bluuebunny/crossref_metadata_2025_split huggingface dataset:
Group Treatment of Fecal Incontinence
Authors: Gonring Kelsey , Dolan Bridget , Kapke Theresa L. , Begotka Andrea , Sood Manu , Silverman Alan H. 
Published: May 2019

ABSTRACTIntroduction:Approximately 5% of children in the United States have chronic fecal incontinence. Unfortunately, standard medical management of fecal incontinence fails in 20% to 60% of cases. A combined medical‐behavioral model is often recommended in these cases. The purpose of this pilot study was to describe an interdisciplinary group‐based treatment for fecal incontinence in school‐aged children, and to present a description of changes in treatment adherence rates that affect clinical effectiveness.Method:Poop group employed a developmentally appropriate model of care in which caregivers and children participated in separate but simultaneously held therapy groups. This interdisciplinary 6‐week protocol is designed to increase appropriate stooling, decrease soiling events, and increase medication adherence pre‐ to post‐treatment. Group sessions focus on the GI system, medication, toilet sitting posture, hydration, fiber, and behavior contracts. In addition, participant families consult with an Advanced Nurse Practitioner privately at each session discussing symptoms and making medication modifications as needed.Results:Nineteen families completed the 6‐week protocol. Appropriate stool frequency was improved (P ⩽ 0.01), and soiling was reduced (P ⩽ 0.00). Medication adherence was also improved (P ⩽ 0.04). Treatment results were maintained at 1‐month follow‐up.Discussion:A developmentally targeted intervention and interdisciplinary focus of treatment likely account for treatment successes.Conclusion:Poop group may be an effective interdisciplinary treatment option for families of children who fail traditional outpatient treatment.
A Randomized Trial of Maternal Docosahexaenoic Acid Supplementation to Reduce Inflammation in Extremely Preterm Infants
Authors: Valentine Christina J. , Dingess Kelly A. , Kleiman Jeanne , Morrow Ardythe L. , Rogers Lynette K. 
Published: May 2019

ABSTRACTMaternal supplementation with 1000 mg/day docosahexaenoic acid (DHA) provides third trimester DHA accretion levels in breast milk for the preterm infant. We hypothesized that DHA supplementation to mothers providing breastmilk for extremely preterm infants would result in decreased inflammatory markers, in the infant. Mother/infant dyads (n = 27) were enrolled at birth and mothers were assigned to receive 200 or 1000 mg/day of DHA. Milk and plasma samples were analyzed for fatty acids and inflammatory markers. Decreases in inflammation were observed in both maternal and infant plasma and correlated with red blood cell (RBC) DHA levels. The fact that maternal DHA supplementation decreases infant markers of inflammation implies that DHA, delivered through breastmilk, has the potential to decrease inflammation in the infant.
Acquired Hearing Loss, Anger, and Emotional Distress
Authors: Ferrari Silvia , Monzani Daniele , Gherpelli Chiara , MacKinnon Andrew , Mongelli Francesca , Federici Gaia , Forghieri Matilde , Galeazzi Gian Maria 
Published: May 2019

Abstract
The aim of the study was to test whether acquired hearing loss (AHL)–related perceived disability mediates the association between AHL and psychological outcomes, including anger. Two-hundred ninety-seven consecutive outpatients with AHL assessed by pure tone average (PTA) loss completed the following: Hearing Handicap Inventory for Adults (HHIA), State-Trait Anger Expression Inventory–2 (STAXI-2), Brief Symptom Inventory (BSI), Diagnostic Criteria for Use in Psychosomatic Research (DCPR), and Social Functioning Questionnaire. In the sample, composed of 44.5% males with a mean age of 53.8 and a mean PTA of 30.7, AHL was associated to perceived hearing handicap, also correlating to all psychological measures except DCPR demoralization. Associations were stronger between the HHIA–Emotional Subscale, STAXI-2 State Anger and Feeling Angry, and BSI-Somatization, Interpersonal Sensitivity, Depression, and Psychoticism. Perceived disability predicted the presence of almost all psychosocial outcomes and confirms to be the most significant target of clinical action.
The Burden of Burnout Syndrome in Pediatric Intensive Care Unit and Pediatric Emergency Department
Authors: Yazıcı Mutlu Uysal , Teksam Ozlem , Agın Hasan , Erkek Nilgun , Arslankoylu Ali Ertug , Akca Halise , Esen Feyza , Derinoz Oksan , Yener Nazik , Kılınc Mehmet Arda , Yılmaz Resul , Koksoy ÖzlemTemel , Kendirli Tanıl , Anıl Ayse Berna , Yıldızdas Dincer , Ozturk NiluferYalındag , Tekerek NazanUlgen , Duyu Muhterem , Kalkan Gokhan , Emeksiz Serhat , Kurt Funda , Alakaya Mehmet , Goktug Aytac , Ceylan Gokhan , Bayrakcı Benan 
Published: May 2019

