bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Pediatric Risk of Hospital Admission Score: A Second-Generation Severity-of-Illness Score for Pediatric Emergency Patients
Authors: Chamberlain James M. , Patel Kantilal M. , Pollack Murray M. 
Published: February 2005

Objective. To develop and validate a second-generation severity-of-illness score that is applicable to pediatric emergency patients. The Pediatric Risk of Admission (PRISA) score was developed in a single hospital and was recalibrated and validated in 2, previous, small studies from academic pediatric hospitals. This study was performed to develop and validate a score in a larger sample of diverse hospitals.
Methods. Emergency departments (EDs) were block randomly selected as part of a study on ED quality on the basis of 3 care characteristics: annual patient volume (high or low compared with national median), presence or absence of a pediatric emergency medicine subspecialist, and presence or absence of residents. Patients were selected randomly on the basis of daily arrival logs. Medical records were photocopied, and abstracted data included demographic, historical, physiologic, and therapeutic information. The total sample was randomly divided into a 75% development sample and a 25% validation sample. Univariate and multivariate analyses were used to model the risk of mandatory admission, admissions for which preidentified, inpatient medical resources were used. The resulting multiple logistic regression model coefficients were converted to integer scores. Calibration (Hosmer-Lemeshow goodness of fit) and discrimination (area under the ROC curve) were used to measure performance. As a measure of construct validity, proportions of patients in ordered risk intervals were correlated with the outcomes of admission, mandatory admission, and ICU admission.
Results. Sixteen EDs enrolled 11664 patients. Mean patient age (±SD) was 6.8 ± 5.8 years, and 53% were male. Nine percent arrived by emergency medical services, and 6.9% were admitted. The most common diagnoses were minor injuries, otitis media, and fever. The multivariate analysis yielded a score with 7 historical variables, 8 physiologic variables, 1 therapy (oxygen) term, and 1 interaction term. Calibration was excellent. In the development sample, 442 mandatory admissions were predicted and 442 were observed (total χ2 = 2.275), and in the validation sample, 136.6 were predicted and 145 were observed (χ2 = 8.575). The area under the receiver operator characteristic curve was 0.82 ± 0.01 (SE) in the development sample and 0.77 ± 0.02 in the validation sample. In ordered predicted risk intervals, the proportion of patients with admissions, mandatory admissions, and ICU admissions increased in a linear manner.
Conclusions. The second-generation PRISA II score for pediatric ED patients has been developed and validated in a large sample of diverse hospitals. Performance characteristics indicate that PRISA II will be useful for institutional comparisons, benchmarking, and controlling for severity of illness when enrolling patients in clinical trials.
Overweight, Obesity, and Health-Related Quality of Life Among Adolescents: The National Longitudinal Study of Adolescent Health
Authors: Swallen Karen C. , Reither Eric N. , Haas Steven A. , Meier Ann M. 
Published: February 2005

Objective. Childhood and adolescent overweight and obesity have increased substantially in the past 2 decades, raising concerns about the physical and psychosocial consequences of childhood obesity. We investigated the association between obesity and health-related quality of life in a nationally representative sample of adolescents.
Methods. A cross-sectional analysis was conducted using the 1996 National Longitudinal Study of Adolescent Health, a nationally representative sample of adolescents in grades 7 to 12 during the 1994–1995 school year, and 4743 adolescents with direct measures of height and weight. Using Centers for Disease Control and Prevention growth charts to determine percentiles, we used 5 body mass categories. Underweight was at or below the 5th percentile, normal BMI was between the 5th and 85th percentiles, at risk for overweight was between the 85th and 95th percentiles, overweight was between the 95th and 97th percentiles + 2 BMI units, and obese was at or above the 97th percentile + 2 BMI units. Four dimensions of health-related quality of life were measured: general health (self-reported general health), physical health (absence or presence of functional limitations and illness symptoms), emotional health (the Center for Epidemiologic Studies Depression Scale and Rosenberg's self-esteem scale), and a school and social functioning scale.
Results. We found a statistically significant relationship between BMI and general and physical health but not psychosocial outcomes. Adolescents who were overweight had significantly worse self-reported health (odds ratio [OR]: 2.17; 95% confidence interval [CI]: 1.34–3.51), as did obese adolescents (OR: 4.49; 95% CI: 2.87–7.03). Overweight (OR: 1.81; 95% CI: 1.22–2.68) and obese (OR: 1.91; 95% CI: 1.24–1.95) adolescents were also more likely to have a functional limitation. Only among the youngest adolescents (ages 12–14) did we find a significant deleterious impact of overweight and obesity on depression, self-esteem, and school/social functioning.
Conclusions. Using a nationally representative sample, we found that obesity in adolescence is linked with poor physical quality of life. However, in the general population, adolescents with above normal body mass did not report poorer emotional, school, or social functioning.
Effect of Pneumococcal Vaccination on Quality of Life in Children With Recurrent Acute Otitis Media: A Randomized, Controlled Trial
Authors: Brouwer Carole N. M. , Maillé A. Rianne , Rovers Maroeska M. , Veenhoven Reinier H. , Grobbee Diederick E. , Sanders Elisabeth A. M. , Schilder Anne G. M. 
Published: February 2005

