bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Pediatricians, Pediatric Associations, and Academic Departments in Ensuring Optimal Early Childhood Development Globally: Position Paper of the International Pediatric Association
Authors: Uchitel Julie , Alden Errol , Bhutta Zulfiqar A. , Cavallera Vanessa , Lucas Jane , Oberklaid Frank , Patterson Janna , Raghavan Chemba , Richter Linda , Rikard Blaire , Russell Robert Ross , Mikati Mohamad A. 
Published: August 2022

ABSTRACT:
Early childhood (birth–8 years), particularly the first 3 years, is the most critical time in development because of the highly sensitive developing brain. Providing appropriate developmental care (i.e., nurturing care, as defined by the World Health Organization [WHO]) during early childhood is key to ensuring a child's holistic development. Pediatricians are expected to play a critical role in supporting early childhood development (ECD) through providing developmental services such as developmental monitoring, anticipatory guidance, screening, and referral to medical and/or community-based services when delay is identified. Pediatricians are also expected to serve as advocates within their clinics and communities for improved delivery of ECD services, such as advocating for increasing funding for ECD initiatives, increasing insurance coverage of ECD services, and working to increase other pediatricians' awareness of the principles of ECD and how to deliver developmental services. However, this does not always occur. Typically, pediatricians' training and practice emphasizes treating disease rather than enhancing ECD. Pediatricians are further hindered by a lack of uniformity across nations in guidelines for developmental monitoring and screening. In this article, we present the vision of the International Pediatric Association (IPA) of the roles that pediatricians, academic departments, medical training programs, and pediatric associations should fulfill to help support ECD, including raising ECD to higher levels of priority in routine pediatric care. First, we present the challenges that face these goals in supporting ECD. We then propose, with supportive literature, strategies and resources to overcome these challenges in collaboration with local and international stakeholders, including the IPA, the WHO, UNICEF, and the World Bank.
Prevalence and Risk Factors of Glaucoma Among Chinese People From the China Health and Retirement Longitudinal Study
Authors: Sun Junran , Li Tong , Zhao Xiaohuan , Lu Bing , Chen Jieqiong , Liu Wenjia , Zhou Minwen , Sun Xiaodong 
Published: August 2022

Précis:
This study demonstrated the prevalence of self-reported glaucoma and its strong association with preexisting systemic chronic diseases in China using the baseline data from China Health and Retirement Longitudinal Study (CHARLS), a nationwide population-based cohort.

Purpose:
The purpose of this study is to estimate the prevalence of self-reported glaucoma and its risk factors using data from the CHARLS.

Materials and Methods:
Data on age, sex, area of residence, education, marital status, health-related behaviors, and preexisting comorbidities for this cross-sectional study were retrieved from the CHARLS for 17,713 subjects who completed a questionnaire between June 2011 and March 2012. The prevalence of glaucoma was estimated, and a multivariate weighted analysis was performed to estimate the odds ratios (ORs) of its risk factors.

Results:
Of 16,599 respondents (93.7%) who answered questions regarding glaucoma and their history of systemic chronic diseases, 314 (1.89%) reported having glaucoma before the index date. Qinghai and Beijing had the highest prevalence of glaucoma in China. Glaucoma was significantly associated with hypertension [OR: 1.362; 95% confidence interval (CI), 1.801–2.470], diabetes (OR: 2.597; 95% CI, 1.661–10.207), dyslipidemia (OR: 1.757; 95% CI, 1.157–3.650), lung disease (OR: 2.098; 95% CI, 1.674–6.527), stroke (OR: 5.278; 95% CI, 1.094–25.462), heart disease (OR: 1.893; 95% CI, 1.237–3.363), and health-related behaviors such as smoking and alcohol consumption after adjusting for age, sex, area, education, marital status, and medical insurance.

Conclusions:
Geographic variation in the prevalence of self-reported glaucoma and its strong association with preexisting systemic chronic diseases were observed, suggesting that in addition to ophthalmological examinations, regular physical examinations are necessary for glaucoma patients, especially in areas of high incidence. Appropriate strategies to improve preventive measures for glaucoma are recommended for the Chinese population.
Outcomes of Kahook Dual Blade Goniotomy for Uveitis Associated Open Angle Glaucoma or Ocular Hypertension
Authors: Miller Victoria J. , Patnaik Jennifer L. , Young Cara E. Capitena , SooHoo Jeffrey R. , Seibold Leonard K. , Kahook Malik Y. , Ertel Monica K. , Palestine Alan G. , Pantcheva Mina B. 
Published: August 2022

Précis:
Kahook Dual Blade (KDB) goniotomy can successfully lower intraocular pressure in some patients with uveitis-associated ocular hypertension or glaucoma.

