bluuebunny/crossref_metadata_2025_split huggingface dataset:
Media Violence
Authors:   Committee on Communications
Published: December 2021

American children and adolescents are being exposed to increasing amounts of media violence, especially in television, movies, video games, and youth-oriented music. By age 18, the average young person will have viewed an estimated 200 000 acts of violence on television alone.1 Video game violence, children's cartoons, and music lyrics have become increasingly graphic. In movies, action films depict anatomically precise murders, rapes, and assaults; with each sequel, the number of deaths increase dramatically.2 Although media violence is not the only cause of violence in American society, it is the single most easily remediable contributing factor.3
According to recent Nielsen data, the average American child views 21 to 23 hours of television per week.4 By the time today's children reach age 70, they will have spent 7 to 10 years of their lives watching television.5 Although movies and video games are more graphic in depictions of violence, television is the single most important medium in the lives of young people (98% of all American house-holds have at least one television set).4 Despite public concern about television violence, the amount of television violence has not changed appreciably in the past two decades: the level of prime-time violence has remained at three to five violent acts per hour, and violence in Saturday morning children's programming ranges between 20 to 25 violent acts per hour.6-8 American media are the most violent in the world, and American society is now paying a high price in terms of real-life violence.9,10
Some people in the entertainment industry maintain that: 1) violent programming is harmless because no studies exist that prove a connection between violence in the media and aggressive behavior in children and 2) young people know that television, movies, and video games are simply fantasy.11
Health Care for Children of Farmworker Families
Authors:   Committee on Community Health Services
Published: December 2021

Migrant and seasonal farmworkers constitute a major portion of the labor force in the American agricultural industry. By harvesting and processing farm crops, they contribute positively to farm communities and the American economy.
In 1988, the Office of Migrant Health estimated that nationwide migrant and seasonal farmworkers and their dependents numbered between 3 and 5 million.1 The majority of farmworkers are married and/or have children. Only 10% to 25% of farmworkers are estimated to be unauthorized workers. The average annual income for migrant and seasonal farmworkers is well below the poverty level despite the prevalence of families with two wage earners. Although most farmworker families qualify for some type of public assistance, only 18% actually receive it.2 Because health care insurance is invariably beyond the reach of farmworker family budgets, and employers of farmworkers rarely provide health care benefits for their employees, these families are usually uninsured. In some cases, these families lack US citizenship or are in this country illegally, further limiting access to health care for their children. Medicaid eligibility is complicated by migration, because different eligibility requirements must be met in each state.
Because of their income level, lack of insurance, and mobile lifestyle, families of farmworkers often find that comprehensive child health care (health maintenance, anticipatory guidance, and preventive medicine) is essentially unavailable. Additionally, recent changes in immigration policy and economic developments have resulted in a rapid growth of population that is not parallelled by the growth of health care facilities. Other problems that delay or prevent access to health care for the children of farmworker families include language barriers and differences in culture.
Factors Related to Immunization Status Among Inner-City Latino and African-American Preschoolers
Authors: Wood David , Donald-Sherbourne Cathy , Halfon Neal , Tucker M. Belinda , Ortiz Vilma , Hamlin Julie Shea , Duan Naihua , Mazel Rebecca M. , Grabowsky Mark , Brunell Philip , Freeman Howard 
Published: December 2021

