bluuebunny/crossref_metadata_2025 huggingface dataset:
Conformation and stability of the Streptococcus pyogenes pSM19035-encoded site-specific β recombinase, and identification of a folding intermediate
Authors: Bhardwaj Anshul , Welfle Karin , Misselwitz Rolf , Ayora Silvia , Alonso Juan C. , Welfle Heinz
Published: June 2006

Solution properties of β recombinase were studied by circular dichroism and fluorescence spectroscopy, size exclusion chromatography, analytical ultracentrifugation, denaturant-induced unfolding and thermal unfolding experiments. In high ionic strength buffer (1 M NaCl) β recombinase forms mainly dimers, and strongly tends to aggregate at ionic strength lower than 0.3 M NaCl. Urea and guanidinium chloride denaturants unfold β recombinase in a two-step process. The unfolding curves have bends at approximately 5 M and 2.2 M in urea and guanidinium chloride-containing buffers. Assuming a three-state unfolding model (N2→2I→2U), the total free energy change from 1 mol of native dimers to 2 mol of unfolded monomers amounts to ΔG
tot=17.9 kcal/mol, with ΔG
N2→2I=4.2 kcal/mol for the first transition and ΔG
I→U=6.9 kcal/mol for the second transition. Using sedimentation-equilibrium analytical ultracentrifugation, the presence of β recombinase monomers was indicated at 5 M urea, and the urea dependence of the circular dichroism at 222 nm strongly suggests that folded monomers represent the unfolding intermediate.
Pathogenicity of catalytic antibodies: catalytic activity of Bence Jones proteins from myeloma patients with renal impairment can elicit cytotoxic effects
Authors: Matsuura Kinji , Ohara Kyoko , Munakata Hiroshi , Hifumi Emi , Uda Taizo
Published: June 2006

Some Bence Jones proteins (BJPs) can display catalytic activity. Although the catalytic activity of BJPs might be associated with the pathogenesis of disease, this relationship has not yet been established. We tested the effects of seven BJPs on LLC-PK1 cells to assess their pathogenicity. Two out of the seven BJPs showed cytotoxic activity, as assessed by microscopic analysis, the WST method and TUNEL staining. Moreover, the cytotoxic BJPs were excreted by patients who presented with renal impairment. The cytotoxic BJPs displayed 20- to 40-fold higher catalytic activities (kcatof 3.5–2.2 min-1) in hydrolyzing a chromogenic substrate compared to the other BJPs. By treating the cytotoxic BJPs with diisopropylfluorophosphate, they lost not only their catalytic activity, but also the cytotoxic effects. These results indicate a direct link between cytotoxicity and the catalytic activity of the BJPs. The catalytic activity of BJPs contributes to the pathogenesis, as well as to development, of symptoms of multiple myeloma. Inhibition of the catalytic activity of BJPs may form the basis of a novel treatment for multiple myeloma patients with renal dysfunction.
Transgenic expression of gallerimycin, a novel antifungal insect defensin from the greater wax moth Galleria mellonella, confers resistance to pathogenic fungi in tobacco
Authors: Langen Gregor , Imani Jafargholi , Altincicek Boran , Kieseritzky Gernot , Kogel Karl-Heinz , Vilcinskas Andreas
Published: June 2006

A cDNA encoding gallerimycin, a novel antifungal peptide from the greater wax mothGalleria mellonella, was isolated from a cDNA library of genes expressed during innate immune response in the caterpillars. Upon ectopic expression of gallerimycin in tobacco, usingAgrobacterium tumefaciensas a vector, gallerimycin conferred resistance to the fungal pathogensErysiphe cichoracearumandSclerotinia minor. Quantification of gallerimycin mRNA in transgenic tobacco by real-time PCR confirmed transgenic expression under control of the inducible mannopine synthase promoter. Leaf sap and intercellular washing fluid from transgenic tobacco inhibitedin vitrogermination and growth of the fungal pathogens, demonstrating that gallerimycin is secreted into intercellular spaces. The feasibility of the use of gallerimycin to counteract fungal diseases in crop plants is discussed.
Pediatric Resident Education in Palliative Care: A Needs Assessment
Authors: Kolarik Russ C. , Walker Gena , Arnold Robert M.
Published: June 2006

OBJECTIVE. The goal was to characterize pediatric residents' perceived educational needs for pediatric palliative care. The data generated from this study will facilitate the planning of specific educational interventions.

METHODS. All residents in the Children's Hospital of Pittsburgh pediatrics residency program were asked to complete a survey in September 2003. Participation in the study was voluntary. Residents rated their previous training, personal experience, knowledge, competence, and emotional comfort with 10 specific aspects of pediatric palliative care. This rating was followed by 13 questions related to attitudes about palliative care practices and training. The last section asked the respondents to rank 11 palliative care educational topics in order of importance.

RESULTS. Forty-nine of 75 eligible residents participated. Although residents thought that pediatricians should have an important role in providing palliative care, residents reported minimal training, experience, knowledge, competence, and comfort in virtually all areas of palliative care for children. We found no significant improvement in any of these areas from the pediatric level-1 year to the pediatric level-3 year. Residents wanted more training regarding pain management. After pain control, the next 4 educational needs were communication skills, namely, discussing prognosis, bad news, and code status and talking with children about end-of-life care.

