bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impasse or mutation? Austerity and (de)financialisation of local governments in Britain
Authors: Dagdeviren Hulya , Karwowski Ewa 
Published: June 2021

AbstractPost crisis, local governments’ (LGs) budgets have been drastically cut in Britain. Similar budgetary strains had serious consequences in the past, leading to major restructuring in LGs’ functions. This paper interrogates the spatial dynamics of short-term municipal finances by putting into dialogue the political economy perspectives on financialisation with the economic geography literature on urban governance. Using data for over 400 municipal authorities in Britain, we examine locational underpinnings of changing financial practices with respect to spending cuts. We find that austerity increased risk and uncertainty for LGs. To preserve key services in such an environment, they resorted to short-term borrowing in breach of regulatory guidance. Effectively, an internal market for inter-council lending and borrowing has been created based on market principles in which LGs with surplus cash and reserves have extended credit to those with liquidity problems. On the asset side, the austerity programme forced them to embrace financial logics through a spectacular shift from cash and deposit holdings to investment in money market funds and credit extension as they have strived to generate as much income as possible to fund services at risk.
Directed evolution of alditol oxidase for the production of optically pure D-glycerate from glycerol in the engineeredEscherichia coli
Authors: Zhang Chao , Chen Qian , Fan Feiyu , Tang Jinlei , Zhan Tao , Wang Honglei , Zhang Xueli 
Published: June 2021

AbstractD-glycerate is an attractive chemical for a wide variety of pharmaceutical, cosmetic, biodegradable polymers, and other applications. Now several studies have been reported about the synthesis of glycerate by different biotechnological and chemical routes from glycerol or other feedstock. Here, we present the construction of an Escherichia coli engineered strain to produce optically pure D-glycerate by oxidizing glycerol with an evolved variant of alditol oxidase (AldO) from Streptomyces coelicolor. This is achieved by starting from a previously reported variant mAldO and employing three rounds of directed evolution, as well as the combination of growth-coupled high throughput selection with colorimetric screening. The variant eAldO3-24 displays a higher substrate affinity toward glycerol with 5.23-fold than the wild-type AldO, and a 1.85-fold increase of catalytic efficiency (kcat/KM). Then we introduced an isopropyl-β-D-thiogalactopyranoside (IPTG)-inducible T7 expression system in E. coli to overexpress the variant eAldO3-24, and deleted glucosylglycerate phosphorylase encoding gene ycjM to block the consumption of D-glycerate. Finally, the resulting strain TZ-170 produced 30.1 g/l D-glycerate at 70 h with a yield of 0.376 mol/mol in 5-l fed-batch fermentation.
Crisis-Induced Innovation: Quality Upgrading in Chinese Industrial Clusters
Authors: Hu Xiangting , Ruan Jianqing , Zhang Xiaobo 
Published: June 2021

Abstract
Supporting institutions and policies play a key role in facilitating upgrades to product quality among manufacturing firms. However, the emergence of quality-supporting institutions has not been well studied. Based on qualitative and quantitative evidence in Chinese clusters, this paper shows that quality-enhancing institutions and policies often emerge in response to crises, such as consumer boycotts and impositions of export barriers, which can catalyze collective action from entrepreneurs and local governments to improve product quality. (JEL codes: L15; L22; L51; L60).
Limited speech outside the home in a young girl who speaks normally at home
Authors: Sharma Sumita 
Published: June 2021

Abstract
Selective mutism (SM) is a childhood anxiety disorder characterized by failure to speak in at least one specific social setting such as school, despite the ability to speak in other, more familiar settings. The symptoms must persist for at least one month. Many children with SM also have excessive shyness, poor eye contact, and fear of embarrassment. Despite the failure to speak, the child’s nonverbal communication ability is typically age appropriate and prosocial nonverbal communication such as nodding or giggling is often observed. Since SM frequently co-occurs with other communication disorders, the assessment should include a hearing and speech and language evaluation. Behavioral therapy and cognitive behavioral therapy (CBT) are the primary treatments for SM. Medications are most effective when combined with behavioral treatments and may include the use of selective serotonin reuptake inhibitors (SSRIs).
Worries about being embarrassed in front of classmates
Authors: Grossman Mila N. 
Published: June 2021

