bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors and Growth Trends Associated With the Need for Gastrostomy Tube in Neonates With Congenital Diaphragmatic Hernia
Authors: Schwab Marisa E. , Burke Shannon , Klarich Mary Kate , Vu Lan T. 
Published: June 2021

ABSTRACT

Objectives:
A third of infants with congenital diaphragmatic hernia (CDH) require a gastrostomy tube (GT) for nutritional support. We compared CDH infants who are GT-dependent to those able to meet their nutritional needs orally, to identify factors associated with requiring a GT and evaluate their long-term growth.

Methods:
Patients with CDH repaired at a single institution between 2012 and 2020 were included. Charts were retrospectively reviewed for demographic, surgical, and post-operative details. Mann-Whitney test and Fischer exact test were performed to compare GT-dependent neonates (n = 38, experimental) with orally fed neonates (n = 63, control). Significance was set at <0.05.

Results:
Thirty-eight percent received a GT (median 67 days, interquartile range [IQR] 50–88). GT-dependent neonates were significantly more likely to have a lower lung-to-head ratio (median 1.2, IQR 0.9–1.4, vs 1.6, IQR 1.3–2.0, IQR P < 0.0001), undergone patch or flap repair (79% vs 33%, P < 0.0001), and been hospitalized longer (median 47, IQR 24–75 vs 28 days, P < 0.0001). Fourteen of 38 had their GT removed (median 26 months, IQR 14–36). GT-dependent neonates initiated oral feeds (calculated as time since extubation) later (median 21, IQR 8–26, vs 8 days, IQR 4–13, P = 0.006). Height-for-age z scores remained stable after GT removal, while weight-for-age z scores dropped initially and began improving a year later.

Conclusions:
The need for a gastrostomy for nutritional support is associated with more severe CDH. Over a third of patients no longer needed a GT at a median of 26 months. Linear growth generally remains stable after removal. These results may help counsel parents regarding nutritional expectations.
Mixed Methods Study of Nurse Assessment of Patient Preferences for Engagement During Hospitalization
Authors: Jerofke-Owen Teresa A. , Zielinski Alexandria , Brown Roger L. 
Published: June 2021

Background
Global healthcare initiatives emphasize the importance of engaging patients in their healthcare to improve patients’ experience and outcomes. Assessing patient preferences for engagement is critical, as there are many ways patients can engage in their care and preferences vary across individuals.

Objective
The primary purpose of this study was to evaluate the effect of implementation of the Patient Preferences for Engagement Tool 13-Item Short Form (PPET13) during hospitalization on patient and nurse experience of engagement. Readmissions and emergency department (ED) usage within 30 days postdischarge were also examined.

Methods
The mixed methods study was conducted within two medical units in the United States between December 2018 and May 2019. Preimplementation group patients completed a demographic survey and the Patient Experience of Engagement Survey (PEES) on discharge. Implementation group patients completed the PPET13 within 24 hours of admission with their nurse and the demographic survey and PEES on discharge. A focus group with nurses who implemented the PPET13 was conducted following the implementation period. Data analysis included confirmatory factor analysis, multiple and logistic regression, and qualitative content analysis.

Results
There was significant improvement in PEES scores during the implementation phase. The PEES score was a significant predictor of ED visits, but not 30-day readmissions. Nurses were not always certain how to best integrate patient preferences for engagement into their care delivery and suggested integrating the PPET13 into the electronic health record to assist with streamlining the assessment and communicating preferences across the care team.

Discussion
Assessing patients’ preferences for engagement using the PPET13 was associated with an improved experience of engagement, which was found to mediate the relationship between utilization of PPET13 and ED usage within 30 days postdischarge. Use of a patient engagement preference tool, such as the PPET13, can help inform the delivery of individualized engagement strategies to improve patient and family engagement and outcomes; however, nurses need formalized education on how to tailor their care to meet the individual engagement preferences of their patients.
Bacterial Vaginosis and Alcohol Consumption: A Cross-Sectional Retrospective Study in Baltimore, Maryland
Authors: Froehle Leah , Ghanem Khalil G. , Page Kathleen , Hutton Heidi E. , Chander Geetanjali , Hamill Matthew M. , Gilliams Elizabeth , Tuddenham Susan 
Published: June 2021

Background
Bacterial vaginosis (BV) is the most cited cause of vaginal complaints among women of reproductive age. Its etiology and associated risk factors are not entirely understood. Here we examined the association between BV and at-risk alcohol consumption in women attending 2 sexually transmitted infection (STI) clinics in Baltimore, MD.

