bluuebunny/crossref_metadata_2025_split huggingface dataset:
How Children With Special Needs Travel With Their Parents: Observed Versus Reported Use of Vehicle Restraints
Authors: Korn Taube , Katz-Leurer Michal , Meyer Shirley , Gofin Rosa 
Published: March 2007

OBJECTIVES. The difficulties entailed in transporting children with special physical and behavioral needs could influence child restraint misuse and nonuse within this population. Although parental interview is often used to assess child vehicle restraint use, little research had been performed to validate this approach, and none has been done in the special-needs population. The objectives of this study were to assess the prevalence of nonuse and misuse of child restraints in the special-needs population and to assess the validity of using parental report as a measure of child restraint use.
METHODS. Restraint use in 115 children with special needs, aged 0 to 18 years, was observed on their arrival at the parking lot of the Alyn Hospital Pediatric Rehabilitation Center in Jerusalem. The observation noted type of restraint used or absence thereof. If a restraint was used, correct use/misuse was recorded. In 94 cases, the parents were interviewed later that day in the clinic.
RESULTS. Seventy percent of the children were observed as traveling unrestrained or with a restraint that was grossly misused to the extent that it provided no meaningful protection. The remaining children were observed displaying a variety of errors in the selection or use of the restraint that compromised their safety to varying degrees. Analysis of the observation results versus parental reporting revealed a 44% overreporting of child restraint use. Sensitivity was 71%, and specificity was 86%.
CONCLUSIONS. The high prevalence of restraint nonuse and misuse within the special-needs population defines this as a population at risk and emphasizes the need for intervention. Cautious interpretation is required of information acquired from parental reporting of child restraint use. The results of this study should raise awareness among professionals working with children with special needs as to the need for tailored assessment and intervention in the area of child-passenger safety.
Stress Predicts Brain Changes in Children: A Pilot Longitudinal Study on Youth Stress, Posttraumatic Stress Disorder, and the Hippocampus
Authors: Carrion Victor G. , Weems Carl F. , Reiss Allan L. 
Published: March 2007

OBJECTIVE. Does stress damage the brain? Studies of adults with posttraumatic stress disorder have demonstrated smaller hippocampal volumes when compared with the volumes of adults with no posttraumatic stress disorder. Studies of children with posttraumatic stress disorder have not replicated the smaller hippocampal findings in adults, which suggests that smaller hippocampal volume may be caused by neurodevelopmental experiences with stress. Animal research has demonstrated that the glucocorticoids secreted during stress can be neurotoxic to the hippocampus, but this has not been empirically demonstrated in human samples. We hypothesized that cortisol volumes would predict hippocampal volume reduction in patients with posttraumatic symptoms.PATIENTS AND METHODS. We report data from a pilot longitudinal study of children (n = 15) with history of maltreatment who underwent clinical evaluation for posttraumatic stress disorder, cortisol, and neuroimaging.RESULTS. Posttraumatic stress disorder symptoms and cortisol at baseline predicted hippocampal reduction over an ensuing 12- to 18-month interval.CONCLUSIONS. Results from this pilot study suggest that stress is associated with hippocampal reduction in children with posttraumatic stress disorder symptoms and provide preliminary human evidence that stress may indeed damage the hippocampus. Additional studies seem to be warranted.
Predictors of Pain and/or Fever at 3 to 7 Days for Children With Acute Otitis Media Not Treated Initially With Antibiotics: A Meta-analysis of Individual Patient Data
Authors: Rovers Maroeska M. , Glasziou Paul , Appelman Cees L. , Burke Peter , McCormick David P. , Damoiseaux Roger A. , Little Paul , Le Saux Nicole , Hoes Arno W. 
Published: March 2007

