bluuebunny/crossref_metadata_2025_split huggingface dataset:
01 Vaping, mental and physical health in adolescents in a COMPASS-Quebec cohort
Authors: Payette Audrey , Bélanger Richard E , Turcotte-Tremblay Anne-Marie , Gansaonre Rabi Joel , Leatherdale Scott , Haddad Slim 
Published: October 2024

Abstract

Background
Better knowledge of the association between vaping and youth’s health would help raise awareness among adolescents, parents, professionals and decision-makers on the likely threat it represents.

Objectives
Our objective is to examine the association between vaping, its frequency, and adolescent health.

Design/Methods
This observational study is based on data from the 2022-23 survey round of COMPASS-Quebec school cohorts through self-reported measures. It includes 45,203 respondents aged from 12 to 18 years old from 99 schools of Eastern Quebec. A four-modality variable depicts the vaping frequency in the last twelve months (abstinence, &lt; once/month, ≥ once/month, ≥ once/week, daily). The measurement of health states is based on 5 dichotomous indicators: (i) good vs poor physical health (excellent, very good, good, vs fair, poor), (ii) maximum oxygen consumption considered at risk for health vs not (estimated VO2max, calculated using Léger’s equation); (iii) good vs poor mental health (excellent, very good, good, vs fair, poor); (iv) the presence vs absence of moderate to severe anxiety (GAD7, score ≥10/30) and; (v) the presence vs absence of significant depressive symptoms (CESD-R, score ≥10/21). Sex, age and family material deprivation level are taken into account as confounding factors.

Results
The proportion of adolescents who have vaped in the last 12 months is 26.8%. After adjustment, daily vaping is associated with poor physical health, a VO2max considered at risk for health, poor mental health, moderate to severe anxiety and significant depressive symptoms, compared to abstinence (adjusted relative risk [aRR] 2,46 [95%CI: 2,05-2,88]; 1,66 [95%CI: 1,44-1,89]; 1,88 [95%CI: 1,66-2,11]; 1,75 [95%CI: 1,53-1,97]; 1,55 [95%CI: 1,40-1,70]). A gradient in the associations between vaping frequency and lower mental health indicators has been observed. Adolescents who have vaped &lt;once/month, ≥once/month, ≥once/week and daily have more risk of presenting moderate to severe anxiety (aRR 1,21 [95%CI: 1,09-1,33]; 1,44 [95%CI: 1,27-1,61]; 1,54 [95%CI: 1,37-1,72]; 1,75 [95%CI: 1,53-1,97]). Regarding significant depressive symptoms, aRR are 1,23 [95%CI: 1,14-1,32], 1,39 [95%CI: 1,27-1,51], 1,49 [95%CI: 1,36-1,62], 1,55 [95%CI: 1,40-1,70]. Regarding poor mental health, aRR are 1,29 [95%CI: 1,17-1,42], 1,61 [95%CI : 1,43-1,79], 1,63 [95%CI : 1,45-1,81], 1,88 [95%CI: 1,66-2,11].

Conclusion
This study suggests a consistent association between health, both physical and mental, and use of electronic cigarettes in adolescents. Longitudinal studies would help clarify possible causal influence of vaping on youth's health.
29 A call for action - The lived experiences of caregivers of children diagnosed with Fetal Alcohol Spectrum Disorder during assessment and following diagnosis
Authors: Mahal Mandeep , Salh Gurpreet , Sohi Gurpreet , Wang Elsie , Oberlander Tim , Hutchison Sarah , Boerner Katelynn 
Published: October 2024

Abstract

Background
Individuals diagnosed with Fetal Alcohol Spectrum Disorder (FASD) have a heterogeneous range of neurodevelopmental impairments with lifelong impacts on functioning. In Canada, a FASD diagnosis is made through a multidisciplinary team assessment, using the 2015 Canadian FASD Diagnostic Guidelines. Studies show that early diagnosis and intervention reduces secondary FASD related disabilities and improves outcomes in adulthood. However, little has been published about accessibility of services and intervention for children diagnosed with FASD in Canada.

Objectives
The current study explores the lived experiences of caregivers in (1) undergoing a diagnostic assessment for FASD and (2) obtaining services and interventions for their child in the first two years following diagnosis. Using a qualitative approach, the study aimed to identify strengths and gaps in the system with respect to supporting Canadian children with FASD and their families.