Objective. To identify factors associated with undervaccination at 3 months and 24 months among low-income, inner-city Latino and African-American preschool children.
Design. Interviews with a representative sample of inner-city families using a cross-sectional, multi-stage, cluster-sample design combined with a replicated quota sampling approach.
Setting. South Central and East Los Angeles areas in inner-city Los Angeles.
Population. Eight hundred seventeen Latino and 387 African-American families with children between 12 and 36 months of age.
Main Outcome Variables. Being fully immunized or up-to-date (UTD) at 3 months (1 diphtheria-tetanus-pertussis vaccine and 1 oral polio vaccine) and 24 months of age (4 diphtheria-tetanus-pertussis vaccines, 3 oral polio vaccines, and 1 measles-mumps-rubella vaccine).
Methods. Logistic regressions of UTD immunization status at 3 and 24 months by population and health care system factors.
Results. Seventy percent of Latino children and 53% of African-American children were UTD at 3 months of age. At 24 months of age, 42% of Latino children and 26% of African-American children were UTD on their immunizations. Receipt of the first immunizations by 3 months was associated with smaller family size, and evidence of connection to prenatal care. Latino children were less likely to be UTD at 24 months if they obtained well child care from private providers versus public clinics (odds ratio [OR] = 0.45, 95% confidence interval [CI] = 0.26, 0.79). There was also a trend for Latino children to be less well immunized if they were in health maintenance organizations versus public clinics (0.31, .0.05 &lt; P &lt; .1). African-American children were more likely to be UTD at 24 months if they were UTD at 3 months (OR = 5.56, 95% CI = 1.43, 21.6), had more health visits (OR = 1.13, 95% CI = 1.01, 1.27), and were less likely to be UTD at 24 months if they were on Medicaid versus private insurance (OR = 0.26, 95% CI = 0.08, 0.90).
Implications. Both African-American and Latino children in inner-city Los Angeles have low immunization rates at 3 and 24 months. Prenatal care and family size are strongly associated with being UTD by 3 months; however, family and child characteristics are relatively unimportant predictors of being UTD at 24 months of age. Important risk factors for underimmunization at 2 years of age in the inner-city, low-income communities studied include type of health insurance and source of well child care, with the public sector having higher rates than private doctors' offices or health maintenance organization/managed care plans.
The Relationship of Selenium Status to Respiratory Outcome in the Very Low Birth Weight Infant
Authors: Darlow Brian A. , Inder Terrie E. , Graham Patrick J. , Sluis Karl B. , Malpas Tim J. , Taylor Barry J. , Winterbourn Christine C. 
Published: December 2021

Objective. To examine the relationship between plasma and erythrocyte selenium and glutathione peroxidase (GPx) levels in premature infants and outcome measures.
Design. Prospective observational longitudinal study.
Setting. Two regional neonatal intensive care units in the South Island of New Zealand, an area with low soil selenium.
Patients. Seventy-nine infants with birth weights less than 1500 g or gestation less than 32 weeks admitted within 48 hours of birth from November 1992 through November 1993.
Main Outcome Measures. Oxygen requirement at 28 days (chronic lung disease), or 36 weeks postmenstrual age and for all or most of the time from birth (bronchopulmonary dysplasia), total days in oxygen, retinopathy of prematurity, periventricular hemorrhage, or ventricular dilatation.
Results. Initial infant plasma selenium and GPx levels were about two thirds of maternal levels and fell a further 30% in 28 days. In contrast to adults, there was a poor correlation in infant plasma between selenium and GPx at birth and 28 days. Plasma selenium at 28 days was significantly lower in infants with chronic lung disease and bronchopulmonary dysplasia. After controlling for gestational age and age when fully fed orally, 28-day plasma selenium was significantly associated with the log of total days of oxygen requirement, each drop of 0.1 µmol/L in 28-day selenium being associated with a 58% increase in days of oxygen dependency. No significant associations of other parameters of selenium status and respiratory outcome were found, and there were no significant associations of any parameters of selenium status with other outcome measures.
Conclusions. This study demonstrates for the first time in human infants that low plasma selenium levels are significantly associated with an increased respiratory morbidity. Whether selenium deficiency is etiologically important in determining the respiratory outcome or the result of sickness in the infant should be investigated in a randomized, controlled trial.
Enzyme Replacement Therapy for Gaucher Disease: Skeletal Responses to Macrophage-targeted Glucocerebrosidase
Authors: Rosenthal Daniel I. , Doppelt Samuel H. , Mankin Henry J. , Dambrosia James M. , Xavier Ramnik J. , McKusick Kenneth A. , Rosen Bruce R. , Baker John , Niklason Loren T. , Hill Suvimol C. , Miller Stephen P. F. , Brady Roscoe O. , Barton Norman W. 
Published: December 2021

