bluuebunny/crossref_metadata_2025_split huggingface dataset:
School-Based Exercise Intervention Improves Blood Pressure and Parameters of Arterial Stiffness in Children: A Randomized Controlled Trial
Authors: Ketelhut Sascha , Ketelhut Sebastian R. , Ketelhut Kerstin 
Published: September 2020

Purpose: To evaluate the effectiveness of a school-based exercise intervention on endurance performance (EP), blood pressure (BP), and arterial stiffness in children. Methods: A total of 105 students (mean age = 8.2 [0.6] y; 51% girls; body mass index = 17.8 [3.0] kg/m2) were randomized to the intervention group (IG, n = 51) and control group (CG, n = 54). During a 37-week experimental period, the IG received an exercise intervention (2 × 45 min/wk) in addition to their regular school physical education class (3 × 45 min/wk). EP, peripheral and central BP, pulse pressure, augmentation pressure, augmentation index, and aortic pulse wave velocity were assessed. Results: Following the intervention, significant changes (P < .05) in EP, peripheral and central systolic BP, pulse pressure, augmentation pressure, augmentation index, and aortic pulse wave velocity were found in the IG. Children in the CG displayed significant changes in peripheral and central diastolic BP. An analysis of the baseline-to-post changes revealed significant between-group differences in EP (P < .001), pulse pressure (P = .028), augmentation pressure (P = .007), and aortic pulse wave velocity (P = .037) that favored the IG and in peripheral and central diastolic BP that favored the CG. Conclusion: The school-based exercise intervention had beneficial effects not only on EP but also on different hemodynamic parameters.
Intravenous paracetamol for neonates: long-term diseases not escalated during 5 years of follow-up
Authors: Juujärvi Sanna , Saarela Timo , Pokka Tytti , Hallman Mikko , Aikio Outi 
Published: September 2020

ObjectiveTo evaluate the long-term adverse reactions of paracetamol in children who required intensive care shortly after birth. Paracetamol is a widely used analgesic in neonates, but the long-term studies are lacking. Previous epidemiological studies have reported associations between early paracetamol intake and diseases in childhood.DesignFive-year follow-up cohort of children who required intensive care shortly after birth.SettingSingle tertiary care hospital; neonatal and paediatric intensive care units.InterventionsIntravenous paracetamol was administered for pain and discomfort to the neonates during their intensive care, while for the control infants, it was not available.Main outcome measuresThe primary outcome was the incidence of asthma; secondary outcomes were neonatal diseases and long-term morbidities (atopic dermatitis, inflammatory bowel disease, autism, speech disorders, cerebral palsy). Long-term morbidities were adjusted based on antenatal and neonatal risk factors.ResultsWe screened all neonates admitted to the intensive care units soon after birth in Oulu University Hospital, Oulu, Finland, during 1 October 2007 to 31 December 2013. Altogether, 1552 infants needed intensive care. Of them, 735 (47%) were treated with intravenous paracetamol. We obtained their long-term data from the Finnish National Institute for Health and Welfare, including all physician-made diagnoses from all primary healthcare units and hospitals in Finland. We found no difference in the asthma incidence or in other long-term morbidities between paracetamol-treated and non-exposed infants.ConclusionsIntravenous paracetamol given to neonates did not associate with childhood disorders compared with the non-exposed infants during the 5-year follow-up. The previous hypothesis that early paracetamol use causes childhood morbidities was not confirmed.
Clinical presentation of paediatric patients with COVID-19 admitted to a single paediatric intensive care unit (PICU) in Iran
Authors: Saeed Amir , Shorafa Eslam , Sanaeidashti Anahita , Kadivar Mohammad Rahim 
Published: September 2020

ObjectivesTo describe the clinical characteristics of paediatric patients admitted to a single paediatric intensive care unit (PICU) in Iran with COVID-19.MethodsA cross-sectional study of paediatric patients who were admitted to a COVID-19-dedicated PICU from 16 March 2020 to 21 April 2020 with COVID-19.ResultsSix children had confirmed COVID-19 and four had suspected COVID-19. Six had pre-existing chronic medical conditions. Nine had respiratory failure and needed ventilation. Five children, of whom four had chronic medical conditions, died. Four had cardiac arrhythmias. Clinical presentation included fever and cough.ConclusionCOVID-19 can be fatal in paediatric patients, especially in those with a chronic medical condition.
Determining child drowning mortality in the Sundarbans, India: applying the community knowledge approach
Authors: Gupta Medhavi , Bhaumik Soumyadeep , Roy Sujoy , Panda Ranjan Kanti , Peden Margaret , Jagnoor Jagnoor 
Published: September 2020

