bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategies for regulation of hemolymph pH in acidic and alkaline water by the larval mosquitoAedes aegypti(L.) (Diptera; Culicidae)
Authors: Clark Thomas M. , Vieira Marcus A. L. , Huegel Kara L. , Flury Dawn , Carper Melissa 
Published: November 2007

SUMMARYThe responses of larval Aedes aegypti to media of pH 4, 7 and 11 provide evidence for pH regulatory strategies. Drinking rates in pH 4 media were elevated 3- to 5-fold above those observed in pH 7 or 11. Total body water was elevated during acute exposure to acidic media. During chronic exposure, total body water was decreased and Malpighian tubule mitochondrial luminosity, quantified using Mitotracker Green FM, increased. Malpighian tubule secretion rates and energy demands thus appear to increase dramatically during acid exposure. In alkaline media, drinking rates were quite low. Larvae in pH 11 media excreted net acid (0.12 nequiv H+g–1 h–1) and the pH indicators azolitmin and bromothymol blue revealed that the rectal lumen is acidic in vivo at all ambient pH values. The anal papillae (AP) were found to be highly permeant to acid–base equivalents. Ambient pH influenced the length, and the mass-specific length, of the AP in the presence of NaCl (59.9 mmol l–1). In contrast, the length and mass-specific length of AP were not influenced by ambient pH in low NaCl conditions. Mitochondrial luminosity was reduced in AP of larvae reared in acidic media, and was not elevated in alkaline media, relative to that of larvae reared in neutral media. These data suggest that the AP may compromise acid–base balance in acidic media, and may also be an important site of trade-offs between H+ homeostasis and NaCl uptake in dilute, acidic media.
Effectiveness of Emergency Department Asthma Management Strategies on Return Visits in Children: A Population-Based Study
Authors: Guttmann Astrid , Zagorski Brandon , Austin Peter C. , Schull Michael , Razzaq Asma , To Teresa , Anderson Geoff 
Published: November 2007

BACKGROUND. Emergency departments play an important role in the care of children with asthma. Emergency department return-visit rates provide a measure of the quality of acute asthma care.
OBJECTIVE. Our goal was to describe the characteristics of children treated in emergency departments for asthma, the resources and asthma management strategies used by emergency departments, and their effect on return visits within 72 hours.
DESIGN, SETTING, AND PATIENTS. We used a population-based cohort study that incorporated both comprehensive administrative heath and survey data from all 152 emergency departments in Ontario, Canada. We studied all 2- to 17-year-old children who had a visit to an emergency department for asthma from April 2003 to March 2005.
RESULTS. A total of 32996 children (&gt;9% of children with asthma in Ontario) had at least 1 visit to an emergency department for the care of asthma, and most of these visits (68.5%) were triaged as high acuity. The vast majority (148 of 152 [97%]) of emergency departments reported using at least 1 asthma management strategy, and 74% used 3 or more. The overall return-visit rate was 5.6%. Logistic regression models that accounted for the clustering of patients in emergency departments and controlled for patient and emergency department characteristics indicated that preprinted order sheets and access to a pediatrician for consultation were strategies significantly associated with a reduction in return visits. The 11 (17%) emergency departments that used both of these strategies had return visit rates of 4.4% compared with 6.9% in the 95 (63%) that used neither strategy.
CONCLUSIONS. Emergency departments use a range of strategies to manage asthma in children. Preprinted order sheets and access to pediatricians are associated with important reductions in return-visit rates, and more emergency departments should consider using these strategies.
Pediatric Emergency Department Visits for Diarrheal Illness Increased After Release of Undertreated Sewage
Authors: Redman Ryan L. , Nenn Cheryl A. , Eastwood Daniel , Gorelick Marc H. 
Published: November 2007

