bluuebunny/crossref_metadata_2025 huggingface dataset:
Political leadership in an anti‐political age
Authors: Kenny Michael , Pearce Nick
Published: September 2014

Michael Kenny and Nick Pearce ask how political leadership might be rehabilitated in the current anti‐political climate, and argue that a widely held desire for popular self‐government requires new kinds of leadership that can direct this sensibility towards, rather than against, democracy itself.
Another crack at power‐sharing?: Which way forward for the Lib Dems?
Authors: Green Miranda
Published: September 2014

Miranda Green considers what the Lib Dems' strategy should be for the next election. Should they seek to share power for another term, or recapture its mantle as a radical insurgent? Can they combine both ambitions into a single platform?
Investing in reform: A new bond could beat our addiction to fossil fuel subsidies
Authors: Hale Tom , Ogden Pete
Published: September 2014

Fossil fuel subsidies are woven into the fabric of many economies, holding back the transition towards clean energy. Tom Hale and Pete Ogden propose a new form of financial instrument – ‘SPARC bonds’ – that could overcome the political and economic barriers to reform.
Crystal Structure and Effective Dielectric Response of Ba0.5Sr0.5TiO3–MgO Composites Synthesized In Situ Process
Authors: Zhang Jingji , Ji Ludong , Jia Xuanrui , Wang Jiangying , Zhai Jiwei , Zhou Yun
Published: September 2014

(1 − x)Ba0.5Sr0.5TiO3(BST)–xMgO composite ceramics have been prepared in situ by a citrate–nitrate combustion process, and their crystal structure and effective dielectric response have been investigated systematically. Results reveal that MgO particles homogeneously disperse in BST particles. Rietveld refinement of X‐ray diffraction data shows that the amount of the incorporation of MgO into BST lattice is increased with increasing the MgO volume fraction (ƒM). It is identified that the incorporation of Mg2+ into B site gives rise to the formation of F centers in the composites. Related with the incorporation of Mg2+ into BST lattice, the permittivity of BST in the composite is strongly dependent on ƒM, which is defined by the relation . Also, the high percolation threshold of ƒM = 0.60 is observed, which is well in agreement with the theoretical predictions of the modified effective medium approximation coupled with the spherical inclusion model.
High‐Strength ZrC Ceramics Doped with Aluminum
Authors: Wang Xin‐Gang , Zhang Guo‐Jun , Zhao Jian , Xue Jia‐Xiang , Xu Chang‐Ming , Wang Pei‐Ling
Published: September 2014

High‐strength ZrC ceramics with relative density above 98% were prepared by reactive hot pressing of ZrC and Al at 1900°C. The reaction between ZrC and Al resulted in the formation of ZrC1−x, Zr3Al3C5 and Zr–Al compound such as AlZr3 and Al–C–Zr. The intermediate product AlZr3 below 1600°C and remained Al–C–Zr phase could form liquid phase and promoted the first stage of densification process. The improvement in densification behavior at higher temperatures (1800°C–1900°C) could be attributed to the formation of nonstoichiometric ZrC1−x. Adding 5 wt% and 7.5 wt% Al to ZrC, the formed ZrC0.85–Zr3Al3C5 and ZrC0.80–Zr3Al3C5 based ceramics had 3‐point bending strength as high as 757 ± 79 MPa and 967 ± 50 MPa, respectively, with hardness and fracture toughness being 16.2–18.3 GPa and 3.3–3.5 MPa m1/2, respectively.
Relaxor Behavior and Large Room‐Temperature Polarization of Ferroelectric Sr4CaBiTi3Nb7O30 Ceramics
Authors: Gong Gaoshang , Zerihun Gebru , Fang Yujiao , Huang Shuai , Yin Chongyang , Yuan Songliu
Published: September 2014

A new relaxor ferroelectric ceramics, Sr4CaBiTi3Nb7O30, were prepared. The microstructure, morphology, dielectric, and ferroelectric properties were studied. The ceramics were found that growing in some directions preferentially. Two dielectric relaxations were observed below the Burns temperature TB = 460 K and relaxation‐I can be described by the Vogel–Fulcher law. The Curie–Weiss constant (C) of 1.33 × 105 K confirms the displacive‐type ferroelectric phase transition. The ceramics exhibit the first‐order diffuse ferroelectric phase transition feature. The diffusion exponent varies from 1.99 to 1.92 with different applied frequencies. Room‐temperature (RT) polarization was evaluated, and Pr = 2.6 μC/cm2, Ec = 15.2 kV/cm values were obtained. The high breakdown voltage (≥80 kV/cm) and low leakage current confirmed the high quality of Sr4CaBiTi3Nb7O30 ceramics. All of these features suggest that Sr4CaBiTi3Nb7O30 may be used to substitute lead‐based relaxor ferroelectric materials for environmental friendly. Raman spectra and polarization measured at different temperatures attribute the high‐ and low‐temperature dielectric relaxation to flipping and breathing of polar nanoregions, respectively.
Differential associations of early callous‐unemotional, oppositional, and ADHD behaviors: multiple domains within early‐starting conduct problems?
Authors: Waller Rebecca , Hyde Luke W. , Grabell Adam S. , Alves Martha L. , Olson Sheryl L.
Published: September 2014

Background

Early‐starting child conduct problems (CP) are linked to the development of persistent antisocial behavior. Researchers have theorized multiple pathways to CP and that CP comprise separable domains, marked by callous‐unemotional (CU) behavior, oppositional behavior, or ADHD symptoms. However, a lack of empirical evidence exists from studies that have examined whether there are unique correlates of these domains.

