bluuebunny/crossref_metadata_2025_split huggingface dataset:
The cardiovascular disease burden attributable to kidney dysfunction from 1990 to 2021: an age–period–cohort analysis of the Global Burden of Disease study
Authors: Dong Jiayang , Zhang Zhiqiang , Sun Jiayi , Yang Xinyue , Zhang Wenjuan 
Published: October 2024

Abstract

Background
Kidney dysfunction (KD) poses a severe threat to human health. The aim of this study is to gain a comprehensive understanding of the trends in cardiovascular disease (CVD) burden attributable to KD, thereby providing a theoretical basis for relevant public health policies.

Methods and results
This study analysed trends in the burden of CVD attributable to KD using the 2021 Global Burden of Disease data. It also examined the differences in mortality rates across various age groups, genders, and subtypes of CVD. Additionally, the age–period–cohort model combined with joinpoint regression analysis was employed to gain further insights into the changing trends and inflection points of CVD-related mortality. In 2021, the global number of deaths from CVD attributable to KD significantly increased compared to 1990. However, the global age-standardized mortality rate (ASMR) decreased in 2021. The burden of CVD due to KD was particularly heavy among the elderly. Analysis using the age–period–cohort model revealed a decline in CVD-related mortality rates, with similar trends observed for both men and women.

Conclusion
This study reveals that although the ASMR for CVD due to KD is on a declining trend globally, the absolute number of deaths has significantly increased. This trend is especially pronounced among individuals aged 80 and older, males, and regions with a middle socio-demographic index. In the context of global aging, the burden of CVD related to KD is becoming increasingly substantial.
Who's Afraid of Policy Experiments?
Authors: Dur Robert , Non Arjan , Prottung Paul , Ricci Benedetta 
Published: October 2024

Abstract
In many public policy areas, randomised policy experiments can greatly contribute to our knowledge of the effects of policies and can thus help to improve public policy. However, policy experiments are not very common. This paper studies whether a lack of appreciation for policy experiments among voters may be the reason for this. Collecting survey data representative of the Dutch electorate, we find clear evidence contradicting this view. Voters strongly support policy experimentation and particularly so when they do not hold a strong opinion about the policy. In a subsequent survey experiment among a selected group of Dutch politicians, we find that politicians conform their expressed opinion about policy experiments to what we tell them the actual opinion of voters is.
The Effects of APOE Alleles, Cognitive Activities, and Social Activities on Cognitive Decline in African Americans
Authors: Nsor Neke A , Bourassa Kyle J , Barnes Lisa L , Brown Casey K 
Published: October 2024

Abstract

Objectives
Older African Americans are among the fastest-growing populations, yet are underrepresented in studies examining risk factors related to decline. The present study examines whether biological factors (apolipoprotein [APOE] alleles) interact with behavioral factors including cognitive activities (e.g., reading, playing games) and social activities (e.g., participating in social groups) to predict cognitive decline in African Americans.

Methods
In total, 734 African American adults from the Minority Aging Research Study, aged 65 and older (with no known dementia at the time of enrollment), underwent annual cognitive testing for up to 10 years. At baseline, APOE status was determined and participants reported their frequency of participation in social and cognitive activities. Structural equation modeling was used to examine the effects of APOE, cognitive activities, and social activities on cognitive decline, and their interaction effects over a 10-year period.

Results
The number of APOE alleles had an effect on cognitive decline, such that a greater number of APOE4 alleles was associated with greater cognitive decline, whereas a greater number of APOE2 alleles was associated with less cognitive decline. Cognitive and social activities did not interact with APOE count to predict cognitive decline; however, APOE4 and social activities had additive, independent effects on cognitive decline.

