bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Initial Timing and Burden of Viral Gastrointestinal Infections in Australian Infants
Authors: Mihala Gabor , Grimwood Keith , Lambert Stephen Bernard , Ware Robert Stuart 
Published: September 2021

ABSTRACTThe timing and nature of initial infections by potentially vaccine‐preventable gastrointestinal viruses (group‐F adenoviruses, classic human astrovirus, norovirus I/II, and sapovirus I/II/IV/V) was investigated in a community‐based birth cohort. Weekly stool samples were collected from 158 children aged <2 years in an Australian subtropical city. Median age at initial infection was lowest for norovirus II (13.8 months) followed by sapovirus (14.3 months) and classic human astrovirus (17.6 months), and was >24 months for the remaining viruses. Norovirus II and sapovirus were most often associated with acute gastroenteritis symptoms (57% and 44%, respectively). Overall, healthcare was sought for 45% of symptomatic initial infections, which varied between 17% for norovirus I to 55% for norovirus II. Age at initial infection was lower when participants were exposed to other children. Norovirus II and sapovirus were the most important pathogens in this cohort, providing further evidence for them being priority targets for vaccine development.
Is Low-level Laser Therapy a Candidate to Be a Good Alternative in the Treatment of Mucositis in Childhood Leukemia?
Authors: Karaman Kamuran , Sarica Ayca , Tunc Serap Keskin , Karaman Serap 
Published: September 2021

Background and Aim:
Oral mucositis (OM) is a common side effect of systemic chemotherapy (CT) in cancer patients. The aim was to evaluate the effect of low-level laser therapy (LLLT) for the treatment of CT-induced OM children.

Patients and Methods:
The study was carried out in 40 pediatric patients 3 to 18 years of age, who were hospitalized for the diagnosis of leukemia and underwent CT between June 1, 2019, and December 31, 2019. They were randomly divided into 2 groups with 20 cases in each group. The LLLT group was treated with GaAlAs diode laser (l): 830 nm (infrared), power: 150 mW, dose: 4.5 J/cm2 and the control group underwent bicarbonate treatment. Patients received intervention for 3 days. The grade of OM was clinically assessed by the World Health Organization (WHO) Common Toxicity Criteria Scale. Visual Analog Scale was used on the same days with OM grade to evaluate the pain status.

Results:
While there was no significant difference between the groups in terms of OM grade at the beginning of the treatment and on the first, second, fourth, and 11th days of the treatment, the average OM grade of the LLLT group was found to be statistically significantly lower on the third, fifth, sixth, and seventh days of the treatment. The Visual Analog Scale score of the LLLT group was statistically significantly lower compared with the control group at all examinations starting from the first day of treatment (P<0.05).

Conclusion:
In the treatment of oral OM that occurs in children after CT, both standard care and LLLT treatment improve the grade and pain of OM.
Transition for Adolescents and Young Adults With Sickle Cell Disease in a US Midwest Urban Center: A Multilevel Perspective on Barriers, Facilitators, and Future Directions
Authors: Calhoun Cecelia , Luo Lingzi , Baumann Ana A. , Bauer Anna , Shen Evelyn , McKay Virginia , Hooley Cole , James Aimee , King Allison A. 
Published: September 2021

Background:
Sickle cell disease (SCD), an inherited red blood cell disorder, primarily affects African Americans in the United States. Adolescents and young adults with SCD (AYA-SCD) are at risk of high morbidity and mortality when transitioning from pediatric to adult care. The goal of this qualitative study was to understand factors associated with optimal implementation of the AYA-SCD transition.

Methods:
Participants were recruited from a large hospital system and the community. Interview guides included topics on access to primary and specialized care, beliefs and practices related to pain control, transition from pediatric to adult care, and patient experiences in the emergency department. Data were coded and analyzed using an inductive thematic coding approach in combination with a deductive coding approach using domains from the Consolidated Framework for Implementation Research (CFIR).

Results:
Fifty-nine participants, including 21 AYA-SCD from both the pediatric and adult clinics, 17 caregivers, 9 pediatric SCD providers, 6 adult SCD providers, and 6 emergency department providers, completed 11 focus groups and 5 semistructured interviews. Results identified multiple factors within the domains of CFIR including the outer setting, inner setting, individual characteristics, and intervention characteristics. Results were incorporated into a transition framework to inform local practice improvement.

