bluuebunny/crossref_metadata_2025 huggingface dataset:
When the Ear Dreams: Dolby Digital and the Imagination of Sound
Authors: Sobchack Vivian
Published: June 2005

Abstract Nine Dolby theatrical “trailers” were made from the mid-1990s to 2003 specifically to visualize and promote the audio capabilities of digital sound. Drawing on Bachelard's The Poetics of Space and Chion's Audio-Vision, this essay explores the trailers' sound-driven imagery and suggests its implications for contemporary “mainstream” narrative cinema.
The Grand Style
Authors: Geuens Jean-Pierre
Published: June 2005

Abstract Film style used to be the preserve of the artist. It made it possible to distinguish good filmmaking from mainstream work. Today, however, new technologies enable even beginners to load their images with stimuli of all kinds. This article explores the question of how this “grand style” is different, and what it portends for cinema's future.
The genetic heterozygosity and fitness of tetraploid embryos and embryonic stem cells are crucial parameters influencing survival of mice derived from embryonic stem cells by tetraploid embryo aggregation
Authors: Li Xiangyun , Wei Wei , Yong Jun , Jia Qing , Yu Yuansong , Di Keqian
Published: June 2005

The aim of this paper was to determine whether the genetic background of tetraploid embryos contributed to the survival of mice derived from embryonic stem (ES) cells by tetraploid embryo complementation. Twenty-five newborns were produced by aggregation of hybrid ES cells and tetraploid embryos with different genetic backgrounds. These newborns were entirely derived from ES cells judged by microsatellite DNA (A specific sequence of DNA bases or nucleotides that contains mono, di, tri or tetra repeats) and coat colour phenotype and germline transmission. Fifteen survived to adulthood while seven died of respiratory failure. All newborns were derived from outbred or hybrid tetraploid aggregates and no newborns were from the inbreds. Our results demonstrate that the genetic heterozygosity, fitness of tetraploid embryos and fitness of ES cells are crucial parameters influencing survival of mice derived from ES cells by tetraploid embryo aggregation. In addition, this method represents a simple and efficient procedure for immediate generation of targeted mouse mutants from genetically modified ES cell clones, in contrast to the standard protocol, which involves the production of chimeras and several breeding steps.
Rural Definitions for Health Policy and Research
Authors: Hart L. Gary , Larson Eric H. , Lishner Denise M.
Published: June 2005

The term “rural” suggests many things to many people, such as agricultural landscapes, isolation, small towns, and low population density.

However, defining “rural” for health policy and research purposes requires researchers and policy analysts to specify which aspects of rurality are most relevant to the topic at hand and then select an appropriate definition. Rural and urban taxonomies often do not discuss important demographic, cultural, and economic differences across rural places—differences that have major implications for policy and research. Factors such as geographic scale and region also must be considered.

Several useful rural taxonomies are discussed and compared in this article. Careful attention to the definition of “rural” is required for effectively targeting policy and research aimed at improving the health of rural Americans.
Dough‐Kneading‐Inspired Design of an Adhesive Cardiac Patch to Attenuate Cardiac Fibrosis and Improve Cardiac Function via Regulating Glycometabolism
Authors: Sun Yage , Zhang Xiaoping , Nie Xiongfeng , Yang Rong , Zhao Xinrui , Cui Chunyan , Liu Wenguang
Published: February 2024

Recently, hydrogel adhesive patches have been explored for treating myocardial infarction. However, achieving secure adhesion onto the wet beating heart and local regulation of pathological microenvironment remains challenging. Herein, a dough‐kneading‐inspired design of hydrogel adhesive cardiac patch is reported, aiming to improve the strength of prevalent powder‐formed patch and retain wet adhesion. In mimicking the polysaccharide and protein components of natural flour, methacrylated polyglutamic acid (PGAMA) is electrostatically interacted with hydroxypropyl chitosan (HPCS) to form PGAMA/HPCS coacervate hydrogel. The PGAMA/HPCS hydrogel is freeze‐dried and ground into powders, which are further rehydrated with two aqueous solutions of functional drug, 3‐acrylamido phenylboronic acid (APBA)/rutin (Rt) complexes for protecting the myocardium from advanced glycation end product (AGEs) injury by reactive oxygen species (ROS) ‐responsive Rt release, and hypoxanthine‐loaded methacrylated hyaluronic acid (HAMA) nanogels for enhancing macrophage targeting ability to regulate glycometabolism for combating inflammation. The rehydrated powders bearing APBA/Rt complexes and HAMA‐hypoxanthine nanogels are repeatedly kneaded into a dough‐like gel, which is further subjected to thermal‐initiated crosslinking to form a stabilized and sticky patch. This biofunctional patch is applied onto the rats’ infarcted myocardium, and the outcomes at 28 days post‐surgery indicate efficient restoration of cardiac functions and attenuation of cardiac fibrosis.
Rise of atomically dispersed metal catalysts: Are they a new class of catalysts?
Authors: Kim Jae Hyung , Joo Sang Hoon
Published: February 2024

Atomically dispersed metal catalysts or single‐atom catalysts have made great strides during the past decade in the catalysis field. While an initial vision of atomically dispersed metal catalysts was to combine the advantages of homogeneous and heterogeneous catalysts, their unexpected potentials continue to be discovered. In this account, we introduce historical backgrounds underpinning the emergence of atomically dispersed metal catalysts. Next, we illustrate some recent examples demonstrating the unusual reactivities of atomically dispersed metal catalysts, which are hard to realize by homogeneous or heterogeneous catalysts. We conclude the account by suggesting the remaining challenges in this exciting field.
Parameter instance learning with enhanced vision transformers for aerial person re‐identification
Authors: Peng Houfu , Lu Xing , Xu Lili , Xia Daoxun , Xie Xiaoyao
Published: February 2024

