bluuebunny/crossref_metadata_2025_split huggingface dataset:
0925 Associations Between Co-sleeping And Sleep Quality Of Urban Preschool Children
Authors: Stein M , DiSanti N , Weaver-Rogers S , Garcia W , Bonilla-Santiago G , Daniel L C 
Published: May 2020

Abstract

Introduction
Perspectives on co-sleeping vary by family cultural background and socio-demographic characteristics; furthermore, families may choose to co-sleep based on family values or out of necessity. To better understand the role of co-sleeping in young children from ethnic minority backgrounds, the current study sought to test the relationship between co-sleeping and sleep outcomes in an urban early childhood setting.

Methods
141 Parent-child dyads with children aged 1-5 years old (N=141,50.4% female, M=4.01 [SD=1.05]; 41% African American; 41% Latinx; median income $20-30,000) were recruited through an urban preschool. Parents completed demographic information and the Brief Child Sleep Questionnaire, which yielded insomnia and sleep hygiene indices. Step-wise regressions were used to examine the relationship between sleeping location and sleep outcomes (insomnia, sleep health, and child sleep quality), controlling for child age.

Results
Approximately half of the sample (n=71) reported that their child sleeps in a space shared by caregivers or siblings. Co-sleeping did not differ by race/ethnicity [χ 2(3)=1.45, p=.694], child age [F(1, 140)=2.15, p=.145], or income [χ 2(5)=7.05, p=.217]. Controlling for age, insomnia was higher in co-sleeping children [F(2,140)=4.10, p=.019], although sleep location was not a significant independent predictor. Sleep hygiene [F(2,140)=2.39, p=.095] and sleep quality [F(2,139)=0.94, p=.394] did not differ by sleeping location, when controlling for age.

Conclusion
Co-sleeping was common but was not related to sociodemographic factors as described in prior research. Controlling for age, co-sleeping predicted higher insomnia scores suggesting that co-sleeping may be related to symptoms of behavioral insomnia. Sleep hygiene practices and sleep quality did not differ by sleeping location, suggesting that in children without behavioral insomnia symptoms, co-sleeping may not affect sleep. Future studies that seek to better understand caregiver preference and intentions regarding co-sleeping may be important to intervention development seeking to improve behavioral insomnia in ethnic/minority samples.

Support
0929 Caregiver-Reported Versus Clinician-Documented Child Sleep Problems and Sleep-Related Health Behaviors in Primary Care
Authors: Williamson A A , Bhandari E , Cicalese O , Heaps E , Ostan A , Collins M , Lupini F , Mindell J A 
Published: May 2020

Abstract

Introduction
Sleep problems are highly prevalent in early childhood but often under-identified in pediatric primary care. This study identified the prevalence of caregiver-reported versus primary care provider (PCP)-documented sleep problems and sleep-related health behaviors in young children presenting to well child visits (WCVs).

Methods
Caregivers (85.4% mothers) of 198 young children (2-5 years, M = 3.3, 53.7% female, 62.9% Black) presenting to urban (74.1%) and suburban (25.9%) primary care sites for well child visits (WCVs) completed research surveys on child behavioral sleep problems, snoring, and sleep-related health behaviors (e.g., caffeine consumption) on the day of their child’s WCV. Electronic medical record review was used to identify the rate of PCP-documented sleep problems and related recommendations in the WCV progress note.

Results
Fifteen percent of caregivers reported a child sleep problem according to questionnaire data, which did not significantly differ from the 12.0% of children with a PCP-documented sleep problem in the WCV progress note (p = .31). However, significantly more caregivers (28.3%) reported bedtime difficulties (resistance; tantrums) on questionnaires (p &lt;.001), which were not captured in the 12.0% of WCVs noting sleep problems. A total of 8% of WCVs included child sleep recommendations. Child snoring was reported by 17.0% of caregivers, but was less frequently documented in WCVs (4.5%, p &lt;.001). Although many caregivers reported poor child sleep-related health behaviors, including daily child caffeine consumption (21.1%) and bedroom electronics (62.9%), significantly fewer PCPs documented these issues (caffeine: 2.0%; electronics: 6.6%) or related recommendations (decrease caffeine: 1.0%; eliminate electronics: 3.5%) in the progress note (all p-values &lt;.001).

