bluuebunny/crossref_metadata_2025 huggingface dataset:
The Repair of an Advanced Gas Cooled Reactor at Hunterston ‘B’ Power Station following an Ingress of Sea Water
Authors: Gray J L , Colquhoun J , Pearson R
Published: October 2007

A major repair of a 660 MWe advanced gas cooled reactor at Hunterston ‘B’ Power Station was undertaken after some 8000 litres of sea water had entered a space below the boiler region of the reactor gas circuit. The remedial activities comprised surveys to establish the condition of the reactor internals, removal of affected reactor vessel insulation, shot blasting of surfaces to remove salt and corrosion products, refurbishing of studs and other components and rebuilding of the insulation. Four hundred and eighty man-years of work were completed during the twenty-four months of the repair exercise, which required a peak site supervision and labour force of 340.

The reactor was returned to power in February 1980 and has since operated successfully with no restriction arising from the incident.
On the Dynamics of Ships in Heavy Seas
Authors: Bishop R E D , Price W G
Published: October 2007

When a ship encounters waves, it moves bodily and it distorts. The structure being elastic and the waves being random, this behaviour is in the nature of a narrow-band response. A systematic study of linear ship structural dynamics in which this standpoint is adopted was started in University College London about ten years ago and an attempt is made here to explain the present position.

Far from putting a largely unnecessary gloss on traditional techniques of naval architecture, this approach to ship dynamics appears to promise much greater insight into ship behaviour at a time when apparently well found and competently handled ships continue to be lost in the open sea.
Development of a Turbine-Generator Thermal Performance Monitoring System
Authors: Sochaczewski Z W , Clay C A E , Morris J A
Published: October 2007

The development of a facility for continuously monitoring turbine-generator thermal performance, based on the measurement of heat rejected to the condenser and employing an acoustic flowmeter with an extended computer program, is described. Details are given of the laboratory and site tests carried out to study the viability of the concept and its practical application to a 500 MW turbine-generator. The results obtained confirm the new technique's ability to respond to changes in turbine-generator operating parameters and measure thermal efficiency continuously. Reference is made to the possible extension to cover monitoring of a whole power station.
Instability in the Hand-Brake Performance of Cars and Vans
Authors: Harding P R J , Day A J
Published: October 2007

Drum brakes of leading and trailing shoe design are commonly used on the rear axles of cars and vans, and their handbrake actuation is frequently accomplished by means of a strut between the two shoes. Occasional instability in the handbrake performance, which may culminate in brake lock and consequent shock loading of brake components, has been investigated experimentally and analytically. Lining friction and contact pattern, brake geometry and design are all considered as influencing factors and some unusual mechanisms of brake operation, which may occur under certain conditions, are explained as causes of the instability.
Effects of Exhaust Gas Recirculation on Fuel Consumption
Authors: Nakajima Y , Sugihara K , Takagi Y , Muranaka S
Published: October 2007

The effects of EGR on fuel consumption were analysed quantitatively in terms of factors improving and deteriorating fuel economy through experiments as well as thermodynamic calculations. To examine the effects of combustion duration on fuel economy under heavy EGR, experiments were performed with three engine variations. In calculation models, changes in specific heats, heat transfer rate, and dissociation rate caused by changes in gas temperature were considered.

In conclusion, it may be stated that reductions of pumping loss, cooling loss, and dissociation were found to be improving factors, where the contribution ratio was approximately 4.5:4.0:1.5. The sum of calculated fuel economy gain increased steadily as the EGR increased, and reached more than 10 per cent at a 20 per cent EGR under light load condition. On the other hand, a major deteriorating factor was found to be a combustion fluctuation. This combustion fluctuation could be significantly reduced by achieving a ‘fast burn’ through increased turbulence and/or dual point ignition.
The Electric Multiple Unit Trains of the Hong Kong Mass Transit Railway Corporation
Authors: Ball N D , Vint J W
Published: October 2007

The paper outlines the development of the main specification parameters. The vehicles are described including the mechanical construction and major sub-systems. It concludes with a review of experience to date and relevant technical data.
Present Trends, Applications and Future Prospects for the Use of Industrial Robots
Authors: Heginbotham W B
Published: October 2007

The application of industrial robots has been glamorized by much publicity over the last decade. Nevertheless, realizations have fallen short of expectations, except in relatively few application areas. It is becoming more apparent that many important changes of industrial philosophy will have to take place. These changes must encompass all levels, from the technology used for the design of products to the design of complete manufacturing plant. Significant changes in attitudes at all levels of the workforce are essential prerequisites to success and these must take place throughout the whole system including senior management and shop floor workers alike. In order to achieve these transitions, it is important that the true economic advantages of such devices must be known, and it is critical to understand how to make valid comparisons with present labour intensive methods, particularly in small batch production. There is little known about this facet of robot applications technology at present, and the situation will continue until enough working experience has been gained to enable optimal operating conditions to be evaluated. This lecture considers these problems with indications of how future applications may be accelerated, together with a look at the prospects for more advanced technology which can be built on for the very important basic concepts which need to be established.
A Lightweight Split-Torque Transmission for a 330 KW Helicopter
Authors: White G
Published: October 2007

A simple split-torque gear train is used as the main rotor transmission of a single-engine helicopter. Overall speed reduction ratio achieved is 103:1 between the engine at a nominal 36 000 rev/min and the main rotor at 350 rev/min. This ratio is generated from three stages of fixed-axis gear trains containing only eight gears. Alternative configurations are outlined and discussed.

