bluuebunny/crossref_metadata_2025 huggingface dataset:
Prophylactic anticoagulation to prevent venous thromboembolism in traumatic intracranial hemorrhage: a decision analysis
Authors: Scales Damon C , Riva-Cambrin Jay , Wells Dave , Athaide Valerie , Granton John T , Detsky Allan S
Published: April 2010

Introduction

Patients with intracranial hemorrhage due to traumatic brain injury are at high risk of developing venous thromboembolism including deep vein thrombosis (DVT) and pulmonary embolism (PE). Thus, there is a trade-off between the risks of progression of intracranial hemorrhage (ICH) versus reduction of DVT/PE with the use of prophylactic anticoagulation. Using decision analysis modeling techniques, we developed a model for examining this trade-off for trauma patients with documented ICH.

Methods

The decision node involved the choice to administer or to withhold low molecular weight heparin (LMWH) anticoagulation prophylaxis at 24 hours. Advantages of withholding therapy were decreased risk of ICH progression (death, disabling neurologic deficit, non-disabling neurologic deficit), and decreased risk of systemic bleeding complications (death, massive bleed). The associated disadvantage was greater risk of developing DVT/PE or death. Probabilities for each outcome were derived from natural history studies and randomized controlled trials when available. Utilities were obtained from accepted databases and previous studies.

Results

The expected value associated with withholding anticoagulation prophylaxis was similar (0.90) to that associated with the LMWH strategy (0.89). Only two threshold values were encountered in one-way sensitivity analyses. If the effectiveness of LMWH at preventing DVT exceeded 80% (range from literature 33% to 82%) our model favoured this therapy. Similarly, our model favoured use of LMWH if this therapy increased the risk of ICH progression by no more than 5% above the baseline risk.

Conclusions

Our model showed no clear advantage to providing or withholding anticoagulant prophylaxis for DVT/PE prevention at 24 hours after traumatic brain injury associated with ICH. Therefore randomized controlled trials are justifiable and needed to guide clinicians.
Outcomes for Children and Adolescents With Cancer: Challenges for the Twenty-First Century
Authors: Smith Malcolm A. , Seibel Nita L. , Altekruse Sean F. , Ries Lynn A.G. , Melbert Danielle L. , O'Leary Maura , Smith Franklin O. , Reaman Gregory H.
Published: April 2010

Purpose

This report provides an overview of current childhood cancer statistics to facilitate analysis of the impact of past research discoveries on outcome and provide essential information for prioritizing future research directions.

Methods

Incidence and survival data for childhood cancers came from the Surveillance, Epidemiology, and End Results 9 (SEER 9) registries, and mortality data were based on deaths in the United States that were reported by states to the Centers for Disease Control and Prevention by underlying cause.

Results

Childhood cancer incidence rates increased significantly from 1975 through 2006, with increasing rates for acute lymphoblastic leukemia being most notable. Childhood cancer mortality rates declined by more than 50% between 1975 and 2006. For leukemias and lymphomas, significantly decreasing mortality rates were observed throughout the 32-year period, though the rate of decline slowed somewhat after 1998. For remaining childhood cancers, significantly decreasing mortality rates were observed from 1975 to 1996, with stable rates from 1996 through 2006. Increased survival rates were observed for all categories of childhood cancers studied, with the extent and temporal pace of the increases varying by diagnosis.

Conclusion

When 1975 age-specific death rates for children are used as a baseline, approximately 38,000 childhood malignant cancer deaths were averted in the United States from 1975 through 2006 as a result of more effective treatments identified and applied during this period. Continued success in reducing childhood cancer mortality will require new treatment paradigms building on an increased understanding of the molecular processes that promote growth and survival of specific childhood cancers.
The Time of Breach: Class Division and the Contemporary African American Novel
Authors: Murray Rolland
Published: April 2010

Literary and cultural critics have tended to interpret African American literary postmodernism as a broad threat to the cohesion of racial community. Alternatively, this essay submits that contemporary novels by Charles Johnson, Andrea Lee, and others have also construed these changes in racial collectivism as opportunities to recast the political and formal protocols of black fiction. More specifically, these writers draw on the class divisions that intellectuals have viewed primarily through the lens of crisis as a means to challenge existing models of racial solidarity and to renovate the formal features of narrative itself.
Photographic Fictions: Nineteenth-Century Photography and the Novel Form
Authors: Novak Daniel A.
Published: April 2010

“Photographic Fictions” argues that the discussion of fragmentation and totality, parts and wholes that photography provoked in the work of nineteenth-century writers and photographers is important for how we think of the novel form in the age of photography. Victorian writers and photographers consistently represented photography as a process that both dismembered the body and rendered photographic subjects anonymous and interchangeable. Moreover, critics routinely argued that photographic form was itself fragmented and incoherent. However, rather than focus only on what Georg Lukács argued is the novel's tendency to “disintegrate into disparate, heterogeneous parts” (Theory of the Novel), this essay explores the mechanisms by which both photography and the novel stage their own totality. In doing so, I follow theorists of the novel such as Michael McKeon and Terry Eagleton as well as Lukács (especially in his later work), who represent the novel form in terms of an abstract totality. In the context of Victorian visuality, I argue that it is precisely the abstract nature of photographic representation—its tendency to homogenize details and identities—that made possible the productions of art photographers such as Oscar Rejlander and Henry Peach Robinson, who transposed bodies and even body parts into different scenes and visual narratives. Ironically, then, the very qualities that seemed to disqualify photography as an artistic medium (fragmentation and abstraction) turn out to be the enabling conditions of a certain kind of literary narrative and literary form.
Antisocial Fictions: Mill and the Novel
Authors: Plotz John
Published: April 2010