CONCLUSIONS. There is a clear need for increased efforts in pediatric palliative care education during residency training. Pediatric residents do not think that they are trained adequately in palliative care, and this perception does not improve with time. Pediatric residents view palliative care as important for primary care physicians and desire more education.
Ann-of-1 Trial Service in Clinical Practice: Testing the Effectiveness of Stimulants for Attention-Deficit/Hyperactivity Disorder
Authors: Nikles C. Jane , Mitchell Geoffrey K. , Del Mar Chris B. , Clavarino Alexandra , McNairn Norma
Published: June 2006

OBJECTIVE. We sought to describe the clinical use of n-of-1 trials for attention-deficit/hyperactivity disorder in publicly and privately funded family and specialized pediatric practice in Australia.

METHODS. We used a within-patient randomized, double-blind, crossover comparison of stimulant (dexamphetamine or methylphenidate) versus placebo or alternative stimulant using 3 pairs of treatment periods. Trials were conducted from a central location using mail and telephone communication, with local supervision by the patients’ clinicians.

PATIENTS. Our study population included children with clinically diagnosed attention-deficit/hyperactivity disorder who were aged 5 to 16 years and previously stabilized on an optimal dose of stimulant. They were selected because treatment effectiveness was uncertain.

MAIN OUTCOME MEASURES. Our measures included number of patients recruited, number of doctors who used the service, geographic spread, completion rates, response rate, and post–n-of-1 trial decisions.

RESULTS. Forty-five doctors across Australia requested 108 n-of-1 trials, of which 86 were completed. In 69 drug-versus-placebo comparisons, 29 children responded better to stimulant than placebo. Immediately posttrial, 19 of 25 drug-versus-placebo responders stayed on the same stimulant, and 13 of 24 nonresponders ceased or switched stimulants. In 40 of 63 for which data were available, posttrial management was consistent with the trial results. For all types of n-of-1 trials, management changed for 28 of 64 children for whom information was available.

DISCUSSION. Attention-deficit/hyperactivity disorder n-of-1 trials can be implemented successfully by mail and telephone communication. This type of trial can be valuable in clarifying treatment effect when it is uncertain, and in this series, they had a noticeable impact on short-term management.
Familial and Genetic Susceptibility to Major Neonatal Morbidities in Preterm Twins
Authors: Bhandari Vineet , Bizzarro Matthew J. , Shetty Anupama , Zhong Xiaoyun , Page Grier P. , Zhang Heping , Ment Laura R. , Gruen Jeffrey R. ,   for the Neonatal Genetics Study Group
Published: June 2006

BACKGROUND. Intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia remain significant causes of morbidity and mortality in preterm newborns.

OBJECTIVES. Our goal was to assess the familial and genetic susceptibility to intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia.

METHODS. Mixed-effects logistic-regression and latent variable probit model analysis were used to assess the contribution of several covariates in a multicenter retrospective study of 450 twin pairs born at ≤32 weeks of gestation. To determine the genetic contribution, concordance rates in a subset of 252 monozygotic and dizygotic twin pairs were compared.

RESULTS. The study population had a mean gestational age of 29 weeks and birth weight of 1286 g. After controlling for effects of covariates, the twin data showed that 41.3%, 51.9%, and 65.2%, respectively, of the variances in liability for intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia could be accounted for by genetic and shared environmental factors. Among the 63 monozygotic twin pairs, the observed concordance for bronchopulmonary dysplasia was significantly higher than the expected concordance; 12 of 18 monozygotic twin pairs with ≥1 affected member had both members affected versus 3.69 expected. After controlling for covariates, genetic factors accounted for 53% of the variance in liability for bronchopulmonary dysplasia.

CONCLUSIONS. Twin analyses show that intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia are familial in origin. These data demonstrate, for the first time, the significant genetic susceptibility for bronchopulmonary dysplasia in preterm infants.
Ultrasonographic Features and Severity Scoring of Periventricular Hemorrhagic Infarction in Relation to Risk Factors and Outcome
Authors: Bassan Haim , Benson Carol B. , Limperopoulos Catherine , Feldman Henry A. , Ringer Steven A. , Veracruz Elaine , Stewart Jane E. , Soul Janet S. , DiSalvo Donald N. , Volpe Joseph J. , du Plessis Adré J.
Published: June 2006

OBJECTIVE. Early diagnosis of periventricular hemorrhagic infarction in premature infants is based on bedside neonatal cranial ultrasonography. Currently, evaluation of its morphology and evolution by cranial ultrasound relies largely on data predating major advances in perinatal care and lacks a consistent classification system for determining severity of injury. The objective of this study was to examine the ultrasonographic morphology and evolution of periventricular hemorrhagic infarction in the modern NICU and to determine the value of a cranial ultrasonography-based severity score for predicting outcome.

METHODS. We retrospectively evaluated all cranial ultrasounds and medical records of 58 premature infants with periventricular hemorrhagic infarction. We assigned each subject a severity score based on extent of echodensity, unilateral versus bilateral, and presence or absence of midline shift. A neurologic examination was performed after 12 months adjusted age.

RESULTS. The parenchymal echodensity of periventricular hemorrhagic infarction most often involved parietal and frontal territories and evolved into single and/or multiple cysts. One quarter of cases were bilateral, and nearly 70% were extensive. Higher severity scores were significantly associated with pulmonary hemorrhage and low bicarbonate levels and with outcomes of fatality, early neonatal seizures, and motor disability.

