bluuebunny/crossref_metadata_2025 huggingface dataset:
Electrolytic Treatment of Human Urine to Remove Nitrogen and Phosphorus
Authors: Ikematsu Mineo , Kaneda Kazuhiro , Iseki Masahiro , Matsuura Hidefumi , Yasuda Masashi
Published: May 2006

Depending on the dilution ratio, nitrogen and phosphorus in human urine could be completely removed by electrolytic treatment using an iron electrode. Chemical oxygen demand (CODMn) could also be reduced by 85%. The treatment would decrease the nitrogen and phosphorus levels in domestic wastewater to 20 and 50%, respectively.
Synthesis of SnNb2O6 Nanoplates and Their Photocatalytic Properties
Authors: Hosogi Yasuhiro , Kato Hideki , Kudo Akihiko
Published: May 2006

The visible light-driven photocatalyst SnNb2O6 was synthesized by reacting Sr2Nb2O7 with molten SnCl2 at 573 K. SEM observations revealed that the SnNb2O6 sample had a surface area of 56 m2 g−1, with particles having a nanoplate shape, a thickness of ca. 10 nm and widths of several hundred nm. A Pt-loaded SnNb2O6 nanoplate sample showed photocatalytic activity for H2 evolution from an aqueous methanol solution under visible light irradiation.
Ni/(Rare Earth Phosphate) as a New Effective Catalyst for Autothermal Reforming of Methane
Authors: Nagaoka Katsutoshi , Eiraku Toshikazu , Nishiguchi Hiroyasu , Takita Yusaku
Published: May 2006

The stability of metal phosphate during H2 reduction is one of the critical factors that determine the catalytic behavior of Ni/(metal phosphate) in CH4 autothermal reforming. Ni/(rare earth phosphate), particularly Ni/(Gd, Ce, or ErPO4), has been found to be a new family of effective catalysts.
Patterned Metal Deposition on Si Based on Self-Assembly and Inkjet Printing
Authors: Wang Jin-Yi , Huo Sheng-Juan , Cai Wen-Bin , Xu Qun-Jie
Published: May 2006

A novel maskless and wet process for patterned metallization on a Si wafer was proposed, which incorporates an initial self-assembly of aminosilane as the organic glue layer followed by patterned inkjet printing of Au colloids or Pd(II) species as the catalyst template and finalized by selective chemical plating to form desired patterns of metals.
Effective Depolymerization Waste FRPs by Treatment with DMAP and Supercritical Alcohol
Authors: Kamimura Akio , Yamada Kazuo , Kuratani Tomohiro , Taguchi Yohei , Tomonaga Fumiaki
Published: May 2006

Waste FRP, fiber-reinforced plastic, was readily depolymerised by treatment with supercritical MeOH in the presence of catalytic amounts of DMAP and the decomposed mixture was separated into three portions, monomeric portion, polymeric portion, and inorganic residue, by simple manipulation; the recovered organic and inorganic materials were readily used for further recycling use.
Intramolecular Cyclization of Aminoalkynes Catalyzed by PdMo3S4 Cubane Clusters
Authors: Takei Izuru , Enta Yutaka , Wakebe Youhei , Suzuki Toshiaki , Hidai Masanobu
Published: May 2006

PdMo3S4 cubane clusters [(Cp*Mo)3(μ3-S)4Pd(L)][PF6] (Cp* = η5-C5Me5; L = dba (2), ma (3); dba = dibenzylideneacetone, ma = maleic anhydride) showed high catalytic activity for the intramolecular hydroamination of aminoalkynes to afford the corresponding cyclic imines in good yields under mild conditions. A molecular structure of 3 has been determined by X-ray diffraction study.
Site-specific Scission of Lambda Phage Genomic DNA by Ce(IV)/EDTA-based Artificial Restriction DNA Cutter
Authors: Yamamoto Yoji , Miura Kazuyuki , Komiyama Makoto
Published: May 2006

Lambda phage genomic DNA (48502 base pairs) was site-selectively hydrolyzed by artificial restriction DNA cutter (ARCUT), which we have developed by combining Ce(IV)/EDTA and pseudo-complementary PNA. PNA satisfactorily invaded lambda DNA and activated the target site for the scission by Ce(IV)/EDTA.
Phenylene-bridged Polysilaalkane Macrocycles as Framed Molecular Rotor
Authors: Setaka Wataru , Sato Keisuke , Ohkubo Atsushi , Kabuto Chizuko , Kira Mitsuo
Published: May 2006

Using ring-closing hydrosilylation, trans- and cis-isomers of 2,5-dichrolo-1,4-phenylene-bridged macrocyclic polysila-alkanes were synthesized as molecular tops with a frame and characterized by X-ray crystallography. Dynamic 1H NMR analysis for the cis-isomers in toluene-d8 showed the internal rotation of the phenylene ring in solution.
Photocontrol of ζ-Potential of Poly(styrene) Microspheres Prepared by Soap-free Emulsion Copolymerization
Authors: Kishimoto Hiroaki , Watanabe Masaru , Iyoda Tomokazu , Nagai Katsutoshi , Nakagawa Masaru
Published: May 2006

Exposure to UV light at wavelengths of ≥254 nm caused poly(styrene) microspheres in deionized water to exhibit a negatively shifted ζ-potential value by generation of carboxyl groups due to photooxidation. Their ζ-potential value could be tuned simply by an exposure dose without a change in their average diameter.
China's 1994 Tax-Sharing Reforms: One System, Differential Impact
Authors: Loo Becky P. Y. , Chow Sin Yin
Published: May 2006

