bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of the Quality of Postpartum Sleep and its Health Determinants on Human Milk Volume
Authors: Carrega Joanna , Lee Shih-Yu , Clark Patricia , Cranford Joan , Lloyd Steven 
Published: August 2020

Abstract

Purpose:
To examine the impact of postpartum sleep disturbance on 24-hour milk volume and breastfeeding during the early postpartum period. Factors associated with postpartum sleep disturbance also were examined.

Study Design and Methods:
A descriptive, correlational design was used. The sample included 29 first-time mothers exclusively breastfeeding healthy, full-term newborns. A home visit was conducted to collect self-report data for sleep, stress, fatigue, depression, and anxiety at 2 weeks postpartum. Infant test weights as an estimate of 24-hour milk volume also were performed. At 1 month, a phone interview was conducted for breastfeeding status. Pearson's correlation and hierarchical regression were used for data analysis.

Results:
All mothers were breastfeeding at 2 weeks and at 1 month postpartum. Most (69.2%) reported significant sleep disturbance. Higher degree of stress was associated with more disturbed sleep (β = .59, p = .001), and sleep disturbance was associated with more symptoms of fatigue (r = .70, p = - .001), depression (r = .58, p = .001), and anxiety (r = .52, p = - .01). Poor sleep quality was the only significant predictor for lower milk volume (β = - .70, p = .02).

Clinical Implications:
Clinically significant sleep disturbance is common during the early postpartum period and may have a negative impact on human milk production and other important maternal health indicators. A better understanding of postpartum sleep disturbance and its impact on breastfeeding and maternal health is needed.
Intraoperative Mother and Baby Skin-to-Skin Contact during Cesarean Birth
Authors: Frederick Anitra , Fry Tena , Clowtis Licia 
Published: August 2020

Abstract

Purpose:
Experts recommend immediate skin-to-skin (SSC) contact for all alert and stable mothers and newborns after birth. Clinicians are working to incorporate immediate (intraoperative) SSC during cesarean birth. The purpose of this systematic review is to describe the state of the science of intraoperative SSC for mother and baby and increase clinician's awareness of its potential benefits and risks.

Study Design and Methods:
A systematic approach was followed throughout the review process. CINAHL, PubMed, and Embase databases were searched using strategies constructed by an academic health sciences librarian. Articles included in the review focused on SSC initiated during cesarean birth.

Results:
Thirteen studies were selected for the mixed-method systematic review. Six prospective studies, four retrospective chart reviews, and three qualitative studies met the inclusion criteria. Maternal stress levels were reduced, whereas comfort, oxytocin, and antioxidant levels increased with intraoperative SSC. Physiologic measures of successful newborn transition showed little difference between newborns held in intraoperative SSC and those who were not. Synthesis of qualitative experiences revealed mothers' intense desire to hold and know their baby immediately after birth.

Clinical Implications:
Intraoperative SSC is a safe, beneficial, and highly desirable practice for mothers and newborns experiencing cesarean birth. Although barriers exist to its implementation, nurses can facilitate and support this practice. Evidence-based, family-centered intraoperative SSC should be offered to all stable mothers and babies according to recommendations and in a manner that promotes safe outcomes, including following current nurse staffing guidelines.
The Efficacy of a Brief Educational Training Session in Point-of-Care Pediatric Hip Ultrasound
Authors: Pade Kathryn H. , Niknam Kian R. , Lobo Viveta E. , Anderson Kenton L. 
Published: August 2020

Background
Pediatric limp is a common presenting complaint to emergency departments. Despite this, diagnosis can be difficult in young patients with no history of trauma. Ultrasound can be used to identify a hip effusion, which may be the etiology of limp in pediatric patients. Brief educational training sessions have successfully been used to introduce novice ultrasound users to point-of-care (POC) ultrasound; however, the education of POC hip ultrasound is underexplored, and the efficacy of educational training sessions in this domain remains unknown.

Objective
To evaluate the feasibility and efficacy of using a brief educational training session to teach novice ultrasound users to identify hip anatomy and effusions.

