bluuebunny/crossref_metadata_2025_split huggingface dataset:
AD CAMPAIGNS AND MEDICAL SCHOOLS
Authors: L. J. F. 
Published: December 2021

As medical education has become something of a buyer's market, a Midwest medical school and a Texas university are resorting to advertising for students.
The Medical College of Ohio in Toledo has taken out ads in 23 Ohio college newspapers urging premed students to consider applying. Meanwhile, the University of Texas System, in a broader appeal, is running TV ads urging young Texans to choose health careers.
University of Texas officials hope their ad campaign will help stem a decline in enrollments in the state's medical and related schools, the same trend observed nationally for the past 15 years. Medical-school enrollments declined 37% nationwide between 1974 and 1988, according to the Association of American Medical Colleges.
IS ERROR FRAUD?
Authors: L. J. F. 
Published: December 2021

Prof. David Baltimore of the Massachusetts Institute of Technology is under attack by Representative John Dingell of Michigan. Why should anyone outside of the Government or basic biomedical research care?
Dr. Baltimore's reputation is at stake, but the rest of us will be affected by the outcome of these investigations as well. What has come under a legislative cloud for the first time in a very long time, perhaps ever in this country, is the legitimacy of the scientific method itself. This is an immediate and serious threat to science and medicine.
The N.I.H. will have the last word on Dr. Baltimore's published research. But as I understand the Congressman's case, it is that published science must be free of error, and that error itself indicates bad faith and fraudulent intent. This is wrong. Published error is at the heart of any real science. We scientists love to do experiments that show our colleagues to be wrong and, if they are any good, they love to show us to be wrong in turn. By this adversarial process, science reveals the way nature actually works.
If we as a country make science a field for only those who enjoy a good lawsuit, we will have shut the door on our future as a technologically serious nation. Clearly Congress cannot wish to do this. I would welcome a Congressional initiative to deal with fraud as such, but I fear that the way Dr. Baltimore is being treated means that witch-hunts are in the offing.
SMEAR
Authors: L. J. F. 
Published: December 2021

Imagine that you won a Nobel Prize at age 37. That you've published some 400 papers on genetics and the human immune system. That you've built from scratch a highly respected scientific research center, the Whitehead Institute in Cambridge, Mass.
And then imagine that you wake up one morning and read in the hometown paper that you're accused of what "appears to be fraud and misrepresentation." The accusation is from a "Pete Stockton," whom you've never met, but who the paper says is a "staff member for Rep. John Dingell."
That's more or less what happened to David Baltimore a year ago. His experience since has taken him into the Kafka maw of "congressional oversight," Dingell-style. Readers of this space will recall that the last time we checked with Congress's grand inquisitor, Chairman Dingell was retreating from a botched attempt to smear a former federal prosecutor. Now he's assailing Dr. Baltimore and, to make the effort really worthwhile, American science.
The first time I met John Dingell I must admit to coming away with some respect for his intelligence and rough-hewn candor. But the more I've watched him and his investigators at work, the more it's clear that they are manning a runaway train. The arrogance bred of unchallenged power has stripped them of self-restraint and distorted their understanding of the public good.
Intraventricular Hemorrhage
Authors: PERLMAN JEFFREY M. 
Published: December 2021

In this issue, Philip et al present data concerning the declining incidence of intraventricular hemorrhage in the premature infant in the 1980s without planned intervention. Before discussing the implications of this work, it may be useful to review some of the pertinent features of intraventricular hemorrhage in the neonate.
Intraventricular hemorrhage is characteristic of the premature infant, particularly the infant less than 32 weeks' gestation. Bleeding typically emanates from capillaries in subependymal germinal matrix, a gelatinous area containing an elaborate but immature capillary bed which, in turn, is subserved by an abundant arterial and venous supply. It is a transitional zone that becomes less prominent during the last 12 to 16 weeks of gestation and is essentially exhausted at term.
FROM THE ANNALS OF HEALTH SUPERVISION
Authors: Wasserman Richard C. 
Published: December 2021

