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Background: Maternal pregestational diabetes and obesity are risk factors for birth defects. Diabetes and obesity often occur together; it is unclear whether their co‐occurrence compounds birth defect risk. Methods: We analyzed 1997–2011 data on 29,671 cases and 10,963 controls from the National Birth Defects Prevention Study, a multisite case‐control study. Mothers self‐reported height, pregestational weight, and diabetes (pregestational and gestational; analyzed separately). We created four exposure groups: no obesity or diabetes (referent), obesity only, diabetes only, and both obesity and diabetes. We estimated odds ratios (ORs) using logistic regression and the relative excess risk due to interaction (RERI). Results: Among mothers with pregestational obesity without diabetes, modest associations (OR range: 1.1–1.5) were observed for neural tube defects, small intestinal atresia, anorectal atresia, renal agenesis/hypoplasia, omphalocele, and several congenital heart defects. Pregestational diabetes, regardless of obesity, was strongly associated with most birth defects (OR range: 2.0–75.9). Gestational diabetes and obesity had a stronger association than for obesity alone and the RERI (in parentheses) suggested additive interaction for hydrocephaly (1.2; 95% confidence interval [CI]: −0.1, 2.5), tetralogy of Fallot (0.9; 95% CI: −0.01, 1.8), atrioventricular septal defect (1.1; 95% CI: −0.1, 2.3), hypoplastic left heart syndrome (1.1; 95% CI: −0.2, 2.4), and atrial septal defect secundum or not otherwise specified (1.0; 95% CI: 0.3, 1.6; only statistically significant RERI). Conclusions: Our results do not support a synergistic relationship between obesity and diabetes for most birth defects examined. However, there are opportunities for prevention by reducing obesity and improving glycemic control among women with pregestational diabetes before conception. [ABSTRACT FROM AUTHOR]

Background and objectives Vein visualization technology ( VVT) devices use near-infrared light to assist location of peripheral veins. The current study investigated the impact of VVT on donor experience and collection success for young blood donors at the Australian Red Cross Blood Service. Materials and Methods The study in donors aged 18 to 30 years used a two intervention to one control randomized trial design with 285 new and 587 returning donors recruited at two sites. Donors reported presyncopal symptoms, phlebotomy pain, anxiety and intentions to redonate along with other measures. Participating phlebotomists rated usefulness of the technology. Flow rates, collection volumes and other donation information were taken from routine data. Results No significant differences were found between control and intervention groups on presyncopal symptoms, phlebotomy pain, anxiety, intentions to redonate, flow rates, collection volumes or vasovagal reactions (all P's > 0·05). Phlebotomist ratings of VVT were significantly more positive when they had less than 5 years of experience ( P < 0·01) or when the vein was not visible to the naked eye ( P < 0·01). Conclusions Results suggest that VVT does not improve the donation experience for younger blood donors. Staff reports indicate that VVT may have some utility for assisting with difficult phlebotomies. [ABSTRACT FROM AUTHOR]

Background and Objectives In Australia since 2000, donors are deferred for 12 months since last male-to-male sexual contact. There is no estimate of the prevalence of non-compliance (i.e. failure to disclose a risk during the predonation interview which would lead to deferral) with the policy in Australia; however, published studies elsewhere indicate a range of 0·8-11%. We investigated the rate of, timing and motivation for non-compliance. Materials and Methods A nationally representative sample of donors who had made a recent donation negative for transfusion-transmissible infection testing was surveyed using an anonymous, online instrument. Non-compliance was considered as a 'yes' response to the current screening question. Non-compliers were requested to define the timing of the last sexual contact relevant to their most recent donation. Univariate and multivariate regression analyses were used to define factors associated with non-compliance. Results Of 14 476 responses from male donors, 34 (0·23%, 95% CI: 0·16-0·33%) were non-compliant of whom 24 (0·17%, 95% CI: 0·11-0·25%) had contact within 6 months of donation. Factors significantly associated with non-compliance included: multiple sexual partners, history of injecting drug use, perception of a lack of privacy during interview and preference for a computer-based questionnaire. Conclusion Our study confirms high compliance (>99·7%) to the 12-month deferral for male-to-male sex in Australia providing reassuring evidence for the efficacy of the screening question. Issues of 'privacy' and 'discomfort' associated with disclosure suggest the use of validated audio computer-assisted structured interview as a possible option for improving compliance with the donor questionnaire. [ABSTRACT FROM AUTHOR]

