bluuebunny/crossref_metadata_2025_split huggingface dataset:
The increase in diabetes in children from underdeveloped countries
Authors: Zhang Cai , Luo Xiaoping 
Published: June 2024

Purpose of review
The incidence of type 1 diabetes (T1D) in children and adolescents has been increased over decades worldwide. Recent studies showed that the trend of T1D incidences were different between developed and underdeveloped countries. This review aimed to summarize the changes of childhood T1D incidences in underdeveloped countries over the past decade.

Recent findings
Majority of the underdeveloped countries lacked of nationwide population-based studies on childhood T1D. We reviewed the trend of childhood T1D in important underdeveloped countries with available data in recent years. The incidences of childhood T1D in underdeveloped countries were low decades ago, but it increased significantly recently, particularly in the sub-Saharan African, Middle East and North African regions.

Summary
The incidences of childhood T1D increased significantly in underdeveloped countries, especially in the sub-Saharan African, Middle East and North African regions. T1D registry and population-based studies are helpful to understand the situation and characteristic of childhood T1D in underdeveloped countries.
Juvenile Xanthogranuloma of the Head and Neck: Imaging Findings in 11 Cases
Authors: Chalard François , Nguyen Toan , Morel Baptiste , Leiber Louis-Marie , Roux Charles-Joris , Petit Philippe , Soto Ares Gustavo , Donadieu Jean , Ducou le Pointe Hubert 
Published: June 2024

Background:
Juvenile Xanthogranuloma (JXG) is a non-Langerhans cell histiocytosis, occurring mainly in infancy. With an extracutaneous lesion, its diagnosis is difficult, because of a wide clinical spectrum. Here we demonstrate and characterize imaging features of 11 patients with JXG of the head and neck in various locations.

Material and Methods:
We recorded clinical data and reviewed all imaging studies of 11 patients with JXG of the head and neck. Ultrasonography (US) alone was performed in 1 patient; MRI alone in 6 patients; US and MRI in 1 patient; and US, CT, and MRI in 3 patients. We evaluated the following characteristics in all studies: location and number of lesions, echogenicity and vascularization on US, density on CT, signal intensity on T1- and T2-weighted images, ADC and enhancement on MRI, and tumor boundaries and bone involvement.

Results:
Lesions were well-defined in 9 cases, and bone erosion was present in 2. On US, lesions were hypoechoic or hyperechoic and with or without vascularization. On CT, lesions were hyper-dense, with no calcification. On MRI, lesions were mildly hyper-intense or iso-intense on T1-weighted images in 8 of 9 patients, hypo-intense on T2-weighted images in 7 of 10, low ADC in 7 of 9, and enhancement in 7 of 7.

Conclusions:
The diagnosis of extra cutaneous JXG may be proposed, with the following suggestive criteria: age < 1 year, well-defined lesion, mild hyper-intensity on T1-weighted images, hypo-intensity on T2-weighted images, low ADC, enhancement, and possible adjacent bone involvement.
Comparison of Yearly Cost Related to Complications Between Deferasirox and Deferiprone Monotherapy in Thalassemia
Authors: Sari Teny Tjitra , Wahidiyat Pustika Amalia , Rahmartani Ludi Dhyani , Iskandar Stephen Diah , Putri Isyanaditta Agung 
Published: June 2024

Background:
Hemoglobin disorders such as thalassemia major have created an economic burden on the health care system. Iron chelation therapy (ICT) is the most expensive cost component in patients with thalassemia. ICT was administered to reduce the toxic effects of iron overload. This study aims to compare the costs of iron chelators as monotherapy in patients with thalassemia major in Indonesia, specifically in Cipto Faculty of Medicine, Universit.

Methods:
This is a retrospective analytical observational study. Data were collected from the thalassemia registry from 2016 to 2019. Patients’ age, gender, type of thalassemia, and type of iron chelation were recorded. Complications and total annual costs were evaluated. All thalassemia patients aged ≥2 years who were only receiving monotherapy ICT and had no history of therapy switching were eligible. We excluded subjects who moved out to other facilities or lost to follow-up.

