bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Colorimetric Test Strips for Monitoring the Effect of Hemodialysis on Salivary Nitrite and Uric Acid in Patients with End-Stage Renal Disease: A Proof of Principle
Authors: Blicharz Timothy M , Rissin David M , Bowden Michaela , Hayman Ryan B , DiCesare Christopher , Bhatia Jasvinder S , Grand-Pierre Nerline , Siqueira Walter L , Helmerhorst Eva J , Loscalzo Joseph , Oppenheim Frank G , Walt David R 
Published: August 2008

Abstract
Background: Initial screening of potential biomarkers for monitoring dialysis was performed with saliva samples collected from patients with end-stage renal disease (ESRD). A more thorough analysis of the most promising markers identified in the initial screening was conducted with saliva samples acquired at hourly intervals throughout dialysis to monitor analyte concentrations as dialysis progressed. We observed that salivary nitrite (NO2−) and uric acid (UA) concentrations consistently decreased as dialysis proceeded.
Methods: Solution-based colorimetric-detection chemistries for NO2− and UA were converted to a test strip format to produce a simple method for semiquantitatively measuring NO2− and UA concentrations in the clinic or at the patient’s home. We assessed the test strips with saliva samples collected from both ESRD patients undergoing dialysis and healthy control volunteers to qualitatively monitor the effect of dialysis on salivary NO2− and UA. We used computer software to analyze digital images of the resulting test strip color intensities.
Results: Test strip measurements showed that mean salivary concentrations of NO2− and UA were decreased in ESRD patients by 86% and 39%, respectively, compared with 15% and 9% for time-matched controls. Comparison of test strip results with calibrated solution-based assays suggests that the test strips can semiquantitatively measure salivary concentrations of NO2− and UA.
Conclusions: The colorimetric test strips monitored changes in salivary NO2− and UA concentrations that occurred in ESRD patients during dialysis. The test strips may prove useful for noninvasively evaluating dialysis progress and may also be useful for monitoring renal disease status.
Who is at Risk for Special Health Care Needs: Findings From the National Survey of Children's Health
Authors: Newacheck Paul W. , Kim Sue E. , Blumberg Stephen J. , Rising Joshua P. 
Published: August 2008

OBJECTIVE. A conceptual model of risk factors for special health care needs in childhood was presented previously. This article uses that conceptual model to identify candidate variables for an exploratory empirical examination of the effects of factors that may increase or decrease the risk of developing a special health care need.
METHODS. The National Survey of Children's Health was used for our analysis (N = 102 353). We used multilevel and multivariate analysis methods. We examined risk factors for special health care needs generally and for specific physical, developmental, behavioral, and emotional conditions cooccurring with special health care needs. Risk factors were grouped into 6 major domains, namely, predisposing characteristics, genetic endowment, physical environment, social environment, health-influencing behavior, and health care system characteristics. We examined preschool-aged and school-aged children separately.
RESULTS. Significant associations were found in 5 of 6 domains studied (no variables in the health care systems characteristics were significant). Individual variables found to decrease or to increase significantly the odds of experiencing special health care needs were expressed at the child level (eg, age and gender), family level (eg, family structure and family conflict), and neighborhood level (eg, perception of supportiveness of the neighborhood).
CONCLUSIONS. This analysis is the first to consider empirically a range of risk factors for special health care needs, using a population health model. Although provisional, the results of our analysis can help us to begin thinking about which characteristics of the child, family, and community are worthy of further exploration. Some of the variables we found to be significantly associated with special health care needs, such as age and ethnicity, are immutable. However, we found a number of significant correlates (ie, possible risk factors) that may be amenable to public health interventions, including breastfeeding practices, exposure to secondhand smoke, family closeness, and neighborhood cohesion.
Infant and Childhood Growth Patterns, Insulin Sensitivity, and Blood Pressure in Prematurely Born Young Adults
Authors: Rotteveel Joost , van Weissenbruch Mirjam M. , Twisk Jos W. R. , Delemarre-Van de Waal Henriette A. 
Published: August 2008