Objectives. Reversal of the hematologic and visceral abnormalities characteristic of Gaucher disease, the most common lipid storage disorder, with biweekly infusions of macrophage-targeted glucocerebrosidase (glucosylceramidase) is well documented. The extent to which the skeleton responds to enzyme replacement therapy has not been systematically investigated.
Methods. To assess the skeletal response to enzyme replacement therapy, we treated 12 patients with type 1 Gaucher disease, who had intact spleens, with macrophage-targeted glucocerebrosidase. The initial dose of enzyme was 60 U/kg body weight every 2 weeks for 24 months, followed by reduction in dosage to 30 and then 15 U/kg body weight every 2 weeks, each for 9 months.
Results. The lipid composition of bone marrow, determined by direct chemical analysis, began to improve after 6 months of treatment at a time when noninvasive imaging studies showed no significant changes. By 42 months, improvement in marrow composition was demonstrable on all noninvasive, quantitative imaging modalities (magnetic resonance score, quantitative xenon scintigraphy, and quantitative chemical shift imaging) used in this study. Quantitative chemical shift imaging, the most sensitive technique, demonstrated a dramatic normalization of the marrow fat content in all patients. Net increases in either cortical or trabecular bone mass, as assessed by combined cortical thickness measurements and dual-energy quantitative computed tomography, respectively, occurred in 10 patients.
Conclusions. Prolonged treatment over 3½ years with macrophage-targeted glucocerebrosidase produces objective reversal of disease in both the axial and appendicular skeleton in patients with Gaucher disease. Marked improvement occurs in marrow composition and bone mass in both children and adults.
Humeral Fractures Without Obvious Etiologies in Children Less Than 3 Years of Age: When Is It Abuse?
Authors: Strait Richard T. , Siegel Robert M. , Shapiro Robert A. 
Published: December 2021

Objective. To determine the occurrence and frequency of abuse in children with humeral fractures without immediately obvious etiologies who are less than 3 years old and present with arm injuries.
Methods. A retrospective chart review was conducted of all children less than 3 years old treated for a humeral fracture at Children's Hospital Medical Center between July 1, 1990, and September 10, 1993. One hundred twenty-four charts of children with humeral fractures were reviewed for possible abuse using previously developed criteria. Charts were evaluated independently by the investigators. Consensus was reached on classification of each chart into the following categories: abuse, indeterminate, or not abuse.
Results. Abuse was diagnosed in 9 of 25 (36%) children less than 15 months of age, but in only 1 of 99 (1%) children older than 15 months (P &lt; .05). Abuse was excluded in 91 of 124 (73%) children. No determination of abuse (indeterminate) could be made in 23 of 124 (18.5%) children. In children less than 15 months of age, abuse was diagnosed in 2 of 10 (20%) with supracondylar fractures and in 7 of 12 (58%) with spiral/oblique fractures.
Conclusion. The prevalence of abuse in our children presenting with humeral fractures was much lower than in other published reports, especially in the children over the age of 15 months. However, we found a higher prevalence of supracondylar fractures associated with abuse than those same reports. Given these findings, abuse should be considered in all children less than 15 months of age with humeral fractures, including those with supracondylar fractures. The majority of humeral fractures in children are accidental, especially beyond the age of 15 months.
Treatment of Acute Streptococcal Pharyngitis and Prevention of Rheumatic Fever: A Statement for Health Professionals
Authors: Dajani Adnan , Taubert Kathryn , Ferrieri Patricia , Peter Georges , Shulman Stanford ,   Committee on Rheumatic Fever, Endocarditis, and Kawasaki Disease of the Council on Cardiovascular Disease in the Young,   American Heart Association
Published: December 2021

