bluuebunny/crossref_metadata_2025 huggingface dataset:
Broadly cross-reactive antibodies dominate the human B cell response against 2009 pandemic H1N1 influenza virus infection
Authors: Wrammert Jens , Koutsonanos Dimitrios , Li Gui-Mei , Edupuganti Srilatha , Sui Jianhua , Morrissey Michael , McCausland Megan , Skountzou Ioanna , Hornig Mady , Lipkin W. Ian , Mehta Aneesh , Razavi Behzad , Del Rio Carlos , Zheng Nai-Ying , Lee Jane-Hwei , Huang Min , Ali Zahida , Kaur Kaval , Andrews Sarah , Amara Rama Rao , Wang Youliang , Das Suman Ranjan , O'Donnell Christopher David , Yewdell Jon W. , Subbarao Kanta , Marasco Wayne A. , Mulligan Mark J. , Compans Richard , Ahmed Rafi , Wilson Patrick C.
Published: January 2011

The 2009 pandemic H1N1 influenza pandemic demonstrated the global health threat of reassortant influenza strains. Herein, we report a detailed analysis of plasmablast and monoclonal antibody responses induced by pandemic H1N1 infection in humans. Unlike antibodies elicited by annual influenza vaccinations, most neutralizing antibodies induced by pandemic H1N1 infection were broadly cross-reactive against epitopes in the hemagglutinin (HA) stalk and head domain of multiple influenza strains. The antibodies were from cells that had undergone extensive affinity maturation. Based on these observations, we postulate that the plasmablasts producing these broadly neutralizing antibodies were predominantly derived from activated memory B cells specific for epitopes conserved in several influenza strains. Consequently, most neutralizing antibodies were broadly reactive against divergent H1N1 and H5N1 influenza strains. This suggests that a pan-influenza vaccine may be possible, given the right immunogen. Antibodies generated potently protected and rescued mice from lethal challenge with pandemic H1N1 or antigenically distinct influenza strains, making them excellent therapeutic candidates.
High prevalence of low affinity peptide–MHC II tetramer–negative effectors during polyclonal CD4+ T cell responses
Authors: Sabatino Joseph J. , Huang Jun , Zhu Cheng , Evavold Brian D.
Published: January 2011

T cell affinity for antigen initiates adaptive immunity. However, the contribution of low affinity cells to a response is unknown as it has not been possible to assess the entire affinity range of a polyclonal T cell repertoire. In this study, we used a highly sensitive two-dimensional binding assay to identify low affinity cells in polyclonal autoreactive and pathogen-reactive CD4+ T cell populations specific for myelin oligodendrocyte glycoprotein (MOG) and lymphocytic choriomeningitis virus (LCMV) antigens, respectively. Low affinity CD4+ T cells, below detection with peptide–major histocompatibility complex class II tetramers, were at least as frequent as high affinity responders and contributed significant effector cytokines in both primary antigen–specific responses. We further demonstrated that MOG- and LCMV-specific CD4+ T cells possessed similarly broad ranges in their affinities (>100-fold wide), only differing in the frequencies of low and high affinity cells. Thus, low as well as high affinity CD4+ T cells are critical effectors in autoimmune and pathogen-specific responses.
Heterogeneity and Distributional Form of Farm‐Level Yields
Authors: Claassen Roger , Just Richard E.
Published: January 2011

Representing farm‐level crop yield heterogeneity and distributional form is critical for risk and crop insurance research. Most studies have used county data, understating both systematic and random variation. Comparison of systematic versus random intra‐county variation is lacking. Few studies compare the various distributional forms that have been proposed. This study utilizes the extensive potential of government farm‐level crop insurance data. Results show that systematic intra‐county variation is surprisingly strong. A newly applied reverse lognormal distribution is preferred when county‐wide variation is removed, but the normal distribution fits surprisingly well in the crop insurance relevant percentiles when county‐wide variation is not removed.
Are Consumers in Developing Countries Willing to Pay More for Micronutrient‐Dense Biofortified Foods? Evidence from a Field Experiment in Uganda
Authors: Chowdhury Shyamal , Meenakshi J. V. , Tomlins Keith I. , Owori Constance
Published: January 2011

Vitamin A deficiency is a major health problem in Africa and in many other developing countries. Biofortified staple crops that are high in pro‐vitamin A have the potential to reduce the prevalence of vitamin A deficiency. Using a choice experiment with the real product in Uganda, we quantify the magnitude of the premium or discount in consumers’ willingness‐to‐pay (WTP) that may be associated with it. Results suggest that taste plays an important role in consumer acceptance, and the provision of nutrition information does translate into substantial premiums for the biofortified variety. There is a substantial hypothetical bias in the WTP for the new varieties, and while cheap talk mitigates this bias, it does not eliminate it.
Demonstrate the Ability to Give Effective Feedback to a Colleague
Authors: Prasad Vibhore
Published: January 2011

