bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Field and Laboratory Assessment of Oil-Spill Effects on Survival and Reproduction of Pacific Herring Following the Exxon Valdez Spill
Authors: Pearson WH , Moksness E , Skalski JR 
Published: March 2009

Pacific herring, Clupea pallasi, spawn along hundreds of kilometres of shoreline in Prince William Sound. Herring eggs incubate in intertidal and shallow subtidal areas attached to kelp and eelgrass. In April 1989, following the Exxon Valdez oil spill, there was potential in Prince William Sound for localized effects on spawning herring, their eggs, and the hatching larvae. Field and laboratory investigations in 1989 and 1990 were designed to assess potential injury to Prince William Sound herring by testing for differences between oiled regions and unoiled reference areas and by relating biological response variables to the concentrations of polycyclic aromatic hydrocarbons (PAH) in eggs-on-kelp samples. Hydrocarbon analyses and laboratory incubation were conducted on eggs-on-kelp samples from Prince William Sound and Sitka Sound. The eggs and hatching larvae were examined to evaluate several response variables: egg development, hatch, larval survival, abnormal development of larvae, larval length, and larval yolk-sac volume.
Analysis of 1989 shoreline surveys indicate that about 96% of the total spawn length (158 km) in Prince William Sound occurred along shorelines with no oiling, and less than 1% of the 1989 total spawn length occurred along shorelines with moderate to heavy oiling. Analysis of shoreline oiling in both 1989 and 1990 from all surveys indicates that about 90 to 91% of the total 1989 spawn length occurred along unoiled shorelines. Effects on herring eggs were minor in 1989 even in oiled areas. No significant relationship was found between 1989 PAH burdens in eggs-on-kelp samples and 9 out of 10 biological response variables. In 1989, significantly lower proportions of developed eggs were observed for Cabin Bay samples visibly contaminated with tarry deposits. The location where these effects were seen represented less than 2% of total 1989 spawn length. No effects of the spill on herring were evident in 1990. No significant relationship was found between 1990 PAH burdens and the seven biological response variables studied. Biological response variables from Sitka Sound were either not significantly different from or significantly lower (more adverse) than those from Prince William Sound.
Our 1989 and 1990 results are consistent with the low exposure of herring to oil and do not indicate an extent of injury that would be significant to the Prince William Sound herring population. The biomass and harvests of Prince William Sound herring had reached record high levels in the three years immediately following the spill so that the minor effects observed in 1989 did not translate into decreases in the population level.
Routine Vaccination Against Pertussis and the Risk of Childhood Asthma: A Population-Based Cohort Study
Authors: Spycher Ben D. , Silverman Michael , Egger Matthias , Zwahlen Marcel , Kuehni Claudia E. 
Published: March 2009

BACKGROUND. In industrialized countries vaccination coverage remains suboptimal, partly because of perception of an increased risk of asthma. Epidemiologic studies of the association between childhood vaccinations and asthma have provided conflicting results, possibly for methodologic reasons such as unreliable vaccination data, biased reporting, and reverse causation. A recent review stressed the need for additional, adequately controlled large-scale studies.
OBJECTIVE. Our goal was to determine if routine childhood vaccination against pertussis was associated with subsequent development of childhood wheezing disorders and asthma in a large population-based cohort study.
METHODS. In 6811 children from the general population born between 1993 and 1997 in Leicestershire, United Kingdom, respiratory symptom data from repeated questionnaire surveys up to 2003 were linked to independently collected vaccination data from the National Health Service database. We compared incident wheeze and asthma between children of different vaccination status (complete, partial, and no vaccination against pertussis) by computing hazard ratios. Analyses were based on 6048 children, 23 201 person-years of follow-up, and 2426 cases of new-onset wheeze.
RESULTS. There was no evidence for an increased risk of wheeze or asthma in children vaccinated against pertussis compared with nonvaccinated children. Adjusted hazard ratios comparing fully and partially vaccinated with nonvaccinated children were close to one for both incident wheeze and asthma.
CONCLUSION. This study provides no evidence of an association between vaccination against pertussis in infancy and an increased risk of later wheeze or asthma and does not support claims that vaccination against pertussis might significantly increase the risk of childhood asthma.
Exploring Emergency Contraception Knowledge, Prescription Practices, and Barriers to Prescription for Adolescents in the Emergency Department
Authors: Goyal Monika , Zhao Huaqing , Mollen Cynthia 
Published: March 2009

