bluuebunny/crossref_metadata_2025 huggingface dataset:
Monitoring of the Blood Response in Blood Purification
Authors: Courtney James M. , Sundaram Sumuk , Lamba Nina M.K. , Forbes Charles D.
Published: July 2010

Abstract: A principal objective of monitoring the blood response in procedures such as hemodialysis and cardiopulmonary bypass is to achieve an enhanced understanding of the relationship between blood component alterations and the biomaterials employed. The aim in a study of blood‐biomaterial interactions of deriving a correlation between a characteristic of the biomaterial and a representative parameter of the blood response can be influenced in a clinical situation by antithrombotic agents, multimaterial contact, device utilization, blood condition, drug therapy, and the nature of the application. The selection of parameters representative of the blood response may require a compromise between the advantages of multiparameter assessment and the benefit of measuring a single parameter by a consistent methodology. Representative parameters are protein adsorption, platelet reactions, intrinsic coagulation and the contact activation phase, fibrinolysis, leukocyte alterations, and complement activation. Assessment during clinical application can be approached by consideration of blood response patterns.
Favorable Effect of New Artificial Liver Support on Survival of Patients with Fulminant Hepatic Failure
Authors: Yoshiba Makoto , Inoue Kazuaki , Sekiyama Kazuhiko , Koh Ichiu
Published: July 2010

Abstract: The two most serious symptoms of fulminant hepatic failure are bleeding and hepatic coma. To overcome these problems, we developed an artificial liver support system comprising a combination of plasma exchange and hemodiafiltration using a high performance membrane. We treated 67 patients with fulminant hepatic failure. Of these, 65 patients (97.0%) regained normal consciousness, and 55 patients (80.9%) were kept alert as long as we continued to apply this system. All 7 patients (100%) with fulminant hepatitis caused by hepatitis A virus infection and 9 of 12 patients (75%) with fulminant hepatitis caused by acute hepatitis B (HB) virus infection survived. In addition, 7 of 15 HB virus carriers (46.7%) who developed fulminant hepatitis and 11 of 29 patients (37.9%) with fulminant hepatitis caused by non‐A, non‐B hepatitis viruses survived. The overall survival rate was 37 of 67 patients (55.2%). Our artificial liver support system allows as high a survival rate as liver transplantation.
Hemodynamic Effects of Cardiomyoplasty in an Experimental Model of Acute Heart Failure and Atrial Fibrillation
Authors: Fischer Edmundo I. Cabrera , Chachques Juan Carlos , Christen Alejandra Ines , Risk Marcelo Raul , Carpentier Alain
Published: July 2010

Abstract: The aim of our work was to study the hemodynamic effects of dynamic cardiomyoplasty on an acute animal model of atrial fibrillated heart failure. Eight anesthetized open chest dogs suffering from atrial fibrillation and heart failure, obtained by topic acetylcholine and propranolol, were treated by a cardiomyoplasty procedure performed with an electrostimulated latissimus dorsi muscle flap (LDMF). Values considered for analysis during LDMF stimulation were selected from cardiac cycles with R‐R intervals similar to those when the LDMF was not stimulated (±20 ms). Atrial fibrillated heart failure showed a significant increase of systemic vascular resistance, end diastolic left ventricular pressure (EDLVP) and right atrial pressure (p < 0.05), and a significant decrease in cardiac output, systolic left ventricular pressure (SLVP), and mean aortic pressure (p < 0.05) compared with control values. LDMF stimulation in atrial fibrillated heart failure resulted in a significant increase of SLVP, cardiac output, and mean aortic pressure (p < 0.05) and a significant decrease of systemic vascular resistance, EDLVP, and right atrial pressure (p < 0.05) compared with nonstimulated values. The highest LVP values were obtained with R‐R intervals long enough to allow an adequate LV filling. We conclude that dynamic cardiomyoplasty provides an appropriate recovery in this animal model of atrial fibrillated heart failure. Cardiomyoplasty is an appropriate procedure for cardiac assist when R‐R intervals allow an adequate LV filling.
Stent Fracture in Wessex Porcine Heart Valve Bioprostheses
Authors: Hurlé Aquilino , Nistal J. Francisco , Revuelta Jose M.
Published: July 2010

Abstract: By January 1994, a total of 40 Wessex porcine bioprostheses (21 mitral, 18 aortic, and 1 tricuspid) were explanted from 31 subjects. They belonged to a series of 150 patients who received 184 of such prostheses in our unit. Seventeen of these explanted prostheses were available for study, and 11 of them presented some sort of stent fracture or fissuring (mean of 3.6 ±1.6 fractures per prosthesis). The disruption occurred in all cases at the base of the commissural arch or at the commissural bar of the stent. The fractures were not detected clinically nor echo‐cardiographically before reoperation, and most valves were explanted for reasons other than the stent rupture itself. Trie actuarial probability of freedom from stent fracture in our series is 66 ±12% at 9 years of follow‐up. In our experience, fracture of the stent is an important mode of structural dysfunction of the Wessex porcine bioprostheses.
Do Sheep Really Have Problems with Cardiopulmonary Bypass for Total Artificial Heart Implantation?
Authors: Kim Won Gon , Kim Young Tae , Park Sung Keun , Kim Hee Chan , Suh Jung Wook , Park Jong Wan , Paik Wan Ki , Lee Bung Han , Min Byoung Goo , Rho Joon Ryang
Published: July 2010

