bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transporting Children With Special Health Care Needs: Comparing Recommendations and Practice
Authors: O'Neil Joseph , Yonkman Janell , Talty Judith , Bull Marilyn J. 
Published: July 2009

OBJECTIVE: We compare the use of the American Academy of Pediatrics (AAP) guidelines for the safe transportation of children with special health care needs (CSHCN) with reported and observed practices.
METHODS: This observational study was based on a convenience sample of vehicles exiting the garage of a tertiary children's hospital. Certified child passenger safety technicians with a health care background and specialized training in the transportation of CSHCN gathered the driver's demographic information and the child's reported medical condition, weight, age, clinic visited, and relation to the driver. The safety technicians observed the car safety seat (CSS) type, vehicle seating position, and if the child required postural support.
RESULTS: During the study, 275 drivers transporting 294 CSHCN were observed. Overall, most drivers complied with AAP recommendations by using a standard CSS seat (75.4%). Among the seats evaluated, 241 (82.0%) were the appropriate choice, but only 75 (26.8%) of 280 assessed had no misuses. Approximately 24% of the drivers modified the CSS, and 19.4% of the children would have benefited from additional body-positioning support. Only 8% of medical equipment was properly secured.
CONCLUSIONS: Although most drivers seemed to choose the appropriate seat, many had at least 1 misuse. Drivers complied with most AAP recommendations; however, some deviated to facilitate care of the child during transport. Discussions with parents or caregivers about the proper transportation of CSHCN and referrals to child passenger safety technicians with special training may improve safety, care, and comfort in the vehicle.
Mental Health Treatment Patterns in Perinatally HIV-Infected Youth and Controls
Authors: Chernoff Miriam , Nachman Sharon , Williams Paige , Brouwers Pim , Heston Jerry , Hodge Janice , Di Poalo Vinnie , Deygoo Nagamah Sandra , Gadow Kenneth D. ,   IMPAACT P1055 Study Team
Published: July 2009

BACKGROUND: Youths perinatally infected with HIV often receive psychotropic medication and behavioral treatment for emotional and behavioral symptoms. We describe patterns of intervention for HIV-positive youth and youth in a control group in the United States.
METHODS: Three hundred nineteen HIV-positive youth and 256 controls, aged 6 to 17 years, enrolled in the International Maternal Adolescent AIDS Clinical Trials 1055, a prospective, 2-year observational study of psychiatric symptoms. One hundred seventy-four youth in the control group were perinatally exposed to HIV, and 82 youth were uninfected children living in households with HIV-positive members. Youth and their primary caregivers completed Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition–referenced symptom-rating scales. Children's medication and behavioral psychiatric intervention histories were collected at entry. We evaluated the association of past or current psychiatric treatment with HIV status, baseline symptoms, and impairment by using multiple logistic regression, controlling for potential confounders.
RESULTS: HIV-positive youth and youth in the control group had a similar prevalence of psychiatric symptoms (61%) and impairment (14% to 15%). One hundred four (18%) participants received psychotropic medications (stimulants [14%], antidepressants [6%], and neuroleptic agents [4%]), and 127 (22%) received behavioral treatment. More HIV-positive youth than youth in the control group received psychotropic medication (23% vs 12%) and behavioral treatment (27% vs 17%). After adjusting for symptom class and confounders, HIV-positive children had twice the odds of children in the control group of having received stimulants and &gt;4 times the odds of having received antidepressants. Caregiver-reported symptoms or impairment were associated with higher odds of intervention than reports by children alone.
CONCLUSIONS: HIV-positive children are more likely to receive mental health interventions than control-group children. Pediatricians and caregivers should consider available mental health treatment options for all children living in families affected by HIV.
Empiric Use of Potassium Citrate Reduces Kidney-Stone Incidence With the Ketogenic Diet
Authors: McNally Melanie A. , Pyzik Paula L. , Rubenstein James E. , Hamdy Rana F. , Kossoff Eric H. 
Published: July 2009

