bluuebunny/crossref_metadata_2025_split huggingface dataset:
144 Characterizing the Pain Experience of Children with Acute Gastroenteritis Based on Identified Pathogens
Authors: Ma Keon , Ali Samina , Xie Jianling , Maki Claudia , Lee Bonita , Chui Linda , Pang Xiao-Li , Zhuo Ran , Parsons Brendon , Vanderkooi Otto G , Poonai Naveen , MacDonald Shannon E , Tarr Phillip , Freedman Stephen 
Published: October 2021

Abstract

Primary Subject area
Emergency Medicine - Paediatric

Background
Many children with acute gastroenteritis (AGE) experience moderate-to-severe pain. To date, the relationship between specific enteropathogens and pain intensity in children with AGE is poorly characterized.

Objectives
To describe pain severity experienced by children with AGE, by enteropathogen type (i.e., bacteria, virus, co-detection) during the 24 hours prior to emergency department (ED) presentation and while in the ED. We also sought to describe analgesic medication use in AGE.

Design/Methods
Children 0 to under 18 years with symptoms of AGE (vomiting and/or diarrhea, less than 7 days duration) were prospectively recruited in two pediatric EDs from December 2014 to August 2018. Rectal swabs and stool specimens were analyzed with a commercial enteric panel, an in-house viral panel, and standard enteric bacterial culture. Pain severity was reported by caregivers, with input from the child whenever possible, using a validated 11-point Verbal Numerical Rating Scale from 0 (no pain) to 10 (maximum pain).

Results
2686 children with AGE participated in the study. The overall maximal mean pain score was 5.50 (SD 3.00) during the 24 hours preceding the ED visit. Children with bacteria detected in their stool had a significantly higher mean pain score (difference: 1.10 [95% CI: 0.36, 1.84]) prior to ED visit and 1.32 (95% CI: 0.54, 2.10) while in the ED, compared to those with no pathogen identified. They also had significantly higher mean pain scores (difference: 1.10 [95%CI: 0.39, 1.81]) prior to ED visit and 1.44 (95%CI: 0.69, 2.20) while in the ED when compared to AGE caused by a single virus. Using a multivariable regression model, the association between pain severity and enteropathogen type was no longer demonstrated; however, longer illness duration (p=0.01), fever (p &lt; 0.0001), increased number of diarrheal (p &lt; 0.0001) and vomiting (p=0.03) episodes, and respiratory symptoms (p=0.03) were all associated with greater pain at home. Overall, analgesic use was low, with 41.6% (1117/2686) and 20.0% (538/2686) of participants receiving an analgesic at home and in the ED, respectively.

Conclusion
Enteropathogen type was not predictive of greater pain severity after adjustment for clinical symptoms (i.e., vomiting and diarrhea). The clinical constellation of symptoms accompanying any particular pathogen may differ between pathogens, and this clinical picture may play the greater role in pain experience. Analgesic use was low in children with this painful condition.
150 Osteoporosis Risk Factors in Children with Cerebral Palsy
Authors: Spenard Sarah , Rahman Arifur , Power Heather , O'Dea Jennifer , Ricci M Florencia 
Published: October 2021

Abstract

Primary Subject area
Complex Care

Background
Cerebral palsy (CP) is a common motor disability in children. Due to their medical complexity, children with CP are prone to osteoporosis, and consequently, fractures. The prevalence of osteoporosis and its risk factors are poorly understood within this population.

Objectives
To determine the prevalence and predictors of osteoporosis among a provincial cohort of Canadian children with CP.

Design/Methods
We performed a retrospective descriptive cohort study in a single Canadian tertiary care pediatric hospital. The medical charts of the 187 children with CP currently followed by the rehabilitation team were reviewed. Primary outcomes were indicators of osteoporosis, including vertebral compression fractures (VCF), long bone fractures and BMD Z-score. Osteoporosis risk factors, including medications, chronic or endocrine disorders linked to secondary osteoporosis, feeding method, and mobilization level (GMFCS), were collected. Two-tail p-values were calculated using the Chi-squared Person’s cumulative test.

Results
Of the 187 included children, the majority were male (59%) and were living in a rural area (62%). Seven (3.7%) individuals met diagnostic criteria for osteoporosis with a VCF without history of high-energy trauma or local disease. Of these, four were females and three were males. Osteoporosis risk factors are presented in Table 1. GMFCS, feeding method and medications linked to secondary osteoporosis had a significant statistical difference in the children diagnosed with a VCF compared to participants without osteoporosis diagnostic criteria.

