bluuebunny/crossref_metadata_2025 huggingface dataset:
Toxicity of Ototopical Drugs: Animal Modeling
Authors: Morizono Tetsuo
Published: January 2017

It is important to be aware of the potential ototoxicity of any drug, vehicle, or antiseptic that is used in the middle ear. Frequently used ear drops (Cortisporin otic suspension, Coly-Mycin S Otic, and VōSoL otic solution) were studied for their ototoxicity. Compound action potentials were measured before and at 1, 2, and 24 hours following drug application on the round window membranes of chinchillas. Each drug was applied for 10 minutes and then was removed by rinsing. The sound pressure in decibels sound pressure level that produced a compound action potential amplitude of 10 μV was defined as the threshold. The change in threshold was interpreted as hearing loss. On the basis of the short-term results at 24 hours following drug application, the ototoxicity of Coly-Mycin was calculated to be twice that of Cortisporin, and the ototoxicity of VōSoL four times that of Cortisporin.
Manual for Use of Montgomery® Laryngeal, Tracheal, and Esophageal Prostheses: Update 1990
Authors: Montgomery William W. , Montgomery Stuart K.
Published: January 2017

This manual is designed to instruct the surgeon, the nurse, and, directly or indirectly, the patient on the updated usage of prostheses involved with reconstructive surgery of the larynx, trachea, and esophagus. The silicone tracheal Safe-T-Tube has been modified in an attempt to prevent its being displaced posteriorly into the trachea. The silicone tracheal cannula can be used in place of a tracheotomy tube unless there is aspiration or positive pressure breathing is required. Its success with sleep apnea has been especially gratifying. The salivary bypass tube and the esophageal tube continue to be of use in treating fistulas, strictures, and reconstruction of the cervical esophagus. The laryngeal keel and stent are described and illustrated for use with reconstructive surgery of the larynx.
Pathogenesis of Experimental Otitis Media with Effusion Caused by a Combination of Eustachian Tube Dysfunction and Immunosuppression
Authors: Fujtta Akihiko , Kurata Kyosuke , Takahashi Haruo , Honjo Iwao
Published: January 2017

Inflammatory factors appear to play an important role in the development of otitis media with effusion (OME). However, otitis media experimentally induced by endotoxin injection or secondary immunoresponse was not persistent. In order to produce refractory OME, two pathologic conditions were necessarily combined: tubal ventilatory dysfunction and suppression of the immunologic defense mechanism by immunosuppressive drugs. In the presence of these two pathologic conditions, all cases that evidenced negative middle ear pressure due to tubal dysfunction developed OME. In the control group with either tubal dysfunction or immunosuppression alone, only 1 of 20 ears developed OME. Transtubal infection due to negative middle ear pressure caused by tubal ventilatory dysfunction may be one of the most important etiologic factors in OME.
Immunologic Characteristics of Cytokines in Otitis Media with Effusion
Authors: Himi Tetsuo , Suzuki Toshio , Takezawa Hiroyuki , Kodama Hiroyuki , Kataura Akikatsu
Published: January 2017

Levels of cytokines, interleukin (IL)–1α, IL-1β, tumor necrosis factor (TNF), and granulocyte-macrophage colony-stimulating factor (GM-CSF) were investigated in samples of the middle ear effusions (MEEs) from 144 ears with otitis media with effusion (OME) by enzyme-linked immunosorbent assay, followed by cytologic analysis. Middle ear effusions of the acute purulent type contained a significantly higher concentration of cytokines compared with normal control sera (p < .001). Cytokines were observed at lower levels in MEE in adults than in children. Tests of children at the chronic stage of MEE showed higher levels of TNF than IL-1 and GM-CSF. Meanwhile, IL-1β showed significantly higher concentrations in acute purulent types than in serous and mucoid types (p < .01). In cytologic analysis, the mean level of IL-1β was significantly higher in the neutrophil-rich group than in other groups (p < .05). Cytokines possess several biologic properties, some of which are associated not only with acute otitis media but also with chronic otitis media. This study showed that cytokines, especially IL-1β, contribute to infiltration into the middle ear by inflammatory cells. This implies that the persistent presence of cytokines in MEE could be a factor in prolonged OME.
Neutrophil Elastase and its Complex with Alpha1-Antitrypsin in the Pathogenesis of Chronic Suppurative Otitis Media
Authors: Hamaguchi Yukiyoshi , Sakakura Yasuo
Published: January 2017

Neutrophil elastase (NE) and its complex with α1-antitrypsin were quantified in ear discharges from 15 patients with chronic suppurative otitis media (CSOM), and their levels were compared to those in middle ear effusions from 10 pediatric patients with chronic otitis media with effusion (OME). The localization of immunoreactive NE was also examined by immunocytologic study. The mean value of total NE was 161.8 ± 29.5 μg/mL in CSOM, which was significantly higher than that in OME (16.5 ± 6.7 μg/mL). The mean value of NE–α1-antitrypsin complex was 13.7 ± 8.8 μg/mL in CSOM and 7.8 ± 4.0 μg/mL in OME. There was no significant difference between culture-positive and culture-negative samples in CSOM. Immunoreactive NE could be observed in the neutrophils of ear discharges, and extracellular release of NE was also observed. Ear discharges in CSOM contain a considerable amount of uncomplexed NE, of which the level does not depend on active bacterial infections. Uncomplexed NE seems to play a role in the chronicity of CSOM.
Distribution of Immunocompetent Cells in the Endolymphatic Sac
Authors: Kawauchi Hideyuki , Kaneda Noritsugu , Ichimiya Issei , Mogi Goro
Published: January 2017