Abstract
Social anxiety disorder is characterized by excessive anxiety about social situations and fear of being scrutinized by others. The child worries that they will act in a way that will be negatively evaluated or lead to feelings of humiliation, embarrassment, or social rejection. These feelings must occur in the presence of peers. This disorder can affect academic performance and a child’s ability to develop healthy relationships with peers. Social anxiety disorder can be distinguished from normative shyness based on the degree of impairment. Cognitive behavioral therapy (CBT) including gradual exposure to social situations and social effectiveness therapy are the main psychotherapeutic treatment approaches. Medication classes used to treat social anxiety disorder include selective serotonin reuptake inhibitors (SSRIs) and serotonin norepinephrine reuptake inhibitors (SNRIs).
An adolescent requesting to pause puberty
Authors: Ross Cordelia Y. , Keuroghlian Alex S. 
Published: June 2021

Abstract
Gender dysphoria occurs when a patient has distress associated with incongruence between a person’s experienced gender and the gender traditionally associated with their sex assigned at birth. This must occur for at least six months. The psychiatric assessment of a patient with gender dysphoria should include exploration of the child’s developmental history of gender-expansive identification and expression; sources of distress relating to familial, community, and social stigma; and ways to help families adopt an accepting and nurturing response. Gender affirmation can include psychological, social, legal, and biological interventions. The goal of psychotherapy is to help a person explore, discover, and affirm their gender identity. Social affirmation may include changing names, pronouns, and gender expression. Legal gender affirmation may take place through a name or gender marker change on official documents. Biological affirmation may include pubertal suppression for younger adolescents, gender-affirming hormone therapy, and/or gender-affirming surgery.
Long-term effects of early pain and injury
Authors: Moriarty Orla , Walker Suellen M. 
Published: June 2021

Abstract
Nociceptive pathways are functional following birth, and acute responses to noxious stimuli have been documented from early in development in clinical and laboratory studies. The ability of noxious afferent input to alter the level of sensitivity of nociceptive pathways in the adult nervous system, with, for example, the development of central sensitization, is well established. However, the developing nervous system has additional susceptibilities to alterations in neural activity, and pain in early life may produce effects not seen following the same input at older ages. As a result, early tissue injury may lead to persistent changes in somatosensory processing and altered sensitivity to future noxious stimuli. Furthermore, there is increasing evidence that neonatal pain can result in long-term changes in cognitive and affective behavior. Effects of pain in early life are superimposed on a highly plastic developing system, and long-term outcomes vary depending on the type and severity of the injury, and on the evaluation methods used. Laboratory studies allow evaluation of different injuries, potential confounding factors, underlying mechanisms, and potential analgesic modulation.
Long-term effects of pain in infants
Authors: Grunau Ruth E. , Vinall Miller Jillian , Chau Cecil M. Y. 
Published: June 2021

Abstract
The long-term effects of infant pain are complex, and vary depending on how early in life the exposure occurs, due to differences in developmental maturity of specific systems underway. Changes to later pain sensitivity reflect multiple factors such as age at pain stimulation, extent of tissue damage, type of noxious insult, intensity, and duration. In both full-term and preterm infants exposed to hospitalization, sequelae of early pain are confounded by parental separation and quality of pain treatment. Neonates born very preterm are outside the protective uterine environment, with repeated exposure to pain occurring during fetal life. Especially for infants born in the late second trimester, the cascade of autonomic, hormonal, and inflammatory responses to procedures may induce excitotoxicity with widespread effects on the brain. Quantitative advanced imaging techniques have revealed that neonatal pain in very preterm infants is associated with altered brain development during the neonatal period and beyond. Recent studies now provide evidence of pathways reflecting mechanisms that may underlie the emerging association between cumulative procedural pain exposure and neurodevelopment and behavior in children born very preterm. Owing to immaturity of the central nervous system, repetitive pain in very preterm neonates contributes to alterations in multiple aspects of development. Importantly, there is strong evidence that parental caregiving to reduce pain and stress in preterm infants in the Neonatal Intensive Care Unit (NICU) may prevent adverse effects, and sensitive parenting after NICU discharge may help ameliorate potential long-term effects.
Genetics and pain in childhood
Authors: Mogil Jeffrey S. 
Published: June 2021

