bluuebunny/crossref_metadata_2025_split huggingface dataset:
Catch‐down growth in infants born large for gestational age
Authors: Dunn Rachel K. , Uhing Michael , Goday Praveen S. 
Published: July 2021

AbstractInfants born large for gestational age (LGA) not exhibiting catch‐down growth (a decline of weight z‐score by 1) have a higher likelihood of future obesity. We aimed to identify the term LGA infants in our neonatal intensive care unit (NICU) and document nutrition interventions that may influence growth. Our 10‐year retrospective review identified 47 term LGA infants who had a NICU length of stay (LOS) ≥7 days. We obtained demographic data, nutrition interventions in the NICU, and data regarding growth patterns. Of the 47 infants, 31 (66%), demonstrated catch‐down growth at discharge at ≥7 days. Overall, 39 of 47 patients (83%) received interventions during their NICU stay, including 32 (69%) who had nasogastric tubes placed, and 24 (51%) had formula fortification to augment weight gain. Among patients with LOS ≥14 days, 23 of 23 patients without catch‐down growth and four of five patients with catch‐down growth had nutrition interventions performed. Of the overall population, only 38% of those who did not demonstrate catch‐down growth had an LOS of ≥14 days vs 77% of all infants that did exhibit catch‐down growth (P = .01). Our data suggest that nutrition interventions in LGA infants are common in the NICU. Our study highlights the need for further clinical studies to help direct care in this population of infants.
Medical nutrition therapy for patients with malnutrition post–intensive care unit discharge: A case report of recovery from coronavirus disease 2019 (COVID‐19)
Authors: Burslem Ryan , Parker Anna 
Published: July 2021

AbstractPatients discharged from an intensive care unit (ICU) are frequently malnourished and experience ongoing inadequate nutrition intake because of a variety of barriers, which may lead to further declines in nutrition status. The coronavirus disease 2019 (COVID‐19) pandemic has drawn increased awareness to this vulnerable patient population and the importance of nutrition rehabilitation to promote optimal recovery from acute illness. Despite this, there are no formal guidelines addressing medical nutrition therapy during the post‐ICU recovery phase. This review provides an overview of the nutrition management of patients during the post‐ICU recovery phase with a specific focus on COVID‐19. A case study will demonstrate how medical nutrition therapy improved the nutrition status and quality of life for a patient who became severely malnourished after a prolonged hospitalization for COVID‐19.
Postpyloric feeding tube placement at the bedside: Complication rate and impact on length of stay
Authors: Gillis Holly Catherine , Lin Ada , Jackson Kenneth , Stewart Claire 
Published: July 2021

AbstractBackgroundPostpyloric feeding tube (PPFT) placement is essential for the ongoing nutrition care of critically ill children requiring noninvasive and invasive ventilation. PPFTs are placed by a variety of providers, including advanced practice nurses (APNs), surgeons, gastroenterologists, and radiologists. Complication rates, time to enteral nutrition (EN) following placement, and association with length of stay (LOS) have not been well documented.MethodsA query of the electronic medical record identified patients in the pediatric intensive care unit (PICU) in whom PPFTs were placed. A retrospective chart review was performed to identify patient demographics; PPFT placement provider, indication, and duration; PICU LOS; hospital LOS; and patient pediatric risk of mortality (PRISM) scores.ResultsA total of 452 PPFTs were placed in 346 patients , with 318 placed by APNs. There was only one complication in 452 placed PPFTs. PRISM scores between patient groups for APN‐placed PPFTs and non‐APN–placed PPFTs were not significantly different. Mean time from hospital admission to PPFT placement was 1.5 days (APN) to 2.0 days (non‐APN) (P < .02). Spearman correlation coefficients demonstrated shorter hospital and PICU LOS were associated with shorter duration to insertion.ConclusionOverall complication rates of PPFT insertion is very low and do not significantly differ between provider type , even in patients with higher PRISM scores. Additionally, early time to insertion of PPFT is associated with decreased hospital and PICU LOS. Further research is needed to determine if the earlier time to insertion of PPFTs is associated with the achievement of goal feeds.
Twelve‐week peptide‐based formula therapy may be effective in inducing remission of active Crohn disease among women who are pregnant or preparing for pregnancy
Authors: Yang Qingfan , Tang Jian , Ding Ni , Chao Kang , Li Miao , Huang Zicheng , Guo Huili , Chen Junrong , Zhi Min , Hu Pinjin , Gao Xiang 
Published: July 2021

