bluuebunny/crossref_metadata_2025 huggingface dataset:
The Increasing Number of Children Using Psychiatric Services: Analysis of a Cumulative Psychiatric Case Register
Authors: Roghmann Klaus J. , Babigian Haroutun M. , Goldberg Irving D. , Zastowny Thomas R.
Published: December 2021

Psychosocial problems of children have received increasing attention in the pediatric literature, but it remains unclear to what extent psychiatric services are available and used for the treatment of these problems. This paper examines the utilization of psychiatric services by children over an 18-year period in Monroe County, NY, where a psychiatric case register monitors utilization since 1960. Reporting to the register is estimated at more than 90% of utilization for the child population. By 1977, the last year for which reasonably complete data are available, enough information had accumulated to study the lifetime utilization of all children up to 17 years of age. During the last three years of the study period, the lifetime prevalence of illness treated in psychiatric facilities including private psychiatrists' offices was 3% for children aged 5 to 9 years, 5.5% for children aged 10 to 14 years, and 7.3% for those aged 15 to 17 years. The incidence of newly recognized and treated illness was approximately .7% per year in the age range 5 to 14 years and 1.0% for those aged 15 to 17. Community mental health centers brought a marked increase in treated incidence especially for the nonwhite population. Utilization rose during the first 15 years of the study period and reached a plateau by the mid-1970s. Two interpretations of this stabilization of utilization are offered. The first one suggests that needs and utilization are still increasing, but that this rise is masked in the data by a drop in reporting providers. The second interpretation suggests that supply and demand for services have become balanced since the establishment of four community mental health centers.
Epstein-Barr Virus (EBV)-Antibody Profile in an Infant Congenitally Infected by the EBV
Authors: Chang R. Shihman
Published: December 2021

In 1973, Blankenship and I reported on an apparently healthy infant who was infected by the Epstein-Barr virus (EBV) in utero.1 In testing for EBV capsid (VCA) antibody in this infant, we found weak positive reactions with undiluted sera but negative reactions with sera diluted at 1/4. Because sera were generally tested at the initial dilution of 1/8 or 1/10 and were considered as negative for VCA antibody if there were no visible reactions,2,3 we concluded that the congenitally infected infant was EBV-seronegative.

See table in the PDF file
Facial Pain
Authors: GAGE ARTHUR A.
Published: December 2021

The article, "Temporomandibular Joint Dysfunction with Facial Pain in Children," (Pediatrics 69:564, 1982) inferred that pains and/or dysfunctions of the temporomandibular (TM) joint constitute a disorder. This is not so. The joint, comprising various tissues, subject to diverse pathologies, may require any of a number of treatment modalities. If a conclusion of one disorder prevailed, it would invite irrational stereotyped "treatment," which, unfortunately does occur.

Pain perceived in the joint region may be referred from a remote source of deep continuous pain, as from an otitis media.
In Reply: Does Mr Yuk Work?
Authors: FERGUSSON D. M.
Published: December 2021

Krenzelok appears to have misread our paper and, in fact, reiterates the very points we made. What we said in our conclusions was: "The present study has, of necessity, evaluated Mr Yuk in isolation from (the National Poisons Center Network Program) and it is possible that various features of (this program) may potentiate the effectiveness of Mr Yuk so that although the label is ineffective when used by itself, it becomes an effective adjunct to an integrated poisoning prevention program. . . . the general conclusions and implications of the study would seem to be that simply supplying Mr Yuk stickers to families with children aged 2 to 3 years is not an effective method of reducing childhood accidental poisoning or poisoning hazards.
Further Observations on the Use of Phenobarbital to Prevent Neonatal Intracranial Hemorrhage
Authors: GOLDSTEIN GARY W. , DONN STEVEN M. , ROLOFF DIETRICH W.
Published: December 2021

Last year we reported our initial results with the use of phenobarbital for the prevention of intraventricular hemorrhage (IVH) in preterm infants. We have continued this controlled investigation and have now enrolled a total of 122 infants. In addition to our study, Morgan et al recently reported their experience using phenobarbital to prevent IVH. These two studies reached different conclusions concerning the efficacy of phenobarbital. In this letter we will present our most recent findings (Donn et al), and we will compare the components of our investigation with that of Morgan et al.
Quinacrine Skin Discoloration Is Associated with Fluorescence of `Y' Chromosome in Male Cells and Malarial Parasites in Malaria
Authors: LEWIN PETER K.
Published: December 2021

Sokol et al reported yellow discoloration in a child treated with quinacrine for giardiasis. This, as the authors suggest, is a well known harmless side effect of quinacrine.

