bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk stratification of systemic allergic reactions during Hymenoptera venom immunotherapy buildup phase
Authors: Stoevesandt Johanna , Hosp Christine , Kerstan Andreas , Trautmann Axel
Published: March 2014

Background

Comparability of previous studies assessing the incidence of systemic reactions during Hymenoptera venom immunotherapy (VIT) is impaired by methodical differences concerning the definition and classification of VIT‐induced anaphylaxis. Our study aims to systematically evaluate the time course and clinical symptoms of VIT‐related systemic reactions.

Patients and Methods

12‐year data on 818 buildup cycles including 8,504 single injections were retrieved from detailed inpatient treatment protocols. The severity of VIT‐related anaphylaxis was graded according to a system proposed by the World Allergy Organization in 2010.

Results

Objective allergic reactions occurred in 28 (3.4 %) buildup cycles; treatment with antihistamines and/or corticosteroids was invariably effective. 23 exclusively cutaneous reactions occurred after a median time interval of 60 minutes (5–480 min.) following the last injection. 0.6 % of the buildup cycles were complicated by moderate to severe anaphylaxis, which occurred more rapidly than mere urticaria and predominantly during honeybee VIT. Patients with moderate to severe anaphylaxis more frequently reported severe index sting reactions and had higher baseline serum tryptase concentrations.

Conclusions

Objective allergic reactions during VIT are rare, and severe anaphylaxis is extremely rare. The use of a consistent classification system for VIT‐induced systemic reactions is required to identify risk factors not only for their general incidence, but also for the exceptionally severe anaphylactic reactions.
Clinical Results for use of local anesthesia with epinephrine in penile nerve block
Authors: Schnabl Saskia Maria , Herrmann Nadine , Wilder Daniel , Breuninger Helmut , Häfner Hans‐Martin
Published: March 2014

Background

It is widely accepted that local anesthetics with epinephrine should not be used in areas served by terminal vessels. There is no evidence in studies for this in penile surgery, and given the anatomy of the penis, perfusion complications are highly unlikely. The goal of this study was to show that a penile block using a local anesthetic with epinephrine is safe.

Patients and Methods

In a follow‐up study between 2005 and 2010, we analyzed 95 patients who got a penile ring block with subcutaneous infusion anesthesia (SIA). The SIA solution consisted of ropivacaine and lidocaine (0.11% and 0.21%) plus epinephrine.

Results

There were no anesthetic complications. Short‐term negative postoperative occurrences (<72 hrs.) were swelling (42%), problems with suture material (22%), pain (19%), hematoma and paresthesia (each 13%), erectile dysfunction (12%), small‐area skin necrosis after wound healing without requiring further surgery (13%), micturition disorders (7%), and wound infection (6%). Two patients on anticoagulation therapy had postoperative bleeding requiring revision surgery. 5% of the patients were given further analgesic sedation. 19% complained about postoperative pain. Persistent complaints (maximum 6 months) were disturbances of skin sensation (7%), swelling (4%), and redness and micturition disorders (3% each).

Conclusions

Supplementing a local anesthetic with epinephrine in penis operations has many advantages, including high patient satisfaction, relatively painless infiltration, low complication rates, improved view of the operating field, and an extended effect of anesthetics with a prolonged reduction in pain. Because of the anatomy of the organ, there is no risk of necrosis related to using a subcutaneous penile ring block. Thus the view that epinephrine should not be used in penis procedures is obsolete.
Spatial mismatch of phylogenetic diversity across three vertebrate groups and protected areas in Europe
Authors: Zupan Laure , Cabeza Mar , Maiorano Luigi , Roquet Cristina , Devictor Vincent , Lavergne Sébastien , Mouillot David , Mouquet Nicolas , Renaud Julien , Thuiller Wilfried
Published: March 2014

Aim

We investigate patterns of phylogenetic diversity in relation to species diversity for European birds, mammals and amphibians to evaluate their congruence and highlight areas of particular evolutionary history. We estimate the extent to which the European network of protected areas (PAs) network retains interesting evolutionary history areas for the three groups separately and simultaneously.

Location

Europe

Methods

Phylogenetic (QEPD) and species diversity (SD) were estimated using the Rao's quadratic entropy at 10′ resolution. We determined the regional relationship between QEPD and SD for each taxa with a spatial regression model and used the tails of the residuals (QERES) distribution to identify areas of higher and lower QEPD than predicted. Spatial congruence of biodiversity between groups was assessed with Pearson correlation coefficient. A simple classification scheme allowed building a convergence map where a convergent pixel equalled to a QERES value of the same sign for the three groups. This convergence map was overlaid to the current PAs network to estimate the level of protection in convergent pixels and compared it to a null expectation built on 1000 randomization of PAs over the landscape.

Results

QERES patterns across vertebrates show a strong spatial mismatch highlighting different evolutionary histories. Convergent areas represent only 2.7% of the Western Palearctic, with only 8.4% of these areas being covered by the current PAs network while a random distribution would retain 10.4% of them. QERES are unequally represented within PAs: areas with higher QEPD than predicted are better covered than expected, while low QEPD areas are undersampled.

