Official journal of the American College of Gastroenterology

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this.features)));n.length>0&&(0,e.R)(36,{targetFeature:r.featureName,missingDependencies:n}),this.features[r.featureName]=new r(this)}))}catch(t){(0,e.R)(22,t);for(const e in this.features)this.features[e].abortHandler?.();const r=(0,R.Zm)();delete r.initializedAgents[this.agentIdentifier]?.api,delete r.initializedAgents[this.agentIdentifier]?.features,delete this.sharedAggregator;return r.ee.get(this.agentIdentifier).abort(),!1}}}({features:[he,w,N,Ne,_e,_,D,ot,ct,je,nt],loaderType:"spa"})})()})();</script><meta charset="utf-8" /><meta name="viewport" content="width=device-width, initial-scale=1" /><meta http-equiv="Expires" content="0" /><meta name="DCSext.AbsHTMLview" content="1" /><meta name="WT.cg_n" content="ajg" /><meta name="WT.cg_s" content="Articles" /><meta name="wkhealth_journal_title" content="Official journal of the American College of Gastroenterology | ACG" /><meta name="wkhealth_journal_title_legacy" content="The American Journal of Gastroenterology" /><meta name="wkhealth_issue" content="3" /><meta name="wkhealth_article_publication_date" content="January 13, 2023" /><meta name="wkhealth_volume" content="118" /><meta name="wkhealth_ovid_accession_number" content="00000434-202303000-00036" /><meta name="wkhealth_issn" content="0002-9270" /><meta name="wkhealth_title" content="A Randomized, Double-Blind, Controlled Trial of Percutaneous Tibial Nerve Stimulation With Pelvic Floor Exercises in the Treatment of Childhood Constipation" /><meta name="wkhealth_authors" content="Yu, Zheng-tong;Song, Jun-Min;Qiao, Lei;Wang, Yang;Chen, Ying;Wang, En-Hui;Zhang, Shu-Cheng" /><meta name="wkhealth_doi" content="10.14309/ajg.0000000000002188" /><meta name="wkhealth_abstract_html_url" content="https://journals.lww.com/ajg/abstract/2023/03000/a_randomized,_double_blind,_controlled_trial_of.36.aspx" /><meta name="wkhealth_fulltext_html_url" content="https://journals.lww.com/ajg/fulltext/2023/03000/a_randomized,_double_blind,_controlled_trial_of.36.aspx" /><meta name="wkhealth_toc_section" content="ARTICLE" /><meta name="wkhealth_toc_sub_section" content="PEDIATRICS" /><meta name="wkhealth_eJpId" content="ajg:2023:03000:00036" /><meta name="wkhealth_firstpage" content="553" /><meta name="wkhealth_date" content="March 2023" /><meta name="wkhealth_pdf_url" content="https://journals.lww.com/ajg/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=Other&an=00000434-202303000-00036" /><meta name="Description" content="INTRODUCTION: The management of childhood constipation is challenging. Pelvic floor dysfunction (" /><meta property="og:site_name" content="LWW" /><meta property="og:type" content="article" /><meta property="og:title" content="A Randomized, Double-Blind, Controlled Trial of... : Official journal of the American College of Gastroenterology | ACG" /><meta property="og:description" content="dividuals and women with PFD. The efficacy of PTNS with PFE in childhood constipation has not been established. METHODS: A randomized, double-blind, controlled trial with 84 children who met the inclusion criteria was conducted. All participants were randomly assigned to PTNS with PFE or sham PTNS with PFE groups and received their individual intervention for 4 weeks with a 12-week follow-up evaluation. The spontaneous bowel movements (SBM) ≥3 per week were the main outcomes, and the risk ratio (RR) with 95% confidence interval (CI) were calculated. High-resolution anorectal manometry and surface electromyography were used for the assessment of pelvic floor function, and the adverse effects were assessed based on symptoms. RESULTS: At the end of the follow-up period, 26 patients (61.9%) in the PTNS with PFE group and 15 patients (35.7%) in the sham group had ≥3 SBM per week compared with baseline (net difference 26.2%, 95% CI 5.6%–46.8%; RR 2.750, 95% CI 1.384–5.466; P < 0.05). PFD remission occurred in 49 children, 33 (78.6%) in the PTNS with PFE group and 16 (38.1%) in the sham group (RR 2.063, 95% CI 1.360–3.128, P < 0.05). No adverse effects occurred. DISCUSSION: PTNS with PFE is a safe and effective method in the treatment of childhood constipation, particularly in children with PFD or dyssynergic defecation...." /><meta property="og:image" content="https://images.journals.lww.com/ajg/SocialThumb.00000434-202303000-00036.F1.jpeg" /><meta property="og:image:width" content="1360" /><meta property="og:image:height" content="1194" /><meta property="og:url" content="https://journals.lww.com/ajg/fulltext/2023/03000/a_randomized,_double_blind,_controlled_trial_of.36.aspx" /><meta property="twitter:card" content="summary" /><meta name="robots" content="index, follow, noarchive" /><meta name="WT.sv" content="ZUSE1PEJPWEB02" /><meta name="Title" content="Official journal of the American College of Gastroenterology | ACG" /><style