bluuebunny/crossref_metadata_2025 huggingface dataset:
DEVELOPMENT OF A MANDARIN-SPEAKING CHILD'S COMPREHENSION OF WH-QUESTIONS
Authors: Thomas LEE Hun-tak
Published: March 2016

On s'attache ici à décrire le développement de la compréhension des interrogatifs chez un enfant entre l'âge de 17;0 à 24;0 parlant le mandarin. Les données se composent d'enregistrements au magnétophone et de notes personnelles. Les questions posées sont les suivantes : Quand et comment l'enfant apprend-il à distinguer entre les interrogatifs et les autres parties du discours ? Quelles stratégies de réponse adopte-t-il face aux interrogatifs employés par les adultes ? Quelles sont les évolutions dans sa compréhension des questions avec shenme "quoi ?", nali "où ?" et shei "qui ?" ?On apporte des éléments qui permettent de répondre que l'enfant, face aux questions qu'il ne comprend pas, s'appuie sur la répétition d'éléments se trouvant dans la question et sur des réponses stéréotypées.

Les informations recueillies indiquent que la compréhension des interrogatifs peuvent suivre plusieurs phases de développement. Enfin, on compare les niveaux de compréhension et de production de phrases avec des interrogatifs chez l'enfant.
L'OPPOSITION ENTRE V-QILAI ET V-DE ET LES ADJECTIFS PREDICATIFS
Authors: Mei-chih Tsai
Published: March 2016

Both V-qilai and V-de can associate with predicative adjectives (PA). Firstly, this work will show the semantic function of V-qilai through the opposition with V-de. Secondly, we will show that the syntactic role of V-qilai in the construction  is related to the nature of the predicative adjective.
Wood anatomy and acoustic properties of selected tropical hardwoods
Authors: Baar Jan , Tippner Jan , Gryc Vladimir
Published: March 2016

Selected anatomical features and ground tissue composition were studied in four tropical hardwoods (Afzelia sp. [Doussié], Intsia sp. [Merbau], Astronium sp. [Muiracatiara] and Millettia sp. [Wengé]). These woods can be applied in musical instrument production, especially for xylophone bars. The measured density, 1st bending natural frequency and the logarithmic decrement of damping were used to calculate other acoustic properties such as dynamic young modulus of elasticity (Erf), specific modulus of elasticity (E´/ρ), internal friction (tan δ), and acoustic conversion efficiency (ACE).

The correlations between anatomy and acoustic properties were determined. Despite difficulties in specifying general characteristics of hardwoods due to their complicated and variable structure, correlations valid between species were found for specific modulus of elasticity. Specific modulus of elasticity was negatively correlated with ray tissue volume and positively with ray height to width ratio and fiber length. The diversity in ground tissue composition was the main criterion for the species choice and probably should condition diverse correlations of anatomical features found for individual species. It seems that better acoustic properties (higher stiffness, ACE or specific modulus of elasticity) are performed by wood with longer fibers and slender rays, causing minimal deflection of adjoining fibers.
Cladistic analysis of Subfamily Bruchomyiinae (Diptera: Psychodidae)
Authors: Wagner RÜDIGER , Stuckenberg BRIAN
Published: March 2016

Subfamily Bruchomyiinae is comprised of 60 species and has been referred to as the most primitive within the Psychodidae. The assumed sister-group relationship with Phlebotominae is based on ecological constraints of their environment. A cladistics analysis based on 29 characters and 52 species revealed the distinction of an Old World clade characterized by males with elongate, narrow vasa deferentia, and a New World clade with males having shorter and basally widened vasa deferentia. The Old World clade consists of the genera Nemopalpus Macquart (9 species), and Eutonnoiria Alexander (1 species). The New World clade includes Bruchomyia Alexander (10 species), Boreofairchildia genus nov. (13 species), Laurenceomyia genus nov. (5 species), and Notofairchildia genus nov. (15 species). Parsimony and Bayesian analyses resulted in trees that generally support this generic classification; however, with some species groups less resolved. Diagnostic features for genera are provided. In contrast to the other New World genera, Notofairchildia is paraphyletic with the provisional inclusion of at least the Australasian taxa.
Revision of the Dysmorphoptilidae (Hemiptera: Cicadomorpha: Prosboloidea) of the Queensland Triassic—Part 2
Authors: LAMBKIN KEVIN J.
Published: March 2016