Dr. Wasserman:
I brought my son Corey in for his 4-year checkup 1/6/89. You were talking to him about wearing seat belts. He told you that he wears one but his Mom doesn't.
When I left that day, we both put on our seat belts and minutes later we were in a car accident.
I just want to thank you for reminding us to wear a seat belt. It saved both of us from being hurt.
So a new rule in our household is when we get into a vehicle, the first thing is to make sure we have our seat belts on.
Cow's Milk Formula and Infantile Colic
Authors: CAREYMD WILLIAM B. 
Published: December 2021

No experienced pediatric clinician doubts the existence of cow's milk allergy in infants. The controversy concerns how often cow's milk proteins cause excessive crying or "colic" in otherwise well young infants. Three interesting papers from our colleagues in Malmö, Sweden, leave the question unanswered despite the considerable sophistication in their research design.
In their first report in 1982, they concluded that in a double-blind study "cow's milk seems to be a major cause of infantile colic in formula-fed infants." However, in the only part that was double-blind, fewer infants improved while receiving soy formula (18%) than did those receiving cow's milk formula (29%).
In Reply: Cow's Milk Formula and Infantile Colic
Authors: LOTHE LASSE , LINDBERG TOR 
Published: December 2021

In reply to Dr Carey, we want to emphasize that the criterion for entering a study was that our definition of colic (as quoted by Dr Carey) was fulfilled (ie, "crying of about 3 hours or longer per day. . ."). In our report, an unfortunate misprint occurred. On page 264, first paragraph of the "Results" section, line 5, is written "infants receiving cow's milk-based formula cried 1.5 hours per day or more." It should have been "3 hours per day or more."
In the double-blind trial, we decided to reduce the time of crying to &gt; 1.5 hours per day to accept the reaction as positive for the following reasons: Experienced pediatricians know that the adverse reaction to food in a food-allergic (intolerant) infant is dose dependent.
The Extracorporeal Membrane Oxygenation Debate
Authors: RHINE WILLIAM D. , FISCHER ALLEN F. , STEVENSON DAVID K. 
Published: December 2021

To the Editor.—
We are concerned about the statistical inferences, assumptions for comparisons, and arguments of logic implicit in the recent article on survival of infants with persistent pulmonary hypertension with ECMO (extracorporeal membrane oxygenation).1 The authors did acknowledge the difficulties of retrospective review, especially over 8 years when obstetrical and neonatal care should be improving. However, other details not reported on their patient population and classification might yield important information for this historical comparison.
The Extracorporeal Membrane Oxygenation Debate
Authors: GROSS IAN 
Published: December 2021

In Reply.—
Drs Short, Rhine et al, and Clark et al raise a number of interesting issues in their letters, some of which were addressed in our article.1
Before responding to the specific issues, I would like to emphasize that our paper does not contest the fact that ECMO may be a effective rescue therapy for some infants with persistent pulmonary hypertension, particularly those who are in dire straights on arrival from a referring hospital.
More Concerning Asthma and Exercise
Authors: ALTENBURGER KARL M. 
Published: December 2021

To the Editor.—
In the position paper on Exercise and the Asthmatic Child,1 the Sections on Allergy and Immunology and Diseases of the Chest fail to focus on the primary obstacle facing these children. In most educational settings, the free and easy access to metered dose inhalers is denied. Most school systems "allow" the used of metered dose inhalers but require students to keep their inhalers in a central administrative office or nurse's station. In practice, this means that students are separated from their peers (and thus made to feel "different") and, if they are lucky, after 10 to 15 minutes (too often longer) they are able to rejoin their classmates whose physical activities are already well underway.
Recommendations on Extracorporeal Membrane Oxygenation
Authors:   Committee on Fetus and Newborn
Published: December 2021