id="SPThemeHideForms" type="text/css">body {opacity:0 !important}</style>  <link href="https://fonts.googleapis.com/css?family=Arvo:400,400i,700|Fira+Sans:300,300i,400,400i,500,500i,600,600i,700,700i&display=swap" 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PFD, pelvic floor dysfunction.","https://images.journals.lww.com/ajg/Rollover.00000434-202303000-00036.F1.jpeg","https://images.journals.lww.com/ajg/Gallery.00000434-202303000-00036.F1.jpeg","https://journals.lww.com/ajg/_layouts/oaks.journals/ImageView.aspx?k=ajg:2023:03000:00036&i=F1&year=2023&issue=03000&article=00036&type=Abstract","https://images.journals.lww.com/ajg/Original.00000434-202303000-00036.F1.jpeg","/ajg/pages/imagegallery.aspx?year=2023&issue=03000&article=00036", "ajg_2023_03000_00036_F1");images["F2"]=new image("F2","T1","F1","Figure 2.","(<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">a</strong>–<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">c</strong>) HR-ARM revealed achalasia or paradoxical contractions of the anal sphincter during defecation. (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">a</strong>) HR-ARM presentation in a normal child: when bearing down, the patient can pull out the probe, and anal pressure declines in number to nearly zero. (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">b</strong>) HR-ARM revealed anal sphincter achalasia during defecation in childhood constipation: the patient cannot pull out the probe, and anal pressure was kept at the baseline level. (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">c</strong>) HR-ARM revealed paradoxical contractions of the anal sphincter during defecation, the patient cannot pull out the probe, and anal pressure increased from the baseline. (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">d</strong> and <strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">e</strong>) sEMG demonstrated elevated surface EMG amplitudes of the pelvic floor in resting and bearing down. (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">d</strong>) sEMG presentation in a normal child, with the sEMG amplitude leveled 4–10 μV. (<strong xmlns:mrws=\"http://webservices.ovid.com/mrws/1.0\">e</strong>) sEMG demonstrated elevated surface EMG amplitudes of the pelvic floor in resting and bearing down. EMG, electromyography; HR-ARM, high-resolution anorectal manometry; sEMG, surface EMG.","https://images.journals.lww.com/ajg/Rollover.00000434-202303000-00036.F2.jpeg","https://images.journals.lww.com/ajg/Gallery.00000434-202303000-00036.F2.jpeg","https://journals.lww.com/ajg/_layouts/oaks.journals/ImageView.aspx?k=ajg:2023:03000:00036&i=F2&year=2023&issue=03000&article=00036&type=Abstract","https://images.journals.lww.com/ajg/Original.00000434-202303000-00036.F2.jpeg","/ajg/pages/imagegallery.aspx?year=2023&issue=03000&article=00036", "ajg_2023_03000_00036_F2");images["T1"]=new image("T1","T2","F2","Table 1.","The demographic and baseline data","https://images.journals.lww.com/ajg/Rollover.00000434-202303000-00036.T1.jpeg","https://images.journals.lww.com/ajg/Gallery.00000434-202303000-00036.T1.jpeg","https://journals.lww.com/ajg/_layouts/oaks.journals/ImageView.aspx?k=ajg:2023:03000:00036&i=T1&year=2023&issue=03000&article=00036&type=Abstract","https://images.journals.lww.com/ajg/Original.00000434-202303000-00036.T1.jpeg","/ajg/pages/imagegallery.aspx?year=2023&issue=03000&article=00036", "ajg_2023_03000_00036_T1");images["T2"]=new image("T2","T3","T1","Table 2.","Effects of intervention on primary outcomes","https://images.journals.lww.com/ajg/Rollover.00000434-202303000-00036.T2.jpeg","https://images.journals.lww.com/ajg/Gallery.00000434-202303000-00036.T2.jpeg","https://journals.lww.com/ajg/_layouts/oaks.journals/ImageView.aspx?k=ajg:2023:03000:00036&i=T2&year=2023&issue=03000&article=00036&type=Abstract","https://images.journals.lww.com/ajg/Original.00000434-202303000-00036.T2.jpeg","/ajg/pages/imagegallery.aspx?year=2023&issue=03000&article=00036", "ajg_2023_03000_00036_T2");images["T3"]=new image("T3","","T2","Table 3.","Effects of intervention on secondary outcomes","https://images.journals.lww.com/ajg/Rollover.00000434-202303000-00036.T3.jpeg","https://images.journals.lww.com/ajg/Gallery.00000434-202303000-00036.T3.jpeg","https://journals.lww.com/ajg/_layouts/oaks.journals/ImageView.aspx?k=ajg:2023:03000:00036&i=T3&year=2023&issue=03000&article=00036&type=Abstract","https://images.journals.lww.com/ajg/Original.00000434-202303000-00036.T3.jpeg","/ajg/pages/imagegallery.aspx?year=2023&issue=03000&article=00036", "ajg_2023_03000_00036_T3"); 