bluuebunny/crossref_metadata_2025 huggingface dataset:
The Art of Mathematical Modeling
Authors: Raynes Sylvain , Rutledge Ann
Published: November 2023

When the pianist Van Cliburn was still a student at the Juilliard School of Music, the legendary Arthur Rubenstein overheard him practicing one day and declared, “Now that you can play the piano so well, maybe you could start to make some music! “
Regression Analysis
Authors: Raynes Sylvain , Rutledge Ann
Published: November 2023

As discussed in chapter 6, the nonlinear nature of structured finance significantly complicates the credit analysis of structured securities and requires the use of iterative solution procedures that fully articulate the codependence between the shape of the yield curve and the target credit ratings. The complexity of the task usually requires access to high-speed computers. In fact, the greatest contribution of numerical analysis over the past twenty years has probably been the ability to solve nonlinear problems without undue recourse to simplifying assumptions. Before proceeding to the techniques of linear and nonlinear regression, however, we must ask ourselves why nonlinearity makes problem solving so complicated. The answer is that, although linearity has a formal definition, nonlinearity does not. Linear operators abound in all branches of mathematics, physics, and economics. They tend to be treated uniformly and generically because they all share the same formal properties. By contrast, each nonlinear operator has idiosyncratic characteristics. In some cases, these characteristics contribute to a closed-form solution, but in others, the problem is virtually unsolvable without the aid of numerical analysis. The heterogeneous character of non-linear problems makes nonlinearity easiest to apprehend as the opposite of linearity.
The Newton-Raphson Nonlinear Optimization Method
Authors: Raynes Sylvain , Rutledge Ann
Published: November 2023

Serious cash flow models used in structured finance are generally required to solve systems of nonlinear equations that stem either from nonlinear regression analysis or from an ad hoc asset-behavior model. Commercial packages exist to solve most nonlinear systems, but integrating them smoothly into a structured analysis code can be difficult; the result is often a hybrid construct no one wants to maintain or use. Our main goal in this section is to guide analysts in building nonlinear solution packages that can be maintained and reused for any given asset class. A subsidiary benefit is the ability to write fast routines that reduce the CPU requirements of Monte Carlo simulations by an order of magnitude. In chapter 20, we discuss Newton-Raphson (NR) implementation in detail in the case of auto-loan-backed securities.
Aircraft Receivable Securitizations
Authors: Raynes Sylvain , Rutledge Ann
Published: November 2023

One day, as he was returning from a lecture tour in Asia Minor, a famous Sophist spotted Socrates on the street. It was common for the philosopher to spend hours talking to a cobbler about what a shoe was. Approaching Socrates, the rhetorician remarked sarcastically, “My dear Socrates, are you still saying the same thing about the same thing?” Socrates replied, “Yes, that I am.
Leaders Talk Leadership
Authors: Ashby Meredith D , Miles Stephen A
Published: November 2023

Leaders Talk Leadership is an impressive collection of interviews with some of the world’s most respected corporate leaders and management scholars. Edited by Ashby and Miles of the preeminent executive search firm Heidrick and Struggles, this compilation of thought leadership spanning industries and geographies addresses the key issues facing executives today such as governance, leadership and strategy, how to lead in volatile times or through a corporate transformation, how to best leverage human capital and how to achieve competitive advantage in today’s environment. Some of the CEO’s featured in the book include Ken Chenault, of American Express, Steve Reinemund of PepsiCo, Heinrich von Pierer of Siemens, Ken Lewis of Bank of America, Edward Tian of China Netcom, Fred Smith of FedEx, Hank McKinnell of Pfizer, A.G. Lafley of Proctor and Gamble, Klaus Zumwinkel of Deutsche Post World Net, William Haseltine of Human Genome Sciences, Linda Sanford of IBM, Larry Weinbach of Unisys and Michael Dell of Dell Computer. Framing these cutting-edge concepts are interviews and written essays by preeminent academics, including Jay Conger from London Business School, Jim Collins of Good to Great, Mohanbir Sawhney of Kellogg School of Management at Northwestern University and Jeffrey Pfeffer of Stanford University. Serving as the line executive’s roadmap to recruiting, retaining and developing talent and an encyclopedia of MBA students worldwide, this book represents path-breaking leadership perspectives from path-breaking leaders.
Total Terror
Authors: Robin Corey
Published: November 2023

It was a sign of his good fortune—and terrible destiny—that Nikolai Bukharin was pursued throughout his short career by characters from the Old Testament. Among the youngest of the “Old Bolsheviks,” Bukharin was, in Lenin’s words, “the favorite of the whole party.” A dissident economist and accomplished critic, this impish revolutionary, standing just over five feet, charmed everyone. Even Stalin. The two men had pet names for each other, their families socialized together, and Stalin had Bukharin stay at his country house during long stretches of the Russian summer. So beloved throughout the party was Bukharin that he was called the “Benjamin” of the Bolsheviks. If Trotsky was Joseph, the literary seer and visionary organizer whose arrogance aroused his brothers’ envy, Bukharin was undoubtedly the cherished baby of the family.
Remains of the Day
Authors: Robin Corey
Published: November 2023

