bluuebunny/crossref_metadata_2025_split huggingface dataset:
Use of Rapid Antigen Triple Test Nasal Swabs (COVID-VIRO ALL-IN TRIPLEX: Severe Acute Respiratory Syndrome Coronavirus 2, Respiratory Syncytial Virus, and Influenza) in Children With Respiratory Symptoms: A Real-life Prospective Study
Authors: Cohen Robert , Haas Hervé , Romain Olivier , Béchet Stéphane , Romain Catherine , de Lays Camille de Truchis , Wollner Alain , Guiheneuf Cécile , de Pontual Loic , Levy Corinne 
Published: December 2023

Abstract

Background
In autumn 2022, the epidemics due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), respiratory syncytial virus (RSV), and influenza overlapped, and these diseases can present with the same symptomatology. The use of a triple antigen test (SARS-CoV-2 + influenza A/B + RSV) seems crucial for accurate viral diagnosis in the context of implementing long-acting monoclonal antibody vaccination against RSV in the upcoming RSV season.

Methods
We assessed the usefulness of the triple test in real life in this prospective study performed from October 2022 to May 2023 and involving 116 pediatricians (2 emergency department pediatricians and 114 ambulatory pediatricians). Children &lt;15 years old with flu-like illness (with fever), bronchiolitis (dyspnea ± wheezing), otitis, and croup were enrolled and sampled with a nasal triple test.

Results
For 8329 children with flu-like illness (65.3%), bronchiolitis (17.9%), otitis (8.8%), and croup (6.3%), the use of the triple test led to a viral diagnosis in 47.9% of cases. The highest RSV positivity occurred in children with bronchiolitis (32.9%). The highest influenza A and B positivity (24.6% and 19.6%) occurred in children with flu-like illness. A succession of 3 epidemics (RSV and influenza A and B) occurred over time with several overlap periods.

Conclusions
The triple test allowed for a viral diagnosis in half of our cases. The upcoming introduction of RSV prevention will emphasize the need for active surveillance with viral results both in ambulatory settings and hospitals.
Clinical Trials Registration. NCT0441231.
Hospitalization, disease severity and mortality rates of patients with inflammatory rheumatic diseases as compared with the normal population in the second wave of SARS-CoV-2 infections
Authors: Dallagiacoma Gloria , Weichenberger Christian X , Raffeiner Bernd , Callegher Sara Zandonella , Matzneller Peter , Hantikainen Essi , Domingues Francisco S , Karadar Lena , Kuppelwieser Iris , Masl Aaron , Mian Michael , Maier Armin , Dejaco Christian 
Published: December 2023

Abstract

Objective
The objective of this study was to investigate the clinical manifestations and outcome of COVID-19 in patients with inflammatory rheumatic and musculoskeletal disease (iRMD) as compared with the general population.

Methods
This is a case–control study of patients selected from the South Tyrol public health service, Italy, with and without iRMD, affected by COVID-19. We included patients ≥18 years and with a positive SARS-CoV-2 PCR test between 1 October 2020 and 1 March 2021. Cases were identified by linking the diagnosis of a rheumatic disease with PCR test positivity; these were then matched in a 1:1.8 (planned 1:2) ratio for age, sex, and date of COVID-19 diagnosis with people from the general population. The outcomes of primary interest were hospitalization, and severe course (intensive care unit, mechanical ventilation/extracorporeal membrane oxygenation, death).

Results
The study population consisted of 561 COVID-19 patients, of which 201 (mean age 60.4 years; 65.2% female) were patients with iRMD and 360 were controls from the general population (59.8 years; 64.7% female). The majority of iRMD patients (88.6%) were receiving an immunosuppressive drug at the time of COVID-19 diagnosis, and 36.3% were receiving glucocorticoids. COVID-19 related hospitalization (12.4% vs 10.6%, P = 0.49), severe course (5.0% vs 5.3%, P = 1.00), and mortality (3.5% vs 4.4%, P = 0.66) were similar between the groups. Among the hospitalized patients, mechanical ventilation was more common in iRMD patients than in controls [n = 5 (20.0%) vs n = 1 (2.6%), P = 0.035].

