bluuebunny/crossref_metadata_2025 huggingface dataset:
A Laser Flash Photolysis Study of Electron Transfer Processes of [Ru(bpy)3]2+ in High Magnetic Field
Authors: Mukai Masahiro , Tanaka Hiroaki , Fujiwara Yoshihisa , Tanimoto Yoshifumi
Published: August 2006

The effect of high magnetic fields (≤13 T) on the charge transfer reaction between Ru(II) tris(2,2′-bipyridine) and methylviologen is studied by laser flash photolysis in a pulse magnet. The initial yield of the methylviologen radical decreases by about 20% at 13 T and the second order decay rate constant of the escaped radicals increases as the magnetic field increases. These effects of high magnetic field are interpreted in terms of the Δg mechanism with strong spin-orbit coupling proposed by Steiner et al.
Photochemical Formation of Colloidal Silver in the Presence of Benzophenone
Authors: Sato Tomoo , Maeda Naohide , Ohkoshi Hideo , Yonezawa Yoshiro
Published: August 2006

An aqueous silver perchlorate–sodium dodecylsulfate (SDS)–benzophenone (BP) solution was photolyzed with either UV or near-UV light. Irradiation with 253.7 nm light, which was absorbed by both BP and silver ions, brought about the formation of collidal silver and the photobleach of BP. Peptization of colloidal silver agglomerates after prolonged irradiation was ascribed to electron injection from the benzophenone ketyl radical (BPK). The formation of colloidal silver and the photobleach of BP were also caused by irradiation with 365 nm light, which was absorbed solely by BP (sensitized reaction). A simple reaction scheme was introduced and the initial rates for the sensitized photoreduction of silver ions and the photobleach of BP were expressed in closed forms. Suitable combinations of the kinetics parameters and the extinction coefficient of colloidal silver were proposed in order to interpret the dependences of the initial rates on the reactant concentrations.
Spectrophotometric and Simultaneous Derivative Spectrophotometric Determination of Gold(III) and Silver(I) with Rhodanine Derivative in Micellar Medium
Authors: El-Sayed Abdel-Aziz Youssef
Published: August 2006

The determination methods of the gold(III) and silver(I) with, 5-(4-hydroxy-3-methoxybenzylidene) rhodanine (3,4-MHBR) in the presence of benzyldimethyltetradecylammonium chloride (zephiramine), and 5(3,4-dihydroxybenzylidene) rhodanine (3,4-DHBR) in the presence of cetyltrimethylammonium bromide (CTAB) have been described. The application of first- and second-derivative spectrophotometry to simultaneous determination of gold(III) and silver(I) in their mixtures have been assayed using “zero-crossing” technique of measurement. In the pH ranges 8.8—9.8 and 9.0—10.2 the ternary 1 : 3 : 3 and 1 : 2 : 2 complexes gold(III)-3,4-MHBR-zephiramine and silver(I)-3,4-MHBR-zephiramine have been formed with molar absorptivities of 4.98 × 104 and 4.64 × 104 dm3 mol−1 cm−1 at 529 and 522 nm, respectively. The ternary 1 : 3 : 4 and 1 : 2 : 3 complexes gold(III)-3,4-DHBR-CTAB and silver(I)-3,4-DHBR-CTAB have been formed in the pH ranges 9.4—10.2 and 9.0—10.5 with molar absorptivities of 8.63 × 104 and 7.76 × 104 dm3 mol−1 cm−1 at 560 and 555 nm, respectively. The first- and second-derivative spectra of these complexes allow the determination of one metal in the presence an excess of the other. Gold(III) (0.21—3.6 μg cm−3) and silver(I) (0.12—2.63 μg cm−3) in different ratios have been determined simultaneously with good precision and accuracy using the proposed methods. The statistical analysis of the experimental results are presented. The methods have been applied to simultaneous determination of gold and silver in silicate rocks.
Reaction of Hydroxide Ion with Electron Donors in Aprotic Solvents
Authors: Umemoto Kisaburo , Nagase Yutaka , Sasaki Yukio
Published: August 2006

In aprotic solvents, the reaction of hydroxide ion with electron acceptors — iodine, tetracyanoquinodimethane, Nitro Blue Tetrazolium, methylviologen, 2,3,5-triphenyltetrazolium chloride, duroquinone, anthraquinone, benzil, 9-fluorenone, perylene — gave reaction products identical to those obtained by the reduction of these electron acceptors with electron donors. The paths of reaction of these electron acceptors with hydroxide ion were found to be composed of successive one-electron reactions. The efficiency of the reaction showed a good correlation with the reduction potential of the electron acceptors; the rate of the reaction decreased with increasing the reduction potential of the electron acceptors.
Syntheses and Characterization of Thiolate-Bridged Manganese(II) Complexes with NNS-Tridentate Thiolic Ligands
Authors: Mikuriya Masahiro , Adachi Fumiya , Iwasawa Hirofumi , Handa Makoto , Koikawa Masayuki , Okawa Hisashi
Published: August 2006