Comparison with a current production design shows the split torque arrangement offers reductions in weight, height, and drive train losses. A low total of gears and bearings offers the potential for improved reliability.
Improving the Performance of a Crankcase-Scavenged Two-Stroke Engine with a Fluid Diode
Authors: Sher E
Published: October 2007

A fluid diode was installed at the inlet port of a crankcase-scavenged two-stroke engine. Experiments on the fired engine showed that the engine torque was significantly improved at low engine speeds. A theoretical model to simulate the gas exchange process, including the flow inside the diode, was developed. The model equations were solved numerically. Theoretical analysis showed that with the diode, backflow was prevented, the delivery ratio was increased and the scavenging mechanism and efficiency were improved. It was concluded that a further improvement in engine performance may be achieved by installing an additional fluid diode at the scavenge port.
The BMW ETA Engine Concept
Authors: Radermacher K
Published: October 2007

The desire to conserve mineral oil reserves has resulted in drastic increases in the cost of fuel which has become the predominant factor in operating cost criteria. Thus intensive efforts are being made throughout the automotive industry to reduce fuel consumption. Next to minimizing resistance forces, the optimization of engine and transmission offers the greatest potential for achieving this goal. For spark ignition engines this is best achieved by adapting the most efficient engine parameters to coincide with the general operating conditions. The BMW Eta engine concept when compared with current engine characteristics gives a comparable vehicle performance at considerably lower engine speeds with higher torque output. In general operating conditions this results in fuel savings of up to 15 per cent.
Predicting Cutting Forces for Oblique Machining Conditions
Authors: Lin G C I , Mathew P , Oxley P L B , Watson A R
Published: October 2007

Using orthogonal (plane strain) machining theory together with certain simplifying assumptions based on experimental observations it is shown how the three components of cutting force in oblique machining can be predicted from a knowledge of the work material flow stress and thermal properties and the cutting conditions. A comparison of predicted and experimental cutting force results is given.
A Theoretical Method of Minimizing Vibration and Noise Generation of a High Energy Rate Forming Machine Structure
Authors: Vasconcelos H F , Taylor S
Published: October 2007

A technique for the numerical optimization of a finite element model of a high energy rate forming machine is introduced. Both the nature of the impulsive loading and selected structural dimensions are optimized with respect to a simple measure of the noise created during a forging operation. The authors conclude that the technique could be applied to other structures or could be based on a more sophisticated noise criterion although dynamic finite element analyses demand considerable computing power.
Outflow of Saturated Water from Horizontal Vessels
Authors: Kubie J
Published: October 2007

An investigation has been made of aspects of steady state outflow of saturated water from horizontal cylindrical vessels with an outlet on their bottom surface. It is shown that there are two regimes of outflow, one governed by the design of the vessel and the other by the design of the outlet. Experimental data on the variation of the level in the vessel with the flowrate are presented, and it is shown that they are in reasonable agreement with the theoretical results applicable to the two flow regimes and the transition between them. Finally, equations governing the variation of the liquid level along the vessel are presented.
Manufacturing Plant for 1985—Developments and Justification
Authors: Sackett P J , Rathmill K
Published: October 2007

Changes in manufacturing techniques and systems are out-dating traditional ways of assessing the selection of new plant. The engineer needs to consider the overall effect of the introduction of new equipment when making an investment appraisal.

The paper reviews trends in manufacture with special reference to computer controlled batch manufacturing equipment and systems with a high level of automation. Methods of assessing these are discussed in detail including the use of computer modelling in arriving at an investment decision which considers the effective operation of the manufacturing system as a whole.
Total Project Management: An Integrated Approach to the Management of Capital Investment Projects
Authors: Darnell H , Dale M W
Published: October 2007

Substandard performance and failure to meet objectives in capital investment has been a major contribution to the catastrophic decline in the profitability of industry in the UK. The structure of a project is described and the differences between a project and ongoing operations are discussed. An approach to capital investment analysis is described which is based on rate of cashflow and which relates closely to the actual events that occur. The nature and character of the risks involved are examined and a variety of problems discussed. The inevitability of the learning process is pointed out together with the benefits of structuring this learning. Some of the human and organizational imperatives required for success are defined and the need for a knowledge-based approach to the main project disciplines is advocated. These disciplines are outlined together with some discussion of their inter-relations. The operational techniques which ensure a total, and avoid a fragmented, approach to managing a project are briefly described and the importance of top management involvement is emphasized. By taking the steps advocated in the paper the risks inherent in capital investment projects can be reduced to an acceptable level.
The Use of Steering AXLE Suspensions to Reduce Wheel and Rail Wear in Curves
Authors: Illingworth R , Pollard M G
Published: October 2007

