bluuebunny/crossref_metadata_2025_split huggingface dataset:
The costs and potential savings of a novel telepaediatric service in Queensland
Authors: Smith Anthony C , Scuffham Paul , Wootton Richard 
Published: March 2007

Abstract
Background
There are few cost-minimisation studies in telemedicine. We have compared the actual costs of providing a telepaediatric service to the potential costs if patients had travelled to see the specialist in person.

Methods
In November 2000, we established a novel telepaediatric service for selected regional hospitals in Queensland. Instead of transferring patients to Brisbane, the majority of referrals to specialists in Brisbane were dealt with via videoconference. Since the service began, 1499 consultations have been conducted for a broad range of paediatric sub-specialities including burns, cardiology, child development, dermatology, diabetes, endocrinology, gastroenterology, nephrology, neurology, oncology, orthopaedics, paediatric surgery and psychiatry.

Results
During a five year period, the total cost of providing 1499 consultations through the telepaediatric service was A$955,996. The estimated potential cost of providing an outpatient service to the same number of patients at the Royal Children's Hospital in Brisbane was A$1,553,264; thus, telepaediatric services resulted in a net saving of approximately A$600,000 to the health service provider.

Conclusion
Telepaediatrics was a cheaper method for the delivery of outpatient services when the workload exceeded 774 consultations. A sensitivity analysis showed that the threshold point was most sensitive to changes related to patient travel costs, coordinator salaries and videoconference equipment costs. The study showed substantial savings for the health department, mainly due to reduced costs associated with patient travel.
Trans-inhibition of HIV-1 by a long hairpin RNA expressed within the viral genome
Authors: Konstantinova Pavlina , ter Brake Olivier , Haasnoot Joost , de Haan Peter , Berkhout Ben 
Published: March 2007

Abstract

Background
Human immunodeficiency virus type 1 (HIV-1) can be inhibited by means of RNA silencing or interference (RNAi) using synthetic short interfering RNAs (siRNAs) or gene constructs encoding short hairpin RNAs (shRNAs) or long hairpin RNAs (lhRNAs). The use of siRNA and shRNA as antiviral therapeutic is limited because of the emergence of viral escape mutants. This problem is theoretically prevented by intracellular expression of lhRNAs generating multiple siRNAs that target the virus simultaneously, thus reducing the chance of viral escape. However, gene constructs encoding lhRNA molecules face problems with delivery to the right cells in an infected individual. In order to solve this problem, we constructed an HIV-1 variant with a 300 bp long hairpin structure in the 3' part of the genome corresponding to the Nef gene (HIV-lhNef).

Results
Intriguingly, HIV-lhNef potently inhibited wild-type HIV-1 production in trans. However, HIV-lhNef demonstrated a severe production and replication defect, which we were able to solve by selecting spontaneous virus variants with truncated hairpin structures. Although these escape variants lost the ability to trans-inhibit HIV-1, they effectively outgrew the wild-type virus in competition experiments in SupT1 cells.

Conclusion
Expression of the lhNef hairpin within the HIV-1 genome results in potent trans-inhibition of wild-type HIV-1. Although the mechanism of trans-inhibition is currently unknown, it remains of interest to study the molecular details because the observed effect is extremely potent. This may have implications for the development of virus strains to be used as live-attenuated virus vaccines.
Tumor necrosis factor alpha and adalimumab differentially regulate CD36 expression in human monocytes
Authors: Boyer Jean Frédéric , Balard Patricia , Authier Hélène , Faucon Bruno , Bernad José , Mazières Bernard , Davignon Jean-Luc , Cantagrel Alain , Pipy Bernard , Constantin Arnaud 
Published: March 2007

