bluuebunny/crossref_metadata_2025_split huggingface dataset:
81 mRNA COVID-19 vaccine safety among children and adolescents from the Canadian National Vaccine Safety Network
Authors: Vanderkooi Otto G , Bettinger Julie , Sadarangani Manish , Top Karina , Isenor Jennifer , Kellner James , Muller Matthew , McGeer Allison , Valiquette Louis , De Serres Gaston 
Published: October 2024

Abstract

Background
The Canadian National Vaccine Safety Network (CANVAS) expanded its active safety surveillance for COVID-19 vaccines among children and adolescents during the COVID-19 pandemic.

Objectives
This analysis aimed to determine whether the first or second dose of mRNA COVID-19 vaccination is associated with health events in children and adolescents.

Design/Methods
Adolescents 15-19 years of age or parents/guardians of children 5-14 years of age were recruited from seven Canadian provinces/territories and followed for the occurrence of health events seven days after doses 1 and 2 or for a seven-day period for unvaccinated participants. The primary outcome was a health event that prevented daily activities, resulted in school absenteeism, and/or required a medical consultation, including emergency department visits or hospitalization. Aged-stratified multivariable logistic regression examined health events associated with mRNA COVID-19 vaccines (BNT162b2, mRNA1273, and mixed [different products for doses 1 and 2]) for children aged 5 to 11 years and adolescents aged 12 to 19 years.

Results
Between January 2021 and February 2023, a total of 249,418 (Children BNT162b2: 205,744, mRNA-1273: 36, and Adolescent BNT162b2: 39,628, mRNA-1273: 4,010) completed the first dose survey and 128,599 (Children BNT162b2: 109,625, mRNA-1273: 3, mixed: 235, and Adolescent BNT162b2: 17,202, mRNA-1273: 1,155, mixed: 474) had completed the second dose survey. A total of 668 unvaccinated participants (Children 431 and Adolescent 237) completed the control survey. In the week following dose 1, health event rates among vaccinated children and adolescents were &lt;4% and lower than in unvaccinated counterparts (6.9%), and neither BNT162b2 nor mRNA-1273 were associated with health events in either age group. Following dose 2, among vaccinated adolescents health events rates (BNT162b2 4.6%, mRNA-1273 8.5%, mixed 10.4%) were higher than unvaccinated adolescents (3.4%), but were self-limiting and resolved within 7 days. Among children, there was no difference in health event rates between vaccinated and unvaccinated groups.

Conclusion
For children, mRNA COVID-19 vaccines were not associated with health events preventing daily activities, resulting in school absenteeism and/or requiring medical consultation. Similar to vaccinated adults our findings found vaccinated adolescents reported higher rates of health events after dose 2 mRNA COVID-19 vaccines, but these were self-limiting and resolved quickly. Our findings can be used to inform adolescents and their parents of what to expect following COVID-19 vaccination.
82 Assessing the usage of and barriers to using language interpretation services in a Canadian tertiary paediatric center
Authors: Brochez Nicholas , Islam Bonnieca , Forbes Karen , Mian Qaasim 
Published: October 2024

Abstract

Background
Canada has one of the highest immigration rates worldwide per population with roughly 447,180 permanent residents welcomed in 2022. Limited-English proficiency (LEP) populations face barriers in accessing health care with implications including delayed presentation, misdiagnosis, poor compliance, decreased patient comprehension, and adverse events. Adequate health care provider training in using language interpretation services (LIS) is crucial to improve the quality of patient care and reduce miscommunication. There is a lack of research in this area in Canadian paediatric populations.

Objectives
To identify attitudes towards and usage of LIS among health care providers in a tertiary paediatric center, as well as levels of LIS training received.

Design/Methods
An online survey was developed and distributed to paediatric health care professionals including physicians, residents/fellows, nursing staff, and allied health providers. Survey completion was anonymous and voluntary; data collection occurred from October 2022–February 2023. Descriptive statistics were used for quantitative data and thematic analysis for free text responses.

Results
345 respondents accessed the survey and 281(81%) completed it. Multiple paediatric professions were surveyed with most responses stemming from nursing staff, residents and physicians, and other allied health. 52.8% of respondents encountered a paediatric patient and/or their caregivers with a language barrier in English once per week or more. LIS were used by 53.1% of respondents once per week or more. 51.5% of respondents reported no previous training in using LIS in patient care, and 3.6% reported previous formal training. 57.9% of respondents felt LIS training was very beneficial to their role and 53.7% reported this increased their LIS usage. Overall, in-person interpreters were perceived as the most effective LIS modality followed by video and telephone interpreters. Barriers to using LIS included: inability to access desired modality and/or language; insufficient time; and lack of comfort in effective usage.

