CYCLICAL CONCENTRATION AND CONSOLIDATION IN BIOTECH R&D: A NEO-SCHUMPETERIAN MODEL

Over the past fifteen years, the agricultural biotechnology industry has exhibited cyclical behavior in concentration and consolidation. This paper provides a theoretical model of endogenous R&D, in which industry concentration exhibits cyclical behavior. The model also generates additional testable hypotheses, and policy implications.Industrial Organization, Research and Development/Tech Change/Emerging Technologies,

Oxide phosphors for light upconversion; Yb3+ and Tm3+ co-doped Y2BaZnO5

Copyright 2011 American Institute of Physics. This article may be downloaded for personal use only. Any other use requires prior permission of the author and the American Institute of Physics. This article appeared in Journal of Applied Physics 109, 063104 (2011) and may be found at

Potential benefits of laparoscopic repair of duodenal atresia: Insights from a retrospective comparative study

Introduction: Congenital duodenal obstruction (CDO) repair can be performed open or laparoscopically. We aimed to determine the potential benefit of laparoscopic repair regarding tolerance of enteral feeding, postoperative pain, hospital stay, and complication rate. Materials and Methods: In a single-center retrospective cohort study, we compared neonates with isolated CDO operated open versus laparoscopically from 2010 to 2019. No transanastomotic tubes were used, and anastomoses were created in a side-to-side fashion in all cases. An early feeding policy is applied for all cases operated at our institution. Statistical comparison was performed using the Mann–Whitney's test or Fisher's exact test where appropriate. Results Forty-one patients analyzed were similar regarding body weight, gestational age, and proportion of patients with trisomy 21. Median follow-up was 21 months. Four (20%) out of 20 laparoscopic procedures started laparoscopically were converted to open. Comparing the 21 open with the 16 laparoscopically completed patients, median anesthetic duration was shorter by 18% in the open versus laparoscopic completed group (218 vs. 179 minutes, respectively; p = 0.025). Median postoperative time to full enteral feeds was shorter by 4 days in the first group (7 vs. 11 days, respectively; p = 0.028). In accordance, the median duration of parenteral nutrition (PN) was less than half in the laparoscopic completed compared with the open group (5 vs. 11.5 days, respectively; p = 0.031). Postoperative opioids were required for only half the duration in the laparoscopically completed group compared with open (2 vs. 4 days, respectively; p = 0.026). Outcomes such as length of stay, the occurrence of strictures or adhesions requiring reintervention, or line sepsis were similar in both groups. Conclusion: Patients undergoing laparoscopic CDO repair at our institution benefited from shorter time to full enteral feeds, and reduced the need for PN as well as postoperative pain medication

Supersoft X-ray Sources in M31: I. A Chandra Survey and an Extension to Quasisoft Sources

We report on very soft X-ray sources (VSSs) in M31. In a survey which was most sensitive to soft sources in four 8'x8' regions covered by Chandra's ACIS-S S3 CCD, we find 33 VSSs that appear to belong to M31. Fifteen VSSs have spectral characteristics mirroring the supersoft X-ray sources studied in the Magellanic Cloud and Milky Way ($k T_{eff} \leq 100$ eV); we therefore call these ``classical'' supersoft sources, or simply supersoft sources (SSSs). Eighteen VSSs may either have small (< 10%) hard components, or slightly higher effective temperatures (but still < 350 eV). We refer to these VSSs as quasisoft sources (QSSs). While hot white dwarf models may apply to SSSs, the effective temperatures of QSSs are too high, unless, e.g., the radiation emanates from only a small portion of surface. Two of the SSSs were first detected and identified as such through ROSAT observations. One SSS and one QSS may be identified with symbiotics, and 2 SSSs with supernova remnants. Both SSSs and QSSs in the disk are found near star-forming regions, possibly indicating that they are young. VSSs in the outer disk and halo are likely to be old systems; in these regions, there are more QSSs than SSSs, which is opposite to what is found in fields closer to the galaxy center. The largest density of bright VSSs is in the bulge; some of the bulge sources are close enough to the nucleus to be remnants of the tidal disruption of a giant by the massive central black hole. By using Chandra data in combination with ROSAT and XMM observations, we find most VSSs to be highly variable, fading from or brightening toward detectability on time scales of months. There is evidence for VSSs with low luminosities ($\sim 10^{36}$ erg s$^{-1}$).Comment: 14 pages, 4 figures. Accepted for publication in ApJ. Classification of supersoft and quasisoft sources is clarifie