In analyzing China's 1994 tax-sharing system, this article focuses on changes in central tax and non-tax budgetary revenue, local upward remittance, central fixed subsidy, tax revenue rebate, and capital construction investment. The results, based on data from Guangdong and Fujian Provinces, suggest that the system has generally achieved its aims but geographical variations remain.
Icons and Reform Politics in India: The Case of S. M. Krishna
Authors: Pani Narendar
Published: May 2006

Reform politics in India reflects an increasing tendency for politicians and others to present themselves as icons of reforms. An analysis of the South Indian state of Karnataka from 1999 to 2001, the initial years of the term of Chief Minister S. M. Krishna, provides us insights into the precise role icons play in the politics of economic reform.
Perceptions of Universal Suffrage and Functional Representation in Hong Kong: A Confused Public?
Authors: Chan Joseph , Chan Elaine
Published: May 2006

This paper reports a fairly common contradictory view held in Hong Kong society—the support of universal suffrage and preservation of functional constituency at the same time.
Mongolia's DPRK Policy: Engaging North Korea
Authors: Batchimeg Migeddorj
Published: May 2006

Since the end of the 1990s, in order to improve relations, Mongolia has intensified its engagement policy with North Korea. This article analyzes the overall development and future prospects of bilateral relations and various aspects of this policy.
Chinese Educationalists in Malaysia: Defenders of Chinese Identity
Authors: Collins Alan
Published: May 2006

During 2002 the Malaysian government announced that English would be the language of instruction used in all primary schools to teach science and math. This decision was called “The Final Solution” by Chinese educationalists. This article shows how these professionals have sought to safeguard the character of Chinese primary schools, important transmitters of identity from one generation to the next, by acting as a pressure group against this new policy.
The 2004 General Elections in Malaysia: A Mandate to Rule
Authors: Moten Abdul Rashid , Mokhtar Tunku Mohar
Published: May 2006

The ruling coalition in Malaysia received an overwhelming mandate to rule in the general elections held in 2004. The major opposition party, which ran an aggressive campaign for an Islamic agenda, suffered a crushing defeat. The election results can be seen as an endorsement of Prime Minister Abdullah's style of moderate governance.
Analysis of Close Stable Homolog Juxtaposition During Meiosis in Mutants ofSaccharomyces cerevisiae
Authors: Lui Doris Y , Peoples-Holst Tamara L , Chang Mell Joshua , Wu Hsin-Yen , Dean Eric W , Burgess Sean M
Published: May 2006

A unique aspect of meiosis is the segregation of homologous chromosomes at the meiosis I division. The pairing of homologous chromosomes is a critical aspect of meiotic prophase I that aids proper disjunction at anaphase I. We have used a site-specific recombination assay in Saccharomyces cerevisiae to examine allelic interaction levels during meiosis in a series of mutants defective in recombination, chromatin structure, or intracellular movement. Red1, a component of the chromosome axis, and Mnd1, a chromosome-binding protein that facilitates interhomolog interaction, are critical for achieving high levels of allelic interaction. Homologous recombination factors (Sae2, Rdh54, Rad54, Rad55, Rad51, Sgs1) aid in varying degrees in promoting allelic interactions, while the Srs2 helicase appears to play no appreciable role. Ris1 (a SWI2/SNF2 related protein) and Dot1 (a histone methyltransferase) appear to play minor roles. Surprisingly, factors involved in microtubule-mediated intracellular movement (Tub3, Dhc1, and Mlp2) appear to play no appreciable role in homolog juxtaposition, unlike their counterparts in fission yeast. Taken together, these results support the notion that meiotic recombination plays a major role in the high levels of homolog interaction observed during budding yeast meiosis.
The Drosophila Boundary Element-Associated Factors BEAF-32A and BEAF-32B Affect Chromatin Structure
Authors: Gilbert Matthew K , Tan Yian Yee , Hart Craig M
Published: May 2006

Binding sites for the Drosophila boundary element-associated factors BEAF-32A and -32B are required for the insulator activity of the scs′ insulator. BEAF binds to hundreds of sites on polytene chromosomes, indicating that BEAF-utilizing insulators are an important class in Drosophila. To gain insight into the role of BEAF in flies, we designed a transgene encoding a dominant-negative form of BEAF under GAL4 UAS control. This BID protein encompasses the BEAF self-interaction domain. Evidence is provided that BID interacts with BEAF and interferes with scs′ insulator activity and that BEAF is the major target of BID in vivo. BID expression during embryogenesis is lethal, implying that BEAF is required during early development. Expression of BID in eye imaginal discs leads to a rough-eye phenotype, and this phenotype is rescued by a third copy of the BEAF gene. Expression of BID in salivary glands leads to a global disruption of polytene chromatin structure, and this disruption is largely rescued by an extra copy of BEAF. BID expression also enhances position-effect variegation (PEV) of the wm4h allele and a yellow transgene inserted into the pericentric heterochromatin of chromosome 2R, while a third copy of the BEAF gene suppresses PEV of both genes. These results support the hypothesis that BEAF-dependent insulators function by affecting chromatin structure or dynamics.
Heterochromatic Genes in Drosophila: A Comparative Analysis of Two Genes
Authors: Schulze Sandra R , McAllister Bryant F , Sinclair Donald A R , Fitzpatrick Kathleen A , Marchetti Marcella , Pimpinelli Sergio , Honda Barry M
Published: May 2006