The extinct hemipteran family Dysmorphoptilidae was a major component of the Triassic insect fauna of Queensland preserved at the Denmark Hill, Dinmore, Mount Crosby and Gayndah fossil insect sites. A total of 13 species have now been identified, of which eight species in five genera were examined in the first part of this revision. This second part revises the remaining five species in three genera. Eoscartoides Evans, 1956 (= Mesonirvana Evans, 1956, syn. nov.), comprising Eoscartoides bryani Evans, 1956 (= Mesonirvana abrupta Evans, 1956, syn. nov.) (Mount Crosby), Eoscartoides orthocladus (Tillyard, 1922) comb. nov. (Denmark Hill), and Eoscartoides dmitryi sp. nov. (Dinmore), is distinguished by a strongly developed arc-like strigil in the basal costal space, a very short stem of RA, and a deeply forked M1+2. The monotypic Eoscarterella Evans, 1956, with type species Eoscarterella media Evans, 1956 (Mount Crosby), has a strongly lobate tegmen with peculiar surface sculpture and M1+2 simple. Eoscartoides and Eoscarterella differ from most dysmorphoptilids in having more or less lobate tegmina with even margins (without the antero-apical emargination so typical of the family), as well as the early entry of RA1 into the costal margin and the associated extensive and antero-apically positioned RA2. These characters are also shared with two other dysmorphoptilids, the Australian Permian Belmontocarta Evans and an unnamed Triassic species from Kyrgyzstan, and the four thus form a distinct subgroup within the family. On the other hand, the monotypic Trifidella Evans, 1956 (= Alotrifidus Evans, 1956, syn. nov.), with type species Trifidella perfecta Evans, 1956 (= Alotrifidus interruptus Evans, 1956, syn. nov.) (Mount Crosby), is a more typical dysmorphoptilid with a distinct emargination, RA entering the margin much more apically, and RA2 of limited extent. Trifidella is presumably the sister of the Queensland Triassic Dysmorphoptiloides Evans, sharing the basal fusion of M and CuA.
A molecular phylogenetic study on South Korean Tettigonia species (Orthoptera: Tettigoniidae) using five genetic loci: The possibility of multiple allopatric speciation
Authors: KIM TAE-KYU , HAN TAEMAN , KIM TAE-WOO , PARK IN GYUN , KIM SEONGHYUN , PARK HAECHUL
Published: March 2016

In Korea, members of the genus Tettigonia have been known as two species, T. ussuriana and T. dolichoptera dolichoptera. However, the taxonomic status of the Jeju Island population of T. ussuriana (JJ-TU) is in question, relative to the mainland population (ML-TU), because of their different body sizes and ratios of wing length. To clarify the relatedness of JJ-TU and ML-TU, we examined the genetic variation and phylogenetic relationships within and between T. ussuriana and related species collected in South Korea, using five genetic loci: three mitochondrial genes (cytochrome c oxidase subunit 1 [CO1], cytochrome c oxidase subunit 2 [CO2], NADH dehydrogenase 1 [ND1]) and two nuclear loci (second internal transcribed spacer [ITS2], and tubulin alpha-1 [TA1]). Unexpectedly, the JJ-TU population is explicitly sister to T. d. dolichoptera, with low genetic distance (0.76–1.22% in CO1), indicating no direct connection with the ML-TU population; this finding suggests a recent divergence involving rapid morphological change without gene flow between JJ-TU and mainland T. d. dolichoptera. The separation of these populations from their common ancestor was caused by geographical isolation during last glacial age. This finding indicates that the JJ-TU population should be elevated to the rank of subspecies, at the very least. Furthermore, the ML-TU population was also revealed to have four genetically divided groups (group A–D) from four localized populations, but no significant morphological differences exist among them. The genetic difference (range 3.19–4.10% in CO1) between group A + B and C + D was especially large, suggesting that cryptic speciation has widely occurred within the mainland areas, caused by allopatric isolations resulting from mountain barriers.
The transfer of two clades of Malaysian Sphenomorphus Fitzinger (Squamata: Scincidae) into the genus Tytthoscincus Linkem, Diesmos, & Brown and the description of a new Malaysian swamp-dwelling species
Authors: GRISMER L. LEE , MUIN MOHD ABDUL , WOOD PERRY L. JR. , ANUAR SHAHRUL , LINKEM CHARLES W.
Published: March 2016

Phylogenetic analyses based on the mitochondrial gene ND2 and its flanking tRNAs indicate the diminutive upland and insular species Sphenomorphus bukitensis, S. butleri, S. langkawiensis, S. perhentianensis, and S. temengorensis form a monophyletic group that is phylogenetically embedded within the Southeast Asian genus Tytthoscincus. The analyses also indicate that a new swamp-dwelling skink from the Bukit Panchor State Park, Pulau Pinang, Peninsular Malaysia is the sister species to the swamp-dwelling species S. sibuensis from Pulau Sibu, Johor and Singapore and that these two are also embedded in the genus Tytthoscincus. By transferring the two Peninsular Malaysian clades of Sphenomorphus into the genus Tytthoscincus, the monophyly of the latter is maintained. The new species T. panchorensis sp. nov. can be distinguished from all other species of Tytthoscincus by having a unique combination of morphological and color pattern characteristics.
Usefulness of Heart-Type Fatty Acid-Binding Protein and Myocardial Performance Index for Early Detection of 5-Fluorouracil Cardiotoxicity
Authors: Turan Turhan , Agac Mustafa Tarik , Aykan Ahmet Çağrı , Kul Selim , Akyüz Ali Rıza , Gökdeniz Tayyar , Gül İlker , Cengiz Ercüment , Boyacı Faruk , Erkan Hakan , Akdemir Ramazan , Celik Sukru
Published: March 2016

