bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diversity in Selected Leadership Positions in United States Academic Pediatric Gastroenterology Programs
Authors: Sanghavi Rinarani , Reisch Joan , Tomer Gitit 
Published: October 2021

ABSTRACTWomen and minorities are underrepresented in leadership positions in academic specialties. We investigated representation of women and minorities in selected leadership positions and in fellowships in North American academic pediatric gastroenterology programs (PGP) via voluntary surveys. We also assessed for factors influencing diversity. We found that 45.8% of Program Directors (PD), 75% of division chiefs (DC), and 71% of Pediatrics department chairs were men. Sixty‐three percentage of the PG fellows were women. Most DCs were male professors. Most PDs, DCs, and department chairs were White (70%, 80%, and 88.3%), with Blacks being the least represented group in leadership and also among fellows. We found a higher likelihood of having a White PD if the department chair was White. We found gender and racial disparities in all PGP leadership positions. This data can serve as a guide in efforts to support diversity for both gender and race at all positions and academic ranks.
Growth of Very Low Birth Weight Infants Who Received a Liquid Human Milk Fortifier
Authors: Masoli Daniela , Mena Patricia , Dominguez Angelica , Ramolfo Pamela , Vernal Patricia , Pantoja Miguel Angel , Esparza Ruth , Hübner Maria Eugenia , Ríos Antonio , Faunes Miriam , Uauy Ricardo , Tapia Jose L. ,   Neocosur Network
Published: October 2021

ABSTRACTObjectives:To evaluate growth (weight, length, head circumference, and knee–heel length [KHL]) in very low birth weight (VLBW) infants (500–1500 g) who received human milk with a liquid fortifier (LHMF) with high protein and fatty acid content versus a traditional powder fortifier (PHMF) for 45 days or until discharge.Methods:This was a multicenter, randomized, controlled trial. An intention‐to‐treat analysis was performed to determine adverse events and withdrawal causes. We also performed an efficacy analysis involving the infants who completed at least 2 weeks of study.Results:Of the 158 infants enrolled in the study, 146 completed at least 2 weeks, and 125 completed the entire study. The biodemographic characteristics were similar between groups, with no differences in increments of weight (22.9 vs 22.7 g kg−1 day−1), length (1.03 vs 1.09 cm/week), head circumference (0.91 vs 0.90 cm/week), or KHL (3.6 vs 3.3 mm/week). The KHL increment was greater in infants weighing >1 kg receiving LHMF (3.7 vs 3.2 mm/week, P = 0.027). Although there were no significant differences in serious adverse events, the incidence difference of the composite outcome death/necrotizing enterocolitis between groups warrants attention (1.3% with LHMF and 8.1% with PHMF).Conclusion:There were no differences in the overall growth between VLBW infants receiving either fortifier.
Interventions to Improve the Preparedness to Care for Family Caregivers of Cancer Patients
Authors: Bilgin Aylin , Ozdemir Leyla 
Published: October 2021

Background
Preparedness for caregiving could balance the negative impacts of caregiving. The interventions aimed at increasing readiness among the caregivers are important during the illness period for both patients and their caregivers.

Objectives
The aims of this study were to review the interventions applied to the caregivers of cancer patients and to examine the effects of these interventions on the preparedness to care.

Methods
The ScienceDirect, Scopus, CENTRAL, Web of Science, MEDLINE, and PubMed were searched for relevant studies published between 2000 and 2020. The methodological quality was assessed using the Quality Assessment Tool for Quantitative Studies. The statistical analyses were performed using the Comprehensive Meta-Analysis software version 3.0. The publication bias was assessed using the Egger test, for funnel plots.

Results
Eleven studies were selected for the meta-analysis, including those about psychoeducation programs (n = 5), education programs (n = 3), supportive programs (n = 2), and a self-care support program for the caregivers (n = 1). The methodological quality assessment revealed 2 studies as “strong.” The results indicated an increase in the caregivers’ preparedness to care after the interventions. The subgroup analysis revealed that the programs with higher ratios of female caregivers were more effective.

