bluuebunny/crossref_metadata_2025_split huggingface dataset:
#22: Clinical Significance of Human Herpes Virus 6 Positivity in Children
Authors: Kinler Zachary K , Inagaki Kengo , Galloway Regina , Palmer April L , Santos Roberto P 
Published: June 2021

Abstract

Background
Human Herpes Virus 6 (HHV6) is a common childhood disease that is typically mild, however, cases where it is the causative agent of meningitis/encephalitis (ME) have been reported. The treatment for HHV6 ME consists of ganciclovir, which is associated with bone marrow suppression and renal insufficiency. While the clinical significance of the presence of HHV6 in cerebrospinal fluid (CSF) in adults has been studied, there is a paucity of research on the clinical significance of HHV6 in the CSF of children with ME. We want to determine if there is clinical significance to HHV6 positivity in the CSF of children.

Methods
20 patients were included whose CSF tested positive for HHV6 on the CSF ME panel from Jan 1, 2017 to May 20, 2020. We obtained a sample of 80 patients whose CSF tested negative for every pathogen on the same CSF ME panel from the same period. Logistic regression was used based on age, sex, race/ethnicity, admission to neonatal intensive care unit (NICU)/pediatric intensive care unit (PICU), clinical presentation, and presence of abnormalities on neuroimaging to determine the propensity score matching (PSM) for each patient. (Table I) The HHV6 positive patients were matched with patients who tested negative for every pathogen on the panel at a 1:1 ratio and within a caliper size of 0.25. The odds ratio (OR) of neurological sequelae at discharge was determined by performing a logistic regression based on HHV6 status in both the group with PSM and without PSM. The length of stay between the HHV6 positive group and the control group were compared with and without PSM using Mann-Whitney U test with p&lt;0.05 considered significant

Results
The OR for HHV6 positivity and experiencing neurological sequelae is 1.35 with a 95% confidence interval (CI) 0.133,13.721 (p=0.799) when compared to the control group without PSM. The OR for HHV6 positivity and experiencing neurological sequelae is 1 with a 95% CI 0.063, 15.988 (p=0.549) when compared to the control group with PSM. Table I shows the neurological sequelae between the HHV6 positive group, control group without PSM and the control group with PSM. It shows the Mann-Whitney U test comparing HHV6 status to the median length of hospital stay in both unmatched- and matched cohorts. We failed to reject the null hypothesis that there was a difference in the median length of hospital stay between HHV6 positive patients and all negative patients with and without PSM.

Conclusion
There is no clinical significance of HHV6 detection on the CSF ME panel in children as well as no statistical significance between the median length of hospital stay among HHV6 positive patients and all negative patients. Further, 10% of the HHV6 positive patients were inappropriately started on ganciclovir. Development of a consensus statement is in place regarding releasing the result of a positive HHV6 from the ME panel only among immunocompromised children to prevent inappropriate antiviral therapy.
#33: Single-cell RNA sequencing analysis of Zika virus infection in human stem cell-derived neuroprogenitor cells and cerebral organoids
Authors: Ocwieja K E , Hughes T K , Baker C C M , Stanton A C , Antonucci J M , Richards A L , Shalek A , Jaenisch R , Gehrke L 
Published: June 2021

Abstract

Background
The molecular mechanisms underpinning the neurologic and congenital pathologies caused by Zika virus (ZIKV) infection remain poorly understood. It is also unclear why congenital ZIKV disease was not reported prior to the recent epidemics in French Polynesia and the Americas, despite evidence that Zika virus has actively circulated in parts of Africa and Asia since 1947 and 1966, respectively.

Methods
Due to advances in the stem cell-based technologies, we can now model ZIKV infections of the central nervous system in human stem cell-derived neural progenitor cells and cerebral organoids, which recapitulate complex 3-dimensional neural architecture. We apply Seq-Well — a simple, portable platform for massively parallel single-cell RNA sequencing — to characterize these neural models infected with ZIKV. We detect and quantify host mRNA transcripts and viral RNA with single-cell resolution, thereby defining transcriptional features of both uninfected and infected cells.

