bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal Informatics—Dream of a Paperless NICU
Authors: Drummond Willa H. 
Published: October 2009

Attempts to “computerize neonatal intensive care units (NICUs)” emerged simultaneously with the development of neonatology, beginning in the 1960s. The academic underpinnings to inform prior computerization attempts awaited the birth of the newly emerging fields contained in “health-care informatics.” Decades of attempts to computerize the NICU environment have produced local, partial successes, including successful installation of computerized monitors that report trends, buying or developing systems that produce letters from coded fact sheets, and development of many focused computer utilities to perform care task-related calculations.Enormous political pressures are urging health care to “get computerized.” Most hospitals are in the process of installing (or reinstalling) “hospital information systems (HISs).” Such efforts have exposed significant problems and limitations of current HIS systems for critical care situations. Extending office-designed computer systems safely and effectively into intensive care units and other real-time hospital venues has presented substantial difficulties. In late 2008, most NICUs still integrate multisource clinical data at the bedside by charting each hour with pen in small boxes on folding paper flowsheets, a slow, error-prone, and imprecise method for tracking unstable situations. To improve minute-by-minute management of unstable patients, all intensivists need automatic, real-time integration of machine, laboratory, and bedside observational data, presented in medically comprehensive, user-definable formats. Clinicians need reflex response speed (14 msec) in every clinical computer utility used in their “workflow.” Similar sets of unique human computer/interactions of teams working in safety critical situations such as nuclear power plants, battleships, and airplane cockpits have been studied extensively by scientists known as “human factors engineers.”Human factors situations rarely have been studied in hospitals, and not at all for NICUs. Overall, this neonatal informatics series defines the current state of the “paperless” effort. Part 1 provides a historic and situational overview of current problems in optimizing hospital computer systems for critical clinicians, including communication, NICU computerization history, and an introduction to systems analysis, which is a key exercise for planning future NICU computer systems.
An Evaluation of HIV Testing Among Inmates in the North Carolina Prison System
Authors: Rosen David L. , Schoenbach Victor J. , Wohl David A. , White Becky L. , Stewart Paul W. , Golin Carol E. 
Published: October 2009

Objectives. We examined the use of voluntary HIV testing among state prisoners in the North Carolina prison system. Methods. We calculated system-wide and facility-specific proportions and rates of adult inmates tested for HIV and estimated associations between testing status and inmate characteristics for prisoners in North Carolina. Results. Of the 54 016 inmates who entered prison between January 2004 and May 2006, 20 820 (38%) were tested for HIV; of those tested, 18 574 (89%) were tested at admission. Across the 8 intake prisons, more than 80% of inmates in both female facilities but less than 15% of inmates in 4 of 6 male facilities were tested. Prisoners with a documented history of heroin use, crack or cocaine use, conventional HIV risk behavior, or tuberculosis were at least 10% more likely to be tested than were inmates without these characteristics. However, more than 60% of men reporting conventional risk behaviors were not tested. Before covariate adjustment, Black men were 30% less likely than White men to be tested; in the multivariable regression model, this difference was attenuated to 13%. Conclusions. Rates of HIV testing varied widely across intake prisons, and many male inmates with documented risk of infection were never tested.
The Burden of Rotavirus Hospitalizations Among Medicaid and Non-Medicaid Children Younger Than 5 Years Old
Authors: Ma Liyuan , El Khoury Antoine C. , Itzler Robbin F. 
Published: October 2009

Objectives. We sought to compare the burden of hospitalizations associated with rotavirus gastroenteritis (RGE) in children younger than 5 years in US Medicaid and non-Medicaid populations in 2000 and 2003. Methods. We used the Kids' Inpatient Database (KID) to examine the burden of RGE-associated hospitalizations in terms of numbers and rates of hospitalizations, lengths of stay, and hospital charges. Two indirect methods were also used to estimate RGE-associated hospitalizations, because rotavirus testing is not routinely performed. Results. Approximately 40% of children younger than 5 years were enrolled in Medicaid in 2003, but this population accounted for nearly 50% of all RGE-associated hospitalizations and 60% of total charges. Children enrolled in Medicaid had significantly greater hospitalization rates, average lengths of stay, and average charges per stay than did those not enrolled. Conclusions. Although RGE affects all socioeconomic groups, the Medicaid population accounted for a disproportionate number of the hospitalizations. With the inclusion of rotavirus vaccines in the pediatric immunization schedule, it is important that US children, especially those enrolled in Medicaid programs, are vaccinated to reduce the burden of RGE.
Pandemic Influenza Planning: Addressing the Needs of Children
Authors: Stevenson Elizabeth , Barrios Lisa , Cordell Ralph , Delozier David , Gorman Susan , Koenig Linda J. , Odom Erica , Polder Jacquelyn , Randolph Jean , Shimabukuro Tom , Singleton Christa 
Published: October 2009

