bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship Characteristics and Contraceptive Use Among Young Adults
Authors: Manlove Jennifer , Welti Kate , Barry Megan , Peterson Kristen , Schelar Erin , Wildsmith Elizabeth 
Published: May 2011

CONTEXT: Young adults have high rates of unintended childbearing and STDs, yet little research has examined the role of relationship characteristics in their contraceptive use.
METHODS: Data collected from the 2002–2005 rounds of the National Longitudinal Survey of Youth yielded a sample of 4,014 dating relationships among sexually active 18–26‐year‐olds. Bivariate analysis and multivariate logistic and multinomial logistic regressions assessed associations between relationship characteristics and contraceptive use at last sex.
RESULTS: In three‐quarters of the relationships, respondents had used some method at last intercourse; respondents in 26% of the relationships had used a condom only, in 26% a hormonal method only and in 23% dual methods. Compared with respondents in relationships in which first sex occurred within two months of starting to date, those who first had sex before dating were more likely to have used any method at last sex (odds ratio, 1.4), particularly condoms or dual methods (relative risk ratio, 1.5 for each). The relative risk of using a hormonal method only, rather than no method or condoms only, increased with relationship duration (1.01) and level of intimacy (1.1–1.2). Discussing marriage or cohabitation was associated with reduced odds of having used any method (0.7) and a reduced relative risk of having used condoms alone or dual methods (0.6 for each). Increasing levels of partner conflict and asymmetry were also linked to reduced odds of any method use (0.97 and 0.90, respectively).
CONCLUSIONS: Prevention programs should address relationship context in contraceptive decision making, perhaps by combining relationship and sex education curricula to foster communication and negotiation skills.
Analysis of Glycosaminoglycans in Cerebrospinal Fluid from Patients with Mucopolysaccharidoses by Isotope-Dilution Ultra-Performance Liquid Chromatography–Tandem Mass Spectrometry
Authors: Zhang Haoyue , Young Sarah P , Auray-Blais Christiane , Orchard Paul J , Tolar Jakub , Millington David S 
Published: May 2011

BACKGROUND
New therapies for the treatment of mucopolysaccharidoses that target the brain, including intrathecal enzyme replacement, are being explored. Quantitative analysis of the glycosaminoglycans (GAGs) that accumulate in these disorders is required to assess the disease burden and monitor the effect of therapy in affected patients. Because current methods lack the required limit of quantification and specificity to analyze GAGs in small volumes of cerebrospinal fluid (CSF), we developed a method based on ultra-performance liquid chromatography–tandem mass spectrometry (UPLC-MS/MS).

METHODS
Samples of CSF (25 μL) were evaporated to dryness and subjected to methanolysis. The GAGs were degraded to uronic acid-N-acetylhexosamine dimers and mixed with internal standards derived from deuteriomethanolysis of GAG standards. Specific dimers derived from heparan, dermatan and chondroitin sulfates (HS, DS and CS) were separated by UPLC and analyzed by electrospray ionization MS/MS using selected reaction monitoring for each targeted GAG product and its corresponding internal standard.

RESULTS
CSF from control pediatric subjects (n = 22) contained &lt;0.38 mg/L HS, 0.26 mg/L DS, and 2.8 mg/L CS, whereas CSF from patients with Hurler syndrome (n = 7) contained concentrations of DS and HS that were at least 6-fold greater than the upper control limits. These concentrations were reduced by 17.5% to 82.5% after allogeneic transplantation and treatment with intrathecal and intravenous enzyme replacement therapy.

CONCLUSIONS
The method described here has potential value in monitoring patients with mucopolysaccharidoses receiving treatment targeted to the brain.
First-Trimester Risk Calculation for Trisomy 13, 18, and 21: Comparison of the Screening Efficiency between 2 Locally Developed Programs and Commercial Software
Authors: Sørensen Steen , Momsen Günther , Sundberg Karin , Friis-Hansen Lennart , Jørgensen Finn Stener 
Published: May 2011

BACKGROUND
Reliable individual risk calculation for trisomy (T) 13, 18, and 21 in first-trimester screening depends on good estimates of the medians for fetal nuchal translucency thickness (NT), free β-subunit of human chorionic gonadotropin (hCGβ), and pregnancy-associated plasma protein-A (PAPP-A) in maternal plasma from unaffected pregnancies. Means and SDs of these parameters in unaffected and affected pregnancies are used in the risk calculation program. Unfortunately, our commercial program for risk calculation (Astraia) did not allow use of local medians. We developed 2 alternative risk calculation programs to assess whether the screening efficacies for T13, T18, and T21 could be improved by using our locally estimated medians.