This article argues that the time has come to reconsider John Stuart Mill's relationship to the novel and to pay more heed to his reflections on the complicated interplay between text-based and face-to-face forms of social intercourse. His early essay “What Is Poetry?” begins a journey that ends, in On Liberty (1859), with Mill's idea that the insidious and invasive powers of the social realm may be circumvented by taking refuge, and taking pleasure, in text-based intimacy, an intimacy that allows others' thoughts and feelings to be present as representations. For Mill, public persuasive writing comes to seem a site where autonomous individuals, endowed with deep feelings, can find a selfhood molded by the thoughts of others but not dogged by the “tyranny of the prevailing opinion and feeling.” Mill eventually decides that immersing oneself in the written emotions and thoughts of others is the best way for individuals to participate in a community without becoming rigidly committed to oppressive everyday social roles. Mill's initial disparagement of fiction as “a series of states of mere outward circumstances” belies his eventual conviction that the mental representation of others, in a state of mixed absorption and critical distance, is the highest form of public colloquy.
Visual Storytelling: Cinematic Ekphrasis in the Latin American Novel of Globalization
Authors: Reber Dierdra
Published: April 2010

Given the cultural ascendance of visuality, what is the place of the written text within visual culture? Are there ways in which written narrative strategies privilege image over word? This essay studies how three Latin American texts move generationally toward the current era of virtuality that is increasingly steeped in the visual: Manuel Puig's El beso de la mujer araña (The Kiss of the Spider Woman) (1976), Alberto Fuguet's Las películas de mi vida (The Movies of My Life) (2003), and Rita Indiana Hernández's La estrategia de Chochueca (The Strategy of Chochueca) (1999). In these texts, the cross-genre “nesting” of the visual within the written becomes less precise of boundary, progressing from a clearly demarcated cinematic ekphrasis to a mode of writing that becomes stylistically cinematic. The role of visuality in these works as a vehicle for the representation of self and world suggests that the visual is a somatic epistemological mode in which the entire body is engaged as an interpreter of its surroundings and a producer of social meaning. In this sense, visuality is the metonymic sensorial medium of the thinking body and the feeling brain as against the outmoded word of the rational mind. These texts are representative of an epistemic shift from reason to affect that is paralleled by a shift from word to image—understanding visuality as the dominant metonym of sensorial representation and cognition.
Too Much Information
Authors: Robbins Bruce
Published: April 2010

“Too Much Information” takes issue with critic James Wood's charge that “information” plays a disproportionate and aesthetically unfortunate role in many of the larger and more ambitious novels recently published in English. It makes a case for the value of information. It does so first by discussing what it calls “commodity origin” scenes in Émile Zola, F. Scott Fitzgerald, and Richard Powers, a genre that like the epic simile interrupts the action to provide background knowledge. Second, it reflects on the famous first sentence of Gabriel García Márquez's One Hundred Years of Solitude and recent novelists who have imitated it, including Salman Rushdie, Michael Chabon, and Jeffrey Eugenides. Linking the extra information this model sentence conveys to the representation of atrocity, it answers Wood's specific charge—that information has taken over from readerly emotion—by showing that the proper management of novelistic emotion, the shaping of emotion appropriate to a brutal and global reality, is precisely the effect that this supplementary information aims at.
“My Contemporaries the Novelists”: Isaac Bickerstaff, Uncle Toby, and the Play of Pulse and Sprawl
Authors: Sherman Stuart
Published: April 2010

Newspapers and novels both tend to run long, but they accomplish their protractions by means so different as to seem at first glance diametrically opposed—the paper by its steady pulse of publication across an open-ended span, the novel by something more like sprawl. Despite these differences, though, the temporalities of newspaper and novel entail considerable crossover. My piece sketches how the timings of the printed news—the rhythms of picking up and putting down, the mesh of ending and not-ending, the play of pulse and sprawl—may have infused the workings of the novel. I deploy, as treasure maps for the whole phenomenon, two acutely comic parables of modern reading proffered, exactly half a century apart, in the pages of the Tatler and Tristram Shandy.
The Novel in Distress
Authors: Solomon Bill
Published: April 2010