Main conclusions

Patterns of diversity strongly diverge between groups of vertebrates in Europe. Although Europe has the world's most extensive PAs network, evolutionary history of terrestrial vertebrates is unequally protected. The challenge is now to reconcile effective conservation planning with a contemporary view of biodiversity integrating multiple facets.
The effect of addition of liraglutide to high‐dose intensive insulin therapy: a randomized prospective trial
Authors: Lane W. , Weinrib S. , Rappaport J. , Hale C.
Published: March 2014

Aims

Patients with type 2 diabetes and insulin resistance may require high insulin doses to control hyperglycaemia. The addition of glucagon‐like peptide‐1 receptor agonists (GLP‐1 RAs) to basal insulin therapy has been shown to reduce insulin requirement while reducing insulin‐associated weight gain [1,2]. The effect of GLP‐1 RA therapy added to intensive (basal/bolus) insulin therapy has not been studied in a prospective trial. This trial evaluated the effect of the addition of liraglutide to high‐dose intensive insulin therapy compared with standard insulin up‐titration in obese insulin‐resistant patients with type 2 diabetes requiring high‐dose insulin therapy.

Methods

Thirty‐seven subjects with type 2 diabetes requiring >100 units of insulin daily administered either by continuous subcutaneous insulin infusion (CSII) or by multiple daily injections (MDIs) with or without metformin were randomized to receive either liraglutide plus insulin (LIRA) or intensive insulin only (controls). Liraglutide was initiated at 0.6 mg subcutaneously (sq) per day and increased to either 1.2 or 1.8 mg daily in combination with intensive insulin therapy. Controls received intensive insulin up‐titration only.

Results

At 6 months, subjects receiving liraglutide plus insulin experienced statistically significant reductions in HbA1c, weight, insulin dose and glycaemic variability (GV) by continuous glucose monitor (CGM) compared with the control group receiving insulin only.

Conclusions

Adding liraglutide to intensive high‐dose (basal/bolus) insulin therapy results in greater improvement in glycaemic control than insulin therapy alone, with additional benefits of weight loss and reduced GV.
Changes in waist circumference and incidence of chronic kidney disease
Authors: Barzin Maryam , Hosseinpanah Farhad , Serahati Sara , Salehpour Mostafa , Nassiri Amir A. , Azizi Fereidoun
Published: March 2014

Background

Many studies have evaluated the association of anthropometric indices with chronic kidney disease(CKD), but the association of waist circumference(WC) changes with CKD incidence is less clear. We evaluated the effect of WC changes on CKD incidence in participants of the Tehran Lipid and Glucose Study(TLGS).

Study design

The risk of CKD incidence was evaluated in three serial phases with interval censoring. A group of 8,183 (46·5% men) participants, mean age 47·4 years, free of previous CKD, were followed. Waist changes were divided into four groups: (i)decrease in WC; (ii) reference group; (iii)mild to moderate increase in WC and (iv)severe increase in WC. Glomerular filtration rate(GFR) was estimated using the MDRD equation.

Results

In 8,183 participants, mean GFR was higher in men (77·1 vs. 74·4 mL/min/1·73 m2, P < 0·001). During the 9 years of follow‐up, 1477 new cases of CKD occurred(1026 in women). WC changes were not associated with the development of CKD in women. In men, decrease in WC was not related to lower risk of CKD (HR: 0·90, 95% CI 0·6–1·4), whereas a mild to moderate increase in WC was associated with a 70% (HR: 1·7, 95% CI 1·3–2·2) higher risk of CKD even after adjusting for covariates (HR: 1·6, 95% CI 1·2–2·2). Severe increase in WC was associated with a fourfold risk of CKD in comparison with reference group (HR: 3·7, 95% CI 2·7–5·1).

Conclusion

Changes in WC are not independent risk factors for CKD development in women, whereas waist gain can adversely influence the development of CKD in men.
Deferasirox for transfusion‐dependent patients with myelodysplastic syndromes: safety, efficacy, and beyond (GIMEMA MDS0306 Trial)
Authors: Angelucci Emanuele , Santini Valeria , Di Tucci Anna Angela , Quaresmini Giulia , Finelli Carlo , Volpe Antonio , Quarta Giovanni , Rivellini Flavia , Sanpaolo Grazia , Cilloni Daniela , Salvi Flavia , Caocci Giovanni , Molteni Alfredo , Vallisa Daniele , Voso Maria Teresa , Fenu Susanna , Borin Lorenza , Latte Giancarlo , Alimena Giuliana , Storti Sergio , Piciocchi Alfonso , Fazi Paola , Vignetti Marco , Tura Sante
Published: March 2014

Background

In the absence of randomized, controlled trial data to support iron chelation therapy in transfusion‐dependent patients with myelodysplastic syndromes (MDS), continued evidence from large prospective clinical trials evaluating the efficacy and safety of iron chelation therapy in this patient population is warranted.

Methods

The safety and efficacy of deferasirox was examined in a prospective, open‐label, single‐arm, multicenter trial of transfusion‐dependent patients with International Prognostic Scoring System low‐ or intermediate‐1‐risk MDS and evidence of transfusion‐related iron overload. The effects of deferasirox therapy on hematological response and disease progression were also examined.

