bluuebunny/crossref_metadata_2025 huggingface dataset:
Adaptive Support Ventilation May Deliver Unwanted Respiratory Rate–Tidal Volume Combinations in Patients with Acute Lung Injury Ventilated According to an Open Lung Concept
Authors: Dongelmans Dave A. , Paulus Frederique , Veelo Denise P. , Binnekade Jan M. , Vroom Margreeth B. , Schultz Marcus J.
Published: March 2011

Background

With adaptive support ventilation, respiratory rate and tidal volume (V(T)) are a function of the Otis least work of breathing formula. We hypothesized that adaptive support ventilation in an open lung ventilator strategy would deliver higher V(T)s to patients with acute lung injury.

Methods

Patients with acute lung injury were ventilated according to a local guideline advising the use of lower V(T) (6-8 ml/kg predicted body weight), high concentrations of positive end-expiratory pressure, and recruitment maneuvers. Ventilation parameters were recorded when the ventilator was switched to adaptive support ventilation, and after recruitment maneuvers. If V(T) increased more than 8 ml/kg predicted body weight, airway pressure was limited to correct for the rise of V(T).

Results

Ten patients with a mean (±SD) Pao(2)/Fio(2) of 171 ± 86 mmHg were included. After a switch from pressure-controlled ventilation to adaptive support ventilation, respiratory rate declined (from 31 ± 5 to 21 ± 6 breaths/min; difference = 10 breaths/min, 95% CI 3-17 breaths/min, P = 0.008) and V(T) increased (from 6.5 ± 0.8 to 9.0 ± 1.6 ml/kg predicted body weight; difference = 2.5 ml, 95% CI 0.4-4.6 ml/kg predicted body weight, P = 0.02). Pressure limitation corrected for the rise of V(T), but minute ventilation declined, forcing the user to switch back to pressure-controlled ventilation.

Conclusions

Adaptive support ventilation, compared with pressure-controlled ventilation in an open lung strategy setting, delivers a lower respiratory rate-higher V(T) combination. Pressure limitation does correct for the rise of V(T), but leads to a decline in minute ventilation.
Perioperative β-Blockade
Authors: Wallace Arthur W. , Au Selwyn , Cason Brian A.
Published: March 2011

Background

The Atenolol study of 1996 provided evidence that perioperative β-blockade reduced postsurgical mortality. In 1998, the indications for perioperative β-blockade were codified as the Perioperative Cardiac Risk Reduction protocol and implemented at the San Francisco Veterans Affairs Medical Center. The current study tested the following hypothesis: Is there a difference in mortality rates between patients receiving perioperative atenolol and metoprolol?

Methods

Epidemiologic analysis of the operations performed at the San Francisco Veterans Affairs Medical Center since 1996 was performed. High-risk inpatients with perioperative β-blockade were divided into two groups: patients who received perioperative atenolol only and those who received metoprolol only. Patients who switched between the two chronic oral β-blocker medications were excluded. IV administration of β-blockers was ignored. Propensity matching analysis was used to correct for population differences in risk factors.

Results

There were 38,779 operations performed from 1996 to 2008, with 24,739 inpatient procedures. Based on analysis of inpatient medication use, 3,787 patients received atenolol only (1,011) or metoprolol only (2,776). Thirty-day mortality (atenolol 1% vs. metoprolol 3%, P < 0.0008) and 1-yr mortality (atenolol 7% vs. metoprolol 13%, P < 0.0001) differed between the two β-blockers. Analysis based on inpatient and outpatient β-blocker use showed a similar pattern. Propensity matching that corrected for multiple cardiac risk factors found an odds ratio (OR) of 2.1 [95% CI 1.5-2.9], P < 0.0001 for increased 1-yr mortality with metoprolol for inpatient use.

Conclusion

Perioperative β-blockade using atenolol is associated with reduced mortality compared with metoprolol.
Plant genotypic diversity increases population size of a herbivorous insect
Authors: Utsumi Shunsuke , Ando Yoshino , Craig Timothy P. , Ohgushi Takayuki
Published: March 2011

It is critical to incorporate the process of population dynamics into community genetics studies to identify the mechanisms of the linkage between host plant genetics and associated communities. We studied the effects of plant genotypic diversity of tall goldenrod
Solidago altissima
on the population dynamics of the aphid
Uroleucon nigrotuberculatum
. We found genotypic variation in plant resistance to the aphid in our experiments. To determine the impact of plant genotypic diversity on aphid population dynamics, we compared aphid densities under conditions of three treatments: single-genotype plots, mixed-genotype plots and mixed-genotype-with-cages plots. In the latter treatment plants were individually caged to prevent natural enemy attack and aphid movement among plants. The synergistic effects of genotypes on population size were demonstrated by the greater aphid population size in the mixed-genotype treatment than expected from additive effects alone. Two non-exclusive hypotheses are proposed to explain this pattern. First, there is a source–sink relationship among plant genotypes: aphids move from plant genotypes where their reproduction is high to genotypes where their reproduction is low. Second, natural enemy mortality is reduced in mixed plots in a matrix of diverse plant genotypes.
Development of anti‐corrosive multi‐layered coatings of zinc‐nickel alloy
Authors: Subbaiah Yogesha , Kaje Venkatakrishna , Chitharanjan Hegde Ampar
Published: March 2011

Purpose

The purpose of this paper is to develop and optimize anti‐corrosive multi‐layered coatings of zinc‐nickel alloy on carbon steel.