Primary prevention of acute rheumatic fever is accomplished by proper identification and adequate antibiotic treatment of group A β-hemolytic streptococcal (GAS) tonsillopharyngitis. Diagnosis of GAS pharyngitis is best accomplished by a throat culture. Penicillin (either oral penicillin V or injectable benzathine penicillin) remains the treatment of choice, because it is cost effective, has a narrow spectrum of activity, has long-standing proven efficacy, and GAS resistant to penicillin have not been documented. Various macrolides, oral cephalosporins, and other β-lactam agents are acceptable alternatives, particularly in penicillin-allergic individuals.
The individual who has had an attack of rheumatic fever is at very high risk of developing recurrences after subsequent GAS pharyngitis and needs continuous antimicrobial prophylaxis to prevent such recurrences (secondary prevention). The duration of prophylaxis depends on the number of previous attacks, the time lapsed since the last attack, the risk of exposure to streptococcal infections, the age of the patient, and the presence or absence of cardiac involvement. Penicillin is again the agent of choice for secondary prophylaxis, but sulfadiazine or erythromycin are acceptable alternatives in penicillin-allergic individuals.
This report is an update of a 1988 statement by this committee. It expands on the previous statement, includes more recent therapeutic modalities, and makes more specific recommendations for the duration of secondary prophylaxis.
Chorioamnionitis and Early Lung Inflammation in Infants in Whom Bronchopulmonary Dysplasia Develops
Authors: Watterberg Kristi L. , Demers Laurence M. , Scott Susan M. , Murphy Shirley 
Published: December 2021

Objective. The development of bronchopulmonary dysplasia (BPD) often has been attributed to injury from mechanical ventilation and supplemental oxygen. Early lung inflammation in infants with BPD has been thought to be secondary to these factors. The purpose of this study was to evaluate whether preexisting (prenatal) inflammation may be a primary causative factor in the development of BPD.
Methods. Intubated newborns of less than 2000 g birth weight were prospectively enrolled. The presence or absence of chorioamnionitis was documented. Lung inflammation was evaluated on days 1, 2, and 4 of intubation by assaying concentrations of interleukin 1β(IL-1β), thromboxane B2, leukotriene B4, and prostaglandin E2 in tracheal lavages. Infants in whom BPD developed were compared with those in whom it did not using these measures.
Results. Fifty-three infants were enrolled; 41 survived. Thirty-eight had respiratory distress syndrome; 15 were intubated for other diagnoses. Infants prenatally exposed to chorioamnionitis were less likely to present with respiratory distress syndrome; however, chorioamnionitis was significantly associated with both the presence of IL-1β from the first day of intubation and the development of BPD. Tracheal lavage concentrations of IL-1β were higher in infants in whom BPD developed. Thromboxane B2 concentrations were similar on day 1 but were higher on days 2 and 4 in infants in whom BPD developed.
Conclusions. In this study, intubated infants weighing less than 2000 g at birth in whom BPD developed had increased exposure to inflammation prenatally (chorioamnionitis) and evidence of increased lung inflammation from the first postnatal day. We speculate that chorioamnionitis may accelerate lung maturation but that it also causes lung inflammation and subsequent lung injury in intubated infants, fostering the development of BPD.
WHAT A SHAMEFUL CONTRAST!
Authors: Student  
Published: December 2021

Poor children in the United States are poorer than the children in most other Western industrialized nations, as young Americans suffer the brunt of several trends toward greater economic inequality, a new study shows . . . The United States has the widest gap between rich and poor . . . the United States also has less generous social programs than the other 17 countries in the study.
In 1950, fewer than 1 million American families earned as much as $60,000 in today's money. So rare was real wealth that the Census Bureau did not even keep numbers on incomes greater than that. As recently as 1967, only slightly more than 1 million American families earned more than $100,000 a year (in 1993 dollars) . . . But by 1980, 2.7 million lucky households counted incomes of more than $100,000. And by 1993, this group has doubled again, to 5.6 million households. And nearly 1 million American households were enjoying incomes over $200,000 . . . Nothing like this immense crowd of wealthy people has been seen in the history of the planet.
"DR UNNECESSARY"
Authors: L. J. F. 
Published: December 2021