OBJECTIVE: Kidney stones are an adverse event with the ketogenic diet (KD), occurring in ∼6% of children who are started on this therapy for intractable epilepsy. Potassium citrate (Polycitra K) is a daily oral supplement that alkalinizes the urine and solubilizes urine calcium, theoretically reducing the risk for kidney stones.
METHODS: Children who started the KD from 2000 to 2008 at Johns Hopkins Hospital, with at least 1 month of follow-up, were evaluated (N = 313). From 2000 to 2005, children were treated with daily Polycitra K at 2 mEq/kg per day only in the setting of identified hypercalciuria, whereas, since 2006, it has been started for all children empirically at KD onset.
RESULTS: Polycitra K was administered to 198 children preventatively overall, 4 (2.0%) of whom developed kidney stones, compared with 11 (10.5%) of 105 who did not receive Polycitra K (P = .003). Two children since 2006 refused Polycitra K, 1 of whom developed a kidney stone. Successful empiric administration of Polycitra K at KD onset resulted in a kidney-stone incidence of 0.9% (1 of 106) compared with administration only because of hypercalciuria, 6.7% (13 of 195; P = .02). Polycitra K resulted in less acidic urine (mean pH: 6.8 vs 6.2; P = .002) but not reduced serum acidosis. No adverse effects of oral citrates were reported.
CONCLUSIONS: Oral potassium citrate is an effective preventive supplement against kidney stones in children who receive the KD, achieving its goal of urine alkalinization. Universal supplementation is warranted.
Management of women with chronic renal disease in pregnancy
Authors: Kapoor Nisha , Makanjuola David , Shehata Hassan 
Published: July 2009

A multidisciplinary team should manage pregnancy in women with chronic renal disease.
The outcome is dependent upon prepregnancy renal function and the presence of hypertension and proteinuria.
Women on dialysis and renal transplant recipients form a special group that needs expert care during pregnancy.

Learning objectives:

To understand the basic principles in prepregnancy counselling of women with chronic renal disease.
To be aware of the risks to the pregnancy as well as to long‐term renal function.

Ethical issues:

The risks of serious complications and adverse effects on long‐term health raise complex ethical issues for the health professionals who counsel women with chronic renal disease and look after them during pregnancy.

Please cite this article as: Kapoor N, Makanjuola D, Shehata H. Management of women with chronic renal disease in pregnancy. The Obstetrician & Gynaecologist 2009;11:185–191.
Prey and Prey‐Age Preference by the Iberian WolfCanis Lupus Signatusin a Multiple‐Prey Ecosystem
Authors: Barja Isabel 
Published: July 2009

In many regions of the Iberian Peninsula, wild ungulates have disappeared and wolvesCanis lupusoften depend on garbage dumps and domestic animals. This paper represents an example of wild ungulate preferences of the Iberian wolfCanis lupus signatusin an environment with no human‐wildlife conflicts, because wolves rarely predate on livestock. I studied the patterns of prey selection by the Iberian wolf during May 1998‐October 2002 in northwestern Spain, in an area which supports a diverse community of wild ungulates and in which also domestic ungulates are present. My analysis of 593 wolf scats showed that wild ungulates were consumed preferentially over other prey (i.e. domestic ungulates, carnivores and lagomorphs). Roe deerCapreolus capreoluswas the most important prey species followed by red deerCervus elaphusand wild boarSus scrofa. Domestic ungulates were poorly represented in the wolf diet. Predation frequencies of domestic and wild ungulates varied seasonally and between years. The consumption of roe deer and wild boar increased during the birthing season, probably because of the higher vulnerability of newly born animals; wolves predate mainly on juvenile roe deer and wild boar.
Can Supplemental Feeding of Red Foxes Vulpes vulpes Increase Roe Deer Capreolus capreolus Recruitment in the Boreal Forest?
Authors: Nordström Jonas , Kjellander Petter , Andrén Henrik , Mysterud Atle 
Published: July 2009

Red fox Vulpes vulpes predation on roe deer Capreolus capreolus fawns is regarded as a very important factor affecting recruitment of roe deer. Therefore from a hunting management perspective, it is of interest to find efficient ways to reduce predation. Because predator removal during summer is highly controversial and banned by law in Scandinavia, supplemental feeding of red foxes during the short, critical fawning period of roe deer has been proposed as a means to relieve predation on fawns. We performed a two‐year study of providing red fox vixens with food, supplied as close to active dens as possible, and monitored recruitment of radio‐marked roe deer in the vicinity of these dens at a realistic management scale (i.e. the size of a large hunting area; ∼65 km2). Even though red foxes found and consumed the food supplied, we found no tendency towards increased recruitment of roe deer. We conclude that supplemental feeding of red foxes during the fawning period is not a solution to this management problem, at least not at the chosen management scale and with the current red fox predation levels.
Anti-tuberculosis Drug Resistance Pattern among Different Category of Tuberculosis Patients
Authors: Rahman Mostafizur , Kamal SM Mostafa , Mohammed Fazle Rabbi , Alam Md Billal , Ahasan HAM Nazmul 
Published: July 2009

