bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accented Clitics in the Ṛgveda
Authors: Lowe John 
Published: April 2013

AbstractI 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

AbstractAmong 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

Abstract 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

AbstractData 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

summaryAgricultural Research and Innovation Systems in TransitionAgricultural 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

summaryThe Importance of the Back‐office for Farm Advisory ServicesAdvisory 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

summaryBiomass, Biovalue and Sustainability: Some Thoughts on the Definition of the BioeconomyThe 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

AbstractBackground: 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.MethodsClinical 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.ResultsThe 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

Summary

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

AbstractObjectivesWeekly 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.MethodsThe 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.ResultsThe 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.ConclusionsInfluenza 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

AbstractBackgroundEarly 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.ObjectivesThe 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.MethodsThis 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.ResultsThere 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.ConclusionsWhile 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

AbstractObjectivesThe 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.MethodsThis 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.ResultsMedian 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.ConclusionsPhysician 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.