bluuebunny/crossref_metadata_2025_split huggingface dataset:
Macular vascular density alteration patterns in Pediatric optic neuritis patients with serum MOG antibody positivity detected by optic coherence tomography angiography
Authors: Peng Chunxia , Zuo Huaxin , Li Siyuan , Liu Xi , Tian Li rong , Zhang Ru , Zhang Yan , Li Li , Wei Shi 
Published: April 2023

Abstract
Purpose
Retinal microvascular net played a crucial role in inflammatory injury of pediatric optic neuritis(PON) with serum MOG antibody positivity (MOG+PON). This study compared retinal microvascular density and structural alterations in MOG+PON eyes with pediatric isolated optic neuritis (PION) eyes, and followed up the final best-corrected visual acuity (BCVA) at least 6 months.
Methods
23 children (42 eyes) with PON including 15 MOG+PON cases (28 eyes), 6 PION cases (10 eyes), NMOSD-PON 2 cases (4 eyes), MOG associated diseases (MOGAD) patients without ON affected eyes (MOG+NPON) 6 cases (10 eyes) and age-gender matched healthy controls (HCs) underwent superficial/deep retinal angiography density (SAD/DAD) and retinal structure quantitively evaluation by optical coherence tomography angiography (OCTA) after fully ophthalmological examinations. And their BCVA was followed up until 6 months after ON onsets.
Results
MOG+PON eyes had better final BCVA, which (35.7±10.3%) suffered severity SAD reduction as well as PION eyes(40.1±10.3%) in contrast to that of MOGAD-NPON （48.7±5.2%）and HCs eyes（55.6±8.2） (P=0.000 and 0.000 respectively). However, DAD in MOG+PON eyes (48.5±9.2%) and MOG+NPON eyes (53.1±3.3%) displayed increasing compared with HCs eyes (45.7±9.6%) (p= 0.028, 0.009 respectively). SAD reduction in PON eyes occurred at acute PON, which can be detected reduction at 2 weeks after PON onsets.
Conclusions
MOG+PON eyes had better final BCVA than PION eyes, which displayed retinal superficial microvascular perfusion reduction and deep microvascular perfusion increases. SAD could be sensitive surrogate to PON attacks in MOGAD children.
Narrative nephrology via clinical scenario-based workshop promotes empathy in medical students
Authors: Yang Fuye , Hu Ying , Lin Wanbing 
Published: April 2023

Abstract
Background: The practice of nephrology demands empathy. The aim of this study was to test the feasibility and effectiveness of providing a narrative training (NT) program for the purpose of promoting empathy.
Methods: The program, including six weekly 1-hour sessions of narrative workshops, was conducted in medical interns in Second Affiliated Hospital of Zhejiang University School of Medicine. During each session, participants encountered a representative clinical scenario. Participants wrote about their attachment and emotional responses to patients, and their attempts to imagine clinical situations from the perspectives of patients and family members. Participants then shared their pieces in a facilitated discussion. This study employed a pre- and post-intervention design and was also supplemented with a separate control of peers who participated in the traditional teaching activities. Participants were surveyed using modified Jefferson Scale of Physician Empathy (JSPE) before and after the interventions.
Results: Eighteen interns who consented and participated in the program completed all baseline and post-intervention measures. The change in JSPE scores from baseline to post-intervention was significantly higher in NT group than control group (p=0.0014, t=3.868). The subsets of Perspective Taking (p=0.00178, t=2.640) and Compassionate Care (p<0.0001, t=5.395) improved at a statistically significant level, and the Standing in patient’s shoes subset trended toward significant improvement (p=0.2895, t=1.093). The participants in workshops considered beneficial for empathy, professionalism and holistic care, and showed enthusiasm in further narrative training.
Conclusions: Clinical scenario-based narrative training was feasible and well-received by students and improved students’ empathy in this short run. Larger studies are required to validate its long-term effects on behavior changes, organizational practice and benefits to patients.
Causal Effect of Parent-Child Relationship on Oppositional Defiant Disorder Symptoms Based on Machine Learning Approach
Authors: Zhou Haiyan , han fengkai , Chen Ruoxi , Huang Jiajin , Chen Jianhui , Lin Xiuyun 
Published: April 2023

