bluuebunny/crossref_metadata_2025 huggingface dataset:
Social Justice Tort Theory
Authors: Chamallas Martha
Published: December 2021

Alongside the dominant law and economics and corrective justice approaches to tort law, a new genre of tort theory based on principles and perspectives of social justice has come into its own and deserves recognition. Social justice tort theory starts from the premise that tort law reflects and reinforces systemic forms of injustice in the larger society and maintains that the compensatory ideal of tort law cannot be extricated from these larger systems. It is multi-dimensional and intersectional, recognizing that the impact of injury lands intersectionally, sometimes changing the intensity of the injury or distorting the nature of the injury. Social justice tort scholars have examined torts in gendered and racialized contexts, as well as in ordinary cases that seem to have little to do with systemic injury. In addition to feminist and critical race theory, they have borrowed from critical disability studies, queer theory and political economy. Their work demonstrates how tort law unfairly distributes damages, fails to provide adequate relief for victims of sexual assault or for people who suffer racial insult and discrimination, and erases maternal and reproductive harms. In their work, we can see common deconstructive moves (an emphasis on disparate impacts and devaluation; a teasing out of cognitive bias; and a critique of exceptionalism in tort doctrine) as well as guiding principles for reconstruction (incorporating victims’ perspectives; treating boundaries between civil rights law and tort law as permeable; and enhancing dignity and recognition).
Coherence and Reduction
Authors: Ragno Andrea Giuseppe
Published: December 2021

Synchronic intertheoretic reductions are an important field of research in science. Arguably, the best model able to represent the main relations occurring in this kind of scientific reduction is the Nagelian account of reduction, a model further developed by Schaffner and nowadays known as the generalized version of the Nagel–Schaffner model (GNS). In their article (2010), Dizadji-Bahmani, Frigg, and Hartmann (DFH) specified the two main desiderata of a reductioná laGNS: confirmation and coherence. DFH first and, more rigorously, Tešic (2017) later analyse the confirmatory relation between the reducing and the reduced theory in terms of Bayesian confirmation theory. The purpose of this article is to analyse and compare the degree of coherence between the two theories involved in the GNS before and after the reduction. For this reason, in the first section, I will be looking at the reduction of thermodynamics to statistical mechanics and use it as an example to describe the GNS. In the second section, I will introduce three coherence measures which will then be employed in the comparison. Finally, in the last two sections, I will compare the degrees of coherence between the reducing and the reduced theory before and after the reduction and use a few numerical examples to understand the relation between coherence and confirmation measures.
Waveguide effective plasmonics with structure dispersion
Authors: Qin Xu , Sun Wangyu , Zhou Ziheng , Fu Pengyu , Li Hao , Li Yue
Published: December 2021

Plasmonic phenomena on the surface between metal and dielectric have received extensive attention, and have boosted a series of exciting techniques. Plasmonics describes the interaction between light and electronics and shows great potential in nanophotonics, optoelectronic devices, quantum physics, and surface-enhanced spectroscopy, etc. However, plasmonic phenomena are always suffering from the inherent loss issue of plasmonic materials at optical frequency, which has restricted further applications of plasmonics. In this review, we focus on the technique of waveguide effective plasmonics, which is a feasible low-loss realization of plasmonic metamaterials in lower frequency based on the structural dispersion. This review provides the underlying physics of the waveguide effective plasmonics and its applications varying from classical plasmonic concepts to novel effective plasmonic devices. Finally, we make a brief discussion on the direction of future researches and a prospect of the potential applications.
When No Laughing Matter Is No Laughing Matter: The Challenges in Developing a Cognitive Theory of Humor
Authors: Hochstein Eric
Published: December 2021

This paper explores the current obstacles that a cognitive theory of humor faces. More specifically, I argue that the nebulous and ill-defined nature of humor makes it difficult to tell what counts as clear instances of, and deficits in, the phenomenon.Without getting clear on this, we cannot identify the underlying cognitive mechanisms responsible for humor. Moreover, being too quick to draw generalizations regarding the ubiquity of humor, or its uniqueness to humans, without substantially clarifying the phenomenon and its occurrences is not only unwise but can actually be a detriment to our study of humor. As such, these sorts of claims must be resisted. I conclude the paper by pointing the way forward to addressing these obstacles.
The Impact of Behavioral Economics on the Law: Introduction
Authors: Engel Christoph
Published: December 2021

Adopting the paradigms, findings and tools of behavioral economics has opened a promising avenue for legal research. This article sketches the broader framework within which the papers assembled in this special issue may be placed.
Nietzsche und die Weltanschauungsliteratur
Authors: Beßlich Barbara
Published: December 2021

The study aims to demonstrate the significance of Friedrich Nietzsche for ›Weltanschauungsliteratur‹ (ideological literature) in the early 20th century. ›Weltanschauungsliteratur‹ adopts thematic elements of Nietzsche’s cultural criticism. Nietzsche’s habitus of the outmoded academic outsider becomes important for the writers’ self-staging. ›Weltanschauungsliteratur‹ closely observes Nietzsche’s combination of philosophical reasoning and literary writing and develops it further. Finally, the article examines exemplary ›Weltanschauungsliteratur‹ by Salomo Friedländer, Theodor Lessing, Rudolf Pannwitz, and Ernst Bertram.
Messung der Homogenität der Strahldichte einer Ulbricht-Kugel mit großer Apertur im SWIR mit einer InGaAs-Infrarotkamera
Authors: König Sebastian , Müller Ingmar , Taubert Richard D.
Published: December 2021

