bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnosing Psychosocial Problems
Authors: Kelleher Kelly J. , Wolraich Mark L.
Published: December 2021

In April 1996, the American Academy of Pediatrics (AAP) Task Force on Mental Health Coding for Children completed 4 years of work on the development of a classification system for children's mental health appropriate for primary care clinicians with the publication of the Diagnostic and Statistical Manual for Primary Care—Child Version (DSM-PC). This work represents a multidisciplinary effort spearheaded by the AAP and supported by grants from the Bureau of Maternal and Child Health, the Robert Wood Johnson Foundation, and the Friends of Children Fund to create a more prevention-oriented, developmentally based system for classifying psychosocial diagnoses of children and adolescents in primary care with mental health symptoms.
Letter To The Editor
Authors: Kohl Steve
Published: December 2021

Dr May's letter raises the important question of the use of varicella vaccine in households with high-risk hosts such as neonates of varicella-susceptible mothers, varicella-susceptible pregnant women, HIV-positive individuals, or individuals receiving immunosuppressive therapy. The manufacturer warns that vaccine recipients avoid such hosts.

On the basis of low to absent levels of transmission of vaccine from healthy recipients to others, the Committee on Infectious Diseases feels this is a very unlikely occurrence. In the Weibel study, using a vaccine with ten times the current vaccine viral load, there were no symptomatic transmissions to unvaccinated siblings, and only 3/439 seroconversions attributed to vaccine transmission (although these actually may have been attributed to wild virus).1
Rapid Placement of Transpyloric Feeding Tubes: A Comparison of pH-assisted and Standard Insertion Techniques in Children
Authors: Krafte-Jacobs Brian , Persinger Melody , Carver Jeannean , Moore Lori , Brilli Richard
Published: December 2021

Objective. To compare transpyloric feeding tube placement using a pH-assisted placement technique versus a standard placement technique in pediatric patients requiring enteral nutrition.

Methods. Critically ill children younger than 4 years were prospectively and randomly assigned to either a pH-assisted or a standard feeding tube placement group. Identical pH-assisted feeding tubes were used in both groups; however, feeding tubes in the standard group were not attached to a portable pH meter. Successful transpyloric placement was confirmed by radiography before beginning feedings. If placement was not successful, a second placement attempt was made after metoclopramide administration. Information regarding tube placement success, number of radiographs, time to initiaction of feedings, and daily caloric intake was collected. A cost comparison between the two groups was performed.

Results. Thirty-four patients were enrolled in the pH-assisted group, and 34 were enrolled in the standard feeding tube group. Ninety-seven percent of patients in the pH-assisted group had successful placement after the first attempt, compared with 53% of patients in the standard group. The average time to successful placement of pH-assisted feeding tubes was 6 minutes. All patients in the pH-assisted group had successful placement after the second attempt, compared with 78% of patients in the standard group. A pH of greater than 5.6 accurately predicted transpyloric placement in 97% (33 of 34) of individuals in the pH-assisted group. Children in the pH-assisted group required significantly fewer radiographs than those in the standard group. Hospital costs were $114 per patient in the pH-assisted group and $135 per patient in the standard group.

Conclusions. Our findings indicate that bedside transpyloric placement of pH-assisted feeding tubes can be accomplished rapidly and with a high success rate. This method is associated with decreased radiation exposure and economic savings when compared with a standard placement technique.
African-American Adolescents Residing in High-risk Urban Environments Do Use Condoms: Correlates and Predictors of Condom Use Among Adolescents in Public Housing Developments
Authors: DiClemente Ralph J. , Lodico Mark , Grinstead Olga A. , Harper Gary , Rickman Richard L. , Evans Patricia E. , Coates Thomas J.
Published: December 2021

Objective. African-American adolescents living in high-risk inner-city environments have been disproportionately affected by the epidemics of human immunodeficiency virus (HIV) and other sexually transmitted diseases. Understanding the factors that influence the use of condoms by adolescents is critical for developing effective behavioral interventions. The present study examined the demographic, psychosocial, and behavioral correlates of condom use among African-American adolescents residing in public housing developements in an HIV epicenter (San Francisco) and prospectively evaluated the stability of these significant cross-sectional variables to predict consistent condom use.

Design. A prospective study.

Setting. Two public housing developments in San Francisco.

Participants. African-American adolescents and young adults between 12 and 21 years of age were recruited though street outreach and completed a theoretically derived research interview assessing HIV-related knowledge, attitudes, and behaviors. After a 6-month period, adolescents completed a follow-up interview similar to the baseline measure. Among adolescents reporting sexual activity in the 6 months before completing the baseline interview (n = 116), logistic regression analysis evaluated the influence of demographic, psychosocial, and behavioral factors on consistent condom use.

Results. Adolescents who had high assertive self-efficacy to demand condom use (adjusted odds ratio [OR], 11), perceived peer norms as supporting condom use (OR, 4.2), had greater impulse control (OR, 3.7), were male (OR, 4.7), and were younger (OR, 2.9) were more likely to report consistent condom use. Frequency of sexual intercourse was inversely related to condom use; adolescents with higher numbers of sexual episodes were less likely to use condoms consistently. Prospective analyses identified the baseline level of condom use as the best predictor of condom use at the 6-month followup Adolescents who were consistent condom users at baseline were 7.4 times as likely to be consistent condom users during the follow-up period. Of those adolescents changing their frequency of condom use during the follow-up interval, significantly more engaged in risky behavior; 33.3% changed from consistent to inconsistent condom use, whereas 20.6% changed from inconsistent to consistent use (OR, 1.6).

