bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serum tumour necrosis factor-alpha as a marker of disease activity in children with nephrotic syndrome
Authors: Gowtham B C , Dawman Lesa , Tiewsoh Karalanglin , Kushwah Sunil , Rawat Amit , Singh Thakurvir , Gupta Aarchie 
Published: August 2024

Abstract
Idiopathic nephrotic syndrome (NS) is a common glomerular disease in children throughout the world; however, the exact pathogenesis of the disease remains unknown. Several studies have shown that tumour necrosis factor-alpha (TNF-α), a proinflammatory cytokine, plays a significant role in the pathogenesis of NS. The literature lacks sufficient data to establish the relationship between TNF-α and NS. This prospective study was conducted on children aged 1–14 years diagnosed with idiopathic NS. All enrolled individuals were followed up from disease onset or relapse of NS until remission or at least 42 days with steroid therapy if remission was not achieved. Serum TNF-α levels were measured at presentation and remission or after 42 days of steroid therapy if remission was not achieved. The role of TNF-α levels in response to steroid therapy in NS was also assessed. One hundred and twelve children (68% boys) with idiopathic NS were enrolled. The median age (interquartile range) at enrolment was 58.5 (37–84.7) months, while the median age at symptom onset was 47.5 (24–60.7) months. The median TNF-α level at presentation was 7.5 (3.5–12.1) pg/ml, and that at remission was 5.25 (1.62–8.8) pg/ml. The median TNF-α levels among first-episode NS at presentation were 3.98 pg/ml and 1.88 pg/ml (P = .04) at remission, whereas in steroid-resistant NS, it was 6.59 pg/ml at presentation and 9.02 pg/ml at 42 days (P = .45). There was a significant negative correlation between the duration of steroid therapy and TNF-α levels, with a correlation factor of −0.021 and R2 of 0.154 (P≤.001). Serum TNF-α levels decrease with steroid therapy in children with steroid-sensitive NS, which correlates clinically with the achievement of remission.
Effects of Gustatory and Olfactory Stimulation on Feeding Outcomes in Preterm Infants
Authors: Li Xia , Guo Xuemei , Wan Xingli , Hu Yanling 
Published: August 2024

Background:
Few primary studies have examined the impact of olfactory and gustatory stimulation on premature infants, and variability exists in reported outcomes.

Purpose:
To explore the effects of olfactory and gustatory stimulation on feeding outcomes in preterm infants.

Data Sources:
A literature search was conducted in 4 databases (CENTRAL, PubMed, Embase, CINAHL) from the inception of the databases to May 2024.

Study Selection:
Randomized controlled trials (RCTs) or quasi-RCTs to explore the effects of olfactory and gustatory stimulation on feeding outcomes in preterm infants were included.

Data Extraction:
Two reviewers independently extracted data from the included studies and completed the form designed for data extraction.

Results:
Eleven RCTs and quasi-RCTs comprising 1009 preterm infants were included. Meta-analysis found that olfactory and gustatory stimulation significantly shortened the time to reach full oral feeds (days) (mean difference [MD]: −2.52, 95% confidence interval [CI]: −3.88 to −1.16, P = .0003), while they had no significant differences in time to achieve full enteral feeds (days), postmenstrual age (PMA) at the removal of the nasogastric tube (weeks), weight at discharge (grams), weight gain (grams), head circumference at discharge (cm), length at discharge (cm), total duration of parenteral nutrition (days), necrotizing enterocolitis, hospitalization duration (days), PMA at discharge (weeks).

Implications for Practice and Research:
Large sample, multicenter studies are needed to demonstrate the effectiveness of olfactory and gustatory stimulation on feeding outcomes in preterm infants.
Malignant Proliferating Pilar Tumor With Sarcomatous Transformation (“Carcinosarcoma”): Case Report With Molecular Profile
Authors: Moran Jakob M. T. , Hoang Mai P. , Mariño-Enríquez Adrian , DeSimone Mia S. 
Published: August 2024

