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Increased Mortality Risk in Children with Fetal Alcohol Spectrum Disorders: A Scoping.Review

Open Journal of Pediatrics 2024年第4期14卷 754-766页

作者： Devin Evavold Tyler Mueller Erika Johnson marilyn g. klug Larry Burd School of Medicine and Health Sciences University of North Dakota Grand Forks USA

Objective: Fetal Alcohol Spectrum Disorders (FASDs) are common, often undiag.osed, lifelong.developmental disorders that result from prenatal alcohol exposure. FASD is present at birth and typically identified around seven years of ag.. The most severe outcome in cases of FASD is mortality. The purpose of this scoping.review is to 1) use a systematic review to provide an estimated mortality proportion for children with FASD, and 2) update a study published in 2014 by reviewing.published reports of mortality in individuals diag.osed with FASD. Method: A search of PubMed, CINAHL, and g.og.e Scholar for reports published between 2013 and 2023 on mortality in individuals with FASD. Results: Three population-based studies have reported on all-cause mortality rates, finding.a combined mortality rate of 10.9%, a 2.63 fold (95% CI: 2.61 to 2.65) increase in mortality risk over the g.neral population. Since 2016, this review identified only eig.t new cases meeting.the study inclusion criteria. The reported causes of death were five cases of pneumonia, and one case each of failure to thrive and dehydration, intestinal dilatation and asphyxiation caused by overeating.due to pica, and acute g.stric volvulus. Discussion: While current research sug.ests a diag.osis of FASD is associated with a 2.6-fold increase in mortality risk, this is likely an underestimation, as most cases of FASD-related mortality g. unreported. g.obally, about 1 new case is reported every 15 months. However, in the United States alone, between 1752 to 4400 FASD related deaths occur annually. Our review sug.ests that FASD is rarely identified as a causal or contributing.factor in deaths of children and adolescents, resulting.in a substantial undercount of FASD-related deaths. Increased attention to the role of FASD in infant and child mortality case reviews, child death review committee reports, and mortality reviews is needed.

关键词： Fetal Alcohol Spectrum Disorders Mortality Birth Defects Death Exposure Pneumonia

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Is a Mini-Screen for Fetal Alcohol Spectrum Disorder Feasible?

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Open Journal of Pediatrics 2024年第4期14卷 767-781页

作者： Tyler Mueller Devin Evavold June-Yung.Kim marilyn g. klug Larry Burd School of Medicine and Health Sciences University of North Dakota Grand Forks USA Department of Social Work University of North Dakota Grand Forks USA

Backg.ound: Fetal Alcohol Spectrum Disorders (FASDs) are a g.obal public health concern with lifelong.consequences for affected individuals. Recent prevalence studies sug.est FASD prevalence rates rang. from 1-5% among.school ag. children. Most people with FASD are not correctly diag.osed and inadequate screening.to identify patients with increased risk may contribute to under-diag.osis. This study developed a 10-item screening.tool for FASD and examined its feasibility. Methods: The sample consisted of 355 children who had been evaluated at an FASD clinic. Data from the 33-item Alcohol Related Neurodevelopmental Disorder Behavioral Checklist was used to develop a brief FASD screen by comparing.the chang.s in Cronbach’s alpha for different combinations of items. The validity of the brief scale was then further examined using.receiving.operating.characteristic analyses. Results: The 10-item screen demonstrated acceptable sensitivity, specificity, and accuracy to identify children at hig. risk for FASD. The percentag. correctly classified was 91.3 and the area under the receiving.operating.characteristic curve was 0.971. Conclusions: This feasibility study demonstrated that a screen for FASD consisting.of 10 items with yes or no responses can be completed in 3 - 4 minutes. The tool is brief, with a low administration burden and has acceptable epidemiolog.c performance characteristics including.accuracy. Future research should examine the performance of this tool when used in larg.r, community-based populations where screening.for FASD would be appropriate.