Abstract
Oppositional defiant disorder (ODD) is one of the most common disorders in children and is highly susceptible to further internalizing and externalizing problems. Research has addressed the multilevel family factors associated with the development of ODD, whereas it is necessary to further investigate the causal relationship between these factors and ODD for effective intervention. Due to the close association to ODD, we investigated the causal effect of parent-child relationship (PCR) on ODD symptoms using the machine learning based Causal Forest (CF) model with observed factual data in this study. Based on the PCR improvement in two consecutive years, 423 longitudinal children were divided into improved and control groups. The ODD symptoms in the second year was set as the dependent variable. Additionally, several factors based on the multilevel family model and the baseline ODD in the first year were included as covariates. The CF model showed PCR had a significant causal effect on ODD symptoms in the samples, which means the improvement of PCR could effectively alleviate the ODD symptoms. Furthermore, the causality exhibited heterogeneity. The causal effect was greater in those children with higher baseline ODD, worse family atmosphere, lower emotion regulation abilities in themselves or their parents. Conversely, the parenting style played a positive role on the causality which suggested the importance of parenting training in ODD families. This study would be helpful in forming personalized family-oriented intervention strategies for ODDs.
The Untargeted Metabolomics Reveals Differences in Energy Metabolism in Patients with Different Subtypes of Ischemic Stroke
Authors: Li Jiaxin , Li Xi , Yu Fang , Feng Xianjing , Luo Yunfang , Xie Weijia , Pan Yinghuan , Xia Jian 
Published: April 2023

Abstract

Objective Stroke has the characteristics of high morbidity, high mortality, high disability rate, and high recurrence rate, which brings great burden of disease. Ischemic stroke (IS) is the most common subtype of stroke, accounting for 71% of all stroke types. The risk factors and pathogenesis of IS are complex and varied due to different IS subtypes. The development of metabolomics technology provides new ideas for the study of the biomarkers and potential pathophysiological mechanisms of IS.Methods We included IS patients who visited Xiangya Hospital of Central South University from October 2017 to September 2018 and divided them into two groups based on the TOAST classification: large-artery atherosclerosis (LAA) subtype group (n = 87) and small-vessel occlusion (SVO) subtype group (n = 39). Plasma metabolomics analysis was performed using liquid chromatography-high-resolution mass spectrometry (LC-HRMS) to identify metabolic profiles in LAA and SVO subtype IS patients and to determine metabolic differences between patients with the two subtypes of IS.Results We identified 26 differential metabolites and 3 differential metabolic pathways between LAA and SVO subtype IS. A multiple prediction model based on the differential metabolites had good predictive ability for IS subtyping (AUC = 0.822, accuracy = 77.8%), with 12,13-DHOME being the most important differential metabolite in the model. The differential metabolic pathways between the two subtypes IS patients were related to the tricarboxylic acid cycle, alanine, aspartate and glutamate metabolism, and pyruvate metabolism, mainly focused on energy metabolism.Conclusion The energy metabolism level of SVO subtype IS patients is more active than that of LAA subtype IS patients.
Value of 18 F-FDG PET/CT for early diagnosis and treatment monitoring of relapsing polychondritis
Authors: Liu， Xiaofei , Fan Yishuo , Zhou Xiaohong , Wu wenjie , Bao Pengtao 
Published: April 2023

