bluuebunny/crossref_metadata_2025 huggingface dataset:
Green synthesis of silver nanoparticles using aqueous extract of Citrus sinensis peels and evaluation of their antibacterial efficacy
Authors: Mogole Lebogang , Omwoyo Wesley , Viljoen Elvera , Moloto Makwena
Published: December 2021

The resistance of microorganisms towards antibiotics remains a big challenge in medicine. Silver nanoparticles (AgNPs) received attention recently for their characteristic nanosized features and their ability to display antimicrobial activities. This work reports the synthesis of AgNPs using the Citrus sinensis peels extract in their aqueous, mild, and less hazardous conditions. The effect of concentration variation (1%, 2%, and 3%) of the plant extracts on the size and shape of the AgNPs was investigated. The antimicrobial activities were tested against gram-positive Staphylococcus aureus and gram-negative Klebsiella pneumoniae. Absorption spectra confirmed the synthesis by the surface Plasmon resonance peaks in the range 400–450 nm for all the AgNPs. FTIR spectra confirmed that Citrus sinensis peels extract acted as both reducing and surface passivating agent for the synthesized AgNPs. TEM revealed spherical AgNPs with average size of 12 nm for 3% concentration as compared to the agglomeration at 1% and 2%. All the AgNPs synthesized using Citrus sinensis peels extracts (1%, 2%, and 3%) exhibited antimicrobial activity against both gram-positive and negative bacteria. These results indicated a simple, fast, and inexpensive synthesis of silver nanoparticles using the Citrus sinensis peels extract that has promising antibacterial activity.
A ceRNA network mediated by LINC00475 in papillary thyroid carcinoma
Authors: Yang Yarong , Hua Wenjuan , Zeng Mei , Yu Liling , Zhang Baijun , Wen Liming
Published: December 2021

Papillary thyroid carcinoma (PTC) is the most frequent histological type of differentiated thyroid carcinoma. Long noncoding RNAs (lncRNAs) have been widely reported to play a key role in human malignancies, and PTC is included. This study aimed to find out the functions and mechanism of lncRNA LINC00475 in PTC. LINC00475 was upregulated in PTC cells and was mainly located in the cytoplasm according to reverse-transcription polymerase chain reaction analyses and subcellular fractionation assays. As shown by cell counting kit-8 assays, ethynyl deoxyuridine incorporation assays, wound healing assays, and transwell assays, LINC00475 knockdown suppressed cell viability, proliferation, migration, and invasion. Mechanistically, LINC00475 upregulated the expression of messenger RNA zinc finger CCHC-type containing 12 (ZCCHC12) by binding to miR-376c-3p. ZCCHC12 was a direct target gene of miR-376c-3p in PTC cells. The relationship between miR-376c-3p and LINC00475 (or ZCCHC12) in PTC cells was probed by luciferase reporter assays, RNA pulldown assays, and RNA immunoprecipitation assays. In addition, both mRNA and protein levels of ZCCHC12 were downregulated due to miR-376c-3p overexpression or LINC00475 silencing. ZCCHC12 overexpression partially reversed the suppressive effect of LINC00475 knockdown on malignant behaviors of PTC cells. In conclusion, LINC00475 promotes PTC cell proliferation, migration, and invasion by upregulating ZCCHC12 via the interaction with miR-376c-3p.
Differences in complications between hepatitis B-related cirrhosis and alcohol-related cirrhosis
Authors: Zhuang Yu-Pei , Wang Si-Qi , Pan Zhao-Yu , Zhong Hao-Jie , He Xing-Xiang
Published: December 2021

Objectives

This study aimed to investigate the differences in complications between hepatitis B virus (HBV)-related and alcohol-related cirrhoses.

Methods

Medical records of patients with HBV-related and alcohol-related cirrhoses treated from January 2014 to January 2021 were, retrospectively, reviewed. The unadjusted rate and adjusted risk of cirrhotic complications between the two groups were assessed.

Results

The rates of hepatocellular carcinoma (HCC) and hypersplenism were higher in HBV-related cirrhosis (both P < 0.05), whereas the rates of hepatic encephalopathy (HE) and acute-on-chronic liver failure (ACLF) were higher in alcohol-related cirrhosis (both P < 0.05). After adjusting for potential confounders, HBV-related cirrhotic patients had higher risks of HCC (odds ratio [OR] = 34.06, 95% confidence interval [CI]: 4.61–251.77, P = 0.001) and hypersplenism (OR = 2.29, 95% CI: 1.18–4.42, P = 0.014), whereas alcohol-related cirrhotic patients had higher risks of HE (OR = 0.22, 95% CI: 0.06–0.73, P = 0.013) and ACLF (OR = 0.30, 95% CI: 0.14–0.73, P = 0.020).