Discussion
Results replicate prior findings linking APOE4 to cognitive decline and highlight the importance of APOE2 and social activities in delaying cognitive decline in African Americans.
Ray and energy-flux velocities at a contact of two viscoelastic anisotropic materials
Authors: Liu Xu , Zhou Bing , Al-Shuhail Abdullatif A , Zhou Wei , Liu Bo , Liao Qinzhuo 
Published: October 2024

SUMMARY
A g*-Hamiltonian method for tracing real rays was developed that can handle cusps and triplication of quasi-shear wave in a general viscoelastic anisotropic medium. We demonstrate that the g*-Hamiltonian method can produce homogeneous ray-velocity vectors (with parallel real and imaginary parts) and the slowness vectors of reflected and transmitted waves at the interface based on the real Snell's law (RSL), which constrains only the continuity of the real parts of the slowness vectors, or the real slowness direction (RSD) method, which ignores the inhomogeneous component of the slowness vector. These methods are based on the characteristic lines with different Hamiltonians. Our research indicates that these methods are limited to pre-critical incidence ranges. Moreover, we derived a complex energy velocity vector (energy flux velocity) expression, which is always homogenous. We found that directions of corresponding energy velocity calculated with complex Snell's law (CSL) at a contact of two viscoelastic anisotropic materials well match the solutions of the RSL and RSD methods for all R/T waves except post-critical incidence in which the RSL and RSD methods fail to obtain homogenous ray velocities. The RSL and RSD methods result in discrepancies in the ray quality factor, R/T coefficients, and energy ratios, especially for post-critical incidence. However, the exact critical angle determined by the RSD method approximates the ‘critical’ angle for anelastic/inhomogeneous waves, which was a previous challenge. Our calculations suggest that the energy velocity and energy quality factor obtained with the CSL method can be used for real ray tracing at the interface of viscoelastic anisotropic media, and the complex energy flux velocity vector is always exactly homogeneous. For the post-critical incidence, the RSL and RSD methods fail because the ray quality factor drastically changes from the infinite down to near 2, which contradicts homogeneous ray velocity even in elastic anisotropic materials for RSD method. However, the energy flux quality factor for the elastic-anisotropic material is all infinite, even for post-critical incidence, which is correct. We also show that the CSL method has the same efficiency as the RSD method.
Family-Centered World Ordering: Polish Conservative Civil Society Seeking Remedies to the World in Crisis
Authors: Kluczewska Karolina 
Published: October 2024

Abstract
This article analyzes bottom-up, conservative, and reactionary world ordering from the margins. It explores actors, visions, and practices of alternative, family-centered world ordering, taking the case of Polish conservative civil society organizations. Members of these organizations came to resent the liberal world order through their own everyday experiences of living through the capitalist transition in Poland after the end of communism in 1989. Consequently, they see the world plunged into overlapping crises of the liberal world order and neoliberal capitalism and seek alternatives. The article investigates where the family-centered visions originate from, how they develop from the ground up, and how they are enacted at community, municipal, national, and international levels. Pointing to the fluidity of the margins, the article shows how conservative civil society has gradually moved from the margins to a central place of the political scene in contemporary Poland and increasingly also internationally.
Anisotropic electronic structure study of MgB2C2 using soft X-ray emission spectroscopy microscopes
Authors: Hada Yuki , Terauchi Masami , Saito Tomoya , Sato Yohei K , Baba Masaaki , Takeda Masatoshi 
Published: October 2024

Abstract
The anisotropic electronic structure of MgB2C2 was studied using soft X-ray emission spectroscopy electron microscopes. MgB2C2 fragments were selected by examining C K-emission profiles. C and B K-emission and Mg L-emission spectra were obtained, revealing common and distinct structures that reflect the mixing of valence orbitals. Since the material is reported to have two-dimensional B–C honeycomb layers, the orientational dependence of these emission spectra was also examined. Experimental data were compared with the theoretically calculated partial density of states of the valence bands (VBs) of the material. The C K-emission profile showed an apparent orientational dependence, while the B K-emission exhibited minimal dependence. This difference originated from the different energy distributions of C-2pz and B-2pz components in the VBs. The Mg L-emission intensity was very small, likely due to charge transfer from Mg atoms to B–N layers. The Mg L-emission profile showed a peak related to structures in C-K and B-K. An unexpected intensity was observed just above the VBs, which also showed orientational dependence, possibly due to a small deviation from the ideal composition of Mg:B:C = 1:2:2.
Is there a place for ‘place’ in an educational theory of Bildung?
Authors: Schaffar Birgit , Kronqvist Camilla 
Published: October 2024