Results
Although flavivirus RNAs lack a poly(A) tail, we present evidence that viral RNAs are specifically primed for reverse transcription at internal runs of adenosines, and that sequencing reads cover the entire non-polyadenylated viral genome. In neural progenitor cells, single cell sequencing reveals that while uninfected bystander cells strongly upregulate interferon pathway genes, these pathways are largely suppressed in cells infected with ZIKV within the same culture dish. Single cell sequencing identifies multiple cell types in our cerebral organoids including neural progenitor cells, intermediate progenitor cells, and neurons of varied maturity. Using this model, we find that neurons, not typically considered targets of ZIKV in the developing brain, contain high copy numbers of ZIKV genomes. It remains uncertain whether neurons are directly infected, or if infected neural progenitor cells differentiate into neurons, carrying virus with them. Notably, the neuronal bystander cell population shows limited interferon gene pathway upregulation compared to neural progenitors.

Conclusions
Overall, our work provides insight into the pathogenesis of ZIKV associated microcephaly, identifies potential new tropisms of ZIKV in the human brain, and suggests that both virus replication and host response mechanisms underlie the neuropathology of ZIKV infection.
#39: An 11-year Review of Lactobacillus Bacteremia at a Pediatric Tertiary Care Center
Authors: Hefter Yosefa , Powell Lauren , Tabulov Christine , Danan Eleanor , Campos Joseph , Hanisch Benjamin 
Published: June 2021

Abstract

Background
Probiotics are used frequently in the pediatric population for treatment of diarrhea and promotion of gastrointestinal health. Lactobacillus is the most commonly used bacterial genus in probiotic formulations. Lactobacillus spp. has been a reported cause of bacteremia, particularly in immunocompromised populations and individuals with impaired gut integrity. To assess the risks and benefits of inpatient probiotic use in a pediatric tertiary care center, we aimed to identify the occurrence of Lactobacillus bacteremia among hospitalized patients and its association with probiotic use over an eleven-year period.

Methods
Cases of Lactobacillus bacteremia were identified through a search of positive blood culture reports from January 1st, 2010 through December 31st, 2020. The clinical chart for each case was independently reviewed for the following risk factors: documented probiotic uses, presence of a central venous catheter, immunocompromising condition or immunosuppressive agent, neutropenia, impaired intestinal function and age below 3 months. Additionally, we reviewed the clinical presentation including presence of fever, need for intensive care and gastrointestinal symptoms. Total inpatient probiotic administration was assessed over the same time period.

Results
Eight cases of Lactobacillus bacteremia were identified in inpatients during the study time period. Two cases had received probiotics in the hospital and a third case had documented outpatient administration of probiotics prior to development of bacteremia. The remaining five cases had no documented probiotic use. All 8 cases were febrile at the time of bacteremia. No patients required blood pressure support medications. Five cases had underlying impaired intestinal function. One case was in an oncology patient and there were no cases in solid organ or bone marrow transplant patients. Two cases, including the oncology patient and one patient with impaired intestinal function, were neutropenic at the time of bacteremia. All but one case, had a central line in place. All cases were treated with antibiotics and had resolution of bacteremia and associated symptoms. Probiotics were administered to 4,478 inpatients during the study period.

Conclusions
Lactobacillus bacteremia is uncommon and occurred in under 0.2% of patients who received probiotics during an inpatient admission. Nevertheless, all eight observed cases were symptomatic and received antibiotic therapy. Additionally, cases were most commonly seen in individuals with underlying impaired intestinal function. These considerations must be weighed in decisions regarding the risks and benefits of probiotic administration in the hospital.
#40: Does Cytomegalovirus (CMV) Viral Load Correlate with Disease Severity in the Setting of Congenital CMV (cCMV) Infection? Results from a Universal cCMV Screening Study
Authors: Kruc R , Osterholm E A , Hernandez-Alvarado N , Rosendahl S , McCann M , Sidebottom A , Amin M , Lanzieri T , Dollard S , Schleiss M R 
Published: June 2021

Abstract

Background
Consideration is being given to universal newborn screening for congenital CMV (cCMV). Early detection could improve neurodevelopmental and audiologic outcomes. For some viral infections, viral load is a biomarker predicting disease severity and directs the use of antiviral agents. cCMV is the most common congenital infection in the United States; its estimated prevalence is 4.5 per 1,000 live births. Since optimal screening strategies are not completely understood, this analysis was conducted to assess whether viral load at birth could stand as a biomarker of CMV symptomatology.