Wir stellen die Untersuchung der Homogenität der Strahldichte einer Ulbricht-Kugel mit großer Apertur vor, die mit einer InGaAs-Kamera im Wellenlängenbereich des SWIR gemessen wurde. Ein in der PTB entwickeltes Verfahren wird verwendet, um die Ungleichförmigkeit der relativen spektralen Empfindlichkeit der verwendeten Infrarotkamera zu korrigieren. Es werden verschiedene Konfigurationen untersucht und die Eignung der untersuchten Ulbricht-Kugel zur Charakterisierung von IR-Kameras geprüft. Es wurde festgestellt, dass die Ulbricht-Kugel eine Homogenität ihrer Strahldichte von ±1 % im integralen Wellenlängenbereich von 0,9 µm bis 1,7 µm aufweist.
Matrix Gla-protein expression in peripheral blood mononuclear cells is related to risk factors in cardiovascular diseased patients
Authors: Kiselova-Kaneva Yoana Dimitrova , Nazifova-Tasinova Neshe , Vankova Deyana , Nikolova Miglena , Pasheva Milena , Yotov Yoto , Atanasov Atanas , Galunska Bistra
Published: December 2021

Objectives

Matrix Gla protein (MGP) is a calcification inhibitor that plays a role in preventing soft tissue calcification and local mineralization of the vascular wall. The present study aimed to assess the expression of MGP in Peripheral Blood Mononuclear Cells (PBMC) in adult patients with CVD pathologies and its association with the presence and severity of coronary artery calcium score (CACS) and conventional CVD risk factors.

Methods

MGP expression was measured in 87 individuals using real time qPCR. Subgrouping was performed according etiologic and metabolic CVD risk factors.

Results

A clear trend for a decreased MGP expression was observed in all subgroups with high CVD risk. This decrease was significant in abdominally obese hypertensive individuals and in those with dyslipidemia. MGP expression was significantly lower in patients representing high Total cholesterol and LDL cholesterol levels. A positive correlation between MGP expression and smoking status in patients with coronary calcium and in the CVD group was established. Atrial hypertension duration correlated negatively with MGP expression in the group without coronary calcium deposits.

Conclusions

The current study supports the hypothesis that MGP expression in PBMC probably reflects CVD pathology and is related to lipid metabolism dysregulation.
Vibronic absorption spectra and excited states of acridine red dye in aqueous solution: TD-DFT/DFT study
Authors: Kostjukov Victor V.
Published: December 2021

The vibronic absorption spectra of acridine red (AR) xanthene dye in an aqueous solution using 40 hybrid functionals, the 6-31++G(d,p) basis set, and the IEFPCM solvent model were calculated. It turned out that the O3LYP functional provided the best agreement with the experiment in the positions of the main maximum and the short-wavelength subband (shoulder). The calculations showed that this shoulder is vibronic. At the same time, the shoulder intensity in the calculated spectrum turned out to be lower than in the experimental one. Apparently, insignificant dimerization, which occurs even at low concentrations of the dye in solution, contributes to the shoulder of the experimental absorption spectrum. Various parameters of the AR cation in the ground and excited states (IR spectra, atomic charges, dipole moments, and transition moment) were calculated. Maps of the distribution of electron density and electrostatic potential have been built. The influence of the strong hydrogen bonds of the dye with three water molecules on the absorption spectrum was analyzed. It has been shown that these bonds are strengthened upon AR excitation. The strengthening of two hydrogen bonds with water upon excitation leads to a lowering of the potential energy surface of the excited state, which causes a decrease in the excitation energy (i.e., an increase in the wavelength of the absorbed photon) as compared to a purely implicit specification of the water environment. Therefore, explicit assignment of waters strongly bound to the dye leads to spectrum redshift.
The shock wave solutions of modified ZK Burgers equation in inhomogeneous dusty plasmas
Authors: Zhang Liping , Zheng Jiangqiong , Liu Chenxiao , Ma Jun
Published: December 2021

This paper offers a shock wave solution to modified Zakharov–Kuznetsov (MZK) Burgers equation in inhomogeneous dusty plasmas with external magnetic field. For this purpose, the fluid equations are reduced to an MZK Burgers equation containing variable coefficients by reductive perturbation method. With the aid of travelling-wave transformation technique, we obtain the analytical oscillatory shock wave solution and monotonic shock wave solution for MZK Burgers equation. The effects of inhomogeneity, external magnetic field, dust charge variation on characteristics of two types of shock waves are examined in detail.
IMPRESSION MANAGEMENT STRATEGY OF COPING WITH ENTREPRENEURIAL FAILURE STIGMA: A TWO-PATH THEORETICAL MODEL
Authors: Xiong Zhuang , Yan Junzhou , Wang Lingling
Published: December 2021

