bluuebunny/crossref_metadata_2025 huggingface dataset:
The time‐varying volatility spillover effects between China's coal and metal market
Authors: Lin Boqiang , Lan Tianxu
Published: February 2024

This study employs a time‐varying parameter vector autoregression methodology with the Diebold and Yilmaz spillover index to scrutinize the temporal fluctuations in volatility spillovers between the Chinese coal and metal markets. The analysis is conducted from the dual perspectives of security indices and futures prices. The findings reveal a robust correlation between the coal and metal markets, with the coal market serving as a primary conduit for volatility spillover into the metal market. Furthermore, this study investigates the time‐specific impacts of coal decommissioning policies, the COVID‐19 pandemic, and the coal supply crisis on the coal–metal market volatility spillovers. The findings indicate that these three unique shocks significantly increase the overall risk spillover index between the coal and metal markets. Moreover, during these exceptional events, the extent or role of risk spillover in the coal–metal market undergoes varying degrees of change. On the basis of these findings, this article presents pertinent policy recommendations.
Linking archaeology and paleoenvironment: Mid‐Holocene occupational sequences in the Varamin Plain (Iran)
Authors: Busch Robert , Bernbeck Reinhard , Hessari Morteza , Kirsten Fabian , Lüthgens Christopher , Pollock Susan , Rol Nolwen , Schütt Brigitta
Published: February 2024

Early human habitation of the arid to semiarid Central Iranian Plateau was strongly connected to the availability of water and associated natural hazards, such as flooding and drought events. In this geoarchaeological study, we focus on the occupation at the prehistoric site of Ajor Pazi within the formerly active fluvial environment of the Varamin Plain. Through radiocarbon and luminescence‐dated sediment cross‐sections, we apply multivariate statistics to sedimentological characteristics of bulk samples collected during a rescue excavation in 2018. Based on facies interpretations, we differentiate depositional processes and present their implications for the environs of Ajor Pazi. Our results show evidence of settlement activities between 6.4 and 5.6 ka cal B.P. (4.4–3.6 ka cal. B.C.E.). Phases of reduced geomorphodynamics can be distinguished when soil‐forming processes take place. Our findings provide insights into the hitherto scarcely explored Transitional Chalcolithic II period during which the site of Ajor Pazi emerged and began to shape its environs.
The impact of social hierarchies on neural response to feedback evaluations after advice giving
Authors: Li Jin , Li Mei , Sun Yu , Zhang Guanfei , Fan Wei , Zhong Yiping
Published: February 2024

Advisors generally evaluate advisee‐relevant feedback after advice giving. The response to these feedback—(1) whether the advice is accepted and (2) whether the advice is optimal—usually involves prestige. Prior literature has found that prestige is the basis by which individuals attain a superior status in the social hierarchy. However, whether advisors are motivated to attain a superior status when engaging in advice giving remains uncharacterized. Using event‐related potentials, this study investigates how advisors evaluate feedback after giving advice to superior (vs. inferior) status advisees. A social hierarchy was first established based on two advisees (one was ranked as superior status and another as inferior status) as well as participants' performance in a dot‐estimation task in which all participants were ranked as medium status. Participants then engaged in a game in which they were assigned roles as advisors to a superior or inferior status advisee. Afterward, the participants received feedback in two phases. In Phase 1, participants were told whether the advisees accepted the advice provided. In Phase 2, the participants were informed whether the advice they provided was correct. In these two phases, when the advisee was of superior status, participants exhibited stronger feedback‐related negativity and P300 difference in response to (1) whether their advice was accepted, and (2) whether their advice was correct. Moreover, the P300 was notably larger when the participants' correct advice led to a gain for a superior‐status advisee. In the context of advice giving, advisors are particularly motivated to attain a superior status when the feedback involving social hierarchies, which is reflected in higher sensitivity to feedback associated with superior status advisees at earlier and later stages during feedback evaluations in brains.
Water‐rock interactions drive chemostasis
Authors: Warix Sara , Navarre‐Sitchler Alexis , Singha Kamini
Published: February 2024

The western U.S. is experiencing shifts in recharge due to climate change, and it is currently unclear how hydrologic shifts will impact geochemical weathering and stream concentration–discharge (C–Q) patterns. Hydrologists often use C–Q analyses to assess feedbacks between stream discharge and geochemistry, given abundant stream discharge and chemistry data. Chemostasis is commonly observed, indicating that geochemical controls, rather than changes in discharge, are shaping stream C–Q patterns. However, few C–Q studies investigate how geochemical reactions evolve along groundwater flowpaths before groundwater contributes to streamflow, resulting in potential omission of important C–Q controls such as coupled mineral dissolution and clay precipitation and subsequent cation exchange. Here, we use field observations—including groundwater age, stream discharge, and stream and groundwater chemistry—to analyse C–Q relations in the Manitou Experimental Forest in the Colorado Front Range, USA, a site where chemostasis is observed. We combine field data with laboratory analyses of whole rock and clay x‐ray diffraction and soil cation‐extraction experiments to investigate the role that clays play in influencing stream chemistry. We use Geochemist's Workbench to identify geochemical reactions driving stream chemistry and subsequently suggest how climate change will impact stream C–Q trends. We show that as groundwater age increases, C–Q slope and stream solute response are not impacted. Instead, primary mineral dissolution and subsequent clay precipitation drive strong chemostasis for silica and aluminium and enable cation exchange that buffers calcium and magnesium concentrations, leading to weak chemostatic behaviour for divalent cations. The influence of clays on stream C–Q highlights the importance of delineating geochemical controls along flowpaths, as upgradient mineral dissolution and clay precipitation enable downgradient cation exchange. Our results suggest that geochemical reactions will not be impacted by future decreasing flows, and thus where chemostasis currently exists, it will continue to persist despite changes in recharge.
Modelling regional effects of artificial groundwater recharge in a multilayer aquifer characterized by perched water tables
Authors: Gómez‐Escalonilla Víctor , Heredia Javier , Martínez‐Santos Pedro , López‐Gutiérrez Julio , De la Hera‐Portillo África
Published: February 2024

