bluuebunny/crossref_metadata_2025 huggingface dataset:
The efficacy of morphine and Entonox analgesia during chest drain removal in children
Authors: BRUCE ELIZABETH , FRANCK LINDA , HOWARD RICHARD F.
Published: November 2005

Background:  Morphine is commonly used for chest drain removal pain, although a few studies in adults suggest that inhalation agents may be effective for this procedure. Little is known about chest drain removal pain and its management in children.

Methods:  Three separate studies were carried out at a large tertiary pediatric hospital to examine the characteristics and management of chest drain removal pain in children. Study 1 examined the prevalence and clinical characteristics of pain and analgesic practices in 135 nonventilated children aged 1 week to 18 years having chest drains removed. Study 2 was an observation study to determine the efficacy and safety of self‐administered Entonox (50% nitrous oxide and oxygen) for chest drain removal pain in 30 children aged 7–18 years. Study 3 was a pilot randomized controlled trial comparing intravenous morphine and continuous flow Entonox for chest drain removal pain in 14 children aged 3.5 months to 2.75 years.

Results:  In study 1, the prevalence of moderate to severe pain during chest drain removal was 76%. Morphine was commonly given preprocedure, but the dose varied considerably. In study 2, children experienced a significant increase in pain during the procedure compared with preprocedure pain at rest, despite receiving Entonox, morphine and/or diclofenac. However, procedure pain was no worse than preprocedure pain during movement or deep breathing. A few minor side effects occurred, which resolved spontaneously. In study 3, no differences were found in pain between the two treatment groups. Children experienced moderate to severe pain during the procedure, despite receiving Entonox or morphine.

Conclusions:  Morphine or Entonox alone are unlikely to provide adequate analgesia for chest drain removal pain in children. More research is needed to determine the most effective interventions for this procedure.
Randomized controlled trial comparing the laryngeal tube and the laryngeal mask in pediatric patients
Authors: BORTONE LUCIANO , INGELMO PABLO M. , NINNO GESÙ DE , TOSI MICHELA , CAFFINI LAURA , TRENCHI JUNA , MERGONI MARIO , MARTORANA FABIO
Published: November 2005

Background:  The laryngeal tube (LT) is a supraglottic ventilatory device used in adults. However, there is limited information about LT use in pediatric patients. This randomized controlled study compares LT with laryngeal mask (LMA) for airway management during spontaneous or assisted ventilation and during fiberoptic laryngoscopy in children.

Methods:  Thirty children under 10‐years old, ASA I–II, scheduled for minor general surgery, Mallampati score I–II, fasted and premedicated were included. Patients with upper respiratory infection, craniofacial malformation, intracranial hypertension, emergency surgery were excluded. The primary outcome measure was the proportion of patients in whom effective spontaneous or assisted ventilation [Vt ≥ 4 ml·kg−1, SpO2 ≥ 95% with FiO2 0.4, PECO2≤7.2 kPa (55 mmHg)] was achieved after 3 min of LT or LMA cuff inflation. The secondary endpoint was the proportion of patients in whom fiberoptic laryngoscopy resulted in identification of the vocal cords.

Results:  Eleven children with LMA and two children in LT group had adequate spontaneous or assisted ventilation after initial positioning (P < 0.01). After head extension or device repositioning 15 of 15 patients in LMA group had adequate ventilation compared with 11 of 15 patients in LT group (P < 0.05). The vocal cords could be observed with fiberoptic laryngoscopy in 11 LMA group patients compared with no patients in the LT group (P < 0.001).

Conclusions:  The LT is less effective than the LMA to allow adequate spontaneous or assisted ventilation and for fiberoptic evaluation of the airway in children under 10 years old.
Futility and inappropriate care in pediatric intensive care: a cross‐sectional survey
Authors: VEMURI GOPI , PLAYFOR STEPHEN DEREK
Published: November 2005

Background : Over recent years, there have been increasing concerns regarding an increase in the number of futile and inappropriate admissions to pediatric intensive care units (PICUs) in the United Kingdom (UK).

Methods : A prospective cross‐sectional survey was carried out using a data collection form distributed by mail to the directors of all PICUs in the UK. Respondents were asked to give details of all patients on their unit on a specific day including age, reason for admission and any preexisting medical conditions. An assessment was made by respondents of whether the care being provided in each case was, in their opinion, appropriate, futile or inappropriate according to standard definitions.

Results : We received responses from 21 units (68%) who reported the details of 111 patients. Care was felt to be appropriate in 88 of these cases (79%), futile in nine cases (8%) and inappropriate in 14 cases (13%). Futile cases were most commonly admitted with respiratory failure and all had preexisting medical conditions, most commonly developmental delay. Where care was felt to be inappropriate, respiratory failure was again the most common reason for admission and all had a preexisting medical condition, most commonly cardiovascular disease.