After every great battle comes a great despair. Particularly if the war is civil and insurgent, whether it is waged with words or arms, both sides feel desolate. Among the vanquished, comrade accuses comrade of treachery or cowardice, soldiers denounce generals for marching them toward folly, and everyone is soon seized by what Tocqueville described as the “contempt” that broken revolutionaries “acquire for the very convictions and passions which moved them” in the first place. Forced to abandon the cause for which they gave up so much, failed rebels “turn against themselves and consider their hopes as having been childish—their enthusiasm and above all, their devotion, absurd.” Unlike the losers, whose defeat is a permanent reminder of their struggle’s unrequited sacrifice, the victors suffer from short memories. Forgetting the hardships of battle, they mourn its lost noise. We felt more alive in the jaws of death, they cry, than we do now, in the lap of comfort. “Let me have a war” one of Aufidius’s servants notes in Coriolanus. “It exceeds peace as far as day does night; it’s spritely, waking, audible, and full of vent. Peace is a very apoplexy, lethargy; mulled, deaf, sleepy, insensible; a getter of more bastard children than war’s a destroyer of men.” Though the winners complain of victory’s deceleration, the real source of their unhappiness is its disenchantment. Victory forces victors to see that the good for which they fought is tarnished and soiled, that every promised land looks better from afar than up close. Perhaps that is why God never allows Moses off Mount Nebo: had he entered Canaan, he might have seen the waiting disappointment.
Introduction to the Debate Over Risky Technologies
Authors: Peters Philip G
Published: November 2023

Modem fertility treatments are miraculous. By offering children to the childless, they replace despair with euphoria. Yet even the simplest of these treatments can pose risks to future children. Failure to screen sperm donors, for example, can make artificial insemination unnecessarily dangerous. And high doses of ovulationinducing drugs can greatly increase the risk of a multiple pregnancy and the complications that accompany it. Today imminent reproductive techniques, like human cloning and germ-line genetic engineering, are believed to pose the risk of injuries so frequent and so serious that some respected experts call for their complete prohibition.
Treatments That Endanger Embryos
Authors: Peters Philip G
Published: November 2023

In vitro fertilization has an ectopic pregnancy rate (5%) that is two to four times higher than the rate for natural pregnancy.’ Human cloning is expected to have a miscarriage rate that is even higher.2 Most infertility patients, however, are willing to accept the risks associated with in vitro fertilization (IVF) and some are reportedly even prepared to run the risks associated with cloning. Should we limit their freedom to do so in order to protect their embryos and foetuses from an early demise? Is spontaneous abortion (miscarriage) yet another way reproductive technologies can harm future persons? News accounts often assume as much. They typically lump the enhanced risk of spontaneous abortion together with the substantial risk of serious birth defects when discussing the threat that cloning poses to future children. Yet birth defects are suffered by persons whose moral status is undisputed. By contrast, spontaneous abortions happen to embryos and foetuses. Thus, the harmfulness of infertility treatments associated with a high rate of embryo loss turns on the moral status assigned to the embryo.
Synthesis
Authors: Peters Philip G
Published: November 2023

Reproductive behaviour can harm future children in three different ways. First, reproductive practices can cause ordinary harm. Ordinary harm occurs when a clinic’s conduct makes a child worse off than she otherwise would have been. Second, the interests of future children are harmed when the birth of an injured child could have been avoided by changes in conduct leading to the birth of a different, healthier child. These injuries are avoidable by the substitution of one child for another. Finally, the use of a risky reproductive technique is also harmful when it cause injuries so serious that life itself is harmful. A harmful life is one that is worse than never existing at all. This comprehensive framework provides a template for identifying the situations in which a risky technology genuinely threatens the welfare of future children. It also provides a basis for targeting responsible protective legislation and for defending those laws from constitutional challenge.
A Critique of the “Deeply Rooted” Test
Authors: Peters Philip G
Published: November 2023

As explained in the last chapter, the history of American substantive due process doctrine is a cyclical history of expansion and contraction. Given our current location in this cycle, the Court’s recent emphasis on historical practices is understandable. But it is not the best choice that the Court could have made. The “deeply rooted” test has shortcomings that should lead to its eventual abandonment in favour of the multi-factorial approach advocated long ago by Justice Harlan. For Harlan, historical practice was only one of many relevant factors to be considered. Hopefully, the court’s recent decision in Lawrence is a sign that the court is now reaching the same conclusion.
Figuring Out What’s Wrong
Authors: Lehman Thomas J A
Published: November 2023

