bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mixed policies give more options in multifunctional tropical forest landscapes
Authors: Law Elizabeth A. , Bryan Brett A. , Meijaard Erik , Mallawaarachchi Thilak , Struebig Matthew J. , Watts Matthew E. , Wilson Kerrie A. 
Published: April 2016

Summary

Tropical forest landscapes face competing demands for conserving biodiversity, sustaining ecosystem services and accommodating production systems such as forestry and agriculture. Land‐sparing and land‐sharing have emerged as contrasting strategies to manage trade‐offs between production and biodiversity conservation. Both strategies are evident in land‐management policies at local‐to‐international scales. However, studies rarely report the impacts of these strategies, assessed for multiple stakeholders and multiple ecosystem services, particularly in real landscapes.

Using a case study from a high‐priority region for forest protection, restoration and rural development in Central Kalimantan, Indonesia, we analysed the potential outcomes under 10 alternative policy scenarios, including land‐sharing, land‐sparing and mixed strategies. We used a novel optimization process integrating integer programming with conservation‐planning software (Marxan with Zones) to identify production possibility frontiers (PPFs), highlighting the trade‐off between smallholder agriculture and oil palm, subject to achievement of a set of carbon, timber and biodiversity conservation targets.

All policy scenarios modelled proved to be capable of achieving all targets simultaneously. Most strategies resulted in an expansion of the PPF from the baseline, increasing the flexibility of land allocation to achieve all targets. Mixed strategies gave the greatest flexibility to achieve targets, followed closely by land‐sparing. Land‐sharing only performed better than the baseline when no yield penalties were incurred, and resulted in PPF contraction otherwise. Strategies assessed required a minimum of 29–37% to be placed in conservation zones, notably protecting the majority of remaining forest, but requiring little reforestation.

Policy implications. Production possibility frontiers (PPFs) can evaluate a broad spectrum of land‐use policy options. When using targets sought by multiple stakeholders within an ecosystem services framework, PPFs can characterize biophysical, socio‐economic and institutional dimensions of policy trade‐offs in heterogeneous landscapes. All 10 policy strategies assessed in our case study are biophysically capable of achieving all stakeholder objectives, provided at least 29–37% of the landscape is conserved for biodiversity. This novel methodological approach provides practical options for systematic analysis in complex, multifunctional landscapes, and could, when integrated within a larger planning and implementation process, inform the design of land‐use policies that maximize stakeholder satisfaction and minimize conflict.
Perception of Coexistence Measures by Farmers in Five European Union Member States
Authors: Tillie Pascal , Dillen Koen , Rodríguez‐Cerezo Emilio 
Published: April 2016

SummaryFarm‐level coexistence measures between GM and non‐GM crops are essential to ensure the freedom of choice of both farmers and consumers that is the cornerstone of European policy in this matter. However, it is important that coexistence measures do not tip the balance against GM crops, and distort farmers’ decisions on whether or not to grow these. Based on a farm survey conducted in 2012, this article analyses the perceptions of the burden of coexistence measures by farmers. A total of 1,403 farmers were interviewed in five Member States of the EU. Results illustrate that farmers perceive coexistence measures that imply a restriction of their freedom of choice as the most burdensome, while they are less affected by practical coexistence measures in the fields or by administrative rules. Liability for damage to non‐GM farmers is also considered extremely burdensome due to the unpredictable outcome of potential litigation. However, according to the survey, few conflicts have arisen because of coexistence issues with neighbouring farmers. The burden of practical, farm‐level coexistence measures also varies across countries, depending on agro‐ecological conditions. This calls for the design of flexible, context‐specific coexistence measures, possibly complemented by non‐production constraining administrative rules.
Asynchronous Flowering or Buffer Zones: Technical Solutions for Small‐scale Farming
Authors: Nadal Anna , Pla Maria , Messeguer Joaquima , Melé Enric , Piferrer Xavier , Serra Joan , Capellades Gemma 
Published: April 2016

