bluuebunny/crossref_metadata_2025_split huggingface dataset:
Validation of the Chinese Version of the Speech, Spatial, and Qualities of Hearing Scale for Parents and Children
Authors: Fang Te-Yung , Lin Pei-Hsuan , Ko Yu , Wu Chen-Chi , Wang Han , Liao Wan-Cian , Wang Pa-Chun 
Published: June 2024

Objectives:
To translate and validate the Chinese version of the Speech, Spatial, and Qualities of Hearing Scale (SSQ) for children with hearing impairment (C-SSQ-C) and for their parents (C-SSQ-P).

Design:
We translated the SSQ for children into Chinese and verified its readability and comprehensibility. A total of 105 participants with moderate-to-profound hearing loss (HL) and 54 with normal hearing were enrolled in the validation process. The participants with HL were fitted with bilateral hearing aids, bimodal hearing, or bilateral cochlear implants. The C-SSQ-P was administered to the parents of participants aged 3 to 6.9 years, and the C-SSQ-C was administered to participants aged 7 to 18 years. The internal consistency, test-retest reliability, and validity were evaluated for both questionnaires.

Results:
Both C-SSQ-P and C-SSQ-C demonstrated high internal consistency (Cronbach’s α >0.8) and good validity (generalized linear model revealed significant negative relationships between the C-SSQ-P subscales with aided better-hearing threshold [β = −0.08 to −0.12, p ≤ 0.001] and between the C-SSQ-C subscales with worse-hearing threshold [β = −0.13 to −0.14, p < 0.001]). Among the children with HL, the participants with bilateral cochlear implants had demonstrated better performance than those with bimodal hearing and bilateral hearing aids, as evidenced by the highest mean scores in three subscales.

Conclusions:
Both C-SSQ-P and C-SSQ-C are reliable and valid for assessing HL in children and adolescents. The C-SSQ-P is applicable in evaluating young children aged 3 to 6.9 years after a 7-day observation period, while the C-SSQ-C is appropriate for children and adolescents aged 7 to 18 years.
Epinephrine Dosing Intervals Are Associated With Pediatric In-Hospital Cardiac Arrest Outcomes: A Multicenter Study*
Authors: Kienzle Martha F. , Morgan Ryan W. , Reeder Ron W. , Ahmed Tageldin , Berg Robert A. , Bishop Robert , Bochkoris Matthew , Carcillo Joseph A. , Carpenter Todd C. , Cooper Kellimarie K. , Diddle J. Wesley , Federman Myke , Fernandez Richard , Franzon Deborah , Frazier Aisha H. , Friess Stuart H. , Frizzola Meg , Graham Kathryn , Hall Mark , Horvat Christopher , Huard Leanna L. , Maa Tensing , Manga Arushi , McQuillen Patrick S. , Meert Kathleen L. , Mourani Peter M. , Nadkarni Vinay M. , Naim Maryam Y. , Pollack Murray M. , Sapru Anil , Schneiter Carleen , Sharron Matthew P. , Tabbutt Sarah , Viteri Shirley , Wolfe Heather A. , Sutton Robert M. ,   for the Oxy-PICU Investigators of the Pediatric Critical Care Society Study Group
Published: June 2024

OBJECTIVES:
Data to support epinephrine dosing intervals during cardiopulmonary resuscitation (CPR) are conflicting. The objective of this study was to evaluate the association between epinephrine dosing intervals and outcomes. We hypothesized that dosing intervals less than 3 minutes would be associated with improved neurologic survival compared with greater than or equal to 3 minutes.

DESIGN:
This study is a secondary analysis of The ICU-RESUScitation Project (NCT028374497), a multicenter trial of a quality improvement bundle of physiology-directed CPR training and post-cardiac arrest debriefing.

SETTING:
Eighteen PICUs and pediatric cardiac ICUs in the United States.

PATIENTS:
Subjects were 18 years young or younger and 37 weeks old or older corrected gestational age who had an index cardiac arrest. Patients who received less than two doses of epinephrine, received extracorporeal CPR, or had dosing intervals greater than 8 minutes were excluded.

INTERVENTIONS:
The primary exposure was an epinephrine dosing interval of less than 3 vs. greater than or equal to 3 minutes.

