bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transgenic expression of gallerimycin, a novel antifungal insect defensin from the greater wax moth Galleria mellonella, confers resistance to pathogenic fungi in tobacco
Authors: Langen Gregor , Imani Jafargholi , Altincicek Boran , Kieseritzky Gernot , Kogel Karl-Heinz , Vilcinskas Andreas 
Published: June 2006

AbstractA cDNA encoding gallerimycin, a novel antifungal peptide from the greater wax mothGalleria mellonella, was isolated from a cDNA library of genes expressed during innate immune response in the caterpillars. Upon ectopic expression of gallerimycin in tobacco, usingAgrobacterium tumefaciensas a vector, gallerimycin conferred resistance to the fungal pathogensErysiphe cichoracearumandSclerotinia minor. Quantification of gallerimycin mRNA in transgenic tobacco by real-time PCR confirmed transgenic expression under control of the inducible mannopine synthase promoter. Leaf sap and intercellular washing fluid from transgenic tobacco inhibitedin vitrogermination and growth of the fungal pathogens, demonstrating that gallerimycin is secreted into intercellular spaces. The feasibility of the use of gallerimycin to counteract fungal diseases in crop plants is discussed.
Pediatric Resident Education in Palliative Care: A Needs Assessment
Authors: Kolarik Russ C. , Walker Gena , Arnold Robert M. 
Published: June 2006

OBJECTIVE. The goal was to characterize pediatric residents' perceived educational needs for pediatric palliative care. The data generated from this study will facilitate the planning of specific educational interventions.
METHODS. All residents in the Children's Hospital of Pittsburgh pediatrics residency program were asked to complete a survey in September 2003. Participation in the study was voluntary. Residents rated their previous training, personal experience, knowledge, competence, and emotional comfort with 10 specific aspects of pediatric palliative care. This rating was followed by 13 questions related to attitudes about palliative care practices and training. The last section asked the respondents to rank 11 palliative care educational topics in order of importance.
RESULTS. Forty-nine of 75 eligible residents participated. Although residents thought that pediatricians should have an important role in providing palliative care, residents reported minimal training, experience, knowledge, competence, and comfort in virtually all areas of palliative care for children. We found no significant improvement in any of these areas from the pediatric level-1 year to the pediatric level-3 year. Residents wanted more training regarding pain management. After pain control, the next 4 educational needs were communication skills, namely, discussing prognosis, bad news, and code status and talking with children about end-of-life care.
CONCLUSIONS. There is a clear need for increased efforts in pediatric palliative care education during residency training. Pediatric residents do not think that they are trained adequately in palliative care, and this perception does not improve with time. Pediatric residents view palliative care as important for primary care physicians and desire more education.
Ann-of-1 Trial Service in Clinical Practice: Testing the Effectiveness of Stimulants for Attention-Deficit/Hyperactivity Disorder
Authors: Nikles C. Jane , Mitchell Geoffrey K. , Del Mar Chris B. , Clavarino Alexandra , McNairn Norma 
Published: June 2006

OBJECTIVE. We sought to describe the clinical use of n-of-1 trials for attention-deficit/hyperactivity disorder in publicly and privately funded family and specialized pediatric practice in Australia.METHODS. We used a within-patient randomized, double-blind, crossover comparison of stimulant (dexamphetamine or methylphenidate) versus placebo or alternative stimulant using 3 pairs of treatment periods. Trials were conducted from a central location using mail and telephone communication, with local supervision by the patients’ clinicians.PATIENTS. Our study population included children with clinically diagnosed attention-deficit/hyperactivity disorder who were aged 5 to 16 years and previously stabilized on an optimal dose of stimulant. They were selected because treatment effectiveness was uncertain.MAIN OUTCOME MEASURES. Our measures included number of patients recruited, number of doctors who used the service, geographic spread, completion rates, response rate, and post–n-of-1 trial decisions.RESULTS. Forty-five doctors across Australia requested 108 n-of-1 trials, of which 86 were completed. In 69 drug-versus-placebo comparisons, 29 children responded better to stimulant than placebo. Immediately posttrial, 19 of 25 drug-versus-placebo responders stayed on the same stimulant, and 13 of 24 nonresponders ceased or switched stimulants. In 40 of 63 for which data were available, posttrial management was consistent with the trial results. For all types of n-of-1 trials, management changed for 28 of 64 children for whom information was available.DISCUSSION. Attention-deficit/hyperactivity disorder n-of-1 trials can be implemented successfully by mail and telephone communication. This type of trial can be valuable in clarifying treatment effect when it is uncertain, and in this series, they had a noticeable impact on short-term management.
Familial and Genetic Susceptibility to Major Neonatal Morbidities in Preterm Twins
Authors: Bhandari Vineet , Bizzarro Matthew J. , Shetty Anupama , Zhong Xiaoyun , Page Grier P. , Zhang Heping , Ment Laura R. , Gruen Jeffrey R. ,   for the Neonatal Genetics Study Group
Published: June 2006

