bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Randomized Trial of Nicotine Nasal Spray in Adolescent Smokers
Authors: Rubinstein Mark L. , Benowitz Neal L. , Auerback Glenna M. , Moscicki Anna-Barbara 
Published: September 2008

OBJECTIVES. Nicotine nasal spray has been 1 of the most successful forms of nicotine-replacement therapy in adult populations. The nasal sprayer has not been studied in adolescent smokers. The objective of this pilot study was to determine the feasibility and utility of using nicotine nasal spray for adolescent smokers who wanted to quit smoking.
METHODS. Forty adolescent smokers who were between 15 and 18 years of age and smoked ≥5 cigarettes daily for at least 6 months were recruited from several San Francisco Bay area schools from 2005 to 2007. Using a randomized, open-label, 12-week trial, adolescent smokers were assigned to receive either weekly counseling alone (control) for 8 weeks or 8 weeks of counseling along with 6 weeks of nicotine nasal spray. Self-reported smoking abstinence was verified by both expired-air carbon monoxide and salivary cotinine.
RESULTS. There was no difference in cessation rates, the numbers of cigarettes smoked per day, or cotinine levels at 12 weeks. Fifty-seven percent of participants stopped using their spray after only 1 week. The most commonly reported adverse effect was nasal irritation and burning (34.8%) followed by complaints about the taste and smell (13%).
CONCLUSIONS. The unpleasant adverse effects, poor adherence, and consequent lack of efficacy observed in our pilot study do not support the use of nicotine nasal spray as an adjunct to counseling for adolescent smokers who wish to quit.
Food Security, Maternal Stressors, and Overweight Among Low-Income US Children: Results From the National Health and Nutrition Examination Survey (1999–2002)
Authors: Gundersen Craig , Lohman Brenda J. , Garasky Steven , Stewart Susan , Eisenmann Joey 
Published: September 2008

OBJECTIVE. A high proportion of children in the United States are overweight, suffer from food insecurity, and live in households facing maternal stressors. The objective of this article was to identify the associations of food insecurity and maternal stressors with childhood overweight among low-income children. We hypothesized that maternal stressors may exacerbate the relationship between food insecurity and child obesity.METHODS. The sample included 841 children (3–17 years old) and their mothers with incomes below 200% of the poverty line from the 1999–2002 National Health and Nutrition Examination Survey. Food insecurity was based on US Department of Agriculture protocol, maternal stressors were assessed from survey questions, and BMI was used to classify weight status. Probit regression models predicted the probability of a child being overweight or obese.RESULTS. In most specifications, there was no direct association between food insecurity or maternal stressors and overweight for children of any age. Among 3- to 10-year-olds, the interaction of food insecurity and maternal stressors was significantly linked to the probability of being overweight; more specifically, an increase in maternal stressors amplified a food secure child's probability of being overweight or obese. This result is robust to alternative specifications. However, these results were not found among 11- and 17-year-old youth.CONCLUSIONS. Younger children in food secure, low-income households in the United States who are experiencing higher levels of maternal stressors have a greater probability of being overweight than food insecure children. This finding was contrary to the hypothesis; 3 reasons for this are covered in the article. Those who create policies that address childhood obesity could consider the benefits to low-income children's well-being resulting from reducing their mothers' stressors. Because most children in the United States are food secure, these policies could have a profound impact on childhood overweight.
Safety Monitoring of Drugs Receiving Pediatric Marketing Exclusivity
Authors: Smith P. Brian , Benjamin Daniel K. , Murphy M. Dianne , Johann-Liang Rosemary , Iyasu Solomon , Gould Barbara , Califf Robert M. , Li Jennifer S. , Rodriguez William 
Published: September 2008