Conclusions : The care being provided in 21% of the PICU cases, described in this study, was felt to be either futile or inappropriate by the directors of those units. There is an urgent need to, accurately, establish the resource consumption associated with these patients and to establish a standard approach to futility and inappropriate care in PICU in the UK.
The revised FLACC observational pain tool: improved reliability and validity for pain assessment in children with cognitive impairment
Authors: MALVIYA SHOBHA , VOEPEL‐LEWIS TERRI , BURKE CONSTANCE , MERKEL SANDRA , TAIT ALAN R.
Published: November 2005

Background:  Difficulty with pain assessment in individuals who cannot self‐report their pain poses a significant barrier to effective pain management. However, available assessment tools lack consistent reliability as pain measures in children with cognitive impairment (CI). This study evaluated the validity and reliability of the revised and individualized Face Legs Activity Cry and Consolability (FLACC) behavioral pain assessment tool in children with CI.

Methods:  Children with CI scheduled for elective surgery were studied. The FLACC was revised to include specific descriptors and parent‐identified, unique behaviors for individual children. The child's ability to self‐report pain was evaluated. Postoperatively, two nurses scored pain using the revised FLACC scale before and after analgesic administration, and, children self‐reported a pain score, if able. Observations were videotaped and later viewed by experienced nurses blinded to analgesic administration.

Results:  Eighty observations were recorded in 52 children aged 4–19 years. Twenty‐one parents added individualized pain behaviors to the revised FLACC. Interrater reliability was supported by excellent intraclass correlation coefficients (ICC, ranging from 0.76 to 0.90) and adequate κ statistics (0.44–0.57). Criterion validity was supported by the correlations between FLACC, parent, and child scores (ρ = 0.65–0.87; P < 0.001). Construct validity was demonstrated by the decrease in FLACC scores following analgesic administration (6.1 ± 2.6 vs 1.9 ± 2.7; P < 0.001).

Conclusions:  Findings support the reliability and validity of the FLACC as a measure of pain in children with CI.
Propofol anesthesia in spontaneously breathing children undergoing magnetic resonance imaging: comparison of two propofol emulsions
Authors: GUTMANN ANTON , PESSENBACHER KLAUS , GSCHANES ANDREA , EGGENREICH UDO , WARGENAU MANFRED , TOLLER WOLFGANG
Published: November 2005

Background:  This study evaluated a propofol‐based anesthesia regimen with spontaneous breathing in pediatric patients scheduled for magnetic resonance imaging (MRI).

Methods:  In this prospective, randomized, double‐blind study propofol formulated with long‐chain triglycerides (LCT) and mixed medium‐chain/long‐chain triglycerides (MCT/LCT) were used. Ninety patients aged 2.4 months to 7.3 years were premedicated with intravenous midazolam. Lidocaine was injected prior to propofol to reduce injection pain. Anesthesia was induced and maintained by propofol. Glycopyrronium bromide was administered for saliva reduction. Hemodynamics, blood oxygen saturation and endtidal capnography were continuously monitored. All patients received additional oxygen. The aggregated propofol dose for induction and maintenance of anesthesia was analyzed for therapeutic equivalence. Incidence of injection pain, laboratory safety values, vital signs, and the adverse event profile were analyzed to compare tolerability and safety.

Results:  Propofol anesthesia was safe and successful in all children. Both propofol formulations were equivalent regarding dose requirements (mean induction and maintenance doses for anesthesia 2.0–4.0 mg·kg−1 and 6.0–8.8 mg·kg−1·h−1 respectively; aggregated doses 8–13.26 mg·kg−1). There were no differences in drug safety such as hemodynamics, spontaneous breathing, injection pain, and laboratory values. Duration of induction and of recovery from anesthesia were short and all examinations were completed with minimal interruption.

Conclusions:  Propofol‐based short‐term anesthesia was well suited for anesthesia during MRI procedures in the studied pediatric patients. There were no clinically relevant differences between the two propofol formulations.
Evaluation of knowledge and anxiety level of patients visiting the colorectal pelvic floor clinic
Authors: Coolen J. C. G. , Florisson J. M. G. , Bissett I. P. , Parry B. R.
Published: November 2005

Objective  Discussing defaecating disorders is difficult for patients and many view anal physiology investigations (ultrasound, manometry, electromyography and pudendal nerve studies) as distasteful. This pilot study sought to assess whether present information sheets supplied to patients and the visit to the colorectal Pelvic Floor Clinic itself influenced patients' knowledge and anxiety.

Patients and methods  Thirty Pelvic Floor Clinic patients from Auckland City Hospital were included. Each patient filled in a questionnaire before and after the clinic. This included objective questions about their knowledge of the structure and function of the pelvic floor and satisfaction with and understanding of the information sheet. Both visual analogue scale (VAS) and multiple choice questions (MCQ) were used. Their subjective and objective knowledge were compared. Anxiety was assessed on a visual analogue anxiety scale (VAAS). Results were expressed as VAS scores or percentage correct and relationships were tested using Fisher's Exact test and paired T‐test.

Results  Subjective knowledge increased in 93% of the patients. The doctor's explanation led to a greater increase in subjective knowledge than the information sheet (35/100 mm, P < 0.001 and 10/100 mm, P = 0.01, respectively). Subjective improvement in knowledge did not however, translate into an increase in objective knowledge (P = 0.63). The information sheet was read by 87% of the patients. The information sheet had reduced anxiety only in 23% of the patients and increased in 10%. Anxiety levels were not significantly influenced by the information sheet, but reduced significantly by the clinic visit in 87% of patients (P < 0.001). The mean anxiety level reduced from 44/100 to 12/100 after the clinic visit.

