bluuebunny/crossref_metadata_2025_split huggingface dataset:
Children as Passengers in Automobiles: The Neglected Minority on the Nation's Highways
Authors: Shelness Annemarie , Charles Seymour 
Published: December 2021

The federal government is urging states to enact legislation requiring that safety belts be worn. Small children are excluded from this requirement.
Following the neonatal period, the motor vehicle poses the greatest single threat to a child's life. Contrary to popular belief, more small children are killed and injured inside the vehicle than outside. The majority of children now ride in cars unprotected or inadequately protected.
Standard safety belts are unsuitable for small children. Special devices capable of distributing collision forces over a large body area should be used.
Original children's car "safety" seats were not intended to protect their occupants in a crash. These seats became subject to a government safety standard in April 1971. Shortly after this standard came into effect it was shown to be grossly inadequate in ensuring crash protection. A proposal for revising current safety criteria was issued in March 1974— to be implemented in September 1975.
A number of progressive companies have developed crashworthy devices. As public awareness is being awakened, manufacturers are beginning to find that "safety" sells.
Child crash protection has not escaped the attention of safety experts whose writings are reviewed, but it is shown that lack of parent awareness and concern can be directly related to sparse and often inaccurate and incomplete information available. Many popular child care books ignore the subject entirely.
Because correct use of devices is of such critical importance, instructions detailing what parents must do should be prominently displayed on a permanent label attached to the device. observation of car seats in use confirms that correct installation of the device itself and/or proper securement of the child within the device is the exception rather than the rule.
The development of child restraints is of recent date. It is essential to keep abreast of advances made in the field. Earlier recommendations may be superseded by more recent research findings.
It has been found that parents are most receplive to new ideas prior to and immediately following the birth of a new baby. In-hospital instruction of expectant and new parents is showing promising results.
There is an urgent need for pediatricians to become involved in this vital area of "preventive medicine."
Inaccuracies in Administering Liquid Medication
Authors: Yaffe Sumner J. , Bierman C. Warren , Cann Howard M. , Cohen Sanfod N. , Freeman John , Segal Sydney , Soyak Lester F. , Weiss Charles F. , Chudzik Gregory , Ballin John C. , Del Pratto Pierre S. , Done Alan K. , Farchione Louis , Oakley Godfrey , Sawchuk Steven , Scott C. P. , Simopoulos Artemis P. 
Published: December 2021

Although pediatricians usually take great care in accurately calculating medication for their patients, the important processes of measuring and administering the dose are often overlooked. Many of the problems encountered in the administration of tablets and capsules to small children have been overcome by the production of medications in liquid form. However, the advantage gained in the administration of liquid products is often lost because of the inaccuracy of the devices used to measure and administer them.
Liquid doses may be inaccurate for several reasons. The measuring devices commonly used today include household spoons, cups, and specific devices provided by pharmaceutical manufacturers to be used with their products. Teaspoons are particularly poor measuring and administering devices. The measured capacity of the teaspoon has been shown to be within the range of 2.5 to 7.8 ml.1,2 In addition, teaspoons are a poor delivery device because they tip easily. Furthermore, the same spoon, when used by different persons, may deliver from 3 to 7 ml.3 Such variations may be related to factors such as pouring the liquids from different-sized bottles, the color of the liquids, and the adequacy of available light. Perhaps the most important factor in measurement is related to the care practiced by the person doing the measuring.
Although the American Pharmaceutical Association (in 1902) and the American Medical Association (in 1903) defined the "standard teaspoonful" as 5 ml, this recommendation has not been universally adopted.4 The practice of some pharmaceutical manufacturers of establishing doses in 4-ml and other fractions of a "teaspoon" tends to confuse the prescribing physician when it comes to instructing patients.
Basilar Artery Migraine in Young Children
Authors: Golden Gerald S. , French Joseph H. 
Published: December 2021

