bluuebunny/crossref_metadata_2025_split huggingface dataset:
Neonatal Candidiasis Among Extremely Low Birth Weight Infants: Risk Factors, Mortality Rates, and Neurodevelopmental Outcomes at 18 to 22 Months
Authors: Benjamin Daniel K. , Stoll Barbara J. , Fanaroff Avory A. , McDonald Scott A. , Oh William , Higgins Rosemary D. , Duara Shahnaz , Poole Kenneth , Laptook Abbot , Goldberg Ronald ,   on behalf of the National Institute of Child Health and Human Development Neonatal Research Network
Published: January 2006

BACKGROUND. Neonatal candidiasis is associated with substantial morbidity and mortality rates. Neurodevelopmental follow-up data for a large multicenter cohort have not been reported.METHODS. Data were collected prospectively for neonates born at &lt;1000 g at National Institute of Child Health and Human Development-sponsored Neonatal Research Network sites between September 1, 1998, and December 31, 2001. Uniform follow-up evaluations, including assessments of mental and motor development with the Bayley Scales of Infant Development II, were completed for all survivors at corrected ages of 18 to 22 months. We evaluated risk factors for the development of neonatal candidiasis, responses to antifungal therapy, and the association between candidiasis and subsequent morbidity and death.RESULTS. The cohort consisted of 4579 infants; 320 of 4579 (7%) developed candidiasis; 307 of 320 had Candida isolated from blood, 27 of 320 had Candida isolated from cerebrospinal fluid, and 13 (48%) of 27 of those with meningitis had negative blood cultures. In multivariate analysis of risk factors on day of life 3, birth weight, cephalosporins, gender, and lack of enteral feeding were associated with development of candidiasis. After diagnosis, most neonates had multiple positive cultures despite antifungal therapy, and 10% of neonates had candidemia for ≥14 days. Death or neurodevelopmental impairment (NDI) was observed for 73% of extremely low birth weight infants who developed candidiasis. Death and NDI rates were greater for infants who had delayed removal or replacement of central catheters (&gt;1 day after initiation of antifungal therapy), compared with infants whose catheters were removed or replaced promptly.CONCLUSIONS. Blood cultures were negative for approximately one half of the infants with Candida meningitis. Persistent candidiasis was common. Delayed catheter removal was associated with increased death and NDI rates.
Factors Associated With Hepatitis A Vaccination Among Children 24 to 35 Months of Age: United States, 2003
Authors: Amon Joseph J. , Darling Natalie , Fiore Anthony E. , Bell Beth P. , Barker Lawrence E. 
Published: January 2006

OBJECTIVES. In 1999, the Advisory Committee on Immunization Practices made recommendations for hepatitis A vaccination of children according to historic rates of hepatitis A incidence in different regions of the country. The objective of this study was to examine hepatitis A vaccination coverage rates among children living in states with different vaccination recommendations and to examine individual characteristics associated with vaccination.
METHODS. Hepatitis A vaccination status data were collected for children 24 to 35 months of age through the National Immunization Survey, a telephone survey with health care provider-verified vaccination results. Vaccination status data were collected from children in each of the 50 states and 28 selected urban areas.
RESULTS. In 2003, 50.9% (95% confidence interval [CI]: 47.6–54.2%) of children living in 11 states where routine hepatitis A vaccination is recommended had received ≥1 dose, compared with 25.0% (95% CI: 21.8–28.2%) of children in 6 states where vaccination is suggested and 1.4% (95% CI: 1.0–1.8%) of children in 33 states without a recommendation. Coverage was higher among children who lived in urban areas, were Hispanic or American Indian/Alaska Native, or were born to women with less education.
CONCLUSIONS. Hepatitis A vaccination is being targeted successfully to children at higher risk of infection; however, overall vaccination coverage remains lower for hepatitis A vaccination, compared with other routine childhood vaccinations.
Costs of Newborn Care in California: A Population-Based Study
Authors: Schmitt Susan K. , Sneed LaShika , Phibbs Ciaran S. 
Published: January 2006