Abstract
In chronic inflammatory diseases, such as rheumatoid arthritis, inflammation acts as an independent cardiovascular risk factor and the use of anti-inflammatory drugs, such as anti-tumor necrosis factor alpha (anti-TNFα), may decrease this risk. The phagocytosis of oxidized low density lipoproteins (LDLs) accumulated in the subendothelium by mononuclear cells influences atherosclerosis and depends on CD36 expression. We investigated the role of TNFα and adalimumab, a human anti-TNFα monoclonal antibody widely used in human pathology, in CD36 expression in human monocytes. Human monocytes were prepared by adherence from whole-blood buffy-coat fractions from healthy donors. CD36 expression was assessed by RT-PCR and flow cytometry, with various TNFα or adalimumab concentrations. Implication of peroxisome proliferator-activated receptor (PPAR)γ in the regulation of CD36 expression was assessed using specific inhibitor or gel shift assays. The impact of redox signaling was investigated using quantification of reactive oxygen species, antioxidant and a NADPH oxidase inhibitor. The F(ab')2 fragment of adalimumab was isolated and its effect was analyzed. TNFα inhibits both CD36 membrane expression and mRNA expression. This inhibition involves a reduction in PPARγ activation. In contrast, adalimumab increases both CD36 membrane expression and mRNA expression. This induction is independent of the Fc portion of adalimumab and involves redox signaling via NADPH oxidase activation. CD36 expression on human monocytes is inhibited by TNFα and independently increased by adalimumab. These data highlight that pro-inflammatory cytokines and their specific neutralization influence the expression of cellular receptors implicated in atherosclerosis. Further studies are needed to investigate the clinical implications of these results in accelerated atherosclerosis observed in rheumatoid arthritis.
The Opportunity Loss of Boarding Admitted Patients in the Emergency Department
Authors: Falvo Thomas , Grove Lance , Stachura Ruth , Vega David , Stike Rose , Schlenker Melissa , Zirkin William 
Published: March 2007

Abstract
Objectives:
Boarding admitted patients in emergency department (ED) treatment beds has been recognized as a major cause of ED crowding and ambulance diversions. When process delays impede the transfer of admitted patients from the ED to inpatient units, the department's capacity to accept new arrivals and to generate revenue from additional patient services is restricted. The objective of this study was to determine the amount of functional ED treatment capacity that was used to board inpatients during 12 months of operations at a community hospital and to estimate the value of that lost treatment capacity.
Methods:
Historical data from 62,588 patient visits to the ED of a 450‐bed nonprofit community teaching hospital in south central Pennsylvania between July 2004 and June 2005 were used to determine the amount of treatment bed occupancy lost to inpatient holding and the revenue potential of utilizing that blocked production capacity for additional patient visits.
Results:
Transferring admitted patients from the ED to an inpatient unit within 120 minutes would have increased the functional treatment capacity of the ED by 10,397 hours during the 12 months of this study. By reducing admission process delays, the hospital could potentially have accommodated another 3,175 patient encounters in its existing treatment spaces. Providing emergency services to new patients in ED beds formerly used to board inpatients could have generated $3,960,264 in additional net revenue for the hospital.
Conclusions:
Significantly higher operational revenues could be generated by reducing output delays that restrict optimal utilization of existing ED treatment capacity.
Wie es vor 25 Jahren war
Authors: Wunderlich Dieter 
Published: March 2007

Abstract
Damals kam die Gründergeneration in das Ruhestandsalter. Man erinnere sich, daß die deutsche Sprachwissenschaft der Nazizeit völkisch, inhaltsbezogen und kulturorientiert war und sich auch danach nur wenige strukturalistische Tupfer erlaubte, als sie, die Gründer, sich 33 Jahre nach Kriegsende (!) endlich eine eigene Organisation schufen, inspiriert von neuen hoffnungsvollen Entwicklungen der generativen Grammatik, der logischen Semantik und der Sprechakttheorie, nämlich die Deutsche Gesellschaft für Sprachwissenschaft – das war fast ein Menschenalter nach der Gründung der Linguistic Society of America im Jahre 1924. So wie zur LSA die Zeitschrift Language gehört, wollte die DGfS ihre eigene Zeitschrift für Sprachwissenschaft haben; es dauerte dann noch drei Jahre, bis der erste Jahrgang 1982 erschien. Diese Gründer nun, aus verschiedensten Gebieten kommend und im Bereich der modernen Linguistik fast allesamt Autodidakten, hatten die Sprachwissenschaft in Deutschland wieder zu einer aktiven Disziplin gemacht – was ihrer Bedeutung ja zukommt –, sie hatten Forschergruppen und Sonderforschungsbereiche betrieben, sich international umgesehen, Bücher und Artikel zunehmend in englischer Sprache geschrieben, Schüler ausgebildet und in die USA vermittelt, neue Zentren gegründet.
Factors Associated With Identification and Management of Maternal Depression by Pediatricians
Authors: Heneghan Amy M. , Chaudron Linda H. , Storfer-Isser Amy , Park Elyse R. , Kelleher Kelly J. , Stein Ruth E. K. , Hoagwood Kimberly Eaton , O'Connor Karen G. , Horwitz Sarah McCue 
Published: March 2007

