bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fecal Microbiome Transplantation for Recurrent Clostridioides difficile Infection: Treatment Efficacy, Short and Long-term Follow-up Results from Consecutive Case Series
Authors: Urbonas Tadas , Ianiro Gianluca , Gedgaudas Rolandas , Sabanas Povilas , Urba Mindaugas , Kiudelis Vytautas , Kiudelis Gediminas , Petkevicius Vytenis , Vitkauskiene Astra , Cammarota Giovanni , Gasbarrini Antonio , Kupcinskas Juozas 
Published: November 2021

Background and Aims: Many studies have shown a high effectiveness of fecal microbiota transplantation (FMT) in treatment of recurrent or refractory Clostridioides difficile infection (CDI). Nevertheless, data on long term outcomes and complications after FMT are still lacking. We aimed to evaluate the efficacy, the peri- procedural safety profile and the long-term efficacy and safety of FMT for recurrent CDI during a median follow up period of 24 months.
Methods: Our study included 60 consecutive patients that were treated from 2015 to 2019 for recurrent CDI. In all patients FMT was performed through the nasoenteric tube placed during gastroscopy. Fresh donor feces were used for FMT from unrelated donors. Pre-FMT preparation included CDI treatment with oral vancomycin 500 mg q.i.d. for at least five days and proton pump inhibitor (PPI) administration before FMT. Follow up data included information about recurrent CDI episodes, early and late complications, health status at 3, 12 and 24 months after FMT.
Results: FMT was performed for 60 patients (median age 72.5 years) with recurrent CDI. Clinical improvement after the first FMT procedure was observed in 48 patients (80%). Ten of 12 initially non-responding patients had a clinical resolution after a second FMT leading to an increased overall cure rate of 96.7 %. The remaining two patients needed a third FMT with a final overall cure rate of 100%. Nine of 60 patients were under immunosuppressive therapy. Six immunosuppressed patients were in the group of initial responders and the remaining three in the initially non-responder group. We observed a very low rate of adverse events in the short and long-term after FMT. During the first eight weeks after the FMT procedure, the death of three patients occurred, but they were not related to the FMT procedure. Patients were followed up for a median of 20 months, with the range from 12 to 55 months. During the follow-up period no long-term serious adverse events (SAE) were documented.
Conclusions: Our study confirms excellent efficacy rates of FMT in the treatment of recurrent CDI. In addition, this study shows that it is possible to avoid short term SAE when FMT is administered via a nasoenteric tube by following a very stringent peri-procedural patient follow-up protocol. Our study also demonstrates good safety with a low rate of long-term adverse events after FMT.
Coding for Pediatrics 2017, 22nd Ed
Authors:   AAP Committee on Coding and Nomenclature
Published: November 2021

Code it right the first time - and minimize claim denials and payment delays with today's most trusted pediatric coding and documentation guide. For beginners and advanced coders alike, this is the first place to look for pediatric-specific coding solutions! A widely used AAP exclusive, Coding for Pediatrics complements standard coding manuals with proven pediatric-specific documentation and billing solutions.
This year's completely updated 22nd edition features updates from both CPT and ICD-10-CM most relevant to pediatrics to provide specific examples and guidance on how to implement the new codes. Some new and revised services under CPT include parent/caregiver health risk assessment and moderate sedation. The book's many clinical vignettes, as well as the many coding pearls included throughout, provide added guidance needed to ensure accuracy and maximize payment.
In addition to revised CPT codes, new and updated features in this edition include
New chapter providing information on coding for services by allied health professionals in the physician practice
New chapter focused on coding for management of chronic and complex medical conditions
More examples of coding for preventive services recommended by Bright Futures
Coding quiz (approved for American Academy of Professional Coders (AAPC) for 4 continuing education units)
E-Cigarettes and Future Cigarette Use
Authors: Barrington-Trimis Jessica L. , Urman Robert , Berhane Kiros , Unger Jennifer B. , Cruz Tess Boley , Pentz Mary Ann , Samet Jonathan M. , Leventhal Adam M. , McConnell Rob 
Published: November 2021

BACKGROUND
There has been little research examining whether e-cigarette use increases the risk of cigarette initiation among adolescents in the transition to adulthood when the sale of cigarettes becomes legal.