This paper reviews a number of methods of improving railway vehicle suspensions in order to overcome problems of excessive wheel flange and rail wear in sharp curves. Means of implementing such ideas are discussed for a variety of railway operations, including freight and rapid transit systems. It is shown that this approach is an attractive alternative to the traditional remedy of flange/rail lubrication in a wide range of practical situations.
Eurosclerosis in European Welfare States: regime theory and the dynamics of change
Authors: Taylor-Gooby Peter
Published: October 2007

The most influential categorisation of capitalist welfare systems – regime theory – suggests that European welfare states will find it difficult to adapt to the changing circumstances of more intense international competition. The problem is seen as particularly severe in the dominant continental corporatist regime. This article uses data from a recent study of the views of politicians, representatives of employers’ organizations, unions, the voluntary sector and religious organizations, civil servants and journalists in four European countries to examine this claim. The pattern of opinion fits that predicted by theory, but the potential for change appears to differ in different countries for specific local reasons. Regime theory may be better at understanding stability than in capturing the forces that make for change, and may find it increasingly difficult to do justice to the increasingly uncertain international context of welfare.
Volunteer Participation in Community Care
Authors: Knapp Martin , Koutsogeorgopoulou Vasiliki , Smith Justin Davis
Published: October 2007

Volunteer inputs to community care (health and social services) are important in the developing mixed economy of welfare. And community care is a common locus for volunteering activity in the UK. But who are these volunteers? And what factors motivate and constrain volunteering? Using data from a UK household survey, the patterns of community care volunteering are examined using multivariate statistical methods. Many individual, household and other characteristics influence volunteering, with quite marked differences in the patterns for distinct types of community care activities: health and social welfare organisations generally, supporting elderly people, visiting sick or elderly people, and transporting or escorting. Methodologically, the results point to failures of previous studies to address adequately the volunteering contributions of, inter alia, black and minority ethnic groups and lower income groups. These and other findings have implications for community care policy and practice.
Good Medicine? A case study of business process re-engineering in a hospital
Authors: Packwood Tim , Pollitt Christopher , Roberts Simon
Published: October 2007

English

Business pocess re-engineering (BPR) is one of the latest approaches to improving organisational performance. It evolved in the US private sector, and has been introduced to Britain and the British public sector, offering radical improvement from radical redesign. This article considers the nature of BPR (and there is more than one variety) and the suitability of its application to the public sector in general and to hospitals in particular. The authors then evaluate the experience and impact of BPR in a London hospital trust. The article concludes by highlighting factors that help to explain the particular example of BPR and draws out some implications for its wider use in the public sector.
Chemistry of materials science phenomena in high-intensity discharge light sources
Authors: Tóth Z. , Lovas H.
Published: October 2007

Continuous development of light sources is required from energy-saving considerations (enhancing luminous efficacy) and an environmental protection point of view (lamps that are easy to recycle or made of environmentally friendly materials). This paper summarizes some of the recent results of materials science research with special attention to chemical aspects. The results will be cited from the field of discharge chemistry, electrodes, ceramics, and other materials.
Maintaining the Trust of Physicians and the Public in the Medical Literature: Report of a Task Force on Scientific Publishing of Clinical Trials
Authors: Shane Elizabeth , Civitelli Roberto , Delmas Pierre D , Drezner Marc , Eisman John A , Lindsay Robert , Lorenzo Joseph , Miller Paul , Ralston Stuart , Reid Ian , Siris Ethel
Published: October 2007

In 2006, the American Society of Bone and Mineral Research and the Journal of Bone and Mineral Research convened a task force to consider whether and how to change our editorial policies to assure complete and unbiased reporting of clinical trials. We invited editors of journals that publish research on osteoporosis and disorders of bone and mineral metabolism and presidents of related societies to participate. The task force was charged to consider whether journals should (1) adopt the Principles for Protecting Integrity in the Conduct and Reporting of Clinical Trials published in 2006 by the American Association of Medical Colleges (AAMC) and should (2) require authors and sponsors of industry-funded clinical trials to provide a jointly signed letter that states that the authors had full access to all the data and analyses on which the manuscript was based. The AAMC Principles recommend that multicenter trials should designate a Lead Investigator, Steering Committee, and Publication and Analysis (P&A) Committee, which should consist of a majority of academic investigators who are not sponsor employees. The P&A Committee should have the right to access any data generated during a study and to conduct its own statistical analyses. A majority of task force members voted to support the AAMC Principles, to require a letter jointly signed by academic investigators and industry sponsor stating that the authors had access to the data on which the submission was based, and to recommend adoption of these requirements to their respective societies and journals. Broad-based adoption of the AAMC Principles and requirement of a jointly signed attestation of data access by journals that publish clinical trials in diseases of bone and mineral metabolism should improve the position of academic clinical investigators in their interactions with industry and other funding sources.
Epistatic Effects Contribute to Variation in BMD in Fischer 344 × Lewis F2 Rats
Authors: Koller Daniel L , Liu Lixiang , Alam Imranul , Sun Qiwei , Econs Michael J , Foroud Tatiana , Turner Charles H
Published: October 2007

