bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tanner’s target height formula underestimates final adult height in Korean adolescents and young adults: reassessment of target height based on the Korean National Health and Nutrition Examination Survey 2010–2019
Authors: Kim Sejin , Yoo Jae Ho , Chueh Hee Won 
Published: September 2024

ObjectiveEstimating children’s target height (TH) plays an important role in diagnosing, evaluating and treating many paediatric endocrinological diseases. However, in many countries, employing Tanner’s formula to predict children’s final adult height (FAH) is considered misleading. Therefore, this study aimed to re-evaluate the validity of Tanner’s formula for predicting the TH of Korean adolescents and young adults and develop a new formula suitable for Korean children.Design/settingData were derived from the Korean National Health and Nutrition Examination Survey 2010–2019.PatientsA total of 2586 participants (1266 men, 1320 women) were included, excluding participants for whom Tanner’s formula could not be calculated because of missing parental height data.Main outcome measuresTanner-based TH was compared with the FAH.ResultsThe difference between Tanner-based TH and FAH was 4.86±0.178 cm for men and 4.81±0.150 cm for women. Sex-specific univariable and multivariable analyses were conducted to determine variables influencing positive height gap (greater than estimated TH). Both men and women with higher education levels were more likely to exhibit a positive height gap. Those with a history of chronic illness were less likely to exhibit a positive height gap, particularly in women. Using a new formula derived using linear regression analysis, the sum of parental heights explained 27.6% and 30.6% of the variance in sons’ and daughters’ heights, respectively.ConclusionsTanner’s formula for calculating TH tended to underestimate FAH; hence, our new formula may offer a better alternative for estimating TH and evaluating growth in Korean children and adolescents.
Use of intranasal and sublingual analgesia in children and adolescents in the paediatric emergency department
Authors: Cozzi Giorgio , Chiappa Sara , La Fauci Giovanna , Calvi Matteo , Castagno Emanuele , Tappi Eleonora , Villa Giovanna , Tommasi Paola , Milani Gregorio Paolo , Cellai Rustici Marta , Casciana Maria Luisa , Tovaglieri Nicola , Masi Stefano , Vezzoli Cesare , Tilatti Sofia Zeuditù , Giangreco Manuela , Barbi Egidio , Benini Franca 
Published: September 2024

BackgroundDespite evidence showing that the intranasal and sublingual routes are safe and effective in providing analgesia, no data are available about their day-to-day use in the emergency department (ED). The aim of this study was to assess the frequency of the use of the intranasal and sublingual routes, and the clinical characteristics of the patients receiving analgesia through these routes.MethodsA multicentre study was performed in the EDs participating in the Pain in Paediatric Emergency Room research group. It included a survey and a retrospective data collection in which the medical records of all patients who received analgesia from 1 April 2022 to 31 May 2022 were collected.Results48 centres (91%) answered the survey. The intranasal and sublingual routes were used in 25 centres (52%). 13 centres (27%) used both routes, 9 centres (19%) used only the sublingual and 3 centres (6%) used only the intranasal route.12 centres (48%) participated in the retrospective study. Data about 3409 patients, median age 9 years (IQR 5–12), were collected. Among them, 337 patients (9.6%) received sublingual analgesia, and 87 patients (2.5%) received intranasal analgesia. The intranasal route was employed for injuries in 79 (90.8%) cases, and fentanyl was the drug delivered in 85 (97.7%) cases. The sublingual route was used mainly for injuries (57.3%), but also for abdominal pain (15.4%), musculoskeletal pain (14.5%) and headache (10.7%). Paracetamol, ketorolac and tramadol were administered through this route.ConclusionsThe use of the intranasal and sublingual routes for analgesia in the paediatric ED is still limited.
Role of communicating diagnostic uncertainty in the safety-netting process: insights from a vignette study
Authors: Cox Caitríona , Hatfield Thea , Fritz Zoë 
Published: September 2024

Background
Safety-netting is intended to protect against harm from uncertainty in diagnosis/disease trajectory. Despite recommendations to communicate diagnostic uncertainty when safety-netting, this is not always done.

Aims
To explore how and why doctors safety-netted in response to several clinical scenarios, within the broader context of exploring how doctors communicate diagnostic uncertainty.