Results

Of 159 participants enrolled from 37 Italian centers, 152 received ≥1 dose of deferasirox (initiated at 10–20 mg/kg/day and titrated as appropriate), and 68 completed the study. Of 84 patients who discontinued deferasirox therapy, 22 died during the trial, and 28 withdrew due to an adverse event (AE). Fourteen treatment‐related grade 3 AEs occurred in 11 patients, whereas no grade 4 or 5 drug‐related AEs were reported. Significant risks for dropout were a higher serum ferritin level at baseline, a higher MDS‐Specific Comorbidity Index, and a shorter diagnosis–enrollment interval. Median serum ferritin level fell from 1966 ng/mL to 1475 ng/mL (P < 0.0001). The cumulative incidence of transfusion independence, adjusted for death and disease progression, was 2.6%, 12.3%, and 15.5% after 6, 9, and 12 months, respectively.

Conclusions

Deferasirox therapy in transfusion‐dependent patients with MDS was moderately well tolerated and effectively lowered serum ferritin levels. Positive hematological responses were observed, and a subset of patients achieved transfusion independence.
The dynamics of assembling food webs
Authors: Fahimipour Ashkaan K. , Hein Andrew M.
Published: March 2014

Community assembly is central to ecology, yet ecologists have amassed little quantitative information about how food webs assemble. Theory holds that colonisation rate is a primary driver of community assembly. We present new data from a mesocosm experiment to test the hypothesis that colonisation rate also determines the assembly dynamics of food webs. By manipulating colonisation rate and measuring webs through time, we show how colonisation rate governs structural changes during assembly. Webs experiencing different colonisation rates had stable topologies despite significant species turnover, suggesting that some features of network architecture emerge early and change little through assembly. But webs experiencing low colonisation rates showed less variation in the magnitudes of trophic fluxes, and were less likely to develop coupled fast and slow resource channels – a common feature of published webs. Our results reveal that food web structure develops according to repeatable trajectories that are strongly influenced by colonisation rate.
Clinical, neuropsychological, and metabolic characteristics of transient epileptic amnesia syndrome
Authors: Mosbah Amel , Tramoni Eve , Guedj Eric , Aubert Sandrine , Daquin Géraldine , Ceccaldi Mathieu , Félician Olivier , Bartolomei Fabrice
Published: March 2014

Objective

Transient epileptic amnesia (TEA) is a recently individualized syndrome occurring in adult patients that includes epileptic seizures with amnestic features and interictal memory disturbances.

Methods

We investigated the clinical, neuropsychological, and 18F‐FDG positron emission tomography (18F‐FDG‐PET) features of 30 consecutive cases of TEA in our center.

Results

The mean age of onset of amnestic seizures was 59 years. Pure acute amnesia was the only epileptic manifestation in 17% of cases. Interictal electroencephalography (EEG) abnormalities were present in 57% on awake recording and in most patients in whom sleep EEG was performed (96%). Nine of 30 patients showed anterograde memory deficit and six of 30 exhibited mild executive functioning impairment. On the autobiographical memory interview (AMI), patients showed a significant deficit for the recent period of the episodic subscale. Outcome under treatment was favorable in the majority of cases. A significant improvement was noted on recollection of autobiographical memory. 18F‐FDG‐PET (22 cases) showed positive correlations between left mesial temporal metabolism levels and anterograde and retrograde memory scores.

Significance

TEA is an emerging epileptic syndrome that likely remains misidentified and misdiagnosed. Neurometabolic data support a dysfunction of a hippocampal‐neocortical network sustaining episodic memory.

A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.
Sex‐Specific Associations Between Nest Defence, Exploration and Breathing Rate in Breeding Pied Flycatchers
Authors: Krams Indrikis A. , Vrublevska Jolanta , Sepp Tuul , Abolins‐Abols Mikus , Rantala Markus J. , Mierauskas Pranas , Krama Tatjana
Published: March 2014

Correlations between behavioural traits constrain animals to a limited range of behavioural choices and set a limit to the available variation in behavioural phenotype of a population. These constraints are especially important during stressful situations, potentially limiting the ability to cope with stress appropriately. As yet, very little consideration has been given to a possible role for sexual selection in maintaining differences in behavioural stability within individuals: sex‐specific differences in behavioural correlations have been seldom studied, especially in the wild. In this field study, we investigated associations between neophobia (latency to enter nest in the presence of a novel object), nest defence (response to a model predator) and breathing rate in response to handling in breeding pied flycatchers (Ficedula hypoleuca). We did not find any significant difference in antipredator responses between males and females, which indicates low sexual conflict over parental care in the pied flycatcher. However, females were more neophobic than males, while males and females did not differ in their breathing rates. Further, our study demonstrated a strong positive correlation between nest defence behaviour and neophobia in male, but not in female pied flycatchers. Males that defended their nest more had lower breathing rate and higher latency to resume nestling feeding after encountering a predator decoy than males that mobbed less intensely. We found only weak evidence that nest partners might affect each other's behaviour in these contexts.
Consistent and Inconsistent Contraception Among Young Women: Insights from Qualitative Interviews
Authors: Reed Joanna , England Paula , Littlejohn Krystale , Bass Brooke Conroy , Caudillo Mónica L.
Published: March 2014

