bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trajectory of AKI in hospitalized pediatric patients—impact of duration and repeat events
Authors: Moffett Brady S , Arikan Ayse Akcan 
Published: July 2021

ABSTRACT

Background
Peak severity of acute kidney injury (AKI) is associated with mortality in hospitalized pediatric patients. Other factors associated with AKI, such as number of AKI events, severity of AKI events and time spent in AKI, may also have associations with mortality. Characterization of these events could help to evaluate patient outcomes.

Methods
Pediatric inpatients (&lt;19 years of age) from 2011 to 2019 who were not on maintenance renal replacement therapy and had least one serum creatinine (SCr) obtained during hospital admission were included. Percent change in SCr from the minimum value in the prior 7 days was used for AKI staging according to Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Maximum value for age appropriate normal was used for patients with only one SCr. Repeat AKI events were classified in patients if KDIGO criteria were met more than once with at least one SCr value between episodes that did not meet KDIGO criteria. Patient demographics were summarized and incidence of AKI was determined along with associations with mortality. AKI characterizations for the admission were developed including: AKI, repeat (more than one) AKI, AKI severity (maximum KDIGO stage) and total number of AKI events. AKI duration as percent admission days in a KDIGO stage and AKI percent velocity were determined. Kaplan–Meier analysis was performed for time to 30-day survival by AKI characterization. A mixed-effects logistic regression model with mortality as the dependent variable nested in patients was developed incorporating patient variables and AKI characterizations.

Results
A total of 184 297 inpatient encounters met study criteria [male 51.7%, age 7.8 years (interquartile range 2.5–13.8) and mortality 0.56%]. Hospital length of stay was 1.9 days (IQR 0.37, 4.8 days), 15.4% had an intensive care unit admission and 12.2% underwent mechanical ventilation. AKI occurred in 5.6% (n = 10 246) of admissions [Stage 1, 4.5% (n = 8310); Stage 2, 1.3% (n = 2363); Stage 3, 0.77% (n = 1423)] and repeat AKI events occurred in 1.92% (n = 3558). AKI was associated with mortality (odds ratio 6.0, 95% confidence interval 4.8–7.6; P &lt; 0.001) and increasing severity (KDIGO maximum stage) was associated with increased mortality. Multiple AKI events were also associated with mortality (P &lt; 0.001). Duration of AKI was associated with mortality (P &lt; 0.001) but AKI velocity was not (P &gt; 0.05).

Conclusions
AKI occurs in 5.6% of the pediatric inpatient population and multiple AKI events occur in ∼30% of these patients. Maximum KDIGO stage is most strongly associated with mortality. Multiple AKI events and AKI duration should also be considered when evaluating patient outcomes.
MYD88 L265P mutation in primary central nervous system lymphoma is associated with better survival: A single-center experience
Authors: Curran Olimpia E , Poon Michael T C , Gilroy Louise , Torgersen Antonia , Smith Colin , Al-Qsous Wael 
Published: July 2021

Abstract

Background
The myeloid differentiation primary response gene (MYD88) mutation in primary central nervous system lymphomas (PCNSL) may be associated with unfavorable prognosis; however, current evidence remains limited. We aimed to characterize PCNSLs by integration of clinicopathological, molecular, treatment, and survival data.

Methods
We retrospectively identified and validated 57 consecutive patients with PCNSLs according to the 2017 WHO classification of lymphoid neoplasms over 13 years. Formalin-fixed paraffin-embedded tumor samples underwent polymerase chain reaction assay to detect MYD88 mutation. We used Cox regression for survival analysis, including age, treatment, and MYD88 as covariates. We searched the literature for studies reporting demographics, treatment, MYD88, and survival of PCNSL patients and incorporated individual patient data into our analyses.

Results
The median age was 66 years and 56% were women. All 57 patients had PCNSL of non-germinal center cell subtype and the majority (81%) received either single or combined therapies. There were 46 deaths observed over the median follow-up of 10 months. MYD88 mutation status was available in 41 patients of which 36 (88%) were mutated. There was an association between MYD88 mutation and better survival in the multivariable model (hazard ratio [HR] 0.277; 95% confidence interval [CI]: 0.09-0.83; P = .023) but not in a univariable model. After incorporating additional 18 patients from the literature, this association was reproducible (HR 0.245; 95% CI: 0.09-0.64; P = .004).