Abstract

Relapsing polychondritis (RP) is a rare autoimmune disease. Few studies have reported the value of18F-fluorodeoxyglucose positron emission-computed tomography (18F-FDG-PET/CT) for diagnosis, guiding biopsy and treatment monitoring of RP.18F-FDG-PET/CT in assessing RP presenting fever of unknown origin (FUO) is not yet reported. To evaluate of18F-fluorodeoxyglucose positron emission-computed tomography (18F-FDG-PET/CT) for early diagnosis, guiding biopsy and treatment monitoring of relapsing polychondritis (RP), especially for the patient of RP presenting FUO. Consistent with 32 cases had been underwent18F-FDG-PET/CT scanning, which showed multiple moderately18F-FDG uptake in the involvement of multiple organs, including the nose, throat, trachea, bronchi, cost cartilage and joint cartilages (SUVmax distribution was 1.93–13.03; mean, 5.02). 50% (16/32) patients were used for PET/CT re-examination after treatment, which revealed that 93.8% (15/16) of patients with RP had decreased obviously for18F-FDG uptake, with 37.6% (6/16) in decreased substantially and 56.2% (9/16) for disappeared, respectively. The time to diagnosis in these cases was 4.2 months, obviously shorter than the average diagnosis time (20months), showing earlier than conventional method. In addition, biopsies were performed in 56.3% (18/32) of all patients; 94.4% (17/18) cases were positive, which showed useful for targeting biopsy sites. 62.5% (20/32) of all patients presenting FUO had been early diagnosed using18F-FDG-PET/CT. Treatment monitoring of RP, especially for the patient presenting FUO. It is of great value for monitoring the activity of inflammatory, and guiding the selection of a biopsy site.
Revisiting Financial Opening and Financial Development: A Regulation Heterogeneity Perspective
Authors: Zhu Chaowei , Zhang Fan , Zhang Yuling 
Published: April 2023

Abstract
The current literature on the effect of financial opening and financial development provides conflicting results. Based on the performances of financial markets in different regulatory settings, we argue that the quality of regulation plays a vital role in determining the effect of financial openings. We apply the dynamic panel threshold model to the data of 114 economies ranging from 2008 to 2019 to estimate the existence of financial regulation threshold and the impact of financial opening on the depth and efficiency of financial development. Results demonstrate that financial opening in less-regulated markets accelerates credit market expansion while does not promote financial efficiency. Although the expansion effect is less remarkable in well-regulated markets, the overall efficiency is increased. This threshold effect indicates the importance of regulatory capacity-building as a precondition for effective financial opening. Our conclusions provide policy implications for emerging markets in accelerating proactive financial opening.
Subject classification codes: G21; F36; C23
Robotic-Assisted Surgery for Gynecological Indications in Children: A Multicenter Experience
Authors: Esposito Ciro , Blanc Thomas , Mento Claudia Di , Lepore Benedetta , Ballouhey Quentin , Fourcade Laurent , Chiodi Annalisa , Esposito Giorgia , Escolino Maria 
Published: April 2023

Abstract
Robotic-assisted surgery (RAS) is increasingly adopted in the pediatric population. This retrospective multicenter study aimed to report application of RAS for pediatric gynecological indications.
The medical records of all children and adolescents with gynecological pathology, operated in 3 different institutions over a 3-year period, were retrospectively collected. Robot docking time, total operative time, length of stay (LOS), requirement time of pain medication, complication rate, conversion rate, and pathology results were analyzed.
Sixteen girls, with median age of 11.7 years (range 0.6-17.9) and median weight of 47.2 kg (range 9-73), received the following RAS procedures: ovarian cystectomy for serous cystoadenoma (n=2), salpingo-oophorectomy for immature teratoma (n=6), bilateral gonadectomy for ovotestis (n=2) and Turner syndrome SRY+ (n=1), salpingectomy for fallopian tube lesion (n=1), Gartner cyst excision (n=1), paravaginal ganglioneuroma resection (n=1), fistula closure in urogenital sinus (n=1) and vaginoplasty using ileal flap in cloaca malformation (n=1). Median operative time was 131.3 minutes (range 65-360), and median docking time was 13.9 min (range 7-20). Conversion to open or laparoscopy was not necessary in any case. Median LOS was 2.3 days (range 1-7), and median analgesic requirement was 1.5 days (range 1-4). One patient needed redo-surgery for recurrent Gartner cyst.
This preliminary experience showed that RAS is safe and feasible for surgical management of pediatric gynecological pathology, although no conclusive data are available to confirm its superiority over traditional laparoscopy. Randomized, prospective, comparative studies are needed to confirm these preliminary results and identify the gold standard approach in such patients.
Case report of 2,4,D poisoning in st. Pauls hospital millennium medical college
Authors: Teshome Tsion , Waganew Woldesenbet , Getnet Bekele , Bahta Benyam 
Published: April 2023