Impression management strategy is an important way to cope with the stigma of failed entrepreneurial firms. However, most existing studies only focused on the process of impression management with a single strategy. Few studies have provided a systematic theoretical explanation on how to use different types of impression management strategies to cope with stigma. To fill this theoretical gap, a two-path model of impression management of entrepreneurial failure stigma was constructed, based on the two-component model of impression management. In addition, the mechanism of impression management strategy selection for failed entrepreneurial firms to cope with stigma was discussed. The findings of the theoretical model reveal two paths for the stigma management strategy of failed entrepreneurial firms: “avoidance motivation → defensive strategy of impression management” and “diluted motivation → acquisitive strategy of impression management.” Moreover, in the selection mechanism of strategy, the formation of impression motivation is affected by the stigma type of entrepreneurial failure, the social status of the firm organization, and the degree of stigma threat. In the face of justifiable stigma, the failed entrepreneurial firms form the avoidance motivation and then implement a defensive strategy of impression management. High social status firms adopt an acquisitive strategy of impression management to cope with the negative impact of entrepreneurial failure stigma. As the threat level of entrepreneurial failure stigma increases, the dilution motivation of the failed entrepreneurial firms to stigma becomes stronger, and the firms are more likely to adopt the acquisitive strategy of impression management. The two-path theoretical model provides decision support for failed entrepreneurial firms to formulate stigma management strategies and expands the research scope of entrepreneurial failure stigma.
ADVERTISING STRATEGY ACCORDING TO THE CONCEPT OF THE FCB MODEL IN THE CONDITIONS OF THE VARIOUS GENERATIONS
Authors: Matušínská Kateřina , Stoklasa Michal
Published: December 2021

The aims of the paper are: 1) to verify the validity of the traditional theoretical definition of the Foote, Cone & Belding (FCB) model based on the use of representative products concerning the age (generation) and gender of the selected target group in the conditions of the Czech Republic, and 2) to verify the validity of defined advertising strategies in the traditional theoretical conception of the Foote, Cone & Belding (FCB) model with the current level of acceptance and perception of advertising within the defined selected target group according to age (generation) and gender in the conditions of the Czech Republic. To meet both aims, both secondary and primary marketing research was implemented. The theoretical background of the paper is based on knowledge of marketing communication principles in general with emphasis on advertising theories. The greatest attention is focused on the traditional version of the FCB model which is based on a matrix of consumer thinking–feeling and high–low involvement behaviours and proposes four advertising strategies. Primary research data were obtained using a questionnaire, on the online panel of research agency Ipsos, on 1,100 Czech respondents. The methods used are positional maps for the FCB grid and chi-squared with a suitable post-hoc test. The outputs reveal the differences of the theoretical FCB model in comparison with its practical implementation. It is necessary to adapt (extend) the model according to specific conditions and identification features of different Czech generations and genders, then adjust recommendations for advertising strategies. In Czech conditions, the sextant grind should be used. There is a prevalence of representative product placement in quadrants 1 and 3, i.e., rational appeals even for products where this is not expected. The outcomes can be used for the choice of correct advertising strategy, advertising media, and types.
Consumer Society As A Legal Form Of Non-For-Profit Legal Entity
Authors: Zozuliak O.I.
Published: December 2021

The scientific article analyses the modem understanding of the term « consumer society « in Ukraine. The author gives reasons for feasibility to separate such independent legal entities’ forms as public associations and consumer societies within the group of non-business entities of the corporate type.

The author explains that the membership in the non-business entity of corporate type may both generate (in consumer societies) and not generate (in public associations) the property relationships between a member of such a legal entity and the legal entity itself.

There are criteria to distinguish non-business entities of public law and non­business entities of private law, namely: 1) the approach chosen by a legislator should constitute the basis 2) the additional criteria are: the category of interest, legal regime of property, the peculiarities of the founder’s liability for the obligations imposed on the established non-business entity.

The consumer society is singled out into the independent legal form of the non­business entities according to the following peculiarities: 1) the property relationship between the consumer society’s participants and the consumer society itself; they are legal entities of the private law; 2) specifics of the society participants’ liability for obligations of the society; 3) private interest of the participants (founders) makes the basis of the society activity.
Constitutional And Legal, Protective Function Of Lands In Ukraine At The Present Stage
Authors: Vivcharenko O.A.
Published: December 2021

The article is devoted to the legal regulation of public relations regarding land protection and its protection function, is based on the creation of a regulatory framework in Ukraine, which defines legal norms in the field of land rights, property and other land rights, based on European standards focused on priority of land protection. Formation and improvement of legal regulation of relations on land protection belongs to the priority areas of adaptation of Ukrainian legislation to European Union legislation, defined by the Law of Ukraine «On National Program of Adaptation of Ukrainian Legislation to European Union Legislation», which is designed to form and improve new regulation relations regarding land plots, ensuring responsibility and harmonization with the legislation at the present stage.

