bluuebunny/crossref_metadata_2025 huggingface dataset:
ARGUMENTUM AD FEMINAM
Authors: Sommers Christina
Published: April 2008

The last issue of this journal published an exchange between Marilyn Friedman and me that had taken place at a lively session of the American Philosophical Association in December, 1990. Friedman's paper “‘They Lived Happily Ever After’: Sommers on Women and Marriage” was a barbed critique of my views on the family. My rejoinder, “Do These Feminist Like Women?” pointed out that Friedman's orthodox brand of feminism was not sensitive to the values and aspirations of most American women. That issue of the Journal of Social Philosophy also published a third paper of Friedman's “Does Sommers Like Women?” twice as long again as my rejoinder. This second critique went further into earlier writings of mine raising new issues, and criticizing me in rather unpleasant ad feminam ways. If an uncharacteristic asperity colors my response, it is because I do not find myself able to deal coolly and impersonally with the accusation that I intentionally misrepresent some of the feminist philosophers I criticize.
WAS THE GULF WAR A JUST WAR?
Authors: Kavka Gregory S.
Published: April 2008

In the early months of 1991, the United States—in alliance with a number of other nations—fought a large scale air and ground war to evict Iraq's occupying army from the emirate of Kuwait. In this paper, I will consider the question of whether this U.S. military campaign was a just war according to the criteria of traditional just war theory—the only developed moral theory of warfare that we have. My aim, however, is not so much to reach a verdict about the morality of the Gulf War, as it is to identify relevant moral issues, and to reveal certain serious problems of application that are inherent in just war theory itself. Just war theory divides into two parts concerning, respectively, the question of whether or not to fight a particular war (justice of war), and the question of how the war is conducted (justice in war). I begin by considering whether it was just, according to the justice of war criteria, for the U.S. to fight the Gulf War at all. I then turn to the question of whether the way the war was conducted satisfied the criteria of justice in war.
PSYCHOANALYSIS AND HUMAN RATIONALITY
Authors: Sayers Sean
Published: April 2008

It is clear that Freud's theories have had a profound and revolutionary impact on ideas about human nature and human rationality. However, the precise nature of that impact is less clear. It is often said that psychoanalysis reveals the irrational forces at the root of even the most apparently rational forms of thought and activity; and that, in so doing, it undermines ideas about human rationality which have dominated western thought. That is undoubtedly true. However, it is only one aspect of the truth. For the implications of psychoanalysis are more complex and far‐reaching than this currently fashionable view suggests.
HENRY THOREAU, NATURE, AND AMERICAN DEMOCRACY
Authors: Taylor Bob Pepperman
Published: April 2008

In a famous passage from “Slavery In Massachusetts,” Thoreau writes, “The remembrance of my country spoils my walk. My thoughts are murder to the State, and involuntarily go plotting against her.”1 Here is Thoreau the anarchist, the misanthrope, the self‐righteous angry young man, as he is so often portrayed in the secondary literature. It would be easy to consider the issue resolved: the conventional wisdom about Thoreau's misanthropy and anarchism are demonstrated, and there is little more to say. It would also be a significant mistake—one that has been made over and over again by commentators on both his political views and his nature writings. Thoreau's comment is not the climax of “Slavery in Massachusetts,” but rather is the prelude to the climax. Consider the passage that follows and leads to the conclusion of the essay:
AEROBICS AS POLITICAL MODEL AND SCHOOLING
Authors: Schatzki Theodore R.
Published: April 2008

Among the theses promulgated by the Frankfort School theorists during the forties and fifties was the decline of the individual under contemporary capitalism. The chief agent of this decline was identified as the culture industry, which served the reigning system by integrating people into its particular regime of production, reproduction, and consumption. By dominating minds, homogenizing behaviors, and normalizing tastes, this industry prepared people for capitalist toil. In so doing, it also obstructed the flowering of individuality. Individuality, if it were possible any longer, could henceforth be found only among the “captains” of capitalism in charge of the system. In fact, however, these captains were equally captive. The future of the individual thus seemed sealed.
Emmanuel Levinas: Thinker between Jerusalem and Athens A Philosophical Biography
Authors: Burggraeve Roger
Published: April 2008

Emmanuel Levinas died a few days before he would have been ninety years old, on December 25, 1995, very early on a Monday morning, in the Paris clinic of Beaujon, where he had been admitted the previous day with serious heart complications.
Regendering the U.S. Abortion Debate
Authors: Jaggar Alison M.
Published: April 2008

This paper originated in a conference presentation with my colleague Michael Tooley, at which we were both asked to re‐evaluate articles about abortion that each of us had written over twenty years earlier. While Tooley and I both contended that abortion should be legally unrestricted, there were striking differences in the style and content of our respective arguments. Contemplating these differences has reinforced my own belief in the importance of emphasizing the centrality of gender when discussing abortion. Since gender as we know it is a system of dominance as well as difference (MacKinnon 1987), I take this to mean that contemporary discussions of abortion must address the relationship between abortion access and the social status of women. My early article addressed this relationship to some extent, but the present paper will raise a number of additional gender issues that the early article did not mention.
The “Social Etymology” of ‘Sexual Harassment’
Authors: Crouch Margaret A.
Published: April 2008

Language does not simply symbolize a situation or object which is already there in advance; it makes possible the existence or the appearance of that situation or object for it is a part of the mechanism whereby that situation or object is created. (Mead 1934, p. 78)
Rent seeking and collusion in the military allocation decisions of Finland, Sweden, and Great Britain, 1920–381
Authors: ELORANTA JARI
Published: April 2008

