Trends in utilization of computer tomography (CT) scans for victims of motor vehicle collision (MVCs) in a level I trauma center from 1996 to 2006

Purpose. To evaluate trends in the utilization of head, abdominal, thoracic and other body regions CTs in the management of victims of MVC at a level I trauma center from 1996 to 2006.^ Method. From the trauma registry, I identified patients involved in MVC's in a level I trauma center and categorized them into three age groups of 13-18, 19-55 and ≥56. I used International Classification of Disease (ICD-9-CM) codes to find the type and number of CTs examinations performed for each patient. I plotted the mean number of CTs per patient against year of admission to find the crude estimate of change in utilization pattern for each type of CT. I used logistic regression to assess whether repetitive CTs (≥ 2) for head, abdomen, thorax and other body regions were associated with age group and year of admission for MVC patients. I adjusted the estimates for gender, ethnicity, insurance status, mechanism and severity of injury, intensive care unit admission status, patient disposition (dead or alive) and year of admission.^ Results. Utilization of head, abdominal, thoracic and other body regions CTs significantly increased over 11-year period. Utilization of head CT was greatest in the 13-18 age group, and increased from 0.58 CT/patient in 1996 to 1.37 CT/patient in 2006. Abdominal CTs were more common in the ≥56+ age group, and increased from 0.33 CT/patient in 1996 to 0.72 CT/patient in 2006. Utilization of thoracic CTs was higher in the 56+ age group, and increased from 0.01 CT/patient in 1996 to 0.42 CT/patient in 2006. Utilization of other CTs did not change materially during the study period for adolescents, adults or older adults. In the multivariable analysis, after adjustment for potential confounders, repetitive head CTs significantly increased in the 13-18 age group (95% CI: 1.29-1.87, p=<0.001) relative to the 19-55 age group. Repetitive thoracic CT use was lower in adolescents (95% CI: 0.22-0.70, p=<0.001) relative to the 19-55 age group.^ Conclusion. There has been a substantial increase in the utilization of head, abdominal, thoracic and other CTs in the management of MVC patients. Future studies need to identify if increased utilization of CTs have resulted in better health outcome for these patients. ^

Comparison of financial trends in small rural and urban hospitals in Texas, 1983--1985

The purpose of this study was to compare the financial performance of small rural hospitals to that of small urban hospitals in Texas. Hospital-specific and environmental factors were studied as control variables.^ Small rural hospitals were found to be financially stronger on measures of liquidity but weaker on measures of profitability. Small urban hospitals performed better on measures of profitability and long-range solvency. When all measures in the five dimensions of financial performance were analyzed, no significant difference was found between the two groups of hospitals. None of the control variables included in the study was significantly associated with financial performance both for rural and urban hospitals. Conclusions were that small rural hospitals in Texas are experiencing a deterioration in financial condition but small, rural hospitals are not doing any worse than small urban hospitals; and that the financial hardship which rural hospitals suffer may be inherent in the nature of the institutions themselves, and not as a result of their smallness nor their rural settings. ^

Who Develops Innovations in Medicine for the Poor? Trends in Patent Applications Related to Medicines for HIV/AIDS, Tuberculosis, Malaria and Neglected Diseases

Who invents medicines for the poor of the world? This question becomes very important where the WTO allows low income countries to be unbound by the TRIPS agreement. This agreement concerns medicines for infectious diseases such as HIV/AIDS, tuberculosis and malaria. These diseases cause serious damage to low income countries. Under these circumstances, some scholars wonder if anyone will continue innovative activities related to treating these diseases. This paper sought to answer this question by collecting and analyzing patent data of medicines and vaccines for diseases using the database of the Japan Patent Office. Results indicate that private firms have led in innovation not only for global diseases such as HIV/AIDS but also diseases such as malaria that are spreading exclusively in low income countries. Innovation for the three infectious diseases is diverse among firms, and frequent patent applications by high-performing pharmaceutical firms appear prominent even after R&D expenditure, economies of scale, and economies of scope are taken into account.

Recent trends in Asian integration and Japanese participation

In East Asia, de facto integration is taking place because Free Trade Agreements (FTAs) and Economic Partnership Agreements (EPAs) are flourishing in the region. ASEAN aims to form an ASEAN Economic Community (AEC) by 2015 with the completion of the ASEAN Free Trade Area (AFTA). Surrounding countries have been competing with each other to forge FTAs or EPAs with ASEAN, including China, Japan, Korea, Australia and New Zealand, and India. As a result, ASEAN has become a trading hub in East Asia. Bilateral FTAs/EPAs are also partly in place among 16 countries (ASEAN + 6). These economic ties in trade, services and investment are accelerating this region’s development as the world’s largest production base and biggest consumption market, helping to turn around the global recession in the aftermath of the so-called Lehman Shock. However, some problems also need to be pointed out in the East Asian integration such as the spaghetti bowl effect, severe competition, labor issues, environmental destruction and power struggles.