SummaryTo ensure consumers' and farmers' freedom of choice, many countries have regulated the labelling of products derived from genetically modified (GM) crops and coexistence of conventional and GM fields. On the basis of published research results a guide for Good Agricultural Practices (GAP) was compiled to facilitate maize coexistence in farming zones with temperate climate. In the frame of the PRICE EU‐funded research project we validated these recommended measures in real agricultural fields representing the worst case scenario, i.e. small‐scale farming in a region with around 75 per cent commercial GM maize. The two alternative strategies proposed in the GAP, buffer zones and flowering asynchrony, successfully guaranteed coexistence in the frame of the present EU regulation. These measures do not lead to unnecessary costs, are simple to apply and are compatible with small deviations resulting from common agricultural practices. The results are applicable for temperate zones such as Southern Europe and cannot easily be transferred to other parts of Europe due to differences in climatic conditions which limit the use of different flowering times as a coexistence strategy.
CMS Maize: A Tool to Reduce the Distance between GM and non‐GM Maize
Authors: Bückmann Heidrun , Thiele Katja , Schiemann Joachim 
Published: April 2016

SummaryTo limit admixture of genetically modified (GM) with non‐GM crops in the early stages of production, codes of good agricultural practice for GM crops have been developed. In addition to general measures, crop‐specific measures including the establishment of ‘isolation distances’ are required. The use of biological means like cytoplasmic male sterility (CMS) in maize provide more flexible isolation distances particularly in cases where GM maize requires higher levels of containment/confinement to ensure coexistence with agricultural production systems that do not cultivate GM plants. This article discusses the role of CMS where plants develop no or no vital pollen but the female fertility is not affected, as a biological means of reducing isolation requirements. Results of the PRICE project and other EU‐funded projects provide evidence that current isolation distances set by EU Member States are disproportionate for achieving admixture levels below the 0.9 per cent GM admixture threshold for labelling and may lead to unnecessary costs for farmers. Distances might be reduced or replaced by the use of GM CMS maize as it provides an efficient biological confinement tool and increases the flexibility for ‘good agricultural practices of GM crop cultivation’.
Issues in GM and Non‐GM Coexistence: A United States Perspective
Authors: Huffman Wallace 
Published: April 2016

SummaryThe US food system is embedded as a supply chain within a diverse, ever‐changing, and broad economic, biophysical, and socio‐political context. A variety of actors with diverse goals are interested in increasing agricultural productivity, protecting the environment, improving food quality, and/or improving specific aspects of health, and their decisions shape the food system. US regulatory policy on GMOs is based on the principle of substantial equivalence – GMO and non‐GMO foods contain comparable amounts of basic components – which is favourable to new technologies. Anti‐GMO activists seem to be less concerned about using mandatory labelling to increase consumer choice and more interested in using a GMO label to stigmatise food products so as to eliminate GMOs from store shelves. However, federal legislation is being considered to create a new voluntary ‘free of GMOs’ food label that would require costly verification and special handling. It would also pre‐empt States from enacting mandatory GM labelling policies. The US is a society where the majority of consumers are indifferent to or favour GMO foods and only a minority, but a growing one, is opposed. A national mandatory GM labelling policy is not expected to gain wide political support but a voluntary ‘free of GMOs’ label might.
Intraoperative cholangiogram during laparoscopic cholecystectomy: A clinical trial in rural setting
Authors: Verma Shreya , Wichmann Matthias W. , Gunning Thomas , Beukes Eben , Maddern Guy 
Published: April 2016