Design/methodology/approach

A variety of composition‐modulated multi‐layer alloy (CMMA) coatings of zinc‐nickel were developed on a carbon steel substrate by cyclic changes in cathode current during electrodeposition, coupled with variation of the thicknesses of the individual layers. The corrosion behavior of the coatings was studied in 5 percent NaCl solution by electrochemical methods. Cyclic cathode current densities (CCCDs) and the number of alloy layers were optimized for highest performance of the coatings against corrosion. The factors responsible for improved corrosion resistance were analyzed in terms of change in the intrinsic electrical properties of the capacitance value at the electrical double layer that was associated with micro/nanometric layering. The formation of the semi‐conductive surface film, which was responsible for the improved corrosion resistance, was supported by a Mott‐Schottky plot and the cyclic polarization study. The formation of multi‐layered deposit and the mechanism of corrosion degradation of the coating were analyzed using scanning electron microscopy.

Findings

CMMA coatings with an optimal configuration of (Zn‐Ni)2.0/4.0/300 showed ∼35 times better corrosion resistance compared to a monolithic (Zn‐Ni)3.0 alloy coating of the same thickness. The peak performance was attributed to the change in intrinsic electrical properties of the coating and this conclusion was supported by dielectric spectroscopy.

Originality/value

The paper describes the optimization of CCCD and the number of deposited layers by development of electrolytic deposition of anti‐corrosive multi‐layered zinc‐nickel coatings from a single plating technique.
Analyzing and forecasting the reliability for repairable systems using the time series decomposition method
Authors: Liang Yi‐Hui
Published: March 2011

Purpose

The purpose of this study is to propose the time series decomposition approach to analyze and predict the failure data of the repairable systems.

Design/methodology/approach

This study employs NHPP to model the failure data. Initially, Nelson's graph method is employed to estimate the mean number of repairs and the MCRF value for the repairable system. Second, the time series decomposition approach is employed to predict the mean number of repairs and MCRF values.

Findings

The proposed method can analyze and predict the reliability for repairable systems. It can analyze the combined effect of trend‐cycle components and the seasonal component of the failure data.

Research limitations/implications

This study only adopts simulated data to verify the proposed method. Future research may use other real products' failure data to verify the proposed method. The proposed method is superior to ARIMA and neural network model prediction techniques in the reliability of repairable systems.

Practical implications

Results in this study can provide a valuable reference for engineers when constructing quality feedback systems for assessing current quality conditions, providing logistical support, correcting product design, facilitating optimal component‐replacement and maintenance strategies, and ensuring that products meet quality requirements.

Originality/value

The time series decomposition approach was used to model and analyze software aging and software failure in 2007. However, the time series decomposition approach was rarely used for modeling and analyzing the failure data for repairable systems. This study proposes the time series decomposition approach to analyze and predict the failure data of the repairable systems and the proposed method is better than the ARIMA model and neural networks in predictive accuracy.
The relationships between supply chain and firm performance
Authors: Johnson Mark , Templar Simon
Published: March 2011

Purpose

Supply chains directly influence the differentiation and cost of a firm's products and services and its exposure to risk. The purpose of this paper is to use secondary financial data to explore the relationship between supply chain and firm performance by developing a unified proxy for supply chain performance.

Design/methodology/approach

Established econometric techniques were used to validate the proxy using a sample frame comprising the annual reports of 117 publicly traded UK manufacturing firms from the period 1995 to 2004.

Findings

Increases in change in the proxy lead to an increase in change in the rate of return on capital employed and a change in the rate of cash‐to‐cash cycle length, both of which are traditional measures of improved supply chain management. Moreover, as the rate of change of the proxy increases, so does enterprise value at a level that is statistically significant, indicating that improving supply chain management practices has a positive impact upon improved firm performance.

Research limitations/implications

As annual financial results were used the analysis is at a high level so there is a lack of resolution in identifying discrete causes. The use of annual financial results also means that the research can only take yearly snapshots of firm performance.

Practical implications

The paper indicates that the supply chain is an enabler, not an impediment, to superior organisational performance.

Originality/value

The originality and value of this paper is that it develops a proxy to explain the relationships between supply chain and an organisation's financial performance taking into account the three imperatives of profitability, liquidity, and productivity.
Study of sharing knowledge resources in business schools
Authors: Ranjan Jayanthi
Published: March 2011

Purpose

The purpose of this paper is to propose a common business school framework based on knowledge resources that are available in business schools. To support the arguments made based on review literature, the paper presents the holistic framework of knowledge resources in a business school and also provides a knowledge value chain in sharing the resources. The paper then applies the framework to study the provisions of knowledge recourses in a business school to examine the effect of knowledge sharing.

