bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sepsis beyond bundles: contextualising paediatric care in resource-limited settings through situational analysis
Authors: Ratner Leah , Warling Allysa , Owusu Sheila Agyeiwaa , Martyn-Dickens Charles , Nettey Gustav , Otchere Emma , Uluer Ahmet , Cagnina R. Elaine , Appiah John Adabie , Kotoh- Mortty Maame Fremah , Martey Eugene 
Published: February 2025

BackgroundPaediatric sepsis remains a significant contributor to morbidity and mortality, particularly in low- and middle-income countries (LMICs), where healthcare resources are often limited. Paediatric sepsis bundles, which include prompt administration of antibiotics, fluid resuscitation and continuous organ function monitoring, are crucial for improving outcomes, especially when initiated within the first ‘golden hour’ of sepsis recognition. These bundles, adapted from adult sepsis care protocols through the Surviving Sepsis Campaign, are increasingly emphasised in global sepsis management guidelines. However, the implementation of these protocols in LMICs is challenged by resource limitations and systemic barriers.MethodsThis situational analysis, conducted at two hospitals in Ghana—a tertiary facility and a district (secondary) facility—maps the availability of critical resources for paediatric sepsis care through a structured environmental scan using survey methodology. We assess staffing levels, access to medications, airway support and diagnostic capabilities. Methods were conceptualised through inner and outer settings of the Consolidated Framework for Implementation Research (CFIR) and reported through the Donabedian model for healthcare quality.ResultsThis study compared paediatric care at a tertiary hospital (Komfo Anokye Teaching Hosptial (KATH)) and a district hospital (Presbyterian Hospital, Agogo (PreHA)) in Ghana, highlighting KATH’s emergency and intensive care unit (ICU) services, specialised staff and broader respiratory support. PreHA, although without a paediatric-specific ICU, leveraged research funding to enhance clinical care capacity. Both hospitals experienced regular power outages but had reliable generators, and while they offered basic medications and treatments, resource limitations, including out-of-pocket costs for families, impacted access to essential medications and laboratory tests.ConclusionConcerns around resource availability, compounded by structural determinants such as financial barriers and historical underfunding hypothesised to be rooted in colonialism, highlight the need for context-sensitive adaptations of paediatric sepsis bundles. Our findings underscore the importance of a participatory approach to guideline adaptation and resource distribution, incorporating local expertise and addressing structural inequities to improve paediatric sepsis outcomes in Ghana. Future qualitative research will explore pre- and peri-hospital barriers to care and inform more effective, contextually appropriate interventions.
Targeted oxygenation in the respiratory care of premature infants at delivery—effects on outcome: a randomised controlled trial (Torpido 3060) study protocol
Authors: Oei Ju Lee , Travadi Javeed , Kirby Adrienne , Marschner Ian , Yeung Carbo , Cruz Melinda , Wright Ian , Hague Wendy , Davis Peter , Ghadge Alpana , Simes John , Keech Anthony , Lui Kei , Osborn David , Tarnow Mordi William 
Published: February 2025

IntroductionThe safest oxygen levels needed for preterm infant respiratory support at birth are uncertain. We aimed to compare the outcomes of infants up to 286weeks gestation who had respiratory care initiated at birth with fractional inspired oxygen (FiO2) 0.3 or 0.6, which was adjusted to meet specific oxygen saturations (SpO2).MethodsThis randomised controlled phase III trial was stratified by (1) site, (2) gestation and (3) multiplicity. Infants between 23+0 to 28+6 weeks gestation were randomised to initial respiratory support with FiO20.3 or 0.6, adjusted to meet common SpO2targets for the first 10 min.Primary outcomeSurvival to 36 weeks gestation without documented brain injury.AssessmentsFiO2, SpO2and heart rate were recorded each minute from delivery for 10 min. Assessments were obtained at baseline, 36 weeks, discharge and at 2 years corrected gestation, along with a parent questionnaire.Statistical analysis planAssuming 32% of infants would die or survive with brain injury by 36 weeks, 735 infants per arm (1470 total) were needed to detect a risk difference of 8% (25% relative risk reduction), with 10% non-adherence to protocol, 85% β and 5% α.EthicsApproved by the John Hunter Human Research Ethics Committee (2019/ETH/3837) for waiver of consent for all Australian sites for randomised allocation and primary outcome.ConclusionRecruitment started in 2018 and was achieved on 30 September 2024. The Data and Safety Committee review found no major safety concerns at 50% recruitment.Trial registration numberACTRN 12618000879268.
Acetyltransferase NAT10 inhibits T-cell immunity and promotes nasopharyngeal carcinoma progression through DDX5/HMGB1 axis
Authors: Xie Haijing , Zhang Kaiwen , Yin Haimeng , Zhang Siyu , Pan Si , Wu Rui , Han Yumo , Xu Yi , Jiang Weihong , You Bo 
Published: February 2025

