bluuebunny/crossref_metadata_2025_split huggingface dataset:
Care Coordination and Multispecialty Teams in the Care of Colorectal Cancer Patients
Authors: Trogdon Justin G. , Chang Yunkyung , Shai Saray , Mucha Peter J. , Kuo Tzy-Mey , Meyer Anne M. , Stitzenberg Karyn B. 
Published: March 2018

Objectives:
To estimate the association between provider and team experience and adherence to guidelines, survival, and utilization among colorectal cancer patients in North Carolina.

Subjects:
The analysis cohort included 7295 patients diagnosed with incident stage II/III colorectal cancer between 2004 and 2013 who received surgery.

Methods:
Primary outcomes included adherence to guidelines: consultation with a medical oncologist (stage III), receipt of adjuvant chemotherapy (stage III), and receipt of surveillance colonoscopy posttreatment. Secondary outcomes included 5-year overall survival, number of surveillance radiology studies, any unplanned hospitalization, and any emergency department visit. The primary predictors were measures of provider volume and patient sharing across surgeons and medical oncologists. Regression analyses adjusted for patient and provider characteristics.

Results:
Patients whose surgeons shared >40% of their colorectal cancer patients in the previous year with a medical oncologist were (1) more likely to have had a consultation with a medical oncologist [marginal effect (ME)=13.3 percentage points, P-value<0.001], (2) less likely to receive a surveillance colonoscopy within 12 months (ME=3.5 percentage points, P-value=0.049), and (3) received more radiology studies (ME=0.254 studies, P-value=0.029). Patients whose surgeon and medical oncologist shared >20% of their colorectal cancer patients with each other in the previous year had a higher likelihood of receiving adjuvant chemotherapy (ME=11.5 percentage points, P-value<0.001) and surveillance colonoscopy within 12 months (ME=6.7 percentage points, P-value=0.030) and within 18 months (ME=6.2 percentage points, P-value=0.054).

Conclusions:
Our study shows that team experience is associated with patients’ quality of care, survival, and utilization.
Successful Management of a Rare Cause of Hemolytic Uremic Syndrome With Eculizumab in a Child
Authors: Alparslan Caner , Yavaşcan Önder , Kasap Demir Belde , Atmiş Bahriye , Karabay Bayazit Aysun , Leblebisatan Göksel , Öncel Elif P. , Alaygut Demet , Mutlubaş Fatma , Aksu Nejat 
Published: March 2018

Background:
Hemolytic uremic syndrome (HUS) is characterized by microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia. It very rarely coexists with acute lymphoblastic leukemia (ALL) emerging before, simultaneously, or after the diagnosis has been made, and management of the patient may be difficult.

Case:
We present the case of a 7-year-old boy who was diagnosed with HUS and initially managed by hemodialysis (HD). Thereafter, HUS progressed, and neurological findings developed. The patient was treated with eculizumab, agressive blood pressure control, and antiepileptic drugs. At the fifth month of follow-up, the patient was diagnosed with acute B-cell lymphoblastic leukemia with fever, bone pain, hepatosplenomegaly, and pancytopenia. After initiation of ALL treatment, he had no episodes of HUS, despite cessation of eculizumab.

Conclusion:
In conclusion, eculizumab may be a treatment of choice to prevent further systemic damage in recurrent HUS episodes of patients with borderline changes in the bone marrow until ALL is constantly diagnosed.
Role of Pediatric Physical Therapists in Promoting Sports Participation in Developmental Coordination Disorder
Authors: Adams Imke L. J. , Broekkamp Wenke , Wilson Peter H. , Imms Christine , Overvelde Anneloes , Steenbergen Bert 
Published: March 2018

Purpose:
To explore the role of pediatric physical therapists (PPT) in promoting sports participation in children with developmental coordination disorder (DCD) and identify associated barriers and facilitators.

Methods:
Questionnaires were provided to 243 PPTs. Qualitative, semistructured, in-depth interviews were administered with the PPTs, children with DCD, and parents.

Results:
Approximately 67% of questionnaires were returned. Approximately 46% of PPTs were active in guiding children with DCD to sports clubs. This guidance was facilitated by knowledge of local sports, clubs that include children with DCD, and contact persons. Barriers to sports participation were the motor impairment or coincident disorder, insufficient participants to compose a team, and lack of guidance on how to include children with DCD.

