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Association between high deductible health plan coverage and age at pediatric umbilical hernia repair

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World Journal of Pediatric surgery 2023年第2期6卷 70-76页

作者： Morgan E Doty Lindsay A Gil Jennifer N Cooper The Ohio state University College of Medicine ColumbusOhioUSA Department of surgery Nationwide Children's HospitalThe Ohio State UniversityColumbusOhioUSA Department of Pediatrics Nationwide Children's HospitalThe Ohio State UniversityColumbusOhioUSA

Background High deductible health plans(HDHPs)are associated with the avoidance of both necessary and unnecessary healthcare.Umbilical hernia repair(UHR)is a procedure that is frequently unnecessarily performed in young children,contrary to best practice guidelines.We hypothesized that children with HDHPs,as compared with other types of commercial health plans,are less likely to undergo UHR before 4 years of age but are also more likely to have UHR delayed beyond 5 years of age.Methods children aged 0-18 years old residing in metropolitan statistical areas(MsAs)who underwent UHR in 2012-2019 were identified in the IBM Marketscan Commercial Claims and Encounters Database.A quasi-experimental study design using MsA/year-level HDHP prevalence among children as an instrumental variable was employed to account for selection bias in HDHP enrollment.Two-stage least squares regression modeling was used to evaluate the association between HDHP coverage and age at UHR.Results A total of 8601 children were included(median age 5 years,IQR 3-7).Univariable analysis revealed no differences between the HDHP and non-HDHP groups in the likelihood of UHR being performed before 4 years of age(27.7%vs 28.7%,p=0.37)or after 5 years of age(39.8%vs 38.9%,p=0.52).Geographical region,metropolitan area size,and year were associated with HDHP enrollment.Instrumental variable analysis demonstrated no association between HDHP coverage and undergoing UHR ats of age(p=0.76)or>5 years of age(p=0.87).Conclusions HDHP coverage is not associated with age at pediatric UHR.Future studies should investigate other means by which UHRs in young children can be avoided.

关键词： pediatric hernia likely

state of telemedicine use in pediatric surgery in the UsA-where we stand and what we can gain from the COVID-19 pandemic: a scoping review

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World Journal of Pediatric surgery 2021年第1期4卷 43-48页

作者： Gregory Metzger Kris Jatana Jordan Apfeld Katherine J Deans Peter C Minneci Ihab Halaweish Department of surgery The Ohio State University Wexner Medical CenterColumbusOhioUSA Department of Pediatric surgery Nationwide Children's HospitalColumbusOhioUSA Department of Pediatric Otolaryngology Nationwide Children's HospitalColumbusOhioUSA Center for surgical Outcomes research Nationwide Children's HospitalColumbusOhioUSA

Background Within the last decade,the use of telemedicine within in primary care in the UsA has greatly expanded;however,use remains uncommon in surgical specialties.The spread of Coronavirus disease 2019(COVID-19)prompted healthcare institutions to limit in-person contact,resulting in an increase in telemedicine across all specialties,including pediatric surgery.The aims of this review were to evaluate potential barriers that limited the use of telemedicine in pediatric surgery prior to the COVID-19 period and to define how best to incorporate its use into a pediatric surgical practice going forward.Methods A scoping review was performed to identify gaps in the literature pertaining to the use of telemedicine within general pediatric surgery in the UsA prior to the outbreak of COVID-19.Next,a focused evaluation of the legislative and organizational policies on telemedicine was performed.Lastly,findings were summarized and recommendations for future research developed in the context of understanding and overcoming barriers that have plagued widespread adoption in the past.Results Despite evidence of telemedicine being safe and well received by adult surgical patients,a total of only three studies representing original research on the use of telemedicine within pediatric surgery were identified.Legislative and organizational policies regarding telemedicine have been altered in response to COVID-19,likely resulting in an increase in the use of telemedicine among pediatric surgeons.Conclusions Telemedicine offers a safe and effective option for patients seeking an alternative to the in-person clinic appointment.The increased utilization of telemedicine during the COVID-19 pandemic will provide an opportunity to learn how best to leverage the technology to decrease disparities and to overcome previous barriers.

关键词： pediatric overcome prompt

Maternal Perfluorinated Compound Exposure and Risk of Early Pregnancy Loss: A Nested Case-control study

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Biomedical and Environmental sciences 2022年第2期35卷 174-179页

作者： MI Xin LIN shi Qi ZHANG Xiao Fen LI Jia Jia PEI Li Jun JIN Feng LIAO Qi XIE Li Min WEI Li Cong HAO Chan Juan ZHANG Ya Wei LI Wei shunyi Women’s and children’s hospital of Beijing children’s hospital Beijing 101300China institute of Population research/China Center on Population Health and Development Peking UniversityBeijing 100871China

Early pregnancy loss,defined as a nonviable intrauterine pregnancy occurring before 12 weeks of gestation,is estimated to affect 25%of clinically diagnosed pregnancies[1].several demographic,lifestyle,and environmental risk factors have been reported to associate with the risk of early pregnancy loss,yet the causes of most early pregnancy losses remain elusive;thus,further studies are needed.Perfluorinated compounds(PFCs)are a class of widespread environmental pollutants that can adversely affect human reproductive health.Humans are inevitably exposed to PFCs through diet,water,air and dust.A wealth of epidemiological and toxicological research using a variety of animal models has warned of the persistence,bioaccumulation,and toxicity of PFCs[2].