The legislation of Ukraine establishes the powers of the subjects of national security. The President of Ukraine, as the Supreme Commander-in-Chief of the Armed Forces of Ukraine, the Chairman of the National Security and Defense Council, exercises general leadership in the spheres of national security and defense of Ukraine. The Verkhovna Rada, within the powers provided by the Constitution of Ukraine, determines the principles of foreign and domestic policy, national security, forms the legal framework in this area, approves decisions on the imposition of state of emergency and martial law, mobilization, general structure, size of the Armed Forces of Ukraine and other military formations created to the laws of Ukraine.
НАЦІОНАЛЬНО-ОСВІТНЯ ДІЯЛЬНІСТЬ БЮРО КУЛЬТУРНОЇ ПОМОЧІ ДЛЯ УКРАЇНСЬКОГО НАСЕЛЕННЯ ЗАЙНЯТИХ ЗЕМЕЛЬ ХОЛМЩИНИ ТА ВОЛИНІ У 1915–1918 рр.
Authors: Адамович Сергій
Published: December 2021

У статті досліджується українська національно-освітня діяльність на Холмщині та Волині в період Першої світової війни. Автор стверджує, що загальне керівництво національно-освітніми проце­сами на Волині, координацію діяльності українських інституцій і забезпечення матеріально-технічної бази українського шкільництва здійснювало Бюро культурної помочі для українського населення зайнятих земель за підтримки Союзу визволення України, Загальної Української Ради та активної учас­ті Українського січового стрілецтва. Автор вважає, що внаслідок успішної національно-освітньої діяль­ності українських організацій у північно-західних землях України у 1915–1918 рр. було створено пе­редумови для опору асиміляційній політиці Польщі у 20–30-х рр. ХХ ст.

Ключові слова: Бюро культурної помочі для українського населення зайнятих земель, Союз ви­зволення України, Загальна Українська Рада, Українське січове стрілецтво, українська національно-освіт­ня діяльність на Холмщині та Волині.
Kartellrechtliche Spielräume und Grenzen für Einkaufskooperationen im Handel
Authors: Schmidt Fabian , Haus Florian C.
Published: December 2021

Die Zusammenarbeit von Wettbewerbern ist in aller Regel am Maßstab des Kartellverbots zu prüfen. Einkaufskooperationen zählen zu denjenigen horizontalen Vereinbarungen, deren wettbewerbsbeschränkende Wirkung häufig gering ist oder jedenfalls von den geschaffenen Effizienzvorteilen aufgewogen wird. Die kartellrechtliche Prüfung ist insbesondere bei Einkaufskooperationen im Handel wegen der potenziellen Vielzahl der betroffenen Märkte und des unterschiedlichen Grades gemeinsamer versus individueller Beschaffung jedoch nicht trivial. Zusätzliche Komplexität schaffen praktisch häufige Aktivitäten von Einkaufskooperation mit eigenen Handelsmarken, da die Kooperation hier in die Rolle eines Herstellers einrückt. Der Beitrag beleuchtet insoweit u. a. Möglichkeiten und Grenzen der Preisgestaltung und -beeinflussung in diesem Zusammenhang.
MARKED HYPOKALEMIA IN PROLONGED DIARRHEA: POSSIBLE EFFECT ON HEART
Authors: GAMBLE ALICE H. , WIESE HILDA F. , HANSEN ARILD E.
Published: December 2021

Remarkably low values for serum potassium were found in an infant with severe diarrhea. This unusual abnormality most likely reflected an extreme deficiency of intracellular potassium which developed because of prolonged diarrhea and maintenance on fluids containing only dextrose and water.1 In the following report, evidences of marked potassium deficiency are presented from the chemical as well as the clinical viewpoint.

Case history

An eight-month-old female infant was admitted to the Children's Hospital of the University of Texas School of Medicine on July 10, 1946, because of severe diarrhea which had persisted for one month. Early in the course of the illness there were 6-8 watery green mucous stools a day, but by the tenth day 18-20 green, watery, blood-streaked stools were passed daily. The child was admitted to a local hospital and during the next week was given 2000 Ml. of 5% dextrose in distilled water by hypodermoclysis and 500 Ml. of blood intravenously. At the end of this time her weight was about 6.6 kg. which represented a loss of approximately 30% of her body weight; inasmuch as her weight was stated to be 9.4 kg. before the onset of her illness. During the month's illness she had refused all solid food and had reportedly taken not over a pint of milk,although 1200-1500 Ml. (40-50 oz.) of tap water were taken by mouth daily.

On admission, the weight was 6.6 kg., temperature 38.2°C., pulse 100 per min., respiration 24 per min., and head circumference 41.8 cm. The
The Search for Effective and Efficient Ambulatory Teaching Methods Through the Literature
Authors: Heidenreich Charlotte , Lye Patricia , Simpson Deborah , Lourich Mary
Published: December 2021

Objective.

Education in ambulatory settings is characterized by the conflicting agendas of clinical efficiency and educational effectiveness. In recognition of the challenge to teach more effectively, this review was undertaken to identify literature-based teaching methods for ambulatory-based education.

Design.

Literature search resources included electronic databases and relevant journal indices. After preliminary title/abstract review, final critical review using a coding sheet was undertaken to define the teaching behavior or characteristic in each article, and to evaluate empirical data related to effectiveness and/or efficiency.

Results.

Our literature search and subsequent article analysis yielded 11 clinical teaching methods, but no agreed upon descriptor or key features for these methods. Synthesis of this literature lead to succinct descriptions of each method and a label.

Conclusions.

