bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long-Path Infrared Spectrocopy for Air Pollution Research
Authors: Stephens Edgar R. 
Published: November 2005

A long-path absorption cell was developed for the measurement of gaseous contaminants in the atmosphere and for the studies of reactions of contaminants in the laboratory The instrument is based on the White multiple-reflection system, having two large spherical mirrors at one end of the 3-meter cell and one smaller one at the other end of equal radius. To avoid excessive loss of radiant energy, the infrared source image is magnified and demagnified to match the cell to the spectrometer Optimum path-length for maximum signal is reached when reflection losses reduce the energy to 1/e of its initial value. CO2 and water vapor interfere with, but do not prohibit, useful analyses of the atmosphere Two of these cells are in use, one in the Philadelphia laboratory and one in a field-study trailer in the Los Angeles area
High Resolution Infrared Spectroscopy in the Analysis of Liquids and Solutions
Authors: Sloane Howard J. 
Published: November 2005

Careful examination of organic liquids and solutions at very narrow spectral slit widths indicates that many compounds exhibit several absorptions of half band width narrower than 5 cm−1, particularly at the medium and long wavelengths. This suggests that sodium chloride prism spectrophotometers are currently being operated under conditions which produce rather significant errors in intensity and band width on some narrow bands. In order that this “finite slit error ‘be 3% or less in measuring peak absorbance, a spectral slit width about 1/5 of the natural half band width must be employed, e.g., a resolution of 1 cm−1 for a band of 5 cm−1 half band width The high resolution afforded by the grating instrument allows accurate intensity measurements on the typically narrow bands of such materials as indene at 1018 cm−1, cyclohexane at 861 and 903 cm−1 and acetonitrile at 2255 cm−1. Other advantages of the high resolution grating spectrophotometer for solution spectroscopy are discussed
The Nuclear Magnetic Resonance Spectra of Compounds Related to DDT. I. Non-Aromatic Protons
Authors: Sharpless Norman E. , Bradley Robert B. 
Published: November 2005

The nuclear magnetic resonance spectra of a series of compounds related to DDT have been studied as they are influenced by ring or aliphatic substituents or by aliphatic structural changes The chemical shift of the benzylic or α proton follows the Hammett equation for ring substituents and the Taft variation of this equation for aliphatic substituents. Alkoxy substituents on the ring show alternation of chemical shift of the —OCH2— group protons with chain length and limiting behavior of the terminal methyl group with chain length. Dehydrochlorination of o,p-DDD produces cis-trans isomers. Coupling constants are shown to be influenced by ring substitution, particularly ortho chlorine.
Administration of Epinephrine for Life-Threatening Allergic Reactions in School Settings
Authors: McIntyre C. Lynne , Sheetz Anne H. , Carroll Constance R. , Young Michael C. 
Published: November 2005

Objective. Although the potential for life-threatening allergic reactions in children is a significant health concern for schools, there is little information about the circumstances surrounding anaphylactic events that occur in schools. The objectives of this study were to determine the incidence of anaphylaxis in schools, describe the circumstances around anaphylactic events, assess practices that are used to manage students with life-threatening allergies, and identify opportunities for improvement.Methods. A total of 109 school districts in Massachusetts completed an Epinephrine Administration Form whenever epinephrine was administered at school. Data were collected from September 2001 to August 2003.Results. Forty-eight school districts reported a total of 115 administrations of epinephrine during the 2-year reporting period. In 24% of the cases, the individual was not known to have a life-threatening allergy. Almost one third (31%) of the students who received epinephrine had allergies to multiple substances, and one quarter (25%) had an allergy to peanuts or tree nuts only. Twenty-two (19%) cases occurred outside the school building on the playground, traveling to and from school, or on field trips. The administration of epinephrine most often occurred in the health office by a registered nurse. The average time from onset of symptoms to administration of epinephrine was 10 minutes. In 92% of the cases, the student was transported to a medical facility via the emergency medical system.Conclusions. Anaphylactic reactions in schools, although not frequent, are not uncommon events. A systematic review of anaphylactic events that required epinephrine administration identified opportunities for improvement in the treatment of students with life-threatening allergies.
Regional Variation in Rates of Low Birth Weight
Authors: Thompson Lindsay A. , Goodman David C. , Chang Chiang-Hua , Stukel Thérèse A. 
Published: November 2005

