bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence of Depression and Anxiety in Adolescents With Hearing Loss
Authors: Cejas Ivette , Coto Jennifer , Sanchez Chrisanda , Holcomb Meredith , Lorenzo Nicole E. 
Published: December 2020

Objective:
To develop and implement a universal screening protocol for depression and anxiety in adolescents serviced in an otology and audiology practice and to estimate the prevalence of depression and anxiety in adolescents with hearing loss, while also comparing rates by degree of hearing loss and type of hearing device used.

Study Design:
Cross-sectional.

Setting:
University tertiary medical center.

Patients:
One hundred four adolescents 12- to 18-years-old who attended an otology clinic in a large metropolitan hospital in the southeastern United States.

Main Outcome Measure:
(s): Depression (PHQ-8), anxiety (GAD-7), degree of hearing loss, type of hearing loss, and type of hearing device utilized.

Results:
Twenty-five percent of adolescents scored above the clinical cutoff on at least one of the depression and/or anxiety measures, with 10% scoring in the elevated range on both measures. Specifically, 17% scored above the cutoff on the PHQ-8 and 16% scored in the clinically significant range for the GAD-7. An additional 30 and 21% scored in the at-risk range for depression and anxiety, respectively. Older adolescents were more likely to score within the elevated range for depression (r = 0.232, p = 0.026). Also, adolescents with severe to profound hearing loss had higher rates of depression and anxiety.

Conclusions:
Integration of mental health screening is needed in otology and audiology practices both to identify those who require psychological support and to provide appropriate treatment to reduce long-term impact of hearing loss on quality of life and mental health functioning in adolescents.
Current Trends and Predictors of Case Outcomes for Malpractice in Colonoscopy in the United States
Authors: Patel Krishan S. , Kothari Pooja , Gantz Owen , Prabhu Arpan , Ayyaswami Varun , Kono Janelle , Ahlawat Sushil 
Published: December 2020

Background:
Over 14 million colonoscopies are performed annually, and this procedure remains the largest contributor to malpractice claims against gastroenterologists. The aim of this study was to evaluate reasons for litigation and predictors of case outcomes.

Materials and Methods:
Cases related to colonoscopy were reviewed within the Westlaw legal database. Patient demographics, reasons for litigation, case payouts, and verdicts were assessed. Multivariate regression was used to determine predictors of defendant verdicts.

Results:
A total of 305 cases were included from years 1980 to 2017. Average patient age was 54.9 years (range, 4 to 93) and 52.8% of patients were female. Juries returned defendant and plaintiff verdicts in 51.8% and 25.2% of cases, respectively, and median payout was $995,000. Top reasons for litigation included delay in treatment (65.9%) and diagnosis (65.6%), procedural error (44.3%), and failure to refer (25.6%). Gastroenterologists were defendants in 71% of cases, followed by primary care (32.2%) and surgeons (14.8%). Cases citing informed consent predicted defendant verdict (odds ratio, 4.05; 95% confidence interval, 1.90-9.45) while medication error predicted plaintiff verdict (odds ratio, 0.18; 95% confidence interval, 0.04-0.59). Delay in diagnosis (P=0.060) and failure to refer (P=0.074) trended toward plaintiff verdict but did not reach significance. Most represented states were New York (21.0%), California (13.4%), Pennsylvania (13.1%), Massachusetts (12.5%).

Conclusions:
Malpractice related to colonoscopy remains a significant and has geographic variability. Errors related to sedation predicted plaintiff verdict and may represent a target to reduce litigation. Primary care physicians and surgeons were frequently cited codefendants, underscoring the significance of interdisciplinary care for colonoscopy.
Treatment Satisfaction With Current Medications for Chronic Constipation
Authors: Hayashi Toshihiro , Miwa Hiroto 
Published: December 2020

Goals:
This survey aims to determine relevant patient characteristics, treatment satisfaction, and bothersome symptoms in Japanese patients with chronic constipation (CC) treated at medical institutions.

Background:
Epidemiological surveys of Japanese patients with CC are limited.

Study:
This internet survey, conducted in 2017, included 500 adults (selected from 589 respondents to match age composition ratio in Japan) who experienced constipation-like symptoms for ≥6 months, were treated at medical institutions for symptoms, and were taking any prescribed medication.