Methods
Newborn screening for cCMV was undertaken at five Twin Cities nurseries. Real-time PCR was performed on dried saliva swabs. Dried blood spot (DBS) PCR was performed independently by the UMN and CDC labs. Infections were categorized as: 1) moderately to severely symptomatic; 2) mildly symptomatic; 3) asymptomatic with isolated sensorineural hearing loss (SNHL); and 4) asymptomatic. Viral load analyses were conducted using Prism software.

Results
Among 16,092 newborns screened for cCMV, 72 cCMV cases were identified (prevalence of 0.44%). The sensitivity and specificity of CMV PCR were 92.9 and 99.9% for saliva, and 85.7 and 100% for DBS, respectively. 83% (60/72) of infants cCMV were classified as asymptomatic; the remaining 17% as symptomatic. In the DBS, a significant difference between viral loads in the symptomatic and asymptomatic groups was not seen (p=0.83; Mann-Whitney, Figure 1). However, in the saliva, a significant difference was seen. Mean saliva viral load in infants with confirmed cCMV and any symptomatic disease was 3.2×103 IU/ml, versus 7×106 IU/ml in asymptomatic infants (p&lt;0.05, Mann-Whitney; Figure 1).

Conclusions
The prevalence of cCMV in the Twin Cities is approximately 0.5%; most infants are asymptomatic at birth. Surprisingly, an inverse relationship was observed between viral load at birth in the saliva samples and severity of CMV sequelae. This may be because maternal infection earlier during pregnancy has been correlated with more severe sequelae, but also induces a fetal immune response that limits viral replication. Hence, viral load at birth may be higher with asymptomatic infections that occur later in the pregnancy.
#5: Trends in Seasonal Prevalence of Respiratory Pathogens Among Children in the United Arab Emirates: A Multi-Center Study.
Authors: Salim Sara , Celiloglu Handan , Tayyab Farah , Malik Zainab A 
Published: June 2021

Abstract

Background
Pediatric respiratory infections cause a high disease burden globally. Their seasonality and molecular epidemiology in the United Arab Emirates (UAE) are not well understood. This data is important for clinical practice, to monitor disease outbreaks and optimize vaccination for influenza and RSV prophylaxis in high risk infants and children. Our objective was to describe the seasonality and molecular epidemiology of respiratory pathogens during a full calendar year among children in Dubai, UAE.

Methods
Children 0–18 years of age who presented to multiple hospitals and clinics within a large private healthcare group in Dubai between January 1st and December 31st, 2019, and had upper respiratory samples positive for any pathogen on multiplex polymerase chain reaction (mPCR) were included in this retrospective analysis. Sociodemographic, clinical, and molecular data were collected.

Results
Two thousand four hundred and twenty-seven children had mPCR sample positive for at least one pathogen. The median age of our population was 39 months, and 56.8% were male. Emergency room was the most common site (32.3%) of sample collection and the vast majority presented with fever (85.7%). Rhinovirus/enterovirus was the most common infection (45%) and peaked in September; followed by respiratory syncytial virus (RSV) (17.1%) which peaked in October; and adenovirus (15.6%) which peaked in June. The latter accounted for 43% of hospitalizations in our study (p&lt;0.05). Viral co-infections, most commonly human rhinovirus/enterovirus and RSV, were seen in 22.1% of children. Other infections occurred in 34.1% of children comprising mainly of streptococcal pharyngitis.

Conclusions
RSV is a common viral pathogen in the UAE, and the RSV season begins earlier than reported in other countries regionally. RSV prophylaxis in high risk infants should be considered in August to provide maximal protection.
Adeno – Adenovirus; Corona – Coronavirus; hMPV – Human Metapneumovirus; Influ A – Influenza A; Influ B – Influenza B; Rhino/Entero – Human rhinovirus/Enterovirus; Para – Parainfluenza virus; RSV – Respiratory Syncytial Virus; Mycoplasma – Mycoplasma pneumoniae; Bordatella para – Bordatella parapertussis; Bordatella Per – Bordatella pertussis; Chlamydia – Chlamydia pneumoniae.
A Simplified Protocol for Microsatellite Instability Evaluation in Iranian Patients at Risk for Lynch Syndrome
Authors: Abdollahi Zeinab , Tabatabaiefar Mohammad Amin , Noruzi Mahnaz , Miar Paniz , Kazemi Mohammad , Naimi Azar , Emami Mohammad Hasan , Zeinalian Mehrdad 
Published: June 2021

Abstract

Objective
The most important tumor characteristic of Lynch syndrome (LS) is microsatellite instability (MSI). In the current study, BAT34c4 and BAT26 mononucleotide markers were evaluated as part of efforts to test a cost-effective panel for MSI testing in Iranian patients, comparing it with the Promega kit.

