1.Background The Olympic motto,"Faster,Higher,Stronger-Together",represents the pursuit of athletic excellence,united as a global community."Excellence,respect and friendship"are the Olympic values...1.Background The Olympic motto,"Faster,Higher,Stronger-Together",represents the pursuit of athletic excellence,united as a global community."Excellence,respect and friendship"are the Olympic values.Both the motto and values are multifaceted and holistic in nature,and all-encompassing in their reach while recognizing no single entity rises above the others.Collectively,these foundational statements anchor the Olympic movement in its quest to build a better world through sport.展开更多
1.Background The importance of physical activity(PA)for health is unequivocal.^(1)Accordingly,population-based recommendations for exercise,and more recently public health guidelines for PA,have been developed and rel...1.Background The importance of physical activity(PA)for health is unequivocal.^(1)Accordingly,population-based recommendations for exercise,and more recently public health guidelines for PA,have been developed and released by authoritative groups for many decades.^(2)Such guidelines emerged with leadership from the exercise physiology discipline and were rooted in,and loyal to,the importance of moderate-to-vigorous intensity PA(MVPA)or exercise.展开更多
Background:The Canadian 24-hour movement behavior(24-HMB)guidelines suggest that a limited amount of screen time use,an adequate level of physical activity(PA),and sufficient sleep duration are beneficial for ensuring...Background:The Canadian 24-hour movement behavior(24-HMB)guidelines suggest that a limited amount of screen time use,an adequate level of physical activity(PA),and sufficient sleep duration are beneficial for ensuring and optimizing the health and quality of life(QoL)of children and adolescents.However,this topic has yet to be examined for children and adolescents with autism spectrum disorder(ASD)specifically.The aim of this cross-sectional observational study was to examine the associations between meeting 24-HMB guidelines and several QoLrelated indicators among a national sample of American children and adolescents with ASD.Methods:Data were taken from the 2020 U.S.National Survey of Children’s Health dataset.Participants(n=956)aged 617 years and currently diagnosed with ASD were included.The exposure of interest was adherence to the 24-HMB guidelines.Outcomes were QoL indicators,including learning interest/curiosity,repeating grades,adaptive ability,victimization by bullying,and behavioral problems.Categorical variables were described with unweighted sample counts and weighted percentages.Age,sex,race,preterm birth status,medication,behavioral treatment,household poverty level,and the educational level of the primary caregivers were included as covariates.Odds ratio(OR)and 95%confidence interval(95%CI)were used to present the strength of association between adherence to 24-HMB guidelines and QoL-related indicators.Results:Overall,452 participants(45.34%)met 1 of the 3 recommendations,216(22.65%)met 2 recommendations,whereas only 39 participants(5.04%)met all 3 recommendations.Compared with meeting none of the recommendations,meeting both sleep duration and PA recommendations(OR=3.92,95%CI:1.639.48,p<0.001)or all 3 recommendations(OR=2.11,95%CI:1.034.35,p=0.04)was associated with higher odds of showing learning interest/curiosity.Meeting both screen time and PA recommendations(OR=0.15,95%CI:0.040.61,p<0.05)or both sleep duration and PA recommendations(OR=0.24,95%CI:0.070.87,p<0.05)was associated with lower odds of repeating any grades.With respect to adaptive ability,participants who met only the PA recommendation of the 24-HMB were less likely to have difficulties dressing or bathing(OR=0.11,95%CI:0.020.66,p<0.05)than those who did not.For participants who met all 3 recommendations(OR=0.38,95%CI:0.150.99,p=0.05),the odds of being victimized by bullying was lower.Participants who adhered to both sleep duration and PA recommendations were less likely to present with severe behavioral problems(OR=0.17,95%CI:0.040.71,p<0.05)than those who did not meet those guidelines.Conclusion:Significant associations were found between adhering to 24-HMB guidelines and selected QoL indicators.These findings highlight the importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the QoL of children with ASD.展开更多
AIM: To evaluate the effect of experience on the accuracy rate of computed tomography colonography (CTC) interpretation and patient preferences/satisfaction for CTC and colonoscopy.
