bluuebunny/crossref_metadata_2025_split huggingface dataset:
Pediatric Preparedness of US Emergency Departments: A 2003 Survey
Authors: Gausche-Hill Marianne , Schmitz Charles , Lewis Roger J. 
Published: November 2007

OBJECTIVES. Our goal was to assess the degree of pediatric preparedness of emergency departments in the United States.METHODS. A closed-response survey based on the American Academy of Pediatrics/American College of Emergency Physicians joint policy statement, “Care of Children in the Emergency Department: Guidelines for Preparedness,” was mailed to 5144 emergency department medical and nursing directors. A weighted preparedness score (scale of 0–100) was calculated for each emergency department.RESULTS. A total of 1489 useable surveys (29%) were received, with 62% completed by emergency department medical directors. Eighty-nine percent of pediatric (age: 0–14 years) emergency department visits occur in non–children's hospitals, 26% of visits occur in rural or remote facilities, and 75% of responding emergency departments see &lt;7000 children per year. The vast majority of visits (89%) occur in emergency department areas shared with adult patients; 6% occur in a separate pediatric emergency department. Only 6% of emergency departments had all recommended equipment and supplies. Emergency departments frequently lacked laryngeal mask airways for children (50%) and neonatal or infant equipment. In contrast, recommended medications were more uniformly available, as were transfer policies for medical or surgical intensive care. Fifty-two percent of emergency departments reported having a quality improvement/performance improvement plan for pediatric emergency patients, and 59% of respondents were aware of the American Academy of Pediatrics/American College of Emergency Physicians guidelines. The median pediatric-preparedness score for all emergency departments was 55. Pediatric-preparedness scores were higher for facilities with higher pediatric volume, facilities with physician and nursing coordinators for pediatrics, and facilities with respondents who reported awareness of the guidelines.CONCLUSION. Pediatric preparedness of hospital emergency departments demonstrates opportunities for improvement.
Predicting Language at 2 Years of Age: A Prospective Community Study
Authors: Reilly Sheena , Wake Melissa , Bavin Edith L. , Prior Margot , Williams Joanne , Bretherton Lesley , Eadie Patricia , Barrett Yin , Ukoumunne Obioha C. 
Published: November 2007

OBJECTIVE. This article responds to evidence gaps regarding language impairment identified by the US Preventive Services Task Force in 2006. We examine the contributions of putative child, family, and environmental risk factors to language outcomes at 24 months of age.
METHODS. A community-ascertained sample of 1720 infants who were recruited at 8 months of age were followed at ages 12 and 24 months in a prospective, longitudinal study in metropolitan Melbourne, Australia. Outcomes at 24 months were parent-reported infant communication (Communication and Symbolic Behavior Scales and MacArthur-Bates Communicative Development Inventories vocabulary production score). Putative risk factors were gender, preterm birth, birth weight, multiple birth, birth order, socioeconomic status, maternal mental health, maternal vocabulary and education, maternal age at birth of child, non–English-speaking background, and family history of speech-language difficulties. Linear regression models were fitted to total standardized Communication and Symbolic Behavior Scales and Communicative Development Inventories vocabulary production scores; a logistic regression model was fitted to late-talking status at 24 months.
RESULTS. The regression models accounted for 4.3% and 7.0% of the variation in the 24-month Communication and Symbolic Behavior Scales and Communicative Development Inventories scores, respectively. Male gender and family history were strongly associated with poorer outcomes on both instruments. Lower Communication and Symbolic Behavior Scales scores were also associated with lower maternal vocabulary and older maternal age. Lower vocabulary production scores were associated with birth order and non–English-speaking background. When the 12-month Communication and Symbolic Behavior Scales Total score was added as a covariate in the linear regression of 24-month Communication and Symbolic Behavior Scales Total score, it was by far the strongest predictor.
CONCLUSIONS. These early risk factors explained no more than 7% of the variation in language at 24 months. They seem unlikely to be helpful in screening for early language delay.
Expression of the Epithelial Sodium Channel in Airway Epithelium of Newborn Infants Depends on Gestational Age
Authors: Helve Otto , Janér Cecilia , Pitkänen Olli , Andersson Sture 
Published: November 2007