There is limited evidence regarding the effectiveness of ambulatory teaching methods in cited literature. By establishing a common nomenclature and descriptions for 11 methods, this review lays the foundation for investigators to systematically study the effectiveness and efficiency of ambulatory-focused clinical teaching methods both within and across specialties.ambulatory education, clinical education, clinical teaching, medical education, precepting teaching behaviors, teaching methods.
THALASSEMIA IN NEGROES
Authors: BANKS L. OTTO , SCOTT ROLAND B.
Published: December 2021

A case with typical features of Cooley's anemia is reported in a two year old Negro male. Thalassemia minor was found in each generation of this family and could be traced down to the patient. The fact that both mother and father have the trait is compatible with the homozygous-heterozygous theory of Neel.
Management of Child and Adolescent Obesity: Psychological, Emotional, and Behavioral Assessment
Authors: Jonides Linda , Buschbacher Virginia , Barlow Sarah E.
Published: December 2021

Objective. The primary objective of this study was to describe the usual psychological, emotional, and behavioral evaluations of overweight children and adolescents to target education of pediatric health care providers. A secondary aim was to determine whether certain provider characteristics were associated with recommended evaluation practices.

Methods. A total of 203 pediatricians, 293 pediatric nurse practitioners, and 444 registered dietitians completed questionnaires about their evaluation of overweight children and adolescents (response rates 19%, 33%, and 27%, respectively). Results were examined for adherence to published recommendations and for associations with certain provider characteristics.

Results. All 3 groups generally followed recommended psychological and emotional evaluation practices. Nearly all respondents obtained a diet history, and >75% evaluated physical activity as recommended. Fifty to 61% routinely initiated treatment in overweight children with no obesity-associated medical conditions, and 13% to 29% initiated treatment in children and adolescents who did not want to control weight. The majority included parents in treatment, but one third or fewer involved all household members. More than 75% sometimes referred to a mental health specialist. In general, provider’s body mass index, gender, years in practice, and practice specialty were not associated with following evaluation recommendations.

Conclusions. Emotional and behavioral assessments were generally consistent with recommendations. Providers will benefit from identification of methods to engage overweight youth who do not want to control weight.
The Natural History of Food Allergy
Authors: Wood Robert A.
Published: December 2021

The natural history of food allergy refers to the development of food sensitivities as well as the possible loss of the same food sensitivities over time. Most food allergy is acquired in the first 1 to 2 years of life, whereas the loss of food allergy is a far more variable process, depending on both the individual child and the specific food allergy. For example, whereas most milk allergy is outgrown over time, most allergies to peanuts and tree nuts are never lost. In addition, whereas some children may lose their milk allergy in a matter of months, the process may take as long as 8 or 10 years in other children. This review provides an overview of the natural history of food allergy and provides specific information on the natural course of the most common childhood food allergies.
Conclusion: The Equity Project
Authors: Goldhagen Jeffrey , Waterston Tony
Published: December 2021

The Issue. As a result of the work completed during the meeting and summarized at the last session, 4 implementation groups have been established as the organizational framework for the American Academy of Pediatrics (AAP)-Royal College of Paediatrics and Child Health (RCPCH) Equity Project. This project will be the mechanism by which the RCPCH and the AAP will continue the endeavor that was initiated at this meeting. The Equity Project Implementation Groups will focus on Education and Training, Practice and Advocacy, Research and Public Policy, and Children’s Rights. The goals and objectives of each group reflect the accomplishments of the conference participants. A call will go out to members of the AAP and the RCPCH to join these groups as the core of the operation of the project. Objectives will be prioritized and joint initiatives developed to focus on these priorities. The project thus will evolve as a broad-based effort to engage as many members of the AAP and the RCPCH as possible in project endeavors.
Research Design, Organization, and Sample Characteristics of the Maternal PKU Collaborative Study
Authors: Koch Richard , Azen Colleen , Friedman Eva , Hanley William , Levy Harvey , Matalon Reuben , Rouse Bobbye , Trefz Friedrich , Ning Jiaping , de la Cruz Felix
Published: December 2021

Objective. The Maternal PKU Collaborative Study (MPKUCS) was initiated in 1984 by the National Institute of Child Health and Human Development (NICHD). The purpose was to assess the efficacy of dietary restriction of phenylalanine in reducing morbidity in offspring of women with hyperphenylalaninemia (HPA). A contract was awarded to Childrens Hospital Los Angeles as the Coordinating Center to provide implementation of the research protocol, data collection, and analysis.

Methods. The Study included four regional contributing centers: Childrens Hospital Los Angeles (Western Region), Boston Children’s Hospital (Northeast Region), University of Illinois (Midwest Region), and University of Texas Medical Branch, Galveston (Southeast Region). Within each region, many participating clinics were responsible for obstetric care, treatment, and monitoring protocols. In 1985, Canada joined the MPKUCS, and in 1992, Germany entered. They were selected because they provided dietary supplies and strong professional services. Acquisition began in 1984 and ended in October 1995. The study included 574 pregnancies in women with HPA and 100 control subjects matched on age, race, parity, and weeks of gestation. The sample included women with blood phenylalanine values >240 μmol/L, 66% of whom had classical PKU, 22% had atypical PKU, and 12% had mild HPA. Informed consents were obtained on all participants. The women ranged in age from 15 to 36 years of age, with a mean age at conception of 23 years. Teenage pregnancies accounted for 19%. Seventy-five percent graduated from high school. Offspring included 416 newborns, 317 of whom were evaluated at 4 years of age and 289 at 6 to 7 years. Follow-up involved medical, nutritional, psychosocial, and psychological assessments.