Conclusion:
Our study highlights the importance of multilevel barriers and facilitators for AYA-SCD transition from pediatric to adult care. Future studies could use implementation science frameworks to understand local context and identify strategies and intervention characteristics to improve transition programming. These efforts will ultimately reduce health disparities and ensure health equity.
STEPS to Enhance Physical Activity After Hematopoietic Cell Transplantation for Multiple Myeloma
Authors: Hacker Eileen Danaher , Richards Rae Lee , Abu Zaid Mohammad , Chung Shu-Yu , Perkins Susan , Farag Sherif Shafik 
Published: September 2021

Background
Finding effective ways to increase physical activity immediately following high-dose chemotherapy and autologous hematopoietic cell transplantation (HCT) for treatment of multiple myeloma (MM) is challenging.

Objective
This pilot randomized clinical trial tested the acceptability, feasibility, and preliminary effects of a free-living physical activity intervention (STEPS) compared with usual care (UC) on physical activity, fatigue, muscle strength, functional ability, sleep, and quality of life following treatment for MM with HCT.

Methods
Using a 2-group pretest/posttest design (N = 32), this study compared the 6-week STEPS intervention to UC. Data were collected using self-report questionnaires, functional performance tests, and wrist actigraphy before HCT and 7 weeks following hospital discharge.

Results
The STEPS group achieved their physical activity goals on 53% of intervention days. The STEPS group experienced greater appetite loss, more diarrhea, and slept more than UC regardless of time point. Both groups reported improvements in mental fatigue, emotional functioning, pain, sleep disturbance, anger, anxiety, and depression but climbed stairs slower and had weaker hand grips after intervention. Both groups subjectively reported fewer sleep disturbances but objectively experienced more wakefulness after sleep onset and an increased number of awakenings postintervention.

Conclusions
The STEPS intervention is acceptable and feasible for people with MM treated with HCT. Both groups reported some improved symptoms but experienced some declines in physical performance postintervention.

Implications for Practice
Nurses strive to optimize health and promote well-being. Helping people increase their physical activity after treatment for MM with HCT may improve symptoms, but additional studies are needed.
Anal Human Papillomavirus Prevalence Among Vaccinated and Unvaccinated Gay, Bisexual, and Other Men Who Have Sex With Men in Canada
Authors: Chambers Catharine , Deeks Shelley L. , Sutradhar Rinku , Cox Joseph , de Pokomandy Alexandra , Grennan Troy , Hart Trevor A. , Lambert Gilles , Moore David M. , Coutlée François , Burchell Ann N. ,   the Engage-HPV Study Team
Published: September 2021

Background
Starting in 2015, human papillomavirus (HPV) vaccine has been publicly funded for gay, bisexual, and other men who have sex with men (GBM) 26 years or younger in Canada.

Methods
Self-identified GBM who reported having sex with another man within the past 6 months were enrolled using respondent-driven sampling (RDS) between February 2017 and August 2019 in Montreal, Toronto, and Vancouver, Canada. Men aged 16 to 30 years self-collected anal specimens for HPV-DNA testing. Prevalence was estimated using RDS-II weights. We compared the prevalence of quadrivalent (HPV-6/11/16/18) and 9-valent (HPV-6/11/16/18/31/33/45/52/58) vaccine types between GBM who self-reported HPV vaccination (≥1 dose) and those reporting no vaccination using a modified Poisson regression for binary outcomes.

Results
Among 645 GBM who provided a valid anal specimen (median age, 26 years; 5.9% HIV positive), 40.3% reported receiving ≥1 dose of HPV vaccine, of whom 61.8% received 3 doses. One-quarter were infected with ≥1 quadrivalent type (crude, 25.7%; RDS weighted, 24.4%). After adjustment for potential confounders, vaccinated GBM had a 27% lower anal prevalence of quadrivalent types compared with unvaccinated GBM (adjusted prevalence ratio [aPR], 0.73; 95% confidence interval [CI], 0.54–1.00). Lower prevalence ratios were found among vaccinated participants who were vaccinated >2 years before enrollment (aPR, 0.47; 95% CI, 0.25–0.86) or received their first vaccine dose at age ≤23 years (aPR, 0.64; 95% CI, 0.42–0.99). Point estimates were similar for ≥2 or 3 doses and 9-valent types.

