bluuebunny/crossref_metadata_2025_split huggingface dataset:
Botulinum toxin (Dysport) treatment of the spastic gastrocnemius muscle in children with cerebral palsy: a randomized trial comparing two injection volumes
Authors: Hu Gwo-Chi , Chuang Yao-Chia , Liu Jen-Pei , Chien Kuo-Liong , Chen Yi-Min , Chen Ying-Fang 
Published: December 2008

Objective: To compare the effect of equivalent doses in two different volumes of botulinum toxin type A (Dysport) on gastrocnemius spasticity. Design: Single-blind, randomized, controlled trial. Setting: Hospital rehabilitation department Subjects: Twenty-two children with spastic diplegic or quadriplegic cerebral palsy. Intervention: High (500 U/5 mL) and low (500 U/1 mL)-volume preparations of Dysport were injected into the gastrocnemius muscles, each child randomly receiving one preparation in the right and the other in the left leg. Main measures: Dynamic ankle joint range of motion (ROM), passive ROM of the ankle joint, modified Ashworth Scale scores, and the areas of the compound muscle action potential assessed before treatment and at four and eight weeks post treatment. Results: Both legs improved significantly. The mean (SD) improvements between baseline and the end of follow-up were 19.7 (10.83) degrees for dynamic ROM, 8.4 (9.19) degrees for passive ROM, -1.3 (0.6) for modified Ashworth Scale scores, and -9.4 (11.41) mV-ms for compound muscle action potential in the high-volume group; and 13.5 (10.45) degrees for dynamic ROM, 7.4 (7.88) for passive ROM, -0.9 (0.5) for modified Ashworth Scale scores, and -5.9 (7.50) mV-ms for areas of compound muscle action potential in the low-volume group. The high-volume preparation yielded significantly greater improvement in dynamic ROM (P<0.001), muscle tone (P < 0.001), and lower compound muscle action potential area (P = 0.006). Conclusions: A high-volume preparation of Dysport is more effective than a low volume in reducing spasticity in the gastrocnemius muscle.
Book Reviews
Authors: Bauwens Jeanne , Hourcade Jack J. 
Published: December 2008

COOPERATIVE TEACHING: REBUILDING THE SCHOOLHOUSE FOR ALL STUDENTS By Jeanne Bauwens and Jack J. Hourcade Austin, TX: PRO-ED, 1995 235 pages, $29.00, paperback INCLUSIVE AND HETEROGENESOUS SCHOOLING: ASSESSMENT, CURRICULM and instruction By May A. Falvey Baltimore: Brookes, 1995 427 pages, $36.00 BUILDING COMMUNITY SCHOOLS BY THOMAS J. SERGIOVANNI, JOSSEY-BASS PUBLISHERS, 1994 219 PAGES, $29.00
The Legal History of Special Education
Authors: Yell Mitchell L. , Rogers David , Rogers Elisabeth Lodge 
Published: December 2008

ABSTRACT Children and youth with disabilities have historically received unequal treatment in the public education system. In the early 20th century, the enactment of compulsory attendance laws in the states began to change the educational opportunities for these students. Opportunities for admittance to public schools were greater, but many students nevertheless did not receive an effective or appropriate education. Beginning in the late 1960s and early 1970s, parents and advocates for students with disabilities began to use the courts in an attempt to force states to provide an equal educational opportunity for these students. These efforts were very successful and eventually led to the passage of federal legislation to ensure these rights. The purpose of this article is to examine the legal history of special education. We will examine these early efforts to ensure a free appropriate education for students with disabilities up to and including the enactment of the Individuals with Disabilities Education Act Amendments of 1997.
β-Arrestin2 Regulates RANKL and Ephrins Gene Expression in Response to Bone Remodeling in Mice
Authors: Pierroz Dominique D , Rufo Anna , Bianchi Estelle N , Glatt Vaida , Capulli Mattia , Rucci Nadia , Cavat Fanny , Rizzoli René , Teti Anna , Bouxsein Mary L , Ferrari Serge L 
Published: December 2008

