bluuebunny/crossref_metadata_2025 huggingface dataset:
B-Type Natriuretic Peptide in the Emergency Diagnosis of Critical Heart Disease in Children
Authors: Maher Kevin O. , Reed Heather , Cuadrado Angel , Simsic Janet , Mahle William T. , DeGuzman Michael , Leong Traci , Bandyopadhyay Subhankar
Published: June 2008

OBJECTIVE. The initial presentation of congenital and acquired heart disease in children can present a diagnostic challenge. We sought to evaluate B-type natriuretic peptide as a marker of critical heart disease in children at presentation in the acute care setting.

METHODS. A cohort of 33 pediatric patients with newly diagnosed congenital or acquired heart disease had B-type natriuretic peptide levels obtained on hospital admission after evaluation in an acute care setting. Patients were admitted from March 2005 through February 2007. A noncardiac cohort of 70 pediatric patients who presented with respiratory or infectious complaints had B-type natriuretic peptide levels obtained during emergency department evaluation. A comparison of B-type natriuretic peptide results was performed.

RESULTS. Cardiac diagnoses included cardiomyopathy (14), left-sided obstructive lesions (12), anomalous left coronary artery from the pulmonary artery (4), total anomalous pulmonary venous return (2), and patent ductus arteriosus (1). Cardiac cohort mean age at presentation was 33.6 months. The 33 patients with new cardiac diagnoses had a mean B-type natriuretic peptide level of 3290 pg/mL (SD: ±1609; range: 521 to >5000 pg/mL). The 70 noncardiac patients' mean age at presentation was 23.1 month, and mean B-type natriuretic peptide level was 17.4 pg/mL (SD: ±20; range: <5 to 174 pg/mL).

CONCLUSIONS. B-type natriuretic peptide levels were markedly elevated at presentation in the acute care setting for all patients in this cohort of children with newly diagnosed congenital or acquired heart disease. B-type natriuretic peptide levels from noncardiac patients were significantly lower, with no overlap to the cardiac disease group. B-type natriuretic peptide level can be useful as a diagnostic marker to aid in the recognition of pediatric critical heart disease in the acute care setting.
Human Milk Consumption and Full Enteral Feeding Among Infants Who Weigh ≤1250 Grams
Authors: Sisk Paula M. , Lovelady Cheryl A. , Gruber Kenneth J. , Dillard Robert G. , O'Shea T. Michael
Published: June 2008

OBJECTIVE. Establishing enteral feeding is an important goal in the care of very low birth weight infants. In such infants, receipt of ≥50 mL/kg per day human milk during hospitalization has been associated with shorter time to full enteral feeding. The objective of this study was to determine whether high proportions (≥50%) of human milk during feeding advancement are associated with shorter time to full enteral feeding and improved feeding tolerance.

METHODS. This was a prospective cohort study of very low birth weight infants (n = 127) who were grouped into low (<50%; n = 34) and high (≥50%; n = 93) human milk consumption groups according to their human milk proportion of enteral feeding during the time of feeding advancement. The primary outcomes of interest were ages at which 100 and 150 mL/kg per day enteral feedings were achieved.

RESULTS. The high human milk group reached 100 mL/kg per day enteral feeding 4.5 days faster than the low human milk group. The high human milk group reached 150 mL/kg per day enteral feeding 5 days faster than the low human milk group. After adjustment for gestational age, gender, and respiratory distress syndrome, times to reach 100 and 150 mL/kg per day were significantly shorter for those in the high human milk group. Infants in the high human milk group had a greater number of stools per day; other indicators of feeding tolerance were not statistically different.

CONCLUSION. In infants who weighed ≤1250 g, enteral feeding that contained at least 50% maternal human milk was associated with fewer days to full enteral feedings.
Annual Risk of Death Resulting From Short Falls Among Young Children: Less Than 1 in 1 Million
Authors: Chadwick David L. , Bertocci Gina , Castillo Edward , Frasier Lori , Guenther Elisabeth , Hansen Karen , Herman Bruce , Krous Henry F.
Published: June 2008

OBJECTIVE. The objective of the work was to develop an estimate of the risk of death resulting from short falls of <1.5 m in vertical height, affecting infants and young children between birth and the fifth birthday.

METHODS. A review of published materials, including 5 book chapters, 2 medical society statements, 7 major literature reviews, 3 public injury databases, and 177 peer-reviewed, published articles indexed in the National Library of Medicine, was performed.

RESULTS. The California Epidemiology and Prevention for Injury Control Branch injury database yielded 6 possible fall-related fatalities of young children in a population of 2.5 million young children over a 5-year period. The other databases and the literature review produced no data that would indicate a higher short-fall mortality rate. Most publications that discuss the risk of death resulting from short falls say that such deaths are rare. No deaths resulting from falls have been reliably reported from day care centers.

CONCLUSIONS. The best current estimate of the mortality rate for short falls affecting infants and young children is <0.48 deaths per 1 million young children per year. Additional research is suggested.
Bone Metabolism in Adolescent Athletes With Amenorrhea, Athletes With Eumenorrhea, and Control Subjects
Authors: Christo Karla , Prabhakaran Rajani , Lamparello Brooke , Cord Jennalee , Miller Karen K. , Goldstein Mark A. , Gupta Nupur , Herzog David B. , Klibanski Anne , Misra Madhusmita
Published: June 2008

OBJECTIVE. We hypothesized that, despite increased activity, bone density would be low in athletes with amenorrhea, compared with athletes with eumenorrhea and control subjects, because of associated hypogonadism and would be associated with a decrease in bone formation and increases in bone-resorption markers.