In the present study, we aimed to evaluate temporal changes in heart-type fatty acid-binding protein (h-FABP) and myocardial performance index (Tei index) following administration of 5-fluorouracil (5-FU), a chemotherapeutic agent associated with myocardial ischemia induced by coronary vasospasm. Thirty-two patients with cancer receiving their first 5-FU-based chemotherapy were included in the study. Prior to chemotherapy and 24 hours after the initiation of chemotherapy, all patients underwent a comprehensive echocardiographic examination. Blood samples were taken for h-FABP and troponin I (TnI) measurements at different time points during the first 24 hours of 5-FU administration. Postinfusion echocardiography revealed worsening in Tei index (0.37 ± 0.08 vs 0.43 ± 0.07, P < .001). Clinically overt cardiotoxicity was evident in 4 (12.5%) of our patient population. Heart-type fatty acid binding protein and TnI levels were within normal ranges at all time points. Our results suggest that ischemia coronary vasospasm due to 5-FU cardiotoxicity should be reviewed. Furthermore, Tei index might be a sensitive indicator of occult 5-FU cardiotoxicity.
Implementing Corporate Social Responsibility: Empirical Insights on the Impact of the UN Global Compact on Its Business Participants
Authors: Schembera Stefan
Published: March 2016

The implementation of corporate social responsibility (CSR) is crucial for the legitimacy of an organization in today’s globalized economy. This study aims to enrich our knowledge of the implementation of the largest voluntary CSR initiative—the UN Global Compact (UNGC). Drawing on insights from stakeholder, network, and institutional theory, I derive a positive impact of UNGC participation duration on the implementation level of the UNGC principles, despite potential weaknesses in the initiative’s accountability structure. Moreover, I scrutinize the validity of the newly introduced UNGC “Differentiation Programme” before applying this framework in the empirical analysis. Results from ordinal, linear, and instrumental variable regression models suggest that, contrary to claims made by UNGC critics, the duration of UNGC participation does affect the level of UNGC implementation. However, this effect appears to be much smaller than previous practitioner studies have suggested. Moreover, strong local UNGC networks affect the implementation level of the UNGC positively. Their hypothesized moderating role between UNGC participation duration and UNGC implementation level, however, is only significant in networks with activities of high quality rather than high quantity.
Parliament will decide: An interplay of politics and principle
Authors: Hillmer Norman , Lagassé Philippe
Published: March 2016

Debates about Parliament’s role in deciding military deployments are clouded by misunderstandings of the relative legal authorities of the executive and the legislature, and the mixture of political objectives and democratic obligation that inform these discussions. Much has been written about the legal aspects of this question. This article considers instead the issues of politics and principle, which we argue are consistently interwoven: while governments have elevated Parliament’s role in military deployments for political purposes, the choice to involve the legislature also reflects the idea that it is the “right thing to do” in a democracy.
The Association Between Income Inequality and Oral Health in Canada
Authors: Moeller Jamie , Quiñonez Carlos
Published: March 2016

Societies exhibiting higher levels of economic inequality experience poorer health outcomes, and the proposed pathways used to explain these patterns are also relevant to oral health. This study therefore examines the relationship between the level of income inequality and the oral health and dental care services utilization of residents from eleven Canadian metropolitan areas. We calculated Pearson correlation coefficients (r) between each metropolitan area's Gini coefficient (used as a proxy for income inequality, calculated from 2006 Canadian census data) and each area's experience of dental pain, self-reported oral health, and use of dental care services (provided by data from the 2003 Canadian Community Health Survey). Greater levels of income inequality in the selected metropolitan areas were related to an increased likelihood of residents self-reporting their oral health as poor/fair and reporting a prolonged absence from visiting a dentist. There was, however, no relationship between the level of income inequality and the likelihood of respondents reporting a recent toothache, tooth sensitivity, or jaw pain. Policies designed to improve the oral health of the population, and Canadians' access to dental care generally, may therefore work best when supported by policies that promote greater economic equality within Canada.
Migrant infrastructure: Transaction economies in Birmingham and Leicester, UK
Authors: Hall Suzanne , King Julia , Finlay Robin
Published: March 2016

Infrastructure convenes social relations, thereby revealing how city dwellers access shared resources in the context of growing inequality. Our exploration of migrant infrastructure engages with how highly variegated migrant groups develop a ‘transaction economy’ (Simone, 2004) within marginalised city streets, exchanging goods and services, and information and care. In the context of ethnically diverse and deprived urban places, where state resources are increasingly diminished, we explore how a precarious yet skilled resourcefulness emerges through the street. Our empirical exploration of migrant infrastructure is located on Rookery Road in Birmingham and on Narborough Road in Leicester, and draws on qualitative surveys with 195 self-employed proprietors from many countries of origin. The streets reveal transaction economies that intersect local and migratory resources, eluding the categorisation of cities associated with either a global North or a global South. Further, the lively nature of street transactions decentres western-centric measures of economic value. From the street, we develop a postcolonial analysis of infrastructure that relates properties of historic depth (power), socio-spatial texture (materiality) and locality (place).
The law is not enough: Seeking the theoretical ‘frontier of urban justice’ via legal tools
Authors: Pierce Joseph , Martin Deborah
Published: March 2016