Background. Limited effectiveness of current treatment strategies for recurrent acute otitis media (RAOM) and increasing antibiotic resistance have diverted attention to prevention of AOM by vaccination. Pneumococcal vaccination for AOM seems to have only modest clinical efficacy. Thus far, the effects on health-related quality of life (HRQoL) or functional health status (FHS) have not been studied.Objective. To assess the effect of vaccination on HRQoL or FHS.Methods. In a double-blind, randomized, controlled trial, 383 children 1 to 7 years old with RAOM were vaccinated with either heptavalent pneumococcal conjugate vaccine followed by pneumococcal polysaccharide vaccine (pneumococcal group: n = 190) or with hepatitis A or B vaccines (control group: n = 193). Parents completed validated Dutch versions of 8 HRQoL and FHS instruments assessing generic FHS (Rand, Functional Status Questionnaire specific, and Functional Status Questionnaire generic), otitis media–specific FHS (OM-6), otitis media–specific child HRQoL (Numerical Rating Scale for Child), family functioning (Family Functioning Questionnaire), and otitis media–specific caregiver HRQoL (Numerical Rating Scale for Caregiver). Scores were compared at baseline and at 14 and 26 months' follow-up.Results. At baseline, the average AOM incidence in the pneumococcal and control group was 5.0 (SD: 2.8) and 4.9 (SD: 2.6) episodes per year, respectively, with 38.4% and 36.8% having suffered from ≥6 episodes per year. AOM frequency decreased 4.4 episodes per year in both groups, with a considerable and comparable improvement in HRQoL and FHS. No substantial differences in HRQoL or FHS were found between the pneumococcal and the control group at baseline or at 14 or 26 months' follow-up.Conclusion. Pneumococcal vaccination has no beneficial effect compared with control vaccination on either HRQoL or FHS in children 1 to 7 years old with RAOM.
Does a Triplet Birth Pose a Special Risk for Infant Development? Assessing Cognitive Development in Relation to Intrauterine Growth and Mother-Infant Interaction Across the First 2 Years
Authors: Feldman Ruth , Eidelman Arthur I. 
Published: February 2005

Objective. To examine whether a triplet birth per se poses a risk to the development of infants' cognitive competencies and to the mother-infant relationship.Methods. Twenty-three sets of triplets were matched with 23 sets of twins and 23 singleton infants (n = 138) with respect to gestational age, birth weight, and medical and demographic features. Infants with perinatal asphyxia, intraventricular hemorrhage of grade 3 or 4, periventricular leukomalacia, or central nervous system infection were excluded from the study. At 6, 12, and 24 months of age, mother-infant interaction was observed and infants' cognitive development was tested with the Bayley II test.Results. Mothers of triplets displayed lower levels of sensitivity at 6, 12, and 24 months and infants were less socially involved at 6 and 24 months, compared with singletons and twins. Triplets scored lower than singletons and twins on the Bayley Mental Developmental Index at 6, 12, and 24 months. A weight discordance of &gt;15% was found for 15 triplet sets (65.2%). The discordant triplets showed decreased cognitive skills at 12 and 24 months, compared with their siblings, and received the lowest scores for maternal sensitivity. Hierarchical multivariate regression analysis revealed that greater medical risk at birth, multiple-birth status, lower maternal sensitivity, and reduced infant social involvement in the first 2 years were each predictive of lower cognitive outcomes at 2 years (R2 = 0.33).Conclusions. Triplets appear to be at higher risk for cognitive delays in the first 2 years of life, and discordant infants are at especially high risk. This delay is related in part to the difficulty of providing sensitive mothering to 3 infants at the same time. The findings may assist practitioners in guiding prenatal and postpartum parental care and management.
Overweight Among Low-Income Preschool Children Associated With the Consumption of Sweet Drinks: Missouri, 1999–2002
Authors: Welsh Jean A. , Cogswell Mary E. , Rogers Sharmini , Rockett Helaine , Mei Zuguo , Grummer-Strawn Laurence M. 
Published: February 2005