This paper presents an approach to estimate the effects of a managed recharge experiment in a multilayer aquifer characterized by the presence of perched water tables in the Medina del Campo groundwater body, Douro basin, central Spain. A numerical model was developed to evaluate the effect of artificial recharge on the shallow sector of a regional‐scale aquifer and on formerly active wetlands. The model was developed in the Visual MODFLOW Pro v.2011.1 environment in order to represent and analyse the regional impact of this artificial recharge event. Results suggest that the assumption of a single perched system may prove useful in regional contexts where data is limited. From a study site perspective, managed recharge is observed to increase shallow storage along the riverbanks, which is considered valuable for environmental purposes. However, downstream wetlands are unlikely to experience a significant recovery. Furthermore, only a small percentage of artificial recharge is expected to reach the deep regional aquifer. This method can be exported to settings characterized by the presence of perched aquifers and associated groundwater dependent ecosystems.
Analysis and partitioning of terrestrial water storage in the Yellow River source region
Authors: Li Xia , Zhou Zuhao , Liu Jiajia , Xu Chongyu , Xia Junqiang , Wang Pengxiang , Wang Hao , Jia Yangwen
Published: February 2024

In order to increase the capability to understand and quantify the spatial differences in terrestrial water storage (TWS), and to reflect the unique energy balance processes and soil freeze–thaw mechanisms in the Qinghai‐Tibet Plateau (QTP), this study improved the energy balance processes of the water and energy transfer processes model, including its surface radiation calculations and snowmelt module. By integrating these improvements, a water and energy transfer processes model in Qinghai‐Tibet Plateau (WEP‐QTP) for the Yellow River source region (YRSR) is developed. Using the improved WEP‐QTP model to perform simulations, we assessed the daily changes in snow cover, soil moisture (SM), permafrost (PM), and groundwater storage (GWS) in the YRSR. Our analysis revealed an increase in TWS of 0.24 mm/yr from 1961 to 2020. Snow water equivalent (SWE), SM, PM, and GWS have proportional contributions of 8.33%, 216.67%, −154.17%, and 29.17% to the increased TWS, respectively. SM is the primary component of TWS. Temperature (T), precipitation (P), evapotranspiration (E), and solar radiation (Rs) influence the spatiotemporal variations in TWS, as well as those of its components. The increase in P is the primary cause for the rise in TWS, SWE, and SM, while the increase in T predominantly contributes to the decrease in PM. Furthermore, permafrost degradation and climate‐induced warming and humidification lead to increased infiltration, resulting in elevated GWS.
Associations among family socioeconomic status, parenting and sustained attention for socioeconomically disadvantaged children at age 5 years
Authors: Meng Wanqiu , Black Caroline F. D. , Feng Min
Published: February 2024

Children whose families experience socioeconomic disadvantage are at risk for poor sustained attention, a foundational skill related to goal‐oriented behaviour, self‐regulation and kindergarten readiness. Maternal parenting behaviours and parenting stress are theorised developmental pathways linking socioeconomic status (SES) to children's sustained attention. However, research has yet to empirically test for these indirect pathways, thus limiting the relevance of extant findings to inform targets of parent‐mediated programmes addressing attentional disparities at school entry for low‐income children. Using a sample of mostly low‐income children from the Future of Families and Child Wellbeing Study (N = 2214) and the process of parenting model, this study tested whether maternal parenting stress, harsh parenting and cognitive stimulation uniquely explained associations between SES and child sustained attention at age 5 years. Results from structural equation modelling revealed that SES was positively and directly associated with child sustained attention. Some of these effects were indirectly transmitted through the pathway of maternal cognitive stimulation; however, neither harsh parenting nor parenting stress helped to explain the relationship between SES and child sustained attention. Implications of the findings are explored in the context of early childhood prevention and promotion programmes serving low‐income families.

Highlights

This study explores the direct and indirect paths of family SES on child sustained attention through the pathways of maternal cognitive stimulation, harsh parenting and parenting stress amongst socioeconomically disadvantaged children.

Results from SEM revealed that SES was positively and directly associated with child‐sustained attention and some of these effects were indirectly transmitted through the pathway of maternal cognitive stimulation.