Conclusions. The findings suggest that HIV prevention programs need to be implemented early, before high-risk behaviors are established and may be more difficult to modify.
T CELL "PRIMING" AGAINST ENVIRONMENTAL ALLERGENS IN HUMAN NEONATES: SEQUENTIAL DELETION OF FOOD ANTIGEN REACTIVITY DURING INFANCY WITH CONCOMITANT EXPANSION OF RESPONSES TO UBIQUITOUS INHALANT ALLERGENS
Authors: Zeiger Robert S.
Published: December 2021

These proliferative T cell findings indicate reciprocal patterns of responses to food and aeroallergens. T cell responses to foods occur often at birth and in infants and infrequently among adults, while aeroallergen reactivity present early in life are preserved and expanded between infancy and adulthood.
A DOSE-RESPONSE STUDY OF THE EFFICACY AND SAFETY OF IPRATROPIUM BROMIDE NASAL SPRAY IN THE TREATMENT OF THE COMMON COLD
Authors: Sachs Martin
Published: December 2021

Ipratropium nasal spray was found to be effective in reducing the specific symptom of rhinorrhea in patients with the common cold. A dose of 84 µg in each nostril produced demonstrable relief of rhinorrhea within 1-hour.
SHORTENED SURVIVAL IN INFANTS VERTICALLY INFECTED WITH HUMAN IMMUNODEFICIENCY VIRUS WITH ELEVATED p24 ANTIGENEMIA
Authors: Church Joseph A.
Published: December 2021

Elevated p24 antigenemia in the first 6 months of life is associated with shorter survival and appears to be a useful predictor of outcome.
Nosocomial Infections Among Neonates in High-risk Nurseries in the United States
Authors: Gaynes Robert P. , Edwards Jonathan R. , Jarvis William R. , Culver David H. , Tolson James S. , Martone William J. ,   National Nosocomial Infections Surveillance System
Published: December 2021

Background. Nosocomial infections result in considerable morbidity and mortality among neonates in high-risk nurseries (HRNs).

Purpose. To examine the epidemiology of nosocomial infections among neonates in level III HRNs.

Methods. Data were collected from 99 hospitals with HRNs participating in the National Nosocomial Infections Surveillance system, which uses standard surveillance protocols and nosocomial infection site definitions. The data included information on maternal acquisition of and risk factors for infection, such as device exposure, birth weight category (≤1000, 1001 through 1500, 1501 through 2500, and >2500 g), mortality, and the relationship of the nosocomial infection to death.

Results. From October 1986 through September 1994, these hospitals submitted data on 13 179 nosocomial infections. The bloodstream was the most frequent site of nosocomial infection in all birth weight groups. Nosocomial pneumonia was the second most common infection site, followed by the gastrointestinal and eye, ear, nose, and throat sites. The most common nosocomial pathogens among all neonates were coagulase-negative staphylococci, Staphylococcus aureus, enterococci, Enterobacter sp, and Escherichia coli. Group B streptococci were associated with 46% of bloodstream infections that were maternally acquired; coagulase-negative staphylococci were associated with 58% of bloodstream infections that were not maternally acquired, most of which (88%) were associated with umbilical or central intravenous catheters.

Conclusions. Bloodstream infections, the most frequent nosocomial infections in all birth weight groups, should be a major focus of surveillance and prevention efforts in HRNs. For bloodstream infections, stratification of surveillance data by maternal acquisition will help focus prevention efforts for group B streptococci outside the HRN. Within the nursery, bloodstream infection surveillance should focus on umbilical or central intravenous catheter use, a major risk factor for infection.
Accidental Administration of an Ergot Alkaloid to a Neonate
Authors: Baum Carl R. , Hilpert Pamela L. , Bhutani Vinod K.
Published: December 2021

We describe a neonate with altered splanchnic arterial blood flow after accidental substitution of an ergot alkaloid, methylergonovine maleate (MEM), for vitamin K1.

CASE REPORT

A 2977-g female product of a full-term pregnancy was born in a hospital birthing suite via spontaneous vaginal delivery to a 26-year-old gravida 6, para 5 mother. Apgar scores were 9 at 1 minute (–1 for color) and 9 at 5 minutes (–1 for color). At approximately 90 minutes of age, the neonate was inadvertently administered 0.5 mL (0.1 mg) of MEM instead of phytonadione (vitamin K1) via intramuscular injection. The error was recognized during administration of a 1-mL premeasured adult dose of the ergot derivative, intended for control of postpartum uterine hemorrhage.
Use of Health Care Services by Inner-city Infants in an Early Discharge Program
Authors: Cooper William O. , Kotagal Uma R. , Atherton Harry D. , Lippert Carrie A. , Bragg Elizabeth , Donovan Edward F. , Perlstein Paul H.
Published: December 2021

Objective. To assess the use of health care services by inner-city infants enrolled in an early discharge program who received care in a tertiary care children's hospital primary care clinic.