METHODS. In a cross-sectional study, we examined bone-density measures (spine, hip, and whole body) and body composition by using dual-energy radiograph absorptiometry and assessed fasting levels of insulin-like growth factor I and bone-turnover markers (N-terminal propeptied of type 1 procollagen and N-telopeptide) in 21 athletes with amenorrhea, 18 athletes with eumenorrhea, and 18 control subjects. Subjects were 12 to 18 years of age and of comparable chronologic and bone age.

RESULTS. Athletes with amenorrhea had lower bone-density z scores at the spine and whole body, compared with athletes with eumenorrhea and control subjects, and lower hip z scores, compared with athletes with eumenorrhea. Lean mass did not differ between groups. However, athletes with amenorrhea had lower BMI z scores than did athletes with eumenorrhea and lower insulin-like growth factor I levels than did control subjects. Levels of both markers of bone turnover were lower in athletes with amenorrhea than in control subjects. BMI z scores, lean mass, insulin-like growth factor I levels, and diagnostic category were important independent predictors of bone mineral density z scores.

CONCLUSIONS. Although they showed no significant differences in lean mass, compared with athletes with eumenorrhea and control subjects, athletes with amenorrhea had lower bone density at the spine and whole body. Insulin-like growth factor I levels, body-composition parameters, and menstrual status were important predictors of bone density. Follow-up studies are necessary to determine whether amenorrhea in athletes adversely affects the rate of bone mass accrual and therefore peak bone mass.
Executive Functioning in the First Year After Pediatric Traumatic Brain Injury
Authors: Sesma Heather Whitney , Slomine Beth S. , Ding Ru , McCarthy Melissa L. ,   the Children's Health After Trauma (CHAT) Study Group
Published: June 2008

BACKGROUND AND OBJECTIVE. Children with traumatic brain injuries often show impaired executive function (the ability to carry out goal-directed behavior). The Behavior Rating Inventory of Executive Function, a caregiver-report questionnaire, measures executive function in everyday activities. In this study, our goal was to use the Behavior Rating Inventory of Executive Function to document changes in children's executive function in the first year after traumatic brain injury and identify child, family, and injury variables associated with greater dysfunction. We predicted that children with traumatic brain injury would have more executive dysfunction than children hospitalized for orthopedic fractures and that more severe traumatic brain injury would predict greater dysfunction. Children's premorbid functioning and family characteristics were expected to moderate their executive function.

PATIENTS AND METHODS. Caregivers of children aged 5 to 15 years (330 mild-to-severe traumatic brain injury, 103 control orthopedic fractures) enrolled onto a longitudinal study of executive function. Caregivers completed the Behavior Rating Inventory of Executive Function by telephone at baseline (obtained retrospectively) and 3 months and 1 year after the injury.

RESULTS. Traumatic brain injury groups and controls showed no baseline differences in Behavior Rating Inventory of Executive Function scores. Three months after the injury, children with traumatic brain injury had more dysfunction than controls on the Global Executive Composite. One year after injury, all traumatic brain injury groups differed from the controls on the Behavioral Regulation Index, Metacognition Index, and Global Executive Composite. The working memory scale was the only scale to discriminate between the control group and all 3 traumatic brain injury severity groups at both 3 and 12 months after injury. Executive-function ratings remained stable from 3 to 12 months after injury. Across time points, preexisting learning/behavior problems, lower respondent education, and poor family functioning predicted greater Global Executive Composite dysfunction.

CONCLUSIONS. Between 18% and 38% of the children with traumatic brain injury had significant executive dysfunction in the first year after injury, with greater dysfunction reported for children with more severe traumatic brain injury. Our findings support previous reports that preinjury learning and behavior problems, limited family resources, and poor family functioning adversely affect executive function. These results suggest a need for more systematic screening for executive dysfunction after traumatic brain injury to increase recognition of cognitive disability and improve access to appropriate services.
Bunk Bed–Related Injuries Among Children and Adolescents Treated in Emergency Departments in the United States, 1990–2005
Authors: D'Souza Anjali L. , Smith Gary A. , McKenzie Lara B.
Published: June 2008

OBJECTIVE. Our goal was to comprehensively examine bunk bed–related injuries in the United States by using a nationally representative sample.

METHODS. Using the National Electronic Injury Surveillance System database, cases of nonfatal bunk bed–related injuries treated in US emergency departments from 1990 through 2005 were selected by using the National Electronic Injury Surveillance System bunk bed product code (0661). Cases concerning individuals ≤21 years old were included.

RESULTS. An estimated 572 580 children and adolescents aged ≤21 years were treated in US emergency departments for bunk bed–related injuries during the 16-year study period, yielding an average of 35 790 cases annually. An average of 42 per 100 000 population were treated annually. Bunk bed–related injuries occurred more frequently among males (60.6%). Lacerations were the most common type of injury (29.7%), followed by contusions and abrasions (24.0%) and fractures (19.9%). The body parts most frequently injured were the head and neck (27.3%) in all age groups. Falls were the most common mechanism of injury (72.5%). Of the cases for which locale of injury was recorded, 93.5% occurred at home. Approximately half of the bunk bed–related injuries that occurred at schools involved individuals aged 18 to 21 years (50.9%). An estimated 2.9% of injuries resulted in hospitalization or transfer to another hospital or required additional observation. The number of bunk bed–related injuries showed no significant trend from 1990 to 2005.

