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Copyright of Cukurova Medical Journal / Çukurova Üniversitesi Tip Fakültesi Dergisi is the property of Cukurova University, Faculty of Medicine and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Review of Applied Psychology is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Nurse managers carry the light of leadership in mining primary healthcare settings (mPHCs). They must ensure that this light shines for their followers to improve the quality of service rendered in primary healthcare. However, the nurse managers in mPHCs are confusing their leadership roles with management roles. The existing policies such as operational management of mPHCs are also not clarifying the leadership roles of nurse managers. Aim: The purpose of this study was to understand the nurse managers' leadership roles in mPHCs. Setting: This study was conducted in mPHCs, situated in Gauteng province, in the West Rand in 2017. Methods: A qualitative, exploratory, descriptive and contextual research design was employed in this study. The participants were selected using a non-probability purposive sampling method. Ten participants formed part of the study. To collect data, individual in-depth interviews were conducted. Giorgi's descriptive thematic data analysis was used to analyse data. Measures to ensure trustworthiness and ethical principles were adhered to. Results: Three themes emanated: confusion of leadership roles with management roles, confusion of leadership roles with clinical roles and confusion of leadership roles with resources management roles. Conclusion: The importance of describing nurse managers' leadership roles surfaced from this study to eradicate confusion. Contribution: The nurse managers in mPHCs are now understanding their leadership roles, and that leadership roles, management roles, clinical roles and resources management roles are distinguishable. [ABSTRACT FROM AUTHOR]

Les syndromes mycotoxiques de latence courte apparaissent dans les six heures qui suivent l'ingestion de champignons. Ils entraînent principalement des signes digestifs rapidement résolutifs et sont généralement banalisés. Une étude réalisée grâce aux données du centre antipoison et de toxicovigilance d'Angers permet de mettre en exergue leur gravité potentielle. Il est important de sensibiliser les professionnels de santé à leur prévention et à une prise en charge adéquate des patients. Short-latency mycotoxic syndromes appear within six hours after ingestion of mushrooms. They mainly lead to digestive signs that resolve quickly and are generally trivialized. A study carried out with data from the Angers Poison and Toxicovigilance Center highlights their potential seriousness. It is important to raise awareness among health professionals about their prevention and proper management of patients. [ABSTRACT FROM AUTHOR]

Confusion, or passing off, is a typical unfair practice recognized internationally, but national laws still differ from each other. Although the Chinese Anti-Unfair Competition Law of 1993 provided a narrow rule on passing off, a rich amount of case law has considerably enlarged its scope of application. The reform of the passing off regime in 2017 was essentially based on case law. This reform consists of four main aspects: expansion of the scope of protectable commercial signs: clarification of the applicability of the passing off rule to registered and unregistered trademarks; the adjustment of fame as a qualifying condition of passing off; and the adoption of a general rule prohibiting confusion. This reform has not only consolidated the case law and approach developed by the courts, but also bestowed an open and flexible spirit in the passing off regime which will enhance its efficiency in the fight against unfair imitation. *PhD (University of Paris I – Pantheon Sorbonne), LLM (Renmin University of China), LLB (Shandong University), Director of the Innovation & Competition Law Center, Former Vice-President of the Trademark & Unfair Competition Committee of the IP Case Law Center (Beijing) of the Chinese Supreme People's Court, Vice President of the Beijing IP Judicial Protection Association, Expert Council Member of China Trademark Association, Co-Chair of American Society of International Law Intellectual Property Interest Group, Visiting Professor or Research Fellow (University of Milan, University of Toulouse I, University of Paris I, University of Paris XI, Max Plank Institute for Procedural Law and Strasbourg University CEIPI). The author is thankful to Miss Kristina DaCosta (LLM graduate of Tsinghua University), Miss Ling Zhang (PhD candidate of Tsinghua University) and Mr Yu Huang (LLM graduate of Tsinghua University) for their valuable assistance in this research. This research is part of the project 20BFX142 of the National Social Science Fund of China. [ABSTRACT FROM AUTHOR]