AbstractBackgroundConventional treatment for Crohn disease (CD) in pregnancy includes mesalamine, thiopurine, and anti–tumor necrosis factor (TNF)‐α agents. However, women may abstain because of complications, nonresponse, or potential adverse outcomes. Peptide‐based formula therapy, through oral or nasogastric feeding without other food intake, is an effective and safe therapy for active CD. Herein, We confirmed the effectiveness and safety of peptide‐based formula therapy for active CD in pregnant women or those preparing for pregnancy.MethodOutcomes of peptide‐based formula therapy to induce CD remission during pregnancy preparation and the conception period were evaluated retrospectively among 14 women. Efficacy was evaluated as the change in serum indices and inflammatory markers after 12‐week treatment. Pregnancy outcomes were compared between 14 women treated with nutrition therapy and eight women using conventional CD drugs.ResultsAfter 12 weeks, 85.7% (12 of 14) of patients treated with peptide‐based formula achieved remission with a significant decrease in the CD activity index (P < .001) and high‐sensitivity C‐reactive protein level (P = .004). There were no effects of peptide‐based formula therapy on pregnancy outcomes compared with conventional CD treatment (P > .05). Among the 12 patients who achieved CD remission with exclusive peptide‐based formula therapy, 10 selected to continue total or partial peptide‐based formula treatment to maintain CD remission throughout pregnancy.ConclusionPeptide‐based formula therapy, without other food intake, may provide a safe and effective alternative to conventional CD drugs to induce disease remission among women during conception and pregnancy.
Use of telehealth in home nutrition support: Challenges and advantages
Authors: Mundi Manpreet S. , Mohamed Elfadil Osman , Bonnes Sara L. , Salonen Bradley R. , Hurt Ryan T. 
Published: July 2021

AbstractCoronavirus disease 2019 (COVID‐19), after initially being detected in Wuhan, China in late 2019, quickly spread to most regions of the world, meeting World Health Organization criteria for a pandemic. Social distancing along with other measures implemented to control spread had a drastic impact on the provision of healthcare including deferred elective procedures and surgeries as well as delayed care and evaluation for emergent diagnoses such as heart attacks and strokes. In the home nutrition practice, patients began to delay routine laboratory tests and were canceling or deferring annual visits. Our group soon began to rapidly deploy telehealth to meet the needs of the home nutrition patients. Telehealth is not a new concept with descriptions of healthcare being provided at a distance with the use of telephone in the 1870s. However, widespread adoption has been limited because of regulation (licensure, prescriptions, credentialing, and privileges), lack of reimbursement, as well as adoption and availability of technology needed to carry out telehealth visits. As regulations and limits on reimbursements were waived during COVID‐19 pandemic, our home nutrition practice began to evaluate core components of the care we provide for our patients and assess which could be successfully transitioned to telehealth. In addition to the history and regulation of telehealth, the current manuscript provides details regarding successful implementation of telehealth visits such as change management, selection of telehealth platform, scheduling and logistics, as well as carrying out the virtual visit including history and physical exam.
The use of nutrition support near the end of life for hospitalized patients with advanced cancer at a reference center: Two realities
Authors: Wiegert Emanuelly Varea Maria , da Costa Rosa Karla Santos , dos Santos Rhayara Thacilla Ferreira , dos Santos Daiane Almeida , de Freitas Renata , de Oliveira Livia Costa 
Published: July 2021