Conclusion. Women with PKU treated before conception and in control of their blood phenylalanine levels between 120 and 360 μmol/L (2–6 mg) exhibited normal pregnancies and neonatal outcome. Surprisingly, women who achieved control in the recommended range by 8 weeks of pregnancy also had a normal fetal outcome.
Relation of Prenatal Phenylalanine Exposure to Infant and Childhood Cognitive Outcomes: Results From the International Maternal PKU Collaborative Study
Authors: Widaman Keith F. , Azen Colleen
Published: December 2021

Objective. The primary aims of this study were to model the form of the relation between prenatal exposure to phenylalanine (Phe) and measures of offspring intellectual development and to estimate the developmental relations of maternal demographic, pregnancy-related, and perinatal variables on offspring intelligence during infancy and childhood.

Methods. The participants were the 413 children and their mothers from the International Maternal PKU Collaborative Study.

Results. Results supported a nonlinear relation between prenatal Phe exposure and offspring cognitive outcomes, with damage to the developing fetus if average Phe levels are above approximately 360 μmol/L. Moreover, prenatal Phe exposure had a strong effect on offspring outcomes at 1 year of age and was the only one of the background, pregnancy-related, or perinatal variables to influence directly offspring outcomes at 2, 4, and 7 years of age.

Conclusion. The present study was able to document the importance of prenatal exposure to Phe for predicting offspring cognitive outcomes in the presence of other predictors of these outcomes.
Structural Studies on Phenylalanine Hydroxylase and Implications Toward Understanding and Treating Phenylketonuria
Authors: Erlandsen Heidi , Patch Marianne G. , Gamez Alejandra , Straub Mary , Stevens Raymond C.
Published: December 2021

Mutations in the gene encoding for phenylalanine hydroxylase (PAH) result in phenylketonuria (PKU) or hyperphenylalaninemia (HPA). Several 3-dimensional structures of truncated forms of PAH have been determined in our laboratory and by others, using x-ray crystallographic techniques. These structures have allowed for a detailed mapping of the >250 missense mutations known to cause PKU or HPA found throughout the 3 domains of PAH. This structural information has helped formulate rules that might aid in predicting the likely effects of unclassified or newly discovered PAH mutations. Also, with the aid of recent crystal structure determinations of co-factor and substrate analogs bound at the PAH active site, the recently discovered tetrahydrobiopterin-responsive PKU/HPA genotypes can be mapped onto the PAH structure, providing a molecular basis for this tetrahydrobiopterin response.
Brain Imaging and Proton Magnetic Resonance Spectroscopy in Patients With Phenylketonuria
Authors: Möller Harald E. , Weglage Josef , Bick Ulrich , Wiedermann Dirk , Feldmann Reinhold , Ullrich Kurt
Published: December 2021

Magnetic resonance imaging studies in patients with phenylketonuria (PKU) revealed white matter alterations that correlated to most recent blood phenylalanine (Phe) concentrations as well as to brain Phe concentrations measured by magnetic resonance spectroscopy. The clinical significance of these changes is unknown. Magnetic resonance imaging data thus have no impact on therapeutic recommendations for adolescents and adults with PKU. Kinetic investigations of patients by magnetic resonance spectroscopy showed differences in brain Phe concentrations despite similar blood Phe levels. These were influenced by interindividual variations of blood-brain barrier Phe transport constants and by variations of the individual brain Phe consumption rate. Blood-brain barrier Phe transport characteristics as well as brain Phe consumption rates thus seem to be causative factors for the individual outcome in PKU.
Summary Statistics of Neonatal Intensive Care Unit Network Neurobehavioral Scale Scores From the Maternal Lifestyle Study: A Quasinormative Sample
Authors: Lester Barry M. , Tronick Edward Z. , LaGasse Linda , Seifer Ronald , Bauer Charles R. , Shankaran Seetha , Bada Henrietta S. , Wright Linda L. , Smeriglio Vincent L. , Lu Jing
Published: December 2021

Descriptive statistics for the Neonatal Intensive Care Unit Network Neurobehavioral Scale summary scores are provided based on data from 1388 1-month-old infants in the Maternal Lifestyle Study (MLS) of prenatal drug exposure and child outcome. The multisite MLS is described, followed by tables with descriptive statistics and percentile for the Neonatal Intensive Care Unit Network Neurobehavioral Scale summary scores. The tables include data for the entire MLS sample as well as tables by drug exposure status, gestational age, poverty status, sex, race and ethnicity, and MLS study site. These tables can be used as quasinorms for comparison with other infants of this age.
Clinical Use of the Neonatal Intensive Care Unit Network Neurobehavioral Scale
Authors: Boukydis C.F. Zachariah , Bigsby Rosemarie , Lester Barry M.
Published: December 2021

Features of the Neonatal Intensive Care Unit Network Neurobehavioral Scale that make the examination useful for clinical application are described. Clinical applications in various settings and populations are described. This is followed by a summary of the clinical significance of the examination according to the packages of administration. We then explain how to use the summary scores clinically, writing a clinical summary and the clinical interpretation of the summary scores. Finally, we present a case study with a clinical summary and a work sheet that clinicians may find useful for clinical consultation with caregivers and parents.
Parent Report of Reading to Young Children
Authors: Kuo Alice A. , Franke Todd M. , Regalado Michael , Halfon Neal
Published: December 2021

Objective. The purpose of this study was to investigate the predictors and frequency of book-sharing activities in a nationally representative sample of families with young children and to examine the extent to which parents report that pediatric health care providers are addressing early literacy activities.

