bluuebunny/crossref_metadata_2025_split huggingface dataset:
Etiology of Severely Dehydrating Diarrheal Illness in Infants and Young Children Residing in Low- and Middle-Income Countries
Authors: Jones Anna , Ahmed Sharia M , Platts-Mills James A , Kotloff Karen L , Levine Adam C , Nelson Eric J , Pavia Andrew T , Khan Ashraful I , Leung Daniel T 
Published: October 2024

Abstract

Background
Severe dehydration due to acute infectious diarrhea remains a leading cause of death among young children worldwide. Diarrhea with severe dehydration is a clinical syndrome with distinct management per the World Health Organization (WHO) Integrated Management of Childhood Illness (IMCI) and the WHO Global Task Force on Cholera Control (GTFCC) guidelines. We sought to characterize the pathogens causing severe dehydration using data from the Global Enteric Multicenter Study.

Methods
We used the IMCI and GTFCC guidelines to define severe dehydration and quantitative polymerase chain reaction–based attribution models to assign the etiology of diarrhea associated with severe dehydration.

Results
The IMCI or GTFCC guidelines classified 2284 of the 5304 (43%) cases with moderate-to-severe diarrhea as having severe dehydration. In one-third of the cases with severe dehydration, no pathogens were attributed. The top pathogens attributed to children with guidelines-classified severe dehydration varied by age and were similar among those requiring intravenous hydration and hospitalization. Rotavirus (30.9%), Cryptosporidium (12.0%), and heat-stable (ST) enterotoxigenic Escherichia coli (ETEC) (10.3%) were the most common pathogens for ages 0–11 months, while Shigella/enteroinvasive E coli (EIEC) (25.8%), rotavirus (19.3%), and ST-ETEC (10.9%) were the most common for ages 12–23 months. Shigella/EIEC (25.9%), Vibrio cholerae (10.4%), and rotavirus (9.2%) were the most common among ages 24–59 months.

Conclusions
The findings inform prioritization of pathogens, in addition to V cholerae, that cause severe dehydration for future preventive and treatment efforts. The schema for prioritization is driven primarily by age stratifications.
Autoantibodies towards HFE and SYT5 in anti-neutrophil cytoplasm antibody-associated vasculitis relapse
Authors: Bayati Shaghayegh , Nazeer Jamsheela , Ng James , George Angel M , Hayes Michael , Little Mark A , Nilsson Peter , Pin Elisa 
Published: October 2024

Abstract

Objective
Identification of those at high and low risk of disease relapse is a major unmet need in the management of patients with ANCA-associated vasculitis (AAV). Precise stratification would allow tailoring of immunosuppressive medication. We profiled the autoantibody repertoire of AAV patients in remission to identify novel autoantibodies associated with relapse risk.

Methods
Plasma samples collected from 246 AAV patients in remission were screened for novel autoantibodies using in-house generated protein arrays including 42 000 protein fragments representing 18 000 unique human proteins. Patients were categorized based on the occurrence and frequency of relapses. We modelled the association between these antibodies and relapse occurrence using descriptive and high dimensional regression approaches.

Results
We observed nine autoantibodies at higher frequency in samples from AAV patients experiencing multiple relapses compared with patients in long-term remission off therapy. LASSO analysis identified six autoantibodies that exhibited an association with relapse occurrence after sample collection. Antibodies targeting homeostatic iron regulator (HFE) and synaptotagmin 5 (SYT5) were identified as associated with relapse in both analyses.

Conclusion
Through a broad protein array-based autoantibody screening, we identified two novel autoantibodies directed against HFE and SYT5 as candidate biomarkers of relapse in AAV.
Defining Urbanicity in the Context of Psychosis Research: A Qualitative Systematic Literature Review
Authors: Mascayano Franco , Lee Jiwon , Yang Xinyu , Li Zeyu , Casanueva Rodrigo , Hernández Viviana , Burgos Javiera , Florence Ana Carolina , Yang Lawrence H , Susser Ezra 
Published: October 2024

Abstract

Background and Hypothesis
Numerous studies have found that being born or raised in urban environments increases the odds of developing psychosis in Northern and Western Europe. However, available research from Southern Europe, Latin America, and Asia has reported null results. A limitation in most studies to date is the inadequate characterization of urban and rural life components that may contribute to varying psychosis risk across regions.