CONCLUSIONS. Despite advances in perinatal medicine, periventricular hemorrhagic infarction remains an important complication of prematurity. Periventricular hemorrhagic infarction can be graded using a scoring system based on sonographic characteristics. Higher severity scores predict worse outcome. Such severity scoring could improve the clinician's ability to counsel parents regarding management decisions and early intervention strategies.
Hospital Volume and Neonatal Mortality Among Very Low Birth Weight Infants
Authors: Bartels Dorothee B. , Wypij David , Wenzlaff Paul , Dammann Olaf , Poets Christian F.
Published: June 2006

BACKGROUND. Very low birth weight infants (<1500 g) are at increased mortality risk. Data on the impact of NICU volume are sparse, in comparison with those on the level of care. We hypothesized that neonatal mortality would be higher in small NICUs (<36 very low birth weight admissions per year) than in large NICUs, with adjustment for volume of the delivery unit.

METHODS. We analyzed population-based data from a quality assurance program in Lower Saxony (Germany). Perinatal data for almost all very low birth weight infants born in 1991 to 1999 (n = 7745) were available. Analyses were restricted to infants born at 24 to 30 weeks (n = 4379). Data validation procedures, univariate data analyses, and logistic regression models based on general estimating equations were performed.

RESULTS. Neonatal mortality among infants admitted to NICUs was 12.2% in small NICUs and 10.2% in large NICUs. The mortality rate in small NICUs was increased significantly. Compared with infants from large delivery hospitals (>1000 births per year) and large NICUs, the adjusted odds ratio was 1.94 for neonates for whom both units were small, 1.75 for those from large delivery units but small neonatal units, and 1.16 for those for whom only the NICU was large. Stratification according to gestational age revealed the greatest impact on mortality for infants of <29 weeks.

CONCLUSIONS. Results suggest that creating larger perinatal centers may improve perinatal health care. The volume of the NICU was associated more strongly with 28-day mortality than was the volume of the delivery hospital, and it had the largest impact on survival for infants of <29 weeks.
Reported Medication Use in the Neonatal Intensive Care Unit: Data From a Large National Data Set
Authors: Clark Reese H. , Bloom Barry T. , Spitzer Alan R. , Gerstmann Dale R.
Published: June 2006

OBJECTIVES. The objectives were (1) to identify the drugs reported most commonly during NICU care, (2) to examine how different methods of documenting drug use could influence prioritization of drugs for future research aimed at evaluating safety and efficacy, (3) to describe the demographic differences in the population samples for some specific medications, (4) to identify which reported medications are used for patient populations with >20% mortality rates, and (5) to examine how reports of drug use change over time.

METHODS. A retrospective review of a large national data set was performed.

RESULTS. The 10 medications reported most commonly for the NICU were ampicillin, gentamicin, ferrous sulfate, multivitamins, cefotaxime, caffeine citrate, furosemide, vancomycin, surfactant, and metoclopramide. Medications used for patient populations with >20% mortality rates included amphotericin, clonazepam, dobutamine, epinephrine, ethacrynic acid, insulin, lidocaine, metolazone, milrinone, inhaled nitric oxide, nitroglycerin, octreotide, pancuronium, phenytoin, sodium nitroprusside, sodium polystyrene sulfonate (Kayexalate), tris-hydroxymethylaminomethane acetate buffer, and tolazoline. Several of these drugs (eg, amphotericin B and bumetanide) were used primarily for extremely premature neonates, and this usage might explain the high mortality rates for the population of neonates treated with these medications. Other medications (clonazepam, milrinone, inhaled nitric oxide, and phenytoin) were used primarily for near-term and term infants. The explanation for the high mortality rates for these neonates is less clear and may be related primarily to the severity of illness for which the medications are used. Utilization rates for several different medications (eg, cisapride, metoclopramide, and dexamethasone) changed by >50% during the past 5 years.

CONCLUSIONS. Data reported here are the first from a large national data set on the use of different medications for neonates admitted for intensive care and should be helpful in establishing priority agendas for future drug studies in this population.
Prevalence of Abnormal Lipid and Blood Pressure Values Among an Ethnically Diverse Population of Eighth-Grade Adolescents and Screening Implications
Authors: Jago Russell , Harrell Joanne S. , McMurray Robert G. , Edelstein Sharon , El Ghormli Laure , Bassin Stanley
Published: June 2006

OBJECTIVES. Our goal was to report the prevalence of elevated blood pressure and lipid levels among eighth-grade adolescents from 3 US locations and differences by gender, ethnicity, and overweight percentile group.

METHODS. Fasting blood samples and blood pressure levels were obtained from 1717 eighth-grade students from 12 predominantly minority schools in 3 states (Texas, California, and North Carolina) during spring 2003. Age, gender, ethnicity, weight, and height were ascertained and BMI calculated. The presence of abnormal total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides, prehypertension, hypertension, at risk for overweight, and overweight were calculated and compared with the findings of previous youth studies. We examined whether prevalence differed by gender, ethnicity, or BMI group.

RESULTS. A total of 23.9% of participants had high blood pressure, 16.7% had borderline total cholesterol, 4.0% had high total cholesterol, 10.5% had borderline low-density lipoprotein cholesterol, 3.9% had high low-density lipoprotein cholesterol, 13.3% had low high-density lipoprotein cholesterol, and 17.2% had high triglycerides. A total of 19.8% of participants were at risk of overweight (BMI ≥85th percentile, <95th percentile) and 29% were overweight (BMI ≥95th percentile). The prevalence of risk factors was associated (P < .05) with the overweight group and differed by age and gender.