BackgroundThe Sundarbans in India is a rural, forested region where children are exposed to a high risk of drowning due to its waterlogged geography. Current data collection systems capture few drowning deaths in this region.MethodsA community-based survey was conducted in the Sundarbans to determine the drowning mortality rate for children aged 1 to 4 years and 5 to 9 years. A community knowledge approach was used. Meetings were held with community residents and key informants to identify drowning deaths in the population. Identified deaths were verified by the child’s household through a structured survey, inquiring on the circumstances around the drowning death.ResultsThe drowning mortality rate for children aged 1 to 4 years was 243.8 per 100 000 children and for 5 to 9 years was 38.8 per 100 000 children. 58.0% of deaths were among children aged 1 to 2 years. No differences in rates between boys and girls were found. Most children drowned in ponds within 50 metres of their homes. Children were usually unaccompanied with their primary caretaker engaged in household work. A minority of children were treated by formal health providers.ConclusionsDrowning is a major cause of death among children in the Sundarbans, particularly those aged 1 to 4 years. Interventions keeping children in safe spaces away from water are urgently required. The results illustrate how routine data collection systems grossly underestimate drowning deaths, emphasising the importance of community-based surveys in capturing these deaths in rural low- and middle-income country contexts. The community knowledge approach provides a low-resource, validated methodology for this purpose.
Nuclear currents in chiral effective field theory
Authors: Krebs Hermann 
Published: September 2020

AbstractIn this article, we review the status of the calculation of nuclear currents within chiral effective field theory. After formal discussion of the unitary transformation technique and its application to nuclear currents we give all available expressions for vector, axial-vector currents. Vector and axial-vector currents are discussed up to order Q with leading-order contribution starting at order $$Q^{-3}$$

Q

-
3

. Pseudoscalar and scalar currents will be discussed up to order $$Q^0$$

Q
0

with leading-order contribution starting at order $$Q^{-4}$$

Q

-
4

. This is a complete set of expressions in next-to-next-to-next-to-leading-order (N$$^3$$

3

LO) analysis for nuclear scalar, pseudoscalar, vector and axial-vector current operators. Differences between vector and axial-vector currents calculated via transfer-matrix inversion and unitary transformation techniques are discussed. The importance of a consistent regularization is an additional point which is emphasized: lack of a consistent regularization of axial-vector current operators is shown to lead to a violation of the chiral symmetry in the chiral limit at order Q. For this reason a hybrid approach at order Q, discussed in various publications, is non-applicable. To respect the chiral symmetry the same regularization procedure needs to be used in the construction of nuclear forces and current operators. Although full expressions of consistently regularized current operators are not yet available, the isoscalar part of the electromagnetic charge operator up to order Q has a very simple form and can be easily regularized in a consistent way. As an application, we review our recent high accuracy calculation of the deuteron charge form factor with a quantified error estimate.
Enhancement of superluminal weak values under Lorentz boost
Authors: Som Abhishek , Das Sourin 
Published: September 2020

The local group velocity defined as the weak value of the velocity operator in (1 + 1)-dimensional Klein-Gordon and Dirac theory is studied. As shown by Berry [J. Phys. A 45, 185308 (2012)], when the pre- and post-selected states for evaluating the weak value are chosen at random from an ensemble of available states, it gives rise to a universal probability distribution for the local group velocity which can have both subluminal and superluminal components. In this work, we explore the possibility of enhancement of the superluminal fraction of this total probability distribution by applying a Lorentz boost and show that it can indeed be enhanced both in the case of Klein–Gordon and Dirac theories.
Hydrological system in Quaternary clastic deposits, Mehedinţi County, Romania: isotope composition, chemistry and radiocarbon dating
Authors: Bojar Ana-Voica , Chmiel Stanislaw , Bojar Hans-Peter , Varlam Carmen , Barbu Victor 
Published: September 2020

