bluuebunny/crossref_metadata_2025 huggingface dataset:
Dragon PolyA Spotter: predictor of poly(A) motifs within human genomic DNA sequences
Authors: Kalkatawi Manal , Rangkuti Farania , Schramm Michael , Jankovic Boris R. , Kamau Allan , Chowdhary Rajesh , Archer John A. C. , Bajic Vladimir B.
Published: April 2013

Contact:  vladimir.bajic@kaust.edu.sa

Supplementary information:  Supplementary data are available at Bioinformatics online.
Exome-based analysis for RNA epigenome sequencing data
Authors: Meng Jia , Cui Xiaodong , Rao Manjeet K. , Chen Yidong , Huang Yufei
Published: April 2013

Motivation: Fragmented RNA immunoprecipitation combined with RNA sequencing enabled the unbiased study of RNA epigenome at a near single-base resolution; however, unique features of this new type of data call for novel computational techniques.

Result: Through examining the connections of RNA epigenome sequencing data with two well-studied data types, ChIP-Seq and RNA-Seq, we unveiled the salient characteristics of this new data type. The computational strategies were discussed accordingly, and a novel data processing pipeline was proposed that combines several existing tools with a newly developed exome-based approach ‘exomePeak’ for detecting, representing and visualizing the post-transcriptional RNA modification sites on the transcriptome.

Availability: The MATLAB package ‘exomePeak’ and additional details are available at http://compgenomics.utsa.edu/exomePeak/.

Contact:  yufei.huang@utsa.edu or jmeng@mit.edu

Supplementary information:  Supplementary data are available at Bioinformatics online.
Novel algorithms and the benefits of comparative validation
Authors: Smith Robert , Ventura Dan , Prince John T.
Published: April 2013

Contact:  2robsmith@gmail.com
SOLID-APPEARING RETINAL CYSTS IN DIABETIC MACULAR EDEMA
Authors: Liang Michelle C. , Vora Robin A. , Duker Jay S. , Reichel Elias
Published: April 2013

Purpose:

To describe a novel finding of solid-appearing retinal cysts in patients with diabetic macular edema.

Methods:

Case series of four patients with diabetic retinopathy discovered to have solid-appearing retinal cysts on spectral-domain optical coherence tomography.

Results:

These cases demonstrate the presence of inner retinal hyporeflective cysts filled with an isoreflective substance on spectral-domain optical coherence tomography. These solid-appearing cysts arise from previously fluid-filled cysts and are not found in relation to intraretinal hemorrhage. Treatment with intravitreal anti–vascular endothelial growth factor agents did not seem to directly alter their natural course.

Conclusion:

The authors report solid-appearing retinal cysts as a new optical coherence tomography finding in four patients with diabetic macular edema. The exact composition of this isoreflective material is unknown. The authors hypothesize that fibrin or other inflammatory by-products fill these spaces.
Gastrointestinal Mucosal Involvement Without Amyloidosis in Children With Familial Mediterranean Fever
Authors: Gurkan Odul Egritas , Dalgic Buket
Published: April 2013

Background and Objectives:

Familial Mediterranean fever (FMF) and inflammatory bowel disease togetherness is well described in the literature. Abdominal pain and various gastrointestinal manifestations may arise directly from FMF or secondary to FMF‐associated diseases such as inflammatory bowel disease, vasculitidies, or amyloidosis. The aim of the study was to document gastrointestinal involvement in familial Mediterranean fever.

Methods:

The medical files of the patients who were diagnosed as having FMF at the Department of Pediatric Gastroenterology, Gazi University School of Medicine between 2007 and 2012 were examined retrospectively. FMF diagnosis was made through performing clinical, laboratory, colonoscopy, endoscopy, and genetic analysis.

Results:

Thirty‐six patients were diagnosed as having FMF during this period. Among them, 11 patients were admitted with vomiting or diarrhea. Colonoscopy and upper gastrointestinal endoscopy were performed. Colonic inflammation and multiple gastric aphthous ulcerations were observed.

Conclusions:

In this report, we described 11 patients who presented with gastrointestinal symptoms and eventually diagnosed as having FMF. Gastrointestinal mucosal involvement without amyloidosis is documented by endoscopic and histopathologic investigations in these patients. We concluded that mucosal involvement of the gastrointestinal tract may be attack‐related manifestations in these patients.
Polyethylene Glycol
Authors: Alper Arik , Pashankar Dinesh S.
Published: April 2013

Constipation is a common problem in children worldwide. It can also be a chronic problem persisting for many months to years. Successful treatment of constipation requires long‐term use of laxatives. Commonly used laxatives in children include milk of magnesia, lactulose, mineral oil, and polyethylene glycol. Compared with other laxatives, polyethylene glycol (with and without electrolytes) is a relatively new laxative used during the last decade. Recent studies report excellent efficacy and safety of polyethylene glycol for the long‐term treatment of constipation in children. Because of excellent patient acceptance, polyethylene glycol has become a preferred choice of laxative for many practitioners. This article reviews the recently published pediatric literature on biochemistry, efficacy, safety, patient acceptance, and pharmacoeconomics of polyethylene glycol.
Analysis and modelling of glacial climate transitions using simple dynamical systems
Authors: Kwasniok Frank
Published: April 2013