AbstractObjectiveTo assess the frequency and factors associated of the provision of nutrition support (NS) in the last 30 days of life in patients with advanced cancer in the palliative or non‐palliative setting.MethodsRetrospective cohort study in palliative and non‐palliative care units at a specialized cancer center for oncology in Brazil. The use of oral nutrition supplements (ONS) and enteral (EN) and parenteral (PN) nutrition in the 30 days before death were assessed.ResultsThe 239 patients included were predominantly older (>60 years; 63.2%) and female (61.1%). The use of ONS was lower in palliative than non‐palliative care during the last 30 (52% vs. 6%), 7 (42% vs. 4%), and 3 (23% vs. 2%) days before death (all P < .001). The use of EN and PN was lower in palliative care, decreasing with the approach of death. The independent factors associated with ONS in non‐palliative care were (odds ratio): breast tumor (3.03), hypoalbuminemia (1.10), and nutrition risk (16.98); in palliative care, only the Karnofsky Performance Status (KPS) ≥40% (1.24) was associated to the use of ONS. The use of EN and PN was associated with head‐neck (HN) tumor in both settings (5.41) in non‐palliative and (8.74) in palliative. Others independent factors were: hypoalbuminemia (3.12) in non‐palliative care and KPS (1.31) in palliative care.ConclusionsThe use of NS near the end of life was high in the non‐palliative and less frequent in palliative care setting. The factors associated with NS differed according to the clinical oncology setting, with one of the factors in palliative care being a better prognosis.
X‐IGALME: Isogeometric analysis extended with local maximum entropy for fracture analysis
Authors: Fathi Farshid , Chen Lin , de Borst René 
Published: July 2021

AbstractAn extended approach is developed by blending isogeometric analysis and the first‐order local maximum entropy for the standard and the enhanced fields, respectively. Isogeometric analysis facilitates the accurate parametrization of the geometry in general, particularly the exact geometric parametrization of the conic curves and quadratic surfaces using NURBS. On the other hand, the local maximum entropy leads to an improved estimate for the enhanced part due to its infinite continuity. Moreover, local maximum entropy paves the way to a nonelementwise crack propagation owing to its meshfree characteristic. To enforce compatibility, the shifting technique is amended for the meshfree enhanced part to localize the effect of the Heaviside function to a narrow region around the crack. Next, a blending technique is exploited to remove the effect of the discontinuity in front of the crack tip. The viability of the approach is illustrated at the hand of several examples comprising straight and curved crack propagation.
Impact of central nervous system‐directed treatment on competence and adjustment among children in early cancer survivorship
Authors: Winning Adrien M. , Moscato Emily L. , Lehmann Vicky , Keim Madelaine C. , Rausch Joseph R. , Lipak Keagan G. , Himelhoch Alexandra C. , Murphy Lexa K. , Prussien Kemar V. , Olshefski Randal S. , Vannatta Kathryn , Compas Bruce E. , Gerhardt Cynthia A. 
Published: July 2021

AbstractBackgroundCentral nervous system (CNS)‐directed treatments can cause long‐term academic, social, and emotional difficulties for children with cancer. However, limited research has examined the emergence of problems longitudinally and has often stratified risk by diagnosis alone. Therefore, this study compared competence and adjustment in children, who did and did not receive CNS‐directed treatment, over the first 3 years following a cancer diagnosis.ProcedureMothers, fathers, and children (ages 5–18 years at diagnosis) from 217 families reported on the child's competence (academic, social) and adjustment (anxious/depressed, withdrawn/depressed) near a new cancer diagnosis or relapse and 3 years later. Children were categorized into CNS‐directed treatment (n = 112; including cranial radiation, intrathecal chemotherapy, and/or neurosurgery) and non‐CNS‐directed treatment (n = 105) groups.ResultsAt enrollment, there were few differences in competence and emotional adjustment among children based on treatment or diagnostic group. At 3 years, mothers and fathers reported poorer social competence for the CNS‐directed treatment group, and fathers reported poorer school competence for the CNS‐directed treatment group. Over time, father ratings of social competence increased for the non‐CNS‐directed treatment group, but not the CNS‐directed treatment group. While father ratings of academic competence declined for the CNS‐directed treatment group, mother ratings declined the most for children diagnosed with a brain tumor. All children demonstrated higher anxious/depressed scores over time.ConclusionsCNS‐directed treatment may be a valuable indicator to identify childhood cancer survivors at risk for poor competence during early survivorship. Follow‐up screening and supportive services are recommended, as well as additional longitudinal research.
A prospective survey study of lower urinary tract dysfunction in childhood cancer survivors after vincristine and/or doxorubicin chemotherapy
Authors: Hecht Sarah L. , Quach Alan , Gao Dexiang , Brazell Andrew , Beltran Gemma , Holbrook Sheryl , Gore Lia , Iguchi Nao , Malykhina Anna , Wilcox Duncan , Cost Nicholas G. 
Published: July 2021