Manganese(II) complexes with 2-[(2-aminoethyl)amino]ethanethiol (HLa), 2-[(3-aminopropyl)amino]ethanethiol (HLb), 2-[(2-pyridylmethyl)amino]ethanethiol (HLc), and 2-[[2-(2-pyridyl)ethyl]amino]ethanethiol (HLd)–[Mn(La)Cl]n (1), [Mn{Mn(Lb)2}2]Cl2·2CH3OH (2), [Mn(Lc)Cl]n (3), and [Mn(Ld)Cl(CH3OH)]n (4) have been synthesized and characterized by elemental analyses, infrared and electronic spectroscopies, and magnetic susceptibilities (80—300 K). The crystal structures of all these complexes were determined by the single-crystal X-ray diffraction method. Complexes 1 and 3 have a thiolate-bridged polymeric chain structure in which each manganese atom is five-coodinated in a trigonal bipyramid. Complex 2 is a thiolate-bridged trinuclear manganese(II) complex displaying a linear arrangement of the three manganese atoms with the two Mn–Mn interactions being equidistant [3.420(1) Å]. Complex 4 is a thiolate-bridged polymeric infinite chain showing a distortion in the octahedral geometry around each manganese atom. The magnetic properties are discussed in relation to the crystal structures.
Oxidative Addition of Benzenethiol to [Rh(PMe3)4]Cl Giving Cationic and Neutral Hydrido(benzenethiolato)rhodium(III) Complexes
Authors: Osakada Kohtaro , Yamamoto Takakazu
Published: August 2006

[Rh(PMe3)4]Cl reacts with HSPh to give cationic hydrido(benzenethiolato)rhodium complex, cis-[RhH(SPh)(PMe3)4]Cl (1). The NMR (1H, 31P{1H}, and 13C{1H}) spectra as well as elemental analyses of 1 indicate the octahedral coordination with a hydrido and an SPh ligand at mutually cis positions. Reaction of [Rh(PMe3)4]Cl with HSPh in the presence of NEt3 gives a mixture of mer-RhCl(H)(SPh)(PMe3)3 (2) (38%) and [Rh2(μ-SPh)2(PMe3)4] (3) ( < 20%). X-Ray crystallography has revealed the molecular structure of 2, which has slightly distorted octahedral coordination around the Rh center with three PMe3 ligands at meridional coordination sites. The hydrido ligand, which is at a distance of 1.52 Å from the Rh center, is at trans position to Cl and cis position to the SPh ligand. Complex 1 reacts with equimolar MeI to give MeSPh in 86% yield.
Clinical and microbiological profiles of ear infections in Osogbo, Nigeria
Authors: Tobih J E , Taiwo S S , Olowe O A , Olaosun O A , Adejumao S D
Published: August 2006

Despite the fact that discharging ears (DE) are one of the most common presentations to ear, nose and throat (ENT) clinics in the tropics, few reports have documented the aetiologic agents involved. The pathogenesis is therefore not fully understood and treatment remains controversial. We present in this report the microbiological characteristics of DE over a 3-year-period at the ENT clinic of Ladoke Akintola University Teaching Hospital, Osogbo, Southwest Nigeria.
Using fishing line for suturing
Authors: Pereira Erlick A C , Cotton Michael H
Published: August 2006

Fishing line is an inexpensive and atraumatic suture material. Its properties and uses are summarized here. Comparison is made between different diameters and types of fishing line and commercially available sutures and needles to enable appropriate line selection for its use as suture material.
Traumatic spinal cord injuries in Ile-Ife, Nigeria, and its environs
Authors: Olasode Babatunde J , Komolafe I E , Komolafe M , Olasode Olayinka A
Published: August 2006

In Ile-Ife, Nigeria, traumatic brain injuries are largely due to traffic accidents caused mainly by the bad maintenance of the roads and unsafe driving. Young men in the productive stage of their lives are those most affected. The resultant disabilities include quadriplegia (in more than half the patients) and paraplegia. The cost of treating and providing adequate facilities for these patients imposes a heavy economic burden upon developing countries.
Intraperitoneal rupture of cysticercosal cyst mimicking appendicular perforation
Authors: Singh R B , Pavithran Nevil M , Bakshi N
Published: August 2006

Anaphylaxis following intraperitoneal rupture of a cysticercosal cyst mimicking pelvic peritonitis secondary to appendicular perforation is reported. Human cysticercosis occurs following ingestion of Taenia solium eggs, usually from faecally contaminated food. A case of pelvic cysicercosis presenting with signs and symptoms of anaphylaxis and peritonitis is reported, with plausible explanations for this unusual presentation.
Association between poverty and malaria in randomly selected families in Dar es Salaam
Authors: Sylvester Boniphace , Ivan R K
Published: August 2006

The present study aimed to reveal the association between family incomes and status of malaria in 50 randomly selected families. Results show that there is an association between income poverty and malaria experiences ( P < 0.05) and that 80% of the low-income families experienced malaria while only 20% of high-income families had experienced malaria ( P < 0.05).
Increase in hospital mortality from non-communicable disease and HIV-related conditions in Bulawayo, Zimbabwe, between 1992 and 2000
Authors: Bardgett H P , Dixon M , Beeching N J
Published: August 2006

The HIV/AIDS pandemic is creating a strain on health care services in the developing world, with knock-on consequences for HIV negative patients. We looked for possible changes over time in the patterns of illness and outcomes of admission to an adult medical unit in Zimbabwe.

We performed a prospective descriptive study of discharge diagnoses and causes of in-hospital ;mortality for all medical patients under the care of one consultant at Mpilo Central Hospital, Bulawayo, Zimbabwe. Two similar 7-month periods were compared in 1992 and 2000. Data recorded included: initials, sex, alive or dead status, diagnosis and HIV/AIDS status.

