PubMed Baby Friendly

The Positive Association Between Duration of Skin-to-Skin Contact and Blood Glucose Level in Full-Term Infants.

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The Positive Association Between Duration of Skin-to-Skin Contact and Blood Glucose Level in Full-Term Infants.

J Perinat Neonatal Nurs. 2018 May 17;:

Authors: Takahashi Y, Tamakoshi K

Abstract
The aim of this study was to evaluate the contribution of the duration of skin-to-skin contact (SSC) on blood glucose levels at 2 hours after birth in healthy full-term infants. This observational study was done at one of the baby-friendly hospitals located in Aichi, Japan in 2009. Sixty newborn infants who were born vaginally from uncomplicated pregnancies were participated. All infants were held SSC within 5 minutes. All data regarding neonatal information, blood glucose levels at 2 hours of age, and maternal information were obtained from their medical history. Multiple linear regression analysis was performed to identify the independent contribution of the duration of SSC. The mean duration of SSC was 59.6 ± 13.6 minutes (range: 11.0-97.0 minutes) and the infant blood glucose level was 53.1 ± 9.5 (range: 30.0-80.0 mg/dL) mg/dL. The duration of SSC (β [95% confidence interval] = .282 [range: 0.037-0.357], standardized β = .282, P < .017) was significantly and positively associated with infant blood glucose levels independent of gestational age, birth weight, sex, length of second-stage labor, and mode of delivery. Thus, the longer early SSC was associated with higher blood glucose level at 2 hours of age in healthy full-term infants.

PMID: 29782439 [PubMed - as supplied by publisher]

The health care system is making 'too much noise' to provide family-centred care in neonatal intensive care units: Perspectives of health care providers and hospital administrators.

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The health care system is making 'too much noise' to provide family-centred care in neonatal intensive care units: Perspectives of health care providers and hospital administrators.

Intensive Crit Care Nurs. 2018 May 11;:

Authors: Benzies KM, Shah V, Aziz K, Lodha A, Misfeldt R

Abstract
AIM: To describe the perspectives of health care providers and hospital administrators on their experiences of providing care for infants in Level II neonatal intensive care units and their families.
RESEARCH METHODS: We conducted 36 qualitative interviews with neonatal health care providers and hospital administrators and analysed data using a descriptive interpretive approach.
SETTING: 10 Level II Neonatal Intensive Care Units in a single, integrated health care system in one Canadian province.
FINDINGS: Three major themes emerged: (1) providing family-centred care, (2) working amidst health care system challenges, and (3) recommending improvements to the health care system. The overarching theme was that the health care system was making 'too much noise' for health care providers and hospital administrators to provide family-centred care in ways that would benefit infants and their families. Recommended improvements included: refining staffing models, enhancing professional development, providing tools to deliver consistent care, recognising parental capacity to be involved in care, strengthening continuity of care, supporting families to be with their infant, and designing family-friendly environments.
CONCLUSION: When implementing family-centred care initiatives, health care providers and hospital administrators need to consider the complexity of providing care in Level II Neonatal Intensive Care Units, and recognise that health care system changes may be necessary to optimise implementation.

PMID: 29759848 [PubMed - as supplied by publisher]

Formula Milk Supplementation on the Postnatal Ward: A Cross-Sectional Analytical Study.

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Formula Milk Supplementation on the Postnatal Ward: A Cross-Sectional Analytical Study.

Nutrients. 2018 May 14;10(5):

Authors: Biggs KV, Hurrell K, Matthews E, Khaleva E, Munblit D, Boyle RJ

Abstract
Breastfeeding rates are low in the UK, where approximately one quarter of infants receive a breastmilk substitute (BMS) in the first week of life. We investigated the reasons for early BMS use in two large maternity units in the UK, in order to understand the reasons for the high rate of early BMS use in this setting. Data were collected through infant feeding records, as well as maternal and midwife surveys in 2016. During 2016, 28% of infants received a BMS supplement prior to discharge from the hospital maternity units with only 10% supplementation being clinically indicated. There was wide variation in BMS initiation rates between different midwives, which was associated with ward environment and midwife educational level. Specific management factors associated with non-clinically indicated initiation of BMS were the absence of skin-to-skin contact within an hour of delivery (p = 0.01), and no attendance at an antenatal breastfeeding discussion (p = 0.01). These findings suggest that risk of initiating a BMS during postnatal hospital stay is largely modifiable. Concordance with UNICEF Baby Friendly 10 steps, attention to specific features of the postnatal ward working environment, and the targeting of midwives and mothers with poor educational status may all lead to improved exclusive breastfeeding rates at hospital discharge.