Before medical school I had to take all the required classes in college. Many of the classes required for medical school satisfied the requirements for majoring in zoology in college. I enjoy the outdoors and was happy to sign up for field zoology as one of the required courses. Armed with guidebooks, we walked around the local hills in small groups with an instructor looking for and identifying birds. Sometimes the instructor would hear a noise or see a bird vaguely in the distance and tell us what it was. Frequently, it was too far away to see the identifying characteristics noted in the guidebook, but when we got closer we would see that he was correct in his identification. Other times one of us would become very excited and announce that we had just seen a bird we had never seen before and we were sure it was, for example, a Mexican jay. The instructor would just shake his head. No matter how sure we were that it matched the picture in the book, he would point out that we were not in (or even close to) Mexico and that a common bird in our area looked a little bit like the Mexican jay. A few minutes’ investigation would invariably prove that he was right and we were wrong. He had been teaching this course in the same hills for many years. Each different bird had a typical behavior, a typical place it was likely to be seen, and a typical time of year it was likely to be there. These things were not in our guidebooks, but the instructor knew them from experience. With years of experience it was easy for him to recognize birds from much further away than we couId and to know when we couId not have seen what we thought we saw. He knew that there were rare exceptions, but they were always unlikely.
Sports Injuries
Authors: Lehman Thomas J A
Published: November 2023

Sports injuries are the most common causes of muscle, bone, and joint pains in childhood. Most are minor injuries related to trauma, easily recognized because the pain started right after falling, running into another child on the field, twisting an ankle, and so on. Often these are minor muscle and tendon injuries (bangs, scrapes, and sprains) that resolve over a few hours or days at most. Pain that is severe or persists requires medical attention.
Family Issues
Authors: Lehman Thomas J A
Published: November 2023

Most of the parents reading this book will not have a child with a serious chronic condition. They can skip this section. However, if your child does have a significant disability, or you think your child’s medical care is starting to take over your life, please read on. In one of my families there were three children; the oldest was a twelve year-old with severe arthritis. The decision was made that he would have a hip replacement after the end of the school year. Both parents were very concerned and everyone knew that Johnny was expected to be in the hospital for five days after the surgery. All of us would have the same initial response: Ask a sitter or a relative to care for Sally and Timmy (8 and 1O years old) so Mom and Dad can be at Johnny’s bedside for the five days. Summer travel plans are off, because Johnny will need a lot of physical therapy to recover and will not be able to travel. This all sounds reasonable, but it’s the wrong answer. Instead, Grandma came to take care of Sally and Timmy for the first two days. After it was clear that Johnny was recovering as expected, Dad took off with Sally and Timmy on a trip to one of their favorite places. Mom and Grandma relieved each other in the hospital. At the end of a week everyone was back at home feeling they had gotten lots of attention. Further, it was agreed that if Johnny made good progress in physical therapy, the whole family would go off to an amusement park at the end of the summer. Otherwise, Sally, Timmy, and Mom would go, and Dad would stay home with Johnny. Everyone got attention. Everyone had a shared goal. No one felt deprived or held back.
Is there a “male menopause”?
Authors: Segal Sheldon J , Mastroianni Luigi
Published: November 2023

Stories about aged fathers are legion, not only in the Bible but also in present times. According to the Guinness Book of Records, the oldest natural father in 2000 was Hu Chin-yao of Taiwan at age 109 years. Credibility of such claims aside, the asserted lifetime reproductive potential of the male does not represent a more advanced reproductive system than the female. To the contrary, the male system is an atavistic carryover from our evolutionary past, with striking similarities to a frog, fish, or mouse, whereas adaptations in the female reproductive system provide the evolutionary advances needed for our highly successful process of assuring nurture and support for single newborns. A microscopist looking at a human testis sees a structure remarkably similar to that of lower vertebrates—a compact body of tightly convoluted tubules held intact by a shiny, fibrous sheath. The structure of the human testis might be characterized as generic. The seminiferous tubules, in which sperm production takes place, would extend for several miles if straightened out. This tubular structure separates the sperm-producing function of the male gonad from the cells that produce its hormones (predominantly testosterone and other androgens). The sperm are produced inside the seminiferous tubules, which make up most of the bulk and weight of the testis, and the hormone-producing cells (Leydig cells) occupy the space outside the tubules.
Is testosterone the only androgen the body produces?
Authors: Segal Sheldon J , Mastroianni Luigi
Published: November 2023

The testis produces several different hormones with androgenic activity. Testosterone is the most well known. It gets blamed for everything macho and its loss is lamented as a farewell to verve. A gradual decline in testosterone begins from the peak blood levels at about 20 years of age. Between ages 50 and 80, the average level of bioavailable testosterone falls more than 50%. There has been an effort to find synthetic compounds that can offset this aging decline. Androgens with unusual chemical structures proved to be a misguided approach because of their association with liver toxicity. Unlike estrogenic hormones, plants and other natural sources have failed to provide a source of androgens for human application. Consequently, the source of molecular models for testosterone substitutes has been the human body. The normal pathways in the body for the synthesis of testosterone explain why men use various testosterone precursor compounds for body-building or to derive other benefits from higher testosterone levels. Sold as nutritional supplements, these precursors are active orally and can be converted in the body to testosterone. Claims that are made for these products must be evaluated with the realization that they are not regulated by the FDA and manufacturers have to prove neither their claims nor product safety before marketing those supplements.
Can AST help brain function in aging men?
Authors: Segal Sheldon J , Mastroianni Luigi
Published: November 2023