Conclusion  Anxiety levels are high in those visiting the Pelvic Floor Clinic. It appears that it is the interaction with the doctor that has a profound influence on anxiety levels and subjective knowledge rather than written information.
Aetiology and surgical management of toxic megacolon
Authors: Ausch C. , Madoff R. D. , Gnant M. , Rosen H. R. , Garcia‐Aguilar J. , Hölbling N. , Herbst F. , Buxhofer V. , Holzer B. , Rothenberger D. A. , Schiessel R.
Published: November 2005

Objective  The purpose of this article is to review the surgical management and outcome of toxic megacolon and to update the aetiology of toxic megacolon.

Patients and method  A retrospective chart review of three academic colorectal surgery units was undertaken. Over a period of 20 years, 70 patients with surgically managed toxic megacolon were identified: 32 men and 38 women, median age 63 years (range, 23–87 years).

Results  In 33 (48%) patients the main cause of toxic megacolon was inflammatory bowel disease. Thirty‐seven (52%) patients had toxic megacolon of different aetiology. Sixty‐three patients underwent colonic resection: 49 (70%) subtotal colectomies and 14 (20%) total colectomies, including 4 (6%) proctocolectomies. Seven (10%) patients had decompression (n = 3) or faecal diversion (n = 4) only. Forty‐four of the resected patients underwent a Hartmann's procedure and an ileostomy; 13 (19%) patients had primary anastomoses, 11 (16%) ileorectal anastomoses (IRA) and 2 (3%) patients had ileal pouch‐anal anastomosis (IPAA). Twenty‐six (37%) patients subsequently had continuity restored. Total surgical complication rate was 19% (n = 13), 8% (n = 4) in patients treated with subtotal colectomy, 21% (n = 3) in patients treated with total proctocolectomy and 86% (n = 6) in patients treated with either decompression or diversion. The total mortality rate was 16% (n = 11).

Conclusions  Toxic colitis complicated by toxic megacolon can occur after various diseases of the colon and remains a life‐threatening disorder associated with a significant risk of postoperative complications. Subtotal colectomy with ileostomy remains the procedure of choice. Surgical colonic decompression with faecal diversion alone is associated with a high rate of complications.
Ultrastructure of the spermatozoon of Apus apus (Linnaeus 1758), the common swift (Aves; Apodiformes; Apodidae), with phylogenetic implications
Authors: Jamieson Barrie G. M. , Tripepi Sandro
Published: November 2005

The spermatozoon of Apus apus is typical of non‐passerines in many respects. Features shared with palaeognaths and the Galloanserae are the conical acrosome, shorter than the nucleus; the presence of a proximal as well as distal centriole; the elongate midpiece with mitochondria grouped around an elongate distal centriole; and the presence of a fibrous or amorphous sheath around the principal piece of the axoneme. The perforatorium and endonuclear canal are lost in A. apus as in some other non‐passerines. All non‐passerines differ from palaeognaths in that the latter have a transversely ribbed fibrous sheath whereas in non‐passerines it is amorphous, as in Apus, or absent. The absence of an annulus is an apomorphic but homoplastic feature of swift, psittaciform, gruiform and passerine spermatozoa. The long distal centriole, penetrating the entire midpiece, is a remarkably plesiomorphic feature of the swift spermatozoa, known elsewhere only in palaeognaths. The long centriole of Apus, if not a reversal, would be inconsistent with the former placement of the Apodiformes above the Psittaciformes from DNA–DNA hybridization. In contrast to passerines, in A. apus the microtubules in the spermatid are restricted to a transient single row encircling the cell. The form of the spermatozoon fully justifies the exclusion of swifts from the passerine family Hirundinidae.
Morpho‐anatomical differences of the Early Cambrian Chengjiang and Recent lingulids and their implications
Authors: Zhang Zhifei , Shu Degan , Han Jian , Liu Jianni
Published: November 2005

Since the publication of Darwin's theory of evolution in 1859, lingulids have probably been the most widely quoted examples of arrested evolution. This, to some degree, may be because few anatomical features are impressed either on or inside valves so these may not adequately reflect the extent of change incurred during lingulid evolution. Two lingulid brachiopods, Lingulella chengjiangensis and Lingulellotreta malongensis, from the Early Cambrian Chengjiang Lagerstätte (Yunnan, South China) show preservation of a series of soft parts, notably the lophophores, setae mantle canals and perfectly impressed visceral region, which are vital to understanding the evolution and lifestyle of brachiopods. Analysis of the valve interiors favours the claim that an epifaunal mode of life could be a plesiomorphic state in contrast to the infaunal one of modern lingulids. Based on these fossils, the three‐pseudosiphon formation of setae found in Recent lingulids is proposed to be an apomorphy derived as an adaptation to an infaunal lifestyle. Comparison between the interior of the fossils with that of modern lingulids does little to support the widespread notion that the morphology of this lineage has remained remarkably constant since at least the early Palaeozoic.
Gonadal morphology and reproductive traits of the Amazonian fish Arapaima gigas (Schinz, 1822)
Authors: Godinho Hugo P. , Santos José E. , Formagio Paulo S. , Guimarães‐Cruz Rodrigo J.
Published: November 2005