Conclusion
The interventions applied to the family caregivers can exert beneficial effects on caregivers’ preparedness to care. Nonetheless, future studies should focus on methodological issues, such as randomization and blinding.

Implications for Practice
Nurse-driven interventions may be used as a useful strategy to improve the preparedness to care among the caregivers of cancer patients. The male caregivers should be closely followed by healthcare professionals for knowledge and support needs.
Case Report: Bilateral Cranial Nerve VI Palsy in Miller Fisher Syndrome
Authors: Malloy Kelly A. , Zeng Tina 
Published: October 2021

SIGNIFICANCE
Miller Fisher syndrome, a variant of Guillain-Barré syndrome, is a condition characterized by ophthalmoplegia, ataxia, and areflexia. Diplopia, particularly secondary to a bilateral abduction deficit, is the most common presenting symptom. The telltale neurologic symptoms associated with this condition can easily be overlooked by eye care providers, delaying timely diagnosis and treatment.

PURPOSE
This study aimed to report a case of diplopia secondary to an uncommon condition (Miller Fisher syndrome) and to highlight the eye care provider's role in helping with diagnosis and management of this condition.

CASE REPORT
A 31-year-old woman presented to the emergency eye care service because of a 2-day history of sudden-onset diplopia, for which no cause was found 1 day prior at a local hospital emergency department. She also reported weakness in her legs, difficulty walking, balance problems, and reduced sensation of her left hand for the past 2 days. Clinical testing revealed bilateral abduction deficits, ataxia, and areflexia, the combination of which suggested Miller Fisher syndrome. Because of the acute onset and progressive severity of her neurologic symptoms, she was referred to a different hospital emergency department for confirmatory diagnosis and treatment of Miller Fisher syndrome.

CONCLUSIONS
Diplopia is a symptom commonly encountered by eye care providers, regardless of their mode of practice. Although there are many potential etiologies of diplopia, performing a comprehensive eye examination combined with a neurologic evaluation can potentially pinpoint the specific cause. Miller Fisher syndrome is one such condition in which the diagnostic triad can be uncovered with in-office ocular motility testing and neurologic examination. Eye care providers need to be aware of the clinical features of Miller Fisher syndrome to aid in prompt diagnosis and treatment for patients with this acute condition.
Repeatability of Anterior Eye Surface Topography Parameters from an Anterior Eye Surface Profilometer
Authors: Niyazmand Hamed , Read Scott A. , Atchison David A. 
Published: October 2021

SIGNIFICANCE
Anterior eye shape measurements are important for clinical contact lens fitting. The detailed assessment of measurement repeatability using the Eye Surface Profiler (ESP; Eaglet Eye B.V., AP Houten, the Netherlands) allows for more reliable interpretation of eye surface topography measurements.

PURPOSE
This study aimed to determine the repeatability of the ESP for anterior central corneal power and anterior eye surface height measurements.

METHODS
A Badal optometer was mounted on the ESP to provide an external fixation target with appropriate accommodation control and refractive correction. Forty-five healthy young adults underwent two sessions of anterior eye measurements, separated by 20 minutes, using the ESP. In each session, three consecutive scans were captured. Sagittal height data were obtained from 8-mm central cornea and from 8- to 14-mm diameter (encompassing the corneal periphery and anterior sclera). Anterior corneal powers were determined from the central cornea. Intersessional and intrasessional repeatability values were determined as coefficients of repeatability and root mean square error differences.

RESULTS
Sagittal height intersessional coefficients of repeatability for central nasal (5 μm) and central temporal (7 μm) were better than peripheral nasal (24 μm) and peripheral temporal (21 μm) regions. Sagittal height intrasessional coefficients of repeatability were 9, 8, 28, and 31 μm for central nasal, central temporal, peripheral nasal, and peripheral temporal regions, respectively. Intersessional coefficients of repeatability of mean sphere, 90/180° (J
0) astigmatism, and oblique (J
45) astigmatism were 0.67, 0.22, and 0.13 D, respectively, with corresponding intrasessional coefficients of repeatability of 1.27, 0.21, and 0.27 D.