Glacial climate variability is studied integrating simple nonlinear stochastic dynamical systems with palaeoclimatic records. Different models representing different dynamical mechanisms and modelling approaches are contrasted; model comparison and selection is based on a likelihood function, an information criterion as well as various long-term summary statistics. A two-dimensional stochastic relaxation oscillator model with proxy temperature as the fast variable is formulated and the system parameters and noise levels estimated from Greenland ice-core data. The deterministic part of the model is found to be close to the Hopf bifurcation, where the fixed point becomes unstable and a limit cycle appears. The system is excitable; under stochastic forcing, it exhibits noisy large-amplitude oscillations capturing the basic statistical characteristics of the transitions between the cold and the warm state. No external forcing is needed in the model. The relaxation oscillator is much better supported by the data than noise-driven motion in a one-dimensional bistable potential. Two variants of a mixture of local linear stochastic models, each associated with an unobservable dynamical regime or cluster in state space, are also considered. Three regimes are identified, corresponding to the different phases of the relaxation oscillator: (i) lingering around the cold state, (ii) rapid shift towards the warm state, (iii) slow relaxation out of the warm state back to the cold state. The mixture models have a high likelihood and are able to capture the pronounced time-reversal asymmetry in the ice-core data as well as the distribution of waiting times between onsets of Dansgaard–Oeschger events.
On the relationship between stratospheric structure and tropospheric blocking patterns
Authors: Cullen M. J. P. , Ngan K.
Published: April 2013

Prediction of long-lived anomalous behaviour in the atmosphere is fundamental to extended range and seasonal forecasting. Prediction of changes in the climatology of such anomalous behaviour is also fundamental to regional climate modelling. Anomalous atmospheric behaviour is often related to mid-latitude tropospheric ‘blocking’ patterns, where the normal westerly flow associated with the temperature difference between the Poles and the Equator is disrupted. Following recent work on stratosphere–troposphere coupling, we show that the vertical structure of the atmosphere can strongly influence the climatology of tropospheric blocking. We invoke dynamical theory to argue that the development and decay of anomalous circulations is most efficient for a preferred aspect ratio of the flow, implying that the development of large-scale anomalies requires a large vertical scale. Evidence for this link comes from the observed evolution of the geopotential height. In particular, we find that the development of the large-scale tropospheric anomalies associated with blocking requires a vertical scale extending well into the stratosphere. This process is inhibited during periods of high stratospheric activity, when the vertical scale of tropospheric developments is restricted, leading to the persistence of large horizontal scales.
Data assimilation on the exponentially accurate slow manifold
Authors: Cotter Colin
Published: April 2013

I describe an approach to data assimilation making use of an explicit map that defines a coordinate system on the slow manifold in the semi-geostrophic scaling in Lagrangian coordinates, and apply the approach to a simple toy system that has previously been proposed as a low-dimensional model for the semi-geostrophic scaling. The method can be extended to Lagrangian particle methods such as Hamiltonian particle–mesh and smooth-particle hydrodynamics applied to the rotating shallow-water equations, and many of the properties will remain for more general Eulerian methods. Making use of Hamiltonian normal-form theory, it has previously been shown that, if initial conditions for the system are chosen as image points of the map, then the fast components of the system have exponentially small magnitude for exponentially long times as
ϵ
→0, and this property is preserved if one uses a symplectic integrator for the numerical time stepping. The map may then be used to parametrize initial conditions near the slow manifold, allowing data assimilation to be performed without introducing any fast degrees of motion (more generally, the precise amount of fast motion can be selected).
SFMBT1 functions with LSD1 to regulate expression of canonical histone genes and chromatin-related factors
Authors: Zhang Jin , Bonasio Roberto , Strino Francesco , Kluger Yuval , Holloway J. Kim , Modzelewski Andrew J. , Cohen Paula E. , Reinberg Danny
Published: April 2013

SFMBT1 (Scm [Sex comb on midleg] with four MBT [malignant brain tumor] domains 1) is a poorly characterized mammalian MBT domain-containing protein homologous to Drosophila SFMBT, a Polycomb group protein involved in epigenetic regulation of gene expression. Here, we show that SFMBT1 regulates transcription in somatic cells and during spermatogenesis through the formation of a stable complex with LSD1 and CoREST. When bound to its gene targets, SFMBT1 recruits its associated proteins and causes chromatin compaction and transcriptional repression. SFMBT1, LSD1, and CoREST share a large fraction of target genes, including those encoding replication-dependent histones. Simultaneous occupancy of histone genes by SFMBT1, LSD1, and CoREST is regulated during the cell cycle and correlates with the loss of RNA polymerase II at these promoters during G2, M, and G1. The interplay between the repressive SFMBT1–LSD1–CoREST complex and RNA polymerase II contributes to the timely transcriptional regulation of histone genes in human cells. SFMBT1, LSD1, and CoREST also form a stable complex in germ cells, and their chromatin binding activity is regulated during spermatogenesis.
MYC/MAX control ERK signaling and pluripotency by regulation of dual-specificity phosphatases 2 and 7
Authors: Chappell James , Sun Yuhua , Singh Amar , Dalton Stephen
Published: April 2013