During work with quinacrine fluorescence of the "Y" chromosome, we observed that malarial parasites within red cells of blood smears also fluoresced brightly. At that time we examined a smear of a Nigerian adult male with malaria, who had yellow discoloration due to quinacrine therapy. Not only did we demonstrate quinacrine fluorescence of "Y" chromosomes in white cells of his unstained blood smear but fluorescent malarial parasites were still present in some red cells.
Postnatal Persistence of Capillary-Venous Differences in Hematocrit and Hemoglobin Values in Low-Birth-Weight and Term Infants
Authors: Rivera Luis M. , Rudolph Nathan
Published: December 2021

Full-term and preterm infants were studied to determine whether differences between capillary and venous hematocrit and hemoglobin values were detectable after the first week of life. Significant differences were shown to persist in both term and preterm infants into at least the third postnatal months. However, the differences were considerably greater in low-birth-weight infants, with mean capillary values at ages 4 to 6 postnatal weeks approximately 11% to 12% higher than the corresponding venous values. The data indicated that capillary-venous differences were related not only to postnatal age, but also to postconceptual age.
Fab Fragments in Treatment of Digoxin Ingestion
Authors: SMITH THOMAS W.
Published: December 2021

To the Editor.—

Accompanying the paper of Zucker et al in the September issue of Pediatrics1 is a listing of sources from which digoxin-specific Fab fragments are stated to be available. Unfortunately, this is no longer the case. All of the individuals and institutions listed have been part of a multicenter trial of clinical safety and efficacy of purified digoxin-specific Fab fragments in the treatment of advanced, life-threatening digitalis toxicity. At the present time, however, supplies of the material are extremely limited, and several of the centers listed have exhausted their supplies of digoxin-specific Fab fragments.
Carbamazepine-Isoniazid Interaction
Authors: WRIGHT J. M.
Published: December 2021

To the Editor.—

The case report of carbamazepine intoxication secondary to isoniazid administration recently described in this journal1 is a clinically significant interaction.

I have previously presented2 a similar case in which a patient receiving carbamazepine, valproate, and nitrazepam developed severe carbamazepine intoxication when isoniazid was added to the drug regimen. The patient was determined to have inherited the slow acetylator phenotype. On careful rechallenge, 300 mg of isoniazid increased carbamazepine steady-state serum concentrations by 85% and decreased carbamazepine clearance by 45%.
Carbamazepine-Isoniazid Interaction
Authors: BLOCK STANLEY HOYT
Published: December 2021

In Reply.—

Wright's similar case of carbamazepine intoxication following the addition of isoniazid is most interesting, and it emphasizes our conclusions that physicians should be aware of the risk of interaction between carbamazepine and certain other medications, such as isoniazid. It is noteworthy that Wright's patient was determined to have inherited the slow acetylator phenotype. This information is not available on our patient.

Wright correctly points out an important clerical error in my recent article, in which the following is printed:
Intracerebellar Hemorrhage in a Premature Newborn: Diagnosis by Real-Time Ultrasound and Correlation with Autopsy Findings
Authors: Perlman Jeffrey M. , Nelson James S. , McAlister William H. , Volpe Joseph J.
Published: December 2021

The identification of intracerebellar hemorrhage in a living premature infant by real-time ultrasound scan and confirmation of the findings at autopsy are described. This represents the first demonstration of the value of this noninvasive, convenient, and safe means of brain imaging in diagnosis of this lesion. Previous studies have described the role of the computed tomography (CT) scan in identification of intracerebellar hemorrhage in the newborn. Because infants with intracerebellar hemorrhage are usually critically ill, a means of identification of the lesion that could be utilized at the bedside rather than an approach that requires transport to a CT scanner is needed. This study indicates that portable real-time ultrasound scanning can satisfy that need.
Feeding the Low-Birth-Weight Infant: I. Taurine and Cholesterol Supplementation of Formula Does Not Affect Growth and Metabolism
Authors: Järvenpää Anna-Liisa , Räihä Niels C. R. , Rassin David K. , Gaull Gerald E.
Published: December 2021

Taurine and cholesterol are constituents of human milk that are present in smaller amounts in infant formulas. Infants fed such formulas have lower plasma and urine concentrations of taurine and of serum total cholesterol. In the present investigation, in infants of 31 to 36 weeks gestational age, the effects of supplementing a 1.5 g/100 mL whey-predominant formula with taurine alone or with taurine plus cholesterol were examined. Infants fed the supplemented formula were compared with infants fed the unsupplemented formula and with infants fed pooled, expressed human milk (185 mL/kg/d). Approximately 45% of the human milk provided to each infant was that of the infant's mother (35% pasteurized and 10% fresh). From the time of reaching a weight of 2,400 g to 4 months of age the last group of infants was fed ad libitum. No consistent statistically significant differences in growth, as measured by rate of gain in crown-rump length, crown-heel length, or head circumference, were observed. There was a tendency, however, for the formula-fed infants to gain weight more slowly before reaching 2,400 g and to gain weight more quickly after a weight of 2,400 g was attained to 4 months of age. No differences in concentrations of BUN, total serum proteins or acid-base status were observed among the formula-fed groups. The concentration of BUN increased in the formula-fed groups compared with the group fed human milk during the last half of the study. The formula-fed infants tended to have higher total serum proteins and to be slightly more acidotic than the infants fed human milk prior to discharge at a weight of 2,400 g but not thereafter. Thus, infants fed 185 mL/kg/d gained weight at rates comparable to those for fetuses of the same gestational age. Supplementation of formulas with taurine or taurine plus cholesterol did not produce changes in growth or general metabolism discernible under the present experimental conditions.
Ornithine Carbamoyltransferase Deficiency in an Adult Male Patient: Significance of Hepatic Ultrastructure in Clinical Diagnosis
Authors: Tallan Harris H. , Schaffner Fenton , Taffet Sanford L. , Schneidman Karmela , Gaull Gerald E.
Published: December 2021