Whereas hospitalists and intensivists are treating the life-threatening respiratory conditions that often accompany COVID-19, delirium prevention, identification, and treatment may inadvertently be taking a backseat. However, delirium identification is important as it can serve as a key marker for hospital providers to identify COVID patients at risk for poor outcomes including ICU stay and death. 2 COVID delirium has been difficult to manage because some COVID treatment methods are inherently deliriogenic and some medications traditionally used to manage delirium have been rendered ineffective among this population. Inpatient neurology and psychiatry practitioners are having to postulate new treatment techniques; one such medication algorithm can be found within this piece. It is important that delirium doesn't get lost in the chaos that is management of the COVID patient. [ABSTRACT FROM AUTHOR]

In Urban Alley Brewery Pty Ltd v La Sirène Pty Ltd, O 'Brien J dismissed a claim for trade mark infringement against La Sirène Pty Ltd brought by Urban Alley Brewery Pty Ltd for a breach of its URBAN ALE trade mark. In the process, O 'Brien J held the URBAN ALE trade mark should be removed from the register because it was not distinctive, and on account of the mark being likely to deceive or cause confusion under s.88 of the Trade Marks Act 1995 (Cth). The decision highlights the perils of registering descriptive trade marks and the advantage of adopting truly distinctive beer labels. And as much as the new generation of craft brewers want to set themselves apart from traditional breweries, they might want to take some pointers from their antecedents--who adopted elaborate devices for their labels. After all, history has shown those labels hold enduring value. [ABSTRACT FROM AUTHOR]

In response to the need to better define the natural history of emerging consciousness after traumatic brain injury and to better describe the characteristics of the condition commonly labeled posttraumatic amnesia, a case definition and diagnostic criteria for the posttraumatic confusional state (PTCS) were developed. This project was completed by the Confusion Workgroup of the American Congress of Rehabilitation Medicine Brain Injury Interdisciplinary Special Interest group. The case definition was informed by an exhaustive literature review and expert opinion of workgroup members from multiple disciplines. The workgroup reviewed 2466 abstracts and extracted evidence from 44 articles. Consensus was reached through teleconferences, face-to-face meetings, and 3 rounds of modified Delphi voting. The case definition provides detailed description of PTCS (1) core neurobehavioral features, (2) associated neurobehavioral features, (3) functional implications, (4) exclusion criteria, (5) lower boundary, and (6) criteria for emergence. Core neurobehavioral features include disturbances of attention, orientation, and memory as well as excessive fluctuation. Associated neurobehavioral features include emotional and behavioral disturbances, sleep-wake cycle disturbance, delusions, perceptual disturbances, and confabulation. The lower boundary distinguishes PTCS from the minimally conscious state, while upper boundary is marked by significant improvement in the 4 core and 5 associated features. Key research goals are establishment of cutoffs on assessment instruments and determination of levels of behavioral function that distinguish persons in PTCS from those who have emerged to the period of continued recovery. [ABSTRACT FROM AUTHOR]

This paper reports on a New Zealand iteration of the Encouraging Persistence, Maintaining Challenge (EPMC) project, which proposes that students learn mathematics best when they build connections between mathematical ideas for themselves. This iteration explores the actions, perceptions and learning of 12 primary teachers and their 281 students during the implementation of a set of challenging tasks related to geometric reasoning. The teachers launched the suggested tasks, ensuring that the challenge was maintained. The students explored these tasks with minimal input from the teacher, and learning was summarised and extended. The teachers were positive about the intervention. The challenging task approach enabled students' thinking became visible and, at times, the teachers' prior perceptions of their students' ability were challenged. A highly significant difference between the students' pre- and post-assessment scores was found. The students were supported to have autonomy in their learning and make mathematical connections themselves. The students became less reliant on their teachers' help and were positive about their involvement in the project. [ABSTRACT FROM AUTHOR]