OBJECTIVE. Preterm infants are at increased risk to develop insulin resistance and high blood pressure. The influence of growth during childhood is not well established.
METHODS. We investigated childhood growth patterns in relation to blood pressure and insulin sensitivity, measured by the hyperinsulinemic euglycemic clamp, in young adults. We compared 29 subjects born preterm appropriate for gestational age, 28 subjects born preterm small for gestational age, and 30 subjects born at term with a normal birth weight.
RESULTS. Insulin sensitivity expressed as Mi value (glucose disposal mg/kg/min (insulin levels pmol/l) × 100) was lower in infants in the POPS-AGA (18.2) and POPS-SGA (15.2) groups than in the CON group (24.7). Systolic and diastolic blood pressure (mmHg) were higher in infants in the POPS-AGA (132/72) and POPS-SGA (127/71) groups than in the CON group (118/65). The preterm-born subjects, in lowest insulin sensitivity quartile had a higher height standard deviation score at ages 1, 2, and 5 years and a higher weight SD score at ages 2, 5, 10, 19, and 21 years than did those in the lowest insulin sensitivity quartile. The infants in the highest systolic blood pressure quartile had a higher height SD score at 3 months of age and at ages 2, 5, 10, 19, and 21 years and a higher weight SD score at ages 1, 2, 5, 10, 19, and 21 years than those in the lowest systolic blood pressure quartile.
CONCLUSIONS. Young adults born preterm have lower insulin sensitivity and higher blood pressure than controls. Increments in height and weight during childhood are associated with lower insulin sensitivity and higher blood pressure in adulthood.
CD4+/CD8+ T Cell Ratio for Diagnosis of HIV-1 Infection in Infants: Women and Infants Transmission Study
Authors: Pahwa Savita , Read Jennifer S. , Yin Wanrong , Matthews Yvonne , Shearer William , Diaz Clemente , Rich Kenneth , Mendez Hermann , Thompson Bruce ,   for the Women and Infants Transmission Study
Published: August 2008

OBJECTIVE. In this study, we tested the hypothesis that the CD4+/CD8+ T cell ratio could predict HIV infection status in HIV-exposed infants.METHODS. CD4+/CD8+ T cell ratios were determined from data for live-born singleton infants who had been prospectively enrolled in the Women and Infants Transmission Study. Data for 2208 infants with known HIV infection status (179 HIV-infected and 2029 uninfected infants) were analyzed.RESULTS. Receiver operating characteristic curves indicated that the CD4+/CD8+ T cell ratio performed better than the proportion of CD4+ T cells for diagnosis of HIV infection as early as 2 months of age, and this relationship was unaffected by adjustment for maternal race/ethnicity, infant birth weight, gestational age, and gender. At 4 months of age, 90% specificity for HIV diagnosis was associated with 60% sensitivity. For ease of use, graphical estimates based on cubic splines for the time-dependent parameters in a Box-Cox transformation (L), the median (M), and the coefficient of variation (S) were used to create LMS centile curves to show the sensitivity and specificity of CD4+/CD8+ T cell ratios in HIV-infected and uninfected infants until 12 months of age. At 6 months of age, a simplified equation that incorporated sequential CD4+/CD8+ T cell ratios and hematocrit values resulted in improved receiver operating characteristic curves, with 94% positive predictive value and 98% negative predictive value. The positive and negative predictive values remained above 90% in simulated infant populations over a wide range of HIV infection prevalence values.CONCLUSIONS. In the absence of virological diagnosis, a presumptive diagnosis of HIV infection status can be made on the basis of CD4+/CD8+ T cell ratios in HIV-1-exposed infants after 2 months of age; sensitivity and specificity can be improved at 6 months by using a discriminant analysis equation.
Clinicians’ Description of Factors Influencing Their Reporting of Suspected Child Abuse: Report of the Child Abuse Reporting Experience Study Research Group
Authors: Jones Risé , Flaherty Emalee G. , Binns Helen J. , Price Lori Lyn , Slora Eric , Abney Dianna , Harris Donna L. , Christoffel Katherine Kaufer , Sege Robert D. 
Published: August 2008

