bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hospital-Acquired Venous Thromboembolism and Invasive Mechanical Ventilation: A Report From the Children’s Hospital Acquired Thrombosis Consortium
Authors: Sochet Anthony A. , Jaffray Julie , Branchford Brian R. , Havlicek Elizabeth E. , Mosha Maua , Amankwah Ernest K. , Ignjatovic Vera , Faustino E. Vincent S. , Goldenberg Neil A. 
Published: October 2023

OBJECTIVES:
To determine if the duration of invasive mechanical ventilation (IMV) was associated with hospital-acquired venous thromboembolism (HA-VTE) among critically ill children.

DESIGN:
A multicenter, matched case-control study as a secondary analysis of Children’s Hospital Acquired Thrombosis (CHAT) Consortium registry.

SETTING:
PICUs within U.S. CHAT Consortium participating centers.

PATIENTS:
Children younger than 21 years old admitted to a PICU receiving IMV for greater than or equal to 1 day duration from January 2012 to March 2022 were included for study. Cases with HA-VTE were matched 1:2 to controls without HA-VTE by patient age groups: younger than 1, 1–12, and older than 12 years.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The primary outcome was IMV duration in days. Descriptive data included demographics, anthropometrics, HA-VTE characteristics (i.e., type, location, and timing), central venous catheterization data, thromboprophylaxis practices, and Braden Q mobility scores. Descriptive, comparative, and associative (multivariate conditional logistic regression for HA-VTE) statistics were employed. A total of 152 cases were matched to 304 controls. Cases with HA-VTE were diagnosed at a median of 7 days (interquartile range [IQR], 3–16 d) after IMV. The HA-VTE were limb deep venous thromboses in 130 of 152 (85.5%) and frequently central venous catheterization-related (111/152, 73%). Cases with HA-VTE experienced a longer length of stay (median, 34 d [IQR, 18–62 d] vs. 11.5 d [IQR, 6–21 d]; p < 0.001) and IMV duration (median, 7 d [IQR, 4–15 d] vs. 4 d [IQR, 1–7 d]; p < 0.001) as compared with controls. In a multivariate logistic model, greater IMV duration (adjusted odds ratio, 1.09; 95% CI, 1.01–1.17; p = 0.023) was independently associated with HA-VTE.

CONCLUSIONS:
Among critically ill children undergoing IMV, HA-VTE was associated with greater IMV duration. If prospectively validated, IMV duration should be included as part of prothrombotic risk stratification and future pediatric thromboprophylaxis trials.
Organ Dysfunction in Children With Blood Culture-Proven Sepsis: Comparative Performance of Four Scores in a National Cohort Study
Authors: Schlapbach Luregn J. , Goertz Sabrina , Hagenbuch Niels , Aubert Blandine , Papis Sebastien , Giannoni Eric , Posfay-Barbe Klara M. , Stocker Martin , Heininger Ulrich , Bernhard-Stirnemann Sara , Niederer-Loher Anita , Kahlert Christian R. , Natalucci Giancarlo , Relly Christa , Riedel Thomas , Aebi Christoph , Berger Christoph , Agyeman Philipp K. A. ,   for the Swiss Pediatric Sepsis Study Group
Published: October 2023

OBJECTIVES:Previous studies applying Sepsis-3 criteria to children were based on retrospective analyses of PICU cohorts. We aimed to compare organ dysfunction criteria in children with blood culture-proven sepsis, including emergency department, PICU, and ward patients, and to assess relevance of organ dysfunctions for mortality prediction.DESIGN:We have carried out a nonprespecified, secondary analysis of a prospective dataset collected from September 2011 to December 2015.SETTING:Emergency departments, wards, and PICUs in 10 tertiary children’s hospitals in Switzerland.PATIENTS:Children younger than 17 years old with blood culture-proven sepsis. We excluded preterm infants and term infants younger than 7 days old.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:We compared the 2005 International Pediatric Sepsis Consensus Conference (IPSCC), Pediatric Logistic Organ Dysfunction-2 (PELOD-2), pediatric Sequential Organ Failure Assessment (pSOFA), and Pediatric Organ Dysfunction Information Update Mandate (PODIUM) scores, measured at blood culture sampling, to predict 30-day mortality. We analyzed 877 sepsis episodes in 807 children, with a 30-day mortality of 4.3%. Percentage with organ dysfunction ranged from 32.7% (IPSCC) to 55.3% (pSOFA). In adjusted analyses, the accuracy for identification of 30-day mortality was area under the curve (AUC) 0.87 (95% CI, 0.82–0.92) for IPSCC, 0.83 (0.76–0.89) for PELOD-2, 0.85 (0.78–0.92) for pSOFA, and 0.85 (0.78–0.91) for PODIUM. When restricting scores to neurologic, respiratory, and cardiovascular dysfunction, the adjusted AUC was 0.89 (0.84–0.94) for IPSCC, 0.85 (0.79–0.91) for PELOD-2, 0.87 (0.81–0.93) for pSOFA, and 0.88 (0.83–0.93) for PODIUM.CONCLUSIONS:IPSCC, PELOD-2, pSOFA, and PODIUM performed similarly to predict 30-day mortality. Simplified scores restricted to neurologic, respiratory, and cardiovascular dysfunction yielded comparable performance.
Skeletal Fluorosis
Authors: Gerges Maria M. , Ngo Victoria T. , Tu Jonathan , Colletti Patrick M. , Wassef Heidi 
Published: October 2023

