bluuebunny/crossref_metadata_2025_split huggingface dataset:
Physical activity in survivors of childhood acute lymphoblastic leukaemia
Authors: Heath John A , Ramzy John M , Donath Susan M 
Published: January 2010

Aim:  To objectively measure levels of physical activity in children, following treatment for acute lymphoblastic leukaemia (ALL).Methods:  Nineteen children who had completed treatment for ALL 6 months–5 years prior to study enrolment wore an accelerometer for 2 weekdays and 2 weekend days.Results:  The children spent an average of 141 ± 74 min/day engaged in moderate to vigorous physical activity (MVPA), an amount similar to that previously documented in healthy children. Only three of the 19 subjects averaged less MVPA than the recommended amount (at least 60 min/day). MVPA levels were significantly higher on weekdays than weekend days (P= 0.006). Overall, boys engaged in significantly more MVPA than girls (P= 0.029). MVPA time was negatively correlated with age (r =−0.80) and age at diagnosis (r =−0.87). No trend between MVPA and time off treatment or body mass index was identified.Conclusions:  Survivors of childhood ALL appear to be engaging in similar amounts of MVPA as those of the healthy children and are meeting recommended levels of physical activity.
Internal jugular vein deformities after central venous catheterisation in neonates: Evaluation by Doppler ultrasound
Authors: Kim Myung Joon , Chang Hye Kyung , Lee Mu Sook , Han Seok Joo , Oh Jung‐Tak 
Published: January 2010

Aim:  The use of a central venous catheter (CVC) through the internal jugular vein (IJV) in neonates is associated with various complications. We postulated that the risk of vein deformity after removing the CVC is underestimated. This study aimed to evaluate, using Doppler ultrasound, morphological changes in the IJV that had undergone CVC insertion during the neonatal period.Methods:  The study consisted of 23 cases, in which 2.7 Fr Broviac (Bard Access Systems, Salt Lake City, Utah, USA) CVCs were inserted through the IJVs of newborns over a 2‐year period. After the removal of the CVCs, the IJVs were examined by Doppler ultrasound.Results:  Seventeen cases had normal appearances, but six (26%) cases had deformities. One case had a completely obstructed IJV, and five had abnormal compressibility, echogenic intravascular masses or monophasic waveforms of blood flow. On follow‐up, IJV deformities were not improved but tended to be aggravated. There were significant differences in gestational age (36.6 ± 3.2 weeks vs. 30.0 ± 3.9 weeks, P= 0.002), body weight at time of CVC insertion (2.60 ± 0.72 kg vs. 1.32 ± 0.47 kg, P= 0.001) and duration of catheter use (25.9 ± 13.6 days vs. 49.0 ± 22.0 days, P= 0.016) between the normal and deformity groups, respectively.Conclusions:  IJV deformities after central venous catheterisation in neonates are common. A lower gestational age, a lower body weight, and more catheter indwelling days are significant factors affecting the incidence of IJV deformities.
Clinical features at the onset of childhood type 1 diabetes mellitus in Shenyang, China
Authors: Xin Ying , Yang Min , Chen Xiao Juan , Tong Ya Jie , Zhang Li Hua 
Published: January 2010

Aim:  To describe the clinical picture and laboratory features of Chinese children with newly diagnosed type 1 diabetes mellitus.Methods:  The clinical and laboratory data of a total of 203 children who presented with newly diagnosed type 1 diabetes mellitus during a 5‐year period (2004–2008) were retrospectively analysed based on hospital records.Results:  There were 88 boys (43.3%) and 115 girls (56.7%) with a median age of 8.3 years. The age distribution was categorised as 0–4 years: 52 (25.6%), 5–9 years: 57 (28.1%) and 10–14 years: 94 (46.3%). We found a peak incidence rate in the older age group. No significant seasonality was observed. The most common symptoms were polydipsia, polyuria and weight loss. Eighty‐five (41.9%) of all patients presented with diabetic ketoacidosis (DKA). The average duration of presenting symptoms before the hospital encounter was 24.5 days. Young age group children had shorter duration (17.1 days, P= 0.03) and significantly lower levels of C‐peptide (P= 0.003) and haemoglobin A1c (P= 0.049) than the other groups. Children with DKA had a higher incidence of preceding infections (P= 0.032), lower free triiodothyronine and free thyroxine levels (P= 0.035, 0.046), and higher white blood cell counts (P= 0.000) than the non‐DKA group.Conclusion:  The duration between the onset of the symptoms and diagnosis was long, and the proportion of DKA in children with newly diagnosed diabetes mellitus was high. These findings call for a collaborative effort for the early recognition of symptoms by patients and physicians in order to avoid more severe types of presentation.
Evidenced‐based clinical practice guideline for management of newborn pain
Authors: Spence Kaye , Henderson‐Smart David , New Karen , Evans Cheryl , Whitelaw Jan , Woolnough Rowena ,   Australian and New Zealand Neonatal Network
Published: January 2010

