bluuebunny/crossref_metadata_2025 huggingface dataset:
DEFINING DISEASE MODIFYING THERAPY FOR ALZHEIMER’S DISEASE
Authors: Cummings J. , Fox N.
Published: November 2021

Background: Disease-modifying therapies (DMTs) are urgently needed to treat the growing number of individuals with Alzheimer’s disease (AD) or at immanent risk for AD. A definition of DMT is required to facilitate the process of DMT drug development. Process: This is a review of the state of the science with regard to definition and development of DMTs. Results: A DMT is as an intervention that produces an enduring change in the clinical progression of AD by interfering in the underlying pathophysiological mechanisms of the disease process that lead to cell death. Demonstration of DMT efficacy is garnered through clinical trial designs and biomarkers. Evidence of disease modification in the drug development process is based on trial designs such as staggered start and delayed withdrawal showing an enduring effect on disease course or on combined clinical outcomes and correlated biomarker evidence of an effect on the underlying pathophysiological processes of the disease. Analytic approaches such as showing change in slope of cognitive decline, increasing drug-placebo difference over time, and delay of disease milestones are not conclusive by themselves but support the presence of a disease modifying effect. Neuroprotection is a related concept whose demonstration depends on substantiating disease modification. No single type of evidence in itself is sufficient to prove disease modification – consistency, robustness, and variety of sources of data will all contribute to convincing stakeholders that an agent is a DMT. Conclusion: DMT is defined by its enduring effect on processes leading to cell death. A variety of types of data can be used to support the hypothesis that disease modification has occurred.
Digital Health Technologies for Remote Monitoring and Management of Inflammatory Bowel Disease: A Systematic Review
Authors: Nguyen Nghia H. , Martinez Ivonne , Atreja Ashish , Sitapati Amy M. , Sandborn William J. , Ohno-Machado Lucila , Singh Siddharth
Published: November 2021

INTRODUCTION:

Digital health technologies may be useful tools in the management of chronic diseases. We performed a systematic review of digital health interventions in the management of patients with inflammatory bowel diseases (IBD) and evaluated its impact on (i) disease activity monitoring, (ii) treatment adherence, (iii) quality of life (QoL) measures, and/or (iv) health care utilization.

METHODS:

Through a systematic review of multiple databases through August 31, 2020, we identified randomized controlled trials in patients with IBD comparing digital health technologies vs standard of care (SoC) for clinical management and monitoring and reporting impact on IBD disease activity, treatment adherence, QoL, and/or health care utilization or cost-effectiveness. We performed critical qualitative synthesis of the evidence supporting digital health interventions in patients with IBD and rated certainty of evidence using Grading of Recommendations Assessment, Development and Evaluation.

RESULTS:

Overall, we included 14 randomized controlled trials (median, 98 patients; range 34—909 patients; follow-up <12 months) that compared web-based interventions, mobile applications, and different telemedicine platforms with SoC (clinic-based encounters). Although overall disease activity and risk of relapse were comparable between digital health technologies and SoC (very low certainty of evidence), digital health interventions were associated with lower rate of health care utilization and health care costs (low certainty of evidence). Digital health interventions did not significantly improve patients' QoL and treatment adherence compared with SoC (very low certainty of evidence). Trials may have intrinsic selection bias due to nature of digital interventions.

DISCUSSION:

Digital health technologies may be effective in decreasing health care utilization and costs, though may not offer advantage in reducing risk of relapse, QoL, and improving treatment adherence in patients with IBD. These techniques may offer value-based care for population health management.
A instituição da racionalidade neoliberal nas políticas educacionais brasileiras a partir dos princípios “continuar aprendendo” e “aprender a aprender”
Authors: Audrei Rodrigo da Conceição Pizolati
Published: November 2021

Considerando o contexto neoliberal no presente e suas implicações no campo da educação, objetiva-se examinar a gênese discursiva do princípio “aprender a aprender” que incide no “continuar aprendendo”, conforme apontam as políticas educacionais para o Ensino Médio. Para tanto, alicerçado teórica e metodologicamente nos estudos das Políticas Educacionais e de Currículo, procede-se à análise histórico-documental. A materialidade elegida concerne em marcos legais subsequentes à Lei de Diretrizes e Bases da Educação Nacional (LDBEN, 1996). Observa-se que a constituição do neossujeito aprendente, de modo flexível, responsabilizado e autônomo reside na promulgação da LDBEN e é referendado paulatinamente em políticas educacionais e curriculares que fundamentam a Base Nacional Comum Curricular - Ensino Médio. O sentido tomado pela educação brasileira na atualidade está em consonância com o que apregoa o mercado, no qual o intuito é internalizar e potencializar pressupostos como o empreendedorismo e o empresariamento de si. Assim, a racionalidade neoliberal tende a consolidar-se por intermédio da individuação e da autonomia flexibilizada do itinerário formativo pensado para o Ensino Médio. Fomenta-se, nesse processo, a instituição de neossujeitos aprendentes ao longo da vida.
Using dyadic observation to explore equitable learning opportunities in classroom instruction
Authors: Alyson L. Lavigne  , Thomas L. Good
Published: November 2021

