bluuebunny/crossref_metadata_2025_split huggingface dataset:
Guidelines for caregivers and healthcare professionals on speaking to children about overweight and obesity: a systematic review of the gray literature
Authors: Lampe Elizabeth W , Abber Sophie R , Forman Evan M , Manasse Stephanie M 
Published: October 2020

Abstract
Caregivers and healthcare professionals (HPs) are increasingly concerned about childhood obesity. A critical consideration of caregivers and HPs is discussing weight status without provoking disordered eating. Given the complexity of these interacting concerns, major health advocacy groups have independently published guidelines for having conversations with children about overweight/obesity. The current investigation represented the first-ever systematic review of these guidelines to analyze their content, consistency, actionability, or scientific support. To conduct a systematic review, the authors performed a web-based search using the terms parent/HP, guidelines, child, and overweight/obesity that identified 59 guidelines on childhood obesity broadly, of which 13 provided explicit direction on how the caregiver or HP should approach a conversation about overweight with a child. Within these 13 guidelines, nine topic domains were identified: attitude modeling (covered by 31% of guidelines), behavior modeling (61%), dietary recommendations (54%), physical activity (46%), body acceptance and self-esteem (69%), conversation advice (92%), contact with HP (46%), talking about “weight” versus “overall health” (54%) and external factors (e.g., bullying, media) (54%). Although guidelines presented similar content, several inconsistencies in recommendations emerged. Notably, only three of the 13 guidelines referenced any scholarly sources and only a small minority of advice was actionable by caregivers or HPs. It is evident that guidelines for caregivers and HPs on speaking to children about obesity offer inconsistent advice, minimally based on empirical evidence. Future guidelines should aim to unify their messages for caregivers and HP and be better supported by empirical data.
A systematic review of intensive outpatient care programs for high-need, high-cost patients
Authors: Delaney Rebecca K , Sisco-Taylor Brittany , Fagerlin Angela , Weir Peter , Ozanne Elissa M 
Published: October 2020

Abstract
Five percent of the patient population accounts for 50% of U.S. healthcare expenditures. High-need, high-cost patients are medically complex for numerous reasons, often including behavioral health needs. Intensive outpatient care programs (IOCPs) are emerging, innovative clinics which provide patient-centered care leveraging multidisciplinary teams. The overarching goals of IOCPs are to reduce emergency department visits and hospitalizations (and related costs), and improve care continuity and patient outcomes. The purpose of this review was to examine the effectiveness of IOCPs on multiple outcomes to inform clinical care. A systematic search of the literature was conducted to identify articles. Six studies were included that varied in rigor of research design, analysis, and measurement of outcomes. Most studies reported results on healthcare utilization (n = 4) and costs (n = 3), with fewer reporting results on patient-reported and health-related outcomes (n = 2). Overall, there were decreasing trends in emergency department visits and hospitalizations. However, results on healthcare utilization varied based on time of follow-up, with shorter follow-up times yielding more significant results. Two of the three studies that evaluated costs found significant reductions associated with IOCPs, and the third was cost-neutral. Two studies reported improvements in patient-reported outcomes (e.g., satisfaction, depression, and anxiety). Overall, these programs reported positive impacts on healthcare utilization and costs; however, few studies evaluated patient characteristics and behaviors (e.g., engagement in care) which may serve as key mechanisms of program effectiveness. Future research should examine patient characteristics, behaviors, and clinic engagement metrics to inform clinical practice.
A systematic review of interventions using health behavioral theories to improve medication adherence among patients with hypertension
Authors: Nili Mona , Mohamed Rowida , Kelly Kimberly M 
Published: October 2020

