bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidemiology and outcome of acute kidney injury in New Zealand children
Authors: Ball Emma F , Kara Tonya
Published: August 2008

Objectives:  To determine the aetiology, incidence and short‐term outcomes of New Zealand children with acute kidney injury (AKI) requiring renal replacement therapy (RRT) over a 6‐year period.

Methods:  A retrospective chart review of all children requiring RRT for AKI from January 2001 to December 2006 at Starship Children's Hospital, Auckland, New Zealand was conducted. The primary outcome was survival to discharge.

Results:  A total of 226 children required RRT for AKI over the 6‐year study period. The annual incidence was 4.0 per 100 000 total population under 15 years of age. The commonest causes of AKI were post cardiac surgery (58%), haemolytic uraemic syndrome (17%), sepsis (13%) and glomerulonephritis (4%). The survival rate to hospital discharge was 89%. A total of 40% of all surviving children had one or more abnormalities at the time of discharge suggestive of ongoing renal dysfunction (hypertension, continuing need for antihypertensive medication, reduced estimated glomerular filtration rate or abnormal urinalysis). More Maori and Pacific Island children were treated for AKI than would be expected from population data (P < 0.0001). Sepsis and glomerulonephritis were seen more commonly as causes of AKI in Maori and Pacific Island children compared with New Zealand European children.

Conclusion:  In our study, 40% of surviving children had evidence of short‐term renal dysfunction at discharge following AKI. This suggests that all children should undergo a period of follow‐up after any episode of AKI to look for resolution or further development of signs of renal injury.
Anthropometry and renal size of children suffering under sustained conflict in Sri Lanka
Authors: Whitehall John
Published: August 2008

Aim:  To measure anthropometry, blood pressure and renal lengths of children in a war torn region of Sri Lanka and compare results with local and international standards.

Methods:  Measurements of 147 Tamil children in Kilinochchi, north‐east Sri Lanka, were compared with the World Health Organization standards using Anthro 2005 software in a period of relative peace in December 2005. Renal lengths were measured by ultrasound and compared with Australian and Indian data.

Results: 

2–5 years of age. The weight‐to‐height ratio for combined sexes revealed 13.9% were <−3 standard deviations (SD) and 33.3% <−2 SD. The height‐to‐age ratio revealed 5.6% <−3 SD and 22.2% <−2 SD. The weight‐to‐age ratio revealed 13.9% <−3 SD and 38.9% <−2 SD. The body mass index of 13.9% of children was <−3 SD, of 25% it was <−2 SD. Stunting and wasting is prevalent, and worse than in other areas of Sri Lanka, except in tea estates.

5–12 years. The height‐to‐age ratio for combined sexes revealed 15.7% were <−3 SD and 38.5% <−2 SD. The weight‐to‐age ratio revealed 6.1% were <−3 SD and 47.3% <−2 SD. The body mass index of 64.0% of children was <5th percentile. More children are stunted and wasted in this older group. Girls are more affected than boys.

Renal lengths fell progressively below −2 SD for both age and height when compared with Australian and Indian children.

Conclusion:  Tamil children in Kilinochchi are more stunted and wasted than others in Sri Lanka, except those in the tea estates. Progressive renal stunting because of under‐nutrition may be a mechanism for later disease. The loss of potential for human development can only be addressed by long‐term improvement in access to nutrition.
Transient middle cerebral artery occlusion disrupts the forelimb movement representations of rat motor cortex
Authors: Gharbawie Omar A. , Williams Preston T. J. A. , Kolb Bryan , Whishaw Ian Q.
Published: August 2008

Infarcts from proximal middle cerebral artery (MCA) stroke can produce impairments in motor function, particularly finger movements in humans and digit flexion in rats. In rats, the extent of neural damage may be limited to basal ganglia structures or may also include portions of the frontal and parietal cortex in severe cases. Although the primary motor cortex (M1) is anatomically spared in proximal MCA occlusion, its functional integrity is suspect because even a small subcortical infarct can damage neural circuits linking M1 with basal ganglia, brainstem, and spinal cord. This motivated the present study to investigate the neurophysiological integrity of M1 after transient proximal MCA occlusion. Rats, preoperatively trained and non‐preoperatively trained to reach for food, received extensive reach training/testing with the contralateral‐to‐lesion paw for several weeks after MCA occlusion. The forelimb movement representations were assayed from the ipsilateral‐to‐lesion M1 with intracortical microstimulation approximately 10 weeks after MCA occlusion. Digit flexion was impaired during food grasping in rats with relatively small subcortical infarcts and was completely abolished in rats that sustained at least moderate subcortical damage. Corresponding forelimb movement representations ranged from abnormally small to absent. The results suggest that ischemia in subcortical territories of the MCA does not spare the neurophysiological properties of M1 despite its apparent anatomical intactness, probably because of damage sustained to its descending fibers. Thus, M1 dysfunction contributes to the impairments that ensue from proximal MCA occlusion, even when the infarct is limited to subcortical regions.
Do We Need Incentives for PhD Supervisors?
Authors: SADOWSKI DIETER , SCHNEIDER PETER , THALLER NICOLE
Published: August 2008

