bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns and Interrelationships of Body-Fat Measures Among Rural Chinese Children Aged 6 to 18 Years
Authors: Wang Hongjian , Story Rachel E. , Venners Scott A. , Wang Binyan , Yang Jianhua , Li Zhiping , Wang Liuliu , Liu Xue , Tang Genfu , Xing Houxun , Xu Xiping , Wang Xiaobin 
Published: July 2007

OBJECTIVES. Our goal was to compare BMI and waist circumference with dual-energy radiograph absorptiometry–based measures of adiposity and to describe the pattern and interrelations of these surrogate and direct adiposity measures in prepubertal and pubertal rural Chinese children.
METHODS. This was a cross-sectional study of 2493 children aged 6 to 18 years from a population-based cohort of twin pairs. Dual-energy radiograph absorptiometry–based measurements included total body fat, percentage of body fat, trunk fat, and percentage of trunk fat. Age- and gender-specific patterns and interrelationships among BMI, waist circumference, and dual-energy radiograph absorptiometry–based measurements were described by using smoothing plots and age- and gender-specific correlation analyses.
RESULTS. In girls, BMI, waist circumference, total body fat, percentage of body fat, trunk fat, and percentage of trunk fat all increased linearly with age. In boys, BMI and waist circumference increased linearly with age, but total body fat, percentage of body fat, and trunk fat did not increase significantly with age. In both genders, percentage of trunk fat reached a nadir around 12 years of age and then increased with age. Before puberty (6–11 years), BMI and waist circumference were correlated well with total body fat, percentage of body fat, and trunk fat in both genders. During puberty (12–18 years), the correlations between BMI and each of the dual-energy radiograph absorptiometry–based measurements were higher in girls than in boys. Similar trends were found in the correlations between waist circumference and each of the dual-energy radiograph absorptiometry–based measurements.
CONCLUSIONS. In this relatively lean rural Chinese population, BMI and waist circumference were highly correlated with each other and were good surrogates of total body fat, trunk fat, and percentage of body fat in prepubertal children of both genders and in pubertal girls. However, both BMI and waist circumference overestimated total and trunk fat, especially percentage of body fat in pubertal boys.
Frequency and Characteristics of Pediatric and Adolescent Visits in Naturopathic Medical Practice
Authors: Weber Wendy , Taylor James A. , McCarty Rachelle L. , Johnson-Grass Amy 
Published: July 2007

OBJECTIVES. This work sought to identify naturopathic physicians in Washington State who frequently provide pediatric care and to describe the conditions treated and therapies recommended for children.
PATIENTS AND METHODS. A mailed survey of licensed naturopathic physicians residing in Washington State collected demographic information and practice descriptions. For naturopathic physicians treating ≥5 pediatric patients per week, data were collected on the conditions seen and treatments provided to children during a 2-week period.
RESULTS. Of 499 surveys delivered to providers, 251 surveys were returned (response rate: 50.3%). Among the 204 naturopathic physicians currently practicing, only 31 (15%) saw ≥5 children per week. For these pediatric naturopathic physicians, pediatric visits constituted 28% of their office practice. Pediatric naturopathic physicians were more likely to be licensed midwives (19.4% vs 0.6%) and treated significantly more patients per week (41.6 vs 20.2) than naturopathic physicians who provided less pediatric care. Eighteen of the 31 pediatric naturopathic physicians returned data on 354 pediatric visits; 30.5% of the visits were by children &lt;2 years old, and 58.5% were by those &lt;6 years old. The most common purpose for presentation included health supervision visits (27.4%), infectious disease (20.6%), and mental health conditions (12.7%). Pediatric naturopathic physicians provided immunizations during 18.6% of health supervision visits by children &lt;2 years old and 27.3% of visits by children between the ages of 2 and 5 years.
CONCLUSIONS. Although most naturopathic physicians in Washington treat few children, a group of naturopathic physicians provide pediatric care as a substantial part of their practice. Based on the ages of children seen and the conditions treated, pediatric naturopathic physicians may provide the majority of care for some children. Efforts should be made to enhance collaboration between naturopathic physicians and conventional providers so that optimal care can be provided to children.
Injuries in Canadian Youth Ice Hockey: The Influence of Relative Age
Authors: Wattie Nick , Cobley Stephen , Macpherson Alison , Howard Andrew , Montelpare William J. , Baker Joseph 
Published: July 2007