If you find yourself in a position where you have to give feedback to a colleague, this can often be a daunting prospect. This article will give you some practical tips and guidance, along with relevant theory, so that you can approach such a task with confidence. Primary care is a multidisciplinary speciality in which there is often little hierarchy. This means that you could find yourself getting feedback to a colleague from a different background to yourself or find yourself giving feedback to someone whom you see as a senior clinician.
Nucleotide composition-linked divergence of vertebrate core promoter architecture
Authors: van Heeringen Simon J. , Akhtar Waseem , Jacobi Ulrike G. , Akkers Robert C. , Suzuki Yutaka , Veenstra Gert Jan C.
Published: January 2011

Transcription initiation involves the recruitment of basal transcription factors to the core promoter. A variety of core promoter elements exists; however for most of these motifs, the distribution across species is unknown. Here we report on the comparison of human and amphibian promoter sequences. We have used oligo-capping in combination with deep sequencing to determine transcription start sites inXenopus tropicalis. To systematically predict regulatory elements, we have developed a de novo motif finding pipeline using an ensemble of computational tools. A comprehensive comparison of human and amphibian promoter sequences revealed both similarities and differences in core promoter architecture. Some of the differences stem from a highly divergent nucleotide composition ofXenopusand human promoters. Whereas the distribution of some core promoter motifs is conserved independently of species-specific nucleotide bias, the frequency of another class of motifs correlates with the single nucleotide frequencies. This class includes the well-known TATA box and SP1 motifs, which are more abundant inXenopusand human promoters, respectively. While these motifs are enriched above the local nucleotide background in both organisms, their frequency varies in step with this background. These differences are likely adaptive as these motifs can recruit TFIID to either CpG island or sharply initiating promoters. Our results highlight both the conserved and diverged aspects of vertebrate transcription, most notably showing co-opted motif usage to recruit the transcriptional machinery to promoters with diverging nucleotide composition. This shows how sweeping changes in nucleotide composition are compatible with highly conserved mechanisms of transcription initiation.
Genome-Wide Analysis of Light-Dependent Transcript Accumulation Patterns during Early Stages of Arabidopsis Seedling Deetiolation
Authors: Peschke Florian , Kretsch Thomas
Published: January 2011

Light is among the most important exogenous factors that regulate plant development. To sense light quality, intensity, direction, and duration, plants have evolved multiple photoreceptors that enable the detection of photons from the ultraviolet B (UV-B) to the far-red spectrum. To study the effect of different light qualities on early gene expression, dark-grown Arabidopsis (Arabidopsis thaliana) seedlings were either irradiated with continuous far-red, red, or blue light or received pulses of red, UV-A, or UV-A/B light. The expression profiles of seedlings harvested at 45 min and 4 h were determined on a full genome level and compared with the profiles of dark controls. Data were used to identify light-regulated genes and to group these genes according to their light responses. While most of the genes were regulated by more than one light quality, a considerable number of UV-B-specific gene expression responses were obtained. An extraordinarily high similarity in gene expression patterns was obtained for samples that perceived continuous irradiation with either far-red or blue light for 4 h. Mutant analyses hint that this coincidence is caused by a convergence of the signaling cascades that regulate gene expression downstream of cryptochrome blue light photoreceptors and phytochrome A. Whereas many early light-regulated genes exhibited uniform responses to all applied light treatments, highly divergent expression patterns developed at 4 h. These data clearly indicate that light signaling during early deetiolation undergoes a switch from a rapid, but unspecific, response mode to regulatory systems that measure the spectral composition and duration of incident light.
The genetic architecture of embryonic developmental rate and genetic covariation with age at maturation in rainbow trout Oncorhynchus mykiss
Authors: Easton A. A. , Moghadam H. K. , Danzmann R. G. , Ferguson M. M.
Published: January 2011

The genetic architecture underlying variation in embryonic developmental rate (DR) and genetic covariation with age of maturation (MAT) was investigated in rainbow trout Oncorhynchus mykiss. Highly significant additive parental effects and more limited evidence of epistatic effects on progeny hatching time were detected in three diallel sets of families. Genome scans with an average of 142 microsatellite loci from all 29 linkage groups in two families detected significant quantitative trait loci (QTL) for developmental rate on RT‐8 and RT‐30 with genome‐wide and chromosome‐wide effects, respectively. The QTL on linkage group RT‐8 explained 23·7% of the phenotypic variation and supports results from previous studies. The co‐localization of QTL for both DR and MAT to several linkage groups and the observation that alleles associated with faster developmental rate were found significantly more often in early maturing rather than typical and later maturing male ancestors supports the hypothesis of genetic covariation between DR and MAT. The maturation background and schedule of additional sires, however, did not have a consistent association with their progeny hatching times, suggesting that other genetic, environmental and physiological effects contribute to variation in these life‐history traits.
The application of risk and disease modelling to emerging freshwater diseases in wild aquatic animals
Authors: THRUSH MARK A. , MURRAY ALEXANDER G. , BRUN EDGAR , WALLACE STUART , PEELER EDMUND J.
Published: January 2011

1. Emerging diseases pose significant ecological and economic threats in fresh waters. Both risk assessment and mathematical modelling have potential to improve our understanding of the uncertainties associated with emerging disease events and make informed predictions about their likely impact.

2. We review the different methodologies that may be used to estimate the likely geographic spread and potential impact of new and emerging diseases in fresh waters. We also highlight the limitations of the currently available methods and requirements for future development.