Children represent one quarter of the US population. Because of its enormous size and special needs, it is critically important to address this population group in pandemic influenza planning. Here we describe the ways in which children are vulnerable in a pandemic, provide an overview of existing plans, summarize the resources available, and, given our experience with influenza A(H1N1), outline the evolving lessons we have learned with respect to planning for a severe influenza pandemic. We focus on a number of issues affecting children—vaccinations, medication availability, hospital capacity, and mental health concerns—and emphasize strategies that will protect children from exposure to the influenza virus, including infection control practices and activities in schools and child care programs.
Pandemic Influenza and Farmworkers: The Effects of Employment, Social, and Economic Factors
Authors: Steege Andrea L. , Baron Sherry , Davis Shelley , Torres-Kilgore Judith , Sweeney Marie Haring 
Published: October 2009

Employment, social, and economic factors have the potential to affect the magnitude of an influenza pandemic among farmworkers. Prevention efforts targeted toward livestock farmworkers, including increased access to seasonal influenza vaccine, risk reduction training, various forms of personal protection, and workplace sanitation, are needed. Crop and livestock farmworkers are at increased risk of exposure to influenza A viruses because of limited resources, substandard housing, immigration status, communication and cultural barriers, and discrimination. Recommendations were gathered from migrant clinicians, farmworker advocates, state and federal government agencies, industry stakeholders, and researchers to overcome these barriers, including surveillance of livestock farmworkers, inclusion of farmworker service organizations in planning efforts, and separation of immigration enforcement from emergency assistance.
Effective Health Risk Communication About Pandemic Influenza for Vulnerable Populations
Authors: Vaughan Elaine , Tinker Timothy 
Published: October 2009

The consequences of pandemic influenza for vulnerable populations will depend partly on the effectiveness of health risk communications. Strategic planning should fully consider how life circumstances, cultural values, and perspectives on risk influence behavior during a pandemic. We summarize recent scientific evidence on communication challenges and examine how sociocultural, economic, psychological, and health factors can jeopardize or facilitate public health interventions that require a cooperative public. If ignored, current communication gaps for vulnerable populations could result in unequal protection across society during an influenza pandemic. We offer insights on communication preparedness gleaned from scientific studies and the deliberations of public health experts at a meeting convened by the Centers for Disease Control and Prevention, May 1 and 2, 2008.
Preparing for and Responding to Pandemic Influenza: Implications for People With Disabilities
Authors: Campbell Vincent A. , Gilyard Jamylle A. , Sinclair Lisa , Sternberg Tom , Kailes June I. 
Published: October 2009

State, local, tribal, and territorial emergency managers and public health officials must address the specific needs of people with disabilities in their pandemic influenza plans. Evidence from Hurricane Katrina indicated that this population was disproportionately affected by the storm and aftermath. People with disabilities, particularly those who require personal assistance and those who reside in congregate care facilities, may be at increased risk during an influenza pandemic because of disrupted care or the introduction of the virus by their caregivers. Emergency and public health planners must ensure that personal assistance agencies and congregate care operators make provisions for backup staffing and that those who provide critical care are given adequate antiviral drugs and vaccines as they become available.
Protecting Vulnerable Populations From Pandemic Influenza in the United States: A Strategic Imperative
Authors: Hutchins Sonja S. , Truman Benedict I. , Merlin Toby L. , Redd Stephen C. 
Published: October 2009

