bluuebunny/crossref_metadata_2025_split huggingface dataset:
J'accuse!-M. LeComte de LaPlace a Prohibé le Recrutement des Alvéoles du Poumon
Authors: NELSON NICHOLAS M. 
Published: December 2021

A recurrent concept throughout all the natural sciences is that of capacitance—"the extension or displacement of a loaded structure per unit load." The electrical engineer knows capacitance as the ratio of charge/voltage. Physicists (since Hooke, who first enunciated the concept) recognize strain/stress as compressibility (the inverse of the modulus). Pulmonary physiologists look at volume/pressure and call it compliance, while biochemists view the volume of molecules that can be liganded to a carrier and call it a binding curve. Clinicians recognize this form as the oxygen-dissociation curve, instantly identified by its sigmoid shape.
This shape also describes the inflation curve of the gasless lung—in the following sequence of increasing transpulmonary pressure: (1) a flat portion with only a small increase in volume—this segment describes the discontinuous openings of the smaller airways and alveoli, once their interfacial tensions have been overcome;
Questions About Varicella Vaccine
Authors: LAVIN ARTHUR 
Published: December 2021

The promotion of the varicella vaccine has been based on habit and profit rather than science, and has exposed the premise of immunization to doubtful legitimacy. Dr Plotkin's commentary (Pediatrics. 1996;97:251-253) nicely illustrates these problems with the varicella vaccine program, and helps explain why pediatricians who care for children are hesitant to participate.
The recent development of hepatitis B and varicella universal vaccination recommendations broke new ground in the history of immunizations. For the first time, universal immunizations were recommended for a problem that the community and its physicians did not agree presented a danger sufficient to justify such an intervention.
Educational Principles of Community-based Education
Authors: Roberts Kenneth B. 
Published: December 2021

Much of medical education remains teacher centered, as exemplified by the continued emphasis on lectures. Increasingly, however, the importance of the learner is being recognized and acknowledged in medical school curricula. The distinction between teaching and learning is also an issue for graduate medical education; accreditation bodies focus on programs and teaching, and credentialing bodies determine whether individuals have accomplished sufficient learning. The true mission of teaching is to facilitate learning, and adult learning is enhanced by four elements: respect, building on previous experiences, immediacy of application, and the opportunity to practice. These elements should be considered when designing educational experiences in the community.
Educational planning includes five steps, represented by the mnemonic GNOME: goals, needs assessment, objectives, methods, and evaluation. Goals are broad aspirations, which are refined by the learners' needs to specific, measurable objectives. Methods are selected to match the objective, and evaluation determines whether the objectives were achieved. The results of the evaluation serve as another needs assessment, and the process continues until the goals are achieved. Throughout the process, the primary focus should be on the resident, with the program in a supporting role.
Implementing Community-based Education: Essential Elements and Recommendations
Authors: Osborn Lucy M. 
Published: December 2021

Two elements are essential for implementing community-based educational programs: a vision of how community experiences fit into the training of the health professionals of the future and a local environment that will support innovation, change, and growth. Change cannot occur unless very basic assumptions regarding medical education are challenged. What is "quality education"? Can programs oriented toward tertiary and specialty care adequately provide the training that should be the core of a 3-year general training program? Do schools and programs select and train physicians to function within the microcosm of the academic center, or do they prepare physicians to manage the country's health care needs? National consensus has had little influence over local environments. Each medical school, training program, and teaching facility must reexamine its values and its culture. Each must have a vision of the physicians of the future and a commitment to train them appropriately.
The role of vision and culture in creating successful programs has been clearly described. Several key elements have been found to be consistent with success, the first being vision. Four basic principles will bring the vision to fruition: (1) preserving core values while still stimulating progress; (2) emphasizing the process by which programs are created, implemented, and changed rather than the product; (3) avoiding the "tyranny of the or," learning to be inclusive with a broad vision rather than limited to an "either-or" approach; and (4) aligning the process, management, and values in working toward envisioned progress for the future. Effective leadership is essential for a group or organization to accomplish its mission, as is an organizational structure that aligns responsibility, authority, resources, and accountability.
Anemia in Infancy: Iron Deficiency and Vitamin E Deficiency
Authors: Oski Frank A. 
Published: December 2021

It is now established that vitamin E is an essential nutrient for all animals including man. It is now established that a deficiency of this vitamin, particularly in the infant, will result in a shortening of red cell life-span. The magnitude of the anemia appears related to the presence of associated factors such as the lipid composition of the red cell membrane and the nature of associated oxidant stresses.
Healthy term infants who are fed either human milk or proprietary formulas in quantities sufficient to meet their caloric requirements will receive adequate amounts of vitamin E. The same appears to be true for small preterm infants even when the formulas are fortified with iron. Infants who are receiving inadequate volumes of formula should receive vitamin E supplementation of approximately 15 mg/day.
Neonatal Jaundice
Authors: Gartner Lawrence M. 
Published: December 2021