Abstract: Although the use of sheep in total artificial heart (TAH) implantation has many advantages, they are known to show a significant morbidity rate on cardiopul‐monary bypass (CPB); this has been considered to be a major limiting factor in using them for TAH experiments. We conducted a series of ovine CPB experiments to evaluate the sheep's pathophysiological response to CPB. CPB‐related hemolysis, bleeding, and lung dysfunction were analyzed in 5 sheep, which had undergone CPB, used at our hospital for TAH implantation. Four of the 5 sheep survived the experimental procedures, and 3 of them survived on a long‐term basis. Unacceptable degrees of hemolysis related to CPB were not observed. Postoperative bleeding was not remarkable, and coagulation test results did not show significant abnormal findings. Acute lung injuries of a mild to moderate degree were found mainly at the microscopic level, but rarely had clinical significance. In conclusion, this experiment suggests that sheep can be used for the animal model for TAH implantation with acceptable risk on CPB circuits and techniques are used.
Transplantation in Parkinson's Disease
Authors: Fink J. Stephen
Published: July 2010

Abstract: The modification of nervous system function by cell replacement and the introduction of heterologous genes are being developed as possible therapeutic approaches in degenerative diseases of the nervous system. The use of cellular transplantation in the nervous systemof patients with neurodegenerative diseases will be reviewed with an emphasis on Parkinson's disease.
Effects of Tilting Disk Heart Valve Gap Width on Regurgitant Flow Through an Artificial Heart Mitral Valve
Authors: Maymir Juan‐Carlos , Deutsch Steven , Meyer Richard S. , Geselowitz David B. , Tarbell John M.
Published: July 2010

Abstract: While many investigators have measured the turbulent stresses associated with forward flow through tilting disk heart valves, only recently has attention been given to the regurgitant jets formed as fluid is squeezed through the gap between the occluder and housing of a closed valve. The objective of this investigation was to determine the effect of gap width on the turbulent stresses of the regurgitant jets through a Bjork‐Shiley monostrut tilting disk heart valve seated in the mitral position of a Penn State artificial heart. A 2 component laser‐Doppler velocimetry system with a temporal resolution of 1 ms was used to measure the instantaneous velocities in the regurgitant jets in the major and minor orifices around the mitral valve. The gap width was controlled through temperature variation by taking advantage of the large difference between the thermal expansion coefficients of the Delrin occluder and the Stellite housing of Bjork‐Shiley monostrut valves. The turbulent shear stress and mean (ensemble averaged) velocity were incorporated into a model of red blood cell damage to assess the potential for hemo‐lytic damage at each gap width investigated. The results revealed that the minor orifice tends to form stronger jets during regurgitant flow than the major orifice, indicating that the gap width is not uniform around the circumference of the valve. Based on the results of a red blood cell damage model, the hemolytic potential of the mitral valve decreases as the gap width increases. This investigation also established that the hemolytic potential of the regurgitant phase of valve operation is comparable to, if not greater than, the hemolytic potential of forward flow, consistent with experimental data on hemolysis.
Single Lead Atrial Synchronous Ventricular Pacing in Japanese Patients with Complete Atrioventricular Block
Authors: Otaki Masaki , Inoue Takehiro , Matsumoto Terufumi , Ueda Masao , Kitayama Hitoshi , Nakamoto Susumu , Wakaki Nobuo , Saga Toshihiko , Oka Hiroshi , Oku Hidetaka
Published: July 2010

Abstract: The purpose of this study was to review our experience with atrial synchronous ventricular pacing devices (THERA VDD pacing systems, Medtronic, Inc., U.S.A.) using single atrioventricular leads in Japanese patients with complete atrioventricular block and normal sinus function. Twenty patients with a mean age of 55 ± 13 years underwent implantation of VDD pacemakers. At implantation the amplitude of atrial signals in the supine position during normal breathing, which was measured directly using an external pacing system analyzer, ranged from 1.8 to 5.8 mV with a mean amplitude of 3.4 ± 1.4 mV. Atrial amplitudes did not change during deep breathing (3.3 ± 1.1 mV) or in the semi‐Fowler position (3.4 ± 1.6 mV). Atrial oversensing or undersensing was not observed in any of the patients. During a follow‐up period, the percentage of atrial synchronization was >95% in 19 patients, and none of the patients had pacemaker related tachycardia or pacemaker related complications. These results were promising enough to warrant the extension of the clinical use of the VDD pacemaker.
Long‐Term Sedation with Isoflurane in Postoperative Intensive Care in Cardiac Surgery
Authors: Tanigami Hironobu , Yahagi Naoki , Kumon Keiji , Watanabe Yasuhiko , Haruna Masaki , Matsui Junki , Hayashi Hideaki
Published: July 2010