Abstract:
Malignant proliferating pilar tumors (MPPTs) are rare, unique cutaneous adnexal tumors. Sarcomatous transformation in MPPTs is even rarer (4 previous cases reported). Here, we report an extraordinary case of a MPPT with sarcomatous transformation occurring on the scalp of a 63-year-old man with an in-depth molecular profile along with histologic, immunohistochemical, and follow-up data. Shared mutations in the epithelial and sarcomatous components included a loss-of-function TP53 mutation. An inactivating TP53 mutation was only identified in the epithelial component, and an inactivating CDKN2A mutation was only identified in the sarcomatous component. Copy number variations previously reported in MPPT were also identified, including 6p21.1 loss, 6q arm loss, and 15q21.1-q26.3 gain [epithelial], and 6p22.2-p22.3 loss [sarcoma]. Histologically, the tumor demonstrated juxtaposed areas of proliferating pilar tumor, carcinoma with clear cell change, and sarcomatous areas that did not stain for AE1/AE3, p40, CD34, S100 protein, and smooth muscle actin by immunohistochemistry. The patient is alive at 2 years without evidence of recurrence or metastasis.
Association Between Food Insecurity and Developmental Delay and Behavioral Problems in US Children 2 to 5 Years of Age
Authors: Savant Devina , Gjelsvik Annie , Yatchmink Yvette , High Pamela 
Published: August 2024

Objectives:
To investigate the relationship between food insecurity and developmental delay and/or behavior problems (DD/PB) in US children aged 2 to 5 years before the COVID-19 pandemic.

Methods:
Data from 14,464 children aged 2 to 5 years from the National Survey of Children's Health from 2016 to 2017 were analyzed. Children with food insecurity came from families reporting they sometimes or often could not afford nutritious meals. Diagnosis of DD/PB by a professional was obtained through a caregiver report.

Results:
A quarter of children aged 2 to 5 years lived in food insecure homes, and 9% were diagnosed with DD/PB. Children in food insecure households were more likely to be from minoritized populations publicly insured, with single parents, without high school education, living =< 130% Federal poverty line, and receiving supplemental nutrition assistance program (SNAP) benefits (all p < 0.001). Adjusting for age, sex, race, ethnicity, poverty, family structure, and parent education, children in food insecure households had 1.57 times the odds of being diagnosed with DD/PB compared with children in food secure households. In similarly adjusted models excluding poverty and stratified by SNAP use, homes not receiving SNAP maintained this association between food insecurity and diagnosis of DD/PB, whereas in homes receiving SNAP, the association was not significant.

Conclusion:
In this population-based study, US children aged 2 to 5 years in food insecure households were more likely to be diagnosed with DD/PB compared with those in food secure households. When stratified, there was no association between food insecurity and DD/PB among those receiving SNAP; the association remained for those not receiving SNAP. The potential long-term impact of this safety net program on our most vulnerable citizens must be considered as policymakers contemplate federal spending priorities.
Associations of Infant Sleep Characteristics with Childhood Cognitive Outcomes
Authors: Finkel Morgan A. , Duong Ngoc , Hernandez Amanda , Goldsmith Jeff , Rifas-Shiman Sheryl L. , Dumitriu Dani , Oken Emily , Shechter Ari , Woo Baidal Jennifer A. 
Published: August 2024

ABSTRACT:

Objective:
The objective of this study was to quantify associations of infant 24-hour sleep duration and nighttime sleep consolidation with later child cognition.

Methods:
This study included children from Project Viva, a prospective cohort in Massachusetts with (1) sleep measures in infancy (median age 6.4 months) and (2) child cognition in early childhood (median age 3.2 years) or mid-childhood (median age 7.7 years). Main exposures were parental reports of infant 24-hour sleep duration and nighttime sleep consolidation (% of total daily sleep occurring at nighttime). Cognitive outcomes were (1) early childhood vocabulary and visual-motor abilities and (2) mid-childhood verbal and nonverbal intelligence quotient (IQ), memory, and visual-motor abilities. We examined associations of infant sleep with childhood cognition using linear regression models adjusted for child sex, age, and race or ethnicity; maternal age, education, and parity; and household income.

Results:
Early and mid-childhood analyses included 1102 and 969 children, respectively. Most mothers reported infant race or ethnicity as White (69%) and were college graduates (71%). The mean infant 24-hour sleep duration was 12.2 ± 2.0 hours, and the mean nighttime sleep consolidation was 76.8% ± 8.8%. Infant 24-hour sleep duration was not associated with any early or mid-childhood outcomes. Higher infant nighttime sleep consolidation was associated with higher mid-childhood verbal intelligence (β: 0.12 points per % nighttime sleep; 95% CI, 0.01–0.22), but not with any early childhood cognitive measures.