Aim:  To facilitate the uptake of evidence and to reduce the evidence practice gap for management of newborn pain through the development of a clinical practice guideline.Method:  An audit of practice and an appraisal of clinical practice guidelines were undertaken to establish current practices and guideline availability for the management of newborn pain in 23 hospitals in Australia. Guidelines were appraised using the Appraisal of Guidelines for Research and Evaluation instrument. A literature search was undertaken to acquire the evidence for best practice for management of newborn pain.Results:  Neonatal units in 17 hospitals had clinical practice guidelines. Each was peer reviewed and assessed according to the domains of the Appraisal of Guidelines for Research and Evaluation instrument. There was lack of consistency across the guidelines. As a result, a best practice guideline was developed based on current best evidence and the Royal Australian College of Physicians recommendations. To facilitate an ongoing compliance with the guideline, an audit tool was included together with algorithms for procedural pain and pain assessment.Conclusion:  The clinical practice guideline can be used by clinicians in varying settings such as the neonatal intensive care and special care unit. The document can be used to support existing practices or challenge clinicians to close the evidence practice gap for the management of newborn pain.
A bench test to confirm the core features of volume‐assured non‐invasive ventilation
Authors: OSCROFT Nicholas S. , SMITH Ian E. 
Published: January 2010

ABSTRACTBackground and objective:  Volume‐assured non‐invasive positive pressure ventilation (va‐NIPPV) is a novel mode designed to adapt pressure support (PS) to achieve a target minute ventilation (TgV). This may optimize ventilation; however, no data confirm that va‐NIPPV compensates appropriately for the changes in pulmonary mechanics and circuit leak seen in clinical practice. Bench testing assessed these principles.Methods:  A ventilator featuring a va‐NIPPV mode was studied. A test lung with varying compliance and resistance, and pneumotachograph were used. Eight lung model settings were chosen: (i) low resistance and high compliance; (ii) low resistance and low compliance; (iii) high resistance and high compliance; and (iv) high resistance and low compliance, all with and without additional circuit leak. An expiration valve, respiratory rate of 15, inspiratory time of 1 s and PS between 3 and 21 cm H2O were used. Va‐NIPPV was tested with varying TgV after establishing the range of minute ventilation possible in a pressure preset mode.Results:  At a TgV of 10 L/min, va‐NIPPV delivered minute ventilation of (median (interquartile range) ): 11 (10.9–11, 10.2 (10.2–10.3), 12.4 (12.4–12.4) and 11.2 (10.9–11.2) L/min in test lung settings 1, 2, 3 and 4, respectively. Additional leak between 8–33 L/min had little effect. Similar results were seen at other TgV, within the ventilator's PS capabilities.Conclusions:  These data confirm that va‐NIPPV is able to approximate a preset TgV with varying lung compliance and resistance, and that additional circuit leak has little effect on the delivered minute ventilation.
Validation of Embletta portable diagnostic system for identifying patients with suspected obstructive sleep apnoea syndrome (OSAS)
Authors: NG Susanna S.S. , CHAN Tat‐On , TO Kin‐Wang , NGAI Jenny , TUNG Alvin , KO Fanny W.S. , HUI David S.C. 
Published: January 2010

