Search

Highlights Female soccer players have been identified as presenting with low energy availability (LEA), though the prevalence of LEA may be overestimated given inaccuracies associated with self‐reporting dietary intakes. Accordingly, we aimed to quantify total daily energy expenditure (TDEE) via the doubly labelled water (DLW) method, energy intake (EI) and energy availability (EA). Adolescent female soccer players (n = 45; 16 ± 1 years) completed a 9–10 day ‘training camp’ representing their national team. Absolute and relative TDEE was 2683 ± 324 and 60 ± 7 kcal kg−1 fat free mass (FFM), respectively. Mean daily EI was lower (P < 0.01) when players self‐reported using the remote food photography method (RFPM) (2047 ± 383 kcal day−1) over a 3‐day period versus DLW derived EI estimates accounting for body mass (BM) changes (2545 ± 518 kcal day−1) over 7–8 days, representing a mean daily Δ of 499 ± 526 kcal day−1 and 22% error when using the RFPM. Estimated EA was different (P < 0.01) between methods (DLW: 48 ± 14 kcal kg−1 FFM, range: 22–82; RFPM: 37 ± 8 kcal kg−1 FFM, range: 22–54), such that prevalence of LEA (<30 kcal kg−1 FFM) was lower in DLW compared with RFPM (5% vs. 15%, respectively). Data demonstrate the potential to significantly underestimate EI when using self‐report methods. This approach can therefore cause a misrepresentation and an over‐prevalence of LEA, which is the underlying aetiology of ‘relative energy deficiency in sport’ (REDs). What is the central question of this study? Do self‐reported dietary intakes (via remote food photography method, RFPM) overestimate low energy availability (LEA) prevalence in female soccer players compared with energy intake evaluation from the doubly labelled water (DLW) method? What is the main finding and its importance? Estimated energy availability is greater with the DLW method compared with RFPM, such that the prevalence of LEA is greater when self‐reporting dietary intakes. Accordingly, data demonstrate the potential to misrepresent the prevalence of LEA, an underlying factor in the aetiology of ‘relative energy deficiency in sport’ (REDs). What is the central question of this study?Do self‐reported dietary intakes (via remote food photography method, RFPM) overestimate low energy availability (LEA) prevalence in female soccer players compared with energy intake evaluation from the doubly labelled water (DLW) method?What is the main finding and its importance?Estimated energy availability is greater with the DLW method compared with RFPM, such that the prevalence of LEA is greater when self‐reporting dietary intakes. Accordingly, data demonstrate the potential to misrepresent the prevalence of LEA, an underlying factor in the aetiology of ‘relative energy deficiency in sport’ (REDs). [ABSTRACT FROM AUTHOR]

Confirmation bias is an ever‐present risk to the rapid decision‐making required in emergency departments (EDs). We present a case of a young woman who was brought to ED by ambulance with hypotension, syncope and vaginal bleeding, with a presumptive pre‐hospital diagnosis of ruptured ectopic pregnancy. On arrival in ED, she was found to have intra‐abdominal free fluid on bedside ultrasound. This finding could have been used by clinicians to confirm their suspicion of a ruptured ectopic; however, with further investigations, it was found that anaphylaxis was the most likely cause of the patient's symptoms. This case highlights that point‐of‐care ultrasound findings can play a potentially dangerous role in confirmation bias and that we should maintain an open mind when making a diagnosis by treating the patient, rather than the ultrasound picture. [ABSTRACT FROM AUTHOR]

DNA barcoding and metabarcoding provide new avenues for investigating biological systems. These techniques require well‐curated reference libraries with extensive coverage. Generating an exhaustive national DNA barcode reference library can open up new avenues of research in ecology, evolution and conservation, yet few studies to date have created such a resource. In plant DNA barcoding, herbarium collections provide taxonomically robust material but also pose challenges in lab processing. Here, we present a national DNA barcoding resource covering all of the native flowering plants and conifers of the United Kingdom. This represents 1,482 plant species, with the majority of specimens (81%) sourced from herbaria. Using Sanger sequencing of the plant DNA barcode markers, rbcL, matK, and ITS2, at least one DNA barcode was retrieved from 98% of the UK flora. We sampled from multiple individuals, resulting in a species coverage for rbcL of 96% (4,477 sequences), 90% for matK (3,259 sequences) and 75% for ITS2 (2,585 sequences). Sequence recovery was lower for herbarium material compared to fresh collections, with the age of the specimen having a significant effect on the success of sequence recovery. Species level discrimination was highest with ITS2, however, the ability to successfully retrieve a sequence was lowest for this region. Analyses of the genetic distinctiveness of species across a complete flora showed DNA barcoding to be informative for all but the most taxonomically complex groups. The UK flora DNA barcode reference library provides an important resource for many applications that require plant identification from DNA. [ABSTRACT FROM AUTHOR]