To further delineate the factors underlying the complex genetic architecture of BMD in the rat model, a genome screen for epistatic interactions was conducted. Several significant interactions were identified, involving both previously identified and novel QTLs.

Introduction: The variation in several of the risk factors for osteoporotic fracture, including BMD, has been shown to be caused largely by genetic differences. However, the genetic architecture of BMD is complex in both humans and in model organisms. We have previously reported quantitative trait locus (QTL) results for BMD from a genome screen of 595 female F2 progeny of Fischer 344 and Lewis rats. These progeny also provide an excellent opportunity to search for epistatic effects, or interaction between genetic loci, that contribute to fracture risk.

Materials and Methods: Microsatellite marker data from a 20-cM genome screen was analyzed along with weight-adjusted BMD (DXA and pQCT) phenotypic data using the R/qtl software package. Genotype and phenotype data were permuted to determine a genome-wide significance threshold for the epistasis or interaction LOD score corresponding to an α level of 0.01.

Results and Conclusions: Novel loci on chromosomes 12 and 15 showed a strong epistatic effect on total BMD at the femoral midshaft by pQCT (LOD = 5.4). A previously reported QTL on chromosome 7 was found to interact with a novel locus on chromosome 20 to affect whole lumbar BMD by pQCT (LOD = 6.2). These results provide new information regarding the mode of action of previously identified rat QTLs, as well as identifying novel loci that act in combination with known QTLs or with other novel loci to contribute to the risk factors for osteoporotic fracture.
Identification of a Major Locus for Paget's Disease on Chromosome 10p13 in Families of British Descent
Authors: Lucas Gavin JA , Riches Phillip L , Hocking Lynne J , Cundy Tim , Nicholson Geoff C , Walsh John P , Ralston Stuart H
Published: October 2007

Mutations of SQSTM1 are an important cause of PDB, but other genes remain to be discovered. A major susceptibility locus for PDB was identified on chromosome 10p13 by a genome-wide linkage scan in families of British descent, which accounted for the vast majority of cases not caused by SQSTM1 mutations.

Introduction: Paget's disease of bone (PDB) has a strong genetic component, and several susceptibility loci have been identified by genome-wide linkage scans. We previously identified three susceptibility loci for PDB using this approach on chromosomes 5q35, 2q36, and 10p13 in 62 families of mainly British descent, but subsequently, mutations in the SQSTM1 gene were found to be the cause of PDB in 23 families from this cohort. Here we reanalyzed the results of our genome-wide search in families from this cohort who did not have SQSTM1 mutations.

Materials and Methods: The study population consisted of 210 individuals from 39 families of predominantly British descent with autosomal dominant inheritance of PDB in whom SQSTM1 mutations had been excluded by mutation screening. The average family size was 5.44 ± 3.98 (SD) individuals (range, 2-24 individuals). Genotyping was performed using standard techniques with 382 microsatellite markers spaced at an average distance of 9.06 cM throughout the autosomes. Multipoint linkage analysis was performed using the GENEHUNTER program under models of homogeneity and heterogeneity.

Results: Multipoint parametric linkage analysis under a model of homogeneity and nonparametric linkage analysis under a model of heterogeneity both showed strong evidence of linkage to a single locus on chromosome 10p13 (LOD score, +4.08) close to the marker D10S1653 at 41.43cM. No evidence of linkage was detected at the chromosome 2q36 locus previously identified in this population, and linkage to other candidate loci previously implicated in the pathogenesis of PDB was excluded.

Conclusions: We conclude that there is an important susceptibility gene for PDB on chromosome 10p13 in families of British descent and find no evidence to support the existence of a susceptibility locus on chromosome 2q36 or other previously identified candidate loci for PDB in this population. The gene that lies within the 10p13 locus seems to account for the development of PDB in the vast majority of families of British descent who do not carry SQSTM1 mutations.
Growth and Bone Mineral Accretion During Puberty in Chinese Girls: A Five-Year Longitudinal Study
Authors: Zhu Kun , Greenfield Heather , Zhang Qian , Du Xueqin , Ma Guansheng , Foo Leng Huat , Cowell Chris T , Fraser David R
Published: October 2007

There are few longitudinal data on bone development during puberty in children with low calcium intake. This 5-yr longitudinal study showed that, in Chinese girls, the mean apparent calcium retention efficiency during puberty was 40.9%, PHV occurred at 3–0 yr before menarche, and peak bone mineral accretion occurred 1 yr later than PHV. Chinese girls have high calcium retention efficiency during puberty.