Colour trade marks are among the most controversial kind of trade marks. The Court of Venice recently adjudicated a case concerning use of the colour orange used, respectively, on Champagne and Prosecco. The court acknowledged that a colour mark is inherently non-distinctive and it may only acquire distinctiveness through intensive use. As the evidence showed acquired distinctiveness, and since champagnes and prosecco target a public with an average level of attention, which is not particularly high, the Court held for infringement. However, the court denied that acquired distinctiveness is equal to reputation. [ABSTRACT FROM AUTHOR]

This paper introduces an effective image encryption method based on fractals for colored images. Fractals are now widely used in image security due to its randomness property and infinite boundaries. Since images are traversed over the public channel in day-to-day life confidentiality, integrity and authenticity must be pledged for prosperous transmission. This method capsulizes a larger key space and complex behavior to accomplish a productive confusion and diffusion techniques in a fruitful way. Julia set and Mandelbrot set are constructed and active confusion is exerted till the image pixels are altogether disordered and ensuing diffusion with XOR operation. Experimental results show the ability of the proposed system with respect to various statistical measures. [ABSTRACT FROM AUTHOR]

This study assesses whether university students experience stress while using Piazza, an online discussion forum. Along with other forms of educational technology, the online discussion forum Piazza offers students and instructors potential benefits as well as drawbacks. Online discussion can generate several Piazza posts per day per student, along with additional emails and notifications. This near-constant stream of information could pressure students to keep up with new content, which could potentially lead to stress and confusion when posts may be incorrect and/or provide misconceptions. The aim is to clarify the impact on university students of the "always on" aspects of Piazza and other discussion forums. Data was gathered about how students use Piazza; their specific experiences; and whether using Piazza leads to stress or confusion. We found that although the content of discussion posts itself does not indicate stress or other emotions, students report pressure associated with checking websites and notifications. Students also report a mix of positive and negative emotions, including stress and anxiety, associated with Piazza use. [ABSTRACT FROM AUTHOR]

Considering the various design dissemination methods, this article explores the impact o f 3D printing on the consumer protection rationale o f trade marks and its implications for determining consumer-based infringement. It concludes that the extent to which trade marks can fulfil their consumer protection function is determined by three factors: consumer attributes, the status o f 3D printing technology, and the applied method o f design dissemination [ABSTRACT FROM AUTHOR]

Acute changes in mental status represent a broad collection of symptoms used to describe disorders in mentation and level of arousal, including the more narrowly defined diagnoses of delirium and psychosis. A wide range of precipitating factors may be responsible for symptom onset including infection, intoxication, and metabolic disorders. Neurologic causes that may be detected on neuroimaging include stroke, traumatic brain injury, nonconvulsive seizure, central nervous system infection, tumors, hydrocephalus, and inflammatory disorders. Not infrequently, two or more precipitating factors may be found. Neuroimaging with CT or MRI is usually appropriate if the clinical suspicion for an acute neurological cause is high, where the cause of symptoms is not found on initial assessment, and for patients whose symptoms do not respond appropriately to management. There was disagreement regarding the appropriateness of neuroimaging in cases where a suspected, nonneurologic cause is found on initial assessment. Neuroimaging with CT is usually appropriate for patients presenting with delirium, although the yield may be low in the absence of trauma or a focal neurological deficit. Neuroimaging with CT or MRI may be appropriate in the evaluation of new onset psychosis, although the yield may be low in the absence of a neurologic deficit. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment. [ABSTRACT FROM AUTHOR]

Image encryption has attained a great attention due to the necessity to safeguard confidential images. Digital documents, site images, battlefield photographs, etc. need a secure approach for sharing in an open channel. Hardware - software co-design is a better option for exploiting unique features to cipher the confidential images. Cellular automata (CA) and synthetic image influenced transform domain approach for image encryption is proposed in this paper. The digital image is initially divided into four subsections by applying integer wavelet transform. Confusion is accomplished on low - low section of the transformed image using CA rules 90 and 150. The first level of diffusion with consecutive XORing operation of image pixels is initiated by CA rule 42. A synthetic random key image is developed by extracting true random bits generated by Cyclone V field programmable gate array 5CSEMA5F31C6. This random image plays an important role in second level of diffusion. The proposed confusion and two level diffusion assisted image encryption approach has been validated through the entropy, correlation, histogram, number of pixels change rate, unified average change intensity, contrast and encryption quality analyses. [ABSTRACT FROM AUTHOR]