In an agnostic space environment, aerial person re‐identification (Re‐ID) is a task that the query person may not occur in the gallery set, it is considered a subordinate task within the domain of open‐world person Re‐ID, and is a more challenging and practical application research. The aerial person images, captured by unmanned aerial vehicles, present more significant challenges such as weak appearance features, fewer individual person samples and occlusion due to variations in camera height and viewing angles compared to ground‐level images. Most state‐of‐the‐arts person Re‐ID methods developed for open‐world datasets rely heavily on local convolutional neural networks but exhibit suboptimal performance when directly applied to aerial person Re‐ID tasks. In this article, a parameter instance learning based on vision transformers (ViT) model is introduced for the design of aerial person Re‐ID. Initially, we employ a self‐supervised paradigm grounded in parameter instance discrimination, aiming to capture feature alignment and instance similarity. Subsequently, using labeled training data, we optimize the network model through the calculation of two types of loss functions. Finally, we employ a feature enhancement strategy utilizing zero‐padding and displacement techniques. This strategy effectively and directly enhances the robustness of the ViT model against issues such as occlusion and misalignment. We conducted experiments on a Re‐ID dataset to validate the effectiveness of the method. Our approach achieves a mean average precision of 57.31% and a Rank‐1 accuracy of 65.29% on the aerial person Re‐ID dataset PRAI‐1581.
Recurrent catamenial absence status epilepticus persisting in post‐menopausal period: The pivotal role of video‐EEG
Authors: Reale Chiara , Di Claudio Maria Teresa , Bianchi Maria Rachele , Papantonio Anna Maria , Cantalupo Gaetano , Darra Francesca , d'Orsi Giuseppe
Published: February 2024

Content available: Video.
Study on synergistic effects of curcumin and bixin against foodborne pathogens
Authors: Hosseini Fereshteh , Habibi Najafi Mohammad Bagher , Rasool Oromiehie Abdul , Nasiri Mahalati Mehdi , Yavarmanesh Masoud
Published: February 2024

Various studies have shown that natural colorants, in addition to their coloring attributes, have valuable biological effects such as antioxidant, anti‐inflammation, and anticarcinogenic properties. Moreover, their use as a food colorant can restrict the potential disadvantages of synthetic additives and turn foods into functional products. In this study, in vitro antimicrobial activities of two natural colorants of bixin and curcumin against some important foodborne pathogens: Staphylococcus aureus (S. aureus), Listeria innocua (L. innocua), and Escherichia coli (E. coli) were investigated by disk diffusion method. Minimum inhibitory concentration and minimum bactericidal concentration values were determined by agar dilution and broth microdilution methods. The synergistic activity of the colorants against selected microorganisms was assayed by the checkerboard microdilution method. The results showed that the inhibitory effects of bixin against S. aureus were more pronounced than E. coli and L. innocua. The lowest concentration of curcumin (0.6 mg/mL) in the disk diffusion method was not inhibited by any tested bacteria. However, it was effective at the higher concentrations against three microorganisms, but its diameter of inhibition zones was lower than gentamicin in all concentrations. Synergetic effects were observed by curcumin and bixin combination against S. aureus (FICI ≤ 0.5), but they act as an antagonist against E. coli and L. innocua. The results of the synergy test were confirmed by the isobologram curves.
Effects of Prednisolone and Dexamethasone on Alkali Burns of the Esophagus in Rabbit
Authors: Bautista A. , Tojo R. , Varela R. , Estevez E. , Villanueva A. , Cadranel S.
Published: February 2024

Steroids have been widely used to prevent the severe secondary strictures that inevitably follow accidental ingestion of caustic substances by children, though with controversial results. To confirm the efficacy of large early doses of dexamethasone, we conducted an experimental study in rabbits. A cotton swab soaked in sodium hydroxide was placed on the esophageal mucosa of 30 rabbits. The rabbits were then treated with antibiotics and randomly allocated to one of three groups. One group received no steroids; the second group was treated with prednisolone; and the third was given dexamethasone. After 21 days, the rabbits were killed and the severity of the lesion was evaluated by radiological, anatomical, and histological examination. Rabbits with moderate or severe stricture, as defined on the basis of radiological examination, made up 80% of the control group, 70% of the prednisolone‐treated group, and 40% of the dexamethasone‐treated group. Rabbits with third‐degree burns, with or without macroscopic ulcers, made up 60% of the control group, 40% of the prednisolone‐treated group, and 30% of the dexamethasone‐treated group. On histological examination, rabbits with third‐degree lesions made up 70% of the control group, 40% of the prednisolone‐treated group, and only 20% of the dexamethasone‐treated group. Only the difference between the control and dexamethasone‐treated group was statistically significant. Taken together, our results clearly indicate that, in rabbits, rapid postburn administration of dexamethasone leads to significant reductions in the frequency and severity of strictures and in the severity of burns.
Variables Related to Urinary Calcium Excretion in Young Girls
Authors: O'Brien Kimberly O. , Abrams Steven A. , Stuff Janice E. , Liang Lily K. , Welch Thomas R.
Published: February 2024