METHODS
We established these estimates from 19 594 women with singleton pregnancies and from 100 pregnant women carrying a fetus affected with trisomy (11 with T13, 23 with T18, and 66 with T21). All measured values were recalculated to a multiple of the median (MoM) and log10 transformed; the mean and SD were calculated for each group.

RESULTS
At a given risk cutoff value, we observed a slight improvement in detection rate (DR) for T13, T18, and T21 for a slightly higher false-positive rate (FPR) compared with the commercial program. The lower FPR in the commercial program was caused mainly by an inaccuracy in the PAPP-A median.

CONCLUSIONS
Center-specific medians for NT, hCGβ, and PAPP-A should be used in risk calculation programs to ensure high DRs and low FPRs for all 3 trisomies at a given risk cutoff.
Comparative Analysis of PCR–Electrospray Ionization/Mass Spectrometry (MS) and MALDI-TOF/MS for the Identification of Bacteria and Yeast from Positive Blood Culture Bottles
Authors: Kaleta Erin J , Clark Andrew E , Cherkaoui Abdessalam , Wysocki Vicki H , Ingram Elizabeth L , Schrenzel Jacques , Wolk Donna M 
Published: May 2011

BACKGROUND
Emerging technologies for rapid identification of microbes demonstrate a shift from traditional biochemical and molecular testing algorithms toward methods using mass spectrometry (MS) for the semiquantitative analysis of microbial proteins and genetic elements. This study was performed to assess the diagnostic accuracy of 2 such technologies, PCR–electrospray ionization (ESI)/MS and MALDI-TOF/MS, with respect to phenotypic and biochemical profiling as a reference standard method. A positive challenge set of blood culture bottles was used to compare PCR-ESI/MS and MALDI-TOF/MS performance on a matched set of samples.

METHODS
We performed characterization of bloodstream infections from blood cultures using the Ibis T5000 PCR-ESI/MS and the Bruker MALDI Biotyper 2.0 (MALDI-TOF/MS) platforms for microbial identification. Diagnostic accuracy was determined by independent comparison of each method to phenotypic and biochemical characterization with Vitek2 analysis as the reference standard identification.

RESULTS
The diagnostic accuracy, represented as positive agreement, at the genus level was 0.965 (0.930–0.984) for PCR-ESI/MS and 0.969 (0.935–0.987) for MALDI-TOF/MS, and at the species level was 0.952 (0.912–0.974) with PCR-ESI/MS and 0.943 (0.902–0.968) for MALDI-TOF/MS. No statistically significant difference was found between PCR-ESI/MS and MALDI-TOF/MS in the ability to rapidly identify microorganisms isolated from blood culture.

CONCLUSIONS
Our results demonstrate that PCR-ESI/MS and MALDI-TOF/MS are equivalent in their ability to characterize bloodstream infections with respect to the reference standard, and highlight key differences in the methods that allow for each method to have a unique niche as a tool for rapid identification of microbes in blood cultures.
Effect of sample collection, temperature and time of storage on β-galactosidase and total hexosaminidase activities in dried blood collected on filter paper
Authors: de Castilhos Cristina D. , Mezzalira Jamila , Goldim Mariana P.S. , Werlang Frederico G. , Coelho Janice C. 
Published: May 2011

Abstract

Background: Dried blood spots (DBS) on filter paper is a valuable sampling technique in clinical chemistry, but the stability of enzymes used in the diagnosis of lysosomal storage diseases (LSDs) needs to be evaluated.

Methods: In a first experiment, blood from 20 subjects was collected using a syringe without additives and distributed into EDTA tubes, heparin tubes, and spotted on filter paper for the comparison of sampling effects. In a second experiment, blood from 30 healthy subjects was spotted on filter paper and analyzed for β-galactosidase and total hexosaminidase activities after storage of the samples at different temperatures for up to 180 days.

Results: Initially, we observed that enzyme activities were the same, independent of the collection method. When DBS was stored at 37°C the activity of β-galactosidase dropped to 85% of the initial value after 180 days (p<0.05). At all other temperatures (–20°C, 4°C and 25°C), the results were within the methodological error. Total hexosaminidase activity did not change significantly during the entire study period and at different storage temperatures.