To better understand the role of immunocompetent cells in the defense mechanism of the inner ear, the distribution patterns of those cells were investigated in the endolymphatic sac (ES) of mice maintained in three different conditions: germ-free (GF), specific pathogen—free (SPF), and conventional (CV). In another experiment, the recruitment of lymphocyte subsets was examined in the ES of SPF rats undergoing a perilymphatic antigen challenge after systemic presensitization. In the ES of GF mice, no immunocompetent cells were found. In the ES of SPF and CV mice, cells positive for IgG, IgA, IgM, and Lyt-1 were present in much smaller numbers than in the nasal mucosa. Cells positive for Lyt-2 were not seen in the ES of any mice. In the ES of rats that underwent a perilymphatic antigenic stimulation after a systemic presensitization, B lymphocyte subsets (positive for IgG, IgA, IgM) were mobilized in increased numbers, and T cell subsets (helper/inducer and suppressor) were also found 1 week after perilymphatic antigen challenge. These results taken together suggest that the ES is not originally equipped to possess immunocompetent cells and mount an immune response, but that once it has been activated with the inner ear antigenic stimuli, the ES can be the active site of a local immune response of the inner ear.
Cochlear and Renal Pathology in the Autoimmune Strain Mouse
Authors: Tago Chiaki , Yanagita Noriyuki
Published: January 2017

This study was designed to investigate the role of immunologic mechanisms in sensorineural hearing disorders and the relationship between inner ear and renal disorders. Autoimmune strain (NZB/kl) mice, in which autoimmune disease can be spontaneously induced, were used in this study. The mice were tested for acoustic brain stem responses, cochlear and renal disorders, and circulating immune complex serology by means of enzyme immunoassay. Pathologic studies consisted of observation of tissue changes following hematoxylin and eosin staining and indirect immunofluorescence staining under light microscopy. Compared to controls, the hearing was impaired in NZB/kl mice. Indirect fluorescence staining showed immunoglobulin G deposits in the stria vascularis. There was a correlation between the degree of hearing impairment and the severity of stria vascularis lesions. The NZB/kl mouse can provide a model for sensorineural hearing disorders secondary to immunologic disorders.
Cochlear Pathology in Presbycusis
Authors: Schuknecht Harold F. , Gacek Mark R.
Published: January 2017

A survey of the temporal bone collection at the Massachusetts Eye and Ear Infirmary reveals 21 cases that meet the criterion for the clinical diagnosis of presbycusis. It is evident that the previously advanced concept of four predominant pathologic types of presbycusis is valid, these being sensory, neural, strial, and cochlear conductive. An abrupt high-tone loss signals sensory presbycusis, a flat threshold pattern is indicative of strial presbycusis, and loss of word discrimination is characteristic of neural presbycusis. When the increments of threshold loss present a gradually decreasing linear distribution pattern on the audiometric scale and have no pathologic correlate, it is speculated that the hearing loss is caused by alterations in the physical characteristics of the cochlear duct, and the loss is identified as cochlear conductive presbycusis. It is clear that many individual cases do not separate into a specific type but have mixtures of these pathologic types and are termed mixed presbycusis. About 25% of all cases of presbycusis show none of the above characteristics and are classified as indeterminate presbycusis.
Prolonged Intubation Injuries of the Larynx: Endoscopic Diagnosis, Classification, and Treatment
Authors: Benjamin Bruce
Published: January 2017

Laryngeal trauma from prolonged endotracheal intubation occurs in patients of all ages. Most changes are superficial and heal quickly. Injuries that are found consistently during intubation include nonspecific changes, edema, granulation tissue, ulceration, and other miscellaneous injuries. In this paper significant, severe, and lasting trauma of the larynx has been classified on the basis of the known factors in pathogenesis, observations made at endoscopy, and photographic documentation. This classification has required introduction of new descriptive terminology: “tongues of granulation tissue,” “ulcerated troughs,” “healed furrows,” and “healed fibrous nodule.” During intubation the degree of injury can be precisely assessed under general anesthesia by using telescopes for image magnification, thus assisting a decision whether to continue intubation or perform tracheotomy to minimize long-term morbidity. Changes that are found after extubation result from granulation tissue, ulceration, or a combination of both and have been illustrated on flow charts; a knowledge and understanding of these sequelae allows them to be identified by both indirect and direct laryngoscopy so that treatment can be planned.
New Developments in Treating Otitis Media
Authors: Paparella Michael M. , Schachern Patricia
Published: January 2017