Because of poverty, many children do not receive adequate prenatal care, nutrition, or early childhood education. These inequities combine to ensure that many students enter school with considerably less academic content knowledge and skills for learning than their peers. Teachers and schools did not create these gaps, but they must address them. The impact of schools in reducing gaps has been explored for decades only to yield inconsistent findings. One possible reason for these contradictory results is because these studies ignore classroom process. We argue for the inclusion of process in research on opportunity and achievement gaps to better articulate if schools provide inequitable learning opportunities. Further, we argue for dyadic (teacher to individual student) measurement of classroom process because commonly-used observation instruments only measure teachers’ interactions with the whole class. These instruments obscure differential teacher treatment that may exist in some classrooms. To improve policy and practice, we call for supplementing extant measures of teachers’ whole-class interactions (process) and student outcome (product) measures with those that measure dyadic interactions to learn how opportunities to learn in classrooms and schools are distributed among students to reduce, sustain, or enhance learning gaps.
Implicancias de la inclusión financiera y el empleo informal en la pobreza monetaria de los departamentos del Perú
Authors: Grados Smith Pedro
Published: November 2021

A pesar de un crecimiento sostenido del PBI del Perú en los últimos veinte años, la pobreza monetaria aún es el principal problema económico y social. Este fenómeno se extiende a dos factores importantes: la inclusión financiera y el empleo informal, que tienen implicancias en la sostenibilidad de los mecanismos impulsores del crecimiento económico para aliviar la pobreza. Utilizando el modelo econométrico de mínimos cuadrados generalizados factibles (FGLS) con efectos fijos (FEGLS), a fin de controlar los efectos heterogéneos entre los departamentos del Perú durante el periodo 2010-2019, este documento evalúa empíricamente el impacto de la inclusión financiera y el empleo informal en la pobreza monetaria. Los resultados empíricos muestran que la expansión de la inclusión financiera beneficiaría a la reducción de la pobreza monetaria, en tanto con respecto al empleo informal se revela que existe una relación negativa: se determina que su desarrollo está asociado con la reducción de la pobreza, pero no es determinante para su alivio.
Statistical and computational techniques for extraction of underlying systematic risk factors: a comparative study in the Mexican Stock Exchange
Authors: Rogelio  , Torra Porras Salvador , Monte Moreno Enric
Published: November 2021

This paper compares the dimension reduction or feature extraction techniques, e.g., Principal Component Analysis, Factor Analysis, Independent Component Analysis and Neural Networks Principal Component Analysis, which are used as techniques for extracting the underlying systematic risk factors driving the returns on equities of the Mexican Stock Exchange, under a statistical approach to the Arbitrage Pricing Theory. We carry out our research according to two different perspectives. First, we evaluate them from a theoretical and matrix scope, making a parallelism among their particular mixing and demixing processes, as well as the attributes of the factors extracted by each method. Secondly, we accomplish an empirical study in order to measure the level of accuracy in the reconstruction of the original variables.
Red blood cell distribution width-standard deviation but not red blood cell distribution width-coefficient of variation as a potential index for the diagnosis of iron-deficiency anemia in mid-pregnancy women
Authors: Kai Yang , Ying Pan , Bo Yan , Furong Yu , Jin Chen , Juanjuan Fu , Pingping Tian , Fasu Zhang
Published: November 2021

The aim of this study was to compare the diagnostic values of red blood cell distribution width-coefficient of variation (RDW-CV) and red blood cell distribution width-standard deviation (RDW-SD) in mid-pregnancy women with iron deficiency anemia (IDA). To obtain the results, 115 mid-pregnancy women with IDA, defined as the IDA group, and 142 healthy mid-pregnancy women, selected as the control group, were enrolled in this study. Hematological parameters and ferritin concentrations in the serum were analyzed. The efficiency of RDW-CV and RDW-SD to distinguish IDA from mid-pregnancy women was evaluated using receiver operating characteristic (ROC) curves. The RDW-SD value in the IDA group was significantly higher than that in the control group (p < 0.05), while the RDW-CV value did not differ between them (p = 0.84). Significantly negative correlations were found between RDW-CV (r = −0.297, p = 0.001), RDW-SD (r = −0.404, p = 0.000), and serum ferritin in the IDA group but not in the control group. For the diagnosis of IDA, RDW-CV and RDW-SD produced areas under the ROC curves of 0.58 and 0.84. To conclude, our results suggest that RDW-SD, but not RDW-CV, can be used as a diagnostic index of IDA for mid-pregnancy women.
The influence of MTHFR genetic polymorphisms on methotrexate therapy in pediatric acute lymphoblastic leukemia
Authors: Shen Yaqing , Wang Zhujun , Zhou Fen , Jin Runming
Published: November 2021

MTHFR is a crucial enzyme in folate metabolism. This study aimed to determine the relationship between MTHFR genetic polymorphism and elimination and toxicities of methotrexate (MTX). To do that, the study enrolled 145 patients diagnosed with acute lymphoblastic leukemia, who received chemotherapy following the Chinese Children’s Cancer Group Acute Lymphoblastic Leukemia (CCCG-ALL)-2015 protocol (clinical trial number: ChiCTR-IPR-14005706). We analyzed the effects of MTHFR C677T and A1298C polymorphisms on MTX elimination and toxicities. Patients with the MTHFR C677T TT genotype could tolerate a significantly higher MTX dose than those with the CC/CT genotype. However, patients with C677T TT genotypes had an increased risk of hypokalemia (1.369 to CC and 1.409 to CT types). The MTX infusion rate in patients with the MTHFR A1298C AC genotype was slightly lower than that in those with CC or AA genotypes. Patients with the A1298C AA genotype had a 1.405-fold higher risk of hepatotoxicity than those with the AC genotype (P > 0.05). There was no significant difference between the prevalence of other toxicities among MTHFR C677T or A1298C genotypes (P > 0.05). Neither MTHFR C677T nor A1298C polymorphisms were significantly associated with delayed MTX clearance. To conclude, MTHFR polymorphisms were not good predictors of MTX-related toxicities.
Supercapacitor electrodes based on modified titania nanotube arrays on flexible substrates
Authors: Thulasi Kunnambeth M. , Manikkoth Sindhu Thalappan , Paravannoor Anjali , Palantavida Shajesh , Vijayan Baiju Kizhakkekilikoodayil
Published: November 2021

