bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feeding Difficulties and Gastrointestinal Tract Morphology and Innervation in ‘Charge’ Syndrome
Authors: Hudson A , Macdonald M , Cloney K , Steele S , Berman J , Blake K , Stoyek M , Croll R , Smith F 
Published: September 2022

Abstract
BACKGROUND: CHARGE syndrome has been linked to mutations in the CHD7 gene and results in a number of physiological and structural abnormalities. The estimated incidence in the Atlantic Provinces is 1 in 8500 births. Challenges include eating problems, which have a profound impact throughout a child’s life and can lead to complications and even death.
OBJECTIVES: To investigate feeding difficulties and model the morphology and innervation of the gastrointestinal tract in CHARGE syndrome.
DESIGN/METHODS: Three research studies (two clinical, one basic science) were conducted to assess feeding difficulties in CHARGE syndrome. The first study conducted a qualitative analysis of parent interviews to understand packing and problematic feeding behaviors. The second study investigated general eating and GI motility problems by having parents complete a series of feeding questionnaires. The third study modeled CHARGE syndrome in zebrafish by using a morpholino to knock down the expression of CHD7.
RESULTS: Study 1: Twenty parents completed a phone interview, describing their child/adult’s (2-32 years) adverse feeding behaviors. Parents reported food packing most commonly with bread and pasta (33%), and reported that food was held in cheeks for hours after a meal had ended (35%). Packing was reported to prolong mealtimes for over an hour (30%). Parents were worried about choking during eating (30%).Study 2: Sixty-nine parents of children (age 1-18 years) completed the questionnaires. Those who were tube fed had significantly more gastrointestinal symptoms (stomach pain, nausea, etc.) and worse feeding difficulties than those who were orally fed. The CHARGE characteristics of choanal atre-sia/stenosis and cranial nerve IX/X dysfunction were associated with significantly more gastrointestinal symptoms. Parents identified constipation as a major challenge. Study 3: Immunohistochemistry demonstrated changes in the enteric innervation of the gastrointestinal tract in the CHARGE syndrome zebrafish models. There was decreased branching of the gastrointestinal nerve network surrounding the stomach. Use of fluorescent microbeads demonstrated reduced motility and delayed passage of the microbeads through the gastrointestinal tract.
CONCLUSION: These three studies provided a comprehensive analysis of feeding and gastrointestinal difficulties, from mouth to anus, in CHARGE syndrome. They provide a deeper understanding of adverse feeding behaviors, feeding difficulties, and the abnormal morphology of the gastrointestinal system. The information from this study can be useful for general pediatricians and feeding therapy teams who are involved in the care of these individuals starting in infancy. The team-based approach of conducting multiple research projects investigating a common issue may be useful in other genetic disorders.
Investigating the Need for Routine Hip Ultrasound to Detect Developmental Dysplasia of the Hips In Babies Born with Breech Presentation
Authors: D'Alessandro M , Dow K 
Published: September 2022

Abstract
BACKGROUND: Breech presentation at birth increases the risk for developmental dysplasia of the hips (DDH). However, international consensus with regards to screening guidelines for infants at increased risk of DDH is lacking. Kingston General Hospital (KGH), a Canadian tertiary care center, currently employs a DDH ultrasound screening protocol at 6 weeks of age for all infants born with breech presentation.
OBJECTIVES: To investigate the utility of routine ultrasound scanning in detecting DDH in patients born breech with a negative physical exam of the hips.
DESIGN/METHODS: A retrospective chart review was conducted in which electronic medical records at KGH were reviewed to identify infants born breech who received routine hip ultrasound screening for DDH between 2010 and 2015. Physical exam findings of the hips, ultrasound reports, and subsequent treatment modalities were extracted as well as gestational age, birth weight, and gender.
RESULTS: 319 infants born with breech presentation who underwent routine hip ultrasound regardless of physical exam status were identified (192 (60.2%) female; 127 (39.8%) male). 27 (8.5%) had a negative physical exam but a positive finding on ultrasound. The gender distribution of this subset was significantly different than that of the total group (p CONCLUSION: For infants born with breech presentation with a negative physical exam of the hips, consideration could be given to direct routine ultrasound screening for DDH at females only.
Infectious Episodes in Paediatric Patients with Moderate-To-Severe Chronic Benign Neutropenia and Normal Bone Marrow Evaluation
Authors: Bernard-Genest J , Beaulieu-Genest L , Michon B 
Published: September 2022