In recent years,pediatric health care has embraced the concept of quality improvement to improve patient outcomes.As quality improvement efforts are implemented,network collaboration(where multiple centers and practic...In recent years,pediatric health care has embraced the concept of quality improvement to improve patient outcomes.As quality improvement efforts are implemented,network collaboration(where multiple centers and practices implement standardized programs)is a popular option.In a collaborative network,improvement in the conduct of structural,process and outcome quality measures can lead to improvements in overall health,and benchmarks can be used to assess and compare progress.In this review article,we provided an overview of the quality improvement movement and the role of quality indicators in this movement.We reviewed current quality improvement efforts in pediatric inflammatory bowel disease (IBD),as well as other pediatric chronic illnesses.We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care,and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance.We aimed to assess current quality improvement efforts in pediatric IBD and other diseases,such as childhood asthma,childhood arthritis,and neonatal health.By doing so,we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD.展开更多
Purpose.This study aimed to examine the levels and correlates of 24-h movement behaviors(i.e.,physical activity,sedentary time,and sleep),and different patterns of these behaviors in a nationally representative sample...Purpose.This study aimed to examine the levels and correlates of 24-h movement behaviors(i.e.,physical activity,sedentary time,and sleep),and different patterns of these behaviors in a nationally representative sample of South Koreans aged 12 years and older.This study also aimed to examine the sociodemographic correlates of 24?h movement behaviors stratified by age groups.Methods.Self-reported,repeated cross-sectional data from 10,708 participants in the 2014 and 2015 Korea National Health and Nutrition Examination surveys were used.Key variables included moderate-to-vigorous intensity physical activity,muscular strengthening exercises,walking,active transportation,sedentary time,and sleep.Sociodemographic variables included age,sex,household income,area of residence,and education level.Descriptive statistics by sex and age as well as general linear models by age group were performed.Results.The proportions of individuals meeting the moderate-to-vigorous intensity physical activity,muscular strengthening exercises,and sleep guidelines were,respectively,21.6%,22.1%,and 32.5%in male youth;6.9%,4.5%,and 22.8%in female youth;55.5%,30.8%,and 54.0%in male adults;48.8%,14.4%,and 57.6%in female adults;44.0%,30.6%,and 45.5%in male older adults;and 29.5%,8.9%,and 37.3%in female older adults.The proportions of individuals showing the most ideal combinations of 24-h movement behaviors were only 3.2%in youth,0.4%in adults,and 0 in older adults.Universally,older age,female sex,or living in metro Seoul were associated with unfavorable patterns of 24-h movement behaviors across different age groups.However,the associations of income and education with movement behaviors were mixed across age groups.Conclusion.Overall,the proportion of South Koreans with a healthy 24-h movement behavior pattern is low.The sociodemographic correlates of different types of 24-h movement behaviors should be considered when designing targeted interventions for the promotion of healthy active living for South Koreans.展开更多
Background:Meeting the 24-Hour Movement Guidelines(physical activity,screen time,and sleep duration) has been associated with positive health indicators.However,there are no previous meta-analyses that have examined t...Background:Meeting the 24-Hour Movement Guidelines(physical activity,screen time,and sleep duration) has been associated with positive health indicators.However,there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world.Therefore,the main purpose of this systematic review and meta-analysis was to examine the overall(non)adherence to the 24-Hour Movement Guidelines among preschoolers,children,and adolescents worldwide.Methods:Four electronic databases(MEDLINE,Scopus,Web of Science,and Cochrane Database of Systematic Reviews) were searched for quantitative studies published in Spanish and English between January 2016 and May 2021.Studies that were conducted with apparently healthy participants and reported the overall(non)adherence to the 24-Hour Movement Guidelines in preschoolers and/or children and/or adolescents were included.Results:Sixty-three studies comprising 387,437 individuals(51% girls) aged 3-18 years from 23 countries were included.Overall,7.12%(95%confidence interval(95%CI):6.45%-7.78%) of youth met all three 24-Hour Movement Guidelines,and 19.21%(95%CI:16.73%-21.69%)met none of the 3 recommendations.Concerning sex,adherence to all recommendations was significantly lower in girls(3.75%,95%CI:3.23%-4.27%) than in boys(6.89%,95%CI:5.89%-7.89%)(p <0.001).However,there were no sex differences regarding adherence to any of the 3 individual recommendations(girls,15.66%,95%CI:8.40%-22.92%;boys,12.95%,95%CI:6.57%-19.33%).In terms of age group,adherence to the 3 recommendations was 11.26%(95%CI:8.68%-13.84%),10.31%(95%CI:7.49%-13.12%),and 2.68%(95%CI:1.78%-3.58%) in preschoolers,children,and adolescents,respectively.Conversely,8.81%(95%CI:5.97%-11.64%) of preschoolers,15.57%(95%CI:11.60%-19.54%) of children,and 28.59%(95%CI:22.42%-34.75%) of adolescents did not meet any of the recommendations.South America was the region with the lowest adherence(all:2.93%;none:31.72%).Overall adherence to the 24-Hour Movement Guidelines was positively related to country Human Development Index(β=-0.37,95%CI:-0.65 to-0.09;p=0.010).Conclusion:Most young people fail to meet the three 24-Hour Movement Guidelines,particularly adolescents,girls,and those who are from countries with a lower Human Development Index.Moreover,1 in 5 young people did not meet any of these recommendations.Therefore,these results highlight the need to develop age-and sex-specific strategies to promote these movement behaviors from the early stages of life.展开更多