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id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnsubscribeJournalId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenUnsubscribeMessage" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenTopicalCollectionId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenTopicalCollectionId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenOvidId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenOvidId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$ucUnsubscribeToAlertsUserControl$hiddenJournalId" id="ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId" /> <script type="text/javascript"> function alerts_ShowUnSubscribeeTOCPopup(title, alertType, journalId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = alertType; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == null || document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == '') { document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value = journalId; } if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Root(title, journalId, alertType) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = alertType; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Citation(title, journalId, ovidId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = 'Citation'; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenOvidId').value = ovidId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCPopup_Topical(title, journalId, topicalCollectionId) { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); var lblUnsubscribeMessage = document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_lblUnsubscribeMessage'); lblUnsubscribeMessage.innerHTML = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeMessage').value = title; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnSubscribeAlertType').value = 'Topical'; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenUnsubscribeJournalId').value = journalId; document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenTopicalCollectionId').value = topicalCollectionId; $('#' + 'ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_pUnsubscribeButtons').show(); if (document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == null || document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value == '') { document.getElementById('ctl00_ctl51_Header_UserActionTools_ucUnsubscribeToAlertsUserControl_hiddenJournalId').value = journalId; } if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } function alerts_ShowUnSubscribeeTOCSuccessPopup() { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.show(); } } $('.js-close').on('click', function() { var unSubscribeeTocPopup = $find('unSubscribeToAlerts'); if (unSubscribeeTocPopup != null) { unSubscribeeTocPopup.hide(); } return false; }); </script> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_dummyTargetControl"></span> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenSubscribeToEtocPopupState" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscribeToEtocPopupState" value="showemail" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenConfirmSubscriptionPageUrl" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenConfirmSubscriptionPageUrl" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenJournalId" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId" /> <input type="hidden" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$hiddenSubscriptionType" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType" /> <div id="divPopupOverLay" class="Popup-Overlay" style="display: none; position: fixed; left: 0; top: 0; z-index: 3800; width: 1920px; height: 4517px;"></div> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlSubscribeToEtoc" class="etoc-popup ej-box-modal-drop-shadow" style="display: none;"> <div tabindex="-1" role="dialog" class="wk-modal horizontally-centered small wk-modal-with-overlay wk-modal-small ejp-modal"> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlMain" onkeypress="javascript:return WebForm_FireDefaultButton(event, 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_btnContinue')"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblTitle"></span> </div> <button aria-label="close dialog" class="js-close primary-button wk-button-icon wk-modal-close ejp-modal-close "> <i class="fa fa-times"></i> </button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <div class="wk-field-body"> <strong> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblThankYouMessage"></span></strong> </div> <div class="wk-field-body"> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError" style="color:Black;display:none;"> <div class="ej-error-message"> <p class="ej-error-message-icon error-red"> </p> </div> </span> <label for="Email input">Enter your Email address:</label> <div class="wk-field-body"> <input name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$txtEmailAddress" type="text" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress" class="ej-box-modal-style-1-input" /> </div> </div> <div class="wk-button-bar"> <div class="wk-button-group-left"> <input type="submit" name="ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$btnContinue" value="Continue" onclick="javascript:WebForm_DoPostBackWithOptions(new