bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aspartame enhances the scavenging activity of mice to low‐dose Escherichia coli infection via strengthening macrophage phagocytosis caused by sweet taste receptor activation
Authors: Liu Yulin , Huang Yilin , Yang Wei , Hu Weiqing , Wu Zhizhongbin , Wu Tianyue , Pu Yu , Jiang Yunbin , Zhu Huifeng , Zhang Jifen , Cheng Fang , Feng Shan 
Published: November 2024

AbstractAspartame is the most common artificial sweetener and a famous sweet‐taste receptor agonist. Macrophages are essential in the antibacterial system to maintain the stability of the intestinal environment. Recently, the sweet taste receptor has been found in macrophages. However, the effects of aspartame on macrophage phagocytosis in the gastrointestinal tract are little known. The current study sought to assess the influence of aspartame intake on the scavenging activity of mice to low‐dose Escherichia coli infection and related mechanisms. Firstly, no inflammatory response or pathological injury was observed in the intestines of mice after oral administration of aspartame (25–100 mg/kg, i.g.) for 2 weeks. Subsequently, aspartame intake was found to enhance the scavenging activity of mice to low‐dose E. coli infection. Similarly, aspartame dose‐dependent strengthened the ability of RAW264.7 cells to phagocytose GFP‐E.coli J96. Further mechanism evaluation reflected that aspartame could enhance macrophage phagocytosis, migration, and rearrangement via PLCβ‐2/Ca2+/PKCβ/Rho A/ROCK1 pathway caused by sweet taste receptor activation. In conclusion, the present study, for the first time, demonstrated that aspartame could enhance the scavenging activity of mice to low‐dose E. coli infection via strengthening macrophage phagocytic function through activating sweet taste receptor. It is then suggested that aspartame may affect the antibacterial activity of human gastrointestinal macrophages, and further studies need to validate these effects.
Size Matters: A Comparative Study on Midday Fogging and Lens Settling in Patients With Keratoconus Wearing Mini-Scleral Lenses With Two Different Diameters
Authors: Bagatur Vurgun Elif , Akkaya Turhan Semra , Toker Ayşe Ebru 
Published: November 2024

Purpose:
The objective of this study was to compare the changes in postlens fluid optical density, timing and quantity of lens settling, and the clinical performance between two different mini-scleral lenses.

Methods:
Seventeen eyes of 10 patients with keratoconus were fitted with a 15-mm mini-scleral lens (AirKone Scleral Lenses; Laboratoire LCS, Normandy, France), and 15 eyes of 10 patients with keratoconus were fitted with 16.5-mm mini-scleral lenses (Misa Lenses; Microlens Contactlens Technology, Arnhem, The Netherlands). The lens fit was evaluated with biomicroscopy and anterior segment optical coherence tomography (AS-OCT). At 0, 2, and 4 hrs, corneal clearances were measured with AS-OCT, and optical density measurements were made by Scheimpflug tomography. High-contrast visual acuity (HCVA) and contrast sensitivity (CS) were assessed at each time point. At the end of the 4th hour, participants' comfort, visual quality, and general satisfaction were evaluated with a 5-point Likert scale and 100-mm Visual Analog Scale (VAS) scale.

Results:
The mean age (24.4 ± 5.4 vs. 21.7 ± 4.5, P = 0.145) and best spectacle-corrected HCVA (0.36 ± 0.15 vs. 0.35 ± 0.20, P = 0.984) were similar in both groups. The mean Snellen HCVA significantly improved with dispensing both mini-scleral lenses and remained stable at 4 hrs in both groups. In comparison, CS significantly decreased at 4 hrs in both groups (P = 0.02). Both groups' optical density significantly increased over time (P = 0.003). In the 15-mm mini-scleral lens group, the settling amount was 62.2 ± 11.9 μm (62.6%) and 99.5 ± 14.2 μm (100%) at 2 and 4 hrs, respectively; in the 16.5-mm mini-scleral lens group, it was 46.4 ± 22.3 μm (56.4%) and 82.1 ± 37.3 μm (100%) at 2 and 4 hrs, respectively. More than 50% of settling occurred in the first 2 hrs in both groups. No significant difference was observed between the two groups with regard to visual acuity, CS, optical density, and total settling amount at 4 hrs (P > 0.05). Patient in the 15-mm mini-scleral lens group scored higher in comfort (4.65 ± 0.7 vs. 3.60 ± 0.9), visual quality (4.76 ± 0.4 vs. 3.73 ± 0.7), and overall satisfaction (95.7 ± 6.0 vs. 65.3 ± 20.3) (P < 0.0001).