Cognitive stimulation is a crucial pathway through which SES may promote or impede the development of children's sustained attention skills.
An ultrathin and crack‐free metal‐organic framework film for effective polysulfide inhibition in lithium–sulfur batteries
Authors: Zhou Cheng , Dong Chenxu , Wang Weixiao , Tian Yu , Shen Chunli , Yan Kaijian , Mai Liqiang , Xu Xu
Published: February 2024

Due to their extensive microporous structure, metal‐organic frameworks (MOFs) find widespread application in constructing modification layers, functioning as ion sieves. However, the modification layers prepared by existing methods feature gaps between MOFs that are noticeably larger than the inherent MOF pore dimensions. Polysulfides and lithium ions unavoidably permeate through these gaps, hindering the full exploitation of the structural advantages. Herein, an ultrathin (20 nm) and crack‐free MOF film is formed on the separator by atomic layer deposition for the first time. Based on the separator, the mechanism of different MOF layers has been verified by phase field simulation and in situ Raman spectroscopy. The results accurately prove that the MOF particle layer can relieve the shuttle of polysulfides, but it does not have the effect of homogenizing lithium ions. Only the ultrathin and crack‐free MOF film with proper pore size can act as the ion sieve for both polysulfides and lithium ions. As a result, under the test condition of 2 mA cm−2–2 mAh cm−2, the overpotential of the Li/Li symmetric battery is only 18 mV after 2500 h. The capacity retention rate of the lithium–sulfur battery is 95.6% after 500 cycles and 80% after 1000 cycles at 2 C.
A principled examination of US bankruptcy law and the accounting for value in conversions between chapters 7 and 13
Authors: Ritter Gavin
Published: February 2024

This article focuses on the apportionment and distribution of post‐filing pre‐conversion increases in equity of assets in a debtor’s estate when a debtor converts from a Chapter 13 to a Chapter 7 bankruptcy proceeding. Through an examination of the history of the US Bankruptcy Code and adequate examination of differing approaches, this article argues that courts should adopt the position that the post‐filing increase in equity due to appreciation should inure to the estate rather than to the debtor, while the increases in equity through payback plans should inure to the debtor. This approach creates the fairest situation for a debtor, placing them in a situation where they receive the full benefits of the Chapter 13 bankruptcy proposition and provides sufficient economic benefits to creditors.
A phase II study of guadecitabine combined with irinotecan vs regorafenib or TAS‐102 in irinotecan‐refractory metastatic colorectal cancer patients
Authors: Lee Valerie , Parkinson Rose , Zahurak Marianna , Cope Leslie , Cercek Andrea , Verheul Henk , Gootjes Elske , Lenz Heinz Josef , Iqbal Syma , Jones Peter , Baylin Stephen , Rami Vandna , Ahuja Nita , El Khoueiry Anthony , Azad Nilofer S.
Published: February 2024

DNA methyltransferase inhibitors (DNMTi) have demonstrated benefit in reversing resistance to systemic therapies for several cancer types. In a phase II trial of guadecitabine and irinotecan compared to regorafenib or TAS‐102 in pts with advanced mCRC refractory to irinotecan. Patients with mCRC refractory to irinotecan were randomized 2:1 to guadecitabine and irinotecan (Arm A) vs standard of care regorafenib or TAS‐102 (Arm B) on a 28‐day cycle. Between January 15, 2016 and October 24, 2018, 104 pts were randomized at four international sites, with 96 pts undergoing treatment, 62 in Arm A and 34 in Arm B. Median overall survival was 7.15 months for Arm A and 7.66 months for Arm B (HR 0.93, 95% CI: 0.58–1.47, P = .75). The Kaplan–Meier rates of progression free survival at 4 months were 32% in Arm A and 26% in Arm B. Common ≥Grade 3 treatment related adverse events in Arm A were neutropenia (42%), anemia (18%), diarrhea (11%), compared to Arm B pts with neutropenia (12%), anemia (12%). Guadecitabine and irinotecan had similar OS compared to standard of care TAS‐102 or regorafenib, with evidence of target modulation. Clinical trial information: NCT01896856.
Age‐related phenotypes in breast cancer: A population‐based study
Authors: Svanøe Amalie A. , Humlevik Rasmus O. C. , Knutsvik Gøril , Sæle Anna K. M. , Askeland Cecilie , Ingebriktsen Lise M. , Hugaas Ulrikke , Kvamme Amalie B. , Tegnander Amalie F. , Krüger Kristi , Davidsen Benedicte , Hoivik Erling A. , Aas Turid , Stefansson Ingunn M. , Akslen Lars A. , Wik Elisabeth
Published: February 2024

Breast cancer in young (<40 years) is associated with a higher frequency of aggressive tumor types and poor prognosis. It remains unclear if there is an underlying age‐related biology that contributes to the unfavorable outcome. We aim to investigate the relationship between age and breast cancer biology, with emphasis on proliferation. Clinico‐pathologic information, immunohistochemical markers and follow‐up data were obtained for all patients aged <50 (Bergen cohort‐1; n = 355, not part of a breast screening program) and compared to previously obtained information on patients aged 50 to 69 years (Bergen cohort‐2; n = 540), who participated in the Norwegian Breast Cancer Screening Program. Young breast cancer patients presented more aggressive tumor features such as hormone receptor negativity, HER2 positivity, lymph‐node metastasis, the HER2‐enriched and triple‐negative subtypes and shorter survival. Age <40 was significantly associated with higher proliferation (by Ki67). Ki67 showed weaker prognostic value in young patients. We point to aggressive phenotypes and increased tumor cell proliferation in breast cancer of the young. Hence, tumors of young breast cancer patients may present unique biological features, also when accounting for screen/interval differences, that may open for new clinical opportunities, stratifying treatment by age.
Incidence of late recurrence and second primary cancers 5–10 years after non‐metastatic colorectal cancer
Authors: Nors Jesper , Gotschalck Kåre Andersson , Erichsen Rune , Andersen Claus Lindbjerg
Published: February 2024

