bluuebunny/crossref_metadata_2025_split huggingface dataset:
Characteristics of General and Subspecialty Pediatricians Who Choose Not to Recertify
Authors: Freed Gary L. , Dunham Kelly M. , Althouse Linda A. ,   American Board of Pediatrics, Research Advisory Committee
Published: April 2008

OBJECTIVE. The goal was to determine the reasons given for nonparticipation in maintenance of certification by general pediatricians and pediatric subspecialists whose board certification had expired.
METHODS. All United States-based pediatricians whose board certification had expired and who had not recertified as a generalist or subspecialist in 2004 or 2005 were surveyed. The total sample included 1001 pediatric generalists and 1237 subspecialists. We conducted a mail survey study, with a total of 3 mailings to nonrespondents. Analyses initially were conducted separately for generalists with expired certificates, subspecialists with active subspecialty but expired general pediatrics certificates, and subspecialists with expired subspecialty certificates (regardless of their general pediatrics certification status).
RESULTS. The overall response rates were 68% for generalists and 76% for subspecialists. Of pediatricians who had allowed their certificates to expire, the majority still intended to recertify (65% of the generalists and 86% of the subspecialists, in their primary subspecialty). The most common reasons cited by the 35% of generalists with expired certificates who were not planning to participate in maintenance of certification were the expense, the time required to complete maintenance of certification, and the perceived lack of relevance to their current practice. The 14% of subspecialists who were not planning to recertify in their primary subspecialty most commonly cited the expense, a change in career path making recertification unnecessary, and the time required.
CONCLUSIONS. Although the physicians in this study had allowed their certificates to expire, they still overwhelmingly believed that physicians who provide direct patient care should maintain their certification. There was general consensus among our respondents regarding the professional value to patients and peers of participation in the maintenance of certification program.
Comparison of Critically Ill and Injured Children Transferred From Referring Hospitals Versus In-House Admissions
Authors: Gregory Christopher J. , Nasrollahzadeh Farid , Dharmar Madan , Parsapour Kourosh , Marcin James P. 
Published: April 2008

OBJECTIVE. The purpose of this work was to compare the outcomes, severity of illness, and resource use of patients transferred to PICUs from outside hospitals to patients admitted from within the same hospital.
METHODS. We conducted a secondary analysis of patients from the 20 US PICUs in the most recent Pediatric Intensive Care Unit Evaluations Software Recalibration Database on a total of 13017 emergent PICU admissions between January 2001 and January 2006. Dependent variables were PICU resource use and risk-adjusted mortality. The main independent variable was the PICU admission source: patients transferred from referring emergency departments and inpatient wards versus in-house admissions from the same hospitals' emergency departments and inpatient ward.
RESULTS. Patients admitted from referring emergency departments had higher use of vasoactive infusions (7.31% vs 5.23%) and mechanical ventilation (33.45% vs 23.6%) than same-hospital emergency department admissions. Compared with in-house ward admissions, patients transferred from referring inpatient wards had higher mechanical ventilation rates (45.05% vs 28.56%) and PICU lengths of stay (8.0 vs 6.7 days).
CONCLUSIONS. On average, children admitted to a cohort of US PICUs from referring hospitals were more ill and required more intensive care resources than patients admitted to the same PICUs from within the institution. Hospital-level differences in PICU efficiency and severity of illness were highly variable. These data highlight the need for standardized PICU admission criteria to maximize hospital efficiency and suggest opportunities for earlier intervention and consultation by hospitals with PICU-level services to improve quality of care for critically ill children.
Positive Screening for Autism in Ex-preterm Infants: Prevalence and Risk Factors
Authors: Limperopoulos Catherine , Bassan Haim , Sullivan Nancy R. , Soul Janet S. , Robertson Richard L. , Moore Marianne , Ringer Steven A. , Volpe Joseph J. , du Plessis Adré J. 
Published: April 2008