Results:
Of 500 patients, 65.6% were female and 62.6% had experienced constipation for >10 years. Abdominal bloating, infrequent bowel movement, hard consistency of stool, and difficulty of defecation were the most frequently reported and most bothersome symptoms in males and females. Overall, 29% of patients were satisfied with treatment (36% of males, 26% of females); the individual major CC symptom with the highest level of treatment satisfaction was infrequent bowel movement (31% of total, 45% of males, 26% of females). The level of treatment satisfaction for most individual major CC symptoms was lower in females than in males, and overall treatment satisfaction by therapeutic categories ranged from 16% to 46%. Mean overall treatment satisfaction, as well as mean treatment satisfaction for each major symptom, decreased with increasing number of treatments.

Conclusions:
The survey results suggest that conventional treatment options were not effective enough to improve bothersome symptoms or treatment satisfaction. Treatment selection that is tailored to individual symptoms and takes patient characteristics into consideration may be key to improving patients’ treatment satisfaction.
Moderate‐to‐severe Endoscopic Inflammation is Frequent After Clinical Remission in Pediatric Ulcerative Colitis
Authors: Sarbagili‐Shabat Chen , Weiner Dror , Wardi Joram , Abramas Lee , Yaakov Michal , Levine Arie 
Published: December 2020

ABSTRACTObjectives:Pediatric ulcerative colitis (UC) is characterized by low sustained remission rates and frequent extension of disease even if clinical remission is obtained with therapy. Moderate‐to‐severe endoscopic activity is a risk factor for relapse while prospective evidence regarding early mucosal healing or persistence of inflammation after remission in children is not available. Our aim was to evaluate if significant inflammation is common after clinical remission and could explain the high relapse rate in pediatric UC.Methods:Pediatric UC patients with clinical remission, defined as pediatric UC activity index (PUCAI) scores <10, were prospectively assessed for mucosal healing by endoscopy 3 to 5 months after remission was documented. Mayo score was assessed for each segment by a blinded adult gastroenterologist using central reading. Symptomatic patients before sigmoidoscopy were excluded. Sustained remission was assessed retrospectively at 18 months follow‐up.Results:Forty‐two children were screened, 28 children in continuous clinical remission at time of sigmoidoscopy were included. Mayo 0 was present in 12/28 (42.86%), Mayo 1 in 2/28 (7.1%) and Mayo 2 to 3 in 14/28 (50.0%) endoscopies. Among 23 patients with follow‐up through 18 months, remission was sustained in 6/12 (50.0%) with Mayo score 0 to 1 versus 2/11 (18.18%) of patients with Mayo 2 and 3.Conclusions:Over 50% of children assessed for mucosal healing 3 to 5 months after clinical remission is obtained, have endoscopic disease, primarily moderate‐to‐severe Mayo 2 to 3 inflammation, which was associated with lower sustained remission.
Management of Gastrointestinal and Nutritional Problems in Children With Neurological Impairment
Authors: Romano Claudio , Dipasquale Valeria , Van Winckel Myriam , Hulst Jessie , Broekaert Ilse , Bronsky Jiri , Dall'Oglio Luigi , Mis Nataša Fidler , Hojsak Iva , Orel Rok , Papadopoulou Alexandra , Schaeppi Michela , Thapar Nikhil , Wilschanski Michael , Sullivan Peter , Gottrand Frédéric 
Published: December 2020

ABSTRACTObjectives:The main aim of this study was to determine the impact on clinical practice of the first European Society of Gastroenterology, Hepatology, and Nutrition (ESPGHAN) position paper on the diagnosis and management of nutritional and gastrointestinal problems in children with neurological impairment (NI).Methods:In this pilot‐study, a web‐based questionnaire was distributed between November, 2019 and June, 2020, amongst ESPGHAN members using the ESPGHAN newsletter. Fifteen questions covered the most relevant aspects on nutritional management and gastrointestinal issues of children with NI. A descriptive analysis of responses was performed.Results:A total of 150 health professionals from 23 countries responded to the survey. A considerable variation in clinical practice concerning many aspects of nutritional and gastrointestinal management of children with NI was observed. The most frequently used method for diagnosing oropharyngeal dysfunction was the direct observation of meals with or without the use of standardised scores (n = 103). Anthropometric measurements were the most commonly used tools for assessing nutritional status (n = 111). The best treatment for gastroesophageal reflux disease (GERD) was considered to be proton pump inhibitor therapy by most (n = 116) participants. Regarding tube feeding, nearly all respondents (n = 114) agreed that gastrostomy is the best enteral access to be used for long‐term enteral feeding. Fundoplication was indicated at the time of gastrostomy placement especially in case of uncontrolled GERD.Conclusions:More studies are required to address open questions on adequate management of children with NI. Identifying knowledge gaps paves the way for developing updated recommendations and improving patient care.
Actinomyces in Forensic Practice
Authors: Olds Kelly L. , Gilbert John D. , Byard Roger W. 
Published: December 2020