Conclusion
Although caregiver-endorsed child sleep problems on surveys did not differ from PCP-documented concerns, there are gaps in documenting other problematic sleep-related health behaviors, such as caffeine consumption and electronics use. More resources to address sleep-related health behaviors, as well as sleep problems, in pediatric primary care are needed.

Support
Sleep Research Society Foundation and K23HD094905 (AAW)
0942 Alternating Leg Muscle Activation and Hypnagogic Foot Tremor in Children: Comparative Study of Polysomnographic and Clinico-Demographic Variables
Authors: de Menezes G M , Almeida L A , Sander H H , Fernandes R M , Éckeli Á L 
Published: May 2020

Abstract

Introduction
The clinical and polysomnographic meaning of the Alternating Leg Muscle Activation (ALMA) and Hypnagogic Foot Tremor (HFT) patterns in children is not known.

Methods
A descriptive study was carried out to identify the prevalence and polysomnographic characteristics of ALMA and HFT sequences in a sample of 122 children sequentially admitted in the sleep laboratory, with the analysis of clinical and demographic characteristics of the ALMA/HFT group in relation to a comparison group without this condition, paired by age and gender.

Results
Sample prevalence was 14.8% for any HFT/ALMA event, 13.1% for ALMA and 10.7% for HFT. In the HFT/ALMA group, the mean age was 8 years old (2-12 years old), 66.7% of males. Obstructive Sleep Apnea was observed in 75% of children, but HFT / ALMA sequences only occasionally occurred in association with respiratory events. The use of medications with monoaminergic activity was associated with the occurrence of HFT/ALMA, p=0,019. There was higher N1 sleep content in the HFT / ALMA group, p=0,0301. There was no significant difference between both groups regarding the other clinical-demographic or polysomnographic parameters analyzed. Autonomic activation represented by heart rate fluctuations often occurred in association with the HFT / ALMA sequences, irrespective of the occurrence of arousals, awakenings, other motor or respiratory events.

Conclusion
HFT / ALMA is a frequent condition in children that are referred to the sleep lab.The stereotypy of the HFT / ALMA series suggests that their origin might be motor central pattern generators, which are potentially influenced by substances with monoaminergic effect. The finding of higher superficial sleep content in children with HFT / ALMA may indicate greater susceptibility to alteration of pediatric sleep architecture by such subtle motor events. The possibility of clinical consequences and cardiovascular diseases should be considered in relation to the association of HFT / ALMA with observed autonomic activation.

Support
None.
0957 The Association Between Sleep and Sustained Attention Differs in Children vs. Adolescents With ADHD
Authors: Gagnon K , Theoret R , Rudd E , Lepage C , Chirica A , Godbout R 
Published: May 2020

Abstract

Introduction
Sleep disturbance in children with attention-deficit/hyperactivity disorder (ADHD) is frequent, and lead to shorter sleep duration which has been associated with lower performance on sustained attention tasks. However, no study has investigated this association in adolescents with ADHD. We sought to explore whether the association between sleep and sustained attention performance of children with ADHD is similar in adolescents with ADHD given that sleep patterns are different.

Methods
Parents of 32 children (mean age = 8.0; SD = 1.3) and 10 adolescents (mean = 15.2; SD = 1.3) with ADHD completed a developmental questionnaire including sleep questions. Children and adolescents were medication free and underwent a comprehensive neuropsychological evaluation. Three sleep variables were extracted from the questionnaire, namely the duration of the sleep period during week nights and weekends as well as the difference between the two (“weekend shift”). The Continuous Performance Test was used to measure sustained attention (omission, commission, hit reaction time). Pearson correlations between sleep variables and sustained attention measures were calculated.

Results
Children showed a positive correlation between hit reaction time and the duration of the sleep period during week nights (r = 0.37; p =0.04), weekends (r = 0.51; p = 0.004) and the weekend shift (r = 0.37; p =0.04). No significant correlations were found in the adolescent group.