OBJECTIVE. The survival of very low birth weight infants has increased markedly in recent years. Unfortunately, the prevalence of significant and lifelong motor, cognitive, and behavioral dysfunction has remained a major problem confronting these children. The objective of this study was to perform screening tests for early autistic features in children with a history of very low birth weight and to identify risk factors associated with a positive screening result.
METHODS. We studied 91 ex-preterm infants ≤ 1500 g at birth. Infants underwent conventional MRI studies at preterm and/or term-adjusted age. We collected pertinent demographic, prenatal, intrapartum, acute postnatal, and short-term outcome data for all infants. Follow-up assessments were performed at a mean age of 21.9 ± 4.7 months, using the Modified Checklist for Autism in Toddlers, the Vineland Adaptive Behavior Scale, and the Child Behavior Checklist.
RESULTS. Twenty-six percent of ex-preterm infants had a positive result on the autism screening tool. Abnormal scores correlated highly with internalizing behavioral problems on the Child Behavior Checklist and socialization and communication deficits on the Vineland Scales. Lower birth weight, gestational age, male gender, chorioamnionitis, acute intrapartum hemorrhage, illness severity on admission, and abnormal MRI studies were significantly associated with an abnormal autism screening score.
CONCLUSIONS. Early autistic behaviors seem to be an underrecognized feature of very low birth weight infants. The results from this study suggest that early screening for signs of autism may be warranted in this high-risk population followed by definitive autism testing in those with positive screening results.
Changing Patterns in NeonatalEscherichia coliSepsis and Ampicillin Resistance in the Era of Intrapartum Antibiotic Prophylaxis
Authors: Bizzarro Matthew J. , Dembry Louise-Marie , Baltimore Robert S. , Gallagher Patrick G. 
Published: April 2008

OBJECTIVE. The goal was to determine current trends in Escherichia coli-related early- and late-onset sepsis and patterns of ampicillin resistance in relation to institutional changes in the use of intrapartum antibiotic prophylaxis.METHODS. A retrospective review of data for all infants with E coli sepsis at Yale-New Haven Hospital from 1979 to 2006 was performed. Study periods were based on predominant intrapartum antibiotic prophylaxis practices at Yale-New Haven Hospital, that is, (1) 1979 to 1992 (no formal intrapartum antibiotic prophylaxis), (2) 1993 to 1996 (risk factor-based), and (3) 1997 to 2006 (screening-based). Sepsis rates and patterns of ampicillin resistance were compared.RESULTS. Fifty-three cases of E coli early-onset sepsis and 129 cases of E coli late-onset sepsis were identified over 3 eras. In very low birth weight (&lt;1500 g) infants, increases in E coli early-onset sepsis (period 1: 2.83 cases per 1000 very low birth weight admissions; period 2: 7.12 cases per 1000 very low birth weight admissions; period 3: 10.22 cases per 1000 very low birth weight admissions), intrapartum ampicillin exposure, and ampicillin-resistant E coli were observed. Intrapartum ampicillin exposure was determined to be an independent risk factor for ampicillin-resistant E coli early-onset sepsis. For the first time, a significant increase in E coli late-onset sepsis was observed in preterm infants (period 1: 10.39 cases per 1000 very low birth weight admissions; period 2: 16.01 cases per 1000 very low birth weight admissions; period 3: 21.66 cases per 1000 very low birth weight admissions) and term infants (period 1: 4.07 cases per 1000 admissions; period 2: 4.22 cases per 1000 admissions; period 3: 8.23 cases per 1000 admissions).CONCLUSIONS. Studies to provide a better understanding of potential consequences of intrapartum antibiotic exposure and its contribution to evolving trends in neonatal sepsis are urgently needed.
Variability in Expert Assessments of Child Physical Abuse Likelihood
Authors: Lindberg Daniel Martin , Lindsell Christopher John , Shapiro Robert Allan 
Published: April 2008