CONCLUSIONS. Bunk beds are a common source of injury among children and adolescents, and these injuries mostly involve the head and face. Given the continuing large numbers of bunk bed–related injuries at homes and in schools, increased efforts are needed to prevent bunk bed–related injuries among children and adolescents.
Epidemiological Features of High School Baseball Injuries in the United States, 2005–2007
Authors: Collins Christy L. , Comstock R. Dawn
Published: June 2008

OBJECTIVES. The goals were to calculate injury rates among high school baseball players and to characterize the general epidemiological features of high school baseball injuries and, more specifically, injuries attributed to being hit by a batted ball.

METHODS. We analyzed baseball exposure and injury data collected over the 2005–2006 and 2006–2007 school years from a nationally representative sample of 100 US high schools by using an injury surveillance system, Reporting Information Online.

RESULTS. Nationally, an estimated 131555 high school baseball-related injuries occurred during the 2005–2006 and 2006–2007 academic years, for an injury rate of 1.26 injuries per 1000 athletic exposures. The most commonly injured body sites were the shoulder (17.6%), ankle (13.6%), head/face (12.3%), hand/finger (8.5%), and thigh/upper leg (8.2%). The most common injury diagnoses were ligament sprains (incomplete tears) (21.0%), muscle strains (incomplete tears) (20.1%), contusions (16.1%), and fractures (14.2%). Although the majority of injuries resulted in a time loss of <7 days, 9.7% resulted in medical disqualification for the season, and 9.4% required surgery. Of the 431 reported baseball injuries, 50 (11.6%) were attributed to being hit by a batted ball. Greater proportions of injuries attributed to being hit by a batted ball were to the head/face (48.0%) and mouth/teeth (16.0%), compared with injuries not attributed to being hit by a batted ball (8.2% and 1.3%, respectively). A greater proportion of injuries attributed to being hit by a batted ball required surgery (18.0%), compared with other baseball-related injuries (6.8%).

CONCLUSIONS. Although high school baseball is relatively safe, targeted, evidence-based interventions could reduce the rate of high school baseball-related injuries. On the basis of our findings, we strongly recommend that helmets with face shields or at least mouth guards and eye protection be used by pitchers, infielders, and batters at the high school level.
Reducing Absenteeism From Gastrointestinal and Respiratory Illness in Elementary School Students: A Randomized, Controlled Trial of an Infection-Control Intervention
Authors: Sandora Thomas J. , Shih Mei-Chiung , Goldmann Donald A.
Published: June 2008

BACKGROUND. Students often miss school because of gastrointestinal and respiratory illnesses. We assessed the effectiveness of a multifactorial intervention, including alcohol-based hand-sanitizer and surface disinfection, in reducing absenteeism caused by gastrointestinal and respiratory illnesses in elementary school students.

METHODS. We performed a school-based cluster-randomized, controlled trial at a single elementary school. Eligible students in third to fifth grade were enrolled. Intervention classrooms received alcohol-based hand sanitizer to use at school and quaternary ammonium wipes to disinfect classroom surfaces daily for 8 weeks; control classrooms followed usual hand-washing and cleaning practices. Parents completed a preintervention demographic survey. Absences were recorded along with the reason for absence. Swabs of environmental surfaces were evaluated by bacterial culture and polymerase chain reaction for norovirus, respiratory syncytial virus, influenza, and parainfluenza 3. The primary outcomes were rates of absenteeism caused by gastrointestinal or respiratory illness. Days absent were modeled as correlated Poisson variables and compared between groups by using generalized estimating equations. Analyses were adjusted for family size, race, health status, and home sanitizer use. We also compared the presence of viruses and the total bacterial colony counts on several classroom surfaces.

RESULTS. A total of 285 students were randomly assigned; baseline demographics were similar in the 2 groups. The adjusted absenteeism rate for gastrointestinal illness was significantly lower in the intervention-group subjects compared with control subjects. The adjusted absenteeism rate for respiratory illness was not significantly different between groups. Norovirus was the only virus detected and was found less frequently on surfaces in intervention classrooms compared with control classrooms (9% vs 29%).

CONCLUSIONS. A multifactorial intervention including hand sanitizer and surface disinfection reduced absenteeism caused by gastrointestinal illness in elementary school students. Norovirus was found less often on classroom surfaces in the intervention group. Schools should consider adopting these practices to reduce days lost to common illnesses.
Streptococcal Infection and Exacerbations of Childhood Tics and Obsessive-Compulsive Symptoms: A Prospective Blinded Cohort Study
Authors: Kurlan Roger , Johnson Dwight , Kaplan Edward L. ,   and the Tourette Syndrome Study Group
Published: June 2008

OBJECTIVE. If pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections is a unique clinical entity, we hypothesized that children meeting diagnostic criteria would have more clinical exacerbations temporally linked to bona fide group A β-hemolytic streptococcus infection than matched control subjects (chronic tic and/or obsessive-compulsive disorder with no known temporal relationship to group A β-hemolytic streptococcus infection).