Treatment of otitis media has changed over time as the disease has become better understood and as clinical experience and technology have expanded and grown. Successful treatment depends on accurate definitions and classifications of types of otitis media. An awareness of the pathogenic and pathologic correlates of otitis media enhances accurate diagnosis and improves the results of treatment. An understanding of the otitis media continuum also assists in management. On the basis of studies largely emanating from the University of Minnesota's Otitis Media Pathogenesis Research Program, we here highlight definitions, classifications, and diagnosis of the otitis medias, and medical treatments of these various clinical and pathologic entities and their sequelae.
Surgical Advances in Treating Otitis Media
Authors: Paparella Michael M. , Froymovich Oleg
Published: January 2017

Surgical methods of treating otitis media and its sequelae are discussed, according to the classification of otitis media presented in an earlier report Surgical management of otitis media with effusion and recurrent purulent otitis media includes myringotomy and use of ventilation tubes. Occasionally, otitis media with effusion will lead to structural and other pathologic changes in the middle ear, and conservative treatments such as use of medication or tubes will not suffice. Indications and methods for exploratory tympanotomy and reconstruction of the middle ear are discussed. In such instances, tympanoplasty can be used to the patient's benefit Chronic otitis media with mastoiditis, defined by the presence of intractable pathologic tissue, generally requires surgical correction. Classic methods include simple mastoidectomy, modified radical (Bondy) mastoidectomy, and radical mastoidectomy. Current classifications of procedures would also include closed-cavity tympanomastoidectomy, open-cavity tympanomastoidectomy, and intact-bridge tyrnpanomastoidectomy (a combined approach). The diagnostic and surgical approach to silent or subclinical otitis media is discussed. Diagnosis and treatment of sequelae of otitis media, including sequelae in the middle ear and, less commonly, in the inner ear, are discussed.
Adenoidectomy for Otitis Media with Effusion
Authors: Gates George A.
Published: January 2017

The efficacy of adenoidectomy in the surgical treatment of children with otitis media with effusion (OME) persisting after adequate medical therapy has been established in three independent randomized clinical trials. Although each of these studies used a different experimental design, all showed significant reductions in morbidity from ome after adenoidectomy as compared to the control groups. Subsequent application of these findings in formulating clinical guidelines for the use of adenoidectomy has yet to be realized, and recommendations to parents for or against the procedure appear to vary more with the surgeon's philosophy than with the condition of the child. This discussion examines the effectiveness and cost of adenoidectomy for the treatment of children with chronic OME and addresses the question of whether adenoidectomy should be used as a primary or a secondary surgical therapy. The argument is made to use adenoidectomy as a primary therapy in selected cases on the basis of patient age, type of OME, and patient preference, and to base the decision not on the size of the adenoid, but on its known pathophysiology.
Implantation of the Clarion® Cochlear Implant in an Ossified Cochlea
Authors: Harker Lee A. , Gentile Natalie , Veazey Deborah , McCleary Elizabeth
Published: January 2017

This report describes the successful implantation of the CLARION® Multi-Strategy™ Cochlear Implant electrode in the totally ossified cochlea of a 5-year-old child via a radical mastoidectomy approach. Postoperatively, the child demonstrated responses to auditory stimuli, even though the electrode array contacted only bone and muscle graft tissue with no visible evidence of nerve fibers or cochlear lumen. Responses to sound did not begin to emerge until 10 weeks following initial stimulation and improved slowly over time. Although the child's postoperative auditory performance is more limited than that of most implanted children, she derives substantially more benefit from her implant than she did from conventional hearing aids.
Multichannel Cochlear Implantation in Children with Large Vestibular Aqueduct Syndrome
Authors: Harker Lee A. , Vanderheiden Scott , Gentile Natalie , Veazey Deborah , McCleary Elizabeth
Published: January 2017

This study examined the postoperative performance of multichannel cochlear implantation in children with severe-to-profound sensorineural hearing loss secondary to large vestibular aqueduct syndrome. Five children between ages 4 and 13 years who had large vestibular aqueducts confirmed by computed tomography scans underwent implantation of a CLARION® Multi-Strategy™ Cochlear Implant between January 1995 and June 1996 at Boys Town National Research Hospital. In addition to preoperative evaluations, they were examined postoperatively with their implants on a battery of open-set speech recognition tests at 3, 6, 12, and 18 months following initial stimulation. Results indicated a noticeable improvement in open-set speech recognition within the first 3 months of implant use compared to preimplant performance with hearing aids. All 5 patients demonstrated substantial benefit from their implants, but there was variation among the children in the rate and amount of improvement in speech recognition skills.
Electrically Evoked Potentials Recorded in Adult and Pediatric Clarion® Implant Users
Authors: Firszt Jill B. , Chambers Ron D. , Rotz Lee Ann , Novak Michael A.
Published: January 2017