This essay adopts Susan Stewart's notion of distressed genres as a way to interrogate the seemingly nostalgic strain of American modernist fiction produced in the early decades of the twentieth century. The first section reads Sherwood Anderson's Winesburg, Ohio alongside Walter Benjamin's “The Storyteller,” arguing that the literary text and the critical essay reach comparable insights into the ideological dimensions of the struggle to rehabilitate oral narrative practices. The second section takes these insights as the point of departure for an examination of the functional aspirations animating William Faulkner's Depression-era achievement. In this case, the guiding claim is that his novelistic enterprise culminates in a reflexive analysis of the fantasy organizing his literary labors throughout the period. More precisely, “The Bear” in Go Down Moses reveals the extent to which the anachronistic dream of recovering the collective experiences of preindustrial life masks the author's insertion into an industrialized system of literary production. The concluding portion of this discussion turns to F. Scott Fitzgerald's affiliated attempt to recreate or refashion the fairy tale as a (compensatory) response to the burdens of everyday existence in urban-industrial modernity. Here again the thesis is that the writer's mournful negation of his own project generates a perspective that parallels Benjamin's brief speculations on the folkloric genre.
“Verticality Is Such a Risky Enterprise”: The Literary and Paraliterary Antecedents of Colson Whitehead'sThe Intuitionist
Authors: Tucker Jeffrey Allen
Published: April 2010

Colson Whitehead's The Intuitionist (1999) tells the story of a black female elevator inspector who “intuits” the machines' safety. The protagonist searches for both those responsible for the apparent sabotage of an elevator for which she was responsible and the blueprints for “the Black Box,” the perfect elevator. The novel announces its participation in the tradition of African American literature by performing numerous standard tropes; it responds to the call of antebellum slave narratives by linking literacy and freedom and addresses topics such as double consciousness, invisibility, passing, and racial uplift. The ambiguity of its setting, which is congruent with its assertion of the inherent ambiguities of language and of individual and generic identities, marks The Intuitionist as an example of “postmodern” fiction. An analysis of the novel's allusions to the paraliterary genres of detective fiction and comic books reveals how its race consciousness and postmodernism inform each other. Samuel R. Delany theorizes paraliterature as the discursive other against which “literature” is defined. The Intuitionist takes paraliterature seriously so as to (1) pay homage to Edgar Allan Poe and participate in recent critical approaches to the father of detective fiction that read him in the context of the racial discourse of his day, and (2) critique the hierarchical thinking that both banishes comics to the realm of the “subliterary” and sustains racist ideology. In this sense, The Intuitionist reveals verticality to be “a risky enterprise.”
Novel Futures
Authors: Van Annette
Published: April 2010

This essay speculates about the future of the novel and the novel's futurism, focusing on the ethics of this form given its historical links to the emergence of the Enlightenment subject under capitalism and the nation-state. Do we still need or desire the novel? Is the novel still capable of novelty, of imagining new forms of subjectivity, material relations, and social systems?
The Novel and Prejudice
Authors: Winter Sarah
Published: April 2010

This essay identifies a new subgenre of the novel, the novel of prejudice, which appears at the end of the eighteenth century. Modeling an awareness of prejudice as an ethical and political problem of modernity distinct from the reader identification and empathy associated with sentimental fiction, the novel of prejudice draws on Enlightenment theories of toleration to develop a narrative focus on the self-critical and complicit conscience.
The Facts We Deliver
Authors: Wood Michael
Published: April 2010

This essay is a study of a mischievous but powerful theory of fiction elaborated in different ways by Fielding and Cervantes. It rests on a suspicion of history that is also a longing for history. Fiction, these writers suggest, tells truths history cannot tell—because it is willing to make “mistakes” (Fielding), because it is full of “lies” (Cervantes). The deep enabling doubt behind this theory (and the practice that deploys it) is whether any kind of writing can securely represent even the mere facts of a human case, and in this sense novelists are as vulnerable as historians. This is not a doctrine of skepticism, but an expression of limitations.
Literature, Fictiveness, and Postcolonial Criticism
Authors: Yadav Alok
Published: April 2010

This essay sketches out, and challenges, two broad ways of understanding the fictiveness of literary works, one that associates fictiveness with unreal contents and one that associates it with a distinctive register or key in which a given discourse is to be received. Both conceptions run counter not only to assumptions that are commonly made in the practice of political criticism of literature, but also to basic features of our ordinary engagement with fictional discourses. The essay then examines the controversy surrounding Salman Rushdie's The Satanic Verses, a controversy that Rushdie and many of his defenders characterized as the result of a failure to attend to the fictiveness of fiction. The essay points out, in the context of this controversy, the temptation to assert a categorical distinction between fictive and nonfictive discourses—and the limitations of any such assertion. The essay upholds a view of fiction as a mixed mode, one that crucially involves a constant engagement of nonfictional actualities. It concludes by sketching out some of the essential features of any more adequate account of the fictiveness of literary works and suggests that a more sustained engagement with the question of fictiveness should be on the agenda of political criticism.
John Hirsch at Yale
Authors: Osborn M. Elizabeth
Published: April 2010

“Soon after the death of Rabbi Moshe, Rabbi Mendel of Kutsk asked one of his disciples, ‘What was most important to your teacher?’ The disciple thought and then replied, ‘Whatever he happened to be doing at the moment.’”

What the renowned Canadian director John Hirsch happened to be doing on March 1, 1988 included reading a series of Hasidic stories like this one to a group of student designers and directors at Yale. In previous years Hirsch had come to New Haven to lead - with host Ming Cho Lee's hospitable assistance - three-week explorations of Pericles and King Lear. This time the focus was to be on Hirsch's own adaptation of the classic Yiddish play The Dybbuk, and the students would find themselves called to a consideration of the spiritual side of human life.