Background: Anti-Tuberculosis (TB) drug resistance is emerging as a new global health problem. No national data on drug resistance is available in Bangladesh. The absolute number of multidrug resistant TB (MDR-TB) is expected to be high considering high TB burden. This study was aimed to determine the resistance pattern of mycobacterium tuberculosis (MTB) isolates among different category of patient. Method: A total 1123 randomly selected patients having clinical and or radiological features of tuberculosis attending out patients department of NIDCH were enrolled in this study during January to December, 2008. Sputum were collected and processed for culture by digestion, decontamination and concentration following modified Petroff's method and were inoculated on to two slopes of Lowenstein- Jensen (L-J) media for six weeks. The identity of the isolates was made by growth rate, colony morphology, P-nitrobenzoic acid (PNB) susceptibility, catalase and nitrate reduction tests. Ultimately drug susceptibility testing (DST) were performed. Result: Drug susceptibility testing for Isoniazid (INH), Rifampicin (RIF), Ethambutol (EMB) and Streptomycin (SM) was done among 363 cases. Resistance rates for INH, RIF, EMB and SM were 76.03%, 71.63%, 27.55% and 55.65% respectively. According to DST report, total 221 cases were detected as multi drug resistant TB (MDR-TB). Among them, 87% cases were MDR-TB in category II (CAT - II) failure and 13% were MDR-TB in category I (CAT - I) failure and it was 0% in new cases. Conclusion: Pattern of anti TB drug resistance was identified in this study. More surveillance and immediate therapeutic interventions should be performed in order to combat the threat of MDR-TB to the general population. Keywords: Tuberculosis, Multi drug resistance, Drug susceptibility testing. doi: 10.3329/jom.v10i2.2812 J MEDICINE 2009; 10 : 45-47
Evaluation of Oxidative Stress, Antioxidant and Thyroid Hormone Status in Patients with Diabetes Mellitus
Authors: Pasupathi P , Chandrasekar V , Kumar U Senthil 
Published: July 2009

Oxidative stress is currently suggested as mechanism underlying diabetes and diabetic complications. The aim of the study was to evaluate the magnitude of oxidative stress in patients with diabetes by measuring the lipid peroxidation as well as the status of the antioxidant defense system, thyroid hormones status and other biochemical variables. The study population consisted of 100 subjects divided into two groups viz. diabetic (n=50) and healthy controls (n=50). Changes in the levels of lipid peroxidation and antioxidants and thyroid hormones status were determined in diabetic and non-diabetic subjects. The level of thiobarbituric acid reactive substances (TBARS) was found to be increased significantly in diabetic patients compared to healthy controls. On the other hand, the activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-S-transferase (GST), reduced glutathione (GSH), vitamin A, vitamin E and vitamin C were found to be decreased significantly in diabetics when compared to control subjects. We also noticed a marked increase in serum total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL-C), very low-density lipoprotein cholesterol (VLDL-C), and decrease in highdensity lipoprotein cholesterol (HDL-C), total protein and albumin in diabetic patients. The level of TSH was significantly decreased whereas the levels of T4 and FT4 were significantly increased in diabetic patients than the control subjects. However, the T3 and FT3 levels did not differ significantly between groups. Our findings indicate that changes in oxidant and antioxidant equilibrium will have biological and possibly pathological role in the development of secondary complications. It also demonstrate that detection of thyroid hormone status in the early stage of the disease will help the patients to improve quality of life and reduce the morbidity rate. Key Words: Diabetes mellitus, Oxidative stress, Lipid peroxidation, Antioxidant status, Thyroid hormones. doi: 10.3329/jom.v10i2.2816 J MEDICINE 2009; 10 : 60-66
Mycobacterium abscessus Glycopeptidolipids Mask Underlying Cell Wall Phosphatidyl-myo-Inositol Mannosides Blocking Induction of Human Macrophage TNF-α by Preventing Interaction with TLR2
Authors: Rhoades Elizabeth R. , Archambault Angela S. , Greendyke Rebecca , Hsu Fong-Fu , Streeter Cassandra , Byrd Thomas F. 
Published: July 2009