WebForm_PostBackOptions("ctl00$ctl51$Header$UserActionTools$SubscribeToEtocPopupControl$btnContinue", "", true, "", "", false, false))" id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_btnContinue" class="primary-button" /> <input type="button" value="Cancel" id="btnCancel" class="js-close secondary-button" /> </div> </div> </div> <div class="wk-field-item"> <div class="wk-field-body"> <a id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hypPrivacy" href="https://journals.lww.com/ajg/_layouts/oaks.journals/privacy.aspx" target="_blank">Privacy Policy</a> </div> </div> </div> </section> </div> <div id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlAuthenticatedUser" style="display: none;"> <section class="wk-modal-content"> <header class="wk-modal-header ejp-modal-header"> <div class="wk-modal-title ejp-modal-title"></div> <button aria-label="close dialog" class="js-close primary-button wk-button-icon wk-modal-close ejp-modal-close "><i class="fa fa-times"></i></button> </header> <div class="wk-modal-body"> <div class="wk-field-item"> <p> <strong> <span id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblAuthenticatedUserTitle"></span> </strong> </p> </div> <p id="ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pAuthenticatedUserMessage"> </p> </div> </section> </div> </div> </div> <div id="ej-clear-float"> </div> <script type="text/javascript"> function alerts_SaveSubscriptionTypeInHiddenField(url, subscriptionType, journalId, yearId, issueId, articleId) { if (journalId && yearId && issueId && articleId) { logCounterDataAlertWhenCitedSynchronously(journalId, yearId, issueId, articleId); } $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType').val(subscriptionType); $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId').val(journalId); if (url) window.location = url; else __doPostBack('hypSubscribeToAlerts'); return false; } function alerts_ShowSubscribeeTOCPopup(journalTitle, journalId, subscriptionType, displaySubscriptionType) { $('#' + 'ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscriptionType').val(subscriptionType); var subscribeToEtocPopup = $find('subscribeToEtoc'); subscribeToEtocPopup.show(); document.getElementsByTagName( 'html' )[0].classList.add('no-scroll'); var modelPopupState = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenSubscribeToEtocPopupState'); var emailTextBox = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress'); var thanksPanel = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlAuthenticatedUser'); var mainPanel = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlMain'); var thankYouMessageUnAuthenticated = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblThankYouMessage'); var thankYouMessageAuthenticated = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_lblAuthenticatedUserTitle'); if (!displaySubscriptionType) { displaySubscriptionType = subscriptionType; } if (modelPopupState.value == 'showthanksmessage') { thanksPanel.style.display = "block"; mainPanel.style.display = "none"; thankYouMessageAuthenticated.innerHTML = "Thank you for subscribing to the " + displaySubscriptionType + " for " + journalTitle + "."; } if (modelPopupState.value == 'showemail') { thanksPanel.style.display = "none"; mainPanel.style.display = "block"; thankYouMessageUnAuthenticated.innerHTML = "Thank you for choosing to subscribe to the " + displaySubscriptionType + " for " + journalTitle + "."; } if ($('.etoc-popup') != null) { document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenJournalId').value = journalId; if (modelPopupState.value == 'showemail') emailTextBox.focus(); } } $('.js-close').on('click', function () { document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_txtEmailAddress').value = ""; document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError').style.display = "none"; var pageUrl = document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_hiddenConfirmSubscriptionPageUrl'); var subscribeeTocPopup = $find('subscribeToEtoc'); if (subscribeeTocPopup != null) { subscribeeTocPopup.hide(); document.getElementsByTagName( 'html' )[0].classList.remove('no-scroll'); if (pageUrl.value !== '' && pageUrl.value !