OBJECTIVE. The objective of this study was to assess the proportion of emergency medicine physicians who had prescribed emergency contraception pills to adolescents, to identify potential barriers to emergency contraception pill prescription for adolescents, and to assess physician knowledge of emergency contraception pills.
PARTICIPANTS AND METHODS. A cross-sectional, anonymous, Internet-based survey of members of the American Academy of Pediatrics Section of Emergency Medicine was conducted. Providers were included in analysis if they were attending physicians caring for children (&lt;22 years of age) in the emergency department setting &gt;30% of the time. Survey questions included demographics, emergency contraception pill prescription rates for adolescents, attitudes toward emergency contraception pills for adolescents, and emergency contraception pill knowledge questions.
RESULTS. A total of 1005 Section of Emergency Medicine members were contacted; 424 (42%) responded, and 133 did not meet inclusion criteria. Of the 291 eligible respondents, 282 had complete surveys. Eighty-five percent of the respondents stated that they had prescribed emergency contraception pills to adolescents, 71% within the previous year. Of those, 81% prescribed emergency contraception pills &lt;5 times. The 5 most frequently cited barriers were concern for lack of follow-up (72%), time constraints (40%), lack of clinical resources (33%), discouraging regular contraceptive use (29%), and concern about birth defects (27%). Thirty-nine percent of respondents identified ≥5 barriers to emergency contraception pill prescriptions for adolescents. Forty-three percent incorrectly answered &gt;50% of the questions. Physicians were more likely to report prescribing emergency contraception pills if they had answered &gt;3 of the knowledge-based questions correctly and were less likely to report prescribing if they identified &gt;5 barriers.
CONCLUSIONS. Although a large proportion of emergency department physicians reported prescribing emergency contraception pills to adolescents, the pills were prescribed infrequently. Factors associated with nonprescription were decreased knowledge of emergency contraception pills and identifying &gt;5 barriers. Identification of these potential barriers and education regarding emergency contraception pills may ultimately improve adolescent access to emergency contraception pills in the emergency department.
Airway Obstruction During Mask Ventilation of Very Low Birth Weight Infants During Neonatal Resuscitation
Authors: Finer Neil N. , Rich Wade , Wang Casey , Leone Tina 
Published: March 2009

OBJECTIVES. The delivery of adequate but not excessive ventilation remains one of the most common problems encountered during neonatal resuscitation, especially in the very low birth weight infant. Our observations suggest that airway obstruction is a common occurrence after delivery of such infants, and we use colorimetric carbon dioxide detectors during bag-and-mask resuscitation to assist in determining whether the airway was patent. We reviewed our experience to determine the frequency of the occurrence of recognizable airway obstruction during resuscitation of very low birth weight infants.
METHODS AND PATIENTS. The previous prospective trial randomly assigned preterm infants &lt;32 weeks' gestation to resuscitation with either room air or 100% oxygen using pulse oximetry. Colorimetric carbon dioxide detectors were used to assist with bag-and-mask ventilation and to confirm intubation. From the video recordings, the number of positive pressure breaths without a color change in the detector until the breaths were associated with an unequivocal color change was counted as obstructed breaths. From the analog tracings, the number of breaths that had a peak pressure plateau of ≥0.2 second and were not associated with a color change was recorded as the number of obstructed breaths.
RESULTS. None of the studied infants required cardiopulmonary resuscitation or received epinephrine, and all were judged to have an effective circulation during resuscitation. Six of the 24 infants enrolled in the trial received only continuous positive airway pressure. The remaining 18 infants received a median of 14 obstructed breaths (range: 4–37 breaths) delivered over a mean and median interval of 56.7 and 45.0 seconds, respectively (range: 10.0–220.0 seconds). A subgroup of 11 infants was analyzed using airway-pressure data. The target peak inspiratory pressure was 30 cm H2O. Ten of these 11 infants had obstructed breaths as defined by no change in the PediCap despite reaching the target pressure for ≥0.2 second.
CONCLUSION. Airway obstruction occurs in the majority of the very low birth weight infants who receive ventilation with a face mask during resuscitation and the use of a colorimetric detector can facilitate its recognition and management.
Pediatric Primary Care to Help Prevent Child Maltreatment: The Safe Environment for Every Kid (SEEK) Model
Authors: Dubowitz Howard , Feigelman Susan , Lane Wendy , Kim Jeongeun 
Published: March 2009

