bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intellectual Property Rights Systems and Innovation in the Plant Breeding Industry
Authors: (Hans) Dons J.J.M. 
Published: April 2013

summaryIntellectual Property Rights Systems and Innovation in the Plant Breeding IndustryThe debate on Intellectual Property Rights (IPR) in the plant breeding industry over the past 3 years has been important for the future of the plant breeding sector and for global food security in the coming decades. Intensive discussions have led to initiatives aimed at reducing the imbalance that appeared to have developed between two intellectual property systems: Plant Breeders Rights (PBR) on new plant varieties and patent rights on plant‐related inventions. A better balance can be achieved by a combination of several measures that will strengthen the PBR system as the most important instrument for IP protection in this sector. Patents on plant‐related inventions are important for encouraging innovation, but must be restricted to inventions meeting strict legal criteria. Access to such inventions (technologies, traits) can be realised via a limited breeder’s exemption and/or licences that can be negotiated in a Fair, Reasonable and Non‐Discriminatory (FRAND) way. Although the debate is not yet finalised, the sector has taken several initiatives at both a European and global level. All measures together form a major step forwards in safeguarding access to genetic variation. They also safeguard the IP position of the breeder, which is important for ensuring a fair return on investment and encouraging further innovation in the plant breeding sector.
Information and Communication Technology as a Driver for Change in Agri‐food Chains
Authors: Poppe Krijn J. , Wolfert Sjaak , Verdouw Cor , Verwaart Tim 
Published: April 2013

summaryInformation and Communication Technology as a Driver for Change in Agri‐food ChainsAgri‐food chains will be changed in the coming years by Information and Communication Technology (ICT). Technological trends and economic analysis suggest that ICT will be a major driver for innovation. Satellites and sensors make precision agriculture possible. More and more data are being generated in agriculture and the rest of the food chain, which helps to steer production processes with greater precision. However, there is a low level of integration of these data between actors in the food chain. By improving this ‘interoperability’ of data, processes in the food chain can be optimised and new business models developed. Data‐intensive food chains have the potential to alleviate many of the current sustainability and food safety issues and contribute to human health. The economic and policy effects of such developments still need to be explored. At first sight it could lead to more closely integrated supply chains that make the farmer act as a franchise taker with limited freedom. But the opposite could also be true, with more transparency and easier options for direct sales via consumer food webs, using smart solutions for the ‘last mile’ delivery. New issues like a trade‐off between transparency and privacy or pricing data might well arise.
Marked Reduction in Length of Stay for Patients With Psychiatric Emergencies After Implementation of a Comanagement Model
Authors: Polevoi Steven K. , Jewel Shim J. , McCulloch Charles E. , Grimes Barbara , Govindarajan Prasanthi 
Published: April 2013

AbstractObjectivesPatients with psychiatric emergencies often spend excessive time in an emergency department (ED) due to limited inpatient psychiatric bed capacity. The objective was to compare traditional resident consultation with a new model (comanagement) to reduce length of stay (LOS) for patients with psychiatric emergencies. The costs of this model were compared to those of standard care.MethodsThis was a before‐and‐after study conducted in the ED of an urban academic medical center without an inpatient psychiatry unit from January 1, 2007, through December 31, 2009. Subjects were all adult patients seen by ED clinicians and determined to be a danger to self or others or gravely disabled. At baseline, psychiatry residents evaluated patients and made therapeutic recommendations after consultation with faculty. The comanagement model was fully implemented in September 2008. In this model, psychiatrists directly ordered pharmacotherapy, regularly monitored effects, and intensified efforts toward appropriate disposition. Additionally, increased attending‐level involvement expedited focused evaluation and disposition of patients. An interrupted time series analysis was used to study the effects of this intervention on LOS for all psychiatric patients transferred for inpatient psychiatric care. Secondary outcomes included mean number of hours on ambulance diversion per month and the mean number of patients who left without being seen (LWBS) from the ED.ResultsA total of 1,884 patient visits were considered. Compared to the preintervention phase, median LOS for patients transferred for inpatient psychiatric care decreased by about 22% (p < 0.0005, 95% confidence interval [CI] = 15% to 28%) in the postintervention phase. Ambulance diversion hours increased by about 40 hours per month (p = 0.008, 95% CI = 11 to 69 hours) and the mean number of patients who LWBS decreased by about 26 per month (p = 0.106; 95% CI = −60 to 5.9 visits per month) in the postintervention phase.ConclusionsA comanagement model was associated with a marked reduction in the LOS for this patient population.
Guidelines for Safety of Trainees Rotating Abroad: Consensus Recommendations from the Global Emergency Medicine Academy of the Society for Academic Emergency Medicine, Council of Emergency Medicine Residency Directors, and the Emergency Medicine Residents' Association
Authors: Hansoti Bhakti , Douglass Kate , Tupesis Janis , Runyon Michael S. , Sanson Tracy , Babcock Christine , Jacquet Gabrielle , Schroeder Erika D. , Hoffelder David , Martin Ian B. K. 
Published: April 2013