An account of gonadal morphology and reproductive traits of the Amazonian arapaimatid, Arapaima gigas (Schinz 1822), is given. The only functional ovary (left) was foliaceous in shape having the ventral surface without an ovarian capsule. The absence of the ovarian capsule ventral portion, absence of oviduct and funnel‐shaped coelomic cavity are features that imply that oocytes are freed in the coelomic cavity before being shed to the aquatic environment through a genital papilla. The only functional testis (left) was cord‐like with a maximum diameter of 1–1.5 cm and was connected to the genital papilla through a spermatic duct. Size at sexual maturity was 145–154 cm and 115–124 cm, total length class, for females and males, respectively.
A predictive tool for the self‐management of diabetes (Librae): evaluation using a continuous glucose monitoring system
Authors: Franklin V. L. , Wilson A. W. , Butler R. A. , Greene S. A.
Published: November 2005

Aims  Diabetes self‐management involves a difficult balancing act between insulin, food and exercise. The challenge is to develop innovative, validated algorithms to aid patient decision‐making and optimize glycaemic control. ‘Librae’ is a computerized diabetes simulator in diary format, developed as an educational predictive tool for patients, reducing ‘trial and error’ by allowing patients to simulate and experiment with dietary or insulin adjustments on a ‘body double’. We have evaluated the predictive ability of Librae using continuous blood glucose monitoring (CGMS).

Methods  Patients with Type 1 Diabetes attending the Paediatric Clinic were invited to use ‘Librae’ for 1 week and were then fitted with a CGMS for 72 h. The predictive ability of ‘Librae’ was compared with concurrent data obtained from the CGMS.

Results  Seven thousand nine hundred and sixty paired blood glucose values were obtained from the 11 patients who completed the study. ‘Librae’ underestimated the measured CGMS values, the error having a positive mean of 0.35 mmol/l (95% confidence interval 0.22–0.48 mmol/l). However, Librae tended to overestimate at low levels of blood glucose readings, and underestimate at high levels of blood glucose readings.

Conclusion  The modelled values of ‘Librae’ correlated well with the CGMS data, but clinically unacceptable errors occurred at extremes of blood glucose levels. Concurrent CGMS recordings have provided a large data set to modify and improve the existing Librae model and patient feedback has led to improvements in its usability. Librae may provide a useful tool to improve diabetes self‐management education and optimize glycaemic control.
Evidence for a Gene-Environment Interaction in Predicting Behavioral Inhibition in Middle Childhood
Authors: Fox Nathan A. , Nichols Kate E. , Henderson Heather A. , Rubin Kenneth , Schmidt Louis , Hamer Dean , Ernst Monique , Pine Daniel S.
Published: November 2005

Gene-environment interactions are presumed to shape human behavior during early development. However, no human research has demonstrated that such interactions lead to stable individual differences in fear responses. We tested this possibility by focusing on a polymorphism in the promoter region of the gene for the serotonin transporter (5-HTT). This polymorphism has been linked to many indices of serotonin activity. Specifically, we tested the hypothesis that an interaction between children's 5-HTT status and maternal reports of social support predicts inhibited behavior with unfamiliar peers in middle childhood. Results were consistent with this hypothesis: Children with the combination of the short 5-HTT allele and low social support had increased risk for behavioral inhibition in middle childhood.
Pronouns in Marital Interaction
Authors: Simmons Rachel A. , Gordon Peter C. , Chambless Dianne L.
Published: November 2005

Recent studies in social psychology have found that the frequency of certain words in people's speech and writing is related to psychological aspects of their personal health. We investigated whether counts of “self” and “other” pronouns used by 59 couples engaged in a problem-solving discussion were related to indices of marital health. One spouse in each couple had a diagnosis of obsessive-compulsive disorder or panic disorder with agoraphobia; 50% of the patients and 40% of their spouses reported marital dissatisfaction. Regardless of patients' diagnostic status, spouses who used more second-person pronouns were more negative during interactions, whereas those who used more first-person plural pronouns produced more positive problem solutions, even when negative behavior was statistically controlled. Moreover, use of first-person singular pronouns was positively associated with marital satisfaction. These findings suggest that pronouns used by spouses during conflict-resolution discussions provide insight into the quality of their interactions and marriages.
Self-Discipline Outdoes IQ in Predicting Academic Performance of Adolescents
Authors: Duckworth Angela L. , Seligman Martin E.P.
Published: November 2005

In a longitudinal study of 140 eighth-grade students, self-discipline measured by self-report, parent report, teacher report, and monetary choice questionnaires in the fall predicted final grades, school attendance, standardized achievement-test scores, and selection into a competitive high school program the following spring. In a replication with 164 eighth graders, a behavioral delay-of-gratification task, a questionnaire on study habits, and a group-administered IQ test were added. Self-discipline measured in the fall accounted for more than twice as much variance as IQ in final grades, high school selection, school attendance, hours spent doing homework, hours spent watching television (inversely), and the time of day students began their homework. The effect of self-discipline on final grades held even when controlling for first-marking-period grades, achievement-test scores, and measured IQ. These findings suggest a major reason for students falling short of their intellectual potential: their failure to exercise self-discipline.
Visual Short-Term Memory Load Suppresses Temporo-Parietal Junction Activity and Induces Inattentional Blindness
Authors: Todd J. Jay , Fougnie Daryl , Marois René
Published: November 2005