Abstract

A groundwater geochemistry study was carried out on 24 samples collected from different springs and wells situated in a plateau area at an elevation of 200–300 m in the Mehedinţi County, southwestern Romania. The study was motivated by the fact that springs have represented the only source of potable water in the region, only recently completed by tens of metres-deep well drillings. Spring distributions and geological data reveal the presence of a multilayered system situated in the Lower Quaternary deposits. The mean
δ
18
O and
δ
D values of groundwater, −9.8 and −67.8‰, respectively, reflect the yearly weighted mean of the isotopic composition of precipitation, demonstrating locally derived recharge. The Piper ternary diagrams indicate that the dominant hydrochemical type is HCO
3
−
–Ca
2+
–Mg
2+
with transition towards higher SO
4
2−
and Mg
2+
contents to the deeper aquifer. The anions vary from HCO
3
−
with transition to no dominant type and with Cl
−
contents higher for the shallower aquifer. The sequence of abundance of cations is generally Ca
2+
> Mg
2+
> K
+
> Na
+
and for anions: HCO
3
−
> SO
4
2−
> Cl
−
> NO
3
−
> F
−
. Radiocarbon dating of dissolved inorganic carbon indicates a subrecent recharge of the aquifers. The vertical and lateral variations in groundwater chemistry may vary, and are influenced by lateral lithologic variation of the Quaternary clastic deposits. This is an unpredictable quality factor when taking the decision for the drinking water drill locations.
Intratumoral Immunotherapy: From Trial Design to Clinical Practice
Authors: Champiat Stéphane , Tselikas Lambros , Farhane Siham , Raoult Thibault , Texier Matthieu , Lanoy Emilie , Massard Christophe , Robert Caroline , Ammari Samy , De Baère Thierry , Marabelle Aurélien 
Published: September 2020

AbstractSystemic immunotherapies such as immune checkpoint blockade targeted at PD(L)1 and CTLA4 have demonstrated their ability to provide durable tumor responses and long-term overall survival benefits for some patients in several solid tumor types. However, a majority of patients remain resistant to these treatments and a significant proportion of them develop severe autoimmune and inflammatory adverse events. Preclinical studies have demonstrated that intratumoral injections of immunostimulatory products (oncolytics, pattern recognition receptor agonists,…) that are able to trigger type I IFN release and enhance tumor antigen presentation on immune cells could generate a strong antitumor immunity and overcome the resistance to systemic immune checkpoint blockade therapies. The intratumoral immunotherapy strategies that are currently in clinical development offer a unique therapeutic and exploratory setting to better understand the immune contexture across tumor lesions of patients with metastatic cancer. Also these local therapeutic products could turn cold tumors into hot and improve the response rates to cancer immunotherapies while diminishing their systemic exposure and toxicities. Intratumoral immunotherapies could prime or boost the immunity against tumors and therefore radically change the combinatorial therapeutic strategies currently pursued for metastatic and local cancers to improve their long-term survival. We aimed to review and discuss the scientific rationale for intratumoral immunotherapy, the challenges raised by this strategy in terms of drug development within clinical trials and the current state-of-the-art regarding the clinical practice of this innovative approach.
Pediatric PK/PD Phase I Trial of Pexidartinib in Relapsed and Refractory Leukemias and Solid Tumors Including Neurofibromatosis Type I–Related Plexiform Neurofibromas
Authors: Boal Lauren H. , Glod John , Spencer Melissa , Kasai Miki , Derdak Joanne , Dombi Eva , Ahlman Mark , Beury Daniel W. , Merchant Melinda S. , Persenaire Christianne , Liewehr David J. , Steinberg Seth M. , Widemann Brigitte C. , Kaplan Rosandra N. 
Published: September 2020

Abstract

Purpose:
Simultaneously targeting the tumor and tumor microenvironment may hold promise in treating children with refractory solid tumors. Pexidartinib, an oral inhibitor of tyrosine kinases including colony stimulating factor 1 receptor (CSF-1R), KIT, and FLT3, is FDA approved in adults with tenosynovial giant cell tumor. A phase I trial was conducted in pediatric and young adult patients with refractory leukemias or solid tumors including neurofibromatosis type 1–related plexiform neurofibromas.