METHODS
The Children’s Health Study is a prospectively followed cohort in Southern California. Data on e-cigarette use were collected in 11th and 12th grade (mean age = 17.4); follow-up data on tobacco product use were collected an average of 16 months later from never-smoking e-cigarette users at initial evaluation (n = 146) and from a sample of never-smoking, never e-cigarette users (n = 152) frequency matched to e-cigarette users on gender, ethnicity, and grade.

RESULTS
Cigarette initiation during follow-up was reported by 40.4% of e-cigarette users (n = 59) and 10.5% of never users (n = 16). E-cigarette users had 6.17 times (95% confidence interval: 3.30–11.6) the odds of initiating cigarettes as never e-cigarette users. Results were robust to adjustment for potential confounders and in analyses restricted to never users of any combustible tobacco product. Associations were stronger in adolescents with no intention of smoking at initial evaluation. E-cigarette users were also more likely to initiate use of any combustible product (odds ratio = 4.98; 95% confidence interval: 2.37–10.4), including hookah, cigars, or pipes.

CONCLUSIONS
E-cigarette use in never-smoking youth may increase risk of subsequent initiation of cigarettes and other combustible products during the transition to adulthood when the purchase of tobacco products becomes legal. Stronger associations in participants with no intention of smoking suggests that e-cigarette use was not simply a marker for individuals who would have gone on to smoke regardless of e-cigarette use.
Firearm Homicide and Other Causes of Death in Delinquents: A 16-Year Prospective Study
Authors: Teplin Linda A. , Jakubowski Jessica A. , Abram Karen M. , Olson Nichole D. , Stokes Marquita L. , Welty Leah J. 
Published: November 2021

BACKGROUND
Delinquent youth are at risk for early violent death after release from detention. However, few studies have examined risk factors for mortality. Previous investigations studied only serious offenders (a fraction of the juvenile justice population) and provided little data on females.

METHODS
The Northwestern Juvenile Project is a prospective longitudinal study of health needs and outcomes of a stratified random sample of 1829 youth (657 females, 1172 males; 524 Hispanic, 1005 African Amer-ican, 296 non-Hispanic white, 4 other race/ethnicity) detained between 1995 and 1998. Data on risk factors were drawn from interviews; death records were obtained up to 16 years after detention. We compared all-cause mortality rates and causes of death with those of the general population. Survival analyses were used to examine risk factors for mortality after youth leave detention.

RESULTS
Delinquent youth have higher mortality rates than the general population to age 29 years (P &lt; .05), irrespective of gender or race/ ethnicity. Females died at nearly 5 times the general population rate (P &lt; .05); Hispanic males and females died at 5 and 9 times the general population rates, respectively (P &lt; .05). Compared with the general population, significantly more delinquent youth died of homicide and its subcategory, homicide by firearm (P &lt; .05). Among delinquent youth, racial/ethnic minorities were at increased risk of homicide compared with non-Hispanic whites (P &lt; .05). Significant risk factors for external-cause mortality and homicide included drug dealing (up to 9 years later), alcohol use disorder, and gang membership (up to a decade later).

CONCLUSIONS
Delinquent youth are an identifiable target population to reduce disparities in early violent death.
Firearm Possession Among Adolescents Presenting to an Urban Emergency Department for Assault
Authors: Carter Patrick M. , Walton Maureen A. , Newton Manya F. , Clery Michael , Whiteside Lauren K. , Zimmerman Marc A. , Cunningham Rebecca M. 
Published: November 2021

BACKGROUND AND OBJECTIVES
Firearm violence is a leading cause of death among youth. The objectives of this study were (1) determine firearm possession rates and associated correlates among youth seeking care for assault in an emergency department (ED); (2) understand differences in risk factors for youth with firearm possession; and (3) identify firearm possession characteristics in this population: type, reason for possession, and source of firearms.

