bluuebunny/crossref_metadata_2025_split huggingface dataset:
DNA supercoiling enhances DNA condensation by ParB proteins
Authors: Martin-Gonzalez Alejandro , Tišma Miloš , Analikwu Brian T , Barth Anders , Janissen Richard , Antar Hammam , Kemps Gianluca , Gruber Stephan , Dekker Cees 
Published: October 2024

Abstract
The ParABS system plays a critical role in bacterial chromosome segregation. The key component of this system, ParB, loads and spreads along DNA to form a local protein–DNA condensate known as a partition complex. As bacterial chromosomes are heavily supercoiled due to the continuous action of RNA polymerases, topoisomerases and nucleoid-associated proteins, it is important to study the impact of DNA supercoiling on the ParB–DNA partition complex formation. Here, we use an in-vitro single-molecule assay to visualize ParB on supercoiled DNA. Unlike most DNA-binding proteins, individual ParB proteins are found to not pin plectonemes on supercoiled DNA, but freely diffuse along supercoiled DNA. We find that DNA supercoiling enhances ParB–DNA condensation, which initiates at lower ParB concentrations than on DNA that is torsionally relaxed. ParB proteins induce a DNA–protein condensate that strikingly absorbs all supercoiling writhe. Our findings provide mechanistic insights that have important implications for our understanding of bacterial chromosome organization and segregation.
Impact of molecular classification on prognosis in children and adolescents with spinal ependymoma: Results from the HIT-MED database
Authors: Engertsberger Lara , Benesch Martin , Mynarek Martin , Tonn Svenja , Obrecht-Sturm Denise , Perwein Thomas , Stickan-Verfürth Martina , Funk Angela , Timmermann Beate , Bockmayr Michael , Eckhardt Alicia , Claviez Alexander , Kortmann Rolf-Dieter , Riemenschneider Markus J , Pietsch Torsten , Bison Brigitte , Warmuth-Metz Monika , Pajtler Kristian W , Rutkowski Stefan , Schüller Ulrich 
Published: October 2024

Abstract

Background
Ependymomas of the spinal cord are rare among children and adolescents, and the individual risk of disease progression is difficult to predict. This study aims to evaluate the prognostic impact of molecular typing on pediatric spinal cord ependymomas.

Methods
Eighty-three patients with spinal ependymomas ≤22 years registered in the HIT-MED database (German brain tumor registry for children, adolescents, and adults with medulloblastoma, ependymoma, pineoblastoma, and CNS-primitive neuroectodermal tumors) between 1992 and 2022 were included. Forty-seven tumors were analyzed by DNA methylation array profiling. In 6 cases, HOXB13 and MYCN proteins were detected as surrogate markers for specific methylation classes. Ten patients had NF2-related schwannomatosis.

Results
With a median follow-up time of 4.9 years, 5- and 10-year overall survival (OS) were 100% and 86%, while 5- and 10-year progression-free survival (PFS) were 65% and 54%. Myxopapillary ependymoma (SP-MPE, n = 32, 63%) was the most common molecular type followed by spinal ependymoma (SP-EPN, n = 17, 33%) and MYCN-amplified ependymoma (n = 2, 4%). One case could not be molecularly classified, and one was reclassified as anaplastic pilocytic astrocytoma. 5-year PFS did not significantly differ between SP-MPE and SP-EPN (65% vs. 78%, P = .64). MYCN-amplification was associated with early relapses (&lt;2.3 years) in both cases and death in one patient. Patients with SP-MPE subtype B (n = 9) showed a non-significant trend for better 5 years-PFS compared to subtype A (n = 18; 86% vs. 56%, P = .15). The extent of resection and WHO tumor grades significantly influenced PFS in a uni- and multivariate analysis.