Abstract
Medication adherence is a major problem in the treatment of hypertension. Approximately half of the patients who use antihypertensive medications are not adherent. Several interventions have endeavored to improve medication adherence among patients with hypertension, and some have used health behavioral models/theories. However, the quality and effectiveness of using health behavioral models/theories in improving medication adherence among patients with hypertension remain unknown. The main aim of this systematic review was to describe study characteristics and types of health behavioral models/theories used in interventions for improving medication adherence among adults with hypertension. PubMed, Scopus, Ovid MEDLINE, CINAHL, and PsycINFO databases were searched for randomized clinical trial interventions using any health behavioral models/theories published in English from 1979 to 2019. Following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, two independent reviewers searched, screened abstracts and articles, extracted data, and assessed the risk of bias and the use of the model/theory using the Theory Coding Scheme. A total of 11 articles were included in this systematic review. Two studies reported significant improvement in medication adherence. The Self-Regulation Model and Social Cognitive Theory were the most common types of models/theories. Nine studies used a single model/theory, and four studies measured the constructs of a model/theory. Risk of bias was good (n = 4) and fair (n = 5) in interventions. Using health behavioral models/theories may be an efficient way for health care professionals to improve adherence to medications among patients with hypertension. More interventions with rigorous designs are needed that appropriately utilize health behavioral models/theories for improving medication adherence among adults with hypertension.
A systematic review examining the relationship between food insecurity and early childhood physiological health outcomes
Authors: Simonovich Shannon Deirdre , Pineros-Leano Maria , Ali Asma , Awosika Olanrewaju , Herman Anne , Withington Margaret H C , Loiacono Bernardo , Cory Molly , Estrada Monica , Soto Danya , Buscemi Joanna 
Published: October 2020

AbstractFood insecurity, or limited access to nutritious foods, is a significant public health concern especially among vulnerable populations including infants and young children in low-income households. While literature to date has thoroughly examined the psychological and behavioral impacts of food insecurity on children, no known study to date has specifically synthesized the literature exploring the relationship between food insecurity and physiological health outcomes during early childhood. The purpose of this study was to review the literature on physiological health outcomes associated with food insecurity during early childhood among children aged 0–5 years in developed countries. Our literature search sources included PubMed, PsycInfo, CINAHL, and Embase databases. A total of 657 articles published up to September 2019 were reviewed for eligibility by two coders, with a third reviewer in cases of disagreement. Eighty-three articles remained after screening by abstract, with a final 27 studies ultimately included in the final synthesis. This review is registered with PROSPERO and adhered to PRISMA guidelines. In total, 20 articles (74%) noted significant relationships between food insecurity and physiological health outcomes in young children. Findings included an association with overweight or obesity (n = 9), anemia (n = 3), poor child health (n = 3), low birth weight (n = 3), chronic illness (n = 1), special health care needs (n = 1), and increased cortisol (n = 1), in young children who experience food insecurity. Identifying relationships between food insecurity and health outcomes during early childhood has the potential to inform future prevention interventions to reduce health disparities in these vulnerable populations.
A systematic review and meta-analysis of physical activity interventions among colorectal cancer survivors
Authors: Mbous Yves Paul , Patel Jayeshkumar , Kelly Kimberly M 
Published: October 2020

Abstract
With the growing number of colorectal cancer survivors (CRCS), theory-based, high-quality physical activity (PA) interventions are needed to promote quality and quantity of life. This systematic review and meta-analysis synthesized theory-based PA interventions among CRCS. Using PubMed, PsyINFO, CINAHL, MEDLINE, SportDiscus, and Cochrane databases, studies including CRCS participants, a PA outcome, a behavioral theory/model or behavior change techniques (BCTs), and randomized research design were identified. Two reviewers coded BCT, intervention reproducibility (Template for Intervention Description and Replication–TIDier), risk of bias, and quality of evidence. From an initial screen of 1,328 articles, 10 RCTs met our inclusion criteria. The Transtheoretical Model (n = 3), Social Cognitive Theory (n = 3), and Theory of Planned Behavior (n = 2) were the most used theories. “Goal setting (behavior)” (n = 10), “goal setting (outcome)” (n = 10), “action planning” (n = 9), and “problem solving” (n = 9) were the most commonly used BCTs. Intervention modalities were primarily print material based (n = 4) and telephone counseling (n = 4). Findings demonstrated that theory-based PA interventions are successful at increasing PA among CRCS as meta-analysis evidenced a small effect size of 0.26. TDier items 3, 9, and 12 hindered intervention replicability. Lack of blinding and bias in the measurement of outcomes by assessors resulted in serious bias. In-depth theoretical applications are needed for PA interventions that minimize bias and improve outcomes measurement. Intervention adherence and fidelity, as well as theoretical construct measurement pre- and post-intervention, will enhance the behavioral research enterprise. PROSPERO registration: CRD42019142816.
A systematic review of the implementation of obesity prevention interventions in early childcare and education settings using the RE-AIM framework
Authors: Sanchez-Flack Jennifer C , Herman Annie , Buscemi Joanna , Kong Angela , Bains Alexis , Fitzgibbon Marian L 
Published: October 2020