OBJECTIVES. Primary care clinicians participating in the Child Abuse Reporting Experience Study did not report all suspected physical child abuse to child protective services. This evaluation of study data seeks (1) to identify factors clinicians weighed when deciding whether to report injuries they suspected might have been caused by child abuse; (2) to describe clinicians’ management strategies for children with injuries from suspected child abuse that were not reported; and (3) to describe how clinicians explained not reporting high-suspicion injuries.
METHODS. From the 434 pediatric primary care clinicians who participated in the Child Abuse Reporting Experience Study and who indicated they had provided care for a child with an injury they perceived as suspicious, a subsample of 75 of 81 clinicians completed a telephone interview. Interviewees included 36 clinicians who suspected child abuse but did not report the injury to child protective services (12 with high suspicion and 24 with some suspicion) and 39 who reported the suspicious injury. Interviews were analyzed for major themes and subthemes, including decision-making regarding reporting of suspected physical child abuse to child protective services and alternative management strategies.
RESULTS. Four major themes emerged regarding the clinicians’ reporting decisions, that is, familiarity with the family, reference to elements of the case history, use of available resources, and perception of expected outcomes of reporting to child protective services. When they did not report, clinicians planned alternative management strategies, including active or informal case follow-up management. When interviewed, some clinicians modified their original opinion that an injury was likely or very likely caused by abuse, to explain why they did not report to child protective services.
CONCLUSIONS. Decisions about reporting to child protective services are guided by injury circumstances and history, knowledge of and experiences with the family, consultation with others, and previous experiences with child protective services.
Growth of Children on Classical and Medium-Chain Triglyceride Ketogenic Diets
Authors: Neal Elizabeth G. , Chaffe Hannah M. , Edwards Nicole , Lawson Margaret S. , Schwartz Ruby H. , Cross J. Helen 
Published: August 2008

OBJECTIVE. The objectives of this study were to examine growth in children on classical and medium-chain triglyceride ketogenic diets and to investigate any association between growth and calorie or protein intake.
METHODS. Weight, height, and BMI z scores were recorded for children who were initiated on 1 of 2 ketogenic diets at baseline and after 3, 6, and 12 months, if continued. Mean calorie and protein intakes during treatment were calculated for children who completed 12 months on the diet. Changes in growth were compared between the 2 diets, and the association between growth and dietary intake was examined.
RESULTS. Seventy-five children provided growth data. Weight z scores decreased significantly between baseline and 3, 6, and 12 months; height z scores showed no change at 3 months but decreased significantly by 6 and 12 months. This was more significant in the younger and ambulatory children. Subdivision according to diet type showed weight z scores to decrease significantly in the medium-chain triglyceride group only at 3 and 6 months and in both groups at 12 months. Height z scores decreased significantly in both groups by 6 and 12 months. Forty children completed 12 months of treatment; in this group, the slopes of best-fit regression lines of serial z-score measures were used to represent growth trend. There were no significant differences in mean slope between classical and medium-chain triglyceride diet groups for weight, height, or BMI. There was no significant difference in mean calorie intake during the 12 months between the 2 diets, but the medium-chain triglyceride group had significantly higher protein intake. There was no significant correlation between calorie or protein intakes and the slope of the best-fit line for weight, height, or BMI.
CONCLUSIONS. Both weight and height z scores decreased during diet treatment. By 12 months, there was no difference in outcome between classical and medium-chain triglyceride protocols despite the increased protein in the latter diet.
Preliminary Assessment of Pediatric Health Care Quality and Patient Safety in the United States Using Readily Available Administrative Data
Authors: McDonald Kathryn M. , Davies Sheryl M. , Haberland Corinna A. , Geppert Jeffrey J. , Ku Amy , Romano Patrick S. 
Published: August 2008