This commentary examines the conceptual limits of urban justice through the use of legal tools, both generally and in actually existing neoliberal urban contexts. Our interest emerges from previous research on social service siting in a region with legal tools that seem exceptionally friendly to spatial justice due to limits on exclusionary zoning. Conceptually, such powerful legal levers might be expected to mitigate the generally observed tendency towards revanchism in contexts of urban government devolution. However, even given exceptional legal accommodations, we found a spatially concentrated service landscape, mirroring neoliberal market-led framings of ‘highest and best use’. Using this prior research as a point of departure, we highlight related findings in the broader literature on the use of the law by urban social justice activists. We argue that even maximally powerful legal protections for justice-oriented actors cannot blunt systematic spatio-political dynamics that lead marketised states towards revanchist outcomes. We call for future research which more explicitly charts the specific frontiers of the potential of the law as a tool for social justice.
When Urania meets Terpsichore: A Theatrical Turn for Astronomy Lectures in Early Nineteenth–Century Britain
Authors: Huang Hsiang–Fu
Published: March 2016

This paper highlights the significance of popular astronomy lectures in British theatres during the first half of the nineteenth century. The popular astronomy lecturing trade inherited from Enlightenment natural philosophy discourses. A ‘theatrical turn’ developed in the late eighteenth century and became extensive by the 1820s. Lecturers moved astronomy displays into theatres and used theatrical facilities, which resulted in a distinct type of show blending scientific instruction with sensational amusement. Lent was especially high season for this business in a metropolitan entertainment market. Pre–eminent cases of private entrepreneurs in this trade included William Walker, Deane Franklin Walker, George Bartley, and C. H. Adams. By exploring astronomy lectures in theatres, this paper also shows the spatial influence of the site on the format and style of the performance: the benefits and constraints of a theatre made a theatrical astronomy lecture distinct from others at a formal institution.
A Systematic Review of the Gender Pay Gap and Factors That Predict It
Authors: Bishu Sebawit G. , Alkadry Mohamad G.
Published: March 2016

This study conducts a systematic review of 98 peer-reviewed journal articles that empirically investigate the presence of the gender pay gap along with factors that espouse it in organizations. The purposes of this study are threefold. First, it aims to explore trends in recurring themes that surface as factors that engender the gender pay gap in the workforce. Second, based on identified themes, the review summarizes and compares the gender pay gap by sector. Finally, the study presents a discussion on how the public sector fairs out in closing the gender pay gap and factors that predict it.
Reduced-order disturbance observer design for discrete-time linear stochastic systems
Authors: Su Jinya , Li Baibing , Chen Wen-Hua , Yang Jun
Published: March 2016

Conventional disturbance observers for discrete-time linear stochastic systems assume that the system states are fully estimable and the disturbance estimate is dependent on the estimated system states, hereafter termed full-order disturbance observers (FODOs). This paper investigates the design of reduced-order disturbance observers (RODOs) when the system state variables are not fully estimable. An existence condition of RODOs is established, which is shown to be more easily satisfied than that of conventional FODOs and consequently it has substantially extended the scope of applications of disturbance observer theory. Then a set of recursive formulae for the RODO is developed for online applications. Finally, it is further shown that the conventional FODOs are a special case of the proposed RODO in the sense that the former reduces to the RODO when the states become fully estimable in the presence of disturbances. Examples are given to demonstrate the effectiveness and advantages of the proposed approach.
Hybrid time-varying delay projective synchronization in complex dynamical networks
Authors: Wei Qiang , Xie Cheng-jun , Liang Yi , Lin Da , Wang Bo
Published: March 2016

In this paper, a hybrid time-varying delay projective synchronization method for a complex dynamical network is proposed using a hybrid feedback controller. The existing synchronous errors of the delay projective synchronization are constant. However, the synchronous errors of the time-varying delay projective synchronization show time-varying delay. The time-varying delay projective synchronization improves the delay projective synchronization and the different component variables of the system of the node achieve a different time-varying delay projective synchronization. This paper researches the hybrid time-varying delay projective synchronization of two different types of complex dynamical network. Numerical simulations are given to demonstrate the effectiveness of the proposed synchronization scheme.
The Immoral Assumption Effect
Authors: Meindl Peter , Johnson Kate M. , Graham Jesse
Published: March 2016

Jumping to negative conclusions about other people’s traits is judged as morally bad by many people. Despite this, across six experiments (total N = 2,151), we find that multiple types of moral evaluations—even evaluations related to open-mindedness, tolerance, and compassion—play a causal role in these potentially pernicious trait assumptions. Our results also indicate that moralization affects negative—but not positive—trait assumptions, and that the effect of morality on negative assumptions cannot be explained merely by people’s general (nonmoral) preferences or other factors that distinguish moral and nonmoral traits, such as controllability or desirability. Together, these results suggest that one of the more destructive human tendencies—making negative assumptions about others—can be caused by the better angels of our nature.
Celebrity capital in the political field: Russell Brand’s migration from stand-up comedy to Newsnight
Authors: Arthurs Jane , Shaw Sylvia
Published: March 2016

Our case study of charismatic celebrity comedian Russell Brand’s turn to political activism uses Bourdieu’s field theory to understand the process of celebrity migration across social fields. We investigate how Brand’s capital as a celebrity performer, storyteller and self-publicist translated from comedy to politics. To judge how this worked in practice, we analysed the comedic strategies used in his stand-up show Messiah Complex and undertook a conversational analysis of his notorious interview with Jeremy Paxman on the British Broadcasting Corporation (BBC)’s flagship current affairs programme Newsnight. We argue that Brand was able to secure political legitimacy by creatively constituting himself as an authentic anti-austerity spokesperson for the disenfranchised left in United Kingdom. In order to do so, he repurposed his celebrity capital to political ends and successfully deployed the cultural and social capitals he had developed as a celebrity comedian to secure widespread engagement with his media performances.
Reconstruction of Lateral Skull Base Defects
Authors: Howard Brittany E. , Nagel Thomas H. , Barrs David M. , Donald Carrlene B. , Hayden Richard E.
Published: March 2016

Objectives

To compare reconstructive techniques, operative times, duration of hospitalization, and need for subsequent flap revisions between reconstructive approaches to lateral skull base defects.