== window.location.pathname) window.location = pageUrl.value; } return false; }); </script> <div id="ctl00_ctl51_Header_UserActionTools_eTocTopContainer"> <div id="eTocTop" style="display: none;"> <a rel="nofollow" title href="javascript:javascript: alerts_ShowSubscribeeTOCPopup('Official journal of the American College of Gastroenterology | ACG','ajg','eTOC', 'eTOC');;" onclick="javascript: alerts_ShowSubscribeeTOCPopup('Official journal of the American College of Gastroenterology | ACG','ajg','eTOC', 'eTOC');"><span id="ctl00_ctl51_Header_UserActionTools_alertLinkControlTop_defaultText" class="hideOnFixed">Subscribe to eTOC</span></a> </div> </div> <script> $(function () { //find recent searches link and move container var recentSearchesControl = $("a[id$='RecentSearches']"); if (recentSearchesControl.length) { recentSearchesControl.click(function (e) { e.stopPropagation(); if ($("#ResentSearchContainer").is(":hidden")) { $("#ResentSearchContainer").slideDown("slow"); recentSearchesControl.addClass('open'); } else { $("#ResentSearchContainer").hide(); recentSearchesControl.removeClass('open'); } }); } var eTocAccountLink = $("ul.js-user-action-toolbar__dropdown>li>a[id='SubscribeToEToc']"); if (eTocAccountLink.length) { eTocAccountLink.parent().html($("#eTocTop>a")); } }); </script> <a class="logo-secondary white" href="http://wolterskluwer.com/" target="_blank"> <h3 class="logo-secondary-text">Secondary Logo</h3> </a> <a href="#" class="sticky-search"><i class="fa fa-search"></i></a> </div> <div class="header__layout-bottom wk-grid-page-container"> <a id="hypJournals" class="logo-main" href="https://journals.lww.com/ajg/pages/default.aspx"> <h3 class="logo-main-text">Journal Logo </h3> </a> <div class="search-v2"> <div class="search-wrapper"> <select name="ctl00$ctl51$Header$SearchTopBoxControl$ddlContentScope" id="ctl00_ctl51_Header_SearchTopBoxControl_ddlContentScope"> <option value="All">All</option> <option selected="selected" value="Articles">Articles</option> <option value="Images">Images</option> <option value="Videos">Videos</option> <option value="Podcasts">Podcasts</option> <option value="Blogs">Blogs</option> </select> <div class="input-group" id="globalSearch"> <input name="ctl00$ctl51$Header$SearchTopBoxControl$txtKeywords" type="text" value="Search" id="ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords" class="form-control searchText" /> <span class="input-group-btn"> <button id="ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearchMagnifier" type="submit" class="btn btn-default"><i class="fa fa-search"></i></button> </span> <input type="hidden" name="ctl00$ctl51$Header$SearchTopBoxControl$IsAutoCompleteEnabled" id="ctl00_ctl51_Header_SearchTopBoxControl_IsAutoCompleteEnabled" value="false" /> <input type="hidden" name="ctl00$ctl51$Header$SearchTopBoxControl$AutocompleteApiUrl" id="ctl00_ctl51_Header_SearchTopBoxControl_AutocompleteApiUrl" value="https://platformservices.wolterskluwerhealth.com/autocomplete/AJGAST/shingle/" /> </div> </div> <div class="advance-search" style=""> <a id="ctl00_ctl51_Header_SearchTopBoxControl_lnkAdvanceSearch" href="https://journals.lww.com/ajg/pages/advancedsearch.aspx">Advanced Search</a> <input type="submit" name="ctl00$ctl51$Header$SearchTopBoxControl$btnGlobalSearch" value="" id="ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch" disabled="disabled" class="aspNetDisabled btnGlobalSearch" style="display: none;" /> <input name="ctl00$ctl51$Header$SearchTopBoxControl$hfldKeywords" type="hidden" id="ctl00_ctl51_Header_SearchTopBoxControl_hfldKeywords" class="hfldKeywords" value="disableButton" /> </div> </div> <script> $(function() { try { var objSearchBox = { btnGlobalSearchMagnifierId: 'ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearchMagnifier', searchButtonId: 'ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch', txtKeywordsId: 'ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords', hfldKeywordsHiddenId: 'ctl00_ctl51_Header_SearchTopBoxControl_hfldKeywords', defaultSearchText: 'Search' }; new Searchbox(objSearchBox).Init(); } catch (e) { console.error(e); } }); //autocomplete functionality for basic search //this functionality will call the SBA url and start suggesting after typing 3rd character var textKeywords = null; var hiddenAutocompleteApiUrl = null; var buttonGlobalSearch = null; $(function () { try { var objAutocomplete = { hiddenIsAutoCompleteEnabled: $('#ctl00_ctl51_Header_SearchTopBoxControl_IsAutoCompleteEnabled'), textKeywords: $('#ctl00_ctl51_Header_SearchTopBoxControl_txtKeywords'), hiddenAutocompleteApiUrl: $('#ctl00_ctl51_Header_SearchTopBoxControl_AutocompleteApiUrl'), buttonGlobalSearch: $('#ctl00_ctl51_Header_SearchTopBoxControl_btnGlobalSearch'), enableNewAutoComplete: true, newAutoCompleteUrl: 'https://dxg-search-na-prd.wkgposvc.cloud/Query.svc/Query_Expand', newAutoCompleteMaxSuggestions: '10', newAutoCompleteDictionaryIds: 'ovid_sted28_mesh22' }; autoComplete(objAutocomplete); } catch (e) { console.error(e); } }); $(function () { let searchSelect = $('select[id$="ddlContentScope"]');; if (searchSelect.length){ searchSelect.selectize(); } }); </script> </div> <div id="main-nav-container-v2"> <nav id="main-nav" class="navbar navbar-default yamm wk-grid-page-container"> <div class="navbar-header"> <button id="fatJuicy" type="button" class="navbar-hamburger-button navbar-toggle collapsed pull-left" data-bs-toggle="collapse" data-bs-target="#zz1_TopNavigationMenu" aria-expanded="false" aria-controls="navbar"> <span class="visually-hidden">Toggle navigation</span> <span class="icon-bar"></span> <span class="icon-bar"></span> <span class="icon-bar"></span> <span class="navbar-hamburger-button__text"></span> </button> </div> <div id="navActionButtons" class="btn-group navbar-hover-color" role="group" aria-label="..."