Suppression of extracellular signal-regulated kinase (ERK) signaling is an absolute requirement for the maintenance of murine pluripotent stem cells (mPSCs) and requires the MYC-binding partner MAX. In this study, we define a mechanism for this by showing that MYC/MAX complexes suppress ERK activity by transcriptionally regulating two members of the dual-specificity phosphatase (DUSP) family. DUSPs function by binding and then inactivating ERK1,2 by dephosphorylating residues required for catalytic activity. MYC/MAX complexes achieve this by binding the promoters of DUSP2 and DUSP7, leading to their transcriptional activation, resulting in the attenuation of ERK activity. In the absence of MYC, ectopic DUSP2,7 expression severely delays differentiation, while loss of DUSP2,7 ectopically activates ERK, resulting in loss of pluripotency. These findings elucidate a novel regulatory role for MYC in PSC maintenance involving the stimulation of phosphatases that directly inhibit the MAPK/ERK signaling pathway. Moreover, it provides a mechanism for how leukemia inhibitory factor (LIF)/STAT3 signaling reaches across to the MAPK/ERK pathway through MYC and MAX to sustain pluripotency.
A new oxyfluorotellurate(IV), InTe2O5F
Authors: Jennene Boukharrata Nefla , Duclère Jean-René , Laval Jean-Paul , Thomas Philippe
Published: April 2013

A new oxyfluorotellurate(IV), indium fluoridopentaoxidotellurate(IV), InTe2O5F, has been synthesized by solid-state reaction and structurally characterized. The crystal structure consists of a three-dimensional framework formed by InO4F2octahedra and Te2O5units. The InO4F2octahedra are linked through the F atoms, which lie on twofold axes, giving rise to helical chains. These helical chains are connectedviathe Te2O5units. The helical chains of indium octahedra surround cavities, into which the lone pairs of electrons of the Te atoms point.
Lactobacillus plantarum CS24.2 prevents Escherichia coli adhesion to HT‐29 cells and also down‐regulates enteropathogen‐induced tumor necrosis factor‐α and interleukin‐8 expression
Authors: Dhanani Akhilesh S. , Bagchi Tamishraha
Published: April 2013

The aim of the present study was to evaluate the potential of Lactobacillus plantarum CS24.2 to antagonize Escherichia coli adhesion and modulate expression of the responses by HT‐29 cells of inflammatory molecules to E. coli adhesion. Experiments were performed under different adhesion conditions and findings compared with the responses of Lactobacillus rhamnosus GG. Tests of competitive adhesion, adhesion inhibition and displacement assays were performed for lactobacilli (L. rhamnosus GG and L. plantarum CS24.2) and E. coli O26:H11 to HT‐29 cells. Both the lactobacilli significantly reduced E. coli adhesion to HT‐29 cells (P < 0.05). The ability of lactobacilli to modulate tumor necrosis factor‐α and interleukin‐8 expression was analyzed in HT‐29 cells stimulated with E. coli using qRT‐PCR. L. plantarum CS24.2 significantly down regulated expression of both the genes induced by E. coli in HT‐29 cells at 6 hr as well as 24 hr, which was more significant than the corresponding findings for L. rhamnosus GG. The present findings suggest that L. plantarum CS24.2 inhibits pathogen adhesion to a similar extent as does the established probiotic strain L. rhamnosus GG. It may also attenuate tumor necrosis factor‐α and interleukin‐8 expression in HT‐29 cells stimulated with E. coli.
Strains in the genus Thauera exhibit remarkably different denitrification regulatory phenotypes
Authors: Liu Binbin , Mao Yuejian , Bergaust Linda , Bakken Lars R. , Frostegård Åsa
Published: April 2013

Denitrifiers differ in how they handle the transition from oxic to anoxic respiration, with consequences for NO and N2O emissions. To enable stringent comparisons we defined parameters to describe denitrification regulatory phenotype (DRP) based on accumulation of NO2−, NO and N2O, oxic/anoxic growth and transcription of functional genes. Eight Thauera strains were divided into two distinct DRP types. Four strains were characterized by a rapid, complete onset (RCO) of all denitrification genes and no detectable nitrite accumulation. The others showed progressive onset (PO) of the different denitrification genes. The PO group accumulated nitrite, and no transcription of nirS (encoding nitrite reductase) was detected until all available nitrate (2 mM) was consumed. Addition of a new portion of nitrate to an actively denitrifying culture of a PO strain (T. terpenica) resulted in a transient halt in nitrite reduction, indicating that the electron flow was redirected to nitrate reductase. All eight strains controlled NO at nano‐molar concentrations, possibly reflecting the importance of strict control for survival. Transient N2O accumulation differed by two orders of magnitude between strains, indicating that control of N2O is less essential. No correlation was seen between phylogeny (based on 16S rRNA and functional genes) and DRP.
Globalisation and the Resilience of Social Democracy: Reassessing New Labour's Political Economy
Authors: Smith Martin
Published: April 2013

Research Highlights and Abstract

This article:

Places New Labour's political economy in historical context using macro-economic data; Demonstrates that the arguments on policy convergence have led to a simplification of the nuances of Labour's political economy and underestimated its partisan nature; Highlights how globalisation rather than restraining Labour allowed an unprecedented increase in borrowing and spending making Labour very different to Conservative administrations and more ‘old’ Labour than previous Labour administrations.