In Victoria Plum v Victorian Plumbing, the High Court decided that keyword bidding by competing traders on each other’s long-established confusingly similar trading names was an infringement of trade mark and passing off. This article identifies the deficiencies in the court’s reasoning, in particular the failure to take account of the impact of honest concurrent use on the origin function of a trade mark when considering whether the confusion caused by such advertising leads to the conclusion that there is an infringement of the competing trader’s rights. [ABSTRACT FROM AUTHOR]

Copyright of Pregled is the property of University of Sarajevo and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article will explore an interesting trade mark opposition decision which demonstrates that the outsized reputation and fame of the opponents' senior marks per se neither enhances nor reduces the likelihood of confusion in Japan, but rather the factual determination and judgment of the similarity examination of the conflicting marks is the main driver of success in contentious trade mark proceedings. The article will also explore the procedural pitfalls, strategic shortcomings and 17 years of statistical data regarding Japan s trade mark opposition system and several instructive Japanese appellate invalidation decisions that will demonstrate why brand owners will be better served by using its invalidation appeal system to police competitors ' trade marks in the world's third largest economy, Japan. [ABSTRACT FROM AUTHOR]

In Messi v EUIPO, the General Court of the EU stated that the signs at issue, "Messi" and "Massi", are visually and phonetically similar, as ruled by the First Board of Appeal. However, the General Court concluded that EUIPO erred in considering that Messi's reputation is limited only to that part of the public with an interest in football and sport in general. In fact, Messi is a well-known public figure who appears regularly on television and whose name is often in the papers. Thus, this case demonstrates the influence of notoriety on the strength of a trade mark. [ABSTRACT FROM AUTHOR]

The Intellectual Property High Court of Japan (IPHC) ruled in favour of Ryohin Keikaku Co Ltd, the operator of the famous MUJI retail chain, against Cainz Co Ltd, one of Japan's largest DIY chain stores, of violating the Unfair Competition Prevention Law (UCPL) in Cainz Co Ltd v Ryohin Keikaku Co Ltd. This commentary will examine the decision, the use of survey evidence in unfair competition litigation, and other unfair competition litigation developments in Japan. [ABSTRACT FROM AUTHOR]

This article will analyse the claim of trade mark infringement under s. 10(2) of the Trade Marks Act 1994, where the requisite confusion is the "wrong-way-round". The Court of Appeal has, relatively recently, confirmed that this unorthodox type of confusion is sufficientfor the claimant to succeed in proceedings for trade mark infringement. However, an appeal to the Supreme Court has been withdrawn following confidential settlement. This article will argue that interpreting s. 10(2), so as to encompass instances o f wrong-way-round confusion, is not simply a matter of addressing the chronological order in which a consumer interacts with the trade mark and the infringing sign. On the contrary, it expands s.10(2) so as to protect against (1) an adverse effect on the trade mark's function, a type of harm which should be confined to s.10(1), and/or (2) blurring, a type o f harm which should be confined to s,10(3), and/or (3) initial "disinterest" confusion, a sub-category of tarnishing which should be confined to s,10(3). As such, wrong-way-round confusion should not be permitted. [ABSTRACT FROM AUTHOR]