Methods

Doctors working in internal medical specialties (n=36) from five hospitals were given vignettes in a randomised order (all depicting different clinical scenarios involving diagnostic uncertainty). After reading each, they told an interviewer what they would tell a ‘typical patient’ in this situation. A follow-up semistructured interview explored reasons for their communication. Interviews were recorded, transcribed and coded. We examined
how
participants safety-netted using a content analysis approach, and
why
they safety-netting with thematic analysis of the semistructured follow-up interviews using thematic analysis.

Results
We observed n=78 instances of safety-netting (across 108 vignette encounters). We found significant variation in how participants safety-netted. Safety-netting was common (although not universal), but clinicians differed in the detail provided about symptoms to be alert for, and the action advised. Although many viewed safety-netting as an important tool for managing diagnostic uncertainty, diagnostic uncertainty was infrequently explicitly discussed; most advised patients to return if symptoms worsened or new ‘red flag’ symptoms developed, but they rarely linked this directly to the possibility of diagnostic error. Some participants expressed concerns that communicating diagnostic uncertainty when safety-netting may cause anxiety for patients or could drive inappropriate reattendance/over-investigation.

Conclusions
Participants safety-netted variously, even when presented with identical clinical information. Although safety-netting was seen as important in avoiding diagnostic error, concerns about worrying patients may have limited discussion about diagnostic uncertainty. Research is needed to determine whether communicating diagnostic uncertainty makes safety-netting more effective at preventing harm associated with diagnostic error, and whether it causes significant patient anxiety.
Cluster randomised evaluation of a training intervention to increase the use of statistical process control charts for hospitals in England: making data count
Authors: Schmidtke Kelly Ann , Kudrna Laura , Quinn Laura , Bird Paul , Hemming Karla , Venable Zoe , Lilford Richard 
Published: September 2024

BackgroundThe way that data are presented can influence quality and safety initiatives. Time-series charts highlight changes but do not clarify whether data lie outside expected variation. Statistical process control (SPC) charts make this distinction and have been demonstrated to be effective in supporting hospital initiatives. To improve the uptake of the SPC methodology by hospitals in England, a training intervention was created. The current study evaluates the effectiveness of that training against the background of a wider national initiative to encourage the adoption of SPC charts.MethodsA parallel cluster randomised trial was conducted with 16 English NHS hospitals. Half were randomised to the training intervention and half to the control. The primary analysis compares the difference in use of SPC charts within hospital board papers in a postrandomisation period (adjusting for baseline use). Trainees completed feedback forms with Likert scale and open-ended items.ResultsFifteen hospitals participated across the study arms. SPC chart use increased in both intervention and control hospitals between the baseline and postrandomisation period (29 and 30 percentage points, respectively). There was no statistically significant difference between the intervention and control hospitals in use of SPC charts in the postrandomisation period (average absolute difference 9% (95% CI −34% to 52%). In the feedback forms, 93.9% (n=31/33) of trainees affirmed learning and 97.0% (n=32/33) had formed an intention to change their behaviour.ConclusionsControl chart use increased in both intervention and control hospitals. This is consistent with a rising tide and/or contamination effect, such that the culture of control chart use is spreading across hospitals in England. Further research is needed to support hospitals implementing SPC training initiatives and to link SPC implementation to quality and safety outcomes. Such research could support future quality and safety initiatives nationally and internationally.Trial registration numberNCT04977414.
Posterior quadratus lumborum block versus intrathecal morphine analgesia after scheduled cesarean section: a prospective, randomized, controlled study
Authors: Giral Thomas , Delvaux Bernard Victor , Huynh Davy , Morel Bertrand , Zanoun Nabil , Ehooman Franck , Garnier Thierry , Maupain Olivier 
Published: September 2024