The purpose of this study was to record electrical auditory brain stem responses (EABRs) and electrical middle latency responses (EMLRs) in the clinic from 3 adult CLARION® Multi-Strategy™ Cochlear Implant subjects and to record EABRs in the operating room from 3 pediatric subjects. For 2 of the 3 adult subjects, EABR thresholds were within the subject's behavioral dynamic range, whereas 1 adult subject's EABR thresholds were either absent or, when present, exceeded the upper limit of the dynamic range. For this subject, EMLRs were absent or of poor morphology for the channels tested. Moreover, this subject was not able to understand speech in an open-set, auditory-only format. The EABR thresholds obtained with children were within the behavioral dynamic range for 2 of the 3 subjects, but exceeded comfortable loudness levels for 1 subject. Although the EABR thresholds were measured at stimulus levels that were audible for all subjects, the relationship of the EABR threshold levels to behavioral measures of loudness varied. Evoked potentials that originate more centrally, such as the EMLR, should be investigated further to determine the possible relationship to postimplant performance.
Using Electrically Evoked Auditory Reflex Thresholds to Fit the Clarion® Cochlear Implant
Authors: Hodges Annelle V. , Dolan-Ash Shelly , Butts Stacy , Balkany Thomas J.
Published: January 2017

This paper describes a method for measuring electrically elicited auditory reflex thresholds (EARTs) in young children who use the CLARION® Multi-Strategy™ Cochlear Implant. The EART is an objective measure that can guide the fitting of a cochlear implant in individuals who are unable to perform behavioral tasks required to program the device. Reflexes were obtained in 11 of 17 pediatric Clarion users. The EART current level indicated a point at which an auditory percept was present and the sound was loud, but not uncomfortable. The EART then was used as a basis for conditioning behavioral responses, and as a guideline for setting most comfortable loudness levels.
Speech Perception of Young Children Using Nucleus 22-Channel or Clarion® Cochlear Implants
Authors: Young Nancy M. , Carrasco Vincent N. , Grohne Kristine M. , Brown Carolyn
Published: January 2017

This study compares the auditory perceptual skill development of 23 congenitally deaf children who received the Nucleus 22-channel cochlear implant with the SPEAK speech coding strategy, and 20 children who received the CLARION® Multi-Strategy™ Cochlear Implant with the Continuous Interleaved Sampler (CIS) speech coding strategy. All were under 5 years old at implantation. Preimplantation, there were no significant differences between the groups in age, length of hearing aid use, or communication mode. Auditory skills were assessed at 6 months and 12 months after implantation. Postimplantation, the mean scores on all speech perception tests were higher for the Clarion group. These differences were statistically significant for the pattern perception and monosyllable subtests of the Early Speech Perception battery at 6 months, and for the Glendonald Auditory Screening Procedure at 12 months. Multiple regression analysis revealed that device type accounted for the greatest variance in performance after 12 months of implant use. We conclude that children using the CIS strategy implemented in the Clarion implant may develop better auditory perceptual skills during the first year postimplantation than children using the SPEAK strategy with the Nucleus device.
Speech Production Results in Children Implanted with the Clarion® Implant
Authors: Brown Carolyn , McDowall Deborah W.
Published: January 2017

Speech production changes were examined in 24 profoundly hearing-impaired children following implantation with the CLARION® Multi-Strategy™ Cochlear Implant. All study participants were implanted below the age of 6, and with 1 exception, the children were congenitally deaf, with little or no auditory experience prior to implantation. A within-subjects design was used in which the children's preoperative speech skills with hearing aids were compared to postoperative performance with the Clarion after 3 and 6 months of implant use. Production skills were evaluated with a measure designed specifically to assess hearing-impaired children's spontaneous use of early developing phonological patterns in words. The results revealed significant improvement over time in 8 of the 9 speech features examined. The greatest improvement occurred between the 3- and 6-month postoperative intervals, with more limited improvement evident between the preimplant and 3-month time periods. The results demonstrate that significant improvements occur in speech production skills in very young children with congenital deafness after they have used current implant technology for a relatively limited amount of time.
Specific Language Growth in Young Children Using the Clarion® Cochlear Implant
Authors: Bollard Priscilla M. , Popp Amy , Chute Patricia M. , Parisier Simon C.
Published: January 2017

General and specific language growth was evaluated in 10 children who had received the CLARION® Multi-Strategy™ Cochlear Implant during the clinical trial. The mean age at implantation was 37 months, and the children were followed for 18 months thereafter. Language comprehension and use were assessed with the Peabody Picture Vocabulary Test, the Reynell Developmental Language Scales, and mean length of utterance (MLU). The mean vocabulary scores indicated a 42-month increase in 18 months. The mean language comprehension increased from 20.4 to 40.8 months, and language use increased from 21.5 to 38.1 months. The mean MLU increased from 1.8 words to 4.8 words during the test period. Results indicated the children learned language at the same rate as their hearing peers of the same language age (except for vocabulary, which was faster), but retained a language delay relative to their hearing peers of the same chronological age.
Universal Modular Glottiscope System: The Evolution of a Century of Design and Technique for Direct Laryngoscopy
Authors: Zeitels Steven M.
Published: January 2017

