bluuebunny/crossref_metadata_2025_split huggingface dataset:
State and Regional Variation in Regulations Related to Feeding Infants in Child Care
Authors: Benjamin Sara E. , Taveras Elsie M. , Cradock Angie L. , Walker Elizabeth M. , Slining Meghan M. , Gillman Matthew W. 
Published: June 2009

OBJECTIVE: The purpose of this study was to compare state and regional variation in infant feeding regulations for child care facilities and to compare these regulations to national standards.
METHODS: We reviewed regulations for child care for all US states and Washington, DC, and examined patterns according to type of facility and geographic region. We compared state regulations with national standards for feeding infants in child care. The standards included were: (1) infants are fed according to a feeding plan from a parent or physician; (2) breastfeeding is supported by the child care facility; (3) no solid food is given before 6 months of age; (4) infants are fed on demand; (5) infants are fed by a consistent caregiver; (6) infants are held while feeding; (7) infants cannot carry or sleep with a bottle; (8) caregivers cannot feed &gt;1 infant at a time; (9) no cow's milk is given to children &lt;12 months of age; (10) whole cow's milk is required for children 12 to 24 months of age; and (11) no solid food is fed in a bottle.
RESULTS: The mean number of regulations for states was 2.8 (SD: 1.6) for centers and 2.0 (SD: 1.3) for family child care homes. No state had regulations for all 11 standards for centers; only Delaware had regulations for 10 of the 11 standards. For family child care homes, Ohio had regulations for 5 of the 11 standards, the most of any state. States in the South had the greatest mean number of regulations for centers (3.3) and family child care homes (2.2), and the West had the fewest (2.3 and 1.9, respectively).
CONCLUSIONS: Many states lacked infant feeding regulations. Encouraging states to meet best-practice national standards helps ensure that all child care facilities engage in appropriate and healthful infant feeding practices.
Estimation of Optimal CPR Chest Compression Depth in Children by Using Computer Tomography
Authors: Braga Matthew S. , Dominguez Troy E. , Pollock Avrum N. , Niles Dana , Meyer Andrew , Myklebust Helge , Nysaether Jon , Nadkarni Vinay 
Published: June 2009

OBJECTIVE: Pediatric consensus-driven cardiopulmonary resuscitation guidelines target chest compression (CC) depths of one third to one half anterior-posterior (AP) chest depth. Estimates for this target as assessed by computed tomography (CT) measurements of internal and external AP chest dimensions could direct future pediatric cardiopulmonary resuscitation guidelines.
METHODS: A total of 280 consecutive chest CT scans in permuted blocks of 20 for each of 14 age divisions between 0 and 8 years were reconstructed and analyzed. External and internal AP depths were measured at midsternum, and residual chest depth was calculated at simulated one-third and one-half AP compressions.
RESULTS: After a simulated compression calculation, one-half external AP depth CC would result in residual internal depth of &lt;10 mm for 94% (263 of 280) of children 3 months to 8 years. For a one-third external AP CC, only 0.4% (1 of 280) of children 3 months to 8 years had a calculated residual internal chest depth &lt;10 mm.
CONCLUSIONS: By using CT reconstruction estimates of chest dimensions across the developmental spectrum from 0 to 8 years of age, we demonstrated that a simulated CC targeting approximately one-third external AP chest depth seems radiographically appropriate for children aged 3 months to 8 years, whereas simulated CC targeting approximately one-half external AP chest depth seems radiographically to be too deep, resulting in residual internal chest depth of &lt;10 mm for most patients of this age.
Using Personal Health Records to Improve the Quality of Health Care for Children
Authors:   Council on Clinical Information Technology
Published: June 2009