Conclusion
It was evident respondents felt LIS was integral to patient care, especially with an increasingly diverse population. Multiple barriers to using LIS were identified with likely applicability to other Canadian paediatric facilities. Suggested improvements were themed around improving LIS accessibility, improving LIS education and awareness, and increasing access to rare languages. This study has important implications for LIS and paediatric care, including informing educational and advocacy initiatives, policy change, and LIS resource allocation.
The translation of transformative policy ambitions in funding research for climate change
Authors: Wicher Magdalena 
Published: October 2024

Abstract
This paper addresses how research and innovation (R&I) policy responds to global challenges, which demand fundamental transformations of societies and economies. The paper presents the case of a transnational, European funding call (SOLSTICE) for climate change research led by social sciences and humanities. Both the development of SOLSTICE and the research community’s responses are analysed in relation to the transformative R&I policy literature, identifying potential future avenues for improving the transformative outcomes of this type of funding. The study concludes that unlocking the value of transformative R&I policy concepts and approaches depends on wide stakeholder engagement in the funding instrument design phase and an active and sustained focus on achieving societal outcomes during project implementation. In addition, barriers to the effectiveness of (European) transnational funding programmes are identified, particularly when policies target community-level socio-technical transitions to address global challenges.
Exploring the link between comorbid insomnia and sleep apnea (COMISA) and erectile dysfunction: implications for male sexual health
Authors: Andersen Monica Levy , Gozal David , Tufik Sergio 
Published: October 2024

Abstract

Introduction
This review explores the interplay between comorbid insomnia and sleep apnea (COMISA) and erectile dysfunction (ED), 2 conditions that significantly impact men’s health. COMISA, a recently recognized condition characterized by the coexistence of insomnia and obstructive sleep apnea, has been shown to disrupt sleep architecture and cause intermittent hypoxia. These disturbances are increasingly linked to the exacerbation of ED, a prevalent issue among men. Understanding the connection between COMISA and ED is crucial for developing integrated treatment approaches that address both sleep and sexual health.

Objectives
We aim to explore the epidemiological, physiological, and potential therapeutic intersections of COMISA and ED. This review sets out to develop a better understanding of the relationship between these conditions and to emphasize the need for an integrated diagnostic and therapeutic approach that addresses both sleep and sexual health.

Methods
Through a comprehensive analysis, including a detailed examination of extant studies, we address the hormonal imbalances and alterations in neural pathways that collectively contribute to the complex pathophysiology of ED and how these are particularly susceptible to the concurrent presence of COMISA.

Results
Our analysis indicates that disruptions in sleep architecture and intermittent hypoxia associated with COMISA can exacerbate ED. Hormonal imbalances, endothelial dysfunction, autonomic imbalance, and increased inflammation and oxidative stress are key mechanisms through which COMISA influences ED. These factors collectively impair vascular health, reduce testosterone levels, disrupt neural control of erections, and contribute to the severity of ED.

Conclusions
This review underscores the necessity for an integrated approach to diagnosis and therapy that considers both sleep and sexual health to improve overall outcomes. These insights should foster a deeper understanding of the relationship between COMISA and ED, encourage further research in this area, and potentially lead to the development of innovative treatment strategies to manage these closely intertwined health concerns.
Growth performance of neonatal calves fed milk replacer 2 vs. 3 times per day
Authors: Olagunju Lydia K , Casper David P , Anele Uchenna Y 
Published: October 2024