OBJECTIVE. The purpose of this study was to investigate the relationship between relative age and injury prevalence in Canadian youth ice hockey.METHODS. In study 1, youth ice hockey–related injuries (among children 10–15 years of age) collected by the Canadian Hospitals Injury Reporting and Prevention Program between 1995 and 2002 were analyzed. The relative ages of injured children were compared across different age groups and injury characteristics (mechanism of injury and severity of injury). In study 2, injuries reported in the Hockey Canada Insurance Database were analyzed. The relative ages of injured children at different levels of play (ie, representative versus house league teams) were compared.RESULTS. In study 1, the majority of injured players were of older relative age. However, relative age was not related to mechanism of injury or severity of injury. In study 2, ∼40% of injured players at the highest level of play were relatively older, whereas only 20% to 25% of house league injured players were relatively older.CONCLUSION. Relatively older children within ice hockey age groups are at increased risk of injury compared with their younger peers. Furthermore, the risk of injury for relatively older players is greater at more competitive levels of play. This study proposes that the relative age advantage associated with selection to Canadian youth ice hockey teams is accompanied by an increased risk of injury.
Abnormal Thermoregulatory Responses in Adolescents With Chronic Fatigue Syndrome: Relation to Clinical Symptoms
Authors: Wyller Vegard Bruun , Godang Kristin , Mørkrid Lars , Saul Jerome Philip , Thaulow Erik , Walløe Lars 
Published: July 2007

OBJECTIVES. Chronic fatigue syndrome is a common and disabling disease of unknown etiology. Accumulating evidence indicates dysfunction of the autonomic nervous system. To further explore the pathophysiology of chronic fatigue syndrome, we investigated thermoregulatory responses dependent on catecholaminergic effector systems in adolescent patients with chronic fatigue syndrome.
PATIENTS AND METHODS. A consecutive sample of 15 patients with chronic fatigue syndrome aged 12 to 18 years and a volunteer sample of 57 healthy control subjects of equal gender and age distribution were included. Plasma catecholamines and metanephrines were measured before and after strong cooling of 1 hand. Acral skin blood flow, tympanic temperature, heart rate, and mean blood pressure were measured during moderate cooling of 1 hand. In addition, clinical symptoms indicative of thermoregulatory disturbances were recorded.
RESULTS. Patients with chronic fatigue syndrome reported significantly more shivering, sweating, sudden change of skin color, and feeling unusually warm. At baseline, patients with chronic fatigue syndrome had higher levels of norepinephrine, heart rate, epinephrine, and tympanic temperature than control subjects. During cooling of 1 hand, acral skin blood flow was less reduced, vasoconstrictor events occurred at lower temperatures, and tympanic temperature decreased more in patients with chronic fatigue syndrome compared with control subjects. Catecholamines increased and metanephrines decreased similarly in the 2 groups.
CONCLUSIONS. Adolescent patients with chronic fatigue syndrome have abnormal catecholaminergic-dependent thermoregulatory responses both at rest and during local skin cooling, supporting a hypothesis of sympathetic dysfunction and possibly explaining important clinical symptoms.
A Decline in the Frequency of Neonatal Exchange Transfusions and Its Effect on Exchange-Related Morbidity and Mortality
Authors: Steiner Laurie A. , Bizzarro Matthew J. , Ehrenkranz Richard A. , Gallagher Patrick G. 
Published: July 2007