CONCLUSIONS. Prevalence of elevated blood pressure was higher in this sample than in previous national surveys in which subjects were less overweight. Associations between overweight and both elevated lipid and blood pressure levels suggest that adolescents overweight or at risk for overweight should be screened for elevated blood pressure and lipid levels.
Neonatal Herpes Simplex Virus Infections in Canada: Results of a 3-Year National Prospective Study
Authors: Kropp Rhonda Y. , Wong Thomas , Cormier Louise , Ringrose Allison , Burton Sandra , Embree Joanne E. , Steben Marc
Published: June 2006

OBJECTIVE. The goal was to determine incidence, determinants, and morbidity and mortality rates of neonatal herpes simplex virus infections in Canada.

METHODS. From October 1, 2000, to September 30, 2003, reports of neonatal herpes simplex virus infection were solicited actively from all Canadian pediatricians and pediatric subspecialists on a monthly basis.

RESULTS. Fifty-eight cases of neonatal herpes simplex virus were reported (5.9 cases per 100000 live births). Cesarean section was performed in 24.6% of cases, 28.1% of patients were born prematurely, 28.6% had birth weights of <2500 g, and 7.5% had Apgar scores of <7 at 5 minutes of life. Mothers <20 years of age and those reporting Aboriginal ethnicity were affected disproportionately; 40% of mothers had no history of genital herpes before delivery, and intrapartum genital lesions were present in only 1 of 58 cases. Of cases with known herpes simplex virus type, 62.5% were herpes simplex virus-1. Localized infections accounted for 59.6% of cases, whereas disseminated disease and central nervous system disease were reported for 17.5% and 22.8%, respectively. Localized infections were more likely to be herpes simplex virus-1 and disseminated and central nervous system infections herpes simplex virus-2. Nine of 58 cases were fatal. All cases with known treatment information (n = 55) were treated with intravenously administered acyclovir.

CONCLUSIONS. This is the first study to examine the national incidence of neonatal herpes simplex virus in Canada. Many women had no genital herpes simplex virus history before delivery, and the majority of cases were herpes simplex virus-1, which has implications for prenatal screening and vaccine/drug development. Follow-up monitoring of case subjects is being performed annually for 3 years, to be completed in October 2006.
Tobacco Promotion and the Initiation of Tobacco Use: Assessing the Evidence for Causality
Authors: DiFranza Joseph R. , Wellman Robert J. , Sargent James D. , Weitzman Michael , Hipple Bethany J. , Winickoff Jonathan P. ,   for the Tobacco Consortium, Center for Child Health Research of the American Academy of Pediatrics
Published: June 2006

OBJECTIVE. We sought to determine whether there is evidence of a causal link between exposure to tobacco promotion and the initiation of tobacco use by children.

METHODS. We conducted a structured search in Medline, PsycINFO, and ABI/INFORM Global to identify relevant empirical research. The literature was examined against the Hill epidemiologic criteria for determining causality.

RESULTS. (1) Children are exposed to tobacco promotion before the initiation of tobacco use; (2) exposure increases the risk for initiation; (3) there is a dose-response relationship, with greater exposure resulting in higher risk; (4) the increased risk is robust; it is observed with various study methods, in multiple populations, and with various forms of promotion and persists after controlling for other factors; (5) scientifically plausible mechanisms whereby promotion could influence initiation exist; and (6) no explanation other than causality can account for the evidence.

CONCLUSIONS. Promotions foster positive attitudes, beliefs, and expectations regarding tobacco use. This fosters intentions to use and increases the likelihood of initiation. Greater exposure to promotion leads to higher risk. This is seen in diverse cultures and persists when other risk factors, such as socioeconomic status or parental and peer smoking, are controlled. Causality is the only plausible scientific explanation for the observed data. The evidence satisfies the Hill criteria, indicating that exposure to tobacco promotion causes children to initiate tobacco use.
Practices and Perceptions of Long-term Follow-up Among State Newborn Screening Programs
Authors: Hoff Timothy , Hoyt Adrienne
Published: June 2006

OBJECTIVES. The purposes of the study were to describe and to analyze the types of policies and practices that exist currently among state newborn screening programs in relation to long-term follow-up oversight and activities for newborns with confirmed disorders and to examine the perceptions of newborn screening program leaders regarding long-term follow-up activities.

METHODS. A 23-question survey was administered to state newborn screening program coordinators in each of the 50 states, the District of Columbia, Puerto Rico, and the US Virgin Islands in January to February 2005.

RESULTS. Survey findings revealed significant variation in terms of how long-term follow-up is defined, staffed, and conducted within state newborn screening programs. This variation does not seem to be related to existing state program capacity, in terms of size of newborn screening programs or available resources. In addition, at present many state programs do not conduct long-term follow-up oversight or activities for newborns with diagnosed disorders, and many of those that do seem to lack necessary staffing and quality assurance mechanisms for effective long-term follow-up.

