bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Community Hospital NICU Developmental Care Partner Program
Authors: Clubbs Brooke Hildebrand , Barnette Alan R. , Gray Natallia , Weiner Lauren , Bond April , Harden Jane , Pineda Roberta 
Published: March 2019

Background:
Volunteers can provide staff-directed sensory inputs to infants hospitalized in the NICU, but research on volunteer programs is limited.

Purpose:
To evaluate the feasibility of a developmental care partner (DCP) program in a level III NICU and determine its relationship with provider burnout and infant infection rates.

Methods:
DCPs were trained to provide sensory input to infants, based on the behavioral cues observed by the occupational therapists and nursing staff, in medically stable infants. Feasibility was assessed by documenting the process of training and utilizing volunteers, as well as tracking duration and frequency of DCP visits. Staff burnout measures were assessed using the Maslach Burnout Inventory Human Services Survey (MBI-HSS) before and after implementation. Infant infection rates before and after the introduction of volunteers were compared. Results: Seventy-two volunteers were interested, and 25 (35%) completed the DCP competencies and provided sensory exposures to 54 neonates, who were visited an average of 8 times (range 1-15). Twelve (48%) DCPs did once-per-week visits, and 9 (36%) did at least 50 contact hours. MBI-HSS scores for staff emotional exhaustion (P < .001) and depersonalization (P < .006) were lower after DCP implementation. There were no differences in infant infection rates before and after DCP implementation (Fisher exact P = 1.000).

Implications for Practice:
Volunteer-based DCP programs may be feasible to implement in community hospitals and could help reduce staff emotional exhaustion and depersonalization without increasing the incidence of infant infections.

Implications for Research:
Future research on NICU volunteer programs with larger sample sizes and different infant populations is warranted.
What Is the Impact of NICU-Dedicated Lactation Consultants? An Evidence-Based Practice Brief
Authors: Mercado Kathryn , Vittner Dorothy , McGrath Jacqueline 
Published: March 2019

Background:
Benefits of exclusive human milk diets for preterm and low birth-weight infants are well established. Despite known benefits, supporting mothers in the provision of mother's own milk for high-risk infants is challenging. Lactation support in the neonatal intensive care unit (NICU) is highly variable. Lactations consultants (LCs) are often shared between postpartum units and the NICU, potentially increasing LC workload with less time spent with high-risk mothers. Furthermore, less than half of NICUs in the United States staff an international board-certified lactation consultant. Limited understanding exists regarding impacts of NICU-specific lactation support on breastfeeding outcomes.

Purpose:
The purpose of this evidence-based practice brief is to synthesize the literature on the impact of NICU-specific lactation support, LCs who work exclusively in the NICU, and provide guidance about how NICU staffing with LCs solely focused on supporting mothers of high-risk infants impacts breastfeeding outcomes for low birth-weight infants.

Search Strategy:
CINAHL PLUS, PubMed, Cochrane Library, and OVID databases were searched using key words and restricted to English language.

Findings:
During hospitalization, NICUs staffed with dedicated board-certified LCs have increased potential to yield improved breastfeeding rates through hospital discharge, increased proportion of infants who receive mother's own milk, and increased duration of breastfeeding or human milk expression through hospital discharge.

Implications for Practice:
Human milk nutrition is related to improved outcomes for high-risk infants. Neonatal intensive care unit–specific lactation support can potentially optimize maternal breastfeeding practices and improve outcomes for high-risk infants.

Implications for Research:
There is a need for further studies pertaining to NICU-specific lactation consultants and influences on breastfeeding outcomes.
Disparities in Care: Do Children with Autism Spectrum Disorder Experience Differential Medication Receipt In The Emergency Department?
Authors: Friedlaender Eron , Griffis Heather , Faerber Jennifer , Quarshie William , Ely Beth 
Published: March 2019

ABSTRACT:

Objective:
The primary objective of this study was to describe analgesia administration between neurotypical (NT) individuals and those with autism spectrum disorder (ASD) diagnosed with appendicitis or long bone fractures in the emergency department (ED). A secondary objective was to compare the rates of complicated appendicitis as a proxy for delayed diagnosis between the groups.