Conclusions:
PPTs currently guide children with DCD to sports clubs, but this guidance may be improved by connecting them to special exercise programs and mainstream sports clubs and examining children's experiences during sports.
Use of a Midliner Positioning System for Prevention of Dolichocephaly in Preterm Infants
Authors: McCarty Dana B. , O'Donnell Shannon , Goldstein Ricki F. , Smith P. Brian , Fisher Kimberley , Malcolm William F. 
Published: March 2018

Purpose:
The purpose of this study was to determine effectiveness of a midliner positioning system (MPS, Tortle Midliner) for preventing dolichocephaly.

Methods:
This was a nonrandomized, prospective study of 30 premature infants (study cohort, SC) using an MPS compared with a retrospective study cohort (RSC) of 65 infants who received standard of care intervention.

Results:
RSC baseline cranial index (CI) of 80% and final CI of 77% significantly decreased over an average 5.5 weeks (P < .0001). The SC baseline CI and the final CI were both 79% over an average 5.7 weeks, indicating no significant difference between CI measures (P = .6). Gestational age, birth weight, reflux, time on continuous positive airway pressure, and time in a supine position were not associated with dolichocephaly.

Conclusions:
The SC developed less cranial molding (ie, had greater CI), compared with the RSC. A larger randomized study is needed to recommend routine use of MPS for prevention and/or treatment of cranial molding in premature infants.
Effects of Postural Management on Hip Migration in Children With Cerebral Palsy: A Systematic Review
Authors: Gmelig Meyling Christiaan , Ketelaar Marjolijn , Kuijper Marie-Anne , Voorman Jeanine , Buizer Annemieke I. 
Published: March 2018

Purpose:
To review the existing literature on the effects of postural management on hip migration in children with cerebral palsy.

Methods:
A systematic literature search was performed using 5 databases. Quality of articles was assessed and study designs were appraised according to the American Academy of Cerebral Palsy and Developmental Medicine Systematic Review Method.

Results:
Eight of 655 identified studies were included, reporting postural management in children with cerebral palsy. Seven of 8 studies reported positive effects on hip migration after postural management interventions. However, level of evidence and quality of the articles were low.

Conclusion:
The evidence for postural management to prevent or reduce hip migration in children with cerebral palsy is limited by the lack of high-quality studies. Strong recommendations for clinical practice are not possible. Future high-quality research is crucial to improve our understanding of the effects of postural management to prevent hip migration in children with cerebral palsy.
Descriptive Report of the Impact of Fatigue and Current Management Strategies in Cerebral Palsy
Authors: Brunton Laura K. 
Published: March 2018

Purpose:
To describe the effect of fatigue and self-management practices for adolescents and young adults with cerebral palsy.

Methods:
A survey of 124 people with cerebral palsy with the Fatigue Impact and Severity Self-Assessment.

Results:
Participants in Gross Motor Function Classification System (GMFCS) level I experienced little effect of fatigue, with high proportions of this group disagreeing to statements about fatigue impacting their general activities, mobility, and social activities. Participants in GMFCS levels II to V reported effect of fatigue on activities. Differences between groups were evident in questions related to fatigue interference with length of time for physical activity and with motivations to participate in social activities. All other items related to management of fatigue were not significantly different between groups.

Conclusions:
Fatigue effect is greater for participants with more functional limitations. The lack of significant differences between groups, on the Management and Activity Modification subscale, indicates more research is needed regarding strategies for fatigue management.
Epidemiology of Cerebral Palsy in Northeastern Switzerland
Authors: Forni Ruben , Stojicevic Violeta , van Son Careen , Lava Sebastiano A. G. , Kuenzle Christoph , Beretta-Piccoli Matteo 
Published: March 2018