Ornithine carbamoyltransferase (OCT) activity was deficient (8% of control) in the liver of a 21-year-old man who died after suddenly becoming comatose. Activities of other enzymes of the urea cycle in the liver were normal. There was no known prior illness or injury; the patient, however, had been taking liquid protein supplements to his diet. Hyperammonemia and orotic aciduria were present, and the concentration of lysine in the plasma was elevated. Survey of earlier reports indicates that neither the specific deficiency of hepatic OCT nor the urine and plasma findings provide a basis for definitive diagnosis of the patient's illness as primary OCT deficiency or as Reye's syndrome. Indeed, the age of the patient at onset of symptoms and the absence of any prodromal infection argue against the OCT deficiency being either primary or a sequel to Reye's syndrome. We suggest that it was secondary to mitochondrial injury caused by an unknown agent. Electron microscopic study of hepatocyte ultrastructure lends support to this view; abnormalities of the patient's mitochondria (bizarre, elongated shapes) do not resemble those seen in Reye's syndrome, nor have abnormalities been found in primary OCT deficiency.
A New Simplified Technique for Pediatric Anorectal Manometry
Authors: Rosenberg Allan J. , Vela A. Richard
Published: December 2021

Using a new simple technique that is well tolerated and rapid for assessing anal sphincter functions in pediatric patients with fecal incontinence and constipation, 86 patients with varying degrees of anorectal dysfunction were tested. A microtip pressure transducer was used for recording anal sphincter responses to rectal balloon distension. Results were obtained within 15 to 30 minutes. In 17 patients, the internal anal sphincter showed no response or positive spike to balloon distension, consistent with the manometric diagnosis of aganglionic megacolon. These findings were confirmed by absence of ganglion cells on rectal biopsy. Sixty-nine children had normal internal sphincter relaxation to rectal distension. Ganglion cells were present in nine biopsy specimens. In the remaining 60 patients, no further workup of aganglionosis was necessary. There were no falsepositive or false-negative results. This technique has proved to be effective for initial evaluation of infants and children with constipation and encopresis.
Speech and Language Development in 41 Children with Sex Chromosome Anomalies
Authors: Bender Bruce , Fry Elizabeth , Pennington Bruce , Puck Mary , Salbenblatt James , Robinson Arthur
Published: December 2021

Forty-one children with sex chromosome anomalies identified from the chromosome screening of a newborn population were blindly evaluated by a speech-language pathologist, along with a control group of 31 siblings. 47,XXX girls and 47,XXY boys were found to have increased problems in auditory perception, receptive language, and expressive language; the problems of the 47,XXY boys were less severe than those of the 47,XXX group, and reflected specific deficits in their ability to process linguistic information rather than a deficit in comprehension. An increased occurrence of speech production problems among the 45,X girls was associated with the presence of oral/structural malformations that often had no measurable effect on their production of speech sounds. Although the 45,X girls and 47,XYY boys had no significant increase of problems in auditory reception, receptive language, and expressive language, the trend of the data suggested more difficulty than in the control groups. The mosaic children were not different from the control subjects. Some children in all groups were found to have normal speech and language development.
Soy Formula Doesn't Help Colic
Authors: LOTHE LASSE , LINDBERG TOR , JAKOBSSON IRÉNE
Published: December 2021

In Reply.—

We fully agree with LeBlanc that there was no significant improvement when infants with colic were given a soy protein-based formula. As pointed out in the "Discussion," as many as 53% of the infants showed an adverse reaction to soy (corresponding figure for cow's milk formula was 71%).

We also emphasized that these figures must be interpreted with caution. In fact, soy protein-based formula was a bad choice as placebo. A placebo substance should be a substance of no importance as an allergen in infancy and soy protein has been shown to be as antigenic as cow's milk proteins (Eastham EJ, et al: J Pediatr 1978;93:561).
Should Screening Programs Be Perfect?
Authors: WYATT PHILIP R.
Published: December 2021

To the Editor.—

The report of the New England Regional Screening Program1 on neonatal hypothyroidism is a stunning illustration of the vulnerability of screening programs. It is unfortunate that this experience will probably be used as an argument to minimize the input of screening programs in the health care system in the United States.

The report illustrates that, in addition to the 2% of the screened population that eluded the program, 14 infants with hypothyroidism escaped the full benefits of early detection and treatment.
Applicability of the Denver Prescreening Developmental Questionnaire in a Low-Income Population
Authors: Rosenbaum Michael S. , Chua-Lim Cristina , Wilhite Joan , Mankad Vipul N.
Published: December 2021