BACKGROUND. Intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia remain significant causes of morbidity and mortality in preterm newborns.OBJECTIVES. Our goal was to assess the familial and genetic susceptibility to intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia.METHODS. Mixed-effects logistic-regression and latent variable probit model analysis were used to assess the contribution of several covariates in a multicenter retrospective study of 450 twin pairs born at ≤32 weeks of gestation. To determine the genetic contribution, concordance rates in a subset of 252 monozygotic and dizygotic twin pairs were compared.RESULTS. The study population had a mean gestational age of 29 weeks and birth weight of 1286 g. After controlling for effects of covariates, the twin data showed that 41.3%, 51.9%, and 65.2%, respectively, of the variances in liability for intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia could be accounted for by genetic and shared environmental factors. Among the 63 monozygotic twin pairs, the observed concordance for bronchopulmonary dysplasia was significantly higher than the expected concordance; 12 of 18 monozygotic twin pairs with ≥1 affected member had both members affected versus 3.69 expected. After controlling for covariates, genetic factors accounted for 53% of the variance in liability for bronchopulmonary dysplasia.CONCLUSIONS. Twin analyses show that intraventricular hemorrhage, necrotizing enterocolitis, and bronchopulmonary dysplasia are familial in origin. These data demonstrate, for the first time, the significant genetic susceptibility for bronchopulmonary dysplasia in preterm infants.
Ultrasonographic Features and Severity Scoring of Periventricular Hemorrhagic Infarction in Relation to Risk Factors and Outcome
Authors: Bassan Haim , Benson Carol B. , Limperopoulos Catherine , Feldman Henry A. , Ringer Steven A. , Veracruz Elaine , Stewart Jane E. , Soul Janet S. , DiSalvo Donald N. , Volpe Joseph J. , du Plessis Adré J. 
Published: June 2006

OBJECTIVE. Early diagnosis of periventricular hemorrhagic infarction in premature infants is based on bedside neonatal cranial ultrasonography. Currently, evaluation of its morphology and evolution by cranial ultrasound relies largely on data predating major advances in perinatal care and lacks a consistent classification system for determining severity of injury. The objective of this study was to examine the ultrasonographic morphology and evolution of periventricular hemorrhagic infarction in the modern NICU and to determine the value of a cranial ultrasonography-based severity score for predicting outcome.METHODS. We retrospectively evaluated all cranial ultrasounds and medical records of 58 premature infants with periventricular hemorrhagic infarction. We assigned each subject a severity score based on extent of echodensity, unilateral versus bilateral, and presence or absence of midline shift. A neurologic examination was performed after 12 months adjusted age.RESULTS. The parenchymal echodensity of periventricular hemorrhagic infarction most often involved parietal and frontal territories and evolved into single and/or multiple cysts. One quarter of cases were bilateral, and nearly 70% were extensive. Higher severity scores were significantly associated with pulmonary hemorrhage and low bicarbonate levels and with outcomes of fatality, early neonatal seizures, and motor disability.CONCLUSIONS. Despite advances in perinatal medicine, periventricular hemorrhagic infarction remains an important complication of prematurity. Periventricular hemorrhagic infarction can be graded using a scoring system based on sonographic characteristics. Higher severity scores predict worse outcome. Such severity scoring could improve the clinician's ability to counsel parents regarding management decisions and early intervention strategies.
Hospital Volume and Neonatal Mortality Among Very Low Birth Weight Infants
Authors: Bartels Dorothee B. , Wypij David , Wenzlaff Paul , Dammann Olaf , Poets Christian F. 
Published: June 2006