Since Kirstein introduced formal direct examination (autoscopy) of the glottis in 1895, a great number of laryngoscopes have been produced to view the vocal folds; however, none have had universal appeal. The primary goals for the designs have been to optimize exposure and to facilitate instrumentation of the glottis. An analysis of more than 50 laryngoscopes was done to assess key design characteristics that would ideally be present in a laryngoscope for optimally viewing the musculomembranous vocal folds. The Pro/Engineer and Pro/Mechanica computer programs were used to model the universal modular glottiscope. This new laryngoscope comprises a plurality of specially designed examining tubes that are bivalved proximally to improve utilization of hand instrumentation, and form a single tube distally to achieve internal distention of the supraglottal tissues. The distal lumen has an arcuate isosceles-triangular conformation to optimally expose the glottis. The base of the tube is detachable for the difficult intubation or the placement of bronchoscopes. The examining tubes vary in size and dimension to accommodate the diversity of human anatomy. The tubes are easily attachable to and detachable from an ergodynamically designed universal handle that can be joined to fulcrum laryngoscope holders or suspension gallows. The universal modular glottiscope evolved from the selective integration of optimal 20th-century design modifications of Kirstein's original autoscope. This new laryngoscope is ideally suited for phonomicrosurgery as well as for difficult intubation.
Analysis of Randomised Block Experiments when Treatments have Different Errors
Authors: Ghosh M. N. , Behari Vinod
Published: January 2017

1. Summary

The theory of linear estimation, when groups of variables have unequal variances was devoloped in Ghosh (1961). Usual least square estimates were shown to possess an optimum property and methods were given for obtaining confidence intervals for linear functions of parameters. Simplified procedures for obtaining such confidence intervals will be considered here and applied to the case of randomised block experiments.
Inference on the Occurrence/Exposure Rate with Mixed Censoring Models
Authors: Rao C. Radhakrishna , Tu D. S.
Published: January 2017

ABSTRACT:

There are many kinds of measures of risk rate for a disease. In this paper we consider one of them known as the occurrence/exposure rate. We use a sample from a mixed censoring model to estimate this risk rate. The asymptotic properties of the empirical risk rate is discussed. The classical asymptotic and bootstrap methods are employed to construct confidence intervals for the theoretical risk rates. The results of this paper are useful in medical research.

AMS Subject Classfications: 62E20, 62GOS, 62G15, 62P10.
Association Schemes, Orthogonal Arrays and Codes from Non‐Degenerate Quadrics and Hermitian Varieties in Finite Projective Geometries
Authors: Chakravarti I. M.
Published: January 2017

ABSTRACT:

In this paper, coexistence of and relations between association schemes, orthogonal arrays and certain families of projective codes have been examined. The projective codes considered are linear spans of a nice projective set P in a hyperplane H = PG ( N -1, s)-such as a quadric or a quadric with its nucleus of polarity or a Hermitian variety. There are two ways to construct association schemes from a projective code. One due to Delsarte (1973) considers the restriction of the Hamming scheme to the code with m weights and if it satisfies Delsarte's condition, an m-class association scheme is obtained by defining two codewords to be i-th associates if the Hamming distance between them is i, i = 0, 1, …, m. The alternative approach, first used by Ray-Chaudburi (1959) and later generalized by Mesner (1967) is to classify points (according to some geometrical criterion) in H = PG(N-1, s) with reference to P. into m types (say). Then, two points of the affine space EG( N, s) (for which H is the hyperplane at infinity) are defined to be i-th associates if the line joining the two points meet H at a point of type i, i = 1, …, m. In many cases, the two association schemes defined with respect to the same projective set have the same parameters. But Examples are given where they do not coincide and, in fact, there are cases where one scheme exists but the other does not.
Decision‐Theoretic Estimation of the Product of Gamma Scales and Generalized Variance
Authors: Rukhin Andrew L. , Sinha Bimal K.
Published: January 2017

ABSTRACT:

The estimation of the product of scale parameters on the basis of n independent gamma distributed variables with known degrees of freedom is considered, Under squared error and entropy loss functions it is shown that the best equivariant estimator is admissible for n = 2, 3 and inadmissible for n ≥ 4. It follows that in the estimation problem cf generalized variance on the basis of a multivariate normal random sample with uriknown mean, the best multiple of the sample generalized variance is inadmissible if the dimension exceeds three and admissible within a well defined subclass of estimates if the dimension does not exceed three.
Estimation of Body Sites Temperatures From Tympanic Measurements
Authors: Fraden Jacob , Lackey Robert P.
Published: January 2017

For many years, measurement of body temperature in routine medical practice was limited to oral, rectal and axillary sites. Recent introduction of infrared non-contact thermometers for the auditory canal requires the establishing of temperature relationships between the ear and more traditional thermometry sites. Since an auditory canal is exposed to the environment, the infrared readings from it are influenced by ambient temperature. A linear model of thermal gradients in the vicinity of an ear canal allows us to find simple formulas connecting temperatures taken from the ear with those from traditional core sites like bladder or pulmonary artery, in addition to rectal and oral. The formulas contain environment coupling coefficients. Their values have been found experimentally by measuring body temperatures from subjects in a walk-in environmental chamber and from multiple clinical studies. The derived coefficients are used in the Thermoscan™ PRO-1 Instant Thermometer to calculate core, oral and rectal equivalent temperatures.
The Pathophysiology of Enuresis in Children and Young Adults
Authors: Nørgaard Jens Peter , Djurhuus Jens Christian
Published: January 2017