Qualitative interviews with young women attending community colleges were used to address why women who do not desire pregnancy vary in how consistently they use contraception. Based on our analysis of the women's sexual histories, we argue that five factors are key to promoting or discouraging consistent use of contraception: efficacy (women's ability to put an intention to contracept into practice), the actions and attitudes of male partners, being in a long‐term relationship, whether women experience side effects, and misinformation or erroneous reasoning about pregnancy risk. Variations in how these factors combine at different times in women's lives explain much about their patterns of contraceptive consistency.
Government‐Supported Healthy Marriage Initiatives Are Not Associated with Changes in Family Demographics: A Comment on Hawkins, Amato, and Kinghorn (2013)
Authors: Johnson Matthew D.
Published: March 2014

In the July 2013 issue of Family Relations, Alan J. Hawkins, Paul R. Amato, and Andrea Kinghorn examined the associations between family demographics and per capita spending on the Healthy Marriage Initiatives, concluding that the results demonstrated the potential of these initiatives for improving the lives of children. In this critique of that article, I make the following points: (1) this article was timely and important, (2) Hawkins and colleagues' conclusions were overly generous given the data they describe, and (3) Hawkins and colleagues' review of prior outcome studies on the Healthy Marriage Initiatives emphasized positive findings, deemphasized null effects, and expunged negative effects. I conclude that future discussions of the Healthy Marriage Initiatives should include dispassionate descriptions of all available data.
Disentangling the Associations Between Contextual Stress, Sensitive Parenting, and Children's Social Development
Authors: Riley Moira R. , Scaramella Laura V. , McGoron Lucy
Published: March 2014

The impact of an accumulation of sociocontextual stress on children's social skill development was examined among 167 predominantly African American mothers and their 2‐year‐old children. Two theoretical models were considered. First, based on Rutter's (1979) cumulative risk approach, an accumulation of stress was hypothesized to moderate the impact of sensitive parenting on change in social skills such that the protective effects of sensitive parenting declined when cumulative stress reached a critical threshold. Second, based on a family stress model approach, an accumulation of stress was expected to indirectly affect social skills by way of sensitive parenting; that is, sensitive parenting was expected to explain or mediate any direct links between cumulative stress and children's social skills. Results were only consistent with the moderational hypothesis. Contrary to expectations, sensitive parenting predicted increases in social skills from age 2 to 4 only under conditions of the highest cumulative stress.
Are the benefits of yield responses to nitrogen fertilizer application in the bioenergy crop Miscanthus × giganteus offset by increased soil emissions of nitrous oxide?
Authors: Roth Brendan , Finnan John M. , Jones Mike B. , Burke James I. , Williams Michael L.
Published: March 2014

A field trial was carried out on a 15 year old Miscanthus stand, subject to nitrogen fertilizer treatments of 0, 63 and 125 kg‐N ha−1, measuring N2O emissions, as well as annual crop yield over a full year. N2O emission intensity (N2O emissions calculated as a function of above‐ground biomass) was significantly affected by fertilizer application, with values of 52.2 and 59.4 g N2O‐N t−1 observed at 63 and 125 kg‐N ha−1, respectively, compared to 31.3 g N2O‐N t−1 in the zero fertilizer control. A life cycle analyses approach was applied to calculate the increase in yield required to offset N2O emissions from Miscanthus through fossil fuel substitution in the fuel chain. For the conditions observed during the field trial yield increases of 0.33 and 0.39 t ha−1 were found to be required to offset N2O emissions from the 63 kg‐N ha−1 treatment, when replacing peat and coal, respectively, while increases of 0.71 and 0.83 t ha−1 were required for the 125 kg‐N ha−1 treatment, for each fuel. These values are considerably less than the mean above‐ground biomass yield increases observed here of 1.57 and 2.79 t ha−1 at fertilization rates 63 and 125 kg‐N ha−1 respectively. Extending this analysis to include a range of fertilizer application rates and N2O emission factors found increases in yield necessary to offset soil N2O emissions ranging from 0.26 to 2.54 t ha−1. These relatively low yield increase requirements indicate that where nitrogen fertilizer application improves yield, the benefits of such a response will not be offset by soil N2O emissions.
Evaluating the effectiveness of wildflower seed mixes for boosting floral diversity and bumblebee and hoverfly abundance in urban areas
Authors: Blackmore Lorna M. , Goulson Dave
Published: March 2014

There is growing interest in improving the biodiversity of urban and suburban areas. Here we report on the effectiveness of a very simple intervention that may be used to boost flower and pollinator abundance; the sowing of plots of wildflowers in amenity grasslands. The abundance of flowers, bumblebees (Bombus spp.), and hoverflies (Syrphidae) was surveyed in 30 such plots, either 1 or 2 years after they had been sown.

Overall, sown plots had 25 times more flowers, 50 times more bumblebees, and 13 times more hoverflies compared to paired control plots. Floral abundance and bee abundance increased from year 1 to year 2, but hoverflies were more abundant in plots in their first year, reflecting their preference for shallow annual flowers.