Abstract
Background 2,4-Dichlorphenoxyacetic acid (2,4-D) a chlorphenoxy group pesticide, is a selective herbicide widely used to kill broad-leaved plants in wheat cultivation.
This toxin is extremely lethal, with a fatality rate that approaches 100%. This poison's severe pulmonary, renal, neurological, gastrointestinal, and myotoxic effects result in fast demise and multi-organ failure. Poisoned patients should be given the option of urine alkalization with high-flow urine output and hemodialysis in addition to supportive care
The aim of this report is to explicitly the case's diagnosis, differential, treatment, and related challenges in relation to the available literature.
Case report: we report a case of 20 years old male patient who presented to the ED after he ingested an unspecified amount of 2,4-D herbicide & lost consciousness for about 16 hours’ duration. Associated with this was frequent vomiting of unspecified amounts of ingested matter.
Conclusion: There is a significant lack of knowledge gap among farmers about pesticide use. poisoned patients should be given the option of urine alkalization with high-flow urine output and hemodialysis in addition to supportive care as much as possible.
Bu Sabura Ã© un DisgraÃ§a
Authors: Tavares Norberto 
Published: April 2023

Audio example of traditional coladeira. Features Cape Verdean
American musician Norberto Tavares playing his coladeira â€œBu Sabura
Ã© un DisgraÃ§a.â€ Field recording by the author, Feb. 19, 1990.
Preeclampsia after Kidney Transplantation
Authors: Lu Joe , Hewawasam Erandi , Davies Christopher E. , Clayton Philip A. , McDonald Stephen P. , Jesudason Shilpanjali 
Published: April 2023

Background
Transplanted women have high rates of preeclampsia. However, determinants of preeclampsia and association with graft survival and function remain uncertain. We aimed to determine rates of preeclampsia and its association with kidney transplant survival and function.

Methods
This was a retrospective cohort study analyzing postkidney transplantation pregnancies (≥20 weeks gestation) from the Australia and New Zealand Dialysis and Transplant Registry (2000–2021). Graft survival was assessed in three models accounting for repeated pregnancies and episodes of preeclampsia.

Results
Preeclampsia status was captured in 357 of 390 pregnancies and occurred in 133 pregnancies (37%). The percentage of pregnancies reported to have preeclampsia rose from 27% in 2000–2004 to 48% from 2018 to 2021. Reported prior exposure to calcineurin inhibitors was high overall and higher in women who had preeclampsia (97% versus 88%, P = 0.005). Seventy-two (27%) graft failures were identified after a pregnancy, with a median follow-up of 8.08 years. Although women with preeclampsia had higher median preconception serum creatinine concentration (1.24 [interquartile range, 1.00–1.50] versus 1.13 [0.99–1.36] mg/dl; P = 0.02), in all survival models, preeclampsia was not associated with higher death-censored graft failure. In multivariable analysis of maternal factors (age, body mass index, primary kidney disease and transplant-pregnancy interval, preconception serum creatinine concentration, era of birth event, and tacrolimus or cyclosporin exposure), only era and preconception serum creatinine concentration ≥1.24 mg/dl (odds ratio, 2.48; 95% confidence interval [CI], 1.19 to 5.18) were associated with higher preeclampsia risk. Both preconception eGFR <45 ml/min per 1.73 m2 (adjusted hazard ratio [HR], 5.55; 95% CI, 3.27 to 9.44, P < 0.001) and preconception serum creatinine concentration ≥1.24 mg/dl (adjusted HR, 3.06; 95% CI, 1.77 to 5.27, P < 0.001) were associated with a higher risk of graft failure even after adjusting for maternal characteristics.