Abstract
Genomic and other “omic” approaches are now routinely applied to the study of pain. Some of these investigations have utilized pediatric populations. This review describes what is currently known about the heritability of pain in children (from twin studies), genes relevant to pain in children (from single-gene mutations, candidate gene, and genome-wide association studies), and the application of newer techniques, such as epigenomics, to pediatric pain.
Pain in children with intellectual or developmental disabilities
Authors: MacDonald Andrina , Bennett Kristi , Stansbury Jean C.K. , Barney Chantel C. , Belew John , Schwantes Scott , Valkenburg Abraham J. , Symons Frank J. 
Published: June 2021

Abstract
Children with intellectual and developmental disabilities (I/DD) are estimated to have more than twice the incidence of chronic pain than their typically developing peers. Pain assessment is particularly challenging given the array of individual cognitive and communication abilities found in children with I/DD. Early recognition and accurate assessment of pain is essential for effective management and ultimately preventing the development of pain syndromes resulting from untreated nociceptive pain. Pain assessment instruments are available to support better pain management; however, more widespread use of these assessments within clinical practice and research studies is a necessary next step.
Procedural sedation
Authors: Tsze Daniel S. , Cravero Joseph P. 
Published: June 2021

Abstract
Pediatric patients undergoing procedures often require sedation to provide the appropriate combination of anxiolysis, analgesia, and motionlessness. Owing to the behavioral and developmental issues involved with this population, children require sedation to accomplish procedures much more often than adults. Pediatric procedural sedation is a dynamic area of practice. This chapter reviews the basic concepts involved in sedation delivery and addresses the various considerations involved in sedation cases, including patient factors, procedure factors, and provider factors. Various drugs available for sedation (and the various routes of delivery) are also reviewed, with comments on appropriate strategies for a variety of common diagnostic and therapeutic procedures.
Inflammatory arthritis and arthropathy
Authors: Chira Peter , Schanberg Laura E. 
Published: June 2021

Abstract
Musculoskeletal pain from childhood-onset rheumatologic conditions such as juvenile idiopathic arthritis is variable in severity and impact. Advancements in understanding the mechanisms of inflammation causing arthritis and its associated pain have led to new treatments and guidelines for improved control of arthritis disease activity when implemented in a timely manner. In spite of these new treatments, pain often persists in childhood arthritis, even when little-to-no active inflammation is detected, highlighting the need to use a biopsychosocial model to address all factors contributing to pain symptoms. Using this holistic approach, we can better manage the pain of children with rheumatologic diseases in routine clinical practice, as well as in settings such as clinical trials and other treatment interventions.
Pain treatment and prevention in pediatric palliative care
Authors: Friedrichsdorf Stefan J. 
Published: June 2021