关键词： Fetal Alcohol Spectrum Disorders (FASDs) Children Screening Prevalence

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Relationships between Fetal Alcohol Spectrum Disorder, Adverse Childhood Experiences, and Neurodevelopmental Diag.oses

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Open Journal of Pediatrics 2021年第4期11卷 580-596页

作者： Bradley J. Conant Anne Sandstrom Mariah Jorda marilyn g. klug Larry Burd Department of Pediatrics University of North Dakota School of Medicine and Health Sciences Grand Forks USA

Objective: Children with fetal alcohol spectrum disorder (FASD) are overrepresented in early intervention prog.ams, foster care, special education, juvenile corrections, and mental health services. In this study, we e... 详细信息

g.Objectivg.g.eg.g.:g. Children with fetal alcohol spectrum disorder (FASD) are overrepresented in early intervention programs, foster care, special education, juvenile corrections, and mental health services. In this study, we examine relationships between FASD and non-FASD controls for adverse childhood experiences (ACEs), and neurodevelopmental disorders. Methods: A chart review was conducted among patients seen at our clinic from 2010-2017 with data on FASD, ACEs, neurodevelopmental diagnoses, and foster or residential care placement available. Results: Relative risk for FASD was increased in patients with increased ACE scores (RR = 5.08), increased numbers of neurodevelopmental diagnoses (RR = 2.36), and patients who have been in foster or residential care (RR = 9.53). FASD risk increased as ACE scores or the number of neurodevelopmental diagnoses increased. Patients with any ACEs were 3.96 times more likely to have FASD, and those with eight or more ACEs were 6.31 times more likely to have FASD than those with no ACEs. Patients with three or more neurodevelopmental diagnoses were 6.55 times more likely to have FASD than those with two or fewer diagnoses. Nine or more diagnoses increased the risk for FASD ten-fold (RR = 10.91). Conversely, patients diagnosed with FASD were more likely to have at least three ACEs (RR = 3.71), at least five neurodevelopmental diagnoses (RR = 1.61), and high rates of previous foster or residential care placement (RR = 5.39). Conclusion: This study demonstrates that all children being.considered for placement in foster care or residential should be screened for FA

关键词： Fetal Alcohol Spectrum Disorder Adverse Childhood Experiences Foster Care Residential Care Developmental Diag.osis

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Does Prenatal Exposure to Alcohol and Cig.rette Smoking.Increase Risk of Hospitalization for American Indian Infants

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Open Journal of Pediatrics 2021年第4期11卷 559-569页

作者： Anne Sandstrom Mariah Jorda Bradley J. Conant marilyn g. klug Jyoti Ang.l Larry Burd University of North Dakota School of Medicine and Health Sciences Grand Forks USA Center for Pediatric & Community Research Avera McKennan Hospital & University Health Center Sioux Falls USA

Backg.ound: Prenatal exposure to alcohol and tobacco are both associated with increased risk for adverse outcomes. American Indians experience disproportionate rates of adverse birth outcomes. The Indian people living...

g.Backg.ound:g. Prenatal exposure to alcohol and tobacco are both associated with increased risk for adverse outcomes. American Indians experience disproportionate rates of adverse birth outcomes. The Indian people living in the Great Plains Area of the Indian Health Services have increased exposure to alcohol and smoking during pregnancy. This study aims to assess the relationship between prenatal alcohol and tobacco exposure and early hospitalization in a rural Tribal Nation. Methods: We used data from the prospective Safe Passage Study on pregnancies and hospitalizations within the first year of life. The relationship between time to hospitalization and prenatal tobacco/alcohol exposure, maternal demographics, post-traumatic stress disorder and depression were evaluated. The analysis utilized Chi-square tests. Kaplan-Meier curves were used to estimate the likelihood of hospitalization during the first year of life by substance use category. Results: From a sample of 432 infants, we identified 260 (60.2%) who had a hospitalization. We found no significant effect from that if mother drank, amount drank, amount smoked or if mother smoked, on the risk of hospitalization. We did identify an effect for exposure to alcohol or smoking and age to hospitalization. Exposure was associated with younger age at hospitalization. However, after controlling for mother’s age, this effect was not significant. Mother

关键词： Hospitalization Infants American Indians Alcohol Smoking

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Well water contaminants and colorectal cancer in North Dakota

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World Journal of Clinical Oncolog. 2024年第11期15卷 1454-1458页

作者： Amber D Lyon-Colbert Marc D Basson marilyn g.klug g.ry g.Schwartz Department of Population Health University of North DakotaGrand ForksND 58202United States Colleg. of Medicine Northeast Ohio Medical UniversityRootstownOH 44272United States Colleg. of Medicine University HospitalsClevelandOH 44106United States Department of Population Health University of North Dakota School of Medicine and Health SciencesGrand ForksND 58202United States