PATIENTS AND METHODS. Subjects included 40 matched pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections case-control pairs who were prospectively evaluated with intensive laboratory testing for group A β-hemolytic streptococcus and clinical measures for an average of 2 years. Additional testing occurred at the time of any clinical exacerbations or illness. Laboratory personnel were blinded to case or control status and clinical (exacerbation or not) condition. Clinical raters were blinded to the results of laboratory tests.

RESULTS. The cases had a higher clinical exacerbation rate and a higher bona fide group A β-hemolytic streptococcus infection rate than the control group. Only 5 of 64 exacerbations were temporally associated (within 4 weeks) with a group A β-hemolytic streptococcus infection, and all occurred in cases. The number (5.0) was significantly higher than the number that would be expected by chance alone (1.6). Yet, ≥75% of the clinical exacerbations in cases had no observable temporal relationship to group A β-hemolytic streptococcus infection.

CONCLUSIONS. Patients who fit published criteria for pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections seem to represent a subgroup of those with chronic tic disorders and obsessive-compulsive disorder who may be vulnerable to group A β-hemolytic streptococcus infection as a precipitant of neuropsychiatric symptom exacerbations. Group A β-hemolytic streptococcus infection is not the only or even the most common antecedent event associated with exacerbations for these patients. Additional intensive studies are needed to determine whether there is clinical or scientific evidence to support separating out subgroups of tic disorder and/or obsessive-compulsive disorder patients based on specific symptom precipitants.
Head Covering and the Risk for SIDS: Findings From the New Zealand and German SIDS Case-Control Studies
Authors: Mitchell Edwin A. , Thompson John M.D. , Becroft David M.O. , Bajanowski Thomas , Brinkmann Bernd , Happe Arusha , Jorch Gerhard , Blair Peter S. , Sauerland Cristina , Vennemann Mechtild M.
Published: June 2008

OBJECTIVES. The aim of this investigation was to identify risk factors for being found with the head covered in sudden infant death syndrome cases and determine whether head covering was likely to be an agonal event or potentially part of the causal pathway in some cases. By using the data from 2 sudden infant death syndrome case-control studies, consistency of the findings could be assessed.

METHODS. Two case-control studies were assessed: (1) the New Zealand Cot Death Study (1987–1990, 393 sudden infant death syndrome cases) and (2) a German SIDS case-control study (1998–2001, 333 sudden infant death syndrome cases).

RESULTS. The proportion of sudden infant death syndrome cases in which infants were found with their head covered was 15.6% in the New Zealand study and 28.1% in the German study. Being found with head covering was associated with older infant age. In both studies, being found with head covering was associated with being very sweaty when found. Head covering was also associated with the incidence and severity of thymic petechiae in both studies. Both the position in which the child was placed to sleep and the position in which the child was found were not associated with head covering.

CONCLUSIONS. The finding that sudden infant death syndrome cases in which infants were found with their heads covered were often very sweaty suggests that head covering was not an agonal event and that it preceded the death and may have been causally related to the death. Infants who were found with their head covered were older, which probably reflects motor development.
Effects of Parental Smoking on Interferon γ Production in Children
Authors: Tebow Gina , Sherrill Duane L. , Lohman I. Carla , Stern Debra A. , Wright Anne L. , Martinez Fernando D. , Halonen Marilyn , Guerra Stefano
Published: June 2008

OBJECTIVES. Environmental tobacco smoke is associated with several negative health outcomes in children, including an increased susceptibility to infections. One of the postulated mechanisms for these effects is the impairment of the immune system function and/or development. Yet, it remains unknown whether cumulative exposure to parental smoking is associated with altered immune responses in childhood and whether these effects are independent of in utero exposure to maternal smoking. In a population-based birth cohort, we sought to determine the relation of parental smoking, as assessed prospectively since pregnancy, to the child's interferon γ and interleukin 4 production at 11 years of age.

PATIENTS AND METHODS. We used data on 512 children and their parents from the Tucson Children's Respiratory Study cohort. Information on maternal and paternal smoking was collected prospectively by questionnaire, and pack-years for mother, father, and both parents combined were assessed prospectively between the prenatal period and year 11. At age 11 years, children's interferon γ and interleukin 4 production from mitogen-stimulated peripheral blood mononuclear cells was measured.

RESULTS. Children of parents who smoked between the prenatal period and year 11 were more likely to be in lower quartiles of interferon γ production than children of nonsmoking parents. In addition, maternal, paternal, and parental pack-years showed significant inverse dose-response relationships with interferon γ production in the child. These dose-response relationships with interferon γ remained significant for both paternal and parental pack-years among children of mothers who did not smoke during pregnancy, suggesting the existence of specific postnatal effects of environmental tobacco smoke exposure. In contrast, no significant effects of parental smoking were found on interleukin 4 production.

CONCLUSIONS. Interferon γ responses of school-aged children are impacted by parental smoking.
Determinants of Height in Adolescent Girls With Anorexia Nervosa
Authors: Prabhakaran Rajani , Misra Madhusmita , Miller Karen K. , Kruczek Kimberly , Sundaralingam Shankeertha , Herzog David B. , Katzman Debra K. , Klibanski Anne
Published: June 2008

BACKGROUND. Anorexia nervosa, a condition characterized by marked caloric restriction and low insulin like growth factor-1 levels, would be expected to cause short stature. However, this disorder is also associated with hypogonadotropic hypogonadism and high growth hormone levels. Delays in growth-plate closure from associated hypogonadism may result in a longer period of time available for statural growth with protective effects on stature. In addition, growth hormone may have direct effects on the growth plate independent of insulin-like growth factor 1 to increase statural growth.