Eight children with recurrent attacks of neurologic dysfunction referable to the brainstem and cerebellum are reported. The episodes occur suddenly, clear completely, and leave the patient without residua. The most frequent signs are ataxia, alternating hemipareses, and vertigo. The majority of patients are girls, and most have the onset of the condition prior to the age of 4 years.
Headache was definitely present in three children, and possibly present in four. A striking history of migraine was found in seven families, accounting for 16 affected relatives. Fifteen of these were female and 14 were on the maternal side.
Follow-up of the children has not provided any evidence for progressive neurologic disease. The patient followed for the longest period of time has developed classic migraine.
The Surgical Management of Pediatric Breast Masses
Authors: Turbey Wilson J. , Buntain William L. , Dudgeon David L. 
Published: December 2021

Information regarding the surgical management of breast masses in the pediatric age group is sparse and is primarily directed at unusual neoplasms. We have reviewed the surgical treatment of 50 patients with inflammatory and neoplastic breast masses occurring in a 15year period (1957 to 1973) at the Children's Hospital of Los Angeles.
There were 42 girls and 8 boys, ranging in age from 12 days to 18 years. All patients had either surgical excision or incision and drainage of the masses with a subsequent histologic diagnosis.
A variety of pathologic entities were encountered, but there were no primary malignancies. There were 33 patients with fibroadenomas, including four patients with multiple masses. Thirteen patients, six of whom were male, had cellulitis with an underlying breast abscess. The offending organism was gram-negative in one third of these abscesses.
While none of the masses in this series were malignant, surgery was indicated to (1) establish diagnosis, (2) allay fears of patient, family, and referring physician, and (3) correct an obvious cosmetic deformity. Surgical drainage encouraged resolution of the inflammatory process, aided in the recovery of the organism, and assured appropriate drug therapy.
Comments on Breast Feeding: Second Thoughts
Authors: Jelliffe Derrick B. 
Published: December 2021

It was timely to read the article by Dr. John Gerrard on the proven immunological value of human milk.
In fact, similar review papers could also be written concerning anti-allergic, contraceptive, economic, emotional, and metabolic-nutritional advantages.
A major difficulty in keeping up with the flood of recent "hard" scientific data in this field is because these reports have been published in a wide spectrum of journals ranging, for example, from endocrinological to sociological to psychological and to those concerned with family planning, "tropical pediatrics," and economics.
Superfluous Impedimenta
Authors: Carey Donald E. , Harris George S. , Pilliod James P. 
Published: December 2021

We were astonished to receive the recent statement on snowmobile safety from the Committee on the Pediatric Aspects of Physical Fitness, Recreation and Sports of the American Academy of Pediatrics with its implicit acceptance, ce, and perhaps even approval under certn circumstances, of this so-called sport.
These superfluous impedimenta of our affluent gadgethappy appy society should be permanently relegated to limbo. But then, there probably is not as much money to be made from ski touring.
Presumptive Histoplasmosis Presenting as Cerebellar Ataxia With Spontaneous Recovery
Authors: Shearer William T. , Kobayashi George , Prensky Arthur L. 
Published: December 2021

There have been relatively few reported cases of histoplasmosis of the central nervous system in children and no reported survivors without therapy.1-5 Most reported cases involving the central nervous system in children are described at postmortem examination.1,2 Involvement of extrapulmonic organ systems with Histoplasma capsulatum without a prominent preceding or concomitant pulmonic infection occurs occasionally.
The reported neurological signs and symptoms of histoplasmosis of the central nervous system in children are: vomiting, irritability, opisthotonos, clonus of extremities, Babinski sign, progressive weakness of extremities, deterioration of vision, ptosis, weakness of facial muscles, bladder and anal atony, bilateral spastic hemiparesis, delayed motor development, and coma.1-5
Trends in Fatness and the Origins of Obesity
Authors: Garn Stanley M. , Clark Diane C. , Lowe Charles U. , Forbes Gilbert , Garn Stanley , Owen George M. , Smith Nathan J. , Weil William B. , Nichaman Milton Z. , Johansen Erling , Rowe Nathaniel 
Published: December 2021

