bluuebunny/crossref_metadata_2025_split huggingface dataset:
Antenatal Corticosteroids for the Prevention of Respiratory Distress Syndrome in Premature Twins
Authors: Viteri Oscar A. , Blackwell Sean C. , Chauhan Suneet P. , Refuerzo Jerrie S. , Pedroza Claudia , Salazar Ximena C. , Sibai Baha M. 
Published: August 2016

OBJECTIVE:To estimate whether antenatal corticosteroids before 34 weeks of gestation are associated with reduced incidence of respiratory distress syndrome (RDS) and composite neonatal morbidity in preterm twins.METHODS:This was a secondary analysis of a multicenter randomized trial for the prevention of preterm birth in multiple gestations. All liveborn, nonanomalous twins delivered between 24 0/7 and 36 6/7 weeks of gestation were included. Neonatal outcomes were compared between women who received antenatal corticosteroids and those who did not. The primary outcome was the incidence of RDS. The secondary outcome was the incidence of serious composite neonatal morbidity. Multivariable log Poisson regression with correlation adjustment between twins born to the same mother was performed for confounder control. Adjusted relative risks (RRs) are reported for study outcomes. Based on a post hoc power analysis, this study was powered to detect an RR less than 0.63 for RDS and greater than 1.43 for composite neonatal morbidity outcomes.RESULTS:A total of 432 women (850 neonates) were included. Only 300 (35%) neonates were born to women receiving antenatal corticosteroids. After multivariable regression, antenatal corticosteroids were not associated with a reduced incidence of RDS (81 [27%] compared with 92 [17%] neonates, adjusted RR 1.28, 95% confidence interval [CI] 0.97–1.71) or composite neonatal morbidity (87 [29%] compared with 108 [20%] neonates, adjusted RR 1.21, 95% CI 0.93–1.56). However, antenatal corticosteroids were associated with increased rates of neonatal intensive care unit admissions (235 [78%] compared with 322 [59%] neonates, adjusted RR 1.22, 95% CI 1.09–1.36) and mechanical ventilation (70 [23%] compared with 66 [12%] neonates, adjusted RR 1.52, 95% CI 1.12–2.09). Focusing analysis to newborns delivered before 34 weeks of gestation (n=311), 161 (52%) received antenatal corticosteroids. Similarly, no differences in the rate of RDS (66 [41%] compared with 68 [45%] neonates, adjusted RR 1.01, 95% CI 0.76–1.34) or composite neonatal morbidity (72 [45%] compared with 81 [54%] neonates, adjusted RR 0.95, 95% CI 0.74–1.22) were noted.CONCLUSION:In this cohort of preterm twins, antenatal corticosteroid administration was not associated with a reduced incidence of RDS and composite neonatal morbidity.
Smoking Before and During Pregnancy Among Women Reporting Depression or Anxiety
Authors: Tong Van T. , Farr Sherry L. , Bombard Jennifer , D'Angelo Denise , Ko Jean Y. , England Lucinda J. 
Published: August 2016

OBJECTIVE:
To describe prepregnancy smoking, prenatal smoking, and prenatal cessation among women reporting and not reporting depression or anxiety.

METHODS:
We analyzed cross-sectional data from the 2009–2011 Pregnancy Risk Assessment Monitoring System, a population-based survey of women with live births (N=34,633). Smoking status was defined as self-reported prepregnancy smoking (during the 3 months before pregnancy), prenatal smoking (during the last 3 months of pregnancy), and prenatal cessation (no smoking by the last 3 months among prepregnancy smokers). Depression and anxiety status was self-reported of having either condition or both during the 3 months before pregnancy. We compared smoking prevalence by self-reported depression and anxiety status using χ2 tests and adjusted prevalence ratios.

RESULTS:
Overall, 16.9% of women in our sample reported depression, anxiety, or both during the 3 months before pregnancy. Compared with those who did not report, women who reported depression or anxiety had significantly higher prepregnancy (46.7% compared with 22.5%, P<.01) and prenatal smoking (27.5% compared with 10.5%, P<.01). A lower proportion of prepregnancy smokers who reported depression or anxiety quit smoking by the last 3 months of pregnancy than those who did not report (41.4% compared with 53.8%, P<.01). In adjusted analyses, women reporting depression or anxiety were 1.5 and 1.7 times more likely to smoke prepregnancy and prenatally, respectively, and less likely to quit smoking (adjusted prevalence ratio 0.86, 95% confidence interval 0.80–0.92).