CONTEXT. Contamination of local waterways may occur through release of partially treated sewage. The Environmental Protection Agency has recently reviewed regulatory standards for this practice. However, the health effects of these events have not been well studied.
OBJECTIVE. Our goal was to identify any increase in visits to a pediatric emergency department for diarrheal illness after sewage bypass into Lake Michigan.
METHODS. The study was conducted as a retrospective, observational time-series analysis in a tertiary care children's hospital emergency department with an annual volume of ∼45000 visits. We collected data for 2002–2004 pertaining to the daily number of emergency department visits for children (aged &lt;19 years) for diarrheal illness (using specified International Classification of Diseases, Ninth Edition codes as a reference). Daily diarrheal illness visits were the dependent variable in a time-series model. The primary independent variable was the occurrence of a sewage-bypass event in the 3 to 7 preceding days. Potential confounders included the season and daily rainfall. Separate models were created for visits from people living in zip codes that used Lake Michigan drinking water and those who used other water sources.
RESULTS. Over the 3-year study period, there was a mean of 5.0 ± 3.8 (SD) daily visits for diarrheal illness from people who lived in zip codes that used Lake Michigan drinking water and 1.2 ± 1.4 (SD) from outside that area. There were 6 sewage-bypass events identified. After adjusting for the season and rainfall, there was a significant increase of 2.5 to 2.7 visits only from people who lived in zip codes that used Lake Michigan drinking water after the 2 largest of the 6 bypass events.
CONCLUSIONS. Emergency department visits for diarrheal illness increased significantly after 2 events of release of partially treated sewage into area waterways. These data suggest a potentially harmful effect of such practices.
Behaviors Associated With Fever in Children With Autism Spectrum Disorders
Authors: Curran Laura K. , Newschaffer Craig J. , Lee Li-Ching , Crawford Stephen O. , Johnston Michael V. , Zimmerman Andrew W. 
Published: November 2007

OBJECTIVE. Clinical case reports have suggested that the behaviors of children with autism spectrum disorders may improve with fever. The purpose of this study was to investigate the effect of illness on behaviors of children with autism spectrum disorders. Understanding the role of fever, if any, may be informative regarding causative mechanisms of and treatment opportunities for autism.
METHODS. We conducted a prospective study of 30 children (aged 2–18 years) with autism spectrum disorders during and after an episode of fever. Parent responses to the Aberrant Behavior Checklist were collected during fever (body temperature ≥ 38.0°C/100.4°F), when fever had abated and the child was asymptomatic, and when the child had been fever-free for 7 days. Data were compared with those collected from parents of 30 age-, gender-, and language skills–matched afebrile children with autism spectrum disorders during similar time intervals.
RESULTS. Fewer aberrant behaviors were recorded for febrile patients on the Aberrant Behavior Checklist subscales of irritability, hyperactivity, stereotypy, and inappropriate speech compared with control subjects. Per expectation, lethargy scores were greater during fevers, and all improvements were transient. Data from patients with fever were stratified on variables related to illness severity. In the majority of these subgroup comparisons, the data suggested that effects from fever persisted in the less sick patients as well as in those with more severe illness.
CONCLUSIONS. We documented behavior change among children with autism spectrum disorders during fever. The data suggest that these changes might not be solely the byproduct of general effects of sickness on behavior; however, more research is needed to prove conclusively fever-specific effects and elucidate their underlying biological mechanisms (possibly involving immunologic and neurobiological pathways, intracellular signaling, and synaptic plasticity).
Early Determinants of Fruit and Vegetable Acceptance
Authors: Forestell Catherine A. , Mennella Julie A. 
Published: November 2007