3. In the realm of aquatic animal health, risk assessment has been used mainly to examine the risks of disease spread through international trade import risk analysis (IRA). Import risk analysis of newly emerged diseases underpins the development of appropriate risk mitigation measures to minimise further spread. This is best illustrated by assessments of the spread of Gyrodactylus salaris and also illustrates how risk assessment can examine disease interaction between wild and farmed fish.

4. Various approaches have been employed to study disease transmission within freshwater fish populations at a range of spatial scales. There is scope for the application of these techniques to predict the impact of economically and environmentally important emerging freshwater diseases that arise from new pathogens, known diseases spreading to new locations or changes in pathogenicity owing to changing environmental conditions (e.g. because of climate change).

5. Population models are widely used in freshwater fishery management. The integration of disease processes within freshwater aquatic animal population models is required to provide tools to assess the likely impact of newly emerged diseases and allow mitigation measures to be assessed.

6. Compared with their use in other areas of animal health, modelling has been relatively little used for aquatic animal disease studies. The wide range of modelling methods used to study disease in human and terrestrial animals can usefully be applied to inform the development of policies to protect the health of wild stocks from emerging diseases.
The relationship between selected developmental assets and health‐promoting behaviours of adolescents in Southern Taiwan
Authors: Wang Ruey‐Hsia , Chen Shu‐Wen , Tang Shan‐Mei , Lee Shu‐Li , Jian Shu‐Yuan
Published: January 2011

Aims and objectives.  To examine the relationship between selected developmental assets and health‐promoting behaviours of adolescents.

Background.  Developmental assets can be considered as potential health assets for adolescents. Understanding the relationship between developmental assets and health‐promoting behaviours among adolescents could provide nurses with a new approach to design intervention programmes for adolescent health‐promoting behaviours.

Design.  A cross‐sectional study design.

Methods.  Anonymous questionnaires were administered to 453 adolescents aged between 13–16 years. Canonical correlation analysis was used to examine the relationship between selected developmental assets and health‐promoting behaviours.

Results.  Canonical correlation analysis indicated two significantly meaningful variate pairs between selected developmental assets and health‐promoting behaviour sets. The first pair variate accounted for 51·3% of the total variance, which showed that adolescents who had better self‐esteem, future aspirations, responsible choices, family communication, non‐parental adult role models, peer role models and community involvement had better behaviours of life appreciation, health responsibility, social support, stress management, nutrition and exercise. The second pair variate accounted for 9·6% of the total variance, which showed that adolescents who had better responsible choices had better stress management behaviours.

Conclusion.  Developmental assets are important to adolescents’ health‐promoting behaviours. Interventions focusing on strengthening developmental assets can potentially provide an innovative approach for nurses to improve health‐promoting behaviours of adolescents.

Relevance to clinical practice.  Strengthening developmental assets can potentially improve the health‐promoting behaviours of adolescents. Individual and sociopolitical domains should be incorporated into programmes for enhancement of developmental assets. School nurses can cooperate with family and community and provide environments improving adolescents’ developmental assets. Nurses should actively engage in developmental asset programmes for adolescents. The tools for measuring developmental assets modified and developed in this study were valid and reliable. They can be used for further examination of the developmental assets for adolescents in various subset populations.
A psychometric evaluation of the Taiwan version of the Individual Workload Perception Scale
Authors: Lin Shu‐Yuan , Lin Chung‐Hui , Yeh Mei Chang , Lin Shu‐Ying , Hwang Yueh‐Jiau
Published: January 2011

Aim. The aim was to evaluate the psychometric properties of the Taiwan version of the Revised Individual Workload Perception Scale on staff nurses in southern Taiwan.

Background. Most psychometric measures of the nursing work environment were developed in North America and reflect nursing practice in Western health care environments. As these instruments are used most often in translation, it is important to inquire whether they appropriately capture the characteristics of nursing work in environments outside of the original contexts.

Design. A descriptive, cross‐sectional study was conducted between 1 June–30 September 2009, with a convenience sample of 344 nurses providing direct patient care at a regional teaching hospital in southern Taiwan. The Taiwan version of the Revised Individual Workload Perception Scale was created by translating the original English language Individual Workload Perception Scale–Revised, which is used to measure the staff nurses’ perceptions of their work environment. The Taiwan version of the Revised Individual Workload Perception Scale is a 24‐item five‐point Likert scale measuring manager support, peer support, unit support, workload and intent to stay. Content validity, construct validity and reliability of the Taiwan version of the Revised Individual Workload Perception Scale were evaluated.

Results. The content validity index of the Taiwan version of the Revised Individual Workload Perception Scale was 0·93. Cronbach’s alpha for the total Taiwan version of the Revised Individual Workload Perception Scale was 0·88, with a range of 0·61–0·85 for the subscales. Factorial validity was supported using a five‐factor model solution that accounted for 55·47% of the total variance for nursing work environment. Manager support had the highest explained variance (28·38%).

Conclusions. Acceptable reliability and content validity were found; the Taiwan version of the Revised Individual Workload Perception Scale is recommended for measuring nurses’ perceptions of their work environment.

