bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Frequency of Aichivirus in Children With Acute Gastroenteritis in Iran
Authors: Taghinejad Mohammad , Ghaderi Mostafa , Mousavi-Nasab Seyed Dawood 
Published: February 2020

Background:
Initially, detection and isolation of Aichivirus as a new member of Picornaviridae family was documented in Japan. Aichivirus species belongs to genus Kobuvirus, including 3 genotypes A, B and C. In previous studies, it has been suggested that Aichivirus infect humans by fecal-oral route. To establish an investigation for the occurrence of Aichivirus among pediatric patients involved to acute gastroenteritis, we developed a reverse transcription quantitative polymerase chain reaction assay for detection and quantification of Aichivirus in stool specimens.

Material and Methods:
In this study, a total of 160 stool samples from September 2018 to May 2019 were collected from pediatric patients presenting with acute gastroenteritis in Karaj hospital, Iran. After viral RNA extraction, the reverse transcription quantitative polymerase chain reaction was performed to amplify the 3CD junction region of Aichivirus genome and viral load was assessed. Aichivirus genomic RNA was detected in 13/160 (8.1%) of stool samples. The highest Aichivirus detection rate was in December (30.7%). The maximum viral load was determined to be 3.9 × 108 copies/g in one sample obtained from a 1-month-old patient. The co-infection of Aichivirus with salivirus and saffold virus was also assessed by reverse transcription quantitative polymerase chain reaction, among which frequent mixed infections by 2 or more viruses were identified.

Conclusions:
This is the first documentation of Aichivirus detection in stool samples that demonstrates Aichivirus has been circulating among Iranian pediatric patients.
Mutation profiles of classic myeloproliferative neoplasms detected by a customized next-generation sequencing-based 50-gene panel
Authors: Huang Xiu , Wu Jiawei , Deng Xuan , Xu Xiao , Zhang Xinju , Ma Weizhe , Hu Tingting , Yang Jianmin , Guan Ming , Tang Gusheng 
Published: February 2020

Objective:
A sequencing panel consisting of 50 genes was customized to reveal the potential molecular land-scapes of essential thrombocytosis, polycythemia vera, and primary myelofibrosis in Chinese patients with myeloproliferative neoplasm (MPN).

Methods:
Sixty-five MPN patients (38 with essential thrombocytosis, 21 with polycythemia vera, and 6 with primary myelofibrosis), including 12 triple-negative patients, were recruited and were screened for their mutational spectrum using next-generation sequencing technology in this retrospective observational study. This study was approved by the Institutional Review Board of Changhai Hospital, Naval Military Medical University, China.

Results:

In addition to the typical driver mutations in
JAK2
,
CALR
, and
MPL
, pathogenic mutations in 15 other genes were frequently detected among the 65 patients with MPN. The 15 mutated genes were
TET2, EZH2, ASXL1, MIR662, MLH1, MLH3, SF3B1, MSH6, BARD1, DNMT3A, KIT, MSH2, RUNX1, TP53
, and
NRAS
in this order according to the mutational frequency detected. The average number of mutated genes was 1.2 genes per patient, while in the 12 triple-negative patients with MPN (ie, patients that lack the
JAK2
,
CALR
, or
MPL
mutations), at least one of the 15 pathogenic mutations was detected for each patient. Interestingly, 4 single nucleotide polymorphisms (rs4858647, rs9376092, rs58270997, rs621940) that might be correlated to individual susceptibility to myeloproliferative neoplasm were identified among the 65 patients. We also found that single nucleotide polymorphism and/or single nucleotide variation mutations occurred in multiple loci of mismatch repair-related genes, which might contribute to the development of MPN.

Conclusion:
Our study confirms the importance of the previously known MPN relative genes and, more importantly, provides some new and potentially valuable information about mutations associated with MPNs.
Public Health Surveillance for the Prevention of Pesticide-Related Illness in Illinois
Authors: Kyeremateng-Amoah Emmanuel , Friedman Lee , Wahl Michael , Forst Linda 
Published: February 2020

Objectives:
There is no pesticide related illness (PRI) surveillance program in Illinois. This study examines the quality of state-based data sources for their ability to inform public health surveillance on PRI.

Methods:
We estimated the counts of PRI by probabilistic data linkage of hospital discharge, emergency department, and poison center databases from 2010 to 2015. We characterized identified PRI cases.

