bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex differences in energetic costs explain sexual dimorphism in the circadian rhythm modulation of the electrocommunication signal of the gymnotiform fishBrachyhypopomus pinnicaudatus
Authors: Salazar Vielka L. , Stoddard Philip K.
Published: February 2008

To understand the evolution of sexually dimorphic communication signals, we must quantify their costs, including their energetic costs, the regulation of these costs, and the difference between the costs for the sexes. Here, we provide the first direct measurements of the relative energy expended on electric signals and show for the focal species Brachyhypopomus pinnicaudatus that males spend a significantly greater proportion of their total energy budget on signal generation (11–22%) compared with females (3%). Both sexes significantly reduce the energy spent on electric signals during daylight hours through circadian modulation of the amplitude,duration and repetition rate of the electric signal, but this effect is more marked in males. Male body condition predicted the energy spent on electric signals (R2=0.75). The oxygen consumed by males for signal production closely paralleled the product of the electric signal's waveform area (R2=0.99) and the discharge rate(R2=0.59), two signal parameters that can be assessed directly by conspecifics. Thus the electric communication signal of males carries the information to reveal their body condition to prospective mates and competing males. Because the electric signal constitutes a significant fraction of the energy budget, energy savings, along with predation avoidance,provides an adaptive basis for the production of circadian rhythms in electric signals.
A newly identified extrinsic input triggers a distinct gastric mill rhythmviaactivation of modulatory projection neurons
Authors: Blitz Dawn M. , White Rachel S. , Saideman Shari R. , Cook Aaron , Christie Andrew E. , Nadim Farzan , Nusbaum Michael P.
Published: February 2008

Neuronal network flexibility enables animals to respond appropriately to changes in their internal and external states. We are using the isolated crab stomatogastric nervous system to determine how extrinsic inputs contribute to network flexibility. The stomatogastric system includes the well-characterized gastric mill (chewing) and pyloric (filtering of chewed food) motor circuits in the stomatogastric ganglion. Projection neurons with somata in the commissural ganglia (CoGs) regulate these rhythms. Previous work characterized a unique gastric mill rhythm that occurred spontaneously in some preparations,but whose origin remained undetermined. This rhythm includes a distinct protractor phase activity pattern, during which a key gastric mill circuit neuron (LG neuron) and the projection neurons MCN1 and CPN2 fire in a pyloric rhythm-timed activity pattern instead of the tonic firing pattern exhibited by these neurons during previously studied gastric mill rhythms. Here we identify a new extrinsic input, the post-oesophageal commissure (POC) neurons,relatively brief stimulation (30 s) of which triggers a long-lasting (tens of minutes) activation of this novel gastric mill rhythm at least in part via its lasting activation of MCN1 and CPN2. Immunocytochemical and electrophysiological data suggest that the POC neurons excite MCN1 and CPN2 by release of the neuropeptide Cancer borealis tachykinin-related peptide Ia (CabTRP Ia). These data further suggest that the CoG arborization of the POC neurons comprises the previously identified anterior commissural organ (ACO), a CabTRP Ia-containing neurohemal organ. This endocrine organ thus appears to also have paracrine actions, including activation of a novel and lasting gastric mill rhythm.
Maxillofacial Training is No Longer than Other Surgical Specialties
Authors: Cameron Malcolm , Westcott Lucy
Published: February 2008

INTRODUCTION

There is a perception that the training pathway for oral and maxillofacial surgery (OMFS) is unduly long and arduous, as consultant oral and maxillofacial surgeons must be doubly qualified (that is, hold degrees in medicine and dentistry) and be holders of two higher fellowships.

MATERIALS AND METHODS

We reviewed the data regarding the average age of National Training Number (NTN) holders and GMC data on the year of first registration and the year of entry onto a specialist surgical list for all 9 surgical specialties.

RESULTS

The results showed the average age of the surgical SpR populations ranged from 33.5 to 38.2 years with an average age of 36.14 years. OMFS SpR's average age is 37.69 years. The GMC data showed the average number of months from full to specialist registration ranged from 90.83 months to 135.24 months, with OMFS surgeons having the lowest average.

CONCLUSIONS

These data suggest that OMFS surgeons are of a similar age to other surgeons whilst in training. In addition, they have the shortest transit time between full GMC registration and entry onto the specialist list. The length of this training even with dual qualification is similar to other surgical specialties.
Wedding Rings are not a Significant Source of Bacterial Contamination Following Surgical Scrubbing
Authors: Al-Allak A , Sarasin S , Key S , Morris-Stiff G
Published: February 2008

INTRODUCTION

Despite some evidence that the wearing of rings may increase the microbial load, there is currently nothing to suggest that viable bacteria remain following a standard surgical scrub. The aim of the study was to examine the distribution and type of microbial flora seen on the hands of doctors following a standard surgical scrub.

MATERIALS AND METHODS

Ten surgeons and 10 anaesthetists, all of whom wore wedding rings on the fourth finger of their left hand, participated in the study. Each individual was asked to ‘scrub-up’ as for their normal first scrub of the day. Following completion of washing, the wedding ring was removed, its internal circumference swabbed and the swab placed in a culture medium. Volunteers placed each hand palm-down on separate agar plates. The plates were incubated and the number of colonies counted and classified.