Introduction: There are few longitudinal data on bone development during puberty in children with low dietary calcium intake. The aim of this study was to examine the rate of growth and bone mineral accretion and study the predictors of total body BMC during puberty in a 5-yr longitudinal study with Chinese girls.

Materials and Methods: Ninety-two girls, 9.5–10.5 yr of age at baseline, from the unsupplemented control group of a school milk intervention trial were included in this analysis. Data on anthropometric measurements, total body BMC as assessed by DXA, and calcium intake as assessed by a 3-day food record were obtained at baseline and 1, 2, 4, and 5 yr.

Results: The mean age of menarche was 12.1 ± 1.0 yr. The mean annual rate of bone mineral accretion was 197.4 g/yr during the follow-up period, representing a calcium accretion rate of 162.3 mg/d. This calcium retention rate and the average dietary calcium intake of 444.1 mg/d gave an apparent calcium retention efficiency of 40.9%. Peak height velocity (PHV) occurred at 3–0 yr before menarche. Peak bone mineral accretion occurred 1 yr later than PHV. There was a decrease in size-corrected BMD in the year before menarche. In the linear mixed-effects model analysis containing body size and lifestyle factors, we found that height, body weight, and calcium intake were significant independent predictors of total body BMC.

Conclusions: Chinese girls with low habitual dietary calcium intake have high calcium retention efficiency during puberty. Because calcium intake is a significant predictor of total body BMC, increasing dietary calcium intake may have beneficial effects on bone mineral accretion in these girls.
Review of Twin and Family Studies on Neuroanatomic Phenotypes and Typical Neurodevelopment
Authors: Schmitt J. Eric , Eyler Lisa T. , Giedd Jay N. , Kremen William S. , Kendler Kenneth S. , Neale Michael C.
Published: October 2007

This article reviews the extant twin studies employing magnetic resonance imaging data (MRI), with an emphasis on studies of populationbased samples. There have been approximately 75 twin reports using MRI, with somewhat under half focusing on typical brain structure. Of these, most are samples of adults. For large brain regions such as lobar volumes, the heritabilities of large brain volumes are consistently high, with genetic factors accounting for at least half of the phenotypic variance. The role of genetics in generating individual differences in the volumes of small brain regions is less clear, mostly due to a dearth of information, but rarely because of disagreement between studies. Multivariate analyses show strong genetic relationships between brain regions. Cortical regions involved in language, executive function, and emotional regulation appear to be more heritable than other areas. Studies of brain shape also show significant, albeit lower, genetic effects on population variance. Finally, there is evidence of significant genetically mediated relationships between intelligence and brain structure. At present, the majority of twin imaging studies are limited by sample sizes small by the standards of behavioral genetics; nevertheless the literature at present represents a pioneering effort in the pursuit of answers to many challenging neurobiological questions.
Genetic and Phenotypic Stability of Measures of Neuroticism Over 22 Years
Authors: Wray Naomi R. , Birley Andrew J. , Sullivan Patrick F. , Visscher Peter M. , Martin Nicholas G.
Published: October 2007

People meeting diagnostic criteria for anxiety or depressive disorders tend to score high on the personality scale of neuroticism. Studying this dimension of personality can therefore give insights into the etiology of important psychiatric disorders. Neuroticism can be assessed easily via self-report questionnaires in large population samples. We have examined the genetic and phenotypic stability of neuroticism, measured up to 4 times over 22 years, on different scales, on a data set of 4999 families with over 20,000 individuals completing at least 1 neuroticism questionnaire. The neuroticism scales used were the Eysenck Personality Questionnaire revised (EPQ-R), the EPQ-R shortened form, and the NEO 5 factor inventory personality questionnaire. The estimates of heritability of the individual measures ranged from .26 ± .04 to .36 ± .03. Genetic, environmental, and phenotypic correlations averaged .91, .42, and .57 respectively. Despite the range in heritabilities, a more parsimonious ‘repeatability model’ of equal additive genetic variances and genetic correlations of unity could not be rejected. Use of multiple measures increases the effective heritability from .33 for a single measure to .43 for mean score because of the reduction in the estimate of the environmental variance, and this will increase power in genetic linkage or association studies of neuroticism.
Differences in Smoking Habits of MZ and DZ Twins: A Commentary on Tishler and Carey
Authors: Kaprio Jaakko
Published: October 2007

