bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fever management in children and insights into fever of unknown origin: a survey among Italian pediatricians
Authors: Chiappini Elena , Orlandi Michela , Chiarugi Alberto , Di Mauro Antonio , Insalaco Antonella , Milani Gregorio Paolo , Vallini Monica , Lo Vecchio Andrea 
Published: November 2024

BackgroundFever is a common symptom in children, but despite existing guidelines, pediatricians may not fully apply recommendations. Fever of Unknown Origin (FUO) is generally referred to as an unexplained prolonged fever. However, a standardized FUO definition and management is missing.ObjectiveTo collect updated data on the approach to fever and FUO among Italian pediatricians.MethodsA cross-sectional anonymous survey was conducted among a large sample of primary care and hospital pediatricians. The panel group formulated and proposed a practical FUO definition, using a modified Delphi approach. A 75% consensus was required to reach an agreement.ResultsAmong 620 respondents, paracetamol was the first-choice antipyretic for 97.7% of participants, followed by ibuprofen; 38.4% prescribed antipyretics based on a specific body temperature rather than on child's discomfort, while physical methods were almost completely abandoned. Alternate treatment was recommended by 19.8% (123/620) of participants, 16.9% (105/620) would prescribe antipyretics to prevent adverse events following immunization. Regarding FUO diagnosis, 58.3% (362/620) considered as cut-off a body temperature above 38°C; the duration required was one week according to 36.45% (226/620) of participants, two weeks according to 35.32% (219/620). The FUO definition proposed by the expert panel reached 81% of consent. Large agreement was observed on first-level laboratory and instrumental investigations in the diagnostic evaluation of FUO, whereas more discrepancies arose on second and third-level investigations. Compared to what participants reported for the treatment of non-prolonged fever, a significant decrease in the prescription of paracetamol as first-choice drug in children with FUO was observed (80.5%; P &lt; 0.0001). Interestingly, 39% of participants would empirically recommend antibiotics, 13.7% steroids, and 4.5% Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) for persistent FUO.ConclusionNon-recommended behaviors in fever management persist among pediatricians, including alternating use of paracetamol and ibuprofen, and their prophylactic use for vaccinations. Our data confirm the variability in the definition, work-up, and management of FUO. We observed that in children with FUO paracetamol was significantly less commonly preferred than in non-prolonged fever, which is not supported by evidence. Our findings combined with evidence from existing literature underlined the need for future consensus documents.
Association of recent antibiotic exposure and coronary artery lesions in Kawasaki disease: nationwide study
Authors: Ansai Hideto , Yamada Masaki , Masuda Hiroshi , Imadome Ken-Ichi , Yashiro Mayumi , Noval Rivas Magali , Arditi Moshe , Nakamura Yosikazu , Abe Jun 
Published: November 2024

ObjectivesTo investigate the relationship between recent antibiotic exposure and the development of coronary artery lesions (CALs) during the clinical course of Kawasaki disease (KD).DesignData were obtained from the 25th nationwide epidemiological survey of KD conducted in Japan from 2017 to 2018. Baseline characteristics and clinical course were compared between Antibiotics (+) and Antibiotics (–) groups.SettingNationwide survey of KD in Japan.ParticipantsKD patients were enrolled by response to a questionnaire sent to physicians working in pediatrics at hospitals with &gt;100 beds.ExposureAntibiotic exposure within one week before the first hospital visit as KD patients.Main outcome measuresThe relationship between recent antibiotic exposure and the development of coronary artery lesions (CALs).ResultsOut of 28,265 KD patients, 12,918 (45.7%) received antibiotics. In KD patients who received antibiotics in the week before KD diagnosis, the frequency of coronary artery lesions (CALs) at each phase were significantly higher compared to those who did not receive antibiotics. In further analysis using propensity score matching, recent antibiotic exposure and the initial IVIG resistance were associated with CALs at the acute and the sequelae phase. After adjusting for the status of initial IVIG resistance, recent antibiotic exposure remained associated with CALs during the acute phase (adjusted OR 1.29, 95%CI 1.16, 1.43) and the sequelae phase (1.26, 95%CI 1.04, 1.52).ConclusionsThese observations suggest that recent antibiotic exposure might be associated with higher frequency of CAL development in KD patients, possibly by altering the gut microbiota and diminishing beneficial bacteria.
D-mannose reduces oxidative stress, inhibits inflammation, and increases treg cell proportions in mice with ulcerative colitis
Authors: Lu Yuqing , Xiong Yongjian , Zhang Shuangshuang , Wang Boya , Feng Yuntao , Pu Zhuonan , Wei Kun , Chen Jun , Chen Dapeng , Zhang Peng 
Published: November 2024