Background Increased availability and usage of ultrasound screening have led to improved identification of fetal structural abnormalities prenatally. Few population-based studies have been published on prenatal detection for structural birth defects in the United States. The aim of this study is to determine the frequency of maternal reporting of abnormal prenatal ultrasounds for selected birth defects and to investigate associated maternal characteristics. Methods Participants included 4013 mothers enrolled in the National Birth Defects Prevention Study who carried a fetus with at least one of 14 structural birth defects between 1997 and 2004. Frequencies of abnormal prenatal ultrasounds were based on maternal report and computed for isolated and multiple defects. Associations between maternal characteristics and abnormal prenatal ultrasounds were assessed using logistic regression. Results Overall, 46% of participants reported an abnormal ultrasound. Infants with omphalocele, anencephaly, gastroschisis, and renal agenesis were more likely to have abnormal prenatal ultrasounds than those with cleft and limb abnormalities. Hispanic women were less likely to report abnormal prenatal ultrasounds of birth defects than Caucasians, as were women who had a body mass index ≥ 30 kg/m2 compared with those with a normal body mass index. CONCLUSION Of the 14 selected birth defects in this study, less than half were reported by mothers of affected infants to have had an abnormal ultrasound during pregnancy. The frequency of reporting abnormal prenatal ultrasounds varies by type of defect, maternal race/ethnicity, and maternal body mass index status. Birth Defects Research (Part A) 100:4-12, 2014. © 2013 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

BACKGROUND We examined differences in selected pregnancy-related risk factors, including maternal sociodemographic characteristics, health-related conditions, and periconceptional behavioral factors, among foreign-born versus U.S.-born control mothers across race/ethnic groups. METHODS We used data from the National Birth Defects Prevention Study, and calculated odds ratios (ORs) and 95% confidence intervals (CIs) of the risk factors, for foreign-born Hispanic, non-Hispanic white, non-Hispanic black, and Asian/Pacific Islander (API) mothers, compared to their U.S.-born counterparts. RESULTS Across all race/ethnic groups, foreign-born mothers were older and had lower odds of obesity compared to their U.S.-born counterparts. With the exception of foreign-born black mothers, foreign-born mothers from other race/ethnic groups had significantly lower odds of binge drinking during the periconceptional period. Compared to U.S.-born, foreign-born Hispanic mothers had twice the odds of gestational diabetes (OR = 2.23; 95% CI = 1.36-3.66). Certain health behaviors were less prevalent in foreign-born black mothers (e.g., folic acid use; OR = 0.54; 95% CI = 0.31-0.96) and foreign-born API mothers (e.g., cigarette smoking; OR = 0.10; 95% CI = 0.02-0.48). CONCLUSIONS Significant differences in pregnancy related risk factors during the periconceptional period and throughout pregnancy were observed between maternal nativity groups and across race/ethnicity. Prevention efforts for both prepregnancy and after conception should be designed and delivered according to maternal nativity for each racial/ethnic group. Birth Defects Research (Part A), 2011. © 2011 Wiley-Liss, Inc. [ABSTRACT FROM AUTHOR]

Lupo PJ, Symanski E, Chan W, Mitchell LE, Waller DK, Canfield MA, Langlois PH. Differences in exposure assignment between conception and delivery: the impact of maternal mobility. Paediatric and Perinatal Epidemiology 2010; 24: 200–208. In studies of reproductive outcomes, maternal residence at delivery is often the only information available to characterise environmental exposures during pregnancy. The goal of this investigation was to describe residential mobility during pregnancy and to assess the extent to which change of residence may result in exposure misclassification when exposure is based on the address at delivery. Maternal residential mobility was compared between neural tube defect cases and unaffected controls from Texas participants in the National Birth Defects Prevention Study (NBDPS). Maternal residential information was obtained from the NBDPS interview. Data from the U.S. EPA National Air Toxics Assessment [Assessment System for Population Exposure Nationwide (ASPEN)], modelled at the census tract level, were used to estimate benzene exposure based on address at conception and address at delivery. Quartiles of exposure were assigned based on these estimates and the quartile assignments based on address at conception and address at delivery were compared using traditional methods (kappa statistics) and a novel application of mixed-effects ordinal logistic regression. Overall, 30% of case mothers and 24% of control mothers moved during pregnancy. Differences in maternal residential mobility were not significant between cases and controls, other than case mothers who moved did so earlier during pregnancy than control mothers ( P = 0.01). There was good agreement between quartiles of estimated benzene exposure at both addresses (kappa = 0.78, P < 0.0001). Based on the mixed-effects regression model, address at delivery was not significantly different from using address at conception when assigning quartile of benzene exposure based on estimates from ASPEN (odds ratio 1.03, 95% confidence interval 0.85, 1.25). Our results indicate that, in this Texas population, maternal residential movement is generally within short distances, is typically not different between cases and controls, and does not significantly influence benzene exposure assessment. [ABSTRACT FROM AUTHOR]