Conclusions
In this large and contemporaneous registry cohort, preeclampsia was not associated with worse graft survival or function. Preconception kidney function was the main determinant of graft survival.
Management and Outcome of COVID-19 Infection Using Nirmatrelvir/Ritonavir in Kidney Transplant Patients
Authors: Giguère Pierre , Deschenes Marie-Josée , Van Loon MacKenzie , Hoar Stephanie , Fairhead Todd , Pazhekattu Rinu , Knoll Greg , Karpinski Jolanta , Parikh Namrata , McDougall Jessica , McGuinty Michaeline , Hiremath Swapnil 
Published: April 2023

Background
Nirmatrelvir/ritonavir has been shown to reduce the risk of coronavirus disease 2019 (COVID-19)–related complications in patients at high risk for severe COVID-19. However, clinical experience of nirmatrelvir/ritonavir in the transplant recipient population is scattered due to the complex management of drug–drug interactions with calcineurin inhibitors. We describe the clinical experience with nirmatrelvir/ritonavir at The Ottawa Hospital kidney transplant program.

Methods
Patients who received nirmatrelvir/ritonavir between April and June 2022 were included and followed up to 30 days after completion of treatment. Tacrolimus was withheld for 24 hours and resumed 72 hours after the last dose of nirmatrelvir/ritonavir (on day 8) on the basis of the drug level the day before. The first 30 patients had their dose adjusted according to drug levels performed twice in the first week and as needed thereafter. Subsequently, a simplified algorithm with less frequent calcineurin inhibitor–level monitoring was implemented. Outcomes, including tacrolimus-level changes, serum creatinine and AKI (defined as serum creatinine increase by 30%), and clinical outcomes were described globally and compared between algorithms.

Results
Fifty-one patients received nirmatrelvir/ritonavir. Tacrolimus levels drawn at the first time point, 7 days after withholding of calcineurin inhibitor, and 2 days after discontinuing nirmatrelvir/ritonavir were within the therapeutic target in 17/44 (39%), subtherapeutic in 21/44 (48%), and supratherapeutic in 6/44 (14%). Two weeks after, 55% were within the therapeutic range, 23% were below, and 23% were above it. The standard and simplified algorithms provided similar tacrolimus level (median 5.2 [4.0–6.2] µg/L versus 4.8 [4.3–5.7] µg/L, P = 0.70). There were no acute rejections or other complications.

Conclusions
Withholding tacrolimus starting the day before initiation of nirmatrelvir/ritonavir with resumption 3 days after completion of therapy resulted in a low incidence of supratherapeutic levels but a short period of subtherapeutic levels for many patients. AKI was infrequent. The data are limited by the small sample size and short follow-up.

Podcast
This article contains a podcast at https://dts.podtrac.com/redirect.mp3/www.asn-online.org/media/podcast/CJASN/2023_07_10_CJN0000000000000186.mp3
APROVEITAMENTO DOS RESÍDUOS AGROINDUSTRIAIS DA CASTANHA-DO-BRASIL ATRAVÉS DO TRATAMENTO PIROLÍTICO EM REATOR DE LEITO FIXO
Authors: Silva Antonelli Santos , Pedroza Marcelo Mendes , Martinez Maristela Silva , Oliveira Luciana Rezende Alves de 
Published: April 2023