Methods
This was a retrospective cross-sectional analysis using data from first clinic visits from 2011–2016. At-risk alcohol use was defined as heavy episodic (“binge”) drinking within the last 30 days or a self-report of having had vaginal or anal sex in the context of alcohol consumption. Pearson χ2 test and Student t test were used to assess baseline associations. Log binomial models were used to estimate prevalence ratios (PRs) before and after adjustments for potential confounding factors.

Results
Of the 10,991 women included in the analysis, 2173 (19.7%) met the clinical diagnostic criteria for BV. Having had vaginal or anal sex in the context of alcohol consumption was associated with an increased risk of BV (PR, 1.25; 95% confidence interval, 1.13–1.37), as was binge drinking (PR, 1.15; 95% confidence interval, 1.04–1.27) after adjustment for confounders.

Conclusions
In this population, at-risk alcohol consumption was associated with an increased risk of BV. The mechanisms remain uncertain. Future prospective studies are needed to verify and evaluate causality in these associations.
Hands-On Workshops Improve Emergency Department Physicians' Self-Reported Understanding of Pediatric Hand Injuries
Authors: Market Marisa , Zhu-Pawlowsky Julia , Bhatt Maala , Cheung Kevin 
Published: June 2021

Objectives
The aims of this study were to assess emergency department (ED) physician perception of hand injuries and improve their understanding and confidence in treating these injuries.

Methods
Combined didactic and hands-on workshops for ED physicians were developed and run by a team of medical students, plastic surgeons, and ED physicians. The workshops consisted of a short review by a hand surgeon followed by hands-on sessions involving radiograph assessment, administration of local anesthetic, closed reduction, and splinting. Two sessions, 6 months apart, were provided. The workshops were evaluated using preworkshop and postworkshop questionnaires to assess the following domains: confidence and competence in treating hand injuries, knowledge of basic hand injury care, and feedback on the intervention itself.

Results
Fifty physicians participated in the workshops. After the workshops, physician recognition of hand fracture reduction as a critical skill increased. Self-efficacy ratings of fracture assessment, administration of local anesthetic, performing a reduction, and applying postreduction immobilization increased. Median scores on knowledge-testing questions also increased postintervention from 73.3% (95% confidence interval, 70.2–78.5) to 86.7% (95% confidence interval, 79.3–86.2) (P < 0.05). Finally, physicians reported that they found the intervention educational, useful, and important, and approximately 90% of participants indicated they intended to change their practice based on this intervention.

Conclusions
Knowledge sharing between specialists and generalists through combined didactic and hands-on workshops is an effective and well-received method of refining physician knowledge and increasing confidence in treating subspecialty-specific clinical presentations.
Point-of-Care Ultrasound to Evaluate the Acute Abdomen
Authors: Malik Rabia , Leviter Julie , Gross Isabel , Saluja Saurabh , Cowles Robert A. , Riera Antonio 
Published: June 2021

Abstract
We report the case of a 3-year-old boy who presented to the pediatric emergency department in undifferentiated shock with an acute abdomen. Point-of-care ultrasound revealed viscous perforation with a large amount of free fluid. Intraoperatively, a single magnet was discovered as the likely cause of bowel perforation and the resulting state of shock.
Pediatric Ocular Injury Due to Hand Sanitizer Exposure
Authors: Wasser Lauren M. , Koppel Jordanna H. , Zadok David , Berkowitz Liron , Abulafia Adi , Heiman Eyal , Aryan Ahmad , Roditi Eduardo , Weill Yishay 
Published: June 2021

Objectives
The objective of this study was to describe the incidence and severity of ocular exposure to alcohol-based hand rub (ABHR) in children presenting to a tertiary medical center during the severe acute respiratory syndrome coronavirus 2 pandemic.

