bluuebunny/crossref_metadata_2025_split huggingface dataset:
Whither Health Research
Authors: Patrinos Dimitri , McDougall Robyn , Beauvais Michael J. S. , Knoppers Bartha Maria 
Published: December 2023

Abstract
Under Article 24 of the Convention on the Rights of the Child (crc), children have the right to the highest attainable standard of health. One component of this right that has received little attention is the connection between children’s health and their participation in health-related research. This represents a missed opportunity in the full realisation of the right to health. This paper accordingly argues that Article 24 should obligate or incentivise State Parties to create more research opportunities for children in implementing this right. It explores the links between paediatric research and children’s health, highlighting the impacts of the lack of research on the paucity or absence of many treatment and prevention options for childhood diseases. It also considers the application of other rights which may be implicated in paediatric research. While paediatric health-related research is imperative, it must occur within a framework which respects all children’s rights.
‘Doing Harm Was the Point’
Authors: Risley Amy 
Published: December 2023

Abstract
This article analyses the Trump administration’s policy of forcibly separating thousands of immigrant families at the border. Using a rights-based and childist approach, I explore the policy’s severe consequences for children’s rights to family unity and protection from cruel and degrading treatment. I argue that family separations abandoned the best-interests principle and entailed severe rights violations and due process irregularities. The policy deliberately inflicted suffering and trauma on immigrant families to deter immigrants and coerce asylum-seekers into relinquishing their claims to protection, contrary to treaty obligations and domestic laws. The article also examines the policy’s formulation and implementation, which were characterised by cruelty, chaos and confusion. This case provides incontrovertible evidence of the myriad strategies governments use to exclude immigrant children from the benefits of the global children’s rights regime.
Most of the Time we are Taking Decisions for Children
Authors: Shaik Naseema 
Published: December 2023

Abstract
It is imperative that children’s participatory rights are supported and therefore it is incumbent upon adults genuinely to listen to them and take their views seriously. However, 28 years into a democratic South Africa and children’s participatory rights are not fully actualised and implementation seems to be problematic in early childhood education. The purpose of this article was to explore 13 final-year student teachers’ understandings about children’s participatory rights in the Reception Year (Grade R) and how these understandings influence their practice using Lundy’s model of participation and Honneth’s theory of recognition. A qualitative approach was applied, and data was collected through a focus group interview that was undertaken online. The data revealed that student teachers had a limited understanding of children’s participatory rights but aligned more towards children’s protection rights. Additionally, whilst the participants related the concepts of Lundy’s model of participation to mainly pedagogical scenarios that lacked children’s genuine participation, the participants gave children the recognition to building their self-confidence, self-respect and self-esteem.
Effect of reinforcement ratio and textile pre-impregnation on the mechanical properties of flax textile reinforced sulfoaluminate matrix
Authors: Bardouh Rafik , Homoro Omayma , Amziane Sofiane 
Published: December 2023

This study evaluates the effect of reinforcement ratio and textile pre-impregnation on the tensile behavior of flax textile, embedded in an inorganic CSA matrix (sulfoaluminate cementitious matrix), known as Fabric Reinforced Cementitious Matrix (FRCM). Two reinforcement ratios of (3 and 6%) and two impregnation techniques (polymeric and mineral) are applied. Direct tensile tests are conducted on FRCM specimens as well as on bare flax textiles featuring three configurations: NP (non-impregnated), PP (polymeric-impregnated), and PM (mineral-impregnated), between 1L (one layer) and 2L (two layers) of flax textile. The results show a direct correlation between the reinforcement ratio and the enhancement of mechanical properties, with a notable 44% increase in mechanical strength observed for NP FRCM specimens between 1L and 2L of flax textile. Mineral pre-impregnation enhances yarn-cement matrix bonding inside FRCM, while FRCM specimens with polymeric-impregnated textiles have limited influence on the mechanical properties due to premature failure. Polymeric impregnation has a pronounced effect when applied to bare flax textiles, with PP flax textiles demonstrating exceptional mechanical strength and rigidity, reaching up to 480 MPa and 37 GPa, respectively. In contrast, this effect was mitigated when employing PP textiles in FRCM specimens, where the lowest fabric efficiency reached 12% for the 2L.PP configuration suggests significant chemical incompatibility between epoxy resin and CSA matrix. Mineral-impregnated specimens display consistent efficiency regardless of reinforcement ratio, suggesting a novel and homogeneous distribution of cement matrix particles within the yarns of textiles. Two distinct failure modes of FRCM are observed in this study, a delamination for PP configurations and a fiber pullout for NP and PM configurations. No effect of reinforcement ratio is remarked on the failure mode. The cracking mode in PM FRCM configurations showcased improved aesthetics, durability, and elongation after rupture (6.28%). As a result, 2L.PM FRCM is the best configuration in terms of mechanical strength, rigidity, ductility, and durability.
The relationship between echocardiographic parameters and albumin bilirubin score in patients with acute pulmonary thromboembolism
Authors: Evlice Mert , Kurt İbrahim H 
Published: December 2023

