bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Effect of Rapid Screening for Methicillin-ResistantStaphylococcus aureus(MRSA) on the Identification and Earlier Isolation of MRSA-Positive Patients
Authors: Creamer Eilish , Dolan Anthony , Sherlock Orla , Thomas Toney , Walsh John , Moore Joan , Smyth Edmond , O'Neill Eoghan , Shore Anna , Sullivan Derek , Rossney Angela S. , Cunney Robert , Coleman David , Humphreys Hilary 
Published: February 2010

Objectives.(1) To determine whether rapid screening with polymerase chain reaction (PCR) assays leads to the earlier isolation of patients at risk for methicillin-resistantStaphylococcus aureus(MRSA) colonization, (2) to assess compliance with routine MRSA screening protocols, (3) to confirm the diagnostic accuracy of the Xpert MRSA real-time PCR assay (Cepheid) by comparison with culture, and (4) to compare turnaround times for PCR assay results with those for culture results.Design.Before-and-after study conducted in a 700-bed acute tertiary care referral hospital. Study periods were (1) a 5-week period before PCR testing began, (2) a 10-week period when the PCR assay was used, and (3) a 5-week period after PCR testing was discontinued.Results.Among 489 at-risk patients, MRSA was isolated from 20 (33%) of 60 patients during period 1, 77 (22%) of 349 patients during period 2, and 18 (23%) of 80 patients during period 3. Twenty-two (27%) of 82 at-risk patients were not screened during period 1, compared with 40 (10%) of 389 at-risk patients not screened during period 2 (P< .001). More MRSA-positive patients were preemptively isolated during periods 1 and 3 compared with period 2 (34 [24%] of 140 vs 28 [8%] of 389;P< .001); however, more MRSA-positive patients were isolated after notification of MRSA-positive results during period 2 (47 [13%] of 349) compared with periods 1 and 3 (2 [1%] of 140;P< .001). The sensitivity, specificity, positive predictive value, and negative predictive value of the PCR assay were 95%, 97%, 82%, and 99%, respectively. The mean turnaround time from receipt of specimens in the laboratory to PCR assay result was 2.6 hours.Conclusions.Rapid screening with the Xpert MRSA PCR assay facilitated compliance with screening policies and the earlier isolation of MRSA-positive Patients. Discrepant results confirm that PCR testing should be used as a screening tool rather than as a diagnostic tool.
Neoconstructivism
Authors: Johnson Scott 
Published: February 2010

Abstract
Arguments over the developmental origins of human knowledge are ancient, founded in the writings of Plato, Aristotle, Descartes, Hume, and Kant. They have also persisted long enough to become a core area of inquiry in cognitive and developmental science. Empirical contributions to these debates, however, appeared only in the last century, when Jean Piaget offered the first viable theory of knowledge acquisition that centered on the great themes discussed by Kant: object, space, time, and causality. The essence of Piaget's theory is constructivism: the building of concepts from simpler perceptual and cognitive precursors. In particular, from experience gained through manual behaviors and observation. The constructivist view was disputed by a generation of researchers dedicated to the idea of the “competent infant,” endowed with knowledge (say, of permanent objects) that emerged prior to facile manual behaviors. Taking this possibility further, it has been proposed that many fundamental cognitive mechanisms—reasoning, event prediction, decision-making, hypothesis testing, and deduction—operate independently of all experience and are, in this sense, innate. The competent-infant view has an intuitive appeal, attested to by its widespread popularity, and it enjoys a kind of parsimony: it avoids the supposed philosophical pitfall posed by having to account for novel forms of knowledge in inductive learners. But this view leaves unaddressed a vital challenge: to understand the mechanisms by which new knowledge arises. This challenge has now been met. The neoconstructivist approach is rooted in Piaget's constructivist emphasis on developmental mechanisms.
Mixing the Old with the New and the New with the Old: Combining Prior and Current Knowledge in Conceptual Change
Authors: Mareschal Denis , Westermann Gert 
Published: February 2010

AbstractThis chapter examines two approaches to resolving the question of how prior knowledge and current knowledge interact in category learning. The first relies on mathematical models of statistical inference. The second is an implemented connectionist computational model. To illustrate the usefulness of these latter models, the chapter develops a possible connectionist model of how prior knowledge and on-line learning integrate during early concept learning.
A Bottom-up Approach to Infant Perception and Cognition: A Summary of Evidence and Discussion of Issues
Authors: Cohen Leslie B. 
Published: February 2010