Methods

We examined differential correlates of CU, oppositional, and ADHD behaviors during the preschool years to test their potentially distinct nomological networks. Multimethod data, including parent and teacher reports and observations of child behavior, were drawn from a prospective, longitudinal study of children assessed at age 3 and age 6 (N = 240; 48% female).

Results

Dimensions of CU, oppositional, and ADHD behaviors were separable within Confirmatory Factor Analyses across mother and father reports. There were differential associations between CU, oppositional, and ADHD behaviors and socioemotional, cognitive, and behavioral outcomes: CU behavior was uniquely related to lower moral regulation, guilt, and empathy. ADHD was uniquely related to lower attentional focusing and observed effortful control. Finally, CU behavior uniquely predicted increases in teacher‐reported externalizing from ages 3–6 over and above covariates, and ADHD and oppositional behavior.

Conclusions

Consistent with theory, dimensions of CU, ADHD, and oppositional behavior demonstrated separable nomological networks representing separable facets within early‐starting CP.
Sarcocystis caninum and Sarcocystis svanai n. spp. (Apicomplexa: Sarcocystidae) Associated with Severe Myositis and Hepatitis in the Domestic Dog (Canis familiaris)
Authors: Dubey Jitender P. , Sykes Jane E. , Shelton G. Diane , Sharp Nick , Verma Shiv K. , Calero‐Bernal Rafael , Viviano Jenifer , Sundar Natarajan , Khan Asis , Grigg Michael E.
Published: September 2014

There are several reports of Sarcocystis sarcocysts in muscles of dogs, but these species have not been named. Additionally, there are two reports of Sarcocystis neurona in dogs. Here, we propose two new names, Sarcocystis caninum, and Sarcocystis svanai for sarcocysts associated with clinical muscular sarcocystosis in four domestic dogs (Canis familiaris), one each from Montana and Colorado in the USA, and two from British Columbia, Canada. Only the sarcocyst stage was identified. Most of the sarcocysts identified were S. caninum. Sarcocysts were studied using light microscopy, transmission electron microscopy (TEM), and polymerase chain reaction. Based on collective results two new species, S. caninum and S. svanai were designated. Sarcocystis caninum and S. svanai were structurally distinct. Sarcocystis caninum sarcocysts were up to 1.2 mm long and up to 75 μm wide. By light microscopy, the sarcocyst wall was relatively thin and smooth. By TEM, the sarcocyst wall was “type 9”, 1–2 μm thick, and contained villar protrusions that lacked microtubules. Bradyzoites in sections were 7–9 μm long. Sarcocysts of S. svanai were few and were identified by TEM. Sarcocystis svanai sarcocysts were “type 1”, thin walled (< 0.5 μm), and the wall lacked villar protrusions but had tiny blebs that did not invaginate. DNA was extracted either from infected frozen muscle biopsies or formalin‐fixed paraffin‐embedded sections. Dogs were either singly infected with S. caninum or multiply co‐infected with S. caninum and S. svanai (the result of a mixed infection) based on multilocus DNA sequencing and morphology. BLASTn analysis established that the sarcocysts identified in these dogs were similar to, but not identical to Sarcocystis canis or Sarcocystis arctosi, parasites found to infect polar bears (Ursus maritimus) or brown bears (Ursus arctosi), respectively. However, the S. caninum sequence showed 100% identify over the 18S rRNA region sequenced to that of S. arctica, a parasite known to infect Arctic foxes (Vulpes lagopus).
A reappraisal of bridge piers scour vulnerability: a case study in the Upper Tiber River basin (central Italy)
Authors: Barbetta S. , Camici S. , Moramarco T.
Published: September 2014

The issue of bridge piers vulnerability to scour is addressed by comparing two procedures. The first method quantifies the Scour Vulnerability Index (SVI) considering the combined effects of local and contraction scour. The method requires that a scale factor, for taking account of the scour depth overestimation provided by empirical formulae, is quantified for the selected case study through inspection campaigns. The second approach identifies a vulnerability index to vertical instability depending on several indicators. The study is carried out for a sample of 46 bridges in the Tiber River basin, central Italy, and shows that the two methods identify the same number of piers affected by ‘high’ vulnerability. Results are supplemented by outcomes of inspections that identified, through the scale factor, a high correlation between measured scour depth and SVI value. SVI, simpler and most practical, seems useful for an expeditious estimate of scour vulnerability in large areas and can be adopted by decision makers to identify the structures requiring attention in terms of maintenance and control. The presented results do not provide a general rule for a correct estimate of scour. They refer to solely the investigated case study and need to be verified in other rivers context.
FOMC Forecasts as a Focal Point for Private Expectations
Authors: HUBERT PAUL
Published: September 2014

We explore empirically the theoretical prediction that public information acts as a focal point in the context of the U.S. monetary policy. We aim at establishing whether the publication of Federal Open Market Committee (FOMC) inflation forecasts affects the cross‐sectional dispersion of private inflation expectations. Our main finding is that publishing FOMC inflation forecasts has a negative effect on the cross‐sectional dispersion of private current‐year inflation forecasts. This effect is found to be robust to another survey data set and to various macroeconomic controls. Moreover, we find that the dispersion of private inflation forecasts is not affected by the dispersion of views among FOMC members.
R&D Shocks and News Shocks
Authors: JINNAI RYO
Published: September 2014

Most of the theoretical work in the news shock literature abstracts away from structural explanations, assuming instead that news is a pure signal giving agents advance notice that aggregate technology will undergo exogenous change at some future point. This paper proposes that a surprise improvement in sector‐specific productivity in the research and development sector can be seen as news about aggregate productivity. I not only offer a deeper explanation for the news but also show that the model performs modestly better in matching empirical facts than a standard, one‐sector neoclassical growth model augmented with exogenous news shocks does.
Downward Nominal Wage Rigidities Bend the Phillips Curve
Authors: DALY MARY C. , HOBIJN BART
Published: September 2014

