bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of Age at Kasai Operation on Its Results in Late Childhood and Adolescence: A Rational Basis for Biliary Atresia Screening
Authors: Serinet Marie-Odile , Wildhaber Barbara E. , Broué Pierre , Lachaux Alain , Sarles Jacques , Jacquemin Emmanuel , Gauthier Frédéric , Chardot Christophe 
Published: April 2009

BACKGROUND. Increased age at surgery has a negative impact on results of the Kasai operation for biliary atresia in infancy and early childhood. It remained unclear if an age threshold exists and if this effect persists with extended follow-up. In this study we examined the relationship between increased age at surgery and its results in adolescence.
METHODS. All patients with biliary atresia who were living in France and born between 1986 and 2002 were included. Median follow-up in survivors was 7 years.
RESULTS. Included in the study were 743 patients with biliary atresia, 695 of whom underwent a Kasai operation; 2-, 5-, 10-, and 15-year survival rates with native liver were 57.1%, 37.9%, 32.4%, and 28.5%, respectively. Median age at Kasai operation was 60 days and was stable over the study period. Whatever the follow-up (2, 5, 10, or 15 years), survival rates with native liver decreased when age at surgery increased (≤30, 31–45, 46–60, 61–75, and 76–90 days). Accordingly, we estimated that if every patient with biliary atresia underwent the Kasai operation before 46 days of age, 5.7% of all liver transplantations performed annually in France in patients younger than 16 years could be spared.
CONCLUSIONS. Increased age at surgery had a progressive and sustained deleterious effect on the results of the Kasai operation until adolescence. These findings indicate a rational basis for biliary atresia screening to reduce the need for liver transplantations in infancy and childhood.
Not Just Little Adults: Candidemia Epidemiology, Molecular Characterization, and Antifungal Susceptibility in Neonatal and Pediatric Patients
Authors: Blyth Christopher C. , Chen Sharon C. A. , Slavin Monica A. , Serena Carol , Nguyen Quoc , Marriott Deborah , Ellis David , Meyer Wieland , Sorrell Tania C. ,   on behalf of members of the Australian Candidemia Study
Published: April 2009

OBJECTIVE. The purpose of this work was to identify differences in incidence, risk factors, microbiology, treatment, and clinical outcome of candidemia in neonates, children, and adults that might impact on management.
PATIENTS AND METHODS. Cases of candidemia in Australia were identified prospectively by blood culture surveillance over 3 years. Episodes of candidemia in neonatal, pediatric, and adult age groups were analyzed and compared.
RESULTS. Of 1005 incident cases, 33 occurred in neonates, 110 in children, and 862 in adults. The respective annual age-specific incidences were 4.4, 0.9, and 1.8 per 100 000 population. Prematurity and ICU admission were major risk factors in neonates. Hematologic malignancy and neutropenia were significantly more frequent in children than in neonates and adults. Diabetes, renal disease, hemodialysis, and recent surgery were more common in adults. Candidemia was attributed to a vascular access device in 58% of neonates, 70% of children, and 44% of adults. Candida albicans caused ∼48% of cases in all of the age groups. Candida parapsilosis was significantly more common in neonates and children (42% and 38% vs 15%). Candida glabrata was infrequent in neonates and children (9% and 3% vs 17%). Significantly more isolates from children were susceptible to fluconazole compared with those from adults (95% vs 75%). Fluconazole-resistant candidal isolates were infrequent in all of the age groups. Neonates and children were more likely to receive amphotericin B compared with adults. Adults were more likely to receive fluconazole. Survival rates at 30 days were 78% in neonates, 90% in children, and 70% in adults.
CONCLUSIONS. This study identifies significant differences in candidemia in neonates, children, and adults. Neonatologists and pediatricians must consider age-specific differences when interpreting adult studies and developing treatment and prevention guidelines.
Short Sleep Duration and Behavioral Symptoms of Attention-Deficit/Hyperactivity Disorder in Healthy 7- to 8-Year-Old Children
Authors: Paavonen E. Juulia , Räikkönen Katri , Lahti Jari , Komsi Niina , Heinonen Kati , Pesonen Anu-Katriina , Järvenpää Anna-Liisa , Strandberg Timo , Kajantie Eero , Porkka-Heiskanen Tarja 
Published: April 2009