For this first two-hour session John Hirsch talked about his life in art; it was one of the things he did best. What follows is an edited version of the first hour. The vivid narratives grounded in intensely emotional memory, the catholicity of what drew this artist's observant eye and eager spirit, the affirmation of theatre's high meaning: all characterize the man.

John Hirsch died of AIDS on August 1, 1989. In retrospect this March 1 meeting becomes a remarkably vital meditation on death. It looks as if the artist's antenna Hirsch speaks about was working that day, taking him where it was useful for him to go.
Optical diagnostics in dielectric barrier discharges at atmospheric pressure
Authors: Dilecce Giorgio , Ambrico Paolo F. , De Benedictis Santolo
Published: April 2010

Our recent work on optical emission spectroscopy (OES) and laser-induced fluorescence (LIF) applied to dielectric barrier discharge (DBD) at atmospheric pressure (ATP) is reported. The interplay of discharge kinetics and diagnostic techniques features is evidenced, with emphasis on collision processes that, with their variety of state-to-state characteristics and rate constants, determine the observation of a peculiar collision-dominated non-equilibrium system.
Uncontrollably Herself: Deleuze's Becoming-woman in the Horror Films of Michael Almereyda
Authors: O'Connor Tom
Published: April 2010

The philosophers Gilles Deleuze and Felix Guattari chose the term Becoming-woman to signify our desire to continually and productively transform ourselves as well as an ever-evolving, contingent world. They picked this particular term because women's possibilities have not been completely
territorialized in an aesthetic or philosophical sense (even when they're codified in a bourgeois sense). Becoming-woman is thus radically different from most mainstream, filmic portrayals of both men and women's possibilities. In this article, I flesh out how the two female protagonists from
the horror films Nadja (1994) and The Eternal (1998), both written and directed by Michael Almereyda, self-create their own powers of Becoming-woman for transformative personal as well as cultural effects.
The Monstrous Masculine: Abjection and Todd Solondz's Happiness
Authors: Wadenius Adam
Published: April 2010

Horror films often use the male as monster, though conventional ideology says that it is not his masculine characteristics that make him monstrous. Barbara Creed writes that in the horror film, the male body is represented as monstrous because it assumes characteristics usually associated
with the female body. The thematic thread of Todd Solondz's Happiness (1998), beneath its facade of domestic anxiety, is that of deviant masculinity. In mapping Billy's horrific trajectory towards maturity, the film's project is an abject representation of the specific rites of passage
that he must undergo in order to accede to manhood. Masculinity in the film is constructed as monstrous via the very characteristics that are inherent to his experience of becoming a man. While at face value Happiness would seem to elude classification as a horror film, it addresses
these issues through the generic conventions of the horror film, employing many of the codes and conventions of horror, evoking an effect on the body of the spectator that is in keeping with the traditional appeal of the genre. Where these films traditionally work to annihilate the threat
to patriarchy and repress the abject, Happiness concludes with images of the paternal order in crisis. Billy comes to embody the monstrous masculine, his semen marking the collapse of symbolic law, illustrated by the failure of the paternal figure to prohibit the incestuous bond that
is established between mother and child.
Dark Looks: An Interview With Valerie Steele
Authors: Spooner Catherine
Published: April 2010

Valerie Steele is the Chief Curator of the Museum at the Fashion Institute of Technology, New York, and one of the most prominent fashion historians working today. Her exhibition Gothic: Dark Glamour ran from September 2008 to February 2009, and is the first major exhibition to focus
on Gothic influences in fashion. An accompanying book, with an additional essay by Jennifer Park, was published by Yale University Press in 2008. I met Steele on 12 February just before the exhibition closed, and talked to her about the process of putting together the exhibition, the popular
reaction to it, and about what Gothic in fashion means more generally.
Drakula halla (1921): The Cinema's First Dracula
Authors: Rhodes Gary D
Published: April 2010

This essay covers the history of Kroly Lajthay's Hungarian film Drakula halla (1921), the cinema's first adaptation of Bram Stoker's novel Dracula. The essay attempts to construct a production history of the film, as well as to create an accurate list of cast members and
key filming locations. As Drakula halla is lost, the essay also features the very first English translation of an extremely rare 1924 Hungarian novella based on the film, which offers much insight into its narrative.
Mummy Knows Best: Knowledge and the Unknowable in Turn of the Century Mummy Fiction
Authors: Macfarlane Karen E
Published: April 2010

This article argues that the figure of the reanimated mummy, which appeared with increasing frequency in imperialist adventure fiction as the nineteenth century drew to a close, is the quintessential monster of imperial gothic. The sudden interest in a figure that some would describe
as a fundamentally flawed monster (perhaps because it is simply too unambiguously dead) at this moment of turn-of-the-century fears of dissolution, degeneration and loss of control signals, I argue here, a profound anxiety about the epistemological underpinnings of the imperial project.
In these stories, reanimated mummies move easily out of their stable positions as artefacts or relics and enter into the Western symbolic order as acting subjects (however conditionally) and as terrifying rivals for epistemological supremacy.
Of Submarines and Sharks: Musical Settings of a Silent Menace
Authors: Koldau Linda Maria
Published: April 2010