OBJECTIVE. In the newborn infant, removal of fetal lung liquid from the airways depends on ion transport through the airway epithelium. The epithelial sodium channel is considered rate limiting for the postnatal clearance of lung liquid, but it is unknown whether during the early postnatal period the expression of epithelial sodium channel is associated with maturity. Our objective was to study the relationship between gestational age and epithelial sodium channel expression in airway epithelium.
METHODS. In 90 newborn infants (preterm [gestational age &lt; 37]: n = 29; term [gestational age ≥ 37]: n = 61), we measured the expression of epithelial sodium channel (reported as attomoles of subunit expression normalized to femtomoles of expression of cytokeratin 18) in nasal epithelium at 1 to 5 and 22 to 28 hours after birth.
RESULTS. At 1 to 5 hours postnatally, airway expression of α-, β-, and γ-subunits of epithelial sodium channel was lower in preterm than in term infants. At this time point, significant correlations existed between gestational age and airway expression of α- and β-epithelial sodium channel. By 22 to 28 hours after birth, only the expression of β-epithelial sodium channel had decreased significantly in the preterm infants, whereas the expression of all epithelial sodium channel subunits had decreased significantly in the term infants. At this time point, no difference in expression of any of the subunits was found between preterm and term infants.
CONCLUSIONS. Airway expression of epithelial sodium channel at 1 to 5 hours of age is significantly lower in preterm than in term infants. Low postnatal expression of α-, β-, and γ-epithelial sodium channel subunits in the airway epithelium may contribute to the development of respiratory distress in the preterm infant.
Cardiac Safety of Central Nervous System Stimulants in Children and Adolescents With Attention-Deficit/Hyperactivity Disorder
Authors: Winterstein Almut G. , Gerhard Tobias , Shuster Jonathan , Johnson Michael , Zito Julie M. , Saidi Arwa 
Published: November 2007

OBJECTIVES. Case reports have raised concerns about the risk of cardiac events associated with central nervous system stimulants for the treatment of attention-deficit/hyperactivity disorder.
PATIENTS AND METHODS. This was a retrospective cohort study that used 10 years (July 1994 to June 2004) of Florida Medicaid claims data cross-linked to Vital Statistics Death Registry data. The cohort was composed of all youth 3 to 20 years old who were newly diagnosed with attention-deficit/hyperactivity disorder. Each month of follow-up was classified according to stimulant claims (methylphenidate, amphetamines, and pemoline) as current use (active stimulant claim), former use (time after periods of current use), or nonuse (time preceding the first stimulant claim, including follow-up of youth who were never exposed to stimulants). The study's end points were (1) cardiac death, (2) first hospital admission for cardiac causes or (3) first emergency department visit for cardiac causes. Risks were compared with time-dependent Cox regression analysis adjusting for various cardiac risk factors.
RESULTS. During 124932 person-years of observation (n = 55383), 73 youth died, 5 because of cardiac causes. No cardiac death occurred during 42612 person-years of stimulant use. Hospital admissions for cardiac cause occurred for 27 children (8 during stimulant use, 11 during 35671 person-years of former use, and 8 during 46649 person-years of nonuse); and 1091 children visited the emergency department for cardiac causes (8.7 per 1000 person-years). Current stimulant use was associated with a 20% increase in the hazard for emergency department visits when compared with nonuse. No increased risk was found for periods of former use when compared with nonuse.
CONCLUSIONS. Incidence rates of cardiac events requiring hospitalization were small and similar to national background rates. Stimulants were associated with an increase in cardiac emergency department visits. More evidence is needed that addresses the long-term risk/benefit of the various treatment options and the effect of other cardiac risk factors and comedications.
Gender Differences in Presentation and Course of Disease in Pediatric Patients With Crohn Disease
Authors: Gupta Neera , Bostrom Alan G. , Kirschner Barbara S. , Ferry George D. , Winter Harland S. , Baldassano Robert N. , Gold Benjamin D. , Abramson Oren , Smith Terry , Cohen Stanley A. , Heyman Melvin B. 
Published: November 2007