Design/Methods
Seventy one (71) children were diagnosed with FASD/At Risk for FASD over a one year period at a tertiary Developmental Assessment Center in Canada. Through non-random convenience sampling, 18 caregivers (the child’s legal guardians: 1 biological parent, 9 adoptive parents, 6 family guardians and 2 social workers) consented to participate in semi-structured interviews. Interviews explored caregiver experiences with the FASD diagnostic process as well as access to supports and intervention services after diagnosis. Interviews were transcribed and analyzed using reflexive thematic analysis.

Results
The following overarching themes were identified: (1) The journey of raising a child with FASD is overwhelming for caregivers; (2) The assessment process was both affirming and disheartening for caregivers; (3) There are significant, multi-level, systemic barriers to accessing supports for children with FASD, and their caregivers; (4) Equity deserving caregivers and their children are particularly vulnerable to falling through the cracks of the medical, educational, and social systems. Within each theme, subthemes further highlight protective factors and specific gaps in the system in supporting children and their families with respect to early intervention, educational/vocational, community and family support.

Conclusion
Children newly diagnosed with FASD are falling through the cracks of our healthcare system. There are clear disparities in the accessibility of intervention and support for children with developmental differences, even with a diagnosis. Wrap around support is needed for children with FASD and their families, as soon as functional impairments are recognized. A formal funding and support system, based on function, is essential for all children with developmental differences - including children with FASD.
35 Discriminating bacteremia from contaminants among children with a preliminary positive blood culture in the emergency department
Authors: Gravel Jocelyn , Grandjean-Blanchet Charlotte , Loghin Alino Demean , Noyon Brandon , Ostrow Olivia , Vallières Émilie 
Published: October 2024

Abstract

Background
Children with preliminary positive blood cultures in the emergency department (ED) often prompt urgent actions due to the risk of bacteremia. Distinguishing true bacteremia from contaminated cultures is crucial to safely prevent unnecessary, potentially harmful interventions.

Objectives
This study aimed to assess a peer institution algorithm for discriminating bacteremia from contaminants in discharged ED patients, and to identify variables associated with bacteremia in children with positive blood cultures.

Design/Methods
This was a retrospective study of all children with positive blood cultures from a tertiary care, paediatric ED between 2018 and 2022. The primary outcome was true bacteremia as defined using a two-step standardized approach based on the bacteria involved and the clinical outcome assessed by two reviewers for each case. The independent variables assessed were demographic data (age and sex), presence of underlying disease, initial blood tests (CBC, CRP), Gram stain, time for positivity (in hours), presence of alternative diagnosis, fever at phone follow-up. The association between independent variables and outcome was measured using logistic regression. It was estimated that a sample of 500 participants would yield at least 200 true bacteremias and allow the evaluation of 20 risk factors.

Results
574 participants; 286 (49.8%) with bacteremia and 288 (50.2%) with contaminants were included. Utilizing the algorithm, 364 children (63%) were classified as high risk of true bacteremia, 178 (31%) as medium risk, and 32 (6%) as low risk. Corresponding bacteremia probabilities were 62%, 34%, and 0%, yielding 100% sensitivity (95% CI: 94-100%) and 11% specificity (95% CI:7.7-15%). A sub-analysis restricted to the 165 patients who were initially discharged classified 104 (63.0%) children at high risk, 35 (32.1%) at medium risk and 26 (15.7%) at low risk with proportions of bacteremia of 53.8%, 11.4% and 0 % respectively. The most significant predictors of bacteremia included suspicion of osteoarticular infection (OR: 40.4), presence of internal hardware (OR: 24.6), presence of Gram negative bacteria or Gram positive cocci in chains/pairs (OR: 25.4), and positivity within 19 hours (OR: 3.72).

Conclusion
While half of the positive blood cultures in our paediatric ED are contaminants, multiple risk factors of true bacteremia were identified. A peer institution algorithm is 100% sensitive to detect discharged patients with bacteremia, it demonstrated low specificity in our population. Multiple improvements opportunities are identified.
65 Neonatal ventilator-associated pneumonia: A tale of three cities in Canada West
Authors: Kowalczyk Alexandra , Balay Celine , Nguyen Bao-Nghi , Elsharkawy Adel , Hamilton Claire , McKanna Julie , Kuan Mimi , Wong Jonathan , Ting Joseph 
Published: October 2024

Abstract

Background
Preterm infants are at increased risk for acquired infections related to invasive devices such as endotracheal tubes (ETT). Wide heterogeneity exists in diagnostic criteria and management of ventilator-associated pneumonias (VAP), which have not been validated in the neonatal population.