Considerable work has been done to demonstrate the effectiveness of extracorporeal membrane oxygenation (ECMO) for certain neonates in imminent danger of death from a narrow range of conditions causing hypoxemia and respiratory distress not responsive to other forms of therapy. Many clinicians are convinced that infants with congenital diaphragmatic hernia and other forms of persistent transitional circulation with pulmonary hypertension, unresponsive to more conventional forms of respiratory support, have been saved through the use of ECMO. However, experience with ECMO has been quite individualized, seldom studied prospectively, and based on criteria that are not generalizable between institutions. Data concerning the longer term outcome of patients who have been treated with ECMO are sparse, and concerns persist about the consequences of carotid artery and/or jugular vein ligation, prolonged anticoagulation, and long-term circulatory bypass. There is a clear need for more information about this technique. Nevertheless, it appears that new ECMO centers are evolving on the basis of current enthusiasm and without a thorough appreciation of the complexity, intensity, potential hazards, and uncertainties of this form of therapy.
The committee makes the following recommendations.
1. The establishment of an ECMO center for newborn infants should occur only when a regional requirement for one has been demonstrated. In addition, the proposed center must demonstrate (a) the ability to manage a stable and successful regional neonatal/perinatal care program, (b) the availability and skills of appropriate personnel to perform ECMO, and (c) ready access to an organized functioning neonatal transport system.
2. ECMO centers should be established only in institutions with a recognized level III regionnal neonatal/perinatal center with appropriate coverage by pediatric medical and surgical subspecialists.
Ceftriaxone vs Cefotaxime for Treatment of Haemophilus influenzae Meningitis
Authors: ARDITI MOSHE , YOGEV RAM 
Published: December 2021

In Reply.—
The issues raised by Madson and Grose do not relate directly to our report, which describes a case of cefuroxime treatment failure in Haemophilus influenzae meningitis and reviews the literature.1 However, since the issues they raised are important we offer this response.
The decision to choose which of the newer cephalosporins to use for treatment of bacterial meningitis must be based on available experience which includes efficacy data, safety and toxicity record, and relative coast analysis.
Topical Skin Anesthesia Before Inserting Hemodialysis Cannula
Authors: BIANCHETTI MARIO B. , SPECK SILVANA , OETLIKER OSKAR H. 
Published: December 2021

To the Editor.—
A new topical anesthetic cream based on a eutectic mixture containing equiponderal amounts of lidocaine based and pnilocaine base has been developed recently.1 In a controlled study, Halpérin2 demonstrated convincingly that this ointment reduces substantially the pain caused by venous, subcutaneous drug reservoir, and lumbar punctures in children submitted to painful diagnostic and therapeutic procedures because of cancer.
Pain inflicted by insertion of large cannulas into arteriovenous fistulas in children and adolescents on regular hemodialysis is cause of concern for children on regular hemodialysis.
Rickets and Metabolic Disorders
Authors: MORRISON STUART C. , KERR DOUGLAS S. 
Published: December 2021

In Reply.—
We have reviewed the letter from Drs Ozsoylu and Besim and have reviewed the metabolic data from our patient with tyrosinosis to determine if there was evidence of rickets in our patient. At the time that the published x-rays were obtained, the patient had normal serum calcium and phosphorus. However, a month earlier, when the x-rays appeared normal apart from probable osteopenia, the patient did have persistent hypophosphatemia, 1.5 to 1.8 mg/dL (normal 4.0 to 6.0 mg/dL), and elevated alkaline phosphatase, 956 IU/L (normal 50 to 380 IU/L).
Parental Presence in the Emergency Department
Authors: BAUCHNER HOWARD , VINCI ROBERT , WARING CHRIS 
Published: December 2021

In Reply.—
We read Dr Connolly's letter with great interest. We agree that no policy should be established with regard to parental presence during procedures in an emergency department. Additional variables that are probably important include the physician's experience, the type of procedure being performed, the anxiety of the parents and physicians, and the familiarity that the physician has with the family. In general, parents should be asked if they would like to be present (at least for many procedures) and more importantly shown ways to help their child.
Dangers of Arterial Catheters in Critically III Neonates
Authors: REZNIK VIVIAN M. , ANDERSON JACK , GRISWOLD WILLIAM R. , SEGALL MICHAEL L. , MURPHY JEROME L. , MENDOZA STANLEY A. 
Published: December 2021

In Reply.—
We read with interest the comments made by Drs Weinberg et al concerning our management of the infant reported in Pediatrics.1 We agree with their conclusion that arterial catheters in critically ill neonates are potentially dangerous and should be monitored closely.
We disagree with Dr Weinberg's contention that thrombolytic therapy was not indicated in this case. Our patient demonstrated deteriorating renal function due to the thrombus. In view of progression of renal failure on hepanin therapy, thrombolytic therapy was clearly appropriate in this case.
Immunogenicity of Haemophilus influenzae Type b Polysaccharide-Protein Conjugate Vaccines in Children With Conditions Associated With Impaired Antibody Responses to Type b Polysaccharide Vaccine
Authors: Weinberg Geoffrey A. , Granoff Dan M. 
Published: December 2021