AbstractA 27-year-old man with polysubstance abuse including methamphetamine, fentanyl, and 1.5 years of electronics compressed gas duster inhalation presented following an assault. Radiologic imaging performed for suspected fractures revealed periosteal reaction, cortical thickening with increased bone density, and ligament and tendon ossification, which were not present on imaging obtained 3 years before presentation. A bone scan was subsequently performed revealing a metabolic superscan with cortical irregularity. Further investigation revealed skeletal fluorosis from electronics compressed gas duster inhalation. Skeletal fluorosis may be considered when these osseous findings are encountered.
α2-ADRENORECEPTOR ANTAGONIST AMELIORATES SEPSIS-ASSOCIATED PULMONARY FIBROSIS BY SUPPRESSING NOREPINEPHRINE-MEDIATED FIBROBLAST DIFFERENTIATION VIA INHIBITING PKC ACTIVATION
Authors: Su Xingyu , Lu Fan , Chen Yihua , Wang Miao , Tang Guoqing , Lin Wan , Liu Yingwen , Wang Huadong , Yin Haiyan , Wang Yiyang 
Published: October 2023

ABSTRACTPulmonary fibrosis is an important factor affecting the prognosis of severe septic patients with acute lung injury. The objective of this study was to explore the effect of norepinephrine (NE) and α2-adrenoreceptor (AR) on sepsis-associated pulmonary fibrosis and the mechanism underlying these effects. We found pulmonary fibrotic changes, and increased NE production and α2A-AR expression in the pulmonary tissue of mice subjected to cecal ligation and puncture surgery. Reserpine and yohimbine alleviated pulmonary fibrosis in mice with sepsis by exhausting NE derived from the lung's adrenergic nerve and blocking α2-AR, respectively. There was no significant difference in the expression of the three α1-AR subtypes. The effect of NE on promoting pulmonary fibroblast differentiationin vitrowas suppressed by yohimbine. Both the protein and mRNA expression levels of α2A-AR were increased in pulmonary fibroblasts treated with LPS. Clonidine, a selective α2-AR agonist, enhanced LPS-induced differentiation in pulmonary fibroblasts, as indicated by the increase in α-smooth muscle actin and collagen I/III, which was mitigated by inhibiting PKC and p38. Furtherin vivoresults indicated that yohimbine alleviated pulmonary fibrosis and inhibited the phosphorylation of PKC, p38, and Smad2/3 in lung tissue of mice exposed to LPS for 4 weeks. Clonidine showed the opposite effect to yohimbine, which aggravated LPS-induced pulmonary fibrosis. These findings demonstrated that the sepsis-induced increase in NE promoted fibroblast differentiation via activating α2-AR. Blockage of α2-AR effectively ameliorated sepsis-associated pulmonary fibrosis by abolishing NE-induced lung fibroblast differentiation and inhibiting the PKC-p38-Smad2/3 pathway.
Comparison among presepsin, procalcitonin, and C-reactive protein in predicting blood culture positivity and pathogen in sepsis patients
Authors: Xiao Hongli , Zhang Hanyu , Wang Guoxing , Wang Yan , Tan Zhimin , Sun Xuelian , Zhou Jie , Duan Meili , Zhi Deyuan , Hang Chenchen , Zhang Guoqiang , Li Yan , Wu Caijun , Zhang Haiyan , Xie Miaorong , Li Chunsheng 
Published: October 2023

