bluuebunny/crossref_metadata_2025_split huggingface dataset:
Generation of Carbon Free Radicals by Reduction of the Cation Pool
Authors: Suga Seiji , Suzuki Shinkiti , Maruyama Tomokazu , Yoshida Jun-ichi 
Published: August 2004

Abstract
The electrochemical reduction of N-acyliminium ions, which were generated by the “cation pool” method, led to the formation of carbon free radicals. Carbon radicals thus generated underwent homo-coupling reactions and the reactions with activated olefins, such as methyl acrylate. In the latter case, a mechanism involving the addition of a carbon radical to the carbon–carbon double bond, followed by one-electron reduction to give carbanions, has been proposed. The present study opens a new possibility for radical-mediated carbon–carbon bond formation based on the reduction of carbocations.
Molecular recognition in bone morphogenetic protein (BMP)/receptor interaction
Authors: Sebald Walter , Nickel Joachim , Zhang Jin-Li , Mueller Thomas D. 
Published: August 2004

AbstractBone morphogenetic proteins (BMPs) and other members of the TGF-β superfamily are secreted signalling proteins determining the development, maintenance and regeneration of tissues and organs. These dimeric proteins bind, via multiple epitopes, two types of signalling receptor chains and numerous extracellular modulator proteins that stringently control their activity. Crystal structures of free ligands and of complexes with type I and type II receptor extracellular domains and with the modulator protein Noggin reveal structural epitopes that determine the affinity and specificity of the interactions. Modelling of a ternary complex BMP/(BMPR-IAEC)2/(ActR-IIEC)2suggests a mechanism of receptor activation that does not rely on direct contacts between extracellular domains of the receptors. Mutational and interaction analyses indicate that the large hydrophobic core of the interface of BMP-2 (wrist epitope) with the type I receptor does not provide a hydrophobic hot spot for binding. Instead, main chain amide and carbonyl groups that are completely buried in the contact region represent major binding determinants. The affinity between ligand and receptor chains is probably strongly increased by two-fold interactions of the dimeric ligand and receptor chains that exist as homodimers in the membrane (avidity effects). BMP muteins with disrupted epitopes for receptor chains or modulator proteins provide clues for drug design and development.
My Mother Caused My Illness: The Story of a Survivor of Münchausen by Proxy Syndrome
Authors: Bryk Mary , Siegel Patricia T. 
Published: August 2004

Objective. Münchausen by proxy syndrome (MBPS) is a form of child abuse in which a parent fabricates or produces illness in a child. Although the medical consequences of MBPS have been well described, there is no detailed published account of what it was like to grow up in a family where the mother systematically induced serious illness. This article describes one victim's childhood experiences.
Methods. The medical history was obtained from a review of the original medical records, notes from the primary physician, discussions with two physicians who provided treatment, and several meetings with the victim and the victim's therapist.
Results. This article chronicles the actual experiences of an MBPS victim through 8 years of medical abuse at the hands of her mother, reveals the victim's account of what happened to her, describes what her family was like, details the long-term consequences on emotional and physical development, identifies the factors that influence recovery, and details the impact on family relationships.
Conclusions. Child maltreatment and MBPS need to be part of the differential diagnosis when the clinical picture is atypical or does not appear medically plausible. The consequences of MBPS are psychological and physical and impact the entire family. Suggestions to assist heath care providers recognize, assess, and report cases of suspected MBPS are provided.
Safety and Pharmacokinetics of Multiple Doses of Recombinant Human CuZn Superoxide Dismutase Administered Intratracheally to Premature Neonates With Respiratory Distress Syndrome
Authors: Davis Jonathan M. , Rosenfeld Warren N. , Richter Susan E. , Parad Richard , Gewolb Ira H. , Spitzer Alan R. , Carlo Waldemar A. , Couser Robert J. , Price Anita , Flaster Edith , Kassem Nadim , Edwards Lionel , Tierney Joan , Horowitz Stuart 
Published: August 2004