Conclusion
The fact that no significant associations were found in the adolescent group suggest an improvement of the arousal system through brain development in ADHD, or that other mechanisms could be involved in the etiology of ADHD in adolescents.

Support
Centre d’apprentissage aux 1001 astuces; Fonds de recherche du Québec - Santé
0969 Early Life Sleep Disturbance Among Children With Autism Spectrum Disorders: A Questionnaire-based Retrospective Study
Authors: Gupta A , Shukla G , Poornima S , Mohd A , Katoch J , Taneja D , Singhal N 
Published: May 2020

Abstract

Introduction
Autism spectrum disorders(ASD) and sleep has hand to hand relationship and few recently published studies have shown that, disturbed infant sleep is associated with Attention deficit hyperactive disorder and Autism. The aim of the study is to evaluate the sleep disturbance in first year of life among the children with ASD.

Methods
In this case control study, pre-diagnosed ASD children between 3-12 year of age (group 1) and controls; sibling of autistic children and community dwelling children(group 2), were enrolled in between June 2014 to November 2017. After giving consent every child underwent, Detailed Clinical [Childhood Autism rating scale-2(CARS-2)] and Sleep evaluation [Brief Infant sleep Questionnaire (BISQ) - Retrospectively, Child sleep habits questionnaire (CSHQ)].

Results
Sixty children in group1 and 60 in group 2 were enrolled and both groups were age [Median 7(2.5-12) vs. 8.5 (2.5-12), p = 0.14] and sex [53(88.33%) vs. 45(75.00 %), p=0.15] matched. On CHSQ poor sleepers are more common among the group 1[40(66.66%) vs. 20(33.33%), p=.003, respectively]. On BISQ children had severe sleep problems during infancy were significantly more among the group 1 [46(76.66%) vs. 6(10%), p=&lt;.001, respectively]. Duration of nocturnal awakening was significantly correlated (r=0.87, p=.001) with the T score of the CARS-2.

Conclusion
Sleep is significantly disturbed since infancy among children with autism spectrum disorder and duration of nocturnal awakenings during infancy is strongly correlated with severity of autism.

Support
NA
0982 Content Analysis Of The Features And Claims Of Smartphone Applications For Children’s Sleep
Authors: Talker I , Kaar J L , Simon S L 
Published: May 2020

Abstract

Introduction
Empirically supported treatments for pediatric sleep problems exist but many families turn to other sources for help with their child’s sleep, such as smartphone applications (apps). Sleep apps are easy for families to access but little evidence exists regarding the validity of the services and information provided. The goal of this study was to examine the features and claims of sleep apps for children.

Methods
A search of the Apple iTunes store and Google Play Store was conducted using the terms “kids sleep” and “baby sleep”. 635 apps were initially identified. Apps were excluded if they were not specifically for children (n=163), not for sleep (n=152), or if they had &lt;100,000 downloads (n=246). Content analyses were used to assess the apps functions, claims, and evidence base.

Results
A total of 74 apps were examined of which only 4% offered sleep improvement strategies. The majority were sound and light apps (77%) and 19% were bedtime games/stories. The apps were highly rated (average 4.4 out of 5) and most were free (54%); the price of paid apps ranged from $0.99 to $119.99 (annual subscription). Only 2 apps were identified as containing empirical evidence, and all of the apps featuring games and stories to be used as part of the bedtime routine are in opposition to the recommendation to avoid the melatonin-suppressing effect of electronics/bright light before bedtime. Despite this, many apps boasted claims that they will help children “fall asleep instantly,” “cry less and sleep better,” or improve child development.

Conclusion
A large variety of sleep applications exist aimed for use with children. Many boast claims that cannot be supported by empirical evidence, and indeed may be in opposition to research support. Collaboration between sleep researchers and technology developers may be beneficial for the creation of evidence-supported apps to help with children’s sleep.