Protecting vulnerable populations from pandemic influenza is a strategic imperative. The US national strategy for pandemic influenza preparedness and response assigns roles to governments, businesses, civic and community-based organizations, individuals, and families. Because influenza is highly contagious, inadequate preparedness or untimely response in vulnerable populations increases the risk of infection for the general population. Recent public health emergencies have reinforced the importance of preparedness and the challenges of effective response among vulnerable populations. We explore definitions and determinants of vulnerable, at-risk, and special populations and highlight approaches for ensuring that pandemic influenza preparedness includes these populations and enables them to respond appropriately. We also provide an overview of population-specific and cross-cutting articles in this theme issue on influenza preparedness for vulnerable populations.
Effects of an Ongoing Epidemic on the Annual Influenza Vaccination Rate and Vaccination Timing Among the Medicare Elderly: 2000-2005
Authors: Yoo Byung-Kwang , Kasajima Megumi , Fiscella Kevin , Bennett Nancy M. , Phelps Charles E. , Szilagyi Peter G. 
Published: October 2009

Objectives. We assessed short-term responsiveness of influenza vaccine demand to variation in timing and severity of influenza epidemics since 2000. We tested the hypothesis that weekly influenza epidemic activity is associated with annual and daily influenza vaccine receipt. Methods. We conducted cross-sectional survival analyses from the 2000–2001 to 2004–2005 influenza seasons among community-dwelling elderly using the Medicare Current Beneficiary Survey (unweighted n = 2280–2822 per season; weighted n = 7.7–9.7 million per season). The outcome variable was daily vaccine receipt. Covariates included the biweekly changes of epidemic and vaccine supply at 9 census-region levels. Results. In all 5 seasons, biweekly epidemic change was positively associated with overall annual vaccination (e.g., 2.7% increase in 2003–2004 season) as well as earlier vaccination timing (P < .01). For example, unvaccinated individuals were 5%–29% more likely to receive vaccination after a 100% biweekly epidemic increase. Conclusions. Accounting for short-term epidemic responsiveness in predicting demand for influenza vaccination may improve vaccine distribution and the annual vaccination rate, and might assist pandemic preparedness planning.
Infection With Viruses From Several Families Triggers Autoimmune Diabetes in LEW.1WR1 Rats
Authors: Tirabassi Rebecca S. , Guberski Dennis L. , Blankenhorn Elizabeth P. , Leif Jean H. , Woda Bruce A. , Liu Zhijun , Winans Donald , Greiner Dale L. , Mordes John P. 
Published: October 2009

OBJECTIVE
The contribution of antecedent viral infection to the development of type 1 diabetes in humans is controversial. Using a newer rat model of the disease, we sought to 1) identify viruses capable of modulating diabetes penetrance, 2) identify conditions that increase or decrease the diabetogenicity of infection, and 3) determine whether maternal immunization would prevent diabetes.

RESEARCH DESIGN AND METHODS
About 2% of LEW.1WR1 rats develop spontaneous autoimmune diabetes, but disease penetrance is much higher if weanling rats are exposed to environmental perturbants including Kilham rat virus (KRV). We compared KRV with other viruses for diabetogenic activity.

RESULTS
Both KRV and rat cytomegalovirus (RCMV) induced diabetes in up to 60% of LEW.1WR1 rats, whereas H-1, vaccinia, and Coxsackie B4 viruses did not. Simultaneous inoculation of KRV and RCMV induced diabetes in 100% of animals. Pretreatment of rats with an activator of innate immunity increased the diabetogenicity of KRV but not RCMV and was associated with a moderate rate of diabetes after Coxsackie B4 and vaccinia virus infection. Inoculation of LEW.1WR1 dams with both KRV and RCMV prior to pregnancy protected weanling progeny from virus-induced diabetes in a virus-specific manner.

CONCLUSIONS
Exposure to viruses can affect the penetrance of autoimmune diabetes in genetically susceptible animals. The diabetogenicity of infection is virus specific and is modified by immunomodulation prior to inoculation. Maternal immunization protects weanlings from virus-induced diabetes, suggesting that modification of immune responses to infection could provide a means of preventing islet autoimmunity.
Raised Late Pregnancy Glucose Concentrations in Mice Carrying Pups With Targeted Disruption of H19Δ13
Authors: Petry Clive J. , Evans Mark L. , Wingate Dianne L. , Ong Ken K. , Reik Wolf , Constância Miguel , Dunger David B. 
Published: October 2009

OBJECTIVE
We have hypothesized that variation in imprinted growth-promoting fetal genes may affect maternal glucose concentrations in pregnancy. To test this hypothesis we evaluated the effects of fetal disruption of murine H19Δ13 on maternal glucose concentrations in pregnancy.