We introduce a model of monetary policy with downward nominal wage rigidities and show that both the slope and curvature of the Phillips curve depend on the level of inflation and the extent of downward nominal wage rigidities. This is true for the both the long‐run and the short‐run Phillips curve. Comparing simulation results from the model with data on U.S. wage patterns, we show that downward nominal wage rigidities likely have played a role in shaping the dynamics of unemployment and wage growth during the last three recessions and subsequent recoveries.
Labor‐Market Institutions and Long‐Term Effects of Youth Unemployment
Authors: KAWAGUCHI DAIJI , MURAO TETSUSHI
Published: September 2014

Graduating from a school during a time of adverse economic conditions has a persistent, harmful effect on workers’ subsequent employment opportunities. An analysis of panel data from OECD countries during the 1960–2010 periods reveals that a worker who experiences a 1 percentage point higher unemployment rate while the worker is 16–24 years old has a 0.14 percentage point higher unemployment rate at ages 25–29 years and 0.03 percentage points higher at ages 30–34 years. The persistence of this negative effect is stronger in countries with stricter employment protection legislation. A composite index for labor‐market rigidity is constructed and the index is shown to have positive correlation with the persistence. Moderating macroeconomic fluctuations is more important in countries that have more persistent labor‐market entry effects on subsequent outcomes.
Constraining the conditions of Barrovian metamorphism in Sikkim, India: P–T–t paths of garnet crystallization in the Lesser Himalayan Belt
Authors: Gaidies F. , Petley‐Ragan A. , Chakraborty S. , Dasgupta S. , Jones P.
Published: September 2014

Garnet crystallization in metapelites from the Barrovian garnet and staurolite zones of the Lesser Himalayan Belt in Sikkim is modelled utilizing Gibbs free energy minimization, multi‐component diffusion theory and a simple nucleation and growth algorithm. The predicted mineral assemblages and garnet‐growth zoning match observations remarkably well for relatively tight, clockwise metamorphic P–T paths that are characterized by prograde gradients of ∼30 °C kbar−1 for garnet‐zone rocks and ∼20 °C kbar−1 for rocks from the staurolite zone. Estimates for peak metamorphic temperature increase up‐structure toward the Main Central Thrust. According to our calculations, garnet stopped growing at peak pressures, and protracted heating after peak pressure was absent or insignificant. Almost identical P–T paths for the samples studied and the metamorphic continuity of the Lesser Himalayan Belt support thermo‐mechanical models that favour tectonic inversion of a coherent package of Barrovian metamorphic rocks. Time‐scales associated with the metamorphism were too short for chemical diffusion to substantially modify garnet‐growth zoning in rocks from the garnet and staurolite zones. In general, the pressure of initial garnet growth decreases, and the temperature required for initial garnet growth was reached earlier, for rocks buried closer toward the MCT. Deviations from this overall trend can be explained by variations in bulk‐rock chemistry.
Effect of nasal speaking valve on speech intelligibility under velopharyngeal incompetence: a questionnaire survey
Authors: Mikamo S. , Kodama N. , Pan Q. , Maeda N. , Minagi S.
Published: September 2014

Velopharyngeal incompetence is known as a contributing factor to speech disorders. Suwaki et al. reported that nasal speaking valve (NSV) could improve dysarthria by regulating nasal emission utilising one‐way valve. However, disease or condition which would be susceptible to treatment by NSV has not been clarified yet. This study aimed to evaluate the effect of NSV by questionnaire survey using ready‐made NSV. Subjects were recruited through the internet bulletin, and NSV survey set was sent to the applicant. Sixty‐six participants, who agreed to participate in this study, used NSV and mailed back the questionnaire which included self‐evaluation and third‐party evaluation of speech intelligibility. Statistical analysis revealed that the use of NSV resulted in significant speech intelligibility improvement in both self‐evaluation and third‐party evaluation (P < 0·01). Regarding the type of underlying disease of dysarthria, significant effect of NSV on self‐evaluation of speech intelligibility could be observed in cerebrovascular disease and neurodegenerative disease (P < 0·01) and that on third‐party evaluation in neurodegenerative disease (P < 0·01). Eighty‐six percent of subjects showed improvement of speech intelligibility by shutting up nostrils by fingers, and the significant effect of NSV on both self‐evaluation and third‐party evaluation of speech intelligibility was observed (P < 0·001). From the results of this study, it was suggested that NSV would be effective in cerebrovascular disease and neurodegenerative disease, as well as in subjects whose speech intelligibility was improved by closing nostrils.
A randomized controlled trial of the effect of a brief cognitive‐behavioral intervention on dental fear
Authors: Spindler Helle , Staugaard Søren Risløv , Nicolaisen Camilla , Poulsen Rikka
Published: September 2014

Objectives

The objective of this study was to examine the effect of a brief cognitive‐behavioral intervention for patients with dental fear in a private dental clinic.

Methods

Patients presenting with subjectively reported dental fear were randomly assigned to either an immediate intervention (n = 53) or a waiting list (n = 51) group. Both groups received an identical intervention, but delayed by 4‐6 weeks in the waiting list group. Participants were asked to fill out two self‐report questionnaires of dental fear at pre‐ and post‐intervention, and again at a 2‐year follow‐up assessment.