Our data demonstrate that flower‐poor amenity grasslands can be readily converted to flower‐rich areas that are highly attractive to pollinators, providing a simple tool for pollinator conservation in urban areas.
Phytosterols and γ‐oryzanol in rice bran oils and distillates from physical refining process
Authors: Sawadikiat Pattong , Hongsprabhas Parichat
Published: March 2014

Commercially available refined rice bran oil (RBO) contained high contents of phytosterol and γ‐oryzanol, that is, 858–1034 and 248–887 mg per 100 g oil, respectively. Although the crude rice bran oil (CRBO) had high contents of both phytochemicals (1362–1376 mg phytosterol per 100 g and 1599–1666 mg γ‐oryzanol per 100 g), physical refining process resulted in their reduction to 820–895 mg phytosterol per 100 g and 933–960 mg γ‐oryzanol per 100 g in RBO (P < 0.05). Both phytochemicals evaporated and accumulated in the deodoriser distillate (DD) to some extent during the deodorising step. Further distillation of DD using molecular distillation (MD) evaporated the free fatty acids (FFAs), resulting in the unevaporated fraction (UMD) having the acid values of 5.6–9.3 mg KOH g−1. The UMD also contained 1585–3391 mg phytosterol per 100 g and 781–848 mg γ‐oryzanol per 100 g. Results suggest potential use of DD as the source of phytochemicals for further concentration by MD.
The Fourth Dimension of Interdisciplinary Modeling
Authors: Biondi Franco
Published: March 2014

Space and time are the domains used by every model in the applied environmental sciences, with the latter normally considered to add a fourth dimension to our simulated versions of reality. Dealing with modern challenges in water‐related disciplines requires that we extend our historical perspective as far back as possible to capture underlying long‐term dynamics that would otherwise be impossible to detect. At the same time, performing and interpreting retrospective studies demands an understanding of their strengths and weaknesses. Here I attempt to clarify both the importance of the past and the inevitable “paleo conundrum” associated with it by drawing on personal experience and on research projects conducted using tree‐ring records in the western U.S. How to best incorporate proxy data, together with instrumental observations, into models used to manage water resources for coping with an uncertain future remains a non‐trivial task.
Qualitative and Visualization Methodologies for Modeling Social‐Ecological Dimensions of Regional Water Planning on the Rio Chama
Authors: Gonzales Moises , Rivera José A. , García J. Jarrett , Markwell Sam
Published: March 2014

Courses in modeling often employ techniques based on mathematical or other computer‐based quantitative models. In this article the authors update a range of social science qualitative and visualization methodologies presented to graduate students at an interdisciplinary modeling course on water issues related to climate change. In part the modeling course featured the coupling of natural and human system dynamics in the context of acequias, gravity flow irrigation systems in New Mexico that depend on winter snowpack for water supply in the form of spring run‐off. While student teams were able to employ STELLA and other models, they were free to explore alternative approaches. As course instructors, we assigned a pilot case study that utilized qualitative methodologies along with visualization tools to model land use, built environment, geo‐spatial, natural systems, and human settlement morphology. Our project described a social‐ecological history of the Rio Chama, a tributary of the upper Rio Grande, where we applied a cross‐disciplinary and inter‐temporal approach on how the land and water resources of the Rio Chama have been developed over time. The case study highlights the social‐ecological dimensions of regional water planning while demonstrating the potential of visualization methodologies as a unique approach to modeling distinct from models based on quantitative data.
Tracking the Influence of Irrigation on Land Surface Fluxes and Boundary Layer Climatology
Authors: Sridhar Venkataramana
Published: March 2014

When the land surface is altered as a first order change in the climate system, it affects the latent heat flux and evaporative cooling, thereby altering the surface temperature and boundary layer development. Modeling the processes associated with land surface alteration requires an interdisciplinary approach in which the hydrologic processes such as evapotranspiration and soil moisture influenced by human‐induced changes are connected to the atmospheric system. The Noah Land Surface Model (LSM) coupled with the Weather Research and Forecasting (WRF) model was modified to represent irrigation in the Snake River basin. By simulating the surface energy balance components and the boundary layer in the growing season, we compared the differences between irrigation and no‐irrigation (control) simulations to assess the differences in climatology attributed to irrigation‐induced cooling. Differences such as increased latent heat flux from the irrigated areas and decreased potential temperature, wind speed, and planetary boundary layer height were evident. This study reiterates the importance of the anthropogenic processes defining the nexus between the land and atmosphere on the local and regional weather and climate.
Seed Number and 100‐Seed Weight of Pearl Millet (Pennisetum glaucum L.) Respond Differently to Low Soil Moisture in Genotypes Contrasting for Drought Tolerance
Authors: Aparna K. , Hash C. T. , Yadav R. S. , Vadez V.
Published: March 2014