Objective To identify the factors associated with important (≥50%) variation in awareness and practice of evidence-based obstetric interventions in an African setting where we have previously reported poor awareness and use of evidence-based reproductive interventions. Design Cross-sectional analysis of data from our Reproductive Health Interventions Study. Setting North-west province, Cameroon, Africa. Population Health workers including obstetricians, other physicians, midwives, nurses and other staff providing reproductive care. Main outcome measures Prevalence ratios (PR) of uniform awareness and practice of four key evidence-based obstetric interventions from the World Health Organization Reproductive Health Library (WHO RHL): antiretrovirals to prevent mother-to-child transmission of HIV/AIDS, antenatal corticosteroids for prematurity, uterotonics to prevent postpartum haemorrhage and magnesium sulphate for seizure prophylaxis. Methods Comparisons of descriptive covariates, applying logistic regression to estimate independent relationships with awareness and use of evidence-based interventions. Results A total of 15.5% (50/322) of health workers were aware of all the four interventions while only 3.8% (12/312) reported optimal practice. Evidence-based awareness was strongly associated with practice (PR = 15.4; 96% CI: 4.3–55.0). Factors significantly associated with awareness were: attending continuing education, access to the WHO RHL, employment as an obstetrician/gynaecologist and working in autonomous military or National Insurance Fund facilities. Controlling for potential confounding, working as an obstetrician was associated with increased awareness (adjusted prevalence odds ratio [aPOR] = 8.3; 95% CI: 1.3–53.8) as was median work experience of 5–15 years (aPOR = 2.0; 95% CI: 1.0–3.8). Internet access was associated with increased practice (aPOR = 3.4; 95% CI: 1.0–11.8). Other potentially important variations were observed, although they did not attain statistical significance. Conclusions Several factors including obstetric training and continuous education positively influence evidence-based awareness and practice of key obstetric interventions. Confirmation and application of this information may enhance the effectiveness of programmes to improve maternal and perinatal outcomes. [ABSTRACT FROM AUTHOR]

Questions: How does the time interval between subsequent stand-replacing fire events affect post-fire understorey cover and composition following the recent event? How important is fire interval relative to broad- or local-scale environmental variability in structuring post-fire understorey communities? Location: Subalpine plateaus of Yellowstone National Park (USA) that burned in 1988. Methods: In 2000, we sampled understorey cover and Pinus contorta density in pairs of 12-yr old stands at 25 locations. In each pair, the previous fire interval was either short (7-100 yr) or long (100-395 yr). We analysed variation in understorey species richness, total cover, and cover of functional groups both between site pairs (using paired t-tests) and across sites that experienced the short fire intervals (using regression and ordination). We regressed three principal components to assess the relative importance of disturbance and broad or local environmental variability on post-fire understorey cover and richness. Results: Between paired plots, annuals were less abundant and fire-intolerant species (mostly slow-growing shrubs) were more abundant following long intervals between prior fires. However, mean total cover and richness did not vary between paired interval classes. Across a gradient of fire intervals ranging from 7-100 yr, total cover, species richness, and the cover of annuals and nitrogen-fixing species all declined while the abundance of shrubs and fire-intolerant species increased. The few exotics showed no response to fire interval. Across all sites, broad-scale variability related to elevation influenced total cover and richness more than fire interval. Conclusions: Significant variation in fire intervals had only minor effects on post-fire understorey communities following the 1988 fires in Yellowstone National Park. [ABSTRACT FROM AUTHOR]

Copyright of Conservation Biology 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.)