OBJECTIVE. The goal was to determine the predictors of a prolonged course for children with acute otitis media.METHODS. A meta-analysis of data with the observation groups of 6 randomized, controlled trials was performed. Participants were 824 children, 6 months to 12 years of age, with acute otitis media. The primary outcome was a prolonged course of acute otitis media, which was defined as fever and/or pain at 3 to 7 days.RESULTS. Of the 824 included children, 303 had pain and/or fever at 3 to 7 days. Independent predictors of a prolonged course were age of &lt;2 years and bilateral acute otitis media. The absolute risk of pain and/or fever at 3 to 7 days for children &lt;2 years of age with bilateral acute otitis media (20% of all children) was 55%, and that for children ≥2 years of age with unilateral acute otitis media (47% of all children) was 25%.CONCLUSIONS. The risk of a prolonged course was 2 times higher for children &lt;2 years of age with bilateral acute otitis media than for children ≥2 years of age with unilateral acute otitis media. Clinicians can use these features (ie, age of &lt;2 years and bilateral acute otitis media) to inform parents more explicitly about the expected course of their child's otitis media and to explain which features should prompt parents to contact their clinician for reexamination of the child.
Steroid Use Among Adolescents: Longitudinal Findings From Project EAT
Authors: vandenBerg Patricia , Neumark-Sztainer Dianne , Cafri Guy , Wall Melanie 
Published: March 2007

OBJECTIVE. We examined the prevalence, persistence, secular and longitudinal trends, and predictors of steroid use in a diverse sample of adolescents.PARTICIPANTS AND METHODS. Data are from Project EAT-II (Eating Among Teens), a 5-year longitudinal study of eating, activity, weight, and related variables in 2516 middle and high school students. Data were collected in 1999 (time 1) and 2004 (time 2).RESULTS. Approximately 1.5% of adolescents reported steroid use at time 2. Use differed by ethnicity but not socioeconomic status. Steroid use was not stable across time, although the risk of use at time 2 was higher for girls and (marginally) for boys who used steroids at time 1. No secular trends were noted in middle adolescents’ steroid use between 1999 and 2004. Developmentally, steroid use decreased as adolescents grew older. Predictors of use for male adolescents included wanting to weigh more and reporting higher use of healthy weight-control behaviors. Female time 2 steroid users had higher BMIs and were less satisfied with their weight, had poorer nutrition knowledge and concern for health, and were marginally more likely to have participated in weight-related sports at time 1.CONCLUSIONS. The prevalence of steroid use in adolescents was low but of concern. Although use was not persistent over 5 years, time 1 use was a risk factor for time 2 use in female adolescents. There was no change in the prevalence of steroid use by middle adolescents between 1999 and 2004 despite a great deal of public interest in steroids during this time period. Steroid use decreased as adolescents grew older. Weight-related variables predicted adolescents’ steroid use 5 years later, and health and nutrition knowledge and concern and (marginally) participation in weight-related sports further predicted use in female adolescents. These findings suggest that early preventive efforts may be most useful.
The Influence of the Timing of Cord Clamping on Postnatal Cerebral Oxygenation in Preterm Neonates: A Randomized, Controlled Trial
Authors: Baenziger Oskar , Stolkin Florian , Keel Mathias , von Siebenthal Kurt , Fauchere Jean-Claude , Das Kundu Seema , Dietz Vera , Bucher Hans-Ulrich , Wolf Martin 
Published: March 2007

OBJECTIVE. Our goal was to investigate the effect of placentofetal transfusion on cerebral oxygenation in preterm infants by near-infrared spectroscopy.SUBJECTS. A total of 39 preterm infants with a median gestational age of 30.4 weeks were randomly assigned to an experiment group (n = 15) and a control group (n = 24).INTERVENTIONS. The delivery of the infants in the experiment group was immediately followed by maternal administration of syntocinon, the infant was placed 15 cm below the placenta, and cord clamping was delayed by 60 to 90 seconds. The infants in the control group were delivered conventionally. At the ages of 4 and 24 hours, cerebral hemoglobin concentrations, cerebral blood volume, and regional tissue oxygenation were measured by near-infrared spectroscopy.RESULTS. Cerebral blood volume was not different between the 2 groups at the age of 4 hours (6.1 vs 5.8 mL/100 g of tissue) nor at the age of 24 hours (6.2 vs 6.2 mL/100 g of tissue). Mean regional tissue oxygenation of the experiment group was higher at the ages of 4 hours (69.9% vs 65.5%) and of 24 hours (71.3% vs 68.1%).CONCLUSION. Delayed clamping of the umbilical cord improves cerebral oxygenation in preterm infants in the first 24 hours.
Cell-Cell and Cell-Extracellular Matrix Interactions Regulate Embryonic Stem Cell Differentiation
Authors: Chen Silvia S. , Fitzgerald Wendy , Zimmerberg Joshua , Kleinman Hynda K. , Margolis Leonid 
Published: March 2007