BackgroundDuring the postoperative period of elective cesarean section, intrathecal morphine is effective in the multimodal analgesic regimen, but can cause significant adverse effects. Bilateral posterior quadratus lumborum block could be alternatively used. The aim of this study was to compare efficacy and safety of both strategies as part of a multimodal analgesic regimen.MethodsThis was a prospective, randomized, blinded, controlled study. 104 parturients were randomly selected to receive intrathecal morphine or posterior quadratus lumborum block during cesarean section under spinal anesthesia. The primary endpoint was patient-controlled 24-hour cumulative intravenous morphine use. Secondary endpoints were 48-hour cumulative morphine use, static/dynamic pain scores, functional recovery (ObsQoR-11 questionnaire) and adverse effects.ResultsThere was no statistical difference in the mean cumulative morphine dose at 24-hour between groups (posterior quadratus lumborum block group, 13.7 (97.5% CI 10.4 to 16.9) mg; intrathecal morphine group, 11.1 (97.5% CI 8.4 to 13.8) mg, p=0.111). Pain scores did not show any difference between groups, excepted at 6 hours for the pain at cough/movement in favor of the posterior quadratus lumborum block group (p=0.013). A better recovery quality was observed at 24 hours in the posterior quadratus lumborum block group (p=0.009). Pruritus was more frequent in intrathecal morphine group parturients (35% vs 2%)ConclusionsNo difference in cumulative morphine dose at 24 hours was observed in posterior quadratus lumborum block group compared with intrathecal morphine group. Posterior quadratus lumborum block can be considered an alternative to intrathecal morphine in cesarean postoperative analgesia, especially in cases of intolerance to morphine.Trial registration numberNCT04755712.
Minimal-length quantum field theory: a first-principle approach
Authors: Bosso Pasquale 
Published: September 2024

AbstractPhenomenological models of quantum gravity often consider the existence of some form of minimal length. This feature is commonly described in the context of quantum mechanics and using the corresponding formalism and techniques. Although few attempts at a quantum field-theoretical description of a minimal length has been proposed, they are rather the exception and there is no general agreement on the correct one. Here, using the quantum-mechanical model as a guidance, we propose a first-principle definition of a quantum field theory including a minimal length. Specifically, we propose a two-step procedure, by first describing the quantum-mechanical models as a classical field theory and subsequently quantizing it. We are thus able to provide a foundation for further exploration of the implications of a minimal length in quantum field theory.
Reflections in the mirror: Studying infinite Coxeter symmetries of GV-invariants
Authors: Kuusela Pyry , McGovern Joseph 
Published: September 2024

We study the problem of computing Gopakumar–Vafa (GV) invariants for multiparameter families of symmetric Calabi–Yau threefolds admitting flops to diffeomorphic manifolds. There are infinite Coxeter groups, generated by permutations and flops, that act as symmetries on the GV-invariants of these manifolds. We describe how these groups are related to symmetries in GLSMs, and the existence of multiple mirrors. Some representation theory of these Coxeter groups is also discussed. The symmetries provide an infinite number of relations between the GV-invariants for each fixed genus. This remarkable fact is of assistance in obtaining higher-genus invariants via the BCOV recursion. This paper is based on joint work with Philip Candelas and Xenia de la Ossa.
Abstract A069 The role of ABCB1 in doxorubicin resistant SMARCB1-deficient cancers
Authors: Skinner Katie T. , Lee Benjamin P. , Yoon Jessica S , Hong Andrew L. 
Published: September 2024