Objectives
To determine the demographic characteristics and prevalence of VAP according to three different existing criteria used in the neonatal intensive care unit (NICU).

Design/Methods
In this retrospective study, we included infants born at &lt;33 weeks gestational age from 3 different NICUs in western Canada, who have been diagnosed with VAP during 2018 – 2022. Infants were diagnosed per three diagnostic criteria: (1) Diagnosed per physician diagnoses (mechanically ventilated infants with stability or improvement ≥48 hours and deterioration at the physician’s discretion); (2) VAP diagnostic consensus adopted by some Canadian NICUs (Canadian criteria) (including escalation in respiratory support such as increase in FiO2 by minimum 0.25, increase in MAP by minimum 4 or change in ventilation mode); and (3) Criteria of a paediatric ventilator-associated condition (PVAC) with a positive respiratory diagnostic test (PVAC criteria) (including escalation in respiratory support such as increase in FiO2 by minimum 0.1, increase in MAP by minimum 2 or change in ventilation mode).

Results
There were 185 neonates diagnosed to have VAP at physicians’ discretion during the study period, with incidences of 4.6%, 8.9%, and 5.7% in the three NICUs. They had a median GA of 25 weeks, a median birth weight of 748-849 grams, and a median onset of VAP ranging from 16-31 days. Among the VAP per physicians’ diagnoses, 18.2-55.0% of infants fulfilled the VAP criteria of Canadian consensus, and 10.9-12.5% of them fulfilled the PVAC criteria with a positive respiratory diagnostic test. The demographic distribution showed similar patterns across the three criteria. Staphylococcus aureus, Enterobacter cloacae complex, Klebsiella species, and oral flora were found to be the most common organisms yielded from ETT aspirate cultures.

Conclusion
We found that 4.6-8.9% of infants born at &lt;33 weeks GA had VAP diagnosed during their NICU stay. Only around one-ninth of infants fulfilled the PVAC criteria with a positive respiratory diagnostic test. Therefore, there is an urgency to develop neonatal-specific and validated diagnostic criteria for VAP.
66 Survival and school-age outcomes of extremely premature neonates with intraventricular hemorrhage
Authors: Kilmartin Keira C , Tsampalieros Anne , Barrowman Nicholas , Nair Asha , Feberova Jana 
Published: October 2024

Abstract

Background
Extremely low gestational age (ELGA) neonates are at risk for intraventricular hemorrhage (IVH) and periventricular hemorrhagic infarction (PVHI). There is no clear consensus on the prognosis of these conditions.

Objectives
The aim of this study was to compare the survival, and the neurodevelopmental outcomes (NDO) at school-age for neonates with IVH and/or PVHI, to those without.

Design/Methods
This retrospective single-center study (2012-2017) included neonates less than 26 weeks gestational age (GA) who received resuscitation and early intensive care. Imaging data were collected from cranial US for the presence of IVH described by Papile grading. Survival was defined as survival to discharge. NDO were classified as no neurodevelopmental impairment (NDI), no NDI with multidisciplinary referrals, and the adverse outcome was defined as NDI at school-age. NDI included any diagnosis of cerebral palsy, global developmental delay, intellectual disability, visual or hearing impairment. Autism spectrum disorder (ASD) was included as an outcome of interest.

Results
164 infants met inclusion criteria, of whom 156 survived resuscitation. Mean GA was 24 weeks and 6 days (SD 6 days) and mean birth weight 701g (SD 125g), grade I-II IVH was present in 43 (28%) infants, and grade III-IV IVH was present in 48 (31%) infants. Survival was 45% for those with bilateral grade III-IV IVH, 53% for unilateral grade III-IV IVH, 78% for bilateral grade I-II IVH, 80% for unilateral grade I-II IVH, and 81% for no IVH groups. 108 infants survived to discharge and 90 had complete follow up at school age. 30% of children had NDI and ASD was diagnosed in 12%. Logistic regression for adverse outcome demonstrated an adjusted odds-ratio (OR) 0.30 (95% CI 0.14, 0.56) for gestational age (p &lt;0.001). The logistic regression resulted in adjusted OR 0.72 (95% CI 0.21, 2.37) for grade I-II IVH and OR 1.43 (95% CI 0.4, 5.03) for Grade III-IV IVH (p=0.63).