Purpose:
The purpose of this study was to report a case series of patients that underwent KDB goniotomy at a single institution for uveitis-associated ocular hypertension or glaucoma with an open angle.

Methods:
We performed a retrospective chart review of all patients with uveitis-associated ocular hypertension or glaucoma who underwent KDB goniotomy with trabecular meshwork excision alone or in combination with phacoemulsification cataract surgery at a single center between August 2017 and February 2020. The case series included 45 eyes of 37 patients. All eyes developed ocular hypertension refractory to maximum-tolerated medical therapy and required surgical intervention. Two eyes were excluded as they were lost to follow-up before 5 months postoperatively. Surgical success was defined as reaching the goal intraocular pressure or lower for each patient, including ongoing medical therapy.

Results:
At most recent follow-up, 25 (55.6%) of 45 eyes had an intraocular pressure that was at goal. Mean follow-up time was 15.2±12.1 months ranging from 0.5 to 36 months postoperatively, considering that patients were eliminated from the data analysis once they required a second surgery. The mean number of preoperative medications, including oral carbonic anhydrase inhibitors was 3.7±1.2 medications. The mean number of postoperative medications through the last clinic visit was 2.5±1.9 medications for a mean reduction of 1.2±1.6 medications (P-value <0.0001*).

Conclusions:
This larger case series shows that some patients with uveitis-associated ocular hypertension or glaucoma with an open angle may have success with KDB goniotomy.
Peripapillary and Macular Structural and Vascular Parameters in Age-Related Choroidal Atrophy
Authors: Ucgul Atilgan Cemile , Hondur Gozde , Citirik Mehmet 
Published: August 2022

Précis:
The macular and peripapillary structural and vascular alterations in elderly patients with age-related choroidal atrophy may mimic glaucomatous degeneration.

Purpose:
To evaluate the peripapillary retinal nerve fiber layer (pRNFL), macular nerve fiber layer (mNFL), ganglion cell layer (mGCL), inner plexiform layer (mIPL) thicknesses, and choroidal vascularity index (CVI) values in patients with age-related choroidal atrophy (ARCA) and to compare with the those of age and sex-matched healthy controls.

Methods:
The cross-sectional, observational study included 95 eyes of 95 patients. The patients were divided into 2 groups according to subfoveal choroidal thickness (sCT) values. Forty eight eyes with sCT<125 µm constituted ARCA group (group 1), and 47 eyes with sCT>125 µm constituted control group (group 2). Peripapillary RNFL, mNFL, mGCL, mIPL, sCT values and fundus autofluorescence images were acquired with spectral domain-optical coherence tomography. Enhanced depth imaging mode spectral domain-optical coherence tomography images were binarized to show the luminal and stromal areas of choroid. CVI (%) was defined as the ratio of the luminal area to the total choroidal area with defined borders.

Results:
The mean age was 78.47±6.07 years in group 1 and 76.95±6.68 years in group 2. The mean, superior and inferior quadrants pRNFL thicknesses were significantly lower in group 1 than in group 2 (P<0.05 for all). The mean mNFL, mGCL, mIPL thickness values were also statistically lower in group 1 than group 2 (P<0.05 for all). The CVI value was 61.29±4.52 in group 1, and 64.81±3.80 in group 2 (P<0.001).

Conclusion:
The patients with ARCA had decreased pRNFL, inner macular layer thickness and CVI values when compared with healthy control eyes. These findings should be considered in the differential diagnosis and the follow up of eyes with glaucoma.
Effect of Aerobic Exercise at Different Intensities on Intraocular Pressure in Young Males
Authors: Alfaqeeh Fatima , Djemai Haidar , Hammad Rami , Hammad Saleh , Noirez Philippe , Dabayebeh Ibrahim M. 
Published: August 2022

Précis:
High intensity aerobic exercise significantly reduced intraocular pressure in healthy young male adults.

Objective:
This study sought to determine how aerobic exercise at various intensities affects intraocular pressure (IOP) in young adults.

Design:
A repeated measures design was adopted.

Participants:
A group of 20 volunteers (mean age: 21.24±1.73 y) took part in this study.