Conclusion

Cirrhotic patients with different etiologies had different types of complications: HBV-related cirrhotic patients exhibited increased risks of HCC and hypersplenism and alcohol-related cirrhotic patients more readily developing HE and ACLF.
Choreographies of Making Archaeological Data
Authors: Huvila Isto , Sköld Olle
Published: December 2021

A lot of different concepts have been utilised to elucidate diverse aspects of archaeological practices and knowledge production. This article describes how the notion of choreography can complement the existing repertoire of concepts and be used to render visible the otherwise difficult to grasp physical and mental movements that make up archaeological work as a practical and scholarly exercise. The conceptual discussion in the article uses vignettes drawn from an observation study of an archaeological teaching excavation in Scandinavia to illustrate how the concepts of choreography, choreographing, and choreographer can be used to inquire into archaeological work and data production. In addition to how explicating physical, temporal, and ontological choreographies of archaeological work can help to understand how it unfolds, the present article suggests that a better understanding of theepistemic choreographiesof archaeological, scientific, and scholarly work can help to unpack and describe its inputs and outputs, the data it produces, what the work achieves, and how it is made in space and time.
“Teach Your Daughters to Wail and One Another to Lament”: Jewish Prayers and Liturgical Texts for Female Victims of Sexual Assault
Authors: Ben-Lulu Elazar
Published: December 2021

Throughout generations, various prayers have been composed to express religious and cultural experiences of the Jewish community, such as holidays life-cycle and national tragedies. However, some social issues, such as sexual assault, have been excluded from this canon. This article uncovers Jewish prayers and liturgical texts dedicated to female victims of sexual assault. Drawing on a qualitative inquiry based on content analysis and interviews with the prayers’ authors, I demonstrate how these texts (re)position sexual assault victims in Jewish liturgy by including new phrasings and references to God; by removing masculine violence related to God; by mentioning biblical female characters who experienced sexual harassment; by denouncing of patriarchal abuse; or by sanctifying the woman’s painful body, which is incorporated as an important agent in the ritual’s structure. Therefore, I suggest considering these texts a political mean to voice women’s traumas and to incorporate them into the religious sphere, thereby rectifying a long-silenced discourse.
New trigonometric B-spline approximation for numerical investigation of the regularized long-wave equation
Authors: Msmali Ahmed Hussein , Tamsir Mohammad , Dhiman Neeraj , Aiyashi Mohammed A.
Published: December 2021

The objective of this work is to propose a collocation technique based on new cubic trigonometric B-spline (NCTB-spline) functions to approximate the regularized long-wave (RLW) equation. This equation is used for modelling numerous problems occurring in applied sciences. The NCTB-spline collocation method is used to integrate the spatial derivatives. We use the Rubin–Graves linearization technique to linearize the non-linear term. The accuracy and efficiency of the technique are examined by employing it on three important numerical examples which have three invariants of motion viz. mass, momentum, and energy. It is observed that the error norms of the present method are less than the error norms of the methods available in the literature. The numerical values of these invariants have also been approximated, which remain conserved during the program run which shows that the propagation of the solitary wave is represented perfectly. The propagation of one and two solitary waves and undulations of waves are depicted graphically. The stability analysis shows that the method is unconditionally stable.
Trafile dotte e popolari del latino nella lessicografia storica romanza (con particolare riguardo alLessico Etimologico Italiano)
Authors: Crifò Francesco
Published: December 2021

One of the main challenges of Romance etymology is the detection of borrowings from Latin into the Romance languages: a significant number of lexemes have been introduced by the educated classes and in Italoromance especially it is not always possible to distinguish these cases from those of “popular” transmission. Phonomorphological, semantic, diachronic, geo-linguistic, lexicological and other arguments can be implemented from time to time. They are applied here to the most recently published section of theLessico Etimologico Italiano.
A Love Letter to Chicanx Studies
Authors: Vasquez Kristian E. , Pacheco Marcial Juan De Dios , Larrañaga Karla , Mandujano Verónica
Published: December 2021

The authors share their joint “love letter” to the field of Chicanx Studies, originally presented during the National Association for Chicana and Chicano Studies (NACCS) conference on April 14, 2021. This collection reflects on the successes, promise, and still deferred promise of a fully realized Chicanx Studies. They focus on the value of a graduate program and training in Chicanx Studies, the need for their work to be engaged in community struggle, the potentials of increased numbers of Chicanx Studies trained scholars, and their personal connections and challenges as graduate students of this field.
Synergistic cortisol suppression by ketoconazole–osilodrostat combination therapy
Authors: Amodru Vincent , Brue Thierry , Castinetti Frederic
Published: December 2021

Here, we describe a case of a patient presenting with adrenocorticotrophic hormone-independent Cushing’s syndrome in a context of primary bilateral macronodular adrenocortical hyperplasia. While initial levels of cortisol were not very high, we could not manage to control hypercortisolism with ketoconazole monotherapy, and could not increase the dose due to side effects. The same result was observed with another steroidogenesis inhibitor, osilodrostat. The patient was finally successfully treated with a well-tolerated synergitic combination of ketoconazole and osilodrostat. We believe this case provides timely and original insights to physicians, who should be aware that this strategy could be considered for any patients with uncontrolled hypercortisolism and delayed or unsuccessful surgery, especially in the context of the COVID-19 pandemic.

Learning points

Ketoconazole–osilodrostat combination therapy appears to be a safe, efficient and well-tolerated strategy to supress cortisol levels in Cushing syndrome.

Ketoconazole and osilodrostat appear to act in a synergistic manner.

This strategy could be considered for any patient with uncontrolled hypercortisolism and delayed or unsuccessful surgery, especially in the context of the COVID-19 pandemic.