Jaundice in the newborn has presented a diagnostic challenge to clinicians for millennia. Because virtually every newborn infant has an elevated serum bilirubin in comparison with the normal adult and more than 50% are visibly jaundiced during the first week of life, the physician's first challenge is to differentiate pathology from variations within the normal range. Today, clinicians are faced with critical therapeutic decisions as well; treatment should be instituted only when benefit will accrue. During the past several years, clinical experts and scholars have reconsidered the risks and possible benefits of bilirubin in the newborn, have altered indications for diagnostic procedures, and have suggested new criteria for therapy. In addition, the relationship between breastfeeding and neonatal jaundice has been clarified. These major new concepts have changed the management of jaundice in the newborn significantly, particularly in the healthy term infant. This review examines these new concepts, places them in a clinical perspective, and provides guidelines for management based on a synthesis of expert opinions and the recently published practice guidelines of the American Academy of Pediatrics. 1
Definitions
The term neonatal jaundice designates all situations in the newborn infant in which the serum bilirubin is sufficiently elevated to cause at least minimally visible yellowing of the skin, ocular sclerae, or both.
Pediatric Dental Update
Authors: Shusterman Stephen 
Published: December 2021

Introduction
Pediatricians are in an ideal position to influence the oral health of their young patients, from the first prenatal interview with prospective parents and the initial newborn examination through the duration of their general pediatric care. Teeth begin calcification between 14 and 16 weeks of embryonic life, and most of the crowns of the primary teeth, as well as the occlusal edges of some permanent teeth, are calcified by birth. Early plaque removal from gum pads and erupting teeth, the use of fluoride as a dietary supplement in nonfluoridated communities, and timely visits to the dentist all will help to assure a caries-free dentition and healthy oral environment for the child of the 21st century.
Dentistry has emerged from its position as a little understood and poorly tolerated sideline of the itinerant surgeon to its status of partner in supporting total bodily health. Such gains as local anesthesia and the means to administer it painlessly, high-speed instrumentation to remove caries comfortably (albeit mechanically), bonded resins (eg, pit and fissure sealants, composite resin restorative materials) to prevent caries and esthetically restore broken or deformed teeth, and implants to replace missing teeth and to restore function and appearance have highlighted its recent evolution.
Nutrition Update
Authors: Barness Lewis A. 
Published: December 2021

Recommendations for improved nutrition have been somewhat modified in the past decade, as evidence clarifies the physiology of digestion, the relation of activity to nutritional requirements, the possible relation of early nutrition to later diseases, the re-evaluation by the American Academy of Pediatrics (AAP) Committee on Nutrition of the use of whole milk in early life, and the recommendations of the USDA of a healthy diet. Breastfeeding continues to be the recommended feeding for infants.
Digestive Processes
Swallow, digestive, and metabolic processes are well developed in the term infant at birth. Fetal swallowing of amniotic fluid occurs at 16 to 17 gestational weeks; at 30 to 34 gestational weeks, infants develop the ability to suck. At birth, development of the lower esophageal sphincter is incomplete and gastroesophageal reflux is demonstrable; reflux is common up to about 4 months.
At birth, the rooting reflex propels the infant to the food source, that is, the mother's or an artificial nipple. The swallowing reflex enables material from the posterior reaches of the mouth to progress to the esophagus, and peristalsis moves the food through the digestive tract. The extrusion reflux, present for up to 2 to 3 months, pushes material out from the anterior part of the mouth, perhaps as a protective mechanism.
Consultation with the Specialist
Authors: McBride Margaret C. 
Published: December 2021

Status epilepticus has been defined as continuous seizure activity or intermittent seizure activity without recovery of consciousness between seizures that lasts for more than 30 minutes. However, if a seizure has continued unabated for 5 minutes, status epilepticus should be presumed and therapy initiated. Status epilepticus is a medical emergency, and all primary care physicians should know how to initiate its treatment.
Usually status epilepticus consists of generalized or asymmetric clonic activity with unconsciousness. However, prolonged absence or partial seizures comprise 10% of episodes. Absence status epilepticus usually occurs in children who have severe primary generalized epilepsy or Lennox-Gastaut syndrome. Partial status epilepticus occurs in children who have focal brain pathology. The initial treatment of both is like that for generalized status epilepticus, with only slightly less urgency. The remainder of this review concerns generalized status epilepticus.
Etiology
It is important to obtain both remote and recent histories from the child's family or attendant as soon as possible so that an appropriate differential diagnosis may be developed. In 25% of cases, status is idiopathic. In another 25% it is provoked only by fever (febrile status). In the 20% of children who have a static encephalopathy, the condition is termed remote symptomatic status epilepticus. In another 20%, status is termed acute symptomatic and is an expression of an acute encephalopathy or brain injury.
Rubella Vaccine
Authors: Hoffman-Rosenfeld Jamie 
Published: December 2021

