bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early diagnosis and response assessment in chronic recurrent multifocal osteomyelitis: changes in lesion volume and signal intensity assessed by whole-body MRI
Authors: Kieninger Angelina , Schäfer Jürgen F. , Tsiflikas Ilias , Moll Monika , Kümmerle-Deschner Jasmin , Kraus Mareen S. , Esser Michael 
Published: December 2021

Objective:
To assess the effectiveness of whole-body MRI (WB-MRI) in early diagnosis of chronic recurrent multifocal osteomyelitis (CRMO) and the prediction of clinical response through quantitative MRI features.

Methods:
20 children (mean age, 10.3 years; range, 5–14 years) with CRMO underwent WB-MRI and were assessed with a clinical score (Jansson) at baseline (median time after first encounter, 8 months) and follow-up (median time after baseline, 11.5 months). Baseline WB-MRI scans were classified as early (within 6 months after first encounter) and late. Clinical responders and non-responders were compared regarding number and localization of bone lesions, lesion volume and T2 signal intensity (SI) ratio (lesion to muscle).

Results:
Diagnosis of CRMO was made promptly in the early WB-MRI group (n = 10; median, 3 months) compared to the late WB-MRI group (n = 10; 18 months; p = 0.006). Bone lesions were mainly located in the lower extremities (n = 119/223; 53%). No significant difference was detected regarding the number of bone lesions and lesion volume in the subgroups of clinical responders (n = 10) and non-responders (n = 10). Responders showed a higher volume reduction of bone lesions at follow-up compared to non-responders (p = 0.03). Baseline and follow-up SI ratios were lower in responders (5.6 and 5.8 vs 6.1 and 7.2; p = 0.047 and p = 0.005).

Conclusion:
The use of WB-MRI within 6 months of disease suspicion may serve as a benchmark to support early diagnosis of CRMO. T2 SI ratios and the reduction of lesions’ volume correlate with clinical outcome.

Advances in knowledge:
WB-MRI at an early stage of suspected CRMO plays a key role for early diagnosis. This is the first study showing that quantitative MRI features are suitable for response assessment and can be used as prognostic markers for the prediction of clinical response.
Lemierre’s syndrome in a child
Authors: Hemani Fatima , Naveed Anjum , Akhtar Shakil , Shahid Saba 
Published: December 2021

Lemierre’s Syndrome (LS) is a rare syndrome most frequently due to an anaerobic organism, Fusobacterium Necrophorum. It is commonly a complication of an acute oropharyngeal infection, but there are exceptions to its presentations. In our case the cause of LS was otitis media caused by Streptococcus species. This is a rather unusual presentation of LS. LS is caused due to septic complications of oropharyngeal infections, which lead to thrombophlebitis of internal jugular vein leading to thrombosis formation. In this case report, we present a case of Lemierre’s syndrome in a seven-year-old male child. The patient presented with high grade fever spikes and earache, which were unresponsive to oral antibiotics. LS was diagnosed in this patient on the basis of clinical, microbiological and radiological findings. After the diagnosis, treatment involved using broad spectrum antibiotics and anticoagulants, followed by surgery. Though role of anticoagulants is controversial in LS, but there is no specific guideline contraindicating the use of anti-coagulants. In our case, timely diagnosis and management enabled us to discharge the patient without any symptoms.
doi: https://doi.org/10.12669/pjms.38.ICON-2022.5773
How to cite this:Hemani F, Naveed A, Akhtar S, Shahid S. Lemierre’s syndrome in a child. Pak J Med Sci. 2022;38(2):433-435. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5773
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Effect of Remdesivir on mortality and length of stay in hospitalized COVID-19 patients: A single center study
Authors: Shaikh Quratulain , Sarfaraz Samreen , Rahim Anum , Hussain Mujahid , Shah Rabeea , Soomro Sara 
Published: December 2021