Water stress after flowering, one of the major factors limiting yields of pearl millet, affects both seed setting and grain filling and is a consequence of more/less water used prior to anthesis. However, whether genotypes have different sensitivities for seed setting and filling under drought, if exposed to similar stress intensity, is unclear. Experiments were conducted in two pairs of pearl millet genotypes, that is, PRLT2/89‐33 and H77/833‐2, 863B and 841B, contrasting for terminal drought tolerance, and two genotypes, ICMR 01046 and ICMR 01029 (IL‐QTLs), introgressed with a terminal drought tolerance QTL from PRLT2/89‐33 into H77/833‐2. Total seed weight, panicle number, 100‐seed weight, seed number and stover biomass were measured at different soil moistures and throughout grain filling. Sensitive H77/833‐2 had higher seed number and yield under well‐watered (WW) conditions than in PRLT2/89‐33 and IL‐QTLs. Upon increases in water stress intensity, H77/833‐2 suffered losses mostly in stover biomass (45 %) and seed number (60 %) at 0.3 FTSW whereas the biomass and seed number of PRLT2/89‐33 decreased little (20 % and 25 %). The 100‐seed weight of H77/833‐2 decreased only 20 % under stress. Tolerant 863B also maintained a higher seed number and biomass under water stress than 841B. Grain filling duration in PRLT2/89‐33 and IL‐QTLs was similar to that of H77/833‐2 under WW conditions but lasted longer than in H77833‐2 under water stress (WS). Similarly, seed growth of 863B was longer than 841B under WS. It is concluded that the higher seed yield of tolerant parents PRLT2/89‐33 and 863B, and of IL‐QTLs under WS was explained by the retention of a higher number of seeds than in sensitive lines, while the decrease in the 100‐seed weight was proportionally less than the decrease in seed number. Phenotype with lesser number and larger size of panicles and larger grain size, like genotypes PRLT2/89‐33 and 863B, withstood post‐anthesis water stress better. IL‐QTL inherited part of these characteristics, indicating a role for the terminal drought QTL in maintaining larger seed number and higher 100‐seed weight. The continuous stover biomass increase under WW in H77/833‐2, due to tillering, might indicate that tiller growth and grains are in competition for resources after anthesis, and this may relate to the relatively shorter grain‐filling period.
Preparing disabled students for professional practice: managing risk through a principles‐based approach
Authors: Hargreaves Janet , Walker Lizzie
Published: March 2014

Aim

A discussion exploring the ways disabled students are managed in practice settings. It proposes and argues for morally and legally viable principles to guide risk assessment and inclusive decision‐making in practice.

Background

Equality law means that universities are bound not to discriminate against students on the basis, amongst other things, of disability. As a consequence in the UK, there is a perceived increase in numbers of disabled people applying for and succeeding as health professionals. Whilst placement providers are equally obliged by the law to have inclusive policies, competing needs including patient safety, public confidence and professional regulations mean that adjustments that can be made in an educational environment to appropriately support student learning may prove to be more difficult in placements that provide direct care to the public.

Data Sources

This discussion is an outcome of recommendations from published research by the authors and their research partners. It is supported by related literature, critical debate amongst academics, disabled students and disabled and non‐disabled practitioners.

Implications for Nursing

Ensuring a nursing workforce that mirrors the diversity of the population it serves is of universal importance. Effective management of disabled students can contribute to achieving this goal and to promoting a positive view of disabled practitioners.

Conclusion

Legislation is necessary to protect disabled people from discrimination. To respect this legislation, when preparing nurses and other health professions, a clear understanding of the law and a principles‐based approach to guiding risk is important.
Effects of video‐feedback on the communication, clinical competence and motivational interviewing skills of practice nurses: a pre‐test posttest control group study
Authors: Noordman Janneke , van der Weijden Trudy , van Dulmen Sandra
Published: March 2014

Aims

To examine the effects of individual video‐feedback on the generic communication skills, clinical competence (i.e. adherence to practice guidelines) and motivational interviewing skills of experienced practice nurses working in primary care.

Background

Continuing professional education may be necessary to refresh and reflect on the communication and motivational interviewing skills of experienced primary care practice nurses. A video‐feedback method was designed to improve these skills.

Design

Pre‐test/posttest control group design.

Methods

Seventeen Dutch practice nurses and 325 patients participated between June 2010–June 2011. Nurse–patient consultations were videotaped at two moments (T0 and T1), with an interval of 3–6 months. The videotaped consultations were rated using two protocols: the Maastrichtse Anamnese en Advies Scorelijst met globale items (MAAS‐global) and the Behaviour Change Counselling Index. Before the recordings, nurses were allocated to a control or video‐feedback group. Nurses allocated to the video‐feedback group received video‐feedback between T0 and T1. Data were analysed using multilevel linear or logistic regression.

Results

Nurses who received video‐feedback appeared to pay significantly more attention to patients’ request for help, their physical examination and gave significantly more understandable information. With respect to motivational interviewing, nurses who received video‐feedback appeared to pay more attention to ‘agenda setting and permission seeking’ during their consultations.