AbstractThis chapter presents a bottom-up approach to infant perception and cognition. It provides evidence from topics ranging from infant angle perception to infant categorization and early word learning that a constructivist, building block type of system seems to capture much of the acquisition process. The system, which is domain-general and occurs at many different ages, uses correlational, conditional, and perhaps other types of relations to construct higher-order units from combinations of lower-order units. Even though this system describes how changes may occur in many aspects of infant perception and cognition, it still is only a description of behavior and behavioral change. A more complete explanation requires models that are explicit about the mechanisms underlying that change. Connectionist models may be one vehicle for doing that, but most of the ones designed so far for infant perception and cognition are limited to a single area of application and do not deal adequately with underlying and repeated developmental changes. The models are a good first step, however, and they do highlight an interesting and important issue. Fundamentally, they are models of learning, some that do require feedback and others that just self-organize from the inputs they receive. But they do raise the issue of similarities and differences between mechanisms underlying learning and mechanisms underlying development.
Pancreaticobiliary Maljunction Without Bile Duct Dilatation in Children: Distinction From Choledochal Cyst
Authors: Ono Yasuyuki , Kaneko Kenitiro , Tainaka Takahisa , Sumida Wataru , Ando Hisami 
Published: February 2010

ABSTRACTObjectives:Pancreaticobiliary maljunction without bile duct dilatation (nondilated type) is rare in children, and its definition remains unclear. There is controversy over treatment between pediatric and adult patients. We reevaluated our previous definition of the nondilated type in children (common bile duct diameter ≤6 mm on cholangiography).Patients and Methods:Of 150 children with pancreaticobiliary maljunction, 14 fulfilled the definition of the nondilated type. Clinical and cholangiographic findings were reviewed and compared with cholangiograms of 17 children without biliary diseases (controls). The age‐related normal range of the choledochal diameter was defined in combination with previous data.Results:All of the patients had symptoms and signs similar to those of choledochal cysts. Cholangiographic features of choledochal cysts were detected in all of the patients (dilated common channel, 8; distal bile duct stenosis, 5; dilated cystic duct, 4; filling defect in the common channel, 8). The choledochal diameter in control children increased with age. Only 4 patients (29%) had a choledochal caliber within the normal range.Conclusions:Most pediatric cases reported as the nondilated type are slightly dilated (forme fruste) choledochal cysts and differ from the nondilated type seen in adults. The nondilated type in children should be defined on the basis of the age‐related choledochal diameter.
Effects on Faecal Microbiota of Dietary and Acidic Oligosaccharides in Children During Partial Formula Feeding
Authors: Magne Fabien , Hachelaf Wahiba , Suau Antonia , Boudraa Ghazalia , Bouziane‐Nedjadi Karim , Rigottier‐Gois Lionel , Touhami Mahmoud , Desjeux Jehan‐François , Pochart Philippe 
Published: February 2010

ABSTRACTObjective:To test the safety and effect on faecal microbiota of a formula with prebiotic oligosaccharides alone or in combination with acidic oligosaccharides in infants at the age of partial formula feeding.Patients and Methods:The study was a double‐blind, placebo‐controlled, randomised intervention trial in which 82 healthy, full‐term, partially breast‐fed children, from 1 week to 3 months old, were given 1 of the following formulae: whey‐based formula (control group), whey‐based formula with galacto‐ and long‐chain fructo‐oligosaccharides (scGOS/lcFOS group), or whey‐based formula with galacto‐ and long‐chain fructo‐oligosaccharides added with pectin‐derived acidic oligosaccharides (scGOS/lcFOS/pAOS group). Children were studied for the duration of the partial formula feeding period and every 2 weeks for 2 months after breast‐feeding cessation. The total bacteria count and the proportion of 7 bacterial families were determined using in situ hybridisation coupled to flow cytometry.Results:The total bacterial count did not alter with time or type of feeding (9.9 ± 0.1 log10 cells per gram wet weight). Compared with the control group, there was an increase of the Bifidobacterium genus (P = 0.0001), and a decrease of proportions for the Bacteroides group (P = 0.02) and the Clostridium coccoides group (P = 0.01) in both oligosaccharide groups. The proportion of bifidobacteria was significantly higher in the scGOS/lcFOS/pAOS compared with the scGOS/lcFOS group (P < 0.01).Conclusions:Infant formulae appear to be clinically safe and effective on infant microbiota. They minimize the alteration of faecal microbiota after cessation of breast‐feeding and promote bifidobacteria proportions, with a stronger effect when acidic oligosaccharides are present.
Polymorphisms in the Tumor Necrosis Factor/Lipopolysaccharides Pathway in Crohn Disease in the Jewish Ashkenazi Population
Authors: Silbermintz Ari , Levine Jeremiah , Weinstein Toba , Silver Jack 
Published: February 2010