Methods:
This is a retrospective cohort study using the Pediatric Health Information System database. Study participants were children aged 6 to 18 years with ASD and with an ED visit for appendicitis or fracture between 2004 and 2015 who were matched to demographically similar NT children. Children with a developmental disorder and/or complex chronic condition were excluded. Coarsened exact matching and logistic regression were used to investigate the association between ASD status and opioid and non-opioid medication receipt. Comparison of the rates of complicated appendicitis in children with ASD and NT children was conducted before matching.

Results:
From 2004 to 2015, 126,412 children with appendicitis and 392,151 children with long bone fractures were identified. Of these, 889 children had a diagnosis of ASD and were matched to 35,672 NT controls with appendicitis. In addition, 2117 children with ASD were matched to 200,635 NT controls with long bone fractures. Receipt of opioids or nonsteroidal anti-inflammatory drugs was not found to be significantly different between the 2 groups. However, a larger proportion of children with ASD presented with complicated appendicitis compared with NT controls (37.1% vs 29.9%, respectively; p < 0.001).

Conclusion:
Receipt of analgesia did not differ significantly between populations of ASD and NT peers. Children with ASD have increased rates of complex appendicitis, possibly suggesting limited access to care or provider difficulty in evaluating this patient population.
Practical Computed Tomography Scan Findings for Distinguishing Metopic Craniosynostosis from Metopic Ridging
Authors: Birgfeld Craig B. , Heike Carrie L. , Al-Mufarrej Faisal , Oppenheimer Adam , Kamps Shawn E. , Adidharma Widya , Siebold Babette 
Published: March 2019

Background:
Premature fusion of the metopic suture (ie, metopic craniosynostosis) can be difficult to discriminate from physiological closure of the metopic suture with ridging (MR). Yet, MCS is treated surgically, whereas MR is treated nonsurgically. Often, the diagnosis can be made by physical examination alone, but in difficult cases, a computed tomography (CT) scan can add additional diagnostic information.

Methods:
We de-identified, randomized, and analyzed the CT scans of patients with MCS (n = 52), MR (n = 20) and age-matched normative controls (n = 52) to identify specific findings helpful in distinguishing between MCS and MR. Four expert clinicians were blinded to the clinical diagnosis and assessed each CT for features of the orbits, frontal bones, and inner table of calvaria.

Results:
Although no single feature was diagnostic of MCS, we identified several signs that were correlated with MCS, MR, or controls. Features such as “posteriorly displaced frontal bone” and “frontal bone tangent to mid-orbit or medial” demonstrated higher correlation with MCS than MR and the addition of other features improves the accuracy of diagnosis as did inclusion of the interfrontal divergence angle.

Conclusion:
The presence of a closed metopic suture in addition to other CT scan findings may improve the accuracy of diagnosing MCS, MR, and normocephaly.
Public Perception of Plastic Surgery in Saudi Arabia
Authors: Almarghoub Mohammed A. , Almarzouq Sawsan F. , Alissa Sami I. 
Published: March 2019

Background:
The general public perceives plastic surgeons as cosmetic surgeons. This study aimed to assess the general public’s awareness of the field of plastic and reconstructive surgery in Saudi Arabia.

Methods:
A short, anonymous, web-based survey was distributed to the public using SurveyMonkey as a platform. Participants were asked to choose the surgeon for managing 16 case scenarios, 11 of which were commonly managed by plastic surgeons.

Results:
In total, 2,116 participants completed the survey. The participants correctly chose plastic surgery as the specialty for managing 3 of the 11 listed plastic surgery case scenarios.