Abstract
The notion of Bildung has been a catalyst for educational theories about the human relation to the material and social world. Place, both as a concrete spatial location and as metaphorical spatialization have been central to the understanding of Bildung. Nevertheless, the tradition of Bildung has treated the material world mainly as a restricting and adversarial space for human becoming. By asking why the role of belonging to a concrete place is absent from several contemporary debates on Bildung, we discuss themes in Hegel’s and Humboldt’s conceptions of human formation, and argue that the preoccupation with different ideas of becoming human, through moving beyond material restrictions, centres on a notion of Bildung as a movement in time, a temporal dialectic. In contrast to conceptualizations of the world as binding and restricting, we then ask what place there is for ‘place’ in a theory of Bildung, and argue that the relation between the subject and the world can be perceived as a much more supportive dialogical relationship than these discussions suggest. With reference to insights from Rudolf Laban’s and Irmgard Bartenieff’s Movement Studies (LBMS), we illustrate an alternative perspective on the role of the material world in human physical, social, and cognitive development. These dimensions of development suggest that becoming and belonging in the world necessarily involve a simultaneously functional and expressive element, where the subject’s expressive movement of freedom and intention is balanced by their trustful resting in a concrete place.
Improvement cycle to act against catheter-related bloodstream infections
Authors: Hernández-Orozco Hilda , Lara-Ramos Adriana , Macías-Avilés Héctor , Aguirre Martha Márquez- , Castañuela-Sánchez Violeta , Candiani Carlos López , Zarate-Espinal Martha , Cristerna-Tarrasa Hernán , Hernández-García Rosa , Lucas-Reséndiz Esperanza , Ibanes-Gutiérrez Cyntia 
Published: October 2024

Abstract

Background
Catheter-related bloodstream infections (CRBSI) pose significant risks, causing a prolongation of hospital stay, increasing costs and increasing the risk of complications and mortality. It is the first healthcare-associated infection in many hospitals including our institution. Preventing CRBSI is essential for safety in patient’s care. To achieve this, we’ve adopted improvement cycles as a tool, aiming to decrease CRBSI rates by 50%.

Methods
Over the period of 2012 to 2023, 9036 pediatric patients were monitored throughout their hospitalizations. We utilized improvement cycles through various interventions: first an intervention bundle, secondly avoiding multipuncture, thirdly improving sampling techniques, fourthly optimizing supply management, and lastly restructuring the vascular access clinic. Each cycle involved resource management and process enhancement. Progress was measured through percentage metrics and the primary outcome indicator was CRBSI rates.

Results
The first cycle achieved a 90% compliance, the achievements were compliance above 85% of the bundle. In the second cycle we attained an 85% compliance, implement a guideline for catheter insertion with only two punctures in practice. The third cycle saw a 70% compliance rate, involving a multidisciplinary team for taking samples, training and monitoring by a skilled supervisor. The fourth cycle reached a 60% compliance through a techno-vigilance process, it was a pity quickly practical solutions didn´t work in practice. The final cycle achieved a 70% compliance, establishing a functional vascular access clinic. Rates CRBSI decreased by 50% overall and in the pediatric intensive care unit, meeting our objective. However this reduction was not observed in other intensive care units.

Conclusion
Improvement cycles simplify changes. Their implementation is effective but requires close monitoring, support from resources and authorities, a committed and proactive team, and continuous changes according to results. There is a need to consolidate the strategies to sustain and enhance our achievements.
Chronic Disseminated Candidiasis among Pediatric Cancer Patients: The Hidden Threat
Authors: Madney Youssef , Khedr Reham , Hafiz Hanfy , Adel Naglaa , Elanany Mervat , Alsheshtawi Khaled , Shalaby Lobna , Elhadad Alaa 
Published: October 2024

Abstract

Background
Chronic disseminated Candidiasis (CDC) is a severe invasive fungal infection observed during neutrophil recovery in patients with acute leukemia treated with intensive chemotherapy. Clinical manifestations include persistent fever under broad-spectrum antibiotics and abdominal discomfort. HSC is characterized by the presence of nodular lesions in the liver, spleen, and other organs (lungs, kidneys, and skin) on radiological imaging.