A prospective study was conducted to assess the applicability of the Denver Prescreening Developmental Questionnaire (DPDQ) in a predominantly black, low-income population in Mobile, Alabama. The effect of an educational intervention designed to increase the accuracy of parental responses to the DPDQ was also assessed. In a longitudinal follow-up program, 127 infants aged 2 weeks to 1 year were recruited. Parents in a randomly selected experimental group observed an audiovisual presentation describing progressive developmental behaviors, received handout materials summarizing these behaviors, and were asked to record their child's subsequent attainment of these behaviors. Mean agreement scores, obtained by comparing parental responses to the DPDQ with the corresponding items of the Denver Developmental Screening Test (DDST), did not differ between the experimental and control groups. These scores showed agreement of 93.6% (3-month visit), 91.3% (6-month visit), 91.6% (9-month visit), and 95.1% (12-month visit), resulting in an overall mean agreement score of 92.9%. The overreferral rate was low (13%) and no underreferrals were obtained. These results attest to the applicability of the DPDQ in low-income population and demonstrate the lack of effectiveness of the educational intervention in increasing the accuracy of parental responses to the DPDQ.
Measles and Acute Glomerulonephritis
Authors: Lin Ching-Yuang , Hsu Hey-Chi
Published: December 2021

A 5-year-old boy had transient glomerulonephritis following measles infection. Serologic studies at the early onset of the disease showed decrease of serum C3, C4, and Clq levels with normal serum properdin factor B. Renal glomerular histology revealed a mild acute proliferative glomerulonephritis. Measles virus antigen, C3, C4, and immunoglobulin G (IgG) were demonstrated in the glomerulus, suggesting an immune complex deposition. Ultrastructurally, subepithelial, intramembranous, and subendothelial electron-dense deposits were noted, suggesting a postinfectious immune complex glomerulonephritis. It is suggested that the measles virus antibody complexes are deposited in the glomerulus and activate the classic pathway of complement, leading to a self-limited glomerulonephritis.
45,X/46,XX Mosaicism in Discordant Monozygotic Twins
Authors: Uchida Irene A. , deSa Derek J. , Whelan Donald T.
Published: December 2021

Monozygotic twins discordant for Turner's syndrome were both mosaic for 45,X/46,XX in the blood with the same low frequency of 2% to 3% 45,X cells. However, the fibroblasts of the abnormal girl were all uniformly 45,X whereas her normal twin had only 46,XX cells. Monozygosity was confirmed by genetic markers, chromosome variants, and a single monochorionic placenta with a shared vascular circulation. The mechanism by which this disparate pair developed from a single zygote is suggested.
Challenge of Pediatric Education
Authors: GEME JOSEPH W. ST.
Published: December 2021

The paper by Starfield1 is provocative and discomforting to all pediatricians whether clinician-practioner or academician-educator. She issues a keen challenge to us, and that is healthy for any professional discipline, certainly for a specialty discipline characterized by optimism and resilience. The data base for Starfield's analysis of pediatric practice is limited by confinement to the conclusion of an era of more abbreviated or traditional subspecialty-oriented graduate pediatric training. She reflects about the practice patterns of pediatricians who were trained before the seminal deliberations and conclusions of the Task Force on Pediatric Education.2 The Task Force and the certifying and accrediting arms of American pediatrics initiated sweeping changes in the philosophy and structure of pediatric residency training.
The Primary Physician and the Death of a Child in a Specialized Hospital Setting
Authors: WESSEL MORRIS A.
Published: December 2021

Pediatricians offer ongoing comprehensive and coordinate care for children. Community-based primary pediatricians assume a large proportion of this repsonsibility, referring a few patients to collegues with specialized skills for consultation and treatment. These consultants, who are often fulltime members of university or other medical centers, provide care extending the lives of many children suffering illnesses that formerly were fatal early in the course of the disease. Some infants and children unfortunately do die after many months or years of treatment at a specialized clinic or hospital service. When this tragedy occurs, parents and siblings have the difficult task of relinquishing their relationship to hospital physicians, nurses, and social workers who have sustained them for many months or years.
Transcutaneous Bilirubin Measurements: Variation in Meter Response
Authors: MAISELS M. JEFFREY , LEE CHERYL
Published: December 2021

The transcutaneous bilirubin meter has been shown to be a useful screening device for the identification of significant neonatal jaundice in full-term infants.1-3 Investigators have, nevertheless, emphasized the necessity for each institution to establish the relationship between the transcutaneous bilirubin index, as measured with a particular instrument, and the serum bilirubin determination obtained from the institution's laboratory. 3 This is important, because of the known variation between laboratories in the measurement of serum bilirubin concentration4 and because no information has been published regarding the potential variation in the response of different transcutaneous bilirubin meters.
Carboxyhemoglobin Concentration in Fetal Cord Blood
Authors: HUCH R. , HUCH A. , TUCHSCHMID P. , ZIJLSTRA W. G. , ZWART A.
Published: December 2021

To the Editor.—

Bureau et al1 reported that the concentration of carboxyhemoglobin (HbCO) is increased more than twofold in cord blood of newborns of smoking mothers as compared to corresponding values in maternal venous blood. Data were obtained from an IL 282 (Instrumentation Laboratory, Lexington) Co-oximeter, an instrument using spectroscopic multicomponent analysis of HbO2, Hb, MetHb, and HbCO in whole blood.

