'I never realised that sex between two women was not safe': narratives of lesbian safer sex.

This paper explores the way in which some lesbians rely on culturally circulated narratives about identity to assess safer sex and their potential risk of sexually transmitted infection (STI) and HIV. A well-established narrative within the literature about lesbian safer sex is that STI risk is non-existent. The implications of this are important because they demonstrate the perception of lesbian identity and notions of safety. This study focuses on how gender and sexuality contextualise an assessment of risk and safety for lesbians. This is vital to understand because there is still a lack of language about lesbian safer sex practices and techniques. Lesbians narrate their assessments of STI and HIV risk through the lenses of gender and sexuality - locating 'risk' in gay men and bisexual women. Using narrative analysis, I find that lesbians assess their risk by constructing characters from culturally circulated narratives steeped in homophobia and biphobia of the sensible lesbian, the risky gay man and the uncertain bisexual.

A data-driven approach for the detection of internal standard outliers in targeted LC-MS/MS assays.

Heavy-labelled internal standard (IS) compounds are commonly used in liquid chromatography-tandem mass spectrometry (LC-MS/MS) assays to control for stochastic and systematic variation. Identifying samples that suffer from unwanted variation is critically important in order to avoid factitiously inaccurate results. Current approaches for outlier detection typically employ arbitrary thresholds and ignore systematic drift. To improve this, we applied robust linear mixed-effects models (LMMs) to capture the within- and between-run variability in IS signal and generate data-driven acceptance ranges for routine use. Data from in-house LC-MS/MS assays for 25-hydroxyvitamin D3 and D2 and prednisolone were retrospectively collected. The variation in the percentage deviation of the internal standard area from the mean of the calibrators was modelled through the use of robust LMMs. The fitted LMMs revealed significant positive drift in IS signal over the analytical runs for vitamin D, with slope coefficients of 0.118 (95% CI: 0.098, 0.138) and 0.192 (0.168, 0.215) for D3 and D2, respectively. In contrast, the models for prednisolone demonstrated a significant negative drift in IS signal, with a slope coefficient of -0.164 (-0.297, -0.036). Non-parametric, cluster bootstrap resampling enabled us to define acceptance ranges for use in future assays. Here, we have described a computational approach to extensively characterise the variation in IS signal in routinely-performed LC-MS/MS assays. This approach facilitates a robust quality assessment of IS outliers in routine practice and thus has the potential to improve patient safety. Importantly, this approach is applicable to other MS assays where linear variation in IS signal is observed.

Disambiguating pharmacological mechanisms from placebo in neuropathic pain using functional neuroimaging.

BACKGROUND: A lack of objective outcome measures and overreliance on subjective pain reports in early proof-of-concept studies contribute to the high attrition of potentially effective new analgesics. We studied the utility of neuroimaging in providing objective evidence of neural activity related to drug modulation or a placebo effect in a double-blind, randomized, placebo-controlled, three-way crossover trial. METHODS: We chronically administered pregabalin or tramadol (first-line and second-line analgesics, respectively), recommended for neuropathic pain, in 16 post-traumatic neuropathic pain patients. We measured subjective pain reports, allodynia-evoked neural activity, and brain resting state functional connectivity from patients during the three sessions and resting state data at baseline from patients after washout of their current medication. All data were collected using a 3 T MRI scanner. RESULTS: When compared with placebo only, pregabalin significantly suppressed allodynia-evoked neural activity in several nociceptive and pain-processing areas of the brain, despite the absence of behavioural analgesia. Furthermore, placebo significantly increased functional connectivity between the rostral anterior cingulate and the brainstem, a core component of the placebo neural network. CONCLUSIONS: Functional neuroimaging provided objective evidence of pharmacodynamic efficacy in a proof-of-concept study setting where subjective pain outcome measures are often unreliable. Additionally, we provide evidence confirming the neural mechanism underpinning placebo analgesia as identified in acute experimental imaging studies in patients during the placebo arm of a clinical trial. We explore how brain penetrant active drugs potentially interact with this mechanism. CLINICAL TRIAL REGISTRATION: NCT0061015.

The genetics of adaptation to discrete heterogeneous environments: frequent mutation or large-effect alleles can allow range expansion.

Range expansions are complex evolutionary and ecological processes. From an evolutionary standpoint, a populations' adaptive capacity can determine the success or failure of expansion. Using individual-based simulations, we model range expansion over a two-dimensional, approximately continuous landscape. We investigate the ability of populations to adapt across patchy environmental gradients and examine how the effect sizes of mutations influence the ability to adapt to novel environments during range expansion. We find that genetic architecture and landscape patchiness both have the ability to change the outcome of adaptation and expansion over the landscape. Adaptation to new environments succeeds via many mutations of small effect or few of large effect, but not via the intermediate between these cases. Higher genetic variance contributes to increased ability to adapt, but an alternative route of successful adaptation can proceed from low genetic variance scenarios with alleles of sufficiently large effect. Steeper environmental gradients can prevent adaptation and range expansion on both linear and patchy landscapes. When the landscape is partitioned into local patches with sharp changes in phenotypic optimum, the local magnitude of change between subsequent patches in the environment determines the success of adaptation to new patches during expansion.

