Reliability, Validity and Classification Accuracy of the South Oaks Gambling Screen in a Brazilian Sample

The purpose of this study was to examine the reliability, validity and classification accuracy of the South Oaks Gambling Screen (SOGS) in a sample of the Brazilian population. Participants in this study were drawn from three sources: 71 men and women from the general population interviewed at a metropolitan train station; 116 men and women encountered at a bingo venue; and 54 men and women undergoing treatment for gambling. The SOGS and a DSM-IV-based instrument were applied by trained researchers. The internal consistency of the SOGS was 0.75 according to the Cronbach`s alpha model, and construct validity was good. A significant difference among groups was demonstrated by ANOVA (F ((2.238)) = 221.3, P < 0.001). The SOGS items and DSM-IV symptoms were highly correlated (r = 0.854, P < 0.01). The SOGS also presented satisfactory psychometric properties: sensitivity (100), specificity (74.7), positive predictive rate (60.7), negative predictive rate (100) and misclassification rate (0.18). However, a cut-off score of eight improved classification accuracy and reduced the rate of false positives: sensitivity (95.4), specificity (89.8), positive predictive rate (78.5), negative predictive rate (98) and misclassification rate (0.09). Thus, the SOGS was found to be reliable and valid in the Brazilian population.

Environmental suitability of a highly fragmented and heterogeneous landscape for forest bird species in south-eastern Brazil

Assessment of the suitability of anthropogenic landscapes for wildlife species is crucial for setting priorities for biodiversity conservation. This study aimed to analyse the environmental suitability of a highly fragmented region of the Brazilian Atlantic Forest, one of the world's 25 recognized biodiversity hotspots, for forest bird species. Eight forest bird species were selected for the analyses, based on point counts (n = 122) conducted in April-September 2006 and January-March 2009. Six additional variables (landscape diversity, distance from forest and streams, aspect, elevation and slope) were modelled in Maxent for (1) actual and (2) simulated land cover, based on the forest expansion required by existing Brazilian forest legislation. Models were evaluated by bootstrap or jackknife methods and their performance was assessed by AUC, omission error, binomial probability or p value. All predictive models were statistically significant, with high AUC values and low omission errors. A small proportion of the actual landscape (24.41 +/- 6.31%) was suitable for forest bird species. The simulated landscapes lead to an increase of c. 30% in total suitable areas. In average, models predicted a small increase (23.69 +/- 6.95%) in the area of suitable native forest for bird species. Being close to forest increased the environmental suitability of landscapes for all bird species; landscape diversity was also a significant factor for some species. In conclusion, this study demonstrates that species distribution modelling (SDM) successfully predicted bird distribution across a heterogeneous landscape at fine spatial resolution, as all models were biologically relevant and statistically significant. The use of landscape variables as predictors contributed significantly to the results, particularly for species distributions over small extents and at fine scales. This is the first study to evaluate the environmental suitability of the remaining Brazilian Atlantic Forest for bird species in an agricultural landscape, and provides important additional data for regional environmental planning.

ARE TWO ITEMS SUFFICIENT TO SCREEN FOR DEPRESSION WITHIN THE HOSPITAL CONTEXT?

Objective: to determine the ability of the reduced form of a screening instrument, the Patient Health Questionnaire-2 (PHQ-2), to assess the presence of depressive disorders in patients admitted to a general hospital. Method: A sample of 227 patients admitted to the clinical wards of a Brazilian general university hospital were assessed with Module A of the Diagnostic Structured Interview for the DSM-IV (SCID-IV) and filled out the PHQ-9 and PHQ-2. Results: The PHQ-2 demonstrated an area under the ROC curve of 0.89 (p < 0.0001), with a cutoff point of three or more being the one that best equilibrated the sensitivity (0.86) and specificity (0.75) values. The agreement index between the PHQ-2 and module A of SCID-W was 78.4% and the Kappa value was 0.51. Regarding reliability, the Cronbach alpha value obtained was 0.64 and the intraclass correlation coefficient was 0.52. Conclusion: PHQ-2 proved to be an instrument with good psychometric properties comparable to those of PHQ-9, being superior to the latter regarding the rate of false-positive results. In addition, it is a brief instrument that elicits little resistance on the part of the patient, being inexpensive and requiring little time, thus being of important help to the treatment teams for the detection of depressive disorder, being suitable for incorporation into hospital admission protocols and thus possibly favoring more immediate interventions. (Int'l J. Psychiatry in Medicine 2012;44:141-148)

Unraveling the drivers of community dissimilarity and species extinction in fragmented landscapes

Communities in fragmented landscapes are often assumed to be structured by species extinction due to habitat loss, which has led to extensive use of the species-area relationship (SAR) in fragmentation studies. However, the use of the SAR presupposes that habitat loss leads species to extinction but does not allow for extinction to be offset by colonization of disturbed-habitat specialists. Moreover, the use of SAR assumes that species richness is a good proxy of community changes in fragmented landscapes. Here, we assessed how communities dwelling in fragmented landscapes are influenced by habitat loss at multiple scales; then we estimated the ability of models ruled by SAR and by species turnover in successfully predicting changes in community composition, and asked whether species richness is indeed an informative community metric. To address these issues, we used a data set consisting of 140 bird species sampled in 65 patches, from six landscapes with different proportions of forest cover in the Atlantic Forest of Brazil. We compared empirical patterns against simulations of over 8 million communities structured by different magnitudes of the power-law SAR and with species-specific rules to assign species to sites. Empirical results showed that, while bird community composition was strongly influenced by habitat loss at the patch and landscape scale, species richness remained largely unaffected. Modeling results revealed that the compositional changes observed in the Atlantic Forest bird metacommunity were only matched by models with either unrealistic magnitudes of the SAR or by models ruled by species turnover, akin to what would be observed along natural gradients. We show that, in the presence of such compositional turnover, species richness is poorly correlated with species extinction, and z values of the SAR strongly underestimate the effects of habitat loss. We suggest that the observed compositional changes are driven by each species reaching its individual extinction threshold: either a threshold of forest cover for species that disappear with habitat loss, or of matrix cover for species that benefit from habitat loss.