Conclusion
Our study indicated similar rates for admission, severe course, and mortality between patients with iRMD and controls affected by COVID-19. Among the hospitalized patients, mechanical ventilation was more frequently required in the iRMD group.
The emerging role of growth differentiation factor 15 as a potential disease biomarker in juvenile dermatomyositis
Authors: Duvvuri Bhargavi , Gonzalez-Chapa Jorge A , Pachman Lauren M , Morgan Gabrielle A , Naik Nidhi , Shenoi Susan , Lood Christian 
Published: December 2023

Abstract

Objective
We aimed to investigate the potential of growth differentiation factor 15 (GDF-15) as a novel biomarker for disease activity in JDM.

Methods
We recruited children with juvenile myositis including JDM (n = 77), PM (n = 6) and healthy controls (n = 22). GDF-15 levels in plasma were measured using ELISA. Statistical analyses were performed using non-parametric tests.

Results
Levels of GDF-15 were significantly elevated in JDM compared with healthy controls (P &lt; 0.001). GDF-15 levels exhibited strong positive correlations with DASs, including the DAS total score, DAS skin score, DAS muscle score and Childhood Myositis Assessment Scale. Additionally, GDF-15 levels could differentiate between active disease and remission based on the Physician Global Assessment of muscle score. Positive correlations were observed between levels of GDF-15 and creatine kinase, neopterin and nailfold end row loops, indicating the potential involvement of GDF-15 in muscle damage, immune activation and vascular pathology. Receiver operating characteristics curve analysis showed GDF-15 to be more effective in assessing disease activity in JDM than creatine kinase [area under the curve (AUC) 0.77, P = 0.001 and AUC 0.6369, P = 0.0738, respectively].

Conclusion
GDF-15 may serve as a valuable biomarker for assessing disease activity in JDM. It exhibits better sensitivity and specificity than creatine kinase and the levels correlate with various DASs and functional measures. GDF-15 may provide valuable information for treatment decision making and monitoring disease progression in JDM.
Epidemiological survey, molecular profiling and phylogenetic analysis of cutaneous leishmaniasis in Khyber Pakhtunkhwa, Pakistan
Authors: Ullah Wasia , Khan Adil , Niaz Sadaf , Al-Garadi Maged A , Nasreen Nasreen , Swelum Ayman A , Ben Said Mourad 
Published: December 2023

AbstractBackgroundCutaneous leishmaniasis (CL), an emerging vector-borne ailment in Khyber Pakhtunkhwa (KPK), Pakistan, exhibits diverse spread patterns and outbreaks.MethodsTo comprehend its epidemiology and identify parasite species, we conducted an active survey on suspected CL cases (n=8845) in KPK.ResultsMicroscopy and internal transcribed spacer-1 PCR–restriction fragment length polymorphism (RFLP) molecular techniques detected Leishmania spp. in blood samples. Phylogenetic analysis gauged genetic affinities with other areas. District Bannu displayed the highest CL impact (14.58%), while Swat had the lowest impact (4.33%) among cases. Annual blood examination rate, parasite incidence and slide positivity rate were 4.96 per 1000 people, 0.0233 and 0.047%, respectively. CL infections were prevalent in 1- to 20-y-olds, with males (57.17%) more vulnerable than females (42.82%). Single lesions occurred in 43.73% of patients, while 31.2% people had two lesions, 17.31% had three lesions and 7.74% had more than three lesions. Most had sand-fly exposure but lacked preventive measures like repellents and bed nets. Leishmania tropica was confirmed via RFLP analysis in amplified samples. Phylogenetic analysis unveiled genetic parallels between L. tropica of KPK and isolates from China, Iran, Afghanistan, India, Syria and Morocco.ConclusionsUrgent comprehensive control measures are imperative. Early detection, targeted interventions and raising awareness of CL and sand-fly vectors are vital for reducing the disease's impact. International collaboration and monitoring are crucial to tackle Leishmania spp.’s genetic diversity and curtail its cross-border spread.
CE: Reducing Bias Against People with Substance Use Disorders
Authors: Ginther Jane , McNally Gretchen 
Published: December 2023