Considering the current cost of newly-released drugs, such a strategy could lower the financial costs for patients and/or society.
Low-temperature alkali-anthraquinone pretreatment of wheat straw: Gradual dissolution of lignin and carbohydrate retention in pretreated solids
Authors: Zhang Lilong , Chen Keli
Published: December 2021

This paper presents a comprehensive study of wheat straw that was alkali-pretreated with NaOH loadings from 60 to 220 mg NaOH/g dry straw and a 0.5% anthraquinone (AQ) loading at 90 °C for 1, 2, and 3 h. Images of the residual solids were taken with a scanning electron microscope. A full compositional analysis of the raw material and residual solids, yield of compounds dissolved in the black liquor (BL), and molecular weight (Mw) after the different pretreatments were presented to track the dissolution process of lignin and carbohydrates. The ratio of the lignin fraction to carbohydrates dissolved in the BL was used for an analysis of the reaction selectivity. The cellulose retained 90% of the carbohydrates in the pretreated straw, while 75% of the lignin was dissolved in the BL gradually with an intermediate value of Mw. Low-molecular weight lignin (Mw ~ 1800 and degree of polymerization ~ 1.05) was dissolved out with the 60 mg NaOH/g dry straw loading. When the NaOH loading was increased to 220 mg NaOH/g dry straw, the Mw of the lignin was 4300 to 4700.
Court Decision Contra Legem or an Application of the Principle of Proportionality in Concreto?
Authors: Dambrauskaitė Asta
Published: December 2021

The article analyses cases of non-application of a national legal rule by cassation court judges hearing civil cases where, based on the analysis of concrete circumstances, the application of such a rule, in the opinion of judges, would lead to an infringement of the principle of proportionality and the European Convention on Human Rights. Decisions of two courts of cassation belonging to the continental law tradition (the Lithuanian Supreme Court and the French Court of Cassation) illustrate such a control of the application of the principle of proportionality in concreto. While national law is subject to an increasing impact of the case law of supranational courts, the legitimacy of such national court decisions is discussed also in the context of the transformations taking place in regard to the role of a judge.
Regulatory and Legal Enforcement of Cyber Security in Countries of the European Union: The Experience of Germany and France
Authors: Kavyn Sviatoslav , Bratsuk Ivan , Lytvynenko Anatoliy
Published: December 2021

This article is devoted to the study of information security in the EU member states, in particular Germany and France, in the context of the analysis of their national legislation, state, national programs and regulations. Particular attention is paid to the study of the features of regulatory and legal security of information security of Germany and France in the context of the study of their national legislation in terms of economic security as an inherent component of national security. In the course of this study the peculiarities of the functioning of the institutional and legal mechanism of cyber defense in the context of the multi-vector system of international security and legal regulation of international cooperation are analyzed. The article substantiates the expediency of developing an integrated, coordinated information policy of the EU member states in order to unify approaches to information security.At the same time, the current realities of European Union policy require comprehensive research in the context of ensuring national interests, developing effective mechanisms for protecting the information space, and legal mechanisms for shaping the economic system as a strategic factor of national security. Accordingly, the approaches to information security adopted in the European Union are currently not unified due to the geopolitical specifics of the EU’s countries. Therefore, the research, evaluation, and implementation of the positive experience of Germany and France in this area, according to the authors, is important in building the information security system of the European Union in the context of reliable protection against cyber threats.
Comparative analysis of methods for assessing the safety of Dunaliella salina Teodoresco and Chlorococcum dissectum Korshikov (Chlorophyta) microalgae cultures after exposure to stress factors
Authors:   Institute for Problems of Cryobiology and Cryomedicine of the NAS of Ukraine, 23 Pereyaslavska Str., Kharkiv 61016, Ukraine, Chernobai N.A. , Vozovik K.D. ,   Institute for Problems of Cryobiology and Cryomedicine of the NAS of Ukraine, 23 Pereyaslavska Str., Kharkiv 61016, Ukraine, Kadnikova N.G. ,   Institute for Problems of Cryobiology and Cryomedicine of the NAS of Ukraine, 23 Pereyaslavska Str., Kharkiv 61016, Ukraine
Published: December 2021

The possibility of using various methods for determining the viability of cultures of microalgae Dunaliella salina and Chlorococcum dissectum before and after freezing-warming was investigated and analyzed. It has been established that the selection of an effective method should be carried out individually for each culture. For an integral assessment of the proliferative and metabolic activity of cells of both species of the studied microalgae, Alamar Blue-test and the ability to grow on liquid nutrient media can be used. The use of the Koch plate method, MTT-test and TTC staining is possible only for the microalga C. dissectum. Vital staining with trypan blue was found to be incorrect.
Features of the seasonal succession of phytoplankton in the Crimean coastal area (Black Sea) in years with different climatic conditions (2009–2014)
Authors:   M.G. Kholodny Institute of the National Academy of Sciences of Ukraine, 2 Tereschenkivska Str., Kyiv 01601, Ukraine, Bryantseva Yu.V.
Published: December 2021