The impact of parenting on the family orientation of university students and their identity formation during adolescence was investigated to identify parenting styles that promoted identity integration and minimized confusion. In addition, cooperation between fathers and mothers was analyzed to explain parenting styles. The results indicated that students of both genders who were raised by parents with an authoritative style more often evaluated that their parents cooperated in raising them compared with those who were raised with other parenting styles. Moreover, identity integration was significantly higher among students who were raised with an authoritative parenting style than among those raised with an authoritarian and uninvolved parenting style, whereas the opposite outcome was seen for identity confusion. Therefore, it was concluded that in the process of identity formation during adolescence, parenting styles that are responsive to children are essential, as is putting demands on them to mature based on proper criteria, i.e. disciplining them. However, further discussion is required about the fact that no differences were seen for the permissive parenting style. [ABSTRACT FROM AUTHOR]

Although brain abscess is a fatal neurological infection, the studies in Thailand are quite limited and outdate. This study aims to identify predictors of mortality among patients with brain abscess in Thailand. Patients with a diagnosis of brain abscess admitted to Songklanagarind Hospital, a referral tertiary care hospital in southern Thailand, between 2002 and 2017 were enrolled into this retrospective case control study. Demographic data, neurological status, clinical presentations, predisposing factors, microbiological profiles, neuroimaging findings, treatments, and outcomes were collected from electronic medical records. Predictors of death outcome were analyzed by univariate and multivariate logistic regression analysis. Among eighty-one patients enrolled into the study, forty-seven patients (58.0%) were male and 34 patients (42.0%) were female. The overall mean age (±SD) was 47.68 (±16.92) years old. The major predisposing factors of brain abscess were an immunocompromised state (42.0%) and the extension of a paracranial infections (24.7%). The common clinical presentations included headache (61.7%), fever (50.6%), and hemiplegia (34.6%). Eleven patients (13.6%) were dead at hospital discharge. The independent factor associated with death outcome identified by multivariate analysis was confusion (odds ratio 7.67, 95% CI 1.95–30.14; p = 0.003). In summary, the current study shows that an immunocompromised state is a significant predisposing factor of brain abscess. The independent factor associated with death outcome was confusion which was correlated with septic encephalopathy. [ABSTRACT FROM AUTHOR]

This paper deals with topic of image encryption based on chaotic maps. A solution which has advantage of robustness against chosen-plaintext attacks is proposed. Permutations of image pixels are carried out in a way that enables operations on grayscale images with arbitrary resolution. All calculations done with user key and also all diffusion processes employ the same chaotic map. This feature enables usage of look-up tables which reduce computational times. The paper includes several experiments which verify achieved results and also briefly describes advantages and drawbacks of proposed solution. [ABSTRACT FROM AUTHOR]

There are a number of differing expert-type issues arising in intellectual property' infringement disputes. The expertise can vary' significantly across the disciplines of trade marks, patents and copyright, as well as varying significantly within each of these separate disciplines. These are discussed in this article. While generally welcome, there has been some controversy in relation to trade mark experts. However, on closer examination this seems to be linked to the relatively confined issue of expert survey evidence. It does not extend to the many other issues upon which expertise can bring light and assistance to the court in trade mark cases. These expert distinctions are examined in the article, highlighting that there is more than meets the eye. Not only is expert evidence welcomed; even the controversy surrounding survey evidence is not a uniform criticism. Additionally, industrial and technological advances are likely to increase the need for more specialist experts. [ABSTRACT FROM AUTHOR]

In this paper, we propose a new image encryption scheme based on confusion and diffusion for securing a color and grayscale images using an Enhanced Skew Tent Map (ESTM). Firstly, since chaotic properties are strongly related to cryptographic properties in confusion and diffusion, we improved the chaotic behavior of the map skew tent map to generate a good chaotic key stream that is more advisable for image encryption. Then, the traditional scrambling techniques confusion and diffusion are applied on the original image decomposed into blocks of size 1×256. The results of the simulation show the validity of the proposed scheme. [ABSTRACT FROM AUTHOR]

Victoria Plum Ltd (t/a Victoria Plum) v Victorian Plumbing Ltd1 concerned the defence of honest concurrent use in the context of keyword advertising. The decision is interesting for a number of reasons which are set out in this comment. [ABSTRACT FROM AUTHOR]