BACKGROUND. Very low birth weight infants (&lt;1500 g) are at increased mortality risk. Data on the impact of NICU volume are sparse, in comparison with those on the level of care. We hypothesized that neonatal mortality would be higher in small NICUs (&lt;36 very low birth weight admissions per year) than in large NICUs, with adjustment for volume of the delivery unit.METHODS. We analyzed population-based data from a quality assurance program in Lower Saxony (Germany). Perinatal data for almost all very low birth weight infants born in 1991 to 1999 (n = 7745) were available. Analyses were restricted to infants born at 24 to 30 weeks (n = 4379). Data validation procedures, univariate data analyses, and logistic regression models based on general estimating equations were performed.RESULTS. Neonatal mortality among infants admitted to NICUs was 12.2% in small NICUs and 10.2% in large NICUs. The mortality rate in small NICUs was increased significantly. Compared with infants from large delivery hospitals (&gt;1000 births per year) and large NICUs, the adjusted odds ratio was 1.94 for neonates for whom both units were small, 1.75 for those from large delivery units but small neonatal units, and 1.16 for those for whom only the NICU was large. Stratification according to gestational age revealed the greatest impact on mortality for infants of &lt;29 weeks.CONCLUSIONS. Results suggest that creating larger perinatal centers may improve perinatal health care. The volume of the NICU was associated more strongly with 28-day mortality than was the volume of the delivery hospital, and it had the largest impact on survival for infants of &lt;29 weeks.
Reported Medication Use in the Neonatal Intensive Care Unit: Data From a Large National Data Set
Authors: Clark Reese H. , Bloom Barry T. , Spitzer Alan R. , Gerstmann Dale R. 
Published: June 2006

OBJECTIVES. The objectives were (1) to identify the drugs reported most commonly during NICU care, (2) to examine how different methods of documenting drug use could influence prioritization of drugs for future research aimed at evaluating safety and efficacy, (3) to describe the demographic differences in the population samples for some specific medications, (4) to identify which reported medications are used for patient populations with &gt;20% mortality rates, and (5) to examine how reports of drug use change over time.
METHODS. A retrospective review of a large national data set was performed.
RESULTS. The 10 medications reported most commonly for the NICU were ampicillin, gentamicin, ferrous sulfate, multivitamins, cefotaxime, caffeine citrate, furosemide, vancomycin, surfactant, and metoclopramide. Medications used for patient populations with &gt;20% mortality rates included amphotericin, clonazepam, dobutamine, epinephrine, ethacrynic acid, insulin, lidocaine, metolazone, milrinone, inhaled nitric oxide, nitroglycerin, octreotide, pancuronium, phenytoin, sodium nitroprusside, sodium polystyrene sulfonate (Kayexalate), tris-hydroxymethylaminomethane acetate buffer, and tolazoline. Several of these drugs (eg, amphotericin B and bumetanide) were used primarily for extremely premature neonates, and this usage might explain the high mortality rates for the population of neonates treated with these medications. Other medications (clonazepam, milrinone, inhaled nitric oxide, and phenytoin) were used primarily for near-term and term infants. The explanation for the high mortality rates for these neonates is less clear and may be related primarily to the severity of illness for which the medications are used. Utilization rates for several different medications (eg, cisapride, metoclopramide, and dexamethasone) changed by &gt;50% during the past 5 years.
CONCLUSIONS. Data reported here are the first from a large national data set on the use of different medications for neonates admitted for intensive care and should be helpful in establishing priority agendas for future drug studies in this population.
Prevalence of Abnormal Lipid and Blood Pressure Values Among an Ethnically Diverse Population of Eighth-Grade Adolescents and Screening Implications
Authors: Jago Russell , Harrell Joanne S. , McMurray Robert G. , Edelstein Sharon , El Ghormli Laure , Bassin Stanley 
Published: June 2006