There has been considerable debate about the way in which globalisation and neo-liberalism have produced convergence in macro-economic policy. In the British case this convergence is seen in the adoption by the Labour Government (1997–2010) of the core elements of Thatcherite economic policy. However, this article argues that that an examination of macro-economic data demonstrates that is difficult to characterise New Labour as neo-liberal and indeed there is some evidence that it shared a number of commonalities with ‘Old’ Labour. Indeed, in many ways the changing structure of the financial markets removed, to some degree, the shackles from Labour and allowed greater borrowing and spending than previous left of centre administrations. Consequently, as Geoffrey Garrett suggests, partisanship remains an important determinant of economic policy in the UK case.
Grammatical Profiles and Aspect in Old Church Slavonic
Authors: Eckhoff Hanne M. , Janda Laura A.
Published: April 2013

We employ a new empirical approach to an enduring controversy concerning the development of a system of imperfective vs. perfective verbs in Slavic. While scholars once claimed that this is an ancient inherited system, dating from the prehistoric era, most now believe that the Slavic aspect‐pair system is an innovation. Different opinions concerning the date of this innovation range from the time of the earliest Slavic texts to the late middle ages. We use two different statistical models to sort Old Church Slavonic data from the PROIEL corpus and compare the results to distributions of verb forms in modern Russian. This comparison shows that there are indeed differences among verbs in Old Church Slavonic that suggest a division into imperfective vs. perfective verbs, although this division is clearly not identical to the division found in modern Russian.
Accented Clitics in the Ṛgveda
Authors: Lowe John
Published: April 2013

I discuss the most controversial and widely studied part of the Ṛgvedic Sanskrit clause, the clause‐initial string. I focus in particular on a few sets of words — relative pronouns, demonstrative pronouns and preverbs — arguing that their treatment in previous analyses requires revision. This is because they can be, in some contexts, clitics. I argue that clisis must be defined in primarily syntactic rather than prosodic terms: Ṛgvedic clitics all share certain syntactic properties, but they do not all necessarily share any single prosodic property (such as lack of lexical accent). I subsequently examine the consequences of this reanalysis of pronouns and preverbs in the clause‐initial string for syntactic accounts of Ṛgvedic word order.
Impact of Lanthanum Carbonate on Cortical Bone in Dialysis Patients with Adynamic Bone Disease
Authors: Yajima Aiji , Inaba Masaaki , Tominaga Yoshihiro , Tanaka Motoko , Otsubo Shigeru , Nitta Kosaku , Ito Akemi , Satoh Shigeru
Published: April 2013

Among the most serious problems in patients with chronic kidney disease (CKD) is fragility of cortical bone caused by cortical thinning and increased cortical porosity; the cortical fragility is sometimes irreversible, with fractures generally initiating from cortical bone. Therefore, development of treatments for problems of cortical bone is urgently desired. Cortical bone has the three surfaces, including the periosteal surface, intracortical spaces and endocortical surface. Bone turnover at the endocortical surface and intracortical resorption spaces are increased as compared with that at cancellous surface. Bone growth sometimes depends on apposition at the periosteal surface.

We treated hyperphosphatemia in two hemodialysis patients with adynamic bone disease with 750–1500 mg/day of lanthanum carbonate, which is a non‐calcium containing phosphate binder; the treatment resulted in a decrease of the serum phosphorus levels (P levels), without significant change of the serum intact parathyroid hormone levels. We now report that treatment of these patients with lanthanum carbonate increased mineralization of the periosteal surface, increased bone mass within the intracortical resorption spaces and increased mineralization of the minimodeling surface at the endocortical surface. In addition, woven bone volume in cortical bone was decreased and mineralization of bone units, namely, osteons, was increased. Although these findings were not observed across all surfaces of the cortical bone in the patients, it is expected that lanthanum carbonate would increase the cortical stability in CKD patients, with consequent reduction in the fracture rate in these patients.
Improvement of MBD Parameters in Dialysis Patients by a Switch to, and Combined Use of Lanthanum Carbonate: Josai Dialysis Forum Collaborative Study
Authors: Shinoda Toshio , Yamasaki Masahiro , Chida Yoshiko , Takagi Masao , Tanaka Yoshiko , Ando Ryoichi , Suzuki Toshiaki , Tagawa Hitoshi
Published: April 2013

The effects of lanthanum carbonate on MBD parameters were investigated in 59 hemodialysis patients who were taking calcium carbonate. Lanthanum carbonate (initial dosage: 750 mg/day), as a replacement for or in combination with calcium carbonate and/or sevelamer hydrochloride, was administered for 12 months with increase/decrease of dosages. Lanthanum carbonate replaced calcium carbonate for 21 cases and was co‐administered in 38 cases. It replaced sevelamer hydrochloride in 20 cases and was co‐administered in 10 cases. Both the number of cases to which calcium carbonate was administered and their dosages decreased to about 70–80% 12 months after the initiation, and cases administered sevelamer decreased to about 30%. In the cases for which lanthanum carbonate was co‐administered, the dosages of calcium carbonate and sevelamer slightly decreased. A significant decrease in serum calcium level was observed. In the serum phosphorus levels (P levels), significant decrease compared with the initial level was observed only at six and nine months. Intact parathyroid hormone (iPTH) level remained stable at around 230 pg/mL without significant change. The dosage of vitamin D and cinacalcet remained without significant change. The results of this trial suggest that, if dosages of vitamin D and cinacalcet are adequately controlled, a switch to lanthanum carbonate and its concomitant use are effective to control the Ca and P levels without changing iPTH levels.
Study of Prolonged Administration of Lanthanum Carbonate in Dialysis Patients
Authors: Gotoh Junichi , Kukita Kazutaka , Tsuchihashi Seiichiro , Hattori Masahiro , Iida Junichi , Horie Takashi , Onodera Kazuhiko , Furui Hidenori , Tamaki Toru , Meguro Junichi , Yonekawa Motoki , Kawamura Akio
Published: April 2013