The structure of the extreme Schwarzschild-de Sitter space-time

The extreme Schwarzschild-de Sitter space-time is a spherically symmetric solution of Einstein's equations with a cosmological constant Lambda and mass parameter m>0 which is characterized by the condition that 9 Lambda m^2=1. The global structure of this space-time is here analyzed in detail. Conformal and embedding diagrams are constructed, and synchronous coordinates which are suitable for a discussion of the cosmic no-hair conjecture are presented. The permitted geodesic motions are also analyzed. By a careful investigation of the geodesics and the equations of geodesic deviation, it is shown that specific families of observers escape from falling into the singularity and approach nonsingular asymptotic regions which are represented by special "points" in the complete conformal diagram. The redshift of signals emitted by particles which fall into the singularity, as detected by those observers which escape, is also calculated.Comment: 19 pages, 10 figures, LaTeX, to appear in Gen. Rel. Gra

Narrative exposure therapy for survivors of human trafficking: feasibility randomised controlled trial

Background Human trafficking is a grave human rights violation and a major public health concern. Survivors present with high rates of mental health problems including post-traumatic stress disorder (PTSD). Studies of effective treatments for PTSD in survivors of human trafficking are lacking. Narrative exposure therapy (NET) is an effective PTSD treatment for multiple, prolonged and complex trauma, but its efficacy has not been rigorously tested in survivors of human trafficking. Aims To test the feasibility and acceptability of a randomised controlled trial (RCT) offering NET as a treatment for PTSD in trafficking survivors with a history of multiple traumatic events, as well as providing preliminary evidence regarding its efficacy (trial registration: ISRCTN95136302). Method A single-blind RCT compared NET with a wait-list control in survivors of trafficking with PTSD (n = 25). In the NET arm of the study, participants attended a mean of 17 sessions. Results NET was well tolerated by participants. There were significant reductions in PTSD, depression and anxiety symptoms post-treatment in the NET group but no significant change in the wait-list group. Conclusions The results indicate that NET is a promising and acceptable treatment for trafficking survivors. Psychological therapy in an RCT design can be safely delivered to this vulnerable group, although modifications are required to ensure their holistic needs are properly addressed

Narrative exposure therapy for survivors of human trafficking: feasibility randomised controlled trial

BACKGROUND: Human trafficking is a grave human rights violation and a major public health concern. Survivors present with high rates of mental health problems including post-traumatic stress disorder (PTSD). Studies of effective treatments for PTSD in survivors of human trafficking are lacking. Narrative exposure therapy (NET) is an effective PTSD treatment for multiple, prolonged and complex trauma, but its efficacy has not been rigorously tested in survivors of human trafficking. AIMS: To test the feasibility and acceptability of a randomised controlled trial (RCT) offering NET as a treatment for PTSD in trafficking survivors with a history of multiple traumatic events, as well as providing preliminary evidence regarding its efficacy (trial registration: ISRCTN95136302). METHOD: A single-blind RCT compared NET with a wait-list control in survivors of trafficking with PTSD (n = 25). In the NET arm of the study, participants attended a mean of 17 sessions. RESULTS: NET was well tolerated by participants. There were significant reductions in PTSD, depression and anxiety symptoms post-treatment in the NET group but no significant change in the wait-list group. CONCLUSIONS: The results indicate that NET is a promising and acceptable treatment for trafficking survivors. Psychological therapy in an RCT design can be safely delivered to this vulnerable group, although modifications are required to ensure their holistic needs are properly addressed

Quantifying the healthcare costs of treating severely bleeding major trauma patients: a national study for England.