The relations among dietary and calcium kinetic factors and 24‐h urinary mineral excretion were evaluated in a group of 89 healthy girls (51 white and 38 black) aged 4.9‐16.7 years. Nutrient intakes were calculated for each participant using a weighed intake of all food and beverage on the day of the 24‐h urine collection study and two subsequent 24‐h food records. A significant relation was noted between urinary calcium and sodium excretion (r = 0.55; p < 0.0001). No significant relations were found between urinary calcium and (a) calcium intake (r = 0.08), (b) protein intake (r = 0.14), or (c) phosphorus intake (r = 0.11). Urinary calcium was not significantly related to fractional calcium absorption (r = 0.03) or net calcium absorption (r = 0.11), but was significantly associated with the bone calcium deposition rate (r = 0.24; p < 0.03). Using a multiple regression model, both urinary sodium and the bone calcium deposition rate were independent predictors of urinary calcium excretion in this population (r = 0.57; p = 0.0001). A substantial number of the children in this population had urinary calcium excretion >4 mg/kg/day (12%). The incidence of hypercalciuria differed between the racial groups and was markedly higher in the white than in the black children (17.6 vs. 5.3%). Over a range of usual calcium intakes, during the rapid‐bone‐growth period in childhood and early adolescence, urinary calcium appears relatively unaffected by calcium intake and is most strongly associated with urinary sodium levels.
Risk of Low Vitamin B6 Status in Infants Breast‐Fed Exclusively Beyond Six Months
Authors: Heiskanen Kaarina , Siimes Martti A. , Perheentupa Jaakko , Salmenperä Leena
Published: February 2024

Our aim was to ascertain the adequacy of human milk as the sole source of vitamin B6 and the associations between maternal and infant status during extended exclusive breast‐feeding. Vitamin B6 status was followed in lactating mothers and their exclusively breast‐fed infants by determinations of erythrocyte pyridoxal 5′‐phosphate concentration and the erythrocyte aspartate transaminase stimulation test at 2 months (n = 118), 4 months (n = 118), 6 months (n = 112), 7.5 months (n = 70), 9 months (n = 36), 10 months (n = 14), 11 months (n = 11), and 12 months (n = 7) postpartum. Of the mothers, 54% had used vitamin B6 supplement during pregnancy, and all received a pyridoxine hydrochloride supplement of 1 mg/day throughout lactation. The infants had a higher vitamin B6 status than their mothers. During the first 4 months, infant vitamin B6 status was generally adequate independently of the actual vitamin status of the nursing mother. Most of the infants with low status at 2 months were those born to mothers who were not supplemented during pregnancy. By 6 months of exclusive breast‐feeding, 30% of cases of low vitamin B6 status in nursing mothers were reflected in their infants. Thereafter, the risk of low vitamin B6 status in exclusively breast‐fed infants increased even if the mother's status was adequate. Our findings suggest that gestationally accumulated stores are important for the maintenance of adequate vitamin B6 status of infants during the early months and that for some infants, human milk alone, without supplementary foods, may be insufficient to meet vitamin B6 needs after 6 months of age.
The 13C‐Octanoic Acid Breath Test: A Noninvasive Technique to Assess Gastric Emptying in Preterm Infants
Authors: Veereman‐Wauters G. , Ghoos Y. , van der Schoor S. , Maes B. , Hebbalkar N. , Devlieger H. , Eggermont E.
Published: February 2024

Gastric emptying (GE) is difficult to evaluate properly in preterm infants because of the lack of safe and reliable noninvasive methods. The 13C‐octanoic acid breath test, a noninvasive method to assess GE, was validated in adults. The aim of this study was to adapt the methodology of the 13C‐octanoic acid breath test regarding test meal and sampling methods and to define normal values for healthy preterm infants. We tested 11 clinically stable preterm infants who demonstreated normal fetal growth. The infant's mean gestational age at birth was 33 weeks, mean birth weight was 1754 g, mean postnatal age at the day of study was 26 days, and mean weight was 2296 g. After a fasting period of 3 h, the subject was fed a test meal with low and stable 13C background activity mixed with 50 μl of 13C‐labeled octanoic acid and 1 g polyethylene glycol 3350. Breath samples were collected using a nasal prong in basal conditions and after the test meal. CO2 production according to weight and age was used in the calculations for 13CO2 enrichment of exhaled air. Results were expressed as percentage of 13C dose excretion per hour and percentage of cumulative 13C after 4 h, gastric emptying coefficient (GEC), and gastric half‐emptying time (t½b). The values for percent of cumulative 13C after 4 h ranged from 30.7 to 52.6% (mean, 40.2%), GEC ranged from 2.7 to 3.4 (mean, 3.0), and the values for t½b ranged from 17 to 100 min (mean, 57 min). We conclude that the 13C‐octanoic acid breath test can be adapted to preterm infants to allow the study of GE in various conditions.
Plasma and Urine Riboflavin and Pyridoxine Concentrations in Enterally Fed Very‐Low‐Birth‐Weight Neonates
Authors: Porcelli Peter J. , Adcock Eugene W. , DelPaggio Dia , Swift Larry L. , Greene Harry L.
Published: February 2024