OBJECTIVE. We sought to describe the current costs of newborn care by using population-based data, which includes linked vital statistics and hospital records for both mothers and infants. These data allow costs to be reported by episode of care (birth), instead of by hospitalization.METHODS. Data for this study were obtained from the linked 2000 California birth cohort data. These data (n = 518704), provided by the California Office of Statewide Health Planning and Development (OSHPD), contain infant vital statistics data (birth and death certificate data) linked to infant and maternal hospital discharge summaries. In addition to the infant and maternal hospital discharge summaries associated with delivery, these data include discharge summaries for all infant hospital-to-hospital transfers and maternal prenatal hospitalizations. The linkage algorithm that is used by OSHPD in creating the linked cohort data file is highly accurate. More than 99% of the maternal and infant discharge abstracts were linked successfully with the birth certificates. These data were also linked successfully with the infant discharge abstracts from the receiving hospital for 99% of the infants who were transferred to another hospital. The hospital discharge records were the source of the hospital charges and length-of-stay information summarized in this study. Hospital costs were estimated by adjusting charges by hospital-specific ratios of costs to charges obtained from the OSHPD Hospital Financial Reporting data. Costs, lengths of stay, and mortality were summarized by birth weight groups, gestational age, cost categories, and types of admissions.RESULTS. Low birth weight (LBW) and very low birth weight (VLBW) infants had significantly longer hospital stays and accounted for a significantly higher proportion of total hospital costs. The average hospital stay for LBW infants ranged from 6.2 to 68.1 days, whereas the average hospital stay for infants who weighed &gt;2500 g at birth was 2.3 days. Overall, VLBW infants accounted for 0.9% of cases but 35.7% of costs, whereas LBW infants accounted for 5.9% of cases but 56.6% of total hospital costs. Although total maternal and infant costs were similar (∼$1.6 billion), the distribution of maternal costs was much less skewed. For infants, 5% of infants accounted for 76% of total infant hospital costs. Conversely, the most expensive 3% of deliveries accounted for only 17% of total maternal costs.CONCLUSIONS. The very smallest infants make up a hugely disproportionate share of costs; more than half of all neonatal costs are incurred by LBW or premature infants. Maternal costs are similar in magnitude to newborn costs, but they are much less skewed than for infants. Preventing premature deliveries could yield very large cost savings, in addition to saving lives.
Mass-Casualty Events at Schools: A National Preparedness Survey
Authors: Graham James , Shirm Steve , Liggin Rebecca , Aitken Mary E. , Dick Rhonda 
Published: January 2006

OBJECTIVE. Recent school shootings and terrorist events have demonstrated the need for well-coordinated planning for school-based mass-casualty events. The objective of this study was to document the preparedness of public schools in the United States for the prevention of and the response to a mass-casualty event.
METHODS. A survey was mailed to 3670 school superintendents of public school districts that were chosen at random from a list of school districts from the National Center for Education Statistics of the US Department of Education in January 2004. A second mailing was sent to nonresponders in May 2004. Descriptive statistics were used for survey variables, and the χ2 test was used to compare urban versus rural preparedness.
RESULTS. The response rate was 58.2% (2137 usable surveys returned). Most (86.3%) school superintendents reported having a response plan, but fewer (57.2%) have a plan for prevention. Most (95.6%) have an evacuation plan, but almost one third (30%) had never conducted a drill. Almost one quarter (22.1%) have no disaster plan provisions for children with special health care needs, and one quarter reported having no plans for postdisaster counseling. Almost half (42.8%) had never met with local ambulance officials to discuss emergency planning. Urban school districts were better prepared than rural districts on almost all measures in the survey.
CONCLUSIONS. There are important deficiencies in school emergency/disaster planning. Rural districts are less well prepared than urban districts. Disaster/mass-casualty preparedness of schools should be improved through coordination of school officials and local medical and emergency officials.
Primary Care Utilization and Detection of Emotional Distress After Adolescent Traumatic Injury: Identifying an Unmet Need
Authors: Sabin Janice A. , Zatzick Douglas F. , Jurkovich Gregory , Rivara Frederick P. 
Published: January 2006