ABSTRACTObjective:Tumor necrosis factor (TNF)‐α plays a role in the inflammatory process in Crohn disease, a disease with an apparent polygenic basis. We investigated whether polymorphisms in multiple genes involved in the lipopolysaccharide–TNF inflammatory pathway are independently associated with Crohn disease in the Jewish Ashkenazi population. Polymorphisms in CD14, Toll‐like receptor 4 (TLR4), and TNF‐α were studied. In addition, we investigated polymorphisms in the TNF‐α converting enzyme (TACE) gene, which to date has not been studied for an association with Crohn disease.Patients and Methods:To examine whether TLR4 Asp299Gly, CD14‐260C/T, TNF‐1031T/C, TNF‐863C/A, TNF‐857C/T, TACE‐172C/T, and TACE‐154C/A polymorphisms are associated with Crohn disease in the Ashkenazi Jewish population, we analyzed families with at least 1 child with Crohn disease for association with these mutations using a family‐based association test (transmission disequilibrium test) for analysis.Results:The allelic frequency in the patient population of TLR4 G allele was 8.0%, CD14 T allele was 51.3%, TNF‐1031C was 18.8%, TNF‐863A was 14.2%, TNF‐857T was 25.2%, TACE172T was 20.7%, and TACE154A was 24.5%. The transmission disequilibrium test transmitted:untransmitted (T:U) result for TLR4G was T:U = 32:20, for CD14T was T:U = 103:88, for TNF‐1031C was T:U = 48:56, for TNF‐863A was T:U = 39:42, for TNF‐857T was T:U = 63:62, for TACE‐172C/T was T:U = 48:59, and for TACE‐154C/A was T:U = 52:55. No statistically significant associations were observed.Conclusions:The transmission disequilibrium test did not demonstrate preferential transmission of these variants in Jewish Ashkenazi patients with Crohn disease. These results suggest that these polymorphisms in the TNF/lipopolysaccharide pathway play little or no role in susceptibility to Crohn disease in the Jewish Ashkenazi population.
Safety and Tolerability of Esomeprazole in Children With Gastroesophageal Reflux Disease
Authors: Gilger Mark A. , Tolia Vasundhara , Vandenplas Yvan , Youssef Nader N. , Traxler Barry , Illueca Marta 
Published: February 2010

ABSTRACTObjectives:To evaluate safety, tolerability, and symptom improvement with once‐daily esomeprazole in children with endoscopically proven gastroesophageal reflux disease (GERD).Patients and Methods:In this 8‐week, multicenter, randomized, uncontrolled, double‐blind study, children ages 1 to 11 years were stratified by weight to receive esomeprazole 5 or 10 mg (children < 20 kg) or 10 or 20 mg (children ≥ 20 kg) once daily. Safety and tolerability was assessed by evaluating adverse events (AEs; both treatment‐ and non‐treatment‐related AEs) and changes from baseline in medical history, physical examinations, and clinical laboratory tests. Investigators scored symptom severity every 2 weeks using the Physician's Global Assessment (PGA). Patients' parents rated GERD symptoms of heartburn, acid regurgitation, and epigastric pain (none to severe, 0–3) at baseline (based on past 72 hours) and daily (from past 24 hours).Results:Of 109 patients randomized, 108 had safety data. AEs were experienced by 68.0% and 65.2% of children <20 kg receiving esomeprazole 5 and 10 mg, respectively, and 83.9% and 82.8% of children ≥20 kg receiving esomeprazole 10 and 20 mg, respectively, regardless of causality. Overall, only 9.3% of patients reported 13 treatment‐related AEs; the most common were diarrhea (2.8% [3/108]), headache (1.9% [2/108]), and somnolence (1.9% [2/108]). Vomiting, a serious AE in 2 patients, was not judged by the investigator to be related to treatment. At the final visit, PGA scores improved significantly from baseline (P < 0.001). Of 58 patients with moderate to severe baseline PGA symptom scores, 91.4% had lower scores by the final visit. GERD symptom scores were significantly improved from baseline to the final week of the study in all of the treatment groups (P < 0.01)Conclusions:In children ages 1 to 11 years with endoscopically proven GERD, esomeprazole (at daily doses of 5, 10, or 20 mg) was generally well tolerated. The frequency and severity of GERD‐related symptoms were significantly reduced during the active treatment period.
Familial Clustering of Habitual Constipation: A Prospective Study in Children From West Virginia
Authors: Ostwani Waseem , Dolan Jenna , Elitsur Yoram 
Published: February 2010

