bluuebunny/crossref_metadata_2025_split huggingface dataset:
NEWSPAPERS TOLD: SIMPLIFY, SIMPLIFY
Authors: L. J. F. 
Published: December 2021

BALTIMORE, April 1—American newspapers are dull and difficult to read. But different ways of writing news articles could help newspapers attract some of the readers they have lost.
That was the conclusion of a major study made public here this week at the annual convention of the American Society of Newspaper Editors. The study suggests that newspapers must challenge many of the rules that have governed journalism for generations.
The study was prepared by the group's literacy committee, which was formed partly because of growing alarm that young Americans do not read well enough to understand newspapers and are abandoning them as a result.
The literacy panel challenged the fundamental form used for newspaper articles, the "inverted pyramid," in which the top is heavy with important facts and trails off into less significant information.
Recovery of Giardia lamblia Cysts From Chairs and Tables in Child Day-Care Centers
Authors: Cody Mildred M. , Sottnek Henry M. , O'Leary Virginia S. 
Published: December 2021

More than 11 million children attend commercial child day care in the US. This number is expected to increase as more mothers of preschool children enter the work force. Infectious diseases are readily transmitted in child day-care settings,1-4 where children are in close contact with one another for approximately 50 hours per week. Diarrheal diseases are common in these settings. Infectious diarrhea can be transmitted by person-to-person contact1,2,5 and, possibly, by contact with fomites.1,3 Many food service surfaces including tables, kitchen counters, ware-washing sinks, and dinner plates in the centers are contaminated with bacterial levels that exceed public health standards.6,7
Giardia lamblia is a pathogenic intestinal protozoan that may produce an acute infection characterized by diarrhea and other clinical symptoms.8 It infects children in day care at a higher rate than the general population.2,5 Family members are at risk of acquiring G. lamblia transmitted from children attending child-care centers3 where infectious cysts of G. lamblia may be shed by infected symptomatic or asymptomatic individuals.1,5 Intervention strategies that rely on exclusion of infected children from day-care settings are expensive and do not control Giardia infections in the child day-care environment.4
We compared the use of a commercially available, indirect immunofluorescent procedure with direct microscopic examination to detect G. lamblia cysts in stools of children attending day-care centers. Because the detection of G. lamblia on environmental surfaces would show their potential for transmitting giardiasis, we used the immunofluorescent procedure to look for G. lamblia cysts on various surfaces. Cysts were removed by swabbing surfaces, recovered on membrane filters, and detected using the indirect immunofluorescent procedure on the filters.
Scabies Outbreak in a Day-Care Center
Authors: Sargent Susie J. , Martin Jena T. 
Published: December 2021

Scabies is a highly contagious condition characterized by cutaneous infestation with the human itch mite, Sarcoptes scabiei var. hominis. Although not a reportable disease, its prevalence has increased in the US since the mid-1970s.1-3 Worldwide, outbreaks have generally occurred in association with conditions of crowding, poor hygiene, or malnutrition.4,5 However, the current nationwide resurgence has affected persons from all socioeconomic levels without regard to age, sex, or personal hygiene.4,6 While scabies is primarily spread by intimate personal contact, skin-to-skin transmission can also occur after prolonged casual contact such as occurs in institutional settings, nursing homes, and day-care centers. Mites can survive for 2 to 3 days on inanimate surfaces, which permits transmission via fomites such as clothes, furniture, floors, and bed linens. Persons with chronic skin disorders are more likely to transmit the mite to others because their infestations may be more difficult to diagnose and treat. Exfoliation of skin flakes may enhance transmission.
To our knowledge, there is no published account of a scabies outbreak in a day-care center. We describe an outbreak of scabies infestation in a hospital-affiliated child-care facility that ultimately involved the treatment of more than 600 people at a cost of more than $16 000 and took at least 4 months to eradicate. All of the childrens' parents were health-care workers at the nearby 1000-bed hospital, so there was potential for spread to patients and thus, a need for rapid control. Elimination of scabies within a day-care center may be particularly problematic unless a coordinated effort among staff, parents, and physicians can be established.
The Risks and Benefits of Cytomegalovirus Transmission in Child Day Care
Authors: Dobbins James G. , Adler Stuart P. , Pass Robert F. , Bale James F. , Grillner Lena , Stewart John A. 
Published: December 2021