关键词： pregnancy viable Early

An immortalized rat pancreatic stellate cell line RP-2 as a new cell model for evaluating pancreatic fibrosis,inflammation and immunity

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Hepatobiliary & Pancreatic Diseases International 2015年第6期14卷 651-659页

作者： Rong-Li Piao Ming Xiu David R Brigstock Run-Ping Gao Department of Hepatic-biliary-pancreatic Medicine the First Hospital of Jilin University The research institute at nationwide children's hospital Division of Pediatric surgery Department of Surgerythe Ohio State University

BACKGROUND： Pancreatic stellate cells （PsCs） play a critical role in the pathogenesis of pancreatic fibrosis and have emerging functions as progenitor cells, immune cells or intermediaries in pancreatic exocrine secretion. Increasing evidence has shown that desmin as an exclusive cytoskeleton marker of PsC is only expressed in part of these cells. This study was to establish a desmin-positive PsC cell line and evaluate its actions on pancreatic fibrosis, inflammation and immunity.

关键词： pancreatic stellate cell pancreatic fibrosis Toll-like receptor 4 inflammation immunity

Circulating fibroblasts present neutrophil-like features in severe COVID-19 cases revealed by single-cell landscape analyses

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Genes & Diseases 2023年第6期10卷 2233-2236页

作者： Xiangjun Liu Jingang Gui Xiaolin Wang Laboratory of Tumor Immunology Beijing Pediatric Research InstituteBeijing Children's HospitalCapital Medical UniversityNational Center for Children's Health(NCCH)Beijing 100045China

severe acute respiratory syndrome coronavirus-2(sARsCoV-2),which causes coronavirus disease 2019(COVID-19)and initially infects epithelial cells of the upper respiratory tract,has recently caused a global health emergency and is still a potential threat to humans.1 Multiple studies have suggested alterations in the immune system,including excessive neutrophil activation and lymphopenia,and excessive inflammatory responses as the key mechanisms for severesymptoms.2However,which cell types contribute to excessive inflammation remains to be explored.Further analysis of human blood immune cells provides insights into the coordinated response to sARsCoV-2 infections and is a significant task for restraining the virus and controlling disease progression.

关键词： neutrophil respiratory alterations

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Hepatobiliary & Pancreatic Diseases International 2017年第4期16卷 443-445页

作者： Li sun Hong-Yan Li David R Brigstock Run-Ping Gao Department of Hepatic-biliary-pancreatic Medicine First Hospital of Jilin University The Research Institute at Nationwide Children’s Hospital and Division of Pediatric surgery Department of SurgeryThe Ohio State University

To the Editor:IgG4-related sclerosing cholangitis（IgG4-sC）has re cently been recognized as a biliary manifestation of IgG4-related disease（IgG4-RD）.Type 3 IgG4-sC pre sented biliary strictures in both the porta hepatis and the distal common bile duct（CBD）.;Its manifestation especially in the absence of autoimmune pancreatitis,is extremely rare and very similar to that of cholangiocarci noma（CC）.

关键词： IgG4-related sclerosing cholangitis and chronic sclerosing sialadenitis mimicking cholangiocarcinoma and neck malignancy is it been of CBD in

Postoperative complications of colectomy and J- pouch with ileostomy versus without ileostomy in children with inflammatory bowel diseases: a systematic review and meta- analysis

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World Journal of Pediatric surgery 2022年第2期5卷 38-45页

作者： Irina Oltean Nicole Travis Manvinder Kaur Viviane Grandpierre Lamia Hayawi Anne Tsampalieros Ahmed Nasr Department of surgery Children's Hospital of Eastern OntarioOttawaOntarioCanada children's hospital of Eastern Ontario research institute Clinical Research UnitOttawaOntarioCanada University of Ottawa OttawaOntarioCanada