Purpose:Cerebral palsy (CP) is the most common motor disability of childhood. Less is known about its prevalence and associated factors in Switzerland, so we aimed to fill this knowledge gap in one Swiss canton, evaluating the feasibility to build up a CP registry.Methods:A retrospective review of medical records was undertaken. Children born during 1995 and 2009 in the canton of Saint Gallen diagnosed with CP were eligible for inclusion.Results:A total of 140 patients formed the study cohort. The prevalence of CP was 0.19%, with 85% of children affected by spastic CP.Conclusions:The results of the present study were comparable with data of the Surveillance of Cerebral Palsy in Europe network. Moreover, this pilot study demonstrated the feasibility and usefulness of creating a registry of children affected by CP.
Head Control Changes After Headpod Use in Children With Poor Head Control: A Feasibility Study
Authors: Brown Julie E. , Thompson Mary , Brizzolara Kelli 
Published: March 2018

Purpose:
To determine the feasibility of Headpod use to improve head control in children with cerebral palsy classified as Gross Motor Function Classification System level V.

Methods:
Children (3-11 years) with poor head control were video recorded before and after 3 and 6 months of Headpod use. Head control without Headpod was measured by active time children could hold head upright and number of head bobs in 5 minutes.

Results:
Fourteen children enrolled with 43% attrition rate. While average active time increased, average head bobs decreased and there were significant improvements in active time, but not head bobs. Active times were higher at 6 months compared with 3 months and baseline. Surveyed parents reported that the changes were apparent, supporting the large quantitative treatment effect.

Conclusions:
Six months of Headpod use, 45 minutes per day, appears to be feasible, has a large effect on active head control, and merits a larger randomized controlled trial.
Functional Mobility Improved After Intensive Progressive Resistance Exercise in an Adolescent With Spina Bifida
Authors: Baym Carol L. , Hedgecock James B. , Rapport Mary Jane K. 
Published: March 2018

Purpose:
To describe the use and effectiveness of a novel intensive progressive resistance exercise (PRE) approach to address the functional goals of a 14-year-old adolescent with a myelomeningocele.

Summary of Key Points:
The child had lower extremity weakness, knee and hip flexion contractures, impaired somatosensation, and cardiopulmonary deconditioning, affecting gait mechanics and functional ambulation. An 8-week intensive PRE-based intervention was designed to improve walking in the home by targeting both power-generating and stabilizing lower extremity musculature. Secondary intervention focused on cardiopulmonary endurance training.

Conclusions:
The child demonstrated improvements in gait speed, walking endurance, and functional lower extremity strength. Knee contracture was moderately responsive to sustained stretching and positioning.

What This Case Adds to Evidence-Based Practice:
This intensive PRE training approach had been effective for improving function among youth with cerebral palsy, and to our knowledge it had not yet been applied to youth with other neurological conditions.
Targeted Training in Managing Children With Poor Trunk Control: 4 Case Reports
Authors: Pin Tamis W. , Butler Penelope B. , Shum Sandra Lai-Fong 
Published: March 2018

Purpose:
This study investigated whether targeted training was feasible with young children younger than 2 years with poor trunk control due to cerebral palsy or developmental delay without using specialized equipment and the overall change in trunk control and functional ability, with the addition of targeted training to standard care physical therapy.

Summary of Key Points:
Four children younger than 24 months with motor disorders were recruited. No difficulty was identified in using targeted training with this group. Within 3 months of commencing intervention, the 4 children had increased trunk control and functional abilities including independent sitting and bilateral hand use in play.

Conclusions and Recommendations for Clinical Practice:
This form of targeted training was feasible for young children with motor disorders and augmented standard care therapy in enhancing both trunk control and motor skills. Targeted training should be further investigated as a potentially effective treatment.
Clubfoot Does Not Impair Gross Motor Development in 5-Year-Olds
Authors: Zapata Karina A. , Karol Lori A. , Jeans Kelly A. , Jo Chan-Hee 
Published: March 2018

Purpose:
To evaluate the gross motor development of 5-year-olds using the Peabody Developmental Motor Scales, 2nd Edition (PDMS-2), test after initial nonoperative management of clubfoot as infants.

Methods:
The PDMS-2 Stationary, Locomotion, and Object Manipulation subtests were assessed on 128 children with idiopathic clubfeet at the age of 5 years. Children were categorized by their initial clubfoot severity as greater than 13, unilateral or bilateral involvement, and required surgery.