Design/methodology/approach

Drawing on insights from review literature the paper starts from a broad view on knowledge sharing in business schools. Then the paper proposes a knowledge‐sharing framework. To evaluate the framework, the paper investigates one of the business school's knowledge sharing tools. Wherever data were insufficient, logical interpretation is provided. The framework is compared with respect to business schools. Then it is analyzed with the business school's online knowledge sharing tool.

Findings

The paper finds that the rapid pace of change in knowledge resources is increasingly influencing the creation, publication and dissemination of educational materials and sharing information – thus, finally having an impact on learning. The paper finds that there is an urgent need to share all the knowledge resources in business schools for effective delivery. Some important general observations are argued for, while studying the online knowledge‐sharing tool. First, effective information technology infrastructure for sharing knowledge resources is a must, and second, all the resources need to be shared online. The paper finds that the purpose of knowledge sharing in business schools would create value in the form of academic and personal value.

Originality/value

The paper provides useful suggestions for business schools to adopt knowledge‐sharing tools. The framework proposed can be adopted by any business school worldwide to enhance their ratings and processes. The paper reveals through study that, business schools must actively explore the immense potential and the wide ramifications of the knowledge resources that are hidden in different academic domains rather than just waiting to adopt passively some tool at different academic domains. This paper sets out to inspire business school leaders to find out more on knowledge sharing tools. The chosen research strategy was to study business schools and analyze their content, looking for similarities and complementarities in their nature and their strategies with respect to knowledge sharing. First, the paper identified existing systems, examining available processes in the business school, and expanding them through more searches. This paper is based on reflections combined with inputs from informal discussions and interviews conducted with several management educators, management consultants, management students and managers, which had taken place at several meetings, seminars and conferences over the last few years.
The speed of knowledge transfer within multinational enterprises: the role of social capital
Authors: Chen Jiun‐Shiu , Lovvorn Al S.
Published: March 2011

Purpose

The success of knowledge transfer very much depends on a company's ability to effectively manage their knowledge transfer process. The purpose of this paper is to argue that a critical component in understanding knowledge transfer in the international arena is the speed of that knowledge transfer (and those factors that influence that speed) within a multinational enterprise (MNE).

Design/methodology/approach

In this paper, social capital theory is used to argue that social capital is related to the speed of knowledge transfer within an MNE. The three dimensions of social capital, i.e. relational, dimensional, and cognitive, facilitate the transfer process and effect the rapidity of technology transfer.

Findings

The role of knowledge transfer speed in MNEs knowledge management has been neglected and, yet, the speed of knowledge transfer is critical for MNE organizations to build or maintain their competitive advantage. A critical component in understanding knowledge transfer in the international arena is the speed of that knowledge transfer (and those factors that influence that speed) between different units.

Originality/value

This study examines social capital to better understand knowledge management at the intra‐firm level of an MNE. The success of knowledge transfer very much depends on a company's ability to effectively manage that knowledge transfer process. Using social capital theory, we argued that the three dimensions of social capital (relational, dimensional, and cognitive) are related to the speed of knowledge transfer from the parent company to the foreign subsidiary.
Turnover intentions
Authors: Wells Janelle E. , Welty Peachey Jon
Published: March 2011

Purpose

This paper aims to investigate the relationship between leadership behaviors (transformational and transactional), satisfaction with the leader, and voluntary turnover intentions. In particular, it aims to investigate the mediation effect of satisfaction with the leader on the relationship between leadership behaviors and voluntary turnover organizational intentions.

Design/methodology/approach

Participants were 208 National Collegiate Athletic Association (NCAA) Division I softball and volleyball assistant coaches in the USA. Using the multifactor leadership questionnaire (MLQ – Form 5X) and an organizational turnover intent questionnaire, participants evaluated their head coach's leadership behavior, satisfaction with the leader, and their own organizational turnover intent.

Findings

Results revealed a direct negative relationship between leadership behaviors (transformational and transactional) and voluntary organizational turnover intentions. Also, satisfaction with the leader mediated the negative relationship between leadership behaviors (transformational and transactional) and voluntary turnover intentions.

Research limitations/implications

The study was limited by the use of professional associations to contact participants, the timing of the data collection, and the exploration of only one of numerous possible mediating variables. Several management implications are discussed, such as managers recognizing that both leadership behaviors can be the basis for effective leadership of work teams and for mitigating voluntary turnover intentions.

Originality/value

The paper's principal theoretical contribution is the addition of satisfaction with the leader as a mediating variable between transformational and transactional leadership behavior and voluntary organizational turnover intentions.
Performance patterns in face‐to‐face and computer‐supported teams
Authors: Pazos Pilar , Beruvides Mario G.
Published: March 2011

Purpose

This paper presents a longitudinal experimental study on teams with the purpose of investigating the impact of communication media on decision‐making teams. The authors aims to achieve that by comparing face‐to‐face (FTF) and computer‐supported (CS) teams over a series of three sessions on three response variables: performance, cohesiveness, and synergy.