Objectives: To see the difference in mortality among hospitalized COVID-19 patients given Remdesivir (RDV) with those who were not given RDV.
Methods: A prospective cohort study was conducted on patients who were admitted to the COVID-19 isolation unit at The Indus Hospital, Korangi Campus Karachi between March and June 2020.
Results: Groups were similar in age and gender distribution. RDV group was more hypoxic, had severe ARDS and needed higher Oxygen support compared to non-RDV group (p=0.000). Median SOFA score was 2 in RDV vs 5 in non-RDV (p=0.000). More than moderate COVID pneumonia was found in 92% of the RDV group while 89% of non-RDV group (p value=0.001). Median day of illness to administer Remdesivir was 10. There was no difference in mortality (45.5% in RDV vs 40.4% in non-RDV; p=0.4) between the two groups. Median length of hospital stay was 12 days (IQR=7.5-14.5) in RDV group compared to 10 days (IQR=6-14) in non-RDV group (p=0.009).
Conclusion: RDV did not show any difference in in-hospital mortality in our patients. More patients had severe ARDS in the RDV group while patients in the non-RDV group had higher SOFA score and multi-organ failure. Length of stay was longer in patients receiving Remdesivir.
doi: https://doi.org/10.12669/pjms.38.ICON-2022.5779
How to cite this:Shaikh Q, Sarfaraz S, Rahim A, Hussain M, Shah R, Soomro S. Effect of Remdesivir on mortality and length of stay in hospitalized COVID-19 patients: A single center study. Pak J Med Sci. 2022;38(2):405-410. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5779
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
The Comparison of the Results of Ultrasound, CT and MRI in the Diagnosis of Angiomyolipoma Kidneys, Including Complicated by Development of the Syndrome Wunderlich
Authors: Vorotynceva N. , Gaidukova M. 
Published: December 2021

Purpose: Analysis the effectiveness of various methods of radiation studies for the detection of renal angiomyolipomas (RAMLs), including the diagnosis of Wunderlich syndrome.
Material and methods: The analysis of the results of a comprehensive radiation study of the kidneys of 115 patients who were diagnosed with focal formation in primary renal ultrasound was carried out. Further, of those 115 people, 47 patients underwent MRI of the kidneys, 60 patients – CT and 8 patients complex MRI+CT, including contrast-enhanced vasculature.
Results and discussion: Angiomyolipoma was detected by ultrasound in 38 (33.0 %) of 115 patients, and according to MRI and CT in total in 27 (23.5 %) patients. Coincidence of ultrasound findings and MRI and CT results was in 18 patients. Consequently, the sensitivity of ultrasound in the diagnosis of RAML was compared with MRI – 45 %; when compared with CT – 42.8 %, and specificity – 55 % and 57.1 %, respectively. Reliable signs of RAML in ultrasound were hyperechogenic homogeneous structure, clear smooth contours of the formation. The rounded form of education is statistically unreliable. Statistically significant characteristics of RAML in magnetic resonance imaging are heterogeneous structure, heterogeneous hyperintense MR-signal on T1 and heterogeneously hypointensity on T2-weighted images, always uniformly hypo-Fs for T1 / T2 Fs, with hypo clear boundary between education and renal parenchyma on T1 in the opp phase. Reliable signs of RAML with CT are non-uniform structure of education, with non-uniform x-ray density.
Conclusion: Ultrasound diagnosis is necessary for screening kidney disease, while CT and MRI have greater sensitivity and specificity to determine the nature of focal formation. With the development of Wunderlich’s syndrome, a complex of radiological methods, including ultrasound, MRI and CT, allows to diagnose the cause of hemorrhage, as well as to obtain complete diagnostic information necessary for the surgeon to plan treatment.
Dynamic Programs with Shared Resources and Signals: Dynamic Fluid Policies and Asymptotic Optimality
Authors: Brown David B. , Zhang Jingwei 
Published: December 2021

Allocating Resources Across Systems Coupled by Shared Information Many sequential decision problems involve repeatedly allocating a limited resource across subsystems that are jointly affected by randomly evolving exogenous factors. For example, in adaptive clinical trials, a decision maker needs to allocate patients to treatments in an effort to learn about the efficacy of treatments, but the number of available patients may vary randomly over time. In capital budgeting problems, firms may allocate resources to conduct R&D on new products, but funding budgets may evolve randomly. In many inventory management problems, firms need to allocate limited production capacity to satisfy uncertain demands at multiple locations, and these demands may be correlated due to vagaries in shared market conditions. In this paper, we develop a model involving “shared resources and signals” that captures these and potentially many other applications. The framework is naturally described as a stochastic dynamic program, but this problem is quite difficult to solve. We develop an approximation method based on a “dynamic fluid relaxation”: in this approximation, the subsystem state evolution is approximated by a deterministic fluid model, but the exogenous states (the signals) retain their stochastic evolution. We develop an algorithm for solving the dynamic fluid relaxation. We analyze the corresponding feasible policies and performance bounds from the dynamic fluid relaxation and show that these are asymptotically optimal as the number of subsystems grows large. We show that competing state-of-the-art approaches used in the literature on weakly coupled dynamic programs in general fail to provide asymptotic optimality. Finally, we illustrate the approach on the aforementioned dynamic capital budgeting and multilocation inventory management problems.
A real-world comparison of outcomes between fractional flow reserve-guided versus angiography-guided percutaneous coronary intervention
Authors: Wong Christopher C. Y. , Ng Austin C. C. , Ada Cuneyt , Chow Vincent , Fearon William F. , Ng Martin K. C. , Kritharides Leonard , Yong Andy S. C. 
Published: December 2021

BackgroundFractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) has been shown to be superior to angiography-guided PCI in randomized controlled studies. However, real-world data on the use and outcomes of FFR-guided PCI remain limited. Thus, we investigated the outcomes of patients undergoing FFR-guided PCI compared to angiography-guided PCI in a large, state-wide unselected cohort.Methods and resultsAll patients undergoing PCI between June 2017 and June 2018 in New South Wales, Australia, were included. The cohort was stratified into the FFR-guided group when concomitant FFR was performed, and the angiography-guided group when no FFR was performed. The primary outcome was a combined endpoint of death or myocardial infarction (MI). Secondary outcomes included all-cause death, cardiovascular (CVS) death, and MI. The cohort comprised 10,304 patients, of which 542 (5%) underwent FFR-guided PCI. During a mean follow-up of 12±4 months, the FFR-guided PCI group had reduced occurrence of the primary outcome (hazard ratio [HR] 0.34, 95% confidence intervals [CI] 0.20–0.56, P<0.001), all-cause death (HR 0.18, 95% CI 0.07–0.47, P = 0.001), CVS death (HR 0.21, 95% CI 0.07–0.66, P = 0.01), and MI (HR 0.46, 95% CI 0.25–0.84, P = 0.01) compared to the angiography-guided PCI group. Multivariable Cox regression analysis showed FFR-guidance to be an independent predictor of the primary outcome (HR 0.45, 95% CI 0.27–0.75, P = 0.002), all-cause death (HR 0.22, 95% CI 0.08–0.59, P = 0.003), and CVS death (HR 0.27, 95% CI 0.09–0.83, P = 0.02).ConclusionsIn this real-world study of patients undergoing PCI, FFR-guidance was associated with lower rates of the primary outcome of death or MI, as well as the secondary outcomes of all-cause death and CVS death.
A qualitative study of child participation in decision-making: Exploring rights-based approaches in pediatric occupational therapy
Authors: O’Connor Deirdre , Lynch Helen , Boyle Bryan 
Published: December 2021

Background
According to Article 12 of the United Nations Convention on the Rights of the Child, therapists are duty-bound to include children in decisions that impact them. Although occupational therapists champion client-centred, collaborative practice, there remains a paucity of studies detailing children’s rights and experiences of decision-making in pediatric occupational therapy.

Purpose
This qualitative study described the decision-making experiences of children, parents and therapists in occupational therapy.

Methods
Semi-structured interviews were conducted with 17 participants (six children, five parents and six occupational therapists), and data analysed using thematic analysis.

Findings
Three themes emerged: 1) Goal-setting experiences; 2) Adults: child-rights gatekeepers or defenders? and 3) Decision-making in context. Findings suggest that decision-making is mostly adult directed, and children’s voices are subsumed by adult-led services, priorities, and agendas.

Implications
Children’s rights need to be embedded as an aspect of best practice in providing services that are child-centred in occupational therapy practices and education.
Detection of child depression using machine learning methods
Authors: Haque Umme Marzia , Kabir Enamul , Khanam Rasheda 
Published: December 2021

Background
Mental health problems, such as depression in children have far-reaching negative effects on child, family and society as whole. It is necessary to identify the reasons that contribute to this mental illness. Detecting the appropriate signs to anticipate mental illness as depression in children and adolescents is vital in making an early and accurate diagnosis to avoid severe consequences in the future. There has been no research employing machine learning (ML) approaches for depression detection among children and adolescents aged 4–17 years in a precisely constructed high prediction dataset, such as Young Minds Matter (YMM). As a result, our objective is to 1) create a model that can predict depression in children and adolescents aged 4–17 years old, 2) evaluate the results of ML algorithms to determine which one outperforms the others and 3) associate with the related issues of family activities and socioeconomic difficulties that contribute to depression.