Abstract
PTH-stimulated intracellular signaling is regulated by the cytoplasmic adaptor molecule β-arrestin. We reported that the response of cancellous bone to intermittent PTH is reduced in β-arrestin2−/− mice and suggested that β-arrestins could influence the bone mineral balance by controlling RANKL and osteoprotegerin (OPG) gene expression. Here, we study the role of β-arrestin2 on the in vitro development and activity of bone marrow (BM) osteoclasts (OCs) and Ephrins ligand (Efn), and receptor (Eph) mRNA levels in bone in response to PTH and the changes of bone microarchitecture in wildtype (WT) and β-arrestin2−/− mice in models of bone remodeling: a low calcium diet (LoCa) and ovariectomy (OVX). The number of PTH-stimulated OCs was higher in BM cultures from β-arrestin2−/− compared with WT, because of a higher RANKL/OPG mRNA and protein ratio, without directly influencing osteoclast activity. In vivo, high PTH levels induced by LoCa led to greater changes in TRACP5b levels in β-arrestin2−/− compared with WT. LoCa caused a loss of BMD and bone microarchitecture, which was most prominent in β-arrestin2−/−. PTH downregulated Efn and Eph genes in β-arrestin2−/−, but not WT. After OVX, vertebral trabecular bone volume fraction and trabecular number were lower in β-arrestin2−/− compared with WT. Histomorphometry showed that OC number was higher in OVX-β-arrestin2−/− compared with WT. These results indicate that β-arrestin2 inhibits osteoclastogenesis in vitro, which resulted in decreased bone resorption in vivo by regulating RANKL/OPG production and ephrins mRNAs. As such, β-arrestins should be considered an important mechanism for the control of bone remodeling in response to PTH and estrogen deprivation.
ECM Compliance Regulates Osteogenesis by Influencing MAPK Signaling Downstream of RhoA and ROCK
Authors: Khatiwala Chirag B , Kim Peter D , Peyton Shelly R , Putnam Andrew J 
Published: December 2008

Abstract
The compliance of the extracellular matrix (ECM) regulates osteogenic differentiation by modulating extracellular signal-regulated kinase (ERK) activity. However, the molecular mechanism linking ECM compliance to the ERK-mitogen-activated protein kinase (MAPK) pathway remains unclear. Furthermore, RhoA has been widely implicated in integrin-mediated signaling and mechanotransduction. We studied the relationship between RhoA and ERK-MAPK signaling to determine their roles in the regulation of osteogenesis by ECM compliance. Inhibition of RhoA and ROCK in MC3T3-E1 pre-osteoblasts cultured on substrates of varying compliance reduced ERK activity, whereas constitutively active RhoA enhanced it. The expression of RUNX2, a potent osteogenic transcription factor, was increased on stiffer matrices and correlated with elevated ERK activity. Inhibition of RhoA, ROCK, or the MAPK pathway diminished RUNX2 activity and delayed the onset of osteogenesis as shown by altered osteocalcin (OCN) and bone sialoprotein (BSP) gene expression, alkaline phosphatase (ALP) activity, and matrix mineralization. These data establish that one possible mechanism by which ECM rigidity regulates osteogenic differentiation involves MAPK activation downstream of the RhoA-ROCK signaling pathway.
β-Adrenergic Blockade and Leptin Replacement Effectively Mitigate Disuse Bone Loss
Authors: Baek Kyunghwa , Bloomfield Susan A 
Published: December 2008

Abstract
Our objective was to test effects of β-adrenergic blockade on hindlimb unloading (HU)-induced bone loss and serum leptin and to compare these responses with those observed with leptin replacement. Adult male rats were randomized into six groups (n = 10 each): HU rats treated with vehicle (VEHHU), leptin analog (LEPHU), or β-blocker (BBHU) during a 28-day HU and cage activity controls (CC) treated with the same three agents and pair-fed to HU rats. On days 0 and 28, pQCT scans of proximal tibia and serum collections for leptin assays were performed, and histomorphometric measures of proximal tibia cancellous bone were assessed. The 20% decrease in cancellous vBMD observed in the VEHHU group was halved in BBHU rats and LEPHU rats. Bone formation rate (BFR) in BBHU rats, but not in LEPHU rats, was preserved. The 3-fold increase in resorption surface with HU was abolished by BB and LEP treatments. The decrease in serum leptin after a 28-day HU was attenuated in BBHU and LEPHU rats and was predictive of the decrease in BFR with HU. Blocking sympathetic adrenergic signaling by peripheral administration of a β-blocker during HU mitigates disuse-induced decreases in cancellous bone mass through stimulation of osteoblastic activity and suppression of osteoclastic activity. A direct effect of β-adrenergic blockade on bone cells during HU may be enhanced by an indirect effect mitigating reductions in circulating leptin, possibly through disinhibition of leptin release from adipocytes.
Improving Early Relationships: A Randomized, Controlled Trial of an Age-Paced Parenting Newsletter
Authors: Waterston Tony , Welsh Brenda , Keane Brigid , Cook Margaret , Hammal Donna , Parker Louise , McConachie Helen 
Published: December 2008