Highly ordered titania nanotube arrays were synthesised on titanium metal foil through electrochemical anodisation. The annealed samples were characterised through scanning electron microscopy and X-ray diffraction analysis. The electrochemical characterisations of the arrays were done through cyclic voltammetry, galvanostatic charge discharge and electrochemical impedance spectroscopy analyses. The titania nanotube arrays exhibited a specific capacitance of 6.8 mF cm–2 at 5 mV s–1 scan rate, which is very much higher than that reported earlier. Pseudocapacitive metal oxides were deposited on these arrays forming composite supercapacitor electrodes and their supercapacitor properties were compared with same deposited on bare titanium foil substrates. Pseudocapacitive metal oxides deposited on these titania nanotube array substrates exhibited improved supercapacitor performance and stability over the same deposited on titanium foil substrates.
Structural properties of CoxCu1−xFe2O4 solid solution**
Authors: Mahmood Natheer B. , Saeed Farqad R. , Gbashi Kadhim R. , Hamodi Ali , Jaffar Zahraa M.
Published: November 2021

Crystallography information files (CIF) were designed formed CoxCu1−xFe2O4 solid solution with the substitution factor x=0 to 1 with an increment of 0.1 depending on Vegard's law by using crystallography software. The effect of the substitution factor has been studied on some parameters and properties of the Co-Cu ferrite system, such as the effect of substitution factor on the lattice parameter, the volume of unit cell, and the density of the unit cell. Also, XRD patterns were estimated by crystallography software depending on the mathematical models of XRD. The XRD results showed a slight shift in the peak position varying with the substitution factor, these are due to the change in lattice parameter caused by the substitution of ions with different ionic radii. XRD also showed an increment in peak intensity varying with the substitution factor, that's due to an increase in the concentration of Cu which led to an increase in the density of electrons.
Robust BOLD Responses to Faces But Not to Conditioned Threat: Challenging the Amygdala's Reputation in Human Fear and Extinction Learning
Authors: Visser Renée M. , Bathelt Joe , Scholte H. Steven , Kindt Merel
Published: November 2021

Most of our knowledge about human emotional memory comes from animal research. Based on this work, the amygdala is often labeled the brain's “fear center”, but it is unclear to what degree neural circuitries underlying fear and extinction learning are conserved across species. Neuroimaging studies in humans yield conflicting findings, with many studies failing to show amygdala activation in response to learned threat. Such null findings are often treated as resulting from MRI-specific problems related to measuring deep brain structures. Here we test this assumption in a mega-analysis of three studies on fear acquisition (n= 98; 68 female) and extinction learning (n= 79; 53 female). The conditioning procedure involved the presentation of two pictures of faces and two pictures of houses: one of each pair was followed by an electric shock [a conditioned stimulus (CS+)], the other one was never followed by a shock (CS–), and participants were instructed to learn these contingencies. Results revealed widespread responses to the CS+compared with the CS–in the fear network, including anterior insula, midcingulate cortex, thalamus, and bed nucleus of the stria terminalis, but not the amygdala, which actually responded stronger to the CS–. Results were independent of spatial smoothing, and of individual differences in trait anxiety and conditioned pupil responses. In contrast, robust amygdala activation distinguished faces from houses, refuting the idea that a poor signal could account for the absence of effects. Moving forward, we suggest that, apart from imaging larger samples at higher resolution, alternative statistical approaches may be used to identify cross-species similarities in fear and extinction learning.

SIGNIFICANCE STATEMENTThe science of emotional memory provides the foundation of numerous theories on psychopathology, including stress and anxiety disorders. This field relies heavily on animal research, which suggests a central role of the amygdala in fear learning and memory. However, this finding is not strongly corroborated by neuroimaging evidence in humans, and null findings are too easily explained away by methodological limitations inherent to imaging deep brain structures. In a large nonclinical sample, we find widespread BOLD activation in response to learned fear, but not in the amygdala. A poor signal could not account for the absence of effects. While these findings do not disprove the involvement of the amygdala in human fear learning, they challenge its typical portrayals and illustrate the complexities of translational science.
D2-Like Receptor Expression in the Hippocampus and Amygdala Informs Performance on the Stop-Signal Task in Parkinson's Disease
Authors: Mann Leah G. , Hay Kaitlyn R. , Song Alexander K. , Errington Steven P. , Trujillo Paula , Zald David H. , Yan Yan , Kang Hakmook , Logan Gordon D. , Claassen Daniel O.
Published: November 2021