Conclusion
In neonates born ELGA, survival decreased with increasing severity of IVH. Decreasing GA, but not severity of IVH, was predictive of neurodevelopmental impairment. Extremely preterm infants born &lt; 26 weeks are at high risk of NDI and of ASD.
78 Supporting rural paediatricians in British Columbia: Could a rural paediatrics clinical network make a difference?
Authors: van Warmerdam Jacqui , Miller Kirsten , Retallack Jennifer 
Published: October 2024

Abstract

Background
British Columbia (BC) is a geographically expansive province with an uneven distribution of population and resources. The number of paediatricians in rural communities is small and they face a unique reality compared to their urban counterparts. In 2020, a clinical network (Sustaining Pediatrics in Rural and Underserved Communities – SPRUCe) was introduced to provide support and connection for rural paediatricians in BC.

Objectives
The rural paediatricians were surveyed shortly after the launch of the network, in June 2021, and again in July 2023 in order to evaluate the impact of the network.

Design/Methods
In British Columbia, communities are designated as rural through the Rural Practice Subsidiary Agreement (RSA). In 2021, there were 12 RSA communities served by 32 paediatricians, while in 2023 there were 14 RSA communities served by 38 paediatricians. Surveys were sent to paediatricians in RSA communities for whom the study coordinators had email contacts in the spring of 2021 and in the summer of 2023. Anonymized survey results were collected, tabulated and compared.

Results
In 2021, surveys were sent to 28 paediatricians with a 96% response rate, while in 2023 surveys were sent to 36 paediatricians with a 69% response rate. Comparing the responses, in 2023 a lower proportion of respondents endorsed being concerned about recruitment (81% in 2021 and 68% in 2023). Similarly, a lower proportion disagreed that effective strategies were in place for paediatrician recruitment to their communities (62% in 2021 and 40% in 2023). In 2023, a higher proportion of respondents agreed that they had methods to engage and interact with other rural paediatricians across the province (30% in 2021 and 52% in 2023). Unfortunately, no improvements were noted in the proportion of respondents who endorsed workload challenges, feelings of burnout or limitations in their ability to secure locum coverage. Rural paediatrician involvement medical learner education of medical learners remained static at 80%.

Conclusion
Strategies to support rural paediatricians in BC are needed to address concerns about workload, burnout, and lack of locum coverage. SPRUCe, a clinical network to support rural paediatrics, provides an example of a potential strategy which may be having a positive impact. The short timeframe between administered surveys and small group of respondents makes demonstrating change challenging, but it is encouraging that decreased recruitment concerns and increased feelings of connectedness among rural paediatricians were noted.
87 Far from home: Qualitative evaluation of the impact of geographic distance from a tertiary paediatric hospital in Canada on family experiences
Authors: van Buuren Asia , Sage Adam , Sernoskie Adam , Udall Brittney , Carwana Matthew 
Published: October 2024

Abstract

Background
Canada’s expansive geography has implications for children and their families seeking tertiary paediatric care. There is minimal literature describing their experiences, particularly challenges associated with receiving inpatient care. This qualitative study builds on previous work that captured out-of-pocket costs and stress levels facing families while admitted to our hospital.

Objectives
Gather an in-depth understanding of family experiences through exploring gaps in current approaches and supports received
2) Generate potential patient-centred solutions to challenges identified

Design/Methods
Ethics approval was obtained. Family partners were involved in all aspects of study design. Qualitative descriptive methodology was adopted to allow for in-depth exploration of family experiences. Semi-structured interviews explored the above objectives. Participants were families that travelled more than 50 km to receive inpatient care under General Paediatrics at a tertiary hospital in Canada within 1 year of when the interview was conducted. In addition, families were purposively recruited through collaboration with community paediatricians until theoretical saturation was reached. Interviews were transcribed verbatim, de-identified, and analyzed for common themes using descriptive analysis in NVivo software.