> <a id="ctl00_ctl51_lnkSubscribe" class="btn btn-default navbar-button" href="https://shop.lww.com/p/0002-9270" target="_blank">Subscribe</a> <a id="ctl00_ctl51_lnkRegister" class="btn btn-default navbar-button" href="https://journals.lww.com/ajg/pages/register.aspx?ContextUrl=%2fajg%2fabstract%2f2023%2f03000%2fa_randomized%2c_double_blind%2c_controlled_trial_of.36.aspx">Register</a> <button class="user-menu__link user-menu__link--login js-ejp-login-btn btn btn-default navbar-button" type="button" data-config="{"eventName":"login","eventDetail":{},"isNull":false}"> <span>Login</span> </button> </div> <div id="ctl00_ctl51_TopNavigationMenuConfiguration" style="display:none" class="js-top-navigation-menu-configuration" data-config="{"browsingHistory":{"isEnabled":true,"serviceUrl":"https://apim-hlrp-ejp-prod.azure-api.net/ee","pdfDownloadUrl":"/_layouts/15/oaks.journals/downloadpdf.aspx?trckng_src_pg=HistoryTab"}}"></div> <div id="zz1_TopNavigationMenu" class="navbar-collapse collapse js-top-navigation-menu noindex ms-core-listMenu-horizontalBox"> <ul id="zz2_RootAspMenu" class="root ms-core-listMenu-root static"> <li class="static dynamic-children"><span class="static dynamic-children menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode"><span aria-haspopup="true" class="additional-background ms-navedit-flyoutArrow dynamic-children"><span class="menu-item-text">Articles & Issues</span></span></span><ul aria-hidden="true" class="dynamic"> <li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/ajg/pages/currenttoc.aspx" accesskey="1"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Current Issue</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/ajg/pages/issuelist.aspx"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Previous Issues</span></span></a></li><li class="dynamic"><a class="dynamic menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode" href="/ajg/toc/latest"><span class="additional-background ms-navedit-flyoutArrow"><span class="menu-item-text">Latest Articles</span></span></a></li> </ul></li><li class="static dynamic-children"><span class="static dynamic-children menu-item ms-core-listMenu-item ms-displayInline ms-navedit-linkNode"><span aria-haspopup="true" class="additional-background ms-navedit-flyoutArrow dynamic-children"><span class="menu-item-text">For 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Double-Blind, Controlled Trial of Percutaneous Tibial Nerve Stimulation With Pelvic Floor Exercises in the Treatment of Childhood Constipation', '01132023', 'Zheng-tong Yu, Jun-Min Song, Lei Qiao, et al', '118', '3', '\u00A9 2023 by The American College of Gastroenterology', '00000434-202303000-00036', '', false, ''); } </script> <div id="ArticleContainer"> <article id="ej-abstract-view" xmlns:ssr="http://ssr-eus-go-csi.cloudapp.net/v1/assets" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xhtml="http://www.w3.org/1999/xhtml"><section class="ejp-r-article-subsection"><div class="ejp-r-article-subsection__text">ARTICLE: PEDIATRICS</div></section><header class="ejp-article-header"><h1 class="ejp-article-title">A Randomized, Double-Blind, Controlled Trial of Percutaneous Tibial Nerve Stimulation With Pelvic Floor Exercises in the Treatment of Childhood Constipation</h1></header><section id="ejp-article-authors"><p id="P7">Yu, Zheng-tong MD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sup>; Song, Jun-Min MD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">2,*</sup>; Qiao, Lei MD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">3,*</sup>; Wang, Yang MD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sup>; Chen, Ying MD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sup>; Wang, En-Hui MD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sup>; Zhang, Shu-Cheng MD<sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sup></p><section><a href="#" id="ejp-article-authors-link"> Author Information <i class="wk-icon-arrow-down-r"></i></a></section></section><section id="ejp-article-authors-info" class="ejp-article-authors-info ejp-article-authors-info--hidden"><div class="ejp-article-authors-info-holder"> <p id=""><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">1</sup>Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China;</p> <p id=""><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">2</sup>Department of Gastroenterology, Shengjing Hospital of China Medical University, Shenyang, China;</p> <p id=""><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">3</sup>Department of General Surgery, Shengjing Hospital of China Medical University, Shenyang, China.