Design/methodology/approach

A total of 24 teams, each of five students, participated in three separate decision‐making sessions in which they solved a survival simulation scenario. Each team was randomly assigned to either face‐to‐face (FTF) or computer‐supported (CS) communication condition. The analysis compared overall means and mean patterns over time on the three response variables across the two communication media.

Findings

Results suggest that there were no differences in overall performance between CS and FTF teams and no differences in performance changes over time between the two media; there were no overall differences in overall synergy or synergy changes over time; and FTF teams reported higher average cohesiveness than CS teams, but cohesiveness improved at a faster rate in CS teams than in FTF teams. Overall these results suggest that the CS communication did not reduce the group's ability to work together. Moreover, the higher increase in cohesiveness reported by CS teams suggests that the ability to build relationships can increase over time.

Practical implications

Given the prominence of information technologies as a communication mechanism, the question of how team members in remote locations perform over time is of great theoretical and practical importance.

Originality/value

This study provides some preliminary evidence that computer communication does not significantly reduce the group's ability to perform over time for decision‐making tasks. CS teams report lower overall levels of cohesiveness which could indicate that some communication barriers might still limit the group's ability to build relationships.
An efficient curvature‐based partitioning of large‐scale STL models
Authors: Hao Jingbin , Fang Liang , Williams Robert E.
Published: March 2011

Purpose

Rapid prototyping (RP) of large‐scale solid models requires the stereolithographic (STL) file to be precisely partitioned. Especially, the selection of cutting positions is critical for the fabrication and assembly of sub‐models. The purpose of this paper is to present an efficient curvature‐based partitioning for selecting the best‐fit loop and decomposing the large complex model into smaller and simpler sub‐models with similar‐shaped joints, which facilitate the final assembly.

Design/methodology/approach

The partition algorithm is benefited from curvature analysis of the model surface, including extracting the feature edges and constructing the feature loops. The efficiency enhancement is achieved by selecting the best‐fit loop and constructing the similar‐shape joints. The utility of the algorithm is demonstrated by the fabrication of large‐scale rapid prototypes.

Findings

By using the proposed curvature‐based partition algorithm, the reasonability and efficiency of STL model partition can be greatly improved, and the complexity of sub‐models has been reduced. It is found that the large‐scale model is efficiently partitioned and the sub‐models are precisely assembled using the proposed partitioning.

Originality/value

The curvature‐based partition algorithm is used in the RP field for the first time. Based on the curvature‐based partitioning, the reasonability and efficiency of large‐scale RP is addressed in this paper.
Social and environmental sustainability in the clothing industry: a case study of a fair trade retailer
Authors: Goworek Helen
Published: March 2011

Purpose

The purpose of this paper is to assess the issues currently involved in social and environmental sustainability in the clothing industry.

Design/methodology/approach

The paper adopts a case study approach to investigate a business that operates successfully in this challenging market.

Findings

As a consequence of increasing demand for ethical clothing, it has become standard practice for UK clothing retailers to develop CSR policies which impact upon their methods of garment sourcing and partnerships with suppliers. There is also a significant trend for retailers to offer ethical clothing ranges made from organic cotton or produced by Fair Trade manufacturers. The paper includes a case study on People Tree, which sells Fair Trade clothing sourced from developing countries. People Tree is rare amongst clothing companies in that it provides customers with a transparent view of its production sources via the internet. The company provides an example of how socially responsible and environmentally sustainable global sourcing can be applied in practice.

Research limitations/implications

The study focuses on aspects of sustainability in an individual retailer. This could be extended to other ethical retailers in different countries, and a longitudinal study of such companies could be conducted.

Originality/value

Literature on ethical fashion companies and their use of socially responsible strategies is sparse, and there is a lack of research that covers both social and environmental sustainability in this market. This paper fills some of the gaps.
Building national innovation platform in China: theoretical exploration and empirical study
Authors: Li Jizhen , Deng Quwen , Jull Sorensen Olav
Published: March 2011

Purpose

China has been putting into effect a program of “national innovation platforms (NIPs)” since 2008. Because it is still at an experimental stage, some key issues remain ambiguous. The purpose of this paper is to conduct a theoretical exploration and empirical study on the NIP program to present the theoretical foundation and draw out implications for its future practice.

Design/methodology/approach

Based on the literature review of national innovation system (NIS) approach, this paper develops an analytical framework for analyzing the mechanism of NIP. Then an in‐depth case study further validates the framework.

Findings

NIP is a practice under the guidance of NIS approach. It effectively accomplishes interaction and cooperation between different actors and encourages flow of innovation resources. Based on NIP of textile industry, managerial and operational implications are drawn out.

Research limitations/implications

Investigation of this paper is limited to a single industry. The result of the NIP program remains to be seen in the future.