We are concerned that the data presented are due to an artifact of HbCO measurement as the instrument used is not suitable for the correct measurement of HbCO concentrations in fetal blood.
Breast-Feeding and Infections
Authors: FRANK ARTHUR L. , TABER LARRY H.
Published: December 2021

In Reply.—

We agree completely with Mick and Grossman and Prober and Bachrach that there were differences between the families of breast-fed and bottle-fed children in our study.1 They note the important difference in parental smoking but there were others shown in our table 1 as well. In the paragraph just before "Implications" (p 244), we made the point that these social and behavioral disparities support our main conclusion that there were few significant differences between the groups and "weaken arguments based on the observed trends to protection."
Role of Xanthine Oxidase and Its Inhibitor in Hypoxia: Reoxygenation Injury
Authors: Saugstad Ola Didrik
Published: December 2021

Objective. This article reviews the biochemistry and function of xanthine dehydrogenase (XDH) and xanthine oxidase (XO) as well as their role in hypoxia-reoxygenation injury. Possible benefits of XO blockade are discussed.

Methodology. The available literature was reviewed. Results. It is evident that relatively high activities of XO are restricted to a few organs in man. Because positive effects of XO blockade with allopurinol have been reported even in organs containing relatively low activities of XO, two other possible favorable actions of allopurinol are mentioned. First it may act as an oxygen radical scavenger, and second, it may augment the adenine nucleotides and, hence, adenosine triphosphate concentration in the cell.

Conclusions. XDH and XO may play an important role in a series of pathophysiologic conditions. Their role in hypoxia-reoxygenation injury has been critically reviewed. However, care should be exercised in starting randomized trials to prevent hypoxia-reoxygenation injury with allopurinol, especially in newborn infants. Speculation. XDH and XO are released from the liver during hypoxic conditions, for instance, and consequently, they may reach a number of organs via the circulation.
Recommended Childhood Immunization Schedule
Authors:   Committee on Infectious Diseases
Published: December 2021

The Recommended Childhood Immunization Schedule United States, July—December 1996 was developed by the Committee on Infectious Diseases of the American Academy of Pediatrics in collaboration with the Advisory Committee on Immunization Practices (ACIP) of the Centers for Disease Control and Prevention, and the American Academy of Family Physicians. Since the Schedule was last published in January 1996, no new vaccines have been approved by the Food and Drug Administration and as of May 15, 1996, no changes had been made in Academy recommendations.1 If additional changes are made before the next publication in the January 1997 issue of Pediatrics, the membership will be informed through other channels. For detailed information on the use of vaccines, providers should refer to the l994 Red Book: Report of the Committee on Infectious Diseases,2 the ACIP General Recommendations on Immunization3 and the vaccine package inserts.
Treatment of Lead-exposed Children
Authors: Marcus Steven M.
Published: December 2021

I am writing in response to the recommendations in the statement "Treatment Guidelines for Lead Exposure in Children," by the Committee on Drugs, reported in the July 1995 issue of Pediatrics. The Committee did an admirable job in reviewing the various aspects of treating lead poisoning; however, there are several points that were made that need to be clarified.

Although no one would argue that treatment is indicated for lead encephalopathy, there have been no studies, to my knowledge, of a double-blind, controlled nature, showing that treatment of lead poisoning, in the absence of clinical symptoms, is of any use in either reversing any neurologic or developmental abnormalities or, in fact, in prevention of such.
Letter To The Editor
Authors: Escobar Gabriel J.
Published: December 2021

Dr Wiswell does well to remind us that selective criteria for lumbar puncture sometimes fail to identify cases of neonatal meningitis (Pediatrics 1995;95:803-806). It should not surprise us when a guideline fails. However, it does not follow that, because of this observation, one should subject every newborn suspected of sepsis (130 000 to 400 000 each year in the United States1-3) to a spinal tap. The history of neonatology is full of unfortunate events resulting from similar blanket recommendations.4
THE WORST IS YET TO COME ..
Authors: L. J. F.
Published: December 2021

Jerome Kassirer, in a current issue of the New England Journal of Medicine, expressed the fear that:

market-driven care is likely to alienate physicians, undermine patients' trusts of physicians' motives, cripple academic medical centers, [and] handicap the research establishment ... On the one hand, doctors are expected to provide a wide range of services, recommend the best treatments, and improve patients' quality of life. On the other, to keep expenses to a minimum they must limit the use of services, increase efficiency, shorten the time spent with each patient, and use specialists sparingly!
NOTABLE QUOTE ON MEDICINE
Authors: Elliot George
Published: December 2021

"I could not be happy in any profession which did not involve the highest intellectual strain, and yet keep me in good warm contact with my neighbors."
Tuberculin Skin Test Screening in Schoolchildren in the United States
Authors: Driver Cynthia R. , Valway Sarah E. , Cantwell Michael F. , Onorato Ida M.
Published: December 2021

Objective. To determine the current practices and results of tuberculin skin test (TST) screening of schoolchildren in the United States.

Methods. Tuberculosis program staff in all states and the District of Columbia were asked about current requirements, practices, and results of school-based TST screening.

Results. Thirty-four states and the District of Columbia (69%) reported no current statewide statutes or policies for tuberculin screening of schoolchildren, and 10 (19%) reported having statewide requirements. In 6 states (12%), requirements were instituted at the local level, and 24 localities in these states were known to require screening. Of the 34 areas requiring screening, 18 (53%) screened all new entrants, 7 (21%) screened children in specific grades, and 9 (26%) used other criteria for screening. TST results were collected for 26 (76%) of 34 areas, and 6 areas collected results of follow-up evaluation of tuberculin-positive children. Additionally, 8 localities in 7 states with no screening requirements conducted tuberculin surveys. Sixteen areas provided results. In 7 of the 8 areas that collected information about birthplace, less than 2% of US-born children were tuberculin positive; foreign-born children had rates 6 to 24 times higher than US-born children. TST screening identified few cases of tuberculosis, less than 0.02% of the children screened.