Background: ABO blood group-incompatible kidney transplantation (ABOiKTx) outcomes are good, but complications are more common than in conventional transplantation. Regimens that use extracorporeal antibody removal therapy (EART) and enhanced immunosuppression are guided by titration of ABO blood group antibodies (using hemagglutination [HA] dilution assays), and these assays vary significantly in performance between centers. This study aims to describe the differences in titer measurement and the effect on clinical practice and outcomes.Study Design and Methods: This multicentre, prospective cohort study of 100 ABOiKTx recipients assessed treatment and outcome data, including HA assay results measured retrospectively in a single central laboratory.Results: Patient and allograft survival at 1 year was 99% and 94%, respectively. There were significant differences in the number of pretransplantation EART sessions in centers undertaking plasma exchange (PEx), compared with immunoadsorption (IA) (median, 6 vs. 4 sessions; p = 0.007). The pre-EART HA titer in both groups was the same when centrally assayed. The local HA assay used to guide treatment yielded significantly higher titers in centers undertaking PEx compared with IA (median, 128 vs. 32; p < 0.005). Patients undergoing PEx rather than IA were significantly more likely to suffer postoperative hematoma (12.9% vs. 1.8%; p = 0.05) or any perioperative collection requiring drainage (19.4% vs. 3.6%; p = 0.02).Conclusion: The colinearity of HA assay sensitivity with the receipt of PEx and EART limits some conclusions regarding the likely direction of causation. However, the association of differences in clinical practice with recognized perioperative complications of ABOiKTx identifies targets for further investigation and quality improvement. [ABSTRACT FROM AUTHOR]

Introduction Magnetic resonance imaging ( MRI) is useful for detecting joint inflammation and damage in the inflammatory arthropathies. This study aimed to investigate MRI cartilage damage and its associations with joint inflammation in patients with gout compared with a group with rheumatoid arthritis ( RA). Methods Forty patients with gout and 38 with seropositive RA underwent 3T- MRI of the wrist with assessment of cartilage damage at six carpal sites, using established scoring systems. Synovitis and bone oedema ( BME) were graded according to Rheumatoid Arthritis MRI Scoring System criteria. Cartilage damage was compared between the groups adjusting for synovitis and disease duration using logistic regression analysis. Results Compared with RA, there were fewer sites of cartilage damage and lower total damage scores in the gout group ( P = 0.02 and 0.003), adjusting for their longer disease duration and lesser degree of synovitis. Cartilage damage was strongly associated with synovitis in both conditions (R = 0.59, P < 0.0001 and R = 0.52, P = 0.0045 respectively) and highly correlated with BME in RA (R = 0.69, P < 0.0001) but not in gout (R = 0.095, P = 0.56). Conclusions Cartilage damage is less severe in gout than in RA, with fewer sites affected and lower overall scores. It is associated with synovitis in both diseases, likely indicating an effect of pro-inflammatory cytokine production on cartilage integrity. However, the strong association between cartilage damage and BME observed in RA was not identified in gout. This emphasizes differences in the underlying pathophysiology of joint damage in these two conditions. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Physiology is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Question: Can cation analyses of water samples within a peatland site be used to infer solute sources to the samples, and so provide an objective criterion of ombrotrophy? Location: Mire complexes within native Pinus sylvestris forest, in Abernethy Forest, north of the Cairngorm Mountains, Scotland, UK. Methods: Chemical analyses of major cations in 200 water samples, and χ2 analysis of contingency tables relating species occurrence in the corresponding quadrat samples to the ombrotrophic-telluric division. Results and conclusions: The chemical data (especially the ratios Ca2+/Mg2+ and Na+/Mg2+) indicated a separation of about 140 essentially ombrotrophic samples from about 60 showing clear telluric influence; these conclusions are consistent with published rainwater analyses. For hydrological and meteorological reasons, a sharp separation cannot be expected, so the limit adopted here (Ca/Mg=1.0) is to some extent arbitrary, but the methods described provide a more objective criterion of ombrotrophy than any other. Contingency tables showed highly significant associations between species occurrence and the ombrotrophic-telluric division. The strongest associations included: (ombrotrophic) Eriophorum vaginatum, Odontoschisma sphagni and Sphagnum cuspidatum; (telluric) Carex panicea, Potentilla erecta, Carex echinata, Narthecium ossifragum, Sphagnum auriculatum s.l. , Agrostis canina, Molinia caerulea, Eriophorum angustifolium, and Sphagnum recurvum s.l. The Abernethy mires are arguably more comparable with mire complexes on base-poor rocks in southern Scandinavia than with most ombrotrophic sites further south and west in Britain. As in Sweden, Narthecium ossifragum and Eriophorum angustifolium, generally ubiquitous on British and Irish ombrotrophic bogs, are 'fen' plants at Abernethy. [ABSTRACT FROM AUTHOR]