This essay analyses the substance of the submarine myth and its relation to the shark myth, as it has been propagated in film since Steven Spielberg's Jaws (1975). The essential elements of the submarine myth are defined, with stealth being at the center of the submarine existence.
As with sharks in the natural ocean surrounding, submarine warfare exploits the basic human fear of the silent monster coming from the depth, unheard and unseen. In fictional film, this highly emotional essence of both the submarine and the shark myth is exploited especially in the design
of the soundtrack. The essay exposes techniques of sound design and musical composition in various films that serve to impart the feeling of a silent, deadly menace.
Marine fungi from two sandy Mediterranean beaches on the Egyptian north coast
Authors: Abdel-Aziz Faten A.
Published: April 2010

I surveyed marine fungi collected from the Mediterranean coast of Egypt. A total of 31 taxa, including 19 ascomycetes and 12 anamorphic fungi, were identified from 100 submerged driftwood samples collected randomly along two sandy beaches. The most frequent fungus wasCorollospora maritima. Other common fungi includeC. portsaidica,Leptosphaeria oraemaris,Cumulospora marinaandPericonia prolifica. Among the 31 taxa identified during this study, 21 are new records for the Mediterranean Sea, bringing the total number of Mediterranean marine fungi to 79. Seven new fungi were recorded during the course of this study, of which two new species ofCorollosporaand one anamorph have been described, and work is in progress to describe the remaining four. An unknown species ofDidymosphaeriais illustrated in this paper, but not formally described because there was insufficient material available for further study of the species.
A tropical assemblage of benthic macroalgae on rocky reefs in a temperate zone on the western Baja California peninsula, Mexico
Authors: de Lara Verónica Castañeda-Fernández , Reyes-Bonilla Héctor , Serviere–Zaragoza Elisa
Published: April 2010

We analyzed rocky reef benthic macroalgae on the western coast of the Baja California peninsula, Mexico. To describe the assemblages, we sampled two reefs that are geographically proximate but influenced by different oceanographic conditions, leading to potential differences in factors that could affect the macroalgal assemblage. Using analyses of similarities, we found significant differences between sites and seasons. Additionally, composition changed seasonally, but was not related to depth. Using SIMPER analysis, the species that defined the assemblages at “Arvin”, Tortugas Bay were Macrocystis pyrifera, Sargassum muticum and Plocamium cartilagineum; in contrast, the key components at “Queen” were Padina caulescens, Polysiphonia johnstonii var. concinna and Dictyota coriacea, showing how oceanographic conditions can influence the biogeographic pattern of macroalgal assemblages along the northwestern coast of Mexico.
The effect of elevated progesterone and pregnancy status on mRNA expression and localisation of progesterone and oestrogen receptors in the bovine uterus
Authors: Okumu L A , Forde N , Fahey A G , Fitzpatrick E , Roche J F , Crowe M A , Lonergan P
Published: April 2010

To investigate the effects of pregnancy or post-ovulatory progesterone (P4) supplementation on the expression of oestrogen and P4 receptors (ESRs and PGRs) in the bovine uterus, heifers (n=263) were randomly assigned to the following treatments: i) cyclic, normal P4; ii) cyclic, high P4; iii) pregnant, normal P4; and iv) pregnant, high P4 on days 5, 7, 13 and 16 of pregnancy/oestrous cycle. Elevated P4 was achieved through P4-releasing intravaginal device insertion on day 3 after oestrus, resulting in increased concentrations from day 3.5 to 8 (P<0.05) in the high groups than in the normal groups. Irrespective of treatment, PGR and ESR1 mRNA expressions were highest on days 5 and 7 and decreased on day 13 (P<0.05), while ESR2 mRNA expression increased on day 7 (P<0.05) and similar levels were maintained within the normal P4 groups subsequently. Expression in the high P4 groups decreased on day 13 (P<0.05). PGR-AB and PGR-B protein expressions were high in the luminal and superficial glands on days 5 and 7, but by day 13, expression had declined to very low or undetectable levels and high P4 concentration tended to decrease or decreased significantly (P<0.05) the expression in these regions on days 5 and 7. ESR1 protein expression was high, with no treatment effect. ESR2 protein was also highly expressed, with no clear effect of treatment. In conclusion, early post-ovulatory P4 supplementation advances the disappearance of PGR protein from the luminal epithelium on days 5 and 7, and decreases ESR2 mRNA expression during the mid-luteal phase, but has no effect on PGR or ESR1 mRNA expression.
Cytotoxicity Study of High Temperature Wool (HT Wool) by Cell Magnetometric Evaluation
Authors: Kudo Yuichiro , Kotani Makoto , Aizawa Yoshiharu
Published: April 2010

Cytotoxicity Study of High Temperature Wool (HT Wool) by Cell Magnetometric Evaluation: Yuichiro Kudo, et al. Department of Preventive Medicine and Public Health, Kitasato University School of Medicine

Objectives

We performed a cytotoxicity study by cell magnetometry, measured lactate dehydrogenase (LDH) activity by enzyme assay, detected DNA ladder formation, and performed morphological examination by electron microscopy in order to evaluate the safety of high temperature wool (HT wool), an asbestos substitute, using long and short chrysotile fibers (CF) as positive controls and phosphate buffered saline (PBS) as a negative control.