Methods
Medical and physician assistant students were enrolled during an ultrasound education conference. A pretest evaluated prior knowledge, experience, and confidence level regarding POC hip ultrasound. Students attended a brief didactic session and then completed an objective structured assessment of technical skill as well as a posttest.

Results
Twenty-eight students naive to hip ultrasound participated in this study. Levels of training included medical and physician assistant students. Mean test scores increased from the pretest (4.8 of 9, SD = 1.6) to the posttest (7.9 of 9, SD = 0.72) (P < 0.001). Average objective structured assessment of technical skill was 4.6 of 5 (SD, 0.75; 95% confidence interval, 4.3–4.9). After the sessions, confidence levels in identifying landmarks, joint space, and a joint effusion significantly increased (P < 0.001).

Conclusions
Pediatric hip ultrasound knowledge, performance, skills, and confidence improved as demonstrated by novice ultrasound users after a brief educational training session. Our study shows that a brief, targeted educational intervention was a feasible and effective method of introducing pediatric POC hip ultrasound to novices.
Outcomes of Short Versus Long Leg Casts for Childhood Accidental Spiral Tibial CAST Fractures
Authors: MacNeille Rhett , Gockley Allison , Hennrikus William 
Published: August 2020

Objective
The objective of the current study was to analyze the outcomes of short versus long leg casts in the treatment of childhood accidental spiral tibial (CAST) fractures.

Methods
A retrospective review was performed of medical records at a single tertiary children's hospital from 2009 to 2014 of children with distal, spiral tibial fractures (CAST fractures). The following points were documented for each patient: sex, laterality of fracture, age at presentation, type of cast, length of time in cast, use of a controlled ankle motion boot after cast removal, suspicion for abuse, and complications including skin irritation, skin breakdown, infection, compartment syndrome, fracture displacement, and gait disturbances.

Results
A total of 21 patients with an age range of 12 to 62 months were found to have CAST fractures as confirmed by x-ray. Fourteen were treated with short leg casts, whereas 7 were treated with long leg casts. Both groups healed with equal outcomes, and there was no documented suspicion for abuse in any case.

Conclusions
A short leg walking cast seems to be an effective and safe method of treatment for CAST fractures and could be considered as potentially preferable to long leg casts because of the added benefits of increased mobility and function. Follow-up to this preliminary study is warranted to better elucidate any differences in benefit between these treatment options, and clinical judgment should be used when considering immobilization options.
Motor Relearning After Hypoglossal-Facial Nerve Anastomosis
Authors: Negley Kelly J. , Rasool Alysha , Byrne Patrick J. 
Published: August 2020

AbstractFacial paralysis is a clinical condition associated with significant functional and psychosocial morbidity (Facial Plast Surg FPS. 2011;27(4):346–57). The management paradigm for this condition continues to evolve with the use of both surgical and nonsurgical strategies (Facial Plast Surg FPS. 2011;27(4):346–57). Hypoglossal-facial nerve anastomosis is a surgical technique whereby the hypoglossal nerve acts as a donor motor nerve to restore facial muscle reinnervation via movements of the tongue (Plast Reconstr Surg. 1979;63(1):63–72). This case describes a 33-yr-old woman with unilateral facial paralysis who underwent hypoglossal-facial nerve anastomosis and 14 wks of postoperative rehabilitation. This report highlights the details of her rehabilitation regimen including the specific techniques used to enhance motor relearning of facial expression through movement of the tongue.
Adverse childhood experiences and chronic pain among children and adolescents in the United States
Authors: Groenewald Cornelius B. , Murray Caitlin B. , Palermo Tonya M. 
Published: August 2020

Abstract

Objective:
To evaluate the association between adverse childhood experiences (ACEs) and chronic pain during childhood and adolescence.

Methods:
Cross-sectional analysis of the 2016-2017 National Survey of Children's Health, including 48,567 child participants of 6 to 17 years of age. Parents of children reported on 9 ACEs. Chronic pain was defined as parents reporting that their children had “frequent or chronic difficulty with repeated or chronic physical pain, including headache or other back or body pain during the past 12 months.” Multivariate logistic regression analysis adjusted for sociodemographic and health-related factors.