AbstractBackgroundSepsis is caused by the invasion of the bloodstream by microorganisms from local sites of infection, leading to high mortality. This study aimed to compare the predictive ability of the biomarkers presepsin, procalcitonin (PCT) and C-reactive protein (CRP) for bacteraemia.MethodsIn this retrospective, multicentre study, a dataset of patients with sepsis who were prospectively enrolled between November 2017 and June 2021 was analysed. The performances of the biomarkers for predicting positive blood cultures and infection with specific pathogens were assessed by the areas under the receiver operating characteristic curves (AUCs). The independent effects of the pathogen and foci of infection on presepsin and PCT levels were assessed by linear logistic regression models.ResultsA total of 577 patients with 170 (29.5%) positive blood cultures were enrolled. The AUC achieved using PCT levels (0.856) was significantly higher than that achieved using presepsin (0.786,p= 0.0200) and CRP (0.550,p< 0.0001) levels in predicting bacteraemia. The combined analysis of PCT and presepsin levels led to a significantly higher AUC than the analysis of PCT levels alone for predicting blood culture positivity (0.877 vs. 0.856,p= 0.0344) and gram-negative bacteraemia (0.900 vs. 0.875,p= 0.0216). In a linear regression model, the elevated concentrations of presepsin and PCT were both independently related toE. coli,Klebsiellaspp.,Pseudomonasspp., andStreptococcusspp. infections and Sequential Organ Failure Assessment (SOFA) score. Presepsin levels were also associated withAcinetobacterspp. and abdominal infection, and PCT levels were positively associated with otherEnterobacteriaceaeand negatively associated with respiratory infection. Combined analysis of presepsin and PCT levels provided a high sensitivity and specificity in identifyingEscherichia coliorKlebsiellaspp infection.ConclusionsPresepsin and PCT were promising markers for predicting bacteraemia and common pathogens at the time of sepsis onset with a synergistic effect.
Secreted tryptophanyl–tRNA synthetase 1 is a prognostic marker in sepsis patients without monocytopenia
Authors: Kim Kyung Su , Suh Gil Joon , Jin Mirim , Kwon Woon Yong , Jung Yoon Sun , Kim Taegyun , Kim Yoon Tae , Kim Hayoung , Park Heesu 
Published: October 2023

ABSTRACT

Objective
This study aimed to test whether the prognostic value of tryptophanyl–tRNA synthetase 1 (WARS1) for 28-day mortality in patients with sepsis was affected by monocytopenia.

Methods
A prospective analysis of retrospectively collected samples from 74 sepsis patients was performed. WARS1, C-reactive protein (CRP), and procalcitonin were measured at admission and 24 and 72 hours after admission. The prognostic value of WARS1, CRP, and procalcitonin for 28-day mortality was compared using repeated measures analysis of variance (ANOVA) and the area under the receiver operating characteristic curve (AUROC). All analyses were performed in patients with or without monocytopenia, defined as an absolute monocyte count less than 0.1 × 109 cells/L.

Results
WARS1 levels differed significantly between survivors and nonsurvivors when all patients and patients without monocytopenia were assessed (p = 0.008, p < 0.001, respectively). In contrast, the WARS1 level did not differ between survivors and nonsurvivors with monocytopenia. CRP and procalcitonin levels were not different between survivors and nonsurvivors regardless of whether they had monocytopenia. The AUROCs of WARS1 at admission and 24 hours for mortality were significantly higher in patients without monocytopenia (0.830, 0.818) than in patients with monocytopenia (0.232, 0.196; p < 0.001, both). When patients without monocytopenia were analyzed, the AUROCs of WARS1 for mortality were 0.830 and 0.818 at admission and 24 hours, respectively, which were significantly higher than those of CRP (0.586, 0.653) and procalcitonin (0.456, 0.453) at the same time points (p = 0.024 and 0.034, respectively).

Conclusion
WARS1 is a useful biomarker for prognosis in sepsis patients without monocytopenia.
Association Between Genital Hiatus Size 8 Weeks Postpartum and Pelvic Organ Prolapse 1 Year After the First Vaginal Delivery
Authors: Rosett Heather A. , Allshouse Amanda A. , Nygaard Ingrid E. , Hill A. Jolyn , Swenson Carolyn W. 
Published: October 2023

Importance
Evidence suggests that genital hiatus (GH) enlargement precedes pelvic organ prolapse development remote from delivery. However, the association of postpartum GH enlargement and prolapse is unknown.