ABSTRACTObjective:To investigate familial clustering of habitual constipation in pediatric patients who attended our medical facilities.Patients and Methods:Children with the diagnosis of functional, habitual constipation or patients without constipation and their respective family members were prospectively recruited to our study. Constipation was established in all participants using a standard questionnaire (Rome criteria).Results:A total of 112 children and their families participated in the study, of which 37 were probands families (test) and 75 children and their respective family members constituted the control group. A total of 310 family members completed the questionnaire. No significant differences were found between the study and the control groups in age, sex, or family size. Siblings or parents from the study group (probands) had significantly higher rates of constipation compared with the control group (30% vs 7% and 42% vs 9%, respectively; P = 0.001).Conclusions:Habitual constipation in children seemed to cluster in families. The pathophysiology behind this phenomenon is yet unknown.
Prolonged Enteral Feeding Is Often Required to Avoid Long‐term Nutritional and Metabolic Complications After Esophagogastric Dissociation
Authors: Madre Chrystèle , Serhal Lydia , Michaud Laurent , Bonnevalle Michel , de Lagausie Pascal , Gottrand Frédéric , Bonnard Arnaud , Hugot Jean‐Pierre 
Published: February 2010

ABSTRACTBackground:Total esophagogastric dissociation (TED) was first described in 1997 by Bianchi as a new surgical procedure to treat severe gastroesophageal reflux disease (GERD) in children with neurological impairment. Recently, TED has been proposed in other conditions, such as esophageal atresia, esotracheal cleft, or caustic esophageal lesions. Although the long‐term results in terms of GERD control have been previously reported, those regarding the nutritional and metabolic status have never been documented.Patients and Methods:All patients without neurological impairment with TED between 1999 and 2004 at Robert Debre Hospital and Jeanne de Flandre Hospital, France, were prospectively investigated, paying particular attention to their metabolic and nutritional status (blood concentration of iron and vitamins A, D, E, and B12; lipid malabsorption; and hyperglycemia test) and growth.Results:Seventeen children underwent TED. Six received primary procedures, whereas 11 were operated on because of severe respiratory diseases or failure to thrive. The mean follow‐up was 6 years (range 3–8 years). Two children died (12%). Seven children were weaned from enteral nutrition support, but 5 of them had failure to thrive, steatorrhea, and/or malabsorption of vitamin B12 and/or fat‐soluble vitamins. Eight patients had dumping syndrome, which was symptomatic in 6 cases.Conclusions:TED is an effective procedure for treatment of GERD. However, nutritional and metabolic complications including dumping syndrome and chronic digestive malabsorption are frequent after TED, especially after enteral nutrition weaning. A long‐term follow‐up of these patients is thus necessary and prolonged enteral nutrition support is recommended.
Effects of Vitamin A Supplementation on Intestinal Barrier Function, Growth, Total Parasitic, and SpecificGiardiaspp Infections in Brazilian Children: A Prospective Randomized, Double‐blind, Placebo‐controlled Trial
Authors: Lima Aldo AM , Soares Alberto M , Lima Noélia L , Mota Rosa MS , Maciel Bruna LL , Kvalsund Michelle P , Barrett Leah J , Fitzgerald Relana P , Blaner William S , Guerrant Richard L 
Published: February 2010