This article presents empirical results of explorative case studies that examine whether the New Public Management mechanisms have improved the academic performance of PhD education in selected German and European economics departments. Our data rely on document analyses of organisational variables and in‐depth semi‐structured interviews with professors in Germany and several European countries. We propose a typology of departments along their PhD production technology and suggest that organisational improvements should look at the processes through which new professional standards gain acceptance in departments and at the means by which long‐term incentive problems of collective action in a department are solved.
ECONOMIC MODELLING OF SUICIDE UNDER INCOME UNCERTAINTY: FOR BETTER UNDERSTANDING OF MIDDLE‐AGED SUICIDE*
Authors: SUZUKI TOMOYA
Published: August 2008

This paper formalises an individual's decision about suicide within a framework of lifetime utility maximisation models. This is in line with the literature on economic modelling of suicide. The novelty of the paper is to take into account income uncertainty. Income uncertainty reduces a risk‐averse individual's expected utility, making them more likely to commit suicide. On the other hand, income uncertainty creates a value to postponing suicide even when their income gets sufficiently low. This is because income uncertainty means that if things go well, they will get higher income in the future. Thus, income uncertainty has two opposite effects on suicidal behaviour. The main objective of this paper is to construct an economic model of suicide for investigating net impacts of income uncertainty on suicidal behaviour. For this purpose, it is assumed that the wage evolves according to a stochastic process. Then, the threshold wage, below which an individual commits suicide, is derived as a function of the parameters of the stochastic process assumed for the wage evolution. Impacts of changes in these parameters on the threshold wage are calculated. With the result, the paper shows how income uncertainty affects suicidal behaviour.
Memory and Attention Make Smart Word Learning: An Alternative Account of Akhtar, Carpenter, and Tomasello
Authors: Samuelson Larissa K. , Smith Linda B.
Published: August 2008

Two general types of accounts have been offered to explain the smartness of young children's word learning. One account postulates that children enter the word‐learning task with specific knowledge about how words link to categories. The second account puts the source of children's smart word learning in knowledge about the pragmatics of communication and social interactions. The present experiment tested a third idea: that children's seemingly smart word learning derives from general, indeed mundane, cognitive processes. Forty‐eight children from 18 to 28 months of age participated in a task designed to test our alternative explanation as applied to Akhtar, Carpenter, and Tomasello's (1996) finding that children use knowledge of the communicative intents of others to interpret a novel noun. Specifically, we suggest that children's attention to the proper referent was guided by the general effects of a contextual shift on memory and attention. The procedure in the present study was identical to that of Akhtar et al. except that we differentiated the target through a nonsocial context shift. Findings similar to that of Akhtar et al. emerged under the present procedures. These results strongly suggest that general attentional and memorial processes, and not knowledge about the communicative intents of others, may guide young children's word learning. These findings provide one demonstration of how smart word learning may emerge from more ordinary (and dumb) cognitive processes.
Environmental Input and Cognitive Growth: A Study Using Time‐Period Comparisons
Authors: Huttenlocher Janellen , Levine Susan , Vevea Jack
Published: August 2008

In this study, we examined the relation of input to cognitive growth in a single population of children. We studied 4 domains: Language, Spatial Operations, Concepts, and Associative Memory. Four groups of children drawn from the same population were tested in October of kindergarten, April of kindergarten, October of first grade, and April of first grade. These time points are 6 months apart, but they span periods that differ in amount of school input children receive. Much greater growth was found over time periods with greater amounts of school input (October to April) than over time periods with less school input (April to October) for Language, Spatial Operations, and Concepts, but not for Associative Memory. These findings suggest that amount of input is causally related to cognitive growth in particular domains.
Sorting Out Sortition: A Perspective on the Random Selection of Political Officers
Authors: Dowlen Oliver
Published: August 2008

The central argument of this article is that it is possible to identify one major or primary potential that sortition brings to the political community when it is used to select office holders. This is to be found when sortition is used in such a way as to maximise its most essential feature – its arationality – and where such an application has the most significant and positive impact on the political process and the political community. In such applications the advantages of using an arational process can be seen as outweighing its disadvantages. In political practice – especially in a republican context – this primary political potential is the ability of sortition to protect the public process of selection from subversion by those who might wish to use it for their own private or partisan ends. This helps to defend the polity from those seeking to exercise unconstitutional or arbitrary power – either in the form of a single tyrant or of factions vying for partisan control. In addition, sortition can produce a series of secondary benefits to the republican polity: the polity can be understood as impartial, the threshold to citizen participation can be lowered and the model of the independent citizen encouraged. These benefits, however, can be seen as deriving from initial protection of the process of selection from manipulation – a quality of lot which is present whatever the motivation of those instigating a particular lottery scheme. Although the political use of lot cannot be confined to the protection of open government, its potential to limit the power of individuals or covert groupings makes it naturally commensurate with this role.
The Specter of AIDS: Testimonial Activism in the Aftermath of the Epidemic
Authors: Decoteau Claire Laurier
Published: August 2008