Autoimmune hepatitis is a chronic liver disease harboring an autoimmune basis and progressive character.Despite still obscurity in etiology and pathogenesis,some evidence supports the importance of sustaining the immu...Autoimmune hepatitis is a chronic liver disease harboring an autoimmune basis and progressive character.Despite still obscurity in etiology and pathogenesis,some evidence supports the importance of sustaining the immune system.Vitamin D is a lipo-soluble vitamin,which has been identified as decreased in our body.It is often due to the daily habit change and decrease of individual sun exposure due to the increase of the ultraviolet-induced potential melanocytic transformation.Here,we emphasize the importance of vitamin D supplementation in patients affected with liver disease.展开更多
Background: The molecular interactions of hepatitis C virus (HCV) with hepatic tissue have yet to be completely elucidated and understood. The purpose of this study was to compare differential gene expression patterns...Background: The molecular interactions of hepatitis C virus (HCV) with hepatic tissue have yet to be completely elucidated and understood. The purpose of this study was to compare differential gene expression patterns in the livers of non-transgenic and transgenic mouse model expressing HCV structural proteins Core, Envelope 1 (E1) and Envelope 2 (E2) using complementary DNA (cDNA) microarrays. Results: Total RNA extracted from the livers of HCV transgenic and non-transgenic mice was analyzed with cDNA microarray and differentially expressed genes confirmed by real-time RT-PCR. Relative expression ratios of individual genes were determined by comparing hybridization of Cy5-labelled cDNA from transgenic mouse livers and Cy3-labelled cDNA from non-transgenic mouse livers. The spot array images were quantified using QuantArray software and the outlier spots was normalized and filtered using five different criteria. 15,297 genes were analyzed using three different analytical methods. Depending on these methods, twenty-one genes were found to be differentially expressed at a statistically significant level. From these, 6 genes had a consistent differential expression. Several genes were directly involved in lipid metabolism and lipid β-oxidation. 5-azacytidine induced gene 2 (AZ2), which is involved in the methylation of genes was down regulated in HCV transgenic mice. Altered transcript levels of these 6 genes were confirmed by real-time RT-PCR analysis. Conclusion: Interactions between HCV and hepatocytes not only involve lipid metabolism and redox balance, but this interaction may also influence DNA methylation, indicating a potential association with the development of hepatocellular carcinoma.展开更多
Antibiotic-impregnated ventricular shunt catheters(AIVSCs)with 0.15%clindamycin and 0.054%rifampin are commonly used to prevent ventriculo-peritoneal(VP)shunt infections.Initially approved by the United States Food an...Antibiotic-impregnated ventricular shunt catheters(AIVSCs)with 0.15%clindamycin and 0.054%rifampin are commonly used to prevent ventriculo-peritoneal(VP)shunt infections.Initially approved by the United States Food and Drug Administration in 2003(https://www.integralife.com/file/general/1561404015.pdf),they have antimicrobial activity documented for minimum 31 days(https://www.accessdata.fda.gov/cdrh_docs/pdf11/K110560.pdf).These antibiotics were chosen as they cover the majority of Staphylococcus aureus and may provide some activity against coagulase negative staphylococci.1 These normal skin flora account for the majority of VP shunt infections.In the largest randomized controlled trial(RCT)to date,AIVSCs significantly reduced the risk of infection compared with standard shunts(cause-specific hazard ratio(HR)0.38).2 This effect was mainly due to a reduction in staphylococcal infections;the number of gram-negative infections was similar in both groups.Observational studies3–5 and a meta-analysis6 in children support the findings of this RCT.The objective of this study was to examine the spectrum of pathogens,time to infection,and outcomes with AIVSCs vs standard shunts.展开更多
文摘1.Background The Olympic motto,"Faster,Higher,Stronger-Together",represents the pursuit of athletic excellence,united as a global community."Excellence,respect and friendship"are the Olympic values.Both the motto and values are multifaceted and holistic in nature,and all-encompassing in their reach while recognizing no single entity rises above the others.Collectively,these foundational statements anchor the Olympic movement in its quest to build a better world through sport.