Results:
We identified 3867 unique cases of PRI and 6269 asymptomatic pesticide exposures. Out of the 3867 PRI cases, there were 1319 emergency department visits and 321 hospitalizations. We identified 13 deaths and 1640 major or moderate effects from PRI. Over half of ingestion related exposures occurred in children aged 0 to 4 years. Workers’ compensation and Emergency Medical Service data were unusable.

Conclusion:
An effective public health surveillance on PRI requires reliable state data sources and cost-effective methods of assembling data from multiple sources.
Physical activity habit formation through a technology-based program
Authors: Davis Jean W. 
Published: February 2020

ABSTRACT

Background:
Only about half of adults in the United States meet the minimum federal guidelines for physical activity (PA), with less than one quarter getting an optimal amount of weekly activity. Programs to increase PA can improve health and increase worker productivity.

Local problem:
Clinic patients of a nurse practitioner–run employee health clinic in a self-insured health care system experienced health conditions associated with insufficient PA and wanted to form habits of adequate PA for health promotion.

Methods:
A quantitative design was used to assess pre- and postintervention measures in this quality improve project.

Interventions:
Patients of the clinic enrolled in a technology-based 3-month PA habit development program that included wearable technology, tracked step counts, daily text messaging, and weekly electronic newsletters. Biometric and habit measures were taken at baseline and at the conclusion of the 3-month program to determine effectiveness.

Results:
Participants who completed the program developed strong habits of PA, on average. Small improvements in blood pressure, weight, and body mass index occurred but were not clinically significant. Two thirds of participants dropped out, which was fewer than anticipated based on prior reports.

Conclusions:
Habits make an activity less difficult to continue than to stop. Thus, PA habits developed through this innovative intervention should persist and lead to decreased risk of conditions such as diabetes, heart disease, cancers, and dementia. The self-insured employer should reap the benefits of employee's PA through increased productivity, decreased absenteeism, and lower health care costs.
Allergic Contact Dermatitis of the Anogenital Region in Men and Women
Authors: Cheng Harriet S. , Fernández-Peñas Pablo 
Published: February 2020

Objectives
Allergic contact dermatitis is an uncommon but important cause of skin disease in the anogenital region. Relevant allergens are described in women and less commonly in men. The aim of this study was to describe outcomes of patch testing in men and women presenting with anogenital dermatoses.

Materials and Methods
Cases patch tested for anogenital conditions at 2 patch test clinics in Sydney, Australia, from 2002 to 2017 were reviewed. Positive and relevant patch test reactions were recorded.

Results
Thirty-seven women and 27 men were included. Dermatitis was the most common diagnosis, followed by psoriasis and lichen sclerosus. Thirty percent had a final diagnosis of allergic contact dermatitis. The most frequent relevant allergens were fragrance mix I (9%), patients own products (9%), Myroxylon pereirae (8%), cocamidopropyl betaine (3%), and benzocaine (3%).

Conclusions
The top positive and relevant allergens seen were in concordance with other reports from Australia and the rest of the world. Fragrances and medicaments are common allergens, and it is recommended that products used on anogenital skin be fragrance free. Testing patients own products is imperative.
Clinical and Histologic Liver Improvement in Siblings With Lysosomal Acid Lipase Deficiency After Enzyme Replacement
Authors: Lyons Hernando , Vouyoukas Eleftherios , Higgins Martha , Maciejko James J. 
Published: February 2020