RESULTS

The culture plates of one of the anaesthetists were damaged in transit leaving a total of 19 subjects for analysis. In all the palm imprint plates, coagulase-negative staphylococci were grown. One surgeon grew coagulase-negative staphylococci from the ring swab. A Candida spp. from the right hand of one surgeon was grown. There was no statistically significant difference between the number of colony-forming units (CFUs) cultured from the right and left (ring-wearing) hands of the surgeons (P = 0.260) and anaesthetists (P = 0.345). There was no statistical difference in CFUs when surgeons were compared with anaesthetists (P = 0.383 for right hand and P = 0.234 for left).

CONCLUSIONS

This preliminary study would suggest that a traditional band wedding ring is not a source of a bacterial load following a standard surgical scrub procedure and, as such, there is no requirement for their removal pre-operatively.
Messung physikalischer Flüssigkeitseigenschaften mit beidseitig eingespannten Balkenstrukturen (Measurement of Liquid Properties Using a Vibrating Clamped–Clamped Beam Structure)
Authors: Reichel Erwin , Weiss Bernhard , Jakoby Bernhard , Riesch Christian , Keplinger Franz
Published: February 2008

In diesem Beitrag wird ein Sensorkonzept zur Messung von Viskosität und Dichte von Flüssigkeiten untersucht. Dabei wird das Resonanzverhalten eines beidseitig eingespannten Balkens ausgewertet. Die durch die Flüssigkeit zustande kommende Widerstandskraft pro Längenheit wird aus einer numerischen Berechnung des Strömungsfeldes abgeleitet. Messungen wurden an einem Sensorelement, basierend auf kupferbeschichteten Polyesterfolien, durchgeführt. Die Balkenschwingung wird elektromagnetisch angeregt. Als Messsignal dient die durch Bewegungsinduktion zustande kommende Spannung. Zusätzlich wurde das Frequenzverhalten mit einer einfachen optischen Methode verifiziert.
Drahtloser, implantierbarer und passiver Dehnungssensor (Wireless Implantable Passive Strain Sensor)
Authors: Gattiker Felix , Neuenschwander Jürg , Sennhauser Urs , Umbrecht Florian , Hierold Christofer
Published: February 2008

Wiederholtes Überbelasten orthopädischer Implantate während Rehabilitationsübungen kann zu deren Versagen führen. Um dies zu verhindern, schlagen wir einen neuartigen, implantierbaren Dehnungssensor vor, mit dessen Hilfe Deformationen solcher Implantate drahtlos erfasst werden können. Das Messprinzip basiert auf der Transformation einer Kraft in eine sich ändernde Flüssigkeitsmenge in einem Mikrokanal, welcher in den Sensor integriert ist. Mittels eines speziellen Ultraschallausleseverfahrens soll der Füllgrad des Mikrokanals durch menschliches Gewebe hindurch ermittelt werden.
Ein tragbares Massenspektrometer in MEMS-Technologie (A Portable MEMS-based Mass Spectrometer)
Authors: Hauschild Jan-Peter , Wapelhorst Eric , Müller Jörg
Published: February 2008

Die Massenspektrometrie gehört zu den wichtigsten Verfahren zur Identifikation von Stoffgemischen. Bisher werden Massenspektrometer jedoch hauptsächlich im Labor eingesetzt, da diese Geräte sehr groß, teuer in der Anschaffung und kompliziert in der Bedienung sind. Um einen Feldeinsatz zu ermöglichen wird ein vollständig integriertes Massenspektrometer, hergestellt in MEMS-Technologie, vorgestellt. Auf Grund der geringen Größe des Systems von nur 5 × 10mm2 kann das Massenspektrometer bei einem Druck von 1Pa betrieben werden, was eine wesentliche Vereinfachung des Vakuumpumpensystems ermöglicht. Der Preis des beschriebenen Systems ist durch die Massenproduktion in Mikrosystemtechnik um Größenordnungen niedriger als bei herkömmlichen Systemen. Massenspektren, die mit dem Mikromassenspektrometer gemessen wurden, belegen die Funktion dieses Systems.
Effectiveness of the 7-Valent Pneumococcal Conjugate Vaccine in Children With Sickle Cell Disease in the First Decade of Life
Authors: Adamkiewicz Thomas V. , Silk Benjamin J. , Howgate James , Baughman Wendy , Strayhorn Gregory , Sullivan Kevin , Farley Monica M.
Published: February 2008

BACKGROUND. The incidence of and mortality from invasive pneumococcal disease are significantly higher in children with sickle cell disease than in the general pediatric population. The objective of this population-based study was to assess the effect of pneumococcal conjugate vaccine on rates of invasive pneumococcal disease among children with sickle cell disease.

PATIENTS AND METHODS. Records, including the history of pneumococcal conjugate vaccine administration, of 1247 children born after 1983 residing in metropolitan Atlanta, Georgia, with confirmed hemoglobinopathies were linked to an active surveillance database for invasive pneumococcal disease for the period of January 1, 1995, through January 1, 2003. The incidence of invasive pneumococcal disease and the percentage of rate reduction were estimated before and after pneumococcal conjugate vaccine licensure. Survival analysis was used to estimate the effect of pneumococcal conjugate vaccine on invasive pneumococcal disease rates while accounting for herd immunity.

