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Habtamu A, Argaw R, Tuli W, Moges A. Magnitude and Determinant Factors of Pediatrics Seizures in Pediatrics Emergency Unit at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia, 2020: A Retrospective and Descriptive Study. Behav Neurol 2023; 2023:3967899. [PMID: 37485287 PMCID: PMC10361829 DOI: 10.1155/2023/3967899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 05/05/2023] [Accepted: 07/01/2023] [Indexed: 07/25/2023] Open
Abstract
Background One of the most prevalent medical problems affecting kids is epilepsy, which is the most prevalent chronic neurological condition in kids in both developed and developing nations. The spectrum of diseases that make up childhood epilepsy syndromes ranges from mild to potentially fatal. Children may experience seizures due to a variety of illnesses, such as infection, severe brain injury, and anatomical deformity. It is the foremost visit calculates in neurological and cognitive impedance in children in low-income countries as well as the foremost common reason for pediatric clinic confirmations in children from destitute countries. All things considered, constrained things have been conducted in Ethiopia. Hence, this ponder points to survey the size and related variables of pediatric seizures among children conceded to Tikur Anbessa pediatric emergency. Methods By looking through 256 patient charts, an institution-based retrospective cross-sectional analysis was done. Data collection utilized a systematic checklist that had been evaluated beforehand. The EpiData version 4.4.2.2 was used to enter the data, which was then exported for analysis to the SPSS version 25. Binary logistic regression and descriptive statistics were employed. Variables from the bivariate analysis that had a p-value of less than 0.25 were carried over to multivariate analysis. The strength and existence of the link were assessed using adjusted odds ratios with a 95% confidence interval and a p-value of 0.05, respectively. Result Patients' ages ranged from 3.7 to 2.8 years on average. 4.5% of patients had seizures, and 155 of them (60.5%) were men, with a male-to-female ratio of (1.5 : 1). Males and females experienced seizures on average at 1.3 (95% CI: 1.1, 1.5) and 2 (95% CI: 1.6, 2.5) years old, respectively. AOR: 2.68 (95% CI: 1.192, 6.68, p = 0.02) and AOR: 2.8 (95% CI: 2.576, 5.302, p = 0.04) both demonstrated statistically significant correlations with pediatric seizure. Conclusion A vast number of children experienced convulsions, with generalized seizures being the most prevalent form. The chances of a child having a seizure were linked to their family history and where they were born. Therefore, health workers and other people who are involved in healthcare need to work harder on the factors that they have already identified.
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Affiliation(s)
- Asaminew Habtamu
- Institute of Health Science, School of Nursing, Department of Emergency Medicine and Critical Care Nursing, Jimma University, Jimma, Ethiopia
| | - Rahel Argaw
- School of Medicine and Critical Care, College of Health Science and Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Wagari Tuli
- School of Medicine and Critical Care, College of Health Science and Medicine, Addis Ababa University, Addis Ababa, Ethiopia
| | - Ayalew Moges
- School of Medicine and Critical Care, College of Health Science and Medicine, Addis Ababa University, Addis Ababa, Ethiopia
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Postnikova TY, Trofimova AM, Zakharova MV, Nosova OI, Brazhe AR, Korzhevskii DE, Semyanov AV, Zaitsev AV. Delayed Impairment of Hippocampal Synaptic Plasticity after Pentylenetetrazole-Induced Seizures in Young Rats. Int J Mol Sci 2022; 23:ijms232113461. [PMID: 36362260 PMCID: PMC9657086 DOI: 10.3390/ijms232113461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 10/26/2022] [Accepted: 11/01/2022] [Indexed: 11/06/2022] Open
Abstract
Data on the long-term consequences of a single episode of generalized seizures in infants are inconsistent. In this study, we examined the effects of pentylenetetrazole-induced generalized seizures in three-week-old rats. One month after the seizures, we detected a moderate neuronal loss in several hippocampal regions: CA1, CA3, and hilus, but not in the dentate gyrus. In addition, long-term synaptic potentiation (LTP) was impaired. We also found that the mechanism of plasticity induction was altered: additional activation of metabotropic glutamate receptors (mGluR1) is required for LTP induction in experimental rats. This disturbance of the plasticity induction mechanism is likely due to the greater involvement of perisynaptic NMDA receptors compared to receptors located in the core part of the postsynaptic density. This hypothesis is supported by experiments with selective blockades of core-located NMDA receptors by the use-dependent blocker MK-801. MK-801 had no effect on LTP induction in experimental rats and suppressed LTP in control animals. The weakening of the function of core-located NMDA receptors may be due to the disturbed clearance of glutamate from the synaptic cleft since the distribution of the astrocytic glutamate transporter EAAT2 in experimental animals was found to be altered.