Methods:
IOP was measured with a tonometer (iCare TA01i, Icare Finland, Finland). Subjects completed 4 cycle ergometer sessions. During the first session, power was increased by 60 W every 3 minutes until exhaustion, corresponding to peak power. For the 3 following tests, each lasting 25 minutes, subjects exercised at intensities of 50%, 70%, and 85% of peak power, respectively, and measurements were taken every 5 minutes.

Main Outcome Measures:
IOP, as determined using a tonometer, was the primary measure.

Results:
There was a significant reduction (P<0.05) in IOP of both eyes during the 25 minutes high-intensity (85%) exercise test. There were also significant interactions between exercise durations and intensities. During high-intensity exercise, IOP, blood pressure, blood lactate, and the rating of perceived exertion were significantly related (P<0.01).

Conclusions:
These data show a significant reduction in IOP at high-intensity aerobic exercise, which may have implications for the management of ocular health.
Outcomes of Penetrating Canaloplasty in Childhood Glaucoma
Authors: Le Rongrong , Xie Yanqian , Cheng Huanhuan , Chen Hong , Ye Wenqing , Deng Yuxuan , Gu Juan , Xu Jing , Hu Cheng , Zhang Shaodan , Liang Yuanbo 
Published: August 2022

Précis:
Penetrating canaloplasty was safe and effective for the management of refractory childhood glaucoma.

Purpose:
The purpose of this paper is to report the safety and efficacy of penetrating canaloplasty for the management of childhood glaucoma.

Materials and Methods:
This single-center prospective interventional case series enrolled 50 eyes of 32 patients with childhood glaucoma between July 2017 and July 2020. Penetrating canaloplasty to create direct communication between the anterior chamber and tensioning suture-dilated the Schlemm canal was performed through a trabecular meshwork ostium in the affected eyes. Preoperative and postoperative intraocular pressure (IOP), number of glaucoma medications, and procedure-related complications were recorded. Qualified and complete success was defined as IOP≥5 and ≤21 mm Hg with or without glaucoma medications, respectively.

Results:
A total of 43 eyes (86.0%) achieved 360 degrees catheterization of Schlemm canal and completed penetrating canaloplasty. The median age at surgery was 5 years (range, 10 d–17 y, mean 6.20±5.46 y). The mean IOP decreased from 33.11±10.89 mm Hg on 2 medications (median, range: 0–5) before surgery to 13.46±4.71 mm Hg on 0 medications (median, range:0–2) postoperatively at 12 months (P<0.001). Complete and qualified success rates were 81.08% and 89.19%, respectively, at the 12-month follow-up. Hyphema (6/43, 13.95%) and a transient shallow anterior chamber with hypotony (5/43, 11.63%) were the most commonly observed early complications.

Conclusion:
Penetrating canaloplasty demonstrated good safety and efficacy in eyes with childhood glaucoma, and may be considered an option for managing refractory childhood glaucoma.
Does Increasing the Severity of Penalties Assessed in Association With the “Zero Tolerance for Head Contact” Policy Translate to a Reduction in Head Impact Rates in Youth Ice Hockey?
Authors: Williamson Rylen A. , Kolstad Ash T. , Nadeau Luc , Goulet Claude , Hagel Brent , Emery Carolyn A. 
Published: August 2022

Objective:
The risk of concussion is high in Canadian youth ice hockey. Aiming to reduce this burden, in 2011, Hockey Canada implemented a national “zero tolerance for head contact (HC)” policy mandating the penalization of any player HC. In 2018 to 2020, Hockey Canada further amended this HC policy including stricter enforcement of severe HCs. This study aimed to compare HC rates, head impact location, and HC enforcement prepolicy, postpolicy, and after policy amendments in elite U15 Canadian youth ice hockey.

Design:
This is a prospective cohort study.

Setting:
A collection of events with the video camera located at the highest point near center ice in public ice hockey arenas in Calgary, Alberta.

Participants:
A convenience sample of 10 AA U15 games prepolicy (2008-2009), 8 games postpolicy (2013-2014), and 10 games after policy amendments (2020-2021).

Independent Variables:
An analysis of 3 cohort years regarding the HC-policy implementation and amendments.

Main Outcome Measures:
Using Dartfish video-analysis software, all player contacts and HCs [direct (HC1), indirect (eg, boards, ice) (HC2)] were tagged using validated criteria. Univariate Poisson regression clustering by team-game offset by game length (minutes) was used to estimate incidence rates (IR) and incidence rate ratios (IRR) between cohorts.

