bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effect of age on the dose of remifentanil for tracheal intubation in infants and children
Authors: HUME‐SMITH HELEN , McCORMACK JON , MONTGOMERY CAROLYNE , BRANT ROLLIN , MALHERBE STEPHAN , MEHTA DISHA , ANSERMINO J MARK 
Published: November 2009

SummaryIntroduction:  This study aimed to determine the age‐specific bolus dose of remifentanil (ED50) to facilitate tracheal intubation without the use of neuromuscular blocking agents.Methods:  ASA 1–2 subjects were recruited into three groups of 0–3 months (group I), 4–12 months (group II), and 1–3 years (group III) of age. A sequential up‐and‐down design determined the remifentanil bolus dose, which was initially started at 3 mcg·kg−1 and adjusted in 1 mcg·kg−1 increments (range 1–6 mcg·kg−1). Following pretreatment with glycopyrrolate 10 μg·kg−1 and an induction dose of propofol 5 mg·kg−1, remifentanil was administered with a blinded study investigator commencing tracheal intubation after 60 s. After tracheal intubation, the time to return of spontaneous ventilation was measured. Logistic regression was used to predict the ED50 and ED95 of remifentanil.Results:  Sixty‐four subjects were recruited. Tracheal intubation was successful at first attempt in over 90% of subjects in each age group. Satisfactory intubating conditions were achieved in 85%, 63%, and 75% of subjects in groups I, II, and III, respectively. The logistic regression results for ED50 (95% CI) were 3.1 (2.5–3.8), 3.7 (2.0–5.4), and 3.0 (2.1–3.9) mcg·kg−1, and ED95 (95% CI) were 5.0 (3.0–7.0), 9.4 (1.5–17.4), and 5.6 (2.9–8.4) mcg·kg−1 in groups I, II, and III, respectively. Infants aged 4–12 months (group II) showed a marked variability in dose response; however, the mean ED50 and ED95 were not different to groups I and III. Older children had a longer duration of apnea than infants, 331 vs 180 s (P < 0.05).Discussion:  The ED50 of remifentanil for tracheal intubation was higher in all age groups than previously reported. Ideal intubating conditions were achieved in 50% of subjects with remifentanil doses of 3.1–3.7 mcg·kg−1. Higher doses will be required for higher success rates and with anticholinergic pretreatment, doses of up to 6 mcg·kg−1 were tolerated, without adverse effects, in two patients. Further investigation of the variability in dose response in infants and assessment of the safety this technique is warranted.
Hypnotic depth and the incidence of emergence agitation and negative postoperative behavioral changes
Authors: FAULK DEBRA J. , TWITE MARK D. , ZUK JEANNIE , PAN ZHAOXING , WALLEN BRETT , FRIESEN ROBERT H. 
Published: November 2009

SummaryBackground:  Emergence agitation (EA) and negative postoperative behavioral changes (NPOBC) are common in children, although the etiology remains unclear. We investigated whether longer times under deep hypnosis as measured by Bispectral Index™ (BIS) monitoring would positively correlate with a greater incidence of EA in the PACU and a greater occurrence of NPOBC in children after discharge.Methods:  We enrolled 400 children, 1–12 years old, scheduled for dental procedures under general anesthesia. All children were induced with high concentration sevoflurane, and BIS monitoring was continuous from induction through recovery in the PACU. A BIS reading <45 was considered deep hypnosis. The presence of EA was assessed in the PACU using the Pediatric Anesthesia Emergence Delirium scale. NPOBC were assessed using the Post‐Hospital Behavior Questionnaire, completed by parents 3–5 days postoperatively. Data were analyzed using logistic regression, with a P < 0.05 considered statistically significant.Results:  The incidence of EA was 27% (99/369), and the incidence of NPOBC was 8.8% (28/318). No significant differences in the incidence of EA or NPOBC were seen with respect to length of time under deep hypnosis as measured by a BIS value of <45.Conclusion:  Our data revealed no significant correlation between the length of time under deep hypnosis (BIS < 45) and the incidence of EA or NPOBC. Within this population, these behavioral disturbances do not appear to be related to the length of time under a deep hypnotic state as measured by the BIS.
Is there thermal benefit from preoperative warming in children?
Authors: CASSEY JOHN G. , KING ROBERT A.R. , ARMSTRONG PETER 
Published: November 2009