Objectives. To examine the safety and pharmacokinetics of multiple intratracheal (IT) doses of recombinant human CuZn superoxide dismutase (rhSOD) in premature infants with respiratory distress syndrome who are at risk for developing bronchopulmonary dysplasia (BPD).Methods. Thirty-three infants (700 to 1300 g) were randomized and blindly received saline, 2.5 mg/kg or 5 mg/kg rhSOD IT within 2 hours of surfactant administration. Infants were treated every 48 hours (as long as endotracheal intubation was required) up to 7 doses. Serial blood and urine studies, chest radiographs, neurosonograms, SOD concentration and activity measurements, and tracheal aspirate (TA) inflammatory markers were assessed throughout the 28-day study.Results. SOD concentrations in serum (0.1 [0.05/0.15] μg/mL–geometric mean with lower/upper confidence intervals), tracheal aspirates (TA) (0.2 [0.1/0.3] μg/mL) and urine (0.3 [0.2/0.4] μg/mL) were similar at baseline in all 3 groups and did not change significantly in the placebo group. In the rhSOD treatment groups, SOD concentrations were increased on day 3 and did not change significantly thereafter over the 14-day dosing period (also measured on days 5, 7, and 13). SOD concentrations averaged 0.4 [0.3/0.5] μg/mL in serum, 0.8 [0.6/1.2] μg/mL in TA and 1.1 [1.0/1.3] μg/mL in urine for the low-dose group and 0.6 [0.5/0.7] μg/mL in serum, 1.1 [0.9/1.5] μg/mL in TA, and 2.2 [1.6/2.9] μg/mL in urine for the high-dose group over the 14-day dosing period. Enzyme activity directly correlated with SOD concentration and rhSOD was active even when excreted in urine. TA markers of acute lung injury (neutrophil chemotactic activity, albumin concentration) were lower in the rhSOD agroups compared with placebo. No significant differences in any clinical outcome variable were noted between groups.Conclusions. These data indicate that multiple IT doses of rhSOD increase the concentration and activity of the enzyme in serum, TA and urine, reduce TA lung injury markers and are well-tolerated. Further clinical trials examining the efficacy of rhSOD in the prevention of BPD are warranted.
Safety of a Fat-reduced Diet: The Dietary Intervention Study in Children (DISC)
Authors: Obarzanek Eva , Hunsberger Sally A. , Van Horn Linda , Hartmuller Virginia V. , Barton Bruce A. , Stevens Victor J. , Kwiterovich Peter O. , Franklin Frank A. , Kimm Sue Y. S. , Lasser Norman L. , Simons-Morton Denise G. , Lauer Ronald M. 
Published: August 2004

Objective. To assess the relationship between energy intake from fat and anthropometric, biochemical, and dietary measures of nutritional adequacy and safety.Design. Three-year longitudinal study of children participating in a randomized controlled trial; intervention and usual care group data pooled to assess effects of self-reported fat intake; longitudinal regression analyses of measurements at baseline, year 1, and year 3.Participants. Six hundred sixty-three children (362 boys and 301 girls), 8 to 10 years of age at baseline, with elevated low-density lipoprotein cholesterol, who are participants of the Dietary Intervention Study in Children.Measures. Energy intake from fat assessed from three 24-hour recalls at each time point was the independent variable. Outcomes were anthropometric measures (height, weight, body mass index, and sum of skinfolds), nutritional biochemical determinations (serum ferritin, zinc, retinol, albumin, β-carotene, and vitamin E, red blood cell folate, and hemoglobin), and dietary micronutrients (vitamins A, C, E, thiamin, riboflavin, niacin, vitamins B-6, B-12, folate, calcium, iron, zinc, magnesium, and phosphorus).Results. Lower fat intake was not related to anthropometric measures or serum zinc, retinol, albumin, β-carotene, or vitamin E. Lower fat intake was related to: 1) higher levels of red blood cell folate and hemoglobin, with a trend toward higher serum ferritin; 2) higher intakes of folate, vitamin C, and vitamin A, with a trend toward higher iron intake; 3) lower intakes of calcium, zinc, magnesium, phosphorus, vitamin B-12, thiamin, niacin, and riboflavin; 4) increased risk of consuming less than two-thirds of the Recommended Dietary Allowances for calcium in girls at baseline, and zinc and vitamin E in boys and girls at all visits.Conclusions. Lower fat intakes during puberty are nutritionally adequate for growth and for maintenance of normal levels of nutritional biochemical measures, and are associated with beneficial effects on blood folate and hemoglobin. Although lower fat diets were related to lower self-reported intakes of several nutrients, no adverse effects were observed on blood biochemical measures of nutritional status. Current public health recommendations for moderately lower fat intakes in children during puberty may be followed safely.
Mortality Within the First 2 Years in Infants Exposed to Cocaine, Opiate, or Cannabinoid During Gestation
Authors: Ostrea Enrique M. , Ostrea Anthony R. , Simpson Pippa M. 
Published: August 2004