Conclusions
Human papillomavirus vaccination was associated with a lower anal prevalence of vaccine-preventable HPV types among young, sexually active GBM. Findings will help inform shared decision making around HPV vaccination for GBM and their healthcare providers.
Identification of United States Counties at Elevated Risk for Congenital Syphilis Using Predictive Modeling and a Risk Scoring System, 2018
Authors: Cuffe Kendra M. , Torrone Elizabeth A. , Hong Jaeyoung , Leichliter Jami S. , Gift Thomas L. , Thorpe Phoebe G. , Bernstein Kyle T. 
Published: September 2021

Background
The persistence of congenital syphilis (CS) remains an important concern in the United States. We use the 2018 data to refine a previous predictive model that identifies US counties at elevated risk for CS in 2018.

Methods
Using county-level socioeconomic and health-related data from various sources, we developed a logistic regression predictive model to identify county-level factors associated with a county having had 1 or more CS case reported to the National Notifiable Diseases Surveillance System in 2018. We developed a risk scoring algorithm, identified the optimal risk score cutpoint to identify counties at elevated risk, and calculated the live birth to CS case ratio for counties by predicted risk level to compare counties at elevated risk with counties not at elevated risk.

Results
We identified several county-level factors associated with a county having 1 or more CS case in 2018 (area under the curve, 88.6%; Bayesian information criterion, 1551.1). Using a risk score cutoff of 8 or higher (sensitivity, 83.2%; specificity, 79.4%), this model captured 94.7% (n = 1,253) of CS cases born in 2018 and identified 850 (27%) counties as being at elevated risk for CS. The live birth to CS case ratio was lower in counties identified as at elevated risk (2,482) compared with counties categorized as not at elevated risk (10,621).

Conclusions
Identifying which counties are at highest risk for CS can help target prevention efforts and interventions. The relatively low live birth to CS case ratio in elevated risk counties suggests that implementing routine 28-week screening among pregnant women in these counties may be an efficient way to target CS prevention efforts.
Association of Bacterial Vaginosis With Higher Vaginal Indole Levels
Authors: Sharma Jyoti , Gupta Kanupriya , Schwebke Jane R. , Geisler William M. , Muzny Christina A. 
Published: September 2021

Abstract
We adapted a simple hydroxylamine-based indole assay to detect indole from stored vaginal swab specimens from women with and without bacterial vaginosis (BV). Women with BV had significantly higher vaginal indole levels compared with women without BV (6451.5 vs 5632.4 μM; P = 0.01), suggesting that indole-producing bacteria are a component of BV.
Association Between Anticholinergic Drug Burden and Adequacy of Enteral Nutrition in Critically Ill, Mechanically Ventilated Pediatric Patients
Authors: Martinez Enid E. , Dang Hongxing , Franks Jennifer , Callif Charles G. , Tasker Robert C. , Madden Kate , Mehta Nilesh M. 
Published: September 2021

OBJECTIVES:
Enteral nutrition delivery is limited by intolerance and interruptions in critically ill children. Anticholinergic properties of frequently administered medications may contribute to altered gastric motility and enteral nutrition intolerance in this population. We examined the association between the anticholinergic burden of administered medications using the Anticholinergic Drug Scale and adequacy of enteral nutrition delivery.

DESIGN:
Secondary analysis of data from a previously characterized PICU cohort.

SETTING:
Multidisciplinary PICU in a quaternary academic medical center.

PATIENTS:
Younger than or equal to 18 years, on mechanical ventilation and received enteral nutrition within the first 3 days of PICU admission.