Results:
Children with treated clubfeet had average gross motor scores (99 Gross Motor Quotient) compared with age-matched normative scores. Children with more severe clubfeet required surgery significantly more than children with less severe scores (P < .01). Peabody scores were not significantly different according to initial clubfoot severity, unilateral versus bilateral involvement, and surgical versus nonsurgical outcomes.

Conclusions:
Clubfoot does not significantly impair gross motor development in 5-year-olds.
Our Journal Unites Us: Global Responsibilities and Possibilities for Pediatric Physical Therapy
Authors: Van Sant Ann F. 
Published: March 2018

Purpose:
This article was designed to describe personal and social responsibilities for strengthening the science of pediatric physical therapy and effective international research collaboration and communication.

Key Points:
Common flaws in research design and analysis are reviewed with recommendations for developing research students' design and analytical skills. Our social responsibility to be informed by global knowledge is highlighted. Barriers to scientific collaboration and communication including international disparities in scientific development and language barriers are presented. Suggestions to reduce these barriers are outlined. The importance of free access to scientific literature in developing countries is reviewed.

Conclusion:
The journal should assume a leadership role in building a strong science of pediatric physical therapy through encouraging personal and social responsibility in research and serving as a model of international collaboration and communication.

Clinical Relevance:
Treatment for children with movement disorders will be improved by stronger science, international collaboration, and communication.
Targeted Muscle Reinnervation: Considerations for Future Implementation in Adolescents and Younger Children
Authors: Zuo Kevin J. , Willand Michael P. , Ho Emily S. , Ramdial Sandra , Borschel Gregory H. 
Published: March 2018

Summary:
Prosthetic options for patients with proximal upper limb absence are limited. Current above-elbow prostheses may restore basic motor functions for crucial activities, but they are cumbersome to operate, lack sensory feedback, and are often abandoned. Targeted muscle reinnervation is a novel surgical procedure that enhances the ability of patients with above-elbow amputations to intuitively control a myoelectric prosthesis. By transferring multiple severed peripheral nerves to a robust target muscle, targeted muscle reinnervation restores physiologic continuity and enables more intuitive prosthetic control. Although reports have been limited to adults, targeted muscle reinnervation has great potential for application in a pediatric population with congenital or acquired proximal upper limb absence. In this review, the authors describe the rehabilitative challenges of proximal upper limb amputees and outline the objectives, techniques, and outcomes of targeted muscle reinnervation. The authors then discuss important considerations for adapting targeted muscle reinnervation to pediatric patients, including cause of upper limb absence, central plasticity, timing of prosthesis fitting, role of the family, surgical feasibility, and bioethical aspects. The authors believe that carefully screened school-age children and adolescents with bilateral proximal upper limb absence, and select adolescents with unilateral proximal upper limb absence, should be seriously considered for targeted muscle reinnervation performed by an experienced surgical and rehabilitation team.
Genetics of Nonsyndromic Craniosynostosis
Authors: Timberlake Andrew T. , Persing John A. 
Published: March 2018

Summary:
Occurring once in every 2000 live births, craniosynostosis is one of the most frequent congenital anomalies encountered by the craniofacial surgeon. Syndromic craniosynostoses account for approximately 15 percent of cases and demonstrate Mendelian patterns of inheritance with well-established genetic causes; however, nonsyndromic craniosynostoses, which account for approximately 85 percent of cases, are genetically heterogeneous and largely unexplored. Nonsyndromic craniosynostosis is sporadic in more than 95 percent of affected families; thus, surgeons have suggested for decades that nonsyndromic craniosynostosis is likely a fluke occurrence. Contrary to this, recent studies have established that genetics underlie a substantial fraction of nonsyndromic craniosynostosis risk. Given the predominantly sporadic occurrence of disease, parents are often bewildered by the primary occurrence of nonsyndromic craniosynostosis or even recurrence in their own families and request genetic testing. Existing genetic testing panels are useful when the phenotype strongly resembles a known syndrome, wherein the risk of disease recurrence can be accurately predicted for future offspring of the parents and the future offspring of the affected child. The diagnostic utility of existing panels for nonsyndromic craniosynostosis, however, is extremely low, and these tests are quite costly. Recent genetic studies have identified several novel genes and pathways that cause nonsyndromic craniosynostosis, providing genetic evidence linking the causes of syndromic and nonsyndromic craniosynostoses, and allowing for genotype-based prediction of risk of recurrence in some nonsyndromic families. Based on analysis of exome sequence data from 384 families, the authors provide recommendations for a new genetic testing protocol for children with nonsyndromic craniosynostosis, which include testing nonsyndromic cases of sagittal, metopic, and coronal craniosynostosis.
Long-Term Outcomes of Smile Reconstruction in Möbius Syndrome
Authors: Domantovsky Irina , Copeland Jocelyne , Clancy Rachel M. , Zuker Ronald M. , Borschel Gregory H. 
Published: March 2018