OBJECTIVES. The Food and Drug Administration Modernization Act provided for an additional 6-month period of marketing exclusivity to companies that perform pediatric drug trials in response to a Food and Drug Administration–issued written request. Because many safety concerns cannot be detected until after the introduction of a product to a larger and more diverse market, the Best Pharmaceuticals for Children Act required the Food and Drug Administration to report to the Pediatric Advisory Committee on adverse events occurring during the 1-year period after granting pediatric exclusivity. We sought to describe the Pediatric Advisory Committee's recommendations made in response to safety reviews informed by data from the Food and Drug Administration Adverse Event Reporting System in 67 drugs granted exclusivity.PATIENTS AND METHODS. Pediatric Advisory Committee meetings and data presented by the Food and Drug Administration for all drugs were reviewed from June 2003 through April 2007. We divided the drugs into 2 groups: those that were returned to routine adverse event monitoring and those that had specific Pediatric Advisory Committee recommendations.RESULTS. Forty-four (65.7%) drugs were returned to routine monitoring for adverse events. The Pediatric Advisory Committee, sometimes working with other advisory committees, recommended label changes for 12 (17.9%) drugs, continued monitoring for 10 (14.9%), production of MedGuides for 9 (13.4%), and an update on label changes resulting from discussions with the sponsor for 1 (1.5%) drug. Some drugs had &gt;1 action. Several of the adverse events revealed during this process were rare and life-threatening.CONCLUSIONS. Safety monitoring during the early postmarketing period is crucial to detect rare, serious, or pediatric-specific adverse events. Fortunately, the majority of drugs given exclusivity had no adverse events of a frequency or severity that prevented a return to routine adverse event monitoring.
Neonatal Cranial Ultrasound Lesions and Developmental Delays at 2 Years of Age Among Extremely Low Gestational Age Children
Authors: O'Shea T. Michael , Kuban Karl C. K. , Allred Elizabeth N. , Paneth Nigel , Pagano Marcello , Dammann Olaf , Bostic Lisa , Brooklier Kara , Butler Samantha , Goldstein Donald J. , Hounshell Gail , Keller Cecelia , McQuiston Susan , Miller Alice , Pasternak Steve , Plesha-Troyke Susan , Price Joan , Romano Elaine , Solomon Katherine M. , Jacobson Amanda , Westra Sjirk , Leviton Alan ,   for the Extremely Low Gestational Age Newborns Study Investigators
Published: September 2008

BACKGROUND. Studies of the relationship between ultrasound images from preterm newborns and developmental delay most often are based on small samples defined by birth weight and exclude infants not testable with standardized assessments.METHODS. We evaluated associations between ultrasound-defined lesions of the brain and developmental delays at 24 months’ corrected age in 1017 children born before the 28th postmenstrual week. Brain ultrasound scans were read for concordance on 4 lesions: intraventricular hemorrhage, moderate/severe ventriculomegaly, white matter echodense/hyperechoic lesions, and white matter echodense/hypoechoic lesions and 2 diagnoses–periventricular leukomalacia and periventricular hemorrhagic infarction. Certified examiners, who were not aware of the infants’ ultrasound findings, administered the Bayley Scales of Infant Development-Second Edition. Children with an impairment (eg., blindness) that precluded testing with the Bayley Scales and those for whom &gt;2 test items were omitted were classified using the Vineland Adaptive Behavior Scales Motor Skills Domain instead of the Psychomotor Development Index and the Adaptive Behavior Composite instead of the Mental Development Index.RESULTS. Fully 26% of all of the children had delayed mental development (ie, Mental Development Index &lt; 70), and 31% had delayed psychomotor development (ie, Psychomotor Development Index &lt; 70). Ultrasound abnormalities were more strongly associated with low Psychomotor Development Index than with low Mental Development Index. Children without cranial ultrasound abnormality had the lowest probability (23% and 26%) of delayed mental or psychomotor development. Moderate/severe ventriculomegaly was associated with a more than fourfold increase in the risk of psychomotor delay and an almost threefold increase in the risk of mental delay. Echolucency was the next best predictor of delayed mental and psychomotor development. The probability of low scores varied with the number of zones involved and with the location of echolucency. At particularly high risk were infants with bilateral cerebellar hemorrhage, co-occurring ventriculomegaly and echolucency bilateral echolucency, or echolucency located posteriorly.CONCLUSIONS. Focal white matter damage, as characterized by echolucent/hypoechoic lesion, and diffuse damage, as suggested by late ventriculomegaly, are associated with delayed mental and psychomotor development.
Antenatal Use of Selective Serotonin-Reuptake Inhibitors and QT Interval Prolongation in Newborns
Authors: Dubnov-Raz Gal , Juurlink David N. , Fogelman Rami , Merlob Paul , Ito Shinya , Koren Gideon , Finkelstein Yaron 
Published: September 2008

