bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical Evaluation of the Addition of Lyophilized, Heat‐Killed Lactobacillus acidophilus LB to Oral Rehydration Therapy in the Treatment of Acute Diarrhea in Children
Authors: Simakachorn Nipat , Pichaipat Vorapun , Rithipornpaisarn Prayungari , Kongkaew Chumnian , Tongpradit Pisamai , Varavithya Wandee
Published: February 2024

Background:

Addition of a medication to the World Health Organization protocol for treatment of acute diarrhea in children is controversial. In this trial, the clinical efficacy of a medication (Lactéol Fort sachets; Laboratoire du Lactéol du Docteur Boucard, Houdan France) containing lyophilized heat‐killed Lactobacillus acidophilus LB was assessed as an adjunct to oral rehydration therapy.

Methods:

Children aged 3 to 24 months with acute diarrhea and mild or moderate dehydration were enrolled in the study. Children received oral rehydration therapy for the first 4 hours. After this first rehydration phase, undiluted milk formula or breast milk was fed alternately with oral rehydration solution. Children were fed rice gruel as tolerated. They received either one sachet containing 10 billion of lyophilized heat‐killed L. acidophilus LB or placebo at admission and at 12‐hour intervals for five doses.

Results:

Seventy‐three children (37 L. acidophilus LB, 36 placebo) were enrolled, of whom 40 (17 L. acidophilus LB, 23 placebo) received an antibiotic before inclusion. Rotavirus was identified in approximately 50% of the children in each group. After 24 hours of treatment, the number of rotavirus‐positive children with watery stools was significantly lower (p = 0.012) in the L. acidophilus LB group. Mean duration of diarrhea was decreased (p = 0.034) with L. acidophilus LB (43.4 hours) versus placebo (57.0 hours). This decreased duration was particularly marked in children with no antibiotic therapy before inclusion (31.1 hours): 42.9 hours for the L. acidophilus LB group versus 74.0 hours for the placebo group (p = 0.016).

Conclusions:

Addition of L. acidophilus LB to oral rehydration therapy was effective in the treatment of children with acute diarrhea by decreasing the duration of diarrhea.
Infantile Colic and Food Hypersensitivity
Authors: Hill David J. , Hosking Clifford S. , Simpson Hugh A. , Anderson John A.
Published: February 2024

In this article, some aspects of the phenomenon of infantile colic or fussing and crying behavior in early infancy are reviewed. The major points addressed are as follows: 1) evidence that infants with colic differ significantly in their pattern of distressed behavior from noncolicky infants; 2) the evidence of colic in children with known food allergy; 3) the incidence of food allergy in children with colic; 4) the outcome of trials focusing on the dietary management of colic; 5) the outcome of studies involving behavior modification in colic; 6) the outcome of a preliminary trial of modification of maternal diet in very young infants with colic; and 7) findings of a systematic review of different treatments for colic.
Imaging Changes in the Pancreas in Cystic Fibrosis: A Retrospective Evaluation of 55 Cases Seen Over a Period of 9 Years
Authors: Feigelson Jean , Pécau Yvette , Poquet Myriam , Terdjman Patricia , Carrère Jacqueline , Chazalette Jean‐Pierre , Ferec Claude
Published: February 2024

Background:

Pathologic changes of the pancreas have been observed as early as the recognition of the disease termed initially “cystic fibrosis of the pancreas”. Atrophy of the gland and its fatty infiltration were considered as usual features. The aim of this study was to follow‐up the evolution of cystic fibrosis pancreas and to define its successive stages in correlation with the clinical, biochemical, and imaging findings.

Methods:

Fifty‐five patients were followed up during 9 years. The patients' genetic backgrounds were systematicaly performed. Blood lipase levels were analyzed systematically at each consultation of the patients and in the event of bouts of abdominal pains. Imaging using mainly echograms and tomodensitometric scans were regularly performed: echograms every 6 months, and tomodensitometric scans every 1 to 2 years. Magnetic resonance imaging was performed in four patients.

Results:

Five groups of patients were identified on the basis of tomodensitometric scan findings: normal pancreas (n = 4), incomplete lipomatosis of the pancreas (n = 9), complete lipomatosis of the pancreas (n = 23), cystic pancreas (n = 5), macrocystic pancreas (n = 1), atrophic pancreas (n = 13). Pancreas exocrine function was not correlated with findings. Forty episodes of pancreatitis were observed in seven patients. They had bouts of abdominal pain and elevation of lipase levels. Five of these patients were composite heterozygotes (D508/other). Incomplete lipomatosis represents an intermediate stage leading toward complete lipomatosis or toward atrophy after pancreatitis.

Conclusions:

Studies of pancreatic function should be performed routinely in cystic fibrosis, especially in pancreatic sufficiency or in patients with normal pancreas images. Acute pancreatitis should be diagnosed and properly identified to be differentiated from other acute abdominal syndromes occurring in cystic fibrosis.
Long‐Term Nutritional and Neurodevelopmental Outcome of Liver Transplantation in Infants Aged Less Than 12 Months
Authors: van Mourik Indra D. M. , Beath Sue V. , Brook Gill A. , Cash A. John , Mayer A. David , Buckels John A. C. , Kelly Deirdre A.
Published: February 2024

Background:

Liver transplantation is established treatment for children with end‐stage liver disease and has a 5‐year survival rate of 80% to 85%, even in infants under 12 months. Long‐term outcome in nutritional rehabilitation and normal development is unknown. This study aimed to prospectively evaluate growth and psychoneurologic performance of children who undergo liver transplantation in infancy.