Patients and Methods:
A rolling six design with dose levels (DL) of 400 mg/m2, 600 mg/m2, and 800 mg/m2 once daily for 28-day cycles (C) was used. Response was assessed at regular intervals. Pharmacokinetics and population pharmacokinetics were analyzed during C1.

Results:
Twelve patients (4 per DL, 9 evaluable) enrolled on the dose-escalation phase and 4 patients enrolled in the expansion cohort: median (lower, upper quartile) age 16 (14, 16.5) years. No dose-limiting toxicities were observed. Pharmacokinetics appeared linear over three DLs. Pharmacokinetic modeling and simulation determined a weight-based recommended phase II dose (RP2D). Two patients had stable disease and 1 patient with peritoneal mesothelioma (C49+) had a sustained partial response (67% RECIST reduction). Pharmacodynamic markers included a rise in plasma macrophage CSF (MCSF) levels and a decrease in absolute monocyte count.

Conclusions:
Pexidartinib in pediatric patients was well tolerated at all DL tested, achieved target inhibition, and resulted in a weight-based RPD2 dose.
Shorter Storage Time Is Strongly Associated With Improved Graft Survivorship at 5 Years After Osteochondral Allograft Transplantation
Authors: Merkely Gergo , Ackermann Jakob , Farina Evan M. , VanArsdale Courtney , Lattermann Christian , Gomoll Andreas H. 
Published: September 2020

Background: Current regulations surrounding the use of osteochondral allografts (OCAs) in the United States require delayed graft release after 14 days to complete infectious disease screening. With a generally accepted expiration time of 28 days in storage, a limited window from 14 to 28 days remains for implantation. Yet, the rates of graft survival and thus optimal time for transplantation within this window remain largely unknown. Hypothesis: OCAs transplanted within 19 to 24 days would have lower failure rates at 5 years than those transplanted at 25 to 27 days. Study Design: Cohort study; Level of evidence, 3. Methods: In this retrospective case series, we analyzed data from patients who underwent OCA transplantation (N = 111) by a single surgeon between February 2014 and December 2016 with at least 2-year follow-up. In total, 56 patients received early transplant grafts (storage time, 19-24 days), and 55 received late transplant grafts (storage time, 25-27 days). Survival analysis with Kaplan-Meier curves was performed using log-rank analysis to compare the groups. Multivariable Cox regression analysis was used to assess the influence of OCA storage duration on graft survival while adjusting for age and defect size. Optimal storage time cutoff associated with graft failure was identified by performing receiver operating characteristic curve analysis and calculating the area under the curve. Results: Patients in the late transplant group had a significantly lower rate of graft survival at 5 years postoperatively (70.4%) as compared with patients in the early transplant group (93.1%; P = .027). When correcting for patient age and defect size, late transplant OCAs demonstrated a 3.4-times greater likelihood of failure versus early transplant OCAs. Receiver operating characteristic analysis suggested that OCA transplantation should ideally occur before 25 days of graft storage. Conclusion: OCA transplantation is a safe and successful treatment option for large osteochondral defects of the knee, with excellent rates of in situ graft survival at 5 years. Prioritizing early transplantation of OCAs to <25 days in storage improves rates of graft survival.
Managing Severe Chronic Breathlessness in Chronic Obstructive Pulmonary Disease Is Challenging for General Practitioners
Authors: Politis John , Eastman Peter , Le Brian , Furler John , Irving Louis , Smallwood Natasha 
Published: September 2020