The stop-signal task is a well-established assessment of response inhibition, and in humans, proficiency is linked to dorsal striatum D2receptor availability. Parkinson's disease (PD) is characterized by changes to efficiency of response inhibition. Here, we studied 17 PD patients (6 female and 11 male) using the stop-signal paradigm in a single-blindedd-amphetamine (dAMPH) study. Participants completed [18F]fallypride positron emission topography (PET) imaging in both placebo and dAMPH conditions. A voxel-wise analysis of the relationship between binding potential (BPND) and stop-signal reaction time (SSRT) revealed that faster SSRT is associated with greater D2-like BPNDin the amygdala and hippocampus (right clusterqFDR-corr= 0.026, left clusterqFDR-corr= 0.002). A region of interest (ROI) examination confirmed this association in both the amygdala (coefficient = −48.26,p= 0.005) and hippocampus (coefficient = −104.94,p= 0.007). As healthy dopaminergic systems in the dorsal striatum appear to regulate response inhibition, we interpret our findings in PD to indicate either nigrostriatal damage unmasking a mesolimbic contribution to response inhibition, or a compensatory adaptation from the limbic and mesial temporal dopamine systems. These novel results expand the conceptualization of action-control networks, whereby limbic and motor loops may be functionally connected.

SIGNIFICANCE STATEMENTWhile Parkinson's disease (PD) is characteristically recognized for its motor symptoms, some patients develop impulsive and compulsive behaviors (ICBs), manifested as repetitive and excessive participation in reward-driven activities, including sex, gambling, shopping, eating, and hobbyism. Such cognitive alterations compel a consideration of response inhibition in PD. To investigate inhibitory control and assess the brain regions that may participate, we assessed PD patients using a single-blindedd-amphetamine (dAMPH) study, with [18F]fallypride positron emission topography (PET) imaging, and stop-signal task performance. We find a negative relationship between D2-like binding in the mesial temporal region and top-signal reaction time (SSRT), with greater BPNDassociated with a faster SSRT. These discoveries indicate a novel role for mesolimbic dopamine in response inhibition, and advocate for limbic regulation of action control in this clinical population.
Input Zone-Selective Dysrhythmia in Motor Thalamus after Dopamine Depletion
Authors: Nakamura Kouichi C. , Sharott Andrew , Tanaka Takuma , Magill Peter J.
Published: November 2021

The cerebral cortex, basal ganglia and motor thalamus form circuits important for purposeful movement. In Parkinsonism, basal ganglia neurons often exhibit dysrhythmic activity during, and with respect to, the slow (∼1 Hz) and beta-band (15-30 Hz) oscillations that emerge in cortex in a brain state-dependent manner. There remains, however, a pressing need to elucidate the extent to which motor thalamus activity becomes similarly dysrhythmic after dopamine depletion relevant to Parkinsonism. To address this, we recorded single-neuron and ensemble outputs in the basal ganglia-recipient zone (BZ) and cerebellar-recipient zone (CZ) of motor thalamus in anesthetized male dopamine-intact rats and 6-OHDA-lesioned rats during two brain states, respectively defined by cortical slow-wave activity and activation. Two forms of thalamic input zone-selective dysrhythmia manifested after dopamine depletion: (1) BZ neurons, but not CZ neurons, exhibited abnormal phase-shifted firing with respect to cortical slow oscillations prevalent during slow-wave activity; and (2) BZ neurons, but not CZ neurons, inappropriately synchronized their firing and engaged with the exaggerated cortical beta oscillations arising in activated states. These dysrhythmias were not accompanied by the thalamic hypoactivity predicted by canonical firing rate-based models of circuit organization in Parkinsonism. Complementary recordings of neurons in substantia nigra pars reticulata suggested that their altered activity dynamics could underpin the BZ dysrhythmias. Finally, pharmacological perturbations demonstrated that ongoing activity in the motor thalamus bolsters exaggerated beta oscillations in motor cortex. We conclude that BZ neurons are selectively primed to mediate the detrimental influences of abnormal slow and beta-band rhythms on circuit information processing in Parkinsonism.

SIGNIFICANCE STATEMENTMotor thalamus neurons mediate the influences of basal ganglia and cerebellum on the cerebral cortex to govern movement. Chronic depletion of dopamine from the basal ganglia causes some symptoms of Parkinson's disease. Here, we elucidate how dopamine depletion alters the ways motor thalamus neurons engage with two distinct oscillations emerging in cortico-basal ganglia circuitsin vivo. We discovered that, after dopamine depletion, neurons in the thalamic zone receiving basal ganglia inputs are particularly prone to becoming dysrhythmic, changing the phases and/or synchronization (but not rate) of their action potential firing. This bolsters cortical dysrhythmia. Our results provide important new insights into how aberrant rhythmicity in select parts of motor thalamus could detrimentally affect neural circuit dynamics and behavior in Parkinsonism.
Principles-focused evaluation for agroecology
Authors: Patton Michael Quinn
Published: November 2021

This article offers a framework for evaluating agroecological principles, practices, and claims. Advocates of agroecology offer principles for sustainable, productive, and efficient agricultural systems. The evaluation question that immediately and inevitably arises in the face of such claims is: Does agroecology work? Thus do 2 fields of inquiry intersect: evaluation and agroecology. But there are many approaches to and models of evaluation. The challenge is to match the evaluation framework to the nature of agroecology. Because agroecology is based on principles, the appropriate evaluation approach is principles-focused evaluation. This article (1) elucidates principles-focused evaluation and demonstrates its relevance to evaluating agroecological practices and claims, (2) offers a principles-focused evaluation framework for monitoring agroecological transition and intensification within a particular context, and (3) concludes with lessons about principles-focused evaluation from agroecology.
The ‘Other’ physical transformations in 'The Adventures of Tintin' TV series
Authors: Tungary Octavia
Published: November 2021