OBJECTIVES. Parenting is recognized as a key mediator in both health and educational outcomes. Much is known on the value of support and group work in benefiting parenting, but little is known on the effect of written information. A randomized, controlled trial was conducted to evaluate the effect of a parenting newsletter, sent monthly to the parents' home from birth to 1 year, on maternal well-being and parenting style. We tested the hypothesis that mothers receiving the newsletter would show less stress and better parenting characteristics than controls.
METHODS. Parents of first infants born in a North East England District General Hospital between February and October 2003 who consented to take part in the study were randomly allocated to either the intervention or control arm. Those in the intervention arm were sent 12 monthly issues of an age-paced parenting newsletter containing information on emotional development, parent-child interaction, and play. Both the intervention and control group received normal parenting support. Mothers in both groups completed the Well-being Index, Parenting Daily Hassles Scale, and the Adult-Adolescent Parenting Inventory at birth and at 1 year.
RESULTS. One hundred eighty-five mothers were recruited, with 94 randomly assigned to the intervention group, and 91 controls. Allowing for differences at recruitment, there were significant differences between the groups at 1 year: the intervention mothers had lower frequency and intensity of perceived hassles and fewer inappropriate expectations of the infant on the Adult-Adolescent Parenting Inventory than the control mothers.
CONCLUSIONS. A monthly parenting newsletter sent directly to the home in the first year of life seems to help parents to understand their infant better and feel less hassled. This intervention is low cost and can be applied to all parents, so it is nonstigmatizing.
An Investment in Health: Anticipating the Cost of a Usual Source of Care for Children
Authors: Birken Sarah A. , Mayer Michelle L. 
Published: December 2008

OBJECTIVES. Among adults, having a usual source of care has been associated with lower health care expenditures primarily through decreased emergency department and inpatient expenditures. The extent of this effect among children is unknown. We hypothesized that children with a usual source of care would have greater odds of having any outpatient expenditures, lower odds of emergency department and inpatient expenditures, and lower expenditures overall.PATIENTS AND METHODS. Using a 2-part model, we studied expenditures among children ≤17 years of age in the 2004 Medical Expenditure Panel Survey (N = 8810). Logistic regression was used to assess the relationship between having a usual source of care and the odds of having any outpatient, emergency department, and inpatient expenditures, and ordinary least-squares regression was used to compare the amount of total, outpatient, emergency department, and inpatient expenditures among children with and without a usual source of care, controlling for confounders.RESULTS. The odds of having any expenditures overall and any outpatient expenditures were 2.42 and 2.91 times higher among children with a usual source of care than among those without a usual source of care. The odds of having any emergency department or inpatient visits did not differ between groups. Having a usual source of care was associated with higher total expenditures and lower inpatient expenditures.CONCLUSIONS. Having a usual source of care is associated with increased odds of having any expenditures overall and any outpatient expenditures, higher total expenditures, and lower inpatient expenditures. Because emergency department and inpatient visits are less common among children than among adults, reductions in receipt of such care do not offset the associated increase in total expenditures and may not be appropriate indicators of the benefit of having a usual source of care among children. Intermediate indicators such as receipt of age-appropriate preventive services should be assessed.
Utility of Lumbar Puncture for First Simple Febrile Seizure Among Children 6 to 18 Months of Age
Authors: Kimia Amir A. , Capraro Andrew J. , Hummel David , Johnston Patrick , Harper Marvin B. 
Published: December 2008