AbstractThe goal of a global health elective is for residents and medical students to have safe, structured, and highly educational experiences. In this article, the authors have laid out considerations for establishing a safe clinical site; ensuring a traveler's personal safety, health, and wellness; and mitigating risk during a global health rotation. Adequate oversight, appropriate mentorship, and a well‐defined safety and security plan are all critical elements to a successful and safe experience.
Posted Emergency Department Wait Times Are Not Always Accurate
Authors: Jouriles Nicholas , Simon Erin L. , Griffin Peter , Williams Carolyn Jo , Haller Nairmeen Awad 
Published: April 2013

AbstractObjectivesHospitals around the United States are advertising emergency department (ED) wait times. The objective was to measure the difference between publicly posted and actual ED wait times and to compare these between ED site volumes.MethodsThis study was a retrospective consecutive sample of ED patients at one hospital system with four EDs. The wait times of 8,889 patients were included in this analysis. One ED was in a large teaching hospital with 5,000 ED patients per month; the other three were freestanding or community EDs without teaching and with fewer than 2,000 ED patients per month each. The publicly posted ED wait times at the time of patient arrival were recorded and compared to the actual wait times as retrieved from the ED tracking system. The difference between posted and actual wait times for each site was calculated. Separate one‐way analysis of variance (ANOVA) tests with post hoc testing were conducted to assess actual wait time and wait time difference between ED sites.ResultsMean and standard deviation (SD) wait time difference at the main ED with a volume of 5,000 patients per month was 31.5 (±61.2) minutes. At the facilities with fewer than 2,000 ED patients per month each, the differences in wait times were 4.2 (±21.8), 8.6 (±23.8), and 1.3 (±11.9) minutes. ANOVA results revealed that the main ED had significantly different actual wait time and wait time differences (p < 0.05) when compared to the other three EDs.ConclusionsIn one hospital system, publicly posted ED wait times show better accuracy in EDs that see 2,000 or fewer patients per month and less accuracy for an ED that sees 5,000 patients per month, likely due to flow confounders.
A Survey of Emergency Department Resources and Strategies Employed in the Treatment of Pediatric Gastroenteritis
Authors: Kinlin Laura M. , Bahm Allison , Guttmann Astrid , Freedman Stephen B. 
Published: April 2013

AbstractObjectivesAlthough leading organizations have developed gastroenteritis management guidelines, little is known about emergency department (ED) use of clinical tools to improve outcomes. Our objective was to describe pediatric gastroenteritis clinical decision tools employed in EDs in the province of Ontario and to determine if a greater number of clinical decision tools are employed in academic, high‐volume institutions staffed primarily by emergency medicine (EM)‐trained physicians.MethodsA cross‐sectional, Internet‐based survey was distributed in the summer of 2010 to medical directors and managers of Ontario EDs. Domains included patient population, general resources, and gastroenteritis‐specific strategies. Copies were requested of all gastroenteritis‐specific strategies to enable a content review.ResultsA total of 133 (83%) of 160 eligible participants responded. Practice guidelines, pathways, or order sets; medical directives; and printed discharge instructions were reported to be in use at 38 of the 133 (29%), 69 of 133 (52%), and 105 of 133 (79%) of the responding institutions, respectively. Oral rehydration therapy (ORT) is routinely initiated at triage in only 51 of the 133 of the EDs (38%). High‐volume institutions are more likely to have clinical practice guidelines, pathways, or order sets (p = 0.001) than low‐ and medium‐volume EDs. Physician training in EM was associated with the presence of medical directives for nursing administration of antiemetics and antipyretics (p = 0.04). Review of clinical practice guidelines, pathways, and order sets showed that only six of 27 gastroenteritis‐specific strategies reviewed were correctly classified, and 20 (74%) met prespecified quality criteria.ConclusionsClinical decision tools designed to improve pediatric gastroenteritis management are not commonly implemented. Such strategies are more common in high‐volume EDs and those staffed primarily by physicians with EM training.
The Use of Delayed Telephone Informed Consent for Observational Emergency Medicine Research Is Ethical and Effective
Authors: Offerman Steven R. , Nishijima Daniel K. , Ballard Dustin W. , Chetipally Uli K. , Vinson David R. , Holmes James F. 
Published: April 2013