CONGENITAL CYTOMEGALOVIRUS DISEASE
Congenital infection with cytomegalovirus (CMV) is the leading viral cause of birth defects, and it is the major cause of severe, multiple birth defects in the US. Approximately 40 000 infants, or 1% of all births, are congenitally infected each year; 4000 of these infants are born with the severe defects that define the disease, and another 6000 will have developmental problems later in life. The remaining 30 000 infected infants have no recognizable damage. Defects frequently noted at birth include microcephaly, intracranial calcifications, hearing and vision damage, neurologic damage, and growth retardation. Developmental problems noted later may include partial loss of vision or hearing and learning disabilities.1
Infection of the fetus can result from both primary and recurrent maternal infection, although recurrent infections only rarely produce recognizable congenital disease with severe consequences. This distinction is important because public health intervention is based entirely on preventing primary CMV infection during pregnancy.
Cytomegalovirus
The cause of this damage, CMV, is a common virus that produces a life-long infection. Reactivation of earlier infections is possible, as is reinfection with a different strain of the virus. Usually, both primary and recurrent infections result in either inapparent or mild illness, although some adolescents and adults may develop mononucleosis. In some persons with an impaired immune system, however, infection can be devastating and life-threatening. Persons with AIDS, some transplant patients, cancer patients, and fetuses lack the ability to control infection with CMV.
Person-to-person transmission of the virus occurs through bodily fluids including breast milk, semen and vaginal secretions, blood, and particularly, saliva and urine.
Epidemiology of Physician-Diagnosed Allergic Rhinitis in Childhood
Authors: Wright Anne L. , Holberg Catharine J. , Halonen Marilyn , Martinez Fernando D. , Morgan Wayne , Taussig Lynn M. 
Published: December 2021

Objective. To investigate the natural history of and risk factors for allergic rhinitis in the first 6 years of life.
Methods. Parents of 747 healthy children followed from birth completed a questionnaire when the child was 6 years old. Data were obtained regarding physician-diagnosed allergic rhinitis (PDAR), associated symptoms, and age at onset. Risk-factor data were taken from earlier questionnaires, and data regarding immunoglobulin E (IgE) and skin-test reactivity were obtained at age 6.
Results. By the age of 6, 42% of children had PDAR. Children whose rhinitis began in the first year of life had more respiratory symptoms at age 6 and were more likely to have a diagnosis of asthma. Early introduction of foods or formula, heavy maternal cigarette smoking in the first year of life, and higher IgE, as well as parental allergic disorders, were associated with early development of rhinitis. Risk factors for PDAR that remained significant in a multivanate model included maternal history of physician-diagnosed allergy (odds ratio: 2.2, 95% confidence interval: 1.35-3.54), asthma in the child (4.06, 2.06-7.99), and IgE greater than 100 IU/mL at age 6 (1.93, 1.18-3.17). The odds for atopic as opposed to nonatopic PDAR were significantly higher only among those with high IgE and those who had dogs.
Conclusion. Allergic rhinitis developing in the first years of life is an early manifestation of an atopic predisposition, which may be triggered by early environmental exposures.
Salicylate Intoxication in an Infant With Ichthyosis Transmitted Through Skin Ointment—A Case Report
Authors: Abdel-Magid El Hassan Mohammed , Ahmed Fathel-Rahman El Awad 
Published: December 2021

Accidental salicylate poisoning is becoming less common than it was three decades ago. There was a dramatic drop in the number of children who had this condition in countries where using childproof caps and limiting the number of pills per package was legalized and implemented.1 In some other countries, salicylate still remains a common cause of accidental poisoning among children.2,3 Salicylate intoxication almost always happens after oral ingestion.
Ichthyosis is a group of inherited keratinizing disorders characterized by visible scaling in distinctive patterns of distribution. Lamellar ichthyosis is an autosomal recessive disorder that is usually evident at birth, and is associated with erythroderma.
Infectious Disease in Child Day Care: An Overview
Authors: Osterholm Michael T. 
Published: December 2021