OBJECTIVES. Prolongation of the QT interval is a risk factor for sudden death. Selective serotonin-reuptake inhibitor antidepressants can prolong the QT interval and are widely used by pregnant women. Whether antenatal exposure to selective serotonin-reuptake inhibitor causes QT prolongation in offspring is unknown. The aim of this study was to determine the effect of maternal use of selective serotonin-reuptake inhibitor antidepressants during pregnancy on the QTc interval of the offspring.
METHODS. Between January 2000 and December 2005, we collected data on all of the newborns born at a single tertiary care hospital. Electrocardiograms of infants exposed to selective serotonin-reuptake inhibitor antidepressants in utero were compared with those of healthy control newborns matched on gestational age. The tracings were interpreted by a pediatric cardiologist who was unaware of the drug exposure.
RESULTS. We identified 52 newborns exposed to selective serotonin-reuptake inhibitor antidepressants in the immediate antepartum period and 52 matched control subjects. The mean QTc was significantly longer in the group of newborns exposed to antidepressants as compared with control subjects (409 ± 42 vs 392 ± 29 milliseconds). Five (10%) newborns exposed to selective serotonin-reuptake inhibitor antidepressants had a markedly prolonged QTc interval (&gt;460 milliseconds) compared with none of the unexposed newborns. The longest QTc interval observed among exposed newborns was 543 milliseconds. All of the drug-associated repolarization abnormalities normalized in subsequent electrocardiographic tracings.
CONCLUSIONS. Antepartum use of selective serotonin-reuptake inhibitor antidepressants is associated with QTc interval prolongation in exposed neonates. Additional research using a standardized protocol is needed to determine whether exposure to selective serotonin-reuptake inhibitor antidepressants in late pregnancy is also associated with arrhythmias.
Oxidative Stress Is Associated With Arterial Dysfunction and Enhanced Intima-Media Thickness in Children With Hypercholesterolemia: The Potential Role of Nicotinamide-Adenine Dinucleotide Phosphate Oxidase
Authors: Martino Francesco , Loffredo Lorenzo , Carnevale Roberto , Sanguigni Valerio , Martino Eliana , Catasca Elisa , Zanoni Cristina , Pignatelli Pasquale , Violi Francesco 
Published: September 2008

BACKGROUND. Endothelial dysfunction and intima-media thickness are precocious manifestations of hypercholesterolemia, but the mechanism is unclear.
OBJECTIVE. The aim of the study was to analyze the interplay among endothelial dysfunction, intima-media thickness, and oxidative stress in children with hypercholesterolemia.
METHODS. We performed a cross-sectional study comparing flow-mediated dilation, intima-media thickness, lipid profile, urinary isoprostanes as markers of oxidative stress, and platelet expression of gp91phox, the catalytic unit of nicotinamide-adenine dinucleotide phosphate oxidase, in a population of 50 children with hypercholesterolemia (mean age ± SD: 10.0 ± 3.7 years) and 50 children without hypercholesterolemia (mean age: 9.2 ± 3.5 years). Four children with hereditary deficiency of gp91phox were studied also.
RESULTS. Children with hypercholesterolemia had reduced flow-mediated dilation (mean ± SD: 6.2 ± 2.4 vs 9.2 ± 2.5%) and enhanced intima-media thickness (0.45 ± 0.07 vs 0.40 ± 0.06 mm), urinary isoprostanes (86.9 ± 51.6 vs 45.9 ± 25.6 pg/mg creatinine), and gp91phox platelet expression (4.4 ± 3.8 vs 2.0 ± 1.7 mean fluorescence) compared with control subjects. At bivariate analysis, flow-mediated dilation was correlated with low-density lipoprotein cholesterol, intima-media thickness, urinary isoprostanes, and platelet gp91phox. Stepwise multiple linear regression analysis showed that, in children with hypercholesterolemia, flow-mediated dilation and intima-media thickness were significantly associated with low-density lipoprotein cholesterol and urinary isoprostanes; also, gp91phox platelet expression was an independent predictor of urinary isoprostanes. Children with gp91phox hereditary deficiency showed downregulation of platelet gp91phox and reduced urinary excretion of isoprostanes.
CONCLUSIONS. The study suggests that gp91phox-mediated oxidative stress may have a pathogenic role in the anatomic and functional changes of the arterial wall occurring in children with premature atherosclerosis.
Interrater Reliability and Effect of State on Blood Pressure Measurements in Infants 1 to 3 Years of Age
Authors: Duncan Andrea F. , Rosenfeld Charles R. , Morgan Janet S. , Ahmad Naveed , Heyne Roy J. 
Published: September 2008