Conclusions: The two enzymes investigated in the present study may be stored for up to 17 days (β-galactosidase) or 180 days (total hexosaminidase) until analysis without loss of activity.
Corpus evidence of the viability of statistical preemption
Authors: Goldberg Adele E. 
Published: May 2011

Abstract
The present paper argues that there is ample corpus evidence of statistical preemption for learners to make use of. In the case of argument structure constructions, a verbi is preempted from appearing in a construction A, CxA, if and only if the following probability is high: P(CxB|context that would be suitable for CxA and verbi). For example, the probability of hearing a preemptive construction, given a context that would otherwise be well-suited for the ditransitive is high for verbs like explain that overwhelmingly appear in the dative, and low for verbs like tell that readily appear in the ditransitive. Strength of statistical preemption is determined both by this probability, and by the frequency (ln (F)) of a verb in a preemptive construction when the context is at least as well suited to the preempted construction. The critiques of preemption by Stefanowitsch (Cognitive Linguistics 19: 513–531, 2008, this volume) are countered by arguing that the relevant probabilities were not considered. Moreover, we find evidence that constructions are somewhat less constrained when yoked to non-alternating verbs, as Stefanowitsch (cf. this volume) suggests should be the case.
Treatment with tetrahydrocannabinol (THC) prevents infertility in male cystic fibrosis mice
Authors: Bregman Tatiana , Fride Ester 
Published: May 2011

Abstract

Background: Cystic fibrosis (CF) is a hereditary disease caused by mutations of the gene encoding a channel protein CFTR, conducting Cl– and HCO3
– ions. The disease is characterized by disturbances in most physiological systems, and more than 95% of men are infertile. The mechanism underlying the etiology of CF is associated with an imbalance of fatty acids. It has been suggested that the function of the endocannabinoid system is also disturbed in CF, because endocannabinoids are derivatives of fatty acids. We assumed, therefore, that endocannabinoid activity, which plays an important role in fertility, is disrupted in CF and could be one of the causes of infertility. The aim of the present study was to test the hypothesis that stimulation of endocannabinoid receptors in infancy would normalize their function and prevent infertility in adulthood.

Methods: Knockout male mice (cftr–/–) were treated with tetrahydrocannabinol (THC), endocannabinoid receptors agonist, in infancy from days 7 until 28, daily.

Results: CF males treated with THC were fully fertile, producing offspring comparable by the number of litters and the number of pups with wild-type mice. CF males that were not treated with THC were completely infertile.

Conclusions: The present study shows that (i) endocannabinoid function is impaired in CF mice, as evidenced by the regenerating effect of its stimulation on the fertility of otherwise infertile males, (ii) endocannabinoid system dysfunction is apparently the determining factor causing infertility in CF, and (iii) mild stimulation of the endocannabinoid system in infancy and adolescence appears to normalize many reproductive processes and thereby prevent infertility in CF males.
Risk of Later Seizure After Perinatal Arterial Ischemic Stroke: A Prospective Cohort Study
Authors: Wusthoff Courtney J. , Kessler Sudha Kilaru , Vossough Arastoo , Ichord Rebecca , Zelonis Sarah , Halperin Aviva , Gordon Danielle , Vargas Gray , Licht Daniel J. , Smith Sabrina E. 
Published: May 2011

OBJECTIVE:
Although acute seizures are common among neonates with arterial ischemic stroke (AIS), the incidence of subsequent seizures is unknown. The goals of this study were to determine the incidence of seizures following hospital discharge after perinatal acute AIS, and to assess lesion characteristics associated with later seizure occurrence.

METHODS:
Neonates with confirmed acute AIS on MRI were identified through a prospective stroke registry. Clinic visits and telephone follow-up identified occurrence of seizures after hospital discharge. MRI scans were graded for size and characteristics of infarct, and associations with seizures after stroke were analyzed.

RESULTS:
At a mean (SD) follow-up of 31.3 (16.1) months, 11 of 46 (23.9%) patients with perinatal AIS had at least 1 seizure. Five patients had a single episode of seizure, and 6 developed epilepsy. The Kaplan-Meier probability of remaining seizure-free at 3 years was 73%. Stroke size on MRI was significantly associated with development of later seizures, with an incidence rate of later seizures 6.2 times higher among those with larger stroke size.