Abstract
Mycobacterium abscessus causes disease in patients with structural abnormalities of the lung, and it is an emerging pathogen in patients with cystic fibrosis. Colonization of the airways by nontuberculous mycobacteria is a harbinger of invasive lung disease. Colonization is facilitated by biofilm formation, with M. abscessus glycopeptidolipids playing an important role. M. abscessus can transition between a noninvasive, biofilm-forming, smooth colony phenotype that expresses glycopeptidolipid, and an invasive rough colony phenotype that expresses minimal amounts of glycopeptidolipid and is unable to form biofilms. The ability of this pathogen to transition between these phenotypes may have particular relevance to lung infection in cystic fibrosis patients since the altered pulmonary physiology of these patients makes them particularly susceptible to colonization by biofilm-forming bacteria. In this study we demonstrate that rough variants of M. abscessus stimulate the human macrophage innate immune response through TLR2, while smooth variants do not. Temperature-dependent loss or physical removal of glycopeptidolipid from the cell wall of one of the smooth variants leads to TLR2 stimulation. This response is stimulated in part through phosphatidyl-myo-inositol mannosides that are present in the cell wall of both rough and smooth variants. Mannose-binding lectins bind to rough variants, but lectin binding to an isogenic smooth variant is markedly reduced. This suggests that glycopeptidolipid in the outermost portion of the M. abscessus cell wall masks underlying cell wall lipids involved in stimulating the innate immune response, thereby facilitating colonization. Conversely spontaneous “unmasking” of cell wall lipids may promote airway inflammation.
Flexible Stereospecific Interactions and Composition within Nucleoprotein Complexes Assembled on the TCRα Gene Enhancer
Authors: del Blanco Beatriz , Roberts Joseph L. , Zamarreño Noelia , Balmelle-Devaux Nadège , Hernández-Munain Cristina 
Published: July 2009

Abstract
During thymocyte maturation, enhancers of genes encoding for TCRδ (Tcrd) and TCRα (Tcra), Eδ8, and Eα, work as a developmental switch controlling transition from Tcrd to Tcra activity at the Tcrad locus. Previous experiments revealed that an Eα fragment, Tα1-Tα2, which constitutes a well-characterized compact nucleoprotein structure led to premature activation of V(D)J recombination compared with that observed for the entire Eα or Tα1-Tα4. These experiments indicated that Tα3-Tα4 collaborates with factors bound to Tα1-Tα2 for the strict developmental regulation of Tcra rearrangement. The compact enhanceosome created on Tα1-Tα2 explained the molecular basis for requirement of intact Tα2 TCF/LEF and ets sites for enhancer function. We have created a mutant version of Eα, EαMC, in which Eδ myb and runx sites have been substituted for Tα2 runx and ets sites, that argues against the notion of a requirement for strict Eα enhanceosome structure for function. EαMC resulted in a very potent enhancer indicating that stereospecific interactions among proteins that form an Eα enhanceosome are rather flexible. Activation of V(D)J recombination by EαMC during thymocyte development resulted, however, to be premature and indistinguishable from that of Tα1-Tα2. These results indicate that Tα3-Tα4 itself is not sufficient to impart a developmental delay to a chimeric “early” enhancer, and indicate the need for functional collaboration between Tα2 runx/ets sites binding proteins and proteins bound to Tα3-Tα4 for proper developmental activation. The possibility of assembly of distinct sets of proteins on Eα might represent a more flexible form of information processing during thymocyte development.
Glucocorticoids Induce Protein S-Dependent Phagocytosis of Apoptotic Neutrophils by Human Macrophages
Authors: McColl Aisleen , Bournazos Stylianos , Franz Sandra , Perretti Mauro , Morgan B. Paul , Haslett Christopher , Dransfield Ian 
Published: July 2009