2015 Recommendations for the management of polymyalgia rheumatica: a European League Against Rheumatism/American College of Rheumatology collaborative initiative

Therapy for polymyalgia rheumatica (PMR) varies widely in clinical practice as international recommendations for PMR treatment are not currently available. In this paper, we report the 2015 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) recommendations for the management of PMR. We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) methodology as a framework for the project. Accordingly, the direction and strength of the recommendations are based on the quality of evidence, the balance between desirable and undesirable effects, patients' and clinicians' values and preferences, and resource use. Eight overarching principles and nine specific recommendations were developed covering several aspects of PMR, including basic and follow-up investigations of patients under treatment, risk factor assessment, medical access for patients and specialist referral, treatment strategies such as initial glucocorticoid (GC) doses and subsequent tapering regimens, use of intramuscular GCs and disease modifying anti-rheumatic drugs (DMARDs), as well as the roles of non-steroidal anti-rheumatic drugs and non-pharmacological interventions. These recommendations will inform primary, secondary and tertiary care physicians about an international consensus on the management of PMR. These recommendations should serve to inform clinicians about best practices in the care of patients with PMR.(AU)

Overdominance interacts with linkage to determine the rate of adaptation to a new optimum.

Overdominance, or a fitness advantage of a heterozygote over both homozygotes, can occur commonly with adaptation to a new optimum phenotype. We model how such overdominant polymorphisms can reduce the evolvability of diploid populations, uncovering a novel form of epistatic constraint on adaptation. The fitness load caused by overdominant polymorphisms can most readily be ameliorated by evolution at tightly linked loci; therefore, traits controlled by multiple loosely linked loci are predicted to be strongly constrained. The degree of constraint is also sensitive to the shape of the relationship between phenotype and fitness, and the constraint caused by overdominance can be strong enough to overcome the effects of clonal interference on the rate of adaptation for a trait. These results point to novel influences on evolvability that are specific to diploids and interact with genetic architecture, and they predict a source of stochastic variability in eukaryotic evolution experiments or cases of rapid evolution in nature.

Multilocus estimation of selfing and its heritability.

We describe a new method of estimating the selfing rate (S) in a mixed mating population based on a population structure approach that accounts for possible intergenerational correlation in selfing rate, giving rise to an estimate of the upper limit for heritability of selfing rate (h2). A correlation between generations in selfing rate is shown to affect one- and two-locus probabilities of identity by descent. Conventional estimates of selfing rate based on a population structure approach are positively biased by intergenerational correlation in selfing. Multilocus genotypes of individuals are used to give maximum-likelihood estimates of S and h2 in the presence of scoring artifacts. Our multilocus estimation of selfing rate and its heritability (MESH) method was tested with simulated data for a range of conditions. Selfing rate estimates from MESH have low bias and root mean squared error, whereas estimates of the heritability of selfing rate have more uncertainty. Increasing the number of individuals in a sample helps to reduce bias and root mean squared error more than increasing the number of loci of sampled individuals. Improved estimates of selfing rate, as well as estimates of its heritability, can be obtained with this method, although a large number of loci and individuals are needed to achieve best results.

Dietary stress does not strengthen selection against single deleterious mutations in Drosophila melanogaster.

Stress is generally thought to increase the strength of selection, although empirical results are mixed and general conclusions are difficult because data are limited. Here we compare the fitness effects of nine independent recessive mutations in Drosophila melanogaster in a high- and low-dietary-stress environment, estimating the strength of selection on these mutations arising from both a competitive measure of male reproductive success and productivity (female fecundity and the subsequent survival to adulthood of her offspring). The effect of stress on male reproductive success has not been addressed previously for individual loci and is of particular interest with respect to the alignment of natural and sexual selection. Our results do not support the hypothesis that stress increases the efficacy of selection arising from either fitness component. Results concerning the alignment of natural and sexual selection were mixed, although data are limited. In the low-stress environment, selection on mating success and productivity were concordant for five of nine mutations (four out of four when restricted to those with significant or near-significant productivity effects), whereas in the high-stress environment, selection aligned for seven of nine mutations (two out of two when restricted to those having significant productivity effects). General conclusions as to the effects of stress on the strength of selection and the alignment of natural and sexual selection await data from additional mutations, fitness components and stressors.

Local adaptation does not always predict high mating success.