Methods. This study analyzed data from the 2000 National Survey of Early Childhood Health (NSECH), a telephone survey of 2068 parents of children aged 4 to 35 months. Parents were queried about the frequency of reading with their child, whether their pediatric provider discussed reading in the past year, and, if not, whether a discussion of the importance of reading to their child would have been helpful. Descriptive statistics, bivariate analyses, and multivariate logistic regression to identify predictors of daily reading among parents of young children nationally were used.

Results. Approximately 52% of young children are reportedly read to every day by a parent. Significant predictors of daily reading include older child’s age (19–35 months; odds ratio [OR]: 1.77; 95% confidence interval [CI]: 1.18–2.65, as compared with 4–9 months), maternal education greater than high school (OR: 2.00; 95% CI: 1.24–3.22), greater number of children’s books in the home (OR: 1.01; 95% CI: 1.00–1.01), and discussion of reading by the pediatric provider (OR: 1.66; 95% CI: 1.23–2.24). Lower odds of daily reading are found for maternal full-time working status (OR: 0.68; 95% CI: 0.49–0.95), black race/ethnicity (OR: 0.61; 95% CI: 0.41–0.91), Hispanic race/ethnicity (OR: 0.56; 95% CI: 0.37–0.86), Spanish language–dominant parents (OR: 0.37; 95% CI: 0.22–0.62), and >1 child in the household (2 children OR: 0.68, 95% CI: 0.48–0.97; 3 children OR: 0.53, 95% CI: 0.35–0.82). Approximately 37% of parents of young children stated that their child’s pediatric provider had not discussed reading with them. Nearly half (47%) of these parents indicated that they would have found such a discussion helpful.

Conclusions. Family context and daily reading routines are important for a child’s early literacy development. This national study identifies how family characteristics and routines are associated with the family’s literacy orientation. The analysis also indicates that a large percentage of parents with young children who do not read daily believe that it would be helpful to discuss the importance of reading with their child’s pediatric provider.
Insurance Status and Vaccination Coverage Among US Preschool Children
Authors: Santoli Jeanne M. , Huet Natalie J. , Smith Philip J. , Barker Lawrence E. , Rodewald Lance E. , Inkelas Moira , Olson Lynn M. , Halfon Neal
Published: December 2021

Background. Insurance status has been shown to have an impact on children’s use of preventive and acute health services. The objective of this study was to determine the relationship between insurance status and vaccination coverage among US preschool children aged 19 to 35 months.

Methods. We linked data from 2 national telephone surveys, the National Immunization Survey and the National Survey of Early Childhood Health, conducted during the first half of 2000. Children were considered up to date (UTD) when they had received at least 4 diphtheria-tetanus-acellular pertussis/diphtheria-tetanus-pertussis vaccines, 3 poliovirus vaccines, 1 MMR vaccine, 3 Haemophilus influenza vaccines, and 3 hepatitis B vaccines at the time the interview was conducted.

Results. Among the 735 children in our study sample, 72% were UTD. The vast majority (94%) reported some type of health insurance at the time of the survey. Children with private insurance were more likely to be UTD (80%) than those with public insurance (56%) or no insurance (64%). In a multivariate analysis that controlled for child’s race/ethnicity; household income; maternal age/marital status/educational level; location of usual care; and Special Supplemental Nutrition Program for Women, Infants, and Children participation, insurance was no longer an independent predictor of vaccination.

Conclusions. The disparity in vaccination coverage among publicly, privately, and uninsured children is dramatic, underscoring its importance as a marker for underimmunization, despite the multivariate findings. The Vaccines for Children Program, a partnership between public health and vaccination providers who serve uninsured children and those enrolled in Medicaid, is well suited to target and improve vaccination coverage among these vulnerable children.
MYASTHENIA GRAVIS IN EARLY CHILDHOOD
Authors: MACRAE DONALD
Published: December 2021

Four cases of myasthenia gravis in early childhood are reported. One case is congenital, and exhibited no fetal movement, suggesting that the myasthenia had an intrauterine onset. The relationship of the myasthenia to the coexisting maternal hyperthyroidism—the first case reported—is considered in view of an apparent relationship in adults. That other "toxic" states may play a part is possible.

One of the cases had a sister and possibly other siblings affected with myasthenia gravis. From the published accounts it appears that a familial incidence of myasthenia is considerably higher in childhood. It is, however, concluded that this does not represent a genetic factor—rather that unknown environmental factors are operative.