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Affiliation(s)
- Tatyana Y. Postnikova
- Sechenov Institute of Evolutionary Physiology and Biochemistry of RAS, Saint Petersburg 194223, Russia
| | - Alina M. Trofimova
- Sechenov Institute of Evolutionary Physiology and Biochemistry of RAS, Saint Petersburg 194223, Russia
| | - Maria V. Zakharova
- Sechenov Institute of Evolutionary Physiology and Biochemistry of RAS, Saint Petersburg 194223, Russia
| | - Olga I. Nosova
- Institute of Experimental Medicine, Saint Petersburg 197022, Russia
| | - Alexey R. Brazhe
- Faculty of Biology, Moscow State University, Moscow 119234, Russia
| | | | - Alexey V. Semyanov
- Faculty of Biology, Moscow State University, Moscow 119234, Russia
- Shemyakin-Ovchinnikov Institute of Bioorganic Chemistry, Russian Academy of Sciences, Moscow 117997, Russia
- Department of Clinical Pharmacology, Sechenov First Moscow State Medical University, Moscow 119435, Russia
| | - Aleksey V. Zaitsev
- Sechenov Institute of Evolutionary Physiology and Biochemistry of RAS, Saint Petersburg 194223, Russia
- Correspondence:
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Bailey J, West M, Agarwal R, Kumar G. Measuring the Barriers to Adherence With Neurology Clinic Appointments for Children With Epilepsy: A Pilot Study. Child Neurol Open 2021; 8:2329048X211012544. [PMID: 33997097 PMCID: PMC8107813 DOI: 10.1177/2329048x211012544] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/08/2021] [Accepted: 03/23/2021] [Indexed: 11/15/2022] Open
Abstract
Introduction Epilepsy is one of the most common neurological disorders in children. Missed appointments reflect missed opportunity to provide care for children with epilepsy. The objective of this study was to identify social determinants of health (SDH) and other factors associated with missed appointments in children with epilepsy and measure the relation between missed appointments and frequency of emergency room (ER) visits and inpatient admissions. Methods This was a prospective study conducted in the neurology division at a level 4 epilepsy center. Children (0 to < 18 years of age) with a diagnosis of epilepsy were included and a semi-structured questionnaire was provided to the families. Patients with 2 or more missed neurology clinic appointments in the previous year ("study group", n = 36) were compared to those with 1 or zero missed appointments ("control group", n = 49). A comparison of the clinical characteristics, emergency room visits and hospitalizations in the past year as well as SDH was performed. Statistical analysis was performed using SPSS and p < 0.05 was considered significant. Results The mean age, gender distribution and presence of medical refractoriness were comparable between the 2 groups. Families in the study group reported a higher likelihood of having to make special work arrangements for clinic appointments. Children in the study group were noted to have a significantly higher frequency of single mother households, presence of public insurance, father not graduating from high school and household income less than 50,000 dollars. Within the preceding year, children in the study group were noted to have a higher frequency of visits to the emergency department as well as 6 times higher likelihood of inpatient hospitalization for seizures. Conclusions Social determinants of health play an important role in determining adherence with neurology clinic visits in children with epilepsy. Children with more missed appointments are likely to have a higher frequency of visits to the emergency department as well as a higher incidence of hospitalization for seizures. Identification of high-risk families and implementation of early interventions may improve adherence to office visits and decrease emergency room visits and hospitalization for seizures.