Cognitive function frequently declines with aging, so it is reasonable to suspect that the declining levels of testosterone in aging men may be a factor. Many scientific studies of an observational nature have been carried out to test this hypothesis. One way to approach this question is to determine whether an older man’s testosterone level is correlated with his cognitive function. Do men who perform well on standard neuropsychological tests have higher circulating testosterone levels than men who perform poorly? Yes, it turns out that they do. A group of researchers at the University of California-San Diego did an analysis of more than 500 men, 59–89 years of age. The subjects were noninstitutionalized residents of Rancho Bernardo, California. The investigators recorded the values of the men’s total testosterone, and subsequently a battery of 12 standard neuropsychological tests were given that test memory, immediate and delayed recall, fluency, and several other cognitive functions. Although the association proved to be weak, they found that high total testosterone levels were predictive of better performance on several of the tests for cognitive function. Other investigators have confirmed this, fine-tuning their conclusions to emphasize the importance of bioavailable testosterone (the portion that is active in the body).
Are sign languages real languages?
Authors: Napoli Donna Jo
Published: November 2023

Almost all hearing people have seen Deaf people communicating with each other by moving their hands, either on television or in real life. The manual-visual language the Deaf are using is called sign language. Many hearing children know the manual alphabet used by the Deaf in America, and many hearing children and adults can make a few signs. But most hearing people do not have Deaf friends.

You might object to that last claim because you are a hearing person and you have a friend who has been losing or has already lost his hearing as he grew older. So I want to make a distinction here between people whose first language is a spoken language and who lose their hearing through injury, disease, or aging, and most important, who never use a sign language as their major means of communication—who are typically called deaf people (with a small “d”)—and people who are hard of hearing or cannot hear at all (for whatever reason) and who use a sign language as their major means of communication—who are called Deaf people (with a capital “D”). People in the first group are integrated into hearing society; people in the second group are generally not.
Do animals have language?
Authors: Napoli Donna Jo
Published: November 2023

You may have heard of Koko, the gorilla, or you may have read about bee dances. Many people, including some biologists, think that these examples show that animals have language. One of the biggest issues in this question is determining exactly what language is. I began an informal investigation, surveying a variety of people on the definition of “language.” The first person I asked kept returning to the notion of the passing of information. Undoubtedly some instances of language involve the passing of information. But let’s say I find that a branch has fallen off the big, old silver maple in my front yard, exposing a core of rot. I now know that my tree is sick. Information has been received, but did an event of language occur? Surely not, as my tree does not use language. So the passing of information cannot be sufficient grounds for calling an event an instance of language.
English spelling is hard, and it makes learning to read hard. Should we do anything about it?
Authors: Napoli Donna Jo
Published: November 2023

Many children in the United States try for years to learn to read, and some never succeed. Educators talk about a fourth-grade reading level as a milestone in the process of achieving literacy. The accepted wisdom is that once students reach this level, they cross over from learning to read to reading to learn. So, on average, it would seem to take four years of schooling (not including kindergarten or pre-K education) to gain such proficiency. Gaining analogous levels of proficiency in writing skills takes even longer.

The stumbling blocks in achieving literacy in English are numerous, and many people have called for spelling reform. Instances of rebellion against traditional spelling are often used in advertising, like “lite” for “light.” Chat rooms on the internet have something we can already call a tradition of simplified spellings. Indeed, they have a tradition of acronyms that exist only as spellings, such as “brb” for “be right back.” Text messaging on cell phones is another situation in which simplified spelling is found. We can expect more as technology advances, and we can expect these simplified spellings to creep into other contexts.
A Handful of Adventurers The Myth of Exceptional Men
Authors: Restall Matthew
Published: November 2023

One of the great themes of historical literature over the past five centuries has been the assessment of the European discovery of the Americas as one of the two greatest events in human history. Perhaps the earliest such judgement made in print was the claim by the Paduan philosopher Lazzaro Buo-namico in 1539 that nothing had brought more honor to mankind “than the invention of the printing press and the discovery of the new world; two things which I always thought could be compared, not only to Antiquity, but to immortality.” A similar, better-known pronouncement was penned by Francisco López de Gómara, Hernán Cortés’s private secretary and official biographer, in 1552. “The greatest event since the creation of the world (excluding the incarnation and death of Him who created it),” wrote Gómara, “is the discovery of the Indies [i.e., the Americas].”
Knowledge Capital: How Knowledge-Based Enterprises Really Get Built
Authors: Chatzkel Jay L .
Published: November 2023