Conclusion

Video‐feedback is a potentially effective method to improve practice nurses’ generic communication skills. Although a single video‐feedback session does not seem sufficient to increase all motivational interviewing skills, significant improvement in some specific skills was found. Nurses’ clinical competences were not altered after feedback due to already high standards.
Managing a stigmatized identity—evidence from a longitudinal analysis about people with mental illness
Authors: Ilic Marie , Reinecke Jost , Bohner Gerd , Röttgers Hans‐Onno , Beblo Thomas , Driessen Martin , Frommberger Ulrich , Corrigan Patrick William
Published: March 2014

Previous research about coping with the stigma of mental illness mostly relied on cross‐sectional or qualitative research designs. In the present study, the consequences of ten identity management strategies for mental illness stigma were observed in a longitudinal design. Cross‐lagged analyses were used to describe the influence of the strategies on the frequency of stigma experiences and on mental health in a two‐wave panel of people with mental illness (n = 367, 79% repeated response rate). Selective disclosure and information seeking emerged as adaptive identity management strategies, whereas overcompensation and withdrawal led to lower mental health. Results were mostly unaffected by demographic and psychiatric variables. The results support an empowerment model of stigma resilience that portrays stigmatized people as active constructors of their social world.
Assortative mating based on cooperativeness and generosity
Authors: Tognetti A. , Berticat C. , Raymond M. , Faurie C.
Published: March 2014

Cooperative behaviour and generosity towards nonkin represent costly and risky behaviour that could be used as a signal of mate quality. Therefore, cooperative traits could serve as criteria in mate choice, leading to assortative mating for those traits. There is evidence of similarity in couples for altruistic traits. However, the literature is based on self‐reports and does not provide conclusive proof of either a convergence across time or mating preferences. Here, we report a field experiment, conducted in rural villages in Senegal, showing that husbands and wives are similar with respect to their contributions to a public good and their charity donations. Further analyses suggest that this similarity is due to initial assortment rather than convergence of phenotypes.
Sorghum Flour Characterization and Evaluation in Gluten‐Free Flour Tortilla
Authors: Winger M. , Khouryieh H. , Aramouni F. , Herald T.
Published: March 2014

Four sorghum hybrids (Fontanelle‐625 [F‐625]), Fontanelle‐1000 [F‐1,000], ATx631xRTx2907 [NE#20] and 5,040C) were characterized and evaluated for kernel characteristics, proximate analysis, flour characterization (particle size distributions, starch damage, amylose content and starch pasting properties) and end product in gluten‐free tortilla. A commercial sorghum flour (TVM) was used as a control. Significant differences were found (P < 0.05) among hybrids for kernel and flour composition except total starch (P > 0.05). NE#20 had the largest particle diameter for both flour and starch. F‐1000 had significantly higher starch damage compared with the other hybrids. Flours with smaller particle size and higher starch damage contributed to softer and more extensible tortilla. Amylose content ranged from 20.2 (NE#20) to 27.3 (F‐1000). Tortilla made with TVM flour had the highest extensibility, while the F‐625 tortilla had the lowest. F‐625 tortilla had the lightest color with L* value of 70.38, while the 5,040C tortilla had the darkest with L* value of 61.68. Descriptive sensory results showed significant differences for tortilla grain specks, angle of bend, rancidity, sweetness, springiness, hardness and grittiness. The results have shown that sorghum hybrids can differ in kernel and flour properties, which could help predict sorghum flour quality for the purpose of gluten‐free products.

Practical Applications

Sorghum is a gluten‐free grain tolerated by patients with celiac disease, that has potential in the gluten‐free food market. Despite considerable scientific progress in understanding celiac disease, to date, a strict gluten‐free diet for life is the only treatment for patients with celiac disease. With an increasing number of people being diagnosed with celiac disease and with the market for gluten‐free products growing, there is a great opportunity to create new products using sorghum flour. There are many sorghum hybrids that have not been characterized for grain, flour or end‐product quality. Therefore, understanding the quality attributes of sorghum varieties is critical in translating to end‐product use. The results have shown that sorghum hybrids can differ in kernel and flour characteristics, which could help predict end‐product quality and application in gluten‐free products.
Validation of a food frequency questionnaire to assess food group intake by pregnant women
Authors: Barbieri P. , Crivellenti L. C. , Nishimura R. Y. , Sartorelli D. S.
Published: March 2014

Background

Previous studies conducted among pregnant women to test the accuracy of food frequency questionnaires (FFQ) for estimating food group intake were restricted to one specific trimester of pregnancy. The present study aimed to validate a FFQ for assessing the intake of food groups throughout pregnancy.

Methods

In total, 75 adult pregnant Brazilian women were evaluated. Dietary intake was assessed by the FFQ (completed at the third trimester of pregnancy) and by three 24‐h dietary recalls; one in each trimester of pregnancy.

Results

The food items were classified into 20 groups. Adequate deatenuatted Pearson correlation coefficients (>0.4) were observed for the intake of bread/cake, butter/margarine; milk/dairy products; soft drinks/artificial juices; coffee/tea; and pastries/sandwiches. The FFQ served poorly for estimating fruit and vegetable intake. A high percentage (>70%) of women were classified into the same or adjacent quartiles for estimates of cookies/crackers, butter/margarine, milk/dairy products, fruit juices, soft drinks/artificial juices, coffee/tea, roots, rice, beans, meat/chicken/sausages, fried foods, fish, eggs, sweets/sugars, and pastries/sandwiches. Nevertheless, the agreement of joint classification between the dietary methods was mostly into adjacent quartiles, rather than in the same quartile, and low values of kappa were found.