基金supported in part by an anonymous donation to develop the Precision Child and Youth Mental Health Initiative
文摘1.Background The importance of physical activity(PA)for health is unequivocal.^(1)Accordingly,population-based recommendations for exercise,and more recently public health guidelines for PA,have been developed and released by authoritative groups for many decades.^(2)Such guidelines emerged with leadership from the exercise physiology discipline and were rooted in,and loyal to,the importance of moderate-to-vigorous intensity PA(MVPA)or exercise.
基金supported by Start-up Research Grant of Shenzhen University(20200807163056003)Start-Up Research Grant(PeacockPlan:20191105534C).
文摘Background:The Canadian 24-hour movement behavior(24-HMB)guidelines suggest that a limited amount of screen time use,an adequate level of physical activity(PA),and sufficient sleep duration are beneficial for ensuring and optimizing the health and quality of life(QoL)of children and adolescents.However,this topic has yet to be examined for children and adolescents with autism spectrum disorder(ASD)specifically.The aim of this cross-sectional observational study was to examine the associations between meeting 24-HMB guidelines and several QoLrelated indicators among a national sample of American children and adolescents with ASD.Methods:Data were taken from the 2020 U.S.National Survey of Children’s Health dataset.Participants(n=956)aged 617 years and currently diagnosed with ASD were included.The exposure of interest was adherence to the 24-HMB guidelines.Outcomes were QoL indicators,including learning interest/curiosity,repeating grades,adaptive ability,victimization by bullying,and behavioral problems.Categorical variables were described with unweighted sample counts and weighted percentages.Age,sex,race,preterm birth status,medication,behavioral treatment,household poverty level,and the educational level of the primary caregivers were included as covariates.Odds ratio(OR)and 95%confidence interval(95%CI)were used to present the strength of association between adherence to 24-HMB guidelines and QoL-related indicators.Results:Overall,452 participants(45.34%)met 1 of the 3 recommendations,216(22.65%)met 2 recommendations,whereas only 39 participants(5.04%)met all 3 recommendations.Compared with meeting none of the recommendations,meeting both sleep duration and PA recommendations(OR=3.92,95%CI:1.639.48,p<0.001)or all 3 recommendations(OR=2.11,95%CI:1.034.35,p=0.04)was associated with higher odds of showing learning interest/curiosity.Meeting both screen time and PA recommendations(OR=0.15,95%CI:0.040.61,p<0.05)or both sleep duration and PA recommendations(OR=0.24,95%CI:0.070.87,p<0.05)was associated with lower odds of repeating any grades.With respect to adaptive ability,participants who met only the PA recommendation of the 24-HMB were less likely to have difficulties dressing or bathing(OR=0.11,95%CI:0.020.66,p<0.05)than those who did not.For participants who met all 3 recommendations(OR=0.38,95%CI:0.150.99,p=0.05),the odds of being victimized by bullying was lower.Participants who adhered to both sleep duration and PA recommendations were less likely to present with severe behavioral problems(OR=0.17,95%CI:0.040.71,p<0.05)than those who did not meet those guidelines.Conclusion:Significant associations were found between adhering to 24-HMB guidelines and selected QoL indicators.These findings highlight the importance of maintaining a healthy lifestyle as a key factor in promoting and preserving the QoL of children with ASD.
文摘AIM: To evaluate the effect of experience on the accuracy rate of computed tomography colonography (CTC) interpretation and patient preferences/satisfaction for CTC and colonoscopy.