Abstract
SMARCB1 is a tumor suppressor gene and encodes a core subunit of the SWI-SNF chromatin remodeling complex. Loss of SMARCB1 leads to the development of highly aggressive pediatric malignancies, termed “SMARCB1-deficient cancers.” This includes malignant rhabdoid tumor, atypical teratoid rhabdoid tumor (ATRT), and renal medullary carcinoma (RMC). Survival rates in these patients remain low, and resistance to chemotherapeutic agents used to treat these cancers are common. One such chemotherapy is doxorubicin. Therefore, this project aims to reveal and understand the mechanisms of doxorubicin resistance in SMARCB1-deficient cancers. To address this question, we generated doxorubicin resistant (DR) cells from one ATRT and two RMC primary cell lines (BT16, PEDS005T, and RCRF1009T respectively) utilizing a dose escalation approach. This resulted in DR cell lines that are 10-fold to 30-fold resistant compared to the parental cell line. Upon generation of these stably resistant cell lines, we profiled their transcriptomes by RNA-sequencing and found an upregulation of the multidrug transporter ABCB1, also known as MDR1. To further probe these cell lines, we performed whole-genome sequencing (WGS) on two of our DR cell lines (BT16 and PEDS005T DR). Here, we found a chromosome 7 aneuploidy in BT16 DR cells, but no aneuploidy or mutations were seen in PEDS005T DR cells. ABCB1 is located on chromosome 7. We confirmed this aneuploidy via karyotyping. The mechanism of ABCB1 upregulation in the RMC DR cell lines remains unknown, suggesting multiple modalities leading to ABCB1 upregulation. We then overexpressed ABCB1 in two ATRT parental cell lines (BT16 and CHLA-06-ATRT) and one RMC cell line (PEDS005T) which led to enhanced short-term resistance. This contrasted to JMSU, a SMARCB1 wild-type bladder cancer cell line, where there was stable resistance. Together, this suggests that ABCB1 may be necessary but not sufficient to confer doxorubicin resistance in these SMARCB1-deficient cancer cells. These preliminary findings suggest that despite a common genetic driver (loss of SMARCB1), there may be different pathways to developing resistance to the DNA-damaging agent, doxorubicin. Furthermore, despite the well documented role of ABCB1 in drug resistance, there may be other factors involved in conferring stable resistance in the setting of SMARCB1-deficient cancers.
Citation Format: Katie T. Skinner, Benjamin P. Lee, Jessica S Yoon, Andrew L. Hong. The role of ABCB1 in doxorubicin resistant SMARCB1-deficient cancers [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pediatric Cancer Research; 2024 Sep 5-8; Toronto, Ontario, Canada. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl):Abstract nr A069.
Tracking Rare Single Donor and Recipient Immune and Leukemia Cells after Allogeneic Hematopoietic Cell Transplantation Using Mitochondrial DNA Mutations
Authors: Penter Livius , Cieri Nicoletta , Maurer Katie , Kwok Marwan , Lyu Haoxiang , Lu Wesley S. , Oliveira Giacomo , Gohil Satyen H. , Leshchiner Ignaty , Lareau Caleb A. , Ludwig Leif S. , Neuberg Donna S. , Kim Haesook T. , Li Shuqiang , Bullinger Lars , Ritz Jerome , Getz Gad , Garcia Jacqueline S. , Soiffer Robert J. , Livak Kenneth J. , Wu Catherine J. 
Published: September 2024

Abstract
Combined tracking of clonal evolution and chimeric cell phenotypes could enable detection of the key cellular populations associated with response following therapy, including after allogeneic hematopoietic stem cell transplantation (HSCT). We demonstrate that mitochondrial DNA (mtDNA) mutations coevolve with somatic nuclear DNA mutations at relapse post-HSCT and provide a sensitive means to monitor these cellular populations. Furthermore, detection of mtDNA mutations via single-cell assay for transposase-accessible chromatin with select antigen profiling by sequencing (ASAP-seq) simultaneously determines not only donor and recipient cells but also their phenotype at frequencies of 0.1% to 1%. Finally, integration of mtDNA mutations, surface markers, and chromatin accessibility profiles enables the phenotypic resolution of leukemic populations from normal immune cells, thereby providing fresh insights into residual donor-derived engraftment and short-term clonal evolution following therapy for post-transplant leukemia relapse. As throughput evolves, we envision future development of single-cell sequencing–based post-transplant monitoring as a powerful approach for guiding clinical decision-making.
Significance: mtDNA mutations enable single-cell tracking of leukemic clonal evolution and donor–recipient origin following allogeneic HSCT. This provides unprecedented insight into chimeric cellular phenotypes of early immune reconstitution, incipient relapse, and quality of donor engraftment with immediate translational potential for future clinical post-transplant monitoring and decision-making.
Disparities in Emergency Medical Services Use, Prehospital Notification, and Symptom Onset to Arrival in Patients With Acute Stroke
Authors: Royan Regina , Stamm Brian , Lin Timmy , Baird Janette , Becker Christopher J. , Karb Rebecca , Burton Tina M. , Kleindorfer Dawn O. , Prabhakaran Shyam , Madsen Tracy E. 
Published: September 2024

BACKGROUND:
Disparities in time to hospital presentation and prehospital stroke care may be important drivers in inequities in acute stroke treatment rates, functional outcomes, and mortality. It is unknown how patient-level factors, such as race and ethnicity and county-level socioeconomic status, affect these aspects of prehospital stroke care.