The hypothesis that adaptation to local environments can increase mating success was tested using ten replicate lines of Drosophila melanogaster adapted either to 16 degrees C or to 25 degrees C. Competitive mating trials at both temperatures were performed with males taken from a pair of lines, one adapted to each temperature. There was no average increase in mating success for males adapted to the local environment. Although one pair of lines showed the expected pattern, another pair showed the reverse pattern. More data are needed on this hypothesis, preferably with lines that have more strongly adapted to local environments.

The costs and benefits of resource sharing: reciprocity requires resource heterogeneity.

The evolution of resource sharing requires that the fitness benefits to the recipients be much higher than the costs to the giver, which requires heterogeneity among individuals in the fitness value of acquiring additional resources. We develop four models of the evolution of resource sharing by either direct or indirect reciprocity, with equal or unequal partners. Evolution of resource sharing by reciprocity requires differences between interacting individuals in the fitness value of the resource, and these differences must reverse although previous acts of giving are remembered and both participants survive. Moreover, inequality in the expected reproductive value of the interacting individuals makes reciprocity more difficult to evolve, but may still allow evolution of sharing by kin selection. These constraints suggest that resource sharing should evolve much more frequently by kin selection than by reciprocity, a prediction that is well supported by observations in the natural world.

Male Drosophila melanogaster have higher mating success when adapted to their thermal environment.

Adaptation to new environments is a well-documented phenomenon. Individuals from populations maintained in a particular environment for multiple generations tend to be better able to survive and/or reproduce in that environment than their ancestors or other individuals adapted to alternative environments. A third major component of fitness, mating success, has not been well studied in replicated populations under selection in divergent environments. In this study, we used mating trials to compare the mating success of male Drosophila melanogaster adapted for 10 years to two different temperatures, 18 and 25 degrees C. In competition for female partners, males had significantly higher mating success at their adapted temperature compared with males adapted to a different temperature. These results are consistent with the notion that those mutations favoured by natural selection also tend to be favoured by sexual selection.

Combining probability from independent tests: the weighted Z-method is superior to Fisher's approach.

The most commonly used method in evolutionary biology for combining information across multiple tests of the same null hypothesis is Fisher's combined probability test. This note shows that an alternative method called the weighted Z-test has more power and more precision than does Fisher's test. Furthermore, in contrast to some statements in the literature, the weighted Z-method is superior to the unweighted Z-transform approach. The results in this note show that, when combining P-values from multiple tests of the same hypothesis, the weighted Z-method should be preferred.

Dominance and overdominance of mildly deleterious induced mutations for fitness traits in Caenorhabditis elegans.

We estimated the average dominance coefficient of mildly deleterious mutations (h, the proportion by which mutations in the heterozygous state reduce fitness components relative to those in the homozygous state) in the nematode Caenorhabditis elegans. From 56 worm lines that carry mutations induced by the point mutagen ethyl methanesulfonate (EMS), we selected 19 lines that are relatively high in fitness and estimated the viabilities, productivities, and relative fitnesses of heterozygotes and homozygotes compared to the ancestral wild type. There was very little effect of homozygous or heterozygous mutations on egg-to-adult viability. For productivity and relative fitness, we found that the average dominance coefficient, h, was approximately 0.1, suggesting that mildly deleterious mutations are on average partially recessive. These estimates were not significantly different from zero (complete recessivity) but were significantly different from 0.5 (additivity). In addition, there was a significant amount of variation in h among lines, and analysis of average dominance coefficients of individual lines suggested that several lines showed overdominance for fitness. Further investigation of two of these lines partially confirmed this finding.

Genetic recombination and adaptation to fluctuating environments: selection for geotaxis in Drosophila melanogaster.

Heritable variation in fitness is the fuel of adaptive evolution, and sex can generate new adaptive combinations of alleles. If the generation of beneficial combinations drives the evolution of recombination, then the level of recombination should result in changes in the response to selection. Three types of lines of Drosophila melanogaster varying in their level of genetic recombination were selected over 38 generations for geotaxis. The within-chromosome recombination level of these lines was controlled for 60% of the genome: chromosome X and chromosome II. The full recombination lines had normal, unmanipulated levels of recombination on these two chromosomes. Conversely, nonrecombination lines had recombination effectively eliminated within the X and second chromosomes. Finally, partial recombination lines had the effective rate of within-chromosome recombination lowered to 10% of natural levels for these two chromosomes. The rate of response to selection was measured for continuous negative geotaxis and for a fluctuating environment (alternating selection for negative and positive geotaxis). All selected Drosophila lines responded to selection and approximately 36% of the response to selection was because of the X and second chromosomes. However, recombination did not accelerate adaptation during either directional or fluctuating selection for geotaxis.

A changing pattern of injuries to horse riders.