Purpose The Albumin-Bilirubin (ALBI) score is useful and easy-to-use for objectively assessing liver function. We investigated whether the ALBI score, a parameter indicating liver stiffness, congestion and fibrosis, has any relationship with echocardiographic parameters in patients with acute pulmonary thromboembolism (PTE). Material and Methods A total of 140 patients diagnosed with acute PTE were retrospectively analyzed. These patients were divided into three groups according to the hemodynamic severity of acute PTE: Group I [Low risk]; Group II [Submassive or intermediate-risk]; and Group III [Massive or high-risk]. Biochemical data obtained from venous blood samples taken at admission were analyzed. In addition, data were also analyzed from transthoracic echocardiography and pulmonary computed tomographic angiography performed at admission. ALBI, Bova, and PESI scores were calculated. Results ALBI scores (−3.32 ± 0.21 vs −2.86 ± 0.15 vs −2.46 ± 0.2, p < .001) were statistically significantly higher in Group III than Groups I and II. There was a significant difference between the three groups in terms of echocardiographic parameters, and LVEF and TAPSE values tended to decrease from group I to group III. In multivariate linear regression analysis, sPAP, RV/RA diameter, and NT-pro-BNP were found to be significantly associated with the ALBI score. An ALBI score higher than −2.87 was associated with Bova stage II-III in patients with Group I and Group II PTE, with a sensitivity of 87% and a specificity of 62% (AUC = 0.804; 95% CI 0.713–0.895; p < .001). Conclusion The ALBI score, which is a common, easy-to-use, and inexpensive method, may be beneficial to select intermediate and high-risk patients in patients with acute PTE. Additionally, it may have prognostic value in distinguishing low and intermediate-risk acute PTE patients.
Bivalirudin anticoagulation for cardiopulmonary bypass during cardiac surgery
Authors: Meshulami Noy , Murthy Raghav , Meyer Maisy , Meyer Andrew D , Kaushik Shubhi 
Published: December 2023

Introduction Heparin is the primary anticoagulant for cardiopulmonary bypass (CPB) support during cardiac surgery. While widely used, ∼2% of cardiac surgery patients develop heparin-induced thrombocytopenia (HIT) and 4–26% develop heparin resistance. Bivalirudin is an alternative anticoagulant mainly used for percutaneous coronary interventions. Given the challenges associated with heparin anticoagulation, we conducted a review to explore the use of bivalirudin for CPB surgery. Methods PubMed and Embase scoping review included 2 randomized controlled trials, a retrospective comparison study, 3 pilot studies, and 30 case reports. To provide a contemporary series, we searched for articles published from 2010 to 2023. Our review included studies from both adult and pediatric populations. Results While data is limited, bivalirudin seems to supply similar effectiveness and safety as heparin for CPB anticoagulation. Across the three comparative studies, the heparin cohorts had a 0–9% mortality rate and 0–27% rate of major bleeding/reoperation compared to a 0–3% mortality and 0–6% major bleeding/reoperation rate for the bivalirudin cohorts. Bivalirudin was successfully used as an anticoagulant in a wide range of CPB surgeries (e.g., heart transplants, ventricular assisted device placements, and valve repairs). Successful patient outcomes were reported with bivalirudin infusion of ∼2 mg/kg/hour, activated clotting time monitoring (target >400 s or 2.5× baseline), use of cardiotomy suctions, minimization of stagnant blood, and post-bypass modified ultrafiltration. Conclusion Bivalirudin is a safe and effective anticoagulant for CPB, especially for patients with HIT or heparin resistance. Further comparative research is called for to optimize bivalirudin utilization for CPB during cardiac surgery.
In Vitro Analysis of Dissolution of 18 HA-based Dermal Fillers with Tailored Hyaluronidase Dosing to Achieve Urgent Reversal of Vascular Complications
Authors: Reddy Sahitya , Mihori Marisa , Rostami Soheila 
Published: December 2023