Conclusions
Adjusting for confounders, MYD88-mutant PCNSL appears to show improved survival. While further validation is warranted, detection of MYD88 mutation will aid the identification of patients who may benefit from novel targeted therapies.
Family-wide evaluation of RAPID ALKALINIZATION FACTOR peptides
Authors: Abarca Alicia , Franck Christina M. , Zipfel Cyril 
Published: July 2021

Abstract
Plant peptide hormones are important players that control various aspects of the lives of plants. RAPID ALKALINIZATION FACTOR (RALF) peptides have recently emerged as important players in multiple physiological processes. Numerous studies have increased our understanding of the evolutionary processes that shaped the RALF family of peptides. Nevertheless, to date, there is no comprehensive, family-wide functional study on RALF peptides. Here, we analyzed the phylogeny of the proposed multigenic RALF peptide family in the model plant Arabidopsis (Arabidopsis thaliana), ecotype Col-0, and tested a variety of physiological responses triggered by RALFs. Our phylogenetic analysis reveals that two of the previously proposed RALF peptides are not genuine RALF peptides, which leads us to propose a revision to the consensus AtRALF peptide family annotation. We show that the majority of AtRALF peptides, when applied exogenously as synthetic peptides, induce seedling or root growth inhibition and modulate reactive oxygen species (ROS) production in Arabidopsis. Moreover, our findings suggest that alkalinization and growth inhibition are, generally, coupled characteristics of RALF peptides. Additionally, we show that for the majority of the peptides, these responses are genetically dependent on FERONIA, suggesting a pivotal role for this receptor kinase in the perception of multiple RALF peptides.
Photosynthesis dynamics and regulation sensed in the frequency domain
Authors: Nedbal Ladislav , Lazár Dušan 
Published: July 2021

Abstract
Foundations of photosynthesis research have been established mainly by studying the response of plants to changing light, typically to sudden exposure to a constant light intensity after dark acclimation or light flashes. This approach remains valid and powerful, but can be limited by requiring dark acclimation before time-domain measurements and often assumes that rate constants determining the photosynthetic response do not change between dark and light acclimation. We show that these limits can be overcome by measuring plant responses to sinusoidally modulated light of varying frequency. By its nature, such frequency-domain characterization is performed in light-acclimated plants with no need for prior dark acclimation. Amplitudes, phase shifts, and upper harmonic modulation extracted from the data for a wide range of frequencies can target different kinetic domains and regulatory feedbacks. The occurrence of upper harmonic modulation reflects nonlinear phenomena, including photosynthetic regulation. To support these claims, we measured chlorophyll fluorescence emission of the green alga Chlorella sorokiniana in light that was sinusoidally modulated in the frequency range 1000–0.001 Hz. Based on these experimental data and numerical as well as analytical mathematical models, we propose that frequency-domain measurements can become a versatile tool in plant sensing.
Being a female academic under neoliberal evaluation: A systematic review
Authors: Mula-Flacón Javier , Cruz-González Cristina , Domingo Segovia Jesús , Lucena Rodríguez Carmen 
Published: July 2021

AbstractThe current academic assessment system is drawing a scenario based on neoliberal values. It has contributed to the perpetuation of gender inequalities. This systematic literature review aims to synthesize the most relevant research on the impact of neoliberalism on the professional identity of female academics. For this purpose, a systematized bibliographic search was carried out in four different databases (Web of Science, Scopus, Education Resources Information Center, and Google Scholar), which yielded a total of 26 articles published in international journals. The results illustrate a research field dominated by the USA and the UK and a trajectory of growth in the literature in recent years. The emerging themes reveal some of the challenges faced by women academics in a neoliberal context. These obstacles may be external and even unconsciously imposed by women academics themselves. Motherhood emerges as one of the most influential aspects of their professional development. Furthermore, our findings explore various ways in which women academics reconstruct their identity in the face of systemic challenges. This manuscript culminates with a discussion of the impact that neoliberal values and their general consequences in the performance evaluation processes of academics have on women. Therefore, we provide a number of implications for professional practice and future lines of research.
A predictive clinical-radiomics nomogram for diagnosing of axial spondyloarthritis using MRI and clinical risk factors
Authors: Ye Lusi , Miao Shouliang , Xiao Qinqin , Liu Yuncai , Tang Hongyan , Li Bingyu , Liu Jinjin , Chen Dan 
Published: July 2021