This Policy Statement was retired August 2014.
A personal health record (PHR) is a repository of information from multiple contributors (eg, patient, family, guardians, physicians, and other health care professionals) regarding the health of an individual. The development of electronic PHRs presents new opportunities and challenges to the practice of pediatrics. This policy statement provides recommendations for actions that pediatricians can take to support the development and use of PHRs for children.
Pediatric health care professionals must become actively involved in developing and adopting PHRs and PHR systems. The American Academy of Pediatrics supports development of: educational programs for families and clinicians on effective and efficient use of PHRs;incentives to facilitate PHR use and maintenance; andchild- and adolescent-friendly standards for PHR content, portability, security, and privacy.
Properly designed PHR systems for pediatric care can empower patients. PHRs can improve access to health information, improve coordination of preventive health and health maintenance activities, and support emergency and disaster management activities. PHRs provide support for the medical home for all children, including those with special health care needs and those in foster care. PHRs can also provide information to serve as the basis for pediatric quality improvement efforts.
For PHRs to be adopted sufficiently to realize these benefits, we must determine how best to support their development and adoption. Privacy and security issues, especially with regard to children and adolescents, must be addressed.
Quantification of Phytoestrogens in Industrial Waste Streams
Authors: Lundgren Mark S. , Novak Paige J. 
Published: June 2009

Abstract
Chemical compounds, including plant-based phytoestrogens, can function as hormone mimics and alter endocrine signaling in wildlife. In the present study, the waste streams from 19 plant-processing industries, including biofuel manufacturers, were sampled and analyzed for the phytoestrogens genistein, daidzein, coumestrol, formononetin, biochanin A, and zearalenone, via liquid chromatography/mass spectrometry. Eight of these industries contained phytoestrogens at environmentally relevant levels (≥1,000 ng/L), with the highest at approximately 250,000 ng/L. The influent and effluent streams of three municipal wastewater treatment plants receiving flow from some of these industries also were sampled and analyzed for the same phytoestrogens. It appeared that aerobic biological treatment, such as activated sludge, was able to remove these compounds from the liquid stream. Nevertheless, the effluent stream from one of the wastewater treatment plants had a phytoestrogen concentration above 1,000 ng/L. Results of the present study indicate the need for caution when designing facilities to treat the effluents from biofuel and other plant-processing industries.
Development of a Type 2 Diabetes Risk Model From a Panel of Serum Biomarkers From the Inter99 Cohort
Authors: Kolberg Janice A. , Jørgensen Torben , Gerwien Robert W. , Hamren Sarah , McKenna Michael P. , Moler Edward , Rowe Michael W. , Urdea Mickey S. , Xu Xiaomei M. , Hansen Torben , Pedersen Oluf , Borch-Johnsen Knut 
Published: June 2009

OBJECTIVE
The purpose of this study was to develop a model for assessing the 5-year risk of developing type 2 diabetes from a panel of 64 circulating candidate biomarkers.

RESEARCH DESIGN AND METHODS
Subjects were selected from the Inter99 cohort, a longitudinal population-based study of ∼6,600 Danes in a nested case-control design with the primary outcome of 5-year conversion to type 2 diabetes. Nondiabetic subjects, aged ≥39 years, with BMI ≥25 kg/m2 at baseline were selected. Baseline fasting serum samples from 160 individuals who developed type 2 diabetes and from 472 who did not were tested. An ultrasensitive immunoassay was used to measure of 58 candidate biomarkers in multiple diabetes-associated pathways, along with six routine clinical variables. Statistical learning methods and permutation testing were used to select the most informative biomarkers. Risk model performance was estimated using a validated bootstrap bias-correction procedure.

RESULTS
A model using six biomarkers (adiponectin, C-reactive protein, ferritin, interleukin-2 receptor A, glucose, and insulin) was developed for assessing an individual's 5-year risk of developing type 2 diabetes. This model has a bootstrap-estimated area under the curve of 0.76, which is greater than that for A1C, fasting plasma glucose, fasting serum insulin, BMI, sex-adjusted waist circumference, a model using fasting glucose and insulin, and a noninvasive clinical model.

CONCLUSIONS
A model incorporating six circulating biomarkers provides an objective and quantitative estimate of the 5-year risk of developing type 2 diabetes, performs better than single risk indicators and a noninvasive clinical model, and provides better stratification than fasting plasma glucose alone.
Effect of Ingested Interferon-α on β-Cell Function in Children With New-Onset Type 1 Diabetes
Authors: Rother Kristina I. , Brown Rebecca J. , Morales Miriam M. , Wright Elizabeth , Duan Zhigang , Campbell Carol , Hardin Dana S. , Popovic Jadranka , McEvoy Robert C. , Harlan David M. , Orlander Philip R. , Brod Staley A. 
Published: June 2009

OBJECTIVE
To evaluate the safety and efficacy of ingested human recombinant interferon-α (hrIFN-α) for preservation of β-cell function in young patients with recent-onset type 1 diabetes.