SummaryAim:  We aimed to quantify the impact of a raised preoperative ambient temperature (Tambient) on core temperature (Tcore) after induction of anesthesia in children.Background:  It has been suggested that prewarming of patients before anesthesia induction reduces postinduction drop in Tcore. Neither the prewarming temperature nor its duration is established for adults or children. Nevertheless, it remains common practice to either warm the operating theatre and induction room or employ radiant heaters prior to induction of anesthesia, particularly for infants and neonates. We aimed to quantify the benefit, if any, of this warming practice.Methods:  We conducted a prospective clinical study to assess Tcore behavior in children randomized to either raised or standard ambient temperature as a prewarming technique prior to induction and until the operation commenced. We have called this ‘preoperative’ warming. Well, children scheduled for elective surgery where presurgical anesthetic duration exceeded 20 min were randomized to a Tambient of either 26 or 21°C. Esophageal temperature was monitored continuously until the operative procedure commenced.Results:  There were 30 children in each group. Those in the warmed group (26°C) had a statistically significant higher initial Tcore (0.4°C warmer) and less drop in their Tcore (0.18°C benefit at 20 min). Although younger/lighter/shorter individuals were more likely to drop their Tcore, a warmer Tambient had only 0.1°C thermal benefit irrespective of age.Conclusions:  There are statistically significant thermal advantages to preoperative environmental warming. This study provides data to assist the anesthetist in deciding when these are likely to be clinically relevant.
ON THE ANTICOMPETITIVE EFFECT OF EXCLUSIVE DEALING WHEN ENTRY BY MERGER IS POSSIBLE*
Authors: FUMAGALLI CHIARA , MOTTA MASSIMO , PERSSON LARS 
Published: November 2009

AbstractWe extend the literature on exclusive dealing by allowing the incumbent and the potential entrant to merge. This uncovers new effects. First, exclusive dealing can be used to improve the incumbent's bargaining position in the merger negotiation. Second, the incumbent finds it easier to elicit the buyer's acceptance of exclusivity. Third, despite allowing the more efficient technology to find its way into the industry, exclusive dealing reduces welfare because (i) it may trigger entry through merger whereas independent entry would be socially optimal and (ii) it may deter entry altogether.
An Elected Upper House and Other Fallacies
Authors: PEARCE EDWARD 
Published: November 2009

All fashionable political talk is of an elected House of Lords. Doing this smart, new unthought‐out thing, says Edward Pearce, means dissolving the reliably rebellious upper house regularly rejecting bad bills from Tory and Labour governments, for a House as submissive as the Commons. Second‐line politicians will replace the difficult individual people, soldiers, doctors, academics, scientists, assorted and distinguished experts who, by lucky muddle, go there today.Far better, he says, to abolish actual titles which create a false idea of privilege, but continue drawing upon independent professional specialists. Also, Ministers should be barred from the pernicious Mandelson Effect, of making an instant Minister by life‐ennoblement, huge powers conferred without a voter in sight. An upper house called ‘The Upper House’, chosen as now for competence, will be a House of Commoners, of Independence, of Contradiction. Elected Party‐liners under guidance would be a House of Sheep.
Cerebrospinal fluid and serum antibodies against neurofilaments in patients with amyotrophic lateral sclerosis
Authors: Fialová L. , Švarcová J. , Bartos A. , Ridzoň P. , Malbohan I. , Keller O. , Rusina R. 
Published: November 2009