BackgroundImmunosuppression significantly contributes to treatment failure in nasopharyngeal carcinoma (NPC). Messenger RNA (mRNA) modifications such as methylation and acetylation play crucial roles in immunosuppression. However, N4-acetylcytidine (ac4C), the only acetylation modification event has rarely been studied in NPC.MethodsFirst, clinical tissue samples and nude mouse models were used to explore the expression of N-acetyltransferase 10 (NAT10) in NPC and its influence on it. Second, The Cancer Genome Atlas immune database and transgenic mouse peripheral blood immune cell panel were used to verify the immune cells mainly affected by NAT10. Then, NAT10 ac4C acetylation modification and expression of significantly upregulated transcription factors were explored by acetylated RNA immunoprecipitation sequence binding to RNA sequencing. Then, the downstream regulatory genes of CCAAT enhancer binding protein γ (CEBPG), dead box helicase 5 (DDX5) and helicase-like transcription factors (HLTF) were analyzed by luciferase report and chromatin Immunoprecipitation. Finally, the effect of inhibition of NAT10 on anti-programmed cell death protein 1 (PD-1) treatment sensitivity was verified by animal models.ResultsIn this study, we aimed to explore the role of NAT10, the enzyme responsible for ac4C modification, in NPC progression and patient prognosis. Elevated NAT10 promoted NPC progression and correlated with poor prognosis in patients with NPC. NAT10-mediated ac4C modification ofCEBPG,DDX5, andHLTFmRNA improved their stability and translation efficiency, with the NAT10/ac4C/DDX5 axis upregulating high mobility group box 1 (HMGB1) and inhibiting CD4+ and CD8+ T cells. Inhibition of NAT10 increased the sensitivity to PD-1 therapy. Additionally, HLTF was found to transcriptionally regulate NAT10, indicating the formation of an HLTF-NAT10 positive feedback loop.ConclusionsOur study elucidates the mechanism by which theNAT10/DDX5/HMGB1axis promotes the immunosuppression of NPC by promoting T-cell dysfunction. In addition, NAT10 knockdown can enhance anti-PD-1 treatment sensitivity as a combination therapy for NPC.
Parental knowledge, attitudes, satisfaction and decisional conflict regarding whole genome sequencing in the Genomic Medicine Service: a multisite survey study in England
Authors: Patel Ria , Friedrich Bettina , Sanderson Saskia C , Ellard Holly , Lewis Celine 
Published: February 2025

BackgroundWhole genome sequencing (WGS) for paediatric rare disease diagnosis is now available as a first-line test for certain clinical indications in the Genomic Medicine Service in England. The aim of this study was to assess decisional conflict regarding WGS at the time of consent as well as parental knowledge, attitudes and satisfaction.MethodsWe conducted a multisite quantitative survey including validated measures. Surveys were sent out across seven National Health Service Trusts in England to parents of children offered WGS, within 4 weeks of their appointment.Results374/1366 survey responses were included in the final dataset. Parents were highly satisfied with their WGS appointment (mean=24.47/28), had low decisional conflict (mean=20.09/100) and felt they had received enough information and support to make an informed decision (83.9%). Parents had positive attitudes towards WGS (mean=18.17/20), and those who had discussed WGS with a genetic counsellor or genomic associate had significantly more positive attitudes than those seen by genetic consultants (p<0.001). Most parents (84.3%) strongly agreed (27.2%) or agreed (67.1%) that they had a clear understanding of what a genomic test is. Parents whose child’s condition was reported as more serious (p=0.0011) felt less conflicted about their decision.ConclusionsThe parents in this study had low decisional conflict and most felt they had made an informed decision. Further research after parents receive WGS results to assess whether any, and if so who, regrets their decision, is important.
Effect of vitamin A on adult lung function: a triangulation of evidence approach
Authors: Mongey Róisín , van der Plaat Diana A , Shaheen Seif O , Portas Laura , Potts James , Hind Matthew David , Minelli Cosetta 
Published: February 2025