PMID: 29757936 [PubMed - in process]

Effectiveness of Baby Friendly Community Initiative (BFCI) on complementary feeding in Koibatek, Kenya: a randomized control study.

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Effectiveness of Baby Friendly Community Initiative (BFCI) on complementary feeding in Koibatek, Kenya: a randomized control study.

BMC Public Health. 2018 May 08;18(1):600

Authors: Maingi M, Kimiywe J, Iron-Segev S

Abstract
BACKGROUND: Appropriate infant and young child nutrition is critical for proper growth and development. In order to promote optimal nutrition at an early age, the World Health Organization (WHO) and UNICEF have developed the Baby Friendly Hospital Initiative (BFHI) to address poor breastfeeding practices in maternity wards. However, impact is limited in less developed countries like Kenya, where more than half of all births are home deliveries. Therefore, Kenya has explored the adoption of Baby Friendly Community Initiative (BFCI) in its rural settings. In contrast to the BFHI, the BFCI supports breastfeeding and optimal infant feeding in community. BFCI has been implemented in Koibatek, in rural Kenya. This study aimed at assessing the effectiveness of BFCI on complementary feeding practices of children aged 6-23 months, by comparing intervention and control groups.
METHODS: This was a randomized control study design that included 270 mother-infant pairs enrolled in the Baby Friendly Community Initiative (BFCI) project in Koibatek. Evaluation was carried out using structured questionnaires.
RESULTS: A statistically significantly higher proportion of children in the intervention group compared to the control group attained minimum dietary diversity (77% vs. 58%; p = 0.001), minimum meal frequency (96% vs. 89%; p = 0.046) and minimum acceptable diet (77% vs. 61%; p = 0.005). The odds of attaining minimum dietary diversity, minimum meal frequency and minimum acceptable diet were statistically significantly higher for the intervention group compared to control group (OR: 4.95; 95%CI 2.44-10.03, p = < 0.001; OR: 14.84; 95%CI 2.75-79.9, p = 0.002; OR: 4.61; 95%CI 2.17-9.78, p = < 0.001 respectively).
CONCLUSION: The BFCI intervention was successful in improving complementary feeding practices. Strengthening and prioritizing BFCI interventions could have a significant impact on child health outcomes in rural Kenya.
TRIAL REGISTRATION: ISRCTN03467700 . Registration 24 September 2014. Retrospectively registered.

PMID: 29739374 [PubMed - in process]

Educational videos for practitioners attending Baby Friendly Hospital Initiative workshops supporting breastfeeding positioning, attachment and hand expression skills: Effects on knowledge and confidence.

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Educational videos for practitioners attending Baby Friendly Hospital Initiative workshops supporting breastfeeding positioning, attachment and hand expression skills: Effects on knowledge and confidence.

Nurse Educ Pract. 2018 Apr 26;31:7-13

Authors: Wallace LM, Ma Y, Qiu LQ, Dunn OM

Abstract
UNICEF Baby Friendly Initiative (BFHI) is the global standard for maternity and community services requiring all practitioners to be trained to support mothers in the essential skills of supporting positioning and attachment, and hand expression. These studies aim to rigorously assess knowledge in nurses, midwives, and doctors in these skills, tested before and after watching short videos demonstrating these skills. Practitioners were attending BFHI education, and the video study was additional. In Phase 1 clinicians in England were randomised to one of two videos (practitioner role play or clinical demonstration). The results showed improvements in knowledge and confidence, and a preference for clinical demonstration by mothers and infants. The clinical demonstration video was evaluated in China in Phase 2 where expert trainers viewed the video after completing the BHFI workshop, and in Phase 3 practitioners viewed the video before the BHFI workshop. Phase 2 with expert trainers only showed improvement in knowledge of hand expression but not positioning and attachment. In Phase 3 clinicians showed improved knowledge for both skills. In all Phases there were statistically significant improvements in confidence in practice in both skills. Viewing short videos increased knowledge, particularly about teaching hand expression, and confidence in both skills.