Originality/value

The theoretical study about NIP practice in China is original. The framework derived from NIS theory helps theoretical development in future research and guides future practice.
Hospital doctors' anxieties at work
Authors: Lökman Paula , Gabriel Yiannis , Nicolson Paula
Published: March 2011

Purpose

The purpose of this paper is to examine how maternity doctors deal with anxieties generated through their interactions with patients.

Design/methodology/approach

The authors juxtapose two critical stories, collected as part of a large mixed method field study of leadership and patient care in three UK hospitals. The study of “organizational stories” is particularly relevant in health care settings that are liable to unleash strong emotions and fantasies, stories have a great advantage of offering an outlet for unconscious emotions and fantasies. The authors collected stories (n=48) from different stakeholders, and after extensive discussions and analysis, it was decided to focus this article on two stories told by two different doctors. These stories sum up not only the storytellers' own personal experiences but also reveal something more profound and general about the nature of doctors' anxieties and the means used to contain them. By restricting the discussion to two narratives, many variations are left outside our remit; the benefit, however, is that the nuances contained in these stories can be looked at in far greater detail.

Findings

The principal cause of doctors' anxiety in this study was a constant balancing between an objectifying “I‐it” and a communicative “I‐Thou” relations with their patients and the organization. If the doctors were unable to deliver what in their personal scale would have been good or even satisfactory patient care, anxiety levels started rising. The coping with and managing of anxiety was mainly done through controlling of relations with patients and colleagues.

Originality/value

The paper offers insights into situations that prompt diverse challenging emotions.
The risk implications of multinational enterprise
Authors: Juul Andersen Torben
Published: March 2011

Purpose

Multinational structure has been linked to operational flexibilities that can improve corporate adaptability and a knowledge‐based view suggests that multinational resource diversity can facilitate responsive opportunities. The enhanced maneuverability from this can reduce earnings volatility and hence the corporate performance risk. But, the internationalization process may also require irreversible investments that increase corporate exposures and leave the risk implications of multinational enterprize somewhat ambiguous. Hence, the purpose of the paper is to present an empirical study of the implied relationships between the degree of multinationality and various risk measures including downside risk, upside potential, and performance risk.

Design/methodology/approach

The paper provides a brief literature review, develops hypotheses, and tests them in two‐stage least square regressions on archival data to control for pre‐selection biases.

Findings

The analyses indicate that multinationality is associated with lower downside risk as well as higher upside potential and leads to reduced performance risk. The study finds no trace of diminishing effects from higher degrees of multinationality.

Research limitations/implications

The empirical study uses a sample of large US‐based corporations, which could affect the generalizability of results. However, this is consistent with other studies and eases comparability of findings.

Practical implications

The findings add to the ongoing debate about the risk effects of a multinational corporate structure and confirms that a diverse multinational presence is associated with positive risk outcomes.

Originality/value

The paper complements a limited number of studies with equivocal results and adopts alternative risk outcome measures. The study extends the industry scope by introducing a comprehensive sample of firms operating in different manufacturing and service businesses.
Socio‐economic determinants of drugged driving – a register‐based study
Authors: Karjalainen Karoliina , Lintonen Tomi , Impinen Antti , Lillsunde Pirjo , Mäkelä Pia , Rahkonen Ossi , Haukka Jari , Ostamo Aini
Published: March 2011

Aims  To examine the associations between socio‐economic characteristics and driving under the influence of drugs (DUID), and to elaborate determinants of drugged driving.

Design  A register‐based case–control study.

Setting  Finland.

Participants  Cases (n = 5859) apprehended by the police and suspected of DUID during 1993–2006 and controls (n = 74 809) drawn from the general Finnish population.

Measurements  The effects of parents' and own education, urbanization of municipality, socio‐economic position (SEP), main activity, income, marital status and living arrangements on DUID were estimated using logistic regression analysis. The analyses were conducted separately for men and women, age groups of under 45 years and aged 45 or over, and for substance groups of benzodiazepines only, benzodiazepines with alcohol, amphetamines and cannabinoids.

Findings  Low education, unemployment, disability pension, being divorced and living alone were the strongest individual predictors of DUID in all substance groups. Illicit drug users were more disadvantaged compared to those in the benzodiazepines groups. Contrary to other substance and age groups, higher educational level and higher SEP were associated with DUID among benzodiazepine users aged 45 or over.