Conclusion
3.7% of children followed by the provincial rehabilitation team have osteoporosis. This is one of the first studies that establishes the frequency of osteoporosis among a provincial cohort of Canadian children with CP. Mobilization level, feeding method and consumption of medications linked to secondary osteoporosis seem to be major risk factors for osteoporosis in children with CP. Larger prospective studies are needed to confirm this association, in order to improve prevention strategies.
153 Cost of Hospitalization in Infants with Hypoxic Ischemic Encephalopathy Treated with Therapeutic Hypothermia in a Quebec Tertiary Neonatal Intensive Care Unit and Validation of the Canadian Neonatal Network Costing Algorithm
Authors: Basfar Wijdan , Jabbour Elias 
Published: October 2021

Abstract

Primary Subject area
Neonatal-Perinatal Medicine

Background
Therapeutic hypothermia (TH) is the standard treatment for neonatal hypoxic ischemic encephalopathy (HIE) to improve mortality and long-term impairment. Accurate costing algorithms are essential to evaluate cost-effective interventions and identify cost drivers.

Objectives
We aimed to validate the Canadian Neonatal Network (CNN) costing algorithm for HIE infants treated with TH against costs obtained from hospital-based finance software (CPSS) and compare the costs of TH for infants with mild/moderate to those with severe HIE. We aimed to validate the Canadian Neonatal Network (CNN) costing algorithm for HIE infants treated with TH against costs obtained from hospital-based finance software (CPSS) and compare the costs of TH for infants with mild/moderate to those with severe HIE.

Design/Methods
Retrospective cohort study including 98 infants admitted with HIE and receiving TH in a tertiary NICU between 2016 and 2018. Clinical characteristics and CNN costing data were collected from the local CNN database and actual cost were obtained from CPSS. The primary outcome was the difference in total hospital stay cost between CNN algorithm and CPSS. The differences between both algorithms were also identified in 8 different cost centres such as nursing, respiratory, imaging, etc. Costs per patients using both algorithms were compared using Pearson correlation coefficient (r) and paired t-test. Characteristics and costs per infant were compared between infants with mild/moderate HIE and those with severe HIE.

Results
Among the 98 patients with HIE that received TH, 2 (2%) had mild HIE, 75 (77%) had moderate HIE and 21 (21%) had severe HIE on admission. Mortality rate was 10% (10/98) and median length of stay was 12 days [IQR 10-16]. Total mean cost per infant using the CNN algorithm was $32,727 (SD $23,751 and correlated highly to the CPSS mean $28.373(SD $28.989) (r=0.93, p&lt;0.01). There was no significant difference in mean total costs estimated between the algorithms ($1051, 95% CI $-1073, $3174). There was a strong correlation between cost estimates using the CNN algorithm and CPSS in nursing, physician, transfusion and indirect costs (r range 0.94-0.99) (Figure 1). Mean daily costs per infant with mild/moderate HIE ($1579, SD 808) were lower compared to infants with severe HIE ($2069, SD 1518). In both groups, daily costs were higher in the first days of hospitalization and slightly decreased over time (Figure 2).

Conclusion
The CNN algorithm accurately predicts hospital stay costs for infants diagnosed with HIE and received TH in our centre. Severity of encephalopathy and severity of illness are associated with higher hospital costs.
FIELD MEASUREMENT OF THE UNATTACHED FRACTION AND ACTIVITY CONCENTRATION RATIO OF RADON PROGENY IN TYPICAL DWELLINGS
Authors: Sun Changhao , Wang Yunxiang , Zhang Lei , Wang Hao , Guo Qiuju , Xiao Detao , Liang Juncheng , Wang Shanqiang 
Published: October 2021