OBJECTIVES. With &gt;6 million hospital stays, costing almost $50 billion annually, hospitalized children represent an important population for which most inpatient quality indicators are not applicable. Our aim was to develop indicators using inpatient administrative data to assess aspects of the quality of inpatient pediatric care and access to quality outpatient care.METHODS. We adapted the Agency for Healthcare Research and Quality quality indicators, a publicly available set of measurement tools refined previously by our team, for a pediatric population. We systematically reviewed the literature for evidence regarding coding and construct validity specific to children. We then convened 4 expert panels to review and discuss the evidence and asked them to rate each indicator through a 2-stage modified Delphi process. From the 2000 and 2003 Agency for Healthcare Research and Quality Healthcare Cost and Utilization Project Kids' Inpatient Database, we generated national estimates for provider level indicators and for area level indicators.RESULTS. Panelists recommended 18 indicators for inclusion in the pediatric quality indicator set based on overall usefulness for quality improvement efforts. The indicators included 13 hospital-level indicators, including 11 based on complications, 1 based on mortality, and 1 based on volume, as well as 5 area-level potentially preventable hospitalization indicators. National rates for all 18 of the indicators varied minimally between years. Rates in high-risk strata are notably higher than in the overall groups: in 2003 the decubitus ulcer pediatric quality indicator rate was 3.12 per 1000, whereas patients with limited mobility experienced a rate of 22.83. Trends in rates by age varied across pediatric quality indicators: short-term complications of diabetes increased with age, whereas admissions for gastroenteritis decreased with age.CONCLUSIONS. Tracking potentially preventable complications and hospitalizations has the potential to help prioritize quality improvement efforts at both local and national levels, although additional validation research is needed to confirm the accuracy of coding.
An Approach to Using Recombinant Erythropoietin for Neuroprotection in Very Preterm Infants
Authors: Fauchère Jean-Claude , Dame Christof , Vonthein Reinhard , Koller Brigitte , Arri Sandra , Wolf Martin , Bucher Hans Ulrich 
Published: August 2008

OBJECTIVE. Erythropoietin has been shown to be protective against hypoxic-ischemic and inflammatory injuries in cell culture, animal models of brain injury, and clinical trials of adult humans. The rationale for our study was that early administration of high-dose recombinant human erythropoietin may reduce perinatal brain injury (intraventricular hemorrhage and periventricular leukomalacia) in very preterm infants and improve neurodevelopmental outcome. We investigated whether administration of high-dose recombinant human erythropoietin to very preterm infants shortly after birth and subsequently during the first 2 days is safe in terms of short-term outcome.
METHODS. This was a randomized, double-masked, single-center trial with a 2:1 allocation in favor of recombinant human erythropoietin. Preterm infants (gestational age: 24 to 31 weeks) were given recombinant human erythropoietin or NaCl 0.9% intravenously 3, 12 to 18, and 36 to 42 hours after birth.
RESULTS. The percentage of infants who survived without brain injury or retinopathy was 53% in the recombinant human erythropoietin group and 60% in the placebo group. There were no relevant differences regarding short-term outcomes such as intraventricular hemorrhage, retinopathy, sepsis, necrotizing enterocolitis, and bronchopulmonary dysplasia. For 5 infants who were in the recombinant human erythropoietin group and had a gestational age of &lt;26 weeks, withdrawal of intensive care was decided (3 of 5 with severe bilateral intraventricular hemorrhage, 2 of 5 with pulmonary insufficiency); no infant of the control group died. Recombinant human erythropoietin treatment did not result in significant differences in blood pressure, cerebral oxygenation, hemoglobin, leukocyte, and platelet count.
CONCLUSIONS. No significant adverse effects of early high-dose recombinant human erythropoietin treatment in very preterm infants were identified. These results enable us to embark on a large multicenter trial with the aim of determining whether early high-dose administration of recombinant human erythropoietin to very preterm infants improves neurodevelopmental outcome at 24 months' and 5 years' corrected age.
Impact of Cesarean Section on Neonatal Mortality Rates Among Very Preterm Infants in the United States, 2000–2003
Authors: Malloy Michael H. 
Published: August 2008