Much of the evidence linking the short-latency phasic signaling of midbrain dopaminergic neurons with reward-prediction errors used in learning and habit formation comes from recording the visual responses of monkey dopaminergic neurons. However, the information encoded by dopaminergic neuron activity is constrained by the qualities of the afferent visual signals made available to these cells. Recent evidence from rats and cats indicates the primary source of this visual input originates subcortically, via a direct tectonigral projection. The present anatomical study sought to establish whether a direct tectonigral projection is a significant feature of the primate brain. Injections of anterograde tracers into the superior colliculus of macaque monkeys labelled terminal arbors throughout the substantia nigra, with the densest terminations in the dorsal tier. Labelled boutons were found in close association (possibly indicative of synaptic contact) with ventral midbrain neurons staining positively for the dopaminergic marker tyrosine hydroxylase. Injections of retrograde tracer confined to the macaque substantia nigra retrogradely labelled small- to medium-sized neurons in the intermediate and deep layers of the superior colliculus. Together, these data indicate that a direct tectonigral projection is also a feature of the monkey brain, and therefore likely to have been conserved throughout mammalian evolution. Insofar as the superior colliculus is configured to detect unpredicted, biologically salient, sensory events, it may be safer to regard the phasic responses of midbrain dopaminergic neurons as ‘sensory prediction errors’ rather than ‘reward prediction errors’, in which case dopamine-based theories of reinforcement learning will require revision. [ABSTRACT FROM AUTHOR]

The article presents information on the plant Athyrium distentifolium. Within the British Isles, Athyrium distentifolium is found only in Scotland from 455 m to over 1220 m a.s.l. on open screes with extended snow cover in the central and northern highlands. Growing in the same habitat, but found only at a few sites is A. distentifolium variety flexile. In Scotland. Athyrium distentifolium grows only in sites where snow lies for extended periods during the winter. Snow can lie on the fern beds from October until May or even June. Precipitation on Athyrium distentifolium snowbed vegetation in the period 1941-70 varied from 1600-3200mm in the west to 1200-1600mm in the east Grampians. Several authors reported the susceptibility of A. distentifolium to grazing. Red deer are present at all the sites. At Ben Alder 50 clumps of each taxon were scored in a traverse across the corrie to assess the percentage of whole clumps which had been eaten. Separate populations were identified at intervals of 30-200 m and the first five clumps encountered were scored. Grazing was very variable depending on the terrain.

• Experiments were conducted to determine the genetic relationship between the alpine fern Athyrium distentifolium and the Scottish endemic taxon A. distentifolium var. flexile. • Segregation of the taxa was studied after growing sporophytes from spore families, and after selfing and crossing gametophytes. The growth of both gametophytes and sporophytes was measured under a range of nutrient regimes. • The distinction between the two taxa is due to variation at a single gene with pleiotropic effects expressed at both the sporophyte and gametophyte stages. A. distentifolium sporophytes (genotypes A&supD;/A&supD; or A&supD;/A&supF; ) are taller, have fewer fronds, and produce fewer spores than A. distentifolium var. flexile sporophytes (genotype A&supF;/A&supF; ). Gametophytes containing the A F allele have a 50% higher growth rate than those with the A&supD; allele on a range of media. • The polymorphism may be maintained by a balance between selection for and against the A&supF; allele at the gametophyte and sporophyte stages of the life cycle, respectively. Implications for the conservation of the A. distentifolium var. flexile taxon are discussed. [ABSTRACT FROM AUTHOR]