Under conditions of climatic changes, it is of great interest to study the dynamics of various functional complexes of phytoplankton species. The long-term influence of previous cold winters on the course of the seasonal succession of phytoplankton, as well as the intensity of blooms in the open waters of the Black Sea, were shown earlier. In the coastal zone, this relationship has not yet been sufficiently studied. Based on regular monitoring studies in the coastal area of Sevastopol from 2009–2014, features of the course of seasonal succession of phytoplankton in years with different climatic conditions were revealed: the “cold” years differed from the “warm” ones by a longer dominance of diatom complexes in terms of cell abundance, especially of small-celled species, which characterize the initial stage of seasonal succession of phytoplankton. The level of development of both diatoms and dinoflagellates was minimal compared to other years, with a shift in the periods of maxima to later months. In contrast, the "warm" years were characterized by the predominance of dinoflagellates for most of the study period, with a shift in timing of the maxima to earlier months. Both diatoms and dinoflagellates reached their maximal development in “warm” years in spring and autumn. In the “moderate” years, phytoplankton development proceeded either by analogy with the “cold” (2009) or “warm” (2011) years. The seasonal succession described above is typical for the northwestern Black Sea, in particular, the Sevastopol coastal area, and differs from the average pattern for the northwestern part described earlier for 1992–1993. The difference consisted of an increase in the proportion of stages I and III due to a decrease in stage II compared to 1992–1993.
Полімери спеціального призначення
Authors: Бровко Олександр Олександрович
Published: December 2021

У доповіді наведено найвагоміші результати досліджень з хімії та фізико-хімії багатокомпонентних полімерних систем, отримані в Інституті хімії високомолекулярних сполук НАН України з метою створення композиційних полімерних матеріалів спеціального та подвійного призначення і впровадження методології молекулярного дизайну в процес створення композитів. Розглянуто найважливіші розробки Інституту, впроваджені в різні галузі економіки України.
Variation in Early Inflammatory Marker Testing for Infection-Related Hospitalizations in Children
Authors: Markham Jessica L. , Thurm Cary W. , Hall Matt , Shah Samir S. , Quinonez Ricardo , Tchou Michael J. , Antoon James W. , Genies Marquita C. , Parlar-Chun Raymond , Johnson David P. , Shah Snehal P. , Ittel Molli , Brady Patrick W.
Published: December 2021

BACKGROUND AND OBJECTIVES:

Inflammatory marker testing in children has been identified as a potential area of overuse. We sought to describe variation in early inflammatory marker (C-reactive protein and erythrocyte sedimentation rate) testing for infection-related hospitalizations across children’s hospitals and to determine its association with length of stay (LOS), 30-day readmission rate, and cost.

METHODS:

We conducted a cross-sectional study of children aged 0 to 17 years with infection-related hospitalizations using the Pediatric Health Information System. After adjusting for patient characteristics, we examined rates of inflammatory marker testing (C-reactive protein or erythrocyte sedimentation rate) during the first 2 days of hospitalization. We used k-means clustering to assign each hospital to 1 of 3 groups on the basis of similarities in adjusted diagnostic testing rates across 12 infectious conditions. Multivariable regression was used to examine the association between hospital testing group and outcomes.

RESULTS:

We included 55 771 hospitalizations from 48 hospitals. In 7945 (14.3%), there was inflammatory marker testing in the first 2 days of hospitalization. We observed wide variation in inflammatory marker testing rates across hospitals and infections. Group A hospitals tended to perform more tests than group B or C hospitals (37.4% vs 18.0% vs 10.4%; P < .001) and had the longest adjusted LOS (3.2 vs 2.9 vs 2.8 days; P = .01). There was no significant difference in adjusted 30-day readmission rates or costs.

CONCLUSIONS:

Inflammatory marker testing varied widely across hospitals. Hospitals with higher inflammatory testing for one infection tend to test more frequently for other infections and have longer LOS, suggesting opportunities for diagnostic stewardship.
We All Need a Little TLC: An Argument for an Increased Role of Child Life Services in Patient Care and Medical Education
Authors: Pillai Rajapillai L. I.
Published: December 2021

Child life services (CLS) was created through a synthesis of developmental psychology, a recognition of the inherent difficulties of a hospital environment, and a desire to improve the patient experience of children. Many of the principles of CLS can be applied to other patients as well. In this article, the history of CLS is briefly surveyed, followed by a review of the successes of CLS in the hospital. An argument for an increased role for CLS in medical education and the development of a Program for Adult Life Services is then proposed.
Variation in Care and Clinical Outcomes Among Infants Hospitalized With Hyperbilirubinemia
Authors: DePorre Adrienne G. , Hall Matthew , Puls Henry T. , Daly Ashley , Gay James C. , Bettenhausen Jessica L. , Markham Jessica L.
Published: December 2021

OBJECTIVES:

To assess hospital-level variation in laboratory testing and intravenous fluid (IVF) use and examine the association between these interventions and hospitalization outcomes among infants admitted with neonatal hyperbilirubinemia.

METHODS:

We performed a retrospective multicenter study of infants aged 2 to 7 days hospitalized with a primary diagnosis of hyperbilirubinemia from December 1, 2016, to June 30, 2018, using the Pediatric Health Information System. Hospital-level variation in laboratory and IVF use was evaluated after adjusting for clinical and demographic factors and associated with hospital-level outcomes by using Pearson correlation.