AbstractObjectiveThe routine use of intraoperative cholangiogram (IOC) in laparoscopic cholecystectomy (LC) remains a contentious issue. IOC helps to delineate biliary tree anatomy, prevent bile duct injury and image stones in the common bile duct (CBD). It may prove to be a valuable alternative to ERCP or MRCP, especially in the rural setting with limited resources.Design/Setting/Participants/Interventions/Main outcome measuresAll patients undergoing laparoscopic cholecystectomy during a 12‐month period were audited. For the first 6 months, patients were recruited for routine IOC and for the second 6 months, routine IOC was not performed. Cases were analysed with regard to patient demographics, operative details and clinical outcomes.ResultsA total of 75 patients were analysed within the 12‐month period. The majority were women aged 41–50. Ultrasound suggested common bile duct stones in 6.7% of cases. IOC was attempted in 50.7% of cases. Of these, 29 (76.3%) were successful. IOC added an average of 28 min to total theatre time. A total of 75% (n = 22) of IOCs showed normal flow of contrast into the intra‐ and extra‐hepatic biliary systems. In 17% (n = 5) of patients, stones within the CBD were suspected, and these were referred for further management. ERCP/MRCP confirmed CBD stones in 60% (n = 3) of these patients. There was poor correlation between pre‐operative suspicion and confirmed CBD stones (two patients only with pre‐operative suspected CBD stone confirmed on IOC and ERCP). There were no operative complications related to IOC. There were no post‐operative complications in cases where no IOC was done.ConclusionThe majority of patients treated in our centre were women, middle‐aged patients booked for elective laparoscopic cholecystectomy. Although only 6.7% cases were suspicious for CBD stones pre‐operatively, a total of 17% of patients with routine IOC suggested CBD stones. IOC was found to be safe, taking only an additional 28 min of total theatre time. Routine rather than selective use of IOC could be considered to improve patient safety and long‐term results.
Extracorporeal Respiratory Support With a Miniature Integrated Pediatric Pump‐Lung Device in an Acute Ovine Respiratory Failure Model
Authors: Wei Xufeng , Sanchez Pablo G. , Liu Yang , Claire Watkins A. , Li Tieluo , Griffith Bartley P. , Wu Zhongjun J. 
Published: April 2016

AbstractRespiratory failure is one of the major causes of mortality and morbidity all over the world. Therapeutic options to treat respiratory failure remain limited. The objective of this study was to evaluate the gas transfer performance of a newly developed miniature portable integrated pediatric pump‐lung device (PediPL) with small membrane surface for respiratory support in an acute ovine respiratory failure model.The respiratory failure was created in six adult sheep using intravenous anesthesia and reduced mechanical ventilation at 2 breaths/min. The PediPL device was surgically implanted and evaluated for respiratory support in a venovenous configuration between the right atrium and pulmonary artery. The hemodynamics and respiratory status of the animals during support with the device gas transfer performance of the PediPL were studied for 4 h.The animals exhibited respiratory failure 30 min after mechanical ventilation was reduced to 2 breaths/min, indicated by low oxygen partial pressure, low oxygen saturation, and elevated carbon dioxide in arterial blood. The failure was reversed by establishing respiratory support with the PediPL after 30 min. The rates of O2 transfer and CO2 removal of the PediPL were 86.8 and 139.1 mL/min, respectively.The results demonstrated that the PediPL (miniature integrated pump‐oxygenator) has the potential to provide respiratory support as a novel treatment for both hypoxia and hypercarbia. The compact size of the PediPL could allow portability and potentially be used in many emergency settings to rescue patients suffering acute lung injury.
The Common Assessment Framework form 9 years on: a creative process
Authors: Nethercott Kathryn 
Published: April 2016

AbstractLegislation within England states that local authorities should provide services for all those families in need. However, research has identified that regardless of the introduction of strategies to identify need and enhance family support, ongoing barriers to services adhere.Taking a social constructionist approach, this study explored professionals' experiences of the use of the Common Assessment Framework form. Data were collected in four different local authorities in two phases. Forty‐one professionals from a variety of agencies took part in semi‐structured interviews. Data were analyzed thematically.Findings demonstrate that the professionals experienced difficulties in working through the Common Assessment Framework process, for example, in completing the form and engaging families. This situation led to the more experienced and knowledgeable professionals utilising creative ways to successfully navigate the ‘referral process’. Such creative working practices included the terminology used to complete the form and how the process was ‘sold’ to parents, so that they could be in a better position to engage parents and complete the Common Assessment Framework form. Because of this, more experienced professionals seem to be able to accelerate the referral process in order to access much needed support services for children and young people.
Impact of a multifaceted strategy to improve perioperative diabetes care
Authors: Hommel I. , Wollersheim H. , Tack C. J. , Mulder J. , van Gurp P. J. , Hulscher M. E. J. L. 
Published: April 2016