ABSTRACTObjectives:To assess the effect of long‐term (104 weeks) treatment with recombinant sebelipase alpha (rhSA) on serum lipid and hepatic transaminase levels, and liver histopathology in 4 siblings diagnosed with lysosomal acid lipase deficiency (LAL‐D).Methods:Four male siblings from the same nonconsanguineous parents were diagnosed with the late‐onset phenotype of LAL‐D in 2015. Liver specimens were obtained by biopsy at baseline and after 104 weeks of enzyme replacement with rhSA (1 mg/kg, IV, every 2 weeks). Hepatic transaminase, lipid and lipoprotein levels were assessed at baseline and sequentially every 16 weeks for 104 weeks. Hepatic steatosis was evaluated from hematoxylin and eosin‐stained specimens, and fibrosis was evaluated (Metavir‐scoring system) from trichrome‐stained specimens obtained at baseline and following 104 weeks of treatment with rhSA.Results:All 4 siblings had improvement in their serum lipid and hepatic transaminase levels after treatment with rhSA. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels decreased from baseline by an average of 47% and 56%, respectively. The fasting triglyceride and low‐density lipoprotein cholesterol (LDL‐C) levels decreased from baseline by an average of 43% and 60%, respectively. Hepatic steatosis decreased from baseline grade 3 to posttreatment grade 1. Hepatic fibrosis did not advance following 104 weeks of treatment with rhSA and regressed in 1 sibling.Conclusions:Treatment with rhSA for 104 weeks in 4 siblings with LAL‐D demonstrated improvement in their hepatic transaminase and serum lipid levels, accompanied by reduction of hepatic steatosis and no progression of fibrosis.
Bowel Ultrasound Scan Predicts Corticosteroid Failure in Children With Acute Severe Colitis
Authors: Scarallo Luca , Maniscalco Valerio , Paci Monica , Renzo Sara , Naldini Sara , Barp Jacopo , Tasciotti Laura , Lionetti Paolo 
Published: February 2020

ABSTRACTBackground and objective:Acute severe colitis (ASC) is a potentially life‐threatening event. Optimal timing for second‐line treatment in children is mainly based on the clinical score Pediatric Ulcerative Colitis Activity Index. The aim of our study was to evaluate the potential role of bowel ultrasound scan (BUS) in predicting the need of second‐line therapy in ASC.Methods:Patients younger than 18 years admitted to a single tertiary referral center with ASC were included. We retrospectively reviewed medical records collecting clinical and BUS data. Colonic wall thickness (CWT), loss of colonic wall stratification (CWS), presence of hyperechoic lymph nodes, and colonic wall flow evaluated at power Doppler were assessed at BUS performed within the third day of hospitalization.Results:Sixty‐nine ASC episodes from 52 different patients were identified. CWT showed significantly higher values in patients who required second‐line therapy (5.14 vs 3.69 mm; P < 0.001). Loss of CWS was present in 17 of 36 (47.2%) of steroid‐resistant ASC versus only 1 of 33 of those responding to intravenous corticosteroids (P < 0.001, sensitivity = 47%, specificity = 97%). Using a receiver operating characteristic curve, a cut‐off of 3.4 mm was individuated for CWT to predict steroid treatment failure, showing a sensitivity of 92% and a specificity of 52%. The multivariable binary logistic regression analysis identified thickened colonic wall (CWT >3.4 mm) and loss of CWS as independent predictors of steroid resistance.Conclusions:BUS is a noninvasive, easily accessible, and cost‐effective resource that may identify at an early stage first‐line therapy failure in pediatric ASC.
Solitary Rectal Ulcer Syndrome in Children
Authors: Poddar Ujjal , Yachha Surender K. , Krishnani Narendra , Kumari Niraj , Srivastava Anshu , Sen Sarma Moinak 
Published: February 2020

ABSTRACTObjectives:Solitary rectal ulcer syndrome (SRUS) is said to be rare in children (largest series so far; 55 in children, 116 in adults). We analyzed our experience to look at its clinical presentations, endoscopic appearance, and treatment outcome in a large cohort of children.Methods:Clinical and endoscopic data were collected between 2000 and 2018. Children (18 years or younger) diagnosed to have SRUS on colonoscopy and confirmed by histopathology were included. All children with SRUS were treated with behavioral modification, bulk laxative. Most with ulcer received steroid enema and some sulfasalazine or sucralfate enema.Results:The median age of 140 children was 12 (interquartile range [IQR]: 10–14) years, 79% were boys. The median symptom duration was 21 (IQR: 9–36) months. Rectal bleeding was the presenting feature in 131 (93.6%); constipation in 38 (27%); and small, frequent stools in 79 (56%). Most children had features of dyssynergic defecation such as prolonged sitting in the toilet (131, 93.6%), excessive straining (138, 98.6%), a feeling of incomplete evacuation (130, 92.8%), and rectal digitation (71, 50.7%). Rectal prolapse was noted in 24 (17%) cases. Colonoscopy documented rectal ulcer in 101 (72%) [Single: 84]. Over a median follow‐up of 6 (IQR: 4–18) months, 27 patients were lost to follow‐up and of the remaining 113 cases, 71 (62.8%) showed clinical improvement (healing of ulcer documented in 36/82, 44%).Conclusions:The majority of cases of SRUS presented in second decade with rectal bleeding and features of dyssynergic defecation. Ulcer was noted in three fourths of cases. The outcome of medical treatment with behavioral modification and local therapy was modest.
Peripherally Inserted Central Venous Catheter for Pediatric and Young Adult Patients With Hematologic and Malignant Diseases
Authors: Suzuki Daisuke , Kobayashi Ryoji , Sano Hirozumi , Yanagi Masato , Hori Daiki , Matsushima Satoru , Nakano Takaaki , Kobayashi Kunihiko 
Published: February 2020