Conclusions  A disadvantaged social background is a significant predictor of driving while under the influence of drugs for all substance use groups in Finland. The gradient is greater for amphetamines and cannabinoids than benzodiazepines.
Genetic diversity of mitochondrial cytochrome b gene in Chinese native buffalo
Authors: Lei C. Z. , Zhang C. M. , Weining S. , Campana M. G. , Bower M. A. , Zhang X. M. , Liu L. , Lan X. Y. , Chen H.
Published: March 2011

The origins of the domestic water buffalo remain contentious. To better understand the origins of Chinese water buffalo, we sequenced the complete mitochondrial cytochrome b (MT‐CYB) gene from 270 individuals representing 13 Chinese domestic swamp buffalo populations. We found genetic evidence of introgression of river buffalo into Chinese swamp buffalo herds. Swamp buffalo haplotypes can be divided into two highly divergent lineages (A and B), suggesting that Chinese native swamp buffalo have two maternal origins. We found that the A→G transition in the buffalo MT‐CYB gene stop codon resulted in buffalo haplotypes being terminated by one of two stop codons: AGA or AGG. AGA is common to river buffalo and lineage A of swamp buffalo, while AGG is specific to lineage B of swamp buffalo. Lineage A appears to have been domesticated in China. Further genetic evidence is required to clarify the origins of lineage B.
How first‐time mothers perceive and deal with teething symptoms: a randomized controlled trial
Authors: Plutzer K. , Spencer A. J. , Keirse M. J. N. C.
Published: March 2011

Background  Teething, especially in their first child, continues to be a daunting problem for parents.

Objective  The objective of this paper was to assess the effects of providing first‐time mothers with information about symptoms commonly associated with teething and ways to manage these.

Methods  In a randomized controlled trial to decrease the incidence of early childhood caries, we included information on teething as another issue in a child's oral health. Mothers in the intervention group received three rounds of printed information: at enrolment during pregnancy and when the child was 6 and 12 months old. Information on teething arrived when a child reached 6 months of age. Outcome assessment was at 20 ± 2.5 months of age. Data were complemented with a systematic search for evidence on teething symptoms and how to alleviate them in other populations.

Results  Of 649 expectant mothers enrolled in the study, 441 completed the ‘Child's oral health’ questionnaire. There were no significant differences in teething symptoms reported by mothers in the intervention (n= 232) and control (n= 209) groups. However, mothers in the intervention group were less likely to use topical and oral medications to manage teething problems (P < 0.03) and relied more on rubbing the gums to ease discomfort (P < 0.005) than mothers in the control group.

Conclusions  Providing mothers with information on how to address teething symptoms markedly reduced the use of medications for symptom relief. There is still need for better evidence, first, on what symptoms can or cannot be attributed to teething and, second, on what is effective in alleviating them.
Nature and Origin of the Proteins of Bile
Authors: Dive Ch. , Heremans J.F.
Published: March 2011

Abstract. The specific radioactivities in serum and bile were compared in patients recovering from biliary surgery after intravenous injection of 131I‐labelled albumin, orosomucoid, transferrin and immunoglobulins IgA and IgG. It was found that the major plasma proteins occurring in hepatic bile are entirely derived from the circulating plasma, except for part of the IgA which is of local origin.—A comparative analysis of the concentrations of the different proteins in the two media further indicates that transfer from plasma to bile proceeds along two parallel pathways. One of these consists of bulk transport without distinction being made between the proteins; the other one involves a selection of the proteins as a function of their molecular size, revealing the existence of a semi‐permeable barrier interposed between the plasma and the biliary compartments. To account for the observed sieve effect, the pores of this membrane ought to have a mean radius of about 127 Å.
Recovery of Function and Structure of Dog Ileum and Colon Following Two Hours' Acute Ischaemia*
Authors: Robinson J. W. L. , Haroud M. , Winistörfer B. , Mirkovitch V.
Published: March 2011

Abstract. Loops of dog small intestine and colon have been subjected to two hours' acute ischaemia and their recovery has been studied by functional and histological examinations. — Immediately after the ischaemia, both organs show serious necrotic lesions of the mucosal surface, their active transport capacities are abolished, mucosal Na+‐K+‐ATPase activities are reduced, and a significant liberation of acid phosphatase into the efferent blood is observed. The lesions of the ileal loops are more severe than those of the colonic loops. — The ileal loops have a finite, albeit greatly reduced function 24 hours after the trauma. After 3 days, amino‐acid transport has normalised but sugar transport is still reduced. Histological examination confirms that epithelial cells cover the villi of most samples after 24 hours, and normalisation is almost complete after three days. All parameters are normal after one week. — In five cases out of eight, the colonic mucosa is replaced by a compact polymorphonuclear infiltration bathing in a haemorrhagic exudate 24 hours after the ischaemic period; it is evidently quite functionless. In three loops the mucosa is preserved, but only one had functional activity. Three days after the trauma, functional activity is finite, but lower than that of the control loops; histological study reveals a disorganised mucosa, often with ulcers surrounded by relatively healthy tissue. At seven days, mean transport capacity is normal but there are still pathological signs at the microscopic level. — The results show that the ileum is more sensitive to ischaemic damage, but has a greater regenerative potential than the colon. There is a good relationship between the functional and structural state of the tissues.
Hepatic Balances of Glucose and Insulin in Response to Physiological Increments of Endogenous Insulin during Glucose Infusions in Dogs
Authors: Camu F.
Published: March 2011