Abstract

Objectives
Construct and validate a nomogram model integrating the radiomics features and the clinical risk factors to differentiating axial spondyloarthritis (axSpA) in low back pain patients undergone sacroiliac joint (SIJ)-MRI.

Methods
A total of 638 patients confirmed as axSpA (n = 424) or non-axSpA (n = 214) who were randomly divided into training (n = 447) and validation cohorts (n = 191). Optimal radiomics signatures were constructed from the 3.0 T SIJ-MRI using maximum relevance–minimum redundancy (mRMR) and the least absolute shrinkage and selection operator (LASSO) algorithm in the training cohort. We also included six clinical risk predictors to build the clinical model. Incorporating the independent clinical factors and Rad-score, a nomogram model was constructed by multivariable logistic regression analysis. The performance of the clinical, Rad-score, and nomogram models were evaluated by ROC analysis, calibration curve and decision curve analysis (DCA).

Results
A total of 1316 features were extracted and reduced to 15 features to build the Rad-score. The Rad-score allowed a good discrimination in the training (AUC, 0.82; 95% CI: 0.77, 0.86) and the validation cohort (AUC, 0.82; 95% CI: 0.76, 0.88). The clinical-radiomics nomogram model also showed favourable discrimination in the training (AUC, 0.90; 95% CI: 0.86, 0.93) and the validation cohort (AUC, 0.90; 95% CI: 0.85, 0.94). Calibration curves (P &gt;0.05) and DCA demonstrated the nomogram was useful for axSpA diagnosis in the clinical environment.

Conclusion
The study proposed a radiomics model was able to separate axSpA and non-axSpA. The clinical-radiomics nomogram can increase the efficacy for differentiating axSpA, which might facilitate clinical decision-making process.
Factors Associated with Neonatal Mortality among Newborns Admitted in the Special Care Baby Unit of a Nigerian Hospital
Authors: Ojima Wada Zechariah , Olawade David Bamidele , Awe Olabisi O , Amusa Aminat Opeyemi 
Published: July 2021

Abstract

Background
With Nigeria being one of the countries with the highest neonatal mortality rate globally, identifying the risk factors associated with neonatal mortality is essential as we strive to proffer sustainable solutions.

Aim
This retrospective hospital-based survey aimed to bridge this gap by evaluating the trends and risk factors associated with neonatal mortality in a teaching hospital in Southwestern Nigeria.

Methods
Records of newborns admitted at the special care baby unit from January 2018 to December 2019 (n = 1098) were accessed, and available data were extracted. Descriptive analysis and inferential statistics were performed at 0.05 level of significance.

Results
The mortality rate was determined to be 16.9% (inborn babies- 12.9% and out-born babies- 22.3%), with 83.3% of the newborns dying within the first week. Some of the factors associated with neonatal mortality were proximity of newborns’ mothers home to the hospital [p = 0.041; Odds Ratio (OR) = 0.670; 95% Confidence Interval (CI) = 0.455–0.985], maturity of the baby at delivery (p &lt; 0.001; OR = 0.514; CI = 0.358–0.738), place of delivery—inborn or out-born (p &lt; 0.001; OR = 0.515; CI = 0.375–0.709), place of delivery—in a hospital or a non-hospital setting (p = 0.048; OR = 0.633; CI = 0.401–0.999), and baby's weight (p &lt; 0.001; CI = −0.684 to −0.411).