Design. Retrospective cohort study.

Setting. Large, metropolitan university hospital and a children's hospital.

Patients. Term infants cared for in a single full-term nursery, before and after implementation of a coordinated early discharge program, who received primary care at the children's hospital.

Intervention. The coordinated Early Discharge Program was characterized by in-hospital visits by hospitalbased coordinating nurses, home visits by nurses from a home nursing agency, and communication with physicians for necessary adjustments in postdischarge care.

Methods. After linking birth hospital records and the children's hospital medical records, a retrospective chart review was performed to obtain maternal demographic information and birth hospital length of stay, as well as the infants' attendance at primary care clinic, immunizations, emergency department visits, and rehospitalization.

Main Outcome Measures. Number of primary care visits in the first 3 months of life, completion of one series of immunizations by 3 months of life, and number of emergency department visits and rehospitalization during the first 3 months of life.

Results. The early discharge group (n = 253) had a significantly shorter birth hospital length of stay (35 ± 24 hours, mean ± SD) when compared with the control group (n = 212) (52 ± 14 hours). The early discharge group was also younger than the control group at the first primary care visit, with significantly more infants visiting the primary care clinic in the first month of life. There was also a significant difference between the groups in the mean number of emergency department visits (early discharge = .61 visits/patient, control = .79 visits/patient) and the proportion of patients with no emergency department visits during the first 3 months of life (early discharge = 57%, control = 43%). There was no difference between the two groups in the proportion of infants completing one series of immunizations or in the number of infants rehospitalized during the study period.

Conclusions. Coordinated early discharge with home nursing visits for inner-city infants may result in earlier use of primary care services. Furthermore, there is a significant decrease in use of the emergency department during the first 3 months of life, and no increase in rehospitalization.
Automatic Garage Door Openers: Hazard for Children
Authors: Kriel Robert L. , Gormley Mark E. , Krach Linda E. , Luxenberg Michael G. , Bartsh Shawn M. , Bertrand Jolene R.
Published: December 2021

Objectives. Despite significant advances in automatic garage door opener design, automatic garage door openers continue to severely injure or kill children. In this investigation, we sought to determine the frequency and circumstances of accidents that have caused severe injury or death to children. We also tried to develop a means by which homeowners can evaluate their door openers.

Methods. We present the histories of three children severely injured or killed by automatic garage door openers. We reviewed national data of similar accidents primarily published by the US Product Safety Commission and Underwriters Laboratories. Also, we evaluated 50 automatic door openers for safety of operation. The reversing mechanisms of door openers were tested using a cardiopulmonary resuscitation mannequin, a roll of paper towels, and a block of wood.

Results. In the United States, at least 85 children have had permanent brain injury or have died since 1974 as a result of accidents involving automatic door openers. A review of circumstances of the accidents illustrates that accidents are caused both by use of the openers by children and by faults in design. Most accidents have occurred when children have found access to the activation devices and have been entrapped under closing doors that failed to reverse. However, in one case, an adult activated the opener and left the premises before the door completely closed. Our evaluation of 50 garage door openers showed that although 88% percent reversed when encountering a block of wood, 40% failed to reverse when coming down on a supine, child-sized cardiopulmonary resuscitation mannequin.

Conclusions. Automatic garage door openers pose a serious risk of severe injury or death to children. It is probable that many doors would not reverse if they came down on a young child. Therefore, we have devised a way for homeowners to test their door openers that closely mimics our evaluations using the mannequin by using a large roll of paper towels. If the door fails to reverse using this test, we suggest that homeowners disconnect their openers and operate the doors manually until the openers are serviced or replace their automatic openers with one that meets the latest Underwriters Laboratory standards. We also have other recommendations regarding the safe operation of the doors, including improving the safety standards for openers in apartment complexes. Compliance with these recommendations should reduce the number of injuries to children caused by garage door openers.
The Role of the Primary Care Pediatrician in the Management of High-risk Newborn Infants
Authors:   Committee on Practice and Ambulatory Medicine and Committee on Fetus and Newborn
Published: December 2021

Quality care for high-risk newborns can best be provided by coordinating the efforts of the primary care pediatrician and the neonatologist. This ideally occurs in the newborn period, during the critical care and convalescing periods, and through the time of discharge. This statement offers guidelines for the primary care pediatrician involved in providing neonatal care, and discusses his/her individual and shared responsibilities, roles, and relationships with the neonatologist and the neonatal intensive care unit.
Letter To The Editor
Authors: Judelsohn Richard
Published: December 2021

Dr Schneider raises many cogent points in his letter. Of utmost importance is the assessment, based on his personal experience, that a more complex vaccination schedule may decrease immunization rates, particularly in low socioeconomic and other disadvantaged populations. The outcome could be increased cases of vaccine-preventable diseases, in particular measles, pertussis, and polio.