As online courses become more common, practitioners are in need of clear guidance on how to translate best educational practices into web-based instruction. Moreover, student engagement is a pressing concern in online courses, which often have high levels of dropout. Our goals in this work were to experimentally study routine instructional design choices and to measure the effects of these choices on students' subjective experiences (engagement, mind wandering, and interest) in addition to objective learning outcomes. Using randomized controlled trials, we studied the effect of varying instructional activities (namely, assessment and a step-through interactive) on participants' learning and subjective experiences in a lesson drawn from an online immunology course. Participants were recruited from Amazon Mechanical Turk. Results showed that participants were more likely to drop out when they were in conditions that included assessment. Moreover, assessment with minimal feedback (correct answers only) led to the lowest subjective ratings of any experimental condition. Some of the negative effects of assessment were mitigated by the addition of assessment explanations or a summary interactive. We found no differences between the experimental conditions in learning outcomes, but we did find differences between groups in the accuracy of score predictions. Finally, prior knowledge and self-rated confusion were predictors of post-test scores. Using student behavior data from the same online immunology course, we corroborated the importance of assessment explanations. Our results have a clear implication for course developers: the addition of explanations to assessment questions is a simple way to improve online courses. [ABSTRACT FROM AUTHOR]

Confusion is an emotion that is likely to occur while learning complex information. This emotion can be beneficial to learners in that it can foster engagement, leading to deeper understanding. However, if learners fail to resolve confusion, its effect can be detrimental to learning. Such detrimental learning experiences are particularly concerning within digital learning environments (DLEs), where a teacher is not physically present to monitor learner engagement and adapt the learning experience accordingly. However, with better information about a learner's emotion and behavior, it is possible to improve the design of interactive DLEs (IDLEs) not only in promoting productive confusion but also in preventing overwhelming confusion. This article reviews different methodological approaches for detecting confusion, such as selfreport and behavioral and physiological measures, and discusses their implications within the theoretical framework of a zone of optimal confusion. The specificities of several methodologies and their potential application in IDLEs are discussed. [ABSTRACT FROM AUTHOR]

Copyright of Annals of 'Constantin Brancusi' University of Targu-Jiu. Juridical Science Series is the property of Universitatea Constantin Brancusi din Targu-Jiu and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Lightweight block ciphers have become a standard for security protections on IoT devices. Advanced technology is required to secure the data, thus encryption is the method that can provide information security. From previous studies, comparisons of lightweight algorithms in various literature focus on their performance and implementation. However, a lack of analysis has been done on the relationship between the algorithm components and their security strength. This information is crucial for developers in designing secure algorithms. In this paper, a comprehensive systematic literature review on 101 existing lightweight algorithms is presented. This review focuses on the security aspect of lightweight algorithms that cover the identification of secure design components based on substitution and permutation. Security analysis and the evolution of lightweight algorithms are also presented. This research includes the results and discussions to observe the selections of substitution and permutation functions to analyse their impact on the security strength. Recommendations from the developer's insight on methods and considerations for designing an algorithm are also presented. Findings from the research indicate that various techniques can be used to develop a secure algorithm. Most importantly, an algorithm must be provided with confusion and diffusion properties in the design to ensure sufficient security. [ABSTRACT FROM AUTHOR]

This article advances three interrelated propositions that can stimulate fair competition. It first explores the gradual decoupling of the trade mark from goods or services, then investigates the coupling of the extension of trade mark use to protection against confusion, dilution and free-riding. The article continues by researching the decoupling of protection against dilution from fame or reputation, and then combines these propositions, with reference to the legislation and case law in the US and EU, before providing conclusions. [ABSTRACT FROM AUTHOR]