Abstract
The unattached fraction (fp) and activity concentration ratio of radon progeny (${\boldsymbol C}_{{}{}^{\bf 218}\bf{Po}}:{\boldsymbol C}_{{}{}^{\bf 214}\bf{Pb}}:{\boldsymbol C}_{{}{}^{\bf 214}\bf{Bi}}$) are important for radon exposure dose evaluation. For getting these characteristic parameters in dwellings, a series of field measurement was carried out. For comparison, a semi-continuous measurement was carried out in an office room and outdoors. Results show that the average fp is 4.5% ± 2.2% and 3.8% ± 1.7% in city dwellings and in rural dwellings, respectively. The average activity concentration ratios are 1:0.94:0.70 for radon progeny and 1:0.07:0.06 for unattached radon progeny in city dwellings, while those in rural dwellings are 1:0.88:0.66 and 1:0.09:0.07. The average values of fp are 5.1% ± 0.9% and 5.4% ± 3.1% in the office room and in outdoors without significant difference. The average activity concentration ratios are 1:0.88:0.77 for radon progeny and 1:0.11:0.11 for unattached radon progeny in outdoors.
Associations of sleep measures with neural activations accompanying fear conditioning and extinction learning and memory in trauma-exposed individuals
Authors: Seo Jeehye , Oliver Katelyn I , Daffre Carolina , Moore Kylie N , Gazecki Samuel , Lasko Natasha B , Milad Mohammed R , Pace-Schott Edward F 
Published: October 2021

Abstract

Study Objectives
Sleep disturbances increase risk of posttraumatic stress disorder (PTSD). Sleep effects on extinction may contribute to such risk. Neural activations to fear extinction were examined in trauma-exposed participants and associated with sleep variables.

Methods
Individuals trauma-exposed within the past 2 years (N = 126, 63 PTSD) completed 2 weeks actigraphy and sleep diaries, three nights ambulatory polysomnography and a 2-day fMRI protocol with Fear-Conditioning, Extinction-Learning and, 24 h later, Extinction-Recall phases. Activations within the anterior cerebrum and regions of interest (ROI) were examined within the total, PTSD-diagnosed and trauma-exposed control (TEC) groups. Sleep variables were used to predict activations within groups and among total participants. Family wise error was controlled at p &lt; 0.05 using nonparametric analysis with 5,000 permutations.

Results
Initially, Fear Conditioning activated broad subcortical and cortical anterior-cerebral regions. Within-group analyses showed: (1) by end of Fear Conditioning activations decreased in TEC but not PTSD; (2) across Extinction Learning, TEC activated medial prefrontal areas associated with emotion regulation whereas PTSD did not; (3) beginning Extinction Recall, PTSD activated this emotion-regulatory region whereas TEC did not. However, the only between-group contrast reaching significance was greater activation of a hippocampal ROI in TEC at Extinction Recall. A greater number of sleep variables were associated with cortical activations in separate groups versus the entire sample and in PTSD versus TEC.

Conclusions
PTSD nonsignificantly delayed extinction learning relative to TEC possibly increasing vulnerability to pathological anxiety. The influence of sleep integrity on brain responses to threat and extinction may be greater in more symptomatic individuals.
Effect of rearing cross-fostered piglets in litters of differing size relative to sow functional teat number on preweaning growth and mortality
Authors: Vande Pol Katherine D , Bautista Raphael O , Olivo Alicia , Harper Heath , Shull Caleb M , Brown Catherine B , Ellis Michael 
Published: October 2021

Abstract
Litter sizes of commercial sows have increased considerably over recent decades, and often exceed the number of functional teats on the sow. The objective of this study was to evaluate the effect of litter size after cross-fostering relative to sow functional teat number on piglet preweaning growth and mortality. A total of 39 litters (561 piglets) were used in a randomized complete block design; blocking factors were farrowing day and sow parity, body condition score, and functional teat number. Three Litter Size treatments were compared (relative to sow functional teat number): Decreased (two piglets less); Control (same number of piglets); Increased (two piglets more). Piglets were randomly allotted to treatment at 24 h after birth to form litters of the appropriate size, with similar mean and CV of birth weight within block. Weaning weights (WW) were collected at 19.5 ± 0.50 d of age; preweaning mortality (PWM) was recorded. Litter sizes were between 11 and 17 piglets, depending on block and treatment. The Decreased treatment had lower (P ≤ 0.05) PWM than the Increased (7.7% and 17.9%, respectively); the Control was intermediate (11.5%) and not different (P &gt; 0.05) from the other treatments. The rate of decline in litter size from birth to weaning was greater (P ≤ 0.05) for the Increased than the Decreased treatment (−0.16 vs. −0.05 piglets per day), with the Control (−0.09 piglets per day) being intermediate and different (P ≤ 0.05) to the other two treatments. Litter sizes at weaning were greater (P ≤ 0.05) for the Increased than the Decreased treatment (13.3 and 11.3, respectively); the Control treatment was intermediate (12.6) and not different (P &gt; 0.05) to the other treatments. The log odds of PWM increased with the decreasing birth weight, at a similar rate (P &gt; 0.05) for all Litter Size treatments. However, the intercept was greater (P ≤ 0.05) for the Increased compared with the Decreased treatment; the Control was intermediate and different (P &gt; 0.05) to the other two treatments. Mean WW tended (P = 0.07) to be greater for the Decreased (6.17 kg) compared to the Control and Increased treatments (5.86 and 5.84 kg, respectively). In conclusion, increasing litter size after cross-fostering relative to the number of functional teats of the sow increased piglet PWM, and tended to decrease WW.
A mixed-methods study to test a tailored coaching program for health researchers to manage stress and achieve work-life balance
Authors: Steketee Abby , Chen Susan , Nelson Rachel A , Kraak Vivica I , Harden Samantha M 
Published: October 2021