Methods:

Twenty‐five infants (18 girls, 7 boys) who underwent liver transplantation at less than 12 months of age (median age, 9 months) were evaluated for 4 years. Growth measurements were expressed as standard deviation scores (SDSs; mean ± SEM), and psychoneurologic performance was assessed with the unrevised Griffiths Mental Ability Scales (normal range, 80–120).

Results:

Four children died during the study (4‐year survival, 84%). The children were malnourished before transplantation (SDSs: weight, −1.9 ± 0.2; midarm muscle area, −0.93 ± 0.3; midarm fat area, −1.52 ± 0.3; and height, −0.95 ± 0.3). Nutritional rehabilitation for all parameters occurred within 12 to 24 months after transplantation, which was most significant for weight (−1.1 ± 0.2, P = 0.001), midarm muscle area (0.74 ± 0.3, P = 0.001), and midarm fat area (−0.44 ± 0.3, P = 0.01). There was some improvement in height (−0.72 ± 0.3, P = 0.14), which was not significant, although infants who were severely stunted before transplantation (mean height standard deviation score [SDS] −2.46) showed significant catch‐up at 1 year after transplantation (mean height SDS −1.2, P = 0.003). Psychoneurologic scores were within normal limits before transplantation and were maintained for the 4‐year follow‐up period, although individual scores varied during this period. Improved nutritional status was associated with increased muscle bulk and subsequent improvement in motor scores from 90.6 at initial assessment to 97.3 at 4 years (P = 0.28). There was a temporary reduction in social skills and eye–hand coordination in the first year, which may have been an effect of the hospital environment or cyclosporine immunosuppression. Language abilities also regressed during the first year, possibly related to the effect of nasogastric tube feeding in delaying normal speech development.

Conclusions:

Liver transplantation in infancy has not only a successful outcome but is also associated with long‐term catch‐up growth and nutrition and maintenance of normal development.
Lactobacilli and Acidosis in Children With Short Small Bowel
Authors: Bongaerts Ger , Bakkeren Jan , Severijnen René , Sperl Wolfgang , Willems Hans , Naber Ton , Wevers Ron , van Meurs Alfred , Tolboom Jules
Published: February 2024

Background:

In patients with a short small bowel, D‐lactic acidemia and D‐lactic aciduria are caused by intestinal lactobacilli. The purpose of this study was to obtain a detailed picture of the metabolic acidosis in young children with short small bowel.

Methods:

Feces, blood, and urine of children with short small bowel and acidosis were studied microbiologically and/or biochemically.

Results:

Previous findings were confirmed that more than 60% of the fecal flora of patients with small short bowel, who are not receiving antibiotics, consists of lactic acid‐producing lactobacilli. In blood, D‐lactic acid was the most prominent metabolite: the highest serum D‐lactate (15.5 mmol/l) was observed in a sample taken immediately after the onset of hyperventilation. The highest D‐lactate excretion was in urine collected some hours after the onset of hyperventilation, and amounted to 59 mol/mol creatinine. Acidosis in the patients with short small bowel was related to strongly increased serum D‐lactate and anion gap and to strongly decreased serum bicarbonate and pH.

Conclusion:

In children with small short bowel and acidosis, the common intestinal flora of mainly lactobacilli abundantly produces D‐lactic acid from easily fermentable carbohydrates. Thus, these bacteria directly cause shifts of bicarbonate, pH, and base excess and indirectly cause shifts of the anion gap, as well as hyperventilation. These kinetic parameters are strongly associated.
Prevalence of Hepatitis G Virus in Healthy Children in Liver Disease, and Human Immunodeficiency Virus‐1 Infection: Response to Interferon
Authors: Infante Dámaso , Pich Margarita , Tormo Ramon , Sauleda Silvia , Montané Carlos , Esteban Juan Ignacio , Esteban Rafael
Published: February 2024

Background:

A new virus of the Flaviviridae family, the hepatitis G virus (HGV/HGBV‐C), has been identified recently. The purpose of this study was to determine the prevalence of HGV infection in healthy children, in patients with liver disease, and in human immunodeficiency virus (HIV)‐1–infected patients. The role of HGV in the clinical course of chronic HCV, the response to interferon‐α2b, and the possible implications of intravenous γ‐globulin in the transmission of the virus were also evaluated.

Methods:

Fifty healthy children, 66 patients with a variety of liver diseases, 19 patients with acquired immune deficiency syndrome (AIDS), and various batches of commercial intravenous immunoglobulins were investigated. Viral HGV RNA (5´NCR‐NS5) and anti‐HGV envelope protein E2 were assayed.

Results:

The prevalence of HGV infection was 6% in the healthy children and 42% in the liver disease group. Viremia and anti‐E2 were found in 11% and 79% of patients with AIDS. Four (27%) of 15 patients with chronic HCV, receiving treatment with interferon, were coinfected by HGV and became HGV‐RNA negative during therapy. One year after the end of interferon therapy, three of them were again HGV RNA positive.

Conclusions:

The prevalence of HGV infection is high in healthy children higher in children affected with liver disease, but its potential pathologic implication is questionable, and further studies are warranted. Hepatitis G virus is sensitive to interferon therapy, although the infection often recurs after discontinuation of treatment.
Spontaneous Bowel Perforation in Infants and Young Children: A Clinicopathologic Analysis of Pathogenesis
Authors: Chen Jeng‐Chang , Chen Chiu‐Chiang , Liang Jin‐Tung , Huang Shiu‐Feng
Published: February 2024

Background:

In children beyond the neonatal stage, spontaneous bowel perforation with no specific cause is rare. It has attracted little notice and does not fit into any established clinical category. This often results in treatment delays. To determine the underlying pathogenesis, a clinicopathologic analysis of this group of patients was performed.