Study Design
To deepen our understanding of the different concepts and measures of urbanicity and related factors in psychosis research, we conducted a qualitative systematic literature review extracting information from studies published between 2000 and 2024.

Study Results
Sixty-one articles met the inclusion and exclusion criteria and were used in the thematic analysis. The analysis revealed that urbanicity lacked a single, coherent definition across studies and regions. Three major categories of themes were developed from the analysis: (1) Urbanicity comprises several interconnected constructs, (2) Urbanicity measurements vary between countries from the Global North and the Global South, and (3) Urbanicity operates through key neighborhood-level mechanisms.

Conclusions
Future research on urbanicity and psychosis should consider the potential limitations of urbanicity’s conceptualization and operationalization and aim to address these limitations by focusing on contextual, historical, and community-level factors, utilizing locally validated measures, and employing mixed-method designs.
Role of aminophylline in prevention of acute kidney injury in term neonates with severe perinatal asphyxia: a randomized open-label controlled trial
Authors: Munian Dinesh , Dutta Sukanta , Ghosh Arindam , Saha Ripan 
Published: October 2024

Abstract
Acute kidney injury (AKI) is one of the frequently observed complications in neonates with severe perinatal asphyxia. The efficacy of aminophylline in preventing or alleviating renal dysfunction in these neonates remains controversial. The current study aimed to explore whether treatment with aminophylline as adjunctive therapy is superior to standard care alone in preventing AKI in severely asphyxiated term neonates and to delineate the changes in other renal parameters. In this open-label randomized clinical trial, term neonates with severe asphyxia (n = 41) received a 5 mg/kg intravenous dose of aminophylline within the first hour after birth, in addition to standard care for birth asphyxia. The control group (n = 40) received standard care alone. Their daily urine output, weight, serum creatinine, renal functional status, and complications during the first 5 days of life were monitored and compared. The statistical package for social sciences version 25 was used for analysis. Approximately 24.39% of neonates in the aminophylline group developed AKI, compared to 35.0% in the control group (P = .088). Although urine output was generally higher in aminophylline-treated newborns than in the control group, this increase was not statistically significant (P &gt; .05), with the most notable differences observed on the second and third postnatal days. Also, the changes in plasma creatinine levels between the two groups during this time were not statistically significant. Administering a single dose of aminophylline (5 mg/kg) within the first hour of life to severely asphyxiated term neonates might temporarily enhance urine output, but does not reduce the overall incidence of AKI.
Expanding the spectrum of IPEX: from new clinical findings to novel treatments
Authors: Voarino Marta , Consonni Filippo , Gambineri Eleonora 
Published: October 2024

Purpose of review
This review aims to provide an overview of recent research findings regarding immune dysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome, focusing on clinical and immunological novelties, as well as emerging treatment strategies, based on the published literature of the last few years.

Recent findings
While it is well known that IPEX can present with a wide range of atypical clinical manifestations, new and unique phenotypes continue to emerge, making it essential to maintain a high level of clinical suspicion both at the time of diagnosis and during follow-up. This unpredictability in clinical presentation is further compounded by the lack of a clear genotype-phenotype correlation. A valuable tool for monitoring comes from recent discoveries regarding the epigenetic signature of Tregs, which, by correlating with disease severity, could prove to be a useful biomarker for diagnosis and ongoing management. The use of biological agents is emerging as an alternative to traditional immunosuppression. Additionally, ongoing studies are exploring the feasibility of gene therapy through the introduction of the wild-type FOXP3 into peripheral CD4+ T cells.