MEASUREMENTS AND MAIN RESULTS:
The primary outcome was survival to discharge with a favorable neurologic outcome defined as a Pediatric Cerebral Performance Category score of 1–2 or no change from baseline. Regression models evaluated the association between dosing intervals and: 1) survival outcomes and 2) CPR duration. Among 382 patients meeting inclusion and exclusion criteria, median age was 0.9 years (interquartile range 0.3–7.6 yr) and 45% were female. After adjustment for confounders, dosing intervals less than 3 minutes were not associated with survival with favorable neurologic outcome (adjusted relative risk [aRR], 1.10; 95% CI, 0.84–1.46; p = 0.48) but were associated with improved sustained return of spontaneous circulation (ROSC) (aRR, 1.21; 95% CI, 1.07–1.37; p < 0.01) and shorter CPR duration (adjusted effect estimate, –9.5 min; 95% CI, –14.4 to –4.84 min; p < 0.01).

CONCLUSIONS:
In patients receiving at least two doses of epinephrine, dosing intervals less than 3 minutes were not associated with neurologic outcome but were associated with sustained ROSC and shorter CPR duration.
IMAGING PREDICTORS OF FUNCTIONAL OUTCOMES AFTER RHEGMATOGENOUS RETINAL DETACHMENT REPAIR
Authors: Lee Wei Wei , Francisconi Carolina L. M. , Marafon Samara B. , Juncal Verena R. , Chaudhary Varun , Hillier Roxane J. , Muni Rajeev H. 
Published: June 2024

Purpose:
To evaluate the microstructural optical coherence tomography and fundus autofluorescence imaging predictors of visual acuity, metamorphopsia, and aniseikonia following rhegmatogenous retinal detachment repair.

Methods:
This is a multicenter retrospective study of patients with primary rhegmatogenous retinal detachment who underwent repair. Best-corrected visual acuity, metamorphopsia, and aniseikonia were formally tested at 3 months postoperatively. Metamorphopsia and aniseikonia were quantitatively assessed with M-CHARTS and the New Aniseikonia Test, respectively. High-resolution spectral-domain optical coherence tomography and fundus autofluorescence images were obtained at 3 months postoperatively. Images were assessed for discontinuity of the outer retinal bands on optical coherence tomography and retinal displacement detected by retinal vessel printings on fundus autofluorescence by two masked graders with disagreements adjudicated by a third senior masked grader. Multiple linear regression models were used to determine the predictors of postoperative visual acuity, metamorphopsia, and aniseikonia.

Results:
Six hundred fourteen eyes of 614 patients were included in this study. Regression analysis indicated that significant early postoperative (at 3 months) imaging predictors of visual acuity were discontinuity of the external limiting membrane (P = 0.001) and the presence of retinal vessel printings on fundus autofluorescence (P = 0.033). Discontinuity of interdigitation zone was a significant predictor of metamorphopsia [horizontal metamorphopsia (P =0.004); vertical metamorphopsia (P = 0.056); average of horizontal metamorphopsia + vertical metamorphopsia (P = 0.008)], and presence of retinal vessel printings was a significant predictor of aniseikonia (P = 0.04).

Conclusion:
Discontinuity of the external limiting membrane and retinal displacement were significant predictors of postoperative visual acuity following rhegmatogenous retinal detachment repair. Discontinuity of the interdigitation zone and retinal displacement were significant predictors of metamorphopsia and aniseikonia, respectively.
Region-specific changes in brain glutamate and gamma-aminobutyric acid across the migraine attack in children and adolescents
Authors: Cho Lydia Y. , Bell Tiffany K. , Craddock Lindsay , Godfrey Kate J. , Hershey Andrew D. , Kuziek Jonathan , Stokoe Mehak , Millar Kayla , Orr Serena L. , Harris Ashley D. 
Published: June 2024