BY intent and by design, the Ten-State Nutrition Survey (TSNS) of 1968-1970 was concerned with both undernutrition and overnutrition. One concern was caloric and nutrient insufficiency and the effects of inadequate nutrition on growth and development. A second concern was caloric excess, as reflected by the level of fatness, and especially the prevalence of obesity, in different socioeconomic groupings and in different population segments.
In the design of the TSNS, it was obvious that weight alone—or even weight relative to height—was an inadequate measure of fatness. A child might be "overweight," yet of less than average fatness; another child or adult might be underweight, yet actually obese. Accordingly, two fatfold measurements (commonly but improperly called "skinfolds") were incorporated into the anthropometric program.
One benefit of the TSNS may be seen in the fact that we now have nine-decade triceps or subscapular fatfold data on more than 40,000 individuals; nearly one half of them are American Negro (i.e., black), for whom scant data were previously available. A second benefit is that these new data are sufficient in scope to describe lifelong changes in fatness, including some phases not previously known in detail. A third benefit is the socioeconomic partitioning of fatness, showing both an economic-related fatness increase in the male at all ages and an economic "reversal" of fatness in the female at adolescence and beyond.
The TSNS was conducted on a household and family-line basis, including both parents and their children.1 So we have the opportunity to compare true family-lines, parents and their children, brothers and sisters, and husbands with wives.
Carcinogens in Drinking Water
Authors: Miller Robert W. 
Published: December 2021

There has recently been concern about carcinogens in drinking water.
ASBESTOS
In Duluth, Minnesota, asbestos in substantial amounts has been found in the water supply, which has apparently been contaminated since 1955 with industrial waste from taconite ore discharged into Lake Superior.1 Asbestos, when inhaled, is known to be carcinogenic in man. It causes pleural and peritoneal mesothelioma, lung cancer, and gastrointestinal neoplasia in factory workers exposed to the fibers,2-5 and mesothelioma of the pleura or peritoneum among persons living in the neighborhoods of these factories and perhaps in the households of workers.3,6-9 An increase in the frequency of bronchogenic carcinoma has also been reported among persons with low-level (nonoccupational) exposures to asbestos.10
Asbestos is believed to be carcinogenic because of its physical rather than its chemical properties—specifically, the length and diameter of the fibers are related to their carcinogenicity in rats.11,12 Long thin fibers seem to be more harmful than short thick ones, but short fibers cannot yet be regarded as harmless.13
Millions of asbestos fibers are found per liter of water drawn from the taps in Duluth.1 Most are of short length, less than 5µ. Studies of cancer mortality through 197114,15 showed no increase that was attributable to contamination of the water supply, but the latent period for asbestos-induced cancer is known to be two or more decades, well beyond the interval for which data were available.
The problem, if indeed there is one, may not be limited to Duluth, since other water supplies contain asbestos fibers leached from serpentineor amphibole-rock or from asbestos-containing cement pipes.16,17
A New Approach to Teen-age Smoking
Authors: Garell Dale C. , Guthrie Andrew , Hammar S. L. , Heald Felix P. , Hofmann Adele D. , James W. Scott , Olson Ardis Lee , Shen Jerome T.Y. , Tanner Natalia M. , Thornton Melvin L. , Wasserman Martin P. , Wolfish Martin G. 
Published: December 2021

In January 1964, the Surgeon General's office released its report demonstrating the strong potential relationship between cigarette smoking and lung cancer as well as the pulmonary and cardiovascular diseases which afflict thousands each year.1
Since that time, an estimated 30 million Americans have quit smoking; but, during the last two years, there has been a noticeable increase in per capita cigarette consumption among women and teen-age girls.2 Every day 3,200 adolescents between the ages of 12 and 18 take up smoking (exclusive of those who are just experimenting with smoking, the 10- to 12-year-olds).3 The Bureau of Census estimates that the number of teen-agers smoking rose from 3 million to approximately 4 million between 1968 and 1972. The proportion of smokers in the 12 to 18 age group increased from 14.7% to 15.7% among boys and 8.4% to 13.3% among girls.4
Analysis of research by the Department of Health, Education, and Welfare on teen-age populations indicates there are many environmental factors that affect the initiation of the smoking habit; however, by far the strongest influence is the smoking behavior of parents and siblings.5 If both parents smoke, the teen-ager has about twice the likelihood of being a smoker than if neither parent smokes (the rates are 18.4% to 9.8% respectively). If an older brother or sister smokes, the teen-ager is twice as likely to become a smoker himself.5
When the combined effect of smoking of parents and older siblings is considered, the concept of family patterns is reinforced. The lowest level of smoking is found among teen-agers who live in nonsmoking households.
Academy Policy in Relation to the Pediatric Nurse Associate
Authors:   Executive Board, American Academy of Pediatrics
Published: December 2021