MEASUREMENTS AND MAIN RESULTS:
Daily Anticholinergic Drug Scale score, demographic data, and clinical data were obtained from the primary study. Percent enteral energy adequacy ([kcal delivered ÷ kcal prescribed] × 100) during the first 3 days of PICU admission was calculated. Forty-two patients received enteral nutrition, with median age (interquartile range) 5 years (1.09–12.54 yr), and 62% were male. Median Anticholinergic Drug Scale score was inversely correlated with energy adequacy, with a median 9% decline in energy adequacy per 1-point increase in Anticholinergic Drug Scale score (coefficient, –9.3; 95% CI, –13.43 to –5.27; R
2 = 0.35; p < 0.0001). Median hours of enteral nutrition interruptions directly correlated with Anticholinergic Drug Scale score (coefficient, 1.5; 95% CI, 0.531–2.54; R
2 = 0.19; p = 0.004). Severity score was greater in patients with less than or equal to 25% enteral energy adequacy and directly correlated with median Anticholinergic Drug Scale score.

CONCLUSIONS:
Anticholinergic burden from medications administered in the PICU is a potentially modifiable factor for suboptimal enteral nutrition delivery.
Relationship of Recovery of Contralesional Ankle Weakness With the Corticospinal and Corticoreticular Tracts in Stroke Patients
Authors: Jang Sung Ho , Cho Min Kyeong 
Published: September 2021

Objective
We investigated the relationship between contralesional ankle weakness recovery and the corticospinal tract and corticoreticular tract in stroke patients with complete injuries of the ipsilesional corticospinal tract and corticoreticular tract.

Design
Thirty-six patients with complete injuries of the ipsilesional corticospinal tract and corticoreticular tract were recruited. Medical Research Council and the Functional Ambulation Category were used to determine motor function of ankle dorsiflexor and gait function. Patients were assigned into two groups: group A (poor recovery) and group B (good recovery). Fractional anisotropy, apparent diffusion coefficient, and tract volume were obtained for diffusion tensor imaging parameter.

Results
A total of 58.3% of patients showed good recovery of contralesional ankle dorsiflexor weakness, with remainder having poor recovery. Tract volume of the contralesional corticoreticular tract in group B was higher than that in group A (P < 0.05); no other diffusion tensor imaging parameters were significantly different between two groups. Tract volume of the contralesional corticoreticular tract and corticospinal tract showed strong (r = 0.521) and moderate (r = 0.399) positive correlations with Medical Research Council score of contralesional ankle dorsiflexor, respectively (P < 0.05).

Conclusions
We found that the number of fibers of the contralesional corticospinal tract and corticoreticular tract was closely related to the recovery of contralesional ankle dorsiflexor weakness in stroke patients with complete injuries of the ipsilesional corticospinal tract and corticoreticular tract. Moreover, the contralesional corticoreticular tract had a closer relationship to recovery than the contralesional corticoreticular tract.
Challenges and Lessons Learned for Acute Inpatient Rehabilitation of Persons With COVID-19
Authors: Maltser Susan , Trovato Erika , Fusco Heidi N. , Sison Cristina P. , Ambrose Anne Felicia , Herrera Joseph , Murphy Sean , Kirshblum Steven , Bartels Matthew N. , Bagay Leslie , Oh-Park Mooyeon , Stein Adam B. , Cuccurullo Sara , Nori Phalgun , Donovan Jayne , Dams-O’Connor Kristen , Amorapanth Prin , Barbuto Scott A. , Bloom Ona , Escalon Miguel X. 
Published: September 2021

Objective
The aim of the study was to present: (1) physiatric care delivery amid the SARS-CoV-2 pandemic, (2) challenges, (3) data from the first cohort of post–COVID-19 inpatient rehabilitation facility patients, and (4) lessons learned by a research consortium of New York and New Jersey rehabilitation institutions.

Design
For this clinical descriptive retrospective study, data were extracted from post–COVID-19 patient records treated at a research consortium of New York and New Jersey rehabilitation inpatient rehabilitation facilities (May 1–June 30, 2020) to characterize admission criteria, physical space, precautions, bed numbers, staffing, employee wellness, leadership, and family communication. For comparison, data from the Uniform Data System and eRehabData databases were analyzed. The research consortium of New York and New Jersey rehabilitation members discussed experiences and lessons learned.