Results

Analysis of variance showed that dental fear was significantly reduced in the immediate intervention group (d = 1.5‐2.2), compared with the waiting list group (d = 0.3‐0.4). Additionally, all participants showed a significant reduction of dental fear following the brief intervention, and in the subgroup available for follow‐up, this effect was maintained after 2 years.

Conclusions

This indicates that a brief cognitive‐behavioral intervention may be efficacious in helping a significant number of patients with dental fear return to regular dental treatment. Future research should investigate the applicability of a brief cognitive‐behavioral intervention in the dental clinic.
Identification of key factors affecting the oral absorption of salts of lipophilic weak acids: a case example
Authors: Petrakis Orestis , Vertzoni Maria , Angelou Alexandros , Kesisoglou Filippos , Bentz Kimberly , Goumas Konstantinos , Reppas Christos
Published: September 2014

Objectives

Evaluate the ability of biorelevant media to adequately predict solubility in human gastrointestinal aspirates collected in the fasted state for the sodium salt of a highly dosed, Biopharmaceutics Classification System II (BCS II) compound with weakly acidic properties (L-870,810, pKa 7.3, HA (5-(1,1-dioxothiazinan-2-yl)-N-((4-fluorophenyl)methyl)-8-hydroxy-1,6-naphthyridine-7-carboxamide)). Identify key luminal processes that dictate the behaviour of sodium salt of HA (NaA), after single-dose administrations of high (relatively to solubility limit) doses corresponding to 400 and 800 mg of HA in the fasted state.

Methods

Aspirates from stomach and upper small intestine were collected from eight healthy fasted adults, after administration of 240 ml of water. Solubilities of NaA and HA were measured in aspirated samples and biorelevant media. Dissolution experiments of NaA granules were performed in biorelevant media. Prediction of oral pharmacokinetics was evaluated in silico using Stella software.

Key findings

Equilibrium solubility of NaA in fluids aspirated from the upper gastrointestinal tract is more transient than of HA. Solubility in upper gastrointestinal lumen was adequately estimated by data in biorelevant media. Supersaturation, followed by precipitation, which did not fully revert to the equilibrium solubility of HA, was observed during the dissolution of NaA granules in biorelevant media. Physiologically based pharmacokinetic modelling indicated that while intragastric processes had no significant impact on absorption kinetics, dissolution kinetics, kinetic solubility, radial transport rates and, for the 800-mg dose, precipitation kinetics in the small intestine had the greatest impact on absorption profiles.

Conclusions

Adequate prediction of the average plasma profile, after administration of NaA, required consideration of region-dependent dissolution rates and/or solubilisation.
Cloning of Arabidopsis serotonin N‐acetyltransferase and its role with caffeic acid O‐methyltransferase in the biosynthesis of melatonin in vitro despite their different subcellular localizations
Authors: Lee Hyoung Yool , Byeon Yeong , Lee Kyungjin , Lee Hye‐Jung , Back Kyoungwhan
Published: September 2014

Serotonin N‐acetyltransferase (SNAT) is the penultimate enzyme in melatonin biosynthesis. We cloned SNAT from Arabidopsis thaliana (AtSNAT) and functionally characterized this enzyme for the first time from dicotyledonous plants. Similar to rice SNAT, AtSNAT was found to localize to chloroplasts with peak enzyme activity at 45°C (Km, 309 μm; Vmax, 1400 pmol/min/mg protein). AtSNAT also catalyzed 5‐methoxytryptamine (5‐MT) into melatonin with high catalytic activity (Km, 51 μm; Vmax, 5300 pmol/min/mg protein). In contrast, Arabidopsis caffeic acid O‐methyltransferase (AtCOMT) localized to the cytoplasm. Interestingly, AtCOMT can methylate serotonin into 5‐MT with low catalytic activity (Km, 3.396 mm; Vmax, 528 pmol/min/mg protein). These data suggest that serotonin can be converted into either N‐acetylserotonin by SNAT or into 5‐MT by COMT, after which it is metabolized into melatonin by COMT or SNAT, respectively. To support this hypothesis, serotonin was incubated in the presence of both AtSNAT and AtCOMT enzymes. In addition to melatonin production, the production of major intermediates depended on incubation temperatures; N‐acetylserotonin was predominantly produced at high temperatures (45°C), while low temperatures (37°C) favored the production of 5‐MT. Our results provide biochemical evidence for the presence of a serotonin O‐methylation pathway in plant melatonin biosynthesis.
Phenotypic Characterization of Canine Intestinal Intraepithelial Lymphocytes in Dogs with Inflammatory Bowel Disease
Authors: Haas E. , Rütgen B.C. , Gerner W. , Richter B. , Tichy A. , Galler A. , Bilek A. , Thalhammer J.G. , Saalmüller A. , Luckschander‐Zeller N.
Published: September 2014

Background

Many dogs suffering from inflammatory bowel disease (IBD) are presented to veterinary clinics. These patients are diagnosed based on a history of chronic gastrointestinal signs and biopsy‐confirmed histopathologic intestinal inflammation. Intestinal intraepithelial lymphocytes (IEL) are part of the first line of defense in the gastrointestinal immune system. Alterations in IEL subsets may play a role in the pathogenesis of IBD.

Hypothesis

The aim of this study was to characterize the phenotypes of IEL in dogs with IBD compared with healthy control dogs.

Animals

Intestinal intraepithelial lymphocytes subpopulations of control dogs (n = 5) obtained from endoscopic biopsies (EB) were compared to those obtained from full thickness biopsies (FTB) on the same day. In addition, the phenotypes of IEL from FTB of control dogs (n = 10) were compared with EB of IBD dogs (n = 10). Each participant was scored clinically using the canine inflammatory bowel disease activity index (CIBDAI), and all samples were graded histopathologically. Three‐color flow cytometry of isolated IEL was performed using monoclonal antibodies against T‐ and B‐lymphocyte subpopulations.