OBJECTIVES. In the absence of a gold standard, clinicians and researchers often categorize their opinions of the likelihood of inflicted injury using several ordinal scales. The objective of this protocol was to determine the reliability of expert ratings using several of these scales.METHODS. Participants were pediatricians with substantial academic and clinical activity in the evaluation of children with concerns for physical abuse. The facts from several cases that were referred to 1 hospital's child abuse team were abstracted and recorded as in a multidisciplinary team conference. Participants viewed the recording and rated each case using several scales of child abuse likelihood.RESULTS. Participants (n = 22) showed broad variability for most cases on all scales. Variability was lowest for cases with the highest aggregate concern for abuse. One scale that included examples of cases fitting each category and standard reporting language to summarize results showed a modest (18%–23%) decrease in variability among participants. The interpretation of the categories used by the scales was more consistent. Cases were rarely rated as “definite abuse” when likelihood was estimated at ≤95%. Only 7 of 156 cases rated ≤15% likelihood were rated as “no reasonable concern for abuse.” Only 9 of 858 cases rated ≥35% likelihood were rated as “reasonable concern for abuse.”CONCLUSIONS. Assessments of child abuse likelihood often show broad variability between experts. Although a rating scale with patient examples and standard reporting language may decrease variability, clinicians and researchers should be cautious when interpreting abuse likelihood assessments from a single expert. These data support the peer-review or multidisciplinary team approach to child abuse assessments.
Management of Pediatric Trauma
Authors:   AMERICAN ACADEMY OF PEDIATRICS,   Section on Orthopaedics, Committee on Pediatric Emergency Medicine, Section on Critical Care, Section on Surgery, Section on Transport Medicine, Committee on Pediatric Emergency Medicine,   PEDIATRIC ORTHOPAEDIC SOCIETY OF NORTH AMERICA
Published: April 2008

Injury is the number 1 killer of children in the United States. In 2004, injury accounted for 59.5% of all deaths in children younger than 18 years. The financial burden to society of children who survive childhood injury with disability continues to be enormous. The entire process of managing childhood injury is complex and varies by region. Only the comprehensive cooperation of a broadly diverse group of people will have a significant effect on improving the care and outcome of injured children.
This statement has been endorsed by the American Association of Critical-Care Nurses, American College of Emergency Physicians, American College of Surgeons, American Pediatric Surgical Association, National Association of Children's Hospitals and Related Institutions, National Association of State EMS Officials, and Society of Critical Care Medicine.
Prevention of Influenza: Recommendations for Influenza Immunization of Children, 2007–2008
Authors:   Committee on Infectious Diseases
Published: April 2008

This Policy Statement was retired November 2010.
The American Academy of Pediatrics recommends annual influenza immunization for all children with high-risk conditions who are 6 months of age and older, for all healthy children ages 6 through 59 months, for all household contacts and out-of-home caregivers of children with high-risk conditions and of healthy children younger than 5 years, and for all health care professionals.
To more fully protect against the morbidity and mortality of influenza, increased efforts are needed to identify and immunize all children at high risk and all healthy children ages 6 through 59 months and to inform their parents when annual immunizations are due. Previously unimmunized children who are at least 6 months of age but younger than 9 years should receive 2 doses of influenza vaccine, given 1 month apart, beginning as soon as possible on the basis of local availability during the influenza season. If children in this cohort received only 1 dose for the first time in the previous season, it is recommended that 2 doses be administered in the current season. This recommendation applies only to the influenza season that follows the first year that a child younger than 9 years receives influenza vaccine. A child who then also fails to receive 2 doses the next year should be given only 1 dose per year from that point on. Influenza vaccine should also continue to be offered throughout the influenza season, even after influenza activity has been documented in a community.
On the basis of global surveillance of circulating virus strains, the influenza vaccine may change from year to year; indeed, 1 of the 3 strains in the 2007–2008 vaccine is different from the previous year's vaccine. All health care professionals, influenza campaign organizers, and public health agencies should develop plans for expanding outreach and infrastructure to immunize all children for whom influenza vaccine is recommended. Appropriate prioritization of administering influenza vaccine will also be necessary when vaccine supplies are delayed or limited. Because the influenza season often extends into March, immunization against influenza is recommended to continue through late winter and early spring. Lastly, it is recommended that for the 2007–2008 season, and likely beyond, health care professionals do not prescribe amantadine or rimantadine for influenza treatment or chemoprophylaxis, because widespread resistance to these antiviral medications now exists among influenza A viral strains. However, oseltamivir and zanamivir can be prescribed for treatment or chemoprophylaxis, because influenza A and B strains remain susceptible.
Effects of C60 fullerene nanoparticles on soil bacteria and protozoans
Authors: Johansen Anders , Pedersen Anette L , Jensen Keld A , Karlson Ulrich , Hansen Bjarne M , Scott-Fordsmand Janeck J , Winding Anne 
Published: April 2008