Methods
Amsterdam II clinical criteria were used to identify patients at risk for LS. The MSI status of these patients was determined using BAT34c4 and BAT26 markers, as well as the Promega kit. The results of both methods were compared, and the sensitivity and specificity of new short tandem repeat (STR) markers were estimated using statistical formulas.

Results
Of the 37 patients we studied who were at risk for LS, 27% showed MSI-high results, via the Promega kit. The same results were achieved for BAT34c4 and BAT26 separately.

Conclusions
The novel 2-marker kit for MSI testing has similar accuracy as the Promega kit at a lower cost, due to fewer markers and a more economical labeling method.
The Polish Rider: CH Alexandrowicz and the reorientation of international law, Part II: declension and the promise of renewal
Authors: Landauer Carl 
Published: June 2021

Abstract
This article is the second of a two-part analysis of the work of the international legal historian, CH Alexandrowicz. Part II analyses Alexandrowicz’s narrative of the decline of international law represented by 19th-century positivism and the scramble for African territory, where legal principles such as the protectorate became mere tools for acquisition, and treaties bereft of obligation. It traces his sympathy for the post-independence ‘new states’, his hope for the renewal of international law, the Romantic narrative imbuing his secular, modernist eschatology, and his continuing engagement with Indian Constitutional development.
A life in human rights: a conversation with Dennis Davis
Authors: Krever Tor 
Published: June 2021

Abstract
Dennis Davis is Judge of the High Court of South Africa, Judge President of the Competition Appeal Court, and Honorary Professor of Law at the University of Cape Town. In this wide-ranging conversation with Tor Krever, he reflects on his political and intellectual trajectory—from early encounters with Marx to anti-apartheid activism to a leading position in the South African judiciary—and his lifelong commitment to a radical left politics.
Was it all worth it? The consequences of parental migration decisions for the life satisfaction of their descendants
Authors: Stache Randy , Röder Antje 
Published: June 2021

Abstract
Does migration pay off for subsequent generations? This article applies a counterfactual logic (‘what if the parents had not migrated?’) to compare the life satisfaction of descendants of Turkish guest workers in Western Europe and return migrants with that of Turks without a migration history in the family. Using data from the 2000 Families Study, we test a theoretical model that aims to explain differences along three dimensions: personal resources, social position, and normative settings. Results show that only permanent migration was successful in terms of higher life satisfaction for descendants, as offspring of return migrants do not differ from those without a migration history in the family. The higher life satisfaction of subsequent generations in Europe is largely due to access to higher resources obtained through migration, and persists despite barriers such as a lower relative socioeconomic position and experiences of discrimination. While religiosity appears to only play a minor role in explaining differences, there is evidence that descendants whose lifestyle deviates from the normative expectations of the country-of-origin benefit in particular from the migration of their parents.
Preoperative imaging of glioblastoma patients using hyperpolarized 13C pyruvate: Potential role in clinical decision making
Authors: Chen Jun , Patel Toral R , Pinho Marco C , Choi Changho , Harrison Crystal E , Baxter Jeannie D , Derner Kelley , Pena Salvador , Liticker Jeff , Raza Jaffar , Hall Ronald G , Reed Galen D , Cai Chunyu , Hatanpaa Kimmo J , Bankson James A , Bachoo Robert M , Malloy Craig R , Mickey Bruce E , Park Jae Mo 
Published: June 2021

Abstract

Background
Glioblastoma remains incurable despite treatment with surgery, radiation therapy, and cytotoxic chemotherapy, prompting the search for a metabolic pathway unique to glioblastoma cells.13C MR spectroscopic imaging with hyperpolarized pyruvate can demonstrate alterations in pyruvate metabolism in these tumors.