INTRODUCTION: Severely bleeding trauma patients are a small proportion of the major trauma population but account for 40% of all trauma deaths. Healthcare resource use and costs are likely to be substantial but have not been fully quantified. Knowledge of costs is essential for developing targeted cost reduction strategies, informing health policy, and ensuring the cost-effectiveness of interventions. METHODS: In collaboration with the Trauma Audit Research Network (TARN) detailed patient-level data on in-hospital resource use, extended care at hospital discharge, and readmissions up to 12 months post-injury were collected on 441 consecutive adult major trauma patients with severe bleeding presenting at 22 hospitals (21 in England and one in Wales). Resource use data were costed using national unit costs and mean costs estimated for the cohort and for clinically relevant subgroups. Using nationally available data on trauma presentations in England, patient-level cost estimates were up-scaled to a national level. RESULTS: The mean (95% confidence interval) total cost of initial hospital inpatient care was £19,770 (£18,177 to £21,364) per patient, of which 62% was attributable to ventilation, intensive care, and ward stays, 16% to surgery, and 12% to blood component transfusion. Nursing home and rehabilitation unit care and re-admissions to hospital increased the cost to £20,591 (£18,924 to £22,257). Costs were significantly higher for more severely injured trauma patients (Injury Severity Score ≥15) and those with blunt injuries. Cost estimates for England were £148,300,000, with over a third of this cost attributable to patients aged 65 years and over. CONCLUSIONS: Severely bleeding major trauma patients are a high cost subgroup of all major trauma patients, and the cost burden is projected to rise further as a consequence of an aging population and as evidence continues to emerge on the benefits of early and simultaneous administration of blood products in pre-specified ratios. The findings from this study provide a previously unreported baseline from which the potential impact of changes to service provision and/or treatment practice can begin to be evaluated. Further studies are still required to determine the full costs of post-discharge care requirements, which are also likely to be substantial

Analysis of satellite-derived Arctic tropospheric BrO columns in conjunction with aircraft measurements during ARCTAS and ARCPAC

We derive tropospheric column BrO during the ARCTAS and ARCPAC field campaigns in spring 2008 using retrievals of total column BrO from the satellite UV nadir sensors OMI and GOME-2 using a radiative transfer model and stratospheric column BrO from a photochemical simulation. We conduct a comprehensive comparison of satellite-derived tropospheric BrO column to aircraft in-situ observations of BrO and related species. The aircraft profiles reveal that tropospheric BrO, when present during April 2008, was distributed over a broad range of altitudes rather than being confined to the planetary boundary layer (PBL). Perturbations to the total column resulting from tropospheric BrO are the same magnitude as perturbations due to longitudinal variations in the stratospheric component, so proper accounting of the stratospheric signal is essential for accurate determination of satellite-derived tropospheric BrO. We find reasonably good agreement between satellite-derived tropospheric BrO and columns found using aircraft in-situ BrO profiles, particularly when satellite radiances were obtained over bright surfaces (albedo \u3e0.7), for solar zenith angl

Early surgical complications after congenital diaphragmatic hernia repair by thoracotomy vs. laparotomy: A bicentric comparison

Purpose: The surgical strategy for congenital diaphragmatic hernia (CDH) repair remains debated and mainly depends on the training and preference of the surgeon. Our aim was to evaluate the occurrence and nature of surgical reinterventions within the first year of life, following repair through thoracotomy as compared to laparotomy. / Methods: This is a retrospective bi-centric cohort study comparing postero-lateral thoracotomy (n = 55) versus subcostal laparotomy (n = 62) for CDH repair (IRB: MP001882). We included neonates with isolated, left-sided, Bochdalek-type CDH who were operated on between 2000 and 2017, and had a minimum follow-up of 1 year. Excluded were patients treated prenatally and/or had extra-corporeal membrane oxygenation. Outcomes were occurrence and nature of surgical reinterventions and mortality by 1 year of life. / Results: Both groups had comparable neonatal severity risk profiles. The overall surgical reintervention rate by 1 year of age was higher in the thoracotomy group (29.1% vs. 6.5%; p = 0.001), mainly because of a higher prevalence of acute bowel complications (18.1% vs. 3.2%; p = 0.012) requiring surgery, such as perforation, obstruction and volvulus. At 1 year of follow-up, groups were similar in terms of recurrence (5.5% vs. 1.6%; p = 0.341), surgical interventions related to severe gastroesophageal reflux disease (3.6% vs. 1.6%; p = 0.600) and mortality (5.5% vs. 6.6%; p = 1.000). / Conclusion: Postnatal CDH repair through thoracotomy was associated with a higher rate of surgical reinterventions within the first year of life, especially for severe acute gastro-intestinal complications. There seemed to be no difference in recurrence and mortality rate. / Type of Study: Retrospective Comparative Cohort Study. / Level of Evidence: Level III