OBJECTIVE. Few investigations have assessed the primary care detection of adolescent posttraumatic emotional distress after an injury. We aimed to determine (1) the level of attachment to primary care providers (PCPs) and school providers among this group of high-risk adolescents, (2) the emotional status of this population postinjury, (3) continuity of care between trauma center and community care, and (4) PCPs' detection of emotional problems in adolescents after an injury.
METHODS. This was a prospective cohort study of traumatically injured adolescents aged 12 to 18 who were admitted to a level I regional trauma center. Adolescents were screened for posttraumatic stress symptoms, depressive symptoms, and alcohol use on the surgical ward and 4 to 6 months postinjury. PCPs were contacted by telephone 4 to 6 months postinjury to assess follow-up care and the detection of emotional distress.
RESULTS. In the surgical ward, 39.4% of the adolescent patients or their parents reported no identifiable source of regular medical care. Only 24.3% of the patients had visited a PCP during the 4 to 6 months after injury. At 4 to 6 months postinjury, 30% of the adolescents were experiencing high posttraumatic stress symptom levels, 11% were experiencing high depressive symptom levels, and 17% had high levels of alcohol use. PCPs did not detect any new emotional distress or problem drinking during postinjury office visits.
CONCLUSIONS. Injured adolescents represent a high-risk pediatric population, a substantial number of whom develop mental health problems postinjury. Furthermore, almost 40% of adolescents in our study reported no source of primary care. These results suggest that referrals from trauma centers to PCPs are necessary and that an increase in awareness of and screening for adolescent emotional distress postinjury during follow-up appointments and at school should be routine components of postinjury care.
Interactions between Stocked Walleyes and Native Yellow Perch in Lake Thirteen, Minnesota: A Case History of Percid Community Dynamics
Authors: Pierce Rodney B. , Tomcko Cynthia M. , Negus Mary T. 
Published: January 2006

Abstract
Studies of interactions among percids are important for understanding the fish community consequences of using stocking as a management tool and for understanding the ecological role of percids in lakes where they are native species. Percid community responses to discontinuing, then resuming, the stocking of walleye Sander vitreus were monitored in Lake Thirteen, Minnesota, a north temperate lake with a long-term history of walleye fry stocking. Fish population assessments during 1986–2002 tracked changes in relative abundance, size structure, and growth rates of yellow perch Perca flavescens and walleyes in response to discontinued walleye stocking during 1989–1996. Large changes occurred in the size structure and relative abundance of walleyes. The effect of discontinued stocking was to decrease the abundance of younger age-classes of walleyes in the lake. Reduced predation on small yellow perch allowed their numbers to increase and led to reduced growth rates while stocking was discontinued. When stocking was resumed, predation by stocked walleyes reversed the trend, reducing yellow perch numbers and improving their growth rates. Density-dependent growth was evident for both walleyes and yellow perch. Bioenergetics modeling confirmed walleye predation as a plausible explanation for most changes in the yellow perch population. Manipulation of stocking, and the resulting shifts in predator sizes, caused structural changes in the percid populations that altered levels of intraspecific competition for both the predators and prey.
Effect of Topical Administration of Monosodium Olpadronate on Experimental Periodontitis in Rats
Authors: Goya Juan A. , Paez Hugo A. , Mandalunis Patricia M. 
Published: January 2006

Background: Periodontitis is characterized by gingival inflammation, periodontal pocket formation, and bacterial plaque that lead to alveolar bone destruction. Research studies have recently begun to evaluate the effect of antiresorptive agents using experimental models of periodontitis. Bisphosphonates are the most frequently tested antiresorptive agents; their main effect is inhibition of bone resorption. The aim of this study was to perform a histomorphometric evaluation of the preventive effect of monosodium olpadronate (OPD), an aminobisphosphonate, on experimental periodontitis (EP).Methods: Twenty male Wistar rats were used in this experiment. The animals were assigned to one of two groups: group I: EP; and group II: EP plus topical administration of OPD (EP + OPD). The contralateral side in both groups served as untreated controls (CI and CII), respectively. Mesio‐distally oriented sections of each lower first molar were obtained for histomorphometric evaluation.Results: The treated group (EP + OPD) exhibited marked inhibition of bone loss; interradicular bone volume was significantly greater than that observed in the EP group. The height of the periodontal ligament in the interradicular alveolar bone, which served as an indirect measure of bone loss, was found to be significantly increased in the EP group as compared to the EP + OPD group. Osteoclasts in the OPD treated group were detached from the bone surface, were round in shape, and exhibited a loss of polarity and lack of ruffled borders.Conclusions: The dose used herein was found to inhibit bone loss and to cause marked morphologic changes in osteoclasts. The drug effectively prevented bone loss caused by periodontitis.
Short‐Term Clinical and Microbiologic Effects of Pocket Debridement With an Er:YAG Laser During Periodontal Maintenance
Authors: Tomasi Cristiano , Schander Kerstin , Dahlén Gunnar , Wennström Jan L. 
Published: January 2006

