bluuebunny/crossref_metadata_2025_split huggingface dataset:
Excessive Handling as a Cause of Hypoxemia
Authors: Long John C. , Philip Alistair G. S. , Lucey Jerold F. 
Published: October 2019

Continuous transcutaneous oxygen (TcPo2) monitoring was used to study low-birth-weight infants (15 control, 15 experimental) during their stay in the intensive care nursery (ICN). Twenty hours of continuous recordings were made of heart rate, respiratory rate, and TcPo2 in the first five days after birth. Personnel caring for the control infants were blind to the TcPo2 measurements. Those caring for the experimental group were instructed in the operation of the TcPo2 monitor and used the device to modify the timing and extent of procedures to minimize "undesirable time" (TcPo2 &lt; 40 or &gt; 100 torr). Control group infants had an average of 40 min/20 hr in "undesirable time." When personnel used TcPo2 monitoring to modify care this "undesirable time" was reduced to 6 min/20 hr. This difference was statistically significant (P &lt; .001). Infants in the control group were handled more frequently, and experienced more hypoxemia. Of the hypoxemic time suffered by the control infants 75% was associated with handling. Only 5% of the hypoxemia or hyperoxemia was detected by blood Pao2 analysis or conventional monitors.
Intermittent arterial blood gas sampling is an inadequate method for monitoring arterial oxygenation in low-birth-weight infants since hypoxemia and hyperoxemia are often missed. Continuous TcPo2 monitoring improves care by diminishing "undesirable time."
METAPHORS HELP US TO UNDERSTAND THE BODY
Authors: P. A. G. S. 
Published: October 2019

"... medicine did not make an effective contribution to human welfare until the middle of the twentieth century. The great leap forward is often attributed to a rapid increase in heroic procedures and the discovery of new drugs, but what distinguishes the medicine of the past twenty-five years is not that its practitioners are equipped with an arsenal of antibiotics and antiseptics, but that they are furnished with a comprehensive and unprecedented understanding of what the healthy body is and how it survives and protects itself. ... since finding out what something is is largely a matter of discovering what it is like, the most impressive contribution to the growth of intelligibility has been made by the application of suggestive metaphors.
... It is impossible to imagine how anyone could have made sense of the heart before we knew what a pump was. Before the invention of automatic gun turrets, there was no model to explain the finesse of voluntary muscular movement.
... the subjective experience of the body is usually incoherent and perplexing, and when we want it put right, we refer to people who have learnt to think about it with the help of technical metaphors...."
AN AMERICAN CASE REPORT OF APPARENT TETRALOGY OF FALLOT PUBLISHED ALMOST FIFTY YEARS PRIOR TO FALLOT'S CLASSIC REPORT IN 1888
Authors: C. T. E. 
Published: October 2019

In 1888 Etienne L. A. Fallot (1850-1911) gave an important but not the first account of the condition that bears his name.1 The earliest American description of a child with putative tetralogy of Fallot that I have been able to find was reported in 1842 as follows:
About two years since, I was called to visit a child of Mr. S., of this town, aged two years and six months. Mrs. S. related the history of the case as follows. From birth to the age of eleven months, there was nothing unnatural in the health or appearance of the child. At this time it began to be very much afflicted by ill turns, attended with laborious respiration, palpitation and a peculiar blueness of the skin. After a few minutes the paroxysm would pass off, leaving her in a state of great exhaustion. These paroxysms continued, at regular intervals, with increasing severity, up to the time of its death, which occurred on the 14th inst.
Post-mortem Examination, Sixteen Hours after Death.—Body very much emaciated; face bloated; skin blue; lungs small and dark colored; one and a half ounces of serum in pericardium; heart weighed five and a half ounces; hypertrophy of right ventricle; aorta communicated with both ventricles equally; pulmonary artery very small; its communication with the right ventricle would barely admit a common blunt-pointed probe; foramen ovate imperfectly closed. The remaining viscera natural, with the exception of color, which might be expected from the imperfect arterialization of the blood (A. C. Smith, MD, Haverhill [MA], July 22, 1842).
The Use of Cimetidine in the Newborn
Authors: Chhattriwalla Yousuf , Colon A. R. , Scanlon John W. 
Published: October 2019