Objective. To examine the association between sweet drink consumption and overweight among preschool children.Methods. A retrospective cohort design was used to examine the association between sweet drink consumption and overweight at follow-up among 10904 children who were aged 2 and 3 years and had height, weight, and Harvard Service Food Frequency Questionnaire data collected between January 1999 and December 2001 and height and weight data collected 1 year later. Sweet drinks included vitamin C-containing juices, other juices, fruit drinks, and sodas as listed on the Harvard Service Food Frequency Questionnaire. Logistic regression was used to adjust for age; gender; race/ethnicity; birth weight; and intake of high-fat foods, sweet foods, and total calories. Results were stratified by baseline BMI.Results. Among children who were normal or underweight at baseline (BMI &lt;85th percentile), the association between sweet drink consumption and development of overweight was positive but not statistically significant. Children who were at risk for overweight at baseline (BMI 85th–&lt;95th percentile) and consumed 1 to &lt;2 drinks/day, 2 to &lt;3 drinks/day, and ≥3 drinks/day were, respectively, 2.0 (95% confidence interval [CI]: 1.3–3.2), 2.0 (95% CI: 1.2–3.2), and 1.8 (95% CI: 1.1–2.8) times as likely to become overweight as the referent (&lt;1 drink/day). Children who were overweight at baseline (BMI ≥95th percentile) and consumed 1 to &lt;2 drinks/day, 2 to &lt;3 drinks/day, and ≥3 drinks/day were, respectively, 2.1, 2.2, and 1.8 times as likely to remain overweight as the referent.Conclusions. Reducing sweet drink consumption might be 1 strategy to manage the weight of preschool children. Additional studies are needed to understand the mechanism by which such consumption contributes to overweight.
Changes in Neonatology: Comparison of Two Cohorts of Very Preterm Infants (Gestational Age &lt;32 Weeks): The Project on Preterm and Small for Gestational Age Infants 1983 and The Leiden Follow-Up Project on Prematurity 1996-1997
Authors: Stoelhorst Gerlinde M. S. J. , Rijken Monique , Martens Shirley E. , Brand Ronald , den Ouden A. Lya , Wit Jan-Maarten , Veen Sylvia ,   on behalf of the Leiden Follow-up Project on Prematurity
Published: February 2005