Study Design

Case series with chart review.

Setting

Tertiary academic referral center.

Subjects

Patients (n = 31) undergoing reconstruction of composite lateral skull base defects from 2002 to 2014.

Methods

Data were analyzed for demographics, tumor characteristics, reconstructive technique, operative time, duration of hospitalization, complications, and outcomes.

Results

Thirty‐one patients were identified for inclusion. Lateral temporal bone defects resulted from resection of malignant lesions, including squamous cell carcinoma (n = 25), basal cell carcinoma (n = 2), and other carcinoma (n = 4). Defects were reconstructed with submental flaps (n = 16), pedicled latissimus dorsi flaps (n = 6), and free anterolateral thigh flaps (n = 9). All cases involved neurosurgery, neurotology, and head and neck surgery services. Although time of surgical resection was similar, time saving was noticed with submental reconstruction. Compared with free flaps, submental flap reconstruction was associated with significantly reduced total operative time (mean, 544 vs 683 min; P =. 00817) and duration of hospitalization (4.9 vs 9.8 days; P =. 02067). Submental flaps were significantly less likely to require revision debulking procedures (mean = 0.6) compared with latissimus dorsi flaps (mean, 1.3; P <. 00001) and free flaps (mean, 1.6; P <. 00001). There was 100% flap survival.

Conclusion

The musculocutaneous submental flap provides an excellent option for reconstruction of lateral skull base defects given its proximity, reliability, ease of harvest, and exceptional color match. Submental flap reconstruction was associated with reduced operative time, hospitalization duration, and flap revisions.
Upper Airway Stimulation for OSA
Authors: Kent David T. , Lee Jake J. , Strollo Patrick J. , Soose Ryan J.
Published: March 2016

Objective

To review outcome measures and objective adherence data for patients treated with hypoglossal nerve stimulation (HNS) therapy for moderate to severe obstructive sleep apnea (OSA).

Study Design

Case series with chart review.

Setting

Academic sleep medicine center.

Subjects and Methods

The first 20 implanted patients to complete postoperative sleep laboratory testing were assessed. All patients had moderate to severe OSA, were unable to adhere to positive pressure therapy, and met previously published inclusion criteria for the commercially available implantable HNS system. Data included demographics, body mass index (BMI), apnea‐hypopnea index (AHI), Epworth Sleepiness Score (ESS), nightly hours of device usage, and procedure‐ and therapy‐related complications.

Results

Mean age was 64.8 ± 12.0 years, with 50% female. Mean BMI was unchanged postoperatively (26.5 ± 4.2 to 26.8 ± 4.5 kg/m2; P >. 05). Mean AHI (33.3 ± 13.0 to 5.1 ± 4.3; P <. 0001) and mean ESS (10.3 ± 5.2 to 6.0 ± 4.4; P <. 01) decreased significantly. Seventy percent (14/20) of patients achieved a treatment AHI <5, 85% (17/20) an AHI <10, and 95% (19/20) an AHI <15. Average stimulation amplitude was 1.89 ± 0.50 V after titration. Adherence monitoring via device interrogation showed high rates of voluntary device use (mean 7.0 ± 2.2 h/night).

Conclusion

For a clinical and anatomical subset of patients with OSA, HNS therapy is associated with good objective adherence, low morbidity, and improved OSA outcome measures. Early results at one institution suggest that HNS therapy can be implemented successfully into routine clinical practice, outside of a trial setting.
Obstructive Sleep Apnea
Authors: Scott Brian , Johnson Romaine F. , Mitchell MD Ron B.
Published: March 2016

Introduction

The severity of obstructive sleep apnea in children determines perioperative management and is an indication for postoperative polysomnography. The relationship between increasing weight and sleep apnea severity in children remains unclear.

Objectives

To compare demographic, clinical, and polysomnography parameters in normal‐weight, overweight, obese, and morbidly obese children, as well as identify demographic factors that predict sleep apnea severity.

Study Design

Case series with chart review.

Setting

Academic children’s hospital.

Methods

A retrospective chart review of 290 children aged 2 to 18 years who underwent polysomnography at an academic children’s hospital was performed. Demographics, clinical findings, and polysomnographic parameters were recorded. Children were categorized as normal weight, overweight, obese, or morbidly obese. Differences were assessed using linear and logistical regression models. Significance was set at P <. 05.