Abstract
A 19-year-old woman in septic shock with recent computed tomography findings of a loculated hepatic abscess was transferred to an intensive care unit where she went into asystolic cardiac arrest. After resuscitation, surgical exploration revealed a purulent pericardial effusion with tamponade and a liver abscess. Microbiological analyses from both sites were negative. Shortly after surgical exploration, she developed multiorgan failure and died. At autopsy, pus was observed both within the pericardial cavity and around the left lobe of the liver. Green “sulfur granules” suggestive of infection with Actinomyces spp. were able to be extruded from the liver during the postmortem examination and cultures returned positive for Actinomyces israelii. This case is a rare example of primary hepatic actinomycosis infection that resulted in the death of a young woman. Nonspecific clinical manifestations may delay diagnosis; however, the finding of “sulfur granules” in areas of abscess formation at autopsy should be taken as an indication of possible underlying Actinomyces infection.
Green Discoloration of Human Postmortem Brains
Authors: Ahrendsen Jared T. , Varma Hemant 
Published: December 2020

Abstract
A variety of gross discolorations of human postmortem brains is occasionally encountered and can have diagnostic implications. We describe 3 cases of green discoloration of the human brain observed on postmortem examination. Two patients who succumbed shortly after administration of methylene blue (MB) showed diffuse green discoloration that was detectable as early as 24 hours and was seen for at least 48 hours after MB administration. Green discoloration was largely in cortical and deep gray matter structures with relative sparing of the white matter. In contrast, a patient with severe hyperbilirubinemia who died after intracerebral hemorrhage showed localized bright green bile stained brain parenchyma in the areas surrounding the hemorrhage. We highlight the distinct patterns of discoloration in different causes of green brain discoloration, including MB, bile staining, and hydrogen sulfide poisoning. Recognition of these patterns by practicing pathologists can be used to differentiate between these etiologies and allow correct interpretation in both the medical and forensic autopsy settings.
A Novel Means-End Problem-Solving Assessment Tool for Early Intervention: Evaluation of Validity, Reliability, and Sensitivity
Authors: Cunha Andrea Baraldi , Babik Iryna , Koziol Natalie A. , Hsu Lin-Ya , Nord Jayden , Harbourne Regina T. , Westcott-McCoy Sarah , Dusing Stacey C. , Bovaird James A. , Lobo Michele A. 
Published: December 2020

Purpose:
To evaluate validity, reliability, and sensitivity of the novel Means-End Problem-Solving Assessment Tool (MEPSAT).

Methods:
Children with typical development and those with motor delay were assessed throughout the first 2 years of life using the MEPSAT. MEPSAT scores were validated against the cognitive and motor subscales of the Bayley Scales of Development. Intra- and interrater reliability, developmental trends, and differences among groups were evaluated.

Results:
Changes in MEPSAT scores positively related to changes in Bayley scores across time for both groups of children. Strong intra- and interrater reliability was observed for MEPSAT scoring across all children. The MEPSAT was sensitive to identify change across time and differences in problem-solving among children with varying levels of motor delay.

Conclusions:
The MEPSAT is supported by validity and reliability evidence and is a simple tool for screening early problem-solving delays and evaluating change across time in children with a range of developmental abilities. What this adds to the evidence: The novel MEPSAT is supported by validity and reliability evidence. It is sensitive to detect problem-solving differences among young children with varying motor ability and to capture changes in problem-solving across time. It requires minimal equipment and time to administer and score and, thus, is a promising tool for clinicians to screen for early problem-solving delays or to track intervention progress in young children with or at risk for problem-solving delays.
Improvements in Muscle Strength Are Associated With Improvements in Walking Capacity in Young Children With Cerebral Palsy: A Secondary Analysis
Authors: van Vulpen Liesbeth F. , de Groot Sonja , Rameckers Eugene A. A. , Becher Jules G. , Dallmeijer Annet J. 
Published: December 2020

Purpose:
To evaluate whether changes in lower-limb muscle strength explain changes in walking capacity during 14-week periods of usual care, power training and follow-up for children with spastic cerebral palsy.