CONCLUSIONS:
Seizures occurred in &lt;25% of patients during initial follow-up after perinatal AIS. Of those with seizures, nearly half had a single episode of seizure and not early epilepsy. Larger stroke size was associated with higher risk of seizure. These data suggest that prolonged treatment with anticonvulsant agents may not be indicated for seizure prophylaxis after perinatal AIS. These findings may help guide clinicians in counseling families and could form the basis for much-needed future research in this area.
Inpatient Health Care Utilization for Children Dependent on Long-term Mechanical Ventilation
Authors: Benneyworth Brian D. , Gebremariam Achamyeleh , Clark Sarah J. , Shanley Thomas P. , Davis Matthew M. 
Published: May 2011

OBJECTIVE:
The objective was to describe the characteristics of pediatric discharges associated with long-term mechanical ventilation (LTMV) compared with those with complex chronic conditions (CCCs), and evaluate trends over time in health care utilization for the discharges associated with LTMV.

METHODS:
The Kids' Inpatient Database, compiled by the Agency for Healthcare Research and Quality, was used. Routine newborn care was excluded. Discharges associated with LTMV were identified by using the International Classification of Diseases, Ninth Revision, code v46.1x and compared with discharges associated with CCCs in 2006 using simple regression and χ2 analyses. Trends in LTMV-associated discharges from 2000 to 2006 were assessed using variance-weighted least squares regression.

RESULTS:
In 2006, there were an estimated 7812 discharges associated with LTMV. Compared with discharges for children with CCCs, LTMV discharges had significantly higher mortality, longer lengths of stay, higher mean charges, more emergency department admissions, and more discharges to long-term care. From 2000 to 2006, there was a 55% increase in the number of LTMV discharges and a concurrent 70% increase in aggregate hospital charges. The majority of LTMV discharges occurred in children 4 years old and younger, and ∼50% of the aggregate charges were for children younger than 1 year.

CONCLUSIONS:
Discharges for children associated with LTMV require substantively greater inpatient resource use than other children with CCCs. As the number of discharges and associated aggregate charges increase over time, additional research must examine patterns of care for specific clinical subgroups of LTMV, especially children aged 4 years and younger.
Care Models and Associated Outcomes in Congenital Heart Surgery
Authors: Burstein Danielle S. , Jacobs Jeffrey P. , Li Jennifer S. , Sheng Shubin , O'Brien Sean M. , Rossi Anthony F. , Checchia Paul A. , Wernovsky Gil , Welke Karl F. , Peterson Eric D. , Jacobs Marshall L. , Pasquali Sara K. 
Published: May 2011

OBJECTIVE:
Recently, there has been a shift toward care of children undergoing heart surgery in dedicated pediatric cardiac intensive care units (CICU). The impact of this trend on patient outcomes is unclear. We evaluated postoperative outcomes associated with a CICU versus other ICU models.

PATIENTS AND METHODS:
Society of Thoracic Surgeons Congenital Heart Surgery Database participants (2007–2009) who completed an ICU survey were included. In multivariable analysis, we evaluated outcomes associated with a CICU versus other ICUs, adjusting for center volume, patient factors, and Society of Thoracic Surgeons–European Association for Cardiothoracic Surgery surgical risk category.

RESULTS:
A total of 20 922 patients (47 centers; 25 with a CICU) were included. Overall unadjusted mortality was 3.8%, median length of stay was 6 days (interquartile range: 4–13), and 21% had 1 or more complications. In multivariable analysis, there was no difference in mortality comparing CICUs versus other ICUs (odds ratio: 0.88 [95% confidence interval: 0.65–1.19]). In stratified analysis, CICUs were associated with lower mortality only among those in Society of Thoracic Surgeons–European Association for Cardiothoracic Surgery category 3 (odds ratio: 0.47 [95% confidence interval: 0.25–0.86]), primarily related to atrioventricular canal repair and arterial switch operation. There was no difference in length of stay or complications overall or in stratified analysis.

CONCLUSIONS:
We were not able to detect a difference in postoperative morbidity or mortality associated with the presence of a dedicated CICU for children undergoing heart surgery. There may be a survival benefit in certain subgroups .
Cardiovascular Events and Death in Children Exposed and Unexposed to ADHD Agents
Authors: Schelleman Hedi , Bilker Warren B. , Strom Brian L. , Kimmel Stephen E. , Newcomb Craig , Guevara James P. , Daniel Gregory W. , Cziraky Mark J. , Hennessy Sean 
Published: May 2011

OBJECTIVE:
The objective of this study was to compare the rate of severe cardiovascular events and death in children who use attention-deficit/hyperactivity disorder (ADHD) medications versus nonusers.