Conclusion. School-based tuberculin screening identified low rates of positive TST results in US-born children. Resources should be directed toward screening children at high risk for tuberculous infection, as recommended by the American Academy of Pediatrics and the Advisory Committee for Elimination of Tuberculosis.
Trabalho e família de trabalhadoras domésticas em tempos de pandemia
Authors: Valeriano Marta Maria , Tosta Tania Ludmila Dias
Published: December 2021

Este artigo discute a intersecção de raça, gênero e classe na produção das desigualdades vividas por trabalhadoras domésticas no Brasil e como essas desigualdades se acirram em contexto de crise pandêmica. Com base em uma análise de microdados da Pesquisa Nacional por Amostra de Domicílios (Pnad Contínua) e de entrevistas com trabalhadoras domésticas na região metropolitana de Goiânia, examinamos as desigualdades na relação trabalho e família, considerando aspectos relacionados às condições de trabalho, aos usos do tempo e aos arranjos domésticos. Os resultados indicam que a pandemia, precedida e intensificada por um duro contexto de recessão econômica e de ampliação de políticas de flexibilização dos direitos trabalhistas, acentuou desigualdades historicamente estruturantes da ocupação. Esses elementos incidem sobre o cotidiano das trabalhadoras domésticas, reorganizando os arranjos domésticos e suas vivências temporais.
Diseño de un tablero de control para el seguimiento del desempeño de una grúa torre en un proyecto de construcción
Authors: Gamboa Araya Diego , Mata Abdelnour Erick
Published: December 2021

La grúa torre es un equipo con un alto costo de operación y crítico para el avance de las construcciones verticales. Por ello, surge la necesidad de tener instrumentos que permitan controlar el desempeño de la grúa torre en los proyectos de construcción verticales. En esta investigación, se creó un tablero de control, el cual posibilita la medición y el control del desempeño de la grúa torre durante la ejecución del proyecto constructivo. La herramienta diseñada se implementó en la construcción de un edificio con un sistema estructural compuesto por muros, columnas y losas postensadas. Se estudió solamente una grúa torre.  En algunas ocasiones, se brindaron causas lógicas y razonables para explicar un determinado comportamiento de la grúa torre analizada. Sin embargo, estas causas podrían no ser ni las únicas ni las definitivas. Se recurrió al muestreo de trabajo para obtener representatividad en las muestras. Se estima que la herramienta propuesta traerá las siguientes mejoras: enfoque de la grúa torre en las tareas más críticas; medición y mejora de los rendimientos de diversas tareas esenciales para el avance; determinación y reducción del porcentaje de tiempo muerto; mejor seguimiento a los incidentes y reducción de los accidentes, lo que reduce el tiempo en el que el proyecto está detenido debido a accidentes; y, finalmente, mayor seguimiento al mantenimiento de la grúa torre, lo que disminuye el tiempo en el que el equipo está detenido debido a fallas. El costo de la implementación de la herramienta presentada es viable para la mayoría de empresas a cargo de construcciones de modalidad vertical. La relación costo-beneficio del instrumento propuesto se estimó en un factor de 9.8, lo cual sugiere que los beneficios de la herramienta son considerablemente mayores que sus costos.
The SaeR/S Two Component System: The Security System of Staphylococcus aureus
Authors:   Montana State University, Burroughs Owen , Voyich Jovanka ,   Montana State University
Published: December 2021

Staphylococcus aureus (S. aureus) is a common human pathogen that is responsible for thousands of deaths each year. The bacterium’s severity is caused, in part, by its ability to detect and evade the human immune system. In this article, Owen Burroughs, an undergraduate researcher in the lab of Dr. Jovanka Voyich, describes his research into the SaeR/S two-component system, a “security system” that allows S. aureus to avoid being killed by immune cells. Over the course of Owen’s research, the Voyich lab has determined that the proteins SaeP and SaeQ likely play a major role in the functioning of this security system. By helping us better understand the interactions between S. aureus and its host, this research could pave the way for new treatments and therapies for severe S. aureus infection.
Writing Center Research: Reflecting on “Radical Reciprocity in Online Spaces”
Authors:   Montana State University, Bernard Abby
Published: December 2021

Writing Center peer tutor, Abby Bernard, describes her journey with Writing Center research. Bernard first explains her understanding of Michele Eodice's concept of "participatory hospitality" before examining participatory hospitality in online, asynchronous writing studios. This inquiry presents an opportunity to further understand which tutoring practices may foster participatory hospitality, as well as demonstrates the process of research within Writing Center scholarship.
Bioinformatic Identification of CRISPR Leader Motifs
Authors:   Montana State University, Krishna Pushya
Published: December 2021