OBJECTIVE. Our goal was to evaluate the effects of breastfeeding and dietary experiences on acceptance of a fruit and a green vegetable by 4- to 8-month-old infants.METHODS. Forty-five infants, 44% of whom were breastfed, were assigned randomly to 1 of 2 treatment groups. One group was fed green beans, and the other was fed green beans and then peaches at the same time of day for 8 consecutive days. Acceptance of both foods, as determined by a variety of measures, was assessed before and after the home-exposure period.RESULTS. During the initial exposure, infants ate more calories from peaches than from green beans. Breastfed infants showed greater liking of peaches, as did their mothers, who ate more fruits in general than did mothers who formula fed. Although formula-feeding mothers ate more green beans, there was no difference in their infants' acceptance of this vegetable. For breastfed and formula-fed infants, repeated dietary exposure to green beans, with or without peaches, resulted in greater consumption of green beans (56.8 vs 93.6 g). Only infants who experienced green beans with peaches displayed fewer facial expressions of distaste during feeding. Mothers were apparently unaware of these changes in acceptance.CONCLUSIONS. Breastfeeding confers an advantage in initial acceptance of a food, but only if mothers eat the food regularly. Once weaned, infants who receive repeated dietary exposure to a food eat more of it and may learn to like its flavor. However, because infants innately display facial expressions of distaste in response to certain flavors, caregivers may hesitate to continue offering these foods. Mothers should be encouraged to provide their infants with repeated opportunities to taste fruits and vegetables and should focus not only on their infants' facial expressions but also on their willingness to continue feeding.
Pulmonary Artery Hypertension in Formerly Premature Infants With Bronchopulmonary Dysplasia: Clinical Features and Outcomes in the Surfactant Era
Authors: Khemani Ekta , McElhinney Doff B. , Rhein Lawrence , Andrade Olyn , Lacro Ronald V. , Thomas Kristin C. , Mullen Mary P. 
Published: November 2007

BACKGROUND. Although abnormal pulmonary vascular structure and function in preterm infants with bronchopulmonary dysplasia may predispose infants to pulmonary artery hypertension, little is known about the characteristics and outcomes of bronchopulmonary dysplasia-associated pulmonary artery hypertension in the surfactant era.METHODS. We studied 42 premature infants (&lt;32 weeks of gestation) with bronchopulmonary dysplasia who were diagnosed as having pulmonary artery hypertension ≥2 months after birth, between 1998 and 2006, at a median age of 4.8 months. Pulmonary artery hypertension was graded through echocardiography for all patients; 13 patients also underwent cardiac catheterization.RESULTS. Eighteen (43%) of 42 patients had severe pulmonary artery hypertension (systemic or suprasystemic right ventricular pressure). Among 13 patients who underwent catheterization, the mean pulmonary artery pressure was 43 ± 8 mmHg and the pulmonary vascular resistance index was 9.9 ± 2.8 Wood units. In 12 patients, pulmonary artery pressure and pulmonary vascular resistance improved with 100% oxygen and 80 ppm inhaled nitric oxide but remained elevated. The pulmonary vascular resistance index decreased to 7.9 ± 3.8 Wood units in 100% oxygen and to 6.4 ± 3.1 Wood units with the addition of nitric oxide. Sixteen patients (38%) died during the follow-up period. Estimated survival rates were 64% ± 8% at 6 months and 53% ± 11% at 2 years after diagnosis of pulmonary artery hypertension. In multivariate analyses, severe pulmonary artery hypertension and small birth weight for gestational age were associated with worse survival rates. Among 26 survivors (median follow-up period: 9.8 months), pulmonary artery hypertension was improved, relative to its most severe level, in 24 patients (89%).CONCLUSION. Premature infants with bronchopulmonary dysplasia and severe pulmonary artery hypertension are at high risk of death, particularly during the first 6 months after diagnosis of pulmonary artery hypertension.
Parents as Information Intermediaries Between Primary Care and Specialty Physicians
Authors: Stille Christopher J. , Primack William A. , McLaughlin Thomas J. , Wasserman Richard C. 
Published: November 2007