Two cases showed severe exacerbations during intercurrent infections—one being in complete remission between infections. The manner in which an infection results in an exacerbation is not clear.

The myasthenic-like state affecting the children of myasthenic mothers is discussed in relation to myasthenia. It is concluded from the evidence at present available that the defect in myoneural transmission in myasthenia gravis is the effect of a circulating substance whose nature, source and mode of action, remains obscure; but appears to be continuously or intermittently secreted.

While myasthenia gravis is a rare disorder, it is becoming increasingly apparent that the incidence in early childhood is considerably higher than previously suspected. Some of the reasons causing difficulty in diagnosis are discussed.
THE PEDIATRICIAN AND THE PUBLIC
Authors: GRIEVE CHARLES B. , GILL JAMES M.
Published: December 2021

THE FIRST communication in this issue is by two general practitioners who have written their views of the British National Health Service as a companion article to the one by Professor John Craig which appeared last month. Dr. Charles B. Grieve, a medical practitioner in Aberdeen, is present Chairman of the Local Medical Committee of Aberdeen and also Vice-Chairman of the Executive Council of Aberdeen. Dr. James M. Gill is a country practitioner in Inverurie, a town in the county of Aberdeenshire; he is Vice-Chairman of the Executive Council of the Counties of Aberdeen and Kincardine. Dr. Craig writes that: "They are both liberal-minded men who have thought a lot about the service and have been taking an active part in its planning."

The second communication is a description of private practice in Britain by Dr. Philip Evans, Professor of the Department of Child Health at Guy's Hospital, London. Dr. Evans has translated British medical fees into American dollars but, as noted last month, there is such a difference in the cost of living between the two countries that 2.8 dollars to the pound does not give an accurate picture. On a cost of living basis, the exchange rate is probably nearer 4 than 2.8 dollars to the pound.

THERE must be few doctors with experience of general practice among the poor, the working and lower middle classes in the years before the introduction of the National Health Service who would not agree that the medical care of this group was grossly inadequate.
STUDIES IN SICKLE CELL ANEMIA
Authors: SCOTT ROLAND B. , FREEMAN LELABELLE C. , FERGUSON ANGELLA D.
Published: December 2021

This survey of 1100 Negro children in various age categories was undertaken to determine the effect of age upon the appearance of the sickling phenomenon from infancy throughout childhood. The general incidence of sickling in 1100 Negro children including sickle cell anemia and sickle cell trait was 7.4%. The data on the incidence of the asymptomatic sickling trait and of sickle cell anemia are summarized by age and sex in Tables I and II.

We encountered 22 cases of sickle anemia, seven of which were previously undiagnosed and unknown. Sixteen cases of sickle cell anemia in males and six in females were encountered in the total test group, comprising 651 males and 449 females.

This investigation disclosed 60 subjects bearing the asymptomatic sickling trait. There were 40 and 20 instances of asymptomatic sickling observed in 635 males and 443 females, respectively. When the sexes were divided into two age categories (1 month through 4 years and 5 years through 16 years), there was an actual decrease in the incidence of sickling in the girls and an increase in the sickling phenomenon in the boys. We have no explanation for this finding. The overall incidence of the sickling trait for both sexes in all age groups represents no significant deviation from a 1:1 ratio.

The data available from this study failed to disclose a definite progressive increase in the incidence of sickling in the age groups studied. Quantitatively the general transition from the low incidence of sickling in the newborn (3.4%) to the higher occurrence in older children (7.5%) apparently takes place during the first year of life. Additional studies of both a qualitative and quantitative nature and involving a detailed age breakdown during the first year of life would probably elucidate this period of transition.
THE CONCENTRATION OF DIFFERENT AMINO ACIDS IN THE BLOOD PLASMA IN CHILDREN SUFFERING FROM RICKETS AND SCURVY
Authors: HUISMAN T. H. J.
Published: December 2021

Using the chromatographic analysis with Dowex 50 according to Stein and Moore the ninhydrin positive substances of plasma filtrates were determined before and sometimes after hydrolysis.

Plasma filtrates of two normal adults, four normal children of different ages, two children with scurvy and three patients with some form of rickets were analyzed in whole or in part. It was shown, that most of the common amino-acids are present in notable amounts, while hydroxy-proline is lacking. Many unknown substances are also present, some of them seem to be inherent to age.

Aspartic and glutamic acids are present in large amounts as asparagine and glutamine, while after hydrolysis only alanine, valine, leucine, phenyl-alanine, histidine and perhaps threonine and serine have been increased in concentration.

The chromatographic studies of the plasma of children with scurvy and with rickets showed no significant differences as compared with controls.
OBITUARY
Authors: SCHWENTKER FRANCIS F.
Published: December 2021

FRANCIS F. SCHWENTKER was born in Schenectady, New York, on February 13, 1904. He graduated from Union College in 1925, and in that year entered the Johns Hopkins Medical School. Schwentker was an outstanding student from the onset of his medical career. During the course of his first year study of anatomy, he discovered a small group of cells embedded in the hypoglossal nucleus of the specimen which he was dissecting. He showed that these cells are of definite structure and are constantly present in the human brain and that they are probably a source of autonomic fibers to the tongue.