Results

Morbidly obese were older than normal‐weight children (mean, 8.0 ± 0.5 years vs 5.8 ± 0.3 years; P <. 001) and less likely to have a normal polysomnogram (16% vs 48%; P =. 02). There were no differences in sex, ethnicity, birth status (term or preterm), or tonsil size between normal‐weight, overweight, obese, and morbidly obese children. Sleep efficiency and percentage of time in rapid eye movement were decreased in morbidly obese compared with other children (P <. 05). The apnea‐hypopnea index was positively correlated with increasing body mass index z score only as a function of increasing age (P <. 001).

Conclusion

Obstructive sleep apnea severity is correlated with a combination of increasing age and weight but not with either variable independently. This study suggests that obese and morbidly obese older children are most likely to have severe obstructive sleep apnea.
Efficacy of Upper Airway Stimulation on Collapse Patterns Observed during Drug‐Induced Sedation Endoscopy
Authors: Ong Adrian A. , Murphey Alexander W. , Nguyen Shaun A. , Soose Ryan J. , Woodson B. Tucker , Vanderveken Olivier M. , de Vries Nico , Gillespie M. Boyd
Published: March 2016

Objective

To describe upper airway collapse patterns observed on drug‐induced sedation endoscopy (DISE) during screening for a clinical trial and to evaluate the impact of collapse patterns found on preoperative DISE on response rates to upper airway stimulation (UAS) therapy.

Study Design

Retrospective review of an ongoing prospective multi‐institutional cohort study.

Setting

Twenty‐two participating institutions of the STAR trial.

Subjects and Method

In total, 222 subjects were screened with DISE to determine eligibility for an implantable UAS device. Supine laryngoscopy was performed during moderate sedation (propofol and/or midazolam). Airway collapse pattern and severity were graded at 4 levels, including velum, oropharynx, tongue base, and epiglottis (VOTE classification). Patients with complete concentric collapse (CCC) at the velum were excluded from implantation.

Results

The CCC at the velum was observed in 52 (23%) of screened subjects, and these subjects were subsequently excluded from implantation. Of the 170 subjects without CCC at the velum, 126 (77%) underwent implantation: 121 (96%) had multilevel collapse and 5 (4%) had single‐level collapse. When comparing preimplantation DISE findings, UAS responders at 12 months had lower baseline VOTE scores compared with therapy nonresponders.

Conclusion

Drug‐induced sedation endoscopy is an efficient and safe method for determining UAS eligibility and has the potential to identify UAS nonresponders. Most patients had multilevel airway collapse, illustrating the limitations of single‐level upper airway surgery in treating obstructive sleep apnea. Upper airway stimulation is effective therapy for most patients with multilevel airway collapse; however, patients with complete anterior‐posterior or lateral soft palate and/or epiglottic collapse may be at increased risk of therapy failure.
Financial and Health Impacts of Multidisciplinary Aerodigestive Care
Authors: Skinner Margaret L. , Lee Seohee K. , Collaco Joseph M. , Lefton‐Greif Maureen A. , Hoch Jeannine , Au Yeung Karla J.
Published: March 2016

Objectives

(1) Analyze upstream and downstream activity before and after enrollment with the Multidisciplinary Pediatric Aerodigestive Care Team (MPACT). (2) Identify potential demand for MPACT services with ICD‐9 data.

Study Design

Retrospective review of financial claims data.

Setting

Tertiary care children’s center.

Subjects

Pediatric patients (0‐18 years old) enrolled with MPACT (pediatric otolaryngology, gastroenterology, pulmonary, speech‐language pathology).

Methods

Case mix data from fiscal years (FYs) 2010‐2013 were analyzed for primary, secondary, and tertiary ICD‐9 codes in 4 aerodigestive diagnostic categories (ADCs): dysphagia, chronic cough, gastroesophageal disease, and chronic pulmonary disease/asthma. Inclusion criteria included patients <18 years old, seen by MPACT, with FY2010‐FY2013 case mix data and ≥2 ADCs. Unique outpatient and inpatient encounters and associated charges were evaluated to determine upstream and downstream activity trends.

Results

Of the 126 patients meeting inclusion criteria, 55 (44%) had ≥3 ADCs, and 11 (9%) had 4. These 126 patients received outpatient care during 3068 unique encounters. Outpatient total charges were $282,102 before and $744,542 after MPACT intervention. Eighty‐six (68%) patients received inpatient care during 423 unique encounters. Inpatient charges were $4,257,137 before and $2,872,849 after MPACT enrollment. Overall, a net reduction of $921,848 in total charges, $7316 per MPACT patient, was noted. FY2010‐FY2014 data identified an additional 1728 pediatric patients with ≥2 ADCs not enrolled in MPACT.

Conclusion

A cohort of children with aerodigestive disease experienced a shift from inpatient to outpatient care with an overall 20% reduction in patient charges when the years before and after MPACT enrollment were compared. Available ICD‐9 data suggest potential demand for MPACT services.
Complete carotid and coronary revascularization in brain malperfusion
Authors: Aramendi Claudia , Cubero Alain , Cortés Andrés , Rivas Daniel , Crespo Alejandro , Aramendi José I
Published: March 2016