Abstract
BACKGROUND: Chronic benign neutropenia, often referred as primary autoimmune neutropenia, is the most frequent cause of chronic neutrope-nia in children. Despite being a common and long known entity, evidence supporting its benign infectious course is scarce. More data would help guiding parents and clinicians in regard to patient evolution.
OBJECTIVES: The aim of this study was to describe infectious episodes in children with moderate to severe autoimmune neutropenia supported by a normal bone marrow study. Secondary objectives were to determine the mean duration of the neutropenia and whether the severity of the neutro-penia was correlated to the development of severe infections.
DESIGN/METHODS: We retrospectively reviewed medical records of patients with chronic neutropenia followed by a pediatric hematologist at our tertiary pediatric center, between November 1995 and December 2013. We only included patients with chronic benign neutropenia supported by a normal bone marrow. We excluded patients with immune deficiencies, genetic syndromes and metabolic diseases. Simple and multiple logistic regression were used to determine the association between the presence of severe infections and the absolute neutrophil count (ANC). We classified the severity of infection according to the medical literature.
RESULTS: 84 medical records were retrospectively reviewed. 21 patients were excluded from the study based on exclusion criteria. We were able to collect complete data for 37 patients. The median age at diagnosis and at resolution was respectively 9 months (2mo-13yr) and 37 months (9mo-16y). The median duration of the neutropenia was 17 months (3mo-5y). During the neutropenic period, more than 112 mild infections were observed. 11 patients (29.7%) developed 13 moderate infections. 7 patients (18.9%) underwent 8 severe infections but no bacteremia was reported. ANC was not significantly different between patients who exhibited severe infections and those who did not (mean ANC=663±322×106/L vs 601±326×106/L; p=0.67). Recurrent infections occurred in 9 patients (24.3%).
CONCLUSION: To our knowledge, our study is the largest on benign chronic neutropenia in children with normal bone evaluation. Severe infections have infrequently been reported in the literature for children with chronic benign neutropenia. Yet, almost 20% of our cohort exhibited at least one severe infection, although no bacteremia occurred. Interestingly, no association was found between the severity of the neu-tropenia and the presence of severe infection. We believe that these findings will help guiding the evaluation and management in this commonly occurring affection.
Development and Implementation of a Novel On-Call Structure for Paediatric Residents
Authors: Cawthorn T , Ruhl M , Dhalla M , Lam S , Hall S 
Published: September 2022