OBJECTIVE. The objective of this analysis was to compare the neonatal mortality rates for infants delivered through primary cesarean section versus vaginal delivery, taking into consideration a number of potentially risk-modifying conditions.
METHODS. US linked birth and infant death certificate files for 2000–2003 were used. Demographic, medical, and labor and delivery complications were abstracted from the files with infant information. The primary outcome examined was neonatal death (death at 0–27 days of age). Because of concern regarding misclassification of gestational age, a procedure was used to trim away births for which the birth weight for a specific gestational age was incongruous. Adjusted odds ratios were calculated for the risk of neonatal death relative to the mode of delivery (primary cesarean section versus vaginal delivery), using logistic regression analysis.
RESULTS. There were data for 13 733 neonatal deaths and 106 809 survivors available from the trimmed data set for analysis for the 4-year period. More than 80% of pregnancies with delivery between 22 and 31 weeks of gestation experienced ≥1 risk factor. Adjusted odds ratios demonstrated significantly reduced risk of neonatal death for infants delivered through cesarean section at 22 to 25 weeks of gestation (adjusted odds ratios of 0.58, 0.52, 0.72, and 0.81 for 22, 23, 24, and 25 weeks, respectively).
CONCLUSION. Cesarean section does seem to provide survival advantages for the most immature infants delivered at 22 to 25 weeks of gestation, independent of maternal risk factors for cesarean section.
Effect of Supplementing Pregnant and Lactating Mothers Withn-3 Very-Long-Chain Fatty Acids on Children's IQ and Body Mass Index at 7 Years of Age
Authors: Helland Ingrid B. , Smith Lars , Blomén Birgitta , Saarem Kristin , Saugstad Ola D. , Drevon Christian A. 
Published: August 2008

OBJECTIVES. Arachidonic acid (20:4n-6) and docosahexaenoic acid (22:6n-3) are essential for brain growth and cognitive development. We have reported that supplementing pregnant and lactating women with n-3 very-long-chain polyunsaturated fatty acids promotes higher IQ scores at 4 years of age as compared with maternal supplementation with n-6 polyunsaturated fatty acids. In our present study, the children were examined at 7 years of age with the same cognitive tests as at 4 years of age. We also examined the relation between plasma fatty acid pattern and BMI in children, because an association between arachidonic acid and adipose tissue size has been suggested.METHODS. The study was randomized and double-blinded. The mothers took 10 mL of cod liver oil or corn oil from week 18 of pregnancy until 3 months after delivery. Their children were tested with the Kaufman Assessment Battery for Children at 7 years of age, and their height and weight were measured.RESULTS. We did not find any significant differences in scores on the Kaufman Assessment Battery for Children test at 7 years of age between children whose mothers had taken cod liver oil (n = 82) or corn oil (n = 61). We observed, however, that maternal plasma phospholipid concentrations of α-linolenic acid (18:3n-3) and docosahexaenoic acid during pregnancy were correlated to sequential processing at 7 years of age. We observed no correlation between fatty acid status at birth or during the first 3 months of life and BMI at 7 years of age.CONCLUSION. This study suggests that maternal concentration of n-3 very-long-chain polyunsaturated fatty acids during pregnancy might be of importance for later cognitive function, such as sequential processing, although we observed no significant effect of n-3 fatty acid intervention on global IQs. Neonatal fatty acid status had no influence on BMI at 7 years of age.