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Affiliation(s)
- Jason Bailey
- Division of Child Neurology, Dayton Children's Hospital, Dayton, OH, USA
| | - Melanie West
- Division of Psychiatry, Dayton Children's Hospital, Dayton, OH, USA
| | - Rajkumar Agarwal
- Division of Child Neurology, Dayton Children's Hospital, Dayton, OH, USA
| | - Gogi Kumar
- Division of Child Neurology, Dayton Children's Hospital, Dayton, OH, USA
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Pooventhiran T, Bhattacharyya U, Rao DJ, Chandramohan V, Karunakar P, Irfan A, Mary YS, Thomas R. Detailed spectra, electronic properties, qualitative non-covalent interaction analysis, solvatochromism, docking and molecular dynamics simulations in different solvent atmosphere of cenobamate. Struct Chem 2020. [DOI: 10.1007/s11224-020-01607-8] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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Tian N, Croft JB, Kobau R, Zack MM, Greenlund KJ. CDC-supported epilepsy surveillance and epidemiologic studies: A review of progress since 1994. Epilepsy Behav 2020; 109:107123. [PMID: 32451250 DOI: 10.1016/j.yebeh.2020.107123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Accepted: 04/15/2020] [Indexed: 11/18/2022]
Abstract
To report progress, to identify gaps, and to plan epilepsy surveillance and research activities more effectively, the Centers for Disease Control and Prevention (CDC) Epilepsy Program has summarized findings from selected CDC-supported surveillance and epidemiologic studies about epilepsy from 1994 through 2019. We identified publications supported by CDC funding and publications conducted by the CDC Epilepsy Program alone or with partners. We included only epilepsy surveillance and epidemiologic studies focusing on epilepsy burden, epilepsy-related outcomes, and healthcare utilization. We describe the findings of these studies in the following order: 1)prevalence; 2)incidence; 3)epilepsy-related outcomes by selected demographic characteristics; 4)cysticercosis or neurocysticercosis (NCC); 5)traumatic brain injury (TBI); 6)comorbidity; 7)mortality; 8)access to care; 9)quality of care; and 10) cost. We have characterized these findings in relation to the scope of the first three domains of the 2012 Institute of Medicine report on epilepsy and its relevant first four recommendations. From 1994 through 2019, 76 publications on epilepsy-related epidemiologic and surveillance studies were identified. Over the past 25 years, CDC has expanded community, state, and national surveillance on epilepsy and supported epidemiologic studies by using multiple assessment methods and validated case-ascertainment criteria to identify epilepsy burden, epilepsy-related outcomes, and healthcare utilization in the general population or in population subgroups. Among identified research opportunities, studies on epilepsy incidence and risk factors, mortality, and cost are considered as important surveillance gaps. Other remaining gaps and suggested surveillance strategies are also proposed. Findings from this review may help epilepsy researchers and other stakeholders reference and prioritize future activities for epidemiologic and surveillance studies in epilepsy.
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Affiliation(s)
- Niu Tian
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Epilepsy Program, 4770 Buford Highway, NE, Mailstop S107-6, Atlanta, GA 30341, USA.