Secondly, he emphasizes the increasingly significant role of cost factors in expenditures for health care. In the public health arena, local, state, and federal lawmakers and executives are frugal.
Acellular Pertussis Trial
Authors: Hewlett Erik L.
Published: December 2021

In the supplement to Pediatrics entitled Report of the Nationwide Multicenter Acellular Pertussis Trial, Edwards et al1 describe the serologic responses to individual antigens in thirteen acellular pertussis vaccines which were evaluated in the phase I/II trials performed by National Institute of Allergy and Infectious Diseases-supported Vaccine Treatment and Evaluation Units. In that article, the authors comment that "postimmunization geometric mean (antibody) titers [against pertussis toxin] differed significantly among the acellular vaccine groups and did not seem to correlate with the pertussis toxin (PT) antigen content of the vaccines."
Advising Parents on Discipline: What Works
Authors: Howard Barbara J.
Published: December 2021

Discipline for children is one of the most common behavioral issues encountered when providing health care for children, and 90% of pediatricians report that they include advice about discipline most of the time when providing anticipatory guidance to families.1 Although we should provide advice for discipline strategies that have evidence of being effective, this goal is quite complex because of the broad scope of what constitutes discipline and the multifactorial etiology of behavior problems.

THE BROAD SCOPE OF DISCIPLINE

Discipline refers to systems of teaching, learning, and nurturing that are used in child rearing. These systems include procedures that encourage appropriate behavior and deter misbehavior according to the child's developmental abilities. The systems' ultimate goals are for the child to achieve competence, self-control, and self-direction.2 Some children make these teaching tasks more difficult than others, often due to differences in temperament.3 Children who have aspects of their personality defined as "difficult" are both more likely to have behavior problems and to present a challenge for caregivers trying to be consistent and positive in their discipline teaching. Children with diagnosable mental health problems or developmental disabilities, including attention deficit hyperactivity disorder, often have their own additional special difficulties with socialization and learning. Conversely, children with higher intelligence and better language skills are more resilient to stress, have fewer behavior problems, and respond better to parent-mediated behavior training and therefore are easier to discipline.

Many other factors affect a caregiver's ability to conceive of, establish, and maintain a system of discipline. Many of the same parental factors that interfere with establishing optimal discipline and responding to parent intervention programs are the ones that make it more likely that the child will have problematic behaviors.
FOREWORD
Authors: Sanders Joe M.
Published: December 2021

Effective disciplining of children has been one of the most perplexing issues of parenting since time immemorial. In order to grow into a responsible, capable adult, a child must learn how to function within his immediate and extended environment, to learn right from wrong and good from bad, to be respected by others, and to be respectful of others. Children learn by following examples set by parents and other authority figures, by testing the standards society imposes upon them, and by simple acts of trial and error. They will inevitably make mistakes along this long and complex journey as they learn to control their impulses and funnel their boundless energy into appropriate channels of activity. A major challenge of parenthood is how best to ensure the lesson is learned. Is this best achieved by a thoughtful discussion or by disciplinary spanking?

The controversial subject of corporal punishment—defined as spanking or some other form of physical discipline—was addressed at an invitational conference in February 1996. Although no definite conclusions were reached, an important series of consensus statements have been developed that should form the basis for further study of this obligatory function of parenting.

As a co-sponsor of this conference, the American Academy of Pediatrics would like to acknowledge the following whose efforts contributed immeasurably to the success of this endeavor:

The Department of Pediatrics at the Montefiore Medical Center, Albert Einstein College of Medicine, and specifically to Dr Stanford B. Friedman and Dr S. Kenneth Schonberg, who conceived the idea, organized the program, and served as conference co-chairs.
Nonprotein-bound Iron in Postasphyxial Reperfusion Injury of the Newborn
Authors: Dorrepaal Caroline A. , Berger Howard M. , Benders Manon J.N.L. , van Zoeren-Grobben Diny , Van De Bor Margot , Van Bel Frank
Published: December 2021

Objective. To investigate if the availability of nonprotein-bound iron after birth asphyxia is related to the severity of the postasphyxial injury and neurodevelopmental outcome.

Methods. Nonprotein-bound iron (bleomycin assay) and thiobarbituric-acid-reactive species, an index of oxidative lipid damage, were measured in plasma of 50 newborn infants (gestational age > 34 weeks) between 0 to 8 hours, 8 to 16 hours, and 16 to 24 hours after birth. Three groups were compared: healthy infants (n = 20), moderately asphyxiated infants (n = 15), who were neurologically normal during the first 24 hours after birth and severely asphyxiated infants (n = 15), who developed abnormal neurological signs in the first 24 hours after birth.

Results. In the severely asphyxiated infants, liver enzymes, creatinine, urea, and uric acid concentrations were significantly elevated. Eleven severely asphyxiated infants were brain-damaged, 9 of them died during the neonatal period. Nonprotein-bound iron was detectable in 30% of the control, 60% of the moderately asphyxiated, and 80% of the severely asphyxiated infants. During the whole study period nonprotein-bound iron concentration was significantly elevated in severely asphyxiated infants as compared with controls. Three of the four severely asphyxiated infants who had a normal outcome at 1 year of age, had no detectable nonprotein-bound iron during the study period. Stepwise logistic regression analysis with neurodevelopmental outcome at 1 year of age (normal versus adverse/death) as dependent variable and all the measured parameters for organ damage as independent variables revealed that the nonproteinbound iron concentration at 0 to 8 hours after birth was the most significant variable and at the same time the only variable that entered the model, in relation to neurodevelopmental outcome. Thiobarbituric-acid-reactive species tended to be higher in severely asphyxiated infants, suggesting oxidative lipid damage.