Methods:
Secondary analysis of a previously conducted double-baseline controlled trial of 22 children with spastic cerebral palsy. Generalized estimating equations were used to evaluate the relationships between within-subject changes in isometric muscle strength and walking capacity over 3 periods.

Results:
Changes in hip abductor strength were associated with changes in the Muscle Power Sprint Test, changes in gastrocnemius and hip abductor strength were associated with changes in the Shuttle Run Test, and changes in gastrocnemius strength were associated with changes in the 1-minute walk test. All associations supported better walking capacity with increased strength.

Conclusion:
Walking capacity, especially sprint capacity, can be improved by increasing strength by functional power training in this population.
Using a 3D-Printed Prosthetic to Improve Participation in a Young Gymnast
Authors: Anderson Brittany , Schanandore James V. 
Published: December 2020

Background and Purpose:
The purpose of this case report was to investigate the application of a 3-dimensional (3D)-printed prosthetic hand to improve a child's participation, confidence, and satisfaction in gymnastic classes, specifically, horizontal bar-related skills.

Summary of Key Points:
A 9-year-old child was unable to participate in horizontal bar-related gymnastic skills due to a congenital hand deficiency. A prosthetic hand was designed, 3D printed, modified repeatedly, and incorporated into a program, which resulted in improvements in the child's ability to participate in gymnastics.

Conclusions:
Using a 3D-printed upper limb prosthetic hand improved the child's participation, confidence, and satisfaction in her gymnastic classes permitting use of horizontal bar. To progress to higher-intensity activities, further safety measures and testing of the prosthetic hand are needed.

What This Case Adds to Evidence-Based Practice:
A 3D-printed prosthetic hand was manufactured and customized allowing closely monitored, gradually increased, participation in horizontal bar gymnastics.
Virtual Reality Facilitates Engagement in Physical Therapy in the Pediatric CVICU
Authors: Hemphill Sydney , Nguyen Alan , Kwong Joann , Rodriguez Samuel T. , Wang Ellen , Caruso Thomas J. 
Published: December 2020

Purpose:
The purpose of this report is to demonstrate the successful application of virtual reality to improve physical therapy in the pediatric cardiovascular intensive care unit. Early mobilization and cognitive stimulation improve morbidity of critically ill children. However, maintaining child engagement with these therapies can be challenging, especially during extended intensive care stays.

Summary of Key Points:
While virtual reality has been successfully used as an analgesic and anxiolytic in the cardiovascular intensive care unit, this report demonstrates its novel use as a tool to augment physical therapy for a child who had been debilitated after heart transplantation. Virtual reality encouraged the child to engage in physical therapy sessions, participate for greater durations, and directly address barriers to discharge.

Conclusions and Recommendations for Clinical Practice:
While further studies are needed to define best practice, this report demonstrates that virtual reality can be safely used for carefully selected and monitored children in critical care.
Outcomes of an 8-Week Treadmill Training Program for a Toddler With Williams Syndrome: A Case Report
Authors: Conklin Ashley , Simonds Adrienne H. 
Published: December 2020

Purpose:
This case report highlights the functional and quality-of-life outcomes of an 8-week treadmill training program for an 18-month old child with Williams syndrome who is not walking.

Summary of Key Points:
The child had clinical improvements in gross motor function and quality of life as determined by the Gross Motor Function Measure and Pediatric Quality of Life Inventory after 8 weeks of treadmill training as an outpatient.

Statement of Conclusion and Recommendations for Clinical Practice:
Treadmill training is clinically feasible and effective for this child with Williams syndrome. Further research is necessary for generalizability. Treadmill training should be considered when developing a plan of care for children with Williams syndrome who are not walking or children with similar deficits.
Management of Acute and Traumatic Wounds With Negative-Pressure Wound Therapy With Instillation and Dwell Time
Authors: Diehm Yannick F. , Fischer Sebastian , Wirth Garrett A. , Haug Valentin , Orgill Dennis P. , Momeni Arash , Horch Raymund E. , Lehner Burkhard , Kneser Ulrich , Hirche Christoph 
Published: December 2020

Background:
A promising and useful development of negative-pressure wound therapy (NPWT) is the addition of instillation and dwell time of topical wound solutions (NPWTi-d). Uses of NPWTi-d include acute and traumatic wounds, whereby wound closure may be facilitated via wound cleansing and promotion of granulation tissue formation. This systematic review summarizes publications on NPWTi-d in the treatment of acute and traumatic wounds.