Objective. Low birth weight (LBW; &lt;2500 g) is the result of complex and poorly understood interactions between the biological determinants of the mother and the fetus, the parent’s socioeconomic status, and medical care. After controlling for these established risk factors, the extent of regional variation in LBW rates remains unknown. This study measures regional variation in LBW rates and identifies regions of neonatal health services with significantly high or low adjusted rates.
Methods. Linking the United States 1998 singleton birth cohort (N = 3.8 million) with county and health care characteristics, we conducted a small area analysis of LBW across 246 regions of neonatal health services. We measured observed rates and then used a multivariable, hierarchical model to estimate adjusted LBW rates by regions. We then stratified these rates by race for the 208 regions with adequate sample size.
Results. Observed LBW rates varied across regions from 3.8 to 10.6 per 100 live births (interquartile range: 5.0–6.8 [25th–75th percentile]; median: 5.9). After controlling for known maternal and area risk factors, 67 (27.0%) regions had rates significantly below and 98 (39.8%) regions had rates significantly higher than the national rate of 6.0 per 100 live births. Although black mothers were more likely to give birth to an LBW newborn, regional adjusted rates still varied &gt;3-fold within both black and nonblack subgroups.
Conclusions. After controlling for known maternal and area risk factors, LBW rates markedly varied across US regions of neonatal health services for both black and nonblack mothers. Additional analyses of these regions may provide opportunities for regional accountability in pregnancy outcomes, LBW research, and targeted improvement interventions, especially in high-risk populations.
C-Reactive Protein in the Diagnosis, Management, and Prognosis of Neonatal Necrotizing Enterocolitis
Authors: Pourcyrous Massroor , Korones Sheldon B. , Yang Wenjian , Boulden Thomas F. , Bada Henrietta S. 
Published: November 2005

Objective. In this prospective, observational study, we determined whether serum C-reactive protein (CRP) correlated with necrotizing enterocolitis (NEC) stages II and III. We hypothesized that serial CRP measurement if used as an adjunct to abdominal radiographs would improve the identification of infants with NEC.Methods. Serum CRP level was measured every 12 hours for 3 measurements and, when abnormal, once daily. When clinical signs persisted and the initial abdominal radiographs were abnormal, follow-up radiographs were obtained.Results. Of 241 infants who were evaluated for gastrointestinal signs, 11 had ileus or benign pneumatosis intestinalis with persistently normal CRP; gastrointestinal manifestations resolved within 48 hours, antibiotics were discontinued in &lt;48 hours, and feedings were restarted early without complications. Fifty-five infants had NEC stages II and III; all had abnormal CRP regardless of their blood culture results. In infants with stage II NEC, CRP returned to normal at a mean of 9 days except in those who developed complications such as stricture or abscess formation.Conclusions. In infants with suspected NEC, normal serial CRP values would favor aborted antibiotic therapy and early resumption of feedings. CRP becomes abnormal in both stage II and stage III NEC. In infants with NEC, persistently elevated CRP after initiation of appropriate medical management suggests associated complications, which may require surgical intervention.
Parents’ Perceptions of Factors That Affect Successful Diabetes Management for Their Children
Authors: Ginsburg Kenneth R. , Howe Carol J. , Jawad Abbas F. , Buzby Marianne , Ayala Judith M. , Tuttle Alan , Murphy Kathryn 
Published: November 2005

