bluuebunny/crossref_metadata_2025_split huggingface dataset:
Extracorporeal Membrane Oxygenation for Cardiac Arrest: Does Age Matter?*
Authors: George Naomi , Stephens Krista , Ball Emily , Crandall Cameron , Ouchi Kei , Unruh Mark , Kamdar Neil , Myaskovsky Larissa 
Published: October 2023

OBJECTIVES:
The impact of age on hospital survival for patients treated with extracorporeal cardiopulmonary resuscitation (ECPR) for cardiac arrest (CA) is unknown. We sought to characterize the association between older age and hospital survival after ECPR, using a large international database.

DESIGN:
Retrospective analysis of the Extracorporeal Life Support Organization registry.

PATIENTS:
Patients 18 years old or older who underwent ECPR for CA between December 1, 2016, and October 31, 2020.

MEASUREMENTS AND MAIN RESULTS:
The primary outcome was adjusted odds ratio (aOR) of death after ECPR, analyzed by age group (18–49, 50–64, 65–74, and > 75 yr). A total of 5,120 patients met inclusion criteria. The median age was 57 years (interquartile range, 46–66 yr). There was a significantly lower aOR of survival for those 65–74 (0.68l 95% CI, 0.57–0.81) or those greater than 75 (0.54; 95% CI, 0.41–0.69), compared with 18–49. Patients 50–64 had a significantly higher aOR of survival compared with those 65–74 and greater than 75; however, there was no difference in survival between the two youngest groups (aOR, 0.91; 95% CI, 0.79–1.05). A sensitivity analysis using alternative age categories (18–64, 65–69, 70–74, and ≥ 75) demonstrated decreased odds of survival for age greater than or equal to 65 compared with patients younger than 65 (for age 65–69: odds ratio [OR], 0.71; 95% CI, 0.59–0.86; for age 70–74: OR, 0.84; 95% CI, 0.67–1.04; and for age ≥ 75: OR, 0.64; 95% CI, 0.50–0.81).

CONCLUSIONS:
This investigation represents the largest analysis of the relationship of older age on ECPR outcomes. We found that the odds of hospital survival for patients with CA treated with ECPR diminishes with increasing age, with significantly decreased odds of survival after age 65, despite controlling for illness severity and comorbidities. However, findings from this observational data have significant limitations and further studies are needed to evaluate these findings prospectively.
Diagnosis and Prognosis of Thyroid Cancer by Immune-related Genes
Authors: Li Jinze , Li Zhenjun , Zhao Ping 
Published: October 2023

Background:
Thyroid carcinoma (THCA) is the most common malignant endocrine tumor with low mortality and a relatively good prognosis. Immune genes have attracted much attention as molecular markers of THCA prognosis and potential targets of immunotherapy.

Methods:
Our study analyzed the transcriptome and clinical data of immune-related genes (IRGs) of THCA in gene expression omnibus, the cancer genome atlas-THCA, and ImmPort databases. By univariate Cox regression analysis, 15 genes were significantly correlated with the survival of patients with THCA. Five IRGs (NMU, UBE2C, CDKN2A, COL19A1, and GPM6A) were selected by LASSO regression analysis as independent prognostic factors to construct a disease-free survival-related prognostic risk model.

Results:
Kaplan-Meier survival analysis showed that there was a significant difference in disease-free survival between high and low-risk groups. The higher the risk score, the worse the survival of patients. Clinical correlation analysis showed that age and Stage stage of patients were correlated with risk score (P < 0.05). Quantitative real-time polymerase chain reaction confirmed that there were differences in the expression of 5 IRGs between tumor tissues and normal thyroid tissues. Spearman correlation analysis indicated that the relative expression levels of NMU, CDKN2A, UBE2C, COL19A1, and GPM6A were positively correlated with programmed death-ligand 1 and recombinant a disintegrin and metalloproteinase with thrombospondin 1.

Conclusion:
Based on the bioinformatics method, we constructed a prognosis evaluation model and risk score system of IRGs in THCA, which provided a reference for predicting the prognosis of patients with THCA.
Loss of KDM6B epigenetically confers resistance to lipotoxicity in nonalcoholic fatty liver disease–related HCC
Authors: Hatano Megumi , Akiyama Yoshimitsu , Shimada Shu , Yagi Kohei , Akahoshi Keiichi , Itoh Michiko , Tanabe Minoru , Ogawa Yoshihiro , Tanaka Shinji 
Published: October 2023

Background:
NAFLD caused by abnormalities in hepatic lipid metabolism is associated with an increased risk of developing HCC. The molecular mechanisms underlying the progression of NAFLD-related HCC are not fully understood. We investigated the molecular mechanism and role of KDM6B downregulation in NAFLD-related HCC after the KDM6B gene was identified using microarray analysis as commonly downregulated in mouse NAFLD-related HCC and human nonhepatitis B and nonhepatitis C viral-HCC.