Objective
The aim of this study was to determine the association between enlarged GH at 8 weeks postpartum and prolapse 1 year after first vaginal delivery.

Study Design
This is a secondary analysis of the Motherhood and Pelvic Health study, a prospective cohort of women after their first vaginal delivery. Enlarged GH was defined as ≥4 cm. Prolapse was defined as Pelvic Organ Prolapse Quantification points Ba, Bp, or C at or beyond the hymen. Kaplan-Meier analysis and proportional hazards modeling were used to analyze the association between enlarged GH at 8 weeks postpartum and prolapse at 1 year postpartum. Diagnostic test characteristics of enlarged GH were calculated.

Results
Five hundred eighty women were included. At 1 year postpartum, the prevalence of prolapse was 3 times higher in women with, versus without, an enlarged GH at 8 weeks postpartum (16% vs 5%, P < 0.001). This was confirmed in a Cox proportional hazards model while adjusting for age, body mass index, and early postpartum prolapse (adjusted hazard ratio, 3.3; 95% confidence interval, 1.85–6.06; P < 0.001). The diagnostic properties of postpartum GH to predict prolapse at 1 year are as follows: sensitivity, 0.63; specificity, 0.67; positive predictive value, 0.17; and negative predictive value, 0.95.

Conclusions
Women with an enlarged GH at 8 weeks postpartum have a 3.3-fold increased risk of prolapse at 1 year. As a screening tool, GH <4 cm at 8 weeks postpartum has high negative predictive value.
Healthcare Resource Utilization After Apical Prolapse Surgery in Women Who Received In-Office Versus Telephone-Only Preoperative Teaching
Authors: Lua-Mailland Lannah L. , Roversi Gustavo , Yao Meng , Ferrando Cecile A. 
Published: October 2023

Importance
Despite increasing use of telehealth, no studies have evaluated telehealth use for preoperative teaching and its impact on healthcare resource utilization (HRU) after gynecologic surgery.

Objectives
This study aimed to compare HRU after apical prolapse surgery in women receiving in-office versus telephone-only preoperative teaching and identify factors associated with postoperative HRU.

Study Design
A retrospective cohort study of women who underwent apical prolapse surgery from 2017 to 2020 at a tertiary referral center was conducted. Women were grouped based on the preoperative teaching type they received. Healthcare resource utilization was defined as a composite of patient-initiated calls, unscheduled outpatient visits, emergency department visits, and readmissions before the scheduled 6-week postoperative visit. Healthcare resource utilization was compared between in-office and telephone-only groups. Multivariable regression analysis was performed to identify factors associated with HRU.

Results
A total of 1,168 women underwent in-office teaching, and 181 had telephone-only teaching. Of the 1,349 women, 980 (72.6%) had ≥1 HRU encounter and 222 (16.5%) had ≥5 HRU encounters within 6 weeks after surgery. There was no difference between telephone and office groups for composite outcomes of ≥1 HRU (78.5% vs 71.7%, P = 0.06) and ≥5 HRU (13.3% vs 17.0%, P = 0.21) encounters. A failed voiding trial was associated with a 4.4-fold increased risk of ≥5 encounters. Increasing age and body mass index, concomitant hysterectomy, and abdominal route were associated with a decreased likelihood of ≥5 encounters.

Conclusions
Three of 4 women had at least 1 unanticipated HRU encounter within 6 weeks after apical prolapse surgery. Preoperative teaching type was not associated with postoperative HRU. Telephone visits may be considered as an alternative to in-office visits for preoperative teaching.
Mental maps without vision: Neural signatures of cognitive maps based on haptic input in the hippocampal formation
Authors: Ottink Loes , van den Berg Lennard , Peters Imke , van der Geest Thea , Haak Koen , Doeller Christian , van Wezel Richard 
Published: October 2023