Knowledge Capital: How Knowledge-Based Enterprises Really Get Built is an integrated, structured set of conversations with thought leaders and key practitioners in the fields of intellectual capital and knowledge management, who examine-in the form of conversations-the steps necessary for creating and implementing the various dimensions of a knowledge-based enterprise. These are the dimensions that need to be effectively addressed for the organization to successfully make the transition from an activity-based organization to a truly knowledge-based enterprise. The conversations that make up Knowledge Capital are not studies of theory separated from practice or practice without a strong theoretical base. Rather, they are the stories of how knowledge-based enterprises really get built, in the words of the people who built them. While every contributor begins from his or her own unique perspective and background, each moves toward a convergent understanding of the core elements, perspectives, and practices involved. These systemic conversations provide a body of knowledge and experience on how to craft and implement strategies, as well as the how values, learning, performance, relationships, innovation, and change play in the development of usable knowledge environment. These explorations, together, lead to a mapping of what are quickly becoming the foundations of the next stage of the field. Knowledge Capital gives the reader a readily accessible collection of insights and experiences essential for the new era in intellectual capital and knowledge management.
Miracles of Resurrection: Reinventing Blood Transfusion in the Twentieth Century
Authors: Lederer Susan E
Published: November 2023

In November 1906, a young Cleveland surgeon, George Washington Crile, published a preliminary clinical note about the direct transfusion of blood. Using a newly developed surgical technique, he sewed together the cut end of an exposed artery in a donor’s arm with a similarly exposed vein in the arm of his patient. Crile’s patient was a 23-year-old man who had lost a considerable amount of blood following the removal of several large kidney stones. “It was clear,” the surgeon explained, “that the terminal stage was at hand with all the resources at command exhausted. It seemed therefore a suitable case for transfusion, and one which would afford a crucial test of its value.”With desperation as a justification, Crile performed the surgical cut-down to expose the artery in the arm of his patient’s brother; he then joined this vessel with the exposed vein in patient’s arm.
Organ Recital: Transplantation and Transfusion in Historical Perspective
Authors: Lederer Susan E
Published: November 2023

Transplanting a human face was a new surgical procedure in 2005, but the con-cerns about its implications were not new. The face transplant provoked many of the same concerns about identity, ethics, and the “supply” problem created by the transplantation of glands, skin, bones, and other body parts in the first part of the twentieth century, what some might call the “pre-history” of organ transplantation. These were also among the concerns occasioned by moving blood between human bodies. Like transplantation, blood transfusion redrew the lines between self and other, and raised profound questions of identity and difference.
Postnatal Growth in Infancy
Authors: Niedbala Barbara , Ekvall Shirley W
Published: November 2023

Nutritional intake, from birth on, must be adequate for proper growth and development and must be provided to the infant in a way that is appropriate for his or her developing motor skills and that enhances nurturing between the infant and caregiver. The American Academy of Pediatrics identifies breast-feeding as the ideal method of feeding and nurturing infants and in achieving optimal infant and child health. The nursing relationship confers many benefits to both the mother and the infant. It provides optimal nutrient intake to the infant as well as substances unique to the mother-infant pair. Breast-feeding protects against respiratory infections, diarrhea, and otitis media4 and has been associated with higher developmental scores. Infant formula composition is based on human milk and is continually being modified to replicate the substances in human milk more closely. When nursing the infant is not chosen by the mother or is medically inadvisable, iron-fortified infant formula is the best choice.
The Small-For-Gestational-Age Infant And Problems Of Prematurity
Authors: Itani Oussama , Niedbala, Barbara , Tsang Reginald
Published: November 2023

Intrauterine growth restriction (IUGR) reduces overall weight gain of the fetus compared to an appropriately grown fetus of the same gestational age. The term small for gestational age (SGA) is commonly used to describe infants born with birth weights less than the 10th percentile for gestational age and may also be defined as birth weight and/or length at least two standard deviations below the mean for gestational age. The SGA infants are a heterogeneous group, as they may be born premature, term, or post-mature; furthermore, the growth restriction may differ in its etiology, severity, and duration (Fig. 3–1).
Community-Based Nutrition Services And Resources
Authors: Rokusek Cecilia , Jarka Elvira , Hanley, Barbara , Hahn Joan Earle
Published: November 2023

During the past 30 years the need for nutrition services for children with special needs has increased significantly in communities is throughout the country. Deinstitutionalization, integrated community living programs, supported employment options, least restrictive learning environments, work sites for adolescents, full integration in the school systems, and a philosophy of inclusion or normalcy have been the mandates of communitybased systems to serve the education, social, and health-care needs of all persons with special needs. These directives have confronted nutrition professionals with new and continuing challenges to focus more efforts on the community setting, which can include the home, the clinic, and the school. In addition, qualified nutritionists are now key members of interdisciplinary health-care teams providing services and support for the child with special needs. The interdisciplinary team approach enhances a sense of cooperation among all professionals united by a common goal of achieving optional medical and nutritional support for all individuals.
Sports Nutrition For Children
Authors: Dolins Karen Reznik , Heaner Martica
Published: November 2023