PATIENTS AND METHODS:
We performed a large cohort study using data from 2 administrative databases. All children aged 3 to 17 years with a prescription for an amphetamine, atomoxetine, or methylphenidate were included and matched with up to 4 nonusers on the basis of data source, gender, state, and age. Cardiovascular events were validated using medical records. Proportional hazards regression was used to calculated hazard ratios.

RESULTS:
We identified 241 417 incident users (primary cohort). No statistically significant difference between incident users and nonusers was observed in the rate of validated sudden death or ventricular arrhythmia (hazard ratio: 1.60 [95% confidence interval (CI): 0.19–13.60]) or all-cause death (hazard ratio: 0.76 [95% CI: 0.52–1.12]). None of the strokes identified during exposed time to ADHD medications were validated. No myocardial infarctions were identified in ADHD medication users. No statistically significant difference between prevalent users and nonusers (secondary cohort) was observed (hazard ratios for validated sudden death or ventricular arrhythmia: 1.43 [95% CI: 0.31–6.61]; stroke: 0.89 [95% CI: 0.11–7.11]; stroke/myocardial infarction: 0.72 [95% CI: 0.09–5.57]; and all-cause death: 0.77 [95% CI: 0.56–1.07).

CONCLUSIONS:
The rate of cardiovascular events in exposed children was very low and in general no higher than that in unexposed control subjects. Because of the low number of events, we have limited ability to rule out relative increases in rate.
An Emergency Department Septic Shock Protocol and Care Guideline for Children Initiated at Triage
Authors: Larsen Gitte Y. , Mecham Nancy , Greenberg Richard 
Published: May 2011

BACKGROUND:Unrecognized and undertreated septic shock increases morbidity and mortality. Septic shock in children is defined as sepsis and cardiovascular organ dysfunction, not necessarily with hypotension.OBJECTIVE:Cases of unrecognized and undertreated septic shock in our emergency department (ED) were reviewed with a focus on (1) increased recognition at triage and (2) more aggressive treatment once recognized. We hypothesized that septic shock protocol and care guideline would expedite identification of septic shock, increase compliance with recommended therapy, and improve outcomes.METHODS:We developed an ED septic shock protocol and care guideline to improve recognition beginning at triage and evaluated all eligible ED patients from January 2005 to December 2009.RESULTS:We identified 345 pediatric ED patients (49% male, median age: 5.6 years), and 297 (86.1%) met septic shock criteria at triage. One hundred ninety-six (56.8%) had ≥1 chronic complex condition. Hypotension was present in 34% (n = 120); the most common findings were tachycardia (n = 251 [73%]) and skin-color changes (n = 269 [78%]). The median hospital length of stay declined over the study period (median: 181–140 hours; P &lt; .05); there was no change in mortality rate, which averaged 6.3% (22 of 345). The greatest gains in care included more complete recording of triage vital signs, timely fluid resuscitation and antibiotic administration, and serum lactate determination.CONCLUSIONS:Implementation of an ED septic shock protocol and care guideline improved compliance in delivery of rapid, aggressive fluid resuscitation and early antibiotic and oxygen administration and was associated with decreased length of stay.
Short-Course Versus Standard Chemoradiation in T3 Rectal Cancer
Authors: Hong Theodore S. , Mamon Harvey 
Published: May 2011

Abstract

Presentation of the Case
A 68-year-old woman with no past medical history presents with rectal bleeding. Colonoscopy reveals a mass in the midrectum at approximately 8 cm. Biopsy shows adenocarcinoma. On physical exam, the tip of the mass is barely palpable. A magnetic resonance imaging (MRI) scan of the pelvis demonstrates a tumor with invasion through the muscularis in the midrectum (Fig. 1). There is at least 2 cm between the tip of the mass and the mesorectum. A single 8-mm lymph node is seen in the perirectal space. A medical oncologist, surgical oncologist, and radiation oncologist see the patient and they recommend that the patient receive 6 weeks of infusional 5-fluorouracil (5-FU) and external beam radiation to a dose of 50.4 Gy. After chemoradiation, the oncologists expect the patient to undergo a low anterior resection and, upon recovery, 4 months of 5-FU–based adjuvant chemotherapy. The oncology fellow asks the attending physicians whether short-course radiation therapy is appropriate for this patient.