Data of 36 months were accumulated regarding the effects of lanthanum carbonate (LA) on serum phosphate concentrations in dialysis patients. Fifty‐three patients (average age and dialysis history 58.4 years and 9.1 years) were included in this study who have been receiving outpatient treatment since March 2009, and who have been unable to maintain serum phosphate concentrations of ≤6.0 mg/dL via traditional therapeutic agents used for hyperphosphatemia. Patients were given dosage of LA in addition to, or instead of, co‐hyperphosphatemia treatments already being received. Mean dosages of calcium carbonate (CC) and sevelamer hydrochloride (SH) before starting LA administration were 1301.9 mg and 2462.3 mg, respectively. Dosage of LA for all cases was 750 mg at initial dose; 1528.3 mg at 5 months; and 1416.7 mg at 30 months. Dosage of other phosphate binders were 905.7 mg of CC and 820.8 mg of SH at 5 months; and 687.5 mg of CC and 1031.3 mg of SH at 30 months. Serum phosphorus levels (P levels) were significantly decreased at 1 month of LA administration, and continued until 30 months of La treatment. These results suggest that LA successfully controlled serum P and Ca concentrations simultaneously within target ranges without affecting serum intact parathyroid hormone concentration, although further long‐term prospective cohort study on LA would be required.
Agricultural Research and Innovation Systems in Transition
Authors: Moreddu Catherine , Poppe Krijn J.
Published: April 2013

summary

Agricultural Research and Innovation Systems in Transition

Agricultural knowledge and innovation systems (AKIS) are in transition in many countries from a linear, top‐down approach towards more flexible and interactive arrangements. This transition to a system more responsive to changing demands seeks to improve the adoption of innovation in order to strengthen the competitiveness of the agri‐food sector. This article focuses on the research and innovation components of the AKIS to analyse the main developments of recent years and their drivers. It concludes that the diversity of institutional arrangements and priorities is likely to persist as they are path dependent and respond to different socio‐economic contexts. This article suggests how national governments could foster innovation in the agri‐food sector by considering a whole range of policies and improving their coherence. One suggestion is that the European Union play a role in coordinating (basic) science and research infrastructure, manage spillovers between EU regions, as well as promoting market‐based instruments, support capacity‐building and international exchange of staff, provide information using modern Information and Communication Technologies and guidelines for the evaluation of AKIS, and create a forum to exchange experiences.
The Importance of the Back‐office for Farm Advisory Services
Authors: Labarthe Pierre , Laurent Catherine
Published: April 2013

summary

The Importance of the Back‐office for Farm Advisory Services

Advisory services must deal with new challenges. On the one hand, there is increasing uncertainty as to which agronomic systems and practices can enable farmers to integrate environmental and food safety issues e.g. pesticide use reduction, and to secure the economic performance of their farms. On the other hand, European agriculture is still characterised by a huge structural diversity in terms of farm size, level of specialisation or diversification, pluriactivity of agricultural households, etc. Such farm diversity generates a need for a variety of adapted technical solutions even when famers are confronted with a similar problem, e.g. how to cope with the diversification of crop rotation constraints. Thus, it is crucial to provide the diverse groups of farmers with empirical evidence on the effectiveness of alternative practices in their specific context of production. This article merges debates on the investments needed to produce relevant and robust evidence with those concerning the ongoing transformation induced by the privatisation of agricultural extension systems. It argues that if networking and brokering are key elements of the functioning of these systems, stronger attention should be given to back‐office activities e.g. technology monitoring, training advisors, and production, collection and storage of technical knowledge.
Biomass, Biovalue and Sustainability: Some Thoughts on the Definition of the Bioeconomy
Authors: Brunori Gianluca
Published: April 2013

summary

Biomass, Biovalue and Sustainability: Some Thoughts on the Definition of the Bioeconomy