Analysis of military acquisition policies in Finland, Sweden, and Great Britain in the period from 1920 to 1938 produces evidence of rent seeking, both quantitative and qualitative, in all three cases. The Finnish institutional environment offered the most extensive rents and collusion opportunities, which translated into tangible price advantages for domestic producers. The Swedish and British domestic producers operated under more efficient institutions and thus had to settle for more moderate rents. Evolving institutional environments determined the extent of the rent seeking.
Pondering the Sinlessness of Jesus Christ: Moral Christologies and the Witness of Scripture
Authors: DAVIDSON IVOR J.
Published: April 2008

Abstract:  Traditional claims about the sinlessness of Jesus Christ are often said to be problematic, yet the instinct to construct moral Christologies has remained very powerful in modern theology. The models that typically emerge in modernity face major difficulties. This article seeks to reorient the discussion of sinlessness in biblical terms, and suggests that scripture's witness points toward an account of the moral character of Jesus as grounded specifically in inner‐divine relations rather than in any sort of idealism. Such a trinitarian account also raises questions about some conventional approaches to the metaphysics of sinlessness.
Period of remission after treatment with UVA‐1 in sclerodermic skin diseases
Authors: Kroft EBM , Van De Kerkhof PCM , Gerritsen MJP , De Jong EMGJ
Published: April 2008

Background  Sclerodermic skin diseases can cause severe morbidity and disability. UVA‐1 has shown to be an effective therapy for sclerodermic skin diseases. However, the period of remission in these patients is not clear. In this study, the effect and remission period of UVA‐1 phototherapy in various sclerotic skin diseases is described using a semiquantitative clinical score combined with the durometer score as an objective apparatus to measure the hardness of the skin.

Objective  Our purpose was to determine the effectiveness of UVA‐1 phototherapy and the duration of remission in sclerodermic skin diseases.

Methods  In this prospective study, 10 patients with various sclerodermic skin diseases were treated with UVA‐1 phototherapy. The durometer was used to observe the hardness of the skin. Hardness of the skin was measured by one investigator at 10 locations, distributed evenly on the representative sclerotic skin. Each spot was measured three times, and the average of each of these measurements was summed to give the total durometer score. Durometer scores were recorded weekly until the final treatment date and 4 weeks after treatment. Clinical scores were carried out at the end date of the treatment using a 6‐point scale semiquantitative score. Long‐term effects were evaluated up to 29–46 months.

Results  The patients were treated with UVA‐1 in a cumulative dose of 1286 ± 58.8 (SEM) J/cm2 (range, 846–1470 J/cm2) divided over five times a week for 4 weeks. In all patients studied, the sclerotic skin lesions were markedly softer after UVA‐1 treatment. All durometer scores improved highly significant during the first 3 weeks of treatment and borderline significant during the last week of treatment. There was no significant improvement between the end of UVA‐1 phototherapy and 1 month after ending the therapy (P > 0.05). All patients noted improvement of the semiquantitative clinical score during treatment. Clinical improvement was associated with improvement of the durometer score (95% confidence interval). With a follow‐up until 46 months, the remission period was stable up to 26 months in six patients. The duration of sclerodermic skin diseases before start of treatment did not influence improvement in the clinical or durometer score. One patient had an acute side effect of minimal erythema. No other side effects, except tanning and fatigue, were noted.

Limitations  This is an open‐label uncontrolled study.

Conclusion  UVA‐1 is an effective treatment for sclerodermic skin diseases with a long period of remission and clinical improvement even in patients with a long history of a sclerotic skin disease. UVA‐1 should be considered among the first approaches in the management of sclerotic skin diseases.
Branching out in new directions: the control of root architecture by lateral root formation
Authors: Nibau C. , Gibbs D. J. , Coates J. C.
Published: April 2008

Plant roots are required for the acquisition of water and nutrients, for responses to abiotic and biotic signals in the soil, and to anchor the plant in the ground. Controlling plant root architecture is a fundamental part of plant development and evolution, enabling a plant to respond to changing environmental conditions and allowing plants to survive in different ecological niches. Variations in the size, shape and surface area of plant root systems are brought about largely by variations in root branching. Much is known about how root branching is controlled both by intracellular signalling pathays and by environmental signals. Here, we will review this knowledge, with particular emphasis on recent advances in the field that open new and exciting areas of research.

Contents

Summary
595

I.
Background
595

II.
Formation of lateral roots
596

III.
Endogenous factors regulating the stages of lateral root development
597

IV.
Plasticity: modification of lateral root development by the environment
603

V. 
Transcriptomic studies to identify potential new regulators of lateral root development
608

VI.
Conclusions and future challenges
608

Acknowledgements
608

References
609
An Indicator to Evaluate the Thermodynamic Maturity of Industrial Process Units in Industrial Ecology
Authors: Zvolinschi Anita , Kjelstrup Signe
Published: April 2008