Conclusion:
Patients reported a heightened level of contentment with the smaller-diameter lens; however, it is crucial to emphasize that both diameter scleral lenses showcase comparable clinical efficacy, midday fogging, and settling.
Musculoskeletal Sepsis in the Pediatric Intensive Care Unit
Authors: Hunter Sarah , Brown Elsie , Crawford Haemish , Selak Vanessa , Grant Cameron 
Published: November 2024

Background:
Childhood bone and joint infection (BJI) ranges in severity, with the most unwell children requiring pediatric intensive care unit (PICU) support. We describe demographic and prehospital features of BJI cases associated with PICU admission and report treatment outcomes and costs for these cases.

Methods:
This study includes a retrospective cohort of children ≤15 years of age hospitalized with acute hematogenous osteomyelitis or septic arthritis in Auckland between 2018 and 2023. Cases admitted to PICU were compared to non-PICU hospitalized BJI cases. Direct medical hospitalization costs, treatment type and outcomes were described up to 1 year following discharge.

Results:
Of 563 BJI cases, 43 (8%) were admitted to PICU. PICU cases had shorter prehospital symptom duration (3.78 vs. 5.73 days, P = 0.0002). Sensitive Staphylococcus aureus was equally likely to cause disease in PICU and non-PICU cases (P = 0.86). Average hospitalization was longer (35.78 vs. 8.71 days, P ≤ 0.0001) for those admitted to PICU. Readmission and complication rates were both higher within the first year. Average cost per admission was $378,120 NZ dollars (±$796,891.64) for PICU cases versus $32,219 (±$201,797.33), P = 0.01 for cases not requiring PICU admission. In regression analysis, Māori ethnicity, previous history of infections and congenital conditions were statistically associated with PICU admission.

Conclusion:
In this study, children admitted to PICU with severe BJIs were more likely to have a history of congenital conditions or previous infections. Those of Māori ethnicity are overrepresented. Children treated in PICU have longer hospitalizations and experience more adverse outcomes at 1 year following discharge.
Evaluating the Impact of Moderate and Severe Varicella Infections on Danish Children Under 18 Years Old: A Comprehensive Analysis From 2015 to 2023
Authors: Egeskov-Cavling Amanda Marie , Johannesen Caroline Klint , Folke Fredrik , Fischer Thea K. 
Published: November 2024

Background:
Varicella (chickenpox) caused by varicella-zoster virus (VZV) is a highly contagious pediatric disease. While it typically manifests as a mild disease, complications leading to hospitalization are not uncommon. Knowing the current disease burden, seasonality and risk groups is pivotal for evidence-based decisions on the introduction of a varicella vaccine.

Methods:
Using the Danish National Patient Register and medical helpline records from the Capital Region, we estimated the burden of VZV infections among children younger than 18 years in Denmark from 2015 to June 2023.

Results:
We identified 14,443 cases with annual incidence rates of 325/100,000 children for mild-to-moderate varicella cases (helpline calls), 35/100,000 for moderate-to-severe cases (outpatients) and 10/100,000 for severe cases (hospitalized). Mild cases were most prevalent in children 1–4 years old, while moderate-to-severe cases were most prevalent among infants <1 year old. Among hospitalized cases, 23.2% had underlying diseases and 47.3% experienced complications. In April 2022, rapid surge in all types of VZV cases occurred, where admissions surpassed the prepandemic level.

Conclusion:
This study documents that varicella is highly prevalent among Danish young children. Mild-to-moderately severe cases strain healthcare, causing increased helpline calls and posing a persistent hospitalization risk, especially for infants and children with underlying conditions.
Infantile Pasteurella multocida Meningitis: Case Report and Review of the Literature
Authors: Inglis Christian , Wen Sophie C. H. , Kapoor Vishal 
Published: November 2024

Background:

Pasteurella multocida is a rare cause of deep-seated pediatric infections including osteomyelitis and meningitis. We report a case of P. multocida meningitis from Queensland, with a comprehensive review of literature.

Methods:
Three databases were searched for infants < 12 months of age with confirmed P. multocida meningitis. Mode of transmission, clinical and laboratory features, imaging, treatment and complications were reviewed. Logistic regression analysis was performed to evaluate predictors for outcomes including short-term neurologic complications, any long-term complications and mortality.

Results:
A total of 74 infants were included, with most cases occurring from indirect household animal contact (42/74; 61%). Bacteremia (38/74; 51%) and seizures (15/74, 20%) were common complications with mortality in 6 children (8%). Young infant age appeared to be the single most important risk factor for bacteremia.