The fraction of patients who are cancer‐free survivors 5 years after curative‐intended surgery for colorectal cancer (CRC) is increasing, suggesting that extending surveillance beyond 5 years may be indicated. Here we estimate the incidence of late recurrence, metachronous CRC, and second primary cancers 5–10 years postoperative. All patients resected for UICC stage I–III CRC in Denmark through 2004–2013 were identified. Through individual‐level linkage of nationwide health registry data, recurrence status was determined using a validated algorithm. Cancer‐free survivors 5 years after surgery, were included. Cumulative incidence functions (CIF) of late recurrence, metachronous CRC, and second primary cancer 5–10 years postoperative were constructed. Subdistribution hazards ratios (sHR) were computed using Fine‐Gray regression. Among 8883 patients, 370 developed late recurrence (5–10‐year CIF = 4.1%, 95%CI: 3.7%–4.6%), 270 metachronous CRC (5–10‐year CIF = 3.0%, 95%CI: 2.7%–3.4%), and 635 a second primary cancer (5–10‐year CIF = 7.2%, 95%CI: 6.7%–7.7%). The risk of late recurrence was reduced for patients operated in 2009–2013 compared to 2004–2008 (2.9% vs. 5.6%, sHR = 0.52, 95% CI: 0.42–0.65). The risk of metachronous CRC was likewise reduced from 4.1% to 2.1% (sHR = 0.50, 95%CI: 0.39–0.65). While the risk of second primary cancer did not change between 2009–2013 and 2004–2008 (7.1% vs. 7.1%, sHR = 0.98, 95% CI: 0.84–1.15). Using nation‐wide 10‐year follow‐up data, we document that the incidences of late recurrence and metachronous CRC are low and decreasing from 2004 to 2013. Thus, despite increasing numbers of long‐term cancer survivors, the data do not advocate for extending CRC‐specific surveillance beyond 5 years.
Cultural values, parenting and child adjustment in the Philippines
Authors: Alampay Liane Peña
Published: February 2024

This study examined whether Filipino mothers' and fathers' cultural values, namely individualism, collectivism and conformity values; are associated with parental warmth, rules/limit‐setting and expectations of family obligations; and child internalising and externalising behaviours. Children (n = 103; Mage = 10.52, SDage = .44) and their mothers (n = 100) and fathers (n = 79) from urban Metro Manila, Philippines, responded to self‐report measures orally or in writing. Mothers' collectivistic values, and fathers' individualistic and collectivistic values, were positively associated with expectations for children's familial obligations. Fathers' individualist values predicted lower internalising behaviours in children, whereas the valuing of conformity predicted greater paternal warmth. Future research on cultural values should unpack their dynamic meanings, processes and associations with parenting behaviours and child adjustment.
Malabsorption in Giardiasis
Authors: Poley J. Rainer , Rosenfield Sheila
Published: February 2024

Investigations of the small bowel mucosa by scanning and transmission electron microscopy are reported in two coetaneous children with giardiasis. Serum immunoglobulins and mucosal architecture by light microscopy were normal in both, as well as activities of lactase, sucrase, and maltase. One of the children had suggestive evidence of malabsorption. Scanning and transmission electron microscopic examination of biopsied mucosa of the child with malabsorption suggested the following: increased secretory activity in crypts and increased cell damage, producing excess mucus containing extruded cytoplasm. It is hypothesized that the physicochemical properties of the mucoid material permitted ready interaction with the mucosal surface, the biochemical qualities of which could have been altered by the presence of the parasites. Close adherence of this mucoid layer to the surface gave it the aspect of a pseudomembrane which, by covering wide areas of the mucosal surface, probably functioned as an effective luminal barrier for nutrients. This pseudomembrane was not seen by light microscopy. Excessive secretion of mucus, its physicochemical and immunologic properties, and mueus‐mucosal surface interaction could have been engendered by genetic and environmental factors, which need further study. Although some mucus was present in the mucosa of the other child, it was confined to the base of the villi, and did not cover the mucosal surface. The presence of a luminal barrier (mucoid pseudomembrane) may be added to the list of mechanisms implicated in causing malabsorption in giardiasis.
Milk and Nutrient Intake of Breast‐Fed Infants from 1 to 6 Months
Authors: Dewey Kathryn G. , Lönnerdal Bo
Published: February 2024

Dietary intake, milk composition, growth, and activity were monitored monthly for 20 breast‐fed infants from 1 to 6 months. Breast milk intake (of infants receiving no more than 50 kcal from other foods) ranged from 341 to 1,096 ml/day, with mean intake increasing from 673 to 896 ml/day from 1 to 6 months. Energy intake per kilogram body weight averaged 113 kcal/kg/day at 1 month, decreasing to 85‐89 kcal/kg/day at 5‐6 months—considerably lower than the recommended 115 kcal/kg/day. At 6 months, all infants except one were above the 10th percentile of weight‐for‐age. Nutrient content of milk samples was similar to previously reported values. Protein, iron, zinc, copper, sodium, and potassium levels declined during the first 6 months. Intakes of iron, zinc, calcium, and magnesium were lower than recommended allowances for infants. Weight‐for‐length and weight gain were significantly correlated with total energy intake, but not with activity level, during the first 6 months.
Parietal Cell Function of Full‐Term and Premature Infants
Authors: Marino Lucyndia R. , Bacon Bruce R. , Hines John D. , Halpin Thomas C.
Published: February 2024