The article suggests a measure to evaluate the thermodynamic maturity of industrial systems at the level of single process units. The measure can be quantified with reasonable confidence on the basis of entropy production as defined by irreversible thermodynamics theory. It quantifies, for one process unit, the distance between its actual state of operation and its state with minimum entropy production or optimum exergy efficiency, when the two states are constrained with a fixed production capacity of the process unit. We suggest that the minimum entropy production state is a mature state, or that processes that operate at this state are mature. We propose to call the measure “the thermodynamic maturity indicator” (π), and we define it as the ratio between the minimum entropy production and the actual entropy production. We calculated π on the basis of literature data for some examples of industrial process units in the chemical and process industry (i.e., heat exchanger, chemical reactor, distillation column, and paper drying machine). The proposed thermodynamic measure should be of interest for industrial ecology because it emerges from the entropy production rate, a dynamic function that can be optimized and used to understand the thermodynamic limit to improving the exergy efficiency of industrial processes. Although not a tool for replacing one process with another or comparing one technology to another, π may be used to assess actual operation states of single process units in industrial ecology.
Triage Patients with Suspected Pulmonary Embolism in the Emergency Department Using a Portable Ultrasound Device
Authors: Mansencal Nicolas , Vieillard‐Baron Antoine , Beauchet Alain , Farcot Jean‐Christian , El Hajjam Mostafa , Dufaitre Ghislaine , Brun‐Ney Dominique , Lacombe Pascal , Jardin François , Dubourg Olivier
Published: April 2008

The diagnosis of pulmonary embolism (PE) is difficult, despite validated diagnostic models. We sought to determine the value of a portable ultrasound device for triage of patients with suspected PE referred to the emergency department, using simplified echo criteria. We prospectively studied 103 consecutive patients with suspected PE, referred to our emergency department. After D‐dimer screening, 76 patients were prospectively enrolled in this ultrasound study and underwent helical chest tomography, transthoracic echocardiography, and venous ultrasonography. Among patients with PE (n = 31), a right ventricular dilation was detected in 17 patients (55%), a direct visualization of clot in the lower limbs was present in 18 patients (58%), and 8 patients (26%) had both right ventricular dilation and deep venous thrombosis. The sensitivity and specificity of a combined ultrasound strategy using echocardiography and venous ultrasonography were respectively 87% (95% confidence interval 74% to 96%), and 69% (95% confidence interval 53% to 82%). The sensitivity of this combined strategy was significantly improved as compared to venous ultrasonography alone (P = 0.01) or echocardiography alone (P = 0.005). In patients with dyspnea or with high clinical probability of PE, this combined strategy was particularly relevant with high sensitivities (respectively 94% and 100%). Echocardiography combined with venous ultrasonography using a portable ultrasound device is a reliable method for screening patients with suspected PE referred to an emergency department, especially in patients with dyspnea or with high clinical probability.
Assessment of the Vascularity of a Left Atrial Mass Using Myocardial Perfusion Contrast Echocardiography
Authors: Abdelmoneim Sahar S. , Bernier Mathieu , Dhoble Abhijeet , Mankad Sunil V. , Mulvagh Sharon L.
Published: April 2008

Emerging applications of myocardial contrast echocardiography (MCE) include the evaluation of myocardial perfusion, the improvement of the definition of intracavitary structures, and evaluation of the relative perfusion of a cardiac mass. We present a case of a patient that was found incidentally to have a cardiac mass on transthoracic echocardiography. MCE was used to evaluate the vascularity of the mass. This case is compared with another patient with a left atrial thrombus, which represents an “avascular” cardiac mass by MCE.
The Ebb and Flow of Sociological Interest in Values
Authors: Gecas Viktor
Published: April 2008

Contemporary sociology and social psychology have largely ignored the study of values. In this essay, I explore the reasons for that condition, the exceptions to the rule, and the areas that would most benefit from the consideration of values.
Doing Time in Space: Line‐Joining Rules and Resultant Morphologies1
Authors: Gibson David R.
Published: April 2008

Waiting lines are spatial configurations of people that store information about time of arrival until it is recapitulated as order of service. Someone joining a line has an interest in assuming a position that will be seen as recognizably “in line,” particularly by those arriving later. When physical constraints are few—such as in 30th Street Station, Philadelphia, the site for this research—this is normally accomplished through conformity with the line’s recent trajectory. However, conflict between normally congruent line‐joining rules can occasion a sharp turn; an example is when a self‐identifying group joins the line, muddying the geometry and creating uncertainty as to what should happen next. Further, the normal rules for line formation can misfire, giving rise to mutant lines with multiple “tails” and an impaired capacity for encoding time into space. Alternatives to waiting lines are considered and judged less efficient and more likely to be judged unfair, particularly given the expectation that rewards will be proportional to investments.
Bacteriocins (meningocins) in Norwegian isolates of Neisseria meningitidis: possible role in the course of a meningococcal epidemic
Authors: ALLUNANS JURIS , KRISTIANSEN KNUT IVAN , ASSALKHOU REZA , BJØRÅS MAGNAR
Published: April 2008