Methods:
The 5-hydroxymethylcytosine levels of KDM6B in HCC cells were determined using glycosylated hydroxymethyl-sensitive PCR. Microarray and chromatin immunoprecipitation analyses using KDM6B-knockout (KO) cells were used to identify KDM6B target genes. Lipotoxicity was assessed using a palmitate-treated cell proliferation assay. Immunohistochemistry was used to evaluate KDM6B expression in human HCC tissues.

Results:
KDM6B expression levels in HCC cells correlated with the 5-hydroxymethylcytosine levels in the KDM6B gene body region. Gene set enrichment analysis revealed that the lipid metabolism pathway was suppressed in KDM6B-KO cells. KDM6B-KO cells acquired resistance to lipotoxicity (p < 0.01) and downregulated the expression of G0S2, an adipose triglyceride lipase/patatin like phospholipase domain containing 2 (ATGL/PNPLA2) inhibitor, through increased histone H3 lysine-27 trimethylation levels. G0S2 knockdown in KDM6B-expressed HCC cells conferred lipotoxicity resistance, whereas ATGL/PNPLA2 inhibition in the KDM6B-KO cells reduced these effects. Immunohistochemistry revealed that KDM6B expression was decreased in human NAFLD-related HCC tissues (p < 0.001), which was significantly associated with decreased G0S2 expression (p = 0.032).

Conclusions:
KDM6B-disrupted HCC acquires resistance to lipotoxicity via ATGL/PNPLA2 activation caused by epigenetic downregulation of G0S2 expression. Reduced KDM6B and G0S2 expression levels are common in NAFLD-related HCC. Targeting the KDM6B-G0S2-ATGL/PNPLA2 pathway may be a useful therapeutic strategy for NAFLD-related HCC.
A Tutorial for Propensity Score Weighting for Moderation Analysis With Categorical Variables
Authors: Griffin Beth Ann , Schuler Megan S. , Cefalu Matt , Ayer Lynsay , Godley Mark , Greifer Noah , Coffman Donna L. , McCaffrey Daniel F. 
Published: October 2023

Objective:
To provide step-by-step guidance and STATA and R code for using propensity score (PS) weighting to estimate moderation effects with categorical variables.

Research design:
Tutorial illustrating the key steps for estimating and testing moderation using observational data. Steps include: (1) examining covariate overlap across treatment groups within levels of the moderator; (2) estimating the PS weights; (3) evaluating whether PS weights improved covariate balance; (4) estimating moderated treatment effects; and (5) assessing the sensitivity of findings to unobserved confounding. Our illustrative case study uses data from 41,832 adults from the 2019 National Survey on Drug Use and Health to examine if gender moderates the association between sexual minority status (eg, lesbian, gay, or bisexual [LGB] identity) and adult smoking prevalence.

Results:
For our case study, there were no noted concerns about covariate overlap, and we were able to successfully estimate the PS weights within each level of the moderator. Moreover, balance criteria indicated that PS weights successfully achieved covariate balance for both moderator groups. PS-weighted results indicated there was significant evidence of moderation for the case study, and sensitivity analyses demonstrated that results were highly robust for one level of the moderator but not the other.

Conclusions:
When conducting moderation analyses, covariate imbalances across levels of the moderator can cause biased estimates. As demonstrated in this tutorial, PS weighting within each level of the moderator can improve the estimated moderation effects by minimizing bias from imbalance within the moderator subgroups.
DTPA clearance test: a sensitive method for detecting radiation-induced lung fibrosis in lung cancer patients
Authors: Keşoğlu Tok Hatice , Yetkin Nur Aleyna , Baran Ketencioglu Burcu , Tutuş Ahmet , Eroğlu Celalettin , Tutar Nuri , Oymak Fatma Sema , Gulmez İnci 
Published: October 2023

Objective
The aim of this study is to analyze the frequency of lung injury and the sensitivity of the diethylenetriamine penta-acetic acid (DTPA) clearance test in detecting lung injury in patients undergoing radiotherapy (RT) to the thorax.