Background: The erbium‐doped:yttrium, aluminum, and garnet (Er:YAG) laser is considered a useful tool for subgingival debridement because the laser treatment creates minimal damage to the root surface and has potential antimicrobial effects. The aim of this randomized controlled clinical trial was to evaluate clinical and microbiologic effects of pocket debridement using an Er:YAG laser in patients during periodontal maintenance.Methods: Twenty patients at a recall visit for maintenance were consecutively recruited if presenting at least four teeth with residual probing depth (PD) ≥5 mm. Two pockets in each of two jaw quadrants were randomly assigned to subgingival debridement using 1) an Er:YAG laser (test) or 2) an ultrasonic scaler (control). The laser beam was set at 160 mJ with a pulse frequency of 10 Hz. Clinical variables were recorded at baseline, 1 month, and 4 months after treatment. Primary clinical outcome variables were changes in PD and clinical attachment level (CAL). Microbiologic analysis of subgingival samples was performed at baseline, 2 days, and 30 days after treatment using a checkerboard DNA‐DNA hybridization technique against 12 periodontal disease–associated species.Results: The mean initial PD was 6.0 mm (SD: 1.2) in the test group and 5.8 mm (SD: 0.9) in the control group. At 1 month post‐treatment, the PD reduction was significantly greater for test than control sites (0.9 versus 0.5 mm; P <0.05). The CAL gain also was significantly greater (0.5 versus 0.06 mm; P <0.01). At the 4‐month examination, no significant differences were detected in PD reduction (1.1 versus 1.0 mm) or CAL gain (0.6 versus 0.4 mm). Both treatments resulted in reduction of the subgingival microflora. No significant differences in microbiologic composition were identified between the treatment groups at various time intervals. Degree of treatment discomfort scored significantly lower for the test than the control treatment modality.Conclusion: The results of the trial failed to demonstrate any apparent advantage of using an Er:YAG laser for subgingival debridement, except less treatment discomfort perceived by the patients.
Enamel Matrix Derivative and Coronal Flaps to Cover Marginal Tissue Recessions
Authors: Castellanos T. Adriana , de la Rosa R. Manuel , de la Garza Myriam , Caffesse Raul G. 
Published: January 2006

Background: Correcting recession defects is one of the goals of periodontal therapy, and the efficacy and predictability of the various techniques are important considerations for both patients and clinicians. Several reports have examined the outcome of gingival recession treatment by means of coronally positioned flaps (CPF) and enamel matrix derivative (EMD). The purpose of this study was to clinically evaluate the use of EMD in association with CPF to cover localized gingival recessions compared to CPF alone.Methods: Twenty‐two patients with Miller Class I or II gingival recessions >2 mm were included. One recession from each patient was treated in the study. Two treatments were randomly assigned: coronally positioned flap with EMD (test) and coronally positioned flap alone (control). Clinical parameters measured at baseline and 1, 6, and 12 months included gingival index, plaque index, probing depth, clinical attachment level, vertical and horizontal recession, and width of keratinized gingiva.Results: At 12 months, both treatment modalities showed significant root coverage, gain in clinical attachment, and gain in width of keratinized gingiva (P <0.05). Vertical recessions were reduced from 2.68 ± 1.63 mm to 0.36 ± 0.60 mm in the test group and from 2.31 ± 1.52 mm to 0.90 ± 0.95 mm in the control group. Horizontal recessions decreased from 4.27 ± 2.06 mm to 0.77 ± 0.87 mm in the test group and from 3.68 ± 1.91 mm to 1.72 ± 1.31 mm in the control group. Changes in keratinized gingiva went from 3.81 ± 1.95 mm to 4.63 ± 2.15 mm in the test group and from 3.31 ± 1.81 mm to 3.27 ± 1.80 mm in the control group. When both treatments were compared at 12 months, there was a significant difference in vertical tooth coverage and gain in keratinized gingiva in favor of the experimental group (P <0.05). The average percentage of root coverage for test and control groups was 88.6% and 62.2%, respectively.Conclusions: The coronally positioned flap alone or with EMD is an effective procedure to cover localized gingival recessions. The addition of EMD significantly improves the amount of root coverage.
Inflammatory Infiltrate, Microvessel Density, Nitric Oxide Synthase Expression, Vascular Endothelial Growth Factor Expression, and Proliferative Activity in Peri‐Implant Soft Tissues Around Titanium and Zirconium Oxide Healing Caps
Authors: Degidi Marco , Artese Luciano , Scarano Antonio , Perrotti Vittoria , Gehrke Peter , Piattelli Adriano 
Published: January 2006