Bedwetting is the most common urologic complaint among children. Wetting frequency at age 7 years varies from 5% to 15%. Treatment has been multimodal: drugs to depress bladder activity, increase urethral resistance, or modulate sleep; electrophysiologic treatment; and, recently, urine production modulation. All of these approaches reflect a lack of sufficient knowledge of the underlying pathophysiology of nocturnal enuresis. Over the last 13 years, enuresis studies at the Institute of Experimental Clinical Research, the University of Aarhus, Denmark, have focused on sleep disturbances, bladder reservoir function, urine output, and a combination of the three. Sleep studies indicate that: enuretic patients are normal sleepers; the voiding characteristics of an enuretic episode are similar to those of voluntary voiding during the day; and enuresis can take place during any stage of sleep, but generally occurs when the bladder is filled to the equivalent of maximal daytime functional capacity. Bladder reservoir capacity appears to be normal and bladder instability an unimportant factor in the pathology of nocturnal enuresis. However, enuretic patients have been shown to lack the normal nocturnal increase in antidiuretic hormone levels and had nocturnal urine production up to four times the volume of functional bladder capacity, which explains the need for bladder emptying. These findings open new avenues to the approach to treatment based on antidiuretic therapy.
Concomitant Nonpharmacologic Therapy in the Treatment of Primary Nocturnal Enuresis
Authors: Miller Kenneth
Published: January 2017

Some 5 to 7 million children in the United States suffer from primary nocturnal enuresis (PNE). Although the majority of parents do not seek medical evaluation and treatment for their children with PNE, physicians usually prescribe pharmacotherapy for this condition. Several nonpharmacologic treatment modalities also are available, including bladder-stretching exercises, behavioral therapy, hypnotherapy, and elimination diets. Motivational counseling, another technique, should be a component of all PNE treatment programs. Although none of the methods offers effective resolution of nighttime incontinence in all children, combining methods increases the probability of treatment success and encourages compliance without risk to the child. Required in any program is the active participation of the patient and his or her family and the guidance, education, and reinforcement provided by the physician. Although the health-care professional may have to devote considerable time to help the patient, successful treatment may prevent the development of potentially serious psychosocial effects.
Nordic and World Economic-Political Cooperation: Competition, Adaptation or Participation?
Authors: Sjöstedt Gunnar
Published: January 2017

The world economic-political system seems to be in a process of structural change. To some observers these developments are producing an increasing need for an expanded Nordic cooperation in the area of trade and international economic affairs. One manifestation of this has been the calls for the establishment of a true home market for Scandinavian exporting firms. The desirable, or predicted, future changes in forms and contents of Nordic cooperation should, however, not be considered in isolation. They have to be systematically inter-related to the modifications which are expected to occur in the systems for economic-political cooperation in Western Europe, as well as at the global level, in which Scandinavian countries participate: the EC, EFTA, OECD, GATT, etc. This comprehensive perspective is all the more important because institutionalized economic-political cooperation seems to have entered into a process of structural reform with possible far-reaching consequences. In order to pave the way for a strategic and comprehensive cost/benefit evaluation of Nordic cooperation in the future, a tentative model has been developed for the definition and assessment of the various types of relationships that may exist between Nordic cooperation and other forms of inter-related systems for economic-political collaboration. This "linkage analysis" is undertaken within two contexts: First, a number of theoretical propositions concerning the "anatomy" of institutionalized economic-political cooperation. Secondly, for the sake of empirical illustration, a concrete case: the demand for international cooperation pertaining to the formulation and conduct of Swedish trade policy.
Soviet Foreign Policy towards Her European Allies: Interests and Instruments
Authors: Neumann Iver B.
Published: January 2017

Neumann, I. B. Soviet Foreign Policy towards Her European Allies: Interests and Instruments. Cooperation and Conflict, XXIII, 1988, 215-229.

The aim of this article is to construct a taxonomy for possible Soviet interests towards the CMEA 6, then to discuss what foreign policy instruments the Soviet Union disposes of, and finally to assess whether Soviet instruments are capable of fulfilling Soviet interests. Soviet interests are far-reaching. She wants to have the CMEA 6 as a buffer against aggression, and to prevent CMEA 6 complicity in invasion. Her role as the leader of one of the two main military alliances in the world underlines her status as a superpower. At home, the legitimacy of the communist regime is enhanced by there being other countries which employ the Soviet model. Effective Soviet foreign policy instruments are indeed limited. The military instruments at her disposal can only be used at very high political cost, whereas economic subsidies make up an economic cost. The Soviet Union still depends critically on the actual use of force and on the threat of use of force in her relations with the CMEA 6. As the long-term costs of using military foreign policy instruments are considerable, the prospects for Soviet interest fulfilment towards the CMEA 6 are poor.
Accuracy of Teacher Referrals of Speech Handicapped Children
Authors: James Harriett P. , Cooper Eugene B.
Published: January 2017