The old reality for many psychiatrists was a private practice filled with long-term patients who paid $100 or more for 50 minutes of talk. The new reality? Managing medication for up to 30 new patients a week for half the hourly fee—and answering to case managers who aren't even doctors.
No wonder the number of U.S. medical school graduates in psychiatric residencies dropped nearly 12%—to 3909 from 4447—between 1988 and 1994.
The blame—or the credit—goes to managed care, the catchall term for the revolution that has swept through both the medical and mental health care fields in recent years. Desperate to cut runaway health insurance costs, most companies have axed longstanding fee-for-service plans and instead steer employees seeking psychiatric treatment to health maintenance organizations or specialized managed-care firms.
These organizations decide the type and amount of care patients receive. Psychiatrists have to get with the program—and agree to its treatment plans and fee schedules—or watch the bulk of their practices disappear. Only the rare psychiatrist can attract private patients wealthy enough to pay for traditional psychotherapy without the benefit of insurance.
Fundus Pigmentation in Retinopathy of Prematurity
Authors: Monos Tova , Rosen Shirley D. , Karplus Michael , Yassur Yuval 
Published: December 2021

Objective. A prospective study design was used to investigate the association between different degrees of fundus pigmentation and the incidence of retinopathy of prematurity (ROP) among very low birth weight infants in a large neonatal intensive care unit.
Methods. The study group consisted of 161 infants weighing 1500 g or less at birth and included all infants born from 1988 to 1990 who survived at least 10 weeks. Presence or lack of any acute stage ROP was determined by weekly ophthalmological examination from the age of 4 weeks. The degree of fundus pigmentation was recorded for each infant during the first examination.
Results. Infants with dark fundus pigmentation were found to be at half the risk of developing ROP as compared with the infants having light/medium fundus pigmentation (relative risk 0.5;95% confidence interval = 0.2-1.1). When controlling for birth weight, gestational age, length of oxygen therapy, and ethnic group in multivariate analysis, dark pigmentation was an independent and statistically significant protective factor (odds ratio = 0.09, 95% confidence interval = 0.02-0.6). None of the infants with Stage III ROP or higher had dark pigmentation.
Conclusion. We speculate that large amounts of melanin in the retinal pigment epithelium or choroid may protect the dark-pigmented very low birth weight infant from developing ROP.
Radiation Exposure From Diagnostic Radiographs in Extremely Low Birth Weight Infants
Authors: Wilson-Costello Deanne , Rao Pejavar S. , Morrison Stuart , Hack Maureen 
Published: December 2021

Objective. We sought to examine radiation doses received by infants of less than 750 g birth weight from radiographs.
Methods. We examined the radiology records, including radiograph films, of all 25 surviving infants with birth weight less than 750 g admitted to our center during 1991. The standard method of neonatal radiation dose calculation was modified to consider the body size, postnatal growth, and extramedullary hematopoiesis of the extremely low birth weight infant. To determine overall radiation exposure, we calculated an effective dose equivalent, which is the sum of weighted organ dose equivalents.
Results. The infants had a mean of 31 radiographs performed, including 17 chest radiographs, 5 babygrams, and 9 abdominal radiographs. The majority of chest radiographs and babygrams were performed in the first month, whereas abdominal radiographs increased during the second month of life. Total-body radiation dose and total effective dose equivalent by the standard and modified methods, respectively, for single exposures ranged from 0.01 to 0.02 millisieverts (mSv) for a chest radiograph, from 0.02 to 0.04 mSv for a babygram, and from 0.01 to 0.03 mSv for an abdominal radiograph. Surface organs including the skin, breast, and thyroid received the largest radiation doses. The effective dose equivalent per infant for all radiographs was 0.72 mSv according to the modified method, compared with a total-body dose of 0.40 mSv using the standard method. However, infants with chronic lung disease or necrotizing enterocolitis received up to 1.5 mSv total-body dose, including 3.3 mSv to the breast, 2.4 mSv to the thyroid, and 2.3 mSv to the testes.
Conclusions. Radiation doses received by infants of less than 750 g birth weight are small in comparison with the range of doses that form the basis of risk estimates for cancer.