PMID: 29727794 [PubMed - as supplied by publisher]

Knowledge of, and attitudes to giving expressed breastmilk to infants in rural coastal Kenya; focus group discussions of first time mothers and their advisers.

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Knowledge of, and attitudes to giving expressed breastmilk to infants in rural coastal Kenya; focus group discussions of first time mothers and their advisers.

Int Breastfeed J. 2018;13:16

Authors: Talbert AW, Tsofa B, Mumbo E, Berkley JA, Mwangome M

Abstract
Background: The World Health Organization (WHO)/UNICEF Baby-Friendly Hospital Initiative step number five of the "Ten steps to successful breastfeeding" states "Show mothers how to breastfeed and how to maintain lactation even if they should be separated from their infants." Urban mothers in Nairobi have low rates of exclusive breastfeeding after returning to work but there are no published data on rural Kenya mothers' infant feeding practices when working or schooling away from home.
Methods: We explored knowledge of, and attitudes to, the practice of giving expressed breastmilk in a mixed methods observational study of breastfeeding in rural Kenyan mothers. Fifty mothers with newborns, identified by nurses and community health workers, were asked questions about their experiences of breastfeeding and who they had sought or received advice from on breastfeeding. Focus group discussions, one with community health workers, and four each with mothers and their named advisers were held. Recordings were analyzed using a thematic framework approach.
Results: The main themes were: the baby's right to feed from the breast, lack of knowledge about expressing and giving breastmilk, negative attitudes towards expressed breastmilk, and traditional customs for disposing of expressed breast milk. Most participants did not have any experience of giving expressed breastmilk to infants. They described practices of expressing and discarding milk when the mother or baby was ill, to relieve discomfort from engorgement or after the baby had died.
Conclusions: Feeding expressed breastmilk to infants is a new concept in this context. Promotion of, and training in this practice would help mothers to maintain their milk supply when away from their babies and benefit the infants of working and schoolgirl mothers.

PMID: 29719563 [PubMed]

Molecular diagnostics for Chagas disease: up to date and novel methodologies.

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Molecular diagnostics for Chagas disease: up to date and novel methodologies.

Expert Rev Mol Diagn. 2017 Jul;17(7):699-710

Authors: Alonso-Padilla J, Gallego M, Schijman AG, Gascon J

Abstract
INTRODUCTION: Chagas disease is caused by the parasite Trypanosoma cruzi. It affects 7 million people, mainly in Latin America. Diagnosis is usually made serologically, but at some clinical scenarios serology cannot be used. Then, molecular detection is required for early detection of congenital transmission, treatment response follow up, and diagnosis of immune-suppression reactivation. However, present tests are technically demanding and require well-equipped laboratories which make them unfeasible in low-resources endemic regions. Areas covered: Available molecular tools for detection of T. cruzi DNA, paying particular attention to quantitative PCR protocols, and to the latest developments of user-friendly molecular diagnostic methodologies. Expert commentary: In the absence of appropriate biomarkers, molecular diagnosis is the only option for the assessment of treatment response. Besides, it is very useful for the early detection of acute infections, like congenital cases. Since current Chagas disease molecular tests are restricted to referential labs, research efforts must focus in the implementation of easy-to-use diagnostic tools in order to overcome the access to diagnosis gap.

PMID: 28582629 [PubMed - indexed for MEDLINE]

Analyzing Factors That Impact Breastfeeding Duration in the Postpartum Period: A Secondary Analysis of PRAMS Data.

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Analyzing Factors That Impact Breastfeeding Duration in the Postpartum Period: A Secondary Analysis of PRAMS Data.