Summary
Further research is needed to fully understand the variable clinical presentations of IPEX and optimize tailored therapies, ensuring better management and outcomes for affected individuals.
Inability to Remove Locking Screws From the Femoral Neck System Due to Stripping of the Screwdriver Within the Locking Screw Head
Authors: Park Jung-Wee , Cha Yong-Han , Kim Jin-Woo , Kim Hong-Seok , Nho Jae-Hwi , Jang Byung-Woong , Kim Jung-Taek , Kim Jin-Kak , Kim Tae-Young , Kim Ki-Choul , Lee Young-Kyun 
Published: October 2024

OBJECTIVES:
The purposes of this study were to investigate the frequency of screwdriver stripping in the head of the locking screw that attaches to the side plate to the femur shaft among the patients who underwent implant removal after femoral neck system (FNS) for femoral neck fracture, to determine the risk factors for locking head screw stripping in FNS treatment of femoral neck fracture, and to suggest a surgical tip that removes FNS, which is difficult to remove due to screw stripping.

METHODS:

Design:
Retrospective cohort study.

Setting:
Eight Urban tertiary referral academic hospitals.

Patient Selection Criteria:
Included were patients with Orthopedic Trauma Association/Arbeitsgemeinschaft für Osteosynthesefragen 31-B1, 31-B2, and 31-B3 femoral neck fractures who underwent surgical fixation with FNS from November 2019 to February 2023.

Outcome Measures and Comparisons:
The frequency of locking head screw stripping of FNS during the implant removal was evaluated.

RESULTS:
Among the 47 patients (18 (38%) men and 29 (62%) women) who met the inclusion criteria with an average age of 59.2 years (range, 28–94 years), 13 (27.7%) experienced screwdriver stripping in the head of the distal locking screw during FNS removal surgery. A higher body mass index showed a borderline significant association with the stripping in the adjusted model (odds ratio = 1.233; 95% confidence interval: 0.988–1.539; P = 0.064). No other variables showed significant association with the stripped locking head screw (P > 0.05).

CONCLUSIONS:
Stripping of the screwdriver within the head of the distal locking screw occurred in over one-quarter of cases. While a higher body mass index demonstrated a borderline significant association, none of the other variables examined showed a statistically significant relationship with the stripped locking head screw.

LEVELS OF EVIDENCE:
Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Alterations in the Renin-Angiotensin System in Experimental Septic Shock
Authors: Garcia Bruno , Ter Schiphorst Benoit , Su Fuhong , Picod Adrien , Ikenna-Uba Theo , Favory Raphaël , Annoni Filippo , Mebazaa Alexandre , Vincent Jean-Louis , Creteur Jacques , Taccone Fabio S. , Herpain Antoine 
Published: October 2024

OBJECTIVES:
To analyze dynamic changes in the renin-angiotensin system (RAS) during septic shock, focusing on angiotensin-converting enzyme (ACE) activity and the balance between angiotensin peptides, using a mass spectrometry method.

DESIGN:
Experimental septic shock model induced by peritonitis in swine.

SETTING:
Experimental Laboratory, Department of Intensive Care, Erasme Hospital, Université Libre de Bruxelles.

SUBJECTS:
Forty time points from eight mechanically ventilated pigs.

INTERVENTIONS:
Septic shock was induced using intraperitoneal instillation of autologous feces, followed by standardized fluid resuscitation, norepinephrine infusion, antibiotic administration, and peritoneal lavage.

MEASUREMENTS AND MAIN RESULTS:
The induction of sepsis resulted in a significant increase in plasma renin activity and levels of angiotensin I and II, with a significant decrease in ACE activity observed from 4 hours post-resuscitation and a notable rise in the angiotensin I/angiotensin II ratio at 12 hours. Additionally, a shift toward the angiotensin-(1–7) axis was observed, evidenced by an increased angiotensin-(1–7)/angiotensin II ratio.

CONCLUSIONS:
The study highlighted dynamic shifts in the RAS during septic shock, characterized by reduced circulating ACE activity, elevated angiotensin I/II ratio, and a shift toward the angiotensin-(1–7) axis. These findings suggest an adaptive response within the RAS, potentially offering new insights into sepsis management and therapeutic targets.
Soluble markers of viral rebound and post-treatment HIV control
Authors: Giron Leila B. , Pasternak Alexander O. , Abdel-Mohsen Mohamed 
Published: October 2024

Purpose of review
We focus on the different classes of biological molecules measurable in easily accessible bodily fluids that have the potential to serve as biomarkers for the HIV post-treatment controller (PTC) phenotype and/or the timing of viral rebound after stopping antiretroviral therapy (ART).