ABSTRACTBackground and objectives:  This study aimed to evaluate the diagnostic accuracy of Embletta portable diagnostic system (PDS, Medcare, Reykjavik, Iceland) for the screening of sleep apnoea in clinical practice.Methods:  The Embletta PDS is a digital three‐channel recording device that measures airflow through a nasal cannula connected to a pressure transducer, oxygen saturation plus both respiratory and abdominal movements via built‐in effort and body position sensors. An AHI is determined based on recording time. Nocturnal polysomnography (Alice 4, Healthdyne, Atlanta, USA), with airflow measured by a nasal pressure transducer (PTAF2, Pro‐Tech, Woodinville, WA, USA)) and Embletta PDS recordings, was performed simultaneously in consecutive patients with suspected OSA syndrome. The PSG recordings were analysed manually by a blinded investigator.Results:  Ninety subjects were recruited and 10 failed Embletta PDS studies due to measurement failure. Among the remaining 80 subjects, 63 were males. The mean age (SD) was 51.4 (11.9) years old, BMI 27.1(4.2) kg/m2, neck circumference 38.6 (3.6) cm and Epworth Sleepiness Score 9.7 (5.3). The AHI obtained by the Embletta PDS correlated closely with that obtained by PSG (Pearson correlation, r = 0.979, P < 0.001). Comparison of AHI based on the Embletta PDS against the PSG demonstrated high sensitivity at AHI ≥ 5/h (sensitivity 0.924 and specificity 0.857) and high specificity at AHI ≥ 20/h (sensitivity 0.853 and specificity 0.957).Conclusions:  The Embletta PDS is a highly sensitive and specific screening device in quantifying AHI when compared against PSG in patients with suspected OSA syndrome.
Asthma: Time to confront some inconvenient truths
Authors: HANCOX Robert J. , LE SOUËF Peter N. , ANDERSON Gary P. , REDDEL Helen K. , CHANG Anne B. , BEASLEY Richard 
Published: January 2010

ABSTRACTDespite major advances in the understanding of the pathogenesis of asthma and improvements in management, the accompanying benefits from public health initiatives and clinical practice have arguably been less than expected. For example, there are no effective public health strategies or treatment regimes that reduce the risk of developing asthma or influence its natural history. These represent priority areas for future translational research, which would need to investigate genetic and environmental interactions and vaccine strategies. In terms of asthma management it is tempting to focus on novel drug therapies; however, a case can be made that the priority is to undertake research that leads to improvements in the use of existing treatments through public health and primary care initiatives. Guidelines represent an important component of this approach, with recommendations for asthma imbedded within respiratory guidelines that can be implemented in the developing world where other acute and chronic respiratory disorders are common. This approach offers the best opportunity to close the gap between what is currently achieved in asthma management and that which is potentially achievable.
Celiac disease prevalence in children and adolescents with type 1 diabetes from Serbia
Authors: Djurić Zlatko , Stamenković Hristina , Stanković Tatjana , Milićević Radovan , Branković Ljiljana , Ćirić Vesna , Katić Vuka 
Published: January 2010

AbstractBackground:  The association between celiac disease (CD) and type 1 diabetes mellitus (T1DM) is well known. Up to now, CD prevalence in children and adolescents with T1DM in Serbia has not been reported. The aim of the present study was to determine CD prevalence and its clinical manifestations in patients with T1DM.Methods:  One hundred and twenty‐one patients (70 girls, 51 boys; mean age, 10.8 years) with T1DM (mean duration of diabetes, 3.4 years) and 125 control group participants (75 girls, 50 boys; mean age, 10.4 years) were tested for CD on tissue transglutaminase antibodies (tTG). In seven serologically positive T1DM patients endoscopic small bowel biopsies were taken and examined on histopathology. In all patients with CD and T1DM age, duration of T1DM, height for age, body mass index, glycosylated hemoglobin and clinical symptoms were noted.Results:  Nine patients with T1DM were positive on IgA tTG antibodies. In seven of them small bowel biopsy was performed, and all were proven to have CD on histopathology. The prevalence of biopsy‐proven CD in children and adolescents with T1DM was significantly higher in the study group compared to controls (5.79%. vs 0.8%, P < 0.05).Conclusion:  The significantly higher prevalence of CD in children with type 1 diabetes, in accordance with the large volume of data published in the literature, underlines the need for yearly screening of CD in patients with diabetes in order to promptly start a gluten‐free diet when appropriate.
Urinary N‐telopeptides of type I collagen in healthy children
Authors: Sato Jun , Hasegawa Kosei , Tanaka Hiroyuki , Morishima Tsuneo 
Published: January 2010