Abstract
Dissemination and implementation (D&I) researchers serve critical scientific, practical, and personal roles in translating science to public health benefit. However, they face multifaceted barriers that may erode their capacity to plan, lead, and evaluate implementation. Individualized coaching focused on human flourishing is an unexplored approach to fully actualize D&I researchers’ capacity to bridge the research-practice gap. The purpose of this exploratory pilot study was to investigate a tailored coaching program to support human flourishing among D&I researchers. A pragmatic, mixed-methods approach guided by the RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) Framework was used to evaluate an individualized, nine session coaching program called FUEL (Focus, Unplug, Exercise, Love). Reach and Implementation were assessed through descriptive statistics and rapid qualitative analysis of surveys and coaching logs. Effectiveness and Maintenance were assessed through descriptive statistics and iterative content analysis of participant surveys, as well as iterative content analysis of proxy (e.g., colleague) semi-structured interviews. Reach results indicated that demand for coaching exceeded study enrollment capacity (n = 16 participants). Implementation results showed that the coach spent 12.96 ± 2.82 hr per participant over 3 months. Effectiveness and Maintenance results indicated that FUEL was well-received and provided participants with myriad psychological and professional benefits. Preliminary evidence suggests that the FUEL coaching program is a promising and feasible approach to enhance flourishing among D&I researchers. Future research is needed to evaluate Adoption and scalability. This pilot study may inform future D&I capacity-building initiatives that address researchers’ holistic situatedness within the implementation process.
Experimental study on the effect of canyon cross wind on temperature distribution of buoyancy-induced smoke layer in tunnel fires
Authors: Fan Chuangang , Yang Liliang , Luan Dia , Chen Tao , Jiao Ao , Ouyang Richeng , Wang Juan , Chen Changkun 
Published: October 2021

Abstract
Experiments were conducted in a 1:20 arced tunnel model to investigate the effect of canyon cross wind on buoyancy-induced smoke flow characteristics of pool fires, involving smoke movement behaviour and longitudinal temperature distribution of smoke layer. The canyon wind speed, longitudinal fire location and fire size were varied. Results show that there are two special smoke behaviours with the fire source positioned at different flow field zones. When the fire source is positioned at the negative pressure zone, with increasing canyon wind speed, the smoke always exists upstream mainly due to the vortex, and the smoke temperature near the fire source increases first and then decreases. However, when the fire source is located in the transition zone and the unidirectional flow zone, there is no smoke appearing upstream with a certain canyon wind speed. Meanwhile, the smoke temperature near the fire sources are decreases with increasing canyon wind speed. The dimensionless temperature rise of the smoke layer ΔTs* along the longitudinal direction of the tunnel follows a good exponential decay. As the canyon wind speed increases, the longitudinal decay rate of ΔTs* decreases. The longitudinal decay rate of ΔTs* downstream of the fire is related to the fire location and canyon wind speed, and independent of the fire size. The empirical correlations for predicting the longitudinal decay of ΔTs* downstream of the fire are established. For a relatively large-scale fire, the longitudinal decay rate of ΔTs* upstream of the fire increases as the distance between the fire source and the upstream portal increases, especially for larger canyon wind speeds.
Retired High-Flyers: Exploring the Impact of Accomplishment on Well-being in Retired Female CEOs
Authors: Kronsbein Kristiane , Belovski Meggy , Burke Jolanta 
Published: October 2021