OBJECTIVES. Our goal was to report the prevalence of elevated blood pressure and lipid levels among eighth-grade adolescents from 3 US locations and differences by gender, ethnicity, and overweight percentile group.METHODS. Fasting blood samples and blood pressure levels were obtained from 1717 eighth-grade students from 12 predominantly minority schools in 3 states (Texas, California, and North Carolina) during spring 2003. Age, gender, ethnicity, weight, and height were ascertained and BMI calculated. The presence of abnormal total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol and triglycerides, prehypertension, hypertension, at risk for overweight, and overweight were calculated and compared with the findings of previous youth studies. We examined whether prevalence differed by gender, ethnicity, or BMI group.RESULTS. A total of 23.9% of participants had high blood pressure, 16.7% had borderline total cholesterol, 4.0% had high total cholesterol, 10.5% had borderline low-density lipoprotein cholesterol, 3.9% had high low-density lipoprotein cholesterol, 13.3% had low high-density lipoprotein cholesterol, and 17.2% had high triglycerides. A total of 19.8% of participants were at risk of overweight (BMI ≥85th percentile, &lt;95th percentile) and 29% were overweight (BMI ≥95th percentile). The prevalence of risk factors was associated (P &lt; .05) with the overweight group and differed by age and gender.CONCLUSIONS. Prevalence of elevated blood pressure was higher in this sample than in previous national surveys in which subjects were less overweight. Associations between overweight and both elevated lipid and blood pressure levels suggest that adolescents overweight or at risk for overweight should be screened for elevated blood pressure and lipid levels.
Neonatal Herpes Simplex Virus Infections in Canada: Results of a 3-Year National Prospective Study
Authors: Kropp Rhonda Y. , Wong Thomas , Cormier Louise , Ringrose Allison , Burton Sandra , Embree Joanne E. , Steben Marc 
Published: June 2006

OBJECTIVE. The goal was to determine incidence, determinants, and morbidity and mortality rates of neonatal herpes simplex virus infections in Canada.METHODS. From October 1, 2000, to September 30, 2003, reports of neonatal herpes simplex virus infection were solicited actively from all Canadian pediatricians and pediatric subspecialists on a monthly basis.RESULTS. Fifty-eight cases of neonatal herpes simplex virus were reported (5.9 cases per 100000 live births). Cesarean section was performed in 24.6% of cases, 28.1% of patients were born prematurely, 28.6% had birth weights of &lt;2500 g, and 7.5% had Apgar scores of &lt;7 at 5 minutes of life. Mothers &lt;20 years of age and those reporting Aboriginal ethnicity were affected disproportionately; 40% of mothers had no history of genital herpes before delivery, and intrapartum genital lesions were present in only 1 of 58 cases. Of cases with known herpes simplex virus type, 62.5% were herpes simplex virus-1. Localized infections accounted for 59.6% of cases, whereas disseminated disease and central nervous system disease were reported for 17.5% and 22.8%, respectively. Localized infections were more likely to be herpes simplex virus-1 and disseminated and central nervous system infections herpes simplex virus-2. Nine of 58 cases were fatal. All cases with known treatment information (n = 55) were treated with intravenously administered acyclovir.CONCLUSIONS. This is the first study to examine the national incidence of neonatal herpes simplex virus in Canada. Many women had no genital herpes simplex virus history before delivery, and the majority of cases were herpes simplex virus-1, which has implications for prenatal screening and vaccine/drug development. Follow-up monitoring of case subjects is being performed annually for 3 years, to be completed in October 2006.
Tobacco Promotion and the Initiation of Tobacco Use: Assessing the Evidence for Causality
Authors: DiFranza Joseph R. , Wellman Robert J. , Sargent James D. , Weitzman Michael , Hipple Bethany J. , Winickoff Jonathan P. ,   for the Tobacco Consortium, Center for Child Health Research of the American Academy of Pediatrics
Published: June 2006