Conclusions

The data reported in the present study suggest that the FFQ might not be an appropriate dietary method for evaluating food group intake throughout pregnancy. The joint classification between methods by categories of intake of food groups was mostly into adjacent quartiles, which could lead to attenuated associations when investigating diet–disease relationships during pregnancy.
Recommended dietary intakes for vitamin D: where do they come from, what do they achieve and how can we meet them?
Authors: Cashman K. D. , Kiely M.
Published: March 2014

There is substantial evidence that the prevalence of vitamin D deficiency is high across Europe, particularly, but not exclusively, among those resident at Northerly latitudes. This has significant implications for human health throughout the lifecycle and impacts upon healthy growth and development and successful ageing for current and possibly future generations. In recent years, there have been several important reports from North America and Europe in relation to dietary reference values (DRVs) for vitamin D. These may be of enormous value from a public health perspective in terms of preventing vitamin D deficiency and promoting adequate vitamin D status in the population. In this concise review, we provide a brief summary of current DRVs for vitamin D, their background and their application to vitamin D deficiency prevention. The review also provides some brief guidance with respect to applying the DRVs in a clinical nutrition setting. In addition, the review illustrates how current dietary intakes of most populations, young and adult, are well short of the newly established DRVs. Accordingly, the review highlights potential food‐based or dietary strategies for increasing the distribution of vitamin D intake in the population with the aim of preventing vitamin D deficiency. Finally, despite the explosion in scientific research in vitamin D and health, there are many fundamental gaps in the field of vitamin D from the public health perspective. The impact of these knowledge gaps on current DRVs for vitamin D is highlighted, as are some future developments that may help address these gaps.
Midwifery Care in Rural and Remote British Columbia: A Retrospective Cohort Study of Perinatal Outcomes of Rural Parturient Women With a Midwife Involved in Their Care, 2003 to 2008
Authors: Stoll Kathrin , Kornelsen Jude
Published: March 2014

Introduction

Midwifery has been regulated and publicly funded in British Columbia since 1998. Midwives are currently concentrated in urban areas; access to care is limited in rural communities. Rural midwifery practice can be challenging because of low birth numbers, solo practice, lack of on‐site cesareans and specialist backup, and interprofessional tensions resulting from the integration of midwives into rural maternity care systems. Despite these barriers, rural midwives have made a substantial contribution to rural maternity care in British Columbia. The purpose of this retrospective cohort study is to examine outcomes of midwife‐involved births in rural British Columbia in the postregionalization era.

Methods

We analyzed the outcomes of all parturient women with postal codes outside of the core urban areas of the province, and their singleton infants without a diagnosed congenital anomaly, who had a midwife involved in their care between April 1, 2003, and March 31, 2008. Outcomes are reported for 6 obstetric service levels. Service levels are assigned to parturient women via maternal postal codes. Women who reside further than 60 minutes from a hospital with maternity services were assigned a distance category (2 levels: >2 hours, 1‐2 hours); women residing within one hour of a hospital with maternity services were assigned the level of service available at their catchment hospital (4 levels, ranging from maternity care without cesarean to cesarean provided by general surgeons or obstetricians).

Results

Eight percent of rural parturient women had a midwife involved in their care. Rates of planned home birth exceeded the provincial average (26.1%) in 5 of the 6 service levels. Rates of actual home birth were lowest among women who resided 2 or more hours away from maternity services. Obstetric intervention rates were lower for women residing in communities without cesareans or with intermittent access to cesareans. The prevalence of adverse neonatal outcomes was very low across service levels; perinatal mortality was elevated among women residing in communities more than 2 hours away from services.

Discussion

Despite numerous challenges, midwives provide safe maternity care to rural parturient women and offer choice of birth place. Given the difficulty of recruiting and retaining maternity care providers to rural settings in British Columbia and across Canada, these findings open the door for a more sustained planning process involving midwives in rural communities. Reasons for the elevated perinatal mortality rate among women who live more than 2 hours away from services should be explored in more detail, perhaps via in‐depth interviews with rural midwives who serve this population.
The 2012 American College of Nurse‐Midwives Core Competencies for Basic Midwifery Practice: History and Revision
Authors: Phillippi Julia C. , Avery Melissa D.
Published: March 2014

The American College of Nurse‐Midwives (ACNM) Core Competencies for Basic Midwifery Practice, approved in 2012, (hereafter referred to as Core Competencies) outline the knowledge, skills, and abilities that can be expected of new certified nurse‐midwives (CNMs) and certified midwives (CMs). The Core Competencies are standards for midwifery education, and the document is an important guide for midwifery practice and policy. As a part of the 2012 revision, the Basic Competency Section of the ACNM Division of Education reviewed a variety of national and international documents to ensure that the basic education of CNMs/CMs is consistent with the practice of midwives in the United States and internationally. Few substantive changes were made to the document, but several areas were adjusted and clarified. New graduates continue to be prepared by midwifery education programs to provide safe, evidence‐based midwifery care to women across the lifespan, well newborns up to 28 days, and sexual partners of women diagnosed with sexually transmitted infections.