AbstractAimsTo assess the impact of a multifaceted strategy to improve perioperative diabetes care throughout the hospital care pathway.MethodsWe conducted a controlled before‐and‐after study in six hospitals. The purpose of the strategy was to target four predominant barriers that obstruct optimal care delivery. We provided feedback on baseline indicator performance, developed a multidisciplinary protocol and patient information, and provided professional education. After a 6‐month intervention, we determined the performance changes against three outcome indicators and nine process indicators using data on 811 patients with diabetes who underwent major surgery. The progress of the interventions was monitored closely.ResultsTwo process indicators improved significantly in the intervention hospitals: the proportion of patients for whom glycaemic control had been evaluated preoperatively increased by 9% (P < 0.002) and the proportion of patients with blood glucose measurements within 1 h after surgery increased by 29% (P < 0.0001). Four other process indicators and all three outcome indicators improved more in the intervention hospitals than in the control hospitals, but the differences were not statistically significant. These included the proportion of patients with all glucose values at 6–10 mmol/l (+3%) and the proportion of patients with hyperglycaemia (−8%). The implementation of the multidisciplinary protocol was still ongoing after the 6‐month intervention period.ConclusionsThe multifaceted improvement strategy had a limited impact on the quality of perioperative diabetes care. This study demonstrates the complexity of improving perioperative diabetes care throughout the multiprofessional hospital care pathway.
Sitagliptin plus pantoprazole can restore but not maintain insulin independence after clinical islet transplantation: results of a pilot study
Authors: Senior P. A. , Koh A. , Yau J. , Imes S. , Dinyari P. , Malcolm A. J. , Light P. , Shapiro A. M. J. 
Published: April 2016

AbstractAimsResuming insulin use due to waning function is common after islet transplantation. Animal studies suggest that gastrointestinal hormones, including gastrin and incretins may increase β–cell mass. We tested the hypothesis that pantoprazole plus sitagliptin, would restore insulin independence in islet transplant recipients with early graft insufficiency and determined whether this would persist after a 3–month washout.MethodsSingle‐centre, uncontrolled, open label study of sitagliptin 100 mg daily plus pantoprazole 40 mg twice daily for 6 months.ResultsAfter 6 months of treatment, two of eight participants (25%) achieved the primary endpoint, defined as HbA1C < 42 mmol/mol (6%), fasting plasma glucose < 7.0 mmol, C–peptide > 0.5 nmol and no insulin use. There was a significant reduction in mean insulin dose, but no change in HbA1C or weight. There were no changes in the acute insulin response to arginine, the mixed meal tolerance test or blinded continuous glucose monitoring. After the washout, no participants met the primary endpoint and HbA1C increased from 45 ± 8 mmol/mol (6.3 ± 0.7%) to 51 ± 6 mmol/mol (6.8 ± 0.6%) (P < 0.05). Two participants had mild–moderate transient gastrointestinal side effects. There were no episodes of hypoglycaemia.ConclusionsSitagliptin plus pantoprazole is well tolerated and safe and may restore insulin independence in some islet transplant recipients with early graft insufficiency, but this was not sustained when treatment was withdrawn. A larger, controlled trial is required to confirm the effectiveness of this combination to achieve insulin independence and to confidently exclude any persistent benefit for graft function. (Clinical Trials Registry No.: NCT00768651)
Aspirin for primary prevention of cardiovascular and all‐cause mortality events in diabetes: updated meta‐analysis of randomized controlled trials
Authors: Kunutsor S. K. , Seidu S. , Khunti K. 
Published: April 2016

AbstractAimsTo evaluate the benefits and harms of aspirin for the primary prevention of cardiovascular disease and all‐cause mortality events in people with diabetes by conducting a systematic review and meta‐analysis.MethodsRandomized controlled trials of aspirin compared with placebo (or no treatment) in people with diabetes with no history of cardiovascular disease were identified from MEDLINE, EMBASE, Web of Science, the Cochrane Library and a manual search of bibliographies to November 2015. Study‐specific relative risks with 95% CIs were aggregated using random effects models.ResultsA total of 10 randomized trials were included in the review. There was a significant reduction in risk of major adverse cardiovascular events: relative risk of 0.90 (95% CI 0.81–0.99) in groups taking aspirin compared with placebo or no treatment. Limited subgroup analyses suggested that the effect of aspirin on major adverse cardiovascular events differed by baseline cardiovascular disease risk, medication compliance and sex (P for interaction for all > 0.05).There was no significant reduction in the risk of myocardial infarction, coronary heart disease, stroke, cardiovascular mortality or all‐cause mortality. Aspirin significantly reduced the risk of myocardial infarction for a treatment duration of ≤ 5 years. There were differences in the effect of aspirin by dosage and treatment duration on overall stroke outcomes (P for interaction for all < 0.05). There was an increase in risk of major or gastrointestinal bleeding events, but estimates were imprecise and not significant.ConclusionsThe emerging data do not clearly support guidelines that encourage the use of aspirin for the primary prevention of cardiovascular disease in adults with diabetes who are at increased cardiovascular disease risk.
Casein glycomacropeptide for active distal ulcerative colitis: a randomized pilot study
Authors: Hvas Christian L. , Dige Anders , Bendix Mia , Wernlund Pernille G. , Christensen Lisbet A. , Dahlerup Jens F. , Agnholt Jørgen 
Published: April 2016