RESULTS:

We identified 4396 infants hospitalized with hyperbilirubinemia. In addition to bilirubin level, the most frequently ordered laboratories were direct antiglobulin testing (45.7%), reticulocyte count (39.7%), complete blood cell counts (43.7%), ABO blood type (33.4%), and electrolyte panels (12.9%). IVFs were given to 26.3% of children. Extensive variation in laboratory testing and IVF administration was observed across hospitals (all P < .001). Increased use of laboratory testing but not IVFs was associated with a longer length of stay (P = .007 and .162, respectively). Neither supplementary laboratory use nor IVF use was associated with either readmissions or emergency department revisits.

CONCLUSIONS:

Substantial variation exists among hospitals in the management of infants with hyperbilirubinemia. With our results, we suggest that additional testing outside of bilirubin measurement may unnecessarily increase resource use for infants hospitalized with hyperbilirubinemia.
IMMUNIZATION AGAINST SCARLET FEVER WITH TANNIC ACID-PRECIPITATED ERYTHROGENIC TOXIN
Authors: SCHAEFFER MORRIS , TOOMEY JOHN A.
Published: December 2021

With the use of a purified tannic acid-precipitated erythrogenic streptococcus toxin prepared according to the method of Veldee and given intradermally in three doses of 750, 3,000, and 10,000 STD at weekly intervals, 362 Dick positive individuals, including student nurses and inmates of orphanages, were inoculated. This resulted in a reversal of the Dick reaction in 86.7% of the group.

The majority of those immune to one STD were negative also to 2½ and 5 STD for at least six months, and only a few reversed to Dick positive within a year.

None of the immunized who remained Dick negative developed scarlet fever within the one to one and one-half year observation period.

Two cases of scarlet fever were observed in those immunized, but they had reverted from negative to positive Dick reactions prior to contracting the disease.

Some practical and theoretical considerations regarding scarlet fever immunization are discussed.
PAROXYSMAL TACHYCARDIA IN INFANTS
Authors: PHILIPSBORN HERBERT F. , GIBSON STANLEY
Published: December 2021

Two cases of supraventricular paroxysmal tachycardia in infants are presented. In each instance the abnormal cardiac rate was converted to sinus mechanism by the intravenous administration of acetylcholine bromide. One child died from cerebral hemorrhage; the other child survived.
THE USE OF PENICILLIN IN OIL AND WAX IN CHILDREN
Authors: RILEY CONRAD M. , STRONG PAUL S.
Published: December 2021

Penicillin in oil and wax was administered to 106 infants and children in a total of 510 single injections at 24 hour intervals as therapy for acute infections. The Clinical response was comparable to that seen with aqueous penicillin administered at more frequent intervals. From this study the following conclusions were reached.

1. The danger of local reaction is not great, as in only five cases there appeared urticarial lesions near the site of injection which seemed to cause no discomfort and which deared within 48 hours. There were no more serious reactions.

2. There is no satisfactory correlation between the size of dose per unit of body weight and the resulting blood level of penicillin 24 hours after injection. There is, however, a relation between the absolute dose and the resulting blood level. A dose of 300,000 units in all patients regardless of size produced a satisfactory level for the control of ordinary infections.

3. Both sodium and potassium salts were used. There is doubtful statistical evidence that the potassium salt produces higher levels at the end of 24 hours.
Acute Sinusitis—Principles of Judicious Use of Antimicrobial Agents
Authors: O'Brien Katherine L. , Dowell Scott F. , Schwartz Benjamin , Marcy S. Michael , Phillips William R. , Gerber Michael A.
Published: December 2021

Establishing an accurate diagnosis of bacterial sinusitis is challenging but critical, because viral rhinosinusitis is at least 20 to 200 times more common than bacterial infection of the sinuses. Strict criteria for clinical diagnosis that require either prolonged and persistent symptoms or an acute severe presentation are supported with published evidence.
The Common Cold—Principles of Judicious Use of Antimicrobial Agents
Authors: Rosenstein Nancy , Phillips William R. , Gerber Michael A. , Marcy S. Michael , Schwartz Benjamin , Dowell Scott F.
Published: December 2021

Most children will suffer between 3 and 8 colds per year, and over half of patients seen for the common cold are given an antimicrobial prescription. Unnecessary antimicrobial therapy can be avoided by recognizing the signs and symptoms that are part of the usual course of these diseases. Controlled trials of antimicrobial treatment of the common cold are reviewed. These trials consistently fail to show that treatment changes the course or outcome. Furthermore, antimicrobial therapy for patients with viral rhinosinusitis is not an effective way to prevent bacterial complications. Mucopurulent rhinitis (thick, opaque, or discolored nasal discharge) frequently accompanies the common cold and is part of the natural course of viral rhinosinusitis. It is not an indication for antimicrobial treatment unless it persists without improvement for >10 to 14 days.
Overweight Children and Adolescents: Description, Epidemiology, and Demographics
Authors: Troiano Richard P. , Flegal Katherine M.
Published: December 2021

We describe prevalence and trends in overweight among children and adolescents (6 to 17 years old) in the US population and variation in the prevalence by sex, age, race-ethnicity, income, and educational level. Height and weight were measured in nationally representative surveys conducted between 1963 and 1994: cycles II (1963 to 1965) and III (1966 to 1970) of the National Health Examination Survey (NHES) and the National Health and Nutrition Examination Surveys (NHANES I, 1971 to 1974; NHANES II, 1976 to 1980; and NHANES III, 1988 to 1994). Overweight was defined by the age- and sex-specific 95th percentile of body mass index (BMI) from NHES II and III. BMI values between the 85th and 95th percentiles were considered an area of concern, because at this level there is increased risk for becoming overweight.