Conclusion:
In this cohort, higher infant nighttime sleep consolidation was associated with higher verbal IQ in mid-childhood. Future studies should investigate causal relationships of infant sleep consolidation with child cognition among diverse populations.
Toward More Equitable Care: A Closer Look at Autism Clinic Intake Practices and Paperwork
Authors: Srinivasan Anisha P. , Nishiguchi Erika Phelps , Gonzalez Cassandra , Jimenez Manuel E. , Zuckerman Katharine E. , Lion Katherine C. 
Published: August 2024

ABSTRACT:

Objective:
To describe intake requirements among autism clinics and to assess how well intake paperwork aligns with national standards for enhancing language and literacy accessibility.

Methods:
This was a survey of 126 autism clinics in the Children's Hospital Association, assessing intake processes and intake paperwork readability conducted between November 2021 and August 2022. Descriptive analyses characterized intake requirements and paperwork components. Free-text responses about intake support strategies were categorized into themes. Logistic regression models examined associations between clinic patient demographics and odds of requiring intake paperwork. Intake packet length, content, and reading grade level were examined.

Results:
Of the invited clinics, 73% completed the survey. Among the participating clinics, 55% required intake paperwork before scheduling appointments, 34% offered English forms only, and 89% had no plain language forms. Clinic patient demographics were not associated with intake paperwork requirements. Analyzed intake packets (n = 67) averaged 11 pages long, and most were written above the fifth-grade reading level. Most packets solicited medical, developmental, and educational/therapy history. Many also requested psychoeducational evaluations and teacher rating forms. Reported intake support strategies for families with language or literacy needs included making ad hoc exceptions to the usual process, task shifting to outside organizations, providing support at family's request, and delegating to support staff.

Conclusion:
Many autism clinics nationwide require intake paperwork before diagnostic evaluation. Many clinics offer intake paperwork in English only, and paperwork often does not meet health literacy standards. Reducing paperwork requirements and providing more routine and robust intake support may facilitate equitable access to autism diagnostic evaluations.
Evidence of Mitophagy in Lens Capsule Epithelial Cells of Patients With Pseudoexfoliation Syndrome
Authors: Aydemir Dilara , Sonmez Sadi Can , Kisakurek Zeynep Busra , Gozel Merve , Karslioglu Melisa Zisan , Guleser Umit Yasar , Sahin Afsun , Hasanreisoglu Murat 
Published: August 2024

Précis:
Alterations in the PTEN-induced kinase 1 (PINK)-mediated mitophagy pathway play an important role in pseudoexfoliation syndrome (PEX) disease.

Purpose:
PEX is a condition in which aberrant fibrillary protein builds up in various components of the eye and other extraocular tissues. In this study, we aim to investigate the functionality of intracellular auto-degradative machinery—especially mitophagy—and related genes and proteins in PEX.

Materials and Methods:
Anterior lens capsules were obtained from cataract patients with and without PEX to constitute the PEX group and age-matched controls during microincision cataract surgery. PINK1-mediated mitophagy markers were evaluated on the transcriptional and translational level via reverse transcriptionquantitative polymerase chain reaction and immunohistochemistry analysis, respectively.

Results:
The lens epithelial cells of PEX patients were characterized by significantly higher PINK1 gene expression compared with that of the controls (P<0.05). In terms of intensity of staining of expressed proteins, PINK1 (P<0.05), Parkin (P<0.01), and microtubule-associated protein 1A/1B-light chain 3 B (P<0.01) were all statistically higher in PEX, compared with the controls.

Conclusion:
Altered auto-degradative response—specifically mitophagy—is a component of increased oxidative stress in PEX patients. The role of this mechanism in emerging complications warrants further research.
Implications of Requiring the Physician Assistant College Admissions Test on Physician Assistant Program Applicant Pool: Lessons Learned
Authors: Fogelgren Lauren 
Published: August 2024

Introduction
To present a physician assistant (PA) program's experience and lessons learned by requiring a new standardized test as an admissions requirement. A state academic PA program changed an admission requirement by requiring the Physician Assistant College Admissions Test (PA-CAT) instead of the Graduate Record Examination. The admissions requirement change correlated with a 72% drop in the applicant pool.

Methods
Data from previous literature present background information on standardized testing and predictors of student success. The program-specific data retrospectively evaluate changes in application numbers.