BackgroundVitamin A, an essential micronutrient obtained through the diet, plays a crucial role in lung development and contributes to lung regeneration. We aimed to investigate its effect on adult lung function using triangulation of evidence from both observational and genetic data.MethodsUsing data on 150 000 individuals from UK Biobank and correcting for measurement error (generalised structural equation modelling), we first investigated the association of dietary vitamin A intake (total vitamin A, carotene and retinol) with lung function (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1)/FVC)). We then assessed the causality of these associations using Mendelian randomisation (MR), and we investigated the effects on adult lung function of 39 genes related to vitamin A, and their interaction with vitamin A intake.FindingsOur observational analysis suggests a positive association between carotene intake and FVC only (13.3 mL per 100 µg/day; p=2.9×10−9), with stronger associations in smokers, but no association of retinol intake with FVC or FEV1/FVC. The MR similarly shows a beneficial effect of serum beta-carotene on FVC only, with no effect of serum retinol on FVC nor FEV1/FVC. Nine of the vitamin A-related genes were associated with adult lung function, six of which have not been previously identified in genome-wide studies and three (NCOA2, RDH10, RXRB) in any type of genetic study of lung function. Five genes showed possible gene-vitamin A intake interactions.InterpretationOur triangulation study provides convincing evidence for a causal effect of vitamin A, carotene in particular, on adult lung function, suggesting a beneficial effect of a carotene-rich diet on adult lung health.
Control and sorting of inhomogeneous dielectric core–shell nanoparticles using two counter-propagating plane waves
Authors: Abraham-Ekeroth Ricardo Martín , Lester Marcelo , Torrent Dani 
Published: February 2025

Abstract
Many typical nanoscale structures consist of dielectric nanoparticles with an inevitable oxide-generated coating around them. Depending on the fabrication techniques and the intended purposes, these coatings may not be homogeneous, and their distortion can cause advantages or disadvantages in the applications of such systems. Based on finite element simulations, inhomogeneous core–shell nanoparticle systems are numerically studied when illuminated with two counter-propagating plane waves in the optical range. It is found that the electromagnetic field distortions caused by the inhomogeneous system under Mie resonance conditions allow the system to exhibit controllable one-directional impulsion and rotation, which mainly depends on the offset between the core and shell. The overall geometry and composition of the system also dictate the type of resonance being excited. Overall, this “photonic thruster” effect consisting of an accelerating and spinning projectile would provide stability to particle movement and additionally establish a method to distinguish inhomogeneous from homogeneous particles. The method can be scaled to a wide range of nanoscale dielectric particles. Thus, the results are useful for detecting defects in nanosystems with a simple concept and may open avenues for improving nanoparticle synthesis methods.
Exploring nonlinear optical properties of single δ-doped quantum wells: influences of position-dependent mass, temperature, and hydrostatic pressure
Authors: Sayrac M. , Acıkgoz L. , Tuzemen A. T. , Mora-Ramos M. E. , Ungan F. 
Published: February 2025

Abstract
This study investigates the multifaceted impact of position-dependent effective mass, temperature, and hydrostatic pressure on the electronic and optical properties of single-doped quantum wells, with a particular emphasis on varying doping levels. Utilizing effective mass and parabolic band approximations, calculations were meticulously conducted via the diagonalization method, employing a trigonometric orthonormal function basis to elucidate the eigenvalues and eigenfunctions of the confined electron potential. The obtained results unveil substantial alterations in electron energies, state transitions, and absorption spectra consequent to fluctuations in doping levels, temperature, and pressure. These findings provide profound insights into the intricate interplay between semiconductor characteristics and external stimuli, laying a foundation for the optimization of laser and optoelectronic devices through the tailored engineering of material properties. This comprehensive understanding not only advances fundamental knowledge in semiconductor physics but also paves the way for the development of innovative materials with customized optical functionalities, thus driving progress in a wide array of technological applications.
A Flexible and Holistic Multi-Agent Framework for Local Energy Aggregation Approaches
Authors: Bettermann Michael , De Meer Hermann 
Published: February 2025