Reporting on a study of activists living with HIV/AIDS who give testimonials of their experiences with the disease in various educational settings, this article employs the notion of ‘haunting’ as a means of analyzing the effect of social justice activism in the “aftermath” of the HIV/AIDS epidemic. Because of a shift in both the discursive construction of AIDS and the material symptoms of the disease (due to widespread availability of anti-retroviral medication), the signified of AIDS is “out of joint” with the signification of the disease in the public sphere. AIDS, as a social phenomena and a personal, traumatic experience has been rendered spectral through processes of social othering, structural disenfranchisement, and cultural denialism. Most of the presenters included in this study utilize a strategy of “survivorhood” in order to promote prevention and combat stigma. In doing so, they inadvertently buttress dominant discourses that claim that the disease is now “manageable,” normalized, and under control. By contrast, one presenter utilizes a completely different performative approach. In order to confront and subvert the “aftermath” discourse and thereby presence the living trauma of AIDS, this presenter embodies the specter of AIDS. As such, his presentation forces the audience to reckon with processes of social exclusion and cultural otherness.
Clinical heterogeneity and genotype‐phenotype correlations in hereditary spastic paraplegia because of Spatacsin mutations (SPG11)
Authors: Paisan‐Ruiz C. , Nath P. , Wood N. W. , Singleton A. , Houlden H.
Published: August 2008

Background:  Autosomal recessive hereditary spastic paraplegia (ARHSP) with thin corpus callosum is a distinct and usually severe form of complex hereditary spastic paraplegia classified as SPG11. Recently mutations on SPG11 gene (KIAA1840), which is localized to chromosome 15q13‐q15, were shown to cause the majority of SPG11 cases.

Methods:  We analysed the 40 coding exons of this gene in the probands from eight families with complex ARHSP, four of these families had a thin corpus callosum and two has mild thinning.

Results:  Three families were identified with novel mutations in the SPG11 gene. One family was of Asian origin with a homozygous nonsense mutation and had a very severe phenotype but only very mild thinning of the corpus callosum. In the other two English families the parents were unrelated and the mutations were compound heterozygotes. In these two families the phenotype was mild and both probands had a thin corpus callosum.

Conclusion:  Given the probable mechanism of action of the mutations in the Spatacsin gene, we discuss the probable genotype phenotype correlations in these families. This study confirms the frequent occurrence of Spatacsin mutations in complex ARHSP with genotype phenotype effects and exposes the spectrum of clinical heterogeneity in SPG11.
Pareto‐Optimal Predictor Composite Formation: A complementary approach to alleviating the selection quality/adverse impact dilemma
Authors: Sackett Paul R. , De Corte Wilfried , Lievens Filip
Published: August 2008

In our rejoinder to the comments of Kehoe (this issue) and Potosky, Bobko and Roth (this issue) we emphasize that our proposal on Pareto‐optimal predictor composite formation is a complementary and not a competitive alternative for reducing the tension between selection quality and adverse impact. Our work addresses the decisions to be made once one has decided to use a predictor composite. We also further clarify the basic features of Pareto‐optimal tradeoffs and Pareto‐optimal composites within the context of personnel selection. In particular, we indicate that Pareto‐optimal tradeoffs between validity and adverse impact emerge because these goals are different and not because of any dualism between them.
Activation of nociceptin/orphanin FQ‐NOP receptor system inhibits tyrosine hydroxylase phosphorylation, dopamine synthesis, and dopamine D1 receptor signaling in rat nucleus accumbens and dorsal striatum
Authors: Olianas Maria C. , Dedoni Simona , Boi Marianna , Onali Pierluigi
Published: August 2008

Nociceptin/orphanin FQ (N/OFQ) has been reported to inhibit dopamine (DA) release in basal ganglia mainly by acting on NOP receptors in substantia nigra and ventral tegmental area. We investigated whether N/OFQ could affect DA transmission by acting at either DA nerve endings or DA‐targeted post‐synaptic neurons. In synaptosomes of rat nucleus accumbens and striatum N/OFQ inhibited DA synthesis and tyrosine hydroxylase (TH) phosphorylation at Ser40 via NOP receptors coupled to inhibition of the cAMP/protein kinase A pathway. Immunofluorescence studies showed that N/OFQ preferentially inhibited phospho‐Ser40‐TH in nucleus accumbens shell and that in this subregion NOP receptors partly colocalized with either TH or DA D1 receptor positive structures. In accumbens and striatum N/OFQ inhibited DA D1 receptor‐stimulated cAMP formation, but failed to affect either adenosine A2A or DA D2 receptor regulation of cAMP. In accumbens slices, N/OFQ inhibited DA D1‐induced phosphorylation of NMDA and α‐amino‐3‐hydroxy‐5‐methylisoxazole‐4‐propionate glutamate receptors, whereas in primary cultures of accumbal cells, which were found to coexpress NOP and DA D1 receptors, N/OFQ curtailed DA D1 receptor‐induced cAMP‐response element‐binding protein phosphorylation. Thus, in accumbens and striatum N/OFQ exerts an inhibitory constraint on DA transmission by acting on either pre‐synaptic NOP receptors inhibiting TH phosphorylation and DA synthesis or post‐synaptic NOP receptors selectively down‐regulating DA D1 receptor signaling.
The co‐presence of Na+/Ca2+‐K+ exchanger and Na+/Ca2+ exchanger in bovine adrenal chromaffin cells
Authors: Pan Chien‐Yuan , Tsai Ling‐Ling , Jiang Jhih‐Hang , Chen Lih‐Woan , Kao Lung‐Sen
Published: August 2008