Abstract
In patients with migraine, an excitation–inhibition imbalance that fluctuates relative to attack onset has been proposed to contribute to the underlying pathophysiology of migraine, but this has yet to be explored in children and adolescents. This prospective, observational, cohort study examined glutamate and gamma-aminobutyric acid (GABA) levels across the phases of a migraine attack and interictally in children and adolescents using magnetic resonance spectroscopy. Macromolecule-suppressed GABA (sensorimotor cortex and thalamus) and glutamate (occipital cortex, sensorimotor cortex, and thalamus) were measured in children and adolescents (10-17 years) with a migraine diagnosis with or without aura 4 times over 2 weeks. Linear mixed-effects models examined changes in glutamate and GABA during the 72 hours leading up to, and after the onset of an attack. We found significant region-specific changes in glutamate and GABA. Specifically, sensorimotor GABA significantly increased leading up to the headache phase, whereas glutamate significantly decreased following the headache onset in the occipital cortex and the thalamus. Post hoc analyses examined the 24 hours leading up to or following the onset of the headache phase. In the 24 hours before the headache onset, sensorimotor glutamate, occipital glutamate, and thalamic GABA decreased. In the 24 hours post headache onset, sensorimotor glutamate continued to decrease. Our results suggest changes in glutamate and GABA that are consistent with the thalamocortical dysrhythmia hypothesis. These findings provide insight into developmental migraine pathophysiology and may open future avenues for treatment targets specific to children and adolescents.
Bowel Management in the Acute Phase of Spinal Cord Injury
Authors: Plante Elizabeth , Rhudy Lori 
Published: June 2024

ABSTRACT

BACKGROUND: Neurogenic bowel and bladder are well-known complications of spinal cord injury. During the acute phase of recovery from spinal cord injury, spinal shock occurs, resulting in loss of reflexes and peristalsis of the gastrointestinal tract. These impairments can result in complications in the gastrointestinal tract and, secondarily, the respiratory system due to the distention of the abdomen. Current guidelines for bowel management target the chronic phase of spinal cord injury after a diagnosis of neurogenic bowel dysfunction can be made. METHODS: The purpose of this literature review was to determine evidence-based recommendations for bowel management during the acute phase of spinal cord injury. A systematic search using the databases CINAHL, PubMed, Cochrane Library, and ProQuest was used to identify relevant evidence. RESULTS: The available evidence is based on expert consensus, is dated, and tends to be based on studies conducted during the chronic phase of injury. Careful assessment of the symptoms of bowel dysfunction would indicate that during the acute phase of spinal cord injury, spinal shock causes a patient to experience an areflexive bowel pattern where bowel motility is limited and reflexes are absent. Management of areflexive bowel includes establishment of a daily bowel program including manual removal of stool. To improve emptying of stool, factors such as rectal and oral medications, fluid, fiber, and activity may be adjusted according to need. CONCLUSION: There is limited evidence focused specifically on bowel management in the acute phase of spinal cord injury. Bowel management is complex and multifaceted and needs to be individualized to the patient as well as frequently reevaluated with changes in condition. Further research is needed to evaluate outcomes for bowel management in the acute phase of spinal cord injury to promote best practices.
What Works? Fostering Inclusivity in Physician Assistant/Associate Education: The Retention, Outreach, Alignment, and Diversity (ROAD) Framework
Authors: Bester Vanessa , Dorough Ramona , Burwell Nicole , Suzuki Sumihiro , Kayingo Gerald , Bradley-Guidry Carolyn 
Published: June 2024

Introduction
There are well-known strategies to increase diversity in health professions education, evidence is sparse on how such strategies are practically implemented and longitudinally sustained. This study investigated the most widely used strategies across physician assistant/associate (PA) educational programs that have consistently demonstrated the ability to graduate racial and ethnic underrepresented students.

Methods
Following a grounded theory, qualitative interviews were conducted with 41 nationally accredited PA programs identified as top performers in consistently graduating racial and ethnic underrepresented students. Semistructured interviews were conducted with a program representative focused on ascertaining the characteristics and strategies attributable to the successful recruitment and retention of underrepresented PA matriculants. The interviews comprehensively explored program resources, efforts, and practices. Transcripts were coded, and themes were identified.

Results
The study revealed 4 overarching themes: (1) Pathways from the Community to the Program and Into Healthcare; (2) Dedication to Student Retention and Support; (3) Commitment to Diverse and Inclusive Learning Environments; and (4) Alignment of Mission, Inclusive Action, and Improving Diversity Outcomes. Based on these emerging themes, we propose a new diversity framework that hinges on Retention, Outreach, Alignment, and Diversity (ROAD Framework). This framework seeks to explain the overarching goals, high-impact behaviors, and actionable steps that can be effectively implemented across PA education to facilitate further diversification.