Material and method
Twenty individuals scheduled for RT for lung cancer were included as the patient group. The healthy control group consisted of 20 age and gender-matched individuals who were nonsmokers with no history of comorbidities. We conducted follow-up with patients at 0–1-6 months, performing carbon monoxide diffusion test (DLCO), DTPA clearance test (excluding the first month), and high-resolution computed tomography of the thorax. The control group was followed up with DLCO between the baseline and 6th months.

Results
Ninety percent of the patient group was male, and the median age was 62 years. Seventy percent of the patients had squamous cell carcinoma and adenocarcinoma. Pneumonitis was detected in the patient group in the first month (100%) and fibrosis in the sixth month (%100) Both at the beginning and in the sixth month, the DLCO values of patients who received RT were lower than those of the control group (P = 0.001 and P < 0.001, respectively). While DTPA clearance was similar between irradiated and non-radiated lungs at the beginning, there was a substantial decrease in the irradiated lung in the sixth month(P = 0.001). There was no significant correlation between malignancy type, RT dose, and tumor size(P > 0.05).

Conclusion
The DTPA clearance test could be an alternative method for demonstrating radiation injury in patients receiving RT.
Brain positron emission tomography in idiopathic normal-pressure hydrocephalus: new 18F-fluorodeoxyglucose pattern in a long-known syndrome
Authors: Cistaro Angelina , Quartuccio Natale , Piccardo Arnoldo , Meo Giuseppe , Gandoglia Ilaria , Schiera Irene Giovanna , Fania Piercarlo , Lupidi Francesco , Bottoni Gianluca , Massollo Michela , Altrinetti Vania , Pestarino Emanuela , Iacozzi Massimiliano , Iantorno Massimiliano , Del Sette Massimo 
Published: October 2023

Aim
Patients with idiopathic normal-pressure hydrocephalus (iNPH) can show a global reduction in cerebral glucose metabolism at [18F]Fluorodeoxyglucose (FDG) PET. The presence of caudate hypometabolism has been identified as a potential biomarker in iNPH, yet there is limited evidence of hypermetabolic findings in patients with iNPH so far.

Methods
We retrieved retrospectively patients with iNPH and normal cognitive assessment, evaluated before surgery undergoing brain [18F]FDG-PET. The 18F-FDG-PET brain scans were compared to those of a control group of healthy subjects, matched for age and sex, by statistical parametric mapping (SPM) to identify areas of relative hypo- and hypermetabolism. Furthermore, the existence of a correlation between areas of hypo- and hypermetabolism in the patient group was tested.

Results
Seven iNPH patients (mean age 74 ± 6 years) were found in the hospital database. SPM group analysis revealed clusters of significant hypometabolism (P = 0.001) in the iNPH group in the dorsal striatum, involving caudate and putamen bilaterally. Clusters of significant hypermetabolism (P = 0.001) were revealed in the bilateral superior and precentral frontal gyrus (BA 4, 6). A significant inverse correlation between striatal hypometabolism and bilateral superior and precentral frontal gyrus hypermetabolism was revealed (P < 0.001 corrected for multiple comparisons).

Conclusion
In this cohort, patients with iNPH showed subcortical hypometabolism, including bilateral dorsal striatum. To the best of our knowledge, this is the first report demonstrating a hypermetabolic pattern in the primary motor and premotor areas, and showing an inverse correlation between the striatum and motor cortex in patients with iNPH.
A practical approach to caring for atopic dermatitis in children
Authors: Bayer Diana K. 
Published: October 2023

Purpose of review
Atopic dermatitis is a chronic, systemic disease with primary cutaneous clinical manifestations and is commonly attributed to an exaggerated Th2 inflammatory response. Recent research regarding risk factors, prevention, clinical features, and management of atopic dermatitis will be reviewed.

Recent findings
In the last decade, advances have been made in identifying the factors that either confer increased risk for or protection from atopic dermatitis and associated atopy. Progress has also been made in the clinical management of this disease. Promising biomarkers and therapeutically informative characteristics of this disease have been identified in young children with and without the presence of eczema, but much has yet to be elucidated. Progress has also been made in clarifying the advantages and disadvantages of respective medical managements, including but not limited to topical corticosteroids, topical calcineurin inhibitors, phototherapy, systemic immunosuppressants, and targeted immunotherapy. Given that medical management may show variable efficacy in a child, an optimized skin care regimen is of utmost importance as well.