Recent findings
Various viral components and host factors measurable in body fluids can play crucial roles in understanding and predicting the PTC phenotype. We review recent findings linking viral components, the quantitative and qualitative features of antibodies (including autologous HIV-specific antibodies), markers of inflammation and tissue damage, other host proteins (including hormones such as sex hormones), as well as metabolites, extracellular vesicles, and cell-free DNA to HIV control post-ART interruption. Several of these molecules can or have the potential to predict the time and probability of viral rebound after stopping ART and are biologically active molecules that can directly or indirectly (by modulating immune pressures) impact the size and activity of HIV reservoirs during and post-ART interruption.

Summary
A comprehensive model combining multiple markers is needed to predict the PTC phenotype. This model can be leveraged to predict and understand the PTC phenotype, which can guide novel curative interventions to replicate this phenotype in post-treatment non-controllers.
Tissue Expanders for Hair Restoration in the Scalp: Overexpansion Does Matter
Authors: Mohamed Mohamed Mohamed Elsayed , Kotb Mohamed Osama Adly 
Published: October 2024

Background:
Tissue expansion to treat of alopecia of the scalp is the corner stone to restore a hairy scalp, although the process of expansion takes time to achieve a satisfactory result. Overexpansion could help in managing limited areas of donor sites or inadequate supply of tissue expanders. Meticulous patient selection and follow-up is the key to avoid complications and to obtain good results.

Methods:
Tissue expanders were used to restore the hairy scalp after burns or direct trauma. More than one tissue expander could be used simultaneously or after the first stage; the expander could be reused for the same patient for further expansion in another part of the hairy scalp to complete hair restoration and removal of all scar tissue.

Results:
Twenty-five patients with alopecia underwent hair restoration with 28 expanders, all of which were overexpanded. Three pairs of expanders were used simultaneously in three patients. Three expanders were reused in the other three patients after removal to complete the second stage. All patients showed complete restoration of their hairy scalp with minimal complications and a high rate of satisfaction.

Conclusions:
Tissue expansion is a cornerstone in the treatment of scalp alopecia. Meticulous patient selection and follow-up provided the most satisfactory results, with fewer postoperative complications. Overexpansion can be safely used.
Analgesic Use of Virtual Reality for Burn Dressing Changes in Low- and Middle-income Countries: A Feasibility Study
Authors: Brown Theodore , Dee Alli , McCullough Meghan , Santos Pedro , Kulber David 
Published: October 2024

Background:
The paucity of pain management options in resource-limited settings is a significant and systemically unaddressed problem. To improve global health equity, it is important to bridge this gap in care without introducing the peril of opioid dependence. We present a proof-of-concept case series wherein virtual reality (VR) was successfully used to manage discomfort in patients undergoing burn dressing changes in sub-Saharan Africa.

Methods:
Nine patients presenting with burn injuries of variable severity underwent routine stabilization and dressing as part of standard-of-care treatment. During dressing changes, a VR intervention consisting of the Dream Flight interactive game displayed on an Oculus Quest 2 headset was offered to patients. Patient mood scores were collected before VR initiation and at the conclusion of the dressing change by a translator using the Youth Feelings Scale.

Results:
There were no adverse events associated with use of the VR headset and no patients elected to terminate the VR during their procedure. Patients and physicians subjectively reported satisfaction with the device’s utility in the procedure. Before VR initiation, the 95% confidence interval for patient mood score was 4.89 ± 1.725. After VR initiation, the 95% confidence interval for patient mood score was 8.78 ± 1.40.

Conclusions:
Our results of this proof-of-concept case series to suggest both feasibility of use and positive influence on patient discomfort and periprocedural satisfaction. We propose that VR should be explored as an analgesic alternative and/or adjunct to narcotics in resource-limited countries, particularly for high-pain, low-duration procedures.
Indications, Postoperative Outcomes, and Complications of the Lateral Arm Free Flap: A Systematic Review and Meta-analysis
Authors: Dong Edward T. C. , Martineau Jérôme , Kalbermatten Daniel F. , Oranges Carlo M. 
Published: October 2024

Background:
The lateral arm free flap (LA-FF) has become an increasingly popular choice in the reconstruction of soft tissue defect in many anatomical regions. However, there is a paucity of literature regarding its safety and efficacy. The aim of this study is to analyze its different applications along with their surgical outcomes.

