bluuebunny/crossref_metadata_2025_split huggingface dataset:
Timing of adjuvant radiotherapy and treatment outcome in childhood ependymoma
Authors: Liu Anthony Pak‐Yin , Shing Matthew Ming‐Kong , Yuen Hui‐Leung , Li Chak‐Ho , Ling Siu‐Cheung , Luk Chung‐Wing , Ha Shau‐Yin , Li Chi‐Kong , Kwong Dora Lai‐Wan , Chan Godfrey Chi‐Fung 
Published: October 2013

AbstractBackgroundSeveral trials incorporating adjuvant focal RT for treatment of young children with ependymoma have demonstrated improved survival with acceptable adverse effects. The optimal timing of RT administration is, however, unknown.ProcedureA retrospective review of territory‐wide database was performed to identify pediatric patients with ependymoma diagnosed between 1995 and 2011. OS and EFS were compared between patients receiving upfront RT (<150 days of diagnosis), delayed RT (≥150 days of diagnosis), or no RT.ResultsThirty‐one patients with intracranial ependymoma were identified. Median age was 3.5 years and 14 (45%) were male. Primary tumor was supratentorial in 10 (32%) and infratentorial in 21 (68%). All patients underwent initial surgery, with gross‐total resection (GTR) in 27 (87%). Twelve (39%) received upfront RT, 10 (32%) had delayed RT and 9 (29%) had no RT. During the study period, there were 11 relapses (35%) and 10 deaths (32%). Five‐year OS was 69.9% and 5yr‐EFS was 49.3%. In univariate analysis, GTR led to improved OS (P < 0.001) and EFS (P = 0.004); superior OS and EFS was observed in patients who received RT when compared with those without (P = 0.018 and 0.011, respectively). Upfront RT also resulted in better OS and EFS than delayed RT (P = 0.049 and 0.014, respectively). No significant effect on survival was observed with age, sex, tumor location, RT dosage, and protocol used. In multivariate analysis, GTR significantly improved OS (P = 0.002) and EFS (P = 0.004).ConclusionsOur results support the early initiation of adjuvant RT in the multi‐modal management of pediatric ependymomas. Pediatr Blood Cancer 2014;61:606–611. © 2013 Wiley Periodicals, Inc.
A randomized, double‐blind, placebo‐controlled clinical trial of megestrol acetate as an appetite stimulant in children with weight loss due to cancer and/or cancer therapy
Authors: Cuvelier Geoff D.E. , Baker Tina J. , Peddie Elaine F. , Casey Linda M. , Lambert Pascal J. , Distefano Dianne S. , Wardle Marlene G. , Mychajlunow Beth A. , Romanick Marcel A. , Dix David B. , Wilson Beverly A. 
Published: October 2013

AbstractBackgroundMegestrol acetate (MA) is an appetite stimulant with efficacy in promoting weight gain in adults with cancer‐associated anorexia–cachexia. Studies documenting MA efficacy in children, however, are limited. We present the first randomized, double‐blind, placebo‐controlled clinical trial of MA versus placebo in children with cancer and weight loss.MethodsSubjects <18 years of age with weight loss (minimum 5% from highest previous weight; or %ideal body weight <90%) due to cancer and/or cancer therapy were randomized to either MA (7.5 mg/kg/day) or placebo for a planned study duration of 90 days. Primary outcome was the difference between groups in mean percent weight change from beginning to end of the study period. Secondary outcomes included effects on anthropometrics, body composition, need for tube feeding or parenteral nutrition, and toxicities.ResultsTwenty‐six patients were randomly assigned (13 MA, 13 placebo). The MA group experienced a mean weight gain of +19.7% compared to a mean weight loss of −1.2% in the placebo group, for a difference of +20.9% (95%CI: +11.3% to +30.5%, P = 0.003) in favor of MA over placebo. MA subjects experienced significant increases in weight for age z‐scores, body mass index z‐scores, and mid upper arm circumference compared to placebo. DXA scanning suggested disproportionate increases in fat accrual. Adrenal suppression was the main toxicity of MA.ConclusionIn children with high‐risk malignancies, MA resulted in significant increases in mean percent weight change compared to placebo. Further studies of MA should be pursued to better delineate the effect on nutritional status. Pediatr Blood Cancer 2014;61:672–679. © 2013 Wiley Periodicals, Inc.
A new 2D model for the electrical potential in a cell stripe in thin‐film solar modules including local defects
Authors: Pieters Bart E. , Rau Uwe 
Published: October 2013