| | - Janet B Croft
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Epilepsy Program, 4770 Buford Highway, NE, Mailstop S107-6, Atlanta, GA 30341, USA
| | - Rosemarie Kobau
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Epilepsy Program, 4770 Buford Highway, NE, Mailstop S107-6, Atlanta, GA 30341, USA
| | - Matthew M Zack
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Epilepsy Program, 4770 Buford Highway, NE, Mailstop S107-6, Atlanta, GA 30341, USA
| | - Kurt J Greenlund
- Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Population Health, Epilepsy Program, 4770 Buford Highway, NE, Mailstop S107-6, Atlanta, GA 30341, USA
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Picinich C, Madden LK, Brendle K. Activation to Arrival: Transition and Handoff from Emergency Medical Services to Emergency Departments. Nurs Clin North Am 2019; 54:313-323. [PMID: 31331619 DOI: 10.1016/j.cnur.2019.04.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The burden of neurologic disease in the United States continues to increase due to a growing older population, increased life expectancy, and improved mortality after cancer and cardiac disease. Emergency medical services (EMS) providers are responding to more patients with stroke, traumatic neurologic injury, neuromuscular weakness, seizure, and spontaneous cardiac arrest. Efficient prehospital care and triage to facilities with specialized services improve outcomes. Effective handoff from EMS to an emergency department ensures continuity of care and patient safety. Although advancements in prehospital cardiopulmonary resuscitation have increased rates of return to spontaneous circulation, a large proportion of patients sustain neurologic injury.
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Affiliation(s)
- Christine Picinich
- Department of Neurological Surgery, UC Davis Health, 4860 Y Street, Suite 3740, Sacramento, CA 95817, USA.
| | - Lori Kennedy Madden
- Center for Nursing Science, UC Davis Health, 2315 Stockton Boulevard, Sacramento, CA 95817, USA
| | - Kellie Brendle
- Heart and Vascular Services, UC Davis Health, 2315 Stockton Boulevard, Sacramento, CA 95817, USA
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Durkin MS, Yeargin-Allsopp M. Socioeconomic Status and Pediatric Neurologic Disorders: Current Evidence. Semin Pediatr Neurol 2018; 27:16-25. [PMID: 30293586 PMCID: PMC8340602 DOI: 10.1016/j.spen.2018.03.003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Socioeconomic status (SES) is an important risk factor for many neurological disorders and a determinant of health outcomes and quality of life, especially for individuals with neurologic disorders and developmental disabilities. This article focuses on the relationship between SES and pediatric epilepsy, cerebral palsy, autism spectrum disorder, and intellectual disability. Disparities in the prevalence and long-term impact of SES on functioning in persons with disabilities are observed worldwide. Clinicians can use the information presented in the article to target early identification and interventions for improving outcomes in populations most at risk for these disorders and for poor health, social, and economic outcomes.
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Affiliation(s)
- Maureen S Durkin
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin - Madison, Madison, Wisconsin
| | - Marshalyn Yeargin-Allsopp
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia.
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Sports participation for young athletes with medical conditions: Seizure disorder, infections and single organs. Curr Probl Pediatr Adolesc Health Care 2018; 48:161-171. [PMID: 30017601 DOI: 10.1016/j.cppeds.2018.06.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Organized and recreational sports have been shown to be an important part of growth and development in children, adolescents and young adults. In addition to the health benefits of increased physical activity, sports also provide social benefits. Pediatricians play an important role in determining if young athletescan participate in various sports and the proper equipment or precautions that are necessary. This review provides information on sports participation for athletes with specific health considerations, such as: febrile illnesses, solitary organs, seizures, and skin infections.
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Berg AT, Goldman S. Getting serious about the early-life epilepsies. Neurology 2018; 90:842-848. [DOI: 10.1212/wnl.0000000000005423] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Accepted: 02/15/2018] [Indexed: 12/15/2022] Open
Abstract
Early-life epilepsies represent a group of many individually rare and often complex developmental brain disorders associated with lifelong devastating consequences and high risk for early mortality. The quantity and quality of evidence needed to guide the evaluation and treatment to optimize outcomes of affected children is minimal; most children are treated within an evidence-free practice zone based solely on anecdote and lore. The remarkable advances in diagnostics and therapeutics are implemented haphazardly with no systematic effort to understand their effects and value. This stands in stark contrast to the evidence-rich practice of the Children's Oncology Group, where standard of care treatments are identified through rigorous, multicenter research studies, and the vast majority of patients are treated on protocols developed from that research. As a consequence, overall mortality for childhood cancers has declined from ∼90% in the 1950s to ∼20% today. The situations of these 2 rare disease specialties are contrasted, and some suggestions for moving early-life epilepsy onto a fast track for success are offered. Chief amongst these is that early-life epilepsy should be treated with the same urgency as pediatric cancer. The best diagnostics and evidence-based treatments should be used in a systematic fashion right from the start, not after the child and family have been subjected to the ravages of the disorder for months or years. This will require unity and cooperation among physicians, researchers, and institutions across state and national borders.