Conclusions
Molecular typing of pediatric spinal ependymomas aids in identifying very high-risk MYCN-amplified ependymomas. Further insights into the molecular heterogeneity of spinal ependymomas are needed for future clinical decision-making.
Assessing Dietary Creatine Intake in Population Studies: Challenges and Opportunities
Authors: Ostojic Sergej M 
Published: October 2024

Abstract
Limited data exist for establishing the dietary requirements for creatine in the general population. This paper delineates the challenges linked to estimating creatine intake from a typical diet, and explores opportunities to improve the assessment of population-wide creatine intake. Conducting additional food chemistry studies with creatine as a standard analyte, labeling the creatine content in common foods, generating more diverse data from population-based studies, and validating new biomarkers could facilitate the establishment of nutrient reference values for this conditionally essential nutrient.
Social media homophily among women and men political candidates
Authors: Cioroianu Iulia , Coffé Hilde 
Published: October 2024

Abstract
This paper assesses differences between women and men political candidates in their likelihood to interact with peers who share the same gender, political affiliation, electoral district, incumbency, age, and the governmental status of their party. Using Twitter (currently X) data from Finland’s 2019 election campaign, we find a tendency towards homophily—a tendency to interact predominantly with similar others—among all candidates across the various studied characteristics. However, some gender differences in the tendency towards homophily emerge. Notably, women are more inclined than men to retweet candidates from their own party but are less likely to retweet peers with the same incumbency status and the same gender. Our multivariate analyses further show that retweet tendencies based on age, shared electoral district and party governmental status exhibit no significant gender disparities. These nuanced variations in homophilous relations highlight the complex interplay between gender and other characteristics in candidates’ social media interactions during electoral campaigns.
23 Probing bias: Understanding the experiences of Black, Indigenous and People of Colour (BIPOC) caregivers for children with developmental disabilities and their involvement with child protection
Authors: Nallathamby Shanthiya , Young Elizabeth , Jegathesan Thivia , Peak Julia , Baptiste Nekeisha Jean , Forbes Patricia , Minhas Ripudaman , Suleman Shazeen , Milligan Karen 
Published: October 2024

Abstract

Background
In Canada and abroad, a disproportionate number of Black Indigenous and Persons of Colour (BIPOC) experience referral to child protective services (CPS). Children with developmental disabilities, including Autism Spectrum Disorders (ASD) and intellectual disabilities (IDD), are also disproportionately CPS-involved. Recent Canadian research has suggested that almost a quarter of children from a complex care paediatric program are CPS-involved, however there is no known research for ASD/IDD populations seen in a general paediatric clinic. Further, intersections of race/ethnicity and ASD/IDD and CPS involvement have not been examined.

Objectives
We are conducting a mixed methods study to explore the intersections of race, developmental disabilities and involvement with CPS for our paediatric population.

Design/Methods
Phase 1: We completed a retrospective cohort study of 349 patients (0-18 years of age) who were seen by a paediatrician and social worker at a large, hospital-based paediatric clinic in Toronto, Canada in 2019. Electronic medical record data was reviewed and the following binary variables (yes/no) coded CPS-involved or referral made, 1+ caregiver identify as BIPOC, and primary language of caregiver(s) not English.

Results
Preliminary analyses indicate that 11.7% of our sample is CPS-involved. Contrary to over-representation of BIPOC families in the general CPS population, we found that the proportion of families involved with CPS was lower for BIPOC than non-BIPOC families. A similar pattern was observed for primary language, with a trend towards caregivers who reported English as a second language being less likely to be CPS-involved. In our presentation, we will present analyses regarding the type and intensity of CPS involvement and include other demographic characteristics of the family. These findings will be interpreted with findings from Phase 2 (currently underway), which explores lived experiences of 40 caregivers involved with CPS drawn from Phase 1.