Conclusions:
Infantile P. multocida meningitis although rare has potentially devastating complications. Younger infants are more likely to develop concomitant bacteremia. Household hand hygiene is imperative after trivial interactions with pets.
Challenges of Congenital HHV6 Infection Diagnosis and Treatment: Two Case Reports and Literature Review
Authors: Fernandes Andreia , Pereira Mafalda , Oliveira Íris , Novo Marta , Soares Marta , Ramalho Ana Raquel , Santos Vera , Vinagre Elsa , Lopo Silvia , Gaspar Luísa 
Published: November 2024

Introduction:
Congenital human herpesvirus 6 (HHV6) infection occurs in 1% of the general population and may result from the transmission of an inherited chromosomally integrated HHV6 (iciHHV6) or transplacental infection. It is mostly asymptomatic.

Case reports:
Case 1: a 29th-week-old female preterm newborn, admitted to the neonatal intensive care unit, became clinically unstable and irritable on the 20th day of hospitalization. Cranial ultrasound, revealed a significant posthemorrhagic tetraventricular dilation, with signs of ventriculitis. Investigations revealed HHV6 positivity on cerebrospinal fluid polymerase chain reaction multiplex panel testing and HHV6-DNA high viral loads in plasma samples. Case 2: a female late preterm newborn was admitted to the neonatal intensive care unit due to early-onset sepsis. Investigations revealed group B streptococcus positive blood cultures and cerebrospinal fluid HHV6 positivity on polymerase chain reaction multiplex panel testing, with negative bacterial culture. After 3 days of adequate antibiotic treatment, she maintained persistent moaning, which motivated a cranial ultrasound, revealing mild brain edema. Clinical improvement was observed only after beginning antiviral treatment in both newborns. Due to the persistency of high viral loads in both cases, despite antiviral treatment and clinical improvement, an iciHHV6 was suspected and posteriorly confirmed.

Discussion/conclusion:
Congenital iciHHV6 infection diagnosis is challenging because the presence of an iciHHV6 results in persistently high viral loads, even in the absence of active infection. Only a few diagnostic techniques can confirm active replication; unfortunately, these are not available in most countries. The decision to initiate antiviral treatment should be based on clinical judgment. Better ways for the diagnosis of active infection are needed.
The Prevalence, Serogroup Distribution and Risk Factors of Meningococcal Carriage in Children, Adolescents and Young Adults in Turkey Meningo-Carr-TR Study PART 3: COVID-19 Pandemic Situation
Authors: Kizil Mahmut Can , Kara Yalcin , Karbuz Adem , Oz Fatma Nur , Ciftci Ergin , Kurugol Zafer , Iseri Nepesov Merve , Celebi Solmaz , Cetin Benhur Sirvan , Yilmaz Dilek , Dinleyici Meltem , Kizmaz Isancli Didem , Kilicaslan Onder , Ozdemir Halil , Inceli Belkis Hatice , Penezoglu Dondu Nilay , Dortkardesler Burce , Sezer Yamanel Rabia G. , Aksoy Fatma Dilsad , Tekin Can Sedanur , Agrali Eröz Nesli , Kaya Mucahit , Kilic Omer , Dinleyici Ener Cagri 
Published: November 2024

Background:
The prevalence of meningococcal carriage and serogroup distribution is crucial for assessing the epidemiology of invasive meningococcal disease, forecasting outbreaks and formulating potential immunization strategies. Following the meningococcal carriage studies conducted in Turkey in 2016 and 2018, we planned to re-evaluate meningococcal carriage in children, adolescents and young adults during the COVID-19 pandemic period.

Methods:
In the MENINGO-CARR-3 study, we collected nasopharyngeal samples from 1585 participants 0–24 years of age, across 9 different centers in Turkey. We used polymerase chain reaction and serogroup distribution to determine how common it is for people to carry Neisseria meningitidis.

Results:
The overall meningococcal carriage rate was 8.5% (n = 134). The serogroup distribution was as follows: serogroup A, 6%; serogroup B, 30.6%; serogroup W, 12.7%; serogroup Y, 3.7%; serogroup X, 1.5% and nongroupable as 45.5%. The highest carriage rate was found in 15–17-year-old adolescents (24.1%, 17.9%, and 20.2%, respectively). The carriage rate was higher among participants who had a previous COVID-19 infection (P = 0.05; odds ratio: 1.95; 95% confidence interval: 1.11–3.44). The nasopharyngeal carriage rate was also higher than in the 2016 and 2018 studies (8.45% vs. 6.3% and 7.5%, respectively), and the most prevalent groupable serogroup was B during this study period, followed by serogroup W in 2016 and serogroup X in 2018.