Conclusion
Findings from the study indicate that newborns delivered at home, traditional birth attendant centres or hospitals without essential healthcare facilities have a higher mortality risk. This suggests that measures to improve the accessibility of pregnant women to essential healthcare services are a prerequisite to reducing the neonatal mortality rate in Nigeria.
Functional outcome after dual mobility cups total hip replacement versus bipolar hemiarthroplasty in femoral neck fractures in active elderly patients: a randomized controlled trial
Authors: Makeen Tony Maher , Abdelazim Mohamed Haytham , Mohasseb Ahmed Mohamed , Elshabrawy Waleed El Sayed Abd Elaleem , Ashoub Mostafa Mamdouh , El Ganzoury Ibrahim Mostafa 
Published: July 2021

Background:
Bipolar hemiarthroplasty (BA) has long been the preferred treatment and is performed in most patients with femoral neck fracture (FNF). The dual mobility cup total hip arthroplasty (DMTHA) has emerged as a relevant alternative to BA. Since then there is an on-going debate on the best implant to use. Age, comorbidities, patient independence, and potential surgical complications must be considered when choosing implants. The risk of dislocation is a crucial factor because of its important consequences. The authors evaluated the functional and mechanical outcomes of BA versus DMTHA in FNF in active elderly patients.

Methods:
This study was a randomized comparative interventional single-blinded study that was performed at Ain Shams University Hospitals. A total of 33 patients underwent DMTHA or BA after displaced FNF. Primary outcomes were functional outcome and postoperative dislocation rate. Secondary outcomes were operative time and amount of blood loss.

Results:
There were no significant differences between the demographic data and preoperative parameters between the two groups. There was a significant difference in the postoperative Harris Hip Score (HHS) between the two groups (P=0.01). VAS of groin pain was significantly different between the two groups (P<0.001). There was no significant difference between the two groups regarding the dislocation rate.

Conclusions:
The authors concluded that DMTHA offered a better functional outcome than BA with no significant complications or mortality, and there was no significant difference between DMTHA and BA in the rate of dislocation.

Level of Evidence:
Level II.
What Is New in Pediatric Bone Health
Authors: Beck Jennifer J. , Mahan Susan T. , Nowicki Philip , Schreiber Verena M. , Minkowitz Barbara 
Published: July 2021

Background:
This review paper aims to report on the last 5 years of relevant research on pediatric bone health in regard to nutrition and obesity, ethnic disparities, common orthopaedic conditions, trauma, spine, and sports medicine.

Methods:
A search of the PubMed database was completed using the following terms: bone health, Vitamin D, pediatric, adolescent, sports medicine, fractures, spine, scoliosis, race, ethnicity, obesity, Slipped Capital Femoral Epiphysis, Osteogenesis Imperfecta, Duchenne’s Muscular Dystrophy, neuromuscular, and cancer. Resultant papers were reviewed by study authors and determined to be of quality and relevance for description in this review. Papers from January 1, 2015 to August 31, 2020 were included.

Results:
A total of 85 papers were selected for review. General results include 7 key findings. (1) Obesity inhibits pediatric bone health with leptin playing a major role in the process. (2) Socioeconomic and demographic disparities have shown to have a direct influence on bone health. (3) Vitamin D deficiency has been linked to an increased fracture risk and severity in children. (4) Formal vitamin D monitoring can aid with patient compliance with treatment. (5) Patients with chronic medical conditions are impacted by low vitamin D and need ongoing monitoring of their bone health to decrease their fracture risk. (6) Vitamin D deficiency in pediatrics has been correlated to low back pain, spondylolysis, and adolescent idiopathic scoliosis. Osteopenic patients with AIS have an increased risk of curve progression requiring surgery. Before spine fusion, preoperative screening for vitamin D deficiency may reduce complications of fractures, insufficient tissue repair, loosening hardware, and postoperative back pain. (7) Increasing youth sports participation has resulted in increased bone health related injuries. However, improved understanding of Relative Energy Deficiency in Sport effects on bone health has recently occurred.