Centromeric heterochromatin comprises ∼30% of the Drosophila melanogaster genome, forming a transcriptionally repressive environment that silences euchromatic genes juxtaposed nearby. Surprisingly, there are genes naturally resident in heterochromatin, which appear to require this environment for optimal activity. Here we report an evolutionary analysis of two genes, Dbp80 and RpL15, which are adjacent in proximal 3L heterochromatin of D. melanogaster. DmDbp80 is typical of previously described heterochromatic genes: large, with repetitive sequences in its many introns. In contrast, DmRpL15 is uncharacteristically small. The orthologs of these genes were examined in D. pseudoobscura and D. virilis. In situ hybridization and whole-genome assembly analysis show that these genes are adjacent, but not centromeric in the genome of D. pseudoobscura, while they are located on different chromosomal elements in D. virilis. Dbp80 gene organization differs dramatically among these species, while RpL15 structure is conserved. A bioinformatic analysis in five additional Drosophila species demonstrates active repositioning of these genes both within and between chromosomal elements. This study shows that Dbp80 and RpL15 can function in contrasting chromatin contexts on an evolutionary timescale. The complex history of these genes also provides unique insight into the dynamic nature of genome evolution.
The Drosophila Nbs Protein Functions in Multiple Pathways for the Maintenance of Genome Stability
Authors: Ciapponi Laura , Cenci Giovanni , Gatti Maurizio
Published: May 2006

The Mre11/Rad50/Nbs (MRN) complex and the two protein kinases ATM and ATR play critical roles in the response to DNA damage and telomere maintenance in mammalian systems. It has been previously shown that mutations in the Drosophila mre11 and rad50 genes cause both telomere fusion and chromosome breakage. Here, we have analyzed the role of the Drosophila nbs gene in telomere protection and the maintenance of chromosome integrity. Larval brain cells of nbs mutants display telomeric associations (TAs) but the frequency of these TAs is lower than in either mre11 or rad50 mutants. Consistently, Rad50 accumulates in the nuclei of wild-type cells but not in those of nbs cells, indicating that Nbs mediates transport of the Mre11/Rad50 complex in the nucleus. Moreover, epistasis analysis revealed that rad50 nbs, tefu (ATM) nbs, and mei-41 (ATR) nbs double mutants have significantly higher frequencies of TAs than either of the corresponding single mutants. This suggests that Nbs and the Mre11/Rad50 complex play partially independent roles in telomere protection and that Nbs functions in both ATR- and ATM-controlled telomere protection pathways. In contrast, analysis of chromosome breakage indicated that the three components of the MRN complex function in a single pathway for the repair of the DNA damage leading to chromosome aberrations.
Genetic Interactions Between TFIIF and TFIIS
Authors: Fish Rachel N , Ammerman Michelle L , Davie Judith K , Lu Betty F , Pham Cindy , Howe LeAnn , Ponticelli Alfred S , Kane Caroline M
Published: May 2006

The eukaryotic transcript elongation factor TFIIS is encoded by a nonessential gene, PPR2, in Saccharomyces cerevisiae. Disruptions of PPR2 are lethal in conjunction with a disruption in the nonessential gene TAF14/TFG3. While investigating which of the Taf14p-containing complexes may be responsible for the synthetic lethality between ppr2Δ and taf14Δ, we discovered genetic interactions between PPR2 and both TFG1 and TFG2 encoding the two larger subunits of the TFIIF complex that also contains Taf14p. Mutant alleles of tfg1 or tfg2 that render cells cold sensitive have improved growth at low temperature in the absence of TFIIS. Remarkably, the amino-terminal 130 amino acids of TFIIS, which are dispensable for the known in vitro and in vivo activities of TFIIS, are required to complement the lethality in taf14Δ ppr2Δ cells. Analyses of deletion and chimeric gene constructs of PPR2 implicate contributions by different regions of this N-terminal domain. No strong common phenotypes were identified for the ppr2Δ and taf14Δ strains, implying that the proteins are not functionally redundant. Instead, the absence of Taf14p in the cell appears to create a dependence on an undefined function of TFIIS mediated by its N-terminal region. This region of TFIIS is also at least in part responsible for the deleterious effect of TFIIS on tfg1 or tfg2 cold-sensitive cells. Together, these results suggest a physiologically relevant functional connection between TFIIS and TFIIF.
Fitness Benefits of Systemic Acquired Resistance During Hyaloperonospora parasitica Infection in Arabidopsis thaliana
Authors: Heidel Andrew J , Dong Xinnian
Published: May 2006

We investigated the fitness benefits of systemic acquired resistance (SAR) in Arabidopsis thaliana using a mutational and transformational genetic approach. Genetic lines were designed to differ in the genes determining resistance signaling in a common genetic background. Two mutant lines (cpr1 and cpr5) constitutively activate SAR at different points in SAR signaling, and one mutant line (npr1) has impaired SAR. The transgenic line (NPR1-H) has enhanced resistance when SAR is activated, but SAR is still inducible similarly to wild type. The fitness benefits were also investigated under two nutrient levels to test theories that preventing pathogen damage and realized resistance benefits may be affected by nutrient availability. Under low-nutrient conditions and treatment with the pathogenic oomycete, Hyaloperonospora parasitica, wild type had a higher fitness than the mutant that could not activate SAR, demonstrating that normal inducible SAR is beneficial in these conditions; this result, however, was not found under high-nutrient conditions. The mutants with constitutive SAR all failed to show a fitness benefit in comparison to wild type under a H. parasitica pathogen treatment, suggesting that SAR is induced to prevent an excessive fitness cost.
Linkage Disequilibrium on the Bovine X Chromosome: Characterization and Use in Quantitative Trait Locus Mapping
Authors: Sandor Cynthia , Farnir Frédéric , Hansoul Sarah , Coppieters Wouter , Meuwissen Théo , Georges Michel
Published: May 2006