Methods:

From 1984 through 1997, 15 previously healthy children (10 boys and 5 girls) with bowel perforations were enrolled in this study. Children in whom the specific cause was established were excluded. The ages of the patients ranged from 3 months to 5 years, 5 months (average age: 2 years, 4 months). Data on clinical course, surgical and pathologic findings, and outcomes were analyzed.

Results:

All the patients had high fever and acute, watery diarrhea with clinical dehydration. Abdominal distension developed and bowel perforation ensued 5 to 30 days after the onset of diarrhea. In all cases, the perforation consisted of either an isolated patch of bowel (n = 8) or patchy lesions in a segment (n = 7), which was confined to one of the following three anatomic watershed areas: the splenic flexure (n = 7); the lower sigmoid (n = 3); and the ileocecal region (n = 5). One patient died, and three had major sequelae including intra‐abdominal abscess, adhesion ileus, and peristomal fistula. Specimens from 13 patients were submitted for histopathologic evaluation. All specimens had acute suppurative inflammation diffusely around the perforation site. Seven had areas of coagulation necrosis of the muscularis propria, especially in the inner circular muscle layer.

Conclusion:

In acute diarrheal diseases, dehydration may cause bowel ischemia and lead to perforation. Physicians should be alert to the possibility of this abdominal catastrophe when progressive abdominal distension followed by acute diarrheal episodes occurs in children.
Effects of Liver Transplantation on Long‐Chain Polyunsaturated Fatty Acid Status in Infants with Biliary Atresia
Authors: Lapillonne Alexandre , Hakme Christine , Mamoux Valérie , Chambon Michelle , Fournier Vincent , Chirouze Véronique , Lachaux Alain
Published: February 2024

Background

The long‐chain polyunsaturated fatty acid (LC‐PUFA) status of infants with untreated biliary atresia (BA) is known to be poor and is correlated to the severity of the liver disease. Liver transplantation (LT) markedly increases survival of patients with BA but the extent to which this reverses poor LC‐PUFA status is not known.

Methods

To explore this question, the erythrocyte (red blood cell, RBC) phospholipid content of eight infants with BA who underwent LT was determined 2 months after an initial portoenterostomy, immediately before LT, and 6 and 12 months after LT. Before LT, all infants were fed a protein hydrolysate formula containing medium‐chain triglycerides and essential fatty acids. Afterward, they were fed a normal diet for age. The RBC phospholipid content at each time point was compared with that of 28 age‐matched control infants.

Results

Just before LT, median RBC phospholipid content of C20:4n‐6, C20:5n‐3, and C22:6n‐3 was 25%, 48%, and 30% lower, respectively, than that observed in age‐matched control infants. After LT, the RBC phospholipid content of most fatty acids reached normal values by 6 months. However, that of C20:4n‐6 and C22:6n‐3 contents remained 5% and 15% lower, respectively, than in normal control infants. Twelve months after LT, C20:4n‐6 content remained lower than in normal children, but that of C22:6n‐3 did not differ. The ratio of C20:3n‐6/C20:4n‐6, a reflection of Δ‐5 desaturase activity, was abnormal compared with normal children before LT (0.17 vs. 0.10, P < 0.009) but normalized by 6 months after LT (0.11 vs. 0.10, not significant).

Conclusions

These data show that the abnormal LC‐PUFA status of children with BA improves after LT but is not entirely reversed within a year after surgery. They suggest that the abnormal status before LT may be secondary, in part, to low Δ‐5 desaturase activity. The extent to which a different pre‐and/or post‐LT diet can prevent PUFA deficiency and/or hasten recovery of PUFA status remains to be determined.
Lactulose–Mannitol Intestinal Permeability Test in Children With Diarrhea Caused by Rotavirus and Cryptosporidium
Authors: Zhang Ying , Lee Ben , Thompson Matthew , Glass Roger , Lee Rosa Cama , Figueroa Dante , Gilman Robert , Taylor David , Stephenson Charles ,   Diarrhea Working Group Peru
Published: February 2024

Background:

The relationship between intestinal permeability and acute secretory diarrheal syndromes caused by rotavirus and Cryptosporidium parvum in infants less than 36 months of age was studied using the lactulose–mannitol excretion assay.

Methods:

An oral solution containing 0.4 g/kg lactulose and 0.1 g/kg mannitol was administered to 15 infants with rotavirus, 7 with Cryptosporidium infection and a control group of 7 with secretory diarrhea admitted to the Oral Rehydration Unit of the National Children's Hospital in Lima, Peru. Urinary sugar excretion was measured using an enzymatic spectrophotometric method. The ratio of urinary excretion of lactulose to mannitol was used to measure intestinal mucosal permeability, with higher ratios indicative of increased intestinal permeability. Infants in all three groups were retested 20 days after the initial test.

Results:

The (mean ± SE) lactulose:mannitol (L:M) excretion ratios during the acute phase (day 1) of diarrhea in infants with rotavirus or Cryptosporidium and control infants were 0.67 ± 0.1, 0.76 ± 0.16, and 0.26 ± 0.04, respectively. In the convalescent phase (day 20) the ratios were 0.19 ± 0.02, 0.28 ± 0.05, and 0.29 ± 0.07, respectively. Significant reductions in L:M ratios were noted in rotavirus patients between days 1 and 20 (paired t‐test;P < 0.01), Cryptosporidium patients between days 1 and 20 (paired t‐test;P < 0.05), and between control subjects on day 1 and rotavirus patients on day 1 and Cryptosporidium patients on day 1 (unpaired t‐tests;P < 0.05 for both). There were no significant differences in control subjects between days 1 and 20, control subjects and rotavirus patients on day 20, or control subjects and Cryptosporidium patients on day 20.