Methods
The YMM, the second Australian Child and Adolescent Survey of Mental Health and Wellbeing 2013–14 has been used as data source in this research. The variables of yes/no value of low correlation with the target variable (depression status) have been eliminated. The Boruta algorithm has been utilized in association with a Random Forest (RF) classifier to extract the most important features for depression detection among the high correlated variables with target variable. The Tree-based Pipeline Optimization Tool (TPOTclassifier) has been used to choose suitable supervised learning models. In the depression detection step, RF, XGBoost (XGB), Decision Tree (DT), and Gaussian Naive Bayes (GaussianNB) have been used.

Results
Unhappy, nothing fun, irritable mood, diminished interest, weight loss/gain, insomnia or hypersomnia, psychomotor agitation or retardation, fatigue, thinking or concentration problems or indecisiveness, suicide attempt or plan, presence of any of these five symptoms have been identified as 11 important features to detect depression among children and adolescents. Although model performance varied somewhat, RF outperformed all other algorithms in predicting depressed classes by 99% with 95% accuracy rate and 99% precision rate in 315 milliseconds (ms).

Conclusion
This RF-based prediction model is more accurate and informative in predicting child and adolescent depression that outperforms in all four confusion matrix performance measures as well as execution duration.
REVOLUTION (Routine EValuatiOn of people LivIng with caNcer)—Protocol for a prospective characterisation study of patients with incurable cancer
Authors: Patton Rebekah , Cook Jane , Haraldsdottir Erna , Brown Duncan , Dolan Ross D. , McMillan Donald C. , Skipworth Richard J. E. , Fallon Marie , Laird Barry J. A. 
Published: December 2021

Introduction
There is a pressing need for a holistic characterisation of people with incurable cancer. In this group, where quality of life and improvement of symptoms are therapeutic priorities, the physical and biochemical manifestations of cancer are often studied separately, giving an incomplete picture. In order to improve care, spur therapeutic innovation, provide meaningful endpoints for trials and set priorities for future research, work must be done to explore how the tumour influences the clinical phenotype. Characterisation of the host-tumour interaction may also provide information regarding prognosis, allowing appropriate planning of investigations, treatment and referral to palliative medicine services.

Methods
Routine EValuatiOn of people LivIng with caNcer (REVOLUTION) is a prospective observational study that aims to characterise people with incurable cancer around five key areas, namely body composition, physical activity, systemic inflammatory response, symptoms, and quality of life by developing a bio-repository. Participants will initially be recruited from a single centre in the UK and will have assessments of body composition (bio-impedance analysis [BIA] and computed tomography [CT]), assessment of physical activity using a physical activity monitor, measurement of simple markers of inflammation and plasma cytokine proteins and three symptom and quality of life questionnaires.

Discussion
This study aims to create a comprehensive biochemical and clinical characterisation of people with incurable cancer. Data in this study can be used to give a better understanding of the ‘symptom phenotype’ and quality of life determinants, development of a profile of the systemic inflammatory response and a detailed characterisation of body composition.
Performance of GenoType MTBDRsl assay for detection of second-line drugs and ethambutol resistance directly from sputum specimens of MDR-TB patients in Bangladesh
Authors: Rahman S. M. Mazidur , Nasrin Rumana , Rahman Arfatur , Ahmed Shahriar , Khatun Razia , Uddin Mohammad Khaja Mafij , Rahman Md. Mojibur , Banu Sayera 
Published: December 2021

Background
Rapid and early detection of drug susceptibility among multidrug-resistant tuberculosis (MDR-TB) patients could guide the timely initiation of effective treatment and reduce transmission of drug-resistant TB. In the current study, we evaluated the diagnostic performance of GenoType MTBDRsl (MTBDRsl) ver1.0 assay for detection of resistance to ofloxacin (OFL), kanamycin (KAN) and ethambutol (EMB), and additionally the XDR-TB among MDR-TB patients in Bangladesh.

Methods
The MTBDRsl assay was performed directly on 218 smear-positive sputum specimens collected from MDR-TB patients and the results were compared with the phenotypic drug susceptibility testing (DST) performed on solid Lowenstein-Jensen (L-J) media. We also analyzed the mutation patterns of gyrA, rrs, and embB genes for detection of resistance to OFL, KAN and EMB, respectively.