OBJECTIVES. American Academy of Pediatrics consensus statement recommendations are to consider strongly for infants 6 to 12 months of age with a first simple febrile seizure and to consider for children 12 to 18 months of age with a first simple febrile seizure lumbar puncture for cerebrospinal fluid analysis. Our aims were to determine compliance with these recommendations and to assess the rate of bacterial meningitis detected among these children.METHODS. A retrospective cohort review was performed for patients 6 to 18 months of age who were evaluated for first simple febrile seizure in a pediatric emergency department between October 1995 and October 2006.RESULTS. First simple febrile seizure accounted for 1% of all emergency department visits for children of this age, with 704 cases among 71 234 eligible visits during the study period. Twenty-seven percent (n = 188) of first simple febrile seizure visits were for infants 6 to 12 months of age, and 73% (n = 516) were for infants 12 to 18 months of age. Lumbar puncture was performed for 38% of the children (n = 271). Samples were available for 70% of children 6 to 12 months of age (131 of 188 children) and 25% of children 12 to 18 months of age (129 of 516 children). Rates of lumbar puncture decreased significantly over time in both age groups. The cerebrospinal fluid white blood cell count was elevated in 10 cases (3.8%). No pathogen was identified in cerebrospinal fluid cultures. Ten cultures (3.8%) yielded a contaminant. No patient was diagnosed as having bacterial meningitis.CONCLUSIONS. The risk of bacterial meningitis presenting as first simple febrile seizure at ages 6 to 18 months is very low. Current American Academy of Pediatrics recommendations should be reconsidered.
Functional Magnetic Resonance Imaging of the Sensorimotor System in Preterm Infants
Authors: Heep Axel , Scheef Lukas , Jankowski Jakob , Born Mark , Zimmermann Nadine , Sival Deborah , Bos Arie , Gieseke Jürgen , Bartmann Peter , Schild Hans , Boecker Henning 
Published: December 2008

OBJECTIVE. Preterm birth at &lt;32 weeks' gestational age has a specific predilection for periventricular white matter injury. Early prediction of concomitant motor sequelae is a fundamental clinical issue. Recently, functional MRI was introduced as a noninvasive method for investigating the functional integrity of the neonatal brain. We aimed at implementing a unilateral passive forearm extension/flexion functional MRI paradigm in a routine clinical MRI setup to allow noninvasive mapping of the sensorimotor system in preterm infants and to relate the functional data to structural and behavioral data.PATIENTS AND METHODS. Eight patients (median gestational age: 26.5 weeks; median birth weight: 885 g) were included. The functional MRI was performed at term-equivalent age (median: 39 weeks' postconceptional age) under chloral hydrate (50 mg/kg) sedation. In 5 of 8 patients, functional MRI data acquisition was successful. This resulted in 10 functional data sets (5 for passive stimulation of each forearm).RESULTS. Unilateral stimulation was associated with mainly bilateral activation of the primary sensorimotor cortex (n = 7 of 10 data sets), the prevailing hemodynamic response being a negative blood oxygenation level–dependent signal. Positive blood oxygenation level–dependent response or failure to activate the sensorimotor cortex (n = 3 of 10 data sets) were seen in those patients with aberrant structural/behavioral indices.CONCLUSIONS. Our data show the feasibility of passive unilateral sensorimotor stimulation during neonatal clinical MRI protocols. The bilateral activation pattern observed at this age is compatible with a bilaterally distributed sensorimotor system. Our data validate initial accounts for a raised incidence of negative blood oxygenation level–dependent responses in the primary sensorimotor cortex at this developmental stage. The negative blood oxygenation level–dependent response is likely to reflect a reduction of the oxy/deoxy–hemoglobin ratio during a maturational stage characterized by rapid formation of synapses, yet ineffective processing. Positive blood oxygenation level–dependent responses or failure to activate the sensorimotor cortex may be an early indicator of abnormal development and will have to be followed up carefully.
Thelarche, Pubarche, and Menarche Attainment in Children With Normal and Elevated Body Mass Index
Authors: Rosenfield Robert L. , Lipton Rebecca B. , Drum Melinda L. 
Published: December 2008