RESULTS. A significant decline in invasive pneumococcal disease in children with sickle cell disease ≤10 years of age was noted after pneumococcal conjugate vaccine licensure, from 1.7 infections per 100 person-years (1995–2000) to 0.5 infections per 100 person-years (2001–2002), which represents a 68% reduction. The effectiveness of ≥1 dose of pneumococcal conjugate vaccine was estimated by crude analysis to be 84.5% and by stratified survival analysis to be 81.4% when controlling for the presence of herd immunity in the 2 years after pneumococcal conjugate vaccine licensure. Serotype 6A invasive pneumococcal disease represented 36% of invasive pneumococcal disease before pneumococcal conjugate vaccine licensure and 0% after pneumococcal conjugate vaccine licensure, suggesting a protective effect against this pneumococcal conjugate vaccine-related serotype.

CONCLUSIONS. Invasive pneumococcal disease significantly decreased in children with sickle cell disease ≤10 years of age after pneumococcal conjugate vaccine licensure. Pneumococcal conjugate vaccine was effective even when controlling for herd immunity. Extending guideline recommendations for catch-up vaccination beyond 4 years of age should be considered.
Effects of Asthma Education on Children's Use of Acute Care Services: A Meta-analysis
Authors: Coffman Janet M. , Cabana Michael D. , Halpin Helen Ann , Yelin Edward H.
Published: February 2008

OBJECTIVE. National Heart, Lung, and Blood Institute clinical practice guidelines strongly recommend that health professionals educate children with asthma and their caregivers about self-management. We conducted a meta-analysis to estimate the effects of pediatric asthma education on hospitalizations, emergency department visits, and urgent physician visits for asthma.

PATIENTS AND METHODS. Inclusion criteria included enrollment of children aged 2 to 17 years with a clinical diagnosis of asthma who resided in the United States. Pooled standardized mean differences and pooled odds ratios were calculated. Random-effects models were estimated for all outcomes assessed.

RESULTS. Of the 208 studies identified and screened, 37 met the inclusion criteria. Twenty-seven compared educational interventions to usual care, and 10 compared different interventions. Among studies that compared asthma education to usual care, education was associated with statistically significant decreases in mean hospitalizations and mean emergency department visits and a trend toward lower odds of an emergency department visit. Education did not affect the odds of hospitalization or the mean number of urgent physician visits. Findings from studies that compared different types of asthma education interventions suggest that providing more sessions and more opportunities for interactive learning may produce better outcomes.

CONCLUSIONS. Providing pediatric asthma education reduces mean number of hospitalizations and emergency department visits and the odds of an emergency department visit for asthma, but not the odds of hospitalization or mean number of urgent physician visits. Health plans should invest in pediatric asthma education or provide health professionals with incentives to furnish such education. Additional research is needed to determine the most important components of interventions and compare the cost-effectiveness of different interventions.
Effect of a School-Entry Vaccination Requirement on Racial and Ethnic Disparities in Hepatitis B Immunization Coverage Levels Among Public School Students
Authors: Morita Julie Y. , Ramirez Enrique , Trick William E.
Published: February 2008

OBJECTIVE. We evaluated the overall effect of Illinois’ school-entry mandate on hepatitis B vaccination coverage levels and racial/ethnic differences in vaccination coverage before and after the mandate.

METHODS. In 1997, the Illinois Department of Public Health mandated hepatitis B vaccination before entry into 5th grade. We conducted a retrospective cohort study of 6 consecutive Chicago public schools’ 12th-grade classes; 4 entered 5th grade before the mandate (premandate cohorts) and 2 afterward (postmandate cohorts). We used Chicago public schools’ vaccination database and calculated annual coverage levels for 2nd through 12th grades; the cohorts entered 12th grade during 2000–2005. We compared hepatitis B vaccination coverage levels according to race/ethnicity and coverage levels for the premandate and postmandate cohorts.

RESULTS. We evaluated 106 541 students. The postmandate cohort had significantly higher hepatitis B vaccination coverage levels than the premandate cohort at 5th-grade (38.2% vs 4.3%) and 9th-grade (85.0% vs 37.4%) entry. For 9th-grade students, compared with white students, black students were less likely to have received hepatitis B vaccination before the mandate; this disparity decreased for the first postmandate cohort. For Hispanic students, the disparity was less pronounced and also decreased after the mandate. By 9th grade in the postmandate cohorts, coverage levels for all racial/ethnic groups exceeded 80%.

CONCLUSIONS. There was a dramatic decrease in the disparity of hepatitis B vaccination coverage between white and black or Hispanic students. School-entry requirements effectively increased hepatitis B vaccination coverage levels regardless of race or ethnicity and should be considered for other recently recommended adolescent vaccines.
Detection of Hypoglycemia by Children With Type 1 Diabetes 6 to 11 Years of Age and Their Parents: A Field Study
Authors: Gonder-Frederick Linda , Zrebiec John , Bauchowitz Andrea , Lee Jarim , Cox Daniel , Ritterband Lee , Kovatchev Boris , Clarke William
Published: February 2008

OBJECTIVES. The objectives of this study were to (1) assess accuracy of hypoglycemia detection in children with type 1 diabetes and their parents, using personal digital assistant technology to collect glucose estimates and meter readings, (2) identify demographic, clinical, and psychological predictors of individual differences in accuracy, and (3) test whether poor hypoglycemia detection is a risk factor for severe hypoglycemia in children.

METHODS. Sixty-one children aged 6 to 11 and their parents completed 70 trials, over 1 month, of a survey programmed on a personal digital assistant, which asked them to rate symptoms, estimate current blood glucose level, and then measure blood glucose level. For the subsequent 6 months, parents reported children's severe hypoglycemia episodes bimonthly.