Conclusions:

The results indicate that increased intestinal permeability caused by rotavirus or cryptosporidium infections in Peruvian infants less than 36 months of age is a significant but reversible phenomenon. The temporal relationship observed in the current study and the contribution of such alterations in intestinal mucosal integrity to the burden of diarrheal disease and the development of malnutrition in developing countries is discussed.
Direct Measurement of Pancreatic Enzymes After Stimulation With Secretin Versus Secretin Plus Cholecystokinin
Authors: Del Rosario Marian A. F , Fitzgerald Joseph F , Gupta Sandeep K , Croffie Joseph M
Published: February 2024

Background:

Direct measurement of pancreatic enzymes after administration of pancreatic secretagogues is the gold standard in the assessment of exocrine pancreatic function. Recent experience at the authors' institution showed that endoscopic collection of pancreatic secretions 5, 10, and 15 minutes after intravenous administration of secretin is useful in screening for pancreatic insufficiency. Concomitant administration of intravenous cholecystokinin has been a subject of debate. The purpose of this study was to compare pancreatic enzyme levels after administration of secretin versus secretin plus cholecystokinin and to validate the timing of collection of duodenal fluid.

Methods:

A prospective, randomized, double‐blind study was conducted from September 1997 through September 1998. Patients scheduled for pancreatic enzyme sampling were randomly assigned to receive intravenous secretin (2 U/kg) plus placebo (group 1) or intravenous secretin (2 U/kg) plus cholecystokinin (0.02 μg/kg [Group 2]). Duodenal fluid was collected 5, 10, and 15 minutes later and placed in dry ice. Samples were measured for the levels of trypsin, amylase, lipase, and chymotrypsin.

Results:

Twenty patients were assigned to each group. The age range was similar in both groups: 12 months to 16 years, 8 months in group 1 (median, 2.1 years) and 15 months to 13 years, 7 months in group 2 (median, 2.5 years). Group 2 had a greater number of patients with all four enzymes at normal levels during at least one of the time points, 75% versus 50% (P = 0.102). The difference in enzyme levels at the 5‐, 10‐, and 15‐minute collections was statistically significant. For all four enzymes in both groups, values varied from highest to lowest with time (P = 0.0001). The enzyme levels at 10 minutes were close to the enzyme levels at 5 minutes; the lowest values occurred at 15 minutes.

Conclusions:

Higher pancreatic enzyme levels were obtained after administration of secretin plus cholecystokinin, although the trend did not reach statistical significance. Pancreatic enzyme levels are highest at 5 and 10 minutes, indicating that collections of duodenal fluid should be completed within 10 minutes of the administration of the secretagogues.
Deep Sedation With Inhaled Sevoflurane for Pediatric Outpatient Gastrointestinal Endoscopy
Authors: Montes Ramon G , Bohn Roger A
Published: February 2024

Background:

Sevoflurane is an inhaled anesthetic agent with ideal properties for achieving deep sedation during pediatric outpatient gastrointestinal endoscopy. This is a comparison of experience with this gas and other sedation methods used in the authors' hospital.

Methods:

Retrospective chart review and statistical analysis of data from children receiving inhaled sevoflurane administered by an anesthesiologist through laryngeal insufflation, intravenous propofol, or intravenous midazolam‐fentanyl‐ketamine in any combination to achieve deep sedation for outpatient gastrointestinal endoscopy. Anesthesia was administered in a dedicated procedure room. The intravenous drugs were administered by pediatric intensivists in the intensive care unit. The same endoscopist performed all the procedures.

Results:

A total of 248 procedures were reviewed (midazolam‐fentanyl‐ketamine 67, propofol 114, and sevoflurane 67). All patients were adequately sedated with sevoflurane, and no intravenous access was required. Time (in minutes) to awakening (midazolam‐fentanyl‐ketamine 47.15, propofol 36.12, sevoflurane 5.70), discharge (midazolam‐fentanyl‐ketamine 141.99, propofol 91.20, sevoflurane 53.34), and total time, including induction and procedure (midazolam‐fentanyl‐ketamine 163.97, propofol 119.40, sevoflurane 73.93), were significantly lower for sevoflurane (P < 0.01). The complication rate for sevoflurane (4.5%) was lower (P < 0.05) than for midazolam‐fentanyl‐ketamine (13.4%) and for propofol (17.5%). Charges for room use and medications were also lower for sevoflurane (P < 0.01). The total charges for sedation (U.S.$) were comparable for sevoflurane (688.10) and propofol (723.08) but were higher for midazolam‐fentanyl‐ketamine (855.10, P < 0.01).

Conclusions:

Deep sedation with inhaled sevoflurane for pediatric outpatient gastrointestinal endoscopy is as safe as conventional sedation techniques, potentially less expensive, increases endoscopy unit productivity, and eliminates the inconvenience associated with obtaining intravenous access in children.
The Euro‐Growth Study: Why, Who, and How
Authors: van't Hof Martin A. , Haschke Ferdinand ,   Euro‐Growth Study Group
Published: February 2024

Background:

Assessment of growth is important in health management of infants and children. Evaluation of growth performance requires anthropometric measurements, with proper interpretation depending on the use of appropriate references. Europe‐specific growth references have not been available. The purpose of the present study was to generate such references for infants and children from birth to 3 years of age. The study was further intended to assess the influence of nutrition and lifestyle factors on growth.

Methods:

The Euro‐Growth Study was designed as a multicenter longitudinal cohort study. This report describes the study design, the sample (cohort), and the methods used. Quality control measures included standardized measurement techniques with ongoing cross‐sectional and longitudinal consistency checks. Selectivity in participation and discontinuation and reproducibility of data over time were evaluated.