Describing a race through the verbal and visual description of physical appearance is often used to create binary opposition between ‘Us’ and ‘Other’, so it does in The Adventures of Tintin comic books by Hergé. In The Adventures of Tintin TV series adaptation (1991-2) by Stéphane Bernasconi, ‘Other’s verbal and visual physical depictions that are portrayed in the comic books undergo transformations that occur on non-White characters. These transformations－changes, additions, and omissions－ can be clearly seen in the Tintin TV series entitled The Blue Lotus, Cigars of the Pharaoh, and The Broken Ear that are adapted from the comic books of the same titles. The theory of adaptation by Linda Hutcheon and Orientalism by Edward Said are used to reveal and explain the adapter’s strategies to make the skin colours, costume, and deformity moderation and negotiation in order that the TV series can be accepted by the audience around the world today.
Is There Any Relation between Serum Levels of Interleukin-10 and Neurophysiological Abnormalities in Bell’s Palsy?
Authors: Maghbooli Mehdi , Esmaeilzadeh Abdolreza , Karami Zarandi Fatemeh , Jafarzadeh Arezoo , Biglari Sajjad , Azizi Shalbaf Nazanin , Farhoudi Negar
Published: November 2021

Background: Bell’s palsy is the most common cause of peripheral facial palsy. The etiology and treatment of Bell’s palsy are still controversial. Previous studies emphasize the role of herpes simplex and herpes zoster viruses in this ailment. The role of Interleukin-10 (IL-10) in Bell’s palsy is yet unknown, and few studies have shed light on the matter. This study intended to assess the prognostic value of IL-10 and its relation to the intensity of electrodiagnostic abnormalities and evaluate its potential use as a factor for judging the need for medical or surgical interventions.Materials and Methods: 30 patients in the acute phase of Bell’s palsy participated in this study. Peripheral blood samples were obtained for IL-10 assessment within the first 72 hours (before commencing treatment), and a nerve conduction study (NCS) was performed six days after symptom onset.Results: There was no significant correlation between IL-10 serum levels and the severity of nerve conduction pathology in Orbicularis oculi and Orbicularis oris muscles. Also, IL-10 serum levels did not show any meaningful relationships with participants’ age, gender, or symptoms.Conclusion: The IL-10 serum levels are not relevant to the pathology of Bell’s palsy, and the assessment of IL-10 serum levels cannot be used as an alternative to NCS for evaluating the severity of acute Bell’s palsy.
Guide to Learning Disabilities for Primary Care
Authors: Silver Larry B. , Silver Dana L.
Published: November 2021

All-new clinical resource to help primary caregivers take a lead role in the diagnosis, evaluation, and management of children with learning disabilities. Developed by a leading child and adolescent psychiatrist and a noted pediatrician, this all-new clinical resource is purpose-built to help primary caregivers take a lead role in the diagnosis, evaluation, and management of children with learning disabilities. Turn here for:

Clear, concise overviews of the full range of learning disorders, Expert management recommendations and valuable clinical pearls, Clinical interventions and related psychiatric disorders. Contents: Part I: Learning and Related Disorders, Learning Disorders vs. Learning Disabilities,

Learning Disabilities, Diagnosing Learning Disabilities, Language Disabilities, Motor Disabilities, Confirming a Learning, Language or Motor Disability. Part II: The Related Disorders: The Secondary Emotional, Social, and Family Problems, The Related Neurologically-based Disorders, ragmatic Social Skill Disabilities. Part III: Clinical Interventions: The Public School System, The Public School: Laws and Policies, The Public School: Assessment and Interventions. Part IV: Clinical Interventions: The Related Psychiatric Disorders, Interventions for the Primary, Comorbid Disorders, Intervention for the Secondary Emotional, Social, and Family Problems. Part V: Resources, Organizations and Resources.
Preparticipation Physical Evaluation
Authors:   American Academy of Family Physicians,   American Academy of Pediatrics,   American College of Sports Medicine,   American Medical Society for Sports Medicine
Published: November 2021

Must-have resource guides health care professionals through the PPE process for young athletes from middle school through college. The explosive growth of children's athletics makes the preparticipation physical evaluation (PPE) an important part of many pediatric practices.
Pediatric Pulmonology
Authors: Pulmonology AAP Section on Pediatric
Published: November 2021

All new resource expertly guides you through the diagnosis, treatment, and ongoing management of virtually every pulmonary issue you're likely to encounter. This policy book from the American Academy of Pediatrics guides you through the diagnosis, treatment, and ongoing management of virtually every pulmonary issue you're likely to encounter. You'll turn here often for the latest AAP findings and recommenations; assessment and testing how-tos; proven therapeutic strategies; procedures, and techniques; home care and monitoring considerations; and much more. Powerful problem-solving features in each information-rich chapter include illustrative case reports, key point summaries; and definitions of pulmonary-specific terms. Nearly 300 finely detailed images complement the text. Content highlights: Foundation knowledge and know-how - anatomy and physiology; physical examination; pulmonary testing; imaging; bronchoscopy; Allergic conditions - acute bronchopulmonary aspergillosis; asthma; Anatomical disorders; congenital anomalies; chest wall and spinal deformities and much more.
Breastfeeding Telephone Triage and Advice
Authors: Bunik Maya
Published: November 2021