Objective. To determine the mortality rate, during the first 2 years of life, in infants who were exposed to cocaine, opiate, or cannabinoid during gestation.
Methods. For a period of 11 months, a large group of infants were enrolled and screened at birth for exposure to cocaine, opiate, or cannabinoid by meconium analysis. Death outcome, within the first 2 years after birth, was determined in this group of infants using the death registry of the Michigan Department of Public Health.
Results. A total of 2964 infants was studied. At birth, 44% of the infants tested positive for drugs: 30.5% positive for cocaine, 20.2% for opiate, and 11.4% for cannabinoids. Compared to the drug negative group, a significantly higher percentage (P &lt; .05) of the drug positive infants had lower weight and smaller head circumference and length at birth and a higher percent of their mothers were single, multigravid, multiparous, and had little to no prenatal care. Within the first 2 years of life, 44 infants died: 26 were drug negative (15.7 deaths per 1000 live births) and 18 were drug positive (13.7 deaths per 1000 live births). The mortality rate among cocaine, opiate, or cannabinoid positive infants were 17.7, 18.4, and 8.9 per 1000 live births, respectively. Among infants with birth weight ≤2500 g, infants who were positive for both cocaine and morphine had a higher mortality rate (odds ratio = 5.9, confidence interval [CI] = 1.4 to 24) than drug negative infants. Eleven infants died from the sudden infant death syndrome (SIDS); 58% were positive for drugs, predominantly cocaine. The odds ratio for SIDS among drug positive infants was 1.5 (CI = 0.46 to 5.01) and 1.9 (CI = 0.58 to 6.2) among cocaine positive infants.
Conclusion. We conclude that prenatal drug exposure in infants, although associated with a high perinatal morbidity, is not associated with an overall increase in their mortality rate or incidence of SIDS during the first 2 years of life. However, a significantly higher mortality rate was observed among low birth weight infants (≤2500 g) who were positive for both cocaine and opiate.
Determinants of Behavior in Homeless and Low-income Housed Preschool Children
Authors: Bassuk Ellen L. , Weinreb Linda F. , Dawson Ree , Perloff Jennifer N. , Buckner John C. 
Published: August 2004