Polysaccharide-protein conjugate vaccines are members of a new class of vaccines designed to immunize infants against diseases caused by encapsulated bacteria, including H influenzae type b. There are at least four H influenzae type b polysaccharide-protein conjugate vaccines undergoing clinical evaluation in the United States,1 and three of the four recently were licensed for use in 18-month-old children. Although these conjugate vaccines differ considerably in chemical composition and immunologic properties, each consists of the H influenzae type b polysaccharide, polyribosylribitolphosphate (PRP) (or a derivative thereof), covalently coupled to a carrier protein or proteincontaining complex. As a group, the H influenzae type b polysaccharide-protein conjugate vaccines are more immunogenic in healthy infants and older children than the conventional PRP vaccine.1,2
Several groups of children have been found to be at increased risk for invasive disease caused by H influenzae type b compared with children in the general US population. These include Native Americans (Apaches, Navajos, and Alaskans),3-6 blacks (when studied with regard to allotype),7-9 and children with previous disease caused by H influenzae type b.10,11 Other groups of children who have underlying diseases or genetic phenotypes associated with impaired serum antibody responses to immunization with conventional PRP vaccine have been described (Table 1). In most instances, children without these conditions also are considered to be at a higher risk of invasive disease caused by H influenzae type b than children of comparable ages in the general population.3-6,22,24-26 The reasons for the poor antibody responses to PRP vaccine in children with these underlying conditions, in children of certain racial groups, or in children with hyporesponsive genetic phenotypes are not well understood.
Immunogenicity of a New Haemophilus influenzae Type b Conjugate Vaccine (Meningococcal Protein Conjugate) (PedvaxHIBTM)
Authors: Vella Philip P. , Staub Joan M. , Armstrong Jack , Dolan Kathleen T. , Rusk Cynthia M. , Szymanski Sally , Greer William E. , Marburg Stephen , Kniskern Peter J. , Schofield Timothy L. , Tolman Richard L. , Hartner Fredrick , Pan Shih-hsie , Gerety Robert J. , Ellis Ronald W. 
Published: December 2021

Haemophilus influenzae type b is responsible for an estimated 15 000 to 20 000 cases of meningitis per year in the United States, mainly in children 2 months to 5 years old.1-4 The mortality rate from meningitis due to H influenzae type b infections ranges from 5% to 10%. Despite antibiotic treatment, up to 35% of survivors have permanent neurologic sequelae. In addition to meningitis, H influenzae type b is responsible for other invasive infections, including epiglottitis, septicemia, cellulitis, septic arthritis, osteomyelitis, pneumonia, pericarditis, and otitis media; approximately 30 000 cases H influenzae diseases occur annually in the United States. The diseases peak in incidence between 6 and 12 months of age, with almost one half of the cases occurring before 1 year of age. About 75% of disease caused by H influenzae type b occurs in children younger than 24 months old. The incidence of disease is higher in children of certain groups, including blacks, Hispanics, Eskimos and Native Americans, young children attending day-care facilities, patients with asplenia or antibody-deficiency syndromes, and children of lower socioeconomic status.5
There is considerable evidence that antibody to the capsular polysaccharide (polyribosylribitol-phosphate [PRP]) of H influenzae type b is protective.6-8 These antibodies activate complement for bactericidal antibody,9,10 induce opsonophagocytic activity,11,12 and protect infant rats from bacteremia due to challenge with H influenzae type b.13,14 It has been demonstrated clinically that antibodies induced by vaccination of older children with PRP are protective.7,15 The level of antibodies correlated with protection has been estimated to be 0.05 to 0.15 µg/mL after natural infection16 or after passive acquisition via immunoglobulin17 and 1.0 µg/mL for vaccine-induced protection.18
Disease Caused by Haemophilus influenzae Type b in the Immediate Period After Homologous Immunization: Immunologic Investigation
Authors: Sood Sunil K. , Daum Robert S. 
Published: December 2021