OBJECTIVE. We sought to identify characteristics of pediatricians that were associated with identification or management (referral and/or treatment) of mothers with depression.METHODS. A cross-sectional survey was mailed to a random sample of 1600 of the 50818 US nonretired members of the American Academy of Pediatrics. Overall, 832 responded, with 745 responses from nontrainee members. The 662 fellow nontrainee members who engaged in direct patient care and completed information on identifying, referring, and treating maternal depression were included in the analyses.RESULTS. A total of 511 of 662 respondents reported identifying maternal depression; of those who reported identifying maternal depression, 421 indicated they referred and 29 that they treated maternal depression in their practices. Pediatricians who are older, work in practices that provide child mental health services, see primarily (≥75%) white patients, use ≥1 method to address maternal depression, agree that pediatricians should be responsible for identifying maternal depression, think that maternal depression has an extreme effect on children's mental health, and are attitudinally more inclined to identify or manage maternal depression had significantly higher odds of reporting identification of maternal depression. Positive correlates of identification and management of maternal depression included practicing in the Midwest, using ≥1 method to address maternal depression, working in a practice that provides child mental health services, thinking that caregiving problems attributable to maternal health have an extreme effect on children's physical health, having attitudes that are more inclined to identify and to manage maternal depression, and usually inquiring about symptoms routinely to identify maternal depression.CONCLUSIONS. Pediatricians' practice characteristics and attitudes are associated with their identification and management of mothers with depression.
Inaccuracy in Pediatric Outpatient Blood Pressure Measurement
Authors: Podoll Amber , Grenier Michelle , Croix Beth , Feig Daniel I. 
Published: March 2007

OBJECTIVE. Hypertension is common in the pediatric population. There is increasing evidence for early hypertensive target organ damage that may lead to substantial long-term morbidity. Because a critical aspect of any screening program for hypertension is the ability to measure blood pressure accurately, we compared typical blood pressure measurements at a vital sign station with those that were obtained following recommendations set forth in “The Fourth Report on the Diagnosis, Evaluation, and Treatment of High Blood Pressure in Children and Adolescents.”
METHODS. We compared the blood pressure measurements that were obtained with standard practice vital sign station screening with those that were obtained by trained personnel in accordance with Fourth Task Force recommendations. A total of 390 children were evaluated at 580 visits to the Pediatric Hypertension Clinic at Texas Children’s Hospital.
RESULTS. Seventy-four percent of the readings were higher at the vital sign station, and only 12% differed by &lt;5 mm Hg for both systolic blood pressure and diastolic blood pressure. The mean difference between vital sign station and examination room was 13.2 ± 8.9 mm Hg for systolic blood pressure and 9.6 ± 7.6 mm Hg for diastolic blood pressure. Multiple regression analyses revealed that age, gender, race, obesity, first versus subsequent visit, essential versus secondary, or white coat hypertension and antihypertensive medications made no statistically significant difference in the lack of correlation of the readings.
CONCLUSION. These results suggest that if pediatricians use vital sign station screening for blood pressure, children with elevated initial measurements must be reevaluated in the examination room.
Mortality of Late-Preterm (Near-Term) Newborns in Utah
Authors: Young Paul C. , Glasgow Tiffany S. , Li Xi , Guest-Warnick Ginger , Stoddard Gregory 
Published: March 2007