RESEARCH DESIGN AND METHODS
Subjects aged 3–25 years in whom type 1 diabetes was diagnosed within 6 weeks of enrollment were randomly assigned to receive ingested hrIFN-α at 5,000 or 30,000 units or placebo once daily for 1 year. The primary outcome was change in C-peptide secretion after a mixed meal.

RESULTS
Individuals in the placebo group (n = 30) lost 56 ± 29% of their C-peptide secretion from 0 to 12 months, expressed as area under the curve (AUC) in response to a mixed meal. In contrast, children treated with hrIFN-α lost 29 ± 54 and 48 ± 35% (for 5,000 [n = 27] and 30,000 units [n = 31], respectively, P = 0.028, ANOVA adjusted for age, baseline C-peptide AUC, and study site). Bonferroni post hoc analyses for placebo versus 5,000 units and placebo versus 30,000 units demonstrated that the overall trend was determined by the 5,000-unit treatment group. Adverse events occurred at similar rates in all treatment groups.

CONCLUSIONS
Ingested hrIFN-α was safe at the doses used. Patients in the 5,000-unit hrIFN-α treatment group maintained more β-cell function 1 year after study enrollment than individuals in the placebo group, whereas this effect was not observed in patients who received 30,000 units hrIFN-α. Further studies of low-dose ingested hrIFN-α in new-onset type 1 diabetes are needed to confirm this effect.
Hypoglycemia and Clinical Outcomes in Patients With Diabetes Hospitalized in the General Ward
Authors: Turchin Alexander , Matheny Michael E. , Shubina Maria , Scanlon James V. , Greenwood Bonnie , Pendergrass Merri L. 
Published: June 2009

OBJECTIVE
Hypoglycemia is associated with adverse outcomes in mixed populations of patients in intensive care units. It is not known whether the same risks exist for diabetic patients who are less severely ill. In this study, we aimed to determine whether hypoglycemic episodes are associated with higher mortality in diabetic patients hospitalized in the general ward.

RESEARCH DESIGN AND METHODS
This retrospective cohort study analyzed 4,368 admissions of 2,582 patients with diabetes hospitalized in the general ward of a teaching hospital between January 2003 and August 2004. The associations between the number and severity of hypoglycemic (≤50 mg/dl) episodes and inpatient mortality, length of stay (LOS), and mortality within 1 year after discharge were evaluated.

RESULTS
Hypoglycemia was observed in 7.7% of admissions. In multivariable analysis, each additional day with hypoglycemia was associated with an increase of 85.3% in the odds of inpatient death (P = 0.009) and 65.8% (P = 0.0003) in the odds of death within 1 year from discharge. The odds of inpatient death also rose threefold for every 10 mg/dl decrease in the lowest blood glucose during hospitalization (P = 0.0058). LOS increased by 2.5 days for each day with hypoglycemia (P &lt; 0.0001).

CONCLUSIONS
Hypoglycemia is common in diabetic patients hospitalized in the general ward. Patients with hypoglycemia have increased LOS and higher mortality both during and after admission. Measures should be undertaken to decrease the frequency of hypoglycemia in this high-risk patient population.
ATLANTIC DIP: Pregnancy Outcome for Women With Pregestational Diabetes Along the Irish Atlantic Seaboard
Authors: Dunne Fidelma P. , Avalos Gloria , Durkan Meave , Mitchell Yvonne , Gallacher Therese , Keenan Marita , Hogan Marie , Carmody Louise A. , Gaffney Geraldine ,   for the ATLANTIC DIP collaborators
Published: June 2009

OBJECTIVE
Prospective evaluation of pregnancy outcomes in pregestational diabetes along the Atlantic seaboard 2006–2007.

RESEARCH DESIGN AND METHODS
The Atlantic Diabetes in Pregnancy group, representing five antenatal centers in a wide geographical location, was established in 2005. All women with diabetes for &gt;6 months before the index pregnancy were included. Results were collected electronically via the DIAMOND Diabetes Information System. Pregnancy outcome was compared with background rates.