Results
Between June and October 2023, 16 caregivers participated in our study. The key themes identified were in the following categories: navigating the unknown, bridging the gaps for far away families through equitable resources, and the role of self-advocacy. Families spoke to the overwhelm they faced when being admitted to our centre. For many, it was their first time in our city and the costs associated with being in this city were significant. They identified key gaps in resources and supports, such as knowledge of medical teams, difficulties with eligibility requirements and reimbursement, and inadequate availability of resources after-hours and on weekends. Self-advocacy was important to all participants and innovative solutions were proposed, such as knowledge exchange facilitated by caregivers with lived experience and caregiver-facilitated trainings for providers.

Conclusion
This qualitative study highlights the unique challenges facing families traveling significant distances to receive essential healthcare at a tertiary paediatric hospital in Canada. While significant gaps in resources exist, participants suggested innovative, patient-centred, equitable strategies to bridge these gaps. We plan to partner with patient partners to translate this data into evidence-based interventions to support these families at our institution.
Zircon Typology: a Synthesis. Applications to Magmatic, Metamorphic and Sedimentary Rocks
Authors: Pupin J P 
Published: October 2024

Abstract
The study of more than 101 000 zircon crystals from 1105 different magmatic rocks (anatectic crustal, calc-alkaline, alkaline or tholeiitic) enables a general synthesis to be established which is useful for arguments in petrology. Populations are defined in typological distributions, mean points and typological evolutionary trends according to genetic groups. The overall logic obtained confirms the essential factors (temperature, chemistry) responsible for typological variations. The Hf contents of zircons, in substitution for Zr, make it possible to refine their origins (crustal, hybrid or mantle-derived), in particular by considering the early phase of crystallization, in equilibrium with the initial magma. They support the typological arguments and underline the role of the fluid phase in the magmatic evolution. Zircon crystals first formed in a given environment and subsequently immersed in a new medium of different chemical composition, temperature and fluid content show a spectacular readjustment of their typology. All the data obtained from the magmatic rocks are directly usable on ortho-derived metamorphic rocks with preserved zircon populations. For migmatites affected by partial melting, inherited zircon nuclei provide evidence (morphology, geochemistry notably Hf, Y) to constrain the nature of the protolith. Synthetic tables are proposed to help in the search for the origin of zircons found in sedimentary or volcano-sedimentary rocks, with a special mention for the most significant types and subtypes.
Ribosome binding of phasiRNA precursors accelerates the 24-nt phasiRNA burst in meiotic maize anthers
Authors: Han Yingjia , Jiang Siqi , Dong Xiaomei , Dai Xing , Wang Shunxi , Zheng Ying , Yan Ge , Li Shengben , Wu Liuji , Walbot Virginia , Meyers Blake C , Zhang Mei 
Published: October 2024

Abstract
Reproductive phasiRNAs (phased, secondary, small interfering RNAs), produced from numerous PHAS loci, are essential for plant anther development. PHAS transcripts are enriched on endoplasmic reticulum-bound ribosomes in maize (Zea mays), but the impact of ribosome binding on phasiRNA biogenesis remains elusive. Through ribosome profiling of maize anthers at 10 developmental stages, we demonstrated that 24-PHAS transcripts are bound by ribosomes, with patterns corresponding to the timing and abundance of 24-PHAS transcripts. Ribosome binding to 24-PHAS transcripts is conserved among different maize inbred lines, with ribosomes enriched upstream of the miR2275 target sites. We detected short open reading frames (sORFs) in the ribosome-binding regions of some 24-PHAS transcripts and observed a 3-nt periodicity in most sORFs, but mass spectrometry failed to detect peptides corresponding to the sORFs. Deletion of the entire ribosome-binding region of 24PHAS_NO296 locus eliminated ribosome binding and decreased 24-nt phasiRNA production, without affecting 24PHAS_NO296 transcript levels. In contrast, disrupting only the sORFs in 24PHAS_NO296 did not substantially affect the generation of 24-nt phasiRNAs. A newly formed sORF in these mutants may have re-directed ribosome binding to its transcripts. Overall, these findings demonstrate that sORFs facilitate ribosome binding to 24-PHAS transcripts, thereby promoting phasiRNA biogenesis in meiotic anthers.