Abstract: After cardiac surgery, patients often require prolonged mechanical ventilation. We studied the effectiveness and potential toxicity of isoflurane sedation in 40 patients undergoing mechanical ventilation after cardiovascular surgery. All patients who received isoflurane (0.5‐1.0 minimum alveolar concentration [MAC]) were well sedated by it without significant adverse effects, such as renal, hepatic, or cardiovascular dysfunction. The highest serum inorganic fluoride concentration recorded was 45 |x molL after 98 MAC h. Patients on isoflurane recovered more rapidly and were weaned from mechanical ventilation sooner than those sedated with intravenous drugs including fentanyl/midazolam. Patients who received intravenous sedatives, but not those on isoflurane, often showed tachyphylaxis in the early stages, and some exhibited an abstinence syndrome involving nonpurposeful movements. Patients sedated with isoflurane did not show these two side effects. In conclusion, isoflurane can provide effective long‐term sedation for patients after cardiovascular surgery without significant adverse effects.
Low Molecular Weight Heparin as an Alternative to Unfractionated Heparin in the Immediate Postoperative Period After Left Ventricular Assist Device Implantation
Authors: Sandner Sigrid E. , Zimpfer Daniel , Zrunek Philipp , Steinlechner Barbara , Rajek Angela , Schima Heinrich , Wolner Ernst , Wieselthaler Georg M.
Published: July 2010

We present a regimen for anticoagulation in the immediate postoperative period after left ventricular assist device (LVAD) implantation using low molecular weight heparin (LMWH) as an alternative to unfractionated heparin. Between May and September 2007, eight consecutive patients undergoing LVAD implantation for advanced heart failure received the LMWH nadroparin. Nadroparin was given twice daily to achieve anti‐Factor Xa activity target peak levels of 0.4 ± 0.1 U/mL. The antiplatelet therapy consisted of aspirin (100 mg/day) and dipyridamole (3 × 75 mg/day). One patient underwent heart transplantation, three patients died, and four patients continued to receive device support. The median duration of support was 78 days (range, 46 to 174). No major bleeding was observed; minor bleeding occurred in three patients. In two patients, pump thrombosis was suspected. There were two ischemic and no hemorrhagic strokes. The use of LMWH may provide a new anticoagulation treatment option in the immediate postoperative period after LVAD implantation.
Ultrasound Image and Augmented Reality Guidance for Off‐pump, Closed, Beating, Intracardiac Surgery
Authors: Bainbridge Daniel , Jones Douglas L. , Guiraudon Gerard M. , Peters Terrence M.
Published: July 2010

Our project is the reintroduction of off‐pump intracardiac surgery using the Universal Cardiac Introducer (UCI) for safe intracardiac access. The purpose of this study was to evaluate multimodality visualization using three ultrasound modalities and ultrasound augmented with virtual reality. Image guidance was tested on implanting a mitral valve prosthesis via the UCI in 12 pigs. Initially, two‐dimensional (2‐D) transesophageal echocardiography (TEE) ultrasound, intravascular ultrasound (intracardiac echocardiography [ICE]), and three‐dimensional (3‐D) epicardial ultrasound were utilized. Ultrasound augmented with virtual reality was used in the last three experiments. A 2‐D TEE assisted navigating the prosthesis into the orifice. Positioning was not intuitive and required trial and error method. A 3‐D epicardial ultrasound allowed positioning of the valve into the orifice. Positioning of the clip was difficult because of artifacts with multiple reflections and shadowing. Augmented reality displayed the entire prosthesis and the tools without artifacts; provided intuitive information on navigation, positioning, and orientation of tools; and improved significantly image guidance and surgical skill. Augmented virtual reality, with tracked 2‐D or 3‐D ultrasound imaging, provides guidance that can effectively substitute for direct vision during beating heart intracardiac surgery.
Surgical Treatment of Hypertrophic Obstructive Cardiomyopathy in Pediatric Patients With Severe Hypertrophy
Authors: Borisov Konstantin V. , Bockeria Leo A. , Sinyov Alexei F.
Published: July 2010

We have undertaken a study over a period of 5 years on 35 hypertrophic obstructive cardiomyopathy (HOCM) patients with severe hypertrophy in the age range between 8 and 15 years. The indication for surgery was based on the diagnosis of severe myocardial hypertrophy in association with serious cardiac failure (New York Heart Association class III or IV) or elevated intraventricular pressure gradients refractory to medical therapy. Furthermore, patients were considered for operation if they met a history of sudden death within their families. A new technique of HOCM surgical correction in pediatric patients with severe hypertrophy was proposed. Conceptually, this approach offers a number of advantages: it affords the excision of the asymmetrically hypertrophied area of the ventricular septum without penetration into the left ventricle cavity; it avoids mechanical damage to the heart conduction system and aortic valve; and for the surgeon, it improves visual inspection of the area to be resected. Here, we describe the disease history of 35 patients, their diagnostic evaluations, the surgical procedure, and the postoperational observations as well as the results of follow‐up assessments. We state that the surgery was successful in all 35 cases. There were no early or late deaths. Acute postoperative pericarditis developed in three patients early after surgery. The follow‐up period was 38 ± 7 months, and complications were not observed so far.
Locating Supreme Court Opinions in Doctrine Space
Authors: Clark Tom S. , Lauderdale Benjamin
Published: July 2010

We develop a scaling model to estimate U.S. Supreme Court opinion locations and justice ideal points along a common spatial dimension using data derived from the citations between opinions. Citations from new opinions to precedent opinions usually apply and endorse the doctrine of the precedent opinion; however, sometimes they implicitly or explicitly dispute the precedent opinion. We collect original datasets classifying citations from search and seizure and freedom of religion opinions written between 1953 and 2006 into these different types and develop a model relating the similarity of the doctrine embodied in the citing and cited opinions to the relative probability of these different types of citations. The resulting spatial estimates of opinion location are used to evaluate theories of Supreme Court bargaining and opinion writing. We find empirical support for theoretical models that predict the majority opinion will fall at the ideal point of the median member of the majority coalition. Given the centrality of theories of judicial policymaking to various substantive problems in political science, the method of scaling opinions developed in this article can facilitate a range of future research.
Suppression of hyaluronan synthase 2 expression reflects the atrophogenic potential of glucocorticoids
Authors: Averbeck Marco , Gebhardt Carl , Anderegg Ulf , Simon Jan C.
Published: July 2010

Please cite this paper as: Suppression of hyaluronan synthase 2 expression reflects the atrophogenic potential of glucocorticoids. Experimental Dermatology 2010; 19: 757–759.