CONCLUSIONS
The modified measuring procedure for the ESP used in this study provides highly repeatable sagittal height measurements in the central cornea but is less repeatable in the corneal periphery and scleral region. Results of the current study can be considered when using ESP in the interpretation of anterior eye surface shape measurements and in contact lens fitting and design.
Emergency Department Initiated Mental Health Interventions for Young People
Authors: Walker Natasha , Medlow Sharon , Georges Amanda , Steinbeck Katharine , Ivers Rebecca , Perry Lin , Skinner S. Rachel , Kang Melissa , Cullen Patricia 
Published: October 2021

Objective
Young people (10–24 years old) with mental health concerns are increasingly presenting to hospital emergency departments (EDs). The purpose of this review was to identify the core components and outcomes of mental health interventions for young people that are initiated in the ED, such that they are delivered in the ED and/or by ED health workers.

Methods
Six electronic databases were systematically searched. Primary peer-reviewed qualitative or quantitative studies describing an ED-initiated mental health intervention for young people published between 2009 and 2020 were included.

Results
Nine studies met the inclusion criteria. The included studies demonstrated that compared with traditional ED care, ED-initiated mental health interventions lead to improved efficiency of care and decreased length of stay, and a core component of this care was its delivery by allied health practitioners with mental health expertise. The studies were limited by focusing on service efficiencies rather than patient outcomes. Further limitations were the exclusion of young people with complex mental health needs and/or comorbidities and not measuring long-term positive mental health outcomes, including representations and whether young people were connected with community health services.

Conclusions
This systematic review demonstrated that ED-initiated mental health interventions result in improved service outcomes, but further innovation and robust evaluation are required. Future research should determine whether these interventions lead to better clinical outcomes for young people and staff to inform the development of best practice recommendations for ED-initiated mental health care for young people presenting to the ED.
Motor Developmental Delay After Cardiac Surgery in Children With a Critical Congenital Heart Defect: A Systematic Literature Review and Meta-analysis
Authors: Sprong Maaike C. A. , Broeders Willem , van der Net Janjaap , Breur Johannes M. P. J. , de Vries Linda S. , Slieker Martijn G. , van Brussel Marco 
Published: October 2021

Purpose:
To systematically review evidence regarding the severity and prevalence of motor development in children with a critical congenital heart defect (CCHD) without underlying genetic anomalies.

Summary of Key Points:
Twelve percent of all included studies reported abnormal mean motor developmental scores, and 38% reported below average motor scores. Children with single-ventricle physiology, especially those with hypoplastic left heart syndrome, had the highest severity and prevalence of motor delay, particularly at 0 to 12 months. Most included studies did not differentiate between gross and fine motor development, yet gross motor development was more affected.

Recommendations for Clinical Practice:
We recommend clinicians differentiate between the type of heart defect, fine and gross motor development, and the presence of genetic anomalies. Furthermore, increased knowledge about severity and prevalence will enable clinicians to tailor their interventions to prevent motor development delays in CCHD.
Material Hardship and Association With Sexual Risk Behavior Among Adolescent Sexual Minority Males in 3 US Cities—National HIV Behavioral Surveillance—Young Men Who Have Sex With Men, 2015
Authors: Trujillo Lindsay , Robbins Taylor , Morris Elana , Sionean Catlainn , Agnew-Brune Christine ,   for the NHBS-YMSM Study Group
Published: October 2021

Introduction:
Adolescent sexual minority males (ASMMs) are disproportionately affected by HIV relative to other youth within the United States. Social determinants of health have been explored among this population; however, economic determinants, such as material hardship, remain understudied. We examined the relationship between material hardship and sexual behavior among ASMMs aged 13–18 years residing in 3 US cities using 2015 data from CDC's National HIV Behavioral Surveillance among Young Men Who Have Sex with Men.