RESEARCH DESIGN AND METHODS
Experimental mice were pregnant females that had inherited the disrupted H19Δ13 from their fathers and were therefore phenotypically wild type due to imprinting; approximately half of their litters were null for H19Δ13 through maternal inheritance of the disrupted gene. In control mice approximately half the litter paternally inherited the disrupted H19Δ13, so the pups were either genetically wild type or phenotypically wild type due to imprinting. Blood glucose concentrations were assessed by intraperitoneal glucose tolerance tests on days 1, 16, and 18 of pregnancy.

RESULTS
There were no differences in the glucose concentrations of control and experimental pregnant mice at day 1. However, at day 16 mothers carrying H19Δ13-null pups had a significantly higher area under the glucose tolerance test curves than controls (1,845 ± 378 vs. 1,386 ± 107 mmol · min · l−1 [P = 0.01]) in association with increasing pregnancy-related insulin resistance. Although this difference lessened toward term, overall, mothers of maternally inherited H19Δ13 mutants had significantly higher glucose concentrations during the last trimester (1,602 ± 321 [n = 17] vs. 1,359 ± 147 [n = 18] mmol · min · l−1 [P = 0.009]).

CONCLUSIONS
This study provides evidence that maternal glucose concentrations in pregnant mice can be affected by targeted disruption of fetal H19Δ13. This implies that variable fetal IGF2 expression could affect risk for gestational diabetes.
Effects of high plasma fentanyl concentrations on minimum alveolar concentration of isoflurane in horses
Authors: Knych Heather K. DiMaio , Steffey Eugene P. , Mama Khursheed R. , Stanley Scott D. 
Published: October 2009

Abstract
Objective—To verify the isoflurane anesthetic minimum alveolar concentration (MAC)-sparing effect of a previously administered target plasma fentanyl concentration of 16 ng/mL and characterize an anticipated further sparing in isoflurane MAC associated with higher target plasma fentanyl concentrations.
Animals—8 horses.
Procedures—Horses were assigned 2 of 3 target plasma fentanyl concentrations (16, 24, and 32 ng/mL), administered in ascending order. Following determination of baseline MAC, horses received a loading dose of fentanyl followed by a constant rate infusion; MAC determination was performed in triplicate at baseline and at each fentanyl concentration. Venous blood samples were collected throughout the study for determination of actual plasma fentanyl concentrations. Recovery from anesthesia was monitored, and behaviors were rated as excellent, good, fair, or poor.
Results—Mean ± SD fentanyl plasma concentrations were 13.9 ± 2.6 ng/mL, 20.1 ± 3.6 ng/mL, and 24.1 ± 2.4 ng/mL for target concentrations of 16, 24, and 32 ng/mL, respectively. The corresponding changes in the MAC of isoflurane were −3.28%, −6.23%, and +1.14%. None of the changes were significant. Recovery behavior was variable and included highly undesirable, potentially injurious excitatory behavior.
Conclusions and Clinical Relevance—Results of the study did not verify an isoflurane-sparing effect of fentanyl at a plasma target concentration of 16 ng/mL. Furthermore, a reduction in MAC was not detected at higher fentanyl concentrations. Overall, results did not support the routine use of fentanyl as an anesthetic adjuvant in adult horses.
Analgesic effects of carprofen and liposome-encapsulated butorphanol tartrate in Hispaniolan parrots (Amazona ventralis) with experimentally induced arthritis
Authors: Paul-Murphy Joanne R. , Sladky Kurt K. , Krugner-Higby Lisa A. , Stading Ben R. , Klauer Julia M. , Keuler Nicholas S. , Brown Carolyn S. , Heath Timothy D. 
Published: October 2009