OBJECTIVE. The objective of this study was to determine the interrater variability and effect of state on systolic blood pressure measurements in infants ≤3 years of age.METHODS. Study 1 examined interrater variability, determined by interclass correlation coefficient for 2 raters, and the effect of state on systolic blood pressure measurements in infants at 1, 2, and 3 years. Study 2 examined the variability of duplicate systolic blood pressure measurements by a single rater determined by interclass correlation coefficient and effect of state in 120 infants at 1, 2, and 3 years. Systolic blood pressure was defined as the Doppler-amplified sound corresponding to the first Korotkoff sound using a sphygmomanometer with appropriate cuff size. State was scored as follows: 1, sleeping; 2, awake and calm; 3, awake and fussy/restless; and 4, awake and vigorously crying/screaming.RESULTS. In study 1, the overall interclass correlation coefficient for systolic blood pressure was 0.81 and decreased when state varied between raters. When compared with a calm state 1 and/or 2 at both measurements, noncalm state 3 and/or 4 at both measurements was associated with an increase in systolic blood pressure. Although state was similar in infants born at ≤36 and &gt;36 weeks' gestational age, the former had a systolic blood pressure 13.0 ± 14 mm Hg greater than the 50th centile for age and gender versus 2.4 ± 12 mmHg for those &gt;36 weeks' gestation. In study 2, the interclass correlation coefficient for repeated measurements by a single rater was 0.85, and noncalm state at both measurements was associated with an elevated systolic blood pressure.CONCLUSIONS. Systolic blood pressure can be accurately measured in the first 3 years after birth, but state modifies systolic blood pressure and must be determined at the time of measurement. Infants born at ≤36 weeks' estimated gestational age may be at risk for an elevated systolic blood pressure, but this requires additional study.
Administration of Tetanus, Diphtheria, and Acellular Pertussis Vaccine to Parents of High-Risk Infants in the Neonatal Intensive Care Unit
Authors: Dylag Andrew M. , Shah Shetal I. 
Published: September 2008

OBJECTIVE. Tetanus, diphtheria, and acellular pertussis vaccination is recommended for adults who are in contact with infants who are younger than 12 months and in the NICU. The objective of this study was to determine the feasibility of tetanus, diphtheria, and acellular pertussis vaccine administration to parents in a tertiary care, level III NICU and to measure its effect on vaccination rates among parents of this high-risk population.METHODS. For a 4-month period from July to October 2007, all parents of admitted patients were informed of the risks and benefits of tetanus, diphtheria, and acellular pertussis vaccine by placing an information letter at their infant's bedside. All staff were educated about the dangers of pertussis infection and instructed to reinforce the need to obtain vaccination. Immunization was available for 20 hours per day at no cost. Student's t tests were used for data analysis.RESULTS. During the study period, 352 children (598 eligible parents) were admitted to the NICU at gestational ages ranging from 23 to 42 weeks, and 495 (82.8%) parents were offered the vaccine. Overall vaccination rate was 86.9% (430 parents) of the screened population. Fifty-five (11.1%) parents in the screened cohort refused vaccination, predominately citing pertussis as an insignificant health threat or disbelief in vaccination. There were no differences in vaccination rate on the basis of parental age. No allergic reactions to vaccination were observed. The 54 infants whose parents were not offered vaccine had a significantly shorter length of stay, higher birth weight, and higher gestational age than parents who were offered vaccine.CONCLUSIONS. Administration of tetanus, diphtheria, and acellular pertussis vaccine in the NICU is an effective means of increasing vaccination rates of parents of this population. Logistic barriers persist when implementing this program for infants with a short (&lt;3-day) length of stay.
Permissive Hypercapnia and Risk for Brain Injury and Developmental Impairment
Authors: Hagen Erika W. , Sadek-Badawi Mona , Carlton David P. , Palta Mari 
Published: September 2008