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Zack MM, Kobau R. National and State Estimates of the Numbers of Adults and Children with Active Epilepsy - United States, 2015. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2017; 66:821-825. [PMID: 28796763 PMCID: PMC5687788 DOI: 10.15585/mmwr.mm6631a1] [Citation(s) in RCA: 388] [Impact Index Per Article: 55.4] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Matthew M Zack
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Rosemarie Kobau
- Division of Population Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Wagner JL, Modi AC, Johnson EK, Shegog R, Escoffery C, Bamps Y, Austin JK, Schultz RJ, MapelLentz S, Smith G. Self-management interventions in pediatric epilepsy: What is the level of evidence? Epilepsia 2017; 58:743-754. [PMID: 28233908 DOI: 10.1111/epi.13711] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2017] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To respond to recommendations put forth by the Institute of Medicine to improve self-management resources for youth with epilepsy by conducting a systematic review of the self-management literature in pediatric epilepsy. METHODS Inclusion criteria: youth birth to 18 years with a seizure disorder or an epilepsy diagnosis and/or their caregivers, published 1985-2014 in English, and conducted in countries with a very high human development index. Abstract and keywords had to explicitly refer to "self-care" (pre-1996) and/or self-management (post-1996). The review was conducted in seven phases: (1) identification of bibliographical search criteria and databases; (2) abstract assessment; (3) full article review; (4) organization of final citations into instrument development, intervention, factors associated with self-management categories; (5) American Academy of Neurology level of evidence (LOE) assessment for intervention studies; (6) CONsolidated Standards of Reporting Trials (CONSORT) evaluation of LOE level III articles utilizing a control group; and (7) categorization of intervention outcomes across four self-management domains. RESULTS Of the 87 articles that met eligibility criteria, 24 were interventions and received LOE scores of level III or IV. Most studies (n = 20, 80%) were scored at level III; however, only eight had a control group and adhered to CONSORT guidelines. They largely neglected information on intervention components (e.g., implementation, treatment fidelity), randomization, participant flow, missing data, and effect size or confidence intervals. The 24 intervention studies reported significant impact in four domains: individual (n = 13), family (n = 6), health care system (n = 3), and community (n = 2). SIGNIFICANCE There are no level I or II studies. No study met full CONSORT guidelines. Outcomes were well described; however, the nature of self-management interventions (e.g., multiple foci, skills targeted) and the observed heterogeneity in outcomes complicates comparisons across studies. Randomized controlled trials (RCTs) that include large sample sizes, impact of the intervention, treatment fidelity, and power analyses are necessary to further this evidence base.
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Affiliation(s)
- Janelle L Wagner
- Department of Pediatrics, College of Nursing, Medical University of South Carolina, Charleston, South Carolina, U.S.A
| | - Avani C Modi
- Center for Treatment Adherence and Self-Management, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, U.S.A
| | - Erica K Johnson
- Harborview Medical Center, University of Washington, Seattle, Washington, U.S.A
| | - Ross Shegog
- Prevention Research Center & School of Public Health, University of Texas, Houston, Texas, U.S.A
| | - Cam Escoffery
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, U.S.A
| | - Yvan Bamps
- Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, U.S.A
| | - Joan K Austin
- School of Nursing, Indiana University-Purdue University Indianapolis, Bloomington, Indiana, U.S.A
| | - Rebecca J Schultz
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas, U.S.A
| | - Sarah MapelLentz
- Department of Pediatrics & Adolescent Health, University of Minnesota, Minneapolis, Minnesota, U.S.A
| | - Gigi Smith
- Department of Pediatrics, College of Nursing, Medical University of South Carolina, Charleston, South Carolina, U.S.A
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