bluuebunny/crossref_metadata_2025_split huggingface dataset:
A prospective cohort study of severe sepsis-induced dyslipidemia and changes in D-dimer levels in children: do they affect the prognosis?
Authors: Abdelaziz Tarek A. , Mohamed Mohamed Ali Abdou , Ismail Weaam Ibrahim , Idreis Ibrahim Ali Ibrahim , Baz Eman Gamal 
Published: December 2023

Abstract
Background
The dyslipidemia and changes in D-dimer values that occur in children with severe sepsis remain unidentified.

Objective
The current research aimed to explore the relationship between D-dimer and lipid profile values, including total cholesterol (TC), lipoproteins, apolipoprotein A-V (Apo A-5), triglycerides (TG), and in-hospital nonsurvival in children with severe sepsis or septic shock in pediatric intensive care.

Study design
The study design is as follows: prospective cohort study.

Participants
Children with severe sepsis or septic shock who were admitted to the intensive care unit of a university pediatric hospital.

Intervention
Vital signs, sepsis assessment, pediatric sequential organ failure assessment (PSOFA) score, high-density lipoprotein (HDL), Apo A-5, TG, low-density lipoprotein (LDL), TC, D-dimer, mortality outcome, and pediatric risk of mortality (PRISM) III score were evaluated.

Outcomes
The primary outcome was in-hospital nonsurvival.

Results
The nonsurvivors had significantly higher D-dimer levels than the survivors, with a significant cutoff level of 0.87 μg/mL (AUC: 0.85, sensitivity: 93.3%, PVN: 90.6%, accuracy: 79.0%, PVP: 72.5%, and specificity: 64.7%). D-dimer was inversely correlated with WBC count and positively correlated with patient age, PRISM III score, PSOFA score, and INR. However, nonsurvivors had higher TG levels and lower TC, HDL, LDL, and Apo A-5 levels than survivors, but this variation was insignificant. Apo A-5 levels were inversely correlated with HDL and positively correlated with TG levels.

Conclusions
This study suggests that D-dimer is a promising biomarker for severe sepsis in children, with a mortality cutoff level of 0.87 μg/mL. However, lipid profiles are not predictors of sepsis-related mortality.
Moving behavioral interventions in nursing homes from planning to action: a work system evaluation of a urinary tract infection toolkit implementation
Authors: Ford James H. , Nora Anna T. , Crnich Christopher J. 
Published: December 2023

Abstract
Background
Implementation evaluations based on a hybrid deductive-inductive approach provide a detailed understanding of organizational choices to introduce and implement complex interventions and may help explain implementation success or failure. However, such evaluations may not be feasible due to resource constraints. Qualitative analyses of artifacts collected for other purposes during implementation may represent a cost-effective method to understand program implementation when robust evaluations are not feasible. This study used a work systems evaluation of how nursing homes (NHs) implemented a urinary tract infection (UTI) recognition and management improvement toolkit.

Methods
Thirty NHs participated in a randomized control trial in which intervention NHs (n = 12) were assigned a clinical coach who employed a standard template to structure coach calls with the NH champion. A hybrid inductive-deductive approach, using the Systems Engineering Initiative for Patient Safety (SEIPS) model, characterized three action domains related to (1) engagement of staff and providers, (2) distribution of toolkit elements, and (3) toolkit use.

Results
A total of 369 coded segments from 148 coach notes generated by three coaches working with 18 NH champions were examined. Planned changes (n = 203) were more frequent compared to actual changes (n = 169). While most NHs quickly engaged staff and providers, which leadership appeared to support, engagement actions were hindered in some NHs due to champion instability or extended champion or medical director absences. Dissemination of materials to family and providers and distribution of tools to staff occurred quickly in 75% of NHs, although delays were encountered in some NHs, usually because of champion instability.