Results

No significant differences in the composition of IEL subpopulations were found in control dogs based on method of biopsy. The IBD dogs had significantly higher CIBDAI and histopathologic scores compared with control dogs and their IEL contained a significantly higher frequency TCRγδ T‐cells.

Conclusions and Clinical Importance

Endoscopic biopsies provide suitable samples for 3‐color flow cytometry when studying canine intestinal IEL and IBD patients show significant changes of major T‐cell subsets compared to healthy control dogs.
Remarks on the Experimental Turn in the Study of Scalar Implicature, Part II
Authors: Chemla Emmanuel , Singh Raj
Published: September 2014

In Part I, we have introduced two of the main approaches to scalar implicature: the Gricean approach and the grammatical approach. We have argued that although they rely on conceptually different views about the phenomenon, they share various insights, and we argued that their empirical differences were more subtle than what one may have expected. In this second part of this review paper, we will sample some experimental results with two goals in mind. First, we will exemplify some simplifications that are found in the literature and examine the consequences of these simplifications on the interpretability of experimental results. Second, we will suggest future directions that the experimental turn might consider exploring, directions that seem to us to have the potential to illuminate the richness of the competing theories and the potential to dissociate or improve them.
Remarks on the Experimental Turn in the Study of Scalar Implicature, Part I
Authors: Chemla Emmanuel , Singh Raj
Published: September 2014

Abstract (for Part I and Part II)

There has been a recent ‘experimental turn’ in the study of scalar implicature, yielding important results concerning online processing and acquisition. This paper highlights some of these results and places them in the current theoretical context. We argue that there is sometimes a mismatch between theoretical and experimental studies, and we point out how some of these mismatches can be resolved. We furthermore highlight ways in which the current theoretical and experimental landscape is richer than is often assumed, and in light of this discussion, we offer some suggestions for what seem to us promising directions for the experimental turn to explore.

The article is divided in two parts. Part I first presents the two dominant families of accounts of scalar implicature, the domain‐general Gricean account and the domain‐specific grammatical account. We try to separate the various components of these theories and connect them to relevant psycholinguistic predictions. Part II examines and reinterprets several prominent experimental results in light of the theoretical presentation proposed in the first part.
Effect of carboxyhemoglobin on postoperative complications and pain in pediatric tonsillectomy patients
Authors: Koyuncu Onur , Turhanoglu Selim , Tuzcu Kasım , Karcıoglu Murat , Davarcı Isil , Akbay Ercan , Cevik Cengiz , Ozer Cahit , Sessler Daniel I. , Turan Alparslan
Published: September 2014

Background

Carbon monoxide (CO) is a product of burning solid fuel in stoves and smoking. Exposure to CO may provoke postoperative complications. Furthermore, there appears to be an association between COHb concentrations and pain. We thus tested the primary hypothesis that children with high preoperative carboxyhemoglobin (COHb) concentrations have more postoperative complications and pain after tonsillectomies, and secondarily that high‐COHb concentrations are associated with more pain and analgesic use.

Methods

100 children scheduled for elective tonsillectomy were divided into low and high carbon monoxide (CO) exposure groups: COHb ≤3 or ≥4 g·dl−1. We considered a composite of complications during the 7 days after surgery which included bronchospasm, laryngospasm, persistent coughing, desaturation, re‐intubation, hypotension, postoperative bleeding, and reoperation. Pain was evaluated with Wong‐Baker Faces pain scales, and supplemental tramadol use recorded for four postoperative hours.

Results

There were 36 patients in the low‐exposure group COHb [1.8 ± 1.2 g·dl−1], and 64 patients were in the high‐exposure group [6.4 ± 2.1 g·dl−1]. Indoor coal‐burning stoves were reported more often by families of the high‐ than low‐COHb children (89% vs 72%, P < 0.001). Second‐hand cigarette smoke exposure was reported by 54% of the families with children with high COHb, but only by 24% of the families of children with low COHb. Composite complications were more common in patients with high COHb [47% vs 14%, P = 0.0001, OR:7.4 (95% Cl, lower = 2.5‐upper = 21.7)], with most occurring in the postanesthesia care unit. Pain scores in postanesthesia care unit and one hour after surgery were statistically significantly lower in the low‐exposure group [respectively, P = 0.020 (95%CI, lower = −1.21‐upper = −0.80), P = 0.026 (95% CI, lower = −0.03‐upper = 0.70)], and tramadol use increased at 4 h (3.5 (interquartile range: 0–8) vs 6 (5–9) mg, P = 0.012) and 24 h (3.5 (0–8) vs 6 (5–9) mg, P = 0.008).

Conclusion

High preoperative COHb concentrations are associated with increased postoperative complications and pain.
Neurosurgical conditions and procedures in infancy are associated with mortality and academic performances in adolescence: a nationwide cohort study
Authors: Hansen Tom G. , Pedersen Jacob K. , Henneberg Steen W. , Morton Neil S. , Christensen Kaare
Published: September 2014

Background

Few human cohort studies on anesthesia‐related neurotoxicity and the developing brain have focused on and compared specific surgeries and conditions. These studies cannot disentangle the effects of anesthesia from those of the surgery and underlying conditions. This study aimed at assessing the impact of specific neurosurgical conditions and procedures in infancy on mortality and academic achievements in adolescence.