Abstract
Objective—To evaluate the microcrystalline sodium urate (MSU) method for inducing arthritis in parrots and to compare the analgesic efficacy of long-acting liposome-encapsulated butorphanol (LEBT), carprofen, or a combination of both.
Animals—20 Hispaniolan parrots.
Procedures—MSU was injected into a tibiotarsal-tarsometatarsal (intertarsal) joint to induce arthritis (time 0). Four treatments were compared (LEBT [15 mg/kg, SC] administered once at time 0; injections of carprofen [3 mg/kg, IM, q 12 h] starting at time 0; administration of LEBT plus carprofen; and a control treatment of saline [0.9% NaCl] solution). Weight load testing and behavioral scoring were conducted at 0, 2, 6, 26, and 30 hours.
Results—Injection of MSU into the intertarsal joint induced arthritis, which resolved within 30 hours. Treatment with LEBT or LEBT plus carprofen resulted in significantly greater weight-bearing load on the limb with induced arthritis, compared with the control treatment. Treatment with carprofen alone caused a slight but nonsignificant improvement in weight-bearing load on the arthritic limb, compared with the control treatment. Behaviors associated with motor activity and weight bearing differed between the control and analgesic treatments.
Conclusions and Clinical Relevance—Butorphanol was an effective treatment for pain associated with arthritis, but carprofen administered every 12 hours was insufficient. Injection of MSU to induce arthritis in a single joint was a good method for evaluating tonic pain in parrots, and measurement of the weight-bearing load was accurate for assessment of arthritic pain; however, behavioral changes associated with pain were subtle.
Pathogenicity of an emergent, ovine abortifacient Campylobacter jejuni clone orally inoculated into pregnant guinea pigs
Authors: Burrough Eric R. , Sahin Orhan , Plummer Paul J. , Zhang Qijing , Yaeger Michael J. 
Published: October 2009

Abstract
Objective—To compare pathogenicity of an emergent abortifacient Campylobacter jejuni (IA 3902) with that of reference strains after oral inoculation in pregnant guinea pigs.
Animals—58 pregnant guinea pigs.
Procedures—12 animals were challenged IP with C jejuni IA 3902 along with 5 sham-inoculated control animals to confirm abortifacient potential. Once pathogenicity was confirmed, challenge via oral inoculation was performed whereby 12 guinea pigs received IA 3902, 12 received C jejuni isolated from ovine feces (OF48), 12 received a fully sequenced human C jejuni isolate (NCTC 11168), and 5 were sham-inoculated control animals. After abortions, guinea pigs were euthanized; samples were collected for microbial culture, histologic examination, and immunohistochemical analysis.
Results—C jejuni IA 3902 induced abortion in all 12 animals following IP inoculation and 6 of 10 animals challenged orally. All 3 isolates colonized the intestines after oral inoculation, but only IA 3902 induced abortion. Evidence of infection existed for both IA 3902 and NCTC 11168; however, C jejuni was only recovered from fetoplacental units of animals inoculated with IA 3902. Immunohistochemical analysis localized C jejuni IA 3902 infection to subplacental trophoblasts, perivascular tissues, and phagocytes in the placental transitional zone.
Conclusions and Clinical Relevance—This study revealed that C jejuni IA 3902 was a unique, highly abortifacient strain with the ability to colonize the intestines, induce systemic infection, and cause abortion because of its affinity for the fetoplacental unit. Guinea pigs could be effectively used in the study of septic abortion after oral inoculation with this Campylobacter strain.
Prevalence of clinical abnormalities in cats found to have nonneoplastic middle ear disease at necropsy: 59 cases (1991–2007)
Authors: Schlicksup Michael D. , Van Winkle Thomas J. , Holt David E. 
Published: October 2009

Abstract
Objective—To determine the prevalence of nonneoplastic middle ear disease among cats undergoing necropsy and the prevalence of clinical abnormalities in cats in which nonneoplastic middle ear disease was identified.
Design—Retrospective case series.
Animals—59 cats that underwent necropsy between January 1991 and August 2007.
Procedures—Medical records were searched to identify cats in which nonneoplastic middle ear disease was identified at necropsy. For cats included in the study, data that were recorded included signalment, initial complaint, whether the cat had any clinical signs of middle or external ear disease, whether the cat had upper respiratory tract disease, necropsy diagnosis, gross appearance of the bullae, and reason for euthanasia. Signs of middle ear disease that were considered included unilateral peripheral vestibular disease without motor deficits, Horner syndrome, and facial nerve paralysis.
Results—Of the 3,442 cats that underwent necropsy during the study period, 59 (1.7%) had nonneoplastic middle ear disease. Six of the 59 (10%) cats, including 1 cat that was affected bilaterally, had clinical signs of middle ear disease. Of these, 5 had signs of unilateral peripheral vestibular disease, and 1 had Horner syndrome.
Conclusions and Clinical Relevance—Results suggested that most cats with nonneoplastic middle ear disease did not have associated clinical signs. Findings may be of clinical relevance for cats in which middle ear disease is identified as an incidental finding during computed tomography or magnetic resonance imaging for unrelated diseases.