AbstractBackgroundIn ulcerative colitis (UC), dietary supplements may have anti‐inflammatory properties and improve disease course. We investigated the effects of casein glycomacropeptide (CGMP), a fraction of bovine whey protein, in active UC.Materials and methodsIn a randomized open‐label intervention study, 24 patients with active UC involving 10–40 cm of the distal colon were randomized in a 2 : 1 ratio into two groups. The first group was administered their usual treatment plus a daily supplement of CGMP 30 g, and the second group was administered a dose escalation to 4800 mg oral mesalamine daily (standard treatment) for 4 weeks. Clinical, endoscopic, mucosal and circulating disease activity markers were monitored. Acceptance of and adherence to CGMP up to 8 weeks were documented.ResultsAfter 4 weeks of treatment, 10 of 16 (63%) patients who received CGMP had an unchanged or decreased Simple Clinical Colitis Activity Index (SCCAI), which was similar to the four of eight (50%) (P = 0·67) patients on the standard treatment. The number of patients in which SCCAI decreased by three or more did not differ between the two groups: nine of 16 (56%) in the CGMP group vs. four of eight (50%) in the standard treatment group (P = 0·77). Changes in disease extent and severity were similar between the two groups. CGMP was well tolerated and accepted by the patients.ConclusionsThe addition of CGMP as a nutritional therapy to standard treatment was safe and accepted by patients with active distal UC. The disease‐modifying effect of CGMP was similar to that of the mesalamine dose escalation.
Defective ceramide synthases in mice cause reduced amplitudes in electroretinograms and altered sphingolipid composition in retina and cornea
Authors: Brüggen Bianca , Kremser Christiane , Bickert Andreas , Ebel Philipp , vom Dorp Katharina , Schultz Konrad , Dörmann Peter , Willecke Klaus , Dedek Karin 
Published: April 2016

AbstractComplex sphingolipids are strongly expressed in neuronal tissue and contain ceramides in their backbone. Ceramides are synthesized by six ceramide synthases (CerS1–6). Although it is known that each tissue has a unique profile of ceramide synthase expression and ceramide synthases are implicated in several neurodegenerative disorders, the expression of ceramide synthase isoforms has not been investigated in the retina. Here we demonstrate CerS1, CerS2 and CerS4 expression in mouse retina and cornea, with CerS4 ubiquitously expressed in all retinal neurons and Müller cells. To test whether ceramide synthase deficiency affects retinal function, we compared electroretinograms and retina morphology between wild‐type and CerS1‐, CerS2‐ and CerS4‐deficient mice. Electroretinograms were strongly reduced in amplitude in ceramide synthase‐deficient mice, suggesting that signalling in the outer retina is affected. However, the number of photoreceptors and cone outer segment length were unaltered and no changes in retinal layer thickness or synaptic structures were found. Mass spectrometric analyses of ceramides, hexosyl‐ceramides and sphingomyelins showed that C20 to C24 acyl‐containing species were decreased whereas C16‐containing species were increased in the retina of ceramide synthase‐deficient mice. Similar but smaller changes were also found in the cornea. Thus, we hypothesize that the replacement of very long‐chain fatty acyl residues by shorter C16 residues may affect the electrical properties of retina and cornea, and alter receptor‐mediated signal transduction, vesicle‐mediated synaptic transmission or corneal light transmission. Future studies need to identify the molecular targets of ceramides or derived sphingolipids in light signal transduction and transmission in the eye.