This telehealth care resource helps nurses, lactation professionals, and other medical staff confidently advise breastfeeding mothers. The volume introduces more than 60 practice-tested breadstfeeding protocols.
Breastfeeding Handbook for Physicians
Authors:   American Academy of Pediatrics,   American College of Obstetricians and Gynecologists
Published: November 2021

Breastfeeding Handbook for Physicians, 2nd Edition is an essential one-stop guide to the latest and best in breastfeeding management, support, education, and advocacy. Jointly developed by the American Academy of Pediatrics (AAP) and the American College of Obstetricians and Gynecologists (ACOG), with additional critical review by the American Academy of Family Physicians (AAFP), it features contributions from distinguished experts.
Pediatric Clinical Practice Guidelines & Policies
Authors:   American Academy of Pediatrics
Published: November 2021

This evidence-based decision-making tool for managing common pediatric conditions has been revised and updated for 2014, with clinical practice guidelines for more than 30 conditions, plus every AAP policy statement, clinical report, and technical report through December 2013.
Baby Care Anywhere
Authors: Spitalnick Ben , Seibert Keith
Published: November 2021

This portable pocket guide to baby basics fits in a diaper bag or stroller pocket, making it a great interactive resource for on-the-go moms and dads. Written by 2 pediatricians, Baby Care Anywhere addresses 150 of the most frequent questions and concerns raised by new parents.

It covers picking a pediatrician, pediatric checkups, jaundice, diaper rash, earaches, immunizations, sleep, reflux, fever, and much more!
Waking Up Dry
Authors: Bennett Howard J.
Published: November 2021

This completely revised comprehensive and authoritative self-help guide on bedwetting is written for parents, caregivers, and children (ages 6 to 13). Parents and children can address the challenge of bedwetting together with this delightful book that guides them through Dr. Bennett's Waking Up Dry Program. Includes instruction on behavior management techniques, calendars, contracts, and bedwetting alarms as well as practical tips and easy-to-follow activities. Available for purchase at https://shop.aap.org/waking-up-dry-a-guide-to-help-children-overcome-bedwetting-2nd-edition-paperback/
Coding for Pediatrics, 2016
Authors:   AAP Committee on Coding
Published: November 2021

Coding for Pediatrics is the signature publication in a comprehensive suite of coding products offered by the American Academy of Pediatrics (AAP). This AAP exclusive complements standard coding manuals with pediatric-specific documentation and billing solutions for pediatricians, nurse practitioners, administration staff, and pediatric coders.

The 21st edition has been fully updated and revised to include all changes to the 2016 Current Procedural Terminology (CPT®), complete with accompanying guidelines for their application. The numerous clinical vignettes and examples featured in the book, as well as the many coding pearls included throughout, have also been fully revised and revisited.

Coding for Pediatrics, 2016 continues to provide guidance on ICD-10-CM transition including coding tips highlighting key conventions and documentation elements to support specific and accurate ICD-10-CM code selection.

Other updates for this edition include

Detailed information on new and revised CPT® codes for 2016 including

Prolonged clinical staff time

Removal of impacted cerumen with irrigation or lavage

Revision of photo-screening services

New chapter on enhanced quality and pay for performance

Expanded coding resources including articles for the AAP Pediatric Coding Newsletter, coding fact sheets, sample appeal letter, denial tracking tool, and more

All clinical vignettes presented with corresponding ICD-10-CM codes. Some included with valuable quality measure.

Online access to many additional practice resources

Table of Contents

New and Revised CPT® Codes for 2016

Diagnosis Coding: ICD-10-CM

Modifiers and Coding Edits

Evaluation and Management Documentation (E/M) and Coding Guidelines: Incident-To, PATH Guidelines, and Scope of Practice Laws

Preventive Services

Evaluation and Management Services in the Office, Outpatient, Home, or Nursing Facility Setting

Perinatal Counseling and Care of the Neonate

Noncritical Hospital Evaluation and Management Services

Emergency Department Services

Critical Care and Intensive Care

Evolving Evaluation and Management for Nonphysician Services

Common Procedures and Non-E/M Medical Services

Coding for Quality and Performance Measures\

Preventing Fraud and Abuse: Compliance, Audits, and Paybacks

The Business of Medicine: From Clean Claims to Correct Payment and Emerging Payment Methodologies
Spanish for Pediatric Medicine, 3rd ed
Authors: Machtinger Edward L. , Nigrovic Peter A.
Published: November 2021

Spanish for Pediatric Medicine features a quick-reference design that enables the user to rapidly identify and explore common medical problems.

https://shop.aap.org/spanish-for-pediatric-medicine-3rd-edition-paperback/
NICU Journal: A Parent's Journey
Authors:   American Academy of Pediatrics
Published: November 2021

Fully revised and updated new edition!