Methods

A nationwide unselected register‐based follow‐up study of the Danish birth cohorts 1986–1990 compared academic performances of all children having undergone neurosurgeries as infants with a randomly selected, age‐matched 5% sample of the same cohorts. The two groups were compared regarding mortality prior to June 1st, 2006, average test scores at ninth grade, and finally the proportion of children not attaining test scores.

Results

The exposure group comprised 228 and the control group 14 698 individuals. Hydrocephalus (n = 130), craniotomy (n = 43), and myelomeningocele/encephalocele children (n = 55) had a higher mortality (18.5.0%, 18.6%, and 7.3%, respectively) vs controls (1.3%; P < 0.00001, P < 0.00001, and P = 0.0052, respectively). Average test scores were significantly lower than controls in hydrocephalus and craniotomy (P = 0.0043 and P = 0.0077) but not myelomeningocele/encephalocele children (P = 0.2785); the proportion of available test scores were significantly lower in all three groups (40.8%, 60.0%, and 67.3%, respectively) vs 86.8% in controls (P < 0.00001, P = 0.000077, and P = 0.000064).

Conclusion

Neurosurgery in infancy was associated with high mortality and significantly impaired academic achievements in adolescence. When studying anesthesia‐related neurotoxicity and the developing brain, focus on specific surgeries/conditions is important. Pooling of major/minor conditions and major/minor surgeries should be avoided.
Rare cause of macroscopic hematuria in a pediatric patient: Nephrogenic adenoma of the bladder
Authors: Goknar Nilufer , Silay Mesrur Selcuk , Tosuner Zeynep , Oktem Faruk
Published: September 2014

Pediatric nephrogenic adenoma (NA) is an uncommon benign metaplastic lesion occurring in the urothelium. Herein we report a case of NA of the urinary bladder in a 14‐year‐old boy. The patient presented with macroscopic hematuria and had a history of ureteral surgery and long‐term smoking. NA should be considered in the differential diagnosis of any urinary tract tumor in the pediatric population.
Comparison of fluid leakage from four different cuffed pediatric endotracheal tubes using a pediatric airway simulation model
Authors: Komasawa Nobuyasu , Fujiwara Shunsuke , Miyazaki Shinichiro , Soen Masako , Minami Toshiaki
Published: September 2014

This study used an airway model to compare the ability of a pediatric endotracheal tube with a taper‐shaped cuff to prevent microaspiration relative to endotracheal tubes with conventional cuffs. Four different types of 5.0‐mm inner diameter cuffed pediatric endotracheal tubes (taper‐shaped cuff [Taper], high‐volume low‐pressure [Hi‐Lo], middle‐volume low‐pressure [Intermediate], and low‐volume low‐profile [Lo‐Pro]) were fixed within vertically placed acrylic tubes. The cuffs were maintained at 10, 20, or 30 cmH2O pressure and 3 mL of simulated stomach contents was added to the top of the cuffs. The volume of leakage around the cuffs after 5 min and 4 h was measured. After 5 min, the volume of leakage was significantly lower with the Taper than with the Hi‐Lo, Intermediate, or Lo‐Pro at all pressure settings. After 4 h, leakage was significantly lower with the Taper than with the other three tubes regardless of initial cuff pressure (P < 0.05).
Experience of decortication for restrictive hemodynamics in adults with congenital heart disease
Authors: Mizuno Masanori , Ohuchi Hideo , Kagisaki Koji , Miyazaki Aya , Ishibashi‐Ueda Hatsue , Yamada Osamu
Published: September 2014

We treated four postoperative adults with congenital heart disease with severe restrictive hemodynamics (RH), and performed decortication (DC) with the anticipation of some relief of the RH. The catheterizations before DC showed high central venous, and right and left ventricular end‐diastolic pressures with “dip‐and‐plateau” pressure waveforms in the right and left ventricles. Upon myocardial histopathologic examination, moderate myocardial fibrotic change was demonstrated in two of three cases. DC led to decrease in type B natriuretic peptide levels in all cases, resulting in a decline in the central venous, right and left ventricular end‐diastolic pressures in three cases. Successful DC‐related relief of RH, dilatation of the ventricles with decline in central and end‐diastolic pressures, was observed in only one case. Our limited DC‐related hemodynamic improvement indicates a complexity of the severe RH, which may represent a unique intractable heart failure pathophysiology in intractable postoperative adult congenital heart disease.
Rapid deterioration of primary fourth ventricular outlet obstruction resulting in syndrome of inappropriate antidiuretic hormone secretion
Authors: Hashimoto Hiroyuki , Maeda Akiko , Kumano Koichi , Kimoto Tatsuya , Fujisawa Yuko , Akai Takuya
Published: September 2014

Fourth ventricular outlet obstruction (FVOO) is a rare cause of obstructive hydrocephalus. Although FVOO accompanied by malformative syndrome and secondary causes of obstruction are common, there are few reports of primary FVOO (PFVOO). The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is a rare presenting feature of hydrocephalus. A 1‐year, 8‐month‐old boy with a normal head circumference developed SIADH accompanied by rapid deterioration of symptoms of intracranial hypertension. PFVOO was diagnosed because magnetic resonance imaging revealed an enlarged ventricular system with a barely visible membranous obstacle at the foramen of Magendie. All symptoms were resolved by endoscopic third ventriculostomy. PFVOO should be considered as a rare form of congenital obstructive hydrocephalus, especially in patients with tetraventricular hydrocephalus. To the best of our knowledge, this is the first case of an infant with SIADH, resulting from acute deterioration of non‐tumoral raised pressure hydrocephalus.
Japanese pediatric guideline for the treatment and management of bronchial asthma 2012
Authors: Hamasaki Yuhei , Kohno Yoichi , Ebisawa Motohiro , Kondo Naomi , Nishima Sankei , Nishimuta Toshiyuki , Morikawa Akihiro , Aihara Yukoh , Akasawa Akira , Adachi Yuichi , Arakawa Hirokazu , Ikebe Toshiichi , Ichikawa Kunio , Inoue Toshishige , Iwata Tsutomu , Urisu Atsuo , Ohya Yukihiro , Okada Kenji , Odajima Hiroshi , Katsunuma Toshio , Kameda Makoto , Kurihara Kazuyuki , Sakamoto Tatsuo , Shimojo Naoki , Suehiro Yutaka , Tokuyama Kenichi , Nambu Mitsuhiko , Fujisawa Takao , Matsui Takehiko , Matsubara Tomoyo , Mayumi Mitsufumi , Mochizuki Hiroyuki , Yamaguchi Koichi , Yoshihara Shigemi
Published: September 2014