Objective. To determine changes in peri- and neonatal care concerning neonatal mortality and morbidity by comparing 2 cohorts of very prematurely born infants (gestational age [GA] &lt;32 weeks), 1 from the 1980s and 1 from the 1990s.Methods. The Leiden Follow-Up Project on Prematurity (LFUPP-1996/97), a regional, prospective study, includes all infants who were born alive after a GA &lt;32 weeks in 1996 and 1997 in the Dutch health regions Leiden, The Hague, and Delft. The Project On Preterm and Small for Gestational Age Infants (POPS-1983), a national, prospective study from the presurfactant era, includes all liveborn infants &lt;32 weeks' GA and/or &lt;1500 g from 1983 (n = 1338). For comparison, infants from the POPS-1983 cohort with a GA &lt;32 weeks from the same Dutch health regions were selected (n = 102).Results. The absolute number of preterm births in the study region increased by 30%: 102 in 1983 to on average of 133 in 1996–1997. Centralization of perinatal care improved: the percentage of extrauterinely transported infants decreased from 61% in 1983 to 35% in 1996–1997. A total of 182 (73%) of the LFUPP-1996/97 infants were treated antenatally with glucocorticosteroids compared with 6 (6%) of the POPS-1983 infants. A total of 112 (42%) of the LFUPP-1996/97 infants received surfactant. In-hospital mortality decreased from 30% in the 1980s to 11% in the 1990s. Mortality of the extremely preterm infants (&lt;27 weeks) decreased from 76% to 33%. The incidence of respiratory distress syndrome remained the same: ∼60% in both groups. Mortality from respiratory distress syndrome, however, decreased from 29% to 8%. The incidence of bronchopulmonary dysplasia increased from 6% to 19%. For the surviving infants, the average length of stay in the hospital and the mean number of NICU days stayed approximately the same (∼67 days total admission time and 44 NICU days in both groups); including the infants who died, the mean NICU admission time increased from 27 days in the 1980s to 41 days in the 1990s. Equal percentages of adverse outcome (dead or an abnormal general condition) at the moment of discharge from hospital were found (±40% in both groups).Conclusions. An increase in the absolute number of very preterm births in this study region was found, leading to a greater burden on the regional NICUs. Improvements in peri- and neonatal care have led to an increased survival of especially extremely preterm infants. However, increased survival has resulted in more morbidity, mainly bronchopulmonary dysplasia, at the moment of discharge from the hospital.
Patterns of Molecular Diversity in Naturally Occurring and Refugial Populations of the Least Chub
Authors: Mock K. E. , Miller M. P. 
Published: February 2005

AbstractThe least chub Iotichthys phlegethontis is a small, rare cyprinid fish endemic to the Bonneville basin, Utah. Although it was once widely distributed within the basin, naturally occurring populations are now known to exist only in four isolated geographical regions. We used nuclear (amplified fragment length polymorphism) and mitochondrial genetic markers to describe the patterns of genetic divergence and diversity within and among populations from these regions and to assess genetic diversity in two refugial populations. We found that a large proportion of the diversity in this species was attributable to population structuring (FST = 0.52). Given that a high proportion of the genetic variation is accounted for by population differentiation and that three of the existing populations have been discovered in the last 10 years, we suggest that surveys to discover additional populations be a high management priority. We also recommend that existing populations be studied for evidence of adaptive divergence. The refugial populations that we studied closely resembled their source populations with respect to both genetic divergence and diversity, indicating that the current policy of founding these populations with large numbers of fish is effective.
Repetitive behaviors in CHARGE syndrome: Differential diagnosis and treatment options
Authors: Bernstein Veronika , Denno Laurie S. 
Published: February 2005

AbstractTwenty‐nine students with CHARGE syndrome were evaluated using the Compulsive Behavior Checklist (CBC). Most of the students obtained a high score for repetitive behaviors, averaging 11.5 repetitive behaviors per student. Most students' repetitive behaviors significantly interfered with their daily routine. Thirty‐four percent of the students responded to redirection with aggression toward themselves or others. Many of these behaviors do not respond well to traditional behavioral techniques. Through observation, definitions, and using functional analysis of behavior, repetitive behaviors were assigned to one of four categories. Each category has different treatment options. A case study of an adolescent girl with CHARGE syndrome who has profound deafness, colobomas, and moderate cognitive delay is presented. She displayed severe behavior challenges and significant medical issues. The course of treatment is outlined over 5 years. Behavior management, medical management, and psychiatric management were used in regulating her behavior, medical issues, and anxiety disorder. Close coordination between disciplines and excellent family involvement led to a very positive outcome. The student, now 19 years old, has made progress in her educational program and has been able to experience more community integration. © 2005 Wiley‐Liss, Inc.
Chasing Molecules That Were Never There: Misassigned Natural Products and the Role of Chemical Synthesis in Modern Structure Elucidation
Authors: Nicolaou K. C. , Snyder Scott A. 
Published: February 2005

AbstractOver the course of the past half century, the structural elucidation of unknown natural products has undergone a tremendous revolution. Before World War II, a chemist would have relied almost exclusively on the art of chemical synthesis, primarily in the form of degradation and derivatization reactions, to develop and test structural hypotheses in a process that often took years to complete when grams of material were available. Today, a battery of advanced spectroscopic methods, such as multidimensional NMR spectroscopy and high‐resolution mass spectrometry, not to mention X‐ray crystallography, exist for the expeditious assignment of structures to highly complex molecules isolated from nature in milligram or sub‐milligram quantities. In fact, it could be argued that the characterization of natural products has become a routine task, one which no longer even requires a reaction flask! This Review makes the case that imaginative detective work and chemical synthesis still have important roles to play in the process of solving nature's most intriguing molecular puzzles.
Use of the cell wall protein Pir4 as a fusion partner for the expression of Bacillus sp. BP‐7 xylanase A in Saccharomyces cerevisiae
Authors: Andrés Isabel , Gallardo Oscar , Parascandola Palma , Javier Pastor F.I. , Zueco Jesús 
Published: February 2005