We have previously shown that there is high Na+/Ca2+ exchange (NCX) activity in bovine adrenal chromaffin cells. In this study, by monitoring the [Ca2+]i change in single cells and in a population of chromaffin cells, when the reverse mode of exchanger activity has been initiated, we have shown that the NCX activity is enhanced by K+. The K+‐enhanced activity accounted for a significant proportion of the Na+‐dependent Ca2+ uptake activity in the chromaffin cells. The results support the hypothesis that both NCX and Na+/Ca2+‐K+ exchanger (NCKX) are co‐present in chromaffin cells. The expression of NCKX in chromaffin cells was further confirmed using PCR and northern blotting. In addition to the plasma membrane, the exchanger activity, measured by Na+‐dependent 45Ca2+ uptake, was also present in membrane isolated from the chromaffin granules enriched fraction and the mitochondria enriched fraction. The results support that both NCX and NCKX are present in bovine chromaffin cells and that the regulation of [Ca2+]i is probably more efficient with the participation of NCKX.
Truck schedule recovery for solid waste collection in Porto Alegre, Brazil
Authors: Li Jing‐Quan , Borenstein Denis , Mirchandani Pitu B.
Published: August 2008

This paper considers a truck schedule recovery problem in the context of solid waste collection in the city of Porto Alegre, Brazil. When a truck on a scheduled trip breaks down, a backup truck needs to be selected to serve the cargo on that trip and other trucks might be rescheduled in order to gain the minimum operating and delay costs. The problem consists of designing, in the case of a severe disruption in a trip, new schedules taking into account the existing trucks in the system and a set of unfinished and not initiated collection trips, on which the trucks collect the solid waste in fixed routes and empty the loads in one of the several operational recycling facilities. The main objective is to minimize the total distances traveled and delay costs, as well as to obtain balanced assignments of truck unloads into the recycling facilities, due to the social benefits of the solid waste program. We modeled the problem as a mixed‐integer linear problem and used CPLEX to solve it. Finally, computational experiments are conducted on real‐world data. The results show that our approach successfully reduces the distances traveled and delays, simultaneously balancing the number of trucks unloading at each recycling facility, in comparison with the current manual strategy.
Location–price competition with externality: an application to the Tenerife tram
Authors: Dorta‐González P. , Santos‐Peñate D. R. , Suárez‐Vega R.
Published: August 2008

This paper presents a location–price equilibrium problem on a tree. A sufficient condition for having a Nash equilibrium in a spatial competition model that incorporates price, transport, and externality costs is given. This condition implies both competitors are located at the same point, a vertex that is the unique median of the tree. However, this is not an equilibrium necessary condition. Some examples show that not all medians are equilibria. Finally, an application to the Tenerife tram is presented.
Emergency service systems: The use of the hypercube queueing model in the solution of probabilistic location problems
Authors: Galvão Roberto D. , Morabito Reinaldo
Published: August 2008

Probabilistic location problems are surveyed from the perspective of their use in the design of emergency service systems, with special emphasis on emergency medical systems. Pioneering probabilistic models were defined in the 1980s, as a natural extension of deterministic covering models (first generation models) and backup models (second generation). These probabilistic models, however, adopted simplifying assumptions that in many cases do not correspond to real‐world situations, where servers usually cooperate and have specific individual workloads. Thus the idea of embedding the hypercube queueing model into these formulations is to make them more adherent to the real world. The hypercube model and its extensions are initially presented in some detail, which is followed by a brief review of exact and approximate methods for its solution. Probabilistic models for the design of emergency service systems are then reviewed. The pioneering models of Daskin and ReVelle and Hogan are extended by embedding the hypercube model into them. Solution methods for these models are surveyed next, with comments on specialized models for the design of emergency medical systems for urban areas and highways.
Suspected lily‐of‐the‐valley (Convallaria majalis) toxicosis in a dog
Authors: Atkinson Kathryn J. , Fine Deborah M. , Evans Tim J. , Khan Safdar
Published: August 2008

Objective:To describe successful treatment of third‐degree atrioventricular (AV) block using temporary noninvasive transthoracic pacing and placement of a permanent transvenous pacemaker in a case of suspected lily‐of‐the‐valley (Convallaria majalis) intoxication in a dog.

Case summary:A 2‐year‐old neutered male Beagle weighing 17.8 kg was presented to the emergency service for treatment of bradycardia, vomiting, and lethargy. An electrocardiogram revealed third‐degree AV block that was nonresponsive to atropine. Ten hours after admission, the dog became obtunded. Treatment initially consisted of temporary noninvasive transthoracic pacing and eventually placement of a permanent transvenous pacemaker. The initial history did not suggest that the dog had access to any known cardiotoxins. However,C. majalis, which contains cardiac glycosides, was identified within the dog's environment and the dog's serum did contain digoxin or an immunologically cross‐reactive compound.

New or unique information provided:This is the first reported successful management ofC. majalistoxicosis in a dog. Temporary noninvasive transthoracic pacing was used in the management of this case as a safe and effective bridge to permanent pacemaker implantation.
Glucose metabolism in five septic neonatal foals
Authors: Jose‐Cunilleras Eduard , Hinchcliff Kenneth W. , Nout Yvette S. , Geor Raymond J.
Published: August 2008

Objective:Glucose metabolism is often deranged in septic animals. Bacteremia and sepsis are common in foals and clinical experience suggests that glucose metabolism is abnormal in some of these animals. The purpose of this study was to provide initial estimates of rates of glucose appearance, disappearance, and metabolic clearance rate in septic foals.