Abstract
Previous systematic reviews have examined the efficacy of obesity prevention interventions within early childcare/education settings. Often lacking in these reviews is reporting on external validity, which continues to be underemphasized compared to internal validity. More attention to external validity would help better translate evidence-based interventions to real-world settings. This systematic review aimed to determine the availability of data on both internal and external validity across dimensions of the Reach, Efficacy/Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework in studies reporting on obesity prevention interventions in early childcare/education settings. Inclusion criteria included: randomized controlled trials, early childcare/education setting, targeted children 2–6 years old, addressed both diet and physical activity, collected measures of weight status and diet and/or physical activity, and published within the last 10 years. Searches were conducted in ERIC, PsychInfo, and PubMed; 23 studies met inclusion criteria. A validated RE-AIM abstraction tool was used to code studies. Most commonly reported dimensions were Reach (62.3%), Implementation (53.5%), and Efficacy/Effectiveness (48.7%). Adoption (21.7%) and Maintenance (11.6%) were less often reported. All studies reported on primary outcomes, but few reported on RE-AIM indicators of characteristics of participation and adoption, quality of life, methods used to identify staff, staff inclusion/exclusion criteria and adoption rates, implementation fidelity, measures of cost to start-up and deliver the intervention, and indicators of maintenance. This systematic review underscores the need for more focus on external validity to inform replication, dissemination, and implementation so that evidence-based early childcare/education obesity interventions can be generalized to real-world settings.
Responses of native and invasive woody seedlings to combined competition and drought are species-specific
Authors: Bueno Andrea , Pritsch Karin , Simon Judy 
Published: October 2020

AbstractWoody species invasions are a major threat to native communities with intensified consequences during increased periods of summer drought as predicted for the future. Competition for growth-limiting nitrogen (N) between native and invasive tree species might represent a key mechanism underlying the invasion process, because soil water availability and N acquisition of plants are closely linked. To study whether the traits of invasive species provide an advantage over natives in Central Europe in the competition for N under drought, we conducted a greenhouse experiment. We analyzed the responses of three native (i.e., Fagus sylvatica L., Quercus robur L. and Pinus sylvestris L.) and two invasive woody species (i.e., Prunus serotina Ehrh. and Robinia pseudoacacia L.) to competition in terms of their organic and inorganic N acquisition, as well as allocation of N to N pools in the leaves and fine roots. In our study, competition resulted in reduced growth and changes in internal N pools in both native and invasive species mediated by the physiological characteristics of the target species, the competitor, as well as soil water supply. Nitrogen acquisition, however, was not affected by competition indicating that changes in growth and N pools were rather linked to the remobilization of stored N. Drought led to reduced N acquisition, growth and total soluble protein-N levels, while total soluble amino acid-N levels increased, most likely as osmoprotectants as an adaptation to the reduced water supply. Generally, the consequences of drought were enhanced with competition across all species. Comparing the invasive competitors, P. serotina was a greater threat to the native species than R. pseudoacacia. Furthermore, deciduous and coniferous native species affected the invasives differently, with the species-specific responses being mediated by soil water supply.
Flexible Fibreoptic Bronchoscopy and Bronchoalveolar Lavage for Confirmation of Pulmonary Hydatid Disease in Children: A Case Series
Authors: Kumar Ketan , Mathew Joseph L , Vaidya Pankaj C , Bal Amanjit , Gupta Nalini , Singhal Kamal K , Saxena Akshay Kumar , Singh Meenu 
Published: October 2020