Similar numbers of patients were admitted in 1992 and 2000 (1305 and 1369), but in-hospital mortality increased from 13.3% to 28.6% ( P<0.001), especially in male patients (13.1% to 33.9% P<0.001). Mortality rates increased for both infectious and non-communicable diseases such as cardiac failure, stroke and diabetes. The 10 most common diagnoses were similar, apart from Pneumocystis carinii pneumonia (PCP) cases, which increased from 18 to 90. The proportion of patients clinically or serologically positive for HIV/AIDS rose from 13.9% to 51.1% ( P<0.001), but the number of cases of the HIV wasting syndrome (SLIM)/chronic gastroenteritis did not change significantly. In 1992 there happened to be a large number of cases of malaria transmission.

Mortality related to both communicable and non-communicable diseases increased, confirming that HIV negative patients are also being affected by the strain on health services. Although based on clinical and radiological diagnosis, PCP pneumonia appears to be increasingly common in this area.
Gastrointestinal parasites in Ugandan cancer patients: a retrospective departmental review
Authors: Robinson A J , Katongole-Mbidde E
Published: August 2006

Of all cancer patients, 28% had gastrointestinal parasites of medical importance.
Exemption policies and community preferences for tropical endemic diseases in the Bamako initiative programme in Nigeria
Authors: Uzochukwu Benjamin S C , Onwujekwe Obinna E
Published: August 2006

We determined the actual written policies/guidelines and practices of fee exemptions aimed at the primary health-care level for tropical diseases treatment within the Bamako initiative system and the community's and decision makers' preferences for exemption in Nigeria. Health policy documents from the federal and state ministries of health were reviewed to determine the guidelines for exemptions, services, goods and category of people to receive exemptions. The records of the local government areas, health centres and community health committees were also reviewed to check who had received exemptions and modalities for doing so. In addition, household surveys using questionnaires was conducted.

There is no clear-cut national policy regarding exemption. In areas where exemption exists, these are largely unofficial, as no official documents exist to support exemption. A total of 1594 individuals were surveyed. Community members prefer pregnant women, children and patients with TB, malaria, onchocerciasis and leprosy to be exempted from payment of fees: decision makers prefer the poor, children and patients with malaria, TB and leprosy to be exempted from payment for drugs, registration, consultation and preventive services such as immunization and antenatal services. One area of divergence between the preferences of the community and decision makers is the issue of exempting people with malaria and HIV/AIDS.
A qualitative study of the educational potential of joint teleconsultations at the primary-secondary care interface
Authors: Macfarlane Anne , Harrison Robert , Murray Elizabeth , Berlin Anita , Wallace Paul
Published: August 2006

We conducted an evaluation of joint teleconsultations involving specialists, general practitioners (GPs) and their patients. Semistructured interviews (n= 39) and focus groups (2 groups with specialists; 6 groups with GPs) were used to collect data to explore participants’ views on the educational aspect of joint teleconsultations, and to seek examples of learning that had taken place. The results showed that the teleconsultation was a complex situation in which some learning took place for the generalists, but overall participants were disappointed. Three themes emerged that could enhance the educational potential in future: generalists’ reasons for referral as an influence on perceived learning; lack of clarity among clinicians regarding their role and conduct; and the presence of patients as an inhibitor in doctor-doctor interactions.
Integration of monitoring and motor-training units for a tele-rehabilitation service
Authors: Rogante M , Silvestri S , Bufano M , Paone F , Macellari V
Published: August 2006

A tele-rehabilitation system has been designed for general use. The service can extend the rehabilitation treatment of patients affected by neurological diseases such as stroke or multiple sclerosis to their home, while under the control, supervision and responsibility of a hospital. Part of the initial work involved identifying the functional blocks of a tele-rehabilitation service. There are three parties involved in the tele-rehabilitation service: the health provider (the central unit of the system), the health operator (the medical unit of the system, generally a therapist) and the home platform (a central console with a high level of modularity). Tele-rehabilitative services that are easy to use could radically change the routine care and rehabilitation process.
Enhanced pharmacy training for counter-terrorism and disaster response
Authors: Armitstead John A , Burton Deborah C
Published: August 2006

State and federal authorities in the USA have identified pharmacists as important in terrorism detection activities. However few pharmacists are trained for disaster response planning, or providing services at disaster sites. A distance training programme was created by the College of Pharmacy at the University of Kentucky, Chandler Medical Center (UKCMC) in collaboration with an academic Medical Center, urban and rural community pharmacists, experts in pharmacy and infectious disease, and two state pharmacy associations. There was a substantial improvement in bioterrorism training knowledge as judged by pre- and post-test results. During two years of training, a total of 142 licensed pharmacists received certification (approximately 4.7% of all those in Kentucky). In addition, a network of bioterrorism-trained pharmacists was created for the state.
Diabetes education via mobile text messaging
Authors: Wangberg Silje C , Årsand Eirik , Andersson Niklas
Published: August 2006

Living with diabetes makes great educational demands on a family. We have tested the feasibility of using the mobile phone short message service (SMS) for reaching people with diabetes information. We also assessed user satisfaction and perceived pros and cons of the medium through interviews. Eleven parents of children with type 1 diabetes received messages for 11 weeks. The parents were positive about the system and said that they would like to continue to use it. The pop-up reminding effect of SMS messages in busy everyday life was noted as positive. Some parents experienced the messages as somewhat intrusive, arriving too often and at inconvenient times. The parents also noted the potential of the messages to facilitate communication with their adolescent children. The inability to store all of the messages or to print them out were seen as major disadvantages. Overall, the SMS seems to hold promise as means of delivering diabetes information.
Spatial Memory Formation and Memory-Enhancing Effect of Glucose Involves Activation of the Tuberous Sclerosis Complex–Mammalian Target of Rapamycin Pathway
Authors: Dash Pramod K. , Orsi Sara A. , Moore Anthony N.
Published: August 2006