Tishler and Carey (this issue, 2007) have analyzed the difference in ever smoking prevalence between monozygotic (MZ) and dizygotic (DZ) twins in 8 published twin studies. They conclude that the lower prevalence in MZ twins might invalidate conclusions from classic twin models. I critique the conducted meta-analysis and suggest additional analyses to be conducted. A reanalysis of the Finnish Twin Cohort 1975 questionnaire data (included in Tisher and Carey) indicates that when intrapair correlations are correctly taken into account, the MZ-DZ difference in that study is no longer statistically significant. Even if the Tisher/Carey finding holds up in further analyses, it pertains only to the observed trait, the effect is small in size, and the mechanism underlying it needs to be explored.
A Longitudinal Genetic Study of Uric Acid and Liver Enzymes in Adolescent Twins
Authors: Middelberg Rita P. S. , Medland Sarah E. , Martin Nicholas G. , Whitfield John B.
Published: October 2007

Biochemical traits such as plasma alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyltransferase (GGT) and uric acid are associated with obesity, and with risk of cardiovascular disease, metabolic syndrome and diabetes. Each is subject to genetic influences, but little is known about changes in genetic and environmental influences on these traits over time. We investigated the contribution of genetic and environmental influences to variation in these biochemical traits in adolescent twins and their nontwin siblings from 965 twin families. Twins were studied at ages 12, 14 and 16 years. Multivariate genetic models that included effects of age and sex were fitted to determine whether the same or different genetic or environmental factors influence each trait at different ages. Results showed that the genetic factors influencing AST, ALT, GGT and uric acid change over time during adolescence, and that the magnitude of these effects differs between males and females. The nonshared environment effects were generally time specific. There are developmental changes in genes affecting these traits during adolescence.
Maternal Risk Factors for Potential Maltreatment Deaths Among Healthy Singleton and Twin Infants
Authors: Luke Barbara , Brown Morton B.
Published: October 2007

Our aim was to evaluate the risk of death among healthy infants due to maltreatment, using national linked vital statistics data. The study population included all nonanomalous, full-term (≥ 37 weeks), non-low birthweight (> 2500 grams) infants born between 1995 and 2000 and their linked death certificates: 18,673,439 singleton pregnancies (36,864 deaths) and 77,800 twin pregnancies (356 pregnancies with a death). The underlying cause of death was characterized as due to maltreatment, sudden infant death syndrome (SIDS), and other causes, based on ICD-9 and ICD-10 codes, and modeled by maternal age using multinomial logistic regression; mothers aged 25 to 29 were the reference group. The highest risk for infant mortality was among the youngest mothers for maltreatment (AOR 2.45 and 1.95 for singleton mothers < 20 and aged 20 to 24, respectively; AOR 4.34 and 2.25 for twin mothers < 20 and aged 20 to 24, respectively). The risk of death overall and for each category was modeled by maternal age < 20, aged 20 to 24, and ≥ 25, with and without the father's age present on the birth certificate, with mothers ≥ 25 and father's age present as the reference group. All risks of death were significantly increased for mothers younger than age 25, with the highest risks among the youngest mothers and missing father's age. The pattern for twins was similar, with elevated risks among younger mothers with or without father's age present on the birth certificate. These results add to the body of knowledge regarding risk factors for infant mortality among healthy singletons and twins.
Small Changes in Dietary Sugar and Physical Activity as an Approach to Preventing Excessive Weight Gain: The America on the Move Family Study
Authors: Rodearmel Susan J. , Wyatt Holly R. , Stroebele Nanette , Smith Sheila M. , Ogden Lorraine G. , Hill James O.
Published: October 2007

OBJECTIVES. The intent of this study was to evaluate whether small changes in diet and physical activity, as promoted by the America on the Move initiative, could prevent excessive weight gain in overweight children.

METHODS. In this family-intervention study, the America on the Move small-changes approach for weight-gain prevention was evaluated in families with at least 1 child (7–14 years old) who was overweight or at risk for overweight. These children were the primary target of the intervention, and parents were the secondary target. Families were randomly assigned to either the America on the Move group (n = 100) or the self-monitor–only group (n = 92). Families who were assigned to the America on the Move group were asked to make 2 small lifestyle changes: (1) to walk an additional 2000 steps per day above baseline as measured by pedometers and (2) to eliminate 420 kJ/day (100 kcal/day) from their typical diet by replacing dietary sugar with a noncaloric sweetener. Families who were assigned to the self-monitor group were asked to use pedometers to record physical activity but were not asked to change their diet or physical activity level.

RESULTS. During a 6-month period, both groups of children showed significant decreases in BMI for age. However, the America on the Move group compared with the self-monitor group had a significantly higher percentage of target children who maintained or reduced their BMI for age and, consistently, a significantly lower percentage who increased their BMI for age. There was no significant weight gain during the 6-month intervention in parents of either group.