Introduction: Hyaluronidase (HYAL), a hyaluronic acid-degrading enzyme, is commonly used “off-label” as part of the gold standard management of hyaluronic acid (HA) dermal filler complications. It is paramount that injectors be cognizant to diagnose and treat filler complications, particularly vascular emboli, where there may be a narrow window for timely treatment. There is a paucity of studies, however, that provide HYAL dosage guidelines in the setting of acute vascular obstruction that are specific to each of the 18 reversible HA-based dermal fillers commercially available on the current US market. Differences in resistance to HYAL degradation is based on variation in cross-linking technique, concentration of HA, and cohesive properties that each filler may possess. This in vitro study investigates optimal dosage parameters of HYAL to achieve gross dissolution of every reversible HA-based filler commercially available to better improve outcomes after filler-induced vascular complications. Methods: Standardized in vitro analysis using 0.5-mL aliquots of all 18 commercially available HA-based fillers included all Restylane products (Lyft, Restylane-L, Silk, Refyne, Defyne, Kysse, Contour), Juvederm products (Volbella, Vollure, Voluma, Ultra XC, Ultra Plus XC), Revanesse products (Versa+, Lips+), Teoxane products (RHA 2, RHA 3, RHA 4), and Belotero. Hylenex, recombinant human HYAL, was used in 150 IU increments for total quantities of either 300, 450, 600, or 750 IU to achieve timed assessment of the gross dissolution of filler using photographic and videographic documentation. Inert dye was used to improve filler visibility against the HYAL. Mechanical integration of HYAL into the filler mimicked massage technique commonly implemented to incorporate HYAL into the perivascular soft tissue to help relieve a filler-induced vascular obstruction. Results: The cross-linking technology utilized by each HA-filler manufacturer played a significant role in the readiness of filler dissolution with HYAL. Fastest dissolution times ranged from 11 seconds to approximately 32 minutes, with a strong correlation with Restylane products dissolving the fastest, followed by Juvederm & Revanesse products. The slowest to achieve gross dissolution were Belotero and the RHA series. Discussion: All 18 HA-based fillers achieved complete gross dissolution within the first 32 minutes, however, due to differences in cross-linking technology and molecular properties, there was large variation in in vitro HYAL-induced degradation that can be extrapolated clinically to help reverse urgent vascular obstruction. This may also help beginner injectors strategically choose the HA-based dermal fillers that have the fastest degradation response to HYAL. Further in vivo studies are necessary to integrate these into clinical practice.
An Investigation of COVID-19 Outcomes and College Student Demographics: Results from a National Sample
Authors: Lederer Alyssa M. , Hoban Mary T. , Kukich Christine 
Published: December 2023

Purpose To assess the effects of COVID-19 on college students and any differential outcomes across collegiate sub-populations towards the beginning of the pandemic. Design Cross-sectional survey. Setting Fall 2020 American College Health Association-National College Health Assessment. Subjects N = 13 373 undergraduate/graduate/professional students; 22 colleges/universities. Measures Six COVID-19 outcomes; 10 demographics. Analysis Campus-specific weights for student enrollment/sex distribution. Cross-tabulations/Pearson χ2 test; Cramer’s V/effect size; Bonferroni multiple testing correction ( P < .0009). Results 5.6% of students had been diagnosed with COVID-19. Compared to counterparts within each demographic category, rates were significantly higher among many BIPOC student groups (e.g., Native Hawaiian/Other Pacific Islander: 15.0%); cisgender women (5.9%) and men (5.6%); heterosexuals (6.1%); undergraduates (6.3%); and sorority/fraternity members (13.7%). Due to COVID-19, 8.8% of students had lost a loved one; 14.6% had a loved one with long term effects from COVID; 38.6% had increased stress; 61.4% had more financial concerns; and 52.7% had more difficulty accessing mental healthcare. Students identifying as BIPOC; cisgender women and transgender/gender non-conforming (TGNC); queer-spectrum; undergraduate; first-generation; having a disability; and taking courses online were significantly more affected by most of these outcomes (all comparisons P < .0009). Conclusions Students were widely impacted by COVID-19 with substantive differences across sub-populations. Future research should examine trends over time and explore ways to reduce health disparities.
Talocalcaneal Ligament Reconstruction Kinematic Simulation for Progressive Collapsing Foot Deformity
Authors: Mania Sylvano , Beeler Silvan , Wirth Stephan , Viehöfer Arnd 
Published: December 2023