OBJECTIVE. In this study we assessed the views of parents of children referred to specialty care and the views of the children's primary care and specialty physicians about parents' roles as information intermediaries.METHODS. We enrolled 179 patients who were newly referred from primary care pediatricians in 22 practices to 15 pediatric subspecialists in 5 specialties in a study of primary care pediatrician-specialist communication. Parents, primary care pediatricians, and specialists completed questionnaires by mail or telephone at the first visit and 6 months later. Questions included perceived responsibilities of parents as information conduits between primary care pediatricians and specialists. Opinions of parents, primary care pediatricians, and specialists about parents' roles were compared for the sample as a whole, as well as for individual cases. Agreement between parents and providers was assessed. Demographic and clinical determinants of parents reporting themselves as “comfortable with” or “acting” as primary intermediaries were assessed using logistic regression.RESULTS. More parents (44%) than primary care physicians (30%) felt comfortable with parents acting as primary communicators between their children's physicians; 31% of parents who reported that they were the primary communicators felt uncomfortable in that role, and there was no agreement between parents and physicians about the role of parents in individual cases. Although no demographic characteristics of children or parents were associated with parent comfort as the primary communicator, parents of children who saw the same specialist more than once during the 6-month period felt more comfortable in this role. The presence of a chronic condition was not associated with parent comfort.CONCLUSIONS. Although parents report more comfort with their own ability as information intermediaries than do their children's physicians, the role in which they feel comfortable is highly variable. Physicians should discuss with parents the roles they feel comfortable in assuming when specialty referrals are initiated.
Intimate Partner Violence and Health Care Costs and Utilization for Children Living in the Home
Authors: Rivara Frederick P. , Anderson Melissa L. , Fishman Paul , Bonomi Amy E. , Reid Robert J. , Carrell David , Thompson Robert S. 
Published: November 2007

Objective. The goal was to determine whether differences in health care costs and utilization exist for children whose mothers experienced intimate partner violence versus those who did not.
Methods. A longitudinal cohort study was performed in an integrated health care delivery organization with 760 children of mothers with no history of intimate partner violence and 631 children of mothers with a history of intimate partner violence since age 18. Health care utilization and costs for children before, during, and after intimate partner violence exposure were compared with utilization and costs for children with nonabused mothers.
Results. Health care utilization and health care costs were higher in most categories of care for children of mothers with a history of intimate partner violence, with significantly higher values for mental health services, primary care visits, primary care costs, and laboratory costs. Children of mothers with a history of intimate partner violence that ended before the child was born had significantly greater utilization of mental health, primary care, specialty care, and pharmacy services than did children of mothers who reported no intimate partner violence. Children exposed directly to intimate partner violence (after birth) had greater emergency department and primary care use during the intimate partner violence and were 3 times as likely to use mental health services after the intimate partner violence ended.
Conclusions. Children whose mothers experienced intimate partner violence have higher health care utilization and costs, even if their mothers' abuse stopped before they were born. Screening of women for intimate partner violence should be a routine part of their health care, and interventions for both the women and their children are likely necessary to minimize the effects of intimate partner violence in the family.
The Role of Schools in Combating Illicit Substance Abuse
Authors:   Council on School Health and Committee on Substance Abuse
Published: November 2007

This Policy Statement was retired July 2017.
Disturbingly high levels of illicit drug use remain a problem among American teenagers. As the physical, social, and psychological “home away from home” for most youth, schools naturally assume a primary role in substance abuse education, prevention, and early identification. However, the use of random drug testing on students as a component of drug prevention programs requires additional, more rigorous scientific evaluation. Widespread implementation should await the result of ongoing studies to address the effectiveness of testing and evaluate possible inadvertent harm. If drug testing on students is conducted, it should never be implemented in isolation. A comprehensive assessment and therapeutic management program for the student who tests positive should be in place before any testing is performed. Schools have the opportunity to work with parents, health care professionals, and community officials to use programs with proven effectiveness, to identify students who show behavioral risks for drug-related problems, and to make referrals to a student's medical home. When use of an illicit substance is detected, schools can foster relationships with established health care experts to assist them. A student undergoing individualized intervention for using illicit substances merits privacy. This requires that awareness of the student's situation be limited to parents, the student's physician, and only those designated school health officials with a need to know. For the purposes of this statement, alcohol, tobacco, and inhalants are not addressed.
Glucarpidase (Carboxypeptidase G2) Intervention in Adult and Elderly Cancer Patients with Renal Dysfunction and Delayed Methotrexate Elimination After High-Dose Methotrexate Therapy
Authors: Schwartz Stefan , Borner Klaus , Müller Krystina , Martus Peter , Fischer Lars , Korfel Agnieszka , Auton Timothy , Thiel Eckhard 
Published: November 2007