OBJECTIVES AND METHODS. To determine the impact of undernutrition, hypogonadism, and acquired growth hormone resistance on height in adolescents with anorexia nervosa (aged 12–18 years), we examined 208 girls: 110 with anorexia nervosa and 98 controls of comparable chronological age. Sixty-three girls with anorexia nervosa and 79 controls were followed prospectively over 1 year. Mean duration of illness was 11.6 ± 13.2 months. In a subset, overnight growth hormone sampling was performed every 30 minutes for 12 hours, and fasting insulin-like growth factor 1 levels were obtained.

RESULTS. The difference between height and target height and between predicted adult height and target height did not differ between the groups, indicating preservation of height potential. The groups had comparable bone age, but bone age was lower than chronological age in girls with anorexia nervosa. Girls with anorexia nervosa had lower insulin-like growth factor 1 levels and higher nadir growth hormone levels than those of controls. Nadir growth hormone levels predicted height SD scores and predicted adult-height SD scores in controls but not in the girls with anorexia nervosa. In girls with anorexia nervosa, insulin-like growth factor 1 and duration of illness predicted height measures. Height SD scores of <0 were more likely after 32 months of illness and at insulin-like growth factor 1 levels of <134 ng/mL. Delayed baseline bone age predicted subsequent increases in height SD scores in immature girls with anorexia nervosa.

CONCLUSIONS. Our data suggest that preservation of height potential in this cohort of girls with anorexia nervosa may be a consequence of delayed bone age. Hypogonadism may negate the deleterious effects of undernutrition on stature by allowing for a longer duration of growth.
Compliance in Rhode Island Emergency Departments With American Academy of Pediatrics Recommendations for Adolescent Sexual Assaults
Authors: Merchant Roland C. , Kelly Erin T. , Mayer Kenneth H. , Becker Bruce M. , Duffy Susan J. , Pugatch David L.
Published: June 2008

OBJECTIVES. We assessed the offering of American Academy of Pediatrics–recommended tests and prophylaxes after sexual assault to adolescents who presented to Rhode Island emergency departments for 3 categories of sexual exposures: sexual assault, consensual sex, and suspected sexual abuse.

PATIENTS AND METHODS. This study entailed a retrospective review of visits for adolescent sexual exposures across 11 Rhode Island emergency departments between January 1995 and June 2001. Cases were identified through billing codes. Offering of each test and prophylaxis was compared by gender, category of sexual exposure, and type of sexual assault. Multivariable linear regression models were used to identify factors associated with the offering of a greater number of tests and prophylaxes after sexual assault.

RESULTS. The vast majority of emergency department visits for adolescent sexual exposures were by sexually assaulted girls (82.5%). Across the 3 sexual exposure categories, girls were offered tests and prophylaxes more often than boys (eg, chlamydia or gonorrhea testing and prophylaxis). Among sexually assaulted adolescents, 32.8% of girls and no boys were offered all recommended tests and prophylaxes. The multivariable linear regression found that vaginally and/or anally assaulted girls were offered, on average, 2.5 more tests and prophylaxes than patients with other types of sexual assaults. Girls presenting for care at the state's women's health care specialty hospital emergency departments were offered 1.7 more tests and prophylaxes than those evaluated in general hospital emergency departments.

CONCLUSIONS. Many adolescents did not receive American Academy of Pediatrics–recommended tests and prophylaxes after sexual assault. Boys received fewer tests than girls. Testing and prophylaxis varied by type of emergency department. Efforts are needed to improve and standardize emergency department medical management of adolescent sexual exposures.
Symptom-Based Screening of Child Tuberculosis Contacts: Improved Feasibility in Resource-Limited Settings
Authors: Kruk Alexey , Gie Robert P. , Schaaf H. Simon , Marais Ben J.
Published: June 2008

OBJECTIVE. National tuberculosis programs in tuberculosis-endemic countries rarely implement active tracing and screening of child tuberculosis contacts, mainly because of resource constraints. We aimed to evaluate the safety and feasibility of applying a simple symptom-based approach to screen child tuberculosis contacts for active disease.

METHODS. We conducted a prospective observational study from January through December 2004 at 3 clinics in Cape Town, South Africa. All of the children <5 years old in household contact with an adult tuberculosis source case were assessed by documenting current symptoms and tuberculin skin test and chest radiograph results.

RESULTS. During the study period, 357 adult tuberculosis cases were identified; 195 cases (54.6%) had sputum smear and/or culture positive results and were in household contact with children aged <5 years. Complete information was available for 252 of 278 children; 176 (69.8%) were asymptomatic at the time of screening. Tuberculosis treatment was administered to 33 (13.1%) of 252; 27 were categorized as radiologically “certain tuberculosis,” the majority (n = 22) of which had uncomplicated hilar adenopathy. The negative predictive value of symptom-based screening varied according to the case definition used, with 95.5% including all of the children treated for tuberculosis and 97.1% including only those with radiologically “certain tuberculosis.”