Results:
In this nationally representative sample, 49.8% of children were exposed to one or more ACEs during their lifetime. Children with exposure to 1 or more ACEs had higher rates of chronic pain (8.7%) as compared to those with no reported ACEs (4.8%). In multivariate analysis, children with ACEs had increased odds for chronic pain (adjusted odds ratio [aOR]: 1.6, 95% confidence interval [CI]: 1.3–2.2, for 0 vs 1 ACE and aOR: 2.7, 95% CI: 2.1–3.4 for 0 vs 4+ ACEs). The strongest associations of individually measured ACEs with chronic pain included financial instability (aOR: 1.9, 95% CI: 1.6–2.2), living with a mentally ill adult (aOR: 1.8, 95% CI: 1.5–2.2), and having experienced discrimination based on race (aOR: 1.7, 95% CI: 1.3–2.2).

Conclusions:
Children and adolescents with ACEs had increased risk for chronic pain, and this association increased in a dose-dependent fashion.
Predictors of Resumption of Menses in Anorexia Nervosa: A 4-Year Longitudinal Study
Authors: Castellini Giovanni , Rossi Eleonora , Cassioli Emanuele , Giardinelli Lisa , Fanelli Alessandra , Fisher Alessandra D. , Vignozzi Linda , Ricca Valdo 
Published: August 2020

ABSTRACTObjectiveAmenorrhea is a disabling medical consequence of anorexia nervosa (AN); therefore, resumption of menses (ROM) represents an important goal in the treatment for these patients. The aim of the present study was to evaluate possible clinical, psychopathological, and biological predictors of ROM, including age, body mass index (BMI), AN subtype, childhood abuse, duration of illness, general and eating disorder (ED)–specific psychopathology, and sex hormones.MethodsFifty amenorrheic patients with AN were enrolled. Baseline clinical data and information on childhood abuse were collected. Questionnaires to evaluate general and ED-specific psychopathology were administered, and blood samples were drawn. All patients received treatment as usual and underwent regular follow-up visits for 4 years or until ROM. Time to ROM, BMI at last evaluation, and data regarding diagnostic crossover into bulimia nervosa were collected.ResultsTwenty-nine (58.0%) patients recovered menses. Diagnostic crossover was associated with a higher probability of ROM (odds ratio = 10.3,p= .030). Time-to-event analysis showed that a shorter duration of illness (χ2(1) = 11.00,p= .001), binge-eating/purging subtype (χ2(1) = 7.01,p= .008), and history of childhood abuse (χ2(1) = 4.03,p= .045) were associated with an earlier ROM. Furthermore, higher baseline ED-specific psychopathology was associated with a reduced likelihood for ROM, whereas higher general psychopathology and follicle-stimulating hormone levels predicted an earlier ROM (all,p< .050). Age, BMI, luteinizing hormone, and estrogen hematic levels had no predictive value with respect to ROM.ConclusionsThe present study provides data in support of an integrated model, emphasizing the importance of duration of illness, childhood abuse, and psychopathological characteristics of amenorrheic patients with AN in predicting ROM.
Expected Estimation Errors in Studies of the Cortisol Awakening Response: A Simulation
Authors: Segerstrom Suzanne C. , Boggero Ian A. 
Published: August 2020

ABSTRACT

Objective
Misestimation as a consequence of small sample sizes, small effect sizes, and noisy measurement may be particularly problematic in biomarker studies, the cost of which can adversely affect design decisions. This simulation study used real study designs reported in a meta-analysis of psychosocial correlates of the cortisol awakening response to investigate the probability that the results of these designs would yield misestimates in a cross-sectional study.

Methods
For each of the 212 designs, 100,000 simulated data sets were produced and the percentages of effects that were in the wrong direction and/or that differed by more than 0.10 from the true effect (b = 0.10) were calculated.