Background: In progressive collapsing foot deformity (PCFD), an internal and plantar rotation of the talus relative to the calcaneus may result in painful peritalar subluxation. Medial soft tissue procedures (eg, spring ligament repair) aim to correct the talar position via the navicular bone if bony correction alone is not sufficient. The effect of the medial soft tissue reconstruction on the talar reposition remains unclear. We hypothesized that a subtalar talocalcaneal ligament reconstruction might be favorable in PCFD to correct talar internal malposition directly. This pilot study aims to evaluate the anatomical feasibility and kinematic behavior of a subtalar ligament reconstruction in PCFD. Methods: Three-dimensional surface model from 10 healthy ankles were produced. A total of 1089 different potential ligament courses were evaluated in a standardized manner. A motion of inversion/eversion and talar internal/external in relation to the calcaneus were simulated and the ligament strain, expressed as a positive length variation, for each ligament was analyzed. The optimal combination for the ligament reconstruction with increased length in internal rotation of the talus, isometric kinematic behavior in inversion/eversion, and extraarticular insertion on talus and calcaneus was selected. Results: A laterodistal orientation of the talar insertion point in respect to the subtalar joint axis and laterodistal deviation of the calcaneal insertion point presents the highest ligament lengthening in internal talar rotation (+0.56 mm [3.8% of total length]) and presented a near-isometric performance in inversion/eversion (+0.01 to −0.01 mm [0.1% of total length]). Conclusion: This kinematic model shows that a ligament reconstruction in the subtalar space presents a pattern of length variation that may stabilize the internal talar rotation without impeding the physiological subtalar motion. Clinical Relevance: This study investigates the optimal location, feasibility, and kinematic behavior of a ligament reconstruction that could help stabilize peritalar subluxation in progressive collapsing foot deformity.
Cardiovascular Safety of Atomoxetine and Methylphenidate in Patients With Attention-Deficit/Hyperactivity Disorder in Japan: A Self-Controlled Case Series Study
Authors: Zheng Yunlong , Fukasawa Toshiki , Yamaguchi Fumitaka , Takeuchi Masato , Kawakami Koji 
Published: December 2023

Objective: To investigate the association between atomoxetine or methylphenidate use and arrhythmia, heart failure (HF), stroke, and myocardial infarction (MI) in attention-deficit/hyperactivity disorder (ADHD) patients mainly focused on the people of working age. Methods: In a self-controlled case series study using a Japanese claims database, we identified events of arrhythmia, HF, stroke, and MI among 15,472 atomoxetine new users and 12,059 methylphenidate new users. Adjusted incidence rate ratios (aIRRs) of outcome events were estimated using multivariable conditional Poisson regression. Results: An increased risk of arrhythmia was observed during the first 7 days after the initial atomoxetine exposure (aIRR 6.22, 95% CI [1.90, 20.35]) and in the subsequent exposure (3.23, [1.58, 6.64]). No association was found between methylphenidate exposure and arrhythmia, nor between atomoxetine or methylphenidate exposure and HF. The limited number of stroke and MI cases prevented thorough analysis. Conclusions: Clinicians should consider monitoring for arrhythmia after patients initiating or re-initiating atomoxetine.
Treatment Utilization Pattern of Preschool Children With Attention-Deficit/Hyperactivity Disorder
Authors: Baweja Raman , Baweja Ritika , Weidlich Hunter , Nyland Jennifer E. , Waschbusch Daniel A. , Waxmonsky James G. 
Published: December 2023

Objective: The aim of this study was to identify patterns of ADHD care, including factors that guide selection and sequencing of treatments in a large nationwide sample of preschool-aged youth over the past 6 years. Method: A retrospective cohort study utilizing a large electronic health record (TriNetX) of nearly 24,000 children ages 3 to 6 diagnosed with ADHD. Results: One in three preschoolers with ADHD were prescribed psychotropic medication, most commonly methylphenidate and guanfacine. One in 10 had at least one psychotherapy billing code during the entire assessment with most youth starting medication before psychotherapy. Rates of most treatments, including polypharmacy, increased with comorbid psychiatric disorders or sleep problems and over the course of the coronavirus pandemic. Conclusion: Rates of treatment have increased over time but are still largely inconsistent with published care guidelines that advise therapy before medication. Clinicians appear to prioritize psychiatric comorbidity and sleep problems when selecting treatments.
A Phase II Study of 131I-rituximab for Patients With Relapsed or Refractory Marginal Zone Lymphoma
Authors: Jang Yoon Jung , Lim Sang Moo , Lee Inki , Byun Byung Hyun , Lim Ilhan , Kim Byung Il , Choi Chang Woon , Lee Seung-Sook , Yang Sung Hyun , Na Im Il , Lee Hyo-Rak , Shin Dong-Yeop , Kang Hye Jin 
Published: December 2023