OBJECTIVE. It has been hypothesized that sleep deprivation may manifest in children as behavioral symptoms rather than as tiredness, but only a few studies have investigated this hypothesis. The objective of our study was to evaluate whether short sleep is associated with behavioral symptoms of attention-deficit/hyperactivity disorder in 7- to 8-year-old children.METHODS. We performed a cross-sectional study of children born in 1998 in Helsinki, Finland. The participants included 280 (146 girls, 134 boys) children with a mean age of 8.1 years (SD: 0.3; range: 7.4–8.8). Sleep quality was measured by using actigraphs. The Sleep Disturbance Scale for Children and the Attention-Deficit/Hyperactivity Disorder Rating Scale IV were administered to parents.RESULTS. Children whose average sleep duration as measured by actigraphs was short (&lt;10th percentile, ie, &lt;7.7 hours) and had a higher hyperactivity/impulsivity score (9.7 vs 7.8 or 7.5) and a higher attention-deficit/hyperactivity disorder total score (17.3 vs 14.5 or 13.1) but a similar inattention score (7.6 vs 6.7 or 5.6) compared with children sleeping 7.7 to 9.4 hours or &gt;9.4 hours. In multivariate statistical models, short sleep duration remained a statistically significant predictor of hyperactivity/impulsivity, and sleeping difficulties were associated with hyperactivity/impulsivity, inattention, and the total score. There were no significant interactions between short sleep and sleeping difficulties.CONCLUSIONS. Children's short sleep duration and sleeping difficulties increase the risk for behavioral symptoms of attention-deficit/hyperactivity disorder.
Strategies for the Prevention of MP3-Induced Hearing Loss Among Adolescents: Expert Opinions From a Delphi Study
Authors: Vogel Ineke , Brug Johannes , van der Ploeg Catharina P. B. , Raat Hein 
Published: April 2009

OBJECTIVE. To identify parties involved in the prevention of MP3-induced hearing loss among adolescents and potentially effective prevention strategies and interventions.
METHODS. Thirty experts in fields such as scientific research, medical practice, community health professions, education, youth work, music entertainment, and enforcement authorities participated in a qualitative, electronic, 3-round, Web-based Delphi study.
RESULTS. Multiple parties involved in the prevention of MP3-induced hearing loss among adolescents were identified; the most relevant are the adolescents themselves, their parents, manufacturers of MP3 players and earphones, and the authorities. The experts did not expect that adolescents in general would perform the necessary protective behaviors to prevent MP3-induced hearing loss. Two environmental health protection measures were identified as both relevant and feasible to be implemented (ie, authorities encourage manufacturers to produce safer products, and public health campaigns will be held to improve knowledge of the risks of high-volume music, possible protective measures, and consequences of hearing loss).
CONCLUSIONS. Authorities, the music industry in general, and especially manufacturers of MP3 players and earphones should recognize their responsibility and create a safer MP3-listening environment by taking measures to protect today's youth from the dangers of listening to high-volume music on MP3 players.
Recent Decline in Age at Breast Development: The Copenhagen Puberty Study
Authors: Aksglaede Lise , Sørensen Kaspar , Petersen Jørgen H. , Skakkebæk Niels E. , Juul Anders 
Published: April 2009

OBJECTIVE. Recent publications showing unexpectedly early breast development in American girls created debate worldwide. However, secular trend analyses are often limited by poor data comparability among studies performed by different researchers in different time periods and populations. Here we present new European data systematically collected from the same region and by 1 research group at the beginning and end of the recent 15-year period.
METHODS. Girls (N = 2095) aged 5.6 to 20.0 years were studied in 1991–1993 (1991 cohort; n = 1100) and 2006–2008 (2006 cohort; n = 995). All girls were evaluated by palpation of glandular breast, measurement of height and weight, and blood sampling (for estradiol, luteinizing hormone, and follicle-stimulating hormone). Age distribution at entering pubertal breast stages 2 through 5, pubic hair stages 2 through 5, and menarche was estimated for the 2 cohorts.
RESULTS. Onset of puberty, defined as mean estimated age at attainment of glandular breast tissue (Tanner breast stage 2+), occurred significantly earlier in the 2006 cohort (estimated mean age: 9.86 years) when compared with the 1991 cohort (estimated mean age: 10.88 years). The difference remained significant after adjustment for BMI. Estimated ages at menarche were 13.42 and 13.13 years in the 1991 and 2006 cohorts, respectively. Serum follicle-stimulating hormone and luteinizing hormone did not differ between the 2 cohorts at any age interval, whereas significantly lower estradiol levels were found in 8- to 10-year-old girls from the 2006 cohort compared with similarly aged girls from the 1991 cohort.
CONCLUSIONS. We found significantly earlier breast development among girls born more recently. Alterations in reproductive hormones and BMI did not explain these marked changes, which suggests that other factors yet to be identified may be involved.
Infant Functional Status: The Timing of Physiologic Maturation of Premature Infants
Authors: Bakewell-Sachs Susan , Medoff-Cooper Barbara , Escobar Gabriel J. , Silber Jeffrey H. , Lorch Scott A. 
Published: April 2009