AbstractBackground:  Urinary N‐telopeptides of type I collagen (NTx) is a specific marker of bone resorption. The NTx levels of children have been reported to be higher than in adults, but such reports are limited. The aim of the present study was to measure the urine NTx of healthy children to define reference values, and study the circadian rhythm of urine NTx excretion between the first and second voided urines.Methods:  Three hundred and sixty‐two healthy Japanese children (209 boys and 153 girls; age range, 6–11 years) served as subjects to study age‐related changes in NTx. Urine samples were collected as the first voided specimen of the day. To evaluate the circadian variation, we measured the excretion of urinary NTx of the first and second voided urine specimens in 30 healthy Japanese children (15 boys and 15 girls), 6–12 years of age. Urine NTx was measured on enzyme‐linked immunosorbent assay (ELISA).Results:  Urinary NTx levels were higher in children of both genders than in healthy adults. In boys, the urinary NTx levels decreased with age. In girls, the urinary NTx levels decreased with age between 6 and 9 years of age, but increased between 9 and 10 years of age. NTx of the first voided urine specimen was significantly higher than the second voided urine specimen. Moreover, a significant linear relationship between the first voided urine and the second void urine existed in both genders.Conclusions:  Urinary NTx levels in children are higher than in adults. The urine NTx of the first voided urine specimen may be a good marker of bone resorption for children.
Diagnosis of infectious mononucleosis caused by Epstein–Barr virus in infants
Authors: Dohno Sumitaka , Maeda Akihiko , Ishiura Yoshihito , Sato Tetsuya , Fujieda Mikiya , Wakiguchi Hiroshi 
Published: January 2010

AbstractBackground:  The diagnosis of infectious mononucleosis (IM) is usually on serologic tests. The responses of anti‐Epstein–Barr virus (anti‐EBV) antibodies are weak in infants. The authors encountered some IM infants in whom anti‐EBV antibodies were undetectable during early stage, although EBV genome was found in their blood. The aim of the present study was therefore to clarify the frequency of anti‐EBV‐antibody negative IM cases.Methods:  The EBV serostatus of 104 IM children diagnosed on Sumaya criteria was retrospectively studied. The EBV genome in peripheral blood mononuclear cells was measured.Results:  The anti‐viral capsid antigen‐IgM (anti‐VCA‐IgM)‐positive rate in the acute phase was only 25% in infants but 80% in patients ≥4 years of age. Twenty percent of the infants were negative for all anti‐EBV antibodies and required repeated serologic tests. For infants, the significant rise in anti‐VCA‐IgG was the most sensitive marker. Three seronegative infants with IM symptoms, with circulating EBV genome during acute phase, were eventually considered as having IM on anti‐VCA‐IgG seroconversion thereafter.Conclusions:  To diagnose IM in infants the serologic test alone in the acute phase is not sensitive enough. It is proposed that the EBV genome be evaluated in peripheral blood mononuclear cells when infants presenting with IM symptoms are negative for anti‐EBV antibodies during the acute phase.
Repeated systematic surveillance of Kawasaki disease in Ontario from 1995 to 2006
Authors: Lin Yahui T. , Manlhiot Cedric , Ching Joyce C.Y. , Han Ra K. , Nield Lynne E. , Dillenburg Rejane , Pepelassis Dion , Lai Lillian S. , Smythe John F. , Chahal Nita , Yeung Rae S.M. , McCrindle Brian W. 
Published: January 2010

AbstractBackground:  Rising incidences of Kawasaki disease (KD) have been reported worldwide. Reported herein are the results of 4 triennial KD surveillances conducted in Ontario.Methods:  Between 1995 and 2006 all hospitals in Ontario were asked on 4 occasions to identify all patients with discharge diagnoses of KD and report incident cases.Results:  The latest surveillance identified 697 new KD patients (100% response rate) for a total of 2378 KD patients through all 4 surveillances. Yearly incidence was 26.2/100 000 for <5 years old, 6.7/100 000 for 5–9 years old and 0.9/100 000 for 10–14 years old. KD incidence significantly increased from 1995 to 2006, although the increase seemed to plateau between the 3rd and 4th surveillance. There was an increase in the proportion of patients diagnosed with incomplete KD and a significant reduction in the rate of coronary artery abnormalities, possibly due to better disease recognition and treatment. Hospitals reporting <20 cases per surveillance were found to be more likely to report cases with incomplete KD. These patients were also less likely to be treated with i.v. immunoglobulin and aspirin but were more likely to be treated with antibiotics, suggesting uncertainties regarding diagnosis and management of KD patients in those centers.Conclusions:  The incidence of KD in Ontario is possibly one of the highest outside of Asia and has been rising since 1995. Although the most recent surveillance demonstrated improved cardiac outcomes, treatment delays or absence thereof continue to be a problem. Effective diagnosis and prompt treatment remain critical aspects of KD management.
Risk factors of paternal depression in the early postnatal period in Japan
Authors: Nishimura Akiko , Ohashi Kazutomo 
Published: January 2010