Preterm infant formulas (PIFs) for very‐low‐birth‐weight (VLBW) infants (birth weight, <1,500 g) are augmented to provide daily riboflavin and pyridoxine at levels up to five‐fold greater than in term infant formula and 18‐fold greater than in human milk. We evaluated plasma riboflavin and pyridoxine concentrations in VLBW infants who received PIF during their first postnatal month. Eighty‐eight plasma and 124 urine samples were collected for riboflavin‐ and pyridoxine‐concentration measurements from 57 clinically healthy VLBW infants weekly during their first postnatal month. Concentrations were measured using high‐performance liquid chromatography. At the time of the sample, patients were receiving ≥80% of their total calories via enteral feedings. Plasma riboflavin concentrations rose from 45.3 ± 7.3 ng/ml at baseline (mean ± SEM) to 173.5 ± 20.3 ng/ml by 1 week of age and remained at 177.3‐199.7 ng/ml during the following three weekly measurements; values were up to 14‐fold above baseline concentration. Urine riboflavin concentration increased from 534 ± 137 ng/ml at baseline to 3,521 ± 423 ng/ml by 1 week of age and remained at 4,451‐5,216 ng/ml during the next 3 weeks. In a similar pattern, baseline plasma (69.4 ± 10.4 ng/ml) and urine (145 ± 30 ng/ml) pyridoxine concentrations were significantly increased by 1 week postnatal age; they remained at 163‐248 ng/ml (plasma) and 1,573‐2,394 ng/ml (urine) through the first postnatal month. Plasma and urine riboflavin and pyridoxine concentrations in enterally fed VLBW infants increased from baseline concentrations by 1 week of postnatal age and remained elevated for the first postnatal month. High daily intake and immature renal development are probable contributing causes of the elevated plasma riboflavin and pyridoxine concentrations. We suggest that lower daily enteral administration of riboflavin and pyridoxine should maintain adequate blood concentrations and minimize potential toxicity.
Superoxide Dismutase Activity in Helicobacter pylori—Positive Antral Gastritis in Children
Authors: Broide Efrat , Klinowski Elieser , Varsano Rina , Eshchar Jerachmiel , Herbert Mehrdad , Scapa Eitan
Published: February 2024

Reactive oxygen metabolites have been implicated in gastric mucosal injuries. Superoxide dismutase, a scavenger of superoxide radical, is a key enzyme in gastric mucosal protection against several damaging factors. This study was aimed at investigating the relationship of superoxide dismutase activity to Helicobacter pylori—induced antral gastritis in children. Two groups of 11 children each, one positive and the other negative for Helicobacter pylori, were studied. Biopsies from the antrum and corpus were obtained for evaluation of Helicobacter pylori by CLOtest and histology as well as for superoxide dismutase activity (cytochrome c method). Erythrocytic and serum superoxide dismutase levels were determined as well. Superoxide dismutase activity was significantly higher only in the antrum of children with Helicobacter pylori—induced antral gastritis. There was no significant difference in superoxide dismutase activity in the corpus, erythrocytes, or serum of both groups. These findings may suggest a pathogenic relationship between the presence of Helicobacter pylori and oxygen radicals in inducing antral mucosal injury.
Plasma Amino Acid Concentrations in Healthy, Full‐Term Infants Fed Hydrolysate Infant Formula
Authors: Decsi T. , Veitl V. , Szász Mária , Pintér Z. , Méhes K.
Published: February 2024

The effect of feeding hydrolysate infant formula (HF) on protein and amino acid metabolism was investigated in healthy, full‐term infants who were either breast‐fed (BF, n = 10) or received conventional formula (CF, n = 10) or HF based on soy and beef collagen (n = 10) with equal total protein equivalent contents. There were no differences between groups for gain in weight, length, and head and chest circumferences throughout the study. Plasma concentrations of total proteins, albumin, urea nitrogen, uric acid, and creatinine as well as total amino acid and total essential amino acid concentrations did not differ at the ages of 2, 4, and 8 weeks. In contrast, significant differences were seen in concentrations of five free amino acids. Arginine concentrations were significantly higher at the age of 4 weeks in the infants fed HF than in the other groups (71 ± 12 versus 27 ± 6 and 30 ± 4, μmol/L, mean ± SEM, HF versus BF and CF, p < 0.01). Plasma histidine concentrations were also higher in infants receiving HF (4 weeks: 217 ± 33 versus 91 ± 18, HF versus BF, p < 0.01; 8 weeks: 218 ± 33 versus 105 ± 20, HF versus CF, p < 0.01). The most pronounced feeding‐related differences were seen in plasma glycine concentrations (2 weeks: 653 ± 89 versus 345 ± 55, HF versus BF, p < 0.01; 8 weeks: 613 ± 74 versus 385 ± 56 and 312 ± 46, HF versus BF and CF, p < 0.01), with the mean value exceeding the upper limit of the normal range in infants fed HF. Although the biological importance of the differences observed remains to be clarified, further investigations on amino acid metabolism are needed to establish the final nutritional safety of feeding hydrolysate infant formulae.
Comparison of Two Regimens of Feeding and Oral Electrolyte Solutions in Infants with Diarrhea
Authors: Goepp Julius G. , Katz Scott , Cuervo Elizabeth , Reid Raymond , Moran J. Roberto , Santosham Mathuram
Published: February 2024

Background:

Glucose‐based oral rehydration solutions (ORS) available in the United States do not appear to reduce the severity or duration of diarrhea. The use of cereal‐derived ORS and cereal‐based feedings appears to diminish the severity of illness in studies conducted in the developing world. To our knowledge, no controlled trials of cereal‐derived ORS or cereal‐based feedings have been performed in the United States.

Methods:

We performed a randomized, double‐blind trial of two ORS feeding regimens in outpatients with diarrhea. Patients aged 2‐13 months with acute watery diarrhea were enrolled. Subjects received standard glucose‐based ORS in alternation with soy‐based, lactose‐free infant formula (Group 1) or rice syrup solid containing ORS in alternation with rice‐based, lactose‐free infant formula (Group 2). Subjects were visited at home daily to determine the severity of illness and characteristics of the stool.