Summary
Atopic dermatitis is a challenging, chronic systemic disease that incurs significant morbidity in affected children. Although management options have been somewhat disappointing in years past, promising results have been observed in recent advances in targeted immunotherapy.
Probiotic Supplementation for Promotion of Growth in Undernourished Children: A Systematic Review and Meta-Analysis
Authors: Imdad Aamer , Pandit Natasha G. , Ehrlich Julie M. , Catania Joseph , Zaman Muizz , Smith Abigail , Tanner-Smith Emily E. , Zackular Joseph P. , Bhutta Zulfiqar A. 
Published: October 2023

Objectives:
Probiotic supplementation has been proposed as a therapeutic intervention to improve growth outcomes in children with undernutrition. The objective of this review is to synthesize the current evidence on probiotic supplementation for promotion of growth in undernourished children.

Methods:
We searched MEDLINE, Cochrane CENTRAL, CINAHL, Embase, LILACS, and Scopus for randomized controlled trials (RCTs) that administered probiotics or eligible comparators to undernourished children below 5 years of age. Our primary outcomes of interest were weight-for-age, height-for-age, and weight-for-height at the longest follow-up points reported. Random-effects meta-analysis was used to calculate standardized mean differences (SMD) for continuous outcomes and risk ratios for dichotomous outcomes. The Grading of Recommendations Assessment, Development and Evaluation criteria were used to assess certainty of the evidence.

Results:
Nine RCTs with 5295 children in total were included. Durations of treatment ranged from 1 month to 1 year. Pooled analyses from 7 studies showed that probiotics may have little to no effect on weight-for-age (SMD 0.05 standard deviation [SD], 95% CI: −0.04 to 0.13, n = 2115 children; low-certainty evidence) and height-for-age (SMD −0.04 SD, 95% CI: −0.14 to 0.07, n = 1357 children; low-certainty evidence). The evidence was very uncertain about the effect on weight-for-height.

Conclusions:
Probiotics may have little to no effect on anthropometry in undernourished children, though there is considerable heterogeneity among the trials reviewed thus far. The interaction between gut microbiota and human nutrition is complex, and further research is needed to determine how the gut microbiome may contribute to undernutrition and how probiotics may affect growth in this vulnerable population.
Percutaneous Transcatheter Retrieval of Central Venous Port Fragments in Pediatric Patients; A Single-center Experience From the Pediatric Cardiology Department
Authors: Duman Derya , Aykan Hayrettin Hakan , Ertuğrul İlker , Ardiçli Burak , Aypar Ebru , Alehan Dursun , Karagöz Tevfik 
Published: October 2023

Background:
Split/fracture and embolization of central venous/shunt catheters are rare but serious complications in children. Percutaneous retrieval of intravascular foreign bodies is an important minimal invasive treatment. This study is aimed to represent our largest pediatric sample experience till now of 17 years from a single institution. Another aim is to compare the results regarding the removal or leaving in place of embolized or ruptured intravascular or cardiac venous catheter parts in children.

Patients and Methods:
A total of 26 cases were included in this study. Any pediatric patient with normal coagulation parameters and a fractured catheter fragment was included in this study. Other intravascular foreign bodies related to interventional devices and/or pacemaker/implantable cardiac defibrillator leads were excluded from this study.

Results:
Twenty-six patients, of whom 25 had oncologic diseases and 1 had a ventriculoatrial shunt, were included. The median age was 83.5 months (between 20 mo and 18 y) at treatment.
Superior vena cava (9 cases), followed by the right atrium (5 cases), were the most two common sites of embolization for cardiovascular foreign bodies. The success rate of percutaneous retrieval was 92.3% in all patients. There were neither complications nor deaths. The retrieval technique revealed a predisposition for extraction through the femoral vein (96.1%) and using snare techniques (100%). Additional catheters like pigtail, National Institutes of Health, or ablation catheters were used for stabilization in selective cases in which the permanent central venous fragments stuck to the vessels. A tractional maneuver and capturing the ruptured material in the middle were other trick points for successful retrieval. Patients were asymptomatic in 76.9% of cases (20/26).