Abstract
Cell interactions with the extracellular matrix (ECM) play a critical role in their physiology. Here, we sought to determine the role of exogenous and endogenous ECM in the differentiation of nonhuman primate ESCs. We evaluated cell differentiation from expression of lineage gene mRNA and proteins using real-time polymerase chain reaction and immunohistochemistry. We found that ESCs that attached to and spread upon highly adhesive collagen do not differentiate efficiently, whereas on the less adhesive Matrigel, ESCs form aggregates and differentiate along mesoderm and especially endoderm lineages. To further decrease ESC attachment to the substrate, we cultured them either on nonadhesive agarose or in suspension. In both cases, ESCs formed aggregates and efficiently differentiated along endoderm and mesoderm lineages, most strikingly into cardiomyocytes. Aggregates formed by thus-differentiated ESCs started to beat with a frequency of 50–100 beats per minute and continued to beat for approximately a month. In spite of the presence of exogenous ECM, ESCs were dependent on endogenous ECM for their survival and differentiation, as the inhibition of endogenous collagen induced a gradual loss of ESCs and neither a simple matrix, such as type I collagen, nor the complex matrix Matrigel was able to rescue these cells. In conclusion, adhesiveness to various ECM and nonbiological substrates determines the differentiation of ESCs in such a way that efficient cell-cell aggregation, together with less efficient cell attachment and spreading, results in more efficient cell differentiation.
Characterization of the Limbal Epithelial Stem Cell Niche: Novel Imaging Techniques Permit In Vivo Observation and Targeted Biopsy of Limbal Epithelial Stem Cells
Authors: Shortt Alex J. , Secker Genevieve A. , Munro Peter M. , Khaw Peng T. , Tuft Stephen J. , Daniels Julie T. 
Published: March 2007

Abstract
It is anticipated that stem cell (SC) therapy will enable the regeneration of diseased tissues and organs. Understanding SC niches is an essential step toward realizing this goal. By virtue of its optical transparency and physical separation of SC and transient amplifying cell compartments, the human cornea provides a unique opportunity to visualize and observe a population of adult stem cells, limbal epithelial stem cells (LESCs), in their niche environment. To date, the characteristics of the LESC niche have remained unclear. State-of-the-art imaging techniques were used to construct a three-dimensional (3D) view of the entire human corneal limbus and identify the structural characteristics of the LESC niche. Two distinct candidate LESC niche structures were identified. Cells within these structures express high levels of the putative limbal stem cell markers p63α and ABCG2; however, current methods cannot identify for certain which exact cells within this cell population are truly LESCs. These structures could be located and observed in vivo in normal human subjects, but not in patients with clinically diagnosed corneal LESC deficiency. The distribution of these structures around the corneal circumference is not uniform. Biopsies targeted to limbal regions rich in LESC niche structures yielded significantly higher numbers of LESCs in culture. Our findings demonstrate how adult stem cell niches can be identified and observed in vivo in humans and provide new biological insight into the importance of LESC niche structures in maintaining normal LESC function. Finally, the concept of targeted biopsy of adult SC niches improves stem cell yield and may prove to be essential for the successful development of novel adult stem cell therapies.
Disclosure of potential conflicts of interest is found at the end of this article.
Subgingival Chlorhexidine Varnish Administration as an Adjunct to Same‐Day Full‐Mouth Root Planing. I. Clinical Observations
Authors: Cosyn Jan , Wyn Iris , De Rouck Tim , Sabzevar Mehran Moradi 
Published: March 2007