OBJECTIVES: To describe the demographics and nature of injuries occurring on or around horses, to examine the nature of protective clothing in relation to these injuries, and to compare our data with previously published work in this area. METHODS: Patients were identified using the term "sports injury-horse riding" from the departmental database for one calendar year from February 2000. Data were collected regarding demographics, injuries, protective clothing, and outcome. The data were then analysed and compared with the previously published literature. RESULTS: 260 patients' records were analysed. The patients were mostly young (median age 26) and female (84.6%). The majority of patients had a single injury (88.8%). Seventeen per cent had an isolated head injury, all of which proved to be minor. Multiple injuries including the head accounted for 8.5% of all injuries. These again proved minor, bar one fatality where the helmet came off before impact. Upper limb injuries accounted for 29.2% of all injuries of which 61.8% sustained a fracture of which 36.2% were to the wrist. When compared with previous work the incidence and severity of head injury continues to decline while the relative number and severity of upper limb injuries increases. CONCLUSIONS: The majority of head injured riders are wearing approved helmets and sustaining only minor injury. There is currently no protective gear recommended for the upper limb and more specifically the wrist. This paper identifies the potential need for research and development of such protection.

Inbreeding changes the shape of the genetic covariance matrix in Drosophila melanogaster.

The pattern of genetic covariation among traits (the G matrix) plays a central role in determining the pattern of evolutionary change from both natural selection and random genetic drift. Here we measure the effect of genetic drift on the shape of the G matrix using a large data set on the inheritance of wing characteristics in Drosophila melanogaster. Fifty-two inbred lines with a total of 4680 parent-offspring families were generated by one generation of brother-sister mating and compared to an outbred control population of 1945 families. In keeping with the theoretical expectation for a correlated set of additively determined traits, the average G matrix of the inbred lines remained proportional to the outbred control G matrix with a proportionality constant approximately equal to (1 - F), where F is the inbreeding coefficient. Further, the pattern of covariance among the means of the inbred lines induced by inbreeding was also proportional to the within-line G matrix of the control population with a constant very close to the expectation of 2F. Although the average G of the inbred lines did not show change in overall structure relative to the outbred controls, separate analysis revealed a great deal of variation among inbred lines around this expectation, including changes in the sign of genetic correlations. Since any given line can be quite different from the outbred control, it is likely that in nature unreplicated drift will lead to changes in the G matrix. Thus, the shape of G is malleable under genetic drift, and the evolutionary response of any particular population is likely to depend on the specifics of its evolutionary history.

A genetic interpretation of ecologically dependent isolation.

Hybrids may suffer a reduced fitness both because they fall between ecological niches (ecologically dependent isolation) and as a result of intrinsic genetic incompatibilities between the parental genomes (ecologically independent isolation). Whereas genetic incompatibilities are common to all theories of speciation, ecologically dependent isolation is a unique prediction of the ecological model of speciation. This prediction can be tested using reciprocal transplants in which the fitness of various genotypes is evaluated in both parental habitats. Here we expand a quantitative genetic model of Lynch (1991) to include two parental environments. We ask whether a sufficient experimental design exists for detecting ecologically dependent isolation. Analysis of the model reveals that by using both backcrosses in both parental environments, environment-specific additive genetic effects can be estimated while correcting for any intrinsic genetic isolation. Environment-specific dominance effects can also be estimated by including the F1 and F2 in the reciprocal transplant. In contrast, a reciprocal transplant comparing only F1s or F2s to the parental species cannot separate ecologically dependent from intrinsic genetic isolation. Thus, a reduced fitness of F1 or F2 hybrids relative to the parental species is not sufficient to demonstrate ecological speciation. The model highlights the importance of determining the contribution of genetic and ecological mechanisms to hybrid fitness if inferences concerning speciation mechanisms are to be made.

Factors affecting the genetic load in Drosophila: synergistic epistasis and correlations among fitness components.

Two factors that can affect genetic load, synergistic epistasis and sexual selection, were investigated in Drosophila melanogaster. A set of five chromosomal regions containing visible recessive mutations were put together in all combinations to create a full set of 32 homozygous lines fixed for different numbers of known mutations. Two measures of fitness were made for each line: productivity (a combined measure of fecundity and egg-to-adult survivorship) and competitive male mating success. Productivity, but not male mating success, showed a pattern of strong average synergistic epistasis, such that the log fitness declined nonlinearly with increasing numbers of mutations. Synergistic epistasis is known to reduce the mutation load. Both fitness components show some positive and some negative interactions between specific sets of mutations. Furthermore, alleles with deleterious effects on productivity tend to also diminish male mating success. Given that male mating success can affect relative fitness without changing the mean productivity of a population, these additional effects would lead to lower frequencies and lower fixation rates of deleterious alleles without higher costs to the mean fitness of the population.