bluuebunny/crossref_metadata_2025_split huggingface dataset:
Thermal, water, and land cover factors led to contrasting urban and rural vegetation resilience to extreme hot months
Authors: Wang Yaoping , Mao Jiafu , Brelsford Christa M , Ricciuto Daniel M , Yuan Fengming , Shi Xiaoying , Rastogi Deeksha , Mayes Melanie M , Kao Shih-Chieh , Warren Jeffrey M , Griffiths Natalie A , Cheng Xinghua , Weston David J , Zhou Yuyu , Gu Lianhong , Thornton Peter E 
Published: April 2024

Abstract
With continuing global warming and urbanization, it is increasingly important to understand the resilience of urban vegetation to extreme high temperatures, but few studies have examined urban vegetation at large scale or both concurrent and delayed responses. In this study, we performed an urban–rural comparison using the Enhanced Vegetation Index and months that exceed the historical 90th percentile in mean temperature (referred to as “hot months”) across 85 major cities in the contiguous United States. We found that hot months initially enhanced vegetation greenness but could cause a decline afterwards, especially for persistent (≥4 months) and intense (≥+2 °C) episodes in summer. The urban responses were more positive than rural in the western United States or in winter, but more negative during spring–autumn in the eastern United States. The east–west difference can be attributed to the higher optimal growth temperatures and lower water stress levels of the western urban vegetation than the rural. The urban responses also had smaller magnitudes than the rural responses, especially in deciduous forest biomes, and least in evergreen forest biomes. Within each biome, analysis at 1 km pixel level showed that impervious fraction and vegetation cover, local urban heat island intensity, and water stress were the key drivers of urban–rural differences. These findings advance our understanding of how prolonged exposure to warm extremes, particularly within urban environments, affects vegetation greenness and vitality. Urban planners and ecosystem managers should prioritize the long and intense events and the key drivers in fostering urban vegetation resilience to heat waves.
Different responses of oxygen and hydrogen isotopes in leaf and tree-ring organic matter to lethal soil drought
Authors: Lehmann Marco M , Diao Haoyu , Ouyang Shengnan , Gessler Arthur 
Published: April 2024

Abstract
The oxygen and hydrogen isotopic composition (δ18O, δ2H) of plant tissues are key tools for the reconstruction of hydrological and plant physiological processes and may therefore be used to disentangle the reasons for tree mortality. However, how both elements respond to soil drought conditions before death has rarely been investigated. To test this, we performed a greenhouse study and determined predisposing fertilization and lethal soil drought effects on δ18O and δ2H values of organic matter in leaves and tree rings of living and dead saplings of five European tree species. For mechanistic insights, we additionally measured isotopic (i.e. δ18O and δ2H values of leaf and twig water), physiological (i.e. leaf water potential and gas-exchange) and metabolic traits (i.e. leaf and stem non-structural carbohydrate concentration, carbon-to-nitrogen ratios). Across all species, lethal soil drought generally caused a homogenous 2H-enrichment in leaf and tree-ring organic matter, but a low and heterogenous δ18O response in the same tissues. Unlike δ18O values, δ2H values of tree-ring organic matter were correlated with those of leaf and twig water and with plant physiological traits across treatments and species. The 2H-enrichment in plant organic matter also went along with a decrease in stem starch concentrations under soil drought compared with well-watered conditions. In contrast, the predisposing fertilization had generally no significant effect on any tested isotopic, physiological and metabolic traits. We propose that the 2H-enrichment in the dead trees is related to (i) the plant water isotopic composition, (ii) metabolic processes shaping leaf non-structural carbohydrates, (iii) the use of carbon reserves for growth and (iv) species-specific physiological adjustments. The homogenous stress imprint on δ2H but not on δ18O suggests that the former could be used as a proxy to reconstruct soil droughts and underlying processes of tree mortality.
Age-dependent Sagittal Plane Remodeling of Pediatric Supracondylar Fractures
Authors: Kim Yun Ki , Lee Seung Hoo 
Published: April 2024

Background:
Current treatment guidelines for pediatric supracondylar fractures have not fully accounted for age-related variations in the remodeling potential. This study aimed to explore age-dependent sagittal plane remodeling in supracondylar fractures by assessing cases with residual deformities after treatment.