Results:

Of 2245 infants who were enrolled in the study at 22 study sites in 11 countries, 1746 (78%) provided longitudinal data until 12 months of age, 1205 (57%) until 24 months of age, and 1071 (48%) until 36 months of age. Anthropometric measurements were performed on 21,773 occasions. As a result of cross‐sectional and longitudinal data checks, 209 data points (0.09% of all data points) were rejected. Comparison of participants's demographic data with those of nonparticipating local subjects indicated that the cohort was selective in maternal age (higher), maternal education level (higher), household location, and family structure. The withdrawal rate during the study was low (24%), and withdrawals occurred at random. Analysis of reproducibility over time resulted in the elimination of the data from one study site.

Conclusion:

The Euro‐Growth Study provided longitudinal growth data from a large cohort of normal European children. Because of the chosen sampling method, the study cohort ws somewhat selective relative to the local background population. Internal validity was satisfactory in that the reproducibility of anthropometric measurements was high in 21 sites and the withdrawal rate was low and random.
Iodine Supply in Children From Different European Areas: The Euro‐Growth Study
Authors: Manz Friedrich , van't Hof Martin A. , Haschke Ferdinand ,   Committee for the Study of Iodine Supply in European Children: The Euro‐Growth Study Group
Published: February 2024

Background:

In many areas of Europe iodine deficiency disorders still exist. Urinary iodine excretion is a valuable tool in characterizing the iodine supply of a population. However, there is a continuing discussion on the most appropriate parameter to measure urinary iodine excretion.

Methods:

In 247 children (ages 3–5 years) from six European centers, spot urine samples were analyzed for urinary iodine concentration and urinary iodine‐creatinine ratio.

Results

: The median values of urinary iodine concentration from the six centers were very similar (90–106 μg/l) corresponding to a normal or marginal iodine supply according to the criteria of the World Health Organization. However, the median values of the urinary iodine‐creatinine ratio from the six centers differed significantly (143–445 μg/g, P < 0.001). The different results of the two urinary parameters to assess urinary iodine supply were due to large significant differences in the urinary creatinine concentration reported by the various centers, which probably reflect marked differences in water intake.

Conclusions:

Iodine deficiency is still a significant health problem in many European countries. In comparable and homogeneous population subgroups (even from different countries), the urinary iodine‐creatinine ratio appears to be a much better parameter for assessing iodine supply than urinary iodine concentration.
Review of The Supervisor's Guidebook: Evidence‐Based Strategies for Promoting Work Quality and Enjoyment Among Human Service Staff (2nd edition) by Dennis Reid, Marsha Parsons, and Carolyn Green
Authors: Bartle Grace E. , Braren J. Turner B. , DiGennaro Reed Florence D.
Published: February 2024

This article summarizes a review of the book The Supervisor's Guidebook: Evidence‐Based Strategies for Promoting Work Quality and Enjoyment Among Human Service Staff (2nd edition) by Reid, Parsons, and Green. We describe the book's organization and content. In addition, strengths and areas for improvement are noted. The book provides rich, relevant content to guide supervisory practices within a participative, evidence‐based approach that could be applied in various human service settings.
Low thyroid function is associated with metabolic dysfunction‐associated steatotic liver disease
Authors: Wang Shuo , Xia Ding , Fan Hong , Liu Zhenqiu , Chen Ruilin , Suo Chen , Zhang Tiejun
Published: February 2024

Background and Aim

Metabolic dysfunction‐associated steatotic liver disease (MASLD) is recently introduced to better highlight the pathogenic significance of cardiometabolic dysfunction, as compared with non‐alcoholic fatty liver disease. This study aimed to investigate the association between low thyroid function and MASLD in the new context.

Methods

We recruited 2901 participants for our retrospective cohort study from 2016 to 2021. Participants were divided into strict‐normal thyroid function and low thyroid function groups (low‐normal thyroid function, subclinical hypothyroidism) based on initial thyroid stimulating hormone (TSH) levels, respectively. Cox regression models were used to estimate the hazard ratios (HRs) and 95% CI.

Results

During a median follow‐up of 15.6 months, 165 (8.9%) strict‐normal thyroid function subjects and 141 (13.4%) low thyroid function subjects developed MASLD; this result was statistically relevant (P < 0.05). Univariate regression analysis showed that low thyroid function and subclinical hypothyroidism were statistically significantly associated with MASLD (low thyroid function: HR1.53; 95% CI 1.22–1.92; subclinical hypothyroidism: HR1.95; 95% CI 1.47–2.60).

Conclusions

MASLD is associated with low thyroid function and the relationship between MASLD and low thyroid function is independent.
A phenylalanine‐free recombinant nutritional protein for the dietary management of phenylketonuria
Authors: Mücke Yvonne , Jablonka Natalia , Rimann Nicole , Grisch‐Chan Hiu Man , Hoffmann Bernhard , Schillberg Stefan , Thöny Beat , Rasche Stefan
Published: February 2024

Phenylketonuria (PKU) is a congenital metabolic disorder that causes the systemic elevation of phenylalanine (Phe), which is neurotoxic and teratogenic. PKU is currently incurable, and management involves lifelong adherence to an unpalatable protein‐restricted diet based on Phe‐free amino acid mixtures. Seeking a palatable dietary alternative, we identified a Bacillus subtilis protein (GSP16O) with a well‐balanced but low‐Phe amino acid profile. We optimized the sequence and expressed a modified Phe‐free version (GSP105) in Pseudomonas fluorescens, achieving yields of 20 g/L. The purified GSP105 protein has a neutral taste and smell, is highly soluble, and remains stable up to 80°C. Homozygous enu2 mice, a model of human PKU, were fed with diets containing either GSP105 or normal protein. The GSP105 diet led to normalization of blood Phe levels and brain monoamine neurotransmitter metabolites, and prevented maternal PKU. The GSP105 diet thus provides an alternative and efficacious dietary management strategy for PKU.
Connections between different characteristics of the Tibetan Plateau vortices
Authors: Ma Jun , Li Lun
Published: February 2024