CONCLUSIONS. The small-changes approach advocated by America on the Move could be useful for addressing childhood obesity by preventing excess weight gain in families.
Family-Member Presence During Interventions in the Intensive Care Unit: Perceptions of Pediatric Cardiac Intensive Care Providers
Authors: Kuzin Julie K. , Yborra Jennifer G. , Taylor Michael D. , Chang Anthony C. , Altman Carolyn A. , Whitney Gina M. , Mott Antonio R.
Published: October 2007

OBJECTIVE. Should family members be present during interventions in an ICU? This question is a source of debate among health care providers. We propose to define perceptions and practice regarding family-member presence during ICU interventions from a multidisciplinary group of pediatric cardiac intensive care providers.

METHODS. A 20-question survey was created and distributed to attendees of the 2004 Pediatric Cardiac Intensive Care Symposium, 1 year after the meeting. Interventions were defined as noninvasive (team rounds), invasive (tracheal intubation, central/arterial line placement, chest tube placement, or pericardiocentesis), or extremely invasive (cardiopulmonary resuscitation).

RESULTS. A total of 211 surveys (145 physicians and 66 nonphysicians) were completed. Of all responders, the majority believe family members have a right to be present during cardiopulmonary resuscitation (75%), team rounds (77%), and invasive procedures (57%). Sixty-five percent of respondents encounter families that frequently request to be present for team rounds. However, the majority of respondents encounter families that rarely request to be present during invasive procedures (69%) and cardiopulmonary resuscitation (73%). Many providers practice in ICUs where family-member presence is allowed; 64% allow family members to attend team rounds. Some of the concerns providers have regarding family-member presence in the ICU include family-member presence causing stress to the provider during invasive procedures along with distractions and nervousness among the team during cardiopulmonary resuscitation. The majority of providers predict family-member presence during cardiopulmonary resuscitation would not increase medicolegal concerns.

CONCLUSIONS. Most respondents, nonphysicians more than physicians, believe that family members have a right to be present during all ICU interventions. The majority of respondents encounter families that frequently request to be present for team rounds. However, the majority of respondents encounter families that rarely request to be present during invasive procedures and cardiopulmonary resuscitation. Most respondents believe family-member presence during cardiopulmonary resuscitation would not increase medicolegal concerns.
How Do Toddler Eating Problems Relate to Their Eating Behavior, Food Preferences, and Growth?
Authors: Wright Charlotte M. , Parkinson Kathryn N. , Shipton Deborah , Drewett Robert F.
Published: October 2007

OBJECTIVES. Eating problems are a common cause of concern for the parents of toddlers, but few studies have examined the correlates of eating problems or the growth patterns associated with them in a large population-based sample. Our goal was to examine the distribution of eating behaviors in a large representative sample of toddlers and their mothers' approach to feeding. In addition, we describe the prevalence of parentally perceived eating problems and how they relate to specific behaviors, food preferences, and growth in the child.

METHODS. We conducted a cross-sectional analysis of data from a United Kingdom population-based birth cohort, the Gateshead Millennium Baby Study, which included 455 questionnaires completed by parents when their children were aged 30 months.

RESULTS. Eating was perceived to be a problem by 89 (20%) parents. Eating a limited variety (79 [17%]) and preferring drinks to food (57 [13%]) were the most prevalent problem behaviors. Thirty-seven children (8%) were described by parents as definitely “faddy” (picky), and these children liked fewer foods and had higher eating restriction scores than those described as not faddy. Children who were described as having an eating problem gained less weight over the first 2 years; 11.1% had weight faltering compared with 3.5% in children not described as having an eating problem. Being faddy was only weakly associated with poor growth, and simply eating a limited variety was unrelated to growth. High milk consumption was associated with lower appetite but not with poor growth.

CONCLUSIONS. Eating problems are common in toddlers and in the majority are associated with normal growth, although weight faltering is more common in such children. Excessive milk-drinking may be a cause of low appetite at meal times.
Healthy Buddies: A Novel, Peer-Led Health Promotion Program for the Prevention of Obesity and Eating Disorders in Children in Elementary School
Authors: Stock Suzanne , Miranda Charmaine , Evans Stacey , Plessis Suzanne , Ridley Julia , Yeh Sophia , Chanoine Jean-Pierre
Published: October 2007

OBJECTIVE. We designed and tested a novel health promotion program for elementary schools that was based on peer teaching from older to younger schoolchildren (“Healthy Buddies”).

SUBJECTS AND METHODS. This prospective pilot study compared the effect of our program (2–3 hours/week, 21 weeks) in 2 Canadian elementary schools (intervention: n = 232 children, the whole school implementing the program; control: n = 151). Older students (4th through 7th grade) were given direct instruction from 1 intervention teacher and were paired with younger students (kindergarten through 3rd grade) for the whole school year. Students in 4th through 7th grade then acted as teachers for their younger “buddies.” All lessons included 3 components of healthy living: nutrition, physical activity, and healthy body image. The students first learned how to be positive buddies and learned the 3 components of a healthy life. Thereafter, they learned how to overcome challenges to living a healthy life. Outcome measures (intervention and control schools at the beginning and end of the school year) included validated questionnaires that assessed healthy-living knowledge, behavior and attitude, a 9-minute fitness run, self-competence, body satisfaction, disordered eating symptoms, and anthropometry (BMI, blood pressure, and heart rate).