We herein demonstrate that in the Holstein–Friesian dairy cattle population, microsatellites are as polymorphic on the X chromosome as on the autosomes but that the level of linkage disequilibrium between these markers is higher on the X chromosome than on the autosomes. The latter observation is not compatible with the small male-to-female ratio that prevails in this population and results in a higher gonosomal than autosomal effective population size. It suggests that the X chromosome undergoes distinct selective or mutational forces. We describe and characterize a novel Markovian approach to exploit this linkage disequilibrium to compute the probability that two chromosomes are identical-by-descent conditional on flanking marker data. We use the ensuing probabilities in a restricted maximum-likelihood approach to search for quantitative trait loci (QTL) affecting 48 traits of importance to the dairy industry and provide evidence for the presence of QTL affecting 5 of these traits on the bovine X chromosome.
Neurophysiologic Assessment of Neonatal Sleep Organization: Preliminary Results of a Randomized, Controlled Trial of Skin Contact With Preterm Infants
Authors: Ludington-Hoe Susan M. , Johnson Mark W. , Morgan Kathy , Lewis Tina , Gutman Judy , Wilson P. David , Scher Mark S.
Published: May 2006

BACKGROUND. Sleep is important to brain organization, but few strategies to promote sleep among premature infants have been tested. Behaviorally based measures of sleep have shown increased quiet sleep (QS) and decreased active sleep (AS) during skin-to-skin contact (SSC) with the mother, but these results have not been confirmed with objective electroencephalographic/polysomnographic measures of sleep organization. Important differences exist between behavioral and electroencephalographic/polysomnographic definitions of sleep state.

METHODS. Data for the first 28 relatively healthy, preterm subjects of an ongoing randomized trial of one 2- to 3-hour session of SSC or incubator care between feedings are reported here. Infants were positioned prone, inclined, and nested in an incubator during the 2- to 3-hour pretest period, were fed, and then went into the test period of SSC or incubator care. Infants were left largely undisturbed throughout testing. A mixed-model regression analysis compared the test-pretest differences in outcome measures within and between groups.

RESULTS. Results showed that arousals were significantly lower in the SSC group, compared with the control group, for the entire study period and for test-pretest matched segments of QS and AS. Rapid eye movement was significantly lower for the SSC group for the study period and AS segments. Indeterminate sleep was significantly lower for the SSC group when confounding environmental variables were included in the regression analysis. When 4 subjects who experienced excessive ambient light levels during SSC were removed from analysis, QS increased during SSC.

CONCLUSIONS. The patterns demonstrated by the SSC group are analogous to more-mature sleep organization. SSC may be used as an intervention to improve sleep organization in this population of preterm infants.
Inhibition of Meconium-Induced Cytokine Expression and Cell Apoptosis by Pretreatment With Captopril
Authors: Zagariya Alex , Bhat Rama , Navale Shan , Chari Gopal , Vidyasagar Dhormapuri
Published: May 2006

OBJECTIVE. To study whether pretreatment of newborn lungs by captopril inhibits meconium-induced lung injury and inflammatory cytokine expression.

DESIGN. Four groups of 2-week-old rabbit pups were used for the study: group 1, saline instilled rabbits; group 2, captopril-pretreated rabbits; group 3, meconium-instilled rabbits; and group 4, captopril-pretreated and then meconium-instilled rabbits. Each group was studied at different time points: 0, 2, 4, 8, and 24 hours after instillation of meconium. Experiments were done at the University of Illinois and Michael Reese Hospital at Chicago. After treatment and instillation of meconium, the right lung was fixed with formalin, and 2-μm slices were obtained for immunohistochemistry. The left lung was used for obtaining of lung lavage and measurement of total proteins (for enzyme-linked immunosorbent assay) and mRNA (for reverse transcription-polymerase chain reaction) purification.

RESULTS. We found that meconium induces inflammatory cytokine expression and apoptotic lung cell death. In situ end labeling revealed a dramatic DNA fragmentation in the meconium group, which supports the presence of apoptosis. Using enzyme-linked immunosorbent assay, we demonstrated increase of interleukin 6 and interleukin 8 cytokines in meconium-instilled lungs, which were significantly decreased in captopril-pretreated lungs. Captopril pretreatment also decreased meconium-induced cell death and angiotensinogen expression. We believe this effect is explained by the ability of captopril to decrease processing of ANGEN to angiotensinogen (ANG) I and finally to ANG II. It suggests that captopril inhibits ANG II-induced lung cell apoptosis.

CONCLUSION. Our results demonstrate that captopril pretreatment significantly inhibits meconium-induced lung cell death, cytokine, and ANGEN expression in newborn lungs.
Predictors of Fatality in Postdiarrheal Hemolytic Uremic Syndrome
Authors: Oakes Robert S. , Siegler Richard L. , McReynolds Markham A. , Pysher Theodore , Pavia Andrew T.
Published: May 2006

OBJECTIVES. Describe the cause of deaths among patients with postdiarrheal hemolytic uremic syndrome (HUS) and identify predictors of death at the time of hospital admission.

METHODS. Case-control study of 17 deaths among patients with HUS identified from the Intermountain HUS Patient Registry (1970–2003) compared against all nonfatal cases.

RESULTS. Of the 17 total deaths, 15 died during the acute phase of disease. Two died because treatment was withdrawn based on their preexisting conditions, and 1 died because of iatrogenic cardiac tamponade; they were excluded from analysis. Brain involvement was the most common cause of death (8 of 12); congestive heart failure, pulmonary hemorrhage, and hyperkalemia were infrequent causes. Presence of prodromal lethargy, oligoanuria, or seizures and white blood cell count (WBC) >20 × 109/L or hematocrit >23% on admission were predictive of death. In multivariate analysis, elevated WBC and elevated hematocrit were independent predictors. The combination of prodromal dehydration, oliguria, and lethargy and admission WBC values >20 × 109/L and hematocrit >23% appeared in 7 of the 12 acute-phase deaths.