In the early 1980s, the Minnesota Department of Health began to address the growing concern of the risk of infectious diseases in child day care by initiating a planning process that resulted in the first national symposium on infectious diseases in child day care. That symposium, which was held in June 1984 in Minneapolis, highlighted the fact that different vocabularies and points of reference would need to be bridged if day-care providers and regulators, clinicians, and public health practitioners are to work side-by-side in defining the risk of infectious diseases in day care and in developing appropriate prevention strategies.1 As a result of this meeting, the Minnesota Public Health Association submitted a resolution to the American Public Health Association (APHA) in the fall of 1984, stating that child-care standards, especially in the area of prevention of infectious diseases, were needed. This resolution, together with a simultaneous recommendation from the APHA's Maternal and Child Health Section for the development of health and safety standards for out-of-home child-care facilities, began a process which eventually led to the monumental effort now known as the American Public Health Association/American Academy of Pediatrics, National Health and Safety Performance Standards: Guidelines for Out-of-Home Child Care Programs.2
In June, 1992, the Centers for Disease Control and Prevention sponsored the "International Conference on Child Day Care Health: Science, Prevention and Practice," a historic meeting bringing together concerned individuals from many disciplines to further define and set the future agenda for the science, prevention and practice of child day-care health.
ISPAD DECLARATION OF KOS
Authors: Weber Bruno , Brink Stuart 
Published: December 2021

On September 4, 1993, on the island of Kos, the members of the International Study Group of Diabetes in Children and Adolescents (ISGD), assembled at our 19th annual international scientific meeting and in the process of transforming ISGD into the International Society of Pediatric and Adolescent Diabetes (ISPAD), renew their Hippocratic Oath by proclaiming their commitment to implement the St Vincent Declaration to promote optimal health, social welfare, and quality of life for all children and adolescents with diabetes around the world by the year 2000. We take this unique opportunity to reaffirm the commitments by diabetes specialists in the past and, in particular, unanimously pledge to work towards the following:
1. to make insulin available for all children and adolescents with diabetes;
2. to reduce the morbidity and mortality rate of acute metabolic complications or missed diagnosis related to diabetes mellitus;
3. to make age-appropriate care and education accessible to all children and adolescents with diabetes as well as to their families;
4. to increase the availability of appropriate urine and blood self-monitoring equipment for all children and adolescents with diabetes;
5. to develop and encourage research on diabetes in children and adolescents around the world; and
6. to prepare and disseminate written guidelines and standards for practical and realistic insulin treatment, monitoring, nutrition, psychosocial care and education of young patients with diabetes—and their families—emphasizing the crucial role of health care professionals—and not just physicians—in these tasks around the world.
Recombinant Human Erythropoietin Stimulates Erythropoiesis and Reduces Erythrocyte Transfusions in Very Low Birth Weight Preterm Infants
Authors: Shannon Kevin M. , Keith Julian F. , Mentzer William C. , Ehrenkranz Richard A. , Brown Mark S. , Widness John A. , Gleason Christine A. , Bifano Ellen M. , Millard Dietra D. , Davis Charles B. , Stevenson David K. , Alverson Dale C. , Simmons Charles F. , Brim Marlene , Abels Robert I. , Phibbs Roderic H. 
Published: December 2021