Methods:
A systematic review was performed analyzing articles from major clinical databases. Only clinical studies ≥10 patients reporting on the application of NPWTi-d in acute and traumatic wounds were included.

Results:
One hundred ninety-two articles were retrieved, of which 10 articles met inclusion criteria. Of those, 2 were lesser-quality randomized controlled trials, comparative studies or prospective cohorts, 2 were retrospective studies, and 6 retrospective cohort studies. In total, included publications reported 109 patients with acute and traumatic wounds treated with NPWTi-d. Data from these studies indicated the potential for reduction in bacterial bioburden through wound cleansing and promotion of granulation tissue formation, thereby facilitating wound closure, reduced length of therapy and hospital time. However, for most publications, different wound causes and subsequently no isolated results for acute and traumatic wounds were reported.

Conclusion:
NPWTi-d has promise to be effective in facilitating wound closure and reducing the time for wound closure. The present systematic review demonstrates a relatively low level of evidence available to objectively support this effect. To underline these positive results, large prospective, randomized controlled trials are necessary to manifest the role of NPWTi-d in the daily clinical routine for this wound category.
Challenges and Management in Wound Care
Authors: Teot Luc , Ohura Norihiko 
Published: December 2020

Summary:
Wounds have been one of the most prominent pathologies since the beginning of humanity. For the last 5 decades, a drastic improvement of healing has been observed, thanks to new medical devices based on fluid aspiration capacities and the development of negative pressure wound therapy. Negative-pressure wound therapy was initially designed for a double action, fluid aspiration and mechanical stimulation of wound edges by a foam. Successive technical evolutions of negative pressure wound therapy were declined since 1997 when Argenta and Morykwas first presented their solution. The adjunct of instillation in 2009 was considered as the first interactive dressing, allowing topical wound solutions to sequentially reach the wound, in alternance with negative pressure. Other devices based on the same principle were designed to prevent postoperative infections when placed over a suture after surgery. This long evolution could enhance the armamentarium of possible solutions, considerably reducing the wound healing time.
Helicobacter pylori and Upper Endoscopy in Systemic Sclerosis
Authors: Zullo Angelo , Bruzzese Vincenzo , Pellegrino Greta , Scolieri Palma , Stefanantoni Katia , Angelelli Carlotta , Riccieri Valeria 
Published: December 2020

Background/Aims
A role for Helicobacter pylori in triggering systemic sclerosis (SSc) has been proposed, but data are conflicting. In previous studies, infection has been generally searched for by using serology. We designed this study to assess H. pylori prevalence in SSc patients with histology of gastric mucosa, considered the criterion standard for infection diagnosis.

Methods
This cross-sectional study enrolled 30 SSc patients who complained of upper gastrointestinal symptoms. All underwent upper endoscopy with gastric biopsies. Endoscopic alterations were recorded, and gastric mucosa biopsies were used for both histological examination and searching for H. pylori. The role for proton-pump inhibitor (PPI) therapy was considered. Fisher exact test was used for statistical analysis.

Results
Data of 28 SSc patients were available, 14 with ongoing PPI therapy. Helicobacter pylori infection at histology was detected in 14.3% patients, and it equally occurred in patients with or without PPI therapy. Erosive esophagitis/Barrett esophagus was detected in 26.6% of cases. Among patients with PPI therapy, 30% received half dose only. The prevalence of intestinal metaplasia was low (14.3%). Endoscopic esophageal alterations were significantly more frequent in those patients showing anti-Scl70 antibody positivity.

Conclusions
This study showed that prevalence of H. pylori is very low in SSc patients, so that it seems not having a role in triggering SSc. Management of gastroesophageal diseases in SSc patients needs to be improved, and looking to the autoimmune profile may be of help. Thus, collaboration between rheumatologist and gastroenterologist is highly recommended.