CONTEXT. Effective strategies for preventing child maltreatment are needed. Few primary care–based programs have been developed, and most have not been well evaluated.
OBJECTIVE. Our goal was to evaluate the efficacy of the Safe Environment for Every Kid model of pediatric primary care in reducing the occurrence of child maltreatment.
METHODS. A randomized trial was conducted from June 2002 to November 2005 in a university-based resident continuity clinic in Baltimore, Maryland. The study population consisted of English-speaking parents of children (0–5 years) brought in for child health supervision. Of the 1118 participants approached, 729 agreed to participate, and 558 of them completed the study protocol. Resident continuity clinics were cluster randomized by day of the week to the model (intervention) or standard care (control) groups. Model care consisted of (1) residents who received special training, (2) the Parent Screening Questionnaire, and (3) a social worker. Risk factors for child maltreatment were identified and addressed by the resident physician and/or social worker. Standard care involved routine pediatric primary care. A subset of the clinic population was sampled for the evaluation. Child maltreatment was measured in 3 ways: (1) child protective services reports using state agency data; (2) medical chart documentation of possible abuse or neglect; and (3) parental report of harsh punishment via the Parent-Child Conflict Tactics scale.
RESULTS. Model care resulted in significantly lower rates of child maltreatment in all the outcome measures: fewer child protective services reports, fewer instances of possible medical neglect documented as treatment nonadherence, fewer children with delayed immunizations, and less harsh punishment reported by parents. One-tailed testing was conducted in accordance with the study hypothesis.
CONCLUSIONS. The Safe Environment for Every Kid (SEEK) model of pediatric primary care seems promising as a practical strategy for helping prevent child maltreatment. Replication and additional evaluation of the model are recommended.
Trends in High-Turnover Stays Among Children Hospitalized in the United States, 1993–2003
Authors: Macy Michelle L. , Stanley Rachel M. , Lozon Marie M. , Sasson Comilla , Gebremariam Achamyeleh , Davis Matthew M. 
Published: March 2009

OBJECTIVE. Brief hospitalizations for children may constitute an opportunity to provide care in an alternative setting such as an observation unit. The goal of this study was to characterize recent national trends in brief inpatient stays for children in the United States.METHODS. Using the Nationwide Inpatient Sample from 1993–2003, we analyzed hospital discharges among children &lt;18 years of age, excluding births, deaths, and transfers. Hospitalizations with lengths of stay of 0 and 1 night were designated as “high turnover.” Serial cross-sectional analyses were conducted to compare the proportion of high-turnover stays across and within years according to patient and hospital-level characteristics. Diagnosis-related groups and hospital charges associated with these observation-length stays were examined.RESULTS. In 2003, there were an estimated 441 363 high-turnover hospitalizations compared with 388 701 in 1993. The proportion of high-turnover stays increased from 24.9% in 1993 to 29.9% in 1999 and has remained ≥30.0% since that time. Diagnosis-related groups for high-turnover stays reflect common pediatric medical and surgical conditions requiring hospitalization, including respiratory illness, gastrointestinal/metabolic disorders, seizure/headache, and appendectomy. Significant increases in the proportion of high-turnover stays during the study period were noted across patient and hospital-level characteristics, including age group, payer, hospital location, teaching status, bed size, and admission source. High-turnover stays contributed $1.3 billion (22%) to aggregate hospital charges in 2003, an increase from $494 million (12%) in 1993.CONCLUSIONS. Consistently since 1999, nearly one third of children hospitalized in the United States experience a high-turnover stay. These high-turnover cases constitute hospitalizations, that may be eligible for care in an alternative setting. Observation units provide 1 model for an efficient and cost-effective alternative to inpatient care, in which resources and provider interactions with patients and each other are geared toward shorter stays with more timely discharge processes.
Explaining the Low Risk of Preterm Birth Among Arab Americans in the United States: An Analysis of 617451 Births
Authors: El-Sayed Abdulrahman M. , Galea Sandro 
Published: March 2009