Results
Several studies have evaluated various preadmission metrics and their correlation to student success. However, the PA-CAT and its predictor of student success in the program and passing the Physician Assistant National Certifying Exam still need to be evaluated.

Discussion
Requiring standardized testing increases the barrier to applicant PA school admissions. Despite its potential, the PA-CAT has yet to be extensively studied to predict success in matriculated PA students and should be used cautiously. The implications of using the PA-CAT as an admissions requirement are a potential decrease in the strength of applicants, the number of total applicants, and the overall decline in the quality of graduating PAs. This cautionary note is crucial for maintaining the quality and integrity of our PA programs.
Breastfeeding may reduce the effects of maternal smoking on lung cancer mortality in adult offspring: a prospective cohort study
Authors: Yin Hang , Wang Yixue , Wang Siyu , Zhang Shijie , Ling Xiaodong , Han Tianshu , Sun Changhao , Ma Jianqun , Wei Wei , Zhu Jinhong , Wang Xiaoyuan 
Published: August 2024

Background:
Although previous research has indicated a correlation between smoking and the mortality rate in patients with lung cancer, the impact of early life factors on this relationship remains unclear and requires further investigation. This study aimed to investigate the hypothesis that breastfeeding reduces the risk of lung cancer-related death.

Methods
The authors conducted a prospective cohort study involving 501 859 participants recruited from the United Kingdom Biobank to explore the potential association between breastfeeding and the risk of lung cancer mortality using a Cox proportional hazards model. Subsequently, the polygenic risk score for lung cancer was calculated to detect interactions between genes and the environment.

Results:
Over a median follow-up duration of 11.8 years, encompassing a total of 501 859 participants, breastfeeding was found to reduce the risk of lung cancer-related death and the impact of maternal smoking on lung cancer mortality in adult offspring. This association remained consistent after stratification. Furthermore, the influence of maternal smoking and breastfeeding on the risk of lung cancer mortality was significant at a high genetic risk level.

Conclusion:
Breastfeeding can reduce the risk of lung cancer-related death and the impact of maternal smoking on lung cancer mortality in adult offspring. This correlation has the potential to reduce the probability of lung-cancer-related deaths in subsequent generations.
Efficacy of HA380 hemoperfusion in the treatment of septic shock
Authors: Chen Li , Zhou Shenglin , Wang Chao , Qie Guoqiang , Tai Zijian , Wang Feng , Ding Ruiqi , Liu Guangyun , Liu Yan , Bai Xue , Zhang Jicheng 
Published: August 2024

Background:
To evaluate the clinical efficacy of HA380 hemoperfusion (HP) in the treatment of septic shock.

Methods:
This study retrospectively analyzed the clinical data of patients with septic shock admitted to Ward II of the Department of Critical Care Medicine at the Shandong Provincial Hospital Affiliated to Shandong First Medical University from January 2022 to December 2023. These data included general information, temperature, heart rate (HR), mean arterial pressure (MAP), oxygenation index, norepinephrine (NE) dose, lactic acid, white blood cell count, neutrophil percentage, lymphocyte absolute value, procalcitonin (PCT), interleukin-6 (IL-6), acute physiology and chronic health evaluation II (APACHE II), sequential organ failure assessment (SOFA) before and after each blood perfusion (HA380), total hospital stay, intensive care unit (ICU) stay, and 28-day survival.

Results:
A total of 41 patients with septic shock were included in this study, consisting of 38 males and 3 females. According to their primary diseases, there were 18 cases of severe pneumonia, 16 cases of abdominal infection, 4 cases of bloodstream infection, 2 cases of urinary infection, and 1 case of soft tissue infection. At the time of inclusion, 33 patients underwent mechanical ventilation for respiratory support, and 4 patients were treated with extracorporeal membrane oxygenation. Statistically significant differences (all P < 0.05) were observed in body temperature, HR, MAP, oxygenation index, norepinephrine dose, lactic acid, PCT, IL-6, creatinine (Cr), APACHE II, and SOFA before and after HP (HA380) treatment. According to the 28-day survival status of patients, patients were allocated into survival and death groups. The total hospital stay and ICU stay were statistically significantly different between the two groups (all P < 0.05). Additionally, there were also statistically significant differences in APACHE II and SOFA before and after treatment (all P < 0.05). Based on the severity stratification of IL-6 and PCT levels, it was observed that following HP (HA380) treatment, all subgroups showed varying degrees of improvement in SOFA and APACHE II scores (P < 0.05).