The Academy has been involved with the concept of the pediatric nurse associate (PNA) since its evolution in the early 1960's. At that time it was recognized that there were children in this country who were receiving inadequate or no health care. In addition, predictions were being made of an impending physician shortage. It was also becoming increasingly apparent that there was a reservoir of health professionals who were not being utilized to their fullest potential within the health care system. This reservoir was nursing; thus, the concept of the PNA was conceived, developed, and has continued to grow over the past ten years.
The education of the PNA has many unique aspects, for in this endeavor medicine and nursing assume joint responsibility in the development and administration of the educational programs. The PNA is a professional nurse with additional education in the field of child health care. In addition to his/her nursing role, she/he assumes certain functions and responsibilities which traditionally have been the domain of medicine. In the provision of these medical services the PNA functions under the supervision, direction, and review of the physician. Thus, it is imperative that medicine be actively involved, not only in the educational process, but also in the development of the role of the PNA within the health care system.
There have been many changes not only within the specialty of pediatrics, but also within the health care system in general in recent years. To mention a few: a decline in the birth rate; the development of national health programs; rapid expansion of medical schools and classes; an increased emphasis on primary care and avoidance of fragmentation of care; the emergence of the family physician; and a crisis in the medical profession regarding professional liability coverage.
When Should a Child Be in the Hospital?
Authors: North A. Frederick 
Published: December 2021

With the advent of more active and widespread utilization review activities, spurred federally by Professional Standards Review Organization1 (PSRO) legislation and locally by various types of quality assurance programs, physicians who care for children are increasingly concerned with setting norms, criteria, and standards for judging the necessity for admission to hospital and the duration of hospital care.2 Most of the current approaches to devising utilization standards attempt to identify for each common diagnostic category a standard for length of stay based either on statistical analyses of current hospitalization practices3,4 or upon normative values based on a consensus of expert opinion.3 Criteria for admission may also be derived for each diagnosis.2,5-7 Committees of the American Academy of Pediatrics and of state and local medical and pediatric societies are currently devoting a great deal of effort to formulating admission and length of stay standards for a variety of diagnoses which are associated with hospitalization of children.
The approach to formulating utilization standards using separate diagnostic categories may prove not to be well suited to children. As is shown in Tables I and II, a large number of diagnostic categories must be dealt with, and many of the diagnostic categories are so broad that admission and length of stay standards would be impossible to derive except for much smaller subsets. Table I shows the 25 most common diagnoses of children admitted to approximately 1,200 hospitals which reported data to the Professional Activities Survey (PAS) in 1970.2 The diagnostic categories used in this analysis group several separate ICDA diagnostic codes together.
Complications of Peritonsillar Abscess Due to Fusobacterium necrophorum
Authors: Oleske James M. , Starr Stuart E. , Nahmias André J. 
Published: December 2021

Even though anaerobic bacteria have been causally related to peritonsillar abscesses and secondary complications,1-3 such infections have been diagnosed infrequently. Reported here is a patient with a peritonsillar abscess, complicated by cellulitis and lung abscesses. An anaerobic organism, Fusobacterium necrophorum,, was identified as the etiological agent.
CASE REPORT
A 14-year-old black boy was in good health until three weeks prior to admission when he developed a sore throat, dysphasia, fever, and chills. His physician diagnosed viral pharyngitis; a throat culture was not obtained and no antimicrobial therapy was prescribed. During the following 12 days, because the patient had developed a nonproductive cough and experienced a 4.52-kg weight loss, he was brought to the Pediatric Emergency Clinic, Grady Memorial Hospital.
Intellectual Deficits After Transient Tyrosinemia in the Term Neonate
Authors: Mamunes Peter , Prince Paul E. , Thornton Nancy H. , Hunt Patricia A. , Hitchcock Elizabeth S. 
Published: December 2021