The success of innovation policies addressing the bioeconomy – and particularly those related to agriculture and food – will depend on how the concept is translated into policies, and therefore on how the term is understood and defined. In this article, different ‘clusters’ of definitions are considered, alternatively biotechnologies, biomass, and biochemical and biophysical processes as key criteria for identification. It is argued that none of these definitions properly address the issue of sustainability. In fact, a ‘broad’ definition of bioeconomy, encompassing all biochemical and biophysical processes, would make it useless for policy purposes. The article proposes building a definition of the bioeconomy around the concept of biovalue. It identifies the goal of the bioeconomy as the capacity to mobilise science to obtain high biovalue returns from low‐cost living matter, for example organic waste, and includes the value of non‐market goods associated with agriculture and food. In this regard, a distinction is made between ‘natural biovalue’, produced by quality agriculture, and ‘biotechnological biovalue’. It is argued that the bioeconomy and the production of natural biovalue deserve specific attention and that a sustainable bioeconomy should not undermine the potential of natural biovalue through competition for the same land and water resources.
Meta‐analysis of insulin aspart versus regular human insulin used in a basal–bolus regimen for the treatment of diabetes mellitus (在基础—餐时糖尿病治疗方案中使用门冬胰岛素与使用常规人胰岛素对照研究的Meta分析)
Authors: Heller Simon , Bode Bruce , Kozlovski Plamen , Svendsen Anne Louise
Published: April 2013

Background: 

The objective of the current study was to compare the efficacy of two different insulin formulations, insulin aspart (IAsp) and regular human insulin (RHI), for prandial insulin coverage with neutral protamine Hagedorn (NPH) insulin as basal insulin using a meta‐analysis approach. The primary endpoint was change in A1c over time. Secondary endpoints included incidence of hypoglycemia and postprandial glycemic control.

Methods

Clinical trials (Type 1 and Type 2 diabetes) complying with Good Clinical Practice, and with individual patient data, were included in the meta‐analysis. Trials were randomized, consisting of (at least) two treatment arms and had a minimum duration of 12 weeks. Estimates were calculated using fixed‐effects and random‐effects models. Heterogeneity was assessed for each analysis. The effect of baseline parameters on A1c was analyzed in extended simultaneous models.

Results

The mean difference in A1c was 0.1% (95% confidence interval [CI] [−0.15; −0.04], P < 0.001) in favor of IAsp. Higher accumulated dose of IAsp, higher age and increased rates of hypoglycemia were associated with improved A1c outcome. Fasting plasma glucose was not significantly different between regimens. Postprandial glucose was significantly lower after treatment with IAsp compared with RHI, but the analysis did present a significant level of heterogeneity (P < 0.001). The overall rate of hypoglycemia was the same with both regimens, but nocturnal hypoglycemia was significantly lower with IAsp.

Conclusions: 

A basal–bolus regimen with IAsp as bolus insulin provided minimal, but statistically significant, improvement in overall glycemic control with a lower rate of nocturnal hypoglycemic episodes, compared with a corresponding regimen with bolus RHI.
To fit or not to fit: evaluating stable isotope mixing models using simulated mixing polygons
Authors: Smith James A. , Mazumder Debashish , Suthers Iain M. , Taylor Matthew D.
Published: April 2013

Stable isotope analysis is often used to identify the relative contributions of various food resources to a consumer's diet. Some Bayesian isotopic mixing models now incorporate uncertainty in the isotopic signatures of consumers, sources and trophic enrichment factors (e.g. SIAR, MixSIR). This had made model outputs more comprehensive, but at the expense of simple model evaluation, and there is no quantitative method for determining whether a proposed mixing model is likely to explain the isotopic signatures of all consumers, before the model is run.

Earlier linear mixing models (e.g. IsoSource) are easier to evaluate, such that if a consumer's isotopic signature is outside the mixing polygon bounding the proposed dietary sources, then mass balance cannot be established and there is no logical solution. This can be used to identify consumers for exclusion or to reject a model outright. This point‐in‐polygon assumption is not inherent in the Bayesian mixing models, because the source data are distributions not average values, and these models will quantify source contributions even when the solution is very unlikely.

We use a Monte Carlo simulation of mixing polygons to apply the point‐in‐polygon assumption to these models. Convex hulls (‘mixing polygons’) are iterated using the distributions of the proposed dietary sources and trophic enrichment factors, and the proportion of polygons that have a solution (i.e. that satisfy point‐in‐polygon) is calculated. This proportion can be interpreted as the frequentist probability that the proposed mixing model can calculate source contributions to explain a consumer's isotopic signature. The mixing polygon simulation is visualised with a mixing region, which is calculated by testing a grid of values for point‐in‐polygon.

The simulation method enables users to quantitatively explore assumptions of stable isotope analysis in mixing models incorporating uncertainty, for both two‐ and three‐isotope systems. It provides a quantitative basis for model rejection, for consumer exclusion (those outside the 95% mixing region) and for the correction of trophic enrichment factors. The simulation is demonstrated using a two‐isotope study (15N, 13C) of an Australian freshwater food web.
Impact of Seasonal and Pandemic Influenza on Emergency Department Visits, 2003–2010, Ontario, Canada
Authors: Schanzer Dena L. , Schwartz Brian
Published: April 2013

Objectives

Weekly influenza‐like illness (ILI) consultation rates are an integral part of influenza surveillance. However, in most health care settings, only a small proportion of true influenza cases are clinically diagnosed as influenza or ILI. The primary objective of this study was to estimate the number and rate of visits to the emergency department (ED) that are attributable to seasonal and pandemic influenza and to describe the effect of influenza on the ED by age, diagnostic categories, and visit disposition. A secondary objective was to assess the weekly “real‐time” time series of ILI ED visits as an indicator of the full burden due to influenza.