A 1‐h basal collection of gastric secretions was taken from 14 healthy full‐term infants (group I) and 10 premature infants (group II). Simultaneously, acid and intrinsic factor (IF) secretion was measured. In an additional group of 19 full‐term infants (group III), 16 had IF detectable in their gastric secretions immediately at birth. Volumes of gastric juice (ml/kg/h) and IF secretion (ng/ kg/h) were similar for group I and group II infants. Acid secretion (mEq/kg/h) was significantly less in group II (p < 0.01). There was a linear correlation between acid secretion (mEq/kg/h) and IF secretion (ng/kg/h) for group I (r = 0.85, p < 0.001). There was no correlation between the values for the premature infants in group II. The study documents that the parietal cell of the premature infant has the same capacity to secrete IF as the cell of the more mature infant. It also demonstrates the presence at birth of IF in gastric secretions, which suggests in utero secretion and independence from enteral feeding for stimulation.
Glycogen Storage Disease
Authors: Yudkoff Marc , Nissim Itzhak , Stanley Charles , Baker Lester , Segal Stanton
Published: February 2024

The effects of intragastric glucose infusions on [15N]glycine kinetics and whole body protein turnover were investigated in four children with type I and two children with type III glycogen storage disease. Either fasting or the administration of insufficient glucose was associated with a diminution in the glycine pool size relative to values observed when patients received adequate glucose. The cause of the smaller pool size was an increased fractional glycine turnover. Simultaneous determination of whole body protein turnover, using a stochastic model based on [15N]urea excretion, showed higher rates of protein synthesis, nitrogen flux, net tissue protein retention, and reutilization of amino acid nitrogen derived from protein catabolism, in patients receiving sufficient exogenous glucose. Depletion of amino acid pools, presumably because of intensive utilization of these gluconeogenic precursors when inadequate glucose is administered, was associated with a lower rate of whole body protein synthesis.
Effects of Loperamide on Intestinal Ion Transport
Authors: Guandalini S. , Fasano A. , Rao M. C. , Ferola A. , Migliavacca M. , Marchesano G. , Rubino A.
Published: February 2024

The synthetic opiate loperamide (LPMD) is an antidiarrheal compound which affects both intestinal motility and the transport of water and electrolytes. We have investigated its effects on ion transport in the stripped ileal mucosa of rabbits, mounted in Ussing chambers in vitro. Addition of LPMD to serosal bathing medium resulted in a dose‐dependent decrement of short‐circuit current (Isc). LPMD (50 μM) significantly increased net Cl absorption (Jc1,) and JRnet (assumed to represent HCO3 secretion). LPMD also inhibited the Isc increments evoked either by agents that increase 3‘,5’‐cyclic adenosine monophosphate (cAMP) content (theophylline and prostaglandin E2) or by the Ca2+ ionophore A23187; the opiate, however, did not prevent the Isc change induced by 3‘,5’‐cyclic guanosine monophosphate (cGMP)‐related agents such as 8‐Br‐cGMP and Escherichia coli heat‐stable enterotoxin. LPMD did not alter basal or secretagogue‐stimulated tissue cAMP. In contrast, LPMD caused a small increase in cGMP content of stripped ileal mucosa, but not in that of isolated entero‐cytes. The role of Ca2+ in LPMD action is suggested by the significantly different effect of the drug on JCtnet in the presence and in the absence of Ca2+ in the serosal solution.
Cholestasis Associated with Total Parenteral Nutrition
Authors: Merritt Russell J.
Published: February 2024

It appears that neonates, especially those with very low birthweights, may be at especially high risk of developing cholestasis associated with total parenteral nutrition (TPN). Within 2 weeks of starting intravenous alimentation, it would appear highly desirable to be able to start at least small enteral feedings to interrupt the physiology of fasting. Such feedings may not have to be of much nutritional benefit to improve cholestasis. Calorie and amino acid intake should be limited to the requirements of the infant being treated. Whether protection of the TPN infusate from light is of benefit remains to be determined. Drug therapies for TPN‐associated cholestasis of infancy have not been proven safe or effective. Additional investigations to further clarify the pathogenesis of this syndrome, and clinical studies of prophylaxis and therapy, are needed to enhance our ability to provide nutritionally effective and metabolically safe parenteral nutrition.
Bloody Diarrhea—A Possible Complication of Sulfasalazine Transferred Through Human Breast Milk
Authors: Branski David , Kerem Eitan , Gross‐Kieselstein Eva , Hurvitz Haggit , Litt Ruth , Abrahamov Abraham
Published: February 2024

Sulfasalazine very rarely causes bloody diarrhea. A 3‐month‐old infant had bloody diarrhea that could be related to sulfasalazine that had been taken by his mother and was transferred through his mother's breast milk. The patient was exclusively breast fed, and no other known etiological factors could be detected for the infant's bloody diarrhea.
Controlled Trial of Rice Powder and Glucose Rehydration Solutions as Oral Therapy for Acute Dehydrating Diarrhea in Infants
Authors: Mohan Man , Sethi J. S. , Daral T. S. , Sharma Mamta , Bhargava S. K. , Sachdev H. P. S.
Published: February 2024