Relevance to clinical practice. Psychometric properties of a scale such as the Individual Workload Perception Scale translate cross‐culturally, with minor adjustments. The Taiwan version of the Revised Individual Workload Perception Scale can be used to provide data and analyses in comparisons with nursing work environment features internationally.
Efficacy of controlling night‐time noise and activities to improve patients’ sleep quality in a surgical intensive care unit
Authors: Li Shu‐Yen , Wang Tsae‐Jyy , Vivienne Wu Shu F , Liang Shu‐Yuan , Tung Heng‐Hsin
Published: January 2011

Aim.  The aim of the study was to test the efficacy of sleep care guidelines for controlling night‐time noise and improving sleep quality of patients in a surgical intensive care unit.

Background.  Poor sleep quality places critically ill patients at greater risk for infection, complications and mortality. Environmental stimuli such as noises, continuous lighting and frequent care‐related activities in an intensive care unit interfere with patients’ sleep.

Design.  The study used a quasi‐experimental design.

Method.  Sixty surgical patients were recruited from an intensive care unit in Taiwan during December 2007–May 2008. The control group received the usual care, and the experimental group was cared for by nurses who followed the sleep care guidelines for noise and light reduction. Data were collected on noise level and sleep quality using the Sleep in the Intensive Care Unit Questionnaire, the Richards Campbell Sleep Questionnaire and a decibel meter.

Results.  The results showed that both the peak sound level (χ2 = 50·1, p < 0·001) and average noise level (χ2 = 46·5, p < 0·001) were reduced significantly, after implementing the guidelines. The perceived noise (t = −2·07, p = 0·046) and sleep interruptions from care‐related activities (t = 5·282, p < 0·001) and noises (t = 4·361, p < 0·001) were all significantly lower in the experimental group than in the control group. The experimental group also reported better sleep quality (t = −2·28, p = 0·027) and sleep efficiency (t = −2·03, p = 0·047) than did the control group.

Conclusions.  These results support the efficacy of the guidelines for controlling night‐time noise and care activities to improve patients’ sleep quality.

Relevance to clinical practice.  Nurses should try to reduce external environmental stimuli and maintain an almost undisturbed period between midnight and 5:00 a.m. to enhance patients’ sleep in a surgical intensive care unit.
Conflict management styles used by nurse managers in the Sultanate of Oman
Authors: Al‐Hamdan Zaid , Shukri Raghda , Anthony Denis
Published: January 2011

Aim.  The study aimed at investigating the conflict management styles used by nurse managers in the Sultanate of Oman.

Background.  Conflict is inevitable in daily nursing work. Several styles are used to manage conflict situations. In previous studies conducted in Western countries, avoiding and compromising conflict management styles appear to be the first choices for the nurses. In Arab countries, no study to date has examined the conflict management styles used by nurse managers to compare with the results from studies conducted in Western countries.

Design.  Survey.

Method.  A questionnaire was distributed to all nurse managers working in the three‐management levels from nine referral hospitals in Sultanate of Oman, 271 were returned, a response rate of 86%. The results were analysed using spss version 16.

Results.  Nurse managers in Oman used all five conflict management styles, with integrating style as the first choice followed in order by compromising, obliging, dominating and avoiding. These results differ from the results of the studies conducted on nurses in other countries.

Conclusion.  The results of this study have implications for people who work in the hospitals, whether practitioners or policy makers. Recommendations are offered to improve nurse managers’ work environment.

Relevance to clinical practice.  Conflict can affect patient care if handled badly. Poorly handled conflict results in lower staff morale and poorer retention, both adversely affect patient care.
The Patient‐Centred Medical Home in the USA
Authors: Epperly Ted
Published: January 2011

Rationale  The Patient‐Centred Medical Home (PCMH) is a new model of health care delivery in the USA at the primary care level that emphasizes integrated and coordinated care around the patients' needs and desires. The PCMH emphasizes a practice‐wide team approach to provide high quality, accessible and cost‐effective health care for acute, chronic and prevention‐oriented problems.

Method  This article is a descriptive overview of the PCMH in the USA.

Results  The data on the PCMH have shown decreased mortality, morbidity and increased patient and physician satisfaction with care. Additionally, quality of care and patient access have improved. There has been decreased emergency room utilization, decreased hospitalization and decreased cost per patient.

Conclusion  The PCMH in the USA has been an outstanding transformative model change to re‐centre health care back to cost‐effective, quality, accessible primary care.
The Individual Practice Development Theory: an individually focused practice development theory that helps target practice development resources
Authors: Melton Jane , Forsyth Kirsty , Freeth Della
Published: January 2011

Background  Research indicates that multifaceted practice development (PD) interventions are more effective than single strategies. However, models of education in health care need to consider cost‐effectiveness.

Objectives  This paper presents a research‐based, PD theory called the Individual Practice Development Theory. It argues that programmes that use the Individual Practice Development Theory to tailor PD support to the learning needs of practitioners will result in more engagement in PD and will target PD resources efficiently.

Methods  The in‐depth qualitative, multi‐method realistic evaluation was of a multifaceted, organization‐wide PD programme in one National Health Service Mental Health and Learning Disabilities Trust. Semi‐structured interviews, practice observation and documentation audit were used to gather data from occupational therapists.