Future trends in Animal Breeding due to new genetic tecnologies

The Darwin theory of evolution by natural selection is based on three principles: (a) variation; (b) inheritance; and (c) natural selection. Here, I take these principles as an excuse to review some topics related to the future research prospects in Animal Breeding. With respect to the first principle I describe two forms of variation different from mutation that are becoming increasingly important: variation in copy number and microRNAs. With respect to the second principle I comment on the possible relevance of non-mendelian inheritance, the so-called epigenetic effects, of which the genomic imprinting is the best characterized in domestic species. Regarding selection principle I emphasize the importance of selection for social traits and how this could contribute to both productivity and animal welfare. Finally, I analyse the impact of molecular biology in Animal Breeding, the achievements and limitations of quantitative trait locus and classical marker-assisted selection and the future of genomic selection

Trends in climatic variables and future reference evapotranspiration in Duero Valley (Spain)

The impact of climate change and its relation with evapotranspiration was evaluated in the Duero River Basin (Spain). The study shows possible future situations 50 yr from now from the reference evapotranspiration (ETo). The maximum temperature (Tmax), minimum temperature (Tmin), dew point (Td), wind speed (U) and net radiation (Rn) trends during the 1980–2009 period were obtained and extrapolated with the FAO-56 Penman-Montheith equation to estimate ETo. Changes in stomatal resistance in response to increases in CO2 were also considered. Four scenarios were done, taking the concentration of CO2 and the period analyzed (annual or monthly) into consideration. The scenarios studied showed the changes in ETo as a consequence of the annual and monthly trends in the variables Tmax, Tmin, Td, U and Rn with current and future CO2 concentrations (372 ppm and 550 ppm). The future ETo showed increases between 118 mm (11 %) and 55 mm (5 %) with respect to the current situation of the river basin at 1042 mm. The months most affected by climate change are May, June, July, August and September, which also coincide with the maximum water needs of the basin’s crops

The Agrobacterium vitis T-6b oncoprotein induces auxin-independent cell expansion in tobacco

Among the Agrobacterium T-DNA genes, rolB, rolC, orf13, orf8, lso, 6b and several other genes encode weakly homologous proteins with remarkable effects on plant growth. The 6b oncogene induces tumors and enations. In order to study its properties we have used transgenic tobacco plants that carry a dexamethasone-inducible 6b gene, dex-T-6b. Upon induction, dex-T-6b plants develop a large array of morphological modifications, some of which involve abnormal cell expansion. In the present investigation, dex-T-6b-induced expansion was studied in intact leaves and an in vitro leaf disc system. Although T-6b and indole-3-acetic acid (IAA) both induced expansion and were non-additive, T-6b expression did not increase IAA levels, nor did it induce an IAA-responsive gene. Fusicoccin (FC) is known to stimulate expansion by increasing cell wall plasticity. T-6b- and FC-induced expansion were additive at saturating FC concentrations, indicating that T-6b does not act by a similar mechanism to FC. T-6b expression led to higher leaf osmolality values, in contrast to FC, suggesting that the T-6b gene induces expansion by increasing osmolyte concentrations. Metabolite profiling showed that glucose and fructose played a major role in this increase. We infer that T-6b disrupts the osmoregulatory controls that govern cell expansion during development and wound healing.

Current Trends in Pan-European Identity Management Systems

The demand for electronic identity has grown as a result of governments? promotion of e-Government, in which the citizen-public administration relationship often has a strictly personal nature and requires digital identification systems that are univocal, secure, and global. The management of this identity by public administrations is an important challenge, accentuated when interoperability among public administrations of different countries become necessary. In this paper current trends in pan-euroean identity management systems are analysized and a outlook of the future European scenary is shown.

State of the Art and Future Trends in Grid Codes Applicable to Isolated Electrical Systems

Isolated electrical systems lack electrical interconnection to other networks and are usually placed in geographically isolated areas—mainly islands or locations in developing countries. Until recently, only diesel generators were able to assure a safe and reliable supply in exchange for very high costs for fuel transportation and system operation. Transmission system operators (TSOs) are increasingly seeking to replace traditional energy models based on large groups of conventional generation units with mixed solutions where diesel groups are held as backup generation and important advantages are provided by renewable energy sources. The grid codes determine the technical requirements to be fulfilled by the generators connected in any electrical network, but regulations applied to isolated grids are more demanding. In technical literature it is rather easy to find and compare grid codes for interconnected electrical systems. However, the existing literature is incomplete and sparse regarding isolated grids. This paper aims to review the current state of isolated systems and grid codes applicable to them, specifying points of comparison and defining the guidelines to be followed by the upcoming regulations.

State of the Art and Future Trends in Grid Codes Applicable to Isolated Electrical Systems

Electrical power systems are changing their traditional structure, which was based on a little number of large generating power plants placed at great distances from loads by new models that tend to split the big production nodes in many smaller ones. The set of small groups which are located close to consumers and provide safe and quality energy is called distributed generation (DG). The proximity of the sources to the loads reduces losses associated with transportation and increases overall system efficiency. DG also favors the inclusion of renewable energy sources in isolated electrical systems or remote microgrids, because they can be installed where the natural resource is located. In both cases, as weak grids unable to get help from other nearby networks, it is essential to ensure appropriate behavior of DG sources to guarantee power system safety and stability. The grid codes sets out the technical requirements to be fulfilled for the sources connected in these electrical networks. In technical literature it is rather easy to find and compare grid codes for interconnected electrical systems. However, the existing literature is incomplete and sparse regarding isolated electrical systems and this happens due to the difficulties inherent in the pursuit of codes. Some countries have developed their own legislation only for their island territory (as Spain or France), others apply the same set of rules as in mainland, another group of island countries have elaborated a complete grid code for all generating sources and some others lack specific regulation. This paper aims to make a complete review of the state of the art in grid codes applicable to isolated systems, setting the comparison between them and defining the guidelines predictably followed by the upcoming regulations in these particular systems.

Current Trends in LSP Research: Aims and Methods

Languages for Specific Languages (LSP) represent a dynamic approach both in research and practice and, as such, it is in constant evolution. It was earlier related to the use of English as an international language of communication in business and technology and thus designated as ESP (English for Specific Purposes). In Genre Analysis, Swales (1990) brought in new horizons with the notions of genre and discourse community. Thereafter, research on LSP learning and discourse have thrived over a large range of thematic contents and methods. Current Trends in LSP Research: Aims and Methods can be inserted in this latest streak