Conclusion:
More efforts are needed from plastic surgeons and media to educate the public about the scope of plastic and reconstructive surgery.
Biota Dose Assessment of Small Rodents Sampled Near Breccia Pipe Uranium Mines in the Grand Canyon Watershed
Authors: Minter Kelsey M. , Jannik G. Timothy , Hinck Jo Ellen , Cleveland Danielle , Kubilius Walter P. , Kuhne Wendy W. 
Published: March 2019

Abstract
The biotic exposure and uptake of radionuclides and potential health effects due to breccia pipe uranium mining in the Grand Canyon watershed are largely unknown. This paper describes the use of the RESRAD-BIOTA dose model to assess exposure of small rodents (n = 11) sampled at three uranium mine sites in different stages of ore production (active and postproduction). Rodent tissue and soil concentrations of naturally occurring uranium (234U, 235U, and 238U), thorium (228Th, 230Th, and 232Th), and radium (226Ra) radioisotopes were used in the dose model. The dose assessment results indicated that the potential internal, external, and total doses to rodents were below the US Department of Energy’s biota dose standard of 1 mGy d−1. As expected, tissue concentrations of 238U, 234U, and 230Th were in approximate equilibrium; however, 226Ra results in tissue were 1.25 to 5.75 times greater than 238U, 234U, and 230Th tissue results for 10 out of 11 samples. Soil at the three sites also displayed 226Ra enrichment, so it is likely that the 226Ra enrichment in the rodents was from soil via typical activities (i.e., burrowing, incidental ingestion, bathing, etc.) or by dietary uptake of translocated 226Ra. The results suggest that 226Ra is more mobile in this environment and bioaccumulates in these rodent species (e.g., in bones via the bloodstream). Internal dose accounting suggests that 226Ra is the radionuclide of most concern for rodent exposure and health.
Study of Primordial 226Ra, 228Ra, and 40K Concentrations in Dietary Palm Dates and Concomitant Radiological Risk
Authors: Khandaker Mayeen Uddin , Shuaibu Hauwau Kulu , Alklabi Farida Assghir Amar , Alzimami Khalid S. , Bradley D.A. 
Published: March 2019

Abstract
The presence of natural radionuclides in the food chain point to a need to assess concentration levels and concomitant radiological risk. Highly popular and forming a staple part of the diet in North Africa, the Arabian Peninsula, and West Asia, palm dates growing naturally there have even greater marketability than simple satisfaction of domestic demand, the palm dates representing a valuable export item. Accurate knowledge of the levels of natural radioactivity in the fruit is thus of importance. In this study, using high-purity germanium gamma-ray spectrometry, quantification has been made of natural radionuclide concentrations in imported dates originating from Iran, Saudi Arabia, and Tunisia. Sample analyses reveal respective mean activity concentrations of 1.4 ± 0.3, 0.8 ± 0.4, and 186 ± 9 Bq kg−1 dry weight for 226Ra, 228Ra, and 40K. For each nuclide, the mean concentration varies little between the dates of the three represented regions. The estimated committed effective dose resulting from the consumption of date fruits for a typical adult was found to be 29.9 μSv y−1, well below the global internal dose of 290 μSv y−1 assessed by the United Nations Scientific Committee on the Effects of Atomic Radiation to be due to food and water intake. Similarly, the excess lifetime cancer risk due to naturally occurring radioactive material exposure via date fruit consumption is seen to be below the International Commission on Radiological Protection cancer risk factor of 2.5 × 10−3 based on the additional annual dose limit of 1 mSv for a member of the general public. The results show no significant uptake in the analyzed date fruits.
Immunohistochemical Analysis of the Lacrimal Sac Mucopeptide Concretions
Authors: Ali Mohammad Javed , Heichel Jens , Paulsen Friedrich 
Published: March 2019

Fibronectin and vWF are present in the core of the dacryoliths. Blood components may act as a nidus in the evolution of lacrimal sac mucopeptide concretions.

Purpose:
To investigate the presence and distribution patterns of proteins in the lacrimal sac mucopeptide concretions.

Methods:
The study was performed on 10 mucopeptide concretions obtained from the lacrimal sac during an endoscopic dacryocystorhinostomy. Immunohistochemical labeling was performed for assessing the presence and distribution of von Willebrand factor, fibronectin, collagen I, collagen III, human beta-defensin 2, beta-defensin 3, lysozyme, prolactin, cytokeratin (CK)—CK4, CK7, CK18, immunoglobulin M (IgM), immunoglobulin G (IgG), psoriasin (S100-A7), and migration inhibitory factor-related protein (MRP14/S100-A9). The results were then scored as positive or negative and the distribution pattern, if any, within the sectioned concretions was assessed.