Methods:
This study included 62 patients under 16 years of age treated for supracondylar fractures at our institution from 2002 to 2022. The distance between the posterior and anterior aspects of the capitellar ossific nucleus (CON) was defined as the CON size, while the distance from the anterior humeral line to the posterior aspect of CON was termed DAP-CON. The value obtained by subtracting the DAP-CON on the unfractured side from the DAP-CON on the fractured side was divided by the CON size and multiplied by 100 and termed the displacement of CON (d-CON). The absolute value of the difference between d-CON after intervention and d-CON at the last follow-up was denoted as sagittal plane remodeling.

Results:
For this patient cohort, the mean age was 5.5 years (range, 1.4 to 14.6 years), and the mean follow-up period was 30.4 months (range, 12.0 to 137.1 months). Sagittal plane remodeling was more pronounced in children younger than 5 years (group I) compared with those older (group II) (P<0.001). In multiple regression analysis, only age at the time of injury was found to be a significant variable (P<0.001). The receiver operating characteristic curve analysis identified 4.2 years as the cutoff age for predicting >33% sagittal plane remodeling, with an area under the curve of 0.975.

Conclusions:
Children below the age of 5 years exhibit sagittal plane remodeling, with a cutoff age identified at 4.2 years for achieving >33% of d-CON. This indicates that mild deformities (16.5%<d-CON ≤ 33%) can be expected to be fully remodeled before the age of 4.2 years, suggesting that the patient’s age needs to be considered in the treatment guidelines.

Level of Evidence:
Level IV—retrospective study.
Impact and Feasibility of Mechanical Ventilation at a Surgical Center in Sierra Leone: Experience From EMERGENCY’s Hospital in Goderich*
Authors: Spagnolello Ornella , Cole Richmond Dixon , Unisa Jalloh , Vandi Hawa , Macarthy Marian , Gatti Sofia , Cormio Manuela , Portella Gina , Baiardo Redaelli Martina 
Published: April 2024

OBJECTIVES:
Despite the large burden of critically ill patients in developing countries, mechanical ventilation (MV) is scarce in these low-resource settings. In the absence of data, issues like costs and lack of training are often felt to outweigh the benefits of potential MV implementation in such places. We aimed to investigate the impact and feasibility of MV in a surgical ICU in West Africa.

DESIGN:
This is a 7-month retrospective observational study (from October 25, 2022, to May 25, 2023), covering all patients consecutively admitted to ICU.

SETTING:
The NGO EMERGENCY’s hospital in Goderich, Freetown, Sierra Leone. The hospital is a referral center for acute care surgery.

PATIENTS:
Critical patients admitted to the hospital’s ICU.

INTERVENTIONS:
Following brief, practical training of the nursing staff, one basic mechanical ventilator was installed at the hospital’s ICU, under the supervision of two intensivists. Only patients with a body weight of over 15 kg and who met the “extreme criteria” for MV received this life-saving therapy.

MEASUREMENTS AND MAIN RESULTS:
Of the 195 files of patients admitted to ICU during the study period, 162 were analyzed. The median age was 16 (interquartile range 7–27) and 48.1% of the population were under 14 years. The most common cause of admission was trauma (58.6%), followed by acute abdomen (33.3%), caustic soda ingestion (6.2%), and burns (1.9%). Of the overall population, 26 patients (16%) underwent MV (88.5% trauma cases vs. 11.5% acute abdomen). Median time on MV was 24 hours (12–64). The mortality rate in the MV group was 30.8% (8/26), while in the overall study population, it was 11.7% (19/162). One potentially life-threatening event of tube obstruction was handled appropriately.

CONCLUSIONS:
This study strongly supports the implementation of MV in low-resource settings. In our experience, the consistent benefit of reduced mortality among critical patients largely outweighs the associated challenges.
Increased vascular stiffness in children exposed in utero but not children exposed postnatally to emissions from a coal mine fire
Authors: Hemstock Emily J. , Bigaran Ashley , Allgood Shantelle , Wheeler Amanda J. , Dalton Marita , Williamson Grant J. , Gao Caroline X. , Abramson Michael J. , Negishi Kazuaki , Johnston Fay H. , Zosky Graeme R. 
Published: April 2024

Background:
Chronic, low-intensity air pollution exposure has been consistently associated with increased atherosclerosis in adults. However, there was limited research regarding the implications of acute, high-intensity air pollution exposure during childhood. We aimed to determine whether there were any associations between early-life exposure to such an episode and early-life vascular function changes.