Approximately 11% of children and adolescents were overweight in 1988 to 1994, and an additional 14% had a BMI between the 85th and 95th percentiles. The prevalence of overweight did not vary systematically with race-ethnicity, income, or education. Overweight prevalence increased over time, with the largest increase between NHANES II and NHANES III. Examination of the entire BMI distribution showed that the heaviest children were markedly heavier in NHANES III than in NHES, but the rest of the distribution of BMI showed little change.

Data are limited for assessing the causes of the rapid change in the prevalence of overweight. The increased overweight prevalence in US children and adolescents may be one manifestation of a more general set of societal effects. Childhood overweight should be addressed from a public health perspective.
Measurement Issues Related to Studies of Childhood Obesity: Assessment of Body Composition, Body Fat Distribution, Physical Activity, and Food Intake
Authors: Goran Michael I.
Published: December 2021

This article reviews the current status of various methodologies used in obesity and nutrition research in children, with particular emphasis on identifying priorities for research needs. The focus of the article is 1) to review methodologic aspects involved with measurement of body composition, body-fat distribution, energy expenditure and substrate use, physical activity, and food intake in children; and 2) to present an inventory of research priorities.
Development of Eating Behaviors Among Children and Adolescents
Authors: Birch Leann L. , Fisher Jennifer O.
Published: December 2021

The prevalence of obesity among children is high and is increasing. We know that obesity runs in families, with children of obese parents at greater risk of developing obesity than children of thin parents. Research on genetic factors in obesity has provided us with estimates of the proportion of the variance in a population accounted for by genetic factors. However, this research does not provide information regarding individual development. To design effective preventive interventions, research is needed to delineate how genetics and environmental factors interact in the etiology of childhood obesity. Addressing this question is especially challenging because parents provide both genes and environment for children.

An enormous amount of learning about food and eating occurs during the transition from the exclusive milk diet of infancy to the omnivore's diet consumed by early childhood. This early learning is constrained by children's genetic predispositions, which include the unlearned preference for sweet tastes, salty tastes, and the rejection of sour and bitter tastes. Children also are predisposed to reject new foods and to learn associations between foods' flavors and the postingestive consequences of eating. Evidence suggests that children can respond to the energy density of the diet and that although intake at individual meals is erratic, 24-hour energy intake is relatively well regulated. There are individual differences in the regulation of energy intake as early as the preschool period. These individual differences in self-regulation are associated with differences in child-feeding practices and with children's adiposity. This suggests that child-feeding practices have the potential to affect children's energy balance via altering patterns of intake. Initial evidence indicates that imposition of stringent parental controls can potentiate preferences for high-fat, energy-dense foods, limit children's acceptance of a variety of foods, and disrupt children's regulation of energy intake by altering children's responsiveness to internal cues of hunger and satiety. This can occur when well-intended but concerned parents assume that children need help in determining what, when, and how much to eat and when parents impose child-feeding practices that provide children with few opportunities for self-control. Implications of these findings for preventive interventions are discussed.
Humoral Antibody Formation in Infants Aged One to Three Months Injected With a Triple (Diphtheria–Tetanus–Pertussis) Alum-precipitated Antigen, by William L. Bradford, MD, et al,Pediatrics, 1949;4:711–718
Authors: Katz Samuel Lawrence
Published: December 2021

Infants 1 to 3 months of age were immunized with a vaccine combining diphtheria and tetanus toxoids with pertussis organisms. The combination product was adjuvanted with alum. Infants were injected at four-week intervals between 1–3 months of age and boosted at 7–9 months of age. Serum antibody determinations were done 3 months after completion of the initial three administrations; again at 7–9 months of age, 6 months after completion of the original course; and a booster injection was given and final determinations obtained on serum collected at eight to ten months of age. Utilizing a variety of antitoxin and agglutination techniques, more than 90% of infants had effective antitoxin levels against diphtheria and tetanus on all three laboratory determinations whereas only 53% at 3 months, 51% at 6 months and 80% at 10 months had titers judged protective vs pertussis. It was therefore demonstrated that infants at this young age could respond satisfactorily with humoral antibodies against both diphtheria and tetanus toxoids but less so against pertussis.
Agammaglobulinemia, by Col. Ogden C. Bruton, MC, USA,Pediatrics, 1952;9:722–728
Authors: Buckley Rebecca H.
Published: December 2021

A hitherto unrecognized entity manifested by complete absence of gamma globulin with otherwise normal serum proteins and recurrent pneumococcal sepsis is described in an 8-year-old male. The patient appeared to be normal in other respects and, after extensive study, no structural or functional change could be demonstrated in any body system. He was unable to produce antibody to the pneumococcus with the four antigenic substances used; a positive Schick test persisted despite numerous attempts to reverse it with diphtheria toxoid. No antibody could be demonstrated following administration of typhoid vaccine in the usual manner, and his serum was negative for complement-fixing antibodies of epidemic parotitis after he experienced a typical clinical picture of that disease.