Parents of babies in the NICU will become more informed partners in care with this essential resource. This fully revised and updated journal provides educational content and a way to monitor their baby's progress. The journal includes helpful information on common questions about the NICU, offers tips on coping, and provides helpful checklists to help parents stay organized and informed while in the NICU.
eCigarettes
Authors:   American Academy of Pediatrics
Published: November 2021

More data continues to emerge on teen use of eCigarettes that leads to smoking. Renowned AAP journal editors have created this new, first-in-series, Pediatric Collection with high-impact articles that address the public health trend among adolescents and young adults, and the unintended nicotine poisonings among younger children.

https://shop.aap.org/pediatric-collections-ecigarettes-paperback/
A Tailored Family-Based Obesity Intervention: A Randomized Trial
Authors: Taylor Rachael W. , Cox Adell , Knight Lee , Brown Deirdre A. , Meredith-Jones Kim , Haszard Jillian J. , Dawson Anna M. , Taylor Barry J. , Williams Sheila M.
Published: November 2021

OBJECTIVE

To determine whether a 2-year family-based intervention using frequent contact and limited expert involvement was effective in reducing excessive weight compared with usual care.

METHODS

Two hundred and six overweight and obese (BMI ≥85th percentile) children aged 4 to 8 years were randomized to usual care (UC) or tailored package (TP) sessions at university research rooms. UC families received personalized feedback and generalized advice regarding healthy lifestyles at baseline and 6 months. TP families attended a single multidisciplinary session to develop specific goals suitable for each family, then met with a mentor each month for 12 months, and every third month for another 12 months to discuss progress and provide support. Outcome measurements (anthropometry, questionnaires, dietary intake, accelerometry) were obtained at 0, 12, and 24 months.

RESULTS

BMI at 24 months was significantly lower in TP compared with UC children (difference, 95% confidence interval: −0.34, −0.65 to −0.02), as was BMI z score (−0.12, −0.20 to −0.04) and waist circumference (−1.5, −2.5 to −0.5 cm). TP children consumed more fruit and vegetables (P = .038) and fewer noncore foods (P = .020) than UC children, and fewer noncore foods were available in the home (P = .002). TP children were also more physically active (P = .035). No differences in parental feeding practices, parenting, quality of life, child sleep, or behavior were observed.

CONCLUSIONS

Frequent, low-dose support was effective for reducing excessive weight in predominantly mild to moderately overweight children over a 2-year period. Such initiatives could feasibly be incorporated into primary care.
Cost-Effectiveness of a Clinical Childhood Obesity Intervention
Authors: Sharifi Mona , Franz Calvin , Horan Christine M. , Giles Catherine M. , Long Michael W. , Ward Zachary J. , Resch Stephen C. , Marshall Richard , Gortmaker Steven L. , Taveras Elsie M.
Published: November 2021

OBJECTIVES

To estimate the cost-effectiveness and population impact of the national implementation of the Study of Technology to Accelerate Research (STAR) intervention for childhood obesity.

METHODS

In the STAR cluster-randomized trial, 6- to 12-year-old children with obesity seen at pediatric practices with electronic health record (EHR)-based decision support for primary care providers and self-guided behavior-change support for parents had significantly smaller increases in BMI than children who received usual care. We used a microsimulation model of a national implementation of STAR from 2015 to 2025 among all pediatric primary care providers in the United States with fully functional EHRs to estimate cost, impact on obesity prevalence, and cost-effectiveness.

RESULTS

The expected population reach of a 10-year national implementation is ∼2 million children, with intervention costs of $119 per child and $237 per BMI unit reduced. At 10 years, assuming maintenance of effect, the intervention is expected to avert 43 000 cases and 226 000 life-years with obesity at a net cost of $4085 per case and $774 per life-year with obesity averted. Limiting implementation to large practices and using higher estimates of EHR adoption improved both cost-effectiveness and reach, whereas decreasing the maintenance of the intervention’s effect worsened the former.

CONCLUSIONS

A childhood obesity intervention with electronic decision support for clinicians and self-guided behavior-change support for parents may be more cost-effective than previous clinical interventions. Effective and efficient interventions that target children with obesity are necessary and could work in synergy with population-level prevention strategies to accelerate progress in reducing obesity prevalence.
The Role of the Pediatrician in Primary Prevention of Obesity
Authors: Daniels Stephen R. , Hassink Sandra G.
Published: November 2021

The adoption of healthful lifestyles by individuals and families can result in a reduction in many chronic diseases and conditions of which obesity is the most prevalent. Obesity prevention, in addition to treatment, is an important public health priority. This clinical report describes the rationale for pediatricians to be an integral part of the obesity-prevention effort. In addition, the 2012 Institute of Medicine report “Accelerating Progress in Obesity Prevention” includes health care providers as a crucial component of successful weight control. Research on obesity prevention in the pediatric care setting as well as evidence-informed practical approaches and targets for prevention are reviewed. Pediatricians should use a longitudinal, developmentally appropriate life-course approach to help identify children early on the path to obesity and base prevention efforts on family dynamics and reduction in high-risk dietary and activity behaviors. They should promote a diet free of sugar-sweetened beverages, of fewer foods with high caloric density, and of increased intake of fruits and vegetables. It is also important to promote a lifestyle with reduced sedentary behavior and with 60 minutes of daily moderate to vigorous physical activity. This report also identifies important gaps in evidence that need to be filled by future research.
Obesogenic Behavior and Weight-Based Stigma in Popular Children’s Movies, 2012 to 2015
Authors: Howard Janna B. , Skinner Asheley Cockrell , Ravanbakht Sophie N. , Brown Jane D. , Perrin Andrew J. , Steiner Michael J. , Perrin Eliana M.
Published: November 2021

BACKGROUND

Obesity-promoting content and weight-stigmatizing messages are common in child-directed television programming and advertisements, and 1 study found similar trends in G- and PG-rated movies from 2006 to 2010. Our objective was to examine the prevalence of such content in more recent popular children’s movies.