CONCLUSIONS. Diarrheal HUS patients presenting with oligoanuria, dehydration, WBC >20 × 109/L, and hematocrit >23% are at substantial risk for fatal hemolytic uremic syndrome. Such individuals should be referred to pediatric tertiary care centers.
Economic Analysis of Prevaccination Serotesting Compared With Presumptive Immunization for Polio, Diphtheria, and Tetanus in Internationally Adopted and Immigrant Infants
Authors: Cohen Adam L. , Veenstra David
Published: May 2006

BACKGROUND. No consensus exists about whether to conduct prevaccination serotesting or to presumptively vaccinate internationally adopted and immigrant infants with inactivated polio (IPV) and diphtheria-tetanus-acellular pertussis (DTaP) immunizations.

OBJECTIVE. To study the clinical and economic outcomes from a societal perspective of prevaccination serotesting in a hypothetical 12-month-old internationally adopted or immigrant infant.

DESIGN AND METHODS. A decision analysis model was developed comparing presumptive vaccination with IPV versus serotesting for poliovirus type 1, 2, and 3 antibodies followed by vaccination in unprotected patients. A similar decision analysis model was developed comparing presumptive vaccination with DTaP versus serotesting for diphtheria and tetanus toxoid antibodies. The main outcome measures were cost per patient protected from polio, diphtheria, and tetanus.

RESULTS. Compared with presumptive immunization, prevaccination serotesting for polio increases the cost per patient from $57 to $62 and decreases the percentage of patients protected against polio from 95.3% to 94.0%. Serotesting for diphtheria and tetanus increases the cost per patient from $62 to $119 and increases the percentage of patients protected against both diphtheria and tetanus from 91.5% to 92.3%. Presumptive immunization with DTaP costs less and is more clinically effective than serotesting if >80% of patients do not complete the full vaccine series or if antibody seroprevalence to both diphtheria and tetanus is <51%.

CONCLUSIONS. Presumptive immunization for polio improves outcomes and saves costs compared with prevaccination serotesting in internationally adopted and immigrant infants. The results for DTaP are less definitive, although immunization is the preferred strategy in populations with poor vaccine compliance or low seroprevalence of antibodies to diphtheria and tetanus.
The Associations Among Childhood Headaches, Emotional and Behavioral Difficulties, and Health Care Use
Authors: Strine Tara W. , Okoro Catherine A. , McGuire Lisa C. , Balluz Lina S.
Published: May 2006

BACKGROUND. Headaches are common among children and adolescents, particularly migraine and tension-type headaches. They contribute to missed school days, affect children's peer and family relationships, and significantly impact children's quality of life, often times into adulthood.

OBJECTIVES. This study, based on responses to the Strengths and Difficulties Questionnaire, was designed to examine difficulties and impairments related to emotions, concentration, behavior, and social functioning among children with frequent or severe headaches (FSH).

METHODS. We used a cross-sectional study of 9264 children aged 4–17 years from the 2003 National Health Interview Survey, an ongoing, computer-assisted personal interview survey of the noninstitutionalized US population.

RESULTS. Approximately 6.7% of children experienced FSH during the previous 12 months. Overall, children with FSH were 3.2 times more likely than children without FSH to have a high level of difficulties and 2.7 times more likely to have a high level of impairment, suggesting potential mental health issues. More specifically, analyses revealed that children with FSH were significantly more likely than those without FSH to exhibit high levels of emotional, conduct, inattention-hyperactivity, and peer problems and were significantly more likely than children without FSH to be upset or distressed by their difficulties and to have their difficulties interfere with home life, friendships, classroom learning, and leisure activities.

CONCLUSION. Because children with FSH experience notable pain, mental health issues, and functional limitations, integrated care using a biopsychosocial approach is warranted.
Clinical Value of Autoantibodies Against C1q in Children With Glomerulonephritis
Authors: Kozyro Ina , Perahud Iryna , Sadallah Salima , Sukalo Alexander , Titov Leonid , Schifferli Jürg , Trendelenburg Marten
Published: May 2006

OBJECTIVE. Autoantibodies against C1q (anti-C1q) have been found in a number of autoimmune and renal diseases. They are best described in adult patients with systemic lupus erythematosus, where a strong correlation between the occurrence of anti-C1q and severe lupus nephritis (LN) has been observed. However, the role of anti-C1q in children with systemic lupus erythematosus has not yet been determined. Furthermore, the clinical importance of anti-C1q in other forms of glomerulonephritis remains to be elucidated. The aim of this study was to investigate anti-C1q in children with different forms of glomerulonephritis including LN.

METHODS. We prospectively investigated 112 children with different forms of newly diagnosed glomerulonephritis for the presence of anti-C1q by an enzyme-linked immunosorbent assay and compared them with healthy controls. Associations between anti-C1q and disease manifestations at the time of the measurements and during follow-up were investigated.

RESULTS. Twenty-one of 112 patients were positive for anti-C1q compared with 0 of 40 healthy controls. Anti-C1q was associated with activity in LN and with disease severity in patients with acute poststreptococcal glomerulonephritis (APSGN). In LN, 7 of 12 patients were found to be anti-C1q positive. Six of these 7 had active disease at the time of the serum sampling compared with 1 of 5 of the anti-C1q-negative children. In children with APSGN, 8 of 24 were positive for anti-C1q. Anti-C1q-positive APSGN patients had significantly higher proteinuria and more often hypertension than those without anti-C1q. All 4 patients in which APSGN did not resolve spontaneously were anti-C1q positive.