Breastfeed Med. 2018 Apr 30;:

Authors: Pounds L, Shostrom V

Abstract
BACKGROUND: Benefits of breastfeeding are well established. What is more, breastfeeding is associated with lower healthcare costs. More U.S. hospitals are adopting the World Health Organization's Ten Steps to Successful Breastfeeding; however, most hospitals fall short on key factors.
OBJECTIVE: To our knowledge, this project is the first of its kind to use national-level data and a complex statistical modeling approach to identify a more complete picture of the variables related to breastfeeding duration within the postpartum period.
METHODS: This secondary data analysis project used the Phase 7 Core PRAMS Research File (2012-2013) and the Standard Questions B1, B2, B3, and B4 variables in the statistical analysis. The outcome variable of interest was length of breastfeeding during the postpartum period. The postpartum period was defined as 8 weeks after delivery rather than the usual definition of 6 weeks to accommodate the way quit time is reported in the Pregnancy Risk Assessment Monitoring System (PRAMS) data. Univariate and multivariate analyses were conducted using PC SAS version 9.4.
RESULTS: The multivariate analysis indicates that many of the modifiable factors associated with quitting breastfeeding within the postpartum period are hospital related. This pilot study reinforces the importance of 7 of the 10 Steps.
CONCLUSIONS: These results underscore the importance of hospitals adopting evidence-based best practices for breastfeeding. The relationship found between Women, Infants, and Children receiving supplemental nutrition benefits and breastfeeding quit times requires further exploration. The study results also highlight the need to address modifiable factors that may be overlooked in traditional breastfeeding promotion efforts, such as depression and alcohol use.

PMID: 29708765 [PubMed - as supplied by publisher]

'We knew it was a totally at random thing': parents' experiences of being part of a neonatal trial.

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'We knew it was a totally at random thing': parents' experiences of being part of a neonatal trial.

Trials. 2017 Aug 01;18(1):361

Authors: Harvey M, Nongena P, Edwards D, Redshaw M

Abstract
BACKGROUND: Studies exploring parents' trial experiences generally relate to their understanding of the consent process and the development of researcher strategies to facilitate recruitment and retention. The aim was to better understand parents' experience of being part of a trial at the time and their perceptions of trial participation in retrospect.
METHODS: Data were collected in a number of ways: from recorded discussions between parents and clinicians about the MRI or ultrasound, in open-text responses to questionnaires and in qualitative interviews at 1 and 2 years after participation. Thematic analysis was undertaken using NVivo10.
RESULTS: Key themes identified were 'deciding to take part', with subthemes associated with 'benefitting self', 'benefitting others' and 'being prepared'; 'the randomisation process' with subthemes relating to 'acceptance' and 'understanding' and 'actual engagement' with subthemes of 'practicalities' and 'care from responsive staff'.
CONCLUSION: Parents' perspectives on the trial and the processes and information received reflect their understanding and experience of the trial and the value of parent-friendly information-giving about participation, randomisation and follow-up. The practical and logistical points raised confirm the key issues and parents' need for sensitive care and support in the course of a trial. Looking back, almost all parents were positive about their experience and felt that the family had benefitted from participation in the trial and follow-up studies, even when the developmental outcomes were poor.
TRIAL REGISTRATION: ClinicalTrials.gov, ID: NCT01049594. https://clinicaltrials.gov/ct2/show/NCT01049594 . Registered on 13 January 2010. EudraCT: EudraCT: 2009-011602-42. https://www.clinicaltrialsregister.eu/ .

PMID: 28764800 [PubMed - indexed for MEDLINE]

Characteristics and respiratory risk profile of children aged less than 5 years presenting to an urban, Aboriginal-friendly, comprehensive primary health practice in Australia.

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Characteristics and respiratory risk profile of children aged less than 5 years presenting to an urban, Aboriginal-friendly, comprehensive primary health practice in Australia.