Conclusion:
HP (HA380) can improve the clinical efficacy of patients with septic shock. In addition, this method improves hemodynamics, effectively reduces lactic acid levels and infection indexes, and alleviates organ function damage in patients with septic shock, which can strive for more time for subsequent treatment.
Evaluation of the Clinical and Paraclinical Symptoms of Children Intoxicated With Amphetamines in Akbar Hospital of Mashhad, Iran 2021–2022
Authors: Aria Arsalan , Pourbadakhshan Nafiseh , Alizadeh Anahita 
Published: August 2024

Introduction
Amphetamine poisoning in children is a significant public health concern due to its potential for severe adverse effects on physical and mental health. In this article, we describe a case series of 29 children under the age of 14 presenting with sympathomimetic toxidrome due to confirmed amphetamine poisoning.

Material and Method
In this cross-sectional study, children (1 month to 14 years old) who were hospitalized in the emergency and pediatric departments of Imam Reza and Akbar Hospital in Mashhad from the beginning of April 2021 to September 2022 were identified with the diagnosis of amphetamine poisoning. Their demographic, clinical, and paraclinical (laboratory and electrocardiogram) information, which was included in the relevant checklists, were analyzed and reported.

Findings
Out of 29 children included in the study, 18 (62%) were male and the rest were female. The average age of children was 44.75 ±43.9 months; most of them were less than 4 years old. In all patients, glasgow coma scale (GCS) was 15. In 25.92% of cases (8 patients) blood pressure was above the 90% percentile for age and sex, 82.60% (24 cases) were tachycardia, 72.41% crying (21 cases), 86.20% were restless (25 cases), 10.34% tremor (3 cases), 10.34% had body pain (3 cases), and 6.89% (2 cases) had delusions. None of the subjects had a seizure. The serum level of creatine phosphokinase was on average 771.99 ± 966 units/L. All children had an increase in creatine phosphokinase (CPK) and 25.9% of children had an increase in CPK to more than 1000 units/L.

Conclusion
Based on the results, in children with symptoms such as restlessness, crying, and tachycardia, poisoning with amphetamine group substances should be included in the differential diagnosis list, and also measuring CPK and investigating the possible occurrence of rhabdomyolysis in cases of poisoning of children with amphetamine seems necessary.
Central Venous Oxygen Saturation in Children With Cancer
Authors: Vissing Nadja Hawwa , Dungu Kia Hee Schultz , Andersen Frederik Mølkjær , Mønster Mette Bondo , Hjalgrim Lisa Lyngsie , Schmiegelow Kjeld , Nygaard Ulrikka 
Published: August 2024

Objective
Central venous saturation (ScvO2) can guide resuscitation of children with septic shock. The normal range of ScvO2 is typically considered as 0.70–0.80, but has not been established in children with cancer. Children with cancer are particularly prone to develop sepsis due to their immunosuppressive therapy, and usually have a permanent central venous catheter, making ScvO2 readily available. We aimed to investigate normal values of ScvO2 in clinically stable children with cancer, and the association between ScvO2, hemoglobin, and lactate.

Methods
We conducted a prospective clinical study at the outpatient clinic of a tertiary pediatric hematology/oncology unit. Blood samples were collected from stable children aged 0–17.9 years who were treated for cancer between January 1 and November 30, 2019, during their routine outpatient clinic visits.

Results
A total of 183 blood samples were collected from 68 patients (24 girls and 44 boys). The predicted mean level of ScvO2 with a 95% confidence interval was 0.67 (0.56–0.78). The ScvO2 value was below the expected lower normal limit of 0.70 in 126 (69%) of the samples and in 48 patients (71%) at least once. ScvO2 was significantly associated with hemoglobin (β1 = 0.012 per g/L hemoglobin, P < 0.001), but not with age, sex, underlying diagnosis, or lactate.

Conclusions
The study revealed that a substantial portion of clinically stable childhood cancer patients exhibited ScvO2 levels below the typical reference value of 0.70, suggesting that these children may have inherently lower baseline ScvO2 levels. This should be kept in mind when evaluating children with cancer for septic shock, emphasizing the importance of tailored assessments in this population. Further understanding of baseline ScvO2 abnormalities may be helpful if ScvO2 is used to guide resuscitation.