Conclusion. Nonprotein-bound iron may play an important role in oxidative damage-mediated postasphyxial brain injury and subsequent neurodevelopmental outcome.
Pediatric Trauma: Impact on Work and Family Finances
Authors: Osberg J. Scott , Kahn Paul , Rowe Katherine , Brooke Marvin M.
Published: December 2021

Objectives. National data now exist on incidence, prevalence, and cost of injury. However, the personal impact of injury on work and family finances has not been thoroughly studied. We examine the extent and nature of work and financial problems after pediatric trauma and identify predictors. Clinicians are alerted so they can better counsel parents about potential postinjury work and financial difficulties.

Methods. Staff collected comprehensive data on the acute care and short-term rehabilitation of 182 Massachusetts children with injuries. Consenting parents were surveyed and their children were given a battery of medical, functional, and psychosocial tests. Information on work and financial impact at 1 and 6 months postinjury was available from 120 parents.

Results. Given these children's generally mild injuries, the impact on work and family finances was remarkable. For many families work and financial problems were short-lived; however, for others serious problems remained at 6 months postdischarge. Families whose children were severely injured were at highest risk for work and financial problems. Middle-class parents and parents on public assistance or in our other insurance category reported more work and financial problems than those in health maintenance organizations. Long acute hospital stay and four or more impairments at discharge were also strong predictors.

Conclusion. Childhood injury can lead to serious work and financial problems for families. Given the central role of the family in pediatric rehabilitation, clinicians and policymakers involved in acute trauma care and rehabilitation should pay greater attention to the financial repercussions of injury.
Interchangeability of Haemophilus influenzae Type b vaccines in the Primary Series: Evaluation of a Two-dose Mixed Regimen
Authors: Bewley Kathleen M. , Schwab Joel G. , Ballanco Gerard A. , Daum Robert S.
Published: December 2021

Objective. To evaluate two- or threedose "mixed" regimens of Haemophilus influenzae type b conjugate vaccines in the priming series.

Design. Two randomized clinical trials with 140 and 181 infants, respectively.

Setting. Private practices in New Orleans and Chicago.

Methods. In trial I, infants received one of four regimens. Two were recommended regimens for polyribosylribitol phosphate (PRP)—meningococcal protein conjugate (M) and PRP—tetanus toxoid conjugate (T). Two mixed regimens consisted of M at 2 months followed by two doses of T or PRP—diphtheria toxoid conjugate (D) at 4 and 6 months. Trial II consisted of three groups. Two were recommended regimens for M and T. The third was a two-dose mixed regimen consisting of M at 2 months and T at 4 months. Parents were interviewed and instructed to record side effects after each vaccination. Serum was assayed for H influenzae type b anticapsular antibody (anti-PRP).

Results. Minor differences in safety profiles likely reflected α error. In trial I, M (lot 0884T, one of several known to have had decreased immunogenicity), probably primed for substantial increase in serum antibody when D or T was given at 4 and 6 months. In trial II, infants who received the two-dose mixed regimen (M from immunogenic lot 0116W at 2 months and T at 4 months) had a significantly higher mean area under the curve than recipients of the three-dose TIT regimen when antibody concentration was plotted against age, although the geometric mean anti-PRP antibody concentration for the MT-recipients was significantly lower at 7 months.

Conclusions. M used in trial I may have primed infants despite poor immunogenicity. The two-dose mixed regimen (MT-) in trial II produced a mean anti-PRP antibody concentration with higher sustained anti-PRP concentrations from 2 to 7 months, as judged by the area under the curve, but a lower mean anti-PRP antibody concentration at 7 months.
Commentary on the Revised Vaccine Injury Table
Authors: GLEZEN W. PAUL
Published: December 2021

New guidelines for the national Vaccine Injury Compensation Program (VICP) have been announced. Several important changes are included in the revised Vaccine Injury Table. First, a new condition of chronic arthritis was added to the Table for vaccines containing the attenuated rubella virus. Second, the time of onset for certain conditions in relation to the time of vaccine administration was altered. For instance, the interval for onset of anaphylaxis after vaccination was shortened from 24 hours to 4 hours. Clarification of definitions of conditions such as encephalopathy were made in the Qualifications and Aids to Interpretation that accompany the Table. Finally, some conditions, such as residual seizure disorder and hypotonic-hyporesponsive episode after diphtheria-tetanus-pertussis (DTP) immunization, were removed from the Table.
Positioning and Sudden Infant Death Syndrome (SIDS): Update
Authors:   TASK FORCE ON INFANT POSITIONING AND SIDS
Published: December 2021

This statement provides an update to the June 1992 American Academy of Pediatrics' policy, "Infant Positioning and SIDS," which recommended that healthy term infants be placed on their sides or backs to sleep. Recent data show that the original policy appears to have had a positive effect in decreasing the prevalence of prone sleeping significantly. Simultaneously, the SIDS rate in the United States has also dropped. New data also suggest that the supine position confers the lowest risk; however, the side position is still significantly safer than the prone position. Additional information regarding sleeping surface and exceptions to these recommendations are addressed.
Some Unchanging Values of Pediatric Education During a Time of Changing Technology and Practice
Authors: Behrman Richard E.
Published: December 2021