J Paediatr Child Health. 2017 Jul;53(7):636-643

Authors: Hall KK, Chang AB, Anderson J, Dunbar M, Arnold D, O'Grady KF

Abstract
AIM: There are no published data on factors impacting on acute respiratory illness (ARI) among urban Indigenous children. We describe the characteristics and respiratory risk profile of young urban Indigenous children attending an Aboriginal-friendly primary health-care practice.
METHODS: We conducted a cross-sectional analysis of data collected at baseline in a cohort study investigating ARI in urban Indigenous children aged less than 5 years registered with an Aboriginal primary health-care service. Descriptive analyses of epidemiological, clinical, environmental and cultural factors were performed. Logistic regression was undertaken to examine associations between child characteristics and the presence of ARI at baseline.
RESULTS: Between February 2013 and October 2015, 180 Indigenous children were enrolled; the median age was 18.4 months (7.7-35), 51% were male. A total of 40 (22%) children presented for a cough-related illness; however, ARI was identified in 33% of all children at the time of enrolment. A total of 72% of children were exposed to environmental tobacco smoke. ARI at baseline was associated with low birthweight (adjusted odds ratio (aOR) 2.54, 95% confidence interval (CI) 1.08-5.94), a history of eczema (aOR 2.67, 95% CI 1.00-7.15) and either having a family member from the Stolen Generation (aOR 3.47, 95% CI 1.33-9.03) or not knowing this family history (aOR 3.35, 95% CI 1.21-9.26).
CONCLUSIONS: We identified an urban community of children of high socio-economic disadvantage and who have excessive exposure to environmental tobacco smoke. Connection to the Stolen Generation or not knowing the family history may be directly impacting on child health in this community. Further research is needed to understand the relationship between cultural factors and ARI.

PMID: 28436124 [PubMed - indexed for MEDLINE]

Beyond BFHI: The Spatz 10-Step and Breastfeeding Resource Nurse Model to Improve Human Milk and Breastfeeding Outcomes.

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Beyond BFHI: The Spatz 10-Step and Breastfeeding Resource Nurse Model to Improve Human Milk and Breastfeeding Outcomes.

J Perinat Neonatal Nurs. 2018 Apr/Jun;32(2):164-174

Authors: Spatz DL

Abstract
A report released by the World Health Organization states that worldwide less than 10% of birth occur in hospitals certified through the Baby-Friendly Hospital Initiative. Furthermore, the Baby-Friendly Hospital Initiative's primary focus is on breastfeeding for healthy, mother-infant dyads. This article provides alternative models for implementing evidence-based care during maternal-infant separation so that mothers can achieve their personal breastfeeding goals. These include the Spatz 10-step model for human milk and breastfeeding in vulnerable infants and the Breastfeeding Resource Nurse model. Clinical outcome data are provided to demonstrate the effectiveness of the models as well as a road map of strategies to implement the models and measure outcomes.

PMID: 29689018 [PubMed - in process]

Baby-Friendly as a Regional Collaborative Quality Improvement Project in an Academic Medical Center Environment.

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Baby-Friendly as a Regional Collaborative Quality Improvement Project in an Academic Medical Center Environment.

J Perinat Neonatal Nurs. 2018 Apr/Jun;32(2):136-143

Authors: Krauss MJ, Sharp M

Abstract
In 2012, the state of South Carolina lacked any Baby-Friendly designated hospitals. The Medical University of South Carolina had a strong lactation service since 2002 but continued to struggle with improving breastfeeding rates. The Baby-Friendly Hospital Initiative was the catalyst to increase breastfeeding rates at this academic medical center. In 2012, membership in the Best Fed Beginnings Learning Collaborative heightened awareness of the importance of interdisciplinary collaboration. Participation in the regional collaborative provided evidence-based breastfeeding education and best clinical practices that supported the maternal-infant dyad. These improved practices are achieved by implementation of the Ten Steps to Successful Breastfeeding. The collaborative model accelerated change, and the goals to reach 80% of each metric were met. The exclusive breastfeeding rate increased by 30%. As a result of swiftly achieving designation, the institution was then able to focus on sustainability issues and efforts to expand breastfeeding support into the community. The purpose of this article is to review one hospital's journey while providing guidance to other organizations undergoing the process of becoming Baby-Friendly. The invaluable membership in the Best Fed Beginnings Learning Collaborative quality improvement initiative proved to be a major incentive and source of support in efficiently achieving Baby-Friendly status.

PMID: 29689014 [PubMed - in process]

Incorporating "Father-Friendly" Breastfeeding Language in Maternity Settings.

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Incorporating "Father-Friendly" Breastfeeding Language in Maternity Settings.