This study investigated the ability of 30 third grade teachers to identify speech handicapped children and the extent to which this ability was related to the type and/or the severity of the speech problem. Results indicated that classroom teachers identified approximately two out of five children with speech problems; however, teachers referred four out of five children whose speech problems were severe enough to warrant therapy. The percentage of accurate referrals tended to rise as the severity of the disorder increased. These results, when considered with those obtained in similar studies, may be interpreted two ways: (a) teachers consistently fail to identify a large percentage of speech handicapped children, and (b) therapists' judgments as to what constitutes a speech problem are unnecessarily severe.
Who are the Retarded?
Authors: Garrison Mortimer , Hammill Donald D.
Published: January 2017

Eleven year old children in educable (N=378) and regular (N=319) classes from the five county greater Philadelphia area were compared on the Slosson Intelligence Test for Children and Adults, an adaptation of the Test of Social Inference, an adaptation of the Temple Informal Reading Inventory, and the Auditory Reception and Verbal Expression subtests from the 1968 Illinois Test of Psycholinguistic Abilities. The distributions for the total sample were converted into T scores, and the children scoring above and below a T score of 45 (equivalent in our data to an IQ of 75) on each of the variables were identified. Applying Jastak and his colleagues' concept of multiple criteria suggests that 25 percent of the children in educable classes may be misplaced since they scored above the cutting point on at least four of the five criteria. Only 31 percent of those in the educable classes failed either four or five of the five criteria. The combination of a reading problem and a lower IQ is highly associated with educable placement. The findings support efforts to place most children found in educable classes into the regular classroom through the use of tutoring and resource rooms.
Changing Role Perceptions for Parents of Handicapped Children
Authors: Meadow Kathryn P. , Meadow Lloyd
Published: January 2017

Socialization to the role of parent of a handicapped child is usually a traumatic and conflict producing experience. There are both instrumental (technical) and expressive (emotional) aspects of this role change which need resolution. The agents of socialization, such as doctors, teachers, social workers, and handicapped adults, play an important role in the socialization process. The transition in role perception is also influenced by the socioeconomic status, age, religion, and physical characteristics of the parents and by the sex and birth order of the child. An understanding of the influence of these factors should assist the agents of socialization in helping parents and in turn be beneficial to the handicapped child in making an effective adjustment to his handicap.
An Investigation of Teacher Expectancies of Instructional Materials
Authors: Bogatz Boris E.
Published: January 2017

This study investigated the possibility that a teacher's preconceived notion of the worth of an instructional material would affect the academic achievement of the children with whom the material was used. Participating teachers were provided with materials accompanied by fictitious evaluative summaries deliberately prepared to bias their opinion in either a positive or negative direction. Analyses of students' pretest and posttest mean scores suggest that the impression a teacher holds of an instructional material may significantly influence subsequent academic achievement. Results also indicate that a teacher's impression of the material may be significantly influenced by the evaluative activities of Special Education Instructional Materials Centers.
Learning and Behavior Disorders: A Longitudinal Study
Authors: Rubin Rosalyn , Balow Bruce
Published: January 2017

In a survey of school learning and behavior problems manifested in a longitudinal study population of 967 children in kindergarten through third grade, it was found that 41 percent of the subjects (50 percent of the boys and 31 percent of the girls) were classified in one or more of the following categories: (a) special class placement, (b) retention, (c) receipt of special services, and (d) problems of behavior and attitude. Special placement or services had been instituted for 24.3 percent of the study population. Since previous testing yielded essentially normal scores on measures of school readiness, language development, and intelligence, the large proportion of educationally relevant problems identified raises serious questions regarding the ability of our present educational system to adequately accommodate the broad range of individual differences found within the typical school population.
Learning Deficiency Versus Developmental Conceptions of Mental Retardation
Authors: Iano Richard P.
Published: January 2017

Descriptions of the mentally retarded and educational recommendations based on learning deficiency concepts are criticized, and an alternative developmental view of mental retardation is proposed. The educational consequences of learning deficiency and developmental views of mental retardation are contrasted.
Computer Aided Analysis of Turbine Blade Vibration Test Data
Authors: N-Nagy F. L. , Taylor S. R.
Published: January 2017

A pilot system has been developed which automatically scans and evaluates experimental vibration data obtained from a test rig replica of a bladed wheel of a turbine in service. High vibration amplitude signals are selected for further analysis. This data is converted into digital form using an analogue to digital converter and is processed in a digital computer suitably programmed for harmonic analysis. The results are plotted on a Campbell Diagram using an on-line digital X-Y plotter which gives a visual record of the most salient information from the tests in a readily interpreted form. The paper describes the equipment used, the method of converting the analogue-type signals to digital form, analyses the accuracy of the conversion method, and gives the reasons for undertaking such vibration analysis.
Lie-Proof Measurements: The Multiple Binary Philosophy of the ‘Hydrastep’ Boiler Water Level Gauge
Authors: Hasler E. F. , Martin R. E.
Published: January 2017

The philosophy is presented of multiple binary measurement, an approach capable of providing simultaneously the desiderata of ‘self-validation’, ‘fail-safe’ and ‘fail-operative’. The systems described continually examine the validity of their outputs such that any measurement malfunction causing an error greater than a predetermined and insignificant value automatically raises an alarm.