Results
The sensitivity and specificity of the MTBDRsl compared to phenotypic L-J DST were 81.8% (95% CI, 69.1–90.9) and 98.8% (95% CI, 95.6–99.8), respectively for OFL (PPV: 95.7% & NPV: 94.1%); 65.1% (95% CI, 57.5–72.2) and 86.7% (95% CI, 73.2–94.9), respectively for EMB (PPV: 94.9% & NPV: 39.4%); and 100% for KAN. The diagnostic accuracy of KAN, OFL and EMB were 100, 94.5 and 69.6%, respectively. Moreover, the sensitivity, specificity and diagnostic accuracy of MtBDRsl for detection of XDR-TB was 100%. The most frequently observed mutations were at codon D94G (46.8%) of gyrA gene, A1401G (83.3%) of rrs gene, and M306V (41.5%) of the embB gene.

Conclusion
Considering the excellent performance in this study we suggest that MTBDRsl assay can be used as an initial rapid test for detection of KAN and OFL susceptibility, as well as XDR-TB directly from smear-positive sputum specimens of MDR-TB patients in Bangladesh.
Short communication: Distribution of phospholipids in parotid cancer by matrix-assisted laser desorption/ionization imaging mass spectrometry
Authors: Kanetake Hirofumi , Kato-Kogoe Nahoko , Terada Tetsuya , Kurisu Yoshitaka , Hamada Wataru , Nakajima Yoichiro , Hirose Yoshinobu , Ueno Takaaki , Kawata Ryo 
Published: December 2021

BackgroundParotid cancer is relatively rare, and malignancy varies; therefore, novel markers are needed to predict prognosis. Recent advances in matrix-assisted laser desorption/ionization imaging mass spectrometry (MALDI-IMS), useful for visualization of lipid molecules, have revealed the relationship between cancer and lipid metabolism, indicating the potential of lipids as biomarkers. However, the distribution and importance of phospholipids in parotid cancer remain unclear.ObjectiveThis study aimed to use MALDI-IMS to comprehensively investigate the spatial distribution of phospholipids characteristically expressed in human parotid cancer tissues.MethodsTissue samples were surgically collected from two patients with parotid cancer (acinic cell carcinoma and mucoepidermoid carcinoma). Frozen sections of the samples were assessed using MALDI-IMS in both positive and negative ion modes, with anm/zrange of 600–1000. The mass spectra obtained in the tumor and non-tumor regions were compared and analyzed. Ion images corresponding to the peak characteristics of the tumor regions were visualized.ResultsSeveral candidate phospholipids with significantly different expression levels were detected between the tumor and non-tumor regions. The number of unique lipid peaks with significantly different intensities between the tumor and non-tumor regions was 95 and 85 for Cases 1 and 2, respectively, in positive ion mode, and 99 and 97 for Cases 1 and 2, respectively, in negative ion mode. Imaging differentiated the characteristics that phospholipids were heterogeneously distributed in the tumor regions.ConclusionPhospholipid candidates that are characteristically expressed in human parotid cancer tissues were found, demonstrating the localization of their expression. These findings are notable for further investigation of alterations in lipid metabolism of parotid cancer and may have potential for the development of phospholipids as biomarkers.
We’re Not Here to Entertain: Punk Rock, Ronald Reagan, and the Real Culture War of 1980s America, Kevin Mattson (2020)
Authors: Mego Paul 
Published: December 2021

Review of: We’re Not Here to Entertain: Punk Rock, Ronald Reagan, and the Real Culture War of 1980s America, Kevin Mattson (2020)
New York: Oxford University Press, 288 pp.,
ISBN 978-0-19090-823-2, h/bk, £14
Care-Arbeit und Care-Berufe
Authors: Werding Martin 
Published: December 2021

Abstract
Care work can be provided in various forms and in differing institutional settings, ranging from private households over social networks and charitable organizations to public or private entities employing professional care persons. All these forms of care work create a value-added, but are subject to very different economic conditions. Focusing on professional care and building on German micro-data, the article shows preliminary evidence that there might be a »care wage-gap«, i.e., a systematic disadvantage of care workers compared to other professions in terms of their remuneration. It points out how this presumption could be thoroughly scrutinized and suggests possible reasons - among other things, the existence of informal care - that could be tested in subsequent steps.