J Perinat Neonatal Nurs. 2018 Apr/Jun;32(2):112-115

Authors: Johnston JT

Abstract
The purpose of this commentary is to provide perinatal providers with the tools they need to incorporate fathers into the breastfeeding relationship. Research shows that engaged fathers increase initiation rates, decrease the rate of breastfeeding complications that lead to premature cessation, and increase the duration and exclusivity of a mother's breastfeeding efforts. Despite this evidence, studies frequently show that fathers report being ignored or excluded from breastfeeding education. This is likely an oversight on the behalf of perinatal providers rather than a conscious effort. Ultimately, however, perinatal providers need to be prepared to address the concerns of all parents who will provide care to the infant and not the mother alone. This commentary discusses the value of fathers as breastfeeding supporters and offers evidence-based teaching strategies requested by fathers. This commentary also identifies and describes 4 father-friendly breastfeeding promotion resources and highlights the techniques used to draw fathers into the mother's breastfeeding efforts.

PMID: 29689012 [PubMed - in process]

Live Birth after Rescue In vitro Maturation-intracytoplasmic Sperm Injection in Type 1 Diabetes, Polycystic Ovary Syndrome Patient Using Clomiphene-antagonist Protocol.

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Live Birth after Rescue In vitro Maturation-intracytoplasmic Sperm Injection in Type 1 Diabetes, Polycystic Ovary Syndrome Patient Using Clomiphene-antagonist Protocol.

J Hum Reprod Sci. 2018 Jan-Mar;11(1):75-78

Authors: Sankari S, Elanchezhian M, Selvamani D, Nagarajan M, Gopikrishnan D

Abstract
Infertility in patients with polycystic ovary syndrome (PCOS) associated with diabetes leads to challenging situations seeking alternative treatments. In vitro maturation (IVM) followed by intracytoplasmic sperm injection (ICSI) could overcome the challenges with promising pregnancies in such patients. In the treatment of a 32-year-old diabetic woman who also had PCOS, single immature oocyte was retrieved. Rescue IVM followed by ICSI yielded a grade 1 day 3 embryo which on transferring resulted in pregnancy and a healthy infant was delivered. Rescue IVM-ICSI could help in achieving pregnancy and live birth. Stimulation involving clomiphene and gonadotropin-releasing hormone antagonist is an effective and patient-friendly protocol for women with PCOS and diabetes and also for poor responders.

PMID: 29681720 [PubMed]

Retrieval and clinical analysis of distraction-based dual growing rod constructs for early-onset scoliosis.

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Retrieval and clinical analysis of distraction-based dual growing rod constructs for early-onset scoliosis.

Spine J. 2017 Oct;17(10):1506-1518

Authors: Hill G, Nagaraja S, Akbarnia BA, Pawelek J, Sponseller P, Sturm P, Emans J, Growing Spine Study Group, Bonangelino P, Cockrum J, Kane W, Dreher M

Abstract
BACKGROUND CONTEXT: Growing rod constructs are an important contribution for treating patients with early-onset scoliosis. These devices experience high failure rates, including rod fractures.
PURPOSE: The objective of this study was to identify the failure mechanism of retrieved growing rods, and to identify differences between patients with failed and intact constructs.
STUDY DESIGN/SETTING: Growing rod patients who had implant removal and were previously enrolled in a multicenter registry were eligible for this study.
PATIENT SAMPLE: Forty dual-rod constructs were retrieved from 36 patients across four centers, and 34 of those constructs met the inclusion criteria. Eighteen constructs failed due to rod fracture. Sixteen intact constructs were removed due to final fusion (n=7), implant exchange (n=5), infection (n=2), or implant prominence (n=2).
OUTCOME MEASURES: Analyses of clinical registry data, radiographs, and retrievals were the outcome measures.
METHODS: Retrievals were analyzed with microscopic imaging (optical and scanning electron microscopy) for areas of mechanical failure, damage, and corrosion. Failure analyses were conducted on the fracture surfaces to identify failure mechanism(s). Statistical analyses were performed to determine significant differences between the failed and intact groups.
RESULTS: The failed rods fractured due to bending fatigue under flexion motion. Construct configuration and loading dictate high bending stresses at three distinct locations along the construct: (1) mid-construct, (2) adjacent to the tandem connector, or (3) adjacent to the distal anchor foundation. In addition, high torques used to insert set screws may create an initiation point for fatigue. Syndromic scoliosis, prior rod fractures, increase in patient weight, and rigid constructs consisting of tandem connectors and multiple crosslinks were associated with failure.
CONCLUSION: This is the first study to examine retrieved, failed growing rod implants across multiple centers. Our analysis found that rod fractures are due to bending fatigue, and that stress concentrations play an important role in rod fractures. Recommendations are made on surgical techniques, such as the use of torque-limiting wrenches or not exceeding the prescribed torques. Additional recommendations include frequent rod replacement in select patients during scheduled surgeries.