Methods
The retrospective study was conducted from 2013 - 2022 including all pediatric hematological patients diagnosed with chronic disseminated candidiasis admitted and treated in Children’s Cancer Hospital Egypt (CCHE). Data included primary diagnosis, clinical presentation, microbiological, radiological, and treatment data.

Results
Three hundred fifty (350) pediatric cancer patients were diagnosed with candidemia. The median age was four years (4 months- 18 years). Chronic dissemination candidiasis (CDC) was reported in 30(9%) of our patients. The most affected organs were Liver (19 patients), spleen (13), renal (13), cautelous (13), brain (2) and retina (2). Candida tropicalis was the most common isolated spp. from blood/tissue culture (24 patients) followed by C. parapsilosis (3 patients). The primary diagnosis in patients with CDC was ALL (24 Patients) while (4 patients) has AML. CDC was developed on top of antifungal prophylaxis in 7 patients (24%): liposomal-amho B (3 patients), Micafungin (3 patients) and voriconazole (1 patient). Candida tropicalis was the most common isolated spp. from blood/tissue culture (80%). Steroid as treatment for CDC immune reconstitution syndrome done in around 50% of patients (Persistent fever with neutrophil recovery, absent progressive clinical/radiological findings). PET-CT was done in 10 patients with positive uptake in all cases, was helpful in resuming intensive chemotherapy in six patients despite persistent lesions in CT and was used to stop antifungal treatment despite positive radiological lesions in CT in three patients. The first line of treatment was echinocandin (53%) and liposomal ampho-B (46%) with overall mortality among CDC patients were 30%.

Conclusion
CDC is still a hidden threat among pediatric patients with still high mortality rate. Antifungal stewardship through screening and Rapid diagnosis using non-culture diagnostics are needed. PET scan is a helpful tool for diagnosis and response assessment and can add to treatment decision.

Figure 1. Chronic Disseminated Candidiasis among Pediatric Cancer patients.
Clinical and epidemiological characterization of infections in pediatric hemato-oncology patients with febrile neutropenia in the North of Mexico
Authors: Aparicio Denisse Vaquera , Cavazos Luis Gerardo Castillo , de Santos Abiel Mascareñas los , Castillo José Iván , Samaniego Rebeca Aguayo , Pedraza Julia Esther Colunga 
Published: October 2024

Abstract

Background
Neutropenic fever is the most common complication in patients undergoing chemotherapy, where the choice of empirical antibiotic treatment should be based on the probable focus of infection, the predominant causative microorganisms, and the sensitivity of those organisms to antibiotics, which varies between each hospital and region. Over time, the spectrum of isolated microorganisms in different clinical syndromes of patients presenting during their infectious episode has changed. Our objective is to describe the prevalence of infectious etiology in pediatric patients with neutropenic fever, as well as the clinical characteristics of patients with documented infection.

Methods
The study design is ambispective, observational, and descriptive of a cohort type. Patients between 0 and 18 years old from the pediatric department of the “Dr. José E. González” University Hospital will be included from May 2019 to June 2023, with hematological-oncological disease during their febrile neutropenia infectious process with a complete medical record.

Results
A total of 326 episodes of febrile neutropenia were included, of which 15% had microbiological isolation (49 patients). The etiological classification during the events was as follows: bacteria 81%, viruses 14%, and fungi 4%. Five different infection sites were identified. Among these, bacteremia were the most frequent site of infection (10%), followed by gastrointestinal infections (2.4%), respiratory infections (1.5%), skin and soft tissue infections (1.2%), and lastly, urinary tract infections (1%). A total of 45 microorganisms were isolated from different infection sites. Among these, gram-negative bacteria (28 isolates, 62%) were more common and outnumbered gram-positive bacteria (14 isolates, 31%). Among gram-negatives, Escherichia coli (42%) was the most common isolate, followed by Pseudomonas aeruginosa (17%), and Klebsiella pneumoniae (14%). Among gram-positives, Streptococcus mitis (28%), Coagulase-negative Staphylococcus (21%), and Rothia mucilaginosa (14%) were identified.