BackgroundRegulatory T (Treg) cells is required to dampen immune responses against intestinal microbiota, which aid in a healthy body to promise that the resident gut microbiota should not attract the attention of the immune system. Inflammation and inflammatory bowel disease (IBD) can be induced if the immune system fails to ignore the resident gut microbiota and targets them instead. D-mannose, a common monosaccharide in nature, has been shown to ameliorate multiple autoimmune diseases. This study aimed to investigate the therapeutic effect of D-mannose on mice ulcerative colitis (UC) induced by 2,4,6-trinitrobenzene sulfonic acid (TNBS), and elucidate its underlying mechanisms.MethodsTo simulate human IBD, we constructed a mouse model of UC by injecting TNBS into the colon.ResultsOur results demonstrated that D-mannose treatment effectively alleviated TNBS-induced UC in mice, as evidenced by the amelioration of UC symptoms. D-mannose treatment significantly reduced inflammation by decreasing the expression of proinflammatory cytokines and inflammation mediators. D-mannose treatment also significantly inhibited oxidative stress, promoted the expression of GSH and SOD, decreased the expression of MDA. Mechanistically, D-mannose upregulated the proportion of both CD4(+) Tregs and CD8(+) Tregs.ConclusionIn summary, our study provides the first evidence of the therapeutic effect of D-mannose on mice with UC, which is likely mediated by upregulating Treg proportions.
Hypoxia-induced PD-L1 expression and modulation of muscle stem cell allograft rejection
Authors: Raiten Jacob , Abd Genevieve M. , Handelsman Shane B. , Patel Harshank V. , Ku Jennifer C. , Parsons Agata M. , Wassink Jonathan L. , Hayes Sheridan L. , Overbay Juliana , Li Yong 
Published: November 2024

Stem cell therapy has shown immense promise in treating genetic disorders, particularly muscular diseases like Duchenne muscular dystrophy (DMD). This study investigates a novel method to enhance the viability of stem cell transplants in DMD by upregulating Programmed Death Ligand 1 (PD-L1) in muscle stem cells (MuSCs) through preconditioning with hypoxia and/or interferon-γ (IFN-γ) to mitigate T cell immune rejection. MuSCs were treated with 5% hypoxia for 72 h and further treated with IFN-γ to enhance PD-L1 expression. Additionally, gain and loss experiments using a PD-L1 inhibitor (BMS-1) were conducted to investigate cellular expression profiles in vitro and cell transplantation outcomes in vivo. Our results showed significant upregulation of PD-L1 in MuSCs under hypoxia and IFN-γ conditions without affecting cellular proliferation and differentiation in vitro. In vivo, these preconditioned MuSCs led to decreased infiltration of CD4+ and CD8+ T cells in implanted limb muscles of mouse models. Blocking PD-L1 reduced graft survival in muscles treated with MuSCs. Conversely, increased PD-L1 expression and reduced T cell infiltration correlated with improved graft survival, as identified by pre-labeled LacZ + MuSCs following transplantation. This study provides evidence that hypoxia and IFN-γ preconditioning of MuSCs can significantly enhance the efficacy of cell therapy for DMD by mitigating immune rejection. Our strategic approach aimed to improve donor cell survival and function post-transplantation by modifying immune responses towards the donor cells.
Spatio-temporal dynamics of root water uptake and identification of soil moisture thresholds for precision irrigation in a Mediterranean yellow-fleshed kiwifruit orchard
Authors: Calabritto Maria , Mininni Alba N. , Di Biase Roberto , Pietrafesa Angela , Dichio Bartolomeo 
Published: November 2024