PMID: 28456673 [PubMed - indexed for MEDLINE]

Breastfeeding during infancy and neurocognitive function in adolescence: 16-year follow-up of the PROBIT cluster-randomized trial.

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Breastfeeding during infancy and neurocognitive function in adolescence: 16-year follow-up of the PROBIT cluster-randomized trial.

PLoS Med. 2018 Apr;15(4):e1002554

Authors: Yang S, Martin RM, Oken E, Hameza M, Doniger G, Amit S, Patel R, Thompson J, Rifas-Shiman SL, Vilchuck K, Bogdanovich N, Kramer MS

Abstract
BACKGROUND: Evidence on the long-term effect of breastfeeding on neurocognitive development is based almost exclusively on observational studies. In the 16-year follow-up study of a large, cluster-randomized trial of a breastfeeding promotion intervention, we evaluated the long-term persistence of the neurocognitive benefits of the breastfeeding promotion intervention previously observed at early school age.
METHODS AND FINDINGS: A total of 13,557 participants (79.5% of the 17,046 randomized) of the Promotion of Breastfeeding Intervention Trial (PROBIT) were followed up at age 16 from September 2012 to July 2015. At the follow-up, neurocognitive function was assessed in 7 verbal and nonverbal cognitive domains using a computerized, self-administered test battery among 13,427 participants. Using an intention-to-treat (ITT) analysis as our prespecified primary analysis, we estimated cluster- and baseline characteristic-adjusted mean differences between the intervention (prolonged and exclusive breastfeeding promotion modelled on the Baby-Friendly Hospital Initiative) and control (usual care) groups in 7 cognitive domains and a global cognitive score. In our prespecified secondary analysis, we estimated mean differences by instrumental variable (IV) analysis to account for noncompliance with the randomly assigned intervention and estimate causal effects of breastfeeding. The 16-year follow-up rates were similar in the intervention (79.7%) and control groups (79.3%), and baseline characteristics were comparable between the two. In the cluster-adjusted ITT analyses, children in the intervention group did not show statistically significant differences in the scores from children in the control group. Prespecified additional adjustment for baseline characteristics improved statistical precision and resulted in slightly higher scores among children in the intervention for verbal function (1.4 [95% CI 0.3-2.5]) and memory (1.2 [95% CI 0.01-2.4]). IV analysis showed that children who were exclusively breastfed for ≥3 (versus <3) months had a 3.5-point (95% CI 0.9-6.1) higher verbal function, but no differences were observed in other domains. While our computerized, self-administered cognitive testing reduced the cluster-level variability in the scores, it may have increased individual-level measurement errors in adolescents.
CONCLUSIONS: We observed no benefit of a breastfeeding promotion intervention on overall neurocognitive function. The only beneficial effect was on verbal function at age 16. The higher verbal ability is consistent with results observed at early school age; however, the effect size was substantially smaller in adolescence.
PROBIT TRIAL REGISTRATION: ClinicalTrials.gov NCT01561612.

PMID: 29677187 [PubMed - in process]

A novel sandwich enzyme-linked immunosorbent assay with covalently bound monoclonal antibody and gold probe for sensitive and rapid detection of bovine β-lactoglobulin.

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A novel sandwich enzyme-linked immunosorbent assay with covalently bound monoclonal antibody and gold probe for sensitive and rapid detection of bovine β-lactoglobulin.