Background:
Gracilis muscle transplant is the standard of care for smile reconstruction in children with Möbius syndrome. The authors describe the long-term clinical efficacy, durability, and psychosocial impact of this approach at a mean follow-up of 20 years.

Methods:
Patients with Möbius syndrome who underwent gracilis muscle transfer between 1985 and 2005 were included in the study. The authors assessed midfacial movements using photographs and Scaled Measurement of Improvement in Lip Excursion measure, administered the patient-reported Facial Clinimetric Evaluation Scale, and used semistructured interviews.

Results:
The mean age at surgery was 13.2 ±10.6 years and the mean follow-up was 20.4 ± 4.4 years postoperatively. Twenty-two gracilis muscle transplants were performed, all innervated by the motor nerve to the masseter. Photographic analysis using Scaled Measurement of Improvement in Lip Excursion software demonstrated that movement of the muscle was unchanged 20 years after surgery. Smile symmetry was stable long term. The overall mean Facial Clinimetric Evaluation score of the cohort was 62.3 ± 12.0. Facial comfort (86.4 ± 21.2) and social function (69.9 ± 18.5) subdomains were the highest. Although the facial movement subdomain score was 35.6 ± 12.4, the score related to smiling alone was 84.1 ± 20.2, indicating satisfaction with the midfacial reconstruction. Interview responses indicated high satisfaction with surgery; fulfilled expectations of social acceptance; improved communication; enhanced self-confidence; and a sense of increased facial symmetry, spontaneity, and smile excursion.

Conclusion:
Segmental gracilis muscle transplantation provides long-lasting, durable improvements in objective and patient-reported measures of facial function.
Using Black Bone Magnetic Resonance Imaging in Craniofacial Virtual Surgical Planning: A Comparative Cadaver Study
Authors: Suchyta Marissa A. , Gibreel Waleed , Hunt Christopher H. , Gorny Krzysztof R. , Bernstein Matthew A. , Mardini Samir 
Published: March 2018

Background:
The use of magnetic resonance imaging (MRI) for virtual surgical planning has not yet been described. In the United States, over 600,000 computed tomographic (CT) scans are performed annually on children, who are at higher risk than adults of developing cancer caused by ionizing radiation. The aim of this study was to demonstrate whether three-dimensionally–printed craniofacial surgical guides created from “black bone” MRI are comparable in accuracy to those created from CT scans.

Methods:
A mock craniosynostosis surgery translocating four calvarial segments was virtually planned and performed in 10 cadavers. For five specimens, planning was performed and three-dimensionally–printed guides were created using black bone MRI scans. Five specimens underwent standard planning using CT scans. Reconstructed skulls underwent CT scans and three-dimensional reconstruction. Accuracy was compared to that of virtually planned surgeries.

Results:
The preoperative black bone MRI scan had an average deviation from the preoperative CT scan of 1.37 mm. There was no statistically significant difference in the fit accuracy of MRI versus CT–created guides. Average deviation of postoperative anatomy from preoperative plan was within 1.5 mm for guides created from either scanning modality, with no statistically significant difference in accuracy between the two methods. Planned versus postoperative skull volume was not statistically significantly different when MRI versus CT was used.

Conclusions:
This study demonstrates that virtual surgical planning and three-dimensional craniofacial surgical guide creation can be performed using black bone MRI with accuracy comparable to that of CT. This could dramatically reduce radiation exposure of craniofacial reconstruction patients.