OBJECTIVE. We sought to determine whether there is evidence of a causal link between exposure to tobacco promotion and the initiation of tobacco use by children.METHODS. We conducted a structured search in Medline, PsycINFO, and ABI/INFORM Global to identify relevant empirical research. The literature was examined against the Hill epidemiologic criteria for determining causality.RESULTS. (1) Children are exposed to tobacco promotion before the initiation of tobacco use; (2) exposure increases the risk for initiation; (3) there is a dose-response relationship, with greater exposure resulting in higher risk; (4) the increased risk is robust; it is observed with various study methods, in multiple populations, and with various forms of promotion and persists after controlling for other factors; (5) scientifically plausible mechanisms whereby promotion could influence initiation exist; and (6) no explanation other than causality can account for the evidence.CONCLUSIONS. Promotions foster positive attitudes, beliefs, and expectations regarding tobacco use. This fosters intentions to use and increases the likelihood of initiation. Greater exposure to promotion leads to higher risk. This is seen in diverse cultures and persists when other risk factors, such as socioeconomic status or parental and peer smoking, are controlled. Causality is the only plausible scientific explanation for the observed data. The evidence satisfies the Hill criteria, indicating that exposure to tobacco promotion causes children to initiate tobacco use.
Practices and Perceptions of Long-term Follow-up Among State Newborn Screening Programs
Authors: Hoff Timothy , Hoyt Adrienne 
Published: June 2006

OBJECTIVES. The purposes of the study were to describe and to analyze the types of policies and practices that exist currently among state newborn screening programs in relation to long-term follow-up oversight and activities for newborns with confirmed disorders and to examine the perceptions of newborn screening program leaders regarding long-term follow-up activities.METHODS. A 23-question survey was administered to state newborn screening program coordinators in each of the 50 states, the District of Columbia, Puerto Rico, and the US Virgin Islands in January to February 2005.RESULTS. Survey findings revealed significant variation in terms of how long-term follow-up is defined, staffed, and conducted within state newborn screening programs. This variation does not seem to be related to existing state program capacity, in terms of size of newborn screening programs or available resources. In addition, at present many state programs do not conduct long-term follow-up oversight or activities for newborns with diagnosed disorders, and many of those that do seem to lack necessary staffing and quality assurance mechanisms for effective long-term follow-up.CONCLUSIONS. The results point generally to a need for greater attention in aligning state newborn screening program capacity with long-term follow-up, increased emphasis on standardization for long-term follow-up activities, and development of stronger quality assurance oversight from state newborn screening programs if effective long-term follow-up oversight is to occur nationally. Given the present expansion of newborn screening in many states, additional research and policymaking with respect to long-term follow-up seem warranted.
Postnatal Head Growth Deficit Among Premature Infants Parallels Retinopathy of Prematurity and Insulin-like Growth Factor-1 Deficit
Authors: Löfqvist Chatarina , Engström Eva , Sigurdsson Jon , Hård Anna-Lena , Niklasson Aimon , Ewald Uwe , Holmström Gerd , Smith Lois E. H. , Hellström Ann 
Published: June 2006

BACKGROUND. We hypothesized that in premature infants, retinal vascular growth retardation between birth and postmenstrual age of ∼30 to 32 weeks that initiates retinopathy of prematurity is paralleled by brain growth retardation.
METHODS. In a prospective longitudinal study, we measured postnatal head growth, retinopathy of prematurity stage, protein and energy intake, severity of illness and serum insulin-like growth factor-1 levels in 58 preterm infants (mean gestational age at birth: 27.6 weeks) from birth until postmenstrual age of ∼40 weeks.
RESULTS. Premature infant head growth decelerates dramatically after birth until postmenstrual age of ∼30 weeks. Head growth retardation coincides with retinal vascular growth suppression. Accelerated growth follows between post menstrual ages of ∼30 to 32 weeks and ∼40 weeks. The degree of head growth retardation up to postmenstrual age of 31 weeks corresponds to the degree of retinopathy of prematurity and to the degree of suppression of serum levels of insulin-like growth factor-1. At postmenstrual age of 31 weeks, if a child’s head circumference SD is below −2.5, then the probability of also developing at least stage 3 retinopathy of prematurity increases fivefold compared with head circumference above −2.5 SD (32% vs 6%) suggesting parallel processes in brain and retina. Serum insulin-like growth factor-1 levels correlate positively with head circumference SD score and with the degree of retinopathy of prematurity.
CONCLUSIONS. The correlation between head and retinal growth is consistent with insulin growth factor-1 being one of the postnatal growth factors involved in this multifactorial process and also suggests that factors that contribute to retinopathy of prematurity during this critical period may also affect neurological dysfunction. Additional studies are required to establish this connection.