Methods
A retrospective single-center observational study conducted from February 21, 2020, to October 11, 2020. Subjects 10 years or younger who presented with ABHR-induced ocular injury were included. The same period from 2019 was studied and a comparison was performed between the 2 years. Outcome measures included the number of subjects with ocular injury due to ABHR, extent of ocular epithelial defects, length of hospitalization and time to resolution.

Results
A total of 9 patients presented to the Pediatric Emergency Department after sustaining ocular chemical injuries from ABHR during this period. Treatment included immediate irrigation followed by topical antibiotics, steroids, and lubrication. Six children were discharged and followed as outpatients with no reported adverse ocular sequelae. Three patients exhibited epithelial defects involving 85% to 100% of the cornea, 30% to 75% of the conjunctiva and required inpatient treatment ranging from 4 to 11 days. All patients experienced a complete resolution of the ocular epithelial defects after 12 to 19 days. No long-term irreversible damage was observed and visual acuity returned to normal in all patients.

Conclusions
The utilization of ABHR during the severe acute respiratory syndrome coronavirus 2 pandemic resulted in childhood ocular injury. Prompt treatment led to good visual outcomes. These products should be regarded as potentially toxic and stored out of the reach of young children.
Single Versus Double-Sided Hypotheses and Probabilities
Authors: Murata Michelle A. , Yamamoto Loren G. 
Published: June 2021

Single-sided (1-tailed) and double-sided (2-tailed) probabilities are products of statistical tests that can be crucial to drawing accurate conclusions in scientific studies. In a review of articles published in issues of Pediatric Emergency Care from 2020, we identified 2 where single-sided versus double-sided probability issues potentially reversed a conclusion of study investigators. The purpose of this study is to describe single-sided versus double-sided probability issues found in Pediatric Emergency Care 2020 articles to increase awareness surrounding these issues.

Methods
This study involved a review of all articles from 2020 issues of the Pediatric Emergency Care journal, examining whether P values between and including the values 0.05 and 0.10, were characterized as not significant when, in fact, they resulted from a double-sided test and arguably should have been halved to yield significant single-sided probabilities less than or equal to 0.05.

Results
Two such studies were identified. In the first study, researchers concluded that their intervention resulted in “no statistically significant improvement,” citing a P value of 0.08, but if a single-sided P value was used, it would have been 0.04 and the authors would have instead concluded that their intervention resulted in significant improvement. In the second study, researchers measured resuscitation times in pediatric and adult manikin simulations. They concluded no difference, citing a P value of 0.088, but if a single-sided P value was used, it would have been 0.044, and the authors would have instead concluded that the resuscitation times took longer in the pediatric simulation.

Conclusions
These articles demonstrate how single-sided versus double-sided probability issues can cause researchers to draw inaccurate conclusions. As such, we would urge that this be more rigorously evaluated when the P values are between 0.05 and 0.10.
Distinct Basal Brain Functional Activity and Connectivity in the Emotional-Arousal Network and Thalamus in Patients With Functional Constipation Associated With Anxiety and/or Depressive Disorders
Authors: Li Guanya , Zhang Wenchao , Hu Yang , Wang Jia , Li Jingyuan , Jia Zhenzhen , Zhang Lei , Sun Lijuan , von Deneen Karen M. , Duan Shijun , Wang Huaning , Wu Kaichun , Fan Daiming , Cui Guangbin , Zhang Yi , Nie Yongzhan 
Published: June 2021

ABSTRACT

Objective
Functional constipation (FC) is a common gastrointestinal disorder. Anxiety and/or depressive disorders are common in patients with FC (FCAD). Brain dysfunction may play a role in FC, but the contribution of comorbid anxiety and/or depression in patients with FC is poorly understood.

Methods
Sixty-five FC patients and 42 healthy controls (HCs) were recruited, and a hierarchical clustering algorithm was used to classify FC patients into FCAD and patients without anxiety/depressive status (FCNAD) based on neuropsychological assessment. Resting-state functional magnetic resonance imaging measures including fractional amplitude of low-frequency fluctuation (fALFF) and functional connectivity were used to investigate brain functional differences.