OBJECTIVE. Our goal was to identify trends in patient demographics and indications for and complications related to neonatal exchange transfusion over a 21-year period in a single institution using a uniform protocol for performing the procedure.METHODS. A retrospective chart review of 107 patients who underwent 141 single- or double-volume exchange transfusions from 1986–2006 was performed. Patients were stratified into 2 groups, 1986–1995 and 1996–2006, on the basis of changes in clinical practice influenced by American Academy of Pediatrics management guidelines for hyperbilirubinemia.RESULTS. There was a marked decline in the frequency of exchange transfusions per 1000 newborn special care unit admissions over the 21-year study period. Patient demographics and indications for exchange transfusion were similar between groups. A significantly higher proportion of patients in the second time period received intravenous immunoglobulin before exchange transfusion. There was a higher proportion of patients in the 1996–2006 group with a serious underlying condition at the time of exchange transfusion. During that same time period, a lower proportion of patients experienced an adverse event related to the exchange transfusion. Although a similar percentage of patients in both groups experienced hypocalcemia and thrombocytopenia after exchange transfusion, patients treated from 1996–2006 were significantly more likely to receive calcium replacement or platelet transfusion. No deaths were related to exchange transfusion in either time period.CONCLUSIONS. Improvements in prenatal and postnatal care have led to a sharp decline in the number of exchange transfusions performed. This decline has not led to an increase in complications despite relative inexperience with the procedure.
Preventable and Unpreventable Causes of Childhood-Onset Epilepsy Plus Mental Retardation
Authors: Camfield Carol , Camfield Peter 
Published: July 2007

OBJECTIVE. The objective of this study was to determine the causes of childhood epilepsy associated with mental retardation and determine whether these causes are preventable.
METHODS. We selected all patients from the Nova Scotia population-based childhood epilepsy cohort (n = 692) who had mental retardation and had epilepsy onset between 1977 and 1985. Causes and family history were determined by chart review and caregiver interview after 18.8 (SD: ±7) years of follow-up.
RESULTS. Overall, 147 patients had mental retardation and epilepsy (21% of all childhood epilepsy). Standard psychological testing was available for 57%; 38.5% were too impaired for testing, which left 4% with the degree of mental retardation assessed clinically. Severe/profound mental retardation predominated (mild: 24%; moderate: 23%, severe/profound: 53%). Fifty-nine percent had additional severe neurologic deficits, most often associated with severe mental retardation. Epilepsy syndromes were symptomatic generalized (n = 73), partial (n = 58), and other (n = 16). Most had a brain imaging study: 91% had a computed tomography scan, and 12% had an MRI scan. Sixty-three percent had a defined cause; 37% had an unknown cause. A defined cause was more likely in those with severe mental retardation (60 of 78 vs 31 of 65). Identified causes were prenatal or genetic (65%), perinatal (8%), or complications of prematurity (13%). Only 11 (7%) had an acquired cause that was potentially preventable. Many (36%) had a first- or second-degree relative with epilepsy, more often in those without a clear cause (54% vs 30%) and without additional neurologic disability (57% vs 26%).
CONCLUSIONS. Approximately 20% of children with epilepsy have mental retardation. The cause is prenatal or genetic in nearly two thirds, and only 7% have an acquired, preventable cause. Important genetic influences may be present, especially in the absence of a defined cause.
Malpractice Claims Involving Pediatricians: Epidemiology and Etiology
Authors: Carroll Aaron E. , Buddenbaum Jennifer L. 
Published: July 2007