IntroductionActinidia is highly susceptible to water stress, both excess and shortage, and is therefore a model fruit crop for irrigation management, requiring precise water application. The present study was carried out in a mature kiwifruit orchard in southern Italy to investigate the physiology of a yellow-fleshed kiwifruit cultivar under non-limiting soil water conditions and in response to a progressive decrease in soil water content in a Mediterranean environment, with the aim of defining soil moisture thresholds to guide irrigation management.MethodsThe progressive lowering in soil moisture was monitored using multi-profile probes, taking into account a 60 cm layer. Plant water status and physiological parameters were measured throughout the experiment and were significantly correlated with soil water status, suggesting that the level of soil water deficit affects plant physiological performance.ResultsReference minimum values of stem water potential reached during the day under non-limiting soil water conditions ranged from -0.4 to -0.7 MPa, with a value of -0.8 MPa identifying the threshold below which stomatal conductance began to decrease significantly. Soil moisture thresholds were defined according to the spatio-temporal dynamics of available water (AW) reduction, which decreased by approx. 10% and 1% before the onset of water stress and 16% and 2% at the onset of water stress, considered in the 0-30 cm and 30-60 cm soil layers, respectively, compared to the AW content of the whole soil profile.DiscussionResults confirmed that root uptake was mainly concentrated in the first 30 cm of soil depth, which should be properly managed by irrigation, as reduced soil water availability could easily lead to plant water stress. An integrated approach, combining plant measurements and soil water content monitoring, together with an assessment of root water uptake dynamics, is essential to identify soil water thresholds and develop precision irrigation, especially for high water-demanding crops and environments.
Assessing key soft skills in organizational contexts: development and validation of the multiple soft skills assessment tool
Authors: Colledani Daiana , Robusto Egidio , Anselmi Pasquale 
Published: November 2024

IntroductionSoft skills, also known as transversal skills, have gained significant attention in the organizational context due to their positive impact on various work-related outcomes. The present study aimed to develop and validate the Multiple Soft Skills Assessment Tool (MSSAT), a short self-report instrument that evaluates interpersonal skills (initiative-resourcefulness, assertiveness, conflict management), interpersonal communication skills, decision-making style (adaptive and maladaptive), and moral integrity.MethodsThe scale development process involved selecting and adapting relevant items from existing scales and employing a cross-validation approach with a large sample of workers from diverse organizational settings and job positions (N = 639). In the first step, 28 items were carefully chosen from an item pool of 64 items based on their content, factor loadings, item response theory analyses, differential item functioning, and fit statistics. Next, the structure of the resulting scale was evaluated through confirmatory factor analyses.ResultsThe MSSAT demonstrated gender invariance and good reliability and validity. The results of a network analysis confirmed the relationships between soft skills and positive work-related outcomes. Notably, interpersonal communication skills and moral integrity emerged as crucial skills.DiscussionThe MSSAT is a valuable tool for organizations to assess the soft skills of their employees, thereby contributing to design targeted development programs.
Effects of forest bathing (Shinrin-yoku) in stressed people
Authors: Queirolo Luca , Fazia Teresa , Roccon Andrea , Pistollato Elisa , Gatti Luigi , Bernardinelli Luisa , Zanette Gastone , Berrino Franco 
Published: November 2024