AbstractXylanase A from Bacillus sp. BP7, an enzyme with potential applications in biotechnology, was used to test Pir4, a disulfide bound cell wall protein, as a fusion partner for the expression of recombinant proteins in standard or glycosylation‐deficient mnn9 strains of Saccharomyces cerevisiae. Five different constructions were carried out, inserting in‐frame the coding sequence of xynA gene in that of PIR4, with or without the loss of specific regions of PIR4. Targeting of the xylanase fusion protein to the cell wall was achieved in two of the five constructions, while secretion to the growth medium was the fate of the gene product of one of the constructions. In all three cases localization of the xylanase fusion proteins was confirmed both by Western blot and detection with Pir‐specific antibodies and by xylanase activity determination. The cell wall‐targeted fusion proteins could be extracted by reducing agents, showing that the inclusion of a recombinant protein of moderate size does not affect the way Pir4 is attached to the cell wall. Also, the construction that leads to the secretion of the fusion protein permitted us to identify a region of Pir4 responsible for cell wall retention. In summary, we have developed a Pir4‐based system that allows selective targeting of an active recombinant enzyme to the cell wall or the growth medium. This system may be of general application for the expression of heterologous proteins in S. cerevisiae for surface display and secretion. © 2005 Wiley Periodicals, Inc.
Flow pattern visualization in a mimic anaerobic digester using CFD
Authors: Vesvikar Mehul S. , Al‐Dahhan Muthanna 
Published: February 2005

AbstractThree‐dimensional steady‐state computational fluid dynamics (CFD) simulations were performed in mimic anaerobic digesters to visualize their flow pattern and obtain hydrodynamic parameters. The mixing in the digester was provided by sparging gas at three different flow rates. The gas phase was simulated with air and the liquid phase with water. The CFD results were first evaluated using experimental data obtained by computer automated radioactive particle tracking (CARPT). The simulation results in terms of overall flow pattern, location of circulation cells and stagnant regions, trends of liquid velocity profiles, and volume of dead zones agree reasonably well with the experimental data. CFD simulations were also performed on different digester configurations. The effects of changing draft tube size, clearance, and shape of the tank bottoms were calculated to evaluate the effect of digester design on its flow pattern. Changing the draft tube clearance and height had no influence on the flow pattern or dead regions volume. However, increasing the draft tube diameter or incorporating a conical bottom design helped in reducing the volume of the dead zones as compared to a flat‐bottom digester. The simulations showed that the gas flow rate sparged by a single point (0.5 cm diameter) sparger does not have an appreciable effect on the flow pattern of the digesters at the range of gas flow rates used. © 2005 Wiley Periodicals, Inc.
Column flow reactor using acetohydroxyacid synthase I from Escherichia coli as catalyst in continuous synthesis of R‐phenylacetyl carbinol
Authors: Engel Stanislav , Vyazmensky Maria , Berkovich Dvora , Barak Ze'ev , Merchuk Jose , Chipman David M. 
Published: February 2005

AbstractWe tested the possibility of utilizing acetohydroxyacid synthase I (AHAS I) from Escherichia coli in a continuous flow reactor for production of R‐phenylacetyl carbinol (R‐PAC). We constructed a fusion of the large, catalytic subunit of AHAS I with a cellulose binding domain (CBD). This allowed purification of the enzyme and its immobilization on cellulose in a single step. After immobilization, AHAS I is fully active and can be used as a catalyst in an R‐PAC production unit, operating either in batch or continuous mode. We propose a simplified mechanistic model that can predict the product output of the AHAS I‐catalyzed reaction. This model should be useful for optimization and scaling up of a R‐PAC production unit, as demonstrated by a column flow reactor. © 2005 Wiley Periodicals, Inc.