Clustered Regularly Interspersed Short Palindromic Repeats (CRISPR) and CRISPR associated (Cas) proteins serve as a sophisticated adaptive immune system to defend bacteria and archaea from viral infection. CRISPR mediated immunity occurs in three stages which allow the bacteria to adapt and respond to new as well as previously encountered viruses. The initial step of CRISPR adaptation requires the help of the Integration Host Factor (IHF) and a stretch of 200 base pairs known as the CRISPR leader to ensure encounters with new viruses are properly recorded in the host organism’s immunological memory. A bioinformatic analysis of over 15,000 CRISPR leaders reveals that IHF is a prevalent and widespread feature of CRISPR adaptation across several different CRISPR subtypes and host organisms.
Purple Dreamscape and Soft Green Haze
Authors:   Montana State University, Ross Olivia
Published: December 2021

>“Soft Green Haze” and “Purple Dreamscape” are two oil paintings on wood panels by Olivia Ross, a Studio Art student at Montana State University. In creating these two works, Olivia looks to examine how narrative and aesthetic choices draw a viewer into a piece. Olivia removed any indication of a clear narrative or recognizable spaces and instead relies on abstraction to prompt an audience to engage. Olivia found even with the absence of these the viewer is enticed to explore further, not only in physical proximity to the work, but in projecting their own ideas onto it. Olivia thinks that this inclination to create one’s own relationship with a piece when there is no clear narrative to grasp makes a nontangible, abstracted space that’s much more reactively powerful.
O conflito público-privado no SUS: a atenção ambulatorial especializada no Paraná
Authors: Straub Michele , Gomes Rogerio Miranda , Albuquerque Guilherme Souza Cavalcanti de
Published: December 2021

RESUMO O conflito fundamental da saúde em sociedades capitalistas - direito social versus mercadoria - também se expressa no interior do Sistema Único de Saúde (SUS). Este trabalho analisou a relação público-privado na oferta de serviços ambulatoriais especializados pelo SUS no estado do Paraná, no período de 1995 a 2015, em comparação com a realidade nacional. Realizou-se um estudo descritivo, com procedimentos selecionados, a partir da coleta de dados no Sistema de Informações Ambulatoriais (SIA), por meio da plataforma do Datasus Tabnet On-line nos anos de 1995, 1999, 2003, 2007, 2011 e 2015. Os resultados demonstram que a atenção ambulatorial especializada, secundária e terciária, sofreu ampliação nas duas décadas, acompanhando a expansão do SUS. O percentual de participação privada é, em geral, minoritária nos serviços de média complexidade e majoritária nos de alta complexidade, sendo que, no Paraná, o grau de privatização é consideravelmente maior que no âmbito nacional. Assim, diferentemente do preconizado constitucionalmente, em vários serviços e áreas do SUS, o público é que assume o papel de complementar ao privado. Discutem-se os possíveis impactos da privatização interna do SUS sobre seus limites em se constituir como sistema universal, integral e igualitário.
Representações sociais de pessoas vivendo com HIV: autopercepção da identidade egoecológica
Authors: Melo Dayana Souza de , Mello Rosâne
Published: December 2021

RESUMO Este artigo objetivou compreender a identidade ego-ecológica da pessoa vivendo com HIV e analisar as influências exercidas pelo profissional de saúde sobre esses indivíduos. A pesquisa é de abordagem qualitativa, com base teórico-metodológica na Teoria das Representações Sociais. Foram realizadas entrevistas com complementação de frases com 20 pessoas vivendo com HIV que recebem atendimento no laboratório de imunologia de um hospital universitário. O perfil populacional do estudo influenciou positivamente no lidar com o agravo, dada a maior idade e tempo de tratamento. Apesar disso, os estigmas sociais negativos ainda se fizeram presentes. Enfatizou-se o profissional de saúde com potencial de transformação, sendo este vinculado à oferta qualificada de cuidado. Por fim, concluiu-se que ainda há preconceitos e tabus direcionados a pessoas vivendo com HIV, indicando assim a necessidade de um olhar atencioso às vulnerabilidades biopsicossociais dessa população.
Inpatient flow for Covid-19 in the Brazilian health regions
Authors: Silva Everton Nunes da , Soares Fernando Ramalho Gameleira , Frio Gustavo Saraiva , Oliveira Aimê , Cavalcante Fabrício Vieira , Martins Natália Regina Alves Vaz , Oliveira Klébya Hellen Dantas de , Santos Leonor Maria Pacheco
Published: December 2021

ABSTRACT The study aims to investigate the flows of Covid-19 hospitalizations in the 450 Brazilian health regions and 117 health macro-regions between March and October 2020. This descriptive study includes all Covid-19 hospitalizations registered in the Influenza Epidemiological Surveillance Information System between the eighth and forty-fourth epidemiological weeks of 2020. In Brazil, 397,830 admissions were identified for Covid-19. Emigration was 11.9% for residents in health regions and 6.8% in macro-regions; this pattern was also maintained during the peak period of Covid-19 hospitalizations. The average evasion for residents of health regions was 17.6% in the Northeast and 8.8% in the South. Evasion was more accentuated in health regions with up to 100 thousand inhabitants(36.9%), which was 7 times greater than that observed in health regions with more than 2 million inhabitants (5.2%). The negative migratory efficacy indicator (-0.39) revealed a predominance of evasion. Of the 450 Brazilian health regions, 117 (39.3%) had a coefficient of migratory efficacy between-1 and-0.75, and 113 (25.1%) between-0.75 and-0.25. Results indicate that the regionalization of the health system exhibited adequate organization of healthcare in the territory; however, the long distances traveled are still worrisome.
Health collapse in Manaus: the burden of not adhering to non-pharmacological measures to reduce the transmission of Covid-19
Authors: Barreto Ivana Cristina de Holanda Cunha , Costa Filho Raimundo Valter , Ramos Ronaldo Fernandes , Oliveira Luciana Gonzaga de , Martins Natália Regina Alves Vaz , Cavalcante Fabrício Vieira , Andrade Luiz Odorico Monteiro de , Santos Leonor Maria Pacheco
Published: December 2021