Results:
From a total of 256 subjects, 249 subjects were included. The median age is 28 years old. Both sexes were represented equally. As many as 96.8% of subjects have thalassemia beta. Deferiprone was the most common iron chelator used (86.7%). Complications were observed in the subjects based on 4-year data collection; most of them were cardiomyopathy, diabetes mellitus, delayed puberty, and malnutrition (P=0.422; P=0.867; P=0.004; and P=0.125, respectively). Deferiprone had a lower mean annual cost of USD 3581 than deferasirox, which had a cost of USD 6004.

Conclusions:
Cardiomyopathy, diabetes mellitus, delayed puberty, and malnutrition were the most common complications found in the study. This study showed that deferiprone should be taken as consideration as a drug of choice to treat iron overload in thalassemia provided by Indonesian national health insurance which is less costly despite the probability of complications found after the treatment was given. Further investigations are required to evaluate contributing factors of complications in thalassemia.
Physical independence and related factors among older adults: a systematic review and meta-analysis
Authors: Miri Sahar , Farhadi Bahar , Takasi Poorya , Ghorbani Vajargah Pooyan , Karkhah Samad 
Published: June 2024

Background:
Adopting a physically active lifestyle is advocated as a strategy to prevent loss of physical independence and support healthy aging. This study aimed to evaluate the physical independence and related factors among older adults.

Materials and methods:
This systematic review and meta-analysis was conducted through electronic databases such as Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database from the earliest to 1 April 2022. Two researchers independently extracted information from the studies and evaluated the quality of the studies. The analysis was conducted using CMA program version 3, and each study’s importance was determined based on its inverse variance.

Results:
Five thousand seven hundred thirty-three older adults participated in this review in six studies. All evaluated studies had high quality. The mean score of physical independence in older adults was 20.07 (SE=0.76) out of 24 (95% CI: 18.58–21.56; I2
=98.573%; P<0.001). Physical activity is very important for physical independence and reduces the risk of physical dependence in older adults. Other factors, such as sex, BMI, age, abnormal performance, timed performance, sufficiently active, muscle function, handgrip strength, lower extremity function, lower body strength, maximal isometric knee extension power, lung function, aerobic endurance, sedentary time, agility, and the prevalence of arthritis, had a significant relationship with physical independence in older adults.

Conclusion:
Older adults demonstrate favourable levels of physical independence. Notably, physical activity emerges as a significant determinant positively associated with such independence. Thus, policymakers and administrators are encouraged to strategize the creation of conducive environments for walking and exercise among older adults.
When Vaping Isn't Actually Safer
Authors: Ogburn Timothy , Chaudhry Irfan , Knight Laura D. 
Published: June 2024

Abstract
Vape juice is a diluent for e-cigarette active ingredients, nicotine or tetrahydrocannabinol (THC). Lack of strict regulation in vape juice production is a concern as ingredients and their concentrations may vary widely from the labeling.
A 43-year-old woman was transported via ambulance to the hospital after ingesting homemade vape juice, presenting unresponsive with decerebrate posturing. She reportedly made a tincture combining a vape juice purchased online (containing “ethylene glycol”) and THC for “endometriosis-related pain relief.” Laboratory evaluation revealed anion gap metabolic acidosis, elevated serum lactate, and high serum osmolality. Urine fluoresced under Wood's lamp, and fomepizole was administered as an ethylene glycol antidote, but she expired the following afternoon. Clinical serum toxicology results returned after death revealed 235 mg/dL of methanol, and no ethylene glycol.
Autopsy findings included ischemic changes of the gastrointestinal tract and cerebral edema with herniation. Postmortem toxicology performed on hospital admission blood revealed methanol (220 mg/dL), propylene glycol (59 mg/dL), Δ-9 THC and metabolites, and medications administered during hospitalization. The medical examiner determined the cause of death to be methanol and propylene glycol toxicity.
To our knowledge, this is the first report of accidental death from ingestion of vape juice contaminated with toxic alcohol.
State Requirements for Non-Medical US Cannabis Retail Personnel
Authors: LoParco Cassidy R. , Cui, MSPH Yuxian , McCready, MS Darcey , Romm, PHD Katelyn F. , Yang, ScD, LLM, MPH Y. Tony , Rossheim, PhD, MPH Matthew E. , Carlini, PhD, MPH Beatriz , Vinson, BS Katie , Cavazos-Rehg, PhD Patricia , Berg, PhD, MBA, LP Carla J. 
Published: June 2024