Objective. To learn which factors parents perceive to be most influential in determining successful type 1 diabetes management.
Methods. A 4-stage mixed qualitative-quantitative method that consists of a series of focus groups, a survey, and in-depth interviews was used to ensure that parents generated, prioritized, and explained their own ideas. In each stage, parents offered a new level of insight into their perception of how children achieve good metabolic control while living as normal a life as possible. The survey responses were divided into statistically different ranks, and the Kruskal-Wallis test was used to compare the results between subgroups.
Results. A total of 149 parents participated in the formative qualitative phases, 799 families (66%) responded to the parent-generated survey, and 67 explanatory interviews were conducted. The families who responded to the survey had children of varied ages (mean: 11.9 years; SD: 4.44) and diabetes control (mean hemoglobin A1c: 8.22%; SD: 1.65); 84.1% of respondents were white, 12.3% were black, and 89% were privately insured. The 30 survey items were statistically discriminated into 8 ranks. The items cover a wide range of categories, including concrete ways of achieving better control, families’ or children’s traits that affect coping ability, actions of the health care team that support versus undermine families’ efforts, and the availability of community supports. No clear pattern emerged regarding 1 category that parents perceived to matter most.
Conclusions. Clinicians can affect many of the factors that parents perceive to make a difference in whether they can successfully raise a resilient child in good diabetes control. Future research needs to determine whether health care teams that address the concerns that parents raised in this study are more effective in guiding children to cope well with diabetes, to incorporate healthier lifestyles, and ultimately to achieve better metabolic control.
Prevalence of Impaired Fasting Glucose and Its Relationship With Cardiovascular Disease Risk Factors in US Adolescents, 1999–2000
Authors: Williams Desmond E. , Cadwell Betsy L. , Cheng Yiling J. , Cowie Catherine C. , Gregg Edward W. , Geiss Linda S. , Engelgau Michael M. , Narayan K. M. Venkat , Imperatore Giuseppina 
Published: November 2005

Objective. PEDIATRICS (ISSN 0031 4005). Published in the public domain by the American Academy of Pediatrics.Several studies have reported increases in the occurrence of type 2 diabetes in youths. People with prediabetic states such as impaired fasting glucose (IFG) are at increased risk for developing diabetes and cardiovascular disease (CVD). The objective of this study was to examine the prevalence of IFG and its relationship with overweight and CVD risk factors in a nationally representative sample of US adolescents who were aged 12 to 19 years.
Methods. We used data from the 1999–2000 National Health and Nutrition Examination Survey (NHANES). Adolescents who had fasted for 8 hours or more were included in the study (n = 915). IFG was defined as a fasting glucose of 100 to 125 mg/dL. Participants were classified as overweight when their age- and gender-specific BMI was ≥95th percentile and as at-risk for overweight when their BMI was ≥85th and &lt;95th percentile.
Results. In 1999–2000, the prevalence of IFG in US adolescents was 7.0% and was higher in boys than in girls (10.0% vs 4.0%). Prevalence of IFG was higher in overweight adolescents (17.8%) but was similar in those with normal weight and those who were at risk for overweight (5.4% vs 2.8%). The prevalence of IFG was significantly different across racial/ethnic groups (13.0%, 4.2%, and 7% in Mexican Americans, non-Hispanic black individuals, and non-Hispanic white individuals, respectively). Adolescents with IFG had significantly higher mean hemoglobin A1c, fasting insulin, total and low-density lipoprotein cholesterol, triglycerides, and systolic blood pressure and lower high-density lipoprotein cholesterol than those with normal fasting glucose concentrations.
Conclusions. These data, representing 27 million US adolescents, reveal a very high prevalence of IFG (1 in 10 boys and 1 in 25 girls) among adolescents; the condition affects 1 in every 6 overweight adolescents. Adolescents with IFG have features of insulin resistance and worsened CVD risk factors. Evidence for prevention is still forthcoming in this age group.
Cost and Utilization Analysis of a Pediatric Emergency Department Diversion Project
Authors: Wang Cheng , Villar Maria Elena , Mulligan Deborah A. , Hansen Toran 
Published: November 2005