Results:

After the first 2 days, significantly more Group 1 subjects continued to have diarrhea than did Group 2 subjects (median duration of diarrhea 3 vs. 2 days) as demonstrated by Kaplan‐Meier survival curves (p = 0.04).

Conclusion:

We conclude that infants fed a regimen consisting of rice syrup solid containing ORS and rice formula resolved their diarrhea sooner than did infants fed a regimen of standard glucose‐based ORS with soy formula. The relative contributions of ORS and formula to this more rapid recovery can be elucidated by further studies.
Surgical Therapy and Follow‐up of Pancreatitis in Children
Authors: Petersen C. , Goetz A. , Bürger D. , Mildenberger H.
Published: February 2024

Background

Acute and chronic pancreatitis in children differ from that in adults both from the etiology and the therapeutic approach. Within the frame of a blunt abdominal trauma‐the most frequent cause in children‐acute pancreatitis is often detected by emergency laparotomy and external drainage is recommended. Chronic relapsing pancreatitis, and particularly its hereditary form, is very rare in children and requires a different therapeutic concept. The results of surgical therapy for both forms of pancreatitis in childhood were evaluated in the present study.

Methods

Sixteen patients with acute and chronic relapsing pancreatitis were operated on in our facility between 1976 and 1988. Their history and postoperative course were analyzed in a retrospective study, including a final examination at the end of the follow‐up period.

Results

Eight children with acute pancreatitis were operated on at an average age of 6 years and were followed up for an average of 7.5 years, with good results. The remaining children, aged between 3 and 14 years (average age of 9 years), were operated on for chronic relapsing pancreatitis. Our experience with early operative treatment, on average 2.7 years after onset of symptoms, is presented. Only three patients experienced a mild relapse during the follow‐up period of 2‐13 years (average of 5.4 years).

Conclusions

For acute pancreatitis in childhood, operative treatment by inner drainage is necessary and effective only in case of complications, should conservative treatment fail. In children with chronic relapsing pancreatitis, the good exocrine and the normal endocrine function of the pancreas in these patients justified the early operation. Timely treatment is recommended in cases with typical changes of the pancreatic duct so as to shorten the relapsing clinical problems of the children and to maintain the function of the pancreas.
Treatment of Childhood Peptic Esophagitis: A Double‐Blind Placebo‐Controlled Trial of Nizatidine
Authors: Simeone Domenico , Caria Maria Cristina , Miele Erasmo , Staiano Annamaria
Published: February 2024

Background:

Nizatidine is an H2 histaminic receptor blocker, which acts on the oxintic cells in the stomach. The efficacy of nizatidine on acid gastric secretion has been widely studied in adults with erosive and ulcerative esophagitis, but not in children. The aim of the present study was to evaluate the therapeutic efficacy of nizatidine in children with reflux esophagitis.

Methods:

Twenty‐six patients were studied; all of them underwent endoscopy with multiple esophageal biopsies and 24‐h intraesophageal pH monitoring. The diagnosis of esophagitis was based on histologic features. Patients were randomly assigned to double‐blind treatment with either nizatidine or a placebo (10 mg/kg/day in two doses) for 8 weeks. A symptomatic score assessment was evaluated during the study.

Results:

Twenty‐four patients completed the 8‐week protocol. After therapy, 9/13 (69%) patients on nizatidine and 2/13 (15%) patients on the placebo were healed (p < 0.007 by Fisher's exact test). Histological findings were improved in two other (16.7%) patients and unchanged in the last (8.3%) patient on nizatidine. In the placebo group there was histological improvement in three (25%) patients, no variation in six (50%), and worsening in one (8.3%). After therapy, determination of esophageal pH showed a statistically significant decrease of the total acid exposure time (p < 0.01) only in the nizatidine group. The clinical score analysis showed an improvement of symptoms only in the nizatidine group (p < 0.01), except for vomiting, which was reduced in both groups.

Conclusions:

Our results show that nizatidine is effective in treating children with reflux esophagitis. The children included in this study did not have severe esophagitis, and the conclusion must be limited to those with mild to moderate degrees of disease.
Normal Gastric Histology in Helicobacter pylori‐Infected Children
Authors: Gottrand F. , Cullu F. , Turck D. , Vincent P. , Michaud L. , Husson M. O. , Martin‐Delasalle E. , Farriaux J. P.
Published: February 2024

Background:

In adults, Helicobacter pylori infection is always associated with gastritis or ulcer. However, very active gastritis and ulcers are rarely seen in children. The aim of the present work was to study the relationships between H. pylori and gastric mucosa in children.

Methods:

Eighty infected children and adolescents including 48 (60%) neurologically impaired institutionalized patients, aged 2 months‐22 years (mean 11.7 ± 5.2 years) were studied retrospectively. All the patients underwent gastroscopy, and three antral and two fundic biopsy specimens were taken for histology and bacteriology.

Results:

A normal gastric mucosa was found in 22 of 80 patients (27.5%), whereas the others had gastritis (n = 58, 72.5%). There were no statistical differences between patients with normal histology and those presenting with gastritis for age, sex, ethnic background, symptoms, and the degree of bacterial colonization. The macroscopic aspect of gastritis was less frequently found in children with a normal histology compared with those with histological gastritis (p < 0.001).