Abstract
Hydatid disease of the lungs is common in endemic regions. It can be suspected clinically by non-specific respiratory symptoms in children living in endemic regions, especially when they are close to sheep or dogs. Chest imaging X-ray or computed tomography may show characteristic cysts in some cases, but typical findings are absent in many children. Hydatid serology may contribute to the diagnosis, but does not have sufficient sensitivity for pulmonary cysts. Thus, there is no confirmatory diagnostic test, other than surgical excision and histopathologic examination. Hence, there is a need for more reliable diagnostic tests. We present a series of children, both with and without suspected pulmonary hydatid, wherein flexible fibreoptic bronchoscopy (FFOB) performed under conscious sedation, revealed hydatid membranes in the airways. Bronchoalveolar lavage (BAL) analysis revealed hydatid in most of them. Thus the diagnosis could be confirmed even before surgical excision of cysts was performed. We propose that FFOB with BAL could be useful to confirm the diagnosis of pulmonary hydatid in children. This will be particularly helpful in children without characteristic radiological or serological findings. To the best of our knowledge, this is a completely novel approach to the condition with potential to alter the diagnostic paradigm
Lay summary
Hydatid disease of the lungs is commonly encountered in endemic regions. However, there is no confirmatory diagnostic test for pulmonary hydatid cyst, other than surgical excision and histopathologic examination. Imaging including chest X-ray and computed tomography may not be typical, especially in complicated cysts and hydatid serology does not have a satisfactory sensitivity for diagnosing lung cysts. Thus, there is a need for more reliable diagnostic tests. We present a series of children, both with and without suspected pulmonary hydatid, wherein flexible fibreoptic bronchoscopy (FFOB) under conscious sedation, revealed hydatid membranes in the airways. Bronchoalveolar lavage (BAL) analysis confirmed hydatid in most of them. We propose FFOB with BAL as a useful diagnostic modality to confirm pulmonary hydatid in children, prior to surgical excision. To the best of our knowledge, this is a completely novel approach to the condition with potential to alter the diagnostic paradigm.
Peaceful revolution in genome size: polyploidy in the Nabidae (Heteroptera); autosomes and nuclear DNA content doubling
Authors: Sadílek David , Vilímová Jitka , Urfus Tomáš 
Published: October 2020

AbstractGenome size and the position of 18S ribosomal DNA (rDNA) were analysed in two Himacerus, eight Nabis and two Prostemma species from the family Nabidae using flow cytometry and fluorescence in situ hybrization techniques. The karyotypes of Nabis biformis and Nabis maoricus, each with 2n = 16 + XY, and Prostemma aeneicolle, with 2n = 26 + XY, were recorded for the first time. All the species displayed one or two 18S rDNA signals on the X chromosome and up to two signals on the Y chromosome. Several females exhibited two different types of X chromosome breakage, namely within or outside of the 18S rDNA region. Measurements of nuclear DNA content revealed significant differences between all three genera under study. Most notably, the nuclear DNA content of Himacerus species, with 2n = 32/36 + XY (2C = 9–10 pg), was double that of Nabis species, with 2n = 16 + XY (2C = 4–6 pg). Therefore, the previously rejected theory of an autosomal polyploidy event in the evolution of the genus Himacerus is strongly supported by the results of the present study and is now being resurrected.
Success of Surgical Simulation in Orthopedic Training and Applications in Spine Surgery
Authors: Sayari Arash J. , Chen Oscar , Harada Garrett K. , Lopez Gregory D. 
Published: October 2020

Study Design:
This was a narrative review.

Objective:
This study aimed to review the current literature on surgical simulation in orthopedics and its application to spine surgery.

Summary of Background Data:
As orthopedic surgery increases in complexity, training becomes more relevant. There have been mandates in the United States for training orthopedic residents the fundamentals of surgical skills; however, few studies have examined the various training options available. Lack of funding, availability, and time are major constraints to surgical simulation options.