AbstractBackgroundTwo chemotherapeutic agents used widely in pediatric oncology are vincristine (VCR) and doxorubicin (DOX), which may cause neuropathy and myopathy, respectively. The study hypothesis is that neurotoxic effects of VCR and/or myotoxic effects of DOX affect bladder physiology and manifest clinically as lower urinary tract dysfunction (LUTD).ProcedureBased on a priori power analysis, 161 children divided evenly by gender were recruited. Children aged 5–10 years completed the dysfunctional voiding scoring system (DVSS) survey. The study cohort comprised cancer survivors treated with VCR and/or DOX. Healthy controls were recruited from well‐child clinic visits. Exclusion criteria included pelvic‐based malignancy, pelvic irradiation, pre‐existing LUTD, neurologic abnormalities, and treatment with cyclophosphamide/ifosfamide. DVSS scores and presence of LUTD, defined as DVSS scores above gender‐specific thresholds (males ≥9, females ≥6), were compared across cohorts.ResultsMedian DVSS scores were higher in the study cohort (6 vs. 4, p = .003). Moreover, children in the study cohort were more likely to exceed threshold scores for LUTD (38.8% vs. 21%, p = .014; OR 1.8). Subanalysis by gender revealed female cancer survivors are more likely to report LUTD than controls (57.5% vs. 30%, p = .013, OR 1.9). This did not hold true for males (20% vs. 12.2%, p = .339).ConclusionsChildhood cancer survivors who received VCR and/or DOX reported higher rates of LUTD than controls. Female cancer survivors appear more likely to suffer from LUTD than males. Further study with a positive control cohort of cancer survivors who received non‐VCR, non‐DOX chemotherapy is underway to elucidate the contribution of a cancer diagnosis to LUTD.
Adolescent and young adult childhood cancer survivors’ preferences for screening and education of sexual function
Authors: Sopfe Jenna , Marsh Rebekah , Frederick Natasha N. , Klosky James L. , Chow Eric J. , Dorsey Holliman Brooke , Peterson Pamela N. 
Published: July 2021

AbstractBackgroundSexual dysfunction (SD) is a common yet underrecognized concern among childhood cancer survivors (CCS). CCS who are now adolescent and young adult (AYA‐CCS) identify SD as an unmet need. This study sought to explore AYA‐CCS preferences on how, when, where, and by whom SD‐focused communication should occur.ProcedureThis qualitative study utilized semi‐structured interviews to explore AYA‐CCS (now aged 15–24 years) experiences with, and preferences for, SD conversations. Thematic analysis methodology guided interpretation; themes were clustered into categories of who, how, when, and where SD conversations should occur.ResultsAYA‐CCS highlighted the importance of patient–provider rapport to facilitate SD conversations, but did not have consistent preferences regarding provider type or specialty. Providers should reduce discomfort by normalizing ongoing, personalized conversations. Some AYA‐CCS mentioned that notification that such a conversation is going to occur would be appreciated, and most were in favor of a screening tool to facilitate conversations. Preferences for when and where SD conversations should occur were centered on maximizing privacy.ConclusionsSD is an inadequately addressed concern in AYA‐CCS, and providers must familiarize themselves with AYA‐CCS preferences for discussing SD to reduce communication barriers and address this unmet need. In addition to corroborating prior studies’ findings such as normalizing ongoing SD conversations, this study demonstrated novel ideas for reducing barriers, including use of a notification to prepare them prior to SD conversations, favoring the use of a screening tool, and the importance of establishing rapport prior to the SD conversations.
Early death and treatment‐related mortality: A report from SUCCOUR ‐ Supportive Care for Children with Cancer in Africa
Authors: Israels Trijn , Afungchwi Glenn Mbah , Chagaluka George , Hesseling Peter , Kouya Francine , Paintsil Vivian , Landman Lisa , Chitsike Inam , Njuguna Festus , Sung Lillian , Molyneux Elizabeth 
Published: July 2021