A few of the opportunities and difficulties of educating pediatric residents in a particular community-based setting, the managed care organization, are discussed in this article. Some of these organizations have deliberately recruited corporate employees with young families, offering relatively complete coverage. Quality problems remain, however. Children may benefit, because managed care arrangements may reduce overdiagnosis and overtreatment, but children may also be deprived, particularly in Medicaid managed care programs, of needed, appropriate care. Pediatric faculties must be confident about the quality of care, the quality of teaching, and the opportunity for residents to develop interpersonal skills before residents are placed in managed care settings.

First, however, important, broader aspects of contemporary pediatric education are discussed. These essentials of contemporary pediatric education apply in any setting, community based or not, and not only to physicians in training, but to those who are delivering ongoing care as well.

A case study illustrates the impact of technologic advances on medical diagnosis and management. Such advances may lead to the chance for better outcomes but also to confusion, including misperceptions about disease prevalence, the natural history of disease, and therapeutic effectiveness.

To meet patient needs and to provide a medically educated physician, the understanding of biology and disease that grows out of scientific advances must be balanced with the illness-related functions of the physician. Two approaches to this goal are suggested: (1) the epidemiologic and demographic anatomy of the health of populations and the socioeconomic kinetics of our society and its diverse value systems relevant to health care should be deliberately structured into all phases of medical education; and (2) the sites of the educational process should be diversified so that residents are placed, perhaps as much as half the time, in those settings in which most patients interact with physicians.
Geochemistry and Petrogenesis of Basic Paleogene Volcanic Rocks in Alamut Region
Authors: Nazari Sarem Mehdi , Vosoghi Abedini Mansour , Dabiri Rahim , Ansari Mohammad Reza
Published: December 2021

Structurally, the study area belongs to the tectonic range of the Central Alborz. The rocks were analyzed to detect main elements as well as rare and rare earth elements. Based on microscopic studies, the rocks in the region include basalt, trachyandesite and basaltic andesite with alkaline geochemical properties. According to geochemical studies, the early magma was affected by Nb, Ti, Ta, Eu negative anomalies, the enrichment of Rhizosphere rocks of rare earth elements (LRRE), high LREE/HREE ratio and low K/Nb ratio and high ratios of Th/Nb, La/Nb, Ba/Nb, Zr/ Nb magmatic contamination. The early basaltic magma has been formed of a garnet lherzolite mantle with phlogopite/pargasite by metasomatism at a pressure of 2.5-5.3 GPa at depths of more than 80-150 km. Structural evidence suggests the formation of these volcanic rocks in intercontinental rift zones. The formation of these rocks can be attributed to the effects of intercontinental extensional phases in deep faults during Eocene Alpine orogeny phases.
Sedimentation in reservoirs. Case study: the reservoir of the São Bartolomeu stream, Viçosa, Minas Gerais, Brazil
Authors: Saito Youlia Kamei , Viana Lucas José Ferreira , Ferreira Ítalo Oliveira , Marques Eduardo Antonio Gomes
Published: December 2021

Sedimentation in bodies of water is a worldwide problem that impairs its navigability and utilization, and, in reservoirs, this process reduces their partial or total storage capacity. Using single-beam bathymetric survey techniques, this study evaluates the silting process in a reservoir section at the Federal University of Viçosa (UFV), located in Viçosa, Minas Gerais, in the Southeast region of Brazil. An analysis of the charts showing the DEM (Digital Elevation Models) and the Elevation x Surface Area x Accumulated Volume for three surveys conducted in 2010, 2012, and 2016 provided the sedimentation rates between these years, as well as the accumulated volume of sediments in the area under analysis for each year. The information we collected shows sediments accumulated in the deepest part of the reservoir in the period between 2010 and 2012. From 2012 to 2016, however, the silting effect was concentrated in shallower depths, whereas the desilting was observed in the deepest parts. Moreover, the sedimentation rate in the analyzed area was linked to the total precipitation in the municipality during the concerning time frame, as well as to changes in land use that occurred over the past years throughout the watershed. This data indicates a call for management actions to reduce soil erosion in the watershed, as well as a need for desilting of the reservoirs in order to recover its storage capacity.
Tracing the source of heavy metal pollution in water sources of Tourist Attractions Based on GIS remote sensing
Authors: Mo Jianghong , Tian Xinling , Shen Wei
Published: December 2021