OBJECTIVES. Arab Americans have a lower risk for preterm birth than white Americans. We assessed factors that may contribute to the association between ethnicity and preterm birth risk in Michigan, the state with the largest concentration of Arab Americans in the United States. Factors assessed as potential contributors to the ethnicity/preterm birth risk association were maternal age, parity, education, marital status, tobacco use, and maternal birthplace.
METHODS. Data were collected about all births in Michigan between 2000 and 2005. Stratified analyses, trivariate analyses, and manual stepwise logistic regression model building were used to assess potential contributors to the ethnicity/preterm birth risk association.
RESULTS. Arab ethnicity was associated with lower preterm birth risk compared with non-Arab white subjects in the unadjusted model. Maternal birthplace inside or outside the United States explained 0.17 of the difference in preterm birth risk between Arab ethnicity and non-Arab white mothers; ethnic differences in marital status and tobacco use explained less of the observed ethnic difference in preterm birth risk. In the final model adjusted for all explanatory variables, Arab ethnicity was no longer associated with preterm birth risk.
CONCLUSIONS. Maternal birthplace, marital status, and tobacco use may contribute to the preterm birth risk difference between Arab ethnicity and non-Arab white mothers. Additional work is needed to consider the mechanisms relating factors such as maternal birthplace and marital status to ethnic differences in preterm birth risk.
Reduced Infant Response to a Routine Care Procedure After Sucrose Analgesia
Authors: Taddio Anna , Shah Vibhuti , Katz Joel 
Published: March 2009

OBJECTIVES. Sucrose has analgesic and calming effects in newborns. To date, it is not known whether the beneficial effects extend to caregiving procedures that are performed after painful procedures. Our objective was to determine the effect of sucrose analgesia for procedural pain on infant pain responses during a subsequent caregiving procedure.
PATIENTS AND METHODS. We conducted a double-blind, randomized, controlled trial. Healthy neonates within 2 strata (normal infants and infants of diabetic mothers) were randomly assigned to a sucrose or placebo water group before all needle procedures after birth. Pain response during a diaper change performed after venipuncture for the newborn screening test was determined by using a validated multidimensional measure, the Premature Infant Pain Profile.
RESULTS. The study was conducted between September 15, 2003, and July 27, 2004. Altogether, 412 parents were approached; 263 consented. Twenty-three infants were not assigned, leaving 240 for participation (n = 120 per group), with an equal number in each infant strata. Of those, 186 (78%) completed the study. There were no significant differences in birth characteristics between groups. During diaper change, sucrose-treated infants had lower pain scores than placebo-treated infants. The relative risk of having pain, defined as a Premature Infant Pain Profile score of ≥6, was 0.64 with sucrose compared with placebo.
CONCLUSIONS. This study demonstrates that when used to manage pain, sucrose reduces the pain response to a subsequent routine caregiving procedure. Therefore, the benefits of sucrose analgesia extend beyond the painful event to other aversive and potentially painful procedures.
Intersex (Testicular Oocytes) in Smallmouth Bass from the Potomac River and Selected Nearby Drainages
Authors: Blazer V. S. , Iwanowicz L. R. , Iwanowicz D. D. , Smith D. R. , Young J. A. , Hedrick J. D. , Foster S. W. , Reeser S. J. 
Published: March 2009