AbstractBackgroundDeaths during paediatric cancer treatment are common in Africa. It is often difficult to distinguish between treatment‐related and disease‐related causes. To prevent these deaths, it is important to study them and identify the cause. The Supportive Care for Children with Cancer in Africa (SUCCOUR) programme enabled a study with the objective to identify the reasons for early death during treatment.MethodsWe conducted a multicentre prospective, observational cohort study in sub‐Saharan Africa. Children younger than 16 years with newly diagnosed cancer treated with curative intent were included from 1 September 2019 until 30 March 2020. Data were abstracted in real time by trained personnel using standardised case report forms. The treating clinician's assessment of the cause of death and signs, symptoms and laboratory values of patients who died during the first 3 months of treatment (early death) were documented.ResultsWe included 252 patients (median age 6.0, range 0.2–15.0 years, 54% male). The most common cancer was Burkitt lymphoma (63/252, 25%). Fifteen percent of patients (37/252) died during the first 3 months of treatment. Of these 37 patients, 33 (89%) died of a treatment‐related cause. Treatment‐related mortality of all patients in the first 3 months of treatment was 13% (33/252).ConclusionFifteen percent of patients had an early death during treatment and 13% had a treatment‐related death. This suggests the need to improve supportive care. Implementation of supportive care pathways adapted to local circumstances may be helpful.
Utilization of drugs with reports on potential efficacy or harm on COVID‐19 before, during, and after the first pandemic wave
Authors: Enners Salka , Gradl Gabriele , Kieble Marita , Böhm Michael , Laufs Ulrich , Schulz Martin 
Published: July 2021

AbstractPurposeConflicting information on potential benefits of drugs as well as reports on hypothetical harm of commonly used drugs in COVID‐19 treatment have challenged clinicians and healthcare systems. We analyzed the change in ambulatory drug utilization before, during, and after the first wave of the pandemic in 2020.MethodsWe explored dispensing data of nearly 19 000 pharmacies at the expense of the statutory health insurance funds covering 88% of Germany's population. We analyzed utilization of publicly discussed drugs with conflicting information. Drug utilization as number of packages dispensed per week from January to June 2020, reflecting 314 million claims, was compared with 2019.ResultsUtilization of hydroxychloroquine increased +110% during March 2020 and then slightly decreased until week April 13–19. Renin–angiotensin–aldosterone system inhibitors and simvastatin/atorvastatin increased, +78% and +74%, respectively, and subsequently decreased below 2019 levels. Utilization of azithromycin and all systemic antibiotics decreased continuously from March 2–8 until June to levels considerably lower compared to 2019 (June 22–28: azithromycin: −55%, all systemic antibiotics: −27%). Pneumococcal vaccines utilization initially increased +373%, followed by supply shortages. Paracetamol utilization showed an initial increase of +111%, mainly caused by an increase of over‐the‐counter dispensings.ConclusionsApart from the pandemic itself, the data suggest that dissemination of misinformation and unsound speculations as well as supply shortages influenced drug prescribing, utilization, and purchasing behavior. The findings can inform post‐pandemic policy to prevent unfounded over‐ and underprescribing and off‐label use as well as drug shortages during a public health crisis.
Uncommon side effects of common drugs in patients with familial dysautonomia
Authors: Perl Liat , Hakimian David , Maayan Channa , Rekhtman David , Fried Elchanan , Salmon‐Divon Mali , Sapozhnikov Daniel Mark , Cheishvili David 
Published: July 2021

AbstractPurposePatients with the autosomal recessive disorder of familial dysautonomia typically exhibit exacerbated adverse side effects to many common drugs. We aimed to catalog these adverse effects – with a focus on common drugs that are frequently administered to FD patients and compare their incidences to those within the general population.MethodsWe used data of 595 FD patients from an international database with information on drugs received and adverse effects. To investigate the molecular causes of reported differences in drug responses in FD patients, we used expression microarrays to compare the mRNA expression profiles in peripheral blood leukocytes of FD patients (n = 12) and healthy individuals (n = 10).ResultsSeveral drug classes, including cholinergics, anti‐cholinergics, anti‐convulsants, methylxanthines, SSRIs, and antibiotics caused either unreported symptoms or elevated rates of adverse events in FD patients. FD patients experienced different or more frequent adverse side effects than the general population in 31/123 drugs. These side effects included blood cell dyscrasias, amenorrhea, gastrointestinal bleeding, and bronchospasm. New findings include enhanced reaction of FD patients to H2 antagonist agents and to serotonin receptor agonists. We also detected eight genes differentially expressed between FD patients and healthy individuals that may underlie the differential drug responses of FD patients.ConclusionWe provide evidence that suggests the use of several common drugs should be discontinued or reduced in FD patients.