bluuebunny/crossref_metadata_2025_split huggingface dataset:
Childhood poisoning: Access and prevention
Authors: Ozanne‐Smith J , Day L , Parsons B , Tibballs J , Dobbin M 
Published: March 2003

Objectives: To investigate the circumstances and means of access to six poisoning agents by children under 5 years of age and to make recommendations for countermeasures and strategies for implementation. Methodology: A case series study of access to six poisoning agents was conducted. Cases were identified prospectively through a poisons information centre and hospital emergency departments. Interviews were conducted with 523 parents and caregivers using a structured questionnaire. Results: The majority of children (94.1%) accessed the agent in their own home or another home and, in 38% of cases (excluding mistakes in administration), the parent or caregiver was present in the immediate area at the time of the incident. In cases in which the child was alone in the room, caregivers were frequently involved in household duties (51%), with only 10% undertaking leisure activities and 8% on the telephone. The span of unsupervised time reported was 5 min or less in 79.5% of these cases. The means of access was generally during periods of use of the agent (75.3%), including just purchased, rather than when agents were in their usual storage place. Conclusions: There is little scope for improved supervision as a major intervention. Design and regulatory changes such as local safe storage for bench tops and while travelling, improved labelling and packaging, improved child‐resistant packaging and its more general application are required. These and agent‐specific interventions, including child‐resistant bait stations for rodenticides and well covers for vaporizers, are more likely to prevent poisoning. The recent identification of childhood poisoning prevention as a national priority may lead to coordinated action to implement these and other preventive measures.
Diagnostic accuracy of paediatric echocardiograms interpreted by individuals other than paediatric cardiologists
Authors: Ward CJB , Purdie J 
Published: March 2003

Objective: To assess the diagnostic error rate among echocardiograms undertaken by individuals other than paediatric cardiologists in our referral area. Methodology: External group: The charts and echocardiographic results of all patients who had undergone outside echocardiograms between January 1996 and December 1999 were reviewed (110). Age at echocardiography, diagnostic complexity, presence of any diagnostic errors and the severity of any diagnostic errors were identified. Internal group: To assess our own error rate, the initial echocardiographic diagnoses of 100 patients undergoing cardiac catheterisation or corrective surgery were compared with the post‐catheterisation or postoperative diagnoses. Age and diagnostic complexity were also assessed in the control group. Results: Diagnostic errors occurred in 47/110 patients (44%) of the externally studied group (of which 24% were either major or life threatening) as opposed to 3/100 of the internally studied group, despite the internally studied group being of increased diagnostic complexity. Errors were more common and of increased severity in infants less than 1 month of age but extended throughout all age groups. Major and life threatening errors increased with increasing diagnostic complexity. In the externally studied group, 8/47 errors were patients inappropriately designated as normal. Four of these patients required cardiac surgery or interventional cardiac catheterisation. Conclusions: This study suggests an unacceptably high error rate in paediatric echocardiographic diagnoses by non‐paediatric cardiologists throughout all age groups. Such errors are more likely in younger infants and with increasing diagnostic complexity.
Successful clot lysis using low dose of streptokinase in 22 neonates with aortic thromboses
Authors: Cheah F‐C , Boo N‐Y , Rohana J , Yong S‐C 
Published: March 2003

Objective: To determine whether intravenous infusion of low dose of streptokinase was effective in lysing umbilical arterial catheter (UAC)‐associated aortic thrombi. Method: A prospective cohort study of 31 consecutive newborn infants with UAC‐associated aortic thrombi which were detected by abdominal ultrasonography after removal of UAC. Twenty‐two infants were treated with intravenous infusion of low dose (1000 U/h) streptokinase, while nine others were not treated due to various contra‐indications. Thrombolysis occurred after a mean interval of 2.2 days (standard deviation (SD) = 1.8) in the treated infants. In the untreated infants, spontaneous thrombolysis occurred significantly later, after a mean interval of 16.9 days (SD = 14.7) (95% confidence intervals of difference between mean intervals – 26.0, – 3.4; P = 0.02). Only one treated infant developed mild bleeding directly attributed to streptokinase therapy. Conclusion: Low dose streptokinase infusion was effective and safe in thrombolysing UAC‐associated aortic thrombi.
Comparison of Dinamap 8100 with sphygmomanometer blood pressure measurement in a prepubertal diabetes cohort
Authors: Jin RZ , Donaghue KC , Fairchild JM , Chan A , Silink M 
Published: March 2003