Conclusion
Within an ASD/IDD patient sample, BIPOC families were less likely to be involved with CPS than non-BIPOC families. This finding is in stark contrast to provincial rates that suggest a 2.2 times greater likelihood of CPS-involvement for Black youth. While these results on the surface suggest equity, they may still reflect bias. It is possible that the concerns of BIPOC families are being downplayed in comparison to non-BIPOC families, reducing their access to supportive services.
37 Adverse events associated with paediatric emergency medicine virtual clinic visits
Authors: Manolescu Sabrina , Chase Alexander , Belisle Sheena , Joubert Gary , Berhe Abel , Istasy Paul 
Published: October 2024

Abstract

Background
Emergency medical care inherently carries a potential for adverse events. With the increase in virtual medical care due to its ease of access and ability to limit the spread of infection, there is a need to evaluate the safety of paediatric emergency medicine virtual clinics.

Objectives
To elucidate the frequency of adverse events occurring within 7 days of accessing medical care provided by a Paediatric Emergency Medicine Virtual Clinic. We then seek to characterize the severity, nature, and preventability of the adverse events and to provide a knowledge base for future work related to patient safety in the virtual emergency care domain.

Design/Methods
This study was a prospective cohort study where the primary outcome was the proportion of patients who experienced an adverse event within 7 days of accessing care through a virtual emergency clinic. Data was collected through telephone interviews and chart analysis with the use of a validated adverse events trigger tool to determine which charts required independent physician review. The final data was categorized using descriptive statistics, and logistic regression analysis was conducted to examine potential predictors of adverse events.

Results
Of 593 eligible families, 232 (39%) consented to participate and completed the interview process. Of these families, 89 were flagged for further review, and subsequent analysis concluded that 5 (2.2%) had experienced an adverse event. Of the adverse events, 4 (80%) were considered preventable and the most common type of adverse event was sub-optimal follow up (60%). The median patient age was 3.0 years (IQR 1.0-5.0). There were no clinically significant differences between the patients who experienced an adverse event and those that did not across the parameters studied (age, sex, gender, medical complexity, length of symptoms, language of fluency, and self-identification of visible minority status).

Conclusion
2.2% of patients, approximately 1 in 45, experienced adverse events related to the care they received at the virtual clinic. The majority of these adverse events were preventable. That said, the rates of events were within the published norm, suggesting the virtual clinic provides a viable option in paediatric emergency medicine.
39 Impact of the COVID-19 pandemic on routine immunization coverage in Canada: Results from a novel national surveillance system
Authors: Jeevakanthan Ahash , Gilbert Nicolas , Granger Morag , Henderson Allison , O’Connell Jeanine , Wertz Sophie , Shahid Maaz 
Published: October 2024

Abstract

Background
The COVID-19 pandemic has posed unprecedented challenges to routine immunization programs globally. There is a growing body of evidence highlighting the impact of the pandemic on other routinely administered public health services. Understanding vaccination trends for routinely administered vaccinations during the pandemic is crucial for addressing potential gaps in protection and devising targeted strategies to enhance routine immunization programs.

Objectives
This study investigates the impact of the pandemic on routine immunization coverage in Canada, focusing on DTaP (Diphtheria, Tetanus, and Pertussis) with at least 4 doses and MMR (Measles, Mumps, and Rubella) with at least 1 dose, among children at age 2.

Design/Methods
Data were collected from the Routine Childhood Vaccination Coverage Surveillance system (RCVCSS) a novel national surveillance based on standardized detailed reports prepared by participating provinces and territories using data from their immunization registries. This analysis covers the years 2019 to 2022, capturing pre-pandemic, pandemic, and post-pandemic phases with data from 4 reporting provinces and territories (Alberta, Saskatchewan, New Brunswick and Yukon). The primary objective was to assess any changes in vaccination coverage at age 2 for routinely administered immunizations from 2019 to 2022, i.e., before, during and after the COVID-19 pandemic.

Results
Analysis reveals a decline in routine immunization coverage from 2019 to 2022. DTaP vaccination coverage at age 2 decreased from 82.0% in 2019 to 71.8% in 2022. Likewise, MMR vaccination coverage at two years showed a decline from 90.8% in 2019 to 81.7% in 2022. Similar downward trends in coverage were observed for other sets of antigens vaccinated against at age 2 including Varicella, Rotavirus, Polio, Pneumococcal and Hepatitis B. No major differences were observed when looking at vaccination coverage over time by sex. There were regional variations, with certain jurisdictions experiencing more pronounced declines than others and an increase in coverage in 2022 the post pandemic year.