AbstractThe human hippocampus is the key region for forming cognitive maps of our environment. Such a map can support spatial navigation. It is unclear whether this area is similarly involved when an environment is explored with our haptic sense. In this study, we investigated the neural representation of distances on a tactile map in the hippocampal formation, in visually impaired and sighted persons. To this end, 47 participants (22 persons with a visual impairment, PVIs, and 25 sighted controls) performed a navigation task where they learned a tactile city-like map including five item locations. We combined magnetic resonance imaging with adaptation analysis to assess representation of distances between item locations in the hippocampus and entorhinal cortex. Additionally, we assessed cognitive map formation on a behavioural level. We also looked at functional connectivity between navigation-related areas during a subsequent resting-state block. Our data reveal across all participants that the left entorhinal cortex represents distances between locations on a tactile map. Here, we provide the first evidence that maps in the hippocampal formation is preserved when an environment is presented in a non-visual modality. The results also suggest that both PVIs and sighted persons constructed accurate cognitive maps of the tactile environment on a behavioural level. However, early PVIs showed lower performance compared to late PVIs, suggesting an advantage of visual experience. Additionally, we reveal functional connectivity between areas that were involved in the navigation task during a subsequent resting-state block. This might suggest either visual imagination of stimuli during the preceding tasks, or cognitive processes related to our spatial navigation task, which possibly involve replay of stimulus-specific activity.
XGBoosting Early Detection: Advancing Parkinson’s Disease Diagnosis through Machine Learning
Authors: Santos Dheiver Francisco 
Published: October 2023

AbstractParkinson’s disease (PD) is a significant neurodegenerative disorder, affecting millions worldwide. Early and accurate diagnosis is pivotal for effective treatment. In this study, we explore the application of XGBoost, a powerful machine learning algorithm, for classifying PD based on speech signal features. Our research presents a systematic methodology, addressing data preparation, model development, and performance evaluation. The XGBoost model achieved an accuracy of 80.09% in distinguishing individuals with and without PD, demonstrating its promise for disease classification. Moreover, we discuss the potential for XGBoost in healthcare and highlight the need for further research in the intersection of machine learning and disease diagnosis.
Biolistics-mediated transformation of hornworts and its application to study pyrenoid protein localization
Authors: Lafferty Declan J. , Robison Tanner A. , Gunadi Andika , Gunn Laura H. , Van Eck Joyce , Li Fay-Wei 
Published: October 2023

AbstractHornworts are a deeply diverged lineage of bryophytes that are sister to mosses and liverworts. Hornworts have an array of unique features that can be leveraged to illuminate not only the early evolution of land plants, but also alternative paths for nitrogen and carbon assimilation via cyanobacterial symbiosis and a pyrenoid-based CO2-concentrating mechanism (CCM), respectively. Despite this, hornworts are one of the few plant lineages with limited available genetic tools. Here we report an efficient biolistics method for generating transient-expression and stable transgenic lines in the model hornwort,Anthoceros agrestis. An average of 569 (± 268) cells showed transient expression per bombardment, with green fluorescent protein expression observed within 48 hours. A total of 81 stably transformed lines were recovered across three separate experiments, averaging six lines per bombardment. We followed the same method to transiently transform nine additional hornwort species, and obtained stable transformants from one. This method was further used to verify the localization of Rubisco and Rubisco activase in pyrenoids, which are central proteins for CCM function. Together, our biolistics approach offers key advantages over existing methods as it enables rapid transient expression and can be applied to widely diverse hornwort species.HighlightWe developed a new transformation method for hornworts, a lineage of understudied bryophytes, and demonstrated its effectiveness in studying subcellular localization of proteins involved in pyrenoid-based CO2-concentrating mechanism.
Mapping the landscape of lineage-specific dynamic regulation of gene expression using single-cell transcriptomics and application to genetics of complex disease
Authors: Abe Hanna , Lin Phillip , Zhou Dan , Ruderfer Douglas M. , Gamazon Eric R. 
Published: October 2023

AbstractSingle-cell transcriptome data can provide insights into how genetic variation influences biological processes involved in human biology and disease. However, the identification of gene-level associations in distinct cell types faces several challenges, including the limited reference resource from population scale studies, data sparsity in single-cell RNA sequencing, and the complex cell-state pattern of expression within individual cell types. Here we develop genetic models of cell type specific and cell state adjusted gene expression in mid-brain neurons in the process of specializing from induced pluripotent stem cells. The resulting framework quantifies the dynamics of the genetic regulation of gene expression and estimates its cell type specificity. As an application, we show that the approach detects known and new genes associated with schizophrenia and enables insights into context-dependent disease mechanisms. We provide a genomic resource from a phenome-wide application of our models to more than 1500 phenotypes from the UK Biobank. Using longitudinal genetically determined expression, we implement a predictive causality framework, evaluating the prediction of future values of a target gene expression using prior values of a putative regulatory gene. Collectively, this work demonstrates the insights that can be gained into the molecular underpinnings of diseases by quantifying the genetic control of gene expression at single-cell resolution.