Abstract:  We recently demonstrated that dexamethasone, a strongly atrophogenic glucocorticoid (GC), downregulated hyaluronan (HA) production in human keratinocytes and fibroblasts in vitro and after topical application to human skin in vivo via suppression of hyaluronan synthase 2 (HAS2). To test whether HAS2 activity might discriminate the atrophogenic potential of other substances applied topically to skin, we compared the HA metabolism in cultured human fibroblasts following in vitro treatment with GCs and the non‐atrophogenic calcineurin inhibitor tacrolimus. GCs suppressed HAS2 mRNA expression and decreased HA as shown by qRT‐PCR or ELISA. Tacrolimus did not affect hyaluronan‐metabolizing enzymes nor total HA. Neither mometasone nor tacrolimus affected the expression of collagen mRNAs in human fibroblasts. In conclusion, suppression of HAS2 activity may represent an early process of GC‐induced skin atrophy that precedes the suppression of collagens. Analysis of HAS2 regulation may thus be of value to assess the atrophogenic potential of drugs being developed.
Adrenal insufficiency after glucocorticoid withdrawal in children with rheumatic diseases
Authors: Huber Benedikt M , Bolt Isabel B , Sauvain Marie‐Josèphe , Flück Christa E
Published: July 2010

Aim:  Glucocorticoids (GCs) are often used for the treatment of rheumatic disorders. However, doses are prescribed, which may suppress the hypothalamic–pituitary–adrenal (HPA) axis. After GC withdrawal, recovery of the HPA axis may be delayed putting the patient at risk for adrenal insufficiency. We assessed adrenal function and factors influencing adrenal responsiveness after termination of GC therapy in paediatric patients with rheumatic diseases.

Methods:  Nineteen patients aged 2–15 years were followed clinically, and adrenal function was tested by low‐dose adrenocorticotropic hormone test 1 month after GC withdrawal. In case of adrenal insufficiency by test, re‐assessment was performed after 6 and 18 months.

Results:  No signs or symptoms of adrenal insufficiency occurred in any of the patients during and after GC withdrawal. Biochemical examination revealed adrenal insufficiency in 32% (6/19) at 4 weeks and in 11% (2/19) at 20 months after GC withdrawal.

Conclusions:  In conclusion, current strategies to withdraw GC from paediatric patients with rheumatic diseases are safe. Routine adrenal function testing after GC therapy and withdrawal may not be needed considering the low risk but high number of patients treated with GCs. Nevertheless, awareness of the potential risk and information of patients and their caregivers are crucial to avoid adrenal crisis.
THE BOOK SHELF
Authors: Bailey Franklin C.
Published: July 2010

Books reviewed in this article:

1. Allen, Gina, and Clement G. Martin, M.D. Intimacy (subtitle, Sensitivity, Sex, and the Art of Love).

2. Dreyfuss, Henry. Symbol Sourcebook.

3. Fast, Julius. The New Sexual Fulfillment.

4. Glasser, Wm., M.D. The Identity Society.

5. Mindess, Harvey. Laughter and Liberation.

6. Otto, Herbert A. (Ed.) The New Sexuality.

7. Carpenter, Don. Getting Off.

8. Doebler, C. H. Planning Your Child's Education.

9. Gersh, Marvin J., M.D., Iris F. Litt, M.D. The Handbook of Adolescence.

10. Schutz, William C. Hero Comes Everybody.
SHARED PARENTING: CRITICAL REVIEW OF THE RESEARCH LITERATURE
Authors: Benjamin Michael , Irving Howard H.
Published: July 2010

This critical review of the shared parenting research literature highlights the need for sociolegal reform. This article was submitted to the Meyer Elkin Essay Contest and was selected for publication because of its quality and relevance.
FACTORS THAT ENHANCE OR CURTAIL THE SOCIAL FUNCTIONING OF FEMALE SINGLE PARENTS
Authors: Sev'er Aysan , Pirie Marion
Published: July 2010

Explored in this study of 67 women who have been divorced for 2 or more years are the factors enhancing or limiting the social functioning of these individuals. The path analysis identifies such factors as duration of marriage, number of children, involvement of ex‐spouse, and family support as determinants of postdivorce adjustment.
INTERPARENTAL CONFLICT AND CHILD ADJUSTMENT
Authors: Depner Charlene E. , Leino E. Victor , Chun Ann
Published: July 2010