Conclusions:
The present study found that meningococcal carriage was higher during the post-COVID-19 pandemic period, especially in adolescents and young adults. Severe acute respiratory syndrome coronavirus-2 virus itself and/or pandemic mitigation strategies may affect both meningococcal carriage and serogroup distribution. Serogroup distribution varies between years, and further immunization strategies, including adolescent immunization, may play a role in controlling invasive meningococcal disease.
Potential Impact of Rapid Molecular Microbiologic Diagnosis for Mechanically Ventilated Children in Intensive Care With Suspected Pneumonia
Authors: Silcock Robyn , Clifford Vanessa , Osowicki Joshua , Gelbart Ben 
Published: November 2024

Background:
Lower respiratory tract infections (LRTIs) remain a leading cause of community-acquired and nosocomial infection in children and a common indication for antimicrobial use and intensive care admission. Determining the causative pathogen for LRTIs is difficult and traditional culture-based methods are labor- and time-intensive. Emerging molecular diagnostic tools may identify pathogens and detect antimicrobial resistance more quickly, to enable earlier targeted antimicrobial therapy.

Methods:
This is a single-center, prospective observational laboratory study evaluating the use of the Biofire FilmArray pneumonia panel (FA-PP) (BioFire Diagnostics, Salt Lake City, UT) for bronchoalveolar lavage specimens from mechanically ventilated children admitted with suspected or presumed pneumonia. We aimed to determine its feasibility and utility for identifying pathogens, antimicrobial resistance and its potential influence on antibiotic prescribing.

Results:
We analyzed 50 samples taken from 41 children with a median age of 6 months. Positive agreement between culture and FA-PP was 83% and negative agreement was 76%. Agreement between FA-PP (mecA/C or MREJ) and culture was high for methicillin-resistant Staphylococcus aureus. In 3 cases, extended-spectrum beta-lactamase-producing Gram-negative organisms were detected by culture and not FA-PP. Hypothetically, FA-PP results would have affected antimicrobial prescribing in approximately half the cases (24, 48%).

Conclusions:
FA-PP is a useful adjunct to traditional culture methods in mechanically ventilated children with LRTIs and may influence clinical decision-making regarding antibiotic escalation or stewardship.
Precipitate, preterm labor in acute organophosphate poisoning in pregnancy: a case report
Authors: Shah Rosy , Pokhrel Amrit , Shrestha Anil , Shrestha Saroj , Sah Amrita , Shah Raj 
Published: November 2024

Introduction:
Acute organophosphorus poisoning (AOPP) during pregnancy is uncommon. When complicated by preterm labor, it presents therapeutic dilemmas due to the lack of established guidelines.

Case presentation:
The authors describe a case of a 19-year-old primigravida at 33 weeks of gestation with AOPP. During her treatment, she unexpectedly experienced preterm, precipitate labor, resulting in the delivery of a live, healthy baby.

Discussion:
Late-pregnancy exposure to organophosphates may trigger preterm labor through receptor hyperstimulation from excess acetylcholine, causing premature contractions. Atropine, progesterone, and magnesium sulfate may help manage these effects.

Conclusion:
This case underscores the importance of vigilance and frequent clinical examinations in patients with AOPP to identify subtle early signs of potential complications.
Prognostic Significance of C-MYC and EGFR Overexpression in Gastrointestinal Stromal Tumors: An Immunohistochemical Study
Authors: Ben Rejeb Sarra , Aloui Dorra , Ayari Asma , Chouchen Adnen 
Published: November 2024

Introduction:
In addition to mutations in KIT and PDGFRA, many other genetic alterations have been described in gastrointestinal stromal tumors (GISTs), including amplifications of C-MYC and EGFR, which are often associated with increased protein expression. The main of this study was to investigate the prognostic significance of C-MYC and EGFR expression in GISTs using immunohistochemistry (IHC).

Methods:
We collected all GIST cases over a 16-year period. These cases were tested using antibodies against C-MYC (Leica, clone EP121) and EGFR (Leica, clone 113). C-MYC staining was assessed using the H-score method for nuclear, cytoplasmic, and combined staining. For EGFR staining (either cytoplasmic or nuclear), the intensity was graded as follows: 0 (no staining), 1 (weak staining), 2 (moderate staining), and 3 (strong staining). The percentage of positive cells was evaluated using a semiquantitative approach. Statistical analysis was performed using SPSS24.