Series Summary:Rates of glucose entry, and exit from blood were determined by use of infusion of isotopically labeled glucose in 5 foals with confirmed sepsis. Serum concentrations of glucose, insulin, glucagon, and cortisol were measured concurrent with measurement of rates of glucose turnover. Median glucose turnover rate was 24 μmol/kg/min (range 17–53 μmol/kg/min), and median glucose metabolic clearance rate was 3.2 mL/kg/min (range 1.7–6.7 mL/kg/min). Median concentration of serum immunoreactive insulin was 55 pmol/L (range 36–190 pmol/L), median serum immunoreactive glucagon was 65 pmol/L (range 19–120 pmol/L), and median serum cortisol was 207 nmol/L (range 100–333 nmol/L).

New or unique information provided:These data, although limited in scope and by the lack of data in healthy foals, demonstrate the magnitude and variation in glucose appearance, disappearance, and metabolic clearance rate in septic foals, provide an estimate of rates of glucose utilization in sick foals, and will be useful in guiding future studies of energy metabolism in healthy and ill foals.
Ultrasonographic abnormalities in eyes with traumatic hyphema obscuring intraocular structures: 33 cases (1991–2002)
Authors: Book Bradley P. , Van Der Woerdt Alexandra , Wilkie David A.
Published: August 2008

Objective: To examine ultrasonographic abnormalities in eyes with traumatic hyphema obscuring intraocular structures.

Design: Retrospective clinical study.

Setting: The ophthalmology services of a private practice and university veterinary teaching hospital.

Animals: Twenty‐two dogs, 6 cats, 3 horses, and 2 birds.

Measurements and main results: Medical records were reviewed for signalment, history, ophthalmic examination, ultrasonographic findings, treatment, and outcome in all patients that presented to the ophthalmology service with trauma‐induced hyphema obscuring intraocular structures. Thirty‐three patients were included and there were 35 affected eyes (17 left and 18 right). Abnormalities noted on ophthalmic examination included hyphema obscuring intraocular details beyond the iris (100%), corneal laceration (23%), iris prolapse (23%), fibrin clotting within the anterior chamber (17%), and subconjunctival and periocular bruising (17%). Ocular ultrasonography revealed the presence of either vitreous hemorrhage or a retinal detachment in 32 of 35 eyes (91%) with traumatic hyphema. Of the remaining 3 eyes, ocular ultrasonography revealed a lens luxation with posterior eye wall rupture in 1 eye and collapsed globes in the other 2 eyes. Twelve eyes were enucleated and 23 were treated medically. Ten of the medically treated eyes were lost to follow‐up. Blindness was noted in all the affected eyes upon their final discharge and recheck examination.

Conclusions: Ocular ultrasonography revealed vitreous hemorrhage or a retinal detachment in 32 eyes (91%) with traumatic hyphema. Blindness was noted on the last available examination of every eye. The prognosis for vision in an eye with traumatic hyphema obscuring intraocular detail is poor.
Use of Modified Threat Reduction Assessments to Estimate Success of Conservation Measures within and Adjacent to Kruger National Park, South Africa
Authors: ANTHONY BRANDON P.
Published: August 2008

Abstract:  The importance of biodiversity as natural capital for economic development and sustaining human welfare is well documented. Nevertheless, resource degradation rates and persistent deterioration of human welfare in developing countries is increasingly worrisome. Developing effective monitoring and evaluation schemes and measuring biodiversity loss continue to pose unique challenges, particularly when there is a paucity of historical data. Threat reduction assessment (TRA) has been proposed as a method to measure conservation success and as a proxy measurement of conservation impact, monitoring threats to resources rather than changes to biological parameters themselves. This tool is considered a quick, practical alternative to more cost‐ and time‐intensive approaches, but has inherent weaknesses. I conducted TRAs to evaluate the effectiveness of Kruger National Park (KNP) and Limpopo Province, South Africa, in mitigating threats to biodiversity from 1994 to 2004 in 4 geographical areas. I calculated TRA index values in these TRAs by using the original scoring developed by

Margoluis and Salafsky (2001)

and a modified scoring system that assigned negative mitigation values to incorporate new or worsening threats. Threats were standardized to allow comparisons across the sites. Modified TRA index values were significantly lower than values derived from the original scoring exercise. Five of the 11 standardized threats were present in all 4 assessment areas, 2 were restricted to KNP, 2 to Limpopo Province, and 2 only to Malamulele municipality. These results indicate, first, the need to integrate negative mitigation values into TRA scoring. By including negative values, investigators will be afforded a more accurate picture of biodiversity threats and of temporal and spatial trends across sites. Where the original TRA scoring was used to measure conservation success, reevaluation of these cases with the modified scoring is recommended. Second, practitioners must carefully consider the need and consequences of generalizing threats into generic categories for comparative assessments. Finally, continued refinement of the methodology and its extension to facilitate the transfer of successful conservation strategies is needed.
Quality of Life of Caregivers of Very Low–Birthweight Infants
Authors: Donohue Pamela K. , Maurin Elana , Kimzey Lee , Allen Marilee C. , Strobino Donna
Published: August 2008