Summary: A controlled, randomized trial was conducted in 50 infants (3 to 18 months old) hospitalized with acute noncholera dehydrating diarrhea to compare the safety, efficacy, and acceptability of the standard World Health Organization (WHO) recommended glucose oral rehydration solution (ORS) (Group A: 25 infants) with that of a rice powder ORS (Group B: 25 infants), containing 30 g/L of rice powder instead of glucose (20 g/L). The electrolyte composition of both solutions was identical. The proportion of successfully treated patients in each group was 92%, and the two rehydrating solutions proved comparable in correcting and maintaining the hydration status and the serum sodium and potassium levels. The mean rehydration time, stool output, stool frequency, ORS intake, weight gain, and urine output were comparable (p > 0.05) in both groups. It is concluded that rice powder ORS is safe, effective, and acceptable as the standard WHO glucose ORS for the treatment of acute noncholera dehydrating diarrhea in infants.
Parenteral Nutrition for Infants
Authors: Koo Winston W. K. , Tsang Reginald C. , Steichen Jean J. , Succop Paul , Babcock Diane , Oestreich Alan E. , Noseworthy John , Horn Jack , Farrell Michael K.
Published: February 2024

Calcium (Ca) and phosphorus (P) homeostasis were determined in 18 infants (birth weight, 2,810 ± 135 g; gestational age, 37.4 ± 0.5 weeks; mean ± SEM) who received high or low Ca and P content (Ca, P) parenteral nutrition (PN) with a fixed, low dose of vitamin D (25 IU/dl). Nine infants were randomized into low (standard) Ca, P (20 mg Ca and 15.5 mg P/dl) and nine into high Ca, P (60–80 mg Ca and 46.5–62 mg P/dl) PN, and then were studied for up to 6 weeks. The high Ca, P group had stable serum 1,25 dihydroxyvitamin D [1,25(OH)2D], which consistently remained within the normal range (<116 pg/ml). Tubular reabsorption of phosphorus (TRP) also was stable and remained consistently <90%. The low Ca, P group had elevated and higher 1,25(OH)2D (p = 0.03) than the high Ca, P group. The mean serum 1,25(OH)2D concentration rose from 32 to 112, 115, and 133 pg/ml over a period of 6 weeks. TRP also was higher (p = 0.02) and remained consistently >90%. There were no significant differences between groups in serum parathyroid hormone, calcitonin, Ca, Mg, P, alkaline phosphatase, vitamin D binding protein, and 25 hydroxyvitamin D concentrations; urine Ca/creatinine and Mg/creatinine ratios, and fractional excretion of sodium (Na). Thus, a “high” Ca (60 mg/dl) and P (46.5 mg/dl) content in PN solutions can result in stable serum 1,25(OH)2D and TRP, presumably reflecting minimal stress to Ca and P homeostatic mechanisms without further increase in urinary Ca excretion.
Meconium Ileus and Its Equivalent as a Risk Factor for the Development of Cirrhosis
Authors: Maurage Chantal , Lenaerts Catherine , Weber Andrée , Brochu Pierre , Yousef Ibrahim , Roy Claude C.
Published: February 2024

Although dehydrated obstructing mucus is thought to account for the obstructive pathology involving the lungs, the pancreas, the reproductive system, and the intestinal tract, its relationship with CF‐associated liver disease remains largely hypothetical and little is known about possible risk factors. Complete clinical and autopsy records were available in 38 of 73 deaths occurring over a 10‐year period. The liver was normal in only five cases, and they were all infants. Steatosis was the only lesion present in 9, hypoxic liver disease was documented in 8, and biliary cirrhosis in 16 (focal in 10 and multilobular in 6). There was no relationship between the presence of cirrhosis, gallbladder abnormalities, age at death, and clinical status recorded during the year precoding their demise. Mucus plugs characterized by amorphous eosinophilic material within proliferated bile ductules were present in 75% of children with focal or multilobular biliary cirrhosis as opposed to 14% in those without (p = 0.015). A history of meconium ileus or its equivalent was recorded more frequently (p = 0.038) in those with cirrhosis. Finally, biliary cirrhosis was invariably present when there was a history of meconium ileus or its equivalent and when mucus plugs were noted. These findings suggest that patients with intestinal obstruction are at greater risk for the development of cirrhosis and that strategies should be developed to increase the detergent capacity of bile and its flow in order to decrease the viscosity of mucus in the biliary tree.
Infliximab Is Effective in Acute but not Chronic Childhood Ulcerative Colitis
Authors: Russell George H. , Katz Aubrey J.
Published: February 2024

Purpose:

The authors report their experience with infliximab in pediatric patients with ulcerative colitis (UC).

Methods:

Fourteen patients were reviewed. Group 1 included five patients with newly diagnosed, fulminant colitis refractory to 7 to 10 days of intravenous steroids. Group 2 included four patients with ulcerative colitis in remission off steroid therapy who experienced relapse and were hospitalized with fulminant colitis refractory to intravenous steroids for 7 to 10 days. Group 3 included five patients chronically dependent on steroids with colitis refractory to medical management. All patients were treated on an open‐label basis with infliximab infusions of 5 mg/kg/dose at 0, 2, and 6 weeks and every 6 to 8 weeks thereafter. Follow‐up was maintained for at least 6 weeks. Clinical status was scored with the Lichtiger Colitis Activity Index (LCAI) at each visit. LCAI ≥10 was considered treatment failure. We defined success as LCAI ≤2, a score consistent with UC remission. Response was categorized for each group.