Background: The aim of the present study in humans was to conduct a comparative immunohistochemical evaluation of vascular endothelial growth factor (VEGF) and nitric oxide synthase (NOS) expression, inflammatory infiltrate, proliferative activity expression, and microvessel density (MVD) in peri‐implant soft tissues of titanium and zirconium oxide healing caps.Methods: Five patients, three men and two women (aged 30 to 66 years; mean: 49 years), participated in this study. All patients received dental implants that were 3.8 mm in diameter and 11 mm in length. All implants were left to heal in a non‐submerged (single‐stage) mode. Healing caps (3.8 mm in diameter and 3.0 mm in height) were inserted in all implants. Half of the implants were supplied with standard, prefabricated caps of commercially pure titanium, whereas the other half were provided with test zirconium oxide caps. After a 6‐month healing period, a gingival biopsy was performed with a circular scalpel (5.5 mm in diameter) around the healing caps of both groups, without unscrewing or removing the healing caps. The dimensions of the gingival biopsies were 1.7 mm (5.5 − 3.8 mm) in thickness and 3 mm in height.Results: Statistically significant differences were found in the microvessel density between titanium and zirconium oxide healing caps and group II (P ≤0.0001). Statistically significant differences were likewise found in the low and high intensities of NOS1, NOS3, and VEGF (P ≤0.0001). In conclusion, the high intensity of NOS1, NOS3, and VEGF were mostly expressed in the titanium group, whereas the low intensity of NOS1, NOS3, and VEGF were mostly expressed in the zirconium oxide group.Conclusions: In our specimens, the inflammatory infiltrate was mostly present in the titanium specimens. Their extension was much larger than that of the zirconium oxide specimens. Higher values of MVD were observed in the titanium specimens (29.1 versus 15.8). In addition, a higher expression of VEGF intensity was observed in the peri‐implant tissues of titanium healing caps, whereas predominantly lower expressions of VEGF intensity were noted around the zirconium oxide healing caps. The Ki‐67 expression was higher in the titanium specimens. All these data revealed that the tissues around titanium healing caps underwent a higher rate of inflammation‐associated processes, most probably correlated to the higher inflammation processes observed in these tissues. A higher intensity expression of NOS1 and NOS3 was recorded in the tissues around titanium, whereas, on the contrary, a lower intensity of expression was found in the tissues around zirconium oxide specimens. These latter data indicate that the higher expression of these two mediators could be correlated to the higher amount of bacteria present around the titanium samples.
An Exploratory Study of Post-Traumatic Stress Disorder Symptoms among Bereaved Children
Authors: McClatchey Rene S. , Vonk M. Elizabeth 
Published: December 2005

Purpose: This study reports on the incidence of post-traumatic stress disorder (PTSD) symptoms among a sample ( n = 46) of bereaved children. PTSD symptoms in children who have experienced loss due to an expected death through illness have not been previously studied. Method: An exploratory cross-sectional design was used to compare Impact of Event Scale (IES) scores between two groups of bereaved children. One group experienced the sudden, unexpected death of a family member; the second group experienced the expected death of a family member following protracted illness. Findings: Overall, almost two-thirds of the children were found to be experiencing moderate to severe levels of PTSD related symptoms of intrusion and avoidance as measured by the IES. Additionally, there was no significant difference in the IES scores of the two groups of children. Implications: Findings are discussed in relation to current practice with and research on bereaved children.