Context: Patients with advanced chronic obstructive pulmonary disease (COPD) can develop increasing breathlessness, which can persist despite optimal medical management—refractory breathlessness. Management can be challenging for all clinicians and requires a broad approach that includes optimization of disease directed therapies, non-pharmacological strategies to manage breathlessness and for some patients opioids. Objectives: To explore the approaches to breathlessness management and palliative care undertaken by Australian General Practitioners (GP) for patients with severe COPD and refractory breathlessness. Methods: A case-vignette based survey was conducted with Australian GPs to determine their approaches to breathlessness management and palliative care in COPD. Results: Of the 137 GPs, 66% recommended commencing an additional medication to manage refractory breathlessness. Thirty-eight GPs (28%) recommended opioids and 26 (19%) recommended guideline discordant treatments. Two-thirds of GPs had concerns regarding the use of opioids in COPD. Half (55%) of GPs were comfortable providing general palliative care to patients with COPD and 62 (45%) had referred patients with COPD to specialist palliative care services. Most respondents wanted further training to manage severe COPD and severe chronic breathlessness. Conclusion: Most GPs recognized and were willing to add specific treatments for severe chronic breathlessness. However, experience prescribing opioids for severe chronic breathlessness was low, with many practitioners holding significant concerns regarding adverse effects. Many GPs are uncomfortable offering a palliative approach to their COPD patients, yet these patients are not routinely referred to specialist palliative care services despite their immense needs. GPs therefore desire education and support to overcome these barriers.
Role of SMARCA4 (BRG1) and SMARCB1 (INI1) in Dedifferentiated Endometrial Carcinoma With Paradoxical Aberrant Expression of MMR in the Well-Differentiated Component: A Case Report and Review of the Literature
Authors: Kaur Ramandeep , Mehta Jay , Borges Anita M. 
Published: September 2020

Introduction Dedifferentiated endometrial carcinoma is an uncommon highly aggressive uterine tumor. It comprises 2 components: a well-differentiated, low-grade epithelial carcinoma and an undifferentiated carcinoma. The undifferentiated carcinoma frequently exhibits rhabdoid cytologic features. Many of these tumors are characterized by an aberrant switch/sucrose non-fermenting (SWI/SNF) complex. They may also exhibit aberrant expression of mismatch repair (MMR) proteins. Together, these play an important role in the pathogenesis and aggressive nature of the tumor. Material and Methods We present a case of dedifferentiated endometrial carcinoma in a 63-year-old female showing loss of expression of SWI/SNF-related, matrix-associated, actin-dependent regulator of chromatin, subfamily A, member 4 (SMARCA4/BRG1), and aberrant expression of MMR proteins. We also review the literature starting from the earliest recognition of this entity and the various studies done to explain its molecular pathogenesis and prognostic importance. Results and Conclusions Recognition of SWI/SNF complex-deficient dedifferentiated endometrial carcinoma is important as these tumors do not respond to platinum-based chemotherapy, and consideration of alternative therapies is often necessary. We also want to emphasize that though most of the studies have found MMR deficiency in the undifferentiated carcinoma component, it may be seen only in the low-grade, well-differentiated component, as observed in this case.
Cyto-SAT: A self-assessment tool for the safe handling of cytotoxic drugs adapted for use in low- and middle-income countries
Authors: von Grünigen Sandrine , Geissbühler Antoine , Bonnabry Pascal 
Published: September 2020

Introduction The handling of cytotoxic medicines is a high-risk process for human and environmental health. Considering the rising burden of cancer in low- and middle-income countries (LMICs), we aimed to develop, validate, and pilot test a self-assessment tool to support the implementation of safe handling practices and promote continuous quality improvement for cytotoxic drug management in LMICs. Methods First, the self-assessment tool Cyto-SAT was developed and validated. Key sources on the safe handling of cytotoxic medicines were reviewed to derive items addressing safety and quality aspects at every stage of the process. A two-round online Delphi survey was conducted to validate and prioritize the items. The validation rules in the first and second rounds were defined as ≥65% and ≥75% agreement, respectively. Then, intended users in healthcare facilities in LMICs evaluated the Cyto-SAT tool in a pilot test. They were asked to fill out an online evaluation questionnaire. Results Twenty-seven experts from 13 high-income countries and LMICs participated in the Delphi survey. Final expert consensus was achieved for 134/137 (97.8%) items. Consensus on priority was achieved for 52 of 134 (38.8%) items. The final Cyto-SAT tool comprises 134 items in 10 domains and 28 subdomains covering the whole cytotoxic drug handling process ( https://pharmed.datapharma.ch/cyto-sat_en/ ). Staff from 34 institutions in 28 LMICs completed the Cyto-SAT evaluation. Almost all of them reported total agreement or agreement with its usefulness (96%), applicability (94%), usability (98%), and acceptability (97%). Conclusion Cyto-SAT is the first self-assessment tool designed to assist professionals in LMICs in the safe handling of cytotoxic drugs. The pilot test revealed that Cyto-SAT is a useful and highly appreciated tool that supports practice improvement in LMICs. Cyto-SAT will be used in an international survey to obtain a global overview of handling practices in various LMIC settings.