METHODS:
Cross-sectional study of patients with ischemic stroke, intracerebral hemorrhage, and subarachnoid hemorrhage in the Get With the Guidelines-Stroke registry, presenting from July 2015 to December 2019, with symptom onset ≤24 hours. Multivariable logistic regression and quantile regression were used to investigate the outcomes of interest: emergency medical services (EMS) transport (versus private vehicle), EMS prehospital notification (versus no prehospital notification), and stroke symptom onset to time of arrival at the emergency department. Prespecified covariates included patient-level, hospital-level, and county-level characteristics.

RESULTS:
The inclusion criteria was met by the 606 369 patients. Of the patients, 51.2% were men and 69.9% White, with a median National Institutes of Health Stroke Severity of 4 (IQR, 2–10), and median social deprivation index (SDI) of 51 (IQR, 27–75). Median symptom onset to arrival time was 176 minutes (IQR, 64–565). Black race was significantly associated with prolonged symptom onset to emergency department arrival time (+28.21 minutes [95% CI, 25.59–30.84]), and decreased odds of EMS prehospital notification (OR, 0.80 [95% CI, 0.78–0.82]). SDI was not associated with differences in EMS use but was associated with lower odds of EMS prehospital notification (upper SDI tercile versus lowest, OR, 0.79 [95% CI, 0.78–0.81]). SDI was also significantly associated with stroke symptom onset to emergency department arrival time (upper SDI tercile versus lowest +2.56 minutes [95% CI, 0.58–4.53]).

CONCLUSIONS:
In this national cross-sectional study, Black race was associated with prolonged symptom onset to time of arrival intervals and significantly decreased odds of EMS prehospital notification, despite similar use of EMS transport. Greater county-level deprivation was also associated with reduced odds of EMS prehospital notification and slightly prolonged stroke symptom onset to emergency department arrival time. Efforts to reduce place-based disparities in stroke care must address significant inequities in prehospital care of acute stroke and continue to address health inequities associated with race and ethnicity.
Associations of Rest‐Activity Rhythm Disturbances With Stroke Risk and Poststroke Adverse Outcomes
Authors: Gao Lei , Zheng Xi , Baker Sarah N. , Li Peng , Scheer Frank A. J. L. , Nogueira Ricardo C. , Hu Kun 
Published: September 2024

Background
Many disease processes are influenced by circadian clocks and display ~24‐hour rhythms. Whether disruptions to these rhythms increase stroke risk is unclear. We evaluated the association between 24‐hour rest‐activity rhythms, stroke risk, and major poststroke adverse outcomes.

Methods and Results

We examined ~100 000 participants from the UK Biobank (aged 44–79 years; ~57% women) assessed with actigraphy (6–7 days) and 5‐year median follow‐up. We derived (1) most active 10‐hour activity counts across the 24‐hour cycle and the timing of its midpoint timing; (2) the least active 5‐hour count and its midpoint; (3) relative amplitude; (4) interdaily stability; and (5) intradaily variability, for stability and fragmentation of the rhythm. Cox proportional hazard models were constructed for time to (1) incident stroke (n=1652) and (2) poststroke adverse outcomes (dementia, depression, disability, or death). Suppressed relative amplitude (lowest quartile [quartile 1] versus the top quartile [quartile 4]) was associated with stroke risk (hazard ratio [HR], 1.61 [95% CI, 1.35–1.92];
P
<0.001) after adjusting for demographics. Later most active 10‐hour activity count midpoint timing (14:00–15:26; HR, 1.26 [95% CI, 1.07–1.49];
P
=0.007) also had higher stroke risk than earlier (12:17–13:10) participants. A fragmented rhythm (intradaily variability) was also associated with higher stroke risk (quartile 4 versus quartile 1; HR, 1.26 [95% CI, 1.06–1.49];
P
=0.008). Suppressed relative amplitude was associated with risk for poststroke adverse outcomes (quartile 1 versus quartile 4; HR, 2.02 [95% CI, 1.46–2.48];
P
<0.001). All associations were independent of age, sex, race, obesity, sleep disorders, cardiovascular diseases or risks, and other comorbidity burdens.

Conclusions
Suppressed 24‐hour rest‐activity rhythm may be a risk factor for stroke and an early indicator of major poststroke adverse outcomes.