Nutrition and physical activity play a dual role in good health. Because the two are inextricably linked, it is important to avoid focusing on one area while neglecting the other. Both regular exercise and good nutrition can provide a wide array of physiological, psychological, and functional health benefits to all children, especially those with chronic illnesses or developmental disorders. When implementing physical activity regimens, follow established exercise guidelines and make any necessary modifications as dictated by the child’s specific medical condition. Nutritional intake should meet the child’s basic nutritional needs to optimize health as well as to enhance the child’s physical performance.
Vegetarian Diets For Children
Authors: Hodgkin Georgia
Published: November 2023

Children of all ages may be consuming vegetarian diets, either by their choice or by their family’s choice. Two percent of children aged 6–17 said in a 2000 Roper poll that they never eat meat, fish, or poultry; 6% said they never eat meat. These data mirror those in a similar poll in 1995. Approximately 2% of the adult population are vegetarian.
Cerebral Palsy
Authors: Bandini Linda , Ekvall, Shirley W , Stallings Virginia
Published: November 2023

Cerebral palsy (CP) is a chronic, nonprogressive motor disability that results from an injury to the developing brain early in life. Dysfunctions in motor coordination and muscle tone characterize CP. Several factors increase the likelihood of cerebral palsy, such as premature birth, low birth weight, blood type incompatibility between the mother and infant, and placental insufficiency. Other risk factors include maternal infection with German measles or other viral diseases; bacterial infections of the mother, fetus, or infant (injuring the central nervous system); loss of oxygen during delivery; and severe neonatal jaundice. Nationally representative CP prevalence data are not readily available. A rough estimate of prevalence of CP can be obtained from a population-based study in metropolitan Atlanta in which CP prevalence for the years 1986–1991 was reported as 2.0 per 1000 one-year-old survivors.
Autism
Authors: Nordin Viviann , Ekvall Shirley W
Published: November 2023

Leo Kanner first described autism in 1943 as a rare condition featuring lack of emotional contact and resistance to change. In 1944 Hans Asperger identified a group of children with problems in the same areas. Later work on diagnostic criteria has placed autism among the developmental disorders as a pervasive developmental disorder (PDD) (DSM-IV, ICD-10, WHO). Epidemiological studies have documented a span of signs and symptoms as an autistic spectrum. In autism, there is a pattern of impairments in three areas: (1) qualitatively impaired reciprocal social interaction and (2) communication and (3) restricted, repetitive, and stereotyped interests and behavior. Idiosyncratic reactions to sensory information are not included in the diagnostic criteria but are often important symptoms; they are reported by many persons who have autism. The DSM-IV diagnostic criteria for autistic disorder are listed in Table 13–1 (they are the same criteria as for childhood autism in ICD-10). The term Asperger syndrome is most often used to describe children with autistic spectrum problems and a normal or near-normal cognitive level, but there is not complete agreement about these criteria among researchers. Pervasive developmental disorder not otherwise specified (PDD NOS) is a diagnostic term without clear definition. It may be used for persons who do not fulfill the criteria for autistic disorder but have obvious problems in the development of reciprocal social interaction and some problems in one or both of the other two domains (about the same as in atypical autism in ICD-10). In the autistic spectrum and in each diagnostic subgroup, there is a continuum from mild impairment to severe developmental disorder.
The Fetal Alcohol Syndrome
Authors: Huber Agnes , Ekvall Shirley W
Published: November 2023

Ulleland et al. in Seattle were the first researchers in the United States to document that heavy alcohol consumption during pregnancy has a deleterious effect on the offspring. The growth retardation, malformations, and central nervous system effects of infants exposed to alcohol in utero were first termed fetal alcohol syndrome (FAS) by Jones et al. Infants who show some symptoms of FAS but not the full constellation were labelled as having fetal alcohol effects (FAE). Other terms have been proposed, such as alcohol-related birth defects (ARBD) or neurodevelopmental disorders due to alcohol exposure (ARND). Since children with alcohol-related problems suffer from lifelong disabilities and since there is no safe level of alcohol ingestion by pregnant women, the American Academy of Pediatrics has suggested that women who plan to become pregnant or are pregnant should abstain from alcohol use during pregnancy. The incidence of FAS may be underreported. Surveys have shown figures ranging from 0.9 to 1.9 per 1000 live births, an incidence believed to be higher than that of Down syndrome or cerebral palsy. Newer data suggest incidence rates of 5.2 per 10,000 live births.4 Among alcohol-abusing women, rates of FAS are in the range of 24–42 per 1000 in the southwestern Apache and Ute tribes, 209 per 1000 in Ireland, and 259 per 1000 in Germany. Fetal alcohol effects are thought to occur in 3 to 5 births per 1000. The central and associated features of FAS are summarized in Tables 14–1 and 14–2, based on data from Clarren and Smith.7 Microcephaly and abnormal weight and length are recognized at birth, as are facial dysmorphies8 (see Fig. 14–1).
Drug Therapy And Nutrition
Authors: Springer Ninfa , Shlafer Marshal
Published: November 2023