Abstract
BACKGROUND: At the Alberta Children’s Hospital, residents provide 24-hour coverage of inpatient units through several shifts: a day team, an evening team, an overnight team, and a weekend team. The evening shift was designed to limit consecutive hours worked by the night team, allowing provision of five consecutive nights of coverage. Recently, residents and Hospitalist Pediatricians expressed a desire to optimize the continuity of care provided by our call system. Cross-covering residents working the evening shift felt that they were at higher risk of committing an error during these times. Furthermore, there were external pressures to reduce consecutive resident work hours to less than 15 hours.
OBJECTIVES: To design and implement a novel call system for pediatric residents at the Alberta Children’s Hospital.
DESIGN/METHODS: A committee was established to identify areas for improvement. Based on stakeholder input, a novel system was created that centered on a 12 hour construct (0800-2000) with a primary “day team” and “night team” for each weekday. A key feature of the system ensured that weekday coverage was provided by “on-service” residents (residents on a CTU rotation) and that weekend coverage was provided by “off-service” residents (on other rotations). The first iteration of the new call system was implemented in April of 2015.
RESULTS: A total of 19 residents completed a 6 month follow-up survey in November of 2015;89% of polled residents felt the new system was superior to the previous system. The majority of residents (84%) felt that patient care was improved during the weekdays, with the remaining residents indicating that weekday care was unchanged. Weekend care was felt to be unchanged under the new system by the majority of residents (74%). There were differing opinions on the impact of the new system on resident fatigue level (38% improved, 22% unchanged, 12% worsened, 27% unsure). Surveys indicated that the new system was associated with a lower perceived risk of committing a medical error across all shifts.
CONCLUSION: We were able to successfully implement a novel call system which dose not rely on either an evening “covering” shift, or 24 hour shifts. The new call system was very well received by all stakeholders and was associated with improved resident perception of patient care during the week, and decreased perceived risk of medical error across all shifts. The new system was also associated with a trend toward reduced resident fatigue overall.
Developing a Consultation Model for Neonatal Neurocritical Care: A 2-Year Experience
Authors: Mohammad K , Goswami I , Buchhalter J , Bello-Espinosa L 
Published: September 2022

Abstract
BACKGROUND: Developing brain has unique pattern of injury and responds to injury differently. Management of neonatal seizures, perinatal asphyxia as well as ischemic-hemorrhagic preterm brain injury requires specific skill sets of neonatology, neurology, neurophysiology and neuroradiology. The impact of neurological conditions extends beyond neonatal intensive care unit stay warranting continuity of care in order to improve outcomes.
OBJECTIVES: Establishing a special interest group to run within the existing intensive care facility based on separate subspeciality model of neurocritical care in adults and study the impact of the change on short term outcome of neurological conditions in neonates.
DESIGN/METHODS: A multidisciplinary team was formulated including faculties from Neonatology, Pediatric Neurology, Diagnostic Imaging and Neonatal Follow up to form a neonatal neurocritical care (NNCC) core team. Roles to each team members was defined and oncall schedule for round the clock coverage developed. Hypoxic Ischemic Encephalopathy (HIE) was targeted first by standardized policies and procedures to be followed after admission, introduction of continuous video EEG monitoring and series of training sessions for nurses and fellows on bedside application of diagnostic tools. The core team was involved in care of the infant from admission to discharge with a well defined follow up plan and had 24 hour remote access to EEG recorded in any of the 2 Level 3 NICU involved.
RESULTS: On comparing management and outcomes prior to and following the start of NNCC we found that the use of anti-epileptic drugs (AED) reduced from 60 to 46%, the use of maintenance dose was halved. Considerable reduction in death or MRI documented brain injury was noted.

CONCLUSION: Consultation model of NNCC resulted in improved communication and collaboration between disciplines, better HIE care pathway and short term outcomes, creation of database that will allow assessment of long term outcome. The group is currently targeting Intra-Ventricular hemorrhage and post-hemorrhagic hydrocephalus management. In future the team will focus on real time multimodal brain monitoring.
The Cost of the Gluten-Free Diet: Household Food Expenditures in Families With a Child or Adolescent With Celiac Disease
Authors: Alzaben A , Mager D , Turner J , Marcon M , Anders S 
Published: September 2022