RESULTS. Both parents and children showed poor ability to recognize high or low blood glucose levels, making clinically significant errors as frequently as clinically accurate estimates. Parents failed to recognize >50% of readings <3 mmol/L (<55 mg/dL) and made potentially dangerous errors such as believing the blood glucose level was high when it was low 17% of the time. Children were significantly more accurate at recognizing their hypoglycemia but still failed to detect >40% of episodes. Higher depression scores for children related to lower accuracy. Children who were less accurate at detecting hypoglycemia subsequently experienced more severe hypoglycemia.

CONCLUSIONS. Ability to recognize hypoglycemia is a significant problem for children with type 1 diabetes and their parents. For children, poor ability to detect low blood glucose levels may be a significant and underappreciated risk factor for severe hypoglycemia. More effort is needed to provide education and training designed to improve hypoglycemia detection in this population.
Ethical, Legal, and Social Concerns About Expanded Newborn Screening: Fragile X Syndrome as a Prototype for Emerging Issues
Authors: Bailey Donald B. , Skinner Debra , Davis Arlene M. , Whitmarsh Ian , Powell Cynthia
Published: February 2008

Technology will make it possible to screen for fragile X syndrome and other conditions that do not meet current guidelines for routine newborn screening. This possibility evokes at least 8 broad ethical, legal, and social concerns: (1) early identification of fragile X syndrome, an “untreatable” condition, could lead to heightened anxiety about parenting, oversensitivity to development, alterations in parenting, or disrupted bonding; (2) because fragile X syndrome screening should be voluntary, informed consent could overwhelm parents with information, significantly burden hospitals, and reduce participation in the core screening program; (3) screening will identify some children who are or appear to be phenotypically normal; (4) screening might identify children with other conditions not originally targeted for screening; (5) screening could overwhelm an already limited capacity for genetic counseling and comprehensive care; (6) screening for fragile X syndrome, especially if carrier status is disclosed, increases the likelihood of negative self-concept, societal stigmatization, and insurance or employment discrimination; (7) screening will suggest risk in extended family members, raising ethical and legal issues (because they never consented to screening) and creating a communication burden for parents or expanding the scope of physician responsibility; and (8) screening for fragile X syndrome could heighten discrepancies in how men and women experience genetic risk or decide about testing. To address these concerns we recommend a national newborn screening research network; the development of models for informed decision-making; materials and approaches for helping families understand genetic information and communicating it to others; a national forum to address carrier testing and the disclosure of secondary or incidental findings; and public engagement of scientists, policy makers, ethicists, practitioners, and other citizens to discuss the desired aims of newborn screening and the characteristics of a system needed to achieve those aims.
Predictors of Persistent and New-onset Fatigue in Adolescent Girls
Authors: ter Wolbeek Maike , van Doornen Lorenz J. P. , Kavelaars Annemieke , Heijnen Cobi J.
Published: February 2008

OBJECTIVE. The purpose of this study was to investigate the stability of fatigue in adolescents and to explore whether psychological, somatic, and lifestyle factors are involved in the onset and persistence of fatigue during adolescence.

METHODS. In this longitudinal study, a total of 653 adolescent girls (aged 14.40 ± 1.45 years) who previously participated in an epidemiological study filled out questionnaires 6 (T2) and 12 (T3) months after the initial assessment (T1). Fatigue severity, depression, anxiety, and chronic fatigue syndrome–related symptoms were assessed. We determined the prevalence of severely fatigued cases at T2 and T3 and evaluated whether persistently fatigued participants initially differed from nonfatigued participants and participants with transient fatigue. We examined which factors predicted the development of new-onset fatigue and investigated whether changes in fatigue covaried with changes in other complaints and changes in lifestyle.

RESULTS. Of all participants who were severely fatigued at T1, 25.7% were persistently fatigued throughout the study. Persistently fatigued participants had higher levels of depression and anxiety at the beginning of the study, were less physically active, and slept shorter. New-onset fatigue was predicted by depression, less physical activity, and more nightlife activities. Interestingly, new onset was not predicted by initial levels of fatigue. Persistently fatigued participants did not differ in initial fatigue severity from short-term fatigued patients. A decrease in fatigue severity was associated with a decrease in depression, anxiety, and chronic fatigue syndrome–related symptoms and, to a lesser extent, with an increase in physical activity and sleep duration.

CONCLUSIONS. The stability of severe fatigue among adolescents is substantial. The involvement in the onset and persistence of fatigue suggests that both preventive and therapeutic strategies with respect to fatigue treatment in adolescents should concentrate on emotional well-being. Moreover, adolescents at risk should be stimulated to spend more time on physical activities and to sleep longer.
A Population-Based, Multisite Cohort Study of the Predictors of Chronic Idiopathic Thrombocytopenic Purpura in Children
Authors: Glanz Jason , France Eric , Xu Stan , Hayes Taru , Hambidge Simon
Published: February 2008

OBJECTIVE. The objective of this study was to identify risk factors for developing chronic idiopathic thrombocytopenic purpura in a cohort of pediatric patients with idiopathic thrombocytopenic purpura.