RESULTS. Compared with control students, both older and younger intervention students showed an increase in healthy-living knowledge, behavior, and attitude scores and a smaller increase in systolic blood pressure. BMI and weight increased less in the intervention students in 4th through 7th grade and height more in the intervention students in kindergarten through 3rd grade.

CONCLUSIONS. Our student-led curriculum improved knowledge not only in older schoolchildren but also in their younger buddies. It also decreased weight velocity in the older students. Student-led teaching may be an efficient, easy-to-implement way of promoting a healthy lifestyle from kindergarten to 7th grade.
Characteristics of Neonatal Units That Care for Very Preterm Infants in Europe: Results From the MOSAIC Study
Authors: Van Reempts Patrick , Gortner Ludwig , Milligan David , Cuttini Marina , Petrou Stavros , Agostino Rocco , Field David , den Ouden Lya , Børch Klaus , Mazela Jan , Carrapato Manuel , Zeitlin Jennifer ,   for the MOSAIC Research Group
Published: October 2007

OBJECTIVES. We sought to compare guidelines for level III units in 10 European regions and analyze the characteristics of neonatal units that care for very preterm infants.

METHODS. The MOSAIC (Models of Organising Access to Intensive Care for Very Preterm Births) project combined a prospective cohort study on all births between 22 and 31 completed weeks of gestation in 10 European regions and a survey of neonatal unit characteristics. Units that admitted ≥5 infants at <32 weeks of gestation were included in the analysis (N = 111). Place of hospitalization of infants who were admitted to neonatal care was analyzed by using the cohort data (N = 4947). National or regional guidelines for level III units were reviewed.

RESULTS. Six of 9 guidelines for level III units included minimum size criteria, based on number of intensive care beds (6 guidelines), neonatal admissions (2), ventilated patients (1), obstetric intensive care beds (1), and deliveries (2). The characteristics of level III units varied, and many were small or unspecialized by recommended criteria: 36% had fewer than 50 very preterm annual admissions, 22% ventilated fewer than 50 infants annually, and 28% had fewer than 6 intensive care beds. Level II units were less specialized, but some provided mechanical ventilation (57%) or high-frequency ventilation (20%) or had neonatal surgery facilities (17%). Sixty-nine percent of level III and 36% of level I or II units had continuous medical coverage by a qualified pediatrician. Twenty-two percent of infants who were <28 weeks of gestation were treated in units that admitted fewer than 50 very preterm infants annually (range: 2%–54% across the study regions).

CONCLUSIONS. No consensus exists in Europe about size or other criteria for NICUs. A better understanding of the characteristics associated with high-quality neonatal care is needed, given the high proportion of very preterm infants who are cared for in units that are considered small or less specialized by many recommendations.
Impact of Hurricane Katrina on Newborn Screening in Louisiana
Authors: Lobato Mark N. , Yanni Emad , Hagar Arthur , Myers Charles , Rue Alison , Evans Catherine , Lambert Lauren A. , Olney Richard S. ,   for the Louisiana OPH-CDC Newborn Screening Assessment Team
Published: October 2007

OBJECTIVE. The Louisiana Office of Public Health and the Centers for Disease Control and Prevention assessed the extent to which newborn screening was disrupted from August 15 to September 21, 2005, the immediate period before and after Hurricane Katrina.

METHODS. A list of hospitals with labor and delivery services was obtained from the Louisiana Hospital Association. A survey sent to hospitals on October 17, 2005, asked about the number of live births during the assessment period, disruption in hospital services, the number of specimens sent to alternative laboratories, and the number of children without screening results.

RESULTS. Among 64 Louisiana hospitals with labor and delivery units, 6 remained closed at the time of the survey. Of the 58 open hospitals, 53 (91.4%) completed the questionnaire. Twenty-one (36.2%) of 58 hospitals experienced disruption of newborn screening services. Respondents from 31 (58.5%) of the 53 open hospitals acknowledged receiving the advisory from the Office of Public Health regarding resumption of newborn screening laboratory services. Hospitals stated that of 5958 specimens submitted, reports had not been received for 1207 (20.3%) newborns. The Office of Public Health laboratory reviewed the names of 2828 newborns received from hospitals and determined that no specimen was received within 14 days of collection for 631 (22.3%). Thirty percent of the specimens received from infants who were born between August 15 and September 21 were rejected as a result of having been received >14 days after collection. Ten children had confirmed positive screening results during the assessment period; all were located, and treatment was initiated.

CONCLUSIONS. Collaboration between the Office of Public Health and the Centers for Disease Control and Prevention was essential to increase awareness of changes in laboratory procedures after the hurricane and to help identify infants who might be in need of screening or rescreening.