ABSTRACT
Addiction is a highly misunderstood and stigmatized chronic illness frequently encountered by health care providers during routine medical care. People with substance use disorders, in particular, face extraordinary stigma and bias when interacting with health care providers, including nurses. Stigma associated with addiction contributes to health inequities and is recognized as a significant barrier to people seeking and receiving necessary health care. Since patients often spend the most time with nurses in the clinical setting, nurses are ideally positioned to address addiction stigma. However, many nurses lack knowledge about addiction, stigma, and the impact of the words they use, whether in conversation or in clinical documentation. This article reviews the consequences of addiction stigma (labeling, stereotyping, or discrimination) and the steps nurses can take to reduce biases related to substance use. A case scenario based on our experience will be used to guide a discussion of opportunities for nurses to intervene and improve care.
Oxygenation During Venoarterial Extracorporeal Membrane Oxygenation: Physiology, Current Evidence, and a Pragmatic Approach to Oxygen Titration
Authors: Premraj Lavienraj , Brown Alastair , Fraser John F. , Pellegrino Vincent , Pilcher David , Burrell Aidan 
Published: December 2023

OBJECTIVES:
This review aims to: 1) identify the key circuit and patient factors affecting systemic oxygenation, 2) summarize the literature reporting the association between hyperoxia and patient outcomes, and 3) provide a pragmatic approach to oxygen titration, in patients undergoing peripheral venoarterial extracorporeal membrane oxygenation (ECMO).

DATA SOURCES:
Searches were performed using PubMed, SCOPUS, Medline, and Google Scholar.

STUDY SELECTION:
All observational and interventional studies investigating the association between hyperoxia, and clinical outcomes were included, as well as guidelines from the Extracorporeal Life Support Organization.

DATA EXTRACTION:
Data from relevant literature was extracted, summarized, and integrated into a concise narrative review. For ease of reference a summary of relevant studies was also produced.

DATA SYNTHESIS:
The extracorporeal circuit and the native cardiorespiratory circuit both contribute to systemic oxygenation during venoarterial ECMO. The ECMO circuit’s contribution to systemic oxygenation is, in practice, largely determined by the ECMO blood flow, whereas the native component of systemic oxygenation derives from native cardiac output and residual respiratory function. Interactions between ECMO outflow and native cardiac output (as in differential hypoxia), the presence of respiratory support, and physiologic parameters affecting blood oxygen carriage also modulate overall oxygen exposure during venoarterial ECMO. Physiologically those requiring venoarterial ECMO are prone to hyperoxia. Hyperoxia has a variety of definitions, most commonly Pao
2 greater than 150 mm Hg. Severe hypoxia (Pao
2 > 300 mm Hg) is common, seen in 20%. Early severe hyperoxia, as well as cumulative hyperoxia exposure was associated with in-hospital mortality, even after adjustment for disease severity in both venoarterial ECMO and extracorporeal cardiopulmonary resuscitation. A pragmatic approach to oxygenation during peripheral venoarterial ECMO involves targeting a right radial oxygen saturation target of 94–98%, and in selected patients, titration of the fraction of oxygen in the mixture via the air-oxygen blender to target postoxygenator Pao
2 of 150–300 mm Hg.

CONCLUSIONS:
Hyperoxia results from a range of ECMO circuit and patient-related factors. It is common during peripheral venoarterial ECMO, and its presence is associated with poor outcome. A pragmatic approach that avoids hyperoxia, while also preventing hypoxia has been described for patients receiving peripheral venoarterial ECMO.
Incidence, clinical characteristics, and risk factors associated with recurrent alcohol-associated hepatitis
Authors: Patidar Kavish R. , Guarnizo Ortiz Maria , Slaven James E. , Nephew Lauren D. , Vilar Gomez Eduardo , Kettler Carla D. , Ghabril Marwan S. , Desai Archita P. , Orman Eric S. , Chalasani Naga , Gawrieh Samer 
Published: December 2023

Background:
Alcohol relapse occurs frequently in alcohol-associated hepatitis (AH) survivors, but data on the frequency and course of recurrent alcohol-associated hepatitis (rAH) are sparse. We investigated the incidence, risk factors, and outcomes of rAH.