CONCLUSION:
Women who reported depression, anxiety, or both were more likely to smoke before and during pregnancy and less likely to quit smoking during the prenatal period. Screening recommendations for perinatal depression and anxiety provide an opportunity to identify a subpopulation of women who may have a higher prevalence of smoking and to provide effective tobacco cessation interventions and mental health care.
Complications Associated With Epiphysiodesis for Management of Leg Length Discrepancy
Authors: Makarov Marina R. , Dunn Samuel H. , Singer Dustin E. , Rathjen Karl E. , Ramo Brandon A. , Chukwunyerenwa Chukwudi K. , Birch John G. 
Published: August 2016

Background:
Epiphysiodesis is well-established surgical treatment for the management of leg length discrepancy (LLD) in children; however, a variety of complications may occur. This study evaluates the nature, rate, and potential risk factors of complications associated with epiphysiodesis in a large patient population treated in 1 institution.

Methods:
We evaluated the medical and radiographic records of 863 children who had lower extremity epiphysiodesis to manage LLD between 1980 and 2011.

Results:
Sixty patients (7.0%) incurred complications of some type. Twenty-three patients (2.7%) had perioperative complications unrelated to physeal growth; all resolved without surgical treatment. These included 2 patients with transient intraoperative complications (laryngospasm and allergic rash), 7 with transient neurological symptoms (5 cutaneous nerve dysesthesia or numbness and 2 peroneal nerve neuropathies), and 14 with postoperative knee stiffness which resolved with therapy. Thirty-seven patients (4.3%) developed physeal growth-related complications, including 6 patients who developed overcorrection of leg length inequality (3 had contralateral epiphysiodesis to prevent overcorrection, while 3 declined), and 31 patients who developed angular deformity and/or continued growth of the physis. Of these 31 patients, 15 had reexploration of the epiphysiodesis site, 6 underwent corrective osteotomy, while in 10, no treatment was undertaken. Compared with patients who did not develop angular deformity, these 31 patients had significantly greater LLD (5.6 vs. 3.7 cm, respectively, P<0.01), were younger (10.7 vs. 11.7 in girls; 12.4 vs. 13.5 in boys; P<0.01), and were more likely to have a congenital etiology for their LLD (P<0.01).

Conclusions:
Epiphysiodesis is a safe and effective procedure for the correction of leg length inequality. The rate of complications in this study was 7.0%, the most prevalent being the development of angular deformity. Congenital etiology, younger age, and larger limb length inequalities were risk factors for the development of angular deformity. Both surgeons and families should be aware of nature and rate of complications associated with epiphysiodesis.

Level of Evidence:
Level IV.
Parents' Concerns as They Relate to Their Child's Development and Later Diagnosis of Autism Spectrum Disorder
Authors: Richards Megan , Mossey Jana , Robins Diana L. 
Published: August 2016

ABSTRACT:

Objective:
Data from a toddler screening study were used to examine: (1) categories of concerns regarding the development of their child reported by parents prior to diagnostic evaluation, (2) congruence of parent concerns with their child's later diagnosis, (3) the extent to which parent concern(s) were associated with the therapies their child received and types of specialists consulted, and (4) the association between the number of parental concern categories and clinical measures.

Method:
Toddlers who screened positive for autism spectrum disorder (ASD) during well-child checkups received a diagnostic evaluation and parents completed a history questionnaire (n = 532; 274 ASD, 258 non-ASD). Parents' concerns about their child's development, therapy received, and specialists consulted were coded into discrete categories.

Results:
Most parents (>90%) reported concerns about their child's development. The most common concern in both the ASD and non-ASD groups was speech/communication (78.6%). Significant differences were found between diagnostic groups in the speech/communication, restricted/repetitive behaviors, social, behavioral, and medical concern categories. Parent concerns were associated with therapies received and specialists consulted. The number of concern categories was positively associated with several ASD scores.

Conclusion:
The developmental concerns expressed by parents of undiagnosed toddlers were highly consistent with the diagnosis the child later received. Based in part on their areas of concern, parents made contact with the appropriate professionals and their children received some therapy prior to diagnosis. Finally, parents who reported concerns across different areas endorsed more symptoms during screening. Results emphasize the need for providers to elicit and take seriously parent concerns during the referral and diagnostic processes.
MACULAR HOLE FORMATION IDENTIFIED WITH INTRAOPERATIVE OCT DURING VITRECTOMY FOR VITREOMACULAR TRACTION SYNDROME
Authors: Sawaguchi Shota , Maruko Ichiro , Mikami Yuriko , Hasegawa Taiji , Koizumi Hideki , Iida Tomohiro 
Published: August 2016

Purpose:
To report the identification of macular hole formation using intraoperative optical coherence tomography (OCT) during vitrectomy for vitreomacular traction syndrome.