Drug therapy and nutrition for developmentally disabled (DD) and the mentally retarded (MR) individuals living in intermediate care facilities (ICF/DD and ICF/MR) are regulated by federal guidelines, which are symptom-based rather than diagnosisbased Some drugs, including vitamins in pharmacological dosage, can cause undesirable food-drug or nutrient-drug interactions. This needs to be differentiated from the supplemental use of vitamins/minerals, as presented in several sections of this chapter. Supplements used in this context compensate for adverse drug effects; amounts used are based on individual needs determined during nutrition assessment (see Chapter 4). Drugs used for chronic diseases are too numerous to discuss in this chapter. Those used for developmental disabilities, and substances that are commonly abused, are summarized in Table 27–1. In most cases, only drugs generally prepared as prototypes of the class are listed in this table. When there are important differences among other members of a class, individual drugs are noted separately. Drug-drug interactions are not emphasized; pharmacology textbooks provide more information.
HIV Infection In Children
Authors: Ayoob Keith-Thomas
Published: November 2023

Acquired immune deficiency syndrome (AIDS) is caused by the human immunodeficiency virus type 1 (HIV) and is usually transmitted by the exchange of blood or blood products or sexual contact. In children, HIV is acquired perinatally from high-risk HIVinfected mothers (85%) or through receipt of contaminated blood products. High-risk mothers are identified as injecting drug users, sexual partners of infected persons, or recipients of HIV contaminated blood or blood products. Breast milk is also known to transmit HIV. Antiretroviral drugs have been used to dramatically reduce the rate of mother-to-child transmission. The first cases of pediatric HIV were noted in the United States in 1982. Since that time, the number of HIV and AIDS cases has increased dramatically. As of December 2001, the latest date for which statistics are available from the Centers for Disease Control (CDC), 9074 AIDS cases were reported in children under 13 in the United States and 4428 AIDS cases were reported in children ages 13 to 19.4 A total of 3923 cases of HIV had been reported in children under age 13 as of December 2001, although this number is likely underreported, as it reflects only areas with confidential HIV reporting. The vast majority of these cases occur in minority populations. Cumulatively, 83% and 82% of reported cases of HIV and AIDS, respectively, have occurred in black and Hispanic children. New York, New Jersey, Florida, and Texas account for 60% of all children under the age of 13 living with HIV/AIDS. Human immunodeficiency is diagnosed by blood analysis for the virus. Infants are not routinely tested for the presence of HIV at birth unless HIV is suspected in the mother. Presence of the virus, rather than just its antibodies, can now be detected in the blood. The test can be done at birth, allowing pharmacological intervention immediately, if necessary. The CDC expanded the diagnostic criteria for AIDS in 1993 for persons ages 13 years and older to include anyone with HIV whose CD4 T cell count is below 200 cells per microliter.
Gastrointestinal Disorders Of Infancy And Childhood (With Nutrition Support And Probiotics)
Authors: Farrell Michael
Published: November 2023

For a child to grow and develop normally, food must be ingested, digested, and absorbed. The gastrointestinal (GI) tract is crucial in this process. This chapter describes primary and secondary conditions that interfere with the normal digestive and absorptive functions of the GI tract. The past decade has seen the development of a variety of nutrition support modalities that allow children with any type of gastroenterological dysfunction to develop normally. An understanding of the physiology of digestion and the pathophysiology of GI diseases allows selection of the appropriate method of nutritional support. Nutritional problems are common in children with neuromotor disorders and other chronic conditions. The most frequent nutritional problems are inadequate nutrient intake, obesity, constipation, nutrient-drug interactions, and inadequate standards with which to compare the growth and adequacy of nutrient intake. Adequate nutrition begins with ingestion of the appropriate amounts and type of calories. Infants with chronic medical and developmental disorders often have difficulty ingesting adequate nutrients. This may be due to oromotor dysfunction, a decreased level of consciousness, and/or spasticity (see Chapter 24). The practitioner must remember that feeding difficulties may be the initial manifestation of a chronic condition, neurological or otherwise. Regardless of the etiology, malnutrition adversely affects the quality of life of children with cerebral palsy and other chronic neurological conditions.
Methylmalonic Acidemia And Propionic Acidema
Authors: Frazier Dianne
Published: November 2023

The organic acidemias are a class of autosomal recessive inborn errors of metabolism sharing the characteristic of having a block in a specific step of amino acid catabolism that results in the excretion of abnormally high concentrations of non-amino organic acids. This chapter will discuss two of these disorders: propionic acidema (PPA) and methylmalonic acidemia (MMA). The disorders 3-methylcrotonyl-CoA carboxylase deficiency (3MCC), isovaleryl-CoA dehydrogenase deficiency (IVA), glutaric acidemia type I (GAI), and 2-ketoadipic aciduria will be described in later chapters.
Hyperuricemias (Lesch-Nyhan Disease)
Authors: Nyhan William
Published: November 2023