OBJECTIVE. Our goals were to examine malpractice claims data that are specific to the specialty of pediatrics and to provide a better understanding of the effect that malpractice has on this specialty.
METHODS. The Physician Insurers Association of America is a trade association of medical malpractice insurance companies. The data contained in its data-sharing project represent ∼25% of the medical malpractice claims in the United States at a given time. Although this database is not universally comprehensive, it does contain information not available in the National Practitioner Data Bank, such as information on claims that are not ultimately paid and specialty of the defendant. We asked the Physician Insurers Association of America to perform a query of its data-sharing project database to find malpractice claims reported between January 1, 1985, and December 31, 2005, in which the defendant's medical specialty was coded as pediatrics. Comparison data were collected for 27 other specialties recorded in the database.
RESULTS. During a 20-year period (1985–2005), there were 214226 closed claims reported to the Physician Insurers Association of America data-sharing project. Pediatricians account for 2.97% of these claims, making it 10th among the 28 specialties in terms of the number of closed claims. Pediatrics ranks 16th in terms of indemnity payment rate (28.13%), with dentistry ranked highest at 43.35%, followed by obstetrics and gynecology at 35.50%. Indemnity payment refers to settlements or awards made directly to plaintiffs as a result of claim-resolution process. Data are presented on changes over time, claim-adjudication status, expenses on claims, the causes of claims, and injuries sustained.
CONCLUSIONS. Malpractice is a serious issue. Some will read the results of this analysis and draw comfort; others will view the same data with alarm and surprise. Regardless of how one interprets these findings, they are important in truly informing the debate with generalizable facts.
Botulinum Toxin for Spasticity in Children With Cerebral Palsy: A Comprehensive Evaluation
Authors: Bjornson Kristie , Hays Ross , Graubert Cathy , Price Robert , Won Francine , McLaughlin John F. , Cohen Morty 
Published: July 2007

BACKGROUND. Spasticity is a prevalent disabling clinical symptom for children with cerebral palsy. Treatment of spasticity with botulinum toxin in children with cerebral palsy was first reported in 1993. Botulinum toxin provides a focal, controlled muscle weakness with reduction in spasticity. Interpretation of the literature is difficult because of the paucity of reliable measures of spasticity and challenges with measuring meaningful functional changes in children with disabilities.OBJECTIVE. This study documents the effects of botulinum toxin A injections into the gastrocnemius muscles in children with spastic diplegia. Outcomes are evaluated across all 5 domains of the National Centers for Medical and Rehabilitation Research domains of medical rehabilitation.METHODS. A randomized, double-masked, placebo-controlled design was applied to 33 children with spastic diplegia with a mean age of 5.5 and Gross Motor Function Classification System Levels of I through III. Participants received either 12 U/kg botulinum toxin A or placebo saline injections to bilateral gastrocnemius muscles. Outcomes were measured at baseline and 3, 8, 12, and 24 weeks after injection.RESULTS. Significant decreases in the electromyographic representation of spasticity were documented 3 weeks after botulinum toxin A treatment. A significant decrease in viscoelastic aspects of spasticity was present at 8 weeks, and subsequent increases in dorsiflexion range were documented at 12 weeks for the botulinum toxin A group. Improvement was found in performance goals at 12 weeks and in maximum voluntary torque and gross motor function at 24 weeks for the botulinum toxin A. There were no significant differences between groups in satisfaction with performance goals, energy expenditure, Ashworth scores, or frequency of adverse effects.CONCLUSIONS. The safety profile of 12 U/kg of botulinum toxin A is excellent. Although physiologic and mechanical effects of treatment with botulinum toxin A were documented with functional improvement at 6 months, family satisfaction with outcomes were no different. Communication is needed to ensure realistic expectations of treatment.
Preparation for Emergencies in the Offices of Pediatricians and Pediatric Primary Care Providers
Authors:   Committee on Pediatric Emergency Medicine
Published: July 2007

This Policy Statement was reaffirmed June 2011 and November 2018.
High-quality pediatric emergency care can be provided only through the collaborative efforts of many health care professionals and child advocates working together throughout a continuum of care that extends from prevention and the medical home to prehospital care, to emergency department stabilization, to critical care and rehabilitation, and finally to a return to care in the medical home. At times, the office of the pediatric primary care provider will serve as the entry site into the emergency care system, which comprises out-of-hospital emergency medical services personnel, emergency department nurses and physicians, and other emergency and critical care providers. Recognizing the important role of pediatric primary care providers in the emergency care system for children and understanding the capabilities and limitations of that system are essential if pediatric primary care providers are to offer the best chance at intact survival for every child who is brought to the office with an emergency. Optimizing pediatric primary care provider office readiness for emergencies requires consideration of the unique aspects of each office practice, the types of patients and emergencies that might be seen, the resources on site, and the resources of the larger emergency care system of which the pediatric primary care provider's office is a part. Parent education regarding prevention, recognition, and response to emergencies, patient triage, early recognition and stabilization of pediatric emergencies in the office, and timely transfer to an appropriate facility for definitive care are important responsibilities of every pediatric primary care provider. In addition, pediatric primary care providers can collaborate with out-of-hospital and hospital-based providers and advocate for the best-quality emergency care for their patients.
Comparative Thermal Requirements of Westslope Cutthroat Trout and Rainbow Trout: Implications for Species Interactions and Development of Thermal Protection Standards
Authors: Bear Elizabeth A. , McMahon Thomas E. , Zale Alexander V. 
Published: July 2007