OBJECTIVE. The objective of this study was to determine gender differences in pediatric patients with Crohn disease.
METHODS. We conducted a retrospective cohort study of 989 consecutive pediatric patients (566 boys, 423 girls) who had Crohn disease (aged 0 to 17 years at diagnosis) by using the Pediatric IBD Consortium Registry. Uniform data were analyzed to compare the presentation and course of disease according to gender.
RESULTS. Median follow-up time was 2.8 years. Mean ± SD age at diagnosis of inflammatory bowel disease (11.5 ± 3.8 years) did not differ by gender. Compared with boys, girls had a higher prevalence of mouth sores at symptom onset and a higher prevalence of hypoalbuminemia at the time of diagnosis. Location of disease did not differ by gender. A higher proportion of girls had abnormal anti–outer membrane porin of Escherichia coli levels compared with boys. Girls were at increased risk for erythema nodosum/pyoderma gangrenosum and decreased risk for growth failure compared with boys.
CONCLUSIONS. Girls appear to have an overall more severe course of disease; however, boys are at increased risk for developing growth failure. Disease course and the impact of disease severity on growth according to gender in pediatric Crohn disease require prospective study.
Pediatric Myocarditis: Emergency Department Clinical Findings and Diagnostic Evaluation
Authors: Freedman Stephen B. , Haladyn J. Kimberly , Floh Alejandro , Kirsh Joel A. , Taylor Glenn , Thull-Freedman Jennifer 
Published: November 2007

OBJECTIVE. The goal was to determine, in children with myocarditis, the frequency of various presenting symptoms and the sensitivity of clinical and laboratory investigations routinely available in the emergency department.METHODS. We performed a retrospective review of all patients &lt;18 years of age who were diagnosed as having myocarditis at our institution between May 2000 and May 2006 and who initially presented to an emergency department. Patients were categorized as having definite myocarditis (positive endomyocardial biopsy results) or probable myocarditis(diagnosis assigned by a pediatric cardiologist on the basis of history, physical examination, and investigation results in the absence of an endomyocardial biopsy or in the presence of negative biopsy results). All patients were assigned a predominant category of symptoms at presentation on the basis of criteria defined a priori.RESULTS. There were 16 cases of definite myocarditis and 15 cases of probable myocarditis. The age distribution was nonnormal, with peaks among children ≤3 years and ≥16 years of age. Of 14 patients who were seen by a physician before being diagnosed with myocarditis, 57% were originally diagnosed as having pneumonia or asthma. Thirty-two percent of patients presented with predominantly respiratory symptoms, 29% had cardiac symptoms, and 6% had gastrointestinal symptoms. Although evidence of cardiac dysfunction was frequently present in the form of respiratory distress, only a minority of children had evidence of hepatomegaly or abnormal cardiac examination results. The sensitivities of electrocardiograms and chest radiographs as screening tests were 93% and 55%, respectively. Among laboratory tests studied, aspartate aminotransferase measurement was the most sensitive (sensitivity: 85%).CONCLUSIONS. Children with myocarditis present with symptoms that can be mistaken for other types of illnesses; respiratory presentations were most common. When clinical suspicion of myocarditis exists, chest radiography alone is an insufficient screening test. All children should undergo electrocardiography. Aspartate aminotransferase testing may be a useful adjunctive investigation.
Flow Preferences for Juvenile Robust Redhorses in an Experimental Mesocosm: Implications for Developing Sampling Protocols
Authors: Mosley Diarra L. , Jennings Cecil A. 
Published: November 2007