OBJECTIVE. Permissive hypercapnia is a respiratory-care strategy that is used to reduce the risk for lung injury. The goal of this study was to evaluate whether permissive hypercapnia is associated with higher risk for intraventricular hemorrhage and early childhood behavioral and functional problems than normocapnia among very low birth weight infants.METHODS. Very low birth weight infants from a statewide cohort were eligible for this study when they were born at &lt;32 weeks' gestational age and survived at least 24 hours. Infants were classified as receiving a permissive hypercapnia, normocapnia, or unclassifiable respiratory strategy during the first 24 hours after birth according to an algorithm based on Pco2 values and respiratory-treatment decisions that were abstracted from medical charts. Intraventricular hemorrhage diagnosis was also abstracted from the medical chart. Behavioral and functional outcomes were assessed by parent interview at 2 to 3 years. Logistic regression was used to evaluate the relationship between intraventricular hemorrhage and respiratory strategy; ordinary linear regression was used to evaluate differences in behavior and function scores between children by respiratory strategy.RESULTS. Infants who received a permissive hypercapnia strategy were not more likely to have intraventricular hemorrhage than those with normocapnia. There were no differences in any of the behavioral or functional scores among children according to respiratory strategy. There was a significant interaction between care strategy and 1-minute Apgar score, indicating that infants with lower Apgar scores may be at higher risk for intraventricular hemorrhage with permissive hypercapnia.CONCLUSIONS. This study suggests that permissive hypercapnia does not increase risk for brain injury and impairment among very low birth weight children. The interaction between respiratory strategy and Apgar score is a potential worrisome exception to this conclusion. Future research should further evaluate the effect of elevated Pco2 levels among those who are sickest at birth.
Attribution of flood risk in urban areas
Authors: Dawson R. J. , Speight L. , Hall J. W. , Djordjevic S. , Savic D. , Leandro J. 
Published: September 2008

Flooding in urban areas represents a particular challenge to modellers and flood risk managers because of the complex interactions of surface and sewer flows. Quantified flood risk estimates provide a common metric that can be used to compare risks from different sources. In situations where there are several organisations responsible for flood risk management we wish to be able to disaggregate the total risk and attribute it to different components in the system and/or agents with responsibility for risk reduction in order to target management actions. Two approaches to risk attribution are discussed: Standards-based attribution, which is a deterministic approach, based upon the performance of different engineering components in the system at their “design standard”. Sensitivity-based attribution, which apportions risk between the variables that influence the total flood risk.
Whilst both these approaches are feasible for the small system considered here, in practice urban flooding systems involve tens of thousands of variables. The only feasible approach to tackling this problem for large urban systems is therefore by hierarchical simplification of the system, with the attribution analysis being applied in several tiers of detail. In this paper, the applicability of a hierarchical approach is demonstrated in the context of sewer pipe blockages. The results demonstrate the potential of attribution methods to support the development of integrated urban flood risk management strategies, as they can identify the forcing variables and infrastructure components that have the most influence upon flood risk.
Left-handed chiral metamaterials
Authors: Sabah Cumali 
Published: September 2008

Abstract
In this work, the concept of left-handed chiral metamaterials is analyzed by emphasizing their optical ability on the rotation of the plane of polarization of a wave. The possibilities of a negative phase velocity, negative and positive propagation constants, and basic electromagnetic properties of this novel medium are also presented. After the characterization of left-handed chiral metamaterial, we provide a reflection and transmission study for two planar boundaries of nonchiral-left-handed chiral metamaterial for normal angles of incidence. Some numerical results are also provided to validate the formulation found in the analysis and to show the role of the chirality in the propagation constants, phase velocities, reflection and transmission.