Methods

Alveolar macrophages were isolated from male Fisher rats. Following the addition of iron oxide particles (Fe3O4) to macrophages, HT wool, long or short CF was added. Then, the remanence strength was measured for 20 min after magnetization by an external field. Percent LDH release was calculated after determining LDH activity. DNA was detected using an apoptosis detection kit. Morphological observation was performed by taking electron micrographs of macrophages in the groups treated with HT wool and long‐ and short‐CF.

Results

Rapid relaxation, an indicator of decay of cytotoxicity, was observed by cell magnetometry immediately after magnetization was ended in the groups treated with HT wool and PBS, showing that HT wool causes no harmful effect on the cytoskeleton. The CF‐treated groups had higher LDH activity than the PBS‐ and HT wool‐treated groups. No fragmentation of DNA was observed in any group. In morphological observation, cytotoxicity in macrophages was lower in the HT wool‐treated groups than in the CF‐treated groups.

Conclusions

The results suggest that HT wool has no cytotoxicity, as evaluated by cell magnetometry, enzyme assay, DNA ladder detection and morphological examination.
Thermal Reconditioning Characteristics of a Respirator Cartridge for Organic Vapors Using Humid Air as the Desorption Gas
Authors: Hori Hajime , Ishidao Toru , Ishimatsu Sumiyo
Published: April 2010

Thermal Reconditioning Characteristics of a Respirator Cartridge for Organic Vapors Using Humid Air as the Desorption Gas: Hajime Hori, et al. Department of Environmental Management, School of Health Sciences, University of Occupational and Environmental Health

Objectives

Thermal reconditioning characteristics of organic vapors from a respirator cartridge were studied by introducing humid air into a cartridge that had adsorbed organic vapors in order to develop a thermal reconditioning method.

Methods

Five different organic vapors (methanol, 2‐propanol, acetone, dichloromethane and methyl acetate), most of which have relatively weak adsorption affinity to charcoal, were used in this study. Adsorption was carried out at a temperature of 25°C. The relative humidity of the adsorption air with organic vapor was 50%. When the vapor concentration in the downstream of the respirator exceeded the breakthrough concentration, that is, the occupational exposure limits in Japan, the vapor supply was stopped. Then, desorption was started by introducing clean humid air from opposite side of the cartridge under a heated condition. When the desorbed vapor concentration fell below the limit of quantification, desorption process was ended and the next adsorption cycle was started after the temperature had returned to room temperature. This adsorption ‐ desorption cycle was repeated more than three times. The desorption temperature was 65°C and the relative humidity of desorption air was 20%, 50% or 70% at 25°C.

Results

When the relative humidity was 20%, the breakthrough times of regenerated cartridges were shorter than that of a new one, but no difference was observed in the breakthrough curves when the relative humidity was greater than 50%.

Conclusion

The results suggest that the thermal reconditioning of respirator cartridges using humid air is possible for these vapors.
Positioning for Lumbar Puncture in Children Evaluated by Bedside Ultrasound
Authors: Abo Alyssa , Chen Lei , Johnston Patrick , Santucci Karen
Published: April 2010

BACKGROUND:

Lumbar punctures are commonly performed in the pediatric emergency department. There is no standard, recommended, optimal position for children who are undergoing the procedure.

OBJECTIVE:

To determine a position for lumbar punctures where the interspinous space is maximized, as measured by bedside ultrasound.

METHODS:

A prospective convenience sample of children under age 12 was performed. Using a portable ultrasound device, the L3-L4 or L4-L5 interspinous space was measured with the subject in 5 different positions. The primary outcome was the interspinous distance between 2 adjacent vertebrae. The interspinous space was measured with the subject sitting with and without hip flexion. In the lateral recumbent position, the interspinous space was measured with the hips in a neutral position as well as in flexion, both with and without neck flexion. Data were analyzed by comparing pairwise differences.

RESULTS:

There were 28 subjects enrolled (13 girls and 15 boys) at a median age of 5 years. The sitting-flexed position provided a significantly increased interspinous space (P < .05). Flexion of the hips increased the interspinous space in both the sitting and lateral recumbent positions (P < .05). Flexion of the neck, did not significantly change the interspinous space (P = .998).

CONCLUSIONS:

The interspinous space of the lumbar spine was maximally increased with children in the sitting position with flexed hips; therefore we recommend this position for lumbar punctures. In the lateral recumbent position, neck flexion does not increase the interspinous space and may increase morbidity; therefore, it is recommended to hold patients at the level of the shoulders as to avoid neck flexion.
Systematic Evidence Review of Newborn Screening and Treatment of Severe Combined Immunodeficiency
Authors: Lipstein Ellen A. , Vorono Sienna , Browning Marsha F. , Green Nancy S. , Kemper Alex R. , Knapp Alixandra A. , Prosser Lisa A. , Perrin James M.
Published: April 2010

CONTEXT:

Severe combined immunodeficiency (SCID) is a group of disorders that leads to early childhood death as a result of severe infections. Recent research has addressed potential newborn screening for SCID.