Abstract. Hepatic glucose uptake was measured in dogs in relation to physiological increments of plasma insulin levels under steady state conditions. Endogenous insulin secretion was stimulated by the infusion of small glucose loads, achieving normoglycaemia or mild hyperglycaemia. The measurement of hepatic arterial and portal venous blood flows allowed calculation of the relationships between net hepatic balances of insulin and glucose, the magnitude of insulin extraction by the liver and the hepatic sensitivity to physiological levels of insulin. During normoglycaemia, small glucose loads (2 and 4.5 mg/min. kg) reduced hepatic glucose output without a concomitant increase of the estimated total glucose utilization. No changes in arterial or hepatic venous plasma insulin levels occurred. Portal venous plasma insulin alone rose under the influence of the glucose stimulus. In the presence of hyperglycaemia, the liver further reduced its glucose output. Infusions of 11.3 mg/min. kg glucose resulted in reversal of hepatic glucose output to a net uptake of glucose. However, due to the large amounts of insulin emerging from the liver, peripheral tissue glucose utilization was significantly increased. A strong inverse correlation existed between arterial glucose concentration and hepatic glucose output as well as between portal venous plasma insulin level and hepatic glucose output. The net hepatic balance of insulin was promptly raised in response to the glucose perfusions, even when normoglycaemia was maintained. A highly significant, inverse correlation was demonstrated between net hepatic balance of insulin (i.e. net uptake of insulin by the liver) and hepatic glucose output. Hepatic insulin extraction ratio and hepatic plasma insulin clearance increased during glucose administration but no evident relationship to portal venous plasma insulin levels was found. These data suggest that insulin rather than glucose is the primary agent responsible for the reversal of the hepatic gradient of glucose in vivo.
Quantitative Iodination of Human Blood Polymorphonuclear Leukocytes
Authors: Hakim J. , Cramer E. , Boivin P. , Troube H. , Boucherot J.
Published: March 2011

It was shown by Pincus and Klebanoff that a correlation existed between leukocytic iodination measured in vivo and microbicidal leukocytic activity. We have analysed the results of this test in relation to time and in the presence of variable quantities of polymorphonuclear leukocytes (PMN). The Values observed per time and PMN unit proved to be equivalent in the presence of 2.5 × 105 PMN or 5.0 × 105 PMN per 0.5 ml of incubation medium, measured after 10, 20 and 30 minutes or in the presence of 1.0 × 106 PMN, measured after 10 minutes. That is to say iodination is proportional to leukocyte concentration and incubation time. Increase of either the quantity of cells or the incubation time, beyond the area we defined, reduce iodination per cell and per unit of time. Concerning the patients with an insufficient iodination, we have studied 2 parameters in the presence of 5.0 × 105 PMN:1***) initial iodination measured after 10 and 20 minutes and 2) stability of iodination measured after 60 minutes. These two parameters were equally affected in two cases with myelofibrosis, 3 patients with acquired refractory anaemia, one with chronic lymphoid leukaemia, one with erythroleukaemia, one with hairy cell leukaemia, one with systemic mastocytosis and almost complete myeloperoxidase deficiency, one with sickle cell disease, two with liver diseases and two with chronic myeloid leukaemia. The iodination at the 60th minute was more affected than at the 10th minute with a patient with myelofibrosis and 4 other Patients with acquired refractory anaemias. The significance of these differences is not well understood; however the meaning of the decrease in the iodination of whatever type is that a PMN anomaly exists directly related to the myeloperoxidase H2O2 halogenation system, or to one of the stages of engulfment and/or metabolic events preceeding it and leading to the production of H2O2. This test, with the alterations we introduced, is suggested as a test for detection of functional PMN abnormalities.
Changes in Potassium Content of Erythrocytes during Exercise in Man
Authors: Kawakami Y. , Kishi F. , Uchiyama K. , Irie T. , Murao M.
Published: March 2011

Abstract. Factors affecting erythrocyte K+ content and plasma electrolytes during light exercise were examined in 8 normal subjects and 27 patients with chronic obstructive lung disease. The patients were classified into bronchitis, emphysema and intermediate groups. Arterial blood was obtained during rest, after 2, 5, and 7 min. of exercise on a bicycle ergometer (30 km/h without mechanical brake), and at 10 and 20 min. during recovery for analysis of Po2, PCo2, plasma H+, Na+, K+, and Cl−, erythrocyte K+ content and whole blood lactate. Plasma H+ increased significantly in all subjects after 2 min. of exercise and PCo2 rose in normal, bronchitis, and emphysema groups during exercise, Whereas Po2 did not change significantly. Plasma K+ rose promptly after the beginning of exercise and remained at high values during exercise. The rapid rise in PCo2 was associated with a significant decrease of calculated erythrocyte K+ in patients with chronic bronchitis. Although changes in plasma H+ were dependent on both PCo2 and lactate, erythrocyte K+ changes were significantly related only to changes in PCo2. These results indicate that the decrease in erythrocyte K+ is mainly controlled by changes in arterial PCo2 during light exercise in patients with chronic bronchitis.
Alteration of Drug Metabolism During Cholestasis in Man*
Authors: Carulli N. , Manenti F. , De Leon M. Ponz , Ferrari A. , Salvioli G. , Gallo M.
Published: March 2011