CONCLUSIONS. The results point generally to a need for greater attention in aligning state newborn screening program capacity with long-term follow-up, increased emphasis on standardization for long-term follow-up activities, and development of stronger quality assurance oversight from state newborn screening programs if effective long-term follow-up oversight is to occur nationally. Given the present expansion of newborn screening in many states, additional research and policymaking with respect to long-term follow-up seem warranted.
Postnatal Head Growth Deficit Among Premature Infants Parallels Retinopathy of Prematurity and Insulin-like Growth Factor-1 Deficit
Authors: Löfqvist Chatarina , Engström Eva , Sigurdsson Jon , Hård Anna-Lena , Niklasson Aimon , Ewald Uwe , Holmström Gerd , Smith Lois E. H. , Hellström Ann
Published: June 2006

BACKGROUND. We hypothesized that in premature infants, retinal vascular growth retardation between birth and postmenstrual age of ∼30 to 32 weeks that initiates retinopathy of prematurity is paralleled by brain growth retardation.

METHODS. In a prospective longitudinal study, we measured postnatal head growth, retinopathy of prematurity stage, protein and energy intake, severity of illness and serum insulin-like growth factor-1 levels in 58 preterm infants (mean gestational age at birth: 27.6 weeks) from birth until postmenstrual age of ∼40 weeks.

RESULTS. Premature infant head growth decelerates dramatically after birth until postmenstrual age of ∼30 weeks. Head growth retardation coincides with retinal vascular growth suppression. Accelerated growth follows between post menstrual ages of ∼30 to 32 weeks and ∼40 weeks. The degree of head growth retardation up to postmenstrual age of 31 weeks corresponds to the degree of retinopathy of prematurity and to the degree of suppression of serum levels of insulin-like growth factor-1. At postmenstrual age of 31 weeks, if a child’s head circumference SD is below −2.5, then the probability of also developing at least stage 3 retinopathy of prematurity increases fivefold compared with head circumference above −2.5 SD (32% vs 6%) suggesting parallel processes in brain and retina. Serum insulin-like growth factor-1 levels correlate positively with head circumference SD score and with the degree of retinopathy of prematurity.

CONCLUSIONS. The correlation between head and retinal growth is consistent with insulin growth factor-1 being one of the postnatal growth factors involved in this multifactorial process and also suggests that factors that contribute to retinopathy of prematurity during this critical period may also affect neurological dysfunction. Additional studies are required to establish this connection.
Pediatric Medication Safety and the Media: What Does the Public See?
Authors: Stebbing Claire , Kaushal Rainu , Bates David W.
Published: June 2006

BACKGROUND. In the safety community, it is widely thought that a culture of safety is required to achieve high levels of safety. However, the press tends to report accidents, which are negative by their nature. Pediatric cases are often especially tragic. Relatively few data have been available on the role that the media play in forming opinions about patient safety and the subsequent impact on the culture of safety.

METHODS. To address these issues, we analyzed newspaper coverage of pediatric medication errors and adverse drug events. We searched Lexis Nexis for newspaper articles on pediatric medication safety from the United States, Canada, United Kingdom, Australia, and Ireland, during a 10-year period (1994–2004), by using specific keywords. Main outcome measures were the number of articles (adjusted for population), the type of events covered, and article slant. We also examined qualitatively the overall themes and the extent to which these articles portrayed a culture of safety to the public.

RESULTS. Throughout the world, there was a steady increase in articles on pediatric medication safety, peaking in 2003, with the highest per-capita rate in Canada. Approximately 65% of articles were about patient incidents, 20% mentioned policy, and 25% discussed research. Of the reported events judged to be negative for patient safety, 75% were covered in a neutral manner and 19% were covered in an unduly negative manner.

CONCLUSIONS. Media coverage of pediatric medication safety has increased in the past 10 years. Reporting of patient safety failures was generally fair, and reports were generally framed in light of a culture of safety.
Variation in the Use of Intracranial-Pressure Monitoring and Mortality in Critically Ill Children With Meningitis in the United States
Authors: Odetola Folafoluwa O. , Tilford John M. , Davis Matthew M.
Published: June 2006

OBJECTIVE. Our goal was to describe patient and hospital characteristics associated with the use of intracranial pressure monitors and outcomes in critically ill children with meningitis.

METHODS. This was a retrospective cohort study of children 0 to 17 years of age hospitalized with meningitis and requiring mechanical ventilation using the 1997 and 2000 Kids' Inpatient Database. We generated national estimates of rates of intracranial pressure monitoring and in-hospital mortality by patient and hospital characteristics, and compared in-hospital mortality, hospital length of stay, and total charges for children who received an intracranial pressure monitor with those who did not.

RESULTS. There were an estimated 1067 and 1170 hospitalizations nationally for childhood meningitis requiring mechanical ventilation in 1997 and 2000, respectively. Most (79%) of the hospitalizations involved infants. Overall, intracranial-pressure monitors were used in 7% of hospitalizations for meningitis, with the highest rates in children aged 5 to 17 years and lowest rates in children <1 year. In-hospital mortality was 19.6%, highest in children aged 5 to 17 years and in children with pneumococcal infections. In multivariate regression analyses, intracranial pressure monitor use was positively associated with age, patient volume, and hospitals located in the West census region. In-hospital mortality was associated with increasing age, hospitalization in the year 2000, self-pay/other insurance status, and pneumococcal meningitis. There was no difference in hospital mortality associated with use of intracranial pressure monitors, but both length of stay and log-transformed total hospital charges were significantly higher in the group that received an intracranial-pressure monitor.