Design and methods. We hypothesized that treatment with recombinant human erythropoietin (r-HuEPO) would stimulate erythropoiesis and would thereby reduce the need for erythrocyte transfusions in preterm infants. We treated 157 preterm infants born at 26.9 ± 1.6 weeks of gestation who weighed 924 ± 183 g at birth with either subcutaneous r-HuEPO (100 U/kg/d, 5 days per week) or placebo for 6 weeks in a randomized, double-blind, controlled clinical trial. All patients received oral iron and were managed according to uniform conservative transfusion guidelines.
Results. Treatment with r-HuEPO was associated with fewer erythrocyte transfusions (1.1 ± 1.5 per infant in the r-HuEPO group versus 1.6 ± 1.7 per infant in the placebo group; P = .046) and with a reduction in the volume of packed erythrocytes transfused (16.5 ± 23.0 mL versus 23.9 ± 25.7 mL per infant; P = .023). Overall, 43% of the infants in the r-HuEPO group and 31% of placebo-treated infants were transfusion-free during the study (P = .18). The volume of blood removed for laboratory tests and the need for respiratory support at the start of treatment had major effects on transfusion requirements independent of r-HuEPO. Reticulocyte counts were higher during treatment in the r-HuEPO group (P = .0001), and r-HuEPO-treated infants had higher hematocrit values at the end of the study (32% versus 27.3% in the placebo group; P = .0001). We found no differences in the incidence of major complications of prematurity between the treatment groups.
Conclusion. We conclude that treatment with r-HuEPO at a weekly dose of 500 U/kg stimulates erythropoiesis, moderates the course of anemia, is associated with a reduction in erythrocyte transfusions, and appears safe in very low birth weight preterm infants who are receiving iron supplements. Conservative transfusion criteria, minimization of phlebotomy losses, and treatment with r-HuEPO are complementary strategies to reduce erythrocyte transfusions in these infants.
DOCTORS' OWN GUIDELINES HURT THEM IN COURT
Authors: L. J. F. 
Published: December 2021

Doctors are finding that they can get burned by cookbook medicine.
Recent court cases, as well as a Harvard University study, suggest that written guidelines on how to treat particular medical conditions have become powerful weapons for plaintiffs in malpractice cases. Where plaintiffs once had to rely on hired experts to argue that a procedure was botched, they can now point to official treatment recipes issued by physician groups themselves.
"Lawyers like me are using them in court all the time to say, "Gee, your own organization says this is a minimum standard of care, and you didn't follow it."
Ironically, doctors have embraced and developed guidelines in recent years, believing they could be used to fight malpractice suits. "The hope was that guidelines would say specifically what the standard of care was," says Troyen Brennan, a health law expert and an author of the Harvard study.
Medical groups have issued dozens of guidelines, from instructions on performing Caesarian deliveries to recommendations on treating intoxicated trauma patients ... the Harvard study warns that the rising use of guidelines in malpractice litigation could "chill physicians' interest" in writing new ones.
According to the Harvard study, which was released earlier this year by the School of Public Health, such guidelines are about three times more likely to be used against doctors than in their defense. The Harvard researchers examined 13 years of court decisions and 259 claims filed with malpractice insurers.
Where it's clear that a doctor met the required standards, the guidelines can aid physicians.
REVISING MISS AMERICA'S STORY
Authors: L. J. F. 
Published: December 2021

Concerned about news reports linking the hearing loss of the new Miss America to a childhood vaccination, the American Academy of Pediatrics said the actual culprit was a bacterial infection.
The Academy said in a statement on Thursday that it had learned from her pediatrician, Dr. Ted Williams of Dothan, AL, that the nerve damage to Heather Whitestone's ears was caused by a Hemophilus influenzae, or H-influenzae infection.
Infant Sleep Position: Pediatricians' Advice to Parents
Authors: Hudak Bonnie B. , O'Donnell Jane , Mazyrka Nadine 
Published: December 2021