The right temporo-parietal junction (TPJ) is critical for stimulus-driven attention and visual awareness. Here we show that as the visual short-term memory (VSTM) load of a task increases, activity in this region is increasingly suppressed. Correspondingly, increasing VSTM load impairs the ability of subjects to consciously detect the presence of a novel, unexpected object in the visual field. These results not only demonstrate that VSTM load suppresses TPJ activity and induces inattentional blindness, but also offer a plausible neural mechanism for this perceptual deficit: suppression of the stimulus-driven attentional network.
Unique Temporal Change Is the Key to Attentional Capture
Authors: von Mühlenen Adrian , Rempel Mark I. , Enns James T.
Published: November 2005

Attentional capture refers to the observation that some events break through and attract one's attention even when one is engaged in a task for which these events are irrelevant. Previous research, focusing primarily on spatial factors, has shown that a new object is more salient in this regard than an abrupt change in an object's features. Here we show that feature changes can be as effective as new objects in capturing attention, provided that they occur during a period of temporal calm. Conversely, both feature changes and new objects are far less effective in capturing attention when they occur simultaneously with other display changes, such as coincident with the initial onset of the display or with small visual transients that occur during a display transition. These results highlight the importance of considering both space and time in studies of attentional capture; the most effective stimulus is unique in both dimensions.
Secret Agents
Authors: Saxe R. , Tenenbaum J.B. , Carey S.
Published: November 2005

Considerable evidence indicates that preverbal infants expect that only physical contact can cause an inanimate object to move. However, very few studies have investigated infants' expectations about the source of causal power. In three experiments, we found that (a) 10- and 12-month-old infants expect a human hand, and not an inanimate object, to be the primary cause of an inanimate object's motion; (b) infants' expectations can lead them to infer a hidden causal agent without any direct perceptual evidence; and (c) infants do not infer a hidden causal agent if the moving object was previously shown to be capable of self-generated motion.
False Discovery Control for Multiple Tests of Association Under General Dependence
Authors: MEINSHAUSEN NICOLAI
Published: November 2005

Abstract.  We propose a confidence envelope for false discovery control when testing multiple hypotheses of association simultaneously. The method is valid under arbitrary and unknown dependence between the test statistics and allows for an exploratory approach when choosing suitable rejection regions while still retaining strong control over the proportion of false discoveries.
Improving Ecological Impact Assessment by Statistical Data Synthesis Using Process-Based Models
Authors: Demyanov V. , Wood S. N. , Kedwards T. J.
Published: November 2005

Population dynamic modelling often entails parameterizing quite sophisticated biological and ecological mechanisms. For models of moderate mechanistic complexity, this has traditionally been done in an ad hoc manner, with different parameters being estimated independently. The point estimates so obtained are then used for model simulation, perhaps with some further ad hoc adjustment based on comparison with any available data on population dynamics. Quantitative assessments of model adequacy and prediction uncertainty are not easily made using this approach. As an alternative, the paper investigates the practical feasibility of fitting a moderately complex population dynamic model directly and simultaneously to all the data available for parameterization of the model, and to all available data on the population dynamics of the target animal. This alternative approach allows us to combine all available quantitative information on the target species, to assess the viability of the model, the mutual consistency of model and different sources of data and to estimate the uncertainties that are associated with model-based predictions. The target organism in this study is the freshwater amphipod Gammarus pulex (L.), which we model using a stage-structured population dynamic model, implemented via a set of delay differential equations describing the basic demography of the population. Target data include population dynamic data from two sites, information on basic physiological relationships and environmental temperature data. Fitting is performed by using a non-linear least squares approach supplemented with a bootstrapping method for avoiding small scale local minima in the least squares objective function. Variance estimation is performed by further bootstrapping. Interest in Gammarus pulex population dynamics in this case is primarily related to likely population level responses to chemical stressors, and for this we examine predicted ‘recovery times’ following exposure to a known toxicant.
Assessing Poisson Variation of Intestinal Tumour Multiplicity in Mice Carrying a Robertsonian Translocation
Authors: Newton Michael A. , Hastie David I.
Published: November 2005

Tumour multiplicity is a frequently measured phenotype in animal studies of cancer biology. Poisson variation of this measurement represents a biological and statistical reference point that is usually violated, even in highly controlled experiments, owing to sources of variation in the stochastic process of tumour formation. A recent experiment on murine intestinal tumours presented conditions which seem to generate Poisson-distributed tumour counts. If valid, this would support a claim about mechanisms by which the adenomatous polyposis coli gene is inactivated during tumour initiation. In considering hypothesis testing strategies, model choice and Bayesian approaches, we quantify the positive evidence favouring Poisson variation in this experiment. Statistical techniques used include likelihood ratio testing, the Bayes and Akaike information criteria, negative binomial modelling, reversible jump Markov chain Monte Carlo methods and posterior predictive checking. The posterior approximation that is based on the Bayes information criterion is found to be quite accurate in this small n case-study.
Joint Modelling of Event Counts and Survival Times
Authors: Cowling B. J. , Hutton J. L. , Shaw J. E. H.
Published: November 2005