ABSTRACTBackground:This study evaluates the effects of retinol on intestinal barrier function, growth, total parasites, andGiardiaspp infections in children in northeastern Brazil.Subjects and Methods:The study was a double‐blind, randomized placebo‐controlled trial (http://clinicaltrials.gov; register no. #NCT00133406) involving 79 children who received vitamin A 100,000–200,000 IU (n = 39) or placebo (n = 40) at enrollment, 4, and 8 months and were followed for 36 months. Intestinal barrier function was evaluated using the lactulose:mannitol ratio test. Stool lactoferrin was used as a marker for intestinal inflammation.Results:The groups were similar with regard to age, sex, nutritional parameters (zscores), serum retinol concentrations, proportion of lactoferrin‐positive stool samples, and intestinal barrier function. The lactulose:mannitol ratio did not change during the same time of follow‐up (P> 0.05). The proportion of lactoferrin‐positive samples evaluated at 1 month did not change between groups (P> 0.05). Total intestinal parasitic, specifically new, infections were significantly lower in the vitamin A treatment compared with control group; these were accounted for entirely by significantly fewer newGiardiainfections in the vitamin A treatment group. The cumulativezscores for weight‐for‐length or height, length or height‐for‐agezscores, and weight‐for‐age did not change significantly with vitamin A intervention for 36 months of follow‐up.Conclusions:These data showed that total parasitic infection andGiardiaspp infections were significantly lower in the vitamin A treatment group when compared with the placebo group, suggesting that vitamin A improves the host's defenses againstGiardiainfections.
Protection of Intestinal Occludin Tight Junction Protein by Dietary Gangliosides in Lipopolysaccharide‐induced Acute Inflammation
Authors: Park Eek J , Thomson Alan BR , Clandinin Michael T 
Published: February 2010

ABSTRACTObjectives:Intestinal permeability and barrier function are regulated by expression of tight junction proteins. Lipopolysaccharide (LPS), tumor necrosis factor‐α, and interleukin‐1β induce expression of nitric oxide (NO) and reduce the expression of gut tight junction proteins. The purpose of this study was to determine whether dietary gangliosides (GGs) increase the concentration of the anti‐inflammatory cytokine interleukin‐10 (IL‐10) in response to LPS, thereby inhibiting NO production and protecting gut occludin tight junction protein from degradation.Materials and Methods:Rats were fed semipurified diets with (n = 16) or without (n = 16) GGs (0.1% w/w of total lipid). After 2 weeks of feeding, animals were injected with saline (n = 8/diet group) or LPS (n = 8/diet group) (IP, 3 mg mL−1 kg−1). Intestinal tissue, mucosa, and blood sample were collected 6 hours post‐LPS exposure. The effect of dietary GGs on production/expression of IL‐10, NO, inducible NO synthase, and occludin protein was determined.Results:Dietary GGs increased IL‐10 content in intestinal mucosa significantly by 32‐fold (P < 0.0001) and in plasma by 2.4‐fold (P < 0.001). Feeding animals a ganglioside‐enriched diet decreased total NO content in intestinal mucosa and plasma by 44% and 30%, respectively, and inhibited inducible NO synthase expression following LPS exposure compared with control animals. Dietary GGs reduced the degradation of occludin tight junction protein in response to LPS.Conclusions:Dietary GGs inhibit degradation of gut occludin tight junction protein during LPS‐induced acute inflammation. Thus, dietary GGs have a role in protecting the integrity of the intestinal barrier during acute gut inflammation.
Performance of the AST‐to‐Platelet Ratio Index as a Noninvasive Marker of Fibrosis in Pediatric Patients With Chronic Viral Hepatitis
Authors: McGoogan Katherine E , Smith P Brian , Choi Steve S , Berman Wallace , Jhaveri Ravi 
Published: February 2010

ABSTRACTWe investigated the performance of aspartate aminotransferase to platelet ratio index (APRI) as a noninvasive marker of fibrosis and cirrhosis in children with chronic viral hepatitis. All of the patients 0 to 20 years old with chronic hepatitis B or C presenting at a tertiary medical center from 1992 to 2008 were identified. Thirty‐six patients were evaluated with 48 biopsy results. The areas under the receiver operating characteristic curve were 0.71 for fibrosis and 0.52 for cirrhosis. When examining subgroups, the APRI performed better in older patients and in those with vertically transmitted hepatitis C virus. Further research into APRI and the other noninvasive markers of fibrosis in children with chronic viral hepatitis is warranted.