METHODS. We conducted a retrospective cohort analysis of 259 children who were diagnosed with idiopathic thrombocytopenic purpura between 1991 and 2000 at 1 of 8 managed care organizations that comprise the Vaccine Safety Datalink. We reviewed the charts of 595 potential patients with idiopathic thrombocytopenic purpura from the 8 Vaccine Safety Datalink sites and excluded patients with known causes of thrombocytopenia. Chronic idiopathic thrombocytopenic purpura was defined as having thrombocytopenia for 6 months beyond the initial diagnosis. The risk for developing chronic idiopathic thrombocytopenic purpura was assessed using simple and multivariable analyses.

RESULTS. Of the 259 cases of idiopathic thrombocytopenic purpura, 197 (76%) were acute, 60 (23%) were chronic, and 2 (1%) could not be determined. Among the acute cases, the mean duration of illness was 22 days. There was 1 serious bleeding outcome in the cohort. In multivariable regression analysis, the patients with chronic illness were older, less likely to present with mucosal bleeding, less likely to have had an acute illness before diagnosis, and more likely to present with a platelet count >20000/μL than children with acute idiopathic thrombocytopenic purpura. In particular, children whose illness was diagnosed at ≥10 years of age and who had platelet counts ≥20000/μL had an approximate fivefold risk for progressing to chronic disease when compared with children who presented at ≤2 years of age with platelet counts <20000/μL.

CONCLUSIONS. Although idiopathic thrombocytopenic purpura tends to be a benign and self-limited condition, acute and chronic idiopathic thrombocytopenic purpura seem to be distinct illnesses defined by age, platelet count, bleeding symptoms, and the presence of acute illness before diagnosis. Physicians should be aware of these differences when advising their patients and families.
Breastfeeding Helps Explain Racial and Socioeconomic Status Disparities in Adolescent Adiposity
Authors: Woo Jessica G. , Dolan Lawrence M. , Morrow Ardythe L. , Geraghty Sheela R. , Goodman Elizabeth
Published: February 2008

OBJECTIVES. Studies suggest that breastfeeding is protective for later obesity; however, this association has not held among all racial and socioeconomic status groups. Racial and socioeconomic status differences in breastfeeding behavior have also been noted. In this study, we formally test whether breastfeeding mediates the relationship between race and socioeconomic status with adolescent adiposity.

METHODS. Data were analyzed from 739 black and white 10- to 19-year-old adolescents who participated in a large, school-based study. Parents provided information on parental education, used to measure socioeconomic status, and whether the child was breastfed as an infant. BMI was used to measure adolescent adiposity and was analyzed as a continuous measure (BMI z score) using linear regression and categorically (BMI ≥85th and ≥95th percentile) using logistic regression.

RESULTS. Black adolescents and those without a college-educated parent were less likely to have been breastfed for >4 months. Race and parental education were each independent predictors of BMI z score and of having BMI ≥85th percentile or BMI ≥95th percentile. When added to the model, being breastfed for >4 months was also independently associated with lower BMI z score and lower odds of having BMI ≥85th percentile or BMI ≥95th percentile. Inclusion of being breastfed for >4 months resulted in a 25% decrease in racial and parental education differences in adolescent BMI z score, supporting partial mediation.

CONCLUSIONS. Having been breastfed for >4 months was associated with lower adolescent BMI z score and lower odds of having a BMI ≥85th percentile or BMI ≥95th percentile, independent of race or parental education. Furthermore, these analyses suggest that being breastfed for >4 months partially explains the relationship between social disadvantage and increased adiposity. Increasing breastfeeding duration could result in lower adolescent adiposity for all racial and socioeconomic status groups and potentially minimize socioeconomic disparities in adiposity.
Efficacy of Cognitive Behavioral Therapy for Adolescents With Chronic Fatigue Syndrome: Long-term Follow-up of a Randomized, Controlled Trial
Authors: Knoop Hans , Stulemeijer Maja , de Jong Lieke W. A. M. , Fiselier Theo J. W. , Bleijenberg Gijs
Published: February 2008

OBJECTIVES. The purpose of this work was to assess the long-term outcome of adolescents with chronic fatigue syndrome who received cognitive behavioral therapy and to determine the predictive value of fatigue severity and physical impairments of the adolescent and the fatigue severity of the mother at baseline for the outcome of the treatment at follow-up.

PATIENTS AND METHODS. Sixty-six adolescent patients with chronic fatigue syndrome who previously participated in a randomized, controlled trial that showed that cognitive behavioral therapy was more effective than a waiting-list condition in reducing fatigue and improving physical functioning were contacted for a follow-up assessment. Fifty participants of the follow-up study had received cognitive behavioral therapy for chronic fatigue syndrome (32 formed the cognitive behavioral therapy group in the original trial, and 18 patients received cognitive behavioral therapy after the waiting period). The remaining 16 patients had refused cognitive behavioral therapy after the waiting period. The main outcome measures were fatigue severity (Checklist Individual Strength), physical functioning (Short-Form General Health Survey), and school attendance.

RESULTS. Data were complete for 61 patients at follow-up (cognitive behavioral therapy group: 47 patients; no-treatment group: 14 patients). The mean follow-up time was 2.1 years. There was no significant change in fatigue severity between posttreatment and follow-up in the cognitive behavioral therapy group. There was a significant further increase in physical functioning and school attendance (10% increase). The adolescents in the cognitive behavioral therapy group were significantly less fatigued and significantly less functionally impaired and had higher school attendance at follow-up than those in the no-treatment group. Fatigue severity of the mother was a significant predictor of treatment outcome.