Objective
The objective of this study was to detect variables associated with burnout syndrome (BS) in pediatric intensive care units (PICUs) and pediatric emergency medicine departments (PEDs) in high-volume centers from different parts of Turkey.

Methods
An observational, cross-sectional multicenter study was performed. The Maslach Burnout Inventory scale was administered to all of health care providers working in PICUs and PEDs. In this study, health care providers were defined as physicians, nurses, and other staff (secretaries, cleaning and patient care staff) working in PICU and PEDs.

Results
A total of 570 participants completed the survey. The major finding of this study was that 76.1% (n = 434) of PICU and PED health care professionals had BS. The most prominent subscale of BS was emotional exhaustion (62.5%). The rate of BS was higher among health care providers working in PEDs compared with PICUs (79.1% vs 73.7%, P = 0.04). The frequency of BS according to emotional exhaustion and depersonalization subscales was higher in health care providers of PEDs. The rate of BS was also significantly higher in younger employees, females, those working 51 or more hours totally in a week, those having a low monthly salary, those single or divorced, those without children, those with no childcare at home, those not owning a home, those not doing regular exercise and not having regular breakfast, those with total employment time of less than 1 year, and those not having a car or not having a hobby. In PEDs, when the daily evaluated number of patients was equal to or more than 44 (sensitivity, 88%; specificity, 66%), it predicted the occurrence of BS. In PICUs, when the number of patients cared for by 1 nurse was equal to or more than 3, it predicted the occurrence of BS (sensitivity, 78%; specificity, 62%).

Conclusions
By creating early intervention programs to prevent BS, shortages of health care professionals can be avoided and the costs of health care expenditures related to infections can be decreased.
Impact of a Stroke Recovery Program Integrating Modified Cardiac Rehabilitation on All-Cause Mortality, Cardiovascular Performance and Functional Performance
Authors: Cuccurullo Sara J. , Fleming Talya K. , Kostis William J. , Greiss Christine , Gizzi Martin S. , Eckert Anne , Ray Arlen Razon , Scarpati Rosann , Cosgrove Nora M. , Beavers Traymon , Cabrera Javier , Sargsyan Davit , Kostis John B. 
Published: May 2019

Objective
Using a feasibility analysis and matched subgroup analysis, this study investigated the implementation/safety/outcomes of a stroke recovery program (SRP) integrating modified cardiac rehabilitation for stroke survivors.

Design
This prospective cohort study of 783 stroke survivors were discharged from an inpatient rehabilitation facility to an outpatient setting; 136 SRP-participants completed a feasibility study and received the SRP including modified cardiac rehabilitation, 473 chose standard of care rehabilitation (nonparticipants), and a group (n = 174) were excluded. The feasibility study assessed the following: safety/mortality/pre-post cardiovascular performance/pre-post function/patient/staff perspective. In addition to the feasibility study, a nonrandomized subgroup analysis compared SRP-participants (n = 76) to matched pairs of nonparticipants (n = 66, with 10 nonparticipants used more than once) for mortality/pre-post function.

Results
The feasibility study showed the SRP to have the following (a) excellent safety, (b) markedly low 1-yr poststroke mortality from hospital admission (1.47%) compared with national rate of 31%, (c) improved cardiovascular performance over 36 sessions (103% increase in metabolic equivalent of tasks times minutes), (d) improved function in Activity Measure of Post-Acute Care domains (P < 0.001), (e) positive reviews from SRP-participants/staff. Subgroup analysis showed the SRP to (a) positively impact mortality, nonparticipants had a 9.09 times higher hazard of mortality (P = 0.039), and (b) improve function in Activity Measure of Post-Acute Care domains (P < 0.001).