AbstractThe performance of solar modules is strongly influenced by the presence of local defects (shunts) in the module. Modeling cell stripes with local defects requires at least a 2D model. Most works on such 2D models are based on the numerical solution of the involved differential equations. These numerical models are quite computationally intensive and hence tedious for applications that require many evaluations of the model, for example, fitting experiments, computing accurate current/voltage characteristics, and finding a maximum power point. In this work, we present a fast 2D model for a cell stripe based on the superposition of several analytical expressions. This model uses a linearization of the solar cell current/voltage characteristics and takes the sheet resistance of one electrode into account (i.e., the other electrode is assumed to be a perfect conductor). With our model, the potential distribution in a cell stripe in the presence of local shunts can be computed in a matter of seconds. The model has been made freely available. Copyright © 2013 John Wiley & Sons, Ltd.
Development of high‐performance multicrystalline silicon for photovoltaic industry
Authors: Yang Y. M. , Yu A. , Hsu B. , Hsu W. C. , Yang A. , Lan C. W. 
Published: October 2013

AbstractThe low cost and high quality of multicrystalline silicon (mc‐Si) based on directional solidification has become the main stream in photovoltaic (PV) industry. The mc‐Si quality affects directly the conversion efficiency of solar cells, and thus, it is crucial to the cost of PV electricity. With the breakthrough of crystal growth technology, the so‐called high‐performance mc‐Si has increased about 1% in solar cell efficiency from 16.6% in 2011 to 17.6% in 2012 based on the whole ingot performance. In this paper, we report our development of this high‐performance mc‐Si. The key ideas behind this technology for defect control are discussed. With the high‐performance mc‐Si, we have achieved an average efficiency of near 17.8% and an open‐circuit voltage (Voc) of 633 mV in production. The distribution of cell efficiency was rather narrow, and low‐efficiency cells (<17%) were also very few. The power of the 60‐cell module using the high‐efficiency cells could reach 261 W as well. Copyright © 2013 John Wiley & Sons, Ltd.
Think twice: Misleading food‐induced respiratory symptoms in children with food allergy
Authors: Ahrens B. , Mehl A. , Lau S. , Kroh L. , Magdorf K. , Wahn U. , Beyer K. , Niggemann B. 
Published: October 2013

SummaryReported food‐related symptoms of patients may sometimes be misleading. A correct delineation of food‐induced symptoms is often difficult and various differential diagnoses have to be considered. We report on two cases of food‐induced, predominantly respiratory symptoms (in one case life‐threatening) in children with food allergy. First, a two‐year‐old boy with no history of allergies and suspected foreign body aspiration which was finally diagnosed as an anaphylactic reaction to fish, and secondly a six‐year‐old girl with multiple food allergies and allergic asthma who during an electively performed oral food challenge developed severe respiratory distress, drop in blood pressure, and asphyxia not due to an anaphylactic reaction but due to choking on an unnoticed sweet. These two cases represent challenging, life‐threatening symptom constellations involving food‐induced reactions in food allergic children, reminding us to question first impressions. Pediatr Pulmonol. 2014; 49:E59–E62. © 2013 Wiley Periodicals, Inc.
The role of farm operational and rural environments as potential risk factors for pediatric asthma in rural Saskatchewan
Authors: Barry Rebecca J. , Pickett William , Rennie Donna C. , Dosman James A. , Pahwa Punam , Hagel Louise , Karunanayake Chandima , Lawson Joshua A. ,   on Behalf of the Saskatchewan Rural Health Study Team
Published: October 2013