Objectives. To describe the characteristics of homeless and low-income preschool-aged children, and to identify family and environmental determinants of their behavior.
Methods. An unmatched case-control design was used to recruit a sample of sheltered homeless families and a comparison group of low-income housed families who were never homeless in Worcester, Massachusetts. Seventy-seven sheltered homeless and 90 low-income housed mothers with preschool-age children were assessed using a comprehensive interview protocol. Information about mothers' housing, income, service use, par-enting practices, and children's father was obtained. Data about children's background, health, and life events were included. Standardized instruments were administered to assess mothers' mental health and their children's behavior. Comparisons of homeless and low-income housed families were used to describe the sample of 167 preschoolers. Multiple linear regression was used to examine the association of various stressors, such as homelessness, and family factors with their behavior.
Results. Although homeless preschoolers were significantly more likely to have experienced stressful life events, undergone a care and protection investigation, and been placed in foster care when compared with low income preschoolers, differences in adverse behaviors were minimal. Although homeless children scored higher than housed children on the internalizing, externalizing, and total problem score on the Child Behavior Checklist (CBCL) (52.5 vs 49.9, 54.8 vs 51.2, and 54.4 vs 51.1, respectively), approximately equal numbers of children from both groups scored in the clinical range. With regard to determinants of behavior, mothers' emotional status was one of the strongest independent predictors of negative behavioral outcomes on both subscales. Foster care placement and death of a child's friend were predictors of adverse internalizing behavioral outcomes on the CBCL. After controlling for housing status, parenting practices, child's age, child's history of physical abuse, and specific life stressors predicted adverse externalizing behavioral outcomes. For both subscales, housing status and behavior were only marginally associated in the multivariate model.
Conclusions. Both homeless and low-income children experienced significant adversity in their lives, with homeless preschool children facing more stress. However, differences in behavior as measured by the CBCL were minimal. Mothers' emotional status, in addition to various stressors, strongly predict children's negative outcomes for both CBCL subscales. These findings emphasize the importance of preventive family-oriented interventions that address the needs of preschoolers and their mothers.
Does the Supine Sleeping Position Have Any Adverse Effects on the Child?: I. Health in the First Six Months
Authors: Hunt Linda , Fleming Peter , Golding Jean ,   the ALSPAC Study Team
Published: August 2004

Objective. To assess whether the recommendations that infants sleep supine could have adverse health consequences.Design. A prospective study of infants, delivered before, during, and after the Back to Sleep Campaign in the United Kingdom (UK), followed to 6 months of age. The children were part of the Avon Longitudinal Study of Pregnancy and Childhood (ALSPAC).Subjects. Singletons born to mothers resident in the three former Bristol-based health districts of Avon in the period June 1991 to December 1992, and for whom questionnaires were completed on sleeping position at 4 to 6 weeks of age (n = 9777); for these infants 8524 questionnaires were also completed at 6 to 8 months of age.Main Outcome Measures. Subjective measures of health, the presence of specific signs and symptoms, duration of sleep at night, and calling the family doctor to the home.Results. Of 43 outcomes considered, after adjustment for 12 factors using logistic regression only 2 were associated with raised risk among infants put to sleep on their back (diaper rash and cradle cap). Infants put to sleep prone had increased risk of a number of health outcomes, including cough and possibly pyrexia.Conclusions. There is no evidence that putting infants to sleep in the supine position results in increased morbidity, although changes in prevalence of rare disorders would not have been identified.
Predictors of Hemolytic Uremic Syndrome in Children During a Large Outbreak ofEscherichia coliO157:H7 Infections
Authors: Bell Beth P. , Griffin Patricia M. , Lozano Paula , Christie Dennis L. , Kobayashi John M. , Tarr Phillip I. 
Published: August 2004

Objective. To evaluate risk factors for progression of Escherichia coli O157:H7 infection to the hemolytic uremic syndrome (HUS).Study Design. We conducted a retrospective cohort study among 278 Washington State children &lt;16 years old who developed symptomatic culture-confirmed E coli O157:H7 infection during a large 1993 outbreak. The purpose of the study was to determine the relative risk (RR) of developing HUS according to demographic characteristics, symptoms, laboratory test results, and medication use in the first 3 days of illness.Results. Thirty-seven (14%) children developed HUS. In univariate analysis, no associations were observed between HUS risk and any demographic characteristic, the presence of bloody diarrhea or of fever, or medication use. In multivariate analysis, HUS risk was associated with, in the first 3 days of illness, use of antimotility agents (odds ratio [OR] = 2.9; 95% confidence interval [CI] 1.2–7.5) and, among children &lt;5.5 years old, vomiting (OR = 4.2; 95% CI 1.4–12.7). Among the 128 children tested, those whose white blood cell (WBC) count was ≥13 000/μL in the first 3 days of illness had a 7-fold increased risk of developing HUS (RR 7.2; 95% CI 2.8–18.5). Thirteen (38%) of the 34 patients with a WBC count ≥13 000/μL developed HUS, but only 5 (5%) of the 94 children whose initial WBC count was &lt;13 000/μL progressed to HUS. Among children who did not develop HUS, use of antimotility agents in the first 3 days of illness was associated with longer duration of bloody diarrhea.Conclusions. Prospective studies are needed to further evaluate measures to prevent the progression of E coliO157:H7 infection to HUS and to assess further clinical and laboratory risk factors. These data argue against the use of antimotility agents in acute childhood diarrhea. Our finding that no intervention decreased HUS risk underscores the importance of preventing E coliO157:H7 infections.
School-related Issues Among HIV-Infected Children
Authors: Cohen Joyce , Reddington Catherine , Jacobs Dawn , Meade Regina , Picard Donna , Singleton Kathy , Smith Dorothy , Caldwell M. Blake , DeMaria Alfred , Hsu Ho-Wen ,   the Massachusetts Working Group on Surveillance of HIV in Children, Health Massachusetts Department of Public ,   the Centers for Disease Control and Prevention
Published: August 2004