Tibetan Plateau vortices (TPVs) are major rainfall triggers over the Tibetan Plateau (TP), which often cause heavy rainfalls in eastern China when moving off the TP. Although previous studies have revealed the climatic characteristics of TPVs at different timescales, the relationships between the different activity characteristics of TPVs are unclear. In this study, TPVs during May to August during 1998–2020 are objectively identified based on ERA5 reanalysis data, and connections between the initial states of TPVs and their subsequent activities, as well as the connections between the states of TPVs before moving off the TP and those after moving off are investigated. It is reported that the TPVs generated over the central and western TP north of 32° N, particularly near 84° E, 35° N, are always stronger, maintain longer and move further in their subsequent life, and the TPVs generated near 95° E over the eastern TP move eastwards the fastest. The initial intensity of most TPVs is smaller than 1.1 × 10−4 s−1; regarding these TPVs, their average duration, movement distance and movement speed exhibit an initial decrease followed by an increase as the initial intensity rises. The stronger the TPVs initially are, the stronger they are in their entire lifetime. The majority of the moving‐off TPVs are generated over the eastern TP; generally, TPVs generated further east with a large initial intensity are more likely to move off the TP. After moving off the TP, most TPVs remain in the same movement direction as before; if the TPVs are strong when they are over the TP, they tend to be strong, last long and move eastwards further after moving off the TP, and vice versa.
Points to consider regarding prophylactic total gastrectomy in germline CDH1 variant carriers
Authors: Corso Giovanni , Davis Jeremy L. , Strong Vivian E.
Published: February 2024

Pathogenic germline CDH1 mutation confers high risk for developing diffuse gastric and lobular breast cancers in asymptomatic carriers. In these individuals, the estimated gastric cancer risk at 80 years of age is up to 70% for males and 56% for females. Due to this high‐risk predisposition, prophylactic total gastrectomy is considered a unique life‐saving approach in germline CDH1 carriers, as endoscopy often fails to detect early stage diffuse gastric carcinoma. However, surgical indication is controversial in some clinical contexts, with possible contraindications. This review discusses points against and in favor of a more aggressive surgical approach for consideration during the decision‐making process.
Relationship between Swallowing Pressure and Saliva Residue on Endoscopic Evaluation in Pharyngeal Dysphagia
Authors: Chitose Shun‐ichi , Fukahori Mioko , Kurita Takashi , Hamakawa Sachiyo , Sato Kiminobu , Kuroiwa Taikai , Ono Takeharu , Umeno Hirohito , Sato Kiminori
Published: February 2024

Objective

In pharyngeal dysphagia, poor pharyngeal contraction and upper esophageal sphincter (UES) dysfunction result in post‐swallow saliva residue (SR). This study aimed to clarify the relationship between swallowing pressure and SR in the valleculae and piriform sinuses on flexible endoscopic evaluation of swallowing (FEES).

Methods

Pharyngeal dysphagia patients with Wallenberg syndrome were included. Amounts of post‐swallow SR in the valleculae and piriform sinuses were classified into four grades using SR scores based on FEES. The Hyodo score was also calculated to evaluate swallowing function. High‐resolution manometric data in the nasopharyngeal, oropharyngeal, hypopharyngeal, oro‐hypopharyngeal, and UES zones on swallowing were obtained for comparison with SR and Hyodo scores.

Results

Of the 31 recruited, data from 26 patients who successfully underwent FEES and manometry were analyzed. Vallecular SR scores were strongly negatively correlated with a maximum pressure of the oropharynx (r = −0.52, p = 0.006), distal contractile integrals (DCI) of the oropharynx (r = −0.52, p = 0.007), and DCI of the oro‐hypopharynx (r = −0.55, p = 0.004). Hyodo scores for parameters 1 and 4 (corresponding to salivary pooling and pharyngeal clearance, respectively) were strongly negatively correlated with a maximum hypopharyngeal pressure (r = −0.57, p = 0.002) and strongly positively correlated with peristaltic velocity (r = 0.53, p = 0.007), respectively. SR scores and Hyodo scores related to SR were not correlated with pressure data of the UES.

Conclusion

Manometric analysis of our SR scoring method using FEES revealed that a higher amount of SR in the valleculae, but not in the piriform sinuses, is associated with weaker pharyngeal pressure in pharyngeal dysphagia, especially at the oropharyngeal level.

Level of Evidence

4 Laryngoscope, 134:3519–3526, 2024
Ultra‐Compact and Efficient Integrated Multichannel Mode Multiplexer in Silicon for Few‐Mode Fibers
Authors: Zhou Wu , Zhang Zunyue , Chen Hao , Tsang Hon Ki , Tong Yeyu
Published: February 2024