The tuberous sclerosis complex–mammalian target of rapamycin (TSC–mTOR) cascade integrates growth factor and nutritional signals to regulate the synthesis of specific proteins. Because both growth factor signaling and glucose have been implicated in memory formation, we questioned whether mTOR activity is required for long-term spatial memory formation and whether this cascade is involved in the memory-augmenting effect of centrally applied glucose. To test our hypothesis, we directly administered rapamycin (an inhibitor of mTOR), glucose, 5-aminoimidazole-4-carboxamide-1β-4-ribonucleoside (AICAR; an activator of AMP kinase), or glucose plus rapamycin into the dorsal hippocampus after we trained rats in the Morris water maze task. The results from these studies indicate that glucose enhances, whereas AICAR and rapamycin both impair, long-term spatial memory. Furthermore, the memory-impairing effect of targeted rapamycin administration could not be overcome by coadministration of glucose. Consistent with these behavioral results, biochemical analysis revealed that glucose and AICAR had opposing influences on the activation of the TSC–mTOR cascade, as indicated by the phosphorylation of ribosomal S6 kinase (S6K) and 4E binding protein 1 (4EBP1), targets of mTOR. Together, these findings suggest that memory formation requires the mTOR cascade and that the memory-enhancing effect of glucose involves its ability to activate this pathway.
RNA Interference Screen Reveals an Essential Role of Nedd4–2 in Dopamine Transporter Ubiquitination and Endocytosis
Authors: Sorkina Tatiana , Miranda Manuel , Dionne Kalen R. , Hoover Brian R. , Zahniser Nancy R. , Sorkin Alexander
Published: August 2006

The function of the dopamine transporter (DAT) to terminate dopamine neurotransmission is regulated by endocytic trafficking of DAT. To elucidate the mechanisms of DAT endocytosis, we generated a fully functional mutant of the human DAT in which a hemagglutinin epitope (HA) was incorporated into the second extracellular loop. The endocytosis assay, based on the uptake of an HA antibody, was designed to study constitutive- and protein kinase C (PKC)-dependent internalization of HA-DAT expressed in non-neuronal cells and rat dopaminergic neurons. Large-scale RNA interference analysis of PKC-dependent endocytosis of HA-DAT revealed the essential and specific role of an E3 ubiquitin ligase, Nedd4–2 (neural precursor cell expressed, developmentally downregulated 4–2), as well as the involvement of adaptor proteins present in clathrin-coated pits, such as epsin, Eps15 (epidermal growth factor pathway substrate clone 15), and Eps15R (Eps15-related protein). Depletion of Nedd4–2 resulted in a dramatic reduction of PKC-dependent ubiquitination of DAT. Endogenous Nedd4–2, epsin, and Eps15 were coimmunoprecipitated with heterologously expressed human HA-DAT and endogenous DAT isolated from rat striatum. A new mechanistic model of DAT endocytosis is proposed whereby the PKC-induced ubiquitination of DAT mediated by Nedd4–2 leads to interaction of DAT with adaptor proteins in coated pits and acceleration of DAT endocytosis.
UNC-13 and UNC-10/Rim Localize Synaptic Vesicles to Specific Membrane Domains
Authors: Weimer Robby M. , Gracheva Elena O. , Meyrignac Olivier , Miller Kenneth G. , Richmond Janet E. , Bessereau Jean-Louis
Published: August 2006

Synaptic vesicles undergo a maturation step, termed priming, in which they become competent to fuse with the plasma membrane. To morphologically define the site of vesicle priming and identify fusion-competent synaptic vesicles, we combined a rapid physical-fixation technique with immunogold staining and high-resolution morphometric analysis atCaenorhabditis elegansneuromuscular junctions. In these presynaptic terminals, a subset of synaptic vesicles contact the plasma membrane within ∼100 nm of a presynaptic dense projection. UNC-13, a protein required for vesicle priming, localizes to this same region of the plasma membrane. In anunc-13null mutant, few synaptic vesicles contact the plasma membrane, suggesting that membrane-contacting synaptic vesicles represent the morphological correlates of primed vesicles. Interestingly, a subpopulation of membrane-contacting vesicles, located within 30 nm of a dense projection, are unperturbed inunc-13mutants. We show that UNC-10/Rim, a protein implicated in presynaptic plasticity, localizes to dense projections and that loss of UNC-10/Rim causes an UNC-13-independent reduction in membrane-contacting synaptic vesicles within 30 nm of the dense projections. Our data together identify a discrete domain for vesicle priming within 100 nm of dense projections and further suggest that UNC-10/Rim and UNC-13 separately contribute to the membrane localization of synaptic vesicles within this domain.
Bioethics: Past and Future
Authors: Evans John H.
Published: August 2006

The academic field of bioethics has a strong influence on public policy. Founded in the late 1960s, it is now experiencing growing pains and a conflict between its liberals and conservatives on “culture wars” issues. Renée C. Fox, the Annenberg Professor Emerita of Sociology at the University of Pennsylvania, was working in the field well before the invention of bioethics. In this interview, she looks back on the field she helped define.
Learning from Drag Queens
Authors: Taylor Verta , Rupp Leila J.
Published: August 2006