Findings  Results indicated that environmental contexts, particularly the support of the immediate team, and the participant's personal circumstances affected PD behaviour change. Six mechanisms acted as catalysts. These were: Building Confidence, Finding Flow, Accumulating Reward, Conferring with Others, Constructing Knowledge Know‐how and Channelling Time. Four stages of PD characterized as: ‘In the Hangar’, ‘On the Runway’, ‘Take‐off’ and ‘In the Air’ were identified. The research also illustrated the interconnectivity between outcome levels, contextual circumstances and activating mechanisms.

Discussion  The findings suggested that PD interventions need to be more individually tailored to achieve optimum learning outcomes. The identification of four discernable stages permits rapid understanding of PD support needs in order to focus PD support.

Conclusion  With a systematic and individualized approach to PD in health care, more target PD supports can be put in place.
Evaluation of effectiveness and satisfaction outcomes of a mental health screening and referral clinical pathway for community nursing care
Authors: ALLEN J. , ANNELLS M. , NUNN R. , PETRIE E. , CLARK E. , LANG L. , ROBINS A.
Published: January 2011

Accessible summary

The study aimed to develop, trial and evaluate a feasible, best‐practice mental health screening and referral clinical pathway for generalist community nursing care of war veterans and war widow(er)s in Australia.

This paper reports the evaluation pertaining to clients on whom the pathway was trialled and their informal carers, most of whom were highly satisfied or satisfied with care provided through application of the pathway.

Understanding is gained of how community nurses might productively screen for mental health difficulties among not only war veteran and war widow(er) clients, but possibly clients in general.

The trialled pathway, which was modified and refined following the study, is now available on the Internet as an evidence‐based resource for community nurses in Australia to guide holistic community nursing care for war veterans and war widow(er)s where that care is funded by Department of Veterans' Affairs.

The study aimed to explore the effectiveness of a mental health screening and referral clinical pathway for generalist community nursing care of war veterans and war widow(er)s in Australia on outcomes of client self‐reported mental health, quality of life, and client and carer satisfaction. The pathway was developed by literature review and consultation, then trialled and evaluated. Validated screening tools were embedded within the pathway to support generalist nurses' mental health decision making. Pre‐ and post‐measures were applied. Clients on whom the pathway was trialled were invited to complete an evaluation survey questionnaire, as were their informal carers. Most clients and carers who responded to these questionnaires were highly satisfied or satisfied with care provided through application of the pathway. This study adds understanding about one way that community nurses might identify people with mental health difficulties. The trialled pathway, which was modified and refined following the study, is now available on the Internet as an evidence‐based resource for community nurses in Australia to guide practice and maximize holistic care for war veterans and war widow(er)s where that care is funded by Department of Veterans' Affairs.
Diseases in tropical and plantation crops as affected by climate changes: current knowledge and perspectives
Authors: Ghini R. , Bettiol W. , Hamada E.
Published: January 2011

Tropical and plantation crops include important crops for food security and alternative energy resources. Even so, there are few studies on the impact of climate change on diseases of these crops. Findings from previous studies concerning some climate‐change effects on diseases of coffee, sugarcane, eucalyptus, cassava, citrus, banana, pineapple, cashew, coconut and papaya have been summarized to provide a context. By reviewing available methods to evaluate the impact of climate change on diseases of tropical and plantation crops, we present trends for some diseases and their management strategies, identify critical gaps in knowledge, and suggest experimental and analytical approaches to advance knowledge. As the projected climate conditions will probably vary greatly in the future from continent to continent and from developed to developing countries, studies must be conducted under tropical regions considering their specific environmental conditions. Multifactor studies under realistic field situations, such as free air CO2 enrichment with increasing CO2 and O3 concentrations incorporating spectral reflectance measures in situ for realistic assessment of plant growth, are a way forward. Effects of a changing climate on chemical and biological controls are discussed in the context of changing global outlook on environmental demands for the future.
Host suitability of Vitis rootstocks to root‐knot nematodes (Meloidogyne spp.) and the dagger nematode Xiphinema index, and plant damage caused by infections
Authors: Gutiérrez‐Gutiérrez C. , Palomares‐Rius J. E. , Jiménez‐Díaz R. M. , Castillo P.
Published: January 2011