In studies of recurrent events, such as epileptic seizures, there can be a large amount of information about a cohort over a period of time, but current methods for these data are often unable to utilize all of the available information. The paper considers data which include post-treatment survival times for individuals experiencing recurring events, as well as a measure of the base-line event rate, in the form of a pre-randomization event count. Standard survival analysis may treat this pre-randomization count as a covariate, but the paper proposes a parametric joint model based on an underlying Poisson process, which will give a more precise estimate of the treatment effect.
Identification of conserved modes of expression profiles during hippocampal development and neuronal differentiation in vitro
Authors: Dabrowski Michal , Adach Alicja , Aerts Stein , Moreau Yves , Kaminska Bozena
Published: November 2005

Gene expression profiles can be regarded as sums of simpler modes, analogous to the modes of a vibrating violin string. Decomposition of temporal gene expression profiles into modes by singular value decomposition (SVD) was reported before, but the question as to what degree the SVD modes can be interpreted in terms of biology remains open. We report and compare the results of SVD of published datasets from hippocampal development, neuronal differentiation in vitro, and a control time‐series hippocampal dataset. We demonstrate that the first SVD mode reflects the magnitude of expression, interpretable on the Affymetrix platform. In the datasets from gene profiling of hippocampal development and neuronal differentiation, the second mode reflects a monotonous change in expression, either up‐ or down‐regulation, in the time course of experiment. We demonstrate that the top two SVD modes are conserved between datasets and therefore, likely reflect properties of the underlying system (gene expression in hippocampus) rather than of a particular experiment or dataset. Our results also indicate that the magnitude of expression, and the direction of change in expression during hippocampal development, are uncorrelated, suggesting that they are regulated by largely independent mechanisms.
Conventional protein kinase C isoforms mediate neuroprotection induced by phorbol ester and estrogen
Authors: Cordey Myriam , Pike Christian J.
Published: November 2005

Rapid signal transduction pathways play a prominent role in mediating neuroprotective actions of estrogen in the CNS. We have previously shown that estrogen‐induced neuroprotection of primary cerebrocortical neurons from β‐amyloid peptide (Aβ) toxicity depends on activation of protein kinase C (PKC). PKC activation with phorbol‐12‐myristate‐13‐acetate (PMA) also provides neuroprotection in this paradigm. Because the PKC family includes several isoforms that have opposing roles in regulating cell survival, we sought to identify which PKC isoforms contribute to neuroprotection induced by PMA and estrogen. We detected protein expression of multiple PKC isoforms in primary neuron cultures, including conventional (α, βI, βII), novel (δ, ε, θ) and atypical (ζ, ι/λ) PKC. Using a panel of isoform‐specific peptide inhibitors and activators, we find that novel and atypical PKC isoforms do not participate in the mechanism of either PMA or estrogen neuroprotection. In contrast, a selective peptide activator of conventional PKC isoforms provides dose‐dependent neuroprotection against Aβ toxicity. In addition, peptide inhibitors of conventional, βI, or βII PKC isoforms significantly reduce protection afforded by PMA or 17β‐estradiol. Taken together, these data provide evidence that conventional PKC isoforms mediate phorbol ester and estrogen neuroprotection of cultured neurons challenged by Aβ toxicity.
Identification of a noradrenaline‐rich subdivision of the human nucleus accumbens
Authors: Tong Junchao , Hornykiewicz Oleh , Kish Stephen J.
Published: November 2005

The nucleus accumbens, situated at the junction between rostral pre‐commissural caudate and putamen, is now considered to be critically involved in rewarding and motivational functions mediated by the neurotransmitter dopamine. However, in the human, the precise anatomical boundaries of this nucleus are still undetermined and controversy exists as to the extent to which nucleus accumbens activity is controlled by noradrenaline, a related neurotransmitter now much neglected (in favor of dopamine) by the scientific community. Here we resolve the question of noradrenaline in the human nucleus accumbens and identify, in autopsied brain of normal subjects, a small subdivision of the caudomedial portion of this nucleus that selectively contains strikingly high levels of noradrenaline and thus represents the only area in human brain having equally high levels of both noradrenaline and dopamine. The presence of very high, localized noradrenaline concentrations in the caudomedial nucleus accumbens implies a special biological role for this neurotransmitter in human brain motivational processes.
New polymorphic microsatellite loci in two fish species: bluefin killifish (Lucania goodei) and yellow bullhead (Ameiurus natalis)
Authors: CREER DOUGLAS A. , TREXLER JOEL C.
Published: November 2005