Methods:
A PubMed review of the current literature was performed on all relevant articles that examined orthopedic trainees using surgical simulation options. Studies were examined for their thoroughness and application of simulation options to orthopedic surgery.

Results:
Twenty-three studies have explored orthopedic surgical simulation in a setting that objectively assessed trainee performance, most in the field of trauma and arthroscopy. However, there was a lack of consistency in measurements made and skills tested by these simulators. There has only been one study exploring surgical simulation in spine surgery.

Conclusions:
While there has been a growing number of surgical simulators to train orthopedic residents the fundamentals of surgical skills, most of these simulators are not feasible, reproducible, or available to the majority of training centers. Furthermore, the lack of consistency in the objective measurements of these studies makes interpretation of their results difficult. There is a need for more simulation in spine surgery, and future simulators and their respective studies should be reproducible, affordable, applicable to the surgical setting, and easily assembled by various programs across the world.
Telemedicine in cardiac procedures: considerations for a remote future
Authors: Weiss J. Peter 
Published: October 2020

Purpose of review
Present a review of relevant literature and suggest a framework for discussion of the considerations affecting the evolution and adoption of Telerobotic Support and Telerobotic Collaboration in the practice of cardiac procedural medicine.

Recent findings
Recent medical practice has undergone remarkable transformation in the adoption of telemedicine. This evolution has been accelerated by the COVID-19 (SARS-CoV-2) pandemic and has largely been focused on outpatient medicine. Clinical studies and opinion articles have highlighted benefits including reduced costs, increased patient engagement, and saved time, while also raising concerns regarding privacy, care quality and data security. Early and current efforts implementing remote procedural medicine have not only demonstrated technical success but also highlighted the many issues that must be resolved before acceptance as a major aspect of everyday patient care.

Summary
It is inevitable that remote technologies will play an increasing role in procedural medicine as they have in outpatient clinical medicine. Thoughtful participation by physicians in the evolution of these technologies and their modes of use will be necessary to maximize the benefits to our patients and healthcare systems.
Polaprezinc (Zinc–l-Carnosine Complex) as an Add-on Therapy for Binge Eating Disorder and Bulimia Nervosa, and the Possible Involvement of Zinc Deficiency in These Conditions
Authors: Sakae Kensaku , Suka Machi , Yanagisawa Hiroyuki 
Published: October 2020

AbstractBackgroundZinc plays an important role in appetite regulation.l-Carnosine, an endogenous dipeptide, may also regulate eating behavior via its histaminergic and antiglutamatergic properties. Polaprezinc (zinc–l-carnosine complex) is a medication for gastric ulcers. A small case series reported successful treatment of binge eating with add-on polaprezinc.MethodsThis was an open trial of add-on polaprezinc in patients with binge eating disorder (BED; n = 22) or bulimia nervosa (BN; n = 7) receiving antidepressants. A 4-week baseline period was followed by a 16-week polaprezinc treatment at 150 mg/d (containing 34 mg zinc and 116 mgl-carnosine) in addition to ongoing psychotropic medications. We also assessed their zinc status via a laboratory index and zinc deficiency–related symptoms.ResultsAt the study end, both conditions showed a significant reduction in the 4-week frequency of combined objective and subjective binge eating episodes, the 4-week frequency of days when at least 1 such episode occurred (only in BED), several aspects of eating disorder psychopathology (rated by the Eating Disorder Examination–Questionnaire), and comorbid depressive symptoms (rated by the 16-item Quick Inventory of Depressive Symptomatology [Self-Report]). Serum copper/zinc ratio decreased from 1.4 to 1.1 on average in both conditions. All patients had multiple zinc deficiency–related symptoms at baseline that substantially improved after polaprezinc treatment. Overall, the effectiveness of polaprezinc was greater in BED patients than in BN patients, with minor adverse effects.ConclusionsThese findings offer preliminary evidence for the effectiveness of polaprezinc in treating BED and BN and suggest the involvement of zinc deficiency in these conditions.