Objective: To compare the conventional sphygmomanometer with the semiautomated Dinamap 8100 (Critikon, Tampa, FL, USA) for the measurement of blood pressure in prepubertal children with insulin‐dependent diabetes mellitus. Methodology: Blood pressure was measured using both methods in 61 prepubertal children (aged 8–13 years) on 189 occasions over 4 years. The measurements were compared using the Bland–Altman plot. Tracking correlations of blood pressure centiles over time were analyzed by the general estimating equation. Results: Accuracy criteria of the Association for the Advancement of Medical Instrumentation were met and a British Hypertensive Society ‘B’ grading was reached. Differences in systolic and diastolic blood pressure were found between the two methods (P < 0.01). For systolic blood pressure, common correlations were 0.54 (Dinamap) and 0.51 (sphygmomanometer) and for diastolic blood pressure were 0.33 and 0.42, respectively. Conclusion: The Dinamap 8100 is an acceptable alternative in clinic practice and research for prepubertal children.
Low‐density lipoprotein subclasses in children under 10 years of age
Authors: Steinbeck KS , Bermingham MA , Mahajan D , Baur LA 
Published: March 2003

Objective: To examine the prevalence of small dense low density lipoprotein (LDL) in a cohort of children under 10 years of age and to investigate the relationship to other biochemical variables and to measures of fatness. A preponderance of small dense LDL (pattern B), is associated with obesity, abdominal fat accumulation, insulin resistance and risk of heart disease in adults. Methodology: LDL peak particle diameter (PPD) was determined by gel electrophoresis in 53 children under 10 years of age and in 65 of their parents: apoproteins A1 and B were determined by turbidimetry. Anthropometric variables, basic lipid profiles, insulin and leptin had been determined previously. Differences between patterns A (large light particles > 25.5 nm diameter) and B were examined by t‐test, Chi‐square, or Mann–Whitney test. Relationships between the variables were reported as Pearson correlation coefficients. Results: Pattern B (PPD of ≤ 25.5 nm) prevalence was 7.5% in children and 11% in parents (17% in men and 5% in women). Most of the children (86%) who had PPD ≤ 26.0 nm also had parents with PPD in this range. A strong association was found between children’s and mother’s PPD (r = 0.60, P < 0.001), but this was somewhat less with fathers (r = 0.40, P = 0.02). Children in the lowest tertile of PPD had a tendency towards a higher body mass index, waist, fat mass and insulin. Conclusions: The prevalence of small dense LDL is lower in children under 10 years of age than in their parents; fathers had a higher prevalence of pattern B than mothers and there is some evidence of a familial effect in the inheritance of pattern B.
Children with disruptive behaviours II: Clinical and community service needs
Authors: Hazell PL , Tarren‐Sweeney M , Vimpani GV , Keatinge D , Callan K 
Published: March 2003

Objective: To assist in health service planning by determining the perceived clinical and community service needs of families resident in the Hunter region who care for a child manifesting disruptive behaviour. Methodology: Families were eligible to participate in the survey if they had at least one child known to have one of the DSM‐IV disruptive behaviour disorders, autistic spectrum disorders, behaviour problems associated with rarer forms of brain disease, brain injury or mild intellectual disability or were identified by school personnel as having significant behaviour problems. Families were recruited to the survey via schools, early education centres and clinical services. Parents completed a questionnaire, mailed to them by educational and/or clinical services. Parents were asked to prioritize options for improving or expanding clinical services and for reducing their treatment costs. Results: A total of 1412 families responded to the survey. The highest‐ranked clinical service options involved the expansion of mainstream community treatment services for children with disruptive behaviour problems and their families, with a particular emphasis on counselling services. Respite care and in‐patient services were given relatively low priority. Subgroup analyses showed that disadvantaged and stressed families gave higher rankings to out of home options, such as respite care, in‐patient care and subsidised holiday camps, than the aggregate sample. Conclusions: Enhancement of community based counselling services would meet the needs of the greatest number of participating families. Resource‐intense residential services are required by a small but important group of families who experience disadvantage and high levels of stress.
Statistical evaluation of calcium carbonate equilibrium in natural water
Authors: Dabrowski Wojciech , Buchta Robert 
Published: March 2003