Conclusions:

These data show that H. pylori infection can be associated with a normal gastric histology in children.
Introduction of 6‐Mercaptopurine in Crohn's Disease Patients During the Perioperative Period: A Preliminary Evaluation of Recurrence of Disease
Authors: Kader Howard A. , Raynor Stephen C. , Young Rose , Kaufman Stuart S. , Vanderhoof Jon , Ruby Elizabeth I. , Mack David R.
Published: February 2024

Background:

Recurrence of Crohn's disease after surgery is a common occurrence, pointing to the need for a strategy to prevent recurrent disease. We report the postoperative course of 10 patients who required intestinal resections for complications related to Crohn's disease.

Methods:

All patients had a Pediatric Crohn's Disease Activity Index score of 10 or greater. Among these patients, 5 began treatment with 6‐mercaptopurine in the perioperative period. All 10 had received various combinations of prednisone and salicylate compounds. Patients who were given 6‐mercaptopurine did not discontinue the medication until 2 years after the surgery.

Results:

To date, none of the five patients who were placed on 6‐mercaptopurine have had recurrence of their Crohn's disease (mean disease‐free period 32.6 ± 18.4 months). Among those five patients not receiving 6‐mercaptopurine there have been three relapses (mean time to relapse 3.7 ± 1.2 months). Logrank sum analyses of Kaplan‐Meier survival curves show benefit to patients receiving 6‐mercaptopurine in preventing relapses after intestinal resection (p < 0.05).

Conclusions:

Although the underlying pathophysiologic reasons leading to the high relapse rate after intestinal surgery in Crohn's disease are unknown, we conclude that treatment with 6‐mercaptopurine in the perioperative period may be warranted to help prevent the recurrence of Crohn's disease after surgery.
Transpyloric Enteral Feeding in Critically Ill Children
Authors: Panadero Esther , López‐Herce Jesus , Caro Lourdes , Sanchez Amelia , Cueto Elisa , Bustinza Amaya , Moral Ramon , Carrillo Angel , Sancho Luis
Published: February 2024

Background:

Nutrition is important in childhood because the child has a lower energy reserve than the adult and a higher demand for calories because of ongoing growth. In this study, the utility of transpyloric enteral feeding (TEF) in critically ill children was evaluated.

Methods:

A prospective, descriptive study was made in a pediatric intensive care unit of a tertiary pediatric center of 41 critically ill children, 30 after surgical procedures and 11 with nonsurgical illness, aged 8 days to 12 years, who received transpyloric enteral feeding with 8‐ or 10‐Fr weighted feeding tubes. Analysis was made of tolerance and complications (vomiting, abdominal distension, excessive gastric residual, diarrhea, and pulmonary aspiration) of TEF.

Results:

The mean duration of TEF was 19.5 ± 26.8 days (range, 1‐120 days). The administration of sedative agents or inotropic drugs did not alter toleration of TEF. Eight of 12 patients treated with continuous infusion of vecuronium tolerated TEF without complications. Eleven gastrointestinal complications occurred in 10 patients, abdominal distension and excessive gastric residual in 7 (17%), and diarrhea in 4 (9.7%). In 7 patients gastrointestinal complications improved, with decreasing use or transitory interruption of TEF, but in 4 patients (9.7%), TEF had to be withdrawn. Gastrointestinal complications were more frequent in postsurgical than in nonsurgical patients (p < 0.001). No patients suffered from pulmonary aspiration, and the incidence of pulmonary infection and hepatic dysfunction diminished during TEF.

Conclusions:

Transpyloric enteral feeding is a good method of nutritional support in critically ill children and can be used in patients treated with neuromuscular blocking agents. The frequency and severity of complications and the risks of pulmonary infection and hepatic dysfunction related to TEF are low.
Vitamin E Status in Preterm Infants: Assessment by Plasma and Erythrocyte Vitamin E‐Lipid Ratios and Hemolysis Tests
Authors: van Zoeren‐Grobben Diny , Jacobs Nicole J. M. , Houdkamp E. , Lindeman Jan H. N. , Drejer Dik F. , Berger Howard M.
Published: February 2024

Background:

Vitamin E is an essential component of the antioxidant defenses, but supplementation can have side effects in the preterm infant. Careful monitoring of vitamin E status is thus essential, however no consensus has been reached on the best clinical method.

Methods:

In 47 healthy preterm infants, several methods for assessment of vitamin E status were evaluated: plasma and erythrocyte vitamin E levels were measured, vitamin E lipid ratios were calculated, and two variations of the hydrogen peroxide hemolysis test were conducted.

Results:

At birth, the plasma and erythrocyte vitamin E levels were low. After birth, the plasma levels rose gradually, whereas the erythrocyte levels remained low. In contrast, the vitamin E‐total‐lipid ratio was in the low normal range from birth onwards. Vitamin E‐lipid ratios using two lipid components (cholesterol with triglycerides, or cholesterol with phospholipids) or one lipid component (cholesterol) correlated with the vitamin E‐total‐lipid ratio with a good sensitivity and specificity. The susceptibility of erythrocytes to hydrogen peroxide‐induced damage (measured as potassium release or malondialdehyde production) was high at birth and declined after birth. However, this susceptibility did not correlate with plasma or erythrocyte vitamin E levels or vitamin E‐total‐lipid ratio, and the hydrogen peroxide hemolysis test is not a reliable indicator of vitamin E status in preterm infants.

Conclusions:

Our study indicated that a gold standard for clinical assessment of vitamin E status in preterm infants is yet to be found.
Copper in Infant Nutrition: Safety of World Health Organization Provisional Guideline Value for Copper Content of Drinking Water
Authors: Olivares Manuel , Pizarro Fernando , Speisky Hernán , Lönnerdal Bo , Uauy Ricardo
Published: February 2024

Background:

Copper is an essential nutrient for humans. Recently, a limit of 31.48μmol/l (2 mg/l) was proposed by the World Health Organization as the provisional guideline value for copper content of drinking water. The objective of the study was to determine the tolerance of chronic exposure to drinking water with low or high copper content in infants.