Results:

All patients began the study with LCAI ≥11 before infliximab treatment. All group 1 patients experienced response to infliximab. All but one (75%) patient in group 2 had a response. Only one (20%) group 3 patient had a response to infliximab.

Conclusion:

Infliximab was an effective agent in the treatment of acute UC in our patients. Long‐term steroid use and emergency colectomy were avoided. Infliximab was less effective in patients who were dependent on steroids.
Safety of Infliximab Treatment in Pediatric Patients with Inflammatory Bowel Disease
Authors: Friesen Craig A. , Calabro Cheryl , Christenson Kathy , Carpenter Ellen , Welchert Eleanor , Daniel James F. , Haslag Sara , Roberts Charles C.
Published: February 2024

Background:

Infliximab appears to be efficacious in the treatment of pediatric Crohn disease (CD). There are few large‐scale pediatric studies on the complications of infliximab therapy.

Methods:

A retrospective review of all infliximab infusions administered to IBD patients at a tertiary children's hospital was undertaken. Data was obtained from an infliximab infusion database maintained in the section of Pediatric Gastroenterology, pharmacy records and patient charts.

Results:

594 infusions were administered to 111 IBD patients (88 CD and 23 UC; 55 male and 56 female; ages 4 to 20 years; mean age, 13.4 years). The number of infusions ranged from 1 to 24 with a mean of 5.4/patient. Infusion reactions occurred in 8.1% of patients (seven early and two delayed) and in 1.5% of all infusions. Reactions occurred more frequently in female patients (14% versus 2%; P = 0.03). All reactions were mild and responded rapidly to treatment. Four patients had infections deemed unusual, including three cutaneous tinea infections and one case of shingles.

Conclusion:

Infliximab is safe in pediatric IBD patients with a low incidence of generally mild reactions that respond rapidly to intervention. Infusion reactions are more common in female patients. Our patients had no serious infectious complications, although cutaneous tinea infection may represent a newly reported associated complication.
Immunogenicity and Safety of an Inactivated Hepatitis A Vaccine in Children With Down Syndrome
Authors: Ferreira Cristina Targa , Leite Júlio César , Taniguchi Adriano , Vieira Sandra Maria , Pereira‐Lima Jorge , Silveira Themis Reverbel da
Published: February 2024

Objectives:

Hepatitis A vaccine has not been investigated in children with Down syndrome. The aim of this study was to evaluate immunogenicity and safety of an inactivated hepatitis A vaccine in noninstitutionalized children with Down syndrome and compare their responses to those of healthy control children.

Methods:

An open, prospective, controlled trial of 127 children ages 1 to 12 years, 63 with Down syndrome and 64 healthy control subjects, was conducted at a single hospital. Inactivated hepatitis A virus (HAV) vaccine containing 720 enzyme‐linked immunosorbent assay units of alum‐adsorbed HAV was administered intramuscularly in a two‐dose schedule at 0 and 6 months. Seroconversion and anti‐HAV titers were measured at months 1 and 7.

Results:

Seroconversion rates at month 1 were 92% and 94% and geometric mean titers (GMT) were 164.02 and 160.77 mIU/mL in the Down syndrome (DS) and control groups, respectively. At month 7, seroconversion rates were 100% in both groups, with GMT of 1,719.86 and 2,344.90 mIU/mL in the DS and control groups, respectively (P = 0.117). Both doses were well tolerated and no significant adverse events observed. Local reaction at the injection site was the most common adverse event reported in both groups (15% in DS and 11% in controls).

Conclusions:

The authors’ data demonstrate a good response to HAV vaccination in children with DS living at home, with GMT not statistically different from that of healthy control children. HAV vaccine is well tolerated and highly immunogenic in children with DS.
Prebiotic Oligosaccharides in Dietetic Products for Infants: A Commentary by the ESPGHAN Committee on Nutrition
Authors: Agostoni Carlo , Axelsson Irene , Goulet Olivier , Koletzko Berthold , Michaelsen Kim F. , Puntis John W. L. , Rigo Jacques , Shamir Raanan , Szajewska Hania , Turck Dominique ,   ESPGHAN Committee on Nutrition
Published: February 2024

This article by the ESPGHAN Committee on Nutrition summarizes available information on the effects of adding prebiotic oligosaccharides to infant and follow‐on formulae. Currently there are only limited studies evaluating prebiotic substances in dietetic products for infants. Although administration of prebiotic oligosaccharides has the potential to increase the total number of bifidobacteria in feces and may also soften stools, there is no published evidence of clinical benefits of adding prebiotic oligosaccharides to dietetic products for infants. Data on oligosaccharide mixtures in infant formulae do not demonstrate adverse effects, but further evaluation is recommended. Combinations and dosages in addition to those so far studied need to be fully evaluated with respect to both safety and efficacy before their use in commercial infant food products. Well‐designed and carefully conducted randomized controlled trials with relevant inclusion/exclusion criteria, adequate sample sizes and validated clinical outcome measures are needed both in preterm and term infants. Future trials should define optimal quantity and types of oligosaccharides with prebiotic function, optimal dosages and duration of intake, short and long term benefits and safety. At the present time, therefore, the Committee takes the view that no general recommendation on the use of oligosaccharide supplementation in infancy as a prophylactic or therapeutic measure can be made.
Colostrum Protein Concentrate Enhances Intestinal Adaptation After Massive Small Bowel Resection in Juvenile Pigs
Authors: Nagy Èva S. , Paris Monique C. J. , Taylor Russell G. , Fuller Peter J. , Sourial Magdy , Justice Fran , Bines Julie E.
Published: February 2024

Objectives:

Short bowel syndrome (SBS) usually results from the surgical removal of a large segment of small intestine. Patient outcome depends on the extent of intestinal resection and adaptation of the remaining intestine. We evaluated the impact of colostrum protein concentrate (CPC) on intestinal adaptation after massive small bowel resection in a porcine model of infant SBS.