Methods:
We conducted a prospective cohort study of children (<9 years old) who lived in the vicinity of the Hazelwood coal mine fire (n = 206). Vascular function was measured using noninvasive diagnostic methods including carotid intima-media thickness and pulse wave velocity (PWV). Exposure estimates were calculated from prognostic models and location diaries during the exposure period completed by each participant’s parent. Linear mixed-effects models were used to determine whether there were any associations between exposure and changes in vascular outcomes at the 3- and 7-year follow-ups and over time.

Results:
At the 7-year follow-up, each 10 μg/m3 increase in daily PM2.5 in utero was associated with increased PWV (β = 0.13 m/s; 95% confidence interval [CI] = 0.02, 0.24; P = 0.02). The association between in utero exposure to daily PM2.5 was not altered by adjustment for covariates, body mass index, and maternal fire stress. Each 1 µg/m3 increase in background PM2.5 was associated with increased PWV (β = 0.68 m/s; 95% CI = 0.10, 1.26; P = 0.025), in children from the in utero exposure group. There was a trend toward smaller PWV (β = −0.17 m/s; 95% CI = −0.366, 0.02) from the 3- to 7-year follow-up clinic suggesting that the deficits observed previously in children exposed postnatally did not persist.

Conclusion:
There was a moderate improvement in vascular stiffness of children exposed to PM2.5 from a local coal mine fire in infancy. There was a mild increase in vascular stiffness in children exposed to PM2.5 from a local coal mine fire while their mothers were pregnant.
Diagnosis and Treatment of Perioperative Allergic Complications: A Practical Review
Authors: Schroeder Michael J. , Kraft Casey T. , Janis Jeffrey E. , Kraft Monica T. 
Published: April 2024

Background:
Reported drug allergies are commonly encountered by surgeons and can lead to uncertainty in selecting an appropriate agent due to concerns of associated risks with related and cross-reactive drugs. This uncertainty can ultimately lead to increased infection rates.

Methods:
A literature review was conducted in PubMed using a combination of the terms “allergy,” “allergic reaction,” “anaphylaxis,” and “surgery,” “surgical,” or “operating room” for articles published within the last 10 years. Publications identified with these search terms were then filtered for review articles, sorted by “best match,” and a maximum of 100 articles were manually reviewed for each combination of search terms.

Results:
Search results yielded 46,484 articles, 676 of which were ultimately included for manual review, based on selection criteria. Specifically, articles selected for inclusion focused on surgical allergic reactions that were either related to mechanism of action, causative agent for the allergic reaction, timing of allergic reaction, or recommendations for appropriate management.

Conclusions:
Allergic reactions can be a common occurrence in the operative room. Knowledge of likely causative agents, timing of a reaction to various agents, and appropriate management in the immediate and delayed setting can improve outcomes and safety for plastic surgery patients.
Reconstruction after Resection of Undifferentiated Pleomorphic Sarcoma and Invasive Ductal Carcinoma in a Patient with Li-Fraumeni Syndrome
Authors: Lue Melinda , Harrah Payden , Shrestha Sabi , Wang Howard T. 
Published: April 2024

Summary:
This case exhibits a presentation of multiple primary malignancies in a patient with Li-Fraumeni syndrome, necessitating surgical excision and multistaged reconstruction. Due to Li-Fraumeni syndrome patients’ predisposition to developing malignancies, management includes lifelong surveillance and aggressive treatment of cancers. Plastic surgeons can minimize damage to patient’s quality of life by carrying out reconstruction in a thoughtful manner that maximizes function and considers a potential lifetime of future reconstructive needs.
Superficial Intramuscular Gluteal Lipograft by Doppler Ultrasound: A Report of 24 Patients
Authors: Roblero Rivera Carlos Alexander , Manzaneda Cipriani Raul , Flores Gonzáles Emmanuel Armando , Scheneider Salomone Viaro Mauricio 
Published: April 2024

Background:
Gluteal fat grafting is a common procedure in liposculpture. This study proposes a Doppler ultrasound–guided intramuscular and subcutaneous gluteal lipotransfer technique that allows for visualization of the location of the gluteal vessels, avoiding approaching them during lipotransfer by having the cannula localized during fat infiltration.