AbstractA simple statistical model for the Langelier Saturation Index has been developed for all drinking water intakes supplying Cracow. The model has been tested by comparison with the solution of the set of equations governing calcium carbonate equilibria. A high degree of agreement with the results of calculations was achieved, including not only the ionic strength of water solutions but also the so‐called ion‐pair effects. The model is summarised by simple formulae, which can be used for manual calculation of the Langelier Saturation Index.
Trends in interannual yield variation of reservoir fisheries in Bangladesh, with special reference to Indian major carps
Authors: Ahmed Khan Kamal Uddin , Hambrey John B. , Rahman Sanzidur 
Published: March 2003

AbstractInterannual variation in yield per species from a freshwater reservoir in Bangladesh was analysed by using long‐term landing data. Each species was categorized according to characteristics in interannual yield variation. The characteristics were defined with respect to size of the interannual variation in terms of absolute and relative variation around the mean yield and long‐term trends in catch levels. Annual variation was directly (t18 = 7.84; P < 0.01) related to the yield and can serve as a good indication of the status of the fishery when catches are low. The target fish, Indian major carps (IMC) Labeo rohita, Labeo calbasu, Catla catla and Cirrhinus mrigala, showed large variation in annual yield. This might have occurred because of variation in annual recruitment. Illegal use of gears is mostly related to variation in year class strength, and is assumed to be the most important source of change of stock variation. An increase in catch rate was recorded for Corica soborna. Such a stable combination may only be possible for a certain period without a long‐term trend. Trends in the yield rate of the major fish category for three decades reveal a sharp decline in the catch of IMC. In contrast, small clupeid‐like C. soborna have the highest yield rate. Fishing gears can play a crucial role in this fishery. Fisheries managers must always be alert when issuing fishing licenses and on the control on gears. The conclusion is that the IMC fishery of Kaptai Reservoir is an overexploited fish stock. In this fishery, the same gears are usually employed indiscriminately for different species and size classes. To stabilize the fishery, the existing policy needs to be strengthened and more effectively implemented. Also, some fishing gears and traps need to be restricted. An effective stock protection policy is suggested. Further study on catch size of individual species is essential prior to the development and implementation of any management scheme.
Record of mercury pollution in sediments of lakes Nakaumi and Shinji in Japan
Authors: Chandrajith Rohana , Okurnura Minoru , Ueno Takashi 
Published: March 2003

AbstractTwo sediment core profiles from lakes Shinji and Nakaumi were studied in order to understand the level of mercury (Hg) pollution in lakes in northwestern Japan. The sedimentation rates were established on the basis of the activity of [210Pb] and [131Cs] in the sediments. In Lake Shinji, the highest level of Hg (130 ng g–1) in the sediment was found at a depth of 20–22 cm, while 195 ng g–1 was found at a depth of 10–12 cm in the core profiles from Lake Nakaumi. The relative increase in Hg concentration in lake sediments started after 1960 and significant contamination events occurred in the early 1960s. Mercury profiles in lake sediments from lakes Shinji and Nakaumi are found to reflect the anthropogenic Hg released into the environment in the 1950s and 1960s. A pronounced maximun concentration of Hg is found in both lakes, where sediment accumulation rates differ.
Challenges and opportunities in watershed management for Laguna de Bay (Philippines)
Authors: Oledan M. T. T. 
Published: March 2003