AimThis study aims to explore the physiological effect of forest bathing on stress management.MethodsA total of 29 volunteers participated in this pre-post design, which lacked a control group. Several physiological parameters were recorded, including heart rate (HR), heart rate variability (HRV), electrodermal activity (EDA), blood pressure (BP), immunoglobulin A (IGA), and salivary cortisol (sCort). Additionally, the Perceived Stress Scale (PSS-10) was administered before forest exposure. Measurements were taken before and after participants spent 2 days fully immersed in a forest environment. To further assess stress management, participants completed a Mental Arithmetic Task (MAT) before and after forest immersion, during which EDA, HRV, and HR were monitored using an Empatica E4 wristband. Measurements were taken at baseline, during MAT, and afterward (recovery).ResultsParticipants exhibited moderate perceived stress levels before forest immersion (mean PSS-10 = 21.22, SD = 3.78). Post-forest exposure, there was a significant decrease in sCort (p &lt; 0.05) and EDA (p &lt; 0.001), while HRV increased (p &lt; 0.001), and diastolic blood pressure rose (p &lt; 0.05). ANOVA results from the MAT showed a significant increase in parasympathetic activity across all conditions post-immersion (p &lt; 0.05), except during recovery, while EDA decreased in all conditions post-forest exposure (p &lt; 0.05).ConclusionShinrin-yoku significantly improved stress management at a physiological level and could be a valuable intervention for individuals experiencing stress. However, longitudinal studies with a control group are necessary to determine whether these effects are sustained over time. Nonetheless, this study highlights the potential benefits of forest immersion for stress reduction by enhancing sympathovagal balance and the adaptability of the stress response system.
Effects of yoga on stress in stressed adults: a systematic review and meta-analysis
Authors: Schleinzer Alina , Moosburner Alina , Anheyer Dennis , Burgahn Laura , Cramer Holger 
Published: November 2024

BackgroundWith the increasing prevalence of stress, stress reduction is getting more and more important. Yoga is being considered as a non-pharmacological treatment option for stress.ObjectiveInvestigation of the effects of yoga on stress in stressed adults from the general population.MethodsDatabases were searched up to March 17, 2023 (updated search on May 17, 2024). Randomised controlled trials (RCTs) of yoga for stressed adults were included if they assessed perceived stress. Further outcomes were quality of life and stress-related physiological measures. Standardised mean differences (SMDs) and 95% confidence intervals (CIs) were calculated. The quality of the included studies was assessed using the Cochrane tool, and the quality of the evidence for each outcome was graded according to the GRADE recommendations.ResultsA total of 13 RCTs with 1026 participants were included in the qualitative analysis and nine RCTs in the quantitative analysis. The meta-analyses revealed low quality of evidence for short-term effects of yoga on stress compared to passive control groups (SMD=-0.69, 95%CI=-1.12- -0.25) and low quality of evidence for long-term effects on stress in favour of active control groups (SMD=0.23, 95%CI=0.06-0.40). There was moderate quality of evidence for short-term effects of yoga on quality of life compared to passive control groups (SMD=0.86, 95%CI=0.72-1.00). No adverse events occurred in the three safety reporting studies.ConclusionsAs there is low quality of evidence for short-term effects of yoga on perceived stress in stressed adults from the general population compared to passive control groups, yoga can be considered as a non-pharmacological treatment option for stress reduction.Systematic review registrationhttps://inplasy.com/wp-content/uploads/2023/03/INPLASY-Protocol-4595.pdf INPLASY, identifier 202330062.
The effect of occupational exposure to organic dust on lung function parameters among African industrial workers: a systematic review and meta-analysis
Authors: Ashuro Zemachu , Debela Berhanu Gidisa , Daba Chala , Hareru Habtamu Endashaw , Abaya Samson Wakuma , Byrne Anthony L. 
Published: November 2024