Rubella usually is a mild viral illness characterized by an erythematous maculopapular rash, slight fever, and lymphadenopathy. Although serious complications of rubella, such as encephalitis and thrombocytopenia, are rare in children, the devastating consequences of the congenital rubella syndrome continue to propel a multipronged strategy to eliminate rubella infection.
Rubella vaccine is a live virus vaccine, which in the United States is the RA27/3 rubella virus strain grown in human diploid cell culture. Although one dose of vaccine confers lifelong immunity in greater than 90% of vaccine recipients, two doses now are recommended in conjunction with the measles vaccine. Because congenital rubella is a potentially devastating consequence of primary vaccine failure, the second dose of vaccine serves as an additional safeguard against such failures.
INDEX OF SUSPICION
Authors: Kidd John , Batisky Donald L. , Stratakis Constantine A. , Garnica Adolpho , Waller Benjamin R. , Pendergrass Landon B. 
Published: December 2021

This section of Pediatrics in Review reminds clinicians of those conditions that can present in a misleading fashion and require suspicion for early diagnosis. Emphasis has been placed on conditions in which early diagnosis is important and that the general pediatrician might be expected to encounter, at least once in a while. The reader is encouraged to write possible diagnoses for each case before turning to the discussion, which is on the following page.
We invite readers to contribute case presentations and discussions.
Case 1 Presentation
A 4-year-old boy who has SC (sickle cell-hemoglobin C) hemoglobinopathy comes to the Resident Practice Group Clinic for a preschool evaluation. At present he has no complaints, although he has had several hospital admissions related to febrile illnesses and painful crises from his sickle cell disease. He has been receiving penicillin prophylaxis and folic acid supplementation.
A complete blood count yields the following findings: white blood cell count, 27 900/mm3, with 1% band forms, 19% segmented neutrophils, 26% lymphocytes, 9% monocytes, and 45% eosinophils; hemoglobin, 10.9 g/dL; hematocrit, 31.8%; and platelet count, 464 000/mm3.
Further evaluation is undertaken because of his abnormal hematologic picture, revealing two unsuspected conditions.
Case 2 Presentation
Twins are born after a 29-week first pregnancy to healthy parents.
Consultation with the Specialist
Authors: Siegel David M. 
Published: December 2021

Introduction
Inflammation involving any part of the uveal tract (iris, ciliary body, and choroid) is described as uveitis. Adjacent ocular structures, including the retina, vitreous, and optic nerve, may be affected as well. The term uveitis is derived from the Latin uva, or "grape," due to the similarity in appearance between the bluish vein structure visible in a peeled blue grape and the middle vascular layer of the eye, the uvea. Within the broader term of uveitis are more specific designations, depending on the anatomic area involved. Thus, inflammation of the iris is called iritis, inflammation of the ciliary body is called cyclitis, and both occurring together is termed iridocyclitis. These latter structures, along with the anterior choroid, share a common blood supply and, if affected, tend to be inflamed together. Such inflammation can be referred to as anterior uveitis. Posterior uveitis describes inflammation of the posterior choroid (choroiditis), the retina (retinitis), or both (chorioretinitis). When the middle portion of the eye is involved (primarily retinal vessels and the peripheral portions of the retina and uveal tract), the condition is described as intermediate uveitis. This term has replaced other labels that appear in the literature, including chronic cyclitis, peripheral uveitis, and pars planitis.
Microcephaly
Authors: Rios Angel 
Published: December 2021

Microcephaly is characterized by a head circumference that is below the normal range. The diagnosis is made by measuring the largest circumference of the head, using the glabella and the occipital protuberance as reference points.
Head circumference reflects brain volume, with a small skull usually reflecting a small brain. Furthermore, the smaller the head, the less likely that intelligence will be normal. Avery et al reported that the incidence of moderate-to-severe mental retardation among infants who have a head circumference from 2 to 3 standard deviations (SD) below the mean is 33%, while among infants who have a head circumference more than 3 SD below the mean, the incidence is 62%.
Malabsorption in Childhood
Authors: Talusan-Soriano Karen , Lake Alan M. 
Published: December 2021