Abstract
Nanotechnology should produce numerous new materials in the coming years. Because of the novel design of nanomaterials with new physicochemical characteristics, their potential adverse impact on the environment and human health must be addressed. In the present study, agglomerates of pristine C60 fullerenes (50 nm to μm-size) were applied to soil at 0, 5, 25, and 50 mg/kg dry soil to assess their effect on the soil microbiota by measuring total respiration; biomass, number, and diversity of bacteria; and total number and diversity of protozoans during 14 d. Respiration and microbial biomass were unaffected by the fullerenes at any time, whereas the number of fast-growing bacteria was decreased by three- to fourfold just after incorporation of the nanomaterial. Protozoans seemed not to be very sensitive to C60, because their number decreased only slightly in the beginning of the experiment. With polymerase chain reaction and denaturing gradient gel electrophoresis analysis of eubacteria and kinetoplastids from the soil, however, a difference between the fullerene treatments and nonamended controls was demonstrated. The fullerenes did not induce more than 20 to 30% of relative dissimilarity (with both bacteria and protozoans) between treatments, but this effect was persistent throughout the experiment. It therefore is recommended that fullerene nanomaterial not be spread deliberately in the environment and that their ecotoxicology be further clarified.
Development of a brain nucleus involved in song production in zebra finches (Taeniopygia guttata) is disrupted by Aroclor 1248
Authors: Hoogesteijn Almira L , Kollias George V , Quimby Fred W , De Caprio Anthony P , Winkler David W , DeVoogd Timothy J 
Published: April 2008

Abstract
We studied whether polychlorinated biphenyls (PCBs) may alter the development of song control brain nuclei in zebra finch (Taeniopygia guttata) offspring of pulse-exposed hens. We orally administered 40 μg of Aroclor 1248 to adult female finches before egg laying. When the progeny were 50 d old, we measured the volumes of the song control nuclei robustus arcopallialis (RA) and higher vocal center (HVC) using light microscopy. Both male and female progeny of exposed birds had a significantly smaller RA than control birds (36 and 16%, respectively; p ≤ 0.05). The HVC did not differ in either sex between exposed and control groups. Perhaps impaired development of RA was caused by PCB action on steroid receptors. We conclude that animals living in contaminated areas may be at risk of neurological damage in hormone-sensitive brain areas and that changes in brain nuclei related to song may be a sensitive indicator of low-level PCB exposure.
Nanomaterials in the environment aquatic ecotoxicity tests of some nanomaterials
Authors: Velzeboer Ilona , Hendriks A. Jan , Ragas Ad M. J , van de Meent Dik 
Published: April 2008

Abstract
Nanoparticles of TiO2, ZrO2, Al2O3, CeO2, fullerene (C60), single-walled carbon nanotubes, and polymethylmethacrylate were tested for ecotoxic effects using one or more ecotoxicity endpoints: Microtox® (bacteria), pulse-amplitude modulation (algae), Chydotox (crustaceans), and Biolog® (soil enzymes). No appreciable effects were observed at nominal concentrations of up to 100 mg/L. Dilution of nanoparticle suspensions, either in ultrapure (Milli-Q®) water or in natural (pond) water, led to formation of larger particles, which settled easily. (Nano)particles in water were characterized by means of atomic force microscopy, energy-dispersive x-ray analysis, inductively coupled plasma–mass spectrometry, flow cytometry, and spectrophotometry. It is concluded that the absence of ecotoxicity is the result of low concentrations of free nanoparticles in the tests, and it is suggested that colloid (in)stability is of primary importance in explaining ecotoxic effects of nanoparticles in the natural environment.
Basin-wide impacts of compounds with estrogen-like activity on longnose dace (Rhinichthys cataractae) in two prairie rivers of Alberta, Canada
Authors: Jeffries Ken M , Nelson Erik R , Jackson Leland J , Habibi Hamid R 
Published: April 2008