OBJECTIVE:

To conduct a systematic review of the evidence for newborn screening for SCID, including test characteristics, treatment efficacy, and cost-effectiveness.

METHODS:

We searched Medline and the OVID In-Process & Other Non-Indexed Citations databases. We excluded articles if they were reviews, editorials or other opinion pieces, or case series of fewer than 4 patients or if they contained only adult subjects or nonhuman data. The remaining articles were systematically evaluated, and data were abstracted by 2 independent reviewers using standardized tools. For topics that lacked published evidence, we interviewed experts in the field.

RESULTS:

The initial search resulted in 719 articles. Twenty-six met inclusion criteria. The results of several small studies suggested that screening for SCID is possible. Interviews revealed that 2 states have begun pilot screening programs. Evidence from large case series indicates that children receiving early stem-cell transplant for SCID have improved outcomes compared with children who were treated later. There is some inconclusive evidence regarding the need for donor-recipient matching and use of pretransplant chemotherapy. Few data on the cost-effectiveness of a SCID-screening program.

CONCLUSIONS:

Evidence indicates the benefits of early treatment of SCID and the possibility of population-based newborn screening. Better information on optimal treatment and the costs of treatment and screening would benefit policy makers deciding among competing health care priorities.
Inhalant Abuse: Monitoring Trends by Using Poison Control Data, 1993–2008
Authors: Marsolek Melinda R. , White Nicole C. , Litovitz Toby L.
Published: April 2010

PURPOSE:

To demonstrate the value of poison control data as an adjunct to national drug abuse surveys and a source of data to inform and focus prevention efforts.

METHODS:

National Poison Data System (NPDS) data are collected and compiled in real time by the 60 US poison centers as callers seek guidance for poison exposures. Demographic, geographic, product, outcome, and treatment-site data for the 35453 inhalant cases reported between 1993 and 2008 were analyzed.

RESULTS:

The prevalence of inhalant cases reported to US poison control centers decreased 33% from 1993 to 2008. Prevalence was highest among children aged 12 to 17 years and peaked in 14-year-olds. In contrast to national survey data showing nearly equal use of inhalants by both genders, 73.5% of NPDS inhalant cases occurred in boys, which suggests that boys may pursue riskier usage behaviors. Most cases (67.8%) were managed in health care facilities. More than 3400 different products were reported. Propellants, gasoline, and paint were the most frequent product categories. Propellants were the only product category that substantially increased over time. Butane, propane, and air fresheners had the highest fatality rates. Prevalence for all inhalants was highest in western mountain states and West Virginia, but geographic distribution varied according to product type. Gasoline was a proportionately greater problem for younger children; propellants were an issue for older children.

CONCLUSIONS:

NPDS should be used to monitor inhalant abuse because it provides unique, timely, and clinically useful information on medical outcomes experienced by users, includes detailed product information (brand and formulation), and can potentially be used to identify real-time demographic, geographic, and product trends. Focusing inhalant prevention efforts on the most hazardous products and most seriously affected users may improve and facilitate strategic prevention, enabling interventions such as targeted education, product reformulation, repackaging, relabeling, or prohibition of sales of especially hazardous inhalant products to youth.
Unnecessary Child Care Exclusions in a State That Endorses National Exclusion Guidelines
Authors: Hashikawa Andrew N. , Juhn Young J. , Nimmer Mark , Copeland Kristen , Shun-Hwa Li , Simpson Pippa , Stevens Martha W. , Brousseau David C.
Published: April 2010

OBJECTIVE:

No study has evaluated the association between state endorsement of American Academy of Pediatrics (AAP) and American Public Health Association (APHA) national guidelines and unnecessary exclusion decisions. We sought to determine the rate of unnecessary exclusion decisions by child care directors in a state that endorses AAP/APHA guidelines and to identify factors that are associated with higher unnecessary exclusion decisions.

METHODS:

A telephone survey was administered to directors in metropolitan Milwaukee, Wisconsin. Directors were randomly sampled from a list of 971 registered centers. Director, center, and neighborhood characteristics were obtained. Directors reported whether immediate exclusion was indicated for 5 vignettes that featured children with mild illness that do not require exclusion by AAP/APHA guidelines. Weighted data were summarized by using descriptive statistics. Regression analysis was used to identify factors that were associated with directors' exclusion decisions.

RESULTS:

A total of 305 directors completed the survey. Overall, directors would unnecessarily exclude 57% of children. More than 62% had never heard of the AAP/APHA guidelines. Regression analysis showed fewer exclusions among more experienced compared with less experienced directors, among larger centers compared with smaller centers, and among centers that were located in areas with a higher percentage of female heads of household. Centers with ≤10% children on state-assisted tuition excluded more.