Background The efficacy of performing a restorative proctocolectomy and J-pouch ileoanal anastomosis without diverting ileostomy in children with inflammatory bowel disease has been a longstanding debate.A systematic review and meta-analysis is presented comparing the occurrence of postoperative complications in children who underwent either the pouch-anal anastomosis(IPAA)with ileostomy(diverted)versus the undiverted procedure.Methods Records were sourced from CINAHL,CENTRAL,EMBAsE and MEDLINE databases.studies followed the Preferred Reporting Items for systematic Reviews and Meta-Analyses guidelines and compared postoperative complications in pediatric patients diagnosed with inflammatory diseases aged less than 18 years who underwent J-pouch with ileostomy versus without ileostomy.The primary outcome was the occurrence of postoperative leaks,and the secondary outcomes were presence of postoperative small bowel obstruction(sBO),pouchitis,stricture and fistula complications.A random-effects meta-analysis was used.Results Twenty-three observational studies in the systematic review were included with 658 patients(83%diverted,17%undiverted).Pooled estimates showed no difference in occurrence of leaks in children who underwent J-pouch/IPAA with ileostomy versus without(odds ratio(OR)0.54,95%confidence interval(CI)0.17 to 1.64,I^(2)=16%).There was no difference in the occurrence of sBO,pouchitis or strictures in children who underwent J-pouch/IPAA with ileostomy versus without(sBO:OR 2.27,95%CI 0.52 to 9.92,I^(2)=0%,pouchitis:OR 1.76,95%CI 0.95 to 3.24,I^(2)=0%,strictures:OR 2.72,95%CI 0.44 to 16.69,I^(2)=66%).Conclusion The meta-analysis did not find differences in the occurrence of complications in pediatric patients who underwent the IPAA with ileostomy procedure versus without ileostomy.

关键词： complications bowel diseases

Racial differences in pet ownership in families of children with asthma

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世界儿科杂志:英文版 2016年第3期12卷 343-346页

作者： shahid I sheikh Judy Pitts Nancy A Ryan-Wenger Karen s McCoy Don Hayes Departments of Pediatrics The Ohio State University College of MedicineColumbusOhioUSA Internal Medicine The Ohio State University College of MedicineColumbusOhioUSA section of Pulmonary Medicine Nationwide Children's HospitalColumbusOhioUSA Department of Nursing research Nationwide Children's HospitalColumbusOhioUSA section of Allergy/Immunology Nationwide Children's HospitalColumbusOhioUSA

Background:Exposure to household domestic animals such as cats and dogs in early life may have some role in pathogenesis of asthma.Racial differences exist in the prevalence of asthma.We hypothesized that there may also be racial differences in pet ownership in families with asthma.Methods:A cross sectional study was conducted from June 2011 to December 2014 on 823 of 850(97%)families of children with asthma for pet ownership.Comparisons among racial groups were done using chi square analysis and one-way analysis of variance.Results:The mean age of the cohort was 6.9±4.4 years.A total of 540(65.62%)patients were Caucasian,195(23.7%)African American,42(5.1%)hispanics,and 26(3.2%)biracial with one Caucasian parent.Pets in the home were reported by 470(58.5%)households.signifi cantly fewer African American and hispanic families had pets in the home(26.9% and 44.7%)than biracial and Caucasian families(72% and 69.9%,Pse,significantly more biracial and Caucasian families were noted to have dogs(52% and 54.4%)or cats(25.4%and 40%)or both cats and dogs(28% and 18%)than African Americans families(20.3%,Pspectively.Conclusion:Among families with asthmatic children,pet ownership is significantly more likely in Caucasian families compared with African-American and Hispanic families,thus there is a racial diversity in pet ownership among families of children with asthma.

关键词： asthma cat children dog ethnicity pets

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Journal of sport and Health science 2023年第3期12卷 414-422页

作者： Joseph M.Bano Rebecca J.McAdams Kristin J.Roberts Jingzhen Yang Lara B.McKenzie Center for Injury research and Policy Abigail Wexner Research Institute at Nationwide Children's HospitalColumbusOH 43205USA Department of Pediatrics The Ohio State UniversityCollege of MedicineColumbusOH 43205USA Division of Epidemiology The Ohio State UniversityCollege of Public HealthColumbusOH 43210USA

Background:Lacrosse is one of the fastest-growing sports in the United states.Its rules regarding permitted contact differ by sex and age.There are no known studies using a nationally representative data set to analyze lacrosse injury patterns over several years by sex and age in the youth population.Methods:A retrospective analysis was performed using data from the National Electronic Injury surveillance system for youth aged 11-18 years who were treated for lacrosse-related injuries in U.s.emergency departments from 2000 to 2016.Based on our review of the case narratives,we created and coded a new injury-mechanism variable.We generated national estimates from 6406 cases.Results:An estimated 206,274 lacrosse-related injuries to youths aged 11-18 years were treated in U.s.emergency departments from 2000 to 2016.The rate of injuries per 10,000 significantly increased from 1.9 in 2000 to a peak of 5.3 in 2012(psignificant decrease to 3.4 in 2016(p=0.020).Injury mechanism,body part injured,and diagnosis differed by sex.Boys were 1.62 times(95%confidence interval(95%CI):1.25-2.09)more likely than girls to be injured by player-to-player contact.Girls were 2.21 times(95%CI:1.96-2.49)more likely than boys to have non-contact injuries.Overall,as age increased,the percentage of injuries from lacrosse sticks decreased and player-toplayer contact increased.Conclusion:Despite additional protective regulations in the sport,lacrosse is an important source of injury where we continue to see differences by sex and age.This study supports the continuation,modification,and addition of rules aimed at reducing lacrosse injury risk.

关键词： Lacrosse National Electronic Injury surveillance system sex differences Youth injuries