Conclusions
Implementing NH practice change is challenging, and studies examining actions to support planned versus actual change in this setting are limited. The application of the SEIPS model to coach notes collected during the implementation of a structured behavioral intervention to improve the recognition and management of UTI in NHs generated unique insights into the work system and how staff attempted to implement changes. This study identified several factors that interfered with progression from planning to actual change. Future studies are needed to better understand how to best support change interventions in NHs.

Trial registration
ClinicalTrials.gov, NCT03520010, Registered May 9, 2018.
Data mining twitter for COVID-19 sentiments concerning college online education
Authors: Brandon Daniel 
Published: December 2023

AbstractIn the last decade there has been a large increase in corporate and public reliance on social media for information, rather than on the traditional news and information sources such as print and broadcast media. People freely express their views, moods, activities, likes/dislikes on social media about diverse topics. Rather than surveys and other structured data gathering methods, text data mining is now commonly used by businesses to go through their unstructured text in the form of emails, blogs, tweets, likes, etc. to find out how their customers feel about their company and their products/services. This paper reports upon a study using Twitter (recently renamed to “X”) data to determine if meaningful and actionable information could be gained from such social media data in regard to pandemic issues and how that information compares to a traditional survey. In early 2020, the COVID-19 pandemic hit and forced colleges to move classes to an online format. While there is considerable literature in regard to using social media to communicate geo-political issues and in particular pandemics, there is not a study using social media to explore public sentiment in regard to COVID’s forcing online education upon the public. In this study, text data mining was used to gain some insight into the feeling of Twitter users in regard to the effect of COVID-19 and the switch to online education in colleges. This study found that Twitter data mining did produce actionable information similar to the traditional survey, and the study is important since its results may influence organizations to explore the use of Twitter (and possibly other social media) to obtain people’s sentiments instead of (or in addition to) traditional surveys and other traditional means of gathering such information. This paper demonstrates both the process of text data mining social media and its application to current real-world issues.
Validation of the Indonesian version of the thyroid cancer-specific quality of life as a tool to assess the quality of life among pediatric thyroid cancer patients
Authors: Azhar Yohana , Achmad Dimyati , Rudiman Reno , Candrawinata Valeska Siulinda 
Published: December 2023

Abstract
Background
Diagnosis and management of pediatric cancer develop a major life event that might impact psychosocial functioning and quality of life (QoL) even long after the initial therapy has been completed. Treatment outcomes have been measured in terms of survival time, but they also significantly impact survivors’ quality of life. The pediatric differentiated thyroid carcinoma survivors’ QoL has rarely been evaluated. This study aims to translate and validate the Indonesian version of the ThYCA-QoL questionnaire.

Results
The median age of 105 eligible survivors was 20.88 years old. Eighty percent of the survivors were female, were married or in a relationship (86.7%), and had paid jobs or were full-time students (71.7%). The median follow-up time was 64.82 months. Cronbach-α co-efficient was > 0.70 for psychological, concentration, throat, and mouth problems. For sympathetic, neuromuscular, voice, and sensory, the scores were < 0.70, where a multi-trait scaling analysis showed that all item correlations were > 0.40. Validity was assessed using the Pearson correlation coefficient for y-QoL with r > 0.60 and p < 0.01.

Conclusions
The Indonesian ThYCA-QoL questionnaire is a reliable and valid tool to evaluate pediatric patients’ QoL after treatment. This simple assessment tool can be used to evaluate and manage pediatric thyroid cancer patients’ HRQoL.
The multidimensional benefits of eicosapentaenoic acid: from heart health to inflammatory control
Authors: Nassar Mahmoud , Jaffery Aelia , Ibrahim Bassel , Baraka Bahaaeldin , Abosheaishaa Hazem 
Published: December 2023