In order to determine if prolonged, significant transient neonatal tyrosinemia (TNT) is injurious to the developing central nervous system, 15 term infants who had suffered from this disorder for a mean duration of 50 days underwent comprehensive psychometric evaluations at a mean (± 1 SD) age of 56.5 ± 7.8 months. Their mean maximum detected tyrosine level had been 25.8 mg/dl (range, 13.6 to 42.0) and their defect was considered secondary to a combination of a high protein formula intake and a lack of supplemental vitamin C.
Compared to a control group, significantly lower mean scores were obtained by the TNT group on the McCarthy Scale of Children's Abilities (77.1 vs. 92, P = .008) and the Illinois Test of Psycholinguistic Ability (92.3 vs. 109.9, P = .002). Performance scores varied inversely with the duration of TNT. Although these children are not classifiable as "mentally retarded," TNT may cause specific learning disabilities. There is, therefore, a need to determine the frequency of TNT in infants fed evaporated milk and other high-protein milk formulas and to develop ways to prevent its occurrence.
Vitamin D: The Discovery of Its Metabolites and Their Therapeutic Applications
Authors: Beale Mary G. , Chan James C. M. , Oldham Susan B. , DeLuca Hector F. 
Published: December 2021

Our understanding of the role of vitamin D in calcium-phosphorus metabolism has changed considerably in the last decade. Studies performed in tissue culture, animal, and man have firmly established that the natural compound requires hydroxylation in the liver at the C-25 position and in the kidney at the C-1 position to form the biologically active derivative 1,25-(OH)2D3. These hydroxylation reactions are finely regulated to maintain normal calcium-phosphorus homeostasis: We now regard 1,25-(OH)2D3 as a hormone which is released by the kidney during periods of hypocalcemia. This hormone acts on the intestinal mucosa to facilitate calcium absorption and on bone to increase calcium mobilization. Its function in other tissues is still being evaluated.
The active metabolites of vitamin D and several closely related analogs have been synthesized. It has been clearly demonstrated that 1,25-(OH)2D3 and 1α-OH-D3 promote healing in uremic bone disease. Administration of small amounts of these compounds has corrected the biochemical disturbances in vitamin D-dependency and hypoparathyroidism. Limited clinical experience with 25-OH-D3 and 1,25-(OH)2D3 in children with familial hypophosphatemia has failed to show convincing evidence of a therapeutic effect. Further clinical studies are needed to fully evaluate the therapeutic potential of this new family of compounds.
The Automobile and Heat Stress
Authors: Roberts Kenneth B. , Roberts Ellen C. 
Published: December 2021

This study suggests that the thermal burden of poorly ventilated parked automobiles can be considerable, particularly when the automobiles are exposed to direct sunlight. Leaving the windows open two inches does not appear to be protective.
The practice of exposing infants and toddlers to such thermal risk appears to be common and the need for adequate ventilation unrecognized. Education measures stressing the use of carseats and other safety devices should include the potential hazards of high temperature in parked automobiles.
Mycoplasma pneumoniae Meningoencephalitis and Transverse Myelitis in Association with Low Cerebrospinal Fluid Glucose
Authors: Klimek Joseph J. , Russman Barry S. , Quintiliani Richard 
Published: December 2021

Awareness of the neurologic complications of Mycoplasma pneumoniae is increasing as is indicated by two recent review articles on this subject1,2 and by the appearance of more frequent isolated case reports on the same subject.3-6
The association of M. pneumoniae with central nervous system dysfunction has been based mainly on clinical observations and serological data from serial serum samples. Direct evidence of an etiologic relationship is still lacking, for attempts at isolation of this organism from the cerebrospinal fluid (CSF) of brain tissue have been uniformly unsuccessful. In fact, most of the serological support for this association has been established from serum samples rather than from studies of the CSF.