Conclusion:
Percutaneous retrieval of cardiovascular foreign bodies is a reasonable, safe, and effective way in children when the catheter fragments are free and mobile. It should be considered the preferred treatment option instead of surgery. In patients where catheter fragments are stuck and are adherent to vessels, it could be left, and followed up by anticoagulation. Novel techniques accompanied by an experienced team could be helpful in difficult cases.
Vitamin D Status in Children With High-risk Neuroblastoma
Authors: Izurieta-Pacheco Ana Carolina , Sangrós-Gimenez Ana , Martínez-Garcia Esther , Perez-Jaume Sara , Mora Jaume , Gorostegui-Obanos Maite 
Published: October 2023

Background:
Vitamin D deficiency has become a matter of concern in pediatric cancer patients. A relationship between neuroblastoma and Vitamin D signaling pathways has been revealed with interest in the antiproliferative and antiinvasive properties of vitamin D. Our aim is to describe the prevalence of Vitamin D deficiency among children with high-risk neuroblastoma (HR-NB) and to explore its association with disease status.

Materials and Methods:
In all, 182 patients with HR-NB were managed at our center from 2017 to 2021. Serum 25(OH)D levels were tested at the first blood analysis performed and correlated with clinical data and disease status.

Results:
One hundred forty-eight (81.4%) had low 25(OH)D levels (48.4% categorized as deficiency (25(OH)D below 20 ng/mL) and 33.0% as insufficiency (25(OH)D 20 to 30 ng/mL). Median Vitamin D level was 20.2 ng/mL. Vitamin D levels were not associated with race or sex. Although malnourished patients had lower median 25(OH)D levels(11.1 ng/mL), no statistical association was observed with Vitamin D deficiency. There was no association between Vitamin D levels and disease status. An inverse correlation was found between age and vitamin D levels (P=0.0040).

Conclusion:
A concerning high prevalence of low Vitamin D levels affects more than two-thirds of patients with HR-NB in our cohort, regardless of the disease status at the time of evaluation. Older children are at a higher risk for deficient levels of vitamin D.
Radiolucent foreign body leading to complete small bowel obstruction: a diagnostic dilemma – a case report
Authors: Yadav Krishna K. , Ghimire Ranjeet , Subedi Sudan , Kandel Krishna , Yadav Rupesh K. , Ghimire Bikal , Shah Jayant K. 
Published: October 2023

Introduction and importance:
Foreign body ingestion leading to luminal obstruction in both the small and large bowels is rare, especially in children. The authors present a case of a 7-year-old patient who presented with a small bowel obstruction caused by an ingested radiolucent foreign body. The previous herniotomy surgery 1 year back led to initial diagnostic confusion, highlighting the need for a broad differential diagnosis.

Case presentation:
A 7-year-old child with a history of herniotomy presented with symptoms of small bowel obstruction. Radiological imaging revealed a soft tissue mass mimicking a polyp or cystic lesion. During exploratory laparotomy, a cystic structure was discovered in the terminal ileum. The foreign body, identified as a fluid-filled balloon, was inaccessible to endoscopy and was gently maneuvered into the ascending colon. It was punctured and removed during on-table colonoscopy.

Clinical discussion:
This case underscores the challenges of diagnosing and managing luminal obstruction caused by radiolucent foreign bodies in children. The presence of previous surgery can mislead clinicians, necessitating a broad differential diagnosis. Radiological imaging played a crucial role in identifying the foreign body. Surgical intervention guided by an on-table colonoscopy allowed successful removal.

Conclusion:
Foreign body ingestion leading to luminal obstruction should be considered, even in cases with previous abdominal surgery. Radiological imaging aids in identification, and timely surgical intervention, guided by on-table colonoscopy, facilitates foreign body removal. Awareness of such cases is essential for optimal care in pediatric patients with luminal obstruction caused by foreign body ingestion.
Student Peer Review and Receptiveness to Feedback in Global Classrooms
Authors: Tornwall Joni , Ikonen Riikka 
Published: October 2023

Background:
Development of skills in peer-to-peer feedback in multicultural and global contexts is important to excellent teaching practice in nursing education.

Purpose:
This study identified student attitudes toward giving and receiving peer-to-peer feedback between international peers in a graduate-level online instructional design course.

Methods:
Twenty-one graduate nursing students in 2 nurse educator programs from the United States and Finland participated in this descriptive study. Pre- and postcourse Feedback Orientation Scale (FOS) scores were analyzed in combination with student reflections on learning experiences related to peer-review course activities.

Results:
Mean pre- to postcourse overall FOS scores increased, suggesting greater student receptiveness to peer feedback, particularly in the dimensions of utility and self-efficacy. Postcourse reflections demonstrated increased appreciation for opportunities to triangulate feedback from multiple, diverse sources.

Conclusions:
Opportunities for graduate students in nurse educator programs to exchange peer-to-peer feedback with international peers foster growth in positive attitudes toward receiving and using peer feedback.