CONCLUSIONS. The positive effects of cognitive behavioral therapy in adolescents with chronic fatigue syndrome are sustained after cognitive behavioral therapy. Higher fatigue severity of the mother predicts lower treatment outcome in adolescent patients.
A Guide for Monitoring Child Development in Low- and Middle-Income Countries
Authors: Ertem Ilgi O. , Dogan Derya G. , Gok Canan G. , Kizilates Sevim U. , Caliskan Ayliz , Atay Gulsum , Vatandas Nilgun , Karaaslan Tugba , Baskan Sevgi G. , Cicchetti Domenic V.
Published: February 2008

OBJECTIVE. In low- and middle-income countries, methods for clinicians to address difficulties in language, social-emotional, cognitive, behavioral, or neuromotor development during early childhood are lacking. To fill this gap, we designed, in Turkey, the Guide for Monitoring Child Development, which aims to aid clinicians in monitoring and supporting child development and the early detection and management of developmental difficulties. The Guide for Monitoring Child Development monitoring component is a practical, open-ended interview that catalyzes communication between clinicians and caregivers and obtains a portrayal of the child's development. We report on the development and psychometric properties of the Guide for Monitoring Child Development monitoring component for children aged 0 to 24 months.

METHODS. We examined the ages of attainment of Guide for Monitoring Child Development milestones and internal consistency in a cross-sectional study of healthy children receiving well-child care (study 1). In 2 clinical samples, we studied the interrater reliability between medical students and a child development specialist administering the guide (study 2), as well as the concurrent validity of the guide administered during a health visit and a comprehensive developmental assessment (study 3).

RESULTS. In study 1 (N = 510), item-total scale correlations ranged from 0.28 to 0.91. An age-dependent attainment pattern was seen in all of the milestones. In study 2 (N = 92), interrater reliability between medical-student pairs and between the child development specialist and students was high (kappa scores were 0.83–0.88). In study 3 (N = 79), the sensitivity, specificity, and positive and negative predictive values were 0.88, 0.93, 0.84, and 0.94, respectively.

CONCLUSIONS. The Guide for Monitoring Child Development is an innovative method for monitoring child development that is designed specifically for use by health care providers in low- and middle-income countries. Studies in Turkey provide preliminary evidence for its reliability and validity.
Beyond the “Big Talk”: The Roles of Breadth and Repetition in Parent-Adolescent Communication About Sexual Topics
Authors: Martino Steven C. , Elliott Marc N. , Corona Rosalie , Kanouse David E. , Schuster Mark A.
Published: February 2008

OBJECTIVE. Most studies of parent-adolescent communication about sexuality focus on the frequency of communication without distinguishing between the breadth of topics covered and repetition. The goal of this study was to assess the independent influence of breadth and repetition of sexual discussion on adolescents' perceptions of their relationship and communication with their parents.

METHODS. Data came from 312 adolescents who, along with their parents, were control participants in a randomized, controlled trial to evaluate a worksite-based intervention designed to improve parent-adolescent sexual communication. Adolescents completed surveys before the intervention (time 1) and at 1 week, 3 months, and 9 months after the intervention (times 2, 3, and 4, respectively). At each survey, adolescents reported whether they had discussed each of 22 sex-related topics with their parent. Breadth was defined as the number of topics discussed for the first time between times 1 and 4, and repetition was defined as the number of previously discussed topics repeated during that period.

RESULTS. Adolescents whose sexual communication with their parents involved more repetition felt closer to their parents, felt more able to communicate with their parents in general and about sex specifically, and perceived that discussions with their parents about sex occurred with greater openness than did adolescents whose sexual communication with their parents included less repetition. Breadth of communication was associated only with the perceived ease of parent-adolescent sexual communication: adolescents who discussed more new topics with their parents between times 1 and 4 felt that their sexual discussions occurred with greater openness than did adolescents who discussed fewer topics.

CONCLUSIONS. Clinicians may want to advise parents about the value of discussing sexual topics repeatedly with their children, because this may provide parents an opportunity to reinforce and build on what they have taught their children and provide children the opportunity to ask clarifying questions as they attempt to put their parents' sexual education into practice.
Residual stress and microstructure of as-deposited and annealed, sputtered yttria-stabilized zirconia thin films
Authors: Quinn David J. , Wardle Brian , Spearing S. Mark
Published: February 2008

The microstructure and residual stress of sputter-deposited yttria-stabilized zirconia (YSZ) films are presented as a function of thickness (5–1000 nm), deposition pressure (5–100 mTorr), and post-deposition temperature. The as-deposited residual stress of YSZ ranges from −1.4 GPa to 100 MPa with variations in sputtering conditions. Transitions from compressive to tensile stress are identified with variations in working pressure and film thickness. The origins and variations in as-deposited stress are determined to be from tensile stress due to grain coalescence/growth, and compressive stresses are due to forward sputtering/“atomic peening” of target atoms. The evolution of residual stress with post-deposition annealing shows a tensile stress hysteresis of up to 1 GPa for films deposited at low working pressures. This hysteresis is believed to be due to crystallization and the diffusive relief of compressive stresses initially generated by atomic peening during deposition. Discussion and evaluation of other common residual stress mechanisms are presented throughout.
REMO4 (RE = Y, Gd; M = Nb, Ta) phosphors from hybrid precursors: Microstructure and luminescence
Authors: Xiao Xiuzhen , Yan Bing
Published: February 2008