ABSTRACT: Background:The health and developmental outcomes of very low–birthweight infants are unpredictable over the first year of life. This uncertainty may have meaningful consequences for parents’ quality of life. The objective of this study was to explore the quality of life of caregivers of these infants.Methods:Primary caregivers of very low–birthweight infants, 12 to 18 months old, who had been cared for in an inner‐city hospital were enrolled in the study. Primary caregivers of full‐term infants of the same age served as a comparison group. During a telephone survey, participants answered questions about their quality of life, mental and physical health, living arrangements, and child’s health.Results:Eighty‐three caregivers of very low–birthweight infants and 84 caregivers of full‐term infants were enrolled in the study. Demographic characteristics of the caregivers were similar between the groups. Forty‐five percent of caregivers of very low–birthweight infants reported that their child had an ongoing medical problem compared with 23 percent of caregivers of full‐term infants. Both groups of caregivers reported significant physical and mental health problems. Caregivers of very low–birthweight infants reported higher quality of life than did caregivers of full‐term infants, but the difference did not reach statistical significance.Conclusions:Although very low–birthweight infants had poorer health and required significantly more health care resources than full‐term infants, caregivers’ quality of life did not differ between the two groups. Caregivers of both groups of infants reported substantial mental and physical health problems but perceived good quality of life. These data will aid parents, physicians, and policy makers as they struggle to make decisions concerning care of high‐risk, costly, very low–birthweight infants. (BIRTH 35:3 September 2008)
Breastfeeding and Smoking among Low‐Income Women: Results of a Longitudinal Qualitative Study
Authors: Goldade Kate , Nichter Mimi , Nichter Mark , Adrian Shelly , Tesler Laura , Muramoto Myra
Published: August 2008

ABSTRACT:  Background:
The benefits of breastfeeding for infants and mothers have been well established, yet rates of breastfeeding remain well below national recommendations in the United States and even lower for women who smoke during pregnancy. Primary goals of this study were to explore contextual factors that contribute to breastfeeding intentions and behavior and to examine how smoking status affected women’s decision making about breastfeeding.
Methods:
This paper is based on a longitudinal qualitative study of smoking, pregnancy, and breastfeeding among 44 low‐income women in the southwest U.S. who smoked during pregnancy. Each woman was interviewed 9 times; 6 times during pregnancy and 3 times postpartum using semistructured questionnaires. Interviews lasted 1 to 3 hours and were tape‐recorded, transcribed, and analyzed.
Results:
Despite 36 (82%) respondents stating that they intended to breastfeed for an average duration of 8 months, rates of breastfeeding initiation and duration were much lower than intentions. By 6 months postpartum, only two women were breastfeeding exclusively.
Conclusions:
Women perceived that a strong risk of harming the baby was posed by smoking while breastfeeding and received little encouragement to continue breastfeeding despite an inability to stop smoking. The perceptions of the toxic, addictive, and harmful effects of smoking on breastmilk constitution and quantity factored into reasons why women weaned their infants from breastfeeding much earlier than the recommended 6 months. The results indicate a need for more consistency and routine in educating women on the relationship between smoking and breastfeeding and in promoting breastfeeding in spite of smoking postpartum. (BIRTH 35:3 September 2008)
Newly diagnosed single unprovoked seizures and epilepsy in Stockholm, Sweden: First report from the Stockholm Incidence Registry of Epilepsy (SIRE)
Authors: Adelöw Cecilia , Åndell Eva , Åmark Per , Andersson Tomas , Hellebro Eva , Ahlbom Anders , Tomson Torbjörn
Published: August 2008

Purpose:  To describe and report initial findings of a system for prospective identification and follow‐up of patients with newly diagnosed single unprovoked seizures and epilepsy in Stockholm, Sweden, the Stockholm Incidence Registry of Epilepsy (SIRE).

Methods:  From September 2001 through August 2004, a surveillance system has been in use to identify incident cases of first unprovoked seizures (neonatal seizures excluded) and epilepsy among residents of Northern Stockholm, an urban area with approximately 998,500 inhabitants. Potential cases are identified through multiple mechanisms: Network of health care professionals, medical record screening in specific hospital units, including outpatient clinics, emergency room services, and review of requests for electroencephalography (EEG) examination. Potential cases are classified 6 months after the index seizure based on review of medical records.

Results:  After screening approximately 10,500 EEG requests and 3,300 medical records, 1,015 persons met the criteria for newly diagnosed unprovoked seizures (430 single seizures; 585 epilepsy). The crude incidence for first unprovoked seizures and epilepsy was 33.9/100,000 person years, (the same adjusted to the European Standard Million), highest the first year of life (77.1/100,000) and in the elderly. No cause could be identified in 62.4%.

Conclusions:  We have established a sustainable system for prospective identification of new onset epilepsy cases in Stockholm. Despite a possible under‐ascertainment, the registry provides a useful starting point for follow‐up studies.
Ethanol‐Mediated DNA Damage and PARP‐1 Apoptotic Responses in Cultured Fetal Cortical Neurons
Authors: Cherian Priscilla P. , Schenker Steven , Henderson George I.
Published: August 2008

Background:  Prior studies by many laboratories have illustrated that ethanol can elicit a cascade of caspase‐dependent apoptotic events in cultured neurons. Studies in our laboratory have connected this to oxidative stress and effects on fetal cortical neuron glutathione homeostasis.

Aims:  The intent of the following studies is to address mechanisms underlying ethanol‐associated DNA damage that may be connected to apoptotic death of neurons.