Methods:
Young men ages 13–18 years residing in 3 US cities were recruited through venue-based, respondent-driven, or Facebook sampling. We estimated adjusted prevalence ratios (aPRs) with 95% confidence intervals (CIs) for condomless anal intercourse (CAI) with a male sex partner in the past 12 months and with having 4 or more male sex partners in the past 12 months.

Results:
Of 547 ASMMs, 27% reported experiencing material hardship in the past 12 months. After adjusting for demographics, household characteristics, and city, ASMMs who experienced material hardship were more likely to report CAI with a male partner in the past 12 months (aPR: 1.55, 95% CI: 1.25 to 1.93) and to have had 4 or more male sex partners in the past 12 months (aPR: 1.44, 95% CI: 1.08 to 1.91).

Discussion:
More than a quarter of ASMMs experienced material hardship that was associated with increased sexual risk behavior among ASMMs. Incorporating services that address all unmet needs is important to consider for HIV prevention efforts for ASMMs.
Utility of Preoperative Helmet Molding Therapy in Patients With Isolated Sagittal Craniosynostosis
Authors: Zapatero Zachary D. , Slawinski Steven K. , Kosyk Mychajlo S. , Kalmar Christopher L. , Cheung Liana , Carlson Anna R. , Swanson Jordan W. , Taylor Jesse A. , Bartlett Scott P. 
Published: October 2021

Abstract
The purpose of this study was to review our institution's experience using helmet molding therapy in children with isolated non-syndromic sagittal craniosynostosis before placement of cranial springs and provide objective measurements of craniometric changes to help determine its role in treatment.
Patients who underwent preoperative helmet molding therapy for sagittal craniosynostosis were retrospectively reviewed. Three-dimensional surface tomography scans were used to measure head circumference, cranial width, cranial length, cranial index (CI), and cranial vault asymmetry.
Seventeen patients underwent orthotic helmeting therapy before spring mediated cranial vault expansion. Patients spent a median of 48 days (interquartile range [IQR] 32, 57) in preoperative orthotic helmeting therapy. There were increases in both cranial width and length post-helmeting (median: 107.5 mm [IQR 104.8, 110.4] versus 115.6 mm [IQR 114.5, 119.3]; P < 0.001) (median: 152.8 mm [IQR 149.2, 154.9] versus 156.8 mm [IQR 155.0, 161.5]; P < 0.001), respectively. There was a greater increase in cranial width (P = 0.015). Consequently, patients’ CI improved after preoperative helmeting (median: 0.702 [IQR 0.693, 0.717] versus 0.739 [0.711, 0.752]; P < 0.001). There was no evidence of growth restriction from helmeting (pre-helmeting Head circumference [HC]: median 96.8 percentile [IQR 90.6, 99.9] versus post-helmeting HC: 98.7 percentile [IQR 94.7, 99.8]; P = 0.109).
Preoperative helmeting in patients with non-syndromic isolated sagittal craniosynostosis can be used to improve CI before surgical correction. Significant benefits can be achieved in shorter preoperative helmeting durations than previously reported with no evidence of cranial growth restriction, which supports its feasibility and utility in children undergoing spring mediated cranial vault expansion.
Potential Value of Presepsin Guidance in Shortening Antibiotic Therapy in Septic Patients: a Multicenter, Prospective Cohort Trial
Authors: Xiao Hongli , Wang Guoxing , Wang Yan , Tan Zhimin , Sun Xuelian , Zhou Jie , Duan Meili , Zhi Deyuan , Tang Ziren , Hang Chenchen , Zhang Guoqiang , Li Yan , Wu Caijun , Li Fengjie , Zhang Haiyan , Wang Jing , Zhang Yun , Zhang Xinchao , Guo Wei , Qi Wenjie , Xie Miaorong , Li Chunsheng 
Published: October 2021

ABSTRACT

Introduction:
Long-term use of antibiotics for septic patients leads to bacterial resistance, increased mortality, and hospital stay. In this study, we investigated an emerging biomarker presepsin-guided strategy, which can be used to evaluate the shortening of antibiotic treatment in patients with sepsis without risking a worse outcome.