CONCLUSION. Intracranial pressure monitoring for the treatment of critically ill children with meningitis varies by census region, the number of cases treated, and patient age. The use of intracranial pressure monitoring was not statistically associated with mortality in this national sample.
Parenting Styles and Overweight Status in First Grade
Authors: Rhee Kyung E. , Lumeng Julie C. , Appugliese Danielle P. , Kaciroti Niko , Bradley Robert H.
Published: June 2006

OBJECTIVE. The goal was to determine the relationship between the 4 parenting styles (authoritative, authoritarian, permissive, and neglectful) and overweight status in first grade.

METHODS. Data from the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development were analyzed. Children with complete data for parenting parameters at 54 months and measured weight and height in first grade were included in the analysis. Overweight was defined as BMI of ≥95th percentile. The 4 parenting styles were constructed with 2 scales, namely, maternal sensitivity and maternal expectations for child self-control. Multivariate logistic regression analysis was used to evaluate the relationship between parenting style and overweight in first grade, controlling for gender, race, maternal education, income/needs ratio, marital status, and child behavior problems.

RESULTS. A total of 872 children, 11.1% overweight and 82.8% white, were included in the analysis. Children of authoritarian mothers (n = 298) had an increased risk of being overweight, compared with children of authoritative mothers (n = 179). Children of permissive (n = 132) and neglectful (n = 263) mothers were twice as likely to be overweight, compared with children of authoritative mothers. Of the covariates, only income/needs ratio was significant and did not alter the relationship between parenting style and overweight risk.

CONCLUSIONS. Among the 4 parenting styles, authoritarian parenting was associated with the highest risk of overweight among young children. Understanding the mechanisms through which parenting styles are associated with overweight risk may lead to the development of more-comprehensive and better-targeted interventions.
Recurrent Wheeze in Early Childhood and Asthma Among Children at Risk for Atopy
Authors: Ly Ngoc P. , Gold Diane R. , Weiss Scott T. , Celedón Juan C.
Published: June 2006

OBJECTIVES. Little is known about the natural history of wheezing disorders among children at risk for atopy. We examined the relation between early wheeze and asthma at 7 years of age among children with parental history of asthma or allergies followed from birth.

METHODS. Information on wheeze was collected bimonthly from birth to age 24 months and every 6 months thereafter. Recurrent early wheeze was defined as ≥2 reports of wheezing in the first 3 years of life. Frequent early wheeze was defined as ≥2 reports of wheezing per year in the first 3 years of life. At 7 years of age, asthma was defined as physician-diagnosed asthma and wheezing in the previous year.

RESULTS. Of the 440 participating children, 223 (50.7%) had ≥1 report of wheeze before 3 years old, 111 (26.0%) had recurrent early wheeze, and 12 (2.7%) had frequent early wheeze. Whereas only 31 (13.9%) of 223 children with ≥1 report of wheeze developed asthma at 7 years of age, 24 (21.6%) of 111 children with recurrent early wheeze developed asthma at 7 years of age. Among the 12 children with frequent early wheeze, 6 (50%) had asthma at 7 years of age. After adjustment for other covariates, recurrent early wheeze in children at risk for atopy was associated with a fourfold increase in the odds of asthma at 7 years of age, and frequent early wheeze was associated with an ∼12-fold increase in the odds of asthma at 7 years of age. Most (94%) of the children without frequent early wheeze did not develop asthma at 7 years of age.

CONCLUSIONS. The absence of recurrent early wheeze indicates a very low risk of asthma at school age among children with parental history of asthma or allergies. Early identification of children who will develop asthma at school age is difficult, even in children at risk for atopy. However, children with parental history of asthma or allergies who have frequent early wheeze, in particular, are at greatly increased risk of asthma and merit close clinical follow-up.
Self-injurious Behaviors in a College Population
Authors: Whitlock Janis , Eckenrode John , Silverman Daniel
Published: June 2006

OBJECTIVE. The goal was to assess the prevalence, forms, demographic and mental health correlates of self-injurious behaviors in a representative college sample.

METHODS. A random sample of undergraduate and graduate students at 2 northeastern US universities were invited to participate in an Internet-based survey in the spring of 2005. Thirty-seven percent of the 8300 invited participants responded.

RESULTS. The lifetime prevalence rate of having ≥1 self-injurious behavior incident was 17.0%. Seventy-five percent of those students engaged in self-injurious behaviors more than once. Thirty-six percent reported that no one knew about their self-injurious behaviors and only 3.29% indicated that a physician knew. Compared with non-self-injurers, those with repeat self-injurious behavior incidents were more likely to be female, bisexual or questioning their sexual orientation. They were less likely to be Asian/Asian American and >24 years of age. When controlling for demographic characteristics, those with repeat self-injurious behavior incidents were more likely to report a history of emotional abuse or sexual abuse, ever having considered or attempted suicide, elevated levels of psychological distress, and ≥1 characteristic of an eating disorder. A dose-response gradient was evident in each of these areas when single-incident self-injurious behaviors were compared with repeat-incident self-injurious behaviors.