In the Neisseria meningitidis strain MC58 (serogroup B; ET‐5 complex) genome three putative islands of horizontally transferred DNA (IHTs) have been identified. IHT‐A2 codes for eight hypothetical proteins and two disrupted open reading frames with similarity to a secretion protein (NMB0097) and an ABC transporter (NMB0098). The strains MC58 and 44/76 (shown here) are meningocin resistant/weakly sensitive. None of these strains are meningocin producers. However, NMB0097 and NMB0098 homologues with open reading frames are found in meningocin producers (N. meningitidis P241 (serogroup A; systemic isolate) and BT878 (serogroup B; carrier isolate), and also in strain FAM18 (serogroup C; ET‐37 complex). Knocking out either of the two genes in the strain BT878 yielded mutants that did not secrete meningocin. A similarly disrupted tolC mutant in strain BT878 still released meningocin. Among systemic meningococcal isolates prior to and at the onset (mid‐1973 to the end of 1974) of the epidemic peaking in 1975 in North Norway, 12 of 30 (40%) isolates of serogroup A were meningocin producers. However, the rate for serogroup B was 1 of 45 (2.2%). Serogroup B meningocin‐resistant/weakly sensitive non‐producers dominated in the region from mid‐1975 and spread to the rest of the country from then on. No producers were found in selected pharyngeal isolates from healthy carriers collected in Svalbard in the early spring of 1975. Our results suggest that meningocinogeny has played a part in the change from serogroup A to serogroup B among isolates in North Norway during the first half of 1975.
A prospective study of diagnosis of Toxoplasma gondii infection after bone marrow transplantation
Authors: EDVINSSON BENJAMIN , LUNDQUIST JESSICA , LJUNGMAN PER , RINGDÉN OLLE , EVENGÅRD BIRGITTA
Published: April 2008

Active infection with Toxoplasma gondii in immunocompromised transplant recipients can lead to toxoplasmosis, which may have a rapid disease course and in some cases be fatal. It is of paramount importance to diagnose toxoplasmosis at an early stage, and to initiate specific treatment to improve the outcome. Polymerase chain reaction (PCR) is today the primary diagnostic tool to diagnose toxoplasmosis in immunocompromised patients. Timely diagnosis may, however, be difficult if toxoplasmosis is at first asymptomatic. To investigate the magnitude of toxoplasmosis after bone marrow transplantation (BMT), we conducted a screening study by PCR where 21 autologous and 12 allogeneic BMT recipients were included. Peripheral blood samples were taken one week prior to BMT; thereafter, blood samples were drawn weekly for the first 6 months, and monthly up to one year after BMT. The samples were analyzed by conventional PCR and real‐time PCR. T. gondii DNA was detected in peripheral blood from one patient 5 days post allogeneic BMT. There were no clinical signs of toxoplasmosis. Medical records were reviewed and showed a previously undiagnosed eye infection in another allogeneic BMT recipient. These two patients were seropositive for T. gondii. We concluded that monitoring for T. gondii DNA in peripheral blood samples using PCR might be a valuable method for identifying toxoplasma‐seropositive stem cell transplant recipients.
Distribution of p53 expression in tissue from 774 Danish ovarian tumour patients and its prognostic significance in ovarian carcinomas
Authors: HØGDALL ESTRID V. S. , CHRISTENSEN LISE , HØGDALL CLAUS K. , FREDERIKSEN KIRSTEN , GAYTHER SIMON , BLAAKAER JAN , JACOBS IAN J. , Kjaer Susanne K.
Published: April 2008

The clinical roles played by normal and altered p53 in cancer are under intensive investigation, but larger studies describing the pattern as well as the prognostic value are still needed. The aim of this study was, using tissue array (TA), to examine the overexpression of p53 protein in 774 epithelial ovarian tumour tissues from Danish women and to evaluate whether p53 tissue expression levels correlate with clinicopathological parameters and prognosis. The distribution of p53 expression levels at different stages of disease, in different histological subtypes, and the prognostic value of p53 tissue expression were examined. Overall, p53 was expressed in 24/189 (13%) low malignant potential ovarian tumours (LMP) and in 278/585 (48%) ovarian cancers (OC). No significant difference in frequency of p53 tissue expression in LMP tissue was noted with increasing tumour stage (p=0.98). By contrast, there was a significant increase in the frequency of p53 tissue expression in OC with increasing FIGO stage (p<0.00001). Multivariate Cox regression analysis found that less than 20% tissue expression of p53 was associated with longer OC disease‐specific survival. Tissue p53 expression may be of prognostic value in women with OC.
Monitoring the effect of belinostat in solid tumors by H4 acetylation
Authors: MARQUARD LENA , PETERSEN KAMILLE DUMONG , PERSSON MORTEN , HOFF KIRSTEN DAMGAARD , JENSEN PETER BUHL , SEHESTED MAXWELL
Published: April 2008

Histone deacetylase (HDAC) inhibition is a novel entity in medical oncology, and several HDAC inhibitors are in clinical trials. One of them is the hydroxamic acid belinostat (PXD101) that has demonstrated therapeutic efficacy for several clinical indications. Acetylation of histones is a key event after treatment with HDAC inhibitors, and could thus be used as a marker for monitoring cellular response to HDAC inhibitor treatment. Here we describe the utility of a newly described monoclonal antibody against acetylated H4 for immunohistochemistry on paraffin‐embedded fine needle biopsies from nude mice carrying A2780 human ovarian cancer xenografts. Acetylated H4 was monitored in vivo by immunohistochemistry during treatment with belinostat, and compared with pharmacokinetics in plasma and tumor tissue. We found an increased level of acetylated H4 15 min after a single treatment (200 mg/kg i.v.) with maximum level reached after 1 h. H4 acetylation intensity reflected the belinostat concentration in plasma and tumor tissue. The threshold level for belinostat activity, indicated by acetylated H4, correlated with belinostat plasma concentrations above 1,000 ng/ml. In conclusion, examination of H4 acetylation in fine needle biopsies using the T25 antibody may prove useful in monitoring HDAC inhibitor efficacy in clinical trials involving humans with solid tumors.
Prenatal diagnosis of congenital heart defects—a population based study
Authors: Nikkilä Annamari , Björkhem Gudrun , Källén Bengt
Published: April 2008

Aim: The aim of this study was to describe the efficiency of routine prenatal ultrasound screening for the detection of cardiac defects in a Swedish region and to study the effect of prenatal diagnosis on the survival and outcome of the child.