In September 2023, we examined requirements for budtenders working in nonmedical dispensaries in the 20 states with active non-medical cannabis markets. Two coders extracted data from each state’s licensing board and/or governmental websites. The age requirement for budtenders was ≥21 years old (n = 17) or ≥18 (n = 3). Most states (n = 16) required background checks; 10 specified felony convictions preventing employment, 5 allowed the Department to determine eligibility, and 2 allowed petitions upon denial. Twelve states required fingerprinting. There were application fees ($25-$300) in 13 states. Structured training was required in 7 states, while 5 states required employee training. Given the diverse budtender requirements, the evaluation of budtender standards is essential to assess the impacts of training on regulatory compliance and consumer education, and of application costs and conviction-based employment restrictions on social equity. This must inform the development of effective regulations and enforcement protocols, as well as and how to promote equity in cannabis regulations.
Nationwide Analysis of Adult-Onset Still Disease With and Without Hemophagocytic Lymphohistiocytosis
Authors: Sami Faria , Manansala Michael , Arora Shilpa , Manadan Augustine M. 
Published: June 2024

Introduction
Adult-onset Still disease (AOSD) is a rare inflammatory condition with a monophasic, intermittent, or chronic clinical course, and a subset may experience life-threatening complications such as hemophagocytic lymphohistiocytosis (HLH). This study aims to characterize concurrent AOSD and HLH and identify variables independently associated with in-hospital death.

Methods
We performed a medical records review of AOSD with and without HLH from the 2016–2019 National Inpatient Sample database. We performed a multivariable logistic regression analysis for in-hospital death. Results were reported as adjusted odds ratios (ORadj).

Results
There were 5495 hospitalizations with AOSD, of which 340 (6.2%) had HLH. Thirty (9.0%) of the combined AOSD and HLH group died in the hospital compared with 75 (1.5%) of those without HLH. Multivariable analysis in AOSD inpatients showed that disseminated intravascular coagulation (ORadj 6.13), hepatic failure (ORadj 7.16), infection (ORadj 3.72), respiratory failure (ORadj 6.89), and thrombotic microangiopathy (ORadj 14.05) were associated with higher odds of death. However, HLH itself was not an independent predictor of mortality in AOSD population.

Conclusions
HLH occurred in a small minority of inpatients with AOSD. HLH itself was not an independent risk factor for in-hospital death. Disseminated intravascular coagulation, hepatic failure, infection, respiratory failure, and thrombotic microangiopathy were associated with higher odds of in-hospital death in AOSD. Better awareness of these life-threatening complications may improve hospital outcomes.
Implementation of 300-mL Rule for Management of Traumatic Hemothorax
Authors: Al Tannir Abdul Hafiz , Biesboer Elise A , Tentis Morgan , Seadler Monica , Patin Bryce B , Golestani Simin , Morris Rachel S , Peschman Jacob , Carver Thomas W , de Moya Marc A 
Published: June 2024

BACKGROUND:
Traumatic hemothorax (HTX) is often managed with tube thoracostomy (TT); however, TT carries a high complication rate. In 2017, a guideline was implemented at our Level I trauma center to observe traumatic HTX 300 mL or less in patients who are hemodynamically stable. We hypothesized that this guideline would decrease TT placement without increasing observation failure rates.

STUDY DESIGN:
This was a single-center retrospective review of all adult patients admitted with an HTX on CT before (2015 to 2016) and after (2018 to 2019) the guideline implementation. Exclusion criteria were TT placement before CT scan, absence of CT scan, death within 5 days of admission, and a concurrent pneumothorax more than 20 mm. HTX volume was calculated using CT scan images and Mergo’s formula: V = d
2 × L (where V is the volume, d is the depth, and L is the length). The primary outcome was observation failure, defined as the need for TT, video-assisted thoracoscopic surgery, thoracotomy after repeat imaging or worsening of symptoms, and pulmonary morbidity.

RESULTS:
A total of 357 patients met inclusion criteria, of whom 210 were admitted after guideline implementation. No significant differences in baseline demographics, comorbidities, or injury characteristics across both cohorts were observed. The postimplementation cohort had a significant increase in observation rate (75% vs 59%) and a decrease in TT placement (42% vs 57%). The postimplementation group had a statistically significant shorter hospital (6 vs 8 days) and ICU (2 vs 3 days) length of stay. No significant differences in observation failure, pulmonary complications, 30-day readmission, or 30-day mortality were observed across both cohorts.