Results:
Immunohistochemical labeling was strongly positive for von Willebrand factor and fibronectin in the core areas of the concretions. Collagen I was widely dispersed both in the peripheral and core areas whereas collagen III was mostly limited to only few areas of the core. Strong immunoreactivity was noted for lysozyme, which was abundantly distributed, whereas prolactin receptors were positive on the surface and also the dispersed cells within the concretion matrices. Very few peripheral areas of concretions showed MRP14 or S100-A9 positivity in a noncontiguous fashion. Immunoreactivity was uniformly negative for CK-18, IgM, IgG, and psoriasin.

Conclusions:
The presence of fibronectin and von Willebrand factor in the core of the concretions strengthens the earlier hypothesis that blood components may act as a nidus for subsequent mucopeptide deposition. The study also provides possible clues to the lacrimal defenses mounted during dacryolithiasis.
Further Evidence of the Relationship Between Cochlear Implant Electrode Positioning and Hearing Outcomes
Authors: Chakravorti Srijata , Noble Jack H. , Gifford René H. , Dawant Benoit M. , O’Connell Brendan P. , Wang Jianing , Labadie Robert F. 
Published: March 2019

Background:
Postoperative imaging studies by numerous groups have revealed that final cochlear implant (CI) electrode position impacts audiological outcomes with scalar location consistently shown to be a significant factor. Modiolar proximity has been less extensively studied, and findings regarding the effect of insertion depth have been inconsistent.

Methods:
Using previously developed automated algorithms, we determined CI electrode position in an Institutional Review Board-approved database of 220 CI ears. Generalized linear models (GLM) were used to analyze the relationship between audiological outcomes and factors including age, duration of CI use, device type, and electrode position.

Results:
For precurved arrays, GLM revealed that scalar position, modiolar proximity, base insertion depth, and sex were significant factors for Consonant-Nucleus-Consonant (CNC) words (R = 0.43, p < 0.001, n = 92 arrays), while scalar position, modiolar proximity, age, and postlingual onset of deafness were significant for Bamford-Kawal-Bench Sentences in Noise (BKB-SIN) (R = 0.51, p < 0.001, n = 85) scores. Other factors were not significant in the final model after controlling for these variables. For straight arrays, we found the insertion depth, postlingual deafness, and length of CI use to be highly significant (R = 0.47, p < 0.001) factors for CNC words (91 arrays), while for BKB-SIN scores the most significant (R = 0.47, p < 0.001) factors were insertion depth, younger age, and postlingual deafness (89 arrays).

Conclusion:
Our results confirm the significance of electrode positioning in audiological outcomes. The most significant positional predictors of outcome for precurved arrays were full scala tympani (ST) insertion and the modiolar distance, while for the lateral wall arrays the depth of insertion was the most significant factor.
Parental Perceptions of Displayed Patient Data in a PICU: An Example of Unintentional Empowerment*
Authors: Asan Onur , Scanlon Matthew C. , Crotty Bradley , Holden Richard J. , Flynn Kathryn E. 
Published: March 2019

Objectives:
To explore the perceptions of parents of pediatric patients in a PICU regarding real-time open electronic health record data displayed in patient rooms.

Design:
Cross-sectional qualitative interview study.

Setting:
PICU in a large Midwestern tertiary-care children’s hospital.

Subjects:
Parents of patients in a PICU (n = 33).

Measurements and Main Results:
Qualitative data were collected through in-person semi-structured, individual, and small-group interviews. Data were collected from March 2016 to July 2016, with approval from the study hospital’s institutional review board. Data were analyzed using inductive thematic analysis. Results included positive effects of accessing real-time open electronic health record data on family empowerment, situation awareness, potential error detection, understanding of medical data, and facilitating discussions during rounds. Concerns were reported regarding privacy of information as well as potential misinterpretation of displayed data. We identified several ways to improve this collaborative technology to make it more family-centered.