A growing number of communities have expressed a desire for self-sufficiency and the reduction of carbon emissions. These are two of the reasons why the interest of self-governed local energy community approaches has caught the attention of many. In [2], the notion of locality is kept rather vague. However, often the range of a low- or medium-voltage grid level is chosen for, e.g., local energy market designs [1], which coincides with the locality definition in this paper. A key difference between these concepts lies in the coordination approach. For instance, local energy markets focus on utilising market mechanisms, while other aggregation concepts, such as energy cells, rely on more technical approaches and may directly control assets to optimise energy consumption. This paper refers to these methodologies as local aggregation approaches. The goal of this paper is to provide a holistic and flexible model of local aggregation approaches, which provides structure during the design phase, but leaves enough flexibility to allow for adjustments, according to the local communities' needs and capabilities. Throughout this paper, a
holistic
model refers to a model, which operates in its whole local spectrum (e.g., a low-voltage grid), summarising all major entities and their concerns. The contributions of this paper are:

(1) An approach for the development of a holistic model of local aggregation approaches, allowing a coherent realisation of variations, such as virtual power plants or energy islands
(2) A holistic model which allows the integration of:
(a) Infrastructure provider signalling for intelligent grid operation, such as flexible grid tariffs
(b) Communication with external entities, such as the wholesale market
(c) Coordination algorithms adjusted to the local environment
(d) Strategies for preference maximisation on the consumer level
A Prototype for Integral Elimination
Authors: Lemaire François , Roussel Louis 
Published: February 2025

We present in this extended abstract some ongoing work which has been presented in [13]. This extended abstract contains no new results w.r.t. [13], and is intended to present our prototype integral_elimination for performing Integral Elimination. This prototype is a first step to the generalization of the differential elimination algorithms for the integral case, where the differentiation is replaced by an integration operator.
Our approach is incomplete and still needs an important theoretical development. However it is already sufficient to handle nontrivial examples The originality of our approach consists in using new types of reductions and introducing exponential terms during the computations. Our prototype has been implemented in Python using SymPy.
We briefly motivate the context, and present some examples treated by our prototype.
Sparse Hensel Lifting Algorithms for Multivariate Polynomial Factorization
Authors: Chen Tian 
Published: February 2025

Each quarter we are pleased to present abstracts of recent doctoral dissertations in Computer Algebra and Symbolic Computation. We encourage all recent Ph.D. graduates who have defended in the past two years (and their supervisors), to submit their abstracts for publication in CCA.
Please send abstracts to the CCA editors <editors SIGSAM@acm.org> for consideration.
Ivabradine for Incessant Atrial Tachycardia in a 1‐Year‐Old Child After Tetralogy of Fallot Repair
Authors: Balweel Haikal , Sukardi Rubiana , Marwali Eva Miranda , Eri Rifqi Rizkani , Tafriend Novaro Adeneur , Harsoyo Agus 
Published: February 2025

Background: Ivabradine is a novel drug with the ability to reduce heart rate without compromising myocardial contractility or blood pressure. Studies on this drug exist mainly for heart failure and coronary artery disease; for arrhythmia, the studies are limited to small sample trials and case series, mostly unrandomized. Additionally, its evidence for arrhythmia in pediatric patients is limited. Here, we present a case of successful ivabradine administration for incessant atrial tachycardia in a 1‐year‐old child following tetralogy of Fallot (TOF) repair.Case: A 1‐year‐old child experienced incessant tachyarrhythmia episodes after TOF repair. Multiple standard therapies, including adenosine, amiodarone, multiple cardioversions, beta‐blockers, and digoxin, failed to convert the rhythm. Considering the limited therapy options and existing case reports, ivabradine was administered at a dose of 0.1 mg/kg. Subsequently, sinus rhythm was restored 8 h after its administration, with the heart rate significantly decreased, and the patient returned to a stable hemodynamic status.Discussion: Ivabradine may be an option for incessant atrial tachycardia in pediatric patients. Although most tachyarrhythmias following TOF repair occur due to a reentry mechanism, focal mechanisms can also occur, suggested by timing, gradual acceleration after cardioversion and its response to ivabradine. Future studies are needed to further understand the safety and efficacy of ivabradine for atrial tachycardia in pediatric patients.
Cyclosporin‐Induced Gingival Enlargement in a Periodontitis Patient With Pemphigus Vulgaris: A Case Report
Authors: Chong Wee-Jian , Ibrahim Norliwati , Mohd-Said Shahida 
Published: February 2025