Results
The COVID-19 patients (N = 320) were treated during the study period. Most patients were male, average age of 61.9 yrs, and 40.9% were White. The average acute care length of stay before inpatient rehabilitation facility admission was 24.5 days; mean length of stay at inpatient rehabilitation facilities was 15.2 days. The rehabilitation research consortium of New York and New Jersey rehabilitation institutions reported a greater proportion of COVID-19 patients discharged to home compared with prepandemic data. Some institutions reported higher changes in functional scores during rehabilitation admission, compared with prepandemic data.

Conclusions
The COVID-19 pandemic acutely affected patient care and overall institutional operations. The research consortium of New York and New Jersey rehabilitation institutions responded dynamically to bed expansions/contractions, staff deployment, and innovations that facilitated safe and effective patient care.
Effects of custom-made insoles on foot pressure redistribution, gait parameters, and pain in calcaneal apophysitis—a pretest and posttest study
Authors: Feyzioğlu Özlem , Öztürk Özgül , Muğrabi Selim 
Published: September 2021

Background:
Calcaneal apophysitis is a self-limiting disorder that often affects adolescents with a high level of activity and leads to increased pain severity, impairments in gait parameters, and poor health-related quality of life.

Objective:
To investigate the combination of custom-made insoles and exercise on foot pressure distribution, spatial–temporal gait parameters, and pain intensity in patients with calcaneal apophysitis.

Study design:
A one-group pretest–posttest design.

Methods:
Forty patients, aged between 8 and 15 years, diagnosed with calcaneal apophysitis, were included in this study. Patients were asked to use the custom-made insoles and to perform a home exercise program for 3 days a week. The duration of treatment was 4 weeks. The pain severity was evaluated with the Visual Analog Scale. The spatial–temporal gait parameters and foot pressure distribution were assessed with the Zebris FDM-THM-S treadmill system before and after the treatment.

Results:
At posttreatment assessment, there were significant changes in step length, stance phase percentage, swing phase percentage, and gait speed (P < 0.05), except step width and cadence (P > 0.05). Moreover, significant differences were found in forefoot, midfoot, and rearfoot pressure distribution (P < 0.05). There was also a significant decrease in pain intensity during activity compared to the pretreatment (P < 0.05).

Conclusion:
Our study results suggest that the combination of the custom-made insoles and exercise program created improvements in spatial–temporal gait parameters and foot pressure distribution by reducing the pain severity.
Improving Quality of PrEP Counseling for Adolescent Girls and Young Women in Kenya With Standardized Patient Actors: A Dose–Response Analysis
Authors: Larsen Anna , Abuna Felix , Owiti George , Kemunto Valarie , Sila Joseph , Wilson Kate S. , Owens Tamara , Pintye Jillian , Richardson Barbra A. , Kinuthia John , John-Stewart Grace , Kohler Pamela 
Published: September 2021

Background:
Health care worker (HCW) training using standardized patient actors (SPs) is an evidence-based approach for improving patient–provider interactions. We evaluated whether SP training among HCWs in Western Kenya improved the quality of pre-exposure prophylaxis (PrEP) counseling for adolescent girls and young women (AGYW).

Methods:
We conducted a 2-day SP training intervention among HCWs providing PrEP counseling for AGYW. Six trained SPs role played one encounter each with HCWs following scripts depicting common PrEP-seeking scenarios. SPs used checklists to report and discuss domains of adherence to national PrEP guidelines, communication, and interpersonal skills using validated scales after each encounter. HCWs presented to each case in a random order. Overall and domain-specific mean score percentages were compared between the first and subsequent case encounters using generalized linear models, clustering by HCWs.

Results:
During 564 training cases among 94 HCWs, the overall mean quality of PrEP counseling score was 83.1 (SD: 10.1); scores improved over the course of the 6 encounters (P < 0.001). Compared with the first case encounter, the mean scores for the fourth were significantly higher (79.1 vs. 85.9, P < 0.001). The mean scores plateaued from the fourth to the sixth case (85.2). Although HCWs demonstrated high baseline communication (95.3) and interpersonal skills (83.7), adherence to PrEP guidelines at baseline was suboptimal (57.6). By the fourth case, scores increased significantly (P < 0.001) for all domains.

Conclusions:
SP training improved PrEP counseling overall and in domains of interpersonal skills, use of guidelines, and communication with AGYW and could be useful in efforts to improve the quality of PrEP counseling for AGYW.