Conclusions:
This study suggests that a new health information technology system providing continuous access to open electronic health record data may be an effective way to empower and engage parents in the PICU, but potential drawbacks were also noted. The results also provide insights into the collaborative use of health information technology in the PICU setting.
Cardiopulmonary Exercise Test Using Arm Ergometry in Children With Spina Bifida: A Prediction Model for VO2peak
Authors: Tuijtelaars Jana A. M. , Leonardi-Figuiredo Marisa Maia , Crescencio Julio , Gallo Lourenço , Martinez Edson Zangiacomi , Bloemen Manon , Takken Tim , Mattiello-Sverzut Ana Claudia 
Published: March 2019

Purpose:
This study aimed to develop a prediction model for peak oxygen uptake (

JOURNAL/ppyty/04.03/00001577-201904000-00015/15FSM1/v/2023-08-23T235932Z/r/image-gif

O2peak) in children with spina bifida (SB), considering peak workload (W
peak), peak heart rate, age, sex, anthropometric measures, walking level, physical activity level, and level of the lesion.

Methods:
Data of 26 participants with SB performing a graded arm crank test were used to develop the prediction model. An unrelated data set of participants with SB was used for validation.

Results:
The following equation was developed to predict

JOURNAL/ppyty/04.03/00001577-201904000-00015/15FSM1/v/2023-08-23T235932Z/r/image-gif

O2peak of participants with SB:

JOURNAL/ppyty/04.03/00001577-201904000-00015/15FSM1/v/2023-08-23T235932Z/r/image-gif

O2peak (mL/min) = 194+18 × W
peak – 110 × sex (adjusted R
2 = 0.933, SEE = 96 mL/min). Bland-Altman analysis showed a nonsignificant mean difference between the measured and predicted values of

JOURNAL/ppyty/04.03/00001577-201904000-00015/15FSM1/v/2023-08-23T235932Z/r/image-gif

O2peak (−0.09 L/min) and limits of agreement of −0.4036 and 0.2236 L/min.

Conclusions:
The prediction model shows promising results; however, further validation using the same protocol is warranted before implementation in clinical practice.
Relationship Between Torticollis and Gastroesophageal Reflux Disorder in Infants
Authors: Bercik Deborah , Diemer Susan , Westrick Stephanie , Worley Sarah , Suder Ryan 
Published: March 2019

Purpose:
Although pediatric physical therapists may evaluate and treat infants with both congenital muscular torticollis (CMT) and gastroesophageal reflux disorder (GERD), a literature review found only 1 article suggesting a connection between these diagnoses. This study investigates a correlation between CMT and GERD.

Methods:
A retrospective chart review spanning 5 years including 2519 infants younger than 12 months examined the correlation between CMT, GERD, and other comorbidities including developmental dysplasia of the hip, oligohydramnios, multiparity, and breech positioning.

Results:
The CMT cohort had a significantly higher rate of GERD versus the general population. For all age groups, the GERD rate was significantly higher in the CMT population than in the reference population. The rate of developmental dysplasia of the hip, oligohydramnios, and breech positioning was higher in infants with both CMT and GERD.

Conclusions:
The increased likelihood of infants with CMT also having GERD has clinical implications for the pediatric physical therapist.
Assessment of Spinal Curvatures in Children With Upper Trunk Obstetrical Brachial Plexus Palsy
Authors: Acaröz Candan Sevim , Fırat Tüzün , Livanelioğlu Ayşe 
Published: March 2019

Purpose:
Effects of upper trunk obstetrical brachial plexus palsy (OBPP) on the spinal curvature and relationship between the curvature degrees and upper limb movements have not been reported.

Methods:
Spinal Mouse was used to assess spinal curvature characteristics in the sagittal and frontal planes. Upper limb movements were assessed with using the Active Movement Scale in only study group.

Results:
The degree of frontal plane curvatures was higher in the study group. In the OBPP group, 11 of 25 (44%) children had thoracal C-shaped scoliosis. Nine of these children had contralateral side scoliosis. Shoulder external rotation was inversely correlated with scoliosis angle. Moreover, shoulder external rotation and elbow flexion were lower in children with scoliosis in the OBPP group.

Conclusions:
Upper trunk OBPP may affect frontal plane alignment. Especially insufficient shoulder external rotation scores may lead to constitute thoracal scoliosis as a result of trunk compensation.