CONCLUSIONS. Anti-C1q is associated with active LN in children. In addition, children with anti-C1q-positive APSGN have more severe disease than those who are anti-C1q negative. These data suggest APSGN is another disease in which anti-C1q has a pathogenic role.
Cost-Effectiveness of Neonatal Extracorporeal Membrane Oxygenation Based on 7-Year Results From the United Kingdom Collaborative ECMO Trial
Authors: Petrou Stavros , Bischof Matthias , Bennett Charlotte , Elbourne Diana , Field David , McNally Helena
Published: May 2006

OBJECTIVE. To assess the long-term cost-effectiveness of extracorporeal membrane oxygenation (ECMO) for mature newborn infants with severe respiratory failure.

METHODS. A prospective economic evaluation was conducted alongside a pragmatic randomized, controlled trial in which 185 infants were randomly allocated to ECMO (n = 93) or conventional management (n = 92) and then followed up to 7 years of age. Information about their use of health services during the follow-up period was combined with unit costs (£, 2002–2003 prices) to obtain a net cost per child. The cost-effectiveness of neonatal ECMO was expressed in terms of incremental cost per additional life year gained and incremental cost per additional disability-free life year gained. The nonparametric bootstrap method was used to present cost-effectiveness acceptability curves and net benefit statistics at alternative willingness-to-pay thresholds held by decision-makers for an additional life year and for an additional disability-free life year.

RESULTS. Over 7 years, neonatal ECMO was effective at reducing known death or severe disability. Mean health service costs during the first 7 years of life were £30270 in the ECMO group and £10229 in the conventional management group, generating a mean cost difference of £20041 that was statistically significant. The incremental cost per life year gained was estimated at £13385. The incremental cost per disability-free life year gained was estimated at £23566. At the notional willingness-to-pay threshold of £30000 for an additional life year, the probability that neonatal ECMO is cost-effective at 7 years was estimated at 0.98. This translated into a mean net benefit of £24362 for each adoption of neonatal ECMO rather than conventional management.

CONCLUSIONS. This study provides rigorous evidence of the cost-effectiveness of neonatal ECMO during childhood.
The Changing Face of Race: Risk Factors for Neonatal Hyperbilirubinemia
Authors: Beal Anne C. , Chou Shu-Chiung , Palmer R. Heather , Testa Marcia A. , Newman Christine , Ezhuthachan Sudhakar
Published: May 2006

OBJECTIVES. Race is a predictor of health outcomes and risk for some clinical conditions, for example, mother's race predicts risk for hyperbilirubinemia in newborns, with blacks at lowest risk. Little is known about the correlation of race as recorded in medical records with self-reported race. Also, use of maternal race to predict newborn risk for hyperbilirubinemia has not been tested for multiracial mothers and newborns. We sought to examine how maternal race documented in medical records correlates with self-reported race and to examine the correlation between mothers' and newborns' race in the context of risk for neonatal hyperbilirubinemia, focusing on multiracial mothers and newborns.

DESIGN. A cohort study with 3021 newborns at ≥35 weeks gestation discharged from normal nursery between January 2001 and October 2002 with a telephone survey of their mothers within 6 months of birth.

SETTING. The study was conducted in the Neonatology Department of Henry Ford Hospital.

PATIENTS. There were 1773 mothers (58%) with incorrect telephone numbers. Of 1248 mothers contacted, 866 (69%) completed the interview.

OUTCOME MEASURES. We measured mother's race in hospital database and mother's reported race for herself, her newborn, and the father, allowing ≤5 responses for each.

RESULTS. Of mothers documented in the medical record as white, 64% self-reported as white. Among mothers recorded as black, 70% self-reported as black. Mothers identified 93 newborns as ≥2 races with primary race matching both parents for 41%, father for 25%, mother for 23%, and neither parent for 11%. Of 70 newborns whose parents were not the same race, mothers identified 45 (64%) as ≥2 races.

CONCLUSIONS. There is incomplete overlap between racial identification in medical records versus self-report. Given 1 choice, mothers of multiracial infants overselect black in their newborns' ancestry. Because black race is the lowest risk category for neonatal hyperbilirubinemia, this may lead to underestimating their risk.
Controlled Clinical Trial of Dichloroacetate for Treatment of Congenital Lactic Acidosis in Children
Authors: Stacpoole Peter W. , Kerr Douglas S. , Barnes Carie , Bunch S. Terri , Carney Paul R. , Fennell Eileen M. , Felitsyn Natalia M. , Gilmore Robin L. , Greer Melvin , Henderson George N. , Hutson Alan D. , Neiberger Richard E. , O'Brien Ralph G. , Perkins Leigh Ann , Quisling Ronald G. , Shroads Albert L. , Shuster Jonathan J. , Silverstein Janet H. , Theriaque Douglas W. , Valenstein Edward
Published: May 2006

OBJECTIVE. Open-label studies indicate that oral dichloroacetate (DCA) may be effective in treating patients with congenital lactic acidosis. We tested this hypothesis by conducting the first double-blind, randomized, control trial of DCA in this disease.

