Genomic Selection Outperforms Marker Assisted Selection for Grain Yield and Physiological Traits in a Maize Doubled Haploid Population Across Water Treatments.

To increase genetic gain for tolerance to drought, we aimed to identify environmentally stable QTL in per se and testcross combination under well-watered (WW) and drought stressed (DS) conditions and evaluate the possible deployment of QTL using marker assisted and/or genomic selection (QTL/GS-MAS). A total of 169 doubled haploid lines derived from the cross between CML495 and LPSC7F64 and 190 testcrosses (tester CML494) were evaluated in a total of 11 treatment-by-population combinations under WW and DS conditions. In response to DS, grain yield (GY) and plant height (PHT) were reduced while time to anthesis and the anthesis silking interval (ASI) increased for both lines and hybrids. Forty-eight QTL were detected for a total of nine traits. The allele derived from CML495 generally increased trait values for anthesis, ASI, PHT, the normalized difference vegetative index (NDVI) and the green leaf area duration (GLAD; a composite trait of NDVI, PHT and senescence) while it reduced trait values for leaf rolling and senescence. The LOD scores for all detected QTL ranged from 2.0 to 7.2 explaining 4.4 to 19.4% of the observed phenotypic variance with R2 ranging from 0 (GY, DS, lines) to 37.3% (PHT, WW, lines). Prediction accuracy of the model used for genomic selection was generally higher than phenotypic variance explained by the sum of QTL for individual traits indicative of the polygenic control of traits evaluated here. We therefore propose to use QTL-MAS in forward breeding to enrich the allelic frequency for a few desired traits with strong additive QTL in early selection cycles while GS-MAS could be used in more mature breeding programs to additionally capture alleles with smaller additive effects.

Brevis plant1, a putative inositol polyphosphate 5-phosphatase, is required for internode elongation in maize.

In maize (Zea mays L.), as in other grass species, stem elongation occurs during growth and most noticeably upon the transition to flowering. Genes that reduce stem elongation have been important to reduce stem breakage, or lodging. Stem elongation has been mediated by dwarf and brachytic/brevis plant mutants that affect giberellic acid and auxin pathways, respectively. Maize brevis plant1 (bv1) mutants, first identified over 80 years ago, strongly resemble brachytic2 mutants that have shortened internodes, short internode cells, and are deficient in auxin transport. Here, we characterized two novel bv1 maize mutants. We found that an inositol polyphosphate 5-phosphatase orthologue of the rice gene dwarf50 was the molecular basis for the bv1 phenotype, implicating auxin-mediated inositol polyphosphate and/or phosphoinositide signalling in stem elongation. We suggest that auxin-mediated internode elongation involves processes that also contribute to stem gravitropism. Genes misregulated in bv1 mutants included genes important for cell wall synthesis, transmembrane transport, and cytoskeletal function. Mutant and wild-type plants were indistinguishable early in development, responded similarly to changes in light quality, had unaltered flowering times, and had normal flower development. These attributes suggest that breeding could utilize bv1 alleles to increase crop grain yields.

Referral and counter-referral system between secondary and tertiary care facilities in a children's hospital network of Greater Buenos Aires.

INTRODUCTION: Hospital El Cruce is a tertiary care facility which is part of a healthcare network that has been operating since July 2008 and includes health centers from five municipalities of the South of Greater Buenos Aires. The objective of the study was to describe the referral and counter-referral system at the pediatric intermediate medical care unit of the Hospital El Cruce, the tertiary level care of the network, and secondly to identify the critical points that could go against the consolidation of the network and to analyze the level of knowledge about it. POPULATION AND METHODS: This was a cross-sectional, prospective study conducted at the pediatric intermediate medical care unit of Hospital El Cruce between July 2008 and December 2010. Indicators related to patient admission and discharge were analyzed. A survey was administered to all the heads of the network's pediatric departments in order to assess the level of knowledge they had about it. RESULTS: A total of1677patients were hospitalized; 83.9% were referred from the network. Of all referrals made, 71.1% were accepted. There were 156 patients (9.4%) who were counter-referred to the referring facility. The survey results showed that 70% of heads of pediatric departments were unaware of the range of services provided by the network. CONCLUSIONS: Health care exchange was predominantly based on accepting patients referred from secondary care facilities to Hospital El Cruce and a minimum number of counter-referrals to referring facilities, with a radial pattern dynamics. There was scarce knowledge about the availability of the network health service delivery.