Background: The aim of the study was to assess autoimmune involvement in amyotrophic lateral sclerosis (ALS).Methods: We measured IgG antibodies against light (NFL) and medium (NFM) subunits of neurofilaments using ELISA in paired cerebrospinal fluid (CSF) and serum samples from 38 ALS patients and 20 controls.Results: Serum levels of anti‐NFL were higher in ALS patients than in controls (P < 0.005). Serum anti‐NFL antibodies and intrathecal anti‐NFM antibodies were related to patient disability (serum anti‐NFL:P < 0.05; intrathecal anti‐NFM:P < 0.05). Anti‐NFL levels were significantly correlated with anti‐NFM levels in ALS (P < 0.001) and the control group (P < 0.0001) in the CSF, but not in serum. Anti‐NFL and anti‐NFM antibodies significantly correlated between serum and CSF in the ALS group (anti‐NFL:P < 0.0001; anti‐NFM:P < 0.001) and in the control group (anti‐NFL:P < 0.05; anti‐NFM:P < 0.05).Conclusions: Autoimmune humoral response to neurocytoskeletal proteins is associated with ALS.
Lipid profile in normal weight migraineurs – evidence for cardiovascular risk
Authors: Gruber H. ‐J. , Bernecker C. , Pailer S. , Lechner A. , Horejsi R. , Möller R. , Fazekas F. , Truschnig‐Wilders M. 
Published: November 2009

Background:  Recent studies suggest that migraine is associated with metabolic disorders. In particular, migraine may be associated with cardiovascular risk; however, an association of migraine with cardiovascular risk factors like hypercholesterolemia has been proposed, but previous studies have yielded in part conflicting results. The aim of the present study is to evaluate the lipid profile in normal weight migraine patients.Methods:  One hundred thirty‐six probands participated in this study. The study group was divided into normal weight migraineurs and control groups, including normal weight controls, obese and overweight controls and migraineurs. Various parameters of the lipid metabolism and inflammatory parameters were investigated.Results:  We found significant increased cholesterol, low density lipoprotein cholesterol (LDL‐C) and oxidized LDL‐C in normal weight migraineurs. Increased oxidized LDL‐C was associated with a 7.93‐fold increased risk for migraine. Alterations in the lipid profile were not accompanied by increased inflammatory parameters.Conclusions:  We show here that normal weight migraineurs exhibit independent of aura symptoms an atherogenic lipid profile, which shares common features with obesity‐related lipid alterations. Our data suggest that migraine is associated with a higher risk for cardiovascular disease and its clinical consequences.
Cerebral perfusion‐CT patterns following seizure
Authors: Gelfand J. M. , Wintermark M. , Josephson S. A. 
Published: November 2009

Background:  Cerebral perfusion‐CT (PCT) is commonly used to image patients with suspected stroke, but PCT may also be useful in detecting abnormalities following seizure.Methods:  We retrospectively identified patients who presented to our stroke center between 2000 and 2008 with acute, transient neurological deficits because of seizure and received PCT imaging within 72 h. We compared the group of seizure patients with abnormal post‐ictal PCT to a group of seizure patients with normal post‐ictal PCT. Patients were excluded from analysis if the seizure occurred secondary to an acute process known to alter cerebral perfusion.Results:  Of 27 patients with acute post‐ictal neurological deficits, PCT was abnormal in 10 (37%) and normal in 17 (63%). The most common post‐ictal perfusion abnormality, seen in eight of 10 patients, was focal hypoperfusion, with prolonged mean transit time (MTT) and decreased cerebral blood flow and cerebral blood volume, in a cortical ribbon pattern, multi‐lobar or holo‐hemispheric distribution, sparing the basal ganglia. CT Angiography (CTA) showed no corresponding large vessel pathology. Two other PCT abnormalities – focal hyperperfusion and an isolated prolonged MTT – were also observed in single patients. Imaging within 2 h after seizure termination was significantly associated with finding a post‐ictal PCT abnormality (P < 0.039).Conclusions:  Post‐ictal cerebral PCT abnormalities are relatively common in patients early after seizure. When PCT abnormalities occur in atypical vascular distributions – and the CTA shows no corresponding large vessel occlusions – seizure should be considered as a diagnostic possibility prior to giving acute stroke therapy.
The effect of cleft lip on socio‐emotional functioning in school‐aged children
Authors: Murray Lynne , Arteche Adriane , Bingley Caroline , Hentges Françoise , Bishop Dorothy V.M. , Dalton Louise , Goodacre Tim , Hill Jonathan ,   the Cleft Lip and Palate Study team
Published: November 2009