Abstract
The robust redhorse Moxostoma robustum, originally described by Edward Cope in 1870 from specimens collected from the Yadkin River, North Carolina, apparently went unnoticed until 1991 when it was rediscovered in the lower Oconee River, Georgia. Despite extensive surveys and an ongoing, decade-long restoration program, wild-spawned juveniles 30–410 mm in total length have not been collected. This project experimentally evaluated one hypothesis (flow class use) that seeks to explain the absence of juvenile robust redhorses from the catch. Two experimental mesocosms were used to determine whether juvenile robust redhorses use flow classes in proportion to their availability. Pond-reared juveniles were exposed to four flow-based habitat types (eddies = −0.12 to −0.01 m/s, slow flow = 0.00–0.15 m/s, moderate flow = 0.16–0.32 m/s, and backwaters) in four 10-d trials, in which 16 pond-reared test fish were used per trial, with replacement. Location data were recorded hourly during daytime hours for each fish in all trials and evaluated with a log-linear, chi-square model. In winter, test fish showed a preference for eddies and backwaters and avoided slow to moderate flows. In early spring, test fish showed a preference for eddies and avoided the moderate flows. Current field sampling for juvenile robust redhorses has not targeted the flow classes used by fish in this experiment; however, collection of wild-caught juveniles may be improved by sampling in eddies and their associated transitional areas.
An Evaluation of the Relative Influence of Spatial, Statistical, and Biological Factors on the Accuracy of Stream Fish Species Presence Models
Authors: Ruiz John C. , Peterson James T. 
Published: November 2007

AbstractModels relating fish species presence to landscape and stream features are increasingly being used by natural resource managers. The accuracy of these models directly influences the ability to make sound stream management decisions. To evaluate the effect of biotic and abiotic factors on model accuracy, we fit parametric (logistic regression) and nonparametric (k‐nearest neighbor) models of species presence at two spatial scales using subwatershed and stream reach characteristics. We then evaluated the influence of model type, spatial scale, and species‐specific characteristics on species presence omission and commission errors for the best‐fitting scale‐specific parametric and nonparametric models (total of four per species). We found that error rates were higher within species than among species and varied among species by 3.9% (omission) and 8.7% (commission). Within‐species variation in error rates was primarily related to model type and spatial scale, whereas among‐species variation was due to the species‐specific characteristic‐habitat specialization. The relationship between these factors and the omission and commission error rates, however, were relatively complex. The k‐nearest neighbor models were generally more accurate (produced lower errors) at predicting species presence at larger, subwatershed scales, whereas the logistic regression models were more accurate at predicting species presence at smaller, stream reach scales. Similarly, commission error rates were lower for models predicting the presence of habitat generalists at larger scales, whereas commission error rates were lowest for models predicting the presence of habitat specialists at smaller, stream reach scales. The findings from this study suggest that species‐specific characteristics and spatial autocorrelation can influence the accuracy of species presence models and that biologists should consider these effects when modeling the presence or absence of fish species.
Current Treatment and Clinical Trial Developments for Ductal Carcinoma In Situ of the Breast
Authors: Boughey Judy C. , Gonzalez Ricardo J. , Bonner Everett , Kuerer Henry M. 
Published: November 2007

Learning Objectives
After completing this course, the reader will be able to: Discuss the role of radiation therapy in the adjuvant treatment of DCIS.Describe the impact of tamoxifen in the treatment of DCIS.Discuss evolving strategies in neoadjuvant treatment for DCIS.
Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
First-Line Chemotherapy for HER-2–Negative Metastatic Breast Cancer Patients Who Received Anthracyclines as Adjuvant Treatment
Authors: Morabito Alessandro , Piccirillo Maria Carmela , Monaco Katia , Pacilio Carmen , Nuzzo Francesco , Chiodini Paolo , Gallo Ciro , Matteis Andrea , Perrone Francesco ,   for the NCI Naples Breast Cancer Group
Published: November 2007

Learning Objectives
After completing this course, the reader will be able to: Discuss the value of retreatment with anthracyclines for HER-2–negative metastatic breast cancer patients who received anthracyclines as adjuvant treatment.Discuss the role of liposomal anthracyclines, taxanes, and combinations without anthracyclines and taxanes, or innovative treatments, including target-based agents.Comment on the weakness and quality of available evidence.
Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
Removable Prostheses May Enhance Marginal Bone Loss Around Dental Implants: A Long‐Term Retrospective Analysis
Authors: Tandlich Moshik , Ekstein Jakob , Reisman Pini , Shapira Lior 
Published: November 2007