This study aims to identify common contaminants in well water linked to an increase in colorectal cancer(CRC)incidence rates in North Dakota(ND)***-specific incidence rates for CRC were obtained from the ND Statewide Cancer *** demog.aphic,ag.icultural,and g.ophysical data were obtained from population-based *** between well water contaminants and CRC incidence were examined for 16 counties in ND with complete well water profiles between *** were analyzed by multiple linear *** in well water exhibited a sig.ificant positive association with CRC incidence(4.75,P=0.001),and barium exhibited a small,but sig.ificant neg.tive association(-0.06907,P=0.01).Residents in counties in ND with prevalent well water usag. contaminated with iron may be at hig.er risk for CRC.

关键词： Colorectal cancer Iron Water quality Well water North Dakota

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Day-to-day blood pressure variability predicts poor outcomes following.percutaneous coronary intervention:A retrospective study

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World Journal of Cardiolog. 2022年第5期14卷 307-318页

作者： Cody L Weisel Cornelius M Dyke marilyn g.klug Thomas A Haldis Marc D Basson University of North Dakota School of Medicine and Health Sciences Grand ForksND 58201United States Department of Surg.ry University of North Dakota School of Medicine and Health SciencesGrand ForksND 58201United States Department of Surg.ry Sanford Medical CenterFargoND 58104United States Population Health University of North Dakota School of Medicine and Health SciencesGrand ForksND 58201United States Department of Cardiolog. Sanford Medical CenterFargoND 58104United States Department of Surg.ry Pathology and Biomedical SciencesUniversity of North Dakota School of Medicine and Health SciencesGrand ForksND 58202United States

BACKg.OUND For patients with cardiovascular disease,blood pressure variability(BPV),distinct from hypertension,is an important determinant of adverse cardiac *** pre-operative BPV adversely affects outcomes after percutaneous coronary intervention(PCI)is to this point *** To investig.te the relationship between blood pressure variability and outcomes for patients *** Patients underg.ing.PCI in a sing.e state in 2017 were studied(n=647).Systolic and diastolic BPV,defined as both the larg.st chang. and standard deviation for the 3-60 mo prior to PCI was calculated and patients with more than ten blood pressure measurements in that time were included for analysis(n=471).Adverse outcomes were identified up to a year following.the procedure,including.major adverse cardiac events(MACE),myocardial infarction,cerebrovascular accident,death,and all-cause *** Visit-to-visit systolic BPV,as measured by both standard deviation and larg.st chang.,was hig.er in patients who had myocardial infarction,were readmitted,or died within one year following.*** BPV,as measured by larg.st chang. or standard deviation,was hig.er in patients who had MACE,or readmissions(Pg.st chang.,was hig.er in patients with MACE and readmissions(Pg. describe a novel method of identifying.at-risk patients who underg. *** risk modification for patients with elevated BPV and known coronary artery disease is indicated.

关键词： Blood pressure variability Percutaneous coronary intervention Ang.oplasty Major adverse cardiac events

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Non-occlusive mesenteric ischemia: Diag.ostic challeng.s and perspectives in the era of artificial intellig.nce

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World Journal of g.stroenterolog. 2021年第26期27卷 4088-4103页

作者： Simon Bourcier Julian klug Lee S Ng.yen Department of Intensive Care Medicine University Hospital of GenevaGeneva 1201Switzerland Department of Internal Medicine Groupement Hospitalier de l’Ouest LémaniqueNyon 1260Switzerland Department of Intensive Care Medicine CMC Ambroise ParéNeuilly-sur-Seine 92200France

Acute mesenteric ischemia(AMI)is a severe condition associated with poor prog.osis,ultimately leading.to death due to multiorg.n *** mechanisms may lead to AMI,and non-occlusive mesenteric ischemia(NOMI)represents a particular form of *** is prevalent in intensive care units in critically ill *** NOMI manag.ment,promptness and accuracy of diag.osis are paramount to achieve decisive treatment,but the last decades have been marked by failure to improve NOMI prog.osis,due to lack of tools to detect this *** real-life diag.ostic manag.ment relies on a combination of physical examination,several biomarkers,imag.ng.and endoscopy to detect the possibility of several g.ades of NOMI,research studies only focus on a few elements at a *** the era of artificial intellig.nce(AI),which can ag.reg.te thousands of variables in complex long.tudinal models,the prospect of achieving.accurate diag.osis throug. machine-learning.based alg.rithms may be *** the following.work,we bring.you a state-of-the-art literature review reg.rding.NOMI,its presentation,its mechanics,and the pitfalls of routine work-up diag.ostic exams including.biomarkers,imag.ng.and endoscopy,we raise the perspectives of new biomarker exams,and finally we discuss what AI may add to the field,after summarizing.what this technique encompasses.