A new version of the Japanese pediatric guideline for the treatment and management of bronchial asthma was published in Japanese at the end of 2011. The guideline sets the pragmatic goal for clinicians treating childhood asthma as maintaining a “well‐controlled level” for an extended period in which the child patient can lead a trouble‐free daily life, not forgetting the ultimate goal of obtaining remission and/or cure. Important factors in the attainment of the pragmatic goal are: (i) appropriate use of anti‐inflammatory drugs; (ii) elimination of environmental risk factors; and (iii) educational and enlightening activities for the patient and caregivers regarding adequate asthma management in daily life. The well‐controlled level refers to a symptom‐free state in which no transient coughs, wheezing, dyspnea or other symptoms associated with bronchial asthma are present, even for a short period of time. As was the case in the previous versions of the guideline, asthmatic children younger than 2 years of age are defined as infantile asthma patients. Special attention is paid to these patients in the new guideline: they often have rapid exacerbation and easily present chronic asthmatic conditions after the disease is established.
Increased satisfaction of maternity hospital staff involved in fetal telediagnosis
Authors: Hishitani Takashi , Kawachi Fumie , Fujimoto Yoshitaka , Sugamoto Kenji , Hoshino Kenji , Ogawa Kiyoshi
Published: September 2014

Questionnaires were sent to 14 maternity hospital staff members for qualitative assessment at the start of fetal telediagnosis and at the end of the study using a five‐point Likert scale: 5, I strongly think so; 4, I think so; 3, I can't decide; 2, I don't think so; 1, I never think so. Ten questionnaires were returned to us (71%). The results showed that the staff reported a significant increase in confidence in performing fetal cardiac screening (score 2.3 at start, 3.4 at study completion; P = 0.034), the rate of score increase rose with the number of telediagnoses (r = 0.72, P < 0.05), feedback from a specialist was very useful (4.4 and 4.9, respectively), and real‐time image transmission was preferred over recorded images (score 3.7 vs 2.4, respectively; P = 0.042). The excellent educational effect of telemedicine is useful for staff members to improve their skills while nurturing their motivation, leading to the promotion of fetal cardiac screening in regional areas.
Measurement of cytokine levels in cerebrospinal fluid over time in neonatal Enterococcal meningitis
Authors: Ikeda Naho , Suganuma Hiroki , Ohkawa Natsuki , Nagata Satoru , Shoji Hiromichi , Shimizu Toshiaki
Published: September 2014

Enterococcus faecalis is rarely involved in neonatal meningitis. Several studies have indicated that the cytokines related to bacterial infection may induce nerve cell damage; therefore, the cytokine levels in cerebrospinal fluid (CSF) could represent a valuable hallmark for rapid recognition of the disease and evaluation of the degree of neurological involvement. We analyzed cytokine levels in the CSF of a neonate with E. faecalis meningitis over time. Tumor necrosis factor‐α (TNF‐α) tended to be elevated during the acute phase of infection, and then decreased during the convalescent stage after treatment. CSF inflammatory cytokine measurement may provide important clues for predicting the development of complications in the host because some of these cytokines, such as TNF‐α, can injure neurons.
Esophago‐gastric motility and nutritional management in a child with ATR‐X syndrome
Authors: Watanabe Toshihiko , Arai Katsuhiro , Takahashi Masataka , Ohno Michinobu , Sato Kaori , Fuchimoto Yasushi , Wada Takahiko , Ida Shinobu , Kawahara Hisayoshi , Kanamori Yutaka
Published: September 2014

X‐linked alpha thalassemia mental retardation (ATR‐X) syndrome is an X‐linked recessive disorder that often involves gastrointestinal symptoms. Aspiration pneumonia related to gastroesophageal reflux has been reported as the major cause of death, but gastrointestinal function has not been well investigated. The present report describes a child with ATR‐X syndrome who suffered from periodical episodes of refractory vomiting. We investigated the function of upper alimentary tract and found that esophago‐gastric dysmotility and severe gastric volvulus were the major causes of gastrointestinal symptoms. This child was surgically treated with anterior gastropexy and jejunal alimentation through gastrostomy, and the symptoms were relieved with good weight gain. This report may provide insight into the gastrointestinal function and nutritional management in children with ATR‐X syndrome.
Emotional function in dementia patients
Authors: Fujii Masahiko , Butler James P. , Sasaki Hidetada
Published: September 2014

Behavioural and psychological symptoms of dementia, which can be considered as hyperreactivity of the emotional functioning of dementia, can be alleviated or aggravated by the behavioural and psychological symptoms of the caregiver. Comfortable stimulations of emotional function through sensory stimulations are effective methods for alleviating behavioural and psychological symptoms of dementia. Although cognitive function deteriorates with age, emotional function is often retained even in advanced years. Thus, it is recommended that care in patients with dementia be focused mainly on the stimulation of emotional function (e.g. sympathy and empathy, which are human traits), rather than relying solely on the stimulation of cognitive function.
From threat to safety: Instructed reversal of defensive reactions
Authors: Costa Vincent D. , Bradley Margaret M. , Lang Peter J.
Published: September 2014