Although uncommon, reflux esophagitis and gastric and duodenal ulcer disease have all been reported to occur in the newborn period.1,2 Cimetidine, a competitive antagonist specific for the histamine H2-receptor, has been demonstrated effective in reducing gastric acidity in the adult. Its neonatal use has not been reported.
The following cases suggest that cimetidine may be beneficial for the newborn with such disorders.
CASE REPORTS
Case 1
Baby L. weighed 740 gm at birth, was at 28 weeks gestation, and had prolonged, severe respiratory illness requiring ventilatory assistance. Repeated attempts at feedings, which began at 6 weeks of age, were associated with regurgitation, abdominal distention, and melenetic gastric aspirates. An upper gastrointestinal (GI) x-ray series confirmed reflux esophagitis. At 8 weeks of age cimetidine treatment was started at a dose of 10 mg/kg/day. The drug was continued for three weeks.
Within one week of the initiation of cimetidine therapy, there was a significant reduction in the frequency of vomiting and abdominal distention and the upper GI bleeding disappeared. There were no neurologic abnormalities noted on serial examinations performed during cimetidine therapy. There were also no changes in renal and liver function studies, or hematologic values associated with drug use.
Case 2
Baby G. was born at 27 weeks gestation and weighed 820 gm. He had severe respiratory distress and required ventilatory assistance. At 3 weeks of age, bronchopulmonary dysplasia was diagnosed by x-ray and by tracheal cytology. Because of clinical deterioration from this process, the baby was started on therapy with corticosteroids at 24 days of age.
A CASE OF PREMATURE DELIVERY (1798)
Authors: C. T. E. 
Published: October 2019

Thomas Denman (1733-1815), an English obstetrician, was the first in his country to recommend the induction of premature labor in cases of narrow pelvis. This had been suggested before but never successfully established as a rule of practice.
His case report below published in 1798 describes his procedure.1
In the year 1798, a lady of rank, who was six months gone with child, came from Ireland to London for the purpose of procuring advice; Dr Savage and myself were called into consultation.
She had been many years married, and in her first pregnancy, through some accident, was brought to bed of a living child about the seventh month. Since that time, though she had enjoyed a good state of health, she had been delivered, after very severe labours, of four children, all of whom were still-born. From the account given us, there was every reason to believe that she had been conducted with great patience and judgment through her labours; but that the pelvis was so much reduced in its dimensions, as to render it impossible for a full-grown living child to pass through it. When we had collected all the information we could, and duly weighed and deliberated upon the circumstances, we agreed in proposing to bring on her labour in the eighth month. Our opinion being represented to her friends, they having heard all the reasons we had to urge in support of it, gave their consent to the measure, though not without some hesitation; but the patient agreed to it very readily.
Subscapular Abscess Due to Haemophilus influenzae Type B
Authors: San Joaquin Venusto H. , Kimball James B. 
Published: October 2019

Localized abscess formation is a rare but previously described manifestation of Haemophilus influenzae infection.1-7 A majority of the reported cases were caused by nontypeable strains of H influenzae.1,4,5,7 We report a case of an extensive subscapular abscess due to β-lactamase-negative H influenzae type B. This, to our knowledge, is the first such case described in English literature.
CASE REPORT
A 15-month-old white girl developed fever, anorexia, and irritability five days prior to admission. The following day a physician diagnosed otitis media and prescribed erythromycin. In spite of the antibiotic therapy, the symptoms persisted. A different physician was consulted, but no focus of infection could be identified.
Radionuclide Joint Imaging: Acute Rheumatic Fever Simulating Septic Arthritis
Authors: Wolff James A. , Tuomanen Elaine I. , Greenberg I. David 
Published: October 2019

Technetium (Tc-99m) diphosphonate skeletal imaging is a sensitive modality for the detection of joint disease.1 Recently, the combined use of Tc-99m diphosphonate and gallium (Ga-67) citrate has been advocated for the evaluation of inflammatory joint disease and in particular the differentiation of septic arthritis from adjacent osteomyelitis and cellulitis.2,3
The case of acute rheumatic fever (ARF) described here demonstrates diffuse radioactive gallium and phosphate uptake in an affected joint. The scan findings, not unexpectedly, simulated those of a septic arthritis. Differentiation of these two entities could only be made on the basis of the clinical and biochemical picture.
CASE REPORT
Type I Glycogen Storage Disease with Focal Nodular Hyperplasia of the Liver and Vasoconstrictive Pulmonary Hypertension
Authors: Pizzo Christopher J. 
Published: October 2019