Background: Chemo‐mechanical treatment concepts have been developed to improve the outcome of non‐surgical periodontal therapy. Recently, the clinical additive value of a supersaturated chlorhexidine varnish was shown when used as an adjunct to staged scaling and root planing. The aim of this study was to investigate the clinical effects of a treatment strategy for chronic periodontitis based on a combination of same‐day full‐mouth root planing and subgingival chlorhexidine varnish administration.Methods: A randomized, controlled, single‐blind, parallel trial was conducted on 33 non‐smoking chronic periodontitis patients. The control group received oral hygiene instructions and same‐day full‐mouth root planing. The test group received the same instructions and treatment; however, all pockets were disinfected using a chlorhexidine varnish. Clinical response parameters were recorded at baseline and after 1, 3, and 6 months.Results: Both groups showed significant reductions in probing depth following therapy (P <0.001). There was no significant difference in full‐mouth probing depth between the groups at any examination point. However, when a site‐specific comparison was made, additive effects were found in the test group; an extra pocket reduction of 0.93 mm (P = 0.044) for initially deep pockets (≥7 mm) was found at study termination. Additive clinical attachment gains seemed to be temporary. Impermanent extra pocket reductions and clinical attachment gains were found for initially medium‐deep pockets (4 to 6 mm).Conclusion: The outcome of same‐day full‐mouth root planing may benefit from the subgingival administration of a highly concentrated chlorhexidine varnish, at least in terms of pocket reduction in initially deep sites (≥7 mm).
A Training Program to Improve the Ability of Periodontal Residents to Estimate Patients' Pain Experience
Authors: Kim Yoon Jeong , Lundgren Tord , Abboud Carlos , Gallez Fabrice , Park Hyoung Jin , Bogle Gary , Egelberg Jan 
Published: March 2007

Background: The purpose of this study was to determine whether periodontal residents could enhance their ability to assess the pain levels experienced by their patients from probing, using visual analog scale (VAS) to record pain. We hypothesized that with increasing experience by repeated comparisons of the patients' VAS pain ratings with independent ratings by the residents, they would improve their ability to assess their patients' pain experiences.Methods: For each of three periodontal residents, 40 consecutive patients with periodontal disease were asked to express the degree of pain they experienced during the probing. Independently, the residents rated the pain levels they perceived that the patients experienced. Subsequently, the residents compared the two VAS ratings and discussed differences in ratings with the patients. Descriptive statistics and intraclass correlation coefficients were used to analyze the findings.Results: Differences between patients' and residents' VAS scores gradually became smaller over time for two of the residents. Results for the third resident were less compelling.Conclusions: This study indicated that the training program improved the residents' ability to estimate the pain experiences of their patients, at least for two of the three participating residents. This training program, using periodontal probing as a model, could serve as an educational tool for students and practitioners who want to improve their sensitivity to their patients' pain experiences.
Effect of Long‐Term Oral Bisphosphonates on Implant Wound Healing: Literature Review and a Case Report
Authors: Wang Hom‐Lay , Weber Daniel , McCauley Laurie K. 
Published: March 2007

Background:Bisphosphonates suppress osteoclast activity, and their intravenous use has been reported in hundreds of cases to be associated with osteonecrosis in the jaw. Little is known of the risks associated with long‐term use of oral bisphosphonates despite their use for >10 years by an oral mode of delivery for the treatment of osteopenia, osteoporosis, and Paget's disease of bone. The purpose of this report is to review the literature associated with bisphosphonate use that could impact bone healing and to report a case of bone necrosis in a patient on long‐term oral bisphosphonates.Methods:A Medline search was carried out to find relevant articles from both medical and dental literature between 1960 and 2006. A patient, who had been taking an oral bisphosphonate for >10 years, developed unexplained clinical signs of bone necrosis after routine dental implant placement. This case was followed, documented, and the treatment of the osteonecrosis described.Results:A summary of how bisphosphonates may play a role in wound healing is presented. The compromised healing noted in a patient, who was under long‐term oral bisphosphonate use, was successfully treated with systemic antibiotics, local microbial mouthrinse, and aggressive defect management (detoxification and mixture of bone graft and tetracycline).Conclusions:This case suggests that patients under long‐term oral bisphosphonate use should be treated with caution. Well‐controlled, prospective clinical trials on the effect of oral bisphosphonates on bone are warranted to determine which patients may be at risk for such complications.
Association of Interleukin‐10 Gene Polymorphisms With Severe Generalized Chronic Periodontitis
Authors: Sumer A. Pinar , Kara Nurten , Keles Gonca Cayir , Gunes Sezgin , Koprulu Hulya , Bagci Hasan 
Published: March 2007