Cues that signal the possibility of receiving an electric shock reliably induce defensive activation. To determine whether cues can also easily reverse defensive reactions, a threat reversal paradigm was developed in which a cue signaling threat of shock reversed its meaning across the course of the study. This allowed us to contrast defensive reactions to threat cues that became safe cues, with responses to cues that continued to signal threat or safety. Results showed that, when participants were instructed that a previously threatening cue now signaled safety, there was an immediate and complete attenuation of defensive reactions compared to threat cues that maintained their meaning. These findings highlight the role that language can play both in instantiating and attenuating defensive reactions, with implications for understanding emotion regulation, social communication, and clinical phenomena.
Gonadotropin‐induced Puberty Does Not Impair Reproductive Performance of Gilts over Three Parities
Authors: Eckhardt OHO , Martins SMMK , Pinese ME , Horta FC , Rosseto AC , Torres MA , De Andrade AFC , Muro BBD , Marino CT , Rodrigues PHM , Moretti AS
Published: September 2014

Contents

The aim of this study was to evaluate the reproductive performance of three parities of gilts treated or not treated with gonadotropin to induce puberty. Sixty gilts received 600 IU of equine chorionic gonadotropin (eCG) followed by 2.5 mg of porcine luteinizing hormone (LH) 72 h later. Fifty‐nine other gilts were exposed only to a mature boar for 15 min twice daily. Artificial insemination (AI) was performed at 0, 12 and 24 h after the detection of oestrus, and gestation was confirmed by ultrasound after 35 days. Sows were inseminated at the first post‐weaning oestrus. The total numbers of piglets born, piglets born alive, stillborn, mummified foetuses, as well as pregnancy and farrowing rates were evaluated for each of the three parities. Culling rates, farrowing intervals and weaning‐to‐oestrous intervals (WEI) were also analysed. Mean age at puberty and oestrous manifestation were not significantly different between treatments (p = 0.0639; 179.20 ± 17.52 compared with 173.96 ± 16.94, 91.66% compared with 94.92%) across the experimental period. However, females that underwent puberty induction showed modest increases both in the number of total pigs born and in the number of piglets born alive. In conclusion, puberty induction through exogenous gonadotropin administration in field conditions did not induce a more concentrated first oestrous manifestation, but trended to a modest increase in the number of pigs born alive in the first parity and a reduced culling rate during the first gestation.
Joint Analysis of Longitudinal and Survival Data Measured on Nested Timescales by Using Shared Parameter Models: An Application to Fecundity Data
Authors: McLain Alexander C. , Sundaram Rajeshwari , Buck Louis Germaine M.
Published: September 2014

We consider the joint modelling, analysis and prediction of a longitudinal binary process and a discrete time-to-event outcome. We consider data from a prospective pregnancy study, which provides day level information regarding the behaviour of couples attempting to conceive. Reproductive epidemiologists are particularly interested in developing a model for individualized predictions of time to pregnancy (TTP). A couple's intercourse behaviour should be an integral part of such a model and is one of the main focuses of the paper. In our motivating data, the intercourse observations are a long series of binary data with a periodic probability of success and the amount of available intercourse data is a function of both the menstrual cycle length and TTP. Moreover, these variables are dependent and observed on different, and nested, timescales (TTP is measured in menstrual cycles whereas intercourse is measured on days within a menstrual cycle) further complicating its analysis. Here, we propose a semiparametric shared parameter model for the joint modelling of the binary longitudinal data (intercourse behaviour) and the discrete survival outcome (TTP). Further, we develop couple-based dynamic predictions for the intercourse profiles, which in turn are used to assess the risk for subfertility (i.e. TTP longer than six menstrual cycles).
Telescoping of Sheaths—An Easy Technique To Facilitate the Removal of a Stuck Ruptured Transluminal Angioplasty Balloon
Authors: Sequeira Adrian , Artikov Shukhrat
Published: September 2014

Balloon rupture during angioplasty is an uncommon event. The ruptured balloon usually is removed through its introducer sheath without any problems. However, there may be occasions when a ruptured balloon cannot be withdrawn from an access. We describe a simple technique that can be used to extricate a stuck ruptured angioplasty balloon.
An improved and validated RNA HLA class I SBT approach for obtaining full length coding sequences
Authors: Gerritsen K. E. H. , Olieslagers T. I. , Groeneweg M. , Voorter C. E. M. , Tilanus M. G. J.
Published: September 2014

The functional relevance of human leukocyte antigen (HLA) class I allele polymorphism beyond exons 2 and 3 is difficult to address because more than 70% of the HLA class I alleles are defined by exons 2 and 3 sequences only. For routine application on clinical samples we improved and validated the HLA sequence‐based typing (SBT) approach based on RNA templates, using either a single locus‐specific or two overlapping group‐specific polymerase chain reaction (PCR) amplifications, with three forward and three reverse sequencing reactions for full length sequencing. Locus‐specific HLA typing with RNA SBT of a reference panel, representing the major antigen groups, showed identical results compared to DNA SBT typing. Alleles encountered with unknown exons in the IMGT/HLA database and three samples, two with Null and one with a Low expressed allele, have been addressed by the group‐specific RNA SBT approach to obtain full length coding sequences. This RNA SBT approach has proven its value in our routine full length definition of alleles.