SummaryBackgroundResearchers have historically reported that farm children have a lower prevalence of asthma compared to more urban children. Potential explanations include theories surrounding differences in personal factors, access to health care, engagement in health risk behaviors, and differences in the environment.ObjectiveThe aims of this study were to: (1) confirm whether the prevalence of asthma varies between farm and small town status among children living in Saskatchewan; (2) identify risk and protective factors for asthma, and use this information to infer which of the above theories is most explanatory for any observed geographic variations in pediatric asthma.MethodsRural students (N = 2383, 42% participation rate) from the province of Saskatchewan participated in a 2011 cross‐sectional study. Parents completed a survey that included questions about location of residence, respiratory symptoms, potential risk factors for respiratory disease, and exposures to farm activities. Multiple logistic regression was used to examine relations between respiratory outcomes (asthma, wheeze) with farm type and farm activities, while accounting for factors that may underlie such relations.ResultsAsthma and wheeze prevalence did not differ by residential status. Living on a grain farm (OR = 0.64, 95% CI = 0.43–0.96), cleaning or playing in pens (OR = 0.69, 95% CI = 0.46–1.02), filling grain bins (OR = 0.56, 95% CI = 0.32–0.96), and riding horses (OR = 0.65, 95% CI = 0.40–1.05) were protective factors for ever diagnosis with asthma.ConclusionsWe identified a number of risk and protective factors for asthma and associated wheeze. This suggests the need to focus on specific environmental explanations to better understand previously observed associations between farm residential status and asthma. Pediatr Pulmonol. 2014; 49:842–851. © 2013 Wiley Periodicals, Inc.
Pediatricians' attitudes and costs of bronchiolitis in the emergency department: A prospective multicentre study
Authors: Garcia‐Marcos Luis , Valverde‐Molina José , Pavlovic‐Nesic Svetlana , Claret‐Teruel Gemma , Peñalba‐Citores Ana C. , Nehme‐Álvarez Daniel , Korta‐Murua Javier , Sánchez‐Etxaniz Jesus , Alonso‐Salas Maria T. , Campos‐Calleja Carmen , Fernández‐Villar Andrés , Rodríguez‐Suarez Julian ,   the BCOST group
Published: October 2013

AbstractBackgroundHow pediatricians manage bronchiolitis and the derived total costs (direct and indirect) in the emergency department (ED) have not been fully characterized. The aim of the present study is to calculate those costs in a European country.MethodsA prospective and observational study, including 10 EDs of tertiary hospitals throughout Spain and during the bronchiolitis season 2010–2011, was performed. Every ED recruited children on random days of the week (3 days per week; always including one non‐working day per every week). Recruitment aimed at a total sample size of 600 children. Direct (diagnostic procedures, time spent in the ED and medication) and indirect costs (work hours lost by parents, babysitting, travels, and meals) were collected. Comparisons between bronchiolitis caused by respiratory syncytial virus (RSV) and non‐RSV bronchiolitis, as well as costs across severity categories were performed with the Kruskal–Wallis test. A multiple regression model was built to assess the influence of several of the studied factors on the total costs, including a RSV positive test and episode severity as independent variables; and gender, age, attending nursery school, preterm birth, low birth weight, smoker mother during pregnancy, and current smoker father as covariates.ResultsFrom the 664 recruited children, direct mean costs were €213.2 ± 91.8 and indirect ones were €35.9 ± 55.3; the total costs being €249.2 ± 122.9. Costs were significantly higher in children positive to RSV and rose with increased severity. Those associations were maintained in the multiple regression analysis.ConclusionsAlthough relatively low at the individual level (€249.2, mean total cost) the costs for just the ED expenses of bronchiolitis in Spain would add up to about €20 million per year. Pediatr Pulmonol. 2014; 49:1011–1019. © 2013 Wiley Periodicals, Inc.
Obesity negatively impacts lung function in children and adolescents
Authors: Davidson Warren J. , Mackenzie‐Rife Kelly A. , Witmans Manisha B. , Montgomery Mark D. , Ball Geoff D.C. , Egbogah Shirley , Eves Neil D. 
Published: October 2013

SummaryObjectivesTo investigate the relationship between weight status (body mass index [BMI] percentile and BMI z‐score) and lung volumes in healthy children and adolescents.HypothesesWe hypothesized that: (a) there would be a significant inverse relationship between age‐ and sex‐specific BMI distribution and functional residual capacity (FRC), and expiratory reserve volume (ERV), respectively; and (b) obese children would have significantly reduced FRC and ERV compared to their non‐obese peers.MethodsThe medical records of all individuals who successfully performed pulmonary function testing between 2000 and 2007 at two university children's hospitals were reviewed. Participants were excluded if they had cardiopulmonary, neuromuscular, or chest wall disease.ResultsOf 1,469 record reviewed, 327 subjects met study criteria. Percent predicted ERV was lowest in the obese group (P < 0.001) while residual volume (RV) was lowest in the overweight and obese groups (P < 0.001). Underweight participants had a lower percent predicted forced vital capacity (FVC) (P = 0.027) and vital capacity (VC; P = 0.039). Obese participants had the lowest FEV1/FVC (P < 0.001). A positive linear relationship existed between BMI z‐score and percent predicted FVC, VC, and diffusing capacity of carbon monoxide (DLCO). A negative linear relationship was found between BMI z‐score and percent predicted FRC, ERV, RV, and absolute FEV1/FVC.ConclusionsOur results show that increasing weight status in children and adolescents is associated with a general reduction in lung volume measurements, which may reflect impaired lung function, increased respiratory symptoms, and decreased functional status. Pediatr Pulmonol. 2014; 49:1003–1010. © 2013 Wiley Periodicals, Inc.
Tracheomalacia is associated with lower FEV1 and Pseudomonas acquisition in children with CF
Authors: Fischer Anthony J. , Singh Sachinkumar B. , Adam Ryan J. , Stoltz David A. , Baranano Christopher F. , Kao Simon , Weinberger Miles M. , McCray Paul B. , Starner Timothy D. 
Published: October 2013