AbstractWhile literature about the relationship between well-being and accomplishment exists, previous studies were mainly quantitative and neglected the subjective experience of female retirees, which the current study aimed to address. Three female retired charity CEOs based in the United Kingdom were interviewed using in-depth, semi-structured interviews. The interpretative phenomenological analysis yielded 3 themes: (1) “accomplishment and well-being—a potentially negative interaction,” (2) “accomplishment and well-being—a positive link through interaction with other well-being domains,” and (3) “retirement—a moderator for negative direct impacts.” The results provided a complex picture of how high-achieving women postretirement perceived accomplishment as a contributor to their well-being. By highlighting an intricate link between accomplishment and other domains of well-being, particularly positive relationships, the findings critique that positive psychology overemphasizes the individual and highlight the need for further research into the interaction between different domains of well-being. The study also contributes to the debate about the relationship between age and well-being by illuminating the individuality of the experience depending on circumstances and environment. Finally, discussed are the implications of the current study in the context of retired high-fliers.
Two rTMS sessions per week: a practical approach for treating major depressive disorder
Authors: Armas-Castañeda Gabriela , Ricardo-Garcell Josefina , Reyes Julian V. , Heinze Gerhard , Salín Rafael J , González Jorge J. 
Published: October 2021

Introduction
Depression is one of the leading causes of disability in the world, and a disease that contributes greatly to the global burden of disease. Repetitive transcranial magnetic stimulation (rTMS) has proven to be a well-tolerated, effective treatment for depression. The present study was designed to evaluate the efficacy of an rTMS treatment scheme with a fewer number of sessions per week.

Methods
In total 91 adult university students with major depressive disorder (MDD). This was a double-blind, randomized clinical trial in which 15 sessions of rTMS were given to each one of two treatment groups made up of adults with active MDD. One treatment group received two sessions per week, the other received five. The study protocol included their respective sham rTMS groups. The patients who received active rTMS also participated in a follow-up procedure that consisted of two sessions of active rTMS per month for three more months.

Results
Measurements by the Hamilton Rating Scale for Depression (HAMD) showed that the groups which received active rTMS had higher percentages of antidepressant response at 96 and 95.5% for five and two sessions/week, respectively, compared to the sham rTMS groups: 27.3 and 4.5% for five and two sessions/week, respectively. Observations at the end of the 3-month follow-up phase showed that the improvements in HAMD scores were maintained in both groups.

Conclusion
This study contributes to demonstrating that rTMS with a more practical schedule of two sessions/week is an effective antidepressant treatment that could be considered the first choice for managing symptoms of depression.
Bi-allelic variants in CHKA cause a neurodevelopmental disorder with epilepsy and microcephaly
Authors: Klöckner Chiara , Fernandez Murray J. Pedro , Tavasoli Mahtab , Sticht Heinrich , Stoltenburg-Didinger Gisela , Scholle Leila Motlagh , Bakhtiari Somayeh , Kruer Michael C. , Darvish Hossein , Firouzabadi Saghar Ghasemi , Pagnozzi Alex , Shukla Anju , Girisha Katta Mohan , Narayanan Dhanya Lakshmi , Kaur Parneet , Maroofian Reza , Zaki Maha S. , Noureldeen Mahmoud M. , Merkenschlager Andreas , Gburek-Augustat Janina , Cali Elisa , Banu Selina , Nahar Kamrun , Efthymiou Stephanie , Houlden Henry , Jamra Rami Abou , Williams Jason , McMaster Christopher R. , Platzer Konrad 
Published: October 2021

AbstractThe Kennedy pathways catalyze the de novo synthesis of phosphatidylcholine and phosphatidylethanolamine, the most abundant components of eukaryotic cell membranes. In recent years, these pathways have moved into clinical focus since four out of ten genes involved have been associated with a range of autosomal recessive rare diseases such as a neurodevelopmental disorder with muscular dystrophy (CHKB), bone abnormalities and cone-rod dystrophy (PCYT1A), and spastic paraplegia (PCYT2, SELENOI).We identified six individuals from five families with bi-allelic variants in CHKA presenting with severe global developmental delay, epilepsy, movement disorders, and microcephaly. Using structural molecular modeling and functional testing of the variants in a in a cell-based S. cerevisiae model, we determined that these variants reduce the enzymatic activity of CHKA and confer a significant impairment of the first enzymatic step of the Kennedy pathway.In summary, we present CHKA as a novel autosomal recessive gene for a neurodevelopmental disorder with epilepsy and microcephaly.