Methods:
In this multicenter prospective cohort trial, patients were assigned to the presepsin or control groups. In the presepsin group, antibiotics were ceased based on predefined cut-off ranges of presepsin concentrations. The control group stopped antibiotics according to international guidelines. The primary endpoints were the number of days without antibiotics within 28 days and mortality at 28 and 90 days. Secondary endpoints were the percentage of patients with a recurrent infection, length of stay in ICU and hospital, hospitalization costs, days of first episode of antibiotic treatment, percentage of antibiotic administration and multidrug-resistant bacteria, and SOFA score.

Results:
Overall, 656 out of an initial 708 patients were eligible and assigned to the presepsin group (n = 327) or the control group (n = 329). Patients in the presepsin group had significantly more days without antibiotics than those in the control group (14.54 days [SD 9.01] vs. 11.01 days [SD 7.73]; P < 0.001). Mortality in the presepsin group showed no difference to that in the control group at days 28 (17.7% vs. 18.2%; P = 0.868) and 90 (19.9% vs. 19.5%; P = 0.891). Patients in the presepsin group had a significantly shorter mean length of stay in the hospital and lower hospitalization costs than control subjects. There were no differences in the rate of recurrent infection and multidrug-resistant bacteria and the SOFA score tendency between the two groups.

Conclusions:
Presepsin guidance has potential to shorten the duration of antibiotic treatment in patients with sepsis without risking worse outcomes of death, recurrent infection, and aggravation of organ failure.

Trial registration:
ChiCTR, ChiCTR1900024391. Registered 9 July 2019-Retrospectively registered, http://www.chictr.org.cn
Frequency band coupling with high-frequency activities during seizures shifts from θ band in tonic phase to δ band in clonic phase
Authors: Hashimoto Hiroaki , Khoo Hui Ming , Yanagisawa Takufumi , Tani Naoki , Oshino Satoru , Hirata Masayuki , Kishima Haruhiko 
Published: October 2021

AbstractObjectiveTo clarify variations in the relationship between high-frequency activities (HFAs) and low-frequency bands from the tonic to the clonic phase in focal to bilateral tonic-clonic seizures (FBTCS), using phase-amplitude coupling.MethodsThis retrospective study enrolled six patients with drug-resistant focal epilepsy who underwent intracranial electrode placement for presurgical invasive electroencephalography at Osaka University Hospital (July 2018–July 2019). We used intracranial electrodes to record seizures in focal epilepsy (11 FBTCS). The magnitude of synchronization index (SIm) and receiver-operating characteristic (ROC) analysis were used to analyze the coupling between HFA amplitude (80–250 Hz) and lower frequencies phase.ResultsThe θ (4–8 Hz)-HFA SIm peaked in the tonic phase, whereas the δ (2–4 Hz)-HFA SIm peaked in the clonic phase. ROC analysis indicated that the δ-HFA SIm discriminated well the clonic from the tonic phase.ConclusionsThe main low-frequency band modulating the HFA shifted from the θ band in the tonic phase to the δ band in the clonic phase.SignificanceIn FBTCS, low-frequency band coupling with HFA amplitude varies temporally. Especially, the δ band is specific to the clonic phase. These results suggest dynamically neurophysiological changes in the thalamus or basal ganglia throughout FBTCS.HighlightsThe θ band (4–8 Hz) was mainly coupled with high-frequency activity (HFA) in the tonic phase of focal to bilateral tonic-clonic seizures (FBTCS).The δ band (2–4 Hz) was mainly coupled with HFA in the clonic phase of FBTCS.The magnitude of the synchronization index related to δ-HFA phase-amplitude coupling discriminated well the clonic from the tonic phase.