Gamma globulin could be demonstrated in his serum after concentrated immune human serum globulin was administered subcutaneously, and its gradual disappearance could be followed by electrophoretic analysis over a period of approximately six weeks. Concurrently, and following administration of human gamma globulin (3.2 gm. gamma globulin) at monthly intervals, he had been free of pneumococcal sepsis for more than a year, whereas he had experienced clinical sepsis at least 19 times in the previous four years. Eight different types of pneumococci had been recovered from blood cultures during 10 different episodes of sepsis.

In the Discussion, [the author] concluded that there was a cause-and-effect relationship between the absence of gamma globulin and the repeated infections, based on the child's dramatic improvement after beginning gamma globulin therapy. [The author] proposed two possible causes–congenital or acquired. While [he] felt that the patient's good health for the first 4.5 years of life argued against a congenital cause, the persistence of the defect supported it.
Test for the Concentration of Electrolytes in Cystic Fibrosis of the Pancreas Utilizing Pilocarpine by Iontophoresis, by Lewis E. Gibson and Robert E. Cooke,Pediatrics; 1959;24:545–549
Authors: Chernick Victor
Published: December 2021

Aim. To develop a method for stimulating sweating that is rapid, painless, and avoids the risk of heat stress.

Background. Since the discovery that there is a high concentration of sodium and chloride in the sweat of patients with cystic fibrosis of the pancreas in 1953, the sweat test has been performed by placing the patient's body in a plastic bag with or without hot water bottles to stimulate sweating. This method is unsatisfactory because of complications such as hyperpyrexia and heat stroke. Direct injection of a cholinergic agent intradermally is painful and therefore not practical.

Methods. A rheostat with a milliampere meter was constructed at a cost of ∼$7 that allowed the iontophoresis of pilocarpine into the skin using negative and positive (2-cm diameter) electrocardiography electrodes. The positive electrode was placed on the flexor surface of the arm over a filter paper soaked in 0.2 mL of 0.2% pilocarpine nitrate. Current (0.2 mA) was applied for 5 minutes and then sweat was collected onto a preweighed filter paper for 30 minutes. Sweat chloride was determined by a polarographic method. Sweat tests were performed on 25 patients with cystic fibrosis (CF), 17 asymptomatic relatives and 27 control patients. Patients with CF had sweat chloride concentration >80 mEq/L; relatives, 32.5 mEq/L (highest 57 mEq/L); and control subjects, 21.1 mEq/L (highest 60 mEq/L).

Conclusions. The iontophoresis of pilocarpine into the skin is a rapid, painless, safe, and reliable method for stimulating sweating and facilitating the determination of sweat chloride concentration.
Reactions to the Threatened Loss of a Child: A Vulnerable Child Syndrome, by Morris Green, MD, and Albert A. Solnit, MD, Pediatrics, 1964;34:58–66
Authors: Shonkoff Jack P.
Published: December 2021

This report describes a constellation of clinical features found in 25 children with a history of an illness or accident from which they recovered, despite their parents' anticipation of a fatal outcome. The paper proposes the hypothesis that children who are expected by their parents to die prematurely often react with a disturbance in psychosocial development that is rooted in the parent-child relationship, which the authors characterize as avulnerable child syndrome. The essential features of the proposed syndrome include difficulty with separation, infantile behavior, bodily overconcerns, and school underachievement. The paper provides an overview of predisposing factors and determinants of the presenting symptoms, along with suggestions for both clinical management and primary prevention.
A Controlled Trial of Antepartum Glucocorticoid Treatment for Prevention of the Respiratory Distress Syndrome in Premature Infants, by G. C. Liggins, MB, PhD, FRCOG, and R. N. Howie, MB, MRACP,Pediatrics, 1972;50:515–525
Authors: Avery Mary Ellen
Published: December 2021

A controlled trial of betamethasone therapy was carried out in 282 mothers in whom premature delivery threatened or was planned before 37 weeks' gestation, in the hope of reducing the incidence of neonatal respiratory distress syndrome by accelerating functional maturation of the fetal lung. A total of 213 mothers were in spontaneous premature labor. When necessary, ethanol or salbutamol infusions were used to delay delivery while steroid or placebo therapy was given. Delay for at least 24 hours was achieved in 77% of the mothers. In these unplanned deliveries, early neonatal mortality was 3.2% in the treated group and 15.0% in the control subjects. There were no deaths with hyaline membrane disease or intraventricular cerebral hemorrhage in infants of mothers who had received betamethasone for at least 24 hours before delivery. The respiratory distress syndrome occurred less often in treated babies (9.0%) than in controls (25.8%), but the difference was confined to babies of <32 weeks' gestation who had been treated for at least 24 hours before delivery (11.8% of the treated babies compared with 69.6% of the control babies). There may be an increased risk of fetal death in pregnancies complicated by severe hypertension–edema–proteinuria syndromes and treated with betamethasone, but no other hazard of steroid therapy was noted.

We conclude that this preliminary evidence justifies additional trials, but that additional work is needed before any new routine procedure is established.
A Process Approach to Describing Mathematics Difficulties in Girls With Turner Syndrome
Authors: Mazzocco Michèle M. M.
Published: December 2021

Objective. To expand on previous reports of mathematics difficulty in girls with Turner syndrome (TS).