Objective. Many children with human immunodeficiency virus (HIV) infection are surviving long enough to reach school age. This study describes issues related to school attendance and disclosure of HIV infection in a population of HIV-infected children.Methods. A statewide pediatric HIV surveillance system was used to collect data on school-age (≥5 years old) HIV-infected children. In addition, HIV clinic nurses familiar with the child's history participated in a cross-sectional survey that collected information on school-related issues during the 1993–1994 school year.Results. Of the 92 school-age children, only 3 were too ill to attend school. Another 5 children were home-schooled. Of the 84 who attended school outside the home, 25% had severe symptoms of HIV infection (Centers for Disease Control and Prevention [CDC] clinical category C). Absence from school ranged from less than 2 weeks during the year for half of the children (51%) to more than 8 weeks for 9 children (12%). Twenty-nine percent of the children received medication in school, usually administered by the school nurse. Over two thirds of the 50 children ages 5 to 10 years had not been told that they had HIV infection. Only 1 of the 20 children more than 10 years of age was not aware of her HIV infection. For 53% of the children attending school, no school personnel had been informed of the child's HIV infection. Administration of HIV medications at school, age of child, and treatment at one particular HIV clinic were associated with the parents' decision to inform school personnel. In the 47% of cases where the school had been informed, school nurses were most frequently notified, followed by principals and teachers.Conclusion. Only 3% of school-age children were too ill to attend school, and almost all were enrolled in public schools. The number of HIV-infected children reaching school age will continue to grow, and public schools will bear the responsibility for educating these children. Health care providers will increasingly be called upon for guidance by both educators and families to assure that HIV-infected children receive the best education possible.
Associated Malformations in Infants With Cleft Lip and Palate: A Prospective, Population-based Study
Authors: Milerad Josef , Larson Ola , Hagberg Catharina , Ideberg Margareta 
Published: August 2004

Objective. Infants with cleft lip and palate may often have other associated congenital defects although the reported incidence and the types of associated malformations vary between different studies. The purpose of this investigation was to assess the prevalence of associated malformations in a geographically defined population.
Methods. The prevalence of associated malformations in infants with clefts were collected prospectively between 1975 to 1992 on all infants born in greater Stockholm, Sweden. The patient records were also compared with data from the National Malformation Registry and other hospital records if any.
Results. Of the 616 cleft infants (367 boys, 249 girls) born during this period, 21% had associated malformations that either required follow-up or treatment. Associated malformations were more frequent in infants who had both cleft lip and palate (28%) than in infants with isolated cleft palate (22%) or infants with isolated cleft lip (8%). Malformations of the upper or lower limbs or the vertebral column were the most common other anomalies and accounted for 33% of all associated defects. Twenty-four percent of associated malformations were in the cardiovascular system and congenital heart disease was the most common isolated associated malformation. Fifteen percent of all associated malformations were multiple and they were frequently associated with mental retardation or chromosomal anomalies. Twenty-two percent of infants with associated malformations were born preterm, compared with an expected 5% incidence of preterm delivery in Sweden.
Conclusion.  A more extensive cleft seems to be associated with a higher risk for associated malformations. Although many associated congenital defects can be detected at a physical examination, the high prevalence of congenital heart disease (16 times that of general population) may justify a routine echocardiographic screening.