Methods:
A 58-year-old woman with vitreomacular traction syndrome underwent the vitrectomy using the 25-gauge system with scanning the macular area using the integrated and intraoperative OCT (Rescan 700, Zeiss). When posterior vitreous detachment at the fovea was performed using a vitreous cutter, the hyperreflective tissue thought to be the rupture of the internal limiting membrane and the full-thickness macular hole were identified on the horizontal and vertical scans simultaneously in intraoperative OCT.

Results:
The procedure was completed after internal limiting membrane peeling and 25% SF6 gas tamponade for closure of macular hole. The closure was confirmed using Swept-Source OCT 1-month after surgery.

Conclusion:
It is possible to change the surgical approach using the real-time intraoperative OCT because the development of macular hole can be visualized during vitrectomy for vitreomacular traction syndrome.
Intussusception Mimicking Rectal Prolapse in a 5-Month-Old Infant
Authors: Wharton Kristin , Garcia Alejandro , Felix Michelle 
Published: August 2016

Abstract
Although rare, an ileocolic intussusception extending to the rectum can mimic a rectal prolapse, which may result in delayed diagnosis and treatment, thereby increasing morbidity in affected infants. Anal prolapse of an ileocolic intussusception is a rare complication of intussusception and more rarely reported in the United States than in developing countries. The aim of this case report is to identify physical exam techniques and radiological findings to distinguish between an anal prolapse intussusception versus a rectal prolapse. There needs to be a high index of suspicion of intussusception in presenting patients with a rectal prolapse in order to minimize morbidity.
A Prospective Blinded Comparison of Video Capsule Endoscopy Versus Computed Tomography Enterography in Potential Small Bowel Bleeding
Authors: Limsrivilai Julajak , Srisajjakul Sitthipong , Pongprasobchai Supot , Leelakusolvong Somchai , Tanwandee Tawesak 
Published: August 2016

Goals:
To compare the efficacy of video capsule endoscopy (VCE) with computed tomography enterography (CTE) in potential small bowel (SB) bleeding, and to identify factors predictive of a high diagnostic yield for CTE.

Background:
In potential SB bleeding, CTE potentially detects some lesions missed by VCE, but few data have determined its clinical utility.

Study:
Consecutive patients with potential SB bleeding were prospectively enrolled. All underwent VCE and CTE within a 1-week interval. Definitive diagnoses were made by surgery or enteroscopy, except when a strategy of VCE and conservative management was suitable. The diagnostic yields and sensitivities of each investigation were measured.

Results:
Fifty-two patients were recruited (41 with overt and 11 with occult bleeding); 36 received a definitive diagnosis. The diagnostic yields and sensitivities of VCE and CTE were 59.6% and 30.8% (P=0.004), and 72.2% and 44.4% (P=0.052), respectively. The combined sensitivity of VCE and CTE (88.9%) was significantly greater than VCE (P=0.03) or CTE (P<0.01) alone. VCE was better for ulcers, enteritis, and angiodysplasia, whereas CTE was better for tumors and Meckel diverticula. Age below 40 years and severe bleeding were associated with a higher diagnostic yield for CTE [odds ratios (95% confidence interval)=7.3 (1.04-51.4), P=0.046 and 6.1 (1.4-25.5), P=0.014, respectively].

Conclusions:
Both investigations complement each other in the diagnosis of potential SB bleeding. CTE should be considered when VCE is negative. Age below 40 years and severe bleeding were independent predictors of a higher diagnostic yield for CTE.
The Effects of a Gluten-free Diet Versus a Hypocaloric Diet Among Patients With Fibromyalgia Experiencing Gluten Sensitivity–like Symptoms
Authors: Slim Mahmoud , Calandre Elena P. , Garcia-Leiva Juan M. , Rico-Villademoros Fernando , Molina-Barea Rocio , Rodriguez-Lopez Carmen M. , Morillas-Arques Piedad 
Published: August 2016

Background and Aims:
Patients with fibromyalgia frequently present with symptoms similar to those experienced by patients with gluten-related disorders, raising the possibility that a subgroup of these patients could be experiencing underlying gluten sensitivity. This study aimed to evaluate the effects of a gluten-free diet (GFD) compared with a hypocaloric diet (HCD) among patients with fibromyalgia.