This article evaluates the past decade's research on the relationship between interparental conflict and children's behavioral, emotional, and social adjustment. Meta‐analysis confirmed an overall conflict‐adjustment relationship that was particularly strong and consistent across studies of behavioral outcomes. The article calls for further refinement of the general conflictadjustment relationship, particularly specification of the various dimensions of conflict and qualifications to limit applications to the particular populations that have been included in research. Secondary analysis is needed to differentiate the effects of family violence from other forms of discord and to compare outcomes for boys and girls. New research must extend inquiry to the full range of sociodemographic groups and family structures in our society. In the next decade, it is crucial to move beyond simple documentation of the general association between conflict and adjustment to identification of the specific conditions that put children at risk and safeguard them from harm.
PLANNING FOR POSTDIVORCE FAMILY RELATIONSHIPS
Authors: Bonney Lewis A.
Published: July 2010

This article proposes that the focus of child custody evaluation and mediation needs to be broadened beyond custody arrangement to consideration of the range of factors that may impact on postdivorce relationships. A review of current social science literature shows that factors such as quality of parent‐child relationships and level of parental conflict may be as important as residence schedule in influencing children's postdivorce adjustment. The article offers strategies for involving parents in drafting agreements to guide relationships with each other and with the children. The goal is for parents to thoughtfully tailor relationships and parenting practices to children's needs during the transition from a one‐household family to a new family plan.
THE ETHICS OF SURROGACY
Authors: Lamb Susan R.
Published: July 2010

This article explores the ethics of surrogacy and examines categories of arguments pertaining to this issue, among them deontological concerns (objections and justifications), consequential concerns (objections and justifications), contractual issues, and a feminist perspective. Also analyzed are competing alternatives. An overall assessment is provided.
REPORT 4: MEDIATED AGREEMENTS ON CHILD CUSTODY AND VISITATION
Authors: Depner Charlene E. , Cannata Karen , Ricci Isolina
Published: July 2010

This report describes child custody and visitation arrangements and assesses the impact of factors thought to influence the terms of mediated agreements. The data is from the California Snapshot Study conducted in June 1991 and is the fourth in a series of reports concerning this landmark study.
“THE PLACE OF JUSTICE IS AN HALLOWED PLACE”1
Authors: McWhinney Robert L. , Metcalfe Kathleen
Published: July 2010

This article discusses the concept of justice and differentiates between restorative and retributive justice. The Judeo‐Christian roots of justice are explored in the context of a need to reform the adversarial nature of the process of family law.
MEDIATION AND CHILD PROTECTION
Authors: McNeilly Gerry K.
Published: July 2010

Mediation as a means of resolving disputes in child welfare (protection) proceedings is relatively new. Mediation as a process has been gaining recognition in almost every area of conflict or contest. It is not surprising, therefore, that its movement into taboo areas such as child welfare matters has occurred. This article focuses on how mediation in this once forbidden area is not only feasible but beneficial. Based on actual case mediations and comments, it will be shown that mediation in this area is necessary and long overdue. A blueprint and criteria will be provided to practitioners in this area as guidelines to be followed.
THE EFFECTS OF DIVORCE AND CUSTODY ARRANGEMENTS ON CHILDREN'S BEHAVIOR, DEVELOPMENT, AND ADJUSTMENT
Authors: Lamb Michael E. , Sternberg Kathleen J. , Thompson Ross A.
Published: July 2010

This article summarizes the consensus among a group of experts from developmental and clinical psychology, sociology, social welfare, and law who sought to evaluate existing empirical evidence regarding the ways in which children are affected by divorce and the varying custody arrangements that follow it. Divorce and/or single parenthood tend to have adverse effects on children's adjustment, with the magnitude of the effects varying depending on the psychological status of the two parents, the extent of conflict between them, and the financial circumstances, particularly after divorce. Children whose nonresidential parents continue to support them financially, those whose custodial parents are psychologically healthy, and those who have and maintain meaningful relationships with nonresidential parents tend to be affected less by the divorce, especially when there is no conflict between the parents. Interventions should thus be designed with these factors in mind.
SOCIAL SECURITY RETIREMENT BENEFITS The Last Insult of a Sexist Society
Authors: Abel Steven L.
Published: July 2010

An older, divorcing couple rarely has assets worth more than their Social Security rights. After a house and pension/retirement plans, Social Security is their largest “asset.” Yet, it is rarely considered by lawyers, mediators, or the parties themselves. A key point, often missed, is that the working spouse receives twice as much Social Security as the nonworking spouse. For many retiring women, getting half as much Social Security as their ex‐husbands is just one more insult from a sexist society. Although a nonworking husband will get the same half, the problem is largely one affecting older women, who earned less on average while they worked and who usually took time off to be with the children while the children were growing up. This article looks at Social Security regulations that make this so and how to avoid this unjust result.
DIVORCE EDUCATION FOR PARENTS AND CHILDREN IN JACKSON COUNTY, MISSOURI
Authors: Glenn Joe Edgar
Published: July 2010

This article outlines the implementation of a children's component of a court‐connected, mandatory divorce education program in Jackson County, Missouri. The efforts made to include significant stakeholders in the planning and implementation process are described. The curriculum for adults and children is summarized, and the structure and administration of the program are presented. Class provider recruitment and teacher qualifications are presented, as well as an overview of the initial responses to the children's classes. The difficulties and successes described may give direction to others considering the inclusion of children in mandatory divorce education classes.
SCIENTIFICALLY CRAFTED CHILD CUSTODY EVALUATIONS. Part Two: A Paradigm for Forensic Evaluation of Child Custody Determination
Authors: Gould Jonathan W.
Published: July 2010