CONCLUSIONS. A substantial number of college students reported self-injurious behaviors in their lifetimes. Many of the behaviors occurred among individuals who had never been in therapy for any reason and who only rarely disclosed their self-injurious behaviors to anyone. Single self-injurious behavior incidents were correlated with a history of abuse and comorbid adverse health conditions but less strongly than were repeat self-injurious behavior incidents. The reticence of these clients to seek help or advice renders it critical that medical and mental health providers find effective strategies for detecting and addressing self-injurious behaviors.
Pediatric All-Terrain Vehicle–Related Injuries in Ohio From 1995 to 2001: Using the Injury Severity Score to Determine Whether Helmets Are a Solution
Authors: Gittelman Michael A. , Pomerantz Wendy J. , Groner Jonathan I. , Smith Gary A.
Published: June 2006

OBJECTIVE. The goal was to identify regions in Ohio with severe pediatric all-terrain vehicle–related injuries and to determine whether helmet usage was associated with lower injury severity scores.

METHODS. We performed a retrospective review of data for all patients entered into the registries of Ohio’s major pediatric trauma centers for the period of January 1, 1995, to December 31, 2001.

RESULTS. Seven hospitals participated. A total of 285 children were admitted; 2 patients died, and 13 required rehabilitation. The mean age was 11.1 years, with 76.1% of patients being male and 88.1% white. Most patients came from the central and southwestern regions of Ohio. An average of 30 admissions per year occurred from 1995 to 1998, but the number increased to 55 admissions per year from 1999 to 2001. Among the 285 injured children, 869 injuries were sustained; 57% of patients sustained multiple injuries. The most commonly injured body parts were the head (22.3%) and lower extremities (12.6%). The most common injuries sustained were fractures (31.4%) and contusions/abrasions (22.2%). Of patients for whom documentation was available, 72.2% (171 of 237 patients) were not helmeted. There was no significant difference in mean injury severity scores between helmeted and nonhelmeted riders (9.58 vs 9.12). Helmet usage was not associated with a reduction in head/facial injuries.

CONCLUSIONS. All-terrain vehicle–related injuries to children nearly doubled between 1995 to 1998 and 1999 to 2001. Fewer than 30% of injured children were wearing helmets at the time of injury. With the injury severity score as an indicator, helmets provided no significant protection for all-terrain vehicle riders in this pediatric population.
Meadow, Southall, and the General Medical Council of the United Kingdom
Authors: Chadwick David L. , Krous Henry F. , Runyan Desmond K.
Published: June 2006

In this article we address the recent actions of the General Medical Council in the United Kingdom affecting 2 pediatricians who are major contributors to pediatric knowledge about the intentional suffocation of infants. The General Medical Council struck one of them from the register of licensed medical practitioners, but the decision was appealed successfully. The council restricted the practice of the other pediatrician. After a review of the transcripts of the hearings, we conclude that the opinions given by both doctors were responsible, and the transcripts suggest that the conduct of the hearings was unfair. Licensing boards may have difficulty in competently regulating doctors' expert testimony, at least in cases involving child maltreatment.
Hypericin‐induced Photocytotoxicity is Connected with G2/M Arrest in HT‐29 and S‐Phase Arrest in U937 Cells
Authors: Sačková Veronika , Fedoročko Peter , Szllardiová Beáta , Mikeš Jaromír , Kleban Ján
Published: June 2006

Susceptibility of the HT‐29 human colon adenocarcinoma cell line and human myeloid leukemia cell line U937 to hypericinmediated photocytotoxicity was investigated and compared in this study. Cellular parameters as viability, cell number, metabolic activity and total protein amount were monitored in screening experiments with subsequent cell‐cycle analysis and apoptosis detection to determine the cellular response of the different tumor types to various concentrations of photoactivated hypericin. The results show concentration dependence of the photosensitizer's cytotoxicity on the studied cell lines, with higher sensitivity of U937 cells. Whereas the two extreme hypericin concentrations (1 × 10−9 M and 1 × 10−6 M) resulted in similar changes in all tested cellular parameters on the two studied cell lines, 1 × 10−8 M and 1 × 10−7 M hypericin treatment resulted in different responses of the cell lines in all monitored parameters except for viability. Although leukemic cells proved sensitive to both 1 × 10−8 M and 1 × 10−7 M hypericin, significant changes on HT‐29 cells were detected only after the 1 × 10−7 M hypericin concentration. Cell‐cycle arrest was related to simultaneously occurring apoptosis in colon cancer. Remarkable is the difference in cell‐cycle profile where G2/M arrest in colon cancer cells versus accumulation of leukemic cells in the S phase appears. This suggests that hypericin treatment affecting the cell‐cycle machinery of different cancer cells is not universal in effect.
Blue Light Irradiation Inhibits the Production of HGF by Human Retinal Pigment Epithelium Cells In Vitro
Authors: Chu Rengyuan , Zheng Xiaofen , Chen Donghong , Hu Dan‐Ning
Published: June 2006