1. Termite nitrogenase activity was highest in autumn and spring (≈ 3 μg N2 fixed termite fresh mass (g)–1 day–1) and lowest in winter and summer (≈ 0·8 μg N2 fixed termite fresh mass (g)–1 day–1). 2. The nitrogenase activity of worker termites was significantly higher than all other castes (1·58 ± 0·27 μg N2 fixed termite fresh mass (g)–1 day–1). 3. Worker termites constituted the largest proportion of all the castes throughout the study period (≈ 90%). 4. The localized input of fixed nitrogen by termites may reach 15·3 mg N log–1 day–1 and 5·6 g N log–1 year–1. [ABSTRACT FROM AUTHOR]

In 1978 and 1980 I planted 660 and 900 seeds of Impatiens capensis Meerb. at four densities in the greenhouse to examine how variation in plant performance is generated. I noted seed weight, seed type (cleistogamous or chasmogamous), maternal parent, and population of origin, and monitored emergence date, cotyledon area, the biomass of competitors within the same flat, and the final size reached by the seedlings after 63 to 80 d of growth. Larger seeds tended to germinate sooner, as did seeds derived from chasmogamous flowers. Seeds from northern populations took longer to germinate. Seeds from different maternal parents also germinated at different rates. Cotyledon area strongly depended on seed weight, and, to a lesser extent, germination date. Maternal parent and seed type significantly affected cotyledon area in 1980. Plant density and cotyledon area influenced final size the most, but almost every factor proved to be statistically significant. As expected, earlier emerging seedlings with larger cotyledons growing at the lowest density grew into the largest plants. I applied path analysis to summarize the interactions among the continuous variables and to disentangle direct from indirect causal effects. This technique revealed that seed weight enhanced performance primarily through its effects on emergence date and cotyledon area. Chasmogamous seedlings outperformed cleistogamous seedlings, and their advantage was expressed during most phases of growth. Together, the predictor variables accounted for over four-fifths of the total variation in final size. The inequality of plant sizes, as measured by the Gini coefficient, increased appreciably during the course of the experiment. There was no simple relation to density, however, suggesting that both intrinsic differences in growth rate, and competitive dominance and supression fuel the establishment of size hierarchies. [ABSTRACT FROM AUTHOR]

Several factors are believed to contribute to impaired responsiveness to arginine vasopressin(AVP) during lithium treatment. The renal kallikrein-kinin system is reported to antagonize the renal effects of AVP in vitro, but there are no reports of its activity during lithium treatment. Urinary active kallikrein excretion in 18 lithium-treated patients was found to be lower than that in eight healthy volunteers. Following intravenous administration of an AVP analogue, des-amino-D-arginine-vasopressin, to the lithium-treated patients, the urinary excretion of active kallikrein was unchanged, despite an impaired urine-concentrating ability. these results suggest that stimulation of renal kallikrein does not contribute to inhibition of the action of AVP, and thus the genesis of nephrogenic diabetes insipidus during lithium treatment. [ABSTRACT FROM AUTHOR]

Examines the circulatory responses of the renin-angiotensin system and its response to hypotension. Role of the renin-angiotensin system in blood pressure control; Secretion of renin into the circulation from the juxtaglomerular apparatus in the afferent renal arteriole; Regulation of aldosterone release by renin through angiotensin II formation.

OBJECTIVE: To develop and evaluate a simplified and condensed cognitive behavioral treatment for bulimia nervosa suitable for use in primary care. METHOD: Once developed, the treatment was tested on a consecutive series of 11 patients. RESULTS: Six patients did well, 3 were nonresponders, and in the other 2 external events interfered with progress. DISCUSSION: This form of treatment may benefit a significant proportion of those patients with bulimia nervosa who are seen in primary care. It can be administered by nonspecialist therapists. [ABSTRACT FROM AUTHOR]