Abstract
Annually, at least 21 million children could benefit from pediatric palliative care (PPC) and 8 million would need specialized PPC services. In the USA alone, more than 40,000 children aged 0–19 years die annually; 55% of them are infants younger than 1 year of age. Pain is common, under-recognized, and under-treated, especially in children with progressive neurodegenerative and chromosomal conditions with central nervous system impairment. Unrelieved pain is also common in children with advanced serious illness during the end-of-life period, and, when treated, the therapy is commonly ineffective. Treating pain in children with serious illness is not profoundly different than advanced pain management for children with complex acute conditions or diseases such as major trauma, burns, cancer, or those with sickle cell disease in vaso-occlusive crisis. It is important to appreciate that children with serious illness are more likely to simultaneously suffer from acute pain, neuropathic pain, visceral pain, total pain, and chronic pain. As such, multimodal analgesic (i.e., multiple agents, interventions, rehabilitation, psychological modalities, and integrative (“nonpharmacologic,” e.g., behavioral, physiological, and psychological) therapies that act synergistically for more effective pediatric pain and symptom control with fewer side effects than a single analgesic or modality must be employed. Opioids, such as morphine, fentanyl, hydromorphone, oxycodone, and methadone, remain the mainstay medications to effectively treat pain in children with serious illness. However, medications alone are often insufficient for optimal pain control. In fact, the paradigm shift away from “medications only” toward offering “multimodal analgesia” to children with serious illness experiencing pain, including addressing chronic pain/primary pain disorders and total pain has become a “game changer” in advancing PPC to ensure that patients can live as long as possible, as well as possible.
Recurrent abdominal pain
Authors: Verrill Schurman Jennifer , Drews Deacy Amanda , Friesen Craig A. 
Published: June 2021

Abstract
Recurrent abdominal pain is a common complaint in children and adolescents; however, it has been historically understudied and not well understood. Development of a discrete symptom-based diagnostic classification system to guide research and treatment has resulted in new research information being generated at an increasing rate. Although significant gaps in our knowledge remain, we are gradually coming to understand the complex etiology of recurrent abdominal pain in children and are making strides in clinical treatment. However, specific clinical practice guidelines do not yet exist and evidence remains limited for most, if not all, of the common treatments employed. This chapter highlights current theory and evidence available to guide office-based assessment and intervention efforts, as well as promising directions for future research.
Brain responses in infants
Authors: Hartley Caroline , Slater Rebeccah 
Published: June 2021

Abstract
We cannot know whether another person is experiencing pain unless they tell us, making reliable pain assessment difficult in nonverbal infants. Consequently, the treatment of infant pain is reliant on inferences based on observations. Understanding how infants respond to noxious stimulation, and how their responses change with factors such as age, pathology, and sex, is essential to improve pain treatment and to evaluate the efficacy of pharmacological and nonpharmacological interventions. Even in the most immature infants, noxious stimulation evokes activity across all levels of the nervous system, eliciting changes in heart rate, respiratory rate, reflex withdrawal, hormonal responses, facial expression, and brain activity. This chapter focuses on measures of noxious-evoked brain activity in infants, including methods of assessment, use in clinical trials, and the current limitations of these techniques.
Principles of clinical pharmacology applied to analgesics in children
Authors: Allegaert Karel , Simons Sinno H.P. , Tibboel Dick 
Published: June 2021

Abstract
Analgesic dosing regimens should take into account the severity and type of pain, the therapeutic window of the drug, and also the age or developmental state of the child. Translation of these concepts to safe and effective pharmacological management of pain in neonates, infants, and children necessitates a thorough understanding of the principles of clinical pharmacology of analgesics in children. Growth, weight or size, and maturation or age evolve in children and profoundly affect the pharmacokinetics (concentration–time profile, absorption, distribution, metabolism, and excretion) and pharmacodynamics (concentration–effect profile, objective assessment) of drugs, and this is also the case for analgesics. This will result in extensive variability in dosing and effects throughout childhood, and this variability is most prominent in infancy. In addition to maturational changes, there are also nonmaturational aspects (preterm neonates and critical illness, obesity, pharmacogenetics) that should be considered to further improve dosing in every individual child.
The nonsteroidal anti-inflammatory drugs and acetaminophen
Authors: Anderson Brian J. 
Published: June 2021