We identified four new polymorphic microsatellite loci in bluefin killifish (Lucania goodei) and five loci in yellow bullheads (Ameiurus natalis). We screened 400 killifish from 20 populations and 180 bullheads from nine populations, finding a high degree of polymorphism (nine to 54 alleles per locus; average expected heterozygosity 0.678–0.976). We found no evidence for linkage disequilibrium. Three of the loci found in bluefin killifish show heterozygote deficiency; the other loci do not deviate from Hardy–Weinberg expectations.
Immigrants in the British Labour Market*
Authors: Dustmann Christian , Fabbri Francesca
Published: November 2005

The main objective of this paper is to provide a comprehensive description of the economic outcomes and performance of Britain's immigrant communities today and over the last two decades. We distinguish between males and females and, where possible and meaningful, between immigrants of different origins. Our comparison group is white British‐born individuals. Our data source is the British Labour Force Survey. We first provide descriptive information on the composition of immigrants in Britain, and how this has changed over time, their socio‐economic characteristics, their industry allocation and their labour market outcomes. We then investigate various labour market performance indicators (labour force participation, employment, wages and self‐employment) for immigrants of different origins, and compare them with British‐born whites of the same age, region and other background characteristics. We find that over the last 20 years, Britain's immigrant population has changed in origin composition and has dramatically improved in skill composition — not dissimilar from the trend in the British‐born population. We find substantial differences in economic outcomes between white and ethnic minority immigrants. Within these groups, immigrants of different origins differ considerably with respect to their education and age structure, their regional distribution and their sector choice. In general, white immigrants are more successful in Britain, although there are differences between groups of different origins. The investigation shows that immigrants from some ethnic minority groups, and in particular females, are particularly disadvantaged, with Pakistanis and Bangladeshis at the lower end of this scale.
Does Germany Collect Revenue from Taxing the Normal Return to Capital?*
Authors: Becker Johannes , Fuest Clemens
Published: November 2005

A widespread objection to the introduction of consumption tax systems claims that this would lead to high tax revenue losses. This paper investigates the revenue effects of a consumption tax reform in Germany. Our results suggest that the revenue losses would be surprisingly low. We find a maximum revenue loss of 1.6 per cent of annual GDP. In some years, we even find tax revenue gains. This implies that the current tax system collects little revenue from taxing the normal return to capital. Based on these results, we calculate a macroeconomic measure of the effective tax rate on capital income.
Early Education and Children's Outcomes: How Long Do the Impacts Last?*
Authors: Goodman Alissa , Sianesi Barbara
Published: November 2005

We evaluate the effects of undergoing any early education (before the compulsory starting age of 5) and of pre‐school on a cohort of British children born in 1958. In contrast to most available studies, we are able to assess whether any effects on cognition and socialisation are long‐lasting, as well as to estimate their net impact on subsequent educational attainment and labour market performance.

Controlling for a particularly rich set of child, parental, family and neighbourhood characteristics, we find some positive and long‐lasting effects from early education. Specifically, pre‐compulsory education (preschool or school entry prior to age 5) was found to yield large improvements in cognitive tests at age 7, which, though diminished in size, remained significant throughout the schooling years, up to age 16. By contrast, attendance of pre‐school (nursery or playgroup) was found to yield a positive but short‐lived impact on test scores. The effects on socialisation appear to be more mixed: we found some positive, though short‐lasting, effects of pre‐compulsory education on teachers' reports of social adjustment (only at age 7); on the other hand, we found some adverse behavioural effects according to parental reports at age 7 which persisted up to age 11.

In adulthood, pre‐compulsory education was found to increase the probabilities of obtaining qualifications and of being employed at age 33. For both pre‐compulsory education and pre‐school per se, we found evidence of a marginally significant 3–4 per cent wage gain at age 33.
Is a Tax Cut on Cultural Goods Consumption Actually Desirable? A Microsimulation Analysis applied to Spain*
Authors: Prieto‐Rodriguez Juan , Romero‐Jordán Desiderio , Sanz‐Sanz José Felix
Published: November 2005

Proposals for tax cuts on cultural goods represent an ongoing debate in cultural policy. The main aim of this paper is to shed some light on this debate using microsimulation tools. First, we have estimated an Almost Ideal Demand System for 19 different groups of goods, including cultural goods. Expenditure and price elasticities have been obtained from this model. Using this information, three alternative cuts in the VAT rate on cultural goods have been microsimulated and evaluated in terms of revenue and welfare. These types of fiscal reforms will lead to welfare and efficiency gains that can be described as regressive.
Local Budgeting and Finance: 25 Years of Developments
Authors: MULLINS DANIEL R. , PAGANO MICHAEL A.
Published: November 2005

This article traces developments in budgeting and finance at the local government level over the past 25 years. In doing so, it uses the 290 related articles published in Public Budgeting & Finance over this period as its foundation and as a sieve for topic selection. Specific attention is directed to intergovernmental finance, financial management, budgeting and budget reform, alternative service delivery, and capital budgeting. The intent is to sift through important developments in each area, highlight their significance at the time and their importance to the present and future.
Changing Revenue Policy in the United States: An Overview of the Record and Perennial Puzzles
Authors: MIKESELL JOHN L.
Published: November 2005