Results
Thirty-seven patients were classified as FCAD, and 28 patients were classified as FCNAD; as compared with HC, both groups showed decreased activity (fALFF) in the perigenual anterior cingulate cortex (pACC), dorsomedial prefrontal cortex (DMPFC), and precuneus; enhanced precentral gyrus–thalamus connectivity and attenuated precuneus-thalamus connectivity in FCAD/FCNAD highlighted the thalamus as a critical connectivity node in the brain network (p
FWE < .05). In comparison with FCNAD/HC, the FCAD group also had decreased fALFF in the orbitofrontal cortex (OFC) and thalamus, and increased OFC-hippocampus connectivity. In the FCNAD group, brain activities (pACC/DMPFC) and connection (precuneus-thalamus) had correlations only with symptoms; in the FCAD group, brain activities (OFC, pACC/DMPFC) and connectivities (OFC-hippocampus/precentral gyrus–thalamus) showed correlations with both constipation symptoms and anxiety/depressive status ratings. Mediation analysis indicated that the relationship between abdominal distension and OFC activity was completely mediated by anxiety in FCAD.

Conclusions
These findings provide evidence of differences in brain activity and functional connectivity between FCAD and FCNAD, potentially providing important clues for improving treatment strategies.
Mindfulness and More: Toward a Science of Human Flourishing
Authors: Davidson Richard J. 
Published: June 2021

ABSTRACT
This commentary for this Special Issue on mindfulness highlights the progress and maturity of this growing field of scientific investigation and points the way toward important questions that require further study. Important methodological and implementation issues including the nature of proper comparison groups, the extension of mindfulness-based interventions to underserved populations, the assessment of baseline characteristics that predict beneficial outcomes, and how mindfulness might be combined with other health-promoting activities such as physical exercise are considered. New questions for future research were also showcased, including best practices for mobile interventions, the development and assessment of microinterventions, and the need for a more expansive framework to cultivate human flourishing. The learning of well-being is conceptualized as an urgent public health need that will require new approaches for global scaling.
What Is the Burden of Heterosexually Acquired HIV Due to HSV-2? Global and Regional Model-Based Estimates of the Proportion and Number of HIV Infections Attributable to HSV-2 Infection
Authors: Silhol Romain , Coupland Helen , Baggaley Rebecca F. , Miller Lori , Staadegaard Lisa , Gottlieb Sami L. , Stannah James , Turner Katherine M. E. , Vickerman Peter , Hayes Richard , Mayaud Philippe , Looker Katharine J. , Boily Marie-Claude 
Published: June 2021

Background:Biological and epidemiological evidence suggest that herpes simplex virus type 2 (HSV-2) elevates HIV acquisition and transmission risks. We improved previous estimates of the contribution of HSV-2 to HIV infections by using a dynamic transmission model.Setting:World Health Organization regions.Methods:We developed a mathematical model of HSV-2/HIV transmission among 15- to 49-year-old heterosexual, non–drug-injecting populations, calibrated using region-specific demographic and HSV-2/HIV epidemiological data. We derived global and regional estimates of the contribution of HSV-2 to HIV infection over 10 years [the transmission population-attributable fraction (tPAF)] under 3 additive scenarios, assuming: (1) HSV-2 increases only HIV acquisition risk (conservative); (2) HSV-2 also increases HIV transmission risk (liberal); and (3) HIV or antiretroviral therapy (ART) also modifies HSV-2 transmission risk, and HSV-2 decreases ART effect on HIV transmission risk (fully liberal).Results:Under the conservative scenario, the predicted tPAF was 37.3% (95% uncertainty interval: 33.4%–43.2%), and an estimated 5.6 (4.5–7.0) million incident heterosexual HIV infections were due to HSV-2 globally over 2009–2018. The contribution of HSV-2 to HIV infections was largest for the African region [tPAF = 42.6% (38.0%–51.2%)] and lowest for the European region [tPAF = 11.2% (7.9%–13.8%)]. The tPAF was higher among female sex workers, their clients, and older populations, reflecting their higher HSV-2 prevalence. The tPAF was approximately 50% and 1.3- to 2.4-fold higher for the liberal or fully liberal scenario than the conservative scenario across regions.Conclusion:HSV-2 may have contributed to at least 37% of incident HIV infections in the past decade worldwide, and even more in Africa, and may continue to do so despite increased ART access unless future improved HSV-2 control measures, such as vaccines, become available.
Multidrug-resistant, gram-negative infections in high-risk haematologic patients: an update on epidemiology, diagnosis and treatment
Authors: Garcia-Vidal Carolina , Stern Anat , Gudiol Carlota 
Published: June 2021