AbstractEicosapentaenoic acid (EPA) is an omega-3 fatty acid found in fatty fish and fish oil supplements. Over the past few decades, research has suggested that EPA has various potential health benefits, particularly for heart health.EPA has been associated with reduced inflammation, improved cholesterol levels, and reduced blood pressure, all of which can contribute to a lower risk of heart disease. Additionally, EPA has been found to reduce the risk of blood clots, which can lead to heart attacks and strokes. This comprehensive review article aims to summarize the current state of knowledge regarding the potential health benefits of EPA. We focus on its effects on cardiovascular health, inflammation, atherosclerotic plaques, blood clots, diabetes, obesity, and cancer. Finally, we provide an overview of the recommended daily dose of EPA for optimal health benefits.This review highlights the importance of EPA in promoting overall health and well-being and provides insights into its potential therapeutic applications.
Trabecular Bone Score as a Marker of Skeletal Fragility Across the Spectrum of Chronic Kidney Disease: A Systematic Review and Meta-analysis
Authors: Bioletto Fabio , Barale Marco , Maiorino Federica , Pusterla Alessia , Fraire Federica , Arvat Emanuela , Ghigo Ezio , Procopio Massimo 
Published: December 2023

Abstract

Context
The impairment of bone microarchitecture is a key determinant of skeletal fragility in patients with chronic kidney disease (CKD). The trabecular bone score (TBS) has been developed as a reliable noninvasive index of bone quality. However, its utility in this setting is still debated.

Objective
The aim of this systematic review and meta-analysis was to summarize the available evidence about TBS as a marker of skeletal fragility across the spectrum of CKD.

Methods
PubMed/Medline, EMBASE, and Cochrane Library databases were systematically searched until July 2023 for studies reporting data about TBS in patients with CKD. Effect sizes were pooled through a random-effect model.

Results
Compared to controls, lower TBS values were observed in CKD patients not on dialysis (−0.057, 95%CI:[−0.090, −0.024], P &lt; .01), in dialysis patients (−0.106, 95%CI:[−0.141, −0.070], P &lt; .01), and in kidney transplant recipients (KTRs) (−0.058, 95%CI:[−0.103, −0.012], P = .01). With respect to fracture risk, TBS was able to predict incident fractures in nondialysis patients at unadjusted analyses (hazard ratio [HR] per SD decrease: 1.45, 95%CI:[1.05, 2.00], P = .02), though only a nonsignificant trend was maintained when fully adjusting the model for FRAX® (HR = 1.26, 95%CI:[0.88, 1.80], P = .21). Dialysis patients with prevalent fractures had lower TBS values compared to unfractured ones (−0.070, 95% CI:[−0.111, −0.028], P &lt; .01). Some studies supported a correlation between TBS and fracture risk in KTRs, but results could not be pooled due to the lack of sufficient data.

Conclusion
CKD patients are characterized by an impairment of bone microarchitecture, as demonstrated by lower TBS values, across the whole spectrum of kidney disease. TBS can also be helpful in the discrimination of fracture risk, with lower values being correlated with a higher risk of prevalent and incident fractures.
Brain Metastases and Leptomeningeal Disease
Authors: Kumthekar Priya , Le Rhun Emilie 
Published: December 2023

ABSTRACT

OBJECTIVE
Central nervous system (CNS) metastases include brain parenchymal, spinal cord, and leptomeningeal metastases. This article discusses the diagnostic and therapeutic advances of the last decade that have improved outcomes for patients with these CNS metastases.

LATEST DEVELOPMENTS
The diagnostic tools for CNS metastases, particularly leptomeningeal disease, have evolved over the past decade with respect to advancements in CSF analysis. Multiple medical therapies are now available for brain metastasis treatment that have shown CNS efficacy, including targeted therapies and antibody-drug conjugates. Molecular testing for CNS metastases has become more common and the repertoire of molecularly targeted therapies continues to expand. Advancements in radiation therapy, including improvements in stereotactic radiation techniques, whole-brain radiation with hippocampal avoidance, and proton beam radiation, have changed the radiation management of patients with CNS metastases. New intrathecal agents are currently being tested for the management of leptomeningeal metastases.