Objective. States are struggling to find effective means to decrease Medicaid costs. The objective of this pilot study was to compare emergency department (ED) cost and utilization by members who were enrolled in a pilot program (designed to reduce the use of hospital EDs) with the costs and utilization incurred by a control group.Methods. A large, private, primary care pediatric practice launched a pilot ED diversion program that provided extended office hours, multiple access locations, and care coordination. Participants in the program were Medicaid recipients who were younger than 18 years. Enrollment in the program was through either patient self-selection or mandatory assignment by the state Medicaid agency. A total of 17382 children who were enrolled in the enhanced access program (intervention group) and 26066 Medicaid-eligible children who received services from other local community primary care providers (control group) were included in the study. Children who had chronic health conditions and were receiving Supplemental Security Income benefits were excluded from this analysis. Regression analyses and t tests were applied to analyze the medical claim data that were collected for this project. Three variables were used as dependent variables to measure different aspects of the ED cost and utilization: per member per month cost, per thousand member per month encounter frequency, and per encounter cost. These variables were used to compare the intervention group with the control group for ED claims, as well as for the overall cost of care during the study period.Results. In the 12-month period subsequent to program initiation, the average per member per month cost for ED utilization of the intervention group was $1.36 less than that of the control group. However, there was no significant difference in terms of per-visit cost related to ED utilization. Therefore, the savings seemed to come as a result of a reduction in ED visits, not from reduced cost per visit. On average, children in the intervention group visited the ED approximately 8 fewer times per thousand members per month than the control group, yet there was no significant difference in the overall (ED and non-ED) cost of care between the intervention and control groups.Conclusion. Analysis from the first year of this pilot program demonstrates that by providing enhanced, coordinated, primary care access to Medicaid children, the utilization of the ED was significantly lowered among healthy children, whereas the overall cost of care remained the same.
Successful Treatment of Chronic Recurrent Multifocal Osteomyelitis With Tumor Necrosis Factor-α Blockage
Authors: Deutschmann Andrea , Mache Christoph J. , Bodo Koppany , Zebedin Doris , Ring Ekkehard 
Published: November 2005

We describe the case of an 18-year-old girl with chronic recurrent multifocal osteomyelitis (CRMO) over a period of 10 years. She had suffered predominantly from very painful recurrent swelling of her cheeks. Various therapeutic regimens including nonsteroidal antiinflammatory drugs and steroids had shown only a partial or temporary response.
Because tumor necrosis factor-α–blocking agents have been successfully applied in Crohn's-associated CRMO and the related SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) syndrome, tumor necrosis factor-α–blocking therapy with infliximab was initiated. Thereafter, apart from 1 mild episode, no additional recurrences were observed during 21 months of follow-up. Infliximab was well tolerated, and steroids were tapered off.
Our observation indicates that infliximab may be an effective therapeutic option in CRMO.
Prenatal Exposure to Cigarettes, Alcohol, and Coffee and the Risk for Febrile Seizures
Authors: Vestergaard Mogens , Wisborg Kirsten , Henriksen Tine Brink , Secher Niels Jørgen , Østergaard John R. , Olsen Jørn 
Published: November 2005

Objective. Febrile seizure is a common type of seizure in childhood, probably caused by both genetic and early environmental factors. Little is known about the effect of environmental factors that operate in prenatal life, although the fetal brain may be particular vulnerable as a result of extensive brain growth and differentiation in this period. We evaluated the association between prenatal exposure to cigarettes, alcohol, and coffee and the risk for febrile seizures in 2 population-based birth cohorts.
Methods. The Aarhus Birth Cohort consisted of 25196 children of mothers who were scheduled to deliver at Aarhus University Hospital (1989–1996). The Aalborg-Odense cohort consisted of 10400 children of women who attended antenatal care in Odense or Aalborg (1984–1987). Both cohorts were linked with the Danish National Hospital Register and followed until December 1998 with a complete follow-up. We extracted from medical records additional information on febrile seizures in children in the Aarhus Birth Cohort who were born between 1989 and 1992.
Results. We found a slightly increased risk for febrile seizures in children who were exposed to 10 or more cigarettes per day in the Aarhus Birth Cohort, but the corresponding association was weak in the Aalborg-Odense cohort. We found no association between maternal alcohol and coffee consumption and the risk for febrile seizures. The results were similar for simple and complex febrile seizures.
Conclusions. Our data suggest that prenatal exposure to low to moderate levels of alcohol and coffee has no impact on the risk for febrile seizures, whereas a modest smoking effect cannot be ruled out.
Sublingual Sugar Administration as an Alternative to Intravenous Dextrose Administration to Correct Hypoglycemia Among Children in the Tropics
Authors: Barennes Hubert , Valea Innocent , Nagot Nicolas , Van de Perre Philippe , Pussard Eric 
Published: November 2005