The host suitability of commercial Vitis rootstocks commonly used in Spain (161‐49C, 41B, 1103P, 110R, 140Ru and SO4) to root‐knot nematodes (Meloidogyne arenaria, M. incognita, M. javanica) and Xiphinema index, and damage caused by nematode infection were determined under controlled conditions. The three root‐knot nematodes reproduced with a rate higher than one in all rootstocks, indicating that they are suitable hosts for these nematodes. Growth of rootstocks infected with the root‐knot nematodes was less vigorous than that of nematode‐uninfected controls in the majority of the rootstocks studied. Root infection resulted in moderate to severe root galling in all rootstocks. The shoot and main stem diameters appeared to be the most sensitive variables of damage caused by infection by Meloidogyne spp., with reduction rates from 36% and 53% in 161‐49C to 57% and 66% in 140Ru, respectively. The shoot height was not significantly affected by the root‐knot nematodes and the root fresh weight generally increased as a consequence of intensive galling. The nematode X. index caused significant root damage with a reproduction factor higher than one in all rootstocks. However, reproduction factor was significantly influenced by the rootstock and significantly decreased by about 12‐fold (5·7 to 18·1‐fold) with the increase in inoculum density from 100 to 1000 nematodes per plant. The root dry weight was reduced by X. index infections, and was the plant growth variable most affected by the nematode infection in all rootstocks at both inoculum densities. Meloidogyne arenaria, M. incognita, M. javanica and X. index, prevalent in many world vineyards, are all shown to have a damaging effect on the six tested rootstocks.
Geographic distribution of plant pathogens in response to climate change
Authors: Shaw M. W. , Osborne T. M.
Published: January 2011

Geographic distributions of pathogens are the outcome of dynamic processes involving host availability, susceptibility and abundance, suitability of climate conditions, and historical contingency including evolutionary change. Distributions have changed fast and are changing fast in response to many factors, including climatic change. The response time of arable agriculture is intrinsically fast, but perennial crops and especially forests are unlikely to adapt easily. Predictions of many of the variables needed to predict changes in pathogen range are still rather uncertain, and their effects will be profoundly modified by changes elsewhere in the agricultural system, including both economic changes affecting growing systems and hosts and evolutionary changes in pathogens and hosts. Tools to predict changes based on environmental correlations depend on good primary data, which is often absent, and need to be checked against the historical record, which remains very poor for almost all pathogens. We argue that at present the uncertainty in predictions of change is so great that the important adaptive response is to monitor changes and to retain the capacity to innovate, both by access to economic capital with reasonably long‐term rates of return and by retaining wide scientific expertise, including currently less fashionable specialisms.
Possible climate‐change effects on mycotoxin contamination of food crops pre‐ and postharvest
Authors: Magan N. , Medina A. , Aldred D.
Published: January 2011

This paper examines the available information on the potential for climate‐change impacts on mycotoxigenic fungi and mycotoxin contamination of food crops pre‐ and postharvest. It considers the effect of changes in temperature/water availability on mycotoxin contamination, especially incidences where aflatoxin B1 and ochratoxin A production has been influenced. The potential of using preharvest models to predict risk from deoxynivalenol (DON) in wheat, fumonisin B1 in maize and aflatoxins in maize and peanuts in different continents are considered in the context of potential for adaptation to include climate‐change scenarios. Available information suggests that slightly elevated CO2 concentrations and interactions with temperature and water availability may stimulate growth of some mycotoxigenic species, especially under water stress. The accumulated knowledge on interacting conditions of water/temperature effects on optimum and boundary conditions for growth and mycotoxin production has been used to predict the effects that +3 and +5°C increases under water stress would have on growth/mycotoxin production by mycotoxigenic species. Various spatial scales, from toxin gene expression to regional approaches using geostatistics, are examined for their use in understanding the impact that climate change may have on food contamination in developing and developed countries. The potential for using an integrated systems approach to link gene expression data, phenotypic toxin production under different interacting abiotic conditions is discussed using Fusarium species and DON as examples. Such approaches may be beneficial for more accurate predictions of risk from mycotoxins on a regional basis and also the potential for new emerging toxin threats.
Soluble Urokinase Plasminogen Activator Receptor During Allogeneic Stem Cell Transplantation
Authors: Haastrup E. , Andersen J. , Ostrowski S. R. , Høyer‐Hansen G. , Jacobsen N. , Heilmann C. , Ullum H. , Müller K.
Published: January 2011

Previous studies have found that soluble urokinase plasminogen activation receptor (suPAR) increases during inflammatory and malignant illness and elevated suPAR levels may be associated with poor clinical outcome. The purpose of this study was to investigate plasma levels of suPAR during the course of allogeneic stem cell transplantation (SCT). Twenty SCT patients were included in the study. suPAR was measured by ELISA in daily taken plasma samples during the pretransplant conditioning with chemotherapy and weekly for 1 month after infusion of the graft. suPAR levels before the start of the conditioning were significantly elevated when compared to those of healthy controls. During the conditioning in particular treatment with antithymocyte globulin was associated with significantly increased suPAR levels (P = 0.012). At day +7 after infusion of the graft, suPAR levels had decreased to pretreatment levels. High suPAR levels at day 0 were associated with increased mortality (P = 0.011). The present study found increased suPAR levels during the conditioning in SCT patients. Further, the data indicated that increased suPAR levels may be associated with increased mortality, suggesting suPAR as a candidate for further studies as an outcome predictor in SCT.
The interface between health systems and vertical programmes in Francophone Africa: the managers’ perceptions
Authors: Keugoung Basile , Macq Jean , Buvé Anne , Meli Jean , Criel Bart
Published: January 2011

Objective  To explores the interface between vertical programmes (VPs) and general health services (GHS) in sub‐Saharan Africa.

Methods  Using semi‐structured interviews, we analysed the perceptions of a selection of experienced mid‐level managers of health systems and of VP originating in francophone Africa on the nature and quality of this interface.