Introduction
The evaluation of the child whose rate of growth is impaired or who fails to thrive frequently includes evaluation for malabsorption. Although diarrhea may be a cardinal feature of most malabsorptive disorders, it may not be present or appreciated. The pediatrician must recognize manifestations of malabsorptive disease so as to establish early diagnosis and initiate treatment to minimize the long-term consequences of malnutrition.
To establish a diagnosis requires an understanding of the physiology and pathophysiology of digestion and absorption. Digestion begins as an intraluminal event, requiring oral, gastric, and pancreatic enzymes and bile acids for micelle formation. Absorption requires adequate mucosal surface area, brush border and intracellular enzymes, and specific transport mechanisms. The diseases and their symptoms vary with age and even with socioeconomic conditions. For example, in the developing world, malabsorption most often is encountered in the context of mucosal injury from recurrent or persistent infections, perpetuated by poor hygiene and nutrition.
Infants present predominantly with congenital disorders of specific nutrient digestion or absorption (Table 1). Older children typically have an acquired mucosal disease such as those listed in Table 2. The overlap is tremendous, and diseases such as cystic fibrosis and gluten-sensitive celiac disease present in different manners at different ages.
Rifampin
Authors: Glatman-Freedman A. 
Published: December 2021

Rifampin is a semisynthetic derivative of rifamycin B that is active against a wide range of microorganisms and bactericidal for extracellular as well as intracellular pathogens. Most gram-positive and many gram-negative bacteria, as well as mycobactenia, are inhibited by nifampin. Staphylococcus aureus, coagulase-negative staphylococci, Neisseria meningitidis, N gonorrheae, and Haemophilus influenzae are very sensitive to rifampin. The drug works by inhibiting DNA-dependent RNA polymerase, thus preventing the initiation of chain formation in RNA synthesis.
Rifampin is available in the United States in oral and intravenous preparations. It is almost completely absorbed from the gastrointestinal tract after oral administration, reaching peak plasma concentrations in 2 to 4 hours.
Ulcerative Colitis and Crohn Disease in Children
Authors: Motil Kathleen J. , Grand Richard J. 
Published: December 2021

Once considered rare in pediatric practice, chronic inflammatory bowel disease is now recognized with increasing frequency in children. Ulceractive colitis and Crohn disease constitute the two major entities, and it is still not clear whether these are two separate entities or different portions of the spectrum of one disease. Abdominal pain, diarrhea, rectal bleeding, weight loss, and anemia are prominent findings in both ulcerative colitis and Crohn disease; however, extraintestinal manifestations may dominate the clinical findings, masquerading as juvenile rheumatoid arthritis, idiopathic growth failure, or even anorexia nervosa. Often, it is not until intestinal manifestations are recognized that a correct diagnosis is made.1
EPIDEMIOLOGY OF INFLAMMATORY BOWEL DISEASE
Since 1950, there has been an increase, in the incidence of Crohn disease, ranging from 100% to 400% in all age groups.2 In contrast, the incidence of ulcerative colitis has not changed significantly. Ulcerative colitis is diagnosed in 15% of patients before the age of 20 years, usually in adolescence. Although ulcerative colitis may occur in infancy, inflammatory disease of the colon during the first year of life is more often due to food allergy3 or infectious disease.
Certain groups of children are at greater risk for the development of inflammatory bowel disease. Ulcerative colitis and Crohn disease occur more commonly among Northern European, Anglo-Saxon races, in urban rather than rural dwellers, and in Jewish individuals living in Europe and North America.
Epidemic of Polypharmacy and Suggestions to Control It
Authors: Stickler Gunnar B. 
Published: December 2021

The term "polypharmacy" is used to describe the excessive use of drug therapy. In 1980, I reviewed the evidence of a continuing epidemic of polypharmacy.1 In 1975, there were 1.7 billion visits per year to physicians in private practice.2 Such visits to a family physician resulted in the prescription of medications to 73% of the patient contacts; in 63% of the patient visits, medications were suggested by a pediatrician. Do two thirds of our patients require medication when seen in an ambulatory setting?
Pediatric hospitals did not fare much better. Of 993 patients admitted to a children's hospital, 36.7% received antibiotics.3 Using strict criteria, these authors concluded that 38% of medical patients received antibiotics inappropriately and 78% of the surgical patients did not require antibiotics.
Effective strategies to manage the teacher intellectual work productivity in distance learning
Authors: Kharadze Natalia , Giorgobiani Maia , Melkoshvili Tina , Dzebisauri Lia , Pirtskhalaishvili Dea 
Published: December 2021

The article aims to empirically determine the effective strategies to manage intellectual work (IW) productivity (IWP) in distance learning (DL), for example, university teachers in Georgia. Based on the expert assessment methods, determining indicators for assessing the level of Teacher Intellectual Work Productivity (TIWP) of three large universities in Georgia and its current level was analyzed using the method of integral assessment. Using the ANOVA method, determined the main factors influencing the TIWP at DL. We use the decision tree to systematize the factors of influence to TIWP and substantiate effective management strategies, taking into account teachers' qualifications, age category, and competencies to ensure the continuity and quality of DL. The results allow flexibility in managing the TIWP in the DL conditions and determining the most effective management strategies, taking into account the characteristics of teachers and the current level of development of the TIWP.