Referral and counter-referral system between secondary and tertiary care facilities in a children's hospital network of Greater Buenos Aires / Sistema de referencia-contrarreferencia entre el segundo y el tercer nivel de salud en una red hospitalaria pediátrica en el conurbano bonaerense

Introduction. Hospital El Cruce is a tertiary care facility which is part of a healthcare network that has been operating since July 2008 and includes health centers from five municipalities of the South of Greater Buenos Aires. The objective of the study was to describe the referral and counter-referral system at the pediatric intermediate medical care unit of the Hospital El Cruce, the tertiary level care of the network, and secondly to identify the critical points that could go against the consolidation of the network and to analyze the level of knowledge about it. Population and Methods. This was a cross-sectional, prospective study conducted at the pediatric intermediate medical care unit of Hospital El Cruce between July 2008 and December 2010. Indicators related to patient admission and discharge were analyzed. A survey was administered to all the heads of the network's pediatric departments in order to assess the level of knowledge they had about it. Results. A total of1677patients were hospitalized; 83.9% were referred from the network. Of all referrals made, 71.1% were accepted. There were 156 patients (9.4%) who were counter-referred to the referring facility. The survey results showed that 70% of heads of pediatric departments were unaware of the range of services provided by the network. Conclusions. Health care exchange was predominantly based on accepting patients referred from secondary care facilities to Hospital El Cruce and a minimum number of counter-referrals to referring facilities, with a radial pattern dynamics. There was scarce knowledge about the availability of the network health service delivery.

Introducción. El Hospital El Cruce es un centro de alta complejidad de una red asistencial que funciona desde julio de 2008 y abarca centros sanitarios de cinco municipios del conurbano sur bonaerense. El objetivo del estudio fue describir el sistema de referencia y contrarreferencia a la unidad de cuidados intermedios pediátricos del Hospital de Alta Complejidad en Red El Cruce, y secundariamente identifcar los puntos críticos que podrían conspirar contra la consolidación de la red y analizar el nivel de autoconocimiento sobre ésta. Población y métodos. Estudio observacional, prospectivo, realizado en la unidad de cuidados intermedios pediátricos del Hospital El Cruce, entre julio de 2008 y diciembre de 2010. Se analizaron los indicadores vinculados al ingreso y egreso del paciente. Se realizó una encuesta a todos los jefes de servicios pediátricos de la red para evaluar el nivel de conocimiento sobre ésta. Resultados. Se internaron 1677 pacientes; 83,9% fueron derivados desde la red. Se aceptaron 71,1% de las derivaciones solicitadas. El 9,4% (156 pacientes) fueron contrarreferidos al centro de origen. En la encuesta, 70% de las respuestas de los jefes de servicios pediátricos expresaron desconocimiento del menú prestacional de la red. Conclusiones. El intercambio asistencial se basó predominantemente en la aceptación de pacientes derivados desde centros de segundo nivel de atención hacia el Hospital El Cruce y escasa contrarreferencia hacia los centros derivadores, con una dinámica de funcionamiento radiada. Hubo escaso conocimiento de la disponibilidad de prestaciones de la red.

Referral and counter-referral system between secondary and tertiary care facilities in a childrens hospital network of Greater Buenos Aires / Sistema de referencia-contrarreferencia entre el segundo y el tercer nivel de salud en una red hospitalaria pediátrica en el conurbano bonaerense

Introduction. Hospital El Cruce is a tertiary care facility which is part of a healthcare network that has been operating since July 2008 and includes health centers from five municipalities of the South of Greater Buenos Aires. The objective of the study was to describe the referral and counter-referral system at the pediatric intermediate medical care unit of the Hospital El Cruce, the tertiary level care of the network, and secondly to identify the critical points that could go against the consolidation of the network and to analyze the level of knowledge about it. Population and Methods. This was a cross-sectional, prospective study conducted at the pediatric intermediate medical care unit of Hospital El Cruce between July 2008 and December 2010. Indicators related to patient admission and discharge were analyzed. A survey was administered to all the heads of the networks pediatric departments in order to assess the level of knowledge they had about it. Results. A total of1677patients were hospitalized; 83.9% were referred from the network. Of all referrals made, 71.1% were accepted. There were 156 patients (9.4%) who were counter-referred to the referring facility. The survey results showed that 70% of heads of pediatric departments were unaware of the range of services provided by the network. Conclusions. Health care exchange was predominantly based on accepting patients referred from secondary care facilities to Hospital El Cruce and a minimum number of counter-referrals to referring facilities, with a radial pattern dynamics. There was scarce knowledge about the availability of the network health service delivery.(AU)