Results
As expected, small samples (n < 100) and noisy measurement contributed to higher probability of errors. The average probability of an effect being in the wrong direction was around 20%, with some designs reaching 40%; misestimation probabilities were around 40%, with some designs reaching 80%. This was true for all studies as well as those reporting statistically significant effects.

Conclusion
Results call for better study designs, and this article provides suggestions for how to achieve more accurate estimates.
Acquired decrease of the C3b /C4b receptor (CR1, CD35) and C4d deposits on Erythrocytes from ICU COVID-19 Patients
Authors: Kisserli Aymric , Schneider Nathalie , Audonnet Sandra , Tabary Thierry , Goury Antoine , Cousson Joel , Mahmoudi Rachid , Bani-Sadr Firouze , Kanagaratnam Lukshe , Jolly Damien , Cohen Jacques HM 
Published: August 2020

ABSTRACTWe determined CR1, CD35 the C3b, C4b receptor density, C3b/C3bi and C4d deposits densities on Erythrocytes (E) in 51 COVID-19 patients undergoing O2 therapy or assisted ventilation in ICU units in Rheims France. A clear acquired decrease of CR1 density of E from COVID-19 patients was observed, particularly among fatal cases, and paralleling several severity parameters.Deposits of C4d largely above values observed in normal individuals, mostly without C3 deposits, have been observed in more than 80% of the patients, reminiscent of the sub endothelial pericapillary deposits in organ transplant rejection, already observed on E in parallel, as well as also observed on E in clinical SLE flares.Conversely, significant C3 deposits were only observed among ¼ of the patients. The decrease of CR1/E density, and the detection of virus spike, C3 or C4 fragment on E, among COVID-19 patients, are likely to be two aspects of the same phenomenon of immune complexes or complement fragment coated cell debris handling and clearance.Measurement of C4d deposit on E might represent a way for assessing inflammation and complement activation occurring in organ capillaries. CR1/E decrease might represent a cumulative index of complement activation in COVID-19 patients.Taken together, these original findings stress on the participation of the complement regulatory proteins in that disease and evidence that E matter in immune mechanisms in COVID-19 patients.The use of CR1, or CR1-like molecules with the aim of down regulating complement activation and inflammation for therapy should also be considered.HIGHLIGHTSAcquired decrease of CR1 on E in COVID-19 patients, particularly among fatal cases, and paralleling several severity parameters.Large C4d deposits on E in most patients, reminiscent of the pericapillary deposits in organ transplant rejection, already observed on E in parallel, as well as on E from SLE flares.C4d deposit on E, a possible way for assessing inflammation and complement activation in organ capillaries.Decreased CR1/E, a possible cumulative index of complement activation in COVID-19 patients.The use of CR1 or CR1-like molecules for down regulating complement activation for therapy should also be considered.
A novel deep learning-based point-of-care diagnostic method for detecting Plasmodium falciparum with fluorescence digital microscopy
Authors: Holmström O. , Stenman S. , Suutala A. , Moilanen H. , Kücükel H. , Ngasala B. , Mårtensson A. , Mhamilawa L. , Aydin-Schmidt B. , Lundin M. , Diwan V. , Linder N. , Lundin J. 
Published: August 2020

AbstractBackgroundMalaria remains a major global health problem with a need for improved field-usable diagnostic tests. We have developed a portable, low-cost digital microscope scanner, capable of both brightfield and fluorescence imaging. Here, we used the instrument to digitize blood smears, and applied deep learning (DL) algorithms to detect Plasmodium falciparum parasites.MethodsThin blood smears (n = 125) were collected from patients with microscopy-confirmed P. falciparum infections in rural Tanzania, prior to and after initiation of artemisinin-based combination therapy. The samples were stained using the 4’,6-diamidino-2-phenylindole fluorogen and digitized using the prototype microscope scanner. Two DL algorithms were trained to detect malaria parasites in the samples, and results compared to the visual assessment of both the digitized samples, and the Giemsa-stained thick smears.ResultsDetection of P. falciparum parasites in the digitized thin blood smears was possible both by visual assessment and by DL-based analysis with a strong correlation in results (r = 0.99, p < 0.01). A moderately strong correlation was observed between the DL-based thin smear analysis and the visual thick smear-analysis (r = 0.74, p < 0.01). Low levels of parasites were detected by DL-based analysis on day three following treatment initiation, but a small number of fluorescent signals were detected also in microscopy-negative samples.ConclusionQuantification of P. falciparum parasites in DAPI-stained thin smears is feasible using DL-supported, point-of-care digital microscopy, with a high correlation to visual assessment of samples. Fluorescent signals from artefacts in samples with low infection levels represented the main challenge for the digital analysis, thus highlighting the importance of minimizing sample contaminations. The proposed method could support malaria diagnostics and monitoring of treatment response through automated quantification of parasitaemia and is likely to be applicable also for diagnostics of other Plasmodium species and other infectious diseases.
The Status and Risk Factors of COVID-19 Related Suicides in Bangladesh
Authors: Boshra Sadia Noosrat , Islam Mohammad Mohiminul 
Published: August 2020