Methods. Mathematics performance was examined by evaluating the types of errors made on mathematics achievement subtests by 29 girls with TS, 26 girls with fragile X syndrome (another genetic condition associated with mathematics difficulty), and 41 girls with neither disorder. Correlations between mathematics achievement scores and measures of IQ, attention, and visuospatial skills were also examined.

Results. Relatively low mathematics achievement was evident in girls with TS before 10 years of age, and a higher percentage of girls with TS made operation (57%) and alignment (48%) errors on a mathematics calculations test than did girls with fragile X syndrome (19% and 14%, respectively). No group differences were found for procedural or multiplication table errors. Girls with TS attempted more “unfamiliar” problems than did girls with fragile X syndrome or girls in the comparison group. Mathematics achievement scores in girls with TS were positively correlated with Judgment of Line Orientation and Wechsler Intelligence Scale for Children–Revised Third Factor scores; these correlations differed from those in the other groups.

Conclusions. The qualitative group differences observed further support the concept of specificity of the TS phenotype and illustrate the importance of a process approach to assessment.
Response to Growth Hormone in Attention Deficit Hyperactivity Disorder: Effects of Methylphenidate and Pemoline Therapy
Authors: Rao Jayashree K. , Julius Joanne R. , Breen Timothy J. , Blethen Sandra L.
Published: December 2021

Objective. To determine whether treatment of attention deficit hyperactivity disorder (ADHD) with methylphenidate hydrochloride or pemoline diminishes the response to growth hormone (GH) therapy in patients with idiopathic GH deficiency (IGHD) or idiopathic short stature (ISS).

Methods. The National Cooperative Growth Study database was used to identify patients between 3 and 20 years of age with IGHD or ISS and those within these groups who were treated with methylphenidate or pemoline for ADHD. Their growth in response to GH treatment (change in height standard deviation score [SDS]) was compared with that of patients with IGHD or ISS who were not treated for ADHD, by using a stepwise multiple regression analysis.

Results. In the IGHD cohort, there were 184 patients who were being treated for ADHD and 2313 who were not. In the ISS cohort there were 117 patients who were being treated for ADHD and 1283 who were not. There was a higher percentage of males being treated for ADHD in both cohorts. In the IGHD cohort, the change in height SDS was positively associated with the number of years of GH treatment, parents' heights, body mass index, and GH injection schedule, and was negatively associated with height SDS at the initiation of GH therapy, age, and maximum stimulated GH level. The use of methylphenidate or pemoline had a negative effect on the change in height SDS, but the magnitude of the effect was small. Similar effects were noted in the ISS cohort, but body mass index and the use of methylphenidate or pemoline had no effect on the change in height SDS.

Conclusions. Concurrent ADHD therapy is associated with a slight decrease in the change in height SDS during GH treatment in patients with IGHD but not in those with ISS. Even in IGHD, the magnitude of the effect is small and should not deter the use of such concurrent therapy.
The Role of Serial Sampling in the Diagnosis of Growth Hormone Deficiency
Authors: Diamond Frank B. , Jorgensen E. Verena , Root Allen W. , Shulman Dorothy I. , Sy Judy P. , Blethen Sandra L. , Bercu Barry B.
Published: December 2021

We analyzed 12-hour serial sampling of growth hormone (GH) levels in two cohorts of short children: 96 children referred to a university endocrine clinic or studied on a research protocol and 825 children in the National Cooperative Growth Study of children treated with exogenous GH.

The mean 12-hour GH levels correlated with growth velocity in 60 children with normal height and growth velocity in the university study, and this correlation was stronger in the boys. The testosterone levels also correlated with growth velocity and mean 12-hour GH levels in the boys. The mean 12-hour GH levels were lower in a group of 36 children with idiopathic short stature than in the control subjects, as were the peak GH levels within 1 hour after the onset of sleep and the insulin-like growth factor I levels.

In the National Cooperative Growth Study cohort, pooled 12-hour GH levels were lower in the group with idiopathic GH deficiency (n = 300) than in the group with idiopathic short stature (n = 525), but the difference was not significant. The duration of GH treatment was the most significant predictor of change in the height SD score in both groups. Indices of spontaneous secretion of GH were not predictive of the response to GH treatment, nor were the results of provocative GH testing, the responses to GH treatment being similar in both groups over time.

We conclude that the results of GH testing must be interpreted for each patient and that several testing modalities may be helpful in finding GH insufficiency that originates at various levels of the somatotropic axis.
Temperament and Regulation of Emotion in the First Years of Life
Authors: Fox Nathan A.
Published: December 2021

Temperament is the tendency to express particular emotions with a certain intensity that is unique to each individual child. Although temperament seems to be biologically based, learning to regulate emotional expressions depends on caregiver input and socialization. Part of this process involves forming a trusting relationship with the infant so that he or she learns to rely on the parents to help “regulate” stressful or frustrating situations.
Learning and Emotion in Infants
Authors: Lipsitt Lewis P.
Published: December 2021

The systematic study of the sensory and learning processes of infants is a rather recent science; indeed, infants far surpass what we “knew” about their capacity for learning a few decades ago. Emotion and learning are closely intertwined, because behaviors that elicit positive emotional response are repeated and learned. Understanding these processes can optimize care of newborns by both professionals and parents.