To effectively prevent heavy metal pollution in water sources in tourist attractions, clarify the degree of control of heavy metal pollution sources, and improve the accuracy of tracing results, a GIS-based remote sensing method of heavy metal pollution in tourist attractions is proposed. Using GIS spatial analysis method, the DEM elevation data monitored by remote sensing is obtained, the watershed geographic information is compiled, and the GPS obtains the longitude and latitude coordinates to locate the source of heavy metal pollution. The plug-in application framework is designed, and the watershed geographic information and plug-in application framework are integrated to build the pollution tracing platform. According to the mixing direction of pollutants after entering the water source, the migration and diffusion coordinate system of heavy metal pollution in the water source is established. The spatial-temporal distribution function model of heavy metal pollutants in water sources is constructed through the migration, transformation, and concentration of heavy metal pollutants in water sources. The tracing results of heavy metal pollution in water sources of scenic spots are obtained. The results showed that the order of variation coefficient of heavy metal pollution elements was Cr > Cd > Cu > Ni > Zn > Pb. The spatial distribution of heavy metal pollution elements was extremely uneven. There was a certain positive correlation between Ni and Cr, and the correlation coefficient of Cu and Zn was 0.78. The positive correlation was very significant, and the homology was very strong. Moreover, the identification result of the proposed method is very close to the real value, which can accurately trace the source of heavy metal pollution in the water source of tourist attractions, with small tracing error and high accuracy of tracing result evaluation.
Mineralogy and Fluid Inclusions of the Cunas Emerald Mine, Maripí, Boyacá, Colombia
Authors: Romero Ordóñez Fernando Helí , González-Durán Andrés Felipe , García-Toloza Javier , Rotlewicz Cohen Jimmy , Cedeño Ochoa Carlos Julio , Alvarado González Holman Rolando , Angarita Sarmiento Luis Gabriel
Published: December 2021

The Cunas mine is currently one of the major producers of fine emeralds in Colombia; its emeralds typically display a magnificent green hue, which is highly appreciated in the world market. The mineralization is found in vanadium-rich black shales of the Muzo formation; emeralds occur in pockets within hydrothermal veins and breccias, consisting mostly of calcite, dolomite, albite, quartz, and minor pyrite, parisite-(Ce), and fluorite; hydrothermal alteration is pervasive and dominated by albitization and carbonatization. Emerald-hosted fluid inclusions are highly abundant and remarkably large and complex. Poly-phase inclusions are ubiquitous, occur both in emeralds and gangue minerals, and consist of two daughter crystals (typically halite and calcite or siderite; exceptionally parisite-(Ce)), a liquid brine, a CO2-N2-CH4-rich gas bubble, and occasionally minor liquid CO2. Vapor-rich inclusions were observed in quartz, and two-phase inclusions were identified in calcite and dolomite, thus suggesting a complex fluid evolution. Microthermometry analysis indicates the emerald-forming fluids were trapped at relatively low temperature ≈ 260-340°C and pressure ≈ 875-2400 kbar, with relatively high density —1.03 g/cm³—, and elevated salinity 39% NaCl eq. Wt.; other aqueous components detected include CaCl2, KCl, and FeCl2. Based on these data, we propose the emerald mineralization at the Cunas mine was originated by the mixing of two hydrothermal fluids of different sources; one fluid with high salinity derived from evaporite dissolution, responsible for the albitization of the host rocks; the second is a calcium-rich fluid evolved from connate waters, which was equilibrated by the interaction with calcareous and organic-rich wall rocks. As a result, emerald mineralization took place at structurally favorable sites where fluid mixing was promoted. The described geological and physicochemical features for the Cunas mine, are in agreement with an epigenetic sediment-hosted mineralization —Colombian-type— formed by the circulation and mixing of relatively low-temperature non-magmatic fluids.
Métodos físicos para reducir inóculo de Sclerotium cepivorum en semilla de ajo morado (Allium sativum L.)
Authors: Gómez-Marroquín Magda Rocío , Torres-Jiménez Diana Marcela , Cruz-Castiblanco Ginna Natalia , Hernández-Guzmán Anngie Katherine , Kobayashi Sadao , Villarreal Andrea Del Pilar
Published: December 2021

Introducción. En Colombia, la producción de ajo se ve afectada por patógenos, principalmente Sclerotium cepivorum, el cual se disemina por el material de siembra. Es necesario establecer tecnologías de bajo costo que permitan controlar este patógeno. Objetivo. Evaluar dos métodos de termoterapia, termoterapia por calor seco y termoterapia por inmersión en agua, para disminuir la presencia de S. cepivorum en semilla de ajo y su efecto sobre características agronómicas de plantas emergidas a partir de bulbillos tratados. Materiales y métodos. Este trabajo se llevó a cabo en el Centro de Investigación Tibaitatá de la Corporación Colombiana de Investigación Agropecuaria (AGROSAVIA), ubicado en Cundinamarca, Colombia, durante el primer semestre del 2019. Se evaluaron nueve tratamientos; cinco en termoterapia por calor seco: 35 ºC por 12 h, 35 ºC por 129,6 h, 50 ºC por 48 min, 5 ºC por 20 días, 38 °C por 1 h; dos en termoterapia por inmersión en agua caliente: 48 °C por 30 min, 50 °C por 20 min y dos controles: desinfección química (tebuconazol) y temperatura ambiente (20 ºC por 20 días), en un diseño en bloques completos al azar. Se evaluó brotación de bulbillos y crecimiento de las plantas de ajo después de aplicar termoterapia a la semilla y viabilidad de esclerocios de S. cepivorum. Resultados. El almacenamiento de la semilla a 5 ºC por 20 días aceleró su brotación, alcanzó una germinación de 80 % a los cinco días, mayor número de hojas y acumulación de biomasa. La germinación de esclerocios estuvo entre 33 y 67 %; el tratamiento que presentó la menor incidencia fue 35 ºC por 129,6 h (33 %). Conclusión. El tratamiento de termoterapia por calor seco a 35 °C por 129,6 h mostró potencial en la reducción del inóculo de S. cepivorum en semillas de ajo.
Viability and infectivity of Ceratobasidium encapsulated in alginate beads under different storage conditions
Authors: López Queenny K. , Castro Cesar A. , Curillo Diana L. , Chica Eduardo J. , Portilla José V. , Peña Denisse F.
Published: December 2021