ABSTRACT This article aims to compare the evolution of Covid-19 in Manaus and Fortaleza, two epicenters of the pandemic in 2020, analyzing legal measures by local governments and levels of social isolation. An algorithm was defined to calculate the Homestay Index (HSI), using data from the Google Mobility Report. We analyzed the decree’s timeline, the HSI evolution, the Covid-19 incidence and the number of deaths from March/2020 to January/2021. The population of Fortaleza was exposed to more consistent measures of social distancing than that of Manaus. Longer homestay was observed from March to May 2020 and Fortaleza achieved higher and more lasting levels. As of June 2020, the HSI fell, notably in Manaus, reaching levels below zero in late December. As an aggravating factor, the government decreed broad isolation in Manaus on December 23, 2020, but after protests it was repealed on December 26, 2020. A judicial decision determined the complete closure in Manaus on January 2nd 2021, but it was too late: the SUS collapsed with an exponential increase in deaths. In Fortaleza, the demand for health services was high, but under control. We consider that only the strict application of non-pharmacological measures and mass immunization can prevent further deaths.
Programa Mais Médicos, uma tentativa de solucionar o problema da distribuição médica no território brasileiro
Authors: Nassar Leonardo Maso , Passador João Luiz , Pereira Júnior Gerson Alves
Published: December 2021

RESUMO O objetivo do estudo foi realizar uma revisão integrativa da literatura utilizando a mnemônica População, Conceito e Contexto do Joanna Briggs Institute para mapear os trabalhos que abordaram a distribuição médica no Brasil, com intuito de analisar criticamente o Programa Mais Médicos (PMM), resultando em 453 trabalhos, com 10 artigos selecionados. Os resultados indicam fatores pecuniários e não pecuniários como motivos para a má distribuição brasileira de médicos. Como solução, foi criado o PMM, que provocou grande expansão do número de cursos de medicina - um aumento estimado de 71% no número de médicos até 2030. Embora haja dificuldades na capacitação técnica e pedagógica docente e de preceptores para supervisionarem essa quantidade abrupta de graduandos, há uma oportunidade para transformar a má qualidade atual do acesso e da assistência prestada à população no Sistema Único de Saúde (SUS). Por outro lado, a falta de um monitoramento contínuo da avaliação da qualidade dos formandos e a falta de investimentos na infraestrutura e na regulação da assistência, bem como da melhor distribuição e qualificação dos programas de residência médica, poderão tornar essa situação, aparentemente vantajosa, uma grande catástrofe (pessoal e profissional), com um mercado de trabalho que pode ter uma enorme oferta de mão de obra pouco qualificada.
Technosociality in the daily lives of primary care professionals and health promotion: scoping review
Authors: Silva Tamires Carolina , Carvalho Andresa Guerra de , Tholl Adriana Dutra , Borrego Maria Aurora Rodriguez , Soto Pablo Jesús López , Viegas Selma Maria da Fonseca
Published: December 2021

ABSTRACT This study aimed to map the available evidence on technosociality in the daily lives of primary care professionals to promote the health of people/families. This is a scoping review based on the Joanna Briggs Institute and Prisma-ScR. The PCC strategy (participants, concept and context) was used. The sample comprises 25 articles. The predominant language was English, the year, 2018, the strength of evidence, 5 and the quality of evidence, high and moderate. Technologies are part of the daily life of PHC professionals and include health control, curative and medication measures. They are sources of communication between professionals and professionals and users. For the use of technologies, it is essential that professionals are trained, using evidence-based practices to achieve the objectives in view of the needs of each one. The use of technologies to promote the health of people/families represents a technological innovation in Primary Health Care, with the possibility of impacting health conditions and promoting healthier life choices.
Vermicompost humates as a salinity mitigator in the germination of basil
Authors: Reyes-Perez Juan José , Amador Bernardo Murillo , Hernández-Montiel Luis Guillermo , Rangel Pablo Preciado , Rueda-Puente Edgar Omar , Ruiz-Espinoza Francisco Higinio
Published: December 2021

ABSTRACT: This study determined the effect of vermicompost humates as salinity mitigator in germination and morphometric characteristics of basil varieties seedlings, tolerant and sensitive to salinity, subjected to vermicompost humates diluted 1/60 (v/v) and 0, 50 and 100 mM NaCl in a completely randomized design with four replications. The rate and percentage of germination, root length, shoot height, root and shoot fresh and dry-weight were measured. The varieties showed differential response, highlighting Napoletano as the most tolerant. Vermicompost humates showed biostimulant effects on variables evaluated, allowing that tolerant variety to improve germination and growth, and increasing the salinity tolerance of the sensitive variety.