文摘In recent years,pediatric health care has embraced the concept of quality improvement to improve patient outcomes.As quality improvement efforts are implemented,network collaboration(where multiple centers and practices implement standardized programs)is a popular option.In a collaborative network,improvement in the conduct of structural,process and outcome quality measures can lead to improvements in overall health,and benchmarks can be used to assess and compare progress.In this review article,we provided an overview of the quality improvement movement and the role of quality indicators in this movement.We reviewed current quality improvement efforts in pediatric inflammatory bowel disease (IBD),as well as other pediatric chronic illnesses.We discussed the need to standardize the development of quality indicators used in quality improvement networks to assess medical care,and the validation techniques which can be used to ensure that process indicators result in improved outcomes of clinical significance.We aimed to assess current quality improvement efforts in pediatric IBD and other diseases,such as childhood asthma,childhood arthritis,and neonatal health.By doing so,we hope to learn from their successes and failures and to move the field forward for future improvements in the care provided to children with IBD.
文摘Purpose.This study aimed to examine the levels and correlates of 24-h movement behaviors(i.e.,physical activity,sedentary time,and sleep),and different patterns of these behaviors in a nationally representative sample of South Koreans aged 12 years and older.This study also aimed to examine the sociodemographic correlates of 24?h movement behaviors stratified by age groups.Methods.Self-reported,repeated cross-sectional data from 10,708 participants in the 2014 and 2015 Korea National Health and Nutrition Examination surveys were used.Key variables included moderate-to-vigorous intensity physical activity,muscular strengthening exercises,walking,active transportation,sedentary time,and sleep.Sociodemographic variables included age,sex,household income,area of residence,and education level.Descriptive statistics by sex and age as well as general linear models by age group were performed.Results.The proportions of individuals meeting the moderate-to-vigorous intensity physical activity,muscular strengthening exercises,and sleep guidelines were,respectively,21.6%,22.1%,and 32.5%in male youth;6.9%,4.5%,and 22.8%in female youth;55.5%,30.8%,and 54.0%in male adults;48.8%,14.4%,and 57.6%in female adults;44.0%,30.6%,and 45.5%in male older adults;and 29.5%,8.9%,and 37.3%in female older adults.The proportions of individuals showing the most ideal combinations of 24-h movement behaviors were only 3.2%in youth,0.4%in adults,and 0 in older adults.Universally,older age,female sex,or living in metro Seoul were associated with unfavorable patterns of 24-h movement behaviors across different age groups.However,the associations of income and education with movement behaviors were mixed across age groups.Conclusion.Overall,the proportion of South Koreans with a healthy 24-h movement behavior pattern is low.The sociodemographic correlates of different types of 24-h movement behaviors should be considered when designing targeted interventions for the promotion of healthy active living for South Koreans.
基金the financial support of the Ministry of Economy and Infrastructures and European Communitysupported by the Ministry of Economy and Infrastructures of Extremadura (PD 18015)funded by FEDER,FSE and Govern of Extremadura,grant numbers GR18102 and TA18027.
文摘Background:Meeting the 24-Hour Movement Guidelines(physical activity,screen time,and sleep duration) has been associated with positive health indicators.However,there are no previous meta-analyses that have examined the overall adherence to the 24-Hour Movement Guidelines from pre-school to adolescence across the world.Therefore,the main purpose of this systematic review and meta-analysis was to examine the overall(non)adherence to the 24-Hour Movement Guidelines among preschoolers,children,and adolescents worldwide.Methods:Four electronic databases(MEDLINE,Scopus,Web of Science,and Cochrane Database of Systematic Reviews) were searched for quantitative studies published in Spanish and English between January 2016 and May 2021.Studies that were conducted with apparently healthy participants and reported the overall(non)adherence to the 24-Hour Movement Guidelines in preschoolers and/or children and/or adolescents were included.Results:Sixty-three studies comprising 387,437 individuals(51% girls) aged 3-18 years from 23 countries were included.Overall,7.12%(95%confidence interval(95%CI):6.45%-7.78%) of youth met all three 24-Hour Movement Guidelines,and 19.21%(95%CI:16.73%-21.69%)met none of the 3 recommendations.Concerning sex,adherence to all recommendations was significantly lower in girls(3.75%,95%CI:3.23%-4.27%) than in boys(6.89%,95%CI:5.89%-7.89%)(p <0.001).However,there were no sex differences regarding adherence to any of the 3 individual recommendations(girls,15.66%,95%CI:8.40%-22.92%;boys,12.95%,95%CI:6.57%-19.33%).In terms of age group,adherence to the 3 recommendations was 11.26%(95%CI:8.68%-13.84%),10.31%(95%CI:7.49%-13.12%),and 2.68%(95%CI:1.78%-3.58%) in preschoolers,children,and adolescents,respectively.Conversely,8.81%(95%CI:5.97%-11.64%) of preschoolers,15.57%(95%CI:11.60%-19.54%) of children,and 28.59%(95%CI:22.42%-34.75%) of adolescents did not meet any of the recommendations.South America was the region with the lowest adherence(all:2.93%;none:31.72%).Overall adherence to the 24-Hour Movement Guidelines was positively related to country Human Development Index(β=-0.37,95%CI:-0.65 to-0.09;p=0.010).Conclusion:Most young people fail to meet the three 24-Hour Movement Guidelines,particularly adolescents,girls,and those who are from countries with a lower Human Development Index.Moreover,1 in 5 young people did not meet any of these recommendations.Therefore,these results highlight the need to develop age-and sex-specific strategies to promote these movement behaviors from the early stages of life.