Background: Radioimmunotherapy (RIT) is a rare treatment option for relapsed or refractory B-cell non-Hodgkin’s lymphoma (NHL). We investigated the safety and efficacy of 131I-rituximab in patients with relapsed or refractory marginal zone lymphomas. Methods: Patients with pathologically confirmed marginal zone lymphoma who relapsed or were resistant to prior therapy were enrolled. The patients received 250 mg/m2 of unlabeled rituximab immediately before receiving a therapeutic 131I-rituximab dose. The primary endpoint was the objective response rate (ORR), and the secondary endpoints were toxicity assessment, progression-free survival (PFS), and overall survival (OS). Results: Ten patients (median age = 57.5 years; range = 32-71) were included. Owing to poor enrollment, only 10 of the initially intended 25 patients were included in the study, rendering it unfeasible to perform the primary endpoint analysis. Before RIT, patients received chemotherapy, with 40% (n = 4) receiving rituximab therapy. Median PFS and OS were 18.9 months (95% confidence interval [CI]: 0.0-38.9) and 100.0 months (95% CI: 39.8-160.1), respectively. The ORR was 90%, and the duration of response was 29.7 months (95% CI: 0.0-61.3). Considering a median follow-up of 78.5 months (95% CI: 42.7-114.3), 4 patients (40%) were diagnosed with secondary malignancy. Hematological toxicities were common treatment-related adverse events, and 60% and 50% of the patients experienced grade 3 to 4 thrombocytopenia and neutropenia, respectively. Conclusions: 131I-rituximab showed marked efficacy in patients with relapsed or refractory marginal zone lymphoma, with a considerable risk of secondary malignancies during long-term follow-up. Radioimmunotherapy is not a recommended treatment option for relapsed or refractory marginal zone lymphoma but may be considered when other treatment options are not feasible.
A wearable device perspective on the standard definitions of disability progression in multiple sclerosis
Authors: Dalla Costa Gloria , Nos Carlos , Zabalza Ana , Buron Mathias , Magyari Melinda , Sellebjerg Finn , Guerrero Ana Isabel , Roselli Lucia , La Porta Maria Libera , Martinis Matteo , Bailon Raquel , Kontaxis Spyridon , Laporta Estela , Garcia Esther , Pokorny Florian B , Schuller Björn W , Folarin Amos , Stewart Callum , Leocani Letizia , Vairavan Srinivasan , Cummins Nicholas , Dobson Richard , Hotopf Matthew , Narayan Vaibhav , Montalban Xavier , Sorensen Per Soelberg , Comi Giancarlo 
Published: December 2023

Introduction: Multiple sclerosis (MS) is a leading cause of disability among young adults, but standard clinical scales may not accurately detect subtle changes in disability occurring between visits. This study aims to explore whether wearable device data provides more granular and objective measures of disability progression in MS. Methods: Remote Assessment of Disease and Relapse in Central Nervous System Disorders (RADAR-CNS) is a longitudinal multicenter observational study in which 400 MS patients have been recruited since June 2018 and prospectively followed up for 24 months. Monitoring of patients included standard clinical visits with assessment of disability through use of the Expanded Disability Status Scale (EDSS), 6-minute walking test (6MWT) and timed 25-foot walk (T25FW), as well as remote monitoring through the use of a Fitbit. Results: Among the 306 patients who completed the study (mean age, 45.6 years; females 67%), confirmed disability progression defined by the EDSS was observed in 74 patients, who had approximately 1392 fewer daily steps than patients without disability progression. However, the decrease in the number of steps experienced over time by patients with EDSS progression and stable patients was not significantly different. Similar results were obtained with disability progression defined by the 6MWT and the T25FW. Conclusion: The use of continuous activity monitoring holds great promise as a sensitive and ecologically valid measure of disability progression in MS.