A 54-year-old man presented with unstable angina and stroke with right hemiplegia and aphasia due to left main coronary plus 3-vessel disease, severe stenosis of bilateral internal carotid, proximal left common carotid, and proximal left subclavian arteries. Simultaneous complete revascularization was undertaken with the use of conventional cardiopulmonary bypass and moderate hypothermia (25℃). The left internal mammary artery and two saphenous vein grafts were used for coronary artery bypass, and brain revascularization consisted of a left aorta-to-common carotid Dacron graft and bilateral carotid endarterectomy. Recovery was good.
Puncture and wiring of extracorporeal circuit for cannula safe removal or exchange
Authors: Heller Samuel , Kovárník Tomáš , Linhart Aleš , Bělohlávek Jan
Published: March 2016

A previously undescribed technique for removing a cannula used in extracorporeal life support (ECLS) is proposed, using an over-the-wire technique by puncturing the circuit and continuing with a pre-close technique for access site closure.
Death after cessation of treatment by cystic fibrosis patients: An international survey of clinicians
Authors: Pisaturo Marisa , Deppen Alain , Rochat Isabelle , Robinson Walter M , Hafen Gaudenz M
Published: March 2016

Background:

Little is known about cystic fibrosis patients, who are not considered to be terminally ill, and who die after voluntary cessation of treatment.

Aim:

This study was undertaken to provide an international snapshot of this issue.

Design:

An online survey was distributed across three continents.

Setting:

Distribution to the medical directors of the cystic fibrosis centres affiliated with the US Cystic Fibrosis Foundation, Cystic Fibrosis Australia (inclusion of New Zealand) and to every clinician member of the European Cystic Fibrosis Society.

Results:

More than 200 cystic fibrosis patients not considered to be terminally ill and, who voluntarily ceased treatment, were reported by the clinicians surveyed. Detailed data were reported in 102 patients (4 children, 25 adolescents and 73 adults). Only one child, six adolescents and one adult were judged by clinicians not to be competent to make the decision to stop treatment. Time-consuming and low immediate-impact therapies, such as respiratory physiotherapy, were most frequently discontinued. Resignation was the main reported reason for discontinuing treatment, followed by reactive depression and lack of familial support. A total of 69% of the patients received palliative care and 72% died in the 6 months following cessation of treatment.

Conclusion:

Death of cystic fibrosis patients, not considered to be terminally ill, is reported in Europe, the United States and Australia due to voluntary cessation of treatment.
Grandparents in Urban and Rural Lower Languedoc at the End of the Middle Ages
Authors: Laumonier Lucie
Published: March 2016

This article analyzes the role and place of grandparents in their kinship groups in Lower Languedoc at the end of the Middle Ages. Based on the notarial documentation (wills, marriage, and donation contracts), the research demonstrates that, although rare in the archives, grandparents were objects of concern—especially if women—but could also take an active part in the administration of estates and families, particularly after the death of their own children. Some authoritative figures stand out from the documentation, whose stories shed light on the daily life of the medieval Languedocian families at times of personal difficulties.
Reliability and Associated Risk Factors for Performance on the Vestibular/Ocular Motor Screening (VOMS) Tool in Healthy Collegiate Athletes
Authors: Kontos Anthony P. , Sufrinko Alicia , Elbin R.J. , Puskar Alicia , Collins Michael W.
Published: March 2016

Background:

The Vestibular/Ocular Motor Screening (VOMS) is a newly developed screening tool that evaluates vestibular and ocular motor symptom (eg, headache, dizziness, nausea, fogginess) provocation after a sport-related concussion. Baseline data on the VOMS are needed to extend the application of this measure to broad age groups and to document normal variations in performance.

Purpose:

The primary purpose of this study was to examine the internal consistency of the VOMS in a large sample of healthy, nonconcussed collegiate athletes. The secondary purpose was to investigate the effects of patient sex and history of motion sickness, migraines, and concussions on baseline VOMS scores.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

A total of 263 National Collegiate Athletic Association Division I athletes (mean ± SD age, 19.85 ± 1.35 years) completed self-reported demographic and medical history at preseason physical examinations and baseline screening. Internal consistency of the VOMS was assessed with Cronbach α. A series of univariate nonparametric tests (χ2 with odds ratios [ORs] and 95% CIs) were used to examine the associations among medical history risk factors and VOMS clinical cutoff scores (score of ≥2 for any individual VOMS symptom, near point of convergence [NPC] distance of ≥5 cm), with higher scores representing greater symptom provocation.

Results:

Internal consistency of the VOMS was high (Cronbach α = .97), and 89% of athletes scored below cutoff levels (ie, 11% false-positive rate). Female athletes (OR, 2.99 [95% CI, 1.34-6.70]; P = .006) and those with a personal history of motion sickness (OR, 7.73 [95% CI, 1.94-30.75]; P = .009) were more likely to have ≥1 VOMS scores above cutoff levels. No risk factors were associated with increased odds of an abnormal NPC distance.