Methods: We identified all fetuses and infants with a diagnosed major cardiac defect born in 1999–2003 in a region of Sweden using a register of the regional paediatric cardiac clinic, various health‐care registers and registers of prenatally detected malformations. The outcome of newborns with and without a prenatal diagnosis of a cardiac defect was compared.

Results: During the study period, 77 241 infants were born in the area. Among 145 major cardiac defects, 21% were detected prenatally. For the two university departments the detection rate was 38%. Of the major cardiac defects diagnosed <23 gestational weeks, 30% were terminated. No significant difference in the outcome was found between children with and without a prenatal diagnosis of a major cardiac defect.

Conclusions: It could not be shown that survival and outcome for children with major cardiac defects was better when the defect was known prenatally than if it was detected postnatally. The size of the study prohibits conclusions on moderate differences.
Do wet diapers induce arousals in sleeping infants?
Authors: Zotter H. , Urlesberger B. , Pichler G. , Mueller W. , Kerbl R.
Published: April 2008

Aim: To find out whether simulated bladder voiding was able to induce arousals in sleeping infants.

Methods: Polygraphic recordings were performed in 34 infants and voiding was simulated by administering water into the diaper.

Results: Heart rate, respiratory frequency and electroencephalogram frequency did not change significantly during this procedure. Furthermore, simulated voiding was unable to cause an awakening or to induce body movements in sleeping infants.

Conclusion: Simulated voiding was unable to induce arousals.
Insulin‐like growth factor 2 (IGF2) and IGF2 receptor gene variants are associated with fetal growth
Authors: Kaku K , Osada H , Seki K , Sekiya S
Published: April 2008

Aim: Normal variation in size at birth is a result of the interaction between fetal genetic factors and the maternal uterine environment. It is, however, unclear how genetic factors contribute to fetal growth. The insulin‐like growth factor (IGF) system regulates uterine, placental and fetal development, thereby partially controlling the rate of fetal growth. The aim of this study was to investigate the associations between the neonatal birth weight and the genotypes of polymorphic loci in the IGF2 and IGF2 receptor (IGF2R) genes.

Methods: We determined the genotypes of two polymorphic loci in the IGF2 gene and four loci in the IGF2R gene in 884 pairs of normal Japanese mothers and their neonates, and compared the genotypes with the birth weight converted into standard deviation scores (SDSs) according to sex, parity and gestational weeks at delivery.

Results: There was a significant difference in birth weight SDSs among the three neonatal +3123/ApaI genotypes of the IGF2 gene; AA, AG and GG. There was also a significant difference in birth weight among the three neonatal c.901C > G genotypes of the IGF2R gene; CC, CG and GG.

Conclusion: These findings indicate that both IGF2 and IGF2R gene variants are associated with fetal growth.
Neurodevelopmental outcome in extremely low birth weight infants: what is the minimum age for reliable developmental prognosis?
Authors: Voss Wolfgang , Neubauer Achim‐Peter , Wachtendorf Michael , Verhey Janko F. , Kattner Evelyn
Published: April 2008

Aim: We present a longitudinal study on the neurodevelopmental outcome in preterm infants with extremely low birth weight <1000 g (ELBW) to answer the question at which age a developmental prognosis can be given.

Methods: A group of 129 ELBW, median birth weight: 794 g (SD 123 g), gestational age: 27.0 weeks (SD 2.0 weeks), born between 1993 and1998, were followed up to the age between 6 and 10 years (mean 8.5 years [SD 1.7 years]) and evaluated by neurodevelopmental and psychometric tests. The status of children without cerebral palsy was ranked into categories of major, minor and no developmental impairments.

Results: At the time of the last follow‐up examination 17% of the children showed a major impairment including 9% cerebral palsy, 42% a minor impairment and 41% were normally developed. The longitudinal analysis of cases without cerebral palsy reveals that an assessment ‘at term’ can only give the correct developmental prognosis in 49% of the cases. At the corrected age of 12 months the prognosis is correct in 59% of the cases, whereas at the corrected age of 3 years 70% proves to be right. Diagnosis of cerebral palsy could be confirmed at the corrected age of 2 years with sufficient reliability.

Conclusion: The neurodevelopmental evaluation of former preterm infants with a birth weight <1000 g demands a follow‐up period of at least 6 years in order to make reliable statements. We are doubtful that follow‐up testing completed prior to this age can yield reliable results.
Breast milk levels of zinc and ω‐6 polyunsaturated fatty acids and growth of healthy Chinese infants
Authors: Xiang M , Harbige LS , Zetterström R
Published: April 2008

Aim: To examine the concentrations of zinc and ω‐6 polyunsaturated fatty acids (ω‐6 PUFAs) in breast milk, the impact of zinc on ω‐6 PUFA metabolism, and the growth rate of infants.

Methods: Forty‐one mother‐term infant pairs from a rural area of northern Beijing, China, who were 1 month (n = 18, group I) and 3 months (n = 23, group II) old and exclusively breastfed, were studied. The dietary records and the concentrations of zinc and ω‐6 PUFAs in the milk of lactating women and the increase in weight and length of their infants during 1 and 3 postnatal months were analysed.