Part 1 of this two‐part series proposed the use of an interdisciplinary model in the development of psycholegal questions that guide child custody evaluations. It was argued that defining the scope and focus of an evaluation at the time that a court order is entered provides a more structured and clearly defined set of questions to be researched and examined within the context of the behavioral science literature. The present article offers a conceptual model to be used in gathering and analyzing data in child custody evaluations. It is argued that the use of forensic methodology provides a more scientific basis for the information provided by the evaluator to the trier of fact, ultimately resulting in a more useful and accurate picture of the family in question.
CHILDREN IN CHANGING FAMILIES
Authors: Fischer Robert L.
Published: July 2010

An extensive body of research has demonstrated that children in families touched by separation and divorce face considerable turmoil in their young lives. This article describes the results of a pilot study of a group curriculum aimed at ameliorating the negative effects of divorce and family instability for children ages 9 to 12. Based on the ratings of parents, many children benefit noticeably from the program, especially those with less self‐expression, low self‐esteem, and more behavioral problems before the program. Teachers, however, often observed no difference in the classroom behavior. The limitations of the study are discussed and caution is recommended in interpreting the findings.
ASSESSING FOR ALIENATION IN CHILD CUSTODY AND ACCESS EVALUATIONS
Authors: Lee S. Margaret , Olesen Nancy W.
Published: July 2010

In‐depth child custody evaluations can be critical in forming an accurate understanding of families in which alienation of children is a concern. By integrating interview and psychological test data of parents and children along with collateral information the evaluator can differentiate an alienated child from children with other forms of parental rejection and can form a thorough understanding of the multiple contributants to the alienation. This comprehensive and integrated understanding is then used to develop a clear and specific intervention plan.
THERAPEUTIC WORK WITH ALIENATED CHILDREN AND THEIR FAMILIES
Authors: Johnston Janet R. , Walters Marjorie Gans , Friedlander Steven
Published: July 2010

This article describes goals and strategies for family‐focused counseling and therapy when children are alienated from a parent after separation and divorce. The confidential intervention takes place within a legally defined contract and is based on a careful assessment of the dynamics of the multiple factors that contribute to the alienation and how the chil?s development is affected. Strategies for forming multiple therapeutic alliances with often reluctant, recalcitrant, and polarized parents are discussed together with ways of helping the child directly.
NON–CHILD SUPPORT EXPENDITURES ON CHILDREN BY NONRESIDENTIAL DIVORCED FATHERS
Authors: Fabricius William V. , Braver Sanford L.
Published: July 2010

Most states' child support guidelines adopt a “cliff” model in providing credits or adjustments for time spent in the nonresidential parent's home. Such guidelines implicitly or explicitly assume that no appreciable expenditures are made directly by obligors for child‐rearing expenses at levels of contact or visitation beneath some threshold value, typically assumed to be around 30% time. As guideline developers are acutely aware, these assumptions have proceeded in the absence of any data. The present investigation sought to provide preliminary evidence of such expenditures by using the approach of getting information about the provision of certain benchmark items: clothes, toys and games, bicycles, a bedroom, and support for car‐related expenses for teenage drivers. The authors generally found a linear, rather than a cliff‐like, relationship of expenditures to time in the nonresidential father's home, with unexpectedly high levels of father's provision of these benchmark items even at quite low levels of contact. These findings support more generous and more continuous adjustments for visitation in child support schemes, to offset nonresidential parent's direct expenditures on children, which appear to be unexpectedly high and arise on a non‐cliff‐like pattern.
IS THE TURN TOWARD COLLABORATIVE LAW A TURN AWAY FROM JUSTICE?
Authors: Murphy Ronalda
Published: July 2010

The new trend in Collaborative Family Law (CFL) in the United States and Canada raises new questions about theories of justice. CFL achieves many of the goals of a viable theory of justice and its implicit critique of the legal system is a valid one. However, it unnecessarily demonizes law and has yet to explicitly articulate where it fits in terms of its own theory of justice. After considering the claims made by CFL, it is apparent that while some are productive, others are problematic and should be discarded. Specifically, CFL's rejection of factual determinacy may be inappropriate in some cases. The CFL approach has the potential to ignore problems of power imbalance, and may sacrifice just outcomes for the sake of efficiency. The emphasis on relationships and the need for their protection is not always an appropriate approach, and in demonizing law in favor of private ordering, CFL unnecessarily rejects the importance of law as a site for public participation in the creation and defense of norms. CFL is an important step forward in law reform, but if it is to fulfill its potential, it needs to incorporate within its practice a theory of justice that avoids the pitfalls of liberal individualism and allows for the public authorship of norms.
Microscopic detection of IgY‐Fc binding signal in the inner layers of ovarian follicular tissue in quail
Authors: KITAGUCHI Kohji , BAE Hae‐Duck , SASANAMI Tomohiro , KOBAYSHI Misato , HORIO Fumihiko , MURAI Atsushi
Published: July 2010