In this paper, YNbO4:0.05Tb3+ and GdTaO4:0.05Eu3+ phosphors were chosen to study the influence of the firing temperature on the phase and morphologies using novel modified in situ chemical coprecipitation technology. Results show that until the temperature reaches 1000 °C, the formation of YNbO4 and GdTaO4 were realized; with the increasing firing temperatures, those samples present better crystalline structure and better morphologies. The luminescent properties of Eu3+ and Tb3+ have shown that after calcinations at 1000 °C, the intensity of Eu3+ and Tb3+ increases strongly with the increasing of the calcinations temperature, while remaining relatively unchanged at the temperatures ranging between 600 and 800 °C. Furthermore, other rare earth ion doped GdTaO4 and Y1−xGdxTaO4:5 mol% Eu3+ with the different yttrium content were also synthesized after calcinating at the preferable temperature using the same method. The photoluminescence of Y1−xGdxTaO4:5 mol% Eu3+ revealed that the red emission intensity of Eu3+ increases with the increasing of gadolinium content, indicating that Gd ion plays an important role in the energy transfer process. Also, the concentration quenching has been studied in the GdTaO4:Eu3+/Dy3+ systems. Moreover, the characteristic emission lines of Tb3+, Pr3+, and Er3+ in GdTaO4 were observed, showing that the energy transfer process appears between host and those activators.
A multiscale model applied to ionic polymer stiffness prediction
Authors: Gao Fei , Weiland Lisa M.
Published: February 2008

A multiscale modeling approach applied to the stiffness prediction of polymers with high cross-link density is discussed. The material of focus in this work is the ionic polymer Nafion®. The approach applies rotational isomeric state theory in combination with a Monte Carlo methodology to develop a simulation model for polymer chain conformation. From this a large number of end-to-end chain lengths between cross links are generated; the probability density function of these lengths is estimated with the most appropriate Johnson family method. This estimation is used in a Boltzmann statistical thermodynamics approach to the multiscale prediction of stiffness. This work addresses the importance of the simulated polymer chain length in the generation of stable predictions. The multiscale prediction is found to be physically reasonable; the approach has the potential of serving as a first-order prediction tool for properties that are experimentally difficult or impossible to measure.
Dynamic annealing of defects in irradiated zirconia-based ceramics
Authors: Devanathan Ram , Weber William J.
Published: February 2008

We have observed efficient damage recovery in large-scale molecular dynamics simulations of 30 keV Zr recoils in pure zirconia and yttria-stabilized zirconia, which is in stark contrast to radiation damage accumulation in zircon. Dynamic annealing is highly effective in zirconia during the first 5 ps of damage evolution, especially in the presence of oxygen structural vacancies. This results in near-complete recovery of damage. Damage recovery on the cation sublattice is assisted by the anion sublattice recovery, which explains the remarkable radiation tolerance of stabilized zirconia. Ceramics engineered to heal themselves in this fashion hold great promise for use in high-radiation environments or for safely encapsulating high-level radioactive waste over geological time scales.
Ex vivo transcriptional profiling of human pancreatic islets following chronic exposure to monounsaturated fatty acids
Authors: Bikopoulos George , da Silva Pimenta Aurelio , Lee Simon C , Lakey Jonathan R , Der Sandy D , Chan Catherine B , Ceddia Rolando Bacis , B Wheeler Michael , Rozakis-Adcock Maria
Published: February 2008

The aim of this study was to assess the effects of chronic free fatty acid (FFA) exposure on gene expression and the functional state of human pancreatic islets. Chronic exposure of islets to oleate (OA) resulted in a significant reduction in glucose-stimulated insulin secretion (GSIS) compared with control (466±82 vs 234±57 ng/μg DNA, P<0.05). OA treatment also led to reduction in total insulin content of the islets (17 609±3816 vs 10 599±3876 ng insulin/μg DNA) and to an increase in the rate of reactive oxygen species (ROS) generation. Interestingly, the suppressive effects of OA on biosynthesis and secretion of insulin were accompanied by alteration in the expression of 40 genes, as determined by microarray analysis and subsequent qPCR validation. The majority of genes regulated by OA encoded metabolic enzymes. The expression of enzymes involved in oxidative defense was elevated, indicating a link between ROS generation and antioxidant defense activation. Additionally, pretreatment of human islets with OA led to a significant increase (30%) in the rate of oxidation of this fatty acid and to a significant decrease (75%) in glucose oxidation. Importantly, individual analysis of gene clusters from the islets of all donors revealed the induction of genes involved in inflammation and immunity, which provides further evidence that FFA are risk factors for the development of type 2 diabetes. In summary, our data indicate that chronic exposure of human islets to FFA activates inflammatory and metabolic pathways that lead to oxidative stress, reduced β-cell insulin content, and inhibition of GSIS.
Endoplasmic reticulum stress is involved in myocardial apoptosis of streptozocin-induced diabetic rats
Authors: Li Zhenhua , Zhang Tao , Dai Hongyan , Liu Guanghui , Wang Haibin , Sun Yingying , Zhang Yun , Ge Zhiming
Published: February 2008

