Notice bibliographique
Résumé
Introduction: Pediatric stone disease incidence has increased steadily over the last several years.Several interrelated factors have been proposed to contribute to these epidemiologic trends including increased ambient temperature, body habitus, and food insecurity.Given the significant cohort of children living with food insecurity in the United States, the aim of this study is to explore the relationship between food desert residence and surgical intervention for stone disease in a cohort of pediatric patients.We also discuss a potential new association with pediatric stone disease: psychiatric comorbidity and the medical management of such diagnoses.Methods: Records of pediatric patients who presented to a single tertiary pediatric medical center for nephrolithiasis between 2009 and 2023 were retrospectively reviewed.Patients were included in the study if they were older than five years of age, lacked anatomical predispositions for stone formation, and were regularly consuming a solid diet.Variables studied included demographics, body mass index (BMI), medical comorbidities and family history, procedures performed, and stone burden.Patients' likelihood of living in a food desert was approximated using the United States Department of Agriculture Food Access Research Atlas.Results: Of 572 patients reviewed, 191 pediatric patients (88 male and 103 female) were included in our analysis.Of these, 69.1% (n=132) had undergone ureteroscopy.Fifty-seven patients (28.6%) had a documented psychiatric comorbidity at time of presentation, with attention-deficit/hyperactivity disorder (ADHD) being the most common psychiatric comorbidity treated via medical management (n=25, 43.9%).Our analysis demonstrated a significant association between surgical intervention and medical history of urinary tract infections (UTI) (p=0.038),food desert residence (p=0.002), or increased stone size (p<0.001).Factors associated with longer time between discharge and surgery decision were past medical history of stones (p=0.015),food desert residence (p=0.047), and psychiatric comorbidity (p=0.050).Among patients with psychiatric comorbidities, ADHD diagnosis and stimulant therapy were also significantly associated with longer mean time before procedural intervention (p=0.009 and p=0.02, respectively).Conclusions: In this study, we found a significant association between food desert residence and surgical intervention for pediatric nephrolithiasis.To our knowledge, our study is among the first to assess association between food insecurity and surgical intervention for pediatric nephrolithiasis, as well as a possible relationship between ADHD and surgical management for stones.Given the importance diet plays in medical management of stone development, clinicians should take care to assess food security status of pediatric nephrolithiasis patients.Further research to determine association between ADHD, pediatric nephrolithiasis, and food insecurity is warranted.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,002 | 0,001 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,451 | 0,280 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».