The past quarter century has produced little change in the government revenue share of gross domestic product in the United States. The federal share has fallen, but the state and local share has increased. There has been no great change among revenue sources, certainly nothing like the flight from the property tax that characterized the prior decade. Several issues have dominated revenue policy discussions over the last quarter century. These include the role of the property tax, realignment of the federal tax base away from income, tax simplification, and base broadening. There have been no definite solutions to date.
The Evolution of the State and Local Government Municipal Debt Market over the Past Quarter Century
Authors: HILDRETH W. BARTLEY , ZORN C. KURT
Published: November 2005

Much has happened in the municipal bond market during the past 25 years. This article provides a retrospective of some of the significant developments in the market during that period of time. These developments include passage of the Tax Reform Act of 1986, innovations in the market in response to changing economic and social conditions, and the regulation, increase in disclosure requirements, and proliferatioin of credit enhancements that renewed the efficacy of municipal securities for American state and local governments.
Spending Stabilization Rules: A Solution to Recurring State Budget Crises?
Authors: SCHUNK DONALD , WOODWARD DOUGLAS
Published: November 2005

Recurring state fiscal crises raise a fundamental question: Is it possible to stabilize budgets over the business cycle? This paper examines spending stabilization rules, an alternative to the inaccurate process of budget forecasting. Under two spending rules, we assess how state budget situations would compare with actual experience. Our analysis reconstructs recent aggregate state budget patterns assuming states had adopted a rule and then takes a closer look at California and South Carolina. With surpluses partially invested in a rainy‐day fund, a spending rule resulted in stable growth of state budgets throughout the recession and sluggish recovery of the early 2000s.
Intraoperative Comparison of a Subthreshold Test Pulse with the Standard High‐Energy Shock Approach for the Measurement of Defibrillation Lead Impedance
Authors: SCHUCHERT ANDREAS , WINTER JOACHIM , BINNER LUDWIG , KÜHL MARTIN , MEINERTZ THOMAS ,   on behalf of the Reliance Investigators
Published: November 2005

There are two methods to measure shocking lead impedance: delivery of high‐energy shocks that require patient sedation, and the painless measurement of impedance from subthreshold test pulses. The aim of this study was to compare the two methods.

Methods: The study included 131 patients implanted with a standard DR (n = 71) or VR (n = 60) ICD connected to either single‐coil (n = 39) or dual‐coil (n = 92) defibrillation leads. The noninvasive high‐energy impedance test was done using a 17 J shock after induction of ventricular tachyarrhythmias and compared to a 0.4 μJ test pulse used by the ICD for the subthreshold measurements.

Results: Defibrillation lead impedance measurements were not significantly different between patients with the same shocking vector configuration. In patients with a single‐coil defibrillation lead the impedance was 62 ± 9 Ω with the high‐energy shock and 62 ± 8 Ω with the subthreshold test pulses (P = 0.13). Patients with a dual‐coil configuration recorded average impedances of 40 ± 5 Ω from both tests (P = 0.44). While there was no difference in values recorded within each lead configuration, there was a significant difference in impedance between the single‐coil and the dual‐coil patient groups (P = 0.001).

Conclusions: There was no significant difference between shocking lead impedances measured with the high‐energy shock or the subthreshold test pulses. This offers the possibility of noninvasive, low‐energy serial measurements of shocking lead impedance at follow‐up visits and removing the need for sedation.
Hemodynamics and Autonomic Control of Heart Rate Turbulence
Authors: WICHTERLE DAN , MELENOVSKY VOJTECH , SIMEK JAN , MALIK JAN , MALIK MAREK
Published: November 2005

Introduction: Late heart rate deceleration parallels the increase of systolic blood pressure during heart rate turbulence (HRT) after ventricular premature complexes (VPC). This is consistent with the involvement of baroreflex mechanism. Physiological background of systolic blood pressure dynamics is not known. Enhanced sympathetic activation and nonautonomic post‐VPC changes of stroke volume have been speculated on.

Methods and Results: We studied 28 subjects (aged 56 ± 11 years; 20 males; 18 normal and 10 abnormal left ventricular (LV) function) with spontaneous occurrence of VPCs. HRT indices and baroreflex sensitivity were analyzed from the ECGs and finger arterial pressure recordings during 30 minutes of spontaneous respiration in supine position. Beat‐by‐beat stroke volume and peripheral vascular resistance were computed by a nonlinear, self‐adaptive model of aortic input impedance (Modelflow, Finapres Medical Systems, Arnhem, The Netherlands). Indices of HRT and baroreflex sensitivity were highly correlated. In patients with preserved LV function, there was no substantial dynamics of stroke volume in the late phase after VPC, while peripheral vascular resistance increased significantly. In patients with impaired LV function, potentiated first sinus beat after VPC triggered transient hemodynamic alternans. Dynamics of peripheral vascular resistance was attenuated and stroke volume was depressed in the late phase after VPC.

Conclusions: Delayed sympathetically mediated vasomotor response to VPC produces systolic blood pressure overshoot. This subsequently induces vagally mediated late heart rate deceleration. Under physiologic conditions, there is no evidence of other hemodynamic and/or mechanical effect outside the autonomic reflex arch. In patients with LV dysfunction, both depressed vagal and sympathetic modulation and, indirectly, enhanced postextrasystolic potentiation account for attenuated HRT.