Support
N/A
Machine learning-based prediction of activity and substrate specificity for OleA enzymes in the thiolase superfamily
Authors: Robinson Serina L , Smith Megan D , Richman Jack E , Aukema Kelly G , Wackett Lawrence P 
Published: May 2020

Abstract
Enzymes in the thiolase superfamily catalyze carbon–carbon bond formation for the biosynthesis of polyhydroxyalkanoate storage molecules, membrane lipids and bioactive secondary metabolites. Natural and engineered thiolases have applications in synthetic biology for the production of high-value compounds, including personal care products and therapeutics. A fundamental understanding of thiolase substrate specificity is lacking, particularly within the OleA protein family. The ability to predict substrates from sequence would advance (meta)genome mining efforts to identify active thiolases for the production of desired metabolites. To gain a deeper understanding of substrate scope within the OleA family, we measured the activity of 73 diverse bacterial thiolases with a library of 15 p-nitrophenyl ester substrates to build a training set of 1095 unique enzyme–substrate pairs. We then used machine learning to predict thiolase substrate specificity from physicochemical and structural features. The area under the receiver operating characteristic curve was 0.89 for random forest classification of enzyme activity, and our regression model had a test set root mean square error of 0.22 (R2 = 0.75) to quantitatively predict enzyme activity levels. Substrate aromaticity, oxygen content and molecular connectivity were the strongest predictors of enzyme–substrate pairing. Key amino acid residues A173, I284, V287, T292 and I316 in the Xanthomonas campestris OleA crystal structure lining the substrate binding pockets were important for thiolase substrate specificity and are attractive targets for future protein engineering studies. The predictive framework described here is generalizable and demonstrates how machine learning can be used to quantitatively understand and predict enzyme substrate specificity.
Productivity Loss Among Parents of Children With Inflammatory Bowel Diseases in Relation to Disease Activity and Patient's Quality of Life
Authors: Stawowczyk Ewa , Kawalec Paweł , Kowalska‐Duplaga Kinga , Mossakowska Małgorzata 
Published: May 2020

ABSTRACTObjectives:To assess the productivity losses among the parents of children with inflammatory bowel diseases (IBDs) in Poland and their relationship with disease activity and the patient's quality of life.Methods:A questionnaire‐based self‐reported Internet survey was conducted among the parents of patients (0‐‐17 years old) with a diagnosis of ulcerative colitis (UC) or Crohn disease (CD). Data on indirect and direct costs, general patient characteristics, disease activity, pharmacological treatment, and children's quality of life measured with the Pediatric Quality of Life Inventory (PedsQL) were collected.Results:A total of 113 completed questionnaires were obtained. Remission was reported in 58.6% of cases. Severe disease was more common in patients with UC (7.3% vs 2.9%). The mean reduction in parents’ daily activities was 40% (range: 0%–100%). The mean (SD) reduction of parents’ work productivity because of absenteeism was 21% (0.27), and the mean cost was €902.77 (1136.90) per year per parent. The mean (SD) productivity loss at paid work of a working parent (presenteeism) was 35% (0.31) and the mean (SD) cost was €1125.13 (1121.16) per year per parent. The PedsQL score was significantly higher among patients with inactive than with active disease.Conclusions:A significant difference between patients with inactive and active disease was observed for the total reduction of parent's work productivity and the PedsQL score. A negative correlation was observed for indirect costs and the PedsQL score for the whole study population; better health‐related quality of life among patients in remission was revealed.
Targeted Rhythmic Auditory Cueing During Treadmill and Overground Gait for Individuals With Parkinson Disease: A Case Series
Authors: Sherron Margaret A. , Stevenson Sarah A. , Browner Nina M. , Lewek Michael D. 
Published: May 2020

Background and Purpose:
Rhythmic auditory cueing and treadmill walking can improve spatiotemporal gait parameters through entrainment of movement patterns. Careful selection of cue frequencies is necessary if treadmill walking is to be employed, because cadence and step length are differentially affected by walking on a treadmill and overground. The purpose of this study was to describe the treatment of gait impairments for individuals with Parkinson disease, using strategically selected rhythmic auditory cue frequencies on both a treadmill and overground.

Case Description:
Three individuals with Hoehn & Yahr stage 2 Parkinson disease participated in this case series.