Methods:
Adult patients diagnosed with fibromyalgia were randomly allocated to receive a GFD or a HCD over a 24-week period. The primary outcome measure was the change in the number of gluten sensitivity symptoms. The following secondary outcomes were evaluated: body mass index, Revised Fibromyalgia Impact Questionnaire, Pittsburgh Sleep Quality Index, Brief Pain Inventory, Beck Depression Inventory-II, State-Trait Anxiety Inventory, Short-Form Health Survey, Patient Global Impression Scale of Severity, Patient Global Impression Scale of Improvement, and adverse events.

Results:
Seventy-five subjects were randomly allocated to receive either a GFD (n=35) or an HCD (n=40). The least squares mean change in the total number of gluten sensitivity symptoms from baseline did not differ significantly between the GFD and HCD groups (−2.44±0.40 for the GFD; −2.10±0.37 for the HCD; P=0.343). Similarly, the 2 dietary interventions did not differ in any of the remaining measured secondary outcomes. Both dietary interventions were well tolerated.

Conclusions:
Both dietary interventions were associated with similar beneficial outcomes in reducing gluten sensitivity symptoms and other secondary outcomes. However, despite its specificity, GFD was not superior to HCD in reducing the number of gluten sensitivity symptoms or secondary outcomes.
Closing the Medicare Doughnut Hole
Authors: Bonakdar Tehrani Ali , Cunningham Peter J 
Published: August 2016

Background:
The Affordable Care Act (ACA) include provisions that reduce beneficiaries’ cost sharing and eventually closes the coverage gap—known as the “doughnut hole”—that was originally part of Medicare prescription drug coverage implemented in 2006.

Objectives:
This study examines changes in overall prescription drug utilization and out-of-pocket spending as well as by manufacturer type (brand vs. generic), through 2013 as a result of the doughnut hole provisions of the ACA.

Materials and Methods:
This analysis is based on data from Medical Expenditure Panel Survey and the sample for this analysis includes all individuals 55 years of age and older. A difference-in-differences methodology was adopted to measure changes in drug utilization and out-of-pocket spending among both the treatment group and the comparison group after the ACA.

Results:
The findings from this study suggest that overall out-of-pocket spending significantly decreased after closing the coverage gap, mainly because of a significant reduction in out-of-pocket spending on brand-name drugs. Conversely, the results show that generic drug utilization increased after closing the coverage gap. As expected, the effects were considerably larger for people who fell into the doughnut hole.

Conclusions:
The ACA doughnut hole provisions likely contributed to a reduction in out-of-pocket spending for prescription drugs for part D beneficiaries, especially for people who fell into the doughnut hole.
Effect of Hospital Closures on Acute Care Outcomes in British Columbia, Canada
Authors: Panagiotoglou Dimitra , Law Michael R. , McGrail Kimberlyn 
Published: August 2016

Background:
In 2002 British Columbia, Canada began redistributing its hospital services.

Objective and Design:
We used administrative data and interrupted time series analyses to determine how recent hospital closures affected patient outcomes.

Subjects:
All adult acute myocardial infarction (AMI), stroke, and trauma events in British Columbia between fiscal years 1999 and 2013. Cases were patients whose closest hospital closed. Controls were matched by condition, year of event, and condition-specific hospital volume where treatment was received.

Measures:
Thirty-day mortality and hospital bypass rates.

Results:
We matched 3267 AMI, 2852 stroke, and 6318 trauma cases to 1996, 1604, and 3640 controls, respectively. The 30-day mortality rate at baseline was 7.0% [95% confidence interval (CI), 4.0%–10.1%] for AMI, 5.3% (95% CI, 2.4%–8.1%) for stroke, and 1.2% (95% CI, 0.3%–2.1%) for trauma controls. The 30-day mortality rate for cases was 14.3% (95% CI, 7.1%–21.7%) for AMI, 12.0% (95% CI, 5.1%–18.9%) for stroke, and 3.1% for trauma (95% CI, 0.9%–5.2%) cases. There was no significant change in 30-day mortality for cases, and no significant difference in change in mortality rates between cases and controls following the intervention. The difference in hospital bypass rates between cases and controls was 50.1% (95% CI, 42.3%–57.9%) for AMI, 36.2% (95% CI, 27.4%–44.9%) for stroke, and 32.2% (95% CI, 27.7%–36.8%) for trauma cases preintervention. Following the intervention, the difference in bypass rates dropped by 15.5% (95% CI, 3.5%–27.5%) for AMI, 25.3% (95% CI, 11.7%–38.8%) for stroke, and 22.7% (95% CI, 15.7%–29.6%) for trauma cases.