Abstract
Intersex, or the presence of characteristics of both sexes, in fishes that are normally gonochoristic has been used as an indicator of exposure to estrogenic compounds. In 2003, during health assessments conducted in response to kills and a high prevalence of skin lesions observed in smallmouth bass Micropterus dolomieu in the South Branch of the Potomac River, the presence of immature oocytes within testes was noted. To evaluate this condition, a severity index (0–4) was developed based on the distribution of oocytes within the testes. Using gonad samples collected from 2003 to 2005, the number of histologic sections needed to accurately detect the condition in mature smallmouth bass was statistically evaluated. The reliability of detection depended on the severity index and the number of sections examined. Examining five transverse sections taken along the length of the gonad resulted in a greater than 90% probability of detecting testicular oocytes when the severity index exceeded 0.5. Using the severity index we compared smallmouth bass collected at selected sites within the South Branch during three seasons in 2004. Seasonal differences in severity and prevalence were observed. The highest prevalence and severity were consistently noted during the prespawn–spawning season, when compared with the postspawn season. In 2005, smallmouth bass were collected at selected out-of-basin sites in West Virginia where fish kills and external skin lesions have not been reported, as well as at sites in the Shenandoah River, Virginia (part of the Potomac drainage), where kills and lesions occurred in 2004–2005. The prevalence of testicular oocytes is discussed in terms of human population and agricultural intensity.
Linear Mandibular Measurements: Comparison between Orthopantomograms and Lateral Cephalograms
Authors: Ongkosuwito E. M. , Dieleman M. M. J. , Kuijpers-Jagtman A. M. , Mulder P. G. H. , van Neck J. W. 
Published: March 2009

Objective: To investigate the reliability of length measurements of the mandible by comparing orthopantomograms (OPTs) with lateral cephalograms. Design: Observational study. Setting: OPTs and lateral cephalograms were taken of 20 human dry skulls. Four orthodontists and four maxillofacial surgeons located landmarks on all radiographs using a computer program for cephalometric measurements. Intraobserver and interobserver variability in locating landmarks was assessed, as well as positioning of the skulls prior to radiography between the x-ray assistants. Magnification differences between the left and right side of the mandible on the OPT were determined for five skulls. Kappa statistics were used to calculate the intraclass correlation coefficient for intraobserver and interobserver differences. An F test was used to assess differences between methods and between type of observer. Results: No significant differences were found in the magnification factor of the left and right side of the mandible. Compared with a lateral cephalogram, the OPT had comparable reliability in measuring mandibular distances condylion-gonion, gonion-menton, and condylion-menton. No significant differences were observed between the x-ray assistants in taking the OPTs and lateral cephalograms or in repositioning the skulls. Significant differences were found between orthodontists and maxillofacial surgeons for landmark measurements. Conclusion: An OPT is as reliable as a lateral cephalogram for linear measurements of the mandible (condylion-gonion, gonion-menton, and condylion-menton).
Evaluation of Craniofacial Care outside the Brazilian Reference Network for Craniofacial Treatment
Authors: Monlleo Isabella Lopes , Mossey Peter Anthony , Gil-da-Silva-Lopes Vera Lucia 
Published: March 2009

Objective: To describe health care provided outside the Brazilian Reference Network for Craniofacial Treatment, and to inform the debate about craniofacial health care policy in Brazil. Design: Observational, retrospective cohort. Methods: Craniofacial care providers completed the same questionnaire previously used to evaluate the Brazilian Reference Network for Craniofacial Treatment (RRTDCF). Results: Units outside the RRTDCF are mainly located in the southeast region of Brazil and in universities. They comprise 56 independent clinics, 22 combined clinics, and four parental associations. Services provided are variable from unit to unit and just six of them meet the American Cleft Palate-Craniofacial Association minimum team standard. Genetic evaluation and counseling is provided by clinical geneticists in 35 units; whereas, in 30 units, it is undertaken by untrained professionals. Conclusion: A significant number of craniofacial units work in parallel and overlap the RRTDCF. They are funded by the government but not recognized as craniofacial teams. Regional disparities and lack of coordination within and between cleft lip and/or cleft palate (CL/P) teams are unsolved problems. Non-RRTDCF units are heterogeneous concerning configuration, service provided, areas of treatment, and composition of the teams. A nationwide and voluntary database on orofacial clefts is a proposed strategy to address some of these problems. Anticipated benefits include strengthening the collaboration within and between healthcare teams and supplying health authorities with a comprehensive and population-specific source of information on this prevalent and potentially preventable group of birth defects.