Abstract
Environmental compounds with estrogen- or antiestrogen-like activity can enter rivers from multiple sources, including municipal wastewater and agricultural runoff. We used longnose dace (Rhinichthys cataractae) to investigate exposure to compounds with estrogen-like activity, which we measured in water at multiple sites in the Oldman and Bow rivers (AB, Canada). We evaluated changes in vitellogenin mRNA with quantitative reverse transcription–polymerase chain reaction, then compared vitellogenin levels to sex ratios and fish performance indices to assess how exposure to compounds with estrogen-like activity affects longnose dace populations. Vitellogenin levels were elevated at least 59 to 110 km downstream of municipalities. In the Oldman River, increased vitellogenin expression and female-biased sex ratios suggest severe endocrine disruption, likely resulting from the combined impacts of municipal wastewater, agriculture, and large cattle operations within the basin. In the Bow River, municipal wastewater may be the major source of compounds with estrogen-like activity that affect longnose dace. The sex ratios were not heavily skewed, as in the more agriculturally influenced Oldman River. We detected organic contaminants in river samples at every site, but the highest concentrations were found downstream of municipalities and in areas with intense agriculture. Vitellogenin levels and sex ratios of longnose dace suggest basin-wide exposure to compounds with estrogen-like activity. Our results demonstrate that it is important to assess rivers at large spatial scales to detect fully the impacts of municipal wastewater and agriculture on fish populations.
Implant Placement at the Time of Mandibular Molar Extraction: Description of Technique and Preliminary Results of 341 Cases
Authors: Fugazzotto Paul A. 
Published: April 2008

Background: Theoretically, the ability to place implants in ideal positions at the time of mandibular molar extraction with concomitant regenerative therapy would simplify and shorten the course of therapy for patients.Methods: A total of 341 implants were placed in 320 individuals at the time of mandibular molar hemisection and extraction. Concomitant regenerative therapy was performed around 332 of the placed implants. No regenerative therapy was performed around the remaining nine implants. Eleven additional sites, in which simultaneous implant placement was planned, were treated instead with regenerative therapy alone using graft material and a covering membrane. Implants were placed in these sites in subsequent surgical visits.Results: One implant was mobile 3 weeks postinsertion. A second implant was lost after 30 months in function. All other implants were stable at the time of uncovery 3 to 7 months postinsertion. A total of 339 implants have been in function for up to 6 years, with a mean time in function of 30.8 months, yielding a cumulative survival rate of 99.1%.Conclusion: Implants may be placed in ideal restorative positions at the time of mandibular molar extraction with or without concomitant regenerative therapy.
Chronic Stress May Modulate Periodontal Disease: A Study in Rats
Authors: Peruzzo Daiane C. , Benatti Bruno B. , Antunes Isabela B. , Andersen Monica L. , Sallum Enilson A. , Casati Márcio Z. , Nociti Francisco H. , Nogueira‐Filho Getúlio R. 
Published: April 2008

Background: The present study aimed to evaluate whether chronic stress (CS) affects ligature‐induced periodontal disease and to investigate the impact of CS on the mRNA levels of interleukin (IL)‐1β, −1 receptor antagonist, −6, and −10, interferon‐gamma (IFN‐γ), receptor activator of nuclear factor‐kappa B ligand (RANKL), and osteoprotegerin in the gingival tissues of rats.Methods: Sixty male Wistar rats were assigned randomly to three groups: G1 (control; non‐ligated sites), G2 (periodontal disease), and G3 (periodontal disease associated with restraint stress for 12 hours/day for the entire study). After 30 days, all animals were sacrificed by decapitation. Blood samples were taken, and the concentrations of corticosterone and catecholamines were measured as biomarkers of CS. Marginal tissues around ligated and non‐ligated teeth were harvested, and gene expression was assessed by quantitative polymerase chain reaction. Moreover, the area of bone loss (ABL) was determined histometrically.Results: Data analysis showed that CS increased serum levels of stress biomarkers (P <0.05), ligature placement resulted in a significant ABL compared to non‐ligated sites, CS significantly increased the amount of ABL in inflamed sites (P <0.001), and CS significantly increased mRNA levels of proinflammatory (IL‐1β and −6 and IFN‐γ) and anti‐inflammatory (IL‐10) cytokines and proresorptive factor (RANKL) in ligated sites (P <0.05).Conclusion: CS significantly increased bone loss resulting from ligature‐induced periodontitis by a local increase in proinflammatory and proresorptive factors.