METHODS
Youth (14 to 24 years old) presenting to a Level 1 ED with assault were administered a computerized screening survey. Validated instruments were administered, measuring demographics, firearm rates and characteristics, attitudes toward aggression, substance use, and previous violence history.

RESULTS
Among 689 assault-injured youth, 23% reported firearm possession in the past 6 months. Only 17% of those reporting firearm possession obtained the gun from a legal source; 22% reported ownership of highly lethal automatic/semiautomatic weapons and 37.1% reported having a firearm for protection. Logistic regression analysis identified significant correlates of firearm possession, including male gender, higher socioeconomic status, illicit drug use, recent serious fight, and retaliatory attitudes.

CONCLUSIONS
ED assault-injured youth had high rates of firearm possession (23.1%), most of which were not obtained from legal sources. Youth with firearm possession were more likely to have been in a recent serious fight, and to endorse aggressive attitudes that increase their risk for retaliatory violence. Future prevention efforts should focus on minimizing illegal firearm access among high-risk youth, nonviolent alternatives to retaliatory violence, and substance use prevention.
Firearm Violence Among High-Risk Emergency Department Youth After an Assault Injury
Authors: Carter Patrick M. , Walton Maureen A. , Roehler Douglas R. , Goldstick Jason , Zimmerman Marc A. , Blow Frederic C. , Cunningham Rebecca M. 
Published: November 2021

BACKGROUND
The risk for firearm violence among high-risk youth after treatment for an assault is unknown.

METHODS
In this 2-year prospective cohort study, data were analyzed from a consecutive sample of 14- to 24-year-olds with drug use in the past 6 months seeking assault-injury care (AIG) at an urban level 1 emergency department (ED) compared with a proportionally sampled comparison group (CG) of drug-using nonassaulted youth. Validated measures were administered at baseline and follow-up (6, 12, 18, 24 months).

RESULTS
A total of 349 AIG and 250 CG youth were followed for 24 months. During the follow-up period, 59% of the AIG reported firearm violence, a 40% higher risk than was observed among the CG (59.0% vs. 42.5%; relative risk [RR] = 1.39). Among those reporting firearm violence, 31.7% reported aggression, and 96.4% reported victimization, including 19 firearm injuries requiring medical care and 2 homicides. The majority with firearm violence (63.5%) reported at least 1 event within the first 6 months. Poisson regression identified baseline predictors of firearm violence, including male gender (RR = 1.51), African American race (RR = 1.26), assault-injury (RR = 1.35), firearm possession (RR = 1.23), attitudes favoring retaliation (RR = 1.03), posttraumatic stress disorder (RR = 1.39), and a drug use disorder (RR = 1.22).

CONCLUSIONS
High-risk youth presenting to urban EDs for assault have elevated rates of subsequent firearm violence. Interventions at an index visit addressing substance use, mental health needs, retaliatory attitudes, and firearm possession may help decrease firearm violence among urban youth.
Announcements Versus Conversations to Improve HPV Vaccination Coverage: A Randomized Trial
Authors: Brewer Noel T. , Hall Megan E. , Malo Teri L. , Gilkey Melissa B. , Quinn Beth , Lathren Christine 
Published: November 2021

OBJECTIVE
Improving provider recommendations is critical to addressing low human papillomavirus (HPV) vaccination coverage. Thus, we sought to determine the effectiveness of training providers to improve their recommendations using either presumptive “announcements” or participatory “conversations.”

METHODS
In 2015, we conducted a parallel-group randomized clinical trial with 30 pediatric and family medicine clinics in central North Carolina. We randomized clinics to receive no training (control), announcement training, or conversation training. Announcements are brief statements that assume parents are ready to vaccinate, whereas conversations engage parents in open-ended discussions. A physician led the 1-hour, in-clinic training. The North Carolina Immunization Registry provided data on the primary trial outcome: 6-month coverage change in HPV vaccine initiation (≥1 dose) for adolescents aged 11 or 12 years.