Background: Children with cleft lip are known to be at raised risk for socio‐emotional difficulties, but the nature of these problems and their causes are incompletely understood; longitudinal studies are required that include comprehensive assessment of child functioning, and consideration of developmental mechanisms.Method: Children with cleft lip (with and without cleft palate) (N = 93) and controls (N = 77), previously studied through infancy, were followed up at 7 years, and their socio‐emotional functioning assessed using teacher and maternal reports, observations of social interactions, and child social representations (doll play). Direct and moderating effects of infant attachment and current parenting were investigated, as was the role of child communication difficulties and attractiveness.Results: Children with clefts had raised rates of teacher‐reported social problems, and anxious and withdrawn‐depressed behaviour; direct observations and child representations also revealed difficulties in social relationships. Child communication problems largely accounted for these effects, especially in children with cleft palate as well as cleft lip. Insecure attachment contributed to risk in both index and control groups, and a poorer current parenting environment exacerbated the difficulties of those with clefts.Conclusions: Children with clefts are at raised risk for socio‐emotional difficulties in the school years; clinical interventions should focus on communication problems and supporting parenting; specific interventions around the transition to school may be required. More generally, the findings reflect the importance of communication skills for children’s peer relations.
Light induces Fos expression via extracellular signal‐regulated kinases 1/2 in melanopsin‐expressing PC12 cells
Authors: Moldrup Marie‐Louise , Georg Birgitte , Falktoft Birgitte , Mortensen Rikke , Hansen Jakob Lerche , Fahrenkrug Jan 
Published: November 2009

J. Neurochem. (2010) 112, 797–806.AbstractThe photopigment melanopsin is expressed in a subtype of mammalian ganglion cells in the retina that project to the circadian clock in the hypothalamic suprachiasmatic nucleus to mediate non‐visual light information. Melanopsin renders these retinal ganglion cells intrinsically photosensitive and the cells respond to light by a membrane depolarization and induction of the immediate early response gene Fos. Previous studies showed that the light activated melanopsin‐induced signaling, the phototransduction, leading to depolarization of the membrane resembles the invertebrate opsins, which involves a Gαq/11 coupled phospholipase C activation. However, the signaling proteins mediating melanopsin‐induced Fos expression are unresolved. In this study, we examined the phototransduction leading to Fos expression in melanopsin‐transfected PC12 cells. A pivotal role of the extracellular signal‐regulated protein kinase 1/2 (ERK1/2) was found as pharmacological blockage of this kinase suppressed the light‐induced Fos expression. Illumination increased the inositol phosphate turnover and induced phosphorylation of ERK1/2 and p38 but not the c‐Jun N‐terminal kinase. The Gαq/11 protein inhibitor YM254890 attenuated these intracellular light responses. Our data strongly indicate that Gαq/11‐mediated ERK1/2 activation is essential for expression of Fos upon illumination of melanopsin‐expressing PC12 cells.
Presence of conspecifics and their odor‐impregnated objects reverse stress‐decreased neurogenesis in mouse dentate gyrus
Authors: Cherng Chianfang G. , Lin Pei‐Syuan , Chuang Jia‐Ying , Chang Wan‐Ting , Lee Yung‐Shuan , Kao Gour‐Shenq , Lai Yu‐Ting , Yu Lung 
Published: November 2009