Blue visible light damage to retinal pigment epithelial cells occurs through a photooxidative mechanism and the resultant damage is hypothesized to induce or exacerbate age‐related macular degeneration. The purpose of the present study was to identify changes in the cell growth and the expression of hepatocyte growth factor (HGF) in cultured human retinal pigment epithelium (RPE) cells as a result of both blue and red light irradiation. HGF is a growth factor and neurotrophic factor that stimulates growth of various ocular cells and promotes the survival of RPE and retinal neurons. Early passages of human RPE cells were exposed to blue light (460 nm) and red light (640 nm). Nonirradiated cells were used as controls. After 24 and 48 h, conditioned medium was collected and the amount of HGF was measured by ELISA. Cells were detached from the well and counted. Cell viability was evaluated by trypan‐blue exclusion study. Blue light at dosage of 63 J/cm 2 significantly inhibited the growth of RPE cells without affecting of cell viability. Amounts of HGF in the culture medium were significantly inhibited by blue‐light irradiation at the dosage from 32 to 63 J/cm2. Red light at a dose of 174 J/cm2 causes a nonsignificant inhibition of growth of RPE cells and a slight decrease of secretion of HGF. As HGF promotes survival of RPE cells and retinal neurons, the inhibition of production of HGF by visible light, especially by blue light, may enhance the phototoxic effects of visible light on the RPE and retinal neurons.
Sampling Silica and Ferrihydrite Colloids with Fiberglass Wicks under Unsaturated Conditions
Authors: Shira Jason M. , Williams Barbara C. , Flury Markus , Czigány Szabolcs , Tuller Markus
Published: June 2006

The suitability of passive capillary samplers (PCAPS) for collection of representative colloid samples under partially saturated conditions was evaluated by investigating the transport of negatively and positively charged colloids in fiberglass wicks. A synthetic pore water solution was used to suspend silica microspheres (330 nm in diameter) and ferrihydrite (172 nm in diameter) for transport experiments on fiberglass wicks. Breakthrough curves were collected for three unsaturated flow rates with silica microspheres and one unsaturated flow rate with ferrihydrite colloids. A moisture characteristic curve, relating tensiometer measurements of matric potential to moisture content, was developed for the fiberglass wick. Results indicate that retention of the silica and the ferrihydrite on the wick occurred; that is, the wicks did not facilitate quantitative sampling of the colloids. For silica microspheres, 90% of the colloids were transmitted through the wicks. For ferrihydrite, 80 to 90% of the colloids were transmitted. The mechanisms responsible for the retention of the colloids on the fiberglass wicks appeared to be physicochemical attachment and not thin‐film, triple‐phase entrapment, or mechanical straining. Visualization of pathways by iron staining indicates that flow is preferential at the center of twisted bundles of filaments. Although axial preferential flow in PCAPS may enhance their hydraulic suitability for sampling mobile colloids, we conclude that without specific preparation to reduce attachment or retention, fiberglass wicks should only be used for qualitative sampling of pore water colloids.
Effects of Moisture and Temperature on Carbon and Nitrogen Mineralization in Mine Tailings Mixed with Sewage Sludge
Authors: Wennman Pär , Kätterer Thomas
Published: June 2006

Digested sewage sludge mixed with copper mine tailings was incubated for 3 mo at 16 combinations of temperature (−1, 5, 10, and 15°C) and soil moisture content (2, 8, 14, and 24% by weight). Carbon dioxide evolution and net N mineralization were measured at increasing time intervals. A two compartment first‐order kinetic model (refractory and labile C) was fitted to the time series of measured CO2 fluxes using nonlinear regression analysis. The dependencies of the rate constants on moisture and temperature could be well described by log‐linear functions. The estimated Q10 value (the factor by which the rate is increased as temperature is increased 10°C) was 2.55. Within the range of temperature and moisture considered here, which correspond to conditions occurring naturally in Sweden, CO2 evolution was more strongly controlled by moisture than by temperature. Less mineral N accumulated during the experiment at the lowest moisture or temperature. However, the dependency of net N mineralization on moisture and temperature in the remaining treatments was less clear than for C evolution, presumably due to denitrification at the higher temperatures and moisture contents. Nitrate was formed after around 2 wk but only at 10 and 15°C.
Organic Phosphorus Fractions in Organically Amended Paddy Soils in Continuously and Intermittently Flooded Conditions
Authors: Yang Changming , Yang Linzhang , Jianhua Lee
Published: June 2006

Soil organic phosphorus (SOP) can greatly contribute to plant‐available P and P nutrition. The study was conducted to determine the effects of organic amendments on organic P fractions and microbiological activities in paddy soils. Samples were collected at the Changshu Agro‐ecological Experiment Station in Tahu Lake Basin, China, from an experiment that has been performed from 1999 to 2004, on a paddy soil (Gleysols). Treatments consisted of swine manure (SM), wheat straw (WS), swine manure plus wheat straw (SM + WS), and a control (chemical fertilization alone). Organic amendments markedly increased soil total organic phosphorus (TOP) and total organic carbon (TOC), especially in continuously flooded conditions. Based on the fractionation of SOP, organic amendments significantly increased soil labile organic phosphorus (LOP), moderately labile organic phosphorus (MLOP), and moderately stable organic phosphorus (MSOP) compared with the control. For SM and SM + WS treatments, LOP in continuously flooded soils decreased by 30.1 and 36.4%, respectively, compared to intermittently flooded soils. In organically amended soils, continuous flooding showed significantly lower microbial biomass phosphorus (MBP) and alkaline phosphatase activities (APA) than intermittent flooding. In intermittently flooded conditions, incorporating organic amendments into soil resulted in greater P uptake and biomass yield of rice than the control. In the intermittently flooded soils, APA (P< 0.05) and MBP (P< 0.01) were significantly and positively related to TOP, LOP, MLOP, and MSOP, whereas in continuously flooded soils, there was a significant (P< 0.05) negative relationship between MBP, TOP, and MSOP. Based on soil organic P fractions and soil enzymatic and microbiological activities, continuous flooding applied to paddy soils should be avoided, especially when swine manure is incorporated into paddy soil.