基金Corresponding author:Consolato M Sergi,MD,PhD,Chief,Anatomic Pathology Division,Pediatric Pathologist,Children’s Hospital of Eastern Ontario(CHEO),401 Smyth Road,Ottawa K1H 8L1,ON,Canada.csergi@cheo.on.ca。
文摘Autoimmune hepatitis is a chronic liver disease harboring an autoimmune basis and progressive character.Despite still obscurity in etiology and pathogenesis,some evidence supports the importance of sustaining the immune system.Vitamin D is a lipo-soluble vitamin,which has been identified as decreased in our body.It is often due to the daily habit change and decrease of individual sun exposure due to the increase of the ultraviolet-induced potential melanocytic transformation.Here,we emphasize the importance of vitamin D supplementation in patients affected with liver disease.
文摘Background: The molecular interactions of hepatitis C virus (HCV) with hepatic tissue have yet to be completely elucidated and understood. The purpose of this study was to compare differential gene expression patterns in the livers of non-transgenic and transgenic mouse model expressing HCV structural proteins Core, Envelope 1 (E1) and Envelope 2 (E2) using complementary DNA (cDNA) microarrays. Results: Total RNA extracted from the livers of HCV transgenic and non-transgenic mice was analyzed with cDNA microarray and differentially expressed genes confirmed by real-time RT-PCR. Relative expression ratios of individual genes were determined by comparing hybridization of Cy5-labelled cDNA from transgenic mouse livers and Cy3-labelled cDNA from non-transgenic mouse livers. The spot array images were quantified using QuantArray software and the outlier spots was normalized and filtered using five different criteria. 15,297 genes were analyzed using three different analytical methods. Depending on these methods, twenty-one genes were found to be differentially expressed at a statistically significant level. From these, 6 genes had a consistent differential expression. Several genes were directly involved in lipid metabolism and lipid β-oxidation. 5-azacytidine induced gene 2 (AZ2), which is involved in the methylation of genes was down regulated in HCV transgenic mice. Altered transcript levels of these 6 genes were confirmed by real-time RT-PCR analysis. Conclusion: Interactions between HCV and hepatocytes not only involve lipid metabolism and redox balance, but this interaction may also influence DNA methylation, indicating a potential association with the development of hepatocellular carcinoma.
文摘Antibiotic-impregnated ventricular shunt catheters(AIVSCs)with 0.15%clindamycin and 0.054%rifampin are commonly used to prevent ventriculo-peritoneal(VP)shunt infections.Initially approved by the United States Food and Drug Administration in 2003(https://www.integralife.com/file/general/1561404015.pdf),they have antimicrobial activity documented for minimum 31 days(https://www.accessdata.fda.gov/cdrh_docs/pdf11/K110560.pdf).These antibiotics were chosen as they cover the majority of Staphylococcus aureus and may provide some activity against coagulase negative staphylococci.1 These normal skin flora account for the majority of VP shunt infections.In the largest randomized controlled trial(RCT)to date,AIVSCs significantly reduced the risk of infection compared with standard shunts(cause-specific hazard ratio(HR)0.38).2 This effect was mainly due to a reduction in staphylococcal infections;the number of gram-negative infections was similar in both groups.Observational studies3–5 and a meta-analysis6 in children support the findings of this RCT.The objective of this study was to examine the spectrum of pathogens,time to infection,and outcomes with AIVSCs vs standard shunts.