AbstractObjectivesThe objective was to describe the rate of successful consent using an altered (deferred telephone) consent process in emergency department (ED) patients.MethodsThis study evaluated the consent process employed during a prospective, multicenter, observational study of outcomes in anticoagulated patients with blunt head trauma. The study was approved by the institutional review boards (IRBs) at all participating centers. Patients were not informed of the study during their enrollment at their index ED visit. Patient names, clinical findings, and contact information were collected at the time of initial ED visits. The patients or their legally designated surrogates were contacted by telephone at least 14 days after ED discharge, given all the elements of informed consent, and then consented for study participation. Study results are presented with simple descriptive statistics.ResultsA total of 506 patients with a mean (±SD) age of 75.8 (±12.2) years including 274 female subjects (54.2%; 95% confidence interval [CI] = 49.7% to 58.6%) were enrolled into the study. Patients or their surrogates were successfully contacted by telephone in 501 of 506 cases (99.0%; 95% CI = 97.7% to 99.7%). Consent was obtained in 500 of 501 cases at time of telephone follow‐up (99.8%; 95% CI = 98.9% to 100.0%). Surrogates provided consent in 199 cases (39.7%; 95% CI = 35.4% to 44.2%). Median time from ED visit to phone contact was 21 days (interquartile range [IQR] = 17 to 27 days). The median number of phone attempts for successful contact was 1 (IQR = 1 to 2 attempts).ConclusionsThe authors achieved a very high rate of successful telephone follow‐up in this predominantly older ED population. Obtaining consent to participate in a research study using a deferred telephone contact process was effective and well received by both subjects and surrogates. IRBs should consider deferred telephone consent for minimal‐risk studies requiring telephone follow‐up, as opposed to a consent process requiring written documentation at the time of initial ED visit.
Working at the frontline in cases of elder abuse: ‘It keeps me awake at night’
Authors: Cairns Jane , Vreugdenhil Anthea 
Published: April 2013

AimTo explore the experiences of frontline health and welfare practitioners in working with older people experiencing abuse.MethodsIn‐depth interviews with 16 Tasmanian community‐based health and welfare practitioners regarding their experiences of working in 49 recent cases of elder abuse. Interview transcripts were analysed using thematic analysis.ResultsAll participants found working in cases of elder abuse challenging and the work itself was perceived as difficult, complex and at times dangerous. The cumulative effect of intimidating work contexts, practice dilemmas and a lack of support resulted in frustration and stress for many practitioners. Nevertheless, participants were committed to providing ongoing services and support for older people experiencing abuse.ConclusionFrontline practitioners working in cases of elder abuse face significant challenges and could be better supported through strengthening organisational elder abuse policies, increased management support and more age‐inclusive family violence support services.
Prenatal diagnosis: array comparative genomic hybridization in fetuses with abnormal sonographic findings
Authors: Vestergaard Else Marie , Christensen Rikke , Petersen Olav B. , Vogel Ida 
Published: April 2013