Results:
A total of 37 cases were included in our study. Nuclear expression of C-MYC was observed in 43% of the cases, with a high H-score in 43%. A statistically significant association was found between a high nuclear H-score for C-MYC and mitotic rate (P=0.046), as well as a high Ki-67 proliferation rate (P=0.046). However, no statistically significant associations were identified between the nuclear H-score of C-MYC and other clinical, pathologic, or survival data. Cytoplasmic expression of C-MYC was noted in 22% of cases, but no significant correlations were found with the clinicopathological data. EGFR staining was observed in 86% of cases, with a high score of 51%. EGFR expression was significantly associated with the mitotic index (P=0.012) and Ki-67 proliferation rate (P=0.046).

Conclusions:
Our findings suggest that both C-MYC and EGFR may be overexpressed and/or amplified in GISTs, indicating their potential prognostic role. This could also pave the way for therapeutic strategies targeting these proteins.
Pregnancy after amputation: A national survey of prosthetic and mobility outcomes in women with lived experience
Authors: Bateman Emma A. , Viana Ricardo , Sales Darda , Payne Michael W. C. 
Published: November 2024

Background:
In pregnancy, women with limb loss or deficiency or lower extremity amputations (LEAs) may experience physiologic changes affecting mobility, prosthesis use, and/or pain. However, little is known about the pregnancy-related experiences of these women.

Objective:
The objective of this research was to characterize pregnancy-related experiences including complications, impact on prosthesis use, gait aid use, and mobility for women with LEAs.

Study Design:
A national, self-administered online survey. Data were analyzed using descriptive statistics. Thematic analyses were performed on open-ended questions. Participants were women with 1 or more LEA(s) who had been pregnant within the last 5 years and were recruited via social media, LEA clinics, and word of mouth.

Results:
Sixteen women from 4 Canadian provinces completed the survey describing 31 pregnancies. A total of 9 had acquired LEAs and 7 had congenital LEAs. All but 1 respondent had unilateral LEAs; most common level was transfemoral (38%). All wore a prosthesis daily and were K-level 4 ambulators. Five (31%) had to decrease or stop prosthesis use, and 6 (25%) required a gait aid or wheelchair during pregnancy. The most common pregnancy-associated complications were low back pain (64%), changes to limb size/prosthesis comfort (64%), reduced balance (44%), falls (38%), and postpartum depression (25%).

Conclusion:
This survey is the first to describe the many unique challenges women with LEAs may experience in pregnancy and highlights important information for women with LEAs, their health care providers, their rehabilitation team, and avenues for future research.
New Diagnoses of Juvenile Idiopathic Arthritis Early in the COVID-19 Pandemic
Authors: Rege Sanika , Parlett Lauren E. , Neikirk Amanda , Iizuka Alicia , Yang Yiling , Huang Cecilia , Crystal Stephen , Davidow Amy , Haynes Kevin , Gerhard Tobias , Rose Carlos D. , Strom Brian L. , Horton Daniel B. 
Published: November 2024

Background/Objective
Little is known about the rates of rheumatic disease diagnosis among children during the COVID-19 pandemic. We examined the impact of the pandemic on the diagnosis of juvenile idiopathic arthritis (JIA) in the United States.

Methods
We performed a historical cohort study using US commercial insurance data (2016–2021) to identify children aged <18 years without prior JIA diagnosis or treatment in the prior ≥12 months. New JIA diagnoses were identified using a combination of ICD-10-CM diagnosis codes, location, and timing of medical services. Crude rates with 95% confidence intervals (CIs) of JIA diagnosis per 100,000 enrolled children per quarter were estimated and stratified by age group, sex, region, JIA type, and uveitis. The incidence rate ratio (95% CI) for JIA diagnosis was estimated using Poisson regression, adjusted for various demographic variables.

Results
From 2018–2021, 643 children were diagnosed with JIA. Crude new JIA diagnoses per 100,000 children per quarter dropped from 2.62 (95% CI, 2.39–2.87) prepandemic to 1.94 (95% CI, 1.66–2.25) during the pandemic. Declines in JIA diagnosis were more apparent in the US Northeast and West regions and among children aged 6–11 years. After adjustment for covariates, JIA diagnoses fell by 30% during the pandemic compared with the prior 3 years (IRR, 0.70; 95% CI, 0.59–0.83).

Conclusions
Compared with the prepandemic period, JIA was diagnosed 30% less often during the early pandemic among commercially insured children in the United States. More research is needed to understand the underlying reasons for these changes in JIA diagnosis and more recent trends.