Background:
Long-term venous access is essential when treating malignant diseases. As an alternative to conventional central venous catheters, peripherally inserted central venous catheter (PICC) are now widely used. The aim of this study is to evaluate the safety, efficacy, and reliability of PICCs in comparison with previous reports, and to describe significant complications associated with their use.

Patients and Methods:
From June 2009 to November 2017, PICCs were inserted 258 times in a total of 160 pediatric and young adult patients at our institution. We retrospectively evaluated our data regarding catheter life, a note of caution during insertion, reasons for removal, infection, and other notable complications.

Results:
The 258 PICCs were placed for a total of 30,901 catheter-days with a median catheter life of 102 days ranging from 2 to 471 days. The most suitable vein for the insertion was a basilic vein. The insertion depth from the cubital fossa to the point of the lower third superior vena cava was found to have a strong correlation with body surface area. Suspected catheter infection requiring catheter removal was observed 30 times (0.97/1000 catheter-days) and catheter-related bloodstream infection was observed 2 times (0.06/1000 catheter-days). All the responsible pathogens were Staphylococcus epidermidis. As notable complications, fibrin sheath formation were seen in 4 patients and catheter tip migration to the thorax in 1 patient.

Conclusions:
Our data suggest that PICC is safe and effective in pediatric and young adult patients receiving long-term treatment. However, clinicians should be aware of the possible complications during PICC use.
Delaying the First Newborn Bath and Exclusive Breastfeeding
Authors: Long Kathleen , Rondinelli June , Yim Ashley , Cariou Catherine , Valdez Regina 
Published: February 2020

Abstract

Purpose:
The purpose of this study was to determine if changing the timing of the initial newborn bath would have an impact on exclusive breastfeeding during hospitalization. The first newborn bath had been routinely done within 2 hours of age; practice was changed to the first bath being delayed until at least 12 hours of age. A secondary purpose was to examine the nurses' perceived benefits and challenges to such a change.

Study Design and Methods:
Through a retrospective design, exclusive breastfeeding rates among mother–infant couplets prepractice change (cohort A) were compared with two postchange cohorts (B and C). Cohorts B and C were from the first 5 months and second 5 months, respectively after the practice change. Demographic information, birth type, bath timing, and feeding data were collected. Comparative statistics were applied to the three cohorts to examine differences in exclusive breastfeeding rates. Postpartum nurses were asked two open-ended questions on concerns and benefits of this change via an anonymous survey. Content analysis was completed on responses.

Results:
There were 1,463 mother–infant couplets included in three cohorts (A: n = 564; B: n = 468; C: n = 431). There were no significant increases in the exclusive breastfeeding rates (baseline 74.1%) in both the first postimplementation delayed bath cohort (70.1%, p = .207) and the second “sustainability” cohort (79.4%, p = .060). Fifteen of the 60 postpartum nurses completed the survey, for a response rate of 25%. Themes generated from survey responses included concerns (infection control, work distribution), as well as benefits (perceived breastfeeding success, decreased workload) with delaying the first newborn bath.

Clinical Implications:
Delaying the first newborn bath may be one factor that can influence exclusive breastfeeding rates during postpartum hospitalization. Results have been mixed based on recent literature. In our study, the exclusive breastfeeding rate was already above average, as would be expected in a Baby-Friendly designated hospital and may be a reason we did not see a significant change in the rate among mother–infant couplets in our study. Randomized trials are needed for a rigorous evaluation of timing of the newborn bath and possible link to exclusive breastfeeding in the hospital and beyond.
Nursing Faculty Experiences With Students' Needlestick Injuries
Authors: Black Thomas Lisa M. 
Published: February 2020

Background
Nursing students are at increased risk of needlestick injury (NSI) due to limited clinical experience and underdeveloped skills.