The systems use a series of binary measurements, each individually derived and each arranged to operate at a small increment of the chosen parameter above the previous measurement: the value of one increment thus represents the maximum tolerance of an instrument. Maloperation of any one binary channel will cause an alarm, either immediately or when the parameter reaches that value dependent on its position in the sequence, to proclaim that it is telling a lie. This applies for either direction of failure, and in conjunction with a suitable display the error is located while the other portions continue their functions unimpaired.

A reference is included of the Hydrastep boiler water level gauge, which has received statutory approval in the UK as a sole gauge for high-pressure boilers, and is one example of a group of instruments conforming to this philosophy.
Boilers and Steam Distribution Systems; Aspects for Simulation
Authors: Martin E. N.
Published: January 2017

In the Institute News section of our last issue, a Call for Papers was published for a conference on ‘Simulating Boilers and Steam Distribution Systems' organised by the Teesside Section and to be held at the Cleveland Scientific Institution, Middlesbrough, on 6 December this year. This article surveys many areas where simulation can be profitable. The papers called for should illuminate some of the problems covered in this article.
Measurement of Electrostatic Charge and Electrical Resistance in a Flat Belt Drive
Authors: Bear J. H. F. , Palmer R. S. J.
Published: January 2017

The article describes measurements of electrical resistance made in accordance with BS 2050 on samples of flat belts under the specified static conditions and compares them with electrostatic measurements taken under dynamic (service) conditions using a probe specially developed by the authors for the purpose.
ISIbus — Fieldbus for High-Speed Communication
Authors: McKenna F , Landet H , Raad B
Published: January 2017

Recently a new concept has been demonstrated and offered to the international standardization bodies as a solution for the physical layer in the forthcoming fieldbus standard. This solution is based on a rugged and environmentally resistant connection method — inductive coupling. Through combining high data rates and power transfer to field devices operating in hazardous areas, this concept is a major contribution to the fieldbus concept.
Shielding Effectiveness of EMI Gasketed Joints
Authors: Kunkel G M
Published: January 2017

EMI gaskets are used extensively by the electrical/electronic engineering community to assist in inhibiting the flow of radiated electromagnetic fields into and out of electronic equipment. Shielding effectiveness tests are used extensively by the manufacturers of EMI gaskets to grade their products. The assumption made by the design engineering community is that the shielding effectiveness as presented in the data is what they will receive in their equipment. This assumption is not true due to the errors associated with the shielding effectiveness testing of the gaskets where errors of as much as 80 dB (10 000 times) can be represented. The paper describes briefly the problems associated with the shielding effectiveness test methods currently used and provides a detailed method of calculating the shielding effectiveness of an EMI gasketed joint using transfer impedance test data.
Microprocessor-Based Protection Systems
Authors: Reeve Alan
Published: January 2017

A report on the symposium for microprocessor-based control systems, sponsored by the Institute of Measurement and Control and the Health and Safety Executive (HSE), held in London on 12th December 1991.
Dynamics of India's Strategic Environment
Authors: Bandyopadhyaya Jayantanuja
Published: January 2017

India's strategic environment has undergone significant changes in recent years, especially in the seventies. From the point of view of Indian foreign policy, the strategic environment and its dynamics can be studied in three different spheres: (1) the global strategic environment, particularly consisting of the strategic confrontation between the United States and its allies on the one hand and the Soviet Union and its allies on the other; (2) the immediate strategic environment, consisting mainly of Pakistan and China; and (3) the intermediate strategic environment, consisting of the non-aligned movement and the Third World. Needless to say, there is considerable and inevitable overlap and feedback among these three spheres of the strategic environment. They are, nevertheless, conceptually and operationally different spheres. The purpose of this article is to analyse the recent changes in these three different spheres of our strategic environment and the implications of these changes for our foreign policy in the foreseeable future.
Sex Differences in Childhood Bullying Victimization and Trajectories of Substance Use From Adolescence to Adulthood
Authors: Connolly Eric J.
Published: January 2017

Recent research has found that repeated bullying victimization increases the risk of developing several unhealthy habits later in life including periodic substance use. Comparatively less research, however, has examined whether the association between bullying victimization and developmental growth in substance use is different for males and females. The present study addressed this gap in the literature by analyzing data from the National Longitudinal Survey of Youth 1997. Results from a series of sex-specific latent growth curve models reveal that bullied males experience faster increases in cigarette and marijuana use from adolescence to young adulthood compared to non-bullied males, while bullied females experience faster increases in cigarette use compared to non-bullied females. Bullied males also experience slower declines in cigarette and marijuana use from adolescence to middle adulthood, while bullied females experience slower declines in alcohol and cigarette use. Implications of these findings for research on sex differences in bullying victimization and developmental patterns of substance use are discussed.