RESULTS
There were 104 singleton pregnancies. The stillbirth rate (25/1,000) was 5 times, perinatal mortality rate (25/1,000) 3.5 times, and congenital malformation rate (24/1,000) 2 times that of the background population. A total of 28% of women received prepregnancy care, 43% received prepregnancy folic acid, and 51% achieved an A1C ≤7% at first antenatal visit.

CONCLUSIONS
Women are not well prepared for pregnancy, and outcomes are suboptimal. A regional prepregnancy care program and centralized glucose management are urgently needed.
Chemometrics as an option to assess clinical data from diabetes mellitus type 2 patients
Authors: Nikolov Marian , Simeonova Pavlina , Simeonov Vasil 
Published: June 2009

Abstract
The present study deals with the application of two major multivariate statistical approaches - Cluster Analysis (CA) and Principal Components Analysis (PCA) as an option for assessment of clinical data from diabetes mellitus type 2 patients. One hundred clinical cases of patients are considered as object of the statistical classification and modeling, each one of them characterized by 34 various clinical parameters. The goal of the study was to find patterns of similarity, both between the patients and the clinical tests. Each group of similarity is interpreted revealing at least five clusters of correlated parameters or five latent factors, which determine the data structure. Relevant explanation of the clustering is found based on the pattern of similarity like glucose level, anthropometric data, enzyme level, liver function, kidney function etc. It is assumed that this classification could be of help in optimizing the performance of clinical test for this type of patients and for designing a pattern for the role of the different groups of test in determining the metabolic syndrome of the patients.
Graubündens Wald im Fokus | Focus on the Grisons forest
Authors: Hefti Reto 
Published: June 2009

In the mountainous canton Grisons, much visited by tourists, the forest has always had an important role to play. New challenges are now presenting themselves. The article goes more closely into two themes on the Grisons forestry agenda dominating in the next few years: the increased use of timber and climate change. With the increased demand for logs and the new sawmill in Domat/Ems new opportunities are offered to the canton for more intensive use of the raw material, wood. This depends on a reduction in production costs and a positive attitude of the population towards the greater use of wood. A series of measures from the Grisons Forestry Department should be of help here.
The risk of damage to infrastructure is particularly high in a mountainous canton. The cantonal government of the Grisons has commissioned the Forestry Department to define the situation concerning the possible consequences of global warming on natural hazards and to propose measures which may be taken. The setting up of extensive measurement and information systems, the elaboration of intervention maps, the estimation of the danger potential in exposed areas outside the building zone and the maintenance of existing protective constructions through the creation of a protective constructions register, all form part of the government programme for 2009 to 2012.
In the Grisons, forest owners and visitors will have to become accustomed to the fact that their forests must again produce more wood and that, on account of global warming, protective forests will become even more important than they already are today.
Intuitive and Axiomatic Arguments for Quantifying Diagnostic Test Performance in Units of Information
Authors: Benish W. A. 
Published: June 2009

Summary
Objectives: Mutual information is a fundamental concept of information theory that quantifies the expected value of the amount of information that diagnostic testing provides about a patient’s disease state. The purpose of this report is to provide both intuitive and axiomatic descriptions of mutual information and, thereby, promote the use of this statistic as a measure of diagnostic test performance.
Methods: We derive the mathematical expression for mutual information from the intuitive assumption that diagnostic information is the average amount that diagnostic testing reduces our surprise upon ultimately learning a patient’s diagnosis. This concept is formalized by defining “surprise” as the surprisal, a function that quantifies the unlikelihood of an event. Mutual information is also shown to be the only function that conforms to a set of axioms which are reasonable requirements of a measure of diagnostic information. These axioms are related to the axioms of information theory used to derive the expression for entropy.
Results: Both approaches to defining mutual information lead to the known relationship that mutual information is equal to the pre-test uncertainty of the disease state minus the expected value of the posttest uncertainty of the disease state. Mutual information also has the property of being additive when a test provides information about independent health problems.
Conclusion: Mutual information is the best single measure of the ability of a diagnostic test to discriminate among the possible disease states.
Computation of a Probabilistic Statistical Shape Model in a Maximum-a-posteriori Framework
Authors: Pennec X. , Ehrhardt J. , Ayache N. , Handels H. , Hufnagel H. 
Published: June 2009