In an unusual case, type I glycogen storage disease was complicated by focal nodular hyperplasia of the liver and vasoconstrictive pulmonary hypertension.
CASE REPORT
The patient was a 16½-year-old girl who had had milk intolerance and hepatomegaly as an infant. A liver biopsy specimen at age 16 months had shown an absence of glucose-6-phosphatase activity. One of the two siblings was similarly affected. Throughout her childhood, the patient consistently demonstrated fasting hypoglycemia and growth retardation. A portocaval shunt performed at age 12 did not improve her growth status; at age 16, she had a bone age of 11. Within a year prior to death, palpable hepatic nodules were discovered and confirmed by liver scan.
Application of Live Varicella Vaccine to Children with Acute Leukemia or Other Malignancies Without Suspension of Anticancer Therapy
Authors: Ha Kyungsae , Baba Koichi , Ikeda Teruo , Nishida Masaru , Yabuuchi Hyakuji , Takahashi Michiaki 
Published: October 2019

A live varicella vaccine was given to children with acute leukemia or other malignancies with minimal clinical reactions.1 In that study, anticancer medication was suspended beginning one week before vaccination and was not resumed until one week after vaccination.
In the present study, we attempted to vaccinate such children without suspension of anticancer medication.
SUBJECTS AND METHODS
Fifteen children with acute leukemia, 12 children with malignant solid tumors (4 neuroblastoma, 4 retinoblastoma, 2 Wilms tumor, 2 teratocarcinoma), and 1 child with lymphosarcoma received a live varicella vaccine1 (500 plaque forming unit/dose) without suspension of anticancer medication. All of these children had been in remission.
A Diagnostic Approach to Metabolic Acidosis in Children
Authors: Kappy Michael S. , Morrow Grant 
Published: October 2019

Accurate evaluation of extracellular fluid acid-base status used to be a rather formidable task. However, with the availability of automated clinical testing, this evaluation is now readily performed on any hospitalized child. The following discussion will be limited to various aspects of metabolic acidosis with a brief review of normal and abnormal physiology. A practical approach to the diagnostic work-up of an acidotic child will also be discussed. Several more detailed discussions of acid-base homeostatic mechanisms are available for the reader who is interested in pursuing this subject.1-5
Acidosis, as used in this article, will refer to an abnormal increase in circulating acid with an accompanying decrease in the buffering capacity of the blood as manifest by a low serum bicarbonate level. Acidosis that ultimately exceeds the body's compensatory buffering mechanisms leads to an increase in extracellular fluid (ECF) H+ concentration such that pH is reduced below 7.35. This state is referred to as acidemia.
NORMAL ACID-BASE PHYSIOLOGY
The normal arterial blood pH is maintained at 7.40 (H+ = 39.8 mEq/liter) and ranges between 7.35 and 7.45. When this pH value drops below the normal range, acidemia is present.6 Acidosis (excess circulating acid) may or may not be accompanied by a fall in pH (acidemia) because the body can compensate for a drop in blood pH by combining some of the excess H+ with bicarbonate to form carbonic acid and then CO2, which is eliminated through the lungs by increased ventilation. Since this compensatory process is limited by the amount of bicarbonate available for the reaction with H+, only prolonged or severe acidosis may lead to acidemia.
Failures in Learning and Failures in Teaching
Authors: Eisenberg Leon 
Published: October 2019

Professor Rutter's remarkable study, reported elsewhere in this issue (p 208), of the impact of secondary schools on behavior and attainment is an extraordinary accomplishment, one with major implications for pediatric practice.
The design, execution, and analysis of the study required some nine years of sustained effort. I will forego comment on what is apparent to any reader familiar with the literature on the measurement of behavior; namely, that conceptual elegance and methodologic rigor are required for the construction of behavioral measures sensitive to both process and outcome. What may be less obvious is the "politics" of a school-based study.
Maternal Transmission of HBV Infection
Authors: Mollica Florindo , Musumeci Salvatore , Mattina Teresa , Rugolo Salvatore 
Published: October 2019

Among 18 children of chronic HBsAg carrier Greek mothers, Papaevangelou and Hoofnagle1 found only three subjects with transiently HBsAg-positive cord blood and five others with evidence of HBV infection more than six months after birth and probably resulting from postnatal exposure. They therefore concluded that transplacental transmission of HBV infection is infrequent.
The study of a similar series of 18 children of chronic HBsAg carrier Sicilian women followed with frequent controls for three to 14 months gave us different results.
Cost-Effective Clinical Decision Making
Authors: O'Boyle Edward J. 
Published: October 2019