Methods:
This new technique was applied to 24 women after obtaining informed consent and providing them with a clear explanation of potential risks and complications. Doppler ultrasound was used to locate the site and depth of blood vessels, and for quadrant scanning of vessels and superficial intramuscular visualization of the cannula’s location. Intramuscular lipotransfer was performed with a volume of 400 mL per gluteus (or less), and 12 patients underwent magnetic resonance imaging before and 3 months after surgery.

Results:
This technique allowed for visualizing the location of the gluteal vessels, and infiltration could be easily performed in patients. In the 24 glutei reviewed postsurgery, from 12 patients who underwent pre- and postsurgery magnetic resonance imaging, intramuscular fat was found; however, there was no migration outside the gluteus maximus muscle.

Conclusions:
No local or systemic complications were observed. The results of our report show that fat filtration did not migrate outside the gluteus maximus muscle. This finding seeks to promote new research to create theoretical/practical precedents for the intervention of plastic surgeons and, from there, promote the standardization of a new and safe technique.
Diagnostic Accuracy of Blind Bronchial Sample Testing by BioFire Pneumonia plus Panel in Pediatric Intensive Care Unit Patients and Its Impact in Early Adaptation of Antimicrobial Therapy: A Prospective Observational Study
Authors: Geslain Guillaume , Cointe Aurélie , Naudin Jérôme , Dauger Stéphane , Poey Nora , Pages Justine , Le Roux Enora , Bonacorsi Stéphane 
Published: April 2024

Background:
Community-acquired and nosocomial lower-respiratory-tract infections in critically ill pediatric patients require early appropriate antibiotic therapy to optimize outcomes. Using blind bronchial samples, we assessed the diagnostic performance of the rapid-multiplex polymerase chain reaction (PCR) assay BioFire Pneumonia plus Panel vs. reference standard culturing with antimicrobial susceptibility testing.

Methods:
For this prospective observational study in a single pediatric intensive care unit, we included consecutive patients younger than 18 years admitted for suspected community-, hospital- or ventilator-associated pneumonia in 2021–2022. Sensitivity, specificity, positive predictive value and negative predictive value of the multiplex PCR assay were determined. The kappa coefficient was computed to assess agreement, and univariate analyses were done to identify factors associated with discrepancies between the 2 diagnostic methods.

Results:
Of the 36 included patients (median age, 1.4 years; interquartile range, 0.2–9.2), 41.7%, 27.8%, and 30.5% had community-, hospital- and ventilator-associated pneumonia, respectively. The overall κ was 0.74, indicating good agreement. Overall, the sensitivity of the multiplex PCR assay was 92% (95% CI: 77%–98%) and specificity 95% (95% CI: 92%–97%), with variations across microorganisms. The median time from sample collection to antimicrobial susceptibility test results was 3.9 (2.5–15) hours with the multiplex PCR assay and 60.5 (47.6–72.2) hours with the reference technique.

Conclusion:
The BioFire Pneumonia plus Panel used to test blind bronchial samples had satisfactory diagnostic performance in critically ill pediatric patients. The rapid results provided by this test may improve the appropriateness of antimicrobial therapy and help minimize the use of antibiotics.
Hepatitis C Exposure Diagnosis and Testing in Infants Born to Hepatitis C Virus-infected Mothers
Authors: Morris Natalie , Hunter Krystal , Bhat Vishwanath , Kushnir Alla 
Published: April 2024

Background:
There has been a 5-fold increase in the number of cases of hepatitis C virus (HCV) infection among pregnant women, which is potentially associated with the increase in opioid use.

Methods:
This study was a retrospective review of infants born at a tertiary urban hospital in New Jersey, from January 1, 2011 to January 1, 2021, who were born to mothers with a prenatal diagnosis of HCV.

Results:
Of the 142 mothers with a prenatal diagnosis of HCV, 114 (80%) infants had a diagnosis of HCV exposure in the electronic health records. Of the HCV-exposed infants with follow-up data at 24 months of age, 52 (46%) were tested, with 34 of 52 (65%) receiving adequate testing. Infants documented as HCV exposed were more likely to be born to a mother with nonopioid drug use in pregnancy (P = 0.01) and have a higher birth weight (P = 0.03). Of tested infants, those with a higher number of well-child pediatrician visits (P = 0.01) were more likely to receive adequate testing. Trends showed more polymerase chain reaction testing than antibody testing for those who were inadequately tested.