Space‐division multiplexing (SDM) is one of the key enabling technologies to increase the capacity of fiber communication systems. However, implementing SDM‐based systems using multimode fiber has been challenging with the need for compact, low‐cost, and scalable mode de/multiplexer (DE/MUX). Here a novel integrated mode MUX for few‐mode fibers (FMFs) is presented which can launch up to eight spatial and polarization channels. The new design is composed of a 2D multimode grating coupler (MMGC), highly compact spot size converters (SSCs), and adiabatic directional couplers (ADCs). Eight data lanes in FMFs can be selectively launched with integrated optical phase shifters. Experimental results reveal efficient chip‐to‐fiber coupling with peak efficiencies of −3.8, −5.5, −3.6, and −4.1 dB for LP01, LP11a, LP11b, and LP21bmodes, respectively. Thanks to the use of an integrated subwavelength Mikaelian lens for mode‐independent field size conversion with loss ≤−0.25 dB, the total footprint of the MMGC and SSCs is only 35×35 µm2. The proposed design shows great potential for densely integrated photonic circuits in future SDM applications.
An appropriate approach of design and machining of mechanical part by means of probabilistic multi‐objective optimization
Authors: Zheng M. , Yu J.
Published: February 2024

Appropriate design and machining of mechanical part are of great importance to guarantee the comprehensive quality of product. In this paper, a rational approach of design and machining of mechanical part with multiple objectives is formulated by combining the probability‐based method for multi‐objective optimization with sequential optimization. The probability‐based method for multi‐objective optimization is employed to transfer the problem of multiple objectives into a single objective one in the respect of probability theory, while the “sequential algorithm for optimization” is used to conduct successive deep optimization quantitatively. By performing the assessment of preferable probability of each scheme and the “sequential algorithm for optimization”, the optimal design of materials processing is thus completed rationally. Furthermore, the approach is used to deal with thermal design of spindle system for computerized numerical control grinder, optimal designs of large floor‐type milling and boring machine spindle box and bending performance of B‐pillar under condition of side impact as examples, respectively. The results indicate the rationality of the approach.
Dry‐Cleaning Chemicals and a Cluster of Parkinson's Disease and Cancer: A Retrospective Investigation
Authors: Dorsey E. Ray , Kinel Dan , Pawlik Meghan E. , Zafar Maryam , Lettenberger Samantha E. , Coffey Madeleine , Auinger Peggy , Hylton Kevin L. , Shaw Carol W. , Adams Jamie L. , Barbano Richard , Braun Melanie K. , Schwarz Heidi B. , Lawrence B. Paige , Kieburtz Karl , Tanner Caroline M. , de Miranda Briana R. , Goldman Samuel M.
Published: February 2024

Background

Environmental exposure to trichloroethylene (TCE), a carcinogenic dry‐cleaning chemical, may be linked to Parkinson's disease (PD).

Objective

The objective of this study was to determine whether PD and cancer were elevated among attorneys who worked near a contaminated site.

Methods

We surveyed and evaluated attorneys with possible exposure and assessed a comparison group.

Results

Seventy‐nine of 82 attorneys (96.3%; mean [SD] age: 69.5 [11.4] years; 89.9% men) completed at least one phase of the study. For comparison, 75 lawyers (64.9 [10.2] years; 65.3% men) underwent clinical evaluations. Four (5.1%) of them who worked near the polluted site reported PD, more than expected based on age and sex (1.7%; P = 0.01) but not significantly higher than the comparison group (n = 1 [1.3%]; P = 0.37). Fifteen (19.0%), compared to four in the comparison group (5.3%; P = 0.049), had a TCE‐related cancer.

Conclusions

In a retrospective study, diagnoses of PD and TCE‐related cancers appeared to be elevated among attorneys who worked next to a contaminated dry‐cleaning site. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Toxic stresses at community level highlight a public health need
Authors: Enos Gary
Published: February 2024

Having a background in both climate action and counseling psychology, Bob Doppelt could clearly make the connection between episodic or ongoing stressors in people's lives and adverse mental health outcomes. Establishing an international coalition devoted to strengthening community resilience, created in the aftermath of 2012's Superstorm Sandy, Doppelt recalls his assessment of populations' need at the time: “This is going to get far, far worse,” he thought.
Silver Hill opens outpatient ketamine program
Authors: Enos Gary
Published: February 2024

Leaders at Silver Hill Hospital in Connecticut expect their newly launched outpatient ketamine treatment program to be able to serve 20 to 30 patients a week at the outset and to become a desired referral destination for those seeking an alternative option for treatment‐resistant depression.
Now is the time to advance mental health, addiction reform
Authors: Kennedy Patrick J.
Published: February 2024

In the complex patchwork of American health care, the rise in mental health illness affects millions of lives. With over 50 million Americans grappling with diagnosable mental health conditions, the urgency to address it cannot be overstated. Shockingly, this equates to more than one in five Americans navigating the often‐challenging terrain of mental illness. Among these, young adults find themselves particularly vulnerable, bearing a disproportionate burden of these challenges. However, the statistics become even more sobering when considering minority populations — a staggering 36% of multiracial Americans face mental health hurdles, underscoring the critical need for equitable access to care across all demographics.
Effect of l‐Carnitine Supplementation on Osteoarthritis: A Systematic Review
Authors: Kou Haiyang , Li Bo , Wang Zhili , Ma Jianbing
Published: February 2024

Scope

Comprehensive assessment of l‐carnitine's safety and effectiveness in reducing inflammatory markers in osteoarthritis (OA) patients.

Methods and results

Journal articles on l‐carnitine for OA are gathered using computer searches of PubMed, Embase, the Cochrane Library, and Web of Science. The kind of literature that is found is restricted to clinical randomized controlled trials (RCTs). The Cochrane Handbook risk of bias assessment tool RevMan 5.4 software is used to conduct a meta‐analysis. The systematic assessment comprises eight trials totaling 619 patients; the included studies’ quality is mediocre. The study's findings demonstrate that OA patients’ Western Ontario and McMaster University (WOMAC) function improves and that treatment efficacy outperforms that of the control group (mean difference [MD] = −7.75, 95% CI [−14.63, −0.86]; Z = 2.21; p = 0.03), WOMAC total (MD = −10.24, 95% CI [−18.97, −1.51]; Z = 2.30; p = 0.02), and visual analogue scale (VAS) pain (MD = −14.01, 95% CI [−16.16, −11.85]; Z = 12.74; p < 0.00001). The studies that are methodically reviewed also discover heterogeneity, which may have resulted from the created pooled data and requires more analysis.