Results:
With additional rule modifications, a 30% reduction in HC1s emerged (IRR2013-2020 = 0.70, 95% CI, 0.51-0.95). Since the HC-policy implementation, HC1s decreased by 24% (IRR2008-2020 = 0.76, 95% CI, 0.58-0.99). The proportion of HC1s penalized was similar across cohorts (P2008-2009 = 14.4%; P2013-2014 = 15.5%; P2020-2021 = 16.2%).

Conclusions:
The HC-policy amendments have led to decreased HC1 rates. However, referee enforcement can further boost the HC-policy effectiveness. These findings can help future referee training and potential rule modifications to increase player safety nationally.
The impact of genital lichen sclerosus and lichen planus on quality of life: A review
Authors: Ranum Alison , Pearson David R. 
Published: August 2022

Background:
Lichen sclerosus (LS) and lichen planus (LP) are inflammatory diseases that demonstrate genital and extra-genital manifestations. Genital involvement may result in pruritus, sexual dysfunction, pain, and irritation. It is intuitive that the severity of symptoms may result in functional impairment and emotional distress, leading to a reduction in quality of life (QoL).

Objective:
Investigate the current literature on the impact of genital LS and LP on QoL.

Methods:
A literature review was performed using PubMed and results were summarized. Articles published between 1994 and 2020 were screened and reviewed by both the authors.

Results:
These diseases have been assessed with dermatological assessments, such as the Skindex-29 and the Dermatology Life Quality Index, general health surveys such as the Short Form-12 questionnaire, and mental health instruments including the Beck Depression Inventory, and others; these instruments consistently demonstrate impaired QoL. It follows that treatment may reduce these symptoms. Interventions, such as photodynamic therapy, have demonstrated improvement in the depressive symptoms that impact QoL. Although both females and males experience a reduction in QoL related to these diseases, they experience the symptomatology differently. Through interviewing, male patients were more likely to report no symptoms compared with female patients, while female patients were also more likely to report worse QoL in the work-school domain of the Dermatology Life Quality Index as compared with male patients.

Limitations:
Few studies have addressed the effect of disease severity or treatment on QoL.

Conclusions:
Understanding how genital LS and LP contribute to reduced QoL for patients is critical for health care providers to better prioritize treatment strategies. Future prospective studies should investigate how QoL correlates with disease severity and response to treatment.
Comparison of clinical profiles and associated factors for acute myocardial infarction among young and very young patients with coronary artery disease
Authors: Zhang Dongfeng , Zuo Huijuan , Yang Hongxia , Zhang Min , Ge Changjiang , Song Xiantao 
Published: August 2022

Background
This study aimed to compare the profiles of young and very young patients with coronary artery disease (CAD) and explore the factors associated with acute myocardial infarction (AMI) based on age.

Methods
Young CAD patients aged between 18 and 44 years diagnosed by angiography were enrolled retrospectively. They were divided into two groups according to age: young CAD was defined as patients aged between 36 and 44 years, and very young CAD was defined as patients aged between 18 and 35 years. Demographic and clinical characteristics of the patients were collected.

Results
In total, 9286 patients were included in the final database. Most were assigned to the young CAD group (86.5%), and 1250 (13.5%) had very young CAD. Most demographic and clinical characteristics of the young and very young patients with CAD differed significantly. The proportion of patients with CAD in the total population increased with age, whereas the incidence of AMI showed a decreasing trend. A previous percutaneous coronary intervention (PCI) was negatively associated with AMI. Dyslipidemia, current smoking, and hyperhomocysteinemia were positively associated with AMI in the overall and young population with CAD.

Conclusions
The clinical profiles and factors associated with AMI in CAD patients of different ages were significantly different. Lifestyle-related factors were significantly associated with AMI in young patients with CAD.
Split-Belt Adaptation and Savings in People With Parkinson Disease
Authors: Thompson Elizabeth D. , Reisman Darcy S. 
Published: August 2022

Background and Purpose:
Upper extremity studies suggest that implicit adaptation is less impaired than explicit learning in persons with Parkinson disease (PD). Little work has explored implicit locomotor adaptation and savings in this population, yet implicit locomotor learning is critical for everyday function. This cross-sectional study examined adaptation and savings in individuals with PD during split-belt treadmill walking.