CONCLUSIONS:

High rates of inappropriate exclusion persist despite state endorsement of AAP/APHA guidelines. Focused initial and ongoing training of directors regarding AAP/APHA guidelines may help to reduce high rates of unnecessary exclusions.
Unintentional Child Poisonings Through Ingestion of Conventional and Novel Tobacco Products
Authors: Connolly Gregory N. , Richter Patricia , Aleguas Alfred , Pechacek Terry F. , Stanfill Stephen B. , Alpert Hillel R.
Published: April 2010

OBJECTIVE:

This study examines child poisonings resulting from ingestion of tobacco products throughout the nation and assesses the potential toxicity of novel smokeless tobacco products, which are of concern with their discreet form, candy-like appearance, and added flavorings that may be attractive to young children.

METHODS:

Data representing all single-substance, accidental poisonings resulting from ingestion of tobacco products by children <6 years of age, reported to poison control centers, were examined. Age association with ingestion of smokeless tobacco versus other tobacco products was tested through logistic regression. Total nicotine content, pH, and un-ionized nicotine level were determined, and the latter was compared with values for moist snuff and cigarettes.

RESULTS:

A total of 13705 tobacco product ingestion cases were reported, >70% of which involved infants <1 year of age. Smokeless tobacco products were the second most common tobacco products ingested by children, after cigarettes, and represented an increasing proportion of tobacco ingestions with each year of age from 0 to 5 years (odds ratio: 1.94 [95% confidence interval: 1.86–2.03]). A novel, dissolvable, smokeless tobacco product with discreet form, candy-like appearance, and added flavorings was found to contain an average of 0.83 mg of nicotine per pellet, with an average pH of 7.9, which resulted in an average of 42% of the nicotine in the un-ionized form.

CONCLUSION:

In light of the novelty and potential harm of dissolvable nicotine products, public health authorities are advised to study these products to determine the appropriate regulatory approach.
Complementary Sampling Methods to Inform Ecosystem-Based Management of Nearshore Fisheries
Authors: Starr Richard M. , Carr Mark , Dan Malone  , Greenley Ashley , McMillan Selena
Published: April 2010

Area-based fishery management and ecosystem-based management strategies are considered beneficial marine resource management tools, but they require finite information about the structure and function of ecosystems to evaluate populations and describe the effects of fishing on ecosystems. The required information is not likely to be obtained from sporadic, fishery-dependent data collected from data-poor fisheries, and funding constraints preclude extensive fishery-independent surveys. This situation has led to an interest in relating or combining information from a variety of disparate sampling methods. From 2003 to 2006, we investigated the relationships between estimates of catch per unit effort (CPUE) and the abundance of fishes generated from typical nearshore commercial fishing operations and estimates of density and abundance derived from scuba surveys in the same locations. The relationships between CPUE and the density estimates derived from different sampling methods were found to be statistically significant in the case of many of the common species sampled across sites in Carmel Bay, California. The compounding effects of within-sample variance and the error associated with the regression equations, however, would result in poor confidence in the values translated from one sampling method to another. Different sampling methods may provide reasonable estimates of population trends, but they are sufficiently different and variable as to preclude the use of a scaling factor to standardize population estimates among sampling methods. Also, the differences in species composition (i.e., relative CPUE or density among species) produced by each sampling method were significant and were also affected by habitat relief and sample depth. Nonetheless, our results suggest the value of a cost-benefit analysis that would allow managers to design optimal sampling strategies for characterizing CPUE relationships within a region of interest. A sampling program that benefits from the complementary strengths of fishing gear and scuba sampling will probably result in the most comprehensive description of nearshore fish assemblages.
End-To-End Models for the Analysis of Marine Ecosystems: Challenges, Issues, and Next Steps
Authors: Rose Kenneth A. , Allen J. Icarus , Artioli Yuri , Barange Manuel , Blackford Jerry , Carlotti François , Cropp Roger , Daewel Ute , Edwards Karen , Flynn Kevin , Hill Simeon L. , HilleRisLambers Reinier , Huse Geir , Mackinson Steven , Megrey Bernard , Moll Andreas , Rivkin Richard , Salihoglu Baris , Schrum Corinna , Shannon Lynne , Shin Yunne-Jai , Smith S. Lan , Smith Chris , Solidoro Cosimo , St. John Michael , Zhou Meng
Published: April 2010

There is growing interest in models of marine ecosystems that deal with the effects of climate change through the higher trophic levels. Such end-to-end models combine physicochemical oceanographic descriptors and organisms ranging from microbes to higher-trophic-level (HTL) organisms, including humans, in a single modeling framework. The demand for such approaches arises from the need for quantitative tools for ecosystem-based management, particularly models that can deal with bottom-up and top-down controls that operate simultaneously and vary in time and space and that are capable of handling the multiple impacts expected under climate change. End-to-end models are now feasible because of improvements in the component submodels and the availability of sufficient computing power. We discuss nine issues related to the development of end-to-end models. These issues relate to formulation of the zooplankton submodel, melding of multiple temporal and spatial scales, acclimation and adaptation, behavioral movement, software and technology, model coupling, skill assessment, and interdisciplinary challenges. We urge restraint in using end-to-end models in a true forecasting mode until we know more about their performance. End-to-end models will challenge the available data and our ability to analyze and interpret complicated models that generate complex behavior. End-to-end modeling is in its early developmental stages and thus presents an opportunity to establish an open-access, community-based approach supported by a suite of true interdisciplinary efforts.