Apoptosis plays a critical role in the diabetic cardiomyopathy, and endoplasmic reticulum stress (ERS) is one of the intrinsic apoptosis pathways. Previous studies have shown that the endoplasmic reticulum becomes swollen and dilated in diabetic myocardium, and ERS is involved in heart failure and diabetic kidney. This study is aimed to demonstrate whether ERS is induced in myocardium of streptozotocin (STZ)-induced diabetic rats. We established a type 1 diabetic rat model, used echocardiographic evaluation, hematoxylin–eosin staining, and the terminal deoxynucleotidyl transferase-mediated DNA nick-end labeling staining to identify the existence of diabetic cardiomyopathy and enhanced apoptosis in the diabetic heart. We performed immunohistochemistry, western blot, and real-time PCR to analyze the hallmarks of ERS that include glucose-regulated protein 78, CCAAT/enhancer-binding protein homologous protein (CHOP) and caspase12. We found these hallmarks to have enhanced expression in protein and mRNA levels in diabetic myocardium. Also, another pathway that can lead to cell death of ERS, c-Jun NH2-terminal kinase-dependent pathway, was also activated in diabetic heart. Those results suggested that ERS was induced in STZ-induced diabetic rats' myocardium, and ERS-associated apoptosis occurred in the pathophysiology of diabetic cardiomyopathy.
Thyroid hormone receptor β2 is strongly up-regulated at all levels of the hypothalamo–pituitary–thyroidal axis during late embryogenesis in chicken
Authors: Grommen Sylvia V H , Arckens Lutgarde , Theuwissen Tim , Darras Veerle M , De Groef Bert
Published: February 2008

In this study, we tried to elucidate the changes in thyroid hormone (TH) receptor β2 (TRβ2) expression at the different levels of the hypothalamo–pituitary–thyroidal (HPT) axis during the last week of chicken embryonic development and hatching, a period characterized by an augmented activity of the HPT axis. We quantified TRβ2 mRNA in retina, pineal gland, and the major control levels of the HPT axis – brain, pituitary, and thyroid gland – at day 18 of incubation, and found the most abundant mRNA content in retina and pituitary. Thyroidal TRβ2 mRNA content increased dramatically between embryonic day 14 and 1 day post-hatch. In pituitary and hypothalamus, TRβ2 mRNA expression rose gradually, in parallel with increases in plasma thyroxine concentrations. Using in situ hybridization, we have demonstrated the presence of TRβ2 mRNA throughout the diencephalon and confirmed the elevation in TRβ2 mRNA expression in the hypophyseal thyrotropes. In vitro incubation with THs caused a down-regulation of TRβ2 mRNA levels in embryonic but not in post-hatch pituitaries. The observed expression patterns in pituitary and diencephalon may point to substantial changes in TRβ2-mediated TH feedback active during the perinatal period. The strong rise in thyroidal TRβ2 mRNA content could be indicative of an augmented modulation of thyroid development and/or function by THs toward and after hatching. Finally, THs proved to exert an age-dependent effect on pituitary TRβ2 mRNA expression.
Chemical Warfare and Medical Response During World War I
Authors: Fitzgerald Gerard J.
Published: February 2008

The first large-scale use of a traditional weapon of mass destruction (chemical, biological, or nuclear) involved the successful deployment of chemical weapons during World War I (1914–1918). Historians now refer to the Great War as the chemist’s war because of the scientific and engineering mobilization efforts by the major belligerents. The development, production, and deployment of war gases such as chlorine, phosgene, and mustard created a new and complex public health threat that endangered not only soldiers and civilians on the battlefield but also chemical workers on the home front involved in the large-scale manufacturing processes. The story of chemical weapons research and development during that war provides useful insights for current public health practitioners faced with a possible chemical weapons attack against civilian or military populations.
Getting Beyond “Don’t Ask; Don’t Tell”: an Evaluation of US Veterans Administration Postdeployment Mental Health Screening of Veterans Returning From Iraq and Afghanistan
Authors: Seal Karen H. , Bertenthal Daniel , Maguen Shira , Gima Kristian , Chu Ann , Marmar Charles R.
Published: February 2008

Objectives. We sought to evaluate outcomes of the Veterans Administration (VA) Afghan and Iraq Post-Deployment Screen for mental health symptoms.

Methods. Veterans Administration clinicians were encouraged to refer Iraq or Afghanistan veterans who screened positive for posttraumatic stress disorder, depression, or high-risk alcohol use to a VA mental health clinic. Multivariate methods were used to determine predictors of screening, the proportions who screened positive for particular mental health problems, and predictors of VA mental health clinic attendance.

Results. Among 750 Iraq and Afghanistan veterans who were referred to a VA medical center and 5 associated community clinics, 338 underwent postdeployment screening; 233 (69%) screened positive for mental health problems. Having been seen in primary care (adjusted odd ratio [AOR]=13.3; 95% confidence interval [CI]=8.31, 21.3) and at a VA community clinic (AOR=3.28; 95% CI=2.03, 5.28) predicted screening. African American veterans were less likely to have been screened than were White veterans (AOR=0.45; 95% CI=0.22, 0.91). Of 233 veterans who screened positive, 170 (73%) completed a mental health follow-up visit.

Conclusions. A substantial proportion of veterans met screening criteria for co-occurring mental health problems, suggesting that the VA screens may help overcome a “don’t ask, don’t tell” climate that surrounds stigmatized mental illness. Based on data from 1 VA facility, VA postdeployment screening increases mental health clinic attendance among Iraq and Afghanistan veterans.