BACKGROUND. The early onset of puberty may be related to obesity, so there is a need to know the prevalence of early pubertal milestones in nonoverweight children.
OBJECTIVE. We compared attainment of stage 2 breasts, stage 3 (sexual) pubic hair, and menarche in the Third National Health and Nutrition Examination Survey sample of children with normal BMI with those with excessive BMI (≥85th percentile).
DESIGN/METHODS. The ages at which 5%, 50%, and 95% of youth had attained key pubertal stages were estimated by probit models. Logit models were then fit to compare attainment of these milestones in children of excessive and normal BMI.
RESULTS. Pubertal signs occurred before 8.0 years of age in &lt;5% of the normal-BMI general and non-Hispanic white female population. However, pubertal milestones generally appeared earlier in normal-BMI non-Hispanic black and Mexican American girls; thelarche occurred before age 8.0 in 12% to 19% of these groups, and the 5th percentile for menarche was 0.8 years earlier for non-Hispanic black than non-Hispanic white subjects. Pubarche was found in ≤3% of 8.0-year-old girls with normal BMI of all of these ethnic groups but was significantly earlier in minority groups. Pubarche appeared before 10.0 years in &lt;2% of normal-BMI boys. Girls with excessive BMI had a significantly higher prevalence of breast appearance from ages 8.0 through 9.6 years and pubarche from ages 8.0 through 10.2 years than those with normal BMI. Menarche was also significantly more likely to occur in preteen girls with an elevated BMI.
CONCLUSIONS. Prevalence estimates are given for the key pubertal milestones in children with normal BMI. Breast and sexual pubic hair development are premature before 8 years of age in girls with normal BMI in the general population. Adiposity and non-Hispanic black and Mexican American ethnicity are independently associated with earlier pubertal development in girls.
Assessing the Impact of the Introduction of the World Health Organization Growth Standards and Weight-for-Height z-Score Criterion on the Response to Treatment of Severe Acute Malnutrition in Children: Secondary Data Analysis
Authors: Isanaka Sheila , Villamor Eduardo , Shepherd Susan , Grais Rebecca F. 
Published: December 2008

OBJECTIVE. The objective of our study was to assess the impact of adopting the World Health Organization growth standards and weight-for-height z-score criterion on the response to treatment of severe acute malnutrition in children compared with the use of the National Center for Health Statistics growth reference.
METHODS. We used data from children aged 6 to 59 months with acute malnutrition who were admitted to the Médecins sans Frontières nutrition program in Maradi, Niger, during 2006 (N = 56214). Differences in weight gain, duration of treatment, recovery from malnutrition, mortality, loss to follow-up, and need for inpatient care were compared for severely malnourished children identified according to the National Center for Health Statistics reference and weight-for-height &lt;70% of the median criterion versus the World Health Organization standards and the weight-for-height less than −3 z-score criterion.
RESULTS. A total of 8 times more children (n = 25754) were classified as severely malnourished according to the World Health Organization standards compared with the National Center for Health Statistics reference (n = 2989). Children included according to the World Health Organization standards had shorter durations of treatment, greater rates of recovery, fewer deaths, and less loss to follow-up or need for inpatient care.
CONCLUSIONS. The introduction of the World Health Organization standards with the z-score criterion to identify children for admission into severe acute malnutrition treatment programs would imply the inclusion of children who are younger but have relatively higher weight for height on admission compared with the National Center for Health Statistics reference. These children have fewer medical complications requiring inpatient care and are more likely to experience shorter durations of treatment and lower mortality rates. The World Health Organization standards with the z-score criterion might become a useful tool for the early detection of acute malnutrition in children, although additional research on the resource implications of this transition is required.
School Absenteeism, Health Status, and Health Care Utilization Among Children With Asthma: Associations With Parental Chronic Disease
Authors: Lipstein Ellen A. , Perrin James M. , Kuhlthau Karen A. 
Published: December 2008

OBJECTIVE. Parents with chronic disease may be more likely than healthy parents to perceive their children with chronic conditions as medically vulnerable. Our objective for this study was to determine if children with asthma whose parents have chronic disease differ in health care utilization, school absenteeism, and reported child health status compared with those whose parents do not have chronic disease.PATIENTS AND METHODS. We selected children with asthma, 5 to 17 years of age, and their parents from the 2003 National Health Interview Survey. We determined whether parents had chronic disease and examined associations of parental chronic disease with child health status, school absenteeism, and health care utilization. We controlled for factors known to influence our dependent variables, including an indicator of child disease severity, in multivariable regression.RESULTS. Among 561 parent-child dyads, children with asthma whose parents had chronic disease were more likely to have less than very good health and missed an average of 1.3 more school days annually than other children with asthma. Among children with less severe asthma, those whose parents had chronic disease had lower reported health status but did not miss more school (mean difference: 0.39) than children whose parents did not have chronic disease. Having a parent with chronic disease was not associated with increased health care utilization.CONCLUSIONS. Compared with other children with asthma, children whose parents have chronic disease have worse health status and miss more school, particularly among children with more severe asthma. Understanding how parents’ health influences children's health care and health status may help providers work with parents to more effectively and efficiently manage their children's asthma care so they can more fully participate in school and other activities.