Methods
Three patients with diagnostic MRI suggestive of a glioblastoma were scanned at 3 T 1–2 days prior to tumor resection using a 13C/1H dual-frequency RF coil and a 13C/1H-integrated MR protocol, which consists of a series of 1H MR sequences (T2 FLAIR, arterial spin labeling and contrast-enhanced [CE] T1) and 13C spectroscopic imaging with hyperpolarized [1-13C]pyruvate. Dynamic spiral chemical shift imaging was used for 13C data acquisition. Surgical navigation was used to correlate the locations of tissue samples submitted for histology with the changes seen on the diagnostic MR scans and the 13C spectroscopic images.

Results
Each tumor was histologically confirmed to be a WHO grade IV glioblastoma with isocitrate dehydrogenase wild type. Total hyperpolarized 13C signals detected near the tumor mass reflected altered tissue perfusion near the tumor. For each tumor, a hyperintense [1-13C]lactate signal was detected both within CE and T2-FLAIR regions on the 1H diagnostic images (P = .008). [13C]bicarbonate signal was maintained or decreased in the lesion but the observation was not significant (P = .3).

Conclusions
Prior to surgical resection, 13C MR spectroscopic imaging with hyperpolarized pyruvate reveals increased lactate production in regions of histologically confirmed glioblastoma.
Physiological Role of Aerobic Fermentation Constitutively Expressed in an Aluminum-Tolerant Cell Line of Tobacco (Nicotiana tabacum)
Authors: Tsuchiya Yoshiyuki , Nakamura Takuji , Izumi Yohei , Okazaki Keiki , Shinano Takuro , Kubo Yasutaka , Katsuhara Maki , Sasaki Takayuki , Yamamoto Yoko 
Published: June 2021

Abstract
Aluminum (Al)-tolerant tobacco cell line ALT301 derived from SL (wild-type) hardly exhibits Al-triggered reactive oxygen species (ROS) compared with SL. Molecular mechanism leading to this phenotype was investigated comparatively with SL. Under normal growth condition, metabolome data suggested the activation of glycolysis and lactate fermentation but the repression of the tricarboxylic acid (TCA) cycle in ALT301, namely aerobic fermentation, which seemed to be transcriptionally controlled partly by higher expression of genes encoding lactate dehydrogenase and pyruvate dehydrogenase kinase. Microarray and gene ontology analyses revealed the upregulation of the gene encoding related to APETALA2.3 (RAP2.3)-like protein, one of the group VII ethylene response factors (ERFVIIs), in ALT301. ERFVII transcription factors are known to be key regulators for hypoxia response that promotes substrate-level ATP production by glycolysis and fermentation. ERFVIIs are degraded under normoxia by the N-end rule pathway of proteolysis depending on both oxygen and nitric oxide (NO), and NO is produced mainly by nitrate reductase (NR) in plants. In ALT301, levels of the NR gene expression (NIA2), NR activity and NO production were all lower compared with SL. Consistently, the known effects of NO on respiratory pathways were also repressed in ALT301. Under Al-treatment condition, NO level increased in both lines but was lower in ALT301. These results suggest that the upregulation of the RAP2.3-like gene and the downregulation of the NIA2 gene and resultant NO depletion in ALT301 coordinately enhance aerobic fermentation, which seems to be related to a higher capacity to prevent ROS production in mitochondria under Al stress.
Hepatitis B and C prevalence in waste pickers: a global meta-analysis
Authors: Souza-Silva Gabriel , Zolnikov Tara Rava , Ortolani Paula Ladeira , Cruvinel Vanessa Resende Nogueira , Dias Sonia Maria , Mol Marcos Paulo Gomes 
Published: June 2021

Abstract

Background
The objective of this research was to use a meta-analysis to understand the prevalence of hepatitis B or C in waste pickers worldwide.

Methods
Epidemiological studies on hepatitis B and C in waste pickers were included adopting a systematic review with meta-analysis. Each selected article had its quality scored by all authors, evaluated according to the Loney’s criteria, and evaluated for quality and bias verified with a funnel plot.

Results
After employing Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, there were 12 studies used for this meta-analysis. The rate of hepatitis B seropositivity was 0.15 (95% CI 0.10–0.20), and hepatitis C was 0.08 (95% CI 0.04–0.12). This information suggests that waste pickers are exposed to many risks associated with poor quality of life working conditions as well as low health literacy rates.

Conclusion
The results of this meta-analysis confirm the vulnerability of waste pickers to hepatitis B and C infection and reinforce the importance of using personal protective equipment and immunizing workers.