Background--Truncating mutations in the giant sarcomeric gene Titin are the most common type of genetic alteration in dilated cardiomyopathy. Detailed studies have amassed a wealth of information about truncating variant position in cases and controls. Nonetheless, considerable confusion exists as to how to interpret the pathogenicity of these variants, hindering our ability to make useful recommendations to patients. Methods and Results--Building on our recent discovery of a conserved internal promoter within the Titin gene, we sought to develop an integrative statistical model to explain the observed pattern of Titin truncation variants in patients with dilated cardiomyopathy and population controls. We amassed Titin truncation mutation information from 1714 human dilated cardiomyopathy cases and >69 000 controls and found 3 factors explaining the distribution of Titin mutations: (1) alternative splicing, (2) whether the internal promoter Cronos isoform was disrupted, and (3) whether the distal C terminus was targeted (in keeping with the observation that truncation variants in this region escape nonsense-mediated decay and continue to be incorporated in the sarcomere). A model using these 3 factors had strong predictive performance with an area under the receiver operating characteristic curve of 0.81. Accordingly, individuals with either the most severe form of dilated cardiomyopathy or whose mutations demonstrated clear family segregation experienced the highest risk profile across all 3 components. Conclusions--We conclude that quantitative models derived from large-scale human genetic and phenotypic data can be applied to help overcome the ever-growing challenges of genetic data interpretation. [ABSTRACT FROM AUTHOR]

The Court of Appeal has rejected Twentieth Century Fox Film Corps appeal against the High Court's findings that it had infringed the UK registered trade mark of Comic Enterprises Ltd through its television programme Glee. The Court of Appeal also rejected Comic Enterprises Ltd's cross-appeal that the use of "Glee" constituted passing off. The judgment examines in detail so-called "wrong way round" confusion and its relevance to trade mark infringement proceedings. [ABSTRACT FROM AUTHOR]

A 63-year-old man was admitted to our hospital for further investigation and management of brain metastases. The patient was initially presented with a 4-day history of confusion. On the day of admission, the patient was confused, agitated, disorientated in place and time, and had visual disturbances. His blood pressure was repeatedly recorded high, with levels of systolic blood pressure between 170–210 mm Hg. A brain magnetic resonance imaging showed areas of high signal on T2 and fluid-attenuated inversion recovery images, located bilaterally in the white matter of the occipital regions and unilateral in the left frontal lobe, suggestive of posterior reversible encephalopathy syndrome. Aggressive treatment of hypertension resulted in complete resolution of the clinical and radiologic features of the syndrome. [ABSTRACT FROM AUTHOR]

Initial interest confusion is a controversial doctrine and has, until now, been largely resisted or ignored. Following Interflora v Marks & Spencer (CAII) and OCH-Ziff Management v OCH Capital, it is necessary to ask whether it ought to be accepted within European trade mark law, and if so, where within the current framework it should sit. [ABSTRACT FROM AUTHOR]

The case law on composite marks is a contentious matter. This article considers the EU case law on the subject, and, as a consequence, respectfully suggests that the jurisprudence has not been correctly applied in cases involving composite marks in England and Wales. [ABSTRACT FROM AUTHOR]

Following the CJEU ruling in Google France and the Court of Appeal decision in Interflora v Marks & Spencer, it has become necessary to re-evaluate the role of the average consumer, especially in relation to art.5(1)(a) of Directive 2008/95: specifically his characteristics, the burden of proof and possible future uses. [ABSTRACT FROM AUTHOR]