Anal Bioanal Chem. 2018 Apr 14;:

Authors: He S, Li X, Wu Y, Wu S, Wu Z, Yang A, Tong P, Yuan J, Gao J, Chen H

Abstract
Bovine milk is a recognized allergenic food source with β-lactoglobulin (BLG) as its major allergen. Reliable detection of BLG epitopes can, therefore, be a useful marker for the presence of milk in processed food products, and for potential allergenicity. At the present, enzyme-linked immunosorbent assays (ELISA) for the detection of BLG are time-consuming and generally not specific to BLG IgE epitopes. In this study, the 1-ethyl-3-(3-dimethylaminopropyl)carbodiimide-activated anti-BLG IgE epitope monoclonal antibody (mAb 1G9) was covalently bound onto the KOH-treated microtiter plate surface. Using this mAb-bound plate in sandwich combination with biotinylated anti-BLG polyclonal antibody-labeled gold nanoparticles, a linear dynamic range between 31.25 and 64 × 103 ng mL-1 with a limit of detection for BLG of 0.49 ng mL-1 was obtained, which is 32 times wider and 16 times more sensitive than conventional sandwich ELISA (sELISA). Total recovery of BLG in spiked food samples was found, without matrix effects. Also in partially hydrolyzed infant formulas, the allergenic BLG residues were detected quantitatively. Compared with conventional and commercial BLG detection sELISAs, our sELISA is reliable, highly BLG epitope-specific, user-friendly, and time-saving and allows accurate detection of potentially allergenic residues in different types of processed foods. This improved sELISA protocol can be easily extended to detect other well-identified and characterized food allergens. Graphical abstract IgE epitope mAb-bound plate in sandwich combination with gold probe for sensitive and rapid detection of bovine β-lactoglobulin and its potentially allergenic residues.

PMID: 29654339 [PubMed - as supplied by publisher]

A novel method for examining corneal endothelial cell morphology in infants.

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A novel method for examining corneal endothelial cell morphology in infants.

J AAPOS. 2017 Jun;21(3):241-243.e1

Authors: Rufai SR, Tan NY, Barbara R, Hartrey R, Self JE

Abstract
Previous studies have suggested that central corneal endothelial cell density (ECD) decreases from 6,100 cells/mm2 in neonates to 3,100 cells/mm2 in 10-year-olds. Currently data on ECD in young children as well as the trend for ECD decrease during childhood is sparse because of the difficulty of examination using existing clinic-based specular microscopes. We developed a novel method of imaging young children intraoperatively with the goal of beginning to establish age-specific normative data for ECD and hexagonality of cells (%HEX). Children were imaged using our novel technique under general anesthesia or awake in clinic using a child-friendly technique. A total of 58 children were recruited (mean age, 5.50; range, 0.44-10.36). Our cohort displayed a significant linear decrease in ECD with age (r = -0.56, P < 0.001). No correlation was found between %HEX and age (r = -0.10, P = 0.48).

PMID: 28347727 [PubMed - indexed for MEDLINE]

Stomach frame-count-based attenuation correction of dynamic posterior view gastric emptying scintigraphy with continuous acquisition in children.

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Stomach frame-count-based attenuation correction of dynamic posterior view gastric emptying scintigraphy with continuous acquisition in children.

Pediatr Radiol. 2017 Nov;47(12):1599-1607

Authors: Cao X, Xu X, Drubach L, Fahey FH

Abstract
BACKGROUND: When performing dynamic gastric emptying scintigraphy with continuous acquisition in children, a single posterior view acquisition is preferred because it allows the young patient to more easily interact with a parent or technologist even though this method tends toward overestimating gastric emptying.
OBJECTIVES: The objective of our study was to develop a new attenuation correction (AC) method to improve the accuracy of the time activity curve and the measurement of residual gastric emptying from 1-h posterior images of gastric emptying scintigraphy with continuous acquisition.
MATERIALS AND METHODS: We developed a frame-count-based AC for gastric emptying scintigraphy from the posterior view (posterior AC method). We retrospectively reviewed 122 gastric emptying studies performed in children using conjugated posterior and anterior views, and evaluated the statistical differences between posterior only (without AC) and posterior AC using the geometric mean method as a reference standard.
RESULTS: The residual values obtained using posterior AC were not significantly different (P=0.813) compared to those using the geometric mean while the values using the posterior only were significantly different (P<0.001) from the geometric mean.
CONCLUSION: The proposed method can replace the geometric mean method to estimate gastric emptying residual fraction using patient-friendly posterior view without a significant difference in 1-h gastric emptying scintigraphy with continuous acquisition.

PMID: 28685191 [PubMed - indexed for MEDLINE]

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