Methods:  Cultures of fetal rat cerebral cortical neurons were utilized. Estimates of DNA damage was determined by Terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) staining and nuclear condensation; Poly(ADP‐ribose) polymerase‐1 (PARP‐1) expression was determined by immunostaining and Western blotting; and occurrence of parylation and AIF translocations were assessed by Western blotting.

Results:  Ethanol treatment of the neurons generated increases in DNA damage by 4 hours while nuclear condensation was low at the short exposure period but increased markedly by 24 hours. This was temporally related to a marked up‐regulation of PARP‐1 expression. Activity of PARP‐1, as assessed by PolyADP‐ribose (PAR) formation, occurred within 15 minutes and peaked by 6 to 8 hours of ethanol treatment. An almost complete translocation of apoptosis inducing factor (AIF) from mitochondria to the nucleus occurred by 24 hours of ethanol treatment (4.0 mg/ml). Ethanol treatment for 4, 12, and 24 hours elicited an increasing caspase‐mediated cleavage of PARP‐1 to its 24 kDa fragment.

Conclusions:  These data illustrate the rapid occurrence of DNA damage following ethanol exposure and that PARP‐1 pathways may play a role in the subsequent apoptotic death of these neurons.
Shear Bond Strength of Four Resin Cements Used to Lute Ceramic Core Material to Human Dentin
Authors: Altintas Subutayhan , Eldeniz Ayçe Unverdi , Usumez Aslihan
Published: August 2008

Purpose: This study evaluated the effect of four resin cements on the shear bond strength of a ceramic core material to dentin.

Materials and Methods: One hundred twenty molar teeth were embedded in a self‐curing acrylic resin. The occlusal third of the crowns were sectioned under water cooling. All specimens were randomly divided into four groups of 30 teeth each according to the resin cement used. One hundred twenty cylindrical‐shaped, 2.7‐mm wide, 3‐mm high ceramic core materials were heat‐pressed. The core cylinders were then luted with one of the four resin systems to dentin (Super‐Bond C&B, Chemiace II, Variolink II, and Panavia F). Half of the specimens (n = 15) were tested after 24 hours; the other half (n = 15) were stored in distilled water at 37°C for 1 day and then thermocycled 1000 times between 5°C and 55°C prior to testing. Shear bond strength of each specimen was measured using a universal testing machine at a crosshead speed of 1 mm/min. The bond strength values were calculated in MPa, and the results were statistically analyzed using a two‐way analysis of variance (ANOVA) and Tukey HSD tests.

Results: The shear bond strength varied significantly depending on the resin cement used (p < 0.05). The differences in the bond strengths after thermocycling were not remarkable as compared with the corresponding prethermal cycling groups (p > 0.05). Significant interactions were present between resin cement and thermocycling (p < 0.05). After 24 hours, the specimens luted with Variolink II (5.3 ± 2.2 MPa) showed the highest shear bond strength, whereas the specimens luted with Chemiace II (1.6 ± 0.4 MPa) showed the lowest. After thermocycling, the bond strength values of specimens luted with Chemiace II (1.1 ± 0.1 MPa) and Super‐Bond C&B (1.7 ± 0.4 MPa) decreased; however, this was not statistically significant (p > 0.05). The increase in the shear bond strength values in the Panavia F (4.5 ± 0.7 MPa) and Variolink II (5.5 ± 2.1 MPa) groups after thermocycling was also not statistically significant (p > 0.05).

Conclusion: Variolink II and Panavia F systems showed higher shear bond strength values than Chemiace II and Super‐Bond C&B. They can be recommended for luting ceramic cores to dentin surfaces.
Sodium Bismuth Titanate‐Based Lead‐Free Piezoceramics Prepared by Aqueous Gelcasting
Authors: Zhou Dongxiang , Li Hui , Gong Shuping , Hu Yunxiang , Han Ke
Published: August 2008

Aqueous gelcasting for 0.94Bi0.5Na0.5TiO3–0.06BaTiO3 (BNBT6) lead‐free piezoceramics was investigated in this paper. A stable BNBT6 suspension with 50 vol% of solid loading and <1Pa·s of viscosity was successfully prepared when 0.5 wt% of PMAA‐NH4 was added with the pH value controlled in the range 8–10. Dehydration and desiccation of the gelled parts could be controlled easily through dipping pretreatment with a 5 wt% ammonium persulfate solution for 24 h or with a 10 wt% ammonium persulfate solution for 12 h. Scanning electron microscopy micrographs show that the BNBT6 ceramic prepared by the gelcasting route exhibits a homogeneous microstructure and a high density. Optimal piezoelectric and dielectric properties were obtained: d33=132pC/N, , tg δ=0.019, and kp=0.25.
Sintering and Mechanical Properties of ZrB2–TaSi2and HfB2–TaSi2Ceramic Composites
Authors: Sciti Diletta , Silvestroni Laura , Celotti Giancarlo , Melandri Cesare , Guicciardi Stefano
Published: August 2008