Drag queens can teach us a lot about sexual desire—especially our own.
The Social Security Debate, Now and Then
Authors: Amenta Edwin
Published: August 2006

The prehistory of Social Security was a series of pitched political battles centered on the Townsend Plan and a senior citizens' pension movement. Today's old-age advocates should take note.
This Revolution is not Being Televised
Authors: Messner Michael A. , Duncan Margaret Carlisle , Willms Nicole
Published: August 2006

American women have flooded into sports at all levels in the last several decades—but you would never know it from watching the evening news.
Today's New Model Army
Authors: Green Harry
Published: August 2006

For ye suffer fools gladly, seeing ye yourselves are wise. —2 Corinthians
The rush to accelerate: Early stages of nuclear physics research in Australia
Authors: HOME R. W.
Published: August 2006

From the mid-1930s, Australian physicists, though few in number, sought to join the exciting new field of research then opening up in experimental nuclear physics. Such research was already, however, largely based on the use of particle accelerators, and to acquire one demanded money and resources on a scale unprecedented in Australian scientific experience. Australian attempts during the period 1935–1960 to build accelerators or to acquire them by other means are described. The difficulties that Australian physicists faced in this connection and the strategies by which they sought to overcome them are considered. Three stages of development are identified: an initial period of small-scale initiatives in the 1930s, a postwar period of “do-it-yourself” accelerator building, and finally a growing practice of buying machines “off the shelf” from commercial suppliers.
Yoshio Nishina and two cyclotrons
Authors: KIM DONG-WON
Published: August 2006

Yoshio Nishina is often honored as “a father of modern physics in Japan.” By performing multiple roles as a competent researcher, a formidable teacher, and a shrewd organizer, he not only made a great contribution to the emergence of a research network that produced two Nobel prize winners in physics but also raised the level of Japanese physics overall. Among Nishina's many contributions to the Japanese physics community, the construction and operation of two cyclotrons during the 1930s and 1940s were the most celebrated. In this paper I try to answer the following questions: why did Nishina start the construction of two cyclotron in the mid-1930s?; how did he secure the necessary financial support?; what were the original objectives of the machines, and how were they were actually used?; what difficulties did he meet and overcome in the construction and running of the cyclotrons?; how significant was the Berkeley connection in contributing to the construction and operation of the cyclotrons?; why did Nishina skip the construction of the medium size cyclotron (30–40 inches) and move directly from a small (26-inch) to a large one (60-inch)?; and how much did the cyclotron project influence the future path of Japanese physics? I argue that Nishina's two cyclotrons, especially the larger one, should be considered as successful examples of reverse engineering, a hallmark of Japanese technology in the interwar period.
The quest for the Brazilian synchrocyclotron
Authors: DE ANDRADE ANA M. RIBEIRO , MUNIZ R.P.A.
Published: August 2006

Early efforts to bring particle accelerators into Brazil exemplify the interactions between advanced scientific countries and the periphery in the years 1948–1956 and between the history of science and the history of foreign affairs. The physicists Cesar Lattes, Ernest Lawrence, Herbert Anderson, Isidor Rabi, and Rear Admiral Álvaro Alberto played central roles in these efforts. The story brings out the role of the military and scientists acting within the Centro Brasileiro de Pesquisas Físicas and the Conselho Nacional de Pesquisas to promote nuclear physics research aimed at the development of nuclear technology in Brazil. The decision-making process involved science, politics, secret agreements, and international affairs.
Restriction of Ongoing Intensive Care in Neonates: A Prospective Study
Authors: Hentschel Roland , Lindner Katharina , Krueger Markus , Reiter-Theil Stella
Published: August 2006

OBJECTIVE. The purpose of this work was to record the current practice of restricting ongoing intensive care in severely ill newborns.

METHODS. This was a prospective observational study over a 30-month period of consecutive newborns for whom restriction of ongoing intensive care was taken into consideration, discussed, or decided on. A standardized form recorded patients' medical condition, the type of restriction decided on, parents' wishes, and their information level. The research was conducted in a neonatal unit of a level III university children's hospital, with no interventions.

RESULTS. Forty patients were enrolled, 25 were preterm, 21 had either a genetic defect or an inborn malformation. Restriction of ongoing intensive care was decided on for 32 patients with a great variety of specified recommendations. Thirty-six patients died during the observation period. In general, parents were well informed; however, their wishes concerning restriction of ongoing intensive care were unknown in ∼25% of cases.

CONCLUSIONS. The decision-making process for restriction of ongoing intensive care is well established, but the role of parents needs to be defined.
The Adverse Effect of Negative Comments About Weight and Shape From Family and Siblings on Women at High Risk for Eating Disorders
Authors: Taylor C. Barr , Bryson Susan , Celio Doyle Angela A. , Luce Kristine H. , Cunning Darby , Abascal Liana B. , Rockwell Roxanne , Field Alison E. , Striegel-Moore Ruth , Winzelberg Andrew J. , Wilfley Denise E.
Published: August 2006

OBJECTIVE. Our purpose with this work was to examine the relationship between negative comments about weight, shape, and eating and social adjustment, social support, self-esteem, and perceived childhood abuse and neglect.