Background. Hypoglycemia is a common determining factor of poor prognosis for children with severe malaria in sub-Saharan Africa. Intravenous dextrose administration is rarely available. Oral mucosal delivery may be an alternative to parenteral administration. A randomized, clinical trial was performed in Burkina Faso among moderately hypoglycemic children, comparing sublingual sugar administration with oral water, oral sugar, and dextrose infusion administrations.
Methods. Sixty-nine children with glucose concentrations of &lt;0.8 g/L were assigned randomly to 1 of 4 methods of administration, 1 with 3 different doses of sugar, as follows: oral group (OG) (n = 15): 2.5 g of sugar; sublingual group (SG) (n = 27): 2.5 g of sugar under the tongue, with 3 treatment subgroups, ie, 0.1 g/kg, 0.15 g/kg, and 0.2 g/kg; intravenous group (IG) (n = 8): 8 mL of 30% dextrose in a single bolus; water group (n = 11). Eight children received sublingual sugar twice, ie, 0.1 g/kg at baseline and 20 minutes later. Blood glucose concentrations were measured every 20 minutes for 80 minutes. Treatment failures, peak glucose concentrations, times to glucose concentration normalization, and kinetic profiles were evaluated.
Results. No treatment failures were observed in the SG and IG, compared with 8 (53%) and 9 (81.8%) failures in the OG and water group, respectively. SG children exhibited glucose kinetic profiles and bioavailabilities (77%, 99%, and 81% in the 3 SG groups) similar to those of IG children. Bioavailabilities were 84% and 38% in the SG and OG, respectively. Children &gt;7 years of age required repeated sublingual administrations to maintain normoglycemia.
Conclusions. The sublingual administration of sugar proved to be effective among moderately hypoglycemic children. It is a simple and promising method to control hypoglycemia among children in both developing and developed countries. This pediatric practice should be investigated in more detail among children with severe malaria.
Insurance Gaps Among Vulnerable Children in the United States, 1999–2001
Authors: Satchell Marlon , Pati Susmita 
Published: November 2005

Objective. To quantify the number of children who experience gaps in insurance coverage and to determine whether vulnerable subgroups of children experience noteworthy lapses in insurance coverage.Methods. We analyzed nationally representative data from 24149 children sampled in the 1999–2001 Medical Expenditure Panel Survey linked to the 1997–1999 National Health Interview Survey. Vulnerable subgroups of children included children with chronic conditions, those from ethnic/racial minorities, and those living in poverty. On the basis of cumulative annual monthly insurance coverage status, each child fell into 1 of 3 groups: continuous coverage, uninsured, or gaps in coverage. Using SAS-callable SUDAAN, we conducted multivariate ordinal logistic regression model to quantify the likelihood of having gaps in coverage for vulnerable subgroups of children.Results. From 1999 to 2001, we found that &gt;9 million American children annually had gaps in coverage and that 5 to 6 million children annually were uninsured for the entire year. Sixty percent of children experienced gaps of at least 4 months, and &gt;40% of all publicly and privately insured children had coverage gaps. After accounting for relevant covariates, children with chronic conditions were just as likely as other children to have gaps in coverage or be uninsured; Hispanic children were most likely to have insurance gaps or be uninsured; and children from poor and near-poor families were 4 to 5 times more likely to have lapsed coverage than children from high-income families. Poverty and maternal education were the strongest factors associated with lapsed coverage.Conclusions. Unstable health insurance is an underrecognized problem for children, including those with chronic conditions. Because unstable insurance coverage can lead to inadequate health care utilization and poor child health outcomes, strategies to promote stable insurance coverage merit serious consideration.