In avian species, it has been assumed that an Fc receptor in the ovarian follicles mediates immunoglobulin Y (IgY) transport into the yolk. However, no such receptor responsible for IgY has been identified to date. To examine potential IgY binding activity in the entire ovarian follicle, whole‐mount sections of quail ovarian follicle were incubated with the Fc fragment of chicken IgY (cIgY). Whole‐mount frozen sections of the second largest ovarian follicle were prepared, and then the sections were incubated with digoxigenin‐labeled Fc or Fab fragments of cIgY. Microscopic observation revealed that incubation with the cIgY‐Fc fragment produced a binding signal in the inner layer of the ovarian follicular tissues, most likely in the granulosa cell layer. However, no such signal was detected when the sections were incubated with cIgY‐Fab. Coincubation of the ovarian sections with Alexa488‐labeled cIgY‐Fc and antiserum raised against ZP1, an envelope protein specifically localized in the perivitelline layer, demonstrated that the source of the Fc binding signals partly coincided with the perivitelline layer. In conclusion, our data suggest that potential IgY binding substances interacting with the Fc domain are present in the inner layers of ovarian follicular tissues, most likely in the granulosa cell layer and/or in the perivitelline layer.
The effect of modified roofing on the milk yield and reproductive performance of heat‐stressed dairy cows under hot‐humid conditions
Authors: KHONGDEE Sriapa , SRIPOON Somchai , CHOUSAWAI Somchai , HINCH Geoff , CHAIYABUTR Narongsak , MARKVICHITR Kanjana , VAJRABUKKA Chanvit
Published: July 2010

The objective was to measure the effects of cooling techniques (shade cloth vs. normal roof) on performance and physiology of 16 Friesian crossbred cows (87.5% Holstein Friesian × 12.5% Brahman) located at Sakol Nakhon Livestock Research and Testing Station, Department of Livestock Development, Ministry of Agriculture and Cooperatives (Sakol Nakhon, Thailand). They were divided randomly into two groups of eight. The two groups were used to evaluate the effects of modified roofing (normal roof fitted with woven polypropylene shade cloth) on the subjects' milk yield and reproductive performance under hot humid conditions. Results indicated that the modified roofing offered a more efficient way to minimize heat stress than the normal roof. The difference was sufficient to enable the cows to have a significantly lower mean rectal temperature and respiration rate (38.56°C, 61.97 breaths/min) than that of the cows housed under normal roofing (39.86°C; 85.16 breaths/min). The cows housed under modified roofing produced more milk (P < 0.05) but did not differ significantly in reproductive performance from the cows housed under normal roofing.
The Industrial Organization of the Japanese Bar: Levels and Determinants of Attorney Income
Authors: Nakazato Minoru , Ramseyer J. Mark , Rasmusen Eric B.
Published: July 2010

Using micro‐level tax data on attorney incomes in 2004 (when the law was changed to make it confidential), we analyze the industrial organization of the Japanese bar. These data suggest two sources of high income: an idiosyncratic return to talent in Tokyo and a compensating differential for the lack of amenities in the provinces. The most able would‐be lawyers (those with the highest opportunity costs) pass the bar‐exam equivalent on one of their first tries or abandon the effort and pursue careers outside of law. If they pass, they opt for careers in Tokyo that involve complex litigation and business transactions. This work places a premium on their talent, and from it they earn appropriately high incomes. The less talented face lower opportunity costs and opt to spend many years studying for the exam. If they do eventually pass, they apparently choose between a relatively low‐income career in Tokyo and a provincial career paying a compensating differential.
The Public Regulation of Land‐Use Decisions: Criteria for Evaluating Alternative Procedures
Authors: Tyler Tom , Markell David
Published: July 2010

In this article we argue for an empirical governance approach—the use of public evaluations—as one basis for deciding whether and how to regulate decisions with public consequences. We propose a conceptual framework for evaluating public acceptability, notably that public judgments should be evaluated against five criteria: overall acceptability ex ante; robustness; consensus; procedurality; and their ranking on nonfairness issues such as cost and convenience. In the article we also move beyond theory to implementation by modeling our framework to evaluate public judgments concerning acceptability in the contentious area of land‐use decisions in Florida.
Lesbian, Gay, Bisexual, and Transgender Families
Authors: Biblarz Timothy J. , Savci Evren
Published: July 2010

This article reviews new scholarship on lesbian, gay, bisexual, and transgender families. The past decade witnessed rapid expansion of data and strong research designs. The most notable advance was in studies on variation among mostly planned lesbian comother families. Cumulative evidence suggests that although many of these families have comparatively high levels of shared labor and parental investment, they may not be as “genderless” as previously depicted. Gay men's diverse paths to family formation and planned parenthood have also been explored, but almost no research studies their children's experiences. Conceptualizations of sexual orientation expanded to include bisexuals and others, and some understanding of the experiences of transgender people has begun to emerge. Future work should explore relationships among members of the families they create.
Diversity in Pathways to Parenthood: Patterns, Implications, and Emerging Research Directions
Authors: Smock Pamela J. , Greenland Fiona Rose
Published: July 2010

This review examines and synthesizes recent research on pathways to parenthood. We begin by providing basic information about patterns, differentials, and trends and discussing adoption and new reproductive technologies. We next turn to several areas of inquiry that became particularly prominent in the last decade: the continued “decoupling” of marriage and childbearing, the parental relationship context of nonmarital childbearing, family structure stability, multiplepartner fertility, and racial and ethnic variation in childbearing patterns. We then consider the implications of this body of scholarship and identify avenues for future research. Throughout, we highlight racial/ethnic and social class variation in childbearing patterns.
Sustained long‐term remissions with weekly interferon maintenance therapy in hairy cell leukemia
Authors: RAMAKRISHNA Raj , MANOHARAN Arumugam
Published: July 2010

Aim:  This study evaluates the efficacy of weekly α‐interferon (IFN) maintenance therapy in hairy cell leukaemia (HCL), a disease that remains incurable.