Methods:
Hospitalized patients with AH from 2010 to 2020 at a large health care system were followed until death/liver transplant, last follow-up, or end of study (December 31, 2021). AH was defined by NIAAA Alcoholic Hepatitis Consortium criteria; rAH was defined a priori as a discrete AH episode >6 months from index AH hospitalization with interim >50% improvement or normalization of total bilirubin. Multivariable competing risk analysis was performed to identify factors associated with rAH. Landmark Kaplan-Meier analysis was performed to compare survival between patients who did versus those who did not develop rAH.

Results:
Of 1504 hospitalized patients with AH, 1317 (87.6%) survived and were analyzed. During a 3055 person‐year follow‐up, 116 (8.8%) developed rAH at an annual incidence rate of 3.8% (95% CI: 2.8–4.8). On multivariable competing risk analysis, marital status [sub-HR 0.54 (95% CI: 0.34, 0.92), p=0.01] and medications for alcohol use disorder [sub-HR 0.56 (95% CI: 0.34, 0.91), p=0.02] were associated with a lower risk for rAH. On landmark Kaplan-Meier analysis, the cumulative proportion surviving at 1 year (75% vs. 90%) and 3 years (50% vs. 78%) was significantly lower in patients who developed rAH compared to those who did not develop rAH (log-rank p<0.001).

Conclusions:
rAH develops in ~1 in 10 AH survivors and is associated with lower long-term survival. Medications for alcohol use disorder lower the risk for rAH and, therefore, could be a key preventative strategy to improve outcomes.
Racial and Ethnic Disparities in Home Health Referral Among Adult Medicare Patients
Authors: Yakusheva Olga , Lee Kathryn A. , Keller Abiola , Weiss Marianne E. 
Published: December 2023

Background:
Home health care (HHC) services following hospital discharge provide essential continuity of care to mitigate risks of posthospitalization adverse outcomes and readmissions, yet patients from racial and ethnic minority groups are less likely to receive HHC visits.

Objective:
To examine how the association of nurse assessments of patients’ readiness for discharge with referral to HHC services at the time of hospital discharge differs by race and ethnic minority group.

Research Design:
Secondary data analysis from a multisite study of the implementation of discharge readiness assessments in 31 US hospitals (READI Randomized Clinical Trial: 09/15/2014–03/31/2017), using linear and logistic models adjusted for patient demographic/clinical characteristics and hospital fixed effects.

Subjects:
All Medicare patients in the study’s intervention arm (n=14,684).

Measures:
Patient’s race/ethnicity and discharge disposition code for referral to HHC (vs. home) from electronic health records. Patient’s Readiness for Hospital Discharge Scale (RHDS) score (0–10 scale) assessed by the discharging nurse on the day of discharge.

Results:
Adjusted RHDS scores were similar for non-Hispanic White (8.21; 95% CI: 8.18–8.24), non-Hispanic Black (8.20; 95% CI: 8.12–8.28), Hispanic (7.92; 95% CI: 7.81–8.02), and other race/ethnicity patients (8.09; 95% CI: 8.01–8.17). Non-Hispanic Black patients with low RHDS scores (6 or less) were less likely than non-Hispanic White patients to be discharged with an HHC referral (Black: 26.8%, 95% CI: 23.3–30.3; White: 32.6%, 95% CI: 31.1–34.1).

Conclusions:
Despite similar RHDS scores, Black patients were less likely to be discharged with HHC. A better understanding of root causes is needed to address systemic structural injustice in health care settings.
Sedation Research in Critically Ill Pediatric Patients: Proposals for Future Study Design From the Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research IV Workshop
Authors: Jackson Shawn S. , Lee Jennifer J. , Jackson William M. , Price Jerri C. , Beers Sue R. , Berkenbosch John W. , Biagas Katherine V. , Dworkin Robert H. , Houck Constance S. , Li Guohua , Smith Heidi A. B. , Ward Denham S. , Zimmerman Kanecia O. , Curley Martha A. Q. , Horvat Christopher M. , Huang David T. , Pinto Neethi P. , Salorio Cynthia F. , Slater Rebeccah , Slomine Beth S. , West Leanne L. , Wypij David , Yeates Keith O. , Sun Lena S. 
Published: December 2023