1 The effects of benzhexol on the absorption and pharmacokinetics of an oral dose of levodopa have been studied in 10 young healthy volunteers. Subjects were given a suspension of levodopa (250 mg) 90 min after either benzhexol (5 mg) or placebo in a randomized cross over design with doses separated by at least 1 week; on each occasion carbidopa was given 1 h before and 5 h after the dose of levodopa. Soluble paracetamol and radiolabelled DTPA were given with the levodopa as markers of gastric emptying. 2 Most subjects showed two peaks in the levodopa plasma concentration-time curve on the placebo day, with the second minor peak occurring 1-2 h after the dose. After benzhexol administration all subjects showed two or more peak levodopa concentrations in plasma. Benzhexol administration caused a significant decrease in the maximum concentration (43%; P<0.05) of the initial peak and an increase (22%; P<0.1) in the maximum concentration of the second peak. This change in absorption profile caused by benzhexol significantly altered the ratios of the second peak compared with the initial peak for both the maximum concentrations ( P<0.02) and for the AUC values ( P<0.05). Benzhexol administration did not affect the total AUC of levodopa (7.30±1.09 vs 7.19±1.26 μg ml−1 h; means±s.d.). 3 The plasma concentration-time curves for paracetamol showed similar profiles to those for levodopa and the ratios of the peak concentrations and AUC values for the second peak compared with the initial peak were increased significantly by benzhexol administration ( P<0.05). The total AUC of paracetamol was not affected by benzhexol administration (39.4±8.2 vs 40.0±8.9 μg ml−1 h; mean±s.d.) 4 Benzhexol altered the gastric emptying profile, shown by γ-scintigraphy, with a reduced extent of initial emptying prior to the establishment of the plateau which is characteristic of levodopa administration in the fasting state. In consequence the ratio of the second to the initial phase of emptying was significantly higher ( P<0.01) following benzhexol treatment. 5 Benzhexol reduces the initial phase of gastric emptying after a dose of levodopa so that there is a decrease in the initial peak and a greater proportion of the dose is absorbed subsequently following the second phase of gastric emptying which occurs approximately 1 h later. Theoretically, this altered concentration-time profile could be an advantage for some patients with Parkinson's disease. [ABSTRACT FROM AUTHOR]

Copyright of Conservation Biology 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.)

The article discusses the extralegal checks on the power of the Chinese Communist Party (CCP) from 1949 through 1967. The relationship between the CCP and the Chinese People's Liberation Army (PLA), including the economic role delegated from the former to the latter, is discussed. An overview of the role that the Chinese bureaucracy and intellectuals play in checking the CCP's power, including in the bureaucracy's hiring of intellectuals for state administrative and management positions in 1958, is provided.

Background: We examined the association between the maternal genotype for celiac disease‐associated variants and risk of neural tube defects (NTDs). Methods: We conducted a case–control study, using data from the National Birth Defects Prevention Study. We evaluated 667 cases (women with an offspring with NTD) and 743 controls (women with an offspring without a birth defect). We classified women as having low, intermediate, or high risk of celiac disease based on human leukocyte antigen (HLA) variants. We used logistic regression to assess the relationship between HLA celiac risk group (low, intermediate, high) and risk of NTDs. Fifteen non‐HLA variants (identified from genome‐wide association studies of celiac disease) were individually evaluated and modeled additively. Results: There was no association between HLA celiac risk group and NTDs (intermediate vs. low risk: aOR, 1.0; 95% CI, 0.8–1.3; high vs. low risk: aOR, 0.8; 95% CI, 0.5–1.3). Of the fifteen non‐HLA variants, we observed five significant associations after accounting for multiple comparisons. Three negative associations were observed with rs10903122, rs13314993, rs13151961 (aOR range: 0.69–0.81), and two positive associations were observed with rs13003464 and rs11221332 (aOR range: 1.27–1.73). Conclusion: If confirmed, our results suggest that the maternal variants related to celiac disease may be involved in the risk of NTDs. [ABSTRACT FROM AUTHOR]

The article discusses various reports published within the issue, including the article which explores the attitudes of community pharmacists to the issue about off-label and unlicensed prescribing for children.

The degree of ligation of T state human haemoglobin crystals is reduced by inositol hexaphosphate (IHP). The structure of a partially ligated haemoglobin has been refined using fast Fourier restrained-least-squares techniques. Manual interventions were required to escape from local minima and introduce a large number of solvent molecules. Individual isotropic temperature factors were refined for all atoms and the final average atomic temperature factor is 32.3 A2. The final R factor is 19.6% for all data between 10 and 1.5 A. The final model consists of 4560 protein atoms and 313 solvent molecules. The occupancies of the ligand atoms and the anisotropic behaviour of the iron atoms have been refined, demonstrating that the alpha haem groups are only partially ligated and that there is no ligation of the beta haems. Density for the IHP indicates that it is not well ordered even though changes in the ligation and structure of the haemoglobin indicate its presence.