SummaryBackgroundTracheomalacia (TM) occurs in approximately 1 in 2,100 children. Because the trachea develops abnormally in animal models of cystic fibrosis (CF), we hypothesized this may also occur in children with CF, increasing their risk of TM.PurposeTo examine the prevalence and clinical consequences of TM in children with CF.MethodsWe studied children with CF born between 1995 and 2012. TM was defined as dynamic collapse of the trachea, and the severity was recorded as described in the chart. The effect of TM on patient outcomes, including FEV1, CT changes, and acquisition of CF pathogens, was assessed using a longitudinal patient dataset.ResultsEighty‐nine percent of children with CF had at least one bronchoscopy (n = 97/109). Fifteen percent of these children had TM described in any bronchoscopy report (n = 15/97). Of the patients with TM, eight had meconium ileus (P = 0.003) and all were pancreatic insufficient. Pseudomonas aeruginosa infection occurred 1.3 years earlier among children with TM (P = 0.01). Starting FEV1 values by age 8 were diminished by over 18% of predicted for patients with TM. Life‐threatening episodes of airway obstruction occurred in 3 of 15 patients with CF and TM, including one leading to death. Gender, prematurity, and hepatic disease were not associated with TM. No difference was observed in the frequency of bronchiectasis.ConclusionsTM is significantly more common in infants and children with CF than in the general population and is associated with airway obstruction and earlier Pseudomonas acquisition. Pediatr Pulmonol. 2014; 49:960–970. © 2013 Wiley Periodicals, Inc.
Disparities in assessments of asthma control between children, parents, and physicians
Authors: Shefer Galit , Donchin Milka , Manor Orly , Levy‐Hevroni Revital , Schechter Abraham , Cohen Rinat , Cohen Herman A. , Kerem Eitan , Engelhard Dan 
Published: October 2013

SummaryObjectiveAssessment of asthma control in children by physicians, patients and their parents was compared, assuming parents may underestimate symptoms in asthmatic children and exploring whether physicians tend to agree with them.DesignAsthma control perception was assessed in 4‐ to 11‐year‐old asthmatic children and their parents, using C‐ACT, during 2011–2012. Pediatric pulmonologists used GINA guidelines for their assessment; pediatricians, not having spirometry, used the information given in addition to physical examination. The C‐ACT scores given by the children and their parents were further analyzed separately, and compared with their physicians' assessment. Statistical methods, which also measured possible influence of different variables, included kappa, Chi‐square, linear‐by‐linear association, McNemar test and logistic regression.Patient SelectionThe study comprised 354 parents and children aged 4–11 years with moderate‐severe asthma; 129 (36.4%) were treated by 23 pediatricians; 225 (63.6%) by 11 pediatric pulmonologists.ResultsThe C‐ACT was generally found valid in assessing asthma control (P < 0.001; κ 0.529; CI 0.441, 0.617) and showed that in 229/354 (53%) of children the asthma was uncontrolled. Nevertheless, of the 229 children who indicated their asthma was uncontrolled, 124 (54.1%) of their parents (κ 0.245; CI 0.15, 0.34) and 96 (41.9%) of their physicians believed it to be controlled (κ 0.331; 0.24, 0.43). Comparing the physician‐child discordance vis‐à‐vis the parents, the significant difference was when 96/229 children (41.9%) and 34/126 parents (27.0%) indicated the asthma was uncontrolled while the physician determined it controlled (OR 1.95; 1.19, 3.24). There were no significant differences between pediatric pulmonologists and pediatricians.ConclusionsIn addition to increasing awareness of parents to symptoms in their asthmatic children, physicians should question the child appropriately, as well as using the children's responses to C‐ACT as an information source for properly assessing asthma control. Pediatr Pulmonol. 2014; 49:943–951. © 2013 Wiley Periodicals, Inc.
Asthma‐predictive‐index, bronchial‐challenge, sputum eosinophils in acutely wheezing preschoolers
Authors: Ater Dorit , Bar Bat‐El , Fireman Nir , Fireman Elizabeth , Shai Hanita , Tasher Diana , Dalal Ilan , Mandelberg Avigdor 
Published: October 2013