Objective. The American Academy of Pediatrics' (AAP) recommendation for side or supine sleep position in healthy babies has generated much controversy. We surveyed primary care physicians to determine the effect of the AAP statement on physician attitude toward infant sleep position and advice to parents.
Methods. We sent a 23-question survey to 194 physicians in Western New York. The survey addressed their attitude toward the AAP recommendations and its impact on their advice to parents.
Results. Of the 149 physicians treating newborns, 121 (82%) completed the questionnaire; 98% were aware of the AAP statement. The most common sources of information were the AAP (86%) and professional literature (77%). Of the respondents, 79% agreed with the AAP statement. Reasons for reservation were lack of data (64%), potential adverse consequences of supine position (52%), and their own experience (47%). Gender, years in practice, and type of reimbursement did not influence attitude toward the AAP recommendation. The AAP statement increased the frequency with which physicians routinely discussed sleep position from 34 to 70% (P &lt; .02). Physicians recommending the prone position decreased from 57 to 7% (P &lt; .001), while those recommending supine sleep position increased from 10 to 42% (P &lt; .001).
Conclusions. Most physicians agreed with the AAP statement and more frequently discussed sleep position following the AAP recommendations. However, they did not routinely recommend supine sleep position. The majority (69%) recommended the side position even though it is unstable. Although the AAP statement has increased discussion of infant sleep position by primary care physicians in WNY, only a minority recommend that infants sleep supine.
Perinatal Brain Injury in Premature Infants Born to Mothers Using Alcohol in Pregnancy
Authors: Holzman Claudia , Paneth Nigel , Little Ruth , Pinto-Martin Jennifer ,   Neonatal Brain Hemorrhage Study Team
Published: December 2021

Objective. Alcohol has been shown to have teratogenic effects on the fetal central nervous system. However, little research has been done to assess the impact of prenatal alcohol exposure on premature infants, a group particularly vulnerable to perinatal brain injury.
Methods. We examined the relation between maternal alcohol use and the most common forms of brain injury in premature infants—germinal matrix/intraventricular hemorrhage (GM/IVH) and white-matter damage—in a large population-based cohort of infants weighing 2000 g or less. The analyses included 349 infants younger than 31 weeks' gestation who received at least one cranial ultrasound scan and whose mothers were queried about prenatal alcohol use in a postpartum interview.
Results. Infants of mothers who reported "moderate" alcohol use (fewer than seven drinks per week and fewer than three drinks per occasion) to "high" use (seven or more drinks per week and/or three or more drinks per occasion) before recognized pregnancy, and moderate alcohol use during pregnancy, were not at increased risk for brain injury. However, after controlling for potentially confounding factors, infants of women reporting high alcohol use during pregnancy were at increased risk of developing isolated brain hemorrhage (odds ratio [OR] = 5.5, 95% confidence interval [CI] = 1.2, 24.7), any brain hemorrhage (OR = 6.7, 95% CI = 1.8, 26.4), and white-matter damage (OR = 9.5, 95% CI = 1.9, 46.4).
Conclusion. Premature infants of women who report consuming seven or more drinks per week and/or three or more drinks per occasion during pregnancy have substantially elevated risks of both of the most common forms of brain injury in premature infants.
THE VALUE OF EXPERT ADVICE?
Authors: L. J. F. 
Published: December 2021

"In 1900, Alexander Graham Bell, the second president of the National Geographic Society, invited prominent editors and publishers to Washington to seek their advice about the society's magazine. They gave him these suggestions:
1. Move to New York, because it is impossible to establish a popular magazine in Washington.
2. Change the name National Geographic to something simpler.
3. Forget about building circulation through membership in a geographic society; sell the magazine on newsstands instead.
4. Never mention the name National Geographic Society in the magazine because people abhor geography."
"... Bell cheerfully ignored all the suggestions,... and set the magazine on its way to becoming the largest popular journal of geography in the world. 9.2 million circulation."
Erythropoietin—Not Yet a Standard Treatment for Anemia of Prematurity
Authors: Wilimas Judith A. , Crist William M. 
Published: December 2021

In this issue of Pediatrics, Shannon and coworkers report that the frequency and volume of red cell transfusions administered to premature infants can be decreased by using recombinant human erythropoietin (r-HuEPO). We believe that the most important contribution of this study may relate as much to its design—that is, the application of clearly defined transfusion guidelines—as to the efficacy of r-HuEPO in this setting.
In this randomized, controlled multicenter trial, 157 infants weighing &lt;1250 g at birth received either r-HuEPO or placebo. These infants (mean age = 24 days) had received an average of 3.5 transfusions before their enrollment. During the study, packed red blood cell transfusions were given according to criteria developed by the investigators.