AbstractWater temperature appears to play a key role in determining population persistence of westslope cutthroat trout Oncorhynchus clarkii lewisi, but specific thermal performance and survival criteria have not been defined. We used the acclimated chronic exposure laboratory method to determine upper thermal tolerances and growth optima of westslope cutthroat trout and rainbow trout O. mykiss, a potential nonnative competitor that occupies much of the former range of westslope cutthroat trout. Rainbow trout had a distinct survival advantage over westslope cutthroat trout at water temperatures above 20°C. The ultimate upper incipient lethal temperature of rainbow trout (24.3°C; 95% confidence interval [CI] = 24.0–24.7°C) was 4.7°C higher than that of westslope cutthroat trout (19.6°C; 95% CI = 19.1–19.9°C). In contrast, both species had similar growth rates and optimum growth temperatures (westslope cutthroat trout: 13.6°C; rainbow trout: 13.1°C) over the temperature range of 8–20°C, although rainbow trout grew over a wider range and at higher temperatures than did westslope cutthroat trout. The rainbow trout's higher upper temperature tolerance and greater growth capacity at warmer temperatures may account for the species' displacement of westslope cutthroat trout at lower elevations. Our results indicate that maximum daily temperatures near the optimum growth temperature of 13–15°C would ensure suitable thermal habitat for westslope cutthroat trout populations. The low upper temperature tolerance and optimum growth temperature of westslope cutthroat trout relative to those of other salmonids suggest that this subspecies may be particularly susceptible to stream temperature increases associated with global warming and anthropogenic habitat disturbance.
Antinociceptive effects of butorphanol, buprenorphine, or both, administered intramuscularly in cats
Authors: Johnson Jacob A. , Robertson Sheilah A. , Pypendop Bruno H. 
Published: July 2007

Abstract
Objective—To characterize the antinociceptive action of IM-administered butorphanol, buprenorphine, or a combination of both by use of a thermal threshold method in cats.
Animals—2 male and 4 female domestic cats.
Procedures—In a controlled, masked, randomized, crossover study design, thermal thresholds were measured by use of a thermal threshold–testing device developed for cats. Each cat received 4 treatments 1 week apart, consisting of 2 simultaneous IM injections in a random order (butorphanol-saline [0.9% NaCl] solution, buprenorphine-saline solution, butorphanol-buprenorphine, and saline solution-saline solution). The tester was unaware of the treatment given. Thermal thresholds were measured prior to injection, at intervals up to 12 hours, and at 22 hours after injection.
Results—There was no significant change in threshold over time after saline solution administration. All 3 opioid treatment groups had significant increases in thermal threshold, compared with pretreatment values (butorphanol, from 50 minutes to 8 hours; buprenorphine, from 35 minutes to 5 hours; and butorphanol-buprenorphine, from 50 minutes to 8 hours). Thermal thresholds did not differ significantly among opioid treatments at any time points, and thermal thesholds of only 2 opioid treatments (butorphanol at 50 minutes and butorphanol-buprenorphine at 8 hours) were significantly different from that of saline solution.
Conclusions and Clinical Relevance—All 3 opioid treatments provided similar antinociception, although there was considerable intercat variability in the response to the different opioid treatments. This emphasizes the importance of assessing each patient individually and applying the treatment that works best for that patient.