Several Haemophilus influenzae type b vaccines have been licensed and recommended for administration to children in the United States. These vaccines have consisted of purified polyribosylribitol-phosphate (PRP), the capsular polysaccharide of H influenzae type b,1 alone or covalently bound to one of several carrier proteins. Two of these saccharide-protein conjugate vaccines are now licensed, a polysaccharide-diphtheria toxoid conjugate (PRP-D)2 and an oligosaccharide-mutant diphtheria toxin conjugate (HbOC).3 Two others, a polysaccharide- Neisseria meningitidis outer membrane protein conjugate (PRP-OMPC)4 and a polysaccharide-tetanus toxoid conjugate (PRP-T),5 are currently in clinical trials.
One concern with the use of PRP vaccine was the suggestion that the incidence of invasive disease caused by H influenzae type b in the immediate period after immunization might be increased; this idea was supported by evidence from several sources. In a case-control study of the efficacy of PRP vaccine, Black et al6 found that 4 children were hospitalized for invasive disease within 1 week of immunization, a rate of invasive disease 6.4 times greater (95% confidence interval [CI], 2.1 to 19.2) than the background rate in unvaccinated children. In Minnesota, the relative risk for invasive disease in the first week after immunization was 6.2 (95% CI, 0.6 to 45.9),7 and the results of a study conducted by the Centers for Disease Control in six areas of the United States revealed a 1.8-fold (95% CI, 0.3 to 10.2) increase in the occurrence of invasive disease caused by H influenzae type b in the first week after immunization.8 Moreover, among 16 cases of disease caused by H influenzae type b occurring within 14 days of immunization that were passively reported to the FDA,9 10 were clustered within the first 72 hours.
Hypoglycemia in Infancy: The Need for a Rational Definition
Authors:   A Ciba Foundation Discussion Meeting, Cornblath Marvin , Schwartz Robert , Aynsley-Green Albert , Lloyd June K. 
Published: December 2021

A discussion meeting was held on October 17, 1989, to address the current status of the definition of significant hypoglycemia in infancy, especially in the normal- and low-birth-weight neonate.
Robert Schwartz introduced the complexity of the problem by indicating the multiple variables (duration, severity, cerebral blood flow, rates of glucose uptake, availability of alternate substrates, oxygen, etc) in equating a plasma glucose value with neurodevelopmental consequences.
Marvin Cornblath reviewed the various definitions of hypoglycemic blood sugar levels reported since 1911 which depend upon the method of blood sugar analysis, clinical recognition and concerns. Severe symptomatic hypoglycemia that persisted or recurred was first reported in neonates in 1937. Lower blood sugar levels, documented since the 1920s in both full-term and premature newborns, had been considered physiologic. The recognition of transient significant hypoglycemia first in symptomatic and then in asymptomatic small-for-gestational-age, neonates required new definitions in the 1960s. These definitions were later modified as changes in treating both the mother in labor and at delivery and the neonate occurred. Intensive care and the survival of very-low-birth-weight newborns have compounded the problem of definition. Currently methods are available to correlate plasma glucose concentrations and glucose metabolism in vivo in the brain with specific neurologic dysfunctions. This should permit a better definition of the continuum of significant hypoglycemia than has been available before.
William Hay analyzed studies of the various rapid bedside glucose oxidase stick techniques used to screen for blood glucose concentrations. He concluded that their dependence on the hematocrit, their requirements for precision in performance and timing, great variance (±5 to 15 mg/dL), and lack of reproducibility, especially at blood glucose values less than 50 mg/dL, made their use in the neonate unsatisfactory (whether read by eye or by meter).
Diagnosing Bird Fancier's Disease in Children
Authors: YEE WILLIAM F. H. , CASTILE ROBERT G. , COOPER AMIEL , ROBERTS MARY , PATTERSON ROY 
Published: December 2021

Bird fancier's disease is a form of hypersensitivity pneumonitis resulting from inhalation of various avian proteins. It is rarely diagnosed in childhood but should be considered in any child with persistent unexplained respiratory symptoms.1,2 We describe two patients referred to our pulmonary clinic with nonspecific respiratory complaints, in whom the diagnosis of avian protein-related hypersensitivity pneumonitis was initially not confirmed by serologic studies.
CASE REPORTS
Patient 1
An 11-year-old boy was admitted to the hospital with a 1-year history of a mild nonproductive cough, poor appetite, weight loss, malaise, and an intermittent low-grade fever. According to an environmental history, the boy's father had been breeding pigeons, canaries, and parakeets in the family yard for years.