Conclusion
There was a sustained decline in DTaP and MMR vaccination coverage at age 2 from 2019 to 2022. Further research is imperative to ascertain whether there has been a catch-up in vaccination coverage and to identify the root causes of the observed declines, so these can be addressed, and targeted interventions can be undertaken to allow coverage level to recover to their pre-pandemic levels.
43 Etiology of community-acquired bacterial meningitis in children seen in the emergency department in Canada
Authors: Besner Anne-Sophie , Renaud Christian , Gravel Jocelyn 
Published: October 2024

Abstract

Background
Bacterial meningitis poses a significant threat to paediatric health, resulting in substantial morbidity and mortality in children. Though previous studies have delineated the causative agents behind community-acquired meningitis, recent vaccination initiatives may have reshaped its underlying etiology.

Objectives
This study aimed to identify the bacteria responsible for community-acquired bacterial meningitis in children in Canada.

Design/Methods
This was a retrospective cohort study including children aged 1 day-18 years with confirmed bacterial meningitis, evaluated at a tertiary-care, Canadian emergency department between July 1st 2014 and December 31st 2022. The primary outcome was the pathogen identified. Other variables of interest were mortality, complications, age, sex, and diagnostic method. Medical charts were identified via the hospital’s archives and reviewed by a single co-author. A random sample of 20 (23%) medical charts were independently reviewed by a second co-author to assess inter-rater reliability. We set a target of evaluating at least 50 cases to allow narrow confidence intervals (+/- 13%) for proportions.

Results
All variables showed excellent inter-rater reliability with Kappa scores and intraclass correlation coefficients higher than 0.60. All 79 eligible cases were included. The main causal agents were Group B Streptococcus (GBS) (n=20; 25%), Streptococcus pneumoniae (n=16; 20%), Neisseria meningitidis (n=16; 20%) and Haemophilus influenzae (n=9; 11%). Etiology exhibited age-dependent variations, with 85% of GBS and 100% of E. coli infections identified in children under two months, while all pneumococcal and Group A Streptococcus cases were in children older than six months. All children infected by S. pneumoniae were vaccinated against pneumococcal infection but the serotype was not covered by vaccination in 7/8 infections. All children with N. meningitidis were either too young to be vaccinated (n=10) or infected by a serotype not covered by the vaccine. Six (7%) patients died and 29 (34%) suffered complications, including hearing impairment (n=5), cerebral ischemia (n=4), seizures (n=4), and subdural abscess (n=3). Fifty-nine bacterias were identified by cerebrospinal fluid culture, 13 by PCR and 7 by both methods.

Conclusion
GBS is the leading etiology of paediatric community-acquired bacterial meningitis in Canada. Causal agents of bacterial meningitis vary greatly by age. Future studies should work on improving the serotype spectrum of vaccines, prophylaxis in mothers who are GBS carriers, and use of PCR as a diagnostic tool for timely clinical interventions.
47 Association between unmet social needs and parental stress in a paediatric asthma clinic
Authors: Botella Mathilde , Drouin Olivier , Perez Tamara , Smyrnova Anna , Islam Mahisa , Ducharme Francine Monique , Fleegler Eric , Lavoie Kim L , Sultan Serge , Tse Sze Man , Zhao Jiaying 
Published: October 2024

Abstract

Background
There are well documented associations between unmet social needs and undesirable health outcomes, but little data exist on the association between unmet social needs and stress in families of children with asthma.

Objectives
To document the relationship between unmet social needs and parental stress in a Canadian paediatric asthma clinic.