METHODS. A retrospective study was conducted with 455 college women with high weight and shape concerns, who participated in an Internet-based eating disorder prevention program. Baseline assessments included: perceived family negative comments about weight, shape, and eating; social adjustment; social support; self-esteem; and childhood abuse and neglect. Participants identified 1 of 7 figures representing their maximum body size before age 18 and parental maximum body size.

RESULTS. More than 80% of the sample reported some parental or sibling negative comments about their weight and shape or eating. Parental and sibling negative comments were positively associated with maximum childhood body size, larger reported paternal body size, and minority status. On subscales of emotional abuse and neglect, most participants scored above the median, and nearly one third scored above the 90th percentile. In a multivariate analysis, greater parental negative comments were directly related to higher reported emotional abuse and neglect. Maximum body size was also related to emotional neglect. Parental negative comments were associated with lower reported social support by family and lower self-esteem.

CONCLUSIONS. In college women with high weight and shape concerns, retrospective reports of negative comments about weight, shape, and eating were associated with higher scores on subscales of emotional abuse and neglect. This study provides additional evidence that family criticism results in long-lasting, negative effects.
State Newborn Screening in the Tandem Mass Spectrometry Era: More Tests, More False-Positive Results
Authors: Tarini Beth A. , Christakis Dimitri A. , Welch H. Gilbert
Published: August 2006

BACKGROUND. The advent of tandem mass spectrometry has made it possible to test newborns for multiple conditions efficiently. It is not known how state newborn screening programs have changed screening practices in response to this technology and how it affects the number of false-positive test results.

METHODS. We obtained data from the National Newborn Screening and Genetics Resource Center regarding the screening practices for each of the 50 states, to determine the number of mandated disorders added to state newborn screening panels between 1995 and 2005. Combining these data with reported specificities from the literature and the number of births in each state, we estimated the number of infants who would have received false-positive results through screening with tandem mass spectrometry in 2005.

RESULTS. The average state mandated screening for 5 disorders in 1995 (range: 0–8 disorders). Wyoming was the only state that decreased its panel size over the next decade. Kansas and Texas were the only states that did not add disorders to their panels between 1995 and 2005; the average state added 19. Iowa, Minnesota, Mississippi, South Dakota, and Tennessee each added ≥40 disorders. Assuming that an individual test for a disorder had a specificity of 99.995%, we estimated that ∼2575 infants would have received false-positive results through screening with tandem mass spectrometry in 2005. If specificity was assumed to be 99.9%, then the number increased to >51000.

CONCLUSIONS. State newborn screening programs have expanded dramatically in the past decade. Because the benefit of such testing may be unclear in some cases and because the number of infants who may receive false-positive results and may be labeled falsely as having disease is potentially sizeable, a more cautious approach is needed.
Topical Ciprofloxacin/Dexamethasone Superior to Oral Amoxicillin/Clavulanic Acid in Acute Otitis Media With Otorrhea Through Tympanostomy Tubes
Authors: Dohar Joseph , Giles William , Roland Peter , Bikhazi Nadim , Carroll Sean , Moe Roderick , Reese Bradley , Dupre Sheryl , Wall Michael , Stroman David , McLean Celeste , Crenshaw Krista
Published: August 2006

OBJECTIVE. This study was a comparison of topical ciprofloxacin/dexamethasone otic suspension to oral amoxicillin/clavulanic acid suspension in children with acute otitis media with otorrhea through tympanostomy tubes.

METHODS. This was a randomized, observer-masked, parallel-group, multicenter trial of topical ciprofloxacin/dexamethasone otic suspension versus amoxicillin/clavulanic acid suspension in 80 children aged 6 months to 12 years with acute otitis media with otorrhea through tympanostomy tubes of ≤3 weeks' duration and visible otorrhea. Patients were randomly assigned to receive either 4 drops of topical ciprofloxacin 0.3%/dexamethasone 0.1% (Ciprodex Sterile Otic Suspension) into the affected ear(s) twice daily for 7 days or 600 mg of amoxicillin/42.9 mg of clavulanic acid oral suspension (Augmentin ES-600 Oral Suspension) every 12 hours for 10 days. Clinical signs and symptoms of acute otitis media with otorrhea through tympanostomy tubes were evaluated on days 1 (baseline), 3, 11 (end-of-therapy), and 18 (test-of-cure), and twice-daily assessments of otorrhea were recorded in patient diaries.

RESULTS. The median time to cessation of otorrhea was significantly shorter with ciprofloxacin/dexamethasone otic suspension than with amoxicillin/clavulanic acid suspension (4.0 vs 7.0 days; n = 79). This resulted in significantly more clinical cures at the test-of-cure visit (85% vs 59%, respectively). Frequent adverse events (>3%) related to ciprofloxacin/dexamethasone otic suspension included ear pain (5.1%) and related to amoxicillin/clavulanic acid suspension included diarrhea (19.5%), dermatitis (7.3%), and gastroenteritis (4.9%).

CONCLUSIONS. Topical otic treatment with ciprofloxacin/dexamethasone otic suspension is superior to treatment with oral amoxicillin/clavulanic acid suspension and results in more clinical cures and earlier cessation of otorrhea with fewer adverse effects in children with acute otitis media with otorrhea through tympanostomy tubes.
Screening for Celiac Disease in Asymptomatic Children With Down Syndrome: Cost-effectiveness of Preventing Lymphoma
Authors: Swigonski Nancy L. , Kuhlenschmidt Heather L. , Bull Marilyn J. , Corkins Mark R. , Downs Stephen M.
Published: August 2006

BACKGROUND. Studies demonstrate an increased prevalence of celiac disease in persons with Down syndrome, leading some organizations and authors to recommend universal screening of children with Down syndrome. However, many children with Down syndrome are asymptomatic, and the long-term implications of screening are unknown. The complication of celiac disease that leads to mortality in the general population is non-Hodgkin's lymphomas.