Background: The aim of the study was to retrospectively evaluate marginal bone loss (MBL) around rough‐surface dental implants, placed in a private clinic, and to construct a multivariate model based on formerly proposed prognostic variables.Methods: Records of patients who were treated previously with dental implants were reviewed. The patients’ latest annual clinical examinations and radiograms were used for data collection and the calculation of MBL. A patient‐based multivariate model was constructed based on two successive iterations of statistical analysis.Results: Eighty‐two patients and 265 implants with ≥30 months of follow‐up were evaluated. The overall survival rate was 95.8% (2.6% early loss and 1.5% late loss). By evaluating the data with the single implant as a unit of analysis, MBL was correlated with time. Higher MBL values were found in smokers and around implants supporting removable prostheses. In the patient‐based analysis, only smoking and the presence of a removable prosthesis correlated with higher values of MBL. Odds ratios for higher rates of MBL were 1.95 and 2.57 for smokers and around removable prostheses, respectively. Neither time nor any of the other suspected variables correlated with higher MBL.Conclusions: The present study corroborated the notion that smoking correlates with higher MBL and implied that implants supporting removable prostheses tend to display more bone loss. Further studies are needed to elucidate the latter finding.
Gingival Crevicular Fluid Levels of Leukotriene B4in Periodontal Health and Disease
Authors: Pradeep A.R. , Manjunath S.G. , Swati Pradeep Patel , Shikha Chowdhry , Sujatha Pai B. 
Published: November 2007

Background:Leukotriene B4(LTB4) is a membrane‐derived lipid mediator formed from arachidonic acid. LTB4is among the most potent stimulants of polymorphonuclear leukocytes (PMNs) and, thus, participates in tissue injury by recruiting PMNs in a pathophysiologic scenario of periodontal diseases. The aim of the present study was to assess the relationship between clinical parameters and concentrations of LTB4within gingival crevicular fluid (GCF) from inflamed gingiva and periodontitis sites before and after the treatment of periodontitis.Methods:Sixty subjects were divided into three groups with 20 subjects in each group: healthy (group 1), gingivitis (group 2), and chronic periodontitis (group 3). Groups were based on periodontal disease index (PDI), clinical attachment loss (CAL), and radiographic evidence of bone loss. Group 4 consisted of the subjects in group 3 at 6 to 8 weeks after treatment, i.e., scaling and root planing (SRP). GCF samples collected from each patient were quantified for LTB4using an enzymatic immunometric assay. In addition, the correlation between in situ LTB4levels and clinical parameters was analyzed in each group.Results:The highest mean LTB4concentration in GCF was observed in group 3 (185.2 pg/μl), and the lowest was observed in group 1 (39.6 pg/μl). Its level in group 3 decreased to 79.35 pg/μl after treatment (group 4). Further, GCF LTB4levels in all groups showed a statistically significant positive correlation with PDI and CAL (P<0.005).Conclusion:The substantial increase in GCF LTB4concentrations with the severity of periodontal disease and a concomitant decrease in its level following SRP in subjects with periodontitis suggest a possible role for LTB4in the progression of periodontal disease.
Immigration and Risk of Childhood Lead Poisoning: Findings From a Case–Control Study of New York City Children
Authors: Tehranifar Parisa , Leighton Jessica , Auchincloss Amy H. , Faciano Andrew , Alper Howard , Paykin Andrea , Wu Songmei 
Published: November 2007

Objectives. We investigated whether foreign birthplace and residence were associated with an increased risk of childhood lead poisoning. Methods. We conducted a matched case–control study among New York City children (mean age=3 years) tested for lead poisoning in 2002 (n=203 pairs). Children were matched on age, date of test, and residential area. Blood lead and housing data were supplemented by a telephone survey administered to parents or guardians. Conditional logistic regression analysis was used to examine the relationship of lead poisoning status to foreign birthplace and time elapsed since most recent foreign residence after adjustment for housing and behavioral risk factors. Results. Both foreign birthplace and time since most recent foreign residence had strong adjusted associations with lead poisoning status, with children who had lived in a foreign country less than 6 months before their blood test showing a particularly elevated risk of lead poisoning relative to US-born children with no foreign residential history before their blood test (odds ratio [OR]=10.9; 95% confidence interval [CI]=3.3, 36.5). Conclusions. Our findings demonstrate an increased risk of lead poisoning among immigrant children.