Design/Methods
Ongoing prospective observational study to determine the association between unmet social needs and parental stress was conducted in a tertiary care paediatric asthma clinic, between September 2022 and September 2023. Participants were parents of children with a diagnosis of asthma, treated with at least one controller medication. Unmet social needs were collected by parental self-report using a questionnaire assessing 8 domains: employment, housing, ability to pay for utilities, financial resources, food security, transportation, childcare, and education. The four-item Perceived Stress Scale was used to assess how parents perceived stress and how they felt they were able to manage situations in their lives. Chi-square tests compared our independent variable, the presence vs. absence of unmet social needs, to our dependent variables; each measure of stress (control over important aspects of ones’ life, confidence in ability to overcome problems, feeling that everything was going well, ability to overcome too many accumulated difficulties).

Results
Of 162 participants, seventy-seven (48%) reported at least one unmet social need. Compared to participants without unmet social needs, those with unmet needs were more likely to report having no control over important aspect of their work or main activity (p&lt; 0.001); less likely to report having confidence in their ability to overcome problems (p&lt; 0.001); less likely to report having the feeling that everything was going well (p&lt; 0.001); and less likely to report having the ability to overcome too many accumulated difficulties (p&lt; 0.001).

Conclusion
Findings suggest significant association between unmet social needs and parental stress of asthmatic children. Parental stress and unmet needs may concomitantly increase the burden of adhering to asthma controller medication, making adherence more challenging through pathways related to the interactions between cognitive burden and precarious living situations. This ongoing Canadian study seeks to elucidate the mechanisms by which these factors make adherence to asthma medication more challenging for families, so these challenges can be addressed.
51 Feasibility of paediatric postoperative telemedicine in Nunavik
Authors: Bugra Adalet , Kabbes Nour , Janssen Ricky , Wissanji Hussein , Osmanlliu Esli 
Published: October 2024

Abstract

Background
To access surgical care, Inuit children from Nunavik are relocated by plane to an urban tertiary hospital. Current processes that require an in-person follow-up appointment extend their stay away from home despite an overall low rate of postoperative complications. Telemedicine presents the opportunity to reduce this delay, but little is known about its feasibility for paediatric postoperative care in Nunavik.

Objectives
To determine the feasibility of paediatric postoperative telemedicine in Nunavik.

Design/Methods
In this mixed methods study using a convergent parallel design (August 2022 – May 2023), we recruited eleven healthcare providers who regularly interact with Inuit families of Nunavik. We conducted individual semi-structured in-depth interviews about postoperative care in this setting and analyzed the data thematically. In parallel, we conducted a narrative synthesis of the literature and gathered input from collaborators to assess the potential resources needed to enable postoperative telemedicine in the region. We then determined the capability for telemedicine in each of the fourteen villages of Nunavik using data provided by the regional health board. A meeting with specialists responsible for telemedicine in the region was held to discuss findings and future steps. We analyzed and compared qualitative and quantitative results to determine the degree of postoperative telemedicine readiness in the region.

Results
The main themes influencing the feasibility of telemedicine were general considerations for telemedicine use as a follow-up modality, patient characteristics most suitable for postoperative telemedicine, resources needed for telemedicine use as a follow-up modality, and the feasibility of postoperative telemedicine as determined by healthcare providers. All interviewees deemed paediatric postoperative telemedicine in this region feasible but highlighted conditions for its success. The narrative review uncovered limited literature on telemedicine use in Nunavik. As of January 2023, the two regional hospitals and three health centers had full capabilities for postoperative telemedicine. The nine other health centers had partial capabilities, mainly due to limited access to stable high-speed Internet and Internet bandwidth. Only regional hospitals had access to hospitalization, imaging, readaptation, and laboratory departments. The participating specialists deemed telemedicine feasible if patient load and burden of administrative work are manageable.

Conclusion
Postoperative paediatric telemedicine in Nunavik is feasible from a resource, healthcare providers and specialists standpoint. Leveraging centers with appropriate capacity would allow the increase in telemedicine usage in Nunavik. Next steps in this research program include interviews with families to evaluate their needs, preferences and attitudes toward postoperative paediatric telemedicine.