OBJECTIVES. The purpose of this work was to determine the relative risk for mortality and the causes and ages of death for late-preterm newborns (gestational age of 34–36 weeks) compared with those born at term.
METHODS. We reviewed data from birth and death certificates of infants born in Utah between 1999 and 2004. We calculated early neonatal (first week), neonatal (first 28 days), and infant (first year) mortality rates for each weekly estimated gestational age cohort from 34 to 42 weeks and, using 40 weeks as the reference, risk ratios for each cohort. Causes of death were grouped into 8 categories and compared for near term and term newborns. Crude mortality rates and risk ratios for death from all causes and for infants dying of all causes other than birth defects were measured.
RESULTS. Birth defects were the single-most common cause of death for both term and late-preterm newborns. Mortality rates for late-preterm newborns remained significantly higher after excluding those who died of birth defects from the comparisons.
CONCLUSIONS. Compared with those born at term, late-preterm (near-term) newborns have significantly higher mortality rates. Each weekly increase in estimated gestational age is associated with a decreasing risk of death. Birth defects are the leading cause of death among late-preterm newborns but do not entirely account for their higher risk of death.
Special Requirements of Electronic Health Record Systems in Pediatrics
Authors: Spooner S. Andrew ,   and the Council on Clinical Information Technology
Published: March 2007

This Clinical Report was revised. See https://doi.org/10.1542/peds.2024-068509.
Some functions of an electronic health record system are much more important in providing pediatric care than in adult care. Pediatricians commonly complain about the absence of these “pediatric functions” when they are not available in electronic health record systems. To stimulate electronic health record system vendors to recognize and incorporate pediatric functionality into pediatric electronic health record systems, this clinical report reviews the major functions of importance to child health care providers. Also reviewed are important but less critical functions, any of which might be of major importance in a particular clinical context. The major areas described here are immunization management, growth tracking, medication dosing, data norms, and privacy in special pediatric populations. The American Academy of Pediatrics believes that if the functions described in this document are supported in all electronic health record systems, these systems will be more useful for patients of all ages.
Directed Neural Differentiation of Human Embryonic Stem Cells via an Obligated Primitive Anterior Stage
Authors: Pankratz Matthew T. , Li Xue-Jun , LaVaute Timothy M. , Lyons Elizabeth A. , Chen Xin , Zhang Su-Chun 
Published: March 2007

Abstract
Understanding neuroectoderm formation and subsequent diversification to functional neural subtypes remains elusive. We show here that human embryonic stem cells (hESCs) differentiate to primitive neuroectoderm after 8–10 days. At this stage, cells uniformly exhibit columnar morphology and express neural markers, including anterior but not posterior homeodomain proteins. The anterior identity of these cells develops regardless of morphogens present during initial neuroectoderm specification. This anterior phenotype can be maintained or transformed to a caudal fate with specific morphogens over the next week, when cells become definitive neuroepithelia, marked by neural tube-like structures with distinct adhesion molecule expression, Sox1 expression, and a resistance to additional patterning signals. Thus, primitive neuroepithelia represents the earliest neural cells that possess the potential to differentiate to regionally specific neural progenitors. This finding offers insights into early human brain development and lays a foundation for generating neural cells with correct positional and transmitter profiles.
Disclosure of potential conflicts of interest is found at the end of this article.
Actinobacillus actinomycetemcomitans Lipopolysaccharide‐Mediated Experimental Bone Loss Model for Aggressive Periodontitis
Authors: Rogers Jill E. , Li Fei , Coatney Derek D. , Rossa Carlos , Bronson Paul , Krieder Jaclynn M. , Giannobile William V. , Kirkwood Keith L. 
Published: March 2007