Conclusion

In patients with OA, l‐carnitine effectively decreases clinical signs and symptoms, inflammatory markers, pain, and stiffness indicators, and significantly improves WOMAC and VAS scores.
Neuromuscular ultrasound changes in unilateral symptomatic subacute lumbosacral radiculopathy: A prospective simple blinded cohort study
Authors: Cuendet David , Valsecchi Daniele , Najberg Hugo , Maestretti Gianluca , Medlin Friedrich
Published: February 2024

Introduction/Aims

Lumbosacral radiculopathy (LR) is a common disorder. Neuromuscular ultrasound (NMU) is a rapidly evolving technique for the investigation of peripheral nerve and muscle disorders, but studies using NMU in LR are lacking. The aim of the present study was to investigate ultrasonographic neuromuscular changes distant from root compression in patients with subacute to chronic compressive LR with motor impairment.

Methods

Patients with unilateral subacute to chronic L4, L5, or S1 radiculopathy with motor impairment and confirmed by magnetic resonance imaging were included. The sciatic and femoral nerve cross‐sectional areas (CSA), the CSA of lower limb muscles, and muscle fasciculation detection rate were assessed using a pre‐specified neuromuscular ultrasound evaluation with blinded side‐to‐side comparison.

Results

Of the 18 included patients, 66% were male and the mean age was 51 years. Overall, 16.7% had L4, 55.5% L5, and 27.8% S1 radiculopathy, mostly due to disc herniation (83%). Sciatic nerve CSA of the symptomatic side was increased (61.4 mm2 vs. 51.3 mm2; p = .001), and the fasciculation detection rate was higher in the affected muscles (delta = 13%, p = .007) compared to unaffected ones. Muscle CSA in affected and nonaffected muscles was decreased on the symptomatic side.

Discussion

NMU evaluation in patients with symptomatic subacute to chronic LR revealed sciatic nerve enlargement distant from nerve root compression and higher fasciculation rates. These structural findings on NMU might be due to an axonal repair mechanism and an inflammatory response with endoneurial edema induced by ongoing nerve damage and potentially reflect progressive axonal loss.
Design, synthesis, and characterization of molecularly imprinted solid phase extraction for alpha Mangostin analysis in blood sample
Authors: Rachmawati Winasih , Hasanah Aliya Nur , Muttaqin Fauzan Zein , Muchtaridi Muchtaridi
Published: February 2024

Low levels of α‐mangostin (AM) in biological fluids require adequate sample preparation to be analyzed. Molecularly imprinted polymers can serve as sorbents in solid phase extraction, enabling concentration and extraction of α‐mangostin from complex matrices, such as biological fluids. To date, there are no molecular imprinted polymers for the analysis of α‐mangostin in biological fluids. In this study, AM molecular imprinted polymer (MIP) was designed using molecular modeling, molecular dynamic simulations, and prepared by bulk polymerization and suspension polymerization methods. The geometry optimization results showed that acrylamide (AAM) monomer forms the most stable complex with AM at the pre‐polymerization with the most negative Gibbs free energy (ΔG) of −6.91818 Kcal/mol. Radial distribution function (RDF) in molecular dynamics simulation of AM:AAM:ethylene glycol dimethacrylate (EGDMA) with mol ratio 1:4:20 shows the complex with the best composition through the formation of four stable hydrogen bonds. Based on the experimental results, molecularly imprinted polymers in suspension exhibit better characteristics, selectivity, and adsorption capacity than in bulk. The suspension polymerization method showed a high recovery (85.88% ± 2.5), which was higher than C18 SPE cartridge (24.19% ± 1.47). Hence, it can be concluded that the MIPs from MD simulations were accessible and could be used in practice, such as in the separation and detection of AM in blood serum.
NiCoMo nanoparticles as an efficient electrocatalyst for methanol electro‐oxidation in alkaline media
Authors: Awad Somia , Al‐Dies Al‐Anood M. , Almahdawi Rihab , Al‐sheqefi F. U. Y. , Abdel‐Hady Esam E.
Published: February 2024

Using the electrospinning approach, various percentages of less expensive metal alloy‐decorated nanofiber catalysts have been successfully made as a substitute for platinum in direct methanol fuel cells (DMFC). This work focuses on the synthesis and characterization of catalysts with metal fixed ratio of 20% wt for DMFC applications, specifically Ni/CNFs, Co/CNFs, and NiCoMo/CNFs. The catalysts are characterized using various techniques, including x‐ray diffraction, scanning electron microscope, transmission electron microscopy, energy dispersive x‐ray, and electrochemical measurements. All the prepared samples, regardless of the metal concentration, had good nanofiber form and a distinct nanoparticle appearance, according to the scanning electron microscope (SEM). Chromatography, scan rate, response time, and cyclic voltammetry all were used to examine the samples' ability to perform methanol electrocatalysis. When Mo is added to Ni with Co, the electrooxidation reaction's activation energy and electrode stability both increase. With a starting potential of 0.22 V, the maximum current density in the NiCoMo/CNF sample was 99.8 mA/cm2 at 0.6 V. To electrooxidize methanol, our electrocatalysts combine diffusion control with kinetic‐limiting processes. This work has shown how to create an effective NiCoMo based methanol electrooxidation catalyst using a special technique.