Lesch-Nyhan disease is an inherited disorder of purine metabolism in which there is enormous over production of uric acid.1,2 It is the most common cause of hyperuricemia that is understood at the molecular level. It is caused by deficient activity of the enzyme hypoxanthine guanine phosphoribosyltransferase (HPRT). Deficiency of HPRT leads to a variety of clinical phenotypes ranging in severity from the classic Lesch-Nyhan disease, in which neurological and behavioral features are seen, along with clinical manifestations of hyperuricemia that are shared with patients with gout, to patients with normal neurology and behavior who have only manifestations directly attributable to uric acid. Among patients with HPRT deficiency, the classic Lesch-Nyhan phenotype is the most common. The variant forms are all rare. Uric acid is the end product of purine catabolism. Hyperuricemia may result from overproduction or from inefficient renal excretion of uric acid. These two forms can be distinguished by analysis of the uric acid content of the urine. Patients with increased uric acid in blood and urine have overproduction of purines and may be assumed to have a metabolic disease. Biosynthesis of purine nucleotides is achieved via a de novo synthetic pathway and a salvage pathway. HPRT catalyzes the reutilization of the purine bases hypoxanthine and guanine in the formation of inosinic and guanylic acids (IMP, GMP) in the salvage pathway. Human HPRT is encoded by a single structural gene on the X chromosome. The gene has been cloned and sequenced,3 and its amino acid sequence has been determined. The importance of an efficient purine nucleotide salvage pathway is underscored by the clinical manifestations of inherited disorders of purine metabolism.
Nutritional Aspects Of Birth Defects
Authors: Saal Howard
Published: November 2023

A birth defect is “any anomaly, functional or structural, that presents in infancy or later in life and is caused by events preceding birth, whether inherited or acquired.” Medically significant birth defects are essentially conditions that are present at birth and require at least some degree of medical intervention (Table 60–1). Approximately 3%–5% of all children are born with a medically significant birth defect. Approximately 150,000 children are born in the United States every year with one or more birth defects. These defects are the single leading cause of infant mortality in the United States, resulting in 20% of all infant deaths. Birth defects are the second leading cause of death in children 1 to 4 years of age and the fourth leading cause of death in children 5 to 15 years. Birth defects are also a leading cause of hospital admissions. Over 11% of all pediatric hospital admissions are due to genetic disorders, and 18.5% are for children with other congenital anomalies.
Heart
Authors: Lin Angela E , Belmont, John , Malik Sadia
Published: November 2023

In common practice, malformation of the heart refers to a defect of the intracardiac structures, that is, the atrial and ventricular chambers and septa, and the atrioventricular and semilunar valves. Beyond the heart itself are the great arteries which are frequently associated with abnormalities of outflow tract septa- tion (conotruncal defects), and the systemic and pulmonary veins. Because intra-cardiac and extra-cardiac malformations cannot be easily separated, this chapter uses the broader term cardiovas-cular malformation (CVM), also known as a congenital heart defect.
Systemic Vasculature
Authors: Bird Lynne M , Jones Kenneth Lyons
Published: November 2023

Interrupted aortic arch is discontinuity of the aortic arch in which either an aortic branch vessel or the ductus arteriosus supplies the descending aorta. Three anatomic forms have been described. In type A, interruption of the arch is distal to the origin of the left subclavian artery; in type B, interruption of the arch is proximal to the origin of the subclavian artery, between the origins of the left common carotid and left subclavian arteries; and in type C, interruption of the arch is proximal to the origin of the left common carotid artery, between the origins of the innominate and the left common carotid arteries (Fig. 3-1).
Spleen
Authors: Aylsworth Arthur S
Published: November 2023

The spleen forms during the week (when the embryo is 8– 10 mm) as a local mesodermal condensation in an area of tissue on the left side of the dorsal mesogastrium. It is the only organ that is left-sided at its inception. The splanchnopleuric epithelium thickens to form a ridge of mesoderm that extends along the dorsolateral border of the developing stomach. The ridge lies between areas of tissue that eventually will form the gastrosplenic and pancreaticosplenic portions of the dorsal mes- entery and extends to the region of the developing mesonephros (Fig. 5-1). Several genes involved in spleen development have been identified in the mouse. These include Hox11, Wt1, Bapx1, and capsulin.
Craniofacial Structures Skull
Authors: Graham John M
Published: November 2023

Neural crest cells in the head region differentiate into mesen- chymal cells that form the bones of the face (viscerocranium), while the cranial base and other portions of the cranium are formed by the mesodermally derived occipital somites and somitomeres. The portion of the skull surrounding the brain is termed the neurocranium. The neurocranium is divided into the membranous part, which forms the flat bones of the cranial vault, and the chondrocranium, which forms the cartilaginous bones of the base of the skull. The chondrocranium develops by fusion of a number of cartilaginous structures, which ossify by endochondral ossification to form the base of the skull. Posteriorly, the base of the occipital bone is formed from parachordal cartilage and three oc- cipital sclerotomes.