Conclusions
Stroke survivors receiving a SRP integrating modified cardiac rehabilitation may potentially benefit from reductions in all-cause mortality and improvements in cardiovascular performance and function.
Physical Medicine and Rehabilitation
Authors: Petriceks Aldis H. , Hales Hannah A. , Srivastava Sakti 
Published: May 2019

Abstract
With an aging and growing US population, American healthcare faces an impending physician shortage. This is important for the field of physical medicine and rehabilitation, because physiatrists’ skills in managing chronic conditions and functional outcomes are especially relevant to an older population. The present study was designed to better understand the future physical medicine and rehabilitation workforce, by recording and analyzing the quantities of Accreditation Council of Graduate Medical Education–accredited physical medicine and rehabilitation graduate medical education programs and positions between 2001–2002 and 2017–2018. Results indicated that physical medicine and rehabilitation graduate medical education has grown since 2001–2002, especially in subspecialties such as pediatric rehabilitation and sports medicine. However, the growth in physical medicine and rehabilitation residency positions has been three-fold lower than that of total graduate medical education. In addition, subspecialization has become increasingly prevalent, and residency positions have declined relative to the population of older adults. The future identity of physical medicine and rehabilitation will continue to develop as professional and demographic trends shape this important medical specialty.
Cannabinoids, cannabis, and cannabis-based medicine for pain management: a protocol for an overview of systematic reviews and a systematic review of randomised controlled trials
Authors: Fisher Emma , Eccleston Christopher , Degenhardt Louisa , Finn David P. , Finnerup Nanna B. , Gilron Ian , Haroutounian Simon , Krane Elliot , Rice Andrew S.C. , Rowbotham Michael , Wallace Mark , Moore R. Andrew 
Published: May 2019

Abstract
Pain is an experience that affects many people worldwide and is associated with higher mortality and lower quality of life. Cannabinoid, cannabis, and cannabis-based medicines (CBMs) are thought to reduce pain, but a proliferation of different products has led to variability in trials, creating a challenge when determining the assessment of efficacy in systematic reviews. We will conduct 2 systematic reviews commissioned by the International Association for the Study of Pain Task Force on the use of cannabinoids, cannabis, and CBMs for pain management: first, an overview review of systematic reviews to summarise the evidence base and second, a systematic review of randomised controlled trials of cannabinoids, cannabis, and CBMs. In these reviews we will determine the harm and benefit of CBM from the current literature and will interpret the findings in light of the quality of evidence and reviews included. We will search online databases and registries in any language for systematic reviews and randomised controlled trials. We will include studies that evaluate any cannabinoid or CBM vs any control for people with acute and chronic pain. Our primary outcomes for both reviews are the number of participants achieving (1) a 30% and (2) 50% reduction in pain intensity, (3) moderate improvement, and (4) substantial improvement. A number of secondary outcome measures will also be included. We will assess risk of bias and quality of evidence. We will analyse data using fixed and random effect models, with separate comparators for cannabis and CBMs. Prospero ID (CRD42019124710; CRD42019124714).
Prospective Relations Between Prenatal Maternal Cortisol and Child Health Outcomes
Authors: Roettger Michael E. , Schreier Hannah M. C. , Feinberg Mark E. , Jones Damon E. 
Published: May 2019

