical training as a doctor. This presentation will outline Royal Australian and New Zealand college of psychiatrists (RANZCP) action to improve community information about psychiatry, psychiatrists and treatment experiences.

Disclosure of interest

The author has not supplied his/her declaration of competing interest.

Patient restrictions following total hip arthroplasty: A national survey

In this prospective nation-wide web based survey we describe the current practice regarding patient restrictions following total hip arthroplasty. A web-based survey involving 20 items was developed and tested prior to administration. The questionnaire included general information, type of restrictions, specification and duration of restrictions. The target population consisted of all orthopaedic surgeons registered with the Dutch Orthopaedic Association working at one of the 94 orthopaedic departments in the Netherlands. The response rate of the orthopaedic departments was 78% (n=74). The majority of orthopaedic departments use patient restrictions following THA. Restrictions were used with different rates per type of surgical approach: anterior (69%), anterolateral (100%), straight lateral (94%) and posterolateral (93%). The duration of these restrictions is generally six weeks. Patient restrictions following THA are current practice, regardless of the surgical approach.

Conservation implications of anthropogenic impacts on visual communication and camouflage

Anthropogenic environmental impacts can disrupt the sensory environment of animals and affect important processes from mate choice to predator avoidance. Currently, these effects are best understood for auditory and chemosensory modalities, and recent reviews highlight their importance for conservation. We examined how anthropogenic changes to the visual environment (ambient light, transmission, and backgrounds) affect visual communication and camouflage and considered the implications of these effects for conservation. Human changes to the visual environment can increase predation risk by affecting camouflage effectiveness, lead to maladaptive patterns of mate choice, and disrupt mutualistic interactions between pollinators and plants. Implications for conservation are particularly evident for disrupted camouflage due to its tight links with survival. The conservation importance of impaired visual communication is less documented. The effects of anthropogenic changes on visual communication and camouflage may be severe when they affect critical processes such as pollination or species recognition. However, when impaired mate choice does not lead to hybridization, the conservation consequences are less clear. We suggest that the demographic effects of human impacts on visual communication and camouflage will be particularly strong when human-induced modifications to the visual environment are evolutionarily novel (i.e., very different from natural variation); affected species and populations have low levels of intraspecific (genotypic and phenotypic) variation and behavioral, sensory, or physiological plasticity; and the processes affected are directly related to survival (camouflage), species recognition, or number of offspring produced, rather than offspring quality or attractiveness. Our findings suggest that anthropogenic effects on the visual environment may be of similar importance relative to conservation as anthropogenic effects on other sensory modalities.

Personality and innate immune defenses in a wild bird: Evidence for the pace-of-life hypothesis

We tested the two main evolutionary hypotheses for an association between immunity and personality. The risk-of-parasitism hypothesis predicts that more proactive (bold, exploratory, risk-taking) individuals have more vigorous immune defenses because of increased risk of parasite exposure. In contrast, the pace-of-life hypothesis argues that proactive behavioral styles are associated with shorter lifespans and reduced investment in immune function. Mechanistically, associations between immunity and personality can arise because personality differences are often associated with differences in condition and stress responsiveness, both of which are intricately linked with immunity. Here we investigate the association between personality (measured as proactive exploration of a novel environment) and three indices of innate immune function (the non-specific first line of defense against parasites) in wild superb fairy-wrens Malurus cyaneus. We also quantified body condition, hemoparasites (none detected), chronic stress (heterophil:lymphocyte ratio) and circulating corticosterone levels at the end of the behavioral test (CORT, in a subset of birds). We found that fast explorers had lower titers of natural antibodies. This result is consistent with the pace-of-life hypothesis, and with the previously documented higher mortality of fast explorers in this species. There was no interactive effect of exploration score and duration in captivity on immune indices. This suggests that personality-related differences in stress responsiveness did not underlie differences in immunity, even though behavioral style did modulate the effect of captivity on CORT. Taken together these results suggest reduced constitutive investment in innate immune function in more proactive individuals.

Habitat structure is linked to the evolution of plumage colour in female, but not male, fairy-wrens

Background

Both natural and sexual selection may drive the evolution of plumage colouration in birds. This can lead to great variation in plumage not only across species, but also between sexes within species. Australasian fairy-wrens are famous for their brightly coloured males, which exhibit colours ranging from bright blue to red and black. Female plumage in fairy wrens (and in general) has been rarely studied, but it can also be highly variable, including both bright and cryptic plumages. We use a comparative framework to explore the basis for this variation, and test the possibility that female fairy-wrens experience selection for cryptic plumage when they occupy more exposed habitats that offer little concealment from predators. We use spectral measurements of plumage for species and subspecies of Australasian fairy-wrens.

Results

We show that female colouration (contrast against background) is strongly correlated with vegetation cover: females in open habitats show less contrast to background colours than females in closed habitats, while male colouration is not associated with habitat type.

Conclusions

Female plumage appears to be under stronger natural selection than male plumage in fairy-wrens, providing an example of how selection may act differently on males and females of the same species.

Electronic supplementary material

The online version of this article (doi:10.1186/s12862-016-0861-3) contains supplementary material, which is available to authorized users.