Background: Nurses have the key roles to detect delirium in hospitalized older patients but under-recognition of delirium among nurses is prevalent. The objectives of this study were to identify the under-recognition rate of delirium by intensive care nurses (ICU) using Confusion Assessment Method for the ICU (CAM-ICU) and factors associated with under-recognition. Methods: Participants were older patients aged ≥65 years who were admitted to the ICU of Srinagarind Medical School, Khon Kaen, Thailand from May 2013 to August 2014. Baseline characteristics were collected. Delirium was rated by a trained clinical researcher using the CAM-ICU. Demographic data were analyzed using descriptive statistics. Univariate and multiple logistic regressions were used to analyze the outcomes. Results: Delirium occurred in 44 of 99 patients (44.4 %). Nurses could not identify delirium in 29.6 % of patients compared with researchers. Pre-existing dementia and depression were found in 47.7 % of patients. Pneumonia or other causes of respiratory failure were the most common causes of admission to ICU (47.7 %). Independent factors associated with under-recognition by nurses were identified-heart failure [adjusted odds ratio (OR), 77.8; 95 % confidence interval (CI) 2.5-2,543, p = 0.01] and pre-existing taking treatment with benzodiazepines (adjusted OR, 22.6; 95 % CI 1.8-85, p = 0.01). Discussion: Under-recognition of delirium is a frequent issue. New independent factors associated with under-recognition were identified. Awareness of delirium in the patients with these factors is recommended. Conclusions: This study supports the finding of high under-recognition rates of delirium among hospitalized older adults in ICU. Patients with heart failure and receiving benzodiazepines were identified as barriers of recognition of delirium. [ABSTRACT FROM AUTHOR]

We often fall into silence. After that, we make a decision through confusion, in most cases. In silence, cool mind runs parallel with warm heart. Traversing over these two, the phenomenon arises, which can be interpreted as a fuzzy event, which can be called waver. In other words, two states of nature develop into conflict, and are covered by a fuzzy event. In confusion, we consider that the states of nature, which had been moving in conflict, not only undergo an inversion, but also a transformation takes place from warm heart into dry mind. It is therefore possible to derive a fuzzy function, resulting from the fuzzification of the transition matrix from silence to confusion, absorbing noise, and taking expectation to link the membership function with the multi-attribute utility function. This short note shows that we can calculate the expected utility by using both the probability of a fuzzy event and the subjective importance of the two states of nature for the decision maker. Further, we can obtain an optimum action, based on the theory of maximum expected utility. [ABSTRACT FROM AUTHOR]

The article discusses the similarities between the legal tests for passing off (product counterfeiting) and likelihood of confusion under Great Britain's trademark laws as of 2015, and it mentions the legal concept of misrepresentation in relation to British trademark infringement claims and consumer confusion. Several British trademark infringement legal cases are examined, including Reed Executive PLC v. Reed Business Information Ltd. and Cosmetic Warriors Ltd. v. Amazon.co.uk Ltd.

Introduction: Delirium is common in critically ill patients and impact in-hospital mortality in patients with pneumonia. The aim of the study was to evaluate the prevalence of delirium symptoms during hospitalization in patients with severe pneumonia and their impact on one-year mortality. Methods: This was an observational, retrospective, cohort study of consecutive patients admitted to the respiratory high dependency unit of the San Gerardo University Hospital, Monza, Italy, between January 2009 and December 2012 with a diagnosis of severe pneumonia. A search through the charts looking for ten key words associated with delirium (confusion, disorientation, altered mental status, delirium, agitation, inappropriate behavior, mental status change, inattention, hallucination, lethargy) was performed by a multidisciplinary team. The primary endpoint was mortality at one-year follow-up. Secondary endpoint was in-hospital mortality. Results: A total of 172 patients were enrolled (78 % males; median age 75 years). At least one delirium symptom was detected in 53 patients (31 %) during hospitalization. The prevalence of delirium symptoms was higher among those who died during hospitalization vs. those who survived (44 vs. 27 %, p = 0.049, respectively). Seventy-one patients (46 %) died during the one-year follow-up. The prevalence of at least one delirium symptom was higher among those who died than those who survived during the one-year follow-up (39 vs. 21 %, p = 0.014, respectively). At the multivariable logistic regression analysis, after adjustment for age, comorbidities and severe sepsis, the presence of at least one delirium symptom during hospitalization was an independent predictor of one-year mortality (OR 2.35; 95 % CI 1.13-4.90; p = 0.023). Conclusions: Delirium symptoms are independent predictors of one-year mortality in hospitalized patients with severe pneumonia. Further studies should confirm our results using prospective methods of collecting data. [ABSTRACT FROM AUTHOR]

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