AbstractIn addition to physical health, the COVID-19 pandemic has affected the global economy and mental health significantly. The economic and social consequence has sparked many psychological mediators. In severe cases, they led to suicidal behavior in individuals like as seen in the 1918-1919 flu pandemic and in the 2003 severe acute respiratory syndrome (SARS) epidemic. Previously, a few articles have been published with regard to COVID-19 suicides in Bangladesh. However, all these articles talked about sporadic cases of suicides with no clear picture of the holistic overview of suicides in Bangladesh. Herein, we looked into all COVID-19 suicide cases from March 01, 2020, to July 31, 2020, as reported in Bangladeshi media. Our study also reports the risk factors contributing to suicidal incidents. Moreover, we also identified the impact of gender, profession, and COVID-19 diagnosis status on committing suicide. This study will shed light on the topic with a clear understanding of the causalities influencing individuals to suicide. Furthermore, it will help the policymakers to take necessary actions to prevent any further suicides.
Post-discharge health status and symptoms in patients with severe COVID-19
Authors: Weerahandi Himali , Hochman Katherine A. , Simon Emma , Blaum Caroline , Chodosh Joshua , Duan Emily , Garry Kira , Kahan Tamara , Karmen-Tuohy Savannah , Karpel Hannah C. , Mendoza Felicia , Prete Alexander M. , Quintana Lindsey , Rutishauser Jennifer , Martinez Leticia Santos , Shah Kanan , Sharma Sneha , Simon Elias , Stirniman Ana , Horwitz Leora I. 
Published: August 2020

AbstractBackgroundLittle is known about long-term recovery from severe COVID-19 disease. Here, we characterize overall health, physical health and mental health of patients one month after discharge for severe COVID-19.MethodsThis was a prospective single health system observational cohort study of patients ≥18 years hospitalized with laboratory-confirmed COVID-19 disease who required at least 6 liters of oxygen during admission, had intact baseline cognitive and functional status and were discharged alive. Participants were enrolled between 30 and 40 days after discharge. Outcomes were elicited through validated survey instruments: the PROMIS® Dyspnea Characteristics and PROMIS® Global Health-10.ResultsA total of 161 patients (40.6% of eligible) were enrolled; 152 (38.3%) completed the survey. Median age was 62 years (interquartile range [IQR], 50-67); 57 (37%) were female. Overall, 113/152 (74%) participants reported shortness of breath within the prior week (median score 3 out of 10 [IQR 0-5]), vs. 47/152 (31%) pre-COVID-19 infection (0, IQR 0-1), p<0.001. Participants also rated their physical health and mental health as worse in their post-COVID state (43.8, standard deviation 9.3; mental health 47.3, SD 9.3) compared to their pre-COVID state, (54.3, SD 9.3; 54.3, SD 7.8, respectively), both p <0.001. A total of 52/148 (35.1%) patients without pre-COVID oxygen requirements needed home oxygen after hospital discharge; 20/148 (13.5%) reported still using oxygen at time of survey.ConclusionsPatients with severe COVID-19 disease typically experience sequelae affecting their respiratory status, physical health and mental health for at least several weeks after hospital discharge.