Methods

The authors performed an ecologic analysis of ED records extracted from the National Ambulatory Care Reporting System (NARCS) database for the province of Ontario, Canada, from September 2003 to March 2010 and stratified by diagnostic characteristics (International Classification of Diseases, 10th Revision [ICD‐10]), age, and visit disposition. A regression model was used to estimate the seasonal baseline. The weekly number of influenza‐attributable ED visits was calculated as the difference between the weekly number of visits predicted by the statistical model and the estimated baseline.

Results

The estimated rate of ED visits attributable to influenza was elevated during the H1N1/2009 pandemic period at 1,000 per 100,000 (95% confidence interval [CI] = 920 to 1,100) population compared to an average annual rate of 500 per 100,000 (95% CI = 450 to 550) for seasonal influenza. ILI or influenza was clinically diagnosed in one of 2.6 (38%) and one of 14 (7%) of these visits, respectively. While the ILI or clinical influenza diagnosis was the diagnosis most specific to influenza, only 87% and 58% of the clinically diagnosed ILI or influenza visits for pandemic and seasonal influenza, respectively, were likely directly due to an influenza infection. Rates for ILI ED visits were highest for younger age groups, while the likelihood of admission to hospital was highest in older persons. During periods of seasonal influenza activity, there was a significant increase in the number of persons who registered with nonrespiratory complaints, but left without being seen. This effect was more pronounced during the 2009 pandemic. The ratio of influenza‐attributed respiratory visits to influenza‐attributed ILI visits varied from 2.4:1 for the fall H1N1/2009 wave to 9:1 for the 2003/04 influenza A(H3N2) season and 28:1 for the 2007/08 H1N1 season.

Conclusions

Influenza appears to have had a much larger effect on ED visits than was captured by clinical diagnoses of influenza or ILI. Throughout the study period, ILI ED visits were strongly associated with excess respiratory complaints. However, the relationship between ILI ED visits and the estimated effect of influenza on ED visits was not consistent enough from year to year to predict the effect of influenza on the ED or downstream in‐hospital resource requirements.
End‐of‐life Decision‐making for Patients Admitted Through the Emergency Department: Hospital Variability, Patient Demographics, and Changes Over Time
Authors: Richardson Derek K. , Zive Dana M. , Newgard Craig D.
Published: April 2013

Background

Early studies suggest that racial, economic, and hospital‐based factors influence the do‐not‐attempt‐resuscitation (DNAR) status of admitted patients, although it remains unknown how these factors apply to patients admitted through the emergency department (ED) and whether use is changing over time.

Objectives

The objective was to examine patient and hospital attributes associated with DNAR orders placed within 24 hours of admission through the ED and changes in DNAR use over time.

Methods

This was a population‐based, retrospective cross‐sectional study of patients 65 years and older admitted to 367 acute care hospitals in California between 2002 and 2010; the subset of patients admitted through the ED formed the primary sample. The primary outcome was placement of a DNAR order within 24 hours of admission. Associations between DNAR order placement and hospital characteristics, patient demographics, and year were tested. Descriptive statistics are reported, and multivariable logistic regression models with generalized estimating equations (GEEs) were used to account for clustering within hospitals.

Results

There were 9,507,921 patients older than 65 years admitted to 367 California hospitals over the 9‐year period, of whom 1,029,335 (10.8%) had DNAR orders placed within 24 hours of admission; 83% of DNAR orders were placed for patients admitted through the ED. Among patients over 65 years admitted through the ED (n = 6,396,910), DNAR orders were used less frequently at teaching hospitals (9.5% vs. 13.7%), for‐profit hospitals (8.6% vs. 14.6% nonprofit), nonrural hospitals (12.0% vs. 26.2%), and large hospitals (11.1% vs. 15.0% for hospitals in the smallest quartile for bed size; all p < 0.0001). In regression modeling adjusted for clustering and patient demographics, these trends persisted for all hospital types, except teaching hospitals. Decreased DNAR frequency was associated with race (African American odds ratio [OR] = 0.59, 95% confidence interval [CI] = 0.51 to 0.67; Asian OR = 0.70, 95% CI = 0.59 to 0.82; reference = white), ethnicity (Hispanic OR = 0.61, 95% CI = 0.55 to 0.68), sex (male OR = 0.90, 95% CI = 0.88 to 0.92), and MediCal insurance (OR = 0.70, 95% CI = 0.57 to 0.85). Statewide rates of DNAR steadily increased from 12.2% in 2002 to 14.3% in 2010, although this trend occurred primarily among white and Asian patients.

Conclusions

While statewide rates of DNAR use have increased over time among patients admitted through the ED, there is variable penetrance of this practice by hospital types, patient race, and patient ethnicity. These patterns may suggest barriers to end‐of‐life discussions, differences in hospital case mix, and variation in cultural or institutional beliefs and practices.
A Long‐term Analysis of Physician Triage Screening in the Emergency Department
Authors: Rogg Jonathan G. , White Benjamin A. , Biddinger Paul D. , Chang Yuchiao , Brown David F. M.
Published: April 2013

Objectives

The problem of emergency department (ED) crowding is well recognized; however, little data exist on the sustainability of potential solutions, including physician triage and screening. The authors hypothesized that a physician triage screening program (Supplemented Triage and Rapid Treatment [START]) sustainably improves standard ED performance metrics.