Results  The respondents acknowledged that VPs lead to both positive and negative effects on the functioning of GHS. The overall result, however, cannot be viewed as a simple summation of the positive effects possibly compensating for the negative ones. Indeed, some of the negative effects have a profound impact on the management and operation of the health care delivery system and may undermine the long‐term institutional capacity of the general health systems. The quality and the nature of the interface between VP and GHS strongly vary in time, between settings and programmes.

Conclusion  We argue for more systematic monitoring of the interface between VP and GHS, so as to identify and address, in a timely manner, significant disruptive effects and deficiencies in a perspective of systemic capacity building of health systems.
The patient‐reported Clinicians’ Cultural Sensitivity Survey: a field test among older Latino primary care patients
Authors: Nápoles Anna M. , Santoyo‐Olsson Jasmine , Farren Georgianna , Olmstead Jill , Cabral Ruben , Ross Barry , Gregorich Steven E. , Stewart Anita L.
Published: January 2011

Background  Patient‐reported measures of clinicians’ cultural sensitivity are important to assess comprehensively quality of care among ethnically diverse patients and may help address persistent health inequities.

Objective  Create a patient‐reported, multidimensional survey of clinicians’ cultural sensitivity to cultural factors affecting quality of care.

Design  Using a comprehensive conceptual framework, items were written and field‐tested in a cross‐sectional telephone survey. Multitrait scaling and factor analyses were used to develop measures.

Setting and participants  Latino patients age ≥50 from primary care practices in California.

Main variables studied  Thirty‐five items hypothesized to assess clinicians’ sensitivity.

Main outcomes measures  Validity and reliability of cultural sensitivity measures.

Results  Twenty‐nine of 35 items measuring 14 constructs were retained. Eleven measures assessed sensitivity issues relevant to all participants: complementary and alternative medicine, mind–body connections, causal attributions, preventive care, family involvement, modesty, prescription medications, spirituality, physician discrimination due to education, physician discrimination due to race/ethnicity and staff discrimination due to race/ethnicity. Three measures were group specific: two to limited English proficient patients (sensitivity to language needs and discrimination due to language) and one to immigrants (sensitivity to immigrant status). Twelve multi‐item scales demonstrated adequate reliability (alpha ≥0.68 except for Spanish discrimination due to education) and evidence of construct validity (item‐scale correlations for all scales >0.40 except for sensitivity to immigrant status). Two single‐item measures demonstrated sufficient construct validity to retain for further development.

Discussion and conclusions  The Clinicians’ Cultural Sensitivity Survey can be used to assess the quality of care of older Latino patients.
Photoselective vaporization for prostatic obstruction with the 120‐W lithium triborate laser: 1‐year clinical outcomes
Authors: Woo Henry Hyunshik , Hossack Tania Anne
Published: January 2011

There are few reports of the clinical outcomes of photoselective vaporization of the prostate (PVP) for benign prostatic hyperplasia (BPH) using the 120‐W lithium triborate (LBO) laser. The present study evaluates clinical outcomes of 76 men treated with the 120‐W LBO laser by an experienced PVP surgeon with 12 months follow up. The International Prostate Symptom Score (IPSS), peak flow rate (Qmax) and post‐void residual (PVR) were examined at baseline and at 3 and 12 months. These parameters at baseline and 12 months were 20 ± 7.0, 7.6 ± 3.5 mL/s, 155 ± 155 mL and 8.1 ± 6.1, 22.5 ± 10.3 mL/s, 59 ± 87 mL, respectively. Clinically, meaningful improvements in IPSS, Qmax and PVR were observed at 3 months and sustained at 12 months. There were few adverse events, with only 5.3% of patients requiring recatheterization. Clinical outcome at 12 months was similar to that at 3 months and to other published series.
Umbilical laparoendoscopic single site surgery versus inguinal varicocelectomy for bilateral varicocele: A comparative study
Authors: Park Sung‐Woo , Kim Tae‐Nam , Lee Wan , Park Hyun Jun , Lee Sang‐Don , Park Nam Cheol
Published: January 2011

We aimed to determine the efficacy of umbilical laparoendoscopic single site surgery (LESS) bilateral varicocelectomy on the basis of a comparative study versus open inguinal bilateral varicocelectomy. We enrolled 39 patients who underwent bilateral varicocelectomy with predetermined surgical indications at two hospitals with either the LESS (n = 19) or the open inguinal approach (n = 20). Operative time, operation‐related pain (10‐point visual analog pain scale), catch‐up growth of the testes, semen parameters, and complications after surgery between the LESS group and the open group at 3 months after surgery were compared. Operative times were 46.8 and 72.8 min (P < 0.001) in the LESS and open surgery groups, respectively. Patients in the LESS group reported lower surgery‐related pain than those in the open surgery group at 3 months (2.5 vs 1.2, P = 0.029). A significant improvement in terms of semen concentration, motility, catch‐up growth of the bilateral testes was observed in both groups, although no significant differences were detected between the groups. Postoperative complications were also similar between the two groups. LESS varicocelectomy required a shorter operative time than inguinal varicocelectomy for bilateral cases. In addition, the LESS procedure showed less postoperative pain and cosmetic benefits with similar seminal outcomes. Thus, LESS for patients undergoing bilateral varicocelectomy represents a promising surgical approach.
Monitoring biodegradative enzymes with nanobodies raised inCamelus dromedariuswith mixtures of catabolic proteins
Authors: Zafra Olga , Fraile Sofía , Gutiérrez Carlos , Haro Amparo , Páez‐Espino A. David , Jiménez Jose I. , de Lorenzo Víctor
Published: January 2011