Abstract
Nonsteroidal anti-inflammatory drugs (NSAIDs) and acetaminophen (N-acetyl-p-aminophenol (APAP; paracetamol)) are the commonest analgesic drugs used in childhood. Though both drugs act through inhibition of prostaglandin H2 synthetase, acetaminophen lacks the anti-inflammatory effects of the NSAIDs. Neonatal acetaminophen hepatic clearance is reduced in premature neonates (5–10% adult rates) and increases to 30% adult rates in neonates born at term; adult rates (approximately 16–20 l/h/70 kg) are reached within the first year of life. NSAID clearance maturation, mostly through cytochrome P450 mixed oxidases, is more rapid. Concentration–response relationships suggest a maximum pain reduction of 5 or 6 on a 10-point scale for both drugs. Combination therapy does not increase this maximum effect but does prolong duration of analgesia. Whilst both drugs have good safety profiles, dosing of both drug groups is tempered by concerns about toxicity. Acetaminophen hepatotoxicity is associated with single doses (&gt;250 mg/kg in preschool children, &gt;150 mg/kg in adults) and therapy duration longer than 3–5 days (&gt;90 mg/kg/day).The most common minor adverse events in NSAID recipients are nausea, dizziness, and headache. More concerning is the potential of NSAIDs to cause gastrointestinal irritation, blood clotting disorders, renal impairment, neutrophil dysfunction, and bronchoconstriction. These adverse effects are uncommon provided care is taken with drug dose, duration of therapy, and recognition of contraindications.
Mother care for procedural pain in infants
Authors: Campbell-Yeo Marsha , Benoit Britney , Richardson Brianna , Johnston Celeste 
Published: June 2021

Abstract
A major role of mothers is to protect their infant from harm, including pain. The aim of this chapter is to review the evidence on the effectiveness of maternal strategies that are efficacious in managing procedural pain. These strategies are naturally occurring and have been used for millenia by mothers, but only recently have been systematically studied. Breastfeeding, holding the baby on the bare chest, known as kangaroo mother care, are such strategies. Whilst providing care in this close manner, other components of the mother’s presence may play a role, such as her voice and her odor. Facsimiles of maternal presence such as a recording of mother’s voice and materials containing her odour have been examined as potential strategies to relieve pain in the infant. The question of the potency of pain relieving strategies provided by caregivers, other than the mother, has been addressed to some extent and will be included in this chapter. The mechanisms underlying the pain relieving effects of maternal care, as they are currently understood, will be presented. Finally, pragmatic issues in implementing maternal strategies for decreasing pain will be discussed
Complementary drugs
Authors: Weydert Joy A. 
Published: June 2021

Abstract
Research into the use of botanical agents, nutritional supplements, and diet to manage pain has increased owing to the interest and demand of patients and physicians. Pharmacological agents are typically used as first-line therapy for pain and symptom management; however, for some patients these agents may not work well in the long term or have side effects that are not tolerated. Other patients may prefer nonpharmacological therapies. Most clinicians are not trained or may not be comfortable recommending these complementary agents. It is the goal of this chapter to introduce to practitioners the evidence-based data that support the safety and efficacy of these complementary drugs.
Knowledge translation strategies for mobilizing individuals to implement pain evidence to practice
Authors: Tutelman Perri R. , Chambers Christine T. , Barwick Melanie 
Published: June 2021

Abstract
Pediatric pain research will only benefit children if the results of this research are used in practice. Knowledge translation (KT) involves the sharing of research evidence to different knowledge users in a manner that is accessible and understandable. This chapter provides an overview of KT and its applications to pediatric pain, with a focus on the effectiveness of KT directed to individual knowledge users (e.g., patients and caregivers, and clinicians) versus organizations or systems. KT goals, strategies, and initiatives are described. The importance of evaluating KT is highlighted. Examples of effective KT strategies, activities, and initiatives directed towards individual patients and caregivers are presented. The importance of effective KT to ensure that children with pain benefit from pediatric pain research evidence is emphasized.