Results: The dietary intakes of mothers in the two groups were the same, i.e. high in carbohydrate and low in fat, protein and energy. The maternal zinc intake was 7.5mg/d and thus reached only 34.6% of the current Recommended Nutrient Intake (RNI). The levels of zinc and arachidonic acid (AA, C20:4 ω‐6) in the milk of group I were significantly higher than those in group II. Furthermore, significant positive correlations were found between the concentrations of zinc and AA in the breast milk and between the level of milk AA and weight gain.

Conclusion: Zinc may be a co‐factor and essential for essential fatty acids (EFA) metabolism. Thus suboptimal zinc intake may cause EFA imbalance. Further studies of Chinese rural mother‐infant pairs are necessary to determine whether zinc supplementation should be recommended when lactation exceeds 3 months.
Somatic and psychiatric co‐morbidity in children with attention deficit hyperactivity disorder
Authors: Van Den Heuvel E , Starreveld J S , De Ru M , Krauwer V , Versteegh F G A
Published: April 2008

Aim: To describe the prevalence of somatic and psychiatric co‐morbidity in children diagnosed with ADHD and other behavioural problems compared to this prevalence in children seen at the outpatient department without either of these conditions.

Methods: A retrospective controlled case study was conducted in 369 children. All children with ADHD were diagnosed by a clinical psychologist in a hospital setting according to the DSM IV classification. Co‐morbidity was determined by pediatricians.

Results: Somatic co‐morbidity was seen in 94 % of the children. However, there was no significant difference in the prevalence of somatic co‐morbidity in patients with ADHD nor in patients with behavioural problems other than ADHD when compared with the control group. Only two differences slight were observed. In the ADHD group and the group with behavioural problems motor impairment was seen more often and in the control group constipation was diagnosed more frequently.

Conclusion: Except for motor impairment, somatic co‐morbidity of any kind does not seem to occur more frequently in children with ADHD.
A comparative study on bacterial cultures of urine samples obtained by clean‐void technique versus urethral catheterization
Authors: Lau Angela Yu , Wong Sik‐Nin , Yip Kam‐Tong , Fong Kwok‐Wah , Li Samantha Po‐Siu , Que Tak‐Lun
Published: April 2008

Contamination during urine collection causes difficulty in diagnosing infantile urinary tract infection (UTI). Though considered a gold‐standard, suprapubic aspiration is traumatic and not always successful. Catheterization and clean void technique were often preferred but their relative usefulness has not been compared.

Objectives: To compare the culture results of clean void urine (CVU) and catheter urine (CathU) from children below 2‐years old known to have no UTI. We tested whether the false‐positive rates of CVU were significantly different from that of CathU.

Methods: Paired CVU and CathU samples were collected from asymptomatic children admitted for micturiting cystourethrogram, and tested for leucocytes and nitrite, and bacterial culture using standard laboratory methods.

Results: Culture results for 98 children (82 boys, 16 girls; aged 6 ± 4.3 months) were analysed. Analysis by presence/absence of growths showed good agreement between CVU and CathU for boys (Kappa 0.42) but poor for girls (Kappa 0.18). When analysed by colony counts, agreement was poor with CVU yielding more counts than CathU (Kappa 0.1 for boys and 0.04 for girls). If all mixed growth results were considered as contaminants, the false positive rates for CathU and CVU were similar whether the cut‐off was defined as 103, 104 or 105/mL. If mixed growth was believed to cause UTI, CathU produced less false‐positive rates than CVU, though both rates were unacceptably high.

Conclusion: In uncircumcized boys, both CVU and CathU were prone to contamination. Though the contaminating bacterial counts were lower in CathU culture, the false‐positive rates were high with the lower cut‐off CFUs. Contrary to previous recommendations, CathU should be interpreted similar to CVU to avoid false positive diagnosis of UTI.
Prenatal smoking exposure and psychiatric symptoms in adolescence
Authors: Indredavik Marit S , Brubakk Ann‐Mari , Romundstad Pål , Vik Torstein
Published: April 2008

Aim: Explore associations between smoking in pregnancy and psychiatric symptoms in the adolescent offspring.

Design/subjects: A prospective population based follow‐up of 84 adolescents at 14 years of age, of whom 32 of the mothers reported smoking during pregnancy.

Main outcome measures: The Achenbach System of Empirically Based Assessment (ASEBA), ADHD‐Rating Scale IV, Autism Spectrum Screening Questionnaire (ASSQ), Children's Global Assessment Scale (CGAS), estimated IQ based on four subscales of WISC‐III.

Results: Adolescents who were born by smokers had significantly more rule‐breaking and aggressive behaviour, externalizing and total problems on the ASEBA than adolescents of non‐smokers (p < 0.01), when reported by mothers, fathers and teachers. ADHD symptoms were reported more frequently (p < 0.05), and mothers also reported more internalizing symptoms (p < 0.05) and social problems (p < 0.001). The ASSQ sum score was higher (p < 0.001), and overall function as measured by the CGAS was lower (p < 0.01) for the smoking‐exposed group. Associations were still present after controlling for possible confounding factors.