CONCLUSIONS. Our findings support current World Health Organization recommendations, demonstrating that symptom-based screening of child tuberculosis contacts should improve feasibility in resource-limited settings and seems to be safe.
Influence of Catch-up Growth on Glucose Tolerance and β-Cell Function in 7-Year-Old Children: Results From the Birth to Twenty Study
Authors: Crowther Nigel J. , Cameron Noel , Trusler Jessica , Toman Marketa , Norris Shane A. , Gray I. Peter
Published: June 2008

OBJECTIVE. The aim of this study was to investigate the effect of catch-up growth occurring at different stages of childhood on glucose levels and β-cell function at 7 years of age.

METHODS. Oral glucose tolerance tests were performed on 152 7-year-old children. Anthropometric data were available from birth to 7 years of age. Children were split into catch-up, catch-down, and normal-growth groups on the basis of growth rates between birth and 1 year, birth and 5 years, and birth and 7 years. Fasting and 30- and 120-minute blood samples collected during the oral glucose tolerance tests were assayed for glucose, insulin, proinsulin, and des-31,32-proinsulin levels, and area-under-the-curve values were calculated.

RESULTS. Children with catch-up growth between birth and 5 years or birth and 7 years had greater area-under-the-curve insulin levels than the children with catch-down growth. Children with catch-up growth only between birth and 7 years exhibited higher proinsulin levels and a greater insulin secretory response to glucose than those who experienced catch-up growth between both birth and 1 year and birth and 7 years of age. Low birth weight children with no catch-up growth between birth and 7 years had the highest glucose and lowest insulinogenic index levels, whereas children with high birth weight and catch-up growth had the highest insulin levels.

CONCLUSIONS. Extremes of birth weight in conjunction with extremes of postnatal growth are all detrimental to childhood metabolism. The negative metabolic effects of catch-up growth between birth and 7 years may be attenuated if catch-up growth also occurs between birth and 1 year of age.
Febrile Seizures: Clinical Practice Guideline for the Long-term Management of the Child With Simple Febrile Seizures
Authors:   Steering Committee on Quality Improvement and Management, Subcommittee on Febrile Seizures
Published: June 2008

Febrile seizures are the most common seizure disorder in childhood, affecting 2% to 5% of children between the ages of 6 and 60 months. Simple febrile seizures are defined as brief (<15-minute) generalized seizures that occur once during a 24-hour period in a febrile child who does not have an intracranial infection, metabolic disturbance, or history of afebrile seizures. This guideline (a revision of the 1999 American Academy of Pediatrics practice parameter [now termed clinical practice guideline] “The Long-term Treatment of the Child With Simple Febrile Seizures”) addresses the risks and benefits of both continuous and intermittent anticonvulsant therapy as well as the use of antipyretics in children with simple febrile seizures. It is designed to assist pediatricians by providing an analytic framework for decisions regarding possible therapeutic interventions in this patient population. It is not intended to replace clinical judgment or to establish a protocol for all patients with this disorder. Rarely will these guidelines be the only approach to this problem.
Microwave heating of soda-lime glass by addition of iron powder
Authors: Yoshikawa Noboru , Wang Haichuan , Mashiko Ken-ichi , Taniguchi Shoji
Published: June 2008

Experimental studies were conducted to investigate the microwave (MW) heating behavior of soda-lime glass beads with added iron powder. These studies were intended to obtain fundamental knowledge for vitrification solidification and for the fabrication of metal-reinforced glass-matrix composites. The glass beads (0.2 mm diameter) did not heat very well by themselves at temperatures greater than 200 °C within 600 s in a multimode applicator at a power of 0.67 W. The addition of iron powder (average 70 μm, volume fraction 18%) made it possible to heat the glass beads above 700 °C within 60 s. At lower fractions of 3–11 vol%, however, a sudden temperature rise [thermal runaway (TRW)] occurred after the incubation time period. A single-mode MW applicator was used for clarifying the electric (E)-field and magnetic (H)-field contributions to the heating of each material and their mixtures. The results of this study demonstrated that the H-field contributed to the heating of the iron and then triggered the heating of the glass. The E-field component is necessary for heating the glass to a temperature higher than 800 °C. The factors determining the threshold values of the volume fraction causing TRW are discussed.
Porous hydroxyapatite-based obturation materials for dentistry
Authors: Brostow Witold , Estevez Miriam , Lobland Haley E. Hagg , Hoang Ly , Rodriguez J. Rogelio , Vargar Susana
Published: June 2008

New porous biomaterials based on hydroxyapatite (HAp) were designed as obturation materials for dental cavities. Synthetic HAp powder with a particle diameter of 150 μm was agglutinated using three different polyurethane monocomponents (rigid, semi-rigid, and flexible), enabling the matching of their properties to those of real teeth. Alumina particles were also added in some cases. Our new hybrid materials contain up to 60% HAp. Interconnected pores range in size from 100 to 350 μm, while the pore volume fraction varies between 25% and 60%. Most of these materials possess the right morphology for implants and prostheses because their porous structures can be vascularized for bone and tooth ingrowth. Some samples also contain alumina particles to improve the abrasion resistance and to support the stresses produced during mastication. The materials were characterized by x-ray diffraction, scanning electron microscopy, and mechanical testing, along with abrasion, scratch, sliding wear, friction, and staining tests.
Apatite-inducing ability of titanium oxide layer on titanium surface: The effect of surface energy
Authors: Wang X.J. , Li Y.C. , Lin J.G. , Hodgson P.D. , Wen C.E.
Published: June 2008