</p> <p id="cor1"><strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">Correspondence:</strong> Shu-Cheng Zhang, MD. E-mail: <span><a href="/cdn-cgi/l/email-protection#1f727e76736b702565777e71786c776a7c777a717828295f2e2d29317c7072" onclick="javascript:window.open('mailto:mailto:zhangshucheng76@126.com');return false"><span class="__cf_email__" data-cfemail="067c6e676861756e73656e6368613130463734302865696b">[email protected]</span></a></span>.</p> <p id=""><strong xmlns:mrws="http://webservices.ovid.com/mrws/1.0">SUPPLEMENTARY MATERIAL</strong> accompanies this paper at <span><a href="https://links.lww.com/AJG/C870" onclick="javascript:window.open('https://links.lww.com/AJG/C870');return false">https://links.lww.com/AJG/C870</a></span></p> <p id="fn1"><sup xmlns:mrws="http://webservices.ovid.com/mrws/1.0">*</sup>Jun-Min Song has equal rights with the corresponding author of Shu-Cheng Zhang, and Lei Qiao has equal rights with the first author of Zheng-tong Yu.</p> </div></section><section id="article-journal-info"><div class="ej-journal-info"><span class="ej-journal-name">The American Journal of Gastroenterology </span><span id="ej-journal-date-volume-issue-pg"><a href="/ajg/toc/2023/03000">118(3):p 553-560, March 2023.</a></span><span> | </span><span class="ej-journal-doi">DOI: </span>10.14309/ajg.0000000000002188</div></section><section id="ejp-article-indicators" class="ejp-article-indicators"><ul class="ejp-article-indicators__list"> <li id="ej-article-indicators-buy" class="ejp-article-indicators__list-item" onmouseover="javascript:Tooltip_Buy()" onmouseout="javascript:Tooltip_MouseOut()"><a href="#ContentAccessOptions"><span class="ejp-indicator">Buy</span></a></li> <li id="ej-article-indicators-sam" class="ejp-article-indicators__list-item" onmouseover="javascript:Tooltip_SDC()" onmouseout="javascript:Tooltip_MouseOut()"><span class="ejp-indicator">SDC</span></li> <li id="ej-article-indicators-imageabstract" class="ejp-article-indicators__list-item" onmouseover="javascript:Tooltip_ImageAbstract()" onmouseout="javascript:Tooltip_MouseOut()"><span class="ejp-indicator">Infographic</span></li> <li class="ejp-article-indicators__list-item" onmouseover="javascript:Tooltip_CustomIndicator('RCT', 'Randomized Controlled Trial')" onmouseout="javascript:Tooltip_MouseOut()"><span><img src="/ajg/PublishingImages/CCIs/rct-icon.png" Alt="RCT" Border="0"></span></li> </ul><button id="openArticleMetricsPopupButton" type="button" class="wk-button wk-button-ghost wk-button-icon-left ejp-article-metrics-btn" data-articleMetricsEndpoint="//services.journals.lww.com/IntegrationServices/ArticleMetricsService.svc" data-articleMetricsDetailsUrl="https://wolterskluwer.altmetric.com/details/" data-doi="10.14309/ajg.0000000000002188" data-suiteId="vrs_woltere_journalsglobalvrs" data-articlePublicationDate="2023-01-13" data-articlePublicationDateString="January 13, 2023" data-receivedDate="2022-11-04" data-revisionReceivedDate="" data-acceptedDate="2023-01-10" data-crossrefRefLinkRoot="https://doi.org/" data-medlineRefLinkRoot="http://www.ncbi.nlm.nih.gov/pubmed/" data-pubMedId="36734654"><i class="wk-icon-filled-chart-r"></i><i class="wk-icon-filled-chart-white-r"></i> Metrics </button></section><section class="ejp-article-tabs" id="abstractWrap"><h2 class="ejp-article-tabs-heading">Abstract</h2> <div class="ejp-article-tabs__tabpanel" id="panel1" role="tabpanel" aria-labelledby="tab1"> <div id="article-abstract-content1"> <div class="ejp-article-text-abstract"> <h3>INTRODUCTION: </h3> <p>The management of childhood constipation is challenging. Pelvic floor dysfunction (PFD) is one of the most common causes of childhood constipation. Percutaneous tibial nerve stimulation (PTNS) with pelvic floor exercises (PFE) has achieved a satisfactory outcome in the elderly individuals and women with PFD. The efficacy of PTNS with PFE in childhood constipation has not been established.</p> <h3>METHODS: </h3> <p>A randomized, double-blind, controlled trial with 84 children who met the inclusion criteria was conducted. All participants were randomly assigned to PTNS with PFE or sham PTNS with PFE groups and received their individual intervention for 4 weeks with a 12-week follow-up evaluation. The spontaneous bowel movements (SBM) ≥3 per week were the main outcomes, and the risk ratio (RR) with 95% confidence interval (CI) were calculated. High-resolution anorectal manometry and surface electromyography were used for the assessment of pelvic floor function, and the adverse effects were assessed based on symptoms.</p> <h3>RESULTS: </h3> <p>At the end of the follow-up period, 26 patients (61.9%) in the PTNS with PFE group and 15 patients (35.7%) in the sham group had ≥3 SBM per week compared with baseline (net difference 26.2%, 95% CI 5.6%–46.8%; RR 2.750, 95% CI 1.384–5.466; <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> < 0.05). PFD remission occurred in 49 children, 33 (78.6%) in the PTNS with PFE group and 16 (38.1%) in the sham group (RR 2.063, 95% CI 1.360–3.128, <em xmlns:mrws="http://webservices.ovid.com/mrws/1.0">P</em> < 0.05). No adverse effects occurred.