RESULTS
The immunization registry attributed 17 173 adolescents aged 11 or 12 to the 29 clinics still open at 6-months posttraining. Six-month increases in HPV vaccination coverage were larger for patients in clinics that received announcement training versus those in control clinics (5.4% difference, 95% confidence interval: 1.1%–9.7%). Stratified analyses showed increases for both girls (4.6% difference) and boys (6.2% difference). Patients in clinics receiving conversation training did not differ from those in control clinics with respect to changes in HPV vaccination coverage. Neither training was effective for changing coverage for other vaccination outcomes or for adolescents aged 13 through 17 (n = 37 796).

CONCLUSIONS
Training providers to use announcements resulted in a clinically meaningful increase in HPV vaccine initiation among young adolescents.
Physician Response to Parental Requests to Spread Out the Recommended Vaccine Schedule
Authors: Kempe Allison , O’Leary Sean T. , Kennedy Allison , Crane Lori A. , Allison Mandy A. , Beaty Brenda L. , Hurley Laura P. , Brtnikova Michaela , Jimenez-Zambrano Andrea , Stokley Shannon 
Published: November 2021

OBJECTIVES
To assess among US physicians (1) frequency of requests to spread out recommended vaccination schedule for children &lt;2 years, (2) attitudes regarding such requests, and (3) strategies used and perceived effectiveness in response to such requests.

METHODS
An e-mail and mail survey of a nationally representative sample of pediatricians and family physicians from June 2012 through October 2012.

RESULTS
The response rate was 66% (534 of 815). In a typical month, 93% reported some parents of children &lt;2 years requested to spread out vaccines; 21% reported ≥10% of parents made this request. Most respondents thought these parents were putting their children at risk for disease (87%) and that it was more painful for children (84%), but if they agreed to requests, it would build trust with families (82%); further, they believed that if they did not agree, families might leave their practice (80%). Forty percent reported this issue had decreased their job satisfaction. Most agreed to spread out vaccines when requested, either often/always (37%) or sometimes (37%); 2% would often/always, 4% would sometimes, and 12% would rarely dismiss families from their practice if they wanted to spread out the primary series. Physicians reported using a variety of strategies in response to requests but did not think they were effective.

CONCLUSIONS
Virtually all providers encounter requests to spread out vaccines in a typical month and, despite concerns, most are agreeing to do so. Providers are using many strategies in response but think few are effective. Evidence-based interventions to increase timely immunization are needed to guide primary care and public health practice.
Obesity: Stigma, Trends, and Interventions
Authors:   American Academy of Pediatrics
Published: November 2021

Obesity is one of the defining health challenges of our generation. Studies project that, if current trends continue, more than 50% of the US population will have obesity within the next 20 years.
https://shop.aap.org/pediatric-collections-obesity-stigma-trends-and-interventions-paperback/
An Integrated Clinic-Community Partnership for Child Obesity Treatment: A Randomized Pilot Trial
Authors: Hoffman Jessica , Frerichs Leah , Story Mary , Jones Jason , Gaskin Kiah , Apple Annie , Skinner Asheley , Armstrong Sarah 
Published: November 2021

BACKGROUND AND OBJECTIVES
Effective treatment of childhood obesity remains elusive. Integration of clinical and community systems may achieve effective and sustainable treatment. However, the feasibility and effectiveness of this integrated model are unknown.

METHODS
We conducted a randomized clinical trial among children aged 5 to 11 presenting for obesity treatment. We randomized participants to clinical care or clinical care plus community-based programming at a local parks and recreation facility. Primary outcomes were the change in child BMI at 6 months and the intensity of the program in treatment hours. Secondary outcomes included health behaviors, fitness, attrition, and quality of life.

RESULTS
We enrolled 97 children with obesity, and retention at 6 months was 70%. Participants had a mean age of 9.1 years and a mean baseline BMI z score of 2.28, and 70% were living in poverty. Intervention participants achieved more treatment hours than controls (11.4 vs 4.4, SD: 15.3 and 1.6, respectively). We did not observe differences in child BMI z score or percent of the 95th percentile at 6 months. Intervention participants had significantly greater improvements in physical activity (P = .010) and quality of life (P = .008).