In the present study, pure titanium (Ti) plates were firstly treated to form various types of oxide layers on the surface and then were immersed into simulated body fluid (SBF) to evaluate the apatite-forming ability. The surface morphology and roughness of the different oxide layers were measured by atomic force microscopy (AFM), and the surface energies were determined based on the Owens–Wendt (OW) methods. It was found that Ti samples after alkali heat (AH) treatment achieved the best apatite formation after soaking in SBF for three weeks, compared with those without treatment, thermal or H2O2 oxidation. Furthermore, contact angle measurement revealed that the oxide layer on the alkali heat treated Ti samples possessed the highest surface energy. The results indicate that the apatite-inducing ability of a titanium oxide layer links to its surface energy. Apatite nucleation is easier on a surface with a higher surface energy.
Elastic properties and phonon conductivities of Ti3Al(C0.5,N0.5)2and Ti2Al(C0.5,N0.5) solid solutions
Authors: Radovic M. , Ganguly A. , Barsoum M.W.
Published: June 2008

Herein we compare the lattice parameters, room temperature shear and Young’s moduli, and phonon thermal conductivities of Ti2AlC0.5N0.5and Ti3Al(C0.5, N0.5)2solid solutions with those of their end members, namely Ti2AlC, Ti2AlN, Ti3AlC2, and Ti4AlN2.9. In general, the replacement of C by N decreases the unit cell volumes and increases the elastic moduli and phonon thermal conductivities. The increase in the latter two properties, however, is sensitive to the concentrations of defects, most likely vacancies on one or more of the sublattices.
Surface oxidation of molten Sn–0.07 wt% P in air at 280 °C
Authors: Xian Ai-Ping , Gong Guo-Liang
Published: June 2008

In this article, we describe oxidation of molten Sn–0.07 wt% P alloy exposed in air at 280 °C. Although oxidation can be effectively reduced by the addition of trace phosphorus, the oxide film has a poor protection for the molten alloy with a high P concentration. The oxide film was analyzed by x-ray photoelectron spectroscopy. Comparing the results with the low P sample, there was a high phosphorous content in the film and a new Sn–P compound on the surface of the high P sample. It is assumed that the poor protection against oxidation of the film could be due to volatility of phosphorus in the Sn–P alloy at the temperature.
Vacuum ultraviolet-visible spectroscopic properties of green phosphor NaGd0.3Y0.5Tb0.2FPO4 for application in plasma display panels
Authors: Tian Zifeng , Liang Hongbin , Li Lan , Su Qiang , Zhang Guobin , Fu Yibing
Published: June 2008

In this article, we present the vacuum ultraviolet-visible spectroscopic properties of NaRFPO4:Tb3+ (R = Gd and Y). Because the samples show intensive absorption near 172 nm and bright emission, the composition of the phosphors has been further optimized and an ideal phosphor NaGd0.3Y0.5Tb0.2FPO4 is obtained. This phosphor exhibits favorable characteristics such as a lower preparation temperature, an intensive emission under 172-nm excitation, a shorter decay time (τ1/10 = 8.7 ms) in comparison with the commercial green plasma display panel (PDP) phosphor Zn2SiO4:Mn2+ (τ1/10 = 10.8 ms), a good thermal stability for luminescence performance, and a uniform particle size around 2.3 μm. Hence, the phosphor NaGd0.3Y0.5Tb0.2FPO4 can be considered a promising green phosphor for use in PDPs.
Organic light-emitting diodes with hydrogenated In-doped ZnO thin films as transparent conductive electrodes
Authors: Park Young Ran , Kim Young Sung
Published: June 2008

Hydrogenated In-doped ZnO (ZIO:H) films grown at different ratios, R, of hydrogen to argon were deposited at a substrate temperature of 100 °C for the organic light-emitting diodes (OLEDs). The OLEDs with the ZIO:H (R = 0.08) anode achieved a maximum luminance efficiency of 3.4 cd/A and a power efficiency of 0.6 lm/W, which are as good as the values of the control device fabricated on a tin-doped indium oxide (ITO) anode. This indicates that the efficiency of the OLEDs is critically affected by the ratio of injected hydrogen gas during the deposition of the ZIO and that the ZIO:H developed herein is promising as an alternative to conventional ITO.
Luminescence distribution of Yb-doped Ca-α-SiAlON phosphors
Authors: Dierre B. , Yuan X.L. , Hirosaki N. , Kimura T. , Xie R-J. , Sekiguchi T.
Published: June 2008

Luminescence properties of Yb-doped Ca-α-SiAlON phosphors with composition of Ca1−xYbxSi12−(m+n)Alm+nOnN16−n were investigated by using cathodoluminescence (CL). The ratio of Yb to Ca was kept constant while the host lattice was changed by replacing m+n(Si–N) bonds with m(Al–N) and n(Al–O) bonds. The luminescence of these phosphors consists of three peaks in the ultraviolet (UV), green (VIS), and infrared (IR) regions, which are attributed to the emissions from secondary phases, Yb2+ and Yb3+, respectively. The UV emission depends on the Si/Al ratio: the UV peak is centered at 310 nm for the Si-rich mix and at 360 nm for the Al-rich mix. We have found that Yb exists in the divalent state in α-SiAlON and in the trivalent state in the secondary phases.
Poly(amic acid)–clay nacrelike composites prepared by electrophoretic deposition
Authors: Wang Chang-An , Long Bin , Lin Wei , Huang Yong , Sun Jialin
Published: June 2008