Background: Bacterial constituents, such as Gram‐negative derived lipopolysaccharide (LPS), can initiate inflammatory bone loss through induction of host‐derived inflammatory cytokines. The aim of this study was to establish a model of aggressive inflammatory alveolar bone loss in rats using LPS derived from the periodontal pathogen Actinobacillus actinomycetemcomitans.Methods: Eighteen female Sprague‐Dawley rats were divided into LPS test (N = 12) and saline control (N = 6) groups. All animals received injections to the palatal molar gingiva three times per week for 8 weeks. At 8 weeks, linear and volumetric alveolar bone loss was measured by micro‐computed tomography (μCT). The prevalence of inflammatory infiltrate, proinflammatory cytokines, and osteoclasts was assessed from hematoxylin and eosin, immunohistochemical, or tartrate‐resistant acid phosphatase (TRAP)‐stained sections. Statistical analysis was performed.Results: A. actinomycetemcomitans LPS induced severe bone loss over 8 weeks, whereas control groups were unchanged. Linear and volumetric analysis of maxillae by μCT indicated significant loss of bone with LPS administration. Histologic examination revealed increased inflammatory infiltrate, significantly increased immunostaining for interleukin IL‐6 and ‐1β and tumor necrosis factor‐alpha, and more TRAP‐positive osteoclasts in the LPS group compared to controls.Conclusion: Oral injections of LPS derived from the periodontal pathogen A. actinomycetemcomitans can induce severe alveolar bone loss and proinflammatory cytokine production in rats by 8 weeks.
Depth Distribution of Sulfonamide Antibiotics in Pore Water of an Undisturbed Loamy Grassland Soil
Authors: Burkhardt Michael , Stamm Christian 
Published: March 2007

ABSTRACTDespite the concern raised by the detections of veterinary antibiotics like sulfonamides (SA) in the environment, their fate in soils is still not sufficiently understood. In a previous article, we demonstrated that manure may substantially influence losses of SA via runoff from soils. Here, we report on the effect of manure on SA availability in soil pore water. Three sulfonamides (sulfadimidine, sulfadiazine, sulfathiazole) and two tracers (bromide and Brilliant Blue) were either applied in manure or as aqueous solution on grassland plots. After 1 and 3 d contact time, the plots were irrigated with deionized water. One day after irrigation, soil cores were taken and profiles of pore water concentrations were determined. The median SA concentrations of the top layer on manured plots varied between 40 and 60 μg L−1 and between 10 and 30 μg L−1 on the controls. For the conservative tracer Br the mass recovery was about 60 to 75% and much lower for the SA (2 to 14%). Apparent distribution coefficients Kd,app of the SA in the topsoil ranged between 3 and 15 L kg−1 on the manured plots and between 30 to 35 kg L−1 on the controls. Below the top layer, the concentration distribution showed a pattern typical for preferential flow. Locally, SA concentrations down to 30‐ to 50‐cm depth were as high as in the top 5 cm with little effect of the two application matrices. In the topmost layer, the data indicate that 10 to 25% of sulfadimidine were transformed to its acetyl‐metabolite.
Surgical management of a thyroglossal duct cyst in a cat
Authors: Giles James T. , Rochat Mark C. , Snider Timothy A. 
Published: March 2007

Abstract
Case Description—A 14-year-old castrated male domestic shorthair cat was evaluated because of a large fluid-filled mass on the ventral aspect of the neck that failed to resolve after repeated draining.
Clinical Findings—Radiography and computed tomography revealed a fluid-filled mass 13 cm in diameter extending from the level of the first cervical vertebra to the manubrium. No evidence of metastasis was seen. Cytologic examination of the fluid revealed it to be a transudate with a T4 concentration considered to be normal. Incisional biopsy of the cyst wall was performed and led to a diagnosis of thyroglossal duct cyst.
Treatment and Outcome—The cyst was excised, and no recurrence was observed 15 months after surgery. Aside from temporary seroma formation, no complications developed after the surgery. A distinct tract through the hyoid apparatus to the base of the tongue, as has been described in humans, was not identified.
Clinical Relevance—Thyroglossal duct cyst should be considered as a differential diagnosis in cats with masses on the ventral aspect of the neck. Complete excision appeared to be curative in the cat of this report.