Learning ObjectivesAfter completing this course, the reader will be able to: Identify risk factors for kidney failure associated with high-dose MTX therapy.Discuss the therapeutic options in patients with delayed MTX elimination.Discuss the potential risks and benefits of glucarpidase intervention.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
Chordoma: The Nonsarcoma Primary Bone Tumor
Authors: Chugh Rashmi , Tawbi Hussein , Lucas David R. , Biermann J. Sybil , Schuetze Scott M. , Baker Laurence H. 
Published: November 2007

Abstract
Chordomas are rare, slowly growing, locally aggressive neoplasms of bone that arise from embryonic remnants of the notochord. These tumors typically occur in the axial skeleton and have a proclivity for the spheno-occipital region of the skull base and sacral regions. In adults, 50% of chordomas involve the sacrococcygeal region, 35% occur at the base of the skull near the spheno-occipital area, and 15% are found in the vertebral column. Craniocervical chordomas most often involve the dorsum sella, clivus, and nasopharynx. Chordomas are divided into conventional, chondroid, and dedifferentiated types. Conventional chordomas are the most common. They are characterized by the absence of cartilaginous or additional mesenchymal components. Chondroid chordomas contain both chordomatous and chondromatous features, and have a predilection for the spheno-occipital region of the skull base. This variant accounts for 5%–15% of all chordomas and up to 33% of cranial chordomas. Dedifferentiation or sarcomatous transformation occurs in 2%–8% of chordomas. This can develop at the onset of the disease or later. Aggressive initial therapy improves overall outcome. Patients who relapse locally have a poor prognosis but both radiation and surgery can be used as salvage therapy. Subtotal resection can result in a stable or improved status in as many as 50% of patients who relapse after primary therapy. Radiation therapy may also salvage some patients with local recurrence. One series reported a 2-year actuarial local control rate of 33% for patients treated with proton beam irradiation.
The Pharmacologic Basis of Ifosfamide Use in Adult Patients with Advanced Soft Tissue Sarcomas
Authors: Tascilar Metin , Loos Walter J. , Seynaeve Caroline , Verweij Jaap , Sleijfer Stefan 
Published: November 2007

Learning ObjectivesAfter completing this course, the reader will be able to: Describe the current role of ifosfamide in the treatment of soft tissue sarcomas in adult patients.Discuss factors that may affect ifosfamide metabolism and its therapeutic index.Explain the advantages of ifosfamide over doxorubicin in the context of new treatment combinations.Discuss strategies to improve survival outcome in patients with soft tissue sarcoma.Access and take the CME test online and receive 1 AMA PRA Category 1 Credit™ at CME.TheOncologist.com
A Patient‐Centered Clinical Evaluation of Acellular Dermal Matrix Graft in the Treatment of Gingival Recession Defects
Authors: Mahajan Ajay , Dixit Jaya , Verma Umesh Pratap 
Published: November 2007

Background: The present randomized controlled trial was conducted to evaluate acellular dermal matrix (ADM) graft in terms of patient satisfaction and its effectiveness and efficiency in the treatment of gingival recession.Methods: Fourteen patients (seven males and seven females) with Miller Class I and II recessions ≥3 mm participated in this 6‐month clinical study. They were assigned randomly to the ADM group (ADM graft and coronally positioned flap [CPF]) or the CPF group (CPF alone). Results were evaluated based on parameters measuring patient satisfaction and clinical outcomes associated with the two treatment procedures. Significance was set at P <0.05.Results: The mean recession was 4.0 ± 1.0 mm and 3.7 ± 0.7 mm for the ADM and CPF groups, respectively. For the ADM group, the defect coverage was 3.85 ± 0.89 mm or 97.14% compared to the CPF group, in which the defect coverage was 2.85 ± 0.89 mm or 77.42%. The difference between the two groups was statistically significant (P <0.05). There were no statistically significant differences between the two groups in the remaining clinical parameters and overall patient satisfaction except in criteria related to patient comfort and cost effectiveness, in which CPF alone produced significantly better results (P <0.03).Conclusions: ADM graft is significantly superior with regard to effectiveness and efficiency in the treatment of gingival recession than CPF alone. CPF emerges as a better option than ADM graft in terms of cost effectiveness and patient comfort.