Conclusion
Febrile neutropenia at the Hospital Universitario primarily affects 6-year-old males with ALL. The microbiological characterization suggests the intentional search for gram-negative bacteremia, allowing us to direct timely and targeted antibiotic therapy to influence clinical prognosis. It is worthwhile to continue the research line that allows us to identify susceptibility and resistance profiles to address these patients more effectively.
Pneumocystis jirovecii pneumonia in hemato-oncological patients; 10 years of experience at Hospital Infantil Teletón de Oncología
Authors: Hernández-Soto Astrid-Anaid , Tinoco-Martínez Andrea , Mata-Castañeda Michel , Félix-Bermúdez Georgina-Elizabeth 
Published: October 2024

Abstract

Background
Pneumocystis jirovecii pneumonia is an opportunistic infection that most frequently affects immunocompromised people, especially patients with HIV; clinical presentation is nonspecific and mortality rate in patients without HIV ranges are between 30% and 75%. In the international literature, there are few case reports of pediatric oncology patients. A series of cases is presented with the objective of describing the epidemiological characteristics, clinical presentation, treatment, and outcomes of Pneumocystis jirovecii pneumonia in this population group.

Methods
An observational, descriptive, and retrospective study was carried out in cancer patients under 18 years, with clinically compatible symptoms, an imaging study suggestive of the pneumonia, and identification of P. jirovecii using a PCR test of bronchial aspirate at Hospital Infantil Teletón de Oncología in Querétaro Mexico, since November 2014 to June 2023.

Results
A total of 17 events were reported with a median age of 9.8 years, 14/17 (82%) with a diagnosis of acute leukemias, 1/17 (6%) Ewing sarcoma, 1/17 (6%) lymphoma large cell anaplastic and 1/17 (6%) neuroblastoma. Regarding their therapeutic phases, 7/17 (41%) were in consolidation, 4/17 (23%) induction, 3/17 (18%) allogeneic HSCT (Hematopoietic stem-cell transplantation), 2/17 (12%) in surveillance, and 1/17 (6%) in maintenance. The clinical presentation in our patients was characterized by the presence of fever in 15/17 (88%), dry cough in 10/17 (59%) and 17/17 (100%) developed acute respiratory distress syndrome, which was classified as mild in 7/17 (41%), moderate in 5/17 (29%) and severe in 5/17 (29%). 13/17 (75%) presented distributive shock. All our patients underwent chest x-rays, 12/17 (70.5%) presented bilateral interstitial infiltrate, 4/17 (23.5%) consolidation, and 1/17 (6%) pleural effusion. Lung CT (computed tomography) was performed in 4/17 (23.5%), and 4/4 (100%) presented ground glass opacities. All of our patients were admitted to the PICU (Pediatric intensive care unit) and 16/17 (94%) required invasive mechanical ventilation. All receive treatment with TMP-SMX (Trimethoprim-sulfamethoxazole). 4/17 patients died (23%) of whom none received prophylaxis. 3/17 patients (18%) received prophylaxis with trimethoprim-sulfamethoxazole (TMP-SMX).

Conclusion
The present study is the first study in Mexico that compiles cases of Pneumocystis Jirovecii pneumonia in pediatric oncology patients. P. jirovecii pneumonia remains a rare cause, but represents a potentially fatal cause in oncology patients, so it is important to have a high clinical suspicion during the evaluation of an immunocompromised patient with evidence of pneumonia during all treatment phases with chemotherapy, in order to start treatment promptly. Thus, we also emphasize the importance of adequate prophylaxis as the most important preventive measure.