ESSENTIAL POINTS
CNS metastases are far more common than primary brain tumors and are increasing in prevalence in the setting of improved treatments and prolonged survival in patients with systemic cancers. There have been many changes in the diagnostics and treatment of CNS metastases, yielding subsequent improvements in patient outcomes with further advancements on the horizon.
Pediatric Neuro-oncology
Authors: Malbari Fatema 
Published: December 2023

ABSTRACT

Objective
This article reviews the most common pediatric brain tumors, neurocutaneous syndromes, treatment-related neurotoxicities, and the long-term outcomes of survivors.

Latest Developments
In the era of molecular diagnostics, the classification, management, and prognostication of pediatric brain tumors and neurocutaneous syndromes has been refined, resulting in advancements in patient management. Molecular diagnostics have been incorporated into the most recent World Health Organization 2021 classification. This knowledge has allowed for novel therapeutic approaches targeting the biology of these tumors with the intent to improve overall survival, decrease treatment-related morbidity, and improve quality of life. Advances in management have led to better survival, but mortality remains high and significant morbidity persists. Current clinical trials focus on tumor biology targeted therapy, deescalation of therapy, and multimodal intensified approaches with targeted therapy in more high-risk tumors.

Essential Points
Molecular diagnostics for pediatric brain tumors and neurocutaneous syndromes have led to novel therapeutic approaches targeting the biology of these tumors with the goals of improving overall survival and decreasing treatment-related morbidity. Further understanding will lead to continued refinement and improvement of tumor classification, management, and prognostication.
Bacterial Brain Abscesses Expand Despite Effective Antibiotic Treatment: A Process Powered by Osmosis Due to Neutrophil Cell Death
Authors: Dahlberg Daniel , Holm Sverre , Sagen Ellen Margaret Lund , Michelsen Annika Elisabet , Stensland Maria , de Souza Gustavo Antonio , Müller Ebba Gløersen , Connelly James Patrick , Revheim Mona-Elisabeth , Halvorsen Bente , Hassel Bjørnar 
Published: December 2023

BACKGROUND AND OBJECTIVES:
A bacterial brain abscess is an emergency and should be drained of pus within 24 hours of diagnosis, as recently recommended. In this cross-sectional study, we investigated whether delaying pus drainage entails brain abscess expansion and what the underlying mechanism might be.

METHODS:
Repeated brain MRI of 47 patients who did not undergo immediate pus drainage, pus osmolarity measurements, immunocytochemistry, proteomics, and 18F-fluorodeoxyglucose positron emission tomography.

RESULTS:
Time from first to last MRI before neurosurgery was 1 to 14 days. Abscesses expanded in all but 2 patients: The median average increase was 23% per day (range 0%-176%). Abscesses expanded during antibiotic therapy and even if the pus did not contain viable bacteria. In a separate patient cohort, we found that brain abscess pus tended to be hyperosmolar (median value 360 mOsm; range 266-497; n = 14; normal cerebrospinal fluid osmolarity is ∼290 mOsm). Hyperosmolarity would draw water into the abscess cavity, causing abscess expansion in a ballooning manner through increased pressure in the abscess cavity. A mechanism likely underlying pus hyperosmolarity was the recruitment of neutrophils to the abscess cavity with ensuing neutrophil cell death and decomposition of neutrophil proteins and other macromolecules to osmolytes: Pus analysis showed the presence of neutrophil proteins (protein-arginine deiminases, citrullinated histone, myeloperoxidase, elastase, cathelicidin). Previous studies have shown very high levels of osmolytes (ammonia, amino acids) in brain abscess pus. 18F-fluorodeoxyglucose positron emission tomography showed focal neocortical hypometabolism 1 to 8 years after brain abscess, indicating long-lasting damage to brain tissue.