AbstractLaguna de Bay is the largest lake in the Philippines and the second largest freshwater lake in South‐East Asia. The lake is shallow with a mean depth of only 2.8 m. Rice paddies, sugar cane fields, coconut plantations and other agricultural fields make up large portions of the catchment area, although there is also extensive urbanization and industrialization. As industry and population around the lake have grown, the lake and its tributaries have become overwhelmed by industrial, commercial, agricultural and domestic pollution resulting in massive fish kills and polluted water. Laguna de Bay is under the management and protection of a national government agency known as Laguna Lake Development Authority (LLDA). In 1983, the LLDA was given the power to control and abate pollution within the Laguna de Bay watershed. The mandate of the LLDA includes the environmental regeneration and sustainable development and use of the lake’s waters, fisheries and wetlands. The LLDA receives no federal funds but it retains and uses collected fees from regulated industries. The LLDA has instituted an environmental‐user fee or pollution‐charge system that has given corporations an incentive to construct and use wastewater treatment plants at a lower cost than the required fees for dumping waste into Laguna de Bay. User fees provide more flexibility about how and when a user or industrial facility cleans up its manufacturing process. Many medium‐ and large‐sized domestic and multinational corporations have achieved at least 30–50% reductions in pollution loads. The user fees also encourage industry water conservation. Other creative approaches to conserving Laguna de Bay include ‘Environmental Armies’ that consist of volunteers who clean up river banks, demolish illegal fish pens and install low‐cost garbage traps at the river’s mouth. ‘Poison Awards’ are given annually and publicly to companies that continue to dump large amounts of waste into lake tributaries. Organizers also name a ‘Most Improved Company’ to provide a positive incentive. Laguna de Bay stakeholders face a severe shortage of resources to continue their work. Innovative strategies are needed to achieve pollution reductions from smaller industries
Sustainable fisheries management in the Great Lakes: Scientific and operational challenges
Authors: McCrimmon Jr Donald A. 
Published: March 2003

AbstractFisheries managers seek to sustain Great Lakes' fish populations in a large, complex lake‐watershed ecosystem responding to often competing issues: non‐indigenous species, resource allocation and environmental quality. Within the past 200 years, human activity has caused dramatic changes in the character of this ecosystem. Before the 1900s, the offshore fish communities in each of the Great Lakes were dominated by the piscivorous lake trout and burbot. The current fish fauna of the Great Lakes' basin includes 179 species representing 29 families in 18 orders and two classes of fish. Twenty‐five non‐indigenous fish species have established populations in the Great Lakes' ecosystem. Sustainable management of Great Lakes' fisheries depends on social, economic and ecological factors. Hundreds of millions of dollars are spent annually to protect and preserve Great Lakes' fisheries and their associated ecosystems. Management of Great Lakes' fisheries on a species‐by‐species basis is pointless. Recreational fishing provides larger economic benefits on the Great Lakes, compared to commercial fisheries. Further, quota management, even when practiced at levels well below maximum sustainable yield, does not lead to stable fish communities. Management will be constrained more by ecological reality than by economic forces, but ultimately a managed system comprised of both indigenous and non‐indigenous fishes is a logical objective.
Dynamics and biogeochemical significance of the physical environment in Lake Biwa
Authors: Kumagai Michio , Ishikawa Kanako , Chunmeng Jiao 
Published: March 2003

AbstractWe have examined two aspects of the dynamics and biogeochemical significance of the physical environment in Lake Biwa. One is the horizontal distribution of cyanobacteria as it relates to the ‘first gyre’ in the north basin of Lake Biwa. We could easily measure the first gyre using a vessel‐mounted acoustic doppler currents profiler. We were able to quantify the dynamics of the horizontal and vertical structure of currents and water temperature of this gyre. The first gyre did not remain at a fixed position; it moved north and south according to the growth of the gyre. This may play a role in the redistribution of cyanobacteria from place to place in the north basin. The second important environmental dynamic we measured was oxygen consumption rates from 1994 to 2000. We found that the minimum oxygen concentration in the hypolimnion has a clear inverse relationship with the apparent oxygen consumption rates in the 80–85 m depth layer. As a reduction in oxygen concentration in the hypolimnion can have a serious impact on benthic organisms, we concluded that the Lake Biwa environment should be monitored carefully and systematically.
Exit‐site and catheter‐related infections in peritoneal dialysis: Problems and progress
Authors: Dasgupta Mrinal K 
Published: March 2003