Conclusion:

The VOMS possesses internal consistency and an acceptable false-positive rate among healthy Division I collegiate student-athletes. Female sex and a history of motion sickness were risk factors for VOMS scores above clinical cutoff levels among healthy collegiate student-athletes. Results support a comprehensive baseline evaluation approach that includes an assessment of premorbid vestibular and oculomotor symptoms.
Helping Parents With Chores or Going Out With Friends: Cultural Differences in Adolescents’ Responses to Potentially Conflicting Expectations of Parents and Peers
Authors: Tamm Anni , Kasearu Kairi , Tulviste Tiia , Trommsdorff Gisela , Saralieva Zaratkhan Kh.-M.
Published: March 2016

The study examined cultural similarities and differences in how adolescents deal with conflicting expectations of parents and peers. It was tested to what extent adolescents’ interdependence values and satisfaction with family and friendships predict the way they would solve the disagreement, where they had planned to go out with friends, but their parents wanted them to stay at home to do chores. Moreover, adolescents’ reasons for their reported actions were examined. The sample included 894 Estonian, German, and Russian adolescents ( M age around 15 years). Russian adolescents were more likely than their Estonian and German peers to comply with parents’ requests. This was possibly due to interdependence values being more important for them. Satisfaction with family relationships and friendships was not linked to adolescents’ compliance. Adolescents from all cultures were similar in terms of suggesting self-oriented reasons for noncompliance, while Estonian and German adolescents expressed their need for autonomy more explicitly. Russian adolescents were, however, more oriented to maintaining good relationships with parents and friends, respectively, in their reasons for compliance and noncompliance. They were also less likely to suggest compromise.
Potential of mannan or dextrin nanogels as vaccine carrier/adjuvant systems
Authors: Gonçalves Catarina , Ferreira Sílvia A , Correia Alexandra L , Lopes Célia , Fleming Carolina E , Rocha Eduardo , Vilanova Manuel , Gama Miguel
Published: March 2016

Polymeric nanogels have been sophisticatedly designed promising a new generation of vaccine delivery/adjuvant systems capable of boosting immune response, a strategic priority in vaccine design. Here, nanogels made of mannan or dextrin were evaluated for their potential as carriers/adjuvants in vaccine formulations. Since lymph nodes are preferential target organs for vaccine delivery systems, nanogels were biotin-labeled, injected in the footpad of rats, and their presence in draining lymph nodes was assessed by immunofluorescence. Nanogels were detected in the popliteal and inguinal lymph nodes by 24 h upon subcutaneous administration, indicating entrapment in lymphatic organs. Moreover, the model antigen ovalbumin was physically encapsulated within nanogels and physicochemically characterized concerning size, zeta potential, ovalbumin loading, and entrapment efficiency. The immunogenicity of these formulations was assessed in mice intradermally immunized with ovalbumin–mannan or ovalbumin–dextrin by determining ovalbumin-specific antibody serum titers. Intradermal vaccination using ovalbumin–mannan elicited a humoral immune response in which ovalbumin-specific IgG1 levels were significantly higher than those obtained with ovalbumin alone, indicating a TH2-type response. In contrast, dextrin nanogel did not show adjuvant potential. Altogether, these results indicate that mannan nanogel is a material that should be explored as a future antigen delivery system.
Local biological effects of adipose stromal vascular fraction delivery systems after subcutaneous implantation in a murine model
Authors: Vigani Barbara , Mastracci Luca , Grillo Federica , Perteghella Sara , Preda Stefania , Crivelli Barbara , Antonioli Barbara , Galuzzi Marta , Tosca Marta C , Marazzi Mario , Torre Maria L , Chlapanidas Theodora
Published: March 2016

The aim of this study was to test alginate beads and silk fibroin non-woven mats as stromal vascular fraction delivery systems to support cell implantation for tissue repair and regeneration, through trophic and immunomodulant paracrine signaling. Furthermore, in vivo scaffold biocompatibility was histologically analyzed in a murine model at different time endpoints, with particular focus on construct-induced vascularization and neoangiogenesis. The fibroin mat induced a typical foreign body reaction, recruiting macrophages and giant cells and concurrently promoted neovascularization of the implanted construct. Conversely, alginate beads triggered a more circumscribed, chronic inflammatory reaction, which decreased over time. The combined in vivo implantation of alginate beads and fibroin mat with stromal vascular fraction promoted vascularization and integration of scaffolds into the surrounding subcutaneous environment. The new blood vessel ingrowth should, hopefully, support engineered cell viability and functionality, as well as the transport of soluble bioactive molecules. Due to their neovascularization properties, stromal vascular fraction administration, using alginate or fibroin scaffolds, is a new, promising, cost-effective tissue engineering approach.
Surface PEGylation of intraocular lens for PCO prevention: An in vivo evaluation
Authors: Xu Xu , Tang Jun-Mei , Han Yue-Mei , Wang Wei , Chen Hao , Lin Quan-Kui
Published: March 2016

Posterior capsular opacification (PCO) is a common complication in cataract surgery. The development of PCO is attributed to the combination of adhesion, migration, proliferation, and transdifferentiation of the residual lens epithelial cells (LEC) onto the interface of intraocular lens (IOL) material and lens posterior, in which the initial adhesion is the beginning step and plays important roles. In the present study, hydrophilic polyethylene glycol (PEG) was immobilized onto IOL surface via plasma-aided chemical grafting procedure. The attenuated total reflection – Fourier transform infrared (ATR-FTIR) and contact angle (CA) – measurements indicate the successful surface PEGylation, as well as the excellent hydrophilicity of the surfaces. Compared with pristine IOL, the PEGylation does not influent its optical property, whereas the initial adhesion of LEC is greatly inhibited. In vivo ocular implantation results show that the PEGylated IOL presents good in vivo biocompatibility, and can effectively prevent the PCO development.