SummaryBackgroundMost preschoolers with viral wheezing exacerbations are not atopic.AimTo test in a prospective controlled trial whether wheezing preschoolers presenting to the ED are different from the above in three different domains defining asthma: the atopic characteristics based on stringent asthma predictive index (S‐API), the characteristics of bronchial hyper‐responsiveness (BHR), and airway inflammation.MethodsThe S‐API was prospectively collected in 41 preschoolers (age 31.9 ± 17.4 months, range; 1–6 years) presenting to the ED with acute wheezing and compared to healthy preschoolers (n = 109) from our community (community control group). Thirty out of the 41 recruited preschoolers performed two sets of bronchial challenge tests (BCT)‐(methacholine and adenosine) within 3 weeks and following 3 months of the acute event and compared to 30 consecutive ambulatory preschoolers, who performed BCT for diagnostic workup in our laboratory (ambulatory control group). On presentation, induced sputum (IS) was obtained from 22 of the 41 children.OutcomesPrimary: S‐API, secondary: BCTs characteristics and percent eosinophils in IS.ResultsSignificantly more wheezing preschoolers were S‐API positive compared with the community control group: 20/41 (48.7%) versus 15/109 (13.7%, P < 0.001). All methacholine‐BCTs—30/30 (100%) were positive compared with 13/14 (92.8%) in the ambulatory control group (P = 0.32). However, 23/27 (85.2%) were adenosine‐BCT positive versus 3/17 (17.5%) in the ambulatory control group (P < 0.001). Diagnostic IS success rate was 18/22 (81.8%). Unexpectedly, 9/18 (50.0%) showed eosinophilia in the IS.ConclusionsWheezing preschoolers presenting to the ED is a unique population with significantly higher rate of positive S‐API and adenosine‐BCT compared with controls and frequently (50%) express eosinophilic airway inflammation. Pediatr Pulmonol. 2014; 49:952–959. © 2013 Wiley Periodicals, Inc.
Physiological correlates of pulmonary function in children with cystic fibrosis
Authors: Wells Greg D. , Wilkes Donna L. , Schneiderman Jane E. , Thompson Sara , Coates Allan L. , Ratjen Felix 
Published: October 2013

SummaryRationaleAlthough peak aerobic capacity (VO2peak) has been linked to outcome in patients with cystic fibrosis (CF), measuring is time consuming, and requires expensive equipment and expertise that is not readily available in all centers. Other fitness parameters such as peak anaerobic power, measures of power and strength may be simpler to deliver in the clinic. The relationship between these measures and established outcomes such as forced expiratory volume in one second (FEV1) and peak aerobic power (VO2peak) in CF remains unclear. Therefore we evaluated (a) aerobic fitness, (b) anaerobic fitness, and (c) upper and lower body muscle strength to determine their relationship to FEV1 and VO2peak in children with CF.MethodsEighty‐two patients (7–18 years) with CF (40 female) from the CF clinic at The Hospital for Sick Children in Toronto performed a maximal incremental cycling test to exhaustion. Anaerobic power (W) for 10 and 30 sec cycling trials as well as vertical jump (VJ) and hand grip strength (HG) were compared to FEV1 and VO2peak.ResultsAbsolute VO2peak (R2 = 0.16, P < 0.001), anaerobic power (R2 = 0.21, P < 0.001), and hand grip strength (R2 = 0.10, P = 0.003) were significantly correlated to lung function whereas measures of explosive lower body strength (VJ) were not. Anaerobic power (R2 = 0.16, P = 0.001) and hand grip strength (R2 = 0.08, P = 0.01) were related to VO2peak. Vertical jump was correlated with VO2peak (R2 = 0.29, P < 0.001) but not FEV1.ConclusionsSimple fitness tests such as hand grip strength and anaerobic cycle tests may be useful indicators of lung health and fitness. Pediatr Pulmonol. 2014; 49:878–884. © 2013 Wiley Periodicals, Inc.