Abstract
Several calf studies demonstrated growth advantages when feeding greater protein and/or milk solids amounts, however, studies comparing 2 times per day vs. 3 times per day feeding are limited. The study objective was to evaluate feeding 2 times per day vs. 3 times per day thereby increasing milk solids intake. Forty 2- to 5-d old Holstein bull calves were blocked by body weight (BW) and randomly assigned to 1 of 2 treatments (N = 20/treatment) using a randomized complete block design. Treatments were 1) 2×: milk replacer (MR) fed 2 times per day; and 2) 3×: MR fed 3 times per day for increased solids intake. The MR was fed at 15% solids at 0630 and 1800 hours and the 3rd 3× feeding was at 1200 hours. Calves on 2× were fed MR at 0.567 kg/d for days 1 to 14, increased to 0.85 kg/d for days 15 to 35, and reduced to 1 time per day at 0.425 kg/d for days 36 to 42 to facilitate weaning at 42 d. Calves on 3× were fed MR 0.851 kg/d for days 1 to 14, increased to 1.275 kg/d for days 15 to 35, and reduced to 1 time per day at 0.425 kg/d for days 36 to 42 followed by weaning. Calf starter (CS; amounts and orts weighed daily) and water were offered for ad libitum intake. Initial BW was not a significant covariate and final BW (81.5 and 80.9 kg, for 2× and 3×, respectively) was similar. A treatment-by-week interaction (P &lt; 0.01) indicated variable BW gains during the study with calves fed 3× demonstrating greater BW during weeks 4 (P &lt; 0.10) and 5 (P &lt; 0.05) compared with calves fed 2×. However, BW gains for calves fed 3× were reduced (P &lt; 0.05) during the weaning period resulting in similar BW gains (36.8 and 36.4 kg) at the study end. Intake of CS (0.65 and 0.46 kg/d) was lower (P &lt; 0.04) for calves fed 3× compared with calves fed 2×. Feed conversions (0.64 and 0.58 kg/kg) were greater (P &lt; 0.02) for calves fed 2× compared with 3× fed calves. Calves fed 2× had less (P &lt; 0.01) scours (fecal score = 0; 34.3 and 29.7 d) compared with 3× fed calves. Providing an additional MR feeding demonstrated minimal BW gains due to lower CS intake. Providing greater MR intake using a 3rd daily feeding reduces CS intake that can inhibit transition to dry feed when weaning calves.
First Detection of the Obligate Biotroph Phytophthora cyperi Causing Disease on Yellow Nutsedge in the United States, and Establishment of Molecular Barcoding Sequences for the Species
Authors: Bourret Tyler B. , Blomquist Cheryl L. , Mohan S. Krishna , Sampangi Ram , Ho Hon H. , Mohammed Israfiel A. 
Published: October 2024

A pathogen causing disease on yellow nutsedge ( Cyperus esculentus) growing in and near irrigated areas of onion seed and bulb fields in Idaho and Oregon during July and August 1996 was morphologically and molecularly characterized. Plant symptoms included necrotic spots and blotches and blighting of leaves, stems (culms), and bracts. Symptomatic tissue contained glistening white masses of mycelium and oval semi-papillate sporangia emerging from stomata on sporangiophores. Later, subspherical oogonia with smooth oospores were found embedded in older infected tissue. Phytophthora cyperi was identified as the causal agent, and pathogenicity was confirmed by inoculating healthy nutsedge plants with sporangia from infected plants. Infected samples tested negative using Agdia's Phytophthora enzyme-linked immunosorbent assay (ELISA) kit, and all efforts to culture the organism on semi-selective or general fungal media failed. To aid future efforts to detect this species, sequences of the two primary barcoding loci, ITS rDNA and mitochondrial cox1, were obtained from the organism and analyzed, finding an unexpectedly large ITS sequence characterized by an approximately 1,300-bp insertion. [Formula: see text] Copyright © 2025 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Where AIRE we now? Where AIRE we going?
Authors: Bez Patrick , Ceraudo Martina , Vianello Fabrizio , Rattazzi Marcello , Scarpa Riccardo 
Published: October 2024

Purpose of review
The purpose of the review is to describe the most recent advancement in understanding of the pivotal role of autoimmune regulator (AIRE) gene expression in central and peripheral tolerance, and the implications of its impairment in the genetic and pathogenesis of autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) manifestations with insight into possible treatment options.

Recent findings
AIRE gene expression has an important role of central and peripheral tolerance. Different AIRE gene mutations cause APECED, whereas polymorphisms and some variants may be implicated in development of other more frequently autoimmune diseases. Impaired negative T cell selection, reduction of T regulatory function, altered germinal center response, activated B cells and production of autoantibodies explain the development of autoimmunity in APECED. Recent data suggest that an excessive interferon-γ response may be the primer driver of the associated organ damage. Therefore, Janus kinase (JAK)-inhibitors may be promising therapies for treatment of broad spectrum of manifestations.