AbstractThis study investigated risk factors of depression in fathers at 4 weeks post‐partum using a cross‐sectional design. Mothers were recruited at the 4 week postnatal health check between March and July 2007. A total of 510 mothers agreed to participate in the study. One‐hundred‐and‐fifty‐six fathers and 181 mothers returned the questionnaires. The Edinburgh Postnatal Depression Scale and the Center for Epidemiologic Studies Depression Scale were filled out to assess depressive symptoms. There was no association between paternal and maternal depression. According to the logistic regression analysis, paternal depression was associated with employment status, history of psychiatric treatment, and unintended pregnancy. Of eight fathers with unstable employment, seven were temporary employees and one was unemployed, suggesting that perinatal care‐providers should independently screen for depression in fathers and mothers and focus attention on paternal employment status, especially temporary employment.
Selective flower abortion maintains moth cooperation in a newly discovered pollination mutualism
Authors: Goto Ryutaro , Okamoto Tomoko , Toby Kiers E. , Kawakita Atsushi , Kato Makoto 
Published: January 2010

Ecology Letters (2010) 13: 321–329AbstractThe evolutionary stability of mutualisms is enhanced when partners possess mechanisms to prevent overexploitation by one another. In obligate pollination–seed consumption mutualisms, selective abortion of flowers containing excessive eggs represents one such mechanism, but empirical tests have long been limited to the yucca–yucca moth mutualism. We present evidence for selective abortion in the recently discovered mutualism between Glochidion trees and Epicephala moths. In Glochidion acuminatum, proportion of aborted flowers progressively increased both with higher egg load and increased ovule damage. Selective abortion resulted in a 16% seed production increase compared with expectations under random abortion, and moths suffered fitness losses as high as 62% when ovipositing into pre‐infested flowers. Moth eggs were laid singly more often than expected under random oviposition, thus avoiding potential disadvantages from multiple infestations. As new pollination mutualisms are being discovered, selective abortion mechanisms may prove to be more widespread than previously thought.
Ciliate diversity and distribution across an environmental and depth gradient in Long Island Sound, USA
Authors: Doherty Mary , Tamura Maiko , Costas Barbara A. , Ritchie Mark E. , McManus George B. , Katz Laura A. 
Published: January 2010

SummaryThe nature and extent of microbial biodiversity remain controversial with persistent debates over patterns of distributions (i.e. cosmopolitanism versus endemism) and the processes that structure these patterns (neutrality versus selection). We used culture‐independent approaches to address these issues focusing on two groups of ciliates, the Oligotrichia (Spirotrichea) and Choreotrichia (Spirotrichea) across an environmental gradient. We assessed SSU rDNA diversity in ciliate communities at six stations in Long Island Sound spanning the frontal region that separates the fresher Connecticut River outflow plume from the open Sound. As in previous studies, we find one abundant cosmopolitan species (Strombidium biarmatum), a few moderately abundant sequences, and a long list of rare sequences. Furthermore, neither ciliate diversity nor species composition showed any clear relationship to measured environmental parameters (temperature, salinity, accessory pigment composition and chorophyll). Overall, we observed that diversity decreased moving from nearshore to offshore. We also conducted analyses to detect clustering among the sampled communities using the software Unifrac. This approach revealed three significant clusters grouping samples from nearshore, surface and deep/well mixed stations. We find no strong fit of our communities to log series, geometric or log normal distributions, though one of the 3 clusters is most consistent with a log series distribution. However, when we remove the abundant cosmopolitan species S. biarmatum, all three clusters fit to a log series distribution. These analyses suggest that, with the exception of one cosmopolitan species, the oligotrich and choreotrich communities at these stations may be distributed in a neutral manner.