METHODS. Forty-three patients who ranged in age from 0.9 to 19 years were enrolled. All patients had persistent or intermittent hyperlactatemia, and most had severe psychomotor delay. Eleven patients had pyruvate dehydrogenase deficiency, 25 patients had 1 or more defects in enzymes of the respiratory chain, and 7 patients had a mutation in mitochondrial DNA. Patients were preconditioned on placebo for 6 months and then were randomly assigned to receive an additional 6 months of placebo or DCA, at a dose of 12.5 mg/kg every 12 hours. The primary outcome results were (1) a Global Assessment of Treatment Efficacy, which incorporated tests of neuromuscular and behavioral function and quality of life; (2) linear growth; (3) blood lactate concentration in the fasted state and after a carbohydrate meal; (4) frequency and severity of intercurrent illnesses and hospitalizations; and (5) safety, including tests of liver and peripheral nerve function.

OUTCOME. There were no significant differences in Global Assessment of Treatment Efficacy scores, linear growth, or the frequency or severity of intercurrent illnesses. DCA significantly decreased the rise in blood lactate caused by carbohydrate feeding. Chronic DCA administration was associated with a fall in plasma clearance of the drug and with a rise in the urinary excretion of the tyrosine catabolite maleylacetone and the heme precursor δ-aminolevulinate.

CONCLUSIONS. In this highly heterogeneous population of children with congenital lactic acidosis, oral DCA for 6 months was well tolerated and blunted the postprandial increase in circulating lactate. However, it did not improve neurologic or other measures of clinical outcome.
Variation in Standards of Research Compensation and Child Assent Practices: A Comparison of 69 Institutional Review Board–Approved Informed Permission and Assent Forms for 3 Multicenter Pediatric Clinical Trials
Authors: Kimberly Michael B. , Hoehn K. Sarah , Feudtner Chris , Nelson Robert M. , Schreiner Mark
Published: May 2006

OBJECTIVE. To systematically compare standards for compensation and child participant assent in informed permission, assent, and consent forms (IP-A-CFs) approved by 55 local institutional review boards (IRBs) reviewing 3 standardized multicenter research protocols.

METHOD. Sixty-nine principal investigators participating in any of 3 national, multicenter clinical trials submitted standardized research protocols for their trials to their local IRBs for approval. Copies of the subsequently IRB-approved IP-A-CFs were then forwarded to an academic clinical research organization. This collection of IRB-approved forms allowed for a quasiexperimental retrospective evaluation of the variation in informed permission, assent, and consent standards operationalized by the local IRBs.

RESULTS. Standards for compensation and child participant assent varied substantially across 69 IRB-approved IP-A-CFs. Among the 48 IP-A-CFs offering compensation, monetary compensation was offered by 33 as reimbursement for travel, parking, or food expenses, whereas monetary or material compensation was offered by 22 for subject inconvenience and by 13 for subject time. Compensation ranged widely within and across studies (study 1, $180–1425; study 2, $0–500; and study 3, $0–100). Regarding child participant assent, among the 57 IP-A-CFs that included a form of assent documentation, 33 included a line for assent on the informed permission or consent form, whereas 35 included a separate form written in simplified language. Of the IP-A-CFs that stipulated the documentation of assent, 31 specified ≥1 age ranges for obtaining assent. Informed permission or consent forms were addressed either to parents or child participants.

CONCLUSION. In response to identical clinical trial protocols, local IRBs generate IP-A-CFs that vary considerably regarding compensation and child participant assent.
The Boston Marathon Study: A Novel Approach to Research During Residency
Authors: Shin Andrew Y. , Almond Christopher S.D. , Mannix Rebekah C. , Duncan Christine N. , Son Mary Beth F. , McLauchlan Heather M. , Kanaan Usama B. , Litzow Jennifer M. , Riney Pearl S. , Trenor Cameron C. , Fortescue Elizabeth B. , Vinci Robert J. , Greenes David S. ,   on behalf of the resident physicians from the Boston Combined Residency Program
Published: May 2006

Resident physicians from a pediatric academic training program developed a hospital-wide research project in an effort to enhance their residency research experience. In this model, residents themselves assumed primary responsibility for each stage of a large prospective clinical research study. The project, which was integrated successfully into the residency program, enabled a large group of residents, with mentorship from a dedicated faculty member, to benefit from a structured clinical research experience while providing the flexibility necessary to meet the demands of a busy residency curriculum. Careful topic selection with a well-defined end point, faculty involvement, resident collegiality, and institutional support were factors identified by study leaders as central to the success of this model.
The Role of Early Maternal Responsiveness in Supporting School-Aged Cognitive Development for Children Who Vary in Birth Status
Authors: Smith Karen E. , Landry Susan H. , Swank Paul R.
Published: May 2006

OBJECTIVES. To examine the relation between the pattern of maternal responsiveness that children experienced in the infancy, preschool, and school-age periods and growth in cognitive skills across 3–10 years of age and determine whether the relation differs by birth status.

METHODS. In 1990–1992, 360 children varying in birth status (very low birthweight [VLBW]; demographically matched controls) were recruited to examine parenting and birth status influences on development. This report includes children with observations of parenting at 6, 12, and 24 months and 3, 4, 6, 8, and 10 years and cognitive skills evaluated at 3, 4, 6, 8, and 10 years of age (71% of original cohort).

RESULTS. Four groups of mothers varying in the pattern of responsiveness displayed across the infancy and the preschool period were found. When controlling for school-age parenting and economic status, children parented with higher levels of responsiveness across both developmental periods, irrespective of birth status, showed higher levels in development than those who experienced responsiveness in only 1 development period or minimal responsiveness. Greater benefit was found for consistency in responsiveness for children born VLBW with less, versus more, severe neonatal complications. Inspection of the means showed that higher risk birth status combined with minimal responsiveness resulted in cognitive scores, on average, 14 points lower than when parented with consistently higher responsiveness.