CONCLUSIONS:
The implementation of the 300-mL guideline led to a decrease in TT placement without increasing observation failure or complication rates.
A predominately pulmonary activation of complement in a mouse model of severe COVID-19
Authors: Szachowicz Peter J. , Wohlford-Lenane Christine , Heinen Cobey J. , Ghimire Shreya , Xue Biyun , Boly Timothy J. , Verma Abhishek , MašinoviĆ Leila , Bermick Jennifer R. , Perlman Stanley , Meyerholz David K. , Pezzulo Alejandro A. , Zhang Yuzhou , Smith Richard J.H. , McCray Paul B. 
Published: June 2024

AbstractEvidence from in vitro studies and observational human disease data suggest the complement system plays a significant role in SARS-CoV-2 pathogenesis, although how complement dysregulation develops in patients with severe COVID-19 is unknown. Here, using a mouse-adapted SARS-CoV-2 virus (SARS2-N501YMA30) and a mouse model of severe COVID-19, we identify significant serologic and pulmonary complement activation following infection. We observed C3 activation in airway and alveolar epithelia, and in pulmonary vascular endothelia. Our evidence suggests that while the alternative pathway is the primary route of complement activation, components of both the alternative and classical pathways are produced locally by respiratory epithelial cells following infection, and increased in primary cultures of human airway epithelia in response to cytokine exposure. This locally generated complement response appears to precede and subsequently drive lung injury and inflammation. Results from this mouse model recapitulate findings in humans, which suggest sex-specific variance in complement activation, with predilection for increased C3 activity in males, a finding that may correlate with more severe disease. Our findings indicate that complement activation is a defining feature of severe COVID-19 in mice and lay the foundation for further investigation into the role of complement in COVID-19.
Persistent Neurological Deficits in Mouse PASC Reveal Antiviral Drug Limitations
Authors: Verma Abhishek Kumar , Lowery Shea , Lin Li-Chin , Duraisami Eazhisaivallabi , Abrahante Lloréns Juan E. , Qiu Qiang , Hefti Marco , Yu C. Ron , Albers Mark W. , Perlman Stanley 
Published: June 2024

AbstractPost-Acute Sequelae of COVID-19 (PASC) encompasses persistent neurological symptoms, including olfactory and autonomic dysfunction. Here, we report chronic neurological dysfunction in mice infected with a virulent mouse-adapted SARS-CoV-2 that does not infect the brain. Long after recovery from nasal infection, we observed loss of tyrosine hydroxylase (TH) expression in olfactory bulb glomeruli and neurotransmitter levels in the substantia nigra (SN) persisted. Vulnerability of dopaminergic neurons in these brain areas was accompanied by increased levels of proinflammatory cytokines and neurobehavioral changes. RNAseq analysis unveiled persistent microglia activation, as found in human neurodegenerative diseases. Early treatment with antivirals (nirmatrelvir and molnupiravir) reduced virus titers and lung inflammation but failed to prevent neurological abnormalities, as observed in patients. Together these results show that chronic deficiencies in neuronal function in SARS-CoV-2-infected mice are not directly linked to ongoing olfactory epithelium dysfunction. Rather, they bear similarity with neurodegenerative disease, the vulnerability of which is exacerbated by chronic inflammation.
The glycoprotein quality control factor Malectin promotes coronavirus replication and viral protein biogenesis
Authors: Davies Jonathan P. , Plate Lars 
Published: June 2024

AbstractCoronaviruses (CoV) rewire host protein homeostasis (proteostasis) networks through interactions between viral nonstructural proteins (nsps) and host factors to promote infection. With the emergence of SARS-CoV-2, it is imperative to characterize host interactors shared across nsp homologs. Using quantitative proteomics and functional genetic screening, we identify conserved proteostasis interactors of nsp2 and nsp4 that serve pro-viral roles during infection of murine hepatitis virus – a model betacoronavirus. We uncover a glycoprotein quality control factor, Malectin (MLEC), which significantly reduces infectious titers when knocked down. During infection, nsp2 interacts with MLEC-associated proteins and the MLEC-interactome is drastically altered, stabilizing association with the Oligosaccheryltransferase (OST) complex, a crucial component of viral glycoprotein production. MLEC promotes viral protein levels and genome replication through its quality control activity. Lastly, we show MLEC promotes SARS-CoV-2 replication. Our results reveal a role for MLEC in mediating CoV infection and identify a potential target for pan-CoV antivirals.
Delayed cerebrovascular reactivity in individuals with spinal cord injury in the right inferior parietal lobe: a breath-hold functional near-infrared spectroscopy study
Authors: Chen Donna Y. , Di Xin , Karunakaran Keerthana Deepti , Sun Hai , Pal Saikat , Biswal Bharat B. 
Published: June 2024