Fully dense fine‐grained ZrB2‐ and HfB2‐based composites contaning 15 vol% TaSi2were produced by hot pressing at 1850°–1900°C. Gas formation and mass loss, which occurred during sintering in both systems, were in agreement with thermodynamic predictions. In both composites, the presence of a solid solution formed by the diffusion of tantalum into the boride matrix was observed. The HfB2‐based composite was harder (22 GPa), stiffer (528 GPa), and tougher (4.1M Pa·m1/2) than the ZrB2‐based composite. Although the room‐temperature flexural strength of the ZrB2‐based composite (830 MPa) was higher than that of the HfB2‐based composite (700 MPa), the opposite was true at 1200° and 1500°C. Contrary to the significant strength decrease observed for the ZrB2‐based materials at elevated temperature, the HfB2composite retained ∼86% of its room temperature strength up to 1500°C (∼600 MPa).
Fabrication and Electrochemical Performance of Anode‐Supported Solid Oxide Fuel Cells by a Single‐Step Cosintering Process
Authors: Ding Jiao , Liu Jiang
Published: August 2008

Anode‐supported cone‐shaped tubular solid oxide fuel cells (SOFCs) are successfully fabricated by a single‐step cosintering process. The cone‐shaped tubular single cell, NiO+YSZ/YSZ/LSM+YSZ/LSM, is comprised of a Ni+yttria‐stabilized zirconia (YSZ) anode, YSZ electrolyte, a La0.7Sr0.3MnO3 (LSM)+YSZ cathode layer, and an LSM cathode current collector layer. The fabrication process involves slip casting of the anode, colloidal spray coating of the electrolyte, slurry coating of the cathode, and single‐step cosintering of the cone‐shaped tubular cells in the temperature range of 1200°–1400°C. The cells are tested with humidified hydrogen (75 mL/min) as fuel and ambient air as oxidant. Cell electrochemical test results and scanning electron microscope graphs show that the optimal temperature of the single‐step cosintering process is 1300°C.
National Growth in Simulation Training within Emergency Medicine Residency Programs, 2003–2008
Authors: Okuda Yasuharu , Bond William , Bonfante Gary , McLaughlin Steve , Spillane Linda , Wang Ernest , Vozenilek John , Gordon James A.
Published: August 2008

Objectives:  The use of medical simulation has grown dramatically over the past decade, yet national data on the prevalence and growth of use among individual specialty training programs are lacking. The objectives of this study were to describe the current role of simulation training in emergency medicine (EM) residency programs and to quantify growth in use of the technology over the past 5 years.

Methods:  In follow‐up of a 2006 study (2003 data), the authors distributed an updated survey to program directors (PDs) of all 179 EM residency programs operating in early 2008 (140 Accreditation Council on Graduate Medical Education [ACGME]‐approved allopathic programs and 39 American Osteopathic Association [AOA]‐accredited osteopathic programs). The brief survey borrowed from the prior instrument, was edited and revised, and then distributed at a national PDs meeting. Subsequent follow‐up was conducted by e‐mail and telephone. The survey concentrated on technology‐enhanced simulation modalities beyond routine static trainers or standardized patient‐actors (high‐fidelity mannequin simulation, part‐task/procedural simulation, and dynamic screen‐based simulation).

Results:  A total of 134 EM residency programs completed the updated survey, yielding an overall response rate of 75%. A total of 122 (91%) use some form of simulation in their residency training. One‐hundred fourteen (85%) specifically use mannequin‐simulators, compared to 33 (29%) in 2003 (p < 0.001). Mannequin‐simulators are now owned by 58 (43%) of the programs, whereas only 9 (8%) had primary responsibility for such equipment in 2003 (p < 0.001). Fifty‐eight (43%) of the programs reported that annual resident simulation use now averages more than 10 hours per year.

Conclusions:  Use of medical simulation has grown significantly in EM residency programs in the past 5 years and is now widespread among training programs across the country.
Defining Systems Expertise: Effective Simulation at the Organizational Level—Implications for Patient Safety, Disaster Surge Capacity, and Facilitating the Systems Interface
Authors: Kaji Amy H. , Bair Aaron , Okuda Yasuharu , Kobayashi Leo , Khare Rahul , Vozenilek John
Published: August 2008

The Institute of Medicine’s report “To Err is Human” identified simulation as a means to enhance safety in the medical field, just as flight simulation is used to improve the aviation industry. Yet, while there is evidence that simulation may improve task performance, there is little evidence that simulation actually improves patient outcome. Similarly, simulation is currently used to model teamwork‐communication skills for disaster management and critical events, but little research or evidence exists to show that simulation improves disaster response or facilitates intersystem or interagency communication. Simulation ranges from the use of standardized patient encounters to robot‐mannequins to computerized virtual environments. As such, the field of simulation covers a broad range of interactions, from patient–physician encounters to that of the interfaces between larger systems and agencies. As part of the 2008 Academic Emergency Medicine Consensus Conference on the Science of Simulation, our group sought to identify key research questions that would inform our understanding of simulation’s impact at the organizational level. We combined an online discussion group of emergency physicians, an extensive review of the literature, and a “public hearing” of the questions at the Consensus Conference to establish recommendations. The authors identified the following six research questions: 1) what objective methods and measures may be used to demonstrate that simulator training actually improves patient safety? 2) How can we effectively feedback information from error reporting systems into simulation training and thereby improve patient safety? 3) How can simulator training be used to identify disaster risk and improve disaster response? 4) How can simulation be used to assess and enhance hospital surge capacity? 5) What methods and outcome measures should be used to demonstrate that teamwork simulation training improves disaster response? and 6) How can the interface of systems be simulated? We believe that exploring these key research questions will improve our understanding of how simulation affects patient safety, disaster surge capacity, and intersystem and interagency communication.