METHODS

Raters examined 31 top-grossing G- and PG-rated movies released from 2012 to 2015. For each 10-minute segment (N = 302) and for movies as units, raters documented the presence of eating-, activity-, and weight-related content observed on-screen. To assess interrater reliability, 10 movies (32%) were coded by more than 1 rater.

RESULTS

The result of Cohen’s κ test of agreement among 3 raters was 0.65 for binary responses (good agreement). All 31 movies included obesity-promoting content; most common were unhealthy foods (87% of movies, 42% of segments), exaggerated portion sizes (71%, 29%), screen use (68%, 38%), and sugar-sweetened beverages (61%, 24%). Weight-based stigma, such as a verbal insult about body size or weight, was observed in 84% of movies and 30% of segments.

CONCLUSIONS

Children’s movies include much obesogenic and weight-stigmatizing content. These messages are not shown in isolated incidences; rather, they often appear on-screen multiple times throughout the entire movie. Future research should explore these trends over time, and their effects.
Prevalence of Obesity and Severe Obesity in US Children, 1999–2016
Authors: Skinner Asheley Cockrell , Ravanbakht Sophie N. , Skelton Joseph A. , Perrin Eliana M. , Armstrong Sarah C.
Published: November 2021

OBJECTIVES

To provide updated prevalence data on obesity trends among US children and adolescents aged 2 to 19 years from a nationally representative sample.

METHODS

We used the NHANES for years 1999 to 2016. Weight status was determined by using measured height and weight from the physical examination component of the NHANES to calculate age- and sex-specific BMI. We report the prevalence estimates of overweight and obesity (class I, class II, and class III) by 2-year NHANES cycles and compared cycles by using adjusted Wald tests and linear trends by using ordinary least squares regression.

RESULTS

White and Asian American children have significantly lower rates of obesity than African American children, Hispanic children, or children of other races. We report a positive linear trend for all definitions of overweight and obesity among children 2–19 years old, most prominently among adolescents. Children aged 2 to 5 years showed a sharp increase in obesity prevalence from 2015 to 2016 compared with the previous cycle.

CONCLUSIONS

Despite previous reports that obesity in children and adolescents has remained stable or decreased in recent years, we found no evidence of a decline in obesity prevalence at any age. In contrast, we report a significant increase in severe obesity among children aged 2 to 5 years since the 2013–2014 cycle, a trend that continued upward for many subgroups.
Stigma Experienced by Children and Adolescents With Obesity
Authors: Pont Stephen J. , Puhl Rebecca , Cook Stephen R. , Slusser Wendelin
Published: November 2021

The stigmatization of people with obesity is widespread and causes harm. Weight stigma is often propagated and tolerated in society because of beliefs that stigma and shame will motivate people to lose weight. However, rather than motivating positive change, this stigma contributes to behaviors such as binge eating, social isolation, avoidance of health care services, decreased physical activity, and increased weight gain, which worsen obesity and create additional barriers to healthy behavior change. Furthermore, experiences of weight stigma also dramatically impair quality of life, especially for youth. Health care professionals continue to seek effective strategies and resources to address the obesity epidemic; however, they also frequently exhibit weight bias and stigmatizing behaviors. This policy statement seeks to raise awareness regarding the prevalence and negative effects of weight stigma on pediatric patients and their families and provides 6 clinical practice and 4 advocacy recommendations regarding the role of pediatricians in addressing weight stigma. In summary, these recommendations include improving the clinical setting by modeling best practices for nonbiased behaviors and language; using empathetic and empowering counseling techniques, such as motivational interviewing, and addressing weight stigma and bullying in the clinic visit; advocating for inclusion of training and education about weight stigma in medical schools, residency programs, and continuing medical education programs; and empowering families to be advocates to address weight stigma in the home environment and school setting.
Raising an Organized Child
Authors: Korb Damon
Published: November 2021

Frustrated parents who are tired of chaos will find concrete, actionable guidance for raising an independent, self-assured, and organized child.

https://shop.aap.org/raising-an-organized-child-paperback/
Pediatric Clinical Practice Guidelines & Policies
Authors:   American Academy of Pediatrics
Published: November 2021

Clinical practice guidelines and policies from the American Academy of Pediatrics covering more than 50 clinical practice guidelines, plus every AAP policy statement, clinical report, and technical report through December 2018.
Caring for Our Children, National Health and Safety Performance Standards
Authors:   American Academy of Pediatrics
Published: November 2021

The fourth edition contains guidelines on the development and evaluation of the health and safety of children in early care and education settings. Available for purchase at https://shop.aap.org/caring-for-our-children-national-health-and-safety-performance-standards-4th-edition-paperback/
Raising Twins
Authors: Flais Shelly Vaziri
Published: November 2021

Pediatrician and twin-mom, Dr. Shelly Vaziri Flais, offers expert advice for raising healthy, well-adjusted twins and triplets in this fully revised and updated third edition. Available for purchase at https://shop.aap.org/raising-twins-paperback/