OBJECTIVES. The purpose of this research in asymptomatic children with Down syndrome was to (1) calculate the number needed to screen to prevent a single case of lymphoma and (2) present a cost-effectiveness study of screening.

METHODS. We constructed a decision tree using probabilities derived from the published literature for Down syndrome or from the general population where Down syndrome-specific data were not available. Celiac disease was determined by serologic screening and confirmation with intestinal biopsy. Sensitivity analysis was used to alter probability estimates affecting the cost of preventing lymphoma.

RESULTS. Using our baseline values, the no-screen strategy is dominant; that is, screening not only costs more but also results in fewer quality-adjusted life-years. A screening strategy costs more than $500000 per life-year gained. Screening all asymptomatic children with Down syndrome for celiac disease costs almost $5 million to prevent a single case of lymphoma.

CONCLUSION. These analyses do not support the cost-effectiveness of screening, and more data are needed before recommendations to screen asymptomatic children with Down syndrome for celiac disease can be made.
Childhood Bullying Involvement and Exposure to Intimate Partner Violence
Authors: Bauer Nerissa S. , Herrenkohl Todd I. , Lozano Paula , Rivara Frederick P. , Hill Karl G. , Hawkins J. David
Published: August 2006

OBJECTIVE. Our objectives with this study were to describe the prevalence of bullying involvement (ie, bullying and victimization) among children from a multigenerational study and to examine the relationship of these childhood behaviors and exposure to intimate partner violence.

METHODS. A community-based cohort of 112 children (aged 6 to 13 years) was asked to self-report on physical, verbal, and relational types of bullying and victimization experienced in the past year. Parents reported on their child's externalizing and internalizing behaviors during the previous 6 months using items from Achenbach's Child Behavior Checklist. The frequency of parental experiences of intimate partner violence perpetration and victimization at 2 time points during the preceding 5 years was measured using Conflict Tactics Scale items. The association of intimate partner violence and parent-reported child behavioral problems was examined, followed by exposure to intimate partner violence and child-reported bullying or victimization. Parental risk factors (eg, race/ethnicity, education, problem drinking) that predispose to intimate partner violence were controlled for using propensity score statistical modeling.

RESULTS. Eighty-two (73.2%) children reported being victimized by peers, and 38 (33.9%) children reported bullying behaviors in the past year. More reports came from girls than from boys (55% for victimization and 61% for bullying). Almost all (97%) child bullies were also victims themselves. Intimate partner violence was reported by parent respondents in 53 (50.5%) households at any or both of the 2 time points. Exposure to intimate partner violence was not associated with child-reported relational bullying behaviors or victimization by peers, However, intimate partner violence–exposed children were at increased risk for problematic levels of externalizing behavior/physical aggression and internalizing behaviors.

CONCLUSIONS. In our sample, children who were 6 to 13 years of age reported a substantial amount of bullying and victimization; a large majority were bully-victims and female. Regression analyses did not show that children who were exposed to intimate partner violence were more likely to engage in relational bullying. However, children who are exposed to intimate partner violence have a higher likelihood of internalizing behaviors and physical aggression.
Metoclopramide for the Treatment of Gastroesophageal Reflux Disease in Infants: A Systematic Review
Authors: Hibbs Anna Maria , Lorch Scott A.
Published: August 2006

OBJECTIVES. Metoclopramide is a commonly used drug to treat gastroesophageal reflux disease in infants. Given its widespread use and growing concern about toxicity in this population, we conducted a systematic review of metoclopramide for the treatment of gastroesophageal reflux disease in infants.

METHODS. We performed a systematic search of PubMed and bibliographies of relevant review articles. We included cohort, case-control, and intervention studies of the efficacy, effectiveness, or toxicity of metoclopramide therapy for gastroesophageal reflux disease in infants. We excluded case reports, case series, review articles, and abstracts.

RESULTS. Twelve articles met our inclusion criteria. Of these, 11 were prospective trials, and 5 were randomized, blinded clinical trials. Study size ranged from 6 to 77 patients. Eight studies showed patient improvement with metoclopramide in at least 1 measured outcome; 1 study showed worsening symptoms with metoclopramide. Of the 5 randomized, blinded trials, 2 showed no effect of metoclopramide on any outcome, and 2 showed a significant placebo effect. Four studies commented on adverse effects of therapy, with irritability being the most frequently reported potential adverse effect of therapy. Other reported adverse effects included dystonic reactions, drowsiness, oculogyric crisis, emesis, and apnea. Among studies, there was marked heterogeneity in the patient populations, dosing, and outcomes studied. Therefore, a meta-analysis was not performed. We both agreed on a US Preventive Service Task Force rating of “poor” for the level of evidence, leading to an “inconclusive” recommendation for the safety and efficacy of metoclopramide in infants.