IntroductionInadequate ventilation and improper use of personal protective equipment are often observed in many occupational settings with a high risk of dust and other fine particle exposure. Workers who are exposed to dust at work may suffer from respiratory difficulties. Previous systematic reviews on organic dust exposure and its association with respiratory health outcomes did not provide a comprehensive assessment. Therefore, the objective of this systematic review and meta-analysis was to summarize the reported effects of organic dust exposure on lung function parameters among African industrial workers.MethodsA compressive literature search was conducted in PubMed, MEDLINE, Google Scholar, Embase, the Web of Science, African Journals Online, and ScienceDirect databases to identify relevant studies for the review. The Newcastle–Ottawa Scale (NOS) was used to assess the quality of the included studies. The lung function indices including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1), the FEV1/FVC ratio, and peak expiratory flow rate (PEFR) were obtained from primary studies and analyzed using STATA version 17. The I2 test was used to assess the heterogeneity of studies. We used a random-effects model to estimate the pooled standard mean difference in lung function indices between organic dust-exposed and non-exposed industrial workers. To analyze publication bias, funnel plots and Egger’s test were applied.ResultsIn this systematic review and meta-analysis, 32 studies involving 7,085 participants were included from 13,529 identified studies. The estimated mean differences with 95% confidence intervals were as follows: −0.53 [−0.83 to −0.36] L for FVC, −0.60 [−0.77 to −0.43] L for FEV1, −0.43 [−0.57, −0.29] L for FEV1/FVC, and −0.69 [−0.88 to −0.50] L/min for PEFR.ConclusionThis systematic review and meta-analysis revealed that the lung function indices, such as FVC, FEV1, FEV1/FVC, and PEFR, were statistically significantly lower among organic dust-exposed industrial workers compared to non-exposed industrial workers. Therefore, effective dust control measures should be implemented to protect workers from exposure to organic dust.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024527139.
Seroprevalence and risk factors for brucellosis amongst livestock and humans in a multi-herd ranch system in Kagera, Tanzania
Authors: Lyimo Beatus , Hugho Ephrasia , Mathew Coletha , Mayenga Charles , Lukambagire Abdul Hamid , Lyimo Samson , Munuo Lidia , Byukusenge Maurice , Withall Jodie , Ashford Roland T. , Mmbaga Blandina T. , Makondo Zachariah , McGiven John , Radzio-Basu Jessica , Ganda Erika , Middlebrook Earl A. , Bartlow Andrew W. , Fair Jeanne M. , Shirima Gabriel , Sriranganathan Nammalwar , Kazwala Rudovick R. , Hudson Peter J. , Cattadori Isabella M. , Kapur Vivek , Buza Joram J. , Katani Robab 
Published: November 2024

BackgroundBrucellosis remains a significant health and economic challenge for livestock and humans globally. Despite its public health implications, the factors driving the endemic persistence of Brucella at the human-livestock interface in Tanzania remain poorly elucidated. This study aimed to identify the seroprevalence of Brucella infection in livestock and humans within a ranching system and determine associated risk factors for disease endemicity.MethodsA cross-sectional sero-epidemiological study was conducted in 2023 in Tanzania’s Karagwe District, involving 725 livestock (cattle, goats, sheep) from 10 herds and 112 humans from associated camps. Seroprevalence was assessed using competitive ELISA while epidemiological data were collected via questionnaires. Generalized Linear Models and Contrast Analysis were used to identify risk factors for infection.ResultsOverall seroprevalence was 34% in livestock and 41% in humans. Goats exhibited the highest prevalence (69.2%), while cattle had the lowest (22.6%). Mixed-species herds (Odds Ratio, OR = 2.96, CI [1.90–4.60]) and small ruminants-only herds (OR = 6.54, CI [3.65–11.72]) showed a significantly higher risk of seropositivity compared to cattle-only herds. Older cattle (OR = 5.23, CI [2.70–10.10]) and lactating females (OR = 2.87, CI [1.78–4.63]) represented significant risks for brucellosis in livestock. In humans, close contact with animals (OR = 7.20, CI [1.97–36.31]) and handling animals during parturition or aborted fetuses (OR = 2.37, CI [1.01–5.58]) were significant risk factors. Notably, no spatial association was found in seroprevalence between herds and nearby human communities.ConclusionThe lack of spatial correlation between livestock and human seroprevalence suggests complex transmission dynamics, potentially involving endemic circulation in livestock and human infections from multiple sources of exposure to livestock. This study highlights the need for comprehensive zoonotic risk education and targeted intervention strategies. Further research is crucial to elucidate transmission pathways and improve Brucella infection control. This includes developing robust methods for identifying infective species and implementing effective strategies to mitigate Brucella infection in endemic regions.