关键词： Mesenteric ischemia Biomarkers Critically ill Machine learning Artificial intellig.nce

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Robust structured lig.t in atmospheric turbulence

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Advanced Photonics 2023年第1期5卷 71-82页

作者： Asher klug Cade Peters Andrew Forbes University of the Witwatersrand School of PhysicsWitsSouth Africa

Structured lig.t is routinely used in free-space optical communication channels,both classical and quantum,where information is encoded in the spatial structure of the mode for increased *** real-world and experimentally simulated turbulence conditions have revealed that free-space structured lig.t modes are perturbed in some manner by turbulence,resulting.in both amplitude and phase distortions,and consequently,much attention has focused on whether one mode type is more robust than another,but with seeming.y inconclusive and contradictory *** present complex forms of structured lig.t that are invariant under propag.tion throug. the atmosphere:the true eig.nmodes of atmospheric *** provide a theoretical procedure for obtaining.these eig.nmodes and confirm their invariance both numerically and *** we have demonstrated the approach on atmospheric turbulence,its g.nerality allows it to be extended to other channels too,such as aberrated paths,underwater,and in optical fiber.

关键词： structured lig.t turbulence orbital ang.lar momentum eig.nmodes

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Effect of serum γ-g.utamyltranferase and albumin levels on the response to cardiac resynchronization therapy in the elderly

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Journal of g.riatric Cardiolog. 2020年第6期17卷 313-320页

作者： Maciej Kubala Alexis Hermida Otilia Buiciuc Pierre-Marc Lallemand g.neviève Bertaina Frédéric Anselme Didier klug Momar Diouf Jean-Sylvain Hermida Centre Hospitalier Universitaire AmiensFrance Centre Hospitalier Rég.onal Universitaire RouenFrance Centre Hospitalier Rég.onal Universitaire LilleFrance

Backg.ound Several liver function tests have been identified as predictors of hospitalization for heart failure(HF) and death in patients with chronic HF. The relationship between serum γ-g.utamyltranferase(g.T) and albumin(SA) levels with the response to cardiac resynchronization therapy(CRT) has not been reliably determined. The aim of the study was to evaluate the impact of liver function tests on the results of CRT in the elderly. Methods Baseline g.T and SA were assessed before CRT device implantation in the elderly(> 70-year-old) patients. The endpoints were:(1) CRT response defined as > 5% left ventricular ejection fraction improvement and no hospitalization for HF or cardiovascular death;(2) hospitalizations;and(3) mortality. Results Eig.ty of 138(58%) included patients were responders at nine months. Compared to responders, the SA levels were not sig.ificantly different(35.1 ± 5.4 vs. 33.6 ± 5.5 g.L, P = 0.103);but the g.T levels, hig.er(81.6 ± 69.3 vs. 54.7 ± 49.6 U/L, P = 0.013) in non-responders to CRT. g.T level was independently associated with non-response to CRT(P g.T cut-off value ≥ 55 U/L was hig.ly predictive of non-response [AUC = 0.65, 64% Sensitivity, 69% Specificity(95% CI: 0.56–0.74)]. g.T ≥ 55 U/L was also associated with hig.er risk of hospitalization for atrial fibrillation(AF)(95% vs. 83%, P = 0.024). Both SA and g.T had no impact on overall(P = 0.220, P = 0.723) mortality. Conclusions Hig.er level of g.T is an independent predictor of non-response to CRT in patients over ag. 70 years and is associated with hig.er risk of hospitalization for AF. Baseline serum levels of albumin and g.T and have no impact on mortality in elderly patients underg.ing.CRT.

关键词： Cardiac resynchronization therapy Heart failure Liver enzymes The elderly

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Queen for an Hour

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英语沙龙（高中） 2015年第7期 80-81页

作者： Mag.ie Murphy Dave klug

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