OBJECTIVES:Sedation and analgesia for infants and children requiring mechanical ventilation in the PICU is uniquely challenging due to the wide spectrum of ages, developmental stages, and pathophysiological processes encountered. Studies evaluating the safety and efficacy of sedative and analgesic management in pediatric patients have used heterogeneous methodologies. The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research (SCEPTER) IV hosted a series of multidisciplinary meetings to establish consensus statements for future clinical study design and implementation as a guide for investigators studying PICU sedation and analgesia.DESIGN:Twenty-five key elements framed as consensus statements were developed in five domains: study design, enrollment, protocol, outcomes and measurement instruments, and future directions.SETTING:A virtual meeting was held on March 2–3, 2022, followed by an in-person meeting in Washington, DC, on June 15–16, 2022. Subsequent iterative online meetings were held to achieve consensus.SUBJECTS:Fifty-one multidisciplinary, international participants from academia, industry, the U.S. Food and Drug Administration, and family members of PICU patients attended the virtual and in-person meetings. Participants were invited based on their background and experience.INTERVENTIONS:None.MEASUREMENTS AND MAIN RESULTS:Common themes throughout the SCEPTER IV consensus statements included using coordinated multidisciplinary and interprofessional teams to ensure culturally appropriate study design and diverse patient enrollment, obtaining input from PICU survivors and their families, engaging community members, and using developmentally appropriate and validated instruments for assessments of sedation, pain, iatrogenic withdrawal, and ICU delirium.CONCLUSIONS:These SCEPTER IV consensus statements are comprehensive and may assist investigators in the design, enrollment, implementation, and dissemination of studies involving sedation and analgesia of PICU patients requiring mechanical ventilation. Implementation may strengthen the rigor and reproducibility of research studies on PICU sedation and analgesia and facilitate the synthesis of evidence across studies to improve the safety and quality of care for PICU patients.
Is a Preservation Solution for Living Donor Liver Transplantation Needed? Adding a New Chapter in LDLT!
Authors: Dogar Abdul Wahab , Ullah Kaleem , Shams-ud-din  , Abbas Syed Hasnain , Hussain Azhar , Ghaffar Abdul , Bilal Hafiz , Siraj-ud-din  , Shoaib Azam , Ahmed Bilal , Raza Hamid , Hamza Ameer , Hafeez Bhatti Abu Bakar , Gupta Subash , Black Sylvester M. , Mumtaz Khalid 
Published: December 2023

Background.
Preservation solutions are required for organ viability in deceased donor liver transplantation (LT). However, their role in live donor LT (LDLT) has not been standardized.

Methods.
Eighty adult recipients who underwent right lobe LDLT at the Department of Liver Transplantation Surgery, Gambat, Pakistan, were studied. Based on shorter cold ischemia time and no back table reconstruction work, recipients were assigned to receive “no preservation solution” (cases/non–histidine-tryptophan-ketoglutarate group; n = 40) or “HTK group” (controls; n = 40). Early allograft dysfunction (bilirubin, transaminases, and international normalized ratio), postoperative complications (biliary and vascular), hospital stay, and 1-y survival were reported. The direct cost was also reported.

Results.
Demographics and clinical characteristics were comparable in the 2 groups. Comparing cases versus controls, mean bilirubin, alanine aminotransferase, aspartate aminotransferase, and international normalized ratio on postoperative day 7 were similar in the 2 groups. Five (12.5%) cases and 4 (10%) controls developed early allograft dysfunction (P = 0.72). Post-LT complications (biliary leak 2.5% in cases versus 0 in control), strictures (15% in cases versus 17.5% in controls), hepatic artery thrombosis (2.5% versus 00%)‚ and portal vein thrombosis (0 versus 2.5%) were comparable. Mean hospital stay (10.80 + 2.36 and 11.78 + 2.91 d) and 30 d mortality (2.5% versus 5%) were also comparable. Finally, 1-y survival based on Kaplan-Meier analysis was comparable in both groups (ie, 92.5%; non-HTK group versus 90%; HTK group) (P = 0.71). The direct cost of using a non-HTK–based approach was less than the HTK solution.

Conclusion.
In a selected cohort of right lobe LDLT recipients, preservation solutions can be avoided safely with comparable outcomes.