Population size of threatened and endemic birds of the Cerrado in Estacao Ecologica de Itirapina, a fragmented area in the State of Sao Paulo, Brazil

The pressures for land use change have led to an increasing isolation of habitat remnants throughout the world. The goal of this study was to estimate the population size and density of some endemic and threatened species in a nature reserve in the Cerrado biome. One hundred and thirty four point transects were undertaken at the Estacao Ecologica de Itirapina (EEI), one of the last natural grassland savannah remnants in Sao Paulo state, in the south-east of Brazil between September and December 2006 and densities estimated for seven species (four endemic to the Cerrado, one near-endemic and two grassland specialists). Neither species reached the minimum viable population size of 500-5000 individuals. Four species, White-banded Tanager, White-rumped Tanager, Black-throated Saltator and Sharp-tailed Tyrant have populations ranging from 112 to 248 individuals, while the other species have a low population (< 60 individuals). The mean densities of Sharp-tailed Tyrant and Cock-tailed Tyrant in the EEI grassland showed similar values to those observed in larger areas of the Cerrado, which may indicate that the EEL grassland area is well conserved. In spite of the restricted size of the EEI, small areas can maintain some endemic and threatened bird populations, thus contributing to local biodiversity and the ecological processes in the region. The capacity of fragments of Cerrado (similar to 2,000 ha) to maintain populations of endemic and threatened bird species is unlikely to be effective in the long term.

Congenital Chagas disease: time to screen pregnant women?

The congenital transmission of Trypanosoma cruzi has gained epidemiological importance because it is partially responsible for the spread of Chagas disease worldwide. The feasibility of a cure when infected children are treated early makes the detection of congenital infection a valuable goal toward the control of the disease. Here, the authors review and discuss the findings of Bua et al., who quantified the parasitemia of infected women and their newborns by quantitative PCR. The authors demonstrate that the maternal parasite burden is directly related to the risk of neonatal infection. This study points out the importance of a quantitative screen for T. cruzi in pregnant women who live in, or have traveled to, endemic areas for improving the diagnosis of infected newborns and providing prompt treatment.

Computed tomography to evaluate the association of fragmented heterolog cortical bone and methylmethacrylate to repare segmental bone defect produced in tibia of rabbits

A 6mm segmental defect was performed on the metaphyseal region of the tibia of 12 rabbits and the autoclaved fragmented heterolog cortical bone conserved in glycerin (98%) and methylmethacrylate was used as a bone graft for the reconstruction. The graft was placed in the receptor bed and its integration was evaluated by computed tomography after 30, 60 and 90 days. There was gradual bone graft incorporation in the receptor bed during the time in 100% of the cases. Fragmented cortical bone heterograft and methylmethacrylate was biologically compatible and promotes bone defect reparation without signs of infection, migration and or rejection, featuring a new option of osseous substitute to fill in bone defects.

A negative screen for mutations in calstabin 1 and 2 genes in patients with dilated cardiomyopathy

Background Calstabins 1 and 2 bind to Ryanodine receptors regulating muscle excitation-contraction coupling. Mutations in Ryanodine receptors affecting their interaction with calstabins lead to different cardiac pathologies. Animal studies suggest the involvement of calstabins with dilated cardiomyopathy. Results We tested the hypothesis that calstabins mutations may cause dilated cardiomyopathy in humans screening 186 patients with idiopathic dilated cardiomyopathy for genetic alterations in calstabins 1 and 2 genes (FKBP12 and FKBP12.6). No missense variant was found. Five no-coding variations were found but not related to the disease. Conclusions These data corroborate other studies suggesting that mutations in FKBP12 and FKBP12.6 genes are not commonly related to cardiac diseases.

Performance of six diagnostic tests to screen for Chagas disease in blood banks and prevalence of Trypanosoma cruzi infection among donors with inconclusive serology screening based on the analysis of epidemiological variables

OBJECTIVE: The frequent occurrence of inconclusive serology in blood banks and the absence of a gold standard test for Chagas'disease led us to examine the efficacy of the blood culture test and five commercial tests (ELISA, IIF, HAI, c-ELISA, rec-ELISA) used in screening blood donors for Chagas disease, as well as to investigate the prevalence of Trypanosoma cruzi infection among donors with inconclusive serology screening in respect to some epidemiological variables. METHODS: To obtain estimates of interest we considered a Bayesian latent class model with inclusion of covariates from the logit link. RESULTS: A better performance was observed with some categories of epidemiological variables. In addition, all pairs of tests (excluding the blood culture test) presented as good alternatives for both screening (sensitivity > 99.96% in parallel testing) and for confirmation (specificity > 99.93% in serial testing) of Chagas disease. The prevalence of 13.30% observed in the stratum of donors with inconclusive serology, means that probably most of these are non-reactive serology. In addition, depending on the level of specific epidemiological variables, the absence of infection can be predicted with a probability of 100% in this group from the pairs of tests using parallel testing. CONCLUSION: The epidemiological variables can lead to improved test results and thus assist in the clarification of inconclusive serology screening results. Moreover, all combinations of pairs using the five commercial tests are good alternatives to confirm results.