Summary
AIRE has a pivotal role in immune tolerance. Disruption of this delicate equilibrium results in complex immune perturbation, ranging from severe autoimmunity, like APECED, to more common organ-specific disorders. Therefore, a deeper understanding of the correlation between AIRE function and clinical phenotype is warranted given the potential translational implication in clinical practice.
Heterogeneity in the Effect of Early Goal-Directed Therapy for Septic Shock: A Secondary Analysis of Two Multicenter International Trials
Authors: Shah Faraaz Ali , Talisa Victor B. , Chang Chung-Chou H. , Triantafyllou Sofia , Tang Lu , Mayr Florian B. , Higgins Alisa M. , Peake Sandra L. , Mouncey Paul , Harrison David A , DeMerle Kimberley M. , Kennedy Jason N. , Cooper Gregory F. , Bellomo Rinaldo , Rowan Kathy , Yealy Donald M. , Seymour Christopher W. , Angus Derek C. , Yende Sachin P. 
Published: October 2024

OBJECTIVES:
The optimal approach for resuscitation in septic shock remains unclear despite multiple randomized controlled trials (RCTs). Our objective was to investigate whether previously uncharacterized variation across individuals in their response to resuscitation strategies may contribute to conflicting average treatment effects in prior RCTs.

DESIGN:
We randomly split study sites from the Australian Resuscitation of Sepsis Evaluation (ARISE) and Protocolized Care for Early Septic Shock (ProCESS) trials into derivation and validation cohorts. We trained machine learning models to predict individual absolute risk differences (iARDs) in 90-day mortality in derivation cohorts and tested for heterogeneity of treatment effect (HTE) in validation cohorts and swapped these cohorts in sensitivity analyses. We fit the best-performing model in a combined dataset to explore roles of patient characteristics and individual components of early goal-directed therapy (EGDT) to determine treatment responses.

SETTING:
Eighty-one sites in Australia, New Zealand, Hong Kong, Finland, Republic of Ireland, and the United States.

PATIENTS:
Adult patients presenting to the emergency department with severe sepsis or septic shock.

INTERVENTIONS:
EGDT vs. usual care.

MEASUREMENTS AND MAIN RESULTS:
A local-linear random forest model performed best in predicting iARDs. In the validation cohort, HTE was confirmed, evidenced by an interaction between iARD prediction and treatment (p < 0.001). When patients were grouped based on predicted iARDs, treatment response increased from the lowest to the highest quintiles (absolute risk difference [95% CI], –8% [–19% to 4%] and relative risk reduction, 1.34 [0.89–2.01] in quintile 1 suggesting harm from EGDT, and 12% [1–23%] and 0.64 [0.42–0.96] in quintile 5 suggesting benefit). Sensitivity analyses showed similar findings. Pre-intervention albumin contributed the most to HTE. Analyses of individual EGDT components were inconclusive.

CONCLUSIONS:
Treatment response to EGDT varied across patients in two multicenter RCTs with large benefits for some patients while others were harmed. Patient characteristics, including albumin, were most important in identifying HTE.
Circulating DNA in Rectal Cancer to Unravel the Prognostic Potential for Radiation Oncologist
Authors: Fiorica Francesco , Mandarà Marta , Giuliani Jacopo , Tebano Umberto , Franceschetto Antonella , Gabbani Milena , Rampello Elvira , Condarelli Giorgia , Napoli Giuseppe , Luca Nicoletta , Mangiola Daniela , Muraro Marco , Singh Navdeep , Remo Andrea , Giorgi Carlotta , Pinton Paolo 
Published: October 2024

Objectives:
Liquid biopsy, with its noninvasive nature and ability to detect tumor-specific genetic alterations, emerges as an ideal biomarker for monitoring recurrences for locally advanced rectal cancer (LARC). Completed studies have small sample sizes and different experimental methods. To consolidate and assess the collective evidence regarding the prognostic role of circulating DNA (ctDNA) detection in LARC patients undergoing neoadjuvant chemoradiotherapy (nCRT).

Methods:
Computerized bibliographic searches of MEDLINE and CANCERLIT (2000 to 2023) were supplemented with hand searches of reference lists. Study selection: studies evaluating oncological outcomes of patients with LARC treated with a nCRT comparing patients with positive and negative liquid biopsy at baseline and after nCRT. Data extraction: data on population, intervention, and outcomes were extracted from each study, in accordance with the intention to treat method, by 2 independent observers, and combined using the DerSimonian method and Laird method.