AbstractObjectiveTo evaluate the clinical value of a high‐resolution whole‐genome array method for examination of genomic imbalances in prenatal samples (46 amniotic fluid, 17 chorionic villus, and 26 products of conception) from fetuses with abnormal ultrasound, in a clinical setting where more than 90% of pregnant women receive first‐trimester combined screening and a second‐trimester anomaly scan.DesignCross‐sectional study.SettingFetal medicine units (national healthcare system) in Central and North Denmark Regions from March 2009 to April 2012.SamplesEighty‐nine samples obtained at 11.5–35.0 (mean 19.3) gestational weeks, either during ongoing pregnancy or after termination.MethodsDNA was extracted directly from amniotic fluid cells and chorionic villus samples, or from cultured cells, and examined with 80‐kb resolution oligonucleotide array‐based comparative genomic hybridization (aCGH).Main outcome measuresClinically significant copy number variations identified by aCGH.ResultsWe detected clinically significant copy number variations in 11 fetuses (12%, confidence interval 6.0–19%) with structural malformations. Three fetuses (3.4%) had uncertain clinical significant variations and incidental findings.ConclusionsaCGH is a valuable diagnostic tool when fetal malformations are detected. More affected fetuses may be diagnosed at an earlier gestational age providing better possibilities for postnatal treatment and allowing for women to decide earlier on termination of pregnancy. When a normal result has reduced the risk of significant chromosomal aberration, aCGH may facilitate parental decision‐making on whether to continue the pregnancy.
Antenatal corticosteroid exposure at term increases adult adiposity: an experimental study in sheep
Authors: Berry Mary J. , Jaquiery Anne L. , Oliver Mark H. , Harding Jane E. , Bloomfield Frank H. 
Published: April 2013

AbstractClinical practice guidelines for elective cesarean section at early‐term gestation (37–38 weeks) recommend antenatal corticosteroids to reduce neonatal respiratory morbidity. However, the long‐term health implications for offspring exposed to corticosteroids at term are unknown and may differ from the effects of preterm corticosteroid exposure. We therefore randomized singleton‐bearing ewes (n = 64) to receive a clinically relevant dose of corticosteroids at term or no treatment. Body composition was assessed in adult offspring using dual‐energy X‐ray absorptiometry. Relative to skeletal size female, but not male, offspring of steroid‐treated ewes had increased weight and a greater fat mass than controls (relative weight: 49.1 ± 1.1 vs. 52.9 ± 1.2 kg/m2, p = 0.02; relative fat mass: 5.4 ± 0.7 vs. 3.4 ± 0.7 kg/m2, p = 0.04). Whether corticosteroid exposure at early‐term gestation increases adult adiposity in humans is unknown and needs further investigation.
Eye motion increases temporal visual field extent
Authors: Denion Eric , Dugué Audrey‐E. , Coffin‐Pichonnet Sophie , Augy Sylvain , Mouriaux Frédéric 
Published: April 2013

Abstract.Purpose:  To study the impact of eye motion on visual field extent.Methods:  Visual fields were tested in 15 healthy volunteers with the Goldmann perimeter using a V4 test object, from seen to unseen, first in primary position of gaze, then allowing eye motion. Temporal points falling out of the cupola were tested again after a controlled nasal head rotation using a headband prototype fitted with a line‐laser level having two orthogonal vial levels. Visual field surface areas (cm2) were calculated as projections on a 30‐cm virtual Goldmann cupola, whose extent would have been large enough to include all points. Reproducibility error of the method assessed by calculation of the relative difference between surface areas of 12 visual field tests and 12 visual field retests was estimated at 14%. Hertel exophthalmometry was recorded to study the influence of globe position on visual field extent.Results:  Binocular visual field surface area increased by 37% with eye motion (p‐value = 1.20·10−9). This increase was highest (46%; p‐value = 1.2·10−24) in the temporal quadrant. Median maximal visual field temporal eccentricity with eye motion was 128.3° (minimum: 109.5°; maximum: 137.7°) and more than 135° in four eyes of three subjects. Hertel exophthalmometry was positively linked to visual field temporal surface area with eye motion (p‐value = 0.013).Conclusions:  Eye motion greatly expands the temporal visual field. This peculiarity is likely an adaptation to terrestrial life with upright bipedal locomotion and may save head movements through horizontal eyeball scanning.
The diameter of the inferior vena cava provides a noninvasive way of calculating central venous pressure in neonates
Authors: Sato Yoshiaki , Kawataki Motoyoshi , Hirakawa Akihiro , Toyoshima Katsuaki , Kato Taichi , Itani Yasufumi , Hayakawa Masahiro 
Published: April 2013