Discussion
This study illuminated on What Works to foster diversity in PA programs. By embracing and implementing the ROAD Framework, institutions can effectively address the persistent issue of underrepresentation and contribute to cultivating a more inclusive and representative healthcare workforce.
Comparison of laparoscopic and open surgery for colorectal malignancy in obese patients: a propensity score-weighted cohort study
Authors: Hsu Yu-Jen , Yu Yen-Lin , Jhuang Jing-Rong , You Jeng-Fu , Liao Chun-Kai , Tsai Wen-Sy , Pan Yi-Ping , Chern Yih-Jong 
Published: June 2024

Background:
Insufficient evidence exists to ascertain the long-term prognosis in patients with obesity undergoing laparoscopic surgery versus open surgery for colorectal cancer.

Methods:
Employing an institutional database from 2009 to 2019, we assessed individuals with a BMI of greater than or equal to 30 kg/m2 who underwent surgery for primary stage I–III colorectal adenocarcinoma. The authors used propensity score-weighted analysis to compare short-term and oncologic outcomes between laparoscopic and open surgical approaches.

Results:
This study enrolled 473 patients (open vs. laparoscopic surgery: 220 vs. 253; median follow-up period, 60 months). The laparoscopy group showed a significantly longer operative time (252 vs. 212 min), a higher anastomotic-leakage rate (5.14% vs. 0.91%), and a greater proportion of Clavien–Dindo class greater than III complications (5.93% vs. 1.82%). The open group showed a higher wound infection rate (7.27% vs. 3.16%) and a higher readmission rate (6.36% vs. 2.37%). After propensity score weighting, laparoscopy was inferior to open surgery in terms of long-term overall survival (hazard ratio: 1.43), disease-free survival (1.39), and recurrence rate (21.1% vs. 14.5%). In the subgroup analysis, female patients, older individuals, stage III patients, patients with rectal cancer, and those who underwent surgery after 2014 showed inferior long-term outcomes after laparoscopy.

Conclusions:
Laparoscopic colorectal cancer surgery for patients with obesity requires significant caution. Despite good short-term outcomes, this procedure is associated with hidden risks and poor long-term prognoses. In female patients, older individuals, stage III patients, patients with rectal cancer, and those treated in the late surgery era subgroups, caution is advised when performing laparoscopic surgery.
Long-term outcomes and risk factors for early bacterial infection after pediatric liver transplantation: a prospective cohort study
Authors: Sun Xicheng , Sun Xiaowei , Zhou Tao , Li Peiying , Wang Bingran , Pan Qi , Zhou Aiwei , Qian Yongbing , Liu Yongbo , Liu Yuan , Xia Qiang 
Published: June 2024

Background:
Liver transplantation (LT) is the most efficient treatment for pediatric patients with end-stage liver diseases, while bacterial infection is the leading reason for post-transplant mortality. The present study is to explore the outcomes and risk factors of early bacterial infection (within 1 months) after pediatric LT.

Methods:
In this prospective cohort study, 1316 pediatric recipients [median (IQR) age: 9.1 (6.3–28.0) months; male: 48.0%; median (IQR) follow-up time: 40.6 (29.1–51.4) months] who received LT from September 2018 to April 2022 were included. Bacterial culture samples such as sputum, abdominal drainage, blood, and so on were collected when recipients were presented with infective symptoms. Kaplan–Meier analysis was applied to estimate the long-term survival rates and logistic regression was used to identify independent risk factors. To explore the role of pretransplant rectal swab culture (RSC) in reducing post-transplant bacterial infection rate, 188 infant LT recipients [median (IQR) age: 6.8 (5.5–8.1) months; male: 50.5%] from May 2022 to September 2023 were included. Log-binomial regression was used to measure the association of pretransplant RSC screening and post-transplant bacterial infection. The ‘Expectation Maximization’ algorithm was used to impute the missing data.