Background: Pemphigus vulgaris (PV) is a chronic autoimmune disorder affecting mucous membranes and skin, with potential life‐threatening risks. It is typically characterized by blisters within the oral cavity with or without subsequent skin involvement. Given the importance of timely intervention, dental professionals are responsible for diagnosing this condition, as prompt detection and intervention greatly influence the disease progression and prognosis.Case Description: A 44‐year‐old male patient presented with swollen and bleeding gums, accompanied by multiple chronic ulcers in the oral cavity. He was initially diagnosed with PV in 2018; his case posed significant challenges, including drug‐influenced gingival enlargement and the psychological burden of managing a chronic, relapsing condition.Management and Prognosis: The patient received treatment with an immunosuppressive medication (cyclosporin) along with long‐term systemic steroids (prednisolone). In November 2022, cyclosporin was replaced with a steroid‐sparing medication (methotrexate) to control drug‐influenced gingival enlargement. The periodontal condition improved after 3 months of changing the medication regimen, nonsurgical periodontal therapy, and reinforced oral hygiene practices. The patient undergoes regular medical evaluations every 6 months with the dermatology department.Clinical Implications: Effective management of PV necessitates long‐term systemic steroid therapy, often supplemented with immunosuppressive agents, to control the disease and minimize relapse risks. Regular clinical assessments are essential for patients receiving steroid and immunosuppressive treatment to monitor potential side effects, including cyclosporin‐induced gingival enlargement. If gingival enlargement is compounded by periodontal disease, it can further complicate the management of PV. Drug‐induced gingival enlargement has a favorable prognosis and is reversible upon discontinuation or substitution of the causative medication. An interdisciplinary approach involving primary clinicians, dentists, and the healthcare team is crucial to addressing the patient’s signs and symptoms effectively.
Oral Metastasis From Colorectal Adenocarcinoma: Report of a New Case and a Scoping Review
Authors: Gioco Gioele , Patini Romeo , Marchesini Denise , Rupe Cosimo , Staderini Edoardo , Lucchese Alberta , De Corso Eugenio , Lajolo Carlo 
Published: February 2025

Objectives: This study is aimed at describing an unusual case of oral metastasis from colorectal adenocarcinoma and at performing a scoping review analyzing the available literature on such cases.Materials and Methods: We present a rare case of oral metastasis from colorectal adenocarcinoma in a 37‐year‐old Italian woman. Clinical oral examination showed the presence of a swollen lesion in the vestibular gingiva of the right mandibular region, associated with Grade III mobility of the second premolar. Radiographic examination revealed a radiolucency apical to the first molar and second premolar associated with the rhizolysis of these teeth. Furthermore, we conducted a scoping literature review of the PubMed, Web of Science, and Scopus databases in line with the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses extension for scoping reviews (PRISMA‐ScR) guidelines.Results: The second premolar was extracted, and an incisional biopsy of the osteolytic lesion was performed for histological and immunohistochemical examination, which revealed an adenocarcinoma fragment with mucinous characteristics and a morphology and immunophenotype compatible with caudal‐related homeobox transcription factor 2 (CDX2) and cytokeratin (CK) 20. In conclusion, the lesion was indicative of oral metastasis from colorectal adenocarcinoma. Furthermore, the review of the existing literature in the English language yielded 112 cases of oral metastases from colorectal adenocarcinoma, which were included in our analysis.Conclusions: Although oral metastasis from colorectal adenocarcinoma has been reported previously, it is a rare manifestation.Clinical Relevance: Because of the rarity of oral metastasis and possible variations in the clinical and histological presentations, correct diagnosis can be challenging and requires careful clinical and histopathological evaluations with adjuvant immunohistochemical studies.