Conclusion: Adolescents exposed to prenatal smoking had higher scores for both externalizing and internalizing psychiatric symptoms, which could not be explained by a broad range of possible psychosocial confounders. Thus, smoking in pregnancy may be a marker for increased risk of psychiatric symptoms in the offspring.
Caesarean delivery and risk of developing asthma in the offspring
Authors: Werner Anette , Ramlau‐Hansen Cecilia Høst , Jeppesen Simone K , Thulstrup Ane Marie , Olsen Jørn
Published: April 2008

Aim: To evaluate the association between caesarean section and risk of developing asthma.

Method: We evaluated this association in a Danish cohort, comprising of 11 147 mothers and their babies of which 7119 mother‐child pairs were included in the analyses. The mothers' reported asthma data on their children were linked to hospitalization records on mode of delivery.

Results: The adjusted odds ratio for developing asthma was 1.11 (95% CI, 0.88–1.39) for caesarean sections versus vaginal births.

Conclusion: We found no evidence that children being delivered by caesarean section have an increased risk of asthma.
Renal functional changes in relation to hemodynamic parameters during exercise test in normoalbuminuric insulin‐dependent children
Authors: Raes A , Matthys D , Donckerwolcke R , Craen M , Van Aken S , Vande Walle J
Published: April 2008

Aim: To examine the relationship between filtration fraction and systemic vasculopathy, in normoalbuminuric insulin‐dependent diabetic adolescents.

Methods: We calculated filtration fraction from measured glomerular filtration rate and renal plasma flow during a hypotonic saline perfusion test in 30 normotensive adolescent diabetic patients (9–19 years), with a mean duration of diabetes of 7.4 years. Blood pressure and heart rate were measured in basal conditions, during a 24‐h ambulatory monitoring and during a dynamic exercise test on a cycle ergometer and peripheral vascular resistance was calculated.

Results: Filtration fraction was increased in the diabetic children compared with controls (30 ± 6% vs. 22 ± 4%, p < 0.001), while renal plasma flow was significantly lower (453 ± 133 mL/min/1.73 m2vs. 593 ± 155 mL/min/1.73 m2, p < 0.001). Peripheral vascular resistance was significantly higher at peak exercise in diabetic children compared to controls (16.3 ± 1.3 mmHg/L min m2vs. 11.4 ± 0.5 mmHg/L min m2, p < 0.01).

Conclusion: These results indicate that in young patients with IDDM, without apparent nephropathy or apparent systemic vasculopathy, filtration fraction is increased, suggesting an increased intraglomerular pressure. The associated reduced decrease of peripheral vascular resistance (increased diastolic blood pressure during exercise) suggests that renal functional abnormalities may be partly explained by a systemic vasculopathy, also present in the kidney.
Understanding diagnostic tests 2: likelihood ratios, pre‐ and post‐test probabilities and their use in clinical practice
Authors: Akobeng Anthony K.
Published: April 2008

The sensitivity and specificity of a test cannot be used to estimate probability of disease in individual patients. They can, however, be combined into a single measure called the likelihood ratio which is, clinically, more useful than sensitivity or specificity. Likelihood ratios provide a summary of how many times more (or less) likely patients with a disease are to have a particular result than patients without the disease. Using the principles of the Bayes theorem, likelihood ratios can be used in conjunction with pre‐test probability of disease to estimate an individual's post‐test probability of disease, that is his or her chance of having disease once the result of a test is known. The Fagan's nomogram is a graphical tool which, in routine clinical practice, allows one to combine the likelihood ratio of a test with a patient's pre‐test probability of disease to estimate post‐test probability.

Conclusion: Likelihood ratios summarize information about a diagnostic test by combining sensitivity and specificity. The Fagan's nomogram is a useful and convenient graphical tool that allows likelihood ratios to be used in conjunction with a patient's pre‐test probability of disease to estimate the post‐test probability of disease.
Why do ALTE infants not die in SIDS?
Authors: Edner Ann , Wennborg Maria , Alm Bernt , Lagercrantz Hugo
Published: April 2008

Aim: To compare known risk factors for sudden infant death syndrome (SIDS) amongst infants with apparent life threatening events (ALTE) with their matched controls, and ALTE infants who subsequently died of SIDS with infants surviving an ALTE.

Methods: Questionnaires with replies were obtained from 58 ALTE infants and 56 sex and age matched ALTE control infants. 244 SIDS cases and 868 SIDS controls were used as comparison.

Results: The incidence of ALTE was found to be 1.9% among SIDS controls, but 7.4% among infants who later on died of SIDS. The parents sought medical advice in 0.9%vs 3.7%. ALTE infants did not differ from their matched controls. In the ALTE group 13.3% of the survivors had the combination of prone sleeping and maternal smoking compared with 33.3% of those who became SIDS victims.

Conclusions: Our results show some major differences between the ALTE infants and SIDS victims not supporting that these conditions belong to the same entity. However, we cannot exclude the possibility that there is a subpopulation of ALTE infants who did not die in SIDS due to that they were sleeping on the back and not exposed to nicotine.
Cardiorespiratory events recorded on home monitors: the effect of prematurity on later serious events
Authors: Naulaers G , Daniels H , Allegaert K , Rayyan M , Debeer A , Devlieger H
Published: April 2008

Objective: To describe severe alarms on home‐documented monitoring in infants born prematurely.