A castanha-do-brasil (Bertholletia excelsea) é um dos principais produtos da região amazônica devido ao comércio e utilização na alimentação, no seu processamento ocorre retirada da casca gerando um resíduo. O estudo teve como objetivo produzir e caracterizar o resíduo (biomassa) e o carvão ativado produzido a partir da pirólise provenientes de uma usina de beneficiamento de castanha-do-brasil no Acre (estado brasileiro). A conversão térmica foi efetuada em um reator de leito fixo de aço inox. Visando a obtenção da fração sólida, foi realizado um planejamento multivariável no sistema de pirólise com dois fatores: temperatura e taxa de aquecimento. A umidade média da biomassa foi de 14.73 % e da biomassa desidratada triturada foi de 5.06 %. A biomassa apresentou 69.21% de material volátil, 1.50 % de cinzas e 24.21 % de carbono fixo. A análise elementar da biomassa mostrou um teor de 48.68 % de carbono, 5.42 % de hidrogênio e 0.71 % de nitrogênio e no carvão ativado um teor de 80.87 % de carbono, 2,80 % de hidrogênio e 1.07 % de nitrogênio. A menor temperatura testada (409 ºC) na pirólise produziu maior teor de carvão (47 %). Dentre as duas variáveis avaliadas, apenas a temperatura influenciou no rendimento. A biomassa estudada revelou um grande potencial de utilização, ao aproveitar resíduos e obter um carvão com menor gasto energético, demonstrando que pode ser uma oportunidade de agregar valor a cadeia produtiva da castanha-do-brasil e ter um retorno ambiental e social.
Opettajien monilukutaidolle antamat merkitykset
Authors: Hankala Mari , Kauppinen Merja , Kulju Pirjo 
Published: April 2023

Tutkimuksen tavoitteena oli selvittää, miten opettajat ymmärtävät monilukutaidon käsitteen: millaisia merkityksiä he antavat monilukutaidolle ja millaisia orientaatioita heillä on sitä kohtaan. Monilukutaito on opetussuunnitelmassa laaja käsite, jonka haltuunotto ja soveltaminen vaativat kä sitteille annettavien merkitysten jäsentämistä ja niiden soveltamista oppimiseen. Tutkimusaineistona ovat täydennyskoulutukseen osallistuneiden 34 opettajan ennakkotehtävät. Niitä tarkasteltiin merkityksen rakentumisen fenomenologiasta käsin sekä diskurssianalyysin keinoin. Tulokset osoittavat, että opettajilla oli varsin laaja käsitys monilukutaidon multimodaalisesta luonteesta mutta käsitteen monikielinen ja -kulttuurinen sekä kriittinen näkökulma jäivät vähemmälle huomiolle. Opettajien orientaatiot monilukutaitoa kohtaan olivat muun muassa neutraaleja, kriittisiä ja epävarmoja. Opettajien yhteiset neuvottelut monilukutaidon käsitteestä ovat tarpeen, sillä yhteisen merkityspohjan päälle opettaja voi rakentaa omaa pedagogista repertuaariaan monilukutaidon opettamiseen. Tällaisille neuvotteluille on tärkeä tarjota mahdollisuuksia opettajankoulutuksessa ja täydennyskoulutuksessa.

Meanings given to multiliteracy by teachers
The aim of the study was to investigate how teachers understand the concept of multiliteracy: what kind of meanings they assign to multiliteracy, and what kind of orientations they have towards it. Multiliteracy is a broad concept in the curriculum, and wide understanding and appliance is needed to assimilate and apply it to teaching and learning. The research data consists of pre-assignments of 34 teachers who participated in the in-service training. The answers were considered from a phenomenological point of view as well as by means of discourse analysis. The results indicate that teachers had a quite broad understanding of the multimodal nature of multiliteracy, but the multilingual and cultural aspects of the concept were not considered widely enough. Teachers' orientations towards multiliteracy were, for example, neutral, critical, and uncertain. Teachers' joint discussions on the concept of multiliteracy are necessary. This way teachers can build their own pedagogical repertoire for teaching multiliteracy skills. It is important to provide opportunities for such discussions in teacher education and in-service training.
Keywords: teachers’ in-service training, multiliteracy, concept forming, curriculum