Method:  Nine patients (six male, three female, aged 41–69 yrs) with hairy cell leukaemia (HCL) received IFN 3mU s.c. once weekly as long‐term maintenance therapy after achieving optimal clinical and hematological response to initial therapy with thrice weekly IFN.

Results:  Eight of the nine patients are in a state of sustained response at 3–17 years (median 12 years).

Conclusion:  Our results are similar to those from three previous studies using long‐term IFN maintenance therapy, bringing the total number of patients in sustained remission to 118. We hope these reports will lead to a multi‐centre, phase III study of IFN maintenance therapy (including pegylated IFN, given less frequently) in HCL patients achieving optimal response to initial therapy, be it IFN or a purine analogue.
A Case Report of Plasmapheresis in the Treatment of Acute Disseminated Encephalomyelitis
Authors: Shinozaki Koichiro , Oda Shigeto , Sadahiro Tomohito , Nakamura Masataka , Abe Ryuzo , Nakamura Shiho , Hattori Noriyuki , Hirano Shigeki , Hattori Takamichi , Hirasawa Hiroyuki
Published: July 2010

Acute disseminated encephalomyelitis (ADEM) is a demyelinating disease of the central nervous system associated with significant morbidity and mortality. High‐dose corticosteroid administration has been considered the mainstay of treatment for ADEM; however, some patients with ADEM are refractory to steroid therapy. We report a case of a 17‐year‐old man suffering from ADEM who did not respond to corticosteroid therapy, but who exhibited a dramatic recovery with plasmapheresis. He became comatose, requiring ventilatory support, and exhibited abnormalities of some brainstem reflexes prior to treatment. He underwent sequential courses of plasma exchange therapy for three days. Plasma exchanges were carried out with concomitant continuous hemodiafiltration (CHDF) to control intracranial pressure by stabilizing pH, plasma Na+ concentration, and colloid osmotic pressure. After plasma exchanges, his reflexes and level of consciousness gradually improved. Eleven months after this treatment, he had only minimal neurological deficit that did not interfere with any of his activities of daily living. The efficacy of plasmapheresis for ADEM has not yet been established. Plasmapheresis may be indicated for ADEM, not only for patients with severe disease in whom high‐dose corticosteroid treatment has failed, but also as first‐line treatment for ADEM. Early initiation of plasmapheresis appears to be associated with moderate to marked improvement. Early recognition and early treatment of ADEM are thus of paramount importance.
The Role of Credit in the Theory of the Household
Authors: HERENDEEN JAMES B.
Published: July 2010

Consumer credit has been neglected in the economic theory of the household. This article examines the role and impacts of credit on household utility, investment, savings and consumption choices. Household consumption‐investment models are developed based on the works of Fisher, Lancaster and Becker. Implications are developed for consumer credit use, credit policy and consumer lending institutions.
The Antisubstitution Laws and Physician‐Ownership of Drug Repackagers
Authors: HOFFER GEORGE
Published: July 2010

During the 1964 Hearings on Physician‐Ownership held by the Senate Subcommittee on Antitrust and Monopoly witnesses charged that certain medical doctors were establishing firms that purchased prepared drugs in bulk, packaged them, and then marketed the drugs in smaller quantities under brand names. Physicians with interests in drug repackagers would write prescriptions specifying brands marketed by their firms, and antisubstitution laws would prevent the pharmacist from using other brands. Critics of the practice argue that physicians purchase drug repackagers and tie drugs to extend their monopoly power into the ethical drugs market with the resulting foreclosure of independent firms. This paper argues that physicians purchase drug interests not to create a new monopoly, but rather to extract more monopoly profits from their original markets. But evidence exists that in doing so physician‐owners impose a welfare loss on their patients. The paper concludes with an analysis of efforts made thus far to end the practice and suggests that amendment of state antisubstitution laws would make it more difficult for physician‐repackager owners to tie drugs.
The Theory and Practice of Swedish Consumer Policy
Authors: JOHANSSON J. K.
Published: July 2010

Based upon Swedish sources including enacted legislation and personal interviews with experts and key enforcement personnel, the basic structure of Swedish consumer protection efforts is developed. It is shown where the underlying philosophy differs from that in the U.S. and how this has led to a different institutional structure in the consumer policy area. The fundamental philosophy is that the consumer is weak relative to the producer and that therefore government institutions need to shoulder the burden of the consumer's protection, information and general welfare. Similar developments in the two countries are exemplified, and some implications of the Swedish experience for the U.S. are discussed.
Consumer Perceptions of the Consumer Credit Process
Authors: DAUTEN DALE A. , DAUTEN JOEL J.
Published: July 2010

This research contrasts the perceptions of consumers with those of loan officers faced with similar credit application situations. Fundamental misperceptions of the credit granting process are encountered. Consumers clearly misperceive the credit standards of both banks and finance companies. Given large interest rate differentials between loan sources and the narrow shopping scope of most consumers for consumer credit, equitable allocation of credit dollars demands greater appreciation of the nature of the credit evaluation process by lender and borrower.