OBJECTIVE. To describe the maturation of physiologic milestones in preterm infants born between 24 and 32 weeks' gestational age.METHODS. We abstracted daily physiologic maturity information on 865 infants born at ≤32 weeks' gestation in the Northern California Kaiser Permanente Medical Care Program between 1998 and 2001. Data included ventilator and incubator settings, body temperature, apnea and bradycardia spells, use of methylxanthines, feeding method, and requirements for intravenous fluids. Multivariable quantile regression models identified risk factors associated with longer postmenstrual age to achieve various physiologic milestones, including time to full oral feeding, time to wean from supplemental heat, the last day with an apnea or bradycardia episode, the last day on methylxanthine medications, and the last day on supplemental oxygen.RESULTS. Most milestones were achieved between 34 and 36 weeks' postmenstrual age, although there were wide variations between patients. In most cases, feeding and oxygen milestones were achieved last. For each milestone there was a monotonic relationship between birth gestational age and the median achievement postmenstrual age. However, bronchopulmonary dysplasia and necrotizing enterocolitis strongly influenced these results in infants of younger gestational age.CONCLUSIONS. This study provides epidemiologic data describing the achievement of basic physiologic milestones that influence the discharge of a premature infant. This work serves as an additional contribution in the development of algorithms to monitor the progress of neonates through their initial hospitalization and provides a reference population for future interventions to improve the physiologic maturation of prematurely born infants.
The Future of Health Insurance for Children With Special Health Care Needs
Authors: Newacheck Paul W. , Houtrow Amy J. , Romm Diane L. , Kuhlthau Karen A. , Bloom Sheila R. , Van Cleave Jeanne M. , Perrin James M. 
Published: April 2009

CONTEXT. Because of their elevated need for services, health insurance is particularly important for children with special health care needs. In this article we assess how well the current system is meeting the insurance needs of children with special health care needs and how emerging trends in health insurance may affect their well-being.METHODS. We begin with a review of the evidence on the impact of health insurance on the health care experiences of children with special health care needs based on the peer-reviewed literature. We then assess how well the current system meets the needs of these children by using data from 2 editions of the National Survey of Children With Special Health Care Needs. Finally, we present an analysis of recent developments and emerging trends in the health insurance marketplace that may affect this population.RESULTS. Although a high proportion of children with special health care needs have insurance at any point in time, nearly 40% are either uninsured at least part of the year or have coverage that is inadequate. Recent expansions in public coverage, although offset in part by a contraction in employer-based coverage, have led to modest but significant reductions in the number of uninsured children with special health care needs. Emerging insurance products, including consumer-directed health plans, may expose children with special health care needs and their families to greater financial risks.CONCLUSIONS. Health insurance coverage has the potential to secure access to needed care and improve the quality of life for these children while protecting their families from financially burdensome health care expenses. Continued vigilance and advocacy for children and youth with special health care needs are needed to ensure that these children have access to adequate coverage and that they fare well under health care reform.
Lyme Carditis in Children: Presentation, Predictive Factors, and Clinical Course
Authors: Costello John M. , Alexander Mark E. , Greco Karla M. , Perez-Atayde Antonio R. , Laussen Peter C. 
Published: April 2009