Methods: In infants born at a post‐menstrual age (PMA) less than 35 weeks, a polysomnography was performed before discharge. A heart rate less than 50 beats per minute (bpm) for more than 3 seconds or an apnea lasting for more than 15 seconds with a heart rate less than 60 bpm were defined as abnormal. These babies were given cardiorespiratory home monitoring with memory. Serious alarms on the home monitor were defined as heart rate less than 50 bpm for more than 3 seconds.

Results: Of 1058 infants, 96 infants needed cardiorespiratory home monitoring. Sixty‐one infants showed alarms at home. The mean post‐conceptional age (PCA) when alarms stopped was 46 weeks. Seventeen patients had serious alarms above the PCA of 50 weeks. There was a significant negative correlation (r =−0.46 and p = 0.0002 by Spearman's rank correlation) between the PMA at birth and the PCA at which the last alarm was noted.

Conclusion: Prematurely born infants with an abnormal polysomnography at discharge are at high risk for developing acute events at home. A younger PMA at birth correlates with a higher risk of alarms at a later PCA.
Usefulness of diffusion‐weighted MRI in human herpesvirus‐6 encephalitis
Authors: Takaya Junji , Araki Atsushi , Mori Kizo , Kaneko Kazunari
Published: April 2008

We report a patient with human herpesvirus‐6 (HHV‐6) encephalitis diagnosed by diffusion‐weighted magnetic resonance imaging (DW‐MRI). A previously healthy 10‐month‐old girl developed acute encephalopathy. HHV‐6 DNA was detected in her cerebrospinal fluid during the acute phase of the disease by polymerase chain reaction. The patient demonstrated cortical diffusion abnormalities in affected brain parenchyma, partially as the initial or most sensitive sign of encephalitis that could be detected not by conventional MRI but by DW‐MRI. Serial imaging showed that the diffusion abnormality DW‐MRI returned to normal after 45 days.

Conclusion: DW‐MRI may be a valuable tool for early detection and diagnosis of HHV‐6 encephalitis and is more sensitive than conventional MRI to detect a subtle edematous change in the brain.
Intestinal permeability in different feedings in infancy
Authors: Colomé Gemma , Sierra Carlos , Blasco Javier , García Ma Victoria , Valverde Esteban , Sánchez Elisa
Published: April 2008

Aim: To determine the intestinal permeability (IP) as a marker of intestinal epithelial integrity in formula‐fed infants compared with healthy breast‐fed infants.

Methods: IP was measured in 57 healthy infants less than 4 months old. A dual sugar test with lactulose and mannitol was performed. Three urinary ratios were established: lactulose/mannitol (L/M), lactulose/creatinine (L/C) and mannitol/creatinine (M/C). Five groups were studied: breast‐fed (n = 11), prebiotic supplemented formula (n 17), nucleotides supplemented formula (n = 9), LC‐PUFA supplemented formula (n = 9) and LC‐PUFA and nucleotides supplemented formula (n = 11).

Results: We have not found any difference in IP between breast‐fed and formula‐fed infants nor when the different formulas are compared with each other. The indirect information of the paracellular pathway by the ratio L/C and the transcellular route by the ratio M/C reflects some difference when the ingredients added are fructooligosaccharides and galactooligosaccharides, expressing a higher degree of lactulose permeation with respect to mannitol. When LC‐PUFA supplementation was evaluated a lesser ratio of L/C was found, expressing intestinal barrier related to a process of epithelial tight.

Conclusions: The most important factor in the maintenance of the integrity of epithelial barrier function is probably the delivery of nutrients in the gastrointestinal tract. The role of the different ingredients added should be clarified.
Hepatitis B e antigen positive mother hepatitis B e antigen long persistence in her non‐infected baby
Authors: Selton D , Andre M , May T , Hascoët J M
Published: April 2008

We report the case of a baby born to a hepatitis B virus (HBV) carrier mother. This infant had a hepatitis B e antigen (HBeAg) in the serum until 6 months of age. Serial sera samples were analysed for HBV markers. No breakthrough of HBV infection was detected. The origin of this HBV marker has been questioned.

Conclusion: HBeAg can persist at a non‐infected baby born to an HBeAg‐positive mother up to the age of 6 months.
Characteristics of infants admitted to hospital for persistent colic, and comparison with healthy infants
Authors: Zwart Pieter , Vellema‐Goud Marije G. A. , Brand Paul L. P.
Published: April 2008

Aim: To describe clinical characteristics of infants with colic admitted to hospital because of ongoing excessive crying (colic).

Methods: Characteristics of 104 infants admitted to hospital because of severe excessive crying (cases) were compared to those of 100 healthy thriving controls randomly selected from records of well baby clinics.

Results: Half of the cases were reported to cry excessively from the day of birth, and feeding changes had been recommended in 77%. A medical cause of excessive crying was identified in none of the cases. Almost all infants showed a rapid transition to normal crying behaviour during admission; none cried for >3 h per day. Mean gestational age and mean Apgar scores were slightly lower in cases than in controls. There was a trend of positive family history of atopy being more common in controls (45%) than in cases (38%, p = 0.14). Feeding problems were more common in cases (71%) than in controls (36%, 95% CI for difference 21.6%–46.9%). Pregnancy or birth complications were much more common in cases (85%) than in controls (37%; 95% CI 35%–58%).

Conclusions: Infants with severe excessive crying show normalization of crying behaviour during hospital admission, and are unlikely to have medical causes for their colic. The most important risk factor for excessive crying was a complicated pregnancy or birth, suggesting that this might predispose parents to regard normal crying behaviour as excessive.