Conclusions:
A significant proportion of infants born to HCV-infected mothers were either not identified at birth (20%) or did not receive adequate testing on follow-up (35%). Further work needs to be done to improve documentation of HCV exposure at birth and follow-up testing to avoid missing congenitally acquired HCV.
Changing Landscape of Antimicrobial Resistance in Neonatal Sepsis: An in silico Analyses of Multidrug Resistance in Klebsiella pneumoniae
Authors: Vijayakumar Santhiya , Kumar Hithesh , Basu Soumya , Chandy Sara , Anbarasu Anand , Manoharan Anand , Ramaiah Sudha 
Published: April 2024

Background:
Neonatal sepsis poses a critical healthcare concern, as multidrug-resistant Klebsiella pneumoniae (K. pneumoniae) infections are on the rise. Understanding the antimicrobial susceptibility patterns and underlying resistance mechanism is crucial for effective treatment.

Objectives:
This study aimed to comprehensively investigate the antimicrobial susceptibility patterns of K. pneumoniae strains responsible for neonatal sepsis using in silico tools. We sought to identify trends and explore reasons for varying resistance levels, particularly for β-lactams and fluoroquinolone.

Methods:

K. pneumoniae isolated from neonates at Kanchi Kamakoti CHILDS Trust Hospital (2017–2020) were analyzed for antimicrobial resistance. Elevated resistance to β-lactam and fluoroquinolone antibiotics was further investigated through molecular docking and interaction analysis. β-lactam affinity with penicillin-binding proteins and β-lactamases was examined. Mutations in ParC and GyrA responsible for quinolone resistance were introduced to investigate ciprofloxacin interactions.

Results:
Of 111 K. pneumoniae blood sepsis isolates in neonates, high resistance was detected to β-lactams such as cefixime (85.91%, n = 71), ceftriaxone (84.9%, n = 106), cefotaxime (84.9%, n = 82) and fluoroquinolone (ciprofloxacin- 79.44%, n = 107). Molecular docking revealed low β-lactam binding toward penicillin-binding proteins and higher affinities for β-lactamases, attributing to the reduced β-lactam efficiency. Additionally, ciprofloxacin showed decreased affinity toward mutant ParC and GyrA in comparison to their corresponding wild-type proteins.

Conclusion:
Our study elucidates altered resistance profiles in neonatal sepsis caused by K. pneumoniae, highlighting mechanisms of β-lactam and fluoroquinolone resistance. It underscores the urgent need for the development of sustainable therapeutic alternatives to address the rising antimicrobial resistance in neonatal sepsis.
Epidemiology of Adenovirus Infection in Hospitalized Children in the United States From 1997 to 2019
Authors: Totapally Balagangadhar R. , Totapalli Seevitha , Sendi Prithvi , Martinez Paul A. 
Published: April 2024

Objective:
The study aimed to explore the prevalence, clinical features, resource utilization, temporal trends and outcomes associated with adenoviral infections in hospitalized children.

Methods:
A retrospective analysis using the Healthcare Cost and Utilization Project’s Kids’ Inpatient Database from 1997 to 2019 was performed. Children 29 days to 17 years of age with adenoviral infection were selected. Chi-square, Kruskal-Wallis tests, linear trend analysis and multivariable analysis were used for data analysis.

Results:
A total of 40,135 children under 18 years of age with adenoviral infection were discharged in the United States with an overall prevalence of 18.9 per 10,000 discharges and 6.9 children per 100,000 population. By linear trend analysis, the hospitalization rate has significantly increased with the highest prevalence in 2019. Adenoviral infection was more prevalent in Black children, in winter months, in the Midwest region, in children with government insurance and in the lowest income quartile. The majority (85%) of adenovirus-related hospitalizations occurred under 6 years of age. Mechanical ventilation, extracorporeal membrane oxygenation support, acute kidney injury and liver failure were documented in 11.9%, 0.4%, 2.7% and 0.4%, respectively. The overall case fatality rate was 1.4%, which decreased from 1997 to 2019 (P < 0.05). By regression analysis, an increased mortality rate was associated with the need for mechanical ventilation, the presence of complex chronic conditions, immune deficiency, central nervous system infection and pneumonia/bronchiolitis.

Conclusions:
Most human adenovirus infections occur in children under 6 years of age and cause mild illness. Human adenovirus can lead to serious illness in children with complex chronic conditions and immune deficiency conditions.