Purpose of review
Multidrug-resistant Gram-negative bacilli (MDR-GNB) infections are a significant cause of morbidity and mortality in high-risk hematologic patients. Early diagnosis and management of antibiotic treatment in these patients is a challenge for physicians. This review focuses on the latest literature reports that concern the epidemiology, diagnosis and treatment of MDR-GNB infections in this population.

Recent findings
High-risk haematological patients have several risk factors that make them particularly susceptible to MDR-GNB infections. Few studies have examined the implementation of rapid diagnostic methods for multidrug resistance, and their impact on management in this population. Inappropriate empiric antibiotic treatment in these patients has been described frequently and is associated with poor outcomes.

Summary
Knowledge of the local epidemiology of MDR-GNB is a basic requirement to guide empiric antibiotic treatments in each centre. New diagnosic tests might help in faster identification of MDR-GNB infections. Appropriate empiric antibiotic treatment is crucial for improving patients’ prognosis. Important strategies to reduce inadequate antibiotic treatment include better risk stratification for MDR-GNB infection and the introduction of new, more broad-spectrum antibiotic therapies
Employment as a Plastic Surgeon
Authors: Davis Matthew J. , Luu Bryan C. , Cole Samuel H. , Abu-Ghname Amjed , Winocour Sebastian , Reece Edward M. 
Published: June 2021

Abstract
Intrinsic to the field of plastic surgery, constant changes in health care policy, consumer demands, and medical technology necessitate periodic evaluation of trends in employment over time. In this article, we review the existing literature to report the current state of plastic surgery employment in the United States with regards to compensation, practice patterns, subspecialty trends, contract negotiation, representation of women in the field of plastic surgery, burnout and job satisfaction, and retirement. Understanding how the plastic surgery job market is changing not only serves as a valuable tool for the individual plastic surgeon regarding the navigation of his or her own career but also offers insight into the future of the field as a whole.
Pediatric Trigger Digit Presenting in the Setting of Trauma
Authors: Tadisina Kashyap Komarraju , Francoisse Caitlin A. , Frojo Gianfranco , Gorski John , Plikaitis Christina Marie 
Published: June 2021

Background
Pediatric trigger digit is a relatively rare condition with incompletely understood etiology. In our practice, we noted a series of children presenting with pediatric trigger digit after an associated local trauma to the hand, which has not been previously described. The aim of this study was to analyze the nature of presentation of trigger digits, the accuracy of initial diagnosis, and the impact on treatment strategies used.

Methods
An institutional review board–approved retrospective review of our institution's experience with pediatric trigger finger from 2001 to 2015 was performed.

Results
Twenty-two patients with 26 affected digits were identified. Eighty-eight percent of patients were diagnosed with trigger thumb, whereas 3 patients (12%) had small finger triggering. Thirteen patients (59%) presented as outpatients, whereas 9 (41%) presented through the emergency department. All patients presenting to the emergency department were in the setting of recent minor trauma. Of this subset of patients, 67% had an incorrect initial diagnosis, leading to an average delay in treatment of 60 days. Ten patients (45% of total) were initially treated with immobilization versus surgical release of the A1 pulley. However, all but 2 of these patients required eventual A1 pulley release for persistent or recurrent triggering (88%).

Conclusions
The cause of trigger digit in children remains incompletely understood and may be multifactorial. In this series, a traumatic component to presentation was found in a significant number of patients. This association with minor trauma may contribute to misdiagnosis and delay in definitive treatment. Although initial treatment with immobilization does not seem to impact surgical outcome, we found a high rate of failure with initial immobilization. Most patients required eventual surgical management, regardless of whether or not the initial presentation was associated with trauma. When performed, we found that A1 pulley release alone has safe, reliable results.