Background: Interleukin‐10 (IL‐10), an anti‐inflammatory cytokine, plays a role in periodontal disease by inhibiting synthesis of proinflammatory cytokines and stimulating protective antibody production. Genetic polymorphisms in the IL‐10 gene might be useful as a marker to diagnose susceptibility to periodontitis. Therefore, the aim of this study was to investigate the association between IL‐10 gene polymorphisms and severe generalized chronic periodontitis (CP) in a Turkish population.Methods: Samples of venous blood and DNA were obtained from 75 patients with severe generalized CP and 73 healthy subjects. The IL‐10 promoter sequences at positions −597 and −824 were amplified by polymerase chain reaction, and polymorphisms were detected by restriction enzyme cleavage. Genotype and allele frequencies were calculated, and data were analyzed using the χ2 test.Results: There was a statistically significant difference in frequencies of genotypes (AA/CC + CA: P = 0.00007, odds ratio = 12.37, 95% confidence intervals = 2.74 to 7.77; CC/CA + AA: P = 0.001, odds ratio = 3.05, 95% confidence intervals = 1.47 to 6.33) and alleles (P = 0.0002, odds ratio = 2.61, 95% confidence intervals = 1.52 to 4.51) at position −597 C to A between patients with severe generalized CP and healthy controls, whereas there was no significant difference in genotypes and allele frequencies at position −824 C to T between patients with CP and healthy subjects.Conclusion: Within the limitations of sample selection and number, the IL‐10 gene polymorphism at position −597 seems to be associated with severe generalized CP.
Arthrodesis of the Knee with a Long Intramedullary Nail Following the Failure of a Total Knee Arthroplasty as the Result of Infection
Authors: Bargiotas Konstantinos , Wohlrab David , Sewecke Jeffrey J. , Lavinge Gregory , DeMeo Patrick J. , Sotereanos Nicholas G. 
Published: March 2007

BACKGROUND:
Knee arthrodesis can be an effective treatment option for relieving pain and restoring some function after the failure of a total knee arthroplasty as the result of infection. The purpose of the present study was to review the outcome of a staged approach for arthrodesis of the knee with a long intramedullary nail after the failure of a total knee arthroplasty as the result of infection.
METHODS:
We reviewed the results for twelve patients who underwent knee arthrodesis after the removal of a prosthesis because of infection. The study group included seven women and five men who had an average age of sixty-eight years at the time of the arthrodesis. All patients were managed with a staged protocol. Implant removal, débridement, and insertion of antibiotic cement spacers was followed by the administration of systemic antibiotics. Provided that clinical and laboratory data suggested eradication of the infection, arthrodesis of the affected knee with use of a long intramedullary nail was carried out. Clinical and laboratory evaluation and radiographic analysis were performed after an average duration of follow-up of 4.1 years.
RESULTS:
Solid union was achieved in ten of the twelve knees. The average time to union was 5.5 months. One patient had an above-the-knee amputation because of recurrence of infection. In another patient, nail breakage occurred three years following implantation. The average limb-length discrepancy was 5.5 cm. The mean Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score improved from 41 to 64 points. None of the seven patients who underwent arthrodesis with a technique involving convex-to-concave reamers had a complication, and the average time to union for these seven patients was shorter than that for the remaining five patients (4.3 compared with 7.4 months).
CONCLUSIONS:
We believe that obtaining large surfaces of bleeding contact bone during arthrodesis following staged treatment of an infection at the site of a failed total knee arthroplasty contributes to stability and enhances bone-healing. Staged arthrodesis with use of a long intramedullary nail and convex-to-concave preparation of bone ends provided a painless functional gait with low complication and reoperation rates in this challenging group of patients.