CONCLUSIONS. Cognitive development for children born at VLBW, particularly those with less severe complications, are supported by consistently responsive parenting across early childhood in similar ways to those born at term. This effect persisted through 10 years of age even after school-age parenting and economic level. These findings have important implications for the timing (across early childhood) and content (responsive interactive behaviors) of early intervention to enhance the outcomes for children born at VLBW.
Factors That Are Associated With Parental Acceptance of Human Papillomavirus Vaccines: A Randomized Intervention Study of Written Information About HPV
Authors: Dempsey Amanda F. , Zimet Gregory D. , Davis Robert L. , Koutsky Laura
Published: May 2006

OBJECTIVES. Prophylactic vaccines against human papillomavirus (HPV) are expected to be available for public use by 2007 and likely will be targeted to preadolescent children. Parental acceptance of these vaccines will be critical for their success. The objectives of this study were (1) to determine the overall acceptance of HPV vaccines for preadolescent children by parents, (2) to evaluate the influence of written educational information about HPV on parental acceptability of HPV vaccines, and (3) to identify independent predictors associated with HPV vaccine acceptability by parents.

METHODS. A randomized intervention study within a cross-sectional survey was conducted. Parental HPV vaccine acceptability was measured under 3 different hypothetical scenarios. A self-administered survey on the knowledge, attitudes, and beliefs about HPV and HPV vaccines was sent to 1600 parents of 8- to 12-year-old children. In addition to a baseline paragraph about HPV that was received by all study participants, a random half of the study participants received a detailed “HPV Information Sheet” outlining the epidemiology and potential clinical sequelae of HPV infection. Independent predictors of parental HPV vaccine acceptability were determined using multivariate linear regression models.

RESULTS. Parents who received the HPV information sheet had higher mean scores on the HPV knowledge assessment tool than the control group. However, despite this apparent improvement in knowledge, there was not a statistically significant difference in HPV vaccine acceptability between the 2 groups.

CONCLUSIONS. Providing parents with an HPV information sheet did seem to improve knowledge about HPV, but this increased knowledge had little effect on the acceptability of these vaccines by parents for their children. Instead, attitudes and life experiences seemed to be more important factors influencing HPV vaccine acceptability among parents.
Mortality and Morbidities Among Very Premature Infants Admitted After Hours in an Australian Neonatal Intensive Care Unit Network
Authors: Abdel-Latif Mohamed E. , Bajuk Barbara , Oei Julee , Lui Kei ,   for the New South Wales and the Australian Capital Territory Neonatal Intensive Care Audit Group
Published: May 2006

OBJECTIVES. To assess risk-adjusted early (within 7 days) mortality and major morbidities of newborn infants at <32 weeks' gestation who are admitted after office hours to a regional Australian network of NICUs where statewide caseload is coordinated and staffed by on-floor registrars working in shift rosters. We hypothesize that adverse sequelae are increased in these infants.

DESIGNS. We conducted a database review of the records of infants (n = 8654) at <32 weeks' gestation admitted to a network of 10 tertiary NICUs in New South Wales and the Australian Capital Territory from 1992 to 2002. Multivariate logistic regression analysis was performed to adjust for case-mix and significant baseline characteristics.

OUTCOMES. Sixty-five percent of infants were admitted to the NICUs after hours. These infants did not have an increase in early neonatal mortality or major neonatal sequelae compared with their office-hours counterparts. Admissions during late night hours after midnight or fatigue risk periods before the end of a medical 12-hour shift were not associated with higher early mortality. Risk factors significantly predictive of early neonatal death were lack of antenatal steroid treatment, Apgar score <7 at 5 minutes, male gender, gestation age, and being small for gestation.

CONCLUSIONS. Current staffing levels, specialization, and networking are associated with lower circadian variation in adverse outcomes and after-hours admission to this NICU network and have no significant impact on early neonatal mortality and morbidity.
A Multicenter Case-Control Study on Predictive Factors Distinguishing Childhood Leukemia From Juvenile Rheumatoid Arthritis
Authors: Jones Olcay Y. , Spencer Charles H. , Bowyer Suzanne L. , Dent Peter B. , Gottlieb Beth S. , Rabinovich C. Egla
Published: May 2006

OBJECTIVE. Acute lymphocytic leukemia (ALL) often presents with musculoskeletal concerns such as pain or swelling, even before appearance of blasts in the peripheral blood. Such presentation may lead to misdiagnosis of a child with juvenile rheumatoid arthritis (JRA). This study was designed to identify the predictive factors for leukemia using basic clinical and laboratory information.

METHODS. A retrospective chart review was performed using a simple questionnaire to compare the clinical and laboratory findings present during the initial visit to a pediatric rheumatology clinic for 277 children who were ultimately diagnosed with either JRA (n = 206) or ALL (n = 71). Sensitivity and specificity analysis of a variety of parameters, both singly and in combination, was performed to identify predictive value for ALL.

RESULTS. The majority (75%) of children with ALL did not have blasts in the peripheral blood at the time of evaluation by pediatric rheumatologists. In children presenting with unexplained musculoskeletal complaints, the 3 most important factors that predicted a diagnosis of ALL were low white blood cell count (<4 × 109/L), low-normal platelet count (150–250 × 109/L), and history of nighttime pain. In the presence of all 3, the sensitivity and specificity for a diagnosis of ALL were 100% and 85%, respectively. Other findings, including antinuclear antibody, rash, and objective signs of arthritis, were not helpful in differentiating between these diagnoses because they occurred at similar rates in both groups.

CONCLUSIONS. When a child develops new-onset bone-joint complaints, the presence of subtle complete blood count changes combined with nighttime pain should lead to consideration of leukemia as the underlying cause.