Conclusions:
Increasing awareness of bone health issues in children will improve their recognition and treatment. Further research is needed on diagnosis, treatment, outcomes, and most importantly prevention of pediatric bone health diseases.
Plaque‐Type Variant of Acquired Rhabdomyomatous Mesenchymal Hamartoma on the Chin: A Case Series
Authors: Lee Yu-Hua , Yao Xiao-Feng , Wu Yu-Hung 
Published: July 2021

Abstract:Rhabdomyomatous mesenchymal hamartoma (RMH) is a rare benign tumor composed of skeletal muscle fibers and other mesenchymal-derived cells. The lesions are generally solitary sessile papules or skin tag lesions that occur during childhood. We retrospectively reviewed patients diagnosed with RMH pathologically between January 2001 and June 2020 at a tertiary medical center. A literature review was conducted. Seven plaque-type RMHs on the chin were found, including 6 in adults and one in a 14-year-old boy. The average age was 45.7 years. The onset of the RMH appearance was between several months and years. Pathologically, all patients showed a scattered haphazard arrangement of skeletal muscle bundles in the dermis and/or subcutis. Subcutis replaced by fibrous tissue and skeletal muscle bundles was present in 2 cases. Some skeletal muscles had a periadnexal distribution. This case series demonstrated a distinct clinical presentation of acquired RMH specifically located on the chin.
Prenatal Diagnosis of a Giant Epignathus in the Second Trimester and Immediate Successful Management at Birth: A Case Report
Authors: Hu Xiaoyu , Chu Yijing , Chen Yunqing , Zhao Min , Wang Xiaofei , Xu Lin 
Published: July 2021

Abstract
Epignathus is an extremely rare congenital oropharyngeal teratoma. Here, we report a case of epignathus without intracranial extension in a fetus. The mass was first found by ultrasonography at 22 gestational weeks. Serial ultrasound examinations and magnetic resonance imaging confirmed that the fetus had neither central nervous system involvement nor abnormal nose or tooth. The baby was delivered at 37 weeks and six days of gestation via cesarean section set up for ex-utero intrapartum treatment. The postnatal pathologic examination confirmed the presence of mature tissues predominantly containing ectopic central nervous tissue, osseous tissue, and bronchial mucosal tissue. Most cases of epignathus are associated with malformation and death. Ultrasound and magnetic resonance imaging prenatal assessments are very important to facilitate counseling and understand prognosis. In conclusion, the ex-utero intrapartum treatment procedure is a good approach to improve the survival of infants with epignathus.
Refining determinants of associations of visit-to-visit blood pressure variability with cardiovascular risk: results from the Action to Control Cardiovascular Risk in Diabetes Trial
Authors: Nuyujukian Daniel S. , Zhou Jin J. , Koska Juraj , Reaven Peter D. 
Published: July 2021

Objectives:
As there is uncertainty about the extent to which baseline blood pressure level or cardiovascular risk modifies the relationship between blood pressure variability (BPv) and cardiovascular disease, we comprehensively examined the role of BPv in cardiovascular disease risk in the Action to Control Cardiovascular Risk in Diabetes (ACCORD) Trial.

Methods:
Using data from ACCORD, we examined the relationship of BPv with development of the primary CVD outcome, major coronary heart disease (CHD), and total stroke using time-dependent Cox proportional hazards models.

Results:
BPv was associated with the primary CVD outcome and major CHD but not stroke. The positive association with the primary CVD outcome and major CHD was more pronounced in low and high strata of baseline SBP (<120 and >140 mmHg) and DBP (<70 and >80 mmHg). The effect of BPv on CVD and CHD was more pronounced in those with both prior CVD history and low blood pressure. Dips, not elevations, in blood pressure appeared to drive these associations. The relationships were generally not attenuated by adjustment for mean blood pressure, medication adherence, or baseline comorbidities. A sensitivity analysis using CVD events from the long-term posttrial follow-up (ACCORDION) was consistent with the results from ACCORD.

Conclusion:
In ACCORD, the effect of BPv on adverse cardiovascular (but not cerebrovascular) outcomes is modified by baseline blood pressure and prior CVD. Recognizing these more nuanced relationships may help improve risk stratification and blood pressure management decisions as well as provide insight into potential underlying mechanisms.