ABSTRACTObjectiveThe aim of the study was to investigate prospective, longitudinal associations between maternal prenatal cortisol response to an interpersonal stressor and child health for the subsequent 3 years.MethodsOne hundred twenty-three women expecting their first child provided salivary cortisol samples between 12 and 32 weeks of gestation (M (SD) = 22.4 (4.9) weeks) before and after a videotaped couple conflict discussion with their partner. Mothers reported on overall child health and several indicators of child illness (sick doctor visits, fevers, ear, and respiratory infections) when children were 6 months (n= 114), 1 (n= 116), and 3 (n= 105) years old. Associations between maternal prenatal cortisol reactivity and recovery and later child health at each of the three time points were analyzed using longitudinal regression models.ResultsGreater cortisol reactivity in response to the couple conflict discussion was associated with maternal self-report of better overall child health (p= .016, 95% CI = 0.06–1.30, Cohen'sf= 0.045) across the study period. Greater cortisol reactivity was also associated with lower incidence rate ratios for maternal reports of sick doctor visits (incidence rate ratio 95% CI = 0.25–0.83,p= .006), fevers (95% CI = 0.25–0.73,p= .002), ear infections (95% CI = 0.25–0.58,p< .001), and respiratory infections (95% CI = 0.08–1.11,p= .073). Cortisol recovery was unrelated to study outcomes (allp's > 0.05). Maternal prenatal depressive symptoms moderated the association between cortisol reactivity and overall child health (p= .034, 95% CI = 0.07–1.87 for interaction term) but no other health outcomes (p's > 0.05). Among women with lower depressive symptoms, cortisol reactivity was not associated with overall child health; among women with higher levels of depressive symptoms, greater cortisol reactivity was associated with better overall child health.ConclusionsThis study provides longitudinal evidence that greater maternal cortisol reactivity to a salient interpersonal stressor during pregnancy is associated with fewer child health problems and better maternal report of overall child health during infancy and into early childhood.Trial Registration:Clinicaltrials.gov ID NCT01901536.
Risk Factors for Falls, Falls With Injury, and Falls With Fracture Among Older Men With or at Risk of HIV Infection
Authors: Erlandson Kristine M. , Zhang Long , Ng Derek K. , Althoff Keri N. , Palella Frank J. , Kingsley Lawrence A. , Jacobson Lisa P. , Margolick Joseph B. , Lake Jordan E. , Brown Todd T. 
Published: May 2019

Background:
Falls and fall risk factors are common among people living with HIV (PLWH). We sought to identify fall risk factors among men with and without HIV.

Methods:
Men aged 50–75 years with (n = 279) and without HIV (n = 379) from the Bone Strength Substudy of the Multicenter AIDS Cohort Study were included. Multinomial logistic regression models identified risk factors associated with falling.

Results:
One hundred fourteen (41%) PLWH and 149 (39%) of uninfected men had ≥1 fall; 54 (20%) PLWH and 66 (17%) of uninfected men experienced ≥2 falls over 2 years. Five and 3% of PLWH and uninfected men, respectively, had a fall-related fracture (P = 0.34). In multivariate models, the odds of ≥2 falls were greater among men reporting illicit drug use, taking diabetes or depression medications, and with peripheral neuropathy; obesity was associated with a lower risk (all P < 0.05). In models restricted to PLWH, detectable plasma HIV-1 RNA, current use of efavirenz or diabetes medications, illicit drug use, and peripheral neuropathy were associated with greater odds of having ≥2 falls (P < 0.05). Current efavirenz use was associated with increased odds of an injurious fall; longer duration of antiretroviral therapy was protective (both P < 0.05). Greater physical activity was associated with lower risk of falls with fracture (P < 0.05).

Conclusions:
Identified risk factors for recurrent falls or fall with fracture included low physical activity, detectable HIV-1 RNA, use of efavirenz, or use of medications to treat diabetes and depression. Fall risk reduction should prioritize interventions targeting modifiable risk factors including increased physical activity, antiretroviral therapy adherence, and transition off efavirenz.
Gadolinium-Based MRI Contrast Agents Induce Mitochondrial Toxicity and Cell Death in Human Neurons, and Toxicity Increases With Reduced Kinetic Stability of the Agent
Authors: Bower Danielle V. , Richter Johannes K. , von Tengg-Kobligk Hendrik , Heverhagen Johannes T. , Runge Val M. 
Published: May 2019

Objectives
This preclinical study was devised to investigate potential cellular toxicity in human neurons induced by gadolinium-based contrast agents (GBCAs) used for contrast-enhanced magnetic resonance imaging (MRI). Neurons modeling a subset of those in the basal ganglia were tested, because the basal ganglia region is 1 of 2 brain regions that displays the greatest T1-dependent signal hyperintensity changes.

Methods
Eight GBCAs were tested. Dopaminergic neurons modeling a subset of those in the basal ganglia were differentiated from an established human neuroblastoma cell line and exposed to increasing concentrations of each agent for 7 days. The tested dosages ranged from clinically relevant concentrations measured in some autopsy patients who had received repeated injections of contrast for MRI, to higher concentrations to reveal dose-dependent toxicity trends. Cell death, mitochondrial membrane potential, mitochondrial oxidative capacity, and mitochondrial function measured by oxygen consumption were quantified in cells treated with each GBCA or the osmolality control mannitol and compared to untreated cells which served as a negative control.