Abstract
BACKGROUND: Celiac disease (CD) is a digestive disease that is caused by an immune reaction to the protein gluten. The gluten free diet (GFD) is the only treatment for CD. In 2012, the sale of GF processed foods reached up to $460million in Canada; an increase in 25% since 2008. Despite being the fastest growing food intolerance category in Canada, GFD consumers face challenges from various voluntary GF-labelling schemes and limited retail and food-service product options.
OBJECTIVES: To estimate GF-food expenditure patterns for affected families with children or adolescents with CD to identify the cost burden of following a GFD and compared against non-GFD Canadian families.
DESIGN/METHODS: A pilot study was conducted in families with a child with biopsy proven CD following the GFD (n=15; 10±3 years) and attending a GI/CD clinic. Family Socio-demographics (age of parents, number of children/number of members following GFD in households) and the receipts of food purchases over a one-month period were obtained from parents/caregivers. The cost of GFD was analyzed as “actual food costs on related receipts” and determined as total GFD cost (per household/per child with CD) basis. The result of this study was compared against average incomes and food expenditures of Canadian households as reported by Statistic Canada in 2013.
RESULTS: The mean age of the parents of child with CD was (44±5 years) and the mean number of children in households was 2.0±0.6. The average duration of following GFD was 4±2 years (age at diagnosis 6±2 years). The median income for Canadian family and for family with children with CD was C$ 84,000/year and C$ 100,000/year, respectively. The average food expenditure was C$ 842/month for the average Canadian household with children vs C$ 1105±393/month for comparable Canadian households affected by CD. The amount of money spent on GF packaged foods was C$ 145±100/month. The average food expenditure of GF food and gluten containing food was C$112±72/child/month (+GF) and C$ 29±14/house-hold member/month (-GF), respectively.
CONCLUSION: Total food expenditures in families with a child/adolescent with CD are higher than the Canadian averages. This has implications on economic access and adherence to GFD in children/adolescents with CD. CD and proper dietary adherence to GFD guidelines poses significant economic burdens on affected families. These results and unanswered questions of economic access, affordability and quality of life hold several Canadian policy implications.
Prioritizing diversity? The allocation of US federal R&D funding
Authors: Graddy-Reed Alexandra , Lanahan Lauren 
Published: September 2022

AbstractWe examine the distribution of federal research and development funding across the academy early in the researcher’s pipeline. We use a unique program, the US National Science Foundation’s Graduate Research Fellowship Program (GRFP), to document diversity and disparity in allocation and assess the relative impact of federal funding across four different academic divisions that include engineering, life sciences, math and physical sciences, and social sciences and psychology. After controlling for disciplinary differences in research practices, we find that the impact of federal funding yields similar rates and impact of research. However, we document disparity in how federal funding is allocated across the country to institutions and individuals. Together, these findings prompt a discussion around the trade-offs of funders focusing on national priorities or broadening participation. We conclude with recommendations for the GRFP.
The effect of supplementing CLOSTAT 500 (Bacillus subtilis PB6) to yearling steers in a commercial feedyard on health, Salmonella spp. prevalence, feedlot growth performance and carcass characteristics
Authors: Word Alyssa , Broadway Paul Rand , Burdick-Sanchez Nicole , Carroll Jeff , Hales Kristin , Karr Kendall , Holland Ben , Ellis Guy , Maxwell Casey , Canterbury Landon , Leonhard John Tyler , LaFleur Doug , Hergenreder Jerilyn , Trojan Sara 
Published: September 2022