Abstract. The morphological and functional alterations of the smooth endoplasmic reticulum of the liver cell related to biliary stasis have brought attention to drug biotransformation during cholestasis. The metabolism of meprobamate, pentobarbital and tolbutamide was assessed in subjects with intrahepatic recurrent cholestasis (3), cholestatic hepatitis (6), extrahepatic biliary obstruction (7) and normal controls (16). In the patients with recurrent intrahepatic cholestasis no differences in drug metabolism were noted as compared to the control group. In cholestatic hepatitis the plasma half‐lives of meprobamate (828 ± 422 min.) and pentobarbital (39 ± 6.5 hours) were significantly longer than in controls (444 ± 37 and 25.4 ± 1.1 respectively). Tolbutamide plasma half‐life appeared unchanged. The most striking variations were observed in the patients with extrahepatic biliary obstruction. In such cases while meprobamate half‐life was unchanged, pentobarbital half‐life was significantly prolonged (31.2 ± 2.5) and the in vitro metabolism of the drug, using liver preparations, was decreased to less than 50 % of the control value. In contrast the metabolism of tolbutamide was accelerated as evidenced by a significant decrease of plasma half‐life (165 ± 48 min. versus 384 ± 76 of the controls) and an enhanced urinary excretion of the drug's metabolites. However the metabolism of tolbutamide in vitro did not show any difference between normal and cholestatic liver.

Whatever the mechanism of the peculiar behaviour of tolbutamide in extrahepatic biliary obstruction it seems to be related to the increased bile salt concentration during cholestasis. In fact the low values of plasma half‐life increase significantly either relieving the biliary obstruction or producing a bile salt depletion with cholestyramine. Preliminary results in vitro suggest the bile salt could displace tolbutamide from albumin binding thus increasing the amount of free drug available for biotransformation by the liver. In conclusion cholestasis may affect drug metabolism depending on the degree of biliary stasis, liver cell injury and the type of drug tested. The mechanism could be that of an impaired biotransformation in the smooth endoplasmic reticulum or could involve extrahepatic factors.
Fatty Acid Pattern of Lipids in Normal and Dystrophic Human Muscle
Authors: Kunze D. , Reichmann G. , Egger E. , Olthoff D. , Döhler K.
Published: March 2011

Abstract. The fatty acid distribution of the main lipid fractions: triglycerides (TG), phosphatidylcholine (PCh), phosphatidylethanolamine (PE), and sphingomyelin (Sph) of muscle from 6 patients with progressive muscular dystrophy (p.m.d.), Duchenne, 8 to 12 years old was estimated and compared with normal controls of different age. In view of the results of several authors about varied fatty acid distribution in immature muscle a third group comprising samples of neonatal muscle was studied. 1. The fatty acid pattern of the lipid fractions TG, Sph, and PE from muscle of patients with p.m.d. shows no important variation in comparison to normal controls. In contrast to this the fatty acid distribution in PCh is extremely varied: the percentage of 18:2 is decreased and correspondingly the content of 18:1 is increased. In view of the high percentage (nearly 10 %) in which linoleic acid is substituted by oleic acid in PCh, effects on the plasma membrane are to be expected. 2. The fatty acid pattern in neonatal muscle shows in nearly all positions of the fractions TG, Sph, PE, and PCh a different distribution from normal or dystrophic muscle. In view of the most important variation in dystrophic muscle it must be stated that generally 18:2 is decreased. This deficit was replaced by an increase of all other fatty acids (not only at a substitution by 18:1 as given in p.m.d.). Therefore the diminished content of linoleic acid in PCh of neonatal and dystrophic muscle cannot be interpreted as expression of a corresponding or similar lipid metabolism in both tissues. The results were seen as signs of significant qualitative alterations especially of PCh in p.m.d. They were discussed as proof of our thesis that the basic defect in p.m.d. concerns the specific acylation of PCh with linoleic acid.
Changes of EEG and Pulmonary Venous Admixture During a Protein Load in Patients With Cirrhosis
Authors: Schomerus H. , Buchta I. , Arndt H.
Published: March 2011

Abstract. 21 patients with cirrhosis of the liver and 24 control patients were studied before and after a protein load (120 g protein per day during one week). An EEG was recorded and a visual assessment of frequency pattern was performed. Venous admixture was estimated during hyperoxia. According to the EEG frequency pattern the patient group with cirrhosis was subdivided into those with EEG slowing after the protein load (n = 7) and those without (n = 14). The following results were obtained: 1) Resting arterial blood gases did not change in either group. 2) There was a significant increase of the AaDO2 (difference between alveolar pO2 and peripheral arterial pO2) in cirrhotics and controls. 3) The increase in AaDO2 was significantly larger in those cirrhotics showing EEG slowing compared to those without EEG ‐ slowing or to the controls. 4) Fractional venous admixture increased significantly in those cirrhotics showing EEG slowing. There was no significant change in those patients who did not show EEG changes or in the controls.