Summary
Objectives: When analyzing shapes and shape variabilities, the first step is bringing those shapes into correspondence. This is a fundamental problem even when solved by manually determining exact correspondences such as landmarks. We developed a method to represent a mean shape and a variability model for a training data set based on probabilistic correspondence computed between the observations.
Methods: First, the observations are matched on each other with an affine transformation found by the Expectation-Maximization Iterative-Closest-Points (EM-ICP) registration. We then propose a maximum-a-posteriori (MAP) framework in order to compute the statistical shape model (SSM) parameters which result in an optimal adaptation of the model to the observations. The optimization of the MAP explanation is realized with respect to the observation parameters and the generative model parameters in a global criterion and leads to very efficient and closed-form solutions for (almost) all parameters.
Results: We compared our probabilistic SSM to a SSM based on one-to-one correspondences and the PCA (classical SSM). Experiments on synthetic data served to test the performances on non-convex shapes (15 training shapes) which have proved difficult in terms of proper correspondence determination. We then computed the SSMs for real putamen data (21 training shapes). The evaluation was done by measuring the generalization ability as well as the specificity of both SSMs and showed that especially shape detail differences are better modeled by the probabilistic SSM (Hausdorff distance in generalization ability ≈ 25% smaller).
Conclusions: The experimental outcome shows the efficiency and advantages of the new approach as the probabilistic SSM performs better in modeling shape details and differences.
Computer-assisted Diagnosis for Precancerous Lesions in the Esophagus
Authors: Kage A. , Wittenberg T. , Mühldorfer S. , Münzenmayer C. 
Published: June 2009

Summary
Objectives: The interpretation of endoscopic findings by gastroenterologists is still a difficult and highly subjective task. Despite important developments such as chromo-endoscopy, pit pattern analysis, fluorescence imaging as well as narrow band imaging it still requires lots of experience and training with a certain tentativeness until the final biopsy. By the development of computer-assisted diagnosis (CAD) systems this process can be supported.
Methods: This paper presents a new approach to CAD for precancerous lesions in the esophagus based on color-texture analysis in a content-based image retrieval (CBIR) framework. The novelty of our approach lies in the combination of newly developed color-texture features with the interactive feedback loop provided by a relevance feedback algorithm. This allows the expert to steer the query and is still robust against accidental false decisions.
Results: We reached an inter-rater reliability of κ = 0.71 on a database of 390 endoscopic images. The retrieval accuracy didn’t change significantly until a wrong decision rate of 20%.
Conclusions: Thus, the system could be able to support practitioners with less experience or in private practice. In combination with a connected case database it can also support case-based reasoning for the diagnostic decision process.
Does a fabella-tibial suture alter the outcome for dogs with cranial cruciate ligament insufficiency undergoing arthrotomy and caudal pole medial meniscectomy?
Authors: Comerford E.J. , Owen M.R. , Tivers M.S. 
Published: June 2009

Summary
Objectives: The objective of this study was to evaluate the effects of fabella-tibial suture (FTS) on long-term outcome in dogs with cranial cruciate ligament (CCL) insufficiency and concurrent medial meniscal tear (MMT) that were managed by an open, caudal pole medial meniscectomy (CPMM).
Methods: A retrospective review was performed of the clinical records of dogs treated for CCL insufficiency with concurrent MMT by open CPMM, with or without the non-random addition of a nylon FTS according to surgeon preference, during the period of 2001 to 2004. The Bristol Osteoarthritis in Dogs questionnaire was modified for owner assessment of outcome using a visual analogue scale based on several criteria: level of activity, disability, severity of lameness and frequency of lameness before and after surgery.
Results: Completed questionnaires from 31 dog owners were received. A FTS was used after CPMM in 22 dogs (FTS group), but in nine dogs (control group) only a CPMM was performed. The median time to follow up was longer in the FTS group (25 months) than the control group (16 months) (P=0.03). There were not any significant differences between the two groups before and after surgery for the following: disability, activity, frequency of lameness, severity of lameness, ability to climb stairs and ability to sit down.
Clinical Significance: The placement of a FTS following stifle joint arthrotomy and CPMM in dogs with CCL deficiency and concurrent MMT may not be a significant factor affecting the ultimate surgical outcome, although our study is limited by the non-randomised study design.