Purpose
The purpose of this study was to describe faculty experiences with nursing students who sustain an NSI.

Methods
A retrospective cross-sectional survey design was used to examine nursing faculty experience with student NSIs occurring during clinical practicum experiences.

Results
Thirty-four percent (n = 904) of nursing faculty respondents reported having supervised at least 1 nursing student who experienced an NSI while providing care to a patient. Only 47% (n = 1112) of faculty indicated that a student could access effective exposure management.

Conclusions
Structured simulation activities in which faculty manage a student NSI would provide faculty with essential NSI exposure management experience. Integrating blood-borne pathogen exposure management simulation into faculty development activities would bring a level of realism to the training that a lecture or written policy cannot provide.
The Impact of Imaging on Negative Appendectomies for Early Appendicitis in Children
Authors: Doolin Elizabeth C. , Doolin Edward J. 
Published: February 2020

Objectives
The rate of negative appendectomy in children is 7%. The value of imaging depends on the institution. In addition, imaging errors can lead to an appendectomy in children who do not have appendicitis. It is the hypothesis that children with short onset of symptoms who undergo negative appendectomy often have erroneous imaging findings.

Methods
A retrospective study of patients' records over a 30-month period was carried out. A search by histologic diagnosis in the department of pathology was used to identify the cases of all patients who did not have a diseased appendix with the preoperative diagnosis of appendicitis. In addition, the imaging report was reviewed for the radiologic diagnosis of each patient, and the operative note was reviewed to document the clinical indication for surgery.

Results
A total of 1377 patients who underwent appendectomy with the preoperative diagnosis of appendicitis were reviewed. Sixty-eight of these children did not have an abnormal pathologic diagnosis; hence, there was a negative appendectomy rate of 4.8%. All 68 had imaging before surgery consistent with appendicitis. Thirty-six of these patients had symptoms less than 3 days. In 30 (84%) of these 36 patients, the note identifies imaging as the indication for surgery.

Conclusions
Children who had an appendectomy and found to have a normal appendix shared 2 characteristics. (1) Their symptoms were less than 3 days, and (2) the imaging was considered the indication by the surgical team. In the situation of an unclear diagnosis and a short onset of symptoms, observation or further evaluation should be considered.
Minimizing Ionizing Radiation in Evaluating Suspected Appendicitis in Children Before and After the Release of the ACEP Clinical Policy
Authors: Whitehead Anne , Fullerton Katherine , Miller Helen C. 
Published: February 2020

Study Objective
The aim of this study was to examine the impact of the ACEP (American College of Emergency Physicians) clinical policy regarding diagnosis of suspected appendicitis on changing practice in the pediatric emergency department (ED) in the absence of a formal departmental protocol.

Methods
This was a retrospective chart review in a pediatric ED in which patients aged 2 to 18 years were evaluated for appendicitis via ultrasound, computed tomography (CT), or both, over a 7-year study period. We compared rates of CT utilization in the period before the release of the ACEP clinical policy regarding diagnosis and treatment of appendicitis (2008–2009) and the period after (2010–2014). Other metrics of interest were ultrasound results and physician response to results, as well as surrogate markers for quality of care.

Results
Seven hundred pediatric ED visits were included, with 200 prepolicy release and 500 postrelease. Computed tomography utilization decreased significantly postpolicy release from 43.5% (95% confidence interval [CI], 36.6%–50.3%) to 22.2% (95% CI, 18.5%–25.8%). The proportion of ultrasounds with indeterminate results also decreased, with 71.5% (95% CI, 65.1%–77.9%) and 55.1% (95% CI, 50.7%–59.5%) in the pre and post groups, respectively. Physicians ordered fewer CTs after indeterminate ultrasounds, decreasing from 63.7% (95% CI, 56.9%–70.5%) to 48.3%% (95% CI, 43.9%–52.7%).

Conclusions
After the release of the clinical policy, CT utilization decreased significantly suggesting possible effectiveness of the policy in bringing about change in practice. Subsequently, there was an increase in the definitiveness in the ultrasound results. Physicians also evolved in their response to indeterminate ultrasound results, with fewer CTs ordered reflexively after indeterminate results.