Methods:

Healthy infants (n = 128) were randomly assigned to receive drinking water with less than 1.57 μmol/l (<0.1 mg/l) (n = 48) or 31.48 μmol/l (2 mg/l) of copper (n = 80) from 3 to 12 months of age. At 6, 9, and 12 months of age, serum concentrations of copper, ceruloplasmin, and superoxide dismutase; erythrocyte metallothionein; bilirubin; transaminases; and γ‐glutamyl transferase were measured.

Results:

Small differences in biochemical indexes of copper nutrition were observed between the groups, but there was no evidence of adverse or toxic effects. These findings may be explained by an adaptive response to the higher copper intake, limiting copper absorption, and increasing biliary secretion, as well as by an increase in copper storage. It is also possible that the sensitivity of the biochemical indicators employed to detect differences in copper status is limited.

Conclusion:

No acute or chronic adverse consequences of consuming water with copper content of 31.48 μmol/l (2 mg/l) were detected in infants during the first year of life. The results support the safety of the World Health Organization's provisional guideline value for copper in drinking water during infancy.
Lack of Correlation Between Genotype and Phenotype in Celiac Disease
Authors: Greco Luigi , Percopo Selvaggia , Clot Fabienne , Bouguerra Faouzi , Babron Marie‐Claude , Eliaou Jean‐François , Franzese Carlo , Troncone Riccardo , Clerget‐Darpoux Françoise
Published: February 2024

Background:

Celiac disease has a wide range of clinical features. The goal of this study was to evaluate whether specific HLA genotypes are associated with particular clinical appearances.

Methods:

One hundred forty‐five patients with confirmed celiac disease were oligotyped for DR and DQ HLA genes. Clinical notes, physical examination, and a questionnaire provided their personal data. Patients were grouped into nine genotypic categories, according to the presence of the specific DQ heterodimer DQA1*0501‐DQB1*0201 (hence termed α0β0), in single or double dose, and the presence of the DRB4 antigen.

Results:

Age at first symptoms and age at beginning of glutenfree diet were not significantly different in the nine groups. The initial symptoms of the disease had a similar distribution in all groups. In twenty‐seven patients, disease was diagnosed by family screening: they shared a similar HLA genotype with those who had relevant symptoms. The actual growth status‐evaluated by standardized height, percentage of median weight for age, and percentage of median weight for height‐was not different in the nine groups. Presence of unusual health complaints was not associated with a specific genotype.

Conclusions:

There is no evidence that clinical features of celiac disease are associated with different HLA genotypes. Genes outside the HLA may play a relevant role.
Effect of Formula Supplemented with Docosahexaenoic Acid andγ‐Linolenic Acid on Fatty Acid Status and Visual Acuity in Term Infants
Authors: Jørgensen Marianne Hørby , Hølmer Gunhild , Lund Pia , Hernell Olle , Michaelsen Kira Fleischer
Published: February 2024

Background:

Docosahexaenoic acid is present in high concentration in retina and does not influence visual development in preterm infants. It is still under discussion whether docosahexaenoic acid is important for visual development in term infants.

Methods:

Thirty‐seven infants fed formula for a median of 14 days were randomized at median age of 25 days to three formulas: a) DHAGF: 0.3 wt% docosahexaenoic acid and 0.5 wt% γ‐linolenic acid; b) DHAF 0.3 wt% docosahexaenoic acid; or c) STF: standard formula without long‐chain polyunsaturated fatty acids and 17 breast‐fed infants were observed, using blood samples and anthropometric measurements from 1 to 4 months of age. At 4 months, visual acuity was measured by swept steadystate visual evoked potential. A cross‐sectional study on 25 breast‐fed infants was carried out as a reference group for the analyses.

Results:

Infants fed the two docosahexaenoic acid‐supplemented formula had relative docosahexaenoic acid concentrations in red blood cell phospholipids almost as high as those in breast‐fed infants, whereas infants in the standard formula group had significantly lower levels. The addition of γ‐linolenic acid to the formula had a positive effect on red blood cell arachidonic acid levels, compared with levels obtained using fish oil only. Visual acuity was significantly different among all feeding groups (analysis of variance;p = 0.05, means ± standard deviation: breast‐fed, 0.37± 0.06 logMAR; DHAF and DHAGF combined, 0.40 ± 0.07 logMAR; and standard formula 0.44 ± 0.07 logMAR. However, there was no statistical difference among the formula groups. In a multiple regression analysis including all formula‐fed infants, weight at delivery (p = 0.002), but not type of formula, was significantly associated with visual acuity at 4 months of age.

Conclusions:

The addition of docosahexaenoic acid resulted in concentrations in red blood cells at similar levels as those in breast‐fed infants, whereas the increase in visual acuity did not reach significance. The addition ofγ‐linolenic acid resulted in higher arachidonic acid concentrations in red blood cells.
Functional Results of Laparoscopic Fundoplication in Children
Authors: Tovar Juan A. , Olivares Pedro , Diaz Mercedes , Pace Rosa A. , Prieto Gerardo , Molina Manuel
Published: February 2024

Background:

There is no evidence that the results of laparoscopic fundoplication in children match those of the open procedure. In the current report, pre‐ and postoperative function of the antireflux barrier is examined in children having laparoscopic fundoplication for gastroesophageal reflux.