Methods:
A systematic review including all studies assessing the surgical outcomes of the LA-FF and proportional meta-analysis using a random-effect DerSimonian–Laird model was performed to assess the postsurgical complications and flap failures.

Results:
Twenty-five articles were included in the final analysis, representing a total of 1272 flaps in 1256 patients. Indications were mainly defects following tumoral resection and trauma. Across the different studies, the reported flap size range varied from 2 × 4 cm to 12 × 16 cm. The overall pooled flap failure rate across all indications was 3% [95% confidence interval (CI), 0.01–0.04], with a pooled failure rate of 2% (95% CI, 0.01–0.04) in the head and neck region, 3% (95% CI, 0.01–0.06) in the upper limb region, and 3% (95% CI, 0.01–0.06) in studies evaluating its use in different anatomical locations. The overall donor site complication rate was 11% (95% CI, 0.03–0.21), with no major complications described.

Conclusions:
This meta-analysis demonstrates safety and efficacy of the LA-FF in reconstructing moderate to large soft tissue defects. It is mainly used for head and neck posttumoral resection and upper and lower limb posttraumatic reconstruction.
Impact of racial, ethnic, and socioeconomic disparities on presentation and survival of HCC: A multicenter study
Authors: Rich Nicole E. , Jones Patricia D. , Zhu Hong , Prasad Tanushree , Hughes Amy , Pruitt Sandi , Murphy Caitlin C. , Seif-El-Dahan Karim , Daher Darine , Figueroa Gloria , Castaneda Stephanie , Quirk Lisa , Gonzales Michael , Carranza Osiris , Bourque Samantha , Baset Nargis , Yopp Adam C. , Singal Amit G. 
Published: October 2024

Background:
Racial and ethnic disparities have been reported for HCC prognosis, although few studies fully account for clinically important factors and social determinants of health, including neighborhood socioeconomic status.

Methods:
We conducted a retrospective multicenter cohort study of patients newly diagnosed with HCC from January 2010 through August 2018 at 4 large health systems in the United States. We used multivariable logistic regression and cause-specific Cox proportional hazard models to identify factors associated with early-stage HCC presentation and overall survival.

Results:
Of 2263 patients with HCC (37.6% non-Hispanic White, 23.5% non-Hispanic Black, 32.6% Hispanic, and 6.4% Asian/other), 42.0% of patients presented at an early stage (Barcelona Clinic Liver Cancer stage 0/A). In fully adjusted models, there were persistent Black-White disparities in early-stage presentation (OR: 0.63, 95% CI: 0.45–0.89) but not Hispanic-White disparities (OR: 0.93, 95% CI: 0.70–1.24). Median survival was 16.2 (IQR: 5.8–36.8) months for White patients compared to 15.7 (IQR: 4.6–34.4) months for Hispanic, 10.0 (IQR: 2.9–29.0) months for Black, and 9.5 (IQR: 3.4–31.9) months for Asian/other patients. Black-White disparities in survival persisted after adjusting for individual demographics and clinical factors (HR: 1.30, 95% CI: 1.09–1.53) but were no longer observed after adding HCC stage and treatment (HR: 1.05, 95% CI: 0.88–1.24), or in fully adjusted models (HR: 0.97, 95% CI: 0.79–1.18). In fully adjusted models, Hispanic-White (HR: 0.87, 95% CI: 0.73–1.03) and Asian/other-White (HR: 0.85, 95% CI: 0.63–1.15) differences in survival were not statistically significant, although patients in high-SES neighborhoods had lower mortality (HR: 0.69, 95% CI: 0.48–0.99).

Conclusions:
In a multicenter cohort of patients with HCC, racial and ethnic differences in HCC prognosis were explained in part by differences in tumor stage at diagnosis and neighborhood SES. These data inform targets to intervene and reduce disparities.