SUMMARY:Silastic peritoneal catheters are used routinely for peritoneal access in peritoneal dialysis (PD) because they are biocompatible. Catheter insertions are usually succeeded by bacterial adhesion and subsequent colonization of the catheter exit site. Despite the reduction in the proportion of peritonitis due to touch contamination, exit‐site and catheter‐related infections, particularly those caused by Staphylococcus aureus, remain the major cause of catheter loss and technique failure in PD. The peritonitis rate in the global PD population is steadily declining, but as the number of patients on PD increases by about 10% per year the stakes in infection control become greater, and one is forced to consider new options that will reduce the PD patient drop‐out rate. Three areas of promising advances in the prevention of exit‐site and catheter‐related infections are reviewed in this paper: (i) the use of prophylactic antibiotics to eliminate the nasal carriage of Staph. aureus and to reduce exit‐site infections; (ii) the Moncrief–Popovich catheter and implantation technique which reduces bacterial colonization of the catheter exit tunnel; (iii) new catheter implants composed in part of rigid biomaterials with antibacterial properties. This last category includes the silver‐coated silastic PD catheter, significant not only because it has great potential as a replacement for the silastic catheter, but also because it is a reminder that caution must be exercised before fully embracing new treatment options.
Transforming growth factor‐β superfamily members: roles in branching morphogenesis in the kidney
Authors: Martinez Gemma , Cullen‐McEwen Luise A , Bertram John F 
Published: March 2003

SUMMARY:The process of nephrogenesis and the number of nephrons formed during kidney development are both highly dependent upon ureteric branching morphogenesis. Abnormalities in branching and growth of the ureter have been implicated in a range of urogenital/renal pathologies including cystic renal disease and some forms of renal agenesis. The issue of how the branching of the ureter is regulated is therefore an important one. There is a growing list of candidate molecules (growth factors, oncogenes, transcription factors and extracellular matrix components) which have been directly or indirectly implicated in the regulation of ureteric branching. Among these, members of the transforming growth factor‐β (TGF‐β) superfamily are well represented. This review summarizes our knowledge of the roles of TGF‐β superfamily members in ureteric branching morphogenesis.
Acute vascular access catheters for haemodialysis: Complications limiting technique survival
Authors: JEFFERYS ANDREW , CHOW JOSEPHINE SF , SURANYI Michael G 
Published: March 2003

SUMMARY: The use of acute vascular access catheters (AVACs) has facilitated the delivery of haemodialysis to patients lacking functioning access. A review of the experience of a tertiary Australian renal treatment centre, consisting of 205 sequential AVACs in 93 patients, was undertaken over 1 year, to identify issues limiting technique survival. Acute vascular access catheters were inserted as acute dialysis access for patients with chronic renal failure (CRF; 21%), failed grafts or fistulae (18%), acute renal failure (12%), failed chronic ambulatory peritoneal dialysis (CAPD; 8%) or failed prior AVACs (37%). The majority of AVACs were on the right (74%), and the placement site was simple jugular (69%), tunnelled jugular (15%), femoral (12%), or subclavian (4%). During follow up, 198 of 205 AVACs were removed. The mean AVAC survival was superior (P < 0.0001, Fisher's protected least significant difference (PLSD) for tunnelled jugular AVACS (62 ± 46 (SD) days) compared with simple jugular (20 ± 19), subclavian (18 ± 13) and femoral (7 ± 6). Causes for AVAC removal were: elective (47%), blockage (31%), infection (20%) or cracked catheter (1%). Routine postremoval tip cultures grew coagulase negative Staphylococcus (CNS, 46%), negative culture (33%), methicillin‐resistant Staphylococcus aureus (MRSA; 9%), Staphylococcus aureus (9%), Gram‐negative rods (1%), Pseudomonas (0.5%) or other uncommon organisms (2%). Blood cultures were drawn through the AVAC in the setting of suspected bacteraemia in 42 of 198 AVACs. Blood cultures were negative in 40%. Positive cultures included Staphylococcus species in 55%: including MRSA (19%), Staphylococcus aureus (29%) and CNS (34%). Rare cultures identified Escherichia coli (2%) or Serratia (2%). Infection and blockage significantly reduced AVAC survival, affecting more than 50% of cases. Approaches to minimize these complications are likely to lead to improved clinical outcomes with AVAC use.