AbstractAimTo explore a less invasive way of assessing preload in neonates than fitting catheters to measure central venous pressure (CVP). This study evaluated the relationship between inferior vena cava (IVC) measurements and gestational age (GA) or body weight (BW) in term and premature infants and the correlation between those measurements and CVP in sick infants under mechanical ventilation.MethodsWe studied 57 clinically stable infants, together with14 sick infants fitted with central venous catheters to measure CVP. Subcostal transverse views were recorded at the level of the left branch of portal vein, and the minimum (DS) and maximum (DL) diameters of the IVC were measured. We evaluated the values of DS and DL and the S/L ratio (DS divided by DL) in the clinically stable infants and the correlation between S/L and CVP in the sick infants with central catheters.ResultsDS and DL correlated positively and strongly with both GA and BW, whereas S/L was almost independent of both GA and BW and correlated strongly with CVP.ConclusionAt the subcostal transverse views, S/L is much less affected by either GA or BW than DS or DL and correlates strongly with CVP in mechanically ventilated infants.
Pathophysiology of hypertension in pre‐eclampsia: a lesson in integrative physiology
Authors: Palei A. C. , Spradley F. T. , Warrington J. P. , George E. M. , Granger J. P. 
Published: April 2013

AbstractDespite being one of the leading causes of maternal death and a major contributor of maternal and perinatal morbidity, the mechanisms responsible for the pathogenesis of pre‐eclampsia have yet to be fully elucidated. However, it is evident that this is a complex disorder involving multiple organ systems, and by using integrative approaches, enormous progress has been made towards understanding the pathophysiology of pre‐eclampsia. Growing evidence supports the concept that the placenta plays a central role in the pathogenesis of pre‐eclampsia and that reduced uteroplacental perfusion, which develops as a result of abnormal cytotrophoblast invasion of spiral arterioles, triggers the cascade of events leading to the maternal disorder. Placental ischaemia leads to release of soluble placental factors, many of which are classified as anti‐angiogenic or pro‐inflammatory. Once these ischaemic placental factors reach the maternal circulation, they cause widespread activation and dysfunction of the maternal vascular endothelium that results in enhanced formation of endothelin‐1 and superoxide, increased vascular sensitivity to angiotensin II and decreased formation of vasodilators such as nitric oxide. This review highlights these links between placental ischaemia, maternal endothelial activation and renal dysfunction in the pathogenesis of hypertension in pre‐eclampsia.
Understanding the dose–response relationship of allopurinol: predicting the optimal dosage
Authors: Graham Garry G. , Kannangara Diluk R. W. , Stocker Sophie L. , Portek Ian , Pile Kevin D. , Indraratna Praveen L. , Datta Indira , Williams Kenneth M. , Day Richard O. 
Published: April 2013

AimsThe aim of the study was to identify and quantify factors that control the plasma concentrations of urate during allopurinol treatment and to predict optimal doses of allopurinol.MethodsPlasma concentrations of urate and creatinine (112 samples, 46 patients) before and during treatment with various doses of allopurinol (50–600 mg daily) were monitored. Non‐linear and multiple linear regression equations were used to examine the relationships between allopurinol dose (D), creatinine clearance (CLcr) and plasma concentrations of urate before (UP) and during treatment with allopurinol (UT).ResultsPlasma concentrations of urate achieved during allopurinol therapy were dependent on the daily dose of allopurinol and the plasma concentration of urate pre‐treatment. The non‐linear equation: UT = (1 – D/(ID50 + D)) × (UP – UR) + UR, fitted the data well (r2 = 0.74, P < 0.0001). The parameters and their best fit values were: daily dose of allopurinol reducing the inhibitable plasma urate by 50% (ID50 = 226 mg, 95% CI 167, 303 mg), apparent resistant plasma urate (UR = 0.20 mmol l−1, 95 % CI 0.14, 0.25 mmol l−1). Incorporation of CLcr did not significantly improve the fit (P = 0.09).ConclusionsA high baseline plasma urate concentration requires a high dose of allopurinol to reduce plasma urate below recommended concentrations. This dose is dependent on only the pre‐treatment plasma urate concentration and is not influenced by CLcr.