Mycorrhizal fungi are important partners of orchids because they establish close symbiotic relationships with this group of plants, and its preservation is also important for the successful conservation of orchids. In the present study, the conservation of Ceratobasidium sp., a fungal symbiont, using encapsulation in alginate beads was tested over different times, temperatures of storage and dehydrated conditions. Osmotically dehydrated and air-dried beads were stored at room temperature (20 ± 2°C), 4°C, -20°C and - 80°C. The fungal growth was verified after 4, 8, 26 and 96 weeks. A second test was carried out to evaluate the encapsulations of fungi as a form of inoculation in Trichoceros antennifer orchid to promote symbiosis and plants development. The results show that the encapsulation of Ceratobasidium in alginate beads is a viable strategy for its conservation, the beads are of easy manipulation and promote plant growth when inoculated in plant substrate. These results may be adopted as part of effective conservation strategies for mycorrhizal fungi and orchids.
Ancora sul concetto di diritto soggettivo nell’ordinamento della Chiesa
Authors: Michowicz Przemysław
Published: December 2021

The paper discuses one of the most commented topic in the contemporary science of canon law, that is the bill of subjective rights and obligations set by the ecclesiastical legislator in the Code of canon law for the Western Church. The author analyses the concept of those rights and obligations in the light of the Principles of revision elaborated by the first Synod of Bishops held in 1967. One of the commission’s first actions was to draft a set of principles to guide the work of rethinking the Code, especially the significance of rights and obligations of the Christian faithful. Given the nature of the Catholic Church developed by the Second Vatican Council (communion and participation), the examination of this document let the author to affirm that the main goal was to emphasise the exercise of authority that should have appear more clearly as service and should be free from abuse rather to define and safeguard the rights of persons. Furthermore, it was also possible to determine the correct intention of the Synod Fathers whose idea was to define the subjective rights in term of liberties in the same way in which they are obtainable in catalogues of human rights. Eventually, the author demonstrates consequences related to the new vision of rights and obligations highlighting for example the clear priority of obligations over rights.
Przyczyny i następstwa desakralizacji – problemy adaptacji obiektów sakralnych do nowych funkcji
Authors: Cora Dominika
Published: December 2021

Problematyka związana z adaptacją obiektów sakralnych do nowych funkcji pojawia się w Europie coraz częściej. W artykule omówiono przyczyny desakralizacji – zjawiska sekularyzacji i laicyzacji społeczeństwa, a także jej następstwa ­– problematykę zniesienia święceń z kościoła czyli eskksekrację, która została zanalizowana w świetle zapisów Kodeksu Prawa Kanonicznego. Dokonano opisu adaptacji obiektów sakralnych do nowych funkcji na wybranych europejskich przykładach, które pozwoliły na przedstawienie tematyki w najszerszy możliwy sposób.
INFLUENCE OF STORAGE TIMES OF SLUDGE FROM THE FERROALLOY INDUSTRY ON THE PROPERTIES OF CEMENT-BASED MIXTURES
Authors: PETROV A. M. , SHEPTUN S. YU.
Published: December 2021

Purpose. The transition to environmentally friendly, waste-free technologies is a priority for most countries in the world. The metallurgical and construction industries make a significant contribution to the formation of large volumes of man-made waste. During the production of ferroalloys, waste is generated in the form of sludge, which is stored in sludge collectors. Sludge storage has been going on for over 25 years. In order to study the effect of the duration of storage of sludge on its properties in the compositions of dry building mixtures on a cement basis, a comparison was made of the efficiency of using sludge with different storage periods. The influence of sludge of various storage periods on the strength of dry construction is estimated. Methodology. The studies were carried out in accordance with the standard methods for determining the physical and mechanical properties of solutions from dry mixtures for the installation of self-leveling floors, specified in DSTU B V. 2.7-126: 2011 “Sludge awesome dry modified. General technical minds”. Sludge from wet gas cleaning of ferrosilicon production is stored in dumps where it is a mixture of lumps of various fractions 5…50 mm in size. To use sludge in the composition of dry building mixtures, it must be dried and crushed on a roller crusher and on a disintegrator. Findings. The best ratio of the "age" of the sludge and its percentage in the composition of the mixture was determined to increase the strength characteristics of the cement stone. Originality. The influence of the chemical nature of sludge from wet gas purifiers of ferrosilicon production on the hydration processes and strength of cement stone is analyzed. Practical value. The use of man-made waste in the formulations of dry building mixtures helps to simultaneously reduce the harmful effect on the environment of industrial enterprises and increase the mechanical and economic characteristics of cement mortars based on dry mixtures.