Results
Mannitol caused no change from negative controls in any of the tests, at any concentration tested. For all GBCAs, cell death increased with exposure dose, with toxicity at clinically relevant doses for agents with lower kinetic stability. Reduction of mitochondrial membrane potential and oxidative respiratory function also generally mirrored the agents' structural kinetic stabilities, with greater impairment at lower concentration for the less stable agents.

Conclusions
In human neurons modeling a subset of those in the basal ganglia, these results demonstrate a toxic effect of gadolinium-containing MRI contrast agents on mitochondrial respiratory function and cell viability. Toxicity increases as agent concentration increases and as the kinetic stability of the agent decreases.
FDG PET/MRI Findings Pointing Toward a Gayet-Wernicke Encephalopathy
Authors: Rozenblum Laura , Habert Marie-Odile , Pyatigorskaya Nadya , Roue-Jagot Carole , Kas Aurélie 
Published: May 2019

Abstract
We report a case of Gayet-Wernicke encephalopathy, revealed by an 18F-FDG PET/MRI performed in a patient with memory impairment. Metabolism showed no pattern of neurodegenerative disease, but a severe decrease in hippocampus and mammillary bodies (MBs). MRI images analyzed in light of PET findings revealed MB atrophy coupled with signal-intensity alterations, suggestive of a Gayet-Wernicke encephalopathy. Patient was known for alcohol use disorders, and all previous MRI scans were considered as inconclusive. Symptoms improved with correction of thiamine (vitamin B1) deficiency. This report highlights ability of hybrid PET/MRI to investigate small neuronal structures, such as the MBs involved in Gayet-Wernicke disease.
The Preventive Effect of Parotid Gland Massage on Salivary Gland Dysfunction During High-Dose Radioactive Iodine Therapy for Differentiated Thyroid Cancer
Authors: Son Seung Hyun , Lee Chang-Hee , Jung Ji-Hoon , Kim Do-Hoon , Hong Chae Moon , Jeong Ju Hye , Jeong Shin Young , Lee Sang-Woo , Lee Jaetae , Ahn Byeong-Cheol 
Published: May 2019

PurposeTo evaluate the preventive effect of parotid gland (PG) massage for PG damage during the131I therapy, we prospectively investigated the serum amylase value and salivary gland scintigraphy (SGS) after131I therapy.Materials and MethodsOne hundred patients with thyroidectomized differentiated thyroid cancer who underwent high-dose131I therapy were enrolled in the clinical trial and randomized into 2 groups (PG massage group and nonmassage group). The serum amylase value was obtained before and 24 hours after131I therapy, and the SGSs were also taken just before and at 8 months after the131I therapy. Change in serum amylase value and SGS was compared between PG massage and nonmassage groups.ResultsThe difference value of serum amylase was significantly lower in PG massage group than in nonmassage group (P= 0.0052). Worsening of PG function on SGS was observed in 43 (45.3%) of the 95 patients. The incidence rate of PG abnormality on F/U SGS was significantly lower in PG massage group than in nonmassage group (odds ratio, 0.3704;P= 0.0195). In the multiple regression analysis, PG massage significantly affected the abnormality on the 8-month F/U SGS (rpartial= −0.2741,P= 0.0090) after adjusting for clinical variables (age, sex, TNM stage, TSH preparation methods for the131I therapy, and131I dose).ConclusionsPG gland massage significantly reduced the incidence rates of salivary gland dysfunction on the 8-month F/U SGS and the level of the serological marker of salivary gland destruction after131I therapy. Therefore, PG gland massage could alleviate salivary gland damage related to131I therapy.
Heterogeneity of 68Ga-PSMA PET/CT Uptake in Fibrous Dysplasia
Authors: Plouznikoff Nicolas , Garcia Camilo , Artigas Carlos , Entezari Kim , Flamen Patrick 
Published: May 2019

Abstract
Fibrous dysplasia is an uncommon benign bone pathology with only rare potential for malignant transformation. We describe the heterogeneous uptake of fibrous dysplasia of a whole rib on 68Ga-labeled prostate-specific membrane antigen (PSMA) PET/CT. 68Ga-PSMA binds to PSMA-expressing prostate cancer cells, but it can also bind to the neovasculature of various solid tumors, as well as to some benign lesions. 68Ga-PSMA expression in fibrous dysplasia should not automatically be equated with malignant transformation or confused with prostate cancer metastases.