Methods:

Twenty‐seven patients with gastroesophageal reflux, aged 7.2 ± 4.5 years, were operated on for unremitting gastrointestinal symptoms (n= 24), with respiratory tract disease (n = 11), cystic fibrosis(n = 2), or brain damage (n = 11). Gastrostomy was added in 5 cases. Barium contrast study, pH‐metering, endoscopic examination, and biopsy were performed before and after a median of 19 months (range, 8 to 46) after operation.

Results:

At diagnosis, 15 of 21 patients had esophagitis that was moderate or severe in 11 (1 with Barrett's esophagus). Symptoms disappeared after fundoplication in all but 2 patients, in whom they became milder. The reflux index decreased from 20.2 ± 20% to 4.9 ± 9% and became normal in all except 4 children (2 with brain damage and 1 with cystic fibrosis). Open repair of the failed wrap was considered necessary in only 1 of them.

Conclusions:

Laparoscopic fundoplication is as effective as the open procedure (14% overall failure rate). However, the failure rate in neurologic patients (18%) suggests that before reaching conclusions on the benefits of this approach, careful long‐term assessment of the functional results is necessary.
Hypocaloric Oral Therapy During an Episode of Diarrhea and Vomiting Can Lead to Severe Malnutrition
Authors: Baker Susan S. , Davis Anne M.
Published: February 2024

Background:

Malnutrition associated with diarrhea and vomiting can be prevented if the focus of treatment is on nutritional requirements. Some pediatricians inappropriately continue to recommend clear liquids followed by dilute feedings or hypocaloric diets until the diarrhea clears.

Methods:

Medical records were retrospectively reviewed, and the literature was reviewed.

Results:

Severe malnutrition occurred in two children with diarrhea and vomiting who were treated with clear liquids followed by restricted nutrient intake.

Conclusions:

Severe malnutrition associated with diarrhea and vomiting can occur when the prescribed treatment is bowel rest followed by hypocaloric diets until diarrhea clears. Malnutrition can be prevented if the focus of treatment is on nutritional requirements. Current American Academy of Pediatrics recommendations for treatment of diarrhea and vomiting are discussed.
Growth Hormone Resistance and Somatomedins in Children with End‐Stage Liver Disease Awaiting Transplantation
Authors: Greer Ristan M. , Quirk Paul , Cleghorn Geoffrey J. , Shepherd Ross W.
Published: February 2024

Background:

The success of orthotopic liver transplantation as treatment for end‐stage liver disease has prompted investigation of strategies to maintain or improve nutrition and growth in children awaiting transplantation, because malnutrition is an adverse prognostic factor. The purpose of this study was to evaluate the effect of recombinant human growth hormone therapy on body composition and indices of liver function in patients awaiting transplant.

Methods:

The study was designed as a placebo‐controlled, double‐blind, crossover trial. Patients received 0.2 U/kg growth hormone, subcutaneously, or placebo daily for 28 days during two treatment periods, separated by a 2‐week washout period. Ten patients (mean age, 3.06 ± 1.15 years; range, 0.51‐11.65 years, five men), with extrahepatic biliary atresia (n= 8) or two with Alagille's syndrome (n = 2), with end‐stage liver disease, completed the trial while awaiting orthotopic liver transplantation. Height, weight, total body potassium, total body fat, resting energy expenditure, respiratory quotient, hematologic and multiple biochemical profile, number of albumin infusions, insulin‐like growth factor‐1 and 1, growth hormone binding protein (GHBP), and insulin‐like growth factor binding protein‐1 (IGFBP‐1) and insulin‐like growth factor binding protein (IGFBP‐3) were measured at the beginning and end of each treatment period.

Results:

Growth hormone treatment was associated with a significant decline in serum bilirubin (‐34.6 ± 16.5 µmol/l vs. 18.2 ± 11.59µmol/l; p < 0.02) but there was no significant effect on any anthropometric or body composition measurements, or on any biochemical or hematologic parameters.

Conclusions:

These children with end‐stage liver disease displayed growth hormone resistance, particularly in relation to the somatomedin axis. Exogenous growth hormone administration may be of limited value in these patients.
Helicobacter pylori Infection May Undergo Spontaneous Eradication in Children: A 2‐Year Follow‐Up Study
Authors: Perri Francesco , Pastore Maria , Clemente Rocco , Festa Virginia , Quitadamo Michele , Niro Grazia , Conoscitore Pasquale , Rutgeerts Paul , Andriulli Angelo
Published: February 2024

Background:

Helicobacter pylori infection is generally acquired early in life. However, it is still unknown whether a spontaneous eradication can occur. The purpose of this study was to evaluate whether H. pylori infection can undergo spontaneous eradication in children.

Methods:

Three hundred and four Italian children (age range, 4.5 to 18.5 years) were tested for H. pylori by means of 13C‐urea breath test. Infected children were followed up every 6 months for as long as 2 years. Parents were instructed to record consumption of antibiotics. At each visit, children underwent a repeat 13C‐urea breath test.

Results:

Eighty‐five out of 304 (27.9%) children were H. pylori infected. Forty‐eight out of 85 infected children (56.4%) participated in the follow‐up study. After 2 years, 8 (16.6%) infected children had negative results on 13C‐urea breath tests; 2 of them were given antibiotics for concomitant infections. One child was negative at 6 months but became positive again at the next 6‐month 13C‐urea breath test. Forty children remained persistently positive; of them, 10 were treated with a short course of antibiotics.

Conclusions:

Our findings support the hypothesis that, at least during childhood,H. pylori infection may be a fluctuating disease with spontaneous eradication and possible recurrence.