Abstract
British and British × Continental crossbred beef steers, n = 2,100; 313 ± 38 kg of initial body weight (BW) were used to evaluate the effects of Bacillus subtilis PB6 supplementation to yearling steers in a commercial feedyard on health, prevalence of Salmonella spp., growth performance, and carcass characteristics. Steers were blocked by arrival date and assigned randomly to pens within the block; pens were randomly assigned to 1 of 2 dietary treatments within block. Treatments, replicated in 15 pens/treatment with 70 steers/pen, included: 1) control (CON), diets containing no supplemental direct-fed microbials; 2) CLOSTAT (CLO), diets supplemented with 0.5 g/steer/d Bacillus subtilis PB6 (CLOSTAT 500, Kemin Industries, Des Moines, IA) to provide 6.6 × 109 CFU/g of the active ingredient. Supplementing CLO decreased the overall incidence of morbidity (P = 0.03), 10.38% (CLO) vs. 13.43% (CON), decreased the percentage of steers treated once for bovine respiratory disease (BRD; P &lt; 0.01), 9.14% (CLO) vs. 12.76% (CON), and decreased the incidence of BRD retreatment (P = 0.03) compared with CON. Mortality did not differ among treatments (P = 0.23); however, overall deads and removals tended to be less for CLO than CON (53 heads vs. 73 heads respectively, P = 0.06). Prevalence of fecal Salmonella did not differ among treatments, (P ≥ 0.35); overall fecal Salmonella counts tended to be less for CLO (1.59 log (10) CFU/g) than CON (2.04 log (10) CFU/g; P = 0.07). Salmonella concentration in subiliac lymph nodes (n =150/treatment) was not different (P = 0.62) between CON (0.22 log (10) CFU/g) or CLO (0.19 log (10) CFU/g); however, there was a 46% reduction in the overall mean prevalence of lymph node Salmonella (P = 0.46; 15.48% vs. 28.66%) for CLO and CON, respectively. With deads and removals included, final BW was heavier for CLO steers than CON, (654 kg vs. 641 kg, respectively, P = 0.05), and average daily gain (ADG; P = 0.08) and gain efficiency (G:F; P = 0.06) tended to be greater for CLO than CON. With deads and removals excluded, final BW, ADG, and G:F did not differ among treatments (P ≥ 0.30). Carcass traits were not different between treatments (P ≥ 0.15). Supplementing CLO throughout the feeding period in a commercial feedyard improved the health outcomes of yearling steers by decreasing BRD and overall treatment rates, reducing the overall abundance of Salmonella, and resulting in fewer steers removed from the study compared with CON.
A combined risk-based and condition monitoring approach: developing a dynamic model for the case of marine engine lubrication
Authors: Ventikos Nikolaos P , Sotiralis Panagiotis , Annetis Emmanouil 
Published: September 2022

Abstract
This paper focuses on the creation of a dynamic probabilistic model which simulates deterioration trends of a marine engine lubrication system. The approach is based on risk and the implementation is achieved through a dynamic Bayesian network (dBN). Risk can be useful for decision making, while dBNs are a powerful tool for risk modelling and prediction models. The model takes into account deterioration of engine components, oil degradation and the off-line condition monitoring technique of oil analysis, in the context of predictive maintenance. The paper aims to efficiently predict probability evolution for main engine lubrication failure and to decide upon the most beneficial schemes from a variety of lubrication oil analysis interval schemes by introducing monetary costs and producing the risk model. Real data and respective analysis, along with expert elicitation, are utilized for achieving model quantification, while the model is materialized through a code in the Matlab environment. Results from the probabilistic model show a realistic simulation for the system and indicate the obvious, that with more frequent oil analyses and respective maintenance or repairs, the probability of failure drops significantly. However, the results from the risk model highlight that the costs can redefine scheme suggestions, as they can correspond to low probabilities of failure but also to higher costs. A two-month interval scheme is suggested, in contrast to the most preferred practice among shipping companies of a three-month interval. The developed model is in general identified as a failure prediction tool focusing on marine engine lubrication failure.
A review of African American women's experiences in menopause
Authors: Williams Makeba , Richard-Davis Gloria , Weickert V. , Christensen Leslie , Ward Earlise , Schrager Sarina 
Published: September 2022

Abstract

Importance and Objective
Little is known and reported about the experiences of African American women as they transition to and experience menopause. Accepted norms are based on the experience of a predominantly White population. The aim of this study is to review available data about the distinct experiences of African American women during the menopause transition and menopause.

Methods
A literature search was developed and executed by the review team in collaboration with a health sciences librarian. The search combined controlled vocabulary and title/abstract terms related to the health status disparities of African Americans in the menopause transition and menopause. The following databases were searched from inception through April 28, 2022: PubMed, Scopus (Elsevier), and Web of Science Core Collection (Clarivate).

Discussion and Conclusion
African American women experience distinct differences in physical, psychological, social, and quality of life measures during menopause. Increasing awareness about the unique menopause experiences of African American women is critically important to improve the health of this underserved population.