CONCLUSION:
Brain abscesses expand despite effective antibiotic treatment. Furthermore, brain abscesses cause lasting damage to surrounding brain tissue. These findings support drainage of brain abscesses within 24 hours of diagnosis.
Neuroprotective Effects of Artificial Cerebrospinal Fluid: Analysis of Brainstem Auditory–Evoked Potential Monitoring During Microvascular Decompression in 117 Consecutive Patients
Authors: Kobayashi Masahito , Hirata Sachiko , Fujimaki Takamitsu 
Published: December 2023

BACKGROUND AND OBJECTIVES:
To study the efficacy of irrigation with artificial cerebrospinal fluid (aCSF) for protection of cranial nerves during surgery; the time required for recovery of brainstem auditory–evoked potentials (BAEPs) that would reflect cochlear function was analyzed in comparison with that for saline irrigation.

METHODS:
This retrospective study included 117 consecutive patients (95 women, mean age 51.5 ± 11.4 year) who underwent microvascular decompression for hemifacial spasm. During surgery, BAEPs were monitored to avoid damage to the auditory pathways. When a delayed latency of >1 ms or a decrease in amplitude of >50% was detected in BAEP wave V, surgical maneuvers were halted, and the operative field was irrigated with saline or aCSF. Saline was used for irrigation in 58 patients and aCSF in the other 59. The time required for BAEP recovery at the first halt in each patient was analyzed, and the results were compared between the groups.

RESULTS:
Surgical procedures were interrupted because of BAEP latency delays or decreases in amplitude in 51 of the patients in the saline group and 54 in the aCSF group. In both groups, the latencies and amplitudes recovered significantly with time and both recovered earlier after aCSF irrigation than after saline irrigation. Hearing outcome was not significantly different between 2 groups.

CONCLUSION:
aCSF is effective for protection of cochlear nerve and promotes recovery from transient dysfunction during surgery. The protective effect may be attributed to multiple factors including conditioned pH, electrolyte composition, glucose, and microelements, such as magnesium and phosphate.
Women Neurosurgeons Worldwide: Characterizing the Global Female Neurosurgical Workforce
Authors: Vaca Silvia D. , Theologitis Marinos , Zygourakis Corinna C. 
Published: December 2023

BACKGROUND AND OBJECTIVES:
As the global neurosurgical workforce expands, so do the contributions of women neurosurgeons. Recent studies highlighted pioneering women leaders in neurosurgery and provided invaluable perspectives into the proportion of women neurosurgeons in regions across the world. To provide a broad perspective of global trends, this study aims to characterize the global female neurosurgical workforce and evaluate its association with countries' economic status, broader physician workforce, and global gender gap index (GGGI).

METHODS:
A literature search included studies dated 2016–2023 characterizing the neurosurgical workforce. Total neurosurgeons, neurosurgeons per capita, and percent of women neurosurgeons by country were collected or calculated from available data. Countries were stratified by World Health Organization (WHO) region, World Bank economic classification, WHO physician workforce, and GGGI. Poisson regressions and Spearman correlation tests were performed to evaluate the association between each country's percent of women neurosurgeons and their economic classification, WHO physician workforce, and GGGI.

RESULTS:
Neurosurgical workforce data were obtained for 210 nations; world maps were created demonstrating neurosurgeons per capita and proportion of women neurosurgeons. Africa had the fewest neurosurgeons (1296) yet highest percentage of women neurosurgeons (15%). A total of 94 of 210 (45%) countries met the minimum requirement of neurosurgeons needed to address neurotrauma. Compared with low-income countries, upper-middle–income and high-income countries had 27.5 times greater the rate of neurosurgeons per capita but only 1.02 and 2.57 times greater percentage of women neurosurgeons, respectively (P < .001). There was a statistically significant association between GGI and women neurosurgeons (P < .001) and a weak correlation between proportion of women in physician workforce and women neurosurgeons (P = .019, rho = 0.33).

CONCLUSION:
Much progress has been made in expanding the neurosurgical workforce and the proportion of women within it, but disparities remain. As we address the global neurosurgeon deficit, improving recruitment and retention of women neurosurgeons through mentorship, collaboration, and structural support is essential.