CONCLUSIONS. The current literature is insufficient to either support or oppose the use of metoclopramide for gastroesophageal reflux disease in infants. In the future, large blinded randomized clinical trials are needed to determine the efficacy and toxicity of metoclopramide in this population.
Factors Influencing the Composition of the Intestinal Microbiota in Early Infancy
Authors: Penders John , Thijs Carel , Vink Cornelis , Stelma Foekje F. , Snijders Bianca , Kummeling Ischa , van den Brandt Piet A. , Stobberingh Ellen E.
Published: August 2006

OBJECTIVE. The aim of this study was to examine the contribution of a broad range of external influences to the gut microbiotic composition in early infancy.

METHODS. Fecal samples from 1032 infants at 1 month of age, who were recruited from the KOALA Birth Cohort Study in the Netherlands, were subjected to quantitative real-time polymerase chain reaction assays for the enumeration of bifidobacteria, Escherichia coli, Clostridium difficile, Bacteroides fragilis group, lactobacilli, and total bacterial counts. Information on potential determinants of the gut microbiotic composition was collected with repeated questionnaires. The associations between these factors and the selected gut bacteria were analyzed with univariate and multivariate analyses.

RESULTS. Infants born through cesarean section had lower numbers of bifidobacteria and Bacteroides, whereas they were more often colonized with C difficile, compared with vaginally born infants. Exclusively formula-fed infants were more often colonized with E coli, C difficile, Bacteroides, and lactobacilli, compared with breastfed infants. Hospitalization and prematurity were associated with higher prevalence and counts of C difficile. Antibiotic use by the infant was associated with decreased numbers of bifidobacteria and Bacteroides. Infants with older siblings had slightly higher numbers of bifidobacteria, compared with infants without siblings.

CONCLUSIONS. The most important determinants of the gut microbiotic composition in infants were the mode of delivery, type of infant feeding, gestational age, infant hospitalization, and antibiotic use by the infant. Term infants who were born vaginally at home and were breastfed exclusively seemed to have the most “beneficial” gut microbiota (highest numbers of bifidobacteria and lowest numbers of C difficile and E coli).
Assent for Treatment: Clinician Knowledge, Attitudes, and Practice
Authors: Lee K. Jane , Havens Peter L. , Sato Thomas T. , Hoffman George M. , Leuthner Steven R.
Published: August 2006

OBJECTIVES. Our purpose for this work was to explore clinician knowledge, attitudes, and practice regarding assent for medical treatment and to compare current practice with existing American Academy of Pediatrics guidelines.

METHODS. One of the investigators administered a questionnaire to clinicians who perform procedures on children at an academic tertiary care pediatric hospital to assess knowledge of assent for medical treatment and familiarity with the American Academy of Pediatrics policy statement on assent and to measure clinician attitudes and approaches to consent/assent in pediatrics.

RESULTS. Of 35 clinicians enrolled, 23 (66%) had heard of the term “assent,” and 9 (26%) of 35 were aware of the American Academy of Pediatrics policy statement on assent. Twenty five (74%) of 34 thought 1 of the main goals of assent was to educate the child. Only 12 (35%) of 34 included the element of seeking the child's agreement as a goal of assent. In practice, the element of explaining the proposed treatment was “always” included by 26 (74%) of 35. The element of seeking the child's agreement was “always” included by 9 (26%) of 35.

CONCLUSIONS. The clinicians in this study had limited explicit knowledge of the concept of assent for medical treatment and were largely unaware of the recommendations from the American Academy of Pediatrics. Their attitudes and practice reflected implicit acceptance of the importance of including children in discussions about their medical care and reluctance to give children decision-making authority. A model of medical decision-making for children that includes education but does not allow children to share decision-making authority may be more applicable to clinical practice than the current American Academy of Pediatrics–supported model of assent.
The Influence of Variation in Type and Pattern of Symptoms on Assessment in Pediatric Asthma
Authors: Fuhlbrigge Anne L. , Guilbert Theresa , Spahn Joseph , Peden David , Davis Kourtney
Published: August 2006

OBJECTIVE. We conducted a national, population-based survey to examine the asthma-related health burden of US children.

METHODS. A telephone-based survey was conducted in 2004 of children 4 to 18 years of age with current asthma in the United States. In 41433 households screened, 1089 children reported current asthma; 801 interviews were completed by parents of children aged 4 to 15 years and by children themselves aged 16 to 18 years. The survey included questions about symptoms, perceived level of control, activity limitations, health care use, medicines, disease management, and knowledge. Global asthma symptom burden, derived from the National Asthma Education and Prevention Program guidelines, was composed of 3 components: short-term symptom burden (4-week recall), long-term symptom burden (past year), and functional impact (activity limitation).

RESULTS. The majority of children were classified with mild intermittent disease on the basis of recent daytime symptoms alone (80%); yet, when report of nighttime symptoms was included, the proportion of children classified as having mild intermittent symptoms decreased (74%). When asthma burden was assessed on the basis of the global symptom burden construct, only a minority (13%) of individuals was classified as having an asthma symptom burden consistent with mild intermittent disease; the majority (62%) was classified as having moderate/severe disease. In addition, the impact of asthma on the daily activities is substantial; avoiding exertion (47%) and staying inside (34%) are common approaches to improve control of asthma symptoms.

CONCLUSIONS. The goals of therapy for asthma, based on the National Asthma Education and Prevention Program guidelines, have not been achieved for the majority of children. In addition, parents and children overestimate the child's asthma control and commonly restrict activities to control asthma symptoms. Deficiencies in the control of asthma may be related to the underestimation of the burden of disease.