AbstractCerebrovascular reactivity (CVR) reflects the ability of blood vessels to dilate or constrict in response to a vasoactive stimulus, and allows researchers to assess the brain’s vascular health. Individuals with spinal cord injury (SCI) are at an increased risk for autonomic dysfunction in addition to cognitive impairments, which have been linked to a decline in CVR; however, there is currently a lack of brain-imaging studies that investigate how CVR is altered after SCI. In this study, we used a breath-holding hypercapnic stimulus and functional near-infrared spectroscopy (fNIRS) to investigate CVR alterations in individuals with SCI (n = 20, 14M, 6F, mean age = 46.3 ± 10.2 years) as compared to age– and sex-matched able-bodied (AB) controls (n = 25, 19M, 6F, mean age = 43.2 ± 12.28 years). CVR was evaluated by its amplitude and delay components separately by using principal component analysis and cross-correlation analysis, respectively. We observed significantly delayed CVR in the right inferior parietal lobe in individuals with SCI compared to AB controls (linear mixed-effects model, fixed-effects estimate = 6.565, Satterthwaite’s t-test, t = 2.663, p = 0.008), while the amplitude of CVR was not significantly different. The average CVR delay in the SCI group in the right inferior parietal lobe was 14.21 s (sd: 6.60 s), and for the AB group, the average delay in the right inferior parietal lobe was 7.08 s (sd: 7.39 s). CVR delays were also associated with the duration since injury in individuals with SCI, in which a longer duration since injury was associated with a shortened delay in CVR in the right inferior parietal region (Pearson’s r-correlation, r = –0.59, p = 0.04). This study shows that fNIRS can be used to quantify changes in CVR in individuals with SCI, and may be further used in rehabilitative settings to monitor the cerebrovascular health of individuals with SCI.
Understanding the impact of the COVID-19 pandemic and its control measures on women and children: A Zimbabwe case study
Authors: Taruvinga Tinotenda , Chingono Rudo S. , Olaru Ioana D. , Masiye Kenneth , Madanhire Claudius , Munhenzva Sharon , Sibanda Sibusisiwe , Mafuva Lyton , O’Sullivan Natasha , Osman Abdinasir Y. , Deane Kevin , Brandson Tsitsi , Munyanyi Manes , Makoni Annamercy C. , Ngwenya Solwayo , Webb Karen , Chinyanga Theonevus T. , Ferrand Rashida A. , Dixon Justin , Kranzer Katharina , McCoy David 
Published: June 2024

ABSTRACTCOVID-19 presented countries with unprecedented health policy challenges. For low-income countries in particular, policymakers had to contend with both the direct threats posed by COVID-19 as well as the social, educational, and economic harms associated with lockdown and other infection prevention and control measures. We present a holistic and contextualised case study of the direct and indirect impacts of COVID-19 on women and children, with some assessment of their uneven distribution across socio-economic, age and gender groups. We used different types of primary and secondary data from multiple sources to produce a holistic descriptive analysis. Primary data included: qualitative data obtained from 28 in-depth interviews of key informants, six focus group discussions; and 40 household interviews. We also extracted data from government reports and announcements, the District Health Information Software version 2 (DHIS2), newspaper articles and social media, as well as from published research articles. Our findings show that the direct and indirect adverse impacts of COVID-19 were compounded by many years of severe political economic challenges, and consequent deterioration of the healthcare system. The indirect effects of the pandemic had the most severe impacts on the poorest segment of society and widened age and gender inequalities. The pandemic and its accompanying infection prevention and control measures negatively affected health service delivery and uptake. The management of COVID-19 presented enormous challenges to policymakers and public health specialists. These included managing the greatest tension between direct and indirect harms; short-term and long-term effects; and the unequal distribution of harms across different segments of society.