Conclusions:
Hospital closures did not affect patient mortality.
Relationship Between Walking Capacity, Biopsychosocial Factors, Self-efficacy, and Walking Activity in Persons Poststroke
Authors: Danks Kelly A. , Pohlig Ryan T. , Roos Margie , Wright Tamara R. , Reisman Darcy S. 
Published: August 2016

Background/Purpose:
Many factors appear to be related to physical activity after stroke, yet it is unclear how these factors interact and which ones might be the best predictors. Therefore, the purpose of this study was twofold: (1) to examine the relationship between walking capacity and walking activity, and (2) to investigate how biopsychosocial factors and self-efficacy relate to walking activity, above and beyond walking capacity impairment poststroke.

Methods:
Individuals greater than 3 months poststroke (n = 55) completed the Yesavage Geriatric Depression Scale (GDS), Fatigue Severity Scale (FSS), Modified Cumulative Illness Rating (MCIR) Scale, Walk 12, Activities-Specific Balance Confidence (ABC) Scale, Functional Gait Assessment (FGA), and oxygen consumption testing. Walking activity data were collected via a StepWatch Activity Monitor. Predictors were grouped into 3 constructs: (1) walking capacity: oxygen consumption and FGA; (2) biopsychosocial: GDS, FSS, and MCIR; (3) self-efficacy: Walk 12 and ABC. Moderated sequential regression models were used to examine what factors best predicted walking activity.

Results:
Walking capacity explained 35.9% (P < 0.001) of the variance in walking activity. Self-efficacy (ΔR
2 = 0.15, P < 0.001) and the interaction between the FGA×ABC (ΔR
2 = 0.047, P < 0.001) significantly increased the variability explained. The FGA (β = 0.37, P = 0.01), MCIR (β = -0.26, P = 0.01), and Walk 12 (β = −0.45, P = 0.00) were each individually significantly associated with walking activity.

Discussion and Conclusion:
Although measures of walking capacity and self-efficacy significantly contributed to “real-world” walking activity, balance self-efficacy moderated the relationship between walking capacity and walking activity. Improving balance self-efficacy may augment walking capacity and translate to improved walking activity poststroke.

Video Abstract available for more insights from the authors (see Supplemental Digital Content 1, http://links.lww.com/JNPT/A139).
Trichomonas vaginalis and Human Immunodeficiency Virus Coinfection Among Women Under Community Supervision: A Call for Expanded T. vaginalis Screening
Authors: Davis Alissa , Dasgupta Anindita , Goddard-Eckrich Dawn , El-Bassel Nabila 
Published: August 2016

Background
The United States has a large community supervision population, a growing number of whom are women. Trichomonas vaginalis infection is strongly associated with an increased risk of human immunodeficiency virus (HIV) acquisition and transmission, particularly among women, but there is a paucity of research on HIV and T. vaginalis co-infection among women under community supervision.

Methods
This article examines the prevalence of T. vaginalis infection and T. vaginalis and HIV coinfection at baseline among women under community supervision in New York City. It also examines the 12-month outcomes of women treated for T. vaginalis. Women received biological tests for HIV and T. vaginalis at baseline and 12 months follow-up.

Results
Of the 333 women tested for sexually transmitted infections, 77 women (23.1%) tested positive for T. vaginalis at baseline and 44 (13.3%) were HIV positive. Human immunodeficiency virus–positive women had significantly higher rates of T. vaginalis infection than HIV-negative women (36.4% vs 21.3%, P ≤ 0.05). Sixteen women (4.8%) were coinfected with T. vaginalis and HIV. Of the 77 women who were positive for T. vaginalis infection at baseline, 58 (75.3%) received treatment by a health care provider. Of those who received treatment, 17 (29.3%) tested positive for T. vaginalis at the 12-month follow-up.

Conclusions
Given the high prevalence of T. vaginalis among this sample of women, particularly among HIV-positive women, and high levels of reinfection or persistent infection, screening for T. vaginalis among women under community supervision may have a substantial impact on reducing HIV acquisition and transmission among this high-risk population.