Aim: To explore the contribution patients can make to medical education from both theoretical and empirical perspectives, to describe a framework for reviewing and monitoring patient involvement in specific educational situations and to generate suggestions for further research. Methods: Literature review. Results: Direct contact with patients can be seen to play a crucial role in the development of clinical reasoning, communication skills, professional attitudes and empathy. It also motivates through promoting relevance and providing context. Few studies have explored this area, including effects on the patients themselves, although there are examples of good practice in promoting more active participation. Conclusion: The Cambridge framework is a tool for evaluating the involvement of patients in the educational process, which could be used by curriculum planners and teachers to review and monitor the extent to which patients are actively involved. Areas for further research include looking at the 'added value' of using real, as opposed to simulated, patients; more work on outcomes for patients (other than satisfaction); the role of real patients in assessment; and the strengths and weaknesses of different models of patient involvement. [ABSTRACT FROM AUTHOR]

A survey conducted throughout the United Kingdom examined the current provision being made to train nurses to care safely and sensitively for patients with HIV and AIDS. Problems relating to intolerance and prejudice are still commonly encountered. The study recommends that HIV and AIDS should be set into a wider context of sexuality, death and infection control rather than singled out for special attention. Nurses, both students and qualified staff, need to gain insight into their own values and prejudices if these are not to inhibit the giving of good quality care. Teaching in this subject area requires special skills and there is concern that nursing is not equipped to deal with it. The involvement of clinical specialists in educating nurses is perceived to have a strongly positive effect, helping to bridge a credibility gap and compensating for the lack of clinical experience amongst the teachers. Providing opportunities for nurses to meet with people whose lives have been profoundly affected by the virus is also a powerful form of learning. There is, however, a great need for support in this stressful area of practice. [ABSTRACT FROM AUTHOR]

How well a person copes is central in determining his or her well-being, no matter how ill he or she is. Without an accurate appreciation of what coping is and how it may be facilitated, attempts to help patients may be both ineffective and harmful. But the subject is multifaceted and poses many problems for clinicians and researchers alike. This paper attempts to synthesize available knowledge on coping from various disciplines and apply it to life as nurses know it. [ABSTRACT FROM AUTHOR]

That having a baby in hospital undergoing intensive care is a stressful experience is beyond dispute. Every parent, no matter how well-developed their own personal resources, depends to some extent on the support of others within their social system to cope with this stress. Grandparents occupy a special place in support networks and their role was studied in families with a very low birthweight baby. Both professional and lay perspectives were investigated and 93 families participated. Questionnaires were sent to family members 1 month after the baby's birth and 1 month after discharge home. There was a general consensus that the principal role of grandparents was to provide emotional support. Many practical forms of help were seen to be expressions of their care and concern. There were, however, discrepancies between professional and parental expectations where both protection from problems and obtaining information on behalf of the parents were concerned. More was expected of grandmothers than of grandfathers and maternal grandmothers in particular were key figures. There were a number of areas of potential conflict of needs and rights and a recommendation has been made to give parents a greater voice on who they choose to support them. [ABSTRACT FROM AUTHOR]

A prospective study was conducted to investigate the perceptions of 21 mothers of singleton babies weighing 1500 g or less. Six in-depth interviews were held with each respondent from 1 week after delivery to 3 months after the baby's discharge from hospital. Diaries and Neonatal Perception Inventories supplied additional data. Six phases were identified each characterized by certain critical factors related to the mother's emotional state, her perceptions of the baby, and family responses. Significant statistical differences were found between those mothers who did not feel ready to take the infant home and the rest of the sample. Those who were not ready demonstrated a marked difficulty in establishing and maintaining relationships and held very inappropriate perceptions of the baby. These findings have important implications for the discharge of very low birthweight babies after a prolonged stay in hospital. [ABSTRACT FROM AUTHOR]

Presents information on a study which examines the complexity of the relationships between local public education provision in central and southern Appalachia. Background information on public education; Realist model of education finance in the Appalachia; Information on the extensive expansion method model used in the study.

This article focuses on a project on staff perception of family needs in neonatal units in Scotland. Sick infants undergoing intensive care in hospitals is a traumatic experience for both parents and relatives. Although most units have clearly articulated policies relating to who may and may not enter neonatal units and what they may do once inside, these decisions appear not to be based on systematically gathered information. A recommendation of this research is that parents themselves should decide who would best be able to support them in the period of the baby's hospitalization. Blanket rules dictating who may visit and what they may do deny parents' rights and in some circumstances add to their stresses.