Results:
Bacterial infection was the primary cause for early (38.9%) and overall mortality (35.6%) after pediatric LT. Kaplan–Meier analysis revealed inferior 1-year and 5-year survival rates for recipients with post-transplant bacterial infection (92.6 vs. 97.1%, 91.8 vs. 96.4%, respectively; P<0.001). Among all detected bacteria, Staphylococcus spp. (34.3%) and methicillin-resistant coagulase-negative Staphylococci (43.2%) were the dominant species and multidrug resistant organisms, respectively. Multivariable analysis revealed that infant recipients [adjusted odds ratio (aOR) 1.49; 95% CI: 1.01–2.20], male recipients (aOR, 1.43; 95% CI: 1.08–1.89), high graft-to-recipient weight ratio (aOR, 1.64; 95% CI: 1.17–2.30), positive post-transplant RSC (aOR, 1.45; 95% CI: 1.04–2.02) and nasopharyngeal swab culture (aOR 2.46; 95% CI: 1.72–3.52) were independent risk factors for early bacterial infection. Furthermore, RSC screening and antibiotic prophylaxis before transplantation could result in a relatively lower post-transplant infection rate, albeit without statistical significance (adjusted RR, 0.53; 95% CI: 0.25–1.16).

Conclusion:
In this cohort study, post-transplant bacterial infection resulted in an inferior long-term patient survival rate. The five identified independent risk factors for post-transplant bacterial infection could guide the prophylaxis strategy of post-transplant bacterial infection in the future. Additionally, pretransplant RSC might decrease post-transplant bacterial infection rate.
Do Common Risk Adjustment Methods Do Their Job Well If Center Effects Are Correlated With the Center-Specific Mean Values of Patient Characteristics?
Authors: Vach Werner , Wehberg Sonja , Luta George 
Published: June 2024

Background:
Direct and indirect standardization are well-established approaches to performing risk adjustment when comparing outcomes between healthcare providers. However, it is an open question whether they work well when there is an association between the center effects and the distributions of the patient characteristics in these centers.

Objectives and Methods:
We try to shed further light on the impact of such an association. We construct an artificial case study with a single covariate, in which centers can be classified as performing above, on, or below average, and the center effects correlate with center-specific mean values of a patient characteristic, as a consequence of differential quality improvement. Based on this case study, direct standardization and indirect standardization—based on marginal as well as conditional models—are compared with respect to systematic differences between their results.

Results:
Systematic differences between the methods were observed. All methods produced results that partially reflect differences in mean age across the centers. This may mask the classification as above, on, or below average. The differences could be explained by an inspection of the parameter estimates in the models fitted.

Conclusions:
In case of correlations of center effects with center-specific mean values of a covariate, different risk adjustment methods can produce systematically differing results. This suggests the routine use of sensitivity analyses. Center effects in a conditional model need not reflect the position of a center above or below average, questioning its use in defining the truth. Further empirical investigations are necessary to judge the practical relevance of these findings.
Lived experiences of COVID-19 disease: a qualitative meta-synthesis
Authors: Fereidouni Zhila , Karimi Zohreh , Mirshah Elham , Keyvanloo Shahrestanaki Sahar , Amrollah majdabadi Zahra , Behnammoghadam Mohammad , Mirzaee Mohammad saeed 
Published: June 2024

Background:
During the COVID-19 pandemic, various aspects of human life were changed around the world. The present study aimed to provide a systematic review of the available evidence on lived experiences of the COVID-19 pandemic.

Methods:
This is a systematic review of the meta-synthesis type. Evidence from studies from 2019 to 2021 was used. Keywords of lived experiences, experiences, people, nation, patients, community, COVID-19, corona, and corona disease were searched in PubMed, Science Direct, Web of Science, and Cochrane databases. The Newcastle–Ottawa scale was used to evaluate the quality of articles. A qualitative meta-synthesis was performed by a researcher based on a three-step meta-synthesis method described by Thomas and colleagues. MAXQDA 10 was used for data analysis. The present study is based on the guidelines for Enhancing transparency in reporting the meta-synthesis of qualitative research (ENTREQ). The reliability of this study had a Kappa coefficient of 0.660 with a consistency rate of 98.766%.

Results:
Finally, the data from 11 articles were analyzed. The main and sub-themes obtained in this study included negative aspects (chaos, hustle associated, dualities, bad body, value decay, seclusion, psychological challenges) as well as positive aspects (opportunities arising from the individual, family, and social stability).

Conclusion:
Problems of life during COVID-19 should be considered as part of the COVID-19 pandemic care program. Individual assessments should normally be considered in a public health crisis. It is recommended to conduct serious, in-depth, and practical research in this field.