OBJECTIVES. We sought to identify predictive factors for Lyme carditis in children and to characterize the clinical course of these patients.
METHODS. We reviewed all cases of early disseminated Lyme disease presenting to our institution from January 1994 through July 2008, and summarized the presentation and course of those patients with carditis. A case-control study was used to identify predictive factors for carditis. Controls were patients with early disseminated Lyme disease without carditis.
RESULTS. Of 207 children with early disseminated Lyme disease, 33 (16%) had carditis, 14 (42%) of whom had advanced heart block, including 9 (27%) with complete heart block. The median time to recovery of sinus rhythm in these 14 patients was 3 days (range: 1–7 days), and none required a permanent pacemaker. Four (12%) of 33 patients with carditis had depressed ventricular systolic function, 3 (9%) of whom required mechanical ventilation, temporary pacing, and inotropic support. Complete resolution of rhythm disturbances and myocardial dysfunction occurred in 24 (89%) of 27 patients for whom follow-up data were available. Most patients with carditis also had other systemic Lyme involvement. By using multivariate logistic regression analysis, we found that children &gt;10 years of age, those with arthralgias, and those with cardiopulmonary symptoms were more likely to have carditis.
CONCLUSIONS. The spectrum of presentation for children with Lyme carditis is broad, ranging from asymptomatic, first-degree heart block to fulminant myocarditis. Variable degrees of heart block are the most common manifestation and occasionally require temporary pacing. Transient myocardial dysfunction, although less common, can be life-threatening. Advanced heart block resolves within 1 week in most cases. In children with early disseminated Lyme disease, older age, arthralgias, and cardiopulmonary symptoms independently predict the presence of carditis.
Short- and Long-Term Outcomes of Necrotizing Enterocolitis in Infants With Congenital Heart Disease
Authors: Pickard Sarah S. , Feinstein Jeffrey A. , Popat Rita A. , Huang Lyen , Dutta Sanjeev 
Published: April 2009

OBJECTIVE. Congenital heart disease is a significant risk factor for necrotizing enterocolitis in the term infant. We compared the short- and long-term necrotizing enterocolitis–specific outcomes of infants with congenital heart disease with those of neonates without congenital heart disease.
PATIENTS AND METHODS. A retrospective study of 202 patients with necrotizing enterocolitis treated at our center from May 1999 to August 2007 was conducted. Infants with necrotizing enterocolitis were grouped according to the presence (n = 76) or absence (n = 126) of congenital heart disease. Demographic and necrotizing enterocolitis–specific outcomes were recorded. The groups were compared by nonparametric and χ2 analyses. Univariate and multivariate odds ratios were determined for each outcome.
RESULTS. The average birth weight and gestational age of the 2 groups were not significantly different. The initial necrotizing enterocolitis severity, as determined by Bell stage, was less for necrotizing enterocolitis subjects with congenital heart disease compared with those without congenital heart disease. When controlling for birth weight and gestational age, the congenital heart disease group had decreased risk of perforation, need for a bowel operation, strictures, need for a stoma, sepsis, and short bowel syndrome compared with the non–congenital heart disease group. Although not statistically significant, subjects with congenital heart disease had a trend toward decreased risk of death from necrotizing enterocolitis, recurrent necrotizing enterocolitis, and need for peritoneal drainage.
CONCLUSIONS. Infants with congenital heart disease and necrotizing enterocolitis have decreased risk of major short- and long-term negative outcomes associated with necrotizing enterocolitis compared with neonates without congenital heart disease. Differences in initial severity, range of age at diagnosis, and prognoses between subjects with necrotizing enterocolitis with and without cardiac disease suggest that necrotizing enterocolitis in the cardiac patient is a distinct disease process and should be labeled cardiogenic necrotizing enterocolitis.
The Effect of Sample Size on the Stability of Principal Components Analysis of Truss‐Based Fish Morphometrics
Authors: Kocovsky Patrick M. , Adams Jean V. , Bronte Charles R. 
Published: April 2009