Methods

This retrospective, observational, before‐and‐after study compared performance measures over 4 years in a tertiary care urban academic medical center with approximately 90,000 annual ED visits. Patients seen between December 2006 and November 2010 were included. Outcome measures included length of stay (LOS) for ED patients, percentage of patients who left without completing assessment (LWCA), percentage of patients treated and dispositioned by START without using monitored beds, and door‐to‐room time. Descriptive statistics were used.

Results

Median LOS for START patients was 56 minutes/patient lower when comparing 2010 to 2007 (p < 0.0001) and for non‐START patients 22 minutes/patient lower (p < 0.0001). The percentage of patients who LWCA decreased from 4.8% to 2.9% (p < 0.0001) during the same time period. In START's first half‐year, 18% of patients were discharged without using monitored beds. This increased to 29% by year 3. In addition, median door‐to‐room time decreased from 18.4 to 9.9 minutes during the same 3‐year interval.

Conclusions

Physician screening appears to provide sustainable improvements in ED performance metrics including ED LOS, percentage of patients who LWCA, door‐to‐room time, and percentage of patients treated without using a monitored bed, despite increasing ED volume. Physician screening delivers additional incremental benefits for several years after implementation and can effectively increase ED capacity by allowing emergency physicians to more efficiently use monitored beds.
An Alternative Approach to the Bedside Assessment of Left Ventricular Systolic Function in the Emergency Department: Displacement of the Aortic Root
Authors: Ünlüer Erden Erol , Karagöz Arif , Bayata Serdar , Akoğlu Haldun
Published: April 2013

Objectives

Left ventricular ejection fraction (LVEF) is a crucial parameter in the management of patients with dyspnea in the emergency department (ED). The use of techniques other than echocardiography such as nuclear or magnetic resonance imaging to measure LVEF is unsuitable in the ED because of time constraints. This study aimed to compare echocardiographic aortic root (AR) excursion and LVEF measurement using the modified Simpson's method (biplane method of disks) as recommended by the American Society of Echocardiography.

Methods

After 2 hours of theoretical video and hands‐on training with 20 patients by an experienced echocardiographer, two emergency physicians prospectively evaluated patients with dyspnea. Two‐dimensional echocardiograms of the parasternal long‐axis view were obtained, and the displacement of the aortic root (DAR) was studied. M‐mode DAR recordings were obtained, and distances were measured as the maximized anterior displacement of the AR from the horizontal axis at end‐systole by using the leading‐edge methodology. LVEF was measured by an experienced cardiologist using the modified Simpson's rule. The sensitivity, specificity, positive and negative likelihood ratios (LR+, LR–), and positive and negative predictive values (PPV, NPV) were analyzed. A new formula for the prediction of the ejection fraction (EF) with the aid of DAR was then created.

Results

The mean (±SD) age with of the 70 study patients was 69.7 (±11.91) years. In these patients, DAR was highly correlated with EF (point biserial correlation coefficient = 0.79, p < 0.001) and one‐way analysis of variance (ANOVA) results were significant (F = 115.9; p < 0.001). The sensitivity was 94.4; specificity, 94.1; LR+, 16.6; LR–, 0.059; PPV, 94.4; and NPV, 94.1.

Conclusions

The results indicate that DAR is a sensitive index of left ventricular systolic function (SF) and can be used to reliably predict EF values using the rough formula of EF = 20 + 44 (DAR).
Role of personality in medical students' initial intention to become rural doctors
Authors: Jones Michael P. , Eley Diann , Lampe Lisa , Coulston Carissa M. , Malhi Gin S. , Wilson Ian , Kelly Brian , Talley Nicholas J. , Owen Cathy , Corrigan Gerry , Griffin Barbara , Humphreys John , Alba Beatrice , Stagg Pamela
Published: April 2013

Objective

Recent efforts to redress the deficit of rural medical practitioners have considered the problem of recruitment and retention of rural doctors as one of influencing individuals’ career choices. Exposure to rural medical environments during basic medical training is one long‐standing example of an initiative aimed in this direction and there is some evidence that it is effective. This study sought to determine whether or not various domains of personality are related to medical students’ attitude to practising as rural doctors after graduation.

Design

The sample comprised 914 students commencing medical studies in Australian universities. They were recruited as part of the Medical Schools Outcomes Database project and indicated intended location of future medical practice.

Setting

Seven Australian basic medical training programs.

Main outcome measures

All students completed the NEO five‐factor index (NEO‐FFI) and Adjective Checklist (ACL) personality instruments.

Results

A preference for a rural practice location was associated with a combination of six domains of personality. The probability of rural preference was greater with higher scores on openness to experience, agreeableness and self‐confidence but lower with higher scores on extraversion, autonomy and intraception. Taken together these six domains of personality provide useful although imperfect discrimination between students with a rural versus urban location preference. After controlling for student age the associations with extraversion and agreeableness failed to reach statistical significance.

Conclusions

While personality does not fully explain medical students' attitude towards practicing as a rural doctor, the data suggest it is an important factor and that some individuals may be better suited to a rural medical career than others. Considering personality along with other characteristics of the individual might allow targeted ‘marketing’ of rural practice.