Poly(amic acid) (PAA)–clay nacrelike composite films have been prepared by electrophoretic deposition of an emulsion of PAA, which was synthesized from pyromellitic dianhydride and 4,4′-dianminodiphenyl ether (ODA), containing various loadings of ODA-modified montmorillonite (MMT). The layered silicate was intercalated through reacting with PAA, and the ordered layered assembly of the PAA–MMT composite films was successfully accomplished, as conformed by Fourier transform infrared analysis and x-ray diffraction. The structural characterization of the films was supported by scanning electron microscopy, which displayed an ordered layered structure. The thermogravimetric analysis showed the content of the ODA-modified clay in PAA–MMT composite films that changed from 14.3 to 32.1 wt% and the improved thermal properties of the composite films. The mechanical properties of the composites were measured by tensile test. It was found that the modulus and strength of the composite films were greatly improved compared to those of the pure polymer film. An increment of about 155% in the modulus and 40% in the tensile strength were obtained from the composite films.
Energetics of ZnO nanoneedles: Surface enthalpy, stability, and growth
Authors: Zhang Peng , Lee Thomas , Xu Fen , Navrotsky Alexandra
Published: June 2008

The surface enthalpy of ZnO nanoneedles has been measured by oxide melt solution calorimetry of samples with different surface areas. Water adsorption calorimetry was carried out to characterize the stabilization effect of surface hydration. The surface enthalpies of hydrated and anhydrous surfaces (8.21 ± 0.67 and 9.81 ± 0.69 J/m2, respectively) are larger than those of nanorods. The less stable surface of nanoneedles provides a driving force for the transformation of nanoneedles into nanorods during aging. The formation of bushlike assemblies of nanoneedles is also discussed.
Fracture behavior of Zr55Cu30Al10Ni5 bulk metallic glass under quasi-static and dynamic compression
Authors: Yang R.Q. , Fan J.T. , Li S.X. , Zhang Z.F.
Published: June 2008

Fracture behavior of Zr55Cu30Al10Ni5 bulk metallic glass was investigated under quasi-static compression at strain rate of 10−4/s using an Instron testing machine and dynamic split Hopkinson bar (SHPB) compression with strain rate of about 1900–4300/s. Pronounced strain softening, especially past the peak stress, was observed under SHPB tests and compared with the distinct flow serrations under quasi-static tests. Scanning electron microscope revealed that the angle between the loading axis and major shear plane is less than 45°, deviating from the maximum shear stress plane. Microscopically, unlike the ordinary veinlike pattern found in quasi-static compression, the elongated veinlike pattern was observed at the onset position of rapid shearing under dynamic test. A closely arrayed dendritelike structure dominated the dynamic fracture, consequently, and should be the major pattern representing the rapid shear band propagation. In addition, a transition state from veinlike to dendritelike pattern was observed at the final instantaneous fracture region in quasi-static tests. Evidence revealed the characteristic dimension of dynamic fracture surface complies with Taylor’s meniscus instability criterion. The roles of free volume and adiabatic heating on the fracture strength and stress concentration on the fracture morphology are also discussed.
Control of stoichiometry, microstructure, and mechanical properties in SiC coatings produced by fluidized bed chemical vapor deposition
Authors: López-Honorato E. , Meadows P.J. , Tan J. , Xiao P.
Published: June 2008

Stoichiometric silicon carbide coatings the same as those used in the formation of TRISO (TRistructural ISOtropic) fuel particles were produced by the decomposition of methyltrichlorosilane in hydrogen. Fluidized bed chemical vapor deposition at around 1500 °C, produced SiC with a Young’s modulus of 362 to 399 GPa. In this paper we demonstrate the deposition of stoichiometric silicon carbide coatings with refined microstructure (grain size between 0.4 and 0.8 μm) and enhanced mechanical properties (Young’s modulus of 448 GPa and hardness of 42 GPa) at 1300 °C by the addition of propene. The addition of ethyne, however, had little effect on the deposition of silicon carbide. The effect of deposition temperature and precursor concentration were correlated to changes in the type of molecules participating in the deposition mechanism.
Interfacial reactions and mechanical properties of In–48Sn solder joint with electroplated Au/Ni ball grid array (BGA) substrate after multiple reflows
Authors: Koo Ja-Myeong , Yoon Jeong-Won , Jung Seung-Boo
Published: June 2008

The interfacial reactions and ball shear properties of an In–48wt%Sn solder joint with an electroplated Au/Ni ball grid array substrate were investigated with increasing numbers of reflows using scanning electron microscopy, transmission electron microscopy, energy dispersive x-ray spectrometry, inductively coupled plasma-atomic emission spectroscopy, x-ray diffractometry, and bonding testing. After one reflow, two different intermetallic compound (IMC) layers, AuIn and AuIn2, were formed at the solder–substrate interface. The AuIn was completely transformed into the AuIn2 after three reflows. The AuIn2 IMC layer broke off, and a thin continuous Ni3(SnxIn1–x)4 IMC layer was formed between the molten solder and the exposed Ni substrate after four reflows. After 10 reflows, the AuIn2 IMC layer completely spalled off the substrate and the Ni3(SnxIn1–x)4 IMC layer was dissolved into the molten solder. These interfacial reactions greatly affected the shear properties of the solder joint.