Results:
Nine studies follow inclusion criteria including 678 patients treated with nCRT. The pooled RD rate of ctDNA negative between measure at baseline and after nCRT is statistically significant 61% (95% CI: 53-70, P=0.0002). The hazard ratio (HR) of progression-free survival between ct-DNA negative and positive is significant 7.41 (95% CI: 4.87-11.289, P<0.00001).

Conclusions:
ctDNA can identify patients with different recurrence risks following nCRT and assess prognosis in patients with LARC. Further prospective study is necessary to determine the utility of ctDNA in personalised therapy for patients with LARC.
Epidural anesthesia as a sole anesthetic for a parturient with cardiac disease and low ejection fraction – a case report in resource limited setup
Authors: Hailu Seyoum , Regasa Teshome , Yohannes Bereket 
Published: October 2024

Introduction and importance:
The effective care of pregnant women with cardiac conditions relies on collaboration among the obstetrician, cardiologist, and anesthesiologist throughout the peripartum period. Limited research exists regarding the safety of specific anesthetic approaches for patients with congestive heart failure (CHF), particularly in the context of pregnancy.

Case presentation:
This was a 28-year-old woman who was pregnant with her third child (gravida III, para II) and has not had a menstrual period for the past 8 months. She had been receiving antenatal care at a local health center. Currently, she was experiencing symptoms including coughing, difficulty breathing, epigastric pain, and chest pain, which had been present for 1 week. Upon examination, she was diagnosed with New York Heart Association class IV CHF with pulmonary edema, and preeclampsia with severe features, and she was in the third trimester of pregnancy.

Clinical discussion:
Pre-existing medical conditions can adversely affect pregnancy outcomes for women and their offspring, especially in resource-poor settings in Africa. The goals of anesthetic management are avoidance of myocardial depression, maintaining normovolemia, avoiding an overdose of drugs during induction as the circulation time is slow, and avoiding sudden hypotension when regional anesthesia is the choice.

Conclusion:
We believe that successful management of anesthesia for this critical case depends on a thorough understanding of the pathophysiology of the disease condition, the selection of anesthetic techniques, and the decision-making of our team. We showed epidural anesthesia could be safely used to manage high-risk cardiac patients, however, further interventional study is needed to prove safety.
COMPARING STAGES OF DIABETIC RETINOPATHY WITH SYSTEMIC VASCULAR STATUS USING FINGER PHOTOPLETHYSMOGRAPHY
Authors: Ab Rahman Nurshazwani , Chellapan Kalaivani , Ong Poh Yan , Adnan Azian , Md Din Norshamsiah 
Published: October 2024

Purpose:
To evaluate systemic vascular fitness measured by finger photoplethysmography in diabetic retinopathy (DR).

Methods:
This was a cross-sectional observational study on patients with Type II diabetes mellitus from October 2020 to May 2021. Data collected include systolic/diastolic blood pressure, visual acuity, glycated hemoglobin, and central macular thickness. Diabetic retinopathy severity was categorized using the Early Treatment Diabetic Retinopathy Study classification. Photoplethysmography signals were acquired using pulse-oximeter modules (OEM-60; Dolphin Medical, Inc) measured for 90 seconds at 275 Hz sampling rate and 16-bit resolution, which records photoplethysmography fitness index, vascular risk prediction index, and vascular age.

Results:
One hundred and forty-one patients were equally distributed into six DR categories. Mean age was 58.8 ± 9.9 years, with female-to-male ratio of 1.27. There were significant differences in mean systolic (125.5 ± 10.0 mmHg, P = 0.007) and diastolic blood pressure (80.0 ± 8.8 mmHg), mean glycated hemoglobin (7.6 ± 1.9%, P = 0.005), median log unit of minimal angle of resolution (0.3, interquartile range: 0.2–0.5, P < 0.001), and central macular thickness (P = 0.003) across DR severity. Significant differences were also seen in photoplethysmography fitness index (P = 0.001), vascular risk prediction index (P < 0.001), and vascular age (P = 0.001), with poorer values in severe compared with mild/moderate DR. After adjusting for age, blood pressure, and glycated hemoglobin, photoplethysmography fitness reduces by 3.3% (regression coefficient, b = −3.27, P < 0.001), vascular age increases by 2.5 years (b = 2.54, P = 0.002), and vascular risk prediction index increases by 3.1 (b = 3.08, P < 0.001) with every DR worsening.

Conclusion:
More severe DR stages were associated with poorer photoplethysmography vascular markers.