Introducción. El Hospital El Cruce es un centro de alta complejidad de una red asistencial que funciona desde julio de 2008 y abarca centros sanitarios de cinco municipios del conurbano sur bonaerense. El objetivo del estudio fue describir el sistema de referencia y contrarreferencia a la unidad de cuidados intermedios pediátricos del Hospital de Alta Complejidad en Red El Cruce, y secundariamente identifcar los puntos críticos que podrían conspirar contra la consolidación de la red y analizar el nivel de autoconocimiento sobre ésta. Población y métodos. Estudio observacional, prospectivo, realizado en la unidad de cuidados intermedios pediátricos del Hospital El Cruce, entre julio de 2008 y diciembre de 2010. Se analizaron los indicadores vinculados al ingreso y egreso del paciente. Se realizó una encuesta a todos los jefes de servicios pediátricos de la red para evaluar el nivel de conocimiento sobre ésta. Resultados. Se internaron 1677 pacientes; 83,9% fueron derivados desde la red. Se aceptaron 71,1% de las derivaciones solicitadas. El 9,4% (156 pacientes) fueron contrarreferidos al centro de origen. En la encuesta, 70% de las respuestas de los jefes de servicios pediátricos expresaron desconocimiento del menú prestacional de la red. Conclusiones. El intercambio asistencial se basó predominantemente en la aceptación de pacientes derivados desde centros de segundo nivel de atención hacia el Hospital El Cruce y escasa contrarreferencia hacia los centros derivadores, con una dinámica de funcionamiento radiada. Hubo escaso conocimiento de la disponibilidad de prestaciones de la red.(AU)

Referral and counter-referral system between secondary and tertiary care facilities in a childrens hospital network of Greater Buenos Aires. / Referral and counter-referral system between secondary and tertiary care facilities in a childrens hospital network of Greater Buenos Aires.

INTRODUCTION: Hospital El Cruce is a tertiary care facility which is part of a healthcare network that has been operating since July 2008 and includes health centers from five municipalities of the South of Greater Buenos Aires. The objective of the study was to describe the referral and counter-referral system at the pediatric intermediate medical care unit of the Hospital El Cruce, the tertiary level care of the network, and secondly to identify the critical points that could go against the consolidation of the network and to analyze the level of knowledge about it. POPULATION AND METHODS: This was a cross-sectional, prospective study conducted at the pediatric intermediate medical care unit of Hospital El Cruce between July 2008 and December 2010. Indicators related to patient admission and discharge were analyzed. A survey was administered to all the heads of the networks pediatric departments in order to assess the level of knowledge they had about it. RESULTS: A total of1677patients were hospitalized; 83.9

were referred from the network. Of all referrals made, 71.1

were accepted. There were 156 patients (9.4

) who were counter-referred to the referring facility. The survey results showed that 70

of heads of pediatric departments were unaware of the range of services provided by the network. CONCLUSIONS: Health care exchange was predominantly based on accepting patients referred from secondary care facilities to Hospital El Cruce and a minimum number of counter-referrals to referring facilities, with a radial pattern dynamics. There was scarce knowledge about the availability of the network health service delivery.

Lactante sibilante atípico: consideraciones diagnósticas. Hendidura laríngea / Atypical sibilant lactate: diagnostic considerations. Laryngeal cleft

El síndrome bronquial obstructivo es un motivo de consulta frecuente en la edad pediátrica. En este trabajo se presenta el caso de un paciente con antecedentes de internaciones recurrentes por infecciones respiratorias agudas bajas y trastorno de deglución con diagnóstico de hendidura laríngea. Se realiza una breve descripción de la hendidura laríngea, sus características clínicas, diagnóstico y tratamiento. Se enumeran los diagnósticos diferenciales de los niños con sibilancias atípicas, sus signos y síntomas y su evaluación inicial.