AbstractMultivariate analysis of fish morphometric truss elements for stock identification, description of new species, assessment of condition, and other applications is frequently conducted on data sets that have sample sizes smaller than those recommended in the literature. Minimum sample size recommendations are rarely accompanied by empirical support, and we know of no previous assessment of minimum sample sizes for multivariate analysis of fish truss elements. We examined the stability of outcomes of principal components analysis (PCA) of truss elements, a commonly applied method of morphometric analysis for fishes, by conducting PCA on 1,000 resamples for each of 24 different sample sizes (N; each sample drawn without replacement) from collections of yellow perch Perca flavescens (397 fish), white perch Morone americana (208 fish), and siscowet lake trout Salvelinus namaycush (560 fish). Eigenvalues were inflated and loadings on eigenvectors were highly unstable for the first three principal components (PCs) whenever N was smaller than the number of truss elements (P). Stability of eigenvalues and eigenvectors increased as the N:P ratio increased for all three species, but the N:P ratio at which stable results were achieved varied by species. Our results suggest that an N:P ratio of 3.5‐8.0 was required for stability of PC2 and PC3, which is required for analysis of fish shape. Because some of our results varied among the species we examined, we recommend similar evaluations for other species. Results from past work that used PCA of truss elements and where N was less than P may require re‐evaluation.
Therapeutic Drug Monitoring of Antimycobacterial Drugs in Patients with Both Tuberculosis and Advanced Human Immunodeficiency Virus Infection
Authors: Holland David P. , Hamilton Carol D. , Weintrob Amy C. , Engemann John J. , Fortenberry Ellen R. , Peloquin Charles A. , Stout Jason E. 
Published: April 2009

Study Objective. To determine the feasibility of therapeutic drug monitoring for adjusting low serum antimycobacterial concentrations in patients with both tuberculosis and advanced human immunodeficiency virus (HIV).Design. Retrospective cohort study.Data Source. De‐identified dataset from a tuberculosis clinic.Patients. Twenty‐one patients (median age 38 yrs, range 25–68 yrs) with advanced HIV infection (CD4+ cell count < 100 cells/mm3) who received treatment for active tuberculosis between March 2002 and September 2007.Measurements and Main Results. We evaluated data based on the practices performed at the tuberculosis clinic. After the daily doses of isoniazid and rifamycins (rifampin or rifabutin) were ingested, serum concentrations were obtained at 2 hours for isoniazid and rifampin, at 3 hours for rifabutin, and, when possible, at 6 hours for all three drugs to detect delayed absorption. Antimycobacterial drug concentrations were compared with published reference levels, and dosages were adjusted to achieve desired concentrations. Costs of monitoring were recorded for all patients. Of the 21 patients, 18 (86%) had low serum concentrations of at least one drug 2 hours after ingestion: 2 (10%) had low isoniazid concentrations, 5 (24%) had low rifamycin concentrations, and 11 (52%) had low serum concentrations of both drugs. The median number of dosage adjustments to attain normal concentrations was 1 (range 0–4 adjustments). The median cost/patient for therapeutic drug monitoring was $619 (range $230–1948). The median final doses to achieve normal concentrations were isoniazid 600 mg/day (range 300–1500 mg/day), rifampin 1050 mg/day (range 600–1200 mg/day), and rifabutin 300 mg (range 150–450 mg) 3 times/week. No patient demonstrated any adverse effects attributed to these higher doses.Conclusion. Low serum concentrations of antituberculous drugs, which suggest malabsorption, are common among patients with advanced HIV who also have tuberculosis but can be overcome with higher doses. Therapeutic drug monitoring may be an effective tool to optimize therapy, but needs further study.
Comparative study of ZnO layers prepared by PLD from different targets at various oxygen pressure levels
Authors: HaÅ¡ko Daniel , Bruncko Jaroslav , Vincze Andrej , Uherek FrantiÅ¡ek 
Published: April 2009

Abstract
Two series of polycrystalline zinc oxide (ZnO) layers, from Zn or ZnO targets, were grown on silicon (1 1 1) substrates by pulsed laser deposition (PLD) at ambient oxygen pressure levels, stepwise increased from 1 to 35 Pa. For ablation of targets, a pulsed Nd:YAG laser was used. The structural and morphological properties of the layers were investigated by scanning electron microscopy (SEM), atomic force microscopy (AFM), and secondary ion mass spectrometry (SIMS). The SEM images of ZnO layers in SE mode show a uniform granular structure and modified surface morphology, depending on oxygen pressure. The mean grain size in height and lateral directions decreases with an increase of oxygen pressure from 1 to 5 Pa, while a subsequent rise of oxygen pressure from 5 to 35 Pa will cause an increase in the grain size. The AFM measurement revealed that the surface structures of zinc oxide layers grown from different targets were similar, and the layers formed at an ambient oxygen pressure of 5 Pa exhibited the smallest values of calculated roughness and granularity. SIMS depth profiling analyses confirmed that the ZnO composition was homogenous across the layer, up to the abrupt change of chemical composition at the interface between the ZnO layer and the Si substrate.