Methods:
Fourteen participants completed the following treadmill protocol: Baseline (6 minutes belts tied), Adaptation (10 minutes split), Washout (10 minutes tied), and Readaptation (10 minutes split). Step length and step symmetry index (SSI) were calculated to determine magnitude and rate of adaptation and savings. Rate was calculated as strides to reach SSI plateau during Adaptation and Readaptation.

Results:
During Early Adaptation and Early Readaptation, SSI was perturbed from Baseline (P < 0.001 and P = 0.002, respectively). Less perturbation in Early Readaptation (P < 0.001) demonstrated savings. In Late Adaptation and Late Readaptation, participants returned to Baseline symmetry (P = 0.026 and P = 0.022, respectively, with adjusted level of significance = 0.007). Adaptation was also seen in reverse asymmetry observed in Early Washout (P = 0.003 vs Baseline). Readaptation rate was faster than in Adaptation (P = 0.015), demonstrating savings.

Discussion and Conclusions:
Individuals with PD showed locomotor adaptation in an implicit sensorimotor adaptation task. They also demonstrated savings, with less perturbation and faster adaptation during the second split-belt exposure. However, performance was variable; some individuals showed minimal adaptation. Variations in learning, savings, and clinical presentation highlight the need to further explore characteristics of individuals with PD most likely to benefit from adaptation-based locomotor training.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A395).
Lessons Learned in Outpatient Physical Therapy for Motor Functional Neurological Disorder
Authors: Maggio Julie , Kyle Kevin , Stephen Christopher D. , Perez David L. 
Published: August 2022

Background and Purpose:
Motor functional neurological disorder is a prevalent and costly condition at the intersection of neurology and psychiatry that is diagnosed using positive “rule-in” signs. Physical therapy is a first-line treatment and consensus recommendations exist to guide clinical care. Nonetheless, optimal outpatient treatment of adults with functional motor symptoms requires an expanded physical therapy tool kit to effectively guide care.

Summary of Key Points:
In this article, lessons learned from a physical therapist practicing in a multidisciplinary and interdisciplinary outpatient functional neurological disorder clinic are highlighted. In doing so, we discuss how use of the biopsychosocial model and neuroscience constructs can inform physical therapy interventions. The importance of team-based care and the delivery of physical therapy through video telehealth services are also outlined.

Recommendations for Clinical Practice:
Use of the biopsychosocial formulation to triage clinical challenges and guide longitudinal care, coupled with application of neuroscience to aid intervention selection, allows for patient-centered physical therapy treatment across the spectrum of functional motor symptoms.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A400).
Neurocheck Frequency
Authors: LaBuzetta Jamie Nicole , Kazer Max R. , Kamdar Biren B. , Owens Robert L. , Evans John H. , Stone Lauren , Malhotra Atul 
Published: August 2022

Background:
Following acute brain injury, patients in the intensive care unit often undergo hourly or every-other-hour exams (“neurochecks”) to monitor for neurodeterioration. We assessed health care provider attitudes towards neurocheck frequency and evaluated providers’ ideal neurocheck frequency.

Methods:
This was a cross-sectional, online survey distributed in Spring 2021 at a tertiary care academic medical center. Providers from multiple intensive care unit and neuroscience clinical specialties including attending faculty, medical trainees, advanced practice providers, and bedside nurses were invited to participate.

Results:
Among 177 participants, 61 (34%) and 116 (66%) were self-identified as ordering and performing providers, respectively. The survey response rate was 58% among physicians and 51% among bedside nurses with neurological expertise. The most common medical and non-medical reasons for ordering hourly neurochecks were “a specific diagnosis with anticipated course” and “standard of care”, respectively. Compared with ordering providers, performing providers felt guidelines regarding neurocheck frequency (P<0.01) and duration (P<0.01) should be proscriptive. Conversely, ordering providers felt hourly neurochecks were detrimental to patients with acute brain injury (P=0.02) and believed they would not utilize hourly neurochecks if there was another mode of monitoring available (P=0.03). Performing providers identified multiple patient-related factors impacting the difficulty of and their willingness to perform frequent neurochecks, and only 70% of neurochecks were perceived to be performed as ordered. Both ordering and performing providers preferred every-other-hour neurochecks following acute brain injury.

Conclusions:
This survey revealed clinically relevant differences in ordering versus performing provider attitudes about frequent neurochecks. Providers preferred every-other-hour rather than hourly neurochecks.