Functional studies of biodegradative activities in environmental microorganisms require molecular tools for monitoring catabolic enzymes in the members of the native microbiota. To this end, we have generated repertories of single‐domain VHHfragments of camel immunoglobulins (nanobodies) able to interact with multiple proteins that are descriptors of environmentally relevant processes. For this, we immunizedCamelus dromedariuswith a cocktail of up to 12 purified enzymes that are representative of major types of detoxifying activities found in aerobic and anaerobic microorganisms. Following the capture of the antigen‐binding modules from the mRNA of the camel lymphocytes and the selection of sub‐libraries for each of the enzymes in a phage display system we found a large number of VHHmodules that interacted with each of the antigens. Those associated to the enzyme 2,3 dihydroxybiphenyl dioxygenase ofBurkholderia xenovoransLB400 (BphC) and the arsenate reductase ofStaphylococcus aureus(ArsC) were examined in detail and found to hold different qualities that were optimal for distinct protein recognition procedures. The repertory of anti‐BphC VHHs included variants with a strong affinity and specificity for linear epitopes of the enzyme. When the anti‐BphC VHHlibrary was recloned in a prokaryotic intracellular expression system, some nanobodies were found to inhibit the dioxygenase activityin vivo. Furthermore, anti‐ArsC VHHs were able to discriminate between proteins stemming from different enzyme families. The easiness of generating large collections of binders with different properties widens considerably the molecular toolbox for analysis of biodegradative bacteria and opens fresh possibilities of monitoring protein markers and activities in the environment.
Mini‐laparotomy approach to radical cystectomy
Authors: Jensen Jørgen B. , Pedersen Knud V. , Olsen Kasper Ø. , Bisgaard Ulla F. , Jensen Klaus M.
Published: January 2011

Study Type – Therapy (case series)

Level of Evidence 4

What’s known on the subject? and What does the study add?

In the recent decade minimally invasive endoscopically approaches have been suggested as a way to reduce morbidity following radical cystectomy.

The present study suggests that the same advantages found, when comparing endoscopical cystectomy to classical open cystectomy, can be achieved by reducing the wound length of the open approach.

OBJECTIVE

To investigate the feasibility of performing radical cystectomy (RC) through a mini‐laparotomy and to evaluate the effect of a smaller incision on wound problems, immediate postoperative pain, bowel function and length of hospital stay (LOS).

PATIENTS AND METHODS

Two consecutive cohorts of patients, one with 75 patients undergoing open RC (ORC) with lymph node dissection up to the aortic bifurcation through a conventional long midline incision and one with 75 patients undergoing RC through a mini‐laparotomy (MinilapRC) of intentionally <8–10 cm.

Patient characteristics, operative duration, estimated blood loss (EBL), incidence and severity of wound problems, return of bowel function, amount of analgesics needed and LOS were analysed according to the intention‐to‐treat principle.

RESULTS

The demographic characteristics of the two groups were similar.

An incision of ≤10 cm was made in 65% of the patients in the MinilapRC group with a median (range) length of incision of 9 (6.5–19) cm. In the final third of patients operated on in the MinilapRC group, 76% had an incision of ≤8 cm.

The operative duration and EBL were not significantly different between the groups.

Wound problems were significantly fewer, bowel function was restored more quickly and the need of postoperative analgesics was less in the MinilapRC group.

In the MinilapRC group LOS was reduced by a median of 3 days.

CONCLUSION

MinilapRC is feasible in most patients without increasing operative duration. The reduced incision length reduces postoperative morbidity.
Focal therapy in the management of localized prostate cancer
Authors: Nguyen Carvell T. , Jones J. Stephen
Published: January 2011

What’s known on the subject? and What does the study add?

Focal therapy, which includes cryotherapy and high‐intensity focused ultrasound, is a nascent and somewhat controversial field in the management of prostate cancer. The current review presents the rationale, indications and potential role for focal therapy in patients with localized prostate cancer.

OBJECTIVES

• To assess the rationale, efficacy, and morbidity of various methods of achieving focal prostatic ablation.

• To determine the current role of focal therapy in the management of localized prostate cancer.

METHODS

• We performed a literature review of focal therapy in prostate cancer, with an emphasis on more established methods such as cryoablation and high‐intensity focused ultrasound.

RESULTS AND CONCLUSIONS

• Focal ablative methods allow targeted destruction of prostatic tissue while limiting the morbidity associated with whole‐gland therapy.

• Local cancer control after focal therapy appears promising but does not approach that of established whole‐gland therapies.

• Until we have the ability to identify patients reliably with truly focal disease and predict their natural history, focal therapy cannot be considered to be the definitive therapy for localized prostate cancer.