Methods:

Four‐week‐old piglets underwent an approximate 75% small bowel resection (R, n = 23) or a control transection operation (C, n = 14). Postoperatively, animals from both groups received either pig chow (R = 6, C = 5), polymeric infant formula (R = 6, C = 3) or polymeric infant formula supplemented with CPC (R = 11, C = 6) for 8 weeks until sacrifice. Clinical outcome measures included weight gain and stool consistency. Morphologic measures were intestinal villus height and crypt depth. Functional outcome measure was mucosal disaccharidase activity.

Results:

Resected animals fed polymeric infant formula alone had reduced weight gain compared with controls fed the same diet (P < 0.005). Despite massive small bowel resection, animals fed pig chow or polymeric infant formula supplemented with CPC grew at an equivalent rate to controls fed polymeric infant formula alone. Resected animals supplemented with CPC had increased villus length and crypt depth in the jejunum (P < 0.001) and ileum (P < 0.001) compared with resected animals fed either pig chow or polymeric infant formula alone.

Conclusion:

In an animal model of SBS, CPC supplementation of polymeric infant formula resulted in normal weight gain and features of enhanced morphologic adaptation.
Bone Quantitative Ultrasound and Bone Mineral Density in Children with Celiac Disease
Authors: Hartman Corina , Hino Bayan , Lerner Aaron , Eshach‐Adiv Orly , Berkowitz Drora , Shaoul Ron , Pacht Avi , Rozenthal Eldad , Tamir Ada , Shamaly Hussein , Shamir Raanan
Published: February 2024

Objectives:

Osteoporosis is the most common manifestation of untreated celiac disease (CD). Bone quantitative ultrasound (QUS) has recently emerged as a new modality for bone status assessment. We evaluated bone status in children with CD using dual‐energy x‐ray absorptiometry and quantitative ultrasound.

Methods:

This cross‐sectional study included 41 children (13 girls, 28 boys) aged 11.2 ± 3.6 years with CD. All children had been diagnosed with CD for at least 1 year (mean, 5.7 ± 4.3 years). The results of lumbar spine bone mineral density assessed by dual‐energy x‐ray absorptiometry and the measurements of the velocity of ultrasound wave (at distal radius and midshaft tibia sites), expressed as speed of sound in m/s, were compared between children adherent to gluten‐free diet (GFD) and non‐compliant children.

Results:

Speed of sound z‐scores at tibia were below −2 SD in 20 of 41 children (49%), whereas lumbar spine bone mineral density z‐scores were below −2 SD in 4 of 41 (10%) children with CD (P = 0.0002). Only 19 of 41 children were strictly compliant to GFD. The prevalence of tibia speed of sound z‐scores <−2 SD was significantly higher in non‐compliant children (15 of 22, 68%) compared with children on GFD (5 of 19, 26%), (P = 0.01). Children non‐compliant with GFD had significantly worse tibia speed of sound z‐scores (−2.3 ± 1.8, mean ± SD) compared with children on GFD (−1.2 ± 1.5, mean ± SD) (P = 0.04).

Conclusions:

Children with CD on a gluten‐containing diet had higher prevalence of abnormal tibia bone SOS and lower z‐scores compared with children on a GFD. These differences were not detected by spinal dual‐energy x‐ray absorptiometry or radius speed of sound. The value of quantitative ultrasound for screening and follow‐up of children with CD should be further evaluated.
Clinical Case Definition for the Diagnosis of Acute Intussusception
Authors: Bines Julie E. , Ivanoff Bernard , Justice Frances , Mulholland Kim
Published: February 2024

Objective:

Because of the reported association between intussusception and a rotavirus vaccine, future clinical trials of rotavirus vaccines will need to include intussusception surveillance in the evaluation of vaccine safety. The aim of this study is to develop and validate a clinical case definition for the diagnosis of acute intussusception.

Methods:

A clinical case definition for the diagnosis of acute intussusception was developed by analysis of an extensive literature review that defined the clinical presentation of intussusception in 70 developed and developing countries. The clinical case definition was then assessed for sensitivity and specificity using a retrospective chart review of hospital admissions. Sensitivity of the clinical case definition was assessed in children diagnosed with intussusception over a 6.5‐year period. Specificity was assessed in patients aged <2 years admitted with bowel obstruction and in patients aged <19 years presenting with symptoms that may occur in intussusception.

Results:

The clinical case definition accurately identified 185 of 191 assessable cases as “probable” intussusception and six cases as “possible” intussusception (sensitivity, 97%). No case of radiologic or surgically proven intussusception failed to be identified by the clinical case definition. The specificity of the definition in correctly identifying patients who did not have intussusception ranged from 87% to 91%.

Conclusions:

The clinical case definition for intussusception may assist in the prompt identification of patients with intussusception and may provide an important tool for the future trials of enteric vaccines.