Duncan Neuhauser's commentary (Pediatrics 60:756, 1977) advocating cost-effectiveness in clinical decision making presents some fundamental problems on both the ethical and technical levels. A satisfactory resolution of both sets of problems is required before this technique is applied in clinical situations.
The cost-effectiveness is based squarely on the principle of economy which justifies allocating resources in a way that produces the greatest gain with the least effort. The technique brushes aside all other principles that are relevant to the allocation of health-care resources, including the principle of equality (every human life is equally precious) and the principle of caring (the most fundamental need of the patient is to be restored to good health and the first duty of the physician is to achieve that end).
Anticancer Uses of Medicinal Plants in Turkish Traditional Medicine
Authors: BOZYEL Mustafa Eray , MERDAMERT BOZYEL Elif , CANLI Kerem , ALTUNER Ergin Murat 
Published: October 2019

The use of plants as therapeutic agents have been known since the
ancient times. In developing countries, traditional medicinal plants are
critical for disease treatment. Various herbal drugs are obtained from these plants for
therapeutic use. These herbal drugs are used in the treatment of many diseases
from diabetes to cancer. Today, cancer is one of the most important
life-threatening diseases for human. Some of the methods used in the treatment
of cancer include herbal sources. The
scientific world is not oblivious to
many herbal drugs used for cancer in traditional treatment methods. Due to the
limited effectiveness of drugs, an increasing number of studies have been
conducted in the last decade to increase the success of cancer treatments. In
recent years, the importance given to the herbal drugs used for medicinal
purposes and the studies on the medicinal uses of plants have increased in our country. In this review,
researches about the herbal drugs traditionally used against cancer by the
local people were investigated. As a result of the study, 160 plant taxa and 17
multi-herbal formulas were reported for cancer treatment in Turkish traditional
medicine.
Böceklerde Farklı Muhafaza Koşulları ve Zamanın Mitokondrial DNA Kalitesi Üzerine Etkisi: Bir Diptera (Tephiritidae) Örneği Çalışması
Authors: AKPINAR Adile , JUMAID Fidan , GÖRMEZ Vedat , KÜTÜK Murat , CAN Canan 
Published: October 2019

Bu çalışmada geleneksel öldürme yöntemleri ile elde
edilmiş ve farklı koşullarda muhafaza edilen Tephritidae familyasına ait Euaresta bullans (Wiedemann, 1830)
örneklerinden DNA izole edilerek muhafaza koşulları ve muhafaza sürelerine
bağlı olarak DNA kalitesi ve PZR başarıları araştırılmıştır. Bu anlamda
standart barkod geni olan mitokondriyal sitokrom oksidaz I (COI) gen bölgesi kullanılmıştır. 15 yıllık
örneklerden kuru ortamda (müze materyali) muhafaza edilenlerin yaşı ile PZR
başarısı arasında tam bir ilişki gözlemlenmemiştir. Ancak alkolde (%95’lik etil
alkol) saklanan örneklerde ise DNA kalitesi ve PZR başarısı yüksek bulunmuştur.
Listening to Cavell
Authors: Young Kay 
Published: October 2019

We hurried to get the front row seats. Even to nineteen-year-olds, it was clear that what was happening in that lecture hall—fittingly, it was Emerson 105—was worth waking up for, worth pushing to the front for, as if we couldn’t get close enough. And what we couldn’t get close enough to was Stanley Cavell lecturing on Western philosophy—a course humbly called “Hum 5” (“Humanities 5: Introduction to Western Philosophy”)—looking back, now forty years later, I can say it was probably the most significant intellectual experience of my life. Cavell’s commanding presence—that big head, fixed gaze, and seriousness of purpose—made his entrance onto the dais, raincoat and brief case in hand, an anticipated event. But what dawns on me now is that it wasn’t so much Cavell’s presence or even what he said that made us feel a shared sense of urgency, but rather how he said it, how he performed this urgency that made us feel like we were somewhere else—a world viewed through Cavell’s mind.
Análisis de significancia de los incrementos al Impuesto al Valor Agregado en la región fronteriza de Quintana Roo de 2003 a 2015
Authors: Lagunas Puls Sergio , Almeida Baeza Alejandra 
Published: October 2019