Abstract
During resolution of an inflammatory response, recruited neutrophil granulocytes undergo apoptosis and are removed by tissue phagocytes before induction of secondary necrosis without provoking proinflammatory cytokine production and release. Promotion of physiological neutrophil clearance mechanisms may represent a viable therapeutic strategy for the treatment of inflammatory or autoimmune diseases in which removal of apoptotic cells is impaired. The mechanism underlying enhancement of macrophage capacity for phagocytosis of apoptotic cells by the powerful anti-inflammatory drugs of the glucocorticoid family has remained elusive. In this study, we report that human monocyte-derived macrophages cultured in the presence of dexamethasone exhibit augmented capacity for phagocytosis of membrane-intact, early apoptotic cells only in the presence of a serum factor. Our results eliminate a role for a number of potential opsonins, including complement, pentraxin-3, and fibronectin. Using ion-exchange and gel filtration chromatography, we identified a high molecular mass serum fraction containing C4-binding protein and protein S responsible for the augmentation of phagocytosis of apoptotic neutrophils. Because the apoptotic neutrophils used in this study specifically bind protein S, we suggest that glucocorticoid treatment of macrophages induces a switch to a protein S-dependent apoptotic cell recognition mechanism. Consistent with this suggestion, pretreatment of macrophages with Abs to Mer tyrosine kinase, a member of the Tyro3/Axl/Mer family of receptor tyrosine kinases, prevented glucocorticoid augmentation of phagocytosis. Induction of a protein S/Mer tyrosine kinase-dependent apoptotic cell clearance pathway may contribute to the potent anti-inflammatory effects of glucocorticoids, representing a potential target for promoting resolution of inflammatory responses.
Dying and Necrotic Neutrophils Are Anti-Inflammatory Secondary to the Release of α-Defensins
Authors: Miles Katherine , Clarke David J. , Lu Wuyuan , Sibinska Zaneta , Beaumont Paula E. , Davidson Donald J. , Barr Tom A. , Campopiano Dominic J. , Gray Mohini 
Published: July 2009

Abstract
Neutrophils are recruited to sites of injury but their timely removal is thought to be vital to prevent exacerbating inflammation. In addition, the recognition of apoptotic cells by cells of the innate immune system provides potent anti-inflammatory and anti-immunogenic signals. In this article, we describe how human neutrophils dying by apoptosis or necrosis release anti-inflammatory peptides, the α-defensins. This family of small cationic peptides effectively inhibits the secretion of multiple proinflammatory cytokines and NO from macrophages, the main innate immune cell found at sites of chronic inflammation. In addition, the systemic administration of necrotic neutrophil supernatants and α-defensins protects mice from a murine model of peritonitis. Hence. their effects may be far-reaching and serve to kill microbes while regulating a potentially tissue-destructive inflammatory response.
Cutting Edge: SWI/SNF Mediates Antisense Igh Transcription and Locus-Wide Accessibility in B Cell Precursors
Authors: Osipovich Oleg A. , Subrahmanyam Ramesh , Pierce Steven , Sen Ranjan , Oltz Eugene M. 
Published: July 2009

Abstract
The stepwise process of Ag receptor gene assembly, termed V(D)J recombination, is coordinated during lymphocyte development by sweeping changes in chromatin that permit or deny access to a single recombinase enzyme. We now show that switching/sucrose nonfermenting (SWI/SNF) chromatin remodeling complexes are recruited to the Igh locus by an enhancer-dependent process and that these complexes are essential for generating recombinase accessibility throughout the locus. Depletion of SWI/SNF in pro-B cells also inhibits antisense transcription through all clusters of Igh gene segments, a pioneering process that has been implicated in the initial opening of chromatin. We conclude that SWI/SNF complexes play multiple roles in Igh gene assembly, ranging from initial locus activation to the spreading and maintenance of chromatin accessibility over large VH, DH, and JH domains.
Cutting Edge: Necrosis Activates the NLRP3 Inflammasome
Authors: Li Hanfen , Ambade Aditya , Re Fabio 
Published: July 2009

Abstract
Cells undergoing necrosis release endogenous danger signals that possess proinflammatory potential. In this study we show that mature IL-1β and IL-18 are released by necrotic cells but not by apoptotic cells. We identify 7-bromoindirubin-3′-oxime, an indirubin oxime derivative that induces necrosis, as a potent inducer of caspase-1 activation and release of mature IL-1β and IL-18. Inflammasome activation was triggered by other necrosis-inducing treatments but was not observed in response to apoptosis-inducing stimuli. Necrosis-induced inflammasome activation was mediated by the NLRP3 and ASC molecules. Release of IL-18 and IL-1β in response to necrosis-inducing stimuli was observed in THP-1 macrophages and the MSTO-211H human mesothelioma cell line independently of LPS priming. Using the in vivo model of naphthalene-induced airway epithelial cell injury, we showed that necrosis activates the ASC inflammasome in vivo. Our study identifies a new mechanism through which necrosis generates proinflammatory molecules that contributes to the sterile inflammatory response.