Intervention:
All participants completed 6 weeks of gait training, in which each session employed rhythmic auditory cueing during treadmill-based gait training followed by overground gait training. We provided targeted rhythmic auditory cueing with a metronome set to 85% and 115% of their self-selected cadence for treadmill and overground training, respectively. We performed clinical tests of gait and balance prior to, midway, and following training, and at a 3-month follow-up.

Outcomes:
All participants improved overground gait speed (participant 1: +0.27 m/s; participant 2: +0.20 m/s; and participant 3: +0.18 m/s) and stride length (15.7 ± 4.17 cm) with small changes to cadence. Likewise, there were only small changes in balance.

Discussion:
We hypothesize that the large improvements in gait speed are due to the concomitant increases in stride length. Further research is needed to test the effect of targeted rhythmic auditory cueing during treadmill and overground gait.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A309).
A Quality Improvement Project to Improve Documentation and Awareness of Limitations of Life-Sustaining Therapies
Authors: Jones Amy H. , Heneghan Julia A. , Brooks Bonnie , Maamari Mia , Ahmad Ali , October Tessie W. , Corriveau Christiane 
Published: May 2020

Purpose:
Poor documentation and understanding of the limitations of life-sustaining therapies upon admission to the pediatric intensive care unit (PICU) can result in moral distress for both providers and families. Limitations of life-sustaining treatments are often not documented and/or understood by members of the health care team.

Methods:
We performed a quality improvement initiative to improve the care teams’ understanding and paper documentation of the limitations of life-sustaining therapies in the PICU of a quaternary children’s hospital from January 2018 to March 2019. We implemented a series of plan-do-study-act cycles, including initiation of an updated rounding tool that included limitations of interventions, in-person and electronic information sessions, and implementation of a visual bedside tool to remind providers when limitations were present. Pre- and postintervention surveys were administered.

Results:
Nursing paper documentation of limitations of life-sustaining therapies increased sequentially from 0% to 88% during plan-do-study-act cycles. Creating a specific area to document limitations on the nursing sheet resulted in the most significant increase in documentation (36.6 points). Nurses reported that they “always” document limitations, which increased from 10% to 38%. The percentage of nurses who understood patients’ intervention limitations increased from 28% to 33%.

Conclusions:
Limitations of life-sustaining therapies in the PICU are nuanced and involve multiple stakeholders. Nursing education and designation of a section of intervention limitations in nursing daily goal paper documentation can increase comfort with therapeutic limitations in the PICU. Future studies should explore impacts on patient care and serve as a framework for the ultimate goal of improving documentation of care limitations and code status in the electronic medical record.
Consequences of Trocar Dynamics on Mental Nerve in Transoral Thyroidectomy
Authors: Zhang Daqi , Li Shijie , Dionigi Gianlorenzo , Wang Tie , Zhang Jiao , Xue Gaofeng , Sun Hui 
Published: May 2020

Background:
Mental nerve (MN) injuries are reported during transoral endoscopic thyroidectomy vestibular approach. Effect of trocar insertion and position on MN are examined in the present study.

Materials and Methods:
Ten millimeter incision was made at the center of the lower lip oral vestibule. Two 5 mm lateral incisions of the lower lip oral vestibule were made at the junction between the incisor and the canine. These 2 lateral incisions were high, just below the edge of lower lip. Nine pigs (18 MN) were randomly divided into 3 groups and MN dissection was performed. The angle between the lateral ports and median line were changed between 15 and 45 degrees among 3 groups and effect on MN was examined.

Results:
During dissection when insertion and other ports are in neutral position visual inspection of MNs did not reveal any compression bilaterally. The distance between MN and the ports was 18.2±2.1 mm (16.3 to 21.2 mm). In group I and group II, MNs have no compression by the lateral trocars. In group III (45 degrees), left MNs were all compressed. Two MNs (66.7%) were compressed on the right side. The MN was compressed at its ramification.

Conclusions:
The results of the present experimental study, endorse the suggested medial and lateral vestibular incisions for transoral endoscopic thyroidectomy vestibular approach. However, during dynamic modification of the lateral port position/angle, MN compression was observed when the angle was >45 degrees.