CONCLUSIONS
An integrated clinic-community model of child obesity treatment is feasible to deliver in a low-income and racially diverse population. As compared with multidisciplinary treatment, the integrated model provides more treatment hours, improves physical activity, and increases quality of life. Parks and recreation departments hold significant promise as a partner agency to deliver child obesity treatment.
Characteristics of Children 2 to 5 Years of Age with Severe Obesity
Authors: Tester June M. , Phan Thao-Ly T. , Tucker Jared M. , Leung Cindy W. , Dreyer Gillette Meredith L. , Sweeney Brooke R. , Kirk Shelley , Tindall Alexis , Olivo-Marston Susan E. , Eneli Ihuoma U. 
Published: November 2021

BACKGROUND AND OBJECTIVES
As a distinct group, 2- to 5-year-olds with severe obesity (SO) have not been extensively described. As a part of the Expert Exchange Workgroup on Childhood Obesity, nationally-representative data were examined to better characterize children with SO.

METHODS
Children ages 2 to 5 (N = 7028) from NHANES (1999–2014) were classified as having normal weight, overweight, obesity, or SO (BMI ≥120% of 95th percentile). Sociodemographics, birth characteristics, screen time, total energy, and Healthy Eating Index 2010 scores were evaluated. Multinomial logistic and linear regressions were conducted, with normal weight as the referent.

RESULTS
The prevalence of SO was 2.1%. Children with SO had higher (unadjusted) odds of being a racial and/or ethnic minority (African American: odds ratio [OR]: 1.7; Hispanic: OR: 2.3). They were from households with lower educational attainment (OR: 2.4), that were single-parent headed (OR: 2.0), and that were in poverty (OR: 2.1). Having never been breastfed was associated with increased odds of obesity (OR: 1.5) and higher odds of SO (OR: 1.9). Odds of &gt;4 hours of screen time were 1.5 and 2.0 for children with obesity and SO. Energy intake and Healthy Eating Index 2010 scores were not significantly different in children with SO.

CONCLUSIONS
Children ages 2 to 5 with SO appear to be more likely to be of a racial and/or ethnic minority and have greater disparities in social determinants of health than their peers and are more than twice as likely to engage in double the recommended screen time limit.
Racial and Ethnic Disparities in Early Childhood Obesity
Authors: Isong Inyang A. , Rao Sowmya R. , Bind Marie-Abèle , Avendaño Mauricio , Kawachi Ichiro , Richmond Tracy K. 
Published: November 2021

OBJECTIVES
The prevalence of childhood obesity is significantly higher among racial and/or ethnic minority children in the United States. It is unclear to what extent well-established obesity risk factors in infancy and preschool explain these disparities. Our objective was to decompose racial and/or ethnic disparities in children’s weight status according to contributing socioeconomic and behavioral risk factors.

METHODS
We used nationally representative data from ~10 700 children in the Early Childhood Longitudinal Study Birth Cohort who were followed from age 9 months through kindergarten entry. We assessed the contribution of socioeconomic factors and maternal, infancy, and early childhood obesity risk factors to racial and/or ethnic disparities in children’s BMI z scores by using Blinder-Oaxaca decomposition analyses.

RESULTS
The prevalence of risk factors varied significantly by race and/or ethnicity. African American children had the highest prevalence of risk factors, whereas Asian children had the lowest prevalence. The major contributor to the BMI z score gap was the rate of infant weight gain during the first 9 months of life, which was a strong predictor of BMI z score at kindergarten entry. The rate of infant weight gain accounted for between 14.9% and 70.5% of explained disparities between white children and their racial and/or ethnic minority peers. Gaps in socioeconomic status were another important contributor that explained disparities, especially those between white and Hispanic children. Early childhood risk factors, such as fruit and vegetable consumption and television viewing, played less important roles in explaining racial and/or ethnic differences in children’s BMI z scores.

CONCLUSIONS
Differences in rapid infant weight gain contribute substantially to racial and/or ethnic disparities in obesity during early childhood. Interventions implemented early in life to target this risk factor could help curb widening racial and/or ethnic disparities in early childhood obesity.