</p> <h3>DISCUSSION: </h3> <p>PTNS with PFE is a safe and effective method in the treatment of childhood constipation, particularly in children with PFD or dyssynergic defecation.</p> </div> <div class="ejp-article-graphical-abstract" id=""> <div class="ejp-article-graphical-abstract-container"> <p id="JCL-P-6"><section class="ejp-r-article-images"><figure class="ejp-r-article-images__figure"><a href="/_layouts/oaks.journals/ImageView.aspx?k=ajg:2023:03000:00036&i=ga&year=2023&issue=03000&article=00036" target="_blank" class="ejp-r-article-images__image-link"><img class="ejp-r-article-images__img js-lazy-load lazy-load" src="javascript:void(0);" data-src="https://images.journals.lww.com/ajg/GAPreview.00000434-202303000-00036.ga.jpeg" data-srcset="https://images.journals.lww.com/ajg/GAPreview@2.00000434-202303000-00036.ga.jpeg 2x" srcset="" alt="Abstract"></a></figure></section><a class="ejp-article-graphical-abstract__export-link" 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id="ctl00_ctl29_g_05816bca_ab8a_4648_9820_e541e93c2483_ctl00_slideShowUserControl_sourceArticleUrl" onclick="HideSlideShow();">A Randomized, Double-Blind, Controlled Trial of Percutaneous Tibial Nerve Stimulation With Pelvic Floor Exercises in the Treatment of Childhood Constipation</a> </div> <div id="ctl00_ctl29_g_05816bca_ab8a_4648_9820_e541e93c2483_ctl00_slideShowUserControl_citationdiv" class="wk-modal-slideshow__source-citation mb4"> Official journal of the American College of Gastroenterology | ACG118(3):553-560, March 2023. </div> </div> </div> <div class="modal-footer wk-modal-footer wk-modal-slideshow__footer pa2 flex flex-column flex-wrap"> <div class="wk-modal-slideshow__zoom-controls flex justify-between items-center mb2"> <div id="zoom_buttons" class="wk-modal-slideshow__zoom-buttons flex justify-between"> <a href="#" onmousedown="$('#zoom_container').z('zoomIn')" onclick="return false" title="Zoom In" class="ph3"><i class="fa fa-plus-square white"></i></a> <a href="#" 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}); Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","DropShadow":true,"PopupControlID":"ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_pnlSubscribeToEtoc","dynamicServicePath":"/ajg/pages/articleviewer.aspx","id":"subscribeToEtoc"}, null, null, $get("ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_dummyTargetControl")); }); document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError').dispose = function() { Array.remove(Page_Validators, document.getElementById('ctl00_ctl51_Header_UserActionTools_SubscribeToEtocPopupControl_cvEmailError')); } g_QuickLaunchControlIds.push("zz1_TopNavigationMenu");_spBodyOnLoadFunctionNames.push('QuickLaunchInitDroppable'); var g_zz1_TopNavigationMenu = null; function init_zz1_TopNavigationMenu() { if (g_zz1_TopNavigationMenu == null) g_zz1_TopNavigationMenu = $create(SP.UI.AspMenu, null, null, null, $get('zz1_TopNavigationMenu')); 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}); Sys.Application.add_init(function() { $create(AjaxControlToolkit.ModalPopupBehavior, {"BackgroundCssClass":"Popup-Overlay","PopupControlID":"ctl00_ctl29_g_05816bca_ab8a_4648_9820_e541e93c2483_ctl00_emailToColleague_pnlEmailToColleague","dynamicServicePath":"/ajg/pages/articleviewer.aspx","id":"emailToColleaguePopupExtender_217635073"}, null, null, $get("ctl00_ctl29_g_05816bca_ab8a_4648_9820_e541e93c2483_ctl00_emailToColleague_hypEmailToColleague")); }); //]]> </script> </form> <span id="DeltaPlaceHolderUtilityContent"> </span> <script type="text/javascript">// <![CDATA[ var g_Workspace = "s4-workspace"; // ]]> </script> <div id="ctl00_ctl64_divAdConfig" data-adconfig="{"adTitle":"Advertisement","slotClass":"ad-slot-container","topBanner":{"sticky":"true","stickyDuration":"5000"},"lazyLoadingEnabled":false,"npiHash":"","pageTargeting":{"ArticleId":"00000434-202303000-00036"}}" data-videoadconfig="{"serverURL":"https://pubads.g.doubleclick.net/gampad/ads","sizes":"320x180|640x360","overlayUnitPath":"/15726702761/Desktop/ajg/Video/overlay","prerollUnitPath":"/15726702761/Desktop/ajg/Video/pre-roll","postrollUnitPath":"/15726702761/Desktop/ajg/Video/post-roll"}" class="js-ad-config"> </div> <div id="ctl00_ctl64_divScripts"><script type="text/plain" async="async" src="https://securepubads.g.doubleclick.net/tag/js/gpt.js" class="optanon-category-C0004"></script> <script type="text/javascript" src="https://lww.com/_layouts/15/oaks.journals/core/ads.js?v=05.24.00.023" defer="true"> </script> </div>  <script type="text/javascript"> (function($) { if (false) { $(".top-microbar-container").addClass('top-microbar-container-moved').insertAfter(".advertisement-content_top"); 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