J. Neurochem. (2010) 112, 1138–1146.AbstractStress and corticosterone level are thought to negatively associate with neurogenesis in mammalian brains. Social support can diminish many adverse effects of stress. The present study examined the modulating effect of social support on stress‐decreased cell proliferation and neuronal differentiation in a mouse model. A randomly‐scheduled foot shock followed by restraint in water was used as a profound stress‐provoking regimen. Bromodeoxyuridine (BrdU) staining was used to indicate newly mitotic cells and doublecortin (DCx) staining was used to reveal immature neurons. This stress‐provoking regimen rapidly decreased BrdU‐ and BrdU/DCx‐labeled cells in the dentate gyrus. However, such a stress‐provoking regimen did not affect the number of these labeled cells in the subventricular zone. Familiar and unfamiliar mice’ company throughout the stress regimen completely reversed the stress‐decreased cell proliferation and neuronal genesis in the dentate gyrus. Likewise, both odor‐familiar (from their home cages) and ‐unfamiliar (from cages other than their home cages) wooden blocks completely reversed the stress‐decreased BrdU/DCx‐labeled cells in the dentate gyrus. In contrast, wooden blocks free of any odor and camphor odor alone failed to affect the stress‐decreased BrdU‐ or BrdU/DCx‐labeled cells. Finally, we showed that conspecifics or their odors during the stress regimen reversed the stress‐decreased cell proliferation and neuronal differentiation in the dentate gyrus via a corticosterone‐independent mechanism. We conclude that stress and familiarity distinctively affect neurogenesis in the dentate gyrus and subventricular zone. Conspecific companions or presence of their odors reverse stress‐decreased neurogenesis in the dentate gyrus, suggesting that social support during stress exposure may improve neurogenesis‐related psychological functions.
Social Changes and Welfare Reform in South Korea: In the Context of the Late‐coming Welfare State
Authors: Kim Sung‐won 
Published: November 2009

AbstractThe Korean welfare state is facing diverse pressures and challenges due to changing economic, social, and demographic circumstances: prevalence of the service economy, labor market flexibility, weakened family function and increase of untraditional families, lowest fertility rate and the most rapid ageing of the population among OECD countries, and so forth. These challenges, which indicate new types of social risks, have been stimulating a series of discussions on welfare reform in Korea. The old social risks such as retirement, ill health, poverty, and unemployment have not disappeared because of insecure or inadequate welfare, and now these risks are even intertwined with the so‐called new social risks. Thereby the Korean welfare state is facing complicated reform tasks. This study attempts to analyze the structure and context of these challenges in Korea, and to explore the various driving forces that have formulated Korean welfare reform in recent decades. Through the above analyses, this study will shed light the characteristics of welfare reform in Korea as a late‐coming welfare state.
International Circumstances as Factors in Building a Welfare State: Welfare Regimes in Europe, Japan and Korea
Authors: Takegawa Shogo 
Published: November 2009

AbstractThe East Asian experiences of welfare‐state building have universal implications for the sociology of the welfare state because they clearly indicate the relevance of international circumstances to welfare‐state building. The convergence theory of the welfare state lays emphasis on the economic development, demographic structure, and age of the social security system. The path dependency theory regards a country's social structure and history as important. However, both these theories clearly state the importance of the domestic factors as well. On the contrary, the East Asian experiences show that the dates of the takeoff of the welfare state and the international context at that time were decisive for the subsequent development of the welfare state. The European welfare states are considered to be a by‐product of “embedded liberalism.” The Japanese welfare state, on the other hand, was established in the context of the worldwide stagflation of the 1970s; therefore, Japan experienced the formation and crisis of the welfare state at the same time and this is what characterized its present welfare system. The Korean welfare state emerged in the age of global capitalism and was consequently shaped by the co‐occurrence of welfare and workfare. Given the above, it can be said that the international circumstances faced by each welfare state characterized the three worlds of welfare capitalism: Europe, Japan, and Korea.
Social Change and Social Policy in China: National Adaptation to Global Challenge
Authors: Xiong Yuegen 
Published: November 2009

AbstractAs a part of designed human intervention against social problems, social policy has to respond and adapt to social changes. In this article, the author aims to discuss social changes that occurred in the past decade in China (including economic, demographic, and cultural changes) and relate them to relevant social policies formulated by the Chinese government to address the concerned social issues. To interpret the roles of the state, nongovernmental organizations (NGOs), and the community in tackling social problems in the changing context of the market economy and globalization, the author attempts to provide a theoretical explanation on the emergence of social policy in China in a new era and to further re‐assess the concept of the welfare regime in East Asian countries.