Desde el año 1995 y hasta 2009, las regiones fronterizas –entre las que se consideraba al estado de Quintana Roo– gozaron de una tasa preferencial del Impuesto al Valor Agregado (IVA) a 10% mientras que para el resto del país aplicaba 15%. Posteriormente, a partir del año 2010 y hasta 2013, la tasa de IVA para regiones fronterizas pasó a 11%; a finales de ese año, el presidente de la República presentó la iniciativa para generalizar la tasa en el nivel nacional en 16%, argumentando que un diseño ideal sería aquel en el que no hubiera excepciones ni tratamientos preferenciales. Por lo anterior, el objetivo del trabajo es evaluar si para Quintana Roo, dichos cambios de tasa pueden considerarse significativos. Para lograrlo se aplican métodos clásicos de significancia contrastados con pruebas para el tamaño del efecto y diferencia tipificada de la media, así como parámetros fundamentales de los meta análisis.

Recepción: 09/08/2016
Aceptación: 03/12/2018
Desigualdad de ingresos y la empresa
Authors: Salazar José de Jesús , Husted Bryan W. 
Published: October 2019

La desigualdad salarial empresarial conlleva una serie de efectos para la empresa, la sociedad y el trabajador, por su parte, su estudio es aún incipiente y plantea complejidades que demandan mayor atención. Se presenta la discusión del fenómeno y se propone una forma de medirlo en sus principales rubros, haciendo el ejercicio para un grupo de empresas situadas en la ciudad de Monterrey, México. Los resultados permiten observar el tipo de desigualdad existente para cada empresa, para el grupo de éstas y su comparación con los índices nacionales. Estas mediciones plantean importantes oportunidades en el diseño de política pública y empresarial, así como un amplio campo de investigación en el ámbito de la relación entre empresa y sociedad.

Recepción: 30/12/2016
Aceptación: 20/03/2019
Contagio vía Cópulas Dinámicas en los Mercados de Capitales del TLCAN (2000-2016)
Authors: Bucio Pacheco Christian , De Jesús Gutiérrez Raúl , Sosa Castro Magnolia Miriam 
Published: October 2019

En este trabajo se estudian las relaciones de dependencia entre los mercados de capitales del bloque del TLCAN, indagando sobre la presencia de contagio. El estudio es realizado a través de la metodología de cópulas con implementación de ventanas móviles. El periodo de análisis es de 2000 a 2016; tomándose tres periodos de 15 años, para los cuales se emplean ventanas móviles de diferente tamaño: a) 2000-2014 utilizando ventanas móviles de dos años siete meses, b) 2001-2015 con ventanas de un año siete meses y c) 2002-2016 con ventanas de siete meses; dichos periodos son seccionados en 3 subperiodos de 5 años cada uno: i) Pre-Crisis, ii) Crisis, y iii) Pos-Crisis. La evidencia empírica muestra notorio contagio durante el periodo de la Crisis Financiera Mundial del 2008 y su consecuente magnitud temporal.

Recepción: 23/10/2017
Aceptación: 13/12/2018
Modelación Markoviana para identificar la dinámica y pronóstico del índice de producción industrial en México de 1980 a 2018
Authors: Cabrera González Gustavo , De León Arias Adrián 
Published: October 2019

En este artículo, por medio de modelación Markoviana estudiamos la identificación de los estados estocásticos y pronóstico del índice mensual de producción industrial en México de 1980 a 2018. Dado que la muestra de datos está sujeta a fuertes fluctuaciones económicas y financieras, de una batería de modelos auto-regresivos (lineales y con parámetros Markovianos de cambio de régimen) se elige la especificación del modelo que mejor se ajusta a los datos a través del factor de Bayes. La selección del modelo provee evidencia de que las tasas de crecimiento mensual de este índice presentan parámetros (media y volatilidad) que cambian con el tiempo. Se lleva a cabo un ejercicio de pronóstico sobre el modelo Markoviano de mejor ajuste a los datos. Para medir su capacidad de inferencia, se compara su eficiencia respecto de la especificación lineal auto-regresiva en la misma serie de datos. Los resultados muestran que la media de los errores de pronóstico (dentro y fuera de la muestra) son menores en la especificación Markoviana. La metodología Bayesiana aplicada permite estimar de